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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

FOXA1 and AR in invasive breast cancer: new findings on their co-expression and impact on prognosis in ER-positive patients

Authors: Nelson Rangel, Nicoletta Fortunati, Simona Osella-Abate, Laura Annaratone, Claudio Isella, Maria Graziella Catalano, Letizia Rinella, Jasna Metovic, Renzo Boldorini, Davide Balmativola, Pietro Ferrando, Francesca Marano, Paola Cassoni, Anna Sapino, Isabella Castellano

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

The role of forkhead-box A1 (FOXA1) and Androgen receptor (AR) in breast cancer (BC) has been extensively studied. However, the prognostic role of their co-expression in Estrogen receptor positive (ER+) BC has not been investigated so far. The aim of the present study was thus to assess the co-expression (protein and mRNA) of FOXA1 and AR in BC patients, in order to evaluate their prognostic impact according to ER status.

Methods

Immunohistochemical expression of AR and FOXA1 was evaluated on 479 consecutive BC, with complete clinical-pathological and follow up data. Fresh-frozen tissues from 65 cases were available. The expression of AR and FOXA1 with ER was validated using mRNA analyses. Survival and Cox proportional hazard analyses were used to evaluate the relationship between FOXA1, AR and prognosis.

Results

Expression of ER, AR and FOXA1 was observed in 78, 60 and 85% of cases respectively. Most AR+ cases (97%) were also FOXA1+. The level of FOXA1 mRNA positively correlated with level of both AR mRNA (r = 0.8975; P < 0.001) and ER mRNA (r = 0.7326; P < 0.001). In ER+ BC, FOXA1 was associated with a good prognosis independently of AR expression in the three subgroups analyzed (FOXA1+/AR+; FOXA1+/AR-; FOXA1−/AR-). Multivariate analyses confirmed that FOXA1 may provide more information than AR in Disease-Free Interval (DFI) of ER+ BC patients.

Conclusion

Our results suggest that in BC the expression of FOXA1 is directly related to the expression of AR. Despite that, FOXA1 is found as superior predicting marker of recurrences compared to AR in ER+ BC patients.
Appendix
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Metadata
Title
FOXA1 and AR in invasive breast cancer: new findings on their co-expression and impact on prognosis in ER-positive patients
Authors
Nelson Rangel
Nicoletta Fortunati
Simona Osella-Abate
Laura Annaratone
Claudio Isella
Maria Graziella Catalano
Letizia Rinella
Jasna Metovic
Renzo Boldorini
Davide Balmativola
Pietro Ferrando
Francesca Marano
Paola Cassoni
Anna Sapino
Isabella Castellano
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4624-y

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