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Patuleia SIS, Suijkerbuijk KPM, van der Wall E, van Diest PJ, Moelans CB. Nipple Aspirate Fluid at a Glance. Cancers (Basel) 2021; 14:cancers14010159. [PMID: 35008326 PMCID: PMC8750428 DOI: 10.3390/cancers14010159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Nipple aspirate fluid (NAF) is a promising source of markers for detection of breast cancer. NAF can be acquired via the nipple by aspiration using a suction device, which is well tolerated by women. Future possible applications of biomarkers for breast cancer derived from NAF could be (1) as a detection tool to identify the initiation of the cancer development process, (2) as an additional tool next to imaging (mammography and breast magnetic resonance imaging) or (3) as a replacement tool for when imaging is not advisable for women, such as during pregnancy and breastfeeding. With this paper, we present a narrative review and perspectives of NAF research at a glance. Abstract Nipple aspirate fluid (NAF) is an intraductal mammary fluid that, because of its close proximity to and origin from the tissue from which breast cancer originates, is a promising source of biomarkers for early breast cancer detection. NAF can be non-invasively acquired via the nipple by aspiration using a suction device; using oxytocin nasal spray helps increase yield and tolerability. The aspiration procedure is generally experienced as more tolerable than the currently used breast imaging techniques mammography and breast magnetic resonance imaging. Future applications of NAF-derived biomarkers include their use as a tool in the detection of breast carcinogenesis at its earliest stage (before a tumor mass can be seen by imaging), or as a supporting diagnostic tool for imaging, such as when imaging is less reliable (to rule out false positives from imaging) or when imaging is not advisable (such as during pregnancy and breastfeeding). Ongoing clinical studies using NAF samples will likely shed light on NAF’s content and clinical potential. Here, we present a narrative review and perspectives of NAF research at a glance.
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Affiliation(s)
- Susana I. S. Patuleia
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (S.I.S.P.); (P.J.v.D.)
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (K.P.M.S.); (E.v.d.W.)
| | - Karijn P. M. Suijkerbuijk
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (K.P.M.S.); (E.v.d.W.)
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (K.P.M.S.); (E.v.d.W.)
| | - Paul J. van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (S.I.S.P.); (P.J.v.D.)
| | - Cathy B. Moelans
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (S.I.S.P.); (P.J.v.D.)
- Correspondence:
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Xu F, Gao Y, Diao X, Li J, Jiang H, Zhao H. Diagnostic value of sialyl-Tn immunocytochemistry in breast cancer presenting with pathological nipple discharge. Cancer Med 2021; 10:1783-1790. [PMID: 33605547 PMCID: PMC7940227 DOI: 10.1002/cam4.3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background Mucin‐associated sialyl‐Tn (sTn) antigen is overexpressed and related with adverse outcome in breast cancer (BC). The role of sTn in BC has not been well defined in pathological nipple discharge (PND) cytology. The authors examined sTn immunocytochemistry (ICC) in PND to determine whether it could be a biomarker of malignancy or aggressive disease. Methods PND was subjected to immunocytochemical staining for sTn antigen expression and thinprep cytology test (TCT) for enhancing the sensitivity and specificity. The examination data was compared with histological findings of subsequent biopsy specimens. Logistic regression analysis was used to determine which factors were most associated with malignant breast lesions. Results PND specimens were collected including 120 cases of intraductal papilloma, 24 cases of hyperplasia, 45 cases of ductal carcinoma in situ (DCIS), and 48 cases of invasive ductal carcinoma (IDC). STn ICC differentiated BC from benign intraductal lesions with a low sensitivity of 41.9% and a high specificity of 95.8%, but increased in combination with TCT to 64.5% and 100%, respectively. A high degree of concordance was observed between the results of sTn expression in cell smears and histological specimens. Moreover, the sTn expression was strongly associated with HER2‐positive IDC (p = 0.039). Multivariate logistic analysis showed that positive sTn expression (OR: 14.241, 95%CI: 2.574, 78.794, p = 0.010) and accompanying mass (OR: 3.307, 95%CI: 1.073, 10.188, p = 0.037) were statistically significant independent risk factors for malignant PND. Conclusions Mucin‐associated sTn expression in PND cytology appears to be a reliable diagnostic marker for BC patients with the chief complaint of malignant nipple discharge and indicates a more aggressive behavior in IDC.
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Affiliation(s)
- Feng Xu
- Department of Breast Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yue Gao
- Department of General Surgery, Beijing Huairou Hospital, Beijing, China
| | - Xiaoli Diao
- Department of Pathology, Beijing Chao-Yang Hospital, Beijing, China
| | - Jie Li
- Department of Breast Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Hongchuan Jiang
- Department of Breast Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Hongying Zhao
- Department of Pathology, Beijing Chao-Yang Hospital, Beijing, China
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Holah NS, Hemida AS. Cyclin D1 and PSA act as good prognostic and clinicopathological indicators for breast cancer. J Immunoassay Immunochem 2019; 41:28-44. [DOI: 10.1080/15321819.2019.1677706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Nanis Shawky Holah
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt
| | - Aiat Shaban Hemida
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt
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Shaheed SU, Tait C, Kyriacou K, Linforth R, Salhab M, Sutton C. Evaluation of nipple aspirate fluid as a diagnostic tool for early detection of breast cancer. Clin Proteomics 2018; 15:3. [PMID: 29344009 PMCID: PMC5763528 DOI: 10.1186/s12014-017-9179-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022] Open
Abstract
There has been tremendous progress in detection of breast cancer in postmenopausal women, resulting in two-thirds of women surviving more than 20 years after treatment. However, breast cancer remains the leading cause of cancer-related deaths in premenopausal women. Breast cancer is increasing in younger women due to changes in life-style as well as those at high risk as carriers of mutations in high-penetrance genes. Premenopausal women with breast cancer are more likely to be diagnosed with aggressive tumours and therefore have a lower survival rate. Mammography plays an important role in detecting breast cancer in postmenopausal women, but is considerably less sensitive in younger women. Imaging techniques, such as contrast-enhanced MRI improve sensitivity, but as with all imaging approaches, cannot differentiate between benign and malignant growths. Hence, current well-established detection methods are falling short of providing adequate safety, convenience, sensitivity and specificity for premenopausal women on a global level, necessitating the exploration of new methods. In order to detect and prevent the disease in high risk women as early as possible, methods that require more frequent monitoring need to be developed. The emergence of "omics" strategies over the last 20 years, enabling the characterisation and understanding of breast cancer at the molecular level, are providing the potential for long term, longitudinal monitoring of the disease. Tissue and serum biomarkers for breast cancer stratification, diagnosis and predictive outcome have emerged, but have not successfully translated into clinical screening for early detection of the disease. The use of breast-specific liquid biopsies, such as nipple aspirate fluid (NAF), a natural secretion produced by breast epithelial cells, can be collected non-invasively for biomarker profiling. As we move towards an age of active surveillance, home-based liquid biopsy collection kits are increasingly being applied and these could provide a paradigm shift where NAF biomarker profiling is used for routine breast health monitoring. The current status of established and newly emerging imaging techniques for early detection of breast cancer and the potential for alternative biomarker screening of liquid biopsies, particularly those applied to high-risk, premenopausal women, will be reviewed.
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Affiliation(s)
- Sadr-Ul Shaheed
- 1Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
| | | | - Kyriacos Kyriacou
- 3The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | | | | | - Chris Sutton
- 1Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
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Ejaz S, Nasim FUH, Ashraf M, Ahmad G. Down-regulation of hK7 in the sera of breast cancer and benign breast disease patients. Heliyon 2017; 3:e00356. [PMID: 28761938 PMCID: PMC5522378 DOI: 10.1016/j.heliyon.2017.e00356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/28/2017] [Accepted: 07/10/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction Breast cancer is known as a leading cause of cancer-related death among women all over the world. Biomarkers facilitate diagnosis at the earliest possible stage and better prognosis of the disease. Hence, may help to improve the overall survival rate among breast cancer patients. To find a better diagnostic/prognostic marker we evaluated human tissue kallikrein 7 (hK7) as biomarker of breast cancer. hK7 is a secreted serine protease having chymotrypsin like activity. Serum hK7 is known to have aberrant expression in ovarian and prostate cancer but has not been yet studied in breast cancer. However, the expression level of KLK7 mRNA in breast cancer tissues has been indicated as a better prognostic marker for the unfavorable prognosis of breast carcinoma. Materials and methods In this study a time-resolved immunofluorometric indirect back titration ELISA (bt-ELISA) was employed for the quantification of hK7 in serum of breast cancer patients (n = 47), benign breast disease patients (n = 13) alongwith the gender and age group specific controls (n = 99). Results hK7 was significantly down-regulated in the sera of female breast cancer patients (p < 0.0001; Mean 0.704 ± 0.533 μg/L) and benign breast disease patients (p = 0.0008; Mean 0.651 ± 0.584) as compared to normal controls (Mean 1.665 ± 1.174 μg/L). Conclusions Down regulation of hK7 suggests the possible role of this protein in natural course of breast cancer and benign breast diseases. Study should be extended on large-scale to confirm the potential of hK7 as biomarker of breast cancer.
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Affiliation(s)
- Samina Ejaz
- Department of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Pakistan
| | - Faiz-Ul-Hassan Nasim
- Department of Chemistry, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Ashraf
- Department of Chemistry, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Gulzar Ahmad
- Department of Surgery, Quaid-i-Azam Medical College, Bahawal Victoria Hospital, Bahawalpur, Pakistan
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Shaheed SU, Tait C, Kyriacou K, Mullarkey J, Burrill W, Patterson LH, Linforth R, Salhab M, Sutton CW. Nipple aspirate fluid-A liquid biopsy for diagnosing breast health. Proteomics Clin Appl 2017; 11. [PMID: 28488344 PMCID: PMC5638085 DOI: 10.1002/prca.201700015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/31/2017] [Accepted: 04/25/2017] [Indexed: 12/14/2022]
Abstract
Purpose Nipple secretions are protein‐rich and a potential source of breast cancer biomarkers for breast cancer screening. Previous studies of specific proteins have shown limited correlation with clinicopathological features. Our aim, in this pilot study, was to investigate the intra‐ and interpatient protein composition of nipple secretions and the implications for their use as liquid biopsies. Experimental design Matched pairs of nipple discharge/nipple aspirate fluid (NAF, n = 15) were characterized for physicochemical properties and SDS‐PAGE. Four pairs were selected for semiquantitative proteomic profiling and trypsin‐digested peptides analyzed using 2D‐LC Orbitrap Fusion MS. The resulting data were subject to bioinformatics analysis and statistical evaluation for functional significance. Results A total of 1990 unique proteins were identified many of which are established cancer‐associated markers. Matched pairs shared the greatest similarity (average Pearson correlation coefficient of 0.94), but significant variations between individuals were observed. Conclusions and clinical relevance This was the most complete proteomic study of nipple discharge/nipple aspirate fluid to date providing a valuable source for biomarker discovery. The high level of milk proteins in healthy volunteer samples compared to the cancer patients was associated with galactorrhoea. Using matched pairs increased confidence in patient‐specific protein levels but changes relating to cancer stage require investigation of a larger cohort.
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Affiliation(s)
- Sadr-Ul Shaheed
- Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
| | | | - Kyriacos Kyriacou
- The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | | | - Wayne Burrill
- Ethical Tissue, University of Bradford, Bradford, UK
| | | | | | | | - Chris W Sutton
- Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
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Gutiérrez-Zúñiga GG, Hernández-López JL. Sensitivity improvement of a sandwich-type ELISA immunosensor for the detection of different prostate-specific antigen isoforms in human serum using electrochemical impedance spectroscopy and an ordered and hierarchically organized interfacial supramolecular architecture. Anal Chim Acta 2015; 902:97-106. [PMID: 26703258 DOI: 10.1016/j.aca.2015.10.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 11/19/2022]
Abstract
A gold millielectrode (GME) functionalized with a mixed (16-MHA + EG3SH) self-assembled monolayer (SAM) was used to fabricate an indirect enzyme-linked immunosorbent assay (ELISA) immunosensor for the sensitive detection of prostate-specific antigen (PSA), a prostate cancer (PCa) biomarker, in human serum samples. To address and minimize the issue of non-specific protein adsorption, an organic matrix (amine-PEG3-biotin/avidin) was assembled on the previously functionalized electrode surface to build up an ordered and hierarchically organized interfacial supramolecular architecture: Au/16-MHA/EG3SH/amine-PEG3-biotin/avidin. The electrode was then exposed to serum samples at different concentrations of a sandwich-type immunocomplex molecule ((Btn)Ab-AgPSA-(HRP)Ab), and its interfacial properties were characterized using electrochemical impedance spectroscopy (EIS). Calibration curves for polarization resistance (RP) and capacitance (1/C) vs. total and free PSA concentrations were obtained and their analytical quality parameters were determined. This approach was compared with results obtained from a commercially available ELISA immunosensor. The results obtained in this work showed that the proposed immunosensor can be successfully applied to analyze serum samples of patients representative of the Mexican population.
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Affiliation(s)
- Gabriela Guadalupe Gutiérrez-Zúñiga
- Centro de Investigación y Desarrollo Tecnológico en Electroquímica, S.C., Parque Tecnológico Querétaro S/N, P.O. Box 064, Pedro Escobedo, Qro., Mexico
| | - José Luis Hernández-López
- Centro de Investigación y Desarrollo Tecnológico en Electroquímica, S.C., Parque Tecnológico Querétaro S/N, P.O. Box 064, Pedro Escobedo, Qro., Mexico.
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8
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Indirect Back-Titration ELISA: A New Format for Estimation of Human Tissue Kallikreins. Appl Immunohistochem Mol Morphol 2015; 24:64-70. [PMID: 26180936 DOI: 10.1097/pai.0000000000000150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Enzyme-linked immunosorbent assay (ELISA) is either based on sandwich, competitive, or inhibition type of format. However, these formats need 2 or 3 monoclonal antibodies (moAB) to estimate 1 antigen. To get a cost-effective, high throughput, ELISA for estimation of human tissue kallikreins we have now developed an indirect, back-titration style, Time Resolved ImmunoFluorometric (TRIF) ELISA that uses only 1 antigen-specific moAB and a general polyclonal antibody. Polystyrene microtiter plate wells coated with a capture antibody, a mouse moAB prepared against a specific human tissue kallikrein are allowed to interact either with the corresponding pure antigen, as the calibrator, or with the corresponding antigen present in a biological fluid or tissue extract. The detection antibody, anti-mouse IgG conjugated with alkaline phosphatase, is added to find the antigen-free immobilized capture moAB. Conjugated enzyme is allowed to hydrolyze diflunisal phosphate to produce a highly fluorescent complex. The fluorescence measured in TRIF mode corresponds to the antigen-free immobilized capture moAB and is used to quantify antigen-bound capture moAB. The detection antibody binds with the antigen-free capture moAB and strength of the signal correlates inversely with the amount of antigen bound to the capture moAB. With a minimum detection level of 20 ng/L the assay has no cross-reactivity with several test molecules. The method is sensitive, specific, applicable to a variety of biological samples, and cost-effective as it uses only 1 moAB and a polyclonal antibody. Using this assay, a single epitope can be estimated without purification.
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9
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Michaelidou K, Kladi-Skandali A, Scorilas A. Kallikreins as Biomarkers in Human Malignancies. BIOMARKERS IN CANCER 2015. [DOI: 10.1007/978-94-007-7681-4_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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10
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A novel method for the sensitive detection of mutant proteins using a covalent-bonding tube-based proximity ligation assay. Anal Chim Acta 2014; 841:17-23. [PMID: 25109857 DOI: 10.1016/j.aca.2014.06.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/20/2014] [Accepted: 06/24/2014] [Indexed: 11/21/2022]
Abstract
Tumorigenesis is the cumulative result of multiple gene mutations. The mutant proteins that are expressed by mutant genes in cancer cells are secreted into the blood and are useful biomarkers for the early diagnosis of cancer. However, some difficulties exist; for example, the same gene will express different protein mutants in different patients, and early tumors secrete only small amounts of mutant protein. Thus, the presence of mutant proteins in plasma has not previously been exploited for the early diagnosis of cancer. Proximity ligation assay is a protein-detection method that has been developed in recent years and has been widely used because of its high sensitivity. However, this approach still suffers from some shortcomings that should be addressed. In this paper, we develop a covalent-bonding tube-based proximity ligation assay (TB-PLA). The limit of detection of TB-PLA for 0.001pM, and the method exhibited a broad dynamic range of up to seven orders of magnitude. Furthermore, we coupled the conformation-specific antibody PAb240 of p53 mutants to PCR tubes for TB-PLA. The assay was capable of detecting an approximately 500-fold lower concentration of mutant p53 in serum compared with sandwich ELISA. Thus, we demonstrate TB-PLA to be a highly sensitive and effective approach that is suitable for the early clinical diagnosis of cancer using the conformation-specific antibodies of protein mutants.
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11
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Sauter ER. Analysis of nipple aspirate fluid for diagnosis of breast cancer: an alternative to invasive biopsy. Expert Rev Mol Diagn 2014; 5:873-81. [PMID: 16255629 DOI: 10.1586/14737159.5.6.873] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over 40,000 women in the USA will die this year of breast cancer. Current generally accepted techniques to detect breast cancer are limited to breast examination and mammography. Abnormalities found by these techniques require an invasive needle or surgical biopsy to determine if cancer is present. The author's ultimate goal is to determine if a woman has breast cancer without the need for invasive biopsies, and do this before the abnormality is detectable by standard screening techniques. Herein, the technology is reviewed as it was, as it is today, and its future potential is discussed.
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Affiliation(s)
- Edward R Sauter
- University of Missouri, One Hospital Drive, Columbia, MO 65212, USA.
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Hall MP, Schneider LV. Isotope-differentiated binding energy shift tags (IDBEST™) for improved targeted biomarker discovery and validation. Expert Rev Proteomics 2014; 1:421-31. [PMID: 15966839 DOI: 10.1586/14789450.1.4.421] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mass spectrometry has proved to be an important tool for protein biomarker discovery, identification and characterization. However, global proteomic profiling strategies often fail to identify known low-abundance biomarkers as a result of the limited dynamic range of mass spectrometry (two to three orders of magnitude) compared with the large dynamic range of protein concentrations in biologic fluids (11 to 12 orders of magnitude for serum). In addition, the number of peptides generated in such methods vastly overwhelms the resolution capacity of mass spectrometers, requiring extensive sample clean-up (e.g., affinity tag, retentate chromatography and/or high-performance liquid chromatography) before mass spectrometry analysis. Baiting and affinity pre-enrichment strategies, which overcome the dynamic range and sample complexity issues of global proteomic strategies, are very difficult to couple to mass spectrometry. This is due to the fact that it is nearly impossible to sort target peptides from those of the bait since there will be many cases of isobaric peptides. IDBEST (Target Discovery, Inc.) is a new tagging strategy that enables such pre-enrichment of specific proteins or protein classes as the resulting tagged peptides are distinguishable from those of the bait by a mass defect shift of approximately 0.1 atomic mass units. The special characteristics of these tags allow: resolution of tagged peptides from untagged peptides through incorporation of a mass defect element; high-precision quantitation of up- and downregulation by using stable isotope versions of the same tag; and potential analysis of protein isoforms through more complete peptide coverage from the proteins of interest.
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Affiliation(s)
- Michael P Hall
- Target Discovery, Inc., 4015 Fabian Way, Palo Alto, CA 94303, USA.
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Chang YF, Hung SH, Lee YJ, Chen RC, Su LC, Lai CS, Chou C. Discrimination of Breast Cancer by Measuring Prostate-Specific Antigen Levels in Women's Serum. Anal Chem 2011; 83:5324-8. [DOI: 10.1021/ac200754x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
| | | | | | | | - Li-Chen Su
- Department of Optics and Photonics, National Central University, Taoyuan 320, Taiwan
| | | | - Chien Chou
- Department of Optics and Photonics, National Central University, Taoyuan 320, Taiwan
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Khan SA, Chatterton RT. Cellular and hormonal content of breast nipple aspirate fluid in relation to the risk of breast cancer. Biomark Med 2010; 2:479-93. [PMID: 20477425 DOI: 10.2217/17520363.2.5.479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In research settings, the measurement of serum and urine hormone concentrations has shown modest positive relationships with breast cancer risk in postmenopausal women. However, the local production of sex steroids in the breast is a significant contributor to the hormonal environment of the breast. Nipple aspiration fluid provides a window into this environment and allows the measurement of hormone and protein content which may show stronger relations to breast cancer risk, and therefore enable both more accurate risk assessment, and the use of preventive measures directed to the lowering of local breast hormonal exposure.
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Affiliation(s)
- Seema A Khan
- Department of Surgery & the Robert H Lurie Comprehensive Cancer of Northwestern University, 301 East Superior Street, Chicago, IL, USA.
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Mannello F, Medda V, Smaniotto A, Tonti GA. Intracrinology of breast microenvironment: hormonal status in nipple aspirate fluid and its relationship to breast cancer. Expert Rev Endocrinol Metab 2009; 4:493-505. [PMID: 30736188 DOI: 10.1586/eem.09.28] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Breast cancer, a complex and multifactorial disease, is the most commonly diagnosed malignancy affecting women. Methods currently available for breast cancer detection have well-described limitations; in this respect, the intraductal approaches directly assess the microenvironment of the breast. Nipple aspirate fluid (NAF) can be noninvasively obtained from the breast in most women and represents a promising biological tool to assess metabolic, hormonal and molecular changes occurring in the cells lining the ducts, from which breast cancer arises. The aim of this review is to highlight the application of NAF studies in the field of biomarker discovery, which provide results useful for early detection and prevention of breast cancer risk; in fact, the analysis of NAF (mirroring the ductal-lobular microenvironment) is a reliable method for assessment of metabolic/hormonal pathways within the mammary gland, identifying biomolecular mechanisms of breast cancer initiation and progression. The intracrinology of breast microenvironment (i.e., hormonal status in NAF) may provide independent diagnostic/prognostic factors, highlighting the importance of early altered hormonal metabolism (e.g., aromatase, estrogen sulfotransferase and steroid sulfatase pathway) in relation to breast cancer initiation. The possible application of targeted therapies through the inhibition of intratumoral enzymes involved in steroid metabolism is also discussed. The intraductal approach to hormone analyses may provide a further panel of biomarkers providing clinical benefits and strengthening the armory against breast cancer.
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Affiliation(s)
- Ferdinando Mannello
- a Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University 'Carlo Bo', Via O. Ubaldini 7, 61029 Urbino (PU), Italy.
| | - Virginia Medda
- b Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University "Carlo Bo", Via O. Ubaldini 7, 61029 Urbino (PU), Italy
| | - Alessandra Smaniotto
- b Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University "Carlo Bo", Via O. Ubaldini 7, 61029 Urbino (PU), Italy
| | - Gaetana A Tonti
- b Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University "Carlo Bo", Via O. Ubaldini 7, 61029 Urbino (PU), Italy
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Sauter ER, Ganz PA, Ehya H, Hewett JE, Schlatter L, Kliethermes B, Daly MB. Prospective multicenter trial to determine the feasibility of collection and predictive ability of breast fluid analysis in postmenopausal women receiving SERMs. Breast 2007; 16:489-94. [PMID: 17482465 DOI: 10.1016/j.breast.2007.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Revised: 12/29/2006] [Accepted: 03/17/2007] [Indexed: 10/23/2022] Open
Abstract
We conducted a prospective ancillary study to the study of tamoxifen and raloxifene (STAR) trial involving 4 institutions to determine: (1) our ability to collect nipple aspirate fluid (NAF) in postmenopausal women taking medication to decrease breast proliferation and (2) NAF biomarkers associated with breast cancer. NAF was collected before and 6 months after starting treatment. Three biomarkers, cytology, fluid volume, and prostate-specific antigen (PSA), were analyzed. NAF was collected from 26 of 33 (79%) enrolled subjects at baseline. We were able to collect fluid in 84% of the subjects who produced NAF at baseline and returned for second aspiration after 6 months of treatment. In these women, cytology was unchanged in 85%, improved in 11%, and worsened in 4% of breasts. Median PSA increased from 37.5 to 112 ng/L after treatment. NAF volume did not significantly change. In conclusion, after treatment with tamoxifen or raloxifene, changes in both NAF cytology and PSA were generally favorable, consistent with their expected antiproliferative effective effect on the breast. Multiinstitutional clinical trials in postmenopausal women using NAF biomarkers as the primary endpoints are feasible.
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Affiliation(s)
- Edward R Sauter
- Department of Surgery, University of Missouri-Columbia, One Hospital Drive, Rm N510, Columbia, MO 65212, USA.
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Birrell SN, Butler LM, Harris JM, Buchanan G, Tilley WD. Disruption of androgen receptor signaling by synthetic progestins may increase risk of developing breast cancer. FASEB J 2007; 21:2285-93. [PMID: 17413000 DOI: 10.1096/fj.06-7518com] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is now considerable evidence that using a combination of synthetic progestins and estrogens in hormone replacement therapy (HRT) increases the risk of breast cancer compared with estrogen alone. Furthermore, the World Health Organization has recently cited combination contraceptives, which contain synthetic progestins, as potentially carcinogenic to humans, particularly for increased breast cancer risk. Given the above observations and the current trend toward progestin-only contraception, it is important that we have a comprehensive understanding of how progestins act in the millions of women worldwide who regularly take these medications. While synthetic progestins, such as medroxyprogesterone acetate (MPA), which are currently used in both HRT and oral contraceptives were designed to act exclusively through the progesterone receptor, it is clear from both clinical and experimental settings that their effects may be mediated, in part, by binding to the androgen receptor (AR). Disruption of androgen action by synthetic progestins may have serious deleterious side effects in the breast, where the balance between estrogen signaling and androgen signaling plays a critical role in breast homeostasis. Here, we review the role of androgen signaling in the normal breast and in breast cancer and present new data demonstrating that androgen receptor function can be perturbed by low doses of MPA, similar to doses achieved in serum of women taking HRT. We propose that the observed excess of breast malignancies associated with combined HRT may be explained, in part, by synthetic progestins such as MPA acting as endocrine disruptors to negate the protective effects of androgen signaling in the breast. Understanding the role of androgen signaling in the breast and how this is modulated by synthetic progestins is necessary to determine how combined HRT alters breast cancer risk, and to inform the development of optimal preventive and treatment strategies for this disease.
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Affiliation(s)
- Stephen N Birrell
- Dame Roma Mitchell Cancer Research Laboratories, The University of Adelaide, Hanson Institute, PO Box 14, Rundle Mall, South Australia, 5000, Australia
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18
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Schallmeiner E, Oksanen E, Ericsson O, Spångberg L, Eriksson S, Stenman UH, Pettersson K, Landegren U. Sensitive protein detection via triple-binder proximity ligation assays. Nat Methods 2006; 4:135-7. [PMID: 17179939 DOI: 10.1038/nmeth974] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Accepted: 10/12/2006] [Indexed: 11/09/2022]
Abstract
The detection of weakly expressed proteins and protein complexes in biological samples represents a fundamental challenge. We have developed a new proximity-ligation strategy named 3PLA that uses three recognition events for the highly specific and sensitive detection of as little as a hundred molecules of the vascular endothelial growth factor (VEGF), the biomarkers troponin I, and prostate-specific antigen (PSA) alone or in complex with an inhibitor--demonstrating the versatility of 3PLA.
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Affiliation(s)
- Edith Schallmeiner
- Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Se-75185 Uppsala, Sweden.
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Abstract
Established methods of breast cancer detection have well-described limitations, and new diagnostic techniques are evolving continually to improve diagnostic accuracy. The intraductal approach encompasses the modalities of nipple aspiration, ductal lavage, and duct endoscopy, and is a means of directly accessing the microenvironment of the breast and either sampling or visualizing this intraductal milieu. The aim of sampling this mammary microenvironment is to obtain samples from the physical surroundings of cells that are undergoing malignant transformation, thereby providing a new method of detection before the development of a clinically or radiologically discernible mass. A literature review was conducted to investigate the evolution of the intraductal approach and its particular application in the field of biomarker discovery, primarily using the intraductal technique of nipple aspiration, in combination with emerging protein profiling techniques.
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MESH Headings
- Angiogenesis Inducing Agents/analysis
- Biomarkers, Tumor/analysis
- Biopsy, Fine-Needle/instrumentation
- Biopsy, Fine-Needle/methods
- Breast Neoplasms/chemistry
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoembryonic Antigen/analysis
- Cell Transformation, Neoplastic/chemistry
- Chromosomal Instability
- DNA Methylation
- Endoscopes
- Endoscopy/methods
- Equipment Design
- Female
- Humans
- Kallikreins/analysis
- Loss of Heterozygosity
- Mammary Glands, Human/chemistry
- Mammary Glands, Human/pathology
- Neoplasm Proteins/analysis
- Nipples
- Proteomics
- Receptor, ErbB-2/analysis
- Receptors, Cell Surface/analysis
- Receptors, Urokinase Plasminogen Activator
- Sensitivity and Specificity
- Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
- Therapeutic Irrigation
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Affiliation(s)
- R Sascha Dua
- Department of Academic Surgery (Breast Unit), Royal Marsden National Health Service Foundation Trust, London, United Kingdom
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Proctor KAS, Rowe LR, Bentz JS. Cytologic features of nipple aspirate fluid using an automated non-invasive collection device: a prospective observational study. BMC WOMENS HEALTH 2005; 5:10. [PMID: 16078997 PMCID: PMC1198234 DOI: 10.1186/1472-6874-5-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 08/03/2005] [Indexed: 11/24/2022]
Abstract
Background Detection of cytologic atypia in nipple aspirate fluid (NAF) has been shown to be a predictor of risk for development of breast carcinoma. Manual collection of NAF for cytologic evaluation varies widely in terms of efficacy, ease of use, and patient acceptance. We investigated a new automated device for the non-invasive collection of NAF in the office setting. Methods A multi-center prospective observational clinical trial involving asymptomatic women designed to assess fluid production, adequacy, safety and patient acceptance of the HALO NAF Collection System (NeoMatrix, Irvine, CA). Cytologic evaluation of all NAF samples was performed using previously described classification categories. Results 500 healthy women were successfully enrolled. Thirty-eight percent (190/500) produced fluid and 187 were available for cytologic analysis. Cytologic classification of fluid producers showed 50% (93/187) Category 0 (insufficient cellular material), 38% (71/187) Category I (benign non-hyperplastic ductal epithelial cells), 10% (18/187) Category II (benign hyperplastic ductal epithelial cells), 3% (5/187) Category III (atypical ductal epithelial cells) and none were Category IV (unequivocal malignancy). Overall, 19% of the subjects produced NAF with adequate cellularity and 1% were found to have cytologic atypia. Conclusion The HALO system is a simple, safe, rapid, automated method for standardized collection of NAF which is acceptable to patients. Cytologic assessment of HALO-collected NAF showed the ability to detect benign and pre-neoplastic ductal epithelial cells from asymptomatic volunteers.
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Affiliation(s)
- Kerry AS Proctor
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Leslie R Rowe
- Institute for Clinical and Experimental Pathology, Associated Regional and University Pathologists (ARUP) Laboratories Inc., Salt Lake City, Utah, USA
| | - Joel S Bentz
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
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