Study on the relationship between lymphovascular invasion and non-sentinel lymph node metastasis in early-stage breast cancer with positive sentinel lymph node / 肿瘤研究与临床

Objective:To explore the relationship between lymphovascular invasion and non-sentinel lymph node (NSLN) metastasis in early-stage invasive breast cancer with positive sentinel lymph node (SLN) and its significance.Methods:The clinicopathological data of 79 patients with stage cT 1-2N 0M 0 invasive breast cancer who had positive SLN by biopsy and underwent axillary lymph node dissection (ALND) from January 2015 to February 2021 in the Central Hospital of Wuhan were retrospectively analyzed. The correlation between patients' clinicopathological characteristics and NSLN metastasis was analyzed. Results:Among 79 patients, 58 patients (73.4%) underwent total mastectomy, 61 patients (77.2%) were Luminal type, 38 patients (48.1%) had lymphovascular invasion, 64 patients (81.0%) had 1-2 positive SLN, and 42 patients (53.2%) with NSLN metastasis were found after ALND. Univariate analysis showed that the proportions of patients with lymphovascular invasion diagnosed by immunohistochemistry [86.8% (33/38) vs. 51.2% (21/41)], Ki-67 positive index>30% [60.5% (23/38) vs. 36.6% (15/41)], positive human epidermal growth factor receptor 2 [36.8% (14/38) vs. 14.6% (6/41)], and elevated lymph node pathological staging [57.9% (22/38) vs. 31.7% (13/41)] in the lymphovascular invasion group were higher than those in the non-lymphovascular invasion group (all P < 0.05). Multivariate logistic regression analysis showed that lymphovascular invasion was an independent risk factor for NSLN metastasis ( OR = 2.935, 95% CI 1.081-7.970, P = 0.035). Conclusions:Lymphovascular invasion is an independent risk factor for NSLN metastasis in SLN-positive stage cT 1-2N 0M 0 invasive breast cancer. It may help to guide the decision-making of local axillary treatment, so as to avoid over or under treatment.

Advance of Forensic Research in Insulin Poisoning / 法医学杂志

Insulin as a com m on clinical hypoglycem ic agent can effectively control serves to low er the concentration of blood glucose. H ow ever, insulin overdose can lead to death. In the w hole fatal cases of insulin overdose, m edical accident is the m ost com m on, follow ed by suicide. T hough insulin hom icide is extrem ely rare, it deserves great attention. T hough there are som e researches about insulin poisoning on forensic toxicology and pathology, it is still a difficult task in forensic practice. In this paper, the m ech-anism of death, pathological changes, detection m ethods and diagnose criteria of insulin overdose w ill be discussed in the view of forensic toxicology and pathology. W e hope that this paper could enhance rela-tive know ledges of insulin poisoning for m edical exam iners.

Progress in the research of diagnosis of amniotic lfuid embolism based on the methodologies in forensic medicine / 中国法医学杂志

Amniotic lfuid embolism refers to the accessible amniotic lfuid component of maternal circulation leading to a series of severe symptoms, such as pulmonary embolism, shock or even death. Up till now, AFE is a diagnosis of exclusion. The sensitivity and specificity of these methods were poor. With the increasing maternal mortality caused by AFE in forensic medicine, it is important to seeking for more precise diagnosis method. This review intends to provide methodological reference for forensic identification through the research progress of the diagnosis of AFE.