The membrane-cytoskeleton crosslinker
ezrin is associated with malignant progression and
metastasis in human
neoplasias. To study the role of
ezrin in
breast cancer, we first assessed
ezrin expression in a panel of
breast cancer cell lines by western blot and confocal microscopy. Western blot revealed no differences in total
ezrin levels among these breast cell lines. However, immunofluorescence staining revealed that
Estrogen receptor (ER)-positive, noninvasive and nontumorigenic cell lines concentrated
ezrin at the apical surface, whereas invasive cell lines localized
ezrin in motile structures (membrane ruffles and filopodia) but also had more diffuse cytoplasmic staining. We next studied
ezrin expression in 509
breast carcinomas using tissue microarrays. Immunohistochemical staining for
ezrin, p53, Ki-67, phospho-Akt, HER2, and hormonal receptors was performed.
Ezrin staining in normal breast epithelium localized at the apical, but not lateral, cell surface, whereas, in most
breast tumor cases (331, 70.3%), it localized in the cytoplasm. Complete membranous staining occurred in 89 (18.9%) samples, and apical staining was seen in 51 (10.8%) cases. There were significant positive associations between cytoplasmic
ezrin localization and adverse
tumor characteristics such as high grade, high level of Ki-67 expression, hormonal-receptor negativity, and
lymph-node metastases. Apical
ezrin staining was associated with favorable clinicopathological features and node-negative
tumors. Membranous
ezrin staining was associated with high grade, strong HER2 and p-Akt expression. In conclusion, the switch of
ezrin localization from the apical membrane to either the complete membrane or to the cytoplasm is correlated with dedifferentiation and adverse features in invasive
breast tumors and
cancer cell lines.