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Objective To discuss the feasibility and value of indocyanine green combined with methylene blue in sentinel lymph node biophy (SLNB) for patients with breast cancer.Methods 196 breast cancer patients who received surgery were studied.SLNB was performed by indocyanine green combined with methylene blue .Frozen section was performed,followed by conventional histopathology .The evaluation criterion of Louisvill University on SLNB was adopted to judge the detection rate ,accuracy rate,sensitivity,false negative rate.Results Among the 196 cases,196 cases were detected with SLN ( detection rate was 100.0%).SLN was all stained in 196 cases. Furthermore,56 cases had ALND metastasis,140 cases had no metastasis,and the sensitivity was 91.8%(56/61). The SLN and ALN fully complied with pathological examination in 191 cases,and the accuracy rate was 97.5%(191/196).Five cases were false negative,and the false negative rate was 8.2%(5 /61).No case was false positive.The total SLNs was 705,and average number of detected SLNs was 3.59 pieces(2-6 pieces).The average ALN was 17.66 pieces(12-26 pieces).Conclusion With the advantages of real-time visual,precise positioning,no radio-active pollution and reduce the operation difficulty ,indocyanine green joint methylene blue as lymph tracer shows high detection rate,accuracy when it is used for SLNB in patients with breast cancer ,it is worthy of clinical application.
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Objective To investigate the expression of miR-30d in breast cancer tissues and demonstrate the regula-tive effects of miR-30d ASO on the invasion and migration of breast cancer cells in vitro. Methods The expression levels of miR-30d in 108 breast cancer tissues and their adjacent tissues were detected by real-time quantitative PCR method. Af-ter transfection with miR-30d ASO, the biological effects of miR-30d on in breast cancer cells was measured by transwell as-say and wound healing assay. The expressions of matrix metalloproteinase (MMP)-2 and MMP-9 were analyzed by Western blot assay. Results The expression level of miR-30d was found to be over-expressed in breast cancer tissues(P<0.05). Compared with control group and nonsense interference group, the miR-30d expression was significantly decreased in breast cancer cells(transfection with miR-30d ASO). Results of transwell and wound healing assay showed that the invasion and mi-gration ability decreased significantly after transfection with miR-30d ASO, and expressions of MMP-2 and MMP-9 were down-regulated (P<0.05). Conclusion miR-30d was over-expressed in human breast cancer. The invasion and migration of breast cancer cells can be effectively inhibited by decreasing the expression of miR-30d. miR-30d may become a new tar-get for the regulation of invasion and migration in breast cancer.
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Objective To study the effect of the ultrasound scalpel and electric knife in axillary lymph node dissection in modified radical mastectomy for breast cancer.Methods The clinical data of 429 patients with modified radical mastectomy for breast cancer were analyzed retrospectively.The axillary lymph node dissection in 178 cases were performed with the ultrasound scalpel (ultrasound scalpel group) and 251 cases were done with the electric knife(electric knife group).The blood loss,operative time,extubation time,the total amount of drainage,the incidence of seroma were compared.Results Two groups were successfully operated,no axillary vessels and long thoracic nerve,chest nerve injury.The blood loss,operative time,extubation time,the total amount of drainage in ultrasound scalpel group were significantly better than those in electric knife group [(98.0 ± 10.2) ml vs.(152.0 ± 11.5) ml,(125.0 ±9.6) min vs.(155.0 ± 12.3) min,(6.0 ± 2.1) d vs.(9.0 ± 4.3) d,(227.0 ± 10.6) ml vs.(319.0 ± 15.8) ml,P＜ 0.05 or ＜ 0.01].The incidence of seroma was no significant difference between two groups (P ＞ 0.05).Conclusions Using ultrasound scalpel in axillary lymph node dissection for breast cancer can significantly reduce operative time,and is consistent with less blood loss,less extubation time and the total amount of drainage.
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Objective:To demonstrate the selection of breast implant during an immediate breast reconstruction post-mastectomy and analyze the indication of this technique. Methods:From June 2007 to June 2012, a total of 121 patients with breast cancer received immediate breast reconstruction with breast implants. Among the 121 patients, 89 patients had simple mastectomy, while the rest under-went modified radical mastectomy in the Department of Breast Neoplasm, Nanchang No.3 Hospital. The volumes of the resected breast tissues were measured using Archimedes principle. The diameters of the tissues were also determined. Proper breast implants were se-lected according to the measured data. Results: Postoperative complications, such as implant exposure, flap necrosis, and infection, were not found. Follow-up period ranged from 6 months to 12 months. Patients answered a questionnaire that displayed their degree of satisfaction for the breast operation outcome. Results show that 89.3%of the patients (108/121) were very satisfied, 9%were (11/121) satisfied, and 1.7%(2/121) were unsatisfied. Conclusion:Immediate breast reconstruction with breast implant post-mastectomy is an ideal method for rebuilding the breast. This technique is advantageous because it prevents damage to the donor site and retains the maxi-mal elasticity of the skin for breast reconstruction. Accurate parameters of breast implants, which are important to achieve good surgical results, could be obtained using Archimedes principle.
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Objective To explore the clinical effect of carbon nanoparticle in the axillary sentinel lymph node tracer of breast cancer.Methods Fifty-seven patients with breast cancer underwent lymphatic tracing with carbon nanoparticle.The carbon nanoparticle suspension was subcutaneously injected around the areola (points at 4 o'clock) and tumor surface skin at 30 min before operation.The first lymph nodes blacked were named sentinel lymph node.Then performed modified radical mastectomy,observing the application value of carbon nanoparticle.Results The detection rate of sentinel lymph node was 98.2％ (56/57).The correct,sensitive and false negative rates were 98.2％(55/56),95.2％(20/21) and 4.8％(1/21),respectively.The false positive rate was 0.Conclusions The carbon nanoparticle suspension injection subcutaneously around areola in sentinel lymph node biopsy is helpful for accurately evaluating the axillary lymph node condition.Being simple to operate,accurate positioning,dyeing time and is worth popularizing.
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Objective To evaluate the effect of neoadjuvant chemotherapy (NAC) by investigating the expression of cyclin D1 in human breast cancer before and after NAC.Methods Eighty-four cases of breast cancer were diagnosed by core biopsies.The expression level of cyclin D1 in cancer tissues was measured by immunohistochemical envision two-step method before and after NAC (pirarubicin and docetaxel regimen for 3-4 cycles).Results Complete remission (CR) occurred in 4 cases of 84 patients (4.76 ％) with 2 pathological complete response cases,partial response (PR) in 54 cases (64.29 ％),stability (SD) in 26 cases (30.95 ％) and no disease progression (PD) patients.The positive rate of cyclin D1 in cancer tissues [65.48 ％ (55/84)] was significantly decreased after NAC [39.29 ％ (33/84)] (x2 =11.55,P =0.001).In clinical level,the ease rate was significantly improved in patients whose cyclin D1 expression switched from positive [86.36 ％ (19/22)] to negative [45.45 ％ (15/33)] after NAC treatment (x2 =9.359,P =0.002).Conclusion NAC significantly decreases the expression of cyclin D1 in breast cancer tissues.Meanwhile,the ease rate is improved when cyclin D1 expression switched from positive to negative after NAC.Therefore,cyclin D1 expression can be used as an evaluation index for the efficiency of NAC.
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Objective To study the impact of the thymosin alpha 1 on the toxicity and celluar immune function during neoadjuvant chemotherapy of breast cancer.Methods 83 patients of Ⅱ b-Ⅲ a stage breast cancer were randomly divided into two groups:study group(40 patients,neoadjuvant chemotherapy of CEF combined with thymosin α 11.6mg HQD) and control group(43 cases,neoadjuvant chemotherapy of CEF alone).Results Rates of gastrointestinal reaction and bone marrow depression in study group were significantly lower than those in control group.The levels of CD3,CD4,CD4/CD8 and NK in study group were significantly higher than those in control group after chemotherapy.Conclusion The combination of thymosin alpha 1 and neoadjuvant chemotherapy for breast cancer can reduce the toxicity,improve the tolerance,enhance cellular immune function and improve the quality of breast cancer patient's life.