Huijiao Chen

CONTEXT: Folate receptor α (FRA) has been shown to be selectively expressed in several types of human cancer, including breast cancer. Currently, several FRA target therapies are under intensive study. OBJECTIVE: To investigate the expression pattern of FRA in a large cohort of patients with breast cancer and analyze its relationship with different clinicopathologic features, with expression of several key biomarkers, and with clinical outcome. DESIGN: Four hundred forty-seven cases of infiltrating ductal carcinoma diagnosed between 1997 and 2008 at the University of Rochester Medical Center were identified and reviewed, and 25 blocks of tissue microassays were constructed. The association between expression of FRA and clinicopathologic features; expression of estrogen receptor (ER), progesterone receptor (PR), HER2/neu, and Ki-67; and clinical outcome of these tumors were evaluated. RESULTS: The expression of FRA was significantly associated with tumors with high histologic grade, higher nodal stages, ER/PR negativity, and high proliferative activity (Ki-67 ≥ 15%), and was independent of HER2/neu overexpression. In all, 74% of ER/PR-negative and 80% of triple-negative breast cancers expressed FRA. The expression of FRA was significantly associated with a worse disease-free survival. CONCLUSIONS: Our data demonstrate that a significant subgroup of ER/PR-negative and triple-negative breast cancers express FRA, and its expression is associated with worse clinical outcome.

BACKGROUND: Melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. The description of the course of the tumors differs somewhat, but it is generally considered as a benign lesion. We investigated the clinicopathologic features, immunophenotypes, and ultrastructural features of 13 patients with nonpsammomatous melanotic schwannoma (NPMS). METHODS: Tumor specimens of each patient were sectioned and stained with hematoxylin-eosin, Fontana-Masson, Prussian blue, and periodic acid-Schiff (PAS). Immunohistochemical markers such as S-100, Leu-7, HMB-45, Melan-A, CK, EMA, vimentin, GFAP, laminin, collagen IV and MIB-1 were detected with the Envision immunohistochemical staining method. Four of the cases were observed by electron microscopy. RESULTS: Of the 13 patients, 8 were male and 5 female, aged from 11 to 92 years (mean, 38.6 years). The tumor sites included the spinal nerve root (5 patients), cranial nerve (1), greater omentum (1), subcutaneous tissue (3), mesentery (1), bone (1) and mediastinum (1). Eleven patients were followed up for over 2 years, with a mean of 5.9 years. One patient (9.1%) with a primary tumor in the greater omentum developed another primary tumor of the same type in the subcutaneous tissue of the abdominal wall after the first operation. Local recurrence of the tumor was seen in 2 patients (18.2%). One patient (9.1%) showed the local recurrence and metastasis. Seven patients (63.6%) showed no evidence of the recurrence or metastasis. Grossly, all tumors were well-circumscribed and the gross findings were suggestive of melanin-containing tumors. The tumor was composed of spindled and epithelioid cells with abundant intracytoplasmic melanin pigments. Nuclei were round and contained delicate, evenly distributed chromatins as well as small, distinct nucleoli. In some areas, the nucleoli were large and prominent. Rare mitoses were seen in most lesions except the larger omentum lesion. The pigment was shown to be positive for the Fontana-Masson and negative for Prussian blue and PAS. Immunohistochemical staining for S-100, Leu-7, HMB-45, Melan-A, and vimentin were strongly positive. Linear immunoreactions of both laminin and collagen IV was detected in all patients. Ultrastructurally, numerous elongated tumor-cell processes, duplicated basement membrane and melanosomes were observed in all developmental stages. CONCLUSIONS: Histologically, melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. Distinguishing between this tumor and malignant melanoma is of paramount importance in planning of management. Immunohistochemically, combined use of laminin and collagen IV is valuable in distinguishing melanotic schwannoma from malignant melanoma. Wide local resection and additional radiotherapy should be advocated. Further studies including cytogenetic or molecular biology are still required to better delineate melanotic schwannoma from malignant melanoma. Appropriate long-term follow-up is needed for all melanotic schwannomas.

Abstract The dry‐wet abrupt alternation (DWAA) event, which is defined as the phenomenon of dry (or wet) spells abruptly following wet (or dry) spells, magnifies the influence of individual wet and dry events. The dynamic evolution of DWAA events has not been studied for different climate zones of China that is particularly susceptible to dry and wet extremes. This study explores the future changes in the abrupt alternations between dry and wet extremes across 10 climate divisions of China, with a thorough assessment of dry and wet conditions using the Standardized Precipitation Evapotranspiration Index (SPEI). We take advantage of an ensemble of regional climate model simulations including the Providing Regional Climate Impacts for Studies (PRECIS) experiment and five CORDEX East Asia experiments to produce high‐resolution climate information for a baseline period of 1975–2004 and a future period of 2069–2098. Our findings disclose that a total of 70% of China's land area suffered from the DWAA events at least once during 1975–2004. The wet‐dry alternation event is projected to become more frequent in summer, and a prominent increase in the number of dry‐wet alternation events is expected to occur in spring over most parts of China. Moreover, an increasing number of DWAA events with intensified magnitude is projected to strike the North China Plain dominated by warm temperature and humid zone, which is the most densely populated region of the country and is also the largest agriculture production area. Our findings also reveal a strong positive correlation between DWAA and heavy rainfall. The 95th percentile rainfall event contributes most to the wet‐dry alternation event for most climate divisions of China.

Abstract Exploring the dynamic evolution of the abrupt alternation between wet and dry spells in adjacent months plays a crucial role in water resources planning and agricultural development in a changing climate. The dry‐wet abrupt alternation (DWAA) has been studied based on hydrometeorological observations over the past several years. However, little effort has been made to explore DWAA from a climate projection standpoint. Furthermore, few studies have investigated potential interrelationships between DWAA and heavy rainfall. In this study, the interrelationships between DWAA events and heavy rainfall with various intensities as well as potential evapotranspiration are revealed explicitly through the convection‐permitting climate simulations for 10 climate divisions over Texas in the United States. Our findings disclose that the increasing heavy rainfall and potential evapotranspiration lead to more frequent occurrence of DWAA events over a larger spatial extent. Heavy rainfall with daily precipitation greater than 20 mm contributes most to the occurrence of DWAA. In addition, a severe phenomenon of dry‐wet‐dry alternation is projected to appear due to the increasing number of heavy rainfall and drought events as well as the deteriorated soil water holding capacity under global warming.