HER2 status in gastric cancers: a retrospective analysis from four Chinese representative clinical centers and assessment of its prognostic significance

BACKGROUND

HER2 has a predictive value in gastric cancer. However, its association with prognosis remains uncertain. The aim of our study was to estimate the HER2-positive rate in Chinese gastric cancers, compare the classical fluorescence in situ hybridization (FISH) method with the novel bright-field dual color silver-enhanced in situ hybridization (DSISH) detection system, and evaluate the relationship between the HER2 status and prognosis.

PATIENTS AND METHODS

Seven hundred and twenty-six resected gastric cancers separately from four clinical centers in China were examined for HER2 by immunohistochemistry (IHC), FISH, and DSISH.

RESULTS

The HER2-positive rate was 13%. The consistency between FISH and DSISH results was high (99%; κ = 0.958; P < 0.001). Tumor heterogeneity and polysomy were the main reasons for inconsistency. There was no significant difference in the 3-year overall survival (OS) between HER2-positive and -negative patients (P = 0.959). Multivariate analysis showed that HER2 was not an independent prognostic factor.

CONCLUSION(S)

HER2 overexpression and amplification occur in a significant number of Chinese gastric cancer patients. Given the obvious advantages and high consistency with FISH, DSISH was superior for evaluating HER2 amplification in gastric cancer. HER2 was not a prognostic factor for gastric cancer in our study.

HER2 status in gastric cancers: a retrospective analysis from four Chinese representative clinical centers and assessment of its prognostic significance

BACKGROUND

HER2 has a predictive value in gastric cancer. However, its association with prognosis remains uncertain. The aim of our study was to estimate the HER2-positive rate in Chinese gastric cancers, compare the classical fluorescence in situ hybridization (FISH) method with the novel bright-field dual color silver-enhanced in situ hybridization (DSISH) detection system, and evaluate the relationship between the HER2 status and prognosis.

PATIENTS AND METHODS

Seven hundred and twenty-six resected gastric cancers separately from four clinical centers in China were examined for HER2 by immunohistochemistry (IHC), FISH, and DSISH.

RESULTS

The HER2-positive rate was 13%. The consistency between FISH and DSISH results was high (99%; κ = 0.958; P < 0.001). Tumor heterogeneity and polysomy were the main reasons for inconsistency. There was no significant difference in the 3-year overall survival (OS) between HER2-positive and -negative patients (P = 0.959). Multivariate analysis showed that HER2 was not an independent prognostic factor.

CONCLUSION(S)

HER2 overexpression and amplification occur in a significant number of Chinese gastric cancer patients. Given the obvious advantages and high consistency with FISH, DSISH was superior for evaluating HER2 amplification in gastric cancer. HER2 was not a prognostic factor for gastric cancer in our study.

Histological improvement of long-term antiviral therapy in chronic hepatitis B patients with persistently normal alanine aminotransferase levels

The aim of this study was to evaluate the histological outcomes of chronic hepatitis B (CHB) patients with persistently normal alanine aminotransferase (ALT) levels after long-term antiviral therapy. Paired liver biopsies before and after lamivudine (LAM) treatment in CHB patients with normal and elevated ALT levels were compared. Histological response was defined as a 1-point decrease according to the Scheuer scoring system, without worsening of fibrosis between pretreatment and posttreatment biopsies. Among the 48 patients who underwent paired liver biopsies, 17 had persistently normal baseline ALT level and 31 had elevated ALT level. The median age of the patients was 44 years and 72.9% of the patients were male. The median duration of antiviral treatment was 44.5 months (range 14-104). Long-term follow-up of liver biopsies revealed that 82.4% of patients in the normal ALT group and 61.3% in the elevated ALT group had a baseline fibrosis score of 4, which was reduced to 17.6% and 38.7% after long-term therapy, respectively, indicating reversal of cirrhosis in a large proportion of both groups, especially in patients with normal baseline ALT levels. Long-term antiviral treatment could achieve significant histological improvement in CHB patients with fibrosis or cirrhosis, regardless of ALT level.

Inhibition of early biofilm formation by glass-ionomer incorporated with chlorhexidine in vivo: a pilot study

BACKGROUND

This pilot study investigated the antibiofilm effects of glass-ionomer cements (GICs) and resin-modified glass-ionomer cements (RMGICs) incorporated with chlorhexidine (CHX) in vivo.

METHODS

Experimental GICs and RMGICs containing 2% CHX were obtained by mixing CHX with the powder of GICs (CHXGIC) and RMGICs (CHXRMGIC). Four groups of specimens were prepared in a standardized size. After polishing and sterilization, they were bonded to the buccal surface of the molars in the first and second quadrant of volunteers and left untouched for 4 hours and 24 hours, respectively. The bacterial vitality of plaque was then analysed by confocal laser scanning microscopy (CLSM). The bacterial morphology and biofilm accumulation were determined by scanning electron microscopy (SEM). The pH value of biofilm was assessed by Plaque Indicator Kits.

RESULTS

CLSM analysis revealed that bacterial vitality of the biofilm on CHXGIC and CHXRMGIC was significantly lower than that on GIC and RMGIC. SEM analysis indicated that the morphology of bacteria on CHXGIC and CHXRMGIC was irregular. The pH value of biofilm on the experimental materials presented no statistically significant difference.

CONCLUSIONS

Twenty-four hour bacterial vitality on GICs and RMGICs with CHX are lower in micro-organisms than on conventional GICs and RMGICs.

Environmental enrichment rescues female-specific hyperactivity of the hypothalamic-pituitary-adrenal axis in a model of Huntington's disease

Huntington's disease (HD) has long been regarded as a disease of the central nervous system, partly due to typical disease symptoms that include loss of motor control, cognitive deficits and neuropsychiatric disturbances. However, the huntingtin gene is ubiquitously expressed throughout the body. We had previously reported a female-specific depression-related behavioural phenotype in the R6/1 transgenic mouse model of HD. One hypothesis suggests that pathology of the hypothalamic-pituitary-adrenal (HPA) axis, the key physiological stress-response system that links central and peripheral organs, is a cause of depression. There is evidence of HPA axis pathology in HD, but whether it contributes to the female R6/1 behavioural phenotype is unclear. We have examined HPA axis response of R6/1 mice following acute stress and found evidence of a female-specific dysregulation of the HPA axis in R6/1 mice, which we further isolated to a hyper-response of adrenal cortical cells to stimulation by adrenocorticotrophin hormone. Interestingly, the adrenal pathophysiology was not detected in mice that had been housed in environmentally enriching conditions, an effect of enrichment that was also reproduced in vitro. This constitutes the first evidence that environmental enrichment can in fact exert a lasting influence on peripheral organ function. Cognitive stimulation may therefore not only have benefits for mental function, but also for overall physiological wellbeing.

Strong running coupling at τ and Z(0) mass scales from lattice QCD

This Letter reports on the first computation, from data obtained in lattice QCD with u, d, s, and c quarks in the sea, of the running strong coupling via the ghost-gluon coupling renormalized in the momentum-subtraction Taylor scheme. We provide readers with estimates of α(MS[over ¯])(m(τ)(2)) and α(MS[over ¯])(m(Z)(2)) in very good agreement with experimental results. Including a dynamical c quark makes the needed running of α(MS[over ¯]) safer.

The impact of prior radiotherapy on fatal complications after self-expandable metallic stents (SEMS) for malignant dysphagia due to esophageal carcinoma

The esophageal stent has been demonstrated to serve as a safe and effective palliative treatment for advanced inoperable esophageal carcinoma. However, the safety of esophageal stents in patients with prior radiotherapy (RT) remains debated. This article aims to investigate the impact of prior RT on the incidence of fatal complications after self-expandable metallic stents for palliation of malignant dysphagia because of esophageal carcinoma. Between January 2007 and July 2010, 93 patients with malignant dysphagia because of esophageal carcinoma underwent placement of self-expandable metallic stents in our hospital. Patients were retrospectively separated into two groups: patients with RT before stent placement (RT group, n=57) and patients with no treatment before stent placement (no RT group, n=35).The median survival after stent placement was 77 days (7-842 days) in the RT group and 246 days (15-878 days) in the no RT group. Improvement in dysphagia score was similar in both groups. The fatal complications included fatal gastrointestinal hemorrhage and uncontrolled pneumonia. The incidence of fatal gastrointestinal hemorrhage and uncontrolled pneumonia were 28.1% and 5.7% (P=0.009), 28.1% and 5.7% (P=0.009), respectively. Logistic regression analysis showed a significant interaction between prior RT and fatal gastrointestinal hemorrhage (relative risk 7.82, 95% confidence interval 1.54-39.61; P=0.013). Mortality of massive hemorrhage was 5.7% (2/35), 0% (0/4), 12.5% (3/24), and 44.8% (13/29), respectively, in patients who received 0, 1Gy∼49Gy, 50Gy∼60Gy, and >60Gy (χ(2) =17.761; P=0.000). Logistic regression analysis disclosed prior RT did not significantly increase the risk of uncontrolled pneumonia (relative risk 1.47, 95% confidence interval 0.21-10.12; P=0.697).