Ruan Xiangyan, Mueck Alfred O
Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany.
Breast Care (Basel). 2023 Jun;18(3):172-178. doi: 10.1159/000527969. Epub 2022 Nov 8.
For the development of PGRMC1, a multifunctional receptor belonging to membrane-associated progesterone receptor proteins (MAPR) family, as possible predictive marker for increased hormone-dependent breast cancer (BC) risk, a systematic research program has been performed, starting with different BC cells, continued with animal studies and finally with clinical studies with BC patients.
In vitro studies showed dose- and time-dependent BC cell proliferations with all available synthetic progestogens (not with progesterone), but mostly significant only in the presence of PGRMC1. Different animal (xenograft) studies confirmed that synthetic progestogens, but not progesterone and dydrogesterone, increased the estradiol-induced tumor proliferation, although with dydrogesterone, a small time-dependent increase could be seen. Clinical studies with hormone replacement therapy (HRT) to confirm these results are still running. In patients with BC expression of PGRMC1 in BC tissue was correlated to tumor characteristics like diameter, grade, and metastatic status. BC patients with PGRMC1 in the tumors had poorer disease-free and overall survival. After developing of an assay, blood levels could be correlated to the expression in BC tissue showing PGRMC1 superior to tumor markers such as CEA, CA125, CA153, and TPS.
This review is summarizing two different functions of PGRMC1: (1) to predict the prognosis of BC patients, already well demonstrated in BC patients and (2) being a possible predictive marker for BC risk during HRT as suggested from in vitro and animal research.
为了研究孕激素受体膜相关蛋白(MAPR)家族中的多功能受体PGRMC1作为激素依赖性乳腺癌(BC)风险增加的潜在预测标志物,开展了一项系统研究计划,该计划从不同的BC细胞开始,接着进行动物研究,最后对BC患者进行临床研究。
体外研究表明,所有可用的合成孕激素(而非孕酮)都能使BC细胞增殖呈现剂量和时间依赖性,但大多仅在存在PGRMC1时才具有显著意义。不同的动物(异种移植)研究证实,合成孕激素而非孕酮和氢孕酮会增加雌二醇诱导的肿瘤增殖,不过对于氢孕酮,可观察到较小的时间依赖性增加。用于证实这些结果的激素替代疗法(HRT)临床研究仍在进行中。在BC患者中,BC组织中PGRMC1的表达与肿瘤特征如直径、分级和转移状态相关。肿瘤中存在PGRMC1的BC患者无病生存期和总生存期较差。在开发出一种检测方法后,血液水平与BC组织中的表达相关,表明PGRMC1优于癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)和组织多肽特异性抗原(TPS)等肿瘤标志物。
本综述总结了PGRMC1的两种不同功能:(1)预测BC患者的预后,这在BC患者中已得到充分证实;(2)如体外和动物研究所示,作为HRT期间BC风险的潜在预测标志物。