Yuning Dai,1,* Yong Yang,1,* Xiaohua Li,2,* Guojian Shi,2,* Ting Ni,1 Qilu Zhu,1 Qin He,1 Aoni Hu,1 Hao Jiang,1 Jianxia Liu,1 Ting Lu,3 Jie Sun,1 Enqiao Yu,1 Liang Sun1 

1Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People’s Republic of China; 2Department of General Surgery, Suzhou Wuzhong People’s Hospital, Suzhou, Jiangsu, 215128, People’s Republic of China; 3Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Enqiao Yu, Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People’s Republic of China, Email yuenqiao2006@163.com Liang Sun, Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People’s Republic of China, Email slyon0511@163.com

Background: Several malignant tumors have been shown to overexpress aldolase A (ALDOA), a crucial enzyme in the glycolytic cycle. Though, it is still unknown how ALDOA contributes to breast cancer (BC).
Methods: Using GEPIA, TIMER, UALCAN, BC-GenExMiner v5.1 database, and immunohistochemistry on 96 BC patients, the expression of ALDOA was investigated. The correlation between ALDOA expression and the prognosis was evaluated by employing the Kaplan-Meier (KM) plotter in breast cancer patients.
Results: The expression of ALDOA mRNA was higher in BC compared to the normal tissues. Certain subtypes of BC showed higher ALDOA expression, including micropapillary, luminal B, non-basal-like, non-triple negative breast cancer (TNBC), and luminal androgen receptor (LAR). Overexpression of ALDOA was related to the presence of lymph node metastasis (LNM), older age, high Ki67 expression, estrogen receptor (ER) and progesterone receptor (PR) positivity, and advanced Scarff-Bloom-Richardson (SBR) and Nottingham Prognostic Index (NPI) grades, while decreased ALDOA mRNA levels were observed in TNBC and basal‐like BC. KM plotter showed that higher ALDOA mRNA levels predicted worse overall survival (OS), relapse-free survival (RFS), and distant metastasis-free survival (DMFS) overall. However, in BC patients with LNM, higher ALDOA levels correlated to better DMFS.
Conclusion: ALDOA was a crucial prognostic factor required for BC advancement, indicating a possible target for BC treatment.

Keywords: ALDOA, expression, prognostic value, breast cancer