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Identification of Immune-Related Risk Signatures for the Prognostic Prediction in Oral Squamous Cell Carcinoma. J Immunol Res 2021; 2021:6203759. [PMID: 34497859 PMCID: PMC8420972 DOI: 10.1155/2021/6203759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer, which remains a major cause of morbidity and mortality in patients with head and neck cancers. However, the critical immune-related signatures and their prognostic values have rarely been investigated. Materials and Methods Gene differential analysis was used to measure the differences of gene expression between the groups. Correlation analysis was used to assess the association between the gene expression levels and immune-related risk score/DNA methylation levels. The gene set enrichment analysis (GSEA) was used to identify the pathways or cell types enriched by those identified differentially expressed genes (DEGs). Results In this study, we identified four immune-related gene signatures, including CTSG, TNFRSF4, LCORL, and PLAU, that were significantly associated with the overall survival in OSCC patients from the Cancer Genome Atlas (TCGA) OSCC cohort. Moreover, these four immune-related signatures were differentially expressed between the OSCC and nontumor tissues. The two groups (high and low risk) stratified by the immune-related risk scores had significantly different OS and mortality rates. The gene expression patterns and prognostic values of these immune-related signatures were also verified in two independent validation cohorts. Furthermore, the downregulated genes in the high-risk group (which were also upregulated in the low-risk group) were significantly enriched in the cell type-specific signatures of type 2 T helper cell (Th2), plasmacytoid dendritic cell (pDC), and memory B cell. In contrast, the upregulated genes in the high-score group were enriched in growth factor receptor-related signaling pathways, such as the VEGFA-VEGFR2 signaling pathway, PI3K-Akt signaling pathway, focal adhesion-PI3K-Akt-mTOR signaling pathway, and PDGF pathway, suggesting that those pathways were inversely correlated with immune cell infiltration. Conclusion In summary, the immune-related signatures had the potential for predicting the risk of OSCC patients. Moreover, the present study also improved our understanding of the association between the growth factor receptor pathways and immune cell infiltration in OSCC.
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Kang J, Yu Y, Jeong S, Lee H, Heo HJ, Park JJ, Na HS, Ko DS, Kim YH. Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis. Ther Adv Med Oncol 2020; 12:1758835920927838. [PMID: 32550865 PMCID: PMC7281710 DOI: 10.1177/1758835920927838] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/27/2020] [Indexed: 12/21/2022] Open
Abstract
Background: High cathepsin D has been associated with poor prognosis in breast cancer;
however, the results of many studies are controversial. Here, we assessed
the association between high cathepsin D levels and worse breast cancer
prognosis by conducting a meta-analysis. Methods: A comprehensive search strategy was used to search relevant literature in
PUBMED and EMBASE by September 2018. The meta-analysis was performed in
Review Manager 5.3 using hazard ratios (HRs) with 95% confidence intervals
(CIs). Results: A total of 15,355 breast cancer patients from 26 eligible studies were
included in this meta-analysis. Significant associations between elevated
high cathepsin D and poor overall survival (OS) (HR = 1.61, 95% CI:
1.35–1.92, p < 0.0001) and disease-free survival (DFS)
(HR = 1.52, 95% CI: 1.31–2.18, p < 0.001) were observed.
In the subgroup analysis for DFS, high cathepsin D was significantly
associated with poor prognosis in node-positive patients (HR = 1.38, 95% CI:
1.25–1.71, p < 0.00001), node-negative patients
(HR = 1.78, 95% CI: 1.39–2.27, p < 0.0001), early stage
patients (HR = 1.73, 95% CI: 1.34–2.23, p < 0.0001), and
treated with chemotherapy patients (HR = 1.60, 95% CI: 1.21–2.12,
p < 0.001). Interestingly, patients treated with
tamoxifen had a low risk of relapse when their cathepsin D levels were high
(HR = 0.71, 95% CI: 0.52–0.98, p = 0.04) and a high risk of
relapse when their cathepsin D levels were low (HR = 1.50, 95% CI:
1.22–1.85, p = 0.0001). Conclusions: Our meta-analysis suggests that high expression levels of cathepsin D are
associated with a poor prognosis in breast cancer. Based on our subgroup
analysis, we believe that cathepsin D can act as a marker for poor breast
cancer prognosis and also as a therapeutic target for breast cancer.
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Affiliation(s)
- Junho Kang
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Yeuni Yu
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Seongdo Jeong
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Hansong Lee
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Hye Jin Heo
- Departmment of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jeong Jun Park
- Departemt of Anesthesiology and Pain Medicine, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Hee Sam Na
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Dai Sik Ko
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yun Hak Kim
- Department of Anatomy and Department of Biomedical Informatics, Pusan National University, 49 Busandaehak-ro, Yangsan 50612, Republic of Korea
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Kim YS, Ryu DW, Lee CH. Analysis of factors related systemic recurrence after breast conserving surgery in stage I breast cancer. KOSIN MEDICAL JOURNAL 2018. [DOI: 10.7180/kmj.2018.33.3.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives In these days, patients with stage I breast cancer have increased by regular health examination and diagnostic tool development. The aim of this retrospective study is to identify systemic recurrence related factors after breast conserving surgery (BCS) for stage I breast cancer. Methods In this study, we analyzed the correlation between systemic recurrence and pathologic factors. We reviewed 223 patients who underwent BCS for stage I breast cancer. Postoperative pathologic factors, recurrent rates and sites were studied. In addition, preoperative patients'data were also collected. Statistical analysis was done by using PASW 16.0 (SPSS Inc., Chicago, IL, USA). Results Systemic recurrence was found in 16 patients (7.17%) within 5 years after primary surgery. 5 patients had lymphatic invasion and 6 patients had vascular invasion. Lymphatic and vascular invasion had statistical correlation with systemic recurrence ( P = 0.004, P = 0.001). Conclusions In this retrospective study, we can conclude that vascular invasion and lymphatic invasion are related systemic recurrence after BCS for stage I patients. Further studies with large cohort will be required to fully understand the risk factors of systemic recurrence for stage I breast cancer patients.
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Pinto AE, Pereira T, Silva GL, André S. Prognostic relevance of DNA flow cytometry in breast cancer revisited: The 25-year experience of the Portuguese Institute of Oncology of Lisbon. Oncol Lett 2017; 13:2027-2033. [PMID: 28454358 DOI: 10.3892/ol.2017.5718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/16/2016] [Indexed: 01/08/2023] Open
Abstract
The potential prognostic significance of DNA flow cytometric measurements (DNA ploidy and S-phase fraction) in breast cancer remains in dispute. Inconclusive data, primarily due to the lack of consistent standardization and quality control programs, have limited its translation into clinical practice. The aim of the present review, based on the 25-year experience of the Portuguese Institute of Oncology of Lisbon, is to assess the clinical relevance and application of DNA flow cytometry for the prognosis of breast cancer. Overall, data from Portuguese Institute of Oncology of Lisbon indicate that DNA flow cytometry provides significant prognostic information that is biologically relevant and clinically useful for the management of patients with breast cancer. Furthermore, this data has demonstrated the independent value of DNA aneuploidy as a prognostic indicator of poor clinical outcome in various subgroups of patients with early or locally advanced breast cancer at short- and long-term follow-up. Notably, aneuploidy identifies subsets of patients with grade (G)1 or G2 tumours who exhibit a poor clinical outcome. These patients may benefit from adjuvant chemotherapy, particularly those with luminal A and luminal B/human epidermal growth factor-2-negative endocrine-responsive breast cancer. In conclusion, data from Portuguese Institute of Oncology of Lisbon reinforces the clinical importance and utility of DNA flow cytometric analysis, particularly DNA ploidy, in the prognostic assessment and therapeutic planning for patients with breast cancer.
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Affiliation(s)
- António E Pinto
- Pathological Anatomy Service, Portuguese Institute of Oncology of Lisbon, Lisbon 1099-023, Portugal
| | - Teresa Pereira
- Pathological Anatomy Service, Portuguese Institute of Oncology of Lisbon, Lisbon 1099-023, Portugal
| | - Giovani L Silva
- Department of Mathematics, Centre for Statistics and Applications, Higher Technical Institute, University of Lisbon, Lisbon 1049-001, Portugal
| | - Saudade André
- Pathological Anatomy Service, Portuguese Institute of Oncology of Lisbon, Lisbon 1099-023, Portugal
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Xu J, Huang L, Li J. DNA aneuploidy and breast cancer: a meta-analysis of 141,163 cases. Oncotarget 2016; 7:60218-60229. [PMID: 27528028 PMCID: PMC5312380 DOI: 10.18632/oncotarget.11130] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/19/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND & AIMS DNA ploidy, a DNA flow cytometry parameter, reflects tumor cell cycle. In breast cancer (BC), ploidy status characterizes genotypic stability and potential metastatic capacity. It is suggested that aneuploidy is an independent prognosticator for BC patients and could aid for individualized medicine. There are extensive studies concerning the prognostic significance of DNA aneuploidy, however, its clinical utility remains controversial. Herein we conducted a meta-analysis to determine the correlation between DNA ploidy status and BC characteristics and survival. METHODS The electronic databases PubMed, EMBASE, and Web of Science were searched for relevant studies. The major investigated parameters were the BC aneuploidy rates in relation to tumor stage, size, lymph node metastasis, grading, estrogen receptor (ER) status, disease-free survival (DFS), and overall survival (OS). Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) for DFS and OS were extracted from each study before meta-analyzed. Risk ratios (RRs) were computed using the fixed-effect or random-effects model according to data heterogeneity, and the Mantel-Haenszel or the inverse-variance method was adopted where appropriate to obtain pooled estimates using RevMan 5.3. The Egger's test was conducted with Stata 11. RESULTS Pooled analyses of data from 29 studies involving a total of 141,163 cases showed that BC patients with more advanced tumors (stage I vs. stages II-IV, RR=0.84; 95% CI, 0.74 to 0.96; P=0.01), larger tumors (≤2 cm vs. >2 cm: RR=0.82; 95% CI, 0.77 to 0.87; P<0.00001), lymph node metastasis (pN0 vs. pN1-3: RR=0.85; 95% CI, 0.83 to 0.87, P<0.00001), poorer tumor proliferation (G2 vs. G1: RR=1.58; 95% CI, 1.40 to 1.79; P<0.00001; G3 vs. G1: RR=2.17; 95% CI, 1.77 to 2.67; P<0.00001; G3 vs. G2: RR=1.41; 95% CI, 1.25 to 1.60; P<0.00001), and ER- status (ER-vs. ER+: RR=1.32; 95% CI, 1.22 to 1.43; P<0.00001) were significantly more frequently aneuploid. BC patients with diploid tumors had better clinical outcomes than those with aneuploid cancers. The pooled HR estimates were0.73 (P<0.0001) for DFS and 0.72 (P=0.0001) for OS, respectively. CONCLUSION This meta-analysis implies that DNA aneuploidy is a significant predictor for BC progression and survival, and should be focused on in the therapeutic planning.
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Affiliation(s)
- Jing Xu
- Department of Medical Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Huang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jun Li
- Department of Medical Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Tumor Cytology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
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Arodola OA, Soliman MES. Molecular Dynamics Simulations of Ligand-Induced Flap Conformational Changes in Cathepsin-D-A Comparative Study. J Cell Biochem 2016; 117:2643-57. [PMID: 27038253 DOI: 10.1002/jcb.25564] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/31/2016] [Indexed: 12/11/2022]
Abstract
The flap region in aspartic proteases is a unique structural feature to this class of enzymes, and found to have a profound impact on protein overall structure, function, and dynamics. Understanding the structure and dynamic behavior of the flap regions is crucial in the design of selective inhibitors against aspartic proteases. Cathepsin-D, an aspartic protease enzyme, has been implicated in a long list of degenerative diseases as well as breast cancer progression. Presented herein, for the first time, is a comprehensive description of the conformational flap dynamics of cathepsin-D using a comparative 50 ns "multiple" molecular dynamics simulations. Diverse collective metrics were proposed to accurately define flap dynamics. These are distance d1 between the flap tips residues (Gly79 and Met301); dihedral angle ϕ; in addition to TriCα angles Gly79-Asp33-Asp223, θ1 , and Gly79-Asp223-Met301, θ2 . The maximum distance attained throughout the simulation was 17.42 and 11.47 Å for apo and bound cathepsin-D, respectively, while the minimum distance observed was 8.75 and 6.32 Å for apo and bound cathepsin-D, respectively. The movement of the flap as well as the twist of the active pocket can properly be explained by measuring the angle, θ1 , between Gly79-Asp33-Met301 and correlating it with the distance Cα of the flap tip residues. The asymmetrical opening of the binding cavity was best described by the large shift of -6.26° to +20.94° in the dihedral angle, ϕ, corresponding to the full opening of the flap at a range of 31-33 ns. A wide-range of post-dynamic analyses was also applied in this report to supplement our findings. We believe that this report would augment current efforts in designing potent structure-based inhibitors against cathepsin-D in the treatment of breast cancer and other degenerative diseases. J. Cell. Biochem. 117: 2643-2657, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Olayide A Arodola
- Molecular Modelling and Drug Design Research Group, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban 4000, South Africa
| | - Mahmoud E S Soliman
- Molecular Modelling and Drug Design Research Group, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban 4000, South Africa.
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Pinto AE, Pereira T, Silva GL, André S. Aneuploidy identifies subsets of patients with poor clinical outcome in grade 1 and grade 2 breast cancer. Breast 2015; 24:449-55. [PMID: 25920680 DOI: 10.1016/j.breast.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/08/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Histological grade is a well-established prognostic/predictive factor in breast cancer. However, mainly within intermediate categories, patients may have unpredictable outcome. We hypothesised whether ploidy status can distinguish different prognostic groups among breast cancer patients with similar tumour grade. MATERIAL AND METHODS The study involved 684 patients with invasive breast carcinoma, and median follow-up of 134.5 months. Pathological staging was evaluated according to WHO classification. Tumour differentiation was assessed using the Nottingham grading system. Ploidy was determined prospectively by DNA flow cytometry. Disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method. RESULTS There were 179 (26.2%) deaths and 239 (33.3%) disease recurrences. For grading, tumours were classified as follows: 163 (23.8%) G1, 356 (52.1%) G2 and 165 (24.1%) G3, while 389 (56.9%) tumours presented aneuploidy. Ploidy and grading are strongly associated (P < 0.001). Patients with aneuploid G2 tumours showed worse DFS (P = 0.001) and OS (P < 0.001), as well as those with aneuploid G1 tumours in relation to OS (P = 0.013). When a subset analysis was performed in early breast cancer patients (n = 451) with Stage I/IIA of disease, it remained the same significant associations of aneuploid G1 (to OS) and G2 tumours (to DFS and OS) with unfavourable prognosis. CONCLUSIONS Aneuploidy identifies subsets of breast cancer patients with G1 and G2 tumours who showed poor clinical outcome. The finding has therapeutic implications, as these patients are potential candidates to risk-adapted adjuvant therapy.
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Affiliation(s)
- António E Pinto
- Serviço de Anatomia Patológica do Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), E.P.E., R. Prof. Lima Basto, 1099-023 Lisboa, Portugal.
| | - Teresa Pereira
- Serviço de Anatomia Patológica do Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), E.P.E., R. Prof. Lima Basto, 1099-023 Lisboa, Portugal.
| | - Giovani L Silva
- Centro de Estatística e Aplicações e Departamento de Matemática do Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
| | - Saudade André
- Serviço de Anatomia Patológica do Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), E.P.E., R. Prof. Lima Basto, 1099-023 Lisboa, Portugal.
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8
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Ma M, Guo X, Chang Y, Li C, Meng X, Li S, Du ZX, Wang HQ, Sun Y. Advanced glycation end products promote proliferation and suppress autophagy via reduction of Cathepsin D in rat vascular smooth muscle cells. Mol Cell Biochem 2015; 403:73-83. [PMID: 25673507 DOI: 10.1007/s11010-015-2338-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/30/2015] [Indexed: 01/12/2023]
Abstract
Autophagy is closely involved in vascular smooth muscle cell (VSMC) function, but little is known about the association between advanced glycation end products (AGEs) and autophagy and its role in AGEs-induced proliferation and migration of VSMCs. The current study investigated the effects of AGEs on the phenotypic modulation and autophagy of VSMCs, as well as the potential underlying mechanisms. Primary rat VSMCs were treated with bovine serum albumin or AGEs. Cell proliferation was detected by MTT assay, real-time cell analyzer and EdU incorporation. Cell cycle was analyzed by Hoechst staining and flow cytometry. The migration of VSMCs was detected by wound-healing assay and transwell migration assay. LC3 transition and p62 accumulation were detected using Western blotting. Acidic vacuoles were measured using AO and MDC staining. Cathepsin D (CatD) was transduced to VSMCs via lentiviral vectors. AGEs enhanced proliferation and migration of primary rat VSMC in a time-dependent manner. AGEs significantly increased LC3-II transition and p62 expression, as well as accumulation of acidic vacuole, which was not further increased by bafilomycin A1. AGEs decreased CatD expression in a time-dependent pattern, and overexpression of CatD prohibited autophagy attenuation mediated by AGEs. CatD overexpression suppressed AGEs-induced proliferation of VSMCs. Nevertheless, CatD exhibited no effects on AGEs-induced migration of VSMCs. AGEs promote proliferation of VSMCs and suppress autophagy, at least in part via CatD reduction.
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Affiliation(s)
- Mingfeng Ma
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
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Song WJ, Kim KI, Park SH, Kwon MS, Lee TH, Park HK, An JS. The Risk Factors Influencing between the Early and Late Recurrence in Systemic Recurrent Breast Cancer. J Breast Cancer 2012; 15:218-23. [PMID: 22807940 PMCID: PMC3395746 DOI: 10.4048/jbc.2012.15.2.218] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 05/14/2012] [Indexed: 12/31/2022] Open
Abstract
Purpose Patients with recurrent breast cancer usually die of their disease, even after radical surgery and adjuvant therapies which could reduce the odds of dying. Many studies analyzed and compared patients who died of recurrent disease with those that died without recurrent disease. However, less attention has been paid to evaluating factors associated with the timing of recurrence. Thus, the objective of this study is to investigate the correlation between various factors and the timing of recurrence. Methods We retrospectively reviewed the data of 95 recurrent breast cancer patients who underwent curative surgery to determine the prognostic factors such as menopausal status, operation method, stage, nodal status, histologic grade, nuclear grade, extensive intraductal carcinoma component, hormone receptor, p53, c-erbB-2, Ki-67, and molecular subtype. We had attempted to compare the recurrent patients within 2 years after operation and adjuvant chemotherapies as the early recurrence with those over 2 years as the late recurrence. Results Histologic grade (p=0.005), nuclear grade (p<0.001), p53 (p=0.022), and Ki-67 (p<0.001) were significant different factors that influenced the systemic recurrence between early recurrence and late recurrence. In stage I/II, histologic grade (p=0.001), nuclear grade (p<0.001), and Ki-67 (p=0.005) were significant factors that influenced the systemic early recurrence. In stage III, nuclear grade (p=0.024), and Ki-67 (p=0.001) were significant factors that influenced the systemic early recurrence. But subtypes (p=0.189, p=0.132, p=0.593, p=0.083) are not associated with the timing of recur rence. Conclusion In systemic recurrent breast cancer patients, the risk factors such as histologic grade, nuclear grade, p53 and Ki-67 are also associated with the timing of recurrence. We sug gest that these patients should be proper treated and be closely followed up.
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Affiliation(s)
- Won Jong Song
- Department of Breast Surgery, Gachon University Gil Hospital, Incheon, Korea
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Masson O, Bach AS, Derocq D, Prébois C, Laurent-Matha V, Pattingre S, Liaudet-Coopman E. Pathophysiological functions of cathepsin D: Targeting its catalytic activity versus its protein binding activity? Biochimie 2010; 92:1635-43. [DOI: 10.1016/j.biochi.2010.05.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 05/14/2010] [Indexed: 11/27/2022]
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Goswami T, Shah M, Isaacs C. Novel molecular prognostic markers in breast cancer. ACTA ACUST UNITED AC 2009; 3:523-32. [PMID: 23495982 DOI: 10.1517/17530050903032653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Advances in the treatment of breast cancer have led to a reduction in breast-cancer-related mortality. However, these therapies are known to be associated with toxicities. Thus there is a crucial need to accurately define the populations of women with an excellent prognosis who may safely avoid the risks of systemic therapy. Recent developments utilizing novel technologies that incorporate our growing understanding of the biology and pathophysiology of breast cancer strive to better identify these patients. OBJECTIVE To provide a review of newer prognostic markers with a focus on the 21-gene recurrence score (Oncotype DX(™)), 70-gene prognosis profile (Mammaprint(®)), and Adjuvant! Online. CONCLUSION These techniques differ in their execution and application and have been demonstrated to provide further data on risk stratification as compared with conventional breast-cancer-risk factors.
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Affiliation(s)
- Trishna Goswami
- Fellow, Georgetown University Hospital, Division of Hematology/Oncology, Washington DC, USA
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12
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Lee HS, Kwak BS, Son BH, Ahn SH. Prognostic Factors Influence on the Systemic Recurrence in Axillary Lymph Node Negative Breast Cancer. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2009. [DOI: 10.4174/jkss.2009.77.4.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hee Seung Lee
- Department of Surgery, Dongguk University, College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Beom Seok Kwak
- Department of Surgery, Dongguk University, College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Byung Ho Son
- Department of Surgery, Ulsan University, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sei Hyun Ahn
- Department of Surgery, Ulsan University, College of Medicine, Asan Medical Center, Seoul, Korea
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13
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Gazic B, Pizem J, Bracko M, Cufer T, Borstnar S, Pohar-Marinsek Z, Us-Krasovec M. S-phase fraction determined on fine needle aspirates is an independent prognostic factor in breast cancer - a multivariate study of 770 patients. Cytopathology 2007; 19:294-302. [PMID: 18070112 DOI: 10.1111/j.1365-2303.2007.00528.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The prognostic significance of DNA ploidy and the S-phase fraction (SPF) have been extensively studied in breast cancer, but their clinical utility remains controversial. The type of tumour material can substantially influence flow cytometric DNA measurements. Material obtained by fine needle aspiration (FNA) biopsy is very suitable for flow cytometric DNA analysis because it contains a low proportion of non-tumour cells and less debris than tissue samples. METHODS The prognostic significance of DNA ploidy and SPF, determined on FNA samples, was analysed in 770 breast cancer patients, diagnosed between 1992 and 1997. DNA ploidy and SPF were determined at the time of diagnosis as part of the diagnostic work-up. The median follow-up was 90 months. Survival analysis included overall cancer specific survival (OS), disease free survival (DFS) and survival after recurrence (SAR). Other variables included in survival analyses were age, histological grade, histological type, lymph node status and tumour size. Disease free interval and the site of recurrence were also included in SAR analysis. RESULTS DNA ploidy and SPF correlated with tumour type, size, lymph node involvement and, especially, tumour grade. In a univariate analysis, both aneuploidy and high SPF were associated with shorter OS, DFS and SAR, but only SPF retained its independent prognostic significance in multivariate analyses. Independent prognostic variables for OS were node status, histological grade, SPF and tumour size. Node status, histological grade and SPF were independent predictors of DFS, while the site of recurrence, SPF, histological grade, disease free interval and age were independent predictors of SAR. CONCLUSIONS DNA ploidy and SPF can be efficiently and routinely determined on FNA samples. High SPF is independently associated with a worse clinical outcome of patients with breast cancer. Although SPF and histological grade share prognostic information to some degree, SPF provides additional, less subjective prognostic information. The prognostic value of SPF determined on FNA samples could be even more relevant in neoadjuvant settings and for patients not amenable for surgical treatment, when histological grade cannot be assessed.
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Affiliation(s)
- B Gazic
- Department of Pathology, Institute of Oncology, Ljubljana, Slovenia
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14
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Colozza M, Azambuja E, Cardoso F, Sotiriou C, Larsimont D, Piccart MJ. Proliferative markers as prognostic and predictive tools in early breast cancer: where are we now? Ann Oncol 2005; 16:1723-39. [PMID: 15980158 DOI: 10.1093/annonc/mdi352] [Citation(s) in RCA: 203] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In the last few decades, proliferative markers have been broadly evaluated as prognostic and predictive factors for early stage breast cancer patients. Several papers evaluating one or more markers have been published, often with contradictory results. As a consequence, there is still uncertainty about the role of these proliferative markers. The present paper critically reviews the current knowledge about the following markers: thymidine labeling index, S phase fraction/flow cytometry, Ki 67, thymidine kinase (TK), cyclins E, cyclin D, the cyclin inhibitors p27 and p21, and topoisomerase IIalpha. For each marker, the prognostic and predictive role was separately analyzed. Only papers published in English in peer-reviewed journals before June 2004 that include at least 100 evaluable patients were selected. In addition, the prognostic and predictive role of the proliferative markers had to be assessed through multivariate analyses. One hundred and thirty-two papers fulfilled these criteria and 159 516 patients were analyzed. Unfortunately, several methodological problems in the research to date prevent us from including any one of these proliferative markers among the standard prognostic and predictive factors. Early incorporation of translational research and new technologies with clinical trials are needed to prospectively validate biological markers and allow their use in clinical practice.
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Affiliation(s)
- M Colozza
- S. C. Oncologia Medica, Azienda Ospedaliera, San Sisto 06132 Perugia, Italy
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Abstract
PURPOSE OF REVIEW A great deal of breast cancer research has been devoted to the search for new prognostic and predictive markers which could, on the one hand, enable a more precise identification of patients at high risk of recurrence and, on the other hand, predict the response of each individual patient to the administered therapy. Proteases have been the center of interest because of their prominent involvement in cancer progression and metastasis. In particular, the matrix metalloproteinases, the serine protease urokinase plasminogen activator, the cathepsins, and corresponding inhibitors have been studied extensively. This article reviews the developments during the last year in this field. RECENT FINDINGS The prognostic effect of urokinase plasminogen activator and plasminogen activator inhibitor 1 was confirmed in a meta-analysis and in a prospective randomized clinical study that provided level 1 evidence for the clinical value of these markers. Furthermore, encouraging data suggest that both urokinase plasminogen activator and plasminogen activator inhibitor 1 might be important predictive markers. To date, findings on the prognostic and predictive value of the matrix metalloproteinases, the cathepsins, and their inhibitors are still inconclusive. SUMMARY On the basis of currently available data, tumor urokinase plasminogen activator and plasminogen activator inhibitor 1 levels could already be used in everyday clinical practice for selection of candidates for adjuvant systemic therapy. Further effort should be put into the standardization of the matrix metalloproteinases and cathepsins determination so that their clinical relevance in breast cancer can be defined.
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Affiliation(s)
- Julie Decock
- Laboratory for Experimental Oncology, Department of General Medical Oncology, University Hospital Gasthuisberg, Leuven, Belgium.
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