前哨淋巴结活检在不同期别乳腺癌新辅助化疗后的意义(英文)

Objective: We aimed to study the success and false negative rate of sentinel lymph node biopsy(SLNB) in different clinical stages breast cancer patients being carried out with neoadjuvant chemotherapy(NAC), and the clinical significance of SLNB, we conducting this trial. Methods: One hunderd and thirty-seven cases were enrolled in this clinical research from March 2003 to March 2007. All of the patients' sentinel lymph nodes were detected with99mTc-Dx and methylene blue. There were 61 patients with stage T1–2 N0 M0 carried SLNB without NAC(group A), 76 cases were carried out NAC 3–4 cycles before SLNB, including 39 T2–4 N0–1 M0 cases(group B) and 27 T2–4 N2–3 M0 cases(group C). The success and false negative rate of SLNB were analysed with chi-square test. Results: In group A, the successful and false negative rate of SLNB were 92.31%(36/39), 8.57%(3/35), and in group B and C were 92.31%(36/39), 8.57%(3/35) and 74.07 %(20/27), 18.52 %(5/27), respectively. The successful rate of group C decreased and false negative rate increased significantly compared with group A and B(P < 0.05), but group A and B had no significant difference(P > 0.05). Conclusion: The SLNB can accurately predict lymph node status of axillary lymph node in N0–1 stage patients with NAC, but in N2–3 stage patients the success rate decreased and false rate increased negative significantly.

Serum semaphorin 4C as a diagnostic biomarker in breast cancer:A multicenter retrospective study

Background:To date,there is no approved blood-based biomarker for breast cancer detection.Herein,we aimed to assess semaphorin 4C(SEMA4C),a pivotal protein involved in breast cancer progression,as a serum diagnostic biomarker.Methods:We included 6,213 consecutive inpatients from Tongji Hospital,Qilu Hospital,and Hubei Cancer Hospital.Training cohort and two validation cohorts were introduced for diagnostic exploration and validation.A pan-cancer cohort was used to independently explore the diagnostic potential of SEMA4C among solid tumors.Breast cancer patients who underwent mass excision prior to modified radical mastectomy were also analyzed.We hypothesized that increased pretreatment serum SEMA4C levels,measured using optimized in-house enzymelinked immunosorbent assay kits,could detect breast cancer.The endpoints were diagnostic performance,including area under the receiver operating characteristic curve(AUC),sensitivity,and specificity.Post-surgery pathological diagnosis was the reference standard and breast cancer staging followed the TNM classification.There was no restriction on disease stage for eligibilities.Results:We included 2667 inpatients with breast lesions,2378 patients with other solid tumors,and 1168 healthy participants.Specifically,118 patients with breast cancer were diagnosed with stage 0(5.71%),620 with stage I(30.00%),966 with stage II(46.73%),217 with stage III(10.50%),and 8 with stage IV(0.39%).Patients with breast cancer had significantly higher serum SEMA4C levels than benign breast tumor patients and normal controls(P<0.001).Elevated serum SEMA4C levels had AUC of 0.920(95%confidence interval[CI]:0.900–0.941)and 0.932(95%CI:0.911–0.953)for breast cancer detection in the two validation cohorts.The AUCs for detecting early-stage breast cancer(n=366)and ductal carcinoma in situ(n=85)were 0.931(95%CI:0.916–0.946)and 0.879(95%CI:0.832–0.925),respectively.Serum SEMA4C levels significantly decreased after surgery,and the reduction was more striking after modified radical mastectomy,compared with mass excision(P<0.001).The positive rate of enhanced serum SEMA4C levels was 84.77%for breast cancer and below 20.75%for the other 14 solid tumors.Conclusions:Serum SEMA4C demonstrated promising potential as a candidate biomarker for breast cancer diagnosis.However,validation in prospective settings and by other study groups is warranted.