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Objective@#To study the relationship between morphological characteristics, grading, diagnosis and prognosis in phyllodes tumors (PT) of the breast.@*Methods@#A retrospective study was carried out on 83 PTs diagnosed between 1999 and 2003 that were classified semi-quantitatively according to the WHO recommendation. Follow-up data was available for some cases, and Cox regression analysis was used to evaluate factors affecting metastasis and recurrence.@*Results@#All cases were classified into the benign (57.8%), borderline (28.9%) and malignant (13.3%). The overall recurrence rate for the 72 cases with follow-up data was 20.8% (15/72), and was 17.5% (7/40) in benign, 22.7% (5/22) in borderline and 3/10 in malignant PT, respectively, with no significant difference (P>0.05). The median interval between the initial diagnosis and the first recurrence was 24 months. Lung or bone metastases occurred in 1/22 borderline and 3/10 malignant PT patients 5 years post-surgery. The mitotic count and the degree of stromal cell atypia were significantly correlated with recurrence (P=0.001 and P=0.006). Multivariate analysis showed that severe stromal cell atypia was an independent predictor of recurrence-free survival in PT [HR=6.40 (95% CI=1.378 to 29.732), P=0.018].@*Conclusions@#Each parameter in the histological grading of PT may have different prognostic value, and markedly increased mitotic count and were predictive of relapse.
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Objective To evaluate the value of ultrasound-guided mammotome in the diagnosis and therapy of breast tumor.Methods From May 2006 to February 2009,a total of 205 cases diagnosed with breast tumor by physical examination or ultrasonography underwent ultrasound-guided mammotome in our department.In the patients,142 cases had single tumor and 63 cases showed multiple tumors.Among the 205 cases,impalpable lesions were detected by ultrasonography in 58 patients.Mammotome biopsy system with 11 G/8 G needles were used in the operation.After the surgery,pathological examination was carried out,and short-and medium-term follow-up results of the patients were analyzed.Results In the 205 cases,totally 356 tumors were detected.The size of the tumors ranged from 0.3 to 3.5 cm in diameter.The operation time of the patients was 10.2 min in average(1-50 min).After the surgery,22 patients showed bruise in the surgical area,and 19 patients developed hematoma(three of them received puncture of the hematoma).Post-operative pathological examination showed fibroadenoma in 98 cases,breast hyperplasia in 246 cases(154 of them were complicated with fibroadenoma),7 had intraductal papilloma,4 were diagnosed with breast cyst,and 1 showed tubular adenoma.Follow-up was achieved in 132 patients for 2 to 36 months,during the period,residual tumor was detected in 4 patients(3.0%).All the patients were satisfied with the cosmetic results of the surgery.Conclusions Ultrasound-guided mammotome is a minimally invasive procedure that can safely and reliably diagnose and remove breast tumor,particularly multiple tumors and impalpable lesions.The cosmetic results of the operation are satisfying.
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Objective To establish a non-irradiated precondition strategy for successful donor specific transplantation tolerance induced by bone marrow transplantation which may be introduced to clinical application by a murine model.Methods Male C57BL/6 and female BALB/c mice were used as skin transplant donors and recipients respectively. In all, 11 groups were studied: group 1, control mice with skin graft and without any other treatment; group 2, mice receiving only donor bone marrow transplantation (DBMT) before skin transplantation; groups 3～5, mice administrated by only high dose FK506, CsA or CTX respectively and then skin transplantation; groups 6～8, mice receiving DBMT preconditioned by high dose FK506, CsA or CTX respectively and followed by skin transplantation. Both skin and bone marrow donors were male C57BL/6 mice in above 8 groups. Mice in groups 9～11 were treated almost equally to groups 6～8 except that skin grafts were from the third party ICR donors to prove specificity of tolerance. Every group included 6 recipients. Survival time of skin graft was recorded. Macrochimerism were examined by PCR method.Results Neither standard dose DBMT nor high dose immnodepressants alone could prolong skin graft survival, and macrochimerism was not detected, either. But skin graft survival time was significantly prolonged and macrochimerism was also detected in mice of 6～8 groups. Survival time of skin graft from the third party mice was not prolonged. Conclusions Bone marrow transplantation preconditioned with high dose immunosuppressants and without irradiation can induce donor specific transplantation tolerance and prolong murine skin graft survival. It may work through the mechanism of establishment of macrochimerism.