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Ma Q, Liu YB, She T, Liu XL. The Role of Ki-67 in HR+/HER2- Breast Cancer: A Real-World Study of 956 Patients. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:117-126. [PMID: 38476641 PMCID: PMC10929654 DOI: 10.2147/bctt.s451617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Objective This study determined the cut-off value of Ki-67 expression and discussed the interaction between Ki-67 and histological grade, further explored the prognostic role of Ki-67 in hormone receptor-positive and human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer;. Materials and Methods We assessed the Ki-67 expression of 956 patients with HR+/HER2 breast cancer diagnosed in the General Hospital of Ningxia Medical University from 2015 to 2019 by immunohistochemistry (IHC), The disease-free survival (DFS) was defined as the time from postoperative to the first local recurrence, distant metastasis or death of the disease. The follow-up by means of inpatient or outpatient medical records and telephone. Results 22.5% was used as the cut-off for low/high Ki-67 expression in HR+/HER2- breast cancer. Compared with the value of 14%, which is commonly used in clinic at present, the consistency of the two values is moderate (Kappa = 0.484, P<0.001). The expression of Ki-67 was increased with the grade. (Median: G1:10%; G2:20%; G3:40%. Mean: G1:13%; G2:23%; G3:39%, P <0.001). Survival analysis was based on all patients for a median of 51 months (24-89 months), 63 cases had recurrence or metastasis during the follow-up, which 21 cases had low expression of Ki-67 and 42 cases had high expression. The patients with Ki-67 ≥ 22.5% had a 2.969 higher risk of early recurrence and metastasis than the patients with Ki-67 < 22.5%. There were 4 cases of local recurrence, 7 cases of regional lymph node metastasis, and 52 cases of distant metastasis in all patients, the common distant metastases were bone, liver, and lung, and rare metastases were adrenal gland, bone marrow, and pericardium. Conclusion In HR+/HER2- breast cancer, patients with Ki-67 > 22.5% have a worse prognosis and are more likely to have early recurrence and metastasis.
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Affiliation(s)
- Qin Ma
- Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Yao-Bang Liu
- Department of Surgical Oncology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Tong She
- Hospital of Zhongwei, Zhongwei, People’s Republic of China
| | - Xin-Lan Liu
- Department of Medical Oncology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
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Abdelhamid MS, El-Farargy AF, Abdelhai Esawi O. Synthesis and evaluation of novel thiazole moiety-containing compounds as antibreast cancer agents. Anticancer Drugs 2023; 34:563-581. [PMID: 36847066 DOI: 10.1097/cad.0000000000001401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Progesterone receptor (PR) agonists represent pivotal agents in trapping breast cancer cells through modulating the expression of estrogen receptor (ER). The present investigation aimed to test three novel thiadiazole-containing compounds as antibreast cancer agents. Test compounds were synthesized and abbreviated as 2-{(5-amino-1, 3, 4-thiazole-2-yl) amino}-4-(4-chloro-3-methylphenyl)-4-oxobutanoic acid (TAB), 4-(4-chloro-3-methylphenyl)-4-oxo 2-[(5-sulfanyl-1, 3, 4-thiadiazol-2-yl)] sulfanyl-butanoic acid (TSB) and 4-(4-chloro-3-methylphenyl)-4-oxo 2-[(5-sulfanyl-1, 3, 4-thiadiazol-2-yl)] sulphonyl-botanic acid (TSSB). Molecular docking of the test compounds with PR was simulated. The IC 50 of the test compounds against both Michigan cancer foundation-7 (MCF-7) and HepG2 was determined. Ehrlich solid tumor (EST) was grown in the right thigh of the mouse as a model of breast cancer in vivo . Hepatic and renal functions, besides hematological indicators, were tested. The expression of ER and ER genes in EST was determined using real-time PCR. Immunohistochemistry was carried out for the determination of Ki-67 and cyclin-dependent kinase 1 (CDK-1) in EST. Our results revealed that TAB, TSB and TSSB reduced Ehrlich tumor size by 48, 64 and 52%, respectively, compared to the EST control group. The docking scores achieved by TAB, TSB and TSSB with PR were -9.29, -9.41 and -9.24 kcal/mol, respectively. The most potent compound against MCF-7 was TSB, with an IC 50 of 3.9 g/ml. The administration of test compounds suppressed Ki-67 and CDK1, and the best effect was observed at TSB. Our findings suggest that test compounds are applicants to be antibreast cancer agents.
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Sun XB, Liu WW, Wang B, Yang ZP, Tang HZ, Lu S, Wang YY, Qu JX, Rao BQ. Correlations between serum lipid and Ki-67 levels in different breast cancer molecular subcategories. Oncol Lett 2022; 25:53. [PMID: 36644143 PMCID: PMC9827470 DOI: 10.3892/ol.2022.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Breast cancer has the highest incidence rate among all cancer types worldwide, seriously threatening women's health. The present retrospective study explored differences in serum lipid contents in different breast cancer (BC) subcategories and their correlation with Ki-67 expression levels in patients with invasive BC with the aim of identifying novel diagnostic and prognostic indicators for personalized BC treatment. The study included 170 patients diagnosed with BC who were diagnosed with invasive BC by postoperative pathological examination. Data on patient age, body mass index and menopausal status were collected, in addition to estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2) and antigen Ki-67 expression levels and pathological tumor type. Preoperative circulating lipid levels, specifically the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and apolipoproteins A1 (ApoA1) and B (ApoB) were also obtained. Molecular subcategories of BC were grouped based on their immunohistochemistry. Differences in serum lipid levels between the groups were assessed, and correlations between serum lipid and Ki-67 expression levels were explored. While TC, LDL-C, HDL-C and ApoA1 levels differed significantly among molecular subcategories. TG and ApoB levels did not. Circulating TC and LDL-C levels were considerably higher in patients with triple-negative BC (TNBC) and HER2-positive [hormone receptor (HR)-negative] BC than in those with luminal A and B (HER2-negative) BC. Serum HDL-C levels were significantly diminished in the TNBC and HER2-positive (HR-negative) groups compared with the luminal A and B (HER2-negative) groups. ApoA1 levels were significantly reduced in cases of TNBC and HER2-positive (HR-negative) BC compared with luminal A and B BC. Ki-67 expression levels were positively correlated with circulating TC and LDL-C levels and inversely correlated with circulating HDL-C and ApoA1 levels but exhibited no correlation with serum ApoB and TG levels. The results indicate that elevated TC and LDL-C levels and diminished HDL-C and ApoA1 levels were high-risk factors in patients with TNBC and HER2-positive (HR-negative) BC, but not patients with luminal subcategories of BC. Abnormal serum lipid levels were correlated with Ki-67 expression levels, with elevated circulating TC and LDL-C levels and reduced circulating HDL-C and ApoA1 levels indicating a poor prognosis in patients with BC.
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Affiliation(s)
- Xi-Bo Sun
- Department of Breast Surgery, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong 271000, P.R. China
| | - Wen-Wen Liu
- The Second Department of General Surgery, Shanxian Central Hospital, He'ze, Shandong 274300, P.R. China
| | - Bing Wang
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Zhen-Peng Yang
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Hua-Zhen Tang
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Shuai Lu
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Yu-Ying Wang
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Jin-Xiu Qu
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China
| | - Ben-Qiang Rao
- Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, P.R. China,Correspondence to: Professor Ben-Qiang Rao, Department of Gastrointestinal Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, 115 Yangfangdian, Haidian, Beijing 100038, P.R. China, E-mail:
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Mighri N, Mejri N, Boujemaa M, Berrazega Y, Rachdi H, El Benna H, Labidi S, Benna F, Boubaker S, Boussen H, Abdelhak S, Hamdi Y. Association between epidemiological and clinico-pathological features of breast cancer with prognosis, family history, Ki-67 proliferation index and survival in Tunisian breast cancer patients. PLoS One 2022; 17:e0269732. [PMID: 36094928 PMCID: PMC9467370 DOI: 10.1371/journal.pone.0269732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 05/26/2022] [Indexed: 11/19/2022] Open
Abstract
Breast cancer has different epidemio-clinical characteristics in Middle East and North-African populations compared to those reported in the Western countries. The aim of this study is to analyze the epidemiological and clinico-pathological features of breast cancer in Tunisia and to determine prognostic factors with special interest to family history, Ki-67 proliferation index and comorbidity. We retrospectively reviewed epidemiological and clinico-pathological data from patients’ medical records, treated in the Medical Oncology Department at Abderrahmane Mami Hospital, in the period 2011–2015. Data has been collected on 602 breast cancer patients and analyzed using SPSS software V.23.0. Our study showed high fractions of young breast cancer patients and cases with dense breasts. The most prevalent comorbidities observed in the studied cohort were cardiovascular diseases and diabetes. Familial breast cancer was found in 23.3% of cases and was associated with younger age at diagnosis (p<0.001) and advanced stage (p = 0.015). Ki-67 index >20% was significantly associated with early age at diagnosis, lymph node involvement (p = 0.002), advanced tumor grade (p<0.001) and high risk of relapse (p = 0.007). Ki-67 cut-off 30% predicted survival in luminal cases. Survival was worse in patients with triple negative breast cancer compared to non-triple negative breast cancer, inflammatory breast cancer compared to non-inflammatory breast cancer, moderately to poorly differentiated tumors compared to well-differentiated tumors and with positive lymph nodes compared to pN0 (p<0.05). Our study showed new insights into epidemiological and clinico-pathological characteristics of breast cancer that are not well explored in Tunisian population. Considering our findings along with the implementation of electronic health record system may improve patient health care quality and disease management.
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Affiliation(s)
- Najah Mighri
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nesrine Mejri
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Medical Oncology Department, Abderrahman Mami Hospital, Faculty of Medicine Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Maroua Boujemaa
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Yosra Berrazega
- Medical Oncology Department, Abderrahman Mami Hospital, Faculty of Medicine Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Haifa Rachdi
- Medical Oncology Department, Abderrahman Mami Hospital, Faculty of Medicine Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Houda El Benna
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Medical Oncology Department, Abderrahman Mami Hospital, Faculty of Medicine Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Soumaya Labidi
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Medical Oncology Department, Abderrahman Mami Hospital, Faculty of Medicine Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Farouk Benna
- Department of Radiation Oncology, University of Tunis, Tunis, Tunisia
| | - Samir Boubaker
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Hamouda Boussen
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Medical Oncology Department, Abderrahman Mami Hospital, Faculty of Medicine Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Sonia Abdelhak
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, LR20IPT05, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis, Tunisia
- * E-mail:
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Skjervold AH, Pettersen HS, Valla M, Opdahl S, Bofin AM. Visual and digital assessment of Ki-67 in breast cancer tissue - a comparison of methods. Diagn Pathol 2022; 17:45. [PMID: 35524221 PMCID: PMC9074355 DOI: 10.1186/s13000-022-01225-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background In breast cancer (BC) Ki-67 cut-off levels, counting methods and inter- and intraobserver variation are still unresolved. To reduce inter-laboratory differences, it has been proposed that cut-off levels for Ki-67 should be determined based on the in-house median of 500 counted tumour cell nuclei. Digital image analysis (DIA) has been proposed as a means to standardize assessment of Ki-67 staining in tumour tissue. In this study we compared digital and visual assessment (VA) of Ki-67 protein expression levels in full-face sections from a consecutive series of BCs. The aim was to identify the number of tumour cells necessary to count in order to reflect the growth potential of a given tumour in both methods, as measured by tumour grade, mitotic count and patient outcome. Methods A series of whole sections from 248 invasive carcinomas of no special type were immunohistochemically stained for Ki-67 and then assessed by VA and DIA. Five 100-cell increments were counted in hot spot areas using both VA and DIA. The median numbers of Ki-67 positive tumour cells were used to calculate cut-off levels for Low, Intermediate and High Ki-67 protein expression in both methods. Results We found that the percentage of Ki-67 positive tumour cells was higher in DIA compared to VA (medians after 500 tumour cells counted were 22.3% for VA and 30% for DIA). While the median Ki-67% values remained largely unchanged across the 100-cell increments for VA, median values were highest in the first 1-200 cells counted using DIA. We also found that the DIA100 High group identified the largest proportion of histopathological grade 3 tumours 70/101 (69.3%). Conclusions We show that assessment of Ki-67 in breast tumours using DIA identifies a greater proportion of cases with high Ki-67 levels compared to VA of the same tumours. Furthermore, we show that diagnostic cut-off levels should be calibrated appropriately on the introduction of new methodology.
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Affiliation(s)
- Anette H Skjervold
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Erling Skjalgssons gate 1, Trondheim, Norway.
| | - Henrik Sahlin Pettersen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Erling Skjalgssons gate 1, Trondheim, Norway.,Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marit Valla
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Erling Skjalgssons gate 1, Trondheim, Norway.,Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Signe Opdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anna M Bofin
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Erling Skjalgssons gate 1, Trondheim, Norway
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Mohamadien NRA, Sayed MHM. Correlation between semiquantitative and volumetric 18F-FDG PET/computed tomography parameters and Ki-67 expression in breast cancer. Nucl Med Commun 2021; 42:656-664. [PMID: 33560720 DOI: 10.1097/mnm.0000000000001376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To evaluate the relationship between semiquantitative and volumetric parameters on 18F-FDG PET/computed tomography (CT), including maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), tumor to liver ratio (TLR) and tumor to mediastinum ratio (TMR) with the level of Ki-67 expression in breast cancer. PATIENT AND METHODS We retrospectively reviewed 105 female patients with newly diagnosed breast cancer who underwent baseline 18F-FDG PET/CT and had immunohistochemical staining to determine the level of Ki-67 expression. The following PET parameters were measured (SUVmax, SUVmean, MTV, TLG, TLR and TMR) and correlated with level of Ki-67 expression. RESULTS Significant moderate positive correlations were found between the PET parameters (primary SUVmax, SUVmean, TLG, TLR and TMR) and level of Ki-67 expression. The primary SUVmax had the highest correlation coefficient (r = 0.461) followed by TMR (r = 0.455) and P value of <0.001 for both. In ROC analysis, primary SUVmax had the largest area under the curve (0.806, P = 0.0001), with sensitivity of 76.5 % and specificity of 75% for prediction of high Ki-67 level. In univariate analysis, all PET parameters, patient age, tumor grade, molecular subtype, estrogen receptor and progesterone receptor status were significantly associated with Ki-67 level. In multivariate regression analysis, only tumor grade [odds ratio (OR) = 20.460, 95% confidence interval (CI): 11.360-29.559, P = <0.0001], molecular subtype (OR = -21.894, 95% CI: -37.921 to -5.866, P = 0.008), SUVmax (OR = 2.299, 95% CI: 0.703-3.895, P = 0.005) and TLR (OR = -4.908, 95% CI: -9.476 to -0.340, P = 0.035) were found to be the strongest independent predictor factors for the level of Ki-67 expression and hence proliferative activity of malignant cells in breast cancer. CONCLUSION The semiquantitative parameters and volumetric 18F-FDG PET/CT parameter, that is, TLG correlated well with proliferation marker Ki-67 in breast cancer. 18F-FDG PET/CT imaging can be used as a useful noninvasive diagnostic tool in imaging cellular proliferation and hence may substitute for in vitro testing of molecular markers in the diagnoses and staging of breast cancer.
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Affiliation(s)
- Nsreen R A Mohamadien
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine. Assiut University, Assiut, Egypt
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ÇAKIR M, YILDIRIM D, AKTÜRK OM, ERÖZGEN F, EKİNCİ BİCKİCİ B. The Analysis of the effect of ER, PR, HER-2 and Ki-67 index on the number of metastasized axillary lymph node in breast cancer. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2020. [DOI: 10.25000/acem.637992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Cartaxo AL, Estrada MF, Domenici G, Roque R, Silva F, Gualda EJ, Loza-Alvarez P, Sflomos G, Brisken C, Alves PM, André S, Brito C. A novel culture method that sustains ERα signaling in human breast cancer tissue microstructures. J Exp Clin Cancer Res 2020; 39:161. [PMID: 32807212 PMCID: PMC7430012 DOI: 10.1186/s13046-020-01653-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Estrogen receptor α (ERα) signaling is a defining and driving event in most breast cancers; ERα is detected in malignant epithelial cells of 75% of all breast cancers (classified as ER-positive breast cancer) and, in these cases, ERα targeting is the main therapeutic strategy. However, the biological determinants of ERα heterogeneity and the mechanisms underlying therapeutic resistance are still elusive, hampered by the challenges in developing experimental models recapitulative of intra-tumoral heterogeneity and in which ERα signaling is sustained. Ex vivo cultures of human breast cancer tissue have been proposed to retain the original tissue architecture, epithelial and stromal cell components and ERα. However, loss of cellularity, viability and ERα expression are well-known culture-related phenomena. METHODS BC samples were collected and brought to the laboratory. Then they were minced, enzymatically digested, entrapped in alginate and cultured for 1 month. The histological architecture, cellular composition and cell proliferation of tissue microstructures were assessed by immunohistochemistry. Cell viability was assessed by measurement of cell metabolic activity and histological evaluation. The presence of ERα was accessed by immunohistochemistry and RT-qPCR and its functionality evaluated by challenge with 17-β-estradiol and fulvestrant. RESULTS We describe a strategy based on entrapment of breast cancer tissue microstructures in alginate capsules and their long-term culture under agitation, successfully applied to tissue obtained from 63 breast cancer patients. After 1 month in culture, the architectural features of the encapsulated tissue microstructures were similar to the original patient tumors: epithelial, stromal and endothelial compartments were maintained, with an average of 97% of cell viability compared to day 0. In ERα-positive cases, fibers of collagen, the main extracellular matrix component in vivo, were preserved. ERα expression was at least partially retained at gene and protein levels and response to ERα stimulation and inhibition was observed at the level of downstream targets, demonstrating active ER signaling. CONCLUSIONS The proposed model system is a new methodology to study ex vivo breast cancer biology, in particular ERα signaling. It is suitable for interrogating the long-term effects of anti-endocrine drugs in a set-up that closely resembles the original tumor microenvironment, with potential application in pre- and co-clinical assays of ERα-positive breast cancer.
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Affiliation(s)
- Ana Luísa Cartaxo
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica António Xavier, Oeiras, Portugal
| | - Marta F Estrada
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica António Xavier, Oeiras, Portugal
| | - Giacomo Domenici
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica António Xavier, Oeiras, Portugal
| | - Ruben Roque
- IPOLFG, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Fernanda Silva
- CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Emilio J Gualda
- ICFO, Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - Pablo Loza-Alvarez
- ICFO, Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - George Sflomos
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, Ecole polytechnique fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Cathrin Brisken
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, Ecole polytechnique fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Paula M Alves
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica António Xavier, Oeiras, Portugal
| | - Saudade André
- IPOLFG, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Catarina Brito
- iBET, Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal.
- Instituto de Tecnologia Química e Biológica António Xavier, Oeiras, Portugal.
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Kanyılmaz G, Yavuz BB, Aktan M, Karaağaç M, Uyar M, Fındık S. Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors. Eur J Breast Health 2019; 15:256-261. [PMID: 31620685 DOI: 10.5152/ejbh.2019.4778] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/21/2019] [Indexed: 11/22/2022]
Abstract
Objective The clinical feature of breast cancer is very heterogeneous because of the variable prognostic factors impact its behaviour. The aim of study is to find the prognostic importance of Ki-67 and to analyse the correlation between Ki-67 index and the other conventional prognostic factors in breast cancer patients. Materials and Methods Between 2010 and 2017, patients with invasive ductal carcinoma who received radiotherapy after surgery were included in study. A single pathologist re-defined of all cases retrospectively. Ki-67 were established three categories based on Ki-67 levels: low (<10%), intermediate (10-25%) and high (>25%). Results A total of 258 patients were included. 46 of 258 (18%) patients were in low, 82 of 258 (32%) patients were in intermediate and 130 of 258 (50%) patients were in high Ki-67 group. There were no correlations between menopausal status, age, and Ki-67 level. Low-pT stages tended to have low Ki-67 expression (p=0.07). Low-pN stages correlated with low Ki-67 values (p=0.007). Patients with ECE (+) were prone to have higher Ki-67 values (p=0.02). The significant correlation was seen between Ki-67 and tumour grading (p=<0.0001). Patients with LVI (+) had higher Ki-67 expression (p=0.007). Luminal A tumours were correlated with low Ki-67 group (p=<0.0001). Ki-67 values had significant effect on DFS (p=0.03) but not OS (p=0.09). Conclusion This study showed that high Ki-67 expression is associated with higher pT-stage, higher pN-stage, higher grade, ER/PR negativity, HER2/neu positivity, ECE and LVI positivity. The prognostic impact of Ki-67 was only demonstrated for DFS.
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Affiliation(s)
- Gül Kanyılmaz
- Department of Radiation Oncology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Berrin Benli Yavuz
- Department of Radiation Oncology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Meryem Aktan
- Department of Radiation Oncology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mustafa Karaağaç
- Department of Clinical Oncology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mehmet Uyar
- Department of Public Health and Biostatistics, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Sıddıka Fındık
- Department of Pathology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
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Özmen V, Özmen T, Doğru V. Breast Cancer in Turkey; An Analysis of 20.000 Patients with Breast Cancer. Eur J Breast Health 2019; 15:141-146. [PMID: 31312788 DOI: 10.5152/ejbh.2019.4890] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/08/2019] [Indexed: 01/22/2023]
Abstract
Objective Breast cancer is the most common type of cancer and the leading cause of cancer-related deaths in women in Turkey. This study presents the characteristics of patients registered in National Breast Cancer Registry Program of Turkish Federation of Breast Diseases Societies. Materials and Methods The registry contains 242 variables under 10 categories and 699 questions. Patients were recorded (online and offline) from nationwide breast centers around Turkey. Results Twenty-thousand patients were registered between May 2005 and April 2017 at 36 centers. After data cleaning, 19,503 women were included in the study. The median age at diagnosis was 51 [14-97]; 17.2% were younger than 40 and 37.2% were premenopausal; 13.6% were nulliparous. Breast conserving surgery rate was 39.3%. Histopathology was invasive ductal cancer in 77%. Majority of patients had stage II cancer (48.3%). Estrogen, progesterone and HER-2 receptor positivity rates in invasive breast cancer were 72.5%, 62.5% and 21.8%, respectively. The mean tumor diameter was 2.5±1.7 cm. During the mean 51.6 months of follow-up, the local/regional and systemic recurrence rates were 3.7% and 5.2%, respectively; five and 10-year overall survival rates were 86% and 76%. Conclusion Despite increasing number of screening centers and free-of-charge mammography (ages 40 to 69) and mobile screening systems in recent years, a significant portion of patients were diagnosed at advanced stage due to lack of breast cancer awareness. In contrast with the study published 5 years ago, there was a decrease in the rate of pre-menopausal women and an increase in the breast conserving surgery.
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Affiliation(s)
- Vahit Özmen
- Department of Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Tolga Özmen
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Florida, USA
| | - Volkan Doğru
- Department of Surgery, Akdeniz University School of Medicine, Antalya, Turkey
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Wang M, McLaren S, Jeyathevan R, Allanson BM, Ireland A, Kang A, Meehan K, Thomas C, Robinson C, Combrinck M, Harvey J, Sterrett G, Dessauvagie B. Laboratory validation studies in Ki-67 digital image analysis of breast carcinoma: a pathway to routine quality assurance. Pathology 2019; 51:246-252. [DOI: 10.1016/j.pathol.2018.12.416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/15/2018] [Accepted: 12/02/2018] [Indexed: 12/24/2022]
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12
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Lin H, Zhang F, Wang L, Zeng D. Use of clinical nomograms for predicting survival outcomes in young women with breast cancer. Oncol Lett 2019; 17:1505-1516. [PMID: 30675206 PMCID: PMC6341825 DOI: 10.3892/ol.2018.9772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 10/12/2018] [Indexed: 02/05/2023] Open
Abstract
Early-onset breast cancer (BC) has been recognized to be more aggressive compared with its later counterparts. Survival models of BC in young patients have rarely been reported in previous studies. The current study aimed to establish and validate prediction models with clinicopathological variables for visceral metastasis-free survival (VFS), disease-free-survival (DFS) and overall survival (OS) time in young patients with BC. Clinicopathological data were obtained for 351 patients with primary breast tumors who were ≤40 years old. Univariate and multivariate analyses were performed and nomograms were established to screen and illustrate the prognostic factors. Risk scores were calculated based on coefficients from the Cox regression analysis. Internal validation of the prediction models was conducted by predicting the prognosis of cases randomly sampled from the cohort used in the current study. Multivariate analysis demonstrated that N stage (P=0.004), molecular subtype (P=0.007) and age (P=0.005) were significant independent prognostic factors for VFS. Similarly, N stage (P=0.002) and molecular subtype (P=0.001) were significantly associated with DFS. In addition, N stage (P=0.006), molecular subtype (P=0.006) and the presence of an initially inoperable tumor (P=0.005) were significant independent prognostic factors for OS. According to the Cox regression analysis, nomograms were generated to illustrate the effect of independent prognostic factors on VFS, DFS and OS. Risk scores were calculated and internal validation demonstrated the reliability of the prediction models. In conclusion, N stage and molecular subtype were identified as predictors for VFS, DFS and OS in early-onset BC. Furthermore, an age of <35 years at diagnosis was revealed to be unfavorable for VFS and the presence of an initially inoperable tumor was identified to reduce OS time.
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Affiliation(s)
- Hui Lin
- Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
- Correspondence to: Dr Hui Lin, Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, Guangdong 515041, P.R. China, E-mail:
| | - Fan Zhang
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - Luanhong Wang
- Department of Gynecology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - De Zeng
- Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
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13
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Ushimado K, Kobayashi N, Hikichi M, Tsukamoto T, Urano M, Utsumi T. Inverse correlation between Ki67 expression as a continuous variable and outcomes in luminal HER2-negative breast cancer. FUJITA MEDICAL JOURNAL 2019; 5:72-78. [PMID: 35111506 PMCID: PMC8766244 DOI: 10.20407/fmj.2018-021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/24/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Few studies to date have investigated the prognostic significance of Ki67 expression as a continuous variable in breast cancer. This study aimed to evaluate the impact of Ki67 expression as a dichotomous or continuous variable on outcomes in estrogen receptor (ER)+ and human epidermal growth factor receptor 2 (HER2)- breast cancer. METHODS Survival analysis was performed to estimate the likelihood of distant recurrence and death in retrospective data from 794 patients with ER+/HER2- breast cancer. We assessed the relationship between outcomes and two Ki67 cutoffs, 14% and 20%, and the Ki67 labeling index as a continuous variable. RESULTS In univariate analysis, T stage, lymph node involvement, histological grade, progesterone receptor status, and Ki67 expression at the two cutoffs and as a continuous variable were identified as significant prognostic factors for distant disease-free survival (DDFS) and overall survival (OS). There were no statistical differences in DDFS and OS between women with Ki67 expression of <14% and 14-<20%. Multivariate analysis showed that Ki67 expression ≥20% was an independent prognostic indicator for DDFS. Regarding the risk of distant metastasis, the 20% cutoff was more reliable than 14%. We also found that Ki67 expression as a continuous variable was an independent prognostic factor for DDFS and OS in multivariate analyses. CONCLUSIONS High Ki67 expression is associated with a survival disadvantage in patients with ER+/HER2- breast cancer, indicating that these patients might have a higher risk of recurrence after primary treatment and might therefore benefit from individualized treatment.
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Affiliation(s)
- Kaori Ushimado
- Department of Breast Surgery, Fujita Health University,
School of Medicine, Toyoake, Aichi,
Japan
| | - Naomi Kobayashi
- Department of Breast Surgery, Fujita Health University,
School of Medicine, Toyoake, Aichi,
Japan
| | - Masahiro Hikichi
- Department of Breast Surgery, Fujita Health University,
School of Medicine, Toyoake, Aichi,
Japan
| | - Tetsuya Tsukamoto
- Department of Diagnostic Pathology, Fujita Health
University, School of Medicine,
Toyoake, Aichi, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Fujita Health
University, School of Medicine,
Toyoake, Aichi, Japan
| | - Toshiaki Utsumi
- Department of Breast Surgery, Fujita Health University,
School of Medicine, Toyoake, Aichi,
Japan
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14
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Wu J, Chen J, Xi Y, Wang F, Sha H, Luo L, Zhu Y, Hong X, Bu S. High glucose induces epithelial-mesenchymal transition and results in the migration and invasion of colorectal cancer cells. Exp Ther Med 2018; 16:222-230. [PMID: 29896243 PMCID: PMC5995072 DOI: 10.3892/etm.2018.6189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/09/2018] [Indexed: 12/31/2022] Open
Abstract
Diabetes mellitus (DM) is associated with an increased risk of colorectal cancer (CRC). Hyperglycemia, a chronic abnormality in diabetes, is an independent predictor of cancer-associated mortality in CRC. However, the underlying biological mechanism of hyperglycemia in CRC cells is largely unknown. In the present study, HCT-116 and HT-29 cell proliferation, apoptosis, migration and invasion were assessed. In addition, the expression of epithelial (E)-cadherin, vimentin and high-mobility group A protein 2 (HMGA2) were assessed using western blotting. The results demonstrated that high glucose (HG; 30 mmol/l) caused CRC cells to lose their epithelial morphology, with a decrease in E-cadherin and an increase in vimentin, suggesting epithelial-mesenchymal transition (EMT). Furthermore, HG significantly enhanced the cell migration and invasion of CRC cells and the expression of HMGA2. Transfection with HMGA2 small interfering RNA reversed the HG-induced changes to CRC cells. In addition, HG promoted CRC cell proliferation and suppressed apoptosis. The results of the present study suggest that hyperglycemia promotes EMT, proliferation, migration and invasion in CRC cells and may provide novel insights into the link between HG and CRC.
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Affiliation(s)
- Jiayan Wu
- Runliang Diabetes Laboratory, Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Jiayi Chen
- Runliang Diabetes Laboratory, Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Yang Xi
- Runliang Diabetes Laboratory, Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Fuyan Wang
- Runliang Diabetes Laboratory, Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Hongcun Sha
- Department of General Surgery, Ningbo Urology and Nephrology Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315192, P.R. China
| | - Lin Luo
- School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Yabin Zhu
- School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Xiaoming Hong
- Department of General Surgery, Ningbo Urology and Nephrology Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315192, P.R. China
| | - Shizhong Bu
- Runliang Diabetes Laboratory, Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China.,School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
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15
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Gallardo A, Garcia-Valdecasas B, Murata P, Teran R, Lopez L, Barnadas A, Lerma E. Inverse relationship between Ki67 and survival in early luminal breast cancer: confirmation in a multivariate analysis. Breast Cancer Res Treat 2017; 167:31-37. [PMID: 28865009 DOI: 10.1007/s10549-017-4486-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Ki67 is a prognostic marker in early breast cancer, but its real usefulness remains controversial. The standard cut-off values for Ki67 have not been universally accepted and different values may be used depending on the type of biopsy (fine needle biopsy versus surgical specimen biopsy). The objective of this study was to evaluate the prognostic significance of Ki67 and to determine the most accurate prognostic cut-off. MATERIALS AND METHODS 495 tissue samples from patients with luminal tumours who underwent breast surgery between 2005 and 2011 were collected from the Department of Pathology at Hospital de la Santa Creu i Sant Pau, Barcelona. Patients with stage IV, HER2-positive tumours or triple-negative breast carcinoma were excluded from the study. Pathology data including tumour grading and ki67 percentage were obtained retrospectively from clinical records. In all cases, the percentage of ki67 was evaluated in fine needle biopsies. RESULTS In the multivariate analysis, Ki67 as a continuous variable was associated with poor overall survival (OS) and cancer-specific survival (CSS) (OS p = 0.0001, HR 1.037, CI 1.014-1.059; CSS p = 0.0001, HR 1.063, CI 1.031-1.096) (Cox regression model). CSS was poor when associated with a KI67 cut-off point >14% (p = 0.013, HR 14.85; CI 1.074-120.53) (Cox regression model). Disease-free survival (DFS) was not associated with Ki67 CONCLUSIONS: Prognosis of luminal breast carcinoma can be predicted using Ki67 as a continuous variable and a standard cut-off value of 14%. Information about the specimen type used to determine ki67 should be recorded in the pathological report.
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Affiliation(s)
- Alberto Gallardo
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Sant Quinti 87-89, 08041, Barcelona, Spain.
| | | | - Paola Murata
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Rolando Teran
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Sant Quinti 87-89, 08041, Barcelona, Spain
| | - Laura Lopez
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Sant Quinti 87-89, 08041, Barcelona, Spain
| | - Agusti Barnadas
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Enrique Lerma
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Sant Quinti 87-89, 08041, Barcelona, Spain
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16
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Ding L, Zhang Z, Xu Y, Zhang Y. Comparative study of Her-2, p53, Ki-67 expression and clinicopathological characteristics of breast cancer in a cohort of northern China female patients. Bioengineered 2017; 8:383-392. [PMID: 28075663 DOI: 10.1080/21655979.2016.1235101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The objective was to study the relationship among Her-2, Ki-67, p53 expression and the clinicopathologic characteristics of breast cancer in the patients of northern China. Expression of Her-2, Ki-67, p53 and clinical characteristics of 260 breast cancer patients were retrospectively studied. Her-2 overexpression led to higher incidence rates of infiltrating ductal carcinoma and axillary lymph node metastasis, bigger diameters of the primary tumors, later pTNM staging, and a lower incidence rate of ductal carcinoma in situ (p < 0.05). High expression of ER and PR led to fewer patients classified histologically in higher grade (p = 0.001), while high expression of Ki-67 and p53 caused more patients classified histologically in higher grade (p = 0.001). In patients histologically classified in grade 1 and 2, the expression of Ki-67 and p53 was significantly (p = 0.001) higher, and the expression of ER and PR was significantly lower, in Her-2 positive patients than Her-2 negative patients. Breast cancer with Her-2 overexpression was more likely to recur and metastasize than Her-2 negative breast cancer. Higher coincidence of high expression of p53 and Ki-67 with Her-2 overexpression and more progressed tumors suggested that in addition to p53, Ki-67 might also be a prognostic biomarker of breast cancer.
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Affiliation(s)
- Li Ding
- a Department of Oncology , Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Zijin Zhang
- a Department of Oncology , Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Yan Xu
- a Department of Oncology , Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Yongqiang Zhang
- a Department of Oncology , Beijing Hospital, National Center of Gerontology , Beijing , China
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17
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Guestini F, McNamara KM, Ishida T, Sasano H. Triple negative breast cancer chemosensitivity and chemoresistance: current advances in biomarkers indentification. Expert Opin Ther Targets 2015; 20:705-20. [PMID: 26607563 DOI: 10.1517/14728222.2016.1125469] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Triple negative breast cancer (TNBC) is a heterogeneous clinicopathological entity constituting approximately 15 - 20% of all breast cancer (BC) patients. It shows high recurrence rate and poor prognosis. At this juncture, because of the lack of specific targeted therapies available and the development in patients of resistance to some therapeutic agents, clinical and translational settings have gained importance over the past decades. AREAS COVERED The development of novel, safe and effective alternatives for the treatment of TNBC are in high demand. Therefore, this review aims to summarize the state of the art of TNBC, its current therapies and potential therapeutic targets. In particular, focus is put on recent advances regarding the identification of emerging biomarkers as prognostic and/or predictive markers, including surrogate markers for molecular tumor subtyping and identifying potential responders to new therapies. EXPERT OPINION Effective development of informative markers could constitute an important armamentarium tool for identifying appropriate therapies to challenge the aggressiveness of TNBC.
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Affiliation(s)
- Fouzia Guestini
- a Department of Anatomic Pathology , Tohoku University School of Medicine , Aoba-ku, Sendai , Japan
| | - Keely May McNamara
- a Department of Anatomic Pathology , Tohoku University School of Medicine , Aoba-ku, Sendai , Japan
| | - Takanori Ishida
- b Department of Surgical Oncology , Tohoku University Graduate School of Medicine , Aoba-ku , Sendai , Japan
| | - Hironobu Sasano
- a Department of Anatomic Pathology , Tohoku University School of Medicine , Aoba-ku, Sendai , Japan
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18
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Tsai KW, Li GC, Chen CH, Yeh MH, Huang JS, Tseng HH, Fu TY, Liou HH, Pan HW, Huang SF, Chen CC, Chang HY, Ger LP, Chang HT. Reduction of global 5-hydroxymethylcytosine is a poor prognostic factor in breast cancer patients, especially for an ER/PR-negative subtype. Breast Cancer Res Treat 2015; 153:219-34. [PMID: 26253945 DOI: 10.1007/s10549-015-3525-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 07/29/2015] [Indexed: 11/28/2022]
Abstract
DNA methylation at the 5 position of cytosine (5 mC) is an epigenetic hallmark in cancer. The 5 mC can be converted to 5-hydroxymethylcytosine (5 hmC) through a ten-eleven-translocation (TET). We investigated the impact of 5 mC, 5 hmC, TET1, and TET2 on tumorigenesis and prognosis of breast cancer. Immunohistochemistry was used to assess the levels of 5 mC, 5 hmC, TET1, and TET2 in the corresponding tumor adjacent normal (n = 309), ductal carcinoma in situ (DCIS, n = 120), and invasive ductal carcinoma (IDC, n = 309) tissues for 309 breast ductal carcinoma patients. 5 mC, 5 hmC, TET1-n, and TET2-n were significantly decreased during DCIS and IDC progression. In IDC, the decrease of 5 hmC was correlated with the cytoplasmic mislocalization of TET1 (p < 0.001) as well as poor disease-specific survival (DSS) (adjusted hazard ratio [AHR] 1.95, p = 0.003) and disease-free survival (DFS) (AHR 1.91, p = 0.006). The combined decrease of 5 mC and 5 hmC was correlated with worse DSS (AHR 2.19, p = 0.008) and DFS (AHR 1.99, p = 0.036). Stratification analysis revealed that the low level of 5 mC was associated with poor DSS (AHR 1.89, p = 0.044) and DFS (AHR 2.02, p = 0.035) for the ER/PR-positive subtype. Conversely, the low level of 5 hmC was associated with worse DSS (AHR 2.77, p = 0.002) and DFS (AHR 2.69, p = 0.006) for the ER/PR-negative subtype. The decreases of 5 mC, 5 hmC, TET1-n, and TET2-n were biomarkers of tumor development. The global reduction of 5 hmC was a poor prognostic factor for IDC, especially for ER/PR-negative subtype.
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Affiliation(s)
- Kuo-Wang Tsai
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, 81362, Kaohsiung, Taiwan
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Yu DD, Wu Y, Shen HY, Lv MM, Chen WX, Zhang XH, Zhong SL, Tang JH, Zhao JH. Exosomes in development, metastasis and drug resistance of breast cancer. Cancer Sci 2015; 106:959-64. [PMID: 26052865 PMCID: PMC4556383 DOI: 10.1111/cas.12715] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/25/2015] [Accepted: 06/03/2015] [Indexed: 02/06/2023] Open
Abstract
Transport through the cell membrane can be divided into active, passive and vesicular types (exosomes). Exosomes are nano-sized vesicles released by a variety of cells. Emerging evidence shows that exosomes play a critical role in cancers. Exosomes mediate communication between stroma and cancer cells through the transfer of nucleic acid and proteins. It is demonstrated that the contents and the quantity of exosomes will change after occurrence of cancers. Over the last decade, growing attention has been paid to the role of exosomes in the development of breast cancer, the most life-threatening cancer in women. Breast cancer could induce salivary glands to secret specific exosomes, which could be used as biomarkers in the diagnosis of early breast cancer. Exosome-delivered nucleic acid and proteins partly facilitate the tumorigenesis, metastasis and resistance of breast cancer. Exosomes could also transmit anti-cancer drugs outside breast cancer cells, therefore leading to drug resistance. However, exosomes are effective tools for transportation of anti-cancer drugs with lower immunogenicity and toxicity. This is a promising way to establish a drug delivery system.
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Affiliation(s)
- Dan-dan Yu
- The First Clinical School of Nanjing Medical University, Nanjing, China.,Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Ying Wu
- The First Clinical School of Nanjing Medical University, Nanjing, China.,Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Hong-yu Shen
- Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Meng-meng Lv
- The First Clinical School of Nanjing Medical University, Nanjing, China
| | - Wei-xian Chen
- The First Clinical School of Nanjing Medical University, Nanjing, China.,Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Xiao-hui Zhang
- Center of Clinical Laboratory, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Shan-liang Zhong
- Center of Clinical Laboratory, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Jin-hai Tang
- Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Jian-hua Zhao
- Center of Clinical Laboratory, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
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