title: Identification of NTN4, TRA1, and STC2 as prognostic markers in breast cancer in a screen for signal sequence encoding proteins.
abstract: OBJECTIVE
  In a previous screen using a signal-trap library, we identified a number of secreted proteins up-regulated in primary tumor cells isolated from invasive breast cancers. The purpose of this study was to assess the expression of these genes in human invasive breast tumors and to determine the significance of their expression for prognosis in breast cancer.
  
  
  METHODS
  A tissue microarray containing 245 invasive breast tumors from women treated with curative surgery followed by anthracycline-based chemotherapy and hormone therapy for the estrogen receptor (ER)-positive tumors was screened by in situ hybridization with probes against thrombospondin 3 (TSP3), insulin-like growth factor binding protein 7 (IGFBP7), tumor rejection antigen 1 (TRA1), stanniocalcin 2 (STC2), and netrin 4 (NTN4). Correlations between categorical variables were done using the chi(2) test and Fisher's exact test. Cumulative survival probabilities were calculated using the Kaplan-Meier method and multivariate survival analysis was done with Cox hazard model. A series of breast cancers were also stained with NTN4 antibodies.
  
  
  RESULTS
  All five genes examined were expressed in invasive breast tumor cells. NTN4 protein expression was also confirmed by immunohistochemistry. Together, these data validate the design and screening of the signal-trap library. Univariate survival analysis revealed that expressions of TRA1, STC2, and NTN4 are correlated with longer disease-free survival and that TRA1 and NTN4 are associated with longer overall survival. Multivariate analysis showed that NTN4 is an independent prognostic factor of overall survival.
  
  
  CONCLUSIONS
  This article describes the identification of three secreted proteins, NTN4, TRA1, and STC2, as potential novel prognostic markers in breast cancer.
authors.affiliation: Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK.
authors.forename: Selma
authors.initials: S
authors.lastname: Esseghir
authors.forename: Alan
authors.initials: A
authors.lastname: Kennedy
authors.forename: Pooja
authors.initials: P
authors.lastname: Seedhar
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Nerurkar
authors.forename: Richard
authors.initials: R
authors.lastname: Poulsom
authors.forename: Jorge S
authors.initials: JS
authors.lastname: Reis-Filho
authors.forename: Clare M
authors.initials: CM
authors.lastname: Isacke
mesh_terms: D000951:Antigens, Neoplasm / Q000378:metabolism; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006023:Glycoproteins / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D036341:Intercellular Signaling Peptides and Proteins / Q000096:biosynthesis*; D008562:Membrane Glycoproteins / Q000096:biosynthesis*; D009414:Nerve Growth Factors / Q000096:biosynthesis*; D000075385:Netrins; D020411:Oligonucleotide Array Sequence Analysis; D011379:Prognosis; D021382:Protein Sorting Signals; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D006023:Glycoproteins; D036341:Intercellular Signaling Peptides and Proteins; D008562:Membrane Glycoproteins; C498815:NTN4 protein, human; D009414:Nerve Growth Factors; D000075385:Netrins; D021382:Protein Sorting Signals; C114997:STC2 protein, human; C053387:endoplasmin