title: Molecular biomarkers screened by next-generation RNA sequencing for non-sentinel lymph node status prediction in breast cancer patients with metastatic sentinel lymph nodes.
abstract: BACKGROUND
  Non-sentinel lymph node (NSLN) status prediction with molecular biomarkers may make some sentinel lymph node (SLN) positive breast cancer patients avoid the axillary lymph node dissection, but the available markers remain limited.
  
  
  METHODS
  SLN positive patients with and without NSLN invasion were selected, and genes differentially expressed or fused in SLN metastasis were screened by next-generation RNA sequencing.
  
  
  RESULTS
  Six candidates (all ER/PR+, HER2-, Ki-67 <20%) with metastatic SLNs selected from 305 patients were equally categorized as NSLN negative and positive. We identified 103 specifically expressed genes in the NSLN negative group and 47 in the NSLN positive group. Among them, FABP1 (negative group) and CYP2A13 (positive group) were the only 2 protein-encoding genes with expression levels in the 8th to 10th deciles. Using a false discovery rate threshold of <0.05, 62 up-regulated genes and 98 down-regulated genes were discovered in the NSLN positive group. Furthermore, 10 gene fusions were identified in this group with the most frequently fused gene being IGLL5.
  
  
  CONCLUSIONS
  The biomarkers screened in present study may broaden our understanding of the mechanisms of breast cancer metastasis to the lymph nodes and contribute to the axillary surgery selection for SLN positive patients.
authors: Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Fengtai District, Beijing, 100071, China. lfpeakcool@126.com.
authors: Feng
authors: F
authors: Liang
authors: CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, 1-104 Beichen West Road, Chaoyang District, Beijing, 100101, China. quhongzhu@big.ac.cn.
authors: Hongzhu
authors: H
authors: Qu
authors: Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Fengtai District, Beijing, 100071, China. 812983585@qq.com.
authors: Qiang
authors: Q
authors: Lin
authors: CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, 1-104 Beichen West Road, Chaoyang District, Beijing, 100101, China. yangyd@big.ac.cn.
authors: Yadong
authors: Y
authors: Yang
authors: CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, 1-104 Beichen West Road, Chaoyang District, Beijing, 100101, China. ruanxy@big.ac.cn.
authors: Xiuyan
authors: X
authors: Ruan
authors: Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Fengtai District, Beijing, 100071, China. 13436660521@qq.com.
authors: Bo
authors: B
authors: Zhang
authors: Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Fengtai District, Beijing, 100071, China. liuyi790114@163.com.
authors: Yi
authors: Y
authors: Liu
authors: Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Fengtai District, Beijing, 100071, China. yuchengze@sina.com.
authors: Chengze
authors: C
authors: Yu
authors: General Hospital of Beijing Military Area, 5 Nanmencang, Dongcheng District, Beijing, 100700, China. roninzhy@126.com.
authors: Hongyan
authors: H
authors: Zhang
authors: CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, 1-104 Beichen West Road, Chaoyang District, Beijing, 100101, China. fangxd@big.ac.cn.
authors: Xiangdong
authors: X
authors: Fang
authors: Affiliated Hospital of Academy of Military Medical Sciences, 8 Dongdajie, Fengtai District, Beijing, 100071, China. hxp307@sina.com.
authors: Xiaopeng
authors: X
authors: Hao
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000235:genetics / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D017423:Sequence Analysis, RNA / Q000379:methods*
chemical_list: D014408:Biomarkers, Tumor