A novel FOXM1 isoform, FOXM1D, promotes epithelial-mesenchymal transition and metastasis through ROCKs activation in colorectal cancer

Epithelial-mesenchymal transition (EMT) is a critical event in metastasis of colorectal cancer (CRC). Rho/ROCKs signaling has a pivotal role in orchestrating actin cytoskeleton, leading to EMT and cancer invasion. However, the underlying mechanisms for ROCKs activation are not fully understood. Here, we identified FOXM1D, a novel isoform of Forkhead box M1 (FOXM1) that has a pivotal role in ROCKs activation by directly interacting with coiled-coil region of ROCK2. FOXM1D overexpression significantly polymerizes actin assembly and impairs E-cadherin expression, resulting in EMT and metastasis in xenograft mouse model and knockdown of FOXM1D has the opposite effect. Moreover, a high FOXM1D level correlates closely with clinical CRC metastasis. FOXM1D-induced ROCKs activation could be abrogated by the ROCKs inhibitors Y-27632 and fasudil. These observations indicate that the FOXM1D-ROCK2 interaction is crucial for Rho/ROCKs signaling and provide novel insight into actin cytoskeleton regulation and therapeutic potential for CRC metastasis.

Model Construction for Biological Age Based on a Cross-Sectional Study of a Healthy Chinese Han population

OBJECTIVES

Biological age (BA) has been proposed to evaluate the aging status in an objective way instead of chronological age (CA). The purpose of our study is to construct a more precise formula of BA in the cross-sectional study based on a largest-ever sample of our studies. This formula aims at better evaluation of body function and exploring the disciplines of aging in different genders and age stages.

METHODS

A total of 1,373 healthy Chinese Han (age range, 19-93 years) were recruited from five cities in China, including 581 males and 792 females. Physical examination, blood routine, blood chemistry, and other lab tests were performed to obtain a total of 74 clinical variables. Then, the principal component analysis (PCA) was used to select variables and estimate BA. The BA formula was further validated in a population with some diseases (n=266), including cardiovascular diseases, type 2 diabetes, kidney diseases, pulmonary diseases, cancer and disorders in nervous system.

RESULTS

The BA formula was constructed as follows: BA = 0.358 (pulse pressure) + 0.258 (trail making test) - 11.552 (mitral valve E/A peak) + 26.383 (minimum intima-media thickness) + 31.965 (Cystatin C) + 0.163 (CA) - 3.902. In validation of the formula, BAs of patients were older than those of healthy persons. The BA accelerates faster in the middle-aged population than in the elderly population (>75 years old).

CONCLUSION

This BA formula can reflect health condition changes of aging better than CA in a Chinese Han population.

[Significance of the combined detection of routine blood test, serum iron and hemoglobin electrophoresis in screening thalassemia in non- high incidence area]

目的

通过分析血常规、血清铁含量及血红蛋白电泳对地中海贫血(地贫)检出率的影响，寻找在地贫非高发区高效的联合检测方法。

方法

抽取上海交通大学医学院附属瑞金医院门诊血液科及妇产科1 000例疑诊地贫患者外周血，EDTA抗凝管及血清管。抽提全血DNA，以跨越裂口PCR(GAP-PCR)及反向斑点杂交法进行地贫常见突变基因检测；进行血常规及血红蛋白电泳检测；GAPPCR及Sanger法测序进行稀有α及β地贫基因检测；作血清铁含量测定。

结果

1 000份标本经常规基因检测，诊断α地贫225例(22.5%)，其中静止型28例，标准型138例及HbH病59例；β地贫403例(40.3%)，其中β地贫携带者390例，β双重杂合子7例以及β纯合子6例；αβ复合地贫15例(1.5%)；未检出常见突变的有357例。1 000例患者中红细胞平均体积(MCV)或红细胞平均血红蛋白含量(MCH)增高的有38例，无一例检出地贫基因；血清铁含量增高且MCV不增高的48例患者，42例(87.5%)检出地贫基因；血红蛋白电泳异常的38例患者中35例为HbH病，另3例为HbF含量高的其他类型地贫患者，符合率为100%。1 000例患者中，有5例患者血红蛋白电泳异常并伴有MCV及MCH降低、血清铁不低，虽常规基因检测未发现突变，经进一步测序分析，均发现稀有突变。

结论

MCV及MCH不低于正常参考范围可基本排除地贫，血清铁含量高为地贫提示及分类指标，血红蛋白电泳异常提示地贫可能。此三者联合检查结果均异常而基因检测未显示异常的，建议进一步进行稀有分型的测序分析。三者联合检测可提高非地贫患者的排除率及地贫患者的检出率。

The Plasma microRNA miR-1914* and -1915 Suppresses Chemoresistant in Colorectal Cancer Patients by Down-regulating NFIX

OBJECTIVE

We investigated mechanisms of colorectal cancer (CRC) chemoresistance to first-line chemotherapy (capecitabine plus oxaliplatin (XELOX)) and identified two putative chemoresistant microRNAs, miR-1914* and -1915, that are downregulated in plasma samples from patients with chemoresistant CRC.

METHODS

A number of plasma samples from CRC patients were analyzed for the levels of miR-1914* and - 1915. Effects of stable and transient expression of 2 microRNAs in human chemoresistant CRC cell lines were analyzed. Tumor formation and chemoresistance in HCT116/5-Fu/OXA that did or did not express 2 microRNAs were analyzed in mice. Nuclear factor I/X (NFIX) was predicted to target the gene of 2 miRNAs and verified in vivo and in vitro.

RESULTS

Plasma levels of miR-1914* and -1915 in chemoresistant CRC patients were different than levels in responders, and associated with clinical response. Overexpression of miR-1914* and -1915 in chemoresistant CRC cells reduced resistance to 5-FU and Oxaliplatin in vitro. The microRNAs suppressed chemoresistance in CRC tumors in mice by affecting cell growth, invasion, apoptosis and tumor suppressor function. miR-1914* and -1915 interacted with the 3'-untranslated region of NFIX and reduced NFIX its level in chemoresistant CRC cells. Overexpression of NFIX did not inhibit chemoresistant CRC cell motility and chemoresistant proteins when miR-1914* and -1915 were transfected.

CONCLUSION

Plasma miR-1914* and -1915 interact with NFIX RNA and reduce its level in chemoresistant CRC cells to first-line chemotherapy. Up-regulation of miR-1914* and -1915 decreased the chemoresistance abilities of chemoresistant CRC cells. The plasma miR-1914* and -1915 may play a role in colorectal cancer therapy and diagnosis.

Associations between vitamin D receptor gene polymorphisms and ankylosing spondylitis in Chinese Han population: a case-control study

We assessed whether the vitamin D receptor gene polymorphisms (FokI, BsmI, ApaI, and TaqI) were associated with ankylosing spondylitis (AS) in a Chinese Han population. The TaqI polymorphism G allele was a risk factor in AS susceptibility.

INTRODUCTION

Previous studies have found that serum vitamin D levels are declined in patients with AS. The present study aims to evaluate the role of vitamin D receptor (VDR) gene polymorphisms in AS susceptibility in a Chinese Han population.

METHODS

Four single nucleotide polymorphisms (SNPs) in the VDR gene (FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236)) were genotyped by the improved multiplex ligase detection reaction (iMLDR) method in 620 AS patients and 620 geographically and ethnically matched healthy controls. Haplotypes were constructed after linkage disequilibrium (LD) analysis.

RESULTS

Statistically significant difference was only found in the TaqI polymorphism between AS patients and controls. The TaqI polymorphism G allele was higher in AS group than that in controls (OR [95 % CI] = 1.624 [1.122-2.352], χ (2) = 6.705, P = 0.006). Linkage disequilibrium has been detected in TaqI and BsmI polymorphisms (D' = 0.87, r (2) = 0.70). Two novel haplotypes (H1: AC and H2: GT) were significantly associated with the risk of AS, and they play protective and risk roles in AS morbidity, respectively.

CONCLUSIONS

The VDR gene TaqI polymorphism G allele may be a risk factor in AS susceptibility.

Collapsin response mediator protein-1 (CRMP1) acts as an invasion and metastasis suppressor of prostate cancer via its suppression of epithelial-mesenchymal transition and remodeling of actin cytoskeleton organization

The cancer cells can acquire migration and invasion capacities during the metastasis process through the developmental regulatory program epithelial–mesenchymal-transition (EMT), and through its reverse process mesenchymal–epithelial transition cancer cells can recolonize at distant metastatic sites. Among the multifaceted effects exerted by this program, reorganization of actin cytoskeleton is the key mechanical drive for the invasive properties gained by cancer cells. Collapsin response mediator protein-1 (CRMP1) is a cytosolic phosphoprotein and originally characterized as the mediator of semaphorin 3A signaling involved in axon differentiation during neural development. Here we report that CRMP1 can act as a suppressor of tumorigenicity and metastasis in prostate cancer cells. We demonstrated that CRMP1 exhibited a decreased expression pattern in high-grade prostate cancer tissues and many prostate cancer cell lines, and its downregulation in cancer cells was attributed to histone deacetylation and direct repression of its gene by the EMT regulator Snail. Functional analyses revealed that CRMP1 suppressed EMT in prostate cancer cells, as its knockdown could trigger EMT and enhance in vitro invasion capacity, whereas its overexpression could inhibit EMT and suppress both in vitro invasion and in vivo metastasis capacities of prostate cancer cells. Moreover, CRMP1 overexpression could significantly confer resistance to EMT induced by Snail or transforming growth factor-β1 in prostatic epithelial cells and prostate cancer cells. Finally, we demonstrated that CRMP1 could associate with actin and WAVE1, an activator of actin nucleation complex Arp2/3, and also its knockdown could stabilize F-actin and trigger the formation of stress fibers in prostate cancer cells. Together, our study shows that CRMP1 acts an EMT and metastasis suppressor in prostate cancer cells via its regulation of actin polymerization and also suggests that targeting the CRMP1-actin signaling in actin organization could be a potential strategy for management of prostate cancer metastasis.

Association between DEFB103 gene copy number variation and ankylosing spondylitis: a case-control study

In this brief communication, we investigate the role of DEFB103 gene copy number variation (CNV) in ankylosing spondylitis (AS) susceptibility. A total of 807 Chinese individuals including 406 AS patients and 401 controls were enrolled. The DEFB103 copy number was measured by two sets of probes to obtain a stable result in a custom-by-design Multiplex AccuCopy(™) kit (Genesky Biotechnologies Inc., Shanghai, China) based on a multiplex fluorescence competitive polymerase chain reaction (PCR) principle. The copy number of DEFB103 ranged from 2 to 6 in both AS patients and controls. Mann-Whitney U test and chi-squared test were performed to analyze the difference of DEFB103 copy number between AS patients and controls while no statistical difference has been found. We considered the copy number of DEFB103 gene may not associate with susceptibility to AS.

A Study of the Applicability of GFR Evaluation Equations for an Elderly Chinese Population

OBJECTIVES

This study screened current GFR evaluation equations that showed high accuracy for elderly populations and evaluated the applicability of these equations for an elderly Chinese population.

MEASUREMENTS

A standard dual plasma sampling method (DPSM) of estimating 99mTc-diethylene triamine penta-acetic acid clearance was used to determine measured GFR (mGFR).

RESULTS

Comprehensive information was received for a total of 151 elderly individuals, with a mean mGFR of 65.39 ± 24.19 ml/min/1.73 m2. For the overall samples, the accuracy (P30), bias, absolute bias and interquartile ranges (IQRs) of the CKD2 (cystatin C(CysC)-serum creatinine(SCr)), CKD-EPI(CysC-SCr), Cockcroft-Gault(CG), CKD2(CysC), CKD-EPI(CysC), and Hoek equations were superior to c-aGFR3, c-aGFR4 and Grubb equation, Bland-Altman analysis also demonstrated a consistent result. Among elderly subjects with mGFR≥60 ml/min/1.73 m2, the CKD2 (CysC-SCr) and CKD-EPI (CysC-SCr) equations showed significantly higher correlations and accuracy than the other examined equations. Among elderly subjects with mGFR<60 ml/min/1.73 m2, only the CG equation showed an accuracy (P30) of greater than 70% and demonstrated higher precision than the other examined equations.

CONCLUSION

For the elderly population, the CG, CKD2, CKD-EPI, and Hoek equations exhibited good accuracy. The CKD2(CysC-SCr) equation and CKD-EPI(CysC-SCr) equation demonstrated relatively high accuracy for evaluating elderly subjects with mGFR≥60 ml/min/1.73 m2, whereas the CG equation was more suitable for evaluating elderly subjects with mGFR<60 ml/min/1.73 m2.

Comparison of two codon optimization strategies enhancing recombinant Sus scrofa lysozyme production in Pichia pastoris

Lysozyme has played an important role in animal feed additive industry, food additive industry and biological engineering. For improving expression efficiency of recombinant lysozyme from Sus scrofa, two genes respectively designed by the most used codon optimization strategies, "one amino acid one codon" and "codon randomization", were synthesized and expressed in Pichia pastoris X&mdash;33. At shaking flask level, Sus scrofa lysozyme (SSL) under two conditions had a highest activity of 153.33±10.41 and 538.33±15.18 U/mL after a 5 days induction of 1% methanol, with secreted protein concentration 80.03±1.94 and 239.60±4.16 mg/L, respectively. Compared with the original SSL gene, the expression of optimized SSL gene by the second strategy showed a 2.6 fold higher level, while the first method had no obvious improvement in production. In total secreted protein, the proportions of recombinant SSL encoded by the original gene, first method optimized gene and the second&mdash;strategy optimized one were 75.06±0.25%, 74.56±0.14% and 79.00±0.14%, respectively, with the same molecular weight about 18 kDa, optimum acidity pH 6.0 and optimum temperature 35degC.

Arabidopsis SHR and SCR transcription factors and AUX1 auxin influx carrier control the switch between adventitious rooting and xylogenesis in planta and in in vitro cultured thin cell layers

BACKGROUND AND AIMS

Adventitious roots (ARs) are essential for vegetative propagation. The Arabidopsis thaliana transcription factors SHORT ROOT (SHR) and SCARECROW (SCR) affect primary/lateral root development, but their involvement in AR formation is uncertain. LAX3 and AUX1 auxin influx carriers contribute to primary/lateral root development. LAX3 expression is regulated by SHR, and LAX3 contributes to AR tip auxin maximum. In contrast, AUX1 involvement in AR development is unknown. Xylogenesis is induced by auxin plus cytokinin as is AR formation, but the genes involved are largely unknown. Stem thin cell layers (TCLs) form ARs and undergo xylogenesis under the same auxin plus cytokinin input. The aim of this research was to investigate SHR, SCR, AUX1 and LAX3 involvement in AR formation and xylogenesis in intact hypocotyls and stem TCLs in arabidopsis.

METHODS

Hypocotyls of scr-1, shr-1, lax3, aux1-21 and lax3/aux1-21 Arabidopsis thaliana null mutant seedlings grown with or without auxin plus cytokinin were examined histologically, as were stem TCLs cultured with auxin plus cytokinin. SCR and AUX1 expression was monitored using pSCR::GFP and AUX1::GUS lines, and LAX3 expression and auxin localization during xylogenesis were monitored by using LAX3::GUS and DR5::GUS lines.

KEY RESULTS

AR formation was inhibited in all mutants, except lax3. SCR was expressed in pericycle anticlinally derived AR-forming cells of intact hypocotyls, and in cell clumps forming AR meristemoids of TCLs. The apex was anomalous in shr and scr ARs. In all mutant hypocotyls, the pericycle divided periclinally to produce xylogenesis. Xylary element maturation was favoured by auxin plus cytokinin in shr and aux1-21. Xylogenesis was enhanced in TCLs, and in aux1-21 and shr in particular. AUX1 was expressed before LAX3, i.e. in the early derivatives leading to either ARs or xylogenesis.

CONCLUSIONS

AR formation and xylogenesis are developmental programmes that are inversely related, but they involve fine-tuning by the same proteins, namely SHR, SCR and AUX1. Pericycle activity is central for the equilibrium between xylary development and AR formation in the hypocotyl, with a role for AUX1 in switching between, and balancing of, the two developmental programmes.

Accumulation and post-translational modifications of plant tubulins

The microtubular cytoskeleton of plant cells provides support for several functions (including the anchoring of proteins, assembly of the mitotic spindle, cytoplasmic streaming and construction of cell walls). Both α- and β-tubulins are encoded through multigene families that are differentially expressed in different organs and tissues. To increase the variability of expression, both protein subunits are subjected to post-translational modifications, which could contribute to the assembly of specific microtubule structures. This review aims to highlight the role of specific post-translational modifications of tubulin in plant cells. We initially describe the expression and accumulation of α- and β-tubulin isoforms in different plants and at different stages of plant development. Second, we discuss the different types of post-translational modifications that, by adding or removing specific functional groups, increase the isoform heterogeneity and functional variability of tubulin. Modifications are proposed to form a 'code' that can be read by proteins interacting with microtubules. Therefore, the subpopulations of microtubules may bind to different associated proteins (motor and non-motor), thus creating the physical support for various microtubule functions.

Being suckled in a large litter mitigates the effects of early-life stress on hypothalamic-pituitary-adrenal axis function in the male rat

The perinatal environment influences stress responses in the long-term, as does body composition. Male rats suckled in large litters, where they have reduced access to milk and attention from the dam, are less anxious and have attenuated hypothalamic-pituitary-adrenal (HPA) axis responses to stress compared to rats from control litters. In the present study, we investigated whether this early-life environment can also ameliorate anxiety and HPA axis function in rats prone to be stress-sensitive. We conducted these experiments in male rats from control litters (n = 12) or large litters (n = 20). Half were given 24 h of maternal separation on postnatal day 10 to induce HPA axis hyperactivity; the remainder staying undisturbed with their dam. When the rats reached adulthood, we examined behavioural indices of anxiety (elevated plus maze) and depression (Porsolt's forced swim test) under basal conditions and after 15 min of restraint stress. We also examined neuronal activation in the paraventricular nucleus of the hypothalamus (PVN) as an index of HPA axis function. Being suckled in a large litter led to a significantly attenuated PVN response to stress in adulthood. Maternal separation strongly exacerbated the stress-induced increase in PVN neuronal activation in control rats but did not affect the PVN response in large-litter rats. Immobility in the forced swim after restraint was also exacerbated in neonatally maternally separated control rats but not in those from large litters. Our findings show that being suckled in large litters mitigates the effects of early-life stress on HPA axis function and indices of depression in the rat.

Association of MeCP2 (rs2075596, rs2239464) genetic polymorphisms with systemic lupus erythematosus: a meta-analysis

Objective

Limited studies have shown an association between the methyl-CpG-binding protein2 ( MeCp2) genetic polymorphisms and systemic lupus erythematosus (SLE) in different populations, but the results are inconclusive. In order to get a precise and systematic estimation, a meta-analysis was performed.

Methods

A systematic literature search using English and Chinese databases (PubMed/Medline, Web of Knowledge, Wanfang Data (Chinese), etc.) for the eligible studies was performed. Based on heterogeneity among studies, random- or fixed-effects models were selected to analyze the risk of SLE associated with single-nucleotide polymorphisms (SNPs) of MeCP2 genetic polymorphisms.

Results

A significant increased risk of both SNPs of MeCP2 genetic variances associated with SLE was found. Analysis using a fixed-effects model found an increased risk of SLE with the A allele of rs2075596 (OR = 1.41, 95% CI: 1.34 to 1.49, p < 0.001), and the random-effects model also identified a risk factor of A allele of rs2239464 (OR = 1.31, 95% CI: 1.15 to 1.49, p = 0.001). Subgroup analysis and sensitivity analysis suggested that the major source of between-study heterogeneity stemmed from the difference between diverse ethnic groups. After omitting the smallest study, no publication bias was found, which further confirmed the reliability and stability of the meta-analysis.

Conclusions

Mutations of SNPs ( rs2075596, rs2239464) of MeCP2 showed increased risk of developing SLE. Large-scale multicenter epidemiological studies in selected populations with other risk factors are urgently required.

Elevated circulating CD4+ ICOS+ Foxp3+ T cells contribute to overproduction of IL-10 and are correlated with disease severity in patients with systemic lupus erythematosus

In this work, we aimed to investigate the frequency, possible categories and clinical significance of circulating CD4+ ICOS+ FoxP3+ T cells in patients with systemic lupus erythematosus (SLE). The frequency of circulating CD4+ ICOS+ FoxP3+ T cells was analysed by flow-cytometric analysis in 32 SLE patients, 10 rheumatoid arthritis patients and 32 healthy controls. Production of IL-10 and mTGF-β by different CD4+ T-cell populations was determined by intracellular cytokine staining. Plasma levels of IL-10 and TGF-β were determined by enzyme-linked immunosorbent assay (ELISA). The frequency of circulating CD4+ ICOS+ FoxP3+ T cells was significantly increased in SLE patients as compared with control groups. The elevated frequency of CD4+ ICOS+ FoxP3+ T cells had a positive correlation with SLE Disease Activity Index (SLEDAI) scores and serum anti-dsDNA but a negative correlation with serum C3. Additionally, the CD4+ ICOS+ Foxp3+ T cells contained significantly higher percentages of IL-10-producing cells than CD4+ ICOS- Foxp3+ T cells. A significant positive correlation was also observed between the frequency of CD4+ ICOS+ Foxp3+ T cells and the plasma level of IL-10 in SLE patients. In conclusion, an increased frequency of circulating CD4+ ICOS+ Foxp3+ T cells was observed in patients with SLE, suggesting its potential importance in the immunopathogenesis of SLE. Analysis of the CD4+ ICOS+ FoxP3+ T-cell population may be useful for the evaluation of lupus disease severity.

Xylan-degrading enzymes in male and female flower nectar of Cucurbita pepo

BACKGROUND AND AIMS

Nectar is a very complex mixture of substances. Some components (sugars and amino acids) are considered primary alimentary rewards for animals and have been investigated and characterized in numerous species for many years. In contrast, nectar proteins have been the subject of few studies and little is known of their function. Only very recently have detailed studies and characterization of nectar proteins been undertaken, and then for only a very few species. This current work represents a first step in the identification of a protein profile for the floral nectar of Cucurbita pepo. In this regard, the species studied is of particular interest in that it is monoecious with unisexual flowers and, consequently, it is possible that nectar proteins derived from male and female flowers may differ.

METHODS

Manually excised spots from two-dimensional (2-D) electrophoresis were subjected to in-gel protein digestion. The resulting peptides were sequenced using nanoscale LC-ESI/MS-MS (liquid chromatography-electrospray ionization/tandem mass spectrometry). An MS/MS ions search was carried out in Swiss-Prot and NCBInr databases using MASCOT software.

KEY RESULTS

Two-dimensional electrophoresis revealed a total of 24 spots and a different protein profile for male and female flower nectar. Four main proteins recognized by 2-D electrophoresis most closely resemble β-d-xylosidases from Arabidopsis thaliana and have some homology to a β-d-xylosidase from Medicago varia. They were present in similar quantities in male and female flowers and had the same molecular weight, but with slightly different isoelectric points.

CONCLUSIONS

A putative function for xylosidases in floral nectar of C. pepo is proposed, namely that they may be involved in degrading the oligosaccharides released by the nectary cell walls in response to hydrolytic enzymes produced by invading micro-organisms. Several types of oligosaccharides have been reported to increase the pathogenic potential of micro-organisms. Thus, it is possible that such a mechanism may reduce the virulence of pathogens present in nectar.

Genetic variation in SH3-domain GRB2-like (endophilin)-interacting protein 1 has a major impact on fat mass

OBJECTIVE

The SH3-domain GRB2-like (endophilin)-interacting protein 1 (SGIP1) gene has been shown to be differentially expressed in the hypothalamus of lean versus obese Israeli sand rats (Psammomys obesus), and is suspected of having a role in regulating food intake. The purpose of this study was to assess the role of genetic variation in SGIP1 in human disease.

SUBJECTS

We performed single-nucleotide polymorphism (SNP) genotyping in a large family pedigree cohort from the island of Mauritius. The Mauritius Family Study (MFS) consists of 400 individuals from 24 Indo-Mauritian families recruited from the genetically homogeneous population of Mauritius. We measured markers of the metabolic syndrome, including diabetes and obesity-related phenotypes such as fasting plasma glucose, waist:hip ratio, body mass index and fat mass.

RESULTS

Statistical genetic analysis revealed associations between SGIP1 polymorphisms and fat mass (in kilograms) as measured by bioimpedance. SNP genotyping identified associations between several genetic variants and fat mass, with the strongest association for rs2146905 (P=4.7 × 10(-5)). A strong allelic effect was noted for several SNPs where fat mass was reduced by up to 9.4% for individuals homozygous for the minor allele.

CONCLUSIONS

Our results show association between genetic variants in SGIP1 and fat mass. We provide evidence that variation in SGIP1 is a potentially important determinant of obesity-related traits in humans.

Preoperative chemotherapy in patients undergoing resection of colorectal liver metastases: Assessment of pattern of tumor response using CT registration imaging

252

Background: A significant radiologic response from preoperative chemotherapy may successfully convert some unresectable colorectal liver metastases (CRLM) to resectable disease. Understanding the pattern of tumor shrinkage in relation to the hepatic structures such as the liver capsule and vascular pedicles is important. We sought to determine the spatial relationship between individual liver metastases before and after chemotherapy, as well as to adjacent intrahepatic structures.

Methods: Using nonrigid registration of temporally separated CT scans before and after preoperative chemotherapy, 42 CRLM were evaluated in 27 patients with radiologic partial response. The response pattern was determined by independent observers and scored as: (1) asymmetric toward the liver periphery, (2) asymmetric toward the liver center, and (3) symmetric response. In addition, the shrinking pattern was characterized in relation to the liver capsule and major vascular pedicles, as well as clinicopathologic features.

Results: Among the tumors evaluated, 38/42 lesions (90%) responded asymmetrically, with only 10% undergoing a symmetric contraction. 43% shrank toward the periphery and 47% centrally. Tumors in proximity to the liver capsule were more likely to respond peripherally compared to deeper lesions (p=0.013). Unexpectedly, R1 resection was more common in tumors with peripherally directed response vs. those with central or symmetric response (p=0.027). In addition, tumors within 5 mm of a single major vascular pedicle were more likely to shrink toward (59%) and not away from the vessel. No difference in response pattern was observed in relation to tumor size, chemotherapy regimen, or presence of steatosis.

Conclusions: Tumors were found to respond asymmetrically in the vast majority of cases, either toward or away from the liver center. In addition, tumors in proximity to major vascular pedicles less commonly move away from these structures. These findings may have important implications when planning curative-intent resection or anticipating the ability to convert patients to resectable disease using preoperative chemotherapy.

No significant financial relationships to disclose.

Oncological outcome of T1 rectal cancer undergoing standard resection and local excision

AIM

We studied the outcome and prognostic factors for T1 rectal cancer patients undergoing standard resection or transanal excision.

METHOD

One hundred and twenty-four patients with T1 rectal cancer were included in the study, of whom 66 (53.2%) underwent standard resection and 58 (46.8%) underwent transanal excision. Survival analysis was performed to compare the outcome.

RESULTS

The 5-year local recurrence rate was 11.0% in the transanal excision group versus 1.6% in the standard resection group (P = 0.031) but the 5-year disease-free survival and overall survival rates were not significantly different between the two groups. Multivariate analysis suggested that a high tumour grade and perineural or lymphovascular invasion were independent risk factors for local recurrence and recurrence-free survival. For high-risk patients (with at least one of the above risk factors), the 5-year local recurrence and 10-year recurrence-free survival rates were 21.2% and 74.5%, versus 1.2% and 92.0% in low-risk patients (P = 0.00003 and P = 0.003). In patients undergoing transanal excision, none in the low-risk group had local recurrence during follow up, while 40% (6 of 15) of patients in the high-risk group developed local recurrence within 5 years after surgery. The 5-year local recurrence rate was 45.0%.

CONCLUSION

Transanal excision in T1 rectal cancer may result in a high rate of local failure for patients with a high-grade tumour, or perineural or lymphovascular invasion. Local excision should be avoided as a curative treatment in high-risk patients.

A Phase I/II Clinical Trial of Accelerated Partial Breast Irradiation Using External Beam and Image-Guidance in Early-Stage Breast Cancer Patients Treated with Breast Conservative Surgery

Purpose: To evaluate the early therapeutic outcome of accelerated partial breast irradiation(APBI) in low-risk breast cancer patients treated with breast conservative surgery(BCS) in a Chinese population, to analyze the intra-fractional and residual error with image-guidance.Material and methods: Eligible patients were age ≥18 years, unicentric Stage I invasive carcinoma or ductal carcinoma in situ(DCIS), treated with BCS with margin&gt;2mm. Sixteen patients were enrolled between June 2008 and April 2009, with median age 53 ys (46-71). Clinical target volume(CTV) is defined by surgical cavities plus 1.5cm margin, another 1cm is expanded to form the planning target volume(PTV), with edition to no closer than 5 mm to the skin surface and no deeper than the anterior chest wall. Three-dimensional treatment plannings with field in field technique were generated with dose of 38.5Gy/10F, bid with interval≥6 hours. Two online cone beam CTs (CBCT) was acquired for each fraction, using Elekta Synergy, X- Ray Imaging system. One is after setup with skin-markers and the other at the end of fraction. Three different registrations: bony structure, grey and grey with manual adjustment(gmanual) were compared. The clip box included: whole breast, ipsilateral lung and part of the vertebras. The registration results of each fraction were recorded. The mean shifts and standard deviation (SD) were calculated on the CBCT pre and post-treatment.Results: The ratio of APBI PTV/whole breast PTV was 25%-40% (median 29.3%). 6MV photon with median fields of 4(3-6) was used. Grade I skin toxicity was found in all the 16 patients after 15-20(median 17) days of treatment, grade II skin reaction occured in 2 patients.The setup errors detected by the initial CBCT are 7mm in lateral(X), 10mm in longitudinal(Y) and 7mm in vertical directions(Z).Table 1 Setup errors detected by the differences between pre-treatment CBCT with skin marker and planning CT  grey  gmanual  x (cm)y(cm)z(cm)x (cm)y(cm)z(cm)Mean-0.010.14-0.1 0.15-0.13SD0.260.370.290.280.370.28system error0.210.320.230.210.310.23random error0.180.190.180.180.230.2margin0.650.930.700.650.940.72 The bony algorithm showed statistical difference with grey or gmanual algorithms (p&lt;0.05). Shift was applied when the registration result by gmanual was &gt;3mm in any directions. The residual error and intra-fraction error was then analyzed after on-line shift and the post-fraction CBCT, which resulted in 6.9mm(X)l, 6.4mm(Y)and 7.3mm (Y) directions, see Table 2.Table 2 The summary of residual errors and intra-fraction errors after shift alignment x (cm)y (cm)z (cm)mean0.010.00-0.07SD0.260.290.29system error0.210.200.23random error0.230.200.22margin0.690.640.73 Conclusion: APBI with 3-D conformal external beam and image guidance is a feasible technique. Grey registration with manual adjustment is recommended for clinical application. The initial set-up error data confirmed the safety of 1cm margin from CTV to PTV. With online shift of any error above 3mm, the combination of residual error and intra-fraction error is 6.9mm, 6.4mm and 7.3mm in X, Y and Z directions, which might provide potential for margin reduction with image guidance.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4111.

A pilot study of biological markers (BM) as predictors for response and prognosis in patients (pts) with R0 resected gastric cancer (GC)

e22076

Background: To evaluate clinical value of biological markers and their prognostic significance in gastric cancer as well as prediction to clinic outcome; To select preference marker for targeted therapy in high risk patients hence to guide personalized treatment. Methods: Retrieved from total 394 patients treated during the period of Jan 2004 to June 2006 of Cancer Hospital, Fudan University with complete medical records and follow up data, 84 patients with pre- and post- operative biological markers examined were selected. All of these patients underwent R0 gastrectomy, 61 (72.6%) patients underwent D2 resection. Forty- one (48.8%) patients received ≥ 4 cycles adjuvant chemotherapy. Preoperative tumor markers include: CEA, AFP, CA199, CA50, CA72–4, CA24–2 and postoperative immunohistochemical examination include: Bax, Bcl-2, P27, CyclinD1, TOPO2, MDR, GST-π, Ki67, AgNOR, EGFR, P21, P53, PCNA, C-myc and Neu were analyzed. Univariate, multivariate and Logistic regression analysis were performed and Kapan-Meier estimates were calculated. Results: For the whole group, 2-year OS and PFS were 76% and 66% respectively. Logistic regression analysis showed bcl-2, ki67, c-myc2 and Neu were relative with more nodal involvement. Patients with lower level of CEA, CA72–4 and higher level of cyclin D1 suivived longer than the other patients. There were different clinical significance with those biomarkers. Patients with lower level of cyclinD1, CEA had more local regional recurrence (p=0.026) while patients with higher PCNA experienced more distant metastasis (p=0.005). Univariate analysis showed that clinical staging, level of cyclinD1 and CEA were correlated with OS (p<0.05). Conclusions: Biological markers may be helpful in predicting the clinical outcome and prognosis for R0 resected gastric cancer patients. Further study are needed to confirm their clinical significance.

No significant financial relationships to disclose.

Population structure of Cercospora kikuchii, the causal agent of Cercospora leaf blight and purple seed stain in soybean

Random amplified polymorphic DNA (RAPD) and microsatellite-primed polymerase chain reaction (MP-PCR) were used to characterize 164 isolates of Cercospora kikuchii, most of which were collected from Louisiana. Plant tissue (seeds versus leaves), but not host cultivar, had a significant impact on pathogen population differentiation. Cluster analysis showed that the Louisiana population was dominated by a primary lineage (group I) with only a few Louisiana isolates belonging to the minor lineage that also included the non-Louisiana isolates (group II). A previous study showed that isolates could be differentiated according to vegetative compatibility groups (VCGs). However, RAPD and MP-PCR data demonstrated that isolates of C. kikuchii were not generally clustered according to these VCGs. Furthermore, genetic relationships within and between VCGs were examined using sequences of the intergenic spacer region of rDNA. These analyses showed that VCG is not an indicator of evolutionary lineage in this fungus. Our results suggest the likely existence of a cryptically functioning sexual stage in some portion of the C. kikuchii population.

Genome-wide scan revealed genetic loci for energy metabolism in Hispanic children and adolescents

OBJECTIVE

Genome-wide scans were conducted in search for genetic locations linked to energy expenditure and substrate oxidation in children.

DESIGN

Pedigreed data of 1030 Hispanic children and adolescents were from the Viva La Familia Study which was designed to investigate genetic and environmental risk factors for the development of obesity in Hispanic families. A respiratory calorimeter was used to measure 24-h total energy expenditure (TEE), basal metabolic rate (BMR), sleep metabolic rate (SMR), 24-h respiratory quotient (24RQ), basal metabolic respiratory quotient (BMRQ) and sleep respiratory quotient (SRQ). Protein, fat and carbohydrate oxidation (PROOX, FATOX and CHOOX, respectively) were also estimated. All participants were genotyped for 384 single tandem repeat markers spaced an average of 10 cM apart. Computer program SOLAR was used to perform the genetic linkage analyses.

RESULTS

Significant linkage for TEE was detected on chromosome 1 near marker D1S2841, with a logarithm of the odds (LOD) score of 4.0. SMR, BMRQ and PROOX were associated with loci on chromosome 18, 17 and 9, respectively, with LOD scores of 4.88, 3.17 and 4.55, respectively. A genome-wide scan of SMR per kg fat-free mass (SpFFM) peaked in the same region as SMR on chromosome 18 (LOD, 5.24). Suggestive linkage was observed for CHOOX and FATOX. Several candidate genes were found in the above chromosomal regions including leptin receptor (LEPR).

CONCLUSION

Regions on chromosomes 1, 9, 17 and 18 harbor genes affecting variation in energy expenditure and substrate oxidation in Hispanic children and adolescents.

Autoantibodies to plasminogen and tissue plasminogen activator in women with recurrent pregnancy loss

Reduced fibrinolytic activity has been described in primary anti-phospholipid syndrome (PAPS), and may be responsible for thrombotic events. Antibodies to tissue type plasminogen activator (t-PA) or plasminogen (PLG) might contribute to the hypofibrinolytic state in autoimmune diseases, but the clinical significance of these antibodies is still unclear in recurrent pregnancy loss (RPL). The aim of this study is to evaluate the prevalence and clinical significance of anti-PLG and anti-t-PA antibodies in 87 patients with a history of RPL: 54 women with well-defined PAPS (mean age 32.5 years; range 26-38) and 33 women with unexplained RPL (mean age 30 years; range 24-39). IgG anti-PLG antibodies were found in 20 and four patients from the group with RPL/PAPS and unexplained RPL, respectively; IgG anti-t-PA antibodies were found in 11 and two patients from the above two groups, respectively. IgG anti-PLG antibodies were associated with the high risk of RPL (OR 7.2, P = 0.004), especially with RPL/PAPS (OR 11.2, P < 0.001) evaluated by Fisher's exact test, while IgG anti-t-PA were associated with RPL/PAPS (OR 10.0, P = 0.01) but not with RPL (OR 6.8, P = 0.06). A significant inhibition of exogenous fibrinolysis was observed by IgG fractions from patients with anti-PLG or anti-t-PA antibodies on microplates and on the human umbilical vein endothelial cells, compared with those from healthy controls. The prevalence of IgG anti-PLG antibodies was high in RPL patients, especially in RPL/PAPS, while the prevalence of IgG anti-t-PA antibodies was high in RPL/PAPS but not in RPL, and some of them might inhibit fibrinolysis in patients.

Study on the relationship between lymphatic vessel density and distal intramural spread of rectal cancer

BACKGROUND

The smallest safe margin of distal clearance for lower rectal cancer is very important for the operation. In a previous study, a few factors were found to play a role in distal intramural spread (DIS), but there are few data regarding the influence of lymphangiogenesis. We studied the relationship between lymphatic vessel density (LVD) and DIS of rectal cancer, analyzing the probable value of LVD in determining the length of distal resection of lower rectal cancer.

METHODS

Nine-two patients who had undergone curative resection of lower rectal cancer were included. The length of DIS, LVD and other clinicopathological factors were evaluated. Immunohistochemical lymphatic vessel staining with LYVE-1 (lymphatic vessel endothelial hyaluronan receptor) were performed to detect the LVD.

RESULTS

44 cases had DIS (range 0.1-2.44, mean 0.31 cm), and cancer emboli were the most common modalities of DIS. The LVD of a peritumoral lesion was significantly higher than that of an intratumoral lesion; the LVD of the DIS subgroup was significantly higher than that of the no DIS subgroup, and the LVD of the 2 subgroups was significantly higher than that of normal rectal tissue. A significant correlation was shown by a rank correlation test between the length of DIS and the LVD at the periphery of the rectal cancer (n = 44, r = 0.755, p < 0.01). The LVD was also related to the extent of infiltration, lymphatic invasion and lymph node metastases.

CONCLUSIONS

Lymphangiogenesis plays an important role in rectal cancer cell metastasis and patients with a higher LVD have a better prognosis. The LVD is closely correlated with DIS. These findings may be helpful in determining the distal clearance length of rectal cancer.