Prognostic Relevance of Progesterone Receptor Levels in Early Luminal-Like HER2 Negative Breast Cancer Subtypes: A Retrospective Analysis
Anna DianaFrancesca CarlinoGiuseppe BuonoGiuliano AntoniolVincenzo FamigliettiCarmine De AngelisSimone CarranoAntonio PiccoloFerdinando De VitaFortunato CiardielloBruno DanieleGrazia ArpinoMichele Orditura
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Abstract:
In luminal-like early breast cancer (BC), the lack of Progesterone Receptor (PR) expression generally correlates with more aggressive behavior but the clinical validity of low PR levels remains a debated issue.The main aim of this retrospective analysis was to assess the survival outcome (Breast cancer specific survival, BCSS) in a cohort of 687 luminal-like HER2 negative early BC patients treated at our Institutions from January 2000 to December 2018, using a sub-classification of tumors in subgroup 1 (PR high/Ki67 low), subgroup 2 (PR high/Ki67 high), subgroup 3 (PR low/Ki67 low), subgroup 4 (PR low/Ki67 high) according to PR and Ki67 values.At a median follow-up of 7 years, BCSS rates were 96.3%, 89%, 86.8% and 85% in the subgroup 1, 2, 3, 4 respectively. Overall, a statistically significant difference in BCSS rates was observed among the 4 subgroups (p=0.0036). On univariate analysis, post-menopause, older age (≥ 50 years), low PR and high Ki67 expression, poorly differentiated grade and size ≥ 2 cm as well as luminal B-like tumors (subgroups 2, 3, 4) were significantly associated with a worse BCSS. Multivariate analysis identified grade, size and subgroup classification of BC as independent prognostic markers of poorer outcome. In particular, subgroups 4, 3 and 2 displayed a significantly higher risk of BC-related death (HR=4.11; p=0.008; HR=3.43; p=0-007; HR=2.57; p=0.020, respectively) when compared to subgroup 1.Our results support the usefulness of PR and Ki67 levels as prognostic markers, corroborating their crucial role in the decision-making process of patients with luminal-like HER2 negative early BC. Clinical application of these parameters should be assessed prospectively.Keywords:
Subgroup analysis
Univariate analysis
Progesterone receptor
The aim of this study was to evaluate the relationship between platelet-lymphocyte ratio (PLR) and prognosis in small cell lung cancer (SCLC) patients.A comprehensive search was carried out to collect related studies. Two independent investigators extracted the data of hazard ratio (HR) and 95% confidence interval (CI) for overall survival (OS) or progression-free survival (PFS). A random-effect model was applied to analyze the effect of different PLR levels on OS and PFS in SCLC patients. Moreover, subgroup analysis was conducted to seek out the source of heterogeneity.A total of 26 articles containing 5,592 SCLC patients were included for this meta-analysis. SCLC patients with a high PLR level had a shorter OS compared with patients with a low PLR level, in both univariate (HR = 1.56, 95% CI 1.28-1.90, p < 0.0001) and multivariate (HR = 1.31, 95% CI 1.08-1.59, p = 0.007) models. SCLC patients with a high PLR level had a shorter PFS compared with patients with a low PLR level, in the univariate model (HR = 1.71, 95% CI 1.35-2.16, p < 0.0001), but not in the multivariate model (HR = 1.17, 95% CI 0.95-1.45, p = 0.14). Subgroup analysis showed that a high level of PLR shortened OS in some subgroups, including the Asian subgroup, the younger subgroup, the mixed-stage subgroup, the chemotherapy-dominant subgroup, the high-cutoff-point subgroup, and the retrospective subgroup. PLR level did not affect OS in other subgroups.PLR was a good predictor for prognosis of SCLC patients, especially in patients received chemotherapy dominant treatments and predicting OS.https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022383069.
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Abstract BackgroundBilateral breast cancer (BBC) is defined as breast cancer diagnosed in both breasts in the same patient. Neoadjuvant chemotherapy (NAC) is a well-established approach to evaluate the tumor response to chemotherapeutic agents. The consensus is that different responses in characteristics after NAC can affect prognosis in unilateral breast cancer (UBC), but little is known about the responses of the BBC to NAC. This analysis explored the characteristics that can affect the prognosis of patients with BBC.MethodsThe characteristics of patients diagnosed with BBC (n = 126) was collected and the immunohistochemistry staining was used to detect expression levels of estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2. A statistical analysis of the differences was performed to identify the factors that affect survival times in all patients with BBC.ResultsA logistic regression indicated that the status of sentinel and axillary lymph node, expression of PR of the right breast tumor, and molecular subtype of the right breast tumor might relate to survival times. Tumor size, status of axillary lymph node, clinical stage, tumor type, histological grade, and molecular subtype of the left breast tumor might have a more profound effect on the survival time than the right breast tumor in the synchronous breast cancer (SBBC) patients. A multivariate analysis of overall survival times in patients with metachronous breast cancer (MBBC) showed that age was the only factor affecting survival time. After NAC treatment in SBBC patients, the Kaplan-Meier survival estimate showed that a decrease in tumor size, clinical stage, Ki67 and P53 levels were positive for a prolonged life span. However, a decrease in ER, PR, and HER2 were negative for prolonged life span. Changes in tumor type and molecular subtype also influenced the survival time.ConclusionCharacteristic changes in the left breast tumor were significant factors affecting survival times in patients with SBBC. After NAC treatment, changes in tumor size, Ki67, P53, ER, PR, and HER2 might affect the prognosis of patients with SBBC. For MBBC, only age was a factor affecting survival time. These findings provide clinical insight for the treatment of patients with BBC.
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Predict Breast (www.predict.nhs.uk) is an online prognostication and treatment benefit tool for early invasive breast cancer. The aim of this study was to incorporate the prognostic effect of progesterone receptor (PR) status into a new version of PREDICT and to compare its performance to the current version (2.2).
Progesterone receptor
Oestrogen receptor
Expression (computer science)
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MicroRNA (miRNA), which are stably present in serum, have been reported to be potentially useful for detecting cancer. In the present study, we examined the expression profiles of serum miRNA in several large cohorts to identify novel miRNA that can be used to detect early stage breast cancer. We comprehensively evaluated the serum miRNA expression profiles using highly sensitive microarray analysis. A total of 1280 serum samples of breast cancer patients stored in the National Cancer Center Biobank were used. In addition, 2836 serum samples were obtained from non‐cancer controls, 451 from patients with other types of cancers, and 63 from patients with non‐breast benign diseases. The samples were divided into a training cohort including non‐cancer controls, other cancers and breast cancer, and a test cohort including non‐cancer controls and breast cancer. The training cohort was used to identify a combination of miRNA that could detect breast cancer, and the test cohort was used to validate that combination. miRNA expressions were compared between patients with breast cancer and non‐breast cancer, and a combination of five miRNA (miR‐1246, miR‐1307‐3p, miR‐4634, miR‐6861‐5p and miR‐6875‐5p) was found to be able to detect breast cancer. This combination had a sensitivity of 97.3%, specificity of 82.9% and accuracy of 89.7% for breast cancer in the test cohort. In addition, this combination could detect early stage breast cancer (sensitivity of 98.0% for Tis).
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Purpose: As there is growing evidence that the vitamin D status is correlated with breast cancer prognosis, in this study, we investigated the correlation between serum 1,25-dihydroxyvitamin D levels and the prognosis of patients with breast cancer in a Korean cohort. Methods: We performed a retrospective analysis of 436 Korean patients with breast cancer who were diagnosed between January 2000 and December 2008. According to the serum 1,25-dihydroxyvitamin D levels, the patients were divided into the following two groups: group 1 (<29.75 ng/mL) and group 2 (â¥29.75 ng/mL). Survival curves were obtained by using the Kaplan-Meier method. Univariate and multivariate analyses were also conducted to assess the independent prognostic significance of serum 1,25-dihydroxyvitamin D levels. Results: During a mean period of 84.66±29.29 months, 51 patients experienced tumor recurrence and 22 patients died. On survival analysis, group 1 showed poorer disease-free survival, especially for patients with luminal type breast cancer. Univariate and multivariate analyses showed that the 1,25-dihydroxyvitamin D status was a significant prognostic factor for disease-free survival, only in patients with luminal type breast cancer. Conclusion: The serum 1,25-dihydroxyvitamin D status can influence disease-free survival in Korean patients with breast cancer, particularly in those with luminal type breast cancer. Keywords: Breast neoplasms; Prognosis; Vitamin D
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Objective
To investigate whether C-reactive protein (CRP) and neutrophil/lymphocyte ration (NLR) can predict the infection complications and predict the short-term survival rate of patients with cirrhosis.
Methods
Data of 208 patients with liver cirrhosis from March 2013 to March 2016 were analyzed retrospectively. The effects of CRP concentration, NLR and other clinical factors on the infection and one-month survival rate of patients with liver cirrhosis were analyzed.
Results
Sixty-five patients with dominant infection during hospitalization were used as the infected group, while the other 143 patients were selected as uninfected group. The levels of CRP and NLR in the infected group were significantly higher than those in the uninfected group (CRP: t=16.216, P=0.003; NLR: t=7.211, P=0.025). The results of univariate analysis showed that age, female, non-alcoholic cirrhosis, systemic inflammatory response syndrome (SIRS), high level of CRP, and high NLR value were important risk factors of infection in cirrhotic patients. In multivariate analysis, female, high level of CRP, and high NLR value were the independent predictor of infection in patients with cirrhosis. Univariate analysis showed that NLR, model for end-stage liver disease (MELD) score, and WBC count were important predictors of 1-month survival. Multivariate analysis showed that high NLR was an independent predictor of one-month survival in Child Pugh C patients.
Conclusions
CRP level and NLR value may be an effective diagnostic marker in patients with liver cirrhosis. The high NLR value in patients with Child-Pugh C is an independent risk factor for poor short survival.
Key words:
C-reactive protein/ME; Granulocytes; Lymphocytes; Liver cirrhosis/CO/ME/IM; Infection/CO/ME/IM
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Background and purpose:Non-small cell lung cancer (NSCLC) is the most frequent histological type of the lung cancer. There are significant differences of prognoses among the patients with advanced NSCLC patients after chemotherapy. The purpose of this study was to explore the prognostic factors of advanced NSCLC patients after chemotherapy. Methods:204 advanced NSCLC patients after chemotherapy were enrolled in the Oncology Center of Shandong Provincial Hospital from Feb.1998 to Jul.2006. Kaplan-Meier method and Log-rank time series analysis for the univariate analysis and Cox proportional hazard model for the multivariate analysis were used. Results:The median survival time was 12 .2 months, 1 year survival rate was 54.9%. The univariate analysis suggested that TNM staging (P=0.0075), KPS scoring (P=0.0151), chemotherapy regiman (P=0.0325), the chemotherapy cycles (P=0.0298) and the status of patients’ immediate response to the treatment (P=0.0061) significantly influenced survival of NSCLC. Multivariate analysis suggested that KPS scoring (P=0.019), TNM staging (P=0.011), and the status of patients’ immediate response to the treatment (P=0.009) were the independent factors of survival. Conclusion:KPS scoring, TNM staging and the status of patients’ immediate response to the treatment are the independent prognostic factors for advanced NSCLC patients after chemotherapy.
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Lymphovascular invasion
Progesterone receptor
Adjuvant Therapy
Hormonal Therapy
Tissue microarray
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Objective: To explore the expression and its clinical significance of hormone receptor and cerbB-2 in breast cancer tissue received neoadjuvant chemotherapy. Methods: The estrogen receptor(ER), progesterone recepter(PR) and cerbB-2 in breast cancer tissue of 89 patients received neoadjuvant chemotherapy were detected by immunohistochemical method, and analysed the relation with response of neoadjuvant chemotherapy. Results: The overall response rate of neoadjuvant chemotherapy on breast cancer was 89. 9%, of which the complete response was 32. 6%, partial response was 57. 3%, pathological complete response was 17. 9%, disease stable 10. 5%. Hormonal receptor expressions was significantly related to treatment response,the pathological complete response rate was 27. 2% in ER/PR negative tumors,but it was 7.1% in the positive tumors (P0. 05). No correlation was observed between the treatment response and cerbb-2 expression. Conclusions: There has higher sensitivity to neoadjuvant chemotherapy in hormonal receptor negative tumors. The hormone receptor of breast cancer in neoadjuvant chemotherapy may be provide important index in decision sensitivity of chemotherapy and clinical evaluation.
Progesterone receptor
Neoadjuvant Therapy
Clinical Significance
Hormonal Therapy
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