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:探讨绝经前乳腺癌患者化疗致闭经(CIA)的影响因素.方法:收集2016至2018年的305例行辅助化疗的绝经前乳腺癌患者,随访其化疗后月经变化情况,分析CIA发生的影响因素.结果:CIA发生率为69.51％(212/305),其中月经恢复率为44.8％(95/212).年龄与CIA发生率、月经恢复情况均显著相关(P<0.05).年轻的患者表现出更低的CIA发生率和更高的月经恢复率.但孕产次、腋窝淋巴结转移与否、雌激素受体(ER)、孕激素受(PR)、HER-2状况、病理分期等因素与CIA发生率均无显著相关性(P>0.05).行AC-T和TAC/AT化疗方案的患者CIA发生率高于行TC方案的患者(P<0.05).用他莫昔芬内分泌治疗的患者CIA发生率为72.63％,略高于未使用者,但无统计学差异(P>0.05).结论:年龄显著影响绝经前乳腺癌患者的CIA发生率,且随着年龄的增大,CIA发生几率增加,月经恢复几率减少.此外,蒽环类与紫杉类药物联合或序贯使用可导致CIA发生率较高.

目的 探讨曲妥珠单抗联合新辅助化疗治疗人表皮生长因子受体2(HER2)阳性乳腺癌的临床疗效及对患者生存质量的影响.方法 采用抽签法随机将30例HER2阳性女性乳腺癌患者分为对照组和观察组,每组15例.对照组患者术前接受新辅助化疗,观察组患者术前接受曲妥珠单抗联合新辅助化疗,比较两组患者的临床疗效、治疗前后的肿瘤相关炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]水平以及治疗前和治疗后8个月的生存质量.结果 观察组患者的总有效率为86.67％(13/15),高于对照组患者的53.33％(8/15),差异有统计学意义(P﹤0.05).治疗前,两组患者的血清IL-6、IL-8、TNF-α、IL-1β水平比较,差异均无统计学意义(P﹥0.05);治疗后,观察组患者的血清IL-6、IL-8、TNF-α、IL-1β水平均明显低于对照组患者,差异均有统计学意义(P﹤0.01).治疗前,两组患者的生存质量评分比较,差异无统计学意义(P﹥0.05);治疗后8个月,观察组患者的生存质量评分明显高于对照组患者,差异有统计学意义(P﹤0.01).结论 与术前单纯新辅助化疗相比,术前曲妥珠单抗联合新辅助化疗治疗HER2阳性乳腺癌可获得更好的临床疗效,且可有效改善患者的生存质量.

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.

目的 分析乳腺导管扩张症并发感染患者采用乳腺区域切除术结合腺体成型治疗的效果.方法 收集我院自2015年8月～2016年9月收治的乳腺导管扩张症并发感染患者60例,按随机数字表法分为观察组与对照组两组,每组各30例.对照组给予部分乳管或全乳管切除术治疗,观察组给予乳腺区域切除术结合腺体成型术治疗.观察并对比两组治疗效果情况.结果 观察组术后平均愈合时间为(7.60±4.56)d,明显短于对照组的(10.61±4.63)d(t=2.5370,P=0.0139);观察组治疗总有效率为93.33％,明显高于对照组的73.33％(P<0.05).观察组术后并发症发生率(10.00％)及术后一年复发率(3.33％)明显低于对照组,两组比较差异具有统计学意义(P<0.05).结论 针对乳腺导管扩张症并发感染患者,给予乳腺区域切除术结合腺体成型治疗,疗效理想,治愈率高,加上术后并发症发生率及术后一年复发率低,安全可靠,具有较高的推广价值.

目的 分析乳腺浸润性导管癌(invasive ductal carcinoma of breast)的分子分型与其临床病理特征的关系.方法 选择首都医科大学附属北京妇产医院2015年1月至2016年10月诊治的女性乳腺浸润性导管癌患者198例,根据免疫组化检测结果将乳腺癌分为4个分子亚型,即Luminal A型、Luminal B(HER-2阴性/HER-2阳性)型、HER-2过表达型和三阴性乳腺癌,分析不同分子亚型在发病部位、年龄、肿瘤大小、腋窝淋巴结转移、病理分期、组织学分级、脉管癌栓和手术方式方面的差异,以及Ki-67表达与雌激素受体(estrogen reseptor,ER)、孕激素受体(proges-terove,receptor,PR)表达的关系.结果 乳腺浸润性导管癌的病灶位置、发病年龄、手术方式在分子各亚型组间差异均无统计学意义(P＞0.05);肿瘤大小、淋巴结转移、pTNM分期、组织学分级及脉管癌栓情况在各亚型组间差异均有统计学意义(P＜0.05).Ki-67的表达水平与ER、PR的表达存在相关性(P＜ 0.05).结论 乳腺浸润性导管癌的分子分型与患者生存及转移模式密切相关,对指导临床个体化治疗具有重要意义.

Objective To investigate the effect of HMGB2 silencing on proliferation, apoptosis, invasion and migration of breast cancer cell line MDA?MB?231. Methods The lentiviral vector was constructed by cloning the oligonucleotides targeting HMGB2 into pLKO.1 puro vector. MDA?MB?231 cells were divided into control group, empty transfection group and HMGB2 interference group. The empty transfection group was transfected with random sequence shRNA and HMGB2 interference group was transfected with lentivi?ral vector targeting HMGB2 shRNA. The control group was treated with routine culture without any transfection. Western blotting was used to detect the level of HMGB2 protein after transfection for 48 h in each group to evaluate the efficiency of transfection. MTT meth?od was used to calculate the survival rate of each group. Flow cytometry was used to detect the apoptosis rate after transfection for 48 h. The Transwell method was used to detect the invasion and metastasis of 48 h after transfection. Results The level of HMGB2 protein in the HMGB2 interference group was lower than those in control group and empty transfection group, and the difference was statistical?ly significant ( P<005) . Compared with control group and empty transfection group, the survival rate of HMGB2 interference group was decreased, and there was a decreasing trend with the increase of transfection time ( P<005) . The early, late and total apoptosis rates of HMGB2 interference group were higher than those in the other two groups, and the number of invasive cells and the number of migrating cells were lower than the other two groups ( P<005) . Conclusion Silencing HMGB2 expression via shRNA in MDA?MB?231 cells has a significant effect, can inhibit cell proliferation, invasion, migration and induce cell apoptosis, to provide a reference for breast cancer targeted therapy.

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.

Objective To explore the effectiveness of ultrasound assisted traction treatment for correction of inverted nipples.Methods The clinical data of sixty patients with inverted nipples treated at our hospital between January 2012 and March 2016 was retrospectively analyzed.Thirty-one of these patients (60 inverted nipples) received ultrasound assisted traction treatment and 29 patients (58 inverted nipples)were treated with traction alone.The duration of surgery and nipple height immediately after surgery in the two groups were analyzed.Results The duration of surgery was (14.2 ± 2.9) min,nipple height (11.5 ± 2.9) mm in the ultrasound assisted traction group,compared with (17.4 ± 1.6) min and (8.3 ± 1.7) mm in the traction alone group.Shorter duration of surgery and higher nipples were observed in the former group(P ＜ 0.001,P ＜ 0.001).In the ultrasound assisted traction group,the result of treatment was found perfect in 57 cases,good in 3 cases,and bad in none,compared to 48,10 and 0 in the traction alone group.There was no case of nipple blood supply obstacles or nipple necrosis in the former group,but 2 cases of blood supply obstacles and 1 case of nipple partial necrosis in the control group.The therapeutic effect was better in the former group without any complications.The difference was statistically significant (P ＜ 0.001).Conclusions Ultrasound assisted continuous traction with self-made tractors is a good approach to each type of inverted nipples.It is a simple,safe,effective,and minimally invasive without any scar.

Objective To compare the outcome of ultrasound-guided minimally invasive biopsy with or without liposuction in treatment of accessory breast .Methods We retrospectively analyzed the clinical data of 35 patients (70 accessory breasts) resected by liposuction combined with ultrasound-guided minimally invasive biopsy ( combined treatment group ) and 29 patients ( 50 accessory breasts ) treated by minimally invasive biopsy alone ( Mammotome group ) in Department of Breast Surgery , Beijing Obstetrics and Gynecology Hospital of Capital Medical University from August 2013 to June 2015 .Skewed distribution data were described as M (P25-P75).The operative time and blood loss between two groups were analyzed by non-parametric test. Results The median operation time was 28.3 (24.5-34.8) min in combined treatment group, significantly shorter than 50.3(40.1-52.7) min in Mammotome group (Z=-8.91, P<0.001).The median intraoperative blood loss was 13.2 ( 8.4-16.6 ) ml in combined treatment group , less than 27.1 ( 22.0-33.1 ) ml in Mammotome group ( Z=-9.11, P<0.001 ).Conclusion Liposuction combined with minimally invasive biopsy for treatment of accessory breasts has the advantages of higher efficiency , less bleeding , better cosmetic results compared with minimally invasive biopsy alone , worthy of clinical application .

目的 研究重组人p53腺病毒(rAd-p53)对人乳腺癌MCF-7/ADR裸鼠移植瘤的耐药逆转作用及其对耐药相关P-糖蛋白(P-glycoprotein,P-gp)表达的影响.方法 建立人乳腺癌MCF-7/ADR裸鼠耐药模型,随机分为对照组、rAd-p53组、阿霉素组、联合组,分别给予不同治疗.观察裸鼠肿瘤体积的变化,western blot检测P-gp蛋白表达情况.结果 成瘤后rAd-p53组、阿霉素组、联合组抑瘤率分别为42.05％、49.21％、69.97％,各治疗组体积与对照组相比差异有统计学意义(P＜0.05),且联合组显著优于rAd-p53组和阿霉素组(P＜0.05).对照组、rAd-p53组、阿霉素组、联合组P-gp表达水平分别为(0.5964±0.0806)、(0.5506±0.0127)、(0.5641±0.0055)、(0.4652±0.0982),联合组P-gp表达水平低于其他各组.结论 Ad-p53对人乳腺癌阿霉素耐药细胞株MCF4/ADR建立的裸鼠移植瘤具有多药耐药的逆转作用,并可下调P-gp的表达.