Clinical efficacy and prognostic factors of postoperative adjuvant radiotherapy for pediatric ependymoma / 中华放射肿瘤学杂志

Objective:To investigate the clinic opathological features, treatment and prognosis of children newly diagnosed with ependymoma.Methods:Clinical data of 127 pediatric ependymoma (EPN) patients (0-16 years old) treated with tumor resection and postoperative radiotherapy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University between 2001 and 2021 were retrospectively analyzed. Among them, 53 children were female and 74 were male. Local control (LR), event-free survival (EFS) and overall survival (OS) rates were analyzed by Kaplan-Meier method. The relationship between clinic opathological factors and clinical prognosis, and the effect of treatment on clinical prognosis of patients were analyzed by Cox proportional hazards model.Results:At a median follow-up time of 29 months (3-251 months), the 3-year OS and EFS rates were 89.5% and 71.5%, respectively. For patients undergoing incomplete resection followed by postoperative adjuvant radiotherapy, the 3-year LR, OS and EFS rates were 78.3%, 65.8% and 85.7%, respectively. A total of 43 children were aged <3 years old when diagnosed and 84 aged ≥3 years old. The interval time between surgery and radiotherapy in children aged <3 years old was 91 d, and 35.5 d in those aged ≥3 years old ( P<0.001). For patients <3 years old, the median EFS was 90 months when initiating radiotherapy within ≤70 d after surgery, compared to 43 months for those who initiated radiotherapy at >70 d after surgery ( P=0.053). According to fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5), 39 children were classified as posterior fossa ependymoma group A (PFA group). The OS and EFS rates in the PFA group were significantly less than those in other groups (3-year OS rate were 69.2% vs. 94.6%, P<0.001; 3-year EFS rate were 46.9% vs. 79.1%, P<0.001). In the PFA group, 12 patients received postoperative adjuvant chemotherapy, 14 did not receive chemotherapy, and whether chemotherapy was given was unknown in 13 cases. No significant differences were observed in OS and EFS between patients treated with and without chemotherapy ( P=0.260, P=0.730). Univariate Cox analysis showed that tumor location and WHO CNS5 molecular classification were significantly associated with EFS, and WHO CNS5 molecular classification was significantly correlated with OS. Multivariate Cox analysis showed that tumor location in the posterior fossa was an independent risk factor for EFS ( HR=2.72, 95% CI=1.1~6.71, P=0.03). Conclusions:Patients newly diagnosed with pediatric ependymoma can obtain favorable survival after surgery combined with postoperative adjuvant radiotherapy. Patients with residual tumors can achieve favorable LC and survival after postoperative adjuvant radiotherapy. Delaying of radiotherapy tends to lead to poor survival for patients aged <3 years old when diagnosed. Children in the PFA group obtain worse prognosis compared to their counterparts in other groups. The tumor location in the posterior fossa is an independent risk factor for pediatric ependymoma.

Epidemiological and etiological characteristics of active surveillance of foodborne illness / 公共卫生与预防医学

Objective To realize the epidemiological and pathogenic characteristics of foodborne illness in Shiyan in 2019 and provide targeted measures for the prevention and control work of the foodborne illness． Methods The active surveillance data of foodborne illness in shiyan in 2019 were collected and analyzed. The Salmonella strains isolated from the patients with foodborne illness were tested with serotyping，PFGE molecular classification and drug sensitivity test respectively according to《National foodborne illness surveillance workbook 2019》. Result A total of 3 191 cases of foodborne illness were analyzed. The pre-school children were the highest-risk group of foodborne diseases. Grain and grain product was the main suspicious contaminated food．The main location of eating place was family. A total of 330 samples were tested. The positive detection rate of foodborne illness was 20.30%（73/330）.The main pathogen were Rotavirus and Salmonella,and the detection rates were 11.21%(37/330) and 4.85%(16/330) respectively. The pre-school children were the group with the highest detection rate, which was 57.27% (63/110). The dominant serotype of the 14 Salmonella strains isolated from patients were Salmonella typhimurium and Salmonella enteritis. 14 different genotypes were obtained through PFGE classification and clustering. 64.29% (9/14) of Salmonella strains were multidrug-resistant strains. The drug resistance rates of ampicillin and tetracycline were the highest, which were 71.43%（11/14）and 64.29%（10/14）respectively. Conclusions The publicity and education of food safety should be strengthened and the surveillance network system of food-borne disease should be further improved according to the epidemiological and pathogenic characteristics of foodborne illness in Shiyan in 2019, and the use of clinical antibiotics should be controlled reasonably as well.

Clinical Application of the Next Generation Sequencing for Molecular Classification in Endometrial Carcinomas / 中山大学学报(医学科学版)

ObjectiveTo explore the clinical application of molecular classification in endometrial cancers with the next generation sequencing （NGS）. MethodsTotally 112 cases of endometrial carcinoma diagnosed by pathology in The Sun Yat-sen University Cancer Center were collected. All of them were tested by hybridized-capture second-generation sequencing based on 1，021 gene panel. The molecular variation spectrum of each subtype and its relationship between the clinicopathological features were analyzed. ResultsThe cases were distributed as follows： 8 （7.1%） POLE mutation， 34 （30.4%） mismatch repair deficient， 26 （23.2%） TP53 mutation， 44 （39.3%） non-specific molecular profile. The median tumor mutation burden was respectively 252.0， 38.4， 5.8 and 5.4 Muts/Mb. There were no significantly differences among four subtypes in clinicopathological features such as age， histological grade， lymph node metastasis and clinical stage. PTEN （75.5%）， PIK3CA （66.7%）， ARID1A （55.9%）， TP53 （40.2%）， NF1 （29.4%） were the most common mutations in endometrial cancers. ConclusionsThe utilization of NGS in endometrial cancers can simultaneously identify molecular subgroups， screen Lynch syndrome and obtain molecular variation spectrum， which can provide guidance for immunotherapy and targeted therapy， contribute to further accumulation and exploration of molecular genetic characteristics.

Temporal and spatial stability of the EM/PM molecular subtypes in adult diffuse glioma / 医学前沿

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.

Research advances in molecular classification for precision diagnosis and treatment of hepatocellular carcinoma / 中华消化外科杂志

Hepatocellular carcinoma (HCC), a highly prevalent malignancy and one of the leading cause of cancer death in China, remains a major public health problem in the next decades. Owing to the tremendous achievements in early diagnosis, precision liver surgery, molecular targeted therapy and immunotherapy, we have witnessed significant improvements in the long-time survival of HCC patients, if properly treated. However, HCC is a highly heterogeneous disease. Even for patients within the same clinical stage, their clinical outcome and treatment efficacy vary significantly. Great efforts to improve the molecular classification of HCC patients are needed to foster precision medicine, paving the way for novel therapeutic strategies. Advances in multi-omics, single-cell analysis, molecular imaging and artificial intelligence will lead to better understanding of the molecular classification and refine precision treatment in HCC, ultimately excluding this neoplasm from the risk list of our Healthy China.

Research advances in molecular classification for precision diagnosis and treatment of hepatocellular carcinoma / 中华消化外科杂志

Hepatocellular carcinoma (HCC),a highly prevalent malignancy and one of the leading cause of cancer death in China,remains a major public health problem in the next decades.Owing to the tremendous achievements in early diagnosis,precision liver surgery,molecular targeted therapy and immunotherapy,we have witnessed significant improvements in the long-time survival of HCC patients,if properly treated.However,HCC is a highly heterogeneous disease.Even for patients within the same clinical stage,their clinical outcome and treatment efficacy vary significantly.Great efforts to improve the molecular classification of HCC patients are needed to foster precision medicine,paving the way for novel therapeutic strategies.Advances in multi-omics,single-cell analysis,molecular imaging and artificial intelligence will lead to better understanding of the molecular classification and refine precision treatment in HCC,ultimately excluding this neoplasm from the risk list of our Healthy China.

Immunohistochemical profile and its association with clinicopathological parameters in carcinoma breast: a prospective study in central India

Background: Carcinoma breast is one of the most common malignancies of women in India. The current study was conducted with the objective of assessing estrogen receptor (ER), progesterone receptor (PR), Her-2/neu (human epidermal growth factor receptor-2) expression and Ki67 index of breast carcinomas and its correlation with histological grade, tumour size and lymph node metastasis.Methods: Forty-seven lumpectomy or modified mastectomy specimens diagnosed as Infiltrating duct carcinoma (IDC): NOS, were selected for panel of imuno histochemistry (IHC) markers on tissue microarray blocks prepared from each case.Results: Maximum of our patients belonged to premenopausal 24/47 (51%) and 20% to younger age group (<30 year). Tumour size of 2-5 cm was observed in maximum females 29 (61%); while 13(27%) had size >5.0cm. The majority of cases diagnosed as grade I (40%) and lymph node involvement was seen in 31/47 (65%). Molecular classification revealed 10 (21%) luminal A, 4 (8%) luminal B, 9 (19%) Her2/neu positive, while triple negative phenotype comprised of maximum 24 (51%) patients. Most of the Luminal group tumours were low grade (14/15); while majority of Her2/neu positive 7/9(77%) and triple negative tumours 19/24 (80%) belonged to higher grades.Conclusions: Breast carcinoma among our patient is characterized by a large percentage of triple negative phenotype that is less susceptible to hormonal therapy. The empirical treatment with tamoxifen should therefore be reconsidered as it would be less effective. Assessment of prognostic markers in breast carcinoma is strongly advocated in order to provide the best therapeutic options.

Molecular targeted therapy for hepatocellular carcinoma / 医学研究生学报

Hepatocellular carcinoma (HCC) is the fourth malignant tumor with the third mortality rate in China. Most patients have lost their chance of surgery at the time of diagnosis and are required to receive systemic treatment. The molecular targeted agent sorafenib has brought revolutionary progress for the treatment of advanced liver cancer. The latest diagnosis and treatment guidelines for hepatocellular carcinoma in China also recommend sorafenib as the first choice for systematic treatment of advanced liver cancer. With the gradual deepening of our understanding of the biology of hepatocellular carcinoma, the continuous accumulation of drug experience and the increasing perfection of clinical research system, molecular targeted agents and effective drug regimens for advanced hepatocellular carcinoma will appear in succession. This article reviews the progress in this field.

Expression of BRCA1 in sporadic invasive breast cancer and its significance / 医学研究生学报

Objective　BRCA1 is one of the most important susceptibility genes of breast cancer. The article aimed to investigate the expression of BRCA1 and its correlation in sporadic invasive breast cancer.　Methods　The expressions of BRCA1, ER, PR, HER2 and Ki67 in 618 cases of sporadic invasive breast cancer in our hospital from January 2015 to December 2017 were detected with immunohistochemistry in order to investigate and analyze the expression of BRCA1 and its correlation with molecular classification, histological type and other related molecular markers in sporadic invasive breast cancer.　Results　The positive rate of BRCA1 was 44.2% consisting of 30.3% weak positive(+) and 13.9% strong positive(++). The positive rates of ER, PR, and HER2 are 60.8%, 54.7%,and 24.9%. The proliferation index ≤30% of Ki67 was 70.7%, >30% was 29.3%. The expression of BRCA1 in luminal type A was significantly lower than the other four types of sporadic invasive breast cancer(P<0.05). The expression of BRCA1 in breast cancer with medullary histological features was significantly lower than those of the other types of breast cancer(P<0.05). There was significant difference between the expression of BRCA1 and the expressions of ER, HER2 and Ki67 (P<0.01). The expression of BRCA1 had positive correlation with expression of HER2 in sporadic invasive breast cancer (r=0.117,P<0.01).　Conclusion　The expression of BRCA1 in sporadic invasive breast cancer with triple negative subtype and medullary histological features is down-regulated and BRCA1 may affect the development and progression of sporadic invasive breast cancer.

Molecular diagnostics of lung cancer and its research progress / 中国实用内科杂志

Molecular markers are research hotspot in the field of malignant tumor research, and have important clinical significance for early diagnosis, prognosis monitoring and treatment of tumors. The precise treatment of individualized patients through molecular diagnosis has gradually become the consensus of clinical treatment of tumors. This article introduces the research progress of molecular diagnostic techniques in lung cancer.

Molecular classification of gastric cancer and individualized immunotherapy / 中国肿瘤生物治疗杂志

@#Gastric cancer (GC) is one of the malignant tumors with the highest morbidity and mortality in China, and conventional therapies such as surgery, chemotherapy and radiotherapy have limited curative effect on it. GC is highly heterogeneous. With the research on GC deepening into a molecular level and the rapid development of immunotherapy, individualized immunotherapy has become the most promising technology in the field of GC therapy. Several molecular classifications have been put forward in recent years, accurately as well as comprehensively depicting the genomic and molecular characteristics of GC. Moreover, molecular classifications also provided molecular immunological information of GC, which gave implications for the screening of benefit population and treatment decision-making. Based on the several existing GC molecular classifications, this review discussed the guiding significance of molecular classifications on the development and application of GC individualized immunotherapy.

Molecular classification and precision therapy of cancer: immune checkpoint inhibitors / 医学前沿

On May 23, 2017, the US Food and Drug Administration (FDA) approved a treatment for cancer patients with positive microsatellite instability-high (MSI-H) markers or mismatch repair deficient (dMMR) markers. This approach is the first approved tumor treatment using a common biomarker rather than specified tumor locations in the body. FDA previously approved Keytruda for treatment of several types of malignancies, such as metastatic melanoma, metastatic non-small-cell lung cancer, recurrent or metastatic head and neck cancer, refractory Hodgkin lymphoma, and urothelial carcinoma, all of which carry positive programmed death-1/programmed death-ligand 1 biomarkers. Therefore, indications of Keytruda significantly expanded. Several types of malignancies are disclosed by MSI-H status due to dMMR and characterized by increased neoantigen load, which elicits intense host immune response in tumor microenvironment, including portions of colorectal and gastric carcinomas. Currently, biomarker-based patient selection remains a challenge. Pathologists play important roles in evaluating histology and biomarker results and establishing detection methods. Taking gastric cancer as an example, its molecular classification is built on genome abnormalities, but it lacks acceptable clinical characteristics. Pathologists are expected to act as "genetic interpreters" or "genetic translators" and build a link between molecular subtypes with tumor histological features. Subsequently, by using their findings, oncologists will carry out targeted therapy based on molecular classification.

The influence of molecular classification of breast cancer on the safety of breast-conserving surgery / 中华肿瘤杂志

Objective@#To analyze the relationship between the breast cancer molecular classification and the prognosis of patients underwent breast-conserving therapy and to discuss the safety of the breast conserving surgery from the choice of operation in terms of breast cancer molecular classification.@*Methods@#Clinical data of 618 patients with breast-conserving therapy in Tianjin Medical University Cancer Institute and Hospital from August 2005 to August 2010 were analyzed retrospectively. According to the molecular classification when breast cancer was diagnosed, patients were subdivided into five groups, including Luminal A, Luminal B1, Luminal B2, HER-2-positive and Triple-negative. Clinicopathological characteristics and prognosis were compared among five groups and the influencing factors of local recurrence, distant metastasis and overall survival were analyzed.@*Results@#Among 618 patients, there were 148 cases Luminal A, 231 cases Luminal B1, 63 cases Luminal B2, 40 cases HER-2-positive and 136 cases Triple-negative. The age, family history, TNM stage, calcification, histological grade, pathological type and response to endocrine therapy of these 5 molecular types of breast cancer patients were significantly different (all P<0.05). The 5-year local regional recurrence-free survival rates of Luminal A, Luminal B1, Luminal B2, HER-2-positive and Triple-negative were 99.3%, 98.7%, 98.4%, 94.9% and 95.9%, respectively, without significant differences (P=0.104). The 5-year distant metastasis-free survival rates of these 5 types were 97.3%, 95.7%, 93.7%, 87.5% and 91.4%, respectively, with significant differences (P=0.013). Moreover, the 5-year overall survival rates of these 5 types were 98.6%, 97.8%, 98.4%, 92.5% and 95.6%, respectively, without significant differences (P=0.153). Multifactor analysis showed that radiotherapy (HR=0.036, P=0.049) and the number of lymph node metastases (HR=10.72, P=0.004) were independent factors of local recurrence of breast cancer patients underwent breast-conserving therapy. The age (HR=0.369, P=0.046), status of surgical margin (HR=5.486, P=0.007), number of lymph node metastases (HR=2.882, P=0.023) and molecular typing (HR=5.191, P=0.008) were independent factors of distant metastasis of above breast cancer patients. None of the factors were found to be independent factors of the overall survival of these breast cancer patients.@*Conclusions@#Breast conserving therapy does not increase the risks of local recurrence and death of HER-2-positive and Triple-negative breast cancer patients. Therefore, breast conserving therapy can be accepted by patients with HER-2-positive and Triple-negative breast cancer.

Characteristics of molecular typing and epidemic of norovirus infection in Wuhu region, 2017 / 中华实验和临床病毒学杂志

Objective@#To understand the status and genotype of norovirus in Wuhu, and provide the basic molecular epidemiological data for norovirus infection control and prevention, 2017.@*Methods@#Anal swab and vomit specimens were collected during outbreaks from patients, primarily using fluorescence quantitative PCR to preliminarily identify the genotype of norovirus; according to preliminary result , through their respective specific primer, RT-PCR was applied, and sequencing was done to identify virus genotypes. Sequence alignment and phylogenetic analysis of norovirus was performed by using biological software.@*Results@#Seventeen norovirus epidemics were observed in Wuhu area, a total of 137 specimens were collected. Real-time fluorescent quantitative PCR result showed that 77 specimens were norovirus nucleic acid testing positive, and all were GⅡ genotype. Through specific primers amplification, sequencing analysis showed that the 2017 outbreaks in Wuhu were caused only by two genotypes, GⅡ.3 and GⅡ. 2, including one case of GⅡ. 3, Six cases of GⅡ.2, and 10 epidemic aggregations, 8 cases of GⅡ. 2, and there were two cases of G Ⅱ. 4 Sydney 2012.@*Conclusions@#Norovirus GⅡ.2 genotype was dominant in norovirus outbreaks and the aggregation epidemics, other genotypes were occasionally seen in Wuhu, 2017.

Molecular classification of endometrial cancer and its association with PD-1/PD-L1 blockade / 中国免疫学杂志

Endometrial cancer is one of the three common cancer of the female genital tract. According to the molecular char-acteristics of endometrial cancer.The cancer genome atlas proposed four molecular subtypes:POLE (DNA polymerase ε,POLE) mutant;microsatellite instability hypermutation;low copy number and high copy number/serous. Numerous preclinical and clinical researches indicated that PD-1/PD-L1 blockade therapy is a promising method for immunotherapy of endometrial cancer. The subtypes of POLE mutant and MSI hypermutation in endometrial cancers are characterized by high tumor mutation burden which may benefit from the treatment of PD-1/PD-L1 blockade. This molecular classification of endometrial cancer provides a new clinical treatment strategy for individualized immunotherapy.

Research progress of translational medicine for gastric cancer / 中华消化外科杂志

Gastric cancer is one of the most common malignant digestive tumors globally.The comprehensive treatment based on surgery of gastric cancer can not satisfy the purpose to reduce morbidity and mortality.In recent years,translational medicine has emerged with the rapid development of basic medical research,such as molecular biology,and the change of medical patterns.The core of translational medicine is to establish a fast conversion channel between basic research and clinical applications which could translate basic research results into theories,technologies and products for clinical practice.In the present paper,the research progress of translational medicine in the diagnosis and treatment of gastric cancer will be summarized,and the role of translational medicine for precise treatment of gastric cancer will be discussed.

Expression of EGFR in breast cancer and its correlation to molecular subtyping and hormone receptor status / 中华内分泌外科杂志

Objective To study the expression of epidermal growth factor receptor 1 (EGFR) protein in breast cancer and its correlation to molecular subtyping and hormone receptor status.Methods 467 cases of breast cancer were included.According to ER,PR,HER2,and Ki-67 status,the cases were categorized into 4 molecular subtypes,including 185 cases of luminal A,109 cases of luminal B,76 cases of HER2-enriched,and 70 cases of triple-negative breast cancer (TNBC).According to ER and PR status,the cases were divided into 4 subtypes,including 240 cases of ER+/PR+,50 cases of ER+/PR-,4 cases of ER-/PR+,and 173 cases of ER-/PR-.Results EGFR protein expression rates in Luminal A,Luminal B,HER2-enriched and TNBC were 16.8％(31/185),54.1％(59/109),97.4％(74/76),78.6％(55/70),respectively.The EGFR expression in HER2-enriched was significantly higher than those in TNBC,Luminal B and Luminal A(P＜0.01),and EGFR expression in TNBC was significantly higher than those in Luminal B and Luminal A (P＜0.01),furthermore,EGFR expression in Luminal B was significantly higher than that in Luminal A (P＜0.01).EGFR protein expression rates in ER+/PR+ subtype,ER+/PR-subtype,ER-/PR+ subtype and ER-/PR-subtype were 25.4％ (61/240),52.0％ (26/50),75.0％ (3/4),88.4％(153/173),respectively.The EGFR expression in ER-/PR-subtype was significantly higher than in ER+/PR+ subtype and ER+/PR-subtype (P＜0.01),and EGFR expression in ER+/PR-subtype was significantly higher than that in ER+/PR+ subtype (P＜0.01).EGFR protein expression rate was higher in ER-/PR-subtype than in ER-/PR+ subtype,and EGFR protein expression rate was higher in ER-/PR+ subtype than that in ER+/PR+ subtype and ER+/PR-subtype,but all of the difference were not statistically significant (P＞0.05).Conclusion EGFR protein expression is closely related to breast cancer molecular subtyping and negative hormone receptor expression,which is a potential biomarker of anti-breast cancer therapy.

The progress and challenges of precision oncology / 复旦学报（医学版）

Precision oncology is applying established clinic-pathological indexes with molecular profiling to create diagnostic,prognostic,and therapeutic strategies precisely tailor to each patient's requirements.It includes precision prevention (cancer risk detection and prophylactic intervention),precision diagnosis (early detection and diagnosis,molecular classification),and precision treatment (molecular targeted therapies,predicting and monitoring treatment response and precision surgery based on the combination of visual,cytology,pathologic review,as well as molecular profiling assessments).Understanding of cancer and clinical decision making from the molecular level is necessary in era of precision oncology.Many challenges,including the heterogeneity and dynamic evolution of cancer cells,few understanding about cancer biology,pairing the massive genomic data with inaccurate clinical information,limited sensitive drugs and unexplained resistance,insufficient cancer biomarkers for precision diagnosis and treatment,have to be overcome before it can be clinical routines.

Clinical value and toxicities of docetaxel plus capecitabine in the first line treatment of metastatic breast cancer / 国际肿瘤学杂志

Objective To evaluate the clinical value and toxicities of docetaxel plus capecitabine in the first-line treatment of metastatic breast cancer (MBC),and compare the outcomes among different molecular subtypes.Methods A total of 108 patients with MBC who received docetaxel plus capecitabine combination treatment between January 1,2012 and December 31,2015 in Bejing Chaoyang District Sanhuan Cancer Hospital were retrospectively analyzed,and 104 cases were available for evaluation.The clinicopathological characteristics,clinical value and toxicities of these patients were evaluated.Results The patients were divided into 3 molecular subtypes,among 104 patients,85 patients in Luminal subtype,14 patients in triple negative breast cancer (TNBC) subtype,and 5 patients in human epidermal growth factor receptor-2 (HER-2) over expression subtype.The treatment achieved objective responses (OR) in 55 patients (52.9％),and the disease control rate (DCR) was 88.5％,including complete response (CR) in 4 patients,partial response (PR) in 51 patients,stable disease (SD) in 37 patients,and progressive disease (PD) in 12 patients.In Luminal subtype,4 patients achieved CR,43 PR,33 SD,and 5 PD.In TNBC subtype,6 patients achieved PR,3 SD,5 PD.In the HER-2 over expression subtype,2 patients achieved PR,1 SD,2 PD.There was no significant difference in the short-term therapeutic effect among 3 molecular subtypes (x2 =4.429,P =0.106).As a result,the progression-free survival (PFS) of the 104 patients was 1.5-121.0 months,and the median PFS was 10.0 months.The median PFS was 11.0 months in Luminal subtype,4.0 months in TNBC subtype and 10.3 months in HER-2 over expression subtype,with a significant difference (x2 =7.510,P =0.006).The most common adverse events were hand-foot syndrome (HFS),nausea or vomiting,neutropenia,anaemia,diarrhea and so on.The incidence of grade 2/3 HFS was 44.2％ (46/104),and the grade 3/4 neutropenia was 39.4％ (41/104).Conclusion The first-line treatment of MBC using docetaxel plus capecitabine is effective,and the toxicities can be tolerable,especially in the Luminal subtype.

Correlations Between Mammography and Ultrasound and Molecular Classification of Breast Infiltrating Ductal Carcinoma in Young Women / 医学研究杂志

Objective To determine the correlations between breast ultrasonic and mammographic features and molecular classification of breast infiltrating ductal carcinoma in young women.Methods A retrospective review of radiological,clinic-pathology features of breast cancers for women under 40 years at our hospital between January 2011 and May 2016 covering 94 patients.Mammography and ultrasound were available for all 94 patients.Results On sonography,basal like type tumours more often appeared as oval or round masses and microlobulated or indistinct margins luminal type irregular mass and angular or spiculated margins(P =0.000,P =0.000).Basal like type masses were often with abrupt interface,luminal A type with echogenic halo (P =0.000).On mamography,HER-2 enriched type cancers more presented as microcal cification only,basal likc type more masses(P =0.002).Luminal typc masses were more often with spiculated or obscured margins,basal like with indistinct margins(P =0.000).Conclusion The imaging charasteristics of breast infiltrating ductal carcinoma in patients under 40 years appear correlated to breast infiltrating ductal carcinoma.