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Overexpression of WT1 in all molecular subtypes of breast cancer and its impact on survival: exploring oncogenic and tumor suppressor roles of distinct WT1 isoforms
Background
Breast cancer is a highly heterogeneous solid tumor, posing challenges in developing targeted therapies effective for all mammary carcinoma subtypes.
WT1
emerges as a promising target for breast cancer therapy due to its potential oncogenic role in various cancer types. Previous works have yielded inconsistent results. Therefore, further studies are needed to clarify the behavior of this complex gene in breast cancer.
Methods and Results
In this study, we examined
WT1
expression in both Formalin Fixed Paraffin Embedded breast tumors (n = 41) and healthy adjacent tissues (n = 41) samples from newly diagnosed cases of ductal invasive breast cancer. The fold change in gene expression between the tumor and healthy tissue was determined by calculating 2
−∆∆Ct
. Disease-free survival analysis was computed using the Kaplan–Meier method. To identify the expression levels of different WT1 isoforms, we explored the ISOexpresso database. Relative quantification of the
WT1
gene revealed an overexpression of
WT1
in most cases. The percentage of patients surviving free of disease at 8 years of follow-up was lower in the group overexpressing
WT1
compared to the group with down-regulated
WT1
.
Conclusions
Interestingly, this overexpression was observed in all molecular subtypes of invasive breast cancer, underscoring the significance of
WT1
as a potential target in all these subtypes. The observed
WT1
down-expression in a few cases of invasive breast cancer, associated with better survival outcomes, may correspond to the down-regulation of a particular WT1-KTS (-) isoform: the WT1 A isoform (EX5-/KTS-). The co-expression of this WT1 oncogenic isoform with a regulated WT1- tumor suppressor isoform, such as the major WT1 F isoform (EX5-/KTS +), could also explain such survival outcomes.
Due to its capacity to adopt dual roles, it becomes imperative to conduct individual molecular expression profiling of the
WT1
gene. Such an approach holds great promise in the development of personalized treatment strategies for breast cancer.