مجال
التميز

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.