Abstract P4-14-14: Clinicopathological features and endocrine therapy mode of ER low expression (1%-9%) breast cancer patients in China

Purpose: Since 2010, ASCO/CAP recommended that ER be considered positive if ≥1% tumor cells with positive nuclear staining by immunohistochemistry (IHC) in breast cancer. ASCO/CAP also recommended considering endocrine therapy (ET) in ER positive patients. However, most breast cancers are either ER negative or ER strongly positive (≥10%), and tumors with low ER (1-9%) expression are rare. Up to now, the effect of ET is controversial for these patients with ER 1-9% and unfortunately, we know little about the clinical information of this subgroup. In this study, we analyzed the clinicopathological characteristics and ET mode of patients with low ER expression. We sought to figure out whether the ASCO/CAP guidelines affect clinical ET decision in China and Which features are important considerations for doctors to choose ET. We also evaluated the efficacy of ET in these patients. Methods: Patients diagnosed stage I-III primary invasive breast cancer with ER low expression (1-9%) between January 2008 and December 2016 were retrospectively identified from six hospitals in China. Result: 457 patients (2.7%) had low expression of ER (1-9%) of 17216 patients. Mean age at diagnosis was 49 years. 288 patients (49.9%)were younger than 50 years old. 254 patients (55.6%) had stage II disease and 37 patients (8.1%) had lymphovascular invasion (LVI). 260 patients (56.9%) were HER2 positive; 408 patients had PR negative or low expression; 327 patients' (71.6%) Ki-67 status were > 20%. 388 patients (85%) received chemotherapy. Of those 388 patients, 90% patients received anthracycline combined with taxol chemotherapy regimens. 170 patients (37.2%)received ET. Before 2010, only 25.7% patients with low ER expression received ET. The proportion of ET increased after the 2010 ASCO/CAP guideline was published. In 2013, 50% patients received ET. The rate of ET was totally different in six hospitals. 55% patients received ET in the hospital with highest rate, while only 4% patients received ET in the hospital with lowest rate. Using the univariate logistic regression analysis of ET, ER expression, PR expression, Ki-67 status and LVI were associated with the rate of ET. But after adjustment for other covariates, only ER level was significantly associated with the rate of ET. Compared to patients with ER<5% tumors, patients with ER≥5% tumors had a significantly higher probability of ET rate (OR, 2.882; 95% CI: 1.928-4.308; P < 0.001). Median follow time was 30 months. The 5-year RFS rate was 85%. Younger age and positive lymph nodes were associated with worse RFS. Survival rate did not differ significantly between patients with or without ET (without ER vs with ET: OR, 0.870; 95% CI: 0.508-1.448; p=0.61). Conclusions: 2010 ACSO/CAP recommendation indeed result in an increase of ET rate for patients with 1%-9% ER positive. But these patients do not appear to benefit from ET. Prospective studies are needed for these patients and we need more accurate way to evaluate ER levels, which associate with endocrine response.

Citation Format: Fu P, Wang S, Yao M, Xiang A, Li J, Wang H, Geng C, Jin F, Yin Y, Huang X, Jiang Z. Clinicopathological features and endocrine therapy mode of ER low expression (1%-9%) breast cancer patients in China [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-14-14.

Construction, identification, and immunogenic assessments of an HSV-1 mutant vaccine with a UL18 deletion

HSV-1 is a mucosal and nerve pathogen, whose morbidity shows an increasing tendency. Although several antiviral drugs exist, there is no cure for viral latency for virtually all carriers. There is an urgent need for an HSV-1 vaccine to control infection and limit its spread and recurrence. The UL18 gene, encoding a vital component of capsids, is one of the essential genes of HSV-1. Deletion of UL18 from HSV-1 may be exploited as a new approach to develop an attenuated vaccine. The purpose of this study was to construct a DNA vaccine with a full-length UL18 gene deletion of the HSV-1 genome that can induce an effective immune response. A UL18-knockdown plasmid (BAC-HSV-1ΔUL18) was constructed using the bacterial markerless gene knockout system, consisting of the functional pREDI plasmid and BAC-HSV-1 plasmid. Mice were immunized weekly for 3 weeks, and at 1 week post immunization, blood and splenocyte samples of vaccinated and control groups of mice were prepared for immunogenicity assessment. The level of immune response was evaluated using a DTH assay, cytokine determination, and splenocyte proliferation assay. Combination of the pREDI plasmid and BAC-HSV-1 plasmid provides an effective bacterial markerless gene knockout system. Using two-step homologous recombination with the UL18 homologous recombination fragment constructed by multistep PCR amplification, BAC-HSV-1ΔUL18 plasmid vaccine was successfully constructed and was found to significantly enhance cellular immune responses.

Giant Magneto-Impedance (GMI) Effect in Single-Layer Soft Magnetic Film Under Stress

The stress-induced magnetic anisotropy can significantly affect giant magneto-impedance (GMI) effect of the soft magnetic film. This paper is devoted to the GMI effect of the single layer soft magnetic film implied without and with a stress. By simulating a physical model with MATLAB and COMSOL software, the impedance expression of the single layer soft magnetic film and the relation between external magnetic field and magnetic permeability are deduced. We observed that, without a stress, the sensitive region increased firstly and then decreased with the increasing of the excitation current frequency from 1 MHz to 200 MHz. While the film was subjected to the stress in the direction of the current with one end stressed, the stress on the film was gradually reduced from stressed end to free end. Also, the impedance change rate of the film changed when the stress was added, which is similar to the effect of adding a bias magnetic field on the film. More importantly, the addition of stress σ can induce the bias of the GMI measurement range and improve its sensitivity near zero magnetic fields. This may provide a new way for designing a GMI sensor with higher sensitivity and adjustable measurement range.

Association of anal symptoms with anal high grade squamous intraepithelial lesions (HSIL) among men who have sex with men: Baseline data from the study of the prevention of anal cancer (SPANC)

BACKGROUND

The association between anal high-grade squamous intraepithelial lesion (HSIL) and anal symptoms has not been systematically investigated.

METHODS

The Study of Prevention of Anal Cancer is a prospective cohort study of men who have sex with men (MSM) ≥ 35 years old in Sydney, Australia. Self-reported symptoms were collected. Anal cytology and high-resolution anoscopy were undertaken. Using baseline visit data, men negative for squamous intra-epithelial lesion (SIL) were compared with men diagnosed with composite-HSIL (cytology and/or histology). Logistic regression analyses were performed to assess the association of symptoms with HSIL.

RESULTS

Among 414 MSM included (composite-HSIL (n = 231); negative for SIL (n = 183)), 306 (73.9%) reported symptom(s) within the last 6 months. There was no association between any symptom and composite-HSIL. A significant association between anal lump and a larger burden of HSIL (at least 2 intra-anal octants) (anal lump within last month: p = 0.014; anal lump within last 6 months: p = 0.010) became non-significant after adjusting for HIV-status and recent anal warts (anal lump within last month: p = 0.057; anal lump within last 6 months: p = 0.182).

CONCLUSIONS

Among MSM age 35 years and older, most anal symptoms are not a useful marker of anal HSIL.

[Endoplasmic reticulum-mitochondrial contact regulates osteogenic differentiation of periodontal ligament stem cells via mitofusion 2 in inflammatory microenvironment]

Objective: To investigate the effect of endoplasmic reticulum (ER)-mitochondria coupling and the expression of mitofusion 2 (Mfn2) in periodontal ligament stem cells (PDLSC), so as to provide a theoretical basis and therapeutic target for promoting periodontal regeneration in treatment of periodontitis. Methods: The periodontal ligament tissue was scraped from extracted intact human teeth and teeth with periodontitis collected in the Department of Oral and Maxillofacial Surgery, the Fourth Military Medical University. The health PDLSC (H-PDLSC) and inflammatory PDLSC (P-PDLSC) were obtained respectively from the primary culture of the human teeth and cloned using 1imited diluted method. The level of ER-mitochondrial coupling was observed by transmission electron microscopy and organelle-specific fluorescence staining. Quantitative real-time PCR (qPCR) was used to detect the expression of Mfn2 in H-PDLSC and P-PDLSC. Tumor necrosis factor alpha (TNF-α) was used to simulate the inflammatory microenvironment. H-PDLSC was cultured in normal medium and media containing 5 and 10 mg/L TNF-α, named as H-PDLSC group, H-PDLSC+TNF-α (5 mg/L) group and H-PDLSC+TNF-α (10 mg/L) group, respectively. At the 7th day, qPCR was applied to detect the mRNA level of Mfn2. The expression of Mfn2 in P-PDLSC was down-regulated by small interfering RNA siMfn2. The osteogenic differentiation of P-PDLSC and P-PDLSC+siMfn2 were examined by qPCR at the 7th day, and alizarin red staining and cetyl pyridine chloride quantitative analysis at the 28th day after osteogenic induction. Results: The level of ER-mitochondrial coupling in the P-PDLSC group (the length of the coupling structure/mitochondrial perimeter was 0.55±0.10, the length of the coupling structure/endoplasmic reticulum perimeter was 0.44±0.08) was significantly higher than that in the H-PDLSC group (P<0.01). The co-localization of endoplasmic reticulum and mitochondria of P-PDLSC group was 0.71±0.09, which was significantly higher than that of H-PDLSC group (P<0.01). The expression level of Mfn2 in P-PDLSC (1.46±0.10) was higher than that in H-PDLSC (0.99±0.08). The expression levels of Mfn2 in H-PDLSC+TNF-α (5 mg/L) and H-PDLSC+TNF-α (10 mg/L) groups were 1.28±0.19, 1.54±0.43, respectively, which were both significantly higher than that in H-PDLSC (0.82±0.14) (P<0.01). P-PDLSC transfected with siMfn2 down-regulated the expression of Mfn2, and the osteogenic differentiation ability of P-PDLSC was restored. The results showed that the expression of alkaline phosphatase, Runt-related transcription factor-2 (RUNX2) and osteocalcin mRNA in P-PDLSC+siMfn2 group were significantly higher than that of the control group (P<0.01). The alizarin red staining and quantitative results of cetyl pyridinium chloride were consistent with the qPCR results. Conclusions: In the microenvironment of inflammation, ER-mitochondrial coupling and the expression of Mfn2 of PDLSC increased, which might lead to a decrease in osteogenic differentiation of PDLSC. The specific mechanism needs to be further studied.

Therapeutic effect of Bifidobacterium combined with early enteral nutrition in the treatment of severe acute pancreatitis: a pilot study

OBJECTIVE

To explore the therapeutic effect of Bifidobacterium combined with early enteral nutrition in severe acute pancreatitis.

PATIENTS AND METHODS

A total of 60 patients with severe acute pancreatitis admitted from November 2012 to November 2016 were retrospectively analyzed. According to the different treatment methods, the patients were divided into Bifidobacterium combined with early enteral nutrition group (experiment group) and early enteral nutrition group (control group). Serum ALB (albumin), CRP (C-reactive protein), WBC (white blood cell count) and PCT (procalcitonin) levels in both groups were observed. The pain relief time, diet recovery time, length of stay, and hospitalization costs between the two groups, were compared. The APACHE (acute physiology and chronic health evaluation scoring system) II score and SOFA (sequential organ failure assessment) score before and after nutritional support were compared between the two groups. Adverse events and complications were observed as well.

RESULTS

58 patients recovered and 2 died after treatment. Improvements in laboratory indicators such as ALB, CRP, WBC and PCT were much better in the experiment group than the control group (p<0.05). Both the length of days and hospitalization cost were lower in the experiment group than those of the control group (p=0.0029, p=0.0435). In the comparison of hospitalization symptoms, shorter pain relief time and diet recovery time were found in the experiment group than those in the control group (p=0.0003, p=0.0218). After the treatment, APACHE II score and SOFA score of the experiment group were also higher than the control group. No significant differences in adverse events and complications between the two groups were exerted (p>0.05).

CONCLUSIONS

Bifidobacterium combined with early enteral nutrition can improve the nutritional status of patients with severe acute pancreatitis in the acute stage, which also enhances the patient's immune capacity and the body's resistance to disease.

Prognostic significance of downregulated BMAL1 and upregulated Ki-67 proteins in nasopharyngeal carcinoma

This study assessed the prognostic value of BMAL1 and Ki-67 expression in patients with nasopharyngeal carcinoma. Level of BMAL1 mRNA was assessed in tissue specimens from 36 nasopharyngeal carcinomas and 20 nasopharyngeal chronic inflammations using quantitative reverse transcriptase-polymerase chain reaction. Expression of BMAL1 and Ki-67 proteins was analyzed immunohistochemically in 90 paired nasopharyngeal carcinoma and distant normal tissues. The Kaplan-Meier curves and the Log-rank test were used to calculate prognostic significance stratified by BMAL1 and Ki67 protein expression and the COX regression model was to analyze the multivariate prognosis. BMAL1 mRNA was significantly reduced in nasopharyngeal carcinoma (4.67 ± 0.27 versus 6.64 ± 0.51 in chronic inflammation tissues, p = 0.002). Level of BMAL1 mRNA was associated with tumor distant metastasis (3.37 ± 0.66 versus 5.04 ± 0.27 compared with non-metastasis, p = 0.011). Level of BMAL1 protein was also reduced in tumor tissues and BMAL1 expression was associated with better 1-, 3- and 5-year overall survival (OS) of cancer patients (92.6%, 69.2% and 62.3% versus 59.1%, 40.9% and 0% in patients with low BMAL1 expressed tumors; p = 0.000). BMAL1 expression and age were independent prognostic factors for OS (p = 0.032). Furthermore, Ki-67 expression was high in tumor versus normal tissues and associated with poor OS of cancer patients (p = 0.035). The Pearson correlation analysis showed that there was an inverse association between BMAL1 and Ki-67 protein expression (p = 0.021). This study demonstrated that lost BMAL1 and Ki-67 overexpression were associated with poor OS of nasopharyngeal carcinoma patients.

Abstract P3-03-04: Not presented

This abstract was not presented at the symposium.

Simultaneous induction of HSP70 expression, and degranulation, in IgE/Ag-stimulated or extracellular HSP70-stimulated mast cells

BACKGROUND

In mast cells, induction of HSP70 expression during antigen stimulation has not been reported.

METHODS

Mouse bone marrow-derived mast cells (BMMC) were stimulated with IgE/Ag or HSP70. Induction of HSP70 expression and signaling protein phosphorylation were evaluated by immunoblotting.

RESULTS

HSP70 expression is induced in BMMC at an early stage of IgE/Ag-dependent stimulation, some of which is released from the cells in a granule-associated form. Induction of HSP70 expression was also observed with an IgE/Ag-stimulated human basophilic cell line, indicating that the phenomenon is not restricted to mouse BMMC. The induction of HSP70 expression, and its release, followed a similar time course to that of degranulation. Released HSP70 seems to be responsible for degranulation and production of eicosanoids, at least in part, because a neutralizing anti-HSP70 antibody mitigated these activities and because exogenous HSP70 not only induced immediate degranulation followed by autocrine HSP70 expression but also enhanced degranulation in IgE/Ag-stimulated BMMC. Extracellular HSP70 was found to induce phosphorylation of linker for activation of T cells (LAT) and a series of downstream signaling molecules in BMMC. We further found that Fyn, Lyn, and spleen tyrosine kinase (Syk), which are known to concern LAT phosphorylation in IgE/Ag-stimulated BMMC, were not phosphorylated in HSP70-stimulated BMMC, whereas lymphocyte-specific protein tyrosine kinase (Lck) was phosphorylated.

CONCLUSION

FcεRI stimulation in BMMC and basophils induces HSP70 expression and its release. Extracellular HSP70 induces degranulation and mediator release via phosphorylation of LAT.