CK19 mRNA in peripheral blood combined with contrast-enhanced ultrasound: the predictive value of axillary lymph node involvement in breast cancer / 中华普通外科杂志

Objective To evaluate a model for axillary lymph node involvement combining CK19 mRNA with contrast enhanced ultrasound sonography (CEUS) score in operable breast cancer.Methods Operable breast cancer patients planned for sentinel lymph node (SLN) biopsy were enrolled.Preoperative CK19mRNA expressions in peripheral blood and CEUS score of axillary lymph nodes were tested before surgery.In the training set,postoperative sentinel lymph node (SLN) and non-sentinel lymph node (nSLN) pathological results were taken as the gold standard,effective modeling variables were screened,logistic regression was used to establish the prediction model.Parallel control studies were conducted between the validation set and the MSKCC model to evaluate the prediction accuracy and prediction efficiency.Results From Oct 2015 to Nov 2016,359 cases (training set) were enrolled and mathematical formulas for predicting SLN and nSLN were established,respectively.The sensitivity,specificity and AUC of predicting SLN involvement were 91.36％,94.92％ and 0.979 respectively.The sensitivity,specificity and AUC of predicting nSLN metastasis were 91.04％,90.53％ and 0.932 respectively.From Dec 2016 to Jul 2017,219 cases (verification set) were included.The sensitivity of SLN metastasis predicted by the model was 91.84％,the specificity was 96.69％,and the AUC was 0.979,significantly superior to the MSKCC model (0.739).The sensitivity,specificity and AUC of predicting nSLN metastasis were 95.35％,92.73％ and 0.945 respectively,significantly superior to the MSKCC model (0.873).Concolusions Combined with peripheral blood CK19 mRNA and CEUS score,the prediction model for axillary lymph node involvement for operable breast cancer,SLN/nSLN involvement probability can be calculated and qualitative judgment can be made.The overall accuracy and AUC of this model are better than the prediction model of MSKCC.

EXPERIMENTAL STUDY OF CHEMOTHERAPY RELATED LEUKOCYTOPENIA TREATED BY VARIOUS PEROAL LEUCOCYTE INCREASING DRUGS.

BACKGROUND: Clinically, the patients with significant WBC decrease are mostly administered G-CSF, this kind of drugs is expensive and adverse reactions are often seen. In contrast, oral leucocyte increasing drug has small adverse reactions, can be used for longer time and can improve the continuity and stability of treatment. The experimental study based on study of mouse was to evaluate the effects of treatment and chemotherapy of related leukocytopenia by five kinds of commonly used peroal leucocyte increasing drugs. MATERIALS AND METHODS: We prepared mice chemotherapy related leukocytopenia model by cyclophosphamide intraperitoneal injection, the positive control drug is G-CSF, respectively fill five kinds of peroal Leucocyte increasing drugs (Qijiao Shengbai Capsule, Weixuening Granule, Compound Zaofan Pill, Berbamine and Leucogen Tablets) in the stomach, the experimental group was divided into normal control group (group A), model group (group B), positive control group (Group rhG-CSF, group C) and treatment groups (group D-H), and treatment groups were divided into Qijiao Shengbai Capsule group (group D), Weixuening Granule group (group E), Compound Zaofan Pill group (group F), Berbamine Tablet group (group G) and Leucogen Tablet group (group H). Calculate the death rate, blood routine and important visceral organ index in each group.. RESULTS: The death rate of mice in each group has no significant difference (P>0.05). WBC of B, D, E and F groups was significantly lower than that of group A (P<0.05 or P<0.01). WBC of C, G and H groups was significantly higher than those of group B (P<0.01). WBC of D, E and F groups was significantly lower than that of group C (P<0.01). WBC of G and H groups was significantly higher than that of D and F groups (P<0.01), WBC of group H is significantly higher than that of group E (P<0.05). RBC of group F, G and H groups was significantly higher than that of group D (P<0.05 or P<0.01). HB of group H is significantly higher than that of group A (P<0.01). HB of C, G and H groups was significantly higher than that of group B (P average <0.01). HB of D, E and F groups was significantly lower than that of group C (P<0.05 or P<0.01). HB of G and H groups was significantly higher than that of D, E and F groups (P average <0.01). PLT of group H was significantly higher than that of group B (P average <0.05). PLT of F, G and H groups was significantly higher than that of group D (P<0.01). Lung index of group G was significantly higher than that of D, E, F and H groups (P<0.01). Liver index of group H is significantly higher than that of group D (P<0.05). Thymus index of G and H groups is significantly higher than that of group F (P<0.05 or P<0.01). CONCLUSIONS: Among all drugs of rising WBC, G-CSF owns strongest effect. In oral drug groups, WBC rising effect of Leucogen Tablets is best, RBC, HB and PLT improvement effect of Berbamine and Leucogen Tablets is best. In addition, Berbamine and Leucogen Tablets respectively caused significant increase of lung and liver index, what indicates that, the two drugs may be accompanied by relevant viscera damage. At the same time, the two drugs also increased thymus index, which indirectly indicates that, the immunity and regulation abilities of Berbamine and Leucogen Tablets are stronger. The spleen index of Qijiao Shengbai Capsule group was significantly higher than that of Berbamine Tablet and Leucogen Tablet groups, what indicates that, the immunity and regulation abilities of Qijiao Shengbai Capsule may be stronger in oral drug group.

A randomized controlled research on treating early breast cancer with axillary lymph node group dissec-tion oriented by sentinel lymph nodes instead of axillary dissection / 中华内分泌外科杂志

Objective To research the impact of axillary limph node group dissection oriented by senti-nel lymph nodes instead of axillary dissection on upper limb lymph edema and disease -free survival ( DFS ).Methods We designed a randomized controlled research , which included 205 cases of operatable breast cancer (AJCC 7th:stage I or stage IIa)from Jan.2011 to Jan.2013.Those cases were separated into 2 groups randomly ( random number method ):group A underwent mastectomy ( or lumpectomy ) and axillary group lymphadenectomy oriented by sentinel lymph node biopsy ( SLNB) ( if positive continued for ALND ) while group B underwent mastec-tomy(or lumpectomy)and axillary lymph node dissection(ALND).All patients underwent SLNB by blue dye method and received adjuvant therapy after surgery according to National Comprehensive Cancer Network ( NCCN) guideline and Chinese anti-cancer association guideline .Results There were 101 cases in group A and 104 ca-ses in group B , but 1 case in group A was excluded for false negative of SLN.The midium follow-up was 30 months.There were no significant differences of average age , tumor size, grade, estrogen receptor (ER),proges-terone receptor ( PR) and human epidermal growth factor receptor 2 ( HER2 ) expression between the 2 groups. Group A had a lower frequency of lymph edema than group B (4.0%vs 17.3%,χ2 =9.384,P=0.002), and al-so a milder degree ( mild 2%vs 11.5%,middle 2%vs 3.8%,severe 0%vs 1.9%).There were no significant differences of upper limb sensory disorder (14.0%vs 16.3%,χ2 =0.218,P=0.641), neither of DFS(Log-Rank analysis:3-year average DFS 32.89 months vs 33.72 months,χ2 =0.186,P=0.667;Cox risk model analysis:HR=1.395,P=0.495)between the 2 groups.Conclusion Axillary group lymphadenectomy oriented by SLNB can reduce the happening of lymph edema from ALND and has a comparative effect on DFS as ALND .

Study on effect of anthracyclines on VEGF-C, VEGFR-3, ER and E-cadherin in serum of patients with breast cancer / 中国生化药物杂志

Objective To investigate effect of anthracyclines of VEGF-C, VEGFR-3, ER and E-cadherin in serum of patients with breast cancer.Methods 43 patients with breast cancer were selected and randomly divided into experimental group and control group, 40 cases in each group.According to the experimental program based on the treatment, serum VEGF-C, VEGFR-3 levels and breast tissue ER and E-cadherin were detected after the end of the treatment.Results Compared with the control group, VEGF-C, VEGFR-3 levels of the experiment group were lower( P<0.05),ER level was lower(P<0.05) and E-cadherin level was higher(P<0.05).Conclusion the ER, VEGFR-3 and VEGF-C levels in breast cancer patients can significantly decrease the E-cadherin level, and it has a guiding significance for clinical.

Study on expression of TPS, VEGF of beast cancer patients and relationship with clinical pathological / 中国生化药物杂志

Objective To investigate expression of TPS, VEGF of beast cancer patients and relationship with clinical pathological.Methods 68 cases of breast cancer were selected as experiment group, 36 cases with breast fibroma were selected as control group.TPS and VEGF were detected by elisa of patients before and after treatment.Serum TPS and VEGF levels and TNM staging were compared after operation.Results TPS and VEGF of the experiment group were higher than control group(P2 cm group(P<0.05).TPS and VEGF of axillary lymph node metastasis group and axillary lymph node metastasis had significant difference(P<0.05).The concentration of TPS was significantly higher than that of estrogen and progesteronepositive group in estrogen receptor negative, progesterone receptor negative (P<0.05).Conclusion TPS, VEGF levels in the serum of breast cancer patients showed high expression, the expression of TPS, VEGF levels related to axillary lymph node metastasis, estrogen receptor, progesterone receptor.