HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer
Jing Zhang,1 Shuo Zhang,2 Song Gao,3 Yan Ma,1 Xueying Tan,1 Ye Kang,4 Weidong Ren1 1Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 2Department of Neurology, Shengjing Hospital of China Medical University, She...
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Dove Medical Press
2020-03-01
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Online Access: | https://www.dovepress.com/hif-1alpha-twist-1-and-itgb-1-associated-with-tumor-stiffness-as-novel-peer-reviewed-article-CMAR |
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author | Zhang J Zhang S Gao S Ma Y Tan X Kang Y Ren W |
author_facet | Zhang J Zhang S Gao S Ma Y Tan X Kang Y Ren W |
author_sort | Zhang J |
collection | DOAJ |
description | Jing Zhang,1 Shuo Zhang,2 Song Gao,3 Yan Ma,1 Xueying Tan,1 Ye Kang,4 Weidong Ren1 1Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 2Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 3Department of Clinical Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 4Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of ChinaCorrespondence: Weidong RenDepartment of Ultrasound, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang City 110004, People’s Republic of ChinaEmail renwdcmu01@163.comPurpose: To investigate the relationship between hypoxia-inducible factor 1-alpha (HIF-1α), Twist family BHLH transcription factor 1 (TWIST-1), and β 1 integrin (ITGB-1) expression and tumor stiffness, and evaluate performance of HIF-1α, TWIST-1, and ITGB-1 alone and in combination with Ki-67 for predicting pathological responses to neoadjuvant chemotherapy (NACT) in breast cancer (BC).Patients and Methods: This was a prospective cohort study of 104 BC patients receiving NACT. Tumor stiffness and oxygen score (OS) were evaluated before NACT by shear-wave elastography and optical imaging; HIF-1α, TWIST-1, ITGB-1, and Ki-67 expression were quantitatively assessed by immunohistochemistry of paraffin-embedded tumor samples obtained by core needle biopsy. Indexes were compared among different residual cancer burden (RCB) groups, and associations of HIF-1α, TWIST-1, ITGB-1, and Ki-67 with tumor stiffness and OS were examined. The value of HIF-1α, TWIST-1, ITGB-1, and Ki-67, and a possible new combined index (predRCB) for predicting NACT responses was assessed by receiver operating characteristic (ROC) curves.Results: HIF-1α, TWIST-1, and ITGB-1 expression were positively correlated with tumor stiffness and negatively with OS. Area under the ROC curves (AUCs) measuring the performance of HIF-1α, TWIST-1, ITGB-1, and Ki-67 for predicting responses to NACT were 0.81, 0.85, 0.79, and 0.80 for favorable responses, and 0.83, 0.86, 0.84, and 0.85 for resistant responses, respectively. PredRCB showed better prediction than the other individual indexes for favorable responses (AUC = 0.88) and resistant responses (AUC = 0.92).Conclusion: HIF-1α, TWIST-1, ITGB-1, and Ki-67 performed well in predicting favorable responses and resistance to NACT, and predRCB improved the predictive power of the individual indexes. These results support individualized treatment of BC patients receiving NACT.Keywords: HIF-1α, TWIST-1, ITGB-1, neoadjuvant chemotherapy, breast cancer, prediction |
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spelling | doaj.art-b4f13c40a57f42bb8b0bce843600c57c2022-12-22T02:42:22ZengDove Medical PressCancer Management and Research1179-13222020-03-01Volume 122209222252700HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast CancerZhang JZhang SGao SMa YTan XKang YRen WJing Zhang,1 Shuo Zhang,2 Song Gao,3 Yan Ma,1 Xueying Tan,1 Ye Kang,4 Weidong Ren1 1Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 2Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 3Department of Clinical Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of China; 4Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, People’s Republic of ChinaCorrespondence: Weidong RenDepartment of Ultrasound, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang City 110004, People’s Republic of ChinaEmail renwdcmu01@163.comPurpose: To investigate the relationship between hypoxia-inducible factor 1-alpha (HIF-1α), Twist family BHLH transcription factor 1 (TWIST-1), and β 1 integrin (ITGB-1) expression and tumor stiffness, and evaluate performance of HIF-1α, TWIST-1, and ITGB-1 alone and in combination with Ki-67 for predicting pathological responses to neoadjuvant chemotherapy (NACT) in breast cancer (BC).Patients and Methods: This was a prospective cohort study of 104 BC patients receiving NACT. Tumor stiffness and oxygen score (OS) were evaluated before NACT by shear-wave elastography and optical imaging; HIF-1α, TWIST-1, ITGB-1, and Ki-67 expression were quantitatively assessed by immunohistochemistry of paraffin-embedded tumor samples obtained by core needle biopsy. Indexes were compared among different residual cancer burden (RCB) groups, and associations of HIF-1α, TWIST-1, ITGB-1, and Ki-67 with tumor stiffness and OS were examined. The value of HIF-1α, TWIST-1, ITGB-1, and Ki-67, and a possible new combined index (predRCB) for predicting NACT responses was assessed by receiver operating characteristic (ROC) curves.Results: HIF-1α, TWIST-1, and ITGB-1 expression were positively correlated with tumor stiffness and negatively with OS. Area under the ROC curves (AUCs) measuring the performance of HIF-1α, TWIST-1, ITGB-1, and Ki-67 for predicting responses to NACT were 0.81, 0.85, 0.79, and 0.80 for favorable responses, and 0.83, 0.86, 0.84, and 0.85 for resistant responses, respectively. PredRCB showed better prediction than the other individual indexes for favorable responses (AUC = 0.88) and resistant responses (AUC = 0.92).Conclusion: HIF-1α, TWIST-1, ITGB-1, and Ki-67 performed well in predicting favorable responses and resistance to NACT, and predRCB improved the predictive power of the individual indexes. These results support individualized treatment of BC patients receiving NACT.Keywords: HIF-1α, TWIST-1, ITGB-1, neoadjuvant chemotherapy, breast cancer, predictionhttps://www.dovepress.com/hif-1alpha-twist-1-and-itgb-1-associated-with-tumor-stiffness-as-novel-peer-reviewed-article-CMARhif-1αtwist-1itgb-1neoadjuvant chemotherapybreast cancerprediction |
spellingShingle | Zhang J Zhang S Gao S Ma Y Tan X Kang Y Ren W HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer Cancer Management and Research hif-1α twist-1 itgb-1 neoadjuvant chemotherapy breast cancer prediction |
title | HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer |
title_full | HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer |
title_fullStr | HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer |
title_full_unstemmed | HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer |
title_short | HIF-1α, TWIST-1 and ITGB-1, associated with Tumor Stiffness, as Novel Predictive Markers for the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer |
title_sort | hif 1 alpha twist 1 and itgb 1 associated with tumor stiffness as novel predictive markers for the pathological response to neoadjuvant chemotherapy in breast cancer |
topic | hif-1α twist-1 itgb-1 neoadjuvant chemotherapy breast cancer prediction |
url | https://www.dovepress.com/hif-1alpha-twist-1-and-itgb-1-associated-with-tumor-stiffness-as-novel-peer-reviewed-article-CMAR |
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