RESUMO
Purpose@#Real-time detection and intervention can be used as potential measures to markedly decrease breast cancer mortality. Assessment of circulating tumor DNA (ctDNA) may offer great benefits for the management of breast cancer over time. However, the use of ctDNA to predict the effectiveness of neoadjuvant treatment and recurrence of breast cancer has rarely been studied. @*Methods@#We prospectively recruited 31 breast cancer patients with 4 subtypes. Three time points were set in this study, including before any therapy (C1), during surgery (T), and six months after surgery (C2). We collected peripheral blood samples from all 31 patients at C1, tumor tissue from all 31 patients at T, and peripheral blood samples from 25 patients at C2. Targeted 727-gene panel sequencing was performed on ctDNA from all blood samples and tissue DNA from all tissue samples. Somatic mutations were detected and analyzed using a reference standard pipeline. Statistical analysis was performed to identify possible associations between ctDNA profiles and clinical outcomes. @*Results@#In total, we detected 159, 271, and 70 somatic mutations in 30 C1 samples, 31 T samples, and 12 C2 samples, respectively. We identified specific genes, such as PIK3CA, TP53, and KMT2C, which were highly mutated in the tissue samples. Furthermore, mutated KMT2C observed in ctDNA of the C2 samples may be an indicator of breast cancer recurrence. @*Conclusion@#Our study highlights the potential of ctDNA analysis at different timepoints for assessing tumor progression and treatment effectiveness, as well as prediction of breast cancer recurrence.
RESUMO
Male breast cancer (MBC) is rare and accounts for approximately 1% of all breast cancer cases worldwide. Previous studies have suggested that several factors significantly increase the risk of MBC. Prolactinoma has the highest incidence rate among patients with functional pituitary tumors. However, whether prolactinoma is involved in the onset and progression of breast cancer remains unclear. To date, there are only five case reports globally on MBC with concurrent prolactinoma. We hereby describe the first case of MBC with prolactinoma in China. We also explored the patient's genetic profile using whole exome sequencing. Our findings may help advance our understanding of the molecular pathogenesis of MBC. Further molecular analyses of such cases are warranted to improve auxiliary molecular diagnostic methods and targeted therapy for MBC.
RESUMO
Objective:To compare the therapeutic effects of microdissection tungsten needle and high-frequency electrosurgical generator on open thyroid surgery.Methods:95 patients who underwent open thyroid surgery from Jan. 2017 to Dec. 2017 in the Department of Breast and Thyroid Surgery, Daping Hospital of Army Military Medical University were divided into microdissection tungsten needle group ( n=50) and high-frequency electrosurgical generator group ( n=45) according to different methods. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative complication rate and recurrence and metastasis rate of the two groups were compared. Results:There were no significant differences in operation time (79.3±14.7 vs 73.7±13.9, t=1.914, P=0.059) , intraoperative blood loss (31.8±9.7 vs 30.3±10.6, t=0.702, P=0.484) and postoperative drainage volume (67.3±13.0 vs 71.3±10.8, t=-1.650, P=0.102) between the two groups ( P>0.05) . There were significant differences between the two groups in temporary recurrent laryngeal nerve (RLN) injury (2% vs 17.8%,χ 2=5.518, P=0.023) and temporary hypoparathyroidism (18% vs 44%,χ 2=7.810, P=0.005) , and the results of the microdissection tungsten needle group were better than high-frequency electrosurgical generator group ( P<0.05) . There were no permanent RLN and permanent hypoparathyroidism in the two groups. There were no recurrence and metastasis during the follow-up period. Conclusions:The microdissection tungsten needle is superior to the high-frequency electrosurgical generator in the protection of RLN and parathyroid gland in open thyroid surgery, which is worthy of promotion in clinical application.
RESUMO
Objective:To summarize the experience of diagnosis and treatment of primary thyroid lymphoma (PTL) and improve the level of diagnosis and treatment.Methods:The clinical and pathological data of 19 patients with PTL admitted to the Department of Breast and Thyroid Surgery, Daping Hospital, Army Medical University From Mar. 2000 to Jul. 2019 were retrospectively reviewed.Results:among the 19 PTL patients, 4 were male and 15 were female, with an average age of 69 years (51-88 years) . 15 cases showed rapid enlargement of neck mass, 9 cases with swallowing obstruction, 7 cases with hoarseness and 5 cases with dyspnea. 13 cases were diagnosed by intervention, the other 6 cases were diagnosed by biopsy. There were 1 case of Hodgkin’s lymphoma and 18 cases of non Hodgkin’s lymphoma, including 13 cases of diffuse large B cell lymphoma and 4 cases of mucosa associated lymphoid tissue lymphoma. 12 cases received chemotherapy and 1 case received radiotherapy. The median follow-up period was 28 months (0-88 months) , 5 cases were lost, 6 cases died, 3 cases died of recurrence and spread of lymphoma, 3 cases died of others.Conclusions:PTL is more likely to occur in the elderly women, which is characterized by sudden enlargement of cervical mass and its related compression symptoms. The diagnosis can be confirmed by coarse needle biopsy or surgical intervention. PTL needs comprehensive treatment including surgery, chemotherapy and targeted treatment.
RESUMO
Purpose@#Real-time detection and intervention can be used as potential measures to markedly decrease breast cancer mortality. Assessment of circulating tumor DNA (ctDNA) may offer great benefits for the management of breast cancer over time. However, the use of ctDNA to predict the effectiveness of neoadjuvant treatment and recurrence of breast cancer has rarely been studied. @*Methods@#We prospectively recruited 31 breast cancer patients with 4 subtypes. Three time points were set in this study, including before any therapy (C1), during surgery (T), and six months after surgery (C2). We collected peripheral blood samples from all 31 patients at C1, tumor tissue from all 31 patients at T, and peripheral blood samples from 25 patients at C2. Targeted 727-gene panel sequencing was performed on ctDNA from all blood samples and tissue DNA from all tissue samples. Somatic mutations were detected and analyzed using a reference standard pipeline. Statistical analysis was performed to identify possible associations between ctDNA profiles and clinical outcomes. @*Results@#In total, we detected 159, 271, and 70 somatic mutations in 30 C1 samples, 31 T samples, and 12 C2 samples, respectively. We identified specific genes, such as PIK3CA, TP53, and KMT2C, which were highly mutated in the tissue samples. Furthermore, mutated KMT2C observed in ctDNA of the C2 samples may be an indicator of breast cancer recurrence. @*Conclusion@#Our study highlights the potential of ctDNA analysis at different timepoints for assessing tumor progression and treatment effectiveness, as well as prediction of breast cancer recurrence.
RESUMO
Male breast cancer (MBC) is rare and accounts for approximately 1% of all breast cancer cases worldwide. Previous studies have suggested that several factors significantly increase the risk of MBC. Prolactinoma has the highest incidence rate among patients with functional pituitary tumors. However, whether prolactinoma is involved in the onset and progression of breast cancer remains unclear. To date, there are only five case reports globally on MBC with concurrent prolactinoma. We hereby describe the first case of MBC with prolactinoma in China. We also explored the patient's genetic profile using whole exome sequencing. Our findings may help advance our understanding of the molecular pathogenesis of MBC. Further molecular analyses of such cases are warranted to improve auxiliary molecular diagnostic methods and targeted therapy for MBC.
RESUMO
Objective To summarize the experience ofmultidisciplinary team (MDT) in diagnosis and treatment of complicated and refractory thyroid tumors.Methods A retrospective review was performed on clinical data of 46 cases with complicated and refractory large thyroid tumors admitted to our hospital from Jan.2010 to Dec.2016.There were 23 cases in MDT group and 23 cases in the control group,respectively.The MDT group received diagnosis and treatment provided by multidisciplinary team during perioperative period whereas the control group received conventional surgery.Results Short-term complications such as trouble breathing and thyroid crisis were not observed in 46 patients after surgery.In the control group,the mean durations were (52±11.5)minutes for anesthesia,(159±38.1) minutes for surgery and (11 ±3.5) days for hospital stay,respectively.After surgery,bleeding occurred in 5 cases,hoarseness in 5 cases,irritating cough when drinking in 7 cases,transient hypocalcemia in 8 cases,permanent hypocalcemia in 6 cases,and neck tracheotomy due to tracheomalacia during surgery in 2 cases.In MDT group,the mean durations were (37±8.5) minutes for anesthesia,(134±28.5) minutes for surgery and (7±1.5) days,respectively.After surgery,bleeding occurred in 0 case,hoarseness in 0 case,irritating cough when drinking in 1 case,transient hypocalcemia in 2 cases,permanent hypocalcemia in 0 case,and neck tracheotomy due to tracheomalacia during surgery in 4 cases.Conclusion Application of multidisciplinary team in diagnosis and treatment of complicated and refractory thyroid tumors can reduce duration of preoperative endotracheal anesthesia as well as surgery,decrease postoperative complications,shorten duration of hospitalization and improve life quality after surgery.
RESUMO
Objective To explore role of functional neck dissection for lower collar-shaped incision at hair margin behind ear in the treatment of differentiated thyroid cancer. Methods The clinical data of 11 patients with thyroid papillary carcinoma who underwent func-tional neck dissection for lower collar-shaped incision at hair margin behind ear were retrospectively analyzed. Results The incisions of all patients were unseen in daily life and patients were satisfied with the postoperative appearances. No case of shoulder syndrome,postoperative local recurrence and distant metastasis was observed. Conclusion Functional neck dissection for lower collar-shaped incision at hair margin behind ear is effective in the treatment of differentiated thyroid cancer. Meanwhile it can obviously improve patients’ postoperative appearance and life quality,therefore it is worth clinical application.