Lymphocyte-predominant triple-negative breast carcinomas in premenopausal patients: Lower expression of basal immunohistochemical markers.

OBJECTIVES: Triple-negative breast carcinomas (TNBCs) correspond to a molecular heterogeneous disease defined by lack of estrogen and progesterone receptor expression, and the absence of overexpression and/or amplification of HER2. Recent data indicate that clinical outcome in TNBC is affected by tumor-infiltrating lymphocytes, suggesting that they can benefit from immunotherapies. We selected 116 consecutive premenopausal patients with TNBC to compare the immunohistochemical profile of the group rich in tumor-infiltrating lymphocytes with those without this characteristic. MATERIALS AND METHODS: We reviewed all the original histological sections to assess pathological features, and to select a representative area for tissue microarrays and immunohistochemical study. Estrogen and progesterone receptors, HER2 and Ki-67 were evaluated in whole histological sections. The following markers were analyzed in tissue microarrays sections: androgen receptor, cytokeratin 5/6, cytokeratin 14, epidermal growth factor receptor (EGFR), vimentin, p16, claudin-3, -4, and -7, p63, and aldehyde dehydrogenase isoform 1 (ALDH1). Lymphocyte-predominant breast cancer (LPBC) was defined by the presence of more than 50% of lymphocytes in the intratumoral stroma. RESULTS: Twenty-six (22.4%) patients present tumors classified as LPBC and 90 (77.6%) as non-LPBC. The two groups were similar regarding age of patients, tumor grade and Ki-67 positive cells. LPBC cases presented lower frequency of expression of the basal cytokeratins, EGFR, and basal-like immunoprofile. There was a trend to higher expression of ALDH1 by stromal intratumoral cells. The expression of all other markers were similar in the two groups. CONCLUSIONS: Lymphocyte-predominant TNBC in premenopausal patients are mostly of non-basal phenotype.

The Apocrine Profile of Triple-negative Breast Carcinomas in Patients Aged 45 Years or Younger: favorable but rare features.

Objective Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype. Methods A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression. Results An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p = 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p = 0.06). Conclusions The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.

The Apocrine Profile of Triple-negative Breast Carcinomas in Patients Aged 45 Years or Younger: favorable but rare features / Perfil apócrino em carcinomas mamários triplonegativos de pacientes até 45 anos: característica favorável, ainda que rara

Abstract Objective Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype. Methods A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression. Results An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p= 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p= 0.06). Conclusions The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.

Resumo Objetivo Carcinomas mamários triplo-negativos representam um grupo heterogêneo de neoplasias, embora geralmente exibam fenótipo clinicamente mais agressivo e sejam mais prevalentes em mulheres jovens. Até o presente, terapias-alvo para esses grupos não foram definidas. O objetivo deste estudo foi avaliar a frequência do subtipo apócrino em carcinomas mamários triplo-negativos de mulheres na pré-menopausa, definido pela expressão imuno-histoquímica do receptor de androgênio, e sua associação com tipo histológico, grau histológico, atividade proliferativa, expressão do receptor do fator de crescimento epidérmico (EGFR) e o fenótipo basal-símile. Métodos Foram selecionadas 118 amostras de tecido tumoral de pacientes com até 45 anos de idade. As amostras foram revisadas quanto a tipo e grau histológicos e expressão do Ki-67. A expressão imuno-histoquímica de receptor de androgênio, citoqueratina basal ⅚, e do EGFR foram analisadas em amostras de microarranjos de tecido. O subtipo apócrino foi definido pela positividade do receptor de androgênio. O fenótipo basal-símile foi caracterizado pela expressão da citoqueratina ⅚ e/ou do EGFR. Resultados O perfil apócrino foi identificado em 6/118 (5,1%) casos. Este subgrupo apresentou menor fração de expressão do Ki-67 (17,5% versus 70,0%, p= 0,02) e uma tendência a menor grau histológico (66,7% versus 27,9%, p= 0,06). Conclusões O subtipo apócrino dos carcinomas mamários triplo-negativos é raro em mulheres na pré-menopausa, e tende a se apresentar como carcinomas de menor grau e menor atividade proliferativa, sugerindo fenótipo biológico menos agressivo.

Efeito de emulsoes lipidicas sobre mecanismos de defesa organica na agressao infecciosa / Effect of lipidic emulsions on organic defense mechanisms in infective aggression

Constitui-se o objetivo da presente pesquisa o estudo do efeito de emulsoes lipidicas comercialmente disponiveis de Triglicerides de Cadeia Longa (TCL) e de Triglicerides de Cadeia Media (TCM) e Longa (TCM/TCL) a 10 por cento sobre a funcao de polimorfonucleares (LPMN) de sangue de ratos apos transfusao endovenosa continua em ratos submetidos a agressao infecciosa por meio da inoculacao intraperitoneal de E. coli. Efetuaram-se provas de funcao dos LPMN (atividades fagocitaria, bactericida e quimiotatica), hemoculturas seriadas, avaliacao clinica, autopsia e avaliacao histopatologica do figado e baco e analise de taxa de mortalidade. Nao se observaram diferencas significativas no comportamento funcional dos LPMN do sangue de ratos