title: Potential Involvement of Jagged1 in Metastatic Progression of Human Breast Carcinomas.
abstract: BACKGROUND
  Jagged1, the ligand of Notch, has been shown to be involved in formation of bone metastases in an experimental study. Here, clinical relevance of Jagged1 expression in tumor progression was assessed in human breast carcinomas.
  
  
  METHODS
  Jagged1 expression was evaluated by immunohistochemistry in 228 tumor tissue samples and compared to clinicopathologic parameters and patients' outcomes. Furthermore, circulating tumor cells (CTCs) from peripheral blood of 100 unmatched metastatic cancer patients with progressive disease were enriched using Ficoll density gradient centrifugation and detected by pan-keratin/Jagged1/CD45 immunofluorescent staining.
  
  
  RESULTS
  Jagged1 expression was detected in 50% of 228 tumors. Jagged1 expression was correlated with higher tumor grade (P = 0.047), vascular invasion (P = 0.026), luminal B subtype (P = 0.016), overexpression of Her-2 (P = 0.001), high Ki-67 expression (P = 0.035), and aldehyde dehydrogenase 1 (ALDH1) positivity (P = 0.013). Jagged 1 expression indicated shorter disease-free survival (DFS) (P = 0.040) and metastasis-free survival (P = 0.048) in lymph node-negative breast cancer for which it was the only independent predictor of DFS (multivariate analysis, P = 0.046). Tumors characterized by the strongest Jagged1 staining intensity (7.5% of cases) correlated with lymph node positivity (P = 0.037), metastatic relapse (P = 0.049), and higher number of disseminated tumor cells in bone marrow aspirates (P = 0.041). Twenty-one unmatched metastatic breast cancer patients with progressive disease were positive for CTCs, and 85.7% of the CTCs also expressed Jagged1. The presence of Jagged1(+) CTCs was significantly associated with shorter progression-free survival in patients treated with bisphosphonates (P = 0.013).
  
  
  CONCLUSIONS
  Jagged1 expression characterizes more aggressive breast carcinoma and might be involved in tumor cell dissemination, metastatic progression, and resistance to bone-targeting therapy in breast cancer patients.
authors.affiliation: Department of Tumour Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany;
authors.forename: Natalia
authors.initials: N
authors.lastname: Bednarz-Knoll
authors.affiliation: Department of Tumour Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; BONE-NET, European Training Network on Cancer Induced Bone Disease, 7th Framework Programme, EU;
authors.forename: Antonia
authors.initials: A
authors.lastname: Efstathiou
authors.affiliation: Department of Tumour Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany;
authors.forename: Frauke
authors.initials: F
authors.lastname: Gotzhein
authors.affiliation: Department of Tumour Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany;
authors.forename: Harriet
authors.initials: H
authors.lastname: Wikman
authors.affiliation: Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
authors.forename: Volkmar
authors.initials: V
authors.lastname: Mueller
authors.affiliation: Department of Molecular Biology, Princeton University, Princeton, NJ.
authors.forename: Yibin
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Tumour Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; pantel@uke.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Pantel
mesh_terms: D000080924:Aldehyde Dehydrogenase 1 Family; D014408:Biomarkers, Tumor / Q000378:metabolism; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002135:Calcium-Binding Proteins / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism*; D007527:Isoenzymes / Q000378:metabolism; D000072100:Jagged-1 Protein; D008207:Lymphatic Metastasis / Q000473:pathology; D008565:Membrane Proteins / Q000378:metabolism*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism / Q000473:pathology; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D050697:Retinal Dehydrogenase / Q000378:metabolism; D000072099:Serrate-Jagged Proteins
chemical_list: D000080924:Aldehyde Dehydrogenase 1 Family; D014408:Biomarkers, Tumor; D002135:Calcium-Binding Proteins; D036341:Intercellular Signaling Peptides and Proteins; D007527:Isoenzymes; D000072100:Jagged-1 Protein; D008565:Membrane Proteins; D018719:Erb-b2 Receptor Tyrosine Kinases; D050697:Retinal Dehydrogenase; D000072099:Serrate-Jagged Proteins; C000606273:JAG1 protein, human; C510223:ALDH1A1 protein, human; C508053:ERBB2 protein, human