Objective To explore the clinicopathological features of bilateral primary breast cancer (BPBC) at different ages. Methods Clinical data of 105 BPBC patients admitted to the Department of Breast Surgery in The First Affiliated Hospital of Zhengzhou University from January 2017 to January 2020 were collected and divided into young group (≤40 years old) and middle-old group (>40 years old) according to age. The characteristics and differences of bilateral tumor lesions in pathological type, molecular type, tumor diameter, histological grade, clinical stage, lymph node metastasis, recurrence or distant metastasis, immunohistochemical indexes expression characteristics, consistency and difference, and overall prognosis between the two groups were retrospectively analyzed. Results There were statistically significant differences between the two groups in the size of the first primary cancer, lymph node metastasis, the high expression rate of Ki-67 in the second primary cancer, clinical stage of double primary cancer and recurrence or distant metastasis (P<0.05). In the young group, the proportion of the first primary cancer with T3–T4 stage was higher, the incidence of lymph node metastasis was higher, the proportion of high expression of Ki-67 in the second primary cancer was higher, and the proportion of patients with double primary cancer at first diagnosed as stage Ⅳ were higher than those in the middle-old group, and were prone to recurrence or distant metastasis. The expression of immunohistochemical indexes in bilateral cancer foci was consistent between the two groups (P<0.05). The expression consistency of ER and Ki-67 in the young group was better, and the expression consistency of PR and HER-2 in the middle-old group was better. The histological grade of the first primary cancer, TNM stage of bilateral primary cancer and recurrence or metastasis were independent factors affecting the prognosis of patients (P<0.05). Conclusions The BPBC patients of different ages have different clinicopathological features, and the expression of immunohistochemical indexes in bilateral cancer foci is consistent. Tumor histological grade of the first primary cancer may affect the prognosis of patients with BPBC, and the prognosis of patients with early bilateral TNM stage is better.
ObjectiveTo summarize the clinicopathological characteristics of 94 patients with pure mucinous breast carcinoma (PMBC), and to retrospectively analyze the prognosis and the prognostic factors. MethodsNinety four patients who were pathologically diagnosed with PMBC from November 1996 to October 2011 were retrieved from the database of breast cancer in West China Hospital. The clinicopathological and long term follow-up data of these patients were analyzed retrospectively. Results① Clinicopathological characteristics:These patients accounted for 1.48% (94/6 330) of all breast cancer patients who treated in our hospital during the same period. They were all female,with a median age of 45 years old (29-85 years)and median duration of 90 d (5-2920 d). A proportion of 63.83% (60/94) of these patients were premenopausal women. Ninety three patients had unilateral lesion, one patient had bilateral lesions, totally 95 lesions. A proportion of 85.29% (58/68) tumors were in T1-T2 staging, and 82.80% (77/93) tumors were node-negative. A proportion of 1.05% (1/95) tumors had metastasized at diagnosis. A proportion of 92.54% (62/67) tumors were in Ⅰ-Ⅱ staging, 84.34% (70/83) tumors were estrogen receptor (ER) positive, 74.70% (62/83) were progesterone receptor (PR) positive, and 20.25% (16/79) were human epidermal growth factor receptor 2 (HER-2/neu) positive. A proportion of 6.32% (6/95) of tumors had breast-conserving surgery. ② Preoperative diagnosis:The detection rate of malignance were 60.87% (14/23), 83.33% (40/48), and 100% (18/18), respectively for patients who were examined with mammography, ultrasonography, and mammography+ultrasonography, and there was significant difference between the three groups (P=0.006). ③ Prognosis and prognostic factors:The follow-up rate was 80.85% (76/94). Two cases had bone metastasis respectively in 14 and 26 months after operation, one of whom died. Both five-year and ten-year overall survival rate (OS) were 98.50%, both five-year and ten-year disease-free survival rate (DFS) were 95.80%. There was no lymph node involvement in patients of T1 phase, and no recurrence, metastasis or death occurred during the follow-up. The univariate analysis showed that the disease course, T staging, TNM staging, and HER-2/neu status were statistically significant prognostic factors for DFS situation (P<0.050). ConclusionsCases in this group displayed indolent behavior and favorable prognosis which are similar to western populations. The disease course, T staging, TNM staging, and HER-2/neu status appear to be significant predictors of worse prognosis. The combination of mammography and ultrasonography could largely improve the diagnostic accuracy, and breast-conserving therapy may be recommended for patients with no contraindications.
Objective To investigate the expression of phosphate and tension homology deleted on chromsome ten (PTEN) and Basigin1, as well as their relationships with clinicopathological factors and molecular subtypes in invasive ductal carcinoma of breast. Methods The expressions of PTEN and Basigin1 protein were examined in 76 invasive ductal carcinoma of breast tissues by immunohistochemical method, and 20 breast benign hyperplasia tissues as control. These 76 patients underwent surgery in our hospital from Jan. 2014 to Dec. 2015. Results The high-expression rate of PTEN protein in invasive ductal carcinoma of breast tissues was lower than that in benign hyperplasia tissues [56.6% (43/76) vs. 85.0% (17/20), χ2=5.457, P=0.019], while the high-expression rate of Basigin1 protein was higher than that of the benign hyperplasia tissues [51.3% (39/76) vs 25.0% (5/20), χ2=4.417, P=0.036]. The high-expression of PTEN protein was positively correlated with WHO grade and lymph node metastasis status (P<0.05). The high-expression of Basigin1 protein was positively correlated with WHO grade, lymph node metastasis status, and TNM stage (P<0.05). In addition, the high-expression of PTEN protein was associated with molecular subtypes of breast cancer (P<0.001), and its high-expression rate was higher in Luminal A and Luminal B patients; the high-expression of Basigin1 protein was associated with molecular subtypes of breast cancer too (P<0.001), and the high-expression rate of Basigin1 protein was higher in Her-2 overexpression and basal-like subtypes of breast cancer patients. Spearman correlation analysis shown that expression of PTEN protein was negatively correlated with expression of Basigin1 protein (rs=–0.481, P<0.001). Conclusion PTEN and Basigin1 protein may have some mechanisms to promote the occurrence and development of breast cancer, which provide a new basis for targeted treatment of breast cancer.
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.
ObjectiveTo understand the research status of diagnosis and treatment of gastric hepatoid adenocarcinoma (GHA) in order to provide a reference for clinical.MethodThe relevant literatures on diagnosis and treatment of GHA at home and abroad in recent years were searched and reviewed.ResultsThe GHA was a special type of gastric cancer with adenoid and hepatocyte differentiations, and the incidence of GHA in all gastric cancers was less than 1%. The histological morphology of GHA was similar to that of hepatocellular carcinoma, which was often accompanied by elevated serum alpha-fetoprotein and was prone to lymph node and liver metastases. The radical surgery and adjuvant chemotherapy were the most important treatment methods. However, even when the radical resection was performed, the recurrence and metastasis were still common, and there was no standard chemotherapy regimen for GHA at present.ConclusionsGHA is a special subtype of gastric cancer with high malignancy, which has rapid clinical progress and poor prognosis. Pathomorphology is the gold standard for the diagnosis of GHA. The therapy of GHA is a comprehensive treatment based on operation and chemotherapy, and gene molecular characteristics and targeted therapy are the research directions in future.
Objective To investigate the clinicopathological features and clinical subtypes of Peutz-Jeghers syndrome (PJS) in Chinese cases. Methods The clinical and pathological data of 295 patients with PJS who were treated in Air Force General Hospital from Nov. 1994 to Aug. 2017 were retrospectively analyzed and a multifactor statistical study was carried out on. Results Two hundreds and ninety-five patients with PJS belonged to 7 nationalities and came from 26 provinces and urban areas. 99.0% (292/295) of the patients had black spots on the lip and buccal mucosa, and the median occurrence time was 2 years old (0–33 years). The median age of inital diagnosis and treatment was 15 years old (1–45 years). The median interval time between the occurrence of black spots and abdominal symptoms was about 10 years (0–45 years). PJS hamartoma polyps were found in alimentary canals of 293 patients (99.3%), and 96.9% distributed in the duodenum and small intestine (n=284), 90.4% distributed in the colorectal (n=265), 79.9% distributed in the stomach (n=234). Patients of black spot appearing at age <3 years and (or) initial treatment at age <14 years were classified as early-onset subtype, otherwise they could be included in delayed-onset subtype. Conclusions The clinical features of PJS are prominent and the harm of PJS hamartoma polyps is serious. The black spots on the lip and buccal mucosa can be used as an early warning signal to divide the PJS patients into 2 clinical subtypes, which should be differentiated in clinical therapy and follow-up strategy.
ObjectiveTo analyze the relation between age and postoperative pathological features of patients with colorectal cancer from Database from Colorectal Cancerr （DACCA）. MethodsThe data in DACCA were updated on January 5, 2022. The patients were selected from DACCA according to the established screening conditions, then were divided into ≤35, 35–59, and ≥60 years old groups. The differences of postoperative pathological （p） TNM （pTNM）, pT, pN, pM stages, perineural invasion （PNI）, high-risk factors grade, and tumor regression grade （TRG） among the three age groups were analyzed, and the correlation between them was analyzed. ResultsAfter screening, 5 628 data rows were enrolled, of whom 196 patients were <35 years old, 2 382 patients were 35–59 years old, and 3 050 patients were >59 years old. Statistical analysis showed that: ① There were statistical differences in the proportions of pN stage, PNI, and high-risk factors grade in the patients of different age groups （H=27.867, P<0.001; H=6.248, P=0.044; H=19.712, P<0.001, respectively）; However, it was not found that there were statistical differences in the proportions of pTNM, pT, pM stages, and TRG after neoadjuvant therapy among different age patients （H=0.920, P=0.631; H=4.923, P=0.085; H=2.272, P=0.321; H=2.337, P=0.311, respectively）. The Spearman correlation analysis results showed that there was a weakly negative correlation between the age and pN stage or grade of high-risk factors （rs=–0.070, P<0.001; rs=–0.067, P<0.001, respectively） and a weakly positive correlation between age and TRG after neoadjuvant therapy （rs=0.100, P=0.009）. ConclusionDACCA data analysis finds that patients of different age groups shows a negative correlation trend with pN stage or grade of high-risk factors and a positive correlation trend with TRG, which needs to be further verified.
ObjectiveTo investigate the expressions of Aurka mRNA and its protein in gastric cancer and adjacent tissues, and to analyzed the relationship between the expression level of Aurka mRAN and clinicopathological characteristics of gastric cancer patients. MethodsRetrospectively collected the gastric cancer and adjacent tissues of 198 gastric cancer patients who treated in the Affiliated Hospital of North Sichuan Medical College between April 2011 and September 2013. Using real time quantitative reverse transcription polymerase chain reaction (RT-PCR) method and immunohisto-chemical staining to detected expressions of Aurka mRNA and its protein of gastric cancer and adjacent tissues respectively. At the same time explored the relationship between expression level of Aurka mRNA in gastric cancer tissues and the clinico-pathological features of gastric cancer patients. ResultsRT-PCR results showed that, the expression level of Aurka mRNA in gastric cancer tissues was 16.62±1.85, which was significantly higher than that of adjacent tissues (7.10±1.59), P < 0.05. Immunohistochemistry results showed that, the positive rate of Aurka protein in gastric cancer tissues was obviously higher than of adjacent tissues[93.9% (186/198) vs. 16.2% (32/198), P < 0.01]. The expression level of Aurka mRNA in gastric cancer tissues was significantly related with a part of the clinicopathological parameters, including TNM staging, T staging, N staging, and differentiation (P < 0.05), but there was no relationship with gender, age, location, and carcino-embryonic antigen (CEA)/CA19-9 level in peripheral blood (P > 0.05). The expression level of Aurka mRNA in Helicobacter pylori (HP)-positive gastric cancer patients was higher than that of HP-negative gastric cancer patients (15.38±1.73 vs. 7.20±1.86, t=-3.74, P < 0.01). ConclusionExpression levels of Aurka gene and its protein were both significantly higher in gastric cancer tissues than those of adjacent tissues, which suggests that Aurka might play a significant role in the procession of the formation and development of gastric cancer as an oncogene, it also suggests that Aurka can be used as a predictor of prognosis and recurrence of patients with gastric cancer.
Objective To compare the differences in clinicopathological features, molecular phenotypes, and prognosis between atypical type A thymoma (AAT) and classic type A thymoma (TAT), and to clarify the aggressive nature of AAT. Methods The data of AAT patients (AAT group) and classic TAT patients (TAT group) who underwent surgical resection for thymoma at West China Hospital of Sichuan University between January 2016 and November 2024 were retrospectively collected. Comparisons on the clinical data, histopathology, immunohistochemistry (CD20, Ki-67), GTF2I mutation status, and survival outcomes were performed between the two groups. Results A total of 53 patients were enrolled, including 22 in the AAT group and 31 in the TAT group. There was no significant difference in age, sex, or initial presenting symptoms between the two groups (P>0.05). Compared with the TAT group, the AAT group had larger tumors [(5.6±2.7) vs. (4.1±2.0) cm, P=0.043], a lower proportion of Masaoka stage Ⅰ (31.6% vs. 61.3%, P=0.041), and worse survival outcomes [progression-free survival: hazard ratio (HR)=2.87, 95% confidence interval (CI) (1.42, 5.81), P=0.004; overall survival: HR=1.96, 95%CI (1.02, 3.78), P=0.013]. Pathologically, the AAT group showed more mitotic figures (mean 6/2 mm2), and tumor necrosis was observed in 45.5% of cases. There was no statistically significant difference in the CD20 expression rate (20.0% vs. 41.9%), Ki-67 index [(11.0±6.0)% vs. (8.0±6.9)%], or GTF2I mutation rate (86.7% vs. 92.3%) between the two groups (P>0.05). Conclusions AAT is a subtype of TAT with distinct aggressive pathological features, including higher mitotic activity, a tendency for necrosis, and a greater propensity for recurrence and metastasis. Pathological diagnosis should integrate morphology and molecular testing to guide more aggressive treatment and follow-up strategies.
目的:探讨肝脾γδT细胞淋巴瘤的临床表现、病理学特征、免疫表型特点。方法:对我院2例确诊的肝脾γδT细胞淋巴瘤患者的临床资料进行分析、追踪随访并进行文献复习。 结果:该组患者均为青年男性,肝脾不同程度长大,发热,全血细胞减少(1/2),肝功能受损,淋巴结未受累;病理示瘤细胞弥漫性肝、骨髓的窦内侵犯;免疫表型:患者瘤细胞表达CD2(+)、CD3(+)、CD56(+)、CD16(+)、CD20()、TIA1(+)、TCRγ／δ(+)。结论:肝脾γδT细胞淋巴瘤是较为罕见的外周T细胞淋巴瘤,以肝脾长大、发热为主要临床表现,通常淋巴结不受累,病情进展快,疗效差,生存期短。