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Breast cancer is a malignant tumor that seriously endangers women's lives. The prognosis of breast cancer patients differs among molecular types. Compared with other subtypes, triple-negative breast cancer (TNBC) has been a research hotspot in recent years because of its high degree of malignancy, strong invasiveness, rapid progression, easy of recurrence, distant metastasis, poor prognosis, and high mortality. Many studies have found that long non-coding RNA (lncRNA) plays an important role in the occurrence, proliferation, migration, recurrence, chemotherapy resistance, and other characteristics of TNBC. Some lncRNAs are expected to become biomarkers in the diagnosis and prognosis of TNBC, and even new targets for its treatment. Based on a PubMed literature search, this review summarizes the progress in research on lncRNAs in TNBC and discusses their roles in TNBC diagnosis, prognosis, and chemotherapy with the hope of providing help for future research.
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Humans , Female , Triple Negative Breast Neoplasms/genetics , RNA, Long Noncoding/genetics , Biomarkers, Tumor/genetics , Gene Expression Regulation, NeoplasticABSTRACT
Sentinel lymph nodes (SLNs) are the first station of lymph nodes that extend from the breast tumor to the axillary lymphatic drainage. The pathological status of these LNs can predict that of the entire axillary lymph node. Therefore, the accurate identification of SLNs is necessary for sentinel lymph node biopsy (SLNB) to replace axillary lymph node dissection (ALND). The quality of life and prognosis of breast cancer patients are related to proper surgical treatment after the precise identification of SLNs. Some of the SLN tracers that have been identified include radioisotope, nano-carbon, indocyanine green (ICG), and methylene blue (MB). However, these tracers have certain limitations, such as pigmentation, radiation dangers, and the requirement for costly detection equipment. Ultrasound contrast agents (UCAs) have good specificity and sensitivity, and thus can compensate for some shortcomings of the mentioned tracers. This technique is also being applied to SLNB in patients with breast cancer, and can even provide an initial judgment on SLN status. Contrast-enhanced ultrasound (CEUS) has the advantages of high distinguishability, simple operation, no radiation harm, low cost, and accurate localization; therefore, it is expected to replace the traditional biopsy methods. In addition, it can significantly enhance the accuracy of SLN localization and shorten the operation time.
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Humans , Female , Sentinel Lymph Node/pathology , Breast Neoplasms/pathology , Quality of Life , Sentinel Lymph Node Biopsy/methods , Ultrasonography/methods , Lymph Nodes/surgeryABSTRACT
Objective To evaluate a model for axillary lymph node involvement combining CK19 mRNA with contrast enhanced ultrasound sonography (CEUS) score in operable breast cancer.Methods Operable breast cancer patients planned for sentinel lymph node (SLN) biopsy were enrolled.Preoperative CK19mRNA expressions in peripheral blood and CEUS score of axillary lymph nodes were tested before surgery.In the training set,postoperative sentinel lymph node (SLN) and non-sentinel lymph node (nSLN) pathological results were taken as the gold standard,effective modeling variables were screened,logistic regression was used to establish the prediction model.Parallel control studies were conducted between the validation set and the MSKCC model to evaluate the prediction accuracy and prediction efficiency.Results From Oct 2015 to Nov 2016,359 cases (training set) were enrolled and mathematical formulas for predicting SLN and nSLN were established,respectively.The sensitivity,specificity and AUC of predicting SLN involvement were 91.36％,94.92％ and 0.979 respectively.The sensitivity,specificity and AUC of predicting nSLN metastasis were 91.04％,90.53％ and 0.932 respectively.From Dec 2016 to Jul 2017,219 cases (verification set) were included.The sensitivity of SLN metastasis predicted by the model was 91.84％,the specificity was 96.69％,and the AUC was 0.979,significantly superior to the MSKCC model (0.739).The sensitivity,specificity and AUC of predicting nSLN metastasis were 95.35％,92.73％ and 0.945 respectively,significantly superior to the MSKCC model (0.873).Concolusions Combined with peripheral blood CK19 mRNA and CEUS score,the prediction model for axillary lymph node involvement for operable breast cancer,SLN/nSLN involvement probability can be calculated and qualitative judgment can be made.The overall accuracy and AUC of this model are better than the prediction model of MSKCC.
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Objective To investigate and analyze the reasons for the omission of adjuvant radiotherapy after breast-conserving surgery (BCS) in patients with breast cancer.Methods The clinicopathologial characteristics and socioeconomic data of 55 breast cancer patients undergoing BCS without postoperative adjuvant radiotherapy in our hospital from 2012 to 2016 were retrospectively analyzed.Results Among the 55 patients who did not receive radiotherapy,25 patients were due to low local recurrence risk,12 patients were due to economic or family reasons,12 patients were due to fear of adverse reactions of radiotherapy,and 5 patients were not recommended by primary physicians for radiotherapy.In addition,3 cases with multiple distant metastases and 3 cases with concomitant thyroid cancer didn't received radiotherapy.Conclnsions Low risk local recurrence is the main reason for the omission of adjuvant radiotherapy,followed by the fear of radiation-induced toxicity and poor financial support.Patient education and medical insurance may improve the adjuvant radiotherapy compliance.
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Some progresses have been made in research of long non-coding RNA (hereunder referred to as LncRNA) related to breast cancer. Lots of data about LncRNA transcription concerning breast cancer have been obtained from large-scale omics research (e.g. transcriptomes and chips). Some LncRNAs would become indices for detecting breast cancer and judging its development and prognosis. LncRNAs may affect genesis and development of breast cancer in multiple ways. Perhaps they could develop into potential targets for treating breast cancer if they are carcinogenic. Like those from other studies of breast cancer, many data gained from omics research remain to be validated by much experimental work. For instance, it is still necessary to demonstrate reliability of LncRNAs as indices for diagnosing breast cancer and judging its prognosis (particularly for various subtypes of breast cancer), effectiveness and feasibility of these genes for treating breast cancer as targets. In this paper, recent years' literatures about LncRNAs which are related to breast cancer are summarized and sorted out to review the research progresses in relationships between LncRNAs and breast cancer.
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BACKGROUND: As a type of new targets for prognosis of malignancies, long non-coding RNA MALAT1 (metastasis-associated lung adenocarcinoma transcription 1) is associated with proliferation and metastatic abilities of several malignancies. However, its relations to development and migration of triple negative and human epidermal growth factor receptor 2 (Her-2) positive breast cancers haven't been reported. OBJECTIVES: In this paper, we aimed to discuss how MALAT1 is connected with and affects proliferation and invasion abilities of cells in Her-2 positive and triple-negative breast cancers (TNBC). METHODS: The expression of MALAT1 in clinical samples with TNBC and Her-2 positive breast cancers was tested by qRT-PCR. The statistical analysis was performed to unveil the potential relationships between the expression of MALAT1 and prognostic factors of breast cancer such as OS (overall survival), RFS (relapse-free survival), number of metastatic lymph nodes and pTNM staging in patients with TNBC or Her-2 positive breast cancer. MALAT1 and XBP1 were knockdown respectively in Her-2 positive cell line MDA-MB-231, and MALAT1 and Her-2 were knockdown respectively in TNBC cell line MDA-MD-435 using siRNA. The alterations of expressions of MALAT1 and related genes were detected by qRT-PCR in two breast cancer cell lines. The changes of proliferation abilities in two cell lines were observed using CCK8 assays. Furthermore, transwell assays were performed to detect changes to invasion abilities of the cells. RESULTS: The expression of MALAT1 in triple negative and Her-2 positive breast cancers was positively correlated to the number of metastatic lymph nodes in patients with breast cancer. MALAT1 promotes proliferation and invasion abilities of breast cancer cells through XBP1 (X-box binding protein 1)-HIF (hypoxia-inducible factor)-1α pathway in MDA-MB-231 and through Her-2 pathway in MDA-MD-435. Moreover, MALAT1 could possibly be involved in regulation of MYC gene and CD47 (an immune checkpoint gene) in both cell lines. CONCLUSIONS: Our study suggested that MALAT1 is a core signaling molecule for promoting development and migration of triple negative and Her-2 positive breast cancers. It would be employed as common markers for prognosis of the two types of breast cancer mentioned above and potential targets for treating them.
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Alternative splicing (AS) is the process of combinatorial rearrangement of parts of exons, and/or parts of introns into mature RNA to result in a multitude of transcripts. AS is a biological process through which organisms produce as many protein variants as possible by a limited genetic resource. It plays an important role in growth and development of the organisms. Over the past few years, alternative splicing has been discovered to be critical for genesis and development of malignant tumors, including breast cancer. If the relationships between AS and breast cancer can be discussed more deeply, it will be helpful for better diagnosis, judging prognosis and intervening with breast cancer. In this paper, the relationships between AS and breast cancer are elaborated from different angles, in hope that this summary is beneficial for readers to understand the roles of AS and breast cancer.
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BACKGROUND: Clinically, the patients with significant WBC decrease are mostly administered G-CSF, this kind of drugs is expensive and adverse reactions are often seen. In contrast, oral leucocyte increasing drug has small adverse reactions, can be used for longer time and can improve the continuity and stability of treatment. The experimental study based on study of mouse was to evaluate the effects of treatment and chemotherapy of related leukocytopenia by five kinds of commonly used peroal leucocyte increasing drugs. MATERIALS AND METHODS: We prepared mice chemotherapy related leukocytopenia model by cyclophosphamide intraperitoneal injection, the positive control drug is G-CSF, respectively fill five kinds of peroal Leucocyte increasing drugs (Qijiao Shengbai Capsule, Weixuening Granule, Compound Zaofan Pill, Berbamine and Leucogen Tablets) in the stomach, the experimental group was divided into normal control group (group A), model group (group B), positive control group (Group rhG-CSF, group C) and treatment groups (group D-H), and treatment groups were divided into Qijiao Shengbai Capsule group (group D), Weixuening Granule group (group E), Compound Zaofan Pill group (group F), Berbamine Tablet group (group G) and Leucogen Tablet group (group H). Calculate the death rate, blood routine and important visceral organ index in each group.. RESULTS: The death rate of mice in each group has no significant difference (P>0.05). WBC of B, D, E and F groups was significantly lower than that of group A (P<0.05 or P<0.01). WBC of C, G and H groups was significantly higher than those of group B (P<0.01). WBC of D, E and F groups was significantly lower than that of group C (P<0.01). WBC of G and H groups was significantly higher than that of D and F groups (P<0.01), WBC of group H is significantly higher than that of group E (P<0.05). RBC of group F, G and H groups was significantly higher than that of group D (P<0.05 or P<0.01). HB of group H is significantly higher than that of group A (P<0.01). HB of C, G and H groups was significantly higher than that of group B (P average <0.01). HB of D, E and F groups was significantly lower than that of group C (P<0.05 or P<0.01). HB of G and H groups was significantly higher than that of D, E and F groups (P average <0.01). PLT of group H was significantly higher than that of group B (P average <0.05). PLT of F, G and H groups was significantly higher than that of group D (P<0.01). Lung index of group G was significantly higher than that of D, E, F and H groups (P<0.01). Liver index of group H is significantly higher than that of group D (P<0.05). Thymus index of G and H groups is significantly higher than that of group F (P<0.05 or P<0.01). CONCLUSIONS: Among all drugs of rising WBC, G-CSF owns strongest effect. In oral drug groups, WBC rising effect of Leucogen Tablets is best, RBC, HB and PLT improvement effect of Berbamine and Leucogen Tablets is best. In addition, Berbamine and Leucogen Tablets respectively caused significant increase of lung and liver index, what indicates that, the two drugs may be accompanied by relevant viscera damage. At the same time, the two drugs also increased thymus index, which indirectly indicates that, the immunity and regulation abilities of Berbamine and Leucogen Tablets are stronger. The spleen index of Qijiao Shengbai Capsule group was significantly higher than that of Berbamine Tablet and Leucogen Tablet groups, what indicates that, the immunity and regulation abilities of Qijiao Shengbai Capsule may be stronger in oral drug group.
Subject(s)
Cyclophosphamide/administration & dosage , Drugs, Chinese Herbal/administration & dosage , Leukopenia/drug therapy , Animals , Blood Cell Count , Humans , Injections, Intraperitoneal , Leukocytes/cytology , Leukocytes/drug effects , Leukopenia/blood , Male , MiceABSTRACT
Objective To investigate expression of TPS, VEGF of beast cancer patients and relationship with clinical pathological.Methods 68 cases of breast cancer were selected as experiment group, 36 cases with breast fibroma were selected as control group.TPS and VEGF were detected by elisa of patients before and after treatment.Serum TPS and VEGF levels and TNM staging were compared after operation.Results TPS and VEGF of the experiment group were higher than control group(P2 cm group(P<0.05).TPS and VEGF of axillary lymph node metastasis group and axillary lymph node metastasis had significant difference(P<0.05).The concentration of TPS was significantly higher than that of estrogen and progesteronepositive group in estrogen receptor negative, progesterone receptor negative (P<0.05).Conclusion TPS, VEGF levels in the serum of breast cancer patients showed high expression, the expression of TPS, VEGF levels related to axillary lymph node metastasis, estrogen receptor, progesterone receptor.
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Objective To investigate effect of anthracyclines of VEGF-C, VEGFR-3, ER and E-cadherin in serum of patients with breast cancer.Methods 43 patients with breast cancer were selected and randomly divided into experimental group and control group, 40 cases in each group.According to the experimental program based on the treatment, serum VEGF-C, VEGFR-3 levels and breast tissue ER and E-cadherin were detected after the end of the treatment.Results Compared with the control group, VEGF-C, VEGFR-3 levels of the experiment group were lower( P<0.05),ER level was lower(P<0.05) and E-cadherin level was higher(P<0.05).Conclusion the ER, VEGFR-3 and VEGF-C levels in breast cancer patients can significantly decrease the E-cadherin level, and it has a guiding significance for clinical.
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Objective To research the impact of axillary limph node group dissection oriented by senti-nel lymph nodes instead of axillary dissection on upper limb lymph edema and disease -free survival ( DFS ).Methods We designed a randomized controlled research , which included 205 cases of operatable breast cancer (AJCC 7th:stage I or stage IIa)from Jan.2011 to Jan.2013.Those cases were separated into 2 groups randomly ( random number method ):group A underwent mastectomy ( or lumpectomy ) and axillary group lymphadenectomy oriented by sentinel lymph node biopsy ( SLNB) ( if positive continued for ALND ) while group B underwent mastec-tomy(or lumpectomy)and axillary lymph node dissection(ALND).All patients underwent SLNB by blue dye method and received adjuvant therapy after surgery according to National Comprehensive Cancer Network ( NCCN) guideline and Chinese anti-cancer association guideline .Results There were 101 cases in group A and 104 ca-ses in group B , but 1 case in group A was excluded for false negative of SLN.The midium follow-up was 30 months.There were no significant differences of average age , tumor size, grade, estrogen receptor (ER),proges-terone receptor ( PR) and human epidermal growth factor receptor 2 ( HER2 ) expression between the 2 groups. Group A had a lower frequency of lymph edema than group B (4.0%vs 17.3%,χ2 =9.384,P=0.002), and al-so a milder degree ( mild 2%vs 11.5%,middle 2%vs 3.8%,severe 0%vs 1.9%).There were no significant differences of upper limb sensory disorder (14.0%vs 16.3%,χ2 =0.218,P=0.641), neither of DFS(Log-Rank analysis:3-year average DFS 32.89 months vs 33.72 months,χ2 =0.186,P=0.667;Cox risk model analysis:HR=1.395,P=0.495)between the 2 groups.Conclusion Axillary group lymphadenectomy oriented by SLNB can reduce the happening of lymph edema from ALND and has a comparative effect on DFS as ALND .
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Objective To observe and analyze the clinical efficacy of docetaxel and S-1 in treatment of anthracycline-resistant triple-negtive breast cancer(TNBC).Methods 64 cases with TNBC admitted in People' Hospital of Shaoxing City from June 2009 to June 2011were selected as research object.The clinical data of these cases were analyzed retrospectively.Anthracycline had been used to treat the cases, but with no effect or recurrence.Then docetaxel combined with S-1 was applied to the cases.Clinical efficacy and adverse reactions of the chemotherapy were observed and analyzed. Results After treatment,the efficiency of 64 cases was 54.69%,and the disease control rate was 79.69%.During the treatment,the main adverse reactions were gastrointestinal reactions and bone marrow suppression,without death,and patients could tolerate the adverse event.Follow-up results showed that the median time of progression was 10.5 months.After two years,progression-free survival rate was 0.Conclusion Docetaxel combined with S-1 has good clinical efficacy for anthracycline-resistant triple-negtive breast cancer,with relatively mild side effects,which may be an ideal adjuvant chemotherapy method.
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Triple negative breast cancer (TNBC) is characterized by lack of expression of the estrogen (ER)and progesterone receptors (PRs) and the human epidermal growth factor receptor (HER-2) that are commonly observed in other breast cancer subtypes.Treatment options are limited since the hormonal receptor and HER-2 antagonists are ineffective for TNBC.In contrast to non-TNBC,TNBC is more aggressive with higher recurrence,metastatic,and mortality rates.Besides further studies on cytotoxic drugs and chemotherapy regimens,More studies on potential targeted molecular treatment of TNBC should be strengthened.For the moment,potential targeted molecular treatment of TNBC including antiangiogenic agents,epidermal growth factor receptor (EGFR) inhibitors and poly (adenosine diphosphate ribose) polymerase (PARP).In contrast to their surprising anti-tumor effectivness in basic experiments,these targeted molecular agents show no promising results in clinical trials by now.This article aims to review advancements of targeted molecular treatment of TNBC in recent years.
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The studies have shown that the genesis and development process of breast cancer is closely related with microRNAs (miRNAs).Multiple miRNAs are involved in the progress of the incidence of breast cancer,and can be used to assess the prognosis,clinical treatment of breast cancer,and to explore the resistance mechanisms.
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Male breast cancer is rare,it mainly caused by the interaction of the genetic factors,hormone levels,way of life,and the environment.Its clinical manifestations are indolent tumors.The diagnosis method includes clinical medical examination and imaging examination,and pathology examination.The treatment is in reference to the female breast cancer treatment model,including surgery,chemoradiotherapy and endocrine therapy.Tumor size and axillary lymph nodes involvement are independent predictors of overall survival.
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ObjectiveTo evaluate the characteristics,treatment and prognosis of metachronous bilateral primary breast cancer(mBPBC). MethodsClinical materials of 48 patients were performed with retrospective study. ResultsIn 48 patients,43 cases taken both sides modified radical mastectomy and 5 cases taken lumpectomy and axillary dissection in the second side.All patients were treated with chemical treatment and treated with radiotherapy in accordance with lymph node metastasis.Besides a part of patients were treated with endocrine therapy in accordance with the expression of estrogen receptor(ER)and progesterone receptor(PR).The follow-up time was 6 ～ 48 months and the average time was 21.9 months.No died and 5 cases found distant metastasis. ConclusionmBPBC should be diagnosed earlier,taken appropriate treatment and followed up actively,so it would have a better therapeutic effect.
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Objective To investigate the feasibility of laparoscopic extirpation for mammary multiple fibroadenoma. Methods A total of 12 patients with multiple fibroadenoma that were diagnosed by ultrasonography and fine needle aspiration were enrolled in this study. Through an axillary small incision, the air was inflated into the retromammary space, which had been obtusely separated to build a surgical space. Then, 58 fibroadenomas were resected under a laparoscope. Frozen-section examination was carried out during the operation. Results All the masses of the 12 patients were laparoscopically extirpated successfully, without operative complications. The operation time was 40-150 minutes with a mean of 80 minutes. One month after the operation, the shape of the breast looked well and the sensation of the nipple remained normal. During a 1- to 36-month follow-up (mean 18.5 months), none of the patients had scars on the breast or tumor recurrence. All of them were satisfied with the cosmetic results. Conclusion Laparoscopic extirpation of mammary multiple fibroadenoma through the retromammary space is safe and feasible.
