The DAG/PKC/CREB1/TGF-β1 axis drives shear-wave elastography stiffness and malignant progression in triple-negative breast cancer via lipid metabolic reprogramming
Abstract
In clinical practice, triple-negative breast cancer (TNBC) patients with varying levels of lipid metabolism exhibit differences in tumor shear-wave elastography (SWE) stiffness and prognosis, but this association with unclear mechanism. In this study, a clinical cohort from FUSCC (n = 147) demonstrated that both elevated BMI and higher SWE stiffness were significantly associated with poorer long-term prognosis in TNBC patients, and these associations were further validated in multi-TNBC animal models. Our findings emphasize the role of SWE stiffness in capturing BMI-related alterations in the tumor mechanical microenvironment. Based on integrated lipidomic and transcriptomic analyses, we demonstrated that diacylglycerol (DAG) serves as a critical lipid molecule promoting elevated SWE stiffness and malignant progression. Mechanistically, DAG upregulates TGF-β1 expression through PKC-mediated enhancement of CREB1 phosphorylation in multiple TNBC cell lines, directly promoting TNBC progression and activating cancer-associated fibroblasts. This creates a self-sustaining feedback loop that accelerates malignancy. Finally, we confirmed that the DAG/PKC/CREB1/TGF-β1 signaling axis profoundly regulates SWE imaging stiffness in TNBC models, with further validation in clinical samples. Our study establishes SWE stiffness as a non-invasive imaging biomarker for the activation of this specific pro-metastatic pathway, providing a mechanistic basis for interpreting SWE features through a…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 147 participants or records.
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