Efficacy and prognosis of vacuum-assisted excision for benign intraductal papilloma of breast:A meta-analysis

Objective:To evaluate the safety and effectiveness of vacuum-assisted excision for benign intraductal papilloma of breast.Methods:The databases including PubMed,Embase,Cochrane Library,WangFang,CNIK,VIP and Web of Science were searched by computer,according the inclusion and exclusion criteria after screening of literature.The Cochrane handbook and Newcastle-Ottawa scale was used to evaluate the studies.Then the Review Manager 5.3 software was to used analyze the data.Results:A total of 1016 patients was included in 9 articles.The amount of blood loss in vacuum-assisted surgery was less than that in open surgery[MD=-6.38,95%CI(-9.90,-2.86),P<0.05].The drainage[MD=-2.56,95%CI(-4.97,-0.15,P<0.05]and drainage time[MD=-0.25,95%CI(-0.40,-0.09),P<0.05]in vacuum-assisted surgery was less than that in open surgery.There were also few postoperative complications than that in open surgery[RR=0.43,95%CI(0.29,0.64),P<0.05].Compared with open surgery,the postoperative recurrence rate was lower in vacuum-assisted surgery[RR=0.26,95%CI(0.14,0.49),P<0.05].Last,there was no statistically significant difference in the operative time between vacuum-assisted surgery and open surgery,[SD=-12.82,95%CI(-25.70,0.06),P=0.05].Conclusion:Compared with open surgery,vacuum-assisted excision has the advantages of less blood loss and lower postoperative complications,but the operative time is not statistically significant compared with open surgery.In addition,compared with open surgery in this study,vacuum-assisted excision has the advantages of lower recurrence rate,but it still needs long-term dynamic observation.

Expression and significance of CD44s, CD44v6, and nm23 mRNA in human cancer

AIM: To investigate the relationship between the expression levels of nm23 mRNA, CD44s, and CD44v6,and oncogenesis, development and metastasis of human gastric adenocarcinoma, colorectal adenocarcinoma,intraductal carcinoma of breast, and lung cancer.METHODS: Using tissue microarray by immuhistochemical (IHC) staining and in situ hybri-dization (ISH), we examined the expression levels of nm23mRNA, CD44s, and CD44v6 in 62 specimens of human gastric adenocarcinoma and 62 specimens of colorectal adenocarcinoma; the expression of CD44s and CD44v6in 120 specimens of intraductal carcinoma of breast and 20 specimens of normal breast tissue; the expression of nm23 mRNA in 72 specimens of human lung cancer and 23 specimens of normal tissue adjacent to cancer.RESULTS: The expression of nm23 mRNA in the tissues of gastric and colorectal adenocarcinoma was not significantly different from that in the normal tissues adjacent to cancer (P＞0.05), and was not associated with the invasion of tumor and the pathology grade of adenocarcinoma (P＞0.05). However, the expression of nm23 mRNA was correlated negatively to the lymph node metastasis of gastric and colorectal adenocarcinoma (r = -0.49, P＜0.01; r = -4.93, P＜0.01). The expression of CD44s in the tissues of gastric and colorectal adenocarcinoma was significantly different from that in the normal tissues adjacent to cancer (P＜0.05;P＜0.01). CD44v6 was expressed in the tissues of gastric and colorectal adenocarcinoma only, the expression of CD44v6 was significantly associated with the lymph node metastasis, invasion and pathological grade of the tumor (r = 0.47, P＜0.01; r = 5.04, P＜0.01). CD44sand CD44v6 were expressed in intraductal carcinoma of breast, the expression of CD44s and CD44v6 was significantly associated with lymph node metastases and invasion (P＜0.01). However, neither of them was expressed in the normal breast tissue. In addition, the expression of CD44v6 was closely related to the degree of cell differentiation of intraductal carcinoma of breast (x2= 5.68, P＜0.05). The expressional level of nm23mRNA was closely related to the degree of cell differentiation (P＜0.05) and lymph node metastasis (P＜0.01), but the expression of nm23 gene was not related to sex, age, and type of histological classification (P＞0.05).CONCLUSION: Patients with overexpression of CD44s and CD44v6 and low expression of nm23 mRNA have a higher lymph node metastatic rate and invasion. In addition, overexpression of CD44v6 is closely related to the degree of cell differentiation. Detection of the three genes is able to provide a reliable index to evaluate the invasion and metastasis of tumor cells.