Reference intervals of C2-C7 lateral spinous process deviation in Chinese adults.

BACKGROUND: Lateral spinous process deviation (LSPD) is a commonly used morphological parameter in the anatomical study of the cervical spinous process. However, quantitative studies on this issue are still lacking. In this study we aimed to establish reference intervals of C2-C7 LSPD in the adult Chinese population and provide decision-making information for clinical practitioners. MATERIALS AND METHODS: This was a retrospective study of 92 adult patients who received neck computed tomography scans, including 42 females and 50 males meeting the inclusion criteria. Three-dimensional reconstruction and anatomical measurements were performed using Mimics Research 19.0 and 3-Matic Research 11.0. RESULTS: The inter-observer reliability of LSPD measurement in this study was excellent (intraclass correlation coefficient value > 0.93). Only 2 cases of LSPD angles of 90 degrees were found, which means most cervical spinous process exist deviation. The reference interval for the C2-C7 LSPD angle was (85.11, 94.75) degrees. The C2 LSPD showed the different directions to C5 and C7 (p < 0.05). In the C4 vertebrae, the male tends to have greater LSPD angles than the female (T = -2.013, p = 0.047). In the C2 vertebrae, there was a statistically significant but weak correlation between age and LSPD angles (r = 0.24, p = 0.029). There was no statistically significant effect of sex or age on other levels of cervical vertebrae. CONCLUSIONS: Cervical spinous process deviation of less than 5 degrees on either side is a common morphological manifestation in Chinese adults. Thus, LSPD may not be an indicator for clinical care. Moreover, the vertebrae may have opposite directions of LSPD in the upper levels (C2-C4) and lower levels (C5-C7).

Plasma soluble cluster of differentiation 147 levels are increased in breast cancer patients and associated with lymph node metastasis and chemoresistance.

INTRODUCTION: Cluster of differentiation 147 (CD147) contributes to breast cancer invasion, metastasis, and multidrug resistance. Recent studies have shown that peripheral soluble CD147 (sCD147) is increased in hepatocellular tumour and multiple myeloma patients and correlated with disease severity. The primary aim of our study was to assess the level, as well as the biological and clinical significance of sCD147 in breast cancer. METHODS: We tested plasma sCD147 levels in 308 breast cancer patients by enzyme-linked immunosorbent assay between February 2014 and February 2017. A subset of 165 cases of benign breast diseases was included as a control group at the same period. We analysed the clinical significance of plasma sCD147 with relevance to clinicopathological factors of breast cancer patients. RESULTS: Plasma sCD147 levels were significantly higher in patients with primary breast cancer than those with benign breast diseases (P=0.001), in patients with locally advanced breast cancer (T3-T4 tumour) than those in early breast cancer (T1-T2 tumour; P=0.001), in patients with lymph node metastasis than in those without (P<0.001), and in patients with high recurrence risk than those with medium recurrence risk (P<0.001). Plasma sCD147 levels were also significantly higher in the chemotherapy-resistant group than in the chemotherapy-sensitive group (P=0.040). Plasma sCD147 was an independent predictor for lymph node metastasis in breast cancer patients (P=0.001). CONCLUSION: This is the first study to demonstrate that plasma sCD147 levels are elevated in breast cancer patients. Soluble CD147 is also associated with tumour size, lymph node metastasis, high recurrent risk, and chemoresistance. Our findings support that plasma sCD147 is an independent predictive factor for lymph node metastasis.

Steroids administered after vacuum-assisted biopsy in the management of idiopathic granulomatous mastitis.

AIMS: The aetiology and treatment options for idiopathic granulomatous mastitis (IGM) are controversial. The aim was to study the clinical and diagnostic features and discuss medical and surgical treatment for IGM in our patients. METHODS: Sixty-five patients who met the histological criteria for IGM were retrospectively studied. The diagnosis of IGM was confirmed using Mammotome (an ultrasound-guided, vacuum-assisted biopsy system), core needle biopsy, quadrantectomy or segmental resection. Forty-five patients were treated with prednisolone (69.2%). Immunohistochemical (IHC) staining for immune-related antigens (CD3, CD4, CD8, CD79a, IgG, and IgM) was performed. RESULTS: Ultrasonography (USG) was carried out in all patients. Among them, 61 were considered to have an inflammatory mass and 15 had accompanying liquefaction. In four patients, the findings mimicked breast carcinoma (6.2%). The IHC results showed CD3, CD4, CD8 and CD79a lymphocytes diffusely distributed in the lesion. Stains for IgG and IgM were negative. Prednisolone was administered to the patients diagnosed with IGM. The success rate was 53 (81.5%) and the whole recurrence was 12 (18.5%). The median follow-up period was 12 months (range 4-42 months). CONCLUSIONS: The aetiology of IGM remains uncertain. The disease has no propensity for the right or left breast. It is a local autoimmune disease, involving humoral and cell-mediated immunity. Hyperprolactinaemia may play a role in some patients. Corticosteroids administered after complete removal of the IGM lesion using the Mammotome biopsy system is an effective treatment option.