Objective This study aimed to explore the relationship between serum lipid and lipoprotein levels and occurrence of breast cancer, and relationship between serum lipid and lipoprotein levels and clinicopathological characteristics of breast cancer patients. Methods Clinical data of 788 patients with breast cancer and 395 patients with benign breast disease were retrospectively collected, who received treatment in The First Affiliated Hospital of Chongqing Medical University from January 2014 to March 2016, and to explore the relationship between levels of total cholesterol (TC)/triglyceride (TG)/high density lipoprotein cholesterol (HDL-c)/low density lipoprotein cholesterol (LDL-c) and occurrence of breast cancer/ clinicopathological characteristics of breast cancer patients. Results ① Influencing factors that affected the occurrence of breast cancer: multifactor logistic analysis showed that, height (OR=0.950, P=0.006), body mass index (OR=1.062, P=0.041), and serum LDL-c level (OR=1.349, P=0.016) were independent influencing factors for occurrence of breast cancer, people had high body mass index and higher level of serum LDL-c had high risk of breast cancer, but people had high height had low risk of breast cancer. ②Association analysis of serum lipid and lipoprotein levels and clinicopathological characteristics of breast cancer patients: the serum TC level was correlated with expression of progesteronereceptors (PR) and lymph node metastasis status (P<0.05), the serum TC levels of patients with negative-expression of PR and lymph node metastasis were slightly higher than that of patients with positive-expression of PR and non-lymph node metastasis; the serum TG level was associated with body mass index (P<0.05), that the serum TG level of patients with body mass index≥25 kg/m2was slightly higher than that of patients with body mass index<25 kg/m2; the serum HDL-c level was correlated with the body mass index and diameter of the tumor (P<0.05), the serum HDL-c level of the patients with body mass index≥25 kg/m2 was slightly lower than that of patients with body mass index<25 kg/m2, the serum HDL-c level of patients with the tumor diameter≤2 cm was slightly higher than that of patients with the tumor diameter >2 cm; the serum LDL-c level was correlated with body mass index, expression of estrogenreceptors (ER) and PR, and molecular typing ( P<0.05), the serum LDL-c level was slightly higher in patients with body mass index≥25 kg/m2, negative expression of ER and PR, and non Luminal type patients, comparing with patients with body mass index<25 kg/m2, positive expression of ER and PR, and Luminal type patients. Conclusions High level of serum LDL-c is strongly associated with occurrence of breast cancer, and levels of serum lipid and lipoprotein are associated with expression of hormone receptor, molecular type of breast cancer, and status of lymph node, but it needs further randomized controlled studies to confirm.
Objective To investigate the clinical characteristics, therapeutic methods, and prognostic factors of patients with rectal stromal tumor. Methods The clinicopathological data of 33 patients with rectal stromal tumor who treated in the Affiliated Hospital of Xuzhou Medical University from January 2008 to November 2014 were retrospectively reviewed, and the therapeutic methods and prognostic factors of these patients were further analyzed. Results The major clinical manifestations of 33 patients included abdominal discomfort in 21 patients, changes of defecation habit and fecal property in 15 patients, bloody stool in 13 patients, and anal pain in 9 patients. CT and MRI examination showed a mass in the pelvic with the clear boundary, growed through the wall of rectum, with the heterogeneous density and signal, sometimes with necrosis, calcification, and haemorrhage. The results of immunohistochemical staining showed that, 31 patients were strongly positive for CD117, 28 patients were strongly positive for CD34, 15 patients were positive for smooth muscle actin (SMA), 13 patients were positive for vimentin, and 3 patients were positive for soluble acid protein (S-100). The therapeutic methods of 33 patients included local excision in 13 patients, low anterior resection in 11 patients, abdominal pelvic resection in 5 patients, and conservative treatment in 4 patients. A total of 26 patients underwent surgery combiend with imatinib therapy. The follow-up time was 10–102 months and the median time was 58 months. During follow-up period, there were 8 patients suffered from recurrence or metastasis, and 15 patients died. The results of Cox proportional hazards regression model showed that, postoperative relapse and metastasis were prognostic factors for survival〔RR=19.338, 95% CI was (2.821, 132.568), P=0.003〕. The survival situation of the patients suffered from postoperative relapse and metastasis was poor. Conclusions CD117 and CD34 could serve as valuable diagnostic indexes for rectal stromal tumor. Surgery is an effective treatment for rectal stromal tumor.
Objective To explore the clinicopathological features of bilateral primary breast cancer (BPBC) at different ages. Methods Clinical data of 105 BPBC patients admitted to the Department of Breast Surgery in The First Affiliated Hospital of Zhengzhou University from January 2017 to January 2020 were collected and divided into young group (≤40 years old) and middle-old group (>40 years old) according to age. The characteristics and differences of bilateral tumor lesions in pathological type, molecular type, tumor diameter, histological grade, clinical stage, lymph node metastasis, recurrence or distant metastasis, immunohistochemical indexes expression characteristics, consistency and difference, and overall prognosis between the two groups were retrospectively analyzed. Results There were statistically significant differences between the two groups in the size of the first primary cancer, lymph node metastasis, the high expression rate of Ki-67 in the second primary cancer, clinical stage of double primary cancer and recurrence or distant metastasis (P<0.05). In the young group, the proportion of the first primary cancer with T3–T4 stage was higher, the incidence of lymph node metastasis was higher, the proportion of high expression of Ki-67 in the second primary cancer was higher, and the proportion of patients with double primary cancer at first diagnosed as stage Ⅳ were higher than those in the middle-old group, and were prone to recurrence or distant metastasis. The expression of immunohistochemical indexes in bilateral cancer foci was consistent between the two groups (P<0.05). The expression consistency of ER and Ki-67 in the young group was better, and the expression consistency of PR and HER-2 in the middle-old group was better. The histological grade of the first primary cancer, TNM stage of bilateral primary cancer and recurrence or metastasis were independent factors affecting the prognosis of patients (P<0.05). Conclusions The BPBC patients of different ages have different clinicopathological features, and the expression of immunohistochemical indexes in bilateral cancer foci is consistent. Tumor histological grade of the first primary cancer may affect the prognosis of patients with BPBC, and the prognosis of patients with early bilateral TNM stage is better.
ObjectiveTo investigate the expressions of stromal cell-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) in local tissues of perianal abscess and their relationships with clinicopathological features and prognosis of patients.MethodsA total of 47 patients with perianal abscess (perianal abscess group) and 58 patients with mixed hemorrhoids (mixed hemorrhoids group) were selected for the study. The tissues were collected during the operation. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expressions of SDF-1 mRNA and CXCR4 mRNA in local tissues of the two groups, the positive expressions of SDF-1 protein and CXCR4 protein in local tissues were detected by immunohistochemistry, and the relationships between the expressions of SDF-1 and CXCR4 protein and the clinical characteristics, prognosis of patients were analyzed.ResultsThe expression levels of SDF-1 mRNA and CXCR4 mRNA in the perianal abscess group were higher than those in the mixed hemorrhoids group, and the positive rates of SDF-1 protein and CXCR4 protein in the perianal abscess group were higher than those in the mixed hemorrhoids group too (P<0.05). The expressions of SDF-1 protein and CXCR4 protein in perianal abscess tissues were both not related to sex, age, location of abscess, and course of disease (P>0.05), but was related to abscess diameter, healing time, and anal fistula (P<0.05). The non-recurrence rates of SDF-1 protein-negative group and CXCR4 protein-negative group were lower than those of SDF-1 protein-positive group and CXCR4 protein-positive group respectively (P<0.05).ConclusionSDF-1 and CXCR4 molecular are up-regulated in the local tissues of perianal abscess, which are related to the size of abscess, healing time, anal fistula, and recurrence of patients.
ObjectiveTo investigate the expressions of Aurka mRNA and its protein in gastric cancer and adjacent tissues, and to analyzed the relationship between the expression level of Aurka mRAN and clinicopathological characteristics of gastric cancer patients. MethodsRetrospectively collected the gastric cancer and adjacent tissues of 198 gastric cancer patients who treated in the Affiliated Hospital of North Sichuan Medical College between April 2011 and September 2013. Using real time quantitative reverse transcription polymerase chain reaction (RT-PCR) method and immunohisto-chemical staining to detected expressions of Aurka mRNA and its protein of gastric cancer and adjacent tissues respectively. At the same time explored the relationship between expression level of Aurka mRNA in gastric cancer tissues and the clinico-pathological features of gastric cancer patients. ResultsRT-PCR results showed that, the expression level of Aurka mRNA in gastric cancer tissues was 16.62±1.85, which was significantly higher than that of adjacent tissues (7.10±1.59), P < 0.05. Immunohistochemistry results showed that, the positive rate of Aurka protein in gastric cancer tissues was obviously higher than of adjacent tissues[93.9% (186/198) vs. 16.2% (32/198), P < 0.01]. The expression level of Aurka mRNA in gastric cancer tissues was significantly related with a part of the clinicopathological parameters, including TNM staging, T staging, N staging, and differentiation (P < 0.05), but there was no relationship with gender, age, location, and carcino-embryonic antigen (CEA)/CA19-9 level in peripheral blood (P > 0.05). The expression level of Aurka mRNA in Helicobacter pylori (HP)-positive gastric cancer patients was higher than that of HP-negative gastric cancer patients (15.38±1.73 vs. 7.20±1.86, t=-3.74, P < 0.01). ConclusionExpression levels of Aurka gene and its protein were both significantly higher in gastric cancer tissues than those of adjacent tissues, which suggests that Aurka might play a significant role in the procession of the formation and development of gastric cancer as an oncogene, it also suggests that Aurka can be used as a predictor of prognosis and recurrence of patients with gastric cancer.
Objective To analyze clinical and pathological features of patients with papillary thyroid carcinoma (PTC) with coexistent chronic lymphocytic thyroiditis (CLT). Methods The clinicopathologic data of 756 cases of PTC were collected from January 2014 to January 2017 in the First Affiliated Hospital, Xinjiang Medical University were collected. The patients were designed to observational group (PTC with coexistent CLT, n=194) and control group (simple PTC, n=562) according to whether CLT was diagnosed by pathology, then the clinical data, ultrasonic features, thyroid function, and pathological features in these two groups were compared. Results The proportion of the female patients, the proportions of theserum thyroid stimulating hormone and thyroid autoimmune antibodies (thyroglobulin antibody and thyroid peroxidase antibody), and the proportion of multifocal carcinoma in the observational group were significantly higher than those in the control group (P<0.05). There were no significant differences in the preoperative ultrasound, tumor diameter, thyroid capsule invasion, central lymph node metastasis, and TNM stage in these two groups (P>0.05). The results of the multivariate analysis showed that the female, serum thyroid autoimmune antibodies, and the multifocal carcinoma were the independent predictive factors of PTC with CLT (P<0.05). Conclusions There might be a certain correlation between PTC and CLT, PTC with coexistent CLT is more common in female patient and with multifocal carcinoma. With coexistent CLT does not increase invasion of PTC. This may be associated with limit of CLT to development of PTC nodules. It is speculated that CLT may be a protective factor of PTC.
ObjectiveTo summarize the clinicopathological characteristics of 94 patients with pure mucinous breast carcinoma (PMBC), and to retrospectively analyze the prognosis and the prognostic factors. MethodsNinety four patients who were pathologically diagnosed with PMBC from November 1996 to October 2011 were retrieved from the database of breast cancer in West China Hospital. The clinicopathological and long term follow-up data of these patients were analyzed retrospectively. Results① Clinicopathological characteristics:These patients accounted for 1.48% (94/6 330) of all breast cancer patients who treated in our hospital during the same period. They were all female,with a median age of 45 years old (29-85 years)and median duration of 90 d (5-2920 d). A proportion of 63.83% (60/94) of these patients were premenopausal women. Ninety three patients had unilateral lesion, one patient had bilateral lesions, totally 95 lesions. A proportion of 85.29% (58/68) tumors were in T1-T2 staging, and 82.80% (77/93) tumors were node-negative. A proportion of 1.05% (1/95) tumors had metastasized at diagnosis. A proportion of 92.54% (62/67) tumors were in Ⅰ-Ⅱ staging, 84.34% (70/83) tumors were estrogen receptor (ER) positive, 74.70% (62/83) were progesterone receptor (PR) positive, and 20.25% (16/79) were human epidermal growth factor receptor 2 (HER-2/neu) positive. A proportion of 6.32% (6/95) of tumors had breast-conserving surgery. ② Preoperative diagnosis:The detection rate of malignance were 60.87% (14/23), 83.33% (40/48), and 100% (18/18), respectively for patients who were examined with mammography, ultrasonography, and mammography+ultrasonography, and there was significant difference between the three groups (P=0.006). ③ Prognosis and prognostic factors:The follow-up rate was 80.85% (76/94). Two cases had bone metastasis respectively in 14 and 26 months after operation, one of whom died. Both five-year and ten-year overall survival rate (OS) were 98.50%, both five-year and ten-year disease-free survival rate (DFS) were 95.80%. There was no lymph node involvement in patients of T1 phase, and no recurrence, metastasis or death occurred during the follow-up. The univariate analysis showed that the disease course, T staging, TNM staging, and HER-2/neu status were statistically significant prognostic factors for DFS situation (P<0.050). ConclusionsCases in this group displayed indolent behavior and favorable prognosis which are similar to western populations. The disease course, T staging, TNM staging, and HER-2/neu status appear to be significant predictors of worse prognosis. The combination of mammography and ultrasonography could largely improve the diagnostic accuracy, and breast-conserving therapy may be recommended for patients with no contraindications.
Objective To investigate the clinical features, treatment, and influence factors of prognosis in patients with gastric neuroendocrine neoplasms (GNENs). Methods From March 2011 to January 2016, the clinicopathological data of 44 patients with GNENs who treated in The Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed to summarize the choice of treatment plan and analyze influence factors of prognosis. Results A total of 44 patients enrolled in this study. The major clinical manifestation included abdominal pain in 18 patients (40.9%), abdominal distension in 16 patients (36.4%), loss of appetite in 4 patients (9.1%), acid regurgitation and belching in 4 patients (9.1%), nausea and vomiting in 1 patient (2.3%), eating after choking sense in 3 patients (6.8%), gastrointestinal bleeding in 2 patients (4.5%), diarrhea in 1 patient (2.3%), and palpitations with weakness in 3 patients (6.8%). The treatment of 44 patients included radical resection in 26 patients (59.1%), endoscopic resection in 13 patients (29.6%), local excision in 1 patient (2.3%), and 4 patients had distant metastasis before operation were conducted of palliative treatment〔palliative resection in 2 patients (4.5%) and conservative treatment in 2 patients (4.5%)〕. Univariate analysis showed that the gender, the age, the tumor size, and the N staging (lymph node metastasis) were not associated with prognosis (P>0.050), but the tumor location and the depth of tumor invasion were related to the prognosis (P<0.050). The tumors located in the upper part of the stomach and the serosal infiltration indicated poor prognosis. However, neither of them can be used as independent factor to evaluate the poor prognosis of GNENs patients (P>0.050). Conclusions GNENs has nonspecific clinical manifestation. Radical surgery and endoscopic resection are the main treatment methods, but the influence factors of prognosis in GNENs patients need further study.
Objective To investigate the clinicopathological characteristics of HER2 protein expression in different degrees in human epidermal growth factor receptor 2 (HER2) negative breast cancer and the factors related to the efficacy of neoadjuvant chemotherapy in breast cancer with low HER2 expression. Methods The clinicopathological data of 161 patients with HER2-negative breast cancer who received neoadjuvant chemotherapy in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from March 2019 to March 2022 were retrospectively collected. The difference of clinical and pathological characteristics of patients with different levels of HER2 protein expression were analyzed, and the factors influencing the pathological complete remission (pCR) rate of breast cancer patients with low HER2 expression after neoadjuvant chemotherapy with unconditional logistic regression model were analyzed. Results Among 161 HER2 negative breast cancer patients, 108 cases were low HER2 expression, accounting for 67.1%. Compared with those with zero expression of HER2 [immunohistochemistry (IHC) 0], the patients with low HER2 expression had higher axillary lymph node metastasis rate (P=0.048), lower histological grade (P=0.006), and higher proportion of positive hormone receptor expression (P<0.001). There was no significant difference in pCR rate among the HER2 IHC 0, IHC 1+ and IHC 2+ / in situ hybridization (ISH)– (P=0.099) , and the pCR rate of low expression of HER2 was lower than that of zero expression of HER2 in the general population and Luminal subgroup, and the difference was statistically significant (P<0.05). There was no significant difference in triple negative breast cancer subgroup (P=0.814). The logistic regression analysis showed that age, histological grade and estrogen receptor expression status were independent influencing factors for pCR rate after neoadjuvant chemotherapy with low HER2 expression (P<0.05). Conclusions Different degrees of HER2 protein expressions in patients with HER2-negative breast cancer have unique clinicopathological characteristics. The pCR rate of neoadjuvant chemotherapy in patients with low HER2-expression breast cancer is lower than that in patients with zero HER2-expression breast cancer. Age, histological grade and estrogen receptor expression status are independent factors influencing the pCR rate of neoadjuvant chemotherapy in patients with low HER2-expression breast cancer.