抑癌基因PTEN在乳腺浸润性导管癌中的表达及临床意义

目的研究乳腺浸润性导管癌中PTEN蛋白表达与乳腺癌不同的临床病理因素、TNM分期的关系及其临床意义。方法采用免疫组织化学SP法,对32例乳腺浸润性导管癌组织中PTEN蛋白的表达水平进行检测。结果正常乳腺组织中PTEN表达阳性,32例乳腺癌中有13例PTEN阴性表达(41%),其中8例雌激素受体(ER)、孕激素受体(PR)阴性(61.5%),而19例PTEN阳性表达标本中仅4例ER、PR均为阴性(21.1%)。有腋淋巴结转移的乳腺浸润性导管癌组织中PTEN表达水平显著低于无腋淋巴结转移的乳腺浸润性导管癌组织(P<0.001);ER阴性者PTEN表达水平明显低于ER阳性者(P<0.05),PTEN表达水平与患者年龄、肿瘤大小、孕激素水平及临床分期无关,但随临床分期的增高,PTEN表达水平呈下降趋势。结论乳腺癌组织中PTEN蛋白失表达与腋淋巴结转移及雌激素阴性水平密切相关。     

Pokemon、E-cadherin和CD44v6蛋白在乳腺癌组织中的表达及其与影像学特征的关系

目的 检测Pokemon、E-cadherin和CD44v6蛋白在乳腺癌组织及癌旁组织中的表达,探讨其与影像学表现的关系.方法 60例新鲜乳腺癌标本,所有标本均含有乳腺癌组织及癌旁组织,采用免疫组织化学法分别检测Pokemon、E-cadherin和CD44v6蛋白的表达.用B超观察乳腺癌的影像学特征.结果 乳腺癌组织中Pokemon蛋白表达率为75.0%,高于癌旁乳腺组织中Pokemon蛋白表达率31.7%(P＜0.05),乳腺癌组织中E-cadherin蛋白的阳性表达率(55.0%)明显低于癌旁乳腺组织中E-cadherin蛋白的阳性表达率(100.0%)(P＜0.05),乳腺癌组织中CD44v6蛋白的表达率(60.0%)显著高于癌旁乳腺组织CD44v6蛋白的表达率(5.0%)(P＜0.05).超声观察,Pokemon、E-cadherin和CD44v6蛋白的表达与乳腺癌的浸润、转移明显相关.结论 Pokemon、E-cadherin和CD44v6蛋白可能在乳腺癌发生、发展及转移中发挥作用,Pokemon、E-cadherin和CD44v6蛋白与超声影像结合可能与乳腺癌的预后有关.     

Ki-67、miR-182在乳腺浸润性导管癌中的表达及相关性

探究Ki-67和miR-182在乳腺浸润性导管癌的表达及相关性。选取2014年7月—2016年7月70例乳腺浸润性导管癌患者的癌组织和癌旁组织标本为研究对象,免疫组化法检测各样本中Ki-67的表达,同时荧光定量PCR检测各组织样本中miR-182的表达,综合分析乳腺浸润性导管癌中Ki-67和miR-182的表达水平、相关性及其临床意义。70例乳腺浸润性导管癌组织标本中,Ki-67阳性表达率明显高于相应的癌旁组织标本中Ki-67的阳性表达率(P0.05)。乳腺浸润性导管癌组织中miR-182的表达水平明显高于癌旁组织中miR-182的表达水平(P0.05)。Ki-67与miR-182的表达呈明显正相关(r=0.435,P0.05)。乳腺浸润性导管癌中Ki-67和miR-182表达水平明显高于癌旁组织,Ki-67和miR-182的表达呈明显的正相关,可作为乳腺浸润性导管癌分子治疗的新靶点。     

乳腺浸润性导管癌RSPO1、β-catenin表达及其特点

探究R-脊椎蛋白1(RSPO1)、β-连环蛋白（β-catenin）与乳腺浸润性导管癌临床病理特征的关系。2017年5月—2020年5月,256例乳腺浸润性导管癌患者,采用免疫组化染色法检测RSPO1、β-catenin在癌组织及癌旁正常组织中表达水平,分析RSPO1、β-catenin表达与乳腺浸润性导管癌患者临床病理特征及预后的关系。结果显示,乳腺浸润性导管癌患者癌组织中RSPO1、β-catenin阳性表达率显著高于癌旁正常组织（P<0.05）;月经状态、年龄、肿瘤直径不同的乳腺浸润性导管癌患者癌组织中RSPO1、β-catenin表达水平差异无统计学意义（P>0.05）;组织学分级、淋巴结转移、TNM分期不同的乳腺浸润性导管癌患者癌组织中RSPO1、β-catenin表达水平差异有统计学意义（P<0.05）;RSPO1、β-catenin阳性表达的乳腺浸润性导管癌患者5年无进展生存率显著低于RSPO1、β-catenin阴性表达的乳腺浸润性导管癌患者（P<0.05）。结果表明,RSPO1、β-catenin在乳腺浸润性导管癌中呈高表达,其表达水平与乳腺浸...     

Slit2在乳腺组织的表达与乳腺癌脑转移的关系

目的 检测神经轴突导向蛋白2(Slit2)在不同乳腺肿瘤组织中的表达,探讨Slit2与乳腺癌脑转移的相关性.方法 采用免疫组织化学LSAB法检测对24例发生脑转移的乳腺浸润性导管癌(IDC)、71例未发生脑转移的乳腺浸润性导管癌、22例乳腺导管内癌和23例乳腺腺纤维瘤组织中Slit2的表达.结果 Slit2在浸润性导管癌中有脑转移患者的阳性表达率(13%)明显低于无脑转移患者(59%)(P＜0.05);在乳腺导管内癌和浸润性导管癌中的阳性表达率(59%和48%)均明显低于乳腺纤维瘤(87%,P＜0.05);但前两者间差异无统计学意义(P＞0.05);在50岁以上乳腺癌患者中的阳性表达率(62%)明显高于50岁及以下患者(34%,P＜0.05);在生存期＜5年的乳腺浸润性导管癌患者组织中Slit2的阳性表达率(18%)明显低于生存期＞5年的患者(59%)(P＜0.05).Slit2阴性的患者总生存时间明显短于Slit2阳性患者(P＜0.01).Slit2在乳腺癌中的表达与肿瘤大小、淋巴结转移状态、病理学分期、组织学分级均无明显相关(P＞0.05).结论 乳腺癌中Slit2的表达和乳腺癌脑转移呈负相关,和乳腺浸润性导管癌患者的发病年龄及预后呈正相关,可成为判断乳腺癌预后和脑转移的分子标志物.     

印迹基因SLC22A18在乳腺癌中的表达及其意义

目的 研究印迹基因SLC22A18在乳腺浸润性导管癌中mRNA和蛋白水平的表达.并分析SLC22A18表达与乳腺癌临床病理特征之间的相关性,从而探讨SLC22A18基因在乳腺癌发生发展中的作用.方法 应用实时荧光定量逆转录聚合酶链反应方法检测46例乳腺浸润性导管癌和对应癌旁乳腺组织,以及20例乳腺良性病变组织中SLC22A18 mRNA的表达,应用免疫组织化学方法检测46例乳腺浸润性导管癌组织、20例乳腺良性病变中SLC22A18蛋白表达,分析SLC22A18 mRNA和蛋白表达与乳腺癌临床病理特征间的关系.结果 SLC22A18在46例乳腺浸润性导管癌中mBNA表达量低于癌旁组织(Z=-4.900,P＜0.01);46例乳腺浸润性导管癌中SLC22A18 mRNA表达量低于乳腺良性病变(Z=-3.182,P＜0.01).40例乳腺浸润性导管癌中SLC22A18 mRNA表达量低于6例导管内癌灶性浸润(Z=-2.022,P＜0.05).SLC22A18蛋白在20例乳腺良性病变、46例乳腺浸润性导管癌中表达阳性率分别为95%、69.6%,两组阳性表达率差异有统计学意义(x2=5.135,P＜0.05).SLC22A18 mRNA和蛋白表达与患者年龄、肿瘤大小、组织学分级、TNM分期及淋巴结转移均无相关性(P＞0.05).结论 SLC22A18在乳腺浸润性导管癌中表达下调,SLC22A18可能参与了乳腺癌的发生,并有可能成为乳腺癌早期诊断的新分子标志物.     

OCT4和Fas表达与浸润性乳腺癌的关系

探讨干细胞因子八聚体结合转录因子4(OCT4)、脂肪酸合成酶(Fas)蛋白在乳腺癌组织中的表达及其临床意义。110例浸润性乳腺癌组织(乳腺癌组)和55例乳腺癌癌旁组织(癌旁组),采用免疫组化染色检测两组标本中的OCT4蛋白、Fas蛋白表达,分析在不同病灶大小、组织学分级、TNM分期、淋巴结转移的乳腺癌组织中的OCT4蛋白、Fas蛋白阳性表达率差异。结果显示,OCT4蛋白阳性表达率乳腺癌组为72.73%,高于癌旁组的16.36%(P0.05);乳腺癌组Fas蛋白阳性表达率40.91%,低于癌旁组的80.00%(P0.05);在不同TNM分期、不同组织学分级、是否发生淋巴结转移的乳腺癌组中的OCT4蛋白、Fas蛋白阳性表达率差异均有统计学意义(P0.05);在不同病灶大小的乳腺癌标本中的OCT4蛋白、Fas蛋白阳性表达率差异无统计学意义(P0.05)。结果表明,浸润性乳腺癌组织中的OCT4蛋白表达上调、Fas蛋白表达下调,与乳腺癌的发生发展关系密切。     

乳腺癌p16蛋白的表达及临床意义

我们应用免疫组织化学方法检测乳腺浸润性导管癌、癌旁组织及正常乳腺组织中ｐ１６蛋白的表达,探讨ｐ１６蛋白在乳腺癌的发生和发展中的作用。１．资料与方法：本组１００例乳腺浸润性导管癌标本为我院１９８８～１９９０年外科切除标本,其中８８例同时取癌旁组织做检测。所有病例均为女性,年龄２４～８２岁,平均５０－２岁;术前均未接受放疗及化疗;８例正常乳腺组织为我院病理科尸检标本。ｐ１６蛋白的检测按文献［１］的方法操作。每批染色均设阴性对照（用ＰＢＳ代替一抗）和阳性对照。阳性细胞数＜３０％定为阴性表达,≥３０％为…     

端粒酶逆转录酶、环氧化酶-2在乳腺癌中的表达及其意义

目的 探讨端粒酶逆转录酶(hTERT)和环氧化酶(cox)-2在乳腺浸润性导管癌中的表达及其临床意义.方法 使用免疫组织化学法分别检测45例乳腺浸润性导管癌和22例乳腺良性病变标本的hTERT和COX-2蛋白表达情况.结果 hTERT在乳腺浸润性导管癌中阳性表达率fig71.11%,明显高于乳腺良性病变9.09%,两者比较差异有统计学意义(P<0.05).hTERT阳性表达与乳腺浸润性导管癌患者的年龄、肿瘤大小、腋窝淋巴结转移情况及雌、孕激素表达水平无相关性(P>0.05),与Her-2表达存在显著相关性(P<0.05).COX-2在乳腺浸润性导管癌中的阳性表达率为82.22%,明显高于乳腺良性病变50.00%,两者比较差异有统计学意义(P<0.05).COX-2阳性表达与乳腺浸润性导管癌患者腋窝淋巴结转移情况、Her-2、ER阳性表达有关(P<0.05).在乳腺浸润性导管癌中hTERT阳性表达与COX-2阳性表达呈正相关(r=0.557,P<0.01).结论 hTERT与COX-2在乳腺浸润性导管癌中的表达显著高于在乳腺良性病变中的表达,hTERT与COX-2在乳腺癌的发生、发展中起重要作用.hTERT表达与COX-2表达存在显著相关性,COX-2的过度表达可能是端粒酶激活和调节的机制之一.     

ALCAM/CD166在乳腺癌组织中表达及意义以及其与Bcl-2、Ki-67的关系

目的研究乳腺浸润性导管癌组织中活化白细胞黏附分子(ALCAM/CD166)的表达及其与凋亡抑制蛋白Bcl-2及增殖细胞核抗原Ki-67的关系,探讨ALCAM/CD166在乳腺浸润性导管癌发生、发展中的作用。方法应用免疫组织化学Elivision~(TM) Plus二步法检测96例乳腺浸润性导管癌组织和30例癌旁非瘤乳腺上皮组织中ALCAM/CD166及Bcl-2、Ki-67蛋白表达的情况,分析ALCAM/CD166蛋白表达与乳腺浸润性导管癌患者的年龄、肿瘤直径、组织病理学分级、淋巴结转移及TNM分期的关系以及其与Bcl-2、Ki-67的相关性。结果 1在96例乳腺浸润性导管癌中ALCAM/CD166蛋白表达阳性率为79.2%(76/96),明显高于其在癌旁非瘤乳腺上皮组织中的10.0%(3/30),差异有统计学意义(P0.01)。2 ALCAM/CD166蛋白阳性表达与乳腺浸润性导管癌患者的年龄、肿瘤直径、组织病理学分级及TNM分期均无关(P0.05),与腋窝淋巴结转移有关(P0.05)。3乳腺浸润性导管癌组织中ALCAM/CD166蛋白表达与Bcl-2蛋白表达呈正相关(rs=0.307,P=0.001),而与Ki-67蛋白表达无关(rs=0.064,P=0.475)。结论 ALCAM/CD166蛋白表达与乳腺浸润性导管癌细胞凋亡及转移有关,可能成为判断肿瘤生物学行为和患者预后的重要参考指标之一。     

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??Armpit incision combined with intraoperative ultrasound positioning treatment of multiple breast fibroma: An analysis of 97 cases LI Wen-tao, ZHAI Bao-ping, JIA Lin-jiao, et al. Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China
Corresponding author: ZHAI Bao-ping, E-mail: zhaibaoping@163.com
Abstract Objective To explore the surgery methods for multiple fibroadenoma of breast, provide a reference for the surgical treatment of breast multiple fibroma. Methods The clinical data of 97 cases of breast multiple fibroadenoma admitted from January 2009 to April 2012 in Department of Breast Surgery, Henan Provincial People's Hospital were analyzed retrospectively. All the cases were applied intraoperative ultrasound positioning, taken the armpit incision after breast surgical approach for resection of multiple breast fibroadenoma. The surgical incision design, surgical procedures and results of operations were analyzed. Results The fibroids of 97 cases were resected guided by color Doppler ultrasound positioning with hidden incision and satisfactory breast appearance. Conclusion Approach surgery color Doppler positioning with the gap after the removal breast multiple fibroadenoma is satisfactory with short operation time and good clinical value.     

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??Expression of c-myc in triple negative breast cancer and its relationship with recurrence and metastasis ZENG Jian-feng*, QIU Cheng-zhi, ZHOU Zhi-ping, et al. *Department of General Surgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000,China
Corresponding author: ZENG Jian-feng, E-mail: bbjian@gmail.com
Abstract Objective To explore the c-myc protein expression in triple negative breast cancer and its relationship with recurrence and metastasis. Methods C-myc expression of 157 cases of women TNBC underwent surgery, 30 cases of non-TNBC and 20 cases of normal breast tissue paraffin samples admitted between January 2005 and April 2008 in the Second Affiliated Hospital of Fujian Medical University??98 cases of TNBC, 20 cases of non-TNBC and 10 cases of normal samples?? and Changji Hui Autonomous Prefecture People's Hospital of Xinjiang Uygur Autonomous Region??59 cases of TNBC, 10 cases of non-TNBC and 10 cases of normal samples?? were analyzed retrospectively. Results Positive rate of c-myc expression in TNBC was higher than that of non-TNBC and that of normal breast with significant difference (P??0.005). Univariate analysis showed that TNM stage, histological grade, axillary lymph node metastasis, postoperative recurrence and metastasis were the related factors of c-myc expression (P??0.05). Logistic regression analysis showed that TNM staging was not the influential factors of c-myc expression ??OR=2.243??P=0.073??. Univariate analysis of affected disease-free survival time showed that age, clinical stage, histological grade, axillary lymph node metastasis and c-myc expression had relationship with recurrence and metastasis of TNBC (P??0.05). Multivariate clinical staging and c-myc expression were excluded. Conclusion C-myc may be an influential factor of postoperative recurrence and metastasis of triple negative breast cancer, but be not an independent risk factor. C-myc expression can be used as one of indicators of progression and malignant degree of TNBC.     

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??Key points and evaluation of quality control of breast cancer surgery MA Rong, ZHANG Kai. Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
Corresponding author: MA Rong, E-mail: marongw2000@163.com
Abstract The purpose of breast cancer surgery quality control is to prevent and reduce postoperative local recurrence and distant metastasis, reduce surgical complications and improve patient's quality of life. Breast cancer surgery should first follow the general principles of surgery, such as aseptic principles, reduce bleeding and damage, function preservation and aesthetic principles. In addition to follow the general principles, breast cancer surgery should also follow the basic principles of tumor surgery: en bloc resection and no-touch principles.     

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??Clinical practice of gene expression tests in bresat cancer XIN Ling??LIU Qian??XU Ling??et al. Breast Disease Center,Department of General Surgery, Peking University First Hospital, Beijing 100034, China
Corresponding author ??LIU Yin-hua, E-mail??liuyinhua@medmail.com.cn
Abstract 2013 St Gallen Panels recommended gene expression tests in breast cancer patients, which affirmed the value of multi-gene assays in clinical management among patients with luminal disease. Two available tests, Oncotype Dx TM and MammaPrintTM, have exhibited good metric performance in the prediction of prognosis and treatment benefit of early-stage breast cancer. However, these genomic predictors are still not ready for routine clinical practice for high cost and inaccessible technology in most area. We now focus on the hot issues of gene expressions and discuss the current status and limitation in clinical practice as follows.     

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??Multi-gene testing in breast cancer and clinical significance MA Rong*, WANG Jian-li. *Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
Corresponding author: MA Rong, E-mail: marongw2000@163.com
Abstract Multi-gene testing (MGT) can provide information that could assist prognosis prediction and therapeutic decision-making in ER-positive cancers. Recently, many MGT models have been endorsed by the American Society of Clinical Oncology, St.Gallen and National Comprehensive Cancer Network guidelines. A panel of clinically validated MGT models including IHC4 score, MammaPrint, PAM50, Oncotype DX, Genomic grade index, Breast Cancer Index, EndoPredict and homologous recombination deficiency score are seven typical MGT, which can predict the risk of metastasis and recurrence and guide the therapy of breast cancer.     

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男性乳腺癌是一种少见的疾病,其发病率呈上升趋势。由于难以开展大宗的临床研究,男性乳腺癌的治疗基本参照女性乳腺癌的研究数据。外科手术以全乳切除加腋窝淋巴结清扫或前哨淋巴结活检为主。多数男性乳腺癌激素受体为阳性,因此,应用他莫昔芬是标准辅助治疗方法。辅助放射治疗和化疗的适应证参照女性乳腺癌标准。内分泌治疗是转移性男性乳腺癌的主要治疗方法,化疗和抗人类表皮生长因子受体2(HER2)治疗对部分病人有较好疗效。     

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??Diagnosis and management of neuroendocrine breast cancer WANG Xu??YU Xin-miao??MAO Xiao-yun??et al. Department of Breast Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Corresponding author:JIN Feng, E-mail:jinfeng66cn@hotmail.com
Abstract Neuroendocrine breast cancer (NEBC) is a group of tumor that share the same morphological characteristics of the gastrointestinal tract and pulmonary neuroendocrine tumor. In the tumor more than 50% of the cancer cells express immunohistochemistry neuroendocrine markers. Solid neuroendocrine carcinoma is more relatively, and large cell neuroendocrine carcinoma is rare. Its clinical characteristics had no significant difference compared with other types of breast cancer. Through mammography, ultrasound, or MRI scans to identify breast neuroendocrine carcinoma is very difficult.Currently there is no unified individualized treatment strategies on neuroendocrine carcinoma of the breast, the mostly using treatment is operation and adjuvant therapy.     

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??Assessment of the Coupler therapeutic effect for venous anastomosis in abdominal free flap breast reconstruction HUANG Sheng*??CHEN Ying??LI Lin??et al. *Department of Breast Surgery??Fudan University Shanghai Cancer Center??Key Laboratory of Breast Cancer in Shanghai??Department of Oncology??Shanghai Medical College??Fudan University??Shanghai 200032??China
Corresponding author??WU Jiong??E-mail: wujiong1122@vip.sina.com
Abstract Objective To analyze free abdominal flap for breast reconstruction with or without Coupler for venous anastomosis??and investigate its safety and effectiveness. Methods From July 2012 to December 2013??45 cases of free abdominal flap breast reconstruction performed in Fudan University Shanghai Cancer Center were enrolled in the study. Patients were divided into two groups (hand-sewn: 28 cases??Coupler: 17cases). Total surgical time??flap ischemic time??vessels anastomotic time and complications incidence were compared between two groups. Results In immediate reconstruction surgery??Coupler group cost less time for total surgical time [??7.1±0.3??h vs. (8.6±0.2) h??P<0.01??]. For all patients??Couplers could not only save flap ischemic time [(85.7±3.7) min vs. (69.3±3.4)min??P<0.01??]??but also save vessels anastomotic time[??47.9±3.3??min vs.??68.5±3.8??min??P<0.01??]. The rate of acute microvessel crisis of flap was 10.7% in hand-sewn group??and 5.9% in Coupler group??without statistical significance (P>0.05). One partial flap necrosis occurred in each group??and no total flap loss occurred. Conclusion Comparing with hand-sewn technique??Coupler provides a safe and reliable method in venous anastomosis??easy to handle and could save surgical time significantly.     

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??Diagnosis and surgery of breast phyllode tumour XIE Fei, WANG Shu. Department of Breast Surgery, Peking University People’s Hospital, Beijing 100044, China
Corresponding author: WANG Shu, E-mail: wangshu@pkuph.edu.cn
Abstract Phyllodes tumours are rare breast tumors,which has certain malignant potential and risk of recurrence and metastasis, and should be differentiated with fibroadenoma and other tumors.Therefore, accurate diagnosis is the key. Wide local excision is the main treatment and the patients should be closely followed up postoperatively.     

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??Clinical value of low-transverse arc collar incision with cervical plexus preservation for papillary thyroid carcinoma GUO Kai??WANG Zhuo-ying??LI Duan-shu??et al. Department of Head and Neck Surgery??Fudan University Shanghai Cancer Center??Department of Oncology??Fudan University Shanghai Medical College??Shanghai 200032??China
Corresponding author??WANG Zhuo-ying??E-mail??zhuoyingwang@hotmail.com
Abstract Objective To evaluate the thoroughness??safety and satisfaction with the appearance of low-transverse arc collar incision (low-collar incision for short) with cervical plexus preservation for papillary thyroid carcinoma (PTC). Methods The clinical data of 284 patients diagnosed with PTC in Department of Head and Neck Surgery??Fudan University Shanghai Cancer Center from Jan. 2013 to Dec. 2013 were analyzed retrospectively. All the patients were performed the operation of total thyroidectomy and central lymph node (level ??) and/or ipsilateral or bilateral neck (level ??~??) dissection. The metastatic rates and resected cervical lymph node numbers of patients with low-collar incision (group low-incision??279 patients) and conventional incision (group conventional-incision??36 patients) were calculated respectively and the patients’ postoperative life quality was estimated through scales and compared with complications. Results The operation time in group low-incision was shorter than that in group conventional-incision, which is with significant difference (P<0.05). There was no difference in total resected lymph node numbers between two types of incisions (P??0.05). But resected lymph node numbers of level ??b and ?? in group low-incision were lower than those in group conventional-incision. Postoperative life quality was improved in group low-incision (P<0.05). Correlation analysis showed the risk of level ??b metastasis increased when level ??a involved (r=0.197 and 0.067??P<0.001)??and the risk of level ??a and ?? metastasis increased when multi-levels involved (r=0.242 and 0.243??P<0.001). Conclusion Low-transverse arc collar incision with cervical plexus preservation for papillary thyroid carcinoma has the characteristics of thoroughness??safety and satisfaction with the appearance. However??conventional incision should be recommended for patients with ??a or multi-levels metastasis.