2009年10月-2011年3月,我们采用超声体表定位切除临床不可触及乳腺病变23例.现分析报告如下. 1临床资料 1.1一般情况 选择因乳房疼痛且临床触诊阴性23例,均为女性;年龄31～65岁,平均41岁.有乳腺癌家族史3例.X线检查均提示为腺体致密性乳腺,显示有局部高密度影5例.

Objective To investigate the changes in the expression of four and a half LIM domains 1(FHL1) in breast neoplasm after neo-adjunct chemotherapy(NCT),and its clinical significance.Methods Expression of FHL1 in breast cancer before and after NCT(with docetaxel combined pirarubicin) was detected by immunohistochemical technique in 76 patients with breast neoplasm.Specimens of 69 cases had received NCT before,of them 63 cases were finally enrolled in present study,among them the specimens were obtained from 59 cases for cohort study.The positive rate and expression intensity of FHL1 before and after NCT were analyzed.Results The positive rate of FHL1 in breast cancer was 79.7% before chemotherapy and 65.1% after chemotherapy.The expression of FHL1 was up-regulated in 17 patients,down regulated in 30 patients,and remained unchanged in 12 patients.The matched pair test showed that the expression of FHL1 significantly down regulated after NCT(P < 0.05).Conclusion NCT may down regulate the expression of FHL1,which may play a harmful effect on the prognosis of a part of patients with breast cancer.

目的:观察多西他赛联合吡柔比星化疗(新辅助化疗)对雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)的影响.方法:选择确诊乳腺癌76例,采用新辅助化疗方案,21天为1个周期,疗程结束后15～20天手术;术中切标本行常规病理检查及免疫组织化学检查,观察新辅助化疗前后ER、PR、HER-2表达水平的变化.结果:76例中,术后病理学完全缓解3例;未达到病理完全缓解的73例中,化疗后ER表达水平较化疗前变化不显著(P＞0.05);PR、HER-2表达水平较化疗前显著下调(P＜0.05).结论:新辅助化疗后PR、HER-2水平下调,可能会对部分患者的预后产生影响.

Objective To study the efficacy of neoadjuvant chemotherapy(NAC) containing THP and docetaxel in treatment of breast cancer and its influential factors.Methods The expression of ER,PR and CerbB-2 in breast cancer tissue of patients receiving NAC were detected by immunohistochemical method.The correlation of ER,PR and CerbB-2 with pathological complete response(pCR) was analysed.Results ER and PR expressions was significantly correlated to treatment response,the pCR rates were 6.1% and 11.1% in ER and PR positive tumors respectively,while they were 28.9% and 29.2% in the ER and PR negative tumors(P 0.05).No correlation was observed between the pCR and CerbB-2 expression,age,stage and number of cycles of chemotherapy.Conclusion The ER and PR may be the important indexes for treatment and prognosis of breast cancer patients receiving neoadjuvant chemotherapy.

患者女,36岁,发现腹部包块6 d就诊.查体:左下腹可触及一15 cm×9 cm的肿物,触之较硬,无活动度.超声检查所见(图1):子宫前位,大小约5.6 cm×4.5 cm×4.0 cm,子宫内膜无增厚,宫腔线显示清晰,宫腔内未见明确占位性病变回声.于左侧附件区探及大小22 cm×8.9 cm×13 cm实性肿物,占据下腹腔,包膜完整,边界尚规则,内部回声不均匀.彩色多普勒于包块内探及较丰富血流信号,脉冲多普勒探及一动脉血流,频谱呈高速低阻样,RI=0.43(图2).右侧卵巢未见异常.双侧腹股沟未见明确肿大淋巴结.腹腔内可见少量游离液体,最大前后径1.8 cm.追问病史患者于2002年因胃癌"行"胃癌根治术".