Abstract
Aim: HER2-positive tumors are associated with a poor prognosis and a shortened disease-free and overall survival as well as with other unfavorable prognostic tumor characteristics (high ...histological grade, high proliferative index, negative or low estrogen receptor expression, etc.). HER2-positive tumors are also responsive to treatment with trastuzumab in reducing the risk of recurrence and improving survival. The aim of this study is to assess the incidence of HER2 gene amplification in selected tumors with adverse prognostic features which scored 1+ by immunohistochemistry (IHC).
Methods: 75 women with infiltrating ductal carcinoma (IDC) and infiltrating lobular carcinoma (ILC) scoring 1+ by IHC were included. Forty-eight invasive breast carcinoma samples were selected according to unfavorable prognostic tumor characteristics and tested by FISH. HER2 amplification was evaluated using Vysis HER2/Cep17 probe (Path Vysion HER2 DNA Probe Kit®, Abbott Molecular, IL); ratio–based amplification was considered present when the HER2/Cep17 ratio was 2 or more and copy number-based amplification was considered present when the mean HER2 copy number was more than 6, in agreement with the ASCO/CAP/SIAPEC guidelines.
Results: In 2013, 331 patients with invasive breast tumors were tested by IHC; 75 cases (23%) were scored 1+ of which 62 cases (19%) of IDC and 13 cases (4%) of ILC. Forty-eight invasive breast carcinoma samples (64%) were selected according to one or more unfavorable prognostic tumor characteristics; 22 out of 48 tumors (46%) showed high histological grade (G3); 27 cases (56%) had high proliferative index (Ki-67 ≥ 30%); 32 tumor samples (67%) were node-positive; and 29 cases (60%) showed vascular invasion. FISH was performed on 28 of the 1+ patients with adverse tumor characteristics and 6 IDC out of 48 (12.5%) showed HER2 amplification.
Conclusions: Our preliminary retrospective data suggest that 6 patients out of 48 (12.5%) scoring 1+ by IHC show HER2 amplification, in agreement with the most recently published literature data. In order to not deny the benefit deriving from trastuzumab administration, in breast cancer patients showing IHC 1 + , it is advisable to test HER2 gene amplification by FISH.
Disclosure: All authors have declared no conflicts of interest.
A general theory has been developed for calculating the reliability of a device which does not deteriorate with time and which is exposed to a stochastic load. Two important cases of stochastic loads ...have been considered: (1) statistically independent random pulses, and (2) a sequence of random pulses, each one separated from the next one by a random period of time during which no load is applied to the device. Numerical examples are included.
This study investigates the interaction of trust, relational selling behavior, team sales, and sales success in a business-to-business environment. The study data were collected in Europe for 270 ...different purchase situations for which business buyers rated their suppliers' salespersons on various dimensions. This research considers the relationships among three levels of trust and relational selling behaviors and measures the interaction of successful or unsuccessful selling environment, continuing purchase conditions for the buyers and the presence of team selling circumstances. The findings indicate that the three levels of trust are related positively, that successful salespersons are rated significantly higher by buyers for all three trust scales and for relational behavior. In addition, relational selling behavior is favored by buyers in repeat purchase conditions. Further results indicate limited interaction among trust and relational behavior in team selling conditions.
A computer program for the calculation of reactor transfer functions has been written and tested. The model used for the temperature feedbacks differs from previous models because it accounts not ...only for heat propagation and heat transport effects but also for effects due to the nonlinearities of thermal parameters, such as the fuel thermal conductivity, the fuel specific heat capacity, and the heat transfer coefficient of the gap between fuel and cladding. Transfer functions are evaluated by making use of analytical methods. Numerical results are also included and show that physical changes in the gap during power oscillations will have an important effect on some particular transfer functions. This result is important if one wants to evaluate the gap heat transfer coefficient from power oscillation experiments.
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