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Normal ageing is associated with an increase in Th2 cells, MCP-1 (CCL1) and RANTES (CCL5), with differences in sCD40L and PDGF-AA between sexes
Mansfield, Aaron S. , Nevala, Wendy K. , Dronca, Roxana , Leontovich, Alexey A. , Shuster, Lynne T., Markovic, S. N. , Mansfield, Aaron S

Mayo Clinic

Clinical and Experimental Immunology | July 23, 2012 | Volume: 170 | Issue: 2 | Pages: 186-193

10.1111/j.1365-2249.2012.04644.x | PMID 23039889 Get It

SummaryWe have observed T helper type 2 (Th2) polarization of systemic immunity in patients with metastatic malignant melanoma. We hypothesized that similar changes in systemic immunity occur with ageing and may be permissive for the development of melanoma. We analysed the peripheral blood of 389 healthy blood donors. All subjects were profiled for peripheral blood T cell and B cell subsets, and 58 of these subjects were profiled for antigen-specific cytotoxic T cell subsets [cytomegalovirus (CMV), influenza and melanoma antigen recognized by T cells 1 (MART-1)]. Ninety-five separate healthy subjects underwent profiling of 42 plasma cytokines. Ageing was associated positively with CD4+CD294+ Th2 cells, and associated negatively with CD3+ T cells, cytotoxic T cells and T helper cells. Ageing was also associated negatively with CMV-, influenza- and MART-1-specific naive and CD8+ T cells. There were significant increases in plasma monocyte chemotactic protein 1 (MCP-1) (CCL1) and regulated upon activation normal T cell expressed and secreted (RANTES) (CCL5) with age. We observed differences in cytokine profiles between males and females; specifically, women had higher levels of sCD40L and PDGF-AA. In summary, we demonstrated in healthy blood donors that ageing was associated with an increase in cellular Th2 bias and a decline in total numbers of T cells. Additionally, there was an increase in MCP-1 and RANTES with ageing. Women had higher levels of sCD40L and PDGF-AA than men.
A Clinical Deterioration Prediction Tool for Internal Medicine Patients
Kirkland, Lisa L., Malinchoc, Michael, O’Byrne, Megan M., Benson, Joanne T., Kashiwagi, Deanne T. , Burton, M. Caroline , Varkey, Prathibha, Morgenthaler, Timothy I. , Morgenthaler, Timothy I

Mayo Clinic

American Journal of Medical Quality | July 21, 2012 | Volume: 28 | Issue: 2 | Pages: 135-142

10.1177/1062860612450459 | PMID 22822159 Get It

Kidney Stone Volume Estimation from Computerized Tomography Images Using a Model Based Method of Correcting for the Point Spread Function
Duan, Xinhui , Wang, Jia , Qu, Mingliang , Krambeck, Amy E. , Leng, Shuai , Liu, Yu , McCollough, Cynthia H.

Mayo Clinic

Journal of Urology | July 21, 2012 | Volume: 188 | Issue: 3 | Pages: 989-995

10.1016/j.juro.2012.04.098 | PMID 22819107 Get It

Abstract LB-348: Integrated analysis of microRNA and mRNA expression in microsatellite-stable colon cancer using next-generation sequencing and cDNA microarrays
Loo, Lenora W. M. , Casey, Graham , Gallinger, Steven , Thibodeau, Stephen N. , Tiirikainen, Maarit , Song, Min‐Ae , Cheng, Iona C. , Marchand, Loı̈c Le

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: LB-348-LB-348

10.1158/1538-7445.am2011-lb-348 Get It

Abstract Alterations in the expression of microRNAs (miRNAs) contribute to the development and progression of colon cancer, which arises from the accumulation of genetic and epigenetic alterations in the colon tissue. With the advent of next-generation sequencing (NGS), new depths can be reached, allowing for comprehensive profiling of known and novel miRNAs. To profile the miRNAs and their associated target genes in colon cancer, we examined differential expression of miRNAs and predicted target genes between tumor and normal tissue of microsatellite stable (MSS) and CpG island methylator phenotype (CIMP)-negative colon cancer. Ten fresh-frozen colon tumors and 10 adjacent normal mucosa were profiled for miRNAs using the SOLiD NGS platform and mRNA expression analysis was conducted using Affymetrix arrays. To identify differentially expressed miRNAs in tumor versus normal tissue, analysis of variance was conducted that included Bonferroni correction. Integrated expression analysis of miRNAs and their target mRNAs was conducted using Pearson's correlation and the Benjamini and Hochberg's false discovery rate. Both analyses were done using Partek Genomics Suite software. Nineteen miRNAs were significantly differentially expressed in tumor versus normal tissue (fold change ≥ ±2 and p<0.05). Six of these 19 miRNAs have previously been associated with colon cancer (miR-30a, miR-31, miR-135b, miR-182, miR-183 and miR-202). Integrated analysis of miRNA and predicted target mRNA expression yielded 97 significantly correlated miRNA::mRNA pairs for 14 miRNAs with 92 genes (absolute r = 0.71–0.88, q<0.05). Within these miRNA::mRNA pairs, expression levels of the 6 colon cancer-associated miRNAs were correlated with 33 target genes and 8 miRNAs newly identified to be differentially expressed in colon cancer were correlated with 57 target genes. The top functional Ingenuity Pathway Analysis gene ontology categories (p<0.05) for the 92 genes were gastrointestinal disease (18 genes), genetic disorder (21genes), inflammatory disease (15 genes) and cancer (21 genes). The correlated target genes included several genes implicated in colon cancer such as CDH3, NKD1, RGS2, TCFL5 and ZEB2. In summary, deep miRNA sequencing among MSS/CIMP-negative colon tumors confirmed differential expression of 6 colon cancer-associated miRNAs and identified 13 miRNAs not previously reported in colon cancer. Differential expression of most of the discovered miRNAs was correlated with the expression of genes potentially relevant for colon cancer. If confirmed, these miRNAs may serve as new biomarkers for colon cancer and may further our understanding of the epigenetic changes and pathways involved in the development of colon cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-348. doi:10.1158/1538-7445.AM2011-LB-348
Abstract LB-346: MiRNA and gene expression signatures in lung adenocarcinoma from never-smokers
Jang, Jin Sung , Jeon, Hyo‐Sung, Lingle, Wilma L., Park, Jae Yong , Ping, Yang, Jin, Jen, Sun, Zhifu , Tang, Hui Jun , Ping, Yang, Jin, Jen

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: LB-346-LB-346

10.1158/1538-7445.am2011-lb-346 Get It

Abstract Lung cancer is the most common cause of smoking-related mortality in worldwide. However, approximately 10 to 25 % cases are not attributable to smoking. Cumulative evidence suggests that lung cancer from never smokers (<100 cigarettes lifetime) may develop via molecular mechanisms that are different from lung cancers in smokers. Recently, miRNAs have been identified as a new class of regulatory molecules that participate in a variety of biological processes. Because each miRNAs can potentially target a large set of mRNA making and therefore may play a critical role in lung tumorigenesis and patient outcome, we sought to examine the role of miRNA in lung adenocarcinoma among never smokers. A total of 298 samples were analyzed in this study including 168 fresh frozen (FF) tissues from 88 lung adenocarcinomas and 80 adjacent non-involved lung tissues; and 132 formalin-fixed paraffin embedded (FFPE) tissues from 68 tumors and 64 normal lung samples. Gene expression profiling was performed for miRNA and mRNA using Illumina Whole Genome DASL platform. We identified 20 miRNAs with the most significant expression changes between the tumor and normal in both FF and FFPE samples (Fold change > 1.5, p <0.01, FDR <0.05). We also examined mRNA expression signature using 56 matched FF tumors and normal lung tissues. Cox proportional hazard analysis was performed independently for both FF and FFPE cohorts and showed that increased expression of mir-708 was strongly associated with an increased risk of patient death after adjusting for age, sex and tumor stage (FF cohort, HR =1.92; 95% CI =1.02–3.63; p < 0.05 and FFPE cohort, HR=1.90; 95% CI=1.08–3.34; P < 0.05). Candidate biological targets of mir-708 were identified using TargetScan and MicroCosm Targets databases. A total of 13 candidate genes were found and one of these genes, CMT11 (Candidate Mir-708 Target), was down-regulated 1.6 fold on average in tumors that were high in mir-708 expression. Based on the sequence, CMT11 is a novel transmembrane protein. In Cox analysis, reduced CMT11 expression was strongly correlated with an increased risk of death in patients (HR = 2.43, 95% CI = 1.17 − 5.26; P <0.01). Functionally, overexpression of mir-708 in A549 and HEK293T cells significantly increased the rate of cellular proliferation and migration. Over expression of mir-708 in HEK293T cells also repressed ∼70% of the luciferase activity when the reporter RNA contained the 3′ UTR of CMT11. Recently, several studies have showed mir-708 is a potential squamous cell lung cancer marker and one of miRNAs that may predict the recurrence of Stage I lung cancer after surgical resection. Additional evidence also suggests that CMT11 is a negative regulator of Wnt-signaling pathway. Our data provides clinical and functional evidence supporting an important role of mir-708 in lung cancer progression and identifies CMT11 as a down stream target gene mediating this process. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-346. doi:10.1158/1538-7445.AM2011-LB-346
Abstract LB-313: Development of a non-invasive, multi-analyte assay for the triage of patients presenting with hematuria
Fernández, Cecilia A., Millholland, John M. , Zwarthoff, Ellen C. , Loughlin, Kevin R. , Karnes, R. Jeffrey , Shuber, Anthony P., Feldman, Adam Scott

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: LB-313-LB-313

10.1158/1538-7445.am2011-lb-313 Get It

Abstract Introduction The presence of blood in the urine (hematuria) is one of the hallmark symptoms of bladder cancer. Thus, the current best practice policy suggests that patients with hematuria undergo cystoscopic examination. However, hematuria can be present in healthy individuals as well as in individuals with various non-life threatening conditions such that a majority of patients with blood in the urine (∼95%) who are screened by cystoscopy do not have bladder cancer. In addition, recent studies have found that a majority of patients with hematuria are not referred on to a specialist for further invasive tests, despite the guidelines. This suggests that the prevalence of cancer in this population may be lower than 5%, making screening by cystoscopy inefficient and, in a large number of cases, unnecessary. We are developing a non-invasive diagnostic assay utilizing urinary protein and DNA biomarkers to triage those patients who do not have cancer from those who should go on to be existing invasive screening modalities. Methods Urine samples were obtained from 48 cancer patients and 256 patients who were evaluated for hematuria but who did not have cancer upon cystoscopic evaluation (Hem+/Cysto−). Twist1 and Nid2 methylation status was assessed using methylation-specific PCR primers and FGFR3 mutational status was determined by quantitative PCR. Matrix Metalloproteinases (MMPs) levels were determined by ELISA. Results Using a novel combination of these DNA and protein markers we identified with high confidence (99% negative predictive value) those patients who do not have cancer and who could be excluded from further testing. Cutoffs could be adjusted such that at 94% sensitivity, 65% of patients who do not have cancer could be excluded. Conclusions The Multi-Analyte Diagnostic Readout (MADR) assay described here combines the best performance characteristics of protein and DNA biomarkers into one assay for optimal clinical performance. Using this approach, the detection of FGFR3 mutations and Twist1 and Nid2 methylation in the urine of hematuria patients undergoing screening for bladder cancer effectively increases the sensitivity and negative predictive value at an established MMP protein cutoff. This non-invasive urinary diagnostic assay could lead to the more efficient triage of hematuria patients by identifying those patients who do not have cancer and could be excluded from receiving invasive procedures. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-313. doi:10.1158/1538-7445.AM2011-LB-313
Abstract LB-308: Hypoxia affects gene expression and proteome of prostate cancer cells
Gómez, Christian R. , Knutson, Gaylord J., Schreiber, Claire A., Kosari, Farhad , Vasmatzis, George , Vuk‐Pavlović, Stanimir

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: LB-308-LB-308

10.1158/1538-7445.am2011-lb-308 Get It

Abstract Tumor-associated hypoxia facilitates malignant progression, metastasis and poor prognosis in prostate cancer (CaP); however, effects of oxygen tension (pO2) in CaP are just beginning to be investigated. To establish mechanisms whereby hypoxia enhances malignant properties and survival of CaP and to identify pO2-regulated tumor-associated macromolecules, we propagated CaP cell lines LnCaP, VCaP and DU145 in hypoxia (pO2=2 kPa) and compared them with normoxically grown cells (pO2=20 kPa); hypoxic cells proliferated faster and secreted more vascular endothelial growth factor (p<0.05). Transcriptome studies revealed different gene expression in cells grown in hypoxia relative to those in normoxia. Interestingly, in hypoxic cells transcripts associated with cancer and urologic disease were overexpressed in comparison to normoxic cells (p<0.001) suggesting an association of low pO2 and aggressive features of CaP. Further, we analyzed the transcriptome in primary CaP cells isolated by laser-capture microdissection (LCM) and whole CaP tissue. We compared the data to those from CaP cells cultured at pO2=20 kPa or pO2=2 kPa. Notably, hypoxia increased transcript levels for pyruvate dehydrogenase kinase isozyme 1, nuclear prelamin A recognition factor, glucose phosphate isomerase, and glyceraldehyde-3-phosphate dehydrogenase in all three cell lines (p<0.05) to levels comparable to those found in primary bulk tissue and LCM isolated cells (p<0.005). This finding suggests that gene expression in hypoxically cultured cells is more akin to that in tumor cells in situ than are cells grown normoxically. By 2D-gel electrophoresis, we found that change in pO2 affected the proteome mostly quantitatively (i.e., by change in spot intensity). Our results suggest that hypoxia affects transcriptome and proteome in CaP cells. In addition, we screened 20 patient sera and 20 healthy control sera for spontaneous antibodies cross-reactive with VCaP cells and found that the sera reacted with numerous proteins, some previously reported to elicit an immune response in CaP patients (e.g., nucleoporin 62 and transitional endoplasmic reticulum ATPase). By this method we detected numerous novel autoantigens (under validation). Currently we are clarifying the pO2 effects on the relationship of transcriptome, proteome and tumor-associated antigens in CaP cells. Support: DOD PC094680 (CRG), Minnesota Partnership for Biotechnology and Medical Genomics, Mayo Clinic Prostate SPORE 5P50CA091956 (FK); Mrs. Adelyn L. Luther, Singer Island, Florida and Mayo Clinic Cancer Center (SV-P). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-308. doi:10.1158/1538-7445.AM2011-LB-308
Abstract 4105: Hedgehog inhibition promotes type I TRAIL cytotoxicity in human cholangiocarcinoma cells
Fernández-Zapico, Martín E. , Bronk, Steve F., Guicciardi, Maria Eugenia , Hibi, Toshifumi , Kurita, Satoshi , Mott, Justin L. , Roberts, Lewis R. , Gores, Gregory J.

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: 4105-4105

10.1158/1538-7445.am2011-4105 Get It

Abstract [Background and Aim] TRAIL is a promising therapeutic agent for human malignancies that can activate apoptosis via mitochondria-independent (Type I) or mitochodria-dependent (Type II) death receptor signaling. However, many malignant cells are resistant to TRAIL cytotoxicity and fail to trigger Type I or Type II killing. Using cholangiocarcinoma cells, we identified a role for Hedgehog signaling via GLI transcription factors in the regulation of TRAIL cytotoxicity, and provide new mechanistic insights whereby Hedghog inhibition increases apoptosis. [Materials and Methods] The human cholangiocarcinoma cell lines KMCH, HuCCT-1, and Mz-ChA-1 were employed. Hedgehog signaling was inhibited with cyclopamine or an shRNA construct targeting smootherned (SMO). Type II TRAIL signaling was inhibited with shRNA constructs for Bid or Bim and siRNA for Bax and Bak. Antiapoptotic mediators including Inhibitor of Apoptosis Proteins (IAPs) and Bcl-2 family proteins were examined by immunoblot analysis and/or real time RT-PCR. Apoptosis was quantified morphologically by DAPI and fluorescence microscopy, and biochemically by caspase-3/7 activity. GLI transcription factor binding to the XIAP promoter was examined by EMSA and chromatin immuneprecipitation (ChIP) assay. [Results] Pharmacologic or genetic inhibition of Hedgehog signaling down-regulates both XIAP and cIAP-1 mRNA and protein expression. Knockdown of XIAP, but not cIAP-1, by small-interfering RNA markedly sensitized cells to TRAIL-induced apoptosis, suggesting XIAP is the functional target. Putative GLI-binding sites were identified in the XIAP promoter, and EMSA and ChIP assays demonstrated direct binding by GLI proteins. Sensitization to TRAIL-induced apoptosis was not altered by knockdown of the BH3-only proteins Bim and Bid, or by knockdown of Bax plus Bak, implicating a mitochondria-independent Type I pathway of apoptosis. [Conclusion] These data provide evidence for up-regulation of XIAP by an oncogenic Hedgehog pathway and demonstrate that Hedgehog inhibition sensitizes cells to TRAIL via decreasing XIAP levels. Hedgehog inhibition thereby promotes Type I death receptor signaling and sensitizes cells to apoptosis, which suggests Hedgehog and XIAP inhibition may be a therapeutic approach for TRAIL-resistant neoplasms. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4105. doi:10.1158/1538-7445.AM2011-4105
Abstract 1902: Aspirin, nonsteroidal antiinflammatory drugs (NSAIDs) acetaminophen and risk of pancreatic cancer
Tan, Xiang‐Lin, Lombardo, Kaye M. Reid, Robinson, Dennis P. , Anderson, Kristin E. , Petersen, Gloria M. , Bamlet, William R.

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: 1902-1902

10.1158/1538-7445.am2011-1902 Get It

Abstract Background: Aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) show indisputable promise as cancer chemoprevention agents. While aspirin and NSAID use have been suggested to lower risk of developing pancreatic cancer, the results of several epidemiological studies are not in consensus. Methods: Using a case-control design, we examined the association between aspirin, NSAID and acetaminophen use and the risk of pancreatic cancer. We enrolled 904 histological or clinically documented pancreatic ductal adenocarcinoma cases, and 1,223 age and gender matched healthy clinic-based controls evaluated at Mayo Clinic from April 2004 and September 2010. All subjects were ≥ 55 years old and self-reported by questionnaire their use of aspirin, NSAIDs, and acetaminophen at ages 41-60, along with extensive epidemiologic and demographic information. Multivariate logistic regression analysis was used to estimate risk of pancreatic cancer after adjusting for potential confounders. Results: The use of aspirin was associated with a decreased risk of pancreatic cancer. The unadjusted odds ratio (OR) associated with aspirin use ≥ 1 day/month, compared with never or < 1 day/month, was 0.79 [95% confidence interval (CI) 0.65. 0.96, p = 0.015]. This effect remained significant [OR 0.71, 95% CI 0.58,0.87, p = 0.0008], after adjusting for the potential confounders of body mass index and smoking status (never, former, current). The inverse relationship was stronger among former smokers (OR 0.61, 95% CI 0.46, 0.82, p =0.0008) than never and current smokers, although there was not a statistically significant interaction (Pintereaction = 0.333). NSAID and acetaminophen use was not associated with the risk of pancreatic cancer. Conclusions: Results from this large case-control study suggest that aspirin use, but not non-aspirin NSAID use, was associated with lower risk of developing pancreatic cancer and was more pronounced among former smokers than never and current smokers. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1902. doi:10.1158/1538-7445.AM2011-1902
Abstract 1900: Age at last birth and endometrial cancer risk: Pooled analysis in the Epidemiology of Endometrial Cancer Consortium
Karageorgi, Stalo , Deming, Sandra L., Anderson, Kristin E. , Brinton, Louise A. , Chen, Chu , Horn‐Ross, Pamela L., Lissowska, Jolanta , Lurie, Galina, Mack, Thomas M. , Matsuno, Rayna K., McCann, Susan E. , Moysich, Kristen B., Pike, Malcolm C. , Shu, Xiao-Ou , Strom, Brian L., Group, The Australian National Endometrial Cancer Study, Ursin, Giske , Webb, Penny M., Weiss, Noel S. , Wentzensen, Nicolas , Setiawan, Veronica Wendy , Bernstein, Leslie , Cai, Hui , Cerhan, James R. , Cozen, Wendy , Doherty, Jennifer A. , Freudenheim, Jo L. , Goodman, Marc T. , Rebbeck, Timothy R. , Robien, Kim , Shu, Xiao-Ou , Spurdle, Amanda B. , Group, The Australian National Endometrial Cancer Study, Xiang, Yong‐Bing , Webb, Penny M., Yang, Hannah , Vivo, Immaculata De , Lissowska, Jolanta

Mayo Clinic

Cancer Research | July 21, 2012 | Volume: 71 | Issue: 8_Supplement | Pages: 1900-1900

10.1158/1538-7445.am2011-1900 Get It

Abstract Some studies show that childbearing at older age is associated with lower risk of endometrial cancer, but whether the association is independent of number of children or other factors still requires clarification. We pooled individual-level data from epidemiologic studies in the Epidemiology of Endometrial Cancer Consortium (E2C2). Data on age at last birth and/or last pregnancy were available from 14 studies: 11 case-control studies and 3 cohort studies; the latter were analyzed using a nested case-control design. A total of 9,613 endometrial cancer cases and 17,112 controls were included in the analysis. The majority of women were White (82%) and older than 55 years (69%). We estimated the effects of age at last birth using data from 12 studies and age at last pregnancy using data from 10 studies on the risk of endometrial cancer by calculating odds ratios (OR) and 95% confidence intervals (95% CI) using logistic regression models. Potential confounders included in the analysis were race, body mass index, parity, age at menarche, age at first birth, oral contraceptive use, postmenopausal hormone use, smoking status, and report of diabetes. After adjusting for potential confounders, a reduction in endometrial cancer risk was observed in women with increasing age at last birth (P trend <0.0001) and age at last pregnancy (P trend <0.0001). The OR per five-year increase in age at last birth and age at last pregnancy was 0.90 (95%CI: 0.86, 0.94) and 0.91 (95% CI: 0.87, 0.95), respectively. Women who had their last child at an age >40 years were at a 34% decreased risk compared with women who had their last child at an age <25 years (95% CI: 0.52, 0.82). Compared to women with age at last pregnancy <25 years, those with age at last pregnancy >40 years had a 30% decreased risk of endometrial cancer (95%CI: 0.57, 0.86). Inverse associations were observed for Whites and Asians in race-specific analysis and also in analysis restricted to women with at least 2 births. In this large pooled analysis, we show that late age at last birth or last pregnancy is a strong and independent protective factor for endometrial cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1900. doi:10.1158/1538-7445.AM2011-1900