The accuracy of magnetic resonance imaging and ultrasound in evaluating the size of early-stage breast neoplasms

Objective Breast cancer is the most frequently diagnosed cancer in women. Accurate evaluation of the size and extent of the tumor is crucial in selecting a suitable surgical method for patients with breast cancer. Both overestimation and underestimation have important adverse effects on patient care. This study aimed to evaluate the accuracy of breast magnetic resonance imaging(MRI) and ultrasound(US) examination for measuring the size and extent of early-stage breast neoplasms.Methods The longest diameter of breast tumors in patients with T_(1–2)N_(0–1)M_0 invasive breast cancer preparing for breast-conserving surgery(BCS) was measured preoperatively by using both MRI and US and their accuracy was compared with that of postoperative pathologic examination. If the diameter difference was within 2 mm, it was considered to be consistent with pathologic examination.Results A total of 36 patients were imaged using both MRI and US. The mean longest diameter of the tumors on MRI, US, and postoperative pathologic examination was 20.86 mm ± 4.09 mm(range: 11–27 mm), 16.14 mm ± 4.91 mm(range: 6–26 mm), and 18.36 mm ± 3.88 mm(range: 9–24 mm). US examination underestimated the size of the tumor compared to that determined using pathologic examination(t = 3.49, P < 0.01), while MRI overestimated it(t =-6.35, P < 0.01). The linear correlation coefficients between the image measurements and pathologic tumor size were r = 0.826(P < 0.01) for MRI and r = 0.645(P < 0.01) for US. The rate of consistency of MRI and US compared to that with pathologic examination was 88.89% and 80.65%, respectively, and there was no statistically significant difference between them(χ~2 = 0.80, P > 0.05).Conclusion MRI and US are both effective methods to assess the size of breast tumors, and they maintain good consistency with pathologic examination. MRI has a better correlation with pathology. However, we should be careful about the risk of inaccurate size estimation.

Prediction of Nipple and Areola Complex Invasion in Breast Cancer Patients. Clinical and Pathological Study of Surgical Specimens

Breast conservation surgery (BCS) and nipple-areola-sparing (NAS) mastectomy have been recognized as two milestones in this period. This study included 60 Egyptian female patients with breast cancer, all of them were subjected to modified radical mastectomy operation. Methods: This study included female patients > 18 years old who have breast cancer with healthy looking non invaded skin of nipple and areola and excluded patients < 18 years old, patients unfit for surger, patients previously subjected to chemo or radiotherapy for breast cancer. We peformed clinical examination of 60 patients with breast cancer. We studied the relevant factors that affect NAC invasion such as patient’s age, menstrual state, family history, tumor size, tumor location (central vs peripheral), tumor to nipple distance, lymphovascular invasion of NAC, lymph node metastasis, histological tumor type, tumor stage, multifocal/multicentric tumors and (ER, PR, HER2) status. Result: In our study, we have shown that NAC invasion is strongly associated with: 1) Nipple retraction as a patient’s complaint;2) Tumor site;3) Tumor-nipple-distance ≤ 4 cm;4) Multifocal/multicentric tumor;5) Tumor grade (grade III tumors);6) Positive lymph node invasion;7) ER and PR receptors negativity;8) HER2 positivity. This helps in preoperative planning for selecting patients for NAS mastectomy. Conclusion: The ideal patients for NAS mastectomy are with these criteria: 1) Clinically normal nipple areola complex;2) Distance from the tumor to the nipple is >4 cm;3) No multifocal/multicentric tumor;4) Absence of lymph node invasion;5) Tumor grade (grade I, II);6) Peripheral not central tumor;7) No sub-areolar lymphovascular invasion (LVI);8) ER receptor positive;9) PR receptor positive;10) HER2 negative.

An analysis of vascularity and neovascularization in surgical pathology materials of breast carcinoma and its clinical significance

Breast cancer is one of the most common malignancies among women and its morbidity has recently increased in many parts of the world[1].Numerous factors have been reported to be associated with development of breast cancer including angiogenesis.Angiogenesis or the formation of new blood vessel networks,not only plays a pivotal role in human normal development,but also in pathophysiological conditions such as inflammatory diseases and neoplasms[2]

The prognostic value of clinical and pathologic features in nonmetastatic operable male breast cancer

Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.

Clinical and pathological features and risk factors for primary breast cancer patients

BACKGROUND Breast cancer is the most common malignancy in women all around the world.According to the latest statistics in 2018,there were more than 2.08 million new breast cancer cases all around the world and more than 620000 deaths;the proportion of breast cancer deaths in women with cancer is 15%.By studying age,clinicopathological characteristics and molecular classification,age at menarche,age at birth,number of births,number of miscarriages,lactation time,surgical history of benign breast lesions,history of gynecological diseases,and other factors,we retrospectively summarized and compared the disease history of patients with primary breast cancer and patients with benign thyroid tumors admitted to our hospital in the past 10 years to explore the clinicopathological characteristics and risk factors for primary breast cancer.AIM To investigate the clinical and pathological features and risk factors for primary breast cancer treated at our center in order to provide a reference for the prevention and treatment of breast cancer in the Zhuhai-Macao region.METHODS Through a retrospective case-control study,149 patients with primary breast cancer diagnosed and treated at Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2013 to March 2020 were included as a case group,and 165 patients with benign breast tumors diagnosed and treated from January 2019 to March 2020 were included as a control group.The data collected included age,age at menarche,age at first birth,number of births,number of miscarriages,lactation time,history of surgery for benign breast lesions,history of familial malignant tumors,history of gynecological diseases,history of thyroid diseases,and the tumor characteristics of the patients in the case group including pathological diagnosis,pathological type,tumor size,lymph node metastasis,distant metastasis,stage,and molecular classification,among others.In the case group,the chi-square test was used to analyze the clinical and pathological features of patients in three age groups(<40,40-59,and≥60 years).A multifactor logistic regression analysis was used to analyze correlations between the two groups.RESULTS Among 149 patients with primary breast cancer,the average age was 48.20±12.06 years,and the proportion of patients at 40-59 years old was the highest,accounting for 61.8%of cases.The molecular type was mainly luminal B type,accounting for 69.2%of cases,and at the time of diagnosis,the tumor stage was mainly stage I/II,accounting for 62.4%of cases.There were no statistically significant differences in the distributions of tumor location,pathological type,tumor size,lymph node metastasis,stage,or molecular classification among the three age groups(<40,40-59,and≥60 years)(P≥0.05).The differences in the distribution of distant metastasis among the three age groups(<40,40-59,and≥60 years)were statistically significant(P<0.01).The differences in lactation time,history of familial malignant tumors,history of gynecological diseases,and history of thyroid diseases between the two groups were not statistically significant(P≥0.05).The differences in age at disease diagnosis,age at menarche,and history of surgery for benign breast lesions were statistically significant(P<0.01).The difference in age at first birth was also statistically significant(P<0.05).CONCLUSION The highest incidence of breast cancer in the Zhuhai-Macao region is present among women aged 40-59 years.There is a larger proportion of stage I/II patients,and the luminal B type is the most common molecular subtype.Distant metastasis occurs mainly in the≥60-year-old group at the first diagnosis;increased age,late age at menarche,and late age at first birth may be risk factors for primary breast cancer,and a history of surgery for benign breast lesions may be a protective factor for primary breast cancer.

Methods of early detection:would clinical breast examination and breast ultrasonography be a good alternative to mammography?

Breast cancer is one of the leading causes of cancer deaths among women[1].In the past 40 years,breast cancer incidence has doubled or even tripled in developed countries such as South Korea and Japan; whereas it is about 20% to 30% in China and India in the past decade[2-4]. An increasing incidence rate of 3%

Clinicopathological analysis of early-stage breast cancer patients that meet indications for BRCA 1/2 genetic testing

Objective:To investigate the clinicopathological characteristics and prognostic factors of early-stage breast cancer patients with indications for breast cancer susceptibility genes 1/2(BRCA1/2)genetic testing in China.Methods:Based on the indication criteria for BRCA genetic testing specified in the National Comprehensive Cancer Network(NCCN)clinical practice guidelines in oncology,genetic/familial high-risk assessment:Breast and ovarian(Version 2.2019),a retrospective analysis was performed on patients with early-stage invasive breast cancer treated at Breast Disease Center,Peking University First Hospital between January 2008 and December 2016.Clinicopathological characteristics of all patients were analyzed,and prognoses were calculated using the KaplanMeier method and a Cox proportionate hazards model.Results:A total of 906 early-stage breast cancer patients who had indications for BRCA genetic testing and had complete clinicopathological data and follow-up information were included in the study group,accounting for34.7%of all breast cancer patients treated in Breast Disease Center,Peking University First Hospital during the study period.Compared with breast cancer patients without indications for BRCA genetic testing,the overall survival(OS)and disease-free survival(DFS)of patients with indications were not significantly different.In the study group,patients with premenopausal status,high T stage,lymph node positive,estrogen receptor(ER)negative,Ki-67>20%and presence of a vascular tumor thrombus had worse prognosis.There were more family histories of gastrointestinal cancer in patients with related indications than in patients without such indications.Conclusions:Single-center data showed that more than 30%of patients with early-stage breast cancer had indications for BRCA genetic testing.There was no prognostic difference in patients with or without indications for BRCA genetic testing.Premenopausal status,high T stage,lymph node positive,ER negative,Ki-67>20%,and presence of a vascular tumor thrombus were associated with poor prognosis.

The Mid-Long Term Outcome of Breast-Conserving Patients with Different Ages

OBJECTIVE Breast-conserving surgery has been a standard treatment for relatively small size of breast cancer. Younger breast cancer patients have more desire to conserve their breasts. This study was to investigate the clinicopathological characteristics and prognosis of younger breast cancer patients who received breastconserving treatment in China. METHODS The data of 232 breast cancer patients who received breast-conserving treatment in Cancer Hospital of Chinese Academy of Medical Science from January Ist, 1999 to December 31st, 2005, were collected and retrospectively analyzed. According to the age, the patients were divided into 2 groups： younger group （age ≤ 35 at the time of diagnosis） and elder group （age 〉35）. The clinical features of the patients in the 2 groups were compared, and their clinical characteristics, recurrence, metastasis and survival status were summarized. RESULTS In the 232 cases, younger patients accounted for 15.9% （37/232）, the elder 84.1% （195/232）. By December 2008, the median time of follow-up was 54 months （ranging from 2 months to 118 months）. Two patients （5.41% , 2/37） in the younger group and 5 patients （2.56% 5/195） in the elder group died. The 5-year overall survival rate （OS） in the younger and elder groups was 96.08% and 97.19%, respectively （X2= 0.69, P = 0.4066）. Local recurrence （LR） or distant metastasis （DM） presented in 5 patients （5/37, 13.51%） in younger group. LR or DM presented in 10 patients （10/195, 5.13%） in elder group. The 5-year disease-free survival （DFS） rate in the younger and elder groups was 82.58% and 95.52%, respectively （X2 = 4.02, P = 0.0451）. Lymph node status and the age of 35 years old or younger were the prognosis factors affecting the DFS of patients who received breast-conserving treatment （OR = 3.467, 95%CI： 1.048-11.472, P 〈0.05; OR = 0.245, 95%CI： 0.069-0.863, P 〈 0.05）. Lymph node status was the only prognostic factor affecting the DFS of younger group patients （OR = 7.357, 95%CI： 1.030-52.563, P 〈0.05）. CONCLUSION Though the younger and elder patients have the same mid-long term survival rate, younger patients are more likely to have recurrence or metastasis than the elder patients. Breast-conserving surgery given to the younger patients especially to the younger patients with lymph nodes positive should be contemplated cautiously.

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.

Surgical Procedures,Pathological Features and Prognosis in Young Women with Breast Cancer in China--a Single Institute Experience

Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical procedures,pathological features and prognosis of 61 cases of young females(≤40 years)and 507 cases of elderly females(>40 years),treated in our department from August 2011 to July 2018.This data was analyzed using SPSS 23.0 program.Results:10.74% of total cases,in this period of time,involve young females.In terms of surgical procedures,24.59%of young patients underwent breast conserving surgery(8.48% elderly,respectively),and 13.11%underwent reconstruction surgery(1.18% elderly,respectively),with statistically significant differences existing between the two groups(P<0.05).Progesterone receptor(PR)expression in young women was significantly higher than in elderly females(P<0.05).There were no significant differences between the two groups in the proportion of invasive ductal carcinoma(IDC),axillary lymph node metastasis(ALNM),expression of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and Ki-67,but the lymphatic metastasis stage showed an increasing rate with younger age.No significant difference was found in 3-year disease-free survival(DFS)and overall survival(OS).Conclusion:The selection rate of breast conserving and reconstructive surgery in young women with breast cancer is significantly higher than that in elderly women.The younger the patient,the more frequently the PR positive expression,and the more likely ALNM to occur.The 3-year prognosis of the young and elderly patients is similar.

Clinic pathological features and prognosis of metaplastic breast carcinoma

Objective:To investigate clinic pathological peculiarities and evaluate the prognosis of metaplastic breast carcinoma.Methods:Patients with metaplastic breast carcinoma at the First Affiliated Hospital of Zhejiang University and Guangxing Hospital Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from 2008 to 2013 were retrospectively selected.Results:A total of 73 female patients were reviewed,including 41 cases of purely epithelial type and 32 cases of mixed epithelial and mesenchymal type.Median tumor size was 4.6cm.Forty-three patients(58.8%)presented with lymph node metastasis,84.9%of cases were in advanced TNM stage,and 60.2%of cases were overexpressed by Ki-67.At a median follow-up of 59 months,median overall survival and disease-free survival were 59.7 and 43.9 months,respectively.Five-year overall survival rate was 45.2%and disease-free survival rate was 30.1%,and 76.7%of patients had recurrence or metastasis.Univariate analysis showed that tumor size,lymph node,and radiotherapy were associated with overall survival and disease-free survival(P<0.05),while Ki-67 over-expression was correlated with overall survival(P<0.05).With multivariate analysis,tumor size,lymph node,and radiotherapy affected prognosis(P<0.05);however,pathological typing was not an independent prognostic factor(P>0.05).Conclusion:Metaplastic breast carcinoma is a rare malignant tumor with large tumor,high lymph node metastasis rate,staging relatively late,high local recurrence and distant metastasis rate.The treatment follows the principle of comprehensive treatment based on surgery,but the prognosis is poor.Tumor size,lymph node,and radiotherapy treatment affect the prognosis.Overexpression of Ki-67 can be used as a potential diagnostic,therapeutic and prognostic indicator for metaplastic breast cancer.

乳腺癌患者病理特征与Bcl-2、CXCL13、PAX8表达情况的关系分析

目的分析乳腺癌患者病理特征与B细胞淋巴瘤/白血病-2基因(Bcl-2)、趋化因子配体13(CXCL13)、配对盒基因8抗体(PAX8)表达情况的关系。方法收集2021年1月至2023年1月该院收治的160例乳腺癌患者临床资料。采用免疫组化法对其癌组织与癌旁组织Bcl-2、CXCL13、PAX8表达情况进行检测,并分析3项指标与患者病理特征的关系。结果与癌旁组织比较,癌组织Bcl-2、CXCL13、PAX8阳性率更高,差异有统计学意义(P<0.05)。与雌激素受体(ER)阴性、肿瘤最大径≥3 cm、孕激素受体(PR)阴性患者比较,ER阳性、肿瘤最大径<3 cm、PR阳性患者中Bcl-2高表达占比更高,差异有统计学意义(P<0.05);与无淋巴结转移、Ⅰ~Ⅱ期患者比较,淋巴结转移、Ⅲ~Ⅳ期患者中CXCL13高表达占比更高,差异有统计学意义(P<0.05);与Ⅰ~Ⅱ期、高/中分化、无淋巴结转移患者比较,Ⅲ~Ⅳ期、低分化、有淋巴结转移患者中PAX8高表达占比更高,差异有统计学意义(P<0.05)。ER、PR表达情况与Bcl-2表达情况呈正相关(P<0.05),肿瘤最大径与Bcl-2表达情况呈负相关(P<0.05);临床分期、淋巴结转移情况与CXCL13、PAX8表达情况呈正相关(P<0.05);分化程度与PAX8表达情况呈负相关(P<0.05)。结论乳腺癌患者Bcl-2、CXCL13、PAX8表达情况对疾病的发生和发展具有明显影响,有望成为评估乳腺癌患者病情严重程度的标志物。

乳腺肿瘤整形保乳手术治疗乳腺癌的临床效果研究

目的探究在乳腺癌患者的治疗中乳腺肿瘤整形保乳手术的临床应用效果。方法106例乳腺癌患者,按入院顺序编号分组,奇数者划至对照组,偶数者划至研究组,各53例。对照组以改良根治术治疗,研究组以整形保乳手术治疗。比较两组临床手术指标、术后并发症发生情况、手术前后血清肿瘤标志物水平、乳房美观满意度。结果研究组患者手术时间(129.74±10.65)min、术中失血量(64.29±9.31)ml、切口长度(4.64±1.19)cm、住院时间(4.88±1.10)d均优于对照组的(150.07±10.53)min、(86.71±10.29)ml、(10.48±3.74)cm、(5.92±1.21)d,组间比较统计学差异明显(P<0.05)。研究组并发症发生率5.66%低于对照组的22.64%,组间比较统计学差异明显(P<0.05)。两组术后癌抗原153(CA153)和癌胚抗原(CEA)均低于术前,统计学差异明显(P<0.05)。研究组患者对乳房美观的总满意度为96.23%,高于对照组的81.13%,组间比较统计学差异明显(P<0.05)。结论对于乳腺癌患者的手术治疗来说,乳腺肿瘤整形保乳手术的实施,可以在保证原有治疗效果的基础上,改善临床手术指标,减少术后并发症风险,同时满足患者在乳房美观度方面的要求,由此可见其良好的临床应用价值,因此可以于临床展开大力推广。

乳腺癌组织中bFGF、Ki-67及ADAM15表达情况及与其临床病理特征的相关性分析

目的 探讨乳腺癌组织中碱性成纤维细胞生长因子(bFGF)、Ki-67及去整合素金属蛋白酶15(ADAM15)表达情况及其与临床病理特征的关系。方法 选取87例乳腺癌患者作为研究对象,均行手术治疗,采集肿瘤标本及癌旁标本行免疫组化染色检查,比较肿瘤组织及癌旁组织内bFGF、Ki-67及ADAM15表达情况,并分析bFGF、Ki-67及ADAM15表达与其临床病理特征的关系。结果 肿瘤组织内bFGF、Ki-67及ADAM15阳性率高于癌旁组织,差异有统计学意义(P<0.05);bFGF阳性组肿瘤Ⅲ~Ⅳ期、有淋巴结转移、肿瘤直径≥3 cm占比高于bFGF阴性组,差异有统计学意义(P<0.05);Ki-67阳性组肿瘤Ⅲ~Ⅳ期、有淋巴结转移、肿瘤直径≥3 cm占比高于Ki-67阴性组,差异有统计学意义(P<0.05);ADAM15阳性组肿瘤Ⅲ~Ⅳ期、有淋巴结转移、肿瘤直径≥3 cm占比高于ADAM15阴性组,差异有统计学意义(P<0.05)。结论 bFGF、Ki-67及ADAM15在乳腺癌组织内存在较高阳性表达,且与肿瘤分期、淋巴结转移及肿瘤直径存在密切关系,或可作为完善乳腺癌治疗方案的新靶点。

乳腺癌组织内VEGF-C、HIF-1α表达与血管生成的相关性研究

目的:探讨乳腺癌患者组织内血管内皮生长因子-C(VEGF-C)、缺氧诱导因子-1α(HIF-1α)表达与血管生成的关系。方法:选取2022年1月—2023年12月泰安市中心医院收治的198例乳腺癌女性患者,并选取同期经病理学检查为乳腺纤维瘤患者50例为对照。采用免疫组化S-P法检测乳腺癌和乳腺纤维瘤组织中VEGF-C、HIF-1α表达及微血管密度(MVD)数,分析VEGF-C、HIF-1α表达与临床病理特征及MVD的关系。结果:乳腺癌患者乳腺组织中VEGF-C、HIF-1α阳性表达率及MVD数均高于乳腺纤维瘤患者,差异有统计学意义(P<0.05)。VEGF-C阳性与阴性表达者年龄、肿瘤直径、组织学分级、ER表达、PR表达等临床病理特征比较,差异无统计学意义(P>0.05);VEGF-C阳性表达者有淋巴结转移、TNM分期为Ⅲ~Ⅳ期、分子分型(Luminal B、HER-2阳性、基底细胞)的患者占比及MVD均高于VEGF-C阴性表达者,差异有统计学意义(P<0.05)。HIF-1α阳性与阴性表达者年龄、肿瘤直径、ER表达、PR表达、分子分型等临床病理特征比较,差异无统计学意义(P>0.05);HIF-1α阳性表达者组织学分级为Ⅱ级、Ⅲ级、有淋巴结转移、TNM分期为Ⅲ~Ⅳ期的患者占比及MVD均高于HIF-1α阴性表达者,差异有统计学意义(P<0.05)。结论:乳腺癌患者组织内VEGF-C、HIF-1α阳性表达率明显升高,并且还与肿瘤血管生成存在显著相关性。

乳腺浸润性癌中CD147和PHH3的表达与临床病理特征的关系

目的观察浸润性乳腺癌中CD147蛋白的定量表达和PHH3阳性细胞数目,分析二者与多个临床病理特征的关系及相关性。方法选取80例乳腺原发浸润性癌手术切除标本为研究对象,29例正常乳腺组织作为对照组,采用免疫组织化学SP法检测CD147和PHH3的表达,用IPP6.0图像分析软件对CD147蛋白表达进行定量测试,计数PHH3阳性个数和有丝分裂指数,分析浸润性乳腺癌中CD147和PHH3的表达与临床病理特征的关系,用Spearman法分析二者之间的相关性。结果CD147主要定位于乳腺癌细胞胞膜或膜浆,PHH3主要定位于浸润性乳腺癌有丝分裂的细胞核内,二者在浸润性乳腺癌组织中的定量表达和阳性数目均显著高于正常乳腺组织(P=0.000)。80例浸润性乳腺癌中,CD147蛋白定量表达在肿瘤直径较大、WHO分级较高、淋巴结有转移、TNMⅢ-Ⅳ期、雌激素受体(estrogen receptor,ER)阴性、Her-2基因无扩增阳性强度较高(P均<0.05);PHH3阳性数目和有丝分裂指数在肿瘤直径较大、WHO分级较高、淋巴结有转移状况及TNM分期Ⅲ-Ⅳ期(P_(均)<0.05)。CD147蛋白表达越高,PHH3阳性数目相应越多,有丝分裂指数越高,Spearman分析显示CD147分别与PHH3阳性数目和有丝分裂指数呈显著正相关(r=0.950,r=0.706,P=0.000)。结论浸润性乳腺癌中CD147和PHH3高表达,与肿瘤的发生发展有关,二者呈正相关,检测乳腺癌中CD147蛋白定量表达、PHH3阳性数目和有丝分裂指数有助于侵袭和转移的判断,为乳腺癌临床病理诊断提供了参考价值。

基于乳腺癌超声特征及临床病理指标的列线图预测腋窝淋巴结转移风险

目的探讨基于超声特征联合临床病理指标的列线图预测乳腺癌腋窝淋巴结转移风险的价值。资料与方法回顾性分析2014年1月—2021年10月于石河子大学第一附属医院经病理证实的1038例乳腺癌患者(共1099个肿块)的超声图像及病理资料,按检查时间分为训练组和验证组。基于多因素Logistic回归筛选与腋窝淋巴结转移相关的独立预测因素,建立回归模型并制作列线图,利用验证组数据及校准曲线验证列线图。绘制受试者工作特征曲线、决策曲线评估列线图的预测效能。结果多因素Logistic分析结果显示,乳腺癌肿块最大径(OR=1.906,95%CI 1.397~2.609,P<0.001)、纵横比(OR=0.425,95%CI 0.284~0.634,P<0.001)、边界(OR=0.373,95%CI 0.267~0.520,P<0.001)、Adler血流分级(OR=3.188,95%CI 2.049~5.107,P<0.001)、病理类型(OR=2.975,95%CI 1.759~5.267,P<0.001)及人表皮生长因子受体2表达状态(OR=1.439,95%CI 1.048~1.982,P=0.025)是预测腋窝淋巴结转移的危险因素。基于以上6个指标构建列线图预测模型,其训练组和验证组一致性指数分别为0.712和0.749,校准曲线(绝对平均误差分别为0.019、0.014)及决策曲线均提示该模型预测能力较好。结论基于乳腺癌原发病灶超声特征及临床病理指标联合构建的预测腋窝淋巴结转移风险列线图模型,可为临床诊断、后期治疗及预后评估提供参考信息。

乳腺癌新辅助化疗病理完全缓解率及影响因素分析

目的:分析影响患者新辅助化疗(neoadjuvant chemotherapy, NAC)后病理完全缓解(pathologic complete remission, pCR)的相关因素,为乳腺癌(breast cancer, BC)患者应用NAC联合保乳手术治疗方案提供参考和依据。方法:研究对象来源于2013年01月至2021年12月在山西白求恩医院乳腺外科治疗的Ⅱ-Ⅲ期女性BC患者。采集患者的人口学特征、临床病理资料以及化疗相关信息,观察肿瘤原发灶的变化评价NAC的短期疗效。结果:研究共260例研究对象,保乳手术(breast-conserving surgery, BCS)率为21.9%,pCR率为18.1%。肿瘤pCR的单因素分析中,是否哺乳(P<0.05)、ER、PR、HER-2、Ki-67表达、分子分型、靶向治疗及治疗方案均与乳腺pCR相关(P≤0.01)。多因素分析中,肿瘤分子分型与肿瘤pCR显著相关(OR=0.077,95%CI:0.022~0.262)。结论:NAC可以减小肿瘤,提高保乳率及pCR率。不同分子分型的肿瘤pCR率有显著差异,尤其是在三阴性乳腺癌患者中。外科医生可选择适合NAC的乳腺癌患者,提高患者的生活质量。

列线图模型对浸润性乳腺癌伴腋窝淋巴结转移的预测价值

目的探讨列线图模型对浸润性乳腺癌伴腋窝淋巴结转移的预测价值。资料与方法回顾性分析2020年9月—2022年3月宁夏医科大学总医院疑诊乳腺癌患者122例,根据有无腋窝淋巴结转移分为转移组57例和非转移组65例。所有病灶经手术病理证实。两组接受合成磁共振、动态对比增强磁共振成像(DCE-MRI)及扩散加权成像扫描,测量乳腺病灶合成磁共振参数[T1、T2、质子密度(PD)]、时间-信号强度(TIC曲线)、表观扩散系数(ADC)。比较两组参数差异,并筛选出浸润性乳腺癌伴腋窝淋巴结转移的独立风险因素。结果Logistic回归结果显示Ki-67(OR=2.971,95%CI 1.306~6.762,P=0.009)、病灶大小(OR=1.652,95%CI 1.067~2.556,P=0.024)、ADCratio(OR=1.685,95%CI 1.014~2.801,P=0.044)、T2ratio(OR=3.015,95%CI 1.433~6.340,P=0.003)、PDratio(OR=2.782,95%CI 1.471~5.262,P=0.002)是浸润性乳腺癌伴腋窝淋巴结转移的独立风险因素。5种模型比较显示逻辑回归模型效能最优,曲线下面积为0.729(95%CI 0.621~0.789),准确度、特异度、敏感度分别为70.65%、62.79%、77.55%。对列线图模型准确性进行检验,得出C-index=0.844,即本次建立的列线图模型准确性良好,其截断风险为0.468,截断分数为143.50,当总分大于143.50时,发生腋窝淋巴结转移的风险将高于46.8%。结论列线图模型对浸润性乳腺癌伴腋窝淋巴结转移具有较好的预测能力。

临床护士乳腺癌筛查保护动机现状及影响因素分析

目的调查安徽省临床护士乳腺癌筛查保护动机现状,并分析其影响因素。方法于2022年9-10月采用便利抽样法选取安徽省864名临床护士作为研究对象,采用一般资料调查表、乳腺癌意识量表、健康信念量表、护士组织支持感量表和乳腺癌筛查保护动机量表进行调查,并对数据进行分析。结果864名临床护士乳腺癌筛查保护动机总分为(53.51±6.87)分,条目均分为(3.15±0.40)分。乳腺癌意识得分、健康信念得分、护士组织支持感得分与乳腺癌筛查保护动机得分均呈正相关(r分别为0.264、0.362、0.178,均P<0.01)。多元回归分析结果显示,亲属是否患乳腺癌、乳腺癌意识、健康信念和护士组织支持感是乳腺癌筛查保护动机的影响因素,共解释乳腺癌筛查保护动机总变异的19.8%。结论临床护士乳腺癌筛查保护动机处于中等水平,有待进一步提升。医院管理者应注重提高临床护士乳腺癌预防意识,改善健康信念水平,给予临床护士充足的组织支持,进而提高其乳腺癌筛查保护动机水平。