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Objective To investigate the survival and prognosis of young and elderly patients with triple negative breast cancer (TNBC).Methods A total of 358 TNBC patients with complete specimens and follow-up data,from 2009 to 2011 in Yueyang Hospital of Integrated Traditional Chinese & Western Medicine and Huangpu District Central Hospital were retrospectively analyzed.Results In the 358 TNBC patients,40 young cases (≤40 years old) accounted for 11.2％ and 33 elderly cases (≥70 years old) accounted for 9.2％.There was no significant difference in tumor size,vessel infiltration and staging between the two groups,while young patients had more lymph node metastases and high expression of Ki67 (P =0.028,P =0.036).In addition,all young patients underwent adjuvant chemotherapy,while 19 elderly patients did not receive chemotherapy.Young patients had better compliance,in whom 31 cases took oral Chinese medicine for at least 2 years,and the difference was statistically significant compared with the old ones (P =0.038).But there was no significant difference in breast cancer-specific survival (BCSS) and overall survival (OS) between the young and elderly patients.There was no significant difference in tumor size,lymph node metastasis,Ki67 expression,vessel infiltration and staging between elderly patients receiving or not receiving chemotherapy.There was also no significant difference in the median BCSS and OS.The survival time of young patients was longer than that of the elderly patients after recurrence and metastisis with significant difference (P =0.04).Conclusions There is no significant difference in the prognosis between young and elderly TNBC patients.Although young patients have more aggressive clinicopathological features than elderly patients,they have better survival outcome after recurrence and metastasis.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the collateral flow of patients with acute ischemic stroke by dynamic CT angiography (CTA) and to analyze the relationship between collateral flow and outcome after intravenous thrombolysis.</p><p><b>METHODS</b>We retrospectively analyzed CT perfusion (CTP) imaging of 22 acute ischemic stroke patients with middle cerebral artery (MCA) or internal carotid artery (ICA) occlusion undergoing intravenous thrombolysis, and reconstructed the images for dynamic CTA in the Second Affiliated Hospital, Zhejiang University School of Medicine from June 2009 to October 2013. The total extent and flow speed of collateral flow based on dynamic CTA images of these patients were evaluated. The scores of National Institute of Health stroke scale (NIHSS) in different collateral flows were compared with repeated measuring. The nonparametric Spearman's rank correlation was used to assess the relationship between collateral flow and modified Rankin scale (mRS) at 3 months after thrombolytic therapy.</p><p><b>RESULTS</b>Compared with the poor collateral flow group, patients with good collateral flow had lower NIHSS at 1 month after thrombolysis (4.7±5.0 vs 25.1±15.1, P=0.001) and higher reperfusion percentage (69%±32% vs 23%±54%, P=0.044). The total condition score of collateral flow was positively correlated with mRS at 3 months after treatment (r=0.450, P=0.001).</p><p><b>CONCLUSION</b>Acute ischemic stroke patients with good collateral flow after intravenous thrombolysis have a better outcome. The dynamic CTA can be used to evaluate the collateral flow and to predict clinical outcomes in patients with acute ischemic stroke after thrombolysis therapy.</p>