乳腺浸润性导管癌钼靶X线表现与腋窝淋巴结转移及p53蛋白表达的关系

Objective To investigate the relationship among the mammography signs, the axillary lymph node ( LN) metastasis, and the p53 expression of infiltrating ductal breast carcinoma. Methods Mammography signs and axillary LN metastasis were analyzed in 72 cases of infiltrating ductal carcinoma. Immunohistochemistry was used to detect p53 expression in tumor specimens. The relationship among the mammography signs, the axillary LN metastasis and the p53 expression was assessed. Results The positive rate of p53 expression was 56. 7% in the patients with axillary LN metastasis, which was higher than 31.4% in the patients without axillary LN metastasis ( P ＜ 0. 05 ). The rate of axillary LN metastasis and p53 expression were 66. 7% and 70. 0% in the tumors larger than 2 cm, 56. 4% and 66. 7% in the tumors with more vascular signs, 28. 6% and 38. 1% in the tumors less than 2 cm, 30. 3% and 33. 3% in the tumors with normal vascular signs (P ＜0. 01) , respectively. The rate of axillary LN metastasis in the patients with spinulation was 70. 8% , which was higher than 41.1% of patients without spinulation (P ＜0.05). Conclusion Mammography signs of breast cancer can evaluate the axillary LN metastasis and p53 expression, and also can provide objective reference for clinical diagnosis, treatment and prognosis of breast carcinoma.     

Expression and clinical significance of FPARγ and β-catenin in breast cancer

Objective To study the expression of peroxisome proliferator-activated receptor γ (PPARγ) and β-catenin in breast cancer, and their correlations with clinicopathological parameters and prognosis. Methods Tissue samples obtained from 70 patients with breast cancer and 20 patients with breast benign mass were immunohistochemically examined for the expression of PPARγ and p-catenin. Results Overexpression rate of PPARγ protein was 34. 3% in breast cancer, significantly lower than that in breast benign mass. Abnormal expression rate of β-catenin in breast cancer was 67. 1%. A significant negative-correlation was found between the expression of PPARγ and β-catenin (r=-0. 398,P<0.05 ). PPARγ expression was inversely associated with histologic grade, tumor size, axillary lymph node metastasis,TNM stage and Ki-67 expression (P<0. 05), while positively correlated with ER status and overall survival rate (P<0. 05). Abnormal β-catenin expression was positively associated with histologic grade, axillary lymph node metastasis and TNM stage (P<0. 05), while inversely correlated with overall survival rate (P<0.05). Conclusion PPARγ and β-catenin are correlated with development of breast carcinoma,suggesting that detection of PPARγ and β-catenin may be of value in evaluating the biological behaviors and the prognosis of breast cancer.     

Expression and clinical significance of FPARγ and β-catenin in breast cancer

Objective To study the expression of peroxisome proliferator-activated receptor γ (PPARγ) and β-catenin in breast cancer, and their correlations with clinicopathological parameters and prognosis. Methods Tissue samples obtained from 70 patients with breast cancer and 20 patients with breast benign mass were immunohistochemically examined for the expression of PPARγ and p-catenin. Results Overexpression rate of PPARγ protein was 34. 3% in breast cancer, significantly lower than that in breast benign mass. Abnormal expression rate of β-catenin in breast cancer was 67. 1%. A significant negative-correlation was found between the expression of PPARγ and β-catenin (r=-0. 398,P<0.05 ). PPARγ expression was inversely associated with histologic grade, tumor size, axillary lymph node metastasis,TNM stage and Ki-67 expression (P<0. 05), while positively correlated with ER status and overall survival rate (P<0. 05). Abnormal β-catenin expression was positively associated with histologic grade, axillary lymph node metastasis and TNM stage (P<0. 05), while inversely correlated with overall survival rate (P<0.05). Conclusion PPARγ and β-catenin are correlated with development of breast carcinoma,suggesting that detection of PPARγ and β-catenin may be of value in evaluating the biological behaviors and the prognosis of breast cancer.     

乳腺浸润性导管癌钼靶X线表现与腋窝淋巴结转移及p53蛋白表达的关系

Objective To investigate the relationship among the mammography signs, the axillary lymph node ( LN) metastasis, and the p53 expression of infiltrating ductal breast carcinoma. Methods Mammography signs and axillary LN metastasis were analyzed in 72 cases of infiltrating ductal carcinoma. Immunohistochemistry was used to detect p53 expression in tumor specimens. The relationship among the mammography signs, the axillary LN metastasis and the p53 expression was assessed. Results The positive rate of p53 expression was 56. 7% in the patients with axillary LN metastasis, which was higher than 31.4% in the patients without axillary LN metastasis ( P ＜ 0. 05 ). The rate of axillary LN metastasis and p53 expression were 66. 7% and 70. 0% in the tumors larger than 2 cm, 56. 4% and 66. 7% in the tumors with more vascular signs, 28. 6% and 38. 1% in the tumors less than 2 cm, 30. 3% and 33. 3% in the tumors with normal vascular signs (P ＜0. 01) , respectively. The rate of axillary LN metastasis in the patients with spinulation was 70. 8% , which was higher than 41.1% of patients without spinulation (P ＜0.05). Conclusion Mammography signs of breast cancer can evaluate the axillary LN metastasis and p53 expression, and also can provide objective reference for clinical diagnosis, treatment and prognosis of breast carcinoma.     

乳腺浸润性导管癌钼靶X线表现与腋窝淋巴结转移及p53蛋白表达的关系

目的 探讨乳腺浸润性导管癌X线征象与腋窝淋巴结转移、p53蛋白表达的关系.方法 观察72例浸润性导管癌的X线征象及腋窝淋巴结转移状况,应用免疫组织化学检测p53表达,分析乳腺癌X线征象与腋窝淋巴结转移、p53表达的关系.结果 淋巴结转移组p53阳性表达率56.7%,较未转移组31.4%高(P＜0.05);≥2 cm组和血管增粗组p53阳性表达率、淋巴结转移率分别为66.7%、70.0%和56.4%、66.7%,均较＜2 cm组28.6%、38.1%和血管正常组30.3%、33.3%高(P均＜0.01);毛刺组淋巴结转移率70.8%高于无毛刺组41.7%(P＜0.05).结论 乳腺癌X线征象可评价腋窝淋巴结转移及p53表达,为临床诊治及预后判断提供参考.

Abstract：

Objective To investigate the relationship among the mammography signs, the axillary lymph node ( LN) metastasis, and the p53 expression of infiltrating ductal breast carcinoma. Methods Mammography signs and axillary LN metastasis were analyzed in 72 cases of infiltrating ductal carcinoma. Immunohistochemistry was used to detect p53 expression in tumor specimens. The relationship among the mammography signs, the axillary LN metastasis and the p53 expression was assessed. Results The positive rate of p53 expression was 56. 7% in the patients with axillary LN metastasis, which was higher than 31.4% in the patients without axillary LN metastasis ( P ＜ 0. 05 ). The rate of axillary LN metastasis and p53 expression were 66. 7% and 70. 0% in the tumors larger than 2 cm, 56. 4% and 66. 7% in the tumors with more vascular signs, 28. 6% and 38. 1% in the tumors less than 2 cm, 30. 3% and 33. 3% in the tumors with normal vascular signs (P ＜0. 01) , respectively. The rate of axillary LN metastasis in the patients with spinulation was 70. 8% , which was higher than 41.1% of patients without spinulation (P ＜0.05). Conclusion Mammography signs of breast cancer can evaluate the axillary LN metastasis and p53 expression, and also can provide objective reference for clinical diagnosis, treatment and prognosis of breast carcinoma.     

乳腺癌患者外周血Metadherin基因表达的检测及其初步应用价值探讨

Objective To establish a quantitative SYBR GreenⅠreal-time PCR method for detection of Metadherin (MTDH) gene expression level in breast cancer, and to investigate the relationship between MTDH mRNA expression level and the clinicopathological characters. Methods Real-time PCR was employed to determine the expression level of MTDH mRNA in peripheral blood of 80 specimens of breast cancer patients and normal females. Results In the 80 specimens, MTDH mRNA was positively expressed in the peripheral blood of 61 cases of breast cancer patients while negatively expressed in the 19 cases of normal females. Among the 61 breast cancer patients, MTDH mRNA showed high expression in 34 cases, accounting for 55.7%, and showed low expression in 27 cases, accounting for 44.3%. Both of the differences in expression rate has statistic significance (Ratio = 2.02 ± 0.81, P<0.05). MTDH expression relative to GAPDH expression in the peripheral blood of breast cancer patients was 1.15 ± 0.36. MTDH mRNA expression has no connection with age, estrogen and progesterone receptors , as well as HER-2.(P＞0.05). There is statistical difference for MTDH mRNA expression level between the group with lymph node metastasis and the group without lymph node metastasis (Ratio=2.02 ± 0.81,P<0.05). MTDH mRNA expression level changed between clinicopathological stage I, II and III, IV. Conclusion The established SYBR Green Ⅰ quantitative real-time PCR method can successfully detect the expression level of MTDH mRNA, which may be closely related to the occurrence and development of breast cancer.     

pN0食管癌Ivor-Lewis手术后淋巴结转移性复发的危险因素

目的 探讨pN0期食管癌病人Ivor-Lewis手术后淋巴结转移性复发的危险因素.方法 对2001年1月至2005年1月间接受Ivor-Lewis手术治疗的82例pN0期胸中段食管鳞癌病人进行前瞻性研究,用RT-PCR检测食管癌组织中淋巴管生成因子C(VEGF-C)mRNA和淋巴结组织中上皮标志物(Mucin1)mRNA的表达;Kaplan-Meier法计算复发率;Log-rank检验比较复发率;Cox回归多因素分析判定独立的危险因素.结果 42例食管癌组织中检测到VEGF-C mRNA表达;23例至少在1枚淋巴结中检测到Mucin1 mRNA表达,诊断为淋巴结微转移;手术后3年内37例发生淋巴结转移;T分期与病人3年内淋巴结转移的发生率相关(P＜0.05);有VEGF-C mRNA表达者3年内淋巴结转移发生率显著高于无VEGF-C mRNA表达者(P＜0.01);有淋巴结微转移者3年内淋巴结转移的发生率显著高于无淋巴结微转移者(P＜0.01).Cox回归分析显示T分期、食管癌组织中VEGF-C mRNA表达和淋巴结微转移是病人手术后3年内淋巴结转移的独立危险因素.结论 T分期、食管癌组织中VEGF-C mRNA表达和淋巴结微转移是pN0食管癌病人Ivor-Lewis手术后淋巴结转移性复发的独立危险因素.

Abstract：

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophageal cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR, VEGF-C mRNA was detected in tumor issues, and Mucin l( MUC1 )mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival rate and lymph nodal metastatic rate. Log-rank test was performed to compare the recurrence rate, and Cox regression multivariate analysis was performed to determine independent prognostic factors. Results VEGF-C mRNA was identified in 42 patients (51.22%), and MUC1 mRNA was identified in 23 patients(28.05% )from at least 1 lymph node station . The diagnosis of lymph node micrometastasis (LNMM) was based on the detection of MUC1 mRNA. The first recurrence exhibiting lymph node metastasis was recognized in 37 patients (45.1%) at the first 3 years after operation and this was significantly associated with T status ( P ＜ 0. 05 ). Lymph node metastatic rate for patients with VEGF-C mRNA expression in tumor issues was significantly higher than that for patients without VEGF-C mRNA expression( P ＜0. 01 ). And lymph node metastatic rate for patients with LNMM was significantly higher than that for patients without LNMM ( P ＜0. 01 ). The results of multivariate analysis confirmed that T status, VEGF-C mRNA expression in tumor issues and LNMM were independent relevant factors. Conclusion Status,VEGF-C mRNA expression in tumor issues and LNMM in patients with N0 esophageal cancer were independent risk factors for 3-year lymph node metastatic recurrence after Ivor-Lewis Esophagectomy.     

EVALUATION OF AXILLARY LYMPH NODE STATUS IN BREAST CANCER WITH MRI

Objective:We performed a retrospective study to establish the optimalradiological criteria for axillary lymph node metastases from breast cancer by measuringall dissected nodes,and to determine whether magnetic resonance imaging(MRI)couldreliably reveal axillary involvement.Methods:Pathological findings and MRI scans of 202patients with invasive breast cancer were reviewed.The long-and short-axis dimensions ofall level Ⅰ and Ⅱ lymph nodes were measured microscopically,and then the long-to-shortaxis(L/S)ratio of each node was calculated.These parameters were compared withpathological nodal status to define radiological criteria for axillary involvement.MRI wascarried iut using T1-weighted spin-eho sequences in the coronal and sagittal planes.OnMRI,every detected lymph node was measured and the shape of the nodal cortex was alsoexamined.Then the diagnostic ability of MRI was assessed using these morphologic criteri-a.Results:On histopathological examinations of 4043 dissected lymph nodes,a long-axisdime     

A Significant Correlation between Nuclear CXCR4 Expression and Axillary Lymph Node Metastasis in Hormonal Receptor Negative Breast Cancer

Background and objectives In breast cancer, the expression pattern of CXCR4 may be correlated with the degree of axillary lymph node involvement. The aim of this study was to evaluate the contributing factors that contribute to the correlation between CXCR4 expression and axillary lymph node metastasis in breast cancer. Methods Between August 1997 and August 2002, sections of paraffin-embedded tissue were obtained from 107 patients who received optimal treatment for breast cancer. The expression of CXCR4 was evaluated by immunohistochemical staining. Results A significant correlation was found in the expression of nuclear CXCR4 and lymph node metastasis (P = 0.03). We found a significant correlation between a high nuclear expression of CXCR4 and axillary lymphatic metastasis in estrogen and progesterone receptor negative breast cancer (P = 0.01 and P = 0.01). There was a significant correlation between the high expression of nuclear CXCR4 and axillary lymphatic metastasis in comparisons between positive estrogen and/or progesterone receptor expression and negative expression (P = 0.02). Conclusions Our results showed that high expression of nuclear CXCR4 was significantly correlated with lymph node metastasis in breast cancer. The high expression of nuclear CXCR4 in hormone receptor negative breast cancer was associated with a high possibility of lymph node metastasis.     

Expression of CXCR4 is associated with axillary lymph node status in patients with early breast cancer

Recent studies have discovered that CXCR4 is associated with tumor metastasis. It is worth understanding the association between CXCR4 expression and axillary lymph node involvement in early breast cancer. Eighty-five patients with early breast cancers were divided into three groups based on their axillary lymph node status. CXCR4 expression was assessed by immunohistochemistry in all cases and its correlation with axillary lymph node involvement was evaluated. There was a significant difference in nuclear CXCR4 expression among these three groups and high nuclear expression of CXCR4 was associated with cases with no lymph node involvement. However, high cytoplasmic expression of CXCR4 was associated with patients who developed high-level axillary lymph node involvement. In conclusion, the different staining locations of CXCR4 have varying biological significance for the metastatic potential of axillary lymph nodes. In particular, it provided information that high cytoplasmic expression of CXCR4 was related to axillary internodal metastasis, and adjuvant radio-chemotherapy was suggested.     

乳腺癌血管生成与nm23基因表达及腋窝淋巴结转移的关系

目的 研究乳腺癌血管生成与转移抑制基因nm23-H1的表达在肿瘤转移中的作用,分析它们与腋窝淋巴结转移的关系。方法 对80例乳腺癌患者采用能量多普勒检测肿瘤内血流信号并通过图像分析技术定量测定肿瘤内血管阳性反应总面积,对手术切除标本采用免疫组织化学技术检测nm23基因蛋白及肿瘤内微血管密度（microvessel density,MVD)的表达。结果 伴有腋窝淋巴结转移组（lymph node postive,LN )肿瘤血管阳性反应总面积、MVD值明显高于不伴有腋窝淋巴结转移组（lymph node negative,LN-)(t=7.07、6．34,P＜0．01）,而nm23-H1的表达则相反,同时nm23-H1阴性表达组的血管阳性反应总面积、MVD值显著高于nm23-H1阳性表达组,（t=6.86、6．49,P＜0．05）。结论 肿瘤血管生成和nm23-H1的表达在乳腺癌腋窝淋巴结转移过程中发挥着重要作用。nm23-H1基因表达与乳腺癌血管生成可能存在某种内在联系。     

nm23基因表达与乳腺癌腋淋巴结转移的关系

目的探讨ｎｍ２３基因在原发性乳腺癌组织中的表达规律,及其与淋巴结转移等预后因素之间的关系。方法应用免疫组织化学方法（ＳＰ法）对１０７例原发性乳腺癌组织进行ｎｍ２３蛋白表达研究。结果ｎｍ２３基因在原发性乳腺癌的表达阳性率为５０５％,在有淋巴结转移的乳腺癌中阳性率为３１％,无淋巴结转移的乳腺癌中阳性率为７３５％（Ｐ＜０．０１）。结论ｎｍ２３基因表达与淋巴结转移呈负相关,而与乳腺癌组织学分类、肿瘤大小无相关性。检测乳腺癌组织中ｎｍ２３的表达是评估预后有价值的生物学指标。     

STAT3及其磷酸化在食管鳞癌组织中的表达及其意义

目的 检测食管鳞癌组织中信号转导子和转录激活子3( STAT3)在mRNA、蛋白质和蛋白质磷酸化3种水平的表达,探讨其在食管鳞癌发生、发展、浸润、转移中的作用。方法 检测43例食管鳞癌组织中的STAT3 mRNA、STAT3和磷酸化STAT3( pSTAT3)的表达,并与相应癌旁正常食管组织作对照研究,分析STAT3 mRNA、STAT3和pSTAT3的表达与临床病理参数的关系。结果 43例实验样本中(1)食管鳞癌组织中STAT3 mRNA相对表达强度比值(1.43±0.59)较癌旁组织的比值(0.98±0.47)明显增高(P＜0.05);(2)食管鳞癌组织中STAT3、pSTAT3表达(2.16±0.39、1.40±0.15)也都显著高于癌旁组织(1.87±0.29、1.25±0.13,P＜0.05);(3)食管鳞癌组织中STAT3mRNA、STAT3和pSTAT3在肿瘤不同分化级别中表达差异有统计学意义,分化级别越低,表达水平越高(P＜0.05),并与肿瘤分化级别呈负相关(-1 ＜r＜-0.301,P＜0.05);它们在TNM分期中Ⅲ期组的表达均高于Ⅰ～Ⅱ期组(P＜0.05),伴有淋巴结转移组表达也都高于无淋巴结转移组(P＜0.05),并与两者呈正相关(两者均为0.301 ＜r＜1,P＜0.05);但未发现它们在性别、年龄、家族史、吸烟史中差异有统计学意义(P＞0.05)。结论 食管鳞癌组织中STAT3磷酸化异常激活后,导致STAT3mRNA、STAT3和pSTAT3的高表达,与食管鳞癌的分化、浸润、转移相关。     

CXCL12/CXCR4生物轴在头颈部鳞癌淋巴转移的作用

目的 观察趋化因子受体4(CXCR4)及其配体12(CXCL12)在头颈部鳞癌(HNSCC)组织及颈部淋巴结中的表达,分析CXCR4、CXCL12的表达与HNSCC临床病理关系,探讨CXCL12/CXCR4生物轴在HNSCC淋巴转移中的作用.方法 半定量逆转录.聚合酶链反应(RT-PCR法)及免疫组织化学SP法检测65例HNSCC组织、15例正常口腔组织及良性病变中CXCR4、CXCL12基因及蛋白表达.结果 RT-PCR结果:CXCR4在鳞癌转移组、非转移组、良性对照组中的表达分别为0.406±0.044、0.464±0.068、0.900±0.108,各组间表达的差异有统计学意义(P<0.05).转移组、未转移组淋巴结中CXCL12的表达分别为0.935±0.087、0.861±0.047,差异无统计学意义(P>0.05).免疫组织化学结果:CXCR4在鳞癌转移组、非转移组、良性对照组中的表达率分别为71.4%、33.3%、13.3%.各组间表达的差异有统计学意义(X2=65.23,P<0.05).CXCR4的表达与临床分期、肿瘤分化程度、淋巴结转移显著相关(P<0.01),与年龄、性别无明显相关(P>0.05).淋巴结中高表达CXCL12,CXCL12的表达在所有参数的分组表达中差异均无统计学意义(P>0.05).结论 CXCR4的高表达可能赋予HNSCC细胞较强的局部侵犯及淋巴转移潜能;CXCL12/CXCR4生物轴在HNSCC淋巴转移中可能发挥作用.     

CD133、CXCR4共表达与胆囊癌转移特性的相关性研究

目的探讨CD133、CXCR4共表达与胆囊癌转移特性之间的关系。方法培养胆囊癌GBC~-SD细胞,并经免疫磁珠分选法分选得到CXCR4~+和CXCR4~-亚群胆囊癌GBC~-SD细胞,分为CD133~-CXCR4~-、CD133~-CXCR4~+、CD133~+CXCR4~-及CD133~+CXCR4~+四组,以Transwell法检测四组胆囊癌GBC~-SD细胞侵袭能力。Western~-blot法检测CD133~+CXCR4~+组与CD133~+CXCR4~-组细胞上皮间质转化相关因子表达。Western blot法检测21例胆囊癌原发灶组织标本中CD133与CXCR4蛋白表达与淋巴结转移、肝脏侵犯、胆管侵犯及TNM分期之间的关系。结果 CD133~+CXCR4~+组平均穿膜细胞数为(32.49±9.45),显著高于CD133~+CXCR4~-组的(16.17±8.55),差异具有统计学意义(P=0.02)。CD133~+CXCR4~+组N~-cadherin蛋白灰度值为(0.8321±0.1259),显著高于CD133~+CXCR4~-组的(0.4572±0.0775),差异有统计学意义(P=0.004)。CD133~+CXCR4~+组E~-cadherin蛋白灰度值为(0.4712±0.0736),显著低于CD133~+CXCR4~-组的(0.8439±0.1339),差异有统计学意义(P=0.006)。CD133~+CXCR4~+组Snail蛋白相对灰度值为(0.9455±0.1228),显著高于CD133~+CXCR4~-组的(0.3219±0.0934),差异有统计学意义(P=0.003)。胆囊癌标本淋巴结转移组、肝脏侵犯组、胆管侵犯组CXCR4蛋白表达值显著高于对应阴性组(P=0.013,P=0.024,P=0.037),Ⅰ/Ⅱ分期组显著低于Ⅲ/Ⅳ组,差异有统计学意义(P=0.016)。淋巴结转移组CD133蛋白表达显著高于对应阴性组,差异有统计学意义(P=0.009),Ⅰ/Ⅱ分期组显著低于Ⅲ/Ⅳ组,差异有统计学意义(P=0.018)。肝脏侵犯组、胆管侵犯组与相应对照组CD133蛋白相对表达差异无统计学意义(P=0.443,P=0.371)。CD133蛋白与CXCR4蛋白表达存在明显正相关(r=0.693,P0.01)。结论 CD133、CXCR4共表达预示胆囊癌具有较强的转移特性。     

乳腺癌哨兵淋巴结转移与肿瘤大小和癌基因及激素受体表达关系的临床观察

目的：探讨影响乳腺癌哨兵淋巴结转移的相关因素。方法：回顾性分析近2年来原发性乳腺癌115例临床资料。行哨兵淋巴结活检（SLNB）与腋窝淋巴结清扫术（ALND）;肿瘤直径≤2cm和2.1~4cm;免疫组化法检测肿瘤组织中C erbB 2，（HER 2/neu）p53，nm23，ER和PR的表达状态及对哨兵淋巴结（SN）转移的影响程度。结果：115例乳腺癌SN检出110例（检出率95.65％）,哨兵淋巴结与腋淋巴结病理结果完全符合，同时相关资料齐全可供分析的95例。其中SN转移36例（37.89％）,SN无转移59例（62.11％），平均每例检出淋巴结1.97枚。SN转移率在肿瘤直径≤2cm组和2.1~4cm组分别是21.43%（9/42）和50.94%(27/53)，两组相比较，随着原发肿瘤的增大SN阳性率相应提高并差异显著（P＜0.01）。SN转移率C erbB 2阴性组为24.32％（9/37），阳性组为46.55％（27/58），两组相比，随着C erbB 2表达增强，SN转移率显著提高并有统计学差异（P＜0.05）。p53, nm23, ER和 PR表达和不表达时影响SN的转移率，但无统计学意义（P＞0.05）。 结论：乳腺癌原发肿瘤大小，C erbB 2表达状态是预测SN转移状态的有用指标。     

The role of pre-operative B mode ultrasound in the evaluation of the axillary lymph node metastases in the initial staging of breast carcinoma

The lymph node status of a breast cancer is one of the main prognostic criterias. This status is very important to determine the therapeutic approach. Physical examination alone is not sufficient to assess axillary metastases. Mammographic examination can give us an idea about breast cancer and axillary involvement. Ultrasonographic evaluation can improve the sensitivity of clinical and mammographic examination in assessing axillary lymph node status. 42 patients operated on for breast cancer between January 2000-January 2003 were included in this prospective study. In the study, we used axillary B mode ultrasound to evaluate the axillary lymph nodes. There are several sonographic features to categorize them. Axillary B mode ultrasound was performed to evaluate the axillary lymph nodes for metastatic involvement. In the evaluation of lymph nodes, the sonographic criteria were centric echogenity, thickening of cortex, length/width ratio (L/W) and the diameter of lymph nodes. Hyperechogenic hilus was accepted as a benign finding. The thickening of the cortex less than 50% of the thickening of the centric echogenic hilus was also accepted as a benign finding. L/W ratio below 2 and parameters above 2 cm were accepted as malignant findings. 168 lymph nodes in 42 patients were evaluated pre-operatively with axillary B mode ultrasound. As a result, these lymph nodes were defined as benign in 19 patients (45.2%) and malignant in 23 patients (54.8%). Axillary lymph node status was found as benign in 18 patients (42.9%) and malignant in 24 patients (57.1%) pathologically . Comparative results of ultrasound and axillary lymph node status can be seen on Table III. As a result, the sensitivity of axillary B mode ultrasound to show the metastases was found as 79.1%, specificity was 77.7%, positive predictive value 82.6% and negative predictive value 73.6%. We think some better results may be obtained in the future and these developments may affect the surgeon's decisions concerning axillary dissection for breast cancer operations.     

PCNA和C-erbB-2及nm-23-H1在乳腺癌组织中的表达及临床意义

目的探讨PCNAC-erbB-2和nm-23-H1在乳腺癌组织中的表达及其与病理分型、临床分期、淋巴结转移、肿瘤大小、组织学分级的关系。方法采用免疫组织化学SP法测定76例乳腺癌组织石蜡切片中PCNAC-erbB-2和nm-23-H1蛋白的表达。结果PCNAC-erbB-2在乳腺癌组织中的表达与肿瘤的组织学分级、淋巴结转移数目、TNM分期呈正相关（P〈0．01），与病理分型、肿瘤大小无关。nm-23-H1与淋巴结转移数目、肿瘤大小、TNM分期呈负相关（P〈0．01），与病理分型、组织学分级无关。PCNA和C-erbB-2的表达呈正相关（P〈0．01）。C-erbB-2和nm-23-H1的表达呈负相关（P〈0．01）。PCNA和nm-23-H1的表达差异无统计学意义（P〉0．05）。结论PCNAC-erbB-2和nm-23-H1可以作为判断乳腺癌生物学行为，后续治疗和预后的三个重要的客观标记物。