Evidence map›Paper›PMID 41972358›Full record

ArticleCancer medicine2026

High Expression of PAPP-A Predicts Poor Outcomes in Oestrogen Receptor-Positive Breast Cancer Patients.

Zeanap Mabruk, Esme Bullock, Xue Xiao, Jingjing Guo, Xuan Zhu, Laura Gómez-Cuadrado, Claus Oxvig, Elizabeth Mallon, Aula Ammar, Amna Malty and 3 more

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In one paragraph

Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Zeanap MabrukCancer Research UK Scotland Centre (Edinburgh), Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, UK.
Esme BullockCancer Research UK Scotland Centre (Edinburgh), Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, UK.
Xue XiaoDepartment of Pathology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.ORCID https://orcid.org/0000-0002-8824-2439
Jingjing GuoDepartment of Pathology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Xuan ZhuDepartment of Pathology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Laura Gómez-CuadradoCancer Research UK Scotland Centre (Edinburgh), Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, UK.
Claus OxvigDepartment of Molecular Biology and Genetics, University of Aarhus, Aarhus, Denmark.
Elizabeth MallonDepartment of Pathology, Queen Elizabeth University Hospital, Glasgow, UK.
Aula AmmarSchool of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-0375-062X
Amna MaltySchool of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, UK.
Kathryn PennelSchool of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0003-0186-1331
Joanne EdwardsSchool of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-7192-6906
Valerie G BruntonCancer Research UK Scotland Centre (Edinburgh), Institute of Genetics & Cancer, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0002-7778-8794

Funding

Cancer Research UK C157/A23219Cancer Research UK CANTAC721\100018Cancer Research UK CTRQQR-2021\100006Endeavour Scholarship 734/2018/878Sichuan Province Science and Technology Support Program NO.2022YFS0601Sichuan Provincial People's Hospital NO.2021ZX02
6 · The paper itself

Abstract

introductionInsulin-like growth factor 1 (IGF-1)/IGF-1 receptor (IGF-1R) signalling is activated in breast cancer and associated with disease progression. Pregnancy-associated plasma protein-A (PAPP-A) is a metalloproteinase that can cleave IGF binding proteins leading to the release of bioactive IGF-1 and the subsequent activation of IGF-1 signalling. Here, we aimed to assess the prognostic significance of PAPP-A in breast cancer.

methodsBreast cancer tissue microarrays were stained for PAPP-A and expression correlated with survival and other clinical features. Analysis of publicly available data sets was carried out to determine associations between PAPPA and gene sets associated with IGF-1/IGF-1R pathway activation.

resultsPAPP-A was expressed in both the tumour and stromal compartments in breast cancer specimens and was higher in oestrogen receptor (ER)-negative (ER-) than ER-positive (ER+) cases. There was a significant association between high PAPP-A expression and reduced cancer-specific survival (CSS) in ER+ (HR 1.389, 95% CI 1.051-1.836, p = 0.021) but not ER- patients (HR 1.040, 95% CI 0.712-1.598, p = 0.838). In a second cohort of ER+ invasive lobular carcinoma (ILC) PAPP-A expression was also associated with reduced CSS (HR 1.765, 95% CI 1.098-2.836, p = 0.019). PAPPA correlated with REACTOME PI3K-AKT and IGF1R signalling gene sets in ER+ breast cancers.

conclusionHigh expression of PAPP-A is associated with poor prognosis in ER+ breast cancer and correlates with IGF-1/IGF-1R pathway activation.

Indexed as

Biomarkers, TumorBreast NeoplasmsPregnancy-Associated Plasma Protein-AReceptors, EstrogenAdultAgedFemaleGene Expression Regulation, NeoplasticHumansInsulin-Like Growth Factor IMiddle AgedPrognosisReceptor, IGF Type 1Signal TransductionBiomarkers, TumorIGF1R protein, humanInsulin-Like Growth Factor IPAPPA protein, humanPregnancy-Associated Plasma Protein-AReceptor, IGF Type 1Receptors, Estrogenbreast cancerIGF‐1 signallinginvasive lobular carcinomapregnancy‐associated plasma protein‐A

Identifiers

PMID41972358
PMCPMC13072045

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.