Abstract P5-10-08: Estrogen receptor quantitative measures and differences in breast cancer survival

Introduction: In New Mexico, Hispanic women have a 1.7-fold increased risk of breast cancer-specific death compared to non-Hispanic white women. In previous studies, race/ethnic minority women have had larger survival disparities in estrogen receptor positive (ER+) than ER- disease, suggesting some aspect of ER may mediate survival outcomes. We thus conducted an extensive assessment of ER quantitative measures.

Objective: To determine whether ER percent positive and intensity differs by ethnicity, and to evaluate whether that potential difference might account for a proportion of survival disparities.

Methods: We conducted a population-based case-cohort study of first invasive breast cancer diagnosed in white females from 1997-2009 in six NM counties, identified through Surveillance Epidemiology End Results (SEER). We selected 15% of breast cancer cases and all breast cancer deaths through 2012. After IRB approval, pathology reports and tissue microarrays served as sources of ER, PR, and Her2 information. Tumors were classified according to modified intrinsic subtypes based on immunohistochemistry. Data were analyzed using Cox proportional hazards models adapted for case-cohort with weighted estimates (cohort weighted by 6.67x), and estimated hazard ratios (HR) and 95% confidence intervals (CI) using the robust variance and alpha=.05. The proportional hazards assumption was verified by Schoenfeld residuals. All analyses were adjusted for age. Interaction was assessed by inclusion of main effects and a product term (subtype* exposure).

Results: ER and intrinsic subtype information was available for 76% of the cohort (867/1143) and 70% of breast cancer deaths (689/991). Median follow up was 7.8 years. In analyses stratified by intrinsic subtype, Hispanic women experienced elevated mortality relative to non-Hispanic whites for luminal A (HR 1.9;95% CI 1.4-2.6), Luminal B (HR 2.9;95% CI 1.5-5.7), and TN tumors (HR 1.9;95% CI 1.0-3.6) but not Her2+ER- disease (HR 1.1;95% 0.3-3.4).

Overall ER Quantitative measures: Among ER+ women, breast cancer mortality decreased with increasing ER+ staining, measured by percent (p-trend=.004) or quartile (p-trend=.002). After adjustment for ER percent(ER%+), women with increased ER intensity (score>2) had reduced mortality, relative to score=1 (HR 0.6;95% CI 0.4-.1.0). Results did not differ by Luminal A or B subtype (p interaction> .05).

Ethnicity-specific ER quantitative measures: ER%+ distribution did not differ by Hispanic ethnicity. However, among Hispanic women, interaction terms for ER%+ (p=.04) or quartile (p=.08) by subtype in relation to breast cancer survival suggest that Hispanic women with increasing ER staining have a reduced risk of mortality in Luminal A but not Luminal B tumors. Such differences were not evident among non-Hispanic white women. In multivariate models, inclusion of ER%+ and staining intensity did not alter Hispanic survival disparity overall, but mediated 8.6% in Luminal B.

Conclusion: After inclusion of ER%+, ER staining intensity is an independent risk factor for breast cancer survival. Differences in ER quantitative measures appear to account for only a small proportion of survival disparities. Survival gaps in ER+ breast cancer may be attributable to host or other tumor factors.Introduction: In New Mexico, Hispanic women have a 1.7-fold increased risk of breast cancer-specific death compared to non-Hispanic white women. In previous studies, race/ethnic minority women have had larger survival disparities in estrogen receptor positive (ER+) than ER- disease, suggesting some aspect of ER may mediate survival outcomes. We thus conducted an extensive assessment of ER quantitative measures.

Objective: To determine whether ER percent positive and intensity differs by ethnicity, and to evaluate whether that potential difference might account for a proportion of survival disparities.

Methods: We conducted a population-based case-cohort study of first invasive breast cancer diagnosed in white females from 1997-2009 in six NM counties, identified through Surveillance Epidemiology End Results (SEER). We selected 15% of breast cancer cases and all breast cancer deaths through 2012. After IRB approval, pathology reports and tissue microarrays served as sources of ER, PR, and Her2 information. Tumors were classified according to modified intrinsic subtypes based on immunohistochemistry. Data were analyzed using Cox proportional hazards models adapted for case-cohort with weighted estimates (cohort weighted by 6.67x), and estimated hazard ratios (HR) and 95% confidence intervals (CI) using the robust variance and alpha=.05. The proportional hazards assumption was verified by Schoenfeld residuals. All analyses were adjusted for age. Interaction was assessed by inclusion of main effects and a product term (subtype* exposure).

Results: ER and intrinsic subtype information was available for 76% of the cohort (867/1143) and 70% of breast cancer deaths (689/991). Median follow up was 7.8 years. In analyses stratified by intrinsic subtype, Hispanic women experienced elevated mortality relative to non-Hispanic whites for luminal A (HR 1.9;95% CI 1.4-2.6), Luminal B (HR 2.9;95% CI 1.5-5.7), and TN tumors (HR 1.9;95% CI 1.0-3.6) but not Her2+ER- disease (HR 1.1;95% 0.3-3.4).

Overall ER Quantitative measures: Among ER+ women, breast cancer mortality decreased with increasing ER+ staining, measured by percent (p-trend=.004) or quartile (p-trend=.002). After adjustment for ER percent(ER%+), women with increased ER intensity (score>2) had reduced mortality, relative to score=1 (HR 0.6;95% CI 0.4-.1.0). Results did not differ by Luminal A or B subtype (p interaction> .05).

Ethnicity-specific ER quantitative measures: ER%+ distribution did not differ by Hispanic ethnicity. However, among Hispanic women, interaction terms for ER%+ (p=.04) or quartile (p=.08) by subtype in relation to breast cancer survival suggest that Hispanic women with increasing ER staining have a reduced risk of mortality in Luminal A but not Luminal B tumors. Such differences were not evident among non-Hispanic white women. In multivariate models, inclusion of ER%+ and staining intensity did not alter Hispanic survival disparity overall, but mediated 8.6% in Luminal B.

Conclusion: After inclusion of ER%+, ER staining intensity is an independent risk factor for breast cancer survival. Differences in ER quantitative measures appear to account for only a small proportion of survival disparities. Survival gaps in ER+ breast cancer may be attributable to host or other tumor factors.

Citation Format: Hill D, Royce M, Lomo L, Barry M, Kang H, Wiggins C, Prossnitz E. Estrogen receptor quantitative measures and differences in breast cancer survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-10-08.

A functional variant of miRNA-149 confers risk for allergic rhinitis and comorbid asthma in Chinese children

The prevalence of allergic rhinitis (AR) and asthma has been increasing, and the comorbidity rates of these diseases are very high. Here, 176 AR patients, 124 patients with comorbid AR and asthma (AR-A) and 206 healthy Chinese children as controls were included in a case-control study. Six single-nucleotide polymorphisms (SNPs), miR-146a (rs2910164, rs57095329 and rs6864584), miR-196a2 (rs11614913), miR-499 (rs3746444) and miR-149 (rs2292832), were genotyped. The prevalence of homozygous miR-149 (rs2292832) CC genotype and C allele were considerably increased in AR and AR-A patients, compared with the controls. AR-A group showed higher frequencies of CC genotype and C allele of rs2292832 than AR group. No significant difference in the genotypic and allelic frequencies of other miRNA SNPs was found between the groups. MiR-149 levels in peripheral blood mononuclear cells (PBMCs) were significantly lower in CC (variant type) cases compared with TT (wild-type) cases. In further experiments, PBMCs obtained from the healthy controls with CC, CT and TT genotypes were stimulated by house dust mite extracts, which led to a significant decrease in the levels of miR-149 in PBMCs obtained from CC and TT individuals. This decrease was more pronounced in CC compared with TT cases. Our results demonstrate that miR-149 rs2292832 variant is not only strongly associated with AR and AR-A, but it may lead to an increase in the susceptibility to allergies following the stimulation with an allergen, through the changes in miR149 expression. Additionally, AR patients with CC genotypes were shown to be more susceptible to asthma.

Feline Panleucopenia Virus NS2 Suppresses the Host IFN-β Induction by Disrupting the Interaction between TBK1 and STING

Feline panleucopenia virus (FPV) is a highly infectious pathogen that causes severe diseases in pets, economically important animals and wildlife in China. Although FPV was identified several years ago, little is known about how it overcomes the host innate immunity. In the present study, we demonstrated that infection with the FPV strain Philips-Roxane failed to activate the interferon β (IFN-β) pathway but could antagonize the induction of IFN stimulated by Sendai virus (SeV) in F81 cells. Subsequently, by screening FPV nonstructural and structural proteins, we found that only nonstructural protein 2 (NS2) significantly suppressed IFN expression. We demonstrated that the inhibition of SeV-induced IFN-β production by FPV NS2 depended on the obstruction of the IFN regulatory factor 3 (IRF3) signaling pathway. Further, we verified that NS2 was able to target the serine/threonine-protein kinase TBK1 and prevent it from being recruited by stimulator of interferon genes (STING) protein, which disrupted the phosphorylation of the downstream protein IRF3. Finally, we identified that the C-terminus plus the coiled coil domain are the key domains of NS2 that are required for inhibiting the IFN pathway. Our study has yielded strong evidence for the FPV mechanisms that counteract the host innate immunity.

Chemical manipulation of edge-contact and encapsulated graphene by dissociated hydrogen adsorption

We investigate the hydrogenation in the h-BN/graphene/h-BN heterostructure and report the successful intercalation and modification of electrical properties.

Effects of sugammadex vs. pyridostigmine-glycopyrrolate on post-operative nausea and vomiting: propensity score matching

BACKGROUND

Sugammadex is a new agent that reverses neuromuscular blockade by aminosteroid neuromuscular blocker. This retrospective study compared the effects of sugammadex on post-operative nausea and vomiting (PONV) with those of a pyridostigmine-glycopyrrolate mixture.

METHODS

We reviewed the electronic medical records of 7179 patients who had received fentanyl-based, intravenous, patient-controlled analgesia (IV-PCA) at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015. We categorized the patients into two groups on the basis of the type of reversal agent to neuromuscular blockade that was used: a traditional reversal agent (pyridostigmine-glycopyrrolate mixture; Group R; n = 7059) and sugammadex (Group S; n = 120). The propensity score matching method was then used to select 408 subjects in Group R and 115 subjects in Group S; on the basis of their covariates, these subjects were then matched with a counterpart in the other group.

RESULTS

After propensity score matching, the two groups were well balanced with respect to all baseline covariates. In Group S, the numeric rating scale of nausea on day 0, as well as the number of patients who vomited on day 0, was lower than that in group R. Furthermore, Group S used fewer rescue antiemetics on day 0 and had a higher complete response on day 0.

CONCLUSION

Sugammadex might be more beneficial for PONV compared to pyridostigmine-glycopyrrolate mixture for patients who have received opioid-based IV-PCA.

Nonsequential Double Ionization by Counterrotating Circularly Polarized Two-Color Laser Fields

We report on nonsequential double ionization of Ar by a laser pulse consisting of two counterrotating circularly polarized fields (390 and 780 nm). The double-ionization probability depends strongly on the relative intensity of the two fields and shows a kneelike structure as a function of intensity. We conclude that double ionization is driven by a beam of nearly monoenergetic recolliding electrons, which can be controlled in intensity and energy by the field parameters. The electron momentum distributions show the recolliding electron as well as a second electron which escapes from an intermediate excited state of Ar^{+}.

Novel mutations in quinolone resistance-determining regions of gyrA, gyrB, parC and parE in Shigella flexneri clinical isolates from eastern Chinese populations between 2001 and 2011

The aim of this study was to evaluate the prevalence of fluoroquinolone resistance and mechanisms of selected fluoroquinolone resistance in Shigella flexneri isolates. A total of 624 S. flexneri strains isolated between 2001 and 2011 in Jiangsu Province of China were analysed for their fluoroquinolone susceptibility. The quinolone resistance-determining region of gyrA, gyrB, parC and parE were amplified and sequenced. In general, 90.5 % of S. flexneri exhibited resistance to nalidixic acid. The mean norfloxacin resistance rate was 22.4 % during the 11 years from 2001 to 2011 (6.4 % from 2001 to 2005 and 36.8 % from 2006 to 2011). Sequencing of gyrA, gyrB, parC and parE genes of all S. flexneri isolates showed that the mutation rate was as high as 93.9 %. In addition, 91.8 % and 92.3 % of S. flexneri harboured mutations in gyrA and parC, respectively. About 35.2 % of S. flexneri isolates susceptible to nalidixic acid contained mutations. Meanwhile, mutations were detected in 91.2 % of norfloxacin-susceptible strains, and almost all S. flexneri isolates resistant to fluoroquinolone contained mutations. To the best of our knowledge, this is the first study reporting the occurrence of point mutations Asn57Lys and His80Pro in gyrA and Ala85Thr, Asp111His and Ser129Pro in parC. Emerging fluoroquinolone resistance with a significantly high mutation rate of the gyrA and parC genes in S. flexneri in Jiangsu Province deserves attention, and monitoring antibiotic susceptibility is important for the effective management of S. flexneri infections.

Effects of Low Dose Ketamine on Tourniquet-induced Haemodynamic Responses during General Anaesthesia

This study investigated the effect of a pre-operative low dose of intravenous ketamine on tourniquet-induced haemodynamic changes. Ten minutes after induction of general anaesthesia, 0.1 mg/kg ketamine in 10 ml of saline (ketamine group, n = 14) or 10 ml of normal saline (control group, n = 14) were administered intravenously. Systolic and diastolic blood pressures, and heart rate relative to tourniquet inflation and deflation were recorded and compared within and between groups. Systolic and diastolic blood pressures in the control group significantly increased relative to baseline during the observation period following tourniquet inflation, but generally did not significantly increase in the ketamine group. The control group had a greater percentage of patients with a 30% rise in blood pressure at 60 min after tourniquet inflation compared with the ketamine group (28.6% vs 7.1%), but this was not statistically significant. We conclude that a pre-operative low dose (0.1 mg/kg) of intravenous ketamine can prevent a systemic arterial pressure increase for at least 60 min after tourniquet inflation under general anaesthesia.

Prevalence, resistance patterns, and characterization of integrons of Shigella flexneri isolated from Jiangsu Province in China, 2001-2011

OBJECTIVE

To provide the epidemiology, resistance pattern, and characterization of integrons in Shigella flexneri isolated between 2001 and 2011 in Jiangsu Province.

METHOD

A total of 624 strains of S. flexneri were collected from both outpatients and inpatients in hospitals in Jiangsu Province from January 2001 to December 2011. The Kirby-Bauer disk diffusion method was used to perform the antimicrobial susceptibility test. Polymerase chain reaction (PCR) was used in the detection of integrons. Pulsed-field gel electrophoresis (PFGE) was applied in the homology studies.

RESULT

Serotype 2a accounted for the largest proportion in S. flexneri, namely 26.4 %. Notably, an increasing trend was detected in the resistance to common antimicrobial agents during the period 2001-2011. In recent years, more than 80.0 % isolates of S. flexneri have proved to be resistant to ampicillin, nalidixic acid, and tetracycline. The positive rates of class 1, class 2, and the atypical class 1 integrons in S. flexneri are 69.3 %, 87.8 %, and 89.2 % respectively. Most integrons detected in our research carry genes encoding resistance to trimethoprim and streptomycin.

CONCLUSION

Antimicrobial resistance in S. flexneri has demonstrated a continuous rising trend in Jiangsu Province. A high prevalence of integrons and gene cassettes play an important role in the transmission of drug resistance in S. flexneri. Effective measures are urgently needed to control the spread of multi-drug-resistant S. flexneri, and more continuing active surveillance of antimicrobial resistance should be established worldwide, especially in developing countries.

Biogeographic patterns of nutrient resorption from Quercus variabilis Blume leaves across China

The variation in nutrient resorption has been studied at different taxonomic levels and geographic ranges. However, the variable traits of nutrient resorption at the individual species level across its distribution are poorly understood. We examined the variability and environmental controls of leaf nutrient resorption of Quercus variabilis, a widely distributed species of important ecological and economic value in China. The mean resorption efficiency was highest for phosphorus (P), followed by potassium (K), nitrogen (N), sulphur (S), magnesium (Mg) and carbon (C). Resorption efficiencies and proficiencies were strongly affected by climate and respective nutrients concentrations in soils and green leaves, but had little association with leaf mass per area. Climate factors, especially growing season length, were dominant drivers of nutrient resorption efficiencies, except for C, which was strongly related to green leaf C status. In contrast, green leaf nutritional status was the primary controlling factor of leaf nutrient proficiencies, except for C. Resorption efficiencies of N, P, K and S increased significantly with latitude, and were negatively related to growing season length and mean annual temperature. In turn, N, P, K and S in senesced leaves decreased with latitude, likely due to their efficient resorption response to variation in climate, but increased for Mg and did not change for C. Our results indicate that the nutrient resorption efficiency and proficiency of Q. variabilis differed strongly among nutrients, as well as growing environments. Our findings provide important insights into understanding the nutrient conservation strategy at the individual species level and its possible influence on nutrient cycling.