目的 探讨分子分型、肿瘤直径、淋巴结情况、增殖细胞核抗原(Ki)-67表达等对乳腺癌患者新辅助化疗效果的影响.方法 收集接受新辅助化疗的44例中晚期乳腺癌患者的临床资料,分析分子分型、肿瘤直径、淋巴结情况、Ki-67表达与新辅助化疗临床疗效间的关系.结果 44例乳腺癌患者病灶影像学评价完全缓解率为6.0％,部分缓解率为54.8％,总缓解率为61.3％,疾病进展率为9.0％,疾病稳定率为29.5％,无效率为38.6％.多因素分析结果显示分子分型、肿瘤直径及Ki-67表达情况均与疗效相关,而淋巴结情况与疗效无显著相关性.结论 分子分型、肿瘤直径、Ki-67表达可作为乳腺癌患者新辅助化疗疗效参考指标,新辅助化疗的疗效可作为其预后指标.

Objective: The aim of this study to examine the expression of FOXA1, ER, and PR in breast cancer and investigate the association between FOXA1 expression and clinical parameters. Materials and Methods: One hundred one cases with primary breast cancer were collected and immunohistochemistry was employed to examine the expression of FOXA1, ER, and PR. The correlation of FOXA1 and ER, PR expression with menopausal status, tumor size, clinical stage, histological grade, recurrence, and clinical index relationship was further analyzed. Results: The positive expression of FOXA1 was 67.3%. The positive expression rate of ER in positive FOXA1 group was 66.2% (45/68). The positive expression rate of PR in positive FOXA group was 57.4% (39/68). There was no correlation between FOXA1 expression and menopausal status. Analysis of the relationship between FOXA1 and tumor diameter showed that the percentage of tumor diameter <= 2 cm, 2-5 cm, and > 5cm was 52.9%, 32.4%, and 14.7% in positive FOXA1 group. The correlation with clinical staging showed that the percentage of Stages I, II, and III was 33.8%, 41.2% and 25%, respectively, in positive FOXA1 group. Analysis of histological grade showed that the percentage of grades 1, 2, and 3 was 48.5%, 20.6%, and 23.5%, respectively, in positive FOXA1 group. The positive expression rate of P53 was 30.9%, the recurrence rate was 14.7%, and the positive expression of FOXA1 had better DFS.

乳腺原发性恶性淋巴瘤(PBL)在临床中十分罕见,本文记录1例弥漫性大B细胞性淋巴瘤组织类型的原发双乳淋巴瘤患者的诊治过程,并行相关文献复习,归纳PBL的临床特征及其诊治要点.

AIM:To observe the effects of gastric bypass surgery on the levels of serum total bile acid in the obese diabetic patients and rats .METHODS: Anthropometric data of obese diabetic patients with gastric bypass surgery from June 2011 to June 2016 were collected in the First Affiliated Hospital of Jinan University .Obese diabetic animal mo-del was established in SD rats by high-fat diet feeding combined with intraperitoneal injection of low-dose streptozocin .Gas-tric bypass surgery or sham operation was performed on the rats with successful modeling .The levels of serum total bile acid were measured by a Hitachi automatic biochemistry analyzer , and the content of hepatic cholesterol 7α-hydroxylase (CYP7A1) was detected by ELISA.The expression of hepatic CYP7A1 and small heterodimer partner (SHP) at mRNA and protein levels was determined by real-time PCR and Western blot, respectively.RESULTS:The serum levels of total bile acid were significantly increased in postoperative obese diabetic patients and rats as compared with control groups .Gas-tric bypass surgery inhibited rat hepatic CYP 7A1 content, mRNA level and protein level , but stimulated hepatic SHP ex-pression.CONCLUSION:Total serum bile acid increases in both patients and rats after gastric bypass surgery by non -typical bile acid synthesis pathway .

Aim:To investigate the expressions and significance of Bcl-2 in breast carcinoma.Meth-ods:The expression level of Bcl-2 protein and in breast cancer tissues from 124 patients was detected with the method of immunohistochemistry and the relationship between Bcl-2 and other clinicopathologic factors were analyzed,also the prognosis value of Bcl-2 was analyzed.Results:The expression of Bcl-2 in breast cancer was positive associated with ER and PR expression,but negative associated with tumor size、clinical stage、lymphovascular and histological grade;In Premenopausal women,Bcl-2 also shows low expression,but shows high expression in Luminal subtypes breast cancer;In all breast cancer,Bcl-2 positive expression have longer disease-free survival compare with Bcl-2 negative expression.Conclu-sion:When Bcl-2 shows positive expressed of breast cancer patients have a better prognosis.So detection of Bcl-2 can be used to predict the prognosis of patients and guide individualized treatment.

AIM: To investigate the expression of GATA3 in human breast carcinoma and its clinical significance.METHODS: The expression level of GATA3 in breast cancer tissues from 124 patients was detected by the method of immunohistochemistry and the relationships between GATA3 expression and other clinicopathological factors were analyzed.RESULTS: Low expression of GATA3 in breast cancer tissues was associated with estrogen receptor(ER) / progesterone receptor(PR) negative,high histological tumor grade,p53 mutation and vascular invasion(P < 0.05),but not with age,tumor size,human epidermal growth factor receptor 2(HER-2) expression and lymph node metastasis(P > 0.05).In all breast cancer tissues,the positive expression rate of GATA3 was 56.4%.The positive expression rate of GATA3 in luminal breast cancer is 68.4%,higher than that in non-luminal breast cancer(32.6%,P < 0.05).In all breast cancer tissues,the expression of GATA3 in middle recurrence risk group was higher than that in high recurrence risk group(P < 0.05).CONCLUSION: GATA3 expression in breast cancer is related to differentiation and biological characteristics of the tumor,which can be a factor for evaluation of the treatment and prognosis.

<正>平滑肌肉瘤是一种常见的肿瘤,多见于子宫及胃肠,有时也见于腹膜后、肠系膜、大网膜及皮下组织。而原发性乳腺平滑肌肉瘤罕见,尤其是原发于男性者。笔者在临床工作中遇见1例,现结合文献复习报告如下。1临床资料患者,男性,65岁,因"触及右乳肿物4月余,伴疼痛2月余"于2012年4月25日收入本院。患者4月前因右乳瘙痒不适触及右乳乳头旁一突起,无明显压痛,无伴皮

<正>患者,女,73岁,因左乳腺癌术后5年,出现右乳肿物4年于2011年2月11日入院。体格检查:右乳见多个溃烂点及破溃口,最大的破溃口大小约6 cm×4 cm,各破溃口流出大量恶臭,褐色脓血样液体,触诊可及巨大实性肿块,占据外上2/3腺体,活动度差。CT提示"右侧乳腺癌,可能轻度侵犯胸壁肌肉";取肿物活检病理回报为乳腺癌。

AIM: To investigate the expression of forkhead box protein A1(FOXA1) BRCA1 protein,P53 and vascular endothelial growth factor(VEGF) in triple negative breast cancer(TNBC) and non-TNBC,and the relevance with the clinicopathological parameters for evaluating the prognosis.METHODS: The tumor samples were collected from 113 cases of breast cancer patients in the First Affiliated Hospital of Jinan University,and divided into TNBC group,luminal subtype group and HER-2 overexpression subtype group by the immunohistochemical results of estrogen receptor,progesterone receptor and HER-2.EnVision two-step method was used to detect the expression of FOXA1,BRCA1,P53 and VEGF in the tumor samples.RESULTS: Total FOXA1 positive expression rate was 63.7%(72/113),with 45.2%(19/42) in TNBC,88.0%(44/50) in luminal subtype and 42.9%(9/21) in HER-2 overexpression subtype.The statistically sigfnificant difference among the 3 groups was observed(P0.01).Total BRCA-1 positive expression rate was 47.8%(54/113),with 66.7%(28/42) in TNBC,44.0%(22/50) in luminal subtype and 19.0%(4/21) in HER-2 overexpression subtype.The statisticallysignificant difference among the 3 groups was also observed(P0.01).In the cases of clinical stages Ⅰ～Ⅱand histological grades 1～2,FOXA1 positive rate was higher than the FOXA1 negative rate(P0.01).Negative correlations between FOXA1 positive rate and expression of P53/VEGF,and between FOXA1 positive rate and the recurrence rate were found(P0.05).In the cases of clinical stages Ⅱ～Ⅲ and histological grades 2～3,the BRCA1 positive rate was higher than the BRCA1 negative rate(P0.05).Positive correlations between BRCA-1 positive rate and the expression of P53/VEGF,and between BRCA1 positive rate and the recurrence rate were also observed(P0.05).CONCLUSION: Expression of FOXA1 and BRCA1 in breast cancer is different.BRCA1 may be an adverse prognostic indicator for triple negative breast cancer.

个体化治疗将成为乳腺癌治疗的发展方向,以生物学差异为划分依据的乳腺癌分子分型对个体化治疗方案的选择具有重要的参考价值。乳腺癌分子分型的研究已从高分子水平深入到基因水平,其相关因子包括ER、PR、HER2基因、p53基因、Ki-67蛋白表达等,这些生物学指标不但与肿瘤的生长、浸润、转移、复发等密切相关,而且对乳腺癌的治疗有指导性的研究价值。

Aim:To investigate the clinical application of Mammotome minimally invasive techniques for breast mass under ultrasonoscopy.The indicatins of minimally invasive Mammotome were saminarized.Methods: Mammotome minimally invasive biopsy 292 cases of breast mass ultrasound explored before operation,a total of 1 055 masses.Results: All masses were reseeted completely,the pathology showed: 686 breast fibroadenoma,253 breast adenosis,64 breast cystic disease,39 papilloma,12 breast cancer,1 dysplasia.Postoperative hematoma happened in 1 case,no infection,skin ulcer and other complications.The patients were followed up after operation 3 months and 6 months,and 98% patients were satisfied the operation.Conclusion:Mammotome minimally invasive techniques can be used as the best method to remove benign breast mass ultrasound explored,and as a way of sub-clinical breast cancer biopsies.

乳腺癌是女性最常见的恶性肿瘤,一些乳腺癌可伴有不同程度的鳞状上皮化生,但真正的乳腺原发性鳞状细胞癌却十分罕见.笔者在临床工作中遇到l例,现结合文献复习,对该肿瘤的组织学发生,临床病理特征及诊断,鉴别诊断和治疗作一报道.

<正>近年女性乳腺癌的发病率有年轻化趋势,一般认为35岁以下年轻乳腺癌在生物学行为、病理类型和预后上不同于其他年龄组病人。本例15岁基底细胞样乳腺癌(Basal-like型)女性乳腺癌患者,患病年龄之小在国内罕见,现结合文献对年轻乳腺癌患者的生物学特征及综合治疗作一报道。