MRI outstands mammogram in sensitivity of breast ductal carcinoma in situ:an analysis of 122 cases / 中华外科杂志

<p><b>OBJECTIVES</b>To compare the sensitivity of mammogram and breast dedicated MRI in detecting ductal carcinoma in situ with microinvaion (DCIS-MI) and ductal carcinoma in situ (DCIS) lesions, and to further investigate the independent predictive factors of mammogram and MRI sensitivity.</p><p><b>METHODS</b>From August 2009 to November 2011, 122 consecutive confirmed breast cancer patients who had received operations were recruited for this clinical research. These patients were divided into two groups including DCIS (72 cases) and DCIS-MI (50 cases) based on pathologic reports. All the patients were female, with mean ages of 52.6 years and 54.4 years. Preoperative bilateral breast mammogram, breast dedicated MRI depictions and reports as well as histopathological reports were collected.</p><p><b>RESULTS</b>Sensitivity of MRI outstood mammogram in each subgroups: 84.7% vs. 42.4% in DCIS (χ(2) = 27.028, P = 0.000), 94.0% vs. 80.0% in DCIS-MI group (χ(2) = 4.540, P = 0.040). And further analysis showed that MRI was more sensitive to high nuclear grade DCIS and DCIS-MI lesions than low nuclear grade ones (OR = 3.471, P = 0.031).</p><p><b>RESULTS</b>of logistic regression analysis proved microcalcification was an independent predictive factor of mammogram sensitivity (OR = 11.287, P = 0.001).</p><p><b>CONCLUSIONS</b>Sensitivity of breast dedicated MRI is superior to mammogram in detecting DCIS and DCIS-MI groups. Lesions with microcalcifiation is an independent predictive marker which meant that mammogram would achieve high detection rate in cancers presented calcification on mammogram image when compared with non-calcification. Diagnostic performance of breast MRI is less affected by clinical and pathological characteristics of the early stage breast cancer patients but further increased detection rate is observed in DCIS and DCIS-MI with high nuclear grade lesions which indicated that MRI could detect more early stage cancers with relative more aggression biological behaviour and provide these patients with early surgical interventions before possible progression to invasive breast cancers.</p>

Expression and significance of Rab5a and APPL1 in breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of Rab5a and APPL1 in breast cancer and fibroma, and analyze their correlation with HER-2 expression, metastasis and development of breast cancer.</p><p><b>METHODS</b>Rab5a and APPL1 in paraffin embedded tissues of 74 breast carcinomas and 40 breast fibromas were detected by immunohistochemistry. Their relationship with metastasis, pathological grade, and HER-2 expression in breast cancer was determined by statistical analysis.</p><p><b>RESULTS</b>There was no expression or low expression of Rab5a and APPL1 in the breast fibroma, but the positive expression rate of Rab5a and APPL1 in the breast carcinomas were 91.9% and 83.8%, respectively. No significant difference in expression of Rab5a and APPL1 was found between metastatic and non-metastatic groups, and pathological grade I/II and grade III groups. But Rab5a was overexpressed in HER-2-positive group compared with that in the HER-2-negative group.</p><p><b>CONCLUSIONS</b>Rab5a and APPL1 are overexpressed in breast cancer, and are positively correlated with the HER-2 expression. These proteins may influence the growth and proliferation of breast cancer cells by HER-2 signal transduction.</p>

Accuracy of physical examination, ultrasonography, and magnetic resonance imaging in predicting response to neo-adjuvant chemotherapy for breast cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Accurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant chemotherapy (NAC) include physical examination (PE), ultrasound (US), and magnetic resonance imaging (MRI). The purpose of this study was to evaluate the accuracy of PE, US, and MRI in predicting the response to NAC in patients with breast cancer.</p><p><b>METHODS</b>According to the response evaluation criteria in solid tumors guidelines, the largest unidimensional measurement of the tumor diameter evaluated by PE, US, and MRI before and after NAC was classified into four grades, including clinical complete response, clinical partial response, clinical progressive disease, clinical stable disease, and compared with the final histopathological examination.</p><p><b>RESULTS</b>Of the 64 patients who received NAC, the pathologic complete response (pCR) was shown in 13 of 64 patients (20%). The sensitivity of PE, US, and MRI in predicting the major pathologic response was 73%, 75%, and 80%, respectively, and the specificity was 45%, 50%, and 50% respectively. For predicting a pCR, the sensitivity of PE, US, and MRI was 46%, 46%, and 39%, respectively, and the specificity was 65%, 98%, and 92% respectively.</p><p><b>CONCLUSIONS</b>Compared with final pathologic findings, all these three clinical and imaging modalities tended to obviously underestimate the pCR rate. A more appropriate, universal, and practical standard by clinical and imaging modalities in predicting the response to neo-adjuvant chemotherapy in vivo is essential.</p>

Advances in cell components of bioartificial liver / 上海第二医科大学学报

The biological artificial liver(BAL) can offer reliable artificial liver support for the patients with hepatic failure.All BAL devices contain hepatocytes as their biological component,whose specific biological characteristics contribute to the function of the BAL.During the past two decades,various cells including human hepatocytes,heterogeneous hepatocytes and liver cell lines have been used and different culture methods have been studied to optimize the activity of the biological component.However,both functionality and safety of these cells should be improved before successful use in BAL. This paper summarizes the latest progress on it.

Advances of Abdominal Multivisceral Transplantation / 上海第二医科大学学报

Abdominal multivisceral transplantation is a new and proved effective therapeutic methods for two or more terminal abdominal organs. Upper abdominal exenteration(resection of the liver,stomach,spleen,pancreaticoduodenal complex,and part of the colon) for the treatment of otherwise unresectable tumors is one of the more radical operations in oncology.Some new surgical methods such as liver-intestinal,liver-kidney,pancreas-kidney and multivisceral cluster transplantation have emerged recently.These new advance surgical approache improve the curative effect of abdominal organ transplantation.

Study on the interface of human hepatocyte L-02 polypropylene:simple culture method of human hepatocyte with spheroidal aggregate culture / 中华外科杂志

<p><b>OBJECTIVE</b>To found new interface of human hepatocyte/poly propylene with good cytocompatibility for made polypropylene hollow fibers bioreactor of bioartificial liver in future.</p><p><b>METHODS</b>Using the macromolecular hydroperoxide groups on the polypropylene membrane surface as initiators, acrylamides were polymerized on the polypropylene membranes, under induction by both UV irradiation and Fe2+ reduction. Growth characteristics of human hepatocyte L-02 were detected when it was cultured on polystyrene, polypropylene and modified polypropylene membrane surface.</p><p><b>RESULTS</b>Water contact angle measurement of the polypropylene and the modified polypropylene membranes decreased from (72 +/- 5) degrees to (30 +/- 4) degrees , which indicated that the hydrophilicity of the membrane was improved obviously after the grafting modification. Human hepatocyte L-02 could not adhere and spread on modified polypropylene membrane surface, and grown in spheroidal aggregate with higher density and higher proliferation ratio measured by MTT method.</p><p><b>CONCLUSIONS</b>Acrylamide polymerized on the polypropylene membranes is a good method which not only improved human hepatocytes cytocompatibility but also found a new simple culture method with spheroidal aggregate culture of human hepatocyte.</p>