Role of secreted protein acidic in hematogenous metastasis of gastric cancer

OBJECTIVE

To investigate tumor microenvironment of metastasis (TMEM) and the expression of SPARC (secreted protein acidic and rich in cysteine) in gastric cancer, and their relationships with hematogenous metastasis.

PATIENTS AND METHODS

Twenty-six pairs of cases with gastric cancer were enrolled, in which there were 26 cases with distant organ metastases and 26 cases of gastric cancer without organ metastases as controls. TMEM (by double-stained immunohistochemistry) and the expression of SPARC were determined in twenty-six pairs of cases. In addition, we selected 48 patients to detect the expression of SPARC, VEGF (vascular endothelial growth factor), and evaluated TAMs (tumor associated macrophages), MVD (the microvessel density), MPI (microvessel pericyte coverage index), and TMEM in gastric cancer tissues by immunohistochemistry.

RESULTS

TMEM count was significantly higher in the metastatic gastric cancer tissues than that in non-metastatic cancer tissues in a case-control study (p<0.01). On the contrary, SPARC expression was lower in the metastatic gastric cancer tissues than that in non-metastatic cancer tissues. TMEM count, TAMs, and MVD were significantly correlated with invasion depth, histological type and TNM stage (p<0.05 or p<0.01). Expression of SPARC and VEGF were significantly correlated with tumor histological types, invasion depth, differentiation and lymph node metastasis of patients (p<0.05). SPARC and VEGF expression in stromal cells of gastric cancer tissues were significantly correlated with TAMs, MVD and MPI (p<0.05). In addition, SPARC expression was significantly inversely correlated with VEGF expression in gastric cancer tissues (p<0.05).

CONCLUSIONS

TMEM was detected in initial gastric cancer resection and closely correlated with hematogenous metastasis. Furthermore, SPARC may be involved in gastric cancer metastasis by effecting on tumor microenvironment.

Magnetic Fluctuations, Precursor Phenomena, and Phase Transition in MnSi under a Magnetic Field

The reference chiral helimagnet MnSi is the first system where Skyrmion lattice correlations have been reported. At a zero magnetic field the transition at T_{C} to the helimagnetic state is of first order. Above T_{C}, in a region dominated by precursor phenomena, neutron scattering shows the buildup of strong chiral fluctuating correlations over the surface of a sphere with radius 2π/ℓ, where ℓ is the pitch of the helix. It has been suggested that these fluctuating correlations drive the helical transition to first order following a scenario proposed by Brazovskii for liquid crystals. We present a comprehensive neutron scattering study under magnetic fields, which provides evidence that this is not the case. The sharp first order transition persists for magnetic fields up to 0.4 T whereas the fluctuating correlations weaken and start to concentrate along the field direction already above 0.2 T. Our results thus disconnect the first order nature of the transition from the precursor fluctuating correlations. They also show no indication for a tricritical point, where the first order transition crosses over to second order with increasing magnetic field. In this light, the nature of the first order helical transition and the precursor phenomena above T_{C}, both of general relevance to chiral magnetism, remain an open question.

Abstract P5-09-02: Breast cancer risk prediction using a polygenic risk score in women of African ancestry: Findings from GWAS in breast cancer in the African diaspora

Background: Multiple common susceptibility loci for breast cancer (BC) have been identified/confirmed in Caucasian women. Combination of these SNPs into a polygenic risk score (PRS) could improve risk stratification and provide guidance for preventive and screening strategies. However, due to differences in allele frequencies of genetic variants, tumor characteristics between women of African and European ancestries, we sought to evaluate the association of PRS with BC in a large consortium of African women.

Methods: The GWAS in BC in the African Diaspora (ROOT consortium) included 3686 participants of African ancestry from Nigeria, USA, and Barbados (1657 cases, 2029 controls). PRS was constructed from the published odds ratios (ORs) from 90 susceptibility loci for BC. Logistic regression was used to examine its association with overall BC risk as well as associations by hormone receptor status, family history and other clinical features.

Results: One unit change in the PRS was associated with an OR of 1.13 (95% CI: 1.01-1.28, P=0.042) for overall BC risk, 1.15 (95%CI: 0.95-1.41, P=0.160) for ER+ BC risk, and 1.17 (95%CI: 0.95-1.44, P=0.133) for ER- BC risk. The ORs for developing BC by percentiles of the PRS, relative to women in the middle quintile, showed weak linear trend. The discriminative accuracy of the PRS, as measured by the C-statistic, was 0.524 (95% CI: 0.505-0.542) for overall BC, 0.511(95% CI: 0.479-0.543) for ER+ BC, and 0.513 (95% CI: 0.481-0.545) for ER- BC. There was a statistically significant interaction between PRS and age, the association between PRS and overall BC risk were stronger in two age groups (aged &lt;40 years and ≥60 years). The PRS was also more strongly associated with PR+ (OR=1.26, 95%CI: 1.01-1.58) compared to PR- (OR=1.08, 95%CI: 0.95-1.44) BC. Association between PRS and BC were similarly non-significant across different strata of family history of BC, BMI, alcohol consumption, oral contraceptive use, menopausal, ER and HER2 status.

Table 1. Performance of the 90-SNP polygenic risk score (PRS) in the GWAS in Breast Cancer in the African DiasporaPercentile of PRS (%) OR (95%CI)  Overall BC (n=1657) vs Ctrl (n=2029)ER+ BC (n=403) vs Ctrl (n=2029)ER- BC (n=374) vs Ctrl (n=2029)&lt;51.01 (0.73-1.41)1.32 (0.28-2.13)0.89 (0.51-1.55)5-100.83 (0.59-1.15)0.71 (0.40-1.26)0.63 (0.34-1.17)10-200.74 (0.57-0.95)0.69 (0.44-1.07)0.72 (0.46-1.12)20-400.97 (0.79-1.19)0.80 (0.56-1.14)0.98 (0.69-1.39)40-601.00 (ref)1.00(ref)1.00(ref)60-800.89 (0.73-1.10)0.94 (0.66-1.33)0.90 (0.63-1.28)80-901.14 (0.89-1.47)0.87 (0.56-1.34)0.90 (0.63-1.28)90-951.14 (0.82-1.58)1.54 (0.92-2.58)0.88 (0.48-1.61)&gt;951.10 (0.79-1.52)1.15 (0.67-1.99)1.34 (0.79-2.25)Note: Odds ratios are for different percentiles of the PRS relative to the middle quintile (40% to 60%). Odds ratios were adjusted for study site and the first ten eigenvectors from principal components analysis.

Conclusion: BC PRS obtained from prior GWASs conducted in Caucasian women didn't provide a comparable degree of risk stratification for African Americans. Additional studies are needed to identify SNPs specific to women of African ancestry that could provide improved risk prediction. Further studies can also combine the PRS with lifestyle/environmental factors.

Citation Format: Wang S, Qian F, Zheng Y, Ogundiran T, Ojengbede O, Zheng W, Blot W, Nathanson KL, Hennis A, Nemesure B, Ambs S, Olopade OI, Huo D. Breast cancer risk prediction using a polygenic risk score in women of African ancestry: Findings from GWAS in breast cancer in the African diaspora [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-09-02.

High tumor-infiltrating FoxP3+ T cells predict poor survival in estrogen receptor-positive breast cancer: A meta-analysis

AIMS

Tumor-infiltrating FoxP3⁺ T cells and FoxP3⁺ tumor cells have been reported in breast cancer (BC), which impaired immunity and promoted tumors progression. However, their prognostic value for survival in patients with breast BC remains controversial.

METHODS

A meta-analysis was performed. Original data included the hazard ratios (HR) of overall survival (OS), relapse-free survival and odds ratio (OR) in BC patients. We pooled HR/OR with 95% confidence intervals (CI) to estimate the hazard.

RESULTS

The overall survival of high tumor-infiltrating FoxP3⁺ T cells patients was lower than low tumor-infiltrating FoxP3⁺ T cells patients with estrogen receptor (ER)-positive (HR 0.86, 95% CI 0.77-0.96; P = 0.009) but not ER-negative (HR 1.09, 95% CI 0.82-1.45; P = 0.569) BC. And FoxP3⁺ tumor cells were not associated with the overall survival and recurrences of BC patients (P > 0.05). In addition, a significant association was revealed between high tumor-infiltrating FoxP3⁺ T cells and grade (I + II/III: OR 0.31, 95% CI 0.17-0.56; P < 0.001), ER status (present: OR 2.39, 95% CI 1.51-3.76; P < 0.001), HER2 status (present: OR 0.53, 95% CI 0.36-0.78; P = 0.001), PR status (present: OR 1.88, 95% CI 1.31-2.71; P < 0.001). And a significant association was revealed between positive FoxP3⁺ tumor cells and Nodal status (present: OR 0.48, 95% CI 0.23-0.97; P = 0.04), grade (I + II/III: OR 0.44, 95% CI 0.22-0.85; P = 0.01), PR status (present: OR 2.37, 95% CI 1.54-3.36; P < 0.001).

CONCLUSIONS

High tumor-infiltrating FoxP3⁺ T cells were associated with a poorer prognosis for ER-positive BC, but not for ER-negative BC.

Serum Cholesterol Levels within the High Normal Range Are Associated with Better Cognitive Performance among Chinese Elderly

OBJECTIVES

The association between cognitive function and cholesterol levels is poorly understood and inconsistent results exist among the elderly. The purpose of this study is to investigate the association of cholesterol level with cognitive performance among Chinese elderly.

DESIGN

A cross-sectional study was implemented in 2012 and data were analyzed using generalized additive models, linear regression models and logistic regression models.

SETTING

Community-based setting in eight longevity areas in China.

SUBJECTS

A total of 2000 elderly aged 65 years and over (mean 85.8±12.0 years) participated in this study.

MEASUREMENTS

Total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) concentration were determined and cognitive impairment was defined as Mini-Mental State Examination (MMSE) score ≤23.

RESULTS

There was a significant positive linear association between TC, TG, LDL-C, HDL-C and MMSE score in linear regression models. Each 1 mmol/L increase in TC, TG, LDL-C and HDL-C corresponded to a decreased risk of cognitive impairment in logistic regression models. Compared with the lowest tertile, the highest tertile of TC, LDL-C and HDL-C had a lower risk of cognitive impairment. The adjusted odds ratios and 95% CI were 0.73(0.62-0.84) for TC, 0.81(0.70-0.94) for LDL-C and 0.81(0.70-0.94) for HDL-C. There was no gender difference in the protective effects of high TC and LDL-C levels on cognitive impairment. However, for high HDL-C levels the effect was only observed in women. High TC, LDL-C and HDL-C levels were associated with lower risk of cognitive impairment in the oldest old (aged 80 and older), but not in the younger elderly (aged 65 to 79 years).

CONCLUSIONS

These findings suggest that cholesterol levels within the high normal range are associated with better cognitive performance in Chinese elderly, specifically in the oldest old. With further validation, low cholesterol may serve a clinical indicator of risk for cognitive impairment in the elderly.

The pore architecture of the cystic fibrosis transmembrane conductance regulator channel revealed by co-mutation in pore-forming transmembrane regions

The cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel contains 12 transmembrane (TM) regions that are presumed to form the channel pore. However, there is no direct evidence clearly illustrating the involvement of these transmembrane regions in the actual CFTR pore structure. To obtain insight into the architecture of the CFTR channel pore, we used patch clamp recording techniques and a strategy of co-mutagenesis of two potential pore-forming transmembrane regions (TM1 and TM6) to investigate the collaboration of these two TM regions. We performed a range of specific functional assays comparing the single channel conductance, anion binding, and anion selectivity properties of the co-mutated CFTR variants, and the results indicated that TM1 and TM6 play vital roles in forming the channel pore and, thus, determine the functional properties of the channel. Furthermore, we provided functional evidence that the amino acid threonine (T338) in TM6 has synergic effects with lysine (K95) in TM1. Therefore, we propose that these two residues have functional collaboration in the CFTR channel pore and may collectively form a selective filter.

Local proliferation initiates macrophage accumulation in adipose tissue during obesity

Obesity-associated chronic inflammation is characterized by an accumulation of adipose tissue macrophages (ATMs). It is generally believed that those macrophages are derived from peripheral blood monocytes. However, recent studies suggest that local proliferation of macrophages is responsible for ATM accumulation. In the present study, we revealed that both migration and proliferation contribute to ATM accumulation during obesity development. We show that there is a significant increase in ATMs at the early stage of obesity, which is largely due to an enhanced in situ macrophage proliferation. This result was obtained by employing fat-shielded irradiation and bone marrow reconstitution. Additionally, the production of CCL2, a pivotal chemoattractant of monocytes, was not found to be increased at this stage, corroborating with a critical role of proliferation. Nonetheless, as obesity proceeds, the role of monocyte migration into adipose tissue becomes more significant and those new immigrants further proliferate locally. These proliferating ATMs mainly reside in crown-like structures formed by macrophages surrounding dead adipocytes. We further showed that IL-4/STAT6 is a driving force for ATM proliferation. Therefore, we demonstrated that local proliferation of resident macrophages contributes to ATM accumulation during obesity development and has a key role in obesity-associated inflammation.

Medical students' child oral-health-related knowledge, practices and attitudes

OBJECTIVE

This study evaluated medical interns' oral health knowledge, and other factors influencing their ability and willingness to perform oral-health-related practices for high-caries-risk children.

METHODS

A 15-item survey was emailed to all eligible graduating fifth-year medical students at King Khalid University Hospital to address these areas of interest. Chi-square statistics and logistic regression models were used to analyse data.

RESULTS

One-hundred and twenty-one (49%) usable surveys were returned from two mailings. On questions regarding comfort levels when performing oral-health-related practices on children under age 3, physicians noted high levels of comfort with all specified oral health practices. Regarding satisfaction of students with medical training, the majority of respondents (87.5%) rated their medical training as fair or poor in preparing them for oral health assessments compared to only 35%, 29% and 7% of respondents giving fair or poor ratings to child abuse identification, caring for special needs patients and primary care paediatric practice, respectively. Additionally, although 90% of respondents noted that the role of primary physicians in counselling/referring children with oral health was important, 60% did not agree with the AAPD and AAP guidelines that state that all children should be referred to a dentist by 12 months of age. Multivariate logistic regression analyses revealed several statistically significant variables that predict the likelihood of performing various oral-health-related practices. The choice of public-health-oriented future clinical goals, the level of oral health knowledge, how interns rated their oral health training in medical school and the average number of children seen per week, all--to varying degrees--proved important predicator variables for the likelihood of performing them once in practice.

CONCLUSIONS

More oral-health-related training of medical students seems warranted and could improve their interest in providing oral-health-related screening and referrals in practice. Increasing student exposure to child patients and increasing exposures to oral health knowledge and problems could be targeted towards students interested in primary care and public health to use resources most efficiently in the effort to combat the growing caries levels amongst young children in Saudi Arabia.

In VitroandIn VivoReversal of Cancer Cell Multidrug Resistance by 2',4'-Dihydroxy-6'-methoxy-3',5'- dimethylchalcone

2',4'-Dihydroxy-6'-methoxy-3',5'-dimethylchalcone (DMC) isolated from the buds of Cleistocalyx operculatus, was investigated for its reversal effects on cancer cell multidrug resistance. DMC potentiated the cytotoxicity of the chemotherapeutic agent doxorubicin to drug-resistant KB-A1 cells. When 5 microM DMC was present simultaneously with doxorubicin, the IC50 of DOX on KB-A1 cells decreased from 13.9 +/- 0.7 microg/ml to 3.6 +/- 0.7 microg/ml. A human carcinoma xenograft model was established with the KB-A1 cell line. DMC could sensitize the tumors to doxorubicin as indicated by a considerable reduction in tumor weight. DMC increased the intracellular accumulation of doxorubicin in KB-A1 cells. When KB-A1 cells were exposed to 10 microg/ml doxorubicin combined with 5, 10, 20 microM DMC for 4 hours, the intracellular concentrations of doxorubicin were increased 1.4-, 1.8-, 3.1-fold, respectively, in comparison with doxorubicin alone treatment. All results indicated that DMC had reversal effects on the multidrug resistance phenotype.

Benign pelvic metastatic leiomyoma: case report

Benign metastasizing leiomyoma is a rare condition characterized by benign soft tissue tumors most frequently involving the lung, and is usually associated with a benign leiomyoma or intravenous leiomyomatosis of the uterus. We present a case of a 58-year-old female patient with abdominal pain and symptoms of urinary tract infection four years after hysterectomy due to uterine fibroid. The results of CT revealed a pelvic mass. Pathological examination confirmed that it was a metastatic pelvic benign metastasizing leiomyoma (BML). BML only involving the pelvis is extremely rare. The patient underwent surgical resection and recovered well.