Vascular Endothelial Growth Factor Expression in Invasive Ductal Carcinoma of Breast

Objective： To detect the expression of VEGF and MVD count in invasive ductal carcinoma of breast to clarify the association of VEGF expression and MVD count with the clinicopathologic features. Methods： The expressions of VEGF, ER, PR, C-erbB-2 and MVD count in 88 cases of invasive ductal carcinoma of breast were examined by immunohistochemistry staining （SP-method）. Results： Sixty-two out of the eighty-eight specimens of breast carcinoma （70.45%） showed positive expression of VEGF. The positive rate of VEGF in cases with lymph node metastasis was higher than that without lymph node metastasis （P〈0.05）. The positive rate of VEGF in stage IIb-Ⅲ was higher than that in stage Ⅰ-Ⅱa （P〈0.05）. The positive rate of VEGF in C-erbB-2 positive group was higher than that in C-erbB-2 negative group （P〈0.05）. Higher expression of VEGF was observed in cases with higher tissue differentiation degree （P〈0.05）. Also, significant higher MVD count was observed in cases with higher tissue differentiation degree （P〈0.01）. The MVD count increased significantly with the increase of the expression of VEGF （P〈0.01）. Conclusion： The result of this study suggested that in invasive ductal carcinoma of breast, angiogenesis and metastasis were mediated mainly by VEGF. The expression of VEGF and MVD might be reference predictors for the biological behavior of breast carcinoma. The antiangiogenic therapy which used VEGF as a target would become a new method to treat patients who were C-erbB-2 positive in the future.

Sentinel lymph node biopsy in clinically detected ductal carcinoma in situ

AIM:To study the indications for sentinel lymph node biopsy(SLNB) in clinically-detected ductal carcinoma in situ(CD-DCIS).METHODS:A retrospective analysis of 20 patients with an initial diagnosis of pure DCIS by an image-guided core needle biopsy(CNB) between June 2006 and June 2012 was conducted at King Faisal Specialist Hospital.The accuracy of performing SLNB in CD-DCIS,the rate of sentinel and non-sentinel nodal metastasis,and the histologic underestimation rate of invasive cancer at initial diagnosis were analyzed.The inclusion criteria were a preoperative diagnosis of pure DCIS with no evidence of invasion.We excluded any patient with evidence of microinvasion or invasion.There were two cases of mammographically detected DCIS and 18 cases of CDDCIS.All our patients were diagnosed by an imageguided CNB except two patients who were diagnosed by fine needle aspiration(FNA).All patients underwent breast surgery,SLNB,and axillary lymph node dissection(ALND) if the SLN was positive.RESULTS:Twenty patients with an initial diagnosis of pure DCIS underwent SLNB,2 of whom had an ALND.The mean age of the patients was 49.7 years(range,35-70).Twelve patients(60%) were premenopausal and 8(40%) were postmenopausal.CNB was the diagnostic procedure for 18 patients,and 2 who were diagnosed by FNA were excluded from the calculation of the underestimation rate.Two out of 20 had a positive SLNB and underwent an ALND and neither had additional non sentinel lymph node metastasis.Both the sentinel visualization rate and the intraoperative sentinel identification rate were 100%.The false negative rate was 0%.Only 2 patients had a positive SLNB(10%) and neither had additional metastasis following an ALND.After definitive surgery,3 patients were upstaged to invasive ductal carcinoma(3/18 = 16.6%) and 3 other patients were upstaged to DCIS with microinvasion(3/18 = 16.6%).Therefore the histologic underestimation rate of invasive disease was 33%.CONCLUSION:SLNB in CD-DCIS is technically feasible and highly accurate.We recommend limiting SLNB to patients undergoing a mastectomy.

Enhancing Breast Cancer Diagnosis with Channel-Wise Attention Mechanisms in Deep Learning

Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-niques for IDC-level classification have been proposed in recent years.Processing speed,memory size,and accuracy can still be improved for better performance.Our study presents ECAM,an Enhanced Channel-Wise Attention Mechanism,using deep learning to analyze histopathological images of Breast Invasive Ductal Carcinoma(BIDC).The main objectives of our study are to enhance computational efficiency using a Separable CNN architecture,improve data representation through hierarchical feature aggregation,and increase accuracy and interpretability with channel-wise attention mechanisms.Utilizing publicly available datasets,DataBioX IDC and the BreakHis,we benchmarked the proposed ECAM model against existing state-of-the-art models:DenseNet121,VGG16,and AlexNet.In the IDC dataset,the model based on AlexNet achieved an accuracy rate of 86.81%and an F1 score of 86.94%.On the other hand,DenseNet121 outperformed with an accuracy of 95.60%and an F1 score of 95.75%.Meanwhile,the VGG16 model achieved an accuracy rate of 91.20%and an F1 score of 90%.Our proposed ECAM model outperformed the state-of-the-art,achieving an impressive F1 score of 96.65%and an accuracy rate of 96.70%.The BreakHis dataset,the AlexNet-based model,achieved an accuracy rate of 90.82%and an F1 score of 90.77%.DenseNet121 achieved a higher accuracy rate of 92.66%with an F1 score of 92.72%,while the VGG16 model achieved an accuracy of 92.60%and an F1 score of 91.31%.The proposed ECAM model again outperformed,achieving an F1 score of 96.37%and an accuracy rate of 96.33%.Our model is a significant advancement in breast cancer diagnosis,with high accuracy and potential as an automated grading,especially for IDC.

HRD1、P53、HER2水平与乳腺浸润性导管癌临床病理特征的关系

目的研究HRD1、P53,HER2与乳腺浸润性导管癌临床病理特征的关系。方法选取确诊并实施相关治疗的82例乳腺癌患者为此次试验的对象,收集全部患者的癌旁组织以及癌组织石蜡切片,应用免疫组织化学EliVi-sion两步法比较癌旁组织以及癌组织中HRD1、P53、HER2水平,分析HRD1、P53、HER2与乳腺浸润性导管癌临床病理特征的相关性。结果癌组织中HRD1(χ^(2)=5.502,P=0.019)、P53(χ^(2)=6.552,P=0.011)、HER2(χ^(2)=5.512,P=0.023)的阳性表达率显著高于癌旁组织;脉管侵犯有无、不同肿瘤直径、TNM不同分期以及淋巴结是否发生转移患者的P53、HRD1、HER2表达水平存在差异(P<0.05);相关性分析发现,患者的肿瘤直径、脉管侵犯、TNM分期以及淋巴结转移情况与患者的HRD1、P53、HER2水平呈正相关。结论HRD1、P53、HER2与乳腺浸润性导管癌临床病理特征呈现显著的相关性,可作为日后治疗的重要靶点。

乳腺导管原位癌、导管原位癌伴微浸润及浸润性导管癌的分子分型差异性

目的:研究乳腺导管原位癌(DCIS)、导管原位癌伴微浸润(DCIS-MI)及浸润性导管癌(IDC)不同临床病理特征及分子分型间的差异。方法:回顾性分析本院2015年01月至2022年06月经病理确诊的乳腺癌患者。分析其临床病理资料,包括患者的年龄、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)、肿瘤细胞增殖活性标记物(Ki-67)、分子分型。采用χ^(2)检验或Fisher确切概率法比较三组患者临床病理表现的差异性。结果:本研究共计选取患者1167例,其中DCIS组为180例(15.42%),DCIS-MI组为67例(5.74%),IDC组为920例(78.83%)。DCIS、DCIS-MI及IDC患者在ER、PR、HER-2、Ki-67中阳性分布及分子分型均有显著差异,具有统计学意义(P<0.05),DCIS-MI患者多以HER-2过表达型为主,ER、PR状态多呈阴性,HER-2多呈阳性,高核分级。DCIS患者多以Luminal A型为主,Ki-67多呈低表达。高核级别、HER-2过表达、ER阴性、PR阴性是影响并促进乳腺DCIS进展为DCIS-MI的预测因子。IDC患者多以Luminal B型为主,ER、PR状态多呈阳性,Ki-67多呈高表达。而在年龄分布上无差异,无统计学意义(P>0.05)。结论:乳腺DCIS、DCIS-MI及IDC间免疫组化标记物和分子分型分布不同,与DCIS相比,DCIS-MI核异型性多呈高核分级,ER、PR阴性比例多,HER-2过表达型比例多,考虑DCIS-MI是独立存在的一种病变,较DCIS有“质”的改变,提示两者处于乳腺癌进展的不同阶段。

多模态影像组学列线图术前预测乳腺浸润性导管癌腋窝淋巴结转移的价值

目的探讨多模态影像组学列线图术前预测乳腺浸润性导管癌腋窝淋巴结(axillary lymph node,ALN)转移的价值。材料与方法回顾性分析2019年1月至2023年6月在我院经手术病理证实为乳腺浸润性导管癌的224例患者的临床及影像资料。首先,选取T2WI图像和动态对比增强MRI(dynamic contrast-enhanced MRI,DCE-MRI)第二期图像的病灶最大层面及同一病灶的钼靶(mammography,MG)头尾位、内外斜位图像勾画感兴趣区,并且提取病灶感兴趣区特征,按照7∶3比例将样本随机分为训练集156例和测试集68例,通过最小绝对收缩和选择算子(least absolute shrinkage and selection operator,LASSO)回归进行特征降维筛选,选择5种机器学习分类器[支持向量机(support vector machine,SVM)、K近邻(K nearest neighbors,KNN)、极端梯度提升决策树(extreme gradient boosting,XGBoost)、逻辑回归(logistic regression,LR)、随机森林(randomforest,RF)]构建多模态影像组学模型并选择预测性能最佳分类器建立MRI、MG影像组学模型。通过单-多因素logistic回归筛选临床高危因素构建临床模型。最终选择影像组学评分联合临床高危因素构建影像组学列线图模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线及曲线下面积(area under the curve,AUC)评价模型预测乳腺癌患者ALN状态的性能,利用校准曲线评价模型的拟合能力,决策曲线评估预测模型的临床实用性。结果最终得到14个最佳影像组学特征。在测试集中5种机器学习分类器AUC值范围为0.764~0.864,其中SVM的AUC值最高(0.864)。淋巴结触诊(P<0.001)及MRI_ALN(P=0.005)是评估ALN是否转移的独立危险因素。列线图模型训练集AUC、敏感度、特异度及准确度分别为0.941、90.7%、88.9%、88.5%;测试集分别为0.926、84.4%、86.1%、85.3%。结论列线图模型性能最佳,在术前预测ALN状态具有重要的价值,可以协助临床制订科学有效的诊疗方案。

乳腺浸润性导管癌肿块大小与多模态超声及免疫指标的相关性分析

目的:探讨不同大小乳腺浸润性导管癌(IDC)的常规超声、声触诊组织成像和定量分析(VTIQ)、超声造影超声特征及免疫指标的差异。方法:回顾性分析2017年-2022年5月在本院经病理证实的106例IDC患者的多模态超声和临床资料。根据肿块大小,将患者分为>2 cm组(55例)和≤2 cm组(51例)。分析两组之间肿瘤的常规超声特征(位置、纵横比、后方回声衰减、边缘毛刺征、Adler血流分级)、VTIQ指标[剪切波速度最大值(SWV_(max))、最小值(SWV_(min))、周边平均值(SWV_(周边AVG))、肿瘤与同切面正常腺体SWV最大值的比值(maxSWVR_(肿瘤/正常乳腺))、最大值与最小值的比值SWVR_(max/min))]和超声造影特征(增强程度、增强速度、增强顺序、病灶边缘放射状汇聚、灌注缺损和增强后病灶范围有无增大)的差异,及其与肿瘤免疫组化指标(ER、PR、Her-2、Ki-67)的相关性。结果:两组之间病变位置(χ^(2)=6.937,P=0.031)、Adler血流分级(χ^(2)=9.456,P=0.002)、SWV周边AVG(Z=-2.504,P=0.012)、maxSWVR肿瘤/正常乳腺(Z=-2.545,P=0.011)、SWVR_(max/min)(Z=-2.469,P=0.014)、增强强度(χ^(2)=3.918,P=0.048)、增强后放射状汇聚(χ^(2)=10.403,P=0.001)、增强后病灶面积增大与否(χ^(2)=8.289,P=0.004)及Ki-67水平(χ^(2)=5.213,P=0.022)的差异均具有统计学意义。Adler血流分级Ⅱ~Ⅲ级、增强后病灶边缘放射状汇聚、增强后病灶面积增大、高SWV周边AVG、高SWVR_(max/min)、高maxSWVR_(肿瘤/正常乳腺)乳腺IDC肿块大小呈正相关。结论:不同直径的乳腺浸润性导管癌(以2 cm为阈值时)的多模态超声特征存在一定差异,可以为临床及超声医师的术前诊断提供参考依据。

磁共振成像中瘤周水肿与乳腺浸润性导管癌侵袭性的相关性研究

目的探讨术前磁共振成像(magnetic resonance imaging,MRI)中瘤周水肿特征与乳腺浸润性导管癌侵袭性的相关性。方法选取2020年1月至2021年5月于宁波大学附属第一医院行乳腺癌根治术且病理诊断为浸润性导管癌的患者79例(79个病灶)纳入浸润性导管癌组,同期45例(49个病灶)乳房良性病变患者纳入良性病变组。比较两组患者的瘤周水肿差异及浸润性导管癌不同病理特征与瘤周水肿的关系。结果良性病变组患者的瘤周水肿显著轻于浸润性导管癌组(χ^(2)=25.330,P<0.05),浸润性导管癌组患者的肿块大小与瘤周水肿程度呈正相关(r=0.381,P<0.05)。不同瘤周水肿分级患者的分子分型、组织学分级、肿瘤T分期、是否淋巴结转移、Ki-67表达水平比较差异均有统计学意义(P<0.05);Ki-67表达水平、淋巴结转移个数与瘤周水肿程度均呈正相关(r=0.348、0.273,P<0.05)。结论MRI中瘤周水肿程度与乳腺浸润性导管癌的侵袭性相关,可将其作为评估乳腺癌的工具之一。

乳腺浸润性导管癌新辅助化疗后转化为化生性鳞状细胞癌1例并文献复习

目的:探讨新辅助化疗后病理类型转化为化生性鳞状细胞癌(metaplasia squamous cell carcinoma,MSCC)的乳腺浸润性导管癌临床病理特征。方法:报道1例乳腺浸润性导管癌在新辅助化疗后原发灶病理完全缓解(pathological complete response,pCR)、腋窝淋巴结转移灶转化为MSCC的病例;复习相关文献归纳总结其临床病理特征。结果:本例初诊为乳腺浸润性导管癌、腋窝淋巴结转移灶伴有局灶鳞状化生,在新辅助化疗后原发灶完全缓解,腋窝淋巴结转移灶完全转化为MSCC,影像显示淋巴结呈囊性改变,HE染色显示囊腔被覆鳞状上皮,形态学符合高分化鳞状细胞癌。免疫组化染色显示该病例分子分型为三阴性型:ER、PR、HER2均阴性。7例(本例加文献报道的6例)新辅助化疗前诊断均为浸润性导管癌,患者中位年龄56岁;5例为原发、2例为复发病例,其中4例有淋巴结转移;分子分型多为三阴性乳腺癌(5/7例);新辅助化疗后7例均转化为MSCC,1例(本例)原发灶pCR,5例淋巴结转移灶中,1例pCR、3例转化为MSCC、1例没有转化。结论:新辅助化疗可以诱导乳腺浸润性导管癌转化为MSCC,这类病例具有独特临床病理特征;探讨其转化的潜在分子机制,对临床个体化治疗及预后评估具有指导意义。

相关血清因子在乳腺导管内癌与乳腺浸润性导管癌中的表达差异及其对预后的影响

目的 探讨外周血白细胞介素(IL)-6、IL-8、IL-22、鳞状细胞癌抗原(SCC-Ag)和细胞角蛋白21-1片段(CYFRA21-1)在乳腺导管内癌(DCIS)与乳腺浸润性导管癌(IDC)中的表达差异及其对预后的影响。方法 选取126例DCIS患者作为DCIS组, 153例IDC患者作为IDC组,另选取134例健康个体作为对照组。根据TNM分期将IDC组患者分为Ⅰ组(轻度IDC患者, TNM分期Ⅰ+Ⅱ期, 62例)及Ⅱ组(重度IDC患者, TNM分期Ⅲ+Ⅳ期, 91例)。DCIS组和IDC组患者接受放疗或放疗联合化疗治疗。采用酶联免疫吸附试验法测定血清IL-6、IL-8、IL-22水平,采用化学发光微粒子免疫分析法测定SCC-Ag水平,采用化学发光法测定CYFRA21-1水平。比较DCIS组与IDC组患者的临床特征,各组血清IL-6、IL-8和IL-22水平,各组不同疗效患者血清IL-6、IL-8和IL-22水平,各组SCC-Ag和CYFRA21-1水平;分析患者生存情况。结果 与对照组相比, DCIS组及IDC-Ⅰ组、Ⅱ组患者血清IL-6、IL-8和IL-22水平均显著升高(P<0.05);与DCIS组相比, IDC-Ⅰ组、Ⅱ组患者血清IL-6、IL-8和IL-22水平显著升高(P<0.05);与IDC-Ⅰ组相比, IDC-Ⅱ组患者血清IL-6、IL-8和IL-22水平显著升高(P<0.05)。DCIS组、IDC-Ⅰ组、IDC-Ⅱ组完全缓解(CR)+部分缓解(PR)患者血清IL-6、IL-8和IL-22水平均较稳定(SD)+进展(PD)患者明显下降(P<0.05)。DCIS组和IDC组术后复发患者分别为5例和16例, DCIS组和IDC组患者SCC-Ag和CYFRA21-1水平较对照组显著升高(P<0.05)。DCIS组术后复发患者SCC-Ag阳性率为60.0%(3/5), CYFRA21-1阳性率为80.0%(4/5);IDC组术后复发患者SCC-Ag阳性率为62.5%(10/16), CYFRA21-1阳性率为68.8%(11/16)。279例乳腺癌患者1、2、3年存活率分别为44.8%(125/279)、18.6%(52/279)、13.3%(37/279)。SCC-Ag阴性患者的中位生存期为25个月,而SCC-Ag阳性患者的中位生存期为16个月, SCC-Ag阴性患者的中位生存期长于SCC-Ag阳性患者;CYFRA21-1阴性患者的中位生存期为14个月, CYFRA21-1阳性患者的中位生存期为9个月, CYFRA21-1阴性患者的中位生存期长于CYFRA21-1阳性患者。结论 血清IL-6、IL-8、IL-22、SCC-Ag和CYFRA21-1被认为是乳腺癌转移和预后的潜在标志物。

乳腺浸润性导管癌PDGF-BB、LCN2的表达及临床意义

目的探析血小板衍生生长因子-BB(PDGF-BB)和脂质运载蛋白2(LCN2)在乳腺浸润性导管(IDC)癌患者血清及组织中的表达及临床意义。方法选取济南市第八人民医院乳腺癌浸润性导管患者90例(IDC组),导管原位癌患者30例(DCIS组)、良性病变者30例(BPBD组),检测及分析乳腺IDC患者血清和瘤组织中PDGF-BB、LCN2表达与临床病理特征的关系及两因子的相关性。结果PDGF-BB、LCD2表达在乳腺IDC组明显高于BPBD组,差异有统计学意义(P<0.05)。乳腺浸润性导管癌患者血清和组织中PDGF-BB、LCN2表达水平与组织学分级、淋巴结转移、TNM分期、ER、PR表达明显相关;PDGF-BB表达量与LCN2表达量呈正相关(P<0.05),差异有统计学意义(P<0.05)。结论乳腺浸润性导管癌患者PDGF-BB、LCN2均呈高表达,增加癌细胞浸润、转移风险;联合检测PDGF-BB、LCN2表达水平,有利于评估乳腺癌预后。

MRI预测乳腺非特殊型浸润性导管癌Luminal分型的临床价值

目的:探讨乳腺非特殊型浸润性导管癌Luminal分型的MRI表现,为乳腺非特殊型浸润性导管癌的诊疗提供更优的选择。方法:回顾性分析2018年10月8日—2021年12月1日经样本医院手术病理证实为乳腺非特殊型浸润性导管癌的119例女性患者的临床及影像学资料。比较Luminal型和非Luminal型的临床特征及MRI影像特征。绘制ROC曲线,计算ROC曲线下的面积及截断点。结果:119例乳腺非特殊型浸润性导管癌中,Luminal型72例,非Luminal型47例。患者有无淋巴结转移、肿瘤的最大径、肿瘤形态、TIC曲线、最小表观扩散系数(apparent diffusion coefficient,ADC)值和平均ADC值比较,差异统计学意义(P<0.05)。当最小ADC值和平均ADC值分别为0.851×10^(-3)mm^(2)/s、0.849×10^(-3)mm^(2)/s时,其特异度和敏感度分别为0.553、0.806和0.681、0.750,ROC曲线下面积分别为0.745、0.761。结论:MRI可以提高乳腺非特殊型浸润性导管癌的诊断效能,其ADC值可作为其临床及预后的重要指标,更有利于临床进行更精准的治疗。

Roles of micro RNA-140 in stem cell-associated early stage breast cancer

An increasing body of evidence supports a stepwise model for progression of breast cancer from ductal carcinoma in situ(DCIS) to invasive ductal carcinoma(IDC). Due to the high level of DCIS heterogeneity, we cannot currently predict which patients are at highest risk for disease recurrence or progression. The mechanisms of progression are still largely unknown, however cancer stem cell populations in DCIS lesions may serve as malignant precursor cells intimately involved in progression. While genetic and epigenetic alterations found in DCIS are often shared by IDC, m RNA and mi RNA expression profiles are significantly altered. Therapeutic targeting of cancer stem cell pathways and differentially expressed mi RNA could have significant clinical benefit. As tumor grade increases, mi RNA-140 is progressively downregulated. mi R-140 plays an important tumor suppressive role in the Wnt, SOX2 and SOX9 stem cell regulator pathways. Downregulation of mi R-140 removes inhibition of these pathways, leading to higher cancer stem cell populations and breast cancer progression. mi R-140 downregulation is mediated through both an estrogen response element in the mi R-140 promoter region and differential methylation of Cp G islands. These mechanisms are novel targets for epigenetic therapy to activate tumor suppressor signaling via mi R-140. Additionally, we briefly explored the emerging role of exosomes in mediating intercellular mi R-140 signaling. The purpose of this review is to examine the cancer stem cell signaling pathways involved in breast cancer progression, and the role of dysregulation of mi R-140 in regulating DCIS to IDC transition.

Metaplastic breast cancer with chondrosarcomatous differentiation combined with concurrent bilateral breast cancer:A case report

BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.

Aberrant methylation of Glutathione S-transferase P1 and E-cadherin in invasive ductal breast carcinoma and fibroadenoma

Objective To investigate the hypermethylation status of glutathione transferase P1(GSTP1)and E-cadherin(ECAD),TSGs(tumor suppressor genes)in our breast cancer samples and explore their correlation with clinicopathological features of corresponding cancer patients.Methods One hundred and thirty-six IDC(invasive ductal carcinoma)patients were recruited for analysis and 16 fibroadenoma patients acted as control.DNA extraction and methylation-specific PCR(MSP)were subsequently performed preceded by pathological examination.Results The percentage of hypermethylated GSTP1 in carcinoma and fibroadenoma groups was 34.92% and 15.79% respectively and the percentage of hypermethylated ECAD in carcinomas and fibroadenomas was 18.00% and 0.00% respectively.Carcinoma had the highest percentage of c-erbB2 overexpression being 54.55% among the clinicopathological parameters.Conclusion Hypermethylation patterns are frequent in IDC and seem to relate to c-erbB2 overexpression,and such epigenetic change should not be neglected in fibroadenoma.Tumor methylation status in cancer patients can be determined at early stage and it may be a reference for better treatment planning.

Application of Dual-Energy Computed Tomography for Breast Cancer Diagnosis

The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.

合成MRI定量参数与乳腺浸润性导管癌分子分型及细胞增殖活性关系研究

目的:探讨合成MRI定量参数与乳腺浸润性导管癌(invasive ductal carcinoma,IDC)不同分子分型及细胞增殖活性的关系。方法:回顾性分析2020年7月至2022年2月于昆明医科大学第三附属医院就诊并经病理证实的112例乳腺IDC患者临床病理资料,均行合成MRI检查,使用ITK-SNAP软件勾画并测量病灶定量参数T1、T2及质子密度(proton density,PD)值。根据雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)和肿瘤增殖核抗原Ki-67表达情况对病灶进行分组,比较乳腺IDC不同分子分型及细胞增殖活性的合成MRI定量参数差异。结果:112例患者中共有112个乳腺IDC病灶,其中Luminal A型40个、Luminal B型49个、HER-2过表达型8个及三阴性乳腺癌15个。ER阳性/阴性、PR阳性/阴性、HER-2阳性/阴性组之间T1、T2值差异均无统计学意义(均P>0.05),Ki-67高表达组的T1和T2值均高于低表达组(均P<0.05),Luminal A型组的T1、T2值均低于Luminal B型和三阴性乳腺癌组,HER-2过表达型组的T2值低于Luminal B型及三阴性乳腺癌组(均P<0.05)。PD值在不同分子分型及Ki-67表达水平中差异均无统计学意义(均P>0.05)。结论:合成MRI定量参数中T1、T2值对乳腺IDC不同分子分型及细胞增殖活性指标Ki-67鉴别具有一定价值,但PD值价值有限。

乳腺导管内乳头状瘤的超声造影特征及定量参数分析

目的 通过对比乳腺导管内乳头状瘤与纤维腺瘤、浸润性导管癌超声造影的不同特征,探讨超声造影对乳腺导管内乳头状瘤的诊断价值。方法 选取自2020年1月至2021年11月新疆医科大学第一附属医院经病理证实为乳腺导管内乳头状瘤患者22例,及同期病理证实为纤维腺瘤患者32例、浸润性导管癌患者31例,回顾分析3组病例超声造影的定性及定量指标特征。结果 (1)超声造影定性分析结果:导管内乳头状瘤组超声造影后快速向心性高增强,增强后范围扩大比率高于纤维腺瘤组(P<0.05);导管内乳头状瘤组超声造影后内部充盈缺损,增强后范围扩大,周边汇聚征,向心性增强比率(9.1%、27.3%、4.5%、54.5%)均低于浸润性导管癌组(48.4%、90.3%、48.4%、87.1%),造影剂分布较浸润性导管癌组更均匀,差异具有统计学意义(P<0.05)。(2)超声造影定量参数分析结果:导管内乳头状瘤组的上升支斜率(K)及梯度(Grad)均小于浸润性导管癌组,峰值强度(A)高于纤维腺瘤组,差异具有统计学意义(P<0.05)。结论 乳腺导管内乳头状瘤具有较好的超声造影特征,超声造影对提高导管内乳头状瘤的诊断提供了更多有价值证据。

An AAS Dependent Method for Quantitative Analysis of Essential Trace Elements from Blood Samples of Pakistani Female Breast Cancer Patients

Breast cancer is the second leading cancer in the world. The long-term exposure of some metallic compounds induces different forms of cancer, including breast cancer. Trace elements are essential metals for the physiological functions of the cell on a molecular level and also contribute in treatment of many diseases. The aim of study was to compare the level of essential trace elements, sodium, potassium, calcium, iron, and zinc in breast cancer patients with normal healthy adult women. Total forty-five patients (age range from 25 - 73 years) were included in this study and divided into three groups according to three different stages of breast cancer including tumor-II, tumor-III and tumor-IV. Blood was collected from all participants after taking history, clinical data and taking consent. However, about fifteen non-cancer healthy women in age range from 26 - 69 years were subjected to this study. The elemental concentrations were determined through atomic absorption spectrophotometer subsequent to microwave-induced acid digestion. The results of Na, K, Zn, Fe, Ca, were observed to decrease in blood samples of breast cancer patients as compared to non-cancer subjects. The results are reliable with other numerous literature reported studies, the efficiency, and deficiency of these trace metals may contribute an important role in the progress of breast cancer.