Invasive breast carcinoma(BRCA)is associated with poor prognosis and high risk of mortality.Therefore,it is critical to identify novel biomarkers for the prognostic assessment of BRCA.Methods:The expression data of po...Invasive breast carcinoma(BRCA)is associated with poor prognosis and high risk of mortality.Therefore,it is critical to identify novel biomarkers for the prognostic assessment of BRCA.Methods:The expression data of polo-like kinase 1(PLK1)in BRCA and the corresponding clinical information were extracted from TCGA and GEO databases.PLK1 expression was validated in diverse breast cancer cell lines by quantitative real-time polymerase chain reaction(qRT-PCR)and western blotting.Single sample gene set enrichment analysis(ssGSEA)was performed to evaluate immune infiltration in the BRCA microenvironment,and the random forest(RF)and support vector machine(SVM)algorithms were used to screen for the hub infiltrating cells and calculate the immunophenoscore(IPS).The RF algorithm and COX regression model were applied to calculate survival risk scores based on the PLK1 expression and immune cell infiltration.Finally,a prognostic nomogram was constructed with the risk score and pathological stage,and its clinical potential was evaluated by plotting calibration charts and DCA curves.The application of the nomogram was further validated in an immunotherapy cohort.Results:PLK1 expression was significantly higher in the tumor samples in TCGA-BRCA cohort.Furthermore,PLK1 expression level,age and stage were identified as independent prognostic factors of BRCA.While the IPS was unaffected by PLK1 expression,the TMB and MATH scores were higher in the PLK1-high group,and the TIDE scores were higher for the PLK1-low patients.We also identified 6 immune cell types with high infiltration,along with 11 immune cell types with low infiltration in the PLK1-high tumors.A risk score was devised using PLK1 expression and hub immune cells,which predicted the prognosis of BRCA patients.In addition,a nomogram was constructed based on the risk score and pathological staging,and showed good predictive performance.Conclusions:PLK1 expression and immune cell infiltration can predict post-immunotherapy prognosis of BRCA patients.展开更多
BACKGROUND Invasive urothelial carcinoma(UC)with squamous and glandular differentiation is a highly malignant and complicated pathological subtype,and the standard care is radical cystectomy(RC).However,urinary divers...BACKGROUND Invasive urothelial carcinoma(UC)with squamous and glandular differentiation is a highly malignant and complicated pathological subtype,and the standard care is radical cystectomy(RC).However,urinary diversion after RC significantly reduces patient quality of life,thus bladder-sparing therapy has become a research hotspot in this field.Recently,five immune checkpoint inhibitors have been approved for systemic therapy of locally advanced or metastatic bladder cancer by the Food and Drug Administration,but the efficacy of immunotherapy combined with chemotherapy for invasive UC is still unknown,especially for pathological subtypes with squamous and glandular differentiation.CASE SUMMARY We report the case of a 60-year-old male who complained of repetitive painless gross hematuria and was diagnosed with muscle-invasive bladder cancer with squamous and glandular differentiation,defined as cT3N1M0 according to the American Joint Committee on Cancer,who had a strong desire to preserve the bladder.Immunohistochemical staining revealed that programmed cell deathligand 1(PD-L1)expression in the tumor was positive.Thus,a transurethral resection to maximize removal of the bladder tumor was performed under cystoscopy,and the patient subsequently received a combination of chemotherapy(cisplatin/gemcitabine)and immunotherapy(tislelizumab)treatment.No tumor recurrence in the bladder was observed following pathological and imaging examination after 2 cycles and 4 cycles of treatment,respectively.The patient achieved bladder preservation and has been tumor-free for more than two years.CONCLUSION This case shows that the combination of chemotherapy and immunotherapy might be an effective and safe treatment strategy for PD-L1 expression positive UC with divergent histologic differentiation.展开更多
Pancreatic cancer currently has no subtypes that inform clinical decisions;hence,there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteri...Pancreatic cancer currently has no subtypes that inform clinical decisions;hence,there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteristics.Nonetheless,accumulating studies to date have revealed the large-duct type variant,a unique subtype of pancreatic ductal adenocarcinoma(PDA)with cystic features.This subtype often radiographically mimics intraductal papillary mucinous neoplasms(IPMNs)and involves multiple small cysts occasionally associated with solid masses.The“bunch-of-grapes”sign,an imaging characteristic of IPMNs,is absent in large-duct PDA.Large-duct PDA defines the mucin profile,and genetic alterations are useful in distinguishing large-duct PDA from IPMNs.Histologically,neoplastic ducts measure over 0.5 mm,forming large ductal elements.Similar to classic PDAs,this subtype is frequently accompanied by perineural invasion and abundant desmoplastic reactions,and KRAS mutations in codon 12 are nearly ubiquitous.Despite such morphological similarities with IPMNs,the prognosis of large-duct PDA is equivalent to that of classic PDA.Differential diagnosis is therefore essential.展开更多
Objective: Mucin 1(MUC1/EMA) and sialyl Lewis X(sLe^(x)) indicate polarity reversal in invasive micropapillary carcinoma(IMPC). The purpose of this study was to evaluate the expression of MUC1/EMA and sLe^(x) and to a...Objective: Mucin 1(MUC1/EMA) and sialyl Lewis X(sLe^(x)) indicate polarity reversal in invasive micropapillary carcinoma(IMPC). The purpose of this study was to evaluate the expression of MUC1/EMA and sLe^(x) and to assess their diagnostic and prognostic value in patients with IMPC.Methods: The expression of sLe^(x) and MUC1/EMA in 100 patients with IMPC and a control group of 89 patients with invasive ductal carcinoma not otherwise specified(IDC-NOS) were analyzed with IHC. Fresh tumor tissues were collected from patients with IMPC or IDC-NOS for primary culture and immunofluorescence analysis.Results: The rate of nodal metastasis was higher in patients with IMPC than those with IDC-NOS, and IMPC cells tended to express more sLe^(x) and MUC1/EMA in the cytomembranes(the stroma-facing surfaces of the micropapillary clusters) than IDC-NOS cells. In IMPC, high cytomembrane expression of sLe^(x), but not MUC1/EMA, indicated poor prognosis. In addition, among the 100 patients with IMPC, 10 patients had sLe^(x)+/EMA-expression patterns, and 8 patients had sLe^(x)-/EMA+ expression patterns. The primary IMPC cells were suspended, non-adherent tumor cell clusters, whereas the primary IDC cells were adherent tumor cells. Immunofluorescence analysis showed that MUC1/EMA and sLe^(x) were co-expressed on the cytomembranes in IMPC cell clusters and in the cytoplasm in IDC-NOS cells.Conclusions: sLe^(x) can be used as a prognostic indicator and can be combined with MUC1/EMA as a complementary diagnostic indicator to avoid missed IMPC diagnosis.展开更多
The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of ...The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study.SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy.The maximum values were recorded for statistical analysis.Medical records were reviewed to determine tumor size,histological grade,lymph node status and immunohistochemical results.Tumor subtypes were categorized as luminal A,luminal B,human epidermal growth factor receptor 2(HER2)positive and triple negative.The correlations between SWV and histological prognostic factors were analyzed.It was found that tumor size showed positive association with SWV(r=0.465,P<0.001).Larger tumors had significantly higher SWV than smaller ones(P=0.001).Histological grade 1 tumors had significantly lower SWV values than those with higher histological grade(P=0.015).The Ki67 expression,tumor subtypes and lymph node status showed no statistically significant correlations with SWV,although triple negative tumors and lymph node-positive tumors showed higher SWV values.It was concluded that tumor size was significantly associated with SWV.Higher histological grade was associated with increased SWV.There was no statistically significant correlations between SWV and other histological prognostic factors.展开更多
BACKGROUND Gastrointestinal metastasis of breast cancer is rare,and clinicians may not have previously encountered this disease in clinical practice.CASE SUMMARY We report a patient with invasive lobular carcinoma of ...BACKGROUND Gastrointestinal metastasis of breast cancer is rare,and clinicians may not have previously encountered this disease in clinical practice.CASE SUMMARY We report a patient with invasive lobular carcinoma of the breast who developed gastrointestinal metastasis two years after modified radical surgery.Mild elevation of carbohydrate antigen 15-3 was observed in the patient at an early stage;however,diagnosis and treatment were delayed due to non-specific clinical manifestations and no identifiable metastasis observed on imaging.CONCLUSION Clinicians should pay attention to gastrointestinal metastasis of breast cancer,especially invasive lobular carcinoma of the breast.展开更多
Invasive stratified mucin-producing carcinoma(ISMC)is a recently described histologic variant of high-risk human papillomavirus(HPV)-associated endocervical adenocarcinoma,as the putative invasive counterpart of the s...Invasive stratified mucin-producing carcinoma(ISMC)is a recently described histologic variant of high-risk human papillomavirus(HPV)-associated endocervical adenocarcinoma,as the putative invasive counterpart of the stratified mucin-producing intraepithelial lesion(SMILE).ISMC can display variable architectural patterns and usually coexists with other more conventional types of HPV-associated carcinomas,which makes diagnosis and differential diagnosis of ISMC is difficult for pathologists.Moreover,the prognosis of ISMC is still controversial.We analyzed 6 ISMCs with detailed pathological and clinical information.Intraepithelial lesion,including 1 high-grade squamous intraepithelial lesion and 1 SMILE,was found.Various architectures were observed(including nest,glandular,solid,trabecular,and single cell).Nuclear peripheral palisading,apoptotic bodies and mitoses,and variable cytoplasmic mucin vacuoles were seen in all of our cases.The predominance of neutrophils infiltration was seen in only 1 tumor.All the tumors infiltrated the cervical stroma in Silva pattern C manner.p63 and/or p40 was characteristically expressed in the peripheral cells in only 2 cases.High-risk HPV infection was observed in 3/3 detected cases.All the patients were alive during the follow-up time.Recognition of this infrequent tumor may help pathologists and oncologists for an accurate diagnosis and a better understanding of the clinicopathological behavior.展开更多
Objective:To investigate the diagnostic value of invasive micropapillary carcinoma(IMPC)by ultrasonography and MRI.Method:63 female patients with IMPC were selected,all of which were confirmed by pathological examinat...Objective:To investigate the diagnostic value of invasive micropapillary carcinoma(IMPC)by ultrasonography and MRI.Method:63 female patients with IMPC were selected,all of which were confirmed by pathological examination,and were assigned to the IMPC group.In the same period,40 patients with invasive ductal carcinoma(IDC group)were selected for diagnostic efficacy control.The efficacy indexes of accuracy,sensitivity,specificity,positive prediction rate and negative prediction rate were 73.0%,65.9%,89.5%,93.5%,46.9%,respectively.The efficiency indexes of accuracy,sensitivity,specificity,positive prediction rate and negative prediction rate of ultrasound combined with breast MRI were 93.6%,93.2%,94.7%,97.6%,85.7%.Ultrasonography combined with MRI has more application value in the diagnosis of IMPC.展开更多
Background:Invasive squamous carcinoma(SCC)is the most frequent malignant neoplasia of the conjunctiva,33%of which will metastasize.C-erbB-2/neu(HER2)is an oncogene associated with poor prognosis,metastatic potential ...Background:Invasive squamous carcinoma(SCC)is the most frequent malignant neoplasia of the conjunctiva,33%of which will metastasize.C-erbB-2/neu(HER2)is an oncogene associated with poor prognosis,metastatic potential and aggressive behavior in several tumors,including breast,stomach,among others.HER2 amplification is also associated with the response to anti-HER2 treatment.The aim of this study is to evaluate HER2 expression in the progression of ocular surface squamous neoplasia(OSSN)and as a potential therapeutical target.Methods:Ninety-eight OSSN lesions including 17 papillomas(P),27 conjunctival intraepithelial neoplasia(CIN)I,19 CIN II,13 CIN III,and 11 SCC were evaluated.Eleven conjunctivas from normal human eyes(NHE)were also included in the analysis.Immunohistochemistry was performed to analyze HER2(clone 29D8)expression,which was graded as follows:complete membrane staining in more than 10%of malignant cells(3+);week to moderate complete staining in more than 10%of malignant cells(2+);none or fewer than 10%cells staining(0 to 1+,respectively).Positive HER2 was considered when a score 2+or 3+was determined.Breast carcinoma with HER2 amplification was used as a positive control.FISH technique was performed in the positive cases to confirm results.Statistical analysis was performed using Fisher’s exact test.Results:HER2 positive expression was detected in 6%of P(100%score 2+),11%of CIN I(100%score 2+),32%of CIN II(100%score 2+),30%of CIN III(100%score 2+),29%of SCC(50%score 2+and 50%score 3+).Benign lesions showed lower HER2 expression than in situ(P=0.03)and invasive tumors(P=0.02).No correlation between HER2 and age or tumor thickness in SCC was found(P>0.05).Conclusions:HER2 is expressed in conjunctival SCC.Moreover,one third of SCC were graded as 2+or 3+.These results support the evaluation of anti-HER2 therapy in conjunctival SCC.Pre-clinical trials should be performed to determine the importance of this marker in conjunctival SCC for predicting response to treatments targeting this pathway.展开更多
Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reprod...Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.展开更多
BACKGROUND Pancreatic mucinous cystic neoplasms(MCNs)represent one of the precursor lesions of pancreatic ductal adenocarcinoma,and their detection has been facilitated by advances in preoperative imaging.Due primaril...BACKGROUND Pancreatic mucinous cystic neoplasms(MCNs)represent one of the precursor lesions of pancreatic ductal adenocarcinoma,and their detection has been facilitated by advances in preoperative imaging.Due primarily to the rarity of MCNs,however,there is limited knowledge regarding the prognostic variables and high-risk factors for malignant transformation.A more comprehensive and nuanced approach is necessary to fill this gap and provide a basis for improved treatment decisions and patient outcomes.AIM To investigate the high-risk factors associated with malignant MCNs and to explore the prognostic factors of MCN with associated invasive carcinoma(MCNAIC).METHODS All cases of resected MCNs from a single high-volume institution between January 2012 and January 2022 were retrospectively reviewed.Only cases with ovarian-type stroma verified by progesterone receptor staining were included.Preoperative features,histological findings and postoperative course were documented.Multivariate logistic regression was employed to investigate variables related to malignancy.Survival analysis was performed using the Kaplan-Meier curve,and the prognostic factors were assessed to evaluate the postoperative course of patients with MCN-AIC.RESULTS Among the 48 patients,36 had benign MCNs,and 12 had malignant MCNs(1 high-grade atypical hyperplasia and 11 MCN-AIC).Age,tumour size,presence of solid components or mural nodules and pancreatic duct dilatation were identified as independent risk factors associated with malignancy.The follow-up period ranged from 12 mo to 120 mo,with a median overall survival of 58.2 mo.Only three patients with MCN-AIC died,and the 5-year survival rate was 70.1%.All 11 cases of MCN-AIC were stage I,and extracapsular invasion was identified as a prognostic factor for poorer outcomes.CONCLUSION The risk factors independently associated with malignant transformation of MCNs included age,tumour size,presence of solid components or mural nodules,and pancreatic duct dilatation.Our study also revealed that encapsulated invasion was a favourable prognostic factor in MCN-AIC patients.展开更多
Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-...Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-niques for IDC-level classification have been proposed in recent years.Processing speed,memory size,and accuracy can still be improved for better performance.Our study presents ECAM,an Enhanced Channel-Wise Attention Mechanism,using deep learning to analyze histopathological images of Breast Invasive Ductal Carcinoma(BIDC).The main objectives of our study are to enhance computational efficiency using a Separable CNN architecture,improve data representation through hierarchical feature aggregation,and increase accuracy and interpretability with channel-wise attention mechanisms.Utilizing publicly available datasets,DataBioX IDC and the BreakHis,we benchmarked the proposed ECAM model against existing state-of-the-art models:DenseNet121,VGG16,and AlexNet.In the IDC dataset,the model based on AlexNet achieved an accuracy rate of 86.81%and an F1 score of 86.94%.On the other hand,DenseNet121 outperformed with an accuracy of 95.60%and an F1 score of 95.75%.Meanwhile,the VGG16 model achieved an accuracy rate of 91.20%and an F1 score of 90%.Our proposed ECAM model outperformed the state-of-the-art,achieving an impressive F1 score of 96.65%and an accuracy rate of 96.70%.The BreakHis dataset,the AlexNet-based model,achieved an accuracy rate of 90.82%and an F1 score of 90.77%.DenseNet121 achieved a higher accuracy rate of 92.66%with an F1 score of 92.72%,while the VGG16 model achieved an accuracy of 92.60%and an F1 score of 91.31%.The proposed ECAM model again outperformed,achieving an F1 score of 96.37%and an accuracy rate of 96.33%.Our model is a significant advancement in breast cancer diagnosis,with high accuracy and potential as an automated grading,especially for IDC.展开更多
Background:Invasive micropapillary carcinoma(IMPC)is an uncommon subtype of breast cancer.Previous studies of this subtype demonstrated a higher propensity for lymph node metastases as compared with invasive ductal ca...Background:Invasive micropapillary carcinoma(IMPC)is an uncommon subtype of breast cancer.Previous studies of this subtype demonstrated a higher propensity for lymph node metastases as compared with invasive ductal carci-noma(IDC).The purpose of the present study was to determine the clinical characteristics,outcomes,and propensity for lymph node metastasis of patients with IMPC of the breast recorded in the National Cancer Database(NCDB).Methods:Records of patients with IMPC diagnosed between 2004 and 2014 were retrieved from the NCDB.Log-rank test was performed to evaluate associations of clinical characteristics with overall survival(OS).Cox proportional hazards model was used to determine variables associated with OS.Results:Overall,2660 patients with IMPC met the selection criteria;the 5-year OS rate was 87.5%and 24.9%of patients had nodal involvement at presentation.Patients with≥4 positive lymph nodes had shorter OS than node-negative patients,whereas patients with 1-3 positive nodes had similar OS to node-negative patients.Age<65 years,receipt of radiotherapy,and estrogen receptor positivity were also associated with prolonged OS.The benefit of radiotherapy was limited to IMPC patients undergoing lumpectomy;there was no benefit for the patients undergoing mastectomy(regardless of nodal positivity/negativity).Conclusions:Favorable prognostic factors of IMPC patients included age<65 years,<4 positive lymph nodes,receipt of radiotherapy,and estrogen receptor positivity.The results presented herein suggest a survival benefit asso-ciated with radiotherapy in IMPC treatment,though this may be limited to the patients treated with lumpectomy.展开更多
Autophagy is a critical cellular homeostatic mechanism,and its dysfunction is linked to invasive breast carcinoma(BRCA).Recently,several omics methods have been applied to explore autophagic regulators in BRCA;however...Autophagy is a critical cellular homeostatic mechanism,and its dysfunction is linked to invasive breast carcinoma(BRCA).Recently,several omics methods have been applied to explore autophagic regulators in BRCA;however,more reliable and robust approaches for identifying crucial regulators and druggable targets remain to be discovered.Thus,we report here the results of multi-omics approaches to identify potential autophagic regulators in BRCA,including gene expression(EXP),DNA methylation(MET)and copy number alterations(CNAs)from The Cancer Genome Atlas(TCGA).Newly identified candidate genes,such as SF3 B3,TRAPPC10,SIRT3,MTERFD1,and FBXO5,were confirmed to be involved in the positive or negative regulation of autophagy in BRCA.SF3 B3 was identified firstly as a negative autophagic regulator,and siRNA/shRNA-SF3 B3 were shown to induce autophagyassociated cell death in in vitro and in vivo breast cancer models.Moreover,a novel small-molecule activator of SIRT3,1-methylbenzylamino amiodarone,was discovered to induce autophagy in vitro and in vivo.Together,these results provide multi-omics approaches to identify some key candidate autophagic regulators,such as the negative regulator SF3 B3 and positive regulator SIRT3 in BRCA,and highlight SF3 B3 and SIRT3 as new druggable targets that could be used to fill the gap between autophagy and cancer drug development.展开更多
BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically ...BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.展开更多
The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without...The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.展开更多
Breast cancer is the second leading cancer in the world. <span style="font-family:Verdana;">The long-term</span><span style="font-family:Verdana;"> exposure </span><span ...Breast cancer is the second leading cancer in the world. <span style="font-family:Verdana;">The long-term</span><span style="font-family:Verdana;"> exposure </span><span style="font-family:Verdana;">of</span><span style="font-family:Verdana;"> some metallic compounds induces different forms of cancer, including breast cancer. Trace elements are essential metals for the physiological functions of the cell on a molecular level and also contribute </span><span style="font-family:Verdana;">in</span> <span style="font-family:Verdana;">treatment</span><span style="font-family:Verdana;"> of many diseases. </span><span style="font-family:Verdana;">The aim of study was</span><span style="font-family:Verdana;"> to compare the level of essential trace elements, sodium, potassium, calcium, iron, and zinc in breast cancer patients with normal healthy adult women. Total forty-five patients (age range from 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">73 years) were included in this study and divided into three groups according to three different stages of breast cancer including tumor-II, tumor-III </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> tumor-IV. Blood was collected from all participants after taking history, clinical data </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> taking consent. However, about fifteen non-cancer healthy women in </span><span style="font-family:Verdana;">age</span><span style="font-family:Verdana;"> range from 26</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">69 years were subjected to this study. The elemental concentrations were determined through atomic absorption spectrophotometer </span><span style="font-family:Verdana;">subsequent to</span><span style="font-family:Verdana;"> microwave-induced acid digestion. The results of Na, K, Zn, Fe, Ca, were observed </span></span><span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">decrease in blood samples of breast cancer patients as compared to non-cancer subjects. The results are reliable with other numerous literature reported studies, the efficiency, and deficiency of these trace metals may contribute </span><span style="font-family:Verdana;">an </span><span style="font-family:Verdana;">important</span><span style="font-family:Verdana;"> role in the progress of breast cancer.</span>展开更多
Mucinous cystic neoplasm(MCN)of the pancreas is an exocrine cystic tumor with a potential of harboring malignancy.The latest World Health Organization classification of tumors of digestive system designates malignant ...Mucinous cystic neoplasm(MCN)of the pancreas is an exocrine cystic tumor with a potential of harboring malignancy.The latest World Health Organization classification of tumors of digestive system designates malignant MCN as MCN with associated invasive carcinoma(MCN-AIC).Since its separation from other pancreatic cystic tumors in 1978,much progress has been made in our understanding of MCN in epidemiology,clinical and pathological features,biological behavior,as well as prognostic characteristics.This review aims to summarize the current knowledge of MCN and MCN-AIC.展开更多
基金funded by the Natural Science Foundation of Higher Education Institutions of Auhui Province(Grant No.KJ2021A0352)the Research Fund Project of Anhui Medical University(Grant No.2020xkj236)Applied Medicine Research Project of Hefei Health Commission(Grant No.HWKJ2019-172-14).
文摘Invasive breast carcinoma(BRCA)is associated with poor prognosis and high risk of mortality.Therefore,it is critical to identify novel biomarkers for the prognostic assessment of BRCA.Methods:The expression data of polo-like kinase 1(PLK1)in BRCA and the corresponding clinical information were extracted from TCGA and GEO databases.PLK1 expression was validated in diverse breast cancer cell lines by quantitative real-time polymerase chain reaction(qRT-PCR)and western blotting.Single sample gene set enrichment analysis(ssGSEA)was performed to evaluate immune infiltration in the BRCA microenvironment,and the random forest(RF)and support vector machine(SVM)algorithms were used to screen for the hub infiltrating cells and calculate the immunophenoscore(IPS).The RF algorithm and COX regression model were applied to calculate survival risk scores based on the PLK1 expression and immune cell infiltration.Finally,a prognostic nomogram was constructed with the risk score and pathological stage,and its clinical potential was evaluated by plotting calibration charts and DCA curves.The application of the nomogram was further validated in an immunotherapy cohort.Results:PLK1 expression was significantly higher in the tumor samples in TCGA-BRCA cohort.Furthermore,PLK1 expression level,age and stage were identified as independent prognostic factors of BRCA.While the IPS was unaffected by PLK1 expression,the TMB and MATH scores were higher in the PLK1-high group,and the TIDE scores were higher for the PLK1-low patients.We also identified 6 immune cell types with high infiltration,along with 11 immune cell types with low infiltration in the PLK1-high tumors.A risk score was devised using PLK1 expression and hub immune cells,which predicted the prognosis of BRCA patients.In addition,a nomogram was constructed based on the risk score and pathological staging,and showed good predictive performance.Conclusions:PLK1 expression and immune cell infiltration can predict post-immunotherapy prognosis of BRCA patients.
文摘BACKGROUND Invasive urothelial carcinoma(UC)with squamous and glandular differentiation is a highly malignant and complicated pathological subtype,and the standard care is radical cystectomy(RC).However,urinary diversion after RC significantly reduces patient quality of life,thus bladder-sparing therapy has become a research hotspot in this field.Recently,five immune checkpoint inhibitors have been approved for systemic therapy of locally advanced or metastatic bladder cancer by the Food and Drug Administration,but the efficacy of immunotherapy combined with chemotherapy for invasive UC is still unknown,especially for pathological subtypes with squamous and glandular differentiation.CASE SUMMARY We report the case of a 60-year-old male who complained of repetitive painless gross hematuria and was diagnosed with muscle-invasive bladder cancer with squamous and glandular differentiation,defined as cT3N1M0 according to the American Joint Committee on Cancer,who had a strong desire to preserve the bladder.Immunohistochemical staining revealed that programmed cell deathligand 1(PD-L1)expression in the tumor was positive.Thus,a transurethral resection to maximize removal of the bladder tumor was performed under cystoscopy,and the patient subsequently received a combination of chemotherapy(cisplatin/gemcitabine)and immunotherapy(tislelizumab)treatment.No tumor recurrence in the bladder was observed following pathological and imaging examination after 2 cycles and 4 cycles of treatment,respectively.The patient achieved bladder preservation and has been tumor-free for more than two years.CONCLUSION This case shows that the combination of chemotherapy and immunotherapy might be an effective and safe treatment strategy for PD-L1 expression positive UC with divergent histologic differentiation.
基金Japan Society for the Promotion of Science(JSPS)KAKENHI,No.19K17480(to Sato H),and No.20H03655(Mizukami Y).
文摘Pancreatic cancer currently has no subtypes that inform clinical decisions;hence,there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteristics.Nonetheless,accumulating studies to date have revealed the large-duct type variant,a unique subtype of pancreatic ductal adenocarcinoma(PDA)with cystic features.This subtype often radiographically mimics intraductal papillary mucinous neoplasms(IPMNs)and involves multiple small cysts occasionally associated with solid masses.The“bunch-of-grapes”sign,an imaging characteristic of IPMNs,is absent in large-duct PDA.Large-duct PDA defines the mucin profile,and genetic alterations are useful in distinguishing large-duct PDA from IPMNs.Histologically,neoplastic ducts measure over 0.5 mm,forming large ductal elements.Similar to classic PDAs,this subtype is frequently accompanied by perineural invasion and abundant desmoplastic reactions,and KRAS mutations in codon 12 are nearly ubiquitous.Despite such morphological similarities with IPMNs,the prognosis of large-duct PDA is equivalent to that of classic PDA.Differential diagnosis is therefore essential.
基金supported by funding from the National Natural Science Foundation of China (Grant Nos. 81672637 and 81872164)。
文摘Objective: Mucin 1(MUC1/EMA) and sialyl Lewis X(sLe^(x)) indicate polarity reversal in invasive micropapillary carcinoma(IMPC). The purpose of this study was to evaluate the expression of MUC1/EMA and sLe^(x) and to assess their diagnostic and prognostic value in patients with IMPC.Methods: The expression of sLe^(x) and MUC1/EMA in 100 patients with IMPC and a control group of 89 patients with invasive ductal carcinoma not otherwise specified(IDC-NOS) were analyzed with IHC. Fresh tumor tissues were collected from patients with IMPC or IDC-NOS for primary culture and immunofluorescence analysis.Results: The rate of nodal metastasis was higher in patients with IMPC than those with IDC-NOS, and IMPC cells tended to express more sLe^(x) and MUC1/EMA in the cytomembranes(the stroma-facing surfaces of the micropapillary clusters) than IDC-NOS cells. In IMPC, high cytomembrane expression of sLe^(x), but not MUC1/EMA, indicated poor prognosis. In addition, among the 100 patients with IMPC, 10 patients had sLe^(x)+/EMA-expression patterns, and 8 patients had sLe^(x)-/EMA+ expression patterns. The primary IMPC cells were suspended, non-adherent tumor cell clusters, whereas the primary IDC cells were adherent tumor cells. Immunofluorescence analysis showed that MUC1/EMA and sLe^(x) were co-expressed on the cytomembranes in IMPC cell clusters and in the cytoplasm in IDC-NOS cells.Conclusions: sLe^(x) can be used as a prognostic indicator and can be combined with MUC1/EMA as a complementary diagnostic indicator to avoid missed IMPC diagnosis.
基金grants from the Fundamental Research Funds for the Central Universities(No.2172015YGYL019)the Fundamental Research Funds for the Central Universities(No.2015LC021)+1 种基金National Natural Science Foundation of China(No.81000616)Hubei Key Laboratory of Molecular Imaging Research Funds(No.02.03.2015-149).
文摘The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study.SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy.The maximum values were recorded for statistical analysis.Medical records were reviewed to determine tumor size,histological grade,lymph node status and immunohistochemical results.Tumor subtypes were categorized as luminal A,luminal B,human epidermal growth factor receptor 2(HER2)positive and triple negative.The correlations between SWV and histological prognostic factors were analyzed.It was found that tumor size showed positive association with SWV(r=0.465,P<0.001).Larger tumors had significantly higher SWV than smaller ones(P=0.001).Histological grade 1 tumors had significantly lower SWV values than those with higher histological grade(P=0.015).The Ki67 expression,tumor subtypes and lymph node status showed no statistically significant correlations with SWV,although triple negative tumors and lymph node-positive tumors showed higher SWV values.It was concluded that tumor size was significantly associated with SWV.Higher histological grade was associated with increased SWV.There was no statistically significant correlations between SWV and other histological prognostic factors.
文摘BACKGROUND Gastrointestinal metastasis of breast cancer is rare,and clinicians may not have previously encountered this disease in clinical practice.CASE SUMMARY We report a patient with invasive lobular carcinoma of the breast who developed gastrointestinal metastasis two years after modified radical surgery.Mild elevation of carbohydrate antigen 15-3 was observed in the patient at an early stage;however,diagnosis and treatment were delayed due to non-specific clinical manifestations and no identifiable metastasis observed on imaging.CONCLUSION Clinicians should pay attention to gastrointestinal metastasis of breast cancer,especially invasive lobular carcinoma of the breast.
基金the Scientific Research Funds Project of the Science and Technology Department of Sichuan Province(Grant No.21YYJC1616 to Liu Y).
文摘Invasive stratified mucin-producing carcinoma(ISMC)is a recently described histologic variant of high-risk human papillomavirus(HPV)-associated endocervical adenocarcinoma,as the putative invasive counterpart of the stratified mucin-producing intraepithelial lesion(SMILE).ISMC can display variable architectural patterns and usually coexists with other more conventional types of HPV-associated carcinomas,which makes diagnosis and differential diagnosis of ISMC is difficult for pathologists.Moreover,the prognosis of ISMC is still controversial.We analyzed 6 ISMCs with detailed pathological and clinical information.Intraepithelial lesion,including 1 high-grade squamous intraepithelial lesion and 1 SMILE,was found.Various architectures were observed(including nest,glandular,solid,trabecular,and single cell).Nuclear peripheral palisading,apoptotic bodies and mitoses,and variable cytoplasmic mucin vacuoles were seen in all of our cases.The predominance of neutrophils infiltration was seen in only 1 tumor.All the tumors infiltrated the cervical stroma in Silva pattern C manner.p63 and/or p40 was characteristically expressed in the peripheral cells in only 2 cases.High-risk HPV infection was observed in 3/3 detected cases.All the patients were alive during the follow-up time.Recognition of this infrequent tumor may help pathologists and oncologists for an accurate diagnosis and a better understanding of the clinicopathological behavior.
文摘Objective:To investigate the diagnostic value of invasive micropapillary carcinoma(IMPC)by ultrasonography and MRI.Method:63 female patients with IMPC were selected,all of which were confirmed by pathological examination,and were assigned to the IMPC group.In the same period,40 patients with invasive ductal carcinoma(IDC group)were selected for diagnostic efficacy control.The efficacy indexes of accuracy,sensitivity,specificity,positive prediction rate and negative prediction rate were 73.0%,65.9%,89.5%,93.5%,46.9%,respectively.The efficiency indexes of accuracy,sensitivity,specificity,positive prediction rate and negative prediction rate of ultrasound combined with breast MRI were 93.6%,93.2%,94.7%,97.6%,85.7%.Ultrasonography combined with MRI has more application value in the diagnosis of IMPC.
文摘Background:Invasive squamous carcinoma(SCC)is the most frequent malignant neoplasia of the conjunctiva,33%of which will metastasize.C-erbB-2/neu(HER2)is an oncogene associated with poor prognosis,metastatic potential and aggressive behavior in several tumors,including breast,stomach,among others.HER2 amplification is also associated with the response to anti-HER2 treatment.The aim of this study is to evaluate HER2 expression in the progression of ocular surface squamous neoplasia(OSSN)and as a potential therapeutical target.Methods:Ninety-eight OSSN lesions including 17 papillomas(P),27 conjunctival intraepithelial neoplasia(CIN)I,19 CIN II,13 CIN III,and 11 SCC were evaluated.Eleven conjunctivas from normal human eyes(NHE)were also included in the analysis.Immunohistochemistry was performed to analyze HER2(clone 29D8)expression,which was graded as follows:complete membrane staining in more than 10%of malignant cells(3+);week to moderate complete staining in more than 10%of malignant cells(2+);none or fewer than 10%cells staining(0 to 1+,respectively).Positive HER2 was considered when a score 2+or 3+was determined.Breast carcinoma with HER2 amplification was used as a positive control.FISH technique was performed in the positive cases to confirm results.Statistical analysis was performed using Fisher’s exact test.Results:HER2 positive expression was detected in 6%of P(100%score 2+),11%of CIN I(100%score 2+),32%of CIN II(100%score 2+),30%of CIN III(100%score 2+),29%of SCC(50%score 2+and 50%score 3+).Benign lesions showed lower HER2 expression than in situ(P=0.03)and invasive tumors(P=0.02).No correlation between HER2 and age or tumor thickness in SCC was found(P>0.05).Conclusions:HER2 is expressed in conjunctival SCC.Moreover,one third of SCC were graded as 2+or 3+.These results support the evaluation of anti-HER2 therapy in conjunctival SCC.Pre-clinical trials should be performed to determine the importance of this marker in conjunctival SCC for predicting response to treatments targeting this pathway.
文摘Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.
基金Supported by the Natural Science Key Project in Universities of Anhui Province,No.KJ2021A0701Natural Science Key Project of Bengbu Medical College,No.2020byzd030Postgraduate Scientific Research Innovation Program of the Bengbu Medical College,No.Byycx22016.
文摘BACKGROUND Pancreatic mucinous cystic neoplasms(MCNs)represent one of the precursor lesions of pancreatic ductal adenocarcinoma,and their detection has been facilitated by advances in preoperative imaging.Due primarily to the rarity of MCNs,however,there is limited knowledge regarding the prognostic variables and high-risk factors for malignant transformation.A more comprehensive and nuanced approach is necessary to fill this gap and provide a basis for improved treatment decisions and patient outcomes.AIM To investigate the high-risk factors associated with malignant MCNs and to explore the prognostic factors of MCN with associated invasive carcinoma(MCNAIC).METHODS All cases of resected MCNs from a single high-volume institution between January 2012 and January 2022 were retrospectively reviewed.Only cases with ovarian-type stroma verified by progesterone receptor staining were included.Preoperative features,histological findings and postoperative course were documented.Multivariate logistic regression was employed to investigate variables related to malignancy.Survival analysis was performed using the Kaplan-Meier curve,and the prognostic factors were assessed to evaluate the postoperative course of patients with MCN-AIC.RESULTS Among the 48 patients,36 had benign MCNs,and 12 had malignant MCNs(1 high-grade atypical hyperplasia and 11 MCN-AIC).Age,tumour size,presence of solid components or mural nodules and pancreatic duct dilatation were identified as independent risk factors associated with malignancy.The follow-up period ranged from 12 mo to 120 mo,with a median overall survival of 58.2 mo.Only three patients with MCN-AIC died,and the 5-year survival rate was 70.1%.All 11 cases of MCN-AIC were stage I,and extracapsular invasion was identified as a prognostic factor for poorer outcomes.CONCLUSION The risk factors independently associated with malignant transformation of MCNs included age,tumour size,presence of solid components or mural nodules,and pancreatic duct dilatation.Our study also revealed that encapsulated invasion was a favourable prognostic factor in MCN-AIC patients.
文摘Breast cancer,particularly Invasive Ductal Carcinoma(IDC),is a primary global health concern predominantly affecting women.Early and precise diagnosis is crucial for effective treatment planning.Several AI-based tech-niques for IDC-level classification have been proposed in recent years.Processing speed,memory size,and accuracy can still be improved for better performance.Our study presents ECAM,an Enhanced Channel-Wise Attention Mechanism,using deep learning to analyze histopathological images of Breast Invasive Ductal Carcinoma(BIDC).The main objectives of our study are to enhance computational efficiency using a Separable CNN architecture,improve data representation through hierarchical feature aggregation,and increase accuracy and interpretability with channel-wise attention mechanisms.Utilizing publicly available datasets,DataBioX IDC and the BreakHis,we benchmarked the proposed ECAM model against existing state-of-the-art models:DenseNet121,VGG16,and AlexNet.In the IDC dataset,the model based on AlexNet achieved an accuracy rate of 86.81%and an F1 score of 86.94%.On the other hand,DenseNet121 outperformed with an accuracy of 95.60%and an F1 score of 95.75%.Meanwhile,the VGG16 model achieved an accuracy rate of 91.20%and an F1 score of 90%.Our proposed ECAM model outperformed the state-of-the-art,achieving an impressive F1 score of 96.65%and an accuracy rate of 96.70%.The BreakHis dataset,the AlexNet-based model,achieved an accuracy rate of 90.82%and an F1 score of 90.77%.DenseNet121 achieved a higher accuracy rate of 92.66%with an F1 score of 92.72%,while the VGG16 model achieved an accuracy of 92.60%and an F1 score of 91.31%.The proposed ECAM model again outperformed,achieving an F1 score of 96.37%and an accuracy rate of 96.33%.Our model is a significant advancement in breast cancer diagnosis,with high accuracy and potential as an automated grading,especially for IDC.
文摘Background:Invasive micropapillary carcinoma(IMPC)is an uncommon subtype of breast cancer.Previous studies of this subtype demonstrated a higher propensity for lymph node metastases as compared with invasive ductal carci-noma(IDC).The purpose of the present study was to determine the clinical characteristics,outcomes,and propensity for lymph node metastasis of patients with IMPC of the breast recorded in the National Cancer Database(NCDB).Methods:Records of patients with IMPC diagnosed between 2004 and 2014 were retrieved from the NCDB.Log-rank test was performed to evaluate associations of clinical characteristics with overall survival(OS).Cox proportional hazards model was used to determine variables associated with OS.Results:Overall,2660 patients with IMPC met the selection criteria;the 5-year OS rate was 87.5%and 24.9%of patients had nodal involvement at presentation.Patients with≥4 positive lymph nodes had shorter OS than node-negative patients,whereas patients with 1-3 positive nodes had similar OS to node-negative patients.Age<65 years,receipt of radiotherapy,and estrogen receptor positivity were also associated with prolonged OS.The benefit of radiotherapy was limited to IMPC patients undergoing lumpectomy;there was no benefit for the patients undergoing mastectomy(regardless of nodal positivity/negativity).Conclusions:Favorable prognostic factors of IMPC patients included age<65 years,<4 positive lymph nodes,receipt of radiotherapy,and estrogen receptor positivity.The results presented herein suggest a survival benefit asso-ciated with radiotherapy in IMPC treatment,though this may be limited to the patients treated with lumpectomy.
基金supported by grants from National Science and Technology Major Project of the Ministry of Science and Technology of the People’s Republic of China(No.2018ZX09735005)National Natural Science Foundation of China(Grant Nos.81522028,81673452,81673455,81873939,81803365 and 81602953)+2 种基金Post-Doctor Research Project(2018M643510,China)Post-Doctor Research Project of West China Hospital,Sichuan University(Grant No.2018HXBH065,China)supported by the grant from“The Recruitment Program of Global Young Experts”(known as“the Thousand Young Talents Plan”,China)。
文摘Autophagy is a critical cellular homeostatic mechanism,and its dysfunction is linked to invasive breast carcinoma(BRCA).Recently,several omics methods have been applied to explore autophagic regulators in BRCA;however,more reliable and robust approaches for identifying crucial regulators and druggable targets remain to be discovered.Thus,we report here the results of multi-omics approaches to identify potential autophagic regulators in BRCA,including gene expression(EXP),DNA methylation(MET)and copy number alterations(CNAs)from The Cancer Genome Atlas(TCGA).Newly identified candidate genes,such as SF3 B3,TRAPPC10,SIRT3,MTERFD1,and FBXO5,were confirmed to be involved in the positive or negative regulation of autophagy in BRCA.SF3 B3 was identified firstly as a negative autophagic regulator,and siRNA/shRNA-SF3 B3 were shown to induce autophagyassociated cell death in in vitro and in vivo breast cancer models.Moreover,a novel small-molecule activator of SIRT3,1-methylbenzylamino amiodarone,was discovered to induce autophagy in vitro and in vivo.Together,these results provide multi-omics approaches to identify some key candidate autophagic regulators,such as the negative regulator SF3 B3 and positive regulator SIRT3 in BRCA,and highlight SF3 B3 and SIRT3 as new druggable targets that could be used to fill the gap between autophagy and cancer drug development.
文摘BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.
文摘The present study aimed to investigate the possibility of using dual-energy computed tomography (CT) before therapy to discriminate between normal breast tissue and tumor tissue in patients with breast cancer, without the need to use a contrast medium. The following patient data were extracted by interview and from the hospital’s radiology information system: height, weight, age, menstrual cycle, CT images of normal tissue and tumors with or without contrast medium, and the histopathological diagnosis of the aspiration biopsy. The median age of the 43 participants was 56 years (range, 30 - 80 years). The CT values were evaluated using a clinical analytical program based on the three-material decomposition technique. Breast cancer was classified into ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, fibromatosis-like metaplastic carcinoma, and apocrine carcinoma. In all conditions, regardless of contrast medium, the CT values of tumor tissues were higher than those of normal breast tissue, indicating the effectiveness of dual-energy CT (DE-CT) in the diagnosis of breast cancer. By contrast, DE-CT showed limited potential for distinguishing ductal carcinoma in situ from invasive ductal carcinoma. There have only been a few reports regarding CT examination of breast cancer, and it is expected this study encourage the development of DE-CT imaging to improve tumor detection in patients with breast cancer.
文摘Breast cancer is the second leading cancer in the world. <span style="font-family:Verdana;">The long-term</span><span style="font-family:Verdana;"> exposure </span><span style="font-family:Verdana;">of</span><span style="font-family:Verdana;"> some metallic compounds induces different forms of cancer, including breast cancer. Trace elements are essential metals for the physiological functions of the cell on a molecular level and also contribute </span><span style="font-family:Verdana;">in</span> <span style="font-family:Verdana;">treatment</span><span style="font-family:Verdana;"> of many diseases. </span><span style="font-family:Verdana;">The aim of study was</span><span style="font-family:Verdana;"> to compare the level of essential trace elements, sodium, potassium, calcium, iron, and zinc in breast cancer patients with normal healthy adult women. Total forty-five patients (age range from 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">73 years) were included in this study and divided into three groups according to three different stages of breast cancer including tumor-II, tumor-III </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> tumor-IV. Blood was collected from all participants after taking history, clinical data </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> taking consent. However, about fifteen non-cancer healthy women in </span><span style="font-family:Verdana;">age</span><span style="font-family:Verdana;"> range from 26</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">69 years were subjected to this study. The elemental concentrations were determined through atomic absorption spectrophotometer </span><span style="font-family:Verdana;">subsequent to</span><span style="font-family:Verdana;"> microwave-induced acid digestion. The results of Na, K, Zn, Fe, Ca, were observed </span></span><span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">decrease in blood samples of breast cancer patients as compared to non-cancer subjects. The results are reliable with other numerous literature reported studies, the efficiency, and deficiency of these trace metals may contribute </span><span style="font-family:Verdana;">an </span><span style="font-family:Verdana;">important</span><span style="font-family:Verdana;"> role in the progress of breast cancer.</span>
文摘Mucinous cystic neoplasm(MCN)of the pancreas is an exocrine cystic tumor with a potential of harboring malignancy.The latest World Health Organization classification of tumors of digestive system designates malignant MCN as MCN with associated invasive carcinoma(MCN-AIC).Since its separation from other pancreatic cystic tumors in 1978,much progress has been made in our understanding of MCN in epidemiology,clinical and pathological features,biological behavior,as well as prognostic characteristics.This review aims to summarize the current knowledge of MCN and MCN-AIC.
