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Objective To explore the correlation of human epidermal growth factor receptor type 2 overexpression (HER-2+)and mammographic and clinical features in breast cancers with estrogen receptor negative expression (ER-).Methods 190 cases of ER-breast cancer were included in this study.There were 78 cases with HER-2+,and 112 cases with HER-2-.The pathological and mammographic features were compared between the two groups.Results Compared with the HER-2- group,the HER-2+ group was more in older women (P<0.001)and more likely to have a lymphonodus metastasis (P=0.011).For mammographic manifesta-tions,pure calcifications were more detected in the HER-2+ group (P=0.000),and pure masses were more detected in the HER-2-group (P<0.001).The HER-2+ group was more likely showed as a lobulated mass (P<0.001),and with spiculated margin (P=0.000). However,the HER-2- group was more likely showed as a round mass (P=0.014),and with smooth margin (P=0.000).The cal-cifications of HER-2+ group were more likely showed as malignancy calcifications (P=0.000).Conclusion HER-2 overexpression breast cancer with ER- has some mammographic and clinical features,which is helpful for individual diagnosis and treatment.
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Objective To evaluate of value of HER2 as a prognostic marker,and to analysis associations with common his-topathological parameters in BC cases.Methods In this study,formalin-fixed,paraffin-embedded samples of tumors from 160 breast cancer patients who underwent curative surgery proce-dures between 2011 and 2014 were tested by immunohisto-chemistry (IHC)as aprimary estimate of HER2 status,followed by fluorescence in situ hybridization (FISH).Concordance rate between IHC and FISH was evaluated.Theχ2 test was used to evaluate the correlation between HER2 gene amplifica-tion status and different clinical pathological features including:(estrogen receptor)ER and (progesterone receptor)PR ex-pression,age,menopausal status and tumor size.Results There was a significant inverse association between expression of hormone receptors (ER and PR)and HER2 amplification (all P0.05).HER2-negative le-sions were of higher grade and more likely to be ER-negative,PR-negative,p5 3-positive,lymph node metastasis,and also Ki-67≥20% as compared to the HER2-positive group and HER2 overe xpression was associated with the levels of ER and PR. Conclusion There is correlation of many clinical factors with HER2 expression.
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<p><b>OBJECTIVE</b>To observe clinical efficacy of using free anterolateral thigh flaps with iliotibial tracts in repairing skin and soft tissue defects around the knee joints with patellar ligament defects.</p><p><b>METHODS</b>Twelve patients with skin and soft tissue defects around the knee joints and patellar ligament defects were hospitalized from June 2010 to June 2014. The defects of skin and soft tissue ranged from 7 cm × 6 cm to 16 cm × 12 cm in area, and patellar ligament ranged from 5 to 12 cm in length and 2.5 to 4.0 cm in width. Free anterolateral thigh flaps with iliotibial tracts were used to repair these defects. During reconstruction of patellar ligament, both ends of iliotibial tract were successively folded to form tendon-like three-layer structure at first, and then the newly formed structure was wrapped around the broken ends of patellar ligament and fixed with suture. The flap size ranged from 9 cm × 8 cm to 18 cm × 14 cm. The iliotibial tract ranged from 7 to 14 cm in length and 8 to 12 cm in width. The donor sites were closed by grafting with autologous split-thickness skin harvested from thigh or trunk, and parked with gauze. Immediately after operation, the knee joints were fixed in extension with orthosis for 6 weeks. Weight bearing training of affected limbs being kept in extension position was started from 2 weeks after operation, and flexion and extension exercise of affected knee joints was begun from 6 weeks after operation. Before operation and 12 months after operation, the degree of pain around the knee joints and knee joint function were evaluated with the international knee documentation committee knee uation form, and the ranges of flexion and extension of knee joints were also evaluated. The integrity of reconstructed patellar ligament was assessed by color Doppler ultrasound from 6 to 12 months after operation. The occurrence of surgery-related complications was observed in all patients within 12 months after operation.</p><p><b>RESULTS</b>(1) After operation, all flaps survived well, and all wounds healed well. (2) The average score of pain around the knee joint was increased from 31 points before operation to 77 points in 12 months after operation. The average score of knee joint function was increased from 14 points before operation to 65 points in 12 months after operation. Before operation, the average ranges of flexion and extension of knee joint were respectively 89° and 65°, and they were respectively increased to 130° and decreased to 15° in 12 months after operation. From 6 to 12 months after operation, color Doppler ultrasound showed that the condition of reconstructive patellar ligaments in all patients was good without the need for further surgical intervention; the superficial sensation of the flaps was recovered in different degrees. No surgery-related complication was observed in all patients within 12 months after operation.</p><p><b>CONCLUSIONS</b>Free grafting of anterolateral thigh flap with iliotibial tract is an effective and reliable method for repairing skin and soft tissue defects around the knee joints combined with patellar ligament defects, and the surgical procedure can recover function and appearance of knee joint satisfactorily.</p>
Subject(s)
Humans , Extremities , Fascia Lata , Knee , Knee Joint , Patellar Ligament , General Surgery , Range of Motion, Articular , Plastic Surgery Procedures , Methods , Skin , Skin Transplantation , Surgical Flaps , Thigh , Wound HealingABSTRACT
Objective To study the predictive value of HER2/neu amplification and lymphovascular invasion for axillary lymph node metastasis in T1 breast cancer patients(mass<2 cm).Methods Reviewed the medical record of 206 T1 breast cancer patients who were the presence or absence of lymph node metastasis with IHC and FISH,analyzed the association be-tween ALNM and various clinicopathological predictive factors such as age,tumor size (T1a,T1b,T1c),multiplicity,the his-tologic grade,the nuclear grade,the presence of lymphovascular invasion (LVI),the estrogen and progesterone receptor sta-tus,an HER2/neu expression,the Ki-67 labeling index and the bcl-2 expression,and discussed the correlation of the various factors with axillary lymph node metastasis of T1 breast cancer.Results One hundred and thirty-nine were the node nega-tive group (T1N0)and the remaining 67 cases were allotted to the node positive group (T1N1-3),age (χ2 = 6.484,P =0.011),LVI (χ2 =72.813,P <0.001),histologic grade (χ2 =74.813,P =0.019),HER2/neu (χ2 =74.813,P <0.005),Ki-67 (χ2 =6.255,P =0.012)and bcl-2 (χ2 =4.977,P =0.026)were the statistically significant predictive factors related to node metastasis.The factors such as tumor size (χ2 =1.544,P =0.254),surgical method (χ2 =2.414,P =2.414),and ucle-ar grading HG (χ2 =2.017,P =0.159),estrogen receptors ER (χ2 =0.140,P =0.709),progesterone receptor PgR (χ2 =2.199,P =2.199),have no significant statistical correlation with early breast cancer lymph node metastasis.Conclusion HER2/neu overexpression and LVI were related to the increased incidence of ALNM in T1 breast cancer patients,LVI was the most predictive factor of ALNM.
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BACKGROUND: Previous studies demonstrated that adventitia fibroblasts exhibit important role in the hyperplasia of newly born endomembrane after blood vessel injury. However, the mechanism regarding phenotypic transition of adventitia fibroblasts in vitro remains unclear. OBJECTIVE: To observe effect of peroxisome proliferators-activated receptor ?agonist (PPAR ?) on phenotypic transition of adventitia fibroblasts induced by transforming growth factor ?1 (TGF-?1) in vitro, as well as the expression of collagen protein Ⅰ. DESIGN, TIME AND SETTING: A randomized grouping control experiment was performed at the Tissue Engineering Laboratory of Ninth Affiliated Hospital of Shanghai Jiao Tong Medical College between July 2007 and October 2008. MATERIALS: The aorta thoracica's adventitial fibroblasts were cultured from Sprague Dawley rats, with 2-month-old, weighing 120 g. The TGF-?1 was supplied by American GenWay Biotech Company. The rosiglitazone power was purchased from Beijing Comens Chemical Co., Ltd. METHODS: The experiment was divided into 3 groups: In the TGF-?1 group, fibroblasts was induced with TGF-?1 with different concentrations (3, 5, 10, 15 ?g/L) for 48 hours; in the rosiglitazone group, fibroblasts was induced with rosiglitazone (5, 10, 30, 50 ?mol/L) for 45 minutes followed by co-culture with 10 ?g/L TGF-?1 for 48 hours. There was no intervention measure in the control group. MAIN OUTCOME MEASURES: The phenotypic transition of fibroblasts was measured by ?-smooth muscle actin, the expression of smooth muscle ? 2-actin, as well as collagen type Ⅰ was determined by protein immunoblotting. RESULTS: Compared with the control group, 5 ?g/L TGF-?1 could significantly stimulate the changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ?2-actin and collagen type Ⅰ, which reach a peak level when treated with 10 ?g/L TGF-?1 (P 0.05). Compared with control group, 30 ?mol/L rosiglitazone could significantly inhibit changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ? 2-actin and collagen type Ⅰ(P
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Transforming growth factor ?1(TGF-?1) is a growth and differentiation factor with highly multi-effect and multi-function,it widely regulates many physiological and pathological processes,such as body's growth,development,inflammation,repair and immune.The vascular restenosis is attributable to a local inflammation after vascular injury,which results in the production of cytokines.TGF-?1 in the local level can stimulate the proliferation and migration of smooth muscle cells,and promote the phenotypic transition and migration of adventitial cells,as well as production and deposition of local extracellular matrix protein,thus promoting vascular restenosis.This article attempts to investigate the role of TGF-?1 in restenosis after pathological vascular injury by the biological characteristics of TGF-?1,pathology of vascular restenosis,relationship between TGF-?1 and vascular restenosis,as well as the mechanism of TGF-?1 on restenosis after vascular injury.