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Purpose@#PIK3CA and TP53 are the most prevalently mutated genes in breast cancer (BC).Previous studies have indicated an association between concomitant PIK3CA/TP53 mutations and shorter disease-free survival. As its clinical utility remains largely unknown, we aimed to analyze the prognostic and predictive roles of this co-mutation. @*Methods@#We retrospectively analyzed patients who were diagnosed with BC at Guangdong Provincial People’s Hospital (GDPH) who underwent next-generation sequencing. The correlation of concomitant PIK3CA/TP53 mutations with clinicopathological and mutational characteristics, and neoadjuvant systemic therapy (NST) responses was analyzed. The Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) dataset was used to verify associations between concurrent mutations and survival outcomes. @*Results@#In the GDPH cohort, concomitant PIK3CA/TP53 mutations were associated with more aggressive phenotypes, including human epidermal growth factor receptor 2 positive status, hormone receptor negative status, high Ki-67 expression, high histological grade, advanced TNM stage, and additional genetic alterations. Co-mutations also portended a worse response to NST, especially taxane-containing regimens, when compared with the TP53 mutant alone (odds ratio, 3.767; 95% confidence interval, 1.205–13.087; p = 0.028). A significant association was observed between concomitant PIK3CA/TP53 mutations and poor survival outcomes in the METABRIC cohort. @*Conclusion@#Concomitant PIK3CA/TP53 mutations not only suggested unfavorable features and poor prognosis in BC but also conferred less benefit to NST than TP53 mutations alone.
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Objective To evaluate the perfusion findings of solitary brain metastasis using MR arterial spin labeling (ASL)imaging,and make a comparison with dynamic susceptibility contrast (DSC)imaging.Methods Twenty-three patients with pathologically proven solitary brain metastasis from lung cancer underwent ASL and DSC imaging.The ASL cerebral blood flow (CBF),DSC regional CBF (rCBF)and DSC regional cerebral blood volume (rCBV)were measured and compared between the tumor and the contralateral brain parenchyma.Pearson correlation test was performed to assess the relations between ASL and DSC measurements.Results Brain metastasis showed ring-like hyper-perfusion on ASL and DSC mappings.ASL CBF values of the tumor and the contralateral brain parenchyma were(54.872±21.131)mL·min-1·100 g-1and (21.109±4.788)mL·min-1·100 g-1,respectively (P<0.01).DSC rCBF values of the tumor and the contralateral brain parenchyma were (1.094 8±0.309 3)mL·min-1·100 g-1and (0.495 7±0.154 1)mL· min-1·100 g-1,respectively (P<0.01).DSC rCBV values of the tumor and the contralateral brain parenchyma were (1.753 1±0.545 5)mL/100 g and (0.729 9±0.215 8)mL/100 g,respectively (P<0.01).There was a strong correlation between ASL CBF and DSC rCBF (r=0.898,P<0.01),and there was no correlation between ASL CBF and DSC rCBV.Conclusion ASL can evaluate the CBF of brain metastasis as DSC dose. It requires no contrast agent administration and can be used in daily clinical practice.