OBJECTIVETo study the expression of human mammaglobin (hMAM) mRNA in the peripheral blood of breast cancer patients and its implication.

METHODSThe expression of human mammaglobin mRNA was determined by using RT-PCR method in 56 patients with peripheral blood breast cancer, 8 patients with breast hyperplasia and 8 women with normal breast. The expression of hMAM mRNA was compared with biological significance and change of hMAM mRNA in chemotherapy after operation.

RESULTSThe expression of hMAM mRNA was negative in 8 patients with breast hyperplasia, 8 women with normal breast and 56 patients with breast cancer, The positive rate was 30.4% (17/56) (chi(2) = 19.766, P < 0.01). The expression of hMAM mRNA in peripheral blood was not correlated with clinical stage, primary tumor size and patients age (chi(2) = 1.256, P > 0.05). After short-term large dose of chemotherapy, 41.2% (7/17) patients turned positive before operation to negative hMAM mRNA expression and negetive expression before operation positive expression after chemotherapy.

CONCLUSIONSThis study suggests that hMAM is sensitive and specific for breast cancer. Detection of the expression of hMAM mRNA in peripheral blood of breast cancer is of value in the diagnosis and judgement of prognosis of breast cancer.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Breast Neoplasms ; blood ; diagnosis ; Female ; Gene Expression ; Humans ; Leukocytes, Mononuclear ; metabolism ; Mammaglobin A ; Middle Aged ; Neoplasm Proteins ; blood ; genetics ; Prognosis ; RNA, Messenger ; blood ; Uteroglobin ; blood ; genetics

OBJECTIVEto evaluate the application of GeneSearch(TM) breast lymph node assay in intraoperative detection of metastases in sentinel lymph node (SLN) from breast cancer patients.

METHODSa total of 225 SLN from 88 patients was prospectively studied. Each SLN was cut into 2 mm slabs which were examined by intraoperative imprint cytology (IIC) first, followed by GeneSearch assay and post-operative serial sectioning. GeneSearch used real-time fluorescence quantitative RT-PCR technology to detect the expression of CK19 and mammaglobin in SLN. The results of GeneSearch assay were correlated with those of IIC and post-operative serial sectioning.

RESULTSamongst the 88 cases studied, 225 SLNs were found, and obvious metastatic carcinoma cells were identified in 27 SLNs and micrometastasis in 9 SLNs. One hundred and eight-nine SLNs were considered as "negative" (with "isolated tumor cells" present in 5 SLNs). The turn-around time of intraoperative GeneSearch assay ranged from 35 to 45 minutes (mean = 40 minutes). The concordance rate between GeneSearch assay and post-operative serial sectioning was 95.6% (215/225), with a sensitivity of 86.1% (31/36), compared with 94.7% (213/225) and 72.2% (26/36) respectively for IIC. The size of metastatic foci correlated with the Ct value of CK19 and mammaglobin (P < 0.01).

CONCLUSIONSGeneSearch assay for intraoperative detection of metastase in SLN has a satisfactory performance and demonstrates a relatively higher sensitivity than IIC. The potential clinical application still requires further evaluation of larger number of cases.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Breast Neoplasms, Male ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; surgery ; Female ; Humans ; Intraoperative Period ; Keratin-19 ; metabolism ; Lymph Nodes ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Mammaglobin A ; Mastectomy ; methods ; Middle Aged ; Neoplasm Proteins ; metabolism ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; methods ; Uteroglobin ; metabolism

OBJECTIVETo investigate the expression of the human mammoglobin (hMAM) mRNA in bone marrow and its clinical significance in the breast cancer patient.

METHODSExpression of hMAM mRNA was detected using nested reverse transcription polymerase chain reaction (RT-PCR) in the bone marrow aspiration sample from 75 breast cancer patients, 15 patients with benign breast lesions and 8 healthy volunteers as control. The possible correlation of hMAM mRNA expression with clinico-pathological parameters and related molecular markers such as Ki67, p53 and VEGF were analyzed.

RESULTSThe sensitivity of RT-PCR in this series reached 10(-6). The hMAM mRNA was found to be positively expressed by RT-PCR in 21 of 75 breast cancer patients with a positive rate of 28.0%. However, hMAM mRNA expression was not detected in the bone marrow aspiration samples from patients with benign breast lesions and healthy volunteers. The hMAM mRNA expression was positively correlated with axillary nodal involvement and progesterone receptor (PR) status (P < 0.05) as well as Ki67 expression in breast cancer tissue (chi2 = 4.936, P = 0.026), but not with age, tumor size, clinical stage, or estrogen receptor (ER) status (P > 0.05).

CONCLUSIONRT-PCR is quite sensitive and has a high specificity in detecting the presence of hMAM mRNA in the bone marrow from breast cancer patients. Thereupon, hMAM mRNA may be useful as a molecular biomarker in detecting disseminated tumor cells (DTC) in the bone marrow of breast cancer patients. Positive hMAM mRNA expression result may have an impact upon therapeutic recommendations and patients' prognostic judgement.

Adult ; Aged ; Biomarkers, Tumor ; genetics ; Bone Marrow ; metabolism ; pathology ; Breast ; metabolism ; pathology ; Breast Neoplasms ; genetics ; pathology ; Breast Neoplasms, Male ; genetics ; pathology ; Carcinoma, Ductal, Breast ; genetics ; pathology ; Female ; Fibroadenoma ; genetics ; pathology ; Humans ; Ki-67 Antigen ; genetics ; Lymphatic Metastasis ; Male ; Mammaglobin A ; Middle Aged ; Neoplasm Proteins ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Progesterone ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Uteroglobin ; genetics

OBJECTIVETo evaluate the diagnostic approach and criteria for intraductal papillary neoplasms of breast.

METHODSAccording to the criteria of 2003 WHO classification, 187 cases of intraductal papillary neoplasm of breast were identified and enrolled into the study. The clinical and histologic features were reviewed and immunohistochemical study for CD10, p63, CK14, CK5/6, CK7, MGB1 and p53 were carried out on 53 cases.

RESULTSAmongst the 187 cases studied, there were 128 cases of intraductal papilloma, 16 cases of atypical intraductal papilloma and 43 cases of intraductal papillary carcinoma. They showed a spectrum of morphologic features including epithelial and stromal hyperplasia and secondary changes. The expression of myoepithelial markers, including CD10 and p63, significantly decreased in ascending order from intraductal papillomas, atypical intraductal papillomas and intraductal papillary carcinomas (P < 0.001). The expression of basal cell markers, including CK5/6 and CK14, showed a mosaic pattern in benign lesions and significantly decreased or was absent in atypical and carcinomatous lesions (P < 0.001). In contrast, the luminal cell marker CK7 expressed in the three groups with no statistically significant difference (P = 0.06). On the other hand, the expression of MGB1 in intraductal papillary carcinomas was much lower than that in the other two groups (P = 0.002 and P = 0.007). The staining for p53 was negative in all of the three groups.

CONCLUSIONSIntraductal papillary neoplasms of breast represent a heterogeneous group of lesions with various morphologic appearances. Correlation with immunostaining results for myoepithelial markers, basal-type cytokeratins and luminal epithelial markers are helpful in arriving at a definitive diagnosis.

Adult ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; Carcinoma, Papillary ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Keratin-7 ; metabolism ; Mammaglobin A ; metabolism ; Middle Aged ; Neprilysin ; metabolism ; Papilloma, Intraductal ; metabolism ; pathology ; Transcription Factors ; metabolism ; Tumor Suppressor Proteins ; metabolism