Transferred-tissue Microarray for Fluorescence In Situ Hybridization Test for Human Epidermal Growth Factor Receptor 2 in Breast Cancer.

CONTEXT: Human epidermal growth factor receptor 2 (HER2) status of breast carcinomas is usually determined by immunohistochemical (IHC) staining and, if the IHC results are equivocal, in situ hybridization (ISH). Multiple ISH tests are sometimes required for multiple primary or metastatic tumors. A method for multiplex ISH test on tissues from multiple blocks is helpful in these situations. OBJECT: To evaluate the clinical application of transferred-tissue microarray (TTM) followed by a dual-probe HER2 fluorescence in situ hybridization (FISH). DESIGN: A 3×3 TTM technique was successfully established using 152 invasive mammary carcinoma tissue fragments. To evaluate detection of HER2 positive tumors, this cohort was enriched with tumors with IHC scores of 2 and 3. RESULTS: The HER2 FISH analyses revealed that all transferred-tissue fragments were adequate for determining HER2 amplification. Tissue loss was minimal and had no major adverse effects on interpretation of the test results. Of the 81 tumors with IHC scores of 3, 72 (88.8%) were positive for HER2 FISH. The remaining tumors were negative for HER2 FISH in both TTM and reflex whole tissue section. Finally, FISH results for tumors with IHC scores of 2 were compared between TTM and whole tissue section. Concordance was high in overall positivity/negativity (100%), HER2 copy number (97.5%), and HER2/CEP17 ratio (100%). CONCLUSIONS: This novel technique is a reliable option for performing multiple HER2 FISH tests simultaneously in clinical and research-oriented settings with less tissue damage compared with conventional tissue microarray techniques.

Expressions of p16 and p27 in urothelial carcinoma and their prognostic value.

Expressions of human p16 and p27 were tested for correlations with clinicopathologic features of urothelial carcinoma (UC). Tissue microarrays (TMA) constructed from paraffin-embedded specimens from 78 patients with UC were analyzed by immunohistochemical staining. In 49 of the 78 tumors (63%), high p16 expression was associated with absence of tumor invasiveness and low-grade carcinoma (p = 0.003 and p = 0.046, respectively). The p27 expression was high in 33 of the 78 tumors (42%) and showed a significant negative association with invasiveness, carcinoma grade, and tumor size (p = 0.016, p = 0.046, and p = 0.014, respectively). Kaplan-Meier analysis indicated that patients with high p27 levels had longer than average overall survival (p = 0.021). This study demonstrates that p16 and p27 are prognostic indicators of tumor stage and grade in UC and that they provide clinicians with the ancillary information needed for selecting suitable therapeutic strategies.

Aberrant deleted in liver cancer-1 expression is associated with tumor metastasis and poor prognosis in urothelial carcinoma.

This study explored the potential role of deleted in liver cancer-1 (DLC-1) as a prognostic indicator of cancer metastasis and survival in urothelial carcinoma (UC). Tissue microarrays were constructed from paraffin-embedded specimens from 88 UC patients, and immunohistochemical staining was performed to investigate the association of DLC-1 with clinicopathologic characteristics and clinical outcome. The DLC-1 expression showed a significant positive correlation with tumor location (p = 0.041) and a significant negative correlation with advanced histological grade (p = 0.013). In tumors with low DLC-1 expression, Bcl-2 positivity was observed in 24.4% of cases. The DLC-1 expression had significant negative associations with Bcl-2 expression (p = 0.032) and with highly metastatic UC (p = 0.032). Kaplan-Meier analysis showed that DLC-1 protein expression was negatively associated with both overall survival (OS) (p = 0.035) and with distant metastasis-free survival (DMFS) (p = 0.041), but not with disease-free survival. Multivariate analyses indicated that tumor size was the significant independent predictors of OS (p = 0.048); however, only DLC-1 expression was a significant independent predictor of DMFS (p = 0.019). In conclusion, reduced DLC-1 protein expression may be an important factor in tumor progression and a useful prognostic molecular marker in UC.

Overexpression of cyclooxygenase-2 in urothelial carcinoma in conjunction with tumor-associated-macrophage infiltration, hypoxia-inducible factor-1alpha expression, and tumor angiogenesis.

This study examines whether the expression of cyclooxgenase-2 (COX-2) in urothelial carcinoma (UC) is associated with macrophage infiltration, hypoxia-inducible factor-1alpha (HIF-1alpha) expression and angiogenesis. We investigated the expression of COX-2 associated with HIF-1alpha and performed double immunohistochemical analysis of 216 UCs for COX-2 expression and the correlation with tumor-associated-macrophage (TAM) density and microvessel density (MVD) in situ. A high expression of COX-2 was positively correlated with tumor invasiveness, histologic grade and HIF-1alpha expression in UC (p<0.0001, p=0.003, p<0.0001, respectively). Quantification of double staining of COX-2/CD34 and COX-2/CD68 showed that a higher MVD and TAM density was found in COX-2 high-expression than in COX-2 low-expression tumor fields (p<0.0001). Adjacent to the principal of COX-2 expression areas, MVD value and TAM density were significantly increased in HIF-1alpha high-expression specimens compared with HIF-1alpha low-expression ones (p<0.0001). Interestingly, our data revealed that high COX-2 expression (p=0.002), high HIF-1alpha expression (p<0.0001) and TAM density (p<0.0001) were all associated with high MVD value. Our results suggest that COX-2 may produce a cooperative effect in promoting tumor progression and may be involved in the process of angiogenesis through increasing TAM infiltration or HIF-1alpha regulation by hypoxia.

Pioglitazone retrieves hepatic antioxidant DNA repair in a mice model of high fat diet.

BACKGROUND: Pioglitazone was reported to improve hepatic steatosis and necroinflammation in human studies. To investigate whether the hepato-protective effect of pioglitazone was associated with an improvement of antioxidant defense mechanism, oxidative DNA damage and repair activity were determined in a high fat diet model. Male C57BL/6 mice were respectively fed with a 30% fat diet, the same diet with pioglitazone 100 mg/kg/day, or a chow diet as control for 8 weeks. Tissue oxidative stress was indicated by malondialdehyde concentration. Oxidative DNA damage was detected by immunohistochemical 8-oxoG staining. Enzymatic antioxidant defense was detected by the real-time PCR of superoxide dismutase (Sod1, Sod2) and DNA glycosylase (Ogg1, MutY). Oxidative DNA repair was detected by immunohistochemical staining and western blotting of OGG1 expression. RESULTS: Our results show that hepatic steatosis was induced by a high-fat diet and improved by adding pioglitazone. Malondialdehyde concentration and 8-oxoG staining were strongly increased in the high-fat diet group, but attenuated by pioglitazone. Gene expressions of antioxidant defense mechanism: Sod1, Sod2, Ogg1 and MutY significantly decreased in the high-fat diet group but reversed by pioglitazone co-administration. CONCLUSION: The attenuation of hepatic oxidative DNA damage by pioglitazone in a high-fat diet may be mediated by up-regulation of the antioxidant defense mechanism and oxidative DNA repair activity. The diminution of oxidative damage may explain the clinical benefit of pioglitazone treatment in patients with non-alcoholic fatty liver disease.

Immunoexpression and prognostic role of hTERT and cyclin D1 in urothelial carcinoma.

The aim was to investigate the expression of human telomerase reverse transcriptase (hTERT) and cyclin D1 in correlation with clinicopathologic features of urothelial carcinoma (UC). Tissue microarrays (TMA) were constructed from paraffin-embedded specimens of 94 UC patients and immunohistochemical staining was used. High hTERT expression was found in 50 (53%) of the 94 tumors and was significantly associated with tumor invasiveness and tumor grade (P=0.008 and 0.0190, respectively). High cyclin D1 expression was found in 69 (73%) of the 94 tumors and was significantly associated with non-invasiveness and smaller tumor size, but there was no correlation with tumor grade. Kaplan-Meier analysis indicated that patients with low hTERT and high cyclin D1 levels had longer local recurrence-free survival (P=0.0482 and 0.0123, respectively). In addition, patients with high cyclin D1 levels had longer disease-free survival (P=0.0195). In conclusion, this study demonstrated that hTERT and cyclin D1 may be of recurrence predictive value for UC, thus providing clinicians with ancillary information when deciding on suitable therapeutic strategies in UC.

A simple and economical method for the manual construction of well-aligned tissue arrays.

Tissue array technology has allowed a substantial progression of studies correlating molecular and immunohistochemical findings with clinico-pathological information. Array construction presents technical difficulties and tissue arrayers are expensive, particularly for small and medium sized laboratories. We describe a simple manual method for producing well-aligned tissue arrays using a hand-made paper mold which can successfully perform immunohistochemical staining. All 200 tissue samples were collected and constructed into blocks by the paper mold. The tissue arrays were smoothly sectioned using a standard microtome and performed for a panel of immunohistochemical study with satisfactory results. This alterative method for building custom arrays could be applied in any laboratory and is both simple and economical.