Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis

Abstract Objectives Breast cancer patients with diabetes are often associated with poor prognosis. This study aims to investigate the role of metformin in ferroptosis and cuproptosis in diabetic breast cancer patients and explore its potential impact on clinical outcomes. Methods We retrospectively...

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Main Authors: Changwen Li, Tao Chen, Yuanyuan Li, Chunyan Zhou, Jing Du, Xiaoxin Li, Chuangang Tang, Cheng Ma, Na Deng, Huaixin Cui
Format: Article
Language:English
Published: Springer 2025-04-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-02425-2
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author Changwen Li
Tao Chen
Yuanyuan Li
Chunyan Zhou
Jing Du
Xiaoxin Li
Chuangang Tang
Cheng Ma
Na Deng
Huaixin Cui
author_facet Changwen Li
Tao Chen
Yuanyuan Li
Chunyan Zhou
Jing Du
Xiaoxin Li
Chuangang Tang
Cheng Ma
Na Deng
Huaixin Cui
author_sort Changwen Li
collection DOAJ
description Abstract Objectives Breast cancer patients with diabetes are often associated with poor prognosis. This study aims to investigate the role of metformin in ferroptosis and cuproptosis in diabetic breast cancer patients and explore its potential impact on clinical outcomes. Methods We retrospectively analyzed tissue samples from 16 breast cancer patients, including 5 non-diabetic and 11 diabetic patients (6 treated with metformin). Immunohistochemistry (IHC) staining was performed for cuproptosis (FDX1, DLAT), ferroptosis (ACSL4, GPX4), and glycolysis markers (LDHA, PKM2). Statistical analysis used quantitative results from immunohistochemistry. Results Patients treated with metformin showed significantly higher expression of FDX1 and ACSL4, along with a significant decrease in GPX4 compared to other groups. Kaplan–Meier survival analysis revealed that high FDX1 expression was associated with longer survival in breast cancer patients. Correlation analysis showed a positive association between ACSL4 and FDX1 (R = 0.51, P = 0.045), suggesting a relationship between these markers. Conclusions Metformin may simultaneously enhance both cuproptosis and ferroptosis in breast cancer. FDX1 expression could serve as a prognostic marker for survival, especially in diabetic patients, providing insights into targeting metabolic and cell death pathways in breast cancer therapy.
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spelling doaj-art-dbcd8b0309c54ed9ab5a8cbf79d624732025-08-20T03:52:19ZengSpringerDiscover Oncology2730-60112025-04-0116111110.1007/s12672-025-02425-2Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysisChangwen Li0Tao Chen1Yuanyuan Li2Chunyan Zhou3Jing Du4Xiaoxin Li5Chuangang Tang6Cheng Ma7Na Deng8Huaixin Cui9The Affiliated Xuzhou Clinical College of Xuzhou Medical UniversityThe Affiliated Xuzhou Clinical College of Xuzhou Medical UniversityThe Affiliated Xuzhou Clinical College of Xuzhou Medical UniversityThe Affiliated Xuzhou Clinical College of Xuzhou Medical UniversitySchool of Life Sciences, Jiangsu Normal UniversityDepartment of Pathology, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast UniversityDepartment of Breast Surgery, Xuzhou Central HospitalDepartment of Gastrointestinal Surgery, Xuzhou Central HospitalDepartment of Breast Surgery, Xuzhou Central HospitalThe Affiliated Xuzhou Clinical College of Xuzhou Medical UniversityAbstract Objectives Breast cancer patients with diabetes are often associated with poor prognosis. This study aims to investigate the role of metformin in ferroptosis and cuproptosis in diabetic breast cancer patients and explore its potential impact on clinical outcomes. Methods We retrospectively analyzed tissue samples from 16 breast cancer patients, including 5 non-diabetic and 11 diabetic patients (6 treated with metformin). Immunohistochemistry (IHC) staining was performed for cuproptosis (FDX1, DLAT), ferroptosis (ACSL4, GPX4), and glycolysis markers (LDHA, PKM2). Statistical analysis used quantitative results from immunohistochemistry. Results Patients treated with metformin showed significantly higher expression of FDX1 and ACSL4, along with a significant decrease in GPX4 compared to other groups. Kaplan–Meier survival analysis revealed that high FDX1 expression was associated with longer survival in breast cancer patients. Correlation analysis showed a positive association between ACSL4 and FDX1 (R = 0.51, P = 0.045), suggesting a relationship between these markers. Conclusions Metformin may simultaneously enhance both cuproptosis and ferroptosis in breast cancer. FDX1 expression could serve as a prognostic marker for survival, especially in diabetic patients, providing insights into targeting metabolic and cell death pathways in breast cancer therapy.https://doi.org/10.1007/s12672-025-02425-2Breast cancerMetforminCuproptosisFerroptosisDiabetesGlycolysis
spellingShingle Changwen Li
Tao Chen
Yuanyuan Li
Chunyan Zhou
Jing Du
Xiaoxin Li
Chuangang Tang
Cheng Ma
Na Deng
Huaixin Cui
Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis
Discover Oncology
Breast cancer
Metformin
Cuproptosis
Ferroptosis
Diabetes
Glycolysis
title Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis
title_full Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis
title_fullStr Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis
title_full_unstemmed Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis
title_short Impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients: an immunohistochemical analysis
title_sort impact of diabetes and metformin on cuproptosis and ferroptosis in breast cancer patients an immunohistochemical analysis
topic Breast cancer
Metformin
Cuproptosis
Ferroptosis
Diabetes
Glycolysis
url https://doi.org/10.1007/s12672-025-02425-2
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