Objective This study focuses on different characteristics of different clinical subtypes breast cancer with local-regional recurrence after breast cancer operation,in order to give different treatments according to different clinical subtypes.Methods From 2007.1 to 2005.2,477 female patients with loco-regional recurrence of breast cancer in Tianjin cancer hospital were analyzed retrospectively,which was divided into luminal A type,luminal B type,HER-2(+)-type,basal-like type by immunohistochemical method.The subtypes were analyzed associated with local recurrence.Results In 477 cases of recurrence,recurrence rate within 1 year is 26.2%,recurrence rate within 2 years is 61.2%,recurrence rate after 2 years is 38.8%.In accordance with clinical types,luminal A type includes 63 cases,luminal B type includes 67 cases,HER-2(+)-type includes 110 cases,basal-like type includes 237cases,there is significantly difference among the 4 subtypes of recurrent rate within and after 2 years(P＜0.01).There are 310 cases metastasized after local recurrence,accounting for 65.0%.Metastasis rate after local recurrence is 28.6% in luminal A type,40.3% in luminal B type,60.9% in HER-2(+)type,83.5% in basal-like type.There is significantly difference of the metastasis rate after recurrence among the 4 subtypes clinical subtypes(P＜0.01).There is significantly difference in simple bone metastasis group(P＜0.01),There is no significantly difference among different groups of simple lung metastasis,liver metastasis and multiple-site metastasis(P＞0.05).Difference of disease progression time among different clinical subtypes is statistically significant(P＜0.05).5-year total survival rate after recurrence is 48.4%,5-year survival rate of luminal A type is 68.3%,luminal B type is 62.7%,HER-2(+)-type is 49.1%,basal-like type is 38.8%,There is significantly difference of the survival rate among different clinical subtypes(P＜0.01).Conclusion Among the recurrence cases,most of them happen in 2 years after breast cancer operation.Basal-like type breast cancer is the easiest one to relapse,which the metastasis rate after recurrence is the highest one,disease progression time is the shortest and survival rate is the lowest,HER-2(+)-type followed.Recurrence rate of luminal B type is lower,which the metastasis rate after recurrence is lower,disease progression time is longer and the survival rate is higher.Recurrence rate of luminal A type is the lowest one,which the metastasis rate after recurrence is the lowest one,disease progression time is the longest and the survival rate is the highest.Luminal B type is more likely to metastasize to the bone.

Objective To investigate the clinical significance of serous angiopoietin-2(Ang-2)in hepatocellular carcinoma(HCC)and the feasibility of using it as a diagnostic indicator.Method The serous Ang-2 level in 30 hepatocellular carcinoma patients,10 cirrhosis patients as well as 10 health controls was detected with enzyme linked immunosorbent assay(ELISA).Result The Ang-2 level of cirrhosis group(1244.21±14.65)μg/L was higher than that of control group(943.01±12.52)μg/L,while the level of HCC group(1892.54±482.82)μg/L was higher than that of both cirrhosis group and control group;HCC group had higher level of AFP(4397.61±613.82)μg/L,CA199(64.88±10.71)U/mL,FERR(401.53±51.32)μg/L and CEA(4.69±1.00)μg/L than that of control group(P＜0.05);the patients of HCC group complicated with cirrhosis also had higher level of Ang-2(2045.41±155.31)μg/L,AFP(5097.17±2830.22)μg/L,CA199(67.53±9.35)U/mL,FERR(462.87±56.79)μg/L and CEA(5.41±2.25)μg/L than those without cirrhosis(P＜0.05).Conclusion The elevated Ang-2 is relevant to the pathogenesis and advancement of HCC,while serous Ang-2 is a promising candidate tumor marker for the diagnosis of HCC.

Objective The aim of this research is to diagnose and analyze the metastasis of mediastinal lymph nodes of non-small cell lung cancer(NSCLC)through the method of visual observation,measurement and the computer pattern recognition;then compared with the pathological diagnosis results,explored the diagnostic efficiency of every method,Which can provide more accuracy information about N staging of NSCLC for the clinicians.Methods 28 cases of preoperative whole body PET/CT imaging with pathological-proven NSCLC were included in the study.Three practised doctors read the lymph nodes images of CT,PET and PET/CT through the method of visual observation and measurement,then compared with the pathological diagnosis.To analyze the lymph node images which were extracted through the new computer pattern recognition of engineering.Results Among CT,PET and PET/CT,the sensibility of mediastinal lymph node involvement was 53.6%,80.4% and 82.1% respectively,the specificity was 92.2%,83.3% and 90.6% respectively,the positive predictive value was 68.2%,60% and 73.0% respectively,the negative predictive value was 86.5%,93.2% and 94.2% respectively and the diagnosis coincidence rate was 83.1%,82.6% and 88.6% respectively;For the method of visual observation,the sensibility of mediastinal lymph node involvement was 53.6%,71.4% and 69.6% respectively,the specificity was 85.0%,82.2% and 88.9% respectively,the positive predictive value was 52.6%,55.6% and 66.7% respectively,the negative predictive value was 85.5%,90.2% and 90.4% respectively and the diagnosis coincidence rate was 77.5%,79.7% and 84.3% respectively.For the computer pattern recognition,the sensibility of PET and CT imaging were 88% and 84% separately,and the specificity was 76% and 66% separately.Conclusion The method of visual observation and measurement of PET/CT imaging for diagnosing the metastasis of mediastinal lymph nodes in patients with non-small cell lung cancer was advantage over the CT and PET imaging.And the method of measurement was advantage over the method of visual observation.This research preliminary explore the engineering method of SVM and multi-resolution histogram to analyze the image of lymph node,and settle a basis for the further combination of multiple subjects.

Objective To study the expression of Bcl-2 protein in locally advanced non-small cell lung cancer(LANSCLC),and to evaluate its relationship with radiosensitivity and prognosis.Methods We analysed data from 88 patients with inoperable locally advanced non-small cell lung cancer from 2002 to 2006 in our hospital.The expression of Bcl-2 was detected by immunohistochemical method in resected tissue specimens gained by fibre branchoscopy test or CT-guide percutaneous lung puncture biopsy.The patients were divided into chemoradiotherapy squamous cell carcinoma group(CRSG),chemoradiotherapy adenocarcinoma group(CRAG)and radiothe rapy squamous cell carcinoma group(RSG),and then each group were divided into expression of Bcl-2 negative group and positive group,and to evaluate the short-term efficacy of radiation therapy,without recurrence survival time(RFS),overall survival(OS),1,2,3-year survival rate.Results The positive expression rate of CRSG,CRAG and RSG were 20.9%(9/43),30.8%(8/26)and 26.3%(5/19)respectively.The short-term radiation therapy efficacy of Bcl-2 positive expression groups of CRSG and CRAG were lower than that of the negative expression groups,the radiation therapy RFS of Bcl-2 positive groups of CRAG and RSG were lower than that of the negative expression groups,the radiation therapy OS of Bcl-2 positive group of CRAG were lower than that of the negative expression group.Bcl-2 positive and groups of CRSG,CRAG and RSG ′s median survival time respectively were 13,12 and 12 months;while negative groups were 26 months,23.5 months,14 months.The variance of 1,2,3-year survival rates of CRAG were significantly(P=0.0047).Conclusion The data show that the expression of Bcl-2 in LANSCLC as anegative factor of RFS maybe associate with the radiotherapy.The findings might suggest that there were negative correlation between expression of Bcl-2 and the prognosis of LANSCLC.Bcl-2 inhibitors may have great efficacy in the radiotherapy of NSCLC.

Objective To investigate the clinical and pathologic characteristics of younger patients with primary colorectal cancer in China and American treatment centers.Methods A retrospective study was undertaken.Data was collected from 107 patients in abdominal surgery of Fujian Tumor Hospital in China from 2004 to 2008 and 52 patients in general surgery of Cleveland Clinic Florida USA from 2002 to 2006.All the patients with colorectal cancer(CRC)were diagnosed by surgery and histology.Results By comparing younger patients with primary colorectal cancer in Fujian Tumor Hospital in China and Cleveland Clinic Florida USA,we had the following results:in terms of gender,the proportion of males of younger patients with primary colorectal cancer in the Chinese Hospital was 51.4%vs.55.8%in the American Hospital(χ²=0.268,P=0.605＞0.01).In terms of tumor location:17.8% of younger patients in the Chinese Hospital had lesions in the proximal colon,23.1% of younger Caucasian patients in the American Hospital had lesions in the same location;82.2% vs.76.9% had cancers located on distal colorectum(χ²=0.631,P=0.427＞0.01).In terms of age,the average age was 34.55±4.39year in the Chinese Hospital vs.33.60±6.67 year in the American Hospital(t=-0.940,P=0.350＞0.01).In terms of pathology,the proportion of tubular adenocarcinoma in the Chinese Hospital was 77.6% vs.85.1% in the American Hospital,the proportion of mucinous adenocarcinoma was 16.8% vs.10.6%(χ²=1.056,P=0.304＞0.01),the proportion of signet-ring cell carcinoma was 3.7% vs.0%,the proportion of carcinoid was 1.9% vs.2.1%,the proportion of adenosquamous carcinoma was 0%vs.2.1%.In terms of pathological differentiation of tumor,12.4% in the Chinese Hospital vs.8.9% in the American Hospital were highly differentiated adenocarcinoma,76.2% vs.77.8% moderately differentiated,11.4% vs.13.3% poorly diferentiated(Z=-0.624,P=0.532＞0.01).In terms of staging,11.2% in the Chinese Hospital vs.22.7% in the American Hospital were stage I,29.0% vs.45.5% were stageⅡ,53.3% vs.25% were stageⅢ,6.5% vs.6.8% were stageⅣ.(Z=-2.846,P=0.004＜0.01).The different pathological staging distribution of younger patients with primary colorectal cancer in the two treatment centers had statistical significance.Conclusion Although the two treatment centers had no diference in age,sex,anatomical resolution,pathologic characteristics and differenciation,proportion of the Chinese Hospital was more than that of the American Hospital in stageⅢ.In other words,prognosis of younger patients with primary colorectal cancer in the Chinese Hospital may was worse than those in the American Hospital.

Objective To explore the expression of AEG-1 in cervical cancer and the relationship with clinicopathological characteristics.Methods The expression of AEG-1 was detected by immunohistochemisty S-P method in 21 cases of normal cervical specimens,36 cases of squamous carcinoma of the cervix,18 cases of adenocarcinoma of the uterine cervix and 30 cases of CIN.The correlation between immunohistochemical results and clinicopathological characteristics were analyzed by SPSS software.Results The positive expression ratios of AEG-1 in squamous carcinoma of the cervix and adenocarcinoma of the uterine cervix were 69.4% and 72.2% respectively,which were significantly higher than those in CIN(40%)and normal cervical tissue(0%).There was a strong correlation between AEG-1 expression and clinical staging,lymph nodes metastasis,tumor sizes,vessel invasion and lamina muscularis invasion(P＜0.05),whereas it was not associated with histological differentiation,histological classification and age(P＞0.05).Conclusion The upregulation of AEG-1 may play an important role in the development and pothogensis of cervical cancer.The overexpression of AEG-1 could be a valuable marker to predict the malignant degree and poor prognosis of cervical cancer.

Objective To compare clinical features and results between transperitoneal laparoscopic radical prostatectomy and extraperitoneal laparoscopic radical prostatectomy.Methods 54 prostate cancer patients succeed treated with laparoscopic radical prostatectomy.Among them,39 cases had been done transperitoneally and 15 cases had been done extraperitoneally.The recorded pre-,peri-,and postoperative parameters and complications,and evaluated the oncological and functional results were collected and compared between the two different approaches.Results All the surgeries had completed successfully in 54 patients.For transperitoneal approach and extraperitoneal approach,the operating time was(256±45)min and(263±62)min(P=0.96),blood loss was(335±296)mL and(352±314)mL(P=0.13),positive surgical margin was 15.4% and 13.3%(P=0.61),Incontinence was 23.1% and 20.0%(P=0.61),all showed no significant differences between the 2 groups.Between two groups catheterization time was(14.2±2.7)d and(11.2±3.3)d(P＜0.001),intestinal functional recovery time was(2.8±0.6)d and(2.0±0.7)d(P=0.04),length of hospital stay was(17.2±3.5)d and(12.2±3.7)d(P＜0.001).There were significant differences regarding the postoperative recovery time of the two groups.Conclusions Laparoscopic radical prostatectomy is feasible and safe in clinical practice.Extraperitoneal approach has better vision,less impact on abdominal organs,faster recovery and shorter hospital stay comparing to transperitoneal approach.

Objective To explore the differential diagnostic value by transrectal ultrasound in diagnosing benign and malignant prostatic tubercle,and to increase diagnostic accordance rate of malignant prostatic tubercle.Methods Analysis was done on 65 puncture samples of prostatic tubercle by transrectal ultrasound,which included 15 malignant prostatic tubercles,2 sarcoma tubercles,1 prostatic cyst,2 tuberculosis tubercles,45 benign prostatic tubercles.The characteristics of ultrasonic images of prostatic nodes were analysed by statistics.Results Ultrasonography of malignant tubercle showed low level of echo,low rate of calcification,and destroying of envelope,the vanishing of exocrine gland symmetry.The diagnosis coincidence rate was 84.6%,sensitivity rate was 83.3%,specificity rate was 88.2% both ultrasound multiple alliance index and pathology result.Conclusions The characteristics of ultrasound are most important in diagnosing benign and malignant prostatic tubercle.

Objective To study 30 cases of pulmonary granuloma misdiagnosed as lung cancer.Method To retrospectively analyze cases from 1995 to 2009 that were imageologically misdiagnosed as lung cancer while whose pathology turned out to be pulmonary granuloma,and then to figure out the strategy for misdiagnosis of this kind.Results Most of the cases were solitary nodules,whose diameter varied from 2.0~6.0cm.Irregular mass were observed in 21 cases while round or lump mass in 9 cases.And uneven and partial lower density in the centre of the mass was observed in most cases in plain scan.Even intra-neoplasma enhancement was observed in 16 cases while uneven in the other 14.Clear margin were seldom found in these cases.Conclusion To avoid misdiagnosis,clear differential diagnoses and seriously study on clinical manifestations between imageological findings is necessary,and some other methods of imagiology may be a complementation.

Objective To observe the inhibitory effect of TBA on H22 transplanted tumor in mice.Method H22 tumor bearing mice were used as model.There were 10 in each group.TBA was administered by oral in TBA high(0.50g/kg),middle(0.25g/kg)and low(0.13g/kg)dose group.0.5% sodium carboxymethyl cellulose solution 2mL/10g^-1 was administered by oral in control group.CTX 20mg/kg was injected intragastric in positive control group.The tumor bearing mice were administered once a day at fixed time and continuous administered for 10 days.Then,the tumor were weighted and tumor inhibition rate were observed in each group,the tumor cell morphology was observed by HE staining.Result The average tumor weight reduced in TBA groups,in which TBA 0.250g/kg group compared with the control group,the differences were significant(P＜0.05),the inhibitory rate of TBA 0.50g/kg,0.25g/kg and 0.13g/kg group were 24.83%,45.52% and 15.86% respectively.Conclusion TBA could inhibit H22 tumor growth of tumor bearing mice by oral administration.

Objective To explore the feasibility of applying the vascular endothelial growth factor(VEGF)to predicting and evaluating cervical cancer chemotherapy by investigating the changes of VEGF before and after chemotherapy,so as to guide the rational treatment.Methods Using enzyme-linked immunosorbent assay(ELISA)to detect and compare serum VEGF levels in 60 cases of cervical squamous cell carcinoma and in 20 healthy women.Results Levels of serum VEGF in cervical carcinoma were significantly higher than those of normal healthy women(P＜0.01),and the serum VEGF values of cervical cancer in Stage Ⅰ were lower than those in Stage Ⅱ(P＜0.05).Expressions of serum VEGF in cervical cancer patients significantly increased after surgery compared with that before surgery(P＜0.01),and decreased significantly after postoperative chemotherapy compared with that after surgery(P＜0.01),but the serum VEGF levels in Stage Ⅰ cervical cancer patients after postoperative chemotherapy showed no significant difference compared with that before surgery(P＞0.05),while those in Stage Ⅱa and Ⅱb cervical cancer patients after postoperative chemotherapy were lower than those before surgery(P＜0.05).The expressions of serum VEGF in Stage Ⅱb cervical cancer patients after neoadjuvant chemotherapy(NACT)were lower than those before NACT(P＜0.05).Conclusion VEGF can be used as the reference for forecasting chemotherapy effects in cervical cancer and for determining whether to reinforce chemotherapy and postoperative chemotherapy regimen.