Management of colorectal high-grade intraepithelial neoplasia based on colonoscopic biopsy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the principle of management of colorectal high-grade intraepithelial neoplasia(HGIN) based on colonoscopic biopsy.</p><p><b>METHODS</b>Patients diagnosed as colorectal HGIN based on colonoscopic biopsy in the Changhai Hospital from January 2002 to December 2009 were enrolled in the study. The clinical data of all the patients were collected and analyzed. According to the subsequent operation, cases were divided into local complete resection group and radical operation group. The discrepancy between the biopsy diagnosis and postoperative diagnosis was investigated.</p><p><b>RESULTS</b>Of the 203 biopsy-based colorectal HGIN lesions, 156 underwent radical resection, while 47 received local complete resection. Univariate analyses indicated that tumors located in colon(P=0.02), tumors with sessile growth (P=0.00) and large tumors (P=0.00) were more likely to be treated with radical resection. Postoperative diagnosis revealed that 163 cases(80.3%) were invasive cancers, while the other 40 cases(19.7%) were HGIN lesions. Of the 156 cases resected radically, 140 cases were invasive cancers, 16 cases were diagnosed as HGIN. Of the 47 cases who underwent local complete resection, 24 cases were confirmed as HGIN but the other 23 cases were invasive cancers, in which 15 cases received subsequent radical operation.</p><p><b>CONCLUSIONS</b>A large proportion of biopsy-proven colorectal HGIN lesions are invasive cancers. Therefore, local resection should be performed to confirm diagnosis. For highly suspected malignant tumors which can not be removed completely by local resection, if anus can be reserved, a radical transabdominal surgery is recommended even without biopsy-proven malignancy in order to avoid treatment delay.</p>

Expression of ER, PR, HER-2, PCNA and P53 genes in breast cancer patients in Shanghai and the relevant clinical significance / 第二军医大学学报

Objective: To investigate the expression of ER, PR, HER-2, PCNA and P53 in breast cancer patients in Shanghai and the relevant clinical significance. Methods: Expressions of ER, PR, HER-2, PCNA and P53 in the breast cancer tissues of 544 patients in Shanghai were detected by immunohistochemistry methods. Statistical analysis was applied to analyze the relationship of these immunohistochemical indices with the clinicopathological features of breast cancer. Results: The positive rates of ER, PR, HER-2, PCNA and P53 in the breast cancer tissues of 544 patients were 62.2%, 57.2%, 15.1%, 82.6% and 58.5%, respectively. The expressions of ER, PCNA and P53 were correlated with the tumor size (P<0.05, P<0.01). The expressions of HER-2 and PCNA were correlated with axillary lymphatic metastasis (P<0.05, P<0.01). ER expression was positively correlated with PR expression(r=0.452, P=0.000) and PR expression was positively correlated with P53 expression (r=0.520, P=0.03). The 123 (22.6%) patients with triple-negative breast cancer (TNBC) had a higher axillary lymphatic positive rate than patients with non-TNBC (P<0.01). Co-expression of HER-2 with PCNA and co-expression of HER-2 with P53 were positively correlated with lymphatic metastasis (P<0.05). Conclusion: Population aging has a influence on the immunohistochemical characteristics of breast cancer patients patients in Shanghai. Combined examination of ER, PR, HER-2, PCNA and P53 is of clinical significance in the diagnosis, treatment, and prognosis prediction of breast cancer patients.