Gene Expression Profiling for Diagnosis of Triple-Negative Breast Cancer: A Multicenter, Retrospective Cohort Study

Background: Triple-negative breast cancer (TNBC) accounts for 12–20% of all breast cancers. Diagnosis of TNBC is sometimes quite difficult based on morphological assessment and immunohistochemistry alone, particularly in the metastatic setting with no prior history of breast cancer.Methods: Molecular profiling is a promising diagnostic approach that has the potential to provide an objective classification of metastatic tumors with unknown primary. In this study, performance of a novel 90-gene expression signature for determination of the site of tumor origin was evaluated in 115 TNBC samples. For each specimen, expression profiles of the 90 tumor-specific genes were analyzed, and similarity scores were obtained for each of the 21 tumor types on the test panel. Predicted tumor type was compared to the reference diagnosis to calculate accuracy. Furthermore, rank product analysis was performed to identify genes that were differentially expressed between TNBC and other tumor types.Results: Analysis of the 90-gene expression signature resulted in an overall 97.4% (112/115, 95% CI: 0.92–0.99) agreement with the reference diagnosis. Among all specimens, the signature correctly classified 97.6% of TNBC from the primary site (41/42) and lymph node metastasis (41/42) and 96.8% of distant metastatic tumors (30/31). Furthermore, a list of genes, including AZGP1, KRT19, and PIGR, was identified as differentially expressed between TNBC and other tumor types, suggesting their potential use as discriminatory markers.Conclusion: Our results demonstrate excellent performance of a 90-gene expression signature for identification of tumor origin in a cohort of both primary and metastatic TNBC samples. These findings show promise for use of this novel molecular assay to aid in differential diagnosis of TNBC, particularly in the metastatic setting

Sternocleidomastoid muscle transfer for treatment of longstanding facial paralysis: long-term outcomes and complications

Background/aim: The use of sternocleidomastoid muscle (SCM) flap for facial reanimation was established in the 1980s by the senior author of this paper. We aimed to analyze long-term outcome and complications of this procedure. Patients and methods: We conducted a retrospective chart review of all patients undergoing SCM reanimation for longstanding facial palsy between January 2009 and December 2015. Patients with follow-up longer than 12 months (range=12-96) were included in the study. Facial muscle function was evaluated before and at each follow-up after the surgery with the House-Brackmann (HB) scale-facial nerve grading system and Facegram analysis. Donor site morbidity and overall complication rates were documented and analyzed. Results: Forty-two patients aged 18-66 years (mean age=37) with a mean duration of facial palsy of 5 years (range=2-48) met the inclusion criteria. The HB score 2 years after surgery improved significantly (p<0.05) in comparison to the pre-operative condition (3.6 vs. 4.7). Twelve months after surgery, oral commissure excursion improved by mean 8.95 mm. No flap necrosis occurred, nor compromise of neck and shoulder function despite an obvious contour defect in the SCM donor site. None of the patients presented head posture or movement issues. Conclusion: The SCM flap transfer is a reliable and effective procedure to achieve moderate improvement of the oral commissure excursion using a local method with moderate donor site morbidity. It can be regarded as a valuable option for dynamic facial reanimation in case of longstanding facial palsy

Hydrocarbon accumulation characteristics in basement reservoirs and exploration targets of deep basement reservoirs in onshore China

Based on the global basement reservoir database and the dissection of basement reservoirs in China, the characteristics of hydrocarbon accumulation in basement reservoirs are analyzed, and the favorable conditions for hydrocarbon accumulation in deep basement reservoirs are investigated to highlight the exploration targets. The discovered basement reservoirs worldwide are mainly buried in the Archean and Precambrian granitic and metamorphic formations with depths less than 4 500 m, and the relatively large reservoirs have been found in rift, back-arc and foreland basins in tectonic active zones of the Meso-Cenozoic plates. The hydrocarbon accumulation in basement reservoirs exhibits the characteristics in three aspects. First, the porous-fractured reservoirs with low porosity and ultra-low permeability are dominant, where extensive hydrocarbon accumulation occurred during the weathering denudation and later tectonic reworking of the basin basement. High resistance to compaction allows the physical properties of these highly heterogeneous reservoirs to be independent of the buried depth. Second, the hydrocarbons were sourced from the formations outside the basement. The source-reservoir assemblages are divided into contacted source rock-basement and separated source rock-basement patterns. Third, the abnormal high pressure in the source rock and the normal–low pressure in the basement reservoirs cause a large pressure difference between the source rock and the reservoirs, which is conducive to the pumping effect of hydrocarbons in the deep basement. The deep basement prospects are mainly evaluated by the factors such as tectonic activity of basement, source-reservoir combination, development of large deep faults (especially strike-slip faults), and regional seals. The Precambrian crystalline basements at the margin of the intracontinental rifts in cratonic basins, as well as the Paleozoic folded basements and the Meso-Cenozoic fault-block basements adjacent to the hydrocarbon generation depressions, have favorable conditions for hydrocarbon accumulation, and thus they are considered as the main targets for future exploration of deep basement reservoirs