Expresssion And Clinical Significance Of MTDH And QPCT In Locally Advanced Breast Cancer

Objective: The continuous progress of breast cancer research has made early breast cancer a curable disease,but for patients diagnosed with locally advanced breast cancer at first diagnosis,the prognosis is poor,with low 5-year survival rate.Studies have shown that MTDH(Metadherin)is highly expressed in breast cancer.The expression of this gene regulates the growth and proliferation of tumor cells,and then leads to tumor invasion,metastasis and drug resistance.MTDH can activate NF-κB signaling pathway and has a positive regulation effect on NF-κB.In recent years,studies have shown that QPCT(glutaminyl-peptidecyclotransferase,QC,glutaminyl peptide cyclic transferase)is closely related to malignant tumors.Studies on thyroid cancer have shown that QPCT expression in cancer tissues is significantly higher than that in normal thyroid tissues,and QPCT is related to the regulation of NF-κB pathway.However,the relationship between QPCT gene and breast cancer has not been reported.This research through the detection of MTDH,QPCT genes are expressed in locally advanced breast cancer in the organization,analysis the correlation between the two genes,and then discusses the MTDH,QPCT expression of relationship with the prognosis of locally advanced breast cancer,hope to be able to judge prognosis and guide the chemotherapy for locally advanced breast cancer provide new molecular biological indicators.Materials and Methods: Fifty-six patients with locally advanced breast cancer who were admitted to the Breast Disease Diagnosis and Treatment Center of the Fourth Hospital of Hebei Medical University from January 2015 to December 2015 were selected.All the patients received neoadjuvant chemotherapy with anthracycline and paclitaxel drugs,and the surgery was completed within 2 weeks after the end of neoadjuvant chemotherapy.Immunohistochemistry was used to detect the expression of MTDH and QPCT in breast cancer biopsy tissues before neoadjuvant therapy,and clinical information including age,menopausal status,tumor size,TNM stage,the expression of ER,HER-2,Ki-67,whether PCR was achieved,the number of lymph node metastasis after surgery,MP grade and other clinical information were collected.Disease-free survival(DFS)and overallsurvival(OS)were obtained by outpatient review or telephone follow-up.Measurement data was expressed as mean ± standard deviation,and enumeration data was expressed as percentage.Chi-square test was used to compare the two groups of data,and Spearman correlation analysis was used to explore the correlation between MTDH and QPCT expression levels.Kaplan-Meier was used to draw survival curves,and log-rank test was used to compare survival curves.Cox univariate and multivariate analysis was used to analyze the influencing factors for the prognosis of locally advanced breast cancer.Results: 1.The relationship between protein expression levels of MTDH and QPCT and age,tumor size,TNM stage,number of lymph node metastasis,ER,HER-2,Ki-67 were detected: MTDH,QPCT and ER were statistically significant(P< 0.05).There were no significant differences with age,tumor size,TNM stage,number of lymph node metastases,HER-2,Ki-67(P> 0.05).There was a positive correlation between MTDH and QPCT,which was statistically significant(rs=0.599,P< 0.05).2.Among 56 locally advanced breast cancer patients,there were 40 patients(71.4%)with high MTDH expression.The DFS of patients with high MTDH expression was shortened by 15.3 months(44.5 months vs.59.8 months,P=0.014),while there was no significant difference in OS between the high MTDH expression group and the low MTDH expression group(56.9 months vs.63.7 months,P=0.115).Cox multivariate analysis showed that MTDH expression was not an independent predictor of prognosis in locally advanced breast cancer patients.3.Among the 56 locally advanced breast cancer patients,41 patients(73.2%)had high expression of QPCT.The DFS of patients with high expression of QPCT was shortened by 14.3 months(45.0 vs 59.3 months,P=0.025),while there was no significant difference in OS between the high expression of QPCT and the low expression group(57.6 vs 62.4 months,P=0.159).Cox multivariate analysis showed that QPCT expression was not an independent predictor of prognosis in locally advanced breast cancer patients.4.There were 36 patients with locally advanced breast cancer with high expression of both MTDH and QPCT before neoadjuvant chemotherapy,and the high expression of both was significantly correlated with DFS,but not with OS(DFS: P=0.038;OS: P=0.2).Cox multivariate analysis showed that high expression of MTDH and QPCT simultaneously was not an independent predictor of DFS in locally advanced breast cancer patients.Conclusions: 1.There was a positive correlation between the expression of MTDH and QPCT,suggesting that MTDH could affect the recurrence and metastasis of breast cancer by regulating the expression of QPCT.2.The high expression of MTDH and QPCT is one of the factors of DFS shortening,but the high expression of MTDH and QPCT alone or simultaneously is not an independent predictor of prognosis in locally advanced breast cancer patients.