Opinion on moderate/low cancer genetic risk markers in medical practice including comment on the article Genetic contribution to all cancers: the first demonstration using the model of breast cancers from Poland stratified by age at diagnosis and tumour pathology by Lubinski et al., Breast Cancer Res Treat 2008 Apr 15

[Excerpt] Breast cancer is a heterogeneous disease characterized by a widely variable morphological appearance, many risk factors and distinct gene expression profiles [1, 2]. Common genetic alterations (e.g. polymorphisms), with possible effects on protein function and/or expression, within genes involved in essential cellular pathways, such as carcinogen metabolism, DNA repair, cell cycle control and cell proliferation, can predispose individuals to various tumours, including breast cancer [3-7]. [...

Immunohistochemistry Applied to Breast Cytological Material

© 2022 S. Karger AG, Basel.Fine-needle aspiration biopsies (FNABs) of the breast are minimally invasive procedures enabling the diagnosis of suspicious breast lesions. Unfortunately, they are often perceived as inferior to core-needle biopsies, namely because they are supposedly unable to differentiate between high-grade ductal carcinoma in situ and invasive carcinoma or provide material for ancillary testing. Several studies have shown, however, that FNAB samples, when handled properly, are indeed capable of providing sufficient and adequate material for ancillary testing, namely immunocytochemistry (ICC). We reviewed the published literature regarding the use of ICC for both diagnostic and theranostic uses in the different types of cytological samples obtained from FNABs of the breast, including smears, liquid-based cytology samples, and cellblocks. We found that p63 and 34βE12 show promise in aiding in the differential diagnosis between in situ and invasive lesions and that most other diagnostic markers may be used as in tissue. Regarding theranostic ICC markers, results vary between publications, but with care, these can successfully be performed in cytological samples. Air-dried smears should be avoided, and cellblocks are overall more versatile than cytology slides, enabling the evaluation of not only hormonal receptors and HER2 by ICC, but also of Ki-67. Particular attention should be paid to fixation and antigen retrieval procedures in all cases. We recommend that laboratories without experience perform short validation runs before adopting these techniques into clinical practice.publishersversionpublishe

An Update on Breast Cancer Multigene Prognostic Tests—Emergent Clinical Biomarkers

Multigene signatures generate crucial prognostic information particularly useful for cancer patients where clinical parameters and traditional immunohistochemical markers alone lead to equivocal prognosis. Clinicians are now provided with molecular tools that assist in the outline of adjuvant therapies, namely helping decide on the extension of adjuvant endocrine therapy or on suppressing adjuvant chemotherapy in patients were toxic effects are particularly deleterious or when this treatment is fundamentally not needed. The importance of cancer multigene prognostic signatures is well elucidated in the guidelines for adjuvant systemic therapy in early-stage breast cancer and the guidelines on disease staging that are progressively integrating gene expression assays as classification biomarkers. In addition to the predictive and prognostic value, some genetic tests provide intrinsic subtyping classification. Herewith, we compare the molecular tests OncotypeDX, MammaPrint, Prosigna, EndoPredict, Breast Cancer Index, Mammostrat, and IHC4 and report the eligibility of each one in the suitable setting. Through to now, there is not a commercially available multigene test that makes recommendations regarding adjuvant treatment for HER-2 and triple negative breast cancers. Thus, these patients still receive adjuvant chemotherapy. Importantly, triple negative carcinomas are very heterogeneous regarding prognosis and new molecular signatures that decipher this very heterogeneous subgroup of breast cancer may improve the clinical management of the disease

p63 expression in sarcomatoid/metaplastic carcinomas of the breast

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Angiogênese, homeostasia e câncer: novos paradigmas e velhos problemas

Neovascularization is a crucial phenomenon for the continuous growing of neoplastic cells and cancer progression. The growth of new blood vessels from pre-existing vessels (angiogenesis) occurs in several physiological and pathological conditions, including cancer, where it is critical for tumor-cells nutrition. Recently, new remarkable insights regarding angiogenesis and blood coagulation (key events in vascular biology) have been described. The serine protease thrombin, which plays a central role in blood coagulation cascade through its ability to cleave fibrinogen conducting to fibrin clot formation, is also known to be involved in embryogenesis, inflammation, wound healing, through its active role on vascular remodeling. Although the increased knowledge of factors regulating angiogenesis and coagulation led to the understanding that angiogenesis, homeostasis and carcinogenesis are three close team players, little is still known about how these pathways support each other in the process of angiogenesis in vivo. This review summarizes current understanding of blood coagulation cascade role in conducting angiogenesis and tumor progression, as well as provides an overview of the emerging anti-angiogenic and anti-coagulation therapies inducing tumor regression.A neovascularização é um processo fundamental para a sobrevivência e a progressão das células neoplásicas malignas. O crescimento de novos vasos sanguíneos a partir de vasos já existentes, fenômeno designado como angiogênese, está envolvido em vários processos fisiológicos e patológicos, incluindo o crescimento tumoral, onde a angiogênese desempenha papel crítico na nutrição das células tumorais. Tal como a angiogênese, o sistema de coagulação sanguínea exerce importante função na biologia vascular. A trombina, uma serina protease, tem papel fundamental na cascata de coagulação, pela quebra enzimática do fibrinogênio e pela conseqüente produção de fibrina. Essa protease encontra-se também implicada em desenvolvimento embrionário, inflamação e cicatrização, processos nos quais a remodelação vascular está altamente ativa. Apesar de o crescente conhecimento de fatores reguladores da angiogênese e da coagulação demonstrar que a carcinogênese, a coagulação e a angiogênese são três close team players, ainda muito pouco se sabe sobre o modo como esses players comunicam-se e interagem no processo de angiogênese in vivo. Esta revisão sumariza os conhecimentos atuais quanto ao papel da cascata de coagulação na condução do processo angiogênico e do crescimento tumoral, bem como oferece uma visão geral sobre recentes terapias antiangiogênicas e anticoagulantes envolvidas na regressão tumoral.(undefined

Lymphangiogenesis: from the pig embryos to cancer

The discovery and the comprehension of lymphatic vessels suffered several historical delays and setbacks. The inherent anatomical problems slowed down the precise identification of the lymphatic system during the development of medical science. Gasparo Aselli, an Italian surgeon and anatomist, was the first to describe the lymphatic vessels in 1627 (De Lacteibus sive Lacteis Venis). However, most original descriptions that report the morphology of the lymphatic system in different organisms were done during the 19th and the 20th centuries. The recent identification of specific lymphatic vasculature molecular markers allows a more accurate identification and characterization of the lymphatic system evolution in different organs, as well as its role in different pathological conditions, including cancer. This study summarizes the current understanding of lymphangiogenesis in tumour progression, as well as it presents a review of the promising data regarding the prognostic value of lymphatic density and the use of therapeutic lymphangiogenic molecules.A descoberta dos vasos linfáticos e sua compreensão enfrentaram uma série de atrasos e dificuldades históricos. As inerentes dificuldades anatômicas retardaram a identificação precisa da rede vascular linfática durante o desenvolvimento da ciência médica. Gasparo Aselli, um anatomista e cirurgião italiano, foi o primeiro a descrever os vasos linfáticos, em 1627 (De Lacteibus sive Lacteis Venis). Entretanto, a maioria das descrições originais que relatam a morfologia do sistema linfático nos diferentes organismos foi realizada depois, entre os séculos XIX e XX. A recente identificação de marcadores moleculares específicos à vasculatura linfática permite agora identificação e caracterização mais acuradas da evolução da rede linfática nos vários órgãos e em diferentes situações, inclusive no câncer. Esta revisão resume o conhecimento sobre a linfangiogênese na progressão tumoral, bem como apresenta uma síntese dos dados mais promissores em relação ao valor prognóstico da densidade linfática e da utilização das moléculas linfangiogênicas como alvo terapêutico.(undefined

Angiogenesis and Breast Cancer

Angiogenesis is an essential step for breast cancer progression and dissemination. The development of new blood vessels in cancer setting (angiogenesis) is conducted by numerous physiological and pathological stimuli, where the main stimulus is hypoxia. The knowledge of different molecular pathways regulating angiogenesis is constantly growing. An increased and complex scenario of angiogenesis is nowadays available in breast cancer, specifically, and permits not only to understand most of the important phases of neoplastic growth but also offer an exciting perspective for new therapeutic proposals based on blocking new blood vessels sprouting. This review focused on historical and recent understanding of angiogenesis occurrence in breast cancer

A comparative study of recombinant and native frutalin binding to human prostate tissues

<p>Abstract</p> <p>Background</p> <p>Numerous studies indicate that cancer cells present an aberrant glycosylation pattern that can be detected by lectin histochemistry. Lectins have shown the ability to recognise these modifications in several carcinomas, namely in the prostate carcinoma, one of the most lethal diseases in man. Thus, the aim of this work was to investigate if the α-<smcaps>D</smcaps>-galactose-binding plant lectin frutalin is able to detect such changes in the referred carcinoma. Frutalin was obtained from different sources namely, its natural source (plant origin) and a recombinant source (<it>Pichia </it>expression system). Finally, the results obtained with the two lectins were compared and their potential use as prostate tumour biomarkers was discussed.</p> <p>Results</p> <p>The binding of recombinant and native frutalin to specific glycoconjugates expressed in human prostate tissues was assessed by using an immuhistochemical technique. A total of 20 cases of prostate carcinoma and 25 cases of benign prostate hyperplasia were studied. Lectins bound directly to the tissues and anti-frutalin polyclonal antibody was used as the bridge to react with the complex biotinilated anti-rabbit IgG plus streptavidin-conjugated peroxidase. DAB was used as visual indicator to specifically localise the binding of the lectins to the tissues. Both lectins bound to the cells cytoplasm of the prostate carcinoma glands. The binding intensity of native frutalin was stronger in the neoplasic cells than in hyperplasic cells; however no significant statistical correlation could be found (<it>P </it>= 0.051). On the other hand, recombinant frutalin bound exclusively to the neoplasic cells and a significant positive statistical correlation was obtained (<it>P </it>< 0.00001). However, recombinant frutalin did not recognise all malignant prostate cases and, when positive, the binding to those tissues was heterogeneous.</p> <p>Conclusion</p> <p>Native and recombinant frutalin yielded different binding responses in the prostate tissues due to their differences in carbohydrate-binding affinities. Also, this study shows that both lectins may be used as histochemical biomarkers for the prostate cancer. Moreover, the successful use of a recombinant lectin in immunohistochemical studies of prostate cancer was for the first time demonstrated, highlighting the advantages of using recombinant systems in the preparation of pure lectin samples for diagnostic purpose.</p

Demystifying molecular techniques in cytopathology practice

The last decade was stimulating with the introduction of new molecular techniques to be applied in pathology laboratories. Accordingly, cytology was also benefited with the innovations emerged from this new era. Molecular cytopathology (MCP) can be defined as molecular studies applied on all types of cytological specimens, namely gynaecology cytology, exfoliative non-gyn cytology and fine needle aspirates. The development of a huge amount of new ancillary techniques has paralleled the emergence of clinical cytology as a major diagnostic speciality. Clinical applications of these techniques have been growing in the last decade. The widespread acceptance of liquid-based systems in gynaecological cytology is a paramount episode which re-draws the relation between cells and molecules. The stretched use of approaches, morphology and molecular biology, in HPV-induced lesions settings, e.g., revealed a potential to optimize, in one single brushed sample, diagnosis and research. Cytology samples from serous effusions, pulmonary tree, bladder urine, and aspirations, among others, are now likely to be studied by different molecular techniques for helping in diagnosis, prognosis, or even to assess therapeutic targets. In this review, we highlight the main results already published concerning the application of molecular techniques in different fields of cytopathology and discuss their application