HER-2 status discrepancy between primary breast cancer and metastatic sites. Impact on target therapy

In this prospective study, we determined HER-2 status in primary breast invasive carcinomas and in the paired lymph node metastases (synchronous and metachronous), local recurrence and metachronous distant metastases, to verify the percentage of discordant cases. HercepTest and Fluorescence in situ hybridization (FISH) were used to determine HER-2 status on 119 cases of primary infiltrating breast carcinoma and paired metastases (45 cases with synchronous lymph node metastases, 9 cases with metachronous lymph node metastases, 30 cases with local recurrence, and 35 cases with metachronous distant metastases). A therapeutically significant HER-2 status discordance was demonstrated between primary carcinoma and synchronous lymph node metastases (6.7%), local recurrence (13.3%) and metachronous distant metastases (28.6%). In the first comparison, there was a normal HER-2 status in primary tumours and HER-2 amplification in paired metastases, in the second the opposite phenomenon was present, and both types of discordance were evident in the third comparison. Considering the cases of local recurrences and metachronous distant metastases all together, 14 out of 65 cases (21.5%) showed a therapeutically significant discordance of HER-2 status between the primary tumour and the paired metachronous recurrence or metastasis (p < 0.001), the 15.4% of cases showing normal HER-2 status in the primary tumour and HER-2 amplification in the neoplastic relapse. For the treatment of metastatic patients, the evaluation of HER-2 status should be performed in neoplastic tissue from metastatic site, whenever possible. This procedure could be also suggested in the patients that are metastatic at the time of diagnosis.     

The loss of E-cadherin, alpha- and beta-catenin expression is associated with metastasis and poor prognosis in invasive breast cancer

Loss of E-cadherin and catenin expression may be associated with distant and lymph node metastases in breast cancer. Heterogeneity of E-cadherin expression is associated with poor prognosis, suggesting that E-cadherin and catenins may serve as useful prognostic markers for invasive breast carcinoma. Reduction or loss of expression of either E-cadherin or catenins is associated with invasion, metastasis and poor prognosis in several types of human malignancies. We investigated the expression of E-cadherin, and alpha- and beta-catenins by immunohistochemistry in 171 cases of primary invasive breast cancer, and compared the expression with clinicopathological parameters to define the relationship between expression and prognosis. E-cadherin immunoreactive protein was shown to be expressed in 97 cases. Reduction or lack of expression of E-cadherin was associated with distant metastasis. Based on immunohistochemical heterogeneity, E-cadherin-positive tumors were classified into heterogeneous, homogeneous and intermediate types. Interestingly, although patients with heterogeneous type demonstrated the lowest incidence of distant metastasis at diagnosis, they showed a higher incidence of subsequent distant metastasis, after surgery, and a lower survival rate than those with homogeneous type (p<0.05). E-cadherin expression was reduced or negative in metastatic axillary lymph nodes regardless of the expression in the primary tumor, suggesting that changes in E-cadherin expression are associated with not only distant metastasis but also lymph node metastasis. Tumors negative for either alpha- or beta-catenin expression demonstrated a higher incidence of distant metastasis than those expressing both catenins, suggesting that the expression of catenins is involved in breast cancer metastasis. Reduction or loss of E-cadherin and catenin expression may be associated with distant and lymph node metastases in invasive breast cancer, and the heterogeneous type may be associated with poor prognosis.     

Expression and prognostic impact of the protein tyrosine phosphatases PRL-1, PRL-2, and PRL-3 in breast cancer

The aim of this study was to investigate the expression of the protein tyrosine phosphatases (PTP) PRL-1, PRL-2, and PRL-3 in human breast cancer and to evaluate its clinical and prognostic significance. PRL-PTP mRNA expression was examined in malignant (n = 7) and nonmalignant (n = 7) cryoconserved breast tissue samples as well as in eight breast cancer cell lines by RT-PCR. Furthermore, protein expression of PRL-3 was analysed semiquantitatively by immunohistochemistry in ductal breast carcinoma in situ (n = 135) and invasive breast cancer (n = 147) by use of tissue microarray technology (TMA). In 24 lymph node-positive patients we selected the corresponding lymph node metastases for analysis of PRL-3 expression, and a validation set (n = 99) of invasive breast cancer samples was examined. Staining results were correlated with clinicopathological parameters and long-term follow-up. PRL-3 mRNA expression was significantly higher in malignant compared to benign breast tissue. For PRL-1 and PRL-2 expression no significant differences were observed. Staining of TMAs showed PRL-3 expression in 85.9% ductal carcinoma in situ and 75.5% invasive breast carcinomas. Analysis of survival parameters revealed a shorter disease-free survival (DFS) in patients with PRL-3-positive carcinomas, and in particular a significantly shorter DFS in nodal-positive patients with PRL-3 overexpressing tumours as compared to PRL-3-negative breast carcinomas (66+/-7 months (95% CI, 52-80) vs 97+/-9 months (95% CI, 79-115); P = 0.032). Moreover, we found a more frequent expression of PRL-3 in lymph node metastases as compared to the primary tumours (91.7 vs 66.7%; P = 0.033). Our results suggest that PRL-3 might serve as a novel prognostic factor in breast cancer, which may help to predict an adverse disease outcome.     

An evaluation of differences in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast.

One-hundred-and-seventy-one patients with invasive lobular carcinomas have been matched with 342 patients with non-lobular invasive carcinomas for lymph node stage, tumour differentiation and patient age on a one to two basis. The two groups were investigated for differences in prognostic factors, survival, disease-free interval, metastatic patterns, receptor status, response to endocrine therapy after distant metastases and bilateral cancer rates. Patients with lobular carcinomas survived significantly longer than patients with carcinomas of no specific type, particularly in survival from the time of diagnosis of distant metastases; lobular carcinomas more often responded to endocrine treatment for systemic disease. Lobular cancers had a significantly higher rate of local recurrence, particularly after treatment by excision and breast irradiation. No differences were found between the two groups with respect to regional or distant recurrence rates, distant organ involvement patterns, distant metastatic free intervals and receptor status. Bilateral cancer was more frequent in patients with lobular carcinoma.     

Expression of the breast cancer metastasis suppressor gene, BRMS1, in human breast carcinoma: lack of correlation with metastasis to axillary lymph nodes.

The BRMS1 (breast cancer metastasis suppressor 1) gene has been found to suppress metastasis in animal models without inhibiting primary tumor growth. The aim of this study was to measure expression of BRMS1 mRNA in a panel of human breast carcinomas and compare its expression with parameters of local dissemination such as tumor size and lymph node metastasis. We also compared expression of BRMS1 mRNA in normal breast tissue, fibroadenomas, primary breast cancers and axillary nodal metastases from primary breast cancers. BRMS1 mRNA was detected in 10/11 (90%) specimens of normal breast tissue, 12/16 (75%) fibroadenomas, 64/82 (78%) primary breast cancer and 11/15 (64%) lymph node metastases (p, NS). In the primary cancer, expression was independent of tumor size, tumor grade, metastasis to axillary nodes and hormone receptor status. Furthermore, similar levels of BRMS1 were found in normal breast tissue, primary breast carcinomas and lymph node metastases from primary breast cancer. Our results do not suggest a role for BRMS1 in suppressing metastasis to local lymph nodes in patients with breast cancer.     

Expression and clinical significance of E-cadherin, β-catenin and E-cadherin-catenins complex in breast cancer and precancerous lesions简

Objective： The aim of our study was to observe the expressions and clinical Significance of E-cadherin, β-catenin and E-cadherin-catenins complex in breast cancer and precancerous lesions, and analyze the relationship between the expressions and clinicopathological features in breast cancer. Methods： Immunhistochemical UltraSensitiveTM S-P method was employed to detect the expression of E-cadherin, β-catenin and E-cadherin-catenins complex in 128 cases of invasive ductal carcinomas, 89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia, 53 cases of usual ductal hyperplasia breast tissues were selected as a control group. The express of E-cadherin, β-catenin and their relationship with mult biological parameters including histological grade, region lymph node metastasis, distant metastasis and recurrence on files were also assessed. Results： （1） The staining patterns character of E-cadherin, β-catenin and E-cadherin-catenins complex： In UDH breast tissues, E-cadherin and a-catenin were expressed on cell membrane of ductal and acinic cells, showing cellular contour and border among cells. The abnormal expression of the three proteins occurred in breast invasive ductal carcinomas, ductal carcinoma in situ and atypical ductal hyperplasia tissues, showing cytoplasmic or nuclear staining, decrease and loss of cytomembrane staining. （2） The abnormal expression rates of E-cadherin, β-catenin and E-cadherin-catenins complex in invasive ductal carcinomas were 53.91%, 65.63% and 81.25%, which were significantly higher than that in ductal carcinoma in situ, atypical ductal hyperplasia, usual ductal hyperplasia tissues （P 〈 0.01）. Compared with usual ductal hyperplasia breast tissues group, the abnormal expression rates of E-cadherin, β-catenin and E-cadherin-catenins complex were significantly decreased （P 〈 0.01） in the breast cancer group. However, there was no significance of the abnormal expression rate between ductal carcinoma in situ and atypical ductal hyperplasia tissues groups （X2 = 0.76, P = 0.38; x2 = 0.14, P = 0.70; x2 = 0.81, P = 0.37; X2 = 2.19, P = 0.14） （P 〉 0.05）. （3） There was a significantly difference in the mean E-cadherin, β-catenin and E- cadherin-catenins complex frequency between estrogen receptor ＆ progesterone receptor positive IDC group and negative group, epidermal growth factor receptor type 2 （HER2/neu） positive and negative groups, Ki-67 proliferation index 〈 14% and 〉 14% groups, histological grade （I ＋ II） and grade III invasive ductal carcinomas groups, with lymph node metastasis, distant metastasis and recurrence groups （P 〈 0.05） and without groups （P 〈 0.05）. However, there was no difference in the mean E-cadherin, β-catenin and E-cadherin-catenins complex frequency between age （_〈 50 years vs 〉 50 years）, tumor diameter （〈 2 cm vs 〉 2 cm） （P 〉 0.05）. Conclusion： In breast cancer, the expressions of E-cadherin, β-catenin and E-cadherin-catenins complex are abnormally decreased and are correlated with pathology grade, differentiation disturbance and metastasis. E- cadherin and β-catenin may be as the predictors for prognosis. Combined detection may improve accuracy and sensitivity of predicting metastasis and prognosis of breast Cancer.     

E-cadherin在乳腺浸润性导管癌中的表达及临床意义

目的 探讨E-钙黏蛋白（E-cad）在乳腺浸润性导管癌中的表达及其与乳腺癌临床病理特征、淋巴结转移及预后的关系。方法 采用免疫组织化学 SP 法检测30例乳腺纤维腺瘤、450例乳腺浸润性导管癌组织中E-cad的表达,分析其表达与临床病理特征的关系, Kaplan-Meier法绘制生存曲线。结果E-cad在无淋巴结转移乳腺癌组织中阳性表达率为49.04％（77／157）,在有淋巴结转移的乳腺癌组织中阳性表达率为29.69％（87／293）,差异有统计学意义（P＜0.05）。E-cad表达与年龄、淋巴结转移、肿块大小、ER表达、分子分型及组织学分级有关（P＜0.05）,而与肿瘤分期、是否绝经、HER-2及Ki-67表达情况无关。乳腺癌淋巴结转移组、三阴性乳腺癌组中E-cad阳性表达者5年生存率优于E-cad阴性表达者,差异有统计学意义（P＜0.05）。结论 E-cad表达与乳腺癌淋巴结转移关系密切,其亦可成为乳腺癌伴淋巴结转移者或三阴性乳腺癌预后的判断指标。     

bcl-2 Expression and apoptosis in primary and metastatic breast carcinomas.

OBJECTIVES: To evaluate the role of bcl-2 and apoptotic index in the progression from primary to metastatic breast carcinoma and their influence on prognosis. METHODS: bcl-2 expression was examined by immunohistochemistry and apoptotic index by in situ end-labelling in 116 surgical breast carcinomas and lymph node metastases from 50 patients. RESULTS: bcl-2 was observed in 69 cases (59.4%) of primitive carcinomas and 26 cases (65%) of metastatic breast carcinomas and there was agreement of bcl-2 expression between primary and metastatic sites except in 3 cases. bcl-2 expression was significantly associated with several favourable prognostic features, such as small tumour size (p = 0.03) and oestrogen and progesterone-receptor positivity (p < 0.01 and p < 0.001, respectively). A high apoptotic index was significantly associated with a number of poor prognostic factors, including poorly differentiated carcinomas, large tumour size, high Ki67 expression and high mitotic count (p < 0.001 in all cases). The mean apoptotic index was higher in lymph node metastasis than in primary carcinomas (1.19 vs. 0.69, p < 0.01). A low bcl-2 expression and a high apoptotic index were significantly associated with short-relapse free survival rates (p = 0.02 and p < 0.01, respectively), but only apoptotic extent provided independent prognostic information by multivariate analysis. CONCLUSIONS: The evaluation of bcl-2 expression and extent of apoptosis may provide useful prognostic information on breast cancer patients; however while increased apoptosis is strongly associated with the progression from primary carcinomas to lymph node metastases, bcl-2 does not seem to play a significant role in this process.     

Expression of HIF-1α in breast cancer and precancerous lesions and the relationship to clinicopathological features简

Objective： The aim of this study was to observe the expressions and clinical significance of HIF-1a in breast cancer and precancerous lesions, and analyze the relationship between the expressions and clinicopathological features in breast cancer. Methods： We analyzed the HIF-1a expression in 128 cases of invasive ductal carcinomas, 146 precancerous lesions patients including 89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia. 53 cases of usual ductal hyperplasia breast tissues were selected as a control group. The specimens were evaluated for HIF-1a, estrogen receptor （ER） ＆ progesterone receptor （PR）, epidermal growth factor receptor type 2 （HER2/neu） and Ki-67. Immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40 x magnification and recorded as the percentage of positive tumor cells over the total number of cells examined in the same area. The percentage scores were subsequently categorized. The express of HIF-1a and their relationship with multiple biological parameters including ER ＆ PR, HER2/neu and Ki-67, the biomarkers levels of CA153, CA125 TSGF, and CEA in blood serum and nipple discharge, histological grade, region lymph node metastasis, distant metastasis and recurrence on files were also assessed. Results： Compared with usual ductal hyperplasia, the positive expression rate of HIF-1a in atypical ductal hyperplasia, ductal carcinoma in situ and invasive ductal carcinomas group was significantly increased （P 〈 0.01）. The positive rates of HIF-1a in invasive ductal carcinomas were 68.75%, which were significantly higher than that in ductal carcinoma in situ （43.8%）, atypical ductal hyperplasia （31.6%）, usual ductal hyperplasia （9.4%; X2 = 13.44, 22.27, 52.79, respectively, P 〈 0.01）. Statistical analysis showed that difference of abnormal expression rate of HIF-1a between ductal carcinoma in situ and usual ductal hyperplasia （X2 = 18.37, P = 0.00）, atypical ductal hyperplasia and usual ductal hyperplasia （x2 = 8.14, P = 0.00） was significant （P = 0.00）. However, no significant difference in the positive expression rate of HIF-1a was found between atypical ductal hyperplasia and ductal carcinoma in situ tissue （X2 = 2.19, P = 0.14）. There was a significantly difference in the mean HIF-1a frequency between ER ＆ PR positive invasive ductal carcinomas group and negative group, epidermal growth factor receptor type 2 （HER2/neu） positive and negative groups, Ki-67 proliferation index 〈 14% and 〉 14% groups, histological grade （I ＋ II） and grade III invasive ductal carcinomas groups, with lymph node metastasis, distant metastasis and recurrence groups （P 〈 0.05） and without groups （P 〈 0.05）. However, there was not difference in the mean HIF-1a between age （〈 50 years vs 〉 50 years）, tumor diameter （〈 2 cm vs 〉 2 cm; P 〉 0.05）. The nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in invasive ductal carcinomas HIF-1a positive patients were significantly higher than those in the negative patients （P 〈 0.05）. Conclusion： In breast cancer, HIF-1a expressibn was abnormally increased. The aberration of HIF-1a may play a key role during oncogenesis （atypical ductal hyperplasia or ductal carcinoma in situ） and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. The abnormal expression of HIF-1a may be as an early event in the development of breast tumor. The over-expression of HIF-1a might be important biological markers for invasion, metastasis and recurrence of breast cancer.     

Inhibin/activin subunits (inhibin-alpha, -betaA and -betaB) are differentially expressed in human breast cancer and their metastasis

Inhibins (INH) are dimeric glycoproteins, composed of an alpha-subunit (INH-alpha) and one of two possible beta-subunits (INH-betaA or -betaB). Aims of this study were to determine the frequency and tissue distribution of INH-alpha, -betaA and -betaB in breast cancer tissue. Paraffin-fixed ductal carcinoma in situ (DCIS; n=7), invasive ductal carcinomas without lymph node metastases (IDC; n=8), infiltrating ductal carcinomas with their lymph node metastases (IDC/LN; n=8), primary ductal carcinomas with their subsequent recurrence (n=7) were analyzed by immunohistochemical means with monoclonal antibodies against inhibin-alpha, -betaA and -betaB subunits. INH-alpha was observed in DCIS (5/7), while its expression was significantly higher in DCIS than IDC (1/7; p<0.05) and IDC/LN (0/8; p<0.005) and recurrent breast cancer tissue (0/7; p<0.005). The INH-betaA subunit was also demonstrated in all DCIS cases with a significantly higher intensity compared to IDC (p<0.05), IDC/LN (p<0.01) and primary carcinoma with subsequent recurrence (p<0.05). INH-betaA expression was significant higher in primary tumors with subsequent recurrence compared to IDC/LN (p<0.05). The metastatic lymph nodes expressed the lowest inhibin-betaA compared to all other groups (p<0.01). INH-betaB was also demonstrated in all mammary carcinoma tissues, but without any statistical differences. The differential expression of INH-alpha in DCIS might suggest a function as a tumor suppressor in breast tissue, suggesting a useful marker for recognizing patients with subsequent risk of developing invasive ductal cancer. The higher INH-betaA expression in DCIS than invasive cancer suggests an important role in mammary carcinogenesis. Interestingly, primary breast tumor with a subsequent recurrence expressed a higher intensity of the inhibin-betaA subunit, suggesting an important role in metastatic pathogenesis, and utilization as a tumor marker. The immunoreactivity of inhibin-betaA was significantly higher in DCIS than invasive ductal carcinomas, suggesting an important role in mammary carcinogenesis. The metastatic lymph nodes expressed lower INH-betaA and -betaB than the primary tumor, which might be the cause of less differentiated and aggressive tumor cells within the primary tumor. Therefore, inhibin/activin subunits might be useful prognostic markers for breast cancer.     

端粒酶hTERT mRNA表达在乳腺癌进展中的意义及其与p53的相关性

目的 探讨端粒酶hTERT mRNA表达在人乳腺癌发生、发展中的意义,观察肿瘤抑制基因p53与hTERT mRNA表达的关系。方法 收集浸润性导管癌标本25例,导管原位癌标本18例,导管上皮不典型增生标本20例,导管上皮单纯性增生标本7例,癌旁正常乳腺组织标本12例。用原位杂交法检测hTERT mRNA表达,并用免疫组化方法检测乳腺导管癌的p53蛋白表达。结果 hTERT mRNA在癌旁正常乳腺组织、乳腺导管单纯性增生中未见表达;在导管不典型增生、导管原位癌、浸润性导管癌中的阳性率分别为25．0％、83．3％和88．0％。导管原位癌、浸润性导管癌组织hTERT mRNA表达明显高于癌旁正常乳腺组织、乳腺导管单纯性增生和导管不典型增生组织（P〈0．05）。hTERT mRNA表达与浸润性导管癌肿块大小及淋巴结转移与否无关（P〉0．05）。43例乳腺导管癌中,hTERT mRNA表达与p53蛋白表达呈正相关（r=0．5540,P〈0．01）。结论 端粒酶hTERT mRNA表达可能在乳腺导管癌的组织发生中起关键作用,半定量原位检测hTERT mRNA表达,可为导管上皮不典型增生与导管原位癌的鉴别诊断提供帮助。p53突变可能与乳腺导管癌hTERT基因转 录激活有关。     

MMP-3在乳腺导管癌中的表达及临床意义

目的：检测MMP-3在乳腺导管癌中的表达,探讨其临床意义及与乳腺导管癌临床病理参数的关系。方法：应用免疫组化MaxVision法检测48例乳腺导管癌患者MMP-3的表达,分析MMP-3与乳腺导管癌患者的年龄、肿瘤大小、组织学类型、淋巴结转移及肿瘤ER、PR、E-cad、C—erbB-2的关系。结果：MMP-3在乳腺导管癌组织中的阳性表达显著高于乳腺正常组织（P〈0．05）。MMP-3在无淋巴结转移和C—erb—B阳性的乳腺导管癌组织的阳性表达率显著高于相应对照组（P〈0．05）;而在不同年龄、肿瘤大小、组织学类型及肿瘤ER、PR、E—cad、C—erbB-2分组问的表达无显著差异（P〉0．05）。结论：MMP-3在无淋巴结转移的乳腺导管癌组织高表达,和较早阶段乳腺导管癌的发生发展密切相关,将有可能预测高危人群作出早期诊断;MMP-3在C—erbB-2阳性的乳腺导管癌组织显著高表达,联合检测这两个指标对判断乳腺导管癌的预后可能有重要意义。     

基质金属蛋白酶及其抑制剂在乳腺癌中的表达及其临床意义

背景与目的:基质金属蛋白酶(matrixmetalloproteinase,MMP)与基质金属蛋白酶组织抑制剂(tissueinhibitorofmatrixmetalloproteinase,TIMP)的表达失平衡在肿瘤侵袭、转移过程中起重要作用,但与乳腺癌预后关系的报道少见。本研究探讨MMP-2、MMP-9和TIMP-1、TIMP-2的表达与乳腺癌侵袭、转移和预后的关系。方法:原位杂交、免疫组化检测66例有临床和随访资料的乳腺癌患者的MMP-2mRNA、TIMP-2mRNA和MMP-2、MMP-9、TIMP-1、TIMP-2蛋白表达。统计学分析采用χ2检验、Kaplan-Meier和Cox多因素回归分析。结果MMP-2mRNA、TIMP-2mRNA和MMP-2、MMP-9、TIMP-1TIMP-2蛋白的阳性表达率分别为66.7%(44/66)、65.2%(43/66)和71.2%(47/66)、68.2%(45/66)、40.9%(2766)、69.7%(46/66),其中MMP-2蛋白与MMP-2mRNAMMP-9蛋白及TIMP-2mRNA与TIMP-2蛋白的表达存在显著性正相关(P<0.01);TIMP-1与MMP-9蛋白表达呈负相关(P<0.01)。有淋巴结转移的乳腺癌中MMP-2、MMP-9蛋白表达显著高于无转移者,但TIMP-2mRNA、TIMP-1蛋白表达显著低于无转移者(P<0.05)。乳腺癌中MMP-2mRNA和MMP-9蛋白表达与肿块大小、生存状况有显著性相关(P0.05),此外,MMP-9蛋白表达与临床分期存在正相关性(P<0.01)。绝经和ER表达阴性患者的MMP-2mRNA表达水平增高(P<0.     

MDR1和Anxa2在乳腺癌组织中的表达与侵袭转移的关系研究

探讨乳腺癌组织中多药耐药基因（MDR1）和膜联蛋白（Anxa2）表达的相关性及其与乳腺癌转移的关系。方法:应用荧光定量PCR的方法检测20例配对的乳腺导管内癌、100例乳腺浸润性导管癌、70例癌旁正常组织中MDR1和Anxa2 mRNA的相对表达情况。结果:MDR1 mRNA在乳腺导管内癌中的表达水平明显高于癌旁正常组织（P=0.005）,乳腺浸润性导管癌组织中mRNA的表达明显高于癌旁正常组织（P=0.017）和导管内癌（P=0.019 6）。Anxa2 mRNA在乳腺导管内癌中表达与癌旁正常组织相比无显著性差异（P=0.188 9）,但是在乳腺浸润性导管癌组织中的表达明显高于导管内癌（P=0.000 8）和癌旁正常组织（P<0.000 1）;MDR1和Anxa2 mRNA的表达升高均与患者出现淋巴结转移有关（P<0.01）;2种基因在乳腺浸润性导管癌中的表达呈正相关（P<0.000 1）。结论:在肿瘤进展过程中,MDR1和Anxa2 mRNA表达上调与乳腺癌的淋巴结转移有关,二者之间表达具有正相关提示肿瘤细胞的多药耐药的获得和肿瘤侵袭转移之间有着密切联系。      

Risk factors of metastasis in oral squamous cell carcinomas

Lymph node and distant metastasis were comparatively studied in 225 oral carcinomas, and factors predisposing toward metastasis were investigated using clinical and immunohistopathological approaches. Neither the sites of tumors nor T-stage was correlated with either type of metastasis. Tumor cell differentiation was weakly correlated with lymph node metastasis, and stromal reaction (the degree of cell infiltration) did not differ greatly between metastasis-positive and negative tumors, although natural killer (NK) activities were correlated with lymph node metastasis. However, the mode of tumor cell invasion was closely associated with both lymph node and distant metastases. In grade 4C and 4D tumors, distant and lymph node metastases were observed in 8 (16%) and 31 (62%) cases, respectively, while of 68 grade 1 and 2 tumors, distant metastasis was not observed in any, and lymph node metastasis occurred in only 15 (22. 1%). In addition, the expression of p53 protein was correlated with lymph node metastasis; of 70 tumors without p53 protein expression, 23 (32.9%) revealed lymph node metastasis, while it occurred in 54 out of 96 tumors positive for p53 protein. However, p53 protein expression was not associated with distant metastasis, and p24 protein, a cyclin-dependent kinase inhibitor, did not show any relationship with either type of metastasis. These results indicate that lymph node metastasis is correlated with multiple factors in the host and tumor cells, but distant metastasis is only correlated with the mode of tumor cell invasion, suggesting that the former can be highly accurately predicted by invasion mode, p53 protein expression and NK activity.     

Gene amplification in ductal carcinoma in situ of the breast

Multiple different biologically and clinically relevant genes are often amplified in invasive breast cancer, including HER2, ESR1, CCND1, and MYC. So far, little is known about their role in tumor progression. To investigate their significance for tumor invasion, we compared pure ductal carcinoma in situ (DCIS) and DCIS associated with invasive cancer with regard to the amplification of these genes. Fluorescence in situ hybridization (FISH) was performed on a tissue microarray containing samples from 130 pure DCIS and 159 DCIS associated with invasive breast cancer. Of the latter patients, we analyzed the intraductal and invasive components separately. In addition, lymph node metastases of 23 patients with invasive carcinoma were included. Amplification rates of pure DCIS and DCIS associated with invasive cancer did not differ significantly (pure DCIS vs. DCIS associated with invasive cancer: HER2 22.7 vs. 24.2%, ESR1 19.0 vs. 24.1%, CCND1 10.0 vs. 14.8%, MYC 11.8 vs. 6.5%; P > 0.05). Furthermore, we observed a high concordance of the amplification status for all genes if in situ and invasive carcinoma of individual patients were compared. This applied also to the corresponding lymph node metastases. Our results indicate no significant differences between the gene amplification status of DCIS and invasive breast cancer concerning HER2, ESR1, CCND1, and MYC. Therefore, our data suggest an early role of all analyzed gene amplifications in breast cancer development but not in the initiation of invasive tumor growth.     

nm23、BRCA-1和ki-67在乳腺癌中的表达及临床意义

目的研究乳腺癌组织中nm23、BRCA-1及ki-67表达的病理临床意义。方法应用免疫组织化学S-P法检测乳腺癌标本中nm23、BRCA-1及ki-67的表达。结果 nm23在33例无淋巴结转移的乳腺癌中阳性占25例,21例有淋巴结转移者中阳性占9例,两者比较差异有统计学意义。在正常乳腺、异型增生、原位癌及浸润性癌中BRCA-1表达呈递减趋势,ki-67表达呈递增趋势,4组乳腺组织中BRCA-1与ki-67蛋白表达呈负相关。nm23、BRCA-1、ki-67与肿瘤直径、发病年龄、ER、PR、Her-2、TNM等情况关系差异无统计学意义。在原位癌与浸润癌之间差异无统计学意义。结论 nm23、BRCA-1及ki-67与传统标志（如ER、PR等）一起可以更好地判断乳腺癌预后及转移,为临床提供参考。     

CD133+细胞在乳腺良恶性病变中的分布特点及其临床病理意义

研究CD133+细胞在乳腺普通型增生、乳腺不典型增生、乳腺原位癌、浸润性乳腺癌中的分布特点及其与乳腺癌临床病理特征的关系。方法:采用免疫组织化学方法对45例正常乳腺组织、41例普通型增生乳腺组织、39例不典型增生乳腺组织、51例乳腺原位癌组织、121例乳腺癌组织中CD133+的表达进行检测,分析CD133+细胞在乳腺良恶性病变中的分布特点。结果:CD133+在正常乳腺组织中不表达,在乳腺普通型增生、不典型增生、原位癌、浸润性癌的表达率逐渐增高,分别为31.7%（13/41）、48.7%（19/39）、64.7%（33/51）、74.4%（90/121）,有显著性差异（P<0.01）。CD133+的表达率随乳腺癌组织学分级［Ⅰ级63.6%（21/33）、Ⅱ级72.2%（26/36）、Ⅲ级82.7%（43/52）,P<0.05］和TNM分期［Ⅰ期57.1%（12/21）、Ⅱ期69.4%（34/49）、Ⅲ期68.7%（11/16）、Ⅳ期94.3%（33/35）,P<0.001］的增高而增高;有淋巴结转移或远处转移者分别高于无转移者、无远处转移者（P<0.05）;有复发者高于无复发者（P<0.05）;与患者年龄、月经状态、肿瘤的组织学类型、肿瘤大小、ER、PR、Her-2的表达无显著相关（P>0.05）。结论:CD133+细胞可能在乳腺增生与癌变过程中起重要作用;CD133+的乳腺癌细胞与乳腺癌的侵袭、转移和复发密切相关,CD133+是提示乳腺癌恶性程度和预后的指标之一。