ABSTRACT
Objective:To explore the expression of programmed death ligand-1 (PD-L1) protein in grade Ⅲ non-special type invasive breast cancer and its related factors, so as to provide a basis for immunotherapy.Methods:A total of 63 surgically resected specimens of grade Ⅲ non-special type invasive breast cancer diagnosed by pathology in Cancer Hospital & Shenzhen Hospital of Chinese Academy of Medical Sciences from February 2017 to February 2021 were collected. The HE-stained sections were reviewed, and the proportion of immune cells (IC) in all invasive active tumor cells in the tumor sections was calculated. The expression of PD-L1 (SP142) protein in all specimens was detected by immunohistochemistry. The relationship between the positive expression of PD-L1 protein and the clinicopathological parameters was analyzed, and the Pearson correlation test was used to analyze the relationship between the expression of PD-L1 (SP142) and the degree of IC infiltration.Results:Among 63 patients, 19 patients (30.2%) were triple-negative type, 34 patients (53.9%) were luminal type, and 10 patients (15.9%) were human epidermal growth factor receptor 2 (HER2) overexpression type. The positive rate of PD-L1 (SP142) in grade Ⅲ non-special type invasive breast cancer was 77.8% (49/63). The positive rate of PD-L1 (SP142) in triple-negative type was 94.7% (18/19), the positive rate in non-triple-negative type was 70.5% (31/44), and the difference between the two groups was statistically significant ( P = 0.047). The positive rate of PD-L1 (SP142) in estrogen receptor (ER)-negative patients or progesterone receptor (PR)-negative patients was both 90.3% (28/31), which was higher than that of ER-positive patients or PR-positive patients (65.6%, 21/32), and the difference was statistically significant ( P = 0.018); the positive rate of PD-L1 (SP142) was not related to the patient's age, tumor site, tumor maximum diameter and number, vascular tumor thrombus, nerve invasion, lymph node metastasis, HER2 status and Ki-67 positive index (all P > 0.05). The expression of PD-L1 was positively correlated with the degree of IC infiltration ( r = 0.716, P<0.001). Conclusion:In grade Ⅲ non-special type invasive breast cancer, the patients with triple-negative type has a high positive rate of PD-L1, and the patient with negative ER or PR has a high positive rate of PD-L1; the tumor IC infiltration is positively correlated with the expression of PD-L1.
ABSTRACT
Objective To investigate the effect and safety of comprehensive therapy based on femoral head arthroplasty in treating old femoral neck fracture in the elderly complicated with other severe basic medical conditions.Methods Thirty-six elderly patients with old femoral neck fracture were treated with femoral head arthroplasty.Mean age of the patients was 78.2 years, and mean duration since injury was 13.7 months.All the patients had at least one severe basic medical problem.Perioperative complications were retrospectively analyzed, and function of hip joint was evaluated 6 months after operation.Results One patient died because of severe pulmonary infection, while 16 electrolyte imbalance, 7 hypotension, 4 arrhythmia, 2 acute heart failure and 1 acute kidney injury were cured in the rest 35 patients.Harris hip score of the 35 patients increased from (22.0 ± 6.8) points pre-operatively to (69.2 ± 10.8) points 6 months post-operatively (P ＜ 0.01).Conclusions Comprehensive therapy based on femoral head arthroplasty is effective for old femoral neck fracture in the elderly suffering severe underlying diseases.Early treatment, perfect pre-operative preparation, correct manipulation and appropriate perioperative management play important roles.