雌激素受体亚型ERα、ERβ在乳腺癌中的表达

目的研究雌激素受体亚型ERα、ERβ在不同乳腺组织中的表达及其在浸润性乳腺癌中与肿瘤病理参数和生物学标志物之间的关系。方法选取70例乳腺癌(其中8例原位癌、44例浸润性导管癌、18例浸润性小叶癌)、15例乳腺增生、15例正常乳腺组织石蜡标本,用免疫组织化学法检测ERα、ERβ、C-erbB-2的表达情况。结果 (1)乳腺癌组织中的ERα阳性表达率明显高于正常乳腺及乳腺增生组织;晚期乳腺癌患者ERα阳性表达率明显低于早期患者;C-erbB-2阳性患者的ERα阳性表达率明显减低。(2)乳腺癌组织中的ERβ阳性表达率明显低于正常乳腺及乳腺增生组织;在浸润性乳腺癌中淋巴结转移阳性者、C-erbB-2表达阳性者的ERβ阳性表达率明显高于对照组患者。结论 ERα在乳腺癌的发生发展中可能起到促进作用,ERα的阳性表达与一些预后良好因素相关。ERβ可能对维持乳腺组织的正常生理功能起着重要作用,其与某些预后不良因素可能相关。     

KLK6 mRNA在乳腺癌组织中的表达及其临床意义

采用实时荧光定量PCR技术检测35例乳腺癌患者组织及正常乳腺组织中KLK6mRNA的表达,及其与组织类型、淋巴结转移,雌激素受体（ER）、孕激素受体（PR）及癌胚表达抗原（CerbB-2）表达的关系。结果 KLK6mRNA在癌组织中表达水平较正常组织明显升高,P〈0．001;伴淋巴结转移者较未转移者明显降低,P〈0．01;雌激素受体阳性者明显低于阴性者,P〈0．01;在PR、CerbB-2阳性与阴性组无统计学意义。提示KLK6基因参与了乳腺癌的发生、发展及预后过程。     

胰腺癌中ERα变异体的表达

目的检测胰腺癌中雌激素受体α(ERα)不同变异体ERC4、ERD3、ERD5 mRNA的表达.方法采用免疫组化和RT-PCR检测技术,对50例胰腺癌和20例乳腺癌患者ERα的表达以及变异体ERC4、ERD3、ERD5 mRNA的表达进行检测.结果胰腺癌ERα蛋白的阳性率为32%.ERD3 mRNA在ER阳性胰腺癌表达低于阴性病例;ERC4 mRNA在ER阴性胰腺癌表达明显低于阳性病例(P < 0.05);ERD5 mRNA在ER阳性胰腺癌表达低于阴性病例.结论 ERα变异体的检出说明它们在胰腺癌发生过程中起一定的作用.在胰腺癌的发生过程中,ERα变异体mRNA的表达失控.     

胰腺癌中ERα变异体的表达

目的检测胰腺癌中雌激素受体α(ERα)不同变异体ERC4、ERD3、ERD5mRNA的表达。方法采用免疫组化和RT-PCR检测技术,对50例胰腺癌和20例乳腺癌患者ERα的表达以及变异体ERC4、ERD3、ERD5mRNA的表达进行检测。结果胰腺癌ERα蛋白的阳性率为32％。ERD3mRNA在ER阳性胰腺癌表达低于阴性病例;ERC4mRNA在ER阴性胰腺癌表达明显低于阳性病例(P<0.05);ERD5mRNA在ER阳性胰腺癌表达低于阴性病例。结论ERα变异体的检出说明它们在胰腺癌发生过程中起一定的作用。在胰腺癌的发生过程中,ERα变异体mRNA的表达失控。     

乳腺癌组织中组织蛋白酶D的表达及意义

应用免疫组化SP法检测50例乳腺囊性增生和50例乳腺癌标本中组织蛋白酶D（CathD）和雌激素受体（ER）的表达。结果乳腺癌组织中CathD阳性表达26例,明显高于乳腺囊性增生组的10例。乳腺癌患者中伴腋窝淋巴结转移者CathD阳性表达23、3例绝经前、后者CathD阳性表达18、8例;ER阳性者CathD阳性表达率78．2％（18／23）,明显高于ER阴性者的29．6（8／27）。可见临床检测CathD的表达对预测乳腺癌患者预后有一定的价值。     

17β-HSD15在乳腺癌和癌旁组织中的表达及其与临床特征的关系

目的 探讨15型17β羟化类固醇脱氢酶(17β-HSD15)在乳腺癌和癌旁非恶性乳腺组织中的表达及其与患者临床特征之间的关系.方法 运用免疫细胞化学法测定17β-HSD15在乳腺癌及同一患者癌旁非恶性乳腺组织中的表达,并统计分析该酶表达与患者年龄、癌及癌旁组织雄激素受体 (AR),雌激素受体α (ERα),孕激素受体B (PRB),CDC47 和肿瘤的分期,肿瘤的大小,阳性淋巴结数和月经状态之间的关系.结果 乳腺癌组织中17β-HSD15阳性表达率(66.7%)明显低于癌旁正常组织(97.6%) (χ2= 27.431,P<0.000 1) .AR和PRB表达在乳腺癌组织中明显高于癌旁正常组织(P<0.01,P< 0.05).癌组织CDC47阳性表达率(77.4%)明显高于非癌组织 (15.5%) (P< 0.001).AR和ERα(r=0.494 97,P=0.000 1);ERα和CDC47 (r=0.224 96,P=0.0397)表达存在明显相关性.结论 17β-HSD15在乳腺癌中调控肿瘤组织内部雌激素和雄激素水平,在乳腺癌的发生发展过程中起到了非常重要的作用.     

雌激素受体α在大鼠心脏组织的分布

目的 :观察不同性别 ,不同雌激素水平时雌激素受体α（ERα）在大鼠心脏及培养的心肌和心脏成纤维细胞的分布。方法 :通过免疫组织化学方法观察正常雄性及雌性 SD大鼠、卵巢切除大鼠、假手术及雌激素替代治疗大鼠心脏组织 ERα的分布 ,以及雌激素对培养的心肌细胞和心脏成纤维细胞 ERα表达的影响。结果 :ERα免疫反应阳性物质呈部位特异性地分布于大鼠心脏组织中 ;不同性别大鼠未见明显差异 ;卵巢切除大鼠心脏组织 ERα免疫反应阳性物质明显减少 ;雌激素替代治疗组 ERα的表达恢复至正常水平 ;离体培养的心肌细胞及心脏成纤维细胞 ERα染色阳性 ,给予生理剂量雌激素后 ,心肌及心脏成纤维细胞 ERα阳性染色明显增强。结论 :ERα不仅存在于心脏组织中 ,且其表达受雌激素的调控。     

ER、PR、C-erbB-2、HMFG在乳腺癌组织中的表达及临床意义

目的探讨乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体-2（C-erbB-2）、人乳脂肪球膜蛋白（HMFG）的表达及意义。方法选择手术切除的乳腺癌组织58份（肿瘤组）及癌旁正常乳腺组织58份（对照组）,采用免疫组化EnVision法检测两组ER、PR、C-erbB-2和HMFG表达水平,并分析各指标间及与乳腺癌临床参数的关系。结果乳腺癌组C-erbB-2表达明显高于对照组（P〈0.05）,余指标两组无统计学差异。C-erbB-2阳性表达与乳腺癌组织学分型及腋窝淋巴结转移有关,HMFG阳性表达与导管癌组织学分级相关;相关分析示ER与PR、HMFG表达呈正相关,其他各指标间无相关性。结论 ER、PR、C-erbB-2和HMFG与乳腺癌的发生、发展有关,四项指标联合检测有助于评价乳腺癌的生物学行为,进而指导治疗及预后判断。     

乳腺癌患者癌组织中组织蛋白酶D和基质金属蛋白酶-2的表达及其判断预后的价值

目的检测乳腺癌患者术后癌组织中组织蛋白酶D(Cath-D)和基质金属蛋白酶(MMP)-2表达及对预后判断的价值。方法应用免疫组织化学技术检测85例乳腺癌术后癌组织及40例乳腺组织Cath-D和MMP-2表达,探讨二者在不同临床特征中的表达意义。结果乳腺癌组织Cath-D和MMP-2阳性表达率明显高于正常乳腺组织,二者的表达与乳腺癌临床分期、淋巴结转移、肿瘤体积、雌激素受体(ER)、孕激素受体(PR)表达密切相关。乳腺癌组织中Cath-D和MMP-2的表达呈正相关性。生存分析显示Cath-D和MMP-2的表达与患者预后密切相关。结论乳腺癌组织Cath-D和MMP-2高表达,二者共同促进肿瘤发生发展,联合检测Cath-D和MMP-2表达水平可能预测患者预后。     

乳腺癌组织中HER-2、ER和PR的表达及意义

应用免疫组化MaxVision二步法检测98例乳腺癌和26例癌旁正常的乳腺组织中的雌激素受体(ER)、催乳素(PR)和甾体激素受体和人类表皮生长因子受体(HER-2).结果 HER-2、ER和PR在乳腺癌中阳性表达率分别为20.4%、53.1%、50.0%,癌旁乳腺组织分别为0、42.3%和100.0%,两组织中HER-2和PR阳性表达率相比,P均＜0.05.乳腺癌组织中HER-2、ER和PR的表达分别与组织学分级有关,同时PR的表达还与肿瘤大小、患者年龄有关(P均＜0.05).乳腺癌中HER-2的表达与ER呈负相关(r=-0.234,P＜0.05),ER和PR呈显著正相关(r=0.695,P＜0.01).认为HER-2、ER和PR与乳腺肿瘤的发生和发展密切相关,可用来指导临床用药和判断预后.     

Tuberculosis of the breast misdiagnosed as breast cancer

The authors report 15 patients with tuberculosis of the breast initially misdiagnosed as breast cancers. Criteria of differentiation of breast tuberculosis were: incidence (Tbc: cancer = 1: 245), lacking in constant site of involvement, possible concomitant involvement of other organs, eg. lung tuberculosis, youth of the patient, multi-para and history of breast feeding, in isolated cases, co-existence of tuberculosis and cancer is not impossible. The authors stress meticulous care in evaluating the history, symptoms, signs and supplementary examinations. Needle biopsy and pathology are indicated.     

Extramedullary plasmacytoma of the breast simulating breast cancer

A patient with a palpable mass in the breast suggestive of carcinoma underwent radical modified mastectomy. Surprisingly, histology of the tumor revealed an extramedullary plasmacytoma. Further diagnostic work up showed no evidence of underlying multiple myeloma. Among neoplastic lesions of the breast, although rare, malignancy of mesenchymal or lymphoproliferative origin should always be considered.     

Quality of life among breast cancer patients undergoing autologous breast reconstruction versus breast conserving therapy

Purpose Besides the quality of the aesthetic results, the quality of life after surgery is one of the most important criteria when reviewing different operation methods, especially in oncologic diseases. This study was performed to evaluate the difference in the health-related quality of life following breast conserving surgery and autologous breast reconstruction after mastectomy. Patients and methods Hundred and forty-four breast cancer patients were included in this study. Sixty seven patients underwent breast conserving surgery followed by radiotherapy. In 77 patients a mastectomy was performed with immediate or late reconstruction. To evaluate the health-related quality of life we used the SF-36 self-administered questionnaire. Results A significant difference was found in quality of life in the subscale “physical functioning” showing better results in the breast reconstruction group (P = 0.01). No significant difference was found in the other subscales, but there was a tendency to a better “emotional role” among the breast reconstruction patients. Conclusion Our study demonstrated that autologous tissue breast reconstruction in breast cancer patients did not affect adversely the health-related quality of life compared to breast conserving therapy when the quality of life is assessed by the standardized questionnaire SF-36. In particular, the physical function is not reported to be significantly influenced negatively by the more extensive surgical therapy. The authors declare that there are no considerations or conflict of interest patients gave informed consent for this study.     

PTEN mutation spectrum in breast cancers and breast hyperplasia

Purpose  

Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is one of the most frequently mutated human tumor suppressor genes. The present study aims to investigate the role of PTEN mutation in breast carcinogenesis by analyzing PTEN mutation spectrum and the protein expression in breast cancers, adjacent hyperplastic lesions, benign breast lesions and normal breast tissues.     

The renin-angiotensin system in the breast and breast cancer

Much evidence now suggests that angiotensin II has roles in normal functions of the breast that may be altered or attenuated in cancer. Both angiotensin type 1 (AT1) and type 2 (AT2) receptors are present particularly in the secretory epithelium. Additionally, all the elements of a tissue renin-angiotensin system, angiotensinogen, prorenin and angiotensin-converting enzyme (ACE), are also present and distributed in different cell types in a manner suggesting a close relationship with sites of angiotensin II activity. These findings are consistent with the concept that stromal elements and myoepithelium are instrumental in maintaining normal epithelial structure and function. In disease, this system becomes disrupted, particularly in invasive carcinoma. Both AT1 and AT2 receptors are present in tumours and may be up-regulated in some. Experimentally, angiotensin II, acting via the AT1 receptor, increases tumour cell proliferation and angiogenesis, both these are inhibited by blocking its production or function. Epidemiological evidence on the effect of expression levels of ACE or the distribution of ACE or AT1 receptor variants in many types of cancer gives indirect support to these concepts. It is possible that there is a case for the therapeutic use of high doses of ACE inhibitors and AT1 receptor blockers in breast cancer, as there may be for AT2 receptor agonists, though this awaits full investigation. Attention is drawn to the possibility of blocking specific AT1-mediated intracellular signalling pathways, for example by AT1-directed antibodies, which exploit the possibility that the extracellular N-terminus of the AT1 receptor may have previously unsuspected signalling roles.     

Male breast cancer

Occurrence of male breast cancer, a rare disease, peaks at age 71 years. Familial cases usually have BRCA2 rather than BRCA1 mutations. Occupational risks include high temperature environments and exhaust fumes, but electromagnetic fields have not been implicated. Hyperoestrogenisation resulting from Klinefelter's, gonadal dysfunction, obesity, or excess alcohol, all increase risk as does exposure to radiation, whereas gynaecomastia does not. Presentation is usually a lump or nipple inversion, but is often late, with more than 40% of individuals having stage III or IV disease. Most tumours are ductal and 10% are ductal carcinoma in situ. Surgery is usually mastectomy with axillary clearance or sentinel node biopsy. Indications for radiotherapy, by stage, are similar to female breast cancer. Because 90% of tumours are oestrogen-receptor-positive, tamoxifen is standard adjuvant therapy, but some individuals could also benefit from chemotherapy. Hormonal therapy is the main treatment for metastatic disease, but chemotherapy can also provide palliation. National initiatives are increasingly needed to improve information and support for male breast cancer patients.     

Products of exocrine secretion of the breast and breast cancer

The breast is an exocrine gland which secretes the proteins present in breast milk, such as casein and lactalbumin. The apocrine metaplasia which often accompanies cystic transformation may result in the production of proteins in the cystic fluid: GCDFP (Gross cystic disease fluid protein). The production of these proteins by breast cancer and their secretion into the blood enable them to be considered as markers of tumour differentiation. They are useful to the clinical oncologist as quantifiable parameters of tumour extension and response to treatment. In the future, they may provide an index of malignant transformation and hormone dependence.     

Isolated internal breast adenopathy. Late recurrence of breast cancer

Invasion of the internal mammary lymph nodes is common in tumoral pathology of the breast, but an isolated internal mammary lymphadenopathy occurring long after treatment of the primary tumour is a rare event. The authors report one case and discuss the prognostic and therapeutic factors involved.