乳腺
乳癌AJCC第8版の予後病期の臨床的有用性－従来の解剖学的病期との比較－
- 演 者：
- 和田 徳昭1，久岡 和彦1, 須田 秀太郎1, 別宮 絵美真1, 下河原 達也1, 門多 由恵1, 小野 滋司1, 小倉 正治1, 浅原 史卓1, 瀧川 穣1, 江口 圭介1, 長谷川 博俊1, 松井 淳一1
- 所属機関：
- 1東京歯科大学・市川総合病院・外科
Background: The American Joint Committee on Cancer (AJCC) 8th edition staging manual introduced a new pathologic prognostic stage (ppStage) for breast cancer incorporating biologic factors in addition to traditional anatomic factors. The aim was to study the clinical utility of AJCC 8th edition ppStage for patients with breast cancer.
Patients and methods: There was a total of 866 patients newly diagnosed with invasive breast cancer in our hospital from Jan 2008 to Jan 2018. Patients receiving neoadjuvant systemic therapy and those with unknown clinicopathologic factors were excluded. According to the AJCC 8th edition cancer staging system, ppStage information included: nuclear grade, HER2, ER and PR status in addition to pathologic T, N status. 481 patients who were determined by ppStage were en-rolled in this study. The ppStage was compared with the traditional clinical anatomic Stage (caStage).
Results: All of patients were female, the median age at the operation of breast cancer was 65 years old [range: 27-94 years old]; 361 (75.1%) were postmenopausal. The number of patients with caStage I, IIA, IIB, IIIA and others were 275 (57.2%), 165 (34.3%), 27 (5.6%), 3 (0.6%) and 14 (2.9%), respectively. The number of patients with ppStage IA, IB, IIA, IIB, IIIA and others were 389 (80.9%), 36 (7.5%), 16 (3.3%), 5 (1.0%), 25 (5.2%) and 10 (2.0%), respectively. 209 (43.5%) patients as for caStage changed compared with ppStage. Among them, only 20 (7.2%) patients of caStage I changed upstaging for ppStage. On the other hand, 120 (72.7%) patients of caStage IIA changed downstaging to ppStage IA. Only three disease specific deaths (0.8%) occurred in ppStage IA at a median follow-up time of 41 months [2-156 month].
Conclusions: The rate of ppStage IA has increased following AJCC 8th edition. The ppStage might provide more accurate prognostic information than the caStage.
MALDI-MSによる血清IgGN型糖鎖修飾プロファイリングを用いた乳がんの診断予測
- 演 者：
- 川口 展子1，杉本 昌弘3, 西風 隆司4, 関谷 禎規4, 児嶋 浩一4, 戸井 雅和2
- 所属機関：
- 1京都大学・腫瘍内科, 2京都大学附属病院・乳腺外科, 3慶應義塾大学・先端生命科学研究所, 4島津製作所・質量分析研究所
[Background]An earlier diagnosis improves the prognosis for breast cancer. Accordingly, an easier, faster, and less-painful test is needed. Immunoglobulin G (IgG) crystallizable fragment (Fc) region N-glycosylation, which affects the function of antibodies, can be analyzed in detail. Also serum IgG Fc N-glycosylation profiling was stable, which is necessary for clinical practice. Previously, we reported that breast cancer patients (N = 55) can be distinguished from cancer-free controls (N = 51) by using a prediction model based on serum IgG Fc N-glycosylation profiling by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) with good sensitivity and specificity. Here, we analyzed another cohort set to improve the prediction model. [Materials and methods] Serum IgG glycans in breast cancer patients (N = 113) and cancer-free controls (N = 110) were profiled using MALDI-MS with quality control samples. IgG was isolated from 5μl serum by using Protein G beads. Following SDS-PAGE, gel containing heavy chains was excised, and glycans were extracted by peptide-N-glycosidase F digestion and analyzed by MALDI-MS. The intensity of 32 glycans was normalized by the sum of their intensity. The ability of discrimination of each glycan was estimated statistically. [Results] The analysis of quality control samples confirmed reliability of the data. Normalized intensity of some glycans had significance or trend in difference between breast cancer patients and cancer-free controls both in first cohort and in second cohort. [Conclusion] Serum IgG Fc N -glycosylation profiling by MALDI-MS is a potential biomarker for breast cancer diagnosis, although further investigation is required.
