PurposeHeart myxomas have been frequently considered as benign lesions associated with Carney’s complex. However, after surgical removal, myxomas re-emerge causing dysfunctional heart.MethodsTo identify whether cardiac myxomas may develop a metastatic… Click to show full abstract
PurposeHeart myxomas have been frequently considered as benign lesions associated with Carney’s complex. However, after surgical removal, myxomas re-emerge causing dysfunctional heart.MethodsTo identify whether cardiac myxomas may develop a metastatic phenotype as occurs in malignant cancers, a profile of several proteins involved in malignancy such as oncogenes (c-MYC, K-RAS and H-RAS), cancer-associated metabolic transcriptional factors (HIF-1α, p53 and PPAR-γ) and epithelial–mesenchymal transition proteins (fibronectin, vimentin, β-catenin, SNAIL and MMP-9) were evaluated in seven samples from a cohort of patients with atrial and ventricular myxomas. The analysis was also performed in: (1) cardiac tissue surrounding the area where myxoma was removed; (2) non-cancer heart tissue (NCHT); and (3) malignant triple negative breast cancer biopsies for comparative purposes.ResultsStatistical analysis applying univariate (Kruskal–Wallis and Dunn’s tests) and multivariate analyses (PCA, principal component analysis) revealed that heart myxomas (7–15 times) and myxoma surrounding tissue (22–99 times) vs. NCHT showed high content of c-MYC, p53, vimentin, and HIF-1α, indicating that both myxoma and its surrounding area express oncogenes and malignancy-related proteins as occurs in triple negative breast cancer.ConclusionsBased on ROC (receiver operating characteristics) statistical analysis, c-MYC, HIF-1α, p53, and vimentin may be considered potential biomarkers for malignancy detection in myxoma.
               
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