Application of biomarkers in sentinel lymph node biopsy for the management of breast cancer

Objective Sentinel lymph node in breast cancer is a predictor of the tumor's metastatic potential.Cytokines emerging from antitumor immune response might also target sentinel lymph node (SLN).In this study,we evaluated the cytokine profile including interleukin-8 (IL-8),interleukin-12 (IL-12),interferon-gamma (IFN-γ),and tumor necrosis factor alpha (TNF-α) for the T-cell response.Methods From January 2008 to August 2010,35 patients with breast mass underwent SLN biopsy in UNIMED Medical Institute.The specimens were formalin-fixed and paraffin-embedded for hematoxylin and eosin staining and immunohistochemistry with following markers:IL-8,IL-12,IFN-γ and TNF-α.The staining intensity was scored according to four grades:negative (-),weak expression (+),moderately positive expression (+ +),strong positive expression (+ + +).The correlation between the expression of cytokines and pathological characteristics were also analyzed using the Spearman Rank Correlation test.Results Out of 35 patients,SLN metastases were observed in 20 patients and among them,75% (15 /20) were strongly stained (+ + +) with IL-8 and moderately stained (+ +) with IL-12,but only 25% (5 /20) were strongly stained (+ + +) with IFN-γ and TNF-α.The expression of IL-8 was significantly associated with all tumor grades (r=0.639,P=0.00),estrogen receptor (r=0.778,P=0.01),progesterone receptor (r=0.759 P=0.00) and HER-2 /neu receptor (r=0.863 P=0.00).Conclusion The strong association between IL-8 expression and SLN metastases might highlight the prognostic significance of IL-8 in SLN.

Aberrant methylation of Glutathione S-transferase P1 and E-cadherin in invasive ductal breast carcinoma and fibroadenoma

Objective To investigate the hypermethylation status of glutathione transferase P1(GSTP1)and E-cadherin(ECAD),TSGs(tumor suppressor genes)in our breast cancer samples and explore their correlation with clinicopathological features of corresponding cancer patients.Methods One hundred and thirty-six IDC(invasive ductal carcinoma)patients were recruited for analysis and 16 fibroadenoma patients acted as control.DNA extraction and methylation-specific PCR(MSP)were subsequently performed preceded by pathological examination.Results The percentage of hypermethylated GSTP1 in carcinoma and fibroadenoma groups was 34.92% and 15.79% respectively and the percentage of hypermethylated ECAD in carcinomas and fibroadenomas was 18.00% and 0.00% respectively.Carcinoma had the highest percentage of c-erbB2 overexpression being 54.55% among the clinicopathological parameters.Conclusion Hypermethylation patterns are frequent in IDC and seem to relate to c-erbB2 overexpression,and such epigenetic change should not be neglected in fibroadenoma.Tumor methylation status in cancer patients can be determined at early stage and it may be a reference for better treatment planning.

Individualized therapy for breast cancer:a decade of improvement

Breast cancer is the most prevalent female cancer in both the developed and less developed world.According to WHO 2013 estimates,there were over 522 000 female breast cancer deaths in2012[1].Breast cancer(1.7 million)was the second commonly diagnosed cancer worldwide after lung cancer(1.8 million),and followed by colorectal cancer(1.4 million)[1].In

Effect of Tai Chi Chuan on serotonin and cortisol for monitoring stress and quality of life in post-treatment breast cancer patients

Objective Immediate physical exercise has been recommended for patients in the recovery phase to improve survival and quality of life(QOL)and reduce recurrence of disease.The new NCCN Guidelines for Survivorship also highlighted the role of exercise in post-cancer health,encouraging patients to perform light physical activity following treatment.The aim of our study is to effect of Tai Chi Chuan(TCC)on serotonin and cortisol for monitoring stress and QOL in post-treatment breast cancer patients.Methods Totally85 post-treatment breast cancer patients were enrolled in this study to observe the effects of practicing TCC on recovery,as well as stress and happiness which are indicators of QOL of in patients.Peripheral blood was drawn from study subjects to analyze the levels of serotonin,cortisol and high sensitive C-reactive protein(HSCRP)at baseline,and at 3,6 and 12 months of TCC practice.Blood was drawn from healthy subjects only at baseline.A QOL questionnaire was administered to study subjects at three time points throughout the study,and once for healthy controls.The data were processed by analysis of variance of repeated measurement.Results At 3,6 and 12 months time points following regular TCC exercise,WBC,RBC,hemoglobin in blood samples showed a statistically significant difference(F=161.55,172.14,289.73;all P=0.00);the level of serotonin(biomarker for well-being),cortisol(indicator of stress)and HS-CRP(biomarker for inflammation)showed a statistical improvement(F=307.46,182.85,102.23;all P=0.00).After 3,6 and 12 months of regular TCC exercise,according to the results of QOL questionnaire,the indicators including quality of sleep,perceived hunger,fatigue,contentment,stress and social interaction presented a significant difference(F=312.98,222.64,543.90,46.05,28.10,78.92,all P<0.05),while there was no statistical difference in life dissatisfaction(F=56.61,P=0.166)Conclusions TCC physical activity for post-treatment breast cancer patients improved QOL and overall well-being,leading to improved mental,physical and psychological functioning.Regulated levels of serotonin and cortisol mediated by TCC exercises are proved to be vital for continued good health.

Expression of cancer stem cell surface markers after chemotherapeutic drug treatment to reflect breast cancer cell regrowth

Objective To detect the cell viability and the expressions of stem cell surface markers after chemotherapeutic drug treatment.Methods We observed the cytotoxic effects of three chemotherapeutic agents[epirubicin(Epi),fluorouracil(5-FU)and cyclophosphamide(Cyc)]in three cell lines,and the cell viabilities after removed these chemotherapeutic agents.Expressions of stem cell surface markers CD44,CD24,CD90,CD14 and aldehyde dehydrogenase1(ALDH1)in breast cancer cells were analyzed by real-time PCR.The post hoc analysis(Tukey’s tests)in conjunction with one-way ANOVA was used for statistical analysis.Results The initial cytotoxic efficacy was most notable.After the treatment of the same therapeutic agents,cell viability was decreased by 64.8%35.14%,32.25%in BT-483 cells,66.4%,22.94%and 45.88%in MDA-MB-231 cells,97.1%,99.5%and 76.4%in MCF cells.The difference was significant compared with that before treatment(P=0.000).However,the inhibitory effects were diminished after chemotherapeutic agent withdrawal.Cell viabilities were increased to 167.9%,212.04%and 188.66%in MDA-MB-231 cells at48 h after withdrawal.At 72 h after withdrawal,cell viability was increased with a significant difference in three cell lines(all P values=0.000).Expressions of CD44 and ALDH1 were most prevalent for MDA-MB-231,BT-483 and MCF-7 cells.ALDH1 mRNA level was significant higher in BT-483(HER-2 overexpression cell line)than MDA-MB-231(triple negative cell line)(P=0.012).CD14 mRNA level in MCF-7 cells were significantly lower than that in MDA-MB-231 and BT-483(P=0.003,0.001).BT-483 showed significantly higher level of CD44 than MDA-MB-231 and MCF-7 cell line(P=0.013,0.020),and no significant difference was detected between MDA-MB-231 and MCF-7 breast cancer cells(P=0.955).CD90 mRNA expressions were detected in MDA-MB-231 cells and MCF-7 cells,but not in BT-483 cells.Conclusion Some malignant cells could survive in vitro and begin to proliferate again between cycles of chemotherapy.

Overview of breast cancer prevention:what's the next?

Breast cancer is the leading cause of death among women at the ages of 20-59 years[1].The incidence of breast cancer in Asia is also shown to be increasing recently,especially in the more affluent cities,and the peak incidence of breast cancer is at the age of 45-50 years[2].Breast cancer prevention has started from secondary prevention strategy of early detection of the disease with different modalities in Asia[3-5]despite the absence of unified nationwide screening program.There are a lot