血清CA153、TK1、TSGF联合检测对乳腺癌诊断的价值

目的：探讨细胞表面糖蛋白（CA153）、胸苷激酶（TKl）、肿瘤生长因子（TSGF）等联合检测在乳腺癌诊断中的应用价值。方法：73例确诊为乳腺癌患者的血清标本作为实验组;66例乳腺良性疾病（包括乳腺纤维瘤、囊肿、增生等）及50例健康人群血清标本作为对照组。采用电化学发光法检测血清CAl53,免疫化学发光法检测TKl,化学显示法检测TSGF的表达。结果：血清CAl53、TKl及TSGF对乳腺癌的敏感性分别为54．8％、53．4％及79．5％,特异性分别为87．9％、81．8％及83．3％;血清CAl53、TKl、TSGF联合检测乳腺癌的敏感性为89．0％,特异性为92．4％。结论：与单项指标检测相比,多个指标联合检测提高了对乳腺癌早期诊断的敏感性．同时又有较好的特异性．有助于良、恶乳腺疾病的鉴别．具有一定的临床应用价值．     

彩色多普勒超声对临床触诊阴性乳腺癌的诊断价值

目的:探讨超声对临床触诊阴性乳腺癌的诊断价值。方法:回顾性分析135个临床触诊阴性乳腺肿块(恶性33个,良性102个)超声直接和间接征象图特征,并与病理结果对照分析,计算超声诊断触诊阴性乳腺肿块灵敏性、特异性、阳性预测值、阴性预测值及准确性。结果:直接征象中微钙化、Ⅱ～Ⅲ级血流、穿支血管、阻力指数RI≥0.7和间接征象中浅筋膜的改变、腋窝淋巴结肿大具有较高诊断价值,良恶性组比较差异有统计学意义(P均<0.01)。超声诊断临床触诊阴性乳腺癌的灵敏性81.82%、特异性93.14%、阳性预测值79.41%、阴性预测值94.06%、准确性90.37%。结论:超声对临床触诊阴性乳腺癌的早期诊断具有重要价值。     

胚胎早期乳腺原基体外培养对乳腺干细胞相关标记表达稳定性的影响

乳腺干细胞具有产生各类乳腺细胞的能力,其研究对于乳腺发育的认知、乳腺癌的治疗以及乳腺生物反应器的开发都具有重要意义。此外,伴随胎儿发育,胚胎期乳腺干细胞所经历的增殖、迁移、侵袭等过程是成体乳腺干细胞没有的,而这些经历与乳腺癌的发生过程非常相似。因此,针对胚胎乳腺干细胞的研究在医学上具有更重要的意义。Sca-1、CD29、CD49f和CD24都是经常被用于乳腺干细胞分离纯化的细胞表面标记。该研究分析了不同的体外处理条件和时间对于上述标记在小鼠乳腺原基中表达稳定性的影响,旨在为胚胎早期乳腺干细胞的分离、纯化以及鉴定奠定分子基础,也为胚胎乳腺发育和乳腺癌发生的相关研究提供支持。     

乳腺良性肿块与乳腺癌患者的超声弹性成像对比

目的:对比乳腺良性肿块与乳腺癌患者的超声弹性成像,明确超声弹性成像的应用价值。方法:选取2014年5月-2016年1月我院乳腺肿块患者128人次共146例肿块,根据病理结果分为乳腺良性肿块和乳腺癌,比较超声弹性成像与病理结果。结果:128个患者共计肿块146例,99例结节为良性肿块,其中32例为乳腺纤维腺瘤,29例为乳腺增生结节,20例为乳腺脂肪瘤,6例为乳腺血管脂肪瘤,4例为乳腺导管腺瘤,8例为乳腺导管内乳头状瘤;47例肿块为恶性,其中37例肿块为浸润性导管癌,9例肿块为粘液腺癌,1例肿块为硬癌。乳腺良性肿块患者81人次共99例,其中1分43例(43.43%),2分34例(34.34%),3分18例(18.18%),4分4例(4.04%);乳腺癌患者47例,其中3分9例(19.15%),4分20例(42.55%),5分18例(38.30%)。超声弹性成像鉴别乳腺良性肿块与乳腺癌的灵敏度为95.96%,特异性为80.85%,准确度为91.10%,阴性预测值为90.48%,阳性预测值为91.35%。结论:超声弹性成像鉴别乳腺良性肿块与乳腺癌的灵敏度高达95.96%,具有较高准确度,可辅助诊断乳腺疾病。     

动态增强磁共振扫描与超声弹性成像对乳腺癌的诊断价值探讨

目的:探讨动态增强磁共振成像扫描与超声弹性成像对乳腺癌良恶性肿瘤的诊断价值,为临床诊断提供影像学依据。方法:回顾性分析2009年10月至2013年5月在我院经穿刺或手术病理证实为乳腺癌的59例患者的临床资料,患者术前均行超声与动态增强MR检查。依据病理组织活检和临床随访分别评价动态增强MR和UE对乳腺癌诊断的准确性。结果:DCE-MRI检测共发现病灶59个,55个初步诊断乳腺恶性肿瘤(BI-RADS 4-5),4个诊断为良性(BI-RADS 3),诊断准确率为93.22%(55/59)。UE对59个病灶进行评分,54个评分为乳腺恶性肿瘤,5个评分为良性,诊断率为91.53%(54/59)。UE检测乳腺癌的敏感性明显低于DCE-MRI及DCE-MRI+UE,DCE-MRI检测乳腺癌的特异性明显低于UE及DCE-MRI+UE,差异具有统计学意义(P0.05)。DCE-MRI+UE诊断乳腺癌的准确率为96.61%(57/59),明显高于DCE-MRI或UE单独检测的准确率(P0.05)。结论:动态增强MR诊断乳腺癌的敏感性较高,而超声弹性成像的特异性较好,两者联合可提高诊断准确率,对乳腺癌的早期诊断具有重要的临床应用价值。     

乳腺上皮细胞特异性敲除Scrib基因杂合子小鼠的制作与鉴定

目的利用Cre．LoxP重组酶系统构建乳腺上皮细胞特异性敲除Serib基因杂合子小鼠,并进行鉴定,为进一步在动物整体水平研究Scrib基因在乳腺癌中的作用提供研究平台。方法将Scrib条件敲除杂合子小鼠（Scrib＋/ft小鼠）进行繁殖并鉴定,然后将鉴定结果为阳性的子代Scrib＋/ft小鼠与乳腺上皮细胞特异性表达Cre重组酶的MMTV．Cre纯合子小鼠进行杂交,鉴定其子代小鼠的基因型。结果成功繁育Scrib条件敲除小鼠和MMTV．Cre小鼠,并通过鉴定得到Scrib＋/ft小鼠,与MMTV-Cre小鼠杂交并繁殖,获得基因型为Scrib＋/ft;MMTVCre＋/-小鼠5只。结论本研究利用Cre．LoxP重组酶系统成功构建了乳腺上皮细胞特异性敲除Scrib基因杂合子小鼠,为进一步研究极性蛋白Scrib表达下调在乳腺癌发生中的作用提供了良好的动物模型。     

破骨细胞分化因子与乳腺发育

破骨细胞分化因子 (RANKL)可以促进乳腺在妊娠中后期形成正常的小叶 腺泡结构 ,其作用机制为RANKL与其特异性受体RANK结合 ,通过IKKα促进乳腺上皮细胞CyclinD1蛋白的表达 ,从而促进乳腺上皮细胞的增生。RANKL在乳腺上皮细胞的表达受催乳素、孕激素等性激素和PTHrP的调节。而且RANKL在妊娠期骨质疏松和乳腺癌骨转移中也有重要作用 ,于是在骨代谢调节中起重要作用的RANKL就成为乳腺与骨之间的新的桥梁。     

MMP-3与乳腺癌上皮间质转化的关系及其意义

为了探讨MMP-3在乳腺癌中表达与乳腺癌上皮间质转化的关系及其在乳腺癌浸润转移中的作用.采用免疫组织化学检测正常乳腺组织、乳腺癌癌旁组织、乳腺癌组织中MMP-3、Claudin-1、Vimentin的表达情况.研究发现:1)MMP-3在乳腺癌组织的阳性表达率较癌旁组织及正常乳腺组织高且具有统计学意义(P<0.05).Claudin-1在乳腺癌中的阳性表达率明显低于癌旁组织及正常乳腺组织具有统计学意义(P<0.05).Vimentin在乳腺癌组织阳性表达率高于癌旁组织及正常乳腺组织具有统计学意义(P<0.05);2)随着乳腺癌病理分期的增加MMP-3表达逐渐增加,同时出现Claudin-1蛋白表达降低及Vimentin蛋白表达升高.相关分析表明MMP-3与Claudin-1的表达呈负相关(r=-0.301,P=0.019),与Vimentin的表达呈正相关(r=0.378,P=0.03),Claudin-1与Vimentin的表达呈负相关(r=-0.278,P=0.031).结果提示,MMP-3可能是通过介导乳腺癌细胞发生上皮间质转化来参与乳腺癌的浸润转移.     

钼靶和超声检查在乳腺癌临床诊断的准确性的比较分析

摘要 目的：比较与分析钼靶和超声检查在乳腺癌临床诊断的准确性。方法：2018年8月到2021年1月选择在本院进行诊治的乳腺肿瘤患者110例作为研究对象,所有患者都给予钼靶和超声检查,记录影像学特征并判断诊断价值。结果：在110例患者中,病理诊断为乳腺良性肿瘤76例、乳腺癌34例。恶性组钼靶的分叶征、钙化、大角征、毛刺征等比例高于良性组,病灶大小也高于良性组(P<0.05)。恶性组超声的形态不规则、边缘不光整、高回声晕、回声衰减、微钙化等比例高于良性组(P<0.05)。钼靶乳腺影像报告及数据系统(Breast imaging report and data system,BI-RADS)判断为乳腺良性肿瘤72例,乳腺癌38例;超声BI-RADS判断为乳腺良性肿瘤75例,乳腺癌35例,钼靶鉴别诊断乳腺癌的敏感性为93.4%,特异性为97.1%,准确性为94.5%;超声鉴别诊断乳腺癌的敏感性为98.7%,特异性为100.0%,准确性为99.1%。多因素logistic回归分析显示病灶大小、分叶征、回声衰减、毛刺征为导致误诊的重要因素(P<0.05)。结论：乳腺癌在钼靶和超声检查中都有明显的征象特征,超声诊断的准确性更高,病灶大小、分叶征、回声衰减、毛刺征为影响诊断效果的很重要因素。     

用于人乳腺癌病理检测的抗人ARD1单克隆抗体的制备

hARD1蛋白是一个乙酰基转移酶,催化蛋白质N末端的乙酰化。前期的研究发现hARD1的高表达可能作为乳腺癌的一个指标。为了制备在乳腺肿瘤组织中特异识别的抗hARD1的单克隆抗体,将纯化的全长hARD1/Histag融合蛋白(1~235aa)免疫Balb/c小鼠,获得了8个稳定的阳性单克隆细胞株,酶联免疫吸附测定(ELISA)结果表明,所得抗体的轻链均为κ型,重链为3种亚型:IgG1、IgG2a和IgG2b。在不同肿瘤组织样本中进行抗体特异性筛选,获得一个在乳腺肿瘤组织中具有相对特异性的抗hARD1单克隆抗体,为进一步将抗hARD1的单克隆抗体应用于乳腺癌的病理诊断奠定基础,同时也为进一步研究hARD1在肿瘤发生中的作用提供了重要的工具。     

Study of a single BRCA2 mutation with high carrier frequency in a small population.

Germ-line changes in the cancer-predisposition gene BRCA2 are found in a small proportion of breast cancers. Mutations in the BRCA2 gene have been studied mainly in families with high risk of breast cancer in females, and male breast cancer also has been associated with BRCA2 mutations. The importance of germ-line BRCA2 mutations in individuals without a family history of breast cancer is unknown. The same BRCA2 mutation has been found in 16/21 Icelandic breast cancer families, indicating a founder effect. We determined the frequency of this mutation, 999del5, in 1,182 Icelanders, comprising 520 randomly selected individuals from the population and a series of 632 female breast cancer patients (61.4% of patients diagnosed during the study period) and all male breast cancer patients diagnosed during the past 40 years. We detected the 999del5 germ-line mutation in 0.6% of the population, in 7.7% of female breast cancer patients, and in 40% of males with breast cancer. The mutation was strongly associated with onset of female breast cancer at age <50 years, but its penetrance and expression are varied. A number of cancers other than breast cancer were found to be increased in relatives of mutation carriers, including those with prostate and pancreatic cancer. Furthermore, germ-line BRCA2 mutation can be present without a strong family history of breast cancer. Comparison of the age at onset for mother/daughter pairs with the 999del5 mutation and breast cancer indicates that age at onset is decreasing in the younger generation. Increase in breast cancer incidence and lower age at onset suggest a possible contributing environmental factor.     

Breast cancer 2004: Progress and promise on the clinical front

Carcinoma of the breast is the most common cancer in u.s. women (excluding skin cancer), and the second leading cause of cancer-related mortality. In 2004, it is estimated that 215,000 u.s. women will develop invasive breast cancer, and 40,000 women will die of the disease. Advancing age and female sex are the two greatest risk factors for the development of breast cancer, although family history, reproductive and hormonal history, lifestyle and environmental factors all contribute to risk. Models are available to help estimate risk of developing breast cancer in individual patients. Inherited mutations, specifically in the genes BRCA1 and BRCA2, account for approximately 5–10% of all breast cancer cases. Significant advances have recently been made in both the primary prevention of breast cancer (including chemoprevention), and secondary prevention (early detection through breast imaging). Breast mri as a tool for screening high risk women is a particularly exciting new tool.When breast cancer is diagnosed, optimal treatment involves a multidisciplinary approach, including surgery, radiation therapy, and systemic therapies. In the field of breast surgery, breast conservation and sentinel lymph node biopsy techniques have allowed substantially decreased surgery in appropriated selected patients with corresponding decreases in complication rates and long-term sequelae. Radiation oncologists are comparing partial breast irradiation versus conventional whole breast radiation in an attempt to minimize toxicity and treatment time, and maximize efficacy. The field of breast medical oncology has evolved at a rapid pace in the past decade, with numerous new hormonal agents, chemotherapeutic agents, and biologically targeted therapies in clinical use and under investigation. The addition of ‘adjuvant’ systemic therapy to the treatment of early stage breast cancer patients has dramatically reduced relapse and death rates. Unfortunately, metastatic recurrence still occurs. Once the cancer has spread beyond the breast and locoregional nodal areas it is felt to be incurable, although still treatable. A better understanding of breast cancer biology has led to the development of a host of new biologically targeted agents, many of which hold substantial promise for improving quality of life and survival rates in metastatic breast cancer patients.     

Association of ABO and Rh blood groups with breast cancer

ObjectivesThe aim of this study was to determine the association of “ABO” and “Rhesus” blood groups with incidence of breast cancer.MethodsIn this study, we identified 70 research documents from data based search engines including “PubMed”, “ISI-Web of Knowledge”, “Embase” and “Google Scholar”. The research papers were selected by using the primary key-terms including “ABO blood type”, “Rhesus” blood type and “breast cancer”. The research documents in which “ABO” and “Rhesus” blood types and breast cancer was debated were included. After screening, we reviewed 32 papers and finally we selected 25 research papers which met the inclusion criteria and remaining documents were excluded.ResultsBlood group “A” has high incidence of breast cancer (45.88%), blood group “O” has (31.69%); “B” (16.16%) and blood group “AB” has (6.27%) incidence of breast cancer. Blood group “A” has highest and blood group “AB” has least association with breast cancer. Furthermore, “Rhesus +ve” blood group has high incidence of breast cancer (88.31%) and “Rhesus –ve” blood group has least association with breast cancer (11.68%).ConclusionBlood group “A” and “Rhesus +ve” have high risk of breast cancer, while blood type “AB” and “Rhesus –ve” are at low peril of breast cancer. Physicians should carefully monitor the females with blood group “A” and “Rh +ve” as these females are more prone to develop breast cancer. To reduce breast cancer incidence and its burden, preventive and screening programs for breast cancer especially in young women are highly recommended.     

Genetic anticipation is associated with telomere shortening in hereditary breast cancer

There is increasing evidence suggesting that short telomeres and subsequent genomic instability contribute to malignant transformation. Telomere shortening has been described as a mechanism to explain genetic anticipation in dyskeratosis congenita and Li-Fraumeni syndrome. Since genetic anticipation has been observed in familial breast cancer, we aimed to study telomere length in familial breast cancer patients and hypothesized that genetic defects causing this disease would affect telomere maintenance resulting in shortened telomeres. Here, we first investigated age anticipation in mother-daughter pairs with breast cancer in 623 breast cancer families, classified as BRCA1, BRCA2, and BRCAX. Moreover, we analyzed telomere length in DNA from peripheral blood leukocytes by quantitative PCR in a set of 198 hereditary breast cancer patients, and compared them with 267 control samples and 71 sporadic breast cancer patients. Changes in telomere length in mother-daughter pairs from breast cancer families and controls were also evaluated to address differences through generations. We demonstrated that short telomeres characterize hereditary but not sporadic breast cancer. We have defined a group of BRCAX families with short telomeres, suggesting that telomere maintenance genes might be susceptibility genes for breast cancer. Significantly, we described that progressive telomere shortening is associated with earlier onset of breast cancer in successive generations of affected families. Our results provide evidence that telomere shortening is associated with earlier age of cancer onset in successive generations, suggesting that it might be a mechanism of genetic anticipation in hereditary breast cancer.     

Comorbid Diseases Interact with Breast Cancer to Affect Mortality in the First Year after Diagnosis—A Danish Nationwide Matched Cohort Study

Background

Survival of breast cancer patients with comorbidity, compared to those without comorbidity, has been well characterized. The interaction between comorbid diseases and breast cancer, however, has not been well-studied.

Methods

From Danish nationwide medical registries, we identified all breast cancer patients between 45 and 85 years of age diagnosed from 1994 to 2008. Women without breast cancer were matched to the breast cancer patients on specific comorbid diseases included in the Charlson comorbidity Index (CCI). Interaction contrasts were calculated as a measure of synergistic effect on mortality between comorbidity and breast cancer.

Results

The study included 47,904 breast cancer patients and 237,938 matched comparison women. In the first year, the strongest interaction between comorbidity and breast cancer was observed in breast cancer patients with a CCI score of ≥4, which accounted for 29 deaths per 1000 person-years. Among individual comorbidities, dementia interacted strongly with breast cancer and accounted for 148 deaths per 1000 person-years within one year of follow-up. There was little interaction between comorbidity and breast cancer during one to five years of follow-up.

Conclusions

There was substantial interaction between comorbid diseases and breast cancer, affecting mortality. Successful treatment of the comorbid diseases or the breast cancer can delay mortality caused by this interaction in breast cancer patients.     

Metallothionein as a prognostic biomarker in breast cancer

Breast cancer is the most common cancer in women, with a general upward trend in incidence. Basic and clinical breast cancer research has continued at a rapid pace, in the endeavor to understand the biology of the disease so as to improve management of patients. Besides traditional pathological indicators, expression of molecular markers in breast cancer has also been comprehensively investigated. This paper will focus on the prognostic utility of metallothioneins (MTs), a family of low molecular weight metal binding proteins encoded by at least 10 functional MT genes that are associated with cell proliferation in breast cancer. Evidence that MT is a potential prognostic biomarker for breast cancer is supported by many reports in the literature. Expression of the MT protein has been detected by immunohistochemistry in a significant portion of invasive ductal breast cancers. MT expression has also been well studied in association with traditional clinico-pathological parameters of breast cancers. Generally, higher MT expression in breast cancers is predictive of worse patient outcomes. The relationship of MT isoforms to histological grade, estrogen receptor (ER) status, and prognosis will also be discussed.     

Multifaceted Roles of Interleukin-6 in Adipocyte–Breast Cancer Cell Interaction

Breast cancer is the most common malignancy in women worldwide, with a developmental process spanning decades. The malignant cells recruit a variety of cells including fibroblasts, endothelial cells, immune cells, and adipocytes, creating the tumor microenvironment. The tumor microenvironment has emerged as active participants in breast cancer progression and response to treatment through autocrine and paracrine interaction with the malignant cells. Adipose tissue is abundant in the breast cancer microenvironment; interactions with cancer cells create cancer-associated adipocytes which produce a variety of adipokines that influence breast cancer initiation, metastasis, angiogenesis, and cachexia. Interleukin (IL)-6 has emerged as key compound significantly produced by breast cancer cells and adipocytes, with the potential of inducing proliferation, epithelial-mesenchymal phenotype, stem cell phenotype, angiogenesis, cachexia, and therapeutic resistance in breast cancer cells. Our aim is to present a brief knowledge of IL-6’s role in breast cancer. This review summarizes our current understanding of the breast microenvironment, with emphasis on adipocytes as key players in breast cancer tumorigenesis. The effects of key adipocytes such as leptin, adipokines, TGF-b, and IL-6 are discussed. Finally, we discuss the role of IL-6 in various aspects of cancer progression.     

The menopause,hormone replacement therapy and breast cancer

Concern exists that the reduction in breast cancer risk associated with the onset of the menopause will be negated with exposure to hormone replacement therapy (HRT). Evidence from large-scale randomised HRT trials support observational data that have shown a modest increase in breast cancer risk with long-term use (i.e. >15 years) of combined therapy, although this falls following HRT cessation suggesting a growth-promoting effect. Randomised evidence demonstrates that the efficacy of anti-estrogens, aromatase inhibitors and raloxifene in the treatment and chemoprevention of breast cancer are restricted to women with oestrogen receptor positive (ER +ve) disease; however, HRT has not been associated conclusively with a predominance of hormone sensitive breast cancer. Despite stimulating the breast cancer cell growth, HRT has not been shown to increase breast cancer recurrence or mortality when prescribed to breast cancer survivors experiencing oestrogen deficiency symptoms and randomised trials have been recommended and commenced. In conjunction with controlled breast cancer trials demonstrating a therapeutic benefit of high dose estrogens and interest in the use of additive oestrogen therapy in patients developing resistance to oestrogen deprivation, the dogma that HRT is an absolute contra-indication following diagnosis is challenged.     

miR-503-3p promotes epithelialemesenchymal transition in breast cancer by directly targeting SMAD2 and E-cadherin

Although progress in clinical and basic research has significantly increased our understanding of breast cancer, little is known about the molecular mechanism underlying breast cancer metastasis. Identification of effective therapeutic targets to prevent breast cancer metastasis is urgently needed. The function of mi R-503-3p has been investigated in other cancers, but its role in breast cancer remains undefined.Here, we found that mi R-503-3p was overexpressed in breast cancer tissue and plasma compared with adjacent normal breast tissue and with plasma from healthy individuals. Moreover, we identified mi R-503-3p to be an oncogene of breast cancer cell proliferation, migration and invasion. Upregulation of mi R-503-3p in breast cancer cells inhibited expression of epithelialemesenchymal transition(EMT)-related protein SMAD2 and the epithelial marker protein E-cadherin by directly binding to their m RNA30 untranslated region, whereas increased expression of mesenchymal marker proteins, including vimentin and N-cadherin. Taken together, our findings support a critical role for mi R-503-3p in induction of breast cancer EMT and suggest that plasma mi R-503-3p may be a useful diagnostic biomarker for breast cancer.