Construction of an oxidative stress-associated genes signature in breast cancer by machine learning algorithms

OBJECTIVE

To construct a prognostic model of a breast cancer-related oxidative stress-related gene (OSRG) signature using machine learning algorithms.

METHODS

The OSRGs of breast cancer were constructed by least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analysis. The Cancer Genome Atlas (TCGA) was used to analyse the gene expression and prognostic value. The Human Protein Atlas was used to analyse the protein expression of hub genes. Receiver operating characteristic analysis, calibration curve and decision curve analysis were used to predict the stability of this model.

RESULTS

The area under the curve of 1-, 3- and 5-year overall survival were 0.751, 0.707 and 0.645 in the TCGA training dataset; and 0.692, 0.678 and 0.602 in the TCGA testing dataset, respectively. Calibration plot showed good agreement between predicted probabilities and observed outcomes. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis (GSEA) pathway analysis indicated that multiple cancer-related pathways were highly enriched in the high-risk group. Immune infiltration analysis showed immune cells and their functions may play a key role in the development and mechanism of breast cancer.

CONCLUSIONS

This new OSRG signature was associated with the immune infiltration and it might be useful in predicting the prognosis in patients with breast cancer.

[Call attention to the overall benefit of digital pathology and promote its development]

The successful operation of the complete digital pathology(CDP) in foreign countries indicates that the full digital pathology process has entered the full implementation stage. Digital pathology in China started late and progressed slowly, so far there has not been a truly meaningful CDP. The pathologist's understanding of digital pathology is not comprehensive enough, and there are still doubts about the time efficiency and cost effectiveness of digital pathology processes. Therefore,a comprehensive analysis of the process, overall advantages and cost-effectiveness of CDP was made by drawing on international successful experience and hands-on practice experience, in order to promote the construction and development of the CDP in our country.

Bioinformatics screening of gene expression profile and diagnostic application of meningeal carcinoma

OBJECTIVE

The aim of this study was to research gene expression profiles and diagnostic applications of meningeal carcinoma based on bioinformatics.

MATERIALS AND METHODS

We used the Gene Expression Omnibus (GEO) database to obtain the GSE43290 dataset based on the expression data of normal meninges and meningiomas consisting of 51 samples divided into two groups (47 samples of meningioma tumors and four samples of normal meninges). We used the GEO2R tool to identify differentially expressed genes (DEGs) by setting the log2 fold change as greater than two and an adjusted p-value lower than 0.05. We used the database for annotation, visualization and integrated discovery (DAVID) to perform gene ontology, biological pathways and functional annotation of the DEGs. A search Tool for the Retrieval of Interacting Gene database (STRING) was used to obtain Protein-Protein Interaction (PPI) and modular networks based on the Markov clustering algorithm.

RESULTS

Our study identified 358 significant DEGs, of which 343 were downregulated genes while 15 were upregulated. Five significant hub genes (CXCL8, AGT, CXCR4, CXCL12 and CXCL2) were associated with various biological pathways, molecular functions and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The DEGs were enriched in biological pathways of chemokine-mediated signaling, positive regulation of leukocyte chemotaxis, second messenger-mediated signaling, induction of positive chemotaxis, CXCR chemokine receptor binding and activities of cytokines.

CONCLUSIONS

These hub genes and pathways could be targeted in clinical research to discover new treatments for meningeal carcinoma.

[The trend of accurate pathology diagnosis of breast cancer]

Accurate pathology diagnosis of breast cancer is the premise of personalized treatment. In recent years, the pathology diagnosis of breast cancer have been updated and optimized to provide better guidance and basis for clinical treatment. In this paper, we provide an overview on the advances in histological classification of breast cancer, the progress of biomarker detection related to novel antibody-drug conjugates and immunotherapy in breast cancer, the pathology evaluation of breast cancer specimen after neoadjuvant therapy and sentinel lymph nodes, the progress of genetic testing in breast cancer, and the application of artificial intelligence in breast pathology.

Depressive symptoms increase the risk of falls and injurious falls in Chinese adults aged ≥ 45 years: A 3-year cohort study

Background

Falls and depressive symptoms are both public health concerns in China, but the effects of depressive symptoms on falls and injurious falls have not been thoroughly investigated.

Methods

This population-based prospective cohort study used data derived from adults aged ≥45 years acquired from the 2015 and 2018 China Health and Retirement Longitudinal Study. Data were analyzed from August 2021 to December 2021. Self-reported depressive symptoms were determined using a 10-item Center for Epidemiologic Studies Depression scale (CESD-10) with a total score range of 0-30. Item responses of 3-4 or 5-7 days were deemed indicative of specific depressive symptoms. The outcome variables were self-reported accidental falls and injurious falls.

Results

Of the 12,392 participants included in the study, 3,671 (29.6%) had high baseline depressive symptoms (CESD-10 scores ≥ 10), 1,892 (15.3%) experienced falls, and 805 (6.5%) experienced injurious falls during 2015-2018 follow-up. High depressive symptoms increased the risk of falls [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.19-1.50] and injurious falls (OR 1.28, 95% CI 1.09-1.51) in a multivariable logistic regression model adjusted for major demographic, health-related, and anthropometric covariates. All of the 10 specific depressive symptoms except "felt hopeless" were associated with falls, and four specific symptoms significantly increased the risk of injurious falls; "had trouble concentrating" (OR 1.32, 95% CI 1.13-1.55); "felt depressed" (OR 1.32, 95% CI 1.12-1.55); "everything was an effort" (OR 1.23, 95% CI 1.04-1.45); and "restless sleep" (OR 1.18, 95% CI 1.02-1.40).

Conclusion

High depressive symptoms are significantly related to risk of falls and injurious falls. Four specific symptoms (had trouble concentrating, felt depressed, everything was an effort, and restless sleep) increase the risk of injurious falls in Chinese adults aged ≥ 45 years.

[Clinical observation of 8 cases with central nervous system anaerobic infection diagnosed by metagenomic next-generation sequencing of cerebrospinal fluid]

The current study summarized the clinical characteristics of 8 patients with central nervous system anaerobic infections who visited the Second Hospital of Hebei Medical University from June 2019 to June 2021. Among the 8 patients, 7 cases had headache and fever as the first symptoms, and 1 case had left-sided limb weakness as the first symptom. Four patients had a previous history of diabetes (1 patient had a history of tooth extraction before the onset of the disease), 1 patient had a previous history of sinusitis, 1 patient had a history of tooth extraction before the onset of the disease, and 2 patients had chronic extensive periodontitis or periapical periodontitis. Five cases showed abnormal intracranial and/or meningeal enhancement on cranial magnetic resonance imaging (MRI), and 1 case showed swelling of the whole brain tissue on cranial computed tomography (CT). After treatment, symptoms of 4 cases were improved, symptoms of 1 case were aggravated, and 3 cases died. Anaerobic infections can occur in various parts of the body:the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin and soft tissues. It is generally believed that anaerobic bacteria rarely cause central nervous system infection, therefore, anaerobic culture of cerebrospinal fluid is usually not performed. Moreover, anaerobic culture is affected by many factors, and thus it is difficult to obtain positive results. Metagenomic next-generation sequencing can identify multiple pathogens (viral, bacterial, fungal, or parasitic) from samples based on DNA and/or RNA sequences and has advantages in diagnosing anaerobic infections of the central nervous system. Prompt empirical antimicrobial therapy is essential for the prognosis of the patients.

[Diagnostic value of MDM2 RNA in situ hybridization in atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma]

Objective: To investigate the value of MDM2 RNA in situ hybridization (RNA-ISH) in diagnosing atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and dedifferentiated liposarcoma (DDL). Methods: A total of 26 ALT/WDL/DDLs diagnosed from March 2017 to May 2019 in West China Hospital, Sichuan University, Chengdu, China and 18 control cases were included. MDM2 RNA-ISH was performed on all samples and compared with the fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) regarding their performance in detecting MDM2. Results: All samples were detected successfully using the three methods. Among 26 ALT/WDL/DDLs, all cases showed MDM2 amplification and positivity for MDM2 RNA-ISH (26/26, 100%). Twenty-four (24/26, 92.3%) of the 26 tested cases were positive for MDM2 IHC while two of them were negative. Eighteen control cases were all negative for MDM2 FISH and RNA-ISH, and 15 (15/18) cases were negative for MDM2 IHC. The sensitivity and specificity of RNA-ISH were both 100%, and those of MDM2 IHC were 92.3% and 83.3%, respectively. Diffuse staining was identified in all MDM2 RNA-ISH positive ALT/WDL/DDLs, but identified in only 8/24 (33.3%) of the MDM2 IHC positive cases. Among the 11 ALT/WDL/DDL samples evaluated on tissue microarray, the positive rate of MDM2 RNA-ISH was 100% with diffuse staining in all cases. The positive rate of MDM2 IHC was 9/11 while only 1 of the 9 cases showed diffuse staining. The result of MDM2 RNA-ISH was identical to that of MDM2 FISH and was overall consistent with that of MDM2 IHC (Kappa=0.763, P<0.001). Conclusions: In ALT/WDL/DDLs, results of MDM2 RNA-ISH are highly consistent with those of FISH. MDM2 RNA-ISH is more sensitive and more specific and has more diffuse positive signals than the IHC. The findings indicate that MDM2 RNA-ISH is highly valuable for the diagnosis and differential diagnosis of ALT/WDL/DDLs.

[Cerebrospinal fluid TP53 gene mutation in patients with lung cancer associated meningitis and its clinical implications]

Objective: To observe the role of cerebrospinal fluid (CSF) TP53 gene mutation in lung cancer associated meningitis. Methods: A retrospective analysis was performed on 35 patients diagnosed with lung cancer associated meningitis at the Second Hospital of Hebei Medical University from December 2015 to December 2018.All patients underwent the next-generation sequencing of CSF, and TP53 gene was found to be mutant or wild type, including 23 patients with TP53 mutant type and 12 patients with TP53 wild type. The clinical characteristics, CSF leukocyte, protein, glucose, chloride, Karnofsky performance (KPS) and overall survival were observed. Results: Headache, nausea and vomiting were the main clinical manifestations in both groups.There were no significant differences in CSF pressure, leukocyte, biochemical indicators and KPS between the two groups. The average time from diagnosis of lung cancer to diagnosis of lung cancer associated meningitis in the TP53 mutant group was significantly shorter than that in the TP53 wild type group (5.79 months vs 25.5 months).The median survival time of patients in the TP53 mutant group from lung cancer diagnosis to the observation endpoint was 19.77 months, while it was 88.73 months in the TP53 wild type group, and the difference was statistically significant (P=0.043). Conclusions: Mutation in the tumor suppressor gene TP53 can be detected in the CSF of patients with lung cancer associated meningitis. Patients with such mutation have earlier meningeal metastasis and shorter median survival time.

[Imaging characteristics of patients with large vestibular aqueduct syndrome and its relationship with the acoustically evoked short latency negative response]

Objective: To explore the imaging characteristics of large vestibular aqueduct syndrome (LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR), so as to provide reference for the diagnosis of LVAS. Methods: Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University, from October 2009 to December 2017 were retrospectively analyzed, including 117 males and 57 females, aged from 5 months to 47 years old, with the median age of 4 years and 4 months. ABR and imaging data of patients were collected. Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images, the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images. The correlation between the above measurements was analyzed by Pearson test using SPSS 17.0. According to whether ASNR was detected in ABR, the above data were divided into two groups, and the differences of the above imaging measurements were compared by the Independent-Sample Test. Results: The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (x±s, the following was the same), and the outlet diameter was (3.07±0.99) mm on CT; the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39±1.37) mm, and the extraosseous parts was (2.50±2.18) mm on MRI. There was a correlation between the four measurements (P<0.05), among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (r=0.760), and the remaining pairs were weakly correlated. ASNR was detected in 241 ears (72.16%,241/334) and undetected in 93 ears (27.84%, 93/334) of the 334 ears with LVAS. Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group, and the difference was statistically significant (t value was 2.814 and 2.754, P<0.05). There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups, and the difference was no statistically significant(t value was 0.101 and 0.683, P>0.05). Conclusions: There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients. There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac. The smaller the diameter of vestibular aqueduct, the lower the occurrence rate of ASNR.

[Comparison of different massive parallel sequencing platforms for mutation profiling in formalin-fixed and paraffin-embedded samples]

Objective: To compare the performance of Miseq and Ion Torrent PGM platforms and library construction method for next-generation sequencing (NGS) technology for formalin-fixed and paraffin-embedded (FFPE) samples. Methods: A total of 204 FFPE cancer samples including 100 non-small cell lung cancers at the First Affiliated Hospital of Zhejiang University, and 104 colorectal cancers at West China Hospital of Sichuan University were retrospectively selected from January 2013 to December 2016. By using the same samples, DNA was extracted, and the same amount of DNA was used for library construction with the same kit, and sequenced on Miseq and Ion Torrent PGM respectively, after passing the quality control. Any discordant mutations between two platforms were validated by amplified refractory mutation system-polymerase chain reaction (ARMS-PCR) method and Sanger sequencing. Results: A total of 204 FFPE samples were included and 197 samples were successfully analyzed by both platforms. The number of reads generated by the samples on Miseq platform sequencing was higher than PGM platform (median 391 634 vs. 298 030, P<0.01). Alignment with human reference genome showed that the mapping rate of Miseq platform was higher than PGM platform (median 100.0% vs. 99.7%, P<0.01). The median sequence depth of samples on Miseq was higher than PGM platform (median 853× vs. 698×, P<0.01). A total of 236 mutations were detected by two platforms, of which 221 were detected on both platforms, with a 93.6% concordance. Miseq platform detected 11 mutations not detected on PGM platform, while PGM platform detected 4 more mutations not detected on Miseq platform. With validation by ARMS-PCR and Sanger sequencing, Miseq platform was more reliable for low-frequency mutations. The main reasons for the discordant mutations between two platforms were that mutation frequency on undetected platform was lower than mutation reporting range (5%) and FFPE samples were stored for a long time. Conclusions: Compared with PGM, Miseq platform shows higher sequencing quality in terms of the number of reads, alignment results and coverage depth, and the test results are more reliable. In clinical practice, the appropriate platform should be chosen based on sample size and actual throughput requirements to aid in the molecular characterization of tumors.

Linking seed germination and plant height: a case study of a wetland community on the eastern Tibet Plateau

Seed germination is the earliest trait expressed in a plant's life history, and it can directly affect the expression of post-germination traits. Plant height is central to plant ecological strategies, because it is a major determinant of the ability of a species to compete for light. Thus, linking seed germination and plant height at the community level is very important to understanding plant fitness and community structure. Here, we tested storage condition and temperature requirements for germination of 31 species from a wetland plant community on the eastern Tibet Plateau and analysed correlation of germination traits with plant height in relation to storage condition. Germination percentage was positively related to plant height, and this relationship disappeared when seeds were incubated at a low temperature (i.e. 5 °C) or after they were stored under wet-cold conditions. The response of seeds to dry+wet-cold storage was negatively related to plant height. Based on the scores of each species on the first two principal components derived from PCA, species were classified into two categories by hierarchical clustering, and there was a significant difference between germination and plant height of species in these two categories. These results suggest that the requirements for seed germination together with seasonal change in environmental conditions determine the window for germination and, in turn, plant growth season and resource utilisation and ultimately plant height.

[Feasibility of amplicon-based targeted next-generation sequencing of colorectal cancer in endoscopic biopsies]

Objective: To investigate whether small endoscopic biopsies of colorectal cancer were sufficient for quality and accurate mutational analysis by amplicon-based next-generation sequencing (NGS). Methods: By using an amplicon-based targeted NGS panel for mutational detection on Illumina Miseq platform, a total of 109 formalin-fixed and paraffin-embedded (FFPE) endoscopic biopsies of colorectal cancer were retrospectively selected, based on specific histopathologic criteria, from January 2012 to June 2016 at West China Hospital of Sichuan University and Peking University Third Hospital. Twelve of these biopsies had corresponding FFPE surgical resection specimens. Quality control parameters of NGS testing were analyzed and NGS results were confirmed by other methods. Mutation calls of the 12 paired endoscopic biopsies and surgical resections were compared. Results: Of the endoscopic biopsy specimens, 97.2% (106/109) had sufficient DNA and qualified sequencing library. NGS generated excellent sequencing data, with a median of 848× for median read depth and 95.7% for uniformity. The success rate of NGS was 95.4% (104/109). Conventional methods confirmed the results of NGS for KRAS and BRAF, and the concordance rate was 100.0%. The clinically actionable mutations detected in the 12 paired endoscopic biopsies and surgical resections were concordant. Conclusion: FFPE endoscopic biopsies of colorectal cancer is suitable for targeted NGS, providing quality sequencing data and accurate mutational information to guide targeted therapy.

[Ki-67 expression and its effect on response to neo-adjuvant chemotherapy in invasive breast cancer]

Objective: To investigate the response to neoadjuvant chemotherapy (NAC) among different molecular subtypes of breast cancers using molecular classification with Ki-67 (ER+ PR+ HER2+ Ki-67) or without Ki-67 (ER+ PR+ HER2). Methods: One hundred and twenty-seven cases of invasive breast cancer confirmed by core needle biopsy before NAC were collected from January 2007 to December 2009 and diagnosed at West China Hospital, Sichuan University. The cases were classified into different molecular subtypes using molecular classifications with or without Ki-67. Their clinical and pathological response to NAC was evaluated and compared. Results: The different subtypes using both molecular classifications showed significant difference in clinical response(with Ki-67: χ(2)=22.40, P<0.01; without Ki-67: χ(2)=9.202, P=0.027)but not pathological(P>0.05) response to NAC. By multivariate analysis, Ki-67 was predictive for a clinical complete response (P=0.041) and clinical overall response (P<0.01); also Ki-67 was the only clinicopathological factor predictive of pathological response(P=0.041). Conclusion: The molecular classification with Ki-67 is better to predict breast cancers responsiveness to NAC than the molecular classification without Ki-67.

Abstract P2-11-19: Expression of folate receptor alpha in ductal carcinoma in situ of the breast and comparison with that of invasive ductal carcinoma

Background: We have previously shown that the expression of Folate receptor alpha (FRA) is associated with high grade ER-/PR- or triple negative (TN) invasive ductal carcinoma of the breast. The aim of the current study is to investigate the expression pattern of FRA in a cohort of ductal carcinoma in situ (DCIS), analyze its relationship with different clinicopathological features and expression of several key biomarkers, and compare these findings to our previous data on invasive ductal carcinoma (IDC).

Methods: Ninety-eight cases of DCIS of the breast diagnosed between 1997 and 2008 in our institution were identified, reviewed and 6 blocks of tissue microassays (TMA) were constructed. The association between the expression of FRA (≥10% designed as positive expression) and the clinicopathologic features, the expression of ER, PR, HER2 and Ki-67, and the clinical outcome were evaluated, and these results were compared to those from IDC (399/430 cases with informative data). Results: Among the 98 cases of DCIS in TMA, 88 cases were informative. The expression rate of FRA was 21% for DCIS, less than the 29% seen in IDC. Expression of FRA was associated with high nuclear grades (42%), though less frequently than with IDC (52%). FRA expression was also associated with ER negativity (46%), PR negativity (33%) and high Ki-67 expression (50%) in DCIS, although significantly less than in IDC (75%, 63%, and 56%, respectively for negative ER and PR, and high Ki-67). Also, only 50% of ER/PR negative, TN and basal-like DCIS expressed FRA, significantly lower than that of IDC (74%, 80% and 80%, respectively). Due to the limited cases of DCIS, we did not demonstrate a significant difference in disease-free survival between FRA positive and negative tumors (p-value = 0.1792), although we did observe that IDC with FRA expression was significantly associated with a worse disease-free survival (p-value = 0.04).

Comparison between FRA expression between DCIS and IDC FRA≥10% in DCISFRA≥10% in IDCp-value 88 cases399 cases Nuclear 342%52%0.0185ER negative46%75%0.0442PR negative33%63%0.0214HER2 3+31%37%0.7003ER-/PR-50%74%0.0973Triple Negative50%80%0.1622Basal-Like50%80%0.1739

Conclusion: Our data demonstrates that FRA expression is associated with high nuclear grade, ER/PR negative and TN DCIS, though at a significantly lower rate than was observed in IDC, suggesting a possible role for this receptor in early breast carcinogenesis. There are differences in the rates of FRA expression between DCIS and IDC, suggesting that FRA may be one of the key molecules involved in progression of DCIS to IDC.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-11-19.

Abstract P2-11-20: Evaluation of folate receptor alpha expression in breast cancer by immunohistochemistry: Analysis with three different cut-off points

Background: Folate receptor alpha (FRA) is a newly recognized molecule that is selectively expressed in certain types of solid tumors, and several targeted therapies against FRA have shown promise in clinical trials for treating FRA-expressing ovarian and lung cancer. FRA has been shown to be selectively expressed in ER/PR negative and triple negative (TN) breast cancer; tumor types which would benefit from FRA targeted therapy. With these FRA-targeted therapies becoming available, correctly identifying eligible patients is very important. Currently, the cut off points for FAR expression by immunochemical (IHC) analysis have not been uniform. The commonly used cut points for expression that have been reported included 5%, 10% and the M score (using both staining intensity (3+, 2+, and 1+) and percentage of cells 0-100% (X, Y, Z for each staining intensity) in the equation (M-score = [3X+2Y+1Z]/ 6). The aim of the current study is to investigate these 3 most frequently used cut off points for FRA IHC analysis, in an effort to identify the one that is the most clinically relevant. Methods: 430 cases of infiltrating ductal carcinoma diagnosed between 1997 and 2008 in our institution were identified, reviewed, and 25 blocks of tissue microassays (TMA) were constructed. The association between the expression of FRA by IHC analysis, the clinicopathologic features, expression of ER, PR, HER2 and Ki-67, and the clinical outcome of these tumors were evaluated. Three cut off points (≥5%, ≥10% and M score of ≥10) were compared. 5% and 10% were scored as percent of membrane/cytoplasmic staining of the tumor cells regardless of the staining intensity while the M score takes into consideration both percentage and intensity of the staining of tumor cells.Results: Among the 430 cases studied, 399 cases had informative data from IHC analysis. The positive rates for FRA were 33%, 29% and 17%, respectively, for 5%, 10% and M score 10 as the positive cut off. All three cut off points were associated with significantly higher tumor grades and higher nodal status; they were also associated significantly with ER negativity, PR negativity or high proliferation rates (Ki-67≥15%) (P-values &lt;0.0001 in all), and ER-/PR-, TN, or Basal-like tumors (p-values &lt;0.0001 in all). Also, they were all significantly associated with worse disease-free survival with the p-values of 0.027, 0.026, and 0.009, for 5%, 10% and M score 10, respectively.

FRA positive rates with three different cut off points FRA ≥5% (%)FRA ≥10% (%)FRA M-score ≥10 (%)Age &gt;50 (year)32%28%17%Tumor size &lt;2 (cm)28%26%16%Histologic grade 351%47%32%LN status &gt;041%34%20%ER negative77%74%56%PR negative66%63%46%HER2 3+48%37%26%Ki67&gt;15%60%56%41%ER-/PR-77%74%54%Triple Negative82%80%60%Basal-like82%80%59%

Conclusion: Our data demonstrates that all three cut off points (5%, 10% and M score 10) could effectively separate breast tumors into subgroups where FRA expression correlated with specific pathologic features and a worse disease-free survival compared with FRA negative tumors. Using an M score of &gt;10 as the cut off for FRA may be most specific method for determining the prognostic significance of FRA expression in breast cancer.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-11-20.

HER2 status in gastric cancers: a retrospective analysis from four Chinese representative clinical centers and assessment of its prognostic significance

BACKGROUND

HER2 has a predictive value in gastric cancer. However, its association with prognosis remains uncertain. The aim of our study was to estimate the HER2-positive rate in Chinese gastric cancers, compare the classical fluorescence in situ hybridization (FISH) method with the novel bright-field dual color silver-enhanced in situ hybridization (DSISH) detection system, and evaluate the relationship between the HER2 status and prognosis.

PATIENTS AND METHODS

Seven hundred and twenty-six resected gastric cancers separately from four clinical centers in China were examined for HER2 by immunohistochemistry (IHC), FISH, and DSISH.

RESULTS

The HER2-positive rate was 13%. The consistency between FISH and DSISH results was high (99%; κ = 0.958; P < 0.001). Tumor heterogeneity and polysomy were the main reasons for inconsistency. There was no significant difference in the 3-year overall survival (OS) between HER2-positive and -negative patients (P = 0.959). Multivariate analysis showed that HER2 was not an independent prognostic factor.

CONCLUSION(S)

HER2 overexpression and amplification occur in a significant number of Chinese gastric cancer patients. Given the obvious advantages and high consistency with FISH, DSISH was superior for evaluating HER2 amplification in gastric cancer. HER2 was not a prognostic factor for gastric cancer in our study.

HER2 status in gastric cancers: a retrospective analysis from four Chinese representative clinical centers and assessment of its prognostic significance

BACKGROUND

HER2 has a predictive value in gastric cancer. However, its association with prognosis remains uncertain. The aim of our study was to estimate the HER2-positive rate in Chinese gastric cancers, compare the classical fluorescence in situ hybridization (FISH) method with the novel bright-field dual color silver-enhanced in situ hybridization (DSISH) detection system, and evaluate the relationship between the HER2 status and prognosis.

PATIENTS AND METHODS

Seven hundred and twenty-six resected gastric cancers separately from four clinical centers in China were examined for HER2 by immunohistochemistry (IHC), FISH, and DSISH.

RESULTS

The HER2-positive rate was 13%. The consistency between FISH and DSISH results was high (99%; κ = 0.958; P < 0.001). Tumor heterogeneity and polysomy were the main reasons for inconsistency. There was no significant difference in the 3-year overall survival (OS) between HER2-positive and -negative patients (P = 0.959). Multivariate analysis showed that HER2 was not an independent prognostic factor.

CONCLUSION(S)

HER2 overexpression and amplification occur in a significant number of Chinese gastric cancer patients. Given the obvious advantages and high consistency with FISH, DSISH was superior for evaluating HER2 amplification in gastric cancer. HER2 was not a prognostic factor for gastric cancer in our study.

Molecular characterization of long terminal repeat of porcine endogenous retroviruses in Chinese pigs

Pigs offer an unlimited source of xenografts for humans. However, vertically transmitted Porcine endogenous retrovirus (PERV) poses an infectious risk in the course of pig-to-human transplantation. In this study, we characterized PERV long terminal repeat (LTR) sequences from three species of Chinese pigs Banna minipig inbred (BMI), Wu-Zhi-Shan pig (WZSP), and Neijiang pig (NJP-A), and compared them with those of known PERVs (PERV-A, PERV-B, PERV-C, PERV-NIH, and 293-PERV-43). Genomic DNA extracted from peripheral blood mononuclear cells (PBMCs) of the Chinese pigs was used for PCR-amplification, cloning, and sequencing of LTRs. The sequences of BMI and WZSP LTRs were found identical with those of PERV-A and PERV-B, while that of NJP-A LTR was found close to those of PERV-C and PERV-NIH. The gammaretroviral nature of PERV LTRs from Chinese pigs was proved. These LTRs contained also promoter elements including enhancer-like repeats comparable with those of other PERVs. These findings suggested that PERVs from Chinese pigs were similar to PERV-A and PRV-B. Moreover, this study provided new data for the evaluation and selection of pigs to be used in the xenotransplantation.

Studies on long-term infection of human cells with Porcine endogenous retrovirus

A major concern in pig-to-human xenotransplantations is the potential risk of transmission of Porcine endogenous retroviruses (PERVs) integrated in the pig genome. Our previous work has shown that PERV provirus genes and gag protein can be detected in human embryonic kidney HEK-293 cells during a long-term infection with PERV (Yu et al., Transplant. Proc. 37, 496-499, 2005). In this study, we continued studying the long-term (>6 months) PERV infection of HEK-293 cells. The results showed no significant differences in morphology, growth, apoptosis, and [(3)H]-thymidine incorporation between PERV-infected and uninfected cells. The PERV LTR sequence showed only an insignifcant mutation after the long-term infection. PERV infection had no effect on the transcription of genes of Human endogenous retrovirus (HERV) naturally occurring in HEK-293 cells. Summing up, this study indicated that a long-term PERV infection of HEK-293 cells in vitro does not result in any significant changes in host cells as well as in PERV LTR sequence.

Genotype <21CAs/≥21CAs and allele <21CAs of the MANBA gene in melanoma risk and progression in a Swedish population

Cutaneous melanoma is characterized by poor patient outcome in its later stages. The search for genetic markers is therefore crucial for the identification of populations at risk for melanoma. Highly polymorphic CA repeats in 3' proximity in the MANBA gene were examined by PCR-capillary electrophoresis in 185 Swedish melanoma patients and 441 tumor-free age- and gender-matched individuals. The associations of the polymorphisms with melanoma risk, the pigment phenotypes of the patients and tumor characteristics were analyzed. A significant difference in allelic distribution between melanoma patients and tumor-free individuals was observed. The frequency of the MANBA genotype <21CAs/≥21CAs was significantly higher in melanoma patients than in the controls. When comparing allele distribution in patients and their matched controls, the allele <21CAs was found to be associated with the female gender (39.8 vs. 31.2%, P=0.041, OR=1.46, 95% CI 1.02-2.10), but not with male gender (34.4 vs. 30.9%, P%0.39). Within the melanoma group, there were no differences in the distribution of the MANBA alleles associated with patient gender or age before or after 55 years at diagnosis, nor was there any association between the MANBA genotype and pigment phenotype or tumor sites. The MANBA allele <21CAs was, however, associated with thin melanomas at diagnosis (Breslow thickness ≤1.5 mm and Clark levels I and II). In conclusion, these data suggest that MANBA polymorphisms might be an indicator of tumor growth and progression and, together with other markers, could be used to identify individuals at increased risk of melanoma.

Transmission of porcine endogenous retrovirus to human cells in nude mouse

Xenotransplantation is associated with the risk of Porcine endogenous retrovirus (PERV) transmission, since it has been shown that PERV can infect human cells in vitro (Specke et al., Virology 285, 177-180, 2001). We evaluated the possibility of PERV infection of human cells in nude mice model. Porcine kidney cells PK15 carrying PERV and human liver cancer cells SMMC-7721 were injected separately into the right and left axilla of nude mice, respectively. Two months later, pig cytochrome oxidase II (COII) gene, PERV DNA, PERV mRNA, and PERV-Gag protein were detected in the mass formed in both axillas and in several organs of nude mice. The pig COII genes were detected in the right and left axilla, but not in other organs of nude mice implicating that the microchimerism of pig cells occurred in human SMMC-7721 cells and induced the formation of the mass. PERV gene and gag protein were detected in all mouse tissues except liver. These data indicated that (i) PERV may be transmitted from porcine to mouse cells, (ii) PERV genes and proteins were detectable in the mass formed by injection of human cells and consequently (iii) there was a possibility of PERV transmission to human cells after xenotransplantation.

Significance of glutathione S-transferases M1, T1 and P1 polymorphisms in Swedish melanoma patients

Polymorphisms of GSTM1, GSTT1 and GSTP1 were examined in melanoma patients and tumor-free individuals. Relationships between the polymorphisms and tumor characteristics and pigment phenotypes of the patients were analyzed. There was no significant difference in GSTM1 null and GSTT1 null genotypes nor GSTP1 GG genotype between melanoma patients and controls. In melanoma patients, these polymorphisms were not correlated with early or later onset of melanomas or gender of the patients. Frequency of GSTM1 null genotype was higher in patients with melanoma >2.5 mm than in those with tumors <1.0 mm, and higher frequency was found in nodular melanoma than in the other tumor types. GSTP1 GG genotype was more often found in the patients with brown and mixed eye color or brown and black hair than those with blue and green eyes or blond hair. It is unlikely that polymorphisms of GSTM1, GSTT1 and GSTP1 are general risk factors for melanoma in the Swedish population. GSTM1 null genotype was correlated with Breslow thickness and tumor type, which might serve as an additional biomarker for a rapid tumor progression. GSTP1 GG increases risk for melanoma in the subgroup of individuals with dark eyes or hair.

Prevention of glutamate excitotoxicity in motor neurons by 5,6-dihydrocyclopenta-1,2-dithiole-3-thione: implication to the development of neuroprotective drugs

Glutamate-induced excitotoxicity and oxidative damage are believed to play an important role in the development of a number of central nerve system disorders. Nuclear-factor erythroid 2-related factor 2 (Nrf2) is a master transcriptional regulator of many cytoprotective genes. We report herein that 5,6-dihydrocyclopenta-1,2-dithiole-3-thione (CPDT), which was previously shown to induce several Nrf2 target genes in non-nervous cells and tissues, significantly activates Nrf2 and Nrf2 target genes in rat spinal cord explants. More importantly, such activation is accompanied by complete inhibition of glutamate-induced motor neuron death in these explants. Further studies show that CPDT inhibits glutamate-induced intracellular Ca(2+) rise, loss of mitochondrial transmembrane potential and depletion of tissue glutathione. CPDT did not appear to modulate glutamate transport or to interfere with glutamate interaction with postsynaptic receptors. Taken together, our studies have identified CPDT as a promising neuroprotective agent and suggest that pharmacological activation of Nrf2 signaling is an important strategy for protection against glutamate-induced excitotoxicity.

The C-terminal peptide of connective tissue growth factor blocks the full molecule binding to tubular epithelial cell

OBJECTIVES

Interstitial fibrosis is a critical pathologic change in chronic allograft nephropathy. The cytokine connective tissue growth factor (CTGF, also CCN2) plays an important role in epithelial-mesenchymal transformation (EMT) of tubular epithelial cells to renal interstitial fibrosis. The hexadeca-peptide within the C-terminal of CTGF (named P2) contains the unique binding domain of CTGF to its potential receptor, integrin alphavbeta3. This study examined whether P2 bound preferentially to the receptor and served as an inhibitor of CTGF.

METHODS

All studies used an established rat kidney tubular epithelial cell line NRK-52E. Chemically synthesized P2 was purified, and some of it labeled with FITC. The affinity of CTGF or P2 to NRK-52E cells was examined by a solid-phase cell adhesion assay. Competitive binding between P2 and CTGF to NRK-52E cells was examined with flow cytometric analysis.

RESULTS

Both P2 and CTGF bound to the NRK-52E cells, mediating cell adhesion. When the cells were incubated in the mixture of P2 and CTGF, P2 bound to the cells preferentially. Furthermore, when cells were preincubated with excessive CTGF, it became difficult for subsequent P2 binding to occur.

CONCLUSIONS

P2 and CTGF seemed to bind to cell membranes at the same binding domain. P2 competitively blocked CTGF binding, acting as a CTGF inhibitor.

Interference of cyclosporine on glucose metabolism: potential role in chronic transplantation kidney fibrosis

OBJECTIVES

To explore the fibrosis induction effects of cyclosporine (CsA) on renal tubular epithelial cells, as well as the potential mechanisms of CsA-mediated alterations of glucose metabolism in chronic allograft nephropathy (CAN).

METHODS

The rat renal tubular epithelial cell line NRK-52E cells were cultured in medium with 50 mmol/L of D-glucose for 7, 14, or 28 days. The expression of TGF-beta1, CTGF, Smad3, and Smad7, which are involved in the fibrosis signal pathway, was detected by immunofluorescence and reverse-transcriptase polymerase chain reaction. Meanwhile, cells were cultured in various concentration of CsA in glucose-free medium for 24 hours followed by the addition of D-[3-(3)H]-glucose for 30 minutes; glucose uptake was detected by examining the radiation intensity.

RESULTS

The expression of TGF-beta1, Smad3, Smad7, and CTGF of NRK-52E cells were up-regulated significantly (P < .05) after culture with 50 mmol/L glucose for 7 days compared with those in 25 mmol/L glucose. At 14 and 28 days, TGF-beta1 was slightly decreased compared with 7 days, but CTGF, Smad3, and Smad7 increased robustly (P < .05). CsA significantly stimulated glucose uptake at various concentrations, with an absorption peak at 60 minutes that decreased at 75 minutes. Furthermore, CsA may have dose-dependent effects on glucose uptake.

CONCLUSION

High glucose concentrations may play an important role in the NRK-52E cell fibrosis during the CAN process due to an interference of CsA on glucose metabolism.

Nuclear Translocation of SMAD3 May Enhance the TGF-β/SMADS Pathway in High Glucose Circumstances

OBJECTIVES

Posttransplant diabetes mellitus is one of the most frequent complications after kidney transplantation. It is considered to be one cause of chronic allograft nephropathy. This study sought to investigate the effects of high glucose on the expression and nuclear translocation of Smad3, which is an important signal mediator involved in the fibrotic signal pathway.

METHODS

The established rat renal mesangial cell line HBZY-1 was cultured in medium with various concentrations of glucose (4.5 mg/mL, 9.0 mg/mL, or 13.5 mg/mL), which was collected at 7, 14, or 21 days. The total expression of Smad3, including both inner and outer nucleus proteins was examined by Western blot analysis. The nuclear translocated Smad3, representing only the inner nucleus protein, was detected by immunofluorescence staining observed under a laser confocal scanning microscope.

RESULTS

No significant difference in the total Smad3 expression was demonstrated by Western blot analysis among the three groups of HBZY-1 cells at various concentration of glucose after 7, 14, or 21 days. There was no fluorescence detected in the nucleus at day 7 by immunofluorescence staining; however, robust positive expression of Smad3 was detected at days 14 and 21.

CONCLUSION

As a restricted Smads member, Smad3 protein might not be upregulated in the presence of high glucose. However, with prolonged culture time, Smad3 translocates from cytoplasm to nucleus, which may be a pivotal step in the fibrotic signal pathway.

Muscle infarction involving muscles of abdominal and thoracic walls in diabetes

AIMS

This paper presents two cases of muscle infarction involving four major muscles of the anterior abdominal wall (case 1) and pectoralis major (case 2) in individuals with diabetes.

METHODS

Erythrocyte sedimentation rate (ESR) and creatine kinase (CK) were measured and Doppler ultrasound, an open muscle biopsy (case 1) and magnetic resonance imaging (MRI) (case 2) were performed.

RESULT

The diagnosis of muscle infarction was made by histological findings and MRI images with hyper-intensive signals on a gadolinium-enhanced T2-weighted sequence, respectively. Both patients were treated with bed rest, immobilization of the involved extremities, analgesia and intensive insulin therapy. In addition, anticoagulant drugs such as low molecular weight heparin sodium and cilostazol, and some traditional Chinese medicines such as ligustrazine and salvia miltiorrhiza were administered. The symptoms of both patients resolved gradually after 3 weeks. However, muscle infarction reoccurred in case 1 on the opposite side of the abdomen and recovered after 40 days.

CONCLUSIONS

This is the first report of muscle infarction involving the muscles of anterior abdominal walls and pectoralis major in diabetes. MRI is the best non-invasive technique and T2-weighted imaging is the most valuable method for the diagnosis. In addition to supportive therapy, administration of anticoagulant agents and some Chinese traditional medicine may be useful in symptom relief.