女性乳腺癌患病因素的探讨

目的:探讨诱发妇女罹患乳腺癌的危险因素。方法:对256例诊断为乳腺癌,年龄在23～54岁之间的妇女,经五家参研医院及2家病例支援医院病理证实乳腺癌者,进行"乳腺癌的钼靶与病理诊断符合率及相关因素多中心研究"调查表的问卷调查。结果:乳腺钼靶X线机诊断乳腺癌或高度疑为恶变者,后经病理证实的256例妇女进行问卷调查,进行分析统计,列出十大项主要因素作为研究与乳腺癌发病可能有关的关系:(1)家族史;(2)婚姻与生育;(3)生殖因素;(4)哺乳;(5)月经紊乱;(6)甲亢;(7)口服避孕药;(8)生活习惯;(9)长期穿戴胸衣紧缩;(10)压抑感情或冲动性格。结论:家庭成员中(母亲、姐妹)有患乳腺癌的妇女其发病率较一般高。未婚未育或已婚未育的妇女患乳腺癌的比例要高。女性月经初潮越早、闭经越晚,乳腺癌的危险性越高。发现乳腺癌中只有92例有哺乳经验,占36(,认为哺乳可以降低卵巢功能;反之,升高会增加患乳癌的风险。月经紊乱,反映妇女内分泌失衡,也算风险之一。"甲亢"认为是激素水平异常,也是致乳腺癌的危险因素。口服避孕药与乳腺癌关系比较复杂,在256例乳腺癌患者中,有230例服用过此药,占90%。不良的生活习惯,也是致乳腺癌的因素。长期穿戴紧缩胸衣,影响乳房血液、淋巴循环,至营养及"排毒"受阻,也是易患乳腺癌的因素。精神因素将直接影响健康与否,这是不容置疑的事实,乳腺癌也不能例外。     

乳腺癌切除与保乳对女性生活的影响

乳腺癌发病率越来越高,发病的年龄也越来越早。随着医疗诊断水平的提高及先进的放疗技术,对乳癌的早期发现及标准治疗越来越得到人们的认可。那么是否所有的乳腺癌都适合保存乳房的手术呢?关键在于早发现。随着人们防癌意识的不断加深,通过体检,尤其是接受先进的“乳腺钼靶摄像”,使得早期或比较早的乳腺癌能够及时“锁定”。女性特别是追求时尚与完美的女性,确实难以接受乳房切除,她们甚至对乳房的缺失有明显的羞耻感。欧美及日本等国家对Ⅰ、Ⅱ期乳腺癌所施行的“小手术、大放疗”,减少和避免了乳房切除后给患者心理上的创伤,保持了女性的…     

近红外线乳腺扫描诊断88例乳腺癌临床分析

乳腺癌患者88例均用近红外线乳腺扫描进行病理组织学诊断,分析其对乳腺癌诊断的临床价值。     

超声对乳腺占位性病变的诊断价值

目前女性乳腺癌发病率日益增高,危害女性的身体健康,早期发现尤为重要。超声对乳腺病变的诊断具有优越性,经过病理组织学诊断对比,充分表明了超声对乳腺占位性病变诊断价值。     

B超和宫腔镜对子宫内膜息肉诊断价值的探讨

目的:比较B超和宫腔镜对子宫内膜息肉(EP)的诊断价值。方法:对355例阴道异常出血、绝经后子宫内膜增厚或不孕的患者进行阴道B超及宫腔镜检查,以病理诊断为标准,计算两种方法与最后病理的诊断符合率、敏感性、特异性、假阴性率、假阳性率。结果:阴道B超对子宫内膜息肉的诊断的符合率、敏感性、特异性、假阴性率、假阳性率分别为62.50%、77.92%、87.05%、12.95%、22.08%。宫腔镜对子宫内膜息肉的诊断符合率、敏感性、特异性、假阴性率、假阳性率分别为89.41%、92.68%、96.70%、3.30%、7.32%。结论:阴道B超诊断子宫内膜息肉与病理的符合率较低,因其无创、方便和快捷,可作为子宫内膜息肉术前筛查和术后随访的手段。宫腔镜诊断子宫内膜息肉具有更高的病理符合率、敏感性和特异性,可作为诊断其的首选检查方法。     

X线透视下子宫输卵管造影术在女性不孕症患者中诊断和治疗中的应用价值研究

目的:探讨X线透视下子宫输卵管造影术在女性不孕症患者中诊断和治疗中的应用价值。方法:选取2014年5月至2015年6月我院收治的160例女性不孕症患者作为研究对象,予以X线透视下子宫输卵管造影术,观察子宫输卵管造影结果、妊娠及并发症发生情况。结果:子宫形态正常142例(88.8%),子宫异常18例(11.2%),以B超检查为标准,X-HSG诊断子宫符合率为94.7%(142/150);输卵管通畅108例(67.5%),通而不畅16例(10.0%),输卵管阻塞36例(22.5%),以B超检查为标准,X-HSG诊断输卵管通畅符合率为95.6%(108/113),通而不畅符合率为75.0%(12/16),阻塞符合率为97.2%(35/36);全部患者经X-HSG后3~12个月怀孕60例(37.5%);并发症主要包括下腹疼痛、阴道出血、静脉回流、恶心、呕吐、发热及头晕等,经对症治疗后均消失。结论:X线透视下子宫输卵管造影术可作为判断女性不孕症患者子宫输卵管通畅情况的诊断方法,同时具有一定的辅助治疗作用,值得在临床上推广应用。     

彩色多普勒超声诊断子宫内膜癌与临床病理的一致性研究

目的:研究彩色多普勒超声诊断子宫内膜癌的临床应用价值及临床病理诊断与彩色多普勒超声诊断的相关性情况。方法:以我院2015年7月至2016年7月收治的721例子宫内膜癌高危者为研究对象,对其术前彩色多普勒超声检查情况及术后病理情况进行比较,对肌层浸润符合情况、血流阻力指数、搏动指数、肿瘤分化程度情况等进行相关性分析。结果:彩色多普勒超声诊断子宫内膜癌患者97例,术后病理证实为子宫内膜癌93例,彩色多普勒超声检查诊断符合率为95.88%,肌层浸润符合率情况由高至低排列为无肌层浸润、浅肌层浸润、深肌层浸润,肿瘤分化、浸润程度、血流阻力指数、血流搏动指数均与肌层浸润情况相关,组间差异具有统计学意义(P<0.05)。结论:彩色多普勒超声检查诊断子宫内膜癌准确性较高,对肌层浸润程度判定及治疗方案制定均具有重要意义。     

发生于皮肤的乳腺浸润性小叶癌1例

正1临床资料患者女,62岁,左乳房上部皮肤肿物5年,加重1年。患者于6年前发现左乳房上部出现一红色结节,无明显自觉症状,就诊于当地外科,彩超显示双侧乳腺未见明显异常,未行任何治疗。后结节逐渐增大,近1年增大明显,就诊于当地医院,行乳腺彩超、钼靶、MRI和腹部彩超、肺部X线等检查,未发现异常,当地乳腺外科建议皮肤科会诊,遂来本院。患者既往体健,无家族肿瘤病史。体检:系统检查未见异常。皮肤科情况:左乳房内上象限见一皮肤肿物,约1. 0 cm×1. 0 cm,质硬、突起,色红,表面光滑无破溃(图1)。皮损组织病理示:表皮未见异常,真     

皮肤鳞状细胞癌17例和光线性角化病45例临床及病理分析北大核心CSCD

目的观察皮肤鳞状细胞癌(SCC)与光线性角化病(AK)的临床和病理特点。方法收集本科2010年1月-2014年12月间经病理确诊的17例SCC和45例AK患者的临床及病理资料进行回顾分析。结果 SCC与AK均好发于老年人,SCC发病年龄更晚于AK;SCC及AK均好发于头、面及四肢远端等暴露部位;SCC临床与病理诊断符合率为52.94%,AK的诊断符合率为51.11%。结论临床上SCC与AK容易相互误诊,两者的鉴别需要依赖组织病理。     

高危型HPVDNA联合TCT检测初筛宫颈癌的检验研究

目的探讨高危型人乳头瘤病毒(HPV)DNA联合新柏氏液基细胞学(TCT)检测初筛宫颈癌的价值研究。方法选取2016年1月至2016年12月前来大冶市人民医院就诊的893例妇女作为研究对象。宫颈病理组织学结果以病理组织学为诊断标准,以CIN I、CIN II、CIN III和浸润癌为病理组织学阳性。取TCT采集的宫颈上皮脱落细胞,一份样本同时进行HPV-DNA检测。观察TCT检测结果与病理组织学结果诊断对照、高危型HPV-DNA检测结果与病理组织学结果诊断对照及TCT联合高危型HPV-DNA与病理组织学检测结果结果。结果 TCT检测结果与病理组织学结果阳性符合率为36.65%;高危型HPV-DNA检测结果与病理组织学结果阳性符合率为37.44%;TCT与高危型HPV-DNA联合检测与病理组织学诊断阳性符合率为89.20%。结论高危型HPVDNA联合TCT检测对初筛宫颈癌具有较高的诊断价值。     

Nipple Adenoma in an Adolescent

Abstract: Nipple adenoma is a rare tumor of the breast which usually appears in middle age women and rarely in adolescents. We describe a 15‐year‐old female diagnosed with nipple adenoma. Nipple adenoma is a benign neoplasia which should be recognized to avoid confusion with breast cancer.     

凋亡抑制蛋白生存素在乳腺癌中的表达及其意义：临床标本47例分析

目的探讨凋亡抑制蛋白生存素在乳腺癌中的表达及其临床意义。方法采用逆转录聚合酶链反应方法检测47例病理证实的乳腺癌组织和26例正常乳腺组织中生存素的mRNA表达。结果生存素在正常乳腺组织中无mRNA表达，而在61．7％的乳腺癌组织中（29／47）mRNA表达阳性。生存素基因mRNA表达率在病理分级为Ⅰ级、Ⅱ级和Ⅲ级的乳腺癌中分别为36．4％、65％和75％，表现出随分级的升高而升高的趋势（P=0．048）。在浸润型的乳腺癌中，生存素基因的mRNA表达率为71．4％，显著高于非浸润型者（33．3％，P=0．019）。生存素基因的mRNA表达率与年龄无关（P=0．563）。结论生存素的异常表达引起细胞凋亡抑制，对乳腺癌的发生、发展起重要作用，生存素的异常表达提示乳腺癌预后不良。     

乳腺癌术后女性身体意象与性状况的研究

目的:为乳腺癌术后女性的身心健康干预措施的制定提供依据,有效提高其生活质量和术后康复效果。方法:本文采用文献回顾的方法对有关乳腺癌女性身体意象和性状况的相关研究进行分析和探讨。结果:乳腺癌及其治疗会导致女性身体意象和性状况的变化,进而影响乳腺癌术后女性的生活品质。结论:在乳腺癌女性的健康照顾中,应重视其身体意象的变化以及对性状况的影响,并为乳腺癌女性和伴侣提供针对性的健康干预措施。     

Morfea postradioterapia en pacientes con cáncer de mama. Posible relación con otras enfermedades autoinmunes

Postirradiation morphea is an uncommon entity that has been mostly described in women with breast cancer. The increasing use of radiotherapy to treat breast cancer and the clinical similarities between morphea and other conditions, such as radiodermatitis, postirradiation fibrosis, and tumor recurrence, highlights the need for dermatologists to be familiar with this entity. We present a series of 6 women with a mean age of 64.2 years and a mean latency of 9.5 years between radiotherapy for breast cancer and onset of morphea. Four of the patients had a history of autoimmune disease: rheumatoid arthritis, Sjögren syndrome, vitiligo, and Crohn disease. No specific risk factors for postirradiation morphea have been identified to date, although it would appear that a history of autoimmune disease could be associated with an increased risk of morphea in patients treated with radiation therapy.     

Cutaneous necrosis is predictive of cancer in adult dermatomyositis

INTRODUCTION: Adult dermatomyositis is associated with cancer in 15 p. 100 to 50 p. 100 of cases and, hence, investigations should be systematically performed to search for cancer. A number of predictive factors have been reported. The aim of our study was to search for predictive factors of cancer, among adults with dermatomyositis. METHODS: We prospectively assessed 26 adults presenting with dermatomyositis, hospitalised in our department of dermatology from January 1993 to June 2000. The parameters assessed were: association with a cancer, age, gender, cutaneous necrosis, muscular weakness, electromyographic abnormalities, erythrocyte sedimentation rate, and muscular enzyme levels. RESULTS: Mean age was of 52 years and sex ratio (M/F) was of 0.53. Cancers were diagnosed in eight cases (31 p. 100) (mean age: 59.5 years; sex ratio=1; cancer localization: lung (2), breast (2), ovary, endometrium, bladder, and melanoma). Five patients in the cancer group had cutaneous necrosis and only 2 in the without cancer (p=0.01; PPV=71.4 p.100). Elevation of muscular enzyme was also associated with cancer. CONCLUSION: Our report demonstrates that cutaneous necrosis is closely associated with cancer and it suggests that in selected patients with dermatomyositis and cutaneous necrosis, more exhaustive and repeated investigations should be performed to search for cancer. The interest of elevation in muscular enzyme as a predictive factor of cancer is discussed.     

乳腺癌患者女性性功能障碍的发生率及其影响因素分析

目的 探讨乳腺癌患者女性性功能障碍(FSD)的发生率及其影响因素.方法 选取2016年1月1日至2020年12月31日上海交通大学医学院附属第九人民医院黄浦分院收治的217例乳腺癌患者作为研究对象,按照治疗后有无FSD分为FSD组(n=149)和非FSD组(n=68).采用亚利桑那性体验量表(ASEX)、广泛性焦虑自评...     

Dermatomyositis and malignancy in Tunisia: a multicenter national retrospective study of 20 cases

OBJECTIVE AND METHODS: The aim of our study was to report the epidemiologic, clinical, and biologic profiles of dermatomyositis (DM) associated with malignancy in patients from Tunisia. From January 1982 to January 2000, we collected retrospectively 20 case reports of DM associated with cancer from the different university hospital centers of Tunisia. Initial workup included anamnesis, clinical examination, cancer staging and classification, serum muscle enzymes (creatine phosphokinase, lactate dehydrogenase, aldolase, and transaminases), electromyography, and muscular biopsy. We calculated the median survival and mean value of all the variables. Comparisons of statistical tests were done with the Kruskal-Wallis test. RESULTS: Among the 130 DM cases of our study, 20 were associated with cancer (15.38%). The mean age of our patients was 49.6 years and the sex ratio (female/male) was equal to 3. Cancers were mainly those of the breast (35%) and nasopharynx (25%). DM followed a paraneoplastic course in 90% of the cases. The profile of seric muscular enzymes showed a significant statistical difference (P =.05) between a group of patients with severe muscular weakness and a group with moderate muscle weakness only for creatine kinase. The median survival was 36.5 months after diagnosis of DM and 48.6 months after that of cancer. The 5-year actuarial survival was 38% as related to cancer and 16% as related to DM. Mortality was 45%, in 90% as a result of cancer. CONCLUSIONS: In our study, nasopharyngeal carcinoma represents the second cancer associated with DM, after breast neoplasm, demonstrating the frequency of these 2 cancers in our country. Despite our reduced number of study samples, our study also suggests a relationship between severe muscle weakness and high seric muscle enzymes.     

Localized scleroderma in breast cancer patients treated with supervoltage external beam radiation: Radiation port scleroderma

Background: An association between systemic scleroderma, radiation, and breast cancer has been recognized. However, localized scleroderma in the radiation port of breast cancer patients has been rarely described.Objective: Our purpose was to describe the concurrence of localized scleroderma, supervoltage radiation, and breast carcinoma.Methods: Patients were prospectively evaluated in a tertiary care cancer center, and the literature was reviewed.Results: We describe six patients with breast cancer in whom localized scleroderma developed within their radiation port.Conclusion: Radiation port localized scleroderma can be a sequela of supervoltage radiation therapy in patients with breast cancer. Recognition is important because localized scleroderma can clinically mimic recurrent breast carcinoma.     

Similarities of cutaneous and breats pathology in Cowden's Syndrome

Abstract: Cowden's Syndrome (CS), or multiple hamartoma syndrome, is an autosomal dominant disorder characterized by mucocutaneous lesions, multiple benign tumors of internal organs and an increased risk of breast cancer. Here, we describe and illustrate in detail the benign breast pathology of 59 breast cases from 19 women with CS. Fibrosis is a significant characteristic of the breasts of patients with CS. Fibroaden- omas appear to hyalinize at an early age and are frequently complex. The specimens demonstrate a spectrum of dense hyalinization of both the lobule and the stroma, and hyaline nodules appear to be the most charac- teristic lesion. This hyalinization process shares striking similarities with keloids, as well as the sclerotic nodules seen in the skin of CS individuals. Ductal carcinoma in CS was common, and it appeared to be associated with stromal hyalinization. Other frequently found benign features are adenosis and cysts. Of interest, the features of the benign breast disease in CS show certain similarities with senescent lobules, fibrous mastopathy of diabetes mellitus, and mammary hamartomas. These observations provide a framework for pathologists to identify this underrecognized syndrome.