The potential of mRNA expression evaluation in predicting HER2 positivity in gastroesophageal cancer

Gastroesophageal cancer (GEC) is an aggressive disease characterized by a high frequency of metastasis and poor overall survival rates. GEC presents HER2 overexpression in 5 to 25% of tumors eligible for HER2-targeted therapy. HER2 evaluation requires protein levels and copy number alteration analyses by immunohistochemistry (IHC) and in situ hybridization (FISH or SISH), respectively. These are semiquantitative methodologies that need an expert and well-trained pathologist. Therefore, the use of new surrogate methods for HER2 evaluation in cancer, such as gene expression analysis, might improve GEC HER2 classification. We evaluated HER2 positivity in GEC through conventional IHC and SISH analyses and investigated the potential application of HER2 mRNA expression by quantitative PCR to categorize GEC samples as HER2-positive or HER2-negative. Among 270 GEC samples, 10.9% were HER2-positive by IHC and SISH analyses. HER2 mRNA was overexpressed in HER2-positive GEC samples and presented high accuracy in distinguishing those tumors from HER2-negative GEC. Nevertheless, HER2 mRNA analysis was not capable of classifying HER2-equivocal GEC samples into HER2-positive or -negative according to SISH data. Quantitative PCR analysis showed HER2 overexpression in HER2-positive GEC samples. Nevertheless, HER2 mRNA analysis failed to classify HER2-equivocal GEC according to SISH data.

MET overexpression and intratumor heterogeneity in esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma (ESCC) is among the ten most frequent and deadly cancers, without effective therapies for most patients. More recently, drugs targeting deregulated growth factor signaling receptors have been developed, such as HGF-MET targeted therapy. We assessed MET and HGF genetic alterations and gene and protein expression profiles in ESCC patients from the Brazilian National Cancer Institute and publicly available datasets, as well as the intratumor heterogeneity of the alterations found. Our analyses showed that HGF and MET genetic alterations, both copy number and mutations, are not common in ESCC, affecting 5 and 6% of the cases, respectively. HGF showed a variable mRNA expression profile between datasets, with no alterations (GSE20347), downregulation (GSE45670), and upregulation in ESCC (our dataset and GSE75241). On the other hand, MET was found consistently upregulated in ESCC compared to non-tumor surrounding tissue, with median fold-changes of 5.96 (GSE20347), 3.83 (GSE45670), 6.02 (GSE75241), and 5.0 (our dataset). Among our patients, 84% of the tumors showed at least a two-fold increase in MET expression. This observation was corroborated by protein levels, with 55% of cases exhibiting positivity in 100% of the tumor cells. Intratumor heterogeneity was evaluated in at least four tumor biopsies from five patients and two cases showed a consistent increase in MET expression (at least two-fold) in all tumor samples. Our data suggested that HGF-MET signaling pathway was likely to be overactivated in ESCC, representing a potential therapeutic target, but eligibility for this therapy should consider intratumor heterogeneity.

Curto período de imobilização provoca alterações morfométricas e mecânicas no músculo de rato / Short-term immobilization causes morphometric and mechanical alterations in rat muscles

OBJETIVO: Analisar as características morfométricas e mecânicas dos músculos sóleo e gastrocnêmio após imobilização na posição de encurtamento. MÉTODO: 20 ratos Wistar (250 ± 20g) foram distribuídos igualmente em grupos imobilizado e controle. A imobilização foi realizada no membro posterior esquerdo por meio de órtese de resina acrílica, com a articulação do tornozelo em flexão plantar máxima. Após 7 dias da imobilização, a massa muscular, número e comprimento de sarcômeros em série, área das fibras musculares, densidade de área de tecido conjuntivo intramuscular e força máxima de ruptura do tríceps sural foram avaliados. Os dados foram analisados pela ANOVA e teste de Tukey (p< 0,05). RESULTADOS: O músculo sóleo imobilizado apresentou alterações em todas as variáveis morfométricas analisadas, enquanto que, no músculo gastrocnêmio, algumas adaptações não foram observadas. Na análise do ensaio de tração, o grupo imobilizado apresentou redução de 20 por cento na força máxima de ruptura muscular. CONCLUSÃO: Os resultados deste estudo revelaram que curto período de imobilização promove alterações nos parâmetros morfométricos das fibras musculares, com repercussões na mecânica muscular. Tais resultados permitem sugerir a necessidade da reabilitação em músculos submetidos à imobilização, mesmo a curto prazo, para que a mesma possibilite o retorno precoce das características musculares normais.

OBJECTIVE: to analyze the morphometric and mechanical characteristics of the soleus and gastrocnemius muscles after immobilization in a shortened position. METHODS: 20 Wistar rats (250 ± 20g) were divided equally into immobilized and control groups. The left hind limb was immobilized by means of an acrylic resin orthosis, with the ankle joint at maximum plantar flexion. After seven days of immobilization, the muscle mass, number and length of sarcomeres in series, muscle fiber cross-sectional area, density of the intramuscular connective tissue area and tensile strength of the triceps surae muscle were evaluated. The data were analyzed by the ANOVA and Tukey tests (p< 0.05). RESULTS: The immobilized soleus muscle presented changes in all the morphometric variables analyzed, while some of these changes were not observed in the gastrocnemius muscle. Analysis of the traction test showed that the immobilized group presented a 20 percent decrease in the maximum tensile muscle strength. CONCLUSION: The results from this study showed that short-term immobilization causes changes to the morphometric parameters of the muscle fibers, with repercussions on muscle mechanics. These results suggest the need for rehabilitation of muscles subjected to immobilization, even if only for a short period, in order to achieve early recovery of normal muscle characteristics.

Correlation of mixed lymphocyte culture with chronic graft-versus-host disease following allogeneic stem cell transplantation

The purpose of the present study was to evaluate the mixed lymphocyte culture as a predictive assay of acute and chronic graft-versus-host disease (GVHD). We studied 153 patients who received a first bone marrow transplantation from human leukocyte antigen-identical siblings. Acute GVHD was observed in 26 of 128 (20.3 percent) patients evaluated and chronic GVHD occurred in 60 of 114 (52.6 percent). One-way mixed lymphocyte culture (MLC) assays were performed by the standard method. MLC results are reported as the relative response (RR) from donor against patient cells. The responses ranged from -47.0 to 40.7 percent, with a median of 0.5 percent. The Kaplan-Meier probability of developing GVHD was determined for patients with positive and negative MLC. There was no significant difference in incidence of acute GVHD between the groups studied. However, the incidence of chronic GVHD was higher in recipients with RR >4.5 percent than in those with RR <=4.5 percent. The Cox Proportional Hazards model was used to examine the effect of MLC levels on incidence of chronic GVHD, while adjusting for the potential confounding effect of others suspected or observed risk factors. The relative risk of chronic GVHD was 2.5 for patients with positive MLC (RR >4.5 percent), 2.9 for those who received peripheral blood progenitor cells as a graft, and 2.2 for patients who developed previous acute GVHD. MLC was not useful for predicting acute GVHD, but MLC with RR >4.5 percent associated with other risk factors could predict the development of chronic GVHD, being of help for the prevention and/or treatment of this late complication

Retinoblastoma. A importancia da tomografia computadorizada. / Retinoblastoma: the value of the computed tomography

Os autores relatam um caso de retinoblastoma com ecografia e estudam a importancia da tomografia computadorizada no diagnostico da invasao do nervo optico