AKR1B10 as a Potential Novel Serum Biomarker for Breast Cancer: A Pilot Study

Background

Aldo-keto reductase 1B10 (AKR1B10) is a secretory protein that is upregulated in breast cancer.

Objective

This case-controlled pilot study evaluated the serum level of AKR1B10 in healthy women and patients with a localized or metastatic breast cancer.

Methods

AKR1B10 levels were measured by ELISA and IHC in several patient cohorts.

Results

Our data showed that serum AKR1B10 was significantly elevated in patients with localized (6.72 ± 0.92 ng/ml) or metastatic (7.79 ± 1.13 ng/ml) disease compared to cancer-free healthy women (1.69 ± 0.17 ng/ml) (p<0.001); the serum AKR1B10 was correlated with its expression in tumor tissues, but not with the tumor burden, molecular subtypes or histological stages. After surgical removal of primary tumors, the serum AKR1B10 was rapidly decreased within 3 days and plateaued at a level similar to that of healthy controls in most patients. ROC curve analysis suggested the optimal diagnostic cut-off value of serum AKR1B10 at 3.456 ng/ml with AUC 0.9045 ± 0.0337 (95% CI 0.8384 - 0.9706), sensitivity 84.75% (95% CI 73.01% to 92.78%), and specificity 93.88% (95% CI 83.13% to 98.72%).

Conclusions

These data indicate the potential value of serum AKR1B10 as a biomarker of breast cancer.

An Investigation of a Cultural Help-Seeking Model for Professional Psychological Services With U.S. and Chinese Samples

Help-seeking processes for participants in the People’s Republic of China and the United States were modeled in the present study. The decision to seek professional services for mental health problems (e.g., psychotherapy) has been primarily studied by applying principles from the theory of planned behavior and reasoned action (TPB). Application of the TPB has commonly been used with a three-level empirical model of help-seeking, whereby expectations/barriers to help-seeking predict attitudes toward therapy, which in turn predicts intentions and behaviors to seek professional help. Informed by the TPB, the present study added a cultural-contextual level to the model to account for the role of cultural identity variables, which included independent and interdependent self-construal as well as gender. The resulting four-level model, the cultural help-seeking (CHS) model, was compared with the conventional three-level help-seeking model using data collected from 296 college students from Mainland China and 334 college students from the United States. Separate analyses were conducted for the Chinese group and American group. Chinese versions of the questionnaires were developed for the present study using translation and back-translation procedures. Using structural regression modeling, the four-level CHS model provided a better fit than the three-level traditional model for both the U.S. and Chinese samples. However, the specific decisional pathways within this four-level model were structurally different for the U.S. and Chinese samples. Findings suggest that including cultural-contextual variables as a first level of the professional help-seeking model is supported by both samples.

Analysis of AKR1B10 levels among various groups of breast cancer patients

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Background: Aldo-keto reductase 1B10 (AKR1B10) is a protein that is primarily expressed in human colon and small intestine, but induced in hepatocellular carcinoma and non-small cell lung cancer. Our recent studies have revealed that AKR1B10 is overexpressed in primary, metastatic, and recurrent cancers of the breast.

Methods: We recruited four cohorts of patients: Patients with breast cancer undergoing primary surgery from whom we procured breast cancer and matched normal adjacent tissue to evaluate AKR1B10 expression in primary tumors. The matched serum samples were collected before surgery and at various time points after the surgery (approximately 3 days, 7 days, and 1 month Patients with recurrent or advanced (metastatic) breast cancer. Serum samples were collected and serially monitored for up to 2years before and during metastatic therapy and correlated with RECIST measurements. Patients with locally advanced disease undergoing neoadjuvant chemotherapy. AKR1B10 serum levels were monitored during therapy and correlated with RECIST measurements. Healthy individuals with normal mammograms were recruited and submitted serum samples for AKR1B10 serum measurements. Results: AKR1B10 rapidly cleared the serum of early stage breast cancer patients with an estimated half-life of 24-30 hours. Serum AKR1B10 levels correlated strongly with tissue IHC staining and PR positivity but not with RECIST levels or Oncotype Dx scores. Neoadjuvant chemotherapy did not affect serum AKR1B10 levels. Individuals with normal mammograms displayed substantially lower levels of AKR1B10 than breast cancer patients. Patients with DCIS also displayed elevated serum AKR1B10 levels.

Conclusions: AKR10 may serve as tumor marker to independently identify high risk patients whose tumors have intermediated risk Oncotype Dx scores and may also identify early breast cancers in patients with equivocal breast biopsies.

Helping Skills Training for Undergraduate Students

We examined the effectiveness of the Hill model of helping skills training for 191 undergraduate students in six sections of a semester-long course. Students completed self-report, performance, and nonverbal measures at the beginning; they conducted one 20-min helping session at the beginning and another toward the end of the semester; and they completed self-efficacy measures at the end of the semester. Students’ helping skills improved over the course of the semester, as evidenced by higher helper- and volunteer client–rated session quality, reduced proportion of words spoken in sessions, increased proportion of exploration skills used in sessions, and increased self-efficacy for using helping skills. Self-reported empathy predicted four of the five helping skills criteria at the beginning-of-semester assessment. Facilitative interpersonal skills predicted end-of-semester self-efficacy in helping skills when controlling for retrospective prelevels and instructor effects. Implications for training and research are presented.

A randomized, placebo-controlled study of rofecoxib with paracetamol in early post-tonsillectomy pain in adults

BACKGROUND AND OBJECTIVE

Effective and early treatment of postoperative pain and nausea have become pivotal for the early discharge of patients after tonsillectomy. Opioid-based analgesia is standard practice but the use of non-steroidal anti-inflammatory drugs is discouraged due to their platelet inhibiting properties. The cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drugs are effective analgesics and do not affect platelet function. We hypothesized that premedication with cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug in addition to paracetamol would provide effective analgesia and decrease opioid consumption during early recovery from tonsillectomy.

METHODS

In a randomized, placebo-controlled study of adult tonsillectomy patients (n=40) one group (R-group; n=20) was premedicated with paracetamol 1.5 g and rofecoxib 50 mg and a control group (P-group; n=20) was premedicated with paracetamol 1.5 g and placebo. Morphine was used as rescue medication. Postoperative (24 h) pain scores (0--10), morphine consumption as well as intraoperative blood loss were recorded.

RESULTS

We found no overall difference in pain scores between the groups but significantly more patients in the placebo group had pain scores >5 within the first 8 h. The rofecoxib group consumed less morphine during the first 12 h. A lower intraoperative blood loss was observed in the rofecoxib group.

CONCLUSION

Our results suggest an early although clinically minor analgesic benefit of the addition of a cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug to paracetamol as premedication for adult tonsillectomy.

Effect of a community action program on adult quit smoking rates in rural australian towns: the CART project

BACKGROUND

This article describes one outcome of a randomized controlled trial of community action for cancer prevention. The aims of this article were to (a) explore the effectiveness of a community action program in decreasing community smoking rates in rural Australian towns and (b) describe the relationship between adult smoking quit and uptake rates and demographic variables.

METHODS

In 1992, 20 towns were selected for randomization. Community action involved formation of community committees and utilization of access point networks to initiate and maintain intervention strategies. At post-test, outcomes were proportion of "quitters" from a cohort of self-described smokers, proportion of "uptakers" from a cohort of self-described nonsmokers, and "net effect."

RESULTS

Differences in quit rate, uptake rate, and net effect for intervention compared to control condition favored the intervention in all cases, although mainly nonsignificant. Significantly more male smokers quit in intervention towns than in control towns [7.0% (95% CI: 0.6, 13.5)].

CONCLUSIONS

Given that CART utilized and improved upon strategies argued as effective in the literature, the limited success of the project in reducing adult smoking, considered in combination with COMMIT findings, suggests the need for further innovation in the field.

Community action for health promotion: a review of methods and outcomes 1990-1995

OBJECTIVE

Our objective was to explore the effectiveness of community action as a strategy for health promotion, through a critical review of five years of community action evaluation literature.

METHODS

Community action was defined as a health promotion, program that involved the community in implementation and control of the process of the program. Criteria for scientific evaluation of programs were proposed for sampling and control procedures, reliability and validity of instruments, analysis techniques, and specification of details of the intervention. A critical review of the literature, located by an on-line and related reference search, was undertaken for community action aimed at reducing cancer and cardiovascular disease, between January 1990 and May 1995.

RESULTS

None of seven community action studies (17 articles) that examined cancer risk factors fulfilled all the criteria for rigorous scientific evaluation. The most methodologically adequate cancer study, the COMMIT intervention, had only a moderate degree of success in reducing community smoking rates. Similarly, none of the six studies (25 articles) on cardiovascular disease fulfilled all the criteria. The results for the most methodologically adequate study, the Minnesota Heart Health Program, were disappointing, with strong secular trends preventing adequate assessment of the intervention effect.

CONCLUSIONS

The finding that none of the reviewed studies met all evaluation criteria was due to several factors, including political considerations, feasibility, and the continued evolution of the science of evaluation in health promotion. Some important questions are posed for researchers by the failure of methodologically superior projects, such as COMMIT, to show major gains in reducing health risk behaviors.