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So KWL, Su Z, Cheung JPY, Choi SW. Single-Cell Analysis of Bone-Marrow-Disseminated Tumour Cells. Diagnostics (Basel) 2024; 14:2172. [PMID: 39410576 PMCID: PMC11475990 DOI: 10.3390/diagnostics14192172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 10/20/2024] Open
Abstract
Metastasis frequently targets bones, where cancer cells from the primary tumour migrate to the bone marrow, initiating new tumour growth. Not only is bone the most common site for metastasis, but it also often marks the first site of metastatic recurrence. Despite causing over 90% of cancer-related deaths, effective treatments for bone metastasis are lacking, with current approaches mainly focusing on palliative care. Circulating tumour cells (CTCs) are pivotal in metastasis, originating from primary tumours and circulating in the bloodstream. They facilitate metastasis through molecular interactions with the bone marrow environment, involving direct cell-to-cell contacts and signalling molecules. CTCs infiltrate the bone marrow, transforming into disseminated tumour cells (DTCs). While some DTCs remain dormant, others become activated, leading to metastatic growth. The presence of DTCs in the bone marrow strongly correlates with future bone and visceral metastases. Research on CTCs in peripheral blood has shed light on their release mechanisms, yet investigations into bone marrow DTCs have been limited. Challenges include the invasiveness of bone marrow aspiration and the rarity of DTCs, complicating their isolation. However, advancements in single-cell analysis have facilitated insights into these elusive cells. This review will summarize recent advancements in understanding bone marrow DTCs using single-cell analysis techniques.
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Affiliation(s)
| | | | | | - Siu-Wai Choi
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (K.W.L.S.); (Z.S.); (J.P.Y.C.)
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Veluponnar D, Dashtbozorg B, Guimaraes MDS, Peeters MJTFDV, de Boer LL, Ruers TJM. Resection Ratios and Tumor Eccentricity in Breast-Conserving Surgery Specimens for Surgical Accuracy Assessment. Cancers (Basel) 2024; 16:1813. [PMID: 38791892 PMCID: PMC11119905 DOI: 10.3390/cancers16101813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
This study aims to evaluate several defined specimen parameters that would allow to determine the surgical accuracy of breast-conserving surgeries (BCS) in a representative population of patients. These specimen parameters could be used to compare surgical accuracy when using novel technologies for intra-operative BCS guidance in the future. Different specimen parameters were determined among 100 BCS patients, including the ratio of specimen volume to tumor volume (resection ratio) with different optimal margin widths (0 mm, 1 mm, 2 mm, and 10 mm). Furthermore, the tumor eccentricity [maximum tumor-margin distance - minimum tumor-margin distance] and the relative tumor eccentricity [tumor eccentricity ÷ pathological tumor diameter] were determined. Different patient subgroups were compared using Wilcoxon rank sum tests. When using a surgical margin width of 0 mm, 1 mm, 2 mm, and 10 mm, on average, 19.16 (IQR 44.36), 9.94 (IQR 18.09), 6.06 (IQR 9.69) and 1.35 (IQR 1.78) times the ideal resection volume was excised, respectively. The median tumor eccentricity among the entire patient population was 11.29 mm (SD = 3.99) and the median relative tumor eccentricity was 0.66 (SD = 2.22). Resection ratios based on different optimal margin widths (0 mm, 1 mm, 2 mm, and 10 mm) and the (relative) tumor eccentricity could be valuable outcome measures to evaluate the surgical accuracy of novel technologies for intra-operative BCS guidance.
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Affiliation(s)
- Dinusha Veluponnar
- Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Behdad Dashtbozorg
- Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Marcos Da Silva Guimaraes
- Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Marie-Jeanne T. F. D. Vrancken Peeters
- Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Surgery, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Lisanne L. de Boer
- Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Theo J. M. Ruers
- Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
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Salman AM, Babaei E, Al-Khafaji ASK. Exploring the modulation of MLH1 and MSH2 gene expression in hesperetin-treated breast cancer cells (BT-474). J Adv Pharm Technol Res 2024; 15:43-48. [PMID: 38389973 PMCID: PMC10880915 DOI: 10.4103/japtr.japtr_279_23] [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: 05/17/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 02/24/2024] Open
Abstract
The major mortality factor for women globally is breast cancer, and current treatments have several adverse effects. Hesperetin (HSP) is a flavone that occurs naturally with anti-tumor capabilities and has been investigated as a potential treatment for cancer. This study aimed to investigate the cytotoxic and anti-malignant potential of HSP on breast cancer cells (BT-474) and normal cells (MCF-10a). The results indicated that HSP has dose-dependent cytotoxicity in BT-474 and MCF-10a cells. The elevated concentration of HSP lowered cell viability and proliferation. The half-maximal inhibitory concentration (IC50) of HSP in BT-474 cancer cells after a 48-h exposure was 279.2 μM/ml, while the IC50 in normal cells was 855.4 μM/ml. The cytotoxicity of HSP was more significant in cancer cell lines than in normal cell lines and this aspect presents a favorable factor in utilizing the drug for the treatment of breast cancer. The apoptotic effect of HSP in BT-474 cells was investigated, and it was found that the higher the concentration of HSP more the cells underwent apoptosis. Furthermore, the highest concentration of HSP led to overexpression of the MLH1 and MSH2 genes in both breast cancer and normal cell lines. Overall, our study suggests that HSP has an anticancer effect on breast cancer cell lines, and the effect is concentration dependent.
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Affiliation(s)
- Ahmed Mohammed Salman
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Esmaeil Babaei
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
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Banys-Paluchowski M, Kühn T, Masannat Y, Rubio I, de Boniface J, Ditsch N, Karadeniz Cakmak G, Karakatsanis A, Dave R, Hahn M, Potter S, Kothari A, Gentilini OD, Gulluoglu BM, Lux MP, Smidt M, Weber WP, Aktas Sezen B, Krawczyk N, Hartmann S, Di Micco R, Nietz S, Malherbe F, Cabioglu N, Canturk NZ, Gasparri ML, Murawa D, Harvey J. Localization Techniques for Non-Palpable Breast Lesions: Current Status, Knowledge Gaps, and Rationale for the MELODY Study (EUBREAST-4/iBRA-NET, NCT 05559411). Cancers (Basel) 2023; 15:cancers15041173. [PMID: 36831516 PMCID: PMC9954476 DOI: 10.3390/cancers15041173] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization (WGL) is most commonly used. Other techniques (radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound) have been developed in the last two decades with the aim of improving outcomes and logistics. METHODS We performed a systematic review on localization techniques for non-palpable breast cancer. RESULTS For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials (RCTs). Radioactive techniques were studied in several RCTs and are non-inferior to WGL. Smaller studies show higher patient preference towards wire-free localization, but little is known about surgeons' and radiologists' attitudes towards these techniques. CONCLUSIONS Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary. This review aims to present the rationale for the MELODY (NCT05559411) study and to enable standardization of outcome measures for future studies.
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Affiliation(s)
- Maggie Banys-Paluchowski
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany
- Correspondence:
| | - Thorsten Kühn
- Department of Gynecology and Obstetrics, Die Filderklinik, 70794 Filderstadt, Germany
| | - Yazan Masannat
- Aberdeen Breast Unit, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK
| | - Isabel Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, 28027 Madrid, Spain
| | - Jana de Boniface
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Surgery, Capio St. Göran’s Hospital, 11219 Stockholm, Sweden
| | - Nina Ditsch
- Breast Cancer Center, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Güldeniz Karadeniz Cakmak
- Breast and Endocrine Unit, General Surgery Department, Zonguldak BEUN The School of Medicine, Kozlu/Zonguldak 67600, Turkey
| | - Andreas Karakatsanis
- Department for Surgical Sciences, Faculty of Pharmacy and Medicine, Uppsala University, 75236 Uppsala, Sweden
- Section for Breast Surgery, Department of Surgery, Uppsala University Hospital, 75236 Uppsala, Sweden
| | - Rajiv Dave
- Nightingale & Genesis Breast Cancer Prevention Centre, Manchester University NHS Foundation Trust, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Markus Hahn
- Department for Women’s Health, University of Tübingen, 72076 Tübingen, Germany
| | - Shelley Potter
- Bristol Medical School (THS), Bristol Population Health Science Institute, Bristol BS8 1QU, UK
| | - Ashutosh Kothari
- Guy’s & St Thomas NHS Foundation Trust, Kings College, London SE1 9RT, UK
| | - Oreste Davide Gentilini
- Department of Breast Surgery, San Raffaele University and Research Hospital, 20132 Milan, Italy
| | - Bahadir M. Gulluoglu
- Department of Surgery, Breast Surgery Unit, Marmara University School of Medicine and SENATURK Turkish Academy of Senology, Istanbul 34854, Turkey
| | - Michael Patrick Lux
- Department of Gynecology and Obstetrics, St. Louise Frauen-und Kinderklinik, 33098 Paderborn, Germany
| | - Marjolein Smidt
- Department of Surgical Oncology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Walter Paul Weber
- Division of Breast Surgery, Department of Surgery, Basel University Hospital, 4031 Basel, Switzerland
| | - Bilge Aktas Sezen
- European Breast Cancer Research Association of Surgical Trialists (EUBREAST), 73730 Esslingen, Germany
| | - Natalia Krawczyk
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | - Steffi Hartmann
- Department of Gynecology and Obstetrics, University Hospital Rostock, 18059 Rostock, Germany
| | - Rosa Di Micco
- Department of Breast Surgery, San Raffaele University and Research Hospital, 20132 Milan, Italy
| | - Sarah Nietz
- Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Francois Malherbe
- Breast and Endocrine Surgery Unit, Groote Schuur Hospital, University of Cape Town, Cape Town 7935, South Africa
| | - Neslihan Cabioglu
- Istanbul Faculty of Medicine, Department of General Surgery, Istanbul University, Istanbul 34093, Turkey
| | - Nuh Zafer Canturk
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli 41001, Turkey
| | - Maria Luisa Gasparri
- Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, 6900 Lugano, Switzerland
- Centro di Senologia della Svizzera Italiana (CSSI), Ente Ospedaliero Cantonale, Via Pietro Capelli 1, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Via Giuseppe Buffi 13, 6900 Lugano, Switzerland
| | - Dawid Murawa
- General Surgery and Surgical Oncology Department, Collegium Medicum, University in Zielona Gora, 65-417 Zielona Góra, Poland
| | - James Harvey
- Nightingale & Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester M13 9PL, UK
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Mostufa S, Akib TBA, Rana MM, Islam MR. Highly Sensitive TiO 2/Au/Graphene Layer-Based Surface Plasmon Resonance Biosensor for Cancer Detection. BIOSENSORS 2022; 12:bios12080603. [PMID: 36004999 PMCID: PMC9405676 DOI: 10.3390/bios12080603] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 05/27/2023]
Abstract
In this article, a hybrid TiO2/Au/graphene layer-based surface plasmon resonance (SPR) sensor with improved sensitivity and capability for cancer detection is presented. The finite element method (FEM) was used for numerical analysis. The proposed SPR biosensor was structured based on the angular analysis of the attenuated total reflection (ATR) method for the detection of various types of cancer using the refractive index component. The resonance angle shifted owing to the increment of normal and cancerous cells' refractive index, which varied between 1.36 and 1.401 for six different types of normal and cancerous cells. According to numerical results, the obtained sensitivities for skin (basal), cervical (HeLa), adrenal gland (PC12), blood (Jurkat), and breast (MCF-7 and MDA-MB-231) cancer cells were 210 deg/RIU, 245.83 deg/RIU, 264.285 deg/RIU, 285.71 deg/RIU, 292.86 deg/RIU, and 278.57 deg/RIU, respectively. Furthermore, the detection accuracy (DA), figure of merits (FOM), and signal-to-noise ratio (SNR) were also obtained, with values of 0.263 deg-1, 48.02 RIU-1, and 3.84, respectively. Additionally, the distribution of the electric field and the propagation of the magnetic field for resonant and non-resonant conditions of the proposed structure were illustrated. It was found that an enhanced field was exhibited on the surface of the plasmonic material for resonant conditions. We also measured the penetration depth of 180 nm using decayed electric field intensity. Furthermore, the impact of using a TiO2/Au/graphene layer was demonstrated. We further conducted analyses of the effects of the thickness of the gold layer and the effects of additional graphene layers on overall sensitivities for six different types of cancer. The proposed TiO2/Au/graphene layered structure exhibited the highest overall sensitivity in terms of detecting cancerous cells from healthy cells. Moreover, the proposed sensor was numerically analyzed for a wide range of biological solutions (refractive index 1.33-1.41), and the sensor linearity was calculated with a linear regression coefficient (R2) of 0.9858. Finally, numerical results obtained in this manuscript exhibited high sensitivity in comparison with previously reported studies.
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Affiliation(s)
- Shahriar Mostufa
- Department of Electrical & Electronic Engineering, Rajshahi University of Engineering & Technology, Rajshahi 6204, Bangladesh
| | - Tarik Bin Abdul Akib
- Department of Electrical & Electronic Engineering, Rajshahi University of Engineering & Technology, Rajshahi 6204, Bangladesh
| | - Md. Masud Rana
- Department of Electrical & Electronic Engineering, Rajshahi University of Engineering & Technology, Rajshahi 6204, Bangladesh
| | - Md. Rabiul Islam
- School of Electrical, Computer and Telecommfiunications Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
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Razali RA, Lokanathan Y, Chowdhury SR, Yahaya NHM, Saim AB, Ruszymah BHI. Human chondrocyte-conditioned medium promotes chondrogenesis of bone marrow stem cells. ASIAN BIOMED 2020. [DOI: 10.1515/abm-2020-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Cell-based therapy for osteoarthritis requires culturing of good quality cells, especially with a chondrogenic lineage, for implantation.
Objective
To investigate the ability of chondrocyte-conditioned medium (CCM) to induced chondrogenesis.
Methods
Bone marrow mesenchymal stem cells (BMSCs) were subjected to chondrogenic induction using CCM and chondrocyte induction medium (CIM). The optimal condition for the collection of CCM was evaluated by quantifying the concentration of secreted proteins. The chondrogenic efficiency of BMSCs induced by CCM (iCCM) was evaluated using immunocytochemical analysis, Safranin-O staining, and gene expression.
Results
Protein quantification revealed that CCM obtained from cells at passage 3 at the 72 h collection point had the greatest amount of protein. Supplementation of CCM results in the aggregation of BMSCs; however, no clumping was visible as in iCIM. The expression of collagen type 2 was detected as early as day 7 for all groups except for non-induced BMSCs; however, the level of expression decreased with culture time. Similarly, all tested groups showed positive staining for Safranin-O as early as day 7. The induction of BMSCs by CCM caused the down-regulation of collagen type 1, along with the up-regulation of the collagen type 2, ACP and SOX9 genes.
Conclusion
The optimum CCM to induce BMSC into chondrocytes was collected at passage 3 after 72 h and was used in a 50:50 ratio of CCM to fresh medium.
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Affiliation(s)
- Rabiatul Adawiyah Razali
- Department of Physiology, Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
| | - Yogeswaran Lokanathan
- Tissue Engineering Centre, Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
| | - Shiplu Roy Chowdhury
- Tissue Engineering Centre, Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
| | - Nor Hamdan Mohamad Yahaya
- Department of Orthopaedic and Traumatology, Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
| | - Aminuddin Bin Saim
- Ear, Nose and Throat Consultant Clinic, Ampang Puteri Specialist Hospital , Selangor , Malaysia
| | - Bt Hj Idrus Ruszymah
- Department of Physiology, Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
- Tissue Engineering Centre, Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia
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Hao Y, Ren G, Yang W, Zheng W, Wu Y, Li W, Li X, Li Y, Guo X. Combination diagnosis with elastography strain ratio and molecular markers effectively improves the diagnosis rate of small breast cancer and lymph node metastasis. Quant Imaging Med Surg 2020; 10:678-691. [PMID: 32269928 DOI: 10.21037/qims.2020.02.14] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background To evaluate the strain ratio (SR) combined with molecular pathological and serum markers for the diagnosis of breast masses. Methods SR and 7-point scale elasticity scores were used with real-time tissue elastography and 2-dimensional color-Doppler ultrasound (US) to diagnose breast lesions in 311 hospitalized patients. Immunohistochemical staining and enzyme-linked immunosorbent assays (ELISAs) were used to examine pathological and serum tumor markers and their correlations with SR findings. Results SR had a higher diagnostic value compared to the 7-point scale elasticity score, displaying an obvious low-to-high distribution from benign to malignant lesions with an optimal cutoff point at 3.88, which yielded an area under the curve (AUC) of 0.896 with 89.1% sensitivity, 85.6% specificity, and positive and negative predictive values of 91.0% and 82.8%, respectively. The differences of SR values between small (≤1.5 cm), large (>3 cm) (P=0.010), and moderate (>1.5 cm and ≤3 cm) sizes (P=0.038) in distinguishing benign from malignant breast masses were statistically significant, with SR being most specific and sensitive for diagnosing small lesions. Expression of 3 molecular pathological indicators (p75NTR, p63, and CK5/6), and 5 serum mastocarcinoma markers (uPA, PAI-I, CA27-29, CEA, and CA15-3) showed statistical significance (P<0.05) in distinguishing between benign and malignant breast lesions. Furthermore, SR combined with CA15-3 and CK5/6 positivity showed 94.2% sensitivity and 89.2% specificity as combined markers for triple-negative (TN) breast cancer, whereas SR combined with D2-40 and CK19 were good diagnostic markers for breast cancer lymph node metastasis. Conclusions SR, together with a molecular and serological marker, may serve as an additional tool for the diagnosis of small breast cancer tumors.
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Affiliation(s)
- Yi Hao
- Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China.,Shenzhen Key Laboratory of Viral Oncology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - Guanghui Ren
- Department of General Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - Wei Yang
- Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - Wenyi Zheng
- Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - Yuming Wu
- Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - WenJing Li
- Department of Ultrasound, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - Xin Li
- Shenzhen Key Laboratory of Viral Oncology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China.,Center for Clinical Research and Innovation (CCRI), Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
| | - Yingjia Li
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xia Guo
- Shenzhen Key Laboratory of Viral Oncology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China.,Center for Clinical Research and Innovation (CCRI), Shenzhen Hospital, Southern Medical University, Shenzhen 518100, China
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Khazaee E, Farzaneh N, Mirshokraei P, Tabatabaeizadeh S, Dehghani H. Expression of endogenous retroviruses in pre‐implantation stages of bovine embryo. Reprod Domest Anim 2018; 53:1405-1414. [DOI: 10.1111/rda.13269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/23/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Elaheh Khazaee
- Department of Clinical Sciences Faculty of Veterinary Medicine Ferdowsi University of Mashhad Mashhad Iran
| | - Nima Farzaneh
- Department of Clinical Sciences Faculty of Veterinary Medicine Ferdowsi University of Mashhad Mashhad Iran
| | - Pezhman Mirshokraei
- Department of Clinical Sciences Faculty of Veterinary Medicine Ferdowsi University of Mashhad Mashhad Iran
- Faculty of Veterinary Medicine Center of Excellence in Ruminant Abortion and Neonatal Mortality Ferdowsi University of Mashhad Mashhad Iran
| | - Seyed‐Elias Tabatabaeizadeh
- Razi Vaccine and Serum Research Institute Agricultural Research, Education and Extension Organization (AREEO) Mashhad Iran
| | - Hesam Dehghani
- Stem Cell Biology and Regenerative Medicine Research Group Research Institute of Biotechnology Ferdowsi University of Mashhad Mashhad Iran
- Department of Basic Sciences Faculty of Veterinary Medicine Ferdowsi University of Mashhad Mashhad Iran
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9
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Abreu A, Milani C, Katayama M, Barbosa E, da Fonseca LG, Góes J, Brentani M, Folgueira MK. Expression of Heterochromatin Protein 1 in the Primary Tumor of Breast Cancer Patients in the Presence or Absence of Occult Metastatic Cells in the Bone Marrow. Int J Biol Markers 2018; 23:219-24. [DOI: 10.1177/172460080802300404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gene silencing may occur in breast cancer samples from patients presenting with occult metastatic cells in the bone marrow and one mechanism regulating gene suppression is heterochromatin formation. We have studied whether members of the heterochromatin protein 1 family (HP1Hsα, HP1Hsβ and HP1Hsγ), which take part in chromatin packaging and gene expression regulation, were differentially expressed in tumors from patients with and without occult metastatic cells in their bone marrow. Tumor samples and bone marrow aspirates were obtained from 37 breast cancer patients. Median age was 63 years and 68% of the patients presented with clinical stage I/II disease. Presence of occult metastatic cells in bone marrow was detected through keratin-19 expression by nested RT-PCR in samples from 20 patients (54.1%). The presence of occult metastatic cells in bone marrow was not associated with node involvement, histological grade, estrogen receptor and ERBB2 immunoexpression. Relative gene expression of HP1Hsα, HP1Hsβ and HP1Hsγ was determined by real-time RT-PCR and did not vary according to the presence of occult metastatic cells in bone marrow. In addition, the combined expression of these three transcripts could not be used to classify samples according to the presence of bone marrow micrometastasis. Our work indicates that regulation of heterochromatin formation through HP1 family members may not be the sole mechanism implicated in the metastatic process to the bone marrow.
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Affiliation(s)
- A.P.S. Abreu
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
| | - C. Milani
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - M.L.H. Katayama
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - E.M. Barbosa
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
| | - L. Gomes da Fonseca
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - J.CS. Góes
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
| | - M.M. Brentani
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
| | - M.A.A. Koike Folgueira
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Radiologia, Disciplina de Oncologia, São Paulo
- Instituto Brasileiro de Controle do Câncer de São Paulo, São Paulo - Brasil
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10
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Gilje B, Nordgård O, Tjensvoll K, Borgen E, Synnestvedt M, Smaaland R, Naume B. Comparison of molecular and immunocytochemical methods for detection of disseminated tumor cells in bone marrow from early breast cancer patients. BMC Cancer 2014; 14:514. [PMID: 25023626 PMCID: PMC4223548 DOI: 10.1186/1471-2407-14-514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disseminated tumor cells (DTCs) have potential to predict the effect of adjuvant treatment. The purpose of this study was to compare two methods, reverse transcription quantitative PCR (RT-qPCR) and immunocytochemisty (ICC), for detecting breast cancer DTCs in bone marrow (BM) from early breast cancer patients. METHODS We investigated a subset (n = 313) of BM samples obtained from 271 early breast cancer patients in the "Secondary Adjuvant Taxotere Treatment" (SATT)-trial. All patients in this study had node positive or intermediate/high-risk node negative non-metastatic disease. The DTCs were detected by ICC using AE1-AE3 anti-cytokeratin monoclonal antibodies. Patients with DTCs detected in their BM by ICC after standard adjuvant fluorouracil, cyclophosphamide, epirubicin (FEC) chemotherapy were offered docetaxel treatment. For comparison, 5 × 106 mononuclear cells from the aliquoted BM samples were also analyzed by RT-qPCR using a multimarker (MM) assay based on the tumor cell mRNA markers keratin 19 (KRT19), mammaglobin A (hMAM), and TWIST1. In the MM-assay, a sample was defined as positive for DTCs if at least one of the mRNA markers was positive. RESULTS The MM RT-qPCR assay identified DTCs in 124 (40%) of the 313 BM samples compared with 23/313 (7%) of the samples analyzed by ICC. The concordance between the MM RT-qPCR and ICC was 61% (Kappa value = 0.04) and twelve of the BM samples were positive by both methods. By RT-qPCR, 46/313 (15%) samples were positive for KRT19, 97/313 (31%) for TWIST1, and 3/313 (1%) for hMAM mRNA. There were no statistically significant associations between the individual mRNA markers. CONCLUSION The RT-qPCR based method demonstrated more DTC-positive samples than ICC. The relatively low concordance of positive DTC-status between the two different assessment methods suggests that they may be complementary. The clinical relevance of the methods will be evaluated based on future clinical outcome data. TRIAL REGISTRATION ClinicalTrials.gov: NCT00248703.
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Affiliation(s)
- Bjørnar Gilje
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway.
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11
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Shupe MP, Graham LJ, Schneble EJ, Flynt FL, Clemenshaw MN, Kirkpatrick AD, Stojadinovic A, Peoples GE, Shumway NM. Future directions for monitoring treatment responses in breast cancer. J Cancer 2014; 5:69-78. [PMID: 24396499 PMCID: PMC3881222 DOI: 10.7150/jca.7048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 07/24/2013] [Indexed: 11/05/2022] Open
Abstract
In the prior review, we outlined the current standard of care for monitoring treatment responses in breast cancer and discussed the many challenges associated with these strategies. We described the challenges faced in common clinical settings such as the adjuvant setting, neoadjuvant setting, and the metastatic setting. In this review, we will expand upon future directions meant to overcome several of these current challenges. We will also explore several new and promising methods under investigation to enhance how we monitor treatment responses in breast cancer. Furthermore, we will highlight several new technologies and techniques for monitoring breast cancer treatment in the adjuvant, neoadjuvant and metastatic setting.
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Affiliation(s)
| | | | | | | | | | | | - Alexander Stojadinovic
- 5. Department of Surgical Oncology, San Antonio Military Medical Center (SAMMC), Brooke Army Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - George E Peoples
- 6. Department of Surgical Oncology, Walter Reid National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA
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Chong MH, Zhao Y, Wang J, Zha XM, Liu XA, Ling LJ, Du Q, Wang S. The dynamic change of circulating tumour cells in patients with operable breast cancer before and after chemotherapy based on a multimarker QPCR platform. Br J Cancer 2012; 106:1605-10. [PMID: 22516945 PMCID: PMC3349184 DOI: 10.1038/bjc.2012.157] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background: The possible presence of early tumour dissemination is the rationale behind the use of systemic adjuvant chemotherapy in patients with operable breast cancer. Circulating tumour cells (CTC) in peripheral blood may represent the possible presence of early tumour dissemination. However, relatively few studies were designed to investigate the relationship between the change of CTC status and the efficacy of adjuvant chemotherapy in operable breast cancer patients. Methods: In a prospective study, we established a multimarker real-time quantitative PCR platform to detect CTC in peripheral blood of breast cancer patients. By using this platform, we detected CTC in peripheral blood of 94 operable breast cancer patients. Control group consisted of 20 patients with benign breast disease and 20 healthy volunteers. For 72 patients who underwent systemic adjuvant chemotherapy, the dynamic CTC status at three different time points (1 day before initiation of chemotherapy, 1 week after three cycles of chemotherapy and 1 week after all cycles of chemotherapy) was observed. Results: Circulating tumour cells were detected in 56% (53 out of 94) of patients with operable breast cancer. The specificity was 95%. Seventy-two patients who received systemic adjuvant chemotherapy were followed up. After three cycles of chemotherapy, 47% (18 out of 38) of patients who were CTC-positive before chemotherapy changed into negative status. In addition, another 5% (2 out of 38) of patients had changed into negative status after all cycles of chemotherapy. Conclusion: Systemic adjuvant chemotherapy had a significant impact on CTC status, and this effect could be observed after three cycles of chemotherapy. Circulating tumour cells detection had the potential to be used to evaluate the efficacy of systemic adjuvant chemotherapy immediately after the chemotherapy was finished in operable breast cancer patients.
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Affiliation(s)
- M-h Chong
- Department of Breast Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
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Picchiassi E, Coata G, Centra M, Pennacchi L, Bini V, Di Renzo GC. Identification of universal mRNA markers for noninvasive prenatal screening of trisomies. Prenat Diagn 2010; 30:764-70. [DOI: 10.1002/pd.2541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Circulating tumour cell detection: a direct comparison between the CellSearch System, the AdnaTest and CK-19/mammaglobin RT-PCR in patients with metastatic breast cancer. Br J Cancer 2009; 102:276-84. [PMID: 19953098 PMCID: PMC2816650 DOI: 10.1038/sj.bjc.6605472] [Citation(s) in RCA: 141] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The detection, enumeration and isolation of circulating tumour cells (CTCs) have considerable potential to influence the clinical management of patients with breast cancer. There is, however, substantial variability in the rates of positive samples using existing detection techniques. The lack of standardisation of technology hampers the implementation of CTC measurement in clinical routine practice. METHODS This study was designed to directly compare three techniques for detecting CTCs in blood samples taken from 76 patients with metastatic breast cancer (MBC) and from 20 healthy controls: the CellSearch CTC System, the AdnaTest Breast Cancer Select/Detect and a previously developed real-time qRT-PCR assay for the detection of CK-19 and mammaglobin transcripts. RESULTS As a result, 36% of patients with MBC were positive by the CellSearch System, 22% by the AdnaTest, 26% using RT-PCR for CK-19 and 54% using RT-PCR for mammaglobin. Samples were significantly more likely to be positive for at least one mRNA marker using RT-PCR than using the CellSearch System (P=0.001) or the AdnaTest (P<0.001). CONCLUSION We observed a substantial variation in the detection rates of CTCs in blood from breast cancer patients using three different techniques. A higher rate of positive samples was observed using a combined qRT-PCR approach for CK-19 and mammaglobin, which suggests that this is currently the most sensitive technique for detecting CTCs.
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Chang CC, Yang SH, Chien CC, Chen SH, Pan S, Lee CL, Lin CM, Sun HL, Huang CC, Wu YY, Yang RN, Huang CJ. Clinical meaning of age-related expression of fecal cytokeratin 19 in colorectal malignancy. BMC Cancer 2009; 9:376. [PMID: 19849844 PMCID: PMC2776602 DOI: 10.1186/1471-2407-9-376] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2009] [Accepted: 10/22/2009] [Indexed: 02/08/2023] Open
Abstract
Background Colorectal cancer (CRC) is one of the leading causes of malignant death worldwide. Because young age of onset is often considered a poor prognostic factor for CRC, it is important to identify the poor outcomes of CRC in a younger population and to consider an aggressive approach by implementing early treatment. Our aim was to specifically quantify the fecal cytokeratin 19 (CK19) transcript from CRC patients and investigate its correlation with clinical stage, tumor malignancy, and age. Methods The quantitation of fecal CK19 transcript was determined by a quantitative real-time reverse transcription polymerase chain in 129 CRC patients (45 younger than 60 years at diagnosis) and 85 healthy controls. The levels of CK19 protein were examined both in colonic cell lines and tissues. Results The analysis of 45 younger CRC patients (age ≤ 60 years) revealed that patients at the M1 stage had significantly higher expression levels of fecal CK19 mRNA when compared with healthy controls (p < 0.001) and patients at the M0 stage (p = 0.004). Additionally, the degree of consistency between the mean level of fecal CK19 mRNA and the distant metastatic rate in each age interval was up to 89% (p = 0.042). Conclusion These results indicate that high levels of fecal CK19 mRNA represent a potential marker for colorectal malignancy and for aggressive treatment of younger CRC patients.
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Affiliation(s)
- Chun-Chao Chang
- Digestive Disease Research Center, Taipei Medical University and Division of Gastroenterology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan, Republic of China.
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Fortunato L, Mascaro A, Baldi A, Farina M, Cortese G, Ventrone MA, Amini M, Vitelli C. Positive bone marrow biopsy is associated with a decreased disease-free survival in patients with operable breast cancer. Ann Surg Oncol 2009; 16:3010-9. [PMID: 19641970 DOI: 10.1245/s10434-009-0619-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 06/15/2009] [Accepted: 06/15/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bone marrow (BM) biopsy has been suggested as an independent prognostic factor in patients with breast cancer. METHODS Patients operated for breast cancer from June 2000 to April 2008 were enrolled in this protocol after signing an informed consent. After primary surgery, BM aspirate from the iliac crest was obtained and 5-10 cc of blood collected. Since 2002 a peripheral blood (PB) sample was also obtained. Both carcinoembryonic antigen (CEA) and Mammaglobin-specific nested reverse-transcription polymerase chain reaction (RT-PCR) were used to examine BM and PB samples. Physicians and patients were blinded to results. RESULTS Two hundred seventy-three patients underwent BM and/or PB test. The median age of the patients was 63 years (31-80 years), and the median tumor diameter was 1.5 cm (0.1-6 cm). BM aspirates were unsuccessful in nine patients, and RT-PCR was not technically feasible in 18 women, leaving 246 patients available for analysis of results and follow-up. Among them, 110 patients (45%) had either a BM or a PB test positive for CEA or Mammaglobin (Test+). At median follow-up of 60 months, 31 events (deaths or relapse) occurred (13%). Disease-free survival (DFS) was significantly lower in the Test+ group (BP and/or PB) (P<0.001). This effect was independent of nodal status. At 5 years, event-free survival for Node-/Test- patients was 46/49 (94%) and for Node+/Test+ patients was 21/33 (64%), while patients with only one status positive (Node-/Test+ or Node+/Test-) had an intermediate disease-free survival (35/43, 81%) (P=0.005). In a subgroup analysis, RT-PCR results for BM and Mammaglobin retained statistical significance on DFS (P<0.001), while those for PB and CEA did not. CONCLUSIONS This study confirms that RT-PCR of the BM is an independent prognostic factor for disease-free survival of breast cancer patients, and may improve their staging, allowing better strategies for therapy and follow-up.
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Affiliation(s)
- Lucio Fortunato
- Department of Surgery, San Giovanni-Addolorata Hospital, Rome, Italy.
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Wang L, Wang Y, Liu Y, Cheng M, Wu X, Wei H. Flow cytometric analysis of CK19 expression in the peripheral blood of breast carcinoma patients: relevance for circulating tumor cell detection. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2009; 28:57. [PMID: 19397830 PMCID: PMC2685124 DOI: 10.1186/1756-9966-28-57] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Accepted: 04/28/2009] [Indexed: 11/21/2022]
Abstract
Background Immunocytochemistry and RT-PCR have been widely used for the detection of circulating tumor cells in patients with breast cancer but their specificity is limited. Our purpose is to utilize a convenient and specific technology to detect circulating tumor cells in breast cancer patients. Methods To determine the sensitivity and specificity of our method, A431 cells were serially diluted with human peripheral blood leukocytes and stained with CK19. A total of 73 blood specimens including 25 healthy volunteers and 48 patients with breast carcinoma and benign tumor were tested by flow cytometry to quantify the expression of CK19. Results The detectable upper limit of A431 cells was 1 cancer cell among 104 human white blood cells. CK19 was detected in 27% of breast cancer patients but none control gives positive result. The number of cancer cells increased gradually along with the disease stages for it was the least in stage I (0%) and the most in stage IV (1.29%). Fifteen patients were observed during three month chemotherapy after surgery, and most of their CK19 expression levels declined after treatment. Conclusion Our research convinces that the detection of CK19 in peripheral blood by flow cytometry is also a specific and feasible method to monitor circulating tumor cells in breast cancer.
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Affiliation(s)
- Lili Wang
- Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China, Anhui, PR China.
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18
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Valladares-Ayerbes M, Iglesias-Díaz P, Díaz-Prado S, Ayude D, Medina V, Haz M, Reboredo M, Antolín S, Calvo L, Antón-Aparicio LM. Diagnostic accuracy of small breast epithelial mucin mRNA as a marker for bone marrow micrometastasis in breast cancer: a pilot study. J Cancer Res Clin Oncol 2009; 135:1185-95. [PMID: 19221791 DOI: 10.1007/s00432-009-0559-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Accepted: 01/29/2009] [Indexed: 02/03/2023]
Abstract
BACKGROUND Detection of isolated tumour cells (ITC) in the blood or minimal deposits in distant organs such as bone marrow (BM) could be important to identify breast cancer patients at high risk of relapse or disease progression. PCR amplification of tissue or tumour selective mRNA is the most powerful analytical tool for detection of this micrometastasis. We have evaluated for the first time, the diagnostic accuracy of small breast epithelial mucin (SBEM) as a potential marker for BM micrometastasis in breast cancer. METHODS A nested RT-PCR assay for detection of SBEM mRNA was compared with immunocytochemistry (ICC) with anticytokeratin AE1/AE3 antibody in paired samples obtained from the BM of breast cancer patients. Associations of SBEM mRNA detection in BM and clinical and pathological parameters were evaluated. SBEM mRNA status and time to breast cancer progression were analysed using Kaplan-Meyer curves. RESULTS Fifty stages I-IV breast cancer female patients were prospectively included in our study. SBEM specific transcript was found in BM in 26% of the patients. Detection rate was similar to the percentage of patients with ITCs detected using ICC (24%). SBEM mRNA in BM aspirates were significantly associated with presence of clinically active disease, including locally advanced and metastatic patients (47%, P = 0.021) and tumours with positive hormonal receptors (36.7%, P = 0.035). In addition association with Her2/neu over-expression (44.4%, P = 0.051) and low proliferating tumours (36%, P = 0.067) were close to significant levels. When we analysed time to breast cancer progression adjusting for grade or hormone receptor status, presence of SBEM mRNA in BM defines distinct prognostic groups. CONCLUSIONS SBEM might represent a suitable marker for molecular detection of ITCs in BM in breast cancer patients. Analysis of prognostic value for SBEM mRNA-based assay should take into account the heterogeneity and different molecular subtypes of breast cancer.
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Affiliation(s)
- Manuel Valladares-Ayerbes
- Medical Oncology Department, La Coruña University Hospital, Servicio Gallego de Salud, CP 15006 La Coruña, Spain.
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19
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Abstract
OBJECTIVES The prognosis of breast cancer patients depends on primary tumor resection and axillary lymph nodes examination. The purpose of this study was to analyze by molecular biology techniques the presence of mammaglobin A and B messenger RNA in breast sentinel lymph node (SLN) by reverse-transcription polymerase chain reaction (RT-PCR). METHODS Sentinel lymph nodes from 50 patients with a diagnosis of breast cancer were prospectively studied between June 2004 and August 2006. Lymph nodes were all examined every 2 mm by intraoperative cytology. Hematoxylin-eosin (HE), immunohistochemistry (IHC) with cytokeratin (clone AE1-AE3, DAKO, dilution 1:100), and molecular biology techniques were used in all cases. RESULTS Deferred study with routine techniques showed subcapsular metastasis in 3/50 cases. Out of 50 cases, 5 were detected with IHC, and 2 of them were negative for HE. Multiplex RT-PCR allowed the detection of 18/50 positive SLN, which included the 5 above-mentioned cases. The other SLN studied (32/50) showed no metastases with the methods herein implemented. CONCLUSIONS The epidemiologic impact of incomplete SLN study has been observed, as the HE technique fails to identify all SLN with micrometastases. In our opinion, SLN should be studied with IHC and molecular biology techniques. The multiplex RT-PCR technique for A and B mammaglobin proves to be specific and sensitive. This study will serve to formulate hypotheses. Further research, including a larger population and a longer-term follow-up period, will be required to confirm these hypotheses. Should our findings be confirmed in the future, molecular biology determinations could modify patients' staging and treatment.
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A small subgroup of operable breast cancer patients with poor prognosis identified by quantitative real-time RT-PCR detection of mammaglobin A and trefoil factor 1 mRNA expression in bone marrow. Breast Cancer Res Treat 2008; 116:329-38. [DOI: 10.1007/s10549-008-0204-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 09/19/2008] [Indexed: 11/26/2022]
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Becker S, Becker-Pergola G, Banys M, Krawczyk N, Wallwiener D, Solomayer E, Schuetz C, Fehm T. Evaluation of a RT-PCR based routine screening tool for the detection of disseminated epithelial cells in the bone marrow of breast cancer patients. Breast Cancer Res Treat 2008; 117:227-33. [DOI: 10.1007/s10549-008-0174-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 08/25/2008] [Indexed: 11/30/2022]
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Mikhitarian K, Martin RH, Ruppel MB, Gillanders WE, Hoda R, Schutte DH, Callahan K, Mitas M, Cole DJ. Detection of mammaglobin mRNA in peripheral blood is associated with high grade breast cancer: interim results of a prospective cohort study. BMC Cancer 2008; 8:55. [PMID: 18289390 PMCID: PMC2292197 DOI: 10.1186/1471-2407-8-55] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Accepted: 02/20/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We sought to examine the detection rate of cancer cells in peripheral blood (PBL) and in bone marrow (BM) using an established 7-gene marker panel and evaluated whether there were any definable associations of any individual gene with traditional predictors of prognosis. METHODS Patients with T1-T3 primary breast cancer were enrolled into a prospective, multi-institutional cohort study. In this interim analysis 215 PBL and 177 BM samples were analyzed by multimarker, real-time RT-PCR analysis designed to detect circulating and disseminated breast cancer cells. RESULTS At a threshold of three standard deviations from the mean expression level of normal controls, 63% (136/215) of PBL and 11% (19/177) of BM samples were positive for at least one cancer-associated marker. Marker positivity in PBL demonstrated a statistically significant association with grade II-III (vs. grade I; p = 0.0083). Overexpression of the mammaglobin (mam) gene alone had a statistically significant association with high tumor grade (p = 0.0315), and showed a trend towards ER-negative tumors and a high risk category. There was no association between marker positivity in PBL and the pathologic (H&E) and/or molecular (RT-PCR) status of the axillary lymph nodes (ALN). CONCLUSION This study suggests that molecular detection of circulating cancer cells in PBL detected by RT-PCR is associated with high tumor grade and specifically that overexpression of the mam gene in PBL may be a poor prognostic indicator. There was no statistically significant association between overexpression of cancer-associated genes in PBL and ALN status, supporting the concept of two potentially separate metastatic pathways.
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Affiliation(s)
- Kaidi Mikhitarian
- Department of Surgery, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425, USA.
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Abstract
PURPOSE OF REVIEW Inflammatory breast cancer is a highly aggressive variant of locally advanced breast cancer that carries a significantly worse prognosis. The purpose of this review is to highlight recent advances in the molecular modus operandi of this particular form of breast cancer. RECENT FINDINGS Studies on tumor cell emboli, E-cadherin, chemokine receptors, steroid hormone receptor, angiogenesis, lymphangiogenesis and gene expression all suggest significant differences with noninflammatory breast cancer and are clearly in line with a different pathogenesis of the condition. SUMMARY This comprehensive review will hopefully allow for better treatment modalities with targeted approaches as suggested by the early data on anti-vascular endothelial growth factor treatment in inflammatory breast cancer.
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Affiliation(s)
- Luc Y Dirix
- Oncology Center, Multidisciplinary Breast Clinic, AZ (Algemeen Ziekenhuis) Sint-Augustinus, Antwerp, Belgium.
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Mirza M, Shaughnessy E, Hurley JK, Vanpatten KA, Pestano GA, He B, Weber GF. Osteopontin-c is a selective marker of breast cancer. Int J Cancer 2008; 122:889-97. [PMID: 17960616 DOI: 10.1002/ijc.23204] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
While the acquisition of invasiveness is a critical step in early stage breast carcinomas (DCIS), no established molecular markers reliably identify tumor progression. The metastasis gene osteopontin is subject to alternative splicing, which yields 3 messages, osteopontin-a, osteopontin-b and osteopontin-c. Osteopontin-c is selectively expressed in invasive, but not in noninvasive, breast tumor cell lines, and it effectively supports anchorage independence. We evaluated osteopontin-c as a biomarker. The RNA message for osteopontin-c was present in 16 of 20 breast cancers (80%), but was undetectable in 22 normal specimens obtained from reduction mammoplasty. In contrast, osteopontin-a RNA was expressed at various levels in all 20 breast cancers, 11 tumor-surrounding tissues and 21 normal samples. The splice variant osteopontin-b was present at barely detectable levels in 18 of 20 cancers and in 6 of 22 normal breasts. By immunohistochemistry, 66 of 69 normal breasts were negative, while 3 showed low level staining. Among the breast cancers, 43 of 56 cores (77%) stained positive for osteopontin-c. When correlated with tumor grade, the staining for osteopontin-c increased from grade 1 to grade 3. In a total of 178 breast specimens analyzed, osteopontin-c was present in 78% of cancers, 36% of surrounding tissues and 0% of normal tissues. Furthermore, osteopontin-c detects a higher fraction of breast cancers than estrogen receptor (ER), progesterone receptor or HER2. In conjunction, osteopontin-c, ER and HER2 reliably predict grade 2-3 breast cancer. Hence, osteopontin-c is a diagnostic and prognostic marker that may have value in a diagnostic panel together with conventional breast cancer markers.
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Affiliation(s)
- Mana Mirza
- College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA
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Watson MA, Ylagan LR, Trinkaus KM, Gillanders WE, Naughton MJ, Weilbaecher KN, Fleming TP, Aft RL. Isolation and molecular profiling of bone marrow micrometastases identifies TWIST1 as a marker of early tumor relapse in breast cancer patients. Clin Cancer Res 2007; 13:5001-9. [PMID: 17785550 PMCID: PMC2680916 DOI: 10.1158/1078-0432.ccr-07-0024] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Micrometastatic cells detected in the bone marrow have prognostic significance in breast cancer. These cells are heterogeneous and likely do not exhibit uniform biological behavior. To understand the molecular diversity of disseminated cancer cells that reside in bone marrow, we enriched this cell population and did global gene expression profiling in the context of a prospective clinical trial involving women with clinical stage II/III breast cancer undergoing neoadjuvant chemotherapy. EXPERIMENTAL DESIGN Enrichment of TACSTD1 (EpCAM)-expressing cells from bone marrow of breast cancer patients was achieved using immunomagnetic beads. Gene expression profiles were compared between enriched cell populations and whole bone marrow from 5 normal volunteers and 23 breast cancer patients after neoadjuvant chemotherapy treatment. Enriched cells from bone marrow samples of breast cancer patients before treatment or at 1 year follow-up were also analyzed (total of 87 data sets). The expression of transcripts specifically detected in enriched cell populations from breast cancer patients was correlated with 1-year clinical outcome using quantitative reverse transcription-PCR in an independent cohort of bone marrow samples. RESULTS Analysis of EpCAM-enriched bone marrow cells revealed specific expression of a subgroup of transcripts, including the metastasis regulator, TWIST1. Most transcripts identified, including TWIST1, were not expressed in enriched populations of bone marrow from normal volunteers, suggesting that this expression profile reflects a signature of breast cancer bone marrow micrometastases that persist after chemotherapy. In an independent set of bone marrow samples obtained before any treatment, TWIST1 expression correlated with early disease relapse. CONCLUSIONS Disseminated breast cancer cells present in bone marrow after chemotherapy possess unique transcriptional signatures. Genes whose expression is overrepresented in these cell populations, such as TWIST1, may prove to be excellent markers of early distant relapse in breast cancer patients.
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Affiliation(s)
- Mark A Watson
- Department of Pathology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Farmen RK, Nordgård O, Gilje B, Shammas FV, Kvaløy JT, Oltedal S, Heikkilä R. Bone marrow cytokeratin 19 mRNA level is an independent predictor of relapse-free survival in operable breast cancer patients. Breast Cancer Res Treat 2007; 108:251-8. [PMID: 17492378 DOI: 10.1007/s10549-007-9592-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Accepted: 04/03/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To study the prognostic significance of elevated cytokeratin 19 (CK19) mRNA levels in the bone marrow (BM) of operable breast cancer patients. PATIENTS AND METHODS From 1998 to 2000, BM was collected from 195 consecutive breast cancer patients immediately prior to surgery and from 34 healthy volunteers. The patients received surgical and adjuvant treatment according to national guidelines at the time. We analyzed the level of CK19 mRNA in the BM samples from patients and normal controls using a real-time RT-PCR assay. The associations with known prognostic factors and the impact of pathological CK19 mRNA levels on patients' prognosis were investigated. RESULTS Using the 99 percentile of the normal control group as a cut-off, 24 (12%) of the 195 patients and 1 (3%) of the 34 volunteers were diagnosed as CK19 mRNA positive. There was no correlation between CK19 BM status and the clinicopathological factors tested. During a median follow-up of 72 months, 7 (29%) of the 24 CK19 mRNA BM positive patients experienced systemic relapse compared to 20 (12%) of the 171 in the CK19 mRNA negative group. The patients with CK19 mRNA-positive BM had significantly shorter systemic recurrence-free survival (P=0.01) and overall recurrence-free survival (P=0.005). Multivariate Cox regression showed CK19 mRNA BM status to be an independent predictor of relapse. CONCLUSION Detection of CK19 mRNA in the BM of breast cancer patients by real-time RT-PCR is an independent predictor of relapse-free survival in operable breast cancer patients.
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Affiliation(s)
- Ragne K Farmen
- Department of Hematology and Oncology, Stavanger University Hospital, Hillevåg, P.O. Box 8100, 4068, Stavanger, Norway
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Borgen E, Pantel K, Schlimok G, Müller P, Otte M, Renolen A, Ehnle S, Coith C, Nesland JM, Naume B. A European interlaboratory testing of three well-known procedures for immunocytochemical detection of epithelial cells in bone marrow. Results from analysis of normal bone marrow. CYTOMETRY PART B-CLINICAL CYTOMETRY 2006; 70:400-9. [PMID: 16924637 DOI: 10.1002/cyto.b.20114] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND This investigation intended to study the unspecific background to be expected in normal bone marrow (BM), comparing three well recognized protocols for immunocytochemical detection of disseminated carcinoma cells. The interlaboratory variation in screening and evaluation of stained cells was analyzed and different screening methods were compared. METHODS BM mononuclear cells (BM MNC) from 48 normal BMs were immunostained in parallel by three participating laboratories. The protocols, based on three different anti-cytokeratin antibodies, have all been in common use for detection of disseminated carcinoma cells: the A45-B/B3 protocol (Hamburg), the CK2 protocol (Augsburg) and the AE1AE3 protocol (Oslo). For all protocols, the immunostained cells were visualized by the same alkaline-phosphatase (AP) detection system (APAAP) followed by detection of the cells by manual screening and by two different automated screening systems (ACIS from Chromavision and MDS1 from Applied Imaging). Detected AP-visualized cells were morphologically classified into unambiguous hematopoietic (Uhc) and questionable cells (Qc, potentially interpreted as tumor cells). RESULTS Seven of 48 BMs (15%) harbored > or = 1 AP-visualized cell(s) among 1 x 10(6) BM MNC, both for the A45-B/B3- and for the AE1AE3 protocol, while for CK2 a higher proportion of BMs (21 BMs; 44%) harbored AP-visualized cells (P < 0.01, McNemar's test). The number of Qc was, for all protocols, 1 log lower than the total number of AP-visualized cells. On average, the frequency of Qc was 0.04, 0.08, and 0.02 per 10(6) BM MNC with A45-B/B3, CK2 and AE1AE3, respectively, and the number of Qc-positive BMs 1, 4, and 1. The MDS1 screening sensitivity was similar to manual screening, while ACIS detected fewer cells (P < 0.001, McNemar's test). CONCLUSIONS All protocols resulted in AP-visualization of occasional hematopoietic cells. However, morphological classification brings the specificity to a satisfactory high level. Approximately 10% of AP-visualized cells were categorized "questionable". The CK2 protocol turned out less specific than the A45-B/B3 and AE1AE3 protocols.
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Affiliation(s)
- E Borgen
- Department of Pathology, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo, Norway.
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28
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Lohoff FW, Dahl JP, Ferraro TN, Arnold SE, Gallinat J, Sander T, Berrettini WH. Variations in the vesicular monoamine transporter 1 gene (VMAT1/SLC18A1) are associated with bipolar i disorder. Neuropsychopharmacology 2006; 31:2739-47. [PMID: 16936705 PMCID: PMC2507868 DOI: 10.1038/sj.npp.1301196] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The vesicular monoamine transporter 1 gene (VMAT1/SLC18A1) maps to the shared bipolar disorder (BPD)/schizophrenia (SZ) susceptibility locus on chromosome 8p21. Vesicular monoamine transporters are involved in transport of monoamine neurotransmitters which have been postulated to play a relevant role in the etiology of BPD and/or SZ. Variations in the VMAT1 gene might affect transporter function and/or expression and might be involved in the etiology of BPD and/or SZ. Genotypes of 585 patients with BPD type I and 563 control subjects were obtained for three missense single nucleotide polymorphisms (SNPs) (Thr4Pro, Thr98Ser, Thr136Ile) and four non-coding SNPs (rs988713, rs2279709, rs3735835, rs1497020). All cases and controls were of European descent. Allele frequencies differed significantly for the potential functional polymorphism Thr136Ser between BPD patients and controls (p=0.003; df=1; OR=1.34; 95% CI: 1.11-1.62). Polymorphisms in the promoter region (rs988713: p=0.005, df=1; OR=1.31; 95% CI: 1.09-1.59) and intron 8 (rs2279709: p=0.039, df=1; OR=0.84; 95% CI: 0.71-0.99) were also associated with disease. Expression analysis confirmed that VMAT1 is expressed in human brain at the mRNA and protein level. Results suggest that variations in the VMAT1 gene may confer susceptibility to BPD in patients of European descent. Additional studies are necessary to confirm this effect and to elucidate the role of VMAT1 in central nervous system physiology.
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Affiliation(s)
- Falk W Lohoff
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
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29
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Ntoulia M, Stathopoulou A, Ignatiadis M, Malamos N, Mavroudis D, Georgoulias V, Lianidou ES. Detection of Mammaglobin A-mRNA-positive circulating tumor cells in peripheral blood of patients with operable breast cancer with nested RT-PCR. Clin Biochem 2006; 39:879-87. [PMID: 16925986 DOI: 10.1016/j.clinbiochem.2006.06.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Revised: 05/10/2006] [Accepted: 06/12/2006] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The development and validation of a nested RT-PCR methodology for the detection of Mammaglobin A-mRNA-positive circulating tumor cells in peripheral blood of patients with operable breast cancer and evaluation of its prognostic significance. DESIGN AND METHODS Different combinations of specific primers were in silico designed and selected, so that false positive results due to genomic DNA contamination were avoided. The specificity of the primers used was evaluated in 30 healthy individuals, 20 patients with colorectal cancer and 20 patients with non-small cell lung cancer. The method was applied in 101 patients with operable breast cancer before the administration of adjuvant chemotherapy and 39 patients with metastatic breast cancer. RESULTS Mammaglobin A-mRNA-positive cells were detected in 14/101 (13.9%) of early breast cancer patients but not in the control population studied (0%); 9 of them (64.3%) relapsed during the follow-up period. Mammaglobin A was detected in 7/39 (17.9%) of patients with verified metastasis. Multivariate analysis revealed the detection of Mammaglobin A-mRNA-positive cells, as an independent risk factor for reduced DFI. CONCLUSIONS Mammaglobin A is a highly specific molecular marker for the detection of circulating tumor cells in operable breast cancer, with important prognostic applications.
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Affiliation(s)
- Maria Ntoulia
- Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Greece
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30
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Abstract
PURPOSE OF REVIEW Whether the occurrence of tumor cells in peripheral blood or bone marrow from patients with solid tumors is predictive for disease recurrence or of any other prognostic relevance remains unknown. This article reviews recently published results focusing on the various methods used, their correlations with clinical or biological parameters and their potential prognostic value. RECENT FINDINGS An increasing number of marker genes and different techniques, alone or in combinations, have been used for the detection of tumor cells in peripheral blood and bone marrow. Various results obtained are hardly comparable, most often due to the different methods in use. The frequency of circulating tumor cells in peripheral blood varied within a broad range and their clinical relevance appeared to be contradictory, at least in part. Disseminated tumor cells in bone marrow reached an independent prognostic value in breast cancer patients, but several investigations led to inconsistent correlations with clinical or prognostic criteria. SUMMARY Still many questions remain unanswered; hence, the detection of tumor cells in peripheral blood or bone marrow cannot yet be taken into account for therapeutic decisions.
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Affiliation(s)
- Otto Zach
- Elisabethinen Hospital, 1st Department of Internal Medicine, Linz, Austria.
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31
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Benoy IH, Elst H, Philips M, Wuyts H, Van Dam P, Scharpé S, Van Marck E, Vermeulen PB, Dirix LY. Prognostic Significance of Disseminated Tumor Cells as Detected by Quantitative Real-Time Reverse-Transcriptase Polymerase Chain Reaction in Patients with Breast Cancer. Clin Breast Cancer 2006; 7:146-52. [PMID: 16800974 DOI: 10.3816/cbc.2006.n.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In this study we have validated the feasibility of detecting disseminated tumor cells (DTC) by real-time reverse-transcriptase polymerase chain reaction (RT-PCR) analysis. Bone marrow samples from a large cohort of patients with breast cancer were analyzed for the presence of DTC by immunocytochemistry (ICC) or a molecular-based method. PATIENTS AND METHODS Bone marrow samples were collected from 170 patients with breast cancer with stage I-IV disease before the initiation of any local or systemic treatment. Staining for cytokeratin (CK)-positive cells was performed with the Epimet kit. Disseminated tumor cells were also quantified by measuring relative gene expression for CK19 and mammaglobin (MAM) using a quantitative RT-PCR detection method. The mean follow-up time was 30 months. Kaplan-Meier analysis was used for predicting overall survival. RESULTS Despite an excellent quantitative correlation and qualitative concordance between ICC and RT-PCR, survival analysis suggested an improved prognostic significance of DTC as detected by quantitative RT-PCR. Univariate survival analysis computed a relative risk of death of 2.87 for women with ICC-positive cells in the bone marrow, as compared with those without positive cells. The relative risk for women with RT-PCR-positive bone marrow was even higher: 3.5 (CK19) and 3.39 (MAM). In multivariate analysis, bone marrow CK19 was a stronger prognostic factor than bone marrow ICC. CONCLUSION Reverse-transcriptase polymerase chain reaction-detected DTC is shown to be prognostically significant in untreated patients with breast cancer. Furthermore, it seems to be a more sensitive method for detecting DTC in bone marrow samples when compared with ICC.
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Affiliation(s)
- Ina H Benoy
- Translational Cancer Research Group Antwerp, Wilrijk, Belgium
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Roberts DW, Newton RA, Beaumont KA, Helen Leonard J, Sturm RA. Quantitative analysis of MC1R gene expression in human skin cell cultures. ACTA ACUST UNITED AC 2006; 19:76-89. [PMID: 16420249 DOI: 10.1111/j.1600-0749.2005.00286.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To address the issue of melanocortin-1 receptor (MC1R) expression in non-melanocytic cells, we have quantitatively evaluated the relative expression levels of both MC1R mRNA and protein in a subset of different cell types. Using semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) at high cycle numbers, we detected MC1R mRNA in all cell types examined, including human embryonic kidney-293 (HEK 293) cells, a cell type widely used as a negative control in melanocortin expression studies. Quantitative real-time PCR revealed the highest levels of MC1R transcripts were in melanocytic cells, whereas the keratinocyte and fibroblast cell cultures examined had only a low level of expression, similar to that of HEK 293 cells. Antibody mediated detection of MC1R protein in membrane extracts demonstrated exogenous receptor in MC1R transfected cell lines, as well as endogenous MC1R in melanoma cells. However, radioligand binding procedures were required to detect MC1R protein of normal human melanocytes and no surface expression of MC1R was detected in any of the non-melanocytic cells examined. This was consistent with their low level of mRNA, and suggests that, if present, the levels of surface receptor are significantly lower than that in melanocytes. The capacity of such limited levels of MC1R protein to influence non-melanocytic skin cell biology would likely be severely compromised. Indeed, the MC1R agonist [NIe(4), D-Phe(7)] alpha-melanocyte stimulating hormone (NDP-MSH) was unable to elevate intracellular cyclic adenosine monophosphate (cAMP) levels in the keratinocyte and fibroblast cells examined, whereas a robust increase was elicited in melanocytes. Although there are a variety of cell types with detectable MC1R mRNA, the expression of physiologically significant levels of the receptor may be more restricted than the current literature indicates, and within epidermal tissue may be limited to the melanocyte.
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Affiliation(s)
- Donald W Roberts
- Melanogenix Group, Institute for Molecular Bioscience, University of Queensland, Brisbane, Qld 4072, Australia
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Benoy IH, Elst H, Philips M, Wuyts H, Van Dam P, Scharpé S, Van Marck E, Vermeulen PB, Dirix LY. Real-time RT-PCR detection of disseminated tumour cells in bone marrow has superior prognostic significance in comparison with circulating tumour cells in patients with breast cancer. Br J Cancer 2006; 94:672-80. [PMID: 16495933 PMCID: PMC2361203 DOI: 10.1038/sj.bjc.6602985] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study assessed the ability of real-time reverse transcription–polymerase chain reaction (RT–PCR) analysis to detect disseminated epithelial cells (DEC) in peripheral blood (PB) and bone marrow (BM) of patients with breast cancer (BC). Detection of DEC in BM is an obvious choice in BC, but blood sampling is more convenient. The aim of this study was to evaluate whether the detection of DEC in either PB or BM predicts overall survival (OS). Peripheral blood and BM samples were collected from 148 patients with primary (stage M0, n=116/78%) and metastatic (stage M+, n=32/21%) BC before the initiation of any local or systemic treatment. Peripheral blood of healthy volunteers and BM of patients with a nonmalignant breast lesion or a haematological malignancy served as the control group. Disseminated epithelial cells was detected by measuring relative gene expression (RGE) for cytokeratin-19 (CK-19) and mammaglobin (MAM), using a quantitative RT–PCR detection method. The mean follow-up time was 786 days (+/− 487). Kaplan–Meier analysis was used for predicting OS. By taking the 95 percentile of the RGE of CK-19 (BM: 26.3 and PB: 58.7) of the control group as cutoff, elevated CK-19 expression was detected in 42 (28%) BM samples and in 22 (15%) PB samples. Mammaglobin expression was elevated in 20% (both PB and BM) of the patients with BC. There was a 68% (CK-19) and 75% (MAM) concordance between PB and BM samples when classifying the results as either positive or negative. Patients with an elevated CK-19 or MAM expression in the BM had a worse prognosis than patients without elevated expression levels (OS: log-rank test, P=0.0045 (CK-19) and P=0.025 (MAM)). For PB survival analysis, no statistical significant difference was observed between patients with or without elevated CK-19 or MAM expression (OS: log-rank test, P=0.551 (CK-19) and P=0.329 (MAM)). Separate analyses of the M0 and M+ patients revealed a marked difference in OS according to the BM CK-19 or MAM status in the M+ patient group, but in the M0 group, only MAM expression was a prognostic marker for OS. Disseminated epithelial cells, measured as elevated CK-19 or MAM mRNA expression, could be detected in both PB and BM of patients with BC. Only the presence of DEC in BM was highly predictive for OS. The occurrence of DEC in the BM is probably less time-dependent and may act as a filter for circulating BC cells. The use of either larger volumes of PB or performing an enrichment step for circulating tumour in blood cells might improve these results.
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Affiliation(s)
- I H Benoy
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - H Elst
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - M Philips
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - H Wuyts
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - P Van Dam
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - S Scharpé
- Medical Biochemistry, University of Antwerp, Wilrijk 2610, Belgium
| | - E Van Marck
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - P B Vermeulen
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
| | - L Y Dirix
- Translational Cancer Research Group Antwerp, Department of Pathology University of Antwerp/University Hospital Antwerp, Edegem 2650, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium
- Translational Cancer Research Group Antwerp, Oncology Centre, General Hospital Sint-Augustinus, Oosterveldlaan 24, Wilrijk 2610, Belgium; E-mail: , www.tcrg.be
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Benoy IH, Elst H, Van Dam P, Scharpé S, Van Marck E, Vermeulen PB, Dirix LY. Detection of circulating tumour cells in blood by quantitative real-time RT-PCR: effect of pre-analytical time. Clin Chem Lab Med 2006; 44:1082-7. [PMID: 16958599 DOI: 10.1515/cclm.2006.210] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractClin Chem Lab Med 2006;44:1082–7.
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Affiliation(s)
- Ina H Benoy
- Translational Cancer Research Group Antwerp, Pathology Laboratory, University of Antwerp/University Hospital Antwerp, Edegem, and Oncology Centre, General Hospital St-Augustinus, Wilrijk, Belgium
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35
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Dirix L, Van Dam P, Vermeulen P. Genomics and circulating tumor cells: promising tools for choosing and monitoring adjuvant therapy in patients with early breast cancer? Curr Opin Oncol 2005; 17:551-8. [PMID: 16224232 DOI: 10.1097/01.cco.0000183669.61767.81] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Gene expression profiling using a class discovery approach has consistently shown that breast cancer emerges as a group of different disease entities: the basal-like, the human epidermal growth factor receptor 2 type, the normal breast-like, and at least two different hormone receptor positive or luminal types. Initial reports have also suggested that certain expression patterns are associated with relapse. Current data on adjuvant therapy are only beginning to consider this biologic heterogeneity (estrogen receptor and human epidermal growth factor receptor 2 status). Similarly, the search for isolated tumor cells in blood or bone marrow has been regarded as another approach for defining prognosis and tailoring adjuvant therapies. The purpose of this review is to highlight the recent data emerging from both approaches as a means of assessing prognosis and tailoring therapy in patients with early breast cancer. RECENT FINDINGS The initial reports on prognosis assessment of breast cancer using the expression profile have been corroborated, but the differences between the actual genes selected for the different prognostic signatures remain difficult to explain. Others have introduced added signatures, such as those associated with proliferation or with wound healing, or selected subgroups on the basis of, for example, estrogen receptor level prior to class comparison. The data on the quantification of expression of a limited number of selected genes are promising for both prognosis and prediction. The segregation of histological grade 2 tumors into genetically defined grade 1 or 3 tumors and its associated prognostic significance is a critical observation. The standardization of methods for measuring isolated tumor cells in blood or bone marrow has resulted in validated data both on prognosis in early breast cancer and in the advanced setting. Methylation of circulating DNA might become another method for selecting patients for extended adjuvant regimens. SUMMARY The new molecular knowledge must be incorporated into prospective clinical studies in patients with early breast cancer. This is the challenge for the years to come.
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Affiliation(s)
- Luc Dirix
- Oncology Center, Algemeen Ziekenhuis Sint-Augustinus, Antwerp, Belgium.
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36
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Jiang WG, Raz A, Douglas-Jones A, Mansel RE. Expression of autocrine motility factor (AMF) and its receptor, AMFR, in human breast cancer. J Histochem Cytochem 2005; 54:231-41. [PMID: 16204225 DOI: 10.1369/jhc.5a6785.2005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Autocrine motility factor (AMF) stimulates, via an autocrine route, the motility of cancer cells. The current study investigated the expression of AMF and its receptor, AMFR (gp78), in breast cancer and attempted to dissect a clinical link. Breast tumor tissues (n=120) and non-neoplastic normal tissues (n=32) were studied. AMF and AMFR distribution in tissues were assessed using immunohistochemistry and their transcripts were analyzed using RT-PCR and quantitative PCR. Median follow-up of the cohort was 10 years. Normal mammary epithelial cells, but not stromal and endothelial cells, weakly stained for AMF and AMFR. However, cancer cells showed stronger staining. Both AMF and AMFR transcripts were significantly higher in tumor than in normal tissues (p=0.003 and p=0.0001, respectively). High levels of AMF and AMFR were seen in patients who died of breast cancer (p=0.049, p=0.0435) and high AMF was also seen in patients who had local recurrence (p=0.039) compared with those who remained disease free. A significant correlation was seen between long-term survival and the AMFR:CK19 ratio, in which patients with high AMFR:CK19 ratio tumors had a significantly shorter survival (101.0 months, 80.6-121.4) compared with those with low ratio (136.0 months, 123.7-148.2), p=0.0331. In conclusion, AMF and AMFR are overexpressed in human breast cancer and are negatively associated with patients' clinical outcome. This strongly indicates that the AMF-AMFR complex plays an important role in the progression of breast cancer, as well as having a prognostic role.
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Affiliation(s)
- Wen G Jiang
- Metastasis and Angiogenesis Research Group, University Department of Surgery, Wales College of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
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Relative microvessel area of the primary tumour, and not lymph node status, predicts the presence of bone marrow micrometastases detected by reverse transcriptase polymerase chain reaction in patients with clinically non-metastatic breast cancer. Breast Cancer Res 2005; 7:R210-9. [PMID: 15743502 PMCID: PMC1064134 DOI: 10.1186/bcr980] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2004] [Accepted: 12/02/2004] [Indexed: 01/01/2023] Open
Abstract
About 50% of patients with breast cancer have no involvement of axillary lymph nodes at diagnosis and can be considered cured after primary locoregional treatment. However, about 20–30% will experience distant relapse. The group of patients at risk is not well characterised: recurrence is probably due to the establishment of micrometastases before treatment. Given the early steps of metastasis in which tumour cells interact with endothelial cells of blood vessels, and, given the independent prognostic value in breast cancer of both the quantification of tumour vascularisation and the detection of micrometastases in the bone marrow, the aim of this study was to determine the relationship between vascularisation, measured by Chalkley morphometry, and the bone marrow content of cytokeratin-19 (CK-19) mRNA, quantified by real-time reverse transcriptase polymerase chain reaction, in a series of 68 patients with localised untreated breast cancer. The blood concentration of factors involved in angiogenesis (interleukin-6 and vascular endothelial growth factor) and of factors involved in coagulation (D-dimer, fibrinogen, platelets) was also measured. When bone marrow CK-19 relative gene expression (RGE) was categorised according to the cut-off value of 0.77 (95th centile of control patients), 53% of the patients had an elevated CK-19 RGE. Patients with bone marrow micrometastases, on the basis of an elevated CK-19 RGE, had a mean Chalkley count of 7.5 ± 1.7 (median 7, standard error [SE] 0.30) compared with a mean Chalkley count of 6.5 ± 1.7 in other patients (median 6, SE 0.3) (Mann–Whitney U-test; P = 0.04). Multiple regression analysis revealed that Chalkley count, not lymph node status, independently predicted CK-19 RGE status (P = 0.04; odds ratio 1.38; 95% confidence interval 1.009–1.882). Blood parameters reflecting angiogenesis and coagulation were positively correlated with Chalkley count and/or CK-19 RGE. Our data are in support of an association between elevated relative microvessel area of the primary tumour and the presence of bone marrow micrometastases in breast cancer patients with operable disease, and corroborate the paracrine and endocrine role of interleukin-6 and the involvement of coagulation in breast cancer growth and metastasis.
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