Objective:To explore the efficacy of the oncoplastic round block technique in surgical management of idiopathic granulomatous mastitis (IGM).Methods:From January 2014 to December 2019, a total of 18 patients (24 to 38 years old, 32.2 years in average) with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, the postoperative clinical efficacy was summarized and analyzed.Results:All 18 patients with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, among them 2 patients underwent round-block reduction surgery of contralateral breast at the same time. The median follow-up duration was 16.1 months (from 6 to 36 months). Incision poor healing occurred in two cases which was cured after dressing change. Recurrence occurred in one case at 6 months after operation, and then cured with conservative measures. No other severe complications occurred. All patients were satisfacted with the results.Conclusions:Application of oncoplastic round block technique in surgical management of IGM may remove more tissue in order to reduce the recurrent rate, and get a better cosmetic results.

Objective:To study the expression of 5-fold transmembrane protein (CD133) and POU3 homobox gene 3-related long non-coding RNA (PANTR1) in breast cancer and their relationship with cell proliferation and invasion ability in vitro. Methods:A total of 50 breast cancer patients admitted to the Department of Breast Cancer, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from February 2019 to February 2021 were enrolled in this study. The expression of CD133 and PANTR1 in breast cancer tissues and adjacent normal tissues was detected by reverse transcription polymerase chain reaction (PCR). In addition, McF-7 cells were divided into control group, CD133 overexpression group, PANTR1 overexpression group, CD133 inhibition group and PANTR1 inhibition group. The CD133 overexpression group was given Lipofectamine 2000 and CD133 sequence, and the PANTR1 overexpression group was given Lipofectamine 2000 and PANTR1 sequence. Lipofectamine 2000 and si-cd133 were given in CD133 inhibition group, and si-pantr1 inhibition group were given Lipofectamine 2000 and si-pantr1. The differences in proliferation and invasion ability, Pum1 and E2F3 protein expression levels in each group were analyzed. The SPSS 22.0 software was used to carry out t test. Results:The relative expression levels of CD133 and PANTR1 mRNA in breast cancer tissues were higher than those in adjacent normal tissues (0.021±0.001 vs. 0.006±0.001, 0.016±0.002 vs. 0.005±0.001, t=75.000, 74.785, P<0.01). After transfection for 24, 48 and 72 h, the proliferation rate of CD133 overexpression group was higher than that of control group (3.05±0.26, 5.40±0.47 and 10.74±1.27 vs. 2.17±0.25, 4.38±0.42, 6.97±0.84, t=4.226, 2.783, 4.298, all P<0.05), and the number of invasive cells at 24 h after transfection was greater than that of the control group (75.29±7.19 vs. 54.01±6.27, t=3.865, P<0.05). After transfection for 24, 48 and 72 h, the proliferation rate of PANTR1 overexpression group was higher than that of the control group (3.11±0.28, 5.45±0.51 and 10.05±1.24 vs. 2.17±0.25, 4.38±0.42, 6.97±0.84, t=4.372, 3.003, 3.570, all P<0.05), and the number of invasive cells at 24 h after transfection was greater than that of the control group (76.03±7.26 vs. 54.01±6.27, t=3.977, P<0.01). The expression levels of Pum1 and E2F3 protein in CD133 overexpression group were higher than those in control group (4.52±0.75, 3.38±0.56 vs. 1.00±0.04, 1.00±0.03, t=8.118, 7.351, P<0.05). The expression levels of Pum1 and E2F3 protein in PANTR1 overexpression group were higher than those in control group (4.55±0.76, 3.41±0.59 vs. 1.00±0.04, 1.00±0.03, t=8.079, 7.066, P<0.01). The expression levels of Pum1 and E2F3 protein in CD133 inhibition group were lower than those in control group (0.45±0.02, 0.37±0.03 vs. 1.00±0.04, 1.00±0.03, t=21.301, 25.720, P<0.01). Pum1 and E2F3 protein expression levels in panTR1-inhibition group were lower than those in control group (0.47±0.03, 0.38±0.02 vs. 1.00±0.04, 1.00±0.03, t=18.360, 29.784, P<0.01). Conclusion:Both CD133 and PANTR1 are significantly overexpressed in breast cancer, and can enhance cell proliferation and invasion ability in vitro, which deserves clinical attention.

目的 探讨三阴性乳腺癌(triple negative breast cancer,TNBC)患者肿瘤组织程序性死亡分子-1(PD-1)/程序性死亡配体-1(PDL-1)的表达水平,及其与肿瘤临床特征和T淋巴细胞免疫功能的相关性.方法 选择2018年6月—2020年2月入我院经病理确诊的TNBC患者76例(TNBC组),非TNBC患者124例(非TNBC组),乳腺良性肿瘤50例(良性组).分别检测3组肿瘤组织中PD-1和PDL-1表达,T淋巴细胞亚群CD4+、CD8+和调节性T细胞(Treg)百分比;探讨3组PD-1和PDL-1定量表达与CD4+、CD8+和Treg百分比的相关性;分析TNBC组PD-1和PDL-1表达与肿瘤临床特征的关系.结果 TNBC组PD-1和PDL-1阳性表达率和定量表达水平均明显高于非TNBC组和良性组,非TNBC组亦明显高于良性组,差异有统计学意义(P<0.05).TNBC组CD4+、CD8+和Treg百分比均明显低于非TNBC组和良性组,非TNBC组亦明显低于良性组,差异有统计学意义(P<0.05).相关分析发现,PD-1和PDL-1定量表达水平与CD4+、CD8+和Treg百分比呈负相关性(P<0.01).TNBC组PD-1和PDL-1阳性表达率在肿瘤TNM分期、组织学分级和淋巴结转移方面有显著差异(P<0.05或P<0.01).结论 TNBC患者肿瘤组织中PD-1/PDL-1异常高表达可能与T淋巴细胞免疫功能抑制和肿瘤恶性生物学行为有关.

目的 探讨原发性浸润性乳腺癌患者发生脉管浸润的相关危险因素.方法 采用多因素Logistic回归模型分析365例原发性浸润性乳腺癌患者发生脉管浸润的独立危险因素.结果 365例原发性浸润性乳腺癌患者中,91例患者发生了脉管浸润.单因素分析结果显示,不同腋窝淋巴结转移数量、TNM分期、组织学分级、Ki-67表达水平和分子分型原发性浸润性乳腺癌患者的脉管浸润发生率比较,差异均有统计学意义(P﹤0.05).多因素分析结果显示,腋窝淋巴结转移数量﹥3个、TNM分期为Ⅲ期、分子分型为Luminal B型、分子分型为HER2阳性型、分子分型为三阴性均是原发性浸润性乳腺癌患者发生脉管浸润的独立危险因素(P﹤0.05).结论 腋窝淋巴结转移数量﹥3个、TNM分期为Ⅲ期、分子分型为Luminal B型、分子分型为HER2阳性型、分子分型为三阴性的原发性浸润性乳腺癌患者发生脉管浸润的风险较高,因此要对该部分患者重点关注,早发现、早治疗,降低脉管浸润的发生率.

Objective To study the clinical value of minimally invasive surgery Mammotome in diagnosing and treating early breast cancer.Methods The clinical data from 41 cases of breast cancer underwent Mammotome from January 2015 to June 2016,were retrospectively analyzed.Results Patients aged 35~50 years old accounted for the highest proportion in patients with breast cancer underwent mini-mally invasive surgery,and patients aged older than 50 years old of age was on the contrary.The incidence of breast cancer in the upper outer quadrant was significantly higher than the other quadrants.The diame-ter of 83% lesions were no more than 20 mm and 85% of all cases had no axilla lymph node metastasis, which suggested that MMT biopsy had advantage of diagnosing early breast cancer.BI-RADS reported as 4a,but MMT biopsy of malignancy accounted for 71%.All cases had no local recurrence and metastasis in 3-months,6-months and 12-months follow-up.Conclusion Mammotome-biopsy not only removes tumors with minimal invasion,but also is good for early diagnosis and therapy of breast cancer.

Objective:To evaluate the diagnosis and curative value of double localization method that mammary ductoscopy combined with methylene blue staining for tumor-like lesion in mammary duct of patients with pathological nipple discharge.Methods: The documents of 80 patients with tumor-like lesion in mammary duct who underwent the detection of double localization that mammary ductoscopy combined with methylene blue staining before operation were researched by using retrospective analysis, and then the diagnostic results were compared with pathological results so as to evaluate the curative effect of surgery.Results: The coincidence rate of the diagnosis of intraductal papilloma between mammary ductoscopy and post-operative pathological results was 83.3%, and the coincidence rate of breast carcinoma was 80%. The differences of distributions of benign lesion and malignant lesion in mammary duct of I-III grade were significant (x2=30.026,P<0.05). Besides, all of operations were accuracy in localization, and the surface of wound were small, and the recurrent cases never been found since the start of follow-up.Conclusion: The double localization method that mammary ductoscopy combined with methylene blue staining has important value in the diagnosis and operative treatment.

三阴性乳腺癌( triple negative breast cancer , TNBC),即雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体-2(HER-2)均为阴性的乳腺癌,其具有高侵袭性、组织学分级较高的特点,易局部复发和远处转移,肺、肝脏及脑等器官转移率较高[1],与激素受体阳性的乳腺癌相比,TNBC 的远处转移率明显升高,且复发多发生于治疗后1~3年内[2],故预后较其他类型乳腺癌差.

Objective To summarize the clinical features of granulomatous mastitis(GM),in order to facilitate the diagnosis and early treatment of GM. Methods From December 2013 to March 2015,we enrolled 44 patients with GM and abscess from Beijing Haidian Maternal & Child Health Hospital as research subjects. A retrospective study was made on general data( including age, course of disease, lactation history, medication history and related medical history ), clinical performance,breast ultrasonic findings, laboratory examination ( bacterial culture, susceptibility test and PCR ), histopathological features,treatment and prognosis. Results 44 patients were definitely diagnosed by pathological examination through tubular needle puncture with the guidance of color doppler ultrasound. The patients were averagely aged(30. 9 ± 4. 1), with a disease course as long as 2 days to 12 months,and 88. 6% (39 / 44)patients had lactation history. The patients sought for treatment manly for lumps,being red and swollen,and pain in breasts,and all of them had lesion in one breast. 23(52. 3% ) patients had congenital nipple retraction on the lesion side,8(18. 2% )patients had ulceration,and 8(18. 2% )patients had nipple discharge. Color ultrasonography showed irregular mixed echo or hypo echo,vague boundary,nonuniform internal echo, and internal liquid flow when pressed. In bacterial culture,32(72. 7% )patients had negative results,12(27. 3% )patients had positive results,and 9 patients had corynebacterium positive. The patients followed up for 6 months,36(81. 8% )patients were cured,5(11. 4% )patients relapsed,and 3(6. 8% )patients were lost to follow up. Conclusion GM is mostly seen in females at reproductive age. The usual symptoms include unilateral painful breast lump and erythema in local skin. Bacterial culture and susceptibility test are important to help doctors choose the best antibiotic therapy combining puncture guided by ultrasound and steroid hormones.