Prognostic Worth of Nrf2/BACH1/HO-1 Protein Expression in the Development of Breast Cancer

Med Princ Pract. 2023;32(6):369-378. doi: 10.1159/000534534. Epub 2023 Oct 12.

Abstract

Objectives: Nrf2/BACH1/HO-1 proteins have been implicated in the development and progression of tumors. However, their clinical relevance in breast cancer remains unclear and understudied. This study evaluated Nrf2/BACH1/HO-1 protein expression and its relationship with age, tumor grade, tumor stage, TNM, ER, PR, HER2, and histologic type.

Methods: 114 female breast cancer and 30 noncancerous tissues were evaluated for Nrf2/BACH1/HO-1 protein expression using immunohistochemistry and Western blot. The relationships between the expression and clinicopathologic factors were assessed using the χ2 test.

Results: 74% of the cancerous samples had high Nrf2 protein expression, and 26% of them had low Nrf2 protein expression. Regarding the non-cancer samples, 43% had high Nrf2 protein expression and 57% had low Nrf2 protein expression (p < 0.002). 39% of the cancerous samples had high BACH1 protein expression, and 61% had low BACH1 protein expression. For the non-cancer samples, 80% had high BACH1 protein expression and 20% had low BACH1 protein expression (p < 0.031). 67% of the cancerous samples had high HO-1 protein expression, and 33% had low HO-1 protein expression. However, for the non-cancer samples, 17% of them had high HO-1 protein expression and 83% had low HO-1 protein expression (p < 0.001). The expression of Nrf2 and HO-1 significantly correlated with tumor grade, while BACH1 was significantly associated with tumor stage (p < 0.05).

Conclusion: Nrf2, BACH1, and HO-1 could be explored as a biomarker for cancer stage, progression, and prognosis.

Keywords: BACH1; Breast cancer; HO-1; Nrf2; Tumor grade; Tumor stage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Basic-Leucine Zipper Transcription Factors* / genetics
  • Basic-Leucine Zipper Transcription Factors* / metabolism
  • Biomarkers, Tumor* / analysis
  • Biomarkers, Tumor* / genetics
  • Biomarkers, Tumor* / metabolism
  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / pathology
  • Female
  • Gene Expression Regulation, Neoplastic
  • Heme Oxygenase-1* / genetics
  • Heme Oxygenase-1* / metabolism
  • Humans
  • Middle Aged
  • NF-E2-Related Factor 2* / genetics
  • NF-E2-Related Factor 2* / metabolism
  • Predictive Value of Tests

Substances

  • NFE2L2 protein, human
  • BACH1 protein, human
  • HMOX1 protein, human
  • NF-E2-Related Factor 2
  • Basic-Leucine Zipper Transcription Factors
  • Heme Oxygenase-1
  • Biomarkers, Tumor

Grants and funding

This research received funding from Natural Scientific Foundation of HeiLongJiang Province (H2016089).