Serum fetuin-A and RANKL levels in patients with early stage breast cancer.

Background: Breast cancer (BC) is the primary cause of mortality due to cancer in females around the world. Fetuin-A is known to increase metastases over signals and peroxisomes related with growing. Receptor activator of nuclear factor-kB ligand (RANKL) takes part in cell adhesion, and RANKL inhibition is used in the management of cancer. We aimed to examine the relationship between serum fetuin-A, RANKL levels, other laboratory parameters and clinical findings in women diagnosed with early stage BC, in our population. Methods: Women having early stage BC (n=117) met our study inclusion criteria as they had no any anti-cancer therapy before. Thirty-seven healthy women controls were also confirmed with breast examination and ultrasonography and/or mammography according to their ages. Serum samples were stored at -80°C and analysed via ELISA. Results: Median age of the patients was 53 (range: 57-86) while it was 47 (range: 23-74) in the healthy group. Patients had lower high-density lipoprotein levels (p=0.002) and higher neutrophil counts (p=0.014). Fetuin-A and RANKL levels did not differ between the groups (p=0.116 and p=0.439, respectively) but RANKL leves were found to be lower in the favorable histological subtypes (p=0.04). Conclusions: In this study, we found no correlation between serum fetuin-A levels and clinical findings in patients diagnosed with early stage BC. However, RANKL levels are found to be lower in subgroups with favorable histopathologic subtypes such as tubular, papillary and mucinous BC and there was statistically significant difference.

The Clinicopathologic Features of 22 Cases With Primary Invasive Papillary Carcinoma of the Breast Identified in 1153 Cases With Invasive Breast Carcinoma: Single-Center Experience.

Objective: Invasive papillary carcinoma (IPC) of the breast is an uncommon histologic subtype with limited data in the literature. The aim of this study was to increase the evidence base by presenting clinicopathological findings of cases diagnosed as IPC. Materials and Methods: Hematoxylin and eosin sections and immunostaining of surgical excision specimens diagnosed as invasive breast carcinoma were re-evaluated, retrospectively. Results: IPC was detected in 22 cases (1.9%), of which 7 (0.6%) had pure and 15 (1.3%) had mixed morphology. Histologic types accompanying IPC were: Invasive ductal carcinoma (IDC) (15/15); invasive micropapillary carcinoma (3/15); and pleomorphic lobular carcinoma (1/15). Patient ages ranged between 36 and 89 (median 56.5) and the tumor size from 8 to 70 mm (median 19 mm). The histologic grade was 3 in five cases, 2 in 13, and 1 in four cases. The nuclear grade was 3 in 10 cases and 2 in 12. The values of positivity for estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2, and Ki-67 index indicated Luminal B phenotype in 16 (72.7%), triple-negative in 5 (22.7%), and Luminal A in 1 case (4.6%). Ductal carcinoma in situ was noted in 19 cases (86.4%). Conclusion: IPC was mostly detected as an accompanying carcinoma to IDC at postmenopausal ages and was mostly Luminal B phenotype with intermediate-to-high grade features.

Investigation of the Presence of Integrin Alpha-3 and Beta-1 Receptors on Tumor Tissue, Metastatic Lymph Node and Normal Tissue in Thyroid Cancer.

Objectives: The important roles of integrins in tumor invasion, migration and proliferation are well known. In this study, we investigated the presence of integrin α3 and ß1 receptors in tumor tissue, metastatic lymph node (LN) and normal thyroid tissue of patients diagnosed with thyroid cancer (TCa) and showed the prognostic and diagnostic value of these molecules as well as peptide-receptor. Methods: Sixty-one patients with TCa were included in this study. The presence of integrin α3 and ß1 expression was investigated by immunohistochemical methods from tumor tissue after total thyroidectomy. TNM system was used in tumor staging. The relationship between prognostic properties such as tumor size, LN metastasis, capsular invasion and the presence of integrin α3 and ß1 expression was investigated. Results: Classical type papillary TCa was the most common subtype in our study group with 31.1%. Integrin ß1 was expressed in 4.9% (n=3) of normal tissue, 57.4% (n=35) of tumor tissue and 16.4% (n=10) of metastatic LN; integrin α3 was expressed in 50.8% (n=31) of normal tissue, 67.2% (n=41) of tumor tissue and 9.8% (n=6) metastatic LN. Integrin ß1 expression was observed 21.3% (n=13), integrin α3 in 14.8% (n=9) and integrin α3 and ß1 expression in 36.1% (n=22). Integrin ß1 expression increased statistically significantly in the presence of LN metastasis and capsular invasion (p=0.022, 0.014, respectively). Furthermore, the expression of integrin α3 was found to be statistically significant in primary tumors of patients with LN metastasis (p=0.045). Conclusion: Our study showed a significant increase in integrin α3 and ß1 expression in LN metastasis or thyroid capsule invasion in tumor. Thus, it appears that the demonstration of the presence of integrin α3 and ß1 expression in TCa is not only a prognostic biomarker but also has value as a potential theranostic target with peptide-bound radioactive agents.

Invasive Breast Carcinoma with Abundant Collagenous Stroma Shows Lower Level of CD68-Positive Tumor Associated Macrophages than Those of Invasive Carcinoma without Abundant Collagenous Stroma.

BACKGROUND AND AIM OF THE WORK: The significance of association between cancer and its stromal microenvironment has been recognized. We aimed to investigate the immunohistochemical staining features of D2-40 (podoplanin), SMA (smooth muscle actin) and CD68 (pan-macrophage marker) in patients with early stage invasive breast cancer with/out peritumoral PASH-like stroma. METHODS: The H&E sections of core needle biopsy specimens of invasive breast carcinomas diagnosed during one-year time period were reviewed in terms of the presence of accompanying PASH-like stroma retrospectively. Cases with similar pattern of growth in their surgical excision materials were included. Eight cases were grouped as 'Invasive tumor with PASH-like stroma' and 21 cases as 'Invasive tumor without PASH-like stroma', consecutively. The results of immunohistochemical staining for D2-40, SMA and CD68 were noted semiquantitatively as 'negative','weak', moderate' or 'strong'. RESULTS: CD68 was found significantly lower in invasive tumor with peritumoral PASH-like stroma than those of tumor without PASH-like stroma. No significant differences were found for SMA and D2-40 between two groups.  Conclusions: Tumor-associated macrophages (CD68 positive) in tumor stroma have been demonstrated in association with tumor behavior in several studies. The presence of peritumoral PASH-like stroma, which is poorly staining for CD68, might be a morphological clue for the behavior of tumor.

The Expression of Galectin-3 in Tumor and Cancer-Associated Fibroblasts in Invasive Micropapillary Breast Carcinomas: Relationship with Clinicopathologic Parameters.

OBJECTIVE: Galectin-3 affects tumor progression and cell surface polarization by expressing from the tumor and cancer-associated fibroblasts (CAFs). Therefore, it may have a role on micropapillary carcinomas (IMPC), which have characteristic morphological features. The aim was to investigate the expression levels of Galectin-3 within tumor and peritumoral CAFs in IMPC, and to compare with expression in invasive ductal carcinomas (IDC). MATERIALS AND METHODS: Hematoxylin and Eosin-stained preparations of resection materials examined between 2010-2016 were re-evaluated. Thirty-four IMPC cases and 34 IDC cases with similar molecular subtype distribution to IMPC were compared. Galectin-3 levels were evaluated with a calculated H-score in tumor and semi-quantitatively in CAFs. RESULTS: While tumoral Galectin-3 expression levels were higher in IMPCs compared to IDCs, there was no difference for Galectin-3 expression in CAFs between the two histologic types. However, there was no significant relationship between tumoral Galectin-3 expression and clinicopathological parameters in IMPCs. When the subjects were divided into two groups, depending on their Galectin-3 status regardless of histological types, the loss of Galectin-3 expression in tumor was found to be related to larger tumor size/advanced pT stage and a greater number of metastatic nodes. Additionally, expression of Galectin-3 in CAFs was found to be associated with distant metastasis. CONCLUSION: IMPC showed prominent Galectin-3 expression in tumor compared to IDC. However, independent from the histological type, whereas the loss of Galectin-3 expression in tumor showed an association with larger tumor size and higher number of metastatic axillary lymph nodes, the presence of Galectin-3 expression in CAFs showed an association with distant metastasis.

Alternative volumetric PET pjmirometers for evaluation of breast cancer cases with 18F-FDG PET/CT imaging: Metabolic tumour volume and total lesion glycolysis.

INTRODUCTION: We aimed to investigate the prognostic and clinical values of two volumetric PET pjmirometers used in conjunction with SUVmax at different thresholds in invasive ductal carcinoma (IDC). METHODS: A total of 139 metastatic IDC BC who underwent 18F-FDG PET/CT imaging were included to study. MTV and TLG (40%, 50%, 60% and 70%) used in conjunction with primary tumour SUVmax . Nodal involvement, distant metastasis, ER, PR, Ki-67 expression and survival data evaluated by comparing FDG PET pjmirometers. RESULTS: Mean ± SD SUVmax of lesions (n = 139) was 13.97 ± 9.21. Primary tumour 18F-FDG uptake associated increased tumour diameter (>2 cm), high Ki-67 (>15%) and distant organ metastasis (DOM) (P = 0.015, 0.005 and 0.016, respectively). There was significant association between molecular subtypes and SUVmax (P = 0.002). High MTV associated with tumour diameter (MTV 40-70%), axillary lymph node (ALN) diameter (MTV 40-70%), and distant nodal metastasis (DNM) (MTV 50-70%). High TLG associated with tumour diameter (TLG 40-70%), high Ki-67 (TLG 40-70%), ALN metastasis (TLG 40%), ALN diameter (TLG 40-70%) and DNM (TLG 40-70%). Median survival found shorter in DOM patients (P = 0.030, Log Rank = 0.110). CONCLUSION: We think evaluation of MTV and TLG at different thresholds in addition to SUVmax would enhance diagnostic and prognostic value of 18F-FDG PET/CT, and thus contribute to disease management.

Preventive role of superoxide dismutase on radiation-induced periprosthetic capsule development.

BACKGROUND: Capsule fibrosis is the most important and annoying complication of breast implant surgery. Radiotherapy (RT) used in the local treatment of breast cancer has an increasing effect on the existing fibrous capsule; this is called radiation-induced fibrosis (RIF). In this randomized controlled experimental study, we aim to investigate the reduction effect of superoxide dismutase (SOD) on RIF. METHODS: Sprague-Dawley rats were randomized into four groups, all of which were subjected to implant surgery. No additional procedures were done for the control group. The other groups were the SOD group, the RT + SOD group, and the RT group. The capsules were evaluated histopathologically. RESULTS: Although SOD reduced surgery-induced capsule formation, it neither prevented nor reduced significantly RIF. CONCLUSIONS: In an experimental model that resembled breast cancer treatment, we concluded that SOD cannot reduce RIF but is effective in reducing capsular fibrosis around the silicone after implant surgery.