Research (ICR) in London. ER, PR, and HER2 were scored in Cambridge while KI67 was scored at the ICR. Both institutions used the Ariol machine (Leica Biosystems, Newcastle UK) for scoring. Ariol has functionality for the automatic separation of malignant and non-malignant cells based on their shape and size characteristics and, by using color deconvolution, it can detect (3 – 3'-diaminobenzidine) positive and negative (hematoxylin) staining malignant epithelial cells. Details of the optimized Ariol algorithms and protocols that were used for the scoring of each of these four markers have been previously described [23, 24]. In brief, for ER, PR, and KI67 nuclear staining, the Ariol system was tuned to distinguish between malignant and non-malignant cells and to count positively and negatively staining malignant cells. Based on the number of positive and number of negative tumor nuclei presented by the machine, the percentage of cells stained (0 – 100%) was calculated as the ratio of positive nuclei to the sum of positive and negative nuclei per tissue core. For HER2, the US Food and Drug Administration-approved Herceptest score  (0, 1 + , 2 + , 3 + ), generated to American Society of Clinical Oncology/College of American Pathol- ogists guidelines was calculated by the system. As pre- viously reported [23, 24], we observed good agreement with standardized pathologists scores for ER (observed agree- ment = 90%; kappa = 0.76), PR (observed agreement = 84%; kappa = 0.66), HER2 (observed agreement = 90%, kappa = 0.69), and KI67 (observed agreement = 87%; kappa = 0.64).
PLC is an aggressive form of breast carcinoma that is becoming more frequently identified. Unlike the usual scenario of a positive ER/PR and over expression of Her2/neu, a pleomor- phic variant of lobular carcinoma can be triple negative, thereby adding to the challenge of planning the treatment strategy of this aggres- sive tumor.
Her2/neu positivity was lower than our study. In a study by Helin et al 72 % of invasive ductal carcinoma were ER positive and 55% were PR positive. ER positivity is higher than our study were as PR positivity is almost similar.(Helin et al., 1989) A study by Collins and Schnitt found Her2/neu over expression in 28% of cases which is lower than our study.(Collins and Schnitt, 2005) A recent study of a cohort of women under age 55 revealed that triple negative tumors were the most common breast cancer subtype diagnosed among African–American women accounting for nearly 47%, compared to 22% among whites.(Lund et al., 2009) In our study triple negative tumors consist of 3.39% only, i.e. much lower than these studies. However, in a study from Japan, a higher proportion of post-menopausal women were present in the triple-negative breast cancer group. (Iwase et al., 2010) As prognostic markers like ER, PR and Her2/neu significantly influence prognosis, survival and selection of therapy in breast carcinomas. IHC is now a days, an integral part of breast carcinoma histopathology reporting for prognosis and treatment, in addition to histological diagnosis. Being a cheap and easy method, immunohistochemistry may be suitable for developing countries like India. According to various studies incidence of recurrence is less among those ER, PR and HER2/neu positive cases who have received targeted therapy. Thus study of these important prognostic markers ER, PR and Her2/ neu should be made mandatory in every cases of carcinoma breast, and this facilities should be made available even in underprivileged rural areas. So, that prognosis and survival of all these patients can be properly accessed and positive cases can be provided with targeted therapy.
Abstract Background:Lymph node metastasis is the most important prognostic factor in breast cancer patients. The present study was carried out to evaluate the association between ER, PR and HER-2/neu expression status, separately and in combinations with axillary lymph node involvement. Patients and methods: Two hundred and fifty eight breast cancer patients treated with modified radical mastectomy with axillary lymph node dissection were included. The primary tumor tissue and axillary lymph node were evaluated histologically and the expression of ER, PR and HER-2/neu was evaluated by immune his to chemistry. Results: ER and PR expression were demonstrated in 78.7% and 76.4%, respectively and over-expression of HER-2/neu was detected in 13.2% of cases. Triple positive breast cancer is more likely to have axillary lymph node metastasis and ER+/PR+/HER-2- (PPN) is the most protected group (p<=0.001). There was a strong correlation between tumor size and tumor grade with lymph node involvement (p= 0.0001 and 0.024, respectively). Conclusion: triple positive breast carcinomas are more likely axillary lymph node metastasis. Tumor size, tumor grade and pathological subtypes correlate with axillary lymph node status. Further confirmatory studies with a larger number of patients are necessary to define factors predicting axillary lymph node status.
Regarding the correlation, this study found statistically significant direct correlation between BCL2 and ER, PR expression this in concordance of other study 20,21 that reported direct correlation of BCL2 and ER, PR expression in cancer condition than benign. In same line result revealed, there were 60.5% of the cases ER+ had C-MYC overexpression with no significant correlation between them, also there was no effect of ER overexpression that confined with recent study 22 that
The results of this study show that the volume of uterine fibroids and the volume of uterus after treatment were smaller than those before treatment in two groups, and the volume of uterine fibroids and the volume of uterus after treatment in the treatment group were significantly less than those in the control group, the differences were statistically significant ( P <0.05). This shows that the modified decoction combined with mifepristone can significantly reduce the tumor in patients with uterine fibroids. Mifepristone can inhibit the secretion of progesterone through the combination with PR, thereby reducing the expression of epidermal growth factor receptor in tumor tissue, slowing the enlargement of tumor body, and playing the role of reducing the volume of uterine fibroids  . It is suggested that the decoction can inhibit the hyperplasia of fibrous tissue, inhibit the formation of cardiovascular and inhibit the enlargement of tumor  . the combination of Modified Decoction and mifepristone in the treatment of mifepristone may have synergistic effect, and the treatment effect is better  . In addition, the results of this study show that The serum levels of ER, PR, P, E 2 , LH, FSH, IGF-I and
Results: In 41 core/resection pairs, the recognised trend to lower ER, PR and Ki67 score on resected material was confirmed. Concordance for ER, PR and Ki67 without changing biomarker status (e.g. ER+ to ER-) was 90, 74 and 80 % respectively. However, in 23 paired core samples (diagnostic core v on table core), Ki67 using a cut off of 13. 25 % was concordant in 22/23 (96 %) and differences in ER and PR immunohistochemistry by Allred or Quickscore between the pairs did not impact hormone receptor status. IPA and GSA demonstrated substantial gene expression changes between paired cores at the mRNA level, including reduced expression of ER pathway analysis on the second core, despite the absence of drug intervention.
Using the log-rank test, significant differences were observed in the DFS curve in terms of TMB (Figure 3). Patients with high TMB (.5.56) had a poor DFS than those with low TMB (83 vs 59 m, P = 0.005). A univariate analysis of the relationships between tumor characteristics and patient outcome indicated that lymph node status and level of TMB were significantly associated with DFS (P,0.05), whereas no significant prognostic values (P.0.05) were found with menopausal status, tumor size, and ER, PR, HER-2, and Ki-67, as listed in Table 3. A Cox proportional hazard regression model was used to determine factors that were independent or joint predictors of DFS. The multivariate analysis indicated that TMB level was an independent risk
This is to certify that dissertation entitled "To assess the stromal expression of cd10 in invasive ductal carcinoma of breast and its correlation with histological grade, ER, PR AND HER2/ neu expression"is a bonafide work done by Dr. S. ULAGANATHAN, a postgraduate student in the Department of Pathology, Coimbatore Medical College, Coimbatore under guidance and supervision of DR. G. S. THIRIVENI BALAJJI, M.D, Associate Professor, Department of Pathology, Coimbatore Medical College, Coimbatore in partial fulfillment of the regulations of the Tamilnadu Dr. M. G. R. Medical University, Chennai towards the award of M. D. Degree ( Branch III) in Pathology.
Methods: The pathological specimens of 267 patients diagnosed with DCIS at Siriraj Hospital were analyzed. By using the expressions of ER, PR, HER2, and Ki-67, breast cancer patients were classified into the five molecular subtypes: luminal A, luminal B/HER2 negative, luminal B/HER2 positive, HER2 overexpression, and triple-negative. Based on the specific molecular subtypes, age, clinical presentation, tumor size, and tumor grade were analyzed separately using univariate analysis.
Neurotensin (NT) is a 13-amino acid peptide with trophic effects on some neoplasms. Its bioactivities are mainly medi- ated by neurotensin receptor 1 (NTSR1). Both NT and NTSR1 were found to be upregulated in breast cancer. NT/NTSR1 thus becomes a potential therapeutic target. We studied whether any correlation exists between the expres- sion of NTSR1 in breast carcinomas and the expression of ER, PR, and Her2. A total 85 cases of invasive ductal (62) and lobular (23) breast carcinomas were studied. Based on their ER/PR profiles, the ductal carcinomas (DCs) were subcategorized into ER+/PR+ (21), ER+/PR− (20), and ER−/PR− (21). All of the lobular carcinomas (LCs) were ER+/PR+. 21.57% of all DCs and 5.56% of LCs were Her2 positive. 77.78% of ER−/PR− DCs were also Her2 negative (triple negative). The expression of NTSR1 was detected by immunohistochemistry and was semiquantitated (as nega- tive, 1+, 2+, 3+). Both 2+ and 3+ were collectively defined as overexpression. The expression of NTSR1 was weak and focal in non-neoplastic mammary epithelial cells. It is increased in 74.19% of DCs (80.95% in ER+/PR+, 75% in ER+/PR−, and 66.67% in ER−/PR− group), and in 95.65% of LCs. The overexpression of NTSR1 is similar between ER+ DCs and ER− DCs (75% vs 66.67%, p > 0.05) as well as between PR+ DCs and PR− DCs (80.95% in ER+/PR+ DCs vs 75% in ER+/PR− DCs, p > 0.05). And it was seen in 77.78% of Her2+ DCs, 78.38% of Her2− DCs, 94.12% of Her2− LCs, and 78.57% of triple negative DCs. Overall, NTSR1 is commonly overexpressed in both ductal and lobular breast carcinomas and is independent of the ER/PR/Her2 profiles of the tumors. The present data supports the potential benefit of developing NTSR1 blockers in the adjuvant therapy of breast carcinomas, particularly for those “triple nega- tive” tumors.
The study entitled Role of ER, PR, HER2 and EGFR in Esophageal Carcinoma was conducted in the department of pathology at the Sher-i- Kashmir Institute of Medical Sciences (SKIMS) Srinagar, Kashmir. It was a prospective study for a period of one and half years from June 2016 to December 2017 and retrospective study for three and half years from January 2013 to May 2016.The study was carried on resected specimens of esophagus over the period mentioned above. All esophageal carcinomas with or without nodal metastasis. Other primary tumors of esophagus, tumors metastasized to esophagus and those who have received neoadjuvant therapy. For the retrospective study, cases were taken from the records maintained in the Department of Pathology at SKIMS. Histopathological data was collected and relevant details were noted. Corresponding slides were collected and photographed wherever available. Prospective study comprised of fresh cases of esophageal carcinomas. In each case a brief clinical history was taken, along with other relevant investigations. The clinical data of the patient was recorded as per proforma. Samples were collected in 10% formalin for routine histopathological examination. After overnight fixation the
In the cohort of breast cancer, the most common histological type was invasive ductal carcinoma. Mean age at presentation was 53.99 years although there is considerable variation in different parts of the world. More extensive collaborative research would be useful to identify the risk factors of breast cancer in different ethnic groups. Evaluation of ER, PR and HER2/neu status and Ki 67 proliferative index are performed routinely in breast carcinoma, in view of the significant clinical implications . ER (+) tumours have more favourable outcome in comparison to ER (-) tumours . HER2/neu positive status is associated with an aggressive behaviour and shorter disease free interval .
DOI: 10.4236/ym.2019.33017 164 Yangtze Medicine 10% of patients with malignant tumors . Breast cancer is the second most common malignant tumor in women. According to the statistics, the quality of breast cancer patients in China has accounted for 12.2% of worldwide breast cancer patients. The number of infected people can reach more than 160,000 per year and it is the second common malignant tumor for women, the deaths can reach more than 40,000, accounting for 9.6% in the world . It is the sixth leading cause of death common malignant tumors among women, and its inci- dence is still increasing year by year. It is estimated that by 2030, the number of persons infected breast cancer will reach 2.64 million cases worldwide and the death toll will be reached 1.7 million . The pathological features, biological characteristics and prognosis of breast cancer are closely related to the expres- sion of ER 、 PR and HER-2 in system. Although surgical treatment is still the first choice for the treatment of breast cancer, the importance of adjuvant chemothe- rapy is getting more and more attention.
The core-level measures of agreement between automated and visual scores for the virtual TMAs in our report are most comparable to those in previous reports as they were based on comparisons of the same exact images. For ER, PR and HER2, they were lower than previously reported by our group using the Ariol system , or an automated scoring algorithm adapted from astronomy , possibly Figure 3. Distribution of ER (A–C) and PR (D–F) continuous automated scores (subject level) and positive/negative status in BCAC data- base, including 6424 cases for ER and 6385 cases for PR from nine studies. (A) Scatter plot of the intensity and percentage automated scores colour coded according to the BCAC ER status (red for positive and blue for negative). The red curve represents the cut-off point for positive/negative status by the ROC method. The smaller inserted plots show ER-positive and ER-negative cases separately (B) Distri- bution of intensity*percent automated scores. (C) Boxplot of the intensity*percent automated score by BCAC ER status. Red lines show the positive/negative cut-off points for the corresponding automated score. Figures D–F show similar plots for PR.
Abstract: Breast cancer subtype was defined by ER, PR, HER2 and Ki67 status since the definition of intrinsic sub- types for breast cancer was renovated in 2013 St. Gallen Consensus Conference. The level of ER, PR, HER2 and Ki67 are the main predictive and prognostic biomarkers in various breast carcinoma subtypes. We retrospectively analyzed clinic pathological parameters and immunohistochemical features of 398 breast cancer patients receiv- ing surgery in our hospital from January 2012 to December 2015. Progress free survival was followed up, and logistic regression was applied to estimate the factors associated with high risk of progression. Among all women with breast cancer, recurrence was higher with low ER levels (HR: 5.59, 95% CI: 2.42-12.95, P<0.001), low PR levels (HR: 0.19, 95% CI: 0.04-0.90, P = 0.036), and high Ki-67 proliferation index (HR: 5.84, 95% CI: 1.91-17.85, P = 0.002). We found that the tumors were larger in patients with ER + /PR - than those with ER + /PR + (P<0.001), and
This is to certify that Dr.R.NARMADHA, post graduate student (2008-2011) in the Department of Pathology, Kilpauk Medical College, has done dissertation on ‘CLINICO-PATHOLOGICAL STUDY OF BREAST CARCINOMAS WITH ER, PR STUDIES’ under my guidance and supervision in partial fulfillment of the regulation laid down by the 'THE TAMILNADU DR MGR MEDICAL UNIVERSITY, CHENNAI - 32' for M.D., Pathology degree examination to be held in April 2011.
This is to certify that the dissertation entitled “CORRELATION OF ER, PR AND HER-2/neu WITH HISTOLOGICAL VARIANTS OF BREAST CARCINOMA” is a record of bonafide work done by DR. R.D. Puvitha, Post graduate student in the Department of Pathology, Coimbatore under the supervision of DR. R. VIMALA, M.D., Professor and Head, Department of Pathology, Coimbatore Medical College and submitted in partial fulfillment of the regulations of the Tamilnadu Dr.M.G.R. Medical University towards the award of M.D. Degree in Pathology.
Objective: Diabetes mellitus, as a risk factor for endometrial cancer (EC), causes an increase in insulin and IGF-1 concentrations in the blood serum. The increase in insulin and IGF-1 are considered mitogenic factors contributory to cancer development. Studies suggest that metformin has preventive activity, decreasing mortality and the risk of neoplasms. Since estrogen (ER), progesterone (PR) and IGF-1 (IGF-1R) receptor expression and β -catenin and PAX-2 mutations are significant in the development of endometrial cancer, it was decided to study these factors in patients with endometrial cancer and type 2 diabetes mellitus (DM2), and to establish the effects of metformin on their expression.
trastuzumab which is a form of targeted therapy, whereas they don’t respond well to hormonal treatment. There are also factors similar to that of ER receptor which affects the outcome of the result. Common methods for determining the HER 2 receptor status are by IHC or FISH. But there is a difference in concordance values between the two. According to the new guidelines proposed by ASCO- CAP, it is necessary that the sections should be fixed for a minimum of 6 hrs to a maximum of 48 hrs, core biopsy specimen should be fixed minimum for one hour. They have also created FDA scoring system to reduce the concordance between FISH and IHC results.