Expression and prognostic significance of MMP9, RANKL, CXCL12, and CXCR4 in Iraqi women with breast cancer

Abstract

Objective: Breast cancer remains a global health burden. The tumour microenvironment plays a key role in invasion and metastasis, partly through the activity of molecules such as MMP9, RANKL, and the CXCL12/CXCR4 axis.

Methods: Blood samples from the periphery were taken from 60 women with breast tumours (30 with primary breast cancers and 30 with benign lesions). The RNA was extracted and then the gene expression levels of MMP9, RANKL, CXCL12 and CXCR4 were measured by real-time PCR. The statistical analysis was performed with SPSS version 26. Comparisons between the groups were determined by Student’s t-test, and p < 0.05 was the threshold for statistical significance.

Results: The mRNA expression levels of MMP9, RANKL, CXCL12, and CXCR4 were significantly higher in the cases of primary breast cancer compared to those having benign lesions with a p-value less than 0.001 for all markers. The mean ± SD expression of CXCL12 was 2.45 ± 1.31 in the cancer group and 0.78 ± 0.75 in the benign group. Along with this, the expression of all four markers was increased in a stepwise fashion with tumour stage and they were significantly correlated with large tumour size (≥3 cm), high histological grade, and lymph node metastasis.

Conclusion: The Iraqi women with breast cancer showed elevated levels of MMP9, RANKL, CXCL12, and CXCR4 expression in tumours, as well as their correlation with advanced clinicopathological features indicates that they may serve as prognostic biomarkers.