Ki67: A Time-Varying Biomarker of Risk of Breast Cancer in Atypical Hyperplasia

Background: Uncontrolled proliferation is a defining feature of the malignant phenotype. Ki67 is a marker for proliferating cells and is overexpressed in many breast cancers. Atypical hyperplasia is a premalignant lesion of the breast (relative risk ∼ 4.0). Here we asked if Ki67 expression could stratify risk in women with atypia.Methods: Ki67 expression was assessed immunohistochemically by digital image analysis in archival sections from 192 women with atypia diagnosed at the Mayo Clinic 1/1/67-12/31/91. Risk factor and follow-up data were obtained via study questionnaire and medical records. Observed breast cancer events were compared to population expected rates (Iowa SEER) using standarized incidence ratios (SIRs). We examined both short-term (within 10 years) and long-term (after 10 years) risk of breast cancer (BC) following atypia biopsy.Results: The median value for percent positive cells for Ki67 was 1.0%; the 75th percentile value was 2.3%. Based on the empirical distribution of staining values in our cohort, we selected a cutoff of 2% cells positive to separate high from low staining. There were no differences in Ki67 levels by age at biopsy, type of atypia (ADH, ALH, or both), number of foci of atypia, or family history. 32 women developed BC over a median of 14.6 years. Among them, those with ≥2% Ki67 expression had a shorter time to breast cancer (median 5.5 years, IQR=3.2-7.2) than those with <2% cells positive (median=13.8 years, IQR=11.6-20.3). There was a positive association between Ki67 overexpression (≥2% of cells positive) and risk of BC in the first 10 years of follow-up (SIR=4.42 [95% CI 2.21-8.84]). This excess risk resulted in a 10-year cumulative incidence of 14.1%. In contrast, in the women with low Ki67 expression, we found no increased risk of BC in the first 10 years, with SIR 1.01 (95% CI 0.38-2.70), which was significantly lower than the women with high expression (p=0.01). The 10-year cumulative incidence of BC was 3% for the low Ki67group, in line with population averages. After 10 years, risk increased significantly in the low Ki67 group [SIR 5.69 (3.63-8.92)] vs. no increased risk in the high Ki67 group [SIR 0.78 (0.11-5.55)]. We formally examined this apparent time-dependent difference in incidence patterns by Ki67 staining levels via Poisson regression analysis, and found a statistically significant interaction between pre- vs. post-10 years incidence and high vs. low staining levels (p<0.001).Conclusions: Ki67 appears to be a time-varying biomarker of risk of breast cancer in women with atypical hyperplasia. Women whose atypias show higher proliferation rates have an increased risk for an earlier BC (within 10 years). Those with lower proliferation rates tend to develop BCs later, after 10 years. Ki67 levels may help to define the time period of greatest risk for women with atypia.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 909.

Lobular Involution and Mammographic Density: Independent Contributors to Breast Cancer Risk

Background: Women with benign breast disease are at elevated breast cancer risk. In order to accurately predict a woman's individual risk of breast cancer, a breast cancer risk-prediction model is needed that incorporates significant breast cancer risk factors. This report describes two factors: tissue based assessment of lobular involution, and radiological marker- mammographic density (MD). Lobular involution, or physiologic atrophy of the breast glandular epithelium, is inversely associated with breast cancer risk. MD is a strong positive risk factor for breast cancer. With increasing age, the extent of lobular involution increases while MD decreases. However, it is unclear whether involution and MD represent independent breast cancer risk factors. We examined breast cancer risk associated with lobular involution and MD in women with benign breast disease (BBD) to determine whether these features are independently associated with breast cancer risk.Methods: Using the Mayo Clinic Surgical and Pathology Indices, 9376 women ages 18 to 85 with benign excisional breast biopsy between January 1, 1967 and December 31, 1991 were identified and formed the Mayo BBD cohort. We studied a sub-cohort of women diagnosed with BBD between 1985 and 1991 (when MD was clinically assessed and recorded) who had a mammogram within 6 months of the BBD diagnosis. Breast cancer outcomes were determined through the Mayo medical records and a study-specific questionnaire. Lobular involution extent was assessed in background tissue as 'none' (0% lobules involuted), 'partial' (1-74% lobules involuted) or 'complete' (≥75% lobules involuted). MD was classified as Wolfe's parenchymal pattern (PP) as N1/ fatty; P1; P2; and DY/ homogenously dense. Hazard ratios and confidence intervals were calculated using Cox regression analyses, adjusting for confounders: age, parity, BMI, BBD histology, menopausal status, family history, PP and involution extent.Results: A total of 2666 women in the Mayo BBD cohort, with biopsies between 1985 and 1991, had a mammogram within 6 months of the breast biopsy. The mean age at biopsy was 54.6 years. After a mean follow-up of 13.3 years, 172 (6.5%) women developed breast cancer. After adjustment for PP and other confounders, women with no or partial involution had elevated risk compared to women with complete involution (HR 2.62 [95% CI 1.39, 4.94] for no involution and 1.61 [95% CI 1.03, 2.53] for partial involution; complete involution as reference group; p for trend 0.003). Moreover, women with dense breasts were at greater risk compared to women with nondense breasts (HR 1.67 [95% CI 1.0, 2.73] for DY pattern, 1.96 [95% CI 1.2 – 3.21] for P2, 1.23 [95% CI 0.67, 2.26] for P1; N1 category as reference group; p for trend 0.02). Multivariate analyses also showed that women with the combination of no involution and dense breasts had greater risk compared to those with complete involution and nondense breasts (HR 4.08 [95% CI 1.72, 9.68]).Conclusion: Lobular involution and MD are both risk factors for breast cancer; this report is the first to demonstrate that each provides unique information about breast cancer risk. These findings emphasize the potential for inclusion of both these factors in future breast cancer risk-prediction models.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6064.

Evaluation of the Tyrer-Cuzick Model in Women with Atypical Hyperplasia

Background: Risk prediction models are important clinical tools for counseling and decision making for women with an elevated risk of breast cancer, such as women with atypical lobular or ductal hyperplasia (atypia). The Gail model has been shown to underestimate the risk of breast cancer in women with atypia. We sought to evaluate the performance of the Tyrer-Cuzick model in a well-defined cohort of women with atypia.Methods: The Mayo Benign Breast Disease (BBD) Cohort includes 9,376 women aged 18 to 85 who had an open breast biopsy with benign pathological findings between 1967 and 1991. The subset of women with atypia was identified by our study pathologists. Risk factor data required by the Tyrer-Cuzick model were collated for each woman, and the model was used to predict each woman's risk of developing invasive breast cancer within ten years. The predicted numbers of breast cancers were compared to the observed numbers to assess overall model calibration, and the concordance between breast cancer outcomes and predicted probabilities was used to measure the accuracy of the model on the individual level. Subset analysis of women with strong family history was performed. Strong family history was defined as: at least one first-degree relative with breast cancer before the age of 50 years or two or more relatives with breast cancer, at least one being a first degree relative.Results: Three hundred and thirty one women with atypia were identified. Over a mean follow up of 13.7 years, 62 (19%) women have developed invasive breast cancer. Thirty one women developed invasive cancer in the first ten years after biopsy. The Tyrer-Cuzick model predicted that 64.6 invasive breast cancers would occur in the first ten years after biopsy. Thus, the predicted to observed ratio was 2.08 [95% CI: 1.47 – 2.96], p < 0.001).The concordance statistic was 0.51, revealing that the Tyrer-Cuzick model did not accurately distinguish, on an individual level, between women who were diagnosed with invasive breast cancer within ten years of biopsy and those who were not.Performance was somewhat better in the subset of 68 women with a strong family history of breast cancer. The model predicted 12.3 invasive breast cancers, and 7 were observed, for a predicted to observed ratio of 1.76 [95% CI: 0.84 – 3.70]. The concordance statistic was 0.57.Conclusion: The Tyrer-Cuzick model significantly overestimated the risk of breast cancer in the first ten years after biopsy for this group of women with atypia. Individual risk estimates showed poor concordance. Performance was slightly improved in women with a strong family history of breast cancer. Physicians should be cautious when using the Tyrer-Cuzick model to predict ten-year risk in patients with atypia.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6063.

Predictive Factors for Positive Non-Sentinel Nodes Following a Positive Sentinel Node Biopsy: NSABP B-32

Background: Following a positive sentinel node biopsy (SNB), current guidelines recommend an axillary dissection (AD) regardless of SN metastatic tumor size. In the majority of clinically node negative patients the risk for positive non-sentinel axillary nodes (NSN) is low. Predictive factors for positive NSNs following a positive SNB are analyzed in NSABP B-32 with inclusion of SN metastatic tumor size.Materials and Methods: After stratification, women with operable invasive breast cancer and clinically negative nodes were randomized to Sentinel Node Resection (SNR) with immediate conventional Axillary Dissection (AD) [Group 1] or to SNR without AD [Group 2]. Group 2 patients with positive SNs underwent AD. A multivariate analysis of SN positive patients from both groups for whom both a SNR and an AD had been performed was used to assess the need for AD following SNB. Nodes were classified as either SNs or NSNs, defined as all axillary dissection nodes plus any intramammary or other nodes that were not resected as SNs.Results: Between May 1999 and February 2004, 5,611 patients were entered into NSABP Protocol B-32. There were a total of 1,361 SN positive patients with AD from both groups. Data from 1,166 patients were available for multivariate analysis which included SN metastatic tumor size in 735 patients: 424 patients with macrometastaes (>2 mm) and 311 with micrometastases (<2 mm). In 626 patients SN metastatic size was unknown.In patients with positive SNB, results from the final multivariate model based on 653 patients with known covariate values indicated clinical tumor size was a significant predictor for positive NSN (p=0.044, OR: 1.17). Lymphovascular invasion was a significant predictor for positive NSN (p=0.0004, OR: 1.85). SN metastatic tumor size (Macro vs Micro) was a highly significant predictor for positive NSN (p<0.0001, OR: 3.42). Age at study entry, treatment type, proposed type of surgery, HER-2 status, and location of tumor were not significant multivariate predictors for positive NSN. Predictive modeling for positive NSN probability will be presented.Conclusion: Completion AD following a positive SNB, although helpful in prognosis and treatment planning, may not be required in patients with small tumors, absence of lymphovascular invasion, and micrometastases.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 301.

p16 Expression and Breast Cancer Risk in Women with Atypical Hyperplasia

Background: p16 is a nuclear protein encoded by the p16INK4a gene that regulates the G1-S cell cycle checkpoint. Its overexpression could reflect normal proliferative arrest, but also the evolution of carcinogenic processes that have overcome the p16 block, with progression from hyperplasic lesions to invasive breast cancer. Our aim with this study was to correlate p16 expression, both individually and in combination with expression of COX-2 and Ki67, with subsequent risk of breast cancer among women with atypical hyperplasia. Methods: p16 expression was assessed by immunohistochemical assays in archival paraffin-embedded, formalin-fixed sections from 233 women with atypia whose biopsy specimens were obtained via surgical excision at the Mayo Clinic from January 1, 1967, through December 31, 1991. p16 expression was scored as percent of cells positive and intensity of staining. Risk factor information and follow-up for breast cancer events were obtained via study questionnaire and the medical records. Standardized incidence ratios (SIRs) were used to compare observed numbers of breast cancer events to population-based expected counts, both at 10 years and over the entire course of follow-up. Results: Forty-seven patients (20%) developed breast cancer with a mean follow-up of 14.3 (SD=6.96) years. The overall risk of developing breast cancer was not modified by increasing p16 overexpression (low percent of staining with RR=3.89, 95% CI=2.72 to 5.56; high percent of staining with RR=3.91, 95% CI=2.43 to 6.28; similar results for intensity of staining). However, overexpression of both p16 and COX2 conveyed a stronger risk of breast cancer (SIR=4.01, 95% CI 2.28 to 7.07) as compared to dual low expression (SIR 1.78, 95% CI 0.67-4.74). Moreover, overexpression of both Ki67 and p16 was related to a higher 10-year breast cancer risk (SIR 6.25, 95% CI 2.35-16.6) as compared to low expression of both markers (SIR 0.87, 95% CI 0.22-3.49). Conclusions: although single expression of p16 does not stratify breast cancer risk, its overexpression in concert with biomarkers that reflect other carcinogenic processes (e.g. Ki67 and COX2) could help to define risk of tumor development.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 910.

Efficacy and safety of sorafenib in patients with advanced renal cell carcinoma with and without prior cytokine therapy, a subanalysis of TARGET

Before the development of targeted therapies, administration of cytokines (e.g., interleukin-2, interferon-alpha) was the primary systemic treatment option for advanced renal cell carcinoma. Sorafenib, an oral targeted, multikinase inhibitor, significantly prolonged progression-free survival and overall survival in the Treatment Approaches in Renal Cancer Global Evaluation Trial (TARGET), a large (N = 903) phase III, double-blind, randomised, placebo-controlled study of patients with advanced renal cell carcinoma resistant to standard therapy. This analysis of a patient subgroup from TARGET evaluated the safety and efficacy of sorafenib in patients who had received prior cytokine therapy (sorafenib: n = 374; placebo: n = 368) and in patients who were cytokine-naïve (sorafenib: n = 77; placebo: n = 84). Progression-free survival was significantly prolonged with sorafenib therapy compared with placebo among patients with and without prior cytokine therapy (respectively 5.5 vs. 2.7 months; hazard ratio, 0.54; 95% confidence interval, 0.45-0.64 and 5.8 vs. 2.8 months; hazard ratio, 0.48; 95% confidence interval, 0.32-0.73). Clinical benefit rates for sorafenib-treated patients compared with placebo patients were also higher (cytokine-treated: 83 vs. 54.3%; cytokine-naïve: 85.7 vs. 56.0%). Sorafenib was well tolerated in both subgroups (grade 3/4: 20 and 22%, respectively). Sorafenib demonstrated a consistent, significant clinical benefit against advanced renal cell carcinoma, with a twofold improvement in progression-free survival and disease control rate, with similar toxicities in patients with or without prior cytokine treatment.

Polymorphic variation in TIRAP is not associated with susceptibility to childhood TB but may determine susceptibility to TBM in some ethnic groups

Host recognition of mycobacterial surface molecules occurs through toll like receptors (TLR) 2 and 6. The adaptor protein TIRAP mediates down stream signalling of TLR2 and 4, and polymorphisms in the TIRAP gene (TIRAP) have been associated with susceptibility and resistance to tuberculosis (TB) in adults. In order to investigate the role of polymorphic variation in TIRAP in childhood TB in South Africa, which has one of the highest TB incidence rates in the world, we screened the entire open reading frame of TIRAP for sequence variation in two cohorts of childhood TB from different ethnic groups (Xhosa and mixed ancestry). We identified 13 SNPs, including seven previously unreported, in the two cohorts, and found significant differences in frequency of the variants between the two ethnic groups. No differences in frequency between individual SNPs or combinations were found between TB cases and controls in either cohort. However the 558C→T SNP previously associated with TB meningitis (TBM) in a Vietnamese population was found to be associated with TBM in the mixed ancestry group. Polymorphisms in TIRAP do not appear to be involved in childhood TB susceptibility in South Africa, but may play a role in determining occurrence of TBM.

Long-term safety of sorafenib (SOR) for the treatment (tx) of advanced clear-cell renal-cell carcinoma (RCC): Data analysis from patients (pts) treated for over 1 year in the phase III TARGET study

e16057

Background: Results of the phase III multicenter TARGET study, a randomized, double-blind, placebo (PBO)- controlled study of tx with SOR in pts with clear-cell RCC in whom 1 prior systemic therapy had failed, indicated that SOR is effective (PFS 5.5 vs 2.8 mo, HR=0.44, P<0.000001, and 39% increase in survival for SOR vs PBO, HR=0.71, P=0.015) and safe in pts with advanced RCC (Escudier et al. N Engl J Med. 2007). With a database cut-off of Sept 8, 2006, we analyzed the safety of long-term use of SOR in pts in TARGET (study start Nov 2003). Methods: Pts (N=903) with advanced metastatic clear-cell RCC that had progressed after 1 systemic tx, ECOG PS 0–2, and low- or intermediate-risk MSKCC score were randomized 1:1 to SOR 400 mg BID or PBO. End points included OS, PFS, and safety. A single planned analysis of PFS showed a significant benefit of SOR over PBO; consequently, pts assigned to PBO were offered SOR. Descriptive analysis of safety and efficacy of pts treated >1 year (y) was conducted. Results: 169/903 pts were randomized to SOR and treated >1 y and 27 pts treated >2 y. Due to crossover of PBO to SOR, only 6 pts randomized to PBO were treated with SOR >1 y. Pts treated with SOR >1 y had median PFS of 10.9 months and a response rate of 22.5%. Median tx duration was 20 months. Drug-related adverse events (AEs) were mainly grades 1 and 2 and occurred early during tx (see Table ); 31% and 22% of pts required dose interruption and reduction, respectively, because of AEs. Conclusions: Long-term tx with SOR did not result in new toxicities or an increase in overall incidence of tx-related AEs. Toxicity was not cumulative and no increase in grades 3/4 AEs was observed. Pts with preexisting cardiac disease or hypertension tolerated long-term tx with SOR; no dose reduction was required. No increase in cardiovascular toxicity was observed in this pt population. Long-term tx of pts with advanced RCC with SOR is medically manageable, with a predictable AE profile. [Table: see text]

[Table: see text]

Search for charged higgs bosons decaying into top and bottom quarks in pp[over ] collisions

We describe a search for production of a charged Higgs boson, qq[over ];{'}-->H;{+}, reconstructed in the tb[over ] final state in the mass range 180< or =M_{H;{+}}< or =300 GeV. The search was undertaken at the Fermilab Tevatron collider with a center-of-mass energy sqrt[s]=1.96 TeV and uses 0.9 fb;{-1} of data collected with the D0 detector. We find no evidence for charged Higgs boson production and set upper limits on the production cross section in the types I, II, and III two-Higgs-doublet models (2HDMs). An excluded region in the (M_{H;{+}}, tanbeta) plane for type I 2HDM is presented.

Smoking in Ghana: a review of tobacco industry activity

Background:

African countries are a major potential market for the tobacco industry, and the smoking epidemic is at various stages of evolution across the continent. Ghana is an African country with a low prevalence of smoking despite an active tobacco industry presence for over 50 years. This study explores potential reasons for this apparent lack of industry success.

Objective:

To explore the history of tobacco industry activity in Ghana and to identify potential reasons for the current low prevalence of smoking.

Methods:

A search was made of tobacco industry archives and other local sources to obtain data relevant to marketing and consumption of tobacco in Ghana.

Findings:

British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954. After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006.

Conclusion:

The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions, which may have restricted industry growth, are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date.

Measurement of the lifetime of the Bc+/- meson in the semileptonic decay channel

Using approximately 1.3 fb(-1) of data collected by the D0 detector between 2002 and 2006, we measure the lifetime of the Bc+/- meson in the Bc-/+-->J/psimicro+/-+X final state. A simultaneous unbinned likelihood fit to the J/psi+micro invariant mass and lifetime distributions yields a signal of 881+/-80(stat) candidates and a lifetime measurement of tau(Bc+/-)=0.448(-0.036)(+0.038)(stat)+/-0.032(syst) ps.

Oestrogen-mediated phosphorylation and stabilization of BRCA2 protein in breast

Disease-associated BRCA2 mutations typically result in protein truncations that delete the phosphorylation-regulated S3291 BRCA2 domain that interacts with Rad51. BRCA2 hereditary breast cancers are usually ER(+), differing from BRCA1 hereditary cancers, which are usually ER(-). We studied BRCA2 protein expression and S3291 phosphorylation in normal breast tissues and in sporadic breast cancers and observed that BRCA2 is expressed and phosphorylated in normal breast and 10 ER(+) breast cancers but not in 10 ER(-) breast cancers. In order to study this correlation between ER and BRCA2 expression, we studied ER(+) breast cancer cell lines. We found that a rapid increase in BRCA2 S3291 phosphorylation occurs following 17-beta-oestradiol (E2) treatment. This increase seen in BRCA2 total and phospho-S3291 protein levels was found to be unaffected with cycloheximide pre-treatment, but decreased following tamoxifen, ICI 182,780 or roscovitine treatment. This suggests a requirement for ER and cdk (cyclin-dependent kinase) in mediating the increased protein levels. MCF7 cell cycle distribution analysis following E2, in both the presence and absence of roscovitine (a cdk inhibitor), did not demonstrate any changes during an 8 h period, which further supports our hypothesis that mitogenic effects of E2 are not predominant at early time points. Studies with MG132 proteasome inhibitor and siRNA to skp2 support a model in which skp2-mediated proteasomal degradation of BRCA2 rapidly degrades BRCA2 protein in the absence of hormone treatment, which likely inhibits this pathway. E2 was shown to improve survival of MCF7 cells upon radiation treatment and roscovitine partially reversed this effect. We have demonstrated that BRCA2 protein is specifically expressed in ER(+) breast cancers and are investigating a pathway that may show a link between E2 action and BRCA2 protein function in breast cancer.

Measurement of the semileptonic branching ratio of B_{s};{0} to an orbitally excited D_{s};{**} state: Br(B_{s};{0}-->D_{s1};{-}(2536)mu;{+}nuX)

In a data sample of approximately 1.3 fb;{-1} collected with the D0 detector between 2002 and 2006, the orbitally excited charm state D_{s1};{+/-}(2536) has been observed with a measured mass of 2535.7+/-0.6(stat)+/-0.5(syst) MeV/c;{2} via the decay mode B_{s};{0}-->D_{s1};{-}(2536)mu;{+}nu_{mu}X. A first measurement is made of the branching ratio product Br(b[over ]-->D_{s1};{-}(2536)mu;{+}nu_{mu}X)xBr(D_{s1};{-}-->D;{*-}K_{S};{0}). Assuming that D_{s1};{-}(2536) production in semileptonic decay is entirely from B_{s};{0}, an extraction of the semileptonic branching ratio Br(B_{s};{0}-->D_{s1};{-}(2536)mu;{+}nu_{mu}X) is made.

Aicardi syndrome in a male patient

Aicardi syndrome ( OMIM 304050) is defined by the clinical triad of early-onset infantile spasms, agenesis of the corpus callosum and chorioretinal lacunae. Almost all patients are females showing severe cognitive and physical disabilities, and early onset seizures. Astrocytic inclusions containing filamin have been found, but the molecular defect in Aicardi syndrome is not yet known. We report a male patient with Aicardi syndrome characterised by agenesis of the corpus callosum, infantile spasms, chorioretinal lacunae, severe psychomotor retardation, periventricular heterotopias, and patent ductus arteriosus. As the latter two symptoms are suggestive of a mutation in the FLNA gene encoding filamin A, this gene was sequenced, but the sequence did not reveal a disease-causing mutation.

A novel breast tissue feature strongly associated with risk of breast cancer

Abstract #5008

Background: Accurate, individualized risk prediction for breast cancer is lacking. Tissue-based features, such as the terminal duct lobular unit (TDLU), may help to stratify women into different risk levels as breast lobules are the anatomic sites of origin of breast cancer. As women age, these lobular structures should regress, which results in reduced breast cancer risk. Regression, however, does not occur in all women.&#x2028; Materials and Methods: We have quantified the extent of lobule regression on a benign breast biopsy in 85 breast cancer cases and 142 age-matched controls from the Mayo Benign Breast Disease Cohort, by determining number of acini/lobule and lobular area. We also calculated Gail model 5-year predicted risks for these women.&#x2028; Results: There is a step-wise increase in breast cancer risk with increasing numbers of acini/lobule (p=0.0004). Adjusting for Gail model score, parity, histology, and family history did not attenuate this association.&#x2028; &#x2028; Lobular area was similarly associated with risk. The Gail model estimates were associated with risk of breast cancer (p=0.03). We examined the individual accuracy of these measures using the concordance (c) statistic. The Gail model c-statistic was 0.60 (95% CI; 0.50-0.70); the acinar count c-statistic was 0.65 (95% CI; 0.54-0.75). Combining acinar count and lobular area, the c-statistic was 0.68 (95% GI; 0.58-0.78). Adding the Gail model to these did not improve the c-statistic.&#x2028; &#x2028; Discussion: Novel, tissue-based features that reflect the status of a woman's normal breast lobules are strongly associated with breast cancer risk. These features appear to provide more accurate risk assessment than the currently used Gail model.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5008.

Search for third generation scalar leptoquarks decaying into taub

We have searched for third generation leptoquarks (LQ3) using 1.05 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron Collider operating at sqrt[s]=1.96 TeV. We set a 95% C.L. lower limit of 210 GeV on the mass of a scalar LQ3 state decaying solely to a b quark and a tau lepton.

Measurement of Bs0 mixing parameters from the flavor-tagged decay Bs0-->J/psiphi

From an analysis of the flavor-tagged decay Bs0-->J/psiphi we obtain the width difference between the Bs0 light and heavy mass eigenstates, DeltaGammas = 0.19+/-0.07(stat)(-0.01)+0.02(syst) ps(-1), and the CP-violating phase, phi s= -0.57(-0.30)+0.24(stat)(-0.02)+0.08(syst). The allowed 90% CL intervals of DeltaGammas and phi s are 0.06 < DeltaGammas < 0.30 ps(-1) and -1.20 < phi s < 0.06, respectively. The data sample corresponds to an integrated luminosity of 2.8 fb(-1) accumulated with the D0 detector at the Fermilab Tevatron collider.

Initial description of the human NLRP3 promoter

Mutations in NLRP3 (CIAS1) are identified in a continuum of related inflammatory disorders, known as cryopyrinopathies since NLRP3 codes for the protein cryopyrin. Approximately 40% of patients with classic presentation lack mutations in the coding region of NLRP3 suggesting heterogeneity or epigenetic factors. Cryopyrin is a key regulator of proinflammatory cytokine release. Therefore, variations in the NLRP3 promoter sequence may have effects on disease state in patients with cryopyrinopathies and other inflammatory diseases. In this report, we confirmed three 5'-untranslated region splice forms with two separate transcriptional start sites, and identified potential promoter regions and six new DNA promoter variants. One variant is unique to a mutation negative cryopyrinopathy patient and increases in vitro gene expression. Additional studies can now be performed to further characterize the NLRP3 promoter and sequence variants, which will lead to better understanding of the regulation of NLRP3 expression and its role in disease.

Search for neutral Higgs bosons in multi-b-jet events in pp[over] collisions at sqrt[s]=1.96 TeV

Data recorded by the D0 experiment at the Fermilab Tevatron Collider are analyzed to search for neutral Higgs bosons produced in association with b quarks. This production mode can be enhanced in the minimal supersymmetric standard model (MSSM). The search is performed in the three b quark channel using multijet triggered events corresponding to an integrated luminosity of 1 fb(-1). No statistically significant excess of events with respect to the predicted background is observed and limits are set in the MSSM parameter space.

Measurement of the forward-backward charge asymmetry and extraction of sin2thetaWeff in pp-->Z/gamma* + X-->e+e- +X events produced at sqrt[s] = 1.96 TeV

We present a measurement of the forward-backward charge asymmetry (A FB) in pp-->Z/gamma* + X-->e+e(-) + X events at a center-of-mass energy of 1.96 TeV using 1.1 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron collider. A FB is measured as a function of the invariant mass of the electron-positron pair, and found to be consistent with the standard model prediction. We use the A FB measurement to extract the effective weak mixing angle sin2thetaWeff = 0.2326+/-0.0018(stat)+/-0.0006(syst).

Measurement of the polarization of the upsilon(1S) and upsilon(2S) states in pp collisions at square root[s]=1.96 TeV

We present a study of the polarization of the Upsilon(1S) and Upsilon(2S) states using a 1.3 fb;{-1} data sample collected by the D0 experiment in 2002-2006 during run II of the Fermilab Tevatron Collider. We measure the polarization parameter alpha=(sigma_{T}-2sigma_{L})/(sigma_{T}+2sigma_{L}), where sigma_{T} and sigma_{L} are the transversely and longitudinally polarized components of the production cross section, as a function of the transverse momentum (p_{T};{Upsilon}) for the Upsilon(1S) and Upsilon(2S). Significant p_{T};{Upsilon}-dependent longitudinal polarization is observed for the Upsilon(1S). A comparison with theoretical models is presented.

Search for pair production of doubly charged Higgs bosons in the H++H- - -->mu+ mu+ mu- mu- final state

We report the results of a search for pair production of doubly charged Higgs bosons via pp over-->H++H - - X-->mu+ mu+ mu- mu- X at sqrt s=1.96 TeV. We use a data set corresponding to an integrated luminosity of 1.1 fb(-1) collected from 2002 to 2006 by the D0 detector at the Fermilab Tevatron Collider. In the absence of an excess above the standard model background, lower mass limits of M(H L +/- +/-) >150 GeV/c2 and M(H R+/- +/-) >127 GeV/c2 at 95% C.L. are set, respectively, for left-handed and right-handed doubly charged Higgs bosons assuming a 100% branching ratio into muons.

Search for Higgs bosons decaying to tau pairs in pp over collisions with the D0 detector

We present a search for the production of neutral Higgs bosons varphi decaying into tau+tau - final states in pp over collisions at a center-of-mass energy of 1.96 TeV. The data, corresponding to an integrated luminosity of approximately 1 fb(-1), were collected by the D0 experiment at the Fermilab Tevatron Collider. Limits on the production cross section times branching ratio are set. The results are interpreted in the minimal supersymmetric standard model yielding limits that are the most stringent to date at hadron colliders.

Measurement of the inclusive jet cross section in pp[over] collisions at square root [s]=1.96 TeV

We report on a measurement of the inclusive jet cross section in pp[over ] collisions at a center-of-mass energy sqrt[s]=1.96 TeV using data collected by the D0 experiment at the Fermilab Tevatron Collider corresponding to an integrated luminosity of 0.70 fb;{-1}. The data cover jet transverse momenta from 50 to 600 GeV and jet rapidities in the range -2.4 to 2.4. Detailed studies of correlations between systematic uncertainties in transverse momentum and rapidity are presented, and the cross section measurements are found to be in good agreement with next-to-leading order QCD calculations.

Search for decay of a fermiophobic Higgs boson hf-->gammagamma with the D0 detector at sqrt s=1.96 TeV

We report the results of a search for a narrow resonance decaying into two photons in 1.1 fb;{-1} of data collected by the D0 experiment at the Fermilab Tevatron Collider during the period 2002-2006. We find no evidence for such a resonance and set a lower limit on the mass of a fermiophobic Higgs boson of m_{h_{f}}>100 GeV at the 95% C.L. This exclusion limit exceeds those obtained in previous searches at the Fermilab Tevatron and covers a significant region of the parameter space B(h_{f}-->gammagamma) vs m_{h_{f}} which was not accessible at the CERN Large Electron-Positron Collider.

Paediatric tuberculosis

Tuberculosis continues to cause an unacceptably high toll of disease and death among children worldwide, particularly in the wake of the HIV epidemic. Increased international travel and immigration have led to a rise in childhood tuberculosis rates even in traditionally low burden, industrialised settings, and threaten to promote the emergence and spread of multidrug-resistant strains. Whereas intense scientific and clinical research efforts into novel diagnostic, therapeutic, and preventive interventions have focused on tuberculosis in adults, childhood tuberculosis has been relatively neglected. However, children are particularly vulnerable to severe disease and death following infection, and those with latent infection become the reservoir for future transmission following disease reactivation in adulthood, fuelling future epidemics. Further research into the epidemiology, immune mechanisms, diagnosis, treatment, and prevention of childhood tuberculosis is urgently needed. Advances in our understanding of tuberculosis in children would provide insights and opportunities to enhance efforts to control this disease.

Search for large extra dimensions via single photon plus missing energy final states at sqrt s = 1.96 TeV

We report on a search for large extra dimensions in a data sample of approximately 1 fb(-1) of pp[over] collisions at sqrt s=1.96 TeV. We investigate Kaluza-Klein graviton production with a photon and missing transverse energy in the final state. At the 95% C.L. we set limits on the fundamental mass scale M(D) from 884 to 778 GeV for two to eight extra dimensions.

Observation of the Bc meson in the exclusive decay Bc-->J/psipi

A fully reconstructed Bc-->J/psipi signal is observed with the D0 detector at the Fermilab Tevatron pp[over] collider using 1.3 fb(-1) of integrated luminosity. The signal consists of 54+/-12 candidates with a significance that exceeds 5 standard deviations, and confirms earlier observations of this decay. The measured mass of the Bc meson is 6300+/-14(stat)+/-5(syst) MeV/c2.

First study of the radiation-amplitude zero in Wgamma production and limits on anomalous WWgamma couplings at sqrt[s]=1.96 TeV

We present results from a study of pp-->Wgamma+X events utilizing data corresponding to 0.7 fb{-1} of integrated luminosity at sqrt[s]=1.96 TeV collected by the D0 detector at the Fermilab Tevatron Collider. We set limits on anomalous WWgamma couplings at the 95% C.L. The one-dimensional 95% C.L. limits are 0.49<kappa{gamma}<1.51 and -0.12<lambda{gamma}<0.13. We make the first study of the charge-signed rapidity difference between the lepton and the photon and find it to be indicative of the standard model radiation-amplitude zero in the Wgamma system.

Search for scalar neutrino superpartners in e+mu final states in pp collisions at sqrt[s]=1.96 TeV

We report a search for R-parity-violating production and decay of sneutrino particles in the emu final state with 1.04+/-0.06 fb-1 of data collected with the D0 detector at the Fermilab Tevatron Collider in 2002-2006. Good agreement between the data and the standard model prediction is observed. With no evidence for new physics, we set limits on the R-parity-violating couplings lambda'311 and lambda312 as a function of the sneutrino mass.

Search for W' boson resonances decaying to a top quark and a bottom quark

We search for the production of a heavy W' gauge boson that decays to third generation quarks in 0.9 fb-1 of pp collisions at square root(s)=1.96 TeV, collected with the D0 detector at the Fermilab Tevatron collider. We find no significant excess in the final-state invariant mass distribution and set upper limits on the production cross section times branching fraction. For a left-handed W' boson with SM couplings, we set a lower mass limit of 731 GeV. For right-handed W' bosons, we set lower mass limits of 739 GeV if the W' boson decays to both leptons and quarks and 768 GeV if the W' boson decays only to quarks. We also set limits on the coupling of the W' boson to fermions as a function of its mass.

Study of direct CP violation in B(+/-)-->J/psiK(+/-)(pi(+/-)) decays

We present a search for direct CP violation in B(+/-)-->J/psiK(+/-)(pi(+/-)) decays. The event sample is selected from 2.8 fb(-1) of pp collisions recorded by D0 experiment in run II of the Fermilab Tevatron Collider. The charge asymmetry A_(CP)(B(+)-->J/psiK(+))= + 0.0075 +/- 0.0061(stat)+/-0.0030(syst) is obtained using a sample of approximately 40, 000 B(+/-)-->J/psiK(+/-) decays. The achieved precision is of the same level as the expected deviation predicted by some extensions of the standard model. We also measured the charge asymmetry A(CP)(B(+)-->J/psipi(+))=-0.09+/-0.08(stat)+/-0.03(syst).

Simultaneous measurement of the ratio R=B(t --> Wb)/B(t --> Wq) and the top-quark pair production cross section with the D0 detector at sqrt(s) = 1.96 TeV

We present the first simultaneous measurement of the ratio of branching fractions, R=B(t --> Wb)/B(t --> Wq), with q being a d, s, or b quark, and the top-quark pair production cross section sigma(tt[over]) in the lepton plus jets channel using 0.9 fb(-1) of pp[over] collision data at sqrt(s)=1.96 TeV collected with the D0 detector. We extract R and sigma(tt[over]) by analyzing samples of events with 0, 1, and > or =2 identified b jets. We measure R=0.97(+0.09)/(-0.08)(stat+syst) and sigma(tt[over])=8.18(+0.09)(-0.84)(stat+syst) +/- 0.50(lumi) pb, in agreement with the standard model prediction.

Measurement of the tt[over] production cross section in pp[over] collisions at sqrt(s)=1.96 TeV

We measure the tt[over] production cross section in pp[over] collisions at sqrt(s)=1.96 TeV in the lepton + jets channel. Two complementary methods discriminate between signal and background: b tagging and a kinematic likelihood discriminant. Based on 0.9 fb(-1) of data collected by the D0 detector at the Fermilab Tevatron Collider, we measure sigma(tt[over])=7.62+/-0.85 pb, assuming the current world average m(t)=172.6 GeV. We compare our cross section measurement with theory predictions to determine a value for the top-quark mass of 170+/-7 GeV.

Measurement of the forward-backward charge asymmetry in top-quark pair production

We present the first measurement of the integrated forward-backward charge asymmetry in top-quark-top-antiquark pair (tt) production in proton-antiproton (pp) collisions in the lepton+jets final state. Using a b-jet tagging algorithm and kinematic reconstruction assuming tt + X production and decay, a sample of 0.9 fb(-1) of data, collected by the D0 experiment at the Fermilab Tevatron Collider, is used to measure the asymmetry for different jet multiplicities. The result is also used to set upper limits on tt+X production via a Z' resonance.

Search for ZZ and Zgamma* production in pp[over ] collisions at square root s=1.96 TeV and limits on anomalous ZZZ and ZZgamma* couplings

We present a study of micro micro micro micro, eeee, and micro micro ee events using 1 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron pp[over ] Collider at square root s=1.96 TeV. Requiring the lepton pair masses to be greater than 30 GeV, we observe one event, consistent with the expected background of 0.13+/-0.03 events and with the predicted standard model ZZ and Zgamma* production of 1.71+/-0.15 events. We set an upper limit on the ZZ and Zgamma* cross section of 4.4 pb at the 95% C.L. We also derive limits on anomalous neutral trilinear ZZZ and ZZgamma* gauge couplings. The one-parameter 95% C.L. coupling limits with a form-factor scale Lambda=1.2 TeV are -0.28<f(40)(Z)<0.28, -0.31<f(50)(Z)<0.29, -0.26<f(40)(gamma)<0.26, and -0.30<f(50)(gamma)<0.28.