RETRACTED ARTICLE: Expression of microRNA-497 and its prognostic significance in human breast cancer

Breast cancer (BC), the top cancer in women both in the developed and the developing world, has been a leading cause of death among women in China, with 1.1 million new cases annually [1]. Although improvements in early detection and treatment have decreased breast cancer mortality rates in recent years, prevention and therapy of breast cancer remain a major public health concern [2]. China’s breast cancer mortality has doubled over the past 30 years. BC is a heterogeneous disease with respect to molecular alteration, cellular composition, and clinical outcome. Breast carcinogenesis is a multistep process characterized by genetic and epigenetic alterations that influence key cellular pathways involved in growth and development [3]. Therefore, a better understanding of the molecular mechanisms involved in BC initiation and progression will likely contribute to providing useful prognostic biomarker and therapeutic target for BC therapy.

MiRNAs are a class of small non-coding RNAs (~22 nt) which are involved in the regulation of gene expression by inducing mRNA degradation or repressing mRNA translation [4, 5]. Increasing evidence indicates that miRNAs play critical roles in many human biological and pathological processes such as growth, apoptosis, development and tumorigenesis [6‐10]. These tumor-related miRNAs function as tumor suppressors or oncogenes and modulate many aspects of carcinogenesis, including cell proliferation, cell-cycle control, metastasis and angiogenesis [11‐13]. Recently, the correlations of dysregulated miRNAs with human BCs are increasingly reported. By microarray and Northern blot analyses, Iorio and his colleagues reported that miRNAs were aberrantly expressed in human breast cancer and the overall miRNA expression could clearly separate normal versus cancer tissues, with the most significantly deregulated miRNAs being mir-125b, mir-145, mir-21, and mir-155 [14]. Using a bead-based flow cytometric miRNA expression profiling method, Blenkiron’ et al. identified 133 miRNAs expressed in human breast tumors, which could be used to classify breast cancer into prognostic molecular subtypes [15]. Lerebours’ et al. showed that a 5-miRNA signature comprising miR-421, miR-486, miR-503, miR-720 and miR-1303 was shown to be predictive for inflammatory BC phenotype with an overall accuracy of 89% [16]. These data clearly indicate that specific miRNA expression patterns are associated with the biological and clinical properties of human BCs. However, there have been a limited number of studies on the potential of miRNAs used for prognostic biomarkers and therapeutic molecular targets in BC. Here, the focus is on miR-497, which has been reported to be downregulated in a variety of malignant tumors, including cervical cancer, colorectal cancer, and prostate cancer [17‐19]. By analysis of the genome-wide expression profiling of miRNAs, Yan and his colleagues showed that seven miRNAs of hsa-miR-497, hsa-miR-31, hsa-miR-355, hsa-miR-320, rno-mir-140, hsa-miR-127 and hsa-miR-30a-3p were significantly downregulated in BC [20]. Additionally, Shen’ et al. reported that miR-497 could induce apoptosis of breast cancer cells by targeting Bcl-w [21]. However, the prognostic significance of miR-497 in BC is not fully understood.

In the present study, qRT-PCR assay was performed to detect the expression of miR-497 in BC and corresponding noncancerous breast tissues. Moreover, the correlations of miR-497 expression with clinicopathologic features of BC patients were statistically analyzed. Finally, we determined the potential role of miR-497 in BC prognostic prediction. Our data showed that miR-497 was significantly downregulated in BC tissues and could be served as a potential molecular biomarker for the prediction of poor prognosis.

As different cancer therapies are effective in different subgroups of patients, there is a tremendous need for novel predictive and prognostic markers to improve the outcomes of cancer patients [23]. BC is a group of heterogeneous diseases that show various biological and clinical characteristics. Patient management is currently based on easily identifiable clinical and pathological characteristics, which only partially reflect disease heterogeneity. Many principal factors, such as patient age, status of axillar lymph nodes, tumor size, histological traits, status of hormonal receptors and HER2, have been used for the prediction of the prognosis of BC patients for many years [24, 25], but their roles in determining the individual risk level of the patient are quite limited. Therefore, it is still needed to exploit clinically useful, readily available prognostic markers in the management of BC.

MiRNAs, important regulators of mRNA and protein expression, are emerging as important modulators of essential biological functions, including cellular development, apoptosis, metabolism and oncogenesis [26]. It is estimated that miRNAs may regulate up to a third of the human genome. They also represent a novel biological entity with potential value as tumour biomarkers, which can improve diagnosis, prognosis, and monitoring of treatment response for human cancers [27, 28]. Application of the potential role of miRNAs as molecular biomarkers in human cancer is increasingly supported by the large number of studies conducted in different cancers, including BC [29, 30]. Tang’ et al. reported that high miR-27a expression was associated with poor overall survival in patients with breast cancer, suggesting that miR-27a could be a valuable marker of breast cancer progression [31]. By a meta-analysis, Hong’ et al. indicated that high expression of miR-210 could predict poor survival in patients with breast cancer [32]. By screening the expression levels of 754 human miRs using miR arrays in 16 breast tumor samples from 8 cases with local recurrence and 8 cases without local recurrence, Zhou and his colleagues reported that microRNA-9 could be used as a potential biomarker for breast cancer local recurrence and tumor estrogen receptor status [33]. As the stability of miRs and their detection in circulation, the miRNAs in body fluids, such as serum and plasma, open up the possibility of using them as noninvasive biomarkers in breast cancer [34, 35]. MiR-497, identified from the microRNA cluster site at chromosome 17p13.1, has been reported to function as a tumor suppressor in a variety of human cancers, including non-small cell lung cancer, hepatocelluar cancer, neroblastoma, colorectal cancer and breast cancer [18, 21, 36‐38]. Meanwhile, it was also reported that miR-497 could modulate multidrug resistance of human cancer cell lines by targeting Bcl-2 [39]. In human cervical cancer, low miR-497 expression appeared to be an unfavorable prognostic factor for patients [17]. By analysis of the expression of 319 microRNAs in 9 primary human male breast tumors and in epithelial cells from 15 male gynecomastia specimens, Lehmann and his colleagues showed that miR-145 and miR-497 were identified as most prominently down-regulated in male BC [40]. However, the status of miR-497 expression in female BC and its prognostic roles are unclear. Thus, the aim of this study was to investigate the correlations of miR-497 expression with clinicopathologic features and prognosis of BC patients.

Here, we first detect the expression of miR-497 in 30 pairs of BC and corresponding noncancerous breast tissues, and showed that the relative expression level of miR-497 in BC was significantly lower than that in noncancerous breast tissues. Then, we detected the expression of miR-497 in another 128 cases of BC tissues and analyzed its clinicopathologic and prognostic significance. Our results indicated that status of miR-497 expression in tissues was significantly correlated with tissue differentiation grade, HER-2 status, incidence of lymph node metastasis and clinical stage of BC patients. It was observed that patients with low miR-497 expression showed poorer differentiation grade, higher incidence of lymph node metastasis and advanced clinical stage, suggesting that downregulation of miR-497 played an important role in BC progression. Interestingly, low miR-497 expression was found to be correlated with positive HER-2 expression. In previous study, type I insulin-like growth factor receptor (IGF-1R) was identified as a functional and direct target of miR-497 in colorectal cancer and cervical cancer [17, 18], and downregulation of miR-497 could lead to the overexpression of IGF-1R, which leads to malignant transformation and tumor development [41]. The IGF/IGF-1R pathway has also been shown to have extensive cross-talk with epidermal growth factor receptor (EGFR), and human epidermal growth factor receptor 2 (HER-2) signaling pathways [42]. Thus, whether downregulation of miR-497 might lead to the activation of HER-2 by inducing upregulation of IGF-1R in human BC is unclear and remains to be elucidated in future studies. Then, we analyzed the correlation of miR-497 expression with prognosis of BC patients, and found that patients with high miR-497 expression showed better DFS and OS than those with low miR-497 expression. More importantly, both the univariate and multivariate survival analyses demonstrated that low miR-497 expression was correlated with shorter OS and DFS in BC, which was also consistent with the prognostic significance of miR-497 in other human malignancies, such as cervical cancer and neuroblastoma. These results indicated that miR-497 might be an important modulator involved in BC development.

Taken together, the current study indicates that miR-497 is downregulated in BC tissues and might be an independent molecular biomarker for predicting the prognosis of BC patients. Of course, this study has several limits. First, as the number of patients in this study is smaller, a larger case population is needed to confirm the prognostic value of miR-497 expression in BC. Second, as formalin-fixed, paraffin-embedded tissues display (FFPE) degradation of nucleic acids if compared to fresh materials, the HOPE-technique with laser microdissection represents a novel tool for future tissue-based studies described recently [43]. Finally, further investigation of the cell biology of miR-497 and its potential as a therapeutic target in BC are clearly warranted.