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Objective:To establish a predictive model for preoperative diagnosis of benign and malignant phyllodes tumor of the breast(PTB). Methods:The clinicopathological data of 69 patients with benign PTB and 41 patients with malignant PTB(24 borderline and 17 malignant)who underwent multiple(≥2)preoperative ultrasound follow-ups in the Cancer Hospital of Harbin Medical University from January 2011 to December 2018 were retrospectively analyzed.The preoperative prediction models of benign and malignant PTB were constructed by using the influencing factors determined by multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the efficiency of the prediction model.In addition,the clinicopathological data of 22 patients of benign PTB and 19 patients of malignant PTB(12 borderline and 7 malignant)admitted to the hospital from January 2019 to April 2022 were selected for external verification. Results:Logistic regression analysis showed that growth rate of tumor>2 mm/month and ultrasound BI-RADS category≥4b were independent predictors for the diagnosis of malignant PTB(OR:4.476,95%CI:1.673~11.975;OR:9.448,95%CI:3.149~28.345;P<0.01).The logistic regression equation:Logit(P)=-1.868+1.499×growth rate of tumor+2.246×ultrasound BI-RADS category.The AUC for the training cohort was 0.795(95%CI:0.699~0.890),the best cut-off value was 0.421,the corresponding sensitivity was 0.732,the specificity was 0.826,and the Jorden index was 0.558,P<0.001.The AUC for the the validation cohort was 0.772(95%CI:0.624~0.919),with the sensitivity of 0.526 and the specificity of 0.773,positive predictive value was 0.667 and negative predictive value was 0.654,P = 0.003.The AUC of the training cohort and the validation cohort were both>0.75,indicating that the model has certain predictive ability. Conclusion:The predictive model constructed by clinicopathological parameters can be used for preoperative diagnosis of benign PTB and malignant PTB,and provide a certain reference value for clinicians to select the appropriate surgical resection scope.
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Objective@#To examine the expression levels of hypoxia inducible factor (HIF)-1α and α-smooth-muscle actin (SMA) in both cervical cancer tissues with concurrent chemoradiotherapy and non-cervical cancer tissues, and assess the clinical significance in cervical cancer.@*Methods@#The immune-histochemistry was used to detect HIF-1α and α-SMA in 68 cases of cervical cancer tissues and 56 cases of non-cervical cancer tissues (including normal cervical tissues, hysteromyoma and cervical intraepithelial neoplasias) from January 2013 to January 2014 in the First Affiliated Hospital of Hebei Northern University.@*Results@#The positive expression rates of HIF-1α and α-SMA in cervical cancer tissues and non-cervical cancer tissues were 58.8% (40/68), 39.3% (22/56) and 54.4% (37/68), 35.7% (20/56) respectively; the differences were significant statistically (P<0.05). The expression of HIF-1α was positively correlated with the expression of α-SMA protein in cervical cancer tissues (r = 0.376, P =0.001). The positive expression of HIF-1α was closely related to International Federation of Gynecology and Obstetrics (FIGO) stages (r = 0.371, P = 0.004), lymph node metastasis (r = 0.243, P = 0.039), abdominal aortic parathyroid lymph node metastasis (r = 0.286, P = 0.014) and serum squamous cell carcinoma antigen (SCC-Ag) (r = 0.271, P = 0.020), but it was not correlated with age and tumor size (P>0.05). The positive expression of α-SMA was associated with lymph node metastasis (r = 0.363, P = 0.001), abdominal aortic parathyroid lymph node metastasis (r = 0.271, P = 0.020) and SCC-Ag (r = 0.272, P = 0.020), but it was not correlated with age, FIGO stage and tumor size (P>0.05) . The short-term effect rates of concurrent chemoradiotherapy in cervical cancer tissues with positive and negative expression of HIF-1α and α-SMA were 27.5% (11/40), 21.6% (8/37), and 64.3% (18/28) and 48.4% (15/31), and there were statistical differences (P<0.05). The medial follow-up time of 68 cases was 60 months, and the 5-year survival rate was 52.9% (36/68). The 5-year survival rates of the patients with positive expression of HIF-1α and α-SMA were 42.5% (17/40) and 40.5% (15/31), the 5-year survival rates of the patients with negative expression of HIF-1α and α-SMA were 67.9% (19/28) and 67.7% (21/31), and the differences were statistically significant separately (χ2 = 4.091 and 4.573, P = 0.043 and 0.032).@*Conclusions@#The elevation of HIF-1α and α-SMA may be used to predict the development and prognosis of cervical cancer with concurrent chemoradiotherapy.
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Objective To examine the expression levels of hypoxia inducible factor (HIF)-1α and α-smooth-muscle actin (SMA) in both cervical cancer tissues with concurrent chemoradiotherapy and non-cervical cancer tissues,and assess the clinical significance in cervical cancer.Methods The immune-histochemistry was used to detect HIF-1α and α-SMA in 68 cases of cervical cancer tissues and 56 cases of non-cervical cancer tissues (including normal cervical tissues,hysteromyoma and cervical intraepithelial neoplasias) from January 2013 to January 2014 in the First Affiliated Hospital of Hebei Northern University.Results The positive expression rates of HIF-1α and α-SMA in cervical cancer tissues and non-cervical cancer tissues were 58.8% (40/68),39.3% (22/56) and 54.4% (37/68),35.7% (20/56) respectively;the differences were significant statistically (P< 0.05).The expression of HIF-1α was positively correlated with the expression of α-SMA protein in cervical cancer tissues (r =0.376,P =0.001).The positive expression of HIF-1α was closely related to International Federation of Gynecology and Obstetrics (FIGO) stages (r =0.371,P =0.004),lymph node metastasis (r =0.243,P =0.039),abdominal aortic parathyroid lymph node metastasis (r =0.286,P =0.014) and serum squamous cell carcinoma antigen (SCC-Ag) (r =0.271,P =0.020),but it was not correlated with age and tumor size (P > 0.05).The positive expression of α-SMA was associated with lymph node metastasis (r =0.363,P =0.001),abdominal aortic parathyroid lymph node metastasis (r =0.271,P =0.020) and SCC-Ag (r =0.272,P =0.020),but it was not correlated with age,FIGO stage and tumor size (P > 0.05).The shortterm effect rates of concurrent chemoradiotherapy in cervical cancer tissues with positive and negative expression of HIF-1α and α-SMA were 27.5% (11/40),21.6% (8/37),and 64.3% (18/28) and 48.4% (15/31),and there were statistical differences (P < 0.05).The medial follow-up time of 68 cases was 60 months,and the 5-year survival rate was 52.9% (36/68).The 5-year survival rates of the patients with positive expression of HIF-1α and α-SMA were 42.5% (17/40) and 40.5% (15/31),the 5-year survival rates of the patients with negative expression of HIF-1α and α-SMA were 67.9% (19/28) and 67.7% (21/31),and the differences were statistically significant separately (x2 =4.091 and 4.573,P =0.043 and 0.032).Conclusions The elevation of HIF-1α and α-SMA may be used to predict the development and prognosis of cervical cancer with concurrent chemoradiotherapy.
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Objective To investigate the chang and impaction of TM and D- Dimer on peripherally inserted central catheter (PICC) associated thrombosis in cancer patients. Methods The expression of TM and D-Dimer from 207 cancer patients with PICC was examined using nzyme-linked immunoassay. Paitents were divided into thrombosis group and control group according to Doppler Sonography. Results The thrombosis group had 33 cases and the control group had 174 cases in 207 malignant tumor patients with PICC. Compared with that in control group, the expression of TM (6.806 ± 1.805)μg/L and D-Dimer (0.786 ± 0.294) mg/L was significantly higher in thrombosis group and respectively statistically significant (P0.05). Conclusions The expression of TM, D-Dimer is elevated, which is expected to assess the early diagnosis and clinical value of PICC associated thrombosis in cancer.
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In the context of precision medicine, although individual treatment of breast cancer under the guidance of molecular classi-fication has become the norm, a precision treatment program with increased efficiency and quality is still required. Compared with the traditional real-time fluorescent quantitative polymerase chain reaction (PCR), the droplet digital PCR (ddPCR) has obvious advantages in the detection of rare mutations and copy number variations, as well as the integration with the second-generation-sequencing tech-nology. This paper reviews the application of a ddPCR platform in different breast cancer subtypes and explores new horizons of breast cancer research through the ddPCR technology.
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Objective To investigate the application value of extracorporeal extended field radiotherapy in locally advanced cervical cancer. Methods A total of one hundred and twenty patients with stage IIB?IVA cervical cancer in the First Affiliated Hospital of Hebei North University from June 2012 to June 2014 were randomly divided into two groups:the control group and the observation group,each with 60 cases. The routine concurrent chemoradiotherapy was adopted in the control group. The observation group was treated with extracorporeal extended field radiotherapy combined with concurrent chemotherapy. The patients have been followed up for three years. The total efficacy rate,toxicity reaction,local progression free survival time ( PFS) and survival rate of the two groups were compared. Results The total efficacy rate in the observation group was significantly higher than that of the control group ( 88. 3%( 53/60 ) vs. 73. 3%( 44/60 ) , χ2 = 4. 357, P=0. 037),while the incidences of toxicity reaction in the two groups were 18. 3%(11/60) and 16. 7%(10/60), the difference was not statistically significant (χ2=0. 058,P=0. 810) ,the percentages of I and II degree in the two groups were 3. 4%( 2/60 ) and 3. 4%( 2/60 ) , the difference between the two groups was not statistically significant (Z=0. 000,P=1. 000). The PFS value in the observation group was significantly longer than that of the control group ( 25. 6 months vs. 13. 8 months,χ2 = 25. 624, P= 0. 000 ) , and the survival rate in the observation group improved significantly ( 53. 3%( 32/60 ) vs. 33. 3%( 20/60 ) , the difference was statistically significant (χ2 = 4. 887, P= 0. 027 ) . Conclusion Extracorporeal extended field radiotherapy is safe and effective in the treatment of locally advanced cervical cancer.
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Objective To investigate the relationship between prothrombin fragment 1+2 (F1+2) and peripherally inserted central catheter (PICC) associated thrombosis in cervical cancer patients, and provide certain clinical basis of early prevention in peripherally inserted central catheter associated thrombosis in cervical cancer patients. Methods One hundred and forty cervical patients with PICC were enrolled in this study, and they were divided into thrombosis group (35 patients) and non-thrombosis group (105 patients). The level of F1+2 was examined using enzyme-linked immunoassay, and was analyzed according to the clinic features. Results The level of F1+2 was correlated with clinical stage (r = 0.640, P = 0.004);but was not correlated with age, type of tumor and concurrent radiochemotherapy (P>0.05). The level of F1+2 in thrombosis group was (520.343 ± 121.759) pmol/L, in non- thrombosis group was (388.361 ± 104.873) pmol/L, and there was significant difference (P =0.001). The multi-factors Logistic analysis showed that the level of F1+2 (OR=1.011, P=0.001) and age (OR = 21.025, P = 0.031) were independent risk factors for the PICC associated with thrombosis in cervical cancer. Conclusions The level of F1+2 is closely related with clinical stage and PICC associated thrombosis, and it is an independent risk factor for the PICC associated with thrombosis in cervical cancer.
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Circulating cell-free DNA (cfDNA), which is released by normal cells and cancer cells, is defined as extracellular DNA in the blood. The cfDNA levels in breast cancer patients are higher than those in healthy control donors. cfDNA also carries the features of tumor tissue, such as mutations, methylations, copy number changes, and loss of heterozygosis. cfDNA is a potential bio-marker in the diagnosis, management, and prognosis of breast cancer. In this review, the authors briefly describe the biological features of cfDNA, and discuss its clinical utility as a blood biomarker in quantitative and qualitative research.
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The spindle assembly checkpoint ( SAC) is an important monitoring mechanism to monitor the connection between centromeres and microtubules and to ensure proper chromosome separation in human .Mitotic arrest defective protein(Mad)family,as an important part of SAC,plays a crucial role in the process of mitosis. Mutations or altered expressions of Mad may lead to abnormal separations of chromosomes and play a partial role in tumorigenesis ,poor prognosis and chemotherapy drug resistance .
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Objective To evaluate the distribution of pathogens causing bone and joint purulent infections and the bacterial resistance to antibiotics,and to provide reference of clinical antibiotic therapy.Methods A total of 514 patients who had bone and joint purulent infections in Department of Orthopedics of Shangrao People’s Hospital from Jan 2009 to Jun 2013 were retrospectively analyzed. Results 296 strains of Gram-negative bacteria were isolated,the infection rate was 47.2%,among which 296 strains of Escherichia coli were the most common infection pathogen,the infection rate was 15.6%,followed by Acinetobacter baumannii,Pseudomonas aeruginosa,and the infection rates were 11.8%,11.3%.331 strains of Gram-positive bacteria were isolated,the infection rate was 52.8%.Staphylococcus epidermidis,Staphylococcus aureus,were the common infection pathogens,following the infection rates were 21.5%,13.7%.Gram-negative bacteria had the highest sensitivity to imipenem,while Gram-positive bacteria had sensitivity to vancomycin.Conclusion Gram-positive bacteria is the main pathogens with bone and joint purulent infections.Selection of antibiotics according to the drug sensitive test has important clinical significance.
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BACKGROUND: The oriented migration of bone marrow mesenchymal stem cells may depend on the interaction between local chemotactic factors and cellsurface receptors. However, which chemotactic factors may mediate the oriented migration of bone marrow mesenchymal stem cells towards the fracture site remains unclear. OBJECTIVE: To tag autologous bone marrow mesenchymal stem cells, evaluate its role in bone healing, and detect the highly expressed factors associated with migration of bone marrow mesenchymal stem cells in the microenvironment. METHODS: The fluorescence/chimeric C57BL/6 mouse models were established, then left shankbone fracture models were also produced. The percentages of green fluorescent protein positive cells to al cells at the fracture site and the percentage of osteoblasts differentiated from bone marrow mesenchymal stem cells to al the osteoblasts were detected at different time points. The role of bone marrow mesenchymal stem cells in the fracture repairing was evaluated. The levels of chemotactic factors protein expression at the fracture site in different time points were detected with immunohistochemistry technology. RESULTS AND CONCLUSION: The percentage of green fluorescent protein positive cells to al cells at the fracture site was (3.011±0.911)%, (9.031±0.145)%, (12.064±0.145)% at 1, 5, 14 days postoperatively; and osteoblasts differentiated from bone marrow mesenchymal stem cells accounted for 50% of al the osteoblasts. After fracture, the stromal cel derived factor-1, colony stimulating factor, hepatocyte growth factor, monocyte chemoattractant protein-1, and matrix metal oproteinases-9 were expressed to varying degrees in the microenvironment, while the expression of granulocyte colony-stimulating factor was negative. The expression of stromal cel derived factor-1 in the fracture microenvironment was the highest, mainly due to the migration of bone marrow mesenchymal stem cells. Experimental findings indicate that, autologous bone marrow mesenchymal stem cells participate in and play an important role in bone healing. The stromal cel derived factor-1 plays an important role in promoting bone marrow mesenchymal stem cells migration and promoting bone healing.