Measurement of the cosmic ray proton spectrum from 40 GeV to 100 TeV with the DAMPE satellite

The precise measurement of the spectrum of protons, the most abundant component of the cosmic radiation, is necessary to understand the source and acceleration of cosmic rays in the Milky Way. This work reports the measurement of the cosmic ray proton fluxes with kinetic energies from 40 GeV to 100 TeV, with 2 ¹/₂ years of data recorded by the DArk Matter Particle Explorer (DAMPE). This is the first time that an experiment directly measures the cosmic ray protons up to ~100 TeV with high statistics. The measured spectrum confirms the spectral hardening at ~300 GeV found by previous experiments and reveals a softening at ~13.6 TeV, with the spectral index changing from ~2.60 to ~2.85. Our result suggests the existence of a new spectral feature of cosmic rays at energies lower than the so-called knee and sheds new light on the origin of Galactic cosmic rays.

Blood Flow Regulates Zebrafish Caudal Vein Plexus Angiogenesis by ERK5-klf2a-nos2b Signaling

BACKGROUND

Vascular network formation induced by angiogenesis plays an important role in many physiological and pathological processes. However, the role of blood flow and underlying mechanisms in vascular network formation, for example for the development of the caudal vein plexus (CVP), is poorly understood.

OBJECTIVE

The aim of this study was to explore the role of ERK5-klf2a-nos2b signaling in the CVP angiogenesis.

METHOD AND RESULTS

In this study on tnnt2a-MO injection and chemical blood flow modulator treatment in zebrafish embryos, we demonstrated that decreased blood flow disrupted CVP formation. The hemodynamic force was quantitatively analyzed. Furthermore, CVP angiogenesis in zebrafish embryos was inhibited by disruption of the blood flow downstream effectors ERK5, klf2a, and nos2b in response to treatment with the ERK5 specific inhibitor and to injection of klf2a-MO, nos2b-MO. Overexpression of klf2a mRNA or nos2b mRNA restored vascular defects in tnnt2a or klf2a morphants. The data suggest that flow-induced ERK5-klf2a-nos2b signaling is involved in CVP angiogenesis in zebrafish embryos.

CONCLUSION

We have demonstrated that blood flow is essential for vascular network formation, specifically for CVP angiogenesis in zebrafish. A novel genetic and mechanical mechanism was discovered in which ERK5 facilitates the integration of blood flow with the downstream klf2a-nos2b signaling for CVP angiogenesis.

Prognostic Significance of Liver Metastasis in Durvalumab-Treated Lung Cancer Patients

INTRODUCTION

Two clinical studies (Study 1108 and ATLANTIC) were analyzed to evaluate the prognostic value of baseline liver metastases (LMs) in advanced/metastatic non-small-cell lung cancer patients treated with durvalumab 10 mg/kg every 2 weeks.

PATIENTS AND METHODS

A multivariate Cox proportional hazards analysis was conducted; covariates included performance status, tumor stage, histology, sex, age, smoking status, and programmed cell death ligand 1 (PD-L1) status.

RESULTS

In all, 569 patients were included. LMs were present in 31.6% (96/304) of Study 1108 patients and 17.9% (47/263) of ATLANTIC patients. Median overall survival (OS) was shorter in patients with LMs than in those without in both studies. In both studies, LMs were an independent negative prognostic factor for OS and progression-free survival. Objective response rates were also significantly lower. PD-L1 independently predicted benefit across all patients.

CONCLUSION

Liver metastases were associated with worse outcomes irrespective of PD-L1 status, but PD-L1 status predicted benefit from durvalumab irrespective of LMs.

Time-dependent Expression and Distribution of AChE during the Skin Incised Wound Healing in Mice

Abstract

Objective To study the time-dependent expression and distribution of acetylcholinesterase （AChE） during skin incised wound healing in mice, and discuss its effect in wound healing as well as the feasibility of using it as a reference index for wound age estimation. Methods A total of 45 C57BL/KsJ mice were randomly divided into one control group and eight incised groups. The skin incised wound model was established in the incised groups with samples of skin wounds taken at 6 h, 12 h, 1 d, 3 d, 5 d, 7 d, 10 d and 14 d post-injury respectively, while the uninjured skin tissue was extracted in the control group. Expression and distribution of AChE in skin samples were detected by immunohistochemistry, double immunofluorescence and Western blotting. Results Immunohistochemistry results indicated that AChE was mainly detected in infiltrating polymorphonuclear cells （PMNs） 6 to 12 h post-injury. A large number of AChE-positive mononuclear cells （MNCs） were observed 1 to 3 d post-injury. The AChE-positive cells were mainly fibroblastic cells （FBCs） 5 to 14 d post-injury. The ratio of the AChE-positive cells increased initially 6 h post-injury, and reached the peak at 1 d post-injury. Double immunofluorescent staining showed that the majority of AChE-positive MNCs and FBCs expressed macrophage marker and myofibroblast marker, respectively. Western blotting results showed that the relative expression level of AChE in the incised group was higher than that in the control group averagely, reached the peak at 1 d post-injury, then reached a second peak at 7 d post-injury. Conclusion The expression of AChE is found in PMNs, macrophages and myofibroblast during skin wound healing, which indicates it might be involved in the adjustment of inflammatory response and fibrotic repair after injury. Moreover, combined use of various methods for the detection of the expression of AChE would provide reference for skin wound age estimation.

[Efficacy and safety of CD19 chimeric antigen receptor T cells for the treatment of 22 patients with B-cell lymphoma]

目的

探讨CD19 CAR-T治疗B细胞淋巴瘤的疗效及安全性。

方法

评估2017年2月1日至2018年7月1日CD19 CAR-T治疗22例B细胞淋巴瘤患者的疗效及不良反应情况。

结果

22例患者输注CD19 CAR-T后，总体完全缓解（CR）率为45.5%，部分缓解（PR）率为31.8%，总有效率为77.3%。其中12例复发难治患者9例有效，2例达CR，7例PR；10例微小残留病（MRD）阳性患者，8例MRD转阴。全部患者外周血中均检测到CD19 CAR-T细胞在体内增殖，复发难治患者与MRD阳性患者T细胞增殖的达峰时间分别为治疗后第4.5（1~12）天和治疗后第12（5~19）天，外周血CAR-T细胞分别占总的T淋巴细胞的4.02%（2.23%~28.60%）和10.10%（3.55%~24.74%）。MRD转阴患者持续缓解，中位随访8（3~18）个月均未复发，且此组患者有3例联合PD-1抗体治疗，均达CR。复发难治患者中，7例CAR-T治疗后达PR患者疗效保持时间为1.5~6.0个月，PD-1表达率为25.7%~55.3%，5例CAR-T治疗无效患者PD-1均高表达；共有3例患者联合应用PD-1抗体，其中2例有效；2例CAR-T治疗后达CR患者中1例行异基因造血干细胞移植，另1例随访12个月仍持续缓解。22例患者输注CAR-T细胞后14例发生不同程度的细胞因子释放综合征（CRS），其中9例为1级CRS，4例为2级CRS，其中1例复发难治患者发生3级CRS，经糖皮质激素、IL-6抗体治疗后CRS得到控制。治疗有效的17例患者中14例发生CRS，治疗无效的5例患者均未发生CRS。难治复发患者发生CRS的严重程度高于MRD阳性患者。

结论

CD19 CAR-T在CD19⁺ B细胞淋巴瘤中取得了疗效。CAR-T联合免疫检查点抑制剂的应用能够更好地提高疗效，CAR-T细胞治疗可作为复发难治患者的挽救治疗，清除B细胞淋巴瘤的MRD效果更好且不良反应小。

A phase I dose escalation and dose expansion study of the anti-programmed cell death-1 (PD-1) antibody AK105

e14006

Background: AK105 is a humanized IgG1 mAb that blocks PD-1 binding to PD-L1 allowing T-cells to recognize and kill tumor cells. Key attributes of AK105 include antibody engineering to eliminate Fc mediated effector function, and a slower off-rate on antigen binding resulting in improved receptor occupancy (RO). These features offer more robust biological effect and enhance anti-tumor activity of AK105. Methods: A multicenter, Phase I, open-label dose escalation and expansion study in solid tumors (NCT03352531) began in Dec 2017, evaluating the safety and efficacy of AK105 administered IV q2w till confirmed progression (RECIST v1.1). For dose escalation, pts were enrolled at dose cohorts of 1, 3, and 10 mg/kg. Expansion of AK105 at the RP2D of 200 mg q2w is ongoing in pts with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma; esophageal squamous-cell carcinoma; hepatocellular carcinoma (HCC); microsatellite instability-high (MSI-H) colorectal cancer. Results: As of 1 Feb, 2019, 34 pts (median age 66.5 years [30–79], female 44%, ECOG 0/1 ([68%/32%]) in cohorts of 1 mg/kg (n = 3), 3 mg/kg (n = 6), 10 mg/kg (n = 7), and 200 mg q2w (n = 18), received a median of 5 (1–29) doses of AK105. No DLTs were reported. Treatment-related adverse events (TRAEs) occurred in 41% of pts (G3 in 12% [4/34], no G4, treatment interruption in 9% [3/34]). Most frequent TRAEs ( > 5%) were hyperthyroidism (9%), hypothyroidism (6%), fatigue (6%), and rash (6%). PD-1 RO analysis showed that pts maintained full occupancy ( > 80%) for all dose levels. Of 25 evaluable heavily pretreated pts, ORR was 24% (6/25; 29% [4/14] in dose escalation and 18% [2/11] in expansion phase) and disease control rate (DCR) was 56% (14/25). Five responses are confirmed and ongoing (HCC, pancreatic carcinoma, cholangiocarcinoma, GBM, gastric adenocarcinoma), one is pending confirmatory scan (GEJ). Conclusions: The RP2D obtained from the dose escalation phase, reported safety profile and encouraging antitumor activity of AK105 supports continued clinical development, which include: pivotal studies in classic Hodgkin lymphoma and nasopharyngeal carcinoma, phase 2/3 combination studies with chemotherapy in NSCLC and combination study with anlotinib, a multi-targeting tyrosine kinase inhibitor in HCC. PD analysis is ongoing and expansion is ongoing at the RP2D. Clinical trial information: NCT03352531.

A phase I/II study of the anti-programmed cell death-1 (PD-1) antibody AK105 in patients with relapsed or refractory classic Hodgkin lymphoma (cHL)

e19017

Background: AK105 is a humanized IgG1 mAb that blocks PD-1 binding to PD-L1 allowing T-cells to recognize and kill tumor cells. Key attributes of AK105 include antibody engineering to eliminate Fc mediated effector function, and a slower off-rate on antigen binding resulting in improved receptor occupancy. These features were designed to offer more robust biological effect and enhance anti-tumor activity of AK105. Methods: A multicenter, Phase I/II, single-arm study in relapsed/refractory cHL (NCT03722147) began in July, 2018, evaluating the safety and efficacy of AK105 administered IV q2w till disease progression (response assessed by Lugano 2014 criteria). Eligible pts had relapsed/refractory cHL after most recent therapy with progression after autologous hematopoietic stem cell transplantation, or at least 2 lines of prior chemotherapy. Enrollment for Phase I part of the study was completed, and Phase II at the RP2D of AK105 200 mg q2w is ongoing. Results: As of 1 Feb, 2019, in the Phase I part, 6 Chinese patients (pts) median age 26.5 years [19–38], female 33%, ECOG 0/1 ([67%/33%]), had received a median of 7 (3–12) doses of AK105 200mg q2w. No DLT and SAE were reported. No immune-related grade 2 (G2) or higher adverse reactions were reported. Treatment-related adverse events (TRAEs) occurred in 83% (5/6) of pts (G3 in 17% [1/6], no G4, none leading to treatment interruption or discontinuation). Most frequent TRAEs (≥2 pts) were hypothyroidism (33%, 2/6) and ALT increased (33%, 2/6). PK profile for Chinse pts is consistent with that in Caucasian pts. Of 5 evaluable heavily pretreated pts, ORR was 100% (5/5, 3 CR and 2 PR). All 3 pts achieved CR at the first tumor assessment (i.e., week 8) and remained in CR at the last assessment (i.e., week 24) prior to data cutoff. The other 2 pts achieved PR at week 8 and the responses are still ongoing. Conclusions: The reported safety profile and encouraging early antitumor activity of AK105 supports continued clinical development, which include: pivotal studies in relapsed/refractory cHL and metastatic nasopharyngeal carcinoma, phase 2/3 combination studies with chemotherapy in NSCLC and combination study with anlotinib, a multi-targeting tyrosine kinase inhibitor in hepatocellular carcinoma. Clinical trial information: NCT03722147.

MXene-based saturable absorber for femtosecond mode-locked fiber lasers

We report simple and compact all-fiber erbium-doped soliton and dispersion-managed soliton femtosecond lasers mode-locked by the MXene Ti₃C₂Tx. A saturable absorber device fabricated by optical deposition of Ti₃C₂Tx onto a microfiber exhibits strong saturable absorption properties, with a modulation depth of 11.3%. The oscillator operating in the soliton regime produces 597.8 fs-pulses with 5.21 nm of bandwidth, while the cavity with weak normal dispersion (~0.008 ps²) delivers 104 fs pulses with 42.5 nm of bandwidth. Our results contribute to the growing body of work studying the nonlinear optical properties of MXene that underpin new opportunities for ultrafast photonic technology.

Immunological methods for the diagnosis of oral mucosal diseases

Immunological methods, which have been widely used in autoimmune blistering diseases (AIBDs) of the oral mucosa, can also be adopted as auxiliary diagnostic tools in oral lichen planus (OLP) and discoid lupus erythematosus (DLE). AIBDs, characterized by autoantibodies against structural proteins of keratinocytes or the basement membrane zone, clinically present as blisters and erosions of the oral mucosa. When atypical lesions occur, OLP or DLE may be confused with AIBDs. The improvement of diagnostic accuracy is necessary due to the significant differences in treatment and prognosis among these diseases. A variety of immunological methods are used for qualitative and quantitative detection of target antigens and autoantibodies. These methods can evaluate efficacy of treatment, monitor diseases and guide treatment decisions. In this review, we discuss the application of immunofluorescence, biochemical tests, and protein microarrays for AIBDs, OLP and DLE, as well as the differential diagnostic methods using immunological tests.

Expression of Annexin A1 during Skin Incised Wound Healing in Mice

OBJECTIVES

To investigate the expression changes of annexin A1 （ANXA1） during the process of skin incision healing, and to explore its expression and function during skin injury repair.

METHODS

The skin injury model of mice was prepared, and skin tissues of the controls and the injured group at 6 h, 12 h, 1 d, 3 d, 5 d, 7 d, 10 d and 14 d after injuries were taken. The morphological changes of the wound were observed by hematoxylin-eosin （HE） staining, and the expression of ANXA1 was detected by immunohistochemistry （IHC） and Western blotting.

RESULTS

HE staining showed normal healing of skin wounds. IHC results revealed that ANXA1 was expressed in the epidermis, hair follicle, sebaceous gland and vascular endothelium. In the injured group, the expression of ANXA1 was enhanced in epidermis and skin appendages around the wound 6-12 h after injury, and ANXA1 was also highly expressed in neutrophils and a small number of mononuclear cells. ANXA1 was mainly positively expressed in monocytes, neovascular endothelial cells and fibroblasts, and small amount of fibroblasts at 1-3 d, 5-10 d, and 14 d after injury, respectively. Western blotting showed that, compared with the controls, the expression of ANXA1 was significantly increased at 6 h after injury, peaked at 1 d, and then decreased gradually in the injured group.

CONCLUSIONS

ANXA1 may be involved in the regulation of skin damage repair, with time-dependent expression during skin wound healing, and thus is expected to be a biological marker for inferring the wound formation time.

[The specific cytotoxicities of chimeric antigen receptor-engineered T cells on different lymphomas]

目的

探讨共刺激分子为4-1BB的二代CD19嵌合抗原受体T细胞（CAR-T细胞）对不同侵袭性淋巴瘤细胞的体内、体外杀伤活性以及CAR-T细胞在体内生存的时间。

方法

采用慢病毒包装并感染T细胞的方法制备CD19 CAR-T细胞，采用CCK-8、ELISA和乳酸脱氢酶细胞毒性检测法检测CD19 CAR-T细胞的增殖能力、炎症因子释放水平和对Raji（套细胞淋巴瘤细胞株）、Pfeiffer（弥漫大B细胞淋巴瘤细胞株）、EHEB（慢性淋巴细胞白血病细胞株）细胞的杀伤活性，采用流式细胞术分析CD19 CAR-T细胞治疗前后荷瘤裸鼠的肿瘤负荷和CAR-T细胞残留水平。

结果

①与二代CAR-T细胞比较，三代CAR-T细胞的体外（24、48 h）增殖能力（P值均<0.05）、对瘤细胞的杀伤活性（P值均<0.05）较强，差异有统计学意义；而炎症因子的释放水平差异无统计学意义（P值均>0.05）。②效靶比为4∶1且共培养48 h时，二代CD19 CAR-T细胞对Raji细胞[（72.36±2.98）%]、Pfeiffer细胞[（55.92±4.16）%]、EHEB细胞[（35.53±3.93）%]的杀伤活性从强到弱，差异有统计学意义（P=0.013）。③裸鼠体内试验结果显示二代CAR-T细胞在EHEB荷瘤小鼠体内存活时间长于Raji荷瘤小鼠（P=0.046）。

结论

共刺激分子为4-1BB的二代CD19 CAR-T细胞对惰性淋巴瘤细胞株的杀伤活性稍低于对侵袭性淋巴瘤细胞株，但在惰性淋巴瘤细胞株荷瘤小鼠体内存活时间更长，可能更适合惰性淋巴瘤的治疗。

Abstract P4-08-32: Derivation and validation of a novel prediction model in breast phyllodes tumors after surgery

Aim

This study aimed to develop a nomogram based on clinicopathological features to evaluate the recurrence probability of breast phyllodes tumors following surgery. The criteria for atypia, mitoses, overgrowth, and surgical margin (AMOS) were also validated.

Method

Data from 334 patients with breast phyllodes tumors, who underwent surgical treatment at Sun Yat-sen Memorial Hospital from January 2005 to December 2014, were used to develop a prediction model. Additionally, data of 36 patients from Peking University Shenzhen Hospital and data of 140 patients from Sun Yat-sen University Cancer Center during the same period were used to validate the model. The medical records and tumor slides were retrospectively reviewed. The log-rank and Cox regression tests were used to develop a clinical prediction model of breast phyllodes tumors as well as validating the AMOS criteriaAll statistical analyses were performed using R and STATA.

Results

Of all 334 patients included in the study, 224 had benign, 91 had borderline, and 19 had malignant tumors. The local and distant recurrence rate was 17.7%. The 1-,3-, and 5-year cumulative recurrence-free survival was 98.5%, 97.9%, and 96.8%, respectively. Surgical margin, mitoses, and tumor border were identified as independent risk factors for breast phyllodes tumors. A nomogram was developed based on these three variables. The C-index of internal and external validation was 0.71and 0.67, respectively. The area under the curve of AMOS criteria was 0.59.

Conclusions

The present study model presented a more concise and objective variables to evaluate the recurrence-free survival of patients after surgery compared with that using the AMOS criteria, which is more appropriate for clinical practice and also allows for a more accurate prediction.

Citation Format: Song E, Chao X, Nie Y, Jin X, Tan C, Cui J, Hu H, Yao H. Derivation and validation of a novel prediction model in breast phyllodes tumors after surgery [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 P4-08-32.

Abstract P2-08-33: A novel seven-gene signature predicts prognosis in early-stage triple-negative breast cancer

Purpose:

Chemotherapy remains the only systemic treatment option for patients with triple-negative breast cancer (TNBC). However, due to the heterogeneity of TNBC, not all patients benefit from chemotherapy, especially those with early-stage disease. In order to improve prognostic assessment and reduce unnecessary adjuvant systemic therapy in these patients, we have developed a novel seven-gene signature.

Experimental Design:

With the ComBat method, we integrated the results from 150 transcriptome microarrays samples and 246 RNA-seq samples of early-stage TNBC patients, and identified mRNAs associated with recurrence-free survival (RFS) using Lasso-Cox model, We further analyzed these TNBC samples and compared them with 60 paired normal breast tissues (40 samples from RNA-seq and 20 samples from microarrays) to identify tumor-specific mRNAs. Twenty-one overlapped mRNAs of the RFS-associated mRNAs and the tumor-specific mRNAs are selected as candidate mRNAs. An additional 371 samples of frozen primary tumors were then collected from early-stage TNBC patients (mean follow-up of 45 months) and randomly divided into two sets: a training set (n = 186) and a validation (n = 185) set. Expression level of candidate mRNAs in these samples were measured using RT-qPCR assays, and a seven-gene signature was built through all subset regression in the training set. The prognostic and predictive accuracy of our signature was tested in the validation set and other public databases (GSE5327, GSE2034 and METABRIC).

Results:

Twenty-one candidate mRNAs were identified in early-stage TNBC patients, from which we developed a novel seven-gene signature (recurrence risk score [mRNA signature] = 1.108*TMEM101 - 0.213*KRT5 - 0.315*ACAN - 0.464*LCA5 + 0.446*RPP40 - 0.373*LAGE3 - 0.257*CDKL2). Patients in the training set were classified into high- or low-risk group based on our seven-gene signature and an optimum cut-off score derived from x-tile. The patients in high-risk group were more likely to suffer from recurrence (HR, 2.718; 95% confidence interval [CI], 1.928–3.726, P= 0.001), and a time-dependent receiver operating curve showed that the seven-gene mRNA signature had a better prognostic value than the clinicopathologic risk factors in both training set and validation set. The prognostic and predictive accuracy of the signature was also validated in the METABRIC and two other public GEO databases (GSE5327 and GSE2034). The time-dependent receiver operating curve showed that this signature had an area under the curve (AUC) of 0.742 (95% CI, 0.705-0.773) in METABRIC, 0.716 (95% CI, 0.682-0.739) and 0.723 (95% CI, 0.683-0.756) in GSE5327 and GSE2034 respectively.

Conclusion:

In this study, we developed a novel seven-gene signature which can provide additional prognostic information and may guidance in identifying early-stage TNBC patients eligible for adjuvant therapy or reduction of chemotherapy. To our knowledge, this is the first study investigating the prognostic potential of mRNA signature in early-stage triple-negative breast cancer. Our novel signature may provide an opportunity for de-escalating treatment in early-stage TNBC patients in the future.

Citation Format: Ren Y, Jiang Y, Zuo W, Xu X, Jin X, Ma D, Shao Z. A novel seven-gene signature predicts prognosis in early-stage triple-negative breast cancer [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 P2-08-33.

Abstract P3-07-12: Identification of luminal A-like subgroup among ER+/PR+/HER2+ breast cancers and its clinical implications

Background Triple positive breast cancers (TPBCs), i.e. estrogen receptor-positive (ER+)/ progesterone receptor-positive (PR+)/ human epidermal growth factor receptor 2-positive (HER2+) breast cancers, constitute a therapeutic challenge due to the functional crosstalk between the hormone receptors and HER2 pathways. The intrinsic molecular subtyping of TPBCs has rarely been studied and may have implications for the prognostic evaluation and therapeutic decision-making.

Methods Our study included four cohorts of patients with TPBC. The first one consisted of 82 patients from The Cancer Genome Atlas (TCGA). The second and third ones were from two publicly available microarray datasets (GSE2603 and GSE2109) and included 37 and 30 patients respectively. The forth one comprised 165 patients from Fudan University Shanghai Cancer Center. First, we examined the PAM50 intrinsic subtypes of TPBCs in the first three cohorts. Then, we tried to find several differentially expressed genes (DEGs) between luminal A and the other subtypes. In cohort 1, we identified DEGs using LIMMA. In cohort 2 and 3, we further filtered and validated them using Wilcoxon's rank sum test. We also performed Receiver operating characteristic analyses to evaluate the accuracy of candidate DEGs in identifying TPBCs of luminal A subtype and determined the top 3 DEGs according to the area under the curve. Finally, in cohort 4, we detected the expression of these 3 genes by immunohistochemical (IHC) staining of tissue sections, defined a group of luminal A-like TPBCs and examined the prognosis and effect of adjuvant trastuzumab for them.

Results The distribution of PAM50 intrinsic subtypes of TPBCs was shown as follows. The three genes that exhibited the highest accuracy in identifying TPBCs of luminal A subtype were STC2, BCL2 (highly expressed in luminal A subtype) and MKI67 (lowly expressed in luminal A subtype). In cohort 4, we defined a group of luminal A-like TPBCs as TPBCs with low expression of MKI67 as well as high expression of STC2 and/or BCL2. Compared with patients with non-luminal A-like TPBC (n = 110), those with luminal A-like TPBC (n = 55) had better disease-free survival (DFS) in both univariate (Log-rank P = 0.029) and multivariate analyses (hazard ratio = 0.25, P = 0.025). In the group with non-luminal A-like TPBCs, patients treated with trastuzumab (n = 67) showed better DFS than those not treated with it (n = 43) (Log-rank P = 0.019), while in the group with luminal A-like TPBCs, there is no difference in DFS between patients treated with trastuzumab (n = 22) and those not treated with it (n = 33) (Log-rank P = 0.993).

PAM50 intrinsic subtypes of TPBCsPAM50 intrinsic subtypeCohort 1Cohort 2Cohort 3 N (%)N (%)N (%)Luminal A43 (52.4)15 (40.5)13 (43.3)Luminal B28 (34.1)17 (45.9)12 (40.0)HER2-enriched9 (11.0)2 (5.4)3 (10.0)Normal-like1 (1.2)2 (5.4)1 (3.3)Basal-like1 (1.2)1 (2.7)1 (3.3)

Conclusions TPBCs are heterogeneous in terms of intrinsic molecular subtype. Evaluating the expression of STC2, BCL2 and MKI67 by IHC staining can help us to conveniently identify a group of luminal A-like TPBCs. Patients with this group of TPBCs have relatively good prognosis and may only gain limited benefit from adjuvant trastuzumab.

Citation Format: Zhao S, Jin X, Jiang Y-Z, Shao Z-M. Identification of luminal A-like subgroup among ER+/PR+/HER2+ breast cancers and its clinical implications [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 P3-07-12.

Tissue inhibitor of the metalloproteinases-3 gene polymorphisms and carotid plaque susceptibility in the Han Chinese population

Tissue inhibitor of metalloproteinases (TIMPs) are endogenous inhibitors of matrix metalloproteinases that are involved in normal cellular processes and in the development and progression of atherosclerosis. Our purpose was to evaluate the polymorphisms of the TIMP-3 genes for their associations with carotid plaques or with serum protein levels in the Han Chinese population. Two promoter variants, -915A/G (rs2234921) and -1296T/C (rs9619311), were genotyped in 548 subjects with no plaques, 462 subjects with echogenic plaques, and 427 subjects with mixture plaques. The serum TIMP-3 levels were measured using an enzyme-linked immunosorbent assay (ELISA). There was a strong linkage disequilibrium between -1296T/C and -915A/G (D' = 1.0, r² = 0.991). The individuals with the genotype (TC+CC) were 1.8 times more likely to have mixture plaques than the individuals with the TT genotype (P = 0.001, OR: 1.836, 95%CI: 1.269-2.665). The frequency of the C allele in the mixture plaque group was significantly higher than in the no plaque group (P = 0.009, CI: 1.119-2.187). We observed a significant elevation of the TIMP-3 levels in the serum of patients affected with mixture plaques compared to those with no plaques (P = 0.013). The current data suggest that genetic variation in the TIMP-3 genes may contribute to individual differences in mixture plaque susceptibility in the Han Chinese population.

[Brief discussion of history of vascular surgery in New China]

The history of vascular surgery in new China could be divided into the following three stages: the first stage, since the early 1980s, the technique of endovascular surgery was introduced in China, developed in some major hospitals, and gradually popularized to some basic hospitals conditionally. Vascular surgery had gradually developed into an independent discipline in China by the late 1980s. The second stage, since the late 1980s, vascular diagnosis and treatment technology, vascular equipment, and related research modification had been improving continuously in China, and achieved certain success, especially since the establishment of the department of vascular surgery affiliated to the Chinese Medical Association in 1993, vascular surgery in China representing its period of primary development. The third stage, since the beginning of the 21st century, the innovation of the technique of endovascular surgery and hybridization technology, and the development of materials technology had contributed to the second leaping forward of vascular surgery in China. Since then, vascular surgery enters a new era of minimally invasive surgery and opens a period of rapid development.