ObjectiveTo explore the expressions of survivin, p53, and Ki67 in recurrence or metastasis breast cancer tissue, and explore their correlations and clinical significance. MethodsEighty-six patients with the chest wall local recurrence, axillary or supraclavicular lymph node metastases get treated in this hospital between January 2005 and January 2010 were excised and the expressions of survivin, p53, and Ki67 were detected by immunohistochemistry test, then compared them between the recurrence and metastasis breast cancer tissues and the primary breast cancer tissues. ResultsThe positive expression rate of survivin, p53, and Ki67 in the recurrence and metastasis breast cancer tissues were significantly higher than those in the primary breast cancer tissues, survivin: 90.70% (78/86) versus 61.63% (53/86), χ2=20.014 895, Plt;0.001; p53: 68.60% (59/86) versus 52.33% (45/86), χ2=4.766 968, Plt;0.05; Ki67: 62.79% (54/86) versus 46.51% (40/86), χ2=4.597 927，Plt;0.05. The positive expression rates of survivin in the recurrence and metastasis patients with p53, Ki67 negative expression were significantly higher than those of the primary breast cancer tissue (70.37% versus 24.39%, χ2=14.071 113, Plt;0.05; 75.00% versus 39.13%, χ2=6.540 373, Plt;0.05). The correlation coefficient of survivin with p53 and Ki67 positive expressions in the recurrence and metastasis breast cancer tissue and the primary breast cancer tissue were 0.876 214, 0.773 643 and 0.725 164, 0.698 112, respectively, Plt;0.05. ConclusionThe positive expression rates of survivin, p53, and Ki67 which increase in recurrence and metastasis breast cancer tissue indicate bad prognosis.
Objective To explore value of multidisciplinary team (MDT) model in diagnosis and treatment of patients with advanced special thyroid cancer who lost chance of operation. Method Two patients with the advanced special thyroid cancer who lost chance of operation were treated by low dose apatinib (250 mg/d) after the MDT discussion. Results One medullary thyroid cancer patient with the compressing of the trachea for mediastinal metastatic lymphadenopathy and inability to lie down underwent the multiple surgical treatment, the therapeutic effect was poor. Then low dose apatinib (250 mg/d) was performed, the patient could supine, breathe smoothly, and move freely, whose life quality was obviously improved, the mediastinal lymph nodes reduced and no serious drug toxicity occurred on month 1 after the treatment. One undifferentiated thyroid cancer patient with the lung metastasis, hemoptysis, and tumor invasion resulted in the inability to lie down and having difficulty in breathing, these symptoms still existed and more pleural effusion occurred after the resection of the invaded trachea. Then low dose apatinib (250 mg/d) was performed, the patient could supine, the pleural effusion disappeared, the hemoptysis stopped, the breathing was smooth, and could do some minor housework, no drug toxicity occurred on month 1 after the treatment. Conclusion After MDT discussion, low dose apatinib in treatment of advanced special thyroid cancer is reliable and safe and has a good short-term effect, which could be used as a new remedy, but long-term effect should be further researched by increasing case samples and a long-term following-up.
Objective To explore therapeutic effect of endocrine therapy in breast cancer patients with negative hormone receptor (HR–) of primary lesion and positive HR (HR+) of metastatic axillary lymph node lesion. Methods Sixty-seven cases of breast cancer with HR– of primary lesion and HR+ of metastatic axillary lymph node lesion from January 2011 to January 2016 were selected. All the patients were randomly divided into endocrine therapy group (33 cases) and control group (34 cases). The patients were given the oral drug of tamoxifen on the basis of conventional chemotherapy in the endocrine therapy group after the surgery, 10 mg/time, twice daily, 5 years; while the patients in the control group were not given the oral drug of tamoxifen but the other therapy same as the endocrine therapy group. The survivals were compared in both groups. Results There were no significant differences in the age, menstrual condition, tumor diameter, preoperative TNM stage, and so on between the endocrine therapy group and the control group (P>0.05). All the patients were followed up for 12–60 months with a 48.5 months of median time. There were no significant differences in the rates of the local recurrence and metastasis, or death rate due to the recurrence and metastasis in both groups (P>0.05). The progression-free survival and overall survival in the endocrine therapy group were significantly higher than those in the control group (P<0.05). The 5-year cumulative progression-free survival and overall survival in the endocrine therapy group were significantly better than those in the control group (P<0.05). Conclusion Pay attention to molecular classification of primary lesion and metastatic axillary lymph node lesion in patients with breast cancer, and endocrine therapy might be able to improve survival rate of breast cancer patients with primary lesion HR– and metastatic axillary lymph node lesion HR+.