Objective To study the relationship between metalloproteinases (MMPs) and breast cancer. Methods The literature in recent years on the relationship between the expression of MMPs and breast cancer was reviewed. Results The balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs) is keeping normally kept in human body. Many of the studies showed that the expression of MMPs is increased in breast cancer. Conclusion The growth, invasion and metastasis of breast cancer is closely related with the increased expression of MMPs. This suggests that MMPs is a valuable prognostic marker and TIMPs would be a novel drug against cancer.
Objectives To analyze the risk factors of secondary infections in breast cancer or lung cancer patients with chemotherapy-induced degree Ⅳ neutropenia, so as to provide reference for clinical treatment. Methods The case-control study design was used. Thirty-seven in-patients of breast cancer or lung cancer with secondary infections and 87 in-patients without secondary infection in the First Affiliated Hospital of Xi’an Jiaotong University from January to December 2014 were enrolled as study population. We collected the retrospective information and analyzed the risk factors of secondary infection with chemotherapy-induced degree Ⅳ neutropenia using factors under univariate analysis and logistic regression analysis. Results Single factor analysis showed that the patients whose MASCC<21 the had higher infection risks (P<0.05). For breast cancer patients with degree Ⅳ neutropenia, secondary infection risk of first two chemotherapy cycles was 2.87 times of subsequent cycles of chemotherapy. For lung cancer patients with degree Ⅳ neutropenia, invasive procedures and preventive use of antibiotics increased risk of infection (P<0.05). Logistic regression analysis showed MASCC score and chemotherapy cycles were significantly associated with secondary infection in breast cancer degree Ⅳ neutropenia patients (P<0.05). Invasive procedures were significantly correlated to secondary infection of patients with lung cancer degree Ⅳ neutropenia (P<0.05). Conclusions MASCC score and chemotherapy cycles are the risk factors of infection in breast cancer patients with degree Ⅳ neutropenia, and invasive procedures are the independent risk factors of infection in lung cancer patients with degree Ⅳ neutropenia.
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.
Objective To review the recent studies on the suppressing function of breast cancer metastasis suppressor 1 (BRMS1) in breast cancer metastasis. Methods The recent literatures on the mechanisms of BRMS1 in the breast cancer that were published in and abroad were reviewed and summarized. Results BRMS1, similar to the other anti-metastasis genes, only suppresses the metastasis of breast cancer cells but has nothing to do with the growth of tumor. BRMS1 could suppress metastasis of tumor cells by reestablishing both the homospecific and the heterospecific gap junctional intercellular comminications (GJIC) and by altering the expressions of relevant metastasis genes in the breast cancer. Conclusion Further studies on BRMS1 may be helpful to understand the metastasis of breast cancer, which may provide a new way for the diagnosis and treatment of breast cancer.
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.
ObjectiveTo evaluate the diagnostic value of contrast enhanced ultrasound (CEUS) to the sentinel lymph node (SLN) of breast cancer. MethodsSeventy-two operable breast cancer patients with clinically negative axillary lymph node were enrolled.Sulphur hexafluoride microbubbles for injection (SonoVue) was used alone as the tracer agent for the sentinel lymph node biopsy (SLNB), and axillary dissection was performed after the methylene blue location.All SLNs were examined pathologically with HE staining.The SLN diagnosis result of contrast enhanced ultrasound and postoperative pathological examination result were comparative analyzed. ResultsAfter the injection of SonoVue can obtain a clear image of the lymphatic vessels and SLN.The success rate of CEUS imaging was 84.72% (61/72) in this group of 72 patients, and the false negative rate was 12.12% (4/33).The sensitivity and specificity of diagnosis by CEUS was 92.50% (37/40) and 92.59% (50/54), respectively, the diagnostic odds ratio (DOR) was 154.17.By the pathology results as the gold standard, the internal consistency of these two methods was good (Kappa value=0.848, P < 0.01). ConclusionCEUS may be a useful orientation and determination method for SLNs.
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.
Day surgery has been applied in practice since more than 30 years ago in western world, which could obviously reduce the length of hospital stay, accelerate the recovery of patients, and achieve desirable economic and social benefits. Despite of the common development of day surgery in various diseases, the application of day surgery in breast general anesthesia surgery is limited. No related management standard has been established. By summarizing the experience of breast cancer day-surgery, Xijing Hospital of Air Force Medical University has established a comprehensive management standard, including preoperation, intraoperation, and postoperation management. Meanwhile, the nursing, resource allocation, follow-up, and stuff management are all enrolled into the management standard, aiming to improve the development of day surgery in general anesthesia breast cancer operation.
Objective To explore the clinical significance of internal mammary nodes in diagnosis and treatment of breast cancer. Methods The research papers on internal mammary nodes at home and abroad were analyzed in order to summarize the distribution, metastasis, detection and the effects of clinical treatment of the internal mammary nodes in breast cancer. Results The internal mammary nodes mainly locate near the sternum, along with the internal mammary artery and vein in the thorax. They were prone to metastasize at early stage and the metastasis rate also increased with the increased number of axillary lymph nodes in breast cancer. It could influence the recovery of the breast cancer patients by taking biopsy and treatment to the internal mammary nodes. Conclusion The biopsy and treatment of internal mammary nodes are useful for the patients with breast cancer to avoid the recurrence and helpful to stage, treatment and prognosis judgement of the breast cancer patients.