Hormone Receptor Expression and Clinicopathologic Features in Male and Female Breast Cancer

Background: Male and female breast cancers were investigated for variation in the clinicopathologiccharacteristics and expression of steroid hormone receptors in the northeast of Iran. Materials and Methods:Tumor specimens of 17 males and 338 females with breast cancer were collected at the hospitals of MashhadUniversity of Medical Sciences. Immunohistochemical expression of hormone receptors and clinicopathologicfeatures of breast cancer were compared between two groups. Results: The mean age in men was 15 years higherthan women (p=0.000). Males and females were mainly in stage II and III respectively (p=0.007). Although morethan 60% of male and female patients were grade II, the respective figures for grade I and III were 25% and12.5% in men but 7.1% and 27.2% in women respectively (p=0.025). ER was significantly more positive in menagainst women; 82.3% versus 53.4% (p=0.016). The related measures for PR was 58.8% and 50.3%, respectively(p=0.424). Males also showed significantly more ER expression than postmenopausal females; 82.3% versus48.9% (p=0.010). Conclusions: Breast cancer in males and females contrasted in age at diagnosis, histologicaltype, stage, grade and ER expression which emphasize they are separate diseases with different behaviors.     

乳腺浸润性导管癌中Clusterin蛋白表达及其与临床病理特征的关系

[目的]探讨细胞凋亡抑制因子Clusterin在乳腺浸润性导管癌组织中的表达及其与临床病理因素的关系。[方法]应用免疫组化SP法检测70例乳腺浸润性导管癌、20例乳腺增生和10例乳腺癌旁组织标本中Clusterin的表达情况。[结果]Clusterin在乳腺癌旁正常组织、乳腺增生及乳腺浸润性导管癌组织中的阳性表达率分别为0、20.0%及71.4%,乳腺浸润性导管癌组织中的Clusterin表达水平明显高于乳腺增生及乳腺癌旁正常组织(P<0.05)。Clusterin蛋白在乳腺浸润性导管癌中的表达与临床分期、组织学分级及淋巴结转移情况有关(P<0.05),而与患者年龄、肿瘤大小无关(P>0.05)。在乳腺浸润性导管癌组织中Clusterin与ER、PR的表达呈负相关(P<0.05)。[结论]Clusterin可能在乳腺癌的发生发展中发挥重要促进作用,可望成为乳腺浸润性导管癌诊断中的标志物及新的治疗靶点。     

三阴型乳腺癌159例临床病理特征分析

目的探讨三阴型乳腺癌的临床病理特征。方法选取2003年3月～2003年11月手术切除并经病理检查证实的女性原发性乳腺癌747例。根据ER、PR、Her-2免疫组织化学表达情况,将747例乳腺癌分为2组,即ER、PR、Her-2蛋白均为阴性的三阴型乳腺癌和非三阴型乳腺癌。比较2组乳腺癌的临床病理特征。结果 747例乳腺癌病例中,159例为三阴型乳腺癌[ER（-）、PR（-）、Her-2（-）],占21.3%。2组乳腺癌在组织学分级上差异有统计学意义（P〈0.05）,三阴型组的组织学Ⅲ级占比高于非三阴型组。三阴型乳腺癌复发转移率高于非三阴型乳腺癌,但无统计学差异（P=0.236）。结论三阴型乳腺癌较非三阴型乳腺癌病理恶性程度高,预后更差。     

三阴型乳腺癌临床病理特征及预后分析

目的：分析三阴型乳腺癌的临床病理特征及其预后。方法：选取2002年1月-2002年6月天津医科大学附属肿瘤医院收治的可手术乳腺癌509例，进行免疫组织化学法测定Her-2、ER、PR蛋白表达并分为两组，一组为三阴型（Triple-Negative）即Her-2（-），ER（-），PR（-），另一组为非三阴型乳腺癌。比较三阴型和非三阴型乳腺癌的临床病理特征，Kaplan-Meier法分析两组乳腺癌的5年无瘤生存率。结果：21.4％（109／509）的病例为三阴型乳腺癌，其髓样癌、组织学Ⅲ级的比例以及复发转移率高于非三阴型乳腺癌（P〈0.05）。三阴型乳腺癌和非三阴型乳腺癌5年无瘤生存率分别为78.9％和87.3％，两组比较差异具有统计学意义（P=0.031）。结论：三阴型乳腺癌比非三阴型乳腺癌易发生局部复发和远处转移，临床预后差。     

乳腺癌层粘连蛋白表达的临床病理分析

本文观察乳腺疾病（良性１０例、恶性８２例），以免疫组化ＰＡＰ法，应用层粘连蛋白抗体对基膜的表达。结果发现乳腺良性病变多有连续线状基膜表达，乳腺癌组织内低分化癌癌团缺乏基膜表达，而高分化癌灶处基膜呈菲薄连续或间断线状表达。指示层粘连蛋白的多寡，将与肿瘤细胞分化和侵袭力强弱有关。     

HER2低表达对早期乳腺癌预后的影响分析

摘 要： ［目的］ 比较早期乳腺癌中不同人表皮生长因子受体2(human epidermal growth factor receptor 2，HER2)蛋白表达患者的临床病理特征及预后的差异性。［方法］ 收集2010年6月至2019年6月内蒙古医科大学附属医院甲状腺乳腺外科收治的792例Ⅰ~Ⅱ期乳腺癌患者的临床病理资料，入组患者根据HER2蛋白表达水平分为HER2不表达301例、HER2低表达309例、HER2阳性182例三组，回顾性分析不同HER2亚组患者临床病理特征及预后的差异性。［结果］ HER2低表达患者主要以Luminal A型为主，三阴性乳腺癌（triple-negative breast cancer，TNBC）所占比例较低。与HER2不表达患者相比，HER2低表达患者腋窝淋巴结阳性、脉管癌栓及激素受体（hormone receptor，HR）阳性所占比例较高，浸润性小叶癌、组织学分级以及Ki-67高表达所占比例较低。共随访792例患者，中位随访时间为56个月，HER2阳性、HER2低表达、HER2不表达患者5年无病生存率（disease free survival，DFS）分别为85.7%、92.9%、91.3%（?字2＝8.268，P＝0.016），5年总生存率（overall survival，OS）分别为92.8%、97.4%、96.8%（?字2＝15.809，P<0.001），按HR状态分层分析后5年DFS差异也无统计学意义。［结论］ 虽然HER2低表达乳腺癌具有独特的临床病理特征，但并未导致HER2低表达和HER2不表达乳腺癌预后差异。研究结果支持HER2低表达乳腺癌作为独立的生物学亚型。     

三阴性乳腺癌临床病理特征及与药物敏感度蛋白的相关性

目的 比较三阴性乳腺癌与非三阴性乳腺癌患者的临床病理特征和药物敏感度蛋白相关性研究,分析对临床预后判断的意义。方法 回顾性分析本院2010年1月至2012年10月初诊为乳腺癌的患者共227例,三阴性乳腺癌患者51例,非三阴性乳腺癌患者176例,统计分析两者临床病理学特征及药物敏感度蛋白表达的差异性。结果 在临床特征方面,三阴性乳腺癌患者中绝经前发病率为60.8%,高于非三阴性乳腺癌的35.8%,差异有统计学意义（P＜0.05）;组织学Ⅱ级以上者64.7%,非三阴性乳腺癌组为40.9%,差异有统计学意义（P＜0.05）;在肿瘤大小、淋巴结是否转移、临床分期上两组相比差异并无统计学意义（P＞0.05）。三阴性乳腺癌患者的TOPOⅡ低表达、β-tubulin Ⅲ高表达、ERCC1低表达、BRCA1和ERCC1共同低水平表达,与非三阴性乳腺癌相比差异均有统计学意义（P＜0.05）,而Ki67与BRCA1两组相比差异无统计学意义（P＞0.05）。结论 与非三阴性乳腺癌相比,三阴性乳腺癌?患者具有在绝经前发病、组织分级较高等高危特点;TOPOⅡ低表达、β-tubulin Ⅲ高表达、ERCC1低表达以及BRCA1和ERCC1共同低水平表达与其临床预后及对药物敏感度有一定相关性,提示在临床预防、治疗和预后中可能有一定的指导意义。     

AR在不同ER状态乳腺癌中的表达及临床病理意义

  目的  探讨雄激素受体（AR）在不同雌激素受体（ER）状态乳腺癌中的表达与临床病理特征间的关系及预后。  方法  从乳腺浸润性导管癌ER阳性和阴性病例中分别随机选取111例（ER+组）与113例（ER-组）,共计224例。采用免疫组化方法检测AR、ER、PR、HER-2、Ki-67、P53表达,对不同ER状态乳腺癌中AR表达与临床病理资料及预后因素进行分析。  结果  AR在浸润性导管癌中的阳性表达率为67.9%（152/224）,ER+组和ER-组分别为80.2%（89/111）、55.8%（63/113）。ER+组中AR的表达与肿瘤大小、组织学分级、pTNM分期和有无淋巴结转移相关（P < 0.05）;在ER-组中AR的表达与组织学分级、HER-2表达、绝经状态相关（P < 0.05）。单因素生存分析显示在ER+组和ER-组AR阳性者均具有较好的预后（P < 0.001,P=0.046）,Cox多因素回归分析显示在ER+组AR表达可作为影响无瘤生存的独立因素。  结论  AR可以作为指导临床内分泌治疗新的靶标,为不同ER状态乳腺癌激素治疗提供依据。      

Clinicopathologic Implications of EpCAM and Sox2 Expression in Breast Cancer

BackgroundThe purpose of this study was to investigate the clinicopathologic significance of EpCAM and Sox2 expression in breast cancer and to study their correlation during breast cancer progression.Patients and MethodsEpCAm and Sox2 expression were assessed using immunohistochemistry in ductal carcinoma insitu (DCIS), invasive breast cancer (IBC) and matched lymph node metastasis (LNM), if present.ResultsEpCAM overexpression was found in 63.2% of DCIS, 72.2% of IBC and 74.4% of LNM. In IBC cases, EpCAM overexpression was associated with high grade (P < .001), large tumor size (P = .051), poor Nottingham Prognostic Index (NPI) (P = .006), histological tumor types (P = .044) and the triple negative phenotype (P = .008). LNM frequently reflected the expression phenotype of the matched primary tumors with no significant differences between LNM and their primary tumors (P = .564). Sox2 expression was detected in 47.4%, 33.3% and 54.7% of DCIS, IBC and LNM respectively. In DCIS group, Sox2 expression was significantly associated with comedo type (P = .037), negative ER (P = .012) and PR (P = .037) and the triple negative phenotype (P = .006). In IBC cases, Sox2 expression showed significant associations with high grade (P = .045), nodal spread (P = .037), poor NPI (P = .018) and the triple negative phenotype (P < .001). LNM showed significantly higher Sox2 expression rates than primary tumors (P < .001). Significant positive associations between EpCAM overexpression and Sox2 positivity in DCIS (P = .027), IBC (P = .001) and LNM (P < .001) were found.ConclusionThis study emphasized the potential role of EpCAM and Sox2 in breast carcinogenesis and revealed their involvement during breast cancer progression and LN metastases.     

Association of Vitamin D Level with Clinicopathological Features in Breast Cancer

A population-based relationship between low vitamin D status and increased cancer risk is now generallyaccepted. However there were only few studies reported on prognostic impact. To determine the effect of lowvitamin D on progression of breast cancer, we conducted a cross-sectional analysis of vitamin D levels and clinicopathologicalcharacteristics in 200 cases of breast cancer diagnosed during 2011-2012 at the National CancerInstitute of Thailand. Vitamin D levels were measured by high-performance liquid chromatography (HPLC). Clinical and pathological data were accessed to examine prognostic effects of vitamin D. We found that themean vitamin D level was 23.0±6.61 ng/ml. High vitamin D levels (≥32 ng/ml) were detected in 7% of patients,. low levels (<32 ng/ml) in 93% Mean vitamin D levels for stages 1-4 were 26.1±6.35, 22.3±6.34, 22.2±6.46 and21.3±5.42 ng/ml respectively (P=0.016) and 24.1 and 21.3 ng/ml for lymph node negative and positive cases(P=0.006). Low vitamin D level (<32 ng/ml) was significantly found in majority of cases with advanced stage ofthe disease (P=0.036), positive node involvement (P=0.030) and large tumors (P=0.038). Our findings suggestthat low and decreased level of vitamin D might correlate with progression and metastasis of breast cancer.     

青年乳腺癌的临床病理特点分析

目的探讨年轻女性乳腺癌的临床病理特点,为年轻女性乳腺癌的诊断治疗提供依据。方法对病理组织学确诊的年轻(≤35岁)乳腺癌患者73例及老年(≥60岁)女性乳腺癌患者510例的临床病理资料进行分析比较。结果 2组乳腺癌患者均以浸润性导管癌为主,年轻组患者组织学分级、淋巴结转移、脉管侵犯均较老年组高,而ER、PR表达率较老年组低(P<0.05)。结论年轻女性乳腺癌较老年女性乳腺癌侵袭性强,腋窝淋巴结转移率高,预后不良。     

Mel-18在前列腺癌中的临床意义

目的研究前列腺癌组织中Mel-18蛋白的表达,探讨Mel-18蛋白与前列腺癌临床病理特征及预后的相关性,了解其能否成为前列腺癌生物学行为及预后的指标。方法对202例前列腺癌患者的前列腺癌标本进行免疫组织化学染色分析。运用SPSS15.0统计软件的Logistic回归、Kaplan-Meier曲线、Cox多因素回归等模块分析Mel-18蛋白与临床资料的关系。结果高Gleason评分的癌组织较低Gleason评分的癌组织染色强度降低。各组间染色分析结果表明：PSA≥100.1组较其它PSA组别染色阳性率减少（P=0.010）;T2N0M0组较其它分期组别染色阳性率增多（P=0.021）;Gleason评分8～10组较Gleason评分5～6组染色阳性率降低（P=0.031）;Gleason评分9,10组较Gleason评分5～8染色阳性率降低（P=0.026）。运用多变量Cox成比例危险因子模型（multivariate cox proportional hazards model）分析表明：阴性Mel-18的染色结果是伴生化复发或前列腺癌特异性生存的独立预测因素（OR：2.143,95%CI：1.035～4.132;OR：2.3659,5%CI：1.194～5.485）。结论免疫组织化学证实了Mel-18表达在高分级前列腺癌中较低分级前列腺癌中显著降低,与前列腺癌进展呈负相关,可能发挥着抑制前列腺癌进展的作用。     

大肠癌中DPC4蛋白表达及与临床病理特征的关系

[目的]介绍一种新的用于患者电子线放射治疗模拟射野制作挡铅的医疗简易器械,并对该器械进行验证分析。[方法]对模拟机和简易电子线模拟仪画出的射野进行对比。[结果]模拟机与简易电子线模拟仪勾画出的挡铅形状在4个不同方向的X1、X2、Y1、Y2结果一致（P〉O．05）。模拟机组完成挡铅形状勾画的时间为14．28±1．13min,而简易模拟机组完成挡铅形状勾画的时间为7．86±0．58min,两组相比有统计学差异（P〈O．001）。[结论]简易电子线模拟仪不但能够保证挡铅制作质量．而且相对于模拟机更为操作简单,省时省力,值得推广。     

大肠癌中DPC4蛋白表达及与临床病理特征的关系

[目的]探讨大肠癌组织中DPC4蛋白的表达及其与患者临床病理特征的关系.[方法]免疫组化Elivison二步法检测60例大肠癌手术切除标本中DPC4蛋白的表达,并探讨其与患者组织学类型、浸润深度、淋巴结转移和远处转移等临床病理特征的关系.并取40例癌旁正常大肠组织作对照.[结果] DPC4蛋白主要在大肠癌和癌旁正常大肠组织的胞浆表达,呈棕黄色细颗粒.60例大肠癌标本中DPC4的阳性表达为21例(35.0％),其中强阳性为4例(6.7％).40例癌旁正常大肠组织中DPC4蛋白表达均为阳性,其中强阳性34例(85.0％).大肠癌组织中DPC4蛋白阳性表达率明显低于癌旁正常大肠组织(x2=42.62,P＜0.01).大肠癌组织中DPC4蛋白表达水平随组织分化程度的增加而增加(P＜0.01),随原发病灶的浸润深度增加、淋巴结转移和远处转移的出现而下降(P＜0.01).[结论]且DPC4蛋白表达降低或缺失在大肠癌的发生发展过程起重要作用,有望成为大肠癌基因诊断和治疗的新靶点.     

176例乳腺癌数字化摄影的X线征象与临床病理关系的探讨

目的:探讨乳腺癌X线特点与临床、病理的关系。方法:将176患者的病灶特点,与临床资料、病理类型、腋淋巴结转移对照。结果:以单纯钙化为表现的乳腺癌多为年轻患者,50岁以下占84.4%;以钙化合并肿块者多为老年患者。导管内癌和导管内癌早期浸润的乳腺癌X线表现多为单纯钙化。以钙化合并毛刺样肿块为表现的乳腺癌具有较高的腋淋巴结转移率;以单纯蠕虫样钙化、单纯毛刺样肿块及单纯非蠕虫样钙化为表现者,腋淋巴结转移率亦较高。单纯蠕虫样钙化伴腋淋巴结转移4～9枚占75.0%(6/8);钙化合并毛刺样肿块者,腋淋巴结转移4～9枚占27.8%(10/36),10枚以上占16.7%(6/36)。结论:单纯钙化多见于年轻患者,多为早期乳腺癌。蠕虫样钙化、毛刺样肿块与腋淋巴结转移阳性关系密切,是预后不良的指标。     

Clinicopathologic Features Predicting Involvement of Nonsentinel Axillary Lymph Nodes in Iranian Women with Breast Cancer

Background: Almost half of the breast cancer patients with positive sentinel lymph nodes have no additional disease in the remaining axillary lymph nodes. This group of patients do not benefit from complete axillary lymph node dissection. This study was designed to assess the clinicopathologic factors that predict non-sentinel lymph node metastasis in Iranian breast cancer patients with positive sentinel lymph nodes. Materials and Methods: The records of patients who underwent sentinel lymph node biopsy, between 2003 and 2012, were reviewed. Patients with at least one positive sentinel lymph node who underwent completion axillary lymph node dissection were enrolled in the present study. Demographic and clinicopathologic characteristics including age, primary tumor size, histological and nuclear grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and number of harvested lymph nodes, were evaluated. Results: The data of 167 patients were analyzed. A total of 92 (55.1%) had non-sentinel lymph node metastasis. Univariate analysis of data revealed that age, primary tumor size, histological grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio, wereassociated with non-sentinel lymph node metastasis. After logistic regression analysis, age (OR=0.13; 95% CI, 0.02-0.8), primary tumor size (OR=7.7; 95% CI, 1.4-42.2), lymphovascular invasion (OR=19.4; 95% CI, 1.4-268.6), extracapsular invasion (OR=13.3; 95% CI, 2.3-76), and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio (OR=20.2; 95% CI, 3.4-121.9), were significantly associated with non-sentinel lymph node metastasis. Conclusions: According to this study, age, primary tumor size, lymphovascular invasion, extracapsular invasion, and the ratio of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes, were found to be independent predictors of non-sentinel lymph node metastasis.     

超声显像特征与乳腺癌组织中HER-2表达的关系研究

目的分析乳腺癌中超声显像特征与乳腺癌组织HER-2表达的关系。方法回顾性分析女性乳腺癌患者共84例,收集其术前检查的超声显像特征,并收集其病理结果中免疫组化法检测的HER-2表达的结果,分析超声显像特征与乳腺癌组织HER-2表达的关系。结果 84例女性乳腺癌患者中,其中HER-2表达为阴性的共21例,弱阳性共26例,阳性29例,强阳性的8例,其中低表达56. 0%,高表达44%,超声特征中乳腺癌的HER-2表达水平与肿瘤大小、内部钙化呈显著相关性(P <0. 05),而乳腺癌的HER-2表达水平与边缘情况、肿瘤形状、肿瘤纵横比、内部回声、后方回声衰减和血供分级没有显著的相关性(P> 0. 05)。结论超声特征中乳腺癌的HER-2表达水平与肿瘤大小和内部钙化具有密切的关系。     

CYP3A4 Expression in Breast Cancer and its Association with Risk Factors in Mexican Women

Background: In Mexico, breast cancer (BCa) is the leading type of cancer in women. Cytochrome P450(CYP450) is a superfamily of major oxidative enzymes that metabolize carcinogens and many antineoplasticdrugs. In addition, these enzymes have influence on tumor development and tumor response to therapy. Inthis report, we analyzed the protein expression in patients with BCa and in healthy women. Links with someclinic-pathological characteristic were also assessed. Materials and Methods: Immunohistochemical analyseswere conducted on 48 sets of human breast tumors and normal breast tissues enrolled in Hospital Militar deEspecialidades de la Mujer y Neonatologia and Hospital Central Militar, respectively, during the time periodfrom 2010 to 2011. Informed consent was obtained from all participants. Statistical analysis was performed usingχ2 or Fisher exact tests to estimate associations and the Mann Whitney U test for comparison of group means.Results: We found a significant CYP3A4 overexpression in BCa stroma and gland regions in comparison withhealthy tissue. A significant association between protein expression with smoking, alcoholism and hormonalcontraceptives use was also observed. Additionally, we observed estrogen receptor (ER) and progesterone receptor(PR) positive association in BCa. Conclusions: We suggest that CYP3A4 expression promotes BCa developmentand can be used in the prediction of tumor response to different treatments. One therapeutic approach may thusbe to block CYP3A4 function.     

MUC1与HER2基因在乳腺癌中的表达及其与临床病理学指标的相关性研究

目的:检测粘蛋白1(mucin1,MUC1)和人类表皮生长因子2(Human epidermal growth factor receptor2,HER2)在乳腺癌组织中的表达,研究其与临床、病理学因子的关系及MUC1与HER2的相关性。方法:应用免疫组化SP法检测111例乳腺癌组织,37例良性乳腺肿瘤和26例癌旁正常组织中MUC1和HER2的表达情况。结果:MUC1和HER2在乳腺癌中的表达率分别为83.78%、46.85%,与良性肿瘤及癌旁正常组织比较,均有显著性差异。乳腺癌组织中,MUC1表达与腋窝淋巴结转移、临床TNM分期有关,与年龄、肿瘤大小、组织学分级、病理类型无关。HER2表达与组织学分级、临床TNM分期有关,与年龄、肿瘤大小、淋巴结转移、病理类型无关。MUC1与HER2表达呈显著正相关,r=0.197,P=0.038。结论:MUC1与HER2基因的联合监测对判断乳腺癌的恶性程度,淋巴转移,预后及治疗有重要意义。