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Chinese Journal of Endocrine Surgery

2007  to  Present  ISSN: 1674-6090

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The role of multidisciplinary teams in diagnosis and treatment of breast cancer

Jin ZHANG ; Xiao CHEN ; Lei LIU

Chinese Journal of Endocrine Surgery.2017;11(5):353-355. doi:10.3760/cma.j.issn.1674-6090.2017.05.001

Breast cancer is a common malignancy in women and is a systemic disease,so the best management of breast cancer patients requires the expertise of experts from different discines,which leads to the emergence of multidisciplinary teams(MDT).MDT members discuss the specific situation of patients,and together make clinical decision in diagnosis and treatment.This is more conducive to the development of individualized treatment programs.

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Recent advances and considerations about robotic thyroidectomy

Qingqing HE ; Xiaolei LI ; Dayong ZHUANG

Chinese Journal of Endocrine Surgery.2017;11(5):356-358. doi:10.3760/cma.j.issn.1674-6090.2017.05.002

Robotic thyroidectomy (RT) system combines the advantages of the surgical robot and remote access thyroidectomy,provides the benefits of excellent three-dimensional visualization,stable operative view and improved surgical dexterity,has been applied in clinical practices for 10 years and proved to have comparable surgical safety and oncological completeness with traditional open operation,and provides smaller surgical injury (psychological and physical injury),better functional protection (including neck function,parathyroid glands and laryngeal nerve),and significantly higher cosmetic satisfaction.There are two mostly common used RT approaches,bilateral axillobreast approach (BABA) and transaxillary approach (TAA).Since surgeons accumulate more experience,the indications of RT have been expanded to differentiated thyroid cancer with tumor size between 2-4 cm with (or without) lateral neck lymph node metastases by far.To date,all related studies are nonrandomized or retrospective comparisons.It's necessary to launch multi-centers randomized studies and long term follow-up to offer higher evidence to boost the future application of RT.

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The value of intravoxel incoherent motion diffusion-weighted MRI in differentiating benign breast lesions from malignant lesions

Xiaojun ZHAO ; Kun LIU ; Xian ZHANG ; Zhihan YAN ; Zhongjie ZHOU

Chinese Journal of Endocrine Surgery.2017;11(5):359-363. doi:10.3760/cma.j.issn.1674-6090.2017.05.003

Objective To study the diagnostic value of intravoxel incoherent motion (IVIM) diffusion-weighted MRI in differentiating benign from malignant breast lesions.Methods 50 female patients with lesions verified by pathology were included in this study,all of them underwent multi-b value (b=0-2000s/mm2) DWI scanning.Tissue diffusivity (D),pseudo-diffusivity (D*),perfusion fraction (f) and apparent diffusion coefficient (ADC) were acquired using IVIM model.The difference of these parameters in benign and malignant breast lesions was analyzed statistically.The diagnostic performance of these parameters was evaluated by ROC analysis.Results In benign lesions,D,D*,f and ADC value was (1.31±-0.47) ×10-3 mm2/s,(26.47±13.81) ×10-3 mm2/s,(17.35±3.78)%,(1.37±0.37)×10-3 mm2/s,respectively.In malignant lesions,D,D*,f and ADC value was(0.95±0.28)×10-3 mm2/s,(24.58±14.62)×10-3 mm2/s,(23.69±4.35)%,(1.03±0.14)×10-3 mm2/s,respectively.There were statistically significant differences between benign and malignant lesions in D,f and ADC value (t=3.203,-5.139,3.991,P<0.05).There was no statisticaly significant difference in D* value (P>0.05).ROC analysis showed that AUC of D value was 0.866,which was the highest one.AUC was increased to 0.934 by combining D with f value for diagnosis.Condusions The parameters acquired from IVIM model are useful to differentiate benign from malignant breast lesions.D value obtained from IVIM model may have relatively high sensitivity and specificity,D Combined with f value can obtain the best diagnostic performance.

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Expression of TGF-β1, VEGF and their clinical significance in breast cancer

Jingping YUAN ; Xiuxue YUAN ; Likun GAO ; Jie RAO ; Jichang HU ; Honglin YAN

Chinese Journal of Endocrine Surgery.2017;11(5):364-368. doi:10.3760/cma.j.issn.1674-6090.2017.05.004

Objective To observe the expression of transforming growth factor factor-β1 (TGF-β1) and vas cular endothelial growth factor (VEGF) in breast cancer to explore the correlation between each other and their relationship with invasion,metastasis and prognosis of breast cancer.Methods Immunohistochemistry was used to detect the expression of TGF-β1 and VEGF in 230 breast cancer tissues and adjacent tissues.The correlation between them and the relationship between their expression and the clinical pathological parameters of breast cancer were analyzed.Results The positive rates of TGF-β1 and VEGF in breast cancer were 72.6% and 68.3%,respectively.But in adjacent breast tissues,the positive rate was 21.3% and 42.2%,respectively.The expression of TGF-β1 was closely related to the histological grade,ER state and 5-year recurrence (P<0.05),while ER status and 5-year recurrence were independent predictors of the positive expression of TGF-β1.The expression of VEGF was significantly correlated with ER status and 5-year recurrence (P<0.05),while ER status was independent predictor of the positive expression of TGF-β1.The expression of VEGF was significantly positively correlated with the expression of TGF-β1 (γ=0.419,P<0.01).Conclusion The expression of TGF-β1 and VEGF in breast cancer is closely related to the invasion,metastasis and prognosis of breast cancer,which has a certain clinical significance.

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Clinical study of gefitinib plus capecitabine in treatment of recurrent and metastatic triple negative breast cancer

Ji WU ; Xiangxin ZHENG ; Shucheng GU ; Mu YUAN ; Xiaohong SHI ; Lei CHEN ; Xiaoqing GUAN

Chinese Journal of Endocrine Surgery.2017;11(5):369-372. doi:10.3760/cma.j.issn.1674-6090.2017.05.005

Objective To evaluate the efficacy and safety of gefitinib plus capecitabine in treatment of recurrent and metastatic triple negative breast cancer.Methods From Jan.2011 to Jun.,41 patients who have recurrent and metastatic triple negative breast cancer after treated by adjuvant chemotherapy were enrolled in this study They were divided into two groups according to their wishes.The 24 cases in the experimental group were treated with gefitinib plus capecitabine.The 17 cases in the control group were treated with capecitabine.The two groups were followed up for 12 months.They were treated until the disease progression or the toxicity could not be tolerated.Results The objective response rate (ORR) in the experimental group and the control group was 70.83%(17/24) vs 35.29%(6/17).The disease control rate (DCR) in the two groups was 91.67% (22/24) vs 64.71% (11/17).The difference between the two groups was statistically significant (P<0.05).The incidence rate of adverse drug reactions in the two groups was similar (P>0.05),and the reactions were tolerable.Conclusion Gefitinib plus capecitabine is an effective and safe treatment for recurrent and metastatic triple negative breast cancer with tolerable adverse reactions,and some patients were able to survive for more than 12 months.

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Nampt-inhibitor-based chemopotentiating effects on breast cancer cells

Tieqiang BI ; Jun ZHOU ; Shuqin LI ; Xitao GAO

Chinese Journal of Endocrine Surgery.2017;11(5):373-376. doi:10.3760/cma.j.issn.1674-6090.2017.05.006

Objective To study the expression of nicotinamide phosphoribosyl transferase (Nampt) in breast cancer and to investigate the effects of Nampt inhibitor on the growth and chemotherapy sensitivity of breast cancer cells.Methods Nampt mRNA expression in breast cancer tissues and adjacent normal tissues was detected by qRT-PCR method.The effect of Nampt inhibitor on the growth of breast cancer cells and chemotherapy sensitization was detected by MTT and soft agar clonogenic assays.Results Nampt in breast cancer was significantly higher than that in normal breast tissue (P=0.000).Nampt inhibitor FK866 repressed breast cancer cell proliferation (24 h,P=0.003;48 h,P=0.001) and suppressed cell anchorage-independent growth (0.3 nM vs 0 nM,P=0.02;3 nM vs 0.3 nM,P=0.0143;0 nM vs 3 nM,P=0.02).FK866 also increased the chemo-sensitivity of breast cancer cells to fluorouracil by greater inhibition of cell proliferation.Conclusion Our findings indicate that Nampt may be a new therapeutic target for breast cancer.

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Expression of TK1 in benign and malignant tumors

Kun FANG ; Hong HOU ; Qitang WANG ; Cuiping WANG ; Peng XU ; Yue WAN ; Qiang MU

Chinese Journal of Endocrine Surgery.2017;11(5):377-379. doi:10.3760/cma.j.issn.1674-6090.2017.05.007

Objective To investigate the expression of thymidine kinase 1 (TK1) in benign and malignant tumors.Methods From Jan.2013 to May.2015,180 female patients with breast diseases aging 16 to 79 years,including 112 cases of breast cancer (breast cancer group),and 68 cases of breast fibroadenoma (breast fibroadenoma group) were collected.The mean age of the patients was 47 years,with a median age of 43 years.We collected all the patients' fasting venous blood,detected the level of TK1,compared their differences of expression levels between patients with fibroadenoma and breast cancer,and the differences in serum TK1 levels in patients with different pathological characteristics.Results The level of TK1 in breast cancer patients was significantly higher than that in patients with fibroadenoma,and the difference was statistically significant (P<0.01).In breast cancer group,the tumor size was not correlated with TK1 expression of (P>0.05).The level of serum TK1 in patients with advanced TNM stage was higher than that in patients with early TNM stage (P=0.038).The level of serum TK1 in patients with advanced lymph node stage was higher than that in early lymph node stage (P=0.048).The level of TK1 in M1 patients was higher than that in M0 patients and the difference had statistical significance (P=0.018).Conclusion TK1,as a new marker of cell proliferation index,can accurately reflect the proliferation of tumor cells in human body,which can be used as an important index to monitor the degree of tumor proliferation and identify benign and malignant tumors.

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Longniu Bugu Decoction for prevention and treatment of bone loss caused by endocrine therapy of premenopausal breast cancer

Hang SHI ; Jing DONG ; Yangbo XU

Chinese Journal of Endocrine Surgery.2017;11(5):380-383. doi:10.3760/cma.j.issn.1674-6090.2017.05.008

Objective To study the clinical effect of Longniu Bubi Granule on prevention and treatment of bone loss caused by premenopausal ovarian function suppression (OFS) combined with breast cancer aromatase inhibitor (AIs).Methods Forty patients with postmenopausal and high risk of breast cancer treated with OFS combined with aromatase inhibitors were divided into treatment group (n=23) and control group (n=17).The two groups were treated with calcium VitD3125IU,1 tablet per day.The treatment group received the additional of Longniu Bugu Decoction,2 doses daily,with continuous medication for 6 months.The bone mineral density (BMD) level,bone mineral density (T) and serum bone alkaline phosphatase (BALP) were measured before and 6 months after treatment.Results There were significant differences in lumbar (L2-4) and femoral neck bone mineral density,bone mineral density (T) and serum bone alkaline phosphatase (P<0.05) between the two groups after treatment,and the treatment group was superior to the control group.Conclusion Longniu Bugu Decoction can reduce bone loss in patients with premenopausal breast cancer caused by OFS combined with AIs therapy and improve patients' life quality.

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Application of ultrasound guided axillary vein infusion port in breast cancer patients with chemotherapy and complications management

Ju QIU ; Feng LUO ; Guo SHI ; Jie HUANG ; Ming CAI

Chinese Journal of Endocrine Surgery.2017;11(5):384-386,413. doi:10.3760/cma.j.issn.1674-6090.2017.05.009

Objective To explore the clinical application and complication management of ultrasound-guided implantation of venous access port via axillary vein in breast cancer patients with chemotherapy.Methods From Sep.2016 to Jan.2017,50 breast cancer patients were implanted implantable venous access ports via the axillary vein under ultrasound guidance in the First Affiliated Hospital of Chongqing Medical University,among whom 25 cases with the left-side breast cancer,the other cases with right-side breast cancer.The effects of the application of implantation method and complication management were observed.Results The success rate of venous access ports via the axillary vein under ultrasound guidance was 98%(49/50).The operation time was (26±4) mins.The number of puncture ≤ 2 times was 96% (48/50).The incidence of intraoperative complications including pneumothorax (0%,0/50),error arterial puncture rate 4% (2/50),catheter ectopic incidence 2%(1/50),and intraoperative blood loss 2%(1/50).The long-term postoperative included pinch-off syndrome (POS) (0%,0/50),thromboembolism (2 %,1/50),infection (2%,1/50) and catheter detachment (0%,0/50).Conclusion Ultrasound-guided implantation of venous access port via axillary vein has features of high success ratio,high safety,and low complication rate,which provides additional venous channel selection of port implantation.

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Hemostasis with balloon urinary catheter after vacuum-assisted breast biopsy

Zhenqiang LIAN ; Haiyun YU ; Simei XIE ; Anqin ZHANG ; Yongnan WANG ; Jian WAN ; Qi WANG

Chinese Journal of Endocrine Surgery.2017;11(5):387-390. doi:10.3760/cma.j.issn.1674-6090.2017.05.010

Objective To evaluate the hemostasis effect of balloon urinary catheter after vacuum-assisted breast biopsy (VABB).Methods From May.2016 to May.2017,270 patients undergoing VABB were randomized into study group (135 cases) and control group (135cases).Patients in the study group received VABB postoperative indwelling catheter balloon hemostasis,while patients in the control group received VABB postoperative conventional thoracic pressure bandage to stop bleeding.Postoperative bleeding and hematoma were recorded and compared between the two groups.Results The rates of postoperative bleeding and hematoma in the study group were significantly lower than that in the control group (6.7% vs 16.3%,P<0.05;8.9% vs 24.4%,P<0.05).Among patients with lesions ≤ 1.5 cm,the rates of postoperative bleeding and hematoma were 1.6% and 4.7% in the study group,and 6.5% and 8.1% in the control group.There was no significant difference between the two group (P>0.05).Among patients with lesions >1.5 cm,the rates of postoperative bleeding and hematoma in the study group were significantly lower than those in the control group (11.3% vs 24.7%,P<0.05;12.7% vs 32.9%,P<0.05).Conclusion Hemostasis with balloon urinary catheter is a safe and effective method for postoperative bleeding and hematoma control after VABB.

Country

China

Publisher

ElectronicLinks

https://zhnfmwkzz.yiigle.com/

Editor-in-chief

E-mail

nfmwk2705@163.com

Abbreviation

Chinese Journal of Endocrine Surgery

Vernacular Journal Title

中华内分泌外科杂志

ISSN

1674-6090

EISSN

Year Approved

2015

Current Indexing Status

Currently Indexed

Start Year

2007

Description

2007-2008:内分泌外科杂志; 2009(1)-;中华内分泌外科杂志

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