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Foersch S, Schmitt M, Litmeyer A, Tschurtschenthaler M, Gress T, Bartsch DK, Pfarr N, Steiger K, Denkert C, Jesinghaus M. TROP2 in colorectal carcinoma: associations with histopathology, molecular phenotype, and patient prognosis. J Pathol Clin Res 2024; 10:e12394. [PMID: 39177576 PMCID: PMC11342791 DOI: 10.1002/2056-4538.12394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/11/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024]
Abstract
Antibody-drug conjugates (ADCs) directed to trophoblast cell surface antigen 2 (TROP2) have gained approval as a therapeutic option for advanced triple-negative breast cancer, and TROP2 expression has been linked to unfavourable outcomes in various malignancies. In colorectal carcinoma (CRC), there is still a lack of comprehensive studies on its expression frequency and its prognostic implications in relation to the main clinicopathological parameters. We examined the expression of TROP2 in a large cohort of 1,052 CRC cases and correlated our findings with histopathological and molecular parameters, tumour stage, and patient outcomes. TROP2 was heterogeneously expressed in 214/1,052 CRCs (20.3%), with only a fraction of strongly positive tumours. TROP2 expression significantly correlated with an invasive histological phenotype (e.g. increased tumour budding/aggressive histopathological subtypes), advanced tumour stage, microsatellite stable tumours, and p53 alterations. While TROP2 expression was prognostic in univariable analyses of the overall cohort (e.g. for disease-free survival, p < 0.001), it exhibited distinct variations among important clinicopathological subgroups (e.g. right- versus left-sided CRC, microsatellite stable versus unstable CRC, Union for International Cancer Control [UICC] stages) and lost its significance in multivariable analyses that included stage and CRC histopathology. In summary, TROP2 is quite frequently expressed in CRC and associated with an aggressive histopathological phenotype and microsatellite stable tumours. Future clinical trials investigating anti-TROP2 ADCs should acknowledge the observed intratumoural heterogeneity, given that only a subset of TROP2-expressing CRC show strong positivity. The prognostic implications of TROP2 are complex and show substantial variations across crucial clinicopathological subgroups, thus indicating that TROP2 is a suboptimal parameter to predict patient prognosis.
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Affiliation(s)
| | - Maxime Schmitt
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
| | - Anne‐Sophie Litmeyer
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
| | - Markus Tschurtschenthaler
- Internal Medicine II, Klinikum rechts der IsarTechnical University MunichMunichGermany
- Institute for Translational Cancer Research, German Cancer Consortium (DKTK), Partner Site MunichMunichGermany
| | - Thomas Gress
- Department of Gastroenterology, Endocrinology and Infectious DiseasesPhilipps‐University Marburg and University Hospital MarburgMarburgGermany
| | - Detlef K Bartsch
- Department of SurgeryPhilipps‐University Marburg and University Hospital MarburgMarburgGermany
| | - Nicole Pfarr
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Katja Steiger
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Carsten Denkert
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
| | - Moritz Jesinghaus
- Institute of PathologyPhilipps‐University Marburg und University Hospital MarburgMarburgGermany
- Institute of PathologyTechnical University of MunichMunichGermany
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Grass A, Kasajima A, Foersch S, Kriegsmann M, Brobeil A, Schmitt M, Wagner D, Poppinga J, Wiese D, Maurer E, Kirschbaum A, Muley T, Winter H, Rinke A, Gress TM, Kremer M, Evert M, Märkl B, Quaas A, Eckstein M, Tschurtschenthaler M, Klöppel G, Denkert C, Bartsch DK, Jesinghaus M. PITX2 as a Sensitive and Specific Marker of Midgut Neuroendocrine Tumors: Results from a Cohort of 1157 Primary Neuroendocrine Neoplasms. Mod Pathol 2024; 37:100442. [PMID: 38309431 DOI: 10.1016/j.modpat.2024.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/12/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
As neuroendocrine tumors (NETs) often present as metastatic lesions, immunohistochemical assignment to a site of origin is one of the most important tasks in their pathologic assessment. Because a fraction of NETs eludes the typical expression profiles of their primary localization, additional sensitive and specific markers are required to improve diagnostic certainty. We investigated the expression of the transcription factor Pituitary Homeobox 2 (PITX2) in a large-scale cohort of 909 NET and 248 neuroendocrine carcinomas (NEC) according to the immunoreactive score (IRS) and correlated PITX2 expression groups with general tumor groups and primary localization. PITX2 expression (all expression groups) was highly sensitive (98.1%) for midgut-derived NET, but not perfectly specific, as non-midgut NET (especially pulmonary/duodenal) were quite frequently weak or moderately positive. The specificity rose to 99.5% for a midgut origin of NET if only a strong PITX2 expression was considered, which was found in only 0.5% (one pancreatic/one pulmonary) of non-midgut NET. In metastases of midgut-derived NET, PITX2 was expressed in all cases (87.5% strong, 12.5% moderate), whereas CDX2 was negative or only weakly expressed in 31.3% of the metastases. In NEC, a fraction of cases (14%) showed a weak or moderate PITX2 expression, which was not associated with a specific tumor localization. Our study independently validates PITX2 as a very sensitive and specific immunohistochemical marker of midgut-derived NET in a very large collective of neuroendocrine neoplasms. Therefore, our data argue toward implementation into diagnostic panels applied for NET as a firstline midgut marker.
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Affiliation(s)
- Albert Grass
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany
| | - Atsuko Kasajima
- Department of Pathology, Technical University of Munich, Munich, Germany
| | | | - Mark Kriegsmann
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Brobeil
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Maxime Schmitt
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany
| | - Daniel Wagner
- Department of Pathology, University Hospital Mainz, Mainz, Germany
| | - Jelte Poppinga
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Dominik Wiese
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Elisabeth Maurer
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Andreas Kirschbaum
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Thomas Muley
- Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany; Translational Research Unit, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Hauke Winter
- Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany; Translational Research Unit, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Department of Thoracic Surgery, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Anja Rinke
- Department of Gastroenterology, Endocrinology and Infectious Diseases, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Thomas M Gress
- Department of Gastroenterology, Endocrinology and Infectious Diseases, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Markus Kremer
- Institute of Pathology, Städtisches Klinikum München, Munich, Germany
| | - Matthias Evert
- Department of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - Bruno Märkl
- Institute of Pathology, University Hospital Augsburg, Augsburg, Germany
| | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Markus Eckstein
- Department of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Tschurtschenthaler
- Institute for Translational Cancer Research, German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Günter Klöppel
- Department of Pathology, Technical University of Munich, Munich, Germany
| | - Carsten Denkert
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany
| | - Detlef K Bartsch
- Department of Surgery, Phillips University Marburg and University Hospital Marburg, Marburg, Germany
| | - Moritz Jesinghaus
- Department of Pathology, Phillips University Marburg und University Hospital Marburg, Marburg, Germany.
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Litmeyer A, Konukiewitz B, Kasajima A, Foersch S, Schicktanz F, Schmitt M, Kellers F, Grass A, Jank P, Lehman B, Gress TM, Rinke A, Bartsch DK, Denkert C, Weichert W, Klöppel G, Jesinghaus M. High expression of insulinoma-associated protein 1 (INSM1) distinguishes colorectal mixed and pure neuroendocrine carcinomas from conventional adenocarcinomas with diffuse expression of synaptophysin. J Pathol Clin Res 2023; 9:498-509. [PMID: 37608427 PMCID: PMC10556265 DOI: 10.1002/cjp2.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
Complementary to synaptophysin and chromogranin A, insulinoma-associated protein 1 (INSM1) has emerged as a sensitive marker for the diagnosis of neuroendocrine neoplasms. Since there are no comparative data regarding INSM1 expression in conventional colorectal adenocarcinomas (CRCs) and colorectal mixed adenoneuroendocrine carcinomas/neuroendocrine carcinomas (MANECs/NECs), we examined INSM1 in a large cohort of conventional CRCs and MANECs/NECs. In conventional CRC, we put a special focus on conventional CRC with diffuse expression of synaptophysin, which carry the risk of being misinterpreted as a MANEC or a NEC. We investigated INSM1 according to the immunoreactive score in our main cohort of 1,033 conventional CRCs and 21 MANECs/NECs in comparison to the expression of synaptophysin and chromogranin A and correlated the results with clinicopathological parameters and patient survival. All MANECs/NECs expressed INSM1, usually showing high or moderate expression (57% high, 34% moderate, and 9% low), which distinguished them from conventional CRCs, which were usually INSM1 negative or low, even if they diffusely expressed synaptophysin. High expression of INSM1 was not observed in conventional CRCs. Chromogranin A was negative/low in most conventional CRCs (99%), but also in most MANECs/NECs (66%). Comparable results were observed in our independent validation cohorts of conventional CRC (n = 274) and MANEC/NEC (n = 19). Similar to synaptophysin, INSM1 expression had no prognostic relevance in conventional CRCs, while true MANEC/NEC showed a highly impaired survival in univariate and multivariate analyses (e.g. disease-specific survival: p < 0.001). MANECs/NECs are a highly aggressive variant of colorectal cancer, which must be reliably identified. High expression of INSM1 distinguishes MANEC/NEC from conventional CRCs with diffuse expression of the standard neuroendocrine marker synaptophysin, which do not share the same dismal prognosis. Therefore, high INSM1 expression is a highly specific/sensitive marker that is supportive for the diagnosis of true colorectal MANEC/NEC.
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Affiliation(s)
- Anne‐Sophie Litmeyer
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Björn Konukiewitz
- Department of PathologyUniversity Hospital Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐Universität zu KielKielGermany
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Atsuko Kasajima
- Institute of PathologyTechnical University of MunichMunichGermany
| | | | - Felix Schicktanz
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Maxime Schmitt
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Franziska Kellers
- Department of PathologyUniversity Hospital Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐Universität zu KielKielGermany
| | - Albert Grass
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Paul Jank
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Bettina Lehman
- Department of SurgeryPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Thomas M Gress
- Department of Gastroenterology, Endocrinology and Infectious DiseasesPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Anja Rinke
- Department of Gastroenterology, Endocrinology and Infectious DiseasesPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Detlef K Bartsch
- Department of SurgeryPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Carsten Denkert
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
| | - Wilko Weichert
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Günter Klöppel
- Institute of PathologyTechnical University of MunichMunichGermany
| | - Moritz Jesinghaus
- Institute of PathologyPhillips University Marburg and University Hospital MarburgMarburgGermany
- Institute of PathologyTechnical University of MunichMunichGermany
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Noordhoek I, de Groot AF, Cohen D, Liefers GJ, Portielje JEA, Kroep JR. Higher ER load is not associated with better outcome in stage 1-3 breast cancer: a descriptive overview of quantitative HR analysis in operable breast cancer. Breast Cancer Res Treat 2019; 176:27-36. [PMID: 30997625 PMCID: PMC6548750 DOI: 10.1007/s10549-019-05233-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE In breast cancer, hormone receptor (HR) status is generally a qualitative measure; positive or negative. Quantitatively measured oestrogen and progesterone receptors (ER and PR) are frequently proposed prognostic and predictive markers, some guidelines even provide different treatment options for patients with strong versus weak expression. AIM To evaluate quantitative HR load assessed by immunohistochemistry as a prognostic and predictive measure in stage 1-3 breast cancer. METHODS We reviewed all the available literature on quantitatively measured HRs using immunohistochemistry. RESULTS All included studies (n = 19) comprised a cohort of 30,754 patients. Only 2 out of 17 studies found a clear correlation between higher quantitative ER and better disease outcome. Only one trial examined quantitative ER both as prognostic and predictive marker and found no association between ER% and survival. Ten studies examined quantitative PR load, only two of those found a significant correlation between higher PR load and better disease outcome. Two trials examined quantitative PR both as prognostic and predictive marker, neither found any association between PR% and disease outcome. CONCLUSIONS There is no clear evidence for using quantitatively assessed ER and PR as prognostic nor predictive marker in patients with stage 1-3 breast cancer. We recommend only using a qualitative HR status in future guidelines and treatment considerations.
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Affiliation(s)
- I Noordhoek
- Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands.
| | - A F de Groot
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - D Cohen
- Department of Pathology, Leiden University Medical Centre, Leiden, The Netherlands
| | - G J Liefers
- Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - J E A Portielje
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J R Kroep
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
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Jaiswal AS, Hirsch-Weil D, Proulx ER, Hong S, Narayan S. Anti-tumor activity of novel biisoquinoline derivatives against breast cancers. Bioorg Med Chem Lett 2014; 24:4850-3. [PMID: 25240616 DOI: 10.1016/j.bmcl.2014.08.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/31/2014] [Accepted: 08/26/2014] [Indexed: 11/28/2022]
Abstract
Breast cancer is classified into three groups according to its expression of hormone/growth factor receptors: (i) estrogen receptor (ER) and progesterone receptor (PR)-positive; (ii) human epidermal growth factor receptor 2 (HER2)-positive; and (iii) ER, PR, and HER2-negative (triple-negative). A series of methoxy-substituted biisoquinoline compounds have been synthesized as a potential chemotherapeutic agent for the triple-negative breast cancers which are especially challenging to manage. Structure activity relationship study revealed that rigid 6,6'-dimethoxy biisoquinoline imidazolium compound (1c, DH20931) exhibited the significant growth inhibitory effects on both triple-positive and triple-negative human breast cancer cell lines with IC50 in the range of 0.3-3.9 μM. The 1c (DH20931) is more potent than structurally related noscapine for growth inhibition of MCF7 cell line (IC50=1.3 vs 57 μM) and MDA-MB231 cell line (IC50=3.9 vs 64 μM).
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Affiliation(s)
- Aruna S Jaiswal
- Department of Anatomy and Cell Biology, University of Florida, Gainesville, FL 32610, USA
| | - Dimitri Hirsch-Weil
- Department of Chemistry, University of Florida, Gainesville, FL 32611-7200, USA
| | - Erick R Proulx
- Department of Chemistry, University of Florida, Gainesville, FL 32611-7200, USA
| | - Sukwon Hong
- Department of Chemistry, University of Florida, Gainesville, FL 32611-7200, USA; Research Institute for Solar and Sustainable Energies (RISE), School of Materials Science & Engineering, Gwangju Institute of Science and Technology, 123 Cheomdan-gwagiro, Buk-gu, Gwangju 500-712, Republic of Korea.
| | - Satya Narayan
- Department of Anatomy and Cell Biology, University of Florida, Gainesville, FL 32610, USA.
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Differential patterns of recurrence and specific survival between luminal A and luminal B breast cancer according to recent changes in the 2013 St Gallen immunohistochemical classification. Clin Transl Oncol 2014; 17:238-46. [PMID: 25270605 DOI: 10.1007/s12094-014-1220-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/20/2014] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In 2011, the St Gallen panel introduced several changes in breast cancer classification, thereby creating the luminal B Her2- subtype. In 2013, the panel also included Ki67 overexpression and PR <20 % as risk factors, while excluding GH3 in the absence of increased Ki67. We compared the classification of 2011 modified with the new 2013 St Gallen classification. PATIENTS AND METHOD Consecutive breast cancer patients referred to the Breast Unit of the University Hospital Mútua Terrassa and Hospital of Terrassa for surgical treatment of either primary or recurrent tumors were prospectively included between 1997 and 2014. Eventually, 1,874 cases were included for the four-subtype analysis. The median follow-up was of 66 months. RESULTS Using the 2013 St Gallen classification no significant differences were found in specific mortality rates between luminal A and B subtypes. There were significant differences at 5, 10, and, 15 years if we excluded luminal A GH3 patients in the absence of increased Ki67 (p = 0.004, 0.005, and 0.007). Luminal A sub-type patients showed significantly less distant metastases than the rest, including luminal B Her2- patients (p < 0.001). Also, luminal B patients showed significantly less distant metastases than pure Her2 (0.05) and triple negative (TN) (p < 0.001). There were no differences between pure Her2 and TN patients (0.055), neither among the different luminal B sub-types. CONCLUSION GH3, PR, and Ki67 may all be discriminatory factors for metastasis and specific mortality. Therefore, we suggest including GH3 in the luminal B subtype in the absence of Ki67.
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García Fernández A, Chabrera C, García Font M, Fraile M, Gónzalez S, Barco I, González C, Cirera L, Veloso E, Lain JM, Pessarrodona A, Giménez N. Differential survival and recurrence patterns of patients operated for breast cancer according to the new immunohistochemical classification: analytical survey from 1997 to 2012. Tumour Biol 2013; 34:2349-55. [DOI: 10.1007/s13277-013-0782-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/27/2013] [Indexed: 02/07/2023] Open
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Van Ewijk RJG, Schwentner L, Wöckel A, König J, Kreienberg R, Blettner M. Trends in patient characteristics, treatment and survival in breast cancer in a non-selected retrospective clinical cohort study of 2,600 patients. Arch Gynecol Obstet 2012; 287:103-10. [DOI: 10.1007/s00404-012-2544-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 08/21/2012] [Indexed: 12/23/2022]
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9
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García Fernández A, Giménez N, Fraile M, González S, Chabrera C, Torras M, González C, Salas A, Barco I, Cirera L, Cambra M, Veloso E, Pessarrodona A. Survival and clinicopathological characteristics of breast cancer patient according to different tumour subtypes as determined by hormone receptor and Her2 immunohistochemistry. A single institution survey spanning 1998 to 2010. Breast 2012; 21:366-73. [DOI: 10.1016/j.breast.2012.03.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 03/06/2012] [Accepted: 03/13/2012] [Indexed: 11/30/2022] Open
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Ali HR, Dawson SJ, Blows FM, Provenzano E, Pharoah PD, Caldas C. Aurora kinase A outperforms Ki67 as a prognostic marker in ER-positive breast cancer. Br J Cancer 2012; 106:1798-806. [PMID: 22538974 PMCID: PMC3365239 DOI: 10.1038/bjc.2012.167] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Proliferation has emerged as a major prognostic factor in luminal breast cancer. The immunohistochemical (IHC) proliferation marker Ki67 has been most extensively investigated but has not gained widespread clinical acceptance. Methods: We have conducted a head-to-head comparison of a panel of proliferation markers, including Ki67. Our aim was to establish the marker of the greatest prognostic utility. Tumour samples from 3093 women with breast cancer were constructed as tissue microarrays. We used IHC to detect expression of mini-chromosome maintenance protein 2, Ki67, aurora kinase A (AURKA), polo-like kinase 1, geminin and phospho-histone H3. We used a Cox proportional-hazards model to investigate the association with 10-year breast cancer-specific survival (BCSS). Missing values were resolved using multiple imputation. Results: The prognostic significance of proliferation was limited to oestrogen receptor (ER)-positive breast cancer. Aurora kinase A emerged as the marker of the greatest prognostic significance in a multivariate model adjusted for the standard clinical and molecular covariates (hazard ratio 1.3; 95% confidence interval 1.1–1.5; P=0.005), outperforming all other markers including Ki67. Conclusion: Aurora kinase A outperforms other proliferation markers as an independent predictor of BCSS in ER-positive breast cancer. It has the potential for use in routine clinical practice.
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Affiliation(s)
- H R Ali
- Department of Oncology, University of Cambridge, Cambridge CB1 9RN, UK.
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Quantum dots-based molecular classification of breast cancer by quantitative spectroanalysis of hormone receptors and HER2. Biomaterials 2011; 32:7592-9. [PMID: 21745686 DOI: 10.1016/j.biomaterials.2011.06.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 06/10/2011] [Indexed: 02/07/2023]
Abstract
The emerging molecular breast cancer (BC) classification based on key molecules, including hormone receptors (HRs), and human epidermal growth factor receptor 2 (HER2) has been playing an important part of clinical practice guideline. The current molecular classification mainly based on their fingerprints, however, could not provide enough essential information for treatment decision making. The molecular information on both patterns and quantities could be more helpful to heterogeneities understanding for BC personalized medicine. Here we conduct quantitative determination of HRs and HER2 by quantum dots (QDs)-based quantitative spectral analysis, which had excellent consistence with traditional method. Moreover, we establish a new molecular classification system of BC by integrating the quantitative information of HER2 and HRs, which could better reveal BC heterogeneity and identify 5 molecular subtypes with different 5-year prognosis. Furthermore, the emerging 5 molecular subtypes based on simple quantitative molecules information could be as informative as multi-genes analysis in routine practice, and might help formulate a more personalized comprehensive therapy strategy and prognosis prediction.
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