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.
【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.
Objective To investigate the expressions of C-erbB-2, estrogen receptor (ER) and progesterone receptor (PR) in breast cancer tissues and to explore their relationship with patients-age, tumor size, lymph node metastasis, histopathological type and the stage of cancer. Methods The expressions of C-erbB-2, ER and PR in 83 cases of breast cancer tissues were detected by immunohistochemistry and the clinical significance was statistically analyzed. Results The positive expression rate of C-erbB-2, ER and PR in 83 cases of breast cancer tissues were 78.3%, 56.6% and 55.4%, respectively. The expressions of C-erbB-2, ER and PR were not correlated to patients’ age, tumor size, histopathological type and the stage of cancer (Pgt;0.05). While the expression of C-erbB-2 rather than ER and PR was correlated to lymph node metastasis (P＜0.05) and the correlation was positive (r=0.387, P＜0.05). Conclusion The positive expression of C-erbB-2 is one of lymph node metastasis factors for breast cancer patients. Combined detection of ER and PR expression may be helpful to clinical treatment and predict prognosis for breast cancer patients.
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.
ObjectivesTo explore the construction method of prediction model of absolute risk for breast cancer and provide personalized breast cancer management strategies based on the results.MethodsA case-control design was conducted with 2 747 individuals diagnosed as primary breast cancer by pathology in West China Hospital of Sichuan University from 2000 to 2017 and 6 307 healthy controls from Breast Cancer Screening Cohort in Sichuan Women and Children Center and Chengdu Shuangliu District Maternal and Child Health Hospital. Standardized questionnaires and information management systems in hospital were used to collect information. Decision trees, logistic regression, the formula in Gail model and registration data in China were used to estimate the probability of 5-year risk of breast cancer. Eventually a ROC (receiver operating characteristics) curve was drawn to identify optimal cut-off value, and the power was evaluated.ResultsThe decision tree exported 4 variables, which were urban or rural sources, number of live birth, age and age at menarche. The median 5-year risk and interquartile range of the controls was 0.027% and 0.137%, while the median 5-year risk and interquartile range of the cases was 0.219% and 0.256%. The ROC curve showed the cut-off value was 0.100%. Through verification, the sensitivity was 0.79, the specificity was 0.73, the accuracy was 0.75, and the AUC (area under the curve) was 0.79.ConclusionsThe methods used in our study based on 9 054 female individuals in Sichuan province could be used to predict the 5-year risk for breast cancer. Predictor variables include urban or rural sources, number of live birth, age, and age at menarche. If the 5-year risk is more than 0.100%, the person will be judged as a high risk individual.
Objective To explore the risk factors of female’s breast cancer in secondary cities of the west and establish a risk prediction model to identify high-risk groups， and provide the basis for the primary and secondary preve-ntion of breast cancer. Methods Random sampling （method of random digits table）? 1 700 women in secondary cities of the west （including 1 020 outpatient cases and 680 physical examination cases） were routinely accept the questionnaire survey. Sixty-two patients were confirmed breast cancer with pathologically. Based on the X-image of the mammary gland patients and questionnaire survey to put mammographic density which classificated into high- and low-density groups. The relationships between the mammographic density， age， body mass index （BMI）， family history of breast cancer， socio-economic status （SES）， lifestyle， reproductive fertility situation， and breast cancer were analyzed， then a risk prediction model of breast cancer which fitting related risk factors was established. Results Univariate analysis showed that risk factors for breast cancer were age （P=0.006）， BMI （P=0.007）， age at menarche （P=0.039）， occupation （P=0.001）， domicile place （P=0.000）， educational level （P=0.001）， health status compared to the previous year （P=0.046）， age at first birth （P=0.014）， whether menopause （P=0.003）， and age at menopause （P=0.006）. The unconditional logistic regr-ession analysis showed that the significant risk factors were age （P=0.003）， age at first birth （P=0.000）， occupation （P=0.010）， and domicile place （P=0.000）， and the protective factor was age at menarche （P=0.000）. The initially established risk prediction model in the region which fitting related risk factors was y=-5.557＋0.042x1-0.375x2＋1.206x3＋0.509x4＋2.135x5. The fitting coefficient （R square）=0.170， it could reflect 17% of the actual situation. Conclusions The breast cancer risk prediction model which established by using related risk factors analysis and epidemiological investigation could guide the future clinical work，but there is still need the validation studies of large populations for the model.
Objective To study a new method of treatment for upper limb lymphedema after radical mastectomy. Methods From Jun. 2001 to Sep. 2003, 11 cases(2with complication of erysipelas ) of upper limb lymphedema being treated with radical mastectomy for more than 2 years were used as model. All the edema of limbs was sucked from hypodermis with liposuction technique and compressed with compression garment. Three months after operation, elasticity stress was conducted every night. Results The reduction of the edema of upper limbswas remarkable. The average decrease of circumference was 4 cm. No erysipelas was observed. Conclusion The liposuction technique and elasticity stress is a new and effective approach to the treatment of upper limb lymphedema.
Objective To explore the tumor shrinking model, the accurate image evaluation of the residual tumor, and the selection criteria for breast-conserving surgery after neoadjuvant chemotherapy. Methods To review literature on the clinical, imaging, and pathologic study of breast cancer after neoadjuvant chemotherapy. Results The possibility of breast-conserving for patients with large primary tumor is enhanced with neoadjuvant chemotherapy. The tumor shrinking mode after neoadjuvant chemotherapy and its correlation factors are still unclear. MRI is the most accurate image evaluation of the residual tumor at present. M.D.Anderson prognostic index and the American National Cancer Institute selection criteria for breast-conserving surgery after neoadjuvant chemotherapy are helpful for selection of surgical type. Conclusion Tumor shrinking mode and its accurate image evaluation is a key to the selection of breast-conserving surgery and the control of local recurrence after neoadjuvant chemotherapy, and is the research direction in future.
Objective To identify the correlative symptoms of breast cancer patients and their influence on quality of life. Methods The cross-sectional study was used. A face-to-face survey was administered to 200 breast cancer patients, using two scales: ① Memorial Symptom Assessment Scale(MSA); ② European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire (Version 3) [EORTIC QLQ-C30]. Results The top five most highly prevalent symptoms were: lack of energy, hair loss, nervousness, sweating and worry. The five most frequent symptoms were: lack of energy, difficulty in sleeping, dry mouth, lack of appetite and sweating. The five most severe symptoms were: hair loss, lack of energy, difficulty in sleeping, nervousness and a change in food preference. The top five symptoms causing much distress were: hair loss, a feeling of“I don’t look like myself”, difficulty in sleeping, lack of appetite and lack of energy. The major factors influencing quality of life were: lack of energy, worry, pain, difficulty in sleeping, constipation, irritability, dry mouth, sweating, numbness/tingling in hands/feet, changes in skin, diarrhea, nausea, lack of appetite, and shortness of breath. Adjusted R square was 0.790. Conclusions The most conspicuous symptom in breast cancer patients is lack of energy. The symptom that distresses patients most is hair loss. The other notable symptoms are: “I don’t look like myself”, difficulty in sleeping, and lack of appetite. In addition, the quality of life is influenced by fourteen symptoms, and these symptoms account for 79.0% of the variance in quality of life.
Breast cancer is the most common malignant tumor among Chinese females. We should focus on the research of risk assessment models of gene-environmental factors to guide primary and secondary prevention, and this public health strategy is expected to maximize the health benefits of the population. This paper introduces previous studies of risk factors and predictive models for Chinese breast cancer and provides three points for future research. Firstly, we should explore the specific risk factors related to breast cancer risk in Chinese population, such as overweight or reproductive control measures. Secondly, we should use evidence-based and machine learning methods to select environmental-genetic risk factors. Finally, we should set up an information collective platform for breast cancer risk factors to test the validity of prediction models based on a long-term follow-up cohort of Chinese females.
