乳腺癌环氧合酶-2和基质金属蛋白酶-2及其抑制因子的表达

目的 研究环氧合酶(COX)-2、基质金属蛋白酶(MMP)-2及其抑制因子(TIMP-2)在乳腺癌组织中的蛋白表达及其相互关系.方法 建立组织芯片平台,应用免疫组织化学S-P法检测127例乳腺癌组织COX-2、MMP-2和TIMP-2蛋白的表达情况.结果 乳腺癌COX-2、MMP-2和TIMP-2阳性率分别为81.1%(103/127)、96.9%(123/127)和60.6%(77/127);COX-2的表达与乳腺癌腋淋巴结转移和TNM分期均呈正相关(P<0.01,P<0.05),与孕激素受体表达呈负相关(P<0.05);MMP-2蛋白表达与COX-2表达呈显著正相关(r=0.290,P<0.01).结论 乳腺癌COX-2表达状况与肿瘤侵袭转移有密切关系,COX-2可能通过调控MMP-2表达来促进肿瘤侵袭转移.     

中央区乳腺癌的保乳治疗

目的探讨Ⅰ、Ⅱ期中央区乳腺癌保乳治疗的可行性,研究手术切口的选择、术中操作技巧及乳房重塑方法。方法对31例肿瘤位于乳房中央区的Ⅰ～Ⅱ期原发性乳腺癌患者,行肿瘤局部扩大切除并乳房重塑及腋窝淋巴结清扫手术,其中2例切除乳头乳晕区。手术后常规给予化疗、放疗、内分泌及生物靶向治疗。结果全部患者成功施行保乳治疗后,经随访6～53个月（中位随访24个月）,无局部复发。保乳治疗后对患侧乳房外观的评价：18例优秀,8例良好,5例一般,总体优良率为83.9%。结论位于中央区的Ⅰ、Ⅱ期原发性乳腺癌患者,只要规范治疗同样适合实施保乳,并可获得良好效果。     

乳腺癌相关抗原在乳腺癌辅助诊断中的应用

目的 探讨乳腺癌相关抗原CA15-3动态检测对乳腺癌的早期诊断价值.方法 运用SEROZYME系统检测了疑有乳房疾患和妇女健康普查的妇女512人外周血CA15-3数值,并对CA15-3值高于27.4 IU/mL的患者1～3月后再次复查CA15-3.结果 CA15-3动态增高组PVPT为85.7%.CA15-3相近和降低组6例,病理检查证实为乳腺癌1例,阳性预测值(PVPT)为16.7%.结论 CA15-3动态检测对乳腺癌早期诊断有重要价值,尤其是CA15-3高于40IU/ml的动态升高组在乳腺癌早期诊断中具有不可替代的预测作用.     

Current concepts in cyclooxygenase inhibition in breast cancer

The prospect that simple medications such as non-steroidal anti-inflammatory drugs (NSAIDs) could be recruited into the physician's armamentarium of anticancer drugs is intriguing, especially in the context of breast cancer, one of the leading causes of mortality in the Western world. There has consequently been a wider exploration of the role of cyclooxygenase (COX) in breast cancer, and we now accept that COX-2, one of its isoenzymes, is clearly implicated in the pathogenesis of the disease. This would seem to translate into a viable role for cyclooxygenase inhibitors in the treatment and prevention of breast cancer, but also raises issues regarding safety and tolerability of these drugs. In this article we discuss the theoretical consequences of cyclooxygenase inhibition, the significance of findings from experimental studies, large scale epidermiological investigations, and the relevance of large population studies of COX-2 inhibitors such as CLASS and VIGOR.     

隐匿性乳腺癌外科治疗

目的 探讨隐匿性乳腺癌的外科治疗方法.方法 对11例隐匿性乳腺癌患者的临床资料进行回顾性分析.结果11例均为女性,年龄44～70岁,中位年龄55岁.首发症状均为腋窝肿物,左侧4例,右侧7例.合并锁骨上淋巴结转移2例.行改良根治术4例,保留乳房仅行腋窝淋巴清扫术3例,腋窝肿物切除术2例,锁骨上淋巴结活检2例.术后按乳腺癌治疗规范行放、化疗和内分泌治疗.随访8个月至9年6个月,死亡3例,5年生存率54.5%(6/11).结论 隐匿性乳腺癌应根据乳腺癌治疗规范进行综合治疗.手术可行改良根治术或根治性保乳术,对于乳腺无原发癌证据者可保留乳房仅行腋窝淋巴清扫术.     

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.     

锌原卟啉对种植性乳腺癌血管生成影响的实验研究

目的探讨锌原卟啉(ZnPP)对种植性乳腺癌VEGF和血管生成的影响。方法应用种植性乳腺癌模型,经过ZnPP和钴原卟啉(CoPP)处理,检测乳腺癌组织中的血红素氧合酶1(HO-1)酶活性,免疫组化、Western blot蛋白印迹杂交检测癌组织中HO-1、VEGF蛋白表达,RT-PCR检测VEGFmRNA,CD34染色肿瘤微血管内皮细胞并对其进行定量分析。结果ZnPP组肿瘤直径[(7±1.06)mm,n=7]明显小于其余各组(t=3.5334,P<0.001);CoPP组[(13±2.82)mm,n=13]大于空白对照组[(10±1.63)mm,n=8](t=3.6564,P<0.002)。CoPP组VEGFmRNA(0.3046±0.0102)明显高于空白对照(0.1524±0.0046)及ZnPP组(0.1216±0.0043)(t=8.8491,P<0.001)。ZnPP处理组HO-1及VEGF蛋白印迹杂交结果低于CoPP组和空白对照组(t=4.698,P<0.005)(t=5.5428,P<0.005)。ZnPP处理组MEA为224.81±79.4266,明显低于CoPP组(448.79±138.46)(t=5.3426,P<0.05)。结论ZnPP可能通过抑制HO-1蛋白的表达来降低VEGF表达,降低肿瘤血管生成,并可能由此降低了肿瘤细胞的增殖生长。     

食管癌患者癌组织COX-2、VEGF-C表达水平对其预后生存的影响

目的分析食管癌患者癌组织环氧合酶2(COX-2)、血管内皮生长因子C(VEGF-C)表达水平对其预后生存的影响。方法回顾性分析2015年4月到2016年10月池州市人民医院经病理确诊的60例食管癌患者临床资料,采用免疫组织化学染色法检测其癌组织标本、癌旁正常食管黏膜组织标本中COX-2、VEGF-C蛋白表达水平,分析癌组织COX-2、VEGF-C表达水平的相关性,分析COX-2、VEGF-C表达水平与患者临床病理特征、预后生存的关系。结果食管癌组织标本中COX-2、VEGF-C表达阳性率均高于癌旁正常食管黏膜组织标本,差异有统计学意义(P<0.05);Spearman相关分析显示,食管癌患者癌组织COX-2表达阳性率与VEGF-C表达阳性率呈正相关(r=0.388,P<0.05);食管癌患者COX-2表达水平与性别、年龄、病理类型无关(P>0.05),而与分化程度、TNM分期、淋巴结转移有关(P<0.05),VEGF-C表达水平与性别、年龄、病理类型、TNM分期无关(P>0.05),而与分化程度、淋巴结转移有关(P<0.05);COX-2阳性患者12个月生存率低于COX-2阴性患者,VEGF-C阳性患者12个月生存率低于VEGF-C阴性患者,但差异无统计学意义(P>0.05);不同COX-2、VEGF-C表达水平患者12个月复发率比较,差异无统计学意义(P>0.05)。结论食管癌患者癌组织中COX-2、VEGF-C表达水平高,且其与临床病理参数也有一定关联,对预后生存的影响尚不明显,但临床检测COX-2、VEGF-C仍可为食管癌患者的预后评估提供参考。     

Impact of breast cancer patients' awareness on attendance at screening

SHIEH S.-H., CHEN H.-C., TSAI W.-C., KUO S.-Y., TSAI Y.-F. & LU C.-H. (2012) Impact of breast cancer patients' awareness on attendance at screening. International Nursing Review59, 353-361 Aim: The purpose of this study is to investigate the impact of breast cancer awareness on the attendance for screening among women with breast cancer prior to diagnoses of breast cancer. Background: Breast cancer is the most commonly diagnosed cancer for women in Taiwan and its incidence rate continues to increase. However, screening for breast cancer is still not common even if the incidence rate has topped the list from 2003 to 2010. Methods: A cross-sectional study was conducted among women diagnosed with breast cancer. Subjects (535 women) were recruited from two medical centres in central Taiwan. Information on attendance for breast cancer screening was collected by self-report. Chi-square test and logistic regression were utilized to analyse the relationships between awareness of breast cancer and attendance at screening. Findings: The results indicated that pre-diagnostic awareness of 'the concept of early treatment relating to higher cure rate'[odds ratio (OR): 4.09; 95% confidence interval (CI): 1.12-14.9], 'various breast cancer screening methods' (OR:3.00; 95% CI: 1.23-7.30), 'the coverage of breast cancer screening programme in the National Health Insurance' (OR:1.76; 95% CI: 1.03-3.02) and 'breast self-examination after each menstrual cycle' (OR:3.42; 95% CI: 1.99-5.87) were all significantly associated with the screening procedures performed. Conclusions: Findings of this study indicated that particular attention should be paid towards enhancement of women's knowledge for prevention and early detection of breast cancer through educational efforts by nurse professionals, medical institutions and/or civil organizations.     

超声微泡在乳腺癌基因治疗中的研究进展

乳腺癌是严重威胁人类健康的恶性肿瘤之一,成为女性疾病致死的首要病因。近年来,随着超声造影技术的不断发展,超声微泡介导基因治疗成为当前肿瘤治疗的研究热点之一,有望成为一种新型的肿瘤治疗方法。本文将针对超声微泡在乳腺癌基因治疗中的研究现状作一综述。     

PTEN与VEGF在乳腺癌中的表达及其意义

目的探讨抑癌基因PTEN蛋白在人乳腺癌中的表达情况及其与VEGF表达的相关性。方法应用免疫组织化学染色S—P法。检测44例乳腺癌组织和10例乳腺纤维瘤石蜡切片中PTEN蛋白、VEGF蛋白的表达情况，比较PTEN蛋白表达与VEGF蛋白表达的相关性及二者与临床病理指标的关系。结果PTEN蛋白表达定位于细胞质，乳腺癌组织PTEN蛋白表达阴性者占47．7％（21／44），表达阳性者占52．3％（23／44）。PTEN在乳腺癌腋淋巴结是否转移（P〈0．01）或ER状态（P〈0．05）组间比较有统计学意义。PTEN与VEGF蛋白表达呈副相关，但差异不显著（rH=-0．236P=0．122）。结论PTEN对乳腺癌预后判定有一定价值，乳腺癌患者PTEN蛋白低表达与预后不良有关。VEGF可能是PTEN的主要下游基因，二者对乳腺癌发生发展起重要作用。     

miR-195 inhibits tumor growth and angiogenesis through modulating IRS1 in breast cancer

Angiogenesis has been found as an attractive target for drug therapy as it is necessary for tumor growth. Accumulating evidences show that microRNAs (miRNAs), which are a group of highly conserved, single-stranded, short non-coding RNAs, play important roles through directly targeting angiogenic factors and protein kinases. The purpose of this study is to investigate the role of miR-195 in breast cancer development and angiogenesis through targeting IRS1. We show that miR-195 is inversely related with Insulin receptor substrate 1 (IRS1) in both breast cancer cells and breast cancer tissues. Induction of miR-195 could suppress IRS1 protein expression through binding to its 3′UTR regions either by transfection with miR-195 oligo or by infection with lentivirus encoding miR-195 gene. Moreover, re-expression of IRS1 reverses miR-195-mediated repression of tumor cell growth and miR-195 inhibits tumor angiogenesis through suppressing IRS1-VEGF axis. These data suggest that miR-195 mimics are potential therapeutic agents for breast cancer diagnose.     

男性异位乳腺癌

目的 探讨男性异位乳腺癌的临床表现、诊断、治疗和预后。方法 对1981—1999年间我院手术及病理学检查证实的3例男性异位乳腺癌临床资料进行回顾性分析研究。结果 男性异位乳腺癌3例，年龄46—76岁（中位年龄61岁）。2例Ⅱ期男性异位乳腺癌病灶位于腋窝，经手术及辅助化疗与放疗均生存10年以上；1例Ⅳ期病例肿瘤发生于左腹股沟伴同侧股骨转移，切除原发灶后给予内分泌治疗、化疗及中草药治疗，并对骨转移灶予以。钴放疗，10个月后死于脑转移。结论 男性乳腺癌少见，男性异位乳腺癌罕见。由于就诊迟或医生对此缺乏经验，易致误诊或漏诊。病理活检可获确诊；细针穿刺抽吸细胞学检查、乳腺摄影及B超有助于诊断。其治疗应采用以手术为主的综合治疗。     

靶向TLR4治疗结直肠癌的可行性探讨

慢性炎症与肿瘤的发生发展密切相关.介导炎症的Toll样受体(toll-like receptor, TLR)家族是感受病原体入侵的一类模式识别受体,其中TLR4与结直肠肿瘤发生发展的关系最为明确.本文着重对TLR4与结直肠癌的发病机制、预后以及治疗进行介绍,并对TLR4作为结直肠癌治疗靶标的可行性进行探讨.     

乳腺癌VEGF的表达与彩色多普勒血流表现及病理的相关分析

目的探讨乳腺癌VEGF的表达与彩色多普勒血流表现及病理因素的相关性。方法检测50例乳腺癌患者VEGF表达与与彩色多普勒血流信号(0～Ⅲ级)及病理因素的分析。结果50例乳腺癌中,VEGF阳性表达者34例(68%)。乳腺癌Ⅱ~Ⅲ级血流组中VEGF表达水平高于乳腺癌0～Ⅰ级血流组,差异有统计学意义(P<0.01);淋巴结转移组中VEGF表达水平高于未转移组,差异有统计学意义(P<0.05);VEGF表达随着癌组织学分级的升高,VEGF表达水平也呈逐渐升高趋势(P<0.05)。结论乳腺癌中彩色血流分级随着VEGF表达水平的增强而明显增高,VEGF在乳腺癌的肿瘤血管生成及转移过程中可能发挥重要的调控作用。     

乳腺癌超声造影特征与C-erbB-2、p53表达的相关性研究

目的 探讨乳腺癌肿块超声造影灌注特征与癌基因C-erbB-2、p53表达的相关性.方法 回顾性分析51例经手术及病理确诊的乳腺癌患者术前超声造影资料,术后对肿瘤标本采用免疫组织学方法测定C-erbB-2、p53蛋白表达情况,并分析其与超声造影特点之间的关系.结果 ①乳腺癌患者肿块C-erbB-2、p53阳性表达率分别为45.1％(23/51)和41.2％(21/51).②51例乳腺癌患者肿块的增强模式均以向心性、快速增强、高增强为主,与C-erbB-2及p53表达无关.③C-erbB-2、p53阳性表达的乳腺癌患者,肿块均出现灌注不均匀的几率增加,两者间有关联(P＜0.05),且C-erbB-2阳性表达的乳腺癌患者肿块出现灌注缺损的几率增加,与阴性表达的乳腺癌患者肿块比较差异有统计学意义(P＜0.05).④C-erbB-2、p53阳性表达的乳腺癌患者,肿块出现放射状或穿支血管的几率增加,两者间有关联(P＜0.05),尤其以后者较为显著(P＜0.01).结论 乳腺癌超声造影特征与C-erbB-2、p53阳性表达之间存在一定的相关性.乳腺癌超声造影特征能在一定程度上反映癌细胞的生物学行为及预后,可为临床选择合理的治疗方案提供参考.     

Optimizing breast cancer follow-up: diagnostic value and costs of additional routine breast ultrasound

A total of 2,546,325 breast cancer survivors are estimated to live in the United States. The organized breast cancer follow-up programs do not generally include breast ultrasound in asymptomatic women. The purpose of our prospective study was to investigate the efficacy of breast ultrasound in detecting previously occult recurrences. A total of 735 eligible patients with a history of breast cancer were recruited. We assessed the same patient population before (routine follow-up program) and after (study follow-up program) the introduction of an additional ultrasound examination. In the routine follow-up program 245 of 735 patients (33.3% [95% confidence-interval (CI): 29.9-36.7]) had an ultrasound due to abnormal local or mammographic findings. 490 of 735 patients (66.7% [95% CI: 63.3-70.1]) were initially considered asymptomatic and received an additional ultrasound exclusively within the study follow-up program.All positive examination results were followed by accelerated core needle biopsy. The routine follow-up program led to a biopsy in 66 of 735 patients (9.0%) revealing a recurrent cancer in 27 cases (3.7%). The study follow-up program with the additional ultrasound led to another 21 biopsies raising the total number of patients who had to undergo a biopsy from 9.0% (95% CI: 6.9-11.1) to 11.8% (95% CI: 9.5-14.2). Finally, we diagnosed a previously occult malignant lesion in an additional six patients following this protocol. Therefore, the rate of detected recurrences rose from 3.7% (95% CI: 2.3-5.0) in the routine follow-up program to 4.5% (95% CI: 3.0-6.0) in the study follow-up program (p = 0.041). Negative side effects were the additional costs (the costs per detected malignancy in the routine follow-up program were $2455.69; the costs for each additionally detected malignancy in the study follow-up program were $7580.30), the higher overall biopsy rate (9.0 vs. 11.8%) and the elevated benign biopsies rate (59.1% vs. 71.4%). Regarding these results, the advantages and disadvantages of additional breast ultrasound must be discussed for every follow-up patient individually even today, as we can detect a significantly higher number of previously occult malignancies. (E-mail s@wojcinski.de)     

Correlation of matrix metalloproteinases and their inhibitors with hypoxia and angiogenesis in premenopausal patients with adenocarcinoma of the breast

Objectives

The present study was designed to correlate the expression of proteins regulating invasion and angiogenesis in patients with adenocarcinoma of the breast.

Design and method

Seventy-five premenopausal breast cancer patients histologically categorized as grades I, II and III were chosen for the study. We analyzed the expression of MMP-2, and -9 and their inhibitors TIMP-2 and RECK together with HIF-1α and VEGF in tumor, adjacent tissues and serum samples by immunohistochemical and Western blot analysis.

Results

The breast tumors analyzed in the present study were characterized by increased expression of MMP-2, -9, HIF-1α and VEGF with differential expression patterns of TIMP-2 and downregulation of RECK.

Conclusions

The simultaneous analysis of the expression of these molecular markers is important to understand the intricate network between key molecules involved in invasion and angiogenesis that eventually determines the clinical course of the disease.     

遗传多态性在乳腺癌易感性中的研究进展及其应用

乳腺癌是女性最常见的恶性肿瘤之一,它的发生发展是多基因协同作用的结果。相关基因遗传多态性,特别是易感基因遗传多态性使人具有不同的乳腺癌易感性。这些多态位点可以作为发病风险的生物标记进而用于个体化预防策略的制定。本文简要介绍了乳腺癌易感基因及易感位点的研究进展,并对应用这些基因及位点的多态性于乳腺癌的个体化预防前景进行了初步探讨。     

癌症焦虑量表在乳腺癌患者术后复发恐惧检测中的应用

目的：了解癌症焦虑量表（ CWS）评分与乳腺癌患者疾病指标的相关性,判断患者的肿瘤复发恐惧程度及分布特征。方法随机选取青岛大学附属医院乳腺病诊疗中心接受诊治的乳腺癌术后未复发患者85例,采用CWS ,以书信或电子邮件的形式进行调查。结果共发放问卷114份,其中85例完成CWS量表的填写,有效回收率74．6％。85例患者 CWS 得分8～22分,平均得分为（11．84±4．06）分;接受保乳手术与接受局部治疗＋全身性治疗患者焦虑程度高于改良手术和只接受局部治疗患者,组间比较差异有统计学意义（χ2值分别为9．071,16．406;P＜0．05）。结论 CWS量表可作为我国乳腺癌患者的肿瘤复发恐惧心理检测工具。对于CWS评分较高的患者,建议临床医疗及护理人员提供适合的心理干预和支持治疗以降低其肿瘤复发恐惧。