Specificity Protein 1 Expression and Cancer Patients Survival: Impact on Breast Cancer Patients Focusing on Race, Cancer Subclass, and Menopause

Purpose: Transcription factors Specificity protein (Sp) 1 and 3 are known to regulate Baculoviral IAP Repeat-Containing 5 (BIRC5), an inhibitor of apoptosis protein, which is involved with poor prognosis and drug resistance in cancer therapy. The objective of this study is to determine the association of Sp1 expression with the prognosis of breast cancer patients using data from The Cancer Genome Atlas (TCGA) and determine the patient survival in relation to race, cancer subclass and menopause. Methods: Using TCGA data, Sp1 levels were monitored in tumor (n=1032) versus normal (non-tumor) breast tissue (n=114). Patient survival data was used to generate Kaplan Meier plots. Sp1 expression in non-tumor and tumor tissues and the association of Sp1 levels with the survival of patients with an emphasis on race, cancer subclass, menopause status and other factors were evaluated. Results: The analysis of TCGA data sets identified several cancers showing poor prognosis associated with higher expression of Sp transcription factors and BIRC5. The top cancers showing such association include adrenocortical carcinoma, brain lower grade glioma, chromophobe renal cell carcinoma, clear cell renal cell carcinoma, papillary renal cell carcinoma, hepatocellular carcinoma, pancreatic adenocarcinoma, rectal adenocarcinoma, sarcoma, and uterine corpus endometrial carcinoma. Breast cancer data showed poor survival rates with high expression of Sp1 and HER 2+ cancer type (p=0.0034). The expression of Sp1 showed significant variability amongst the Caucasian population in BRCA patient survival (p=0.046). While Sp1 expression is associated with poor survival rates in pre-, peri- and postmenopausal patients (p=0.02), the outcomes are worst among postmenopausal patients. Conclusions: The analysis of TCGA data sets showed a poor prognosis of cancer patients with high levels of Sp1, Sp3 and BIRC5. Overall survival is decreased with higher expression of these markers in multiple cancers including breast cancer. Furthermore, our findings suggest potential variations in prognosis based on factors such as race, cancer subclass, and menopausal status amongst breast cancer patients. Further research is needed to confirm the specific role of Sp transcription factors and BIRC5 in cancer patients’ survival focusing on critical variables such as age, sex, race and tumor stage.