Objective To detect the expressions of osteopontin （OPN）， breast tumor kinase （Brk）， and vascular endothelial growth factor （VEGF） in the breast cancer tissue， the adjacent （2cm） normal breast tissue， and the distal（＞5cm） normal breast tissue， and analyze their clinical significances. Method The immunohistochemical method was used to detect the expressions of OPN， Brk， and VEGF in the breast cancer tissue， the adjacent （2cm） normal breast tissue， and the distal （＞5cm） normal breast tissue from 40 cases of breast cancer. Results ① The expressions of OPN，Brk， and VEGF in the breast cancer tissue were significantly higher than those of the adjacent （2cm） normal breast tissue and the distal （＞5cm） normal breast tissue （P＜0.01）， the expression of Brk in the adjacent （2cm） normal breast tissue was significantly higher than that of the distal （＞5 cm） normal breast tissue （P＜0.05）. ② In the breast cancer tissue， the OPN and Brk protein expressions were not associated with age， tumor diameter， and histological grade （P＞0.05），were associated with lymph node metastasis and TNM stage （P＜0.05）. The VEGF protein expression was not associated with age and tumor diameter （P＞0.05）， but was associated with histological grade， lymph node metastasis， and TNM staging （P＜0.05）. ③ In the breast cancer tissue， OPN， Brk， and VEGF had positive correlation with each other （P＜0.05）， but not in the adjacent （2cm） normal breast tissue and the distal （＞5 cm） normal breast tissue （P＞0.05）. Conclusions The expressions of OPN and Brk from the same signal pathway increase by turns in the distal （＞5 cm） normal breast tissue， adjacent （2cm） normal breast tissue， and breast cancer tissue. OPN induced the adhesion and migration of endothelial cells to accelerate vascular repair through VEGF and Brk has correlation with the progress of tumor invasion and metastasis through participating in tumor vascularization.
ObjectiveTo investigate the value of contrastenhanced ultrasonography in differential diagnosis between benign and malignant breast mass. MethodsTotally 65 patients with 70 breast masses were evaluated by general ultrasonography and contrastenhanced ultrasonography with contrast agent SonoVue. The related indexes, such as the degree and mode of contrast enhancement, the lesion boundaries and dissipation mode, were used to describe the difference between benign and malignant mass, which was also compared with pathological results. ResultsHistopathological examination revealed that benign mass was in 37 cases and malignant in 28 cases. The sensitivity, accuracy, positive predictive value, and negative predictive value of contrastenhanced ultrasonography with contrast agent SonoVue were significantly higher than that of general ultrasonography (Plt;0.05), while no significant difference in diagnostic specificity and misdiagnosis rate was observed between them (Pgt;0.05). All tumors showed contrast enhancement in various degrees. Of 28 patients with enhanced mass, hyperenhancement in 22 cases and nodular inhomogeneous enhancement in 21 cases were observed and the boundaries of malignant tumor were irregular with ill-defined and radial enhancement. Most of benign tumors were represented by weak, homogeneous enhancement, and the shape was regular with smooth and tidy boundary and intact capsule except seven cases with unclear boundary. These imaging characteristics of benign and malignant tumors were obviously different (P=0.000). In the resolution phase, both benign and malignant mass showed heterogeneous or homogeneous dissipation, which was not significantly different (P=0.791). ConclusionCompared with general ultrasonography, contrast enhanced ultrasonography may be more helpful for the differential diagnosis of benign and malignant breast tumors.
ObjectiveTo investigate the X-ray diagnostic significance of calcification of the breast tumor without mass. MethodsMammograms of 90 cases of breast tumor without mass confirmed pathologically were retrospectively analyzed. There were 55 cases confirmed benign breast tumor, and the rest cases were breast cancer. The shape, distribution, total number, location of calcifications in the breast, and asymmetric dense of the breast were recorded and watched. Results①The X-ray findings of calcification in benign breast tumors always presented as coarse granular (31), scattered shape (35) with small number, less with the asymmetric dense of the breast (7), and the change of side with axillary lymph node (2). ②Meanwhile, fine sand-like (32), showing the cluster-like distribution (24) with larger number, with the asymmetric dense of the breast (24) and the change of side with axillary lymph node (10). Both of the differences of the calcifications (the shape, the distribution, and the total number) were statistically significant (Plt;0.05). ConclusionsThe calcifications of benign and malignant breast tumors have their unique X-ray characteristics. And there is a great value in differentiating early benign and malignant breast tumor.
ObjectiveTo investigate expressions of ALCAM/CD166, Bcl-2, and Ki-67 in breast infiltrative ductal cancer tissues, so as to assess the role of ALCAM/CD166 protein in the carcinogenesis and progression of breast infiltrative ductal cancer. MethodsThe expressions of ALCAM/CD166, Bcl-2, and Ki-67 proteins were examined by immunohistochemistry(ElivisionTM Plus) in 96 breast infiltrative ductal cancer specimens and 30 adjacent normal tissues of breast cancer specimens(control group). The relation between ALCAM/CD166 protein expression and patient's age, tumor diameter, histopathologic grade, axillary lymph node metastasis, or TNM stage of breast infiltrative ductal cancer was analyzed, and the correlation between ALCAM/CD166 expression and Bcl-2 or Ki-67 was analyzed too. Results①In 96 cases of breast infiltrative ductal cancer, the positive rate of ALCAM/CD166 protein expression was 79.2%(76/96), which was significantly higher than that in the control group〔10.0%(3/30), P < 0.01〕.②In the breast infiltrative ductal cancer tissues, the expression of ALCAM/CD166 was related to axillary lymph node metastasis(P < 0.05), but was not related to patient's age, tumor diameter, histopathologic grade, and TNM stage(P > 0.05).③The ALCAM/CD166 protein expression was positively related to Bcl-2(rs=0.307, P=0.001) and not related to Ki-67(rs=0.064, P=0.475). ConclusionALCAM/CD166 protein expression might be related to the apoptosis and metastasis of breast infiltrative ductal cancer cells and it could serve as an important marker for predicting biological behavior and prognosis of tumor.
ObjectiveTo assess the values of MRI, ultrasound (US), and X-ray in the differential diagnosis of benign and malignant breast lesions. MethodsThe image data of 50 breast lesions confirmed with histopathology were analyzed retrospectively and the values of MRI, US and X-ray mammography in the differential diagnosis of benign and malignant breast lesions based on the breast imaging reporting and data system (BI-RADS) were assessed. The diagnostic efficiency of MRI, US, and X-ray in 50 benign and malignant breast lesions were compared using receiver operating characteristics (ROC) curves. The areas of ROC curves of MRI, US, and X-ray were calculated with Z test using SPSS 16.0. ResultsThere were 44 patients with 50 breast lesions, 26 malignant lesions, 24 benign lesions. Based on the BI-RADS, according to X-ray imaging features, 26 malignant breast lesions were classified as 5 lesions of category 5, 7 lesions of category 4, 6 lesions of category 3, 3 lesions of category 2, 1 lesion of category 1, 4 lesions of category zero. Twenty-four benign breast lesions were classified as 1 lesion of category 4, 3 lesions of category 3, 4 lesions of category 2, 13 lesions of category 1, 3 lesions of category zero. According to the characteristics of US findings, 26 malignant breast lesions were classified as 17 lesions of category 5, 4 lesions of category 4, 1 lesion of category 3, 1 lesion of category 2, 3 lesions of category 1. Twenty-four benign breast lesions were classified as 1 lesion of category 5, 2 lesions of category 4, 4 lesions of category 3, 14 lesions of category 2, 2 lesions of category 1, 1 lesion of category 0. According to MRI imaging findings, 26 malignant breast lesions were classified as 6 lesions of category 5, 18 lesions of category 4, 1 lesion of category 3, 1 lesion of category 1. Twenty-four benign breast lesions were classified as 20 lesions of category 1, 3 lesions of category 2, 1 lesion of category 3. The area under the ROC curve of the MRI, US, and X-ray was 0.977, 0.835, and 0.764, respectively. The differences of MRI with US (Z=2.05, P < 0.05) and MRI with X-ray mammography (Z=2.81, P < 0.05) were statistically significant. While the difference of US with X-ray mammography (Z=0.73, P > 0.05) was't statistically significant. ConclusionsDynamic contrast-enhanced MRI is an accurate examination in the differential diagnosis of benign and malignant breast lesions. The differential diagnostic efficiency of MRI is significantly better than those with US and X-ray.
ObjectiveTo compare the differences of clinical effects between the bilateral endoscopic breast reconstruction and the open breast reconstruction. MethodsThe clinical data of 28 female patients who underwent bilateral breast graft reconstruction in the Department of Breast Surgery of West China Hospital from January 2017 to January 2021 were analyzed retrospectively. The patients were divided into two groups: an endoscopic group (n=12, aged 41.3±8.9 years) and an open group (n=16, aged 41.6±8.8 years). The clinical data of the two groups of patients were compared. Results There was no significant difference in demographic and oncological data between the two groups (P>0.05). There was a significant difference in the implants between the two groups (P=0.008). The operation time (298.2±108.6 min vs. 326.5±95.8 min, P=0.480) and anesthesia time (373.4±91.2 min vs. 400.3±97.1 min, P=0.463) were not significantly different. The total complications (P=0.035) and major complications (P=0.024) in the open group were more than those in the endoscopic group. For the comparison of breast satisfaction, psychosocial well-being and sexual well-being, the scores at six months and one year after surgery were higher in the endoscopic group than those in the open group (P<0.05). ConclusionThe endoscopic reconstruction is safe and effective, with high satisfaction rates regarding breast reconstruction and quality of life, and is superior to conventional open surgery.