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تميز دراسي وبحثي

البحوث المنشورة

البحث (1):

عنوان البحث:

Construction of tissue microarrays from core needle biopsies – a systematic literature review

رابط إلى البحث:

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تاريخ النشر:

25/10/2015

موجز عن البحث:

In some clinical circumstances, core needle biopsy (CNB) may be the only source of material from cancer tissue for diagnostic use. The volume of tissue available in a CNB is low, and opportunities for research use can therefore be limited. The tissue microarray (TMA) principle, if applied to the use of CNBs, could facilitate research studies in circumstances where CNB specimens are available. However, various challenges are expected in applying such a technique in CNBs, which has limited their use in research. We therefore conducted a systematic review of the literature on this subject. A systematic search was carried out with CINAHL, EMBASE, the Cochrane library, and MEDLINE, to identify studies that have primarily developed methods for constructing TMAs from CNBs. Eight studies were found to meet the inclusion criteria; six of these employed the vertical rearrangement technique, and two used multiple layers of biopsy tissue. Representation of the CNB was significantly influenced by the quantity of tumour cells present in the original biopsy and the degree of heterogeneity of biomarker expression. This review shows that technologies have been developed to enable construction of TMAs from CNBs. However, challenges remain to improve amplification and representation.

المؤتمرات العلمية:

المؤتمر (1):

عنوان المؤتمر:

3^rd Symposium on Primary Breast Cancer in Older Women

تاريخ الإنعقاد:

06/03/2015

مكان الإنعقاد:

Nottingham, UK

طبيعة المشاركة:

Poster presentation

عنوان المشاركة:

Accuracy of core needle biopsy in determining histological grade and type of primary breast cancer in older women

ملخص المشاركة:

Background: Core needle biopsy (CNB) is currently the standard diagnostic method of breast cancer that forms the basis of subsequent therapeutic strategies, including neo-adjuvant, primary and/or adjuvant therapy. This study aimed to investigate the accuracy of CNB in determining histological grade and type in older women with primary breast cancer.

Methods: Of a consecutive series of 1758 women diagnosed at ≥70 years with operable (<5 cm) primary breast cancer, those who underwent primary surgery and with histological grade (Elston/Ellis modification of Bloom and Richardson system) and type (WHO criteria) available from the pathology reports of both CNB and surgical specimens were retrospectively reviewed.

Results: Of the 332 patients with grade available, 53%, 61% and 93% of grade 1, 2 and 3 CNBs respectively were shown to have the same grade in the surgical specimens. 6% of grade 1 CNBs were reported as grade 3 in the surgical specimens. None of grade 3 cases (CNB) were reported as grade 1 at surgery. Of the 667 patients with type available, 75%, 64% and 55% reported as invasive ductal (no special type [NST]), lobular carcinoma and ductal carcinoma in situ respectively on CNBs were shown to have the same type in the surgical specimens.

Discussion: A high concordance between CNB and surgical specimens has been demonstrated in this older population, notably in grade 3 tumors and with the common histological type (ductal NST). The fact that grade 1 tumours based on CNB seldom turned out to be grade 3 (and vice versa) is also reassuring.

المؤتمر (2):

عنوان المؤتمر:

Nottingham Pathology 2016

تاريخ الإنعقاد:

28/06/2016

مكان الإنعقاد:

Nottingham, UK

طبيعة المشاركة:

Poster presentation

عنوان المشاركة:

Reporting on Ki67 expression utilising core needle biopsy and surgical excision specimens in older women with invasive breast cancer

ملخص المشاركة:

Introduction: Ki67 is a well-established prognostic marker in breast cancer (BC). Intra-tumour heterogeneous expression of Ki67 might impact its accurate reporting especially on core needle biopsy (CNB). This study aimed to evaluate the reliability of CNB to investigate Ki67 expression by comparing it with surgical excision (SE).

Material and Methods: Paired samples of CNB and full-face SE were collected from 119 older (age ≥70) women with primary invasive BC. Based on the availability of tumour tissue, multiple copies (CNB1, CNB2 & CNB3) from CNB were used to construct a tissue microarray (CNB TMA) block utilising a technique developed in our laboratory. Sections from CNB TMA and full-face SE specimens were immunohistochemically stained with Ki67 (MIB-1 clone, DAKO, Denmark).

Result: High Ki67 expression was detected in 53% (n=63) of cases using SE and 37% (n=44) using CNB. Estimated concordance between SE and cases with one CNB copy was 56%, whereas this estimate increased to 66% with expression from 2 copies and 88% with 3 copies. Estimated false negative cases based on 1 copy was 30%, 2 copies 27%, and 3 copies 0%. On the other hand, positive predictive values showed 59% (95% CI; 38.8%-77.6%) for 1 copy, 80% (95% CI; 44.4%-97.5%) for 2 copies and 86% (95% CI; 42.13%-99.64%) for 3 copies. Concordance between multiple copies of CNB, CNB1&CNB2, CNB1&CNB3 and CNB2&CNB3, were 76%, 100% and 38% respectively.

Conclusion: Sensitivity and specificity of using CNB to report on Ki67 appear to improve with multiple copies. CNB can be used to assess proliferative status of BC in older patients particularly in those where surgery is not the favourable option.