Comparison of single-pore non-liposuction near-infrared laparoscopy with conventional open surgery for axillary sentinel lymph node biopsy in patients with early breast cancer: a single-center, small-sample retrospective study.

BACKGROUND: This study aimed to compare the effects of single-pore non-liposuction near-infrared (NIR) endoscopic surgery and traditional open surgery for axillary sentinel lymph node biopsy (SLNB) in patients with early breast cancer (EBC). METHODS: The clinical pathological data of 61 patients with EBC who underwent axillary SLNB using indocyanine green (ICG) combined with carbon nanoparticle suspension (CNS) were retrospectively collected. Thirty patients received SLNB through single-pore non-liposuction NIR endoscopic surgery (endoscopic group), and the remaining 31 received SLNB through open-incision surgery (open group). The success rate, operation time, volume of intraoperative bleeding, postoperative axillary drainage, axillary extubation time, and the occurrence of postoperative complications were compared between the groups along with the total number of sentinel lymph nodes (SLNs), luminous SLNs, stained SLNs, and the pathological positivity rate of the SLNs. RESULTS: All patients underwent SLNB with a 100% success rate. SLNB operation times of the endoscopic group were longer than those of the open group (t = 3.963, P = 0.000), and the volume of axillary drainage was inferior (t = 3.035, P = 0.004). However, there were no differences in the intraoperative bleeding volumes, axillary extubation times, and postoperative complications (P > 0.05). In the Open group, the mean number of SLNs was 5.12 ± 2.16, and the pathological positivity rate was 13.53%; in the Endoscopic group, these numbers were 4.89 ± 1.73 and 12.39%. The mean number of SLNs detected (t = 0.458, P = 0.649) and the pathological positivity rates (χ2 = 0.058, P = 0.810) did not differ between the two groups. All 61 patients were followed for a median of 14.6 months. There were no local recurrences or distant metastases. CONCLUSIONS: Our single-center results reveal that single-hole non-liposuction NIR endoscopic axillary SLNB is not inferior to open SLNB and may be an appropriate option for patients with early breast cancer who desire breast preservation with fewer incisions. TRIAL REGISTRATION: This retrospective study was "retrospectively registered" at the Sixth Affiliated Hospital of South China University of Technology (no. 2020105) and in National Medical Research Registration and Archival Information System ( https://www.medicalresearch.org.cn , number: MR-44-21-004727).

ß-elemene reverses the drug resistance of lung cancer A549/DDP cells via the mitochondrial apoptosis pathway.

ß-elemene (ß-ELE) is a new anticancer drug extracted from Curcuma zedoaria Roscoe and has been widely used to treat malignant tumors. Recent studies have demonstrated that ß-ELE reverses the drug resistance of tumor cells. To explore the possible mechanisms of action of ß-ELE, we investigated its effects on cisplatin-resistant human lung adenocarcinoma A549/DDP cells. The effects of ß-ELE on the growth of A549/DDP cells in vitro were determined by MTT assay. Apoptosis was assessed by fluorescence microscopy with Hoechst 33258 staining and flow cytometry with Annexin V-FITC/PI double staining. Mitochondrial membrane potential was assessed using JC-1 fluorescence probe and laser confocal scanning microscopy, and intracellular reactive oxygen species levels were measured by 2',7'-dichlorofluorescein-diacetate staining and flow cytometry. Cytosolic glutathione content was determined using GSH kits. The expression of cytochrome c, caspase-3, procaspase-3 and the Bcl-2 family proteins was assessed by western blotting. The results demonstrated that ß-ELE inhibited the proliferation of A549/DDP cells in a time- and dose-dependent manner. Furthermore, ß-ELE enhanced the sensitivity of A549/DDP cells to cisplatin and reversed the drug resistance of A549/DDP cells. Consistent with a role in activating apoptosis, ß-ELE decreased mitochondrial membrane potential, increased intracellular reactive oxygen species concentration and decreased the cytoplasmic glutathione levels in a time- and dose-dependent manner. The combination of ß-ELE and cisplatin enhanced the protein expression of cytochrome c, caspase-3 and Bad, and reduced protein levels of Bcl-2 and procaspase-3 in the A549/DDP lung cancer cells. These results define a pathway of procaspase­3-ß-ELE function that involves decreased mitochondrial membrane potential, leading to apoptosis triggered by the release of cytochrome c into the cytoplasm and the modulation of apoptosis-related genes. The reversal of drug resistance of the A549/DDP cell line by ß-ELE may be derived from its effect in inducing apoptosis.

[Abnormal expression of fragile histidine triad (FHIT) and Mut S homolog 2 (MSH2) proteins in human sporadic colorectal carcinoma and their clinical significance].

BACKGROUND & OBJECTIVE: Frequent loss of fragile histidine triad (FHIT) expression in human gastrointestinal tract carcinomas has been reported; however, there were divergent opinions regarding FHIT expression in colorectal carcinoma. Recent studies have suggested that FHIT inactivation can be a consequence of defects in mismatch repair proteins, particularly mut S homolog 2 (MSH2). This study was designed to investigate the expression and clinical significance of FHIT and MSH2 proteins in human sporadic colorectal carcinoma (SCC). METHODS: Immunohistochemistry SP method was used to determine the expression of FHIT and MSH2 in surgically resected specimens of 84 SCC and its corresponding paratumor normal colorectal tissues, and 23 cases of colonic adenomas. RESULTS: The positive expression rates of FHIT protein were 48.81%, 73.91%, and 100% in SCC, colonic adenomas, and adjacent normal colorectal tissues, respectively. The positive expression rates of FHIT protein showed increasing trend from SCC, colonic adenomas, to paratumor normal colorectal tissues; and the difference was statistically significant (P< 0.05). The expression levels of FHIT were not associated with age, gender, tumor site, and histological type (P >0.05), but were correlated with tumor invasive depth, differentiation degree, Dukes,stage, and lymph node metastasis (P< 0.05). The tumor tissues of deeper invade depth, lower differentiation degree, later Ducks,stage and with lymph node metastasis showed more reduction of FHIT protein expression. The expression level of MSH2 was only related to Dukes, stage (P< 0.05). FHIT expression was closely associated with MSH2 expression in SCC (r=0.3728,P< 0.01). CONCLUSION: (1) Loss or reduction of FHIT protein expression plays an important role in the development and progression of SCC. The expression levels of FHIT protein are related to the malignant degree of SCC and may be a valuable biological indicator for predicting the potent invasion and metastasis of SCC. (2) FHIT protein expression is in a positive correlation fashion with MSH2 protein expression in SCC.