A study on the vascular proliferation in tissues around the tumor in breast cancer

In order to study the vascular proliferation in human breast cancer, blood vessels were counted, per square millimeter, in the tissue immediately around tumors. Mastectomized specimens of 84 patients with breast cancer and specimens from 10 patients with benign mammary diseases were stained by hematoxylin eosin and, where required, by the avidin biotin peroxidase complex method for laminin staining. The vascular density around the breast cancer tissue was 20.35±8.40/mm², which was significantly higher than the value of 13.44±5.85/mm² for noncancerous mammary tissues (p<0.001) or the value of 12.65±4.12/mm² for benign mammary disease tissues (p<0.01). Among the breast cancers, noninvasive carcinoma had a higher vascular density (28.44±6.15/mm²) than invasive carcinoma (19.73±8.22/mm², p<0.02). According to the Japan Mammary Cancer Society Classification of invasive ductal carcinoma, vascularity was higher in the papillotubular type of cancer than in the solid-tubular or scirrhous types of cancer (p<0.02), although the papillotubular type had the lowest rate of nodal metastasis and vascular invasion as compared with the scirrhous and solid-tubular types. The vascular density around the tumors did not change in association with an increase in tumor size and it was suggested that blood vessels around a tumor would increase almost in proportion to the square of the tumor diameter.     

血管内皮生长因子及其受体mRNA在乳腺癌组织中的表达

目的　研究血管内皮生长因子及其受体FLT 1、FLK 1mRNA在乳腺癌组织中的表达及与临床病理因素的相关性。　方法　采用逆转录聚合酶链反应技术对手术的 47例乳腺癌标本 ,11例乳腺良性病变标本中血管内皮生长因子 (VEGF)及其受体FLT 1、FLK 1mRNA的表达进行检测。结果　在良、恶性乳腺组织中均检测到VEGF12 1、165mRNA的表达 ,在乳腺癌组织中表达水平分别为0 42 0± 0 13 3、0 2 91± 0 0 94高于良性乳腺组织 0 196± 0 0 67(P =0 0 0 0 )、0 2 0 6± 0 0 5 8(P =0 0 0 1) ;在乳腺癌组织中 ,VEGF12 1mRNA表达高于VEGF165mRNA(P =0 0 0 0 ) ,而在良性乳腺组织中两者表达水平差异无显著性意义 (P =0 666)。FLT 1、FLK 1mRNA在部分乳腺癌组织中表达 ,分别为 3 8 3 %(18/4 7)和 2 5 5 % (12 /4 7) ,而在良性乳腺组织中未见表达。乳腺癌组织中VEGF12 1、VEGF165、FLT 1、FLK 1mRNA表达与患者年龄、肿块大小、淋巴结转移状况、肿瘤分期及雌、孕激素受体状况之间无明显相关性。　结论　乳腺癌组织中VEGF12 1、165及其受体FLT 1、FLK 1mRNA表达水平上调 ,提示其在乳腺癌的血管生成中起着重要作用。     

A study on the definition of early breast cancer

The most important factor in improving the survival rates of the patients with breast cancer is early detection. A high cure rate can be expected if the condition is discovered in early stage. There were 195 patients with primary breast cancer in our hospital from August 1978 to November 1986. Among 280 patients with breast cancer who received radical operations from July 1970 to November 1986, there were 50 patients (18%) with recurrence. Mammography and echography were effective for the diagnosis of infiltrating cancer smaller than 10mm in diameter as well as those between 11 and 20mm in diameter. None of the patients with non-infiltrating or infiltrating carcinomas smaller than 15 mm or smaller than 20 mm in diameter with negative nodes had recurrence. Consequently, at present we define early breast cancer as the lesions of pathologically noninfiltrating or infiltrating smaller than 15 mm in diameter, or infiltrating smaller than 20 mm in diameter with negative nodes.     

A study on the correlation between estrogen receptor, progesterone receptor and tamoxifen binding sites in human breast cancer tissues

In order to examine the clinical significance of the tamoxifen binding site, correlations between the concentration of the tamoxifen binding site and either the estrogen receptor (ER) or progesterone receptor (PgR) were studied. A saturable high-affinity tamoxifen binding site was detected in human breast cancer tissues. The concentration of the tamoxifen binding sites in 12,000 g supernatant of ER positive tumors was 122.3 +/- 186.8 (mean +/- SD) fmol/mg protein, and that of ER negative tumors was 68.38 +/- 82.97 fmol/mg protein. The concentration of the tamoxifen binding sites in 12,000 g supernatant of PgR positive tumors was 103.7 +/- 137.3 fmol/mg protein, and that in the 12,000 g supernatant of PgR negative tumors was 90.29 +/- 159.0 fmol/mg protein. There was no significant difference between the concentration of the tamoxifen binding sites in the 12,000 g supernatant of ER positive tumors and ER negative tumors, and there was no significant difference between the concentration of the tamoxifen binding sites in the 12,000 g supernatant of PgR positive tumors and PgR negative tumors. The concentration of the tamoxifen binding sites in the cytosol of PgR positive tumors was 90.55 +/- 103.5 fmol/mg protein, and that in the cytosol of PgR negative tumors was 29.13 +/- 42.22 fmol/mg protein. There was a significant difference between them (p less than 0.05). The concentration of tamoxifen binding sites in 12,000 g supernatant had no correlation with the values of ER and PgR. Only the content of tamoxifen binding sites in cytosol, and the PgR value had a significant correlation.(ABSTRACT TRUNCATED AT 250 WORDS)     

A study on the correlation between estrogen receptor,progesterone receptor and tamoxifen binding sites in human breast cancer tissues

In order to examine the clinical significance of the tamoxifen binding site, correlations between the concentration of the tamoxifen binding site and either the estrogen receptor (ER) or progesterone receptor (PgR) were studied. A saturable high-affinity tamoxifen binding site was detected in human breast cancer tissues. The concentration of the tamoxifen binding sites in 12,000 g supernatant of ER positive tumors was 122.3±186.8 (mean±SD) fmol/mg protein, and that of ER negative tumors was 68.38±82.97 fmol/mg protein. The concentration of the tamoxifen binding sites in 12,000 g supernatant of PgR positive tumors was 103.7±137.3 fmol/mg protein, and that in the 12,000 g supernatant of PgR negative tumors was 90.29±159.0 fmol/mg protein. There was no significant difference between the concentration of the tamoxifen binding sites in the 12,000 g supernatant of ER positive tumors and ER negative tumors, and there was no significant difference between the concentration of the tamoxifen binding sites in the 12,000 g supernatant of PgR positive tumors and PgR negative tumors. The concentration of the tamoxifen binding sites in the cytosol of PgR positive tumors was 90.55±103.5 fmol/mg protein, and that in the cytosol of PgR negative tumors was 29.13±42.22 fmol/mg protein. There was a significant difference between them (p<0.05). The concentration of tamoxifen binding sites in 12,000 g supernatant had no correlation with the values of ER and PgR. Only the content of tamoxifen binding sites in cytosol, and the PgR value had a significant correlation. From these results, it was considered that there is a possibility of the tamoxifen binding site being a marker of endocrine therapy.     

曲古菌素A抑制乳腺癌细胞增殖的分子机制

目的研究组蛋白去乙酰酶抑制剂—曲古菌素A（TSA）对乳腺癌T47D细胞增殖的影响和机制。方法不同浓度的TSA作用乳腺癌T47D细胞5d,噻唑蓝（MTr）法检测药物作用前后细胞增殖的情况。流式细胞仪检测TSA作用36h后细胞周期的改变。逆转录·聚合酶链反应（RT-PCR）检测TSA作用36h后Maspin mRNA的表达。结果TSA在20μg/L浓度以上可以明显抑制乳腺癌T47D细胞的增殖,并呈现剂量和时间的依赖性。细胞周期检测发现100μg／LTSA可导致细胞G1期阻滞,并诱导细胞凋亡;而500μg／LTSA可显著的诱导细胞凋亡。RT-PCR显示100μg／LTSA作用36h后Maspin mRNA的表达增强,但在20μgL时其表达与对照组差异无统计学意义。结论TSA可以抑制乳腺癌T47D细胞的生长,可能通过诱导细胞凋亡和Maspin基因的重新表达发挥抑癌作用。TSA可能是乳腺癌治疗的潜在靶点。     

年轻乳腺癌生存者对希望的体验

目的探讨年轻乳腺癌生存者在患病后对希望的体验,以深入了解年轻生存者对希望的理解、希望的来源及希望的影响。方法采用现象学方法,深入访谈17例年轻乳腺癌术后生存者,并采用MAXQDA 10软件,对资料进行整理、编码、分类、归纳、提炼主题。结果年轻乳腺癌生存者对希望的体验涉及:对希望的理解、希望的来源、希望的力量及希望是带癌生存过程中动态变化、不断内化的概念4个主题。结论年轻乳腺癌生存者对希望的体验具有特殊性,护理人员应敏锐洞察生存者的希望来源和目标,并提供全方位的照护,提高其生活质量。     

血管内皮生长因子在脑胶质瘤中自分泌现象对增殖的影响

FR2呈强表达同时Ki-67呈弱表达1例,VEGFR2呈弱表达同时Ki-67呈强表达6例,经一致性分析Kappa=0.543,P＜0.01,两者的共表达存在一致性.结论 脑胶质瘤瘤细胞可能通过VEGF自分泌现象介导瘤细胞的增殖,尤以VEGFR2参与介导的可能性大.     

The Effect of the 2009 USPSTF breast cancer screening recommendations on breast cancer in Michigan: A longitudinal study

In 2009, the revised United States Preventive Services Task Force (USPSTF) guidelines recommended against routine screening mammography for women age 40‐49 years and against teaching self‐breast examinations (SBE). The aim of this study was to analyze whether breast cancer method of presentation changed following the 2009 USPSTF screening recommendations in a large Michigan cohort. Data were collected on women with newly diagnosed stage 0‐III breast cancer participating in the Michigan Breast Oncology Quality Initiative (MiBOQI) registry at 25 statewide institutions from 2006 to 2015. Data included method of detection, cancer stage, treatment type, and patient demographics. In all, 30 008 women with breast cancer detected via mammogram or palpation with an average age of 60.1 years were included. 38% of invasive cancers were identified by palpation. Presentation with palpable findings decreased slightly over time, from 34.6% in 2006 to 28.9% in 2015 (P < .001). Over the 9‐year period, there was no statistically significant change in rate of palpation‐detected tumors for women age <50 years or ≥50 years (P = .27, .30, respectively). Younger women were more likely to present with palpable tumors compared to older women in a statewide registry. This rate did not increase following publication of the 2009 USPSTF breast cancer screening recommendations.     

c-FLIP在乳腺癌中的表达及其与患者预后的相关性研究

目的探讨c-FLIP在乳腺癌中的表达及其与临床病理特征和患者预后的关系,初步探讨其在乳腺癌发生、发展中的意义。方法应用免疫组化SP法对101例术前没有接受过放射治疗和化学治疗的乳腺癌手术标本及相应的16例癌旁组织进行c-FLIP检测,并结合随访资料对c-FLIP和临床病理学指标、患者预后的关系进行综合分析。结果c-FLIP在乳腺癌组织中表达的阳性率为97%,而在癌旁组织中表达的阳性率为50%,癌组织中的表达水平明显高于癌旁组织（P＜0.01）。c-FLIP在乳腺癌中的表达与患者年龄、肿瘤大小、肿瘤分期、组织细胞学类型、分化程度、淋巴结转移等无关（P＞0.05）。不同表达水平的c-FLIP组之间在患者术后远处转移方面无明显差异（P＞0.05）,在患者预后方面差异则有统计学意义（P＜0.05）。结论c-FLIP在乳腺癌组织中有高水平的表达,有可能成为判断乳腺癌患者预后的独立指标。     

乳腺癌的位置与血液供应及其与术前介入化学药物治疗效果的关系

目的探讨乳腺癌的位置与血液供应及其与术前介入化学药物治疗（下称化疗）疗效的关系。方法应用Ｓｅｌｄｉｎｇｅｒ技术对１５例Ⅲ期乳腺癌患者造影,并经乳腺癌癌灶供血动脉采用顺铂、阿霉素、丝裂霉素和５氟尿嘧啶（ＰＡＭＦ）进行灌注化疗。结果乳腺癌的肿瘤供血与部位有关：外侧病灶１１例主要由胸外侧动脉供血,内侧病灶４例主要由胸廓内动脉供血。乳腺癌采用ＰＡＭＦ进行介入化疗后,肿瘤及腋窝淋巴结明显缩小,根治术后１５例均获随访,随访时间２～６年,７例生存期达５年以上,仅２例于术后３年后复发,与同期Ⅲ期乳癌未作介入化疗者相比,复发率明显降低,差异有非常显著意义（Ｐ＜００１）。结论晚期乳腺癌如无化疗禁忌症,应考虑作术前介入化疗,以提高疗效。介入化疗时应仔细全面观察,确认其主要供血动脉是术前介入化疗成功的关键     

HPV感染与乳腺癌及其癌组织C-erbB-2表达的关系

目的：研究人乳头瘤病毒（HPV）感染与乳腺浸润性导管癌（IDC）患者临床病理特征的关系及其癌组织中癌基因C-erbB-2表达的相关性。 方法：用表面等离子谐振法（SPR）检测60例IDC组织和30例乳腺纤维瘤组织以及30例正常乳腺组织HPV DNA及分型;免疫组化法检测IDC组织中C-erbB-2蛋白的表达。 结果：IDC组织HPV感染率为36.7%（22/60）,其中HPV 33占其阳性总数的59.1%（13/22）,乳腺纤维瘤组织与正常乳腺组织HPV感染率分别为13.30%和3.33%,明显低于IDC组织（χ2=5.300,P=0.021）;IDC组织HPV感染与患者组织学分级、腋窝淋巴结转移有关（均P<0.05）;IDC组织中HPV感染和C-erbB-2蛋白的阳性表达呈正相关（r=0.486;P<0.001）。 结论：HPV感染在IDC发病中起了重要作用,且与肿瘤的分化程度及侵袭转移能力密切相关;HPV感染可能通过促进C-erbB-2的高表达而参与乳腺癌的发生发展。     

人乳腺癌组织中p53基因单核苷酸多态性位点变异的研究

目的 观察乳腺癌患者p53基因的单核苷酸多态性位点(SNPs)变异,探讨p53基因在乳腺癌癌基因学中的意义.方法 选取p53基因位于外显子及内含子的共3对引物,利用SSCP(单链多肽构象)分析方法对30例乳腺癌样品进行分析及DNA测序.结果 在检测的30例乳腺癌组织样品中,p53基因在第一内含子和第七内含子中共有4个碱基替换被检测出,其中3个为Hapmap(Hapolotype Map Project,国际单倍型图谱计划)中已公布的SNP位点,另外1个从未被确认.在p53第7内含子位置处发现一高突变率(20%)的G→A(rs12947788)类型基因替换,在其上游20个碱基位置处存在另一已知高突变率的SNP位点A→C(rs12951053),此两者联合出现,在所检测的30例乳腺癌组织样本中共发现6例,占所检测标本的20%.结论 p53基因的SNPs分析对乳腺癌的早期发现、治疗和预后有一定意义.     

YAP 基因干扰对乳腺癌细胞增殖和凋亡的影响

目的：探讨干扰YAP基因的表达对乳腺癌细胞增殖和凋亡的影响。 方法：通过逆转录病毒介导的方法,分别用YAP shRNA（实验组）或阴性对照shRNA（对照组）转染MCF-7乳腺癌细胞,用qRT-PCR和Western blot方法检测干扰效率;溴脱氧核苷尿嘧啶（BrdU）结合实验和MTT法检测细胞增殖活性;流式细胞术和DAPI染色检测细胞凋亡情况。 结果：干扰效率检测显示,转染72 h后,实验组MCF-7细胞YAP mRNA表达量明显降低（P<0.05）,同时YAP蛋白表达也明显下调;细胞增殖检测显示,与对照组比较,实验组MCF-7细胞BrdU结合与OD值明显降低（P<0.05）,转染后24、48、72 h增殖抑制率分别为19.1%、38.5%、53.5%;凋亡检测显示,实验组细胞凋亡率与凋亡细胞数较对照组明显增加（均P<0.05）。 结论：干扰YAP基因的表达能有效抑制乳腺癌细胞的增殖并促进凋亡,YAP可能是乳腺癌潜在治疗靶点。     

Participation in breast cancer screening among breast cancer survivors –A nationwide register-based cohort study

The aim of this study was to analyse if breast cancer survivors without other breast imaging surveillance attend population-based screening differently than women not previously diagnosed with breast cancer. Further, to analyse if any differences depended on the women’s age and years since previous cancer diagnosis.The study was a register-based retrospective cohort study of all women invited to participate in the national breast cancer screening programme in 2015–2016. Participation rates were calculated for breast cancer survivors without breast imaging within 21 months (2–4 years, 4–6 years, 6–10 years and more than 10 years after diagnosis) and for women without previous breast cancer. Relative differences in participation rates between the two groups were calculated.A total of 679,990 women were included in the study (2.6% breast cancer survivors).For breast cancer survivors, participation rates increased with increasing number of years since the previous cancer diagnosis peaking at 80.3% if the cancer diagnosis was more than 10 years ago. For women with no previous breast cancer, participation rate was 80.3%.The relative difference in participation was highest close to the breast cancer diagnosis and for the youngest women participation rates remained lower among breast cancer survivors even more than 10 years after the diagnosis.In conclusion, regardless of age and years since previous breast cancer diagnosis, breast cancer survivors had lower or similar participation rates than women with no previous cancer diagnosis. This indicated that as many as one fifth of the breast cancer survivors are at risk of inadequate surveillance.     

乳腺癌乳房再造术后患者创伤后成长体验的质性研究

目的 深入了解乳腺癌乳房再造术后患者创伤后成长的真实体验,为开展针对性护理干预提供参考。方法 采用现象学研究法,以目的抽样法联合滚雪球抽样法选取12例乳腺癌乳房再造术后患者作为研究对象,以面对面或电话访谈形式进行半结构式深入访谈,采用Colaizzi 7步分析法进行归纳分析并提炼主题。结果 共提炼出自我反思、自我重塑(人生价值观的改变、个人力量增强、对疾病认识由消极转变为积极)、自我实现(积极心理、有效应对、利他行为)3个主题及6个亚主题。结论 乳腺癌乳房再造术后患者在对抗逆境的过程中能体验到创伤后成长,并呈现出积极自我变化。临床医护人员应关注患者的积极体验,激发患者积极力量,促进患者心理健康。