Clinical significance of ERβ mRNA expression in ERα-negative and triple-negative breast cancers.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 545-545
Author(s):  
Young Choi Kim ◽  
Hadong Kim ◽  
Tae-Hoon Kim
Keyword(s):  
Mrna Expression ◽  
Triple Negative ◽  
Myoepithelial Cells ◽  
P Value ◽  
Breast Cancers ◽  
Chi Square ◽  
Ki 67 ◽  
Kaplan Meier ◽  
Asco Meeting

545 Background: Previously at the 2012 ASCO meeting, we reported significant ERβ mRNA expression in ERα-negative (ERα-) and triple negative breast cancers (TNBC). In this study, we analyzed its clinical outcome and correlation with other clinical parameters. Methods: A total of 141 cases consisted of 69 ERα- BC including 41 TNBC and 72 ERα+ BC were obtained from patients aged 29 to 97 years old between 2003 and 2010. Treatments included surgery, hormone, chemo- or radiotherapy, or any combinations. The follow-up period ranged from 1 to 132 months. ERβ mRNA was analyzed from formalin-fixed tumor tissues by RT-PCR. ERα, PR, Her-2, Ki-67, AIB-1, NFk/p65, p-c-jun, Ki-67, TIF-2, SRC-1, CK5/6 and p53 were tested by immunohistochemistry. The correlation was deemed significant if p value less than 0.05 from Chi-square. Overall survival (SVR) was defined from the date of diagnosis to last follow-up or death attributed to BC and was analyzed by the Kaplan-Meier curves and Wilcoxon rank sum. Results: Single or combination of ERβ isoform(s) was highly expressed in both ERα- and TNBC and ERβ2 was the most frequent (48.8%) and ERβ5, the least (30.2%). In contrast, ERβ5 was the most frequent in ERα+BC. Presence of all or any ERβ isoform was associated with significantly higher SVR in all cases, and in TNBC (ERβ total, Wilcoxon p = 0.0177, ERβ2, p= 0.0329), and also with negative LN (p< 0.0001). ERβ2 and ERβ5 were expressed in 63.2% and 30 %, respectively, in 20 patients died in 1 to 60 months. Over expression of AIB-1, NF-kB/p65 and TIF-2 was associated with ERβ1 and ERβ2 (p<0.05). Ki-67 + cells were mostly ERβ + BC than ERα+. ERα mRNA expression was up-regulated, and ERβ,down- regulated, with the ERα: ERβ+ ratio of 3-1000:1. There was no association between ERβ expression and the stage, age, tumor size, and postmenopausal status. Conclusions: Specific ERβ isoform appears to be a significant discriminating factor for SVR and negative node. ERβ2 is the predominant isoform in ERα- but ERβ5 in ERα+BC, suggesting a distinct role of ERβ isoform in ERα- and ERα+BC. ERβ isoform may be a selective therapeutic target in this cohort. ERβ+/ Ki-67+cells appear to be a sub-population of BC arising from basal-myoepithelial cells in this cohort.

ERβ mRNA expression in ERα-negative and triple-negative breast cancers.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 574-574
Author(s):  
Young Choi ◽  
Hadong Kim ◽  
Tae-Hoon Kim
Keyword(s):  
Cyclin D1 ◽  
Mrna Expression ◽  
Triple Negative ◽  
Lymph Node Status ◽  
Mrna Levels ◽  
Nuclear Staining ◽  
Breast Cancers ◽  
Proliferating Cells ◽  
Ki 67 ◽  
Reverse Transcription Pcr

574 Background: ERα is the main prognostic and therapeutic marker in breast cancer (BC). About 30% of BC cases are negative for ER (ERα-) and do not benefit from antiestrogen therapy (TAM). We aim to study ER-beta (ERβ) expression in ERα- and triple negative (TN) cancers to explore alternate pathway of treatment in this cohort. Methods: We studied 67 ERα- BC cases including 44 TN together with 74 ERα +BC cases obtained from patients aged 29 to 97 years old between 2003 and 2010. The histology included 110 intraductal, 12 medullary and 19 other types. 78 cases were grade 3, 52 were grade 2, and 11 were grade 1. RNA was extracted from FFPE and mRNA levels of ERβ isoform and ERα were determined by real-time quantitative reverse transcription PCR. IHC stains were done on TMA the sections for ERα, PR, Her-2, Ki-67, CK5/6 and Cyclin D1. Results: ERβ isoforms were highly expressed in ERα-, TN, basal-like and HER2 type BC cases. ERβ2 was the major ERβ variant expressed. Ki-67 proliferating cells (>20% nuclear staining) were mostly in ERα- rather than ERα+ cases (69.0% vs. 31.0%) as were cyclin D1- cells (82.2% vs. 17.8%). On the other hand, in ERα+ BC, ERα mRNA expression was consistently high and upregulated, and ERβ, low and down regulated, and the ratio of ERα+ to ERβ+ ranged from 3 to 100. ERβ1, 2 and 5 were co-expressed with ERα in 56%, 63%, and 30% of cases, respectively. Overall, ERβ mRNA levels did not show any significant correlation with age, tumor size, lymph node status and histological grades. Conclusions: ERβ-dependent proliferating tumor cells may render them more sensitive to TAM, and increase the effectiveness of TAM and its metabolites in ERα- and TN cases. Increased overall survival after adjuvant TAM ERα-BC may be directly related to ERβ over-expression. ERβ isoform is potential selective therapeutic target in a sub-cohort of ERα- BC. Additionally, when ERβ and ERα are co-expressed, ERβ appears to play a distinct role from its action in ERα- BC. [Table: see text]

scholarly journals Androgen receptor and FOXA1 coexpression define a “luminal-AR” subtype of feline mammary carcinomas, spontaneous models of breast cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elie Dagher ◽  
Violette Royer ◽  
Paul Buchet ◽  
Jérôme Abadie ◽  
Delphine Loussouarn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Androgen Receptor ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Ki 67 ◽  
Mammary Carcinomas ◽  
Definition Of

Abstract Background Invasive mammary carcinomas that spontaneously develop in female cats are associated with high mortality, and resemble the most aggressive human breast cancers, especially triple-negative breast cancer (TNBC). Transcriptome studies showed that TNBCs are a heterogeneous group that includes a potentially hormone-dependent subtype named luminal-AR. Some authors proposed an immunohistochemical definition of the luminal-AR subtype, which is not only positive for Androgen Receptor (AR), but also either positive for the transcription factor Forkhead box A1 (FOXA1), or negative for basal markers. The objectives of this study were to describe AR and FOXA1 expressions in feline mammary carcinomas (FMCs), their prognostic value, and if their coexpression could define a “luminal-AR” subtype of triple-negative mammary carcinomas in cats. Methods In a previously described retrospective cohort of 180 female cats with FMCs, with a 2-year follow-up post-mastectomy, we assessed AR, FOXA1, ER, PR, Ki-67, HER2, and CK14 expressions by automated immunohistochemistry. Results Of the 180 FMCs, 57 (32%) were luminal; i.e., ER and/or PR positive, and 123 (68%) were triple-negative (ER–, PR– and HER2–) FMCs. AR overexpression (found in 33 cases/180, 18%) and FOXA1 index ≥1% (64/180, 36%) were associated with a longer disease-free interval, overall survival, and cancer-specific survival in cats with FMC. Analysis of AR, FOXA1 and CK14 coexpression in triple-negative FMCs showed that AR+ triple-negative FMCs were heterogeneous: there existed an AR+ FOXA1+ CK14– subgroup (n = 7) associated with a better cancer-specific survival by multivariate survival analysis (HR = 0.26, 95% CI: 0.07–0.89, p = 0.03) compared to AR+ FOXA1–CK14+ triple-negative FMCs (n = 46) (HR = 1.00), independently of the pathologic tumor size and pathologic nodal stage. The non-basal-like subtype of triple-negative FMCs that coexpresses AR and FOXA1 (the AR+ FOXA1+ CK14– subgroup) could represent the equivalent of the luminal-AR subgroup of human triple-negative breast cancer. Conclusions We identified an AR+ FOXA1+ CK14– subgroup of triple-negative FMCs that might correspond to the luminal-AR subgroup of human triple-negative breast cancers. Cats with FMC may be interesting spontaneous animal models to investigate new strategies targeting the androgen receptor, especially in the aggressive subtype of AR+ basal-like triple-negative mammary carcinomas with loss of FOXA1 expression (the AR+ FOXA1–CK14+ subgroup).

MCRS1 EXPRESSION MORE IN TUMOR PART AND SERVES AS A POOR PROGNOSTIC FACTOR IN EXTRAHEPATIC CHOLANGIOCARCINOMA

2021 ◽  
pp. 72-75
Author(s):  
Hung-Chune Maa ◽  
Pham van Tuyen ◽  
Yen-Lin Chen ◽  
Yao-Nan Yuan
Keyword(s):  
Prognostic Factor ◽  
Large Scale ◽  
Surgical Margin ◽  
P Value ◽  
Extrahepatic Cholangiocarcinoma ◽  
Poor Prognostic Factor ◽  
Kaplan Meier ◽  
Survival Plot

INTRODUCTION:Microporous protein 1 (MCRS1) acts as a cancer gene. MCRS1 is associated with poor prognosis in several types of cancer including colorectal cancer, hepatocellular carcinoma, glioma, and non-small cell lung cancer. In the current study, we are trying to shed light on the role of MCRS1 in the extrahepatic cholangiocarcinoma. METHODS: We retrospectively selected 13 patients who diagnosed extrahepatic cholangiocarcinoma. All clinical charts and histopathology reports were reviewed for and recoded for age, gender, tumor size, surgical margin status, lymph node metastasis, distant metastasis and TMN staging. All patients were followed for 1~10 years. The median follow-up period was 3.2 years. RESULTS: The expression level of MCRS1 showed signicantly higher in tumor part than non-tumor part. In the Kaplan-Meier survival plot , the high MCRS1 expression group showed poor survival probability with p value of 0.020. The Hazard ratio of MCRS1 showed 8.393 folds in high MCRS1 expression group when compared with low expression group with the borderline p value of 0.05. CONCLUSION:MCRS1 serves as a poor prognostic factor. Further analysis, no correlation was found in proliferation, apoptosis, angiogenesis and EMT markers. The reason may be the sample size and large-scale study in the future is mandatory

P3649Analysis of clinical and angiographic parameters as predictors of recurrent vasospastic angina

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J.-H Park ◽  
G.-S Yoon ◽  
S.-H Choi ◽  
Y S Beak ◽  
S W Kwan ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Odds Ratio ◽  
Troponin I ◽  
Medication Compliance ◽  
Provocation Test ◽  
Vasospastic Angina ◽  
P Value ◽  
Kaplan Meier ◽  
Male Sex

Abstract Background Patients with vasospastic angina (VA) may have recurrent chest symptoms and life-threatening arrhythmias. Despite regular medications, many VA patients experience recurrent episodes of VA. In this study, we evaluate clinical and angiographic predictors of recurrent VA. Patients and methods From January 2010 to May 2018, a total of 858 patients who underwent ergonovine provocation test were retrospectively reviewed. We excluded the patients who had negative results of provocation test, follow up duration less than 1 month and poor medication compliance. The recurrent-VA group consisted of patients who were re-hospitalized, visited the emergency room, or had repeated coronary angiographies because of chest pain. Results A total of 858 patients who underwent ergonovine provocation tests between January 2010 to May 2018 were retrospectively reviewed. Of them, 162 (mean follow-up duration, 3.0 years) were eligible for our study. The patients were divided into two groups: recurrent-VA (n=33, 20.4%) and stable-VA groups (n=129, 79.6%). Compared with the stable-VA group, the recurrent-VA group consisted mostly of men (93.9% vs. 75.2%, P=0.01), and had low LDL-cholesterol levels (93±27 mg/dl vs. 108±31 mg/dl, P=0.01). In the angiographic findings, a degree of coronary artery disease (CAD) and the site and number of spasm-positive vessels showed no difference between the two groups. Nicorandil was more frequently prescribed at discharge in the stable-VA group (15.2% vs. 35.7%, P=0.02). In the multivariate analysis, the male sex (odds ratio [OR], 5.87; 95% confidence interval [CI], 1.31–26.22; P=0.02) and non-use of nicorandil (OR, 3.51; 95% CI, 1.25–9.84; P=0.01) were the independent predictive factors in the recurrent-VA group. In the Kaplan-Meier analysis, men who did not use nicorandil (n=85, 52.5%) had higher incidences of recurrent angina compared to the other group (n=77, 47.5%). (30.6% vs. 6.6%; p<0.001). Univariate and multivariate analysis Refractory VA (n=33) Stable VA (n=129) Odds ratio [95% CI] P value univariate Odds ratio [95% CI] P value multivariate Age <56 years, n (%) 20 (66) 58 (44) 1.88 [0.86–4.10] 0.11 NA NS Male sex, n (%) 31 (93.9) 97 (75.2) 5.11 [1.15–22.56] 0.03 5.87 [1.31–26.22] 0.02 Smoking, n (%) 17 (51.5) 46 (35.7) 1.91 [0.88–4.14] 0.09 NA NS No AMI presentation, n (%) 11 (33.3) 25 (19.4) 2.08 [0.89–4.84] 0.08 NA NS Troponin-I >0.86 ng/ml, n (%) 2 (7.1) 3 (2.7) 2.74 [0.43–17.27] 0.08 NA NS LDL-C <105 mg/dl, n (%) 21 (63) 58 (49) 1.81 [0.81–4.01] 0.14 NA NS No use of nicorandil, n (%) 5 (15.2) 46 (35.7) 3.10 [1.12–8.58] 0.02 3.51 [1.25–9.84] 0.01 Kaplan-Meier curves Conclusions Male sex and non-use of nicorandil were independent predictors of recurrent VA.

scholarly journals Increased Risk of Temporomandibular Joint Disorder in Patients with Rheumatoid Arthritis: A Longitudinal Follow-Up Study

2020 ◽  
Vol 9 (9) ◽  
pp. 3005
Author(s):  
Soo-Hwan Byun ◽  
Chanyang Min ◽  
Hyo-Geun Choi ◽  
Seok-Jin Hong
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporomandibular Disorder ◽  
Population Data ◽  
Control Group ◽  
Chi Square ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Joint Disorder

We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70–3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.

scholarly journals Mechanical Dispersion as a powerful echocardiographic predictor of outcomes after Myocardial Infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.P De Sousa Bispo ◽  
P Azevedo ◽  
P Freitas ◽  
N Marques ◽  
C Reis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Survival Analysis ◽  
Primary Endpoint ◽  
Longitudinal Strain ◽  
Univariate Analysis ◽  
Global Longitudinal Strain ◽  
P Value ◽  
Peak Strain ◽  
Kaplan Meier

Abstract Introduction Several studies have addressed the importance of transthoracic echocardiography (TTE) in risk prediction of subsequent adverse events after ST elevation myocardial infarction (STEMI). While several traditional echo parameters have a well-established prognostic value, data derived from 2D-Speckle Tracking Echocardiography (2DSTE) needs further investigation. Objectives To determine if 2DSTE parameters provide additional information beyond conventional echocardiography to predict long-term adverse outcomes in patients admitted with STEMI Methods Retrospective, single-center study, that included all patients without previous cardiovascular events admitted with STEMI (who underwent primary coronary angioplasty) between 2015 and 2017. Patients with poor acoustic windows, severe valvular disease, irregular heart rhythm, and those who died during hospital stay were excluded. We reviewed all pre-discharge TTE to assess conventional parameters of LV systolic and diastolic function and data obtained by 2DSTE: global longitudinal strain (GLS) and peak strain dispersion (PSD), an index that is the standard deviation from time to peak strain of all segments over the entire cardiac cycle. Demographic and clinical data was obtained through electronic hospital records. Minimum follow-up was 2 years. The primary endpoint was a composite of all-cause mortality and cardiovascular re-admission at follow-up. Survival analysis was used to determine independent predictors of the primary endpoint. Results 377 patients were included, mean age 62±13 years, 72% male. Mean LVEF was 50±10% with 19% of patients having LVEF &lt;40%. Mean indexed left atrium volume (LAVi) was 33±10 ml/m2, mean GLS was −14±4%, and PSD was 60±22 msec. Average follow-up was 36±11 months, with a combined endpoint of mortality and hospitalization of 27% (n=102) Univariate analysis of echocardiographic variables revealed an association between heart rate, LVEF, indexed LV end-systolic volume, indexed stroke volume, LAVi, GLS and PSD with the endpoint. However, on multivariate analysis only LAVi [HR 1.030 (95% CI 1.009 - 1.051), p-value = 0.005] and PSD [HR 1.011 (95% CI 1.002 - 1.020), p-value = 0.012] remained independent predictors of the primary endpoint. We determined that a PSD value higher than 52 msec has a sensitivity of 76% and a negative predictive value of 83% for mortality and hospitalization, and that this cut-off point discriminates patients at a higher risk of events in Kaplan-Meier Survival analysis with a Log-Rank p-value=0.001. Conclusion PSD derived by longitudinal strain analysis is a promising prognostic predictor after STEMI. PSD outperformed conventional echocardiographic parameters in the risk stratification of STEMI patients at discharge. Kaplan-Meier Survival Curves Funding Acknowledgement Type of funding source: None

Clinicopathologic characteristics of triple-negative breast cancer and relationship to basal markers.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11519-e11519
Author(s):  
Dimitrios Tryfonopoulos ◽  
Georgios Oikonomopoulos ◽  
Stamatina Demiri ◽  
Lazaros Lekakis ◽  
Nikolaos Fragkiskos Pistamaltzian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Stage Iv ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Clinicopathologic Characteristics ◽  
Ki 67 ◽  
Immunohistochemical Markers ◽  
Gene Expression Studies

e11519 Background: Triple negative breast cancers are immunohistochemical surrogates of basal-like breast cancers. There is no complete overlap between triple negative and basal-like tumors and as gene expression studies evolve, further subclassification bearing clinical relevance is underway. Our purpose was to correlate clinicopathologic characteristics of triple negative breast cancer tumors with expression of basal markers in an effort to define immunohistochemically subgroups of this heterogenous disease Methods: Data were retrieved and analysed using our electronic databank. Patient samples were reviewed by an expert breast cancer pathologist and stained additionally for EGFR and CK 5/6 antibodies. Results: Sixty-five women with triple negative breast cancer were identified. Mean age was 58.3±12.9 years. Most tumors (86%) were of ductal histology, 53% grade 3, 48% having high Ki-67 index (>14%). 10% of patients presented with Stage IV, 25% with Stage III, 38% with stage II and 27% with stage I disease. 63% of patients were postmenopausal. EGFR staining was present in 43% of tumor samples, whereas CK 5/6 in 38.5%. Both EGFR and CK 5/6 expression was found in 18.5%, whereas 37% of tumors expressed neither EGFR or CK 5/6. No difference was observed between tumors expressing any of these 2 basal markers as compared to EGFR and CK 5/6 negative tumors in terms of Ki-67 index, grade, tumor size and nodal involvement. Lymphovascular invasion and non-ductal histology tended to occur more frequently (p=ns) in non-basal tumors. Additionally, patients with expression of any of the basal markers tended to be more obese than the non-basal triple negative breast cancer patients (p=ns). Conclusions: Further immunohistochemical markers apart from EGFR and CK 5/6 are needed in order to further define clinically meaningful subgroups of triple negative breast cancer.

Correlation of lymphovascular invasion and staging in patients undergoing lymphatic mapping for colon cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 498-498
Author(s):  
Alpesh K. Korant ◽  
Vikrom K. Dhar ◽  
Gregory Johnston ◽  
Supriya Kumar Saha ◽  
Mohammed Shaik ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Prognostic Factors ◽  
Lymphovascular Invasion ◽  
Sentinel Lymph Node Mapping ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Lymph Node Mapping ◽  
Kaplan Meier ◽  
Chi Square Analysis

498 Background: Lymphovascular invasion (LVI) is known as a negative prognostic factor in colon cancer (CCa) patients (pts). Sentinel lymph node mapping (SLNM) is known to upstage more pts than conventional surgery. A retrospective study was undertaken to determine the relationship between LVI and other known prognostic factors in CCa pts undergoing SLNM. Methods: Pts with CCa underwent SLNM. Data was collected for tumor (T) and node (N) stage, distant metastasis (M), size, grade, recurrence, and 5-year overall survival (5yrOS). Chi-square analysis was used to calculate the association between categorical variables with a p value of 0.05 as significant. Kaplan-Meier method was used to calculate 5yrOS. Results: We studied 310 CCa pts undergoing SLNM. Success rate was 100%. Nodal positivity was 46%. LVI was present in 34% of pts overall, in 66% node +ve pts versus only 7% in node -ve pts (p<0.001). Pts with LVI were proportionately of higher grade, larger size, higher T-stage, node +ve and higher AJCC stage. Pts with LVI had significantly higher recurrence and lower 5yrOS (Table). Conclusions: Presence of LVI positively correlated with all known prognostic factors in CCa pts undergoing SLNM, with higher recurrence and significantly lower 5yrOS. [Table: see text]

HER2 targeted therapy and outcome in HER2-equivocal cases after 2018 ASCO/CAP HER2 guideline modification.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14729-e14729
Author(s):  
James Crespo ◽  
Hongxia Sun ◽  
Jimin Wu ◽  
Qingqing Ding ◽  
Guilin Tang ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Small Sample ◽  
Her2 Status ◽  
Breast Cancers ◽  
Negative Group ◽  
Metastatic Site ◽  
Kaplan Meier ◽  
Md Anderson

e14729 Background: The best targeted therapeutic approach for HER2-equivocal cases remains unclear. New ASCO/CAP HER2 guidelines are intended to decrease this ambiguity by combining immunohistochemistry and in situ hybridization to resolve equivocal cases as positive or negative. However, the benefit of anti-HER2 therapy in HER2-equivocal cases is unknown. Methods: We retrospectively reviewed patients who visited MD Anderson from April 2017 to March 2018 with equivocal HER2 results based on the 2013 ASCO/CAP guidelines. The population was divided into 2 cohorts according to biopsy origin (primary cohort: biopsy from breast or axilla; recurrent/metastatic cohort: biopsy from recurrent or metastatic site). HER2 status was redefined using the 2018 ASCO/CAP guidelines. OS and PFS were calculated (Kaplan-Meier method) based on redefined HER2 status and use of HER2 targeted therapy. Results: A total of 139 equivocal results were found. Primary cohort had 90 patients (33 received neoadjuvant and 57 adjuvant therapy). HER2 IHC results were 0 (6.6%), 1+ (37.7%), 2+ (50%), 3+ (1.1%), and no IHC (4.4%). 94% of HER2-equivocal results became HER2 negative. Only 5 patients received anti-HER2 therapy, all of them in the HER2-negative group. After median follow-up of 1.91 yrs, 3 deaths and 8 progressions had occurred. There was no statistically significant association between anti-HER2 therapy and OS (p = 0.67) or PFS (p = 0.49). The recurrence/metastatic cohort had 49 cases with equivocal results. HER2 IHC results were 0 (6.1%), 1+ (22.4%), 2+ (26.5%), and no IHC (44.9%). 55% of HER2-equivocal results became HER2 negative, and only 1 patient received anti-HER2 therapy. After median follow-up of 2.96 yrs, 15 deaths and 35 progressions had occurred. There was no statistically significant association between anti-HER2 therapy and OS (p = 0.61) or PFS (p = 0.78). Conclusions: Most HER2-equivocal results were redefined as HER2 negative using the new ASCO/CAP guidelines. Association between anti-HER2 therapy and OS or PFS according to the new HER2 status was not observed. Although this is a small sample with short follow-up, patients with HER2-equivocal breast cancers seem to have clinical behavior similar to HER2-negative breast cancer.

Nonprogrammable and programmable cerebrospinal fluid shunt valves: a 5-year study

2012 ◽  
Vol 9 (5) ◽  
pp. 462-467 ◽  
Author(s):  
Timothy J. Hatlen ◽  
David B. Shurtleff ◽  
John D. Loeser ◽  
Jeffrey G. Ojemann ◽  
Anthony M. Avellino ◽  
...  
Keyword(s):  
Survival Curve ◽  
Csf Shunt ◽  
Case Control Studies ◽  
Chi Square ◽  
Shunt Insertion ◽  
Term Survival ◽  
Kaplan Meier ◽  
Programmable Valves

Object Programmable valves (PVs) for shunting CSF have increasingly replaced nonprogrammable valves (NPVs). There have been only a few longer-term studies (≥ 5 years) conducted that have compared the effectiveness of NPVs with that of PVs for children with hydrocephalus, and only 1 study has reported NPVs as being favorable over PVs. The objective of this retrospective study was to compare the long-term survival of these 2 types of shunt valves. Methods The authors collected data for all patients who underwent CSF shunt insertion or revision between January 1, 2000, and December 31, 2008. Patients underwent follow-up for a minimum of 2 years postoperatively. Statistical analyses were done using chi-square, Kaplan-Meier survival curve, and multivariate analyses. Results A total of 616 valves were implanted, of which 313 were PVs and 303 were NPVs. Of these, 253 were original shunt implantations and 363 were revisions. The proportion of 5-year survival for NPVs (45.8%) was significantly higher than that for PVs (19.8%) (p = 0.0005, log-rank). The NPVs that survived longer than 6 months also survived through the 5th year better than the PVs (p = 0.0001). Conclusions The authors' data suggest that NPVs survive longer than PVs in children, but there is a need for prospective, case-control studies to confirm these data.

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