MR对乳头溢液的诊断价值

目的:对比乳腺MR、钼靶和超声检查对乳头溢液的诊断价值。方法:对11例因乳头溢液在中山大学附属肿瘤医院就诊的患者进行前瞻性的研究。所有患者均行平扫及动态增强MR扫描、钼靶及超声检查,都做了导管造影,其中4例因各种原因导管造影失败,其余7例均行导管造影检查;11例患者均行手术,恶性者行改良根治术,良性者行乳腺区段切除术。结果:在11例患者的24个病灶中,MR的图象与最后的组织病理学结果均有关联性。MR图象正确诊断出纤维腺瘤3个,乳腺癌3个,导管内乳头状瘤11个,纤维囊性乳腺病5个,小叶增生1个,误诊硬化性腺病为乳腺癌1个,诊断准确率为95.8%(22/24)。而钼靶、导管造影和超声的诊断准确率均低于50%(5/24,12/24及8/24)。结论:乳腺MR检查能鉴别良恶性乳头溢液,提供了一种非侵入性的乳腺导管造影的方法。

以乳头溢液为表现的乳腺导管内肿瘤的诊断与治疗

目的评价乳管镜和病理检查在诊断以乳头溢液为表现的乳腺导管内肿瘤中的价值。方法选取2015年1月至2017年11月该院经术后病理证实为乳腺导管内肿瘤的患者52例,总结分析乳管镜检查与病理诊断治疗经验。结果乳管镜诊断乳腺导管内肿瘤52例,其中单发导管内乳头状瘤27例,多发导管内乳头状瘤20例,乳腺癌5例。术后病理证实:单发导管内乳头状瘤27例,多发导管内乳头状瘤21例,乳腺癌4例;但乳腺导管内肿瘤患者各年龄段分布比较,差异均无统计学意义(χ~2=1.87,P=0.93)。结论乳管镜是诊断和定位乳腺导管内肿瘤的有效手段。

长沙市34所幼儿园儿童乳牙龋病状况调查

【目的】了解长沙市学龄前儿童乳牙龋病的发生及治疗状况。【方法】2007年6月至2008年6月，对本市内34所幼儿因学龄前儿童乳牙龋病检查资料进行比较和统计学分析。【结果】7352名学龄前儿童患龋率为43．4％，填充率为25．3％，患龋率无性别差异，但随着年龄的增大，患龋率亦显著增加（P〈0．05）。【结论】本地区大部分家长对儿童牙痛的预防意识还欠缺，应加强儿童口腔保健宣传教育。

MicroRNA and histopathological characterization of pure mucinous breast carcinoma

Objective: Pure mucinous breast carcinoma (PMBC) is an uncommon histological type of breast cancer characterized by a large amount of mucin production. MicroRNA (miRNA) is a large class of small noncoding RNA of about 22 nt involved in the regulation of various biological processes. This study aims to identify the miRNA expression profile in PMBC. Methods: MiRNA expression profiles in 11 PMBCs were analyzed by miRNA-microarray and real-time polymerase chain reaction (PCR). Thirty-one PMBCs and 27 invasive ductal carcinoma of no special types (IDC-NSTs) were assessed by immunohistochemistry using antibodies against ER, PR-progesterone receptor, HER2, Ki-67, Bcl-2, p53, PCNA, and CK5 and 6. Results: We analyzed the miRNA expression in 11 PMBCs and corresponding normal tissues using miRNA-microarray and real-time PCR, and found that miR-143 and miR-224-5p were significantly downregulated in mucinous carcinoma tissue. Compared with IDC-NSTs, PMBC showed a significantly higher ER positive rate, lower HER-2 positive rate, and lower cell proliferation rates. Conclusions: To our knowledge, this is the first study to demonstrate the miRNA expression profile of PMBC, and our findings may lead to further understanding of this type of breast cancer.

EVALUATION OF SPECTRAL SELECTED PRESS SEQUENCE IN BREAST LESION CHARACTERIZATION

Objective To evaluate the role of ^1H spetral selected point-resolved spectroscopy （SS-PRESS） sequence in distingnishing benign from malignant breast lesions by the malignancy marker of choline peak and to investigate the factors influencing the diagnosis. Methods A total of 131 patients （ aged 24-83 years, average 44. 8 years） were enrolled in this study. The examinations were performed on a 1.5T scanner with four-channel phased array breast coiL Singie-voxel proton magnetic resonance spectroscopy （1H MRS） was acquired by SS-PRESS sequence in these patients referred to surgical or biopsy consultation. Results Among these patients, 74 were proved to have breast carcinomas and 57 have benign lesions by histopathological examinations, Thirty-one elevated choline peaks were observed in these 74 confirmed malignant lesions, and 5 detectable choline peaks were demonstrated in the 57 benign lesions. The sensitivity and specificity of ^1H SSPRESS MRS were 41.9% and 91.2%, respectively. The main factors influencing the diagnosis were signal-to-noise ratio and pathological type. Conclusions ^1H SS-PRESS MRS can provide a noninvasive, biochemical measurement of metabolism and improve the specificity of breast magnetic resonance imaging. Choline peak in vivo is a specific but not sensitive marker of malignancy. Technique factors and histopathological characterization of lesions influence the detection rate.

Relationship between Full-Field Digital Mammographic Features and Clinicopathologic Characteristics in 176 Cases with Breast Cancer

OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been available for clinical use which has led to a revolution in the resolving of images and an increase in early-stage breast cancer detection. Based on the above knowledge, this study was performed to evaluate the relationship between full-field digital mammographic features and clinicopathologic characteristics in breast cancer. METHODS Digital mammograms of 176 patients with pathologically proven breast cancer were reviewed. Also, clinical and pathologic records （histological types and axillary lymph nodes status） were retrospectively examined. RESULTS Most of the patients with a solitary microcalcification were young women under the age of 50（84.4%）, but the majority of the patients with microcalcifications complicated by a mass were elderly women. Microcalcifications detected by mammography occurred frequently in ductal carcinoma in situ （28.1%） and in early invasive carcinoma （15.6%）. Breast cancers with expression of microcalcifications combined with a spiculate mass had a high metastatic rate of axillary lymph nodes （69.4%）. A high metastatic rate of axillary lymph nodes was also found in the patients with solitary worm-like microcalcifications （57.1%）, solitary spiculate mass （53.7%） and solitary non-worm-like microcalcifications （44.4%）. Simple worm-like microcalcifications accompanied with metastasis of 4 to 9 axillary lymph nodes occurred in 42.9% of the（6/14） cases. The patients with microcalcifications combined by a spiculate mass and with metastasis of 4 to 9 axillary lymph nodes accounted for 27.8% （10/36） of the cases, and those with metastases of 10 and over accounted for 16.7% （6/36）. CONCLUSION Solitary microcalcifications occur frequently in young women and are usually associated with early breast cancer. There is a close relationship between worm-like microcalcifications, a spiculate mass and positive metastases of axillary lymph nodes, which are an index of poor prognosis.

Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

Clonal Analysis of Peripheral Papilloma and Cancerous Cells of the Breast

OBJECTIVE Because almost all malignancies represent monoclonal proliferations, we have studied the clonal status of peripheral papillomas （peri-PM）, ductal carcinomas in situ （DCIS）, and normal breast tissues to explore a reliable way to distinguish benign and malignant （or pre-malignant） cases previously diagnosed morphologically. METHODS Twenty-six cases of peri-PM, 25 cases of peri-PM with atypical ductal hyperplasia （ADH）, 27 cases of DCIS, 16 cases of developed canceration and 20 specimens of normal tissue were examined in the study. The clonal status of these tissues was studied using an assay based on inactivation mosaicism of the lenth-polymorphic X-chromosomes at the androgen receptor （AR） locus. RESULTS Loss of polymorphism at the AR locus was found in all DCIS cases and 10 cases （10/25, 40.0%） of peri-PM with ADH, in.dicating the monoclonality of the tumors. Twenty-four out of 26 （92.3%） cases with peri- PM and 19 specimens of normal tissue were shown to be polyclonal. In 16 cases of developed Canceration, identical X chromosome inactivation （monoclonal alterations） was observed from both the peri-PM with ADH part, and the DCIS part in each Case. CONCLUSION These results contribute to the understanding of the genetic changes of peri-PM, and confirm the peri-PM with ADH as a precancerous lesion of the breast. Clonal analysis might be a useful modality to screen high-risk cases from precancerous lesions or to distinguish between benign hyperplasia and early carcinoma.

Lactobacillus plantarum B7 inhibits Helicobacter pylori growth and attenuates gastric inflammation

AIM:To determine the anti-Helicobacter property of Lactobacillus plantarum B7(L.plantarum)B7 supernatants in vitro and the protective effects of L.plantarum B7 on serum tumor necrosis factor-alpha(TNF-?),gastric malondialdehyde(MDA)level,apoptosis,and histopathology in Helicobacter pylori(H.pylori)-induced gastric inflammation in rats. METHODS:In vitro,the inhibition of H.pylori growth was examined using L.plantarum B7 supernatants at pH 4 and pH 7 and at the concentration of 1×,5×and 10×on plates inoculated with H.pylori.The inhibitory effect of H.pylori was interpreted by the size of the inhibition zone.In vitro,male Sprague-Dawley rats were randomly divided into four groups including group 1(control group),group 2(H.pylori infected group), group 3(H.pylori infected with L.plantarum B7 106 CFUs/mL treated group)and group 4(H.pylori infected with L.plantarum B7 1010 CFUs/mL treated group).One week after H.pylori inoculation,L.plantarum B7 106 CFUs/mL or 10 10 CFUs/mL were fed once daily to group 3 and group 4,respectively,for one week.Blood and gastric samples were collected at the end of the study. RESULTS:In vitro,at intact pH 4,mean inhibitory zone diameters of 8.5 mm and 13 mm were noted at concentrations of 5×and 10×of L.plantarum B7 supernatant disks,respectively.At adjusted pH 7, L.plantarum B7 supernatants at concentrations of 5 ×and 10×yielded mean inhibitory zone diameters of 6.5 mm and 11 mm,respectively.In the in vitro study, in group 2,stomach histopathology revealed mild to moderate H.pylori colonization and inflammation.The level of gastric MDA and epithelial cell apoptosis were significantly increased compared with group 1.The serum TNF-??level was significant decreased in group 3 compared with group 2(P<0.05).In addition,L.plantarum B7 treatments resulted in a significant improvement in stomach pathology,and decreased gastric MDA level and apoptotic epithelial cells. CONCLUSION:L.plantarum B7 supernatant inhibits H.pylori growth.This inhibition was dose-dependent and greater at pH 4.Moreover,L.plantarum B7 attenuated H.pylori-induced gastric inflammation.

Multiple biliary adenomas in extrahepatic bile duct: a case report and literature review

Biliary adenoma is uncommon benign neoplasm of the biliary system, of unknown aetiology and account for approximately 0.1%-2% of all gastrointestinal benign tumors. Most of patients are asymptomatic; a few patients have mild jaundice or abdominal discomfort. To our knowledge, there were only a few cases of biliary papillomatosis reported in the previous literatures, which only showed solitary tumor in bile duct. We presented a rare case with multiple biliary adenomas in extrahepatic bile duct confirmed by endoscopic retrograde cholangiopancreatography(ERCP) and histopathology. After 3 months follow-up, the patient remained asymptomatic.

Clinico-pathological study and treatment results of 1009 operable breast cancer cases:Experience of NCI Cairo University,Egypt

Objective： This retrospective study was designed to evaluate ciinico-pathological data including stage, results of treatment, and prognostic factors which affect the overall survival ＆ disease free survival. Methods： This was a retrospective study carried out at the Radiotherapy Department, National Cancer Institute, Cairo University, Egypt on 1009 patients treated for primary breast cancer between 1999-2003. Results： The median follow-up was 68 months. Loco regional relapse occurred in 23 patients （2.3%） and distant relapse occurred in 203 patients （20.1%）. Both Ioco regional and distant relapse were reported in 32 patients （3.2%）. The disease free survival （DFS） at 3 and 5 years were 87% and 78% respectively, while OAS at 3 and 5 years were 96.4% and 91.4% respectively. Multivariate analysis of different prognostic factors showed that the independent bad prognostic factors in the study for disease relapse were positive lymph nodes （LNs, more than 10）, tumor size T3, T4 with significance of 0.0001 for each, and pathologic grade with significance of 0.003. Conclusion： The most important independent bad prognostic factors for relapse are positive LNs more than 10, tumor size T3, T4 and pathologic grade. The timing of radiotherapy affects the disease free survival significantly also it is recommended to analyze the group of patients with LNs negative using well designed randomized trials.

心理诱导在乳牙反合患者取模中的应用价值

目的 探讨心理诱导在乳牙反合患者取模过程中的应用价值.方法 选择84例来本院口腔科就诊的乳牙反合患者,按随机数字表法分为对照组和诱导组各42例.对照组直接取模,诱导组在进行针对性心理诱导后再行取模,比较两组在印模制取过程中的合作程度.结果 经心理诱导后,患儿在取模过程中的合作程度大大提高;诱导组合作率（8 8.09％）高于对照组（69.04％）,差异有统计学意义（P＜0.05）.结论 心理诱导是帮助乳牙反合患儿完成印模制取的有效方法,值得临床推广应用。

HER2 and VEGF expression in breast cancer and their correlations

Objective:The aim of our study was to detect the correlation between the expressions of HER2 and VEGF in breast cancer, and their relations with some pathological factors. Methods:By immunohistochemistry technique, the expressions of HER2 and VEGF in the post-operation samples of 117 cases with breast cancer were assessed, and their relations with some pathological factors were analysed by statistical methods. Fifty samples of hyperplasia of mammary glands were observed as the control. Results: The positive expression rates of HER2 and VEGF in breast cancer were both significantly higher than those in hyperplasia of mammary gland (P<0.05). The expressions of HER2 and VEGF were both correlated to lymph node metastasis (P<0.05), but showed no relations with age, histological type, histological stage, tumor size (P>0.05). The positive expression rate of HER2 had a positive correlation with those of VEGF (P<0.05, r=0.373). Conclusion: The expressions of HER2 and VEGF have no correlations with age, histological type, histological stage, tumor size, but are closely related with lymphatic metastasis. The positive expression rates of HER2 shows a positive correlation with those of VEGF.

Renal Collecting Duct Cancer： a Report of 2 Cases

Renal collecting duct cancer is a rare malignant tumor, which accounts for 1% to 2% of epithelial kidney tumors. Its pathologial appearance has been easily misdiagnosed as a mammilliform renal cell carcinoma or as other tumors. The malignancy of renal collecting duct cancer is high, with early metastasis and poor prognosis. The clinical data for 2 cases of the tumor are discussed in this report, including reports on the histopathology and the changes in immunohistochemistry.

Breast secretory carcinoma: a clinicopathologic study of four cases

Objective: To explore the clinicopathologic features of secretory carcinoma of breast (SCB). Methods: Four cases of SCB were analyzed by light microscopy, histochemistry, immunohistochemistry and electron microscopy. The clinical data were also analyzed. Special staining of periodic acid-Schiff reaction with diastase pretreatment, immunohistochemical staining of ER, PR, HER-2, p53, MIB-1, S-100, p63, CK8/18 and EMA by En Vision method were performed. Results: Solid, cribriform, tubular, or papillary architecture may be seen. Tumor forms cystic spaces filled with abundant pale pink secretory material, positive with diastase resistant periodic acid-Schiff (PAS-DR) stains. Tumor cells were small with bland nuclei and abundant pale, eosinophilic cytoplasm, rare mitotic activity and necrosis. Immunohistochemically, tumor cells were positive for CK8/18, EMA, negative for S-100, p63 and variable partially positive for p53, ER, PR, HER-2 and MIB-1. Under electron microscopy, the tumor cells possessed numerous membrane-bound secretory vacuoles in cytoplasm lined by microvilli. Conclusion: SCB is a rare, low-malignant neoplasm. SCB have pathology, clinical picture, treatment, follow-up, immunohistochemical and genetic features that distinguish them from invasive ductal carcinomas of the usual type.