J Breast Cancer.  2017 Dec;20(4):361-367. 10.4048/jbc.2017.20.4.361.

Wnt7a Deficiency Could Predict Worse Disease-Free and Overall Survival in Estrogen Receptor-Positive Breast Cancer

Affiliations
  • 1Department of Pathology, Hanyang University College of Medicine, Seoul, Korea. sspaik@hanyang.ac.kr
  • 2Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Wnt7a is a glycoprotein involved in embryonic development and the progression of different types of malignant tumors. This study aimed to detect the level of Wnt7a expression in breast cancer and explore its role in the disease progression and prognosis.
METHODS
A total of 258 patients diagnosed with invasive ductal carcinoma of the breast were included in this study. Using tissue microarray and immunohistochemical staining, we evaluated the association between Wnt7a expression and clinicopathological parameters, and the prognostic value of Wnt7a.
RESULTS
Wnt7a expression was significantly correlated with estrogen receptor (ER) expression (odds ratio, 3.95; 95% confidence interval [CI], 1.99-7.80; p < 0.001). On univariate and multivariate analyses, loss of Wnt7a expression was associated with poor disease-free survival (DFS) (multivariate hazard ratio [HR], 9.12; 95% CI, 1.80-46.09; p=0.008), but not with poor overall survival (OS). In the ER-positive group (n=114), loss of Wnt7a expression was an independent prognostic factor for shorter DFS (multivariate HR, 13.54; 95% CI, 1.11-165.73; p=0.042) and OS (multivariate HR, 4.76; 95% CI, 1.29-17.61; p=0.019) on univariate and multivariate analyses. However, in the ER-negative group, there was no significant difference in DFS and OS according to Wnt7a expression.
CONCLUSION
The loss of Wnt7a expression might be a meaningful factor in assessing DFS and OS, especially in ER-positive breast cancer.

Keyword

Breast neoplasms; Estrogen receptors; Prognosis; Wnt proteins

MeSH Terms

Breast Neoplasms*
Breast*
Carcinoma, Ductal
Disease Progression
Disease-Free Survival
Embryonic Development
Estrogens*
Female
Glycoproteins
Humans
Multivariate Analysis
Pregnancy
Prognosis
Receptors, Estrogen
Wnt Proteins
Estrogens
Glycoproteins
Receptors, Estrogen
Wnt Proteins

Figure

  • Figure 1 Representative photographs of Wnt7a expression in the cytoplasm of neoplastic cells. (A) Negative, (B) positive (immunohistochemical stain for Wnt7a, original magnification ×200).

  • Figure 2 Expression of Wnt7a according to molecular subtype. Wnt7a negativity is frequently observed in the triple-negative group compared with other groups including luminal A, luminal B human epidermal growth factor receptor 2 (HER2)−, luminal B HER2+, and HER2 (p<0.001). Values in parentheses represent percentage.

  • Figure 3 Patients' survival according to Wnt7a expression. Kaplan-Meier curves representing disease-free survival in all cases (A), the estrogen receptor (ER)-positive group (B) and the progesterone receptor (PR)-positive group (C) and overall survival in all cases (D), the ER-positive group (E) and the PR-positive group (F).


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