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Objective:To compare the differences in the delineation of the gross tumor volume (GTV) and lymph nodes of nasopharyngeal carcinoma (NPC) patients using computerized tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT), and to investigate the optimal standard uptake value (SUV; relative to the MRI-based delineation) for the automatic delineation of GTV using PET. Methods:A total of 53 NPC patients proposing to receive radiotherapy were selected for this study. The CT, MRI, and PET images of each patient were obtained before radiotherapy. Then GTV and positive lymph nodes were delineated on these three types of images. They were individually named GTV MRI, GTV CT, GTV PET2.5 (SUV=2.5), Lymph MRI, Lymph CT, and Lymph PET2.5 and compared. The GTV ∩2.5 (overlapped GTV) was obtained through the alignment of MRI and PET/CT images. Meanwhile, GTV was delineated on PET images using thresholds of SUV=4.0, 4.5, 5.0, and 5.6, obtaining GTV PET4.0, GTV PET4.5, GTV PET5.0, and GTV PET5.6. Then their volume and Dice similarity coefficients (DSCs) were compared. Results:Compared to GTV MRI, GTV CT decreased by 1.73% ( P>0.05) and GTV PET2.5 increased by 21.34% ( t=-3.52, P < 0.05) in the three types of images. The volume of Lymph PET2.5 was 1.61 and 1.87 times the volume of Lymph MRI and Lymph CT, respectively ( t=-4.12, -5.18; P< 0.05). The volume of high-SUV lymph nodes was 4.07 times the volume of lymph nodes with low SUVs or SUV=0 ( t=5.50, P< 0.05) on PET images. The DSC between GTV PET4.0and GTV MRI was 0.78 ± 0.27, which was lower than that between GTV PET2.5 and GTV MRI (0.84 ± 0.18). However, GTV PET4.0 approximated to GTV ∩2.5 ( P>0.05). Conclusions:Compared to CT and 18F-FDG PET/CT, MRI shows more accurate boundaries of GTV and lymph nodes. When 18F-FDG PET/CT was adopted to automatically delineate GTV, the GTV delineated using SUV=4.0 was closer to GTV MRI.
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Objective: To investigate the prognosis of patients who receive neoadjuvant chemotherapy (NAC) for invasive micropapillary carcinoma (IMPC) of the breast using a propensity score matching (PSM) method and to analyze the effects of NAC. Methods: Clinical and pathological data of a total of 251 cases of IMPC of the breast were collected for this study, from January 2011 to March 2014 in Tianjin Medical University Cancer Institute and Hospital, of which the NAC group comprised 67 cases and the non-NAC group comprised 184 cases. Tumor sizes before and after NAC were compared in the NAC group. Prognostic differences were compared between the NAC group and non-NAC group before and after PSM balancing the baseline. Results: The mean value of the maximum dimensions significantly reduced from 5.0cm to 4.2cm in the NAC group after NAC (P=0.035), but there was no statistically significant difference in T stage changes (P=0.064). A total of 49 pairs of patients were matched after PSM, and differences in the baseline data of the paired group were not significant. Univariate survival analysis showed no significant difference in the recurrence-free survival (RFS) rate between the NAC group (77.6% vs. 89.2%) and non-NAC group (72.1% vs. 91.0%) before and after PSM (all P>0.05). The 5-year distant metastasis-free survival (DMFS) rates in the NAC group before and after PSM were 53.4% and 50.0%, respectively, which were both significantly lower than those in the non-NAC group 69.1%, 59.2% (all P<0.05), and multivariate survival analysis showed that undergoing NAC was an independent prognostic factor of DMFS after PSM. Conclusion: Breast IMPC is a special type of tumor that is not sensitive to chemotherapy. Although some tumors decrease after NAC, IMPC patients do not benefit from NAC in terms of RFS; NAC may even increase the risk of distant metastasis. Therefore, IMPC patients should undergo surgical treatment as soon as possible, and NAC is not recommended.
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With the development and application of microarray and high-throughput sequencing technology, it is possible to genomi-cally scan breast cancer associated CNV and SNPs. Multiple researches showed that the frequent aberrance of 8q24 was associated with breast cancer. Oncogenes such as MYC, PSCA and breast cancer associated loci are located in 8q24, and frequent amplification of 8q24 was proposed to be related with breast cancer development and prognosis. This review summarizes the association of the 8q24 amplification and SNPs with breast cancer by correlated genes on this locus.
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ObjectiveTo analyze clinicopathological characteristics and treatment of male breast cancer (MBC) and the matched female breast cancer (FBC). To compare the survival difference between the 2 groups.To study the factors influencing the prognosis of MBC.Methods63 MBC patients treated in Tianjin Medical University Cancer Institute and Hospital from Jan.1995 to Dec.2008 were enrolled in this study.Each MBC patient in the database was matched with 2 FBC patients.The matching criteria were with similar age, diagnosis time, and TNM stage.Chi-square test and Fisher exact test were employed to compare the clinicopathologic characteristics of MBC and FBC.Kaplan-Meier method, Log-rank test, and Cox hazard regression model were employed respectively to make survival analysis, surival rate comparison and multivariate analysis.ResultsThe 10-year disease-free survival (DFS) rate was 53.9％ for men and 65.1％ for women (P =0.047).The 10-year overall survival (OS) rate was 61.9％ for men and 77％ for women (P =0.032).Univariate analysis showed TNM stage, surgical method and recurrence were factors influencing the prognosis of MBC patients. Multivariate analysis showed TNM stage was an independent factor influencing the prognosis of MBC patients.ConclusionsFBC patients had a better 10-year OS rate and DFS rate than MBC patients.TNM stage is an independent factor influencing the prognosis of MBC patients.
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Objective To evaluate the relationship between neoadjuvant chemotherapy (combination of taxanes and anthracyclines ) induced-neutropenia and the efficacy of neoadjuvant chemotherapy and long-term survival in operable breast cancer patients. Methods Two hundred and eleven patients received 4 cycles of neoadjuvant chemotherapy (combination of taxanes and anthracyclines).Clinicopathological characteristics were compared between patients with neoadjuvant chemotherapy-induced neutropenia and patients without neutropenia. The efficacy of neoadjuvant chemotheray and long-term survival rate were analyzed. Results Among 211 patients there were 51 (24. 2% ) cases suffering from neutropenia and 160 (75.8%) cases were of no-neutropenia. The response to chemotherapy in patients with neutropenia were more effective than in no- neutropenia ones ( P ＜ 0. 05 ). The 5-year disease-free survival (DFS) in patients with neutropenia was 82. 4%, while the 5-year disease-free survival ( DFS) with nonneutropenia was 60% ( P ＜ 0. 01 ). Additionally, the 5-year overall survival ( OS ) in patients with neutropenia was 90. 2% and in patients with non-neutropenia patients was 67. 5% ( P ＜ 0. 01 ).Conclusions Chemotherapy-induced neutropenia during neoadjuvant chemotherapy combination of taxanes and anthracyclines in patients with operable breast cancer has a better prognosis. The sensitivity of tumors given to chemotherapeutic drugs could be evaluated by chemotherapy-induced neutropenia.