PurposeThis aims to investigate the efficacy and safety of intercostal nerve anastomosis among breast cancer patients who undergo immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy.MethodsFrom 2022 to 2023, female patients between the ages of 20 and 60 diagnosed with stage I–IIIA breast cancer, who required and were willing to undergo immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy, were screened and assigned to take the operation with (treatment group) or without (control group) intercostal nerve anastomosis (the nerves with appropriate length and thickness were selected from the 2nd-4th intercostal nerves, which were then dissociated and anastomosed to the posterior areola tissue). A radial incision at the surface projection of the tumor location was used. The patients’ breast local sensation was assessed using Semmes–Weinstein monofilaments before the operation as well as at 10 days, 3 months, and 6 months postoperatively. Furthermore, the patients’ quality of life was evaluated 6 months postoperatively using the EORTC QLQ-C30 questionnaire. Adverse events, operation duration, drainage volume, and the duration of drainage tube carrying time were also monitored and recorded.ResultsCompared to the pre-operative period, a significant decrease in local sensation was observed 10 days after surgery in both groups. However, the control group showed a significant reduction in sensation at 3 and 6 months postoperatively, while the treatment group showed noticeable recovery. A statistically significant difference (P < 0.001) in local sensation between the pre-operative and post-operative periods was observed at the final follow-up in the two groups. By the time of 3 and 6 months postoperatively, a significant difference was seen in the local sensation between the two groups. Intercostal nerve anastomosis was found to significantly improve the patients’ quality of life, including emotional (P = 0.01), physical (P = 0.04), and social functioning (P = 0.02) and pain (P = 0.04). There were no significant differences in general characteristics (such as age, BMI, and subtypes). Although intercostal nerve anastomosis increased the duration of operation by around 20 min (P < 0.001), it did not affect the volume or duration of postoperative drainage tube usage between the two groups.ConclusionThis study indicated that intercostal nerve anastomosis improved the local sensation and quality of life of patients who underwent immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy.Clinical Trial Registrationhttps://www.chictr.org.cn/showproj.html?proj=42487, identifier ChiCTR1900026340.

The aim of the present study was to develop and evaluate a clinical-imaging-radiomic nomogram based on pre-enhanced computed tomography (CT) for pre-operative differentiation lipid-poor adenomas (LPAs) from metastases in patients with lung cancer with small hyperattenuating adrenal incidentalomas (AIs). A total of 196 consecutive patients with lung cancer, who underwent initial chest or abdominal pre-enhanced CT scan with small hyperattenuating AIs, were included. The patients were randomly divided into a training cohort with 71 cases of LPAs and 66 cases of metastases, and a testing cohort with 31 cases of LPAs and 28 cases of metastases. Plain CT radiological and clinical features were evaluated, including sex, age, size, pre-enhanced CT value (CTpre), shape, homogeneity and border. A total of 1,316 radiomic features were extracted from the plain CT images of the AIs, and the significant features selected by the least absolute shrinkage and selection operator were used to establish a Radscore. Subsequently, a clinical-imaging-radiomic model was developed by multivariable logistic regression incorporating the Radscore with significant clinical and imaging features. This model was then presented as a nomogram. The performance of the nomogram was assessed by calibration curves and decision curve analysis (DCA). A total of 4 significant radiomic features were incorporated in the Radscore, which yielded notable area under the receiver operating characteristic curves (AUCs) of 0.920 in the training dataset and 0.888 in the testing dataset. The clinical-imaging-radiomic nomogram incorporating the Radscore, CTpre, sex and age revealed favourable differential diagnostic performance (AUC: Training, 0.968; testing, 0.915) and favourable calibration curves. The nomogram was revealed to be more useful than the Radscore and the clinical-imaging model in clinical practice by DCA. The clinical-imaging-radiomics nomogram based on initial plain CT images by integrating the Radscore and clinical-imaging factors provided a potential tool to effectively differentiate LPAs from metastases in patients with lung cancer with small hyperattenuating AIs.

Background: Breast cancer is a prevalent tumor with high aggressiveness among female populations. MiRNA-145-5p plays an important role in multiple cancers.Materials and Methods: qRT-PCR detected miRNA-145-5p and histone protein family member X (H2AFX) mRNA expression in breast cancer cells, and western blot determined the protein expression of H2AFX. After predicting the target genes via the bioinformatics methods, the targeting relationship between miRNA-145-5p and H2AFX was verified by dual-luciferase, RIP, and RNA pull-down assays. The relationship between H2AFX and clinical indexes was also analyzed. Furthermore, the effects of miRNA-145-5p/H2AFX regulatory axis on breast cancer cell progression were determined by colony formation, wound healing, CCK-8, and Transwell assays.Results: The results suggested that miRNA-145-5p was markedly lowly-expressed in breast cancer tissue and cells, while H2AFX was upregulated, which had a positive correlation with T stages of breast cancer. Besides, overexpressed miRNA-145-5p was found to remarkably suppress progression of breast cancer cells. As bioinformatic analysis predicted that H2AFX was the potential target of miRNA-145-5p, the dual-luciferase assay was conducted, which demonstrated that miRNA-145-5p negatively regulated the expression of H2AFX by targeting its 3'-UTR. The rescue experiment demonstrated that overexpression of miRNA-145-5p could offset the promotion effects of oe-H2AFX on malignant progression. Objective: Our study is aimed at exploring how miRNA-145-5p functions in breast cancer cells.Conclusion: Our findings confirmed that miRNA-145-5p hindered malignant progression of breast cancer by negatively regulating H2AFX. MiRNA-145-5p/H2AFX axis may be a novel therapeutic target for breast cancer.

目的 研究卡培他滨联合曲妥珠单抗治疗人表皮生长因子受体2(HER-2)阳性转移性乳腺癌的临床效果.方法 研究对象均来自2020年6月-2021年6月唐山市人民医院乳腺外科收治的75例HER-2阳性转移性乳腺癌患者,依据随机数字表法把符合条件的患者分成二组,其中对照组37例,观察组38例,对照组患者给予单独卡陪他滨药物治疗,观察组患者给予卡培他滨联合靶向药物曲妥珠单抗治疗.经系统治疗后比较对照组和观察组二组患者治疗疗效的差别情况;通过FACT-B评分比较二组乳腺癌患者生存质量情况;通过免疫功能指标CD4+、CD4+/CD8+比较二组患者免疫功能情况;比较二组患者不良反应发生率.结果 治疗后观察组患者治疗有效缓解率高于对照组;治疗后观察组患者FACT-B评分明显高于对照组;治疗后观察组患者血清CD4+、CD4+/CD8明显高于对照组;治疗后观察组患者出现不良反应(恶心呕吐、白细胞降低、腹泻,肝功能下降)即不良反应发生率低于对照组,以上差异均有统计学意义(均P＜0.05).结论 卡培他滨联合曲妥珠单抗治疗HER-2阳性转移性乳腺癌患者,对于提高该类患者的临床缓解率以及改善其生存质量都起到了重要作用,同时也能提高HER-2阳性转移性乳腺癌患者的一定的免疫功能,降低不良反应的发生情况.

Objective:To study the characteristics of tumor microvascular perfusion by contrast-enhanced ultrasound (CEUS) in patients with breast cancer, and to analyze its relationship with pathology.Methods:The clinical data of 180 breast cancer patients admitted to Tangshan People′s Hospital from February 2019 to March 2021 were retrospectively analyzed. They were examined by contrast-enhanced ultrasound before surgery, and the specimens were sent for pathological biopsy after surgery. The characteristics of tumor microvascular perfusion under CEUS were observed, and the correlation between the characteristics and pathological classification and grade were analyzed.Results:The results of the CEUS showed that the contrast agentrapid infusion was 47.78%(86/180), slowly filled was 60.00%(108/180), the mass showed hyperenhancement when the contrast agent reached its peak was 42.78%(77/180), the contrast agent slowly withdrew was 42.78% (77/180), and the contrast agent retention in clearance was 65.56% (118/180). Pathological biopsy revealed that among 180 patients, 16 patients (8.89%) were non-invasive carcinoma, 41 patients (22.78%) were invasive lobular carcinoma, 88 patients (48.89%) were invasive ductal carcinoma, 10 patients (5.56%) were mucinous adenocarcinoma, 11 patients (6.11%) were medullary carcinoma, 8 patients (4.44%) were squamous carcinoma, 6 patients (3.33%) were hard carcinoma (3.33%). There was no correlation between tumor microvascular perfusion characteristics and pathological classification under CEUS ( P>0.05). Pathological biopsy showed that 95 patients (52.78%) were grade Ⅰ, 49 patients (27.22%) were gradeⅡand 36 patients (20.00%) were grad Ⅲ. There was a certain correlation between tumor microvascular perfusion characteristics and pathological grade under CEUS ( P<0.05). Conclusions:There is a certain relationship between tumor microvascular perfusion characteristics detected by CEUS and pathological grading in patients with breast cancer. Analysis of the microvascular perfusion characteristics can provide an important basis for pathological grading.

目的 探讨超声联合紫杉醇对乳腺癌裸鼠病理学形态、生物学特性及肿瘤抑制的影响.方法 选取健康裸鼠50只,分为健康组(A组)、模型组(B组)、超声组(C组)、紫杉醇组(D组)、联合组(CD组),每组各10只,除健康组外均建立乳腺癌模型,建模后A组、B组行生理盐水腹腔注射;C组用超声波辐射治疗;D组采用经腹腔内注射紫杉醇注射液;CD组在超声引导下经腹腔内多点注射20 mg/kg/w紫杉醇注射液.测量肿瘤体积,TUNEL检测乳腺癌细胞凋亡,HE染色观察病理学形态,免疫印迹检测半胱氨酸蛋白酶Caspase-3、Caspase-2和B淋巴细胞Bax、Bcl-2蛋白表达.结果 经超声显示,B组裸鼠肿瘤体积较大;C组、D组肿瘤体积轻度增大,可见液化坏死;CD组肿瘤体积增长减缓,周边可检测到血流信号.HE染色显示,A组裸鼠无病变现象;B组裸鼠组织结构坏死严重;C组、D组裸鼠癌组织仍有浸润性生长现象;CD组可见少量变性坏死,及组织分布少量残存癌组织,细胞轮廓逐渐稳定.与B组比较,C组、D组肿瘤体积减小(P<0.05);与C组、D组比较,CD组肿瘤体积减小(P<0.05).与A组比较,B组乳腺癌细胞凋亡增加(P<0.05);与B组比较,C组、D组乳腺癌细胞凋亡增加(P<0.05);与C组、D组比较,CD组乳腺癌细胞凋亡增加(P<0.05).与A组比较,B组Caspase-3、Caspase-2、Bax降低,Bcl-2升高(P<0.05);与B组比较,C组、D组Caspase-3、Caspase-2、Bax升高,Bcl-2降低(P<0.05);与C组、D组比较,CD组Caspase-3、Caspase-2、Bax升高,Bcl-2降低(P<0.05).结论 超声联合紫杉醇可抑制乳腺癌裸鼠肿瘤生长、促进癌细胞凋亡,与上调肿瘤组织中Caspase-3、Caspase-2、Bax蛋白表达,抑制Bcl-2活性相关.

Background:Pyrotinib combined with capecitabine has been approved for the treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer in China. To date, the management of early-stage or locally advanced HER2-positive breast cancer in the clinic remains challenging. We conducted this trial to investigate the efficacy and safety of pyrotinib combined with capecitabine as neoadjuvant therapy (NAT) in elderly patients with HER2-positive breast cancer. Due to the stimulation of blood vessels by chemotherapy drugs, the elasticity of blood vessels in the elderly decreases, and then chemotherapy infusion is more likely to lead to phlebitis. Both pyrotinib and capecitabine can be taken to facilitate home treatment for elderly patients with HER2-positive breast cancer (BC).Methods:From January 2020 to March 2021, patients aged between 70 and 81 years old with stage IIA-IIIB HER2-positive breast cancer were screened, enrolled, and assigned to receive six cycles of pyrotinib (320-400 mg, orally, once daily) plus capecitabine (1,250 mg/m2, orally, twice daily) on days 1-14 in every 21-day cycle. The primary endpoint was the objective response rate (ORR). Adverse events (AEs) were assessed in every neoadjuvant cycle. Surgery was performed after the last cycle, and the total pathological complete response (tpCR) was evaluated postoperatively.Results:Of the 23 patients enrolled, the ORR was 100% (23/23; 95% confidence intervals: 85 to 100). All patients underwent surgery with a tpCR rate of 43.5% (10/23; 95% confidence intervals: 23 to 66). The most common AE was diarrhea, occurring in 19 of 23 patients (82.6%); most of these patients sustained mild diarrhea (Grade 1 or Grade 2) and only three had moderate diarrhea (Grade 3). The incidences of other AEs, including weakness, loss of appetite, leukopenia, nausea, vomiting, hand-foot syndrome, etc., were low and the symptoms were mild. No severe AEs (Grade 4 or 5) were observed throughout the treatment.Conclusion:In our study, pyrotinib combined with capecitabine as neoadjuvant therapy in elderly women with HER2-positive breast cancer is safe and showed efficacy in this population, which may be widely used as a protocol for clinical neoadjuvant therapy.

Objective: Cell division cycle 42 (CDC42) facilitates immune escape and drug resistance towards immunotherapy in several malignancies. This prospective study aimed to explore the predictive value of serum CDC42 for immune checkpoint inhibitor (ICI)-treatment response and survival in advanced hepatocellular carcinoma (HCC) patients. Methods: Thirty advanced HCC patients scheduled for ICI or ICI-based treatment were enrolled in this prospective study, whose serum CDC42 was determined via enzyme-linked immunosorbent assay before therapy initiation. Results: The median (interquartile range) of serum CDC42 level was 766.5 (605.0-1329.5) pg/ mL. Serum CDC42 was related to increased tumor size but decreased programmed death-ligand 1 combined positive score (PD-L1 CPS). With respect to ICI or ICI-based treatment outcomes, ele-vated serum CDC42 was associated with decreased disease control rate, but did not link with objective response rate. Patients with high serum CDC42 (vs. low, cut by its median level) had shortened progression-free survival (PFS), while overall survival (OS) only disclosed a reduced trend (lacked statistical significance) in patients with high serum CDC42 (vs. low). In detail, the median (95%CI) PFS and OS were 3.0 (0.0-6.0) months and 11.7 (2.7-20.7) months in patients with high serum CDC42, while they were 11.1 (6.6-15.6) months and 19.3 (14.5-24.1) months in patients with low CDC42. After adjusted by multivariate cox regression analysis, high serum CDC42 (vs. low) was independently associated with shortened PFS, but not OS.Conclusions: Elevated serum CDC42 possesses a potential value in predicting worse ICI or ICI -based treatment outcomes in advanced HCC. & COPY; 2023 Published by Elsevier Masson SAS.

目的 分析三阴性乳腺癌患者雌激素相关受体α(ERRα)的表达情况及其临床意义.方法 选取唐山市人民医院自2013年1月至2016年1月收治的150例三阴性乳腺癌女性患者为研究对象.根据肿瘤组织中ERRα表达结果将患者分入ERRα阳性组和阴性组,比较两组患者的病理特征指标、疾病无进展生存率及总生存率,并采用Cox比例风险回归模型分析三阴性乳腺癌的预后影响因素.结果 150例患者中,ERRα 阳性(阳性组)69例(46.00％),阴性(阴性组)81例(54.00％).阳性组肿瘤分期Ⅲ～Ⅳ期比例、伴淋巴结转移比例、伴脉管癌栓比例均高于阴性组,差异有统计学意义(P<0.05).随访第3、5年,阳性组疾病无进展生存率均低于阴性组,差异有统计学意义(P<0.05).随访第3、5年,阴性组和阳性组总生存率差异均无统计学意义(P>0.05).肿瘤分期、淋巴结转移、脉管癌栓、ERRα表达结果均为三阴性乳腺癌患者的独立预后因素(P<0.05).结论 三阴性乳腺癌患者ERRα 的表达结果与疾病的复发、转移存在相关性,ERRα 阳性的三阴性乳腺癌患者的预后较差.

Objective:To explore the significance of exposing the circummammary ligament under endoscopy and the effect of membrane anatomy in breast reconstruction.Methods:The case data of 49 breast cancer patients who underwent endoscopic nipple-sparing mastectomy combined with one-stage breast reconstruction with prosthesis implantation in Beijing Friendship Hospital, Capital Medical University from February 2014 to December 2021 were retrospectively analyzed, there were 44 cases of posterior pectoralis prosthesis implantation, 5 cases of anterior pectoralis prosthesis implantation. The anatomical structure of the circummammary ligament was observed under endoscopy during operation, and the annular mammary ligament was used as an anatomical marker to complete subcutaneous glandectomy and prosthesis implantation for breast reconstruction, the BREAST-Q scales were used to evaluate the postoperative effect.Results:The medial sternal ligament, sub clavicular ligament, lateral confluence ligament and triangular ligament condensation could be clearly exposed in all 49 cases. Breast reconstruction module of BREAST-Q were used to evaluate the surgery effect after breast cancer surgery, the scores of postoperative breast satisfaction, chest wall status, psychosocial status and sexual health status were 81.43±12.57, 88.39±10.61, 88.04±13.70, 74.82±15.93.Conclusion:The endoscopic technique is beneficial to expose the circummammary ligament during operation, and surgical resection and reconstruction can better restore the appearance of the breast and improve postoperative satisfaction according to the principle of membrane anatomy.

目的 研究新辅助化疗联合改良根治术治疗方案对乳腺癌患者预后以及金属蛋白酶组织抑制剂-1/2(TIMP-1/2)、基质金属蛋白酶-2/9(MMP-2/9)指标的影响.方法 选取本院368例乳腺癌患者,采用随机数字表法分为试验组及对照组各184例,两组患者均采用改良根治术进行乳腺癌治疗,试验组在根治术基础上联合新辅助化疗方案进行治疗.观察两组患者预后情况以及血清TIMP-1/2、MMP-2/9水平变化.结果 治疗后两组患者血清TIMP-1/2、MMP-2/9水平均明显下降,且试验组TIMP-1/2、MMP-2/9下降幅度显著低于对照组,差异有统计学意义(P<0.05);试验组患者总有效率85.87％优于对照组的57.6％,生活质量评估量表各项评分满意度高于对照组患者,差异均有统计学意义(P<0.05).结论 采用新辅助化疗联合改良根治术对乳腺癌患者进行治疗,不仅可以提高患者治疗效果,还可以明显改善患者的术后生活质量.

目的 探讨两步法单孔腔镜乳房重建手术在早期乳腺癌治疗中的临床应用价值.方法 21例早期乳腺癌患者于乳房皮下腺体切除术即刻行两步法单孔腔镜乳房重建手术;记录手术情况、术后并发症及美容效果;术后6个月,应用BREAST Q乳腺癌患者结局量表评价患者对外观满意度和生活质量.结果 21例均顺利完成两步法单孔腔镜乳房重建手术,无中转开放手术病例;术后无假体取出、包膜挛缩发生,2例发生乳头、乳晕缺血坏死,发生率为9.5％.术后6个月,BREAST Q量表评分乳房满意度为(75.3±2.2)分,胸壁状态评分为(90.4±1.5)分,社会心理状态评分为(86.1±2.0)分,性健康程度评分为(71.4±2.6)分.结论 两步法单孔腔镜乳房重建手术在早期乳腺癌治疗中应用效果良好,患者可获较好的外观满意度和生活质量.

目的:建立裸鼠乳腺癌细胞三阴性转移模型,并用超声造影观察三阴性乳腺癌细胞在裸鼠体内的增强情况.方法:将乳腺癌模型小鼠随机分为试验组和对照组,每组10～20只.试验组在用药前1、3、5天给予联合用药,对照组给予生理盐水溶液.常规超声和大体超声观察裸鼠三阴性乳腺癌细胞状态.接种后6周,尾静脉注射SonoVue超声造影剂,瘤周皮下注射超声造影剂.最后对原发性肿瘤和三阴性乳腺癌细胞进行病理检查.结果:A组裸鼠种植后第7天肿瘤形成率为7/7,B组裸鼠种植后第5天肿瘤形成率为5/5;两种方法,实验组肿瘤形成后的第七天,Peak值均显著降低,与对照组差异显著.实验组B中第3、5、7天的Peak值与第1天给药前的Peak值的差值与对照组B间均有统计学意义.在半定量免疫组化分析中,与对照组相比,实验组MVD和VEGF分子的表达水平显著降低.在相关性分析中,方法B第7天的峰值与免疫组化的相关性最高.结论:MDA-MB-231肿瘤组织原位移植可成功促进新一代三阴性乳腺癌细胞在小鼠癌细胞中的增殖.

Background The anti-tumor activity of pyrotinib has been confirmed in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. This study investigated the effect of pyrotinib plus nab-paclitaxel, doxorubicin, and cyclophosphamide as neoadjuvant therapy in patients with HER2-positive locally advanced breast cancer. Methods In this single-center retrospective study, female patients with HER2-positive locally advanced breast cancer received pyrotinib 320 mg orally once a day and the TAC regimen (nab-paclitaxel 260 mg/m2, liposomal doxorubicin 20 mg/m2, and cyclophosphamide 600 mg/m2) on day 1 of each 21-day cycle. Surgery was performed after 4-6 cycles of neoadjuvant therapy. The outcomes included total pathological complete response (tpCR, ypT0/Tis ypN0) rate, objective response rate (ORR) after neoadjuvant therapy, progression-free survival, overall survival, and the incidence of adverse events (AEs). Results Between March 2019 and January 2020, a total of 22 patients were included. The median age was 48 years (range, 32-60). The ORR was 100% after the completion of neoadjuvant therapy. Ten (45.5%) patients achieved tpCR, including four of ten (40.0%) patients with positive hormone receptor, and six of 12 (50.0%) patients with negative hormone receptor. As at December 2020, no disease recurrence, progression, or death occurred. All patients suffered AEs after neoadjuvant therapy, most of which were grade 1-2. Grade ≥3 AEs included diarrhea [4 (18.2%)], rash [2 (9.1%)], and hand-foot syndrome [1 (4.5%)]. Conclusions Neoadjuvant pyrotinib combined with the TAC regimen showed promising clinical benefit in patients with HER2-positive locally advanced breast cancer, with an acceptable safety profile.

目的:探讨复方苦参注射液联合TAC方案新辅助化疗治疗局部晚期乳腺癌的疗效,以及对患者预后的影响.方法:纳入75例采用TAC方案新辅助化疗(对照组)和75例采用复方苦参注射液联合TAC方案新辅助化疗(研究组)的晚期乳腺癌患者进行研究,RECIST1.1实体肿瘤化疗疗效评价标准和美国国立癌症研究所化疗毒性反应及分度标准(NCI-CTCAEV4.0)评价疗效和安全性,Kaplan-Meier分析患者3年生存率、外周血淋巴细胞免疫表型(CD3+、CD4+、CD8+及CD4+/CD8+)进行比较分析.结果:研究组患者CR23例,PR15例,SD30例,PD7例,DCR 90.67％,高于对照组(P＜0.05),RR 50.67％,与对照组无差异(P＞0.05),研究组不良反应率为5.33％,对照组14.67％,两组对比差异具有统计学意义(X2=13.925,P＜0.05).两组患者随访3-5年,中位随访2.8年,研究组1年生存率与对照组对比差异无统计学意义(83.25％ VS 81.05％,P＞0.05),2年生存率对比(75.92％ VS 63.42％),3年生存率对比(67.38％VS 53.49％),差异具有统计学意义(P＜0.05).观察组CD3+、CD4+及CD4 +/CD8+水平均高于对照组,差异具有统计学意义(F=4.14、6.20、5.21,P＜0.05);观察组CD8+水平低于对照组,差异具有统计学意义(F=6.78,P=0.01).结论:复方苦参注射液联合TAC方案新辅助化疗可提高局部晚期乳腺癌治疗疗效和生存率,降低不良反应.

We retrospectively enrolled 825 breast cancer patients, who was primarily diagnosed in our hospital between January 2009 and December 2014 and explored the relationship between red blood cell distribution width (RDW) and long-term prognosis in patients with breast cancer. There were 412 patients with high RDW (RDW > 13.82) and 413 patients with low RDW (RDW ≤ 13.82). Compared with low RDW group, the high w group has large tumor size (the rate of tumor size >2 cm: 60.7 vs 44.8%, P=0.013). The rate of lymph node metastases was higher in the high RDW group thaten that in the low RDW group (62.1 vs 45.8%, P=0.000). RDW was positively associated with tumor stage. The high RDW tended to be advanced stage (P=0.000). Compared with low RDW group, the high RDW group tended to be higher lymphocyte count (P=0.004), elevated fibrinogen (P=0.043), and elevated high-sensitivity C-reactive protein (P=0.000). The Kaplan-Meier analysis indicated elevated RDW was positively associated with disease-free survival (DFS) (P=0.004) and overall survival (OS) (P=0.011). The multivariate Cox regression analysis indicated that the high RDW group had poorer OS (Hazard risk [HR] = 2.43; 95% CI: 1.62-3.21; P=0.024) and DFS (HR = 1.89; 95% CI: 1.28-3.62; P=0.000) compared with low RDW group. The present study found that high pretreatment RDW levels in breast cancer patients were associated with poor OS and DFS. RDW could be a potential predictive factor in differential diagnosis of poor prognosis from all patients.

现代社会中人们的生活水平不断提高，对生活质量的要求也越来越高。女性的乳房已经不仅是哺乳和作为第二性征的标志，而是女性形体美的重要组成部分，是女性魅力之所在。随着乳腺疾病发病率的升高，许多患者不得不接受乳腺手术治疗，随之乳房形态欠缺，对女性造成一定困扰，严重者可影响正常的工作和生活，甚至可以造成心理障碍。腔镜技术引入乳腺外科手术治疗以后，以其能通过腋窝等隐蔽部位切口完成乳房复杂手术的优势，并结合整形美容外科的吸脂技术，在乳房整形外科得到快速发展。本文将阐述腔镜技术在乳腺整形外科中的应用。