Objective To investigate the prognostic differences and decision-making role in postoperative radiotherapy of four molecular subtypes in pT1-2N1M0 stage breast cancer. Methods The clinicopathological data of 1526 patients with pT1-2N1M0 breast cancer treated at West China Hospital of Sichuan University between 2008 and 2018 were retrospectively analyzed. χ2 test was used to compare the clinicopathological features among patients with different molecular subtypes. Kaplan-Meier survival analysis and log-rank test were used to draw the survival curves and compare the overall survival (OS) and breast cancer-specific survival (BCSS) among patients with different molecular subtypes. Cox regression model was used to determine the influencing factors of OS of patients after radical mastectomy. Results Among the 1526 patients with pT1-2N1M0 breast cancer, there were 674 cases (44.2%) of Luminal A subtype, 530 cases (34.7%) of Luminal B subtype, 174 cases (11.4%) of human epidermal growth factor receptor 2 (Her-2) overexpression subtype, and 148 cases (9.7%) of triple-negative subtype. The 5-year OS rates of Luminal A, Luminal B, Her-2 overexpression and triple negative patients were 98.6%, 94.3%, 95.5% and 91.2%, respectively (χ2=11.712, P=0.001), and the 5-year BCSS rates were 99.3%, 94.6%, 95.5% and 92.5%, respectively (χ2=18.547, P<0.001). Multiple Cox regression analysis showed that menstrual status [hazard ratio (HR)=0.483, 95% confidence interval (CI) (0.253, 0.923), P=0.028] and whether endocrine therapy [HR=2.021, 95%CI (1.012, 4.034), P=0.046] were prognostic factors for the 5-year OS rate of breast cancer patients after radical mastectomy (P<0.05). However, it failed to reveal that Luminal subtypes and postoperative radiotherapy were prognostic factors for the 5-year OS rate (P>0.05). Conclusions In pT1-2N1M0 breast cancer patients, the 5-year OS rate and 5-year BCSS rate in triple-negative patients are the lowest. The relationship between Luminal classification, postoperative radiotherapy and survival in patients after radical mastectomy needs further study in the future.
Objective To investigate the clinicopathological features and clinical subtypes of Peutz-Jeghers syndrome (PJS) in Chinese cases. Methods The clinical and pathological data of 295 patients with PJS who were treated in Air Force General Hospital from Nov. 1994 to Aug. 2017 were retrospectively analyzed and a multifactor statistical study was carried out on. Results Two hundreds and ninety-five patients with PJS belonged to 7 nationalities and came from 26 provinces and urban areas. 99.0% (292/295) of the patients had black spots on the lip and buccal mucosa, and the median occurrence time was 2 years old (0–33 years). The median age of inital diagnosis and treatment was 15 years old (1–45 years). The median interval time between the occurrence of black spots and abdominal symptoms was about 10 years (0–45 years). PJS hamartoma polyps were found in alimentary canals of 293 patients (99.3%), and 96.9% distributed in the duodenum and small intestine (n=284), 90.4% distributed in the colorectal (n=265), 79.9% distributed in the stomach (n=234). Patients of black spot appearing at age <3 years and (or) initial treatment at age <14 years were classified as early-onset subtype, otherwise they could be included in delayed-onset subtype. Conclusions The clinical features of PJS are prominent and the harm of PJS hamartoma polyps is serious. The black spots on the lip and buccal mucosa can be used as an early warning signal to divide the PJS patients into 2 clinical subtypes, which should be differentiated in clinical therapy and follow-up strategy.
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 expression of MicroRNA 155 (miR-155) in esophageal squamous cell carcinoma (ESCC) and analyze its correlation with clinicopathological features of ESCC. MethodsThis study included 54 patients with primary ESCC who underwent radical esophagectomy in Department of Thoracic Surgery, Henan Cancer Hospital of Zhengzhou University between January 2010 and November 2012. There were 47 males and 7 females with median age of 61 years (range, 45 to 82 years). Forty patients were in stage Ⅰ or Ⅱ and 14 patients in stage Ⅲ a+b. Expression of miR-155 was determined by SYBR Green qRT-PCR in ESCC tissue and corresponding adjacent normal mucosa in surgical samples from the 54 patients, and its correlation with clinicopathological features was analyzed. ResultsExpression of miR-155 was significantly lower in ESCC tissue than that in adjacent normal mucosa (Z=-4.258, P=0.000).Expression level of miR-155 was significantly correlated with lymph node metastasis (P=0.040), but not significantly correlated with smoking (P=0.430), drinking (P=0.429), age (P=0.769), gender (P=0.671), depth of invasion (P=0.230), differentiation degree (P=0.896) or pTNM (P=0.407) of ESCC. ConclusionUnder-regulation of miR- 155 expression in ESCC tissue may lead to disorders of inflammation response, immune response and relevant tumor suppressor, and may play a significant role in carcinogenesis and progression of ESCC.
ObjectiveTo investigate the correlation between UBE2Q1 expression and clinicopathologic features and prognosis of lung adenocarcinoma. MethodsThis study retrospectively chose the cancer tissue and para-carcinoma tissue samples of 74 patients with stage I to III lung adenocarcinoma who received radical resection in Nanjing Chest Hospital from January 2013 to December 2016. Immunohistochemistry staining was used to detect the expression level of UBE2Q1, and patients were divided into high-expression group and low-expression group according to the Immunohistochemistry staining score. The correlation of UBE2Q1 expression level and clinicopathological characteristics was analyzed by Chi-square test. Kaplan-Meier survival curve analyzed the correlation between UBE2Q1 and prognosis of lung adenocarcinoma patients. The risk factors affecting the survival of lung adenocarcinoma patients were analyzed by univariate and multivariate Cox proportional risk models. ResultsUBE2Q1 was highly expressed in lung adenocarcinoma tissues, and the expression level was correlated with tumor diameter, lymph node metastasis, and TNM stage (P<0.05), and did not correlate with patients’ gender, age, smoking history, and tumor differentiation (P>0.05). The results of the Kaplan-Meier survival analysis showed that patients with low expression of UBE2Q1 compared with those with high expression of UBE2Q1 had longer DFS and OS (both P<0.05). Cox proportional risk model showed that tumor diameter, lymph node metastasis, TNM stage, and high UBE2Q1 expression were the risk factors for DFS and OS, among which TNM stage was an independent risk factor. ConclusionUBE2Q1 was highly expressed in lung adenocarcinoma tissues and correlated with large tumor diameter, lymph node metastasis, late TNM stage and poorer prognosis in lung adenocarcinoma, and UBE2Q1 was a risk factor for lung adenocarcinoma.
Objective To conclude the CT manifestations and pathological features of low-grade appendiceal mucinous neoplasms. Methods We reviewed the clinical and CT findings of 24 patients with low-grade appendiceal mucinous neoplasms, who were confirmed by pathology within 1 month after CT examination in SichuanProvincial People’s Hospital from January 2018 to December 2020. The distribution, morphological characteristics, cyst wall and internal characteristics, CT value and enhancement characteristics of tumors were be detected in detail. Results ① Distribution: of the 24 patients, 22 patients located in the appendix area of the right lower quadrant, 2 patients located in the right middle abdomen, and 2 patients located in the pelvic cavity. ② Morphological characteristics: of the 24 patients, 15 patients manifested as tubular, 3 patients manifested as ellipsoidal, 5 patients manifested as saccular, and 1 patient manifested as irregular shape. The average length of tumors was about 6.4 cm (4.2–12.0 cm), and the average short diameter of tumors was about 2.2 cm (0.8–5.0 cm). The short diameter of 17 patients were more than 1.5 cm. ③ The cyst wall and internal characteristics: all the 24 patients demonstrated as cystic mass, 6 patients had evenly thin and smooth cyst wall, and other 18 patients had uneven cyst wall. Of all the patients,8 patients had arc-shaped, punctate or eggshell-like calcification. ④ The CT value and enhancement characteristics: 24 patients examined by plain CT scan, 22 patients showed uniform low density (the CT value were 7–25 HU), 2 patients contained some slightly high density, 16 patients examined by enhanced CT, the cyst wall, separation, or mural nodules of 8 patients were slightly or moderately enhanced. ⑤ Pathological results: of all the gross specimens, 15 patients showed tubular dilation, 9 patients showed partial or complete dilation as cystic mass. All the 24 patients had gelatinous or mucinous contents. Microscopically, all the patients showed low-grade mucinous epithelial hyperplasia, submucosa, and mucosal muscle atrophy, accompanied by fibrosis or calcification. Conclusion Low-grade appendiceal mucinous neoplasms show some specific CT manifestations, recognize these features can improve the accuracy of preoperative CT.
Objective To investigate the relationship between skin/pectoral muscle invasion and the prognosis of male breast cancer. Methods Clinical data and follow-up information of 79 male breast cancer patients who received treatment between September 2008 to April 2020 in West China Hospital were retrospectively reviewed, to analyze the clinicopathological features of male breast cancer and prognostic value of skin/pectoral muscle invasion. Results Among 79 male breast cancer patients, a total of 23 patients (29.1%) were with skin/pectoral muscle invasion at diagnosis. All the patients were followed up, with a median follow-up period of 63.3 months (1.0–204.5 months). Within follow-up period, 8 patients (10.1%) suffered from relapse, 19 patients (24.7%, 19/77) suffered from metastasis, and 4 patients (5.1%) died. Multivariate Cox proportional risk regression model suggested that patients with skin/pectoral muscle invaded had poor disease free survival [RR=4.48, 95%CI (1.08, 18.52), P=0.038]. Conclusions Skinor pectoral muscle invasion might be a valuable prognostic factor for male breast cancer patients. However, limited by sample size, the conclusion should be proved by further high-level studies.
ObjectiveBy analyzing the correlation between the clinicopathological features of patients with colorectal liver metastases (CRLM) and their postoperative survival, this study is aimed to identify new and accurate prognostic indicators on the prognoses to provide a reference of the treatment strategy selection for patients with CRLM. MethodsThe clinical data of 233 patients with CRLM who received operation treatments in the Eastern Hepatobiliary Hospital of the Second Military Medical University from January 2006 to December 2009 were retrospectively investigated, and their clinicopathological features, as well as their prognosis were analyzed. The survival curve was drawn by Kaplan-Meier method, and the survival rates were analyzed by log-rank test. Parametric survival analysis was used to identify predictors of cancer-specific survival. ResultsThe median survival time after cancer resection was 37.0 months, with cumulative 1-year, 3-year, and 5-year survival rates of 93.0%, 61.0%, and 17.0%, respectively. The median survival time, with cumulative 3-year, and 5-year survival rates of patients who had received radical operations was better than the others who received palliative operations:40.53 months vs 27.20 months, 59.0% vs 29.0%, and 20.0% vs 0(P < 0.05), respectively. In overall surviva, the results of univariate analysis showed that 13 factors, including surgical method, the first relapse after liver metastasis resection, the number of liver metastases, surgical margin, other unresectable extrahepatic metastases or resectable invasion in blood vessels or the surrounding tissue, whether any chronic liver disease was associ-ated, preoperative serum CEA level, preoperative serum CA19-9 leve, the position of the liver metastases, whether the liver metastasis capsule was complete, TNM stagethe of primary cancer, whether the liver metastasis was simultaneous liver metastases, and the maximum diameter of the liver metastases, were closely related to the clinicopathological features associated with prognosis and the differences were statistically significant (P < 0.05). The results of multivariate survival analysis demonstrated that received palliative operations, simultaneous liver metastases, there were other unresectable extrahepatic metastases or resectable invasion in blood vessels or the surrounding tissue, liver metastases without a complete capsule, the number of liver metastases appeared as multiple and widedistribution, unassociated chronic liver disease of the patients, the maximum diameter of the liver metastases>3 cm, were the independent risk factors affecting the postoperative survival of the patients with CRLM (P < 0.05). ConclusionsIt is important for long-term survival of patients with CRLM who were received operations. Received palliative operations, simultaneous liver metastases, there were other unresectable extrahepatic metastases or resectable invasion in blood vessels or the surrounding tissue, liver metastases without a complete capsule, the number of liver metastases appeared as multiple and widedistribution, unassociated chronic liver disease of the patients, the maximum diameter of the liver metastases>3 cm, were the independent risk factors affecting the postoperative survival of the patients with CRLM.
Objective To investigate the relationship between thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and clinicopathological features of breast cancer. Methods Thyroid function data, general clinical data and data reflecting pathological characteristics of breast cancer of 136 breast cancer patients admitted to the Department of Breast and Thyroid Surgery, People’s Hospital of Wuhan University from December 2019 to April 2022 were collected. According to the TPOAb and TGAb antibody levels of patients, 136 breast cancer patients were divided into positive group (antibody level ≥60 U/mL) and negative group (antibody level < 60 U/mL). The general clinical data, thyroid function, breast cancer markers, tumor size, pathological classification, clinical TNM stage, lymph node metastasis and immunohistochemical index expression characteristics of the two groups were analyzed. Results There was no statistically significant difference between the TPOAb positive group and the TPOAb negative group, as well as between the TgAb positive group and the TgAb negative group in terms of age, previous chronic medical history, surgical medical history and menstrual status of breast cancer patients (P>0.05), and there was no significant difference in the results of preoperative ultrasound and molybdenum target examination (P>0.05).Compared with the TPOAb negative group, the level of triiodothyronine (T3) in the TPOAb positive group was lower (P=0.020), and the level of thyroidstimulating hormone (TSH) was higher (P=0.001). TSH level in the TgAb positive group was higher than that in the TgAb negative group (P=0.036). There was no significant difference in tumor markers (carcinoembryonic antigen, carbohydrate antigen 125 and 153) and the number of lymph nodes cleared during operation between the positive and negative groups of TPOAb and TgAb (P>0.05). Compared with the respective negative groups, there was no significant difference tumor size, pathological classification, clinical TNM stage, lymph node metastasis, pathological molecular classification, and the expression of ER, PR and Ki-67 in the TPOAb positive group and the TgAb positive group (P>0.05). The positive rate of HER-2 expression in the TPOAb positive group was higher than that in the TPOAb negative group (P=0.033). There was no significant difference in HER-2 expression between the TgAb positive group and the TgAb negative group (P>0.05). There was no significant difference between the TPOAb positive group and the TPOAb negative group, as well as the TgAb positive group and the TgAb negative group in terms of chemotherapy, invasive carcinoma with carcinoma in situ, with benign lesions and nerve invasion (P>0.05). There was no significant difference between TPOAb positive group and negative group in vascular tumor thrombus rate and single cancer focus rate (P>0.05). Compared with the TgAb negative group, the TgAb positive group had a lower vascular tumor thrombus rate (P=0.034) and a higher single cancer focus rate (P=0.045). Conclusions Thyroid autoantibodies positive breast cancer patients have lower T3 level and higher TSH level, and the positive expression of thyroid autoantibodies is related to HER-2 expression, vascular tumor thrombus and the number of tumor foci in breast cancer. It suggests that thyroid autoantibodies TPOAb and TgAb may have an impact on the prognosis of breast cancer.
Perivascular epithelioid cell tumor (PEComa) is a multi-potential tumor based on mesenchymal cells distributed around capillaries. The main affected population is female, and the clinical manifestations are not specific. It can affect all parts of the body. There are more PEComa in the uterus and very few PEComa in the liver. Due to its low incidence, clinicians lack awareness of it. Based on the relevant literature, this article reviews the clinicopathological features, imaging features, molecular phenotypes, diagnosis, differential diagnosis, and treatment of liver PEComa, so as to strengthen the understanding of the disease, prevent missed diagnosis and misdiagnosis, and guide clinical work.