Analysis Natrium Iodide Symporter Expression in Breast Cancer Subtypes for Radioiodine Therapy Response

Purpose

This study investigates natrium iodide symporter (NIS) expression in three breast cancer subtypes to predict radioiodine response.

Materials and Methods

Frozen breast tissues from triple negative (TN), human epidermal receptor 2 (HER2+), and luminal A cancers were used in this research. NIS protein expression in each subtype was analyzed using immunohistochemistry (IHC) and western blot (WB). Secondary data such as age, subtypes, and Ki 67 index were drawn from the surgical oncologist database. Breast cancer cell lines were used to investigate the effect of radioiodine by measuring cell proliferation.

Results

The forty-one breast cancer samples were analyzed consisted of the following subtypes: TN, HER2+, and luminal A were 58%, 22%, and 20% respectively. The stages of disease were 2A to 4A. Most of samples were at 3B. Ki 67 index of TN, HER2+, and luminal A were 21 ± 12, 19 ± 5, and 7 ± 3 respectively. The NIS expression was detected in 95% of samples in cytoplasm and/or cell membrane; 93% of samples were invasive breast carcinomas. Only 20% of the samples showed NIS expression at cell membrane; four samples were HER2+, and other four were TN subtypes. NIS membrane score was significantly positively correlated with Ki67 index, p = 0.04. NIS protein expression was detected at sizes 88 kDa, 50 kDa, and 27 kDa. Cell proliferation rate means of MDA-MB 231, SKBR3, and MCF7 cells were 81.6 ± 4, 10.6 ± 5, and 15.4 ± 13 respectively (p = 0.009).

Conclusion

NIS protein expression is detectable in breast cancer cells to varying degrees. HER2+ is the most likely to express NIS in the cell membrane followed by TN subtypes. This indicates that radioiodine could be used as a novel adjuvant treatment in breast cancer.

High α-SMA expression in the tumor stroma is associated with adverse clinical parameters in mismatch repair-proficient colorectal cancers only

OBJECTIVES

As mismatch repair status confers differential prognosis in colorectal cancers, this study aimed to determine associations of α-smooth muscle actin (α-SMA) protein expression in mismatch repair-proficient (pMMR) and mismatch repair-deficient (dMMR) colorectal tumors with clinicopathologic and prognostic features.

METHODS

Tissue microarrays from patients with colorectal cancer, immunostained with α-SMA, were assessed through digital image analysis. Total (n = 962), pMMR (n = 782), and dMMR (n = 156) stromal H-scores were assessed for associations with clinicopathologic and survival data.

RESULTS

Higher α-SMA expression was correlated with pMMR status (P = 5.2223 × 10-8). In the pMMR subgroup, higher α-SMA stromal expression at the tumor periphery was correlated with higher T stage (P = .002), perineural invasion (P = .038), infiltrative tumor edge (P = .01), involved nodal status (P = .036), metastases (P = .013), synchronous metastases (P = .007), recurrence (P = .004), and both 3-year and 5-year survival (P = .018). dMMR tumors showed no significant correlations with α-SMA staining.

CONCLUSIONS

The findings highlight that immunostaining with α-SMA in pMMR colorectal tumors, especially at the tumor periphery, has the potential to identify patients with adverse prognostic features. Digital assessment of α-SMA may offer improved objectivity, accuracy, economy of time, and risk stratification for management.

Advantages of automated immunostain analyses for complex membranous immunostains: An exemplar investigating loss of E-cadherin expression in colorectal cancer

As pathology moves towards digitisation, biomarker profiling through automated image analysis provides potentially objective and time-efficient means of assessment. This study set out to determine how a complex membranous immunostain, E-cadherin, assessed using an automated digital platform fares in comparison to manual evaluation in terms of clinical correlations and prognostication. Tissue microarrays containing 1000 colorectal cancer samples, stained with clinical E-cadherin antibodies were assessed through both manual scoring and automated image analysis. Both manual and automated scores were correlated to clinicopathological and survival data. E-cadherin data generated through digital image analysis was superior to manual evaluation when investigating for clinicopathological correlations in colorectal cancer. Loss of membranous E-cadherin, assessed on automated platforms, correlated with: right sided tumours (p = <0.001), higher T-stage (p = <0.001), higher grade (p = <0.001), N2 nodal stage (p = <0.001), intramural lymphovascular invasion (p = 0.006), perineural invasion (p = 0.028), infiltrative tumour edge (p = 0.001) high tumour budding score (p = 0.038), distant metastasis (p = 0.035), and poorer 5-year (p= 0.042) survival status. Manual assessment was only correlated with higher grade tumours, though other correlations become apparent only when assessed for morphological expression pattern (circumferential, basolateral, parallel) irrespective of intensity. Digital assessment of E-cadherin is effective for prognostication of colorectal cancer and may potentially offer benefits of improved objectivity, accuracy, and economy of time. Incorporating tools to assess patterns of staining may further improve such digital assessment in the future.

Profil Pasien Hemorrhagic Postpartum di RSUP Dr. M. Djamil Padang

Perdarahan postpartum menduduki peringkat pertama dalam menyumbangkan angka kematian ibu di dunia, yaitu sebesar 35%. Faktor-faktor yang mempengaruhi kejadian HPP yaitu usia, jumlah paritas, jarak antar kelahiran, ANC, riwayat persalinan dan kehamilan sebelumnya, anemia, dan tingkat pengetahuan ibu. Penelitian ini bertujuan untuk mengetahui gambaran profil pasien hemorrhagic postpartum di RSUP Dr. M. Djamil periode Januari 2016 - September 2017. Penelitian ini merupakan deskriptif retrospektif dengan desain cross-sectional. Sampel berjumlah 39 sampel berupa rekam medis pasien dari bagian rekam medis RSUP Dr. M. Djamil Padang pada bulan Januari 2016 - September 2017 dengan menggunakan teknik simple random sampling dan analisis univariat. Hasil penelitian menunjukkan bahwa HPP terbanyak yang terjadi di RSUP Dr. M. Djamil adalah HPP Primer (79,5%), ibu dengan usia 21-34 tahun (69,2%), ibu dengan paritas lebih dari 2 kali atau multipara (89,4%), ibu dengan tingkat kepatuhan ANC yang tinggi (100%), ibu dengan jarak antara kelahiran <2 tahun (66,7%), ibu yang tidak ada riwayat kehamilan dan persalinan yang buruk (66,7%), ibu dengan kadar Hb <11 gr% (92,4%), ibu dengan tingkat pendidikan tinggi (87,2%), ibu dengan etiologi retensio plasenta (38,5%), dan kematian ditemukan pada ibu dengan HPP primer (2,5%). Dapat disimpulkan bahwa perlunya edukasi kepada wanita terkait pencegahan faktor risiko HPP seperti melakukan ANC rutin untuk mencegah anemia pada ibu hamil dan mengikuti program KB untuk mengatur jarak antara kelahiran.