The 21-gene recurrence score and locoregional recurrence in breast cancer patients.

PURPOSE: Although the 21-gene recurrence score (RS) assay has been validated to assess the risk of distant recurrence in hormone receptor-positive breast cancer patients, the relationship between RS and the risk of locoregional recurrence (LRR) remains unclear. The purpose of this study was to determine if RS is associated with LRR in breast cancer patients and whether this relationship varies based on the type of local treatment [mastectomy or breast-conserving therapy (BCT)]. METHODS: 163 consecutive estrogen receptor-positive breast cancer patients at our institution had an RS generated from the primary breast tumor between August 2006 and October 2009. Patients were treated with lumpectomy and radiation (BCT) (n = 110) or mastectomy alone (n = 53). Patients were stratified using a pre-determined RS of 25 and then grouped according to local therapy type. RESULTS: Median follow-up was 68.2 months. Patients who developed an LRR had stage I or IIA disease, >2 mm surgical margins, and received chemotherapy as directed by RS. While an RS > 25 did not predict for a higher rate of LRR, an RS > 24 was associated with LRR in our subjects. Among mastectomy patients, the 5-year LRR rate was 27.3 % in patients with an RS > 24 versus 10.7 % (p = 0.04) in those whose RS was ≤ 24. RS was not associated with LRR in patients who received BCT. CONCLUSIONS: Breast cancer patients treated with mastectomy for tumors that have an RS > 24 are at high risk of LRR and may benefit from post-mastectomy radiation.

Mercury in soil and perennial plants in a mining-affected urban area from Northwestern Romania.

The mercury (Hg) concentrations were evaluated in soils and perennial plants sampled in four districts of Baia Mare city, a historical mining and ore processing center in Northwestern Romania. The results showed that the Hg concentration exceeded the guideline value of 1.0 mg kg(-1) dry weight (dw) established by the Romanian Legislation, in 24 % of the analyzed soil samples, while the median Hg concentration (0.70 mg kg(-1) dw) was lower than the guideline value. However, Hg content in soil was generally higher than typical values in soils from residential and agricultural areas of the cities all over the world. The median Hg concentration was 0.22 mg kg(-1) dw in the perennial plants, and exceeded the maximum level of Hg (0.10 mg kg(-1)) established by European Directive 2002/32/EC for plants used in animal feed in order to prevent its transfer and further accumulation in the higher levels of food chain. No significant correlations were found between soil Hg and other analyzed metals (Cd, Cu, Pb, Zn) resulted from the non-ferrous smelting activities, probably due to the different physicochemical properties, that led to different dispersion patterns.

c-kit expression in adenoid cystic carcinoma does not have an impact on local or distant tumor recurrence.

BACKGROUND: Adenoid cystic carcinoma (ACC) is a neoplasm with unpredictable behavior with frequent late relapses that lacks good prognostic indicators. c-kit tyrosine kinase oncogene has recently been found to be expressed in ACC. The aim of this study is to correlate the expression of c-kit in ACC with clinical follow-up. METHODS: Paraffin sections of 45 cases of ACC diagnosed during a 15-year period were immunostained for c-kit. RESULTS: Seventy-eight percent of tumors stained positive for c-kit. Mean follow-up time was 6 years. No degree/pattern of c-kit expression correlated to local or distant tumor recurrence. However, there was a significant association between surgical margin involvement by tumor and cell membrane expression of c-kit. Staining quality was not affected by storage time. CONCLUSIONS: Our results suggest that expression of c-kit may not serve as a useful marker for predicting outcome in ACC, although they need to be confirmed in a larger patient population with longer clinical follow-up.

Interpretive yields of screening Pap tests and diagnostic Pap tests.

Recently, our laboratory has introduced the Medicare classification "diagnostic Papanicolaou (Pap) test" (DPT) for both conventional and liquid-based Pap tests. Because little is known regarding the diagnostic yield of DPT, we review our experience with these tests in a community with a low incidence of squamous intraepithelial lesions and contrast this with our experience with screening Pap tests (SPTs). A search of our laboratory's computerized data system identified all Pap tests classified as SPT and DPT from December 3, 2002 to December 2, 2003. The interpretations were tabulated and statistical comparisons were made. Between December 3, 2002 and December 2, 2003 63,626 Pap tests were interpreted (57,922 SPTs and 5704 DPTs). DPTs were far more likely to yield abnormal results (atypical squamous cells or worse, P<0.001) and were especially more likely to yield malignant results. These differences have numerous possible implications regarding screening, rescreening, and the design of studies that investigate the screening value of the Pap test.

Reduced expression of early growth response-1 gene in leiomyoma as identified by mRNA differential display.

OBJECTIVES: Despite being the most common pelvic tumor in women, little is known about the molecular basis of uterine leiomyoma growth. The purpose of this study was to (1) identify genes important for leiomyogenesis by comparing gene expression in leiomyoma and normal myometrium and (2) examine the expression level of selected genes on a larger panel of leiomyomas. METHODS: The technique of mRNA differential display (DD) was used to perform a larger survey of gene expression in leiomyoma by comparing it to matched normal myometrium. Transcripts differentially expressed in leiomyoma were sequenced and further analyzed. Selected differentially expressed transcripts were used as probes on RNA blots of 20 pairs of leiomyomas and their matched myometria to evaluate their expression. The level of expression was analyzed by densitometry. RESULTS: From 80 differentially expressed transcripts picked by DD, 30 were sequenced and compared to GenBank data. Selected transcripts were analyzed for mRNA levels on a panel of 20 pairs of leiomyomas and matched normal myometria. One transcript that matches the early response gene EGR1 was found to be dramatically reduced (9.2 times on average) in leiomyomas. The reduction was present in 100% of the tumors. CONCLUSIONS: mRNA differential display is a valid method for finding differences in gene expression between leiomyoma and normal myometrium. The consistency and level of EGR1 mRNA reduction in leiomyoma is an indication that this gene may play a role in the origin or growth of leiomyoma.