妊娠哺乳期乳腺癌患者的预后情况及其影响因素分析

目的:分析妊娠哺乳期乳腺癌患者的预后情况及其影响因素。方法:将2010年1月至2012年12月期间贵州省贵阳市妇幼保健院、贵州省医科大学和贵州省肿瘤医院收治的妊娠哺乳期乳腺癌患者60例作为研究组,选择同期收治的非妊娠哺乳期乳腺癌患者60例作为对照组,比较两组5年生存率和临床病理特征,并应用单因素和多因素Logistic回归分析患者预后的影响因素。结果:研究组5年生存率为61.67%(37/60),5年无病生存率为46.67%(28/60),均低于对照组的81.67%(49/60),73.33%(44/60)(P0.05)。研究组肿瘤最大直径、腋淋巴结转移率、TNM分期为III期的比例、雌激素受体阳性率、Ki67细胞阳性率≥20%的比例均高于对照组(P0.05),两组孕激素受体阳性率比较无统计学差异(P0.05)。单因素分析显示妊娠哺乳期乳腺癌患者总生存期与肿瘤最大直径、TNM分期、Ki67细胞阳性率≥20%的比例、腋淋巴结转移率有关(P0.05)。多因素Logistic回归分析显示,TNM分期为III期、Ki67细胞阳性率≥20%、腋淋巴结转移是影响妊娠哺乳期乳腺癌患者预后的独立危险因素(P0.05)。结论:妊娠哺乳期乳腺癌患者的预后较差,TNM分期为III期、Ki67细胞阳性率≥20%、腋淋巴结转移是影响患者预后的危险因素,对于临床防治具有重要的启示作用。     

乳腺癌患者心理韧性相关影响因素分析及心理韧性与焦虑的关系

目的:分析乳腺癌患者心理韧性的影响因素,并分析心理韧性与焦虑的关系。方法:于2017年2月～2018年4月期间,选择蚌埠医学院第二附属医院收治的乳腺癌患者287例为研究对象,分别采用心理韧性量表(RS)、焦虑自评量表(SAS)评估研究对象的心理韧性及焦虑状态,并采用多因素Logistic回归分析法分析乳腺癌患者心理韧性相关的影响因素,应用多元逐步线性回归分析法分析乳腺癌患者心理韧性与焦虑的关系。结果:乳腺癌患者RS得分为(76.72±9.82)分。单因素分析显示,不同年龄、居住地、家庭月收入及费用支出形式患者的RS得分比较差异有统计学意义(P0.05);不同文化程度、婚姻状况、手术类型及肿瘤分期患者的RS得分比较差异无统计学意义(P0.05)。多因素Logistic回归分析结果显示,年龄为20～40岁、居住地为农村、家庭月收入3000元、费用支出形式为自费是乳腺癌患者心理韧性的影响因素(P0.05)。乳腺癌患者SAS得分为(5.02±1.42)分,以心理韧性为自变量,焦虑为因变量进行多元逐步线性回归分析,结果显示,乳腺癌患者心理韧性为焦虑的预测因子,其心理韧性水平越高,焦虑程度越低(P0.05)。结论:乳腺癌患者心理韧性水平偏低,且其对患者焦虑状态具有预测作用,年龄为20～40岁、居住地为农村、家庭月收入3000元、费用支出形式为自费是乳腺癌患者心理韧性的影响因素,临床治疗中应该根据以上影响因素进行相关干预。     

Functional profiling of nucleotide Excision repair in breast cancer

Homologous recombination deficiency conferred by alterations in BRCA1 or BRCA2 are common in breast tumors and can drive sensitivity to platinum chemotherapy and PARP inhibitors. Alterations in nucleotide excision repair (NER) activity can also impact sensitivity to DNA damaging agents, but NER activity in breast cancer has been poorly characterized. Here, we apply a novel immunofluorescence-based cellular NER assay to screen a large panel of breast epithelial and cancer cell lines. Although the majority of breast cancer models are NER proficient, we identify an example of a breast cancer cell line with profound NER deficiency. We show that NER deficiency in this model is driven by epigenetic silencing of the ERCC4 gene, leading to lack of expression of the NER nuclease XPF, and that ERCC4 methylation is also strongly correlated with ERCC4 mRNA and XPF protein expression in primary breast tumors. Re-expression of XPF in the ERCC4-deficient breast cancer rescues NER deficiency and cisplatin sensitivity, but does not impact PARP inhibitor sensitivity. These findings demonstrate the potential to use functional assays to identify novel mechanisms of DNA repair deficiency and nominate NER deficiency as a platinum sensitivity biomarker in breast cancer.     

Intraoperative breast radiotherapy: survival,local control and risk factors for recurrence

BackgroundWhole breast irradiation reduces loco-regional recurrence and risk of death in patients submitted to breast-conserving treatment. Data show that radiation to the index quadrant alone may be enough in selected patients.AimTo report the experience with intra-operative radiotherapy (IORT) with Electron-beam Cone in Linear Accelerator (ELIOT) and the results in overall survival, local control and late toxicity of patients submitted to this treatment.Materials and Methods147 patients treated with a median follow up of 6.9 years (0.1?11.5 years). The actuarial local control and overall survival probabilities were estimated using the Kaplan Meier method. All tests were two-sided and p ? 0.05 was considered statistically significant.ResultsOverall survival of the cohort in 5 years, in the median follow up and in 10 years was of 98.3%, 95.1% and 95.1%, respectively, whereas local control in 5 years, in the median follow up and in 10 years was of 96%, 94.9% and 89.5%, respectively. Two risk groups were identified for local recurrence depending on the estrogen or progesterone receptors, axillary or margin status and lymphovascular invasion (LVI) (p = 0.016).ConclusionsIORT is a safe and effective treatment. Rigorous selection is important to achieve excellent local control results.     

The diagnostic value of combined detection of genetic markers and serum protein markers on breast cancer

Objective: The research is to explore the diagnostic value of several detection methods including separated and combined detection of the related genes and related proteins of breast cancer and combined detection of all genetic markers and serum protein markers on breast cancer. Method: The mRNA level expression of the related genes of breast cancer was detected by FQ-PCR technique and the ratio of BRCA-1, Myc, C-erbB2 and β2 micro-globulin was used to express levels of BRCA-1, Myc and C-erbB2; the related proteins of breast cancer were detected through ELISA. Then the research data was analyzed by SPSS19.0 software with t-test as comparison method, and ROC curve was used to calculate the sensitivity, specificity and accuracy of the diagnostic models. Result: No difference can be found among the six indexes in the control group and benign breast tumor group while compared with the benign breast tumor group and the control group, the breast cancer group was significantly different from them; combined detection of genes and that of proteins were both superior to their separated detection; all-marker combined detection was superior to separated detection, which is consistent with combined detection of genes and proteins. Conclusion: More detection indexes will not necessarily outcome better detection effect. Hence, appropriate detection indexes and number are needed to achieve better diagnosis effect. In order to conduct more specific method, more test samples are needed for further researches.     

Selective estrogen receptor degraders with novel structural motifs induce regression in a tamoxifen-resistant breast cancer xenograft

Potent estrogen receptor ligands typically contain a phenolic hydrogen-bond donor. The indazole of the selective estrogen receptor degrader (SERD) ARN-810 is believed to mimic this. Disclosed herein is the discovery of ARN-810 analogs which lack this hydrogen-bond donor. These SERDs induced tumor regression in a tamoxifen-resistant breast cancer xenograft, demonstrating that the indazole NH is not necessary for robust ER-modulation and anti-tumor activity.     

Investigation of B,C-ring truncated deguelin derivatives as heat shock protein 90 (HSP90) inhibitors for use as anti-breast cancer agents

On the basis of deguelin, a series of the B,C-ring truncated surrogates with N-substituted amide linkers were investigated as HSP90 inhibitors. The structure activity relationship of the template was studied by incorporating various substitutions on the nitrogen of the amide linker and examining their HIF-1α inhibition. Among them, compound 57 showed potent HIF-1α inhibition and cytotoxicity in triple-negative breast cancer lines in a dose-dependent manner. Compound 57 downregulated expression and phosphorylation of major client proteins of HSP90 including AKT, ERK and STAT3, indicating that its antitumor activity was derived from the inhibition of HSP90 function. The molecular modeling of 57 demonstrated that 57 bound well to the C-terminal ATP-binding pocket in the open conformation of the hHSP90 homodimer with hydrogen bonding and pi-cation interactions. Overall, compound 57 is a potential antitumor agent for triple-negative breast cancer as a HSP90 C-terminal inhibitor.     

Effect of curcumin-nanoemulsion associated with photodynamic therapy in breast adenocarcinoma cell line

Curcumin, a natural compound has several antineoplastic activities and is a promising natural photosensitizer used in photodynamic therapy. However, its low solubility in physiological medium limit the clinical use of curcumin. This study aimed to analyze the action of curcumin-nanoemulsion, a new and well-designed Drug Delivery System (DDS+) molecule, used as a photosensitizing agent in photodynamic therapy in an in vitro breast cancer model, MCF-7 cells. The empty nanoemulsion fulfils all necessary requirements to be an excellent DDS. Furthermore, the use of curcumin-nanoemulsion in photodynamic therapy resulted in a high phototoxic effect after activation at 440?nm, decreasing to <10% viable tumor cells after two irradiations and increasing the reactive oxygen species (ROS) production. The use of curcumin-nanoemulsion associated with photodynamic therapy resulted in an increase in the levels of caspase 3/7 activity for the studied MCF-7 cell model, indicating that this therapy triggers a cascade of events that lead to cell death, such as cellular apoptosis. In conclusion, curcumin-nanoemulsion proved to be efficient as a photosensitizing agent, had phototoxic effects, significantly decreased the proliferation of MCF-7 cells and stimulating the ROS production in combination with photodynamic therapy, so, this formulation has a great potential for use in treatment of breast cancer.     

The role of CXC chemokine ligand 4/CXC chemokine receptor 3-B in breast cancer progression

Chemokines and their receptors participate in the development of cancers by enhancing tumor cell proliferation, angiogenesis, invasion, metastasis and penetration of tumor immune cells. It remains unclear whether CXC chemokine ligand 4 (CXCL4)/CXC chemokine receptor 3-B (CXCR3-B) can be used as an independent molecular marker for establishing prognosis for breast cancer patients. We evaluated CXCL4 and CXCR3-B expression in 114 breast cancer tissues and 30 matched noncancerous tissues using immunohistochemistry and western blot, and determined the correlation between their expression and clinicopathologic findings. We observed that breast cancer tissues express CXCL4 strongly and CXCR3-B weakly compared to noncancerous tissues. Strong CXCL4 expression was detected in 94.7% and weak CXCR3-B expression was detected in 78.9% of the tissues. Therefore, CXCL4/CXCR3-B might play a crucial role in breast cancer progression. We found no significant correlation between CXCL4 and age, tumor stage, tumor grade or TNM stage. CXCR3-B was associated significantly with tumor grade. Moreover, the Chi-square test of association showed that the expression of CXCL4/CXCR3-B might be an independent prognostic marker for breast cancer. Therefore, we suggest that CXCR3-B is an indicator of poor prognosis and may also be a chemotherapeutic target.