EXT1 as an Independent Prognostic Biomarker in Breast Cancer: Its Correlation with Immune Infiltration and Clinicopathological Parameters
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Date
2025-03-13
Journal Title
Journal ISSN
Volume Title
Type
Article
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Series Info
Immuno; Volume 5, Issue 1 , March 2025 , Article number 1
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Abstract
Exostosin 1 (EXT1) encodes a type II transmembrane glycosyltransferase residing
in the endoplasmic reticulum and plays an essential role in the elongation of heparan sulfate
chain biosynthesis. Additionally, EXT1 may act as an oncogene that could promote cell
proliferation as well as cancer cell metastasis. Herein, we investigated EXT1’s expression
pattern and prognostic value in breast cancer, along with its immunological implications.
Immunohistochemical staining of EXT1 was assessed in 85 breast cancer patients. Patients
were categorized into molecular subtypes, namely luminal A, luminal B, and human
epidermal growth factor receptor 2 (HER2), along with triple-negative breast cancer (TNBC).
Correlations of EXT1 immunostaining with clinicopathological parameters were evaluated.
Furthermore, the correlations of EXT1 expression with tumor immune infiltration and
immune cell surface markers were assessed using TIMER. Moreover, survival analysis was
conducted to reveal EXT1’s prognostic value. EXT1 expression was markedly associated
with the status of the estrogen receptor (ER), molecular subtypes, and recurrence status.
In addition, high levels of EXT1 expression were associated with worse overall survival
(OS) and relapse-free survival (RFS). Analysis of immune infiltration indicated that EXT1
expression was positively correlated with dendritic cells (DCs), macrophages, neutrophils,
CD4+ T cells, and CD8+ T cells, although it showed a negative correlation with the tumor
purity. Overall, this study suggests that the elevated EXT1 expression, particularly in TNBC,
has a positive correlation with poor prognosis and with immune-infiltrated cells in breast
cancer. Therefore, it may emerge as an independent prognostic biomarker, immunological
marker, and potential future therapeutic target for the most aggressive TNBC subtype.
Description
Q2
Keywords
exostosin 1 (EXT1), breast cancer, prognosis, immune infiltration
Citation
Hossny, A., Hassan, H. a. F. M., Fahmy, S. A., Abdelazim, H., Kamel, M. M., Osman, A. H., & Ibrahim, S. A. (2024). EXT1 as an Independent Prognostic Biomarker in Breast Cancer: Its Correlation with Immune Infiltration and Clinicopathological Parameters. Immuno, 5(1), 1. https://doi.org/10.3390/immuno5010001