Correlation of lymphovascular invasion with clinicopathological factors in invasive breast cancer: a meta-analysis.

OBJECTIVES: Lymphovascular invasion (LVI) has been associated with a poor outcome in patients with breast cancer, but it is not included in international TNM staging system and molecular subtype criterion. The current studies have reported the relation between LVI and the tumor size (T), the status of axillary lymph node (ALN), age, histological grade in invasive breast cancer, but the results were debatable. So the meta-analysis was conducted to confirm the relation between LVI and the four clinicopathological factors. METHODS: Literature was searched by entering the terms: breast AND (neoplasm OR cancer OR carcinoma) AND (lymphovascular OR "lymphatic vessel" OR "vascular vessel" OR "blood vessel" OR "lymph vessel") AND (invasion OR "carcinoma embolus") AND (lymph node OR grade OR size OR clinicopathological) in PubMed, The merged odds ratio (OR) and 95% confidence interval (CI) were estimated using fixed-effect or random-effect model, RevMan 5.3 was used to analyze the relation between LVI and tumor size, status of ALN, age, histological grade in invasive breast cancer respectively. The fail-safe number was used to estimate publication bias. RESULTS: The analysis included 6 studies, LVI positive rate was significant lower in T≤2 cm, ALN negative, age >50 y and histological grade 1 groups statistically. The OR and 95% CI were 0.53 [0.46, 0.61], 0.23 [0.15, 0.35], 1.62 [1.42, 1.85], 0.36 [0.17, 0.77] respectively. CONCLUSIONS: LVI was significantly correlated with the expression status of the tumor size, status of ALN, age, histological grade in invasive breast cancer, and was consistent with adverse features of the four factors.

Dermatofibrosarcoma protuberans of the breast: A case report.

Dermatofibrosarcoma protuberans (DFSP) is a rare, metastasizing tumor of the deep dermis and subcutaneous tissue. While it frequently occurs in the trunk and extremities, breast involvement has rarely been reported. In the present case, imaging and pathological technologies were used to detect DFSP of the breast. Surgical excision with wide margins (>3 cm) and pathology revealed spindle cells arranged in storiform patterns and short fascicles which were crucially CD34-positive, enabling a definitive diagnosis prior to surgery.

Perfusion computed tomography evaluation of partial hepatic ischemia reperfusion in a rabbit model.

RATIONALE AND OBJECTIVES: An animal model of partial hepatic ischemia/reperfusion injury (I/R) has benefits for decision making and clinical management after liver transplantation or massive hepatic resection. The aim of this study was to evaluate the change in perfusion parameters after partial hepatic I/R in rabbits using multislice computed tomography perfusion imaging. MATERIALS AND METHODS: Thirty rabbits underwent 60 minutes of left hepatic lobar ischemia followed by 0.5, 2, 6, 12, and 24 hours of reperfusion (six rabbits were used for each reperfusion interval). An additional six rabbits served as sham-operated controls. The perfusion indices of hepatic arterial perfusion, hepatic portal perfusion, total liver perfusion, and hepatic perfusion index were measured. Levels of serum aspartate transaminase and alanine transaminase and liver histopathology at different time points were also examined. RESULTS: Hepatic microvascular flow patterns showed heterogeneity in the 6-hour, 12-hour, and 24-hour groups. Computed tomographic perfusion parameters were significantly different between infarcted liver tissue and viable liver tissue. In poorly enhancing tissues in the 6-hour, 12-hour, and 24-hour groups, hepatic portal perfusion and total liver perfusion were lower compared to the sham group, but hepatic arterial perfusion of poorly enhancing tissues significantly increased in the 6-hour group and then decreased slightly from 12 to 24 hours after reperfusion. The hepatic perfusion index was always higher compared to that of the sham group. Hepatic arterial perfusion, hepatic portal perfusion, total liver perfusion, and hepatic perfusion index in the noninfarcted areas decreased slowly from 6 to 24 hours after reperfusion. The levels of alanine transaminase and aspartate transaminase in the I/R groups significantly increased after reperfusion and were correlated with the computed tomographic perfusion indices of infarcted liver tissue. CONCLUSIONS: Computed tomographic perfusion can dynamically monitor the pathologic processes of liver I/R and reveal the underlying microvascular disorder, improving clinical management after liver surgery.

[Colonic sac duct for first-stage repair of colon anastomotic leakage in miniature pigs].

OBJECTIVE: To study the efficacy, safety and reliability of colonic sac duct for first-stage repair of colorectal anastomotic leakage. METHODS: An animal model of colon anastomotic leakage was established in 30 Tibet miniature pigs, which were randomly divided into treatment group and control group (n=15). Colon anastomotic leakage in the treatment group was repaired using the colonic sac duct, while the control group received conventional surgical repair. At 7, 14, and 21 days after the surgery, the healing of the anastomotic leakage was evaluated by examining the bursting pressure, tissue microvessel density and hydroxyproline content at the anastomosis. RESULTS: Using the colonic sac duct, the anastomotic leakage was successfully repaired without death of the pigs or the occurrence of intestinal stenosis or necrosis. At 7 and 14 days after the surgery, the bursting pressure, hydroxyproline contents, and microvessel density in the treatment groups were higher than those in the control group, but such difference was not found at 21 days. CONCLUSION: Colonic sac duct allows effective repair of colon anastomotic leakage, and is especially useful for leakage lasting for 48-72 h complicated by severe abdominal infection.