Objective To study the methods and mechenism of surgical treatment of breast cancer with synchronous metastasis.Methods 7 cases of breast cancer patients with synchronous metastasis treated by surgery from Jan.1997 to Dec.2007 in our hospital were analyzed retrospectively and the literature was reviewed.Results The median survival time was 27.4 months for the 7 patients who underwent surgery and 20.0 months for the 157 patients who didn't undergo surgery.Conclusion Surgery can prolong survival time of breat cancer patients with metastasis.

Axillary lymph node status isone of the most important prognostic factors for the patients with breast cancer.Physical examination combining with ultrasound, mammography, CT, MRI and PET-CT can improve the predictive efficiency, but there is still high false negative rate.Ultrasound-guided fine-needle aspiration for axillary lymph node can improve preoperative diagnostic rate effectively.Using mathematical and statistical methods, building models for predicting sentinel lymph node or non-sentinel lymph node status with clinicopathological features helps to calculate the risk of lymph node involvement.Whether screening out patients with low risk of lymph node involvement avoiding axillary surgery is safe or not is still to be evaluated by relevant clinical trials.

Primary hyperparathyroidism (PHPT) is a disorder of calcium metabolism, which is characterized by elevated blood calcium and PTH urine calcium, which is easy to involve multiple systems. The disease is mainly caused by a benign adenoma of parathyroid tissue, a few of which are parathyroid hyperplasia or parathyroid adenocarcinoma. As awareness of physical examination increased, the proportion of asymptomatic PHPT patients gradually increased. The disease can be cured by surgical resection of the parathyroid gland, most of which is a real good prognosis, but a few of them are complex and difficult to diagnose and treat. At present, there continue to be many controversies about the diagnosis and treatment of PHPT.This article is a review of the progress in the diagnosis and treatment of PHPT.

Objective To investigate the differences of clinicopathologic characteristics and prognosis between young and old age patients with rectal cancer. Methods From January 1996 to January 2006, 85 young patients(age≤40 years) and 155 older patients(age≥65 years)with rectal cancer were surgically treated. The clinicopathological and follow-up data of them were retrospectively analyzed and compared by survival analysis and COX regression multivariate analysis. Results Rectal cancer under peritoneal in young group were higher than that in older group (69.41 % vs 52.90 %, P =0.013). The young group had significantly higher frequencies of pooly differentiated carcinoma (31.76 % vs 18.71 %, P =0.023) and more mucinous adenocarcinoma as well as signet-ring cell carcinoma (22.35 % vs 8.39 %, P =0.007), There were more lymphatic metastasis in young group than that in old group (N_1+N_2: 63.53 % vs 47.10 %, P =0.015). The overall 5-year survival rates were 48.2 % and 55.7 % in young and old patients respectively, which was not significantly different (P =0.176). COX regression showed that radical operation, tumor infiltration depth,lymph node metastasis and TNM stage were independent prognostic factors. Conclusion As compared to the old age patients, more malignancy and more advanced stage are common in young patients with rectal cancer.However the efficacy of young patients is similar to the older counters by early detection and radical operation combined radiotherapy as well as chemotherapy.

Objective To compare clinicopathological characteristics and prognosis between triple-negative and HER-2-overexpressed breast cancer patients.Methods From Jan.1997 to Jan.2007,data of 725 cases of primary breast cancer patients undergoing surgical treatment were analyzed.The patients were classified into triple-negative and HER-2-overexpressed phenotypes based on immunohistochemistry results.The clinicopathological characteristics and survival of the 2 groups were compared.Results Of the 725 cases,triple-negative and HER-2-overexpressed phenotypes accounted for 12.29%and 24.96%respectively.Compared with HER-2-overexpressed group,the triple-negative group had significantly higher proportion of familial history of malignancy (18.4% vs 5.5%,P=0.001)and higher proportion of patients'histological grade reaching grade 3(54.0% vs 42.0%,P=0.01).There were more lymph node metastasis in triple-negative group than that in HER-2-overexpression group(N1+N2+N3:74.7%vs 64.6%,P=0.045).The recurrence and metastasis rate within 2 years and brain metastasis rate in triple-negative group were higher than those in HER-2-overexpressed group (25.3%,8.0%vs 8.8%,2.2%,respectively,P<0.05).The 5-year disease-free survival rate in triple-negative group was significantly lower than that in HER-2-overexpressed group(55.6%vs 69.8%,P=0.041).There was no statistical difference between the 2 groups in terms of age,menopausal status,tumor size,pathological stage,surgcal procedure,pathological type,adjuvant radio-chemotherapy,the proportion of metastasis to liver,lung and bone as well as overall survival rate(P>0.05).Conclusion Compared to HER-2-overexpressed group,patients with triple-negative breast cancer show higher rate of familial history of malignancy,and they are associated with higher histological grade and poor prognosis.