D-arabinose induces cell cycle arrest by promoting autophagy via p38 MAPK signaling pathway in breast cancer.

Breast cancer patients often have a poor prognosis largely due to lack of effective targeted therapy. It is now well established that monosaccharide enhances growth retardation and chemotherapy sensitivity in tumor cells. We investigated whether D-arabinose has capability to restrict the proliferation of tumor cells and its mechanism. Here, we report that D-arabinose induced cytotoxicity is modulated by autophagy and p38 MAPK signaling pathway in breast cancer cell lines. The proliferation of cells was evaluated by CCK-8 and Colony formation assay. The distribution of cells in cell cycle phases was analyzed by flow cytometry. Cell cycle, autophagy and MAPK signaling related proteins were detected by western blotting. Mouse xenograft model was used to evaluate the efficacy of D-arabinose in vivo. The proliferation of cells was dramatically inhibited by D-arabinose exposure in a dose-dependent manner, which was relevant to cell cycle arrest, as demonstrated by G2/M cell cycle restriction and ectopic expression of cell cycle related proteins. Mechanistically, we further identified that D-arabinose is positively associated with autophagy and the activation of the p38 MAPK signaling in breast cancer. In contrast, 3-Ma or SB203580, the inhibitor of autophagy or p38 MAPK, reversed the efficacy of D-arabinose. Additionally, D-arabinose in vivo treatment could significantly inhibit xenograft growth of breast cancer cells. Our findings were the first to reveal that D-arabinose triggered cell cycle arrest by inducing autophagy through the activation of p38 MAPK signaling pathway in breast cancer cells.

Analysis on status quo and related factors of delays in diagnosis and treatment of breast cancer in Ningxia Hui Autonomous Region.

This study aimed to explore factors contributing to the delays in the diagnosis and treatment of breast cancer (BC) in Ningxia Hui Autonomous Region. We conducted a cohort analysis of 1012 patients with BC diagnosed at the General Hospital of Ningxia Medical University between January 2018 and December 2019. Sociodemographic data were collected through questionnaires, and clinical data were gathered and analyzed from relevant databases. Furthermore, observations were made regarding delays in the diagnosis and treatment of BC, followed by an analysis of the correlations between patient delay and both sociological factors within the population and clinical factors specific to patients with BC. Subsequently, the factors associated with patient delay and system delay were examined using Cox regression analysis, along with the inclusion of neoadjuvant therapy. In the prevention and treatment of BC in Ningxia, the patient delay rate was 33.20%, the diagnosis delay rate was 17.89%, the treatment delay rate was 0.0099% and the system delay rate was 41.60%. There was a higher proportion of patient delay and system delay in aged patients (age ≥ 61 years) with rural registered permanent residence (RPR), multiple clinical symptoms (such as nipple spillage, axillary abnormalities, etc), a T4 tumor size classification, and the initial use of neoadjuvant therapy. Besides, significant positive correlations were observed between patient delay and system delay time with BC stage. Patients aged 51 to 60 and those with molecular types (Limanal1B: ki-67 > 14%, Limanal1B: HER-2 positive) were prone to patient delay, whereas molecular characteristics influenced system delay, unrelated to sociodemographic factors. The study identifies significant age, residency, and tumor molecular subtype correlations with diagnostic and treatment delays in Ningxia's patients with BC, predominantly affecting women aged 41 to 60, especially urban dwellers. These findings underscore the need for targeted interventions to reduce delays and improve BC care in this region.

Identification of Breast Cancer Immune-related Prognostic Characteristics in Tumor Microenvironment.

BACKGROUND: Accumulated evidence suggest that tumor microenvironment (TME) plays a crucial role in breast cancer (BRCA) progression and therapeutic effects. OBJECTIVE: This study aimed to characterize immune-related BRCA subtypes in TME, and identify genes with prognostic value. METHODS: RNA sequencing profiles with corresponding clinical data from The Cancer Genome Atlas (TCGA) database of BRCA patients were downloaded to evaluate immune infiltration using the single-sample gene set enrichment (ssGAEA) algorithm. Further, BRCA was clustered according to immune infiltration status by consensus clustering analysis. Using Venn analysis, differentially expressed genes (DEGs) were overlapped to obtain candidate genes. Kaplan-Meier (K-M) analysis was performed to identify prognostic genes, and the results were verified in the GEO and METABRIC datasets. RT-qPCR was conducted to detect the mRNA expression of prognostic genes. RESULTS: In the TCGA database, 3 immune-related BRCA subtypes were identified [cluster1 (C1), cluster2 (C2), and cluster3 (C2)]. The C2 subtype had better overall survival (OS) compared to the C1 subtype. Higher levels of immune markers and checkpoint protein were found in the C2 subtype than in others. By combining DEGs between BRCA and normal tissues, with the C1 and C2 subtypes associated with different OS, 25 BRCA candidate genes were identified. Among these, 8 genes were identified as prognostic genes for BRCA. RT-qPCR showed that the expressions of 2 genes were significantly elevated in BRCA tissues, while that of other genes were decreased. CONCLUSION: Three BRCA subtypes were identified with the immune index, which may help design advanced treatment of BRCA. The data code used for the analysis in this article was available on GitHub (https://github.com/tangzhn/BRCA1.git).

Association of molecular subtypes and treatment with survival in invasive micropapillary breast cancer: an analysis of the Surveillance, Epidemiology, and End Results database.

BACKGROUND: This study aims to examine the features, treatments, and survival of invasive micropapillary carcinoma (IMPC) according to different molecular subtypes. METHODS: In this cohort study, data between 2010 and 2018 were retrospectively reviewed from the Surveillance, Epidemiology, and End Results database. Molecular subtypes were categorized into four varieties: hormone receptor (HR)+/HER2- (Luminal A), HR+/HER2+ (Luminal B), HR-/HER2- [triple-negative (TN)], and HR-/HER2+ (HER2 enriched). RESULTS: In this study, 1,180 IMPC patients were included, with 99 patients (8.39%) of the 1,180 patients having an overall mortality, and 53 patients (53.54%) of the 99 patients having a breast cancer-specific mortality. The follow-up duration was 40.00 (18.50, 61.00) months. TN molecular subtype was associated with worse OS and BCSS in IMPC patients. Treatment of chemotherapy, radiation, and combination therapy were associated with better survival in HR+/HER2+ molecular subtype and HR+/HER2- molecular subtype. However, in HR-/HER2- molecular subtype, treatment of chemotherapy was associated with a poor BCSS, and treatment of radiation was not associated with OS and BCSS. Surgery treatment was not associated with survival in HR+/HER2+ molecular subtype and HR+/HER2- molecular subtype. However, surgery treatment of mastectomy was associated with better OS in HR-/HER2- molecular subtype (P < 0.05). CONCLUSION: The prognosis of IMPC was significantly influenced by different molecular subtypes. Chemotherapy and radiotherapy are beneficial in HR+/HER2+ and HR+/HER2- patients. However, they should be used with caution in HR-/HER2- (TN) patients.

RANKL Promotes Chemotherapy Resistance in Breast Cancer Cells Through STAT3 Mediated Autophagy Induction.

BACKGROUND: This study was to investigate the functional role and mechanism of receptor activator of nuclear factor-kappa B ligand (RANKL) associated autophagy and chemoresistance in breast cancer. MATERIALS AND METHODS: Cell Counting Kit-8 (CCK-8) assay was used to detect the cell viability. Real-time polymerase chain reaction (PCR) was used for determining the relative mRNA levels of key genes and protein expression was assessed by Western blotting. Immunofluorescence was performed to evaluate the changes in the autophagy flux. Short hairpin (shRNA) was used to knockdown the expression of the target genes in breast cancer cells. Based on The Cancer Genome Atlas (TCGA) database, we explored the expression of receptor activator of nuclear factor-kappa B (RANK), autophagy and signal transducer and activator of transcription 3 (STAT3) signaling associated genes and analyzed their correlation with the prognosis of breast cancer patients. RESULTS: The findings showed that receptor activator of nuclear factor-kappa B ligand (RANKL), the ligand of RANK, could effectively enhance the chemoresistance potential of breast cancer cells. Our results showed that RANKL induced autophagy and enhanced the expression of autophagy associated genes in breast cancer cells. The knockdown of RANK suppressed RANKL mediated autophagy induction in these cells. Furthermore, the inhibition of autophagy suppressed RANKL mediated chemoresistance in breast cancer cells. We found STAT3 signaling pathway was involved in RANKL-induced autophagy. Analysis of the expression of RANK, and autophagy and STAT3 signaling associated genes in breast cancer tissues showed that the expression of autophagy and STAT3 signaling associated genes was correlated with the prognosis of breast cancer patients. CONCLUSION: The present study suggests that the RANKL/RANK axis may potentially mediate chemoresistance in breast cancer cells by inducing autophagy through the STAT3 signaling pathway.

A rare presentation of a large goiter with papillary thyroid microcarcinoma as a chest wall mass: A case report.

Nodular goiter affects numerous individuals worldwide. As the thyroid enlarges, it normally extends into the mediastinum as a result of its anatomical location under the investing layer of the deep cervical fascia. The present study reports the rare case of a 76-year-old man who suffered from a goiter with papillary thyroid microcarcinoma, who presented as a subcutaneous partially cystic with solid areas lesion over the chest. The patient underwent surgery and on histopathological examination, the predominant mass was characterized as a multinodular goiter with hemorrhage, necrosis and cystic change. A papillary thyroid microcarcinoma with a diameter of 0.2 cm was identified. The present study demonstrated a rare, to the best of our knowledge, presentation of a benign multinodular goiter in this way.

RANKL-induced migration of MDA-MB-231 human breast cancer cells via Src and MAPK activation.

Accumulating studies have shown that the receptor activator of nuclear factor-κB ligand (RANKL)/RANK pathway plays an important role in tumor metastasis. However, the involvement of the RANKL/RANK signal transduction pathway in breast cancer metastasis remains unclear. The present study, therefore, investigated the role of downstream molecules of RANKL/RANK signaling in breast cancer cells using Transwell chemotaxis assays. RANKL was shown to direct the migration of MDA-MB-231 breast cancer cells. Osteoprotegerin (OPG; soluble decoy receptor of RANKL) inhibited RANKL-induced migration. RANKL activated Src kinase in MDA-MB-231 cells, as shown by Western blotting, and pretreatment with a Src inhibitor abrogated RANKL-induced cell migration, in a similar manner to OPG. Short-hairpin RNA against RANK, delivered via a lentiviral vector, significantly abolished the expression of phosphorylated Src. Stimulation by RANKL induced the phosphorylation of mitogen-activated protein kinases (MAPKs) (ERK, p38, JNK), and specific inhibitors of MAPKs blocked RANKL-induced cell migration. Furthermore, the expression of phosphorylated MAPKs could be blocked by a Src inhibitor and by small interfering RNA against Src. These findings suggest that Src and MAPK pathways may be involved in RANKL-induced MDA-MB-231 breast cancer cell migration.

Hypoxia induces RANK and RANKL expression by activating HIF-1α in breast cancer cells.

Receptor activator of NF-κB (RANK) and RANK ligand (RANKL) are known to play an important role in the development and progression of breast cancer. However, the mechanisms by which stimuli regulate the expression of RANK and RANKL in breast cancer cells are largely unknown. In this study, we show that hypoxia, a common feature of malignant tumors, can enhance the expression of RANK and RANKL mRNA and protein in MDA-MB-231 and MCF-7 breast cancer cells. In addition, we found that hypoxia induced hypoxia-inducible factor-1 alpha (HIF-1α) and phosphorylation of Akt, resulting in upregulation of RANK and RANKL expression; HIF-1α-targeted siRNA and PI3K-Akt inhibitor abrogated this upregulation in MDA-MB-231 cells. Furthermore, we also observed that hypoxia accelerated RANKL-mediated cell migration, which was inhibited following HIF-1α knockdown and PI3K-Akt inhibition. Thus, we provide evidence that hypoxia upregulates RANK and RANKL expression and increases RANKL-induced cell migration via the PI3K/Akt-HIF-1α pathway.