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Objective: To investigate the efficacy of neoadjuvant therapy (NAT) on HER2-positive breast cancer and to analyze their clinicopathological features. Methods: A total of 480 cases of HER2-positive breast cancer who received neoadjuvant therapy (NAT), diagnosed at the Department of Pathology of Fudan University Shanghai Cancer Center from 2015 to 2020, were retrospectively identified. Clinicopathological parameters such as age, tumor size, molecular subtype, type of targeted therapy, Ki-67 proliferation index, ER and HER2 immunohistochemical expression, and HER2 amplification status were analyzed to correlate with the efficacy of NAT. Results: Among 480 patients with HER2-positive breast cancer, 209 achieved pathology complete response (pCR) after NAT, with a pCR rate of 43.5%. Of all the cases,457 patients received chemotherapy plus trastuzumab and 23 patients received chemotherapy with trastuzumab and pertuzumab. A total of 198 cases (43.3%) achieved pCR in patients with chemotherapy plus trastuzumab, and 11 cases (47.8%) achieved pCR in patients with chemotherapy plus trastuzumab and pertuzumab. The pCR rate in the latter group was higher, but there was no statistical significance. The results showed that the pCR rate of IHC-HER2 3+patients (49%) was significantly higher than that of IHC-HER2 2+patients (26.1%, P<0.001). The higher the mean HER2 copy number in the FISH assay, the higher the pCR rate was achieved. The expression level of ER was inversely correlated with the efficacy of NAT, and the pCR rate in the ER-positive group (28.2%) was significantly lower than that in the ER-negative group (55.8%, P<0.001). The pCR rate (29.1%) of patients with luminal B type was lower than that of HER2 overexpression type (55.8%, P<0.001). In addition, higher Ki-67 proliferation index was associated with higher pCR rate (P<0.001). The pCR rate was the highest in the tumor ≤2 cm group (57.7%), while the pCR rate in the tumor >5 cm group was the lowest (31.1%). The difference between the groups was significant (P=0.005). Conclusions: HER2 copy numbers, HER2 immunohistochemical expression level, molecular subtype, ER expression level and Ki-67 proliferation index are significantly associated with pCR after NAT. In addition, fluorescence in situ hybridization results, HER2/CEP17 ratio and tumor size could also significantly affect the efficacy of NAT.
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Humanos , Feminino , China , Hibridização in Situ Fluorescente , Antígeno Ki-67 , Terapia Neoadjuvante , Estudos Retrospectivos , Trastuzumab , Neoplasias da Mama/tratamento farmacológicoRESUMO
Objective To analyze and compare the epidemiological characteristics of imported malaria in Jiaozuo City before and after malaria elimination, so as to provide insights into the malaria surveillance during the post-elimination stage and prevention of re-establishment of imported malaria. Methods Data pertaining to the epidemic situation and individual investigation of malaria in Jiaozuo City before (from 2010 to 2016) and after malaria elimination (from 2017 to November, 2020) were captured from the National Notifiable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention of Chinese Center for Disease Control and Prevention and were analyzed statistically. Results A total of 74 imported malaria cases were reported in Jiaozuo City from 2010 to 2021. Imported cases were predominantly Plasmodium falciparum malaria cases in Jiaozuo City before and after malaria elimination, and there was no significant difference in the proportion of malaria parasite species (χ2 = 0.234, P > 0.05). The imported malaria cases was predominantly reported in Wuzhi County, and was identified in overseas male farmers and businessmen at ages of 20 to 59 years, while the greatest number of imported malaria cases was reported in June and December before and after malaria elimination. The imported malaria cases predominantly acquired malaria parasite infections in sub-Saharan African countries; however, the proportion of imported malaria cases returning from Southeast Asian counties increased after malaria elimination than before malaria elimination (χ2 = 5.989, P < 0.05). The longest duration from onset to definitive diagnosis of malaria reduced from 27 days before malaria elimination to 18 days after malaria elimination, and the median duration reduced from 3 days to 2 days, while the proportion of definitive diagnosis of malaria increased from 60.47% before malaria elimination to 83.87% after malaria elimination (χ2 = 4.724, P < 0.05). In addition, the proportion of malaria cases definitively diagnosed and reported by medical institutions increased after malaria elimination than before malaria elimination (χ2 = 5.406, P < 0.05). Conclusions The imported malaria patients were predominantly P. falciparum malaria cases in Jiaozuo City during 2010 to 2021, and the patient’s medical care-seeking awareness and medical staff’s diagnosis and treatment ability have improved after malaria elimination. It is necessary to strengthen and improve malaria surveillance and response system and prevent the re-establishment of overseas imported malaria.
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Objective:To analyze the main factors affecting the <italic>Ziziphus jujuba</italic> distribution and expand the understanding of its distribution and the corresponding influencing factors by comparing the distribution sites of <italic>Z. jujuba</italic> predicted by models with those recorded in the literature. Method:More than 200 distribution sites of <italic>Z. jujuba</italic> accompanied by 55 environmental factors were obtained from literature and specimen review. The environmental factors that affect the distribution of <italic>Z. jujuba</italic> were explored by maximum entropy (MaxEnt) model, and the potential distribution areas of <italic>Z. jujuba</italic> in China were analyzed by ArcGIS, followed by the verification of the main environmental factors using receiver-operating characteristic (ROC) curve and Jackknife method. Result:The area under the curve (AUC) values for the test data and training data were both greater than 0.9, which perfectly satisfied the standard, indicating that the research results were accurate and reliable. Conclusion:The annual average temperature, the average temperature in May, the average temperature in the warmest season, vegetation type, soil type, average temperature in June, average temperature in September, and average temperature in August are proved to be the main environmental factors affecting the distribution of <italic>Z. jujuba</italic>, which can be found almost all over China, except for Heilongjiang and Tibet. <italic>Z. jujuba</italic> is most suitable to be planted in southeastern Sichuan, Chongqing, southern Gansu, Ningxia, most areas of central Shaanxi, eastern and southwestern Shanxi, Henan, eastern and northern Hubei, northern and eastern Anhui, Shandong, Hebei, Beijing, Tianjin, western Liaoning, and Zhejiang. As revealed by literature review, the most suitable growing areas of <italic>Z. jujuba</italic> are southeastern Sichuan, central Shaanxi, southwestern Shanxi, western and northern Henan, Shandong, and southwestern and eastern Hebei.
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In response to the outbreak of COVID-19 in Wuhan, Hubei province, more than one thousand medical staff members from the army undertook the medical task of working in Wuhan Huoshenshan Hospital.200 medical staff members were from Wuxi Joint Logistic Support Center. It was proved that the medical team responded quickly and rushed from multiple links such as receiving tasks, task analysis and judgment, team construction, epidemic analysis, ward planning, patient treatment, testing and rapid turnover of beds. These actions were finished orderly and carefully, which reflected the supportive capabilities of our military health service forces. By analyzing the characteristics and experience of the medical tasks of the COVID-19 special hospital, we expected to improve the ability of performing multiple tasks of mobile health service unit.
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In response to the outbreak of COVID-19 in Wuhan, Hubei province, more than one thousand medical staff members from the army undertook the medical task of working in Wuhan Huoshenshan Hospital.200 medical staff members were from Wuxi Joint Logistic Support Center. It was proved that the medical team responded quickly and rushed from multiple links such as receiving tasks, task analysis and judgment, team construction, epidemic analysis, ward planning, patient treatment, testing and rapid turnover of beds. These actions were finished orderly and carefully, which reflected the supportive capabilities of our military health service forces. By analyzing the characteristics and experience of the medical tasks of the COVID-19 special hospital, we expected to improve the ability of performing multiple tasks of mobile health service unit.
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Based on the rapid development of COVID-19 epidemic, China has built Huoshenshan Hospital in Wuhan. This paper analyzes the matching degree between drug consumption in Huoshenshan Hospital and medicine prepared by the medical team in the early stage and the use of medicine in the first week after receiving the patients in Huoshenshan Hospital, and compares it with medicine carried by the medical team. With the novel coronavirus infection developing rapidly, the superior group has a tight schedule and a heavy task, and the preparation time before setting out is only 3 days, the matching degree of pharmaceutical supply can reach 60% within a short period of time, which can already meet the general clinical treatment needs. This paper analyzes the situation of preparing medicine in medical teams in the early stage, and provides experience for future medical teams to carry out the law again.
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Objective To explore the risk factors of recurrent low hemoglobin(RLH) level among students from 6 to 13 years old, and to formulate strategies and policies in this regard. Methods Surveillance on hemoglobin concentration was conducted among 71 742 students aged from 6 to 13y between 2013-2014 based on the annual physical examination for primary and middle school in Minhang District.Of those students, 670 were diagnosed with low hemoglobin level according to WHO criteria.A 1 ︰ 1 matched case-control study was conducted based on gender, age and school type.Questionnaire surveys for data collection were analyzed using Cox′s proportional hazards regression. Results Factors as pregnancy anemia(OR=2.32, 95%CI:1.49-3.63), non-pregnancy anemia(OR=4.65, 95%CI:1.22-17.69), maternal anemia(OR=2.51, 95%CI:1.50-4.21), drinking strong tea(OR=2.56, 95%CI:1.27-5.13) and dietary bias(OR=1.94, 95%CI:1.45-2.59) were risk factors of recurrent low hemoglobin level.Chewing pencils(OR=1.80, 95%CI:1.25-2.59) or toys(OR=1.79, 95%CI:1.10-2.86) and wasting(OR=3.37, 95%CI:1.11-10.21)might be the risk factors. Conclusion The risk factors of recurrent low hemoglobin level among students aged from 6 to 13 years are related to maternal anemia status and their dietary habits.We should strengthen education for women of child-bearing age, and help to develop healthy eating practices for their babies.Emaciated students should be focused on in this regard.
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There are many problems in field training of mobile medical service units, such as lack of training ground, backward training methods, simple training methods and weak comprehensive treatment ability. The purpose of this study is to explore the research and development idea and application effect of mobile combat-injury treatment training assessment system, which consists of handheld mobile terminals, 3 function modules for training mode, training evaluation and inquiry, and 5 basic modules for comprehensive appraisal of training performance, recording and analysis of training results, facilitation of personalized training programs, multi-view summary of training performances and intelligent stratified management of trainees, respectively. This mobile assessment system makes the training equipment more portable, training means more convenient, training activities derestrict to time, place or weather and, as a result, the whole combat-injury treatment training more efficient.
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Performance management is a key direction of the reform of the national medical and health system, and it is also an important starting point for promoting the development of hospital connotation. In view of the contradiction among the current hospital performance distribution system, this paper proposes a design mentality of performance distribution system based on homogenization subsidy base, and expounds the basic connotation and cognitive basis of homogenization subsidy base. The key elements of the design of the performance distribution system are discussed from four aspects: pre-adjusted total control, coefficientized personnel attendance, same performance appraisal, and homogenization subsidy base. At the same time, this paper also analyzes the characteristics of the performance distribution system based on the homogenization subsidy base. The application prospects of the performance distribution system are prospected from three aspects: the national medical reform requirements, the discipline development discipline and the system's own characteristics.
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Dual-energy computed tomography,with fast image acquisition at two different X-ray energies,enables material-specific and spectral imaging,which offers objective and quantitative parameters for tumor detection,characterization,staging,and treatment monitoring without increasing radiation exposure.This article reviews the applications of dual-energy computed tomography technique and its applications in the evaluation of lung cancer and elucidates its future developments.
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Humanos , Neoplasias Pulmonares , Diagnóstico por Imagem , Doses de Radiação , Imagem Radiográfica a Partir de Emissão de Duplo Fóton , Tomografia Computadorizada por Raios XRESUMO
AIM:To study the relativity between reject reaction from donation after cardiac death (DCD) and corneal endothelial cell source of corneal graft after penetrating keratoplasty.METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo,2-3mo,4-6mo,7-12mo after operation.RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1 mo,2-3mo,4-6mo and 7-12mo were 38.23%,49.56%,57.18%,65.04%.Corneal endothelial cell density were 2071.15 ± 311.47,1771.33 ± 348.18,1626.59±353.92,1553.14±307.31.The coefficient variation of corneal endothelial cells was positively correlated with rejection (r =0.95,P < 0.05).The postoperative corneal endothelial cell density was negatively correlated with rejection (r=-0.93,P<0.05).CONCLUSION:The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection.Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.
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Objective To investigate the correlation between Epstein-Barr virus (EBV) infection and systemic lupus erythematosus (SLE) in Chinese population by meta-analysis.Methods The following databases such as China National Knowledge Infrastructure (CNKI),Chinese Weipu Database (VIP),PubMed,EMbase,Chinese Biological Medicine Database (CBM),WANFANG Database were searched from inception to July 2017.For a study it had to be a case-control with SLE and controls in Chinese population.The study had to assay serum anti-EBV antibody in each group.Quality assessments were performed using a modified version of the Newcastle-Ottawa scale (NOS).Then meta-analysis was performed using Rev Man 5.3 software and Stata 12.0 software.Mantel-Haenszel odds ratios (OR) for the detection of anti-EBV antibodies were calculated as well as stability evaluated by sensitivity analysis.Egger test was used to evaluate the publication bias.Resuits Seventeen case-control studies were included.These studies included a total of 1 392 SLE cases and 1 647 controls.Twelve studies measured anti EBV viral capsid antigen (EBV VCA) IgG,there was a statistically significant higher seroprevalence of anti-EBV-VCA IgG (P=0.003) in SLE cases compared to controls.Meta-analysis revealed an overall OR of 2.97 (95% CI=1.43~6.15).Our subgroup analyses failed to demonstrate a significant difference between any of the subgroups considered.The Egger test showed that there was no significant publication bias.Seven studies measured anti-EBV VCA antibodies of the IgA and six studies assayed anti EBV-VCA antibodies of the IgM subclass,Meta-analysis showed a significant association between anti-EBV-VCA IgA,anti-EBV VCA IgM and SLE,with OR =7.01 (95% CI =4.61 ~10.66),9.34(95% CI=4.29~20.34) respectively.The percentage of SLE patients positive for anti EBV-VCA IgA and anti-EBV VCA IgM (37.5 % and 28.5 %,respectively) were significantly lower compared with anti-EBV-VCA IgG (90.3 %).Meta-analysis showed overall OR=1.01 (95% CI=0.61 ~ 1.67) indicating that the difference in seropositivity rates between SLE and control groups for anti EBV-nuclear antigen1 (EBNA1) IgG was not significant (P =0.97).Conclusion The findings support the hypothesis that infection with EBV predisposes to the development of SLE.
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<p><b>OBJECTIVE</b>To explore the effects of IFN-γ on pulmonary GVHD after hematopoietic stem cell transplantation (HSCT).</p><p><b>METHODS</b>The mouse GVHD models were established by using C57BL/6J, B6D2F1 mice and different HSCT. According to HSCT modes, the mice were divided into 3 groups: syngeneic HSCT group(C57BL/6J→C57BL/6J), allogeneic HSCT group (C57BL/6J→B6D2F1) and IFN-γallogeneic HSCT group (IFN-γ→C57BL/6J→B6D2F1). The survival time, GVHD clinical seore, pulmonary pathologic changes in 3 groups were compared and analyzed, and the total cell count in BALF and IFN-γ level in serum were detected in 3 groups after transplantation.</p><p><b>RESULTS</b>The mice in syngeneic HSCT group all survived at day 42 after transplantation without GVHD symptoms in lung, the GVHD clinical score was low. The mice in allogeneic HSCT group survived at day 24 after transplantation (survial rate >50%), the GVHD clinical score was higher than that in syngeneic HSCT group, the pathologic changes in lung did not serious, though the GVHD presentation was observed, but the olveola bleeding and lymphocyte infiltration in lung tissue were observed at day 28 after transplantation. The mice in IFN-γallogeneic HSCT group all died of lethal GVHD within 14 days after transplantation, the GVHD clinical score reached to 6.7± 0.83 at 1st week after tansplantation, which was significantly higher than that in syngeneic and allogeneic HSCT groups. At 1st week after transplantation, the serious GVHD pathological changes occured in lung tissue, total cell count in BALF significanty increased, compared with syngeneic and allogeneic HSCT groups, but IFN-γ level in serum was significantly lower than that in syngeneic and allogeneic HSCT groups (P<0.05).</p><p><b>CONCLUSION</b>Donor-derived IFN-γ plays an important immunoprotective role for lung tissue after HSCT.</p>
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HSP90 is widely expressed in cells with the main function in assisting the maturation of other proteins that are called clients. Many clients play critical roles in the occurrence and development of cancer. Inhibition of HSP90 can lead to degradation of the oncogenic proteins, and result in potent anti-cancer effects. HSP90-HOP interaction is critical for the chaperone function of HSP90, thereby disruption of the HSP90-HOP interaction is a novel strategy in the inhibition of HSP90. Based on the technology of homogeneous time-resolved fluorescence (HTRF), we developed a new assay for the identification of new inhibitors of HSP90-HOP interaction. This method was evaluated in the study of the HSP90-HOP inhibition activity of the pentapeptide MEEVD from HSP90 C-terminal and its derivatives. This study can provide a basis for the screening and discovery of novel HSP90-HOP disruptors.
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<p><b>OBJECTIVE</b>To investigate the computed tomographic (CT) and pathological features of primary pulmonary sarcomatoid carcinoma (PSC).</p><p><b>METHODS</b>The clinical data and CT images of 20 patients with pathologically confirmed PSC were retrospectively analyzed.</p><p><b>RESULTS</b>Solitary pulmonary mass was identified in 18 patients and multiple pulmonary masses in 2 patients, amounting to 22 masses. There were 17 peripheral masses and 5 central masses, including 11 masses larger than 5 cm. The smooth margin was identified in 9 masses, deep lobulation and/or spinous protuberance in 11 masses, and ill-defined margin in 2 masses. Pleural indentation was identified in 2 masses and pleural thickening with wide basement was identified in 14 masses. On plain CT, cavity was observed in 5 masses, hypo-density in 7 masses, and homogeneous density in 10 masses. On contrast-enhanced CT scanning, irregular ring/patchy enhancement were shown in 15 masses and slightly homogenous enhancement in 2 masses. Of all patients, 6 patients had unilateral or bilateral hilar and/or mediastinal lymphadenopathy. There were 16 pleomorphic carcinomas and 4 spindle cell carcinomas. Immunohistochemically, anti-pan cytokeratin antibody was positive in 13 patients, cytokeratin was positive in 8 patients, Vimentin was positive in 15 patients, epithelial membrane antigen was positive in 1 patient, and thyroid transcription factor-1 was positive in 8 patients.</p><p><b>CONCLUSION</b>PSC has some specific CT features; however, the final confirmation of PSC still depends on pathological and immunohistochemical examinations.</p>
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Humanos , Neoplasias Pulmonares , Patologia , Proteínas Nucleares , Estudos Retrospectivos , Sarcoma , Fator Nuclear 1 de Tireoide , Tomografia Computadorizada por Raios X , Fatores de TranscriçãoRESUMO
<p><b>OBJECTIVE</b>To describe the undernutrition status of children under 5-year in China, and study the trend between 2002 and 2013).</p><p><b>METHODS</b>The study was based on two national surveys. Undernutrition was determined against WHO's 2006 growth standards. The prevalence in 2013 and 2002 was weighted by China sixth National Population Census (2010). The relationship between undernutrition and gender/age groups/different areas use weighted logistic regression.</p><p><b>RESULTS</b>The results indicated the overall prevalence of stunting, underweight, and wasting of Chinese children under 5-year was 8.1%, 2.4%, and 1.9% in 2013, respectively. The prevalence of stunting was higher for children aged 12-47 month, while underweight was higher for children aged 48-59 month. The prevalence of undernutrition was higher in rural areas than in urban areas, especially in poor rural areas. There was a decline of stunting, underweight, and wasting between 2002 and 2013 among the children, with greater reduction in rural areas than in urban areas.</p><p><b>CONCLUSION</b>The prevalence of undernutrition of children under 5-year remains high in rural areas especially in poor rural areas in China. It is urgent to take action to control undernutrition in the vulnerable areas and subgroups.</p>
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Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Transtornos da Nutrição Infantil , Epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , China , Epidemiologia , Desnutrição , Epidemiologia , Prevalência , Magreza , Fatores de TempoRESUMO
Eosinophilic granulomatosis with polyangiitis(EGPA),also known as Churg-Strauss syndrome,is a clinically rare small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) and the hypereosinophilic syndromes (HESs),characterized by asthma,disseminated necrotizing vasculitis,extravascular granulomas,peripheral eosinophilia,and tissue eosinophilia. This article reviews the pathology,imaging,and clinical features of EGPA.
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Humanos , Anticorpos Anticitoplasma de Neutrófilos , Asma , Síndrome de Churg-Strauss , Diagnóstico , Patologia , Eosinofilia , Granulomatose com Poliangiite , Diagnóstico , PatologiaRESUMO
<p><b>BACKGROUND</b>Accurate intraoperative diagnosis of sentinel lymph node (SLN) metastases enables the selection of patients for axillary lymph node dissections during the same operation, reducing the need for a second operation. The present study aimed to prospectively compare the GeneSearch(TM) Breast Lymph Node (BLN) Assay with touch imprint cytology (TIC) for intraoperative evaluation of SLNs.</p><p><b>METHODS</b>SLNs were sectioned in 1.5 - 3.0 mm pieces. TIC was performed on all pieces and the BLN Assay and postoperative histology evaluations were performed on different alternating node pieces. Overall performance of the BLN Assay was compared with that of TIC relative to the postoperative histology results.</p><p><b>RESULTS</b>A total of 90 patients enrolled in the study. Complete intraoperative data for both the BLN Assay and TIC were collected in 86 patients. The sensitivity, specificity, and overall accuracy of the BLN Assay were 82%, 97%, and 92%, respectively on a per patient basis compared with those of TIC which were 67%, 100%, and 90%.</p><p><b>CONCLUSIONS</b>Performance of the BLN Assay was superior to that of TIC and the additional application of TIC did not help improve the total sensitivity and accuracy of the intraoperative assessment. The existence of ectopic breast tissue might be a possible cause of false positive for the BLN assay. In addition, the BLN Assay complements histopathology assessment and can minimize sampling error without increasing pathologists' workload.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Citodiagnóstico , Métodos , Período Intraoperatório , Excisão de Linfonodo , Linfonodos , Metástase Linfática , Diagnóstico , Biópsia de Linfonodo Sentinela , MétodosRESUMO
<p><b>OBJECTIVE</b>To study the clinicopathologic features of leiomyosarcoma with prominent osteoclast-like giant cells.</p><p><b>METHODS</b>The clinical and pathologic features of 7 cases of leiomyosarcoma with prominent osteoclast-like giant cells were analyzed. Immunohistochemical and ultrastructural studies were performed. The literature was reviewed.</p><p><b>RESULTS</b>All cases occurred in adults, with a mean age of 63 years. There was no significant sex predilection (male-to-female ratio = 4:3). The tumor involved subcutaneous soft tissue of thigh (number = 2), left back (number = 1), retroperitoneum (number = 1), small intestine (number = 1), breast (number = 1) and uterus (number = 1). Histologic examination showed that the tumor was composed of relatively uniform spindly cells arranged in interlacing fascicles. The hallmark was the presence of prominent osteoclast-like giant cells, either intimately admixed with the spindly cells (number = 6) or forming giant cell tumor-like nodules (number = 1). Immunohistochemically, the spindly cells expressed smooth muscle actin, muscle-specific actin, desmin and h-caldesmon in various degrees, whereas the osteoclast-like giant cells expressed CD68. Ultrastructural study showed smooth muscle differentiation in the spindly cells and histiocytic differentiation in the osteoclast-like giant cells. Follow-up data were available in 6 cases. There were local recurrences and/or metastases in all the 6 patients. Three patients were alive with unresectable or recurrent/metastatic disease and two patients died of the disease.</p><p><b>CONCLUSIONS</b>Leiomyosarcoma with prominent osteoclast-like giant cells is a rare variant of leiomyosarcoma which should be distinguished from the so-called giant cell variant of malignant fibrous histiocytoma. The osteoclast-like giant cells are of histiocytic differentiation. Surgical resection remains the mainstay of management of this high-grade sarcoma.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Actinas , Metabolismo , Antígenos CD , Metabolismo , Antígenos de Diferenciação Mielomonocítica , Metabolismo , Dorso , Neoplasias da Mama , Tratamento Farmacológico , Metabolismo , Patologia , Cirurgia Geral , Proteínas de Ligação a Calmodulina , Metabolismo , Desmina , Metabolismo , Seguimentos , Células Gigantes , Metabolismo , Patologia , Imuno-Histoquímica , Neoplasias Intestinais , Metabolismo , Patologia , Cirurgia Geral , Leiomiossarcoma , Metabolismo , Patologia , Cirurgia Geral , Osteoclastos , Metabolismo , Patologia , Neoplasias Retroperitoneais , Metabolismo , Patologia , Cirurgia Geral , Neoplasias de Tecidos Moles , Metabolismo , Patologia , Cirurgia Geral , Coxa da Perna , Neoplasias Uterinas , Tratamento Farmacológico , Metabolismo , Patologia , Cirurgia Geral , Vimentina , MetabolismoRESUMO
<p><b>OBJECTIVE</b>to evaluate the application of GeneSearch(TM) breast lymph node assay in intraoperative detection of metastases in sentinel lymph node (SLN) from breast cancer patients.</p><p><b>METHODS</b>a total of 225 SLN from 88 patients was prospectively studied. Each SLN was cut into 2 mm slabs which were examined by intraoperative imprint cytology (IIC) first, followed by GeneSearch assay and post-operative serial sectioning. GeneSearch used real-time fluorescence quantitative RT-PCR technology to detect the expression of CK19 and mammaglobin in SLN. The results of GeneSearch assay were correlated with those of IIC and post-operative serial sectioning.</p><p><b>RESULTS</b>amongst the 88 cases studied, 225 SLNs were found, and obvious metastatic carcinoma cells were identified in 27 SLNs and micrometastasis in 9 SLNs. One hundred and eight-nine SLNs were considered as "negative" (with "isolated tumor cells" present in 5 SLNs). The turn-around time of intraoperative GeneSearch assay ranged from 35 to 45 minutes (mean = 40 minutes). The concordance rate between GeneSearch assay and post-operative serial sectioning was 95.6% (215/225), with a sensitivity of 86.1% (31/36), compared with 94.7% (213/225) and 72.2% (26/36) respectively for IIC. The size of metastatic foci correlated with the Ct value of CK19 and mammaglobin (P < 0.01).</p><p><b>CONCLUSIONS</b>GeneSearch assay for intraoperative detection of metastase in SLN has a satisfactory performance and demonstrates a relatively higher sensitivity than IIC. The potential clinical application still requires further evaluation of larger number of cases.</p>