Esophageal carcinoma is a malignancy with a poor prognosis and is the sixth cause of cancer related death worldwide. In Sweden approximately 400 new cases are diagnosed every year. The aim of this present thesis was to investigate predictive factors for esophageal carcinoma patients.126 esophageal carcinoma patients admitted to the department of Oncology at the University Hospital in Uppsala between 1990-2000 were investigated with focus on known and potential prognostic factors. Performance status and stage of the disease were the only independent prognostic factors (p-values <0.001). Angiogenic factors VEGF and bFGF were correlated to platelet and leukocyte counts and VEGF was correlated to tumor volume (p=0.04) whereas bFGF was not (p=0.08) in pre-treatment serum samples from 42 esophageal carcinoma patients. The use of the angiogenic factors as prognostic factors, prior to therapy in patients with esophageal carcinoma, according to the results from the present study, seems limited. HER-2 overexpression was seen in 17% of 97 investigated esophageal tumor samples. In squamous cell carcinoma patients, HER-2 overexpression correlated with poorer survival (p=0.035), whereas in adenocarcinoma patients, HER-2 status did not. HER-2 overexpression seems to be associated with poorer survival in esophageal carcinomas, especially in patients with squamous cell esophageal carcinoma. Telomerase activity was detected in all esophageal cell lines, with a broad range of activity levels. No correlation was found between telomerase activity levels and sensitivity to investigated cytotoxic drugs. We therefore conclude that basal telomerase activity level is not a key determinant of sensitivity to standard cytotoxic drugs in esophageal carcinoma cell lines. The virus HPV-16 was detected in 16 % of the patients; no other type HPV was detected. HPV-16 infection had no significant effect on survival (p=0.72). Our results did not show that HPV-16 increases survival or improve therapy response in patients with esophageal carcinoma.

Improvements in the use of traditional breast cancer therapies have improved the overall survival of women with early stage disease. Remarkable advances in research have created a unique opportunity for developing active vaccination strategies that engage the bodys own immune system in the fight against breast cancer. Human Epidermal Growth Factor Receptor 2 (HER-2/neu) is a breast tumor antigen (Ag) commonly overexpressed in 30% of breast cancer cases. HER-2/neu-targeted DNA-based and fiber-modified dendritic cell (DC)-based vaccines are both analyzed as potent elements in eliciting HER-2/neu specific antitumor immune responses. A HER-2/neu-expressing DNA plasmid (pcDNA/neu) coadministered with the appropriate adjuvant vector was the first study looking at improving vaccine efficacy and enhancing immune responses. Various protection and prevention studies, using FVB/N (wild-type) and FVB/neuN [transgenic (Tg)] mice and Tg1-1 tumor cells, derived from a spontaneous tumor from Tg mice, are used to help narrow down the large panel of adjuvant vectors. Results showed the adjuvant vector pcDNA/TNF-α, when coadministered with pcDNA/neu, induced more efficient protective tumor-specific immunity and significantly delayed breast cancer development in Tg mice.<p>Another study utilized an<i>in vivo</i> murine tumor model expressing the rat neu Ag to compare the immunization efficacy between DC transduced with replication-deficient fiber-modified adenovirus (AdV) containing neu (AdV(RGD)neu), to form DC(RGD)neu, and non-modified DCneu. DC(RGD)neu displayed an upregulation of immunologically important molecules and inflammatory cytokine expression through FACS Analysis, and more importantly increased expression of neu, when compared to DCneu. DC(RGD)neu stimulated a higher percentage of HER-2/neu-specific CD8+ T cells, a stronger neu-specific CTL response, and induced a much stronger Th1- and Th2-type immune response than DCneu. Furthermore, vaccination with DC(RGD)neu induced enhanced protective tumor-specific immunity compared to DCneu in wild-type and Tg mice.<p>Overall the construction of recombinant vectors containing two transgenes (HER-2/neu and TNF-α), can not overcome the induction of HER-2/neu-directed immune tolerance. The fiber-modified (RGD) DCneu vaccine induced enhanced anti-HER-2/neu immunity compared to non-modified DCneu in the prevention of breast cancers.

Improvements in the use of traditional breast cancer therapies have improved the overall survival of women with early stage disease. Remarkable advances in research have created a unique opportunity for developing active vaccination strategies that engage the bodys own immune system in the fight against breast cancer. Human Epidermal Growth Factor Receptor 2 (HER-2/neu) is a breast tumor antigen (Ag) commonly overexpressed in 30% of breast cancer cases. HER-2/neu-targeted DNA-based and fiber-modified dendritic cell (DC)-based vaccines are both analyzed as potent elements in eliciting HER-2/neu specific antitumor immune responses. A HER-2/neu-expressing DNA plasmid (pcDNA/neu) coadministered with the appropriate adjuvant vector was the first study looking at improving vaccine efficacy and enhancing immune responses. Various protection and prevention studies, using FVB/N (wild-type) and FVB/neuN [transgenic (Tg)] mice and Tg1-1 tumor cells, derived from a spontaneous tumor from Tg mice, are used to help narrow down the large panel of adjuvant vectors. Results showed the adjuvant vector pcDNA/TNF-α, when coadministered with pcDNA/neu, induced more efficient protective tumor-specific immunity and significantly delayed breast cancer development in Tg mice.<p>Another study utilized an<i>in vivo</i> murine tumor model expressing the rat neu Ag to compare the immunization efficacy between DC transduced with replication-deficient fiber-modified adenovirus (AdV) containing neu (AdV(RGD)neu), to form DC(RGD)neu, and non-modified DCneu. DC(RGD)neu displayed an upregulation of immunologically important molecules and inflammatory cytokine expression through FACS Analysis, and more importantly increased expression of neu, when compared to DCneu. DC(RGD)neu stimulated a higher percentage of HER-2/neu-specific CD8+ T cells, a stronger neu-specific CTL response, and induced a much stronger Th1- and Th2-type immune response than DCneu. Furthermore, vaccination with DC(RGD)neu induced enhanced protective tumor-specific immunity compared to DCneu in wild-type and Tg mice.<p>Overall the construction of recombinant vectors containing two transgenes (HER-2/neu and TNF-α), can not overcome the induction of HER-2/neu-directed immune tolerance. The fiber-modified (RGD) DCneu vaccine induced enhanced anti-HER-2/neu immunity compared to non-modified DCneu in the prevention of breast cancers.

Title from PDF of title page (University of Missouri--Columbia, viewed on March 10, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Thesis advisor: Dr. Xudong Fan. Includes bibliographical references.

Thesis (Ph. D.)--Ohio State University, 2007. / Full text release at OhioLINK's ETD Center delayed at author's request.

Universiẗat, Diss., 2006--Frankfurt (Main).

Introdução: a superexpressão de HER-2 tem correlação com maior agressividade em carcinomas de mama e estômago, e a sua detecção já foi incorporada como rotina na análise destas neoplasias. Critérios ideais para avaliação do HER-2 em câncer de pâncreas permanecem incertos. Objetivos: avaliar o status do HER-2 e o seu valor preditivo em adenocarcinoma pancreático. Materiais e métodos: análise clinicopatológica e imuno-histoquímica de 112 pacientes com diagnóstico de câncer de pâncreas com base nos critérios propostos para câncer de mama (HercepTest™) e de estômago (ToGA Trial). Resultados: pelo HercepTest™ 5 (4.5%) casos apresentaram escore 3+, 3 (2.7%) escore 2+ e 104 (92.9%) escores 0/1+. Na análise pelo ToGA Trial, 9 (8.0%) obtiveram escore 3+, 32 (28.6%) escore 2+ e 71 (63.4%) escores 0/1+. Todos os casos positivos pelo HercepTest™ também o foram para o ToGA Trial. Pacientes com hiperexpressão (3+) apresentaram sobrevida média maior que aqueles sem (0 a 2+) tanto pelo HercepTest™ quanto pelo ToGa Trial (43.88 vs. 10.3 meses, p = 0.029 e 40.7 vs. 10.1 meses, p = 0.013, respectivamente). Os demais parâmetros não mostraram correlação com a expressão de HER-2. Conclusão: diferenças na incidência e no significado prognóstico da superexpressão podem ser decorrentes do pequeno tamanho amostral e do uso de dois critérios diferentes de positividade para HER-2. Estes resultados servem com impulso para novas investigações de superexpressão e amplificação do HER-2 utilizando, além da imuno-histoquímica, métodos como FISH e SISH, a fim de se obter mais opções terapêuticas para oferecer aos pacientes, como agentes anti-HER-2. / Introduction: HER-2 overexpression is correlated with aggressiveness in breast and gastric cancers, and its detection has been incorporated as routine in the analysis of these neoplasms. Ideal criteria for evaluation of HER-2 in pancreatic cancer remain unclear. Objectives: to assess the HER-2 status and its predictive value in pancreatic adenocarcinoma. Material and methods: clinicopathologic and immunohistochemical analysis were undertaken in 112 patients with pancreatic cancer using the criteria proposed for breast (HercepTest™) and stomach cancer (ToGA Trial). Results: using HercepTest™ 5 (4.5%) cases had a score of 3+, 3 (2.7%) had a score of 2+ and 104 (92.9%) had scores of 0/1 +. By ToGA Trial, 9 (8.0%) obtained score of 3+, 32 (28.6%) had a score of 2+ score and 71 (63.4%) had scores of 0/1 +. All positive cases by HercepTest™ also went to the ToGA Trial. Patients with overexpression (3 +) showed greater survival than those without (0 to 2 +) by both HercepTest™ and ToGa Trial (43.88 vs. 10.3 months, p = 0.029 and 40.7 vs. 10.1 months, p = 0.013, respectively). Other parameters did not show correlation with the expression of HER-2. Conclusion: differences in incidence and prognostic significance of overexpression may be explained from small sample size and the use of two different criteria of positivity for HER-2. These results serve as an impulse for new investigations of overexpression/amplification of the HER-2 using, besides immunohistochemistry, FISH and SISH methods, in order to get more treatment options to provide patients, as agents anti-HER-2.

Introdução: a superexpressão de HER-2 tem correlação com maior agressividade em carcinomas de mama e estômago, e a sua detecção já foi incorporada como rotina na análise destas neoplasias. Critérios ideais para avaliação do HER-2 em câncer de pâncreas permanecem incertos. Objetivos: avaliar o status do HER-2 e o seu valor preditivo em adenocarcinoma pancreático. Materiais e métodos: análise clinicopatológica e imuno-histoquímica de 112 pacientes com diagnóstico de câncer de pâncreas com base nos critérios propostos para câncer de mama (HercepTest™) e de estômago (ToGA Trial). Resultados: pelo HercepTest™ 5 (4.5%) casos apresentaram escore 3+, 3 (2.7%) escore 2+ e 104 (92.9%) escores 0/1+. Na análise pelo ToGA Trial, 9 (8.0%) obtiveram escore 3+, 32 (28.6%) escore 2+ e 71 (63.4%) escores 0/1+. Todos os casos positivos pelo HercepTest™ também o foram para o ToGA Trial. Pacientes com hiperexpressão (3+) apresentaram sobrevida média maior que aqueles sem (0 a 2+) tanto pelo HercepTest™ quanto pelo ToGa Trial (43.88 vs. 10.3 meses, p = 0.029 e 40.7 vs. 10.1 meses, p = 0.013, respectivamente). Os demais parâmetros não mostraram correlação com a expressão de HER-2. Conclusão: diferenças na incidência e no significado prognóstico da superexpressão podem ser decorrentes do pequeno tamanho amostral e do uso de dois critérios diferentes de positividade para HER-2. Estes resultados servem com impulso para novas investigações de superexpressão e amplificação do HER-2 utilizando, além da imuno-histoquímica, métodos como FISH e SISH, a fim de se obter mais opções terapêuticas para oferecer aos pacientes, como agentes anti-HER-2. / Introduction: HER-2 overexpression is correlated with aggressiveness in breast and gastric cancers, and its detection has been incorporated as routine in the analysis of these neoplasms. Ideal criteria for evaluation of HER-2 in pancreatic cancer remain unclear. Objectives: to assess the HER-2 status and its predictive value in pancreatic adenocarcinoma. Material and methods: clinicopathologic and immunohistochemical analysis were undertaken in 112 patients with pancreatic cancer using the criteria proposed for breast (HercepTest™) and stomach cancer (ToGA Trial). Results: using HercepTest™ 5 (4.5%) cases had a score of 3+, 3 (2.7%) had a score of 2+ and 104 (92.9%) had scores of 0/1 +. By ToGA Trial, 9 (8.0%) obtained score of 3+, 32 (28.6%) had a score of 2+ score and 71 (63.4%) had scores of 0/1 +. All positive cases by HercepTest™ also went to the ToGA Trial. Patients with overexpression (3 +) showed greater survival than those without (0 to 2 +) by both HercepTest™ and ToGa Trial (43.88 vs. 10.3 months, p = 0.029 and 40.7 vs. 10.1 months, p = 0.013, respectively). Other parameters did not show correlation with the expression of HER-2. Conclusion: differences in incidence and prognostic significance of overexpression may be explained from small sample size and the use of two different criteria of positivity for HER-2. These results serve as an impulse for new investigations of overexpression/amplification of the HER-2 using, besides immunohistochemistry, FISH and SISH methods, in order to get more treatment options to provide patients, as agents anti-HER-2.

Introdução: a superexpressão de HER-2 tem correlação com maior agressividade em carcinomas de mama e estômago, e a sua detecção já foi incorporada como rotina na análise destas neoplasias. Critérios ideais para avaliação do HER-2 em câncer de pâncreas permanecem incertos. Objetivos: avaliar o status do HER-2 e o seu valor preditivo em adenocarcinoma pancreático. Materiais e métodos: análise clinicopatológica e imuno-histoquímica de 112 pacientes com diagnóstico de câncer de pâncreas com base nos critérios propostos para câncer de mama (HercepTest™) e de estômago (ToGA Trial). Resultados: pelo HercepTest™ 5 (4.5%) casos apresentaram escore 3+, 3 (2.7%) escore 2+ e 104 (92.9%) escores 0/1+. Na análise pelo ToGA Trial, 9 (8.0%) obtiveram escore 3+, 32 (28.6%) escore 2+ e 71 (63.4%) escores 0/1+. Todos os casos positivos pelo HercepTest™ também o foram para o ToGA Trial. Pacientes com hiperexpressão (3+) apresentaram sobrevida média maior que aqueles sem (0 a 2+) tanto pelo HercepTest™ quanto pelo ToGa Trial (43.88 vs. 10.3 meses, p = 0.029 e 40.7 vs. 10.1 meses, p = 0.013, respectivamente). Os demais parâmetros não mostraram correlação com a expressão de HER-2. Conclusão: diferenças na incidência e no significado prognóstico da superexpressão podem ser decorrentes do pequeno tamanho amostral e do uso de dois critérios diferentes de positividade para HER-2. Estes resultados servem com impulso para novas investigações de superexpressão e amplificação do HER-2 utilizando, além da imuno-histoquímica, métodos como FISH e SISH, a fim de se obter mais opções terapêuticas para oferecer aos pacientes, como agentes anti-HER-2. / Introduction: HER-2 overexpression is correlated with aggressiveness in breast and gastric cancers, and its detection has been incorporated as routine in the analysis of these neoplasms. Ideal criteria for evaluation of HER-2 in pancreatic cancer remain unclear. Objectives: to assess the HER-2 status and its predictive value in pancreatic adenocarcinoma. Material and methods: clinicopathologic and immunohistochemical analysis were undertaken in 112 patients with pancreatic cancer using the criteria proposed for breast (HercepTest™) and stomach cancer (ToGA Trial). Results: using HercepTest™ 5 (4.5%) cases had a score of 3+, 3 (2.7%) had a score of 2+ and 104 (92.9%) had scores of 0/1 +. By ToGA Trial, 9 (8.0%) obtained score of 3+, 32 (28.6%) had a score of 2+ score and 71 (63.4%) had scores of 0/1 +. All positive cases by HercepTest™ also went to the ToGA Trial. Patients with overexpression (3 +) showed greater survival than those without (0 to 2 +) by both HercepTest™ and ToGa Trial (43.88 vs. 10.3 months, p = 0.029 and 40.7 vs. 10.1 months, p = 0.013, respectively). Other parameters did not show correlation with the expression of HER-2. Conclusion: differences in incidence and prognostic significance of overexpression may be explained from small sample size and the use of two different criteria of positivity for HER-2. These results serve as an impulse for new investigations of overexpression/amplification of the HER-2 using, besides immunohistochemistry, FISH and SISH methods, in order to get more treatment options to provide patients, as agents anti-HER-2.

Recently, laser scribed graphene (LSG) technology has shown great potential for the development of a plethora of sensing platforms due to its high sensitivity, 3D porous structure, and flexibility. Molecularly imprinted polymers (MIPs) have shown high potential as recognition elements for many applications such as biosensing. Hence, we report in this thesis a novel biosensing platform that utilizes nanostructured gold to enhance the performance of LSG sensors coupled with a biomimetic MIP biosensor. To the best of our knowledge, this is the first report of a nanostructured gold modified MIP based LSG biosensor to detect HER-2, which is an important breast cancer biomarker. HER-2 positive breast cancer is more aggressive and does not respond to the same treatment as standard breast cancer. As such, a simple and accurate sensing approach is highly needed for early detection of this type of cancer biomarkers. The LSG sensor platform was fabricated by irradiation of polyimide substrates using a CO2 laser under optimized conditions. Nanostructured gold was electrodeposited onto LSG to enhance its sensitivity and active surface area. Deposition parameters such as deposition voltage, deposition time, and gold chloride (HAuCl4) concentration were optimized to yield complete nanostructured gold coverage and enhanced electrical conductivity of LSG-Au electrodes. A deposition voltage of -0.9 V at 50 mM HAuCl4 for 4 minutes proved to be the optimal condition for gold deposition to yield a 150% peak current enhancement. To fabricate our MIP biosensor, 3,4- ethylenedioxythiophene (EDOT) was chosen from several functional monomers to form PEDOT due to its high conductivity and synergy with nanostructured gold. Electropolymerization of EDOT is performed after adsorbing 0.4mg/mL of HER-2 on the LSG-Au electrode for 20 min. The efficiency of LSG-Au-MIP was optimized by choosing an appropriate extraction agent and HER-2 concentration to be adsorbed on gold. The developed sensing strategy could differentiate between three rebinding concentrations of 10 ng/mL, 100ng/mL, and 200 ng/mL, which is sufficient to determine the HER-2 status of breast cancer since the clinical cut-off is 30.5ng/mL. The developed sensing strategy showed a high degree of novelty and could be useful for the non-invasive detection of cancer biomarkers.