Research On The Correlation Between Breast Cancer And Dysregulated Glucose Metabolism

Background/AimsResearches have proven that breast cancer cells were at accelerated glucose metabolism than benign tumor cells. Abnormal glucose metabolism is not only a risk factor but also a negative prognostic factor for breast cancer. However, the characteristics of breast cancer glucose metabolism, as well as the relationship between the expression of glucose metabolism related protein and the effect of neoadjuvant chemotherapy for breast cancer was not yet clear. In this study, we analyzed differences of glucose metabolism indexes in patients with breast cancer and benign breast tumor. To summarize the characteristics of glucose metabolism in breast cancer, We further analyzed differences of glucose metabolism indexes in different breast cancer subtypes, and explored the correlation between the expression of glucose transporters and the neoadjuvant chemotherapy effectiveness in breast cancer. This study aims to provide theoretical basis and reference for guiding clinical treatment.Methods1. Breast tumor patients (benign:26 cases, malignant:32 cases) in January 1,2015 to July 30th -2015 of jinling hospital breast surgery center were included in this study. Examinations of glucose metabolism indexes were conducted preoperative (including Oral glucose tolerance test, C peptide release test, Insulin release test, Insulin like growth factor 1, Glycosylated hemoglobin, Insulin resistance index). Immunohistochemistry examinations (including estrogen receptor, progesterone receptor. Human epidermal growth factor receptor 2, Ki-67) were also conducted postoperative to classify breast cancer subtypes. Student’s t-test was used to compare the differences of glucose metabolism between breast cancer and breast benign tumor, and glucose metabolism indexes in different breast cancer subtypes.2.49 breast cancer patients from June 2011 to June 2015 from JinLing hospital breast surgery center were included in our study, all the included study subjects were newly pathologic diagnosed BC patients by core needle biopsy, and treated by neodjuvant chemotherapy before surgery. Chemotherapeutic effectiveness were evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST version 1.1), IHC analysis of GLUT1 and GLUT3 were performed on 5-μm sections from formalin-fixed, paraffin-embedded core needle aspiration biopsy tissue, to compare clinicopathologic characteristics and GLUT1/GLUT3 expression level in different therapeutic effect groups.Results1. IGF-1 and HOMA-IR levels of the breast cancer group was higher than that of the breast benign control group. In the breast cancer group, the insulin and C peptide level were higher than that of the control group in most of the time point. The level of IGF-1 in triple negative breast cancer patients was higher than that in patients with Luminal and HER-2 type. Blood glucose levels, insulin levels and C peptide levels in the TNBC group were higher than those in the other two groups in most of the time point, no significant difference were found in all the data described above.2. Based on the RECIST criteria,10 patients were defined as PR,11 patients were defined as SD,28 patients were defined as PD. We concluded that the tumor size of the three groups were different:tumor sizes were significant larger in PD group than PR and SD group. Significant difference also existed in the 3 groups mentioned above in the GLUT1 and GLUT3 expression level:GLUT1 expression was significant higher in Progressive Disease(PD) group and Stable Disease(SD) group than in Partial Response(PR) group. GLUT3 expression was significant higher in Progressive Disease(PD) group than in Partial Response(PR) group and Stable Disease(SD) group.conclusionsWe found insulin resistant trends existed in breast cancer patients compared with benign control group. Compared with other subtypes of breast cancer patients, the abnormal glucose metabolism level was higher in TNBC patients, but the results of this study are mostly negative, and therefore need to be confirmed by other large scale clinical studies. Both GLUT1 and GLUT3 expression tended to be higher in poor chemotherapy effectiveness breast cancer patients. GLUT1 and GLUT3 may suggest predictive value in breast cancer neoadjuvant chemotherapy effectiveness.