Abstract:Abstract:Objective:To evaluate the results of breast conservation surgery combined with radiotherapy for early stage breast cancer.Methods:The cinical data of 76 breast cancer patients who underwent breast conservation operation plus radiotherapy at Changzheng Hospital in the recent 6 years were retrospectively analyzed.Results:The 3-,and 5-year survival rate was 96.05% and 94.8%,respectively,the 3-,and 5-year local recurrence rate was 5.3% and 6.6% respectively, and the 3-,and 5-year breast conservation rate was 96.05% and 93.3%,respectively.Only one case had chest wall recurrence and there was no mortality.The case with recurrence was a 25-year old unmarried woman, who had an intense desire for breast conservation.After tumor recurrence,mastectomy was performed again and chemotherapy was administered.The patient is presently alive and in good health.Postoperative cosmetic physical results were satisfactory in 80.5% of cases.Conclusions:Breast conservation surgery plus radiotherapy can get satisfactory results.The important aspects for success of breast conservation treatment are standardization of resection and postoperative radiotherapy and integrated systemic therapy.

Abstract:Abstract:Objective:To study the effect of partial axillary lymph node dissection in patients with stage I and II breast cancer. Methods:One hundred and ten patients with stage I and II breast cancer were randomly selected to partial axillary lymph node dissection(PLA) and 110 patients to total axillary lymph node dissection(TAL).After modified mastectomy,partial axillary lymph node dissection(level I,II lymph nodes) was performed in PLA group, and total lymph node dissection was performed in TAL group.The long-term positive relapse rate and upper limb function between the 2 groups were compared.Results:At 5-10-years follow-up,there were 4 cases(3.8%) of local chest recurrence,and 1 case of recurrence in axillary lymph nodes in PAL group; and 5 cases(4.9%) of local chest recurrence,and no case of recurrence in axillary lymph nodes in TAL group.There was no statistical difference between PAL group and TAL group（P＞0.05）. There were 5 cases(4.7%) of upper limb edema and functional handicap in PAL group, and 12 cases(11.7%) of upper limb edema and functional handicap in TAL group, there was a statistical difference between PAL group and TAL group(P＜0.01) . There was no obvious statistical difference in five-year and ten-year survival rates between PAL group and TAL group(P＜0.01).Conclusions:Partial axillary lymph node dissection may reduce upper limb functional handicap after operation in patients with stage I and II breast cancer,and does not increase prognostic risk.

Abstract:Abstract:Objective:To study the correlation of p53,ki-67 and bcl-2 expression in breast cancer with the clinical response to neoadjuvant chemotherapy, and search for biological markers to guide therapy and predict prognosis.Methods:The expression of the p53,ki67 and bcl-2 was examined by immunohistochemical assay in samples of breast cancer tissue which taken from 118 cases of operable breast cancer patients. The relationship between p53, ki-67 and bcl-2 and the effect of neoadjuvant chemotherapy was analyzed by chi-square test. Results:The overall response rate to neoadjuvant chemotherapy was 68.6%. Patients with expression of ki-67 were more likely to respond to treatment. The effect of neoadjuvant chemotherapy had a significantly negative correlation with p53 expression. There was no significant difference between the response to neoadjuvant chemotherapy and bcl-2 expression. Expression of p53 protein was correlated with low expression of bet-2. Expression of p53 and ki-67 protein was significantly related. Conclusions:The results indicated that p53 and Ki-67 expressions are strong prognostic molecular markers that can be a guide for neoadjuvant chemotherapy and prediction of prognosis for patients with breast cancer.

Abstract:Abstract:Objective:To investigate the expression of osteopontin（OPN） mRNA in breast tissues containing microcalcifications and the significance of OPN in tumor pathogenesis and metastasis of breast cancer. Methods:The expression of OPNmRNA in 128 samples of tissues of breast lesions and adjacent breast tissues and 9 samples of metastatic lymph nodes were examined. Results:The expression of OPNmRNA was highest in calcified foci of breast cancer tissues and in metastatic lynph nodes, lower in calcified foci of benign breast tissues and lowest in breast tissues adjacent to breast cancer and in benign tissues without calcification.The differences between the defferent tissues were significant(all P<0.05). Conclusions:Expression of OPNmRNA is related to calcification of breast cancer tissue and to the development of breast cancer.Determination of OPNmRNA expression can be expected to be a guide to clinical therapy and prediction of the prognosis of breast cancer patients.

Abstract:Abstract:Objective:To study the expressions of XIAP and survivin in breast carcinoma tissues and their value in predicting the recurrence of breast carcinoma. Methods:The expression of XIAP and survivin in 65 benign and 65 malignant breast paraffin-embedded specimens was detected by using immunohistochemical assay and the results were compared. Results:The positive rate of XIAP and survivin in recurrent breast carcinoma (recurrent group) was 82.2％ and 85.7％ respectively, and in non-recurrent breast carcinoma tissue（non-recurrent group) was 54.5％ and 45.5％ respectively,and in both groups were increased significantly as compared with that of benign breast tissues（20.0％,and 13.3％ respectively）. The positive expression of XIAP and survivin was increased significantly in recurrent group as compared with non-recurrent group (P＜0.01）. In recurrent group, XIAP expression had a positive correlation with histologic grade（r=0.472,P＜0.05）,but negative correlation to estrogen and progesterone receptors（r=-0.486,P＜0.05）;survivin expression also had a positive correlation with histologic grade（r=0.532,P＜0.05）;XIAP and surviving expression had positive correlation（r=0.447,P＜0.05）. Conclusions:XIAP and survivin oncogene may play an important role in the development of breast cancer, and suggests that their combined detection is valuable for better prediction of the prognosis of breast cancer.

Abstract:Abstract:Objective:To study the significance of expression of prostate-specific antigen mRNA（PSAmRNA）and estrogen receptor beta mRNA(ERβmRNA) in breast cancer(BC), and the relationship of PSAmRNA expression with subtype estrogen receptor expression. Methods:Reverse transcriptase polymerase chain reaction was conducted to detect the expression of PSAmRNA and ERβmRNA in 35 breast cancer samples,12 juxta-carcinoma breast tissues and 10 breast fibroadenoma samples. Immunohistochemical method was conducted to analyze the expression of ERα and PR protein in 35 BC samples. Results:The level of PSAmRNA in BC tissues was significantly lower than that in juxta-carcinoma breast tissues and breast flbroadenoma tissues（all P=0.00）. The expression of ERβmRNA in BC tissues was significantly lower than that in juxta-carcinoma breast tissues and breast flbroadenoma tissues（all P=0.00）. The expression of ERmRNA in PSAmRNA positive expression BC tissues was significantly lower than that in negative expression BC tissues（P=0.038）. The expression of PSAmRNA in ERα and PR positive BC tissues was higher than that in ERβ and PR negative BC tissues（P=0.001, 0.004 respectively）. Conclusions:PSAmRNA and ERβmRNA in BC tissues is downregulated, and PSA gene can be an important marker that reflects the hormonal status of the BC.

Abstract:Abstract:Objective:To explore the expression of p130Cas and paxillin in human breast carcinoma and to investigate the relationships of p130Cas and paxillin levels with clinical and pathological characteristics. Methods:SP immunohistochemistry staining was applied to detect the expression of p130Cas and paxillin in tumor tissues from 53 cases of primary breast carcinoma, 10 cases of breast fibroadenoma and in 10 cases of normal breast tissues. Results:Breast carcinoma tissues showed higher levels of p130Cas（P<0.001）and lower levels of paxillin（P=0.003）than normal and fibroadenoma tissues. The expression of p130Cas was related with age, menopausal status, ER, PR status and histological grades, but not related with tumor size, lymph node status and pathological stages. The expression of paxillin was relateded with pathological stages, histological grades and lymph node status, but not related with age, menopausal status, ER, PR status and tumor size. Conclusions:p130Cas and paxillin have relations with the malignant transformation, invasion and metastasis of breast carcinoma. They can be used as useful factors in predicting the prognosis of breast carcinoma.

Abstract:Abstract:Objective:To study the clinical characteristics and method of diagnosis and treatment of nonfunctioning parathyroid cysts (NFPTC). Methods:The clinical data of 15 cases of nonfunctioning parathyroid cysts admitted in the recent 16 years were retrospectively analyzed.Results:None of the cases were diagnosed before operation, and the diagnosis of all of the cases was verified by pathology. All of the cases were cured by operation.Follow-up found no case with recurrence. Conclusions:Pathologic examination is the most reliable diagnostic method for NFPTC. Needle aspiration of fluid to test for PTH or cytology is an important method in diagnosis before operation. Surgical resection is the most ideal method of treatment.

Abstract:Abstract:Objective:To investigate the calcification of thyroid nodule detected on ultrasound and the relation with benign and malignant disease. Methods:Data of 107 cases of malignant and 703 cases of benign thyroid nodules examined by high-resolution colored ultrasonography preoperatively and pathological diagnosis by paraffin embedded slides postoperatively were collected from our hospital over a period of 3 years. The percentages of calcification and fine stippled psammomatous(FSP) calcification in benign and malignant nodular disease, in different sexes and different age groups were retrospectively reviewed. Results:The incidences of calcification and FSP calcification were significantly higher in malignant group(63.55%, 29.02%, respectively) than in benign group（P＜0.001）. There was no significant difference between male and female groups(24.3%, 1.99%, respectively)（P＞0.05）. Calcification rate showed no significant difference between different age groups(＜45 and ≥45）（P＞0.05）; however, there was a significant difference of the FSP calcification rate between different age groups (P＜0.001）. The sensitivity of malignancy diagnosis was significantly higher in the group of patients younger than 45 years of age with FSP calcification of thyroid nodule. Conclusions:When calcification is noted on ultrasonography, it should raise the clinical index of suspicion for malignancy. FSP Calcification is a very highly specific in prediction of thyroid malignancy.

Abstract:Abstract:Objective:To summarize the methods and outcome of surgical treatment of thyriod carcinoma(TC). Methods:The clinical data of 126 cases of TC admitted between 1990 to 2005 to our 2 hospitals was analyzed. Results:Among the 126 cases, there were papillary carcinoma in 94 cases (74.5%),follicular carcinoma in 20 cases(15.9%), medullary carcinoma in 5 cases(4%), anaplastic carcinoma in 4 cases(3.2%), lymphoma in 2 cases(1.6%) and squamous cell carcinoma was in 1 case(0.8%). Thyroid microcarcinoma(TMC) was found in 56 of 126 cases and all of them were papillary carcinoma. Seventy-eight cases were followed up for more than 5 years after operation and 36 cases for 3 to 5 years, and all have good quality of life. All of the 4 cases with anaplastic carcinoma died in 3 to 6 months. Two cases with medullary carcinoma and 1 case with squamous cell carcinoma died from pulmonary metastases 1 year after operation. Conclusions:For differentiated TC, surgical treatment is the ideal treatment. However, for anaplastic TC, operation is not to be recommended, the choice of treatment is radiotherapy.

Abstract:Abstract:Objective:To explore the expression and relationship of PTEN and mTOR in the development of cholangiocarcinoma, determine the effect of the PI3K/PTEN/AKT/mTOR signal transduction on the development of cholangiocarcinoma. Methods:The expression of mTOR and PTEN in the cholangiocarcinoma was detected by the immunohistochemistry and RT-PCR method. Results:Compared to normal tissues, the expression of mTOR gene in cholangiocarcinoma significantly increased, but the expression of PTEN gene decreased. There was a negative correlation between mTOR gene and PTEN gene expression in cholangiocarcinoma. Conclusions:The expression of mTOR gene in cholangiocarcinoma was increased and the expression of PTEN was decreased. It suggested that the mTOR gene and PTEN gene could play an important role in the process of development of cholangiocarcinoma.

Abstract:Abstract:Objective:To investigate the effects of hyperoxic-hyperosmotic sodium chloride solution(HHSCS) on arterial blood gas and blood lactate in rabbits with hemorrhagic shock, and evaluate the HHSCS effects on hemorrhagic shock resuscitation. Methods:Hemorrhagic shock models were induced in 30 male rabbits. The median arterial pressure(MAP) was declined to 40mmHg within 10 minutes, then maintained for 60 minutes. The animals were then randomly divided into 3 groups:normal saline hyperoxic solution (NSO)group, hyperosmotic sodium chloride solution (HS)group and HHSCS group. Sixty minutes later, NSO，HS or HHSCS 6ml/kg was infused intravenously in 5 minutes. Heart rate(HR) 、respiratory rate(RR)、 MAP and urine drops(UD) before shock and after fluid infusion were recorded; blood lactate(BL) and blood gas were measured before shock，60min after shock，and 30min，60min，120min postinfusion. Finally, the rabbits were killed by bleeding, the lungs were observed in autopsy, and the lung coefficient was measured. Results:HS and HHSCS more effectively raised MAP,enhanced heart function,and increased UD than NSO. HHSCS group significantly reduced BL. At 60,120min after infusion, SaO2 in HHSCS group was significantly higher than that in HS group and NSO group(P<0.05),and PaO2 was significantly higher than HS group and NSO group at 30 min after infusion(P<0.05). The lung coefficient in HS group、HHSCS group was less than that in NSO group(P<0.01). Conclusions:HHSCS can more efficiently decrease BL and increase blood SaO2 and PaO2 than NSO and HS did, and is more effective for hemorrhagic shock resuscitation.