Purpose: hMena (ENAH), a cytoskeleton regulatory protein involved in the regulation of cell motility and adhesion, is overexpressed in breast cancer. The aim of this study was to define at what stage of breast carcinogenesis hMena is overexpressed and to correlate hMena overexpression with established prognostic factors in breast cancer, focusing on human epidermal growth factor receptor-2 (HER-2). Experimental Design: hMena expression was assessed immunohistochemically in a prospective cohort of cases (n = 360) encompassing a highly representative spectrum of benign breast diseases associated with different risk of transformation, in situ, invasive, and metastatic tumors. Correlations with conventional pathologic and prognostic variables, such as proliferation index, hormonal receptor status, and HER-2 overexpression, were also evaluated. In vitro experiments were done to study the effect of neuregulin-1and Herceptin treatments on hMena expression. Results: hMena protein is undetectable in normal breast and is weakly expressed in a small percentage of low-risk benign diseases (9%), but displays a progressive and significant increase of positivity in benign lesions at higher risk of transformation (slightly increased risk 43%; moderate increased risk 67%), in in situ (72%), invasive (93%), and metastatic breast cancer (91%).A significant direct correlation with tumor size (P = 0.04), proliferation index (P < 0.0001), and HER-2 overexpression (P < 0.0001) and an inverse relationship with estrogen (P = 0.036) and progesterone receptors (P = 0.001) are found in invasive carcinomas. In vitro experiments show that neuregulin-1up-regulates, whereas Herceptin down-regulates, hMena expression. Conclusions: Our data provide new insights into the relevance of actin-binding proteins in human breast carcinogenesis and indicate hMena overexpression as a surrogate indicator in breast disease management.
Management of breast cancer, and other malignancies, islikely to benefit from the identification of early markers of transformation. In this context, major efforts are ongoing in the areas of genomic and proteomic profiling aimed at identifying genetic or biochemical markers related to proliferative lesions heralding the development of breast cancer. In view of the increasing evidence that the host immune response contributes to the editing of the tumor phenotype (1), we have recently isolated, by serologic analysis of cDNA expression libraries (SEREX), hMena (ENAH) protein, the human orthologue of murine Mena, which is overexpressed in over 70% of primary breast cancers (2). Mena belongs to the Ena/VASP protein family, which, by controlling the geometry of the actin filament network (3, 4), represents key regulator molecules of cell movement and shape in a large variety of cell types and organisms (5). It has been suggested that Ena/VASP proteins are members of the adherens junction structures and are required for the actin dynamics necessary to seal membranes into epithelial sheets (6), a process frequently deregula...