Complete Measurement of the Λ Electromagnetic Form Factors

The exclusive process e^{+}e^{-}→ΛΛ[over ¯], with Λ→pπ^{-} and Λ[over ¯]→p[over ¯]π^{+}, has been studied at sqrt[s]=2.396  GeV for measurement of the timelike Λ electric and magnetic form factors, G_{E} and G_{M}. A data sample, corresponding to an integrated luminosity of 66.9  pb^{-1}, was collected with the BESIII detector for this purpose. A multidimensional analysis with a complete decomposition of the spin structure of the reaction enables a determination of the modulus of the ratio R=|G_{E}/G_{M}| and, for the first time for any baryon, the relative phase ΔΦ=Φ_{E}-Φ_{M}. The resulting values are R=0.96±0.14(stat)±0.02(syst) and ΔΦ=37°±12°(stat)±6°(syst), respectively. These are obtained using the recently established and most precise value of the asymmetry parameter α_{Λ}=0.750±0.010 measured by BESIII. In addition, the cross section is measured with unprecedented precision to be σ=118.7±5.3(stat)±5.1(syst)  pb, which corresponds to an effective form factor of |G|=0.123±0.003(stat)±0.003(syst). The contribution from two-photon exchange is found to be negligible. Our result enables the first complete determination of baryon timelike electromagnetic form factors.

Amplitude Analysis of D_{s}^{+}→π^{+}π^{0}η and First Observation of the W-Annihilation Dominant Decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}

We present the first amplitude analysis of the decay D_{s}^{+}→π^{+}π^{0}η. We use an e^{+}e^{-} collision data sample corresponding to an integrated luminosity of 3.19  fb^{-1} collected with the BESIII detector at a center-of-mass energy of 4.178 GeV. We observe for the first time the W-annihilation dominant decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}. We measure the absolute branching fraction B(D_{s}^{+}→a_{0}(980)^{+(0)}π^{0^{(}+)},a_{0}(980)^{+(0)}→π^{+(0)}η)=(1.46±0.15_{stat}±0.23_{sys})%, which is larger than the branching fractions of other measured pure W-annihilation decays by at least one order of magnitude. In addition, we measure the branching fraction of D_{s}^{+}→π^{+}π^{0}η with significantly improved precision.

Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability: a retrospective comparative study

AIMS

The aim of this study was to describe the use of 3D-printed sacral endoprostheses to reconstruct the pelvic ring and re-establish spinopelvic stability after total en bloc sacrectomy (TES) and to review its outcome.

PATIENTS AND METHODS

We retrospectively reviewed 32 patients who underwent TES in our hospital between January 2015 and December 2017. We divided the patients into three groups on the basis of the method of reconstruction: an endoprosthesis group (n = 10); a combined reconstruction group (n = 14), who underwent non-endoprosthetic combined reconstruction, including anterior spinal column fixation; and a spinopelvic fixation (SPF) group (n = 8), who underwent only SPF. Spinopelvic stability, implant survival (IS), intraoperative haemorrhage rate, and perioperative complication rate in the endoprosthesis group were documented and compared with those of other two groups.

RESULTS

The mean overall follow-up was 22.1 months (9 to 44). In the endoprosthesis group, the mean intraoperative hemorrhage was 3530 ml (1600 to 8100). Perioperative complications occurred in two patients; both had problems with wound healing. After a mean follow-up of 17.7 months (12 to 38), 9/10 patients could walk without aids and 8/10 patients were not using analgesics. Imaging evidence of implant failure was found in three patients, all of whom had breakage of screws and/or rods. Only one of these, who had a local recurrence, underwent re-operation, at which solid bone-endoprosthetic osseointegration was found. The mean IS using re-operation as the endpoint was 32.5 months (95% confidence interval 23.2 to 41.8). Compared with the other two groups, the endoprosthesis group had significantly better spinopelvic stability and IS with no greater intraoperative haemorrhage or perioperative complications.

CONCLUSION

The use of 3D-printed endoprostheses for reconstruction after TES provides reliable spinopelvic stability and IS by facilitating osseointegration at the bone-implant interfaces, with acceptable levels of haemorrhage and complications. Cite this article: Bone Joint J 2019;101-B:880-888.

Clinical outcomes of ultrasound-guided radiofrequency ablation for the treatment of primary papillary thyroid microcarcinoma

AIM

To evaluate the safety, efficacy, and long-term outcomes of ultrasound-guided radiofrequency ablation (RFA) for the treatment of primary papillary thyroid microcarcinoma (PTMC).

MATERIALS AND METHODS

A total of 37 patients with 38 PTMC nodules underwent RFA at a power of 20 W between September 2014 and December 2017. The clinical data of these patients were reviewed retrospectively and analysed. Imaging studies of the nodules were conducted, and the patients' thyroid function was assessed before RFA; 1, 3, 6, and 12 months after RFA; and every 6 months thereafter. The volumes and volume reduction rate (VRR) of the nodules were also calculated.

RESULTS

RFA with a low power of 20 W was used in the treatment of 37 patients with 38 PTMC nodules. All nodules achieved complete ablation, no complications occurred, and thyroid function was not affected. During follow-up, the volume of the nodules gradually decreased. Twelve months after ablation, the mean volumes of the nodules significantly decreased to 0.01±0.03 ml with a VRR of 99.34±3.49%. At a median follow-up of 6 (range: 1-18) months, 37 of the 38 nodules were completely absorbed, and no recurrence was observed in all 37 patients.

CONCLUSIONS

Low-power RFA showed good safety and promising efficacy outcomes for the treatment of PTMC. In addition to surgery and active surveillance, RFA may be an alternative treatment option for patients with PTMC.

Study of e^{+}e^{-}→γωJ/ψ and Observation of X(3872)→ωJ/ψ

We study the e^{+}e^{-}→γωJ/ψ process using 11.6  fb^{-1} e^{+}e^{-} annihilation data taken at center-of-mass energies from sqrt[s]=4.008  GeV to 4.600 GeV with the BESIII detector at the BEPCII storage ring. The X(3872) resonance is observed for the first time in the ωJ/ψ system with a significance of more than 5σ. The relative decay ratio of X(3872)→ωJ/ψ and π^{+}π^{-}J/ψ is measured to be R=1.6_{-0.3}^{+0.4}±0.2, where the first uncertainty is statistical and the second systematic (the same hereafter). The sqrt[s]-dependent cross section of e^{+}e^{-}→γX(3872) is also measured and investigated, and it can be described by a single Breit-Wigner resonance, referred to as the Y(4200), with a mass of 4200.6_{-13.3}^{+7.9}±3.0  MeV/c^{2} and a width of 115_{-26}^{+38}±12  MeV. In addition, to describe the ωJ/ψ mass distribution above 3.9  GeV/c^{2}, we need at least one additional Breit-Wigner resonance, labeled as X(3915), in the fit. The mass and width of the X(3915) are determined. The resonant parameters of the X(3915) agree with those of the Y(3940) in B→KωJ/ψ and of the X(3915) in γγ→ωJ/ψ observed by the Belle and BABAR experiments within errors.

Observation of the Decay X(3872)→π^{0}χ_{c1}(1P)

Using a total of 9.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.15 and 4.30 GeV collected by the BESIII detector, we search for the processes e^{+}e^{-}→γX(3872) with X(3872)→π^{0}χ_{cJ} for J=0, 1, 2. We report the first observation of X(3872)→π^{0}χ_{c1}, a new decay mode of the X(3872), with a statistical significance of more than 5σ for all systematic fit variations. Normalizing to the previously established process e^{+}e^{-}→γX(3872) with X(3872)→π^{+}π^{-}J/ψ, we find B(X(3872)→π^{0}χ_{c1})/B(X(3872)→π^{+}π^{-}J/ψ)=0.88_{-0.27}^{+0.33}±0.10, where the first error is statistical and the second is systematic. We set 90% confidence level upper limits on the corresponding ratios for the decays to π^{0}χ_{c0} and π^{0}χ_{c2} of 19 and 1.1, respectively.

Composition and tocopherol, fatty acid, and phytosterol contents in micro-endosperm ultra-high oil corn

China has developed a new oil crop, micro-endosperm ultra-high oil corn, approved by the government in 2011 and named Huajian No. 1 (HJ-1). This study analyzed the nutrients in HJ-1 cold-pressed whole-seed oil, their composition and contents in tocopherols, fatty acids, and phytosterols and compares them with those of seven selected vegetable oils. HJ-1 oil contained α-, β-, γ-, and δ-tocopherol, with contents of 433.25 ± 0.13, 26.27 ± 0.08, 570.69 ± 0.27, and 38.41 ± 0.005 mg/kg, respectively, the highest nutritional values among the vegetable oils studied, except for soybean and palm oils. Gas chromatography was used for fatty acid analysis and seven were detected, with the main ones being palmitic, oleic, and linoleic acids. In HJ-1, the ratio of oleic to linoleic acid was close to 1:1, and b-sitosterol, campesterol, and stigmasterol were present with contents of 254.20 ± 0.11, 108.91 ± 0.19, and 105.67 ± 0.58 mg/kg, respectively.

Precision Measurement of the Branching Fractions of η^{'} Decays

Based on a sample of (1310.6±7.0)×10^{6}J/ψ events collected with the BESIII detector, we present measurements of J/ψ and η^{'} absolute branching fractions using the process J/ψ→γη^{'}. By analyzing events where the radiative photon converts into an e^{+}e^{-} pair, the branching fraction for J/ψ→γη^{'} is measured to be (5.27±0.03±0.05)×10^{-3}. The absolute branching fractions of the five dominant decay channels of the η^{'} are then measured for the first time and are determined to be B(η^{'}→γπ^{+}π^{-})=(29.90±0.03±0.55)%, B(η^{'}→ηπ^{+}π^{-})=(41.24±0.08±1.24)%, B(η^{'}→ηπ^{0}π^{0})=(21.36±0.10±0.92)%, B(η^{'}→γω)=(2.489±0.018±0.074)%, and B(η^{'}→γγ)=(2.331±0.012±0.035)%, where the first uncertainties are statistical and the second systematic.

DNA methylation alterations as therapeutic prospects in thyroid cancer

BACKGROUND

Thyroid cancer is one of the most common endocrine malignancies. Although the 10-year survival rate of differentiated thyroid cancer (DTC) is about 90% after conventional treatments, a small proportion of patients still suffer from tumor recurrence or drug resistance.

OBJECTIVE

This review article summarizes recent researches and clinical trials related to target drugs that reduce mortality in thyroid cancer.

METHODS

This is a review of the recent literature and clinical trials on the three main aspects including methylation genes in thyroid cancers, the relationship between BRAF mutation and gene methylation, target and dehypermethylation drugs in clinical trials.

RESULTS

We propose new approaches to treating malignant thyroid cancer, based on advances in understanding the relationship between genetic and epigenetic changes in thyroid cancer. Although the effect of traditional treatment for thyroid cancer is relatively good, a small proportion of patients still suffer from tumor recurrence or drug resistance. Molecular targeted drugs and dehypermethylation drugs have more promising outcomes in aggressive thyroid cancer compared with conventional treatments.

CONCLUSION

Based on what was discussed in this review, we suggest that integration of epigenetic and targeted therapies into conventional treatments will reduce the occurrence of refractory radioiodine differentiated thyroid cancer and improve the outcomes in aggressive thyroid cancer patients.

Magnetic resonance spectroscopy may serve as a presurgical predictor of somatostatin analog therapy response in patients with growth hormone-secreting pituitary macroadenomas

PURPOSE

Somatostatin analogs (SSAs) are considered one of the most effective medical treatments for patients with growth hormone-secreting pituitary adenomas (GH-PAs). The postoperative electron microscopy (EM) pathological subtype and SSTR2 expression in the tumor are the most established predictors of patient response to SSA therapy. The aim of this study was to evaluate how will magnetic resonance spectroscopy (MRS) measurements before surgery predict the EM pathological subtypes and SSTR2 expression of tumors, and thereby serve as an indicator for the therapeutic sensitivity to SSAs of patients with GH-PAs.

METHODS

Eighteen patients with GH pituitary macroadenomas who underwent transsphenoidal surgery were included in this retrospective study. The preoperative MRS data and T2 signal intensity were obtained from patients by 1.5 T MR spectroscopy of the sellar mass. The EM pathological subtypes of tumors were determined after surgery through examination of cell granulations. The expressions of somatostatin receptor 2 (SSTR2), SSTR5, P21, P27, and Ki-67 were evaluated by immunohistochemistry.

RESULTS

The MRS parameters that were found to significantly predict the EM pathological subtypes of tumors, as calculated by the receiver operating characteristic curve, were the choline (Ch) value at 3140.5 MR units (sensitivity 69.2%, specificity 100%) and the choline/creatine (Ch/Cr) ratio at 1.27 (sensitivity 92.3%, specificity 100%). Further, the Ch/Cr ratio, but not other MRS data, was shown to negatively correlate with the expression of SSTR2 (P = 0.02). The Ch/Cr ratio was also found to positively correlate with the Ki-67 value (P < 0.05) and T2 signal (P < 0.05), but not with other factors that were examined in this study. Moreover, the Ch/Cr ratio could predict the EM pathological subtypes of tumors with an accuracy of 83.3% (5/6) for patients with an isointense T2 signal.

CONCLUSION

The Ch/Cr ratio by MRS could effectively predict the tumor subtype and was significantly correlated with the expression of SSTR2, which was consistent with other predictors. It was also able to distinguish the patients with isointense T2 signals. Our results provide a potentially new and non-invasive method to predict the response to SSAs in patients with GH pituitary macroadenomas.

Measurement of the Dynamics of the Decays D_{s}^{+}→η^{(')}e^{+}ν_{e}

Using e^{+}e^{-} annihilation data corresponding to an integrated luminosity of 3.19  fb^{-1} collected at a center-of-mass energy of 4.178 GeV with the BESIII detector, we measure the absolute branching fractions B_{D_{s}^{+}→ηe^{+}ν_{e}}=(2.323±0.063_{stat}±0.063_{syst})% and B_{D_{s}^{+}→η^{'}e^{+}ν_{e}}=(0.824±0.073_{stat}±0.027_{syst})% via a tagged analysis technique, where one D_{s} is fully reconstructed in a hadronic mode. Combining these measurements with previous BESIII measurements of B_{D^{+}→η^{(')}e^{+}ν_{e}}, the η-η^{'} mixing angle in the quark flavor basis is determined to be ϕ_{P}=(40.1±2.1_{stat}±0.7_{syst})°. From the first measurements of the dynamics of D_{s}^{+}→η^{(')}e^{+}ν_{e} decays, the products of the hadronic form factors f_{+}^{η^{(')}}(0) and the Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| are determined with different form factor parametrizations. For the two-parameter series expansion, the results are f_{+}^{η}(0)|V_{cs}|=0.4455±0.0053_{stat}±0.0044_{syst} and f_{+}^{η^{'}}(0)|V_{cs}|=0.477±0.049_{stat}±0.011_{syst}.

Evidence of a Resonant Structure in the e^{+}e^{-}→π^{+}D^{0}D^{*-} Cross Section between 4.05 and 4.60 GeV

The cross section of the process e^{+}e^{-}→π^{+}D^{0}D^{*-} for center-of-mass energies from 4.05 to 4.60 GeV is measured precisely using data samples collected with the BESIII detector operating at the BEPCII storage ring. Two enhancements are clearly visible in the cross section around 4.23 and 4.40 GeV. Using several models to describe the dressed cross section yields stable parameters for the first enhancement, which has a mass of 4228.6±4.1±6.3  MeV/c^{2} and a width of 77.0±6.8±6.3  MeV, where the first uncertainties are statistical and the second ones are systematic. Our resonant mass is consistent with previous observations of the Y(4220) state and the theoretical prediction of a DD[over ¯]_{1}(2420) molecule. This result is the first observation of Y(4220) associated with an open-charm final state. Fits with three resonance functions with additional Y(4260), Y(4320), Y(4360), ψ(4415), or a new resonance do not show significant contributions from either of these resonances. The second enhancement is not from a single known resonance. It could contain contributions from ψ(4415) and other resonances, and a detailed amplitude analysis is required to better understand this enhancement.

Expression of programmed death ligand-1 and programmed death 1 in hepatocellular carcinoma and its clinical significance

Objective

To investigate the correlation between the expression of programmed death 1 (PD-1) and PD ligand-1 (PD-L1) in hepatocellular carcinoma (HCC) and clinical parameters.

Materials and Methods

The study comprised tumor sections from 45 HCC patients treated with curative resection, which were evaluated for PD-1 and PD-L1 protein expression by immunohistochemistry.

Results

PD-1 and PD-L1 expression was increased in cancers compared to adjacent normal tissues, with a positive rate of 37.78% (17/45) and 62.22% (28/45), respectively, which was positively correlated with the tumor stage and lymph node metastasis, negatively with postoperative prognosis. PD-1 positivity was most frequently observed in stromal tumor-infiltrating lymphocytes. The number of PD-1 positive lymphocyte was correlated with PD-L1 positive expression.

Conclusion

PD-L1 and PD-1 are overexpressed in HCC tissues. PD-L1 expression plays a critical role in the pathogenesis of human HCC, suggesting that it might be used as a new biomarker to predict the disease progression and prognosis.

Determination of the Pseudoscalar Decay Constant f_{D_{s}^{+}} via D_{s}^{+}→μ^{+}ν_{μ}

Using a 3.19  fb^{-1} data sample collected at an e^{+}e^{-} center-of-mass energy of E_{cm}=4.178  GeV with the BESIII detector, we measure the branching fraction of the leptonic decay D_{s}^{+}→μ^{+}ν_{μ} to be B_{D_{s}^{+}→μ^{+}ν_{μ}}=(5.49±0.16_{stat}±0.15_{syst})×10^{-3}. Combining our branching fraction with the masses of the D_{s}^{+} and μ^{+} and the lifetime of the D_{s}^{+}, we determine f_{D_{s}^{+}}|V_{cs}|=246.2±3.6_{stat}±3.5_{syst}  MeV. Using the c→s quark mixing matrix element |V_{cs}| determined from a global standard model fit, we evaluate the D_{s}^{+} decay constant f_{D_{s}^{+}}=252.9±3.7_{stat}±3.6_{syst}  MeV. Alternatively, using the value of f_{D_{s}^{+}} calculated by lattice quantum chromodynamics, we find |V_{cs}|=0.985±0.014_{stat}±0.014_{syst}. These values of B_{D_{s}^{+}→μ^{+}ν_{μ}}, f_{D_{s}^{+}}|V_{cs}|, f_{D_{s}^{+}} and |V_{cs}| are each the most precise results to date.

Abstract P3-08-01: Characteristics, outcomes and prognostic factors of luminal androgen receptor (LAR) triple-negative breast cancer (TNBC)

Background: The LAR subtype is a genomically distinct subset of TNBC. Using a large cohort of non-metastatic TNBC patients (pts) with long term follow-up, we sought to further characterize the clinicopathologic features and outcomes of LAR vs non-LAR TNBC.

Methods: From a cohort of 9982 women with surgically-treated non-metastatic breast cancer, 605 met criteria for TNBC (ER/PR&lt;1% and HER2-negative) by central pathology. RNA extracted from 304 FFPE tumor specimens using the HighPure RNA extraction kit was subjected to TruSeq RNA Access library preparation and sequencing on a HiSeq2500. Adequate RNA was available for 283 pts. Tumors were classified as LAR or non-LAR using a shrunken centroid model, CABAL (Clustering Among BAsal and Luminal androgen receptor). In addition to previously described analyses [Leon-Ferre et al, Breast Cancer Res Treat 2017], immunohistochemical (IHC) androgen receptor (AR) staining was performed and the impact of various parameters on invasive disease-free survival (IDFS) and overall survival (OS) was assessed using Cox proportional hazards models.

Results: 58 (20%) tumors were classified as LAR and 225 (80%) as non-LAR. Compared to non-LAR, LAR pts were older (mean age 65 vs 54) and more often postmenopausal (79%vs53%), both p=0.01. Apocrine histology was more common among LAR tumors (21%vs0%), which were also lower grade (grade3: 69%vs95%) and had lower Ki-67 (Ki-67&gt;15%: 64%vs82%), all p&lt;0.01. Additionally, LAR tumors had lower median stromal tumor infiltrating lymphocytes (TILs, 20%vs25%) and were less frequently lymphocyte-predominant [≥50% stromal or intratumoral TILs (19%vs32%)], although neither reached statistical significance. AR IHC was available for 223 of 283 tumors. Median AR IHC score in LAR was 65% (range 0-100%) vs 0% (range 0-90%) in non-LAR. T/N stage, surgery type, and receipt of adjuvant chemotherapy (AdjCT) or radiotherapy were similar between LAR and non-LAR. LAR pts had shorter IDFS and OS compared to non-LAR (5.6 vs 11.8 yrs and 10.8 vs 20.8 yrs, respectively), although this did not reach statistical significance. Test of proportional hazard assumption was not significant for IDFS or OS (p = 0.30 and 0.09). IDFS estimates were numerically higher in LAR vs non-LAR (80.2%vs70.5%,p = 0.92) at 3yrs post-diagnosis; whereas the opposite was true (40.9%vs55.6%,p = 0.07) after 10yrs. OS estimates at 3 and 5yrs were similar between LAR and non-LAR, but at 10yrs OS was inferior in LAR (40.9%vs66.4%,p = 0.24). In a univariate analysis including both LAR and non-LAR, older age, higher N stage, lower TILs and absence of AdjCT were associated with poorer IDFS and OS. In a multivariate analysis, higher N stage and absence of AdjCT remained associated with both poorer IDFS and OS; while lower stromal TILs were associated with poorer IDFS (p=0.01), and with a trend towards poorer OS (p=0.07).

Conclusions: LAR TNBCs occurred in older women, were lower grade, and had lower TIL density than nonLAR tumors. While significant differences in IDFS or OS were not demonstrated, LAR pts exhibited a numerically lower risk of a disease event at 3yrs, but higher risk by 10yrs compared to nonLAR pts. In the entire cohort, higher N stage, absence of AdjCT and lower TILs were independently associated with poorer outcomes.

Citation Format: Leon-Ferre RA, Polley M-Y, Liu H, Kalari KR, Boughey JC, Liu MC, Cafourek V, Negron V, Ingle JN, Thompson KJ, Tang X, Barman P, Carlson E, Visscher DW, Carter JC, Couch FJ, Goetz MP. Characteristics, outcomes and prognostic factors of luminal androgen receptor (LAR) triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-01.

Abstract P3-08-08: SOX11 is a potential prognostic marker of high-risk breast ductal carcinoma in situ

Ductal carcinoma in situ (DCIS) comprises 20-25% of screen-detected breast cancers and, like invasive ductal carcinoma (IDC), is heterogenous in terms of the underlying biology, presentation, and outcome. While there are limited potential biomarkers of outcome for DCIS, estrogen receptor (ER)- positive, progesterone receptor (PR)- positive, and HER2- negative DCIS appears to have a better prognosis compared to ER- negative, PR- negative, and HER2- positive DCIS. The aim of this study was to identify additional clinically relevant markers to stratify DCIS according to risk of relapse or progression to invasive disease. In order to determine the driver genes involved in DCIS evolution, we utilized transcriptional data sets (GSE788, GSE16873), containing data from both normal mammary glands (NMG) and DCIS. Upon performing class comparison (NMG vs DCIS), we identified 297 over-expressed genes and 187 under-expressed genes. The over-expressed genes represented mitotic and proliferative features annotated as mitotic spindle and condensed chromosomes, while the under-expressed genes were associated with loss of epithelial features annotated as epithelial cell differentiation and development. The 484 differentially expressed genes were further correlated with recurrence events using Kessler's breast cancer data set to identify genes contributing to the aggressive features across IDC and subsequently associated with DCIS. Genes correlating with recurrence events were selected. Of the 484 genes, 99 genes were found to be significantly associated with recurrence events of IDC (with P&lt;0.003). Among these 99 genes, component genes of the Oncotype DCIS score and genes reported as relevant to DCIS biology were included for Nanostring transcriptomic analysis. The final number of genes-of-interest were 58, including 5 housekeeping genes. 40 DCIS lesions and 8 NMG tissue were macro- dissected from formalin- fix paraffin- embedded blocks (FFPE) and extracted transcripts were subjected for Nanostring analysis. Gene expression data was clustered in an unsupervised manner using R software. Two sample clusters were identified: an ER/PR- negative cluster and an ER/PR- positive cluster. Over-expression of transcription factor SOX11, along with HER2, was exclusively seen in the ER/PR- negative cluster. This cluster was further categorized into HER2-low/SOX11+ and HER2-high/SOX11+ groups. These RNA expression findings are undergoing confirmation by immunohistochemistry (IHC) of the FFPE tumor sections. An independent series of 15 DCIS cases that have recurred as DCIS or progressed to IDC were analyzed by IHC, revealing SOX11 expression only present in cases displaying a high proportion of HER2+ expression. SOX11 is exclusively expressed in ER/PR-negative DCIS and is a candidate clinical marker for recurrence of DCIS or progression to IDC.

Citation Format: Ladha FA, Kai K, Lu W, Yang F, Tang X, Wistuba II, Sen S, Thompson A. SOX11 is a potential prognostic marker of high-risk breast ductal carcinoma in situ [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-08.

Abstract P1-02-10: Early stage breast cancer screening using an emerging novel liquid biopsy screening technology

Background: An emerging novel liquid biopsy technology called Cancer Differentiation Analysis (CDA) has been evaluated as a viable early stage breast cancer screening tool. CDA technology is a blood-sample based, multi-level, multi-parameter diagnostic method which detects signals from both protein, cellular, and to some extent, molecular levels, in which multiple aspects of information can be collected to improve diagnostic accuracy, even for early stage of cancer. Improving capability to screen breast cancer is an important on-going research effort, as breast cancer represents a leading cancer with high incidence rate.

Methods: In this single-blind study, 22 breast cancer patients and 25 healthy individuals were recruited at Changhai Hospital of Shanghai. Histopathological examination results of breast cancer patients were collected, 22 cases were diagnosed as infiltrating ductal carcinoma of breast, of which 10 patients were stage I breast cancer. 25 individuals were confirmed healthy after physical examinations. Peripheral blood was drawn in EDTA tubes For CDA tests. CDA data of 22 breast cancer patients and 25 healthy individuals were conducted using SPSS, and the results were shown in the table below.

Results: The average CDA of breast cancer, stageIbreast cancer, and controls were 43.20, 44.17 and 36.17 (rel. units) respectively as shown in Table 1. Both breast cancer and stage I breast cancer could be significantly distinguished from the control (p = 0.000, p = 0.001, respectively). For stage I breast cancer vs. control group, Area under ROC curve was 0.876, sensitivity and specificity were both 80.0% (Table 2). In contrast to traditional breast cancer screening methodologies which have relatively low sensitivity and high false positives for stage I detection, often with radiation side effects and high costs, advantages of CDA technology include ability to detect early stage cancer with relatively high sensitivity and specificity, and it is also highly cost effective without side effects.

Conclusions: Initial results showed that CDA technology could effectively distinguish stageIbreast cancer from healthy individuals, CDA could be a potential candidate for breast cancer screening.

Table 1Summary of CDA test resultsGroupSample SizeAge RangeAge MeanAge MedianCDA Mean (rel. units)CDA Median (rel. units)CDA STDEVControl2523 - 67413735.6336.176.98Breast Cancer2239 - 78545343.2042.304.18Stage I Breast Cancer1043 - 78595944.1743.254.29Stage II Breast Cancer839 - 55474941.2840.303.06Stage III Breast Cancer255555542.2042.202.12Stage IV Breast Cancer251 - 64585847.0047.007.78

Table 2AUC, Sensitivity and Specificity of Control vs. Stage I breast cancerStage I Breast Cancer vs. ControlArea Under the CurveSensitivitySpecificity 0.87680.0%80.0%

Citation Format: Liu C, Dou J, Sheng Y, Wu J, Hu W, Li Y, Lin Y, Tao H, Tang X, Du X, Yu C. Early stage breast cancer screening using an emerging novel liquid biopsy screening technology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-10.

Abstract P1-03-04: Molecular subtyping of androgen receptor-positive patients using gene expression profiles

Breast cancer is a heterogeneous disease, and unsupervised clustering approaches using gene expression data have identified 3-6 distinct subtypes of triple negative breast cancer (TNBC). A genomically and clinically distinct subtype of TNBC is referred to as LAR (Luminal Androgen Receptor). Tumors with this subtype typically express high levels of the AR and exhibit alterations within genes involved in the PI3K pathway (e.g. PIK3CA mutations). Prospective studies are underway using drugs that target the AR alone or in combination with PI3K and CDK 4/6 inhibitors. Given the importance of accurately identifying this subtype, we sought to develop an online tool that uses submitted gene expression data to confidently characterize LAR samples by corroborating the classification with previously published clustering approaches.

Methods: We have investigated TNBC RNA-Seq data from The Cancer Genome Atlas (TCGA) breast cancer study (N=123 samples) by cluster analysis. Analysis of the average silhouette width in both biased and unbiased K-means clustering approaches demonstrated LAR and basal as two distinct and significant clusters. A shrunken centroid model of 426 differentially expressed genes, named as CABAL (Clustering Among BAsal and Luminal androgen receptor), was constructed by comparing LAR and basal subtypes.

Results: We applied the CABAL model to classify the four TNBC microarray datasets that were previously used in clustering experiments as well as an independent RNA-Seq data cohort. Non-negative matrix factorization (NMF) and fuzzy clustering were applied to the samples (N=1046). Clustering similarity among the methods was assessed with the adjusted rand index, and CABAL demonstrated significant similarity with both fuzzy and NMF clustering methods. Similarly, hierarchical clustering analysis performed on the pooled cohort of 1046 samples recapitulated the CABAL classification with an area under the receiver operating curve of 0.91.

Conclusions: Confident and robust identification of samples with the LAR phenotype is paramount in the assessment of clinical associations and therapeutic efficacy. To facilitate LAR identification, we have provided a web-based prediction tool of the CABAL classification, integrated with the NMF and fuzzy clustering results to identify candidate LAR samples. The end user is provided with the pair-wise adjusted rand indexes, thus reinforcing in the clustering characterizations. Further, our online LAR depiction tool provides a set of graphical and tabular summaries, which will be illustrated, while providing additional molecular characterizations of the PAM50 and Metabric classifications. The availability of this tool could advance the genomic research and treatment of TNBC patients.

Citation Format: Thompson KJ, Alaparthi T, Sinnwell JP, Carlson EE, Tang X, Bockol M, Vedell PT, Ingle JN, Suman V, Weinshilboum RM, Wang L, Boughey JC, Kalari KR, Goetz MP. Molecular subtyping of androgen receptor-positive patients using gene expression profiles [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-03-04.

Abstract P1-02-09: CDA screening technology for multi-ethnic group, early stage breast cancer screening

Background: Breast cancer is the second leading cause of death from cancer in American women. Current breast cancer screening technologies have issues with poor sensitivity for early stage breast cancer, high false positives, radiation side effects, etc. Cancer Differentiation Analysis (CDA) technology is a blood-sample based, multi-level, multi-parameter diagnostic method which detects signals from both proteins, cells, and to some extent, molecular level, in which multiple aspects of information are collected to improve diagnostic accuracy. CDA technology has been investigated as a viable clinical utility in breast cancer screening, particularly for early stage breast screening with clear advantages (both whole blood and serum can be used, ability to detect early, easy, simple, no side effects, and high degree of sensitivity and specificity).

Methods: In this study, the human subjects involved are Caucasians, with serum samples of 44 pathologically confirmed breast cancer patients and 34 healthy individuals from 3 blood bank centers in the USA, of which 40 cases were stageIbreast cancer, 2 cases were stageII, and the other 2 cases were stage III breast cancer. CDA data of 44 breast cancer patients and 34 healthy individuals were collected in US lab and analyzed using SPSS, and the results were shown in the table below. Results from the above study was compared with a clinical study on Asian group with data collected in lab in China using CDA technology.

Results: The average CDA value of all breast cancer and stageIbreast cancer samples, and controls were 45.99, 45.76 and 42.36 (rel. units) respectively (see Table 1). Both breast cancer and stageIbreast cancer could be significantly distinguished from the control group (p &lt; 0.001) (Table 2). For stageIbreast cancer vs. control group, Area under ROC curve was 0.727, sensitivity and specificity were 62.5% and 82.4% respectively, which is higher than a typical mammogram. To compare with different ethnic groups, data collected on an Asian group is also shown in Table 2, which showed that overall, AUC, sensitivity and specificity are comparable (some difference may be attributed to sample type difference (whole blood vs. serum)) for early stage breast cancer patients for those two ethnic groups, demonstrating that CDA technology can be extended to multiple ethnic groups.

Conclusions: CDA screening can be extended to different ethnic group including Caucasian and Asian with good sensitivity and specificity for stageIbreast cancer.

We thank Ugur Basmaci, Sunsil Pandit and Sharon Vorse-Yu for their support.

Table 1Summary of CDA Test ResultsGroupSample SizeAge RangeAge MeanAge MedianCDA Mean (rel. units)CDA Median (rel. units)CDA STDEVControl3436 -79575742.3642.652.75Breast Cancer4436 – 77606145.9946.504.22Stage I Breast Cancer4036 – 77606145.7645.554.26Stage II Breast Cancer251 – 64585847.0547.054.88Stage III Breast Cancer262 – 75696949.5049.502.55

Table 2AUC, Sensitivity and Specificity of Control vs. Stage I Breast CancerStage I Breast Cancer vs. ControlArea Under the CurveSensitivitySpecificityCaucasian (Stage I)0.72762.5%82.4%Asian# (Stage I)0.87680.0%80.0%# Whole blood samples. 10 stage I breast cancer samples and 25 control samples

Citation Format: Tao H, Lin Y, Liu C, Dou J, Sheng Y, Wu J, Hu W, Li Y, Tang X, Yu C, Du X. CDA screening technology for multi-ethnic group, early stage breast cancer screening [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-09.