EXPRESSION OF THE TYPE 1 TYROSINE KINASE GROWTH FACTOR RECEPTORS EGF RECEPTOR,c-erbB2 AND c-erbB3 IN BLADDER CANCER

Expression of the c-erbB3 protein was determined in transitional cell carcinoma of the bladder by immunohistochemistry. Strong membrane staining was observed in 10 per cent of cases (7/70) and cytoplasmic and membrane overexpression in 20 per cent (14/70). Overexpression of the epidermal growth factor (EGF) receptor (36 per cent, 25/70) and c-erbB2 proteins (9 per cent 6/70) was determined in the same series of cases. c-erbB3 overexpression was positively correlated with EGF receptor expression ( P <0·025) but appeared to be inversely associated with c-erbB2 overexpression.     

Biological role of NHERF1 protein expression in breast cancer

Aims:  To determine the role of Na+/H+ exchanger regulatory factor ( NHERF1 ) in breast cancerogenesis and progression.
Methods and results:  NHERF1 expression was examined in normal tissue, ductal carcinoma in situ (DCIS), invasive carcinoma (IBC), synchronous metastatic lymph node and metachronous distant metastases of a retrospective series of breast cancers. Fifty-one IBC, 42 DCIS and normal tissues were examined immunohistochemically, and the colocalization between NHERF1 and HER2/neu was studied by immunofluorescence. NHERF1 showed a different localization and pattern of expression in the different compartments of the breast. The mean value of cytoplasmic NHERF1 expression in paired samples was significantly higher in DCIS, IBC, distant metastases and metastatic lymph nodes with respect to normal tissues. Moreover, in metastatic lymph nodes NHERF1 was exclusively cytoplasmic. In the membrane NHERF1 was colocalized with overexpressed HER2/neu in DCIS, IBC and distant metastases.
Conclusions:  Breast cancerogenesis is characterized by increased cytoplasmic expression of NHERF1 as the tumour progresses, suggesting a role in this process. The switch from apical membranous to cytoplasmic expression is compatible with a dual role for NHERF1 as a tumour suppressor or tumour promoter dependent on its subcellular localization.     

Studies of c-jun oncogene expression in human breast using a new monoclonal antibody,NCL-DK4

A new monoclonal antibody to human c-jun oncoprotein, designated NCL-DK4, has been produced. NCL-DK4 has been proved to be highly effective for use on formalin-fixed, paraffin-embedded tissues, enabling the study of c-jun expression at a cellular level in both normal and neoplastic human tissues. The expression of c-jun oncogene has been examined in normal, benign, and malignant breast tissues, and c-jun-specific immunoreactivity in carcinomas has been related to histological type, tumour grade, c-erbB-2, oestrogen receptor, progesterone receptor, and epidermal growth factor receptor expression. Normal and benign breast tissues showed c-jun-specific immunostaining, which was weaker and in fewer cells compared with the c-jun immunoreactivity observed in breast carcinomas. No relationship was found between the degree of immunostaining and the extent of proliferative changes in benign breast tissues. Ninety per cent of all breast carcinomas studied showed c-jun-specific nuclear staining. There were no statistically significant differences in the intensity of c-jun immunoreactivity among grade I, II, and III infiltrating ductal carcinomas. There was no significant relationship between c-jun oncoprotein expression and c-erbB-2, oestrogen, progesterone, and epidermal growth factor receptor immunoreactivity.     

NCL-CB11, a new monoclonal antibody recognizing the internal domain of the c-erbB-2 oncogene protein effective for use on formalin-fixed, paraffin-embedded tissue

The c-erbB-2 proto-oncogene encodes a 190 k Mr protein representing a putative growth factor receptor with considerable homology to the EGF receptor. Gene amplification and overexpression of the oncogene protein have been demonstrated in a variety of tumours including breast cancer, where it is associated with a poor prognosis. In this study we have produced and characterized a mouse monoclonal antibody, designated NCL-CB11, to the c-erbB-2 protein. NCL-CB11 was generated to a synthetic peptide sequence corresponding to a site of predicted antigenicity near the C-terminus of the internal domain of the protein. NCL-CB11 produces intense membrane-associated immunohistochemical staining in a proportion of human cancer cells. The specificity of the antibody is supported by Western blotting and immunoprecipitation studies. Reactivity with an internal site of the protein is confirmed by the necessity of cell permeabilization for reactivity in fluorescence-activated cell sorter (FACS) analysis. A high degree of correlation between immunohistochemical staining using NCL-CB11, and c-erbB-2 gene amplification has been observed. NCL-CB11 should prove to be a valuable reagent for investigations into the pathological significance of c-erbB-2 protein expression.     

The assessment of HER2 status and its clinical implication in breast cancer

Amplification and overexpression of human epidermal growth factor receptor 2 (HER2) in breast cancer is associated with an adverse prognosis. The introduction of trastuzumab and lapatinib has substantially improved the clinical outcomes of patients with HER2-positive breast cancer. The key element of the successful application of anti-HER2 therapies in real-world has been the selection of candidates for treatment based on the level of HER2 positivity of the tumor. HER2 status of breast cancer is clinically assessed by HER2 protein expression with immunohistochemistry (IHC) or HER2 gene amplification with in situ hybridization (ISH). The 2018 American Society of Clinical Oncology and the College of American Pathologists (ASCO/CAP) HER2 guideline focused update revised the HER2 scoring criteria. Digital image analysis (DIA) has emerged as an objective and reproducible IHC scoring method and the ASCO/CAP HER2 guideline has acknowledged DIA as a diagnostic modality. In this article, we aim to review the assessment of HER2 status and its clinical application in breast cancer.     

微小染色体维持蛋白2在乳腺癌组织中的表达及意义

目的:探讨微小染色体维持蛋白2(MCM2p)在乳腺癌的表达及其与临床病理特征的关系,并分析MCM2p与Ki-67的相关性。方法:运用免疫组织化学方法检测乳腺癌组织中MCM2p、Ki-67的表达。结果:在乳腺癌组织中MCM2p、Ki-67的表达均高于正常乳腺组织,且MCM2p的标记指数明显高于Ki-67,两者表达呈正相关。MCM2p的表达与肿瘤的分化程度、淋巴结转移、临床病理分期和核分裂指数有非常显著相关性,与患者的年龄、肿瘤大小及组织学类型无显著性关系。结论:MCM2p与乳腺癌临床病理的发展紧密相关,作为病理诊断的参考指标较Ki-67有更强的敏感性。     

The multifunctional role of the immunohistochemical expression of MMP-7 in invasive breast cancer

The secretion of matrix metalloproteinases (MMPs) is crucial in the metastasis of cancer cells, since MMPs are responsible for the degradation of extracellular matrix (ECM). Among them, matrix metalloproteinase-7 (MMP-7) or matrilysin 1 is a stromelysin which degrades type-IV collagen, fibronectin and laminin. Immunohistochemistry was performed to detect MMP-7 protein in infiltrative breast carcinomas. MMP-7 was studied along with clinicopathological parameters, disease-free and overall survival, and p53, c-erbB-2, topoIIa, MMP-2, uPAR and beta-catenin. MMP-7 immunoreactivity was detected in the cytoplasm of cancer cells in 54.2% (96/177) and tumor stromal cells in 47.5% (84/177), as well as in normal epithelium adjacent to malignant epithelium. MMP-7 reactivity in cancer cells displayed an inverse association with nuclear grade (p=0.049) and topoIIa (p=0.03). A parallel association was observed between the expression of MMP-7 in both malignant and stromal cells with uPAR in cancer cells (p=0.033 and p=0.027, respectively). MMP-7 of tumor stromal cells depicted a parallel correlation with MMP-2 of the same cell type (p=0.044), while abnormal beta-catenin expression was inversely associated with MMP-7 of cancer cells (p=0.047). Our results show the multifunctional role of MMP-7 in the mammary gland, since it seems to be associated with a less aggressive phenotype, while, at the same time, being involved in invasion, through its collaboration with indicators of invasion.     

A Ki67/BCL2 index based on immunohistochemistry is highly prognostic in ER-positive breast cancer

There is an urgent need to improve prognostic classifiers in breast cancer. Ki67 and B-cell lymphoma 2 protein (BCL2) are established prognostic markers which have traditionally been assessed separately, in a dichotomous manner. This study was conducted to test the hypothesis that combinatorial assessment of these markers would provide superior prognostic information and improve their clinical utility. Tissue microarrays were used to assess the expression of Ki67 and BCL2 in 2749 cases of invasive breast cancer. We devised a Ki67/BCL2 index representing the relative expression of each protein and assessed its association with breast cancer-specific survival (BCSS) using a Cox proportional-hazards model. Based on our findings, an independent cohort of 3992 cases was used to validate the prognostic significance of the Ki67/BCL2 index. All survival analyses were conducted on complete data as well as data where missing values were resolved using multiple imputation. This study complied with reporting recommendations for tumour marker prognostic studies (REMARK) criteria. The Ki67/BCL2 index showed a significant association with BCSS at 10 years in estrogen receptor (ER)-positive disease. In multivariate analysis, adjusting for major clinical and molecular markers, the Ki67/BCL2 index retained prognostic significance, robustly classifying cases into three risk groups [intermediate- versus low-risk hazard ratio (HR), 1.5; 95% confidence interval (95% CI), 1.0-2.0; p = 0.031; high- versus low-risk HR, 2.6; 95% CI, 1.3-5.0; p = 0.005]. This finding was validated in an independent cohort of 3992 tumours containing 2761 ER-positive tumours (intermediate- versus low-risk HR, 1.7; 95% CI, 1.3-2.1; p < 0.001; high- versus low-risk HR, 2.0; 95% CI, 1.4-2.9; p < 0.001). Ki67 and BCL2 can be effectively combined to produce an index which is an independent predictor of BCSS in ER-positive breast cancer, enhancing their potential prognostic utility.     

Cytoplasmic expression of c-erbB2 in non-small cell lung cancers

The aim of this study was to investigate the expression of c-erbB2 in non-small cell lung cancers (NSCLCs) with attention both to membranous and cytoplasmic reaction, and to try to elucidate the meaning of cytoplasmic expression of c-erbB2 in NSCLCs. Immunohistochemical c-erbB2 expression and related clinico-pathological features were examined in 312 surgically resected patient tissues of NSCLCs, including 175 cases of adenocarcinoma and 137 cases of squamous cell carcinoma. Immunostaining of inner- and ecto-domain of c-erbB2, mRNA expression and the quantitation of soluble c-erbB2 in cultured media were performed in five NSCLC cell lines. Cytoplasmic expression of c-erbB2 was observed more frequently than membranous, both in patient tissues and cell lines. Neither membranous nor cytoplasmic expression of c-erbB2 was significantly correlated with short outcome in NSCLCs. Membranous c-erbB2 was expressed by both inner and ecto-domain, while cytoplasmic c-erbB2 was expressed by either or both inner and ecto-domain. c-erbB2 mRNA was produced in most cell lines; however, the soluble form was only detectable in a cell line that only presented a membranous c-erbB2. In conclusion, cytoplasmic c-erbB2 of NSCLCs was not a full-length protein only expressed in cellular membrane, but reflected degenerated c-erbB2 fragments with less functional ability.     

c-erbB癌基因家族基因扩增与乳腺癌临床病理分期的相关性研究

为探讨c -erbB癌基因家族 4基因扩增与乳腺癌病人临床病理分期的关系及该家族 4基因间的相互作用 ,应用差异聚合酶链反应技术检测 70例乳腺癌组织和癌旁正常乳腺组织中c -erbB家族 4基因扩增情况。结果　 70例乳腺癌组织中c-erbB - 1基因和c -erbB - 4基因在癌组织中无扩增 (P >0 0 5) ,而c-erbB - 2基因和c -erbB - 3基因存在明显扩增(P <0 0 5) ,扩增阳性率分别为 33 %和 37%。c -erbB - 2基因扩增阳性率与病理分期正相关 (P <0 0 5) ,c -erbB - 3基因扩增阳性率在乳腺癌病理I至III期中有上升的趋势。同时 ,c -erbB - 2基因扩增与c -erbB - 3基因扩增具有一致性 (P <0 0 0 1 ) ,表明c -erbB - 3基因可能也是乳腺癌发展进程中有用的分子预后指标。对乳腺癌病人检测c -erbB - 2基因与c -erbB - 3基因扩增 ,有助于乳腺癌的临床诊断和治疗     

Chromogenic in situ hybridization for Her‐2/neu‐oncogene in breast cancer: comparison of a new dual‐colour chromogenic in situ hybridization with immunohistochemistry and fluorescence in situ hybridization

Aims: Her‐2/neu testing is used as a marker for Herceptin^® therapy. The aim was to investigate new dual‐colour chromogenic in situ hybridization (CISH), in a large number of breast carcinomas (n = 205) with DNA‐specific dual‐colour probes (ZytoVision, Bremerhaven, Germany) and to compare the results with immunohistochemistry (n = 205) and fluorescence in situ hybridization (FISH) (n = 129). Methods and results: Paraffin‐embedded tissue of 205 patients was used. After immunohistochemistry with a focus on immunohistochemically uncertain cases, Her‐2/neu amplification using dual‐colour CISH (ZytoVision^®) was analysed. Validation by FISH was performed. The results were: immunohistochemistry, 27.8% with strong expression, 53.7% with uncertain overexpression and 18.5% with no expression; FISH, 25.6% amplified and 74.4% negative; CISH, 35.6% amplified, 62.9% negative and 1.5% not evaluable. Comparison of immunohistochemistry with CISH: CISH negative in 100% with immunohistochemistry 0/1+, amplified in 82.5% with immunohistochemistry 3+; 5.9% contradictory results: 4.4% immunohistochemistry 3+ and negative by CISH, 1.5% negative in immunohistochemistry but amplified by CISH; FISH (129 cases), 8.5% contradictory results to immunohistochemistry, 6.2% immunohistochemistry 3+ and negative by FISH, 2.3% negative by immunohistochemistry and amplified by FISH; comparison of CISH and FISH, 94.6% same results, 3.9% different ones, 1.6% CISH not analysable. Conclusions: CISH, using dual‐colour probes (ZytoVision^®) is as good as FISH for Her‐2/neu analysis. The few discrepant results are likely to be caused by polysomy or tumour heterogeneity.     

The critical role of the ZNF217 oncogene in promoting breast cancer metastasis to the bone

Bone metastasis affects >70% of patients with advanced breast cancer. However, the molecular mechanisms underlying this process remain unclear. On the basis of analysis of clinical datasets, and in vitro and in vivo experiments, we report that the ZNF217 oncogene is a crucial mediator and indicator of bone metastasis. Patients with high ZNF217 mRNA expression levels in primary breast tumours had a higher risk of developing bone metastases. MDA‐MB‐231 breast cancer cells stably transfected with ZNF217 (MDA‐MB‐231‐ZNF217) showed the dysregulated expression of a set of genes with bone‐homing and metastasis characteristics, which overlapped with two previously described ‘osteolytic bone metastasis’ gene signatures, while also highlighting the bone morphogenetic protein (BMP) pathway. The latter was activated in MDA‐MB‐231‐ZNF217 cells, and its silencing by inhibitors (Noggin and LDN‐193189) was sufficient to rescue ZNF217‐dependent cell migration, invasion or chemotaxis towards the bone environment. Finally, by using non‐invasive multimodal in vivo imaging, we found that ZNF217 increases the metastatic growth rate in the bone and accelerates the development of severe osteolytic lesions. Altogether, the findings of this study highlight ZNF217 as an indicator of the emergence of breast cancer bone metastasis; future therapies targeting ZNF217 and/or the BMP signalling pathway may be beneficial by preventing the development of bone metastases. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Prognostic value of combined analysis of cyclin D1 and estrogen receptor status in breast cancer patients

The amplification of cyclin D1, located on chromosome 11q13, in breast cancer patients has been found to be associated with reduced relapse-free and overall survival; however, there still exists strong controversy about these findings. In order to evaluate the prognostic value of cyclin D1 and other prognostic variables in human breast cancers, we have assessed estrogen receptor (ER) status, cyclin D1, c-erbB2 and p53 overexpression in 175 primary breast carcinomas, and investigated the relationships of prognostic variables to the patient clinical outcome and the association between cyclin D1 overexpression and other prognostic variables. There was some degree of variability in staining intensities and proportions within the same tumor. The overexpression of both cyclin D1 and ER revealed a significantly prolonged survival in univariate analysis (P = 0.020). Among the various prognostic variables, distant metastasis showed a statistically significant association with overall survival. A significant correlation was observed between cyclin D1 overexpression and small size of the primary tumor (P = 0.031), low Bloom and Richardson's histological grade (P = 0.001), and positive ER status (P = 0.000). In contrast to what was previously expected, the present study suggests that the overexpression of cyclin D1 has a tendency to have a positive clinical outcome and a potential role in identifying a subset of patients predicting a good prognosis, particularly when ER is coexpressed.     

乳腺癌组织HER2基因扩增的检测方法

目的:评价高分辨率熔体聚合酶链反应(high-resolution melt polymerase chain reaction,HRM-PCR)检测HER2基因扩增的有效性及其与荧光原位杂交(fluorescence in situ hybridization,FISH)和免疫组织化学(immunohistochemistry,IHC)检测法的一致性.方法:采用HRM-PCR法检测HER2阴性及阳性细胞株,评估检测方法的有效性;检测98例已行FISH和/或IHC的临床样本,并与FISH和IHC结果进行比较.结果:HRM-PCR检测可以有效区分HER2阴性及阳性细胞株(P<0.05),具有较好的可重复性;检测98例临床样本显示,阴性和阳性样本检测结果差异有统计学意义(0.18±0.14 vs 1.42±0.88,P<0.01),与IHC的一致性为80.33%(kappa=0.6,P<0.01),与FISH的一致性为87.88%(kappa=0.7,P<0.01),结论:HRM-PCR是一种可靠有效的检测HER2基因扩增的方法,与FISH和IHC均有较好的一致性.     

DEK overexpression is correlated with the clinical features of breast cancer

To investigate the clinicopathological significance of DEK overexpression in breast cancers, a total of 196 cases, including 20 of normal tissues, 12 of intraductal hyperplasia, 31 of ductal carcinoma in situ (DCIS) and 133 of invasive ductal carcinoma of the breast, were selected from the Department of Pathology, Yanbian Tumor Hospital for immunohistochemical staining of DEK, estrogen (ER), progesterone (PR) and Ki-67 proteins. In results, DEK protein had higher positivity in DCIS, compared with the adjacent normal breast tissues. Also, DEK protein was strongly positive in invasive ductal carcinoma of the breast on immunohistochemistry, which was significantly higher than normal breast tissues. However, only two (2/12) cases of intraductal hyperplasia of the breast showed positive staining for DEK protein. Additionally, DEK overexpression was significantly correlated with the increased proliferating index of Ki-67. For the histological grade, DEK positive rate was only 39.6% in G1 breast cancers, but significantly higher in G2 (92.3%) and G3 (97.0%) cases (P<0.05). Also, a strongly positive rate of DEK was lower in Stage-0 (21.4%) and Stage-I (40.9%) compared with Stage-IIa (87.5%), Stage-IIb (89.7%) and Stage-IIIa (92.3%) (P<0.05). And DEK protein showed higher expression level in < 3 years disease free survival breast cancers than it did in ≥ 3 years disease free survival cases (P<0.05). However, no statistically difference was found among DEK expression, lymph node metastasis, and ER and PR expressions. In conclusion, DEK overexpression appears to be associated with breast cancer progression and DEK may potentially be used as a breast cancer biomarker for the early diagnosis, prognostic evaluation and therapeutic target for breast cancer.     

COX-2抑制剂在乳腺癌药物治疗中的研究进展

环氧化酶-2(COX-2)在乳腺癌细胞中过度表达,影响乳腺癌的发生、发展和预后,可作为预防和治疗的靶分子。选择性COX-2抑制剂可联合化疗、内分泌治疗及生物治疗等,作为肿瘤治疗的辅助药物应用于临床,为乳腺癌的治疗提供一种新的途径。     

Observer prediction of HER2 amplification in HercepTest 2+ breast cancers as a potential audit instrument

Going J J
(2011) Histopathology 59 , 333–335 Observer prediction of HER2 amplification in HercepTest 2+ breast cancers as a potential audit instrument Aims: Correct assignment of human epidermal growth factor receptor 2 (HER2) status in breast cancer is important. Indeterminate (2+) HER2 immunohistochemistry (IHC) is usually resolved by FISH for HER2 gene amplification. It was hypothesised that predicting HER2 amplification in IHC 2+ cases could improve audit of HER2 IHC and its interpretation. Methods and results: One observer (J. J. G.) interpreted 4343 assessable HercepTests on consecutive breast cancers from the West of Scotland over 45 consecutive months during 2007–2010, with 2+ cases classified prospectively as ‘probably amplified’, ‘possibly amplified’ or ‘probably not amplified’ prior to FISH. A HER2 to chromosome 17 FISH ratio >2 was taken to define HER2 amplification. There were 265 3+ cases (6.1%) and 883 2+ cases (20.3%). Of 187 ‘probably amplified’ 2+ cases, 166 (88.8%) were amplified, as were 90 (37.8%) of 238 ‘possibly amplified’ 2+ cases. Of 458 ‘probably not amplified’ but still 2+ cases, 59 (12.8%) were in fact amplified (overall χ² 333.89, df 2, P < 0.0001). In total, 580 of 4343 (13.4%) cancers were HER2‐positive (265 3+ by IHC and 315 2+ and HER2 amplified). Conclusions: Breast cancers HER2‐indeterminate (2+) by HercepTest IHC can be strongly separated into those probably HER2 amplified, a core indeterminate group and those probably not HER2 amplified. The percentage of HER2 amplified cases in each category is proposed as an instrument for comparison of HER2 IHC and its interpretation between laboratories and observers.     

Evaluating HER2 amplification and overexpression in breast cancer.

The development of Herceptin (Trazumatab) makes testing for HER2 status important for choosing optimal therapy in breast cancer. This study addresses the precision, accuracy, and reproducibility of HER2 assays. HER2 was assessed retrospectively by immunohistochemistry (IHC) with Dako 'Herceptest', by IHC with the monoclonal antibody CB11, and by fluorescence in situ hybridization (FISH, PathVysion), in a series of 216 formalin-fixed breast carcinomas including 191 for which quantitative HER2 data from radioimmunohistochemistry (Q-IHC) were available. All tests were scored independently by two observers. Positivity rates varied between Herceptest (12.6%), FISH (19.4%), and CB11 IHC (28.5%). Kappa values showed that IHC-based tests were more susceptible to inter-observer variation (kappa=0.67 and 0.74 for Herceptest and CB11, respectively) than FISH (kappa=0.973). Overall test accuracy (see the Materials and methods section) for CB11 IHC (83.8%) was lower than Herceptest (87.4%) or FISH (93.2%). FISH predicted p185 HER2 overexpression (determined by Q-IHC) better (concordance index C.Ind. 0.90) than CB11 IHC (C.Ind.=0.85) or Herceptest (C.Ind.=0.81). Of 42 cases with gene amplification by FISH, 67% were positive in the Herceptest (2+ or 3+) vs. 83% with CB11. Of 174 cases negative by FISH, 96% were negative in the Herceptest and 68% with CB11. In conclusion, FISH is the most accurate, reproducible, and precise predictor of HER2 overexpression in routine diagnostic laboratories.     

COX-2、VEGF在乳腺癌组织中的表达及临床意义

目的探讨血管内皮生长因子(VEGF)和环氧化酶-2(COX-2)在乳腺癌组织中的表达及其与临床病理特征之间的关系。方法应用免疫组化S-P法检测不同乳腺组织中VEGF和COX-2的表达情况。结果VEGF、COX-2在乳腺导管癌组织中的表达明显上调,与其在正常乳腺组织、纤维腺瘤组织中的表达相比差异显著(P<0.01)。VEGF、COX-2在乳腺浸润性导管癌中的阳性表达率高于其在乳腺导管癌中的阳性表达率。两组中COX-2的表达有显著性差异(77.1%vs40%,P<0.05),VEGF的表达无显著性差异(80.0%vs70%,P>0.05)。VEGF在乳腺浸润性导管癌的阳性表达与其临床分期、淋巴结转移密切相关(P<0.05,P<0.01),与肿瘤大小无关(P>0.05)。COX-2在乳腺浸润性导管癌中的阳性表达与其临床分期、淋巴结转移及肿瘤大小均无关(P>0.05)。VEGF、COX-2在乳腺导管癌中的表达呈正相关(r=0.98,P<0.05)。结论VEGF、COX-2的高表达在乳腺癌的发生发展过程中起重要的作用,可作为重要的生物学标志。