BACKGROUND:Although most breast cancer patients are curable, late-stage cases still have a poor prognosis. Early detection can lead to timely treatment and thus improve survival. Less invasive detection methods such as the detection of circulating tumor cells (CTCs) in the bloodstream is becoming more popular.METHODS:To better characterize the prognostic significance of CTCs in breast cancer patients, we detected CTCs in breast cancer patients after surgery and analyzed the relationship between the number of CTCs and patients' clinical outcomes.RESULTS:No significant correlation was observed between the number of total CTCs and overall survival or progression-free survival. The total number of CTCs was often higher in patients over 60 years of age, and the time of detection after surgical excision had a significant effect on the total number of CTCs.CONCLUSIONS:Our data suggest that in order to interpret the results more accurately, testing procedures, especially testing time points, need to be standardized and clinical characteristics such as age need to be taken into account.

目的 探讨乳腺浸润性小叶癌组织中PTEN的表达及临床意义.方法 免疫组化检测46例乳腺浸润性小叶癌组织、癌旁组织及50例乳腺增生组织中PTEN表达,并分析PTEN表达与临床病理特征的关系.结果 PTEN在浸润性小叶癌组织中表达明显低于癌旁组织和乳腺增生组织(P＜0.01).PTEN表达与病理分期、组织学分级、淋巴结转移、脉管癌栓侵犯、Ki-67表达有关(P＜0.01或0.05),而与患者年龄、肿瘤直径、雌激素/孕激素受体、表皮生长因子受体2水平无关(P＞0.05).结论 浸润性小叶癌组织中PTEN表达降低,可能是浸润性小叶癌复发和转移的潜在预测指标.

目的:探讨Rotter淋巴结清扫在乳腺癌手术中的必要性.方法:选取2014年5月-2016年8月本院收治的82例乳腺癌患者,根据治疗方法不同分为对照组与观察组,每组41例.对照组给予乳腺癌改良根治术治疗(术中不清扫Rotter淋巴结),观察组在对照组基础上联合Rotter淋巴结清扫治疗.比较两组手术指标、肿瘤标志物、生活质量及并发症情况;随访3年,比较两组局部复发与远处转移情况.结果:观察组手术时间长于对照组(P<0.05);两组术中出血量、引流量及住院时间比较,差异均无统计学意义(P>0.05);观察组术后7 d癌胚抗原(CEA)与乳腺癌抗原(CA15-3)水平均低于对照组(P<0.05);两组术后7 d各项生活质量评分均高于术前,且观察组均高于对照组(P<0.05);两组术后皮瓣坏死、皮下积液及切口感染等并发症发生率比较,差异无统计学意义(P>0.05);观察组术后局部复发与远处转移发生率均低于对照组(P<0.05).结论:乳腺癌患者清扫Rotter淋巴结未增加手术创伤,能降低肿瘤标志物水平,有助于提高患者生活质量,降低局部复发与远处转移,未增加并发症发生率,可常规开展进行.

OBJECTIVES:Cancer susceptibility candidate 2 (CASC2) and long noncoding RNA (lncRNA) have been identified as a tumor suppressor in colorectal, lung, renal, and stomach cancer as well as in patient gliomas, but the function of CASC2 in papillary thyroid carcinoma (PTC) is not yet clear. The present study aimed to explore the effects of CASC2 in PTC.METHODS:The CASC2 expression was measured in PTC samples and normal tissues by using quantitative real-time polymerase chain reaction. The lentiviral vectors were used to establish CASC2 overexpression models in PTC cell lines to determine the effects of CASC2 on cell proliferation, apoptosis, migration, and invasion. A tumor xenograft animal model was used to examine the functions of overexpression CASC2.RESULTS:CASC2 expression was significantly decreased in PTC tumor tissues than adjacent normal tissues. CASC2 downregulation in PTC tissues significantly correlated with the tumor size, the presence of multifocal lesions, and the advanced pathological stage. CASC2 overexpression suppressed the cell proliferation and promoted apoptosis in PTC cell lines and CASC2 overexpression resulted in the inactivation of protein kinase B (PKB/AKT) and extracellular signal-regulated kinases (ERK1/2). The regulatory effects of CASC2 on PTC cell biological behavior were further enhanced by mitogen-activated protein kinase kinase (MEK) inhibitor U0126 or AKT1/2/3 inhibitor MK-2206 2HCl. CASC2 overexpression suppressed tumor growth in PTC cells in xenograft mouse models.CONCLUSION:Our results indicated that CASC2 significantly suppressed tumorigenesis in PTC and CASC2 may serve as a novel prognostic marker or therapeutic target.

Objective To investigate the clinical characteristics of papillary thyroid carcinoma (PTC) complicated by multinodular goiter (MG).Methods The clinical data of 130 PTC patients treated in the First People's Hospital of Zhaoqing from July 2013 to July 2017 were retrospectively reviewed .Among them , 88 patients with nodular goiter were selected and were treated as PTC combined with MG group , and 42 patients without nodular goiter were selected and were treated as PTC group .The differences in clinical characteristics, such as age, gender, location of lesions, nodule diameter, lymph node metastasis , ultrasonographic features and postoperative complications were compared between the two groups.Results The incidence of papillary thyroid microcarcinoma (PTMC), age of PTC, location of lesions and rate of cervical lymph node metastasis were significantly different between PTC combined with MG group and PTC group ( P<0.05) , there was no significant difference in the gender , maximum diameter of nodule and incidence of hyperthyroidism between the two groups ( P>0.05 ) .In the field of ultrasound imaging, the characteristics of cancer , including echo, nature, density, boundary, internal blood flow, calcification and lymph node enlargement , were not significantly different between the two groups (P>0.05).There was no severe complication occurred in the two groups .Conclusions PTC complicated by MG goiter often occurs in women over 40 years old.The main form is PTMC, cancer is often located in the unilateral leaf gland , and incidence of lymph node metastasis in early stage is low , and there are some general rules that can be followed in ultrasound characteristics .

目的 探讨保腋窝在早期乳腺癌改良根治术中的应用价值.方法 选取我院2015年-2016年间收治的早期乳腺癌患者,共80例,随机分为观察组及对照组,观察组行保腋窝的乳腺癌改良根治术,对照组行清腋窝的乳腺癌改良根治术,各组为40例,术后定期随访.以住院时间、拔管时间、引流量作为近期观察指标,以患侧上肢淋巴水肿、腋窝积液、感觉异常、局部复发率作为远期观察指标,并进行比较分析.结果 观察组住院天数、拔管时间、引流量均优于对照组,而患侧上肢淋巴水肿、腋窝积液、感觉异常的发生率均低于对照组,两组间肿瘤局部复发率无明显差异.结论 保腋窝的乳腺癌改良根治术可缩减手术范围,减少术后并发症,提高患者生活质量,且无瘤生存率与传统的乳腺癌改良根治术相仿,为此,更适合临床推广应用.

Objective To investigate the application value of high negative pressure drainage in modified radical mastectomy of breast cancer. Method Six hundred patients with breast cancer needed modified radical mastectomy were divided into two groups randomly,300 cases in high negative pressure drainage,others 300 cases in low negative pressure drainage. The days of de-tubation,The volume of drainage,The rate of skin flap necrosis,The rate of hypodermic pyema,The rate of postoperative hemor-rhage,The length of hospital stay were observed and analyzed. Results There were no significant differences in The rate of skin flap necrosis,The length of hospital stay. The days of detubation,The volume of drainage,The rate of hypodermic pyema,The rate of postoperative hemorrhage had significant differences. The quality of life in high negative pressure drainage group patients were improved obviously. Conclusion The different drainage methods should reduce the complications of the breast cancer patients,but it can reduce the rate of hypodermic pyema,improve the quality of life in the perioperative period clearly and reduce doctorˋs workload,so it has clinical promotion value.

目的 系统评价我国三阴型乳腺癌的临床病理特征及预后,为筛查高危人群,指导临床防治,评估预后提供循证基础.方法 检索PubMed、EMBASE、Cochrane Library、万方全文数据库、中国知网(CNKI)、中国生物医学文摘数据库(CBM)及维普数据库,系统收集我国三阴型乳腺癌临床病理特征及预后的相关文献,对纳入文献进行质量评估,采用RevMan 5.2软件,建立随机或固定效应模型进行Meta分析.结果 纳入20个临床对照试验,文献质量多为6～7颗星.三阴组与非三阴组乳腺癌之间差异有统计学意义(P＜0.05)的临床特征为发病年龄、乳腺癌家族史、组织学分级、腋窝淋巴结转移情况、病理分期、5年无瘤生存率、5年总生存率,OR值分别为2.48(95％CI=1.47～4.19)、2.05 (95％CI=1.48 ～2.85)、2.19 (95％CI=1.81 ～2.64)、1.64 (95％CI=1.16～2.32)、1.59 (95％CI=1.19～2.13)、0.49(95％CI=0.42～0.57)、0.46(95％CI=0.39～0.53).两组间差异无统计学意义(P＞0.05)的临床特征为绝经情况、瘤体直径、病理类型,OR值分别为1.11 (95％ CI=0.99～ 1.25)、1.23 (95％CI=0.90～1.68)、0.87 (95％ CI=0.74～1.01).结论 与非三阴型乳腺癌相比,三阴型乳腺癌患者发病年龄相对年轻,组织学分级及病理分期较高,淋巴结转移率高,与乳腺癌家族史相关,5年无瘤生存率及总生存率较差.

Objective:To observe the effect of Lidan Decoction treatment for postoperative gallbladder stones recurrence. Method:93 cases of patients with gallbladder stones were selected and randomly divided into observational group (n=47) and control group (n=46),patients on control group were given routine treatment,and the observational group were given Chinese medicine Lidan Decoction oral.Extraction time of T tube postoperatively,gallbladder contraction function,and rate of stone recurrence and recrudesce were compared between the two groups.Results:Extraction time of T tube postoperatively of observational group was significantly shorter than that of control group (P<0.05),and gallbladder contraction function was significantly better than that of control group (P<0.05);The rate of stone recurrence and recrudesce of observational group was significantly lower than that of control group (P<0.05).Conclusion:The application of Lidan Decoction can effectively prevent postoperative gallbladder stones recurrence and improve the contraction function of gallbladder.

目的 对保留乳房的乳腺癌根治术治疗早期乳腺癌进行临床疗效观察.方法 收集我院2008年3月至2010年9月收治的早期乳腺癌患者78例,随机分为观察组(保乳手术治疗组)和对照组(改良根治术治疗组),每组各39例,对两组的临床疗效进行对比分析.结果 两组在手术时间、术中出血量及住院时间上的比较观察组明显优于对照组(P＜0.05);术后随访3年,两组局部复发、远处转移发生率差异无统计学意义(P＞0.05);两组患者在乳房美容效果上观察组明显优于对照组(P＜0.05);两组3年生存率均为100％.结论 保乳术在手术时间、术中出血量、住院时间以及美容效果等方面具备相对优势,值得临床推广使用.

Objective To investigate the application value of vacuum high negative pressure drainage on modified radical mastectomy of breast cancer.Methods One hundred patients with breast cancer needed modified radical mastectomy were divided into two groups randomly,the patients in high negative pressure group(50 cases) were performed with modified radical mastectomy by high negative pressure drainage,the patients in low negative pressure group(50 cases) were performed with modified radical mastectomy by traditional negative pressure drainage.The days of detubation,the days of stay,the volume of drainage,the ratio of skin flap necrosis and hypodermic pyema were observed and analyzed.Results There were no significant differences in the days of detubation,the days of stay,the volume of drainage and the ratio of skin flap necrosis and hypodermic pyema between the two groups.The quality of life of the high negative pressure group(the group of vacuum high negative pressure drainage)patients were improved obviously.Conclusion The different drainage methods shouldn't reduce the complications of the breast cancer patients,but it can improve the quality of life in the perioperative period clearly and reduce doctor's workload,so it has clinical promotion value.