Person: Pettersson, Andreas
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Pettersson
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Andreas
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Pettersson, Andreas
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Publication Pre-diagnostic circulating sex hormone levels and risk of prostate cancer by ERG tumour protein expression(Nature Publishing Group, 2016) Graff, Rebecca; Meisner, Allison; Ahearn, Thomas U; Fiorentino, Michelangelo; Loda, Massimo; Giovannucci, Edward; Mucci, Lorelei; Pettersson, AndreasBackground: Experimental studies have shown androgen receptor stimulation to facilitate formation of the TMPRSS2:ERG gene fusion in prostate cell lines. No study has tested whether higher pre-diagnostic circulating sex hormone levels in men increase risk of developing TMPRSS2:ERG-positive prostate cancer specifically. Methods: We conducted a nested case–control study of 200 prostate cancer cases and 1057 controls from the Physicians' Health Study and Health Professionals Follow-up Study. We examined associations between pre-diagnostic circulating levels of total testosterone, free testosterone, DHT, androstanediol glucuronide, estradiol, and SHBG and risk of prostate cancer by TMPRSS2:ERG status. TMPRSS2:ERG was estimated by ERG immunohistochemistry. We used multivariable unconditional polytomous logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of ERG-positive (n=94) and, separately, ERG-negative (n=106) disease. Results: Free testosterone was significantly associated with the risk of ERG-positive prostate cancer (OR: 1.37, 95% CI: 1.05–1.77), but not ERG-negative prostate cancer (OR: 1.09, 95% CI: 0.86–1.38) (Pdiff=0.17). None of the remaining hormones evaluated showed clear differential associations with ERG-positive vs ERG-negative disease. Conclusions: These findings provide some suggestive evidence that higher pre-diagnostic free testosterone levels are associated with an increased risk of developing TMPRSS2:ERG-positive prostate cancer.Publication The role of tumor metabolism as a driver of prostate cancer progression and lethal disease: results from a nested case-control study(BioMed Central, 2016) Kelly, Rachel; Sinnott, Jennifer; Rider, Jennifer; Noonan, Ericka; Gerke, Travis; Bowden, Michaela; Pettersson, Andreas; Loda, Massimo; Sesso, Howard; Kantoff, Philip; Martin, Neil; Giovannucci, Edward; Tyekucheva, Svitlana; Heiden, Matthew Vander; Mucci, LoreleiBackground: Understanding the biologic mechanisms underlying the development of lethal prostate cancer is critical for improved therapeutic and prevention strategies. In this study we explored the role of tumor metabolism in prostate cancer progression using mRNA expression profiling of seven metabolic pathways; fatty acid metabolism, glycolysis/gluconeogenesis, oxidative phosphorylation, pentose phosphate, purine metabolism, pyrimidine metabolism and the tricarboxylic acid cycle. Methods: The study included 404 men with archival formalin-fixed, paraffin-embedded prostate tumor tissue from the prospective Health Professionals Follow-up Study and Physicians’ Health Study. Lethal cases (n = 113) were men who experienced a distant metastatic event or died of prostate cancer during follow-up. Non-lethal controls (n = 291) survived at least 8 years post-diagnosis without metastases. Of 404 men, 202 additionally had matched normal tissue (140 non-lethal, 62 lethal). Analyses compared expression levels between tumor and normal tissue, by Gleason grade and by lethal status. Secondary analyses considered the association with biomarkers of cell proliferation, apoptosis and angiogenesis. Results: Oxidative phosphorylation and pyrimidine metabolism were identified as the most dysregulated pathways in lethal tumors (p < 0.007), and within these pathways, a number of novel differentially expressed genes were identified including POLR2K and APT6V1A. The associations were tumor specific as there was no evidence any pathways were altered in the normal tissue of lethal compared to non-lethal cases. Conclusions: The results suggest prostate cancer progression and lethal disease are associated with alterations in key metabolic signaling pathways. Pathways supporting proliferation appeared to be of particular importance in prostate tumor aggressiveness. Electronic supplementary material The online version of this article (doi:10.1186/s40170-016-0161-9) contains supplementary material, which is available to authorized users.Publication Postmenopausal mammographic breast density and subsequent breast cancer risk according to selected tissue markers(Nature Publishing Group, 2015) Yaghjyan, Lusine; Pettersson, Andreas; Colditz, Graham A; Collins, Laura; Schnitt, Stuart; Beck, Andrew; Rosner, Bernard; Vachon, Celine; Tamimi, RullaBackground: This study aimed to determine if associations of pre-diagnostic percent breast density, absolute dense area, and non-dense area with subsequent breast cancer risk differ by the tumour's molecular marker status. Methods: We included 1010 postmenopausal women with breast cancer and 2077 matched controls from the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHS II) cohorts. Breast density was estimated from digitised film mammograms using computer-assisted thresholding techniques. Information on breast cancer risk factors was obtained prospectively from biennial questionnaires. Polychotomous logistic regression was used to assess associations of breast density measures with tumour subtypes by the status of selected tissue markers. All tests of statistical significance were two sided. Results: The association of percent density with breast cancer risk appeared to be stronger in ER− as compared with ER+ tumours, but the difference did not reach statistical significance (density ⩾50% vs <10% odds ratio (OR)=3.06, 95% confidence interval (CI) 2.17–4.32 for ER+ OR=4.61, 95% CI 2.36–9.03 for ER−, Pheterogeneity=0.08). Stronger positive associations were found for absolute dense area and CK5/6− and EGFR− as compared with respective marker-positive tumours (Pheterogeneity=0.002 and 0.001, respectively). Stronger inverse associations of non-dense area with breast cancer risk were found for ER− as compared with ER+ tumours (Pheterogeneity=0.0001) and for AR+, CK5/6+, and EGFR+ as compared with respective marker-negative tumours (Pheterogeneity=0.03, 0.005, and 0.009, respectively). The associations of density measures with breast cancer did not differ by progesterone receptor and human epidermal growth factor receptor 2 status. Conclusions: Breast density influences the risk of breast cancer subtypes by potentially different mechanisms.Publication Nondense Mammographic Area and Risk of Breast Cancer(BioMed Central, 2011) Pettersson, Andreas; Hankinson, Susan; Willett, Walter; Lagiou, Pagona; Trichopoulos, Dimitrios; Tamimi, RullaIntroduction: The mechanisms underlying the strong association between percentage dense area on a mammogram and the risk of breast cancer are unknown. We investigated separately the absolute dense area and the absolute nondense area on mammograms in relation to breast cancer risk. Methods: We conducted a nested case-control study on prediagnostic mammographic density measurements and risk of breast cancer in the Nurses' Health Study and the Nurses' Health Study II. Premenopausal mammograms were available from 464 cases and 998 controls, and postmenopausal mammograms were available from 960 cases and 1,662 controls. We used a computer-assisted thresholding technique to measure mammographic density, and we used unconditional logistic regression to calculate OR and 95% CI data. Results: Higher absolute dense area was associated with a greater risk of breast cancer among premenopausal women (OR\(_{\text{tertile 3 vs 1}}\) = 2.01, 95% CI = 1.45 to 2.77) and among postmenopausal women (OR\(_{\text{quintile 5 vs 1}}\) = 2.19, 95% CI = 1.65 to 2.89). However, increasing absolute nondense area was associated with a decreased risk of breast cancer among premenopausal women (OR\(_{\text{tertile 3 vs 1}}\) = 0.51, 95% CI = 0.36 to 0.72) and among postmenopausal women (OR\(_{\text{quintile 5 vs 1}}\) = 0.46, 95% CI = 0.34 to 0.62). These associations changed minimally when we included both absolute dense area and absolute nondense area in the same statistical model. As expected, the percentage dense area was the strongest risk factor for breast cancer in both groups. Conclusions: Our results indicate that absolute dense area is independently and positively associated with breast cancer risk, whereas absolute nondense area is independently and inversely associated with breast cancer risk. Since adipose tissue is radiographically nondense, these results suggest that adipose breast tissue may have a protective role in breast carcinogenesis.