1.Catheter fracture of implantable central venous access port: its prevention and management
Yanshou ZHANG ; Lei LIU ; Cuizhi GENG ; Zhenchuan SONG ; Yunjiang LIU
Journal of Interventional Radiology 2017;26(8):702-704
Objective To discuss the prevention and treatment of catheter fracture of implantable venous access port (IVAP).Methods A total of 878 adult patients,who received IVAP during the period from January 2012 to December 2012 in a single medical center,were collected.Among the 878 patients,catheter fracture occurred in 7 patients.The clinical data of the 7 patients were retrospectively analyzed.By referring to the related literature,the causes and the prevention measures for catheter fracture were discussed.Results As of November 31,2016,the catheter fracture rate of IVAP,which was implanted via internal jugular vein (IJV),was 0.8% (7/878).The fracture occurrence time was 855-1412 days after implantation of IVAP,with a mean of 1133 days.The common fracture sites were catheter-IJV junction,catheter-IVAP base joint,and subcutaneous tunnel segment.Conclusion Catheter fracture is one of the serious complications which occur in the course of long-period use of IVAP after its implantation.Standardization of operative procedure,strengthening of the maintenance and nursing education,timely removal of IVAP,and other necessary measures can help reduce the incidence of IVAP catheter fracture and ensure the safety of patients.
2.Primary breast diffuse large B cell lymphoma:a case study on the treatment of recurrence
Chen HUANG ; Lihong LIU ; Yuhuan GAO ; Chun HAN ; Yueping LIU ; Qingrui LIU ; Cuizhi GENG
Chinese Journal of Clinical Oncology 2013;(22):1404-1407
Primary breast lymphoma (PBL) is a kind of rare primary extranodal lymphoma, which is of relatively poor prognosis and so far there is no unified treatment. In the case diagnosed by Our hospital where one patient recurring breast diffuse large B cell lymphoma (DLBCL) many times, has been treated with good therapeutic effect through surgery, chemotherapy, targeted drug therapy and radiotherapy. A multidisciplinary discussion is made concerning the treatment of the patient in this article for the purpose of further discussing the standard treatment procedure for PBL and promoting multi-disciplinary team.
3.The prevalence of breast cancer in parts of China
Liyuan LIU ; Jinhai TANG ; Jin ZHANG ; Cuizhi GENG ; Cunxian JIA ; Zhigang YU
Cancer Research and Clinic 2010;22(3):206-207
Objective To learn about the incidence and epidemiological characteristics of breast cancer in parts of China by a survey of women's breast health. Methods Multi-stage stratified randomized cluster sampling of the cross-sectional study was applied in collecting data of women aged 25 to 70 in Shandong, Hebei, Jiangsu and Tianjin province. All subjects included in the investigation attended face-toface interviews and clinical breast examinations. Results 122 058 females aged 25-70 years old in three provinces and Tianjin metropolitan were included. 320 (58 incident cases) breast cancer cases were documented in this investigation, that is 262.2/105 in prevalence. There was a higher breast cancer prevalence in subjects aged 45 to 54 and aged 55 to 64 within one year. The standardized detection rate of 54.2/105 in rural areas was higher than urban areas' 45.3/105. Conclusion Carring out the screening of female breast cancer and popularizing the knowledge of breast cancer prevention consistently, which could improve the detected rate of breast cancer.
4.Correlation of Bcl-2 polymorphism with clinical biological behaviors of breast cancer
Yang BAI ; Dianlu DAI ; Guoming MA ; Guilan WANG ; Meixiang SANG ; Xiaoling WANG ; Cuizhi GENG
Tumor 2010;(1):48-52
Objective:To study the correlation of C(-938)A single nucleotide polymorphism (SNP) in the promoter of anti-apoptosis gene Bcl-2 with the clinical biological parameters of breast cancer patients in Hebei Province. Methods:Three genotypes(AA, AC, CC) of Bcl-2 C(-938)A from 113 samples of breast cancer patients were analyzed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, and the results were associated with clinical biological parameters. The distribution of genotype frequency was compared between different groups. Results:When stratified for axillary lymph node metastases, the frequency of AA genotype were 26.8%, 47.8% and 52.6% and the distribution of AC+CC genotypes were 73.2%, 52.2% and 47.4% in negative group, 1-3 metastasis group, and ≥4 metastasis group. The difference between the two groups was significant (χ~2=6.337, P=0.042). Compared with the AC+CC genotypes, the OR value of AA genotype in ≥4 metastasis group was 3.041 (95%CI=1.072-8.626). The frequency of AA genotype were 30.9% and 69.1% in gradeⅠ-Ⅱ group and grade Ⅲ group, and the frequency of AC+CC genotypes were 57.9% and 42.1%. The difference between the two groups was significant (χ~2=5.055; P=0.025). Compared with the AC+CC genotypes, the OR value of AA genotype in differentiated tumors(grade Ⅲ)was 3.082 (95%CI=1.122-8.465). Stratified for estrogen receptor (ER), progesterone receptor (PR) and C-erbB2, there was no difference between the distribution of AA genotype and AC+CC genotypes (χ~2=3.005, χ~2=1.504, χ~2=1.163, P>0.05). Conclusion:The AA genotype of Bcl-2 gene C(-938)A maybe correlated with high lymph node metastasis rate and poor differentiation.
5.Analysis of clinicopathological characteristics and prognosis of in-vasive micropapillary carcinoma of the breast
Yueping LIU ; Yan DING ; Meng YUE ; Fang LI ; Li MA ; Cuizhi GENG
Chinese Journal of Clinical Oncology 2015;42(22):1085-1089
Objective:To investigate the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods:Data of 65 IMPC cases obtained from the Fourth Hospital of Hebei Medical University between Janu-ary 2009 and December 2011 were retrospectively analyzed. The expression of epithelial membrane antigen (EMA) was evaluated us-ing immunohistochemistry (IHC) to detect the micropapillary component in the tumor. The patients were divided into 4 groups based on the percentage of micropapillary component:≤10%, 11%-30%, 31%-50%, and>50%. Expressions of estrogen receptor (ER), pro-gesterone receptor (PR), and HER-2 were analyzed by IHC. Kaplan-Meier method, Log rank test, and multivariate Cox proportional hazard model were used to determine the factors affecting post-treatment survival. Results:Of the 65 cases, 12 were simple IMPC, 46 were IMPC with invasive ductal carcinoma, and 7 were other invasive carcinoma cases. The≤10%, 11%-30%, 31%-50%, and>50%micropapillary component groups comprised 7.69%(5/65), 44.62%(29/65), 26.15%(17/65), and 21.54%(14/65) of the total cases, re-spectively. Statistically significant differences were found in the four groups (P<0.01). IHC results showed that the positive rates of ER, PR, and HER-2 in the IMPC tissues were 76.92%(50/65), 67.69%(44/65), and 24.62%(16/65), respectively. Statistical differences ex-isted among the groups (P<0.05). Kaplan-Meier method indicated that positive rate of lymph node metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 significantly affect survival time of IMPC cases (P<0.05). Conclusion:Positive rate of nodal metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 are correlated with the prognosis of IMPC.
6.Expressions of steroid sulfatase in breast cancer tissues and normal breast tissues and its significance
Zhisong FAN ; Hui ZHANG ; Wei LIU ; Zhonglin FAN ; Yudong WANG ; Yong CHEN ; Cuizhi GENG ; Haiping LI ; Yunjiang LIU ; Yueping LIU ; Xiaoling WANG
Tumor 2010;(1):62-67
Objective:To investigate the mRNA and protein expressions of steroid sulfatase (STS) in breast cancer tissues and normal breast tissues, and analyze its relationship with clinicopathologic characteristics. Methods:The mRNA and protein expressions of STS, in 40 cases of breast cancer tissues and corresponding paracancerous normal breast tissues, were examined by reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry. The correlation of STS expression level with clinicopathologic characteristics was analyzed. Results:STS protein was mainly expressed in the cytoplasm of breast carcinoma cells and epithelial cells in normal breast glands, but not in the stroma. It could be detected in the nucleus of carcinoma cells in 3 cases of breast cancer tissues, which was pathologically classified as invasive ductal carcinoma, invasive lobular carcinoma, and invasive micropapillary carcinoma. STS was not observed in interstitial tissues of breast glands. STS protein expression had positive correlation with its mRNA expressing level. The positivity of STS was 70.0% in breast cancer tissues, significantly higher than that of normal breast tissues (42.5%). The difference was significant (P =0.013). Stratified analysis showed that the positive rates of STS protein were significantly higher in premenopausal patients, the patients with lymph node metastasis, and those with advanced breast carcinoma than those in the matched normal breast tissues (P<0.05). Conclusion:Breast cancer tissues highly expressed STS protein to stimulate local estrogen production, thereby enhancing the progression and migration of breast cancer cells. In addition, as the tumor growth, locally biosynthesized estrogens may play more and more important roles.
7. Correlation between extranodal invasion in axillary lymph node metastasis and prognosis of breast cancer patients
Lingling ZHANG ; Li MA ; Cuizhi GENG ; Ying JIA ; Xiaoling WANG ; Yueping LIU
Chinese Journal of Pathology 2017;46(8):525-529
Objective:
To investigate the significance of extranodal extension of axillary lymph nodes (ALN-ENE) metastases in post-operative primary invasive breast carcinoma of non-specific type.
Methods:
Six hundred and thirty-eight invasive breast cancer cases confirmed by postoperative pathological examination were collected from January 2006 to December 2008. The relationship of lymph node metastases and ALN-ENE with other lymph node parameters and patient outcome was analyzed.
Results:
Among 638 cases, 263 (41.2%) showed axillary lymph node metastases. ALN-ENE was present in 91 cases (36.4%). The rate of ALN-ENE increased with pT stage and tumor size. Five-year recurrence-free survival rate (RFS) and 5-year overall survival rate (OS) was 86.6% and 91.2% respectively for ALN-ENE positive group, and both were lower than ALN-ENE negative group (
8.Clinicopathological characteristics and risk factors of female breast hyperplasia in different age groups
Fei WANG ; Shuohao SHEN ; Liyuan LIU ; Qi WANG ; Hongchuan JIANG ; Lisong TENG ; Zhimin FAN ; Cuizhi GENG ; Feng JIN ; Lili TANG ; Jianguo ZHANG ; Xiang WANG ; Shu WANG ; Xuening DUAN ; Lixiang YU ; Fei ZHOU ; Yujuan XIANG ; Shuya HUANG ; Chao ZHENG ; Qinye FU ; Dezong GAO ; Liang LI ; Zhongbing MA ; Qiang ZHANG ; Zhigang YU
Chinese Journal of General Surgery 2019;34(3):235-239
Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (< 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3% vs.42.7%,P < 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9% vs.61.7%,P <0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4% vs.4.2%,P < 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.
9.Clinical application of totally implantable central venous port.
Yuqiao SUN ; Tao ZHOU ; Yuntao LI ; Jianxin WANG ; Junqin JIAO ; Haoqi WANG ; Cuizhi GENG
Chinese Journal of Surgery 2014;52(8):608-611
OBJECTIVETo summarize the disposal methods and the reasons of complications in operation of totally implantable central venous port (TICVP).
METHODSA total of 2 007 patients were enrolled in this observational, single-center study between December 2008 and March 2013. TICVP implantation was performed with one small skin incision and subcutaneous puncture of subclavian or jugular vein. Patient's profiles, indications of port system, early and delayed complications, and disposal methods were evaluated. There were 38 male and 1 969 female patients, aged from 21 to 85 years, with a mean of 47.6 years.
RESULTSThe mean duration of the TICVP system was (242 ± 12) days, ranging from 9 to 1 243 days. The achievement rate of puncture in the right jugular vein (99.76%) was the highest. Sonographic approach using the internal jugular vein were better than the external landmark-guided technique (99.80% vs. 96.34%, χ² = 29.905, P = 0.000). The rate of immediate complication was 0.80%, which included pneumothorax, hemothorax, lymphatic fistula and thrombosis. Early complications rate was 0.10%, which included pocket hematoma, catheter migration, venous thrombosis, port pocket infection, fibrin sheath formation. Late complications rate was 7.87%, which included catheter fracture, pinch-off syndrome, catheter-related bloodstream infection, fibrin sheath formation, catheter migration, extravasation, port inversion and port reveal. The rate of removal due to complications was 1.34% (27/2 007), and the early complication was higher (χ² = 8.053, P = 0.011).
CONCLUSIONSThe low incidence of complications suggests that TICVP is safe and reliable for long term intermittent venous access. The results support the use of TICVP in the oncology patients and patients requiring long-term intravenous therapy.
Adult ; Aged ; Aged, 80 and over ; Catheterization, Peripheral ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostheses and Implants ; Retrospective Studies ; Young Adult
10. Clinical analysis of 382 immediately breast reconstruction after mastectomy in Beijing City, Tianjin City and Hebei Province from 2012 to 2016
Chao ZHANG ; Haihui SUN ; Jie LI ; Hongchuan JIANG ; Shan GUAN ; Xiang WANG ; Bing WEN ; Tao OUYANG ; Xiru LI ; Cuizhi GENG ; Jian YIN
Chinese Journal of Surgery 2020;58(2):105-109
Objective:
To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province.
Methods:
A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ2 test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ2 test.
Results:
There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ2=47.028,