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University of Glasgow

1. Gujam, Fadia J.A. An investigation of the relationship between the components of tumour microenvironment, signal transduction pathways and outcome in breast cancer.

Degree: PhD, 2017, University of Glasgow

Breast cancer, the most commonly diagnosed type of cancer in women, is a major cause of morbidity and mortality in the western world. Well-established risk factors of breast cancer are mostly related to women’s reproductive history, such as early menarche, late first pregnancy and late menopause. Survival rates have improved due to a combination of factors, including better health education, early detection with large-scale use of screening mammogram, improved surgical techniques, as well as widespread use of adjuvant therapy. At initial presentation, clinicopathological features of breast cancer such as age, nodal status, tumour size, tumour grade, and hormonal receptor status are considered to be the standard prognostic and predictive markers of patient survival, and are used to guide appropriate treatment strategies. Lymphovascular invasion (LBVI), including lymphatic (LVI) and blood (BVI) vessel invasion, has been reported to be prognostic and merit accurate evaluation, particularly in patients with node negative tumours who might benefit from adjuvant chemotherapy. There is a lack of standard assessment and agreement on distinguishing LVI from BVI despite the major challenges in the field. A systematic review of the literatures, examining methods of detection and the prognostic significance of LBVI, LVI and BVI, was carried out. The majority of studies used haematoxylin and eosin (H&E) and classical histochemistry to identify LVI and BVI. Only few recent studies used immunohistochemistry (IHC) staining of the endothelium lining lymphatic and blood vessels, and were able to show clear differences between LVI and BVI. The prognostic significance of LBVI and LVI was well-documented and strongly associated with aggressive features of breast tumours, while the prognostic value and the optimal detection method of BVI were unclear. Assessment and prognostic value of LBVI on H&E sections (LBVIH&E) was examined and compared to that of LVI and BVI detected using IHC with D2-40 for LVI (LVID2–40) and Factor VIII for BVI (BVIFVIII) in patients with breast cancer including node negative and triple negative patients (n=360). LBVIH&E, LVID2–40 and BVIFVIII were present in 102 (28%), 127 (35%) and 59 (16%) patients respectively. In node negative patients (206), LBVIH&E, LVID2–40 and BVIFVIII were present in 41 (20%), 53 (26%) and 21 (10%) respectively. In triple negative patients (102), LBVIH&E, LVID2–40 and BVIFVIII were present in 35 (29%), 36 (35%) and 14 (14%) respectively. LBVIH&E, LVID2–40 and BVIFVIII were all significantly associated with tumour recurrence in all cohorts. On multivariate survival analysis, only LVID2–40 and BVIFVIII were independent predictors of cancer specific survival (CSS) in the whole cohort (P=0.022 and P<0.001 respectively), node negative (P=0.008 and P=0.001 respectively) and triple negative patients (P=0.014 and P<0.001 respectively). Assessment of LVI and BVI by IHC, using D2-40 and Factor VIII, improves prediction of outcome in patients…

Subjects/Keywords: RC0254 Neoplasms. Tumors. Oncology (including Cancer)

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Gujam, F. J. A. (2017). An investigation of the relationship between the components of tumour microenvironment, signal transduction pathways and outcome in breast cancer. (Doctoral Dissertation). University of Glasgow. Retrieved from http://theses.gla.ac.uk/7876/

Chicago Manual of Style (16th Edition):

Gujam, Fadia J A. “An investigation of the relationship between the components of tumour microenvironment, signal transduction pathways and outcome in breast cancer.” 2017. Doctoral Dissertation, University of Glasgow. Accessed May 29, 2017. http://theses.gla.ac.uk/7876/.

MLA Handbook (7th Edition):

Gujam, Fadia J A. “An investigation of the relationship between the components of tumour microenvironment, signal transduction pathways and outcome in breast cancer.” 2017. Web. 29 May 2017.

Vancouver:

Gujam FJA. An investigation of the relationship between the components of tumour microenvironment, signal transduction pathways and outcome in breast cancer. [Internet] [Doctoral dissertation]. University of Glasgow; 2017. [cited 2017 May 29]. Available from: http://theses.gla.ac.uk/7876/.

Council of Science Editors:

Gujam FJA. An investigation of the relationship between the components of tumour microenvironment, signal transduction pathways and outcome in breast cancer. [Doctoral Dissertation]. University of Glasgow; 2017. Available from: http://theses.gla.ac.uk/7876/

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