1.Clinical observation of IMRT therapy combined with astragalus polysaccharide injection on cervicoce-rebral tumor treatment
Dandan ZHU ; Daming ZHOU ; Jiujun ZHAO
The Journal of Practical Medicine 2014;(10):1652-1654
Objective To observe the effect of IMRT combined with astragalus polysaccharide (ASP) injection on cervicocerebral tumor,radiation side effects and its influence on immune function. Methods 61 head and neck tumor patients were randomly divided into two groups.One groups received the IMRT combined with Astragalus Polysaccharide (ASP) injection (n=30) while the other group only received the IMRT(n=31). The recent effect, immune function and the side effects of radiotherapy between the 2 groups were observed and compared , changes of T-lymphocyte subsets, natural killer (NK) cell activity and the dermatitis,oral mucosa reaction,thirsty condition on patients in intraoperative or postoperative period were also observed and compared. Results The total effective rate in experimental group and the control group were 83.0% and 80.6% respectively.The cell viability of peripheral blood lymphocyte and NK cell as well as the T3、T4、NK cell value increased in IMRT-ASP group (P<0.05) after treatment. While T3、T4、NK cell value in peripheral blood decreased (P<0.05). Mucosa,dermatitis and salivary gland damage showed in IMRT-ASP group were significantly better than in control group after 3 weeks treatment (P<0.05). Conclusion ASP can improve immune function effect in head and neck tumor patients during RT, and can also eliminate the side effects of radiotherapy.
2.Nonsentinel lymph nodal status in 1-2 sentinel lymph node positive early breast cancer patients
Dechuang JIAO ; Jiujun ZHU ; Jianghua QIAO ; Lina WANG ; Youzhao MA ; Zhenduo LU ; Zhenzhen LIU
Chinese Journal of General Surgery 2018;33(7):571-574
Objective To investigate the nonsentinel lymph nodal (NSLN) status in 1-2 sentinel lymph node positive early breast cancer and to compare with that in Z0011 ALND group.Methods A total of 234 T1,T2 invasive breast cancer with 1-2 positive sentinel lymph nodes were collected in Henan Tumorr Hospital from Jul 2010 to Aug 2014.The data was compared with that of Z0011 ALND group.Results 234 female patients were enrolled.76 cases had non sentinel lymph node metastases.The proportion of 1 and 2 sentinel lymph node metastases was 75.2% and 24.8%,respectively.The number of positive sentinel lymph nodes and that of negative ones were independent predictors of the non sentinel lymph node status (all P < 0.05).Menstrual status,hormone receptor,Ki67 level and HER2 were not associated with nonsentinel lymph node metastasis (all P > 0.05).They had nonsentinel lymph node positive rate (P > 0.05) similar to that of Z0011 ALND group.Conclusious The number of sentinel lymph nodes and negative sentinel lymph nodes were associated with nonsentinel lymph node metastasis in the 1-2 sentinel lymph positive early stage breast cancer.Those patients had similar positive nonsentinel lymph node rate to that of Z0011 ALND group.
3.Impact of molecular subtypes on prognosis of postoperative patients with invasive breast cancer
Dechuang JIAO ; Jiujun ZHU ; Xuhui GUO ; Yue YANG ; Hao DAI ; Yajie ZHAO ; Lianfang LI ; Chengzheng WANG ; Zhenduo LU ; Xiuchun CHEN ; Zhenzhen LIU
Chinese Journal of General Surgery 2022;37(8):573-578
Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.
4.Relationship between pathologically complete response of metastatic supraclavicular lymph nodes and the prognosis of breast cancer patients after neoadjuvant chemotherapy and surgery
Jiujun ZHU ; Dechuang JIAO ; Xuhui GUO ; Jianghua QIAO ; Lina WANG ; Youzhao MA ; Hui XIAO ; Yue YANG ; Zhenduo LU ; Zhenzhen LIU
Chinese Journal of General Surgery 2020;35(5):366-370
Objective:To investigate the correlation between ipsilateral metastatic supraclavicular lymph nodes(ISLN) pathologically complete response (spCR) and the prognosis in breast cancer after neoadjuvant chemotherapy(NAC) and lymphadenectomy.Methods:Clinical data of 234 breast cancer patients with ISLN at the time of diagnosis and receiving supraclavicular lymph node dissection following NAC were retrospectively analyzed.Results:All patients were female, with a median age of 52 years. The spCR rate was 52.6%. Multivariate analysis showed that the expression level of Ki67, the pathological status of breast and axillary nodes and the dissection number of supraclavicular lymph node were independent relate factors for spCR (all P<0.05). After a median follow-up of 16.6 months, the risk of recurrence and metastasis in the spCR group was 51%. It was lower than that in the non-spCR group ( HR=0.49, 95% CI 0.27-0.89, P=0.020). It was mainly manifested in hormone receptor negative patients. Supraclavicular spCR was an independent prognostic factor for DFS. Conclusions:The expression level of Ki67, pathological state of breast and axillary node and the dissection number of supraclavicular lymph node were independent related factors of spCR, which was also an independent predictor of DFS.
5. The influence of lumpectomy on the axillary lymph node status of breast cancer patients
Dechuang JIAO ; Jiujun ZHU ; Jianghua QIAO ; Lina WANG ; Youzhao MA ; Zhenduo LU ; Zhenzhen LIU
Chinese Journal of Oncology 2018;40(4):284-287
Objective:
To investigate the influence of lumpectomy on axillary lymph node status of breast cancer patients.
Methods:
The clinical data of 738 invasive breast cancer patients with non-palpable axillary lymph node and sentinel lymph node (SLN) biopsy from November 2011 to August 2013 in Henan Provincial Cancer Hospital were collected and retrospectively analyzed. Among them, 136 patients underwent preoperative lumpectomy (lumpectomy group) and 602 patients underwent puncture biopsy only (biopsy group). The difference of axillary lymph node status and positive ratio of SLN detected by color Doppler ultrasound were compared between these two groups.
Results:
Among the 738 breast cancer patients, the axillary lymph nodes of 444 (60.2%) cases could be detected by ultrasound. Among them, 92 cases belonged to lumpectomy group, significantly less than 352 cases of biopsy group (