血清泌乳素含量与乳腺癌关系的探讨

为探讨血清泌乳素（ＰＲＬ）与乳腺癌发生、发展的关系。对１１７例乳腺增生病、３６例乳腺纤维腺瘤及５１例乳腺癌患者进行了血清ＰＲＬ含量的测定,对１７例乳腺癌及２１例纤维腺瘤患者进行了雌激素受体的测定。结果显示：轻度乳腺增生、早期乳腺癌患者血清ＰＲＬ含量与正常对照组比较无显著性差异（Ｐ＞０．０５）,重度乳腺增生、瘤样增生及纤维腺瘤患者均较轻度增生者的血清ＰＲＬ含量增高（Ｐ＜０．０１）;不同期别的乳腺癌患者,其血清ＰＲＬ含量随期别的增加而显著增高（Ｐ＜０．０１）。提示血清ＰＲＬ含量增高是促进乳腺癌发展的重要因素。     

骨形成蛋白-2(BMP-2)与雌激素敏感性的人类乳腺癌的关系

目的：研究BMP-2(Bone Morphogenetic Protein-2，骨形成蛋白-2)在乳腺癌细胞系中的表达，探讨其对乳腺癌细胞的作用机制，评估其在乳腺癌基因治疗上的作用。方法：采用分子生物学方法（Molecular Biology）检测6种人类乳腺癌细胞系中BMP-2的表达，并分析对乳腺癌细胞生长的影响及其与治疗的关系。结果：BMP-2在所有人类乳腺癌细胞系中表达，其抑制乳腺癌细胞的生长，主要抑制于细胞周期的G1期，其抑制作用与p21蛋白的诱导有关。结论：BMP-2是对雌激素敏感的人类乳腺癌细胞的强有力抑制剂，这有可能成为在分子水平上治疗乳腺癌的新方法。     

Relationships Between Psychosocial Adjustment and Hopelessness in Women with Breast Cancer

Objective: Several physical, psychological and social variables influence women with breast cancer. This studywas designed to analyze the relationship between psychosocial adjustment and hopelessness in a group of suchwomen in Turkey. Method: The subjects were 90 women with breast cancer recruited at i Ege University Schoolof Medicine Department of Radiation Oncology Nurse Counsellor Unit and Tülay Aktaş Oncology HospitalOutpatient Chemotherapy Unit. Data were collected using an Introductory Information Form and PsychosocialAdjustment to the Illness Scale - Self-Report (PAIS–SR) and the Beck Hopelessness Scale (BHS) and analyzedby Pearson Correlation Analysis. Results: The mean age of the women was 49.4±11.0. It was found that the levelof psychosocial adjustment of 63.3% of the women was “poor”. A positive relationship was determined betweenPAIS–SR mean score and BHS mean score of the women with breast cancer (r =0.731, p<0.01). Conclusion: Itwas observed that as the psychosocial adjustment worsens, as the level of hopelessness of the women increases.In the light of this relationship, it was concluded that the attempts to increase hope and therefore the supportfor the psychosocial adjustment of patients should play a vital role in increasing their quality of life.     

Relationship Between Breast Density,Breast Cancer Subtypes,and Prognosis

BackgroundIn the United States, Europe, and Asia, a consensus has been reached that there is a higher risk of breast cancer in high density breasts. However, there are some contrary reports that suggest the absence of an association between breast composition and breast cancer subtype; thus, there is conflicting evidence. The purpose of this study was to investigate trends in the incidence of breast cancer subtypes according to breast composition and analyze the survival rates in Japanese women.Patients and MethodsBetween 2007 and 2008, 1258 Japanese patients with invasive breast cancer who underwent mammography and obtained a pathological diagnosis in our institution were included in the study. We compared cancer subtypes with breast composition types (dense and non-dense breast), and classified them based on initial mammography findings. Information on 5- and 10-year survival rates was collected by chart review for patients with dense and nondense breasts. Statistical analysis was performed using the Pearson's chi-square test for breast composition and cancer subtype. The effect of breast composition on mortality was examined using a multivariate Cox proportional hazards model, and adjusted hazard ratios were calculated.ResultsNo significant difference was found between breast cancer subtype and breast composition (P = .08). Five-year (log-rank test, P = .09) and 10-year (log-rank test, P = .31) survival rates were not significantly different between breast composition types.ConclusionThere was no significant association between breast composition and cancer subtypes. There was also no significant difference in the prognosis between patients with and without dense breasts.     

The Relationship Between Vitamin D and Breast Cancer Incidence and Natural History

Endocrine action of vitamin D and its role in calcium homeostasis and bone health are well known. The discovery that breast epithelial cells possess the same enzyme system as the kidney, permitting local manufacture of active vitamin D (1,25 dihydroxyvitamin D, or 1,25[(OH)₂D]) from circulating precursors 25 hydroxyvitamin D [25(OH)D], has suggested an autocrine role for vitamin D, as well. Preclinical and ecologic studies support a role of vitamin D in prevention of breast cancer. Correlative study results of vitamin D intake or measurement of 25(OH)D, the long-lived precursor, are mixed but suggest a protective effect in premenopausal women. The large Women’s Health Initiative failed to show any reduction in breast cancer incidence in postmenopausal women with a modest amount of vitamin D supplementation. Lack of effect, however, may have been related to trial design. A recent report also suggests that vitamin D may reduce breast cancer recurrence and mortality. Finally, vitamin D is being investigated as a means to reduce aromatase inhibitor-induced joint symptoms.     

Psychosocial Stressors,Social Support and Socio-demographic Variables as Determinants of Quality of Life of Turkish Breast Cancer Patients

Purpose: The aim of the present study was to investigate the effects of psychosocial stressors, social supportand socio-demographic variables on quality of life of breast cancer patients. Tools and methods: The study wasconducted between December 2004 and May 2005 and included 101 patients, treated in the Oncology Departmentsof Ege and Pamukkale University Hospitals and Denizli State Hospital. Patients’ demographic data were collectedby questionnaire. The methods used in the interviews were the Rotterdam Symptom Checklist (RSCL), and theMultidimensional Scale of Perceived Social Support (MSPSS), the Karnofsky Performance Status (KPS).Psychosocial stressors were classified according to life events using the DSM-IV multi-axial diagnostic system.Results: It was found that increase of cancer stage triggers a decrease in psychological quality of life (p<0,05);overall global life quality (p<0,001), perceived social support and performance status (p<0,05), all of these beingnegatively affected by family stressors. The patients with increased social support, better psychological andoverall quality of life (p<0,01) and younger age had more physical wellness besides overall quality of life (p<0,05);lower incomes negatively affected overall global life quality (p<0,01) and working at a job decreased thepsychological stressors (p<0,05). Conclusion: From these results, it can be postulated that psychosocial stressors,social support and some socio-demographic variables mostly affected quality of life of the breast cancer patients.     

血浆同型半胱氨酸与乳腺癌关系的研究进展

血浆同型半胱氨酸(Hcy)是一种致血管损伤性氨基酸.近年来研究表明,乳腺癌患者外周血中同型半胱氨酸水平有异常升高,外周血中高水平同型半胱氨酸可能与乳腺癌的存在有一定的联系,降低血浆同型半胱氨酸或许对乳腺癌的预防具有重要价值.文章主要对此进行综述.     

乳腺癌临床病理特点与ER、PR的关系

目的探讨乳腺癌临床病理特点与雌激素受体(ER)、孕激素受体(PR)表达的关系。方法回顾性分析120例乳腺癌患者的临床病理特点,应用免疫组化Elivision法测定乳腺癌组织中ER、PR的表达,并分析临床病理特点与ER、PR表达的关系。结果乳腺癌多发于31～50岁(41.7%)及51～70岁(47.5%);最常见肿瘤类型为浸润性导管癌(78.3%);45.8%患者确诊时已有淋巴结转移;Ⅰ级浸润性导管癌占8.5%,Ⅱ～Ⅲ级占91.5%;ER、PR阴性表达率分别为47.5%、59.2%。Ⅰ级浸润性导管癌ER、PR的阴性表达率均低于Ⅱ～Ⅲ级浸润性导管癌,但差异无统计学意义(P>0.05)。Ⅰ级浸润性导管癌中无一例有脉管内瘤栓和淋巴结转移,而Ⅱ～Ⅲ级浸润性导管癌中脉管内瘤栓和淋巴结转移率分别为(34.9%)和(58.1%)(P<0.01)。结论乳腺癌中ER、PR阴性表达的比例近50%;ER阴性表达与高组织学分级有关;ER阴性表达、高组织学分级易导致淋巴结转移。     

代谢综合征与乳腺癌关系的研究进展

摘 要：大量流行病学资料以及临床研究已证实代谢综合征与乳腺癌的发生发展和预后密切相关,其影响机制可能涉及胰岛素、胰岛素样生长因子-1、胰岛素抵抗、内源性激素、瘦素、脂联素、炎症因子等多种因子。因此,控制血糖、体重和血脂可能是预防乳腺癌发生和复发转移的有利措施。     

被动吸烟与乳腺癌相关性的荟萃分析

[目的]应用Meta分析探讨被动吸烟与乳腺癌的相关性。[方法]全面检索CHKD、CBM、VIP和Medline等中英文数据库,收集2001～2011年发表的被动吸烟与乳腺癌发病风险的相关文献。应用统计学软件对文献数据进行统计分析。[结果]共11项研究被纳入分析。11项研究存在异质性(Q=32.68,P=0.000),采用随机效应模型进行合并计算,合并RR值为1.23,合并95%CI为1.12～1.40。[结论]被动吸烟是乳腺癌的易感因素,通过各种方法减少被动吸烟,可以有效降低乳腺癌的发病风险。     

Relationship Between Certain Radiographic and Biologic Characteristics in Breast Cancer

The relationship between mammographic appearance of micro-calcifications and tumor stage, malignancy grade, estrogen receptor (ER) content and nuclear DNA pattern was studied in 92 mammary carcinomas. The results indicate that no complementary prognostic guidance can be obtained from the radiographic appearance of a tumor apart from a high probability of a spiculated cancer being ER-rich. The finding of a relatively high proportion of aneuploid and ER-poor carcinomas among tumors with microcalcifications indicates that this radiographic characteristic might be associated with increased growth potential.     

MTA1表达与乳腺癌浸润转移的关系

[目的]探讨转移相关基因1（metastasis assiciated gene 1,MTA1）在乳腺癌浸润与转移中作用。[方法]用逆转录聚合酶链反应（RT—PCR）技术联合Zvmed^TM免疫组化方法分别检测55例乳腺癌、癌旁组织中MTA1mRNA和蛋白表达情况。[结果]MTA1 mRNA在乳腺癌中阳性表达率为52．7％（29／55）．在癌旁乳腺组织的阳性率23．6％（13／55）：两者比较差异有统计学意义（P〈0．05）。MTA1蛋白在乳腺癌组织中阳性表达率为49．1％（27／55）,在癌旁乳腺组织中阳性表达率为16．4％（9／55）：两者比较有统计学差异（P〈0．01）。MTA1在乳腺癌组织中的阳性检出率与临床分期、淋巴结转移数目（〉4）、病理分级和C-erbB-2阳性相关（P〈0．05）,与年龄、ER、PR无明显关系（P〉0．05）。[结论]MTA1对乳腺癌浸润、转移可能有促进作用。有可能成为预测乳腺癌浸润与转移的参考指标。     

Unique Stressors Experienced by Unmarried Women with Breast Cancer

Abstract

Although marital status may be a significant variable in determining adjustment to breast cancer, limited empirical research has addressed the unique challenges of single women with this illness. As part of a study examining decision making about pregnancy after breast cancer, 16 unmarried women participated in in-depth interviews. They described five principal Stressors associated with being an unmarried survivor of breast cancer: pessimism regarding future relationships, fears about disclosing their illness to partners, negative body image and impaired sexuality, pain of rejection by partners, and a sense of isolation and inadequate support. These findings suggest that unmarried women with breast cancer may be a vulnerable subpopulation of women with the disease who may benefit from psychosocial interventions tailored to their particular concerns.     

乳腺癌组织p53蛋白与P-耐药糖蛋白表达水平的关系

目的 :研究p53蛋白表达与P 糖蛋白 (P gp)的关系。方法 :用免疫组织化学法检测 50例乳腺癌组织中p53蛋白及P gp表达。结果 :乳腺癌组织中p53阳性表达率为 6 4 % ,P gp阳性表达率为50 % ;p53阳性组的P gp表达率 (6 5.6 % ,2 1/ 32 )显著高于p53阴性组 (2 2 .2 % ,4 / 18) ,(P <0 .0 0 5) ,p53表达与P gp有关。结论 :p53表达可引起多药耐药基因 (MDR1)编码产物P gp表达增高 ,从而使乳腺癌细胞获得多药耐药 (MDR)表型 ;P gp不能作为评判乳腺癌预后和生物学行为的独立指标。     

乳腺癌患者多西他赛药时曲线下面积与中性粒细胞减少的相关性

目的 研究乳腺癌患者化疗后,多西他赛（docetaxel, DTX）药时曲线下面积（area under curve, AUC）与血液学毒性（中性粒细胞减少）的相关性,为患者个体化给药提供理论依据。方法 选择郑州大学附属肿瘤医院2016年12月—2017年7月接受AC序贯T化疗方案的94例乳腺癌患者,采用胶乳免疫比浊法测定患者静脉输注DTX后的血药浓度,并通过非混合效应模型软件计算多西他赛AUC。建立利用AUC预测化疗后中性粒细胞减少百分比的数学模型。结果 多西他赛AUC在（0.7~3.9）mg·h/L之间,平均值为（2.34±0.7）mg·h/L,患者间AUC的变异系数（CV%）为30%。出现低级别（0~2级）及高级别（3~4）中性粒细胞减少的AUC平均值分别为2.29 mg·h/L和2.82 mg·h/L （P=0.003）。利用多西他赛AUC预测中性粒细胞减少百分比的模型为y=-1.8672x2+25.658x-14.92, r=0.643。结论 本研究建立的利用AUC预测中性粒细胞减少百分比的数学模型,为通过测定患者AUC进行多西他赛个体化的给药提供了理论依据。     

Biology and surgical management of Breast Cancer

The surgical treatment of breast cancer has been a source of controversy. The controversy arises from the differences in physicians' philosophies regarding the biology of breast carcinoma. Traditionally, surgeons have emphasized the potential therapeutic value of regional lymph node dissection, maintaining that adequate loco-regional treatment is of prime concern in patients with localized tumors. On the other hand, medical oncologists have always stressed the systemic nature of cancer. However, breast cancer is a very heterogeneous disease with an enormous range of different biologic characteristics, and new information is continually becoming available on the natural history of breast cancer. Therefore, we should seek a more rational theory based on the clinical evidence which can explain the biologic characteristics of breast cancer. We have proposed a new spectrum hypothesis as follows: (a)tumor cells traverse lymphatics to lymph nodes by direct extension, and there is an orderly pattern in the early stage of lymph node metastases; (b)regional lymph nodes are able to trap tumor cells but are ineffective or incomplete barriers to tumor cell spread; (c)regional lymph nodes have biologic importance, and a positive lymph node is an indicator of a host-tumor relationship that correlates with the subsequent appearance of distant disease; (d)lymphatic and hematogenous dissemination occur not serially, but in a parallel fashion; (e)many palpable invasive breast cancers are a systemic disease, but non-invasive or minimally invasive breast cancers are likely to be a local disease; (f)early detection and treatment of in-breast cancer improves survival, but variations in regional therapy are unlikely to have a major influence on survival.     

Predictors of Psychosocial Adjustment to Breast Cancer

Sixty-seven women treated for breast cancer completed a battery of psychological tests to examine which psychological variables contributed most to several indexes of adjustment. An avoidant style of coping was associated with poorer adjustment on several different indexes, and an active coping style was associated with better adjustment on several indexes. Denial was related to poort adjustment on only one index - orientation ot health care. Day-to-day stresses were an important predictor of both psychological and domestic adjustment. Health locus of control and the stage and duration of cancer were not related to any adjustment indexes.     

COVID-19 Pandemic Stressors and Psychological Symptoms in Breast Cancer Patients

Background. The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its relationship with psychological symptoms (i.e., anxiety, depression, insomnia, fear of cancer recurrence) in breast cancer patients. Methods. Thirty-six women diagnosed with a non-metastatic breast cancer completed the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the COVID-19 Stressors Questionnaire developed by our research team. Participants either completed the questionnaires during (30.6%) or after (69.4%) their chemotherapy treatment. Results. Results revealed that most of the participants (63.9%) have experienced at least one stressor related to the COVID-19 pandemic (one: 27.8%, two: 22.2%, three: 11.1%). The most frequently reported stressor was increased responsibilities at home (33.3%). Higher levels of concerns related to the experienced stressors were significantly correlated with higher levels of anxiety, depressive symptoms, insomnia, and fear of cancer recurrence, rs(32) = 0.36 to 0.59, all ps < 0.05. Conclusions. Cancer patients experience a significant number of stressors related to the COVID-19 pandemic, which are associated with increased psychological symptoms. These results contribute to a better understanding of the psychological consequences of a global pandemic in the context of cancer and they highlight the need to better support patients during such a challenging time.     

新辅助化疗诱导乳腺癌细胞凋亡与化疗疗效关系

[目的]探讨乳腺癌采用CEF方案新辅助化疗肿瘤组织标本中凋亡指数(apopto-sis index,AI)及其与化疗疗效的关系.[方法]确诊乳腺癌58例患者经予3个周期CEF方案新辅助化疗.化疗前后均检测AI值资料完整的42例.凋亡指数测定采用原位细胞末端转移标记法(TUNEL法).[结果]CEF方案化疗有效率为62.1%.化疗后AI值显著降低(P＜0.05).AI变化和术前化疗疗效密切相关(P＜0.05).[结论]化疗后凋亡指数高低可以作为预测新辅助化疗效果的指标.