J Cancer 2018; 9(3):604-613. doi:10.7150/jca.19190

Research Paper

Differential expression and clinical significance of epithelial-mesenchymal transition markers among different histological types of triple-negative breast cancer

Shuling Zhou1,2, Xiangjie Sun1,2, Lin Yu1,2, Ruoji Zhou1,2, Anqi Li1,2, Ming Li1,2, Wentao Yang1,2✉

1. Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China;
2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China

Abstract

Background: Triple-negative breast cancer (TNBC) is a heterogeneous disease closely associated with epithelial-to-mesenchymal transition (EMT). This study aimed to investigate the role of EMT in metaplastic carcinoma.

Methods: E-cadherin, Slug, Twist and Vimentin levels were detected by immunohistochemistry in 167 TNBC tumors, including 145 invasive carcinomas of no special type (ICONSTs), 14 spindle cell carcinomas (SpCCs) and 8 matrix-producing carcinomas (MPCs).

Results: Nuclear Slug and Twist were more frequently detected in SpCC and MPC tumors than that in ICONST tumors (p<0.001). The rate of E-cadherin loss was much lower in the ICONST tumors than that in the SpCC and MPC tumors (p<0.001). Vimentin was expressed in all SpCC and MPC tumors. Furthermore, nuclear expression of Slug and Twist was positively associated with the cytoplasmic localization of Vimentin (p<0.001) and was inversely associated with membranous staining of E-cadherin (p<0.001). These trends were more apparent in the SpCC and MPC tumors than in the ICONST tumors. Follow-up data were available for 151 patients. The follow-up times ranged from 1 month to 11 years (mean: 74 m; median: 21 m). The median progression-free survival and overall survival times were 24 months (mean: 32 months) and 22 months (mean: 35 months), respectively. Tumor size, TNM stage and E-cadherin were found to be independent prognostic factors of TNBC.

Conclusions: EMT may play an important role in TNBC, especially in MPC and SpCC. Further researches are needed to confirm this finding. The results of this study may facilitate the future development of targeted therapies based on alterations in the EMT and stem cell markers.

Keywords: epithelial-mesenchymal transition, breast cancer, triple negative, metaplastic carcinoma, clinical significance

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How to cite this article:
Zhou S, Sun X, Yu L, Zhou R, Li A, Li M, Yang W. Differential expression and clinical significance of epithelial-mesenchymal transition markers among different histological types of triple-negative breast cancer. J Cancer 2018; 9(3):604-613. doi:10.7150/jca.19190. Available from http://www.jcancer.org/v09p0604.htm