Abstract P5-05-01: Prevalance of crown-like structures of the breast, a histologic biomarker linked to obesity: A retrospective study of 99 cases
Notice bibliographique
Résumé
Abstract Introduction: Breast cancer risk is multifactorial, and depends partly on obesity and related metabolic imbalances, including inflammation. Obesity is increasing worldwide, and is a known cancer risk albeit with complex mechanisms. Previous reports (Morris et al., 2011; Iyengar et al., 2015) indicate that local inflammation can be seen histologically as a rings of macrophages around necrotic adipocytes ("crown-like structures of the breast", CLS-B). Our goal was to determine the prevalence of CLS-B in routine specimens from a cohort of patients with known BMI. Methods: We retrieved archival H&E slides from a breast cancer cohort (N=99) previously characterized for BMI and fasting plasma/serum metabolic factors. Two pathologists reviewed all available sections of white adipose tissue not adjacent to tumour (median 7 blocks/case), excluding fat necrosis and mastitis, blinded to correlative data/BMI. We recorded the presence/absence and numbers of CLS-B, defined as a continuous ring of macrophages surrounding an adipocyte. Paraffin blocks were available in a subset (N=72) and a representative block was immunostained for CD68 to highlight CLS-B. For all cases, the average fat vacuole size was determined by digital image analysis (NIH ImageJ Software). We performed correlative statistics between CLS-B status and clinical data (χ2, Wilcoxon rank-sum tests). Results: CLS-B were present in 37 of 99 cases (37%). When present the total number of CLS-B ranged from 1 to 18 (mean=4.3, median=3). CLS-B were detected in 7/10 (70%) patients with BMI >30 vs. 30/89 (34%) with BMI ≤ 30 (p=0.02). CLS-B also trended to higher prevalence in women over 60 compared to women under 60 (12/20, 60% vs. 25/79, 32%, p = 0.063). There was no significant association of CLS-B status with tumor T- and N-stage or grade (all P>0.4). The median C-reactive protein in the group with CLS-B was 1.5 mg/L vs. 0.8 mg/L in the group without CLS-B (P=0.10) There was no significant association of CLS-B with insulin, glucose, HOMA, leptin, adiponectin, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, or IGF-1 (all P>0.27). The average fat globule area determined by image analysis correlated significantly with BMI (Spearman correlation 0.54, p<0.0001) but not to the presence of CLS-B (p=0.102). Within the subset immunostained for CD68, 32/72 (44%) had CLS-B on the original H&E sections, whereas 13/72 (18%) had CLS-B on the representative CD68-stained section. This corresponded to a false negative in 22/59 (37%) CD68-negative cases, and increased detection in 3/13 of the CD68-positive cases. Conclusion: In our cohort, obesity is correlated with elevated tissue inflammation as seen by the presence of CLS-B, but CLS-B is not correlated with metabolic markers. CLS-B are well appreciated on routine H&E sections; however, more work is needed to find a practical approach to both ancillary testing (e.g. CD68) and quantitation. Our work independently confirms the association of CLS-B with obesity, and supports the concept that CLS-B is a tissue biomarker of obesity-related inflammation. (Z.E. was co-principal author.) Citation Format: Chang MC, Eslami Z, Ennis M, Goodwin PJ. Prevalance of crown-like structures of the breast, a histologic biomarker linked to obesity: A retrospective study of 99 cases. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-05-01.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».