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Mnikhovich MV, Erofeeva LM, Shiripenko IA, Bezuglova TV, Lozina MV, Sidorova OA. Morphofunctional Characteristics of the Vessels of the Subareolar Lymphatic Plexus in Breast Cancer with Metastasis to the Lymph Nodes of the Axillary Lymphatic Collector. Bull Exp Biol Med 2024; 177:374-378. [PMID: 39138790 DOI: 10.1007/s10517-024-06192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Indexed: 08/15/2024]
Abstract
The subareolar Sappey's plexus was studied using color lymphography and immunohistochemical methods with a panel of antibodies to podoplanin, smooth muscle actin, low molecular weight cytokeratin AE1/AE3, and GATA3 on archival material obtained during radical mastectomies and sectoral resections with lymph node dissection from 86 patients diagnosed with non-special type breast cancer. At the macro- and microscopic levels, the connection between the subareolar lymphatic plexus and the lymphatic system of the breast parenchyma has been demonstrated. In triple negative breast cancer with metastases to the axillary lymph nodes, the involvement of subareolar lymphatic plexus into lymphogenous metastasis to the lymph nodes of the axillary lymphatic collector was shown.
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Affiliation(s)
- M V Mnikhovich
- Avtsyn Research Institute of Human Morphology, Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - L M Erofeeva
- Avtsyn Research Institute of Human Morphology, Petrovsky Russian Research Center of Surgery, Moscow, Russia.
| | - I A Shiripenko
- Avtsyn Research Institute of Human Morphology, Petrovsky Russian Research Center of Surgery, Moscow, Russia
- Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
| | - T V Bezuglova
- Avtsyn Research Institute of Human Morphology, Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - M V Lozina
- Avtsyn Research Institute of Human Morphology, Petrovsky Russian Research Center of Surgery, Moscow, Russia
- Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
| | - O A Sidorova
- Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
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Su T, Zheng Y, Yang H, Ouyang Z, Fan J, Lin L, Lv F. Nomogram for preoperative differentiation of benign and malignant breast tumors using contrast-enhanced cone-beam breast CT (CE CB-BCT) quantitative imaging and assessment features. LA RADIOLOGIA MEDICA 2024; 129:737-750. [PMID: 38512625 DOI: 10.1007/s11547-024-01803-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/14/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Breast cancer's impact necessitates refined diagnostic approaches. This study develops a nomogram using radiology quantitative features from contrast-enhanced cone-beam breast CT for accurate preoperative classification of benign and malignant breast tumors. MATERIAL AND METHODS A retrospective study enrolled 234 females with breast tumors, split into training and test sets. Contrast-enhanced cone-beam breast CT-images were acquired using Koning Breast CT-1000. Quantitative assessment features were extracted via 3D-slicer software, identifying independent predictors. The nomogram was constructed to preoperative differentiation benign and malignant breast tumors. Calibration curve was used to assess whether the model showed favorable correspondence with pathological confirmation. Decision curve analysis confirmed the model's superiority. RESULTS The study enrolled 234 female patients with a mean age of 50.2 years (SD ± 9.2). The training set had 164 patients (89 benign, 75 malignant), and the test set had 70 patients (29 benign, 41 malignant). The nomogram achieved excellent predictive performance in distinguishing benign and malignant breast lesions with an AUC of 0.940 (95% CI 0.900-0.940) in the training set and 0.970 (95% CI 0.940-0.970) in the test set. CONCLUSION This study illustrates the effectiveness of quantitative radiology features derived from contrast-enhanced cone-beam breast CT in distinguishing between benign and malignant breast tumors. Incorporating these features into a nomogram-based diagnostic model allows for breast tumor diagnoses that are objective and possess good accuracy. The application of these insights could substantially increase reliability and efficacy in the management of breast tumors, offering enhanced diagnostic capability.
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Affiliation(s)
- Tong Su
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Yineng Zheng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Hongyu Yang
- Department of Radiology, Chongqing Changshou District People's Hospital, Chongqing, China
| | - Zubin Ouyang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Jun Fan
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Lin Lin
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China.
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Zhang S, Shao H, Li W, Zhang H, Lin F, Zhang Q, Zhang H, Wang Z, Gao J, Zhang R, Gu Y, Wang Y, Mao N, Xie H. Intra- and peritumoral radiomics for predicting malignant BiRADS category 4 breast lesions on contrast-enhanced spectral mammography: a multicenter study. Eur Radiol 2023; 33:5411-5422. [PMID: 37014410 DOI: 10.1007/s00330-023-09513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/20/2022] [Accepted: 02/01/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE To construct and test a nomogram based on intra- and peritumoral radiomics and clinical factors for predicting malignant BiRADS 4 lesions on contrast-enhanced spectral mammography. METHODS A total of 884 patients with BiRADS 4 lesions were enrolled from two centers. For each lesion, five ROIs were defined using the intratumoral region (ITR), peritumoral regions (PTRs) of 5 and 10 mm around the tumor, and ITR plus PTRs of 5 mm and 10 mm. Five radiomics signatures were established by LASSO after selecting features. A nomogram was built using selected signatures and clinical factors by multivariable logistic regression analysis. The performance of the nomogram was assessed with the AUC, decision curve analysis, and calibration curves, and also compared with the radiomics model, clinical model, and radiologists. RESULTS The nomogram built by three radiomics signatures (constructed from ITR, 5 mm PTR, and ITR + 10 mm PTR) and two clinical factors (age and BiRADS category) showed powerful predictive ability in internal and external test sets with AUCs of 0.907 and 0.904, respectively. The calibration curves, decision curve analysis, showed favorable predictive performance of the nomogram. In addition, radiologists improved the diagnostic performance with the help of nomogram. CONCLUSION The nomogram established via intratumoral and peritumoral radiomics features and clinical risk factors had the best performance in distinguishing benign and malignant BiRADS 4 lesions, which could help radiologists improve diagnostic capabilities. KEY POINTS • Radiomics features from peritumoral regions in contrast-enhanced spectral mammography images may provide valuable information for the diagnosis of benign and malignant breast imaging reporting and data system category 4 breast lesions. • The nomogram incorporated intra- and peritumoral radiomics features and clinical variables have good application prospects in assisting clinical decision-makers.
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Affiliation(s)
- Shijie Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Huafei Shao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Wenjuan Li
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Haicheng Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Fan Lin
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Qianqian Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Han Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Zhongyi Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000
| | - Jing Gao
- School of Medical Imaging, Binzhou Medical University, Yantai, Shandong, People's Republic of China, 2640003
| | - Ran Zhang
- Huiying Medical Technology Co, Ltd, Beijing, People's Republic of China, 100192
| | - Yajia Gu
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200000, China
| | - Yunqiang Wang
- Department of Radiology, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, People's Republic of China, 264000.
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000.
| | - Haizhu Xie
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding East Street, Yantai, Shandong, People's Republic of China, 264000.
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Zhu JY, He HL, Jiang XC, Bao HW, Chen F. Multimodal ultrasound features of breast cancers: correlation with molecular subtypes. BMC Med Imaging 2023; 23:57. [PMID: 37069528 PMCID: PMC10111677 DOI: 10.1186/s12880-023-00999-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/15/2023] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVES To investigate whether multimodal intratumour and peritumour ultrasound features correlate with specific breast cancer molecular subtypes. METHODS From March to November 2021, a total of 85 patients with histologically proven breast cancer underwent B-mode, real-time elastography (RTE), colour Doppler flow imaging (CDFI) and contrast-enhanced ultrasound (CEUS). The time intensity curve (TIC) of CEUS was obtained, and the peak and time to peak (TTP) were analysed. Chi-square and binary logistic regression were used to analyse the connection between multimodal ultrasound imaging features and breast cancer molecular subtype. RESULTS Among 85 breast cancers, the subtypes were as follows: luminal A (36 cases, 42.4%), luminal B (20 cases, 23.5%), human epidermal growth factor receptor-2 positive (HER2+) (16 cases, 18.8%), and triple negative breast cancer (TNBC) (13 cases, 15.3%). Binary logistic regression models showed that RTE (P < 0.001) and CDFI (P = 0.036) were associated with the luminal A cancer subtype (C-index: 0.741), RTE (P = 0.016) and the peak ratio between intratumour and corpus mamma (P = 0.036) were related to the luminal B cancer subtype (C-index: 0.788). The peak ratio between peritumour and intratumour (P = 0.039) was related to the HER2 + cancer subtype (C-index: 0.859), and CDFI (P = 0.002) was associated with the TNBC subtype (C-index: 0.847). CONCLUSIONS Multimodal ultrasound features could be powerful predictors of specific breast cancer molecular subtypes. The intra- and peritumour CEUS features play assignable roles in separating luminal B and HER2 + breast cancer subtypes.
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Affiliation(s)
- Jun-Yan Zhu
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Ultrasound, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Han-Lu He
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Ultrasound, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao-Chun Jiang
- Department of Ultrasound, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hai-Wei Bao
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fen Chen
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Ultrasound, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
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Ming W, Li F, Zhu Y, Bai Y, Gu W, Liu Y, Sun X, Liu X, Liu H. Predicting hormone receptors and PAM50 subtypes of breast cancer from multi-scale lesion images of DCE-MRI with transfer learning technique. Comput Biol Med 2022; 150:106147. [PMID: 36201887 DOI: 10.1016/j.compbiomed.2022.106147] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/06/2022] [Accepted: 09/24/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The recent development of artificial intelligence (AI) technologies coupled with medical imaging data has gained considerable attention, and offers a non-invasive approach for cancer diagnosis and prognosis. In this context, improved breast cancer (BC) molecular characteristics assessment models are foreseen to enable personalized strategies with better clinical outcomes compared to existing screening strategies. And it is a promising approach to developing models for hormone receptors (HR) and subtypes of BC patients from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data. METHODS In this institutional review board-approved study, 174 BC patients with both DCE-MRI and RNA-seq data in the local database were analyzed. Slice images from tumor lesions and multi-scale peri-tumor regions were used as model inputs, and five representative pre-trained transfer learning (TF) networks, such as Inception-v3 and Xception, were employed to establish prediction models. A comprehensive analysis was performed using five-fold cross-validation to avoid overfitting, and accuracy (ACC) and area under the receiver operating characteristic curve (AUROC) to evaluate model performance. RESULTS Xception achieved the superior results when using solely tumor regions, with highest AUROCs of 0.844 (95% CI: [0.841, 0.847]) and 0.784 (95% CI: [0.781, 0.788]) for estrogen receptor (ER) and progesterone receptor (PR), respectively, and best ACC of 0.467 (95% CI: [0.462, 0.470]) for PAM50 subtypes. A significant improvement in the model performance was observed when images of the peri-tumor region were included, with optimal results achieved using images of the tumor and the 10 mm peri-tumor regions. Xception-based TF models performed most effectively in predicting ER and PR statuses, with the AUROCs were 0.942 (95% CI: [0.940, 0.944]) and 0.920 (95% CI: [0.917, 0.922]), respectively, whereas for PAM50 subtypes, the Inception-v3-based network yielded the highest ACC as 0.742 (95% CI: [0.738, 0.746]). CONCLUSIONS Transfer learning analysis based on DCE-MRI data of tumor and peri-tumor regions was helpful to the non-invasive assessment of molecular characteristics of BC.
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Affiliation(s)
- Wenlong Ming
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, PR China
| | - Fuyu Li
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, PR China
| | - Yanhui Zhu
- Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Yunfei Bai
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, PR China
| | - Wanjun Gu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, PR China; Collaborative Innovation Center of Jiangsu Province of Cancer Prevention and Treatment of Chinese Medicine, School of Artificial Intelligence and Information Technology, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China
| | - Yun Liu
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China
| | - Xiao Sun
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, PR China
| | - Xiaoan Liu
- Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, PR China.
| | - Hongde Liu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, PR China.
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Nishimura R, Osako T, Okumura Y, Nakano M, Ohtsuka H, Fujisue M, Arima N. An evaluation of lymphovascular invasion in relation to biology and prognosis according to subtypes in invasive breast cancer. Oncol Lett 2022; 24:245. [PMID: 35761943 PMCID: PMC9214702 DOI: 10.3892/ol.2022.13366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022] Open
Abstract
Lymphovascular invasion (LVI) is associated with a poor outcome in breast cancer. The purpose of the present study was to evaluate the clinical significance of LVI in primary breast cancer and to investigate disease-free survival as a prognostic marker according to the breast cancer subtypes. This study examined 4,652 consecutive cases of invasive breast cancer excluding the patients with non-invasive cancer, stage IV and those who underwent neo-adjuvant therapy from February 2002 to February 2021. The clinicopathological characteristics and prognosis of LVI-positive and -negative tumors were compared. LVI was evaluated in H&E staining specimens from surgically resected samples. The LVI expression rates were 29.2% (low, 19.7%; high, 9.5%) in all primary cases. The LVI-positive rate was significantly associated with specimens with the following characteristics: ER/PgR-negative, HER2-positive, p53 overexpression, higher Ki-67 index values, higher nuclear grade, positive nodes and larger tumors. Moreover, the subtypes were significantly associated with LVI positivity; 20% in Luminal A, 34.6% in Luminal B, 40.9% in Lumina/HER2, 38.1% in HER2-enriched and 29.8% in triple negative (TN). There were significant differences in disease-free survival between LVI status in Luminal A, Luminal B and TN subtypes, but there was no difference in the Luminal/HER2 and HER2-enriched subtypes. A multivariate analysis revealed that LVI was a significant factor in Luminal B and TN subtypes. Overall, LVI was significantly associated with the advanced and aggressive characteristics in breast cancer. Luminal A type had a lower LVI rate, and HER2 type had a higher LVI rate. Moreover, LVI was a significant prognostic factor in Luminal B and TN subtypes. These data suggested that the LVI status was useful in predicting the prognosis in HER2 negative breast cancer cases.
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Affiliation(s)
- Reiki Nishimura
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
| | - Tomofumi Osako
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
| | - Yasuhiro Okumura
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
| | - Masahiro Nakano
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
| | - Hiroko Ohtsuka
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
| | - Mamiko Fujisue
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
| | - Nobuyuki Arima
- Department of Pathology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
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Liu D, Zhang W, Hu F, Yu P, Zhang X, Yin H, Yang L, Fang X, Song B, Wu B, Hu J, Huang Z. A Bounding Box-Based Radiomics Model for Detecting Occult Peritoneal Metastasis in Advanced Gastric Cancer: A Multicenter Study. Front Oncol 2021; 11:777760. [PMID: 34926287 PMCID: PMC8678129 DOI: 10.3389/fonc.2021.777760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose To develop a bounding box (BBOX)-based radiomics model for the preoperative diagnosis of occult peritoneal metastasis (OPM) in advanced gastric cancer (AGC) patients. Materials and Methods 599 AGC patients from 3 centers were retrospectively enrolled and were divided into training, validation, and testing cohorts. The minimum circumscribed rectangle of the ROIs for the largest tumor area (R_BBOX), the nonoverlapping area between the tumor and R_BBOX (peritumoral area; PERI) and the smallest rectangle that could completely contain the tumor determined by a radiologist (M_BBOX) were used as inputs to extract radiomic features. Multivariate logistic regression was used to construct a radiomics model to estimate the preoperative probability of OPM in AGC patients. Results The M_BBOX model was not significantly different from R_BBOX in the validation cohort [AUC: M_BBOX model 0.871 (95% CI, 0.814–0.940) vs. R_BBOX model 0.873 (95% CI, 0.820–0.940); p = 0.937]. M_BBOX was selected as the final radiomics model because of its extremely low annotation cost and superior OPM discrimination performance (sensitivity of 85.7% and specificity of 82.8%) over the clinical model, and this radiomics model showed comparable diagnostic efficacy in the testing cohort. Conclusions The BBOX-based radiomics could serve as a simpler reliable and powerful tool for the preoperative diagnosis of OPM in AGC patients. And M_BBOX-based radiomics is simpler and less time consuming.
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Affiliation(s)
- Dan Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Weihan Zhang
- Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, Collaborative Innovation Center for Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Fubi Hu
- Department of Radiology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Pengxin Yu
- Institute of Advanced Research, Infervision, Beijing, China
| | - Xiao Zhang
- Department of Radiology, People's Hospital of Leshan, Leshan, China
| | - Hongkun Yin
- Institute of Advanced Research, Infervision, Beijing, China
| | - Lanqing Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Fang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Wu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiankun Hu
- Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, Collaborative Innovation Center for Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zixing Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Features from MRI texture analysis associated with survival outcomes in triple-negative breast cancer patients. Breast Cancer 2021; 29:164-173. [PMID: 34529241 DOI: 10.1007/s12282-021-01294-1] [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: 02/12/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the study is to evaluate the associations between intratumoral or peritumoral textural features derived from pretreatment magnetic resonance imaging (MRI) and recurrence-free survival (RFS) in triple-negative breast cancer (TNBC) patients. METHODS Forty-three patients with TNBC who underwent preoperative MRI between February 2008 and March 2014 were included. We performed two-dimensional texture analysis on the intratumoral or peritumoral region of interest (ROI) on axial of T2-weighted image (T2WI), dynamic contrast-enhanced (DCE)-MRI and DCE-MRI subtraction images. We also analyzed histopathological data. Cox proportional hazards models were used to investigate associations with survival outcomes. RESULTS Twelve of the 43 patients (27.9%) had recurrence disease, at a median of 32.5 months follow-up (1.4-61.5 months). In univariate analysis, nine texture features in T2WI and DCE-MRI subtraction images were significantly associated with RFS. In multivariate analysis, intratumoral difference entropy in DCE-MRI subtraction images in the initial phase (hazard ratio 11.71; 95% confidence interval (CI) [1.41, 97.00]; p value 0.023) and, peritumoral difference variance in DCE-MRI subtraction images in the delayed phase (hazard ratio 9.60; 95% CI [1.98, 46.51]; p value 0.005), were both independently associated with RFS. Moreover, multivariate analysis revealed the presence of lymphovascular invasion as independently associated with RFS (hazard ratio 8.13; 95% CI [2.16, 30.30]; p value 0.002). CONCLUSIONS At pretreatment MRI, an intratumoral and peritumoral quantitative approach using texture analysis has the potential to serve as a prognostic marker in patients with TNBC.
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Li C, Song L, Yin J. Intratumoral and Peritumoral Radiomics Based on Functional Parametric Maps from Breast DCE-MRI for Prediction of HER-2 and Ki-67 Status. J Magn Reson Imaging 2021; 54:703-714. [PMID: 33955619 DOI: 10.1002/jmri.27651] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Radiomics has been applied to breast magnetic resonance imaging (MRI) for gene status prediction. However, the features of peritumoral regions were not thoroughly investigated. PURPOSE To evaluate the use of intratumoral and peritumoral regions from functional parametric maps based on breast dynamic contrast-enhanced MRI (DCE-MRI) for prediction of HER-2 and Ki-67 status. STUDY TYPE Retrospective. POPULATION A total of 351 female patients (average age, 51 years) with pathologically confirmed breast cancer were assigned to the training (n = 243) and validation (n = 108) cohorts. FIELD STRENGTH/SEQUENCE 3.0T, T1 gradient echo. ASSESSMENT Radiomic features were extracted from intratumoral and peritumoral regions on six functional parametric maps calculated using time-intensity curves of DCE-MRI. The intraclass correlation coefficients (ICCs) were used to determine the reproducibility of feature extraction. Based on the intratumoral, peritumoral, and combined intra- and peritumoral regions, three radiomics signatures (RSs) were built using the least absolute shrinkage and selection operator (LASSO) logistic regression model, respectively. STATISTICAL TESTS Wilcoxon rank-sum test, minimum redundancy maximum relevance, LASSO, receiver operating characteristic curve (ROC) analysis, and DeLong test. RESULTS The intratumoral and peritumoral RSs for prediction of HER-2 and Ki-67 status achieved areas under the ROC (AUCs) of 0.683 (95% confidence interval [CI], 0.574-0.793) and 0.690 (95% CI, 0.577-0.804), and 0.714 (95% CI, 0.616-0.812) and 0.692 (95% CI, 0.590-0.794) in the validation cohort, respectively. The combined RSs yielded AUCs of 0.713 (95% CI, 0.604-0.823) and 0.749 (95% CI, 0.656-0.841), respectively. There were no significant differences in prediction performance among intratumoral, peritumoral, and combined RSs. Most (69.7%) of the features had good agreement (ICCs >0.8). DATA CONCLUSION Radiomic features of intratumoral and peritumoral regions on functional parametric maps based on breast DCE-MRI had the potential to identify HER-2 and Ki-67 status. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 2.
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Affiliation(s)
- Chunli Li
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, China.,Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lirong Song
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiandong Yin
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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10
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Differences in tumour heterogeneity based on dynamic contrast-enhanced MRI between tumour and peritumoural stroma for predicting Ki-67 status of invasive ductal carcinoma. Clin Radiol 2021; 76:470.e13-470.e22. [PMID: 33648758 DOI: 10.1016/j.crad.2020.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
AIM To evaluate and compare the heterogeneity of intratumour and peritumour areas in the prediction of Ki-67 of invasive ductal carcinoma (IDC) and the predictive accuracy of different contrast frames based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS This study included 88 patients with histologically confirmed IDC with 57 patients with high Ki-67 status and 31 patients with low Ki-67 status. All patients underwent DCE-MRI before surgery. A grey-level co-occurrence matrix (GLCM) was performed on slice-matched images from six frames by drawing the region of the interest (ROI) on the inner and outer regions of the tumours. The correlations between texture characteristics and Ki-67 status of lesions were analysed, using the Mann-Whitney test and receiver operating characteristic curve analysis. RESULTS In the high-Ki-67 group, the entropy was significantly higher than that of the low-Ki-67 group (p<0.001). The entropy obtained, based on the tumour boundary as a band-like area inside and outside at the first post-contrast series, revealed the highest receiver operating characteristic (AUC = 0.765). In the multivariate analysis, a higher entropy value (>4.305; p<0.001) remained independently associated with a high-Ki-67 status after adjustment for menopausal status, tumour size, histologic grade, oestrogen receptor (ER) status, and progesterone receptor (PR) status. The other parameters did not show significant differences between the high- and low-Ki-67 groups. CONCLUSION Heterogeneity analysis based on DCE-MRI could discriminate between high- and low-Ki-67 status. Texture characteristics from the band-like region inside and outside the tumour boundary could predict the Ki-67 status and showed higher accuracy.
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Orlando A, Dimarco M, Cannella R, Bartolotta TV. Breast dynamic contrast-enhanced-magnetic resonance imaging and radiomics: State of art. Artif Intell Med Imaging 2020; 1:6-18. [DOI: 10.35711/aimi.v1.i1.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
Breast cancer represents the most common malignancy in women, being one of the most frequent cause of cancer-related mortality. Ultrasound, mammography, and magnetic resonance imaging (MRI) play a pivotal role in the diagnosis of breast lesions, with different levels of accuracy. Particularly, dynamic contrast-enhanced MRI has shown high diagnostic value in detecting multifocal, multicentric, or contralateral breast cancers. Radiomics is emerging as a promising tool for quantitative tumor evaluation, allowing the extraction of additional quantitative data from radiological imaging acquired with different modalities. Radiomics analysis may provide novel information through the quantification of lesions heterogeneity, that may be relevant in clinical practice for the characterization of breast lesions, prediction of tumor response to systemic therapies and evaluation of prognosis in patients with breast cancers. Several published studies have explored the value of radiomics with good-to-excellent diagnostic and prognostic performances for the evaluation of breast lesions. Particularly, the integrations of radiomics data with other clinical and histopathological parameters have demonstrated to improve the prediction of tumor aggressiveness with high accuracy and provided precise models that will help to guide clinical decisions and patients management. The purpose of this article in to describe the current application of radiomics in breast dynamic contrast-enhanced MRI.
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Affiliation(s)
- Alessia Orlando
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
| | - Mariangela Dimarco
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
| | - Roberto Cannella
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
| | - Tommaso Vincenzo Bartolotta
- Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
- Department of Radiology, Fondazione Istituto Giuseppe Giglio, Ct.da Pietrapollastra, Palermo 90015, Italy
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Almahariq MF, Quinn TJ, Siddiqui ZA, Thompson AB, Jawad MS, Chen PY, Gustafson GS, Dilworth JT. Post-mastectomy radiotherapy is associated with improved overall survival in T3N0 patients who do not receive chemotherapy. Radiother Oncol 2020; 145:229-237. [PMID: 32065903 DOI: 10.1016/j.radonc.2020.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/22/2020] [Accepted: 01/26/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE There is limited retrospective evidence addressing the utility of post-mastectomy radiotherapy (PMRT) in patients with T3N0 breast cancer. We performed a retrospective analysis of the National Cancer Database (NCDB) comparing overall survival (OS) in T3N0 patients treated with mastectomy alone (MTX) or with PMRT. MATERIALS AND METHODS We performed a matched-cohort analysis of NCDB breast cancer patients with pT3N0 disease who did not receive NAC, or cT3N0 patients who received NAC treated between 2006 and 2014. Patients were matched for all available baseline characteristics using propensity scores with inverse probability of treatment weighting (IPTW) with stabilized weights. RESULTS We identified 13,901 eligible patients. In the pT3N0 cohort, median follow-up was 47 months for the MTX group and 50 months for the PMRT group. In the cT3N0 cohort, median follow-up was 44 months for the MTX group and 46 months for the PMRT group. OS was higher in pT3N0 patients treated with PMRT compared to MTX: 7-year OS of 74% vs. 65% (P < 0.001). Doubly robust multivariable analysis showed an association between PMRT and improved OS (HR 0.78, 95% CI 0.68-0.89, P < 0.001). There was no benefit to PMRT in patients who received adjuvant chemotherapy (AC). In the NAC cohort, PMRT did not change OS, with 7-year OS of 78% with MTX and 79% with PMRT. There was a trend of improved OS with PMRT in patients with residual disease in the breast and lymph nodes (HR 0.70, 95% CI 0.46-1.07). CONCLUSION PMRT improves OS in patients with pT3N0 disease, but the benefit appears limited to those who do not receive AC. PMRT does not improve OS in patients with cT3N0 disease who receive NAC, but there might be a benefit in patients with a poor response to chemotherapy. However, longer follow-up may be needed to make a definitive conclusion about the benefit of PMRT in patients who receive chemotherapy.
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Affiliation(s)
- Muayad F Almahariq
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Thomas J Quinn
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Zaid A Siddiqui
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Andrew B Thompson
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Maha S Jawad
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Peter Y Chen
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Gregory S Gustafson
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States
| | - Joshua T Dilworth
- Department of Radiation Oncology, Beaumont Health, Royal Oak, MI, United States.
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Zhou J, Zhang Y, Chang KT, Lee KE, Wang O, Li J, Lin Y, Pan Z, Chang P, Chow D, Wang M, Su MY. Diagnosis of Benign and Malignant Breast Lesions on DCE-MRI by Using Radiomics and Deep Learning With Consideration of Peritumor Tissue. J Magn Reson Imaging 2019; 51:798-809. [PMID: 31675151 DOI: 10.1002/jmri.26981] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Computer-aided methods have been widely applied to diagnose lesions detected on breast MRI, but fully-automatic diagnosis using deep learning is rarely reported. PURPOSE To evaluate the diagnostic accuracy of mass lesions using region of interest (ROI)-based, radiomics and deep-learning methods, by taking peritumor tissues into consideration. STUDY TYPE Retrospective. POPULATION In all, 133 patients with histologically confirmed 91 malignant and 62 benign mass lesions for training (74 patients with 48 malignant and 26 benign lesions for testing). FIELD STRENGTH/SEQUENCE 3T, using the volume imaging for breast assessment (VIBRANT) dynamic contrast-enhanced (DCE) sequence. ASSESSMENT 3D tumor segmentation was done automatically by using fuzzy-C-means algorithm with connected-component labeling. A total of 99 texture and histogram parameters were calculated for each case, and 15 were selected using random forest to build a radiomics model. Deep learning was implemented using ResNet50, evaluated with 10-fold crossvalidation. The tumor alone, smallest bounding box, and 1.2, 1.5, 2.0 times enlarged boxes were used as inputs. STATISTICAL TESTS The malignancy probability was calculated using each model, and the threshold of 0.5 was used to make a diagnosis. RESULTS In the training dataset, the diagnostic accuracy was 76% using three ROI-based parameters, 84% using the radiomics model, and 86% using ROI + radiomics model. In deep learning using the per-slice basis, the area under the receiver operating characteristic (ROC) was comparable for tumor alone, smallest and 1.2 times box (AUC = 0.97-0.99), which were significantly higher than 1.5 and 2.0 times box (AUC = 0.86 and 0.71, respectively). For per-lesion diagnosis, the highest accuracy of 91% was achieved when using the smallest bounding box, and that decreased to 84% for tumor alone and 1.2 times box, and further to 73% for 1.5 times box and 69% for 2.0 times box. In the independent testing dataset, the per-lesion diagnostic accuracy was also the highest when using the smallest bounding box, 89%. DATA CONCLUSION Deep learning using ResNet50 achieved a high diagnostic accuracy. Using the smallest bounding box containing proximal peritumor tissue as input had higher accuracy compared to using tumor alone or larger boxes. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2.
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Affiliation(s)
- Jiejie Zhou
- Department of Radiology, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yang Zhang
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Kai-Ting Chang
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Kyoung Eun Lee
- Department of Radiology, Inje University Seoul Paik Hospital, Inje University, Seoul, Korea
| | - Ouchen Wang
- Department of Thyroid and Breast Surgery, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiance Li
- Department of Radiology, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yezhi Lin
- Information Technology Center, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhifang Pan
- Information Technology Center, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peter Chang
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Daniel Chow
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Meihao Wang
- Department of Radiology, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Min-Ying Su
- Department of Radiological Sciences, University of California, Irvine, California, USA
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Associations Between Magnetic Resonance Imaging Findings and Clincopathologic Factors in Triple-Negative Breast Cancer. J Comput Assist Tomogr 2019; 43:252-256. [PMID: 30664119 DOI: 10.1097/rct.0000000000000835] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the magnetic resonance imaging findings associated with clinicopathologic factors in patients with triple-negative breast cancer. METHODS One hundred one patients with surgically confirmed triple-negative breast cancer who underwent preoperative breast magnetic resonance imaging with diffusion-weighted imaging (DWI) were included in this study. Presence of rim enhancement on contrast-enhanced T1-weighted imaging and hyperintense rim on DWI were visually assessed. Pathologic data about presence of recurrence and presence of lymphovascular invasion (LVI) were reviewed. Statistics for relative risk of recurrence carried out. RESULTS Of the 101, 13 cases (12.9%) were recurred after a median follow-up of 18.5 months. Rim enhancement was more frequently seen in the LVI-positive group (P = 0.046). Hyperintense rim on DWI and apparent diffusion coefficient values showed no significant relationship with clinical-pathologic factors. CONCLUSIONS Rim enhancement was significantly associated with positive LVI status in patients with triple-negative breast cancer. Our study suggests that rim enhancement may be useful to predict the prognosis.
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Sa-Nguanraksa D, O-Charoenrat E, Kulprom A, Samarnthai N, Lohsiriwat V, Nimpoonsri K, O-Charoenrat P. Nomogram to predict non-sentinel lymph node status using total tumor load determined by one-step nucleic acid amplification: first report from Thailand. Breast Cancer 2019; 26:471-477. [PMID: 30617675 DOI: 10.1007/s12282-019-00945-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/31/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Axillary staging is a significant prognostic factor often used to determine the treatment course for breast cancer. One-step nucleic acid amplification (OSNA) is now the most accepted method for intra-operative assessment of sentinel lymph nodes (SLN) as it can semi-quantitatively determine the tumor burden in these SLN. Axillary lymph node dissection (ALND) may be omitted in patients with limited disease in the axilla. The objective was to create nomogram for prediction of non-sentinel lymph node (NSLN) status using OSNA to avoid unnecessary ALND. PATIENTS AND METHODS Patients with invasive breast cancer T1-T3 and clinically negative axillary lymph nodes underwent SLN biopsy assessed by OSNA. The patients with positive SLN underwent ALND. Correlations between total tumor load (TTL), clinicopathological parameters, and NSLN status were analyzed by Chi square statistic and logistic regression. Model discrimination was evaluated using receiver-operating characteristic (ROC) analysis. RESULTS The total number of patients who underwent SLN biopsies was 278. There were 89 patients with positive SLN. NSLNs were positive in 40 patients. Larger tumor size, presence of lymphovascular invasion (LVI) and higher log TTL were independent factors that predicted positive NSLN. TTL can discriminate NSLN status with area under the ROC curve of 0.789 (95% CI 0.686-0.892). Two nomograms using different parameters obtained pre- and post-operatively can predict NSLN involvement with better area under the ROC curve (0.801, 95% CI 0.702-0.900 and 0.849, 95% CI 0.766-0.932, respectively). CONCLUSIONS Nomograms using results obtained via OSNA can predict NSLN status, as well as aid in deciding to omit the use of ALND.
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Affiliation(s)
- Doonyapat Sa-Nguanraksa
- Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand
| | | | - Anchalee Kulprom
- Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand
| | - Norasate Samarnthai
- Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand
| | - Visnu Lohsiriwat
- Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand
| | - Kampanart Nimpoonsri
- Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand
| | - Pornchai O-Charoenrat
- Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road Bangkoknoi, Bangkok, 10700, Thailand.
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Tubtimhin S, Promthet S, Suwanrungruang K, Supaattagorn P. Molecular Subtypes and Prognostic Factors among Premenopausal and Postmenopausal Thai Women with Invasive Breast Cancer: 15 Years Follow-up Data. Asian Pac J Cancer Prev 2018; 19:3167-3174. [PMID: 30486605 PMCID: PMC6318416 DOI: 10.31557/apjcp.2018.19.11.3167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and Purpose: This study focused on molecular subtypes and prognostic factors for survival of preand
post-menopausal breast cancer patients. Methods: A retrospective cohort study was performed on 523 patients
with invasive carcinoma of the breast treated at Ubon Ratchathani Cancer Hospital,Thailand from 2002 to 2016.
Patient characteristics were collected based on a systematic chart audit from medical records. Prognostic factors were
performed by observe survival analysis. A Cox regression model was used to calculate hazard ratios of death, taking
into account the age and menopause status, molecular subtype, stage of disease, histological grade, lymphatic and
vascular invasion, resection margin, hormone receptor expression, and treatment modality. Results: The median time
from the diagnosis of invasive breast cancer to the last follow-up or death was 10.2 [95% CI = 9.28-11.95] years in
premenopausal women, and 7.4 [95% CI = 6.48-8.44] years in postmenopausal cases. The overall survival estimates
at 5 and 10 years for younger woman of 71.2% and 51.8% respectively, appeared slightly better than the 68.3% and
40.9% for postmenopausal women [HRadj = 1.27, 95% CI =0.99-1.63]. In the multivariate analysis, 3 prognostic
indicators significantly predicted a worse overall survival in premenopausal patients, triple negative subtype [HRadj =
6.03, 95% CI = 1.94-18.74], HER2-enriched status [HRadj = 4.11, 95% CI = 1.59-10.65] and stage III [HRadj = 2.73,
95% CI = 1.10-6.79]. Statistically significant increased risk of death in postmenopausal patients was noted for only
chemotherapy after mastectomy [HRadj = 8.76, 95% CI = 2.88-26.61], and for a Luminal B status [HRadj = 3.55, 95%
CI = 1.47-8.53]. Conclusion: Postmenopausal women with invasive breast cancer experience a significantly shorter
survival than do their premenopausal counterparts. The predictors of worse overall survival were molecular subtype,
stage of disease and type of treatment administered.
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Affiliation(s)
- Sopit Tubtimhin
- Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Thailand.
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Agarwal S, Singh A, Bagga PK. Immunohistochemical evaluation of lymphovascular invasion in carcinoma breast with CD34 and D2-40 and its correlation with other prognostic markers. INDIAN J PATHOL MICR 2018; 61:39-44. [PMID: 29567882 DOI: 10.4103/ijpm.ijpm_791_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Carcinoma breast is ever-evolving and becoming increasingly prevalent in India. Numerous prognostic factors based on morphology and immunohistochemistry (IHC) have been established which need to be interconnected to give patients best possible treatment. Aims This study aims to confirm and analyze lymphovascular invasion (LVI) detected by hematoxylin and eosin (H and E) using IHC with CD34 and D2-40 and its correlation with other biologic and morphologic prognostic markers. Settings and Design This was a prospective study. Materials and Methods Fifty mastectomy specimens diagnosed as infiltrating ductal carcinoma breast on histopathology selected for the study. Evaluation of formalin-fixed paraffin-embedded sections was done using H and E and IHC for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 HER2/neu receptors, CD34, and D2-40 endothelial markers. Correlation of LVI done with prognostic markers of Carcinoma Breast, namely, age of the patient, tumor size, Nottingham grade, lymph node ratio (LNR), Nottingham prognostic index (NPI), ER/PR status, and HER2/neu status. CD34 and D2-40 utilized to distinguish blood vessel, lymph vessel, and retraction artifacts and to calculate lymphatic microvessel density (LMVD) and blood microvessel density (BMVD). Statistical Analysis Used SPSS Software Package. Results LVI was associated with younger age (P = 0.001), greater tumor size (P = 0.007), higher Nottingham grade (P = 0.001), higher LNR (P = 0.001), higher NPI (P = 0.001), Negative ER Status (P = 0.001), Negative PR Status (P = 0.002), Positive HER2/neu status (P = 0.021), Higher Intratumoral BMVD (P = 0.016), Peritumoral BMVD (P = 0.001), and Intratumoral LMVD (P = 0.009). Blood vessels more commonly invaded than lymph vessels. Retraction artifacts can be mistaken for LVI without IHC. Conclusions D2-40 is a promising marker for lymphatic endothelium. LVI is a poor prognostic marker hence should be evaluated imperatively in all cases of carcinoma breast.
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Affiliation(s)
- Sonal Agarwal
- Department of Pathology, Government Medical College, Amritsar, Punjab, India
| | - Amarjit Singh
- Department of Pathology, Government Medical College, Amritsar, Punjab, India
| | - Permeet Kaur Bagga
- Department of Pathology, Government Medical College, Amritsar, Punjab, India
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Chen JH, Zhang Y, Chan S, Chang RF, Su MY. Quantitative analysis of peri-tumor fat in different molecular subtypes of breast cancer. Magn Reson Imaging 2018; 53:34-39. [PMID: 29969646 PMCID: PMC6684233 DOI: 10.1016/j.mri.2018.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/13/2018] [Accepted: 06/28/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSES The aim of this study was to develop morphological analytic methods to analyze the tumor-fat interface and in different peritumoral shells away from the tumor, and to compare the results among three molecular subtypes of breast cancer. MATERIALS AND METHODS A total of 102 women (mean age 48.5 y/o) with solitary well-defined breast cancers were analyzed, including 46 human epidermal growth factor receptor 2 (HER2) (+), 46 HER2(-) hormonal receptor (HR) (+), and 10 triple negative (TN) breast cancers. The tumor lesion, the breast, the fibroglandular and fatty tissue were segmented using well-established methods. The whole breast fat percentage and the peri-tumor interface fat percentage were measured. Three shells (SH1, SH2, SH3) surrounding the convex hall of the three dimensional (3D) tumor were defined and in each shell the volumetric percentage of fat was calculated. The peri-tumor interface fat percentage and the volumetric percentage of fat in the three peri-tumoral shells were compared among different subtypes. RESULTS In the TN group, the fat percentage on the tumor boundary was 43 ± 20% and 78 ± 12% for two dimensional (2D) and 3D measurement, respectively, which were the highest among the three subtypes but not significantly different. The fat percentage in SH2 and SH3 in the TN group was 82 ± 7% and 85 ± 7%, which was significantly higher compared to the two other two subtypes. The results remained after controlling for the whole breast fat percentage. CONCLUSIONS This study provided a feasible method for quantitative analysis of peri-tumoral tissue characteristics. Because of small patient number, the finding that TN tumors had the highest peri-tumor fat content among the three subtypes needs to be further verified with a large cohort study.
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Affiliation(s)
- Jeon-Hor Chen
- Center For Functional Onco-Imaging of Department of Radiological Sciences, University of California, Irvine, CA, USA; Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan.
| | - Yang Zhang
- Center For Functional Onco-Imaging of Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Siwa Chan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Department of Medical Imaging, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; Department of Radiology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ruey-Feng Chang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Min-Ying Su
- Center For Functional Onco-Imaging of Department of Radiological Sciences, University of California, Irvine, CA, USA
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Kimyon Comert G, Basaran D, Ergin Akkoz H, Celik B, Sinaci S, Turkmen O, Karalok A, Kandemir O, Turan T. Blood Vessel Invasion in Endometrial Cancer Is One of the Mechanisms of Spread to the Cervix. Pathol Oncol Res 2018; 25:1431-1436. [PMID: 30361902 DOI: 10.1007/s12253-018-0498-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/10/2018] [Indexed: 11/28/2022]
Abstract
To evaluate the association between type of invaded vessels (blood or lymphatic) and cervical involvement in endometrial cancer (EC). Pathological slides of 93 patients with EC who had vascular space invasion in hematoxylin-eosin staining underwent immunohistochemical assay with CD31 and podoplanin. CD31 and podoplanin were used to identify blood and lymphatic invaded vessels, respectively. Cervical stromal invasion (CSI) was determined in 21 (30%) patients. The rate of CD31-positivity was significantly higher in patients with CSI than without (76.2 and 34.7%, p = 0.001; respectively). Podoplanin-positivity was determined in 47.6 and 81.6% of patients with and without CSI, respectively (p = 0.005). Age, myometrial invasion and the combination of CD31-positivity with podoplanin-negativity were found as independent predictors for CSI. Blood vessel invasion is an important factor for CSI in EC. Blood vessel invasion rather than lymphatic vessel invasion is one of the predominant ways by which EC spreads to the cervix.
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Affiliation(s)
- Gunsu Kimyon Comert
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Derman Basaran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hayriye Ergin Akkoz
- Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Burcin Celik
- Department of Pathology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Selcan Sinaci
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Osman Turkmen
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Alper Karalok
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Olcay Kandemir
- Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Bennett L, Mallon EA, Horgan PG, Paul A, McMillan DC, Edwards J. The relationship between members of the canonical NF-κB pathway, components of tumour microenvironment and survival in patients with invasive ductal breast cancer. Oncotarget 2018; 8:33002-33013. [PMID: 28423692 PMCID: PMC5464845 DOI: 10.18632/oncotarget.16031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/12/2017] [Indexed: 12/20/2022] Open
Abstract
The aim of the present study was to examine the relationship between tumour NF-κB activation, tumour microenvironment including local inflammatory response (LIR) and cancer-specific survival in patients with operable ductal breast cancer. Immunohistochemistry (tissue microarray of 376 patients) and western blotting (MCF7 and MDA-MB-231 breast cancer cells) was performed to assess expression of key members of the canonical NF-κB pathway (inhibitory kappa B kinase (IKKβ) and phosphorylated p65 Ser-536 (p-p65)). Following silencing of IKKβ, cell viability and apoptosis was assessed in both MCF7 and MDA-MB-231 cell lines. P-p65 was associated with cancer-specific survival (CSS) (nuclear P=0.042 and total P=0.025). High total p-p65 was associated with increase grade tumour grade (P=0.010), ER positivity (P=0.023), molecular subtype (P=0.005), lower Klintrup-Makinen grade (P=0.013) and decreased CD138 count (P=0.032). On multivariate analysis, total p-p65 expression independently associated with poorer CSS (P=0.020). In vitro work demonstrated that the canonical NF-κB pathway was inducible by exposure to TNFα in ER-positive MCF7 cells and to a lesser extent in ER-negative MDA-MB-231 cells. Reduction of IKKβ expression by siRNA transfection increased levels of apoptosis and reduced cell viability in both MCF7 (P=<0.001, P=<0.001, respectively) and MDA-MB-231 cells (P=>0.001, P=0.002, respectively). This is consistent with the hypothesis that canonical IKKβ-NF-κB signalling drives tumour survival. These results suggest that activation of the canonical NF-κB pathway is an important determinant of poor outcome in patients with invasive ductal breast cancer.
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Affiliation(s)
- Lindsay Bennett
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom.,Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom
| | - Elizabeth A Mallon
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom
| | - Paul G Horgan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom
| | - Andrew Paul
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom
| | - Joanne Edwards
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
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Abbasi A, Abbasi F, Nabizadeh A, Esmaili A. Evaluation of lymphatic vessel invasion by immunohistochemistry in breast carcinoma. JOURNAL OF MEDICAL SCIENCES 2018. [DOI: 10.4103/jmedsci.jmedsci_161_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Ahn KJ, Park J, Choi Y. Lymphovascular invasion as a negative prognostic factor for triple-negative breast cancer after surgery. Radiat Oncol J 2017; 35:332-339. [PMID: 29232804 PMCID: PMC5769883 DOI: 10.3857/roj.2017.00416] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/13/2017] [Accepted: 10/10/2017] [Indexed: 01/20/2023] Open
Abstract
Purpose This study aimed to evaluate the prognostic effects of lymphovascular invasion (LVI) in triple-negative breast cancer (TNBC) patients who underwent surgical resection. Materials and Methods A total of 63 non-metastatic TNBC patients who underwent surgical resection were retrospectively investigated from 2007 to 2016 in Inje University Busan Paik Hospital. Pathological tests revealed that 12 patients (19.0%) had LVI. Approximately 61.9% (n = 39) of the patients’ samples stained positive for p53. Additional chemotherapy and radiotherapy (RT) were performed in 53 (84.1%) and 47 (74.6%) patients, respectively. Results The median follow-up period was 39.5 months (range, 5.9 to 123.0 months). The pathological T stage (p = 0.008), N stage (p = 0.014), and p53 positivity (p = 0.044) were associated with LVI. Overall, the 3-year disease-free survival (DFS) rate and overall survival (OS) rate were 85.4% and 90.2%, respectively. Ten patients (15.9%) experienced relapse. LVI (n = 12) was associated with relapses (p = 0.016). p53 positivity was correlated with poor DFS (p = 0.048). Furthermore, LVI was related to poor DFS (p = 0.011) and OS (p = 0.001) and considered as an independent prognostic factor for DFS (p = 0.039). The 3-year DFS of patients with LVI (n = 12) was only 58.3%. Adjuvant RT minimized the negative prognostic effect of LVI on DFS (p = 0.068 [with RT] vs. p = 0.011 [without RT]). Conclusion LVI was related to the detrimental effects of disease progression and survival of TNBC patients. Thus, a more effective treatment strategy is needed for TNBC patients with LVI.
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Affiliation(s)
- Ki Jung Ahn
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Busan, Korea
| | - Jisun Park
- Department of Nuclear Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Yunseon Choi
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Busan, Korea
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23
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Braman NM, Etesami M, Prasanna P, Dubchuk C, Gilmore H, Tiwari P, Plecha D, Madabhushi A. Intratumoral and peritumoral radiomics for the pretreatment prediction of pathological complete response to neoadjuvant chemotherapy based on breast DCE-MRI. Breast Cancer Res 2017; 19:57. [PMID: 28521821 PMCID: PMC5437672 DOI: 10.1186/s13058-017-0846-1] [Citation(s) in RCA: 386] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 04/25/2017] [Indexed: 12/26/2022] Open
Abstract
Background In this study, we evaluated the ability of radiomic textural analysis of intratumoral and peritumoral regions on pretreatment breast cancer dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict pathological complete response (pCR) to neoadjuvant chemotherapy (NAC). Methods A total of 117 patients who had received NAC were retrospectively analyzed. Within the intratumoral and peritumoral regions of T1-weighted contrast-enhanced MRI scans, a total of 99 radiomic textural features were computed at multiple phases. Feature selection was used to identify a set of top pCR-associated features from within a training set (n = 78), which were then used to train multiple machine learning classifiers to predict the likelihood of pCR for a given patient. Classifiers were then independently tested on 39 patients. Experiments were repeated separately among hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+, HER2−) and triple-negative or HER2+ (TN/HER2+) tumors via threefold cross-validation to determine whether receptor status-specific analysis could improve classification performance. Results Among all patients, a combined intratumoral and peritumoral radiomic feature set yielded a maximum AUC of 0.78 ± 0.030 within the training set and 0.74 within the independent testing set using a diagonal linear discriminant analysis (DLDA) classifier. Receptor status-specific feature discovery and classification enabled improved prediction of pCR, yielding maximum AUCs of 0.83 ± 0.025 within the HR+, HER2− group using DLDA and 0.93 ± 0.018 within the TN/HER2+ group using a naive Bayes classifier. In HR+, HER2− breast cancers, non-pCR was characterized by elevated peritumoral heterogeneity during initial contrast enhancement. However, TN/HER2+ tumors were best characterized by a speckled enhancement pattern within the peritumoral region of nonresponders. Radiomic features were found to strongly predict pCR independent of choice of classifier, suggesting their robustness as response predictors. Conclusions Through a combined intratumoral and peritumoral radiomics approach, we could successfully predict pCR to NAC from pretreatment breast DCE-MRI, both with and without a priori knowledge of receptor status. Further, our findings suggest that the radiomic features most predictive of response vary across different receptor subtypes. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0846-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nathaniel M Braman
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA.
| | - Maryam Etesami
- University Hospitals Case Medical Center, Cleveland, OH, 44106, USA
| | - Prateek Prasanna
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | | | - Hannah Gilmore
- University Hospitals Case Medical Center, Cleveland, OH, 44106, USA
| | - Pallavi Tiwari
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Donna Plecha
- University Hospitals Case Medical Center, Cleveland, OH, 44106, USA
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA
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Elkablawy MA, Albasri AM, Mohammed RA, Hussainy AS, Nouh MM, Alhujaily AS. Ki67 expression in breast cancer. Correlation with prognostic markers and clinicopathological parameters in Saudi patients. Saudi Med J 2017; 37:137-41. [PMID: 26837394 PMCID: PMC4800910 DOI: 10.15537/smj.2016.2.12285] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To evaluate Ki67 immunoexpression pattern in Saudi breast cancer (BC) patients and investigate any possible predictive or prognostic value for Ki67. METHODS This is a retrospective study designed to quantitatively assess the Ki67 proliferative index (PI) in retrieved paraffin blocks of 115 Saudi BC patients diagnosed between January 2005 and March 2015 at the Department of Pathology, King Fahd Hospital, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. The Ki67 PI was correlated with individual and combined immunoprofile data of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) with their clinicopathological parameters. RESULTS Ki67 immunoreactivity was highly expressed (greater than 25% of the tumor cells were positive) in 85 (73.9%) patients. The Ki67 PI was significantly associated with poor prognostic clinicopathological parameters including old age (p less than 0.02), high tumor grade (p less than 0.01), lymph node metastasis (p less than 0.001), and Her-2/neu positivity (p less than 0.009). However, the association with ER positivity, PR positivity, tumor size, and lymphovascular invasion were not statistically significant. The Ki67 PI was significantly associated with BC molecular subtypes that were Her2/neu positive (luminal B and HER-2) subtypes compared with the Her2/neu negative (luminal A) subtype (p less than 0.04). CONCLUSION The Ki67 PI is significantly higher in Saudi BC patients comparing with the reported literature. Ki67 PI was highest in the HER-2 and luminal-B molecular subtypes. Along with other prognostic indicators, Ki67 PI may be useful in predicting prognosis and management of Saudi BC patients.
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MESH Headings
- Adenocarcinoma, Mucinous/metabolism
- Adenocarcinoma, Mucinous/pathology
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Female
- Humans
- Immunohistochemistry
- Ki-67 Antigen/metabolism
- Lymph Nodes/pathology
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Saudi Arabia
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Affiliation(s)
- Mohamed A Elkablawy
- Department of Pathology, Faculty of Medicine, Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. E-mail.
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25
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Wright N, Xia J, Cantuaria G, Klimov S, Jones M, Neema P, Il’yasova D, Krishnamurti U, Li X, Reid MD, Gupta M, Rida PCG, Osan R, Aneja R. Distinctions in Breast Tumor Recurrence Patterns Post-Therapy among Racially Distinct Populations. PLoS One 2017; 12:e0170095. [PMID: 28085947 PMCID: PMC5234824 DOI: 10.1371/journal.pone.0170095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/28/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Clinical studies have revealed a higher risk of breast tumor recurrence in African-American (AA) patients compared to European-American (EA) patients, contributing to the alarming inequality in clinical outcomes among the ethnic groups. However, distinctions in recurrence patterns upon receiving hormone, radiation, and/or chemotherapy between the races remain poorly characterized. METHODS We compared patterns and rates (per 1000 cancer patients per 1 year) of recurrence following each form of treatment between AA (n = 1850) and EA breast cancer patients (n = 7931) from a cohort of patients (n = 10504) treated between 2005-2015 at Northside Hospital in Atlanta, GA. RESULTS Among patients who received any combination of adjuvant therapy, AA displayed higher overall rates of recurrence than EA (p = 0.015; HR: 1.699; CI: 1.108-2.606). Furthermore, recurrence rates were higher in AA than EA among stage I (p = 0.031; HR: 1.736; CI: 1.052-2.864) and T1 classified patients (p = 0.003; HR: 2.009; CI: 1.263-3.197). Interestingly, among patients who received neoadjuvant chemotherapy, AA displayed higher rates of local recurrence than EA (p = 0.024; HR: 7.134; CI: 1.295-39.313). CONCLUSION Our analysis revealed higher incidence rates of recurrence in AA compared to EA among patients that received any combination of adjuvant therapy. Moreover, our data demonstrates an increased risk of tumor recurrence in AA than EA among patients diagnosed with minimally invasive disease. This is the first clinical study to suggest that neoadjuvant chemotherapy improves breast cancer recurrence rates and patterns in AA.
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Affiliation(s)
- Nikita Wright
- Department of Biology, Georgia State University, Atlanta, Georgia, United States of America
| | - Jun Xia
- Department of Mathematics and Statistics, Georgia State University, Atlanta, Georgia, United States of America
| | - Guilherme Cantuaria
- Department of Gynecologic Oncology, Northside Hospital Cancer Institute, Atlanta, Georgia, United States of America
| | - Sergey Klimov
- Department of Biology, Georgia State University, Atlanta, Georgia, United States of America
| | - Mildred Jones
- Department of Pathology Oncology Analytics, Northside Hospital Cancer Institute, Atlanta, GA, United States of America
| | - Pranay Neema
- Department of Biology, Georgia State University, Atlanta, Georgia, United States of America
| | - Dora Il’yasova
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Uma Krishnamurti
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Xiaoxian Li
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Michelle D. Reid
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Meenakshi Gupta
- Clinical Pathology and Anatomic Pathology, West Georgia Hospitals, LaGrange, Georgia, United States of America
| | - Padmashree C. G. Rida
- Department of Biology, Georgia State University, Atlanta, Georgia, United States of America
| | - Remus Osan
- Department of Mathematics and Statistics, Georgia State University, Atlanta, Georgia, United States of America
- * E-mail: (RO); (RA)
| | - Ritu Aneja
- Department of Biology, Georgia State University, Atlanta, Georgia, United States of America
- * E-mail: (RO); (RA)
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Bennett L, Quinn J, McCall P, Mallon EA, Horgan PG, McMillan DC, Paul A, Edwards J. High IKKα expression is associated with reduced time to recurrence and cancer specific survival in oestrogen receptor (ER)-positive breast cancer. Int J Cancer 2017; 140:1633-1644. [PMID: 28006839 DOI: 10.1002/ijc.30578] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/11/2016] [Accepted: 12/09/2016] [Indexed: 01/01/2023]
Abstract
The aim of our study was to examine the relationship between tumour IKKα expression and breast cancer recurrence and survival. Immunohistochemistry was employed in a discovery and a validation tissue microarray to assess the association of tumour IKKα expression and clinico-pathological characteristics. After siRNA-mediated silencing of IKKα, cell viability and apoptosis were assessed in MCF7 and MDA-MB-231 breast cancer cells. In both the discovery and validation cohorts, associations observed between IKKα and clinical outcome measures were potentiated in oestrogen receptor (ER) positive Luminal A tumours. In the discovery cohort, cytoplasmic IKKα was associated with disease-free survival (p = 0.029) and recurrence-free survival on tamoxifen (p < 0.001) in Luminal A tumours. Nuclear IKKα and a combination of cytoplasmic and nuclear IKKα (total tumour cell IKKα) were associated with cancer-specific survival (p = 0.012 and p = 0.007, respectively) and recurrence-free survival on tamoxifen (p = 0.013 and p < 0.001, respectively) in Luminal A tumours. In the validation cohort, cytoplasmic IKKα was associated with cancer-specific survival (p = 0.023), disease-free survival (p = 0.002) and recurrence-free survival on tamoxifen (p = 0.009) in Luminal A tumours. Parallel experiment with breast cancer cells in vitro demonstrated the non-canonical NF-κB pathway was inducible by exposure to lymphotoxin in ER-positive MCF7 cells and not in ER-negative MDA-MB-231 cells. Reduction in IKKα expression by siRNA transfection increased levels of apoptosis and reduced cell viability in MCF7 but not in MDA-MB-231 cells. IKKα is an important determinant of poor outcome in patients with ER-positive invasive ductal breast cancer and thus may represent a potential therapeutic target.
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Affiliation(s)
- Lindsay Bennett
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Jean Quinn
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Pamela McCall
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Elizabeth A Mallon
- Department of Pathology, Southern General Hospital, Glasgow, Scotland, United Kingdom
| | - Paul G Horgan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom
| | - Andrew Paul
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Joanne Edwards
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
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27
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Cheng KKW, Dickson A, Gujam FJA, McMillan DC, Edwards J. The relationship between oestrogen receptor-alpha phosphorylation and the tumour microenvironment in patients with primary operable ductal breast cancer. Histopathology 2016; 70:782-797. [PMID: 27891654 DOI: 10.1111/his.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/09/2016] [Accepted: 11/23/2016] [Indexed: 01/26/2023]
Abstract
AIMS Although the role of phosphorylation of oestrogen receptor (ER) at serines 118 (p-S118) and 167 (p-S167) has been studied, the relationship between p-S118, p-S167 and the tumour microenvironment in ER-positive primary operable ductal breast cancers have not been investigated. The aims of this study are to investigate (i) the relationship between p-S118/p-S167 and the tumour microenvironment, and (ii) the effect of p-S118/167 on survival and recurrence in ER-positive primary operable ductal breast cancers. METHODS AND RESULTS Patients presenting at three Glasgow hospitals between 1995 and 1998 with invasive ductal ER-positive primary breast cancers were studied (n = 294). Immunohistochemical staining of p-S118 and p-S167 was performed and their association with clinicopathological characteristics, cancer-specific survival (CSS) and recurrence-free interval (RFI) were examined. In the whole cohort, tumour size (P < 0.05) and microvessel density (P < 0.05) were associated with high p-S118 while increased micovessel density (P < 0.05), apoptosis (P < 0.05), general inflammatory infiltrate measured using the Klintrup-Makinen score (P < 0.05) and macrophage infiltrate (P < 0.05) were found to be associated with high p-S167. Only high p-S167 was associated with shorter CSS (P < 0.005) and shorter RFI in the whole cohort (P = 0.001) and separately in the luminal A (P < 0.05) and B tumours (P < 0.05). CONCLUSIONS This study showed that both p-S118 and p-S167 were associated with several microenvironmental factors, including increased microvessel density. In particular, p-S167 was associated with reduced RFI and CSS in the whole cohort and RFI in luminal A and B tumours and could possibly be employed to predict response to kinase inhibitors.
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Affiliation(s)
| | - Ashley Dickson
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Fadia J A Gujam
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences, University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences, University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Joanne Edwards
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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28
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Kather JN, Marx A, Reyes-Aldasoro CC, Schad LR, Zöllner FG, Weis CA. Continuous representation of tumor microvessel density and detection of angiogenic hotspots in histological whole-slide images. Oncotarget 2016; 6:19163-76. [PMID: 26061817 PMCID: PMC4662482 DOI: 10.18632/oncotarget.4383] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 04/08/2015] [Indexed: 12/19/2022] Open
Abstract
Blood vessels in solid tumors are not randomly distributed, but are clustered in angiogenic hotspots. Tumor microvessel density (MVD) within these hotspots correlates with patient survival and is widely used both in diagnostic routine and in clinical trials. Still, these hotspots are usually subjectively defined. There is no unbiased, continuous and explicit representation of tumor vessel distribution in histological whole slide images. This shortcoming distorts angiogenesis measurements and may account for ambiguous results in the literature. In the present study, we describe and evaluate a new method that eliminates this bias and makes angiogenesis quantification more objective and more efficient. Our approach involves automatic slide scanning, automatic image analysis and spatial statistical analysis. By comparing a continuous MVD function of the actual sample to random point patterns, we introduce an objective criterion for hotspot detection: An angiogenic hotspot is defined as a clustering of blood vessels that is very unlikely to occur randomly. We evaluate the proposed method in N=11 images of human colorectal carcinoma samples and compare the results to a blinded human observer. For the first time, we demonstrate the existence of statistically significant hotspots in tumor images and provide a tool to accurately detect these hotspots.
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Affiliation(s)
- Jakob Nikolas Kather
- Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,Computer Assisted Clinical Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alexander Marx
- Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Frank Gerrit Zöllner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cleo-Aron Weis
- Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
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29
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Elsayed M, Alhussini M, Basha A, Awad AT. Analysis of loco-regional and distant recurrences in breast cancer after conservative surgery. World J Surg Oncol 2016; 14:144. [PMID: 27180041 PMCID: PMC4868020 DOI: 10.1186/s12957-016-0881-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/21/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND A number of patients treated conservatively for breast cancer will develop loco-regional and distant recurrences. Our aim was to determine how their occurrence may be linked to the evolution of the disease. METHODS We analyzed 238 women treated by conservative breast surgery and breast irradiation in a single institution. We evaluated the prognostic factors associated with loco-regional and distant recurrences and the prognostic value of local and regional recurrences on systemic progression. RESULTS After a median follow-up of 5 year (range 1-10), 16 (6.72%) patients in the breast conservative surgery (BCS) groups had loco-regional recurrence. For distant recurrence, 10 (4.2%) patients had experienced distant recurrence. Lympho-vascular invasion (HR 2.55; 95% CI, 076 to 8.49) and an extensive intraductal component (HR, 2.22; 95% CI, 0.69 to 7.15) and nodal status are risk factors for loco-regional recurrence (LRR) after breast conservative therapy (BCT). Tumor size, nodal status, high histologic grade, and breast cancer diagnosed at a young age (≤35 years) are correlated with higher distant recurrence rates after BCT. CONCLUSIONS Risk factors for LRR after BCS include lympho-vascular invasion, extensive inraductal component, and high nodal status, where as risk factors for distant recurrence include tumor size, nodal status, high histologic grade, and breast cancer diagnosed at a young age (≤35 years).
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/complications
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/complications
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/complications
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/surgery
- Egypt/epidemiology
- Female
- Follow-Up Studies
- Humans
- Incidence
- Mastectomy, Segmental/adverse effects
- Middle Aged
- Neoplasm Grading
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/etiology
- Neoplasm Staging
- Prognosis
- Survival Rate
- Young Adult
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Affiliation(s)
- Mostafa Elsayed
- General Surgery and Surgical Oncology, Alexandria University Students Hospital, Alexandria, Egypt.
| | - Mahmoud Alhussini
- General Surgery and Surgical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Basha
- General Surgery and Surgical Oncology, Alexandria, Egypt
| | - A T Awad
- Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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30
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Cadherin-5: a biomarker for metastatic breast cancer with optimum efficacy in oestrogen receptor-positive breast cancers with vascular invasion. Br J Cancer 2016; 114:1019-26. [PMID: 27010749 PMCID: PMC4984911 DOI: 10.1038/bjc.2016.66] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/14/2015] [Accepted: 01/13/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A glycoproteomic study has previously shown cadherin-5 (CDH5) to be a serological marker of metastatic breast cancer when both protein levels and glycosylation status were assessed. In this study we aimed to further validate the utility of CDH5 as a biomarker for breast cancer progression. METHODS A nested case-control study of serum samples from breast cancer patients, of which n=52 had developed a distant metastatic recurrence within 5 years post-diagnosis and n=60 had remained recurrence-free. ELISAs were used to quantify patient serum CDH5 levels and assess glycosylation by Helix pomatia agglutinin (HPA) binding. Clinicopathological, treatment and lifestyle factors associated with metastasis and elevated biomarker levels were identified. RESULTS Elevated CDH5 levels (P=0.028) and ratios of CDH5:HPA binding (P=0.007) distinguished patients with metastatic disease from those that remained metastasis-free. Multivariate analysis showed that the association between CDH5:HPA ratio and the formation of distant metastases was driven by patients with oestrogen receptor (ER+) positive cancer with vascular invasion (VI+). CONCLUSIONS CDH5 levels and the CDH5 glycosylation represent biomarker tests that distinguish patients with metastatic breast cancer from those that remain metastasis-free. The test reached optimal sensitivity and specificity in ER-positive cancers with vascular invasion.
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Fox MJ, Gibbs P, Pickles MD. Minkowski functionals: An MRI texture analysis tool for determination of the aggressiveness of breast cancer. J Magn Reson Imaging 2015; 43:903-10. [PMID: 26453892 DOI: 10.1002/jmri.25057] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 09/15/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This work aims to see whether Minkowski Functionals can be used to distinguish between cancer types before chemotherapy treatment has begun, and whether a response to treatment can be predicted by an initial scan alone. METHODS Fat-nulled T1w 3T DCE-MRI scans were taken of 100 cases of biopsy confirmed breast cancer and a series of binary images created on lesion containing slices. Minkowski Functionals were calculated for each binary image and the change in these values as the binary threshold was raised was described using 6(th) order polynomials. These polynomials were used to compare between patient subgroups, for triple negative breast cancer (TNBC) status, chemotherapy response, biopsy grade, nodal status, and lymphovascular invasion status. RESULTS When using Minkowski Functionals statistically significant (P < 0.05) differences were found between TNBC status, biopsy grade, and lymphovascular invasion status subgroups for all methodologies. The analysis performance did not appear to be affected by the number of threshold steps used. Most notably, very strong differences (P ≤ 0.01) were found between TNBC and other intrinsic subtype patients. When analyzed with a binary logistic regression model, an area under the curve value of 0.917 (0.846-0.987, 95% confidence interval) for TNBC classification was found. CONCLUSION The method of texture analysis presented here provides a novel way to characterize tumors, and demonstrates clear differences between cancer groups which are detectable before treatment begins, and can help with treatment planning as a valuable prognosis tool.
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Affiliation(s)
- Michael J Fox
- Centre for Magnetic Resonance Investigations, HYMS at University of Hull, Hull, United Kingdom
| | - Peter Gibbs
- Centre for Magnetic Resonance Investigations, HYMS at University of Hull, Hull, United Kingdom
| | - Martin D Pickles
- Centre for Magnetic Resonance Investigations, HYMS at University of Hull, Hull, United Kingdom
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Senchukova MA, Nikitenko NV, Tomchuk ON, Zaitsev NV, Stadnikov AA. Different types of tumor vessels in breast cancer: morphology and clinical value. SPRINGERPLUS 2015; 4:512. [PMID: 26405632 PMCID: PMC4573747 DOI: 10.1186/s40064-015-1293-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 08/30/2015] [Indexed: 02/08/2023]
Abstract
Angiogenesis is a key factor of tumor progression. Considering, that the tumor vessels are heterogeneous and differ in morphology and clinical significance, the purpose of this research was to study of the morphological features of tumor vessels and their relationship with the clinical characteristics and morphological features of breast cancer (BC). In this pilot study the tumor samples received from 59 patients with T1–T2 stages of ductal invasive carcinomas were included. The sections were stained with hematoxylin and eosin and immunohistochemically using antibodies to CD34. The morphological features and the number of different types of tumor vessels were assessed microscopically and were compared with grade, lymph node metastasis, hormone receptors, HER2/neu status and with the presence of tumor emboli in vessels (lymphovascular invasion). We identified the following types of tumor vessels in BC: the normal microvessels, the dilated capillaries of peritumoral stroma, the atypical dilated capillaries and the “cavitary” structures (CS) type-1 and type-2 relating to the “cavitary” type of angiogenesis that was described by us earlier. The number of dilated capillaries correlated with CS type-1 (p = 0.003), CS type-2 (p = 0.002), atypical dilated capillaries (p = 0.0008) and with lymphovascular invasion (p = 0.005); the presence of atypical dilated capillaries—with CS type-1 (p < 0.00001), CS type-2 (p = 0.00004), lymphovascular invasion (p = 0.0002) and with the tumor grade (p = 0.003); the number of CS type-1—with estrogen receptor (p = 0.002) and progesterone receptor (p = 0.002) status and with lymphovascular invasion (p = 0.004); the presence of CS type-2—with positive Her2/new status (p = 0.0002) and lymphovascular invasion (p = 0.01). The density of normal microvessels was not associated with other types of tumor vessels and with clinical characteristics of BC. These data indicate that varied types of tumor vessels are associated with different morphological characteristics of BC, such as hormone receptors and HER2/neu status, lymphovascular invasion. We believe that the atypical dilated capillaries are related to the “cavitary” type of angiogenesis. The strong correlations of lymphovascular invasion with CS type-1 and atypical dilated capillaries testify that the “cavitary” type of angiogenesis may play a significant role in the formation of tumor emboli in the vessels.
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Affiliation(s)
| | | | - Olesia N Tomchuk
- Department of Histology, Cytology and Embryology, Orenburg State Medical University, Orenburg, Russia
| | - Nikon V Zaitsev
- Orenburg Regional Clinical Oncology Center, Orenburg, Russia
| | - Alexander A Stadnikov
- Department of Histology, Cytology and Embryology, Orenburg State Medical University, Orenburg, Russia
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Qu W, Wang Y, Wu Q, Liu J, Hao D. Emodin inhibits HMGB1-induced tumor angiogenesis in human osteosarcoma by regulating SIRT1. Int J Clin Exp Med 2015; 8:15054-15064. [PMID: 26628989 PMCID: PMC4658878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 07/17/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED The anti-cancer effects of emodin, including inhibition of proliferation, invasion, metastasis and angiogenesis, were confirmed by various previous studies. However, the specific mechanisms were not clear. In this study, we investigated emodin's anti-angiogenesis effect and focused on the mechanisms in human osteosarcoma (OS). OS cells were implanted to nude mice to form OS xenografts. Immunofluorescence assay was used to assess vWF expression in tumor tissue. MTT assay was employed to screen proper emodin concentrations unrelated with proliferation inhibition. siRNA technique was utilized to silence SIRT1 expression in OS cells. Expression levels of SIRT1 and VEGF were investigated by real-time PCR and western blotting. H4-k16Ac expression which indicated the deacetylation activity of SIRT1 was also detected by western blotting. As in results, HMGB1 treatment exacerbated OS angiogenesis both in vivo and in vitro. Emodin administration attenuated angiogenesis in both OS and HMGB1 treated OS in vivo and in vitro. After emodin treatment, the expression level and deacetylation activity of SIRT1 were dramatically enhanced. HMGB1-induced angiogenesis was more striking in SIRT1 silenced OS cells. SIRT1 silencing also impaired the anti-angiogenesis effect of emodin in OS cells. IN CONCLUSION SIRT expression and deacetylation activity elevation are involved in emodin's anti-angiogenesis effect in human OS.
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Affiliation(s)
- Wei Qu
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine No 555, Friendship Rd, Xi'an 710054, China
| | - Yufei Wang
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine No 555, Friendship Rd, Xi'an 710054, China
| | - Qining Wu
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine No 555, Friendship Rd, Xi'an 710054, China
| | - Jijun Liu
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine No 555, Friendship Rd, Xi'an 710054, China
| | - Dingjun Hao
- Department of Spine Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine No 555, Friendship Rd, Xi'an 710054, China
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