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With the application of high throughput sequencing and other technologies, in recent years people have found that bacteria are not only the causative factors of common breast diseases such as mastitis, but also may be involved in the occurrence and development of breast cancer. There are unique bacterial communities in the internal tissues of the breast, and their existence may be related to the incidence of breast cancer. Recent studies have found that intestinal flora may also affect the incidence of breast cancer by regulating estrogen and other pathways. Further exploration of the influence of bacteria on breast cancer will provide new ideas for diagnosis and treatment of breast cancer.
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Ductal carcinoma in situ (DCIS) is a precursor of invasive ductal breast cancer,and up to 40％ of these lesions will progress to invasive disease if untreated.The micro-environment,genetic aberrations,signal pathways and epigenetics play important roles during the infiltration and transformation of DCIS.Further studies of the infiltration and transformation of DCIS will promote the accurate assessment and prognosis prediction of the patients with DCIS,for finding a comprehensive evaluation standard and the balance between the over and low treatment.
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The treatment of breast cancer is becoming more individualized and minimally invasive,which makes sentinel lymph node biopsy becoming the standard treatment for axillary in patients with early-stage breast cancer who are negative in clinical axillary lymph nodes.Tracers image sentinel lymph nodes or lymphatic vessels for the successful detection of sentinel lymph node biopsy.Tracers selection is also more diverse,such as nano carbon mixed suspension,methylene blue,radioisotope,indocyanine green,etc.Different tracers and combined applications have their advantages and limitations.As for the selection of tracing methods,many factors need to be weighed.
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The understanding of the biological behavior of breast cancer has deepened, hence, local treatments for breast cancer have changed from resection to minimally invasive surgery. For patients with early breast cancer, constructing a minimally invasive interven-tion with low systemic toxicity is a problem, especially for cases involving precancerous lesions. Intraductal therapy for breast cancer, which is performed by inserting reagents through breastfeeding openings using suitable carriers, is a promising, accurate, and minimal-ly invasive method for breast cancer prevention and treatment. The combination of intraductal therapy with new therapeutic strate-gies, such as targeted therapy, endocrine therapy, and immunotherapy, might improve the therapeutic effect. Moreover, the mecha-nisms of intraductal therapy for breast cancer incorporate nanotechnology, molecular imaging, and gene sequencing. Intraductal thera-py is based on clinical and pathologic characteristics of Chinese breast cancer patients, and such characteristics must be determined prior to clinical application. This article mainly discusses the research progress of breast intraductal intervention.
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Objective To analyze the clinicopathological characteristics of patients with benign thyroid nodules(BTN) and thyroid carcinoma(TC),and explore the clinical value of fine-needle aspiration biopsy (FNAB)in diagnosis of TC.Methods A retrospective analysis was conducted on the data of 2918 cases with thyroid carcinoma,who underwent surgery in the People's Hospital of Wuhan University between January 2011 and February 2015.Results Patients aged younger than 45 years old accounted for 26.23％ and 51.26％ in BTN group and CT group,respectively,and the difference between the two groups were statistically significant (P ＜ 0.05).Male patients accounted for 16.82％ and 20.15％ in BTN group and CT group,respectively,and the difference between the two groups were statistically significant (P ＜ 0.05).Patients with family history of thyroid related diseases accounted for 2.93％ and 3.70％ in BTN group and CT group,respectively,and there was no statistically significant difference between the two groups (P ＞ 0.05).Patients with solitary lesion accounted for 40.42％ and 47.95％ in BTN group and CT group,respectively,and the difference between the two groups were statistically significant(P ＜ 0.05).Af ter the application of FNAB,the percentage of the patients diagnosed with TC was increased by 4.83％ (P ＜ 0.05),and the diameter of nodular was increased by 4 cm (P ＜ 0.01).Conclusion Patients with TC have a characteristic of earlier onset age,higher proportion of male patients and lower incidence of multifocality compared with patients with BTN.There was no statistically significant difference between the TC group with family history of thyroid related diseases and the BTN group.The application of FNAB avoids of unnecessary surgeries on some BTN patients with small pathological diameter of nodule,it is important for preoperative diagnosis of thyroid nodules.
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Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration(FNA) and core needle biopsy(CNB).Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected.Cytology,histopathology,and postoperative results were compared with postoperative pathology as the gold standard.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate,false negative rate of FNA and CNB were 91.5％ vs 87.9％,93.2％ vs 87.5％,87.0％ vs 88.9％,94.8％ vs 95.5％,83.3％ vs 72.7％,13.0％ vs 11.1％,6.8％ vs 12.5％,respectively.There was no significant difference between FNA and CNB (P＞0.05).Conclusion Both of FNA and CNB examination show high accuracy,sensitivity and specificity in diagnosis of benign and malignant thyroid nodules,but FNA is more economical,safe,convenient and thus has more extensive clinical application.For lymphoma or borderline tumor,CNB examination combined with immunohistochemistry is of more advantages.
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Objective To evaluate the expression of p53 in triple negative breast cancer( TNBC) and its impact on the prognosis of TNBC systematically. Methods Documents published on PubMed, Medline,CNKI,CNKI,Wanfang data,and VIP data were screened for relative researches. Two reviewers filtered,extracted and assessed the literatures according to the inclusion criteria and exclusion criteria. The meta analysis was conducted by using RevMan5. 0 software. Result A total 13 trails were included,con-taining 11 Chinese documents and 2 English documents. The meta analysis showed that p53 is significantly expressed in TNBC[OR=2. 02,95%CI(1. 28,3. 19)]. TNBC patients with positive p53 expression had higher rates in lymph node metastasis[OR=2. 02,95%CI(1. 28,3. 19)],recurrence[OR=3. 39,95%CI(1.45,7. 90)],metastasis[OR =2. 65(1. 36,5. 18)],disease-free survival[OR =0. 29(0. 18, 0. 47)]and overall survival[OR=0. 29(0. 18,0. 47)]than patients with negative p53 expression. Con-clusion p53 is overexpressed in TNBC,which plays a certain role in guiding the clinical prognosis of TN-BC. It can be regarded as an independent factor to evaluate the prognosis of TNBC,and a therapeutic tar-get in further studies.
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Sentinel lymph node biopsy has been generally accepted as a method for nodal staging in patients with early-stage breast cancer. Patients with negative results of sentinel lymph node biopsy can avoid axillary lymph node dissection and its adverse outcomes. With the development of technology,the in-dications of sentinel lymph node biopsy expand,but its appliance in breast cancer patients with neoadjuvant chemotherapy still remains controversial. This paper reviews the feasibility and timing of sentinel lymph node biopsy for breast cancer patients with neoadjuvant chemotherapy.
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Objective To systematically evaluate the effectiveness and safety of axillary lymph node dissection for breast cancer patients with negative sentinel node biopsy.Methods Literatures in CNKI,PubMed,EMBASE and CBMwere searched from their establishment to December 1,2013.Accord-ing to the inclusion and exclusion criteria,trials of axillary lymph node dissection and sentinel node biopsy for breast cancer were strictly screened and extracted for quality assessment and result analysis.Meta-anal-ysis was conducted by using Revman 5.1 software.Results A total of 10 studies involving 7731 patients were eligible for the final analysis.Because of the large differences in research type,measurement indica-tor,follow-up period and statistical index,subgroup analysis was adopted.Meta-analysis was applied for homogeneous researches and the remaining studies were analyzed with qualitative descriptive analysis.The results showed no significant differences in disease-free survival,overall survival,local recurrence rate,and distant metastasis rate in different follow-up periods.Conclusion For breast cancer patients with single invasive lesion,axillary lymph node dissection is not necessary.More high-quality random control trials and long-term follow-up are required to confirm the conclusions of this systematic review.
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Objective:To investigate the incidence trends and clinicopathologic characteristics of papillary thyroid cancer (PTC). Methods:A retrospective analysis was conducting using the following data:3,766 cases with thyroid disease in the People's Hospital of Wuhan University between January 2001 and July 2013;and 977 cases with thyroid cancer in the Hubei Cancer Hospital between Janu-ary 2006 and July 2013. Results:The incidence of thyroid cancer increased significantly since 2008, ranging from 14.94%to 18.10%(P1 cm tumor diameter and multifocal PTC are more likely to be complicated with NLNM.
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Objective By using quantum dots-based double-color imaging method to simultaneously label human epidermal growth factor 2 (HER2) on breast cancer cell membrane and the type Ⅳ collagen in the extracellular matrix.To monitor the degree of malignancy of breast cancer and the invasive and metastatic potential.Methods The co-expressions of HER2 and the type Ⅳ collagen in breast cancer of 54 cases were detected and quantified by quantum dots-based double-labeling immunofluorescent histochemistry,and its correlation with clinical pathology parameters and prognosis were analyzed.Results With the increasing HER2 expression level,a progressive decrease in collagen Ⅳ around the cancer nest,the expression of HER2 and the type Ⅳ collagen value was negatively correlated (r =-0.980,P ＜ 0.05) ; the expression of HER2 and collagen Ⅳ was associated with lymph note metastasis,pathological stage (TNM) and disease-free survival(P ＜ 0.05).The expression of HER2 and the type Ⅳ collagen between different age groups,menopause and estrogen receptor (ER) and progesterone receptor (PR) were not significantly different (P ＞ 0.05).Conclusions Quantum dots-based double-color imaging method provides direct observable evidence to support the degradation of HER2 and the type Ⅳ collagen expression,which may help in determining the degree of malignancy and evaluating prognosis.
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Objective To analyze the relationship between preoperative biochemical indexes and effect ofpostoperative first 131I internal irradiation for differentiated thyroid carcinoma. Methods One hundred and eighty patients of thyroid carcinoma within the first 131I internal irradiation postoperative. According to curative effect were divided into effective group (96 cases) and invalid group (84 cases) and their clinical data were retrospectively analyzed. Results The preoperative serum alkaline phosphatase (AKP) and thyroid-stimulating hormone (TSH) in effective group and invalid group were respectively (74.83 ± 19.77),(65.50 ± 11.84) U/L and (3.12 ±0.59), (2.57 ±0.56) mU/L. There were significant difference (t =3.77,6.39, P < 0.01) between two groups. Conclusion The levels of preoperative serum A KP and TSH are important factors to influence the effect of postoperative first 131I internal irradiation for differentiated thyroid carcinoma.
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Objective To study the effect of lentivirus-mediated CCL5-RNAi on the biological behaviors of human breast cancer cells. Methods CCL5-specific siRNA gene was synthesized and cloned into the recombinant lentiviral vector, pGCSIL-GFP. Human high-metastatic breast cancer cells, MDA-MB-231, were infected by CCL5-siRNA recombinant lentivirus, which was set as KD group. Cells infected with CCL5-NC was as NC group, and cells cultured was as CON group. The expression of CCL5 mRNA and protein in MDA-MB-231 cells was detected by RT-PCR and western blot, respectively. Cell growth suppression and cell cycle was observed by MTT assay and fluorescence activated cell sorting (FACS). Colony formation and migration ability were determined by colony-rorming assay and Boyden chamber method. Results After infection of CCL5-siRNA recombinant lentivirus, the expression level of CCL5 mRNA and protein in MDA-MB-231 cells as well as the colony formation and migration ability decreased significantly, but cell's proliferation was not affected obviously. Compared with MDA-MB-231 (0.88± 0.15) and MDA-MB-231/CCL5-NC (1.00±0.07) cells, the expression of CCL5 mRNA in MDA-MB-231/ CCL5-siRNA decreased to 0.18±0.03, P<0.01. Compared with MDA-MB-231/CCL5-NC (1.82±0.18) cells, the expression of CCL5 protein in MDA-MB-231/CCL5-siRNA decreased to 0.33±0.13, P <0.01. Colony-forming assay and Boyden chamber method showed that the colony formation and migration ability of MDA-MB-231/CCL5-siRNA decreased markedly (P<0.05). The clone count in KD group was (0.33± 0.10), which was a significant decrease from (0.97±0.09) (NC group) and (1.04±0.07) (CON group), P<0.05. The number of cells that migrated through the chamber membrane of KD group (38± 15) was less than that of NC group (77±11, P <0.05) and CON group (69±9, P <0.05). However, MTT assay and FACS revealed that the proliferation of MDA-MB-231/CCL5-siRNA was not different from MDA-MB-231/CCL5-NC and MDA-MB-231 (P>0.05), the proliferation index (PI) of group KD, NC and CON were (0.48±0.02), (0.44±0.05) and (0.47±0.02) respectively. The difference was not statistically significant by multiple comparison (P>0.05). Conclusion CCL5-specific siRNA can specifically suppress the colony formation and migration of human high-matastatic breast cancer cells.
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Objective To study the role of membrane cytoskeleton linker Ezrin in the growth and metastasis of human breast carcinoma cell line MCF-7.Methods Small interfering RNA(siRNA)targeting Ezrin were transfected into MCF-7 cells.RT-PCR and Western blot were used to detect the down-regulation of Ezrin mRNA and protein.MTT method was used to detect the proliferation of the cells.Flow cytometry was used to detect the cell cycle.Transwell assay was used to detect the migration ability of the transfected MCF-7 cells.Results RT-PCR and Western blot results revealed that Ezrin siRNA down-regulated Ezrin expression at both mRNA and protein levels.Down regulation of Ezrin expression decreased the proliferation rate of the cell line(t=4.479,P＜0.01).The cell proportion in G2-M phase (t=-5.997,P＜0.01)and the invasion ability(t=5.268,P＜0.01)decreased significantly.Conclusion Ezrin plays an important role in the process of proliferation,migration,and invasion of MCF-7 cells.
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Objective To establish and apply the systemic caring and nursing model,the five-heart nursing service model. Methods The five-heart nursing service content was designed,the five-heart nursing service organization was perfected,the five-heart nursing service manual books were compiled and the satisfaction questionnaires for five-heart nursing service were designed.Three tryout departments were selected and the nursing staff was trained by human theory and five-heart nursing service amenity and flow according to the five-heart nursing service requirement. Results The patients satisfaction degree, medical entanglemant complaint and praise after the application of five-heart nursing service were greatly improved compared with those of before its application (P ＜ 0.05). Conclusion The application of five-heart nursing service supplied systemic caring and nursing for patients and it proved effective to improve patients satisfaction degree.