Objective:To explore the differences in clinicopathological features, survival status and prognostic influencing factors of breast cancer patients with different molecular subtypes, and to provide bases for the prevention and treatment of breast cancer.Methods:The clinicopathological data of new-onset female breast cancer patients hospitalized in Shanxi Province Cancer Hospital from January 2015 to December 2016 were retrospectively analyzed, and patients were followed up. The clinicopathological features of patients with different molecular subtypes were compared. The follow-up was performed until June 30, 2021. Kaplan-Meier method was used to analyze the survival of patients, and Cox proportional hazards model was used to analyze the factors affecting overall survival (OS) of patients with different molecular subtypes.Results:There were 272 (14.9%), 1 005 (55.2%), 277 (15.2%) and 268 (14.7%) patients with subtypes of Luminal A, Luminal B, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer (TNBC), respectively. The differences in the distribution of patients with age at diagnosis, age at menarche, menopausal status, age at menopause, pathological type, longest tumor diameter, T staging, N staging, histological grading, and TNM staging were statistically significant among the four groups (all P < 0.05). At a median follow-up of 60 months, the 5-year OS rates of Luminal A, Luminal B, HER2 overexpression and TNBC subtypes were 93.8%, 89.2%, 77.6% and 78.0%, respectively, and the difference was statistically significant ( χ2 = 58.76, P < 0.001). M staging was an independent influencing factor for OS in patients with Luminal A breast cancer ( HR = 16.789, 95% CI 4.972-56.690, P < 0.001); T staging ( HR = 2.721, 95% CI 1.715-4.319), N staging ( HR = 4.460, 95% CI 2.399-8.291) and M staging ( HR = 3.364, 95% CI 1.988-6.670) were independent influencing factors for OS in patients with Luminal B breast cancer (all P < 0.001); N staging ( HR = 4.428, 95% CI 1.836-10.677) and M staging ( HR = 13.489, 95% CI 6.043-30.107) were independent influencing factors for OS of patients with HER2 overexpression breast cancer (both P < 0.01); T staging ( HR = 3.052, 95% CI 1.575-5.915), N staging ( HR = 2.492, 95% CI 1.298-4.785) and M staging ( HR = 33.012, 95% CI 8.606-126.637) were independent influencing factors for OS of patients with TNBC (all P < 0.01). Conclusions:The clinicopathological features and prognostic influencing factors of breast cancer patients with different molecular subtypes are different, and the prognosis of HER2 overexpression and TNBC patients is poor. Clinicians should provide individualized treatment and follow-up programs for patients with different molecular subtypes of breast cancer.

Objective:To explore the clinicopathological characteristics and factors influencing the survival of young breast cancer patients with diagnostic age below 35 years, and to provide the basis for the prevention and treatment of young breast cancer patients.Methods:Epidemiological and clinicopathological data of young female patients with newly diagnosed breast cancer from Shanxi Province Cancer Hospital between January 2015 and December 2016 were retrospectively analyzed. The data included age at diagnosis, reproductive history, history of abortion, menopausal status, and immunohistochemical results. Univariate and multivariate analysis were performed by using Cox regression model.Results:A total of 118 young breast cancer patients were collected, and the median age was 31 years old. Among them, the vast majority of 118 young breast cancer patients were invasive cancer (113 cases, accounting for 95.8%); there were 65 cases (55.1%) with tumor diameter ≤ 20 mm, 61 cases (51.7%) at N 0 stage, and 112 cases (94.9%) at M 0 stage. The positive rates of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) were 73.7% (87/118), 69.5% (82/118) and 28.8% (34/118), respectively. Luminal B breast cancer was the predominant molecular subtype, accounting for 55.1% (65/118). By the end of follow-up (median follow-up period of 60 months), the overall survival rate of young breast cancer patients was 78.8%. Multivariate analysis showed that TNM staging was an independent factor affecting overall survival in young breast cancer patients ( HR = 7.858, 95% CI 2.924-21.120, P < 0.001). Conclusions:Young breast cancer patients have unique clinicopathological features and TNM staging is an independent factor affecting the prognosis. Individualized treatment helps to improve the quality of life and prolong the survival time of patients.

Objective:To investigate the association between breast cancer and thyroid diseases, and to provide evidence for the prevention and treatment of thyroid diseases in breast cancer patients.Methods:A total of 511 newly diagnosed breast cancer patients were recruited between March 2018 and August 2019 from Shanxi Province Cancer Hospital, and 303 age-matched newly diagnosed breast benign disease patients and 341 age-matched healthy controls were recruited during the same time-frame. Thyroid B-ultrasound and thyroid function test were performed in the three groups. By reviewing the medical records, the general and clinicopathological data of the patients were collected, and the differences in the prevalence of thyroid diseases among the three groups were compared. The changes of thyroid function in breast cancer patients before treatment, in the middle stage of chemotherapy and at the end of chemotherapy were compared.Results:Among breast cancer group, breast benign disease group and healthy control group, the differences in the prevalence rates of hypothyroidism [32.5% (166/511), 25.7% (78/303) and 21.7% (74/341)], thyroid nodules [50.7% (259/511), 43.2% (131/303) and 41.6% (142/341)] and Thyroid Imaging Reports and Data System(TI-RADS) grade 4 and above thyroid nodules [15.4% (40/259), 14.5% (19/131) and 4.9% (7/142)] were statistically significant (all P < 0.05). The abnormal rates of thyroid stimulating hormone (TSH) and free thyroxine (fT4) in breast cancer group were higher than those in breast benign disease group and healthy control group [34.1% (174/511) vs. 26.1% (79/303), 23.5% (80/341); 24.9% (127/511) vs. 8.6% (26/303), 3.2% (11/341)], and the differences were statistically significant (both P < 0.05). The levels of fT4, free three iodide thyroxine (fT3), thyroid immunoglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) in breast cancer patients before treatment, in the middle stage of chemotherapy and at the end of chemotherapy were statistically different (all P < 0.05). The abnormal rates of fT4, TgAb and TPOAb in the last chemotherapy cycle were lower than those before chemotherapy [11.5% (59/511) vs. 24.9% (127/511), 5.1% (26/511) vs. 17.4% (89/511), 11.9% (61/511) vs. 20.4% (104/511)] in breast cancer patients, and the differences were statistically significant (all P < 0.001). Conclusions:The breast cancer is associated with thyroid diseases. Clinicians should pay more attention to the changes of thyroid diseases and thyroid function during the treatment and in the follow-up process of breast cancer patients, so as to detect the thyroid diseases early and carry out standardized treatment.

Objective: The aim of the study was to investigate association of response depth and prognosis in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC)patients treated with first-line tyrosine kinase inhibitors (TKIs). Methods: The clinicopathological data and prognosis information of patients with locally advanced or metastatic (ⅢB or Ⅳ) lung adenocarcinoma with EGFR classical (19del or 21L858R) mutation who were treated in our hospital from 2015 to 2016 were collected. The tumor remission depth [stable disease (SD), partial response (PR), complete response (CR)] was measured by recist 1.1 standard. The survival curve was drawn by Kaplan-Meier method and log rank test was performed. Results: During the study period, 204 advanced lung adenocarcinoma patients with 19del or 21L858R mutation were treated with TKI drugs of the first generation. Among them, 24 patients were lost or unable to evaluate the efficacy, 20 patients were evaluated as progression disease (PD), 62 patients as SD, 98 patients as CR or PR. Disease control rate (DCR) and objective remission rate (ORR) were 88.9% and 54.4%, respectively. The median progression free survival time (PFS) was 12.6 months (95% CI: 10.9-14.4 months) and 13.1 months (95% CI: 11.6-14.7) for patients assessed as SD (group A) and CR or PR (group B), respectively, with no significant difference (P=0.27). Subgroup analysis showed that the median overall survival of patients with EGFR 19del and 21L858R mutations was 12.5 months (95% CI: 9.9-15.4) and 12.7 months (95% CI: 9.4-16.1), respectively, with no significant difference (P=0.66); Similar result was also observed in Group B with a median PFS of 13.9 months (95% CI: 12.3-15.5 months) and 12.3 months (95% CI: 9.5-15.1 months) in patients who had EGFR 19del or 21L858R mutations (P=0.41). Conclusions Response depth was not a positive predictor for prognosis in EGFR-mutant NSCLC patients treated with first-line TKIs.

Objective To understand the status and influencing factors of thyroid disease in breast cancer patients, and to identify the high-risk people with thyroid disease. Methods Breast cancer patients were continually collected from Jan 2016 to Mar 2016 in Shanxi Cancer Hospital. Age, surgery time, the state of thyroid disease, medical record, the general condition, immunohistochemistry and pathological findings, thyroid B-mode ultrasonography were investigated respectively. All cases were divided into two groups according to whether to suffer from thyroid disease or not. The influencing factors for thyroid disease in patients with breast cancer were screened. Logistic regression was used for univariate and multivariate analysis. Results A total of 293 cases (69.3 %) suffered from thyroid disease in 423 breast cancer patients. The univariate analysis showed that prevalence rate of thyroid disease had statistical differences in age [<50 years old:49.5%(145/293) vs. 76.1%(99/130); ≥50 years old:50.5%(148/293) vs. 23.9%(31/130);χ2=24.297, P<0.001], body mass index [18.5-23.9 kg/m2:41.0%(120/293) vs. 52.3%(68/130);24.0-27.9 kg/m2:45.4%(133/293) vs. 40.8 % (53/130); ≥28.0 kg/m2: 13.7 % (40/293) vs. 6.9 % (9/130); χ2= 6.395, P=0.041], menopausal state [not: 59.7%(175/293) vs. 77.7%(101/130); yes: 40.3%(118/293) vs. 22.3%(29/130);χ2=12.443, P<0.001], estrogen receptor (ER) [ER--ER+: 44.0%(129/293) vs. 56.9%(74/130);ER++ - ER+++: 56.0 % (164/293) vs. 43.1 % (56/130); χ2 = 5.951, P= 0.015]. There were no significant differences in the times of pregnancy and production, history of abortion, progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), triple negative breast cancer, T stage, N stage, histological grade and TNM stage (P> 0.05). Multivariate analysis showed that the risk factors were age (OR= 3.928, 95 %CI=1.819-8.482, P<0.001) and ER++-ER+++(OR= 1.696, 95 %CI= 1.094-2.628, P= 0.018). Conclusion Age≥50 and ER++-ER+++are the major influencing factors of thyroid disease for patients with breast cancer.

Objective To explore the correlation between lymphatic metastasis and central lymph node metastasis and pre-surgery levels of serum thyrotropin (TSH), thyrobolulin (TG), anti-thyrobolulin antibodies (A-TG), anti-thyroid peroxidase antibodies (A-TPO) in patients with papillary thyroid carcinoma (PTC). Methods The clinical characteristics such as sex, age, tumor diameter, and some markers of thyroid function detection in 289 simple PTC cases were retrospectively analyzed, and their roles in lymphatic metastasis and central lymph node metastasis were discussed. Results Age < 45 years old (χ2= 5.86, P =0.02),multifocal(χ2=38.95, P<0.001), serum increased A-TG level(χ2=13.31,P <0.001) or A-TPO level (χ2= 7.30, P< 0.01) leaded to higher rate of lymphatic metastasis. Different TSH levels had different impact on lymphatic metastasis (χ2= 11.81, P = 0.02). When at 1.81-2.52 mU/L, the lowest rate of lymphatic metastasis was 34.68 %. Multivariable logistic regression analysis showed that focus (OR= 3.29, 95 % CI 1.85-5.52) and serum A-TG level (OR= 2.17, 95 % CI 1.11-4.26) were risk factors, whereas TSH at 1.81-2.52 mIU/L was more safe factor in simple PTC cases with lymphatic metastasis (OR= 0.28,95 % CI 0.09-0.85). Different groups of age (χ2= 11.54, P= 0.001), focal (χ2= 38.95, P< 0.001), serum TG level (χ2=9.01, P=0.01), A-TG level (χ2=14.51, P <0.001) or A-TPO level (χ2= 6.78, P= 0.02) leaded to statistically different central lymph node metastasis ending; further analysis showed that age (OR= 0.96, 95 % CI 0.94-0.98) and focus (OR= 5.47, 95 % CI 3.09-9.69) were risk factors of central lymph node metastatic in PTC patients. Conclusion Higher pre-surgery serum A-TG level and multifocal predict lymphatic metastasis, TSH level in 1.81-2.52 mU/L indicates lower rate of lymphatic metastasis, but age<45 years old and multifocal PTC patients are apt to occur central lymph node metastasis.

Objective To investigate the influence of different treatments for tubal pregnancy on ovarian reserve function by transvaginal color Doppler ultrasonography.Methods One hundred and twentyfour cases of tubal pregnancy were divided into three groups according to the treatment,group A with 45 cases under the salpingectomy,group B with 36 cases under the laparoscopic conservative surgery for retaining oviduct,group C with 43 cases taken by Methotrexate.On the day of a spontaneous cycle,all the cases' antral follicles,the ovarian volume,peak systolic velocity (PSV),resistance index (RI),pulsatility index(PI) were measured by transvaginal color Doppler ultrasound.Results The antral follicles,varian volume and PSV of diseased side in group A were lower than those of the other side(P ＜0.05).The antral follicles,varian volume and PSV of diseased side in group A were lower than those of other groups (P ＜0.001).The PI and RI of diseased side in group A were higher than those of the unaffected side.The PI and RI of two sides in group B and C were not significantly different(P ＞0.05).Conclusions Salpingectomy affects the ovarian reserve function.Methotrexate and conservative surgery could not reduce the ovarion reserve.

Objective To evaluate the association of expressions and gene polymorphism of leptin receptor (LEPR) in breast cancer with tumorigenesis,development and clinicopathologic factors.Methods The immunohistochemical method and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to evaluate LEPR expressions and LEPR Gln223Arg polymorphism in 150 cases with breast cancer,80 cases with benign breast lesions,50 cases with corresponding normal breast tissue and 128 healthy controls.Results The expression rate of LEPR genes in breast cancer tissues was significantly higher than that in benign breast lesions and that in corresponding normal breast tissues [70.67 ％ (106/150) vs 56.25 ％ (45/80) vs 44.00 ％ (22/50),P ＜ 0.005].In breast cancer patients,LEPR gene Gin223Arg genotype polymorphism (GG,GA and AA) frequencies were 70.00 ％ (105 cases),16.67 ％ (25 cases) and 13.33 ％ (20 cases),which were significantly different from those in the benign breast lesions [82.50 ％ (66 cases),13.75 ％ (11 cases),3.75 ％ (3 cases)],those in corresponding normal breast tissues [82.00 ％ (41 cases),14.00 ％ (7 cases),4.00 ％ (2 cases)] or those in the health controls [82.81％ (106 cases),14.85 ％ (19 cases) and 2.34 ％ (3 cases)] (X2 =11.56,P =0.003),while the differences of GG,GA and AA genotype requencies among the breast benign disease group,cancer adjacent normal breast group and healthy control group were not statistically significant (P ＞ 0.05).The frequencies of alleles genes in breast cancer patients (G and A) were 78.33 ％ (235 cases) and 21.67 ％ (65 cases),and the differences were statistically significant compared with those in the benign disease group or in healthy control group (X2 =12.52,P =0.001).The positive expression rate of LEPR gene in patients with lymph node metastasis was 87.8 ％,which was higher than that in patients with no lymph node metastasis (60.2 ％) (P =0.02).According to the results of multivariable analyses,high expression of LEPR gene,LEPR Gin223Arg gene polymorphisms and increased waist-hip ratio (WHR) were risk factors for breast cancer (all OR ＞ 1).Conclusion High expression of LEPR,LEPR Gln233Arg polymorphism and the elevated WHR may be correlated with breast cancer.

Objective Toevaluatethediagnosticvalueofhumanepididymisprotein4(HE4)andcar-bohydrate antigen 1 25 (CA1 25 )for distinguishing between benign and malignant ovarian neoplasms.Methods 1 1 09 patients with ovarian neoplasms were enrolled in this study,serum concentration of HE4 and CA1 25 was assayed using ELISA technique.And the markers were evaluated for significance separately and in combination. Results 1SerumlevelsofHE4andCA125weresignificantlyhigherinpost-menopausalwomenthanthosein pre-menopausal women(t=8.40,P<0.05;t=7.02,P<0.05).In addition,the more children the patients born,the higher serum levels of these two markers were(F=1 5.36,P<0.05;F=1 3.00,P<0.05).2 Serum HE4 levels were significantly higher in the ovarian cancer patients compared with those seen in patients with benign or borderline tumor(t=1 3.68,P<0.05;t=1 4.94,P<0.05).Serum CA1 25 levels were significantly higher in the ovarian cancer patients compared with those seen in patients with benign or borderline tumor(t=1 4.1 6,P<0.05;t=1 7.27,P<0.05).Morever,it also appared in the ovarian cancer patients with ascites and vascular embolism.Morever,the levels of HE4 were significantly higher in the ovarian cancer with ascites and vascular embolism than without it(t=7.08,P<0.05;t=4.41,P<0.05),the levels of CA125 were signifi-cantly higher in the ovarian cancer with ascites and vascular embolism than without it(t=9.67,P<0.05;t=4.75,P<0.05).3 During follow-up,serum HE4 and CA1 25 levels significantly decreased at 3 months after operation(t=9.86,P<0.05;t=5.12,P<0.05).4 Receiver operating characteristic curve,ROC)analysis revealed that no difference was observed in AUC values for HE4,CA1 25 and risk of ovarian malignancy algo-rithm(ROMA).5 Compared to CA1 25 ,HE4 had significantly higher specificity and lower sensitivity.Howev-er,sensitivity were increased when the two markers were combined with each other.However,the sensitivity of combination with two markers was higher than single detection and ROMA,but the specificity was lower in com-bination with two markers than single detection and ROMA.If we divide the ROMA by a woman′s menopausal status,ROMA has a higher sensitivity (73.84%,84.1 9%) and lower specificity (66.06%,66.67%). Conclusions ThelevelsofCA125hasahighsensitivity,andthelevelsofHE4isahighspecificity.CA125 combined with HE4 can provide a more sensitivity and accurate predictor of ovarian cancer than either alone.

Objective The purpose of this study was to discuss the clinical significance of serum levels of Pro-gastrin-releasing peptide (ProGRP) in diagnosis,therapy monitoring and prognosis in patients with small cell lung cancer (SCLC).Methods Clinical diagnostic trial.Serum levels of ProGRP were measured by ELISA assays in 413 SCLC patients,418 NSCLC,120 with benign pulmonary diseases patients and 200 healthy subjects.Patients were recuited by the Shanxi Cancer Hospital from Dec.2005 to Oct.2008.Three hundreds and sixty-eight patients with SCLC were followed up from Dec.2005 to Oct.2011.The receiver operating characteristic curves (ROC) was used to set the cut-off value of ProGRP and the area under ROC (ROC-AUC).The sensitivity and specificity of ProGRP were analyzed for diagnosing SCLC.The survival analysis was performed by the Kaplan-Meier method and Cox's proportional hazards model for multivariate analysis of prognosis.Results Using healthy subjects group as control,the largest Youden index point of ROC was used to set the cut-off values of ProGRP and NSE (45.3 ng/L and 12.4 ng/L).The ROC-AUC of ProGRP was 0.798 (95％ CI:0.746-0.850)the sensitivity and specificity were 79.2％,98.1％ respectively.The AUC of NSE was 0.786(95％ CI:0.726-0.746),the sensitivity and specificity were 71.9％,96.7％ respectively; Combing detection of ProGRP and NSE,the sensitivity and specificity were 88.1％,95.8％ respectively.Serum levels of ProGRP in healthy subjects,benign pulmonary diseases,NSCLC and SCLC groups were 6.9 (5.3-8.6),36.8 (26.3-43.4),21.3 (18.6-35.2) and 1758.7 (368.4-2967.3) μg/L respectively.The serum levels of ProGRP in SCLC groups were significantly higher than those in the healthy group,benign pulmonary diseases group and NSCLC group (H =103.66,P =0.000).Serum levels of ProGRP in SCLC at stage Ⅰ-],stage m,stage Ⅳ were 543.3 (256.8-843.2),1440.6 (1042.4-2543.3) and 1897.6 (1586.5-3958.7) μg/L,respectively (H =25.974,P =0.000).Serum levels of ProGRP in 165 SCLC patients with complete remission(CR) were significantly declined after treatment (U =11.65,P ＜ 0.01).The levels of ProGRP in 146 SCLC patients with partial remission(PR) slowly decreased (U =9.17,P ＜ 0.01).Thirty-nine cases with progressive disease (PD)and 63 cases with stable disease(SD) presented elevated ProGRP levels (U =3.314,P ＜ 0.001 ; U =2.54,P ＜ 0.01,respectively).By the end of October 31st 2011,a total of 368 cases with SCLC were followedup.Ratio of follow-up was 89.1％.There were 56 deaths in 119 SCLC patients with ProGRP ＜ 1000 μg/L (median time =16.0 months,4-23 months) ; 159 deaths in 249 with ProGRP ＞ 1000 μg/L (median survival time =12.0 months,2-18 months).Median survival time of the two groups showed significant differences(x2 =11.04,P =0.001).Multivariate analysis by Cox's proportional hazards model revealed that ProGRP was independent prognostic factor related to the overall survival (OS) of SCLC patients.Conclusions The serum ProGRP is valuable tumor marker for diagnosis,treat monitoring and prognosis of SCLC.It's important to predict relapses and recurrence of diseases earlier,instruct therapy and prognosis assessment.