The effect of adjuvant therapy with or without tamoxifen on the endocrine function of patients with breast cancer

The ovarian and pituitary functions of 64 operable breast cancer patients undergoing adjuvant therapy with cytotoxic chemotherapy and/or tamoxifen were investigated. The post menopausal patients, divided into 3 treatment groups, one with tamoxifen alone, one with tamoxifen and chemotherapy and the other with chemotherapy alone had serum estradiol 17-β (E2) and progesterone levels lower than the evaluable limits. Although there was no significant difference in the level of estrone sulfate (E1-S) between these three groups, the level of lutainizing hormone (LH) and follicle stimulating hormone (FSH) in the patients treated with tamoxifen alone and tamoxifen and chemotherapy were significantly lower than those treated with chemotherapy alone. The decrease in gonadotropin levels induced by tamoxifen treatment was reversible as it appeared after the initiation of tamoxifen and recovered after its cessation. In the premenopausal patients, a group treated with tamoxifen and chemotherapy had significantly higher E1-S, E2 and progesterone levels and significantly lower gonadotropin levels than a group treated with chemotherapy alone or one treated with a cyclophosphamide regimen. These increases in the levels of estrogen and progesterone were also reversible, and induced by tamoxifen. Thus, adjuvant endocrinochemotherapy causes profound alteration in the hypothalamo-pituitary-ovarian axis and therefore, monitoring a variety of hormonal levels is thought to be necessary for assessing the consequences of adjuvant therapy in breast cancer patients, especially in premenopausal patients using tamoxifen.     

P_（53）基因在乳腺癌细胞中异常表达的观察

Ｐ５３基因是一种重要的抑癌基因，它的突变和异常表达，与癌细胞的发生、发展密切相关。本文应用免疫组化ＡＢＣ法检测了５８例乳腺癌石蜡标本中Ｐ５３表达状况。结果表明：Ｐ５３基因异常表达为３９．７％（２３／５８）。并与肿瘤的分化程度、区域淋巴结转移和性激素受体有明显相关性，与乳腺癌患者术后五年生存率有一定关系。     

高密度cDNA微阵列技术检测乳腺癌差异表达基因

目的 描绘乳腺癌的基因差异表达谱，以寻找乳腺癌新的肿瘤相关候选基因和分子标志。方法 用含14000个cDNA克隆的表达微阵列检测乳腺癌组织、乳腺癌旁组织及乳腺非癌组织的mRNA表达，并分析其表达的差异。结果 乳腺癌组织与乳腺非癌组织比较有80个差异表达基因，乳腺癌组织与乳腺癌旁组织比较有57个差异表达基因，乳腺癌旁组织与乳腺非癌组织比较有29个差异表达基因，在乳腺癌组织与乳腺非癌组织和乳腺癌旁组织比较中有14个差异表达基因是一致的。结论 用微阵列技术对乳腺癌的肿瘤相关基因和分子标志作初步探索，为了解中国女性乳腺癌发生发展的分子机制、发展新的诊断和治疗手段提供了信息。     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

原癌基因蛋白质C-erbB-2在乳腺良恶性病变中表达的意义

目的:检测原癌基因蛋白质C-erbB-2在乳腺良恶性病变中的表达及意义.方法:对111例乳腺良恶性病变的石蜡切片标本进行免疫组织化学染色.结果:乳腺良恶性病变中乳腺导管内乳头状瘤病的C-erbB-2阳性率为31.3%,与乳腺纤维腺病和纤维腺瘤比较差异有显著性(P<0.01),乳腺癌C-erbB-2的阳性率为74.3%,与良性病变比较差异有显著性(P<0.01);乳腺癌C-erbB-2表达与肿瘤大小和组织学分级呈正比(P<0.05),与激素受体(ER、PR)水平及5年生存期呈反比(P<0.05),与淋巴结是否转移无关.结论:C-erbB-2表达的乳腺导管内乳头状瘤病容易癌变,C-erbB-2过度表达的乳腺癌组织分化差、生存期短、预后不好.C-erbB-2 可作为判定乳腺导管内乳头状瘤病早期癌变及乳腺癌预后的有效指标.     

人乳腺病变组织AgNORs的形态定量分析

目的：探讨计算机图像分析技术对乳腺肿瘤核仁组成区相关嗜银蛋白（AgNORs）表达在病理学诊断中的意义。方法：选取乳癌、乳腺结构不良、乳腺纤维腺瘤及正常乳腺组织各20例，应用图像分析系统和嗜银染色技术，对乳腺病变组织的AgNORs进行形态计量学分析，观察每个细胞的胞核面积、核周长以及AgNOR颗粒数目、颗粒面积、AgNOR的大颗粒数、形态因子、面积比值、平均面积等8项参数。结果：正常乳腺及乳腺结构不良、乳腺纤维腺瘤组织的细胞核面积、核周长以及AgNOR颗粒数目、颗粒面积明显小于乳癌组织（P＜0．01），AgNOR的大颗粒数、形态因子、面积比值、平均面积在乳癌组织与乳腺纤维腺瘤及正常乳腺组织间差异有统计学意义（P＜0．05）。上述8项参数4组间多类判别分析回代符合率为72．5％，癌和非癌的判别回代符合率达100％。结论：图像分析对于乳腺良、恶性病变的鉴别诊断具有重要价值，是一精确、客观的AgNOR定量研究手段。     

乳腺导管扩张症的诊断与鉴别(附6例临床病理报道)

本文对6例乳腺导管扩张症进行了临床病理报道,6例术前皆被误诊乳腺其他疾病,根据此种情况作了如何正确诊断的阐述.提出了常见误诊病例如何鉴别。     

Correlation between immunohistochemically determined oestrogen receptor content, using monoclonal antibodies, and qualitative and quantitative tissue features in ductal breast cancer

Previous studies have shown that oestrogen receptor content in breast cancer was correlated with qualitative and also, more strongly, with quantitative nuclear features in tissue sections. However, even with the better reproducible quantitative microscopical assessments, the variance in the correlation with oestrogen receptor was considerable. This might be due to the implicit problems of oestrogen receptor determination with the biochemical assay. Therefore, receptor content was studied using monoclonal antibodies in 50 consecutive invasive ductal breast cancers. Oestrogen receptor status was compared with qualitative features and with the mean and standard deviation of the nuclear area, morphometrically evaluated on immunostained and adjacent haematoxylin and eosin stained sections. In agreement with earlier observations, nearly all tumours with prominent elastosis were oestrogen receptor positive; but a minority of negative cases also showed elastosis. The correlation between the other qualitative features and receptor status was weak. A significant inverse correlation (P less than 0.001) existed between the receptor status and the mean and standard deviation of the nuclear area. Even with the highly reproducible morphometrical analysis, correlation between nuclear oestrogen receptor content and quantitative nuclear features was relatively weak. This might indicate that receptor status and nuclear morphometric features reflect different biological characteristics of breast cancers.     

塞来昔布对大鼠化学性乳腺癌的抑制作用及机制

目的 观察环氧化酶-2(cyclooxygenase-2,COX-2)选择性抑制剂塞来昔布对化学致癌剂7,12-二甲基苯蒽(7,12-dimethybenz[a]anthracene,DMBA)化学诱发的大鼠乳腺癌的抑制作用并探讨其机制.方法 将DMBA油剂灌胃复制大鼠乳腺癌模型,大鼠分为对照组(24只)和实验组(25只),观察塞来昔布对大鼠乳腺癌的抑制作用,并采用基因芯片技术了解治疗后2组肿瘤的基因表达谱差异.结果 实验组塞来昔布处理后乳腺肿瘤的数目、直径、体积分别为(2.56±1.26)个、(1.162±0.355)cm、(1.967±1.725)cm.;明显小于实验前的(3.40±1.22)个、(1.948±0.481)cm、(8.794±6.389)cm3;明显小于对照组(3.88±1.73)个、(2.231±0.736)cm、(10.268±5.447)cm3,差异有显著性意义(均P＜0.01).对照组COX一2蛋白表达为62.5%(15/24),实验组COX-2蛋白表达为36.0%(9/25),差异有显著性意义(P＜O.05).基因表达谱显示两组之间表达丰度差异2倍及以上的基因共有243条,其中表达上调2倍或以上的基因片段124条,表达下调2倍或以上的基因片段119条,发现功能不明的新基因6条,其中表达上调的4条.结论 塞来昔布能抑制DMBA诱发的大鼠乳腺癌进展,其机制和多种基因改变有关.     

Matrix Metalloproteinases in Breast Cancer

Abstract: Matrix metalloproteinases (MMPs) represent a class of enzymes able to degrade numerous extracellular matrix macromolecules facilitating tumor invasion and metastasis. The principal MMPs involved in breast pathology are analyzed with their various roles and functions: gelatinases A and B, stromelysin-3, collagenase-3, and MT-MMP1 (membrane type MMP). In vivo and in vitro studies clearly demonstrate an important cooperation between tumor and stromal cells for the expression of these MMPs in breast carcinomas. The large expression of MMPs plead in favor of a major role of these enzymes in breast carcinoma progression and their detection may be used in some cases as a prognostic indicator. Studies now are in progress, directed toward the modulation of these MMPs and their inhibitors with new therapeutic agents to block tumoral invasion and metastasis due to these enzymes.?