Clinicopathologic analysis of the nipple-areolar complex occult involvement in early stage breast carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to investigate the incidence of nipple-areola complex (NAG) involvement in stage I - II a breast cancer patients who underwent skin-sparing mastectomy and to determine the associated risk factors, to provide a theoretical basis for modified radical mastectomy preserving NAC and breast reconstruction in early stage breast cancer patients.</p><p><b>METHODS</b>A total of 68 women with primary breast cancer were included in this study. The following associated risk factors of NAC involvement were assessed and compared with those of non-involvement: the distance from the tumor site to the edge of areola (D), axillary lymph node status, over-expression of HER-2/neu, location of tumor, TNM stage, abnormal nipple (nipple indentation, erosion, discharge), tumor size, age, histological type, as well as status of estrogen receptor (ER) and progesterone receptor (PR), by Chi-square test.</p><p><b>RESULTS</b>The positive rate of NAG involvement was 13.2%. It decreased with an increase in the distance from the tumor site to the edge of the areola (D) (chi2 = 10.68, P <0.01)), and higher incidence of NAG involvement was found in patients with axillary lymph node metastasis (chi2 = 14. 61, P < 0.01) and over-expression of HER-2/neu (chi2 =6.83, P <0.01). Location of tumor (P <0.01), TNM stage (chi2 =3.85, P <0.05), abnormal nipple (chi2 = 11.65, P<0.01), and tumor size (chi2 =4.13, P <0.05) also had influence on the NAG involvement. No significant correlation between NAC involvement and age (P > 0.05)), histological type (chi2 = 0.07, P > 0.05)), as well as status of estrogen receptor (ER) (chi2 = 0.06, P > 0.05) and progesterone receptor (PR) (chi2 = 0.04, P > 0.05) was found. Most of the NAG involvement was caused by ductal infiltration.</p><p><b>CONCLUSION</b>In the stage I - II a breast cancer patients, location of tumor, TNM stage, the distance from the tumor site to the edge of areola (D), abnormal nipple, over-expression of HER-2 and metastases in axillary lymph nodes are the primary influential factors of NAG involvement.</p>

A clinic study of cervical lymph node metastasis in well-differentiated thyroid carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To study the distribution of cervical lymph nodes metastasis and explore the surgical treating modality of cervical lymph nodes in the patients with differentiated thyroid carcinoma.</p><p><b>METHODS</b>The clinic and pathological data of 104 patients with differentiated thyroid carcinoma who had undergone neck lymph nodes dissection from January 2003 to June 2007 were analyzed retrospectively. There were 29 male and 75 female patients. The age of the patients was 12 to 79 years old with a median of 39 years old. Patients were divided into clinic cervical lymph nodes metastasis (cN+) group and clinic no cervical lymph nodes metastasis (cN0) group according the condition of physical examination and image analysis preoperatively and compared respectively with pathological data postoperatively.</p><p><b>RESULTS</b>In the cN+ group 91.3% (63/69) patients were pN+ while in the cN0 group 52.1% (25/48) patients were pN+. The distribution of metastasized lymph nodes: level VI 64.1%, level II 31.6%, level III 44.4%, level IV 40.2%, level V 12.0%, level I 3.2%. In the cN+ group 86.7% (54/63) patients with lymph nodes metastasis had multi-levels lymph nodes metastasis while in the cN0 group 64.0% (16/25) patients had single-level lymph nodes metastasis.</p><p><b>CONCLUSIONS</b>Cervical lymph nodes metastasis in the patients with differentiated thyroid carcinoma mainly localize in level II, level III, level IV, level VI, especially level VI. Patients with lymph nodes metastasis had multi-levels lymph nodes metastasis in the cN+ group but single-level in the cN0 group. The surgical treating modality of cervical lymph nodes should also be different in the two group patients.</p>