Expression of Cytokeratins 17 and 5 Identifies a Group of Breast Carcinomas with Poor Clinical Outcome

While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. In a previous study of 78 breast carcinoma specimens, we noted an associa...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The American journal of pathology 2002-12, Vol.161 (6), p.1991-1996
Hauptverfasser: van de Rijn, Matt, Perou, Charles M., Tibshirani, Rob, Haas, Phillippe, Kallioniemi, Olli, Kononen, Juha, Torhorst, Joachim, Sauter, Guido, Zuber, Markus, Köchli, Ossi R., Mross, Frank, Dieterich, Holger, Seitz, Rob, Ross, Doug, Botstein, David, Brown, Pat
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1996
container_issue 6
container_start_page 1991
container_title The American journal of pathology
container_volume 161
creator van de Rijn, Matt
Perou, Charles M.
Tibshirani, Rob
Haas, Phillippe
Kallioniemi, Olli
Kononen, Juha
Torhorst, Joachim
Sauter, Guido
Zuber, Markus
Köchli, Ossi R.
Mross, Frank
Dieterich, Holger
Seitz, Rob
Ross, Doug
Botstein, David
Brown, Pat
description While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. In a previous study of 78 breast carcinoma specimens, we noted an association between poor clinical outcome and the expression of cytokeratin 17 and/or cytokeratin 5 mRNAs. Here we describe the results of immunohistochemistry studies using monoclonal antibodies against these markers to analyze more than 600 paraffin-embedded breast tumors in tissue microarrays. We found that expression of cytokeratin 17 and/or cytokeratin 5/6 in tumor cells was associated with a poor clinical outcome. Moreover, multivariate analysis showed that in node-negative breast carcinoma, expression of these cytokeratins was a prognostic factor independent of tumor size and tumor grade.
doi_str_mv 10.1016/S0002-9440(10)64476-8
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1850928</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002944010644768</els_id><sourcerecordid>270184171</sourcerecordid><originalsourceid>FETCH-LOGICAL-c552t-f998eeb24ac9f7e88ca71447835a847399eedeb21ab6cb4b00c27ccf3f011c973</originalsourceid><addsrcrecordid>eNqFkU9v1DAQxSMEokvhI4AsJP4dAh7HcewLCFalVKpUJOBseZ1J10tib-2kpd8ep7tqgQsnazy_eXozryieAn0LFMS7b5RSVirO6WugbwTnjSjlvWIBNatLBgruF4tb5KB4lNIml6KS9GFxAIwLAcAXRXf0axsxJRc8CR1ZXo_hJ0YzOp8INMT4ltTkpEU_us5hIoYcxzBtZ_ZTRJNGsjTROh8Gk8iVG9fkawiRLHvnnTU9OZtGGwZ8XDzoTJ_wyf49LH58Pvq-_FKenh2fLD-elrau2Vh2SknEFePGqq5BKa1pIK8mq9pI3lRKIba5D2Yl7IqvKLWssbarOgpgVVMdFu93uttpNWBrs-9oer2NbjDxWgfj9N8d79b6PFxqkDVVTGaBl3uBGC4mTKMeXLLY98ZjmJJuWFMJyngGn_8DbsIUfV5OM5BK1kLOavUOsjGkFLG7dQJUzzHqmxj1nNH8dROjnuee_bnG3dQ-twy82AMm5TN30Xjr0h3H86kqxjL3aset3fn6ykXUaTB9n2VBm80WBGihQSnI5IcdiTmeS4dRJ-vQW2zzlB11G9x_TP8GdK_Hcw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>218985688</pqid></control><display><type>article</type><title>Expression of Cytokeratins 17 and 5 Identifies a Group of Breast Carcinomas with Poor Clinical Outcome</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>ScienceDirect Journals (5 years ago - present)</source><source>PubMed Central</source><creator>van de Rijn, Matt ; Perou, Charles M. ; Tibshirani, Rob ; Haas, Phillippe ; Kallioniemi, Olli ; Kononen, Juha ; Torhorst, Joachim ; Sauter, Guido ; Zuber, Markus ; Köchli, Ossi R. ; Mross, Frank ; Dieterich, Holger ; Seitz, Rob ; Ross, Doug ; Botstein, David ; Brown, Pat</creator><creatorcontrib>van de Rijn, Matt ; Perou, Charles M. ; Tibshirani, Rob ; Haas, Phillippe ; Kallioniemi, Olli ; Kononen, Juha ; Torhorst, Joachim ; Sauter, Guido ; Zuber, Markus ; Köchli, Ossi R. ; Mross, Frank ; Dieterich, Holger ; Seitz, Rob ; Ross, Doug ; Botstein, David ; Brown, Pat</creatorcontrib><description>While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. In a previous study of 78 breast carcinoma specimens, we noted an association between poor clinical outcome and the expression of cytokeratin 17 and/or cytokeratin 5 mRNAs. Here we describe the results of immunohistochemistry studies using monoclonal antibodies against these markers to analyze more than 600 paraffin-embedded breast tumors in tissue microarrays. We found that expression of cytokeratin 17 and/or cytokeratin 5/6 in tumor cells was associated with a poor clinical outcome. Moreover, multivariate analysis showed that in node-negative breast carcinoma, expression of these cytokeratins was a prognostic factor independent of tumor size and tumor grade.</description><identifier>ISSN: 0002-9440</identifier><identifier>EISSN: 1525-2191</identifier><identifier>DOI: 10.1016/S0002-9440(10)64476-8</identifier><identifier>PMID: 12466114</identifier><identifier>CODEN: AJPAA4</identifier><language>eng</language><publisher>Bethesda, MD: Elsevier Inc</publisher><subject>Animals ; Biological and medical sciences ; Biomarkers, Tumor - metabolism ; Breast - cytology ; Breast - metabolism ; Breast Neoplasms - diagnosis ; Breast Neoplasms - pathology ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Immunohistochemistry ; Keratin-5 ; Keratins - genetics ; Keratins - metabolism ; Mammary gland diseases ; Medical sciences ; Neoplasm Staging ; Oligonucleotide Array Sequence Analysis ; Prognosis ; Short Communications ; Survival Rate ; Treatment Outcome ; Tumors</subject><ispartof>The American journal of pathology, 2002-12, Vol.161 (6), p.1991-1996</ispartof><rights>2002 American Society for Investigative Pathology</rights><rights>2003 INIST-CNRS</rights><rights>Copyright American Society for Investigative Pathology Dec 2002</rights><rights>Copyright © 2002, American Society for Investigative Pathology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c552t-f998eeb24ac9f7e88ca71447835a847399eedeb21ab6cb4b00c27ccf3f011c973</citedby><cites>FETCH-LOGICAL-c552t-f998eeb24ac9f7e88ca71447835a847399eedeb21ab6cb4b00c27ccf3f011c973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1850928/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0002-9440(10)64476-8$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,3550,27924,27925,45995,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=14399322$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12466114$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van de Rijn, Matt</creatorcontrib><creatorcontrib>Perou, Charles M.</creatorcontrib><creatorcontrib>Tibshirani, Rob</creatorcontrib><creatorcontrib>Haas, Phillippe</creatorcontrib><creatorcontrib>Kallioniemi, Olli</creatorcontrib><creatorcontrib>Kononen, Juha</creatorcontrib><creatorcontrib>Torhorst, Joachim</creatorcontrib><creatorcontrib>Sauter, Guido</creatorcontrib><creatorcontrib>Zuber, Markus</creatorcontrib><creatorcontrib>Köchli, Ossi R.</creatorcontrib><creatorcontrib>Mross, Frank</creatorcontrib><creatorcontrib>Dieterich, Holger</creatorcontrib><creatorcontrib>Seitz, Rob</creatorcontrib><creatorcontrib>Ross, Doug</creatorcontrib><creatorcontrib>Botstein, David</creatorcontrib><creatorcontrib>Brown, Pat</creatorcontrib><title>Expression of Cytokeratins 17 and 5 Identifies a Group of Breast Carcinomas with Poor Clinical Outcome</title><title>The American journal of pathology</title><addtitle>Am J Pathol</addtitle><description>While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. In a previous study of 78 breast carcinoma specimens, we noted an association between poor clinical outcome and the expression of cytokeratin 17 and/or cytokeratin 5 mRNAs. Here we describe the results of immunohistochemistry studies using monoclonal antibodies against these markers to analyze more than 600 paraffin-embedded breast tumors in tissue microarrays. We found that expression of cytokeratin 17 and/or cytokeratin 5/6 in tumor cells was associated with a poor clinical outcome. Moreover, multivariate analysis showed that in node-negative breast carcinoma, expression of these cytokeratins was a prognostic factor independent of tumor size and tumor grade.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Breast - cytology</subject><subject>Breast - metabolism</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - pathology</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Keratin-5</subject><subject>Keratins - genetics</subject><subject>Keratins - metabolism</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Neoplasm Staging</subject><subject>Oligonucleotide Array Sequence Analysis</subject><subject>Prognosis</subject><subject>Short Communications</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0002-9440</issn><issn>1525-2191</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkU9v1DAQxSMEokvhI4AsJP4dAh7HcewLCFalVKpUJOBseZ1J10tib-2kpd8ep7tqgQsnazy_eXozryieAn0LFMS7b5RSVirO6WugbwTnjSjlvWIBNatLBgruF4tb5KB4lNIml6KS9GFxAIwLAcAXRXf0axsxJRc8CR1ZXo_hJ0YzOp8INMT4ltTkpEU_us5hIoYcxzBtZ_ZTRJNGsjTROh8Gk8iVG9fkawiRLHvnnTU9OZtGGwZ8XDzoTJ_wyf49LH58Pvq-_FKenh2fLD-elrau2Vh2SknEFePGqq5BKa1pIK8mq9pI3lRKIba5D2Yl7IqvKLWssbarOgpgVVMdFu93uttpNWBrs-9oer2NbjDxWgfj9N8d79b6PFxqkDVVTGaBl3uBGC4mTKMeXLLY98ZjmJJuWFMJyngGn_8DbsIUfV5OM5BK1kLOavUOsjGkFLG7dQJUzzHqmxj1nNH8dROjnuee_bnG3dQ-twy82AMm5TN30Xjr0h3H86kqxjL3aset3fn6ykXUaTB9n2VBm80WBGihQSnI5IcdiTmeS4dRJ-vQW2zzlB11G9x_TP8GdK_Hcw</recordid><startdate>20021201</startdate><enddate>20021201</enddate><creator>van de Rijn, Matt</creator><creator>Perou, Charles M.</creator><creator>Tibshirani, Rob</creator><creator>Haas, Phillippe</creator><creator>Kallioniemi, Olli</creator><creator>Kononen, Juha</creator><creator>Torhorst, Joachim</creator><creator>Sauter, Guido</creator><creator>Zuber, Markus</creator><creator>Köchli, Ossi R.</creator><creator>Mross, Frank</creator><creator>Dieterich, Holger</creator><creator>Seitz, Rob</creator><creator>Ross, Doug</creator><creator>Botstein, David</creator><creator>Brown, Pat</creator><general>Elsevier Inc</general><general>ASIP</general><general>American Society for Investigative Pathology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20021201</creationdate><title>Expression of Cytokeratins 17 and 5 Identifies a Group of Breast Carcinomas with Poor Clinical Outcome</title><author>van de Rijn, Matt ; Perou, Charles M. ; Tibshirani, Rob ; Haas, Phillippe ; Kallioniemi, Olli ; Kononen, Juha ; Torhorst, Joachim ; Sauter, Guido ; Zuber, Markus ; Köchli, Ossi R. ; Mross, Frank ; Dieterich, Holger ; Seitz, Rob ; Ross, Doug ; Botstein, David ; Brown, Pat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c552t-f998eeb24ac9f7e88ca71447835a847399eedeb21ab6cb4b00c27ccf3f011c973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Breast - cytology</topic><topic>Breast - metabolism</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - pathology</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Keratin-5</topic><topic>Keratins - genetics</topic><topic>Keratins - metabolism</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Neoplasm Staging</topic><topic>Oligonucleotide Array Sequence Analysis</topic><topic>Prognosis</topic><topic>Short Communications</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van de Rijn, Matt</creatorcontrib><creatorcontrib>Perou, Charles M.</creatorcontrib><creatorcontrib>Tibshirani, Rob</creatorcontrib><creatorcontrib>Haas, Phillippe</creatorcontrib><creatorcontrib>Kallioniemi, Olli</creatorcontrib><creatorcontrib>Kononen, Juha</creatorcontrib><creatorcontrib>Torhorst, Joachim</creatorcontrib><creatorcontrib>Sauter, Guido</creatorcontrib><creatorcontrib>Zuber, Markus</creatorcontrib><creatorcontrib>Köchli, Ossi R.</creatorcontrib><creatorcontrib>Mross, Frank</creatorcontrib><creatorcontrib>Dieterich, Holger</creatorcontrib><creatorcontrib>Seitz, Rob</creatorcontrib><creatorcontrib>Ross, Doug</creatorcontrib><creatorcontrib>Botstein, David</creatorcontrib><creatorcontrib>Brown, Pat</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van de Rijn, Matt</au><au>Perou, Charles M.</au><au>Tibshirani, Rob</au><au>Haas, Phillippe</au><au>Kallioniemi, Olli</au><au>Kononen, Juha</au><au>Torhorst, Joachim</au><au>Sauter, Guido</au><au>Zuber, Markus</au><au>Köchli, Ossi R.</au><au>Mross, Frank</au><au>Dieterich, Holger</au><au>Seitz, Rob</au><au>Ross, Doug</au><au>Botstein, David</au><au>Brown, Pat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Expression of Cytokeratins 17 and 5 Identifies a Group of Breast Carcinomas with Poor Clinical Outcome</atitle><jtitle>The American journal of pathology</jtitle><addtitle>Am J Pathol</addtitle><date>2002-12-01</date><risdate>2002</risdate><volume>161</volume><issue>6</issue><spage>1991</spage><epage>1996</epage><pages>1991-1996</pages><issn>0002-9440</issn><eissn>1525-2191</eissn><coden>AJPAA4</coden><abstract>While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. In a previous study of 78 breast carcinoma specimens, we noted an association between poor clinical outcome and the expression of cytokeratin 17 and/or cytokeratin 5 mRNAs. Here we describe the results of immunohistochemistry studies using monoclonal antibodies against these markers to analyze more than 600 paraffin-embedded breast tumors in tissue microarrays. We found that expression of cytokeratin 17 and/or cytokeratin 5/6 in tumor cells was associated with a poor clinical outcome. Moreover, multivariate analysis showed that in node-negative breast carcinoma, expression of these cytokeratins was a prognostic factor independent of tumor size and tumor grade.</abstract><cop>Bethesda, MD</cop><pub>Elsevier Inc</pub><pmid>12466114</pmid><doi>10.1016/S0002-9440(10)64476-8</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0002-9440
ispartof The American journal of pathology, 2002-12, Vol.161 (6), p.1991-1996
issn 0002-9440
1525-2191
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1850928
source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present); PubMed Central
subjects Animals
Biological and medical sciences
Biomarkers, Tumor - metabolism
Breast - cytology
Breast - metabolism
Breast Neoplasms - diagnosis
Breast Neoplasms - pathology
Female
Gynecology. Andrology. Obstetrics
Humans
Immunohistochemistry
Keratin-5
Keratins - genetics
Keratins - metabolism
Mammary gland diseases
Medical sciences
Neoplasm Staging
Oligonucleotide Array Sequence Analysis
Prognosis
Short Communications
Survival Rate
Treatment Outcome
Tumors
title Expression of Cytokeratins 17 and 5 Identifies a Group of Breast Carcinomas with Poor Clinical Outcome
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T18%3A48%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Expression%20of%20Cytokeratins%2017%20and%205%20Identifies%20a%20Group%20of%20Breast%20Carcinomas%20with%20Poor%20Clinical%20Outcome&rft.jtitle=The%20American%20journal%20of%20pathology&rft.au=van%20de%20Rijn,%20Matt&rft.date=2002-12-01&rft.volume=161&rft.issue=6&rft.spage=1991&rft.epage=1996&rft.pages=1991-1996&rft.issn=0002-9440&rft.eissn=1525-2191&rft.coden=AJPAA4&rft_id=info:doi/10.1016/S0002-9440(10)64476-8&rft_dat=%3Cproquest_pubme%3E270184171%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=218985688&rft_id=info:pmid/12466114&rft_els_id=S0002944010644768&rfr_iscdi=true