1
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Müller M, Ingold-Heppner B, Stocker H, Heppner FL, Dittmayer C, Laue M. Skin lesion specimens as first choice to detect monkeypox virus - Authors' reply. Lancet 2023; 401:1265. [PMID: 37061265 PMCID: PMC10101763 DOI: 10.1016/s0140-6736(23)00271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Markus Müller
- Clinic for Infectious Diseases, St Joseph Krankenhaus, Berlin, Germany
| | | | - Hartmut Stocker
- Clinic for Infectious Diseases, St Joseph Krankenhaus, Berlin, Germany
| | - Frank L Heppner
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Cluster of Excellence, NeuroCure, Berlin, Germany; German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Carsten Dittmayer
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Laue
- National Consultant Laboratory for Diagnostic Electron Microscopy of Pathogens, Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin 13353, Germany.
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2
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Locatelli G, Marques-Ferreira F, Katsoulas A, Kalaitzaki V, Krueger M, Ingold-Heppner B, Walthert S, Sankowski R, Prazeres da Costa O, Dolga A, Huber M, Gold M, Culmsee C, Waisman A, Bechmann I, Milchevskaya V, Prinz M, Tresch A, Becher B, Buch T. IGF1R expression by adult oligodendrocytes is not required in the steady-state but supports neuroinflammation. Glia 2023; 71:616-632. [PMID: 36394300 DOI: 10.1002/glia.24299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022]
Abstract
In the central nervous system (CNS), insulin-like growth factor 1 (IGF-1) regulates myelination by oligodendrocyte (ODC) precursor cells and shows anti-apoptotic properties in neuronal cells in different in vitro and in vivo systems. Previous work also suggests that IGF-1 protects ODCs from cell death and enhances remyelination in models of toxin-induced and autoimmune demyelination. However, since evidence remains controversial, the therapeutic potential of IGF-1 in demyelinating CNS conditions is unclear. To finally shed light on the function of IGF1-signaling for ODCs, we deleted insulin-like growth factor 1 receptor (IGF1R) specifically in mature ODCs of the mouse. We found that ODC survival and myelin status were unaffected by the absence of IGF1R until 15 months of age, indicating that IGF-1 signaling does not play a major role in post-mitotic ODCs during homeostasis. Notably, the absence of IGF1R did neither affect ODC survival nor myelin status upon cuprizone intoxication or induction of experimental autoimmune encephalomyelitis (EAE), models for toxic and autoimmune demyelination, respectively. Surprisingly, however, the absence of IGF1R from ODCs protected against clinical neuroinflammation in the EAE model. Together, our data indicate that IGF-1 signaling is not required for the function and survival of mature ODCs in steady-state and disease.
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Affiliation(s)
- Giuseppe Locatelli
- Institute of Experimental Immunology, University of Zurich, Zurich.,Theodor Kocher Institute, University Bern, Bern, Switzerland
| | | | - Antonis Katsoulas
- Institute of Laboratory Animal Science, University of Zurich, Zurich
| | | | - Martin Krueger
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Barbara Ingold-Heppner
- Institute of Pathology, Campus Mitte, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | | | - Roman Sankowski
- Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Olivia Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany
| | - Amalia Dolga
- Institute for Pharmacology and Clinical Pharmacy, Philipps-Universität Marburg, Marburg, Germany.,Groningen Research Institute of Pharmacy, Department of Molecular Pharmacology, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Magdalena Huber
- Institute for Medical Microbiology and Hospital Hygiene, Philipps University of Marburg, Marburg, Germany
| | - Maike Gold
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Carsten Culmsee
- Institute for Pharmacology and Clinical Pharmacy, Philipps-Universität Marburg, Marburg, Germany
| | - Ari Waisman
- Institute for Molecular Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ingo Bechmann
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Vladislava Milchevskaya
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Marco Prinz
- Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - Achim Tresch
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Burkhard Becher
- Institute of Experimental Immunology, University of Zurich, Zurich
| | - Thorsten Buch
- Institute of Experimental Immunology, University of Zurich, Zurich.,Institute of Laboratory Animal Science, University of Zurich, Zurich.,Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany
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3
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Müller M, Ingold-Heppner B, Stocker H, Heppner FL, Dittmayer C, Laue M. Electron microscopy images of monkeypox virus infection in 24-year-old man. Lancet 2022; 400:1618. [PMID: 36252575 PMCID: PMC9566757 DOI: 10.1016/s0140-6736(22)01969-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Markus Müller
- Clinic for Infectious Diseases, St Joseph Krankenhaus, Berlin, Germany
| | | | - Hartmut Stocker
- Clinic for Infectious Diseases, St Joseph Krankenhaus, Berlin, Germany
| | - Frank L Heppner
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Cluster of Excellence, NeuroCure, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Carsten Dittmayer
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Laue
- National Consultant Laboratory for Diagnostic Electron Microscopy of Pathogens, Centre for Biological Threats and Special Pathogens (ZBS), Robert Koch Institute, Berlin, Germany.
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4
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Jank P, Gehlhaar C, Lederer B, Fontanella C, Schneeweiss A, Karn T, Marmé F, Sinn HP, van Mackelenbergh M, Sinn B, Zahm DM, Ingold-Heppner B, Schem C, Stickeler E, Fasching PA, Nekljudova V, Taube ET, Heppner F, Müller V, Denkert C, Loibl S. Correction: MGMT promoter methylation in triple negative breast cancer of the GeparSixto trial. PLoS One 2021; 16:e0257142. [PMID: 34469495 PMCID: PMC8409660 DOI: 10.1371/journal.pone.0257142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0238021.].
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5
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Elezkurtaj S, Greuel S, Ihlow J, Michaelis EG, Bischoff P, Kunze CA, Sinn BV, Gerhold M, Hauptmann K, Ingold-Heppner B, Miller F, Herbst H, Corman VM, Martin H, Radbruch H, Heppner FL, Horst D. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Rep 2021; 11:4263. [PMID: 33608563 PMCID: PMC7895917 DOI: 10.1038/s41598-021-82862-5] [Citation(s) in RCA: 193] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/21/2021] [Indexed: 01/08/2023] Open
Abstract
Infection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of pre-existing health conditions to death yet is missing, which can be reliably established by autopsy only. We performed full body autopsies on 26 patients that had died after SARS-CoV-2 infection and COVID-19 at the Charité University Hospital Berlin, Germany, or at associated teaching hospitals. We systematically evaluated causes of death and pre-existing health conditions. Additionally, clinical records and death certificates were evaluated. We report findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.
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Affiliation(s)
- Sefer Elezkurtaj
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Selina Greuel
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jana Ihlow
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Edward Georg Michaelis
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Philip Bischoff
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Catarina Alisa Kunze
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Bruno Valentin Sinn
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Manuela Gerhold
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Kathrin Hauptmann
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | | | - Florian Miller
- Department of Pathology, Vivantes Hospitals Berlin, Berlin, Germany
| | - Hermann Herbst
- Department of Pathology, Vivantes Hospitals Berlin, Berlin, Germany
| | - Victor Max Corman
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Infection Research, Berlin, Germany
| | - Hubert Martin
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Helena Radbruch
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frank L Heppner
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Cluster of Excellence, NeuroCure, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany
| | - David Horst
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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6
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Meinhardt J, Radke J, Dittmayer C, Franz J, Thomas C, Mothes R, Laue M, Schneider J, Brünink S, Greuel S, Lehmann M, Hassan O, Aschman T, Schumann E, Chua RL, Conrad C, Eils R, Stenzel W, Windgassen M, Rößler L, Goebel HH, Gelderblom HR, Martin H, Nitsche A, Schulz-Schaeffer WJ, Hakroush S, Winkler MS, Tampe B, Scheibe F, Körtvélyessy P, Reinhold D, Siegmund B, Kühl AA, Elezkurtaj S, Horst D, Oesterhelweg L, Tsokos M, Ingold-Heppner B, Stadelmann C, Drosten C, Corman VM, Radbruch H, Heppner FL. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci 2021; 24:168-175. [PMID: 33257876 DOI: 10.1038/s41593-020-00758-5] [Citation(s) in RCA: 806] [Impact Index Per Article: 268.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 11/12/2020] [Indexed: 02/07/2023]
Abstract
The newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a pandemic respiratory disease. Moreover, thromboembolic events throughout the body, including in the CNS, have been described. Given the neurological symptoms observed in a large majority of individuals with COVID-19, SARS-CoV-2 penetrance of the CNS is likely. By various means, we demonstrate the presence of SARS-CoV-2 RNA and protein in anatomically distinct regions of the nasopharynx and brain. Furthermore, we describe the morphological changes associated with infection such as thromboembolic ischemic infarction of the CNS and present evidence of SARS-CoV-2 neurotropism. SARS-CoV-2 can enter the nervous system by crossing the neural-mucosal interface in olfactory mucosa, exploiting the close vicinity of olfactory mucosal, endothelial and nervous tissue, including delicate olfactory and sensory nerve endings. Subsequently, SARS-CoV-2 appears to follow neuroanatomical structures, penetrating defined neuroanatomical areas including the primary respiratory and cardiovascular control center in the medulla oblongata.
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Affiliation(s)
- Jenny Meinhardt
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Josefine Radke
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Berlin, Germany
| | - Carsten Dittmayer
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Jonas Franz
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Campus Institute for Dynamics of Biological Networks, University of Göttingen, Göttingen, Germany
- Max Planck Institute for Experimental Medicine, Göttingen, Germany
| | - Carolina Thomas
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Max Planck Institute for Experimental Medicine, Göttingen, Germany
| | - Ronja Mothes
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Michael Laue
- Centre for Biological Threats and Special Pathogens (ZBS), Robert Koch Institute, Berlin, Germany
| | - Julia Schneider
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Sebastian Brünink
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Selina Greuel
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Malte Lehmann
- Division of Gastroenterology, Infectiology and Rheumatology, Medical Department, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Olga Hassan
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Tom Aschman
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Elisa Schumann
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Berlin, Germany
| | - Robert Lorenz Chua
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Conrad
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Roland Eils
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Health Data Science Unit, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Werner Stenzel
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Marc Windgassen
- Institute of Legal Medicine and Forensic Sciences, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Larissa Rößler
- Institute of Legal Medicine and Forensic Sciences, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Hans-Hilmar Goebel
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Hans R Gelderblom
- Centre for Biological Threats and Special Pathogens (ZBS), Robert Koch Institute, Berlin, Germany
| | - Hubert Martin
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andreas Nitsche
- Centre for Biological Threats and Special Pathogens (ZBS), Robert Koch Institute, Berlin, Germany
| | | | - Samy Hakroush
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Martin S Winkler
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Björn Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Franziska Scheibe
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Cluster of Excellence, NeuroCure, Berlin, Germany
| | - Péter Körtvélyessy
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Dirk Reinhold
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Britta Siegmund
- Division of Gastroenterology, Infectiology and Rheumatology, Medical Department, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Anja A Kühl
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, and iPATH.Berlin, Berlin, Germany
| | - Sefer Elezkurtaj
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - David Horst
- Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Lars Oesterhelweg
- Institute of Legal Medicine and Forensic Sciences, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Michael Tsokos
- Institute of Legal Medicine and Forensic Sciences, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | | | | | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Victor Max Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and German Centre for Infection Research, Berlin, Germany
| | - Helena Radbruch
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Frank L Heppner
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
- Berlin Institute of Health (BIH), Berlin, Germany.
- Cluster of Excellence, NeuroCure, Berlin, Germany.
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany.
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7
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Priedigkeit N, Ding K, Horne W, Kolls JK, Du T, Lucas PC, Blohmer JU, Denkert C, Machleidt A, Ingold-Heppner B, Oesterreich S, Lee AV. Acquired mutations and transcriptional remodeling in long-term estrogen-deprived locoregional breast cancer recurrences. Breast Cancer Res 2021; 23:1. [PMID: 33407744 PMCID: PMC7788918 DOI: 10.1186/s13058-020-01379-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Endocrine therapy resistance is a hallmark of advanced estrogen receptor (ER)-positive breast cancer. In this study, we aimed to determine acquired genomic changes in endocrine-resistant disease. METHODS We performed DNA/RNA hybrid-capture sequencing on 12 locoregional recurrences after long-term estrogen deprivation and identified acquired genomic changes versus each tumor's matched primary. RESULTS Despite being up to 7 years removed from the primary lesion, most recurrences harbored similar intrinsic transcriptional and copy number profiles. Only two genes, AKAP9 and KMT2C, were found to have single nucleotide variant (SNV) enrichments in more than one recurrence. Enriched mutations in single cases included SNVs within transcriptional regulators such as ARID1A, TP53, FOXO1, BRD1, NCOA1, and NCOR2 with one local recurrence gaining three PIK3CA mutations. In contrast to DNA-level changes, we discovered recurrent outlier mRNA expression alterations were common-including outlier gains in TP63 (n = 5 cases [42%]), NTRK3 (n = 5 [42%]), NTRK2 (n = 4 [33%]), PAX3 (n = 4 [33%]), FGFR4 (n = 3 [25%]), and TERT (n = 3 [25%]). Recurrent losses involved ESR1 (n = 5 [42%]), RELN (n = 5 [42%]), SFRP4 (n = 4 [33%]), and FOSB (n = 4 [33%]). ESR1-depleted recurrences harbored shared transcriptional remodeling events including upregulation of PROM1 and other basal cancer markers. CONCLUSIONS Taken together, this study defines acquired genomic changes in long-term, estrogen-deprived disease; highlights the importance of longitudinal RNA profiling; and identifies a common ESR1-depleted endocrine-resistant breast cancer subtype with basal-like transcriptional reprogramming.
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Affiliation(s)
- Nolan Priedigkeit
- Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.,Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Kai Ding
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA.,Magee-Women's Research Institute, Magee-Women's Research Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - William Horne
- Richard King Mellon Foundation Institute for Pediatric Research, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Jay K Kolls
- Richard King Mellon Foundation Institute for Pediatric Research, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Tian Du
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Peter C Lucas
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jens-Uwe Blohmer
- Institute of Pathology and Department of Gynecology, Charité University Hospital, Berlin, Germany
| | - Carsten Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM), Marburg, Germany
| | - Anna Machleidt
- Institute of Pathology and Department of Gynecology, Charité University Hospital, Berlin, Germany
| | | | - Steffi Oesterreich
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA.,Magee-Women's Research Institute, Magee-Women's Research Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Adrian V Lee
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, PA, USA. .,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA. .,Magee-Women's Research Institute, Magee-Women's Research Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA. .,Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA. .,Magee-Women's Research Institute, 204 Craft Avenue (Room A412), Pittsburgh, PA, 15213, USA.
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Laakmann E, Witzel I, Fasching PA, Rezai M, Schem C, Solbach C, Tesch H, Klare P, Schneeweiss A, Salat C, Zahm DM, Blohmer JU, Ingold-Heppner B, Huober J, Hanusch C, Jackisch C, Reinisch M, Untch M, von Minckwitz G, Nekljudova V, Müller V, Loibl S. Development of central nervous system metastases as a first site of metastatic disease in breast cancer patients treated in the neoadjuvant trials GeparQuinto and GeparSixto. Breast Cancer Res 2019; 21:60. [PMID: 31077239 PMCID: PMC6509843 DOI: 10.1186/s13058-019-1144-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 04/17/2019] [Indexed: 11/28/2022] Open
Abstract
Background The incidence of central nervous system (CNS) metastases in breast cancer patients is rising and has become a major clinical challenge. Only few data are published concerning risk factors for the development of CNS metastases as a first site of metastatic disease in breast cancer patients. Moreover, the incidence of CNS metastases after modern neoadjuvant treatment is not clear. Methods We analyzed clinical factors associated with the occurrence of CNS metastases as the first site of metastatic disease in breast cancer patients after neoadjuvant treatment in the trials GeparQuinto and GeparSixto (n = 3160) where patients received targeted treatment in addition to taxane and anthracycline-based chemotherapy. Results After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed CNS metastases as the first site of recurrence and 411 (13%) patients had metastatic disease outside the CNS. Thirty-six patients (1%) developed both CNS metastases and other distant metastases as the first site of metastatic disease. Regarding subtypes of the primary tumor, 1% of luminal A-like (11/954), 2% of luminal B-like (7/381), 4% of HER2-positive (34/809), and 6% of triple-negative patients (56/1008) developed CNS metastases as the first site of metastatic disease. In multivariate analysis, risk factors for the development of CNS metastases were larger tumor size (cT3–4; HR 1.63, 95% CI 1.08–2.46, p = 0.021), node-positive disease (HR 2.57, 95% CI 1.64–4.04, p < 0.001), no pCR after neoadjuvant chemotherapy (HR 2.29, 95% CI 1.32–3.97, p = 0.003), and HER2-positive (HR 3.80, 95% CI 1.89–7.64, p < 0.001) or triple-negative subtype (HR 6.38, 95% CI 3.28–12.44, p < 0.001). Conclusions Especially patients with HER2-positive and triple-negative tumors are at risk of developing CNS metastases despite effective systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies.
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Affiliation(s)
- Elena Laakmann
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Isabell Witzel
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Mahdi Rezai
- European Breast Center Duesseldorf, Luise-Rainer-Str. 6-10, 40235, Duesseldorf, Germany
| | - Christian Schem
- Department of Gynecology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105, Kiel, Germany.,Breastcancer Center Hamburg, Moorkamp 2-6, 20357, Hamburg, Germany
| | - Christine Solbach
- Department of Gynecology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Hans Tesch
- Center for Hematology und Oncology Bethanien Frankfurt, Im Prüfling 17-19, 60389, Frankfurt/Main, Germany
| | - Peter Klare
- Medical Center, Lichtenberg, Möllendorffstraße 52, 10367, Berlin, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Christoph Salat
- Medical Center for Hematology and Oncology, Winthirstr. 7, 80639, Munich, Germany
| | - Dirk-Michael Zahm
- Department of Gynecology, SRH Wald-Klinikum Gera gGmbH, Strasse des Friedens 122, 07548, Gera, Germany
| | - Jens-Uwe Blohmer
- Department of Gynecology and Breast Cancer, Charité, Charitéplatz 1, 10117, Berlin, Germany
| | | | - Jens Huober
- Department of Gynecology, University of Ulm, Prittwitzstrasse 43, 89075, Ulm, Germany
| | - Claus Hanusch
- Department of Gynecology, Rotkreuzklinikum München, Taxisstraße 3, 80637, Munich, Germany
| | - Christian Jackisch
- Department of Obstetrics and Gynecology, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Germany
| | - Mattea Reinisch
- Breast Unit, Kliniken Essen-Mitte Evang. Huyssens-Stiftung/Knappschaft GmbH, Henricistrasse 92, 45136, Essen, Germany
| | - Michael Untch
- Department of Gynecology, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany
| | - Gunter von Minckwitz
- German Breast Group GmbH, Martin Behaim Strasse 12, 63263, Neu-Isenburg, Germany
| | - Valentina Nekljudova
- German Breast Group GmbH, Martin Behaim Strasse 12, 63263, Neu-Isenburg, Germany
| | - Volkmar Müller
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Sibylle Loibl
- German Breast Group GmbH, Martin Behaim Strasse 12, 63263, Neu-Isenburg, Germany
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Karsten MM, Ingold-Heppner B, Oesterreich S, Sander S, Machleid A, Waldenfels G, Denkert C, Blohmer JU. Clinical and histological characteristics of peritoneal metastases of ILC. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- MM Karsten
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Berlin, Deutschland
| | - B Ingold-Heppner
- Charité – Universitätsmedizin Berlin, Institut für Pathologie, Berlin, Deutschland
| | - S Oesterreich
- University of Pittsburgh, Magee-Women's Research Institute, Pittsburgh, Vereinigte Staaten von Amerika
| | - S Sander
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Machleid
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Berlin, Deutschland
| | - G Waldenfels
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Berlin, Deutschland
| | - C Denkert
- Charité – Universitätsmedizin Berlin, Institut für Pathologie, Berlin, Deutschland
| | - JU Blohmer
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Berlin, Deutschland
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Witzel ID, Laakmann E, Fasching PA, Rezai M, Schem C, Solbach C, Tesch H, Klare P, Schneeweiss A, Zahm D, Blohmer J, Ingold-Heppner B, Huober J, Hanusch C, Jackisch C, Reinisch M, Untch M, von Minckwitz G, Müller V, Loibl S. Abstract P1-17-01: Development of brain metastases in breast cancer patients treated in the neoadjuvant trials Geparquinto and Geparsixto. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-17-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The incidence of brain metastases (BM) in breast cancer patients is rising and has become a major clinical challenge. So far, the incidence of BM after modern neoadjuvant treatment is not clear.
Materials and Methods: In Geparquinto, patients with untreated HER2-positive breast cancer (n=615) received either lapatinib or trastuzumab, patients with HER2 negative breast cancer (n=1925) received bevacizumab in addition to an anthracycline and taxane-containing regimen and those not responding paclitaxel and everolimus (n=32). In Geparsixto, patients with HER2-positive tumors (n=273) received trastuzumab and lapatinib and patients with triple-negative tumors (n=315) received bevacizumab in addition to chemotherapy. We analyzed clinical factors associated with the occurrence of BM as first site of metastatic relapse after neoadjuvant treatment in both trials (n=3160).
Results: After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed BM as first site of recurrence and 411 (13%) patients had distant metastases outside the brain. Brain metastases as first site of recurrence occurred later than other metastases (3--year-relapse free-rate 96.7% for patients who developed BM and 89.5% for patients who developed metastases outside the brain). Regarding subtypes of the primary tumor, 1% of luminal A (11/954), 2% of luminal B (7/381), 4% of HER2 positive (34/809) and 6% of triple-negative patients (56/1008) developed BM as first site of recurrence. In multivariate analysis, risk factors for the development of BM were larger tumor size (cT3-4; HR 1.9, 95%-CI 1.3-2.8, p=0.0022), node positive disease (HR 2.8, 95% CI 1.8-4.4, p<0.0001), no pCR after neoadjuvant chemotherapy (HR 2.7, 95% CI 1.6-4.7, p=0.0003) and HER2 positive (HR 3.8, 95% CI 1.9-7.8, p=0.0002) or triple-negative subtype (HR 8.1, 95% CI 4.2 – 15.8, p< 0.0001). Breast cancer subtype remained the most relevant risk factor for BM. Patients who developed BM were more often HER2 positive or triple-negative tumors compared with patients who developed metastases outside the brain (HER2 positive subtype 32 vs. 19%, triple-negative subtype 52 vs. 40%, p< 0.001).
Conclusion: Especially patients with HER2-positive and triple negative tumors are at risk of developing BM despite active systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies.
Citation Format: Witzel ID, Laakmann E, Fasching PA, Rezai M, Schem C, Solbach C, Tesch H, Klare P, Schneeweiss A, Zahm D, Blohmer J, Ingold-Heppner B, Huober J, Hanusch C, Jackisch C, Reinisch M, Untch M, von Minckwitz G, Müller V, Loibl S. Development of brain metastases in breast cancer patients treated in the neoadjuvant trials Geparquinto and Geparsixto [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 P1-17-01.
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Affiliation(s)
- ID Witzel
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - E Laakmann
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - PA Fasching
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - M Rezai
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Schem
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Solbach
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - H Tesch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - P Klare
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - A Schneeweiss
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - D Zahm
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - J Blohmer
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - B Ingold-Heppner
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - J Huober
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Hanusch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Jackisch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - M Reinisch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - M Untch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - G von Minckwitz
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - V Müller
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - S Loibl
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
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Karsten MM, Ingold-Heppner B, Oesterreich S, Sander S, Machleidt A, von Waldenfels G, Denkert C, Blohmer JU. Abstract P1-01-07: Clinical and histological characteristics of peritoneal metastases of invasive lobular breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-01-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: In previously reported autopsy series, peritoneal metastases have been detected in up to 40% of patients with invasive lobular breast cancer (ILC). Despite modern diagnostic techniques such as high-resolution ultrasound, it remains a challenge to differentiate ovarian cancer from metastatic breast cancer with peritoneal manifestation before or during surgery. The goal of this analysis was to determine typical clinical and immunohistological features of peritoneal metastasis of ILC. Specifically, we asked the question whether there are predictive factors in primary breast cancer associated with subsequent development of peritoneal metastasis. Patients and methods: We identified 58 patients with ovarian metastases in the Charité cancer register (4,792 breast cancer patients from 2003 to 2015). We looked for clinical and pathological differences between breast cancer patients with (N=58) and without (N=4734) peritoneal metastases and between ILC and non-ILC breast cancer subtypes. Imaging and surgical reports of these 58 patients with ILC intraperitoneal metastases were reviewed. Results: The majority (84.7%) of primary breast cancers consisted of subtypes other than ILC and only 15.3% were histologically characterized as ILC. In contrast, 63.6% of patients with peritoneal metastases had histologically proven ILC in the metastatic tissue. Other subtypes where found in the 36.4% of the metastatic tissue (p<0.001). The Odds ratio for peritoneal metastases for ILC was 2.35 (95% CI 1.655-3.332) and for Non-ILC 0.23 (0.185-0.284). There were no significant differences in receptor status between primary and peritoneal metastatic ILC. Comparing ER/PR expressions levels on primary tumor versus metastasis, while statistically not significant (p= 0.805), showed a rise in ER expression in 42.95% in the metastatic tissue while PR expression remained stable with no difference in 53.3% and a rise in the metastatic site in only 26.7% (p= 0.715). Median age of all patients with primary breast cancer was 60 years (10%-90%: 41-75). There was a significant difference in age at diagnosis of metastasis between patients with (50.5 years) and without peritoneal metastases (59 years) (p= 0.002). Median time to development of peritoneal metastases for all patients was 48.5 months (10%-90%: 0-191.7), for ILC 44 months (0-198.2) and for Non-ILC 56.5 months (6.7-206.4) (p= 0.487). Median survival time for patients with ILC and peritoneal metastases was 56 months, for Non-ILC 53 months (p=0.759). 33 of 58 patients had radiologic evidence of disease, 26 with ILC and 7 with Non-ILC. An ovarian mass was detected by imaging in 15/26 patients with ILC and 4/7 patients with non-ILC. Ascites and diffuse peritoneal metastases were seen in 18/26 patients with detectable ILC and in 4/7 patients with Non-ILC.
Conclusion: This is the first comprehensive analysis of clinical and pathological characteristics of peritoneal metastases showing ILC is more frequent than other histologic subtypes. Patients with peritoneal metastasis are significantly younger (median 50.5y.) than patients without. The clinical signs are similar to those of ovarian cancer except and therefore the diagnosis of metastatic ILC must be taken into consideration as a differential diagnosis.
Citation Format: Karsten MM, Ingold-Heppner B, Oesterreich S, Sander S, Machleidt A, von Waldenfels G, Denkert C, Blohmer JU. Clinical and histological characteristics of peritoneal metastases of invasive lobular breast cancer [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 P1-01-07.
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Affiliation(s)
- MM Karsten
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - B Ingold-Heppner
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - S Oesterreich
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - S Sander
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - A Machleidt
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - G von Waldenfels
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - C Denkert
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
| | - JU Blohmer
- Charité Klinik für Gynäkologie mit Brustzentrum, Berlin, Germany; Charité Institut für Pathologie, Berlin, Germany; Charité Comprehensive Cancer Center, Berlin, Germany; Magee Women`s Research-Institute, Pittsburgh, PA
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Sinn BV, Weber K, Denkert C, Fasching PA, Schmitt WD, Thomas K, Ingold-Heppner B, van Mackelenbergh M, Symmans WF, Marmé F, Taube E, Müller V, Kunze CA, Schem C, Pfitzner BM, Stickeler E, von Minckwitz G, Loibl S. Abstract P1-07-01: HLA class I expression is associated with tumor-infiltrating lymphocytes and response and survival after neoadjuvant chemotherapy in hormone receptor-positive, HER2-negative breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-07-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Interactions between cancer cells and the host immune system influence tumor biology, response to therapy and patient survival and their modulation offers promising new approaches for cancer therapy. The downregulation or loss of HLA class I expression in breast cancer cells might be an effective mechanism to evade the recognition by the immune system facilitating malignant behavior.
Aim: To evaluate the association of tumor-infiltrating lymphocytes (TILs) with HLA class I expression and its theranostic value for therapy response and survival after neoadjuvant chemotherapy.
Methods: HLA class I expression was evaluated by immunohistochemistry in a cohort of 732 pre-therapeutic core biopsies from breast cancer patients treated within the neoadjuvant GeparTrio trial. Patients received anthracycline- and taxane-based neoadjuvant therapy and adjuvant endocrine treatment if hormone receptor-positive (HR+). A publicly available microarray dataset of pre-therapeutic core biopsies from 508 breast cancer patients that received neoadjuvant chemotherapy and endocrine treatment if HR+ was used for validation of the results. The association of HLA class I expression with predefined genomic signatures for immune cell populations was evaluated in publicly available data from the cancer genome atlas.
Results: HLA class I expression was associated with TILs (p < 0.001) and was predictive of better response to neoadjuvant chemotherapy in the subgroup of patients with HR+/HER2- breast cancer (14 % in tumors with high HLA vs. 7 % in tumors with low HLA, p = 0.029). Interestingly, high HLA was also predictive for shorter progression-free survival in univariate analysis (HR 1.590, 95 % CI 1.062—2.380; p = 0.024) and after adjustment to clinical and pathological parameters (HR 1.701, 95 % CI 1.105—2.618; p = 0.016). The results could be validated in the independent microarray-based dataset (HR 1.521, 95% CI 1.088 – 2.129; p = 0.0142). HLA class I was not associated with therapy response or survival in hormone receptor-negative breast cancer. HLA class I was associated with a predefined signature for T-cells and cytotoxic T- cells in the cancer genome atlas dataset (rho = 0.546).
Conclusion: HLA class I expression is associated with better response but shorter progression-free survival in HR+/HER2- breast cancer following neoadjuvant chemotherapy. The underlying mechanisms warrant further investigation.
Citation Format: Sinn BV, Weber K, Denkert C, Fasching PA, Schmitt WD, Thomas K, Ingold-Heppner B, van Mackelenbergh M, Symmans WF, Marmé F, Taube E, Müller V, Kunze CA, Schem C, Pfitzner BM, Stickeler E, von Minckwitz G, Loibl S. HLA class I expression is associated with tumor-infiltrating lymphocytes and response and survival after neoadjuvant chemotherapy in hormone receptor-positive, HER2-negative breast cancer [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 P1-07-01.
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Affiliation(s)
- BV Sinn
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - K Weber
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - C Denkert
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - PA Fasching
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - WD Schmitt
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - K Thomas
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - B Ingold-Heppner
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - M van Mackelenbergh
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - WF Symmans
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - F Marmé
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - E Taube
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - V Müller
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - CA Kunze
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - C Schem
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - BM Pfitzner
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - E Stickeler
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - G von Minckwitz
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
| | - S Loibl
- Charité – Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; German Breast Group Forschungs GmbH, Neu-Isenburg, Germany; University Hospital Erlangen, Erlangen, Germany; University Hospital Frankfurt, Frankfurt, Germany; University Hospital Schleswig-Holstein, Kiel, Germany; The University of Texas – MD Anderson Cancer Center, Houston, TX; University Hospital Heidelberg, Heidelberg, Germany; University Hospital Hamburg-Eppendorf, Hamburg, Germany; RWTH Aachen, Aachen, Aachen, Germany
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Amer HA, Schmitzberger F, Ingold-Heppner B, Kussmaul J, El Tohamy MF, Tantawy HI, Hamm B, Makowski M, Fallenberg EM. Digital breast tomosynthesis versus full-field digital mammography-Which modality provides more accurate prediction of margin status in specimen radiography? Eur J Radiol 2017; 93:258-264. [PMID: 28668424 DOI: 10.1016/j.ejrad.2017.05.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 05/25/2017] [Accepted: 05/29/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate the reliability of tumor margin assessment in specimen radiography (SR) using digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in comparison to postoperative histopathology margin status as the gold standard. METHODS After ethics committee approval, 102 consecutive patients who underwent breast conservative surgery for nonpalpable proven breast cancer were prospectively included. All patients underwent ultrasound/mammography-guided wire localization of their lesions. After excision, each specimen was marked for orientation and imaged using FFDM and DBT. Two blinded radiologists (R1, R2) independently analyzed images acquired with both modalities. Readers identified in which direction the lesion was closest to the specimen margin and to measure the margin width. Their findings were compared with the final histopathological analysis. True positive margin status was defined as a margin measuring <1mm for invasive cancer and 5mm for ductal carcinoma in situ (DCIS) at imaging and pathology. RESULTS For FFDM, correct margin direction was identified in 45 cases (44%) by R1 and in 37 cases (36%) by R2. For DBT, 69 cases (68%) were correctly identified by R1 and 70 cases (69%) by R2. Overall accuracy was 40% for FFDM and 69% for DBT; the difference was statistically significant (p<0.0001). Sensitivity in terms of correct assessment of margin status was significantly better for DBT than FFDM (77% versus 62%). CONCLUSION SR using DBT is significantly superior to FFDM regarding identification of the closest margin and sensitivity in assessment of margin status.
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Affiliation(s)
- Heba A Amer
- Dept of Radiology, Zagazig University Hospitals, Zagazig, Egypt; Clinic of Radiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Florian Schmitzberger
- Clinic of Radiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
| | | | - Julia Kussmaul
- Clinic of Radiology, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | | | - Hazim I Tantawy
- Dept of Radiology, Zagazig University Hospitals, Zagazig, Egypt
| | - B Hamm
- Clinic of Radiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - M Makowski
- Clinic of Gynacolgy and Breast Center, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - Eva M Fallenberg
- Clinic of Radiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
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Budczies J, Sinn B, Pfitzner B, Villegas-Angel S, Ingold-Heppner B, Wienert S, Klauschen F, Denkert C. Deciphering the connection of tumor genetics, tumor immune cell infiltration and prognosis in breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Schneeweiss A, Möbus V, Tesch H, Hanusch C, Denkert C, Lübbe K, Huober J, Klare P, Kümmel S, Untch M, Kast K, Jackisch C, Ingold-Heppner B, Thomalla J, Blohmer JU, Rezai M, Nekljudova V, von Minckwitz G, Loibl S. Abstract P5-16-01: A randomised phase III trial comparing two dose-dense, dose-intensified approaches (ETC and PM(Cb)) for neoadjuvant treatment of patients with high-risk early breast cancer (GeparOcto). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- A Schneeweiss
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - V Möbus
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - H Tesch
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - C Hanusch
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - C Denkert
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - K Lübbe
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - J Huober
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - P Klare
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - S Kümmel
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - M Untch
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - K Kast
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - C Jackisch
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - B Ingold-Heppner
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - J Thomalla
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - J-U Blohmer
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - M Rezai
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - V Nekljudova
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - G von Minckwitz
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
| | - S Loibl
- Universitätsklinikum Heidelberg; Klinikum Frankfurt-Höchst; Hämatologisch-Onkologische Gemeinschaftspraxis, Frankfurt; Klinikum zum Roten Kreuz, München; Charite Berlin; Diakovere Henriettenstift Hannover; Universitätsklinikum Ulm; Praxisklinik Krebsheilkunde für Frauen/Brustzentrum Berlin; Kliniken Essen- Mitte, Essen; Helios Kliniken Berlin-Buch; Universitätsklinikum Dresden; Sana Klinikum Offenbach; Praxisklinik für Hämatologie und Onkologie Koblenz; Luisenkrankenhaus Düsseldorf; German Breast Group, Neu-Isenburg
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16
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Fallenberg EM, Schmitzberger FF, Amer H, Ingold-Heppner B, Balleyguier C, Diekmann F, Engelken F, Mann RM, Renz DM, Bick U, Hamm B, Dromain C. Contrast-enhanced spectral mammography vs. mammography and MRI - clinical performance in a multi-reader evaluation. Eur Radiol 2016; 27:2752-2764. [PMID: 27896471 DOI: 10.1007/s00330-016-4650-6] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) to digital mammography (MG) and magnetic resonance imaging (MRI) in a prospective two-centre, multi-reader study. METHODS One hundred seventy-eight women (mean age 53 years) with invasive breast cancer and/or DCIS were included after ethics board approval. MG, CESM and CESM + MG were evaluated by three blinded radiologists based on amended ACR BI-RADS criteria. MRI was assessed by another group of three readers. Receiver-operating characteristic (ROC) curves were compared. Size measurements for the 70 lesions detected by all readers in each modality were correlated with pathology. RESULTS Reading results for 604 lesions were available (273 malignant, 4 high-risk, 327 benign). The area under the ROC curve was significantly larger for CESM alone (0.84) and CESM + MG (0.83) compared to MG (0.76) (largest advantage in dense breasts) while it was not significantly different from MRI (0.85). Pearson correlation coefficients for size comparison were 0.61 for MG, 0.69 for CESM, 0.70 for CESM + MG and 0.79 for MRI. CONCLUSIONS This study showed that CESM, alone and in combination with MG, is as accurate as MRI but is superior to MG for lesion detection. Patients with dense breasts benefitted most from CESM with the smallest additional dose compared to MG. KEY POINTS • CESM has comparable diagnostic performance (ROC-AUC) to MRI for breast cancer diagnostics. • CESM in combination with MG does not improve diagnostic performance. • CESM has lower sensitivity but higher specificity than MRI. • Sensitivity differences are more pronounced in dense and not significant in non-dense breasts. • CESM and MRI are significantly superior to MG, particularly in dense breasts.
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Affiliation(s)
- Eva M Fallenberg
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Florian F Schmitzberger
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Heba Amer
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | | | | | - Felix Diekmann
- Department of Medical Imaging, St. Joseph-Stift Bremen, Bremen, Germany
| | - Florian Engelken
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Ritse M Mann
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Diane M Renz
- Department of Radiology, Universitätsklinikum Jena, Jena, Germany
| | - Ulrich Bick
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernd Hamm
- Clinic of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Clarisse Dromain
- Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France
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17
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Perez Fernandez C, Amer H, Schmitzberger F, Engelken F, Ingold-Heppner B, Denecke T, Fallenberg E. Vergleich der Mammakarzinom-Detektionsraten der kontrastmittelverstärkten spektralen Mammografie (CESM) und dem Ultraschall: Initiale Ergebnisse. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Schreiner B, Ingold-Heppner B, Pehl D, Locatelli G, Berrit-Schönthaler H, Becher B. Deletion of Jun proteins in adult oligodendrocytes does not perturb cell survival, or myelin maintenance in vivo. PLoS One 2015; 10:e0120454. [PMID: 25774663 PMCID: PMC4361052 DOI: 10.1371/journal.pone.0120454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 01/22/2015] [Indexed: 11/18/2022] Open
Abstract
Oligodendrocytes, the myelin-forming glial cells of the central nervous system (CNS), are fundamental players in rapid impulse conduction and normal axonal functions. JunB and c-Jun are DNA-binding components of the AP-1 transcription factor, which is known to regulate different processes such as proliferation, differentiation, stress responses and death in several cell types, including cultured oligodendrocyte/lineage cells. By selectively inactivating Jun B and c-Jun in myelinating oligodendrocytes in vivo, we generated mutant mice that developed normally, and within more than 12 months showed normal ageing and survival rates. In the adult CNS, absence of JunB and c-Jun from mature oligodendrocytes caused low-grade glial activation without overt signs of demyelination or secondary leukocyte infiltration into the brain. Even after exposure to toxic or autoimmune oligodendrocyte insults, signs of altered oligodendrocyte viability were mild and detectable only upon cuprizone treatment. We conclude that JunB and c-Jun expression in post-mitotic oligodendrocytes is mostly dispensable for the maintainance of white matter tracts throughout adult life, even under demyelinating conditions.
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Affiliation(s)
- Bettina Schreiner
- Institute of Experimental Immunology, University Zürich, Zürich, Switzerland
- Department of Neurology, University Hospital Zürich, Zürich, Switzerland
| | | | - Debora Pehl
- Institute of Neuropathology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Giuseppe Locatelli
- Institute of Experimental Immunology, University Zürich, Zürich, Switzerland
- Institute of Clinical Neuroimmunology, LMU Universität München, Germany
| | | | - Burkhard Becher
- Institute of Experimental Immunology, University Zürich, Zürich, Switzerland
- * E-mail:
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19
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von Winterfeld M, Hoffmeister M, Ingold-Heppner B, Jansen L, Tao S, Herpel E, Schirmacher P, Dietel M, Chang-Claude J, Autschbach F, Brenner H, Bläker H. Frequency of therapy-relevant staging shifts in colorectal cancer through the introduction of pN1c in the 7th TNM edition. Eur J Cancer 2014; 50:2958-65. [DOI: 10.1016/j.ejca.2014.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 09/01/2014] [Accepted: 09/10/2014] [Indexed: 11/26/2022]
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20
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Locatelli G, Krüger M, da Costa OP, Ingold-Heppner B, Koch L, Schreiner B, Brüning J, Bechmann I, Becher B, Buch T. Loss of IGF1R from oligodendrocytes ameliorates neuroinflammation without affecting cell survival. J Neuroimmunol 2014. [DOI: 10.1016/j.jneuroim.2014.08.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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21
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Bläker H, Hildebrandt B, Riess H, von Winterfeld M, Ingold-Heppner B, Roth W, Kloor M, Schirmacher P, Dietel M, Tao S, Jansen L, Chang-Claude J, Ulrich A, Brenner H, Hoffmeister M. Lymph node count and prognosis in colorectal cancer: the influence of examination quality. Int J Cancer 2014; 136:1957-66. [PMID: 25231924 DOI: 10.1002/ijc.29221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 12/21/2022]
Abstract
Colorectal cancer guidelines recommend adjuvant chemotherapy in stage II disease when less than 12 lymph nodes are assessed. The recommendation bases on previous studies showing an association of a low lymph node count and adverse outcome. Compared to current standards, however, the quality of lymph node examination in the studies was low. We, therefore, investigated the prognostic role of <12 lymph nodes in cancers diagnosed adherent to current quality measures. Stage I-IV colorectal cancers from 1,899 patients enrolled into a population-based cohort study were investigated for the prognostic impact of a lymph node count <12. The stage specific share of patients diagnosed with ≥12 nodes (stage I-IV: 62, 85, 85, 78%, respectively) was used to compare lymph node examination quality to other studies. We found no impact of a lymph node count <12 on overall, cancer-specific or recurrence-free survival for any tumour stage. Compared to studies reporting an adverse prognostic impact of a low lymph node count in stages II and III the stage-specific shares of patients with ≥12 nodes were markedly higher in this study (85% vs. 24-58% in previous analyses) and this correlated with increased rates of stage III compared to stage II cancers. In conclusion our data indicate, that the previously reported effect of a low lymph node count on the patients' outcomes is eliminated by improved lymph node examination quality and thus question the general applicability of a 12 lymph node cut off for adjuvant chemotherapy decision making in stage II disease.
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Affiliation(s)
- Hendrik Bläker
- Department of General Pathology, Institute of Pathology, Charite University Medicine Hospital, Charitéplatz 1, Berlin, Germany
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22
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Kyeyamwa S, Bartens A, Vasiljeva J, Lanowska M, Speiser D, Ingold-Heppner B, Mangler M. Standardisierte histologische Aufarbeitung von radikalen Trachelektomiepräparaten. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Speiser D, Jahn M, Lanowska M, Mangler M, Ingold-Heppner B. Expression von Zellzyklusregulatoren und ki67 bei Patientinnen mit Rezidiv nach radikaler vaginaler Trachelektomie (RVT). Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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24
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Fallenberg EM, Dromain C, Diekmann F, Renz DM, Amer H, Ingold-Heppner B, Neumann AU, Winzer KJ, Bick U, Hamm B, Engelken F. Contrast-enhanced spectral mammography: Does mammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat 2014; 146:371-81. [PMID: 24986697 DOI: 10.1007/s10549-014-3023-6] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/02/2014] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to compare contrast-enhanced spectral mammography (CESM) with mammography (MG) and combined CESM + MG in terms of detection and size estimation of histologically proven breast cancers in order to assess the potential to reduce radiation exposure. A total of 118 patients underwent MG and CESM and had final histological results. CESM was performed as a bilateral examination starting 2 min after injection of iodinated contrast medium. Three independent blinded radiologists read the CESM, MG, and CESM + MG images with an interval of at least 4 weeks to avoid case memorization. Sensitivity and size measurement correlation and differences were calculated, average glandular dose (AGD) levels were compared, and breast densities were reported. Fisher's exact and Wilcoxon tests were performed. A total of 107 imaging pairs were available for analysis. Densities were ACR1: 2, ACR2: 45, ACR3: 42, and ACR4: 18. Mean AGD was 1.89 mGy for CESM alone, 1.78 mGy for MG, and 3.67 mGy for the combination. In very dense breasts, AGD of CESM was significantly lower than MG. Sensitivity across readers was 77.9 % for MG alone, 94.7 % for CESM, and 95 % for CESM + MG. Average tumor size measurement error compared to postsurgical pathology was -0.6 mm for MG, +0.6 mm for CESM, and +4.5 mm for CESM + MG (p < 0.001 for CESM + MG vs. both modalities). CESM alone has the same sensitivity and better size assessment as CESM + MG and was significantly better than MG with only 6.2 % increase in AGD. The combination of CESM + MG led to systematic size overestimation. When a CESM examination is planned, additional MG can be avoided, with the possibility of saving up to 61 % of radiation dose, especially in patients with dense breasts.
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Affiliation(s)
- Eva Maria Fallenberg
- Clinic of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
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25
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Fallenberg EM, Dromain C, Diekmann F, Engelken F, Krohn M, Singh JM, Ingold-Heppner B, Winzer KJ, Bick U, Renz DM. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size. Eur Radiol 2013; 24:256-64. [PMID: 24048724 DOI: 10.1007/s00330-013-3007-7] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 07/04/2013] [Accepted: 07/25/2013] [Indexed: 11/27/2022]
Affiliation(s)
- E M Fallenberg
- Clinic of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
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26
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Boysen G, Bausch-Fluck D, Thoma CR, Nowicka AM, Stiehl DP, Cima I, Luu VD, von Teichman A, Hermanns T, Sulser T, Ingold-Heppner B, Fankhauser N, Wenger RH, Krek W, Schraml P, Wollscheid B, Moch H. Identification and functional characterization of pVHL-dependent cell surface proteins in renal cell carcinoma. Neoplasia 2012; 14:535-46. [PMID: 22806541 DOI: 10.1596/neo.12130] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 04/27/2012] [Accepted: 04/30/2012] [Indexed: 01/09/2023]
Abstract
The identification of cell surface accessible biomarkers enabling diagnosis, disease monitoring, and treatment of renal cell carcinoma (RCC) is as challenging as the biology and progression of RCC is unpredictable. A hallmark of most RCC is the loss-of-function of the von Hippel-Lindau (pVHL) protein by mutation of its gene (VHL). Using the cell surface capturing (CSC) technology, we screened and identified cell surface N-glycoproteins in pVHL-negative and positive 786-O cells. One hundred six cell surface N-glycoproteins were identified. Stable isotope labeling with amino acids in cell culture-based quantification of the CSC screen revealed 23 N-glycoproteins whose abundance seemed to change in a pVHL-dependent manner. Targeted validation experiments using transcriptional profiling of primary RCC samples revealed that nine glycoproteins, including CD10 and AXL, could be directly linked to pVHL-mediated transcriptional regulation. Subsequent human tumor tissue analysis of these cell surface candidate markers showed a correlation between epithelial AXL expression and aggressive tumor phenotype, indicating that pVHL-dependent regulation of glycoproteins may influence the biologic behavior of RCC. Functional characterization of the metalloprotease CD10 in cell invasion assays demonstrated a diminished penetrating behavior of pVHL-negative 786-O cells on treatment with the CD10-specific inhibitor thiorphan. Our proteomic surfaceome screening approach in combination with transcriptional profiling and functional validation suggests pVHL-dependent cell surface glycoproteins as potential diagnostic markers for therapeutic targeting and RCC patient monitoring.
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Affiliation(s)
- Gunther Boysen
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
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27
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Mihic-Probst D, Kuster A, Kilgus S, Bode-Lesniewska B, Ingold-Heppner B, Leung C, Storz M, Seifert B, Marino S, Schraml P, Dummer R, Moch H. Consistent expression of the stem cell renewal factor BMI-1 in primary and metastatic melanoma. Int J Cancer 2007; 121:1764-70. [PMID: 17597110 DOI: 10.1002/ijc.22891] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Stem cell-like cells have recently been identified in melanoma cell lines, but their relevance for melanoma pathogenesis is controversial. To characterize the stem cell signature of melanoma, expression of stem cell markers BMI-1 and nestin was studied in 64 cutaneous melanomas, 165 melanoma metastases as well as 53 melanoma cell lines. Stem cell renewal factor BMI-1 is a transcriptional repressor of the Ink4a/Arf locus encoding p16(ink4a) and p14(Arf). Increased nuclear BMI-1 expression was detectable in 41 of 64 (64%) primary melanomas, 117 of 165 melanoma metastases (71%) and 15 of 53 (28%) melanoma cell lines. High nestin expression was observed in 14 of 56 primary melanomas (25%), 84 of 165 melanoma metastases (50%) and 21 of 53 melanoma cell lines (40%). There was a significant correlation between BMI-1 and nestin expression in cell lines (p = 0.001) and metastases (p = 0.02). These data indicate that cells in primary melanomas and their metastases may have stem cell properties. Cell lines obtained from melanoma metastases showed a significant higher BMI-1 expression compared to cell lines from primary melanoma (p = 0.001). Further, primary melanoma lacking lymphatic metastases at presentation (pN0, n = 40) was less frequently BMI-1 positive than melanomas presenting with lymphatic metastases (pN1; n = 24; 52% versus 83%; p = 0.01). Therefore, BMI-1 expression appears to induce a metastatic tendency. Because BMI-1 functions as a transcriptional repressor of the Ink4a/Arf locus, p16(ink4a) and p14(Arf) expression was also analyzed. A high BMI-1/low p16(ink4a) expression pattern was a significant predictor of metastasis by means of logistic regression analysis (p = 0.005). This suggests that BMI-1 mediated repression of p16(ink4a) may contribute to an increased aggressive behavior of stem cell-like melanoma cells.
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Affiliation(s)
- Daniela Mihic-Probst
- Department of Pathology, Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
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