目的 探讨真空辅助微创旋切术后不放置引流管治疗坏死型乳腺脓肿的临床效果.方法 依据纳入、排除标准,选取北京市海淀区妇幼保健院2015年1月至2018年7月收治的73例哺乳期坏死型乳腺脓肿患者进行前瞻性研究.采用随机数字表法将患者分为研究组(35例)和对照组(38例).研究组采用真空辅助微创旋切术治疗,术后不放置引流管;对照组采用脓肿置管冲洗引流术治疗.比较2组间治疗指标(术后住院时间、复诊次数)、并发症(乳瘘)及预后(回乳、复发)的差异.偏态分布的计量资料用M(P25～P75)表示.术后住院时间、复诊次数的比较采用Mann-Whitney U检验;回乳率、复发率及乳瘘发生率的比较采用χ2检验及Fisher确切概率检验.结果 研究组与对照组患者术后住院时间分别为5.0(3.0～7.0)d和10.5(8.0～13.3)d,复诊次数分别为3.0(2.0～6.0)次和7.5(3.0～10.0)次,乳瘘发生率分别为2.9％(1/35)和21.1％(8/38),组间比较,差异均有统计学意义(Z=-5.704,P<0.001;Z=-3.626,P<0.001;P=0.029),而回乳率、复发率比较,差异均无统计学意义[回乳率:20.0％(7/35)比39.5％(15/38),χ2=3.282,P=0.070;复发率:8.6％(3/35)比7.9％(3/38),P=1.000].结论 对于脓腔内充满坏死组织的复杂乳腺脓肿,真空辅助微创旋切术后不放置引流管,患者不需特殊护理,术后住院时间短,复诊次数少,可提高母亲患病期间的生活质量.
作为凝血和纤维蛋白溶解活化的标志物，D-二聚体可快速评估血栓形成活性，并在静脉血栓栓塞症的诊断中发挥重要作用。研究表明在乳腺癌患者的血浆中D-二聚体浓度增加，因此，D-二聚体可以用作乳腺癌高凝状态的标志物。D-二聚体高表达反映了乳腺癌的恶性程度，与乳腺癌的侵袭转移密切相关，但与乳腺癌患者分子分型的关系有待研究。D-二聚体表达水平可以反映乳腺癌患者的身体机能状况，并可以指导构建静脉血栓栓塞症风险分层的风险评估模型。化疗和内分泌治疗会导致部分患者D-二聚体表达升高，在接受化疗前乳腺癌患者的D-二聚体浓度升高与化疗相对剂量强度降低相关。D-二聚体是指导乳腺癌患者抗凝治疗、判断预后的有效生物标志物。
染色标记技术是直接肉眼或影像学(超声、X线、乳管镜)辅助下注射特定染色剂(如亚甲蓝、纳米炭等染料)来标记病灶部位、示踪淋巴结，以指导外科手术或复查等诊治过程的方法。染色标记技术用于病理性乳头溢液的乳腺微小病灶及触诊阴性乳腺病灶的术前定位，可实现病灶的精准切除；用于乳腺癌腋窝淋巴结示踪，可指导前哨淋巴结活组织检查和腋窝淋巴结清扫；用于乳腺癌新辅助治疗前，可避免新辅助治疗后临床完全缓解患者行保留乳房手术时的盲目性。临床上，在熟练掌握染色标记技术操作要领的基础上，还要根据各种染色剂的不同特点，选用合适的染色剂和剂量，并在恰当的时间实施标记，才能满足不同的临床需求。染色标记技术的合理应用，提高了实现最小范围的有效切除和最大限度保留正常乳腺结构和生理功能的可行性，有助于精准乳腺外科理念与技术的发展。
Objective To explore the application and clinical significance of the inverted-T pattern breast reduction in patients with breast hypertrophy,especially associated with breast cancer.Metbods This retrospective study enrolled 39 patients with breast hypertrophy in Tongji Hospital and East Hospital Affiliated to Tongji University from October 2007 to October 2017.Those patients underwent inverted-T pattern breast reduction,including medial pedicle used in 25 patients,vertical pedicle in 5 and lateral pedicle in 9.Among 39 patients,there were 18 breast cancer patients,with the indication of breast conserving surgery,so they underwent both breast conserving surgery and inverted-T pattern breast reduction,in which medial pedicle was used in 10 patients,vertical pedicle in 4 and lateral pedicle in 4.The aesthetic effect was evaluated in 6 and 12 months after operation except 18 breast cancer patients who were evaluated after radiotherapy.The postoperative complications,recurrence,metastasis and patient satisfaction were observed.Results All 39 patients were satisfied with natural and symmetrical postoperative appearance,obvious reduction and lifting of the breasts,normal blood supply and sensation of the nipple-areola area,and no obvious scar.One patient had necrosis of the nipple-areola area in one breast two weeks after operation,which healed after debridement and dressing change.Postoperative sensation decrease of bilateral nipple-areola areas occurred in five patients and it returned to normal after 6 months in four patients,12 months in one patient.Postoperative local breast tissue induration was observed in five patients,including three breast cancer patients who received radiotherapy and presented no recurrence after removing the indurated lesions.Dog-ear deformity appeared in the surgical scar of three patients,and it was repaired by surgery under local anesthesia.Another three patients had slightly thickened scars,while the rest had normal scars.Three breast cancer patients developed skin edema after radiotherapy,which subsided 12 months after surgery.Postoperative aesthetic evaluation at 6 months after operation showed that excellent outcome was achieved in 25 cases,good in 10,moderate in 4,poor in 0 (in 18 cases of breast cancer,excellent aesthetic effect was achieved in 9 cases,good in 6,moderate in 3,poor in 0).Postoperative aesthetic evaluation at 12 months after operation showed that excellent aesthetic effect was achieved in 25 cases,good in 13,moderate in 1,poor in 0 (in 18 cases of breast cancer:excellent aesthetic effect was achieved in 9 cases,good in 8,moderate in 1,poor in 0).One patient with severe hypertrophy of both breasts was followed up for 10 years after operation,suggesting no significant change in the appearance of her breasts.All patients were followed up for 15-120 months (median 61 months).None of 18 breast cancer patients had local recurrence or metastasis.Conclusion For patients with breast hypertrophy,especially those who are diagnosed with breast cancer,inverted-T pattern breast reduction can remove the lesions,reduce hypertrophic breasts and accomplish the mammoplasty.
Objective To analyze the concordance of ER,PR,HER-2,Ki67 results in immunohistochemical detection of specimens from core-needle biopsy (CNB) and open surgery in breast cancer patients.Methods The clinical data of 305 breast cancer patients who received no neoadjuvant therapy before surgery in the Department of Thyroid and Breast Surgery,Shenzhen Second People's Hospital from January 2014 to October 2017 were retrospectively analyzed.The Kappa test of paired count data was used to compare the concordance of immunohistochemistry results (ER,PR,HER-2 and Ki67) between preoperative CNB specimens and surgically removed specimens of breast cancer patients.Results The concordant rate of ER and PR expression was 93.1％ (284/305) and 93.1％ (284/305) between CNB specimens and surgically removed specimens (Kappa =0.837,0.858,both P＜0.001).The concordant rate of ER positive staining intensity was 50.0％ (101/202) between CNB specimens and surgically removed specimens (Kappa =0.244,P＜0.001).The concordant rate of PR positive staining intensity was 68.8％ (117/170) between CNB specimens and surgically removed specimens (Kappa =0.433,P＜0.001).The HER-2 expression and Ki67 index showed a moderate consistency between CNB specimens and surgically removed specimens (Kappa =0.543,0.535,both P＜0.001).The concordant rate of the percentage of ER/PR/Ki67 positive cells was 60.7％ (185/305),53.1％ (162/305) and 36.1％ (110/305),respectively.Conclusions In the immunohistochemical detection,ER and PR expression shows high concordant rates between CNB specimens and surgically removed specimens,while the positive staining intensity of ER and PR,HER-2 expression and Ki67 index shows a moderate concordance.The percentage of ER/PR/Ki67 positive cells presents a moderate concordance between two kinds of specimens.
Objective To explore the risk factors of supraclavicular lymph node positive after neoadjuvant chemotherapy in breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastasis,and analyze the prognosis of those patients.Methods A total of 96 breast cancer patients in the Department of Breast and Thyroid Surgery,Southwest Hospital,Army Medical University from January 2005 to July 2015 were enrolled in this retrospective study.The imaging findings indicated synchronous ipsilateral supraclavicular lymph node metastasis in all patients.All patients were treated with preoperative neoadjuvant chemotherapy of 4-6 cycles,radiotherapy,modified radical mastectomy and ipsilateral supraclavicular lymph node dissection.Moreover,the patients with ER,PR or HER-2 positive received the endocrine therapy and targeted therapy,respectively.x2 test and Fisher exact probability test were used to analyze the relationship between clinicopathological characteristics and positive ipsilateral supraclavicular lymph nodes after neoadjuvant chemotherapy.Logistic regression was used to analyze the risk factors of positive ipsilateral supraclavicular lymph nodes after neoadjuvant chemotherapy.Kaplan-Meier survival curve was drawn to analyze the OS and DFS of all patients.Results Postoperative pathology showed that among the 96 patients,50 cases had positive supraclavicular lymph nodes,accounting for 53％ of the total.Univariate analysis showed that the following clinicopathological characteristics were significantly different between ipsilateral supraclavicular lymph node-positive group and ipsilateral supraclavicular lymph node-negative group after neoadjuvant chemotherapy:number of positive axillary lymph nodes,supraclavicular lymph nodes,internal mammary lymph nodes and Ki67 (x2 =36.501,20.548,6.750,5.186,all P＜0.050).Multivariate analysis showed that the number of positive axillary lymph nodes ≥ 4 was an independent risk factor for synchronous ipsilateral supraclavicular lymph node metastasis (4-9 nodes:OR=10.234,95％ CI:1.978-52.946,P=0.006;＞9 nodes:OR=22.322,95％CI:4.887-101.963,P＜0.001).The 3-year DFS and OS of 96 patients were 64.7％ and 75.8％,respectively;the 5-year DFS and OS were 49.6％ and 65.0％,respectively.Conclusions The number of positive axillary lymph nodes after neoadjuvant chemotherapy≥4 is a high risk factor for synchronous ipsilateral supraclavicular lymph node metastasis in breast cancer patients.If the imaging evidences suggest synchronous ipsilateral supraclavicular lymph node metastasis,local treatment (breast,axillary and supraclavicular surgery+radiation therapy) combined with systemic therapy (chemotherapy+endocrine/targeted therapy if necessary) are recommended in order to improve the survival of patients.
Objective To investigate the feasibility of indocyanine green angiography-guided breast reconstruction using the pedicled transverse abdominis myocutaneous (TRAM) flap.Methods This prospective study analyzed the clinical data of 64 patients who underwent breast reconstruction with TRAM flap in Cancer Institute and Hospital of Tianjin Medical University and Zhengzhou Central Hospital Affiliated to Zhengzhou University between January 2015 and June 2017.All cases were divided into the angiography group (34 cases) and the control group (30 cases) by the random number table method.In the angiography group,indocyanine green angiography was used to guide the trim of the flap,while the flap was trimmed in a conventional way in the control group.The incidence of abnormal blood supply in postoperative 12 hours,the flap-related complications and postoperative appearance of the reconstructed breast were compared between two groups using x2 test.The patient satisfaction was compared between two groups using t test.Results In the angiography group,there were no complications related to indocyanine green angiography and the reconstructed breast presented a good appearance after the part of flap was with poor perfusion resected according to the ICG angiography.The incidence of abnormal blood supply in the flap in postoperative 12 hours was 2.9％ (1/34)in the angiography group and 13.3％ (4/30) in the control group,indicating no significant difference (x2 =1.165,P=0.280).The incidence of flap-related complications was 2.9％ (1/34) in the angiography group and 10.0％ (3/30) in the control group,indicating no significant difference (x2=0.418,P =0.518).All the patients were followed up for one year.The patients with good postoperative breast appearance accounted for 97.1％ (33/34) in the angiography group,significantly higher than 76.7％ (23/30) in the control group (x2 =4.338,P=0.037).The score of overall patient satisfaction was 8.91±0.38 in the angiography group and 8.47 + 0.57 in the control group,suggesting a significant difference (t =3.622,P =0.001).Conclusion Indocyanine green angiography can dynamically show blood perfusion of the pedicled TRAM flap,which can provide the guidance for flap trimming in order to achieve a better breast appearance.
Objective Immediate physical exercise has been recommended for patients in the recovery phase to improve survival and quality of life( QOL) and reduce recurrence of disease. The new NCCN Guidelines for Survivorship also highlighted the role of exercise in post-cancer health,encouraging patients to perform light physical activity following treatment. The aim of our study is to effect of Tai Chi Chuan( TCC) on serotonin and cortisol for monitoring stress and QOL in post-treatment breast cancer patients. Methods Totally85 post-treatment breast cancer patients were enrolled in this study to observe the effects of practicing TCC on recovery,as well as stress and happiness which are indicators of QOL of in patients. Peripheral blood was drawn from study subjects to analyze the levels of serotonin,cortisol and high sensitive C-reactive protein( HSCRP) at baseline,and at 3,6 and 12 months of TCC practice. Blood was drawn from healthy subjects only at baseline. A QOL questionnaire was administered to study subjects at three time points throughout the study,and once for healthy controls. The data were processed by analysis of variance of repeated measurement. Results At 3,6 and 12 months time points following regular TCC exercise,WBC,RBC,hemoglobin in blood samples showed a statistically significant difference( F = 161. 55,172. 14,289. 73; all P = 0. 00); the level of serotonin( biomarker for well-being),cortisol( indicator of stress) and HS-CRP( biomarker for inflammation)showed a statistical improvement( F = 307. 46,182. 85,102. 23; all P = 0. 00). After 3,6 and 12 months of regular TCC exercise,according to the results of QOL questionnaire,the indicators including quality of sleep,perceived hunger,fatigue,contentment,stress and social interaction presented a significant difference( F =312. 98,222. 64,543. 90,46. 05,28. 10,78. 92,all P0. 05),while there was no statistical difference in life dissatisfaction( F = 56. 61,P = 0. 166) Conclusions TCC physical activity for post-treatment breast cancer patients improved QOL and overall well-being, leading to improved mental, physical and psychological functioning. Regulated levels of serotonin and cortisol mediated by TCC exercises are proved to be vital for continued good health.
Objective To study the differences of the hormone receptors and HER-2 expression and molecular typing between breast ductal carcinoma in situ (DCIS) and infiltrating ductal carcinoma (IDC) patients. Methods The specimens were collected from 52 cases of DCIS and 224 cases of IDC from March 2006 to September 2012. ER, PR and HER-2 were detected by immunohistochemical method, and Chi-square test was used to analyze the molecular typing of the two groups. Results ER positive expression rate in the IDC group (67.86%, 152/224) was higher than that in the DCIS group (48.08%, 25/52)(χ2=7.18, P=0.01), while the HER-2 positive expression rate in the IDC group (54.02%, 121/224) was lower than that in the DCIS group (73.08%, 38/52)(χ2=6.28,P=0.01). PR expression showed no significant difference (χ2=1.39,P=0.24). The dominant molecular type was HER-2 positive in the DCIS group (44.23%, 23/52), luminal A in the IDC group (43.75%, 98/224), which showed significant difference between the two groups (χ2=13.11,P=0.00). Conclusion The detection of ER, HER-2 expression and molecular typing in DCIS and IDC patients can provide important references to clinical diagnosis and individualized treatment.
Objective To investigate the effect of autophagy on cell growth in triple-negative breast cancer BT-549 cells by transfecting beclin 1. Methods BT-549 cells were divided into 4 groups,including the blank group,the empty vector group,the liposome group and the target gene group (beclin 1 group);besides,MDA-MB-231 cells served as the positive control group.BT-549 cells were transfected with pDsRed-C1-beclin 1 by LipofectamineTM 2000 and the efficiency was evaluated by fluorescence at 24, 36, 48, 60 h after transfection; beclin 1 mRNA levels in each group were examined by RT-PCR at 48 h after transfection. Then the transfected cells were cultured in 1640 medium with and without 10% fetal bovine serum (FBS), respectively. The growth rate and cell survival were detected by MTT at 24, 48, 72, 96 h or 12, 24, 36, 48 h, respectively. The cell apoptosis and distribution of cell cycle were determined by flow cytometry after 24 h of starvation; the numbers of cells containing autophagic vesicles were calculated by acridine orange staining after the culture in serum-deprived 1640 medium for 36 h. Measurement data were calculated by repeated measurement one-way ANOVA; categorical data were calculated by chi-square test. Results The transfection efficiency was the highest at 48 h. RT-PCR showed that the mRNA level in beclin 1 was higher than that in other groups(P0.01). MTT showed that in 1640 medium containing 10% FBS, the cell proliferation rate in beclin 1 group was lower than that in control group (F=112.1, P=0.00) while in serum-deprived 1640 medium, the cell survival at 36, 48 h in beclin 1 group was significantly higher than that in control group (F=37.5, P=0.00). Flow cytometry showed that the percentage of apoptotic cells in beclin 1 group (F=3914.4, P=0.00) and the cells in G0/G1 phase (F=258.8, P=0.00) increased; the number of cells with autophagic vesicles stained by acridine orange obviously increased in beclin 1 group(χ2=7.7, P=0.00). Conclusion Transfecting beclin 1 to induce autophagy in triple-negative breast cancer BT-549 cells can inhibit cell proliferation in normal condition and improve cell survival in starvation.
Objective To investigate the relationship between the patients ’ behaviors and the occurrence of acute lactational mastitis. Methods Totally 237 patients diagnosed as having acute lactational mastitis in our hospital from January 2011 to March 2012 and 237 healthy female volunteers who were not in lactation but with breastfeeding experience were enrolled in the study. The data was collected through a questionnaire and then univariate analysis and logistic regression analysis were performed to investigate the relationship between the patients ’behaviors and the occurrence of the acute lactational mastitis. Results The univariate analysis showed that the duration of breastfeeding (χ2=116.88,P=0.00), sleeping posture (χ2=49.47,P=0.00), way of milk sucking (χ2=74.64,P=0.00), cleaning of the nipple (χ2=61.80,P=0.00)and trauma of the breast (χ2=16.77,P=0.00)were the relative factors. The negative emotions (χ2=1.03,P=0.31)and the time length of breastfeeding (χ2=7.30,P=0.12)were not related with the acute lactational mastitis. The multivariate analysis showed that the supine position in sleep (OR=2.27, 95%CI:1.25-4.14) and breast trauma (OR=3.24, 95%CI:1.31-7.97) were risk factors; the way of sucking the nipple and areola (OR=0.09, 95%CI:0.05-0.19), breastfeeding for more than 6 months (OR=0.05, 95%CI:0.02-0.11), cleaning nipples before breastfeeding(OR=0.17, 95%CI:0.09-0.34) were the protective factors. Conclusions The acute lactational mastitis often occurrs in the first 6 months postpartum. Normal side-lying sleep does not increase the risk of the acute lactational mastitis. It can effectively prevent the acute lactational mastitis by sucking the nipple and areola altogether, and regularly cleaning the nipple. The negative emotions and the time length of breastfeeding are not relevant factors.
Objective To investigate the clinical characteristics and prognosis of different molecular subtypes of breast cancer in young patients. Methods The clinical data of 77 young breast cancer patients (≤35 years old) treated in Department of Breast Surgery, the First Affiliated Hospital of Nanjing Medical University, from May 2003 to December 2009 were retrospectively analyzed. Of these 77 patients, 69 were diagnosed as having invasive cancers, then they were categorized into four molecular subtypes: luminal A, luminal B, HER-2 over-expressing and triple negative, based on immunohistochemistry (IHC) of ER, PR, HER-2 expression. The clinical characteristics and prognosis of different molecular subtypes were analyzed. One-way ANOVA was used for quantitative data, and nonparametric rank test or Fisher’s exact test was used for qualitative data. Results The number of young breast cancer patients accounted for 7.2%(77/1065) of this group in the same period (1065 patients), including 38 (49.4%, 38/77) in T3 stage (5 cm), and 37 (48.1%, 37/77) with axillary lymph node metastases. The proportions of clinical stage Ⅱ and Ⅲ were 42.9% (33/77) and 35.1% (27/77) respectively. Sixty-nine patients had invasive carcinoma among the 77 young patients, including 34 patients (49.3%, 34/69) in luminal A subtype, 8 (11.6%,8/69) in luminal B subtype, 12 (17.4%,12/69) in HER-2 over-expressing subtype, and 15 (21.7%,15/69) in triple negative subtype. There were no statistically significant differences among different molecular subtypes regarding the age, tumor size, lymph node metastasis, clinical stage, lymph vascular invasion, tumor grade, and p53 status (P0.050). Conclusions The clinical stage of young breast cancer patients is more advanced, but there are no significant differences in clinicopathologic characteristics among different molecular subtypes. Furthermore, whether the molecular subtype is valuable to guide the individualized treatment of young breast cancer patients still needs further confirmation.
Objective To investigate the application value of light-emitting filament in the treatment of pathologic nipple discharge. Methods From May 2009 to October 2012, 32 cases of nipple discharge were randomly divided into improved surgery group (14 cases; light-emitting filaments were inserted into the mammary duct through discharge hole) and conventional surgery group (18 cases; high concentration of methylene blue was used for staining in duct). The data on surgical field contamination, identified small lesions and postoperative pathologic results were analyzed with student’s t test. Results Eight patients were observed with methylene blue contaminated field in conventional surgery group(44.4%,8/18), none with surgical field contamination in improved surgery group and the difference was statistically significant(P=0.004). The operative time was (38±9) min in conventional surgery group, (29±10) min in improved surgery group and the difference was statistically significant(t=2.674,P=0.012). The duct lesions were resected in 32 cases of nipple discharge. All patients were pathologically confirmed, and no complications occurred. Conclusion The light-emitting filament can accurately detect the duct lesions and visualize the surgical field so as to bring the convenience and reduce the operative time, which shows good application value in the patients with nipple discharge.
Objective To explore the molecular mechanism of genistein-induced apoptosis in breast cancer MDA-MB-231 cells. Methods MDA-MB-231 cells were treated with 0,5,10,20 μmol / L genistein for 24 h,respectively. CCK-8,Hoechst 33342 staining and flow cytometry were used to determine the effects of genistein on proliferation and apoptosis of MDA-MB-231 cells. The expressions of FADD,cleaved caspase-8, Fas,FasL in the protein level were measured by Western blotting. The expressions of Fas and FasL in the mRNA level were detected by real-time RT-PCR. The one-way ANOVA was conducted after homogeneity for variance was tested. Results The cell proliferation inhibition rate of MDA-MB-231 cells were( 3. 00 ± 1. 41) %,( 14. 02 ± 1. 57) %,( 27. 5 ± 1. 52) %,( 48. 90 ± 1. 44) % after the treatment of 0,5,10, 20 μmol / L genistein for 24 h respectively. Compared with 0 μmol / L group,the inhibition rate was increased in a concentration-dependent manner in the other 3 groups( F = 528. 119,P = 0. 000). The pairwise comparison showed the difference was statistically significant( all P 0. 05). The early apoptotic rate of MDA-MB-231 cells were( 3. 40 ± 0. 40) %,( 9. 34 ± 1. 34) %,( 19. 26 ± 0. 93) %,( 27. 41 ± 1. 12) % in each concentration group, respectively,after genistein treatment for 24 h. Compared with 0 μmol / L group,the early apoptotic rate was increased in a concentration-dependent manner in the other 3 groups( F = 379. 573,P = 0. 000). The pairwise comparison showed the difference was statistically significant( all P 0. 05). Western blotting showed that genistein increased the protein expression levels of FADD,cleaved caspase-8 and FasL( F = 368. 621,456. 744, 419. 129; all P = 0. 000),with no alteration in Fas protein level( F = 0. 800,P = 0. 528). Compared with 10 μmol / L group,FasL protein expression decreased in 20 μmol / L group( F = 92. 235,P = 0. 001). Real-time RT-PCR showed that genistein increased the mRNA expression of FasL( F = 646. 983,P = 0. 000),with alteration in Fas mRNA level( F = 1. 556,P = 0. 274). Compared with 10 μmol / L group,FasL mRNA expression also decreased in 20 μmol / L group( F = 52. 562,P = 0. 020). Conclusion Genistein induces apoptosis of breast cancer MDA-MB-231 cells by up-regulating FasL gene expression in Fas / FasL pathway.
Objective To retrospectively analyze the clinicopathologic features of breast cancer patients with false-negative mammograms. Methods Two hundred thirty-three female patients with primary breast cancer diagnosed by pathology or confirmed by operation in our hospital between January 2007 and December 2010 were involved in this study, with complete data on preoperative mammogram, high-frequency color Doppler ultrasound and pathological examination. They were divided into false-negative group and true-positive group according to the preoperative mammography. Patients’ age, tumor size, lymph node involvement, histological type and hormone receptor expression were compared between 2 groups. The results of preoperative ultrasonography in the false-negative group were also analyzed. Results Of the 233 patients, 10.7% (25/233) were negative in mammogram. The onset age in false-negative group was (44.23±9.62) years, lower than (53.41±11.63) years in true-positive group (t=3.061,P=0.004); the tumor diameter in false-negative group was (2.93±0.78) cm, smaller than (3.48±1.12) cm in true-positive group (t=3.536,P=0.007). The false-negative group had a higher proportion of infiltrating carcinoma than true-positive group (92% vs 64.4%, χ2=7.72,P=0.005) and a lower rate of estrogen receptor expression (36% vs 63.5%, χ2=7.04,P=0.008). The preoperative ultrasound images in all 25 false-negative patients indicated clear tumor and the diagnosis accordance rate of malignancy was 68%. Conclusions Breast cancer patients with false-negative mammograms have younger onset age, dense gland tissue, small tumor size, and a lower rate of estrogen receptor expression, mostly invasive. The mammogram combined with ultrasound examination can increase the detection rate and improve diagnostic accuracy.
Objective To investigate the effect of ellagic acid on proliferation and invasion and metastasis of breast cancer cells MDA-MB-231. Methods The MDA-MB-231 cells were cultured and treated with 0( control group),6,12 μg / ml ellagic acid respectively,then the cells were counted at 24,48,72 h after culture. Chemotaxis experiment and Western Blot were conducted to observe the effects of ellagic acid on chemotaxic movement of MDA-MB-231 cells and SDF-1α signaling pathway activation. The data were analyzed using repeated measurement analysis of variance,and pairwise comparison was performed using the SNK-q analysis. Results Compared with the control group,cell counts in 6,12 μg / ml ellagic acid treatment groups were significantly reduced at 24,48,72 h. Repeated measurement analysis of variance indicated that the comparison between groups( F = 4875. 56,P = 0. 00) and among the three time points( F = 670. 727,P = 0. 00) showed a statistically significant difference and the interaction existed between group and time( F = 122. 92,P = 0. 00). It showed that ellagic acid can significantly inhibit the proliferation of breast cancer cells MDA-MB-231. Chemotaxis experiment of breast cancer cells showed that chemotaxic cells were( 14. 00±1. 00) ×105/ ml,( 7. 70±0. 58) ×105/ ml,( 3. 00±1. 00) ×105/ ml in each group respectively,and the difference was statistically significant( F = 117. 57,P = 0. 00). Western Blot result showed that ellagic acid significantly inhibited CXCR4 expression and activation of AKT signaling pathway by SDF1α/ CXCR4 in breast cancer cells. Conclusion Ellagic acid can inhibit the proliferation and SDF1α / CXCR4 mediated chemotaxic movement of breast cancer cells MDA-MB-231 and regress the activation of SDF1α / CXCR4 signaling pathway,which may have potential value in the prevention of breast cancer recurrence and metastasis.
Objective To detect the expression change of ERα/ERβ and transforming growth factor β1(TGFβ1) in the development of breast cancer. Methods The pathological data of 258 cases surgically treated in department of breast surgery, the Second Affiliated Hospital of Shandong University and department of general surgery, Linyi People’s Hospital from January 2009 to December 2010 were collected. Immunohistochemistry were used to detect the expression of ERα/ERβ and TGFβ1 in breast normal tissue (n=61), papilloma (n=65), carcinoma in situ (n=45) and invasive breast cancer (n=87) tissues. The analysis of variance was used for data processing. Results ERα/ERβ was 0.34, 0.43, 0.68 and 0.71 in normal breast tissue, papilloma, carcinoma in situ and invasive breast cancer tissue respectively, indicating the tendency of increasing. The total score of TGFβ1 expression in papilloma, carcinoma in situ and invasive breast cancer were statistically different from that of normal breast tissue (P0.05). The expression intensity score of TGFβ1 in carcinoma in situ and invasive breast cancer were statistically higher than that in papilloma and normal breast cancer tissue (P0.05). Conclusions The ERα/ERβ increased in the development of breast cancer, which hinted that ERβ may play a protective role against carcinogenesis. TGFβ1 protein expression may be an early event in breast cancer, so the intervention on TGFβ1 expression in early stage may have positive effects in breast cancer prevention.
Objective To evaluate the effect of sequential use of 5-aza-2’-deoxycytidine (DAC) and cisplatin(PDD) on the proliferation in vitro, cell cycle and apoptosis of triple-negative breast cancer(TNBC)cell line MDA-MB-231. Methods The cells were divided into 4 groups: control group, DAC group(treated with 5 μmol/L DAC),PDD group (treated with 15 μmol/L PDD),DAC→PDD group(treated with 2.5 μmol/L DAC for 24 h and then 8 μmol/L PDD for 48 h). MTT and flow cytometry were used to determine the proliferation rate, cells cycles and cells apoptosis rate of MDA-MB-231 cells. Jin’s formula was used to evaluate the combining effect of DAC and PDD. Results The proliferation rate of DAC→PDD group was higher than that of the other two groups(P0.01).The q values of DAC→PDD group were 1.12 at 48 h,1.17 at 72 h, which indicated the synergistic effect. In DAC→PDD group, the cells in G1 and S stage were decreased, and G2/M cells were increased.The cell apoptosis rate of DAC→PDD group was higher than that of the other two groups(P0.01).Conclusion The sequential use of DAC and PDD at a low dosage can inhibit the proliferation and promote the apoptosis of human TNBC cells MDA-MB-231.
Objective To investigate the effects of 5-aza-2′-deoxycitydine (5-Aza-CdR) on apoptosis and expression of Runt-related transcription factor 3 (RUNX3) in breast cancer MCF-7 cell line.Methods MCF-7 cells were cultured with different concentrations (0.4、1.6、6.4、25.6、102.4 μmol/L) of 5-Aza-CdR in vitro. MCF-7 cells cultured with no 5-Aza-cdR served as control. MTT assay was used for analyzing the growth inhibitory effect of 5-Aza-CdR in MCF-7 cells. The apoptosis rate was detected by flow cytometric analysis. The RUNX3 mRNA and protein levels were measured by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. Data were analyzed with Student Newman Keuls (SNK) test of one-way analysis of variance (ANOVA) using SPSS 13.0 software. Results 5-Aza-CdR effectively inhibited MCF-7 cells in a dose- and time-dependent manner. Flow cytometric analysis showed that the apoptosis ratio was 15.33%, 25.35%, 27.95%, 32.39%, 39.27% in the experimental groups with different concentrations of 0.4-102.4 μmol/L 5-Aza-CdR respectively after 48 h treatment. Except 0.4 μmol/L group, the apoptosis ratio in other experiment groups was higher than that in control group(P0.05). RT-PCR and Western-blot results showed that the expressions of RUNX3 on both mRNA and protein levels were increased.Conclusion 5-Aza-CdR can induce the apoptosis of breast cancer MCF-7 cells, which may be due to that 5-Aza-CdR can promote the demethylation and the expressions of RUNX3 mRNA and protein.
Objective To investigate the correlations of microinvasion( MI) with other clinicopathologic parameters in the patients with breast ductal carcinoma in situ( DCIS). Methods The clinical data of totally 131 patients with DCIS treated in our hospital from October 2006 to October 2012 were retrospectively analyzed. Spearman correlation analysis was applied to detect the correlation between DCIS-MI,lymph node metastasis and pathologic grades. Fisher's exact test was used to detect the correlation between DCIS-MI and lymph node metastasis,and analyze the influence of operation methods,pathologic grades,DCIS-MI and axillary lymph node dissection on recurrence. Results( 1) In 131 cases of DCIS,there were 60 cases in low grade of DCIS( 45. 8%),60 in intermediate grade( 45. 8%) and 11 in high grade( 8. 4%). The microinvasion was found in 12,31 and 8 cases in each pathologic grade respectively,which implied that DCIS-MI was correlated with pathologic grades( r = 0. 375,P = 0. 000).( 2) Seventy-six patients received sentinel lymph node biopsy and lymph node metastasis was found in 3 cases; 56 patients received axillary lymph node dissection and lymph node metastasis was found in 5 cases. The incidence of axillary lymph node metastasis was related with DCIS-MI( P=0. 015),but not correlated with pathologic grades( r=0. 154,P=0. 107).( 3) During the follow-up of 3-72 months,1 case died of apoplexy,3 cases experienced a local recurrence and none died of breast cancer. The recurrence of DCIS was not related with operation methods,pathologic grades,DCIS-MI and axillary lymph node dissection( P = 0. 359,1. 000,1. 000,0. 260). Conclusion The patients with higher pathologic grades of DCIS have a higher risk of DCIS-MI; the patients with DCIS-MI have a higher risk of axillary lymph nodemetastasis.
