Jiang Xiaowei, Guo Dan, Li Wenfang, Yu Tianwu, Zhou Jian, Gong Jianping
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China.
Department of Breast Gland Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China.
Mol Med Rep. 2017 Mar;15(3):1123-1134. doi: 10.3892/mmr.2017.6138. Epub 2017 Jan 23.
Twist1 overexpression is involved in epithelial‑mesenchymal transition resulting in migration and metastasis of breast cancer. Carcinoma antigen 15‑3 (CA15‑3) is widely used to monitor the prognosis for patients after treatment. However, the significance of Twist1 in axillary lymph nodes (ALN) and CA15‑3 for co‑examination for survival rates remains to be elucidated. The present study aimed to explore the role of the combination of Twist1 expression in metastasized ALN and the serum level of CA15‑3 in evaluating the prognosis of patients with breast cancer. cluster of differentiation (CD)44, CD24, aldehyde dehydrogenase (ALDH)1 and Twist1 expression in normal and metastasized ALN from 102 patients with breast cancer were detected using laser confocal microscopy and the expression of the genes evaluated by reverse transcription‑quantitative polymerase chain reaction; E‑cadherin, N‑cadherin and vimentin expression was also tested by western blotting. The serum concentrations of CA15‑3 prior to and following surgery were analyzed by chemiluminescence immunoassay. The expression of CD44, ALDH1 and Twist1 mRNA in the primary breast cancer tissues and involved ALN was upregulated compared with the normal ALN (P<0.05). The proteins N‑cadherin and vimentin of the involved ALN were poorly expressed compared with breast cancer tissues, however E‑cadherin protein expression was higher in metastasized and normal ALN compared with primary cancer tissues (P<0.05). Of the 102 patients, the serum CA15‑3 levels of the patients in stages I and II were significantly lower compared with stages III and IV (P<0.05). Twist1+/CA15‑3+, HER2-negative/Twist1+/CA15‑3+ and Triple‑receptor negative/Twist1+/CA15‑3+ groups displayed a shorter progression‑free survival compared with others. The results of the present study demonstrated that CD44, ALDH1 and Twist1 were significantly overexpressed in involved ALN. The serum levels of CA15‑3 in those patients were clearly increased and the survival rates decreased, which suggested that a combination of Twist1 in ALN and CA15‑3 may function as an indicator for the prognosis of patients with breast cancer.
Twist1过表达参与上皮-间质转化，导致乳腺癌的迁移和转移。癌抗原15-3（CA15-3）广泛用于监测患者治疗后的预后。然而，Twist1在腋窝淋巴结（ALN）中的意义以及CA15-3用于生存率联合检测的意义仍有待阐明。本研究旨在探讨转移的ALN中Twist1表达与血清CA15-3水平联合在评估乳腺癌患者预后中的作用。使用激光共聚焦显微镜检测102例乳腺癌患者正常和转移ALN中的分化簇（CD）44、CD24、醛脱氢酶（ALDH）1和Twist1表达，并通过逆转录-定量聚合酶链反应评估基因表达；通过蛋白质印迹法检测E-钙黏蛋白、N-钙黏蛋白和波形蛋白的表达。采用化学发光免疫分析法分析手术前后血清CA15-3浓度。与正常ALN相比，原发性乳腺癌组织和受累ALN中CD44、ALDH1和Twist1 mRNA的表达上调（P<0.05）。与乳腺癌组织相比，受累ALN中的N-钙黏蛋白和波形蛋白表达较低，然而与原发性癌组织相比，转移和正常ALN中的E-钙黏蛋白表达较高（P<0.05）。在102例患者中，I期和II期患者的血清CA15-3水平明显低于III期和IV期（P<0.05）。与其他组相比，Twist1+/CA15-3+、HER2阴性/Twist+/CA15-3+和三受体阴性/Twist1+/CA15-3+组的无进展生存期较短。本研究结果表明，CD44、ALDH1和Twist1在受累ALN中显著过表达。这些患者的血清CA15-3水平明显升高，生存率降低，这表明ALN中的Twist1和CA15-3联合可能作为乳腺癌患者预后的指标。
