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Welsh KG, Rousseau K, Fisher G, Bonser LR, Bradding P, Brightling CE, Thornton DJ, Gaillard EA. MUC5AC and a Glycosylated Variant of MUC5B Alter Mucin Composition in Children With Acute Asthma. Chest 2017; 152:771-779. [PMID: 28716644 PMCID: PMC5624091 DOI: 10.1016/j.chest.2017.07.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/22/2017] [Accepted: 07/03/2017] [Indexed: 01/21/2023] Open
Abstract
Background Diffuse airway mucus obstruction is an important feature of severe and fatal asthma. MUC5AC and MUC5B are the principal gel-forming mucins found in airway mucus. The mucin composition of airway mucus likely affects its functional properties. Methods We quantified the principal airway mucins MUC5AC and MUC5B in the sputum of age-matched children with acute and stable asthma and healthy control subjects by using Western blotting. Results Sputum samples from 38 children (13 with acute asthma, 15 with stable asthma, 10 control subjects) were obtained. Sputum MUC5AC concentrations were 7.6 μg/mL in control subjects, 22.4 μg/mL in those with stable asthma (P = .17), and 44.7 μg/mL in those with acute asthma (P < .05). MUC5B concentrations showed less variation, with 238.5, 208.4 and 165.9 μg/mL in control subjects, those with stable asthma, and those with acute asthma, respectively. The greater MUC5AC concentration in those with acute asthma resulted in a significantly altered MUC5B:MUC5AC ratio between control subjects and those with acute asthma (P < .05). Significant differences in MUC5B glycoforms were present between the groups, with the low-charge-only glycoform being found uniquely in those with acute asthma. Conclusions Increased MUC5AC and the presence of a low-charge-only MUC5B glycoform significantly altered mucin composition in children with acute asthma. These changes may be important contributory factors to the airway mucus obstruction observed during acute asthma.
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Hochfellner D, Gutierrez I, Fisher G. INDIVIDUAL, EMPLOYER, AND JOB-RELATED INFLUENCES ON LATE WORK CAREERS OUTCOMES AND WORK ABILITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hennessey NW, Fisher G, Ciccone N. Developmental changes in pharyngeal swallowing acoustics: a comparison of adults and children. LOGOP PHONIATR VOCO 2017; 43:63-72. [DOI: 10.1080/14015439.2017.1326526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder (incidence 1:33 000-40 000) characterized by formation of central nervous system tumors, due to mutation in the NF2 gene on chromosome 22q12. Vestibular schwannomas are the hallmark lesion, affecting 95% of individuals and typically occur bilaterally. Schwannomas commonly occur on other nerves intracranially and in the spinal compartment, along with meningiomas, ependymomas, and gliomas. Although histologically benign, tumors are associated with significant morbidity due to multiple problems including hearing and vision loss, gait abnormalities, paralysis, pain, and seizures. Risk of early mortality from brainstem compression and other complications is significant. Severity of disease is higher when NF2 presents during childhood. Children have a more variable presentation, which can be associated with significant delays in recognition of the condition. Careful examination of the skin and eyes can identify important clinical signs of NF2 during childhood, allowing timely initiation of disease-specific surveillance and treatment. Monitoring for complications comprises clinical evaluation, along with functional testing including audiology and serial neuroimaging, which together inform decisions regarding treatment. Evidence for disease-specific medical treatment options is increasing, nevertheless most patients will benefit from multimodal treatment including surgery during their lifetime. Patient enrolment in international natural history and treatment trials offers the best opportunity to accelerate our understanding of the complications and optimal treatment of NF2, with a view to improving outcomes for all affected individuals.
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Fader A, Diaz L, Armstrong D, Tanner E, Uram J, Eyring A, Wang H, Fisher G, Greten T, Le D. Preliminary results of a phase II study: PD-1 blockade in mismatch repair–deficient, recurrent or persistent endometrial cancer. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wang F, Calderone K, Smith N, Do T, Kang S, Voorhees J, Fisher G. 268 Enhanced dermal mechanical support rapidly stimulates fibroblasts and stable accumulation of collagen bundles in photoaged human skin. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rittié L, Farr E, Orringer J, Voorhees J, Fisher G. 296 Reduced sweat gland contribution and cell cohesion delay wound closure in elderly skin. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wang P, Sun M, Xu Y, Xu Y, Voorhees J, Fisher G, Li Y. 267 Once weekly topical all-trans retinol restores type I collagen synthesis in photoaged forearm skin within 4 weeks: A protocol for evaluating anti-aging topical agents. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fisher G. Managing young people with self-harming or suicidal behaviour. Nurs Child Young People 2016; 28:25-31. [PMID: 26856575 DOI: 10.7748/ncyp.28.1.25.s29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This literature review aimed to determine the risk factors being used to identify children and young people who are at increased risk of engaging in self-harm and suicidal behaviour, so that optimal care can be provided for this patient group in children's medical ward settings. The two main themes that emerged were mental and neurodevelopmental disorders, and external factors. Management strategies to aid healthcare professionals in caring for this patient group were also identified. The review concludes by highlighting the need to provide healthcare professionals with continuing education about the mental health problems of children and young people, including risk factors and management strategies.
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Fisher G, Foster C. Examining the Needs of Paediatric Nurses Caring for Children and Young People Presenting with Self-Harm/Suicidal Behaviour on General Paediatric Wards: Findings from a Small-Scale Study. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/13575279.2015.1118013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cuzick J, Stone S, Fisher G, Yang ZH, North BV, Berney DM, Beltran L, Greenberg D, Møller H, Reid JE, Gutin A, Lanchbury JS, Brawer M, Scardino P. Validation of an RNA cell cycle progression score for predicting death from prostate cancer in a conservatively managed needle biopsy cohort. Br J Cancer 2015; 113:382-9. [PMID: 26103570 PMCID: PMC4522632 DOI: 10.1038/bjc.2015.223] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/12/2015] [Accepted: 05/25/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The natural history of prostate cancer is highly variable and difficult to predict accurately. Better markers are needed to guide management and avoid unnecessary treatment. In this study, we validate the prognostic value of a cell cycle progression score (CCP score) independently and in a prespecified linear combination with standard clinical variables, that is, a clinical-cell-cycle-risk (CCR) score. METHODS Paraffin sections from 761 men with clinically localized prostate cancer diagnosed by needle biopsy and managed conservatively in the United Kingdom, mostly between 2000 and 2003. The primary end point was prostate cancer death. Clinical variables consisted of centrally reviewed Gleason score, baseline PSA level, age, clinical stage, and extent of disease; these were combined into a single predefined risk assessment (CAPRA) score. Full data were available for 585 men who formed a fully independent validation cohort. RESULTS In univariate analysis, the CCP score hazard ratio was 2.08 (95% CI (1.76, 2.46), P<10(-13)) for one unit change of the score. In multivariate analysis including CAPRA, the CCP score hazard ratio was 1.76 (95% CI (1.44, 2.14), P<10(-6)). The predefined CCR score was highly predictive, hazard ratio 2.17 (95% CI (1.83, 2.57), χ(2)=89.0, P<10(-20)) and captured virtually all available prognostic information. CONCLUSIONS The CCP score provides significant pretreatment prognostic information that cannot be provided by clinical variables and is useful for determining which patients can be safely managed conservatively, avoiding radical treatment.
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Carter C, Reid T, Fisher G, Cho-Phan C, Kunz P, Kaiser H, Oronsky B, Fanger G, Caroen S, Parker C, Scicinski J. Early Results: “ROCKET” a phase II Study of RRx-001, a novel triple epigenetic inhibitor, Resensitization to Irinotecan in Colorectal Cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv081.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cuzick J, Stone S, Fisher G, North B, Berney D, Beltran L, Greenberg D, Moller H, Reid J, Gutin A, Lanchbury J, Brawer M, Scardino P. Combined Analysis of an Rna Cell Cycle Progression (Ccp) Score for Predicting Prostate Cancer Death in Two Conservatively Managed Needle Biopsy Cohorts. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Merson S, Yang ZH, Brewer D, Olmos D, Eichholz A, McCarthy F, Fisher G, Kovacs G, Berney DM, Foster CS, Møller H, Scardino P, Cuzick J, Cooper CS, Clark JP. Focal amplification of the androgen receptor gene in hormone-naive human prostate cancer. Br J Cancer 2014; 110:1655-62. [PMID: 24481405 PMCID: PMC3960602 DOI: 10.1038/bjc.2014.13] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Androgen receptor (AR)-gene amplification, found in 20-30% of castration-resistant prostate cancer (CRPCa) is proposed to develop as a consequence of hormone-deprivation therapy and be a prime cause of treatment failure. Here we investigate AR-gene amplification in cancers before hormone deprivation therapy. METHODS A tissue microarray (TMA) series of 596 hormone-naive prostate cancers (HNPCas) was screened for chromosome X and AR-gene locus-specific copy number alterations using four-colour fluorescence in situ hybridisation. RESULTS Both high level gain in chromosome X (≥4 fold; n=4, 0.7%) and locus-specific amplification of the AR-gene (n=6, 1%) were detected at low frequencies in HNPCa TMAs. Fluorescence in situ hybridisation mapping whole sections taken from the original HNPCa specimen blocks demonstrated that AR-gene amplifications exist in small foci of cells (≤ 600 nm, ≤1% of tumour volume). Patients with AR gene-locus-specific copy number gains had poorer prostate cancer-specific survival. CONCLUSION Small clonal foci of cancer containing high level gain of the androgen receptor (AR)-gene develop before hormone deprivation therapy. Their small size makes detection by TMA inefficient and suggests a higher prevalence than that reported herein. It is hypothesised that a large proportion of AR-amplified CRPCa could pre-date hormone deprivation therapy and that these patients would potentially benefit from early total androgen ablation.
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Molugu C, Fisher G, Hirons B, Hughes D, Raftery S. P151 V-DimERS Study - Value of D-Dimers in Estimating Risk of Significant Pulmonary Embolism and Deep Vein Thrombosis: Abstract P151 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Spooner B, Fisher G. Peri-operative fitness: a question of stamina? Anaesthesia 2013; 68:1280-1. [PMID: 24219263 DOI: 10.1111/anae.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Krishnan M, Beck S, Cowen O, Hughes M, Havelock W, Eeles E, Hubbard R, Johansen A, Michael A, Teo PJ, Fisher G, Duggan E, Donoghue O, Savva G, Cronin H, Kenny R, Finucane C, Bhutta T, Musarrat K, Lakhani D, Musarrat K, Bhutta T, Kumar M, Bridge D, Patel A, Lakhani D, Marchetti R, Bullman N, Srikusalankul W, Varendran R, Anderson-Ranberg K, Ryg J, Vestergaard S, Eriksen ML, Masud T. Falls, fracture and trauma. Age Ageing 2013. [DOI: 10.1093/ageing/aft101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Robinson R, Nelson C, Kisling K, Fisher G, Kirsner S. SU-E-T-334: APBI Contralateral Breast Dose. Med Phys 2013. [DOI: 10.1118/1.4814768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cuzick J, Yang ZH, Fisher G, Tikishvili E, Stone S, Lanchbury JS, Camacho N, Merson S, Brewer D, Cooper CS, Clark J, Berney DM, Møller H, Scardino P, Sangale Z. Prognostic value of PTEN loss in men with conservatively managed localised prostate cancer. Br J Cancer 2013; 108:2582-9. [PMID: 23695019 PMCID: PMC3694239 DOI: 10.1038/bjc.2013.248] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: The natural history of prostate cancer is highly variable and difficult to predict. We report on the prognostic value of phosphatase and tensin homologue (PTEN) loss in a cohort of 675 men with conservatively managed prostate cancer diagnosed by transurethral resection of the prostate. Methods: The PTEN status was assayed by immunohistochemistry (PTEN IHC) and fluorescent in situ hybridisation (PTEN FISH). The primary end point was death from prostate cancer. Results: The PTEN IHC loss was observed in 18% cases. This was significantly associated with prostate cancer death in univariate analysis (hazard ratio (HR)=3.51; 95% CI 2.60–4.73; P=3.1 × 10−14). It was highly predictive of prostate cancer death in the 50% of patients with a low risk score based on Gleason score, PSA, Ki-67 and extent of disease (HR=7.4; 95% CI 2.2–24.6; P=0.012) ), but had no prognostic value in the higher risk patients. The PTEN FISH loss was only weakly associated with PTEN IHC loss (κ=0.5). Both PTEN FISH loss and amplification were univariately predictive of death from prostate cancer, but this was not maintained in the multivariate analyses. Conclusion: In low-risk patients, PTEN IHC loss adds prognostic value to Gleason score, PSA, Ki-67 and extent of disease.
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Ahmad I, Singh LB, Yang ZH, Kalna G, Fleming J, Fisher G, Cooper C, Cuzick J, Berney DM, Møller H, Scardino P, Leung HY. Mir143 expression inversely correlates with nuclear ERK5 immunoreactivity in clinical prostate cancer. Br J Cancer 2013; 108:149-54. [PMID: 23321517 PMCID: PMC3553517 DOI: 10.1038/bjc.2012.510] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: Aberrant mitogen/extracellular signal-regulated kinase 5 (MEK5)–extracellular signal-regulated protein kinase 5 (ERK5)-mediated signalling has been implicated in a number of tumour types including prostate cancer (CaP). The mechanism for ERK5 activation in CaP remains to be fully elucidated. Studies have recently implicated the role of microRNA (miRNA) mir143 expression in the regulation of ERK5 expression. Methods: We utilised a tissue microarray (TMA) of 530 CaP cores from 168 individual patients and stained for both mir143 and ERK5. These TMAs were scored by a combination of observer and automated methods. Results: We observed a strong inverse relation between ERK5 and mir143, which manifested itself most strongly in the subgroup of 417 cores with non-zero mir143 and ERK5 immunoreactivity, or with only one of mir143 or ERK5 being zero (cc=0.2558 and P<0.0001). Mir143 neither correlate with Gleason scores or prostate-specific antigen levels, nor was it a predictor of disease-specific survival on univariate analysis. Conclusion: Although the mechanism for ERK5 activation in CaP remains to be fully elucidated, we have further validated the potential role of mir143 in regulating ERK5 levels in the clinical context. In addition, we demonstrate that the automated counting method for nuclear ERK5 is a clinically useful alterative to observer counting method in patient stratification in the context of ERK5 targeting therapy.
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Fisher G, Ramadan H, Thomson O. Can a high-velocity low-amplitude thrust manipulation of C1-2 affect active depression of the temporomandibular joint in a symptomatic population? INT J OSTEOPATH MED 2013. [DOI: 10.1016/j.ijosm.2013.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khoshkhahesh F, Siahkuhain M, Fisher G, Nakhostin-Roohi B. Influence of a low-dose cox-2 inhibitor drug on exercise-induced inflammation, muscle damage and lipid peroxidation. Biol Sport 2013; 30:61-5. [PMID: 24744468 PMCID: PMC3944556 DOI: 10.5604/20831862.1029824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2012] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to examine the effect of acute low-dose celecoxib administration on exercise-induced inflammation, muscle damage and lipid peroxidation. Twenty healthy untrained males (age: 25.5±4.5 yrs, weight: 72.7±7.9 kg, height: 177.3±7.2 cm) were randomly assigned to treatment (T) or placebo (P) groups. Blood samples were obtained before, immediately after, 3 h after and 24 h after exercise. Subjects ran for 30 min at 75% V.O2 max on a treadmill. Participants consumed 100 mg celecoxib or a placebo immediately after and 12 h after the immediately post-exercise blood sample. Total leukocytes, neutrophils, creatine kinase (CK), C-reactive protein (CRP) and malondialdehyde (MDA) were assessed at each time point. Significant increases in total leukocytes and neutrophils were observed 3 h after exercise in both groups (P < 0.05). CK and CRP levels were significantly increased immediately, 3 h and 24 h after exercise in both groups (P < 0.05). A significant increase in MDA was observed immediately after exercise in both groups (P < 0.05); however, no significant group differences were observed for MDA or CK. These findings suggest that inhibition of cyclo-oxygenase activity with low-dose celecoxib does not affect exercise-induced inflammation, muscle damage, or lipid peroxidation.
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Fisher G, Yang ZH, Kudahetti S, Møller H, Scardino P, Cuzick J, Berney DM. Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort. Br J Cancer 2013; 108:271-7. [PMID: 23329234 PMCID: PMC3566811 DOI: 10.1038/bjc.2012.598] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Standard clinical parameters cannot accurately differentiate indolent from aggressive prostate cancer. Our previous work showed that immunohistochemical (IHC) Ki-67 improved prediction of prostate cancer death in a cohort of conservatively treated clinically localised prostate cancers diagnosed by transurethral resection of the prostate (TURP). Here, we present results in a more clinically relevant needle biopsy cohort. Methods: Biopsy specimens were microarrayed. The percentage of Ki-67 positively stained malignant cells per core was measured and the maximum score per individual used in analysis of time to death from prostate cancer using a Cox proportional hazards model. Results: In univariate analysis (n=293), the hazard ratio (HR) (95% confidence intervals) for dichotomous Ki-67 (⩽10%, >10%) was 3.42 (1.76, 6.62) χ2 (1 df)=9.8, P=0.002. In multivariate analysis, Ki-67 added significant predictive information to that provided by Gleason score and prostate-specific antigen (HR=2.78 (1.42, 5.46), χ2 (1 df)=7.0, P=0.008). Conclusion: The IHC Ki-67 scoring on prostate needle biopsies is practicable and yielded significant prognostic information. It was less informative than in the previous TURP cohort where tumour samples were larger and more comprehensive, but in more contemporary cohorts with larger numbers of biopsies per patient, Ki-67 may prove a more powerful biomarker.
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Staley KG, Fisher G, Brightling CE, Bradding P, Parker D, Gaillard EA. S79 Sputum Inflammatory Cell Profile in Children with Acute Asthma and Following Recovery: Abstract S79 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jeetle SS, Fisher G, Yang ZH, Stankiewicz E, Møller H, Cooper CS, Cuzick J, Berney DM. Neuroendocrine differentiation does not have independent prognostic value in conservatively treated prostate cancer. Virchows Arch 2012; 461:103-7. [PMID: 22767265 DOI: 10.1007/s00428-012-1259-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/10/2012] [Accepted: 05/28/2012] [Indexed: 11/26/2022]
Abstract
In vitro studies have implicated neuroendocrine differentiation in the development of hormone resistant prostate cancer following administration of androgen blockers. Studies on clinical material are equivocal. We wished to understand the significance of neuroendocrine differentiation in our large and well-characterised cohort of clinically localised prostate cancer, treated conservatively. Immunohistochemical expression of chromogranin-A was assessed semi-quantitatively on tissue samples of 806 patients in a tissue microarray approach. The correlation of expression with 10-year prostate cancer survival was examined. Multivariate analysis including contemporary Gleason score was performed and sub-group analysis of early hormone treated patients was also undertaken. Chromogranin-A expression correlated with high Gleason score (χ(2) = 28.35, p < 0.001) and early prostate cancer death (HR = 1.61, 95 %CI = 1.15-2.27, p < 0.001). In univariate analysis, NE differentiation correlated significantly with outcome (HR = 1.61, 95 % CI 1.15-2.27, p < 0.001) However in multivariate analysis including Gleason score, chromogranin-A expression was not an independent predictor of survival (HR = 0.97, 95 %CI = 0.89-1.37, p = 0.87). Although chromogranin-A expression was higher in patients with early hormone therapy (χ(2) = 7.25, p = 0.007), there was no association with prostate cancer survival in this sub-group (p = 0.083). Determination of neuroendocrine differentiation does not appear to have any bearing on the outcome of prostatic carcinoma and does not add to the established prognostic model.
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