1.The application of multimodal ultrasound combined with magnetic resonance imaging based on the ultrasonic elastic strain rate ratio and two-dimensional ultrasound in the differential diagnosis of breast cancer
Youdong HAN ; Chunmei ZHANG ; Chengzheng ZHANG ; Chaomi LI ; Yue YIN
Chinese Journal of Radiological Health 2026;35(3):439-444
Objective This study evaluated the diagnostic value of adding magnetic resonance imaging (MRI) to multimodal ultrasound for breast cancer, where multimodal ultrasound consisted of two-dimensional imaging and the strain ratio (SR) from elastography. Methods We enrolled 180 patients with breast lesions who were admitted to our hospital between August 2023 and August 2025. All patients underwent multimodal ultrasound and MRI examinations. Multimodal ultrasound included two-dimensional imaging and ultrasound elastography with strain ratio measurement. Breast cancer detection rates were assessed for each imaging method. The diagnostic performance of multimodal ultrasound alone, MRI alone, and the two methods combined was compared. Results Among the 180 patients, 82 (45.56%) had benign lesions and 98 (54.44%) had malignant lesions. The numbers of cases consistent with pathological diagnosis were 152 for multimodal ultrasound, 145 for MRI, and 160 for their combination. The sensitivity of the combined diagnosis was 95.92%, which exceeded that of multimodal ultrasound alone (84.69%) and MRI alone (79.59%). The negative predictive value of the combined diagnosis was 94.29%, which was significantly higher than that of MRI alone (77.01%, P<0.05). Conclusion Combining MRI with multimodal ultrasound based on SR and two-dimensional ultrasound significantly improves the differential diagnosis of breast cancer. This strategy compensates for the limitations of using a single modality and provides a more reliable imaging basis for clinical diagnosis and treatment decisions.
2.Targeted axillary dissection after neoadjuvant chemotherapy for highly selective patients with initial cN1 breast cancer: A single-center prospective trial
Xiuchun CHEN ; Zhenduo LU ; Chengzheng WANG ; Minhao LYU ; Jianghua QIAO ; Xianfu SUN ; Lianfang LI ; Chongjian ZHANG ; Zhenzhen LIU
Chinese Medical Journal 2024;137(12):1421-1430
Background::Sentinel lymph node (SLN) biopsy is gradually accepted as the standard of care in breast cancer patients with down-staged axillary disease after neoadjuvant chemotherapy (NAC). However, it is still difficult to precisely define pre-NAC clinical node-positive (cN1) and post-NAC clinical node-negative (ycN0). This prospective single-center trial was designed to evaluate the feasibility and accuracy of standard targeted axillary dissection (TAD) after NAC in highly selective pre-NAC cN1 patients (not considering ultrasound-based axillary ycN staging).Methods::This prospective trial included patients with initial pre-NAC cT1–3N1M0 invasive breast cancer but with a rigorous definition of cN1 from the Affiliated Cancer Hospital of Zhengzhou University. When NAC was effective (including complete and partial responses) and preoperative axillary palpation was negative, preoperative ultrasound-based axillary staging was not considered, and all patients underwent TAD followed by axillary lymph node (LN) dissection. The detection rate (DR) and false-negative rate (FNR) of TAD were calculated.Results::A total of 82 patients were included, and 77 of them were eligible for data analysis. The DR for TAD was 94.8% (73/77). There were 26 patients with one abnormal LN at the time of diagnosis based on ultrasound, 45 patients with two, and 2 patients with three. One patient had one TAD LN, four patients had two TAD LNs, and 68 patients had three or more TAD LNs. Preoperative axillary palpation yielded negative results for all 73 patients who successfully underwent TAD. Preoperative ultrasound-based ycN0 and ycN+ conditions were detected for 52 and 21 cases, respectively. The FNR was 7.4% (2/27) for standard TAD (≥3 SLNs), which was lower than that of all successful TAD (≥1 SLN; 10.0%, 3/30).Conclusions::In rigorously defined pre-NAC cN1 breast cancer patients, standard TAD is feasible for those with negative axillary palpation after NAC, and FNR is also less than 10%.Registration::chictr.org.cn, ChiCTR2100049093
3.Guidance value of QT dispersion and JT dispersion for identification of coronary heart disease with blood stasis syndrome type/
Yongjie YUAN ; Yongjun ZHANG ; Chengzheng HAN
Chinese Journal of cardiovascular Rehabilitation Medicine 2019;28(6):94-97
To explore the guidance value of QT dispersion (QTd) and JT dispersion (JTd) for identifica‐tion of coronary heart disease (CHD) with blood stasis syndrome type .Methods : A total of 246 CHD patients of our hospital were divided into blood stasis block group (n=71) ,Tanbixinyang group (TBXY group ,n=42) ,liver and renal Yin deficiency group (LRYD group ,n=44) ,Qi and Yin deficiency group (QYD group ,n=45) and cardiac and renal Yang deficiency group (CRYD group ,n=35) according to four diagnostic methods of Traditional Chinese Medicine (TCM).The QTd ,corrected QTd (QTcd) ,JTd and corrected JTd (JTcd) were observed in all groups , and their predictive value for blood stasis block were analyzed .Results : Compared with TBXY ,LRYD ,QYD and CRYD group ,there were significant rise in levels of QTd [ (72. 21 ± 16.48) ms ,(50.89 ± 12.77) ms ,(49. 17 ± 7.91) ms ,(62. 54 ± 12.80) msvs.(82.30 ± 19.05) ms] ,QTcd [(73.82 ± 18. 72) ms ,(51.41 ± 12.81) ms ,(51. 12 ± 9.73) ms ,(62.48 ± 13.35) msvs .(87. 75 ± 20. 72) ms] ,JTd [ (74. 54 ± 16.83) ms ,(52.18 ± 12. 68) ms ,(51. 50 ± 10. 78) ms ,(64.75 ± 12. 30) msvs.(89.43 ± 24.40 ) ms] and JTcd [ (75.14 ± 21. 05 ) ms ,(54. 93 ± 11.41 ) ms , (52.90 ± 10. 03) ms ,(65.26 ± 12. 72) msvs.(91. 98 ± 24. 22) ms] in blood stasis block group , P=0. 001 all.Area under curve (AUC) of QTd ,QTcd ,JTd ,JTcd predicting CHD with blood stasis block was 0. 832 ,0. 861 ,0.856 and 0.854 respectively ,and optimal cutoff point was 70.77ms ,69.83ms ,77. 80ms and 77.51ms respectively .Conclu‐sion : QTd and JTd levels on ECG in CHD patients with blood stasis block type are significantly higher than other syndrome types , so they possess certain guidance value for CHD syndrome typing .
4.Vitamin E accelerates breast cancer progression by disrupting ROS-p53 axis
Chengzheng WANG ; Peng YUAN ; Hanzhao YANG ; Xiefu ZHANG
Chinese Journal of Endocrine Surgery 2015;9(4):316-321
Objective To investigate the effect of vitamin E on progression of breast cancer tumor and to explore its underlying mechanism.Methods Human Breast cancer cells MCF-7 were inoculated into mice to establish mouse model of breast cancer and MCF-7 cell was cultured in vitro.Reactive oxygen species (ROS)level and p53 expression were determined by fluorescence probe CM-H2DCFDA and Western blot respectively.In addition,proliferation of human breast cancer cells MCF-7 was observed after transfected by siRNA targeting p53.Results Supplementing the diet with vitamin E markedly increased tumor progression and decreased ROS level and p53 expression in tumor tissue.Supplementing the culture medium with trolox significantly accelerated the growth of MCF-7 and decreased ROS level and p53 expression in tumor cells.p53-siRNA could eliminate p53 expression in MCF-7 and increase the proliferation of MCF-7 cells.Conclusion Vitamin E can accelerate breast cancer tumor progression by reducing ROS level and decreasing the expression of p53 in tumor cells.

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