Neuroendocrine carcinoma of the breast – a pilot study of a Danish population of 240 breast cancer patients

Neuroendocrine carcinoma of the breast – a very recent diagnosis, which was not recognized by WHO until 2003 – has lately been the subject of increasing attention. It is defined as a primary breast cancer with morphologic features similar to other types of neuroendocrine tumors of the lung and gastrointestinal tract combined with positive neuroendocrine immunohistochemical markers. While much information has been gathered during the last decade, most studies suffer from poor statistics due to a low incidence, and there are still fundamental open questions regarding etiology and prognosis. Furthermore, apparent limitations of the WHO definition appear to influence diagnosis. Here, we present our own results obtained from 13 cases and furthermore review previous reports with particular reference to incidence, clinical, histological, and prognostic features.     

Chromogranin A expression correlates with tumour cell type and prognosis in signet ring cell carcinoma of the stomach

Aims:  To investigate neuroendocrine (NE) differentiation in gastric signet ring cell carcinoma (SRCC) using chromogranin A (CgA) as an indicator of a well-differentiated NE phenotype and to determine its relationship to cell type, stage and prognosis.
Methods and results:  102 SRCCs were categorized into five subtypes according to the predominant cell type in the World Health Organization classification. 38 cases (37.3%) showed focal or diffuse CgA positivity. The positive cells were mostly histiocytoid and eosinophilic SRCC cells and some were classical SRCC cells. Small cell and anaplastic-type SRCC cells were only rarely immunopositive. There was no significant relationship between CgA expression and the extent of invasion or presence of metastasis. However, a significant positive correlation existed between CgA positivity and favourable prognosis, with a tendency for greater positivity to be associated with better overall survival. Multivariate analysis showed expression of CgA to be an independent prognostic factor.
Conclusion:  CgA expression is restricted to certain tumour cell types and may help to predict prognosis in gastric SRCCs.     

p38丝裂原活化蛋白激酶通路介导的早期生长反应基因-1活性与乳腺癌细胞表柔比星耐药性的关系

目的 探讨p38丝裂原活化蛋白激酶(MAPK)通路介导的早期生长反应基因(EGR)-1活性与乳腺癌细胞表柔比星耐药的关系.方法 SB203580(15 μmol/L)干预后,激光共聚焦显微镜观察;流式细胞术、四甲基偶氮唑蓝(MTT)、凝胶电泳迁移率法(EMSA)、RT-PCR及Western blot分别检测耐药MCF-7/Adr及亲本MCF-7细胞内磷酸化p38MAPK蛋白表达、细胞凋亡及细胞内表柔比星浓度、EGR-1蛋白活性改变、细胞对表柔比星敏感性;EGR-1 mRNA、P糖蛋白、磷酸化p53及p38蛋白表达.结果 p38MAPK通路激活的MCF-7/Adr细胞经SB203580(15 μmol/L)干预24和48 h后,(1)MCF-7/Adr细胞(早+晚期)凋亡率分别由(0.54±0.17)%和(0.81±0.16)%提高为(25.36±1.17)%和(38.21±1.25)%,P<0.05,并呈一定时间依赖性;(2)MCF-7/Adr细胞的平均荧光强度分别为(32.45±2.36)及(41.66±3.12),均高于空白对照组及DMSO组MCF-7/Adr细胞的(14.17±1.45)及(16.28±0.63),P<0.01;MCF-7/Adr细胞对表柔比星药物的耐受性显著降低;(3)增加了MCF-7/Adr细胞的EGR-1活性,IC50分别为(21.53±2.17)和(8.77±1.02),低于空白对照组(40.74±2.56);伴随p38MAPK通路活性抑制和EGR-1 mRNA表达增加,磷酸化p53蛋白表达显著上调,而P糖蛋白显著下调.结论 p38MAPK通路与乳腺癌表柔比星耐药密切相关,可能与p38MAPK通路介导的EGR-1表达相关,EGR-1激活抑制了其下游耐药基因转录,从而使表柔比星耐药得以逆转.