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增強型血流顯像聯合超聲引導下穿刺活檢技術在乳腺腫物診斷中的價值

【摘要】　目的　總結增強型血流顯像（e-flow）聯合超聲引導下粗針穿刺活檢技術在乳腺腫物診斷中的價值。　方法　將2008年1月-2009年12月住院的100例乳腺腫物患者隨機分成兩組，第1組50例，應用e-flow技術檢測，聯合超聲引導下粗針穿刺活檢技術，對乳腺腫物患者穿刺取材送病理檢查；第2組50例，在超聲引導下，對乳腺腫物患者直接行粗針穿刺取材送病理檢查，并將兩組穿刺結果與手術后病理結果進行對比分析。　結果　第1組50例穿刺病理檢查結果均與術后病理檢查結果符合，其中惡性48例，良性2例；第2組50例中46例與術后病理檢查結果符合，其中惡性45例，診斷敏感性91.8%，良性1例，假陰性4例。　結論　e-flow聯合超聲引導下粗針穿刺活檢技術在乳腺腫物診斷中具有定位準確、實時監測、可靠性高、創傷小、操作簡單等優點，可用作乳腺腫物定性診斷的主要方法。

Clinical Analysis of Plasma Amino Acids and Trace Elements in Breast Cancer Patients

ObjectiveTo understand the function of trace element and amino acids detection in early diagnosis of breast cancer, and explore the correlation between plasma amino acid and trace element changes. MethodsFifty-five patients with breast cancer and 50 normal controls were included in our study from May 2012 to June 2013. Trace elements were detected by atomic absorption spectrophotometer, and the level of amino acids was detected by Hitachi L-8900 amino acids analyzer. Then, we analyzed the correlation between the two indexes. ResultsCompared with the normal controls, breast cancer patients had a higher level of Cu and Fe (P<0.05), and a lower level of Zn (P<0.05). Seven kinds of amino acids had significant changes (P<0.05), including three kinds of increased amino acids, and four reduced. Amino acids and trace element correlation analysis showed that Mg was negatively correlated with Leu, Tyr, Lys, and His; and Ca was negatively correlated with Lys and His. ConclusionThere are many kinds of changes of plasma amino acids and trace elements in breast cancer patients. Serum trace element and amino acids detection in patients with breast cancer are helpful in the severity judgment and regimen design.

Expression of Stromal Cell-Derived Factor-1 and Its Relation with Prognosis in Human Breast Cancer

【Abstract】Objective Stromal cell-derived factor-1(SDF-1, CXCL12) is a member of the CXC subfamily of chemokines which, through its cognate receptor (CXCR4), plays an important role in tumor invasion and metastasis. This study analyzed quantitatively the expression of SDF-1 and its relation with clinicopathologic feature and clinical outcome in human breast cancer.Methods Expression of SDF-1 mRNA in 8 breast cancer cell lines, an endothelial cell line HECV and a fibroblast cell MRC5 was studied by using RT-PCR. In addition, the expression of SDF-1 was investigated at both protein (immunohistochemistry) and mRNA(real-time PCR) levels in a group of human normal mammary(n=32) and tumour tissues(n=120). Results SDF-1 expression was identified in MRC5, MDA-MB435s, MDA-MB436, MCF7 cell lines, breast tumour and normal tissues. Significantly higher level of SDF-1 was seen in lymph node positive than in lymph node negative tumours (399.00±210.00 vs 0.89±0.47), P=0.048. The level of SDF-1 expression in patients who developed local recurrence or metastasis, or patients who died of breast cancer was higher than in patients who were disease free as well, (670.00±346.00 vs 0.83±0.35), P=0.01. It was most notable that level of SDF-1 was significantly correlated with over survival (P=0.01) and incidence free survival (P=0.035, by Cox proportion analysis).Conclusion SDF-1 is a factor that is expressed in both stromal cells and some breast cancer cells. Its level are correlated with lymph node involvement, prognosis and survival in patients with breast cancer. SDF-1 may therefore have a potential prognostic value in breast cancer.

The Application of Serum CA153 and BAKP Measurements in Bone Scanning for Metastasis in Patients with mammary Cancer Diagnostic

摘要:目的:探討血清CA153和BAKP在乳腺癌骨轉移顯像診斷中的應用。方法:對92例乳腺癌患者的核素骨顯像結果、血清CA153和BAKP結果進行回顧性研究。結果:①血清CA15-3和B-AKP的值隨著骨轉移分期的增高而逐步升高,且差異顯著(Plt;0. 01);②血清CA15-3和B-AKP與骨轉移的數目呈正相關;③血清CA15-3gt;25 U/mL時,骨轉移的陽性率為63.3%,血清CA15-3lt;25 U/mL時,骨轉移的陰性預測值為94. 5%;血清B-AKPgt;20 U/L時,骨轉移的陽性率為59. 6%時,骨轉移的陰性預測值為73.5%;當血清CA15-3lt;25 U/mL同時B-AKPlt;20 U/L時,骨轉移的陰性預測值為100%。結論:血清CA15-3和BAKP測定在乳腺癌骨顯像診斷中具有重要的應用價值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.

CLINICAL REPORT OF 30 CASES OF MAMMARY DUCT ECTASIA

目的 探討乳腺導管擴張癥的臨床特點、診斷、鑒別診斷及治療。方法 對我院1990年至1999年收治的30例乳腺導管擴張癥患者，進行一般情況、治療及預后的回顧性分析和總結。結果 本組病例平均發病年齡42歲，首發癥狀以乳腺腫塊和乳頭溢液多見，病變多位于乳暈周圍，所有患者均行手術治療。結論 乳腺導管擴張癥為非感染性炎癥，病史長、易反復，鑒別診斷有一定困難，均需外科治療。

Curative Effects Observation of Capecitabine and Hessaitin Combined with Whole Brain Radiotherapy for Treatment The HER2 Positive Breast Cancer with Brain Metastasis

ObjectiveTo investigate the curative effects of capecitabine and hessaitin combined with whole brain radiotherapy for treatment the HER2 positive breast cancer with brain metastasis. MethodsThe clinical data of 60 cases HER2-positive breast cancer patients with brain metastasis in our hospital in January 2004 to January 2012 were retrospectively analyzed.The 32 cases of observe group were treated by using capecitabine and herceptin combined with whole brain radiotherapy, and the 28 cases of control group were treated by using capecitabine and cisplatin combined with whole brain radiotherapy.The disease control rate, toxicity rate, and survival rate were evaluated. ResultsCompared with the control group, the disease control rate, toxicity rate, and survival rate were all better in observe group (P < 0.05). ConclusionThe capecitabine and hessaitin combined with whole brain radiotherapy for treating patients with HER 2 positive brest cancer transferred to brain are effect and safe.

Expressions of Osteopontin and Related Factors in Breast Cancer Tissues and Its Clinical Significance

Objective　To detect the expressions of osteopontin （OPN）， breast tumor kinase （Brk）， and vascular endothelial growth factor （VEGF） in the breast cancer tissue， the adjacent （2cm） normal breast tissue， and the distal（＞5cm） normal breast tissue， and analyze their clinical significances. Method　The immunohistochemical method was used to detect the expressions of OPN， Brk， and VEGF in the breast cancer tissue， the adjacent （2cm） normal breast tissue， and the distal （＞5cm） normal breast tissue from 40 cases of breast cancer. Results　① The expressions of OPN，Brk， and VEGF in the breast cancer tissue were significantly higher than those of the adjacent （2cm） normal breast tissue and the distal （＞5cm） normal breast tissue （P＜0.01）， the expression of Brk in the adjacent （2cm） normal breast tissue was significantly higher than that of the distal （＞5 cm） normal breast tissue （P＜0.05）. ② In the breast cancer tissue， the OPN and Brk protein expressions were not associated with age， tumor diameter， and histological grade （P＞0.05），were associated with lymph node metastasis and TNM stage （P＜0.05）. The VEGF protein expression was not associated with age and tumor diameter （P＞0.05）， but was associated with histological grade， lymph node metastasis， and TNM staging （P＜0.05）. ③ In the breast cancer tissue， OPN， Brk， and VEGF had positive correlation with each other （P＜0.05）， but not in the adjacent （2cm） normal breast tissue and the distal （＞5 cm） normal breast tissue （P＞0.05）. Conclusions　The expressions of OPN and Brk from the same signal pathway increase by turns in the distal （＞5 cm） normal breast tissue， adjacent （2cm） normal breast tissue， and breast cancer tissue. OPN induced the adhesion and migration of endothelial cells to accelerate vascular repair through VEGF and Brk has correlation with the progress of tumor invasion and metastasis through participating in tumor vascularization.

CLINICAL EVALUATION OF EFFECT OF TRANSPLANTATION BY AUTO-FAT GRANULE INJECTION FORMASTATROPHY POST SUCKLING

【Abstract】 Objective To investigate the cl inical effect of transplanting by auto-fat granule injection for mastatrophy post suckl ing. Methods From March 2000 to June 2006, 73 patients(146 breasts ) with mastatrophy post suckl ing were treated by transplanting auto-fat granule. The mastatrophy occurred between ages 28 and 52 years with a median of 37 years post suckl ing. The breasts shrank and their elasticity decreased gradually within 2-10 years post suckl ing. The autofat granule was obtained by l iposuction with syringe from patient’s abdomen, waist, buttocks and thighs, etc. After repeated wash and purification, the auto-fat granule was transplanted into the interspace behind the breast by injection. The quantity of auto-fat granule was 50-100 mL in each side of breast per transplantation at 3-6 months intervals, and the whole course of treatment needed 2-6 transplantations. Results The incisions in all cases healed primarily postoperatively. In 73 cases, 65 were followed up from 6 months to 3 years post operation. All patients had a significant improvement in their breast size and shape postoperatively and their breasts were soft and natural in appearance and feel. All of them had more perfect arcuation ofphysique and body with strengthened self-confidence, rel ieved mood and improved qual ity of l ife. However, small indurations were found sporadically in 7 cases (10 breasts) within 2-7 months, and calcifications in 5 cases (8 breasts) within 9-14 months post the first operation. Conclusion The transplantation by auto-fat granule injection for mastatrophy post suckl ing is an effective and practical method. The surgical technique is well worth performing in cl inical practice.

Association analysis of serum lipids and lipoprotein levels with the occurrence of breast cancer and clinicopathological characteristics of breast cancer patients

Objective This study aimed to explore the relationship between serum lipid and lipoprotein levels and occurrence of breast cancer, and relationship between serum lipid and lipoprotein levels and clinicopathological characteristics of breast cancer patients. Methods Clinical data of 788 patients with breast cancer and 395 patients with benign breast disease were retrospectively collected, who received treatment in The First Affiliated Hospital of Chongqing Medical University from January 2014 to March 2016, and to explore the relationship between levels of total cholesterol (TC)/triglyceride (TG)/high density lipoprotein cholesterol (HDL-c)/low density lipoprotein cholesterol (LDL-c) and occurrence of breast cancer/ clinicopathological characteristics of breast cancer patients. Results ① Influencing factors that affected the occurrence of breast cancer: multifactor logistic analysis showed that, height (OR=0.950, P=0.006), body mass index (OR=1.062, P=0.041), and serum LDL-c level (OR=1.349, P=0.016) were independent influencing factors for occurrence of breast cancer, people had high body mass index and higher level of serum LDL-c had high risk of breast cancer, but people had high height had low risk of breast cancer. ②Association analysis of serum lipid and lipoprotein levels and clinicopathological characteristics of breast cancer patients: the serum TC level was correlated with expression of progesteronereceptors (PR) and lymph node metastasis status (P<0.05), the serum TC levels of patients with negative-expression of PR and lymph node metastasis were slightly higher than that of patients with positive-expression of PR and non-lymph node metastasis; the serum TG level was associated with body mass index (P<0.05), that the serum TG level of patients with body mass index≥25 kg/m2was slightly higher than that of patients with body mass index<25 kg/m2; the serum HDL-c level was correlated with the body mass index and diameter of the tumor (P<0.05), the serum HDL-c level of the patients with body mass index≥25 kg/m2 was slightly lower than that of patients with body mass index<25 kg/m2, the serum HDL-c level of patients with the tumor diameter≤2 cm was slightly higher than that of patients with the tumor diameter >2 cm; the serum LDL-c level was correlated with body mass index, expression of estrogenreceptors (ER) and PR, and molecular typing ( P<0.05), the serum LDL-c level was slightly higher in patients with body mass index≥25 kg/m2, negative expression of ER and PR, and non Luminal type patients, comparing with patients with body mass index<25 kg/m2, positive expression of ER and PR, and Luminal type patients. Conclusions High level of serum LDL-c is strongly associated with occurrence of breast cancer, and levels of serum lipid and lipoprotein are associated with expression of hormone receptor, molecular type of breast cancer, and status of lymph node, but it needs further randomized controlled studies to confirm.

乳腺葉狀囊肉瘤10例診治體會