隆突性皮肤纤维肉瘤的临床病理分析:附28例报告

目的探讨隆突性皮肤纤维肉瘤的临床病理特征。 方法对28例隆突性皮肤纤维肉瘤从临床表现、病理形态及免疫组化等方面进行观察分析。 结果28例隆突性皮肤纤维肉瘤好发于中青年男性,临床多表现为皮肤固定的结节状肿物,手术切除不完全易局部复发。病理组织学表现为梭形细胞排列成典型的车辐状或席纹状。免疫组化所有病例Vimentin及CD34均阳性,S-100均阴性。其中2例局部伴高级别肉瘤转化,转化区域CD34表达减弱或不均匀。 结论CD34有助于DFSP与其他皮肤梭形细胞肿瘤的鉴别,当CD34表达减弱时需注意观察是否局部伴高级别肉瘤转化。       

Sonography of dermatofibrosarcoma protuberans of the groin

Dermatofibrosarcoma protuberans (DFSP) is an uncommon tumor that arises from the dermis of adults. Its malignant potential is considered to be intermediate. Because the diagnosis of DFSP can frequently be suspected on the basis of physical examination reports on its sonographic appearance are rare. We report a case that highlights the value of sonography in assessing the subcutaneous extent of DFSP.     

隆突性皮肤纤维肉瘤36例临床病理分析

目的：提高对隆突性皮肤纤维肉瘤（DFSP）组织变异的认识。方法：对36例DFSP临床病理资料总结分析及随访，其中13例加做免疫组化标记。结果：36例DFSP的组织形态均有经典的车辐状或席纹状结构，其中6例伴有纤维肉瘤区域、3例伴有黏液样区域、2例瘤细胞含有黑色素、1例可见肌样结节和肌样束。作免疫标记的13例DFSP瘤细胞CD34、VIM均阳性。结论：掌握DFSP各亚型组织形态变异的特点，并辅以CD34标记，有助DFSP的诊断及鉴别诊断。     

手术结合放疗治疗隆突性皮肤纤维肉瘤

目的评价手术结合放疗治疗隆突性皮肤纤维肉瘤的临床疗效。方法42例隆突性皮肤纤维肉瘤患者分成两组,A组（22例）行肿瘤广泛切除联合术后辅助放疗;B组（20例）为对照组,仅行肿瘤广泛切除。所有患者在切除前先行切开活栓证实为隆突性皮肤纤维肉瘤。结果术后随访2～10年,42例均未见有远处转移,无死亡;局部复发率A组为4．54％,B组为35．00％。结论广泛切除结合术后放疗是治疗隆突性皮肤纤维肉瘤理想的治疗方法,可减少肿瘤术后的复发。     

隆突性皮肤纤维肉瘤病理诊断及预后的探讨

目的 探讨隆突性皮肤纤维肉瘤（DFSP）的病理诊断及临床病理参数，增殖细胞核抗原（PCNA）表达与预后的关系。方法 应用免疫组化方法对51例隆突性皮肤纤维肉瘤CD34、PCNA的表达进行检测。并结合病理形态学观察和随访分析。结果 所有DFSP均表达CD34，组织分级，浸润深度、局部切除范围与DFSP复合率显著相关，PCNA计数标记指数平均为41.7%，PCNA高表达组复发率显著高于PCNA低表达组。结论 CD34可作为DFSP与纤维肉瘤特异的鉴别诊断指标。组织分级，浸润深度及PCNA表达可作为判断DFSP预后的指标。扩大切除范围有助于减少复发。     

88例隆突性皮肤纤维肉瘤的临床病理及免疫组化研究

对88例隆突性皮肤纤维肉瘤(DFSP)进行了临床病理及免疫组化研究。结果显示DFSP好发于30～49岁之间;多数发生于躯干和四肢近端;位于真皮,但可浸润深部组织;病程长,生长缓慢,预后较好,但手术后易复发。肿瘤呈索条状浸润,手术不易彻底切净是其易复发的主要原因。初步将DFSP分为四型:普通型、粘液型、色素型和纤维肉瘤型。并对分型标准和意义进行了讨论。免疫组化结果提示DFSP可向神经方向分化。     

隆突性皮肤纤维肉瘤的CT及MRI表现

目的 探讨隆突性皮肤纤维肉瘤（DFSP）的CT及MRI征象。方法 回顾分析16例经手术病理结果证实的DFSP的影像资料（11例接受CT检查,5例接受MR检查）,分析肿瘤的形态、CT及MRI特征。结果 DFSP多发于躯干及头颈部皮肤,呈不同程度隆起于皮肤表面,部分悬吊于皮外。16例中,结节肿块型12例、弥漫型4例。CT上肿块呈与肌肉等密度或稍低密度的实性占位,MRI上T1WI呈等/低信号,T2WI为稍高信号。肿瘤血供较丰富,增强扫描多呈渐进性中度至明显强化。病灶内征象包括"悬吊征"2例,"皮肤尾征" 6例, "筋膜尾征" 1例,"脂肪尾征"4例。结论 DFSP多表现为皮肤及皮下结节肿块型或弥漫生长型实性病变,不同形态其征象不同,但仍具有一定的特征性。     

Risk factors related to postoperative recurrence of dermatofibrosarcoma protuberans: A retrospective study and literature review

BACKGROUNDDermatofibrosarcoma protuberans (DFSP) is a rare low-grade malignant soft tissue tumor characterized by rosette-like infiltrative growth. Postoperative recurrence of this tumor is very common. AIMTo evaluate the risk factors related to recurrence after wide local excision (WLE) of DFSP and to guide clinical diagnosis and treatment.METHODSThe medical records of 44 DFSP patients confirmed by pathology at our hospital from 2012 to 2019 were retrospectively reviewed. The relationship between clinical features, tumor characteristics, treatment, and recurrence risk were analyzed, and the possible risk factors for postoperative tumor recurrence were evaluated.RESULTSThere were 44 patients in total, including 21 males and 23 females. The median progression free survival was 36 mo (range, 1-240 mo). Twenty patients were treated for the first time, while 24 had previous treatment experience. Forty-two cases were followed for 25.76 ± 22.0 mo, among whom four (9.52%) experienced recurrence after WLE (rate was 9.52%). The recurrence rate in the recurrent group was higher than that in the patients with primary tumor (19.05% vs 0%, P = 0.028). Eighteen cases had a history of misdiagnosis (rate was 40.91%). The recurrence rate among patients with previous experience of misdiagnosis was significantly higher than in patients without (68% vs 36.84%, P = 0.04). The tumor diameter in patients with a history of treatment was larger than in patients treated for the first time (4.75 ± 0.70 cm vs 2.25 ± 0.36 cm, P = 0.004). CONCLUSIONTo sum up, the clinical manifestations of DFSP are not specific and are easily misdiagnosed, thus commonly causing the recurrence of DFSP. After incomplete resection, the tumor may rapidly grow. Previous recurrence history may be a risk factor for postoperative recurrence, and tumor location may have an indirect effect on postoperative recurrence; however, we found no significant correlation between sex, age, course of the disease, or tumor size and postoperative recurrence.     

Breast involvement in visceral leishmaniasis

Visceral leishmaniasis usually involves the bone marrow, lymph nodes, liver and spleen. Involvement of the eye or respiratory or gastrointestinal systems is very rare and usually occurs in immunodepressed patients. Only one case of breast involvement by protozoa has been reported in the literature. We report a case of a visceral leishmaniasis with a solid breast mass caused by leishmania and diagnosed by sonography‐guided core biopsy. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009     

隆突性皮肤纤维肉瘤的MRI表现

目的：探讨隆突性皮肤纤维肉瘤的MRI表现。方法：回顾性分析经手术病理证实的隆突性皮肤纤维肉瘤6例。男5例,女1例,年龄21~76岁（平均56岁）。6例均行MRI检查,增强扫描4例。结果：6例均为单发,躯干和四肢皮下各3例;4例表现为边界清楚的类圆形或椭圆形软组织肿块;2例表现为边界欠清的分叶状或不规则软组织肿块。与肌肉信号相比,T1WI表现为等（n=3）或稍高信号（n=3）,T2WI脂肪抑制序列上均表现为略不均匀的高信号,其内可见少许条片状的稍低信号。Gd-DTPA增强扫描病灶均明显强化,4例内部可见不规则弱强化区。结论：隆突性皮肤纤维肉瘤MRI表现有一定的特征;MRI对病灶的术前评估及术后复发的检测有重要的价值。     

Immunohistochemical expression of MAP1LC3A and MAP1LC3B protein in breast carcinoma tissues

Autophagy is a protein degradation process within the cell and its deregulation has been linked to various diseases and the formation of cancer. One of the important proteins involved in the autophagy process is microtubule‐associated protein 1 light chain 3 (MAP1LC3). The aims of this study were to determine the MAP1LC3A and MAP1LC3B protein expression in both normal and cancer breast tissues and to determine the relationship between the expression of these proteins and type of tissues. Immunohistochemistry assessments were carried out on tissue microarrays consisting of breast tissues. MAP1LC3A expression was detected in 52/56 of normal breast tissue cores and 65/67 of breast cancer tissue cores. MAP1LC3B expression was detected in 55/56 of normal breast tissue cores and 67/67 of breast cancer tissue cores. MAP1LC3A and MAP1LC3B protein are expressed in the majority of normal and cancer breast tissues. A large number of MAP1LC3A and MAP1LC3B positive breast cancer tissues cores have high proportion of stained cells (81–100%) as compared with normal breast tissues. However, a significantly higher number of breast cancer tissues were found to express the MAP1LC3A protein with strong immunoreactivity as compared with the normal tissues, suggesting that MAP1LC3A may play a role in breast cancer development. J. Clin. Lab. Anal. 23:249–258, 2009. © 2009 Wiley‐Liss, Inc.     

An Improved Process for Breast Cancer Margin Identification and Orientation

Breast conservation surgery has improved treatment for women faced with a diagnosis of breast cancer. A key factor in breast cancer surgery is the assurance of clear surgical margins. Inadequate or unclear margins prompt the need for re-excision, which can be physically and emotionally stressful for patients.A variety of techniques have been used to indicate margins intraoperatively, but the use of arbitrary methods can contribute to miscommunication between the OR and the radiology and pathology departments. A standardized process to identify surgical margins using radiopaque charms has improved communication and outcomes for patients undergoing breast cancer surgery at one facility. AORN J 90 (October 2009) 525-529. © AORN, Inc, 2009.     

三阴性乳腺癌中VEGF-C表达与淋巴管密度的相关性研究

目的 研究三阴性(雌激素受体、孕激素受体、人表皮生长因子受体2均阴性)乳腺癌淋巴管内皮生长因子(VEGF-C)表达情况和与淋巴管密度的关系.方法 105例乳腺癌标本.其中三阴性乳腺癌42例,非三阴性乳腺癌标本63例,应用免疫组化方法检测标本的VEGF-C表达情况及应用D2-40标记检测淋巴管密度.结果 VEGF-C在三阴性乳腺癌高表达64.2%,与淋巴结有无转移、淋巴管密度、肿瘤大小、临床分期相关(P<0.05),而与年龄、病理类型无关(P<0.05);VEGF-C在三阴性和非三阴性乳腺癌表达分别为64.2%和33.3%,差异有显著性(P<0.05).结论 VEGF-C在三阴性乳腺癌中高表达与淋巴管生成和肿瘤演进相关.     

Self-transformation as a factor in the self-esteem and well-being of breast cancer survivors

Diagnosis with a life-threatening illness can lead to many changes in one's self. These changes, called self-transformation, are not well understood. The present study used triangulation of methods and measures to (i) describe individual differences in self-transformation among breast cancer survivors, (ii) examine factors associated with self-transformation in breast cancer survivors, and (iii) examine the relationships between self-transformation and self-esteem and well-being in breast cancer survivors and age-matched comparison women without cancer. Cancer survivors (n = 60) participated in structured interviews and both survivors and comparison women (n = 60) completed a set of questionnaires. Narrative analysis revealed three categories of transformation among breast cancer survivors: positive transformation, minimal transformation and feeling stuck. These groups differed by age, marital status and income, but not by disease or treatment variables. Breast cancer survivors in the positive transformation group had significantly higher self-esteem and well-being in comparison with (i) survivors grouped as feeling stuck and (ii) age-matched counterparts without cancer. Cancer survivors who reported feeling stuck had significantly lower self-esteem and well-being than the other groups of survivors and lower well-being in comparison with healthy women of the same age. Findings provide support for the concept of self-transformation and a new understanding of disease, demographic and treatment factors associated with the concept. Findings also suggest that self-transformation may be a factor in the self-esteem and well-being of breast cancer survivors.     

带蒂横行腹直肌皮瓣在复发性乳腺癌再次手术中的应用

目的研究带蒂TRAM（Transverse rectus abdominalis musculocutaneous flap,TRAM）皮瓣在复发性乳腺癌再次手术中的应用、临床效果及其常见并发症。方法2001年7月至2009年7月从我院乳腺外科选择8例患者,在复发性乳腺癌再次手术应用带蒂TRAM皮瓣技术修复手术创面。术中均用聚丙烯补片修补腹壁缺损。结果8例患者再手术皮瓣成活,其中有1例患者出现转移皮瓣的感染,治疗后愈合。结论复发性乳腺癌再次手术后应用带蒂TRAM皮瓣修复创面是一种安全有效的治疗方法。     

社会营销模式在乳腺癌早诊早治中的应用

目的探讨社会营销模式在乳腺癌早诊早治中的应用效果。方法制订营销计划,确定目标人群,借鉴市场营销策略,对目标人群宣讲,同时推出促销项目。结果目标人群乳房保健知识和乳腺癌防治知识的知晓率明显提高,参与早期乳腺癌筛查的积极性明显提高,2010年3月至9月参加早期乳腺癌筛查1 503人次,比2009年同期816人次明显增加。结论将社会营销模式用于乳腺癌早诊早治中,可以提高目标人群参加早期乳腺癌筛查的积极性,从而使乳腺癌患者得到早期治疗。     

广东省江门市区妇女乳腺疾病调查及相关风险因素分析

目的 探讨广东省江门市区妇女乳腺疾病发生的相关风险因素,为乳腺疾病的防治提供参考依据。 方法 2009年5月至2010年12月对江门市区12 365名妇女进行乳腺疾病筛查。 结果 江门市区妇女乳腺疾病的患病率达34.51%,乳腺癌检出率为150/10万。高学历、痛经、饮酒、乳腺自检与乳腺疾病呈正相关(OR值分别为1.10、1.15、1.35、1.12),初潮年龄晚、月经周期长、绝经与乳腺疾病呈负相关(OR值分别为0.96、0.99、0.62)。 结论 育龄妇女是乳腺疾病重点防治对象。乳腺疾病筛查应作为妇女保健工作的重点,妇女应适时婚育、合理膳食、学习乳腺自我检查、提高自我保健意识。     

沈阳市城区2000-2009年女性乳腺癌发病趋势分析

目的探讨2000～2009年沈阳市城区女性乳腺癌发病率、年龄分布及变化趋势。方法收集2000～2009年沈阳市疾控中心肿瘤登记报告系统登记的女性乳腺癌发病资料,采用SPSS16．0软件对乳腺癌发病率、标化发病率进行分析。发病趋势采用r趋势检验和线性回归分析。结果2000～2009年沈阳市城区女性乳腺癌年均粗发病率46．03／10万,年均标化发病率35．63／10万,10年间上升了160．41％和109．39％,平均每年递增11．22％和8．56％。粗发病率和标化发病率均呈上升趋势,差异有统计学意义（P〈0．001）。50。64岁年龄组发病率呈直线上升趋势,10年上升271．97％,平均每年递增15．72％。经矿趋势检验及线性回归分析,差异均有统计学意义（x^2=276．743,P=O．000;y=-22355．560＋11．205x,P=0．000）。结论沈阳市城区女性乳腺癌发病率呈上升趋势,并且有发病低龄化,50～64岁年龄组较多发的特点。     

高频及彩色多普勒超声对乳腺肿块的诊断价值分析（附80例报告）

目的：评价高频及彩色多普勒血流成像对乳腺肿块的诊断价值。材料与方法：本文重点对2008年~2009年80例乳腺肿块患者的超声表现进行回顾分析。结果：超声诊断乳腺肿块的显示率为100%,诊断符合率为92.5%（74/80）,其中良性肿块符合率为94.1%（64/68）,恶性肿块符合率为83.3（10/12）。结论：超声诊断乳腺肿块以二维图像为基础,密切观察乳腺肿块内血流,同时结合临床病史,诊断正确率高,可作为首选方法,并可作为乳腺癌普查的首选方法。