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Tumor oxygenation correlates with molecular growth determinants in breast cancer

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Abstract

Hypoxic tumor cells may represent a fraction of cells that are not susceptible to radiation or chemotherapy. Intratumoral oxygen partial pressure (pO2) is the result of oxygen delivery and consumption. Cell proliferation is one factor to effect oxygen consumption and we therefore studied the correlation between tumor pO2 and histological parameters. Patients and methods: In 36 women and one man (age range 29–80 years) with suspected breast cancer. Before tumor resection, intralesional pO2 was determined with a polarographic needle electrode. Under ultrasound control, 200 tumor measurements were obtained; Hb levels, Hk, arterial blood gas parameters, and tissue temperature were determined. The median of pO2 values and the percentage of hypoxic areas (pO2 < 10 mmHg) were calculated and correlated with the histological type, grading, ER, PR, and the expression of Ki-67, p53, EGFR, pS2, and c-erb-B2. Results: The overall median pO2 was 44 mmHg, and 1024 measurements (13.8%) represented hypoxic areas. Ductal and lobular invasive cancers showed median pO2 of 41 mmHg. The mean pO2 of G1 tumors was 59 mmHg and the hypoxic fraction 8%, in contrast to G2 tumors with 43 mmHg and 17%, and G3 tumors with 36 mmHg and 20.4% (p < 0.01). We observed a correlation with tumor size and an increased rate of hypoxic areas in T3–4 lesions (p < 0.02). Also tumors with negative nodes or positive ER had significantly higher pO2 values, as did tumors with an overexpression of c-erb-B2, p53, and cathepsin D. Conclusion: Oxygenation of human breast cancers can safely be measured in patients prior to surgical therapy. pO2 values correlate both with prognostic markers examined histologically and with molecular growth factors. As the efficacy of preoperative or adjuvant treatment in individuals may depend on oxygen partial pressure, efforts to manipulate tumor pO2 for therapeutic purpose could be promising.

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References

  1. Vaupel P, Kallinowski F, Okunieff P: Blood flow, oxygen and nutrient supply, and metabolic microenvironment of human tumors: a review. Cancer Res 49: 6449-6465, 1989

    Google Scholar 

  2. Gatenby RA, Kessler HB, Rosenblum JS, Coia LR, Moldofsky PJ, Hartz WH, Broder GJ: Oxygen distribution in squamous cell carcinoma metastases and its relationship to outcome of radiation therapy. Int J Radiat Oncol Biol Phys 14: 831-838, 1988

    Google Scholar 

  3. Okunieff P, Hoeckel M, Dunphy EP, Schlenger K, Knoop C, Vaupel P: Oxygen tension distributions are sufficient to explain the local response of human breast tumors treated with radiation alone. Int J Radiat Oncol Biol Phys 26: 631-636, 1993

    Google Scholar 

  4. Wike-Hooley JL, Haveman J, Reinhold HS: The relevance of tumor pH to the treatment of malignant disease. Radiother Oncol 2: 343-366, 1984

    Google Scholar 

  5. Young SD, Hill RP: Effects of reoxygenation on cells from hypoxic regions of solid tumors: anticancer drug sensitivity and metastatic potential. J Natl Cancer Inst 82: 371-380, 1990

    Google Scholar 

  6. Brizel DM, Scully SP, Harrelson J, Layfield LJ, Bean J, Prosnitz LR, Dewhirst MW: Tumor oxygenation predicts for the likelihood of distant metastases in human soft tissue sarcoma. Cancer Res 56: 941-943, 1996

    Google Scholar 

  7. Hockel M, Knoop C, Schlenger K, Vorndran B, Baussmann E, Mitze M, Knapstein PG, Vaupel P: Intratumoral pO2 predicts survival in advanced cancer of the uterine cervix. Radiother Oncol 26: 45-50, 1993

    Google Scholar 

  8. Vaupel P, Fortmeyer HP, Runkel S, Kallinowski F: Blood flow, oxygen consumption, and tissue oxygenation of human breast cancer xenografts in nude rats. Cancer Res 47: 3496-3503, 1987

    Google Scholar 

  9. Teicher BA, Sotomayor EA, Dupuis NP, Kusumoto T, Menon K: Reduced oxygenation in a rat mammary carcinoma after chemo-or radiation therapy and reoxygenation with perflubron emulsion/carbogen breathing. J Cancer Res Clin Oncol 120: 593-598, 1994

    Google Scholar 

  10. Vaupel P, Schlenger KH, Hoeckel M, Okunieff P: Oxygenation of mammary tumors: from isotransplanted rodent tumors to primary malignancies in patients. Adv Exp Med Biol 316: 361-371, 1992

    Google Scholar 

  11. Runkel S, Wischnik A, Teubner J, Kaven E, Gaa J, Melchert F: Oxygenation of mammary tumors as evaluated by ultrasound-guided computerized-pO2-histography. Adv Exp Med Biol 345: 451-458, 1994

    Google Scholar 

  12. Vaupel P, Schlenger K, Knoop C, Hockel M: Oxygenation of human tumors: evaluation of tissue oxygen distribution in breast cancers by computerized O2 tension measurements. Cancer Res 51: 3316-3322, 1991

    Google Scholar 

  13. Foekens JA, van Putten WL, Portengen H, de Koning HY, Thirion B, Alexieva Figusch J, Klijn JG: Prognostic value of PS2 and cathepsin D in 710 human primary breast tumors: multivariate analysis. J Clin Oncol 11: 899-908, 1993

    Google Scholar 

  14. Foekens JA, Portengen H, Look MP, van Putten WL, Thirion B, Bontenbal M, Klijn JG: Relationship of PS2 with response to tamoxifen therapy in patients with recurrent breast cancer. Br J Cancer 70: 1217-1223, 1994

    Google Scholar 

  15. Fitzpatrick SL, Brightwell J, Wittliff JL, Barrows GH, Schultz GS: Epidermal growth factor binding by breast tumor biopsies and relationship to estrogen receptor and progestin receptor levels. Cancer Res 44: 3448-3453, 1984

    Google Scholar 

  16. Klijn JG, Look MP, Portengen H, Alexieva Figusch J, van Putten WL, Foekens JA: The prognostic value of epidermal growth factor receptor (EGF-R) in primary breast cancer: results of a 10 year follow-up study. Breast Cancer Res Treat 29: 73-83, 1994

    Google Scholar 

  17. Toi M, Tominaga T, Osaki A, Toge T: Role of epidermal growth factor receptor expression in primary breast cancer: results of a biochemical study and an immunocytochemical study. Breast Cancer Res Treat 29: 51-58, 1994

    Google Scholar 

  18. Nicholson RI, McClelland RA, Finlay P, Eaton CL, Gullick WJ, Dixon AR, Robertson JF, Ellis IO, Blamey RW: Relationship between EGF-R, c-erbB-2 protein expression and Ki67 immunostaining in breast cancer and hormone sensitivity. Eur J Cancer 29A: 1018-1023, 1993

    Google Scholar 

  19. Shrestha P, Yamada K, Wada T, Maeda S, Watatani M, Yasutomi M, Takagi H, Mori M: Proliferating cell nuclear antigen in breast lesions: correlation of c-erbB-2 oncoprotein and EGF receptor and its clinicopathological significance in breast cancer. Virchows Arch Path Anat A 421: 193-202, 1992

    Google Scholar 

  20. Ji H, Lipponen P, Aaltomaa S, Syrjanen K, Syrjanen S: c-erb-B2 oncogene related to p53 expression, cell proliferation and prognosis in breast cancer. Anticancer Res 13:1147-1152, 1993

    Google Scholar 

  21. Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL: Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235: 177-182, 1987

    Google Scholar 

  22. Seshadri R, Firgaira FA, Horsfall DJ, McCaul K, Setlur V, Kitchen P: Clinical significance of HER-2/neu oncogene amplification in primary breast cancer. The South Australian Breast Cancer Study Group. J Clin Oncol 11: 1936-1942, 1993

    Google Scholar 

  23. Allred DC, Clark GM, Elledge R, Fuqua SA, Brown RW, Chamness GC, Osborne CK, McGuire WL: Association of p53 protein expression with tumor cell proliferation rate and clinical outcome in node-negative breast cancer. J Natl Cancer Inst 85: 200-206, 1993

    Google Scholar 

  24. Westley BR, May FE: Cathepsin D and breast cancer. Eur J Cancer 32A: 15-24, 1996

    Google Scholar 

  25. Briozzo P, Morisset M, Capony F, Rougeot C, Rochefort H: In vitrodegradation of extracellular matrix with Mr 52,000 cathepsin D secreted by breast cancer cells. Cancer Res 48: 3688-3692, 1988

    Google Scholar 

  26. Thor AD, Moore DH II, Edgerton SM, Kawasaki ES, Reihsaus E, Lynch HT, Marcus JN, Schwartz L, Chen LC, Mayall BH et al.: Accumulation of p53 tumor suppressor gene protein: an independent marker of prognosis in breast cancers. J Natl Cancer Inst 84: 845-855, 1992

    Google Scholar 

  27. Marks JR, Humphrey PA, Wu K, Berry D, Bandarenko N, Kerns BJ, Iglehart JD: Overexpression of p53 and HER-2/ neu proteins as prognostic markers in early stage breast cancer. Ann Surg 219: 332-341, 1994

    Google Scholar 

  28. Salven P, Joensuu H, Heikkila P, Matikainen MT, Wasenius VM, Alanko A, Alitalo K: Endothelial Tie growth factor receptor provides antigenic marker for assessment of breast cancer angiogenesis. Br J Cancer74: 69-72, 1996

    Google Scholar 

  29. Bevilacqua P, Barbareschi M, Verderio P, Boracchi P, Caffo O, Dalla Palma P, Meli S, Weidner N, Gasparini G: Prognostic value of intratumoral microvessel density, a measure of tumor angiogenesis, in node-negative breast carcinoma - results of a multiparametric study. Breast Cancer Res Treat 36: 205-217, 1995

    Google Scholar 

  30. Cordell JL, Falini B, Erber WN, Ghosh AK, Abdulaziz Z, MacDonald S, Pulford KA, Stein H, Mason DY: Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal antialkaline phosphatase (APAAP complexes). J Histochem Cytochem 32: 219-229, 1984

    Google Scholar 

  31. Thews O, Vaupel P: Relevant parameters for describing the oxygenation status of solid tumors. Strahlenther Onkol 172: 239-243, 1996

    Google Scholar 

  32. Boucher Y, Baxter LT, Jain RK: Interstitial pressure gradients in tissue-isolated and subcutaneous tumors: implications for therapy. Cancer Res 50: 4478-4484, 1990

    Google Scholar 

  33. Roh HD, Boucher Y, Kalnicki S, Buchsbaum R, Bloomer WD, Jain RK: Interstitial hypertension in carcinoma of uterine cervix in patients: possible correlation with tumor oxygenation and radiation response. Cancer Res 51: 6695-6698, 1991

    Google Scholar 

  34. Wiedemann G, Roszinski S, Biersack A, Weiss C, Wagner T: Local hyperthermia enhances cyclophosphamide, ifosfamide and cis-diamminedichloroplatinum cytotoxicity on human-derived breast carcinoma and sarcoma xenografts in nude mice. J Cancer Res Clin Oncol 118: 129-135, 1992

    Google Scholar 

  35. Hohenberger P, Finke LH, Schlag PM: Intracompartmental pressure during hyperthermic isolated limb perfusion for melanoma and sarcoma. Eur J Surg Oncol 22: 147-151, 1996

    Google Scholar 

  36. Rochefort H: The prognostic value of cathepsin D in breast cancer. A long road to the clinic. Eur J Cancer 32A: 7-8, 1996

    Google Scholar 

  37. Kalra J, Prasad K: Oxygen free radicals and cardiac depression. Clin Biochem 27: 163-168, 1994

    Google Scholar 

  38. Monschke F, Muller WU, Winkler U, Streffer C: Cell proliferation and vascularization in human breast carcinomas. Int J Cancer 48: 812-815, 1991

    Google Scholar 

  39. Zeman EM, Calkins DP, Cline JM, Thrall DE, Raleigh JA: The relationship between proliferative and oxygenation status in spontaneous canine tumors. Int J Radiat Oncol Biol Phys 27: 891-898, 1993

    Google Scholar 

  40. Elledge RM, Allred DC: The p53 tumor suppressor gene in breast cancer. Breast Cancer Res Treat 32: 39-47, 1994

    Google Scholar 

  41. Palacios J, Benito N, Pizarro A, Limeres MA, Suarez A, Cano A, Gamallo C: Relationship between ERBB2 and Ecadherin expression in human breast cancer. Virchows Arch 427: 259-263, 1995

    Google Scholar 

  42. Wiltschke C, Kindas Muegge I, Steininger A, Reiner A, Reiner G, Preis PN: Coexpression of HER-2/neu and p53 is associated with a shorter disease-free survival in node-positive breast cancer patients. J Cancer Res Clin Oncol 120: 737-742, 1994

    Google Scholar 

  43. Horiguchi J, Iino Y, Takei H: Expression of pS2 estrogeninducible protein in primary breast cancer. Oncology 53: 12-15, 1996

    Google Scholar 

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Hohenberger, P., Felgner, C., Haensch, W. et al. Tumor oxygenation correlates with molecular growth determinants in breast cancer. Breast Cancer Res Treat 48, 97–106 (1998). https://doi.org/10.1023/A:1005921513083

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