ObjectiveTo evaluate the efficacy and toxicity of TEC and CEF regimen in preoperative chemotherapy for patients with breast cancer. MethodsA total of one hundred breast cancer patients undergoing preoperative chemotherapy were divided into TEC group (n=50) and CEF group (n=50) by the pairgroup method and received surgical therapy after three courses of chemotherapy. The efficacy and toxicity of preoperative chemotherapy of patients in two groups were analyzed. ResultsFour patients with stage ⅢB breast cancer quit from CEF group after two courses of treatment because of the worse satisfaction. Clinical complete remission (cCR) was 7 cases, clinic partial remission (cPR) was 34 cases, stable disease (SD) was 9 cases, therefore, the remission rate (RR) was 82.0% (41/50), and reduction rate of tumor was 64.0% (32/50) in TEC group. cCR was 2 cases, cPR was 32 cases, SD was 12 cases, thus the RR was 680% (34/50), and reduction rate of tumor was 40.0% (20/50) in CEF group. The clinical efficacy and reduction rate of tumor of patients in TEC group were significantly superior than those in CEF group (Plt;0.05). The negative conversion ratio of lymph nodes were 54.1% (20/37) and 57.1% (20/35) in TEC group and CEF group, which was not statistically different (Plt;0.05). The occurrence of hair loss and leukopenia of patients in TEC group were significantly higher than those in CEF group (Plt;0.05), while the differences in thrombocytopenia, low concentration of hemoglobin, nausea, vomiting, diarrhea, cardiac toxicity, and neurotoxicity were not significant (Pgt;0.05). ConclusionTEC regimen is better than CEF regimen in the efficacy and safety of neo-adjuant therapy for patients with breast cancer, and well tolerated.
Eight patients treated with modified radical mastectomy and fenestration of pectoralis muscle to preserve pectoral, nerves are reported and the practical procedure is introduced. The results indicate that this method can overcome the disadvantage of mastectomy (Auchincloss) in that only dissection of fatty tissue and lymph nodes in the lateral part of axilla is carried out. With fenestration of pectoralis major muscle, not only the pectoral nerves can be perserved but also the fatty tissue and lymph nodes, including of those medial to the pectoralis minor, subclavicular and interpectoral nodes can be dissected. This method almost reached Halsted’s demand and it can be used for stage Ⅰ-Ⅱ, and even stage Ⅲ breast cancer if no infiltration to pectoralis major muscle is found.
Objective To investigate the feasibility and operation effect of endoscopic sentinel lymph node biopsy （SLNB） in breast cancer. Methods The data of 410 breast cancer patients who underwent SLNB （including 107 patients with endoscopy and 303 with open operation） were analyzed in our hospital from January 2009 to March 2012. SLNB was performed by using methylene blue staining or the combination of methylene blue and 99Tcm-sulfur colloid tracing. Results The successful rate of SLN detection with methylene blue and 99Tcm-sulfur colloid tracing was 94.56% （139/147） in open operation group and 94.25% （82/87） in endoscopy group. The successful rate of SLN detection with methylene blue was 88.46% （138/156）in open operation group and 85.00% （17/20） in endoscopy group. The mean of detected SLN number with combined method or methylene blue was 1.90/1.98 in open operation group and 1.91/1.82 in endoscopy group respectively. SLN-positive rate was 22.30% （31/139） and 25.36% （35/138） in open operation group， and 19.51% （16/82） and 23.53% （4/17） in endoscopy group， respectively. The rate of subcutaneous effusion in endoscopy group was higher than that in open operation group （P=0.001）, but other postoperative complications presented no significant difference. Conclusions Endoscopic SLNB can obtain the similar safety and the clinical efficacy with traditional SLNB， but superior cosmetic effect. So it is worthy of clinical application in breast cancer.
Objective To investigate the clinical implication on expression of HLA class I in breast cancer tissures.Methods The expression of HLA class I in 271 patients with breast cancer that underwent radical operation was examinedby using immunohistochemically， and the correlation between the expression of HLA class I and clinicalpathological characteristics and prognosis of breast cancer was analyzed. Results The b positive expression of HLA class I in breast cancer tissures was observed in 92 patients （33.9%）， the expressions of HLA class I in 179 patients （66.1%）were downregulation. The expression of HLA class I expression in breast cancer tissures was significantly associated with the axillary lymph node metastasis， TNM stage （P＜0.05）， other lymph node metastasis， and vascular invasion （P＜0.05）. The disease free survival rate of patients with positive expression of HLA class I was higher than that expression downregulation of HLA class I （P＜0.05）. Conclusion The examination of HLA class I expression is useful for the prediction of tumor progression and recurrent risk of breast cancer via the antitumor immune system.
Objective To identify the feasibility of the lymphatic mapping and sentinel node biopsy (SLNB) in patients with breast cancer and to examine whether the characteristics of the sentinel lymph node (SLN) accurately predict the status of axillary lymph node.MethodsFrom March to October 2000, 32 patients with breast cancer were evaluated at the Sichuan Provincial People’s Hospital. Lymphatic mapping was performed using Methlene Blue. A SLN was defined as any blue node. Thirtytwo patients, with breast cancer underwent a complete axillary lymph node resection (ALNR) following SLN biopsy. Subsequently, all SLNs and ALNs were examined by both Hamp;E staining as well as immunohistochemical staining for cytokeratin. ResultsLymphatic mapping was successful in identifying the SLN in 26/32(81.25%) cases of nodes at level Ⅰ. Of the 26 patients mapped successfully, 10 had metastasis to the SLNs.In 3 cases that SLNs were positive, but other axillary lymph nodes were negative. In 2 cases that the SLNs were negative, but other axillary lymph nodes were positive. The sensitivity of SLNB using Methlene Blue in this study was 77.78%(7/9), accuracy 80.77%(21/26), specificity 82.35%(14/17), and false negative rate 22.22%(2/9). ConclusionSLN can predict the status of the axillary lymph nodes reliably. However, the efficacy of SLNB in the setting of randomized, prospective trials must be tested first before abandoning axillary lymph node resection as the standard of care.
Objective To investigate the effect of radiotherapy after neoadjuvant chemotherapy and modified radical surgery on breast cancer specific survival (BCSS) of patients with stage cT1–2N1M0 breast cancer. Methods A total of 917 cT1–2N1M0 stage breast cancer patients treated with neoadjuvant chemotherapy and modified radical surgery from 2010 to 2017 were extracted from the The Surveillance, Epidemiology, and End Results (SEER) database. Of them 720 matched patients were divided into radiotherapy group (n=360) and non-radiotherapy group (n=360) by using propensity score matching (PSM). Cox proportional hazard regression model was used to explore the factors affecting BCSS. Results Patients were all interviewed for a median follow-up of 65 months, and the 5-year BCSS was 91.9% in the radiotherapy group and 93.2% in the non-radiotherapy group, there was no significant difference between the 2 groups (χ2=0.292, P=0.589). The results were the same in patients with no axillary lymph node metastasis, one axillary lymphnode metastasis, two axillary lymph node metastasis and 3 axillary lymph node metastasis group (χ2=0.139, P=0.709; χ2=0.578, P=0.447; χ2=2.617, P=0.106; χ2=0.062, P=0.803). The result of Cox proportional hazard regression analysis showed that, after controlling for Grade grade, time from diagnosis to treatment, efficacy of neoadjuvant chemotherapy, number of positive axillary lymph nodes, molecular typing, and tumor diameter at first diagnosis, radiotherapy had no statistically significant effect on BCSS [HR=1.048, 95%CI (0.704, 1.561), P=0.817]. Conclusions The effect of radiotherapy on the BCSS of patients with stage cT1–2N1M0 breast cancer who have received neoadjuvant chemotherapy and modified radical surgery with 0 to 3 axillary lymph nodes metastases is limited, but whether to undergo radiotherapy should still be determined according to the comprehensive risk of individual tumor patients.
Objective To explore the effect of exogenous estrogen receptor β1 (ERβ1) gene on the expression of p53 as well as the changes of apoptosis in MDA-MB-231 cell line and to investigate the biological role of ERβ1 in breast cancer. Methods Recombinant eukaryotic expressing vector containing ERβ1 cDNA was transfected into human breast cancer cell MDA-MB-231 by using cationic liposome LipofectamineTM 2000. The expression levels of p53 and ERβ1 in mRNA and protein were evaluated by real-time PCR and Western blot, respectively. Cell growth curve was used to detect the changes of cell proliferation ability. Cell apoptosis was detected by flow cytometry. Results After transfected with vector containing ERβ1 cDNA, proliferation ability of MDA-MB-231 cell decreased and the expression levels of both ERβ1 and p53 in both mRNA and protein increased (Plt;0.01). Rate of cell apoptosis increased in ERβ1 upregulation groups （Plt;0.01）. Conclusion ERβ1 can induce apoptosis and inhibit the growth of MDA-MB-231 cells by upregulating p53 expression.
Objective To study the effects of hepatocyte growth factor (HGF) and receptor c-met on the development of primary breast carcinoma, and the relationship between it and prognosis. Methods The study of HGF and c-met related to breast carcinoma was reviewed by history document and experimental study in recent years. Results HGF is a growth factor which has mitogenic, migrating, invasive and angiogenic activities in breast carcinoma cells. The carcinogenic mechanism of breast carcinoma was more clear with the discovery of the relationship between HGF and its receptor c-met. Conclusion The HGF/c-met plays an important role in the generation and progress of breast carcinoma. Studying the effects of HGF/cmet on breast carcinoma is significant in guiding clinical treatment.
目的 通过检测浸润性乳腺癌中白细胞介素18（IL-18）和血管内皮生长因子（VEGF）的表达情况，探讨其表达相关性及与临床病理学参数的关系。 方法 应用免疫组织化学法检测IL-18和VEGF在42例浸润性乳腺癌组织和12例正常乳腺组织中的表达情况。 结果 IL-18和VEGF在42例浸润性乳腺癌中的表达阳性率均显著高于12例正常乳腺组织（P＜0.05）。且在42例浸润性乳腺癌组织中，IL-18阳性组中VEGF阳性率（87.1%）显著高于IL-18阴性组中VEGF阳性率（12.9%），差异有统计学意义（P＜0.05）。在亚组分析中，IL-18的表达只与有无腋窝淋巴结转移有相关性（P＜0.05），而VEGF的表达与有无腋窝淋巴结转移和TNM分期有相关性（P＜0.05）。 结论 在浸润性乳腺癌中，IL-18的表达上调与VEGF的表达上调显著相关，IL-18可能具有促进肿瘤新生血管形成的作用。