Cyclin D‐1, Interleukin‐6, HER‐2/neu, Transforming Growth Factor Receptor‐II and Prediction of Relapse in Women with Early Stage, Hormone Receptor‐Positive Breast Cancer Treated with Tamoxifen
University of Vermont, Burlington, Vermont, United StatesThe Breast Journal (Impact Factor: 1.41). 06/2007; 13(4):337 - 345. DOI: 10.1111/j.1524-4741.2007.00440.x
We hypothesized that amplification or overexpression of HER-2 (c-erbB-2), the Ki-67 antigen (Mib1), cyclin D-1 (CD1), interleukin-6 (IL-6), or the transforming growth factor beta II receptor, (TGFβRII), would predict relapse in women with early stage, estrogen (ER) and/or progesterone receptor (PR) positive breast cancer treated with tamoxifen. Conditional logistic regression models and a new novel analytic method––support vector machines (SVM) were used to assess the effect of multiple variables on treatment outcome. All patients had stage I–IIIa breast cancer (AJCC version 5). We paired 63 patients who were disease-free on or after tamoxifen with 63 patients who had relapsed (total 126); both disease-free and relapsed patients were matched by duration of tamoxifen therapy and time to recurrence. These 126 patients also served as the training set for SVM analysis and 18 other patients used as a validation set for SVM. In a multivariate analysis, larger tumor size, increasing extent of lymph node involvement, and poorer tumor grade were significant predictors of relapse. When HER-2 or CD1 were added to the model both were borderline significant predictors of relapse. The SVM model, after including all of the clinical and marker variables in the 126 patients as a training set, correctly predicted relapse in 78% of the 18 patient validation samples. In this trial, HER-2 and CD1 proved of borderline significance as predictive factors for recurrence on tamoxifen. An SVM model that included all clinical and biologic variables correctly predicted relapse in >75% of patients.
Article: Basic science: (JULY 2007)
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ABSTRACT: To investigate the expression and association of ER, Ki-67 and cyclinD1 in usual ductal hyperplasia(UDH), atypical ductal hyperplasia (ADH) and ductal carcinoma in situ(DCIS) in the breast. The study included 56 cases of pre-cancerous lesions which were surgically excised at Qi Lu Hospital of Shangdong University. Immunohistochemistry was used to determine the expression of ER, Ki-67 and cyclinD1 and double-labelling immunofluorescence technique was used to observe the coexpression of ER and Ki-67. The expression and distribution of ER-positive cells were significantly different in UDH, ADH and DCIS. The ER-positive cells were much more in UDH than in normal TDLUs (terminal duct lobular units). The distribution of ER-positive cells interspersed amid ER-negative cells within UDH. However , the ER positive cells showed marked increases in ADH and low grade nuclear DCIS (P < 0.05), distributing in almost all constituent cells. The expression of ki-67 and cyclinD1 were significantly different between UDH and DCIS (P < 0.05) , and a positive correlation was found between expression of Ki-67 and morphological classification of pre-cancerous lesions (r = 0.3522, P < 0.05) as well as cyclinD1 (r = 0.3901, P < 0.05). Double-labelling immunofluorescence showed that there was no coexpression of ER and Ki-67 in normal breast tissue. The coexpression of the two markers was found in ADH and increased in DCIS. Overexpression of ER, Ki-67 and cyclinD1 significantly accompanies the transition of normal cells and UDH to ADH and DCIS. The coexpression of ER and ki-67 may present the early change in carcinogenesis of breast cancer.
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ABSTRACT: The notions of local, regional and locoregional recurrences of the mammary gland cancer are singled out in modern literature. A confusion of the recurrence notions leads to difficulties not only in detection of their appearance rate and a clinicomorphological characteristic, but in assessment of the disease treatment and prognosis possibilities. The world data of the recurrence appearance clinicomorphological risk factors such as a primary tumor size, the regional lymph node lesion, the patient age, a presence of multiple centers and peritumoral tumor invasion, a use of postoperative radial therapy and etc. is systematized in the review. The data of the tumor receptor status and genetic factor role in development of the mammary gland local recurrences is presented. A clinicomorphological characteristic of the local recurrences considering a localization, number of tumoral nodes, a tumor shift, a presence of calcinates and such complications as a tumor ulceration or decomposition, a germination of neighboring structures and infection is given. The different types of the local recurrence treatment (surgical, medicinal, radial method and their combinations) and a site of local recurrence in prognosis of disease in patients with a mammary gland cancer are studied.
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