A critical review of characteristics of domestic wastewater and key treatment techniques in Chinese villages

As of 2022, China's rural sewage treatment rate is only approximately 31 %. Rapid rural development has led to higher demand. However, China's rural areas are complex and face many problems, such as uneven economic development, population distribution, and water availability. Long-lasting and low-cost wastewater treatment measures are needed for application in rural areas. The quantity and quality of rural domestic wastewater in China were characterized first. Next, the hot topic of domestic wastewater in Chinese villages was confirmed via bibliometric analysis using CiteSpace, and the treatment technologies for rural domestic wastewater were compared. Specifically, the technical status and challenges of the most common technology in rural domestic wastewater treatment, constructed wetlands, were summarized.

Efficient reduction and adsorption of Cr(VI) using FeCl3-modified biochar: Synergistic roles of persistent free radicals and Fe(II)

Transition metal iron and persistent free radicals (PFRs) both affect the redox properties of biochar, but the electron transfer relationship between them and the coupling reduction mechanism of Cr(VI) requires further investigation. To untangle the interplay between iron and PFRs in biochar and the influences on redox properties, FeCl3-modified rice husk biochar (FBCs) was prepared and its reduction mechanism for Cr(VI) without light was evaluated. The FBCs had higher surface positive charges, oxygen-containing functional groups, and PFRs compared with pristine rice husk biochar (BC). Phenoxyl PFRs with high electron-donating capability formed in biochar. The pronounced electron paramagnetic resonance signals showed that the PFRs preferred to form at lower Fe(III) concentrations. While a high concentration of Fe(III) would be reduced to Fe(II) and consumed the formed PFRs. Adsorption kinetics and X-ray photoelectron spectroscopy analysis indicated that the FBCs effectively enhanced the Cr(VI) removal efficiency by 1.54-8.20 fold and the Cr(VI) reduction efficiency by 1.88-9.29 fold compared to those of BC. PFRs quenching and competitive reductant addition experiments revealed that the higher Cr(VI) reduction performance of FBCs was mainly attributed to the formed PFRs, which could contribute to ∼74.0% of Cr(VI) reduction by direct or indirect electron transfer. The PFRs on FBCs surfaces could promote the Fe(III)/Fe(II) cycle through single electron transfer and synergistically accelerate ∼52.3% of Cr(VI) reduction. This study provides an improved understanding of the reduction mechanism of iron-modified biochar PFRs on Cr(VI) in environments.

[Call attention to the overall benefit of digital pathology and promote its development]

The successful operation of the complete digital pathology(CDP) in foreign countries indicates that the full digital pathology process has entered the full implementation stage. Digital pathology in China started late and progressed slowly, so far there has not been a truly meaningful CDP. The pathologist's understanding of digital pathology is not comprehensive enough, and there are still doubts about the time efficiency and cost effectiveness of digital pathology processes. Therefore,a comprehensive analysis of the process, overall advantages and cost-effectiveness of CDP was made by drawing on international successful experience and hands-on practice experience, in order to promote the construction and development of the CDP in our country.

Bioinformatics screening of gene expression profile and diagnostic application of meningeal carcinoma

OBJECTIVE

The aim of this study was to research gene expression profiles and diagnostic applications of meningeal carcinoma based on bioinformatics.

MATERIALS AND METHODS

We used the Gene Expression Omnibus (GEO) database to obtain the GSE43290 dataset based on the expression data of normal meninges and meningiomas consisting of 51 samples divided into two groups (47 samples of meningioma tumors and four samples of normal meninges). We used the GEO2R tool to identify differentially expressed genes (DEGs) by setting the log2 fold change as greater than two and an adjusted p-value lower than 0.05. We used the database for annotation, visualization and integrated discovery (DAVID) to perform gene ontology, biological pathways and functional annotation of the DEGs. A search Tool for the Retrieval of Interacting Gene database (STRING) was used to obtain Protein-Protein Interaction (PPI) and modular networks based on the Markov clustering algorithm.

RESULTS

Our study identified 358 significant DEGs, of which 343 were downregulated genes while 15 were upregulated. Five significant hub genes (CXCL8, AGT, CXCR4, CXCL12 and CXCL2) were associated with various biological pathways, molecular functions and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The DEGs were enriched in biological pathways of chemokine-mediated signaling, positive regulation of leukocyte chemotaxis, second messenger-mediated signaling, induction of positive chemotaxis, CXCR chemokine receptor binding and activities of cytokines.

CONCLUSIONS

These hub genes and pathways could be targeted in clinical research to discover new treatments for meningeal carcinoma.

[The trend of accurate pathology diagnosis of breast cancer]

Accurate pathology diagnosis of breast cancer is the premise of personalized treatment. In recent years, the pathology diagnosis of breast cancer have been updated and optimized to provide better guidance and basis for clinical treatment. In this paper, we provide an overview on the advances in histological classification of breast cancer, the progress of biomarker detection related to novel antibody-drug conjugates and immunotherapy in breast cancer, the pathology evaluation of breast cancer specimen after neoadjuvant therapy and sentinel lymph nodes, the progress of genetic testing in breast cancer, and the application of artificial intelligence in breast pathology.

Direct Atomic-Scale Insight into the Precipitation Formation at the Lanthanum Hydroxide Nanoparticle/Solution Interface

Understanding precipitation formation at lanthanum hydroxide (La(OH)₃) nanoparticle-solution interfaces plays a crucial role in catalysis, adsorption, and electrochemical energy storage applications. Liquid-phase transmission electron microscopy enables powerful visualization with high resolution. However, direct atomic-scale imaging of the interfacial metal (hydro)oxide nanostructure in solutions has been a major challenge due to their beam-driven dissolution. Combining focused ion beam and aberration-corrected high-angle annular dark-field scanning transmission electron microscopy, we present an atomic-scale study of precipitation formation at La(OH)₃ nanoparticle interfaces after reaction with phosphate. The structure transformation is observed to occur at high- and low-crystalline La(OH)₃ nanoparticle surfaces. Low-crystalline La(OH)₃ mostly transformed and high-crystalline ones partly converted to LaPO₄ precipitations on the outer surface. The long-term structure evolution shows the low transformation of high-crystalline La(OH)₃ nanoparticles to LaPO₄ precipitation. Because precipitation at solid-solution interfaces is common in nature and industry, these results could provide valuable references for their atomic-scale observation.

Humic acid controls cadmium stabilization during Fe(II)-induced lepidocrocite transformation

Abiotic reduction of iron (oxyhydr)oxides by aqueous Fe(II) is one of the key processes affecting the Fe cycle in soil. Lepidocrocite (Lep) occurs naturally in anaerobic, clayey, non-calcareous soils in cooler and temperate regions; however, little is known about the impacts of co-precipitated humic acid (HA) on Fe(II)-induced Lep transformation and its consequences for heavy metal immobilization. In this study, the Fe(II)-induced phase transformation of Lep-HA co-precipitates was analyzed as a function of the C/Fe ratio, and its implications for subsequent Cd(II) concentration dynamic in dissolved and solid form was further investigated. The results revealed that secondary Fe(II)-bearing magnetite commonly formed during the Fe(II)-induced transformation of Lep, which further changed the mobility and distribution of Cd(II). The co-precipitated HA resulted in a decrease in the Fe solid phase transformation as the C/Fe ratios increased. Magnetite was found to be a secondary mineral in the 0.3C/Fe ratio Lep-HA co-precipitate, while only Lep was observed at a C/Fe ratio of 1.2 using X-ray diffraction (XRD) and Mössbauer spectroscopy. Based on XRD, scanning electron microscopy (SEM), Mössbauer, X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FTIR) results, newly formed magnetite may immobilize Cd(II) through surface complexes, incorporation, or structural substitution. The presence of HA was beneficial for binding Cd(II) and affected the mineralogical transformation of Lep into magnetite, which further induced the distribution of Cd(II) into the newly formed secondary minerals. These results provide insights into the behavior of Cd(II) in response to reaction between humic matter and iron (oxyhydr)oxides in anaerobic environments.

[Clinical observation of 8 cases with central nervous system anaerobic infection diagnosed by metagenomic next-generation sequencing of cerebrospinal fluid]

The current study summarized the clinical characteristics of 8 patients with central nervous system anaerobic infections who visited the Second Hospital of Hebei Medical University from June 2019 to June 2021. Among the 8 patients, 7 cases had headache and fever as the first symptoms, and 1 case had left-sided limb weakness as the first symptom. Four patients had a previous history of diabetes (1 patient had a history of tooth extraction before the onset of the disease), 1 patient had a previous history of sinusitis, 1 patient had a history of tooth extraction before the onset of the disease, and 2 patients had chronic extensive periodontitis or periapical periodontitis. Five cases showed abnormal intracranial and/or meningeal enhancement on cranial magnetic resonance imaging (MRI), and 1 case showed swelling of the whole brain tissue on cranial computed tomography (CT). After treatment, symptoms of 4 cases were improved, symptoms of 1 case were aggravated, and 3 cases died. Anaerobic infections can occur in various parts of the body:the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin and soft tissues. It is generally believed that anaerobic bacteria rarely cause central nervous system infection, therefore, anaerobic culture of cerebrospinal fluid is usually not performed. Moreover, anaerobic culture is affected by many factors, and thus it is difficult to obtain positive results. Metagenomic next-generation sequencing can identify multiple pathogens (viral, bacterial, fungal, or parasitic) from samples based on DNA and/or RNA sequences and has advantages in diagnosing anaerobic infections of the central nervous system. Prompt empirical antimicrobial therapy is essential for the prognosis of the patients.

Effects of Fe(II)-induced transformation of scorodite on arsenic solubility

Scorodite (FeAsO₄·2H₂O) is a pivotal secondary ferric arsenate that immobilizes most of arsenic (As) in acidic As-contaminated environments, but secondary As pollution may occur during dissolution of scorodite in environments involving redox changes. Reductive dissolution of scorodite by coexisting dissolved Fe²⁺ (Fe(II)_aq) under anaerobic conditions and its effects on the behavior of As have yet to be examined. Here, this study monitored the changes in mineralogy, solubility and speciation of As during scorodite transformation induced by Fe(II) under anaerobic conditions at pH 7.0 and discussed the underlying mechanisms. Mössbauer and X-ray diffraction (XRD) analysis showed the formation of parasymplesite and ferrihydrite-like species during scorodite transformation, which was highly controlled by Fe(II)_aq concentrations. 1 mM Fe(II)_aq enhanced As mobilization into the solution, whereas As was repartitioned to the PO₄^3--extractable and HCl-extractable phases with 5 and 10 mM Fe(II). The neo-formed parasymplesite and ferrihydrite-like species immobilized dissolved As(V) through adsorption and incorporation. Additionally, As(V) reduction occurred during Fe(II)-induced scorodite transformation. Our results provide new insights into the stability and risk of scorodite in anaerobic environments as well as the geochemical behavior of As in response to Fe cycling.

Adsorption of cadmium on clay-organic associations in different pH solutions: The effect of amphoteric organic matter

Clay minerals are important soil components and usually coexist with organic matter, forming mineral-organic associations (MOAs), which control the speciation, mobility, and bioavailability of heavy metals. However, the adsorption mechanism of cadmium (Cd) by MOAs is still unclear, especially for the associations of amphotericorganic matter and clay minerals. In this study, 12-aminododecanoic acid (ALA) and montmorillonite (Mt) were chosen to prepare MOAs via intercalation (Mt-ALA composite) and physical mixing (Mt-ALA mixture). Batch experiments were conducted to investigate the adsorption mechanism of Cd(II) by MOAs under different pH values and initial Cd(II) concentrations. The results showed that the Cd(II) adsorption capacities followed as Mt > Mt-ALA mixture > Mt-ALA composite under acidic conditions, Mt-ALA mixture > Mt > Mt-ALA composite under neutral conditions, and Mt-ALA mixture > Mt-ALA composite > Mt under alkaline conditions, suggesting the adsorption behaviors of Cd(II) by MOAs were primarily constrained by the speciation of ALA and solution pH. Under acidic conditions, cationic HALA⁺ could intercalate into the interlayer of Mt and occupy the adsorption sites, reducing the adsorption capacity of Cd(II). As pH increased to neutral, HALA⁺ decreased and changed to a zwitterionic state, which caused ALA to release out from the interlayer of Mt-ALA composite or not easily enter into Mt-ALA mixture and promoted Cd(II) adsorption. Under alkaline conditions, the increase of anion ALA^- would cause ALA to be mainly adsorbed on the surface of Mt and chelate with Cd(II), enhancing the adsorption of Cd(II). Further analysis by Fourier transform infrared and X-ray photoelectron spectroscopy indicated that the carboxyl and amino groups of ALA both participated in the adsorption of Cd(II). These findings could extend the knowledge on the mobility and fate of Cd in clay-based soils and be used as a basis for understanding the biogeochemical behavior of Cd in the environment.

[Diagnostic value of MDM2 RNA in situ hybridization in atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma]

Objective: To investigate the value of MDM2 RNA in situ hybridization (RNA-ISH) in diagnosing atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and dedifferentiated liposarcoma (DDL). Methods: A total of 26 ALT/WDL/DDLs diagnosed from March 2017 to May 2019 in West China Hospital, Sichuan University, Chengdu, China and 18 control cases were included. MDM2 RNA-ISH was performed on all samples and compared with the fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) regarding their performance in detecting MDM2. Results: All samples were detected successfully using the three methods. Among 26 ALT/WDL/DDLs, all cases showed MDM2 amplification and positivity for MDM2 RNA-ISH (26/26, 100%). Twenty-four (24/26, 92.3%) of the 26 tested cases were positive for MDM2 IHC while two of them were negative. Eighteen control cases were all negative for MDM2 FISH and RNA-ISH, and 15 (15/18) cases were negative for MDM2 IHC. The sensitivity and specificity of RNA-ISH were both 100%, and those of MDM2 IHC were 92.3% and 83.3%, respectively. Diffuse staining was identified in all MDM2 RNA-ISH positive ALT/WDL/DDLs, but identified in only 8/24 (33.3%) of the MDM2 IHC positive cases. Among the 11 ALT/WDL/DDL samples evaluated on tissue microarray, the positive rate of MDM2 RNA-ISH was 100% with diffuse staining in all cases. The positive rate of MDM2 IHC was 9/11 while only 1 of the 9 cases showed diffuse staining. The result of MDM2 RNA-ISH was identical to that of MDM2 FISH and was overall consistent with that of MDM2 IHC (Kappa=0.763, P<0.001). Conclusions: In ALT/WDL/DDLs, results of MDM2 RNA-ISH are highly consistent with those of FISH. MDM2 RNA-ISH is more sensitive and more specific and has more diffuse positive signals than the IHC. The findings indicate that MDM2 RNA-ISH is highly valuable for the diagnosis and differential diagnosis of ALT/WDL/DDLs.

[Cerebrospinal fluid TP53 gene mutation in patients with lung cancer associated meningitis and its clinical implications]

Objective: To observe the role of cerebrospinal fluid (CSF) TP53 gene mutation in lung cancer associated meningitis. Methods: A retrospective analysis was performed on 35 patients diagnosed with lung cancer associated meningitis at the Second Hospital of Hebei Medical University from December 2015 to December 2018.All patients underwent the next-generation sequencing of CSF, and TP53 gene was found to be mutant or wild type, including 23 patients with TP53 mutant type and 12 patients with TP53 wild type. The clinical characteristics, CSF leukocyte, protein, glucose, chloride, Karnofsky performance (KPS) and overall survival were observed. Results: Headache, nausea and vomiting were the main clinical manifestations in both groups.There were no significant differences in CSF pressure, leukocyte, biochemical indicators and KPS between the two groups. The average time from diagnosis of lung cancer to diagnosis of lung cancer associated meningitis in the TP53 mutant group was significantly shorter than that in the TP53 wild type group (5.79 months vs 25.5 months).The median survival time of patients in the TP53 mutant group from lung cancer diagnosis to the observation endpoint was 19.77 months, while it was 88.73 months in the TP53 wild type group, and the difference was statistically significant (P=0.043). Conclusions: Mutation in the tumor suppressor gene TP53 can be detected in the CSF of patients with lung cancer associated meningitis. Patients with such mutation have earlier meningeal metastasis and shorter median survival time.

[Imaging characteristics of patients with large vestibular aqueduct syndrome and its relationship with the acoustically evoked short latency negative response]

Objective: To explore the imaging characteristics of large vestibular aqueduct syndrome (LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR), so as to provide reference for the diagnosis of LVAS. Methods: Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University, from October 2009 to December 2017 were retrospectively analyzed, including 117 males and 57 females, aged from 5 months to 47 years old, with the median age of 4 years and 4 months. ABR and imaging data of patients were collected. Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images, the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images. The correlation between the above measurements was analyzed by Pearson test using SPSS 17.0. According to whether ASNR was detected in ABR, the above data were divided into two groups, and the differences of the above imaging measurements were compared by the Independent-Sample Test. Results: The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (x±s, the following was the same), and the outlet diameter was (3.07±0.99) mm on CT; the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39±1.37) mm, and the extraosseous parts was (2.50±2.18) mm on MRI. There was a correlation between the four measurements (P<0.05), among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (r=0.760), and the remaining pairs were weakly correlated. ASNR was detected in 241 ears (72.16%,241/334) and undetected in 93 ears (27.84%, 93/334) of the 334 ears with LVAS. Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group, and the difference was statistically significant (t value was 2.814 and 2.754, P<0.05). There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups, and the difference was no statistically significant(t value was 0.101 and 0.683, P>0.05). Conclusions: There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients. There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac. The smaller the diameter of vestibular aqueduct, the lower the occurrence rate of ASNR.

[Comparison of different massive parallel sequencing platforms for mutation profiling in formalin-fixed and paraffin-embedded samples]

Objective: To compare the performance of Miseq and Ion Torrent PGM platforms and library construction method for next-generation sequencing (NGS) technology for formalin-fixed and paraffin-embedded (FFPE) samples. Methods: A total of 204 FFPE cancer samples including 100 non-small cell lung cancers at the First Affiliated Hospital of Zhejiang University, and 104 colorectal cancers at West China Hospital of Sichuan University were retrospectively selected from January 2013 to December 2016. By using the same samples, DNA was extracted, and the same amount of DNA was used for library construction with the same kit, and sequenced on Miseq and Ion Torrent PGM respectively, after passing the quality control. Any discordant mutations between two platforms were validated by amplified refractory mutation system-polymerase chain reaction (ARMS-PCR) method and Sanger sequencing. Results: A total of 204 FFPE samples were included and 197 samples were successfully analyzed by both platforms. The number of reads generated by the samples on Miseq platform sequencing was higher than PGM platform (median 391 634 vs. 298 030, P<0.01). Alignment with human reference genome showed that the mapping rate of Miseq platform was higher than PGM platform (median 100.0% vs. 99.7%, P<0.01). The median sequence depth of samples on Miseq was higher than PGM platform (median 853× vs. 698×, P<0.01). A total of 236 mutations were detected by two platforms, of which 221 were detected on both platforms, with a 93.6% concordance. Miseq platform detected 11 mutations not detected on PGM platform, while PGM platform detected 4 more mutations not detected on Miseq platform. With validation by ARMS-PCR and Sanger sequencing, Miseq platform was more reliable for low-frequency mutations. The main reasons for the discordant mutations between two platforms were that mutation frequency on undetected platform was lower than mutation reporting range (5%) and FFPE samples were stored for a long time. Conclusions: Compared with PGM, Miseq platform shows higher sequencing quality in terms of the number of reads, alignment results and coverage depth, and the test results are more reliable. In clinical practice, the appropriate platform should be chosen based on sample size and actual throughput requirements to aid in the molecular characterization of tumors.

Linking seed germination and plant height: a case study of a wetland community on the eastern Tibet Plateau

Seed germination is the earliest trait expressed in a plant's life history, and it can directly affect the expression of post-germination traits. Plant height is central to plant ecological strategies, because it is a major determinant of the ability of a species to compete for light. Thus, linking seed germination and plant height at the community level is very important to understanding plant fitness and community structure. Here, we tested storage condition and temperature requirements for germination of 31 species from a wetland plant community on the eastern Tibet Plateau and analysed correlation of germination traits with plant height in relation to storage condition. Germination percentage was positively related to plant height, and this relationship disappeared when seeds were incubated at a low temperature (i.e. 5 °C) or after they were stored under wet-cold conditions. The response of seeds to dry+wet-cold storage was negatively related to plant height. Based on the scores of each species on the first two principal components derived from PCA, species were classified into two categories by hierarchical clustering, and there was a significant difference between germination and plant height of species in these two categories. These results suggest that the requirements for seed germination together with seasonal change in environmental conditions determine the window for germination and, in turn, plant growth season and resource utilisation and ultimately plant height.

[Feasibility of amplicon-based targeted next-generation sequencing of colorectal cancer in endoscopic biopsies]

Objective: To investigate whether small endoscopic biopsies of colorectal cancer were sufficient for quality and accurate mutational analysis by amplicon-based next-generation sequencing (NGS). Methods: By using an amplicon-based targeted NGS panel for mutational detection on Illumina Miseq platform, a total of 109 formalin-fixed and paraffin-embedded (FFPE) endoscopic biopsies of colorectal cancer were retrospectively selected, based on specific histopathologic criteria, from January 2012 to June 2016 at West China Hospital of Sichuan University and Peking University Third Hospital. Twelve of these biopsies had corresponding FFPE surgical resection specimens. Quality control parameters of NGS testing were analyzed and NGS results were confirmed by other methods. Mutation calls of the 12 paired endoscopic biopsies and surgical resections were compared. Results: Of the endoscopic biopsy specimens, 97.2% (106/109) had sufficient DNA and qualified sequencing library. NGS generated excellent sequencing data, with a median of 848× for median read depth and 95.7% for uniformity. The success rate of NGS was 95.4% (104/109). Conventional methods confirmed the results of NGS for KRAS and BRAF, and the concordance rate was 100.0%. The clinically actionable mutations detected in the 12 paired endoscopic biopsies and surgical resections were concordant. Conclusion: FFPE endoscopic biopsies of colorectal cancer is suitable for targeted NGS, providing quality sequencing data and accurate mutational information to guide targeted therapy.

[Ki-67 expression and its effect on response to neo-adjuvant chemotherapy in invasive breast cancer]

Objective: To investigate the response to neoadjuvant chemotherapy (NAC) among different molecular subtypes of breast cancers using molecular classification with Ki-67 (ER+ PR+ HER2+ Ki-67) or without Ki-67 (ER+ PR+ HER2). Methods: One hundred and twenty-seven cases of invasive breast cancer confirmed by core needle biopsy before NAC were collected from January 2007 to December 2009 and diagnosed at West China Hospital, Sichuan University. The cases were classified into different molecular subtypes using molecular classifications with or without Ki-67. Their clinical and pathological response to NAC was evaluated and compared. Results: The different subtypes using both molecular classifications showed significant difference in clinical response(with Ki-67: χ(2)=22.40, P<0.01; without Ki-67: χ(2)=9.202, P=0.027)but not pathological(P>0.05) response to NAC. By multivariate analysis, Ki-67 was predictive for a clinical complete response (P=0.041) and clinical overall response (P<0.01); also Ki-67 was the only clinicopathological factor predictive of pathological response(P=0.041). Conclusion: The molecular classification with Ki-67 is better to predict breast cancers responsiveness to NAC than the molecular classification without Ki-67.

Abstract P2-11-19: Expression of folate receptor alpha in ductal carcinoma in situ of the breast and comparison with that of invasive ductal carcinoma

Background: We have previously shown that the expression of Folate receptor alpha (FRA) is associated with high grade ER-/PR- or triple negative (TN) invasive ductal carcinoma of the breast. The aim of the current study is to investigate the expression pattern of FRA in a cohort of ductal carcinoma in situ (DCIS), analyze its relationship with different clinicopathological features and expression of several key biomarkers, and compare these findings to our previous data on invasive ductal carcinoma (IDC).

Methods: Ninety-eight cases of DCIS of the breast diagnosed between 1997 and 2008 in our institution were identified, reviewed and 6 blocks of tissue microassays (TMA) were constructed. The association between the expression of FRA (≥10% designed as positive expression) and the clinicopathologic features, the expression of ER, PR, HER2 and Ki-67, and the clinical outcome were evaluated, and these results were compared to those from IDC (399/430 cases with informative data). Results: Among the 98 cases of DCIS in TMA, 88 cases were informative. The expression rate of FRA was 21% for DCIS, less than the 29% seen in IDC. Expression of FRA was associated with high nuclear grades (42%), though less frequently than with IDC (52%). FRA expression was also associated with ER negativity (46%), PR negativity (33%) and high Ki-67 expression (50%) in DCIS, although significantly less than in IDC (75%, 63%, and 56%, respectively for negative ER and PR, and high Ki-67). Also, only 50% of ER/PR negative, TN and basal-like DCIS expressed FRA, significantly lower than that of IDC (74%, 80% and 80%, respectively). Due to the limited cases of DCIS, we did not demonstrate a significant difference in disease-free survival between FRA positive and negative tumors (p-value = 0.1792), although we did observe that IDC with FRA expression was significantly associated with a worse disease-free survival (p-value = 0.04).

Comparison between FRA expression between DCIS and IDC FRA≥10% in DCISFRA≥10% in IDCp-value 88 cases399 cases Nuclear 342%52%0.0185ER negative46%75%0.0442PR negative33%63%0.0214HER2 3+31%37%0.7003ER-/PR-50%74%0.0973Triple Negative50%80%0.1622Basal-Like50%80%0.1739

Conclusion: Our data demonstrates that FRA expression is associated with high nuclear grade, ER/PR negative and TN DCIS, though at a significantly lower rate than was observed in IDC, suggesting a possible role for this receptor in early breast carcinogenesis. There are differences in the rates of FRA expression between DCIS and IDC, suggesting that FRA may be one of the key molecules involved in progression of DCIS to IDC.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-11-19.

Abstract P2-11-20: Evaluation of folate receptor alpha expression in breast cancer by immunohistochemistry: Analysis with three different cut-off points

Background: Folate receptor alpha (FRA) is a newly recognized molecule that is selectively expressed in certain types of solid tumors, and several targeted therapies against FRA have shown promise in clinical trials for treating FRA-expressing ovarian and lung cancer. FRA has been shown to be selectively expressed in ER/PR negative and triple negative (TN) breast cancer; tumor types which would benefit from FRA targeted therapy. With these FRA-targeted therapies becoming available, correctly identifying eligible patients is very important. Currently, the cut off points for FAR expression by immunochemical (IHC) analysis have not been uniform. The commonly used cut points for expression that have been reported included 5%, 10% and the M score (using both staining intensity (3+, 2+, and 1+) and percentage of cells 0-100% (X, Y, Z for each staining intensity) in the equation (M-score = [3X+2Y+1Z]/ 6). The aim of the current study is to investigate these 3 most frequently used cut off points for FRA IHC analysis, in an effort to identify the one that is the most clinically relevant. Methods: 430 cases of infiltrating ductal carcinoma diagnosed between 1997 and 2008 in our institution were identified, reviewed, and 25 blocks of tissue microassays (TMA) were constructed. The association between the expression of FRA by IHC analysis, the clinicopathologic features, expression of ER, PR, HER2 and Ki-67, and the clinical outcome of these tumors were evaluated. Three cut off points (≥5%, ≥10% and M score of ≥10) were compared. 5% and 10% were scored as percent of membrane/cytoplasmic staining of the tumor cells regardless of the staining intensity while the M score takes into consideration both percentage and intensity of the staining of tumor cells.Results: Among the 430 cases studied, 399 cases had informative data from IHC analysis. The positive rates for FRA were 33%, 29% and 17%, respectively, for 5%, 10% and M score 10 as the positive cut off. All three cut off points were associated with significantly higher tumor grades and higher nodal status; they were also associated significantly with ER negativity, PR negativity or high proliferation rates (Ki-67≥15%) (P-values &lt;0.0001 in all), and ER-/PR-, TN, or Basal-like tumors (p-values &lt;0.0001 in all). Also, they were all significantly associated with worse disease-free survival with the p-values of 0.027, 0.026, and 0.009, for 5%, 10% and M score 10, respectively.

FRA positive rates with three different cut off points FRA ≥5% (%)FRA ≥10% (%)FRA M-score ≥10 (%)Age &gt;50 (year)32%28%17%Tumor size &lt;2 (cm)28%26%16%Histologic grade 351%47%32%LN status &gt;041%34%20%ER negative77%74%56%PR negative66%63%46%HER2 3+48%37%26%Ki67&gt;15%60%56%41%ER-/PR-77%74%54%Triple Negative82%80%60%Basal-like82%80%59%

Conclusion: Our data demonstrates that all three cut off points (5%, 10% and M score 10) could effectively separate breast tumors into subgroups where FRA expression correlated with specific pathologic features and a worse disease-free survival compared with FRA negative tumors. Using an M score of &gt;10 as the cut off for FRA may be most specific method for determining the prognostic significance of FRA expression in breast cancer.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-11-20.

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

BACKGROUND

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

PATIENTS AND METHODS

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

RESULTS

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

CONCLUSION(S)

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

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

BACKGROUND

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

PATIENTS AND METHODS

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

RESULTS

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

CONCLUSION(S)

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

Molecular characterization of long terminal repeat of porcine endogenous retroviruses in Chinese pigs

Pigs offer an unlimited source of xenografts for humans. However, vertically transmitted Porcine endogenous retrovirus (PERV) poses an infectious risk in the course of pig-to-human transplantation. In this study, we characterized PERV long terminal repeat (LTR) sequences from three species of Chinese pigs Banna minipig inbred (BMI), Wu-Zhi-Shan pig (WZSP), and Neijiang pig (NJP-A), and compared them with those of known PERVs (PERV-A, PERV-B, PERV-C, PERV-NIH, and 293-PERV-43). Genomic DNA extracted from peripheral blood mononuclear cells (PBMCs) of the Chinese pigs was used for PCR-amplification, cloning, and sequencing of LTRs. The sequences of BMI and WZSP LTRs were found identical with those of PERV-A and PERV-B, while that of NJP-A LTR was found close to those of PERV-C and PERV-NIH. The gammaretroviral nature of PERV LTRs from Chinese pigs was proved. These LTRs contained also promoter elements including enhancer-like repeats comparable with those of other PERVs. These findings suggested that PERVs from Chinese pigs were similar to PERV-A and PRV-B. Moreover, this study provided new data for the evaluation and selection of pigs to be used in the xenotransplantation.

Studies on long-term infection of human cells with Porcine endogenous retrovirus

A major concern in pig-to-human xenotransplantations is the potential risk of transmission of Porcine endogenous retroviruses (PERVs) integrated in the pig genome. Our previous work has shown that PERV provirus genes and gag protein can be detected in human embryonic kidney HEK-293 cells during a long-term infection with PERV (Yu et al., Transplant. Proc. 37, 496-499, 2005). In this study, we continued studying the long-term (>6 months) PERV infection of HEK-293 cells. The results showed no significant differences in morphology, growth, apoptosis, and [(3)H]-thymidine incorporation between PERV-infected and uninfected cells. The PERV LTR sequence showed only an insignifcant mutation after the long-term infection. PERV infection had no effect on the transcription of genes of Human endogenous retrovirus (HERV) naturally occurring in HEK-293 cells. Summing up, this study indicated that a long-term PERV infection of HEK-293 cells in vitro does not result in any significant changes in host cells as well as in PERV LTR sequence.

Genotype <21CAs/≥21CAs and allele <21CAs of the MANBA gene in melanoma risk and progression in a Swedish population

Cutaneous melanoma is characterized by poor patient outcome in its later stages. The search for genetic markers is therefore crucial for the identification of populations at risk for melanoma. Highly polymorphic CA repeats in 3' proximity in the MANBA gene were examined by PCR-capillary electrophoresis in 185 Swedish melanoma patients and 441 tumor-free age- and gender-matched individuals. The associations of the polymorphisms with melanoma risk, the pigment phenotypes of the patients and tumor characteristics were analyzed. A significant difference in allelic distribution between melanoma patients and tumor-free individuals was observed. The frequency of the MANBA genotype <21CAs/≥21CAs was significantly higher in melanoma patients than in the controls. When comparing allele distribution in patients and their matched controls, the allele <21CAs was found to be associated with the female gender (39.8 vs. 31.2%, P=0.041, OR=1.46, 95% CI 1.02-2.10), but not with male gender (34.4 vs. 30.9%, P%0.39). Within the melanoma group, there were no differences in the distribution of the MANBA alleles associated with patient gender or age before or after 55 years at diagnosis, nor was there any association between the MANBA genotype and pigment phenotype or tumor sites. The MANBA allele <21CAs was, however, associated with thin melanomas at diagnosis (Breslow thickness ≤1.5 mm and Clark levels I and II). In conclusion, these data suggest that MANBA polymorphisms might be an indicator of tumor growth and progression and, together with other markers, could be used to identify individuals at increased risk of melanoma.

Transmission of porcine endogenous retrovirus to human cells in nude mouse

Xenotransplantation is associated with the risk of Porcine endogenous retrovirus (PERV) transmission, since it has been shown that PERV can infect human cells in vitro (Specke et al., Virology 285, 177-180, 2001). We evaluated the possibility of PERV infection of human cells in nude mice model. Porcine kidney cells PK15 carrying PERV and human liver cancer cells SMMC-7721 were injected separately into the right and left axilla of nude mice, respectively. Two months later, pig cytochrome oxidase II (COII) gene, PERV DNA, PERV mRNA, and PERV-Gag protein were detected in the mass formed in both axillas and in several organs of nude mice. The pig COII genes were detected in the right and left axilla, but not in other organs of nude mice implicating that the microchimerism of pig cells occurred in human SMMC-7721 cells and induced the formation of the mass. PERV gene and gag protein were detected in all mouse tissues except liver. These data indicated that (i) PERV may be transmitted from porcine to mouse cells, (ii) PERV genes and proteins were detectable in the mass formed by injection of human cells and consequently (iii) there was a possibility of PERV transmission to human cells after xenotransplantation.

Significance of glutathione S-transferases M1, T1 and P1 polymorphisms in Swedish melanoma patients

Polymorphisms of GSTM1, GSTT1 and GSTP1 were examined in melanoma patients and tumor-free individuals. Relationships between the polymorphisms and tumor characteristics and pigment phenotypes of the patients were analyzed. There was no significant difference in GSTM1 null and GSTT1 null genotypes nor GSTP1 GG genotype between melanoma patients and controls. In melanoma patients, these polymorphisms were not correlated with early or later onset of melanomas or gender of the patients. Frequency of GSTM1 null genotype was higher in patients with melanoma >2.5 mm than in those with tumors <1.0 mm, and higher frequency was found in nodular melanoma than in the other tumor types. GSTP1 GG genotype was more often found in the patients with brown and mixed eye color or brown and black hair than those with blue and green eyes or blond hair. It is unlikely that polymorphisms of GSTM1, GSTT1 and GSTP1 are general risk factors for melanoma in the Swedish population. GSTM1 null genotype was correlated with Breslow thickness and tumor type, which might serve as an additional biomarker for a rapid tumor progression. GSTP1 GG increases risk for melanoma in the subgroup of individuals with dark eyes or hair.

Prevention of glutamate excitotoxicity in motor neurons by 5,6-dihydrocyclopenta-1,2-dithiole-3-thione: implication to the development of neuroprotective drugs

Glutamate-induced excitotoxicity and oxidative damage are believed to play an important role in the development of a number of central nerve system disorders. Nuclear-factor erythroid 2-related factor 2 (Nrf2) is a master transcriptional regulator of many cytoprotective genes. We report herein that 5,6-dihydrocyclopenta-1,2-dithiole-3-thione (CPDT), which was previously shown to induce several Nrf2 target genes in non-nervous cells and tissues, significantly activates Nrf2 and Nrf2 target genes in rat spinal cord explants. More importantly, such activation is accompanied by complete inhibition of glutamate-induced motor neuron death in these explants. Further studies show that CPDT inhibits glutamate-induced intracellular Ca(2+) rise, loss of mitochondrial transmembrane potential and depletion of tissue glutathione. CPDT did not appear to modulate glutamate transport or to interfere with glutamate interaction with postsynaptic receptors. Taken together, our studies have identified CPDT as a promising neuroprotective agent and suggest that pharmacological activation of Nrf2 signaling is an important strategy for protection against glutamate-induced excitotoxicity.