曲妥珠单抗联合PC单周化疗方案治疗HER2阳性晚期乳腺癌患者的临床研究

目的:探究曲妥珠单抗联合PC单周化疗方案治疗(HER2)阳性晚期乳腺癌患者的临床效果。方法:选取我院2014年3月～2017年3月收治的64例HER2阳性晚期乳腺癌患者为研究对象,采用随机数字表法分为对照组与观察组,每组32例。对照组予以PC单周化疗方案治疗,观察组在对照组基础上予以曲妥珠单抗治疗。比较两组治疗效果、治疗前后血清CA125、CEA水平及Bax、Bcl-2基因表达水平。结果:观察组治疗有效率明显高于对照组,P<0.05;治疗后,观察组血清CA125、CEA水平均明显低于对照组,P<0.05;观察组Bax表达水平明显高于对照组,Bcl-2表达水平明显低于对照组,P<0.05。结论:曲妥珠单抗联合PC单周化疗方案治疗HER2阳性晚期乳腺癌患者,能提高治疗效果,调节Bcl-2、Bax基因表达,加快肿瘤细胞凋亡,有效控制病程进展。

Screening of miRNAs associated with lymph node metastasis in Her-2-positive breast cancer and their relationship with prognosis

The aim of this study was to identify some biomarkers for predicting lymph node metastasis and prognosis of human epidermal growth factor receptor 2(Her-2)-positive breast cancer(BC). We analyzed correlations between micro RNAs(mi RNAs) and the prognosis of patients with BC based on data collected from The Cancer Genome Atlas(TCGA) database. The expression levels of mi R-455, mi R-143, and mi R-99 a were measured in clinical samples of Her-2-positive BC patients with different degrees of lymph node metastasis. We investigated the impacts of overexpressed mi R-455 on the proliferation and invasiveness of MDA-MB-453 cells and measured its effects on the expression of long non-coding RNA(lnc RNA) metastasis-associated lung adenocarcinoma transcript 1(MALAT1) by quantitative real-time polymerase chain reaction(q RT-PCR). The expression of mi R-455 was significantly and positively correlated to the prognosis and overall survival(OS) of the BC(P=0.028), according to TCGA information. The expression level of mi R-455 was positively correlated with OS and relapse-free survival(RFS) of patients with Her-2-positive BC, and was negatively correlated with the number of metastatic lymph nodes(P<0.05). Transwell assay suggested that MDA-MB-453 cells became much less invasive(P<0.01) after being transfected with mi R-455 mimics. During the q RT-PCR, the expression level of MALAT1 declined significantly after transfection(P<0.01). Overexpressed mi R-455 significantly inhibited the proliferation and migration of MDA-MB-453 cells and the expression of MALAT1. We conclude that mi R-455 may be a useful potential biomarker for forecasting lymph node metastasis and the prognosis of Her-2-positive BC patients. mi R-455 may play an important role in lymph node metastasis of BC by interacting with MALAT1.

HER-2 overexpression and survival in colorectal cancer: a meta-analysis

Objective： Numerous studies examining the relationship between human epidermal growth factor receptor 2 （HER-2） overexpression and survival in patients with colorectal cancer （CRC） have yielded controversial results. We therefore performed a meta-analysis more precisely to estimate its prognostic value. Methods： Published studies investigating the effect of HER-2 overexpression on CRC survival were identified; the hazard ratios （HRs） and their corresponding 95% confidence intervals （95% Cls） were pooled in terms of disease-specific or overall survival. Results Eleven studies were included in the meta-analysis. The pooled data showed that HER-2 overexpression was negatively related to CRC survival （HR=1.10, 95% CI： 0.77-1.44）. Subgroup analyses regarding test method and study quality also demonstrated little association between HER-2 overexpression and CRC survival （HR=0.89, 95% CI： 0.50-1.29; HR=0.90, 95% Ch 0.43-1.37, respectively）, Conclusions： Regardless of several limitations, our study suggested that HER-2 overexpression probably had little impact on CRC survival.

乳腺癌核芯针穿刺印片与组织学诊断的比较研究

目的 探讨印片细胞学（TIC）与组织病理诊断以及印片免疫细胞化学与免疫组织化学检测结果的一致性,评价在乳腺癌新辅助化疗前TIC诊断的临床应用价值.方法 收集行核芯针穿刺组织TIC诊断的乳腺肿物患者289例,其中287例有核芯针活检（CNB）病理结果对照,190例有术后病理结果对照.289例中,64例行印片的雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER-2）免疫细胞化学检测,其中52例有CNB免疫组织化学检测结果,43例有术后病理免疫组织化学检测结果.结果 TIC诊断良性22例,恶性263例,不满意标本4例.假阴性率和不满意率均为1.4%,假阳性率为0.35%.与术后病理结果比较,TIC和CNB诊断乳腺癌的敏感性分别为96.2%和95.0%（P=0.601）,特异性分别为87.5%和100%（P=0.471）,准确率分别为95.8%和95.3%（P=0.804）,差异均无统计学意义.ER、PR和HER-2印片免疫细胞化学检测结果与CNB的免疫组织化学检测结果的符合率分别为86.5%、75.0%和78.8%,与术后病理免疫组织化学检测结果的符合率分别为88.4%、74.4%和75.6%,CNB与术后病理免疫组织化学检测结果的符合率分别为83.7%、74.4%和76.5%,三者差异无统计学意义（P＞0.05）.结论 TIC诊断乳腺癌的敏感性、特异性和准确率较高,与CNB组织病理诊断无明显差异,可以辅助CNB为乳腺肿物患者提供快速的细胞学诊断.印片免疫细胞化学方法可以辅助CNB作为新辅助化疗前检测乳腺癌患者受体水平的手段之一.