Objective: Secretory breast carcinoma(SBC) is a rare type of breast malignancy, accounting for less than 0.02% of all infiltrating breast malignancies. The pure SBC, a type of SBC without another type of breast malign...Objective: Secretory breast carcinoma(SBC) is a rare type of breast malignancy, accounting for less than 0.02% of all infiltrating breast malignancies. The pure SBC, a type of SBC without another type of breast malignant neoplasm, is particularly rare. This study aimed to investigate the clinicopathologic and molecular features of pure SBC.Methods: The main pathological parameters such as estrogen receptor(ER), progesterone receptor(PR), and human epithelial growth factor receptor 2(C-erbB-2) were detected by immunohistochemistry(IHC), and the clinicopathologic and prognostic difference were compared with invasive ductal carcinoma(IDC). Fluorescent in situ hybridization(FISH) and reverse transcription polymerase chain reaction(RT-PCR) was performed to identify the ETV6-NTRK3 rearrangement of SBC.Results: We found that the positivity rates of ER, PR, C-erbB-2, p53, and S-100 were 47.7%(21/44), 52.3%(23/44), 36.4%(16/44), 27.3%(12/44), and 95.5%(42/44), respectively, which were higher than those reported in previous studies. Special periodic acid-Schiff analysis was performed in 36 patients, and the value of the Ki-67 index ranged from 1% to 50%(mean value:10%). Interestingly, most patients with pure SBC harbored an ETV6-NTRK3 rearrangement with an 88.6%(39/44) expression rate. Compared with IDC, the tumor size of most patients with SBC was larger than 2 cm(P = 0.024). Ultrasound showed benign lesions, and the total misdiagnosis rate was higher(P = 0.020). Although the pathological classification was mostly triple-negative breast cancers(P = 0.036), there was less metastasis(P = 0.029), and the overall prognosis was better than that of the IDC group.Conclusions: Although axillary lymph node metastasis, local recurrence, or distant metastasis may occur, SBC is also considered an indolent neoplasm with a good prognosis. Once diagnosed, surgical treatment should be performed as soon as possible,followed by appropriate adjuvant chemotherapy, irradiation, and endocrine therapies.展开更多
Purpose–This study aims to introduce the achievements and benefits of applying wheel/rail-force–based maintenance interval extension of the C80 series wagon in China.Design/methodology/approach–Chinese wagons’exis...Purpose–This study aims to introduce the achievements and benefits of applying wheel/rail-force–based maintenance interval extension of the C80 series wagon in China.Design/methodology/approach–Chinese wagons’existing maintenance strategy had left a certain safety margin for the characteristics of widely running range,unstable service environment and submission to transportation organization requirements.To reduce maintenance costs,China railway(CR)has attempted to extend the maintenance interval since 2020.The maintenance cycle of C80 series heavy haul wagons is extended by three months(no stable routing)or 50,000 km(regular routing).However,in the meantime,the alarming rate of the running state,a key index to reflect the severe degree of hunting stability,by the train performance detection system(TPDS)for the C80 series heavy haul wagons has increased significantly.Findings–The present paper addresses a big data statistical way to evaluate the risk of allowing the C80 series heavy haul wagons to remain in operation longer than stipulated by the maintenance interval initial set.Through the maintenance and wayside-detectordata,whichis divided intothreestages,the extension period(three months),the current maintenance period and the previous maintenance period,this method reveals the alarming rate of hunting was correlated with maintenance interval.The maintainability of wagons will be achieved by utilizing wagon performance degradation modeling with the state of the wheelset and the often-contact side bearing.This paper also proposes a statistical model to return to the average safety level of the previous maintenance period’s baseline through correct alarming thresholds for unplanned corrective maintenance.Originality/value–The paper proposes an approach to reduce safety risk due to maintenance interval extension by effective maintenance program.The results are expected to help the railway company make the optimal solution to balance safety and the economy.展开更多
Objective:Extranodal extension in cervical lymph nodes is an important risk factor for the progression and prognosis of papillary thyroid cancer.The purpose of this study was to identify the common and characteristic ...Objective:Extranodal extension in cervical lymph nodes is an important risk factor for the progression and prognosis of papillary thyroid cancer.The purpose of this study was to identify the common and characteristic preoperative ultrasonography features that are associated with the pathologic extranodal extension of metastatic papillary thyroid carcinoma.Methods:We retrospectively assessed and compared clinicopathologic and ultrasound features between 60 papillary thyroid cancer patients with extranodal extension and 120 control patients with papillary thyroid cancer without extranodal extension.Results:With respect to the pathological N stage and clinicopathologic features,N1b stage papillary thyroid carcinomas were more frequently found in patients who were extranodal extension-positive,in comparison with those who were extranodal extension-negative(78.3%vs.63.3%,P=0.043).Extranodal extension was detected most frequently in level VI cervical lymph nodes(48.7%).In our univariate analysis of patients with papillary thyroid carcinoma,cervical lymph nodes with extranodal extension showed higher incidences of node matting,microcalcification,cystic area,aspect ratio<2,and larger diameter than those without extranodal extension(all P<0.05).Our multivariate analysis demonstrated that node matting and cystic area were independent risk factors for the presence of extranodal extension[odds ratio(OR):4.751,95%confidence interval(CI):1.212~18.626,P=0.025;OR:2.707,95%CI:1.127~6.502,P=0.026].Conclusions:Common ultrasound features may indicate the presence of extranodal extension in patients with metastatic cervical lymph nodes of papillary thyroid carcinoma.展开更多
文摘Objective: Secretory breast carcinoma(SBC) is a rare type of breast malignancy, accounting for less than 0.02% of all infiltrating breast malignancies. The pure SBC, a type of SBC without another type of breast malignant neoplasm, is particularly rare. This study aimed to investigate the clinicopathologic and molecular features of pure SBC.Methods: The main pathological parameters such as estrogen receptor(ER), progesterone receptor(PR), and human epithelial growth factor receptor 2(C-erbB-2) were detected by immunohistochemistry(IHC), and the clinicopathologic and prognostic difference were compared with invasive ductal carcinoma(IDC). Fluorescent in situ hybridization(FISH) and reverse transcription polymerase chain reaction(RT-PCR) was performed to identify the ETV6-NTRK3 rearrangement of SBC.Results: We found that the positivity rates of ER, PR, C-erbB-2, p53, and S-100 were 47.7%(21/44), 52.3%(23/44), 36.4%(16/44), 27.3%(12/44), and 95.5%(42/44), respectively, which were higher than those reported in previous studies. Special periodic acid-Schiff analysis was performed in 36 patients, and the value of the Ki-67 index ranged from 1% to 50%(mean value:10%). Interestingly, most patients with pure SBC harbored an ETV6-NTRK3 rearrangement with an 88.6%(39/44) expression rate. Compared with IDC, the tumor size of most patients with SBC was larger than 2 cm(P = 0.024). Ultrasound showed benign lesions, and the total misdiagnosis rate was higher(P = 0.020). Although the pathological classification was mostly triple-negative breast cancers(P = 0.036), there was less metastasis(P = 0.029), and the overall prognosis was better than that of the IDC group.Conclusions: Although axillary lymph node metastasis, local recurrence, or distant metastasis may occur, SBC is also considered an indolent neoplasm with a good prognosis. Once diagnosed, surgical treatment should be performed as soon as possible,followed by appropriate adjuvant chemotherapy, irradiation, and endocrine therapies.
文摘Purpose–This study aims to introduce the achievements and benefits of applying wheel/rail-force–based maintenance interval extension of the C80 series wagon in China.Design/methodology/approach–Chinese wagons’existing maintenance strategy had left a certain safety margin for the characteristics of widely running range,unstable service environment and submission to transportation organization requirements.To reduce maintenance costs,China railway(CR)has attempted to extend the maintenance interval since 2020.The maintenance cycle of C80 series heavy haul wagons is extended by three months(no stable routing)or 50,000 km(regular routing).However,in the meantime,the alarming rate of the running state,a key index to reflect the severe degree of hunting stability,by the train performance detection system(TPDS)for the C80 series heavy haul wagons has increased significantly.Findings–The present paper addresses a big data statistical way to evaluate the risk of allowing the C80 series heavy haul wagons to remain in operation longer than stipulated by the maintenance interval initial set.Through the maintenance and wayside-detectordata,whichis divided intothreestages,the extension period(three months),the current maintenance period and the previous maintenance period,this method reveals the alarming rate of hunting was correlated with maintenance interval.The maintainability of wagons will be achieved by utilizing wagon performance degradation modeling with the state of the wheelset and the often-contact side bearing.This paper also proposes a statistical model to return to the average safety level of the previous maintenance period’s baseline through correct alarming thresholds for unplanned corrective maintenance.Originality/value–The paper proposes an approach to reduce safety risk due to maintenance interval extension by effective maintenance program.The results are expected to help the railway company make the optimal solution to balance safety and the economy.
文摘Objective:Extranodal extension in cervical lymph nodes is an important risk factor for the progression and prognosis of papillary thyroid cancer.The purpose of this study was to identify the common and characteristic preoperative ultrasonography features that are associated with the pathologic extranodal extension of metastatic papillary thyroid carcinoma.Methods:We retrospectively assessed and compared clinicopathologic and ultrasound features between 60 papillary thyroid cancer patients with extranodal extension and 120 control patients with papillary thyroid cancer without extranodal extension.Results:With respect to the pathological N stage and clinicopathologic features,N1b stage papillary thyroid carcinomas were more frequently found in patients who were extranodal extension-positive,in comparison with those who were extranodal extension-negative(78.3%vs.63.3%,P=0.043).Extranodal extension was detected most frequently in level VI cervical lymph nodes(48.7%).In our univariate analysis of patients with papillary thyroid carcinoma,cervical lymph nodes with extranodal extension showed higher incidences of node matting,microcalcification,cystic area,aspect ratio<2,and larger diameter than those without extranodal extension(all P<0.05).Our multivariate analysis demonstrated that node matting and cystic area were independent risk factors for the presence of extranodal extension[odds ratio(OR):4.751,95%confidence interval(CI):1.212~18.626,P=0.025;OR:2.707,95%CI:1.127~6.502,P=0.026].Conclusions:Common ultrasound features may indicate the presence of extranodal extension in patients with metastatic cervical lymph nodes of papillary thyroid carcinoma.
