Patient-Specific Deep Learning Model for Clinical Target Volume Delineation on Daily CBCT of Breast Cancer Patients based on Intentional Deep Overfit Learning (IDOL) Framework

PURPOSE/OBJECTIVE(S)

Increasingly complex target volumes and the use of modern irradiation techniques emphasize the importance of daily image guidance more than ever. Significant progress has been made in adjuvant breast cancer radiotherapy (RT) and the need for optimized image guidance is growing. Furthermore, the position of the breast during RT after breast-conserving surgery is highly variable than expected. In this context, cone beam computed tomography (CBCT) is a very effective tool enabling prompt and accurate adaptive radiation therapy (ART). In this study, we aim to develop a deep learning (DL)-based algorithm to segment clinical target volume (CTV) from daily CBCT scans. Also, we validate the optimization of further learning when applying the Intentional Deep Overfit Learning (IDOL) framework.

MATERIALS/METHODS

A total of 240 different CBCT scans obtained from 100 breast cancer patients were used for this study. CTV was defined as whole breast plus margin in all patients. The workflow consists of two training stages: (1) training a novel 'generalized' DL model (Swin_UNETR) to identify and delineate breast CTV on CBCT scans using 90 breast cancer patient cases (2) applying an 'intentional overfitting' to the 'generalized' DL model to generate a 'patient-specific' model using the remaining 10 breast cancer patients. In this study, for the intentionally overfitting stage, we additionally trained with CBCT scans from the patient's 1st fraction to the 14th fractions cases. The results of the proposed method were compared quantitatively with the expert's contours on 1st-15th fractions CBCT scans using Dice Similarity Coefficient (DSC).

RESULTS

The average DSC between the 'generalized' DL model-based breast CTV contours and reference contours for the patient's 15th fraction was 0.9672. When implementing the IDOL framework with the CBCT scan obtained during the patient's 1st treatment, the average DSC was improved to 0.9809. When additional CBCT scans taken during each of the 1st to 6th fractions were used for training, the average DSC could be most effectively raised to 0.9835. The p-value comparison between the 'generalized' DL model and the 1st fraction was found to be 3.62E-04, while the comparison with the 6th fractions resulted in a p-value of 8.36E-05. The average time required for IDOL training using one CBCT scan and six CBCT scans was 107 seconds and 127 seconds, respectively.

CONCLUSION

In this study, we developed a patient-specific DL-based training algorithm to segment CTV in CBCT scans for breast cancer patients. The performance improvement was relatively significant and was confirmed that using continual DL with additional CBCT scans, which are taken every day, can be more accurate and efficient than drawing breast CTV using a general model. Our novel patient-specific model can be effectively applied to various ARTs by not only reducing labor and time but also increasing accuracy.

The Chemical Compositions, and Antibacterial and Antioxidant Activities of Four Types of Citrus Essential Oils

Nanfeng mandarins (Citrus reticulata Blanco cv. Kinokuni), Xunwu mandarins (Citrus reticulata Blanco), Yangshuo kumquats (Citrus japonica Thunb) and physiologically dropped navel oranges (Citrus sinensis Osbeck cv. Newhall) were used as materials to extract peel essential oils (EOs) via hydrodistillation. The chemical composition, and antibacterial and antioxidant activities of the EOs were investigated. GC-MS analysis showed that monoterpene hydrocarbons were the major components and limonene was the predominate compound for all citrus EOs. The antibacterial testing of EOs against five different bacteria (Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Salmonella typhimurium) was carried out using the filter paper method and the broth microdilution method. Kumquat EO had the best inhibitory effect on B. subtilis, E. coli and S. typhimurium with MIC (minimum inhibitory concentration) values of 1.56, 1.56 and 6.25 µL/mL, respectively. All citrus EOs showed the antioxidant activity of scavenging DPPH and ABTS free radicals in a dose-dependent manner. Nanfeng mandarin EO presented the best antioxidant activity, with IC₅₀ values of 15.20 mg/mL for the DPPH assay and 0.80 mg/mL for the ABTS assay. The results also showed that the antibacterial activities of EOs might not be related to their antioxidant activities.

The use of instant messaging in clinical data sharing: the EHRA SMS survey

Funding Acknowledgements

Type of funding sources: None.

Background

Nowadays, instant messaging (IM) provides fast and widespread communication. These platforms and apps enable the physicians to quickly share and send clinical data to their peers, to send information to their patients regarding their illnesses and to be reached for counselling and advise. Nevertheless, the use of IM has never been assessed in the cardiology community up until now.

Purpose

To assess the habits of cardiologists related to modern communication tools, their primary and secondary uses in clinical practice and the potential differences and preferences between different media in terms of ease of access, usefulness and trustworthiness.

Methods

An online survey was promoted by the EHRA e-Communication Committee and the EHRA Scientific Initiative Committee during the ESC Digital Health Week. All cardiologists were invited to participate via Twitter, LinkedIn, Facebook and other dedicated channels. The survey consisted of 22 questions and was made anonymous. The questions were made on an individual-basis and collected on SurveyMonkey.

Results

287 physicians from 33 countries responded to the survey. The mean age of the respondents was 43.4 ± 11.5 years, and 74.8% of them were male. 88.3% of all respondents routinely sends and 90.3% receives clinical data through IM. IM is used at least once a week (36.4%) or even once or more a day (40.4%) for sharing clinical data. WhatsApp is the most used IM app to share clinical data (79.4%). On a scale of 1 to 5, IM was second only to face-to-face contact (average 4.46) as the preferred method for sharing clinical data (average 3.69) and was considered better than phone calls (average 3.34) and e-mails (average 3.21). Twelve-lead ECGs (88.6%), medical history (61.4%) and echo loops (55.7%) are the data shared most often. Among potential pros of IM, the respondents listed being a fast way of communication (82.0%) and making it easy to contact colleagues (76.7%), while privacy issues regarding IM apps providers (62.7%) and other colleagues (45.6%) were commonly perceived as drawbacks. Only 57.4% of all respondents anonymize clinical data before sharing them through IM, and only 44.0% of the data received are reported to be anonymized. Of note, 29.3% of the respondents were not aware of the European General Data Protection Regulation (GDPR) on data protection at the time of the survey, and 29.8% do not know if their institution has a specific policy regarding the use of IM for professional use.

Conclusions

IM apps are used by cardiologists worldwide to share and discuss clinical data and are preferred to many other methods of data sharing, being second only to face-to-face contact. IM are often used and to share many different types of clinical data, being perceived as a fast and easy way of communication. Cardiologists should be sensitised to appropriate use of IM in accordance to GDPR and local policies in order to prevent legal and privacy issues.

Characterization of Volatile Organic Compounds of Healthy and Huanglongbing-Infected Navel Orange and Pomelo Leaves by HS-GC-IMS

The Asian citrus psyllid (ACP), Diaphorina citri Kuwayama, is the only natural vector of bacteria responsible for Huanglongbing (HLB), a worldwide destructive disease of citrus. ACP reproduces and develops only on the young leaves of its rutaceous host plants. Olfactory stimuli emitted by young leaves may play an important role in ACP control and HLB detection. In this study, volatile organic compounds (VOCs) from healthy and HLB-infected young leaves of navel orange and pomelo were analyzed by headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS). A total of 36 compounds (including dimers or polymers) were identified and quantified from orange and 10 from pomelo leaves. Some compounds showed significant differences in signal intensity between healthy and HLB-infected leaves and may constitute possible indicators for HLB infection. Principal component analysis (PCA) clearly discriminated healthy and HLB-infected leaves in both orange and pomelo. HS-GC-IMS was an effective method to identify VOCs from leaves. This study may help develop new methods for detection of HLB or find new attractants or repellents of ACP for prevention of HLB.

Connecting particle interactions to agglomerate morphology and rheology of boehmite nanocrystal suspensions

HYPOTHESIS

The rheology of complex suspensions, such as nuclear waste slurries at the Hanford and Savannah River sites, imposes significant challenges on industrial-scale processing. Investigating the rheology and connecting it to the agglomerate morphology and underlying particle interactions in slurries will provide important fundamental knowledge, as well as prescriptive data for practical applications. Here, we use suspensions of nano-scale aluminum oxyhydroxide minerals in the form of boehmite as an analog of the radioactive waste slurry to investigate the correlation between particle interactions, agglomerate morphology, and slurry rheology.

EXPERIMENTS

A combination of Couette rheometry and small-angle scattering techniques (independently and simultaneously) were used to understand how agglomerate structure of slurry changes under flow and how these structural changes manifest themselves in the bulk rheology of the suspensions.

FINDINGS

Our experiments show that the boehmite slurries are thixotropic, with the rheology and structure of the suspensions changing with increasing exposure to flow. In the slurries, particle agglomerates begin as loose, system-spanning clusters, but exposure to moderate shear rates causes the agglomerates to irreversibly consolidate into denser clusters of finite size. The structural changes directly influence the rheological properties of the slurries such as viscosity and viscoelasticity. Our study shows that solution pH affects the amount of structural rearrangement and the kinetics of the rearrangement process, with an increase in pH leading to faster and more dramatic changes in bulk rheology, which can be understood via correlations between particle interactions and the strength of particle network. Nearly identical structural changes were also observed in Poiseuille flow geometries, implying that the observed changes are relevant in pipe flow as well.

In situ liquid SEM imaging analysis revealing particle dispersity in aqueous solutions

A quantitative description on dispersity of boehmite (γ-AlOOH) particles, a key component for waste slurry at Hanford sites, can provide useful knowledge for understanding various physicochemical nature of the waste. In situ liquid scanning electron microscopy (SEM) was used to evaluate the dispersity of particles in aqueous conditions using a microfluidic sample holder, System for Analysis at Liquid Vacuum Interface (SALVI). Secondary electron (SE) images and image analyses were performed to determine particle centroid locations and the distance to the nearest neighbour particle centroid, providing reliable rescaled interparticle distances as a function of ionic strength in acidic and basic conditions. Our finding of the particle dispersity is consistent with physical insights from corresponding particle interactions under physicochemical conditions, demonstrating delicate changes in dispersity of boehmite particles based on novel in situ liquid SEM imaging and analysis. LAY DESCRIPTION: In situ liquid scanning electron microscopy (SEM) was used to determine the interparticle distance of boehmite (γ-AlOOH) particles, a key component for waste slurry at Hanford sites. This type of quantitative measurement is important to understand various physicochemical nature of the radiological waste containing boehmite. In situ liquid SEM was enabled by a unique vacuum compatible microfluidic cell, System for Analysis at Liquid Vacuum Interface (SALVI). We collected secondary electron (SE) images and performed image analyses to determine particle centroid locations and the distance to the nearest neighbour particle centroid to arrive at the interparticle distances in acidic and basic conditions. Our results show that delicate changes occur among boehmite particles under different pH conditions using novel in situ SEM imaging.

Chemical Composition, Antimicrobial, Antioxidant, and Antiproliferative Properties of Grapefruit Essential Oil Prepared by Molecular Distillation

Grapefruit essential oil has been proven to have wide range of bioactivities. However, bioactivity of its molecular distillate has not been well studied. In this study, a light phase oil was obtained by molecular distillation from cold-pressed grapefruit essential oil and GC-MS was used to identify its chemical composition. The antimicrobial activity of the light phase oil was tested by filter paper diffusion method, and the anticancer activity was determined by the Cell Counting Kit-8 (CCK-8) assay. Twenty-four components were detected with a total relative content of 99.74%, including 97.48% of terpenes and 1.66% of oxygenated terpenes. The light phase oil had the best antimicrobial effect on Bacillus subtilis, followed by Escherichia coli, Staphylococcus aureus and Salmonellaty phimurium. DPPH and ABTS assays demonstrated that the light phase oil had good antioxidant activity. The CCK-8 assay of cell proliferation showed that the light phase oil had a good inhibitory effect on the proliferation of HepG2 liver cancer cells and HCT116 colon cancer cells.

Roles of notch signaling pathway and endothelial-mesenchymal transition in vascular endothelial dysfunction and atherosclerosis

OBJECTIVE

To investigate the role of the Notch signaling pathway on the endothelial-mesenchymal transition (EndMT) during vascular endothelial dysfunction and atherosclerosis.

MATERIALS AND METHODS

Human coronary artery endothelial cells (HCAEC) were treated with the exogenous Notch homolog 1 (Notch1) factor to activate the Notch1 pathway, and cells were then observed under the microscope for morphologic changes. Changes in the expression of related proteins were detected by Western blot. In vivo experiments were performed using 18 Sprague Dawley® (SD) rats, and GSI factor was used to specifically inhibit Notch pathway activation. Rats were used and randomly divided into three groups: normal diet (ND) group, high-fat diet (HFD) group, and high-fat diet + GSI (HFD+GSI) group, 6 rats in each group. Hematoxylin and eosin (H&E) staining was used to examine the cardiac aortic morphology of the rats in each treatment group. Real-time polymerase chain reaction (RT-PCR) and Western blot were used to detect the expression of Notch1, Hes1, VE-cadherin and α-SMA in the aortic tissues of rats in each group at mRNA and protein levels, respectively.

RESULTS

After HCAECs were treated with Notch1, endothelial protein levels of VE-cadherin were significantly decreased and levels of the interstitial protein α-SMA were significantly increased. In the animal model, the rats fed with high-fat diet for two months presented obvious atherosclerosis spots in their aorta, but those fed with the same diet and treated with GSI inhibitor of Notch pathway showed significantly fewer atherosclerosis signs. Compared with ND group, mRNA and protein expression levels of Notch1, Hes1 and α-SMA were significantly increased, and the expression levels of endothelial marker VE-cadherin were significantly decreased in aortas of rats in HFD group. Compared with the rats in HFD group, the rats in HFD+GSI group showed significantly reduced expression levels of Notch1, Hes1 and α-SMA.

CONCLUSIONS

The activation of Notch signaling pathway can induce the EndMT progression and promote the development of atherosclerotic lesions.

Uptake of soil-applied thiamethoxam in orange and its effect against Asian citrus psyllid in different seasons

BACKGROUND

Asian citrus psyllid (ACP), Diaphorina citri Kuwayama, is an important pest of citrus worldwide because it transmits the bacteria causing huanglongbing (HLB). We investigated the effects and persistence of two soil application rates of thiamethoxam on ACP populations in two flushing seasons in the field. Thiamethoxam and clothianidin residues in the fruit were detected to evaluate food safety.

RESULTS

Soil application of 50% thiamethoxam water-dispersible granules at concentrations of 4 and 10 g tree^-1 significantly decreased ACP populations, and there was a positive correlation between control efficacy and the persistence of thiamethoxam and clothianidin in leaves, providing longer-term protection for up to 90 days in the fall compared with 60 days in the spring. Higher thiamethoxam and clothianidin amounts were observed in new leaves than in old leaves. Thiamethoxam and clothianidin residues at a high rate in fruit were 0.012 and 0.010 mg kg^-1 at harvest, respectively, and neither insecticides was detectable at low rates.

CONCLUSIONS

These results demonstrate that soil-applied thiamethoxam plays a role in defending ACP, and provides an extended period of control efficacy. This knowledge could provide a reference for the control of ACP by soil application of thiamethoxam to reduce HLB spread. © 2018 Society of Chemical Industry.

Abstract P4-10-11: Pregnancy-associated breast cancer in a contemporary cohort of newly diagnosed women

Introduction: Pregnancy-associated breast cancer (PABC) refers to breast cancer (BC) diagnosed during pregnancy, lactation, or in the postpartum period. There is evidence that PABC is associated with a poorer prognosis, and that the development of the disease is influenced by the unique hormonal milieu of pregnancy. The purpose of this study was to investigate the clinicopathologic characteristics associated with PABC in a contemporary cohort of women with newly diagnosed BC.

Methods: Our institutional Breast Cancer Database was queried for women diagnosed with breast cancer between 2010-17 who had at least one full term pregnancy (FTP). Variables of interest included patient demographics and clinical and tumor characteristics. PABC was defined as breast cancer diagnosed within 24 months of delivery. Statistical analyses included Pearson's chi-square and logistic regression.

Results: Out of a total of 1934 women, 42 (2.2%) had PABC. Median follow up in the total cohort was 4.5 years. After adjusting for age at diagnosis, PABC was associated with older age at first FTP, ethnic minority status, BRCA mutation carriers, presentation with a palpable mass, higher histologic grade, and ER-negative and triple negative receptor status. Variables that were not significantly different between PABC and non-PABC cases included tumor histology, multifocality, presence of lymphovascular invasion, and family history of breast cancer.

Table:Selected Characteristics of Women with PABCVariableNon-PABC (n=1892)PABC (n=42)P-value*Age at first full term pregnancy  <0.001<35 years1610 (85%)28 (66.7%) ≥35 years277 (15%)14 (33.3%) Race  0.001White1397 (73.8%)23 (54.8%) Black181 (9.6%)8 (19%) Asian175 (9.2%)10 (23.8%) Hispanic131 (6.9%)1 (2.4%) Other8 (0.4%)0 (0%) BRCA 1,2 Positive56 (3%)9 (21.4%)<0.001Method of Presentation  0.002Breast Exam579 (30.6%)30 (71.4%) Mammography1137 (60.1%)10 (23.8%) Ultrasound87 (1.6%)2 (4.8%) MRI67 (3.5%)0 (0%) Other22 (1.2%)0 (0%) Invasive Grade  0.014Low213 (15%)0 (0%) Intermediate763 (53.8%)12 (37.5%) High442 (31.2%)20 (62.5%) Estrogen Receptor  0.034Positive1572 (83.9%)29 (69%) Negative301 (16.1%)13 (31%) Triple Negative135 (7.1%)7 (16.7%)0.041*P-values are age-adjusted.

Conclusions: The association of PABC with ethnic minority status in our cohort is interesting and may be reflected in the increased proportion of triple negative breast cancers in the PABC group. In our contemporary cohort, PABC was associated with older age at first FTP. As more women delay childbearing, risk for PABC may increase. Our findings suggest that women who become pregnant at older ages should be followed carefully during pregnancy and in the postpartum period, especially if they are BRCA mutation carriers. The optimal approach for monitoring older women during pregnancy and the postpartum period is unclear. Clinical breast exam may play an important role, especially for those women known to be at increased risk for breast cancer.

Citation Format: Gooch JC, Chun J, Jubas T, Guth A, Schnabel F. Pregnancy-associated breast cancer in a contemporary cohort of newly diagnosed women [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-11.

Abstract P4-10-07: Breastfeeding experience among breast cancer patients in the modern era

Introduction: In recent years, the uptake of breastfeeding has become more common as it is regarded as healthy and beneficial for both mother and infant. The process of parturition and lactation plays a role in the normal differentiation and development of breast tissue, and multiparity has been associated with a decreased risk for breast cancer. The current study sought to describe the breastfeeding experience of a modern cohort of women with newly diagnosed BC, and to examine the clinicopathologic characteristics of their disease.

Methods: A retrospective review of our institutional Breast Cancer Database from 2009-2017 was performed to identify women with at least one full term pregnancy (FTP). Clinicopathologic and demographic information was recorded, including breastfeeding experience and cumulative duration of nursing. Women were grouped by self-reported breastfeeding experience and duration of breastfeeding for analysis. Pearson's chi-square tests were performed.

Results: Of 1919 patients, 1053 (54.9%) reporting breastfeeding. Breastfeeding increased from a low of 30.4% among women with first FTP (FFTP) in the 1950's to 84.6% with FFTP in the 2010's. There were no significant differences between those who did and did not breast feed with regards to race, family history, BRCA status, pathologic stage, grade, tumor histology, lymphovascular invasion (LVI), multifocality, tumor size or receptor status. When stratified by duration of breastfeeding, the most striking finding was that women who breastfed for >12 months were more likely to have tumors associated with LVI (p = 0.028).

Table– Breastfeeding Experience Among Parous Women with Breast CancerVariableNo Breastfeeding (n=866)Breastfeeding (n=1053)p-valueRace  0.432White648 (74.8%)767 (72.8%) Black73 (8.5%)112 (10.6%) Asian78 (9%)102 (9.7%) Hispanic64 (7.4%)67 (6.4%) Other3 (0.3%)5 (0.5%) Family history272 (31.4%)311 (29.6%)0.397BRCA 1,2 positive23 (2.7%)42 (4.0%)0.108Final Pathology Stage  0.2240190 (21.9%)222 (21.1%) I426 (49.2%)507 (48.1%) II197 (22.8%)229 (21.7%) III40 (4.6%)63 (6.0%) IV1 (0.1%)3 (0.3%) No residual (neoadjuvant)12 (1.4%)29 (34.1%) Invasive Grade  0.127Low92 (14.1%)120 (15.3%) Intermediate371 (56.7%)398 (50.6%) High191 (29.2%)268 (34.1%) Histology  0.130DCIS189 (21.8%)223 (21.2%) IDC531 (61.3%)688 (65.3%) ILC113 (13.1%)99 (9.4%) Other33 (3.8%)43 (4.1%) LVI127 (14.7%)174 (16.5%) Multifocality147 (17%)183 (17.4%) Median tumor size (cm; range)1.4 (0-9.5)1.3 (0-12.5)0.489Estrogen Receptor  0.206Positive726 (84.7%)861 (82.6%) Negative131 (15.3%)182 (17.4%) Progesterone Receptor  0.275Positive621 (72.5%)732 (70.2%) Negative236 (27.5%)311 (29.8%) HER2/neu Receptor  0.068Positive78 (12%)121 (15.4%) Negative571 (88%)667 (84.6%) 

Conclusions: Breastfeeding experience was not generally associated with significant differences in tumor or patient characteristics. However, breastfeeding for longer than 12 months was associated with LVI. It is possible that changes in the breast tissue that occur during the process of pregnancy and prolonged lactation may influence future tumor development. These findings are hypothesis generating and suggest that the relationship of prolonged breastfeeding and breast cancer development should be investigated further.

Citation Format: Gooch JC, Chun J, Jubas T, Guth A, Schnabel F. Breastfeeding experience among breast cancer patients in the modern era [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-07.

Abstract P5-02-01: The relationship of breast density in mammography and magnetic resonance imaging (MRI) in women with triple negative breast cancer (TNBC)

Introduction:

TNBC represent 10%–20% of invasive breast cancers. Previous studies showed that TNBC usually present with benign features on mammography, ultrasound and MRI. However, there is a dearth of information on the relationship of mammographic breast density (MBD), background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) on MRI with TNBC. The purpose of this study was to evaluate the relationship between BD, BPE, and FGT in women with TNBC compared to non-TNBC in a contemporary cohort of women with breast cancer.

Methods:

The Institutional Breast Cancer Database was queried for women who had invasive breast cancer and underwent mammography and MRI between (2010-2017). Variables of interest included clinical, pathologic, and imaging characteristics. Statistical analyses included Pearson's Chi Square and logistic regression.

Results:

Of 2224 women, 210 (9%) had TNBC. The median age was 59 years (22-95) and median follow up was 4 years. When we looked at the clinical characteristics of women with TNBC compared to non-TNBC, race, BRCA1,2 status, method of presentation, palpability, histology, grade, and Ki67 were statistically different (Table 1). When we looked at the correlation of MBD, FGT, and BPE for women with TNBC, MBD was correlated with FGT (r=0.64) but weakly correlated with BPE (r=0.22). We found a significant association of low BPE and TNBC compared to the non-TNBCs (p=0.021) (Table 1). In a short period of time, only 8 women with TNBC had a recurrence with no significant association with MBD, BPE, or FGT (Table 1).

Table 1.Imaging Characteristics among TNBC compared to non-TNBCVariableTNBC (N=210)%Non-TNBC (N=2014)%P-valueRace    0.001White13665153376 Black35171749 Hispanic1261156 Asian23111739 Other42191 BRCA1/2    <0.001Positive3025425 Negative897579195 Method of Presentation    <0.001Breast exam1125475738 Mammography7737105753 Ultrasound731106 MRI126553 Palpable    <0.001Yes1185783342 No9144115258 Histology    <0.001DCIS with Microinvasion21382 IDC19693159079 ILC5226913 Invasive Other731176 Invasive Grade    <0.001Grade 11131016 Grade 22714111858 Grade 31688650126 ER    <0.001Positive00189194 Negative2101001226 PR    <0.001Positive00160080 Negative21010041221 Ki67    <0.001Median (range)60 (0-99) 10 (0-99)  Mammographic Density    0.165Less dense82417846 More dense11959103454 MRI BPE    0.021Low BPE707655564 High BPE222431236 MRI FGT    0.370Less dense475440449 More dense404642151 

Conclusions:

In our study population, MBD and FGT did not differ between patients with TNBC compared to non-TNBC. Interestingly, we found a higher proportion of women with lower BPE in the TNBC compared to the non-TNBC group. BPE refers to the amount of enhancing fibroglandular tissue and has been demonstrated to reflect variations in estrogen-mediated vascular permeability. Lower BPE in TNBC may reflect the fact that these tumors are not hormonally sensitive. This may also have implications for radiogenomics, which aims to correlate imaging characteristics with gene expression and genome-related characteristics in tumor biology. Further studies are warranted in looking at these imaging biomarkers and TNBC.

Citation Format: Chun J, Schnabel F, Gooch J, Lee J, Jubas T, Goodgal J, Guth A, Moy L. The relationship of breast density in mammography and magnetic resonance imaging (MRI) in women with triple negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-02-01.

Effects of Ionic Strength, Salt, and pH on Aggregation of Boehmite Nanocrystals: Tumbler Small-Angle Neutron and X-ray Scattering and Imaging Analysis

The US government currently spends significant resources managing the legacies of the Cold War, including 300 million liters of highly radioactive wastes stored in hundreds of tanks at the Hanford (WA) and Savannah River (SC) sites. The materials in these tanks consist of highly radioactive slurries and sludges at very high pH and salt concentrations. The solid particles primarily consist of aluminum hydroxides and oxyhydroxides (gibbsite and boehmite), although many other materials are present. These form complex aggregates that dramatically affect the rheology of the solutions and, therefore, efforts to recover and treat these wastes. In this paper, we have used a combination of transmission and cryo-transmission electron microscopy, dynamic light scattering, and X-ray and neutron small and ultrasmall-angle scattering to study the aggregation of synthetic nanoboehmite particles at pH 9 (approximately the point of zero charge) and 12, and sodium nitrate and calcium nitrate concentrations up to 1 m. Although the initial particles form individual rhombohedral platelets, once placed in solution they quickly form well-bonded stacks, primary aggregates, up to ∼1500 Å long. These are more prevalent at pH = 12. Addition of calcium nitrate or sodium nitrate has a similar effect as lowering pH, but approximately 100 times less calcium than sodium is needed to observe this effect. These aggregates have fractal dimension between 2.5 and 2.6 that are relatively unaffected by salt concentration for calcium nitrate at high pH. Larger aggregates (>∼4000 Å) are also formed, but their size distributions are discrete rather than continuous. The fractal dimensions of these aggregates are strongly pH-dependent, but only become dependent on solute at high concentrations.

Chemical composition and antimicrobial activity of Gannan navel orange (Citrus sinensis Osbeck cv. Newhall) peel essential oils

The present investigation reported the chemical composition of cold pressed Gannan navel orange peel essential oil (EO) and its molecular distillation fraction (light phase EO), and examined their antimicrobial activity against spoiling and pathogenic microorganisms. Gas chromatography-mass spectrometry analysis identified 27 and 20 different chemical constituents in cold pressed EO and light phase EO, respectively. Limonene was the major constituent, accounting for 85.32% of cold pressed EO and 60.44% of light phase EO. Both EOs and some of their constituents showed good antimicrobial activity. Compared to cold pressed EO, light phase EO exhibited the better antimicrobial activity under weak acidic and neutral conditions. The light phase EO presented a higher antimicrobial activity after thermo-treatment at 60-100°C for 20 min than cold pressed EO. These results demonstrated that light phase EO had a potential to be used as a novel antimicrobial agent for food preservation and food processing.

Abstract P5-23-03: Gene expression profiling in male breast cancer

Background:

Tumor gene expression profiling tests are widely used to quantify risk of recurrence of breast cancer and guide systemic therapy in early stage breast cancer. These assays have not been well validated in a male cohort. The purpose of this study was to determine the current rates of genomic testing in male breast cancer (MBC), the distribution of risk of recurrence scores (RRS) in early stage MBC, and the effect of RRS on systemic treatment patterns.

Methods:

The National Cancer Database was queried and found to include 6,227 cases of pathologic T1/T2 and N0/N1 MBC from 2008-2014 with known genomic testing status. Of the 1478 (23.74%) male patients who had gene expression profiling performed, variables of interest included age at diagnosis, stage, estrogen receptor status (ER), RRS, and treatment. We compared the treatment patterns of the 1,343 patients who had RRS available and the 4,527 patients who were not tested. A similar analysis was performed in female breast cancer (FBC) patients to serve as a point of reference. Statistical analysis included multivariate logistic regression and Pearson's chi-square test.

Results:

Of the 1,478 (23.74%) cases of MBC who had gene expression profiling, the most significant variables included: younger age, non-Black race, diagnosis after 2010, tumor Grade II, Estrogen Receptor (ER) positivity, and N0 or N1mi disease. Of those who had results, the distribution of RRS was 59.3% low, 27.4% intermediate, and 13.3% high. A similar distribution was found in 154,705 women who were tested during the same study period. Risk scores in men were significantly associated with tumor grade and size, but not nodal status. 83.4% of men with a low RRS were treated with hormone therapy alone, with an adjusted odds ratio (AOR) of 7.18 (CI 5.78-8.91, p<0.001). Also, 61.8% of men with a high RRS received combination chemotherapy and hormone therapy, with an AOR of 5.16 (CI 3.60-740, p<0.001).

Conclusion:

Although there is limited literature supporting the use of genomic assays in MBC, our study found similar rates of testing in men and women with early stage breast cancer. Treatment patterns varied significantly based on risk stratification, implying that physicians are using gene profiling assays to help guide treatment in MBC. Understanding the role for genomic profiling in MBC is particularly important as these results will be incorporated into the new AJCC 8th edition staging system. Long term follow up is needed to determine whether these tests accurately predict prognosis and recurrence in a male cohort.

Citation Format: Dubrovsky E, Raymond S, Chun J, Schnabel F. Gene expression profiling in male breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-23-03.

Antioxidant and Anticancer Activities of Essential Oil from Gannan Navel Orange Peel

China is one of the leading producers of citrus in the world. Gannan in Jiangxi Province is the top navel orange producing area in China. In the present study, an essential oil was prepared by cold pressing of Gannan navel orange peel followed by molecular distillation. Its chemical composition was analyzed by GC-MS. Twenty four constituents were identified, representing 97.9% of the total oil. The predominant constituent was limonene (74.6%). The anticancer activities of this orange essential oil, as well as some of its major constituents, were investigated by MTT assay. This essential oil showed a positive effect on the inhibition of the proliferation of a human lung cancer cell line A549 and prostate cancer cell line 22RV-1. Some of the oil constituents displayed high anticancer potential and deserve further study.

Fumigant Activity of Sweet Orange Essential Oil Fractions Against Red Imported Fire Ants (Hymenoptera: Formicidae)

Sweet orange oil fractions were prepared by molecular distillation of cold-pressed orange oil from sample A (Citrus sinensis (L.) 'Hamlin' from America) and sample B (Citrus sinensis Osbeck 'Newhall' from China) respectively, and their fumigant activities against medium workers of red imported fire ants (Solenopsis invicta Buren) were investigated. The volatile composition of the orange oil fractions was identified and quantified using GC-MS. Fractions from sample A (A1, A2, and A3) contained 23, 37, and 48 chemical constituents, and fractions from sample B (B1, B2, and B3) contained 18, 29, and 26 chemical constituents, respectively. Monoterpenes were the most abundant components, accounting for 73.56% to 94.86% of total orange oil fractions, among which D-limonene (65.28-80.18%), β-pinene (1.71-5.58%), 3-carene (0.41-4.01%), β-phellandrene (0.58-2.10%), and linalool (0.31-2.20%) were major constituents. Fumigant bioassay indicated that all orange oil fractions exerted good fumigant toxicity against workers of fire ants at 3, 5, 10, and 20 mg/centrifuge tubes, and B1 had the strongest insecticidal potential, followed by A1, B2, A2, B3, and A3. The fractions composed of more high volatile molecules (A1 and B1) showed greater fumigant effects than others. Compounds linalool and D-limonene, which were the constituents of the orange oil, exhibited excellent fumigant toxicity against red imported fire ant workers. Linalool killed red imported fire ant workers completely at 5, 10, and 20 mg/tube after 8 h of treatment, and D-limonene induced >86% mortality at 8 h of exposure.

Dysregulation of lysophosphatidic acids in multiple sclerosis and autoimmune encephalomyelitis

Abstract

Bioactive lipids contribute to the pathophysiology of multiple sclerosis. Here, we show that lysophosphatidic acids (LPAs) are dysregulated in multiple sclerosis (MS) and are functionally relevant in this disease. LPAs and autotaxin, the major enzyme producing extracellular LPAs, were analyzed in serum and cerebrospinal fluid in a cross-sectional population of MS patients and were compared with respective data from mice in the experimental autoimmune encephalomyelitis (EAE) model, spontaneous EAE in TCR¹⁶⁴⁰ mice, and EAE in Lpar2^-/- mice. Serum LPAs were reduced in MS and EAE whereas spinal cord LPAs in TCR¹⁶⁴⁰ mice increased during the ‘symptom-free’ intervals, i.e. on resolution of inflammation during recovery hence possibly pointing to positive effects of brain LPAs during remyelination as suggested in previous studies. Peripheral LPAs mildly re-raised during relapses but further dropped in refractory relapses. The peripheral loss led to a redistribution of immune cells from the spleen to the spinal cord, suggesting defects of lymphocyte homing. In support, LPAR2 positive T-cells were reduced in EAE and the disease was intensified in Lpar2 deficient mice. Further, treatment with an LPAR2 agonist reduced clinical signs of relapsing-remitting EAE suggesting that the LPAR2 agonist partially compensated the endogenous loss of LPAs and implicating LPA signaling as a novel treatment approach.

Graphical abstract

Graphical summary of lysophosphatidic signaling in multiple sclerosis

Electronic supplementary material

The online version of this article (doi:10.1186/s40478-017-0446-4) contains supplementary material, which is available to authorized users.

Abstract P5-16-26: National trends in neoadjuvant therapy for breast cancer

Purpose:Neoadjuvant therapy has been widely integrated in the treatment of locally advanced breast cancer. Over time, this strategy has been extended to include patients with earlier stage disease to allow for assessment of in vivo response to treatment. The aim of this study was to describe the national trends in neoadjuvant therapy for all invasive breast cancers with a particular focus on triple negative disease and HER2 status.

Methods: The National Cancer Database (NCDB), an oncology outcomes database that collects data from more than 1500 Commission on Cancer (CoC) accredited cancer programs, was queried for all women diagnosed with invasive breast cancer from 2006-2013. Patients with unknown systemic therapy sequence were excluded. Women were classified by whether or not they received neoadjuvant systemic, chemo and/or endocrine, therapy.

Results: We identified 1,221,976 cases that were eligible for this analysis. Of these, 29.7% were HER2 negative, 18.4% were classified as triple negative, and 8.9% received neoadjuvant systemic therapy. The percentage of patients receiving neoadjuvant therapy increased from 7.5% in 2006 to 9.8% in 2012 with a slight decrease to 9.5% in 2013. This increase in the use of neoadjuvant therapy over the time period was statistically significant (p<0.0001). There was a small increase in the percent of patients with HER2 positive status who received neoadjuvant therapy, from 5.7% in 2006 to 6.5% in 2013. During this time period, there was a 9% increase in the percent of triple negative patients who received neoadjuvant therapy (13.1% in 2016 to 22.1% in 2013).

Number and percent of patients who received/did not receive neoadjuvant therapy by year2006 (N=136117)2007 (N=143033)2008 (N=148888)2009 (N=154713)2010 (N=154040)2011 (N=162333)2012 (N=163395)2013 (N=159457)No Neoadjuvant Therapy | 125908 (92.5)131559 (91.98)136593 (91.74)141364 (91.37)139459 (90.53)146500 (90.25)147401 (90.21)144306 (90.5)Neoadjuvant Therapy | 10209 (7.5)11474 (8.02)12295 (8.26)13349 (8.63)14581 (9.47)15833 (9.75)15994 (9.79)15151 (9.5)

Conclusions: Over the time period from 2006-2013, there has been an apparent increase in the percentage of patients who received neoadjuvant therapy. This trend is accompanied by increases in the percentage of TNBC patients and in Her2 positive patients who received neoadjuvant therapy. Other factors and the joint effects of these factors on the observed increase in the use of neoadjuvant therapy are under evaluation to elucidate the basis for this observation in the NCDB data.

Citation Format: Schnabel F, Schwartz S, Hochman T, Chun J, Goldberg J. National trends in neoadjuvant therapy for breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-26.

NLRP3 regulates a non-canonical platform for caspase-8 activation during epithelial cell apoptosis

Nod-like receptor, pyrin containing 3 (NLRP3) is characterized primarily as a canonical caspase-1 activating inflammasome in macrophages. NLRP3 is also expressed in the epithelium of the kidney and gut; however, its function remains largely undefined. Primary mouse tubular epithelial cells (TEC) lacking Nlrp3 displayed reduced apoptosis downstream of the tumor necrosis factor (TNF) receptor and CD95. TECs were identified as type II apoptotic cells that activated caspase-8, tBid and mitochondrial apoptosis via caspase-9, responses that were reduced in Nlrp3-/- cells. The activation of caspase-8 during extrinsic apoptosis induced by TNFα/cycloheximide (TNFα/CHX) was dependent on adaptor protein apoptosis-associated speck-like protein containing a CARD (ASC) and completely independent of caspase-1 or caspase-11. TECs and primary human proximal tubular epithelial cells (HPTC) did not activate a canonical inflammasome, caspase-1, or IL-1β secretion in response to TNFα/CHX or NLRP3-dependent triggers, such as ATP or nigericin. In cell fractionation studies and by confocal microscopy, NLRP3 colocalized with ASC and caspase-8 in speck-like complexes at the mitochondria during apoptosis. The formation of NLRP3/ASC/caspase-8 specks in response to TNFα/CHX was downstream of TNFR signaling and dependent on potassium efflux. Epithelial ASC specks were present in enteroids undergoing apoptosis and in the injured tubules of wild-type but not Nlrp3-/- or ASC-/- mice following ureteric unilateral obstruction in vivo. These data show that NLRP3 and ASC form a conserved non-canonical platform for caspase-8 activation, independent of the inflammasome that regulates apoptosis within epithelial cells.

Abstract P6-09-13: Multi-institutional evaluation of women at high-risk for developing breast cancer

Background

Well-established risk factors for breast cancer (BC) include family history, BRCA mutations and biopsies with atypical hyperplasia (AH) or lobular carcinoma in situ (LCIS). Several institutions have registries of these high-risk women but outcomes from these registries require large numbers and long follow-up. We sought to compare characteristics between high-risk populations and evaluate early outcomes.

Methods

Women enrolled in IRB-approved high risk registries at NYU Langone Medical Center (NYU) and University of Vermont (UVM) were evaluated for risk category, uptake of prevention and development of breast cancer. Descriptive statistics were used to summarize the data and Pearson's Chi-Square and Fisher's Exact Tests were performed to compare the variables of interest among the two high risk registries.

Results

Between 2003-14, 1035 women enrolled in these high risk registries. There were significant differences in age and risk characteristics but we found a 99% concordance of variables collected between both high risk registries. Among all risk groups there was a low uptake of prevention opportunities, with 8% taking chemoprevention and 7% undergoing risk-reducing surgeries. Women with AH/LCIS accounted for 66% of those choosing chemoprevention while women with BRCA mutations accounted for 76% of those undergoing risk-reducing surgeries. To date, 43 women (4%) have been diagnosed with breast cancer. 86% were diagnosed with stage 0-1 disease and 70% had moderate or poorly differentiated cancers. There was no significant difference in background risk characteristics when comparing those with breast cancer to those who have not yet developed breast cancer.

Table 1. Clinicopathologic Characteristics between UVM and NYUVARIABLESUVM (N=496, 48%)%NYU (N=539, 52%)%P-valueMEDIAN AGE (years)46 (20-75)50 (20-87)p<0.001RISK FACTORSOne or more 1° relative with BC4428928653p<0.001BRCA positive2559217p<0.001AH631324545p<0.001LCIS22411221p<0.001UPTAKE OF BC PREVENTION METHODSChemoprevention2755410p<0.01Prophylactic bilateral mastectomy10.2458p<0.001Bilateral salpingo-oophorectomy10.2428p<0.001DEVELOPED BC316122p<0.01STAGE OF BC000542p<0.01I2684650 IIA, IIB2618 IIIA, IIIB, IIIC31000 

Conclusions

Despite the low uptake of chemoprevention and risk reducing surgery, only 4% of patients went on to develop breast cancer in the study period. The majority of cancers involved moderate or high-grade lesions and were early stage, suggesting a benefit to participation in surveillance programs. We have demonstrated a high degree of concordance between high risk registries, suggesting no barriers to multi-institutional collaboration. High risk registries represent an important resource for studies into methods to prevent breast cancer and improve outcomes from this disease.

Citation Format: Wood M, Schnabel F, Chun J, Schwartz S, Rounds T, Cuke M. Multi-institutional evaluation of women at high-risk for developing breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-09-13.

Abstract P2-12-12: MarginProbe device use and re-excision rates for breast conservation surgeries

Background: Current methods of intraoperative assessment of lumpectomy margins are limited. Previous studies have found a lower rate of re-excisions with the adjunctive use of the MarginProbe device (Dune Medical Devices Ltd, Israel). The purpose of this study was to compare the tumor characteristics and re-excision rates before and after the use of MarginProbe for patients who had breast conservation surgery (BCS) at our institution.

Methods: The Breast Cancer Database of our medical center was queried for patients who underwent BCS from 1/2010-3/2015 by three breast surgeons. 2 surgeons used the MarginProbe to direct excision of additional margins at the time of primary lumpectomy surgery and 1 surgeon performed routine 6-surface cavity shavings. We compared our historical data (1/2010-12/2014) to MarginProbe data (1/2015-4/2015). The following variables were included: age, mammographic breast density, tumor characteristics, and re-excision rates. Statistical analyses were performed using Pearson's Chi-Square and Fisher's Exact Tests.

Results: We had a total of 1201 women who had BCS among the 3 breast surgeons. The median age was 61 years. The median invasive size was 1.2 cm. Majority of cancers were early stage (stage 0, I), invasive ductal carcinoma (61%), ER-positive (86%), PR-positive (74%), and Her2Neu-negative (88%). These tumor characteristics were not statistically different in the pre- and post-MarginProbe groups. The majority of patients had dense breasts (51%) and density did not differ among the pre- and post-MarginProbe groups (p=0.86). For the surgeons who used the MarginProbe for margin assessment at the time of surgery, the re-excision rate fell from 17% to 0% and 35% to 20% during the 4-month period. In contrast, the surgeon who routinely performed 6-surface shavings had a re-excision rate that fell from 13% to 12% in the same time period. 88% of MarginProbe readings were false positive. There was one false negative reading.

Table 1. Tumor CharacteristicsVARIABLESTotal N=1201%No MarginProbe (N=1144, 95%)%MarginProbe (N=57, 5%)%P-valueTUMOR STAGE0292242782414240.95I64454614543053 IIA, IIB22319211191221 IIIA, IIIB, IIIC39338312 IV30.330.300 HISTOLOGYDuctal carcinoma in situ305252892516280.75Invasive ductal carcinoma73061695613561 Invasive lobular carcinoma1129107959 Invasive other54553512 ESTROGEN RECEPTOR STATUSNegative16314157146110.46Positive101486963865189 PROGESTERONE RECEPTOR STATUSNegative307262942613230.56Positive86774823744477 HER2-NEU STATUSNegative788887538835810.22Positive92108610614 Equivocal19217225 

Conclusions: Routine use of the MarginProbe device was associated with lower re-excision rates compared to historical data and concurrent 6-cavity shaving approach. Better intraoperative margin assessment and lower re-excision rates will decrease the burden of breast cancer on patients and the health care system and support the practice of breast conserving surgery.

Citation Format: Schnabel F, Guth A, Axelrod D, Chun J, Schwartz S, Shapiro R. MarginProbe device use and re-excision rates for breast conservation surgeries. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-12.

Impaired motor performance in adolescents at familial high-risk for schizophrenia

BACKGROUND

The Harvard Adolescent Family High Risk (FHR) Study examined multiple domains of function in young relatives of individuals diagnosed with schizophrenia to identify precursors of the illness. One such area is motor performance, which is deviant in people with schizophrenia and in children at risk for schizophrenia, usually offspring. The present study assessed accuracy of motor performance and degree of lateralization in FHR adolescents and young adults.

METHODS

Subjects were 33 non-psychotic, first-degree relatives of individuals diagnosed with schizophrenia, and 30 non-psychotic comparison subjects (NpC), ranging in age from 13 to 25 who were compared using a line-drawing task.

RESULTS

FHR individuals exhibited less precise and coordinated line drawing but greater degree of lateralization than controls. Performance on the linedrawing task was correlated with degree of genetic loading, a possible predictor of higher risk for schizophrenia in the pedigree.

CONCLUSIONS

The observation of increased motor deviance and increased lateralization in FHR can be utilized in identification and initiation of the treatment in those at high risk in order to prevent or delay the full manifestation of this devastating condition. The use of a rigorously quantified measure is likely to add to the sensitivity of measuring motor performance, especially when impairments may be subtle.

Pyrosequencing Analysis of Subgingival Microbiota in Distinct Periodontal Conditions

Subgingival microorganisms are potentially associated with periodontal diseases. However, changes in the subgingival microbiota during the progress of periodontal diseases are poorly understood. In this study, we analyzed bacterial communities in the subgingival paper point samples from 32 Korean individuals with no sign of disease, gingivitis, or periodontitis using 454 FLX Titanium pyrosequencing. A total of 256,113 reads representing 26 phyla, 433 genera, and 1,016 species were detected. Bacteroidetes, Fusobacteria, Synergistetes, and Spirochaetes were the abundant phyla in periodontitis subjects, whereas Firmicutes and Proteobacteria were identified as the dominant phyla in the gingivitis and healthy subjects, respectively. Although high levels of Porphyromonas, Fusobacterium, Fretibacterium, Rothia, Filifactor, and Treponema genera were observed in the periodontitis subjects, Streptococcus, Capnocytophaga, Leptotrichia, and Haemophilus genera were found at high frequency in the gingivitis subjects. Species including Porphyromonas gingivalis, Fusobacterium nucleatum, and Fretibacterium fastidiosum were significantly increased in periodontitis subjects. On the other hand, Streptococcus pseudopneumoniae, Haemophilus parainfluenzae, and Leptotrichia hongkongensis were preferentially observed in the gingivitis subjects. Intriguingly, the halophile Halomonas hamiltonii was revealed as a predominant species in the healthy subjects. Based on Fast UniFrac analysis, distinctive bacterial clusters were classified for the healthy, gingivitis, and periodontitis state. The current findings might be useful for understanding the pathogenesis, diagnosis, and treatment of periodontal diseases.

LPA signaling initiates schizophrenia-like brain and behavioral changes in a mouse model of prenatal brain hemorrhage

Genetic, environmental and neurodevelopmental factors are thought to underlie the onset of neuropsychiatric disorders such as schizophrenia. How these risk factors collectively contribute to pathology is unclear. Here, we present a mouse model of prenatal intracerebral hemorrhage--an identified risk factor for schizophrenia--using a serum-exposure paradigm. This model exhibits behavioral, neurochemical and schizophrenia-related gene expression alterations in adult females. Behavioral alterations in amphetamine-induced locomotion, prepulse inhibition, thigmotaxis and social interaction--in addition to increases in tyrosine hydroxylase-positive dopaminergic cells in the substantia nigra and ventral tegmental area and decreases in parvalbumin-positive cells in the prefrontal cortex--were induced upon prenatal serum exposure. Lysophosphatidic acid (LPA), a lipid component of serum, was identified as a key molecular initiator of schizophrenia-like sequelae induced by serum. Prenatal exposure to LPA alone phenocopied many of the schizophrenia-like alterations seen in the serum model, whereas pretreatment with an antagonist against the LPA receptor subtype LPA1 prevented many of the behavioral and neurochemical alterations. In addition, both prenatal serum and LPA exposure altered the expression of many genes and pathways related to schizophrenia, including the expression of Grin2b, Slc17a7 and Grid1. These findings demonstrate that aberrant LPA receptor signaling associated with fetal brain hemorrhage may contribute to the development of some neuropsychiatric disorders.

Spinal cord compression injury in lysophosphatidic acid 1 receptor-null mice promotes maladaptive pronociceptive descending control

BACKGROUND

Although activation of the lysophosphatidic acid receptor 1 (LPA1) is known to mediate pronociceptive effects in peripheral pain models, the role of this receptor in the modulation of spinal nociception following spinal cord injury (SCI) is unknown.

AIM

In this study, LPA1 regulation of spinal excitability mediated by supraspinal descending antinociceptive control systems was assessed following SCI in both wild-type (WT) and maLPA1-null receptor mice.

METHODS

The effect of a T8 spinal compression in WT and maLPA1-null mice was assessed up to 1 month after SCI using histological, immunohistochemical and behavioural techniques analysis including electrophysiological recording of noxious toes-Tibialis Anterior (TA) stimulus-response reflex activity. The effect of a T3 paraspinal transcutaneous electrical conditioning stimulus on TA noxious reflex temporal summation was also assessed.

RESULTS

Histological analysis demonstrated greater dorsolateral funiculus damage after SCI in maLPA1-null mice, without a change in the stimulus-response function of the TA noxious reflex when compared to WT mice. While T3 conditioning stimulation in the WT group inhibited noxious TA reflex temporal summation after SCI, this stimulus strongly excited TA reflex temporal summation in maLPA1-null mice. The functional switch from descending inhibition to maladaptive facilitation of central excitability of spinal nociception demonstrated in maLPA1-null mice after SCI was unrelated to a general change in reflex activity.

CONCLUSIONS

These data suggest that the LPA1 receptor is necessary for inhibition of temporal summation of noxious reflex activity, partly mediated via long-tract descending modulatory systems acting at the spinal level.

Cloning and characterization of a SnRK2 gene from Jatropha curcas L

Although the SnRK2 class of Ser/Thr protein kinases is critical for signal transduction and abiotic stress resistance in plants, there have been no studies to examine SnRK2 in Jatropha curcas L. In the present study, JcSnRK2 was cloned from J. curcas using the rapid amplification of cDNA end technique and characterized. The JcSnRK2 genomic sequence is 2578 base pairs (bp), includes 10 exons and 9 introns, and the 1017-bp open reading frame encodes 338 amino acids. JcSnRK2 was transcribed in all examined tissues, with the highest transcription rate observed in the roots, followed by the leaves and stalks; the lowest rate was observed in flowers and seeds. JcSnRK2 expression increased following abscisic acid treatment, salinity, and drought stress. During a 48-h stress period, the expression of JcSnRK2 showed 2 peaks and periodic up- and downregulation. JcSnRK2 was rapidly activated within 1 h under salt and drought stress, but not under cold stress. Because of the gene sequence and expression similarity of JcSnRK2 to AtSnRK2.8, primarily in the roots, an eukaryotic expression vector containing the JcSnRK2 gene (pBI121-JcSnRK2) was constructed and introduced to the Arabidopsis AtSnRK2.8 mutant snf2.8. JcSnRK2-overexpressing plants exhibited higher salt and drought tolerance, further demonstrating the function of JcSnRK2 in the osmotic stress response. J. curcas is highly resistant to extreme salt and drought conditions and JcSnRK2 was found to be activated under these conditions. Thus, JcSnRK2 is potential candidate for improving crop tolerance to salt and drought stress.

Insecticidal, fumigant, and repellent activities of sweet wormwood oil and its individual components against red imported fire ant workers (Hymenoptera: Formicidae)

In total, 29 compounds from sweet wormwood (Artemisia annua L.) oil were identified using gas chromatography-mass spectrometry. The five active components were D-camphor, linalool, cineole, α-terpineol, and L(-)-borneol. The effectiveness of A. annua oil, as well as d-camphor, linalool, cineole, α-terpineol, and L(-)-borneol, as fumigants, contact insecticides, and repellents, were tested on the red imported fire ant Solenopsis invicta Buren. The results indicated that A. annua oil has no significant topical toxicity; however, the spray contact test revealed that it has strong insecticidal activity and the inhibitory effect is stronger during closed exposure than during open exposure. In the fumigant test, cineole and D-camphor exhibited strong fumigant toxicity on minor and major S. invicta workers. They also caused 100% mortality at 5, 3, 2, and 1 mg/centrifuge tube but not at 0.5 mg/centrifuge tube. The mortality rates of linalool, α-terpineol, and L(-)-borneol exceeded 80% at 5, 3, and 2 mg/centrifuge tube. In the repellent test, cineole and d-camphor showed significant repellency at 100, 10, and 1 mg/kg. However, linalool, α-terpineol, and L(-)-borneol significantly facilitated digging at 10 and 1 mg/kg.

Abstract P5-15-02: Beyond the learning curve: Surgical judgment in the approach to breast conserving surgery

Background: Inadequate lumpectomy margins are associated with an increased risk of ipsilateral breast tumor recurrence in patients undergoing breast conserving surgery for malignant disease. Second surgical procedures are often required to achieve acceptable margins. The purpose of this study was to examine the practice of breast conserving surgery by experienced practitioners, focusing on the approach to margins at the time of primary lumpectomy procedure.

Methods: The NYU Langone Medical Center Breast Cancer Database was queried for patients who underwent breast conserving surgery from 1/2010-1/2013 by experienced breast surgeons. Variables of interest, segregated by surgeon, included: characteristics of additional margins taken at primary lumpectomy surgery, re-excision rates, and rates of conversion to mastectomy. Statistical analyses were performed using Pearson's Chi-Square Test, Spearman's correlation, and descriptive analyses.

Results: During the study period, 988 patients opted for breast conserving surgery for invasive and intraductal breast cancer, including 260 patients who underwent at least 1 re-excision procedure. We excluded 31 patients who had initial surgery outside of NYU, yielding a study cohort of 229 patients. Stage 0 disease was associated with an increased frequency of re-excision procedures (p<0.0001). Re-excision rates differed widely among surgeons (10-36%). The average number of additional margins excised did not correlate with surgeons’ re-excision rates (p = 0.18). Additional margins taken at primary lumpectomy surgery included both false positives and true positives (Table 1). Of note, the number of false positive margin excisions was double the number of true positives. Patients who went on to mastectomy after unsuccessful primary lumpectomy surgery (45 of a total of 59 who converted to mastectomy) frequently did so based on their preference (19/45 = 42%). However, patients who converted to mastectomy after multiple excisions generally did so out of concern for extent of disease.

Conclusions: In our study, patients with pure intraductal carcinoma represented a particular challenge as surgeons’ margin assessment was less accurate than in cases of invasive cancer. Re-excision rates varied by surgeon, and did not correlate with the average number of additional margins taken at the primary lumpectomy procedure. The rate of false positive margins excised exceeded the true positive rate, reflecting the limitations of surgeons’ ability to assess margins intraoperatively. We documented a significant number of patients who opted for conversion to mastectomy after a single unsuccessful lumpectomy procedure, underscoring the need for better methods of intraoperative margin assessment to support the practice of breast conserving surgery.

Table 1: Re-excision rates and approach to margins at primary lumpectomy surgerySurgeonPatients undergoing Re-excision - N (%)Avg Additional Margins Taken (per patient) in Primary LumpectomyFalse Positives - N (%)True Positives - N (%)A67 (23%)139 (10%)26 (6%)B53 (10%)4147 (45%)60 (18%)C14 (19%)217 (20%)6 (7%)D11 (31%)01 (1%)3 (5%)E8 (36%)15 (10%)3 (6%)F27 (11%)118 (11%)10 (6%)G20 (15%)335 (29%)26 (22%)H29 (32%)237 (21%)24 (14%)Total229 (16%)2299 (22%)158 (11%)

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-15-02.

Fear extinction and acute stress reactivity reveal a role of LPA(1) receptor in regulating emotional-like behaviors

LPA1 receptor is one of the six characterized G protein-coupled receptors (LPA1-6) through which lysophosphatidic acid acts as an intercellular signaling molecule. It has been proposed that this receptor has a role in controlling anxiety-like behaviors and in the detrimental consequences of stress. Here, we sought to establish the involvement of the LPA1 receptor in emotional regulation. To this end, we examined fear extinction in LPA1-null mice, wild-type and LPA1 antagonist-treated animals. In LPA1-null mice we also characterized the morphology and GABAergic properties of the amygdala and the medial prefrontal cortex. Furthermore, the expression of c-Fos protein in the amygdala and the medial prefrontal cortex, and the corticosterone response following acute stress were examined in both genotypes. Our data indicated that the absence of the LPA1 receptor significantly inhibited fear extinction. Treatment of wild-type mice with the LPA1 antagonist Ki16425 mimicked the behavioral phenotype of LPA1-null mice, revealing that the LPA1 receptor was involved in extinction. Immunohistochemistry studies revealed a reduction in the number of neurons, GABA+ cells, calcium-binding proteins and the volume of the amygdala in LPA1-null mice. Following acute stress, LPA1-null mice showed increased corticosterone and c-Fos expression in the amygdala. In conclusion, LPA1 receptor is involved in emotional behaviors and in the anatomical integrity of the corticolimbic circuit, the deregulation of which may be a susceptibility factor for anxiety disorders and a potential therapeutic target for the treatment of these diseases.

Abstract P1-09-03: Chemoprevention in patients with newly diagnosed breast cancers

Background: Chemoprevention (including tamoxifen, raloxifene, and exemestane) is a strategy to reduce breast cancer incidence in high risk women. Studies have shown at least a 50% decrease in the incidence of breast cancer in users of these drugs. Despite this benefit, the majority of high risk, unaffected women who are offered chemoprevention decline the therapy. However, there is a growing population of women who have used these agents for primary prevention, and a larger population of survivors who have used these drugs as part of their systemic treatment. The purpose of this study was to identify a cohort of women with newly diagnosed breast cancers who had utilized chemoprevention and describe their patterns of disease.

Methods: The Breast Cancer Database of NYU Langone Medical Center was queried for patients who used chemopreventive drugs and developed breast cancer between 1/2010-1/2012. Patients were divided into primary and secondary chemoprevention groups (no previous history of breast cancer and previous history of breast cancer, respectively). Descriptive statistics were utilized.

Results: In the study period, 24 (2%) of 996 patients had used a chemopreventive agent. For 16 of the 24 (67%), the drug was part of systemic therapy for prior breast cancer, with a median of 12 years from the initial diagnosis to the diagnosis of a second breast cancer. The primary chemoprevention group included women with risk based on family history and atypical hyperplasias. The majority of patients were diagnosed with early stage disease (88% DCIS and stage I). This likely reflects their screening behaviors. In both groups, the majority of cancers were ductal in origin. Five of the 8 patients in the primary chemoprevention group were on treatment at the time of their cancer diagnosis, while 63% of patients in the secondary group were prior users. In the secondary group, the majority of cases were contralateral second primary breast cancers, with 31% ipsilateral recurrences. Interestingly, the majority of cancers in both groups were ER/PR positive.