Preoperative dynamic contrast-enhanced MRI can reduce the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma / 中华肿瘤杂志

Objective@#To investigate the value of preoperative dynamic contrast-enhanced MRI in reducing the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma.@*Methods@#Seventy-two patients with early non-mass breast carcinoma received ultrasonographic and mammographic examination and subsequently underwent dynamic contrast-enhanced MRI examination before breast conserving surgery. The control group consisted of 74 patients who had early non-mass breast carcinoma. They only received ultrasonographic and mammographic examination and didn′t undergo contrast-enhanced MRI examination. The comparison of the rate of tumor-positive resection margins between two groups was performed. The MRI findings that had the significant influence on the rate of tumor-positive resection margins were analyzed using Logistic regression model.@*Results@#In 28 patients (28/72, 38.9%), dynamic contrast-enhanced MRI could correct or supplement the ultrasonographic and mammographic findings and resulted in the reasonable change of surgical program. The preoperative MRI examination group (n=30) had lower rate of tumor-positive resection margins than control group for invasive ductal carcinoma (23.3% vs 40.0%, P=0.02), but there was no significant difference (21.4% vs 26.9%, P=0.10) between two groups for ductal carcinoma in situ (n=28). The preoperative MRI examination group (n=14) had lower rate of tumor-positive resection margins than control group for the other pathologic types of breast carcinoma (14.3% vs 38.9%, P=0.02). The statistical analysis on the basis of Logistic regression model showed that some main MRI findings, including change surrounding the tumor, distance between tumor and nipple and tumor size, had the significant influence on the rate of tumor-positive resection margins.@*Conclusion@#Preoperative dynamic contrast-enhanced MRI significantly increased the accuracy of resection margins evaluation, and greatly reduced the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma.

Gastrointestinal stromal tumor with synchronous carcinoma features: a clinicopathologic analysis of 9 cases / 临床与实验病理学杂志

To explore the differentiation of gastrointestinal stromal tumor(GIST) with synchronous carcinoma clinical and pathological features,diagnosis and differential diagnosis.Methods Clinical characteristics,pathological morphology and immunohistochemical staining were observed in 9 cases of GIST with synchronous carcinoma,with review of the relevant literature.Results Microscopically,in 4 cases GIST with esophageal carcinoma,most of tumor cells in central focus were squamous cells and keratin pearls which were well differentiated and the rest of tumor cells are basal like cells on the edge.In the other 5 cases (4 of them with gastric carcinoma and 1 with rectal cancer).Microscopically,the tumors were composed of dysplastic glands which presented as adenoid structures and poorly differentiated.The majority of gastric GIST were spindle cell tumors,which resembled smooth muscle tumors histologically and showed a variety of histological pattern,such as lace like pattern,palisading pattern,antique coins like pattern and eddy pattern.And a perinuclear vacuolization pattern was common.Immunohistochemistry showed that the tumor cells were positive for CK5/6,CK14 and p53,but negative for S-100,CK7 of the 4 cases GIST with esophageal carcinoma.In the other 5 cases (4 of them with gastric carcinoma and 1 with colorectal cancer),showed that CK7,CK20,CEA and HER-2 were positive and negative for S-100.In all the 9 case of GIST,the tumor cells were positive for CD34,CD117 (+),DOG1 and SMA,but negative for S-100,desmin,etc.Conclusion There are no special clinical symptoms in most of GIST with synchronous carcinoma,because these GISTs are generally incidental findings.The proliferative index of GIST with synchronous carcinoma is observably lower than that of GIST without synchronous carcinoma.Most GISTs with synchronous carcinoma can be treated by the standard treatment for the accompanying carcinoma,and do not need specific additional treatments.

Retrospective analysis of the efficacy and safety of anti-hepatitis B virus drugs taken during pregnancy in women from the Guangdong Province / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of anti-hepatitis B virus (HBV) drugs for preventing vertical transmission of HBV and the safety of these drugs when given as treatment during pregnancy (to women) or insemination (to men).</p><p><b>METHODS</b>Cases of women and men who had taken anti-HBV drug therapy during pregnancy or insemination, respectively, were retrospectively selected for study from among 18 hospitals and 33 specialists in the Guangdong Province. Demographic, HBV infection and treatment data was collected for puerperal men or women and their newborns from the medical records.</p><p><b>RESULTS</b>A total of 122 cases with detailed follow-up data were included in the study and including 74 women who were administered lamivudine (LAM) more than telbivudine (LdT) more than adefovir (ADV)more than entecavir (ETV) (hierarchy ranking by number of cases) and 48 men who were administered LAM more than ADV more than LdT more than ETV.None of the 122 newborns related to these cases showed HBV infection at 7 months of follow-up.None of the 74 puerperal women showed complications related to reproduction.There was one ease of a newborn being underweight at birth (2.1 kg), for which the mother had taken LdT during pregnancy. There was also one case of a newborn with a harelip and one case of a newborn with an inguinal hernia, for which both of the fathers had taken ADV during the time of insemination.</p><p><b>CONCLUSION</b>This retrospective investigation carried out in Guangdong Province indicated that not only are anti-HBV drugs efficacious for blocking vertical transmission of HBV but also are safe for both mothers and infants when taken by fathers or mothers during the reproduction phases of insemination and pregnancy.</p>

Expression and the role of myeloid-derived suppressor cells in the peripheral blood in patients with chronic hepatitis B / 中华传染病杂志

Objective To investigate the correlation between the frequency of myeloid-derived suppressor cells (MDSC) and the frequency of regulatory T cells (Treg) in the peripheral blood in patients with chronic hepatitis B (CHB) and its clinical significance.Methods A total of 45 CHB patients including 23 mild-to-moderate CHB patients,22 severe CHB patients,and 15 healthy controls were enrolled.The frequencies of MDSC and Treg in the peripheral blood were studied using flow cytometry and its correlation with clinical data was analyzed by Sepearman correlation analysis.Results The median frequency of MDSC in CHB patients was 0.414％,which was significantly higher than that in healthy controls 0.226％ (Z=-2.356,P=0.018 9).The frequency of MDSC in CHB patients was negatively correlated with the level of alanine transaminase (ALT) and aspartate transaminase (AST) (r=-0.480,-0.478; both P＜0.01),but had no relations with hepatitis B virus (HBV) viral load (r=-0.049,P=0.75).An increase frequency of MDSC was observed in CHB patients with an ALT of 5 × upper limits of normal (ULN) or less or AST of 3 × ULN or less.The frequency of MDSC in CHB patients was positively correlated with that of Treg (r =0.345,P =0.02).Conclusions The activation and proliferation of MDSC may facilitate and maintain HBV persistent infection.The change of the frequency of MDSC is in line with that of Treg,indicating that immunosuppressive functions of MDSC may be related with the development of Treg in CHB.