基于人工神经网络的诊断模型对针吸细胞学诊断小细胞型乳腺癌的应用研究

目的探讨人工神经网络（ANN）诊断模型对小细胞型乳腺癌的针吸细胞学诊断价值。方法利用MPIAS-2000系统对60例乳腺癌及30例乳腺良性病变针吸细胞的29项形态定量参数进行定量分析，建立人工神经网络诊断模型，对19例小细胞型乳腺癌进行人工神经网络诊断模型的判别分析。结果人工神经网络诊断模型对小细胞乳腺癌及良性病变的诊断特异性为100％，敏感性为84．2％。结论利用乳腺癌针吸细胞形态定量的人工神经网络诊断模型，对辅助针吸细胞学诊断小细胞型乳腺癌具有重要的参考价值。     

乳腺肿物细针穿刺细胞学诊断的研究

目的 对细针穿刺细胞学诊断在乳腺肿物穿刺中的应用进行评价。方法 细针穿刺乳腺触及到实变处肿物吸取组织细胞涂片，采用瑞氏-姬姆萨复合染色，显微镜下观察细胞排列、结构、背景特点、细胞形态等方面对乳腺肿物良恶性判定，并与病理组织学诊断进行对比分析，结果其所长乳腺肿物3325例细针穿刺，总准确率为98．1％；655例乳腺癌的诊断准确率为100％；在部分良性病例(乳腺纤维腺瘤)的诊断准确率为88％；疑癌94％，描述性报告7％确诊为乳腺癌。结论 细针穿刺细胞学诊断对于临床诊断良恶性病变有独到价值。且对恶性病例诊断更为可靠。此诊断技术简便，费用低，值得推广应用。     

3,541例乳腺病变针吸细胞学诊断——组织学对照及假阴性报告之探讨

自1978年7月至1986年6月,天津市肿瘤研究所细胞学室共作乳腺疾患针吸细胞学诊断10,816例。其中有3,541例作了手术及组织学检查,以此为对照,细胞学诊断为恶性准确率的89％,良性乳腺疾患之细胞学诊断准确率为90％,假阴性报告为6.8％。细胞学诊断之准确性受技术性限制,如针吸时错过小的病变及深部肿瘤,涂片标本上皮成分不足等造成诊断困难,即使对有经验的细胞学家来说,仅凭细胞分化良好,形态单一去鉴别良、恶性也常有失误,本文对此进行了初步探讨。     

乳腺肿块针吸细胞学与组织学检查271例对照分析

目的 探讨针吸细胞学对乳腺肿块的诊断价值。方法 对271例乳腺肿块细胞学与组织学检查结果进行对比分析。结果 207例乳腺癌细胞学诊断癌及可疑癌者共144例，敏感性为69．6％。64例乳腺良性病变细胞学假阳性率为0％，特异性为100％。结论 针吸细胞学检查是确诊乳腺肿块性质的有效方法。     

乳腺肿物细针穿刺细胞学诊断的研究

目的　对细针穿刺细胞学诊断在乳腺肿物穿刺中的应用进行评价。方法　细针穿刺乳腺触及到实变处肿物吸取组织细胞涂片 ,采用瑞氏 -姬姆萨复合染色 ,显微镜下观察细胞排列、结构、背景特点、细胞形态等方面对乳腺肿物良恶性判定 ,并与病理组织学诊断进行对比分析。结果　乳腺肿物 3 3 2 5例细针穿刺 ,总准确率为 98 1% ;65 5例乳腺癌的诊断准确率为 10 0 % ;在部分良性病例 (乳腺纤维腺瘤 )的诊断准确率为 88% ;疑癌 94% ,描述性报告 7%确诊为乳腺癌。结论　细针穿刺细胞学诊断对于临床诊断良恶性病变有独到价值。且对恶性病例诊断更为可靠。此诊断技术简便 ,费用低 ,值得推广应用。     

820例乳腺肿块针吸细胞学诊断分析

目的探讨我院乳腺肿块针吸细胞学诊断的准确率及误诊原因。方法分析820例乳腺肿块针吸细胞学检查结果,其中498例肿块切除后行组织学检查,比较针吸细胞学与病理组织学诊断结果。结果820例乳腺肿块中良性病变583例,恶性肿瘤237例,498例针吸细胞学与组织学诊断符合率为95.78%。结论乳腺肿块针吸细胞学诊断准确率高,能较准确地鉴别病变良恶性,对临床具有重要的指导意义。     

细胞形态在乳腺良恶性病变中的体视学定量研究

本文采用ＭＰＩＡＳ－５００多媒体病理图文分析系统对５０例乳腺癌及３０例乳腺良性病变细胞形态进行了多参数的体视学定量研究。在２６项参数中有２３项参数乳腺癌与乳腺良性病变差异非常显著（Ｐ＜００１），２项差异显著（Ｐ＜００５），１项无显著性差异（Ｐ＞００５）。同时对定量参数进行灵敏度和特异度评估测算，有１５项参数特异度达９０％以上，其中７项参数达１００％；灵敏度９项参数达９０％以上。本文研究结果充分揭示了乳腺良恶病变细胞的立体形态学特征，其多参数的定量结果对鉴别诊断乳腺良恶性病变有重要价值     

乳腺肿块针吸细胞学检查157例报告

目的 探讨针吸细胞学在乳腺肿块中的诊断价值。方法 对本组中阳性、假阳性和未确定的细胞涂片进行了复查并与石蜡切片进行了对比分析，结果 72例乳腺癌中，针吸细胞学诊断61例（84.7%)。6例假阴性（8.3%)，85例良性病变通过针吸细胞学诊断80例（94%），2例假阳性（2.4%)。8例未明确定性（5.1%)。结论 针吸细胞学检查是确诊乳腺肿块性质的有效方法。     

细胞图像光度学计量对鉴别诊断小细胞型乳腺癌的价值研究

目的:探讨小细胞型乳腺癌针吸细胞图像的光度学特征及与乳腺良性病变之间的量化差异和鉴别价值。方法:用MPIAS—500多媒体病理细胞图像分析仪,对22例小细胞型乳腺癌的针吸细胞分胞体、胞核和胞浆三大结构进行了细胞图像光密度值9项指标的计量研究,并以20例乳腺良性病变做对照。结果:在9项指标中小细胞型乳腺癌有6项指标与乳腺良性病变差异非常显著(P<0.01), 其中胞体1项,胞核2项,胞浆3项;有3项指标差异显著(P<0.05)。结论:利用细胞图像分析仪对小细胞型乳腺癌进行光度学分析,其多参数的光密度指标对协助针吸细胞学鉴别诊断小细胞型乳腺癌有重要参考价值。     

涎腺肿物针吸细胞学的分类诊断探讨

目的：探讨涎腺肿物针吸细胞学（FNAC）特点、诊断价值及误诊原因。方法：通过涎腺肿物针吸细胞学与病理组织学对照，回顾性分析102例涎腺肿物针吸细胞学特点。结果：356例涎腺FNAC中，有组织学对照102例，其中诊断正确91例，正确率89．2％；良性病变诊断准确率94．4％；良性肿瘤诊断准确率89．5％；恶性肿瘤诊断准确率82．4％。FNAC区分良恶性病变的诊断准确率为96．1％。结论：涎腺肿物针吸细胞学诊断是一种快速、简便的检查方法，对涎腺良恶性病变的诊断可靠、准确。对某些肿瘤的分类仍有局限性，需要活检诊断。     

乳腺癌针吸细胞图像光度学计量研究

 目的　探讨乳腺癌针吸细胞图像光度学及与乳腺良性病变的量化差异和鉴别价值。方法　用MPIAS 5 0 0多媒体细胞图像分析仪 ,对 5 0例乳腺癌分胞体、胞核、胞浆三大结构进行了细胞图像光密度值12项指标的计量研究 ,并以 30例乳腺良性病变做对照。结果　在 12项指标中有 10项指标乳腺癌与乳腺良性病变有非常显著性差异 (P <0 .0 1) ,其中胞体及胞核分别有 3项 ;胞浆有 4项。特异度有 5项指标≥80 % (1项为 10 0 % ) ;灵敏度有 7项指标≥ 80 % (2项为 10 0 % ) ,且特异性强 ,灵敏度高的参数主要分布在细胞核和细胞浆中。结论　利用细胞图像分析仪对乳腺癌进行光度学分析 ,其多参数的光密度指标具有科学性和可信性及可比性 ,对乳腺癌与乳腺良性病变的鉴别诊断有重要参考价值。     

SIGNIFICANCE AND CORRELATION OF MAPK/ERK2 AND PI3-K IN HUMAN BREAST TUMORIGENESIS

Objective： MAPK （（Mitogen-actived Protein Kinase） and PI3-K （Phosphatidylinositol 3-kinase） pathways have been implicated in the mitogenic pathways regulating cell growth, proliferation, differentiation and transformation and thus involved in tumorigenesis. This study was designed to examined the protein expression, activity and mRNA levels of both ERK and PI3-K in a series of breast tumors and adjacent mammary glands, and to figure out the changes of ERK2 and PI3-K during the dynamic process of breast tumorigenesis. Methods： A series of breast tumors and adjacent mammary glands were collected at surgery, including 37 cases of breast cancer, 6 cases of atypical hyperplasia-breast carcinoma in situ and 15 cases of benign conditions. Western blot, kinase activity assay and RT-PCR were used to detect the protein expression, kinase activity and mRNA level, respectively. Results： The revels of protein, activity and mRNA of ERK2 were elevated during the stages of both initiation and progression. The increasing tendency in breast cancer was equal to atypical hyperplasia -in situ carcinoma, but higher than in benign lesion and adjacent normal mammary gland. PI3-K was activated during the stage of progression of breast cancer. An inverse correlation between the activity of PI3-K and ERK2 in breast cancer was found. Conclusion： Our findings indicate that ERK2 may perform its function during both the stages of breast cancer initiation and breast cancer progression, while PI3-K may exert its effect during the stage of breast cancer progression. Both PI3-k and ERK2 are involved in the tumorigenesis of breast cancer.     

乳腺良恶细胞核的图像分析

对乳腺疾病细胞核病理形态进行测定研究。方法　对乳腺腺病 4 0例、乳腺腺病伴不典型增生 2 0例及乳腺癌 50例 ,采用常规石蜡切片、HE染色 ,并应用MPIAS - 50 0多媒体病理图像分析系统对其细胞核的形态进行定量测定。结果　定量测定的结果表明了乳腺疾病细胞核 8项形态参数测定。其中有7项存在非常显著性差异 (p <0 . 0 1)。 1项有显著性差异 (p <0 . 0 5)。结论　乳腺疾病细胞核形态参数的测定对鉴别乳腺良恶病变具有一定意义。     

二甲基苯蒽诱导大鼠乳腺癌发生的组织形态学研究

用化学致癌剂二甲基苯蒽（ＤＭＢＡ）诱发大鼠实验性乳腺癌及癌前病变的动物模型。研究在实验性乳腺癌发生过程中乳腺组织、细胞形态学变化及其演变规律。结果发现雌性大鼠在给予致癌剂ＤＭＢＡ后乳腺上皮细胞逐渐发生增生、不典型增生，并在此基础上发生乳腺癌。至实验第２４周，７０％的大鼠发生乳腺癌，其组织形态学特点与人体乳腺癌相似。雄性致癌组未发生乳腺癌。结果提示，ＤＭＢＡ诱导大鼠乳腺癌发生的组织形态学变化与人体乳腺部分良性疾病癌变过程相似。ＤＭＢＡ诱发大鼠实验性乳腺癌及癌前病变可做为模拟人体乳腺癌发生，研究乳腺癌发生机制和预防乳腺癌实验研究的动物模型     

乳腺癌针吸细胞体视学定量与细胞形态学分型的探讨

 本文采用国内先进的MPIAS-500多媒体图像分析仪对50例乳腺癌的针吸细胞形态进行了多参数的体视学定量研究.并以细胞面积、核浆比值两项定量参数为分型标准、对50例乳腺癌进行了分型研究,共分四型、对各型之间细胞形态的体视学定量结果进行了对比分析,同时结合病理组织学分类进行对照分析.本文的研究结果建立了乳腺癌细胞形态体视学的量化指标及探讨了乳腺癌针吸细胞形态学的分型标准和方法,对鉴别诊断乳腺癌和判断乳腺癌的恶性程度以及指导临床观察乳腺癌的生物学特性、疗效及预后有重要意义.     

Differentiation of benign and malignant breast lesions by mechanical imaging

Mechanical imaging yields tissue elasticity map and provides quantitative characterization of a detected pathology. The changes in the surface stress patterns as a function of applied load provide information about the elastic composition and geometry of the underlying tissue structures. The objective of this study is the clinical evaluation of breast mechanical imager for breast lesion characterization and differentiation between benign and malignant lesions. The breast mechanical imager includes a probe with pressure sensor array, an electronic unit providing data acquisition from the pressure sensors and communication with a touch-screen laptop computer. We have developed an examination procedure and algorithms to provide assessment of breast lesion features such as hardness related parameters, mobility, and shape. A statistical Bayesian classifier was constructed to distinguish between benign and malignant lesions by utilizing all the listed features as the input. Clinical results for 179 cases, collected at four different clinical sites, have demonstrated that the breast mechanical imager provides a reliable image formation of breast tissue abnormalities and calculation of lesion features. Malignant breast lesions (histologically confirmed) demonstrated increased hardness and strain hardening as well as decreased mobility and longer boundary length in comparison with benign lesions. Statistical analysis of differentiation capability for 147 benign and 32 malignant lesions revealed an average sensitivity of 91.4% and specificity of 86.8% with a standard deviation of ±6.1%. The area under the receiver operating characteristic curve characterizing benign and malignant lesion discrimination is 86.1% with the confidence interval ranging from 80.3 to 90.9%, with a significance level of P = 0.0001 (area = 50%). The multisite clinical study demonstrated the capability of mechanical imaging for characterization and differentiation of benign and malignant breast lesions. We hypothesize that the breast mechanical imager has the potential to be used as a cost effective device for cancer diagnostics that could reduce the benign biopsy rate, serve as an adjunct to mammography and to be utilized as a screening device for breast cancer detection.     

Expression of the gastrin-releasing peptide gene in carcinomas of the breast.

Expression of gastrin-releasing peptide (GRP), the mammalian homologue of the amphibian bombesin, has been investigated at gene and protein level in a series of 28 primary breast carcinomas, in 6 mammary cancer cell lines and in one transplantable rat mammary carcinoma. Moderate to strong expression of GRP mRNA was detected in 5 breast carcinomas by Northern blot analysis with a pre-pro-GRP probe; 4 other cases were weakly reactive. Two of these cases also gave a specific immunocytochemical reaction for GRP, controlled with absorption experiments. Correlation with NE differentiation [as shown by chromogranins (Cg) and/or NSE and/or Grimelius positivity] was low, since only one case of breast carcinoma co-expressed GRP and Cg mRNAs. Breast cancer cell lines and a rat carcinoma gave negative results. GRP production in breast cancer did not appear to bear prognostic implications, but longer follow-up periods are needed to confirm these data. As shown in small-cell lung cancer, GRP might be involved in autocrine growth control mechanisms of a group of breast carcinomas.