Comparison of the value of ultrasound-guided fine needle aspiration biopsy and contrast-enhanced ultrasound in different sizes of thyroid nodules.

The purpose of this study was to evaluate the diagnostic value of ultrasound-guided fine needle aspiration biopsy (US-FNAB) and contrast-enhanced ultrasound (CEUS) in the presence of thyroid nodules of different sizes. We retrospectively analyzed 110 patients with surgically operated unimodular thyroid nodules in Yichang City Central Hospital from July 1, 2021, to April 1, 2023, all of whom underwent conventional thyroid ultrasound, CEUS, and US-FNAB, and all of whom were classified according to the size of nodules into <0.5, 0.5 to 1, and ≥1 cm groups. The diagnostic accuracy, sensitivity, and specificity of the 2 methods for benign and malignant nodules were calculated. Among 110 thyroid nodules, 102 were malignant nodules and 8 were benign nodules. In patients with nodule diameters <1 cm the sensitivity of US-FNAB and CEUS was 87.02% and 93.89%, respectively, and the specificity was 100.00% and 66.67%, with an accuracy of 87.31% and 93.28%, respectively. In patients with nodule diameter <0.5 cm, the sensitivities of US-FNAB and CEUS were 74.29% and 100.00%, respectively, and the differences were statistically significant (P < 0.05); in patients with nodule diameter 0.5 to 1 cm, the sensitivities of US-FNAB and CEUS were 79.59% and 95.92%, respectively, and the differences were statistically significant (P < 0.05); among patients with nodule diameters ≥1 cm, the sensitivities of US-FNAB and CEUS were 88.89% and 77.78%, respectively, with no statistically significant difference (P > 0.05). For thyroid nodules ≤1 cm in diameter, the sensitivity of CEUS examination was higher than that of US-FNAB; and CEUS still has good diagnostic accuracy in the diagnosis of benign and malignant thyroid nodules <0.5 cm, CEUS is recommended for thyroid nodules diagnosed negatively by US-FNAB with a diameter of <1 cm; and CEUS should be preferred for thyroid nodules with a diameter of <0.5 cm. CEUS should be preferred for thyroid nodules <0.5 cm in diameter.

Incidence, risk factors, prevention and treatment of postmastectomy pain syndrome in breast cancer: A multicenter study.

BACKGROUND: Postmastectomy pain syndrome (PMPS) is a common postoperative condition after breast cancer surgery. PURPOSE: The aim of this study was to investigate the incidence rate and risk factors of PMPS, and to propose prevention and treatment methods. METHODS: The study included 1790 postoperative breast cancer patients from three hospitals from 2017 to 2021, of which 302 (13.0%) patients with PMPS were included in the study. RESULTS: Age, breast surgery type, axillary surgery type and radiotherapy are the risk factors of PMPS. Age, radiotherapy and chemotherapy affect the pain degree of PMPS during movement. CONCLUSIONS: For breast cancer patients with high risk factors, pain should be actively prevented during perioperative period. Oral pharmacological agents, multidisciplinary combination therapy, local anesthetics and regional anesthesia are the most common treatment of PMPS.

Estrogen-induced SDF-1α production promotes the progression of ER-negative breast cancer via the accumulation of MDSCs in the tumor microenvironment.

Estrogen plays a role in the processes of tumorigenesis, metastasis, and drug resistance in estrogen receptor (ER)-positive breast cancer (BC). Whether estrogen contributes to ER-negative BC is unclear. Here, we aimed to investigate whether estrogen could stimulate the secretion of stromal-derived factor-1 (SDF-1α) by cancer-associated fibroblasts (CAFs) to promote the progression of ER-negative BC. We transplanted ER-negative BC cells into ovariectomized mice, which was followed by continuous injection of estrogen, and found that estrogen promoted the tumorigenesis of BC. Furthermore, High levels of SDF-1α and tumor-infiltrating myeloid-derived suppressor cells (MDSCs) were detected in the estrogen treatment group. Estrogen stimulates secretion of SDF-1α by CAFs extracted from BC patients. Recombinant SDF-1α could recruit MDSCs isolated from bone marrow cells of mice. In addition, the co-culture of CAFs and MDSCs demonstrated that the recruitment of MDSCs was increased when CAFs were exposed to estrogen. Using AMD3100 to block the SDF-1α/CXCR4 axis or gemcitabine to delete MDSCs, we observed that both of these agents could neutralize the effect of estrogen on tumorigenesis. Together, these results suggest that estrogen may promote the progression of ER-negative BC by stimulating CAFs to secrete SDF-1α, which can recruit MDSCs to the tumor microenvironment to exert tumor-promoting effects.