P3-07-27: ROCK II Expression Can Be a Potential Marker of Non-Sentinel Lymph Node Metastasis in Breast Cancer Patients with Sentinel Lymph Node Involvement

(Background) It becomes controversy whether axillary lymph node dissection is mandatory performed for breast cancer patients with positive sentinel lymph nodes (SNs), given that more than half of patients with a positive sentinel lymph biopsy have no metastasis in non-sentinel lymph nodes (non-SNs). Rho-associated kinase (ROCK) is essential part in tumor invasion and metastasis, and its activation is reported to be potential marker of lymph node metastasis.

(Purpose) The purpose of this study was to evaluate the expression of ROCK II as predictive factor of non-SNs metastasis in breast cancer patients with positive SNs.

(Patients and Method) ROCK II protein expression was determined using immunohistochemical analysis on formalin-fixed and paraffin-embedded primary tumor samples composed of 119 SN-positive patients who underwent axillary lymph node dissection in National Kyushu Cancer Center. ROCK II expression was defined positive when there was strong intensity of cytoplasm staining.

(Results) ROCK II expression tended to be strong in invasive area, but weak in intraductal component. Of the 119 patients, 35 (29%) were determined to be positive for ROCK II expression. Patients with ROCK II positive tumor had significantly higher probability of non-SNs metastasis compared with patients with ROCK II negative tumor (20/35, 57% for positive; 28/84, 33% for negative, p=0.02). In multivariate analysis, positive ROCK II expression was significantly associated with non-SNs metastasis even after accounting for other predictive factors including tumor size, lymphovascular invasion, number of SNs metastasis and extra-capsule invasion (positive vs. negative, HR 2.6, p=0.04).

Effect of HER2 status on risk of recurrence in women with small, node-negative breast tumours

BACKGROUND

Adjuvant trastuzumab for small, node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains controversial. The purpose of this study was to investigate the risk of recurrence in women with pathological tumour node (pTN) T1 N0 tumours.

METHODS

Patients with pT1 N0 breast cancer diagnosed at the National Kyushu Cancer Centre between 2001 and 2007 were reviewed. Patients were categorized according to HER2 status.

RESULTS

Four hundred and fifty-four patients who had pT1 N0 tumours, and had not received adjuvant trastuzumab, were identified. The HER2-negative and -positive groups comprised 376 and 78 patients (17·2 per cent) respectively. At a median follow-up of 46·3 months, there were 18 recurrences.The 5-year relapse-free survival (RFS) rates were 97·2 and 88 per cent in the HER2-negative and -positive groups respectively (P < 0·001). Multivariable analysis identified HER2-positive tumour as an independent predictor of RFS in patients with pT1 N0 tumours (hazard ratio 6·65, 95 per cent confidence interval 2·53 to 17·49; P < 0·001).

CONCLUSION

Women with pT1 N0 HER2-positive breast cancer have a high risk of recurrence.

[Anal squamous cell carcinoma-a report of 6 cases]

In Japan, surgical therapy is utilized as the main treatment modality for anal squamous cell carcinoma (SCC). Subjects were 6 patients with anal SCC treated at our hospital from 2000-2010, and a study was made on the treatment. In the early 3 cases (Stage IIIA, IIIB, IIIB), chemoradiotherapy (CRT) was used as adjuvant therapy on the premise of surgery. All of them were considered as stable disease, and they all experienced postoperative complications. The average length of the hospital stay was 45 days. Two cases are still surviving without recurrence, but the other one developed a distant metastasis. In contrast, we selected CRT with curative intent in the late 3 cases(Stage II, IIIA, IIIB). Two cases were considered as complete response (CR), and the other one considered as partial response (PR) was performed a salvage operation. Two cases are still surviving without recurrence, but the other case metastasized to the internal iliac lymph nodes. CRT with curative intent for anal SCC demonstrated a good antitumor effect. Salvage operation was safely performed, and showed a good prognosis.

Abstract P3-14-12: High Risk of Recurrence in Japanese Patients with HER2-Positive T1N0 Breast Cancer

Background: The necessity of adjuvant trastuzumab therapy for patients with T1N0M0 tumors remains controversial. The objective of this study is to determine the risk of recurrence in Japanese women with T1N0 HER2- positive tumors compared with HER2-negative tumors. Methods: Among 1,180 patients with breast cancers diagnosed at our institution between 2001 and 2007, we reviewed 464 T1N0M0 diseases in which HER2 status was evaluated by IHC or gene amplification, who had not received trastuzumab in the adjuvant setting. Recurrence free survival (RFS) was estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards models were used to determine the association of each group with the risk of recurrence. Results: Seventy-nine (17%) of 464 patients had HER2-positive tumors and remaining 385 (83%) were HER2-negative diseases. Patients who had HER2-positive tumors tended to be younger (P=0.015), have more hormone receptor-negative tumors (P&lt;0.001), and have higher histological grade (P&lt;0.001). At a median follow-up of 46 months, 18 patients had experienced recurrences. The 5-year recurrence-free survival (RFS) rates were 88.2% and 97.2% in patients with HER2-positive and HER2-negative tumors, respectively (P&lt;0.001). In patients with T1bN0 tumors and T1cN0 tumors, HER2-positive group had worse RFS than HER2-negative group (P=0.004 and P=0.002, respectively), while there were no differences in the RFS between patients with T1aN0 HER2-positive and HER2-negative tumors (P=0.835). In a multivariate analysis, HER2 status was identified as one of the independent risk factors to predict RFS in patients with T1N0M0 breast cancers (hazard ratio 5.23; 95% CI, 2.07 to 13.21; P&lt;0.001). Conclusion: Japanese women with T1bcN0M0 HER2-positive breast cancer have a significant high risk of recurrence, and adjuvant trastuzmab therapy should be considered for those patients.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-14-12.

Surface grafting of biocompatible phospholipid polymer MPC provides wear resistance of tibial polyethylene insert in artificial knee joints

OBJECTIVE

Aseptic loosening of artificial knee joints induced by wear particles from a tibial polyethylene (PE) insert is a serious problem limiting their longevity. This study investigated the effects of grafting with our original biocompatible phospholipid polymer 2-methacryloyloxyethyl phosphorylcholine (MPC) on the insert surface.

METHODS

The hydrophilicity of the PE surface was determined by the contact angle of a water droplet, and the friction torque was measured against a cobalt-chromium alloy component. The wear amount was compared among PE inserts with or without cross-linking and MPC grafting during 5x10(6) cycles of loading in a knee joint simulator. The surfaces of the insert and the wear particles in the lubricant were subjected to electron and laser microscopic analyses. The mechanical properties of the inserts were evaluated by the small punch test.

RESULTS

The MPC grafting increased hydrophilicity and decreased friction torque. In the simulator experiment, the wear of the tibial insert was significantly suppressed in the cross-linked PE (CLPE) insert, and even more dramatically decreased in the MPC-grafted CLPE insert, as compared to that in the non-cross-linked PE insert. Surface analyses confirmed the wear resistance by the cross-linking, and further by the MPC grafting. The particle size distribution was not affected by cross-linking or MPC grafting. The mechanical properties of the insert material remained unchanged during the loading regardless of the cross-linking or grafting.

CONCLUSION

Surface grafting with MPC polymer furnished the PE insert with wear resistance in an artificial knee joint through increased hydrophilicity and decreased friction torque.

Association of radiographic and symptomatic knee osteoarthritis with health-related quality of life in a population-based cohort study in Japan: the ROAD study

OBJECTIVE

Knee osteoarthritis (OA) is a major public health issue causing chronic pain and disability. However, there is little information on the impact of this disease on quality of life (QOL) in Japanese men and women. The objective of the present study was to clarify the impact of radiographic and symptomatic knee OA on QOL in Japan.

METHODS

This study examined the association of radiographic and symptomatic knee OA with QOL parameters such as the Medical Outcomes Study Short Form-8 (SF-8), EuroQOL (EQ-5D) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic knee OA was defined according to Kellgren/Lawrence (KL) grades, and symptomatic knee OA was defined as KL=3 or 4 with knee pain. We also examined the independent association of symptomatic knee OA and grip strength with QOL.

RESULTS

From the 3040 participants in the Research on Osteoarthritis Against Disability (ROAD) study, the present study analyzed 2126 subjects older than 40 years who completed the questionnaires (767 men and 1359 women; mean age, 68.9+/-10.9 years). Subjects with KL=3 or 4 had significantly lower physical QOL as measured by the physical component summary (PCS) score of the SF-8 and pain domains of the WOMAC, whereas mental QOL, as measured by the mental component summary (MCS) score of the SF-8, was higher in subjects with KL=3 or 4 than KL=0 or 1. Symptomatic knee OA was significantly more likely than radiographic knee OA without pain to be associated with physical QOL loss as measured by the PCS score and physical domains of the WOMAC. Symptomatic knee OA and grip strength were independently associated with physical QOL.

CONCLUSION

This cross-sectional study revealed that subjects with symptomatic knee OA had significantly lower physical QOL than subjects without it.

Spontaneous activity resembling tone-evoked activity in the primary auditory cortex of guinea pigs

In the primary auditory cortex (AI), a pure tone evokes propagating activity along a strip of the cortex. We have previously shown that focal activation of AI triggers autonomously propagating activity that resembles tone-evoked activity (Song et al., 2006). Because a focal spontaneous activity is expected to trigger similar activity propagation, spontaneous activity resembling tone-evoked activity may exist in AI. Here we tested this possibility by optical imaging of AI in guinea pigs. After obtaining tone-evoked activities, we made long-duration optical recordings (9-40s) and isolated spontaneous activities from respiration and heartbeat noises using independent component analyses. Spontaneous activities were found all over AI, in all animals examined. Of all spontaneous events, 33.6% showed significant correlation in spatio-temporal pattern with tone-evoked activities. Simulation using a model that captures the temporal feature of spontaneous response in single channels but sets no constraint among channels, generated no spontaneous events that resembled tone-evoked activations. These results show the existence of spontaneous events similar in spatio-temporal pattern to tone-evoked activations in AI. Such spontaneous events are likely a manifestation of cortical structures that govern the pattern of distributed activation in AI.

GRIP1 enhances estrogen receptor alpha-dependent extracellular matrix gene expression in chondrogenic cells

OBJECTIVE

The role of postmenopause on the pathogenesis of cartilage degeneration has been an open question. We assessed cartilage degeneration in estrogen receptor (ER)alpha null mice and examined the role of glucocorticoid receptor-interacting protein 1 (GRIP1) in the ERalpha-dependent transcription of a type II collagen gene (col2a1) with special reference to a crosstalk with the transforming growth factor (TGF)-beta signaling pathway.

METHODS

The vertebral cartilaginous endplate from female ERalpha null mice was subjected to histological analyses. Col2a1 expression of primary chondrocytes (PCs) obtained from ERalpha null mice after 17beta-estradiol (E(2)) and TGF-beta1 stimulation was examined by reverse transcription polymerase chain reaction (RT-PCR). Estrogen response element (ERE) or col2a1 promoter-enhancer luciferase reporter system was used to investigate the crosstalk among ERalpha, GRIP1, and MKK6. Col2a1 expression and glycosaminoglycan (GAG) content were measured in ATDC5 cells treated with GRIP1 small interfering RNA (siRNA).

RESULTS

ERalpha deficiency clearly accelerated impairment of the vertebral cartilaginous endplate. E(2) and TGF-beta1 stimulation increased col2a1 expression in PC from wild-type mice, but not that from ERalpha null mice. The same stimulation increased the col2a1 promoter-enhancer reporter activity, and the elevated activity was decreased by dominant-negative ERalpha and p38 mitogen-activated protein kinase (MAPK) inhibitor. GRIP1 increased the E(2)-dependent ERE activation in the presence of ERalpha and constitutive-active MKK6. GRIP1 siRNA repressed col2a1 expression and GAG production in ATDC5 cells.

CONCLUSIONS

Crosstalks between ERalpha/GRIP1 and TGF-beta/MKK6/p38 MAPK pathway have protective roles on cartilage metabolism via regulating the extracellular matrices expression. The finding may lead to the development of a novel therapeutic approach for cartilage degeneration.

Selection of highly osteogenic and chondrogenic cells from bone marrow stromal cells in biocompatible polymer-coated plates

To enrich the subpopulation that preserves self-renewal and multipotentiality from conventionally prepared bone marrow stromal cells (MSCs), we attempted to use 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer-coated plates that selected the MSCs with strong adhesion ability and evaluated the proliferation ability or osteogenic/chondrogenic potential of the MPC polymer-selected MSCs. The number of MSCs that were attached to the MPC polymer-coated plates decreased with an increase in the density of MPC unit (0-10%), whereas no significant difference in the proliferation ability was seen among these cells. The surface epitopes of CD29, CD44, CD105, and CD166, and not CD34 or CD45, were detectable in the cells of all MPC polymer-coated plates, implying that they belong to the MSC category. In the osteogenic and chondrogenic induction, the MSCs selected by the 2-5% MPC unit composition showed higher expression levels of osteoblastic and chondrocytic markers (COL1A1/ALP, or COL2A1/COL10A1/Sox9) at passage 2, compared with those of 0-1% or even 10% MPC unit composition, while the enhanced effects continued by passage 5. The selection based on the adequate cell adhesiveness by the MPC polymer-coated plates could improve the osteogenic and chondrogenic potential of MSCs, which would provide cell sources that can be used to treat the more severe and various bone/cartilage diseases.

The expressions of claudin-1 and E-cadherin in junctional epithelium

BACKGROUND AND OBJECTIVE

The epithelium provides an important barrier against microbial invasion. Tight junction structural proteins called claudins are known to contribute to the epithelial cell barrier. Junctional epithelium is located at a strategically important interface between gingival sulcus and is interconnected by desmosomes and gap junctions, but not by tight junctions. Although claudins are tight junction-associated proteins, they are also expressed in the epithelium despite its lack of tight junctions in invertebrates. Therefore, claudins may play an important role in junctional epithelium without tight junctions. E-cadherin is a key molecule in the formation of adherence junctions and desmosomes. In the present study, we aimed to investigate the expressions of claudin-1,claudin-3, claudin-7 and E-cadherin in the junctional epithelium of Fischer 344 rats.

MATERIAL AND METHODS

Gingival tissues from Fischer 344 rats were analyzed by immunohistochemical staining for claudin-1, claudin-3, claudin-7, and E-cadherin.

RESULTS

Intense staining for claudin-1 and E-cadherin were observed in the junctional epithelium. In contrast to claudin-1, claudin-3 was mainly expressed in oral gingival epithelium and claudin-7 could not be detected on immunohistochemical analysis of the rat gingiva.

CONCLUSION

These data suggest that claudin-1 and E-cadherin exist in the junctional epithelium and may play an important role in epithelial barrier function.

Behavioral characteristics of children with high functioning pervasive developmental disorders during a game

BACKGROUND

To evaluate children's sociability through their behavior, we compared the motion features of children with high functioning pervasive developmental disorders (HFPDD) and typical development (TD) during a game. We selected 'Jenga' as the game because this is an interactive game played by two people.

METHODS

We observed the behavior of 7 children with HFPDD and 10 children with TD. An optical motion capture system was used to follow the movement of 3-dimensional position markers attached to caps worn by the players.

RESULTS

The range of head motion of the children with HFPDD was narrower than that of the control group, especially in the X-axis direction (perpendicular to the line connecting the two players). In each game, we calculated the range of motion in the X-axis of each child and divided that figure by the matched adult player's range. The average ratios of children with HFPDD and TD were 0.64 and 0.89 (number of games are 61 and 18), and the difference of these two ratios is significant (P < 0.001).

CONCLUSIONS

This ratio has sensitivity to identify HFPDD children and could be useful in their child care.

Transcriptional induction of SOX9 by NF-kappaB family member RelA in chondrogenic cells

OBJECTIVE

Although SOX9 is a key molecule for chondrogenic differentiation, little is known about the upstream signal. The present study attempted to identify transcription factors to induce SOX9 expression and examined the mechanism.

METHODS

Sequences of about 1 kb of 5'-end flanking regions were compared between human and mouse SOX9 genes. In vivo localization was examined by immunohistochemistry in the limb cartilage of fetal mice. Promoter activities of the SOX9, SOX6, and type II collagen (COL2A1) genes were determined in human non-chondrogenic HeLa cells and mouse chondrogenic ATDC5 cells transfected with a luciferase-reporter gene containing the promoter fragments. Protein-DNA binding was examined by electrophoretic mobility shift and chromatin immunoprecipitation assays. The chondrogenic differentiation was assessed by endogenous SOX9, SOX6, and COL2A1 mRNA levels, and by Alcian blue staining and alkaline phosphatase activity.

RESULTS

Among transcription factors whose binding motifs were identified in the highly-conserved regions between human and mouse SOX9 promoters, a nuclear factor kappa B (NF-kappaB) member RelA strongly activated the promoter activity. RelA and SOX9 were co-localized in the limb cartilage. Deletion, mutagenesis, and tandem-repeat analyses identified the core region responsive to RelA at the NF-kappaB binding motif to be around -250bp of the human SOX9 promoter, and this was confirmed to show specific binding to RelA. RelA induced the chondrogenic differentiation parameters in HeLa and ATDC5 cells.

CONCLUSION

We have identified RelA as a transcriptional factor for SOX9 induction and chondrogenic differentiation via binding to an NF-kappaB binding motif in the SOX9 promoter.

Identification and functional analysis of the gene cluster for L-arabinose utilization in Corynebacterium glutamicum

Corynebacterium glutamicum ATCC 31831 grew on l-arabinose as the sole carbon source at a specific growth rate that was twice that on d-glucose. The gene cluster responsible for l-arabinose utilization comprised a six-cistron transcriptional unit with a total length of 7.8 kb. Three l-arabinose-catabolizing genes, araA (encoding l-arabinose isomerase), araB (l-ribulokinase), and araD (l-ribulose-5-phosphate 4-epimerase), comprised the araBDA operon, upstream of which three other genes, araR (LacI-type transcriptional regulator), araE (l-arabinose transporter), and galM (putative aldose 1-epimerase), were present in the opposite direction. Inactivation of the araA, araB, or araD gene eliminated growth on l-arabinose, and each of the gene products was functionally homologous to its Escherichia coli counterpart. Moreover, compared to the wild-type strain, an araE disruptant exhibited a >80% decrease in the growth rate at a lower concentration of l-arabinose (3.6 g liter(-1)) but not at a higher concentration of l-arabinose (40 g liter(-1)). The expression of the araBDA operon and the araE gene was l-arabinose inducible and negatively regulated by the transcriptional regulator AraR. Disruption of araR eliminated the repression in the absence of l-arabinose. Expression of the regulon was not repressed by d-glucose, and simultaneous utilization of l-arabinose and d-glucose was observed in aerobically growing wild-type and araR deletion mutant cells. The regulatory mechanism of the l-arabinose regulon is, therefore, distinct from the carbon catabolite repression mechanism in other bacteria.

Epidemiology of lumbar osteoporosis and osteoarthritis and their causal relationship--is osteoarthritis a predictor for osteoporosis or vice versa?: the Miyama study

SUMMARY

In a 10-year follow-up of a population-based cohort of Japanese subjects, incidences of and causal relationships between osteoporosis (OP) and osteoarthritis (OA) at the lumbar spine were clarified. OP might reduce the risk of subsequent OA at the spine in women, but not in men.

INTRODUCTION

The aim of this study is to clarify the contribution of osteoarthritis (OA) to osteoporosis (OP) and vice versa.

METHODS

A population-based, epidemiological study was conducted in a Japanese rural community. From 1,543 participants aged 40-79 years, 200 men and 200 women were selected and followed up for 10 years. Bone mineral density measurements were repeated after 3, 7, and 10 years, and X-rays were repeated after 10 years.

RESULTS

The incidence of lumbar OP per 10,000 person-years for persons in their 40s, 50s, 60s, and 70s was 0, 0, 109.5, and 151.1 for men and 124.2, 384.0, 227.3, and 239.5 for women, respectively. The cumulative incidence of lumbar OA over 10 years aged 40-79 years was 25.8% in men and 45.2% in women. Cox's proportional hazards model showed no significant relationship between the presence of lumbar OA at the baseline and incidence of lumbar and femoral neck OP in both genders. A significant relationship was demonstrated between the presence of lumbar OP, not femoral neck OP, at the baseline and cumulative incidence of lumbar OA in women (odds ratio, 0.20; 95% confidence interval, 0.05-0.80; P = 0.02).

CONCLUSION

OP in women appears to reduce the future incidence of OA at the lumbar spine.

Sentinel node biopsy in Asian breast cancer patients: An observation study of 1,000 consecutive patients treated at a single institute

e11584

Background: In woman with breast cancer, sentinel lymph node (SLN) biopsy (SLNB) provides staging information and a favorable effect on quality of life if the SLN does not have metastasis. While many reports already showed safety and reliability about SLNB for breast cancer patients in Western countries, few reports have published from Asian countries. Our purpose of this study is to prove the technical success, accuracy and safety of this method for Asian population. Methods: We did feasibility study of 183 patients from 2000 to 2002. After that, we evaluated detection rate, positive rate, axillary relapse rate in 1,000 consecutive patients who underwent sentinel lymph node biopsy for breast cancer at a single institute in Japan from 2002 to August 2008. In this series, both radioactive agent (technetium) and vital blue die (indigocarmine) were used to investigate the SLNs. Results: We could accurately predict SLNs in 994 (99.4%) of the 1,000 patients. The proportion of technical success was high regardless of surgeon's experience. Intraoperative frozen section histology showed that positive SLNs were found in 176 (17.7%) patients (13 micrometastasis and 163 macrometastasis). Defenitive histology found metastasis in 24 cases who defined as negative by the frozen section examination. 15 of 24 (62.5%) cases underwent delayed axillary lymph node dissection (ALND) after definitive histology. The histological concordance between frozen section and permanent sections of SLNs was 97.6%. Finally, 796 patients were followed up without ALND. With a median follow-up time of 3.5 years (0.5–5.2), axillary lymph node recurrence were occurred in 5 patients (5 of 796, 0.6%). The relapse time since SLNB ranged from 16 to 33 months. There were not any patients with allergic reactions. Conclusions: This is the report about observation study including more than 1,000 patients from Asian country. SLNB is seemed to be a safe and acceptably accurate method for Asian early breast cancer patients.

No significant financial relationships to disclose.

Effects of 4-n-octylphenol on the induction of mammary tumors induced by 7,12-dimethylbenz[a]anthracene in rats

We previously reported that a neonatal administration of diethylstilbestrol or 17beta-estradiol affected the mammary carcinogenesis induced by 7,12-dimethylbenz[a]anthracene (DMBA) in rats. The aim of this present study was to investigate the effects of 4-n-octylphenol (OP), a weak estrogenic disruptor, on the induction of mammary carcinomas (MC) and benign proliferative lesions (PL) induced by DMBA in rats. All female rats were administered at 0, 0.1, 10, 100, and 1,000 microg OP once at birth, given 10 mg DMBA at 50 days after birth, and thereafter underwent necropsy at 351 days after birth. All male rats were given 10 mg DMBA at 28, 42, and 56 days after birth, and 0, 10, 100, and 1,000 ppm OP fed from day 70-153; they underwent necropsy at 153 days after birth. Neonatal single administration of OP in female rats showed no effects such as persistent estrus, anovulatory ovaries, or PL. A slight increase in numbers of rats with MC occurred at the highest dosage. Feeding a large dose of OP for a long period in male rats induced atrophy of testes and slightly increased numbers of affected MC but not increased numbers of males while it showed no effects on PL. These results suggested that administration of a large dose of OP for a long period may have had a minimal effect on mammary carcinogenesis in male rats.

Respiratory complications after haematopoietic stem cell transplantation in a patient with chronic granulomatous disease

Chronic granulomatous disease (CGD) is an inherited immunodeficiency disorder caused by defects in NADPH oxidase and characterized by recurrent life-threatening bacterial and fungal infections. Although CGD has been considered to be a target for gene therapy, bone marrow transplantation (BMT) is now selected as the radical treatment in most cases. We performed BMT in a patient with CGD with severe infections and experienced respiratory complications of diffuse alveolar haemorrhage and/or infection-associated alveolar haemorrhage. We suggest that attention be paid to signs of onset of alveolar haemorrhage during BMT in CGD patients.