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  • 1
    In: BMC Cancer, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2012-12)
    Abstract: Increased expression of lipocalin 2 (LCN2) has been observed in several cancers. The aim of the present study was to investigate LCN2 in endometrial cancer in relation to clinico-pathologic phenotype, angiogenesis, markers of epithelial-mesenchymal transition (EMT), and patient survival. Methods Immunohistochemical staining was performed using a human LCN2 antibody on a population-based series of endometrial cancer patients collected in Hordaland County (Norway) during 1981-1990 (n = 256). Patients were followed from the time of primary surgery until death or last follow-up in 2007. The median follow-up time for survivors was 17 years. Gene expression data from a prospectively collected endometrial cancer series (n = 76) and a publicly available endometrial cancer series (n = 111) was used for gene correlation studies. Results Expression of LCN2 protein, found in 49% of the cases, was associated with non-endometrioid histologic type (p = 0.001), nuclear grade 3 (p = 0.001), 〉 50% solid tumor growth (p = 0.001), ER and PR negativity (p = 0.028 and 0.006), and positive EZH2 expression (p  〈  0.001). LCN2 expression was significantly associated with expression of VEGF-A (p = 0.021), although not with other angiogenesis markers examined (vascular proliferation index, glomeruloid microvascular proliferation, VEGF-C, VEGF-D or bFGF2 expression). Further, LCN2 was not associated with several EMT-related markers (E-cadherin, N-cadherin, P-cadherin, β-catenin), nor with vascular invasion (tumor cells invading lymphatic or blood vessels). Notably, LCN2 was significantly associated with distant tumor recurrences, as well as with the S100A family of metastasis related genes. Patients with tumors showing no LCN2 expression had the best outcome with 81% 5-year survival, compared to 73% for intermediate and 38% for the small subgroup with strong LCN2 staining (p = 0.007). In multivariate analysis, LCN2 expression was an independent prognostic factor in addition to histologic grade and FIGO stage. Conclusion Increased LCN2 expression is associated with aggressive features and poor prognosis in endometrial cancer.
    Type of Medium: Online Resource
    ISSN: 1471-2407
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
    detail.hit.zdb_id: 2041352-X
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  • 2
    In: BMC Bioinformatics, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 1471-2105
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2041484-5
    SSG: 12
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  • 3
    In: Journal of Clinical Pathology, BMJ, Vol. 70, No. 4 ( 2017-04), p. 313-319
    Abstract: Vascular invasion in breast cancer is associated with increased risk of recurrence, metastases and death from disease. However, there are few studies discriminating between blood vessel invasion (BVI) and lymphatic vessel involvement (LVI). Methods A population-based series of 282 breast cancers was examined (200 screen-detected and 82 interval patients) with respect to BVI and LVI in addition to basic features and molecular subtypes, using CD31 and D2-40 antibodies. This series is part of the prospective Norwegian Breast Cancer Screening Program. Results The frequency of LVI and BVI was 25% and 15%, respectively. BVI was associated with HER2-positive and basal-like tumours, and several features of aggressive breast cancer, whereas LVI showed weaker associations. BVI was the strongest factor to predict interval cancer presentation. BVI showed significant associations with recurrence-free survival and disease-specific survival in univariate and multivariate analyses, whereas LVI was not significant. Conclusions Our findings indicate that BVI by tumour cells is strongly associated with aggressive tumour features including a basal-like phenotype, and BVI was an independent prognostic factor in contrast to what was found for LVI.
    Type of Medium: Online Resource
    ISSN: 0021-9746 , 1472-4146
    RVK:
    Language: English
    Publisher: BMJ
    Publication Date: 2017
    detail.hit.zdb_id: 2028928-5
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  • 4
    In: Gynecologic Oncology, Elsevier BV, Vol. 114, No. 3 ( 2009-9), p. 491-495
    Type of Medium: Online Resource
    ISSN: 0090-8258
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 1467974-7
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  • 5
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 12, No. 7 ( 2017-7-31), p. e0182030-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2017
    detail.hit.zdb_id: 2267670-3
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  • 6
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2016
    In:  Cancer Research Vol. 76, No. 14_Supplement ( 2016-07-15), p. 3937-3937
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 76, No. 14_Supplement ( 2016-07-15), p. 3937-3937
    Abstract: Background: Nestin, neuroepitheilal stem cell protein, is an intermediate filament protein first described in neural stem or progenitor cells, and its expression has been seen in several tissues, including different types of cancer. In breast cancer, Nestin expression has been linked to the triple negative and basal-like phenotypes. We here evaluated Nestin and its association with clinico-pathologic markers and survival in two prospective Norwegian breast cancer cohorts. Materials and methods: Series I includes 546 women (50-69 years) diagnosed with primary invasive breast cancer (403 screen-detected and 143 interval cancers) as part of the prospective and population-based Norwegian Breast Cancer Screening Program (NBCSP) during 1996-2003 (Hordaland county). Series II includes 282 women (50-69 years) with invasive cancers (199 screen-detected and 83 interval cancers) diagnosed as part of the NBCSP during 2004-2009 (Vestfold County). Immunohistochemical staining of Nestin was done on tissue microarrays (TMAs). Expression in tumor cells was graded by a Staining Index (SI) (values 0-9). Results: Nestin positivity, observed in 9% and 13% of the breast cancer cases in Series I and II, was associated with higher histological grade (OR, odds ratio 14.3 and 8.1), high tumor cell proliferation by Ki-67 (OR 11.4 and 9.1), larger tumor diameter (OR 1.8 and 2.4), but not with lymph node status or HER2 status. Further, Nestin positivity was associated with negativity for estrogen (OR 14.9 and 11.9) and progesterone receptor (8.5 and 3.4), the triple negative phenotype (OR 29.1 and 17.4) and basal-like differentiation by positivity for Cytokeratin 5 (OR 9.1 and 8.7) or P-cadherin (OR 7.0 and 8.5). By univariate survival analysis, Nestin positivity was associated with reduced breast cancer specific (p = 0.002 and p = 0.076) and overall survival (p = 0.005 and p = 0.039). When including the standard variables tumor size, histologic grade and lymph node status in a multivariate analysis, Nestin was still significantly associated with reduced breast cancer specific survival in the largest cohort (Series I). Conclusion: We found that Nestin expression in breast cancer is associated with aggressive features, the triple negative phenotype, basal-like differentiation, and reduced breast cancer specific survival. Citation Format: Kristi Krüger, Elisabeth Wik, Tor Audun Klingen, Ying Chen, Turid Aas, Lars A. Akslen. Nestin expression is associated with a basal-like phenotype and poor prognosis in breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3937.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 7
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 17, No. 10 ( 2011-05-15), p. 3368-3377
    Abstract: Purpose: Overexpression of the oncogen Stathmin has been linked to aggressive endometrial carcinoma and a potential for PI3Kinase inhibitors in this disease. We wanted to validate the prognostic value of Stathmin expression in a large prospective multicenter setting. As lymph node sampling is part of current surgical staging, we also aimed to test if Stathmin expression in endometrial curettage specimens could predict lymph node metastasis. Experimental Design: A total of 1,076 endometrial cancer patients have been recruited from 10 centers to investigate the biological tumor marker Stathmin in relation to clinicopathologic variables, including lymph node status and survival. Stathmin immunohistochemical staining was carried out in 477 hysterectomy and 818 curettage specimens. Results: Seventy-one percent of the patients (n = 763) were subjected to lymph node sampling, of which 12% had metastatic nodes (n = 94). Overexpression of Stathmin was detected in 37% (302 of 818) of the curettage and in 18% (84 of 477) of the hysterectomy specimens investigated. Stathmin overexpression in curettage and hysterectomy specimens were highly correlated and significantly associated with nonendometrioid histology, high grade, and aneuploidy. Stathmin analysis in preoperative curettage samples significantly correlated with, and was an independent predictor of, lymph node metastases. High Stathmin expression was associated with poor disease-specific survival (P ≤ 0.002) both in curettage and hysterectomy specimens. Conclusions: Stathmin immunohistochemical staining identifies endometrial carcinomas with lymph node metastases and poor survival. The value, as a predictive marker for response to PI3Kinase inhibition and as a tool to stratify patients for lymph node sampling in endometrial carcinomas, remains to be determined. Clin Cancer Res; 17(10); 3368–77. ©2011 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 1225457-5
    detail.hit.zdb_id: 2036787-9
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  • 8
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2021
    In:  Cancer Research Vol. 81, No. 13_Supplement ( 2021-07-01), p. 2695-2695
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 13_Supplement ( 2021-07-01), p. 2695-2695
    Abstract: Background and Objective: Breast cancer (BC) diagnosed at ages & lt;40 years is known to present more aggressive tumor phenotypes and poorer clinical outcome compared to older BC patients. To gain a better understanding of the possible age-related expression difference in BC promoting genes, we aimed to identify transcriptional alterations supporting cancer progression in BC of the young. Methods: We studied mRNA gene expression data from METABRIC discovery (n=997), and validation cohort (n=995), and explored the transcriptional patterns associated with BC of the young. We investigated differentially expressed genes (DEGs) between primary BC for patients below and above 40 years at time of diagnosis and explored gene sets (by Gene Set Enrichment Analysis) enriched in BC of the young. Protein-protein interaction (PPI) networks were explored by the STRING database and visualized in Cytoscape software. Hub genes were identified by MCODE and CytoHubba plugins. Results: Among genes differentially expressed between BC of the young and older, 91 DEGs were commonly (for the two cohorts) upregulated and 99 commonly downregulated in the young (Fold change ≥1.5/≤ -1.5). Oncogenic- and proliferation associated signatures were enriched in the young BC, including signatures reflecting KRAS, MTOR and MYC. Proliferation and cell cycle processes were the dominating enriched gene ontology categories (FDR & lt;10%). Six hub genes presenting highest PPI network connectivity were identified, described to be associated with the cell cycle and cell proliferation. A signature score was made by summarizing the hub genes expression values. High signature score was significantly associated with high tumor size, high histologic grade, lymph node metastasis, ER negativity, basal-like, and HER2 enriched subtypes (P & lt;0.001). The signature score showed strong correlation with the proliferation signatures OncotypeDx and PCNA (ρ=0.90-0.96, P & lt;0.001). Our signature score associated with reduced cancer specific survival (P & lt;0.001), also when adjusted for tumor size, histologic grade, and lymph node status in multivariate analyses in both cohorts (HR: 1.074-1.081, 95% CI: 1.046-1.109, P ≤0.003). The signature score maintained independent, significant association with survival when adjusting for the traditional clinico-pathologic variables in OncotypeDx-low tumors in discovery (HR: 1.077, 95% CI: 1.034-1.122) and validation cohort (HR: 1.154, 95% CI: 1.065-1.251), both P & lt;0.001. Conclusion: By genome-wide gene expression analyses, the current study provides new insights into age-related gene expression alterations in breast cancer. We demonstrate enrichment of oncogenic signaling and evidence of higher tumor cell proliferation in young BC patients, and identify a gene expression signature reflecting tumor proliferation, aggressive tumor features and reduced survival, also in subsets of low OncotypeDx score. Citation Format: Lise Martine Ingebriktsen, Lars Andreas Akslen, Elisabeth Wik. Identification of an age-related breast cancer gene expression signature with strong prognostic value [abstract]. In: Proceedings of the American Association for Can cer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2695.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 9
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 19, No. 9 ( 2013-05-01), p. 2331-2341
    Abstract: Purpose: High Stathmin expression has recently been associated with clinical progress in endometrial cancers. Stathmin protein activity is modulated by phosphorylation, and the Serine38 site is one of four Stathmin phospho-sites. The presence and significance of pStathmin(S38) is largely unknown in human cancers, and we here examined the associations between this marker and tumor cell proliferation, clinicopathologic phenotype, and survival impact in endometrial cancer. A relationship with possible treatment targets was explored by integrated analysis of transcriptional alterations. Experimental Design: Primary endometrial cancers from two independent patient series (n = 518/n = 286) were analyzed. Biomarkers were assessed by immunohistochemistry, FISH, flow cytometry, DNA oligonucleotide microarray, single-nucleotide polymorphism array, and Sanger sequencing, and related to clinicopathologic annotations and follow-up information. Results: High pStathmin(S38) level was associated with poor prognosis, independent of other features, and correlated to increased tumor cell proliferation as well as high Stathmin levels. On the basis of transcriptional differences between high/low pStathmin(S38) tumors, phosphoinositide 3-kinase (PI3K)/mTOR/HSP90 were suggested as possible targets in pStathmin(S38)-high cases. High pStathmin(S38) was associated with several PI3K pathway alterations: amplification of the 3q26 region, increased PIK3CA copy number (FISH) and a PI3K activation score (all P & lt; 0.05). Conclusions: High pStathmin(S38) is a novel biomarker of increased tumor cell proliferation and impaired prognosis as reported here for independent cohorts of endometrial cancer and not previously shown in human cancer. Our data support a rationale for further studies exploring effects of drugs inhibiting the PI3K signaling pathway in pStathmin(S38)-high endometrial cancer, including a potential value of pStathmin(S38) in predicting response to PI3K/mTOR/HSP90 inhibitors. Clin Cancer Res; 19(9); 2331–41. ©2013 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2013
    detail.hit.zdb_id: 1225457-5
    detail.hit.zdb_id: 2036787-9
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  • 10
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2015
    In:  Cancer Research Vol. 75, No. 15_Supplement ( 2015-08-01), p. 3864-3864
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 15_Supplement ( 2015-08-01), p. 3864-3864
    Abstract: Introduction: Ploidy is among the most frequently studied biomarkers in endometrial cancer (EC), but lacks validation in larger studies. Mechanisms leading to tumor aneuploidy are only partly understood, and few studies have examined the molecular distinctions between diploid and aneuploid tumors in EC. Loss of the cohesin subunit STAG2 has been proposed as a driver of aneuploidy in several cancer types, but has not yet been explored for EC. Aims: In this study, we wanted to investigate ploidy status in primary EC in relation to standard clinicopathologic variables including FIGO stage, grade, histologic type and age, as well as outcome. Further, we wanted to evaluate genes differentially expressed between aneuploid and diploid primary tumor samples, and the proposed aneuploidy marker STAG2 in EC. Materials and methods: DNA ploidy was determined by flow cytometry in fresh tumor tissue for 794 patients, enrolled from 1980 - 2013. For expression analysis, RNA was extracted from fresh frozen primary tumor tissue from 144 samples, and measured with Agilent DNA microarrays (cat. no G4 112F). Significance Analysis of Microarrays (SAM) was run to identify differentially expressed genes between diploid and aneuploid cases. In order to identify the signature genes reflecting the differences between the two groups with highest accuracy, support vector machine (SVM) with 10-fold cross validation was applied. An aneuploidy score was calculated by subtracting the sum of expression of down-regulated genes from the sum of expression of up-regulated genes in the signature. Immunohistochemistry (IHC) was performed on tissue microarrays from 526 patients, with STAG2 antibody SA-2 (J12): sc-81852 (Santa Cruz Biotechnology). TCGA EC data were explored, and used for external validation. Results: Aneuploidy was significantly associated with predictors of poor outcome including FIGO stage, grade, histologic subtype and age (p & lt;0.001), and worse 5-year disease specific survival (DSS, p & lt;0.001). SVM identified 9 genes (3 up- and 6 down-regulated) yielding a good accuracy for identifying aneuploid tumor status. The aneuploidy score was significantly associated with all standardly applied clinicopathologic surrogate markers for outcome (p & lt;0.01) and DSS (p = 0.001). No association was found between STAG2 expression by IHC and ploidy status, however loss of STAG2 was associated with better DSS than intact STAG2 (p = 0.05). In TCGA data, 8.1% of EC patients had STAG2 mutations, with slightly better DSS compared to patients without mutation (p = 0.05). Conclusions: DNA ploidy estimated by flow cytometry adds prognostic information in EC. Loss of STAG2 expression is not associated with aneuploidy. A 9-gene signature reflects ploidy status and predicts aggressive tumor behavior. The role of the 9 genes will be further explored to unveil potential involvement in aneuploidy development in EC. Citation Format: Karen K. Mauland, Kanthida Kusonmano, Elisabeth Wik, Mari K. Halle, Jone Trovik, Hans K. Haugland, Anne M. Oyan, Helga B. Salvesen. Aneuploidy predicts aggressiveness and poor prognosis in endometrial cancer, and is reflected in a 9-gene signature. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3864. doi:10.1158/1538-7445.AM2015-3864
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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