Application of morphometry, static DNA ploidy analysis, and steroid receptor expression in diagnosis and prognosis of Libyan breast cancer

The aim of this study was to describe the demographic, clinicopathological, biological and morphometric features of Libyan breast cancer patients. The supporting value of nuclear morphometry and static image cytometry in the sensitivity for detecting breast cancer in conventional fine-needle aspiration biopsies were estimated. The findings were compared with findings in breast cancer in Finland and Nigeria. In addation, the value of ER and PR were evaluated. There were 131 histological samples, 41 cytological samples, and demographic and clinicopathological data from 234 Libyan patients. The Libyan breast cancer is dominantly premenopausal and in this feature it is similar to breast cancer in sub-Saharan Africans, but clearly different from breast cancer in Europeans, whose cancers are dominantly postmenopausal in character. At presention most Libyan patients have locally advanced disease, which is associated with poor survival rates. Nuclear morphometry and image DNA cytometry agree with earlier published data in the Finnish population and indicate that nuclear size and DNA analysis of nuclear content can be used to increase the cytological sensitivity and specificity in doubtful breast lesions, particularly when free cell sampling method is used. Combination of the morphometric data with earlier free cell data gave the following diagnostic guidelines: Range of overlap in free cell samples: 55 μm2 -71 μm2. Cut-off values for diagnostic purposes: Mean nuclear area (MNA) >54 μm2 for 100% detection of malignant cases (specificity 84 %), MNA < 72 μm2 for 100% detection of benign cases (sensitivity 91%). Histomorphometry showed a significant correlation between the MNA and most clinicopathological features, with the strongest association observed for histological grade (p <0.0001). MNA seems to be a prognosticator in Libyan breast cancer (Pearson’s test r = - 0.29, p = 0.019), but at lower level of significance than in the European material. A corresponding relationship was not found in shape-related morphometric features. ER and PR staining scores were in correlation with the clinical stage (p= 0.017, and 0.015, respectively), and also associated with lymph node negative patients (p=0.03, p=0.05, respectively). Receptor-positive (HR+) patients had a better survival. The fraction of HR+ cases among Libyan breast cancers is about the same as the fraction of positive cases in European breast cancer. The study suggests that also weak staining (corresponding to as few as 1% positive cells) has prognostic value. The prognostic significance may be associated with the practice to use antihormonal therapy in HR+ cases. The low survival and advanced presentation is associated with active cell proliferation, atypical nuclear morphology and aneuploid nuclear DNA content in Libyan breast cancer patients. The findings support the idea that breast cancer is not one type of disease, but should probably be classified into premenopausal and post menopausal types.

Grass-endophyte coevolution and ploidy levels in fescues

ABSTRACT Fescues consist of wild and cultivated grasses that have adapted to a wide range of environmental conditions. They are an excellent model species for evolutionary ecology studies that investigate symbiosis and polyploidization and their effects on plant performance. First, they are frequently infected with symbiotic endophytic fungi known to affect a plant’s ability to cope with biotic and abiotic environmental factors. Second, fescue species have been reported to have substantial intraspecific variation in their ploidy level and morphology. In my thesis, I examined large-scale generalizations for frequency of polyploidy and endophyte infections and their effects on plant morphology. As a model species, I selected red (Festuca rubra) and viviparous sheep’s (F. vivipara) fescues. They are closely related, but they differ in terms of distribution and endophyte infection frequency. I investigated the biogeographic pattern and population biology of 29 red and 12 viviparous sheep’s fescue populations across ≈300 latitudes in Europe (400-690 N). To examine plant ploidy levels, I implemented time- and cost-efficient plate-based high throughput flow cytometric analysis. This efficient procedure enabled me to analyze over 1000 red fescue individuals. I found three ploidy levels among them: overall 84 %, 9 % and 7 % of the red fescue plants were hexaploid, tetraploid and octoploid, respectively. However, all viviparous sheep’s fescue plants were tetraploid. Ploidy level of red fescue appeared to some extent follow gradients in latitude and primary production as suggested by previous studies, but these results could be explained better by taking the sampling design and local adaptation into account. Three Spanish populations were mostly tetraploids and one high elevation population in northernmost Finland (Halti) was octoploid, while most other populations (25 sites) were dominated by hexaploids. Endophyte infection frequencies of wild fescue populations varied from 0 to 81 % in red fescue populations and from 0 to 30 % in viviparous sheep’s fescue populations. No gradients with latitude or primary production of the sites were detected. As taxonomy of red fescues is somewhat unclear, I also studied morphology, ploidy variation and endophyte status of proposed subspecies of European red fescues. Contrary to previous literature, different ploidy levels occurred in the same subspecies. In addition to wild fescues, I also used two agronomically important cultivars of meadow and tall fescue (Schedonorus phoenix and S. pratensis). As grass-legume mixtures have an agronomic advantage over monocultures in meadows, I carried out a mixture/competition experiment with fescues and red clover to find that species composition, nutrient availability and endophyte status together determined the total biomass yield that was higher in mixtures compared to monocultures. The results of this thesis demonstrate the importance of local biotic and abiotic factors such as grazing gradients and habitat types, rather than suggested general global geographical or environmental factors on grass polyploidization or its association with symbiotic endophytic fungi. I conclude that variation in endophyte infection frequencies and ploidy levels of wild fescues support the geographic mosaic theory of coevolution. Historical incidents, e.g., glaciation and present local factors, rather than ploidy or endophyte status, determine fescue morphology.

Securin, Cdc20 and Cdc27 in predicting the outcome of human breast cancer

Deregulated proliferation has been recognized among the most important factors promoting breast cancer development and progression. The aim of the project is to gain understanding of the role of specific cell cycle regulators of metaphase-anaphase transition and evaluate their potential in breast cancer prognostication and treatment decisions. Metaphase-anaphase transition is triggered by activation of anaphase promoting complex (APC) which is activated by a cascade of regulatory proteins, among them securin, Cdc20 and Cdc27. These proteins promote the metaphase–anaphase transition and participate in the timely separation of the chromatids. This study is based on a patient material of approximately 600 breast cancer patients and up to 22 years of follow-up. As the main observation, based on DNA cytometric and immunohistochemical methods, securin, Cdc20 and Cdc27 protein expressions were associated with abnormal DNA content and outcome of breast cancer. In the studied patient material, high securin expression alone and in combination with Cdc20 and Cdc27 predicted up to 9.8-fold odds for aneuploid DNA content in human breast cancer. In Kaplan–Meier analyses, high expression of securin systematically indicated decrease in breast cancer survival as compared to low expression cases. The adverse effect of high securin expression was further strengthened by combining it with Cdc20 or Cdc27 expressions, resulting in up to 6.8-fold risk of breast cancer death. High securin and Cdc20 expression was also associated with triple-negative breast cancer type with high statistical significance. Securin, Cdc20 or Cdc27 have not previously been investigated in a clinically relevant large breast cancer patient material or in association with DNA ploidy. The present findings suggest that the studied proteins may serve as potential biomarkers for identification of aggressive course of disease and unfavourable outcome of human breast cancer, and that they may provide a future research aim for understanding abnormal proliferation in malignant disease.