Nucleostemin expression in breast cancer is a marker of more aggressive phenotype and unfavorable patients' outcome: A STROBE-compliant article

Medicine (Baltimore). 2019 Mar;98(9):e14744. doi: 10.1097/MD.0000000000014744.

Abstract

Cancer stem cells (CSCs) are postulated to play significant role in the pathogenesis, progression as well as drug resistance of breast cancer. Nucleostemin (NS) is thought to be a key molecule for stemness, and the clinical impact of NS immunoreactivity in breast cancer can indicate its actual role and future therapeutic potentials.The current study is an observational study with an attempt to evaluate the correlation between NS expression (protein and gene expression levels) and different clinicopathological attributes of invasive breast cancer. For that reason, we investigated NS immunohistochemistry expression on commercial tissue microarray (TMA) of 102 patients and 51 archival specimens from patients admitted to Saqr Hospital, Ras Al Khaimah and diagnosed in Al Baraha Hospital, Dubai, UAE. In addition, the association between NS (GNL3) gene expression and different prognostic parameters as well as patient outcome was also evaluated using 2 large publicly available databases.Interestingly, we found NS expression to be associated with less differentiated and more advance stage. In addition, NS expression was significantly higher in larger size (P = .001) and LN-positive tumors (P = .007). Notably, NS expression was significantly correlated to P53 positive (P = .037) status. Furthermore, NS was found to be more expressed in the highly aggressive breast cancer subtypes including human epidermal growth factor receptor 2 (HER-2) and triple negative breast cancer (TNBC) subtypes. Moreover, our results also showed that high GNL3 gene expression to be associated with poor patient outcome and higher chances of tumor recurrence.Our results highlight NS expression as a marker of aggressive phenotype and poor outcome and indicate its possible use as a potential target for CSC-associated breast cancer management.

Publication types

  • Observational Study

MeSH terms

  • Biomarkers, Tumor
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / pathology*
  • Female
  • GTP-Binding Proteins / genetics*
  • Genes, erbB-2 / physiology
  • Humans
  • Immunohistochemistry
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Neoplastic Stem Cells / pathology*
  • Nuclear Proteins / genetics*
  • Phenotype
  • Triple Negative Breast Neoplasms / pathology
  • Tumor Burden
  • Tumor Suppressor Protein p53 / biosynthesis

Substances

  • Biomarkers, Tumor
  • GNL3 protein, human
  • Nuclear Proteins
  • Tumor Suppressor Protein p53
  • GTP-Binding Proteins