Abstract:

Abstract:保乳整复手术是乳腺癌治疗中的一个基本组成部分。这种治疗方式可以切除大量的乳腺组织，提高美容效果，在使患者满意的同时保持良好的肿瘤学切除原则，减少再切除术和乳腺切除率，并有助于辅助放射治疗计划。 我们复习了近年来各种不同保乳整复手术，并描述了在切除乳腺内不同位置肿瘤的技术应用以及选择不同技术时所考虑患者相关的具体因素。最后，对于这种外科手术类型的肿瘤学安全性的证据及并发症进行了讨论。

Abstract:

Objective: To investigate the relations of DNA topoisomerase II IIα (Topo IIα) and class III β tubulin (TUBB3) expressions in breast cancer tissue with the efficacy of anthracycline- and taxane-based neoadjuvant chemotherapy. Methods: Sixty-four women with primary breast cancer were enrolled, and they were randomly designated to receive anthracycline-based regimen (20 cases), taxane-based regimen (20 cases) or anthracycline plus taxane-based regimen (24 cases) respectively, and efficacy evaluation was conducted after 3-4 cycles. The expressions of Topo IIα and TUBB3 in the needle aspiration specimens from these patients before chemotherapy were detected by immunohistochemical staining. Results: The response rate for anthracycline-based, taxane-based and combination-based regimen was 50.00%, 35.00% and 70.83% respectively, but no statistical difference was found among the three regimens (P=0.128). Patients with positive Topo IIα expression had better response to anthracycline-based regimen than those with negative Topo IIα expression (P=0.023), while the response to taxane-based regimen was not associated with Topo IIα expression status of the patients (P=0.642); patients with positive TUBB3 expression showed poorer response to taxane-based regimen than those with negative TUBB3 expression, but the difference did not reach a statistical significance (P=0.057); patients with co-positive Topo IIα and TUBB3 expression were sensitive to anthracycline-based regimen, while those with positive Topo IIα expression and negative TUBB3 expression had better response to taxane-based regimen (P=0.015); the efficacy of combination-based regimen showed no relation with either Topo IIα or TUBB3 expression status (P>0.05). Conclusion: Breast cancer patients with positive Topo IIα expression may obtain better results with anthracycline-based chemotherapy, so it may be used as a predictor for making a personalized treatment plan. However, whether TUBB3 can be used as a predictor for tailored chemotherapy still needs further investigation with larger sample size.

Abstract:Objective: To investigate the clinical efficacy and application value of neoadjuvant chemotherapy plus breast-conserving surgery for middle-advanced stage breast cancer. Methods: The clinical data of 97 patients with stage II-III breast cancer treated from February 2008 to February 2010 were retrospectively analyzed. Of the patients, 41 cases received neoadjuvant chemotherapy plus breast-conserving surgery (breast-conserving group, patients undergoing neoadjuvant chemotherapy before surgery) and 56 cases were subjected to modified radical mastectomy (modified radical surgery group, patients undergoing no chemotherapy before surgery). The clinical efficacies between the two groups were compared. Results: The objective response rate in breast-conserving group was significantly higher than that in modified radical surgery group (73.17% vs. 57.14%, P<0.05). After the follow-up period of a median of 23.2 months, patients in breast-conserving surgery group all survived, with one case of local recurrence and no distant metastasis; in modified radical surgery group, local recurrence occurred in 6 cases and distant metastasis occurred in 5 cases, 3 cases of whom died. The median progression-free survival in breast-conserving group and modified radical surgery group was 32.3 and 22.1 months, respectively (P<0.05). In breast-conserving surgery group, cosmetic evaluation of breast appearance for 82.93% cases was excellent, subjective cosmetic satisfaction in 90.24% cases was very satisfied and in 7.32% cases was satisfied. Conclusion: Neoadjuvant chemotherapy can remarkably decrease the clinical stage of middle-advanced stage breast cancer before breast-conserving surgery, and the short-term postoperative efficacy and cosmetic results are all satisfactory, with important clinical benefits for some of these patents.

Abstract:Objective: To investigate the clinical application value of immediate repair using mammary/perimammary tissue displacement technique for local defect after breast-conserving therapy. Methods: The clinical data of 87 breast cancer patients undergoing immediate repair using mammary/perimammary tissue displacement technique during breast-conserving surgery between January 2009 and January 2012 were reviewed. The characteristics and clinical applicability of this technique were analyzed, and the postoperative complications and cosmetic results were assessed. Results: Repair operation was successfully performed in all the 87 patients, of whom, 61 cases underwent mammoplasty with adjacent gland tissue flap, 12 cases underwent mammoplasty with lateral thoracic fascial flap, and 14 cases underwent mammoplasty with partial latissimus dorsi muscle flap. There were no severe postoperative complications in any of the whole group of patients. Postoperative follow-up was 12 to 27 months and no local recurrence occurred. The cosmetic results were excellent or good in 75 (86.1%) cases, and fair in12 (13.7%) cases. The reconstructed breasts showed natural and symmetrical appearance with good hand-feeling. Conclusion: Application of immediate repair using mammary/perimammary tissue displacement technique for local defect during breast-conserving therapy can avoid serious breast deformation and maintain the dense breast appearance. This procedure is easy, safe and effective, and is of considerable clinical value.

Abstract:Objective: To compare the postoperative recurrence and survival between breast-conserving surgery and modified radical operation in breast cancer women in child bearing age. Methods: The clinical data of 82 breast cancer women in child bearing age admitted from January 2005 to June 2010 were collected. Of the patients, 48 cases (breast-conserving group) underwent breast-conserving therapy and 34 cases (modified radical operation group) were subjected to modified radical operation. The intraoperative conditions, postoperative complications, recurrence, metastasis, and quality of life of the two groups of patients were analyzed. Results: In breast-conserving group compared with modified radical operation group, the operative time [(74.4±8.3) min vs. (92.6±10.7) min], intraoperative blood loss [(46.8±6.7) mL vs. (77.0±68.4) mL] and drainage volume [(398.8±41.3) mL vs. (601.4±62.7) mL] were significantly reduced, the length of hospital stay [(13.4±3.2) d vs. (17.9±2.8) d] was significantly shortened, and the incidence of postoperative complications (6.3% vs. 14.7%) was significantly decreased (all P<0.05). The 1- and 2-year recurrence or metastasis rate showed no statistical difference between the two groups (P>0.05). The scores for social, emotional, role and physical function in breast-conserving group were all significantly higher than those in modified radical operation group (all P<0.05). Conclusion: For breast cancer women in child bearing age, breast-conserving surgery is similar to modified radical operation in regard to postoperative recurrence and metastasis, but the former is superior to the latter in respect to postoperative quality of life.

Abstract:Objective: To investigate the clinicopathologic profile and distributional features of molecular subtypes of breast cancer in Hunan Province, and their differences from other geographic regions in China and other countries. Methods: The clinicopathologic data of 2 324 breast cancer female patients admitted in Xiangya hospital from January 2002 to September 2012 were reviewed, and the features of molecular subtypes divided by the status of estrogen receptor (ER), progestrone receptor (PR), Ki-67, and epidermal growth factor receptor (Her-2) were analyzed. Results: Of the breast cancer patients in Hunan, the average age was 47.57 years, the proportion of premenopausal cases (64.5%) was higher than that of postmenopausal cases (35.5%), and the cases with stage II cancer accounted for the major part; the differences in molecular subtype distribution were all statistically different from those of other geographic regions in China and other countries (all P<0.05); the luminal A subtype accounted for 59.6%, which was higher than that of patients in Shanghai (52.8%), Guangdong (31.1%), and among African-Americans (55.5%), but lower than that of Poles (73.0%) and Americans (66.1%), and the proportion of Her-2 subtype (5.6%) was lower than that in all other populations while the proportion of triple negative (22.0%) was higher than of the majority of other populations; the molecular subtype distribution had statistical difference between or among the groups divided by age, tumor stage, menstrual status and whether or not neoadjuvant chemotherapy was administered (all P<0.05). Conclusion: Among women in China Hunan province, the average age of onset of breast cancer is relatively early, and most of the patients are premenopausal women with luminal A as the predominant subtype; the molecular subtype distribution is related to age, tumor stage, menstrual status and neoadjuvant chemotherapy.

Abstract:Objective: To analyze the learning curve of sentinel lymph node biopsy in early-stage invasive breast cancer. Methods: Sixty patients with early-stage invasive breast cancer undergoing modified radical mastectomy between March 2011 and October 2012 were enrolled. The patients were divided into group A, B and C according to the time order of operation, with 20 cases in each group. The patients underwent sentinel lymph node biopsy before modified radical mastectomy. The operative time, success rate, false negative rate and sensitivity of sentinel lymph node biopsy among groups were compared. Results: The operative time in group A, B and C was (36.6±8.2), (25.1±7.4) and (17.3±5.6) min respectively, and there was statistical difference among the three groups (P<0.05). The success rate, false negative rate, and sensitivity of sentinel lymph node biopsy in group A was 65.0%, 55.6% and 44.4%, in group B was 95.0%, 11.1% and 88.9%, and in group C was 100.0%, 0 and 100.0% respectively, and all the differences in these parameters were statistically different (all P<0.05). Conclusion: With the completion of 20 performances of standardized sentinel lymph node biopsy, one can basically grasp this technique, and may reach full mastery after 40 performances.

Abstract:Objective: To evaluate the value of ultrasonic examination and molybdenum target X-ray mammography for early diagnosis of breast cancer, so as to improve the efficiency of early breast cancer detection. Methods: The clinical data of 528 female patients with early-diagnosed breast cancer were collected. Of the patients, the lesions in 132 cases, which were both mammographically and clinically occult, were diagnosed by B-ultrasonic examination, and in 396 cases were identified by molybdenum target X-ray mammography. The clinical and imaging characteristics, surgical procedure and histopathological profiles, as well as molecular biological markers and types between the patients diagnosed by the two examination methods were compared. Results: Comparison between the two groups of patients demonstrated that ultrasonic examination was more likely to detect the lesions than molybdenum target X-ray mammography in young, premenopausal, and Han nationality (vs. Uyghur nationality) women, in dense breast tissues, and of BI-RADS category 4 in breast imaging (all P<0.05); compared with molybdenum target X-ray mammography, patients preliminarily diagnosed by ultrasonic examination were more likely to undergo breast-conserving surgery and had a low positive rate of lymph node metastasis, and ultrasonic examination was more likely to find the lesions that were less than 1 cm, solitary and well differentiated, and more likely to find the early-stage invasive breast cancer (all P<0.05); ultrasonic examination had high detection rate for ER-positive or luminal A breast cancer, while molybdenum target X-ray mammography had high detection rate for Her-2-positive or Her-2 subtype breast cancer (all P<0.05). Conclusion: Ultrasonic examination has higher detection rate than molybdenum target X-ray mammography for the early-stage breast cancer with low degree of invasiveness and malignancy in dense breast tissue, but both have their advantages in detection of early breast cancer of molecular subtypes. So, combined application of the two methods can increase the early detection rate of breast cancer.

Abstract:Objective: To assess the clinical value of magnetic resonance imaging (MRI) in diagnosis of intraductal papilloma. Methods: One hundred and seventy-six female patients having preoperative MRI data, undergoing surgical treatment and with pathological confirmation were selected. Of the patients, there were 37 cases of intraductal papilloma, 52 cases of non-papilloma benign lesions, and 87 cases of breast cancer. Comparison among the three groups of patients was performed in regard to clinical, pathological and MRI data, and the latter included time-intensity curve, imaging findings, and apparent diffusion coefficient (ADC). Results: Thirty-seven lesions were found in the 37 intraductal papilloma, 56 lesions were found in the 52 patients with non-papilloma benign diseases, and 92 lesions were found in the 87 breast cancer patients, respectively. Compared with patients in other two groups, patients with intraductal papilloma showed no difference in age of onset (F=2.470, P=0.088), but was statistically different in lesion size, location, time-intensity curve, imaging manifestations, and ADC value (all P<0.05). Conclusion: Intraductal papilloma has distinct MRI characteristics, so, with support of ADC value, MRI can be used as an important approach for clinical diagnosis of intraductal papilloma.

Abstract:Objective: To investigate the clinicopathologic features and diagnostic methods of intraductal papillary lesions of the breast. Methods: Using a retrospective approach, the clinical data of 1 211 patients with different types of intraductal papillary lesions of the breast were analyzed, which included age distribution, characteristics of nipple discharge and breast mass, and results of histopathological and imaging examination. Results: Among the 1 211 patients, 874 cases were intraductal papilloma, 231 cases were papillomatosis, and 106 cases were papillocarcinoma. The average age of patients with malignant lesion was significantly higher than that of patients with benign lesion (P<0.01), and the high incidence age for papilloma and papillomatosis was between the ages of 31 and 50 years. Sixteen percent of the patients had a history of breast disease surgery, and the number of cases that experienced repeated breast surgery or bilateral breast surgery in papillomatosis patients was higher than that in papilloma or papillocarcinoma patients (P<0.05). Different types of nipple discharge occurred in 67.8% of the patients, and in papillocarcinoma patients, the number of cases with nipple discharge was lower but the number of cases with bloody discharge was higher than that in patients with benign lesion (P<0.05). Breast mass was seen, during surgery, in about 80% of the patients with benign lesion and in all the patients with malignant lesion, and the incidence of moderate/severe atypical hyperplasia in papillomatosis patients was higher than that in papilloma patients (P<0.05); the mass greater than 1.0 cm was usually accompanied with moderate/severe atypical hyperplasia, and the average size of papillocarcinoma was (1.93±0.78) cm. The accuracy rate of galactography or fiber breast duct endoscopy for diagnosis of benign lesion was higher than that of ultrasound and mammography (P<0.05). Conclusion: Different types of intraductal papillary lesions have some common manifastations, but also have their own characteristics, and knowledge about these features may be helpful for correct clinical diagnosis and treatment.

Abstract:Objective: To investigate and summarize the measures for identification and protection of parathyroid glands in total thyroidectomy (TT). Methods: The clinical data of 3 425 patients who underwent TT from March 2003 to March 2013 were analyzed retrospectively. Results: Of the entire group of patients, 489 cases were male and 2 936 cases were female, and their ages ranged from 9 to 72 years; operation was performed in 2 261 cases of nodular goiter, 684 cases of thyroid cancer, 92 cases of primary hyperthyroidism, 57 cases of hyperthyroidism resulting from a nodular goiter, 41 cases of thyroid adenoma, 31 cases of granulomatous thyroiditis, and 259 cases of Hashimoto’s disease; 364 cases underwent unilateral TT and bilateral TT was done in 3 061 cases; 186 cases underwent neck dissection and 834 cases received parathyroid autotransplantation. The length of postoperative hospital stay was 5 to 8 d and postoperative follow-up period ranged from 2 months to 10 years; there were no cases of permanent hypoparathyroidism and the efficacy of treatment was satisfactory. Conclusion: The parathyroid glands have special anatomical features, with complicated and diverse shapes. During TT, surgeons should operate meticulously, dissect along the tissue planes, and keep a clean operative field so as to accurately identify and protect the parathyroid glands and avoid damaging them, which may effectively reduce the incidence of permanent hypoparathyroidism.

Abstract:Objective: To investigate the causes of thermal injury of recurrent laryngeal nerve (RLN) and the preservation methods. Methods: Between June 2009 to December 2011, 513 patients scheduled for thyroid surgery in Shaanxi Provincial People’s Hospital were randomly divided into two groups for prospective study. Of the patients, 247 cases received preventive treatment for thermal injury of the RLN (observational group) and 266 cases received no preventive treatment (control group) during operation. The surgical management comprised unilateral subtotal thyroidectomy in 205 cases, bilateral subtotal thyroidectomy in 155 cases, unilateral total thyroidectomy in 103 cases, and functional radical neck dissection for thyroid cancer in 50 cases. Results: Follow-up of the patients was conducted for 2 to 30 months, with an average of (25.6±3.2) months for observational group and (22.4±4.4) months for control group. Two-hundred and twenty-five (91.09%) patients in observational group and 248 (93.23%) patients in control group were followed up. RLN injury occurred in 13 patients (2.75%) in the entire group of patients, with 2 (0.89%) cases in observational group and 11 (4.44%) cases in control group which had statistical difference (P<0.05); of the 13 patients, 2 cases of permanent RLN injury were all in control group. Conclusion: Improper use of electric scalpel and ultrasound knife may cause thermal injury of the RLN, which is difficult to repair. Taking effective preventive and protective measures can reduce the incidence of thermal injury of the RLN.

Abstract:Objective: To assess the feasibility and safety of total endoscopic thyroidectomy via bilateral axillary and ipsilateral breast approach (BAIBA). Methods: The data of 35 patients with thyroid diseases who underwent BAIBA endoscopic thyroidectomy performed by the same surgeon between April 2010 and March 2012 were analyzed, and the surgical procedures were described. Results: Operations were successfully completed in all the 35 patients without conversion to open surgery. The average operative time was (126±26.3) min, intraoperative blood loss was (15.3±3.49) mL and mean size of the skin flap was (118.6±8.74) cm2. No postoperative complication occurred, and postoperative drainage volume on day 1 was (89.5±62.36) mL. The average length of postoperative hospital stay was 2–3 d and the postoperative pain score was 0–2. Follow-up ranged from 4 to 20 months; no recurrence was noted and the cosmetic results were satisfactory. Conclusion: BAIBA endoscopic thyroidectomy is safe and feasible, and it has the advantages of excellent cosmetic outcome, less pain, and quick recovery.

Abstract:Objective: To investigate the surgical diagnosis and treatment of primary hyperparathyroidism (PHPT). Methods: The clinical data of 86 PHPT patients treated between 2002 and 2012 were retrospectively analyzed. Results: Of the patients, the initial symptoms presented in 45 cases as skeletal disorders, in 21 cases as urological problems, and in 14 cases as gastrointestinal upsets; six cases had no obvious symptoms. The mean calcium level was (3.13±0.46) mmol/L and the median parathyroid hormone (PTH) level was 864.6 pg/mL in patients before operation. The detection rate of diseases by ultrasound, 99mTc-MIBI, and CT was 90.3%, 95.0% and 78.6%, respectively. Unilateral neck exploration was performed in 58 patients with a solitary parathyroid adenoma (including 5 cases of ectopic parathyroid adenoma), and bilateral neck exploration was performed in 11 patients with multiple parathyroid adenomas, 15 patients with parathyroid adenoma combined with bilateral nodular goiter and 2 patients with parathyroid hyperplasia. Eighty cases were followed up for 3 months to six years, and all of them survived without recurrence. Conclusion: For PHPT, the calcium and PTH levels are the bases for qualitative diagnosis; ultrasound and 99mTc-MIBI are the main approachs for localization; surgery is the most effective treatment method and unilateral neck exploration is the common procedure.

Abstract:Objective: To analyze the epidemiological characteristics of the differentiated thyroid cancer (DTC) in regions with different iodine intake levels and investigate the relation between the iodine level and thyroid carcinoma (TC). Methods: Based on the historical and pre-survey data, Pingtan county and Yongtai county of Fuzhou city were selected as high-iodine intake region and normal-iodine intake region, respectively, for this epidemiological investigation. The morning urine samples before breakfast from students in grade 3 at primary school in the two regions, for the year 2011, were collected, and their urinary iodine values were determined by arsenic-cerium catalytic spectrophotometric method. The detailed data on prevalence of TC in the two regions after national iodine supplementation program were obtained from Fujian tumor prevention and treatment center. Then, the prevalence of DTC and constituent ratio of the pathological types of TC were analyzed. Results: The iodine intake level of Pingtan county was significantly higher than that of Yongtai county in 2011 [(281.3±171.9) μg/L vs. (151.4±77.2) μg/L, t=18.44, P=0.00], and compared with previous years, the proportion of insufficient iodine intake was gradually decreased but the proportion of more than adequate or excessive iodine intake was gradually increased in Pingtan county; the proportion of insufficient iodine intake was gradually decreased and the proportions of adequate or excessive iodine intake tended to be stable, but the proportion of sufficient iodine intake was gradually increased in Yongtai county. From 2001 to 2011, the average annual incidence of DTC in Pingtan county was 52.725/100 000 and the standardized incidence rate was 50.945/100 000, which in Yongtai county was 1.837/100 000 and 1.780/100 000 respectively, and the difference between the two regions was statistically significant (P=0.00). The incidence of DTC in women was higher than that in men regardless of whether they were in high-iodine intake or normal-iodine intake region and, moreover, the percentage of females was much higher in high-iodine intake region (5.34:1 vs. 2.74:1, χ2=6.15, P=0.02). Compared with Yongtai county, the proportion of DTC in Pingtan county was higher (98.5% vs. 91.0%, χ2=23.95, P=0.00), and the papillary thyroid carcinoma (PTC) accounted for the majority (95% vs. 83.3%, χ2=4.76, P=0.03), while the anaplastic thyroid carcinoma (ATC) was far rarer (0.1% vs. 1.3%, χ2=8.49, P=0.00). Conclusion: The incidence of DTC has increased in both high-iodine intake and normal-iodine intake regions and, however, it is far higher in high-iodine intake region than that in normal-iodine intake region, and is more prevalent in women. The increasing trend of TC is mainly responsible for DTC and especially for PTC, with the ATC becoming even rarer, and this trend is especially obvious in high-iodine intake region.

Abstract:Objective: To assess the value of thyroid imaging reporting and data system (TI-RADS) for qualitative diagnosis of thyroid nodules. Methods: The conventional ultrasound image data from 235 patients with total of 432 thyroid nodules (299 benign nodules and 133 malignant nodules) that were confirmed by surgical and pathological findings were retrospectively analyzed. The ultrasound characteristics that had statistical significance in differentiation between benign and malignant lesions were screened, and the nodules, according to the ultrasound characteristics, were divided into 1-5 grades using TI-RADS classification standard, and then the grading results were compared with the final pathological results. Results: Statistical analyses showed that lesions with ill-defined border, irregular shape, solid echo, microcalcifications, irregular vascular pattern, and a short-to-long axis ratio ≥1 or the presence of abnormal lymph nodes were malignant ultrasound characteristics for nodules (all P<0.05). Using grade 3 as the criterion for classifying benign and malignant lesion, the sensitivity, specificity, and accuracy of TI-RADS classification was 83.5%, 91.0% and 88.7%, respectively; if only grade 1-2 (representing benign lesion) and grade 4-5 (representing malignant lesion) were considered, with exclusion of the dubious grade 3, the sensitivity, specificity, and accuracy of TI-RADS classification was 90.1%, 98.9% and 96.2%, respectively. Conclusion: TI-RADS has high sensitivity, specificity, and accuracy; its application is helpful for interpretation of the ultrasonic evaluation and, thereby for making a proper treatment plan. So it has great practical value.

Abstract:Objective: To investigate the effect of forkhead box C2 (FOXC2) gene silencing by siRNA on mRNA and protein expression of cancer stem cell (CSC) marker CD44 in breast cancer. Methods: Breast cancer MCF-7 cells were firstly cultured by routine methods, and then were cultured in mammosphere-forming conditions to enrich and screen out breast cancer CSCs. Next, the obtained CSCs were transfected with the lentiviral vector containing FOXC2-siRNA or negative control-siRNA, and CSCs transfected with empty vector were served as blank control. The FOXC2 mRNA and protein expressions in breast cancer CSCs were determined by real time RT-PCR and Western blot method, respectively, to assess the silencing efficacy, and then CD44 mRNA and protein expressions in each group of breast cancer CSCs were measured by real time RT-PCR and Western blot, respectively. All results were analyzed by comparing to the expression levels of blank control. Results: The breast cancer CSCs were successfully cultured from MCF-7 cells by mammosphere formation. Compared with breast cancer CSCs transfected with negative control siRNA, both FOXC2 mRNA and protein expressions were decreased significantly (P=0.00509, P=0.00001), and both CD44 mRNA and protein levels were down-regulated significantly in FOXC2-siRNA transfected breast cancer CSCs (P=0.00848, P=0.00218). Conclusion: FOXC2 gene silencing can inhibit the CD44 mRNA and protein expression in breast cancer CSCs. So, FOXC2 signaling pathway may possibly participate in the proliferation and differentiation process of breast cancer CSCs through regulating CD44 expression.

Abstract:

Objective: To observe the effects of liquiritigenin on growth, apoptosis, and autophagy of human breast carcinoma MCF-7 cells. Methods: After exposure to different concentration of liquiritigenin (0.05, 0.10, 0.20, 0.40 mmol/L) for 24, 48 and 72 h respectively, the cell viability of MCF-7 cells was determined by MTT assay. The cell apoptosis was determined by Hoechst 33342 staining and cell autophagy was observed by acridine orange (AO) staining after MCF-7 cells were exposed to liquiritigenin of above concentrations for 48 h. Results: With the increase of concentration of liquiritigenin and prolongation of exposure time, the cell viability of MCF-7 cells was gradually decreased, and some of the results reached statistical difference comparing with control (P<0.05 or P<0.01). The apoptotic rate of MCF-7 cells was increasingly elevated with the increase of concentration of liquiritigenin, and became statistically different versus control when liquiritigenin reached 0.20 mmol/L (all P<0.01). Autophagy occurred in MCF-7 cells exposed to each tested concentration of liquiritigenin, but autophagic activity presented a trend of initial increase and subsequent decrease with the increase of concentration of liquiritigenin. Conclusion: Liquiritigenin can inhibit the growth of human breast carcinoma MCF-7 cells, and this action is associated with apoptosis acceleration and autophagy induction.

Abstract:Objective: To observe the activity of the signaling pathway of phosphatidylinositol 3-kinase (PI3K)/Akt in the tumor tissues in obese breast cancer patients. Methods: Breast cancer specimens from 45 obese breast cancer patients (obesity group) and 37 normal-weight breast cancer patients (control group) were collected, and then, the PI3K mRNA expression was determined by RT-PCR, and the protein expressions of PI3K and phosphorylated Akt (p-Akt) were determined by immunohistochemical staining in the two groups of breast cancer tissues, respectively. Results: The results of RT-PCR showed that the PI3K mRNA expression was significantly elevated in breast cancer tissues of obesity group compared with control group (P<0.05). The results of immunohistochemical staining revealed that both PI3K and p-Akt protein expressions in breast tissues of obesity group were significantly higher than those in breast tissues of control group (both P<0.05) and, moreover there was a positive correlation between PI3K and p-Akt protein expression in either group of tissues (r=0.76 and r=0.81, both P<0.05). Conclusion: The activity of PI3K/Akt signaling pathway in cancer tissues of obese breast cancer patients is increased compared with non-obese breast cancer patients, thus, it is speculated to be one of the factors for the increased risk of breast cancer in obese women.

Abstract:Objective: To investigate the relations of CD8+ tumor-infiltrating lymphocytes (TILs) in breast cancer patients with their clinicopathologic features and survival outcomes. Methods: The CD8+ TILs expression in embedded tissue sections from 122 breast cancer patients was detected by immunohistochemical staining. According to the CD8+ TILs expression status, patients were divided into CD8+ TILs positive group and CD8+ TILs negative group, and the relations of CD8+ TILs with clinicopathologic features and survival outcomes were analyzed. Results: Among the specimens, the positive rate of CD8+ TILs expression was 32.14% (36/112). Statistical analysis showed that the differences in CD8+ TILs expression had statistical significance between or among the groups divided by degree of differentiation (χ2=6.277, P=0.043), TNM stage (χ2=3.963, P=0.047), and histological classification (χ2=4.299, P=0.038). The 5-year survival of CD8+ TILs positive group was significantly higher than that of CD8+ TILs negative group (88.89% vs. 71.05%, χ2=4.360, P=0.037). Log-rank test showed that the overall survival of CD8+ TILs positive group was significantly higher than that of CD8+ TILs negative group (P=0.043). Conclusion: CD8+ TILs can be used as a prognostic index for breast cancer patients and low infiltration of CD8+ TILs in tumor tissue may predict a poor outcome.

Abstract:Objective: To investigate the Wnt5a expression in papillary thyroid carcinoma (PTC) tissues and its significance. Methods: The paraffin-embedded specimens that included tumor tissues and adjacent tissues from 47 postoperative pathology confirmed PTC patients, and 10 pairs of fresh surgical specimens of PTC and adjacent thyroid tissues were collected. Wnt5a expression in these PTC and adjacent tissue samples were detected by immunohistochemical staining and real-time PCR method, respectively. Results: In the paraffin-embedded specimens of 47 patients, Wnt5a positive expression rate was 68.09% (32/47) in PTC tissues and 6.38% (3/47) in adjacent thyroid tissues, respectively, and the difference between them had statistical significance (P<0.01); further statistical analyses indicated that Wnt5a expression was irrelevant to the age and sex of the patients (both P>0.05), but was related to their TNM stage and lymph node metastasis (P<0.05 or P<0.01). Examination of the 10 pairs of fresh surgical specimens showed that Wnt5a mRNA expressions in PTC tissues were significantly higher than those in their paired adjacent thyroid tissues (6.43±1.38 vs. 1.12±0.59, P<0.01). Conclusion: Wnt5a expression is increased in PTC tissue, which suggests that Wnt5a may be potentially involved in the occurrence and development of PTC.

Abstract:Immunotherapy is an important treatment method following conventional non-surgical treatment modalities for breast cancer such as chemotherapy, radiotherapy, and endocrinotherapy. As a new treatment strategy for breast cancer, it has great potential for development. Thus, in this paper, the authors present the current research efforts and progress of breast cancer immunotherapy.

Abstract:MicroRNA (miRNA) is a small molecular RNA, which regulates biological process such as proliferation, differentiation, apoptosis, and stress. miRNA participates in the occurrence and development of breast cancer through a number of mechanisms, and this paper addresses the research progress of miRNA specifically in triple negative breast cancer (TNBC).