Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
Objective
To explore regularity of lymph node metastasis and analyze its relation between lymph node metastasis and histological features and its immunohistochemical markers of gastric cancer, and to provide evidence for selection of reasonable operation.
Method
The clinical data of 160 patients with gastric cancer who underwent D2, D3 or D3+ from August 2013 to May 2016 in the Second Hospital of Lanzhou University were retrospectively studied, and the relation between the lymph node metastasis and the pathological features and the immunohistochemical markers in the different location of gastric cancer was analyzed.
Results
① The rate of lymph node metastasis in the early gastric cancer was significantly lower than that in the advanced gastric cancer (P<0.05), which in the T4 stage was significantly higher than that in the T1–T3 stages (P<0.05), in the poorly differentiated gastric cancer was significantly higher than that in the well differentiated gastric cancer (P<0.05), or in the Borrmann type Ⅲ+Ⅳ (infiltrative type) was significantly higher than that in the Borrmann type Ⅰ+Ⅱ (topical type,P<0.05), but which wasn’t associated with the gender, tumor location, or tumor diameter (P>0.05). ② The lymph node metastasis occurred mainly in the first and the second stations for the well differentiated gastric cardia cancer, which not only occurred in the first and the second stations, but also occurred in the No.13 lymph node for the poorly differentiated gastric cardia cancer; which occurred mainly in the first and the second stations and occasionally occurred in the No.12 lymph node for the well differentiated gastric body cancer, which not only occurred in the first and the second stations, but also occurred in the No.12, No.13 and No.14 lymph nodes for the poorly differentiated gastric body cancer; which occurred in the No.11, No.12 and No.13 lymph nodes for the part of well differentiated gastric antrum cancer, which even occurred in the No.15 and No.16 lymph nodes for the part of poorly differentiated gastric antrum cancer. ③ The expression positive rates of the TopoⅡα, Villin, Ki-67, CK-8, and CK-18 proteins in the poorly differentiated gastric cancer were significantly higher than those in the well differentiated gastric cancer (P<0.05), which of the P-gp, GST-π, and c-erbB-2 proteins in the poorly differentiated gastric cancer were significantly lower than those in the well differentiated gastric cancer (P<0.05). The expression positive rates of the TopoⅡα, P-gp, Villin, Ki-67, CK-8, and CK-18 proteins in the gastric cancer with lymph node metastasis were significantly higher than those in the gastric cancer without lymph node metastasis (P<0.05), whereas there were no relation between the expression positive rates of the GST-π and c-erbB-2 proteins and the lymph node metastasis of gastric cancer (P>0.05). ④ The different location of gastric cancer wasn’t associated with the gender, gross type, clinical stage, T stage, degree of differentiation, Borrmann type, or tumor diameter.
Conclusions
In advanced gastric cancer, depth of tumor invasion reached T4, poor degree of differentiation, and Borrmann infiltration type of gastric cancer, lymph node metastasis rates are higher. For gastric cardia cancer patients with well differentiation, standard D2 should be performed, D2+No.13 should be performed for poor differentiation. For gastric body cancer patients with well differentiation, D2+No.12 should be performed, D3 should be performed for poor differentiation. For gastric antrum cancer patients with differentiation degree or not, D3 should be performed, selective dissection of No.15 or No.16 lymph node should be performed for poor differentiation. Combined detection of TopoⅡα, Villin, Ki-67, CK-8, CK-18, P-gp, GST-π, and c-erbB-2 immunohistochemical markers might be helpful to improve accuracy of lymph node metastasis and evaluate degree of malignancy and prognosis of patients with gastric cancer.
ObjectiveTo analyze the clinicopathologic features and prognosis of breast cancer patients with low human epidermal growth factor receptor-2 (HER2) expression. MethodsThe breast cancer patients underwent initially surgical resection in the First Hospital of Shanxi Medical University from October 2015 to October 2017 and met the criterion of this study were retrospectively gathered. Based on the immunohistochemical / in situ hybridization detection results, the patients were divided into three subtypes of HER2 zero, low, and positive expressions, and the differences in the clinicopathologic characteristics, overall survival (OS) and disease-free survival (DFS) of the three subtypes of breast cancer patients were compared. At the same time, the risk factors affecting the OS and DFS of breast cancer patients with low HER2 expression were analyzed. ResultsA total of 315 eligible patients were gathered in this study, including 68 patients with HER2 zero expression, 121 patients with low HER2 expression, and 126 patients with positive HER2 expression. There were no statistic differences in the menstrual status, T stage, and histological classification between the breast cancer patients with low HER2 and positive HER2 expressions (P>0.05), but the proportions of the patients with lymph node metastasis, histological grade Ⅲ, negative hormone receptor (HR) and high Ki67 expression in the low HER2 expression patients were lower than those in the positive HER2 expression patients. And compared with HER2 zero expression breast cancer patients, the proportions of premenopausal / perimenopausal, T2–4, N1–3, histological grade Ⅱ, ductal carcinoma, negative HR, and low Ki67 expression patients in the breast cancer patients with low HER2 expression were higher (P<0.05). While the survival curves of OS and DFS by Kaplan-Meier method had no statistic differences among the three subtypes of the breast cancer patients (χ2=0.070, P=0.966; χ2=0.362, P=0.835). The multivariate analysis results by Cox proportional hazards regression found that the low HER2 expression breast cancer patients with histological grade Ⅲ and negative HR had the higher risks of OS and DFS shortening (P<0.05). In addition, the risk of DFS shortening in the patients with T stage 2–4 and N stage 1–3 was increased (P<0.05). ConclusionsFrom the results of this study, breast cancer patients with low HER2 expression is different from the other two subtypes of breast cancer in terms of clinicopathologic characteristics. However, there are no statistical significances in comparing the OS and DFS of three types of breast cancer patients, but it is found that histological grading and HR are related to the OS and DFS of breast cancer patients with low HER2 expression, and it is also found that T stage and N stage are related to the DFS of breast cancer patients with low HER2 expression, so more attentions should be paid to the treatment plans.
Pulmonary endometriosis (PEM) is a rare disease with diverse clinical manifestations, most commonly presenting as hemoptysis, while patients presenting solely with pulmonary nodules are less common. Here, we report three female patients (aged 32, 19, and 46 years, respectively). One patient sought medical attention due to hemoptysis during menstruation, while the other two had no obvious symptoms and were found to have pulmonary nodules during routine physical examinations. Two patients had a history of cesarean section, and one had a history of miscarriage. Pathologically, one patient of PEM showed extensive hemorrhage in the alveolar spaces, with fragmented endometrial glandular epithelium observed within the hemorrhagic foci. The other two patients exhibited proliferative endometrial glands and stroma, surrounded by old hemorrhage. Immunohistochemistry revealed that the endometrial glands and stroma in all three patients were positive for estrogen receptor, progesterone receptor, and vimentin, with CD10 positivity in the endometrial stroma. All three patients were definitively diagnosed as PEM by pathology and underwent thoracoscopic pulmonary wedge resection. Follow-up periods were 18, 31, and 49 months, respectively, with no recurrence observed in any of the patients.
ObjectiveTo investigate the expression of tripartite motif 21 (TRIM21) in gastric cancer tissues and its relationship with clinical pathological characteristics and clinical prognosis.MethodsPublic database was used to analyze the expression level of TRIM21 in gastric cancer tissues and the relationship between its expression and clinical prognosis. Gene set enrichment analysis (GSEA) was used to analyze the signaling pathways that TRIM21 might participate in. The expressions of TRIM21 in 80 gastric cancer tissues and 30 para-cancer tissues were detected by immunohistochemical staining, and the relationship between TRIM21 expression and clinicopathologic characteristics was analyzed.ResultsTRIM21was significantly low-expression in gastric cancer tissues, and the clinical prognosis of patients with low TRIM21 expression was significantly worse (P<0.05); GSEA showed that TRIM21 was involved in the regulation of helper T cell differentiation in gastric cancer patients (P<0.000 1, FDR<0.000 1).ConclusionsTRIM21 is poorly expressed in gastric cancer tissues and indicates the poor clinical prognosis. Moreover, TRIM21 is involved in the regulation of helper T cell differentiation and has a negative regulatory effect on the occurrence and development of gastric cancer.
ObjectiveTo systematicly evaluate expression of epithelial cell adhesion molecule (EpCAM) in colorectal cancer (CRC) and its correlation with clinicopathologic characteristics of patient with CRC.MethodsPubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, VIP, and other databases were searched comprehensively. The retrieved literatures were imported into Endnote X9. The data about the expression of EpCAM in the CRC and the relationship between EpCAM expression and clinicopathologic characteristics of patients with CRC were screened and extracted. RevMan 5.3 software was used for meta-analysis.ResultsA total of 5 396 patients with CRC were included. The meta-analysis results showed that the expression rate of EpCAM in the CRC tissues or blood was significantly higher than that in the benign colorectal tumor and normal tissue or blood (P<0.05). The high expression rates of EpCAM in the Dukes C+D stage, tumor diameter >3 cm, infiltration state of tumor margin, with lymph node and distant metastasis of the CRC were significantly higher than those in the A+B stage, tumor diameter ≤3 cm, dilated state of tumor margin, without lymph node and distant metastasis (P<0.05).ConclusionResults of this meta-analysis suggest that expression of EpCAM might be related to some clinicopathologic characteristics (carcinogenesis, Dukes stage, tumor size, tumor margin morphology, lymph node metastasis, distant metastasis) of patients with CRC.
ObjectiveTo detect level of circulating tumor cells (CTCs) in peripheral venous blood of fasting patients with gastric cancer (GC) and to analyze relationships between CTCs and clinicopathologic features and prognosis of patients with GC.MethodsOne hundred patients with GC were selected (GC group), who underwent the surgery and confirmed by the histopathology in the 940 Hospital of Joint Service of PLA, from August 2015 to December 2016. Thirty-eight patients with gastric benign lesions who were treated in this hospital at the same time were selected as the control group. The 7 mL peripheral venous blood of the elbow in the morning was taken from the fasting patients and the CTCs were detected by the immunomagnetic microparticle negative enrichment combined with immunofluorescence in situ hybridization within 24 h. The positive rate of CTCs was calculated and its relationships with the clinicopathologic features (tumor location, tumor invasion depth, degree of differentiation, TNM stage, lymph node metastasis, and vascular tumor thrombus) and the progression-free survival of the patients with GC were analyzed.ResultsThe positive rate of peripheral venous blood CTCs in the GC group was 89.0% (89/100), which was higher than that in the control group (10.5%, 4/38), and the difference was statistically significant (P<0.001). The levels of CTCs in the patients with GC were significantly correlated with the tumor invasion depth (P=0.017), lymph node metastasis (P=0.038), and TNM stage (P=0.016), which were not associated with the age, gender, tumor location, degree of differentiation, and vascular tumor thrombus (P>0.050). The predictive value of CTCs for the diagnosis of GC was significantly superior to that of the tumor markers CEA, CA19-9, or CA125. The progression-free survival of patients with low CTCs expression was significantly longer than that in the patients with high CTCs expression (χ2=5.172, P=0.023).ConclusionsDetecting CTCs of patients with GC by immunomagnetic particle negative enrichment combined with immunofluorescence in situ hybridization has a high sensitivity. And it can improve early diagnosis of patients with GC. Preoperative CTCs detection has a certain value in guiding staging of GC and predicting prognosis of patients with GC.
Objective To detect the expression of copine 1 (CPNE1) in the gastric cancer (GC) and investigate its association with prognosis. MethodsThe clinicopathologic data of 121 patients who underwent radical gastrectomy in the Department of General Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army from March 2017 to December 2018 were retrospectively collected. The protein expression of CPNE1 in the GC tissues was detected by immunohistochemical (IHC) staining, and its association with prognosis was analyzed. GC tissues and adjacent tissues samples from 16 patients in the same time were prospectively collected, and the mRNA and protein expressions of CPNE1 were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blot (WB), respectively. Multivariate Cox proportional hazards regression model was used to analyze the prognostic factors of GC patients. ResultsIHC staining results showed that the CPNE1 was mainly expressed in the cell membrane and cytoplasm of gastric epithelial cells, and the color showed different degrees of brown. Among the 121 patients, 70 (57.9%) had high CPNE1 protein expression and 51 (42.1%) had low CPNE1 protein expression. The RT-qPCR and WB results of 16 pairs of fresh tissue specimens showed that the expression levels of CPNE1 mRNA and protein in the GC tissues were higher than those in the corresponding adjacent tissues (CPNE1 mRNA mean value: 1.451 vs. 1.100, P=0.048; CPNE1 protein mean value: 0.995 vs. 0.521, P=0.001). The multivariate Cox proportional hazards regression analysis showed that the high protein expression of CPNE1 [HR (95%CI)=1.931 (1.123, 3.321), P=0.017] was the risk factor affecting the prognosis of the patients with GC. ConclusionCPNE1 highly expresses in GC tissues and is associated with a poor prognosis in patients with GC, and it may be a potential tumor biomarker.
Objective To investigate the relationship between thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and clinicopathological features of breast cancer. Methods Thyroid function data, general clinical data and data reflecting pathological characteristics of breast cancer of 136 breast cancer patients admitted to the Department of Breast and Thyroid Surgery, People’s Hospital of Wuhan University from December 2019 to April 2022 were collected. According to the TPOAb and TGAb antibody levels of patients, 136 breast cancer patients were divided into positive group (antibody level ≥60 U/mL) and negative group (antibody level < 60 U/mL). The general clinical data, thyroid function, breast cancer markers, tumor size, pathological classification, clinical TNM stage, lymph node metastasis and immunohistochemical index expression characteristics of the two groups were analyzed. Results There was no statistically significant difference between the TPOAb positive group and the TPOAb negative group, as well as between the TgAb positive group and the TgAb negative group in terms of age, previous chronic medical history, surgical medical history and menstrual status of breast cancer patients (P>0.05), and there was no significant difference in the results of preoperative ultrasound and molybdenum target examination (P>0.05).Compared with the TPOAb negative group, the level of triiodothyronine (T3) in the TPOAb positive group was lower (P=0.020), and the level of thyroidstimulating hormone (TSH) was higher (P=0.001). TSH level in the TgAb positive group was higher than that in the TgAb negative group (P=0.036). There was no significant difference in tumor markers (carcinoembryonic antigen, carbohydrate antigen 125 and 153) and the number of lymph nodes cleared during operation between the positive and negative groups of TPOAb and TgAb (P>0.05). Compared with the respective negative groups, there was no significant difference tumor size, pathological classification, clinical TNM stage, lymph node metastasis, pathological molecular classification, and the expression of ER, PR and Ki-67 in the TPOAb positive group and the TgAb positive group (P>0.05). The positive rate of HER-2 expression in the TPOAb positive group was higher than that in the TPOAb negative group (P=0.033). There was no significant difference in HER-2 expression between the TgAb positive group and the TgAb negative group (P>0.05). There was no significant difference between the TPOAb positive group and the TPOAb negative group, as well as the TgAb positive group and the TgAb negative group in terms of chemotherapy, invasive carcinoma with carcinoma in situ, with benign lesions and nerve invasion (P>0.05). There was no significant difference between TPOAb positive group and negative group in vascular tumor thrombus rate and single cancer focus rate (P>0.05). Compared with the TgAb negative group, the TgAb positive group had a lower vascular tumor thrombus rate (P=0.034) and a higher single cancer focus rate (P=0.045). Conclusions Thyroid autoantibodies positive breast cancer patients have lower T3 level and higher TSH level, and the positive expression of thyroid autoantibodies is related to HER-2 expression, vascular tumor thrombus and the number of tumor foci in breast cancer. It suggests that thyroid autoantibodies TPOAb and TgAb may have an impact on the prognosis of breast cancer.
