ObjectiveTo evaluate the safety of breast-conserving surgery for ductal carcrnoma in situ (DCIS).MethodsOne hundred and nineteen patients with pathologically confirmed DCIS were analyzed retrospectively. The relationship among local recurrence and distant metastasis with relevant factors including surgical procedure, age, tumor size, estrogen/progesterone status and human epithelial receptor 2 (HER-2) status were analyzed by univariate and multivariate methods.ResultsIn this study 48 patients received breast conserving surgery,71 patients received mastectomy. All patients were followed up for 7-132 months (median 35 months). Chest wall recurrence was found in mastectomy group in one case and none in ipsilateral breast tumor recurrence (IBTR) in breast conservation group (P =0. 384). Two patients had distant metastasis in mastectomy group, and one patient in breast conserving group ( P =0. 383 ). The three year disease-free survival (DFS) were 100％ and 94. 4％ in breast conserving and mastectomy groups respectively(P =0. 225). Univariate analysis showed that age( ＜40 years)was the risk factor for distant metastasis(P =0. 035) ,a factor not confirmed by multivariate analysis (P =0. 086).ConclusionsThere is no significant difference on local recurrence and distant metastasis between breast conserving surgery and mastectomy for DCIS of the breast.

Objectives To explore the differences in therapeutic efficacy between decitabine combined with low dose HAG(D+ HAG)and CAG in elderly patients with acute myeloid leukemia (AML).Methods Totally 32 elderly patients with AML in our department from July 2012 to July 2015 were retrospectively analyzed.15 patients were on a therapy of decitabine combined with low dose HAG,and 17 patients with CAG.Efficacy and side effects were compared between the two groups.Results In(D+HAG)versus CAG groups,the complete remission(CR)was 10 cases(66.7％)vs.6 cases (35.3 ％),partial remission(PR) was 2 cases (13.3％) vs.1 case(5.9 ％),non-remission(NR) was 3 cases(20％)vs.10 cases(58.8％),and the total efficacy rate(CR+PR)was 80％vs.41.2％ (P＜0.05).The side effects in two groups mainly included bone marrow depression,respiratory tract infection,gastrointestinal reaction,which were all alleviated after symptomatic treatments.The incidence rate of side effects had no statistical difference (P ＞ 0.05).Conclusions The treatment of decitabine combined with low dose of HAG is prior to CAG,and the side effects are all tolerated.So decitabine combined with low dose of HAG can be served as the first-line therapy for elderly AML patients.

Objective:To investigate the associations between the hormone receptors,Ki67 expression and response to neoadjuvant anthracycline-based chemotherapy in breast cancer patients.Methods:One hundred sixty-eight primary breast cancer patients received anthracycline-based neoadjuvant chemotherapy.The expression of estrogen receptor(ER),progesterone receptor(PR),and Ki67 were determined by immunohistochemistry assay in core-needle biopsy specimens prior to the chemotherapy,and pathologic response was assessed by Miller & Payne grade(G1 to G5).Results:40%(67/168)of the patients had a good pathologic response,defined as complete pathologic response(pCR or G5)and minimal residual disease(G4).Among the patients,20%(33/168)had a complete pathologic response(G5).ER or PR status was significantly associated with pathological response.Patients with PR-negative tumors had a higher pathological response rate or pCR than those with PR-positive tumors(17/67 vs 45/90,P=0.002;6/67 vs 25/90,P=0.003,respectively),whereas patients with ER-negative tumors had a higher pathological response rate than those with ER-positive tumors.Moreover,Patients with both ER-and PR-negative tumors exhibited a remarkable pathological response as compared with those with any single factor(36/17 vs 26/86,P=0.009).No association between Ki67 expression and pathological was found in this cohort of patients.There was a linear correlation between the expression of Ki-67,ER or PR status and pathologic response.Conclusion:There is a significant association between the hormone receptors and pathological response to neoadjvant anthracycline-based chemotherapy in breast cancer patients,and patients with PR-negative tumors are more likely to respond to chemotherapy.

ObjectiveTo investigate the family history of other cancers in Chinese han women with familial or sporadic breast cancer.Methodswe analyzed the clinical date of 4 847 primary breast cancer patients cancer patients were treated at the Breast Cancer,Peking University Cancer Hospital between October 2003 and February 2011,among them,465 were familial and4 382 were sporadic breast cancer patients.The differences of family history of cancers other than breast or ovarian cancers were compared between the patients with familial breast cancer and sporadic breast cancer.Results The proportion of cancers other than breast or ovarian cancers in familial breast cancer patients was significantly higher than that in sporadic breast cancer patients(29.7％ vs 20.8％,odds ratio 1.61,P＜ 0.001).Furthermore,the proportion in pancreatic cancer,prostate cancer,and renal cancer in familial breast cancer patients was significantly higher than that of sporadic breast cancer patients ( pancreatic cancer:2.2％ vs 0.8％,P =0.002 ; prostate cancer:1.5％ vs 0.3％,P ＜ 0.001 ; renal cancer:1.1％ vs 0.4％,P =0.03,respectively).And the relative risks of pancreatic cancer,prostate cancer,and renal cancer in the familial breast cancer patients were 2.90-fold,6.07-fold,and 2.97-fold higher than that of sporadic breast cancerpatients,respectively.ConclusionsOur results suggest that the relative risk of cancer other than breast or ovarian in familial breast cancer patients is significantly higher than that in sporadic breast cancer patients,especially pancreatic cancer,prostate cancer,and renal cancer.

Objective: To investigate the correlation of MDM2 SNP309 polymorphism with breast cancer risk in Chinese women. Methods: The polymorphism of MDM2 SNP309 was detected by PCR-restriction frag-ment length polymorphisms assay (PCR-RFLP) in 698 women with primary breast cancer and 525 healthy controls. Results: Compared with the T/T genotype, the G allele (T/G or G/G) was not associated with an in-creased risk of breast cancer in the entire population studied (T/G, adjusted OR=1.2, 95% CI: 0.8-1.6, P=0.30; G/G, adjusted OR=1.0, 95% CI: 0.7 ～ 1.5, P=0.88). Among postmenopausal women, the G allele (T/G or G/G) was significantly associated with an increased risk of breast cancer (T/G, adjusted OR=1.8, 95% CI:1.2～3.0, P=0.011; G/G, adjusted OR=1.9, 95% CI: 1.2～3.3, P=0.014). But this association was not ob-served among premenopausal women. Conclusion: MDM2 SNP309 heterozygous T/G genotype and homozy-gous mutant GIG genotype increase breast cancer risk in postmenopausal Chinese women.

Objective To evaluate the clinical significance of sentinel lymph nodes biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy. Methods SLNB was performed in sixty primary breast cancer patients after neoadjuvant chemotherapy using a combination of 99mTc- Rituximab and patent blue. SLN was examined by routine pathologic examination and immunohistochemistry. Routine axillary lymph node resection was performed after SLNB. Results The successful rate of SLNB was 95% (57/60). Twenty-three cases of SLN (40% ) were metastasis positive, including 18 positive cases detected by HE staining and 5 by immunohistochemistry. SLN was the only metastasis lymph nodes in 14 out of 23 cases. One case was of false negative metastasis by SLN. The sensitivity and accuracy of SLNB were 96% (23/24) and 98% (56/57), respectively. The specificity was 100% (33/33) , the false negative rate was 4. 3% (1/23) with the negative predictive value being 97% (36/37). The positive predictive value was 100% (24/24). Internal mammary sentinel lymph node lymphoscintigraphy were positive in 11 cases but all the cases were negative in metastases by pathologic examination. Conclusion The combination of isotope imaging agent and patent blue is suitable for primary breast carcinoma after neoadjuvant chemotherapy. Internal mammary sentinel lymph node biopsy is less clinically important.

Human bocavirus (HBoV) is a recently discovered parvovirus, which is suspected to be an etiologic agent of respiratory disease and gastrointestinal disease in human. In the present study, we screened 941 nasopharyngeal aspirates collected from hospitalized children with lower respiratory tract infections from October 9, 2007 to March 20, 2009 in the Children's Hospital of Hubei Province. Our results showed that 33 of 941 samples (3.51%) were detected positive for HBoV. To obtain a full-length HBoV clone, three segments which covered the nearly full-length genome were amplified by PCR from HBoV positive samples separately and cloned into pBluescript SK II vector, and the resulting plasmid was designated as pWHL-1 (GenBank Acession No. GU139423). We constructed the both EGFP and luciferase reporter gene vectors under the control of the HBoV unique promoter, respectively. Our data demonstrated that the HBoV promoter exhibited very high activity in all mammalian cells tested by fluorescent microscopy observation of the EGFP and luciferase activity assay and its strength was 4-5 fold higher compared to that of the CMV promoter. This work provided an excellent tool for further study of the mechanism of transcription and expression of the viral genome.
Base Sequence ; Child, Preschool ; Cloning, Molecular ; Female ; Genome, Viral ; genetics ; Human bocavirus ; genetics ; isolation & purification ; Humans ; Infant ; Male ; Molecular Sequence Data ; Pneumonia ; virology ; Promoter Regions, Genetic ; genetics ; Sequence Analysis, DNA

Objective To study the effect of adjuvant chemotherapy on the survival of patients with ER ≥ 50％,HER2 negative,lymph node negative breast cancer.Methods 428 patients from Jan 1,2004 to Dec 31,2010 were enrolled.All patients received operation plus chemoendocrine therapy (CET,n =239) or endocrine therapy (ET,n =189).Result The median follow-up time was 76.5 months,with 8.2％ loss to follow-up.The recurrence-free survival (RFS) was 93.7％ in CET group and 95.2％ in ET group,the distant disease-free survival (DDFS) was 94.6％ and 97.4％ in CET and ET group respectively.Multivariate regression indicated that the risk of tumor size ＞ 2 cm was higher than that of tumor size ≤2 cm in recurrence (HR=2.31,95％ CI 1.07-5.29,P =0.047) and metastasis (HR=4.71,95％ CI 1.47-11.85,P =0.01).Compared with CET group,however,no statistical significance was found on RFS (HR =1.08,95 ％ CI 0.46-2.57,P =0.86) and DDFS (HR =0.72,95 ％ CI 0.17-1.37,P =0.55) in ET group.Conclusions Adjuvant chemotherapy cannot improve the RFS and DDFS of ER≥50％,HER2 negative,lymph node negative breast cancer.Tumor size ＞ 2 cm was the risk factor of recurrence and distant metastasis.

Objective: To explore the application value of pedicled thoracodorsal artery perforator flap in immediate partial breast reconstruction for breast cancer. Methods: This study is a prospective case series studies. Totally 128 cases of primary breast cancer patients who prepared to receive the breast-conserving surgery combine with immediate partial breast reconstruction of pedicled thoracodorsalartery perforator flap were enrolled in Breast Cancer Prevention and Treatment Center of Peking University Cancer Hospital from June 2013 to March 2016. Finally, the operations had been completed successfully in 33 eligible cases. All patients were female with a median age of 40 years (ranging from 22 to 52 years). The perforator vessel location, the donor area design, the post-operative complications, the influence of radiation and chemotherapy had been evaluated. Results: The average diameter of thoracic dorsal artery perforators measured by Doppler ultrasound before the operation was (1.5±0.4) mm (ranging from 0.6 to 2.7 mm). The average size of flaps was 15 cm×6 cm. The average time of operations was (271±72) minutes (ranging from 120 to 245 minutes). Drainage tube removed on (4.7±2.1) days after operation (ranging from 3 to 12 days). All patients received follow-up, and there was no local recurrence and distant metastasis during a median follow-up of 17(12) months (M(Q_R)) (ranging from 5 to 38 months). All TDAP flaps were survival, the wound complication rates was 6% (2/33). Conclusions The breast reconstruction of pedicled thoracodorsal artery perforator flap is a good choice of repairing local breast defect of breast conserving surgery.Its advantages are no-influence of latissimus dorsi function and little complications in donor area.

Objective To explore the diagnostic value of ultrasound guided core needle biopsy (CNB) and vacuum assisted biopsy (VAB) in minor breast lesions with diameter 0.6 to 1.0 cm.Methods Totally 7 730 cases of breast lesions examined by ultrasound guided minimally invasive biopsy were enrolled in Breast Cancer Prevention and Treatment Center of Peking University Cancer Hospital from April 2014 to May 2016.254 lesions with maximum diameter 0.6 to 1.0 cm in 243 cases were analysed retrospectively (232 unilateral &11 bilateral) and divided into group CNB(152 lesions) and group VAB (102 lesions).The accuracy of pathological diagnosis and the rate of breast conserving surgery were compared between the two groups.Results There were 94 non-malignant and 58 malignant breast lesions as initially diagnosed by CNB.Among those 94 tentative non-malignant lesions,33 underwent open surgical biopsy and 4 malignancies were finally established by pathology.In group CNB,the sensitivity was 93.4％,the specific was 100％,the accuracy was 97.4％.There were 91 non-malignant and 11 malignant lesions as initially diagnosed by VAB.In those with established malignant disease,the rate of breast conserving surgery between group CNB and group VAB was statistically different (62.9％ vs.27.3％,P =0.045).Conclusions Ultrasound guided core needle biopsy and vacuum assisted biopsy are with high accuracy for small breast lesions.The rate of breast conserving surgery for breast cancer is higher in group CNB patients by the different type of minimally invasive biopsy.