Volume 14,Issue 4,2005 Table of Contents

1 Evaluation of PET/CT imaging versus mammography in detecting breast cancer

ZOU Haidong , MA Rong , YU Zhigang , LIU Qingwei , WANG Chenggang , LI Xin , SUN Jingzhong

2005, 14(4):2. DOI: 10.7659/j.issn.1005-6947.2005.04.001

[Abstract](1373) [HTML](0) [PDF 829.90 K](763)

Abstract:
Abstract:Objective To evaluate the actual value of PET/CT in detecting breast cancer,and make a preliminary study of its clinical significance.
Methods 33 patients with breast mass underwent PET/CT imaging and mammography.The degree of uptake of Fluorodeoxyglucose(FDG) and blood perfusion in the breast masses were respectively analyzed by semiquantitative and qualitative methods and the differences in findings of PET/CT and mammography in detecting breast cancer were compared. Results Breast cancer was diagnosed by PET/CT with sensitivity,specificity and accuracy rates of 92.6%,100% and 93.9%,respectively,and by mammography with rates of 81.5%,80% and 78.8%,respectively;in diagnostic ability,the two methods showed no significant difference(P>0.05). Conclusions In comparison with mammography,PET/CT has a higher degree of sensitivity and specificily in detecting breast cancer,and higher positive predictive value.PET/CT can provide more aspects of in vivo diagnostic information which may be useful in selecting therapeutic strategy and may supplement the inadequacies of mammography.

2 The expression and clinical significance of multigenes in breast cancer

HUANG Baojun , XU Huimian , LI Kai , WANG Huaiyu , ZHANG Hao , TIAN Datong

2005, 14(4):3. DOI: 10.7659/j.issn.1005-6947.2005.04.002

[Abstract](1103) [HTML](0) [PDF 843.35 K](745)

Abstract:
Abstract:Objective To study the expressions of ER, PR, mutant p53, HER2, and MDR1 genes in breast cancer, and their correlation with clinicopathologic factors and prognosis.
Methods Expressions of ER, PR, mutant p53, HER2, and MDR1 gene proteins were examined by immunohistochemistry (IHC) in breast cancer lesions from 215 patients, and their correlation with clinicopathologic features were analyzed.All of the patients were followed up for analysis of disease free survival(DFS) and overall survival(OS) rate, and survival analysis.
Results Of the 215 breast carcinoma samples, the positive rates for ER、PR、mutant p53，HER2，MDR1 gene proteins expression were 40.9%,29.0%,40.5%,37.2% and 37.7%, respectively. Overexpression of PR and mutant p53 was positively correlated with axillary lymph node (P=0.001, 0.037, respectively), and overexpression of HER2 was positively correlated with TNM staging

3 Growth inhibition of human breast cancer by vitamin E succinate combined with chemotherapeutic drugs〖STBZ〗

ZHANG Junchu , ZHANG Wei , ZHU Daqiao , XU Xinyun , ZHANG Lingzhen , WANG Qiang

2005, 14(4):4. DOI: 10.7659/j.issn.1005-6947.2005.04.004

[Abstract](754) [HTML](0) [PDF 825.83 K](788)

Abstract:
Abstract:Objective
To investigate the inhibitory effect of vitamin E succinate(VES) combined with chemotherapeutic drugs on the proliferation of human breast cancer cells. Methods Bcap37 human breast cancer cells were treated with VES combined with chemotherapeutic drugs for 24h and 36h. The concentrations of VES were 10μg/mL and 20μg/mL and those of 5florouracil, mitomycin and cyclophosphamide were 16.9μg/mL and 33.8μg/mL, 1μg/mL and 3.3μg/mL and 100μg/mL and 300μg/mL respectively. The inhibitory effect was measured with MTT method and the cell cycle and cell surface Fas expression were analyzed with flow cytometry assay. Results The combination of VES with chemotherapeutic drugs had a significant inhibitory effect on the growth of Bcap37 human breast cancer cells. Flow cytometry assay of cell cycle showed that the natural apoptptic rate of Bcap37 cells was 0.7%;after treatment with VES 20μg/mL,the apoptotic rate was 19.2%;after treatment with 5Fu,mitomycin and cyclophosphamide the apoptotic rates were 16.2%,16.7% and 12.3%,respectively;after the combined use of VES and the 3 chemotherapeutic drugs,the apoptotic rates were 40.3%,44.8%,39.6%,respectively.Fas expression in cancer cells increased after the coadministration of VES and chemotherapy drugs.
Conclusions VES combined with chemotherapeutic drugs had significant inhibitory effect on the growth of Bcap37 human breast cancer cells. The mechanism may be related to Fas upregulation on the surface of cancer cells.

4 Diagnostic value of intraoperative frozen section in breast neoplasms: analysis of 590 cases

CHEN Jixian , SUN Limin , WU Wenzhen

2005, 14(4):5. DOI: 10.7659/j.issn.1005-6947.2005.04.005

[Abstract](1052) [HTML](0) [PDF 815.05 K](749)

Abstract:
Abstract:Objective To evaluate the diagnostic accuracy of intraoperative frozen section in breast neoplasms and to improve the diagnostic accuracy rate,to promote closer communication betwen clinicians and pathologists,mutually increase an understanding of frozen sections, and thus decrease the rate of misdiagnosis.
Methods The diagnostic reports of intraoperative frozen sections and paraffin sections of 590 cases with breast neoplasms taken in the recent 8 and a half years were analyzed retrospectively.
Results 586 cases (99.32%) of intraoperative frozen sections were diagnosed correctly and 4(0.68%) were misdiagnosed. In the 4 misdiagnosed cases,2 cases of infiltrating ductal carcinoma were misdiagnosed as benign lesions,due to questionable quality of the slides,and 2 cases of lobular cystic sarcoma were misdiagnosed as fibroadeuoma,due to removal of insufficient specimen.
Conclusions The chief causes of misdiagnosis and delayed diagnosis of frozen sections are specimen limitations,varied morphology of the lesions,and quality of the frozen sections.When there is familiarity with the main aspects of diagnosis and differential diagnosis of breast pathology and enhancement of communication between the surgeon and pathologist,then frozen section of breast masses is an accurate and reliable method of investigation.

5 The relation between expression of p16，p53，CDK4/cyclinD1 and prognosis in breast cancer

田兴松，周文红

2005, 14(4):6. DOI: 10.7659/j.issn.1005-6947.2005.04.006

[Abstract](1046) [HTML](0) [PDF 836.95 K](734)

Abstract:
Abstract:Objective To study the expression levels of p16,p53,CDK4/cyclinD1 protein in breast cancer and their relationship to prognosis. 〖WTHZ〗Methods〓〖WTBZ〗The expression of p16,p53,CDK4 and cyclinD1 in breast cancer tissues of 86 patients who did not receive preoperative chemotherapy were examined,and the relationship of their expression to clinicopathological data were analyzed.〖WTHZ〗Results〓〖WTBZ〗(1)p16,p53,CDK4:The positive expression of p16,p53 and CDK4 were significantly different in stages I and II infiltrating ductal carcinoma,but cyclin D showed no difference;their positive expression in lymph node negative and lymph node positive groups were significantly different;their positive expression for patients′age≤50 years and>50 years showed no significat difference;there was significant difference of p53 expression between ER negative and ER positive groups,but p16,CDK4 and cyclin D expression showed no difference;p53 expression was significantly different in ER negative and PR positive groups,but the levels of the other proteins were not significantly different.(2)There were significant differences between the expression of p16 and p53

6 Relationship of oncogene survivin,p53 expression in breast cancer and its prognostic significance

MAO Jie , HAI Jian , SHU Hengping , TANG Lili , SHEN ZHENGtang , WU Yuhui , OU Huiyin

2005, 14(4):7. DOI: 10.7659/j.issn.1005-6947.2005.04.007

[Abstract](1109) [HTML](0) [PDF 824.86 K](563)

Abstract:
摘要：目的探讨乳腺癌组织中survivin基因和p53基因的表达与预后的关系。
方法用免疫组化SP法检测80例乳腺癌组织中survivin、p53的表达，分析其与腋淋巴结转移和5年无病生存率之间的关系。
结果 survivin基因在乳腺癌中阳性表达率为68.75%（55/80）、p53基因阳性表达率为46.25%（37/80），均与腋淋巴结转移相关（P<0.05），与5年无病生存率相关(P＜0.05）。survivin和p53表达与肿瘤病理类型、发病年龄、临床分期无明显相关性（P＞0.05）；survivin和p53基因表达相关（P=0.0025）。
结论 survivin和p53基因可能在乳腺癌的发生、发展过程中起重要作用，联合检测能更好地判断乳腺癌的预后。

7 A study of the blood supply relevant to prevention of nippleareola necrosis in female breast operation

GAO Dezong , SUN Jingzhong , YIN Qunsheng , LIU Shutao

2005, 14(4):8. DOI: 10.7659/j.issn.1005-6947.2005.04.008

[Abstract](704) [HTML](0) [PDF 821.11 K](775)

Abstract:
Abstract:Objective
To study the arterial blood supply of nippleareola and provide the anatomical basis for avoiding nippleareola necrosis in breast operation. Methods The vascular structure of nippleareola of 26 female breasts in 13 cadavers were studied.
Results The nippleareola mainly accepted arterial blood supply from branches of the lateral thoracic artery and the internal thoracic artery. The 2nd~4th intercostal perforating branches of the internal thoracic artery and branches of the lateral thoracic artery reach the base of nippleareola from a superior,medial and upper lateral direction by passing between lobules of mammary gland, then ascend between the lacteal ducts to supply the nippleareola; the perforators of the lateral thoracic artery and the superticial breast perforators of internal thoracic artery, formed extensive anastomoses subcutaneously, and particulatly under areola formed arterial rete, from which branches were given out to nippleareola. The intercostal perforators and thoracoacromial perforators did not supply the nippleareola.
Conclusions When nipplesparing mastectomy is performed, in order to avoid nippleareola necrosis,it is necessary to protect the arterial rete under the areola, and thus, the thickness of areolar skin flap should not be less than 0.5cm; to ensure the blood supply of nippleareola from the internal thoracic artery and the lateral thoracic artery in breast reduction, the superiormedial or superiorlateral breast pedicle should be used and the thickness of preserved posterior breast should not be less than 1.5cm.

8 Effect on cell apoptosis and Bax/Bcl2 gene expression of implanted human breast cancer cells in nude mice by applying RNAi to silence STAT3 gene

WANG Yu , ZHANG Yingchao , PAN Yuzhuo， ZHAO Xuejian , GUAN Wenzeng

2005, 14(4):9. DOI: 10.7659/j.issn.1005-6947.2005.04.009

[Abstract](1320) [HTML](0) [PDF 828.06 K](660)

Abstract:
Abstract:Objective
To discuss the effect on cell apoptosis and Bax/Bcl2 gene expression of nude mice model with implanted human breast cancer cells by applying RNAi technique to silence signal transducers and activators of transcription 3 (STAT3)gene.
Methods MCF7 breast cancer cells were implanted under the skin of female nude mice. After the tumors grew to a definite size,the mice were randomly divided into three groups:saline control group(A), empty plasmid group(B), the experimental group(C). The tumors were respectively injected with saline, empty plasmid with psilencer1.0U6, and recombined plasmid with psilencer1.0U6stat3siRNA . When the growth of group A animals reached the sufficient size,all of the animals were killed, the tumors were taken out, their size and weight were measured,immunohistochemical(IHC) analysis was done, and protein expression of STAT3, Bax and Bcl2 gene in tumors were examined by Western blot.
Results The size and weight of tumors in group C were significantly lower than group A and group B. (P<0.01). Immunohistochemical analysis and microscopic examination showed that there was a large area of cytoclasis and signs of cell apoptosis in the center of tumors of group C, and the STAT3 Immunohistochemistry result of the center was negative but that of the border area was positive; there were no such phenomena in group A and group B. The results of Western blot analysis showed that protein expressions of STAT3 gene in group C were significantly lower than those in group A and group B (P<0.01)， but there were no significant differences between group A and group B（P>0.05）, and protein expressions ofBax gene in tumor of group C were significantly higher than those in group A and group B (P<0.05)，but there were no significant differences between group A and group B （P>0.05）.The protein expressions of Bcl2 gene in all groups showed no significant differences (P>0.05).
Conclusions Silencing STAT3 gene can decrease STAT3 gene expressions , increase Bax gene expressions , induce cell apoptosis and suppress the tumor growth in the human breast carcinoma model by the RNAi technology .

9 Study on the relation between mammary hyperplasia and angiogenesis

SONG Aili , LI Jingwei , LIU Xiaofei , SUN Yian , ZHANG Weidong

2005, 14(4):10. DOI: 10.7659/j.issn.1005-6947.2005.04.010

[Abstract](717) [HTML](0) [PDF 816.41 K](719)

Abstract:
Abstract:Objective
To study the relation between mammary hyperplasia and expression of VEGF,bFGF.
Methods After the breast mass undergoing core needle biopsy, the pathological type and expression of VEGF and bFGF were observed in 140 cases of breast mass.
Results Of the 140 cases, general hyperplasia was found in 92 cases( 65.7%), atypical hyperplasia in 48 cases(34.3%) . The expression of VEGF and bFGF were increased with the increase of pathological degree of breast hyperplasia (P＜0.05).
Conclusion Angiogenesis is increased with increase of mammary hyperplasia, the more degree of hyperplasia, the more expression of VEGF,bFGF.

10 A preliminary study of arsenic trioxide induced apoptosis of human cholangiocarcinoma QBC939 cell line

ZHOU Jun , TANG Huihuang

2005, 14(4):11. DOI: 10.7659/j.issn.1005-6947.2005.04.011

[Abstract](1051) [HTML](0) [PDF 835.35 K](671)

Abstract:
Abstract:Objective
To study arsenic trioxide induces apoptosis of human cholangiocarcinoma cell line QBC939.
Methods MTT was applied to detect the inhibitory effect of arsenic trioxide on cholangiocarcinoma cell line QBC939. Morphological changes were observed by light microscopy and fluorescence microscopy. Rhodamine123 dyeing and analysis of DNA content and cell cycle were examined by flow cytometry. Results Cell growth was significantly inhibited by different concentration(116μmol/L) of arsenic trioxide. The inhibition ratio was dependent on arsenic concentration and time. The typical morphological character of apoptosis was observed, apoptotic peak of hypodiploid was detected and fluorescence intensity of Rhodamine123 decreased when the cells were cultured with 4μmol/L As2O3.
Conclusions As2O3 can induce apoptosis of cell line QBC939. The mechanism may be related to the depolarization of mitochondrial membrane potential.

11 Analysis of the factors affecting the prognosis of surgical treatment of primary hyperparathyroidism

Yuspup Yimit

2005, 14(4):12. DOI: 10.7659/j.issn.1005-6947.2005.04.012

[Abstract](1187) [HTML](0) [PDF 805.59 K](699)

Abstract:
Abstract:Objective To study the pathologic fracture of primary hyperparathyroidism and the effect of the timing of operation of the prognosis of the surgical treatment for hyperparathyroidism.
Methods Analysis of the postoperative followup data of 13 hyperparathyroidic cases were analyzed.
Results The prognosis of hyperpathyroidic cases without pathologic fracture was better than cases with concurrent fracture; Orthomorphia of fracture during perioperative period of parathyroidectomy showed a good prognosis,but those who had delayed treatment of fracture owing to concern of malunion due to severe osteoporosis showed a poor prognosis.Conclusions Resection of the parathyroid gland before the appearance of pathologic fracture has a good proguosis.For those who present with associated pathologic fracture,treatment of the fracture at the time of parathyroidectomy or during the perioperative period of the parathyroidectomy are important factors that can improve the prognosis of hyperparathyroid patients.

12 Modified piggyback liver transplantation:a report of 14cases

ZHU Xiufang , MO Yiwo , LIU Yuming , SUN Zhiwei

2005, 14(4):13. DOI: 10.7659/j.issn.1005-6947.2005.04.013

[Abstract](778) [HTML](0) [PDF 812.46 K](672)

Abstract:
Abstract:Objective
To study donor liver repair in modified piggyback liver transplantation and its relationship to postoperative complications.
Methods The relationship between donor liver repair and development of complications of 14 cases of modified piggyback liver transplantation,which among 17 cases of orthotopic piggyback liver allotransplantation performed in our hospital,were analyzed retrospectively.In the 14 cases,abnormal hepatic artery was repaired in 2 cases,portal vein interposition shunt was done in 1 case;repaired ligaments were sutured in 10 of 14 cases,and not sutured in 4 cases.
Results None of the 14 patients died in the perioperative period. The success rate of the operation was 100%. 3 patients had intraabdominal bleeding,postoperatively,and in 2 cases the bleeding was related to donor liver repair. Postoperatively,there was no thrombosis of hepatic artery or portal vein, and no bile duct necrosis, no hepatic outflow tract occlusion. Conclusions Donor liver repair is an important procedure in liver tramsplantation.The quality of donor liver repair is directly related to the difficulty of operative technique during liver transplantation,and to the development of postoperative complications.In donor liver repair during piggyback liver transplantation,reconstruction of the retrohepatic vera cava is very important.The constructed stoma must be compatible with the donor hepatic vein outflow stoma and be able to effectively prevent the formation of eddy blood flow,ensure patency of the outflow tract and effectively prevent thrombus formation.

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Volume 14,Issue 4,2005 Table of Contents

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