[Study on the relationship between HBV viral loads and the changes of liver pathological features in patients with HBeAg-negative chronic hepatitis B].

OBJECTIVE: To investigate the relationship between serum HBV DNA loads and liver histology damage in the patients with HBeAg-negative chronic hepatitis B. METHODS: The retrospective study was performed. The 514 patients were divided into two groups according to the HBeAg status and the HBeAg positive group was as control. The relationship among HBV DNA loads, live histological inflammation grades and fibrosis stages was analyzed. RESULTS: The HBV DNA loads in HBeAg-negative group and HBeAg-positive group were (5.38 +/- 1.27) log10 copies/ml and (6.80 +/- 1.18) log10 copies/ml respectively (P < 0.001). The inflammation grades and fibrosis stages of liver tissues in HBeAg-negative group were all significantly higher than those in HBeAg-positive group (P < 0.001). In HBeAg-negative group, HBV DNA loads displayed a positive correlation with the inflammation grades and fibrosis stages of liver tissues (P < 0.001). CONCLUSION: In the patients with HBeAg-negative chronic hepatitis B, HBV viral loads are lower than those with HBeAg-positive chronic hepatitis B, and HBV viral loads display a positive correlation with liver the inflammation grades and fibrosis stages of liver tissues.

[An analysis of CD3+CD56+ lymphocytes and their subsets in the peripheral blood of patients with chronic hepatitis B].

OBJECTIVES: To investigate CD3+CD56+ lymphocytes and their subsets in the peripheral blood of chronic hepatitis B patients and to explore the relationship between these cells and the pathogenesis of their diseases. METHODS: Blood samples from 53 chronic hepatitis B patients, 17 from HBV asymptomatic carriers (ASC) and 19 from healthy controls (HC) were collected. CD3+CD56+ lymphocytes were detected by flow cytometry (FCM), then the CD3+CD56+ lymphocytes were gathered to analyze their expressions of CD4, CD8, TCR Valpha24, TCRalpha/beta and TCRgamma/delta. RESULTS: The number of CD3+CD56+ lymphocytes of chronic hepatitis B patients (7.4+/-4.6%) was more than those of ASC (4.5%+/-3.5%) and healthy controls (4.4%+/-3.7%). The expressions of TCR Valpha24 on CD3+CD56+ lymphocytes showed no significant differences among the three groups, but the expression of TCR Valpha24 on CD3-CD56+ lymphocytes of ASC ( 2.8%+/-1.4% ) was much more than that of the HC (1.7%+/-1.0%). For the subsets analysis, the CD8 and TCRalpha/beta subsets of CD3+CD56+ lymphocytes of chronic hepatitis B (61.9%+/-16.8% and 68.1%+/-16.9%) were significantly higher than those of the HC (49.2%+/-15.6% and 56.4%+/-17.9%), while the TCRgamma/delta subsets of chronic hepatitis B and ASC (29.6%+/-15.4% and 30.5%+/-14.8%) were decreased significantly than those of the HC (41.4%+/-19.4%). On the other hand, the CD8 and TCRalpha/beta subsets of CD3+CD56+ lymphocytes of severe chronic hepatitis B (69.0%+/-14.0% and 76.1%+/-12.9%) and CD8 subsets of moderate chronic hepatitis B patients (66.4%+/-14.9%) were significantly higher than those of the mild chronic hepatitis B patients (51.4%+/-16.2% and 62.1%+/-14.6%). CONCLUSION: The pathogenesis of chronic hepatitis B may positively relate to the high expression of CD8 on the CD3+CD56+ lymphocytes.

[Inhibitive effects of mifepristone on growth of breast cancer: experiment with animal model].

OBJECTIVE: To investigate the effects of mifepristone (MIF) on the growth of breast cancer. METHODS: Forty female athymic BALB/c-nude mice underwent subcutaneous injection of breast cancer cells of the line MCF-7, ER +/PR +. Ten days later when tumor nodules were formed, the mice were randomly divided into 4 equal groups to be administered with MIF of the concentrations of 25 mg, 50 mg, 100 mg, and 200 mg/kg x d respectively by gastric perfusion. The tumor size was observed every 3 day till 3 weeks later. Ten mice were used as normal control group, undergoing gastric perfusion of vegetable oil. Parts of the animals were killed 2 weeks later, and the remaining mice were all killed 3 weeks later. The tumors were taken out and underwent immunochemistry to measure the protein expression of CD34, estrogen receptor (ER), progesterone receptor (PR), vascular endothelial growth factor (VEGF), bcl-2, Ki67, p53, and CerbB-2. Microscopy was used to measure the microvessel density (MVD). RESULTS: The growth velocity of tumor of the mice of MIF groups were all slower than that of the control group (all P <0.01). The MVD levels of the MIF groups all decreased time- and dose-dependently. Microscopy showed that in the tumor tissues heteromorphism was significant, pathological caryomitosis was more remarkable, karyoplasmic ratio was greater, endochylema was deep blue, mesenchyma was sparse, and zone of neoplasm necrosis became lager in comparison with the control group. The expression levels of VEGF, bcl-2, Ki67, p53, and CerbB-2 of the MIF groups were all significantly lower, time and dose-dependently, than those of the control group (all P <0.05). CONCLUSION: MIF inhibits the growth of breast cancer by the mechanisms related to apoptosis promotion and inhibition of angiogenesis, so it can be used in breast cancer endocrine therapy.

Six cases of chylous leakage after axillary lymph node dissection.

BACKGROUND: Chylous leakage has been described after several surgical procedures, especially in the region of the neck and thorax. However, it has rarely been reported after axillary lymph node dissection. PATIENTS AND METHODS: We encountered 6 cases of chylous leakage after axillary lymph node dissection out of a total of 882 breast cancer patients between July 2005 and June 2007 in Shandong Provincial Hospital. These 6 cases were confirmed by axillary white fluid and chylomicron interpretation. The patients were treated conservatively, including a low fat diet, compression bandage, and suction drainage. RESULTS: All 6 cases were successfully treated without any complications such as infection, dystrophy, and lymphoceles. The chylous leakage disappeared within a median of 5 days (range: 3-7 days). Adjuvant chemotherapy and radiotherapy were not delayed. After a median follow-up period of 12 months (range: 6-20 months), no chronic complications were observed. CONCLUSION: Chylous leakage after axillary lymph node dissection is quite rare. It can be cured by conservative treatment. Lymphatic vessels should be identified carefully, and the main duct should be carefully ligated during surgical procedures, especially when level II and III lymph nodes are removed.

Clinicopathologic and prognostic characteristics of triple-negative breast cancer.

BACKGROUND: Triple-negative breast cancer (estrogen receptor (ER)-, progesterone receptor (PR)-, and HER2-negative) is a rare subtype with a poor prognosis. However, the clinicopathologic and prognostic characteristics of triple-negative breast cancer remain undetermined. MATERIALS AND METHODS: Immunohistochemical staining was adopted to examine the expressions of ER, PR, p53, C-erbB-2 (HER2), vascular endothelial growth factor (VEGF), and epidermal growth factor receptor (EGFR) protein in 116 samples of paraffin-embedded breast cancer tissues. RESULTS: 22 triple-negative breast cancers were found among 116 informative cases (19%). The triple-negative phenotype significantly correlates with tumor size, histological grade, lymph node status, p53, and EGFR (p < 0.05), and not significantly with age, menopausal status, and VEGF protein. After a median follow-up period of 96 months (range: 32-123 months), 12 triple-negative breast cancer patients and 20 patients with non-triple-negative phenotype had distant relapse (p < 0.05). Survival analysis showed that triple-negative phenotype was inversely associated with overall survival (p < 0.05) but not significantly with disease-free survival (p = 0.2877). Multivariate Cox model analysis showed that tumor size, lymph node status, histological grade, and triple-negative phenotype provided independent significant predictive power. CONCLUSION: Triple-negative breast cancer phenotype has specific clinical and biological characteristics. Patients with triple-negative breast cancer have a poorer prognosis. So far, there is no conclusive effective treatment, which necessitates further studies.

Detecting AFP mRNA in peripheral blood of the patients with hepatocellular carcinoma, liver cirrhosis and hepatitis.

BACKGROUND: The low frequency of disseminated carcinoma cells in the blood now makes immunomagnetic bead sorting and reverse transcriptase-polymerase chain reaction (RT-PCR) technique more popular. METHODS: Three milliliters of peripheral blood were collected from 91 patients and 18 normal donors. The circulating carcinoma cells were enriched with CD45 and Ber-EP4 immunomagnetic beads. The alpha-fetoprotein (AFP) mRNA was amplified with nested RT-PCR. RESULTS: The total positive detection rate was 72.1%, 43.8%, 25.0%, 100%, and 66.7% in patients with hepatocellular carcinoma (HCC) untreated, liver cirrhosis (LC), hepatitis, metastasis liver cancer, and postsurgery of hepatocellular carcinoma, respectively. There was a significant difference among the patients with HCC, LC and hepatitis (HCC vs. LC, P<0.05; HCC vs. hepatitis, P<0.01) and between Class A and B of the HCC patients (P<0.05). Meanwhile, AFP mRNA was markedly expressed in HCC patients compared to the patients with no HCC (LC and hepatitis). The levels of aspartate transaminase (AST) and gamma-glutamyltranspeptidase (GGT) were significantly different in AFP mRNA-positive patients with autoimmune chronic active hepatitis B (CAHB) or LC in contrast to the corresponding negative patients. CONCLUSION: Combining negative and positive immunomagnetic bead sorting and RT-PCR technique can effectively detect circulating tumor cells. AFP mRNA is a more reliable marker of metastasis compared to serum AFP.