{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:56:01Z","timestamp":1760144161740,"version":"build-2065373602"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004738","name":"E-Da Hospital","doi-asserted-by":"publisher","award":["EDAHP112009"],"award-info":[{"award-number":["EDAHP112009"]}],"id":[{"id":"10.13039\/501100004738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Protein growth differentiation factor 11 (GDF11) plays crucial roles in cellular processes, including differentiation and development; however, its clinical relevance in breast cancer patients is poorly understood. We enrolled 68 breast cancer patients who underwent surgery at our hospital and assessed the expression of GDF11 in tumorous, ductal carcinoma in situ (DCIS), and non-tumorous tissues using immunohistochemical staining, with interpretation based on histochemical scoring (H-score). Our results indicated higher GDF11 expressions in DCIS and normal tissues compared to tumorous tissues. In addition, the GDF11 H-score was lower in the patients with a tumor size \u2265 2 cm, pathologic T3 + T4 stages, AJCC III-IV stages, Ki67 \u2265 14% status, HER2-negative, and specific molecular tumor subtypes. Notably, the patients with triple-negative breast cancer exhibited a loss of GDF11 expression. Spearman correlation analysis revealed associations between GDF11 expression and various clinicopathological characteristics, including tumor size, stage, Ki67, and molecular subtypes. Furthermore, GDF11 expression was positively correlated with mean corpuscular hemoglobin concentration and negatively correlated with neutrophil count, as well as standard deviation and coefficient of variation of red cell distribution width. These findings suggest that a decreased GDF11 expression may play a role in breast cancer pathogenesis.<\/jats:p>","DOI":"10.3390\/diagnostics14070701","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T14:14:09Z","timestamp":1711548849000},"page":"701","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tissue Expression of Growth Differentiation Factor 11 in Patients with Breast Cancer"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4905-3408","authenticated-orcid":false,"given":"Chia-Chi","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Department of Physical Therapy, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Department of Occupational Therapy, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thung-Lip","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Ting","family":"Tsai","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0562-8310","authenticated-orcid":false,"given":"Chin-Feng","family":"Hsuan","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung 80794, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Chang","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Health Examination Center, E-Da Dachang Hospital, I-Shou University, Kaohsiung 80794, Taiwan"},{"name":"The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao-Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7119-8451","authenticated-orcid":false,"given":"Yung-Chuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Hsun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu-Mei","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yau-Jiunn","family":"Lee","sequence":"additional","affiliation":[{"name":"Lee\u2019s Endocrinologic Clinic, Pingtung 90000, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Ting","family":"Wei","sequence":"additional","affiliation":[{"name":"The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan"},{"name":"Division of General Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.breast.2022.08.010","article-title":"Current and future burden of breast cancer: Global statistics for 2020 and 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