Objective:To evaluate the clinical value of ultrasound-guided core-needle biopsy (US-CNB) in the diagnosis of breast lesions under categories 4A to 4C of the second edition of the Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon. Meth-ods:The pathological characteristics of 355 patients with breast masses who underwent US-CNB in the Tianjin Medical University Can-cer Institute and Hospital from March 2015 to October 2015 were retrospectively analyzed. Each patient was subjected to postopera-tive pathological examination to confirm diagnosis. Results:According to the US-CNB results, of the 355 patients, 235 were diagnosed with breast cancer, and 120 had benign lesions. Through postoperative pathological examination, 41 of the patients with benign le-sions were confirmed to have breast cancer. The specificity of the US-CNB was 100%in all the categories of breast masses. The sensibil-ities of breast masses under BI-RADS categories 4A, 4B, and 4C were 62.50%, 82.46%, and 89.73%, respectively. The accuracies of the US-CNB in 4A, 4B, and 4C were 84.62%, 87.01%, and 90.74%, correspondingly. Of the 41 patients with false-negative results, 14 had in-traductal carcinoma, 5 had intraductal papillary carcinoma, 3 had mucinous carcinoma, and 19 had invasive ductal carcinoma. Conclu-sion:US-CNB is a safe, reliable, and accurate early diagnostic method for breast masses under the 4B and 4C categories. However, the sensibility of US-CNB was extremely low in patients with breast masses under the 4A category. Thus, final diagnosis should be accom-plished by combining US-CNB with mammography, MRI, or other testing methods. Meanwhile, US-CNB is not recommended for pa-tients with intraductal papillary neoplasms diagnosed through ultrasonography.

The clinical classification of metastatic spinal tumors is based on the degree of malignancy, nervous system function, osteoclasia, and prognosis of patients. The application of this classification system is relatively simple. The assessment and evaluation of patients to estimate the period of survival can guide the individualized treatment of patients. Patients with clear surgical indications can choose to undergo a palliative operation, tumor resection, or total spondylectomy. Alternatively, other patients can opt to have mini-mally invasive surgery aside from the normal surgical approach. Stereotactic radiotherapy and intensity-modulated radiation therapy combined with the use of radiofrequency ablation, radiation, and other therapies can achieve local tumor control, relieve pain, and main-tain normal neurological function. Thus, the quality of life of the patient is improved. Percutaneous vertebroplasty, radiofrequency abla-tion, spinal endoscopy, and other modern forms of minimally invasive surgery will have more applications in the treatment of spinal metastatic tumors.

The acetylation status of histories regulates access of transcription factors to DNA and influences levels of gene expression.Histone deacetylase(HDAC)activity diminishes acctylation of histones,causing compaction of the DNA-histone complex.This compaction blocks gene transcription and inhibits cell differentiation.HDAC inhibitom decompact the DNA-histone complex and promote cell growth arrest,differentiation,and apoptosis of tumor cells.Meantime,HDAC inhibition also affects acetylation status and function of non-histone proteins.HDAC inhibitors not only possess significant anti-tumor effects with single use,but also has great significance in combined therapy with other drugs.

Runt-related transcription factor 2 (Runx2) is a nuclear transcription factor of PEBP2/CBF superfamilies,and can regulate matrix metalloproteinase (MMP),osteopontin (OPN) and bone sialoprotein (BSP) which are associated with the metastasis of tumors including breast cancer and prostate cancer.In these cancers,the expression of Runx2 is highly up-regulated,which is closely correlated with the cell transformation and tumor progress.Lots of studies have demonstrated that the function of Runx2 is involved in several signal pathways activation,which can promote the early metastasis of malignant tumors.Therefore,the treatment targeting to Runx2 may be a new clinically choice to block the metastasis of tumors in the future.

CD44 has been the subject of extensive research because of its role in cancer and many physiological processes.Through binding to different ligands,CD44 can initiate a series of cascade.CD44 not only can promote tumorigenic and tumor metastasis,but also can suppress tumor growth and progression.In-depth study of CD44 and its role in signal pathway may provide a new path for cancer treatment.

Cancer immunotherapy is a new approach to cancer treatment. Dendritic cells, the most potent antigen-presenting cells found in humans, have attracted a lot of researches. However, dendritic cells are insufficient to cross-present self-antigens in-vivo. To improve the dendritic cells' antigen-presenting capabilities and the anti-tumor effect, in vitro preparation of dendritic cell vaccine and combination with pro-apoptotic treatments such as chemotherapy are being used.

Autophagy is an evolutionarily conserved lysosomal pathway for the degradation of cytoplasmic proteins,macromolecules,and organelles.Now,autophagic cell death is considered as programmed cell death type Ⅱ.In multiple studies,inhibition of autophagy will result in contrasting outcomes-survival or death.Thus,whether autophagy in cancer cells causes death or protects cells is controversial.Taken together,the manipulation of autophagy may lead to development of new cancer therapies.This article focuses on recent progresses of autophagy research related to human cancers therapy.

The Aurora kinase family of serine/threonine kinases plays an important role in chromosome alignment,segregation and cytokinesis during mitosis.Overexpression of Aurora kinases has been observed in a variety of human solid tumors and hematological malignancies.Aberrant expression of Aurora kinase can interrupt the function of the checkpoint in mitosis,lead to instability of genetic substance and induce tumorigenesis.

Epithelial-mesenchymal transition cause primary carcinoma cells to acquire mesenchymal features and re-epithelialize to form a secondary mass at a metastatic site. Such plasticity has implications in the progression of breast carcinoma to metastasis, and will likely influence cancer's response to therapy. The transcriptional and epigenetic regulation that underlie the development of breast cancer and result in characteristic changes in cell behavior can be monitored using an array of marker proteins, providing the potential for emergent prognostic and therapeutic targeting.

There is no difference between breast conserving surgery (BCS) combined with radiotherapy and radical surgery in outcomes.However, comparing with the radical surgery, BCS has little trauma, less bleeding and lower infection rate, which makes patients′ quality of life improved.In the practice of BCS, due to the disease, patients, physicians, socio-economic, clinical, security and many other factors, there are still many controversial issuesin the doctor-patient communication, socio-economic, aesthetic, margins width, precision operation procedures of BCS.At the same time, new surgical techniques such as plastic breast conserving surgery, and new intraoperative assessment equipment such as MarginProbe system and other new technology development has brought us new ideas to solve these problems.