Tumor nuclear grade,estrogen receptor,and progesterone receptor: Their value alone or in combination as indicators of outcome following adjuvant therapy for breast cancer

Summary Previous reports by us have shown that the outcome of breast cancer patients who have received systemic adjuvant therapy is influenced by tumor estrogen or progesterone receptor (ER or PR) content or by nuclear grade. This publication provides information regarding the relative merit of those three markers. Findings from patients receiving L-PAM plus 5-FU (PF) or PF plus tamoxifen (PFT) indicate that the disease-free survival and survival within each regimen was almost identical when related to either ER, PR, or nuclear grade. Those having tumors with either of the receptors 10 fmol or a good nuclear grade had a better outcome through five postoperative years than did those with ER or PR 0–9 fmol or poor nuclear grade. The magnitude of the difference was similar for each of the three discriminants. Since they were found to be of equal predictive value, one marker might well serve as a substitute for another. Cox regression analyses, however, clearly indicate that ER, PR, and nuclear grade have an independent influence on outcome and that a more accurate assessment of outcome is obtained when more than one marker is employed. Thus, information should be obtained on as many markers as possible. This conclusion is supported by observations presented which indicate that nuclear grade in combination with either or both of the receptors is a better predictor than either marker alone and that, as indicated by life table probability values and relative odds ratios, an increasing number of favorable tumor prognostic indicators results in a better patient outcome particularly in PFT-treated patients. A possible explanation is considered for why the separation of receptor/nuclear grade categories is more orderly and pronounced in PF-treated patients receiving tamoxifen than in those given PF alone. See Appendix I     

Prolactin concentration in plasma and susceptibility to mammary tumors in female rats from different strains treated chronically with estradiol-17β

Summary Prolactin is associated with the development of mammary tumors in rats. The aim of the present study was to evaluate whether strain differences in susceptibility to the development of mammary tumors could be explained by genetic differences in the response of the pituitary to chronic stimulation by estrogens. Prolactin levels were measured in plasma from rats of the Sprague-Dawley, Wistar WAG/Rij and Brown Norway BN/BiRij strains before and at different times after subcutaneous implantation of estradiol-17 in cholesterol/paraffin pellets. In all strains plasma prolactin was elevated from the second week after implantation of the pellet, although there were quantitative differences between the responses. At 32 weeks after implantation of the pellets the plasma level of prolactin in Sprague-Dawley rats was 1247 ± 367 ng NIAMDD prolactin RP-1/ml (mean ± S.E.M), whereas Wistar WAG/Rij and Brown Norway BN/BiRij had plasma prolactin levels of 679 ± 211 and 182 ± 19 ng/ml respectively. Between 52 and 104 weeks after implantation these values rose to 4016 ± 1116, 5004 ± 1053 and 808 ± 129 ng/ml respectively. The plasma concentration of prolactin of rats in this age group was strongly associated with the occurrence of pituitary adenomas in all three strains. In untreated rats, the concentration of prolactin in the plasma increased with age to only 200–400 ng/ml at 12–24 months of age but no significant differences were observed between the three rat strains. It is concluded that observed differences in spontaneous and estrogen-mediated mammary tumor development in these rat strains cannot be explained by genetic differences in the plasma concentration of prolactin. The development of malignant mammary tumors after estrogen treatment appears to be associated with the extent of the increase in plasma prolactin induced by the estrogen.     

大鼠砷暴露致雌激素效应及对甲状腺功能的影响

目的 探讨大鼠砷暴露和雌激素受体(estrogen receptor α, ERα)抑制剂干预后,对雌激素及其受体和甲状腺相关激素及受体的影响,阐释砷的甲状腺毒性作用途径。 方法 大鼠亚砷酸钠饮水染毒,并给予雌激素受体抑制剂(ICI182780)干预。通过ELISA检测大鼠血清雌二醇(estradiol, E2)、总三碘甲状腺原氨酸(total triiodothyronine, TT3)、总甲状腺素(total thyroxine, TT4)、促甲状腺激素(thyroid stimulating hormone, TSH)水平;透射电镜观察大鼠甲状腺组织病理形态学结构改变;实时荧光定量法检测甲状腺组织ERα、甲状腺激素受体α(thyroid hormone receptor α, TRα)相对表达量。蛋白免疫印迹法检测甲状腺组织TRα蛋白水平。 结果 砷暴露后雌性大鼠E2表达水平较对照组上升(P<0.05),雌雄大鼠低砷组ERα、TRα相对表达量较对照组均下降(P<0.05)。高剂量砷暴露后雌性大鼠TSH、TT3及TRα表达水平较对照组上升,TT4较对照组下降(P<0.05)。ICI182780可降低雌性大鼠E2表达水平的上升,也对砷暴露大鼠TT4、TSH、ERα、TRα表达的改变有反向调节作用(P<0.05)。 结论 低砷暴露对雌性大鼠有明显的雌激素效应,高砷暴露可造成大鼠甲状腺功能紊乱或损伤。ERα可能是体内砷暴露发挥雌激素效应的主要途径之一。ICI182780可拮抗砷暴露导致的雌激素效应并缓解甲状腺功能的损伤。     

葛根异黄酮对去卵巢大鼠骨矿密度和骨强度的影响

目的：研究葛根总异黄酮（TIP）对雌激素缺乏引起的骨质疏松症的防治作用。方法：10月龄SD大鼠,手术切除双侧卵巢后7d,每天igTIP100和20mg/kg,并设假手术组（Sham)、模型对照组（OVX）和尼理论联系实际是性组（E3）,在给药4和7个月时,测定大鼠全身骨矿总量（BMC）和骨矿密度（BMD）及骨生物力学强度等。结果（1）和OVX组相比,TIP大剂量组在给药4个月时BMC和BMD分别提高14．6％和12．1％,7个月时分离提高6．8％和14．2％;小剂量组4个月时分别提高7．8％和6．9％,7个月时分离提高8．65和14．95。（2）TIP大、小剂量组股骨相对体积质量分别提高3．8％和3．4％;胫骨相对休整质量提高6．8％和6．3％,股骨Ca盐密度均提高15％以上。（3）TIP大、小剂量组股骨最大负荷分别提高16．1％和9．1％;结构强度分别提高19．4％和12．5％,（4）TIP使大鼠子宫重量明显增加。结论TIP对去卵巢引起的大鼠骨质疏松症具有明显的防治作用,这种作用可能和它的弱雌激素样活性有关。     

The relationship of CyclinD1 and estrogen receptor expression in the process of proliferation and metastasis in breast neoplasm

Cylin D1 play a very importantrole in the prolifi-ration of tumor cells.The purpose of this study wasto investigate the role of Cylin D1 and estrogen recep-tor ( ER) expression in breast carcinomas and theirrelationship.1　MATERIALSAND METHODS1 .1　 Clinical DataAll the 1 46cases of breast neoplasm were fe-males with age ranging from 1 8to 65 years ( average45 .34± 1 0 .39) .The enrolled in this study were5 6cases of benign breast mass including 44cases ofbreastfibroadenoma,1 2 case…     

Estrogen and estrogen receptors in kidney diseases

Acute kidney injury (AKI) and chronic kidney disease (CKD) are posing great threats to global health within this century. Studies have suggested that estrogen and estrogen receptors (ERs) play important roles in many physiological processes in the kidney. For instance, they are crucial in maintaining mitochondrial homeostasis and modulating endothelin-1 (ET-1) system in the kidney. Estrogen takes part in the kidney repair and regeneration via its receptors. Estrogen also participates in the regulation of phosphorus homeostasis via its receptors in the proximal tubule. The ERα polymorphisms have been associated with the susceptibilities and outcomes of several renal diseases. As a consequence, the altered or dysregulated estrogen/ERs signaling pathways may contribute to a variety of kidney diseases, including various causes-induced AKI, diabetic kidney disease (DKD), lupus nephritis (LN), IgA nephropathy (IgAN), CKD complications, etc. Experimental and clinical studies have shown that targeting estrogen/ERs signaling pathways might have protective effects against certain renal disorders. However, many unsolved problems still exist in knowledge regarding the roles of estrogen and ERs in distinct kidney diseases. Further research is needed to shed light on this area and to enable the discovery of pathway-specific therapies for kidney diseases.     

绝经后骨质疏松性椎体压缩性骨折患者血清雌激素、前脂肪因子-1水平与骨代谢和骨密度相关性研究

目的 研究绝经后骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture,OVCF）患者血清雌激素、前脂肪因子-1（preadipose factor-1,Pref-1）水平与骨代谢和骨密度的相关性。方法 纳入湛江中心人民医院2019年1月至2020年11月期间确诊的64例绝经OVCF患者为OVCF组,同时纳入绝经后的健康女性45名为对照组,比较OVCF组和对照组血清中雌二醇、Pref-1水平,并根据OVCF患者血清中雌二醇、Pref-1的水平分为高低亚组,进行患者骨代谢、骨密度等一系列指标的比较,通过Preason相关性分析雌二醇、Pref-1的水平与骨代谢、骨密度指标的相关性。结果 OVCF患者血清中雌二醇水平较对照组显著降低（t=13.275,P<0.05）,Pref-1水平显著上升（t=10.360,P<0.05）;雌二醇高表达组较低表达组患者血清中25-（OH）VitD、N-MID的水平以及腰椎骨密度、髋部骨密度均显著上升（t=7.378,5.472,10.290,9.774,P<0.05）,PINP、β-CTX水平均显著降低（t=6.447,9.103,P<0.05）;Pref-1高表达组较低表达组患者血清中25-（OH）VitD、N-MID的水平以及腰椎骨密度、髋部骨密度均显著下降（t=8.350,7.426,12.376,10.450,P<0.05）,PINP、β-CTX水平均显著升高（t=8.266,11.205,P<0.05）;OVCF患者血清雌二醇水平与25-（OH）VitD、N-MID以及腰椎骨密度、髋部骨密度均呈正相关（r>0,P<0.05）,与PINP、β-CTX水平呈负相关（r<0,P<0.05）;Pref-1与25-（OH）VitD、N-MID的水平及腰椎骨密度、髋部骨密度均呈负相关（r<0,P<0.05）,与PINP、β-CTX水平呈正相关（r>0,P<0.05）。结论 绝经后OVCF患者血清雌激素显著下调,Pref-1水平明显上调,且二者与骨代谢和骨密度指标之间存在密切相关性,对二者水平的医学干预或能为OVCF的临床治疗带来新的契机。     

Breast cancer in young women: Imaging and clinical course

The purpose of this study was to characterize presenting imaging findings in women younger than 40 diagnosed with invasive breast cancer in the context of pathology and clinical course. Retrospective chart and imaging reviews were performed in patients under 40 diagnosed with breast cancer between July 1, 2004, and December 31, 2013. Patient demographic, imaging, pathology, and clinical data were collected. Overall and recurrence-free survival were estimated using the Kaplan-Meier method. Univariate Cox proportional hazards models were performed to identify factors associated with recurrence-free survival. Our study cohort consisted of 110 patients with invasive mammary carcinoma. One hundred one (91.8%) presented with a palpable mass. The mean size of all lesions on imaging was 3.5 cm ± 2.9 cm. Malignant calcifications were present in 54 (49.1%) cases. Imaging demonstrated multifocal or multicentric disease in 45 (40.9%) cases. Seventy four (67.3%) cancers were high grade. Luminal genomic subtypes were the most common (n = 61, 55.5%). At presentation, 4 (3.6%) patients had bilateral malignancy and 8 (7.3%) patients had distant metastatic disease. Ninety seven (88.2%) underwent neoadjuvant chemotherapy and 67 (60.9%) underwent radiation therapy. Seventy five (68.2%) of the patients underwent mastectomy. The restricted mean time to recurrence was 9.01 years (standard error 3.162 months). ER positivity was associated with compromised recurrence-free survival. The overall survival rate was 0.962 at 10 years. Young patients diagnosed with breast cancer typically present with advanced breast imaging findings and undergo aggressive treatment. Recurrence often occurs >5 years from diagnosis, and ER positive subtypes are at increased risk for recurrence.     

Functional characterization of somatic point mutations of the human estrogen receptor alpha (hERalpha) in adenomyosis uteri

Endometriosis and adenomyosis uteri are chronic, benign diseases caused by the presence of endometrial tissue in ectopic locations, e.g. peritoneal or deep inside the myometrial wall of the uterus and/or in the rectovaginal septum. Although adenomyosis might be considered as a special form of endometriosis, both conditions differ with respect to clinical symptoms and treatment. Induction of a hypo-estrogenic state alone or in combination with surgical removal of the extra-uterine lesion is mostly sufficient for treatment of peritoneal endometriosis. By contrast, adenomyosis uteri rarely responds to hormonal therapy and usually requires a hysterectomy for cure. Consequently, the role of steroid hormone receptors with respect to the aetiology of either condition is still a matter of discussion. Using PCR/single strand conformation polymorphism analysis, we identified somatic estrogen receptor (ER) alpha gene mutations in three out of 55 samples from adenomyosis uteri. Functional characterization revealed that two of the mutant ERalpha proteins display severely impaired DNA-binding and transactivation properties secondary to an altered response to estrogens or changes in epidermal growth factor-mediated ligand-independent activation. Although the exact mechanism remains unknown, we suggest that mutation-related silencing of estrogen responsiveness might render endometriotic cells resistant to hypo-estrogenic conditions thereby accounting for failure of estrogen-ablative therapy in adenomyosis.