乳腺癌中OPN、CD44v6及CD10的表达及其临床意义

目的探讨骨桥蛋白(osteopontin,OPN)、CD44v6、CD10在乳腺癌及腺病中的表达,分析三者与乳腺癌临床病理特征及预后的相关性。方法采用免疫组化En Vision两步法检测OPN、CD44v6、CD10在浸润性癌非特指型(153例)、导管原位癌(40例)、腺病(28例)中的表达;采用χ2检验分析三者与乳腺癌临床病理特征的关系,多因素分析采用Cox回归模型,预后分析采用Kaplan-Meier法,组间差异比较采用Log-rank检验。结果在腺病、导管原位癌、浸润性癌非特指型中,OPN阳性率分别为7.1%、27.5%、56.2%,CD44v6阳性率分别为10.7%、40.0%、57.5%,CD10阳性率分别为3.5%、37.5%、55.6%。三者在腺病中的阳性率均低于乳腺癌,差异具有统计学意义(P=0.020、0.042、0.003)。浸润性癌非特指型组织中OPN、CD44v6和CD10的表达均与组织学分级、淋巴结转移相关,且OPN、CD44v6表达均与p TNM分期相关,CD44v6表达与PR状态相关(P均0.05);在导管原位癌中三者的表达与核分级相关,差异均有统计学意义(P均0.05);三者的表达与患者年龄、绝经状态、脉管浸润、Ki-67增殖指数、ER状态、HER-2状态均无关(P均0.05)。OPN、CD44v6和CD10在乳腺癌中的表达两两间均呈正相关(P均0.001)。多因素分析提示淋巴结转移、CD10阳性是浸润性癌非特指型患者的预后影响因素。生存分析显示在浸润性癌非特指型中,三者均阴性组患者的无病生存率(disease-free survival,DFS)、总生存率(overall survival,OS)均优于三者均阳性组,差异有统计学意义(P=0.010、0.007)。结论 OPN、CD44v6、CD10在乳腺癌中高表达,均与乳腺癌进展相关。联合检测OPN、CD44v6、CD10在乳腺癌中的表达,对于判断患者预后具有重要价值。     

乳腺癌中高迁移率族蛋白B1蛋白表达及其临床病理意义

目的探讨高迁移率族蛋白B1(HMGB1)蛋白在乳腺癌中的表达及临床病理意义。方法收集2006—2018年浙江省东阳市人民医院病理科浸润性乳腺癌石蜡标本417例和同时切除的正常乳腺组织石蜡标本26例。采用免疫组织化学EnVision法检测和比较浸润性乳腺癌组织和正常乳腺组织中HMGB1蛋白的表达。分析HMGB1蛋白胞核高表达及胞质阳性表达与乳腺癌患者临床病理特征的关系。结果(1)乳腺癌中HMGB1蛋白胞核高表达率及胞质阳性率分别为80.8%(337/417)和16.8%(70/417),而其在正常乳腺组织中分别为46.2%(12/26)和0。乳腺癌中HMGB1蛋白胞核高表达率和胞质阳性率均明显高于正常乳腺组织(分别P<0.001,P=0.046)。(2)组织学级别高、雌激素受体(ER)阴性、孕激素受体(PR)阴性的乳腺癌患者,其HMGB1蛋白胞核高表达率明显更高(分别P=0.006,P=0.004,P<0.001),胞质阳性率也明显更高(均P<0.001)。Logistic回归模型多因素分析显示乳腺癌患者HMGB1蛋白胞核高表达的独立相关因素为肿瘤组织学分级(OR=2.188,95%CI=1.078~4.443,P=0.030),而HMGB1蛋白胞质阳性表达的独立相关因素包括肿瘤组织学分级(OR=3.031,95%CI=1.600~5.742,P=0.001)、ER(OR=0.129,95%CI=0.034~0.494,P=0.003)及TNM分期(OR=3.820,95%CI=1.042~14.001,P=0.043)。(3)Cox比例风险模型多因素分析显示HMGB1蛋白胞核高表达是影响乳腺癌患者总生存的独立危险因素(HR=0.366,95%CI=0.138~0.972,P=0.044)。结论HMGB1蛋白胞核高表达及胞质阳性表达与乳腺癌患者多项预后不良因素密切相关,有望成为抗乳腺癌治疗的一个潜在生物学标志。     

胃癌中骨桥蛋白、结缔组织生长因子的表达及其意义

目的 探讨骨桥蛋白(osteopontin,OPN)和结缔组织生长因子(connective tissue growth factor,CTGF)及其联合检测在判断胃癌患者预后中的意义.方法 应用免疫组化PowerVision法检测108例胃癌组织中OPN及CTGF的表达,分析OPN、CTGF表达与患者临床病理特征、术后生存时间之间的关系.结果 TNM III/IV期患者中OPN阳性率高于Ⅰ/Ⅱ期(P<0.001),OPN阳性的患者更易发生淋巴结转移(P=0.002)和远处转移(P=0.022),并且OPN表达与肿瘤浸润深度正相关(P=0.015).CTGF高表达常见于发生淋巴结转移的病例(P=0.038).OPN阳性的患者术后5年生存率低于OPN阴性的患者(P<0.001).高表达CTGF的患者术后5年生存率低于低表达CTGF的患者(P=0.003).分析联合检测OPN和CTGF在胃癌组织中的表达发现OPN阳性/CTGF高表达组、OPN阳性/CTGF低表达或者OPN阴性/CTGF高表达组与OPN阴性/CTGF低表达组3组之间患者的术后生存率存在显著差异(4.2%、34.1%、60.5%,P<0.001).Cox回归分析结果表明TNM分期(P<0.001)、分化程度(P=0.01)和OPN/CTGF联合表达水平(P<0.001)是胃癌患者的独立预后因子.结论 组织中OPN、CTGF表达与胃癌的生物学特征密切相关,尤其是联合检测OPN/CTGF两种蛋白是指示胃癌患者预后的独立指标.     

三阴型乳腺癌中CD151的表达及意义

目的观察CD151在三阴型乳腺癌及非特殊型浸润性乳腺癌中的表达及与乳腺癌临床病理特征的关系。方法采用免疫组化EnVision两步法检测CD151在三阴型乳腺癌及非特殊型浸润性乳腺癌中的表达,运用统计学方法分析CD151表达与乳腺癌临床病理特征、无瘤生存期和预后的关系。结果在三阴型乳腺癌中,CD151表达与淋巴结转移和组织学分级相关(P0.05),CD151表达随着组织学分级的增加而升高,与患者年龄(P=0.081)和肿瘤大小(P=0.170)无明显相关性(P均0.05);三阴型乳腺癌患者肿瘤直径与腋窝淋巴结转移具有相关性(P0.05),CD151高表达患者的腋窝淋巴结转移率较高,无瘤生存期较短。结论 CD151在三阴型乳腺癌患者中高表达,并与淋巴结转移及组织学分级具有相关性,检测CD151有望成为评估三阴型乳腺癌患者预后的重要指标,为临床治疗和研究提供靶标。     

CCR7和VEGF-C蛋白与乳腺癌预后之间的关系

目的:探讨趋化因子受体7(CCR7)及血管内皮生长因子C(VEGF-C)蛋白在乳腺癌组织中的表达水平,并分析二者与乳腺癌预后的关系。方法:采用免疫组织化学技术,联合检测CCR7和VEGF-C蛋白分别在乳腺癌组织及正常乳腺组织中的表达差异情况,并分析二者与乳腺癌各相关临床病理特征之间的关系。采用Kaplan-Meier法来评估CCR7及VEGF-C蛋白的异常表达与乳腺癌患者生存期之间的关系。结果:CCR7蛋白在乳腺癌组织(68%)中的阳性表达率高于正常乳腺组织(30%),差异有统计学显著性(P0.01);而VEGF-C蛋白在乳腺癌组织(71%)中的阳性表达率也明显高于正常乳腺组织(24%),差异也有统计学显著性(P0.01)。且在乳腺癌组织中,CCR7与VEGF-C蛋白的表达呈正相关关系(r=0.613,P0.01)。CCR7和VEGF-C蛋白的高表达均与淋巴结转移和TNM分期有关(P0.05),而与年龄、肿瘤大小、雌激素受体和孕激素受体均无关。CCR7及VEGFC蛋白阳性表达者的生存期低于阴性表达者,两组比较差异有统计学显著性(P0.05)。结论:CCR7与VEGF-C的异常高表达可能与乳腺癌预后关系密切,二者可作为判断乳腺癌预后不良的重要指标之一。     

上皮钙黏蛋白、波形蛋白和Snail蛋白表型在乳腺浸润性导管癌中表达的相关性及其与预后的关系

目的 检测上皮钙黏蛋白(E-cadherin)、波形蛋白(Vimentin)和Snail蛋白在乳腺浸润性导管癌中的表达情况与乳腺癌病理特征的关系及其与浸润性导管癌预后的关系.方法 采用Envision免疫组织化学方法对89例乳腺浸润性导管癌组织中的上E-cadhenn,Vimentin和Snail蛋白表达情况进行检测并分析表达程度与临床病理特征之间的关系;统计分析采用卡方检验、Fisher精确概率法检验Spearman等级相关检验、配对计数资料检验、Kaplan-Meier法进行单因素生存分析,Cox比例风险模型进行生存的多因素分析.结果 E-cadherin、Vimentin和Snail蛋白在浸润性导管癌组织中的阳性表达率分别为、47.1％、53.9％和55.0％,三者呈负相关,(P=0.003);E-cadherin、Vimentin和Snail蛋白的表达与临床TNM分期有关(P ＜0.005).浸润性导管癌中Snail蛋白、Vimentin表达明显增高,Snail蛋白与淋巴结转移有关(P =0.029);Vimentin与淋巴结转移、雌激素状态有关(P =0.006,P＜0.001);E-cadherin表达明显降低,与孕激素状态有关(P =0.030);分子分型结果显示,管腔A型、HER-2阳性型组的Vimentin、Snail蛋白阳性表达率低于基地细胞样型组(P =0.012),而E-cadherin表达率则高于基地细胞样型组(P =0.004).Cox分析发现,E-cadherin低表达和Vimentin的过度表达与患者总生存期(P =0.019、P=0.045)及患者无病生存期(P =0.032、P=0.024)显著相关,但Snail蛋白的表达与总生存期及无病生存期无相关性(P =0.879、P=0.835).结论 E-cadhern、Vimentin和Snail蛋白在乳腺浸润性导管癌的发生、发展、侵袭及转移中起重要作用,对认识乳腺癌的生物学特性以及对指导乳腺癌的诊疗及预后具有重要意义.     

乳腺癌中LAT1和p-s6的表达及其意义

目的探讨L型氨基酸转运子1(LAT1)和磷酸化s6(phospho-s6,p-s6)核糖体蛋白在乳腺癌组织中的表达、意义及两者的相关性。方法采用免疫组化En Vision两步法检测178例乳腺癌组织和78例乳腺良性病变组织中LAT1蛋白和p-s6蛋白的表达,分析两者的表达与乳腺癌临床病理特征的关系。结果乳腺癌组织中LAT1的阳性率为36.5%,显著高于乳腺良性病变组织(23.1%,P0.05);p-s6在乳腺癌组织中的阳性率为33.2%,显著高于乳腺良性病变组织(12.8%,P0.05);乳腺癌组织中LAT1蛋白和p-s6蛋白的表达呈正相关(r=0.345,P0.05)。乳腺癌中LAT1蛋白表达与肿瘤直径、腋窝淋巴结转移、TNM分期和HER-2水平相关(P均0.05),与患者年龄、组织学分级、ER、PR水平均无关(P均0.05);p-s6蛋白表达与腋窝淋巴结转移、TNM分期、患者年龄、ER水平相关(P均0.05);与肿瘤直径、组织学分级、PR、HER-2水平等无关(P均0.05)。多因素分析显示:LAT1蛋白表达与肿瘤直径、HER-2表达水平有关;p-s6蛋白表达与腋窝淋巴结转移有关。结论LAT1蛋白和p-s6蛋白在乳腺癌中表达上调,且两者的表达呈正相关,提示LAT1和p-s6在乳腺癌发生、发展的过程可能发挥一定的协同作用。     

血清p185蛋白和CA153对乳腺癌患者的临床应用价值研究

目的检测乳腺癌患者血清p185蛋白表达及肿瘤标志物CA153水平,分析血清p185蛋白与肿瘤标志物CA153的相关性,探讨二者检测在乳腺癌患者中的临床应用价值。方法收集2010年至2012年间在我院住院治疗的乳腺癌55例患者术前、手术后一周血清各一份,应用免疫PCR法检测血清p185蛋白表达,化学发光法检测血清CA153水平。结果乳腺癌患者血清p185蛋白表达和血清CA153水平与临床分期均显著相关(P<0.05),血清p185蛋白表达与淋巴结转移情况无关系(P﹥0.05),血清CA153水平与淋巴结转移情况相关(P<0.05);乳腺癌患者血清p185表达与手术无关(P>0.05),手术前后血清p185蛋白表达无差异,乳腺癌患者血清CA153水平和手术相关(P<0.05),手术前血清CA153水平明显高于术后;乳腺癌患者术前血清CA153水平和p185蛋白表达相关(P<0.05),乳腺癌血清p185蛋白表达阳性患者,血清CA153水平高于阴性患者;乳腺癌患者复发或转移与血清p185蛋白表达及患者术前血清CA153水平相关(P<0.05),血清p185蛋白阳性患者复发或转移率明显高于阴性患者,术前CA153水平高的患者,复发或转移率高。结论乳腺癌患者血清p185蛋白表达与肿瘤标志物CA153水平有相关性,肿瘤标志物CA153可用于术后随访,术前检测乳腺癌患者血清p185蛋白表达与肿瘤标志物CA153水平可用于乳腺癌的预后判断。     

ALDH1A1在乳腺浸润性导管癌中的表达及临床意义

目的探讨ALDH1A1在乳腺浸润性导管癌中的表达及临床意义。方法收集2004年至2008年在中国医科大学附属第一医院乳腺外科病房行根治性手术的158例有完整随访资料的乳腺浸润性导管癌组织石蜡标本,采用免疫组化SP法检测ALDH1A1蛋白在乳腺癌组织中的表达,分析其与临床病理因素及预后的关系。结果 ALDH1A1主要表达于细胞浆。乳腺癌浸润性导管癌组织中ALDH1A1表达阳性率为56.3%。乳腺癌浸润性导管癌组织中ALDH1A1的表达与年龄、绝经状态、肿瘤大小、临床分期、临床分级无关(P0.05),而与淋巴结转移相关(P=0.009)。ALDH1A1阳性表达患者无病生存时间(DFS)和总生存时间(OS)均短于ALDH1A1阳性表达患者,差异具有有统计学意义(P=0.022和P=0.011)。Cox比例风险回归分析显示ALDH1A1是影响乳腺浸润性导管癌患者预后的危险因素(P=0.025和P=0.014),但不是独立危险因素(P=0.892和P=0.489)。结论 ALDH1A1蛋白在乳腺浸润性导管癌的发生、发展中起一定作用,与淋巴结转移密切相关,可能是影响乳腺浸润性导管癌预后的重要指标。     

乳腺浸润性导管癌不同分子分型中CD90的表达及其意义

目的 探讨CD90在乳腺浸润性导管癌中的表达及其与临床病理特征、分子分型的相关性。方法 构建80例乳腺浸润性导管癌和20例乳腺良性病变的组织芯片,采用免疫组化Max Vision法检测乳腺不同病变组织中CD90、ER、PR、Ki-67和HER-2的表达水平,并进一步分析其相关性。结果 CD90在乳腺浸润性导管癌和乳腺良性病变中的阳性率分别为62.5%和20.0%,两者差异有统计学意义(P0.001);CD90表达与乳腺浸润性导管癌淋巴结转移相关(P0.05),与患者年龄、肿瘤大小、TNM分期及组织学分级无关(P0.05);在乳腺浸润性导管癌不同分子亚型中,CD90阳性率以Luminal A型最低(40.0%)、三阴型最高(82.4%),各亚型之间差异有统计学意义(P0.05);CD90与ER(r=-0.342,P0.05)、PR(r=-0.374,P0.05)表达呈负相关,与Ki-67表达之间无相关性(r=0.084,P0.05)。结论 CD90表达与乳腺癌分子分型有关,其高表达提示患者预后不良。     

Clinical significance of NOB1 expression in breast infiltrating ductal carcinoma

Background: NIN/RPN Binding protein 1 homologue (NOBp1), encoded by NOB1 gene, was reported to play an essential role in the oncogenesis and prognosis of carcinomas. We conducted a study to reveal its expression and clinical significance in breast infiltrating ductal carcinoma. Methods: To explore the relationship between NOB1 expression and the clinical TNM (cTNM), 162 patients who undergone surgery were involved in the study. Compared to healthy tissues, abnormal localization and higher level of NOB1 in tumor cells was observed by Immunohistochemistry staining. Real-time PCR and western-blotting verified the up-regulation of NOB1 in carcinoma individuals. Results: A significant correlation between high level of NOB1 and the T stage, lymph node metastasis and cTNM was shown. Furthermore, patients with higher level of NOB1 predicted a declined overall survival (OS). Notably, multivariate analyses by Cox’s proportional hazard model revealed that expression of NOB1 was an independent prognostic factor in breast infiltrating ductal carcinoma. Conclusions: In summary, our present study clarify that the aberrant expression of NOB1 in breast infiltrating ductal carcinoma is possibly involved with tumorigenesis and development, and the NOB1 protein could act as a potential biomarker for prognosis assessment of breast infiltrating ductal carcinoma. Related mechanism is worthy of further investigation.     

胃癌中骨桥蛋白与OCT2的表达及意义

目的探讨骨桥蛋白（osteopontin,OPN）及转录因子OCT2在胃癌中的表达及其与临床病理参数及预后的关系。方法应用组织微阵列技术和免疫组化SP法检测99例胃癌组织中OPN蛋白与OCT2蛋白的表达情况。结果99例胃癌中OPN蛋白及OCT2蛋白的阳性表达率分别为60．61％、54．55％;OPN蛋白表达与肿瘤大小、浸润深度、脉管侵犯、淋巴结转移及远处转移呈正相关;OCT2蛋白表达也与肿瘤大小、浸润深度、脉管侵犯、淋巴结转移及远处转移呈正相关;OPN蛋白表达与OCT2蛋白表达呈正相关;OPN及OCT2蛋白阳性表达病例的平均生存时间和5年生存率均明显低于阴性表达的病例。结论OPN及OCT2蛋白表达可预测胃癌浸润和转移,是指导临床治疗及评估预后的有价指标。     

Epidermal growth factor receptor immunohistochemistry in different histological types of infiltrating breast carcinoma.

AIMS--To determine the immunohistochemical expression of epidermal growth factor receptor (EGF-R) in high grade, intermediate, and low grade tumours. METHODS--Specimens from 931 breast carcinomas were partly formalin fixed and paraffin wax embedded, to classify cases, and partly frozen in liquid nitrogen, cryostat sectioned, and immunostained using two monoclonal antibodies from clone 455 and 528 to demonstrate EGF-R positive cells. An avidin-biotin complex and peroxidase method was used after incubation with biotinylated anti-mouse antibody; colour was developed using a diaiminobenzidine solution. RESULTS--Low grade carcinomas seldom expressed EGF-R (n = 3) compared with 106 high grade infiltrating ductal carcinomas: EGF-R positive cases were much less common in infiltrating lobular than in infiltrating ductal carcinoma. Medullary carcinomas did not differ from infiltrating ductal carcinomas. CONCLUSIONS--The very low incidence of EGF-R positive cases in the "special type" group of breast carcinomas with a good prognosis is in line with the absence of the homologous c-erbB-2 and p53 oncoproteins, and the rarity of highly proliferating and oestrogen/progesterone negative cases. EGF-R expression in infiltrating lobular carcinoma was in keeping with the intermediate behaviour of this kind of tumour. EGF-R expression in cases of pure medullary carcinoma is the same as that of high grade tumours.     

Frequent E-cadherin gene inactivation by loss of heterozygosity in pleomorphic lobular carcinoma of the breast.

Pleomorphic lobular carcinoma of the breast is a variant of infiltrating lobular carcinoma that has poor prognosis. The pleomorphic appearance of this variant hinders its correct identification and differentiation from ductal carcinoma. The analysis of E-cadherin glycoprotein expression is a powerful tool for distinguishing lobular from ductal carcinomas, because complete loss of E-cadherin expression occurs in most infiltrating lobular tumors and lobular carcinomas in situ, but not in ductal tumors. In the present study, we have evaluated E-cadherin expression by immunohistochemistry in a series of 29 pleomorphic lobular breast carcinomas, including 7 cases with an in situ component. Complete loss of E-cadherin expression was observed in all the cases (29/29, 100%), in invasive and in situ components. To understand better the mechanisms underlying E-cadherin inactivation in this tumor type, the frequency of loss of heterozygosity at the E-cadherin gene locus (16q22.1) was analyzed. All informative tumors (27/27, 100%) showed loss of heterozygosity, thus implying a strong association between loss of E-cadherin expression and loss of heterozygosity at 16q22.1. Moreover, loss of heterozygosity was detected in all in situ components analyzed. These results imply that in terms of E-cadherin inactivation, pleomorphic lobular tumors are identical to classic infiltrating lobular carcinomas and distinct from ductal tumors, and therefore they should be considered a variant of lobular carcinoma of the breast, despite their aggressive behavior.     

Triple negative breast carcinoma: the good,the bad and the ugly

Triple-negative breast cancers (TNBC) are a heterogeneous group of breast cancers defined by their lack of expression of oestrogen and progesterone receptors as well as human epidermal growth factor receptor 2 amplification, and therefore, are resistant to hormonal and Trastuzumab therapy. TNBC accounts for 15% of all breast cancers, and are more common in African-American women than in Whites. Also, BRCA-1 associated tumours are usually TNBC. Since the majority of TNBC fall into the basal-like breast cancer category by molecular studies, they are generally regarded as tumours of poor prognosis. However, some TNBC, such as adenoid cystic carcinoma and medullary carcinomas have excellent prognosis. Others, like metaplastic carcinoma have a prognosis that is comparable to infiltrating ductal carcinoma, not otherwise specified (NOS). Many immunohistochemical markers have been studied as an adjunct tool in classifying TNBC. However, microscopic evaluation remains an important tool in classifying these tumours and therefore predicting their prognosis.     

Increased expression of osteonectin and osteopontin, two bone matrix proteins, in human breast cancer.

Microcalcifications are a common phenomenon associated with breast cancer and are often the only mammographic sign of a malignant breast disease. Although microcalcifications are not restricted to breast cancer and can be also associated with benign lesions, it is noteworthy that they are composed exclusively of hydroxyapatite in breast carcinoma. Hydroxyapatite is the bone-associated phosphocalcic crystal the deposition of which in bone tissue requires the coordinated expression of several molecules such as osteonectin (OSN) and osteopontin (OPN), synthesized by cells of the osteoblastic lineage. In this study, we evaluated the expression of these two bone matrix proteins, using an immunoperoxidase technique and specific antibodies, in 79 breast lesions including 28 benign and 51 cancerous specimens. We found that normal mammary tissue associated with the lesions examined expressed generally undetectable or lightly detectable (0 or 1+) amounts of OSN and OPN (92 and 81%, respectively). Benign breast lesions, including fibroadenoma and fibrocystic dysplasia, were generally weakly stained (0 or 1+) with both anti-OSN and anti-OPN antibodies (96.4 and 60.7%, respectively). Interestingly, the majority of both in situ and invasive breast carcinoma lesions showed a strong expression (2+ or 3+) for OSN or OPN (74.5 and 84.3%, respectively). High expression of these two bone matrix proteins was associated with frequent microcalcification deposition in the lesion. This study is the first extensive study of OSN and OPN expression in mammary cancers. Our data suggest that OSN and OPN could play a role in the formation of ectopic microcalcifications often associated with breast cancer. It is also tempting to speculate that the expression of these two glycoproteins by breast cancer cells play a role in the preferred bone homing of breast metastases.     

Tumor cell expression of HLA-DM associates with a Th1 profile and predicts improved survival in breast carcinoma patients

Studies aimed at elucidating the immunological and prognostic significance of HLA-DR expression on breast carcinoma cells have yielded contradictory results. To expand on previous studies, we have investigated the associations of tumor cell expression of HLA-DR and its related co-chaperones, invariant chain (Ii) and HLA-DM, with infiltrating inflammatory cells, in situ cytokine mRNA levels and prognosis and outcome in 112 breast carcinoma patients with a median follow-up of 59 months. While the majority of HLA-DR+ tumors co-express Ii, only a minority express HLA-DM. Tumor cell expression of HLA-DR and co-chaperones positively associated with both infiltrating CD4+ and CD8+ T-cell subsets (P < 0.01). Expression of HLA-DR and Ii associated with decreased estrogen receptor alpha levels and younger age at diagnosis, suggesting a role for hormones in the control of HLA class II expression in breast carcinoma. Patients with DR+Ii+DM- tumors had markedly decreased recurrence-free and disease-specific survival as compared with patients with DR+Ii+DM+ tumors (P < 0.05) and HLA-DR/co-chaperone expression was an independent predictor of survival by multivariate Cox regression analysis, controlling for standard prognostic indicators. Tumors that co-express HLA-DR, Ii and HLA-DM have increased levels of IFN-gamma, IL-2 and IL-12 mRNA, suggesting improved survival of patients with DR+Ii+DM+ tumors may be attributable to Th1-dominated immunity. We conclude that expression of determinants of the immune response by tumor cells may influence breast tumor progression and patient outcome.     

HER2/neu expression in Venezuelan patients with locally advanced breast cancer

To know the prognosis of a patient with cancer allows choosing the most appropriate therapeutic. The expression of the oncogen HER2/neu has been related to an unfavourable prognosis in patients with infiltrating breast carcinoma, for this reason, the purpose of this work was to analyze its predictive and prognostic value in patients with locally advanced breast cancer, treated in the Oncological Institute "Dr Miguel Perez Carre?o". Information about personal data of 58 patients was compiled, as well as the received treatment, clinical response data of the biopsy report, histological grade, nuclear grade, node status and evolution of the patient. The determination of the HER2/neu expression was made by inmunohistochemistry, using the avidina-estreptavidin-peroxidasa technique. For the interpretation of the HER2/neu, an agreed score from 0 to 3+ was assigned, using the guidelines of interpretation of the Hercep-Test (DAKO). 37.9% of the cases displayed expression of the HER2/neu in the membrane of the tumour cells. The node state and the hormonal receptors state turned out to be significant to predict the disease-free interval. Patients with strong oncoprotein expression seem to have a quimioresistant tendency to the FAC (5-fluorouracil, doxorubicin and cyclophosphamide) regime. The expression of the HER2/neu receptor is related to a reduction of the disease-free interval and global survival in patients with infiltrating ductal breast carcinoma locally advanced, confirming, in this work, to be a good prognostic factor.