Anne Pierre Morel, Laura Mercatali, Emanuela Scarpi, Pietro Fici, Michel Rigaud, Toni Ibrahim, Dino Amadori, Francesco Fabbri, Giulia Gallerani, Alain Puisieux, Fici P., Gallerani G., Morel A.-P., Mercatali L., Ibrahim T., Scarpi E., Amadori D., Puisieux A., Rigaud M., and Fabbri F.
// Pietro Fici 1 , Giulia Gallerani 1 , Anne-Pierre Morel 2, 3, 4, 5, 6 , Laura Mercatali 7 , Toni Ibrahim 7 , Emanuela Scarpi 8 , Dino Amadori 9 , Alain Puisieux 2, 3, 4, 5, 6, 10 , Michel Rigaud 1 , Francesco Fabbri 1 1 Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy 2 Inserm UMR-S1052, Centre de Recherche en Cancerologie de Lyon, Lyon, France 3 CNRS UMR5286, Centre de Recherche en Cancerologie de Lyon, Lyon, France 4 Centre Leon Berard, Lyon, France 5 UNIV UMR1052, Lyon, France 6 Universite de Lyon, Lyon, France 7 Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy 8 Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy 9 Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy 10 Institut Universitaire de France, Paris, France Correspondence to: Pietro Fici, email: pietro.fici@irst.emr.it Keywords: EMT, early breast cancer, tumor aggressiveness, alternative splicing, EMT ratio Received: May 10, 2016 Accepted: November 21, 2016 Published: November 29, 2016 ABSTRACT Epithelial-to-mesenchymal transition (EMT) has been shown to be associated with tumor progression and metastasis. During this process in breast cancer, a crucial role is played by alternative splicing systems. To identify a new early prognostic marker of metastasis, we evaluated EMT-related gene expression in breast cell lines, and in primary tumor tissue from 31 patients with early breast cancer, focusing our attention on EMT-related splicing factors ESRP1, ESRP2 and RBFOX2. Results showed that the expression patterns of these genes were indicative of the onset of EMT in in-vitro models, but not in tissue samples. However, the ratio between ESRP1 or ESRP2 and RBFOX2 significantly decreased during EMT and positively correlated with the EMT-specific phenotype in cell models, representing a promising prognostic markers. Low ESRP1/RBFOX2 ratio value was associated with a higher risk of metastasis ( p < 0.005) in early breast cancer patients, regardless other clinical features. A cut-off of ratio of 1.067 was determined by ROC curve analysis (AUC 0.8375; 95% CI 0.6963–0.9787). Our study show evidence that a decrease in this ratio correlates with cancer progression. The results provide a rationale for using ESRP1/RBFOX2 ratio as a new prognostic biomarker for the early prediction of metastatic potential in breast cancer.