Different protein spectrum of breast cancer tissues in predicting curative effects of neoadjuvant chemotherapy / 中华内分泌外科杂志

Objective To find out related proteins that could possibly predict curative effects of neoadjuvant chemotherapy(NACT) by applying surface-enhanced laser desorption/ionization time-of-flight mass spectrometry(SELDI-TOF MS)to detect the difference in protein spectrum of breast cancer tissues.Methods Cancer tissue samples from 30 cases of breast cancer patients were detected by SELDI-TOF MS before NACT to get protein spectrum of breast cancer tissues.After NACT,the curative effects were evaluated according to RECIST standard and patients were divided into effective group(19 cases with complete response or partial response)and invalid group (11 cases with stable disease or progressive disease).Results 11 different protein peaks (P ＜ 0.05) were screened out:3491 Da(t =3.189 P =0.004),5158 Da(t =3.897 P =0.001),5360 Da(t =2.157 P =0.04),7549 Da(t =2.173 P=0.038),8451 Da(t =2.258 P =0.032),8694 Da(t =3.234 P =0.003),9089 Da (t =2.653 P =0.013),10528 Da(t =3.127 P =0.004),13445 Da(t =2.231 P =0.034),15118 Da(t =3.255 P =0.003),and 44065 Da(t =2.554 P =0.017).They were all expressed higher in effective group than in invalid group.The difference had statistical significance(P ＜ 0.05).Conclusion SELDI-TOF MS technology can screen out protein spectrum sensitive to NACT,providing evidences for breast cancer patients whether or not taking NACT.

Value of doppler ultrasound hook-wire-guided suspicious node biopsy in early breast cancer / 中华内分泌外科杂志

Objective To explore ideal surgical axillary management of early breast cancer,and to determine the feasibility of reducing false negative rate of sentinel lymph node biopsy(SLNB)by combination of axillary suspicious lymph node biopsy and SLNB.Methods From Jan.2008 to Oct.2009,42 consecutive cases with early breast cancer were enrolled.All patients underwent suspicious node hook-wire location by doppler ultrasonography before operation.SLNB and suspicious lymph node biopsy were performed during operation.Complete axillary nodes dissection(ALND)or level II dissection would be conducted according to the biopsy result.The difference of node status prediction between SLNB and SLNB with axillary suspicious lymph node biopsy and was compared.Results All the 42 cases successfully underwent SLNB (100%).There were 2 false negatives occurred in SLNB,resulting in false negative rate of 11%,sensitivity of 88.9%and accuracy of 95.2%in predicting axillary nodes status.By contrast,SLNB with axillary suspicious node biopsy showed a false-negative rate of 0%,sensitivity of 100%,and accuracy of 100%.Conclusions Compared to SLNB in early breast cancer,combination of suspicious node biopsy and SLAB has a tendency of reducing false negative rate.However,Because of the limited samples,the difference has no statistical significance(P=0.2500).

Treatment of differentiated thyroid carcinoma / 中国普通外科杂志

Objective To study the treatment of differentiated thyroid carcinoma. Method The clinical data and, in partricular, the treatment modalities of 173 cases of differentiated thyroid carcinoma were retrospectively analyzed.Results All of the 173 patients were treated by resection and subsequent endocrine therapy.Different types of operations were selected in accordance with the clinical stages.No perioperative deaths occurred.There were altogether 30 operative complications including nerve injury.Ninety-one patients were followed up for over 5 years and no deaths occurred.Jugular lymphatic metastases occurred in 4 patients, sternum metastases in 2 and lung metastasis in 1.Conclusion Surgical resection and endocrine therapy are highly effective for the treatment of differentiated thyroid carcinoma.

Treatment of inflammatory breast cancer / 中国普通外科杂志

Objective To evaluate the effect of combined therapy for inflammatory cancer of breast (ICB). Methods A retrospective analysis was made on the clinical manifestation, pathological type and treatment modalities of 25 patients with ICB from 1985 to 2000.Results All of the 25 patients were treated with mastectomy, including typical Halsted mastectomy in 12 cases, typical Halsted mastectomy with reconstruction of latissimus dorsi flap in 4, and palliative mastectomy in 9. Of the 21 patients 20 received preoperative chemotherapy; and all the 21 patients received postoperative chemotherpyl; while hormonal therapy was used in 11 cases. A mean survival was 23 months (0.5～5years) in 14 followed up patients; and now 5 patieats remain alive (2months～5 years). Conclusions A combined therapy consisting of chemotherapy, surgery and hormonal therapy may improve the prognosis of ICB.

Hyperthyroidism companied with thyroid carcinoma / 中国普通外科杂志

Objective To study the diagnosis and treatment of hyperthyroidism companied with thyroid carcinoma . Methods The clinical data of 11 cases of hyperthyroidism with thyroid carcinoma were retrospectively analysed. Results 9 of 11 cases were diagnosed preoperatively,and comfirmed by frozen section intra-operatively and underwent suitable operation. In the other two cases the final diagnosis was made by pathological examination postoperatively, and re-operation was performed on 1 case . All the patients were followed up for 1～16 years and neither hyperthyroidism nor thyroid carcinoma recurred. Conclusion It is difficult to make diagnosis of hyperthyroidism with thyroid carcinoma preoperatively. B mode ultrasonography may find some nodes in enlarged thyroid; but fine needle aspisation biopsg(FNA) has high false negative diagnostic rate. Intra-operative frozen section examination is important in the diagnosis of hyperthyroidism with thyroid carcinoma .