Luminal group may give more benefit for invasive micropapillary carcinoma component breast cancer patients: experience from Cancer Hospital Fudan University

Abstract #6152

Objective: Comparative studies on clinical features and outcomes of very rare invasive micropapillary carcinoma of breast cancer of 4 subtypes by immunohistochemistry staining.
 Methods: From Aug 2005 to Mar 2008, a total of 52 breast cancer patients(BCPs) with an invasive micropapillary component (IMPC) among 1951 Chinese BCPs with complete of clinicopathologic data in our institution were enrolled into a retrospective analysis. We characterized all these 52 patients and analyzed using various parameters.
 Results: The 52 cases of breast carcinoma with an IMPC all occurred in women. Mean age was 51 years (range from 26-82). All of these patients had breast masses; one also had metastasis to the supraclavicular lymph node at the time of diagnosis., mean tumor size was 2.83cm(T2), 23.08%(12/52) was pure invasive micropapillary carcinoma, and lymph node positive percentage was 75.59 %( 36/51).Fifty one patients received surgery, while one of them lost the chance of surgery. Forty of them received the modified mastectomy while one was performed lumpectomy due to old age. One was performed LAND alone and four were performed lumpectomy and sentinel lymph node biopsy.
 By using IHC staining, when we regard HER2/neu 0 and +as negative. The Luminal A group, Luminal B, trip-negative, HER2+ /ER- were 76.92% (40/52), 11.54 %( 6/52), 7.69 %( 4/52), 3.85 %( 2/52), respectively. Compared to the database of 2005 breast cancer carcinoma in our institution, there was more Luminal A group patients than the whole group (P=0.01, chi-square test.), more Luminal B (P=0.028, Fisher exact possibility test), less trip-negative group (P=0.001, chi-square test). The positive lymph node among the Luminal A group, Luminal B, trip-negative, HER2+ /ER- were 65%,80%, 100%, 100%, respectively, while the lymphvascular invasion were 55%,33.33%,50%,50%,respectively, Mulifocality in Luminal A was 25% , 16.67% in Luminal B , while 50% in both trip-negative and HER2+/ER-.
 Twenty-one of them received both anthracyclines and Taxane, while 27 only received anthracyclines, Four patients only were received only AIs due to old age. All the luminal group patients received endrocine therapy after chemo. After nearly 14 months (2∼34 months) follow up, thirty-six women were disease free, one had local recurrence, and 1 had lung metastasis, while 1 had ovary carcinoma when the diagnosis of breast malignant, one patient lost following up due to mental disorder. Among the luminal B, one had metastasis when diagnosis, others were disease free. One woman of the trip-negative died of non-breast cancer disease,the HER2+/ER- group was no recurrence or metastasis.
 Discussion: The prelimary results showed that more luminal group in the IMPC may get benefit from the endocrine therapy. However the number of these cases is small and follow-up time is not very long, further studies are necessary to explain these rare and unique pattern of invasive carcinoma.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6152.

Seroma formation after breast cancer surgery and its risk factors

Abstract #4085

Background:. Seroma formation is one of the most common complications after breast cancer surgery including modified radical mastectomy and breast conservative surgery. Our study aims to investigate the risk factors of postoperative seroma in Chinese breast cancer patients.
 Methods: Clinical data of 158 women who underwent surgerical therapy for breast cancer in our hospital were collected prospectively and all patients were followed up. The risk factors for seroma occurrence were compared between the seroma group and control group using X 2 test or t test, as well as the logistic regression was used as multivariate analysis.
 Results: Univariate analysis showed that the average age of the seroma group was significantly higher than those without seroma formation(58.71vs51.00, P=0.0019), but the total serum protein and albumin content were lower (68.47g/L vs 72.53g/L, P=0.009 and 40.75g/L vs 42.52g/L,P=0.020, respectively). In seroma group, the drainage volume of the first three days, the total and daily drainage volume were all higher (all p values less than 0.01), as well as drainage duration and hospital stay were longer(8.3d vs 14.4d, P=0.000 and 11.5d vs 23.7d, P=0.000, respectively). Logistic regression showed that older patients (OR=1.080, 95%CI 1.016∼1.148, P=0.013), lower total serum protein content(OR=0.814, 95%CI 0.705∼0.940, P=0.005)and higher drainage volume in d1(OR=1.009, 95%CI 1.001∼1.016, P=0.022) and d3 (OR=1.017, 95%CI 1.005∼1.029, P=0.005) were all independent risk factors for subcutaneous seroma. The daily average drainage curve showed a gradually decreasing trend with a highest collections in the first three days. The seroma group had significantly higher average daily drainage volume( P=0.034) and longer duration (P=0.000).
 Conclusion:The risk factors of seroma formation after breast cancer surgery are complicated. However in order to prevent its occurrence effectively, the factors including age, nutrition status and daily drainage volume should be taken into consideration.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4085.

Clinicopathological features of the triple-negative tumors in Chinese breast cancer patients

Abstract #6080

Background: Triple negative breast cancers are defined by a lack of expression of estrogen, progesterone, and Her-2 receptors. A number of studies suggested that the triple-negative phenotype could contribute to an aggressive behavior and a poor prognosis. However, similar data is still not available for Chinese populations. We sought to analyze the clinicopathological features of this subgroup in our hospital in order to get characteristics for Chinese breast cancer.
 Methods: We performed a retrospective study of 2028 female unilateral breast cancer patients undergoing surgery in our hospital from February 1991 to December 2003. ER, PR and Her-2 status were assessed using immunohistochemical staining. Survival curves were performed with Kaplan-Meier method and annual recurrence hazard was estimated by hazard function.
 Results: According to different combinations of hormone receptor (HR) and Her-2 status, 2028 patients were categorized into the three subgroups as follows: Her-2+ (32.25%), HR+/Her-2- (48.92%) and triple-negative (18.83%). Triple-negative tumors were larger (greater than 2 cm in diameter) than HR+/Her-2- tumors, but smaller than Her-2+ tumors (70.03%, 66.15% and 76.15% respectively, P < 0.001). In addition, 21.99% of patients whose tumors were triple-negative had four or more axillary nodes involved compared with 27.37% of patients with Her-2+ tumors and 22.78% with HR+/Her-2- tumors (P = 0.004). There were statistical differences in the distribution of TP53 mutation and Cathepsin-D status (P < 0.001 for both). In the univariate analysis, we found a statistical significance for recurrence-free survival (RFS) among the three subgroups (P = 0.0036), with the rate of 72.89% for Her-2+ tumors, 78.26% for HR+/Her-2- tumors and 75.61% for triple-negative tumors at the 11th year respectively. When it came to the time of hazard peaks, discrepancies existed in different subgroups. Triple-negative patients showed an early major recurrence surge peaking at the 2.5th year after surgery, followed by a gradual decline until year 6.5 and then a modest increase. As to HR+/Her-2- patients, the hazard plot exhibited a wide initial plateau-like wave covering at least 4 years and a subsequent rise. The hazard rate for Her-2+ patients displayed a tapering sharp at the 1st year and a second rise. Furthermore, the first peak of triple-negative tumors was higher than that of HR+/Her-2- patients, but lower than that of Her-2+ ones.
 Conclusions: The recurrence pattern for triple-negative tumors was intermediate between Her-2+ and HR+/Her-2- counterparts.Our findings suggested that biological characteristics and prognosis of Chinese triple-negative breast cancer might be more favorable and somewhat different from those in Western populations.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6080.

Time distributions and prognosis factors of breast cancer recurrence in different sites after operation

Abstract #2080

Objective Our study aims to analyze the breast caner patients with different sites of recurrence, and to have knowledge of the regular patterns and influence factors of metastastic breast cancer.
 Methods We performed a retrospective study of 210 female breast cancer patients who were continuously followed up in our hospital from January 2005 to May 2007 and had complete data of metastasis. The clinical and biological characteristics were compared between the patients with organ metastases (lung, liver, brain) and non-viscera metastases (lymph node, bone).
 Results Cox regression analysis-hazard function showed that patients with elder age (RR=0.927 95%CI 0.877∼0.981, P=0.008) and HER-2 negative(RR=0.253 95%CI 0.076∼0.836, P=0.024)tended to develop non-viscera metastases, while patients with larger tumors (RR=3.832 95%CI 1.073∼13.687, P=0.039) tended to develop organ metastasesp.
 
 When stratified by the prognostic factors, the annual risk hazard curve of the patients with high risk of recurrence had double peaks at the second year and the ninth years after mastectomy respectively, and it was significantly higher than those of the patients with middle and low risk.[figure1]Annual risk hazard curves of both local relapse and metastasis also showed a double-peaked pattern. The curves for lymph node, bone, lung and liver metastasis showed a similar pattern, but all the peaks of curve emerged later than that of the local relapse.
 
 Conclusion Patients with different clinical and biological characteristics may develop recurrence in different sites. There are certain regular patterns of time distribution for different metastasis sites after mastectomy. The local recurrence may be the foreboding for the metastasis and we should pay attention to the local relapse signs especially in the patients with high risk.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2080.

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Separation of oil from oily wastewater by modified resin

A new type of packing material, polystyrene resin modified by cetyltrimethyl-ammonium bromide (R-CTAB), was developed for separation of emulsified oil wastewater. The unique separation mechanism of the modified resin is due to the hydrogen bond formation between hydrocarbon molecules and the free hydrophilic part of the fixed surfactant. It changed the zeta potential of oil droplets and made them coalescing easier, which provide an optional choice without any chemicals added into the wastewater. A column of R-CTAB was investigated for its performance in separating emulsified oil droplets in oily wastewater. The effects of liquid space velocity and influent oil concentration were studied in particular. The results showed that R-CTAB column was more efficient than the un-modified resin column. Under the optimum experimental conditions, more than 85% of oil was removed by using R-CTAB column that at least 10% higher than the un-modified resin column.

Salicylate increases the gain of the central auditory system

High doses of salicylate, the anti-inflammatory component of aspirin, induce transient tinnitus and hearing loss. Systemic injection of 250 mg/kg of salicylate, a dose that reliably induces tinnitus in rats, significantly reduced the sound evoked output of the rat cochlea. Paradoxically, salicylate significantly increased the amplitude of the sound-evoked field potential from the auditory cortex (AC) of conscious rats, but not the inferior colliculus (IC). When rats were anesthetized with isoflurane, which increases GABA-mediated inhibition, the salicylate-induced AC amplitude enhancement was abolished, whereas ketamine, which blocks N-methyl-d-aspartate receptors, further increased the salicylate-induced AC amplitude enhancement. Direct application of salicylate to the cochlea, however, reduced the response amplitude of the cochlea, IC and AC, suggesting the AC amplitude enhancement induced by systemic injection of salicylate does not originate from the cochlea. To identify a behavioral correlate of the salicylate-induced AC enhancement, the acoustic startle response was measured before and after salicylate treatment. Salicylate significantly increased the amplitude of the startle response. Collectively, these results suggest that high doses of salicylate increase the gain of the central auditory system, presumably by down-regulating GABA-mediated inhibition, leading to an exaggerated acoustic startle response. The enhanced startle response may be the behavioral correlate of hyperacusis that often accompanies tinnitus and hearing loss.

Synthesis and characterization of core-shell structural MWNT-zirconia nanocomposites

Core-shell structural MWNT/ZrO2 nanocomposites were successfully prepared by one-step hydrolyzing of MWNT-dispersed ZrOCl2.8H2O aqueous solution. A highly conformal and uniform monoclinic zirconia coating was deposited on MWNTs by this new and simple method, and the thickness of the coating increased with the reaction time.

A copper(II)-selective chelator ameliorates diabetes-evoked renal fibrosis and albuminuria, and suppresses pathogenic TGF-beta activation in the kidneys of rats used as a model of diabetes

AIMS/HYPOTHESIS

The selective Cu(II) chelator triethylenetetramine (TETA) extracts systemic Cu(II) into the urine of diabetic humans and rats as a model of diabetes, and in the process also normalises hallmarks of diabetic heart disease. However, the role of Cu and its response to TETA in animals with diabetic nephropathy were previously unknown. Here, we report the effects of TETA treatment on Cu and other essential elements, as well as on indices of renal injury and known pathogenic molecular processes, in kidneys from a rat model of diabetes.

METHODS

Rats at 8 weeks after streptozotocin-induction of diabetes were treated with oral TETA (34 mg/day in drinking water) for a further 8 weeks and then compared with untreated diabetic control animals.

RESULTS

Renal tissue Cu was substantively elevated by diabetes and normalised by TETA, which also suppressed whole-kidney and glomerular hypertrophy without lowering blood glucose. The urinary albumin: creatinine ratio was significantly elevated in the rat model of diabetes but lowered by TETA. Total collagen was also elevated in diabetic kidneys and significantly improved by TETA. Furthermore, renal cortex levels of TGF-beta1, MAD homologue (SMAD) 4, phosphorylated SMAD2, fibronectin-1, collagen-III, collagen-IV, plasminogen activator inhibitor-1 and semicarbazide-sensitive amine oxidase all tended to be elevated in diabetes and normalised by TETA.

CONCLUSIONS/INTERPRETATION

Dysregulation of renal Cu homeostasis may be a key event eliciting development of diabetic nephropathy. Selective Cu(II) chelation can protect against pathogenic mechanisms that lead to or cause diabetic nephropathy and might be clinically useful in the treatment of early-stage diabetic kidney disease.

Chinese response to allergy and asthma in Olympic athletes

China is going to host the Games of the XXIX Olympiad from 8-24 August 2008 in Beijing. The number of athletes and accompanying individuals expected to arrive at China for the Beijing Olympics is estimated at over 10 000 and among them at least 2 000 (20%) are suspected to suffer from respiratory allergies. It is important to monitor the pollen counts and improve air quality in Beijing because Olympic athletes would be exposed to airborne allergens and pollutants during competitions which could hinder peak performance. The main pollen and spore families in Beijing are Artemisia, Ambrosia, Chenopodiaceae and Gramineae. They can reach around 307 000 grains of pollen/1000 m(3) of air in August. Economic development in China is usually linked with worsening of air quality. Due to the adoption of various control measures, the ambient air quality in a number of areas in Beijing has actually improved. The ambient air TSP and SO(2) levels in Beijing have been decreasing in the last decade. However, ambient air NO(x) level has been increasing due to the increased number of motor vehicles. Nevertheless, dedicated medical facilities in Beijing will provide medical services to athletes and delegations from all over the world during the Beijing Olympic Games.

Noise exposure-induced enhancement of auditory cortex response and changes in gene expression

Noise exposure is one of the most common causes of hearing loss. There is growing evidence suggesting that noise-induced peripheral hearing loss can also induce functional changes in the central auditory system. However, the physiological and biological changes in the central auditory system induced by noise exposure are poorly understood. To address these issues, neurophysiological recordings were made from the auditory cortex (AC) of awake rats using chronically implanted electrodes before and after acoustic overstimulation. In addition, focused gene microarrays and quantitative real-time polymerase chain reaction were used to identify changes in gene expression in the AC. Monaural noise exposure (120 dB sound pressure level, 1 h) significantly elevated hearing threshold on the exposed ear and induced a transient enhancement on the AC response amplitude 4 h after the noise exposure recorded from the unexposed ear. This increase of the cortical neural response amplitude was associated with an upregulation of genes encoding heat shock protein (HSP) 27 kDa and 70 kDa after several hours of the noise exposure. These results suggest that noise exposure can induce a fast physiological change in the AC which may be related to the changes of HSP expressions.