Abstract P3-08-11: Multi-omics profiling reveals distinct molecular features in young and elderly triple negative breast cancer

Purpose

Age at breast cancer diagnosis not only predicts clinical outcome, but also indicates distinct molecular features thus we can choose the most appropriate treatment strategies. Yet little is known about the molecular profile of young and elderly triple negative breast cancers (TNBCs).

Methods

Clinical, genomic and transcriptome features of young (<40 year-olds) and elderly (≥65 year-olds) TNBC patients were studied in a cohort of 473 TNBCs from Fudan University Shanghai Cancer Center.

Results

In this study, 50, 354 and 69 patients were <40, 40–64 and ≥65 years of age, respectively. Young TNBCs had more relapse or metastasis within the first 2 years after surgery (P=0.036) which was also significant in the basal-like subgroup (P=0.004), while elderly TNBCs were more likely to be luminal androgen receptor (LAR) subtype (46%) harboring frequent PIK3CA and KMT2C/KMT2D somatic mutations, with more fibrosis or mesenchymal-like (MES) subtype (in the basal-like subgroup) and featured by significantly lower Ki-67 index. Gene set enrichment analyses revealed that young TNBCs showed elevated expression of genes involved in cell cycle, nucleotide metabolism and DNA damage repair. In further discussion on nucleotide metabolism, TYMS, a crucial gene encoding thymidylate synthase while is also the target of fluorouracil and capecitabine, were identified to be enriched in young TNBCs independent of molecular subtype in both our cohort (adjusted P<0.001) and METABRIC (adjusted P=0.027). We next studied DNA damage features and found that while TNBCs of different age groups had comparable somatic mutation load, their mutations had distinct generation mechanism that homologous recombination deficiency (HRD) related signature and Aging related signature tend to be enriched in younger and elder patients, respectively. We also observed higher germline BRCA1 mutation rate in young TNBCs (23%). Interestingly, while germline BRCA2 mutation rate was comparable among the groups, copy number (CN) loss of Chr13q13 (with BRCA2 in the 'peak') was almost exclusively found in young patients (adjusted P<0.05). We also found enriched CN loss at Chr15q13 (with FAN1 in the 'peak') and CN amplification at Chr1p34 (with KDM4A in the 'peak') in young patients. These two events significantly affected the expression levels of FAN1 and KDM4A, respectively, and were both corrected with genomic based HRD indexes.

Conclusions

TNBCs of different age had distinct clinical and molecular features. We should pay attention to that nearly half of the TNBCs diagnosed at 65 years-old or later were not basal-like cancers but a special group with positive AR staining. Taking together with the higher fibrosis/MES proportion in elderly TNBC, we should reconsider the benefit of specific treatment strategies (like neoadjuvant chemotherapy) in these patients. The young TNBCs were characterized by activated cell cycle, elevated nucleotide metabolism (especially TYMS expression and corresponding pyrimidine metabolism) and enhanced DNA damage (especially HRD). These molecular features supported the aggressive phenotypes of young TNBC, while also provide us with potential therapeutic strategies.

Citation Format: Ma D, Jiang Y-Z, Xie M-D, Xiao Y, Zhao S, Shao Z-M. Multi-omics profiling reveals distinct molecular features in young and elderly triple negative breast cancer [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 P3-08-11.

Abstract P4-06-24: Microenvironment heterogeneity of triple-negative breast cancer reveals distinct immune escape mechanisms and potential driver events

Background The microenvironment phenotypes strongly affect the immunotherapeutic strategies for triple-negative breast cancer (TNBC). Although the multi-omics profile of TNBC has been comprehensively characterized, few studies have focused on the microenvironment phenotypes of TNBC.

Methods With multi-omics data for the largest single-center TNBC cohort (n=386), we first established a TNBC-specific microenvironment cell signature. We further used single sample gene set enrichment analysis to calculate the relative number of microenvironment cell subsets in each sample. Then, we performed k-means clustering to classify the TNBC microenvironment phenotypes into heterogeneous clusters. Furthermore, we systematically analyzed the extrinsic and intrinsic immune escape mechanisms of different TNBC microenvironment clusters. In addition, we explored genomic alterations that might decrease immune infiltration in certain TNBC microenvironment clusters.

Results We classified the TNBC microenvironment phenotypes into three heterogeneous clusters. Cluster 1 (type 1 “cold tumor”) had low microenvironment cells infiltration. Cluster 2 (type 2 “cold tumor”) was characterized by resting innate immune cells, fibroblasts and endothelial cells infiltration. Cluster 3 (“hot tumor”) was featured by adaptive immune cells infiltration. Analysis of immune escape mechanism revealed that an incapability to attract innate immune cells (resulting in failure of adaptive immunity) led to immune escape of cluster 1. The chemotaxis but inactivation of innate immunity (also leading to failure of adaptive immunity) and low tumor antigen burden resulted in immune escape of cluster 2. High expression of immune checkpoint molecules contributed to immune escape of cluster 3. In addition, we found that tumor infiltrating lymphocytes (TILs) were positively correlated with immune checkpoint molecules expression, while mutation load was negatively correlated with those indicators in triple-negative breast cancer. Analysis of enrichment pathways, mutations and somatic copy number variations between the “cold tumor” and “hot tumor” clusters revealed that amplification of MYC and activation of MYC-related pathways might decrease the immune infiltration of cluster 1. Mutations in PI3K-AKT pathway members and activation of fibroblasts-related pathways might decrease the immune infiltration of cluster 2.

Conclusion Utilizing the largest single-center TNBC cohort with multi-omics data, our study first revealed the heterogeneity of the TNBC microenvironment, with translational significance both clinically and biologically. First, we identified a subtype of “hot tumor” in TNBC (cluster 3), for which immune checkpoint blockers (ICBs) might be effective. TILs and immune checkpoint molecules expression but not mutation load might predict the efficacy of ICBs. Second, we presumed some genomic alterations that might drive “cold tumor” formation in TNBC. Our study represents a step toward personalized immunotherapy for TNBC patients.

Key Words triple-negative breast cancer, multi-omics, microenvironment heterogeneity, immune escape

Citation Format: Xiao Y, Ma D, Zhao S, Jiang Y-Z, Shao Z-M. Microenvironment heterogeneity of triple-negative breast cancer reveals distinct immune escape mechanisms and potential driver events [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 P4-06-24.

Abstract P3-07-12: Identification of luminal A-like subgroup among ER+/PR+/HER2+ breast cancers and its clinical implications

Background Triple positive breast cancers (TPBCs), i.e. estrogen receptor-positive (ER+)/ progesterone receptor-positive (PR+)/ human epidermal growth factor receptor 2-positive (HER2+) breast cancers, constitute a therapeutic challenge due to the functional crosstalk between the hormone receptors and HER2 pathways. The intrinsic molecular subtyping of TPBCs has rarely been studied and may have implications for the prognostic evaluation and therapeutic decision-making.

Methods Our study included four cohorts of patients with TPBC. The first one consisted of 82 patients from The Cancer Genome Atlas (TCGA). The second and third ones were from two publicly available microarray datasets (GSE2603 and GSE2109) and included 37 and 30 patients respectively. The forth one comprised 165 patients from Fudan University Shanghai Cancer Center. First, we examined the PAM50 intrinsic subtypes of TPBCs in the first three cohorts. Then, we tried to find several differentially expressed genes (DEGs) between luminal A and the other subtypes. In cohort 1, we identified DEGs using LIMMA. In cohort 2 and 3, we further filtered and validated them using Wilcoxon's rank sum test. We also performed Receiver operating characteristic analyses to evaluate the accuracy of candidate DEGs in identifying TPBCs of luminal A subtype and determined the top 3 DEGs according to the area under the curve. Finally, in cohort 4, we detected the expression of these 3 genes by immunohistochemical (IHC) staining of tissue sections, defined a group of luminal A-like TPBCs and examined the prognosis and effect of adjuvant trastuzumab for them.

Results The distribution of PAM50 intrinsic subtypes of TPBCs was shown as follows. The three genes that exhibited the highest accuracy in identifying TPBCs of luminal A subtype were STC2, BCL2 (highly expressed in luminal A subtype) and MKI67 (lowly expressed in luminal A subtype). In cohort 4, we defined a group of luminal A-like TPBCs as TPBCs with low expression of MKI67 as well as high expression of STC2 and/or BCL2. Compared with patients with non-luminal A-like TPBC (n = 110), those with luminal A-like TPBC (n = 55) had better disease-free survival (DFS) in both univariate (Log-rank P = 0.029) and multivariate analyses (hazard ratio = 0.25, P = 0.025). In the group with non-luminal A-like TPBCs, patients treated with trastuzumab (n = 67) showed better DFS than those not treated with it (n = 43) (Log-rank P = 0.019), while in the group with luminal A-like TPBCs, there is no difference in DFS between patients treated with trastuzumab (n = 22) and those not treated with it (n = 33) (Log-rank P = 0.993).

PAM50 intrinsic subtypes of TPBCsPAM50 intrinsic subtypeCohort 1Cohort 2Cohort 3 N (%)N (%)N (%)Luminal A43 (52.4)15 (40.5)13 (43.3)Luminal B28 (34.1)17 (45.9)12 (40.0)HER2-enriched9 (11.0)2 (5.4)3 (10.0)Normal-like1 (1.2)2 (5.4)1 (3.3)Basal-like1 (1.2)1 (2.7)1 (3.3)

Conclusions TPBCs are heterogeneous in terms of intrinsic molecular subtype. Evaluating the expression of STC2, BCL2 and MKI67 by IHC staining can help us to conveniently identify a group of luminal A-like TPBCs. Patients with this group of TPBCs have relatively good prognosis and may only gain limited benefit from adjuvant trastuzumab.

Citation Format: Zhao S, Jin X, Jiang Y-Z, Shao Z-M. Identification of luminal A-like subgroup among ER+/PR+/HER2+ breast cancers and its clinical implications [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 P3-07-12.

Phosphoproteome profiling revealed abnormally phosphorylated AMPK and ATF2 involved in glucose metabolism and tumorigenesis of GH-PAs

PURPOSE

Protein phosphorylation plays a key role in tumorigenesis and progression. However, little is known about the phosphoproteome profiles of growth hormone-secreting pituitary adenomas (GH-PAs). The aim of this study was to identify critical biomarkers and signaling pathways that might play important roles in GH-PAs and may, therefore, represent potential therapeutic targets.

METHODS

The differential phosphoprotein expression patterns involved in GH-PAs were investigated by nano-LC-MS/MS in a group of samples. The phosphoprotein expression data were analyzed by bioinformatics. The expression levels of the candidate phosphorylated AMPK (ser496) and ATF2 (ser112) were validated by Western blot analysis in another group of samples.

RESULTS

A total of 1213 phosphorylated protein sites corresponding to 667 proteins were significantly different between GH-PAs and healthy pituitary glands. Among these phosphorylated sites, 871 exhibited lower levels of phosphorylation in GH-PAs. Moreover, 140 novel phosphosites corresponding to 93 proteins were differentially phosphorylated between GH-PAs and healthy pituitary glands, 101 of which showed decreased phosphorylation in GH-PAs. The majority of differentially expressed phosphorylated proteins were significantly enriched in glycolysis and the AMPK signaling pathway in GH-PAs. The AMPK signaling pathway was demonstrated to be inhibited in GH-PAs by pathway activity analysis (z score = - 2.324). Notably, the phosphorylated levels of AMPK (ser496) and ATF2 (ser112) were significantly lower in GH-PAs than in healthy pituitary glands.

CONCLUSION

These findings suggest that decreased phosphorylation of the AMPK/ATF2 pathway may be critical for glucose metabolism and tumorigenesis in GH-PAs.

Molecular characterization, expression pattern and metabolic activity of flavin-dependent monooxygenases in Spodoptera exigua

Enhanced detoxification is one of the important mechanisms for insecticide resistance. Most research in this field to date has focused on the role of cytochrome P450s. Our previous work revealed that flavin-dependent monooxygenases (FMOs) were involved in metabolic resistance of Spodoptera exigua. In the present study we investigated the molecular characteristics, expression patterns and oxidative activities of SeFMO on insecticides. Three FMO genes, which encode proteins with the typical FMO motifs, were cloned from S. exigua. The oxidative activities of eukaryotically expressed SeFMO enzymes were verified with the model substrate of FMO. Importantly, the SeFMOs had significantly higher oxidative activities on metaflumizone and lambda-cyhalothrin than on model substrates and other insecticides tested. The three SeFMOs were mainly expressed in the midgut, fat body and Malpighian tubules. The tissues responsible for xenobiotic metabolism and their expression characteristics were similar to those of P450s acting as detoxification genes. The study also revealed that the expression of SeFMOs could be induced by insecticide exposure, and that SeFMOs were over-expressed in a metaflumizone-resistant strain of S. exigua. These results suggest that SeFMOs are important insecticide detoxifying enzymes, and that over-expression of FMO genes may be one of the mechanisms for metabolic resistance in S. exigua.

Standardizing compression testing for measuring the stiffness of human bone

Objectives

The ability to determine human bone stiffness is of clinical relevance in many fields, including bone quality assessment and orthopaedic prosthesis design. Stiffness can be measured using compression testing, an experimental technique commonly used to test bone specimens in vitro. This systematic review aims to determine how best to perform compression testing of human bone.

Methods

A keyword search of all English language articles up until December 2017 of compression testing of bone was undertaken in Medline, Embase, PubMed, and Scopus databases. Studies using bulk tissue, animal tissue, whole bone, or testing techniques other than compression testing were excluded.

Results

A total of 4712 abstracts were retrieved, with 177 papers included in the analysis; 20 studies directly analyzed the compression testing technique to improve the accuracy of testing. Several influencing factors should be considered when testing bone samples in compression. These include the method of data analysis, specimen storage, specimen preparation, testing configuration, and loading protocol.

Conclusion

Compression testing is a widely used technique for measuring the stiffness of bone but there is a great deal of inter-study variation in experimental techniques across the literature. Based on best evidence from the literature, suggestions for bone compression testing are made in this review, although further studies are needed to establish standardized bone testing techniques in order to increase the comparability and reliability of bone stiffness studies.

Cite this article: S. Zhao, M. Arnold, S. Ma, R. L. Abel, J. P. Cobb, U. Hansen, O. Boughton. Standardizing compression testing for measuring the stiffness of human bone. Bone Joint Res 2018;7:524–538. DOI: 10.1302/2046-3758.78.BJR-2018-0025.R1.

Analysis of evolution and genetic diversity of sweetpotato and its related different polyploidy wild species I. trifida using RAD-seq

BACKGROUND

Sweetpotato (Ipomoea batatas (L.) Lam.) is one of the most important crops from the family of Convolvulaceae. It is widely reported that cultivated sweetpotato was originated from Ipomoea trifida. However, diploid, tetraploid and hexaploid I. trifida were found in nature. The relationship, between them, and among them and sweetpotato, is remaining unclear.

RESULTS

In the present study, we detected the genome diversity and relationship of sweetpotato and different polyploidy types I. trifida using Restriction-site Associated DNA Sequencing (RAD-seq). A total of 38,605 RAD-tags containing 832,204 SNPs had been identified. These tags were annotated using five public databases, about 11,519 tags were aligned to functional genes in various pathways. Based on SNP genotype, phylogenetic relation analysis results confirmed that cultivated sweetpotato has a closer relationship with I. trifida 6× than with I. trifida 4X and I. trifida 2×. Besides, 5042 SSRs were detected in I. trifida 6×, and 3202 pairs of high-quality SSR primers were developed. A total of 68 primers were randomly selected and synthesized, of which 61 were successfully amplified.

CONCLUSION

These results provided new evidence that cultivated sweetpotato originated from I. trifida 6×, and that I. trifida 6× evolved from I. trifida 4X and I. trifida 2×. Therefore, using I. trifida 6× as the model plant of sweetpotato research should be more practical than using I. trifida 2× in the future. Meanwhile, sequence information and markers from the present study will be helpful for sweetpotato and I. trifida studies in the future.

Indoor Visual Positioning Aided by CNN-Based Image Retrieval: Training-Free, 3D Modeling-Free

Indoor localization is one of the fundamentals of location-based services (LBS) such as seamless indoor and outdoor navigation, location-based precision marketing, spatial cognition of robotics, etc. Visual features take up a dominant part of the information that helps human and robotics understand the environment, and many visual localization systems have been proposed. However, the problem of indoor visual localization has not been well settled due to the tough trade-off of accuracy and cost. To better address this problem, a localization method based on image retrieval is proposed in this paper, which mainly consists of two parts. The first one is CNN-based image retrieval phase, CNN features extracted by pre-trained deep convolutional neural networks (DCNNs) from images are utilized to compare the similarity, and the output of this part are the matched images of the target image. The second one is pose estimation phase that computes accurate localization result. Owing to the robust CNN feature extractor, our scheme is applicable to complex indoor environments and easily transplanted to outdoor environments. The pose estimation scheme was inspired by monocular visual odometer, therefore, only RGB images and poses of reference images are needed for accurate image geo-localization. Furthermore, our method attempts to use lightweight datum to present the scene. To evaluate the performance, experiments are conducted, and the result demonstrates that our scheme can efficiently result in high location accuracy as well as orientation estimation. Currently the positioning accuracy and usability enhanced compared with similar solutions. Furthermore, our idea has a good application foreground, because the algorithms of data acquisition and pose estimation are compatible with the current state of data expansion.

Performance and tissue fatty acid profile of broiler chickens and laying hens fed hemp oil and HempOmegaTM

This study was conducted to determine the effects of hemp oil (HO) and HempOmega (HΩ), an equivalent product to HO, on performance and tissue fatty acid profile of layers and broiler chickens in two separate experiments. In the first experiment, forty 19-wk old Lohmann white laying hens were randomized to 1 of 5 dietary treatments, either a control diet or a control diet supplemented with 4 or 8% hemp oil provided by HO or HΩ, for a period of 6 wk (n = 8/diet). In experiment 2, 150-day-old mixed-sex (75 male; 75 female) Ross 308 chicks were randomly allocated into 5 dietary treatments, a control diet or a control diet supplemented with either 3 or 6% hemp oil provided by HO or HΩ, each with six replicates of 5 chicks for a 21-d feeding period. Performance of layers and broilers was not affected by dietary treatments. Animals provided with either HO or HΩ diets had greater total n-3 polyunsaturated fatty acids (PUFAs), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) in egg yolks, thighs, and breasts compared to the control diet (P < 0.01), and monounsaturated fatty acids (MUFAs) content of egg yolks and thighs decreased (P < 0.05). The levels of total n-6 PUFAs, linoleic acid (LA), or arachidonic acid (ARA) of the egg yolk and meat were generally not affected by dietary supplementation with HO or HΩ, but gamma-linolenic acid (GLA) was notably increased (P < 0.01). The current data show that inclusion of hemp oil up to 8% in layer diets and 6% in broiler diets provided by HO or HΩ does not negatively affect overall performance of birds and results in the enrichment of n-3 PUFAs and GLA in eggs and meat.

Gasoline exhaust damages spermatogenesis through downregulating α6-integrin and β1-integrin in the rat model

The health influence of air pollution has been an international public health concern. Increasing evidence has suggested that air pollution has been associated with decreased sperm quality. However, the underlying molecular mechanisms are still not fully elucidated. We aimed to verify whether gasoline exhaust leads to reproductive impairment by injuring spermatogonial stem cells and explore its underlying molecular mechanism. Twenty male Sprague-Dawley rats were randomly divided into two groups: the exposure group (n = 10) and the control group (n = 10). After 6-month exposure, the sperm count and morphology were determined. The histological changes in the seminiferous tubules were examined by HE staining. The expression of α6-integrin and β1-integrin was assessed with Quantitative RT-PCR, Western blot and Immunohistochemical staining. Compared with control group, male rats exposed to gasoline exhaust showed significantly reduced sperm count, increased sperm abnormality rate and the total number of spermatogonia, primary spermatocytes, secondary spermatocytes, spermatids were decreased. (all p < .01). The expression levels of α6-integrin and β1-integrin in the exposure group were significantly lower than those in the control group (all p < .01). Our study showed that exposure to gasoline exhaust caused impairment to spermatogonial stem cells through downregulating α6-integrin and β1-integrin.

[Research progress of HPV therapeutic vaccine]

Bivalent and quadrivalent HPV vaccine have been approved by CFDA successively in China. However, currently available prophylactic vaccines have no therapeutic effect for established infection or disease. In recent years, based on the application of genomics and proteomics for interpretation of tumor antigen, animal experiments and clinical trials of vaccines aiming at a wide variety of antigens have been conducted. In this review, we summarize about the preclinical and clinical research status of HPV therapeutic vaccine and find that the efficacy of HPV therapeutic vaccine alone or combined with other conventional cancer treatment is satisfying, which has potential clinical application value. As the further research of tumor immune regulation and optimization of strategies for the HPV therapeutic vaccine, the vaccine will play an important role in improving the quality of life in cancer patients and eventually become widely used in clinical practice.

Myocardial late gadolinium enhancement: a head-to-head comparison of motion-corrected balanced steady-state free precession with segmented turbo fast low angle shot

AIM

To evaluate the image quality and diagnostic agreement with a head-to-head comparison of late gadolinium enhancement (LGE) images acquired by the motion-corrected (MOCO) balanced steady-state free precession (bSSFP) phase sensitivity inversion recovery (PSIR) and conventional segmented fast low angle shot (FLASH) PSIR methods^15,16 in a patient cohort with a wide spectrum of cardiovascular disease.

MATERIALS AND METHODS

In 59 consecutive patients, signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs) of the normal myocardium (NM), LGE, and blood pool (BP) were pair-wise compared between the two different sequences. A further semi-qualitative score system (graded 1 -4) was used to compare the overall image quality (OIQ). The diagnostic agreement of the two techniques were evaluated by both transmural severity and absolutely quantitative size of LGE.

RESULTS

The SNRs of the NM, LGE, and BP of MOCO bSSFP were 4.8±3.4, 53.6±35.6 and 43.2±29.3, compared with 3.9±3.6 (p=0.126), 27.7±18.5 (p<0.001) and 24.3±13.4 (p<0.001) of FLASH LGE, respectively. The CNRs of LGE to NM, LGE to BP, and BP to NM were 48.3±33.1 versus 23.8±16.7 (p<0.001), 6.5±21.6 versus 3.8±10.8 (p<0.001), and 38.3±27.2 versus 20.3±10.7 (p=0.448), respectively. The OIQ of MOCO bSSFP was higher than that of segmented FLASH (median 4 versus median 3, p<0.001). For quantification of LGE size, there is good agreement and high correlation (r=0.992, p<0.001) between the two methods.

CONCLUSIONS

MOCO bSSFP is a feasible, robust sequence for LGE imaging, especially for patients with arrhythmia and those incapable of breath-holding due to severe heart failure.

Screening for cognitive impairment in SLE using the Self-Administered Gerocognitive Exam

Objective Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can affect the central nervous system in multiple ways, including causing cognitive dysfunction. Cognitive dysfunction is a common complaint of SLE patients yet diagnosis is challenging, time consuming, and costly. This study evaluated the Self-Administered Gerocognitive Exam (SAGE) as a screening test for cognitive impairment in a cohort of SLE patients. Methods A total of 118 SLE patients completed the SAGE. Providers completed the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus International Collaborative Clinics Damage Index (SLICC-DI). SAGE scores were grouped into normal (>16) and abnormal (≤16) categories. Univariate and multivariate analyses were performed. Results Of the 118 participants, 21(18%) scored ≤16 on the SAGE instrument. In univariate analysis, race, ethnicity, household income, and SLICC-DI scores were associated with the SAGE ( p < 0.05). In multivariable analysis, abnormal SAGE score was independently associated with higher SLICC-DI score (odds ratio (OR) = 1.44, 95% confidence intervals 1.04-1.99, p = 0.03)), Hispanic ethnicity (OR = 43.4, 95% CI 3.1-601, p = 0.005), and lower household income (OR = 11.9 for ≤$15,000 vs >$50,000, 95% CI 2.45-57, p = 0.002). Conclusions In SLE patients, this study demonstrates an independent relationship between neurocognitive impairment (as measured by the SAGE) and higher lupus-related damage, as measured by the SLICC-DI, and lower household income. Abnormal SAGE scores were also associated with Hispanic ethnicity. A language barrier could explain this because the SAGE instrument was conducted in English only. The SAGE was feasible to measure in the clinic setting.

Abstract P2-03-03: A multicenter clinical study of Xpert® breast cancer STRAT4 demonstrates high concordance with central lab ER, PgR, HER2, and Ki67 IHC and HER2 FISH tests in FFPE breast tumor tissues

The Xpert® Breast Cancer STRAT4 (STRAT4) is a CE-IVD marked, semi-quantitative, cartridge-based RT-qPCR assay for the detection of ESR1, PGR, ERBB2 (HER2), and MKi67 mRNAs from formalin fixed, paraffin embedded (FFPE) breast tumors. The assay is fast (&lt; 2 hrs), reproducible, robust, and easy to perform.

The aim of this multicenter clinical study was to assess the performance characteristics of the STRAT4 assay relative to central lab immunohistochemistry (IHC) for ER, PgR, HER2, and Ki67 and to fluorescence in situ hybridization (FISH) for HER2 gene amplification.

Methods: A total of 200 archived primary invasive breast cancer FFPE blocks were sourced from Indivumed for this study. From each block, twelve (12) adjacent tissue sections (4-µm thickness) on slides were prepared for pathological H&E confirmation to define tumor area, and for testing by STRAT4, IHC (ER, PgR, HER2,Ki67), and HER2 FISH. Standard STRAT4 lysate preparation using a single unstained slide per specimen and testing on N=84, N=68, and N=48 samples was performed at 3 independent sites, respectively (2 US and 1 EU). A single slide from each specimen was also processed using the recommended concentrated lysate procedure for STRAT4 testing at Cepheid. All IHC and FISH testing was performed by a central academic reference laboratory in the US. For a given sample, STRAT4 data generated using the standard lysate procedure was included for concordance analysis when all target gene test results were valid. In cases where the standard lysate preparation yielded indeterminate test results for any target, data from the concentrated lysate preparation was used for the data analysis. Receiver Operating Characteristic (ROC) analysis, overall percent agreement (OPA), positive percent agreement (PPA), and negative percent agreement (NPA) between STRAT4 and IHC (IHC/FISH for HER2) were determined for ESR1,PGR, ERBB2, and MKi67.

Results: Of the 200 samples tested by STRAT4, all samples generated valid results for ESR1 and ERBB2, 199 of 200 samples were valid for PGR, and 198 of 200 samples were valid for MKi67 using the standard or concentrated lysate preparation protocol. One sample failed to generate results for both ER and PgR IHC. Twelve samples failed to yield HER2 FISH results.

The STRAT4 success rate and results concordance with IHC were comparable across study sites. OPA between STRAT4 and IHC was 97% for ESR1, 88.9% for PGR, 93.3% for HER2 (92.4% for IHC and FISH), and 90.7% for MKi67 (excluding IHC 10-20% staining). Areas under the ROC curves were 0.9922 for ESR1, 0.9509 for PGR, 0.9958 for ERBB2, and 0.9395 for MKi67.

Conclusion: STRAT4 measurements for ESR1, PGR, ERBB2 and MKi67 mRNA expression are robust and highly concordant with IHC (IHC/FISH for HER2). The technical portion of the assay is easily performed in &lt; 2 hrs including hands-on time using standard FFPE tissue sections. Xpert STRAT4 offers local pathology labs an alternative to centralized, subjective IHC/FISH tests that require a higher level of expertise. Further investigations correlating STRAT4 markers directly with clinical outcomes in independent cohorts are in progress.

Citation Format: Wu NC, Wong E, Acca B, Birkmeier J, Tran L, Zhao S, Wong W, Chu VC, Ho K, Malek M, Lu C, Ge G, David K, Quigley NB, Beqaj SS, Davenport S, Weidler J, Bates M, Press M. A multicenter clinical study of Xpert® breast cancer STRAT4 demonstrates high concordance with central lab ER, PgR, HER2, and Ki67 IHC and HER2 FISH tests in FFPE breast tumor tissues [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-03-03.

[Diagnostic significance of lymph node core needle biopsy for lymphoproliferative disease: a clinicopathologic study of 1 013 cases]

Objective: To study the clinicopathologic features of lymphoproliferative disease by lymph node core needle biopsy(CNB)and to evaluate the diagnostic significance of CNB for lymphoproliferative disease. Methods: The annual distribution, entity constitute, clinical finding, gross feature, morphologic change, affiliate study and repeat biopsy diagnosis of 1 013 cases of lymph node CNB diagnosed at West China Hospital of Sichuan University from January 2009 to December 2015 were investigated. Results: (1) Proportion of lymph node CNB in total amount of biopsy specimens increased from 0.2% in 2009 to 0.8% in 2015.(2) The study cohort included 471 lymphomas, 12 atypical lymphoid hyperplasia (ALH), 136 suspected lymphomas, 372 benign lesions, and 22 cases of descriptive diagnoses. The most common types were diffuse large B cell lymphoma and T-lymphoblastic lymphoma. (3) Majority of patients were adolescents and children younger than 20 years or the elderly older than 60 years. 53.1% CNB tumor specimen consisted of ≥4 tissue cores and 40.5% were >2 cm in length. (4) 104 CNB cases with previous history of excision biopsy was included 45 carcinomas(no metastatic carcinoma was found), 32 lymphomas for treatment observation.1/14 suspicious lymphomas, 1/1 ALH and 3/22 cases benign lesions were diagnosed as lymphoma by repeat biopsy respectively. (5) 217 CNB cases were diagnosed as lymphoma by subsequent CNB (70), or subsequent excision biopsy (147) including 78.5%(73/93) suspected lymphomas, 5/7 ALH and 32.3%(20/62)benign lesions. Conclusions: Lymph node CNB has certain clinical indications, although limited for the diagnosis of lymphoproliferative disorders. Suspected lymphomas and ALH diagnosed by CNB should be followed by repeat tissue biopsy. For the benign lesions by CNB it does not rule out additional biopsy to further investigate the lesion.

MICAL2 promotes breast cancer cell migration by maintaining epidermal growth factor receptor (EGFR) stability and EGFR/P38 signalling activation

AIM

MICAL2, a cytoskeleton dynamics regulator, is identified associated with survival and metastasis of several types of cancers recently. This study was designed to investigate the role of MICAL2 in breast cancer cell migration as well as its underlying mechanisms.

METHODS

The relationship between MICAL2 and EGF/EGFR signalling was analysed by gene overexpression and knock-down techniques. Cell migration was measured by wound-healing assays. Activation of EGF/EGFR signalling pathways were evaluated by immunofluorescence, qPCR, Western blotting and zymography techniques. Rac1 activity was assessed by pull-down assay. Correlation of MICAL2 and EGFR in breast cancer specimens was examined by immunohistochemical analysis.

RESULTS

Ectopic expression of MICAL2 in MCF-7 cells augmented EGFR protein level, accompanied by the promotion of cell migration. Silencing MICAL2 in MDA-MB-231 cells destabilized EGFR and inhibited cell migration. In mechanism, the maintaining effect of MICAL2 on EGFR protein content was due to a delay in EGFR degradation. Expression of MICAL2 was also shown positively correlated with the activation of P38/HSP27 and P38/MMP9 signallings, which are the main downstream signalling cascades of EGF/EGFR involved in cell migration. Further analysis indicated that Rac1 activation contributed to the maintaining effect of MICAL2 on EGFR stability. In addition, analysis of breast cancer specimens revealed a positive correlation between MICAL2 and EGFR levels and an association between MICAL2 expression and worse prognosis.

CONCLUSION

MICAL2 is a major regulator of breast cancer cell migration, maintaining EGFR stability and subsequent EGFR/P38 signalling activation through inhibiting EGFR degradation in a Rac1-dependent manner.

Identification of the novel HLA-C*07:530 allele by polymerase chain reaction sequence-based typing

HLA-C*07:530 differs from HLA-C*07:02:01 by a single nucleotide at position 363G>C.

The antibacterial activity and modes of LI-F type antimicrobial peptides against Bacillus cereus in vitro

AIMS

LI-Fs are a family of highly potent cyclic lipodepsipeptide antibiotics with a broad antimicrobial spectrum (Gram-positive bacteria and fungi). In this study, LI-F-type antimicrobial peptides (AMP-jsa9) composing of LI-F03a, LI-F03b, LI-F04a, LI-F04b and LI-F05b were isolated from Paenibacillus polymyxa JSA-9. To better understand the antimicrobial mechanism of AMP-jsa9, the potency and action(s) of AMP-jsa9 against Bacillus cereus were examined.

METHODS AND RESULTS

Flow cytometry, confocal laser microscopy, scanning electron microscopy, transmission electron microscopy (TEM) and atomic force microscopy observation, as well as determination of peptidoglycan and cell wall-associated protein and other methods were used. The results indicate that AMP-jsa9 exhibits strong, broad-spectrum antimicrobial activity. Moreover, AMP-jsa9 targets the cell wall and membrane of B. cereus to impair membrane integrity, increase membrane permeability and enhance cytoplasm leakage (e.g. K⁺ , protein, nucleic acid). This leads to bacterial cells with irregular, withered and coarse surfaces. In addition, AMP-jsa9 is also able to bind to DNA and break down B. cereus biofilms.

CONCLUSIONS

In this study, the action mechanism of LI-Fs against B. cereus was clarified in details.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this study provide a theoretical basis for utilizing AMP-jsa9 or similar analogues as natural and effective preservatives in the food and feed industries. These efforts could also stimulate research activities interested in understanding the specific effects of other antimicrobial agents.

A comparative scanning electron microscopy evaluation of smear layer removal with chitosan and MTAD

The aim of the present study was to compare the efficacy of chitosan and MTAD for the smear layer removal from the root canal through a scanning electron microscope (SEM). Thirty teeth were randomly divided into three groups according to the final irrigants: 0.2% chitosan, MTAD, saline (control group). After the mechanical preparation, the samples were irrigated with saline (control group), 0.2% chitosan and MTDA respectively. Then, the samples were split and the smear layer at the apical, middle, and coronal thirds of each root canal was imaged using SEM. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test (α = 5%). The difference between chitosan and MTDA was statistically significant in the apical region (p < 0.05), no significant difference was obtained in the coronal and middle regions in these two experiment groups (p > 0.05). The control group exhibited the lowest efficacy in smear layer removal in all regions. Thus, from the result of the present study, we may conclude that chitosan was more effective in smear layer removal than MTAD especially in the apical third.

CONTEXT

Irrigation, which serves a variety of purposes including antibacterial action, tissue dissolution, cleaning and chelating, plays a centric role in the final success of root canal treatment. Thus, more and more attention has been put on the improvement and development of various irrigation techniques or systems.

AIMS

The aim of the present study was to compare the efficacy of chitosan and MTAD for the smear layer removal from the root canal through scanning electron microscopy (SEM).

SETTINGS AND DESIGN

Thirty single-canal premolars were instrumented with rotary-files and then, randomly assigned to test groups which were irrigated with chitosan and MTDA, and control group was treated with saline. Thereafter, the efficacy of smear layer removal was evaluated by SEM.

MATERIALS AND METHODS

Thirty teeth were randomly divided into three groups according to the final irrigants: 0.2% chitosan, MTAD, saline (control group). After the mechanical preparation, the samples were irrigated with saline (control group), 0.2% chitosan and MTDA respectively. Then, the samples were split and the smear layer at the apical, middle, and coronal thirds of each root canal was imaged using SEM.

STATISTICAL ANALYSIS USED

Kruskal-Walli test and Mann-Whitney U test Results: The difference between chitosan and MTDA was statistically significant in the apical regions (p < 0.05), no significant difference was obtained in the coronal and middle regions in these two experiment groups (p > 0.05). The control group exhibited the lowest efficacy in smear layer removal in all regions.

CONCLUSION

Thus, from the result of present study, we may conclude that chitosan was more effective in smear layer removal than MTAD, especially in the apical third.

Forty-nine cases of acute lymphoblastic leukaemia/lymphoma in pleural and pericardial effusions: A cytological-histological correlation

INTRODUCTION

Acute lymphoblastic leukaemia/lymphoma (ALL/LBL) is an aggressive entity of precursor lymphoid neoplasm and may cause malignant serous effusion (SE). The current study aimed to analyse the characteristics of SE cytology of ALL/LBL including cytomorphology, immunophenotyping, clonality and evaluate the effectiveness of SE cytology as a diagnostic method for ALL/LBL.

METHODS

SE specimens with final diagnosis of ALL/LBL from 2006 to 2016 were reviewed for clinical data, cytomorphological features and ancillary studies. Cytodiagnoses were compared with histodiagnoses, and the discordant cases were analysed.

RESULTS

A total of 49 specimens including 47 pleural fluids and 2 pericardial fluids from 49 patients were evaluated. Cytomorphology revealed lymphoblasts varied from small size with scant cytoplasm, condensed nuclear chromatin and indistinct nucleoli to large size with dispersed nuclear chromatin and multiple variably prominent nucleoli. Nuclear clefts and hand mirror-shaped blasts were demonstrated. The positive rates of CD99 and terminal deoxynucleotidyl transferase were 90.9% and 81.6%, respectively. Both monoclonal immunoglobulin (Ig)H and T-cell receptor-γ gene rearrangements were demonstrated in 1 of 3 cases. Monoclonal T-cell receptor-γ gene rearrangement was found in 10 of 11 cases. Monoclonal IgH and/or Ig? gene rearrangements were revealed in 2 of 3 cases. Cytodiagnoses included 4 ALL/LBL, 3 B-ALL/LBL and 42 T-ALL/LBL. Histodiagnoses were available in 24 cases including 2 ALL/LBL, 2 B-ALL/LBL and 20 T-ALL/LBL. The concordance rates of cytological-histological diagnoses were 66.7%, 0% and 95.2% in the three categories, respectively. There were 3 cases with discrepancies of cell lineages.

CONCLUSIONS

SE cytological evaluation is a reliable and effective method for the diagnosis of ALL/LBL.

[Clinical research of anxiety and depression state among patients suffered from sudden deafness with vertigo]

Objective:To offer the objective evidences for the diagnosis by analyzing anxiety and depression among patients with sudden deafness and vertigo and their possible causes. Method:Eighty patients with sudden deafness and vertigo of single ear as the observation group; 80 patients with sudden deafness without vertigo and 60 healthy people as control group.Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD) are used for quantitative analysis and compare the results of each group score. Result:①The HAMA score of the deafness group with vertigo was significantly higher than that of the group without vertigo and the healthy group (P<0.01). The HAMD score of the deafness group with vertigo was significantly higher than that of the group without vertigo and the healthy group (P<0.01). ②There was correlation between HAMA and sex, age, duration of dizziness, tinnitus, DHI and efficacy grading (P<0.05). There was no correlation between HAMA and the mean hearing threshold, urban and rural distribution, ear fullness (P> 0.05). There was a correlation between HAMD and sex, age, tinnitus, DHI and efficacy grading (P<0.05). There was no correlation between HAMD and the mean hearing threshold, duration of dizziness, urban and rural distribution, ear fullness (P>0.05). Conclusion:There are anxiety and depression in patients with deafness and vertigo. It is mainly related to sex, age, dizziness duration, tinnitus, DHI and grade of efficacy. It is necessary to pay attention to the mental state of patients in clinical treatment. Psychological counseling or treatment can be used to improve clinical efficacy.