Objective To observe the expression of GLIS3 in triple negative breast cancer(TNBC)and analyze its relationship with the prognosis of TNBC patients.Methods Bioinformatic analysis was applied to analyze the expression level of GLIS3 in Gene Expression Omnibus(GEO).Kaplan-Meier survival curve was plotted to evaluate the impact of GLIS3 expression on the survival rate of patients based on DNA chip data.A total of 125 patients pathologically diagnosed as TNBC in the Fourth Hospital of Hebei Medical University from January to December 2014 were enrolled by cluster random sampling.Among them,53 patients had complete tissue specimens,medical records and follow-up data.Immunohistochemical assay was used to detect the expression of GLIS3 in TNBC and adjacent tissues to tumors,while the relationships between GLIS3 protein expression in breast cancer tissues and clinicopathological parameters such as age,menstrual status,tumor size,clinical stage,histological grade,pathological type,axillary lymph node metastasis,vascular tumor thrombus,and expression of TP53 and Ki-67 were analyzed.Kaplan-Meier survival curve was plotted to analyze the effect of GLIS3 on the overall and disease-free survival of TNBC patients.Cox regression model was established to identify the risk factors impacting the prognosis of the patients.Results Analysis of GEO data showed that the expression of GLIS3 in TNBC was significantly higher than that in paracancer tissues(P＜0.05).The expression of GLIS3 was notably higher in the TNBC tissue than the adjacent tissue to tumor(P＜0.05).A marked augmentation of GLIS3 expression was observed in both the advanced and larger-sized tumors(P＜0.05).Univariate analysis of Cox regression model revealed that lymph node metastasis,TNM stage and GLIS3 expression were all related to disease-free survival of TNBC patients(P＜0.05).Univariate and multivariate analyses displayed that TNM stage was related to the overall survival of TNBC patients(P＜0.05).The patients with high expression of GLIS3 had significant shorter disease-free survival time than those with low expression(P＜0.05),but had no statistical difference in overall survival(P＞0.05).Conclusion GLIS3 protein is highly expressed in TNBC tissues,and tumor size and TNM stage are correlated with its high expression.The high expression of GLIS3 suggests that the patients have poor prognosis and low disease-free survival rate.

Objective: To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province. Methods: A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ² test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ² test. Results: There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ²=47.028, P=0.000). Conclusions There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage Ⅰ to Ⅱ. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients′ demon.

Objective:Breast cancer has been the first cancer among women with the incidence increasing gradually. In September 2016, the Breast Cancer Cohort Study in Chinese Women (BCCS-CW) was initiated, aiming to establish a standardized and sharable breast cancer-specific cohort by integrating the existing cohort resource and improving the quality of follow-up. The BCCS-CW may provide a research basis and platform for the precision prevention and treatment of breast cancer in etiology identification, prevention, early diagnosis, treatment, and prognosis prediction.Methods:We conducted a population-based perspective cohort by questionnaire interview, anthropometry, biological specimens, breast ultrasound and mammography. The cohort was followed by using regional health surveillance and ad hoc survey.Results:Finally, BCCS-CW included 112 118 women, in which 55 419 women completed the standardized investigation and blood specimens were collected from 54 304 women. The mean age of participants was 51.7 years old, 62.7% were overweight or obese, and 48.9% were menopausal.Conclusion:The BCCS-CW will provide population-based cohort resource and research platform for the precise prevention and treatment of breast cancer in Chinese women.

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

Objective To explore the effects of individualized comprehensive intervention on complications during indwelling implantable venous access port (IVAP), so as to provide reasonable suggestion and theory evidence for reducing the incidence of IVAP complications. Methods We selected 400 breast cancer patients with IVAP. All of the patients were completely randomized divided into control group and experimental group. Patients of control group (n=200) received routine intervention including education before implanting IVAP and discharge instruction. On this basis of routine intervention, patients of experimental group (n=200) were treated with the individualized comprehensive intervention and enhancing continuous intervention out hospital aiming at common complications of IVAP. We compared patients' incidences of complications during IVAP between two groups. Results Patients' incidences of complications during IVAP in control group and experimental group were 27.0% and 7.5% respectively with a significant difference (P＜ 0.01). There were 12 patients with unplanned port drawing due to complications in control group and 3 in the experimental group with a significant difference (P＜ 0.05). Conclusions Individualized comprehensive intervention can effectively reduce the incidences of complications during IVAP, improve the utilization time and ratio of IVAP. Enhancing continuous intervention out hospital is also the important measure to decrease the incidence of severe complications.

Objective To discuss the prevention and treatment of catheter fracture of implantable venous access port (IVAP).Methods A total of 878 adult patients,who received IVAP during the period from January 2012 to December 2012 in a single medical center,were collected.Among the 878 patients,catheter fracture occurred in 7 patients.The clinical data of the 7 patients were retrospectively analyzed.By referring to the related literature,the causes and the prevention measures for catheter fracture were discussed.Results As of November 31,2016,the catheter fracture rate of IVAP,which was implanted via internal jugular vein (IJV),was 0.8％ (7/878).The fracture occurrence time was 855-1412 days after implantation of IVAP,with a mean of 1133 days.The common fracture sites were catheter-IJV junction,catheter-IVAP base joint,and subcutaneous tunnel segment.Conclusion Catheter fracture is one of the serious complications which occur in the course of long-period use of IVAP after its implantation.Standardization of operative procedure,strengthening of the maintenance and nursing education,timely removal of IVAP,and other necessary measures can help reduce the incidence of IVAP catheter fracture and ensure the safety of patients.

Objective: To investigate the significance of extranodal extension of axillary lymph nodes (ALN-ENE) metastases in post-operative primary invasive breast carcinoma of non-specific type. Methods: Six hundred and thirty-eight invasive breast cancer cases confirmed by postoperative pathological examination were collected from January 2006 to December 2008. The relationship of lymph node metastases and ALN-ENE with other lymph node parameters and patient outcome was analyzed. Results: Among 638 cases, 263 (41.2%) showed axillary lymph node metastases. ALN-ENE was present in 91 cases (36.4%). The rate of ALN-ENE increased with pT stage and tumor size. Five-year recurrence-free survival rate (RFS) and 5-year overall survival rate (OS) was 86.6% and 91.2% respectively for ALN-ENE positive group, and both were lower than ALN-ENE negative group (P<0.01). One hundred and forty-nine patients with 1 to 3 positive lymph nodes had a 5-year RFS of 91.9%, and 5-year OS of 92.3%, less than ALN-ENE negative group (P<0.01). Univariate analysis showed ALN-ENE positively correlated with lymph node metastasis. Multivariate analysis suggested that ENE was associated with increased recurrence risk and shortened recurrence-free and overall survival, especially in patients with 1 to 3 positive lymph nodes; and it was an independent prognostic factor (P<0.01). Conclusions The number of lymph nodes metastases is an important predictor of survival in breast cancer patients. ALN-ENE is an independent risk indicator for recurrence and overall survival. For patients with 1 to 3 metastatic axillary lymph nodes, ALN-ENE could alter the patient′s clinical pathologic staging, and therefore it is an independent prognostic factor.

Objective:To investigate the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods:Data of 65 IMPC cases obtained from the Fourth Hospital of Hebei Medical University between Janu-ary 2009 and December 2011 were retrospectively analyzed. The expression of epithelial membrane antigen (EMA) was evaluated us-ing immunohistochemistry (IHC) to detect the micropapillary component in the tumor. The patients were divided into 4 groups based on the percentage of micropapillary component:≤10%, 11%-30%, 31%-50%, and>50%. Expressions of estrogen receptor (ER), pro-gesterone receptor (PR), and HER-2 were analyzed by IHC. Kaplan-Meier method, Log rank test, and multivariate Cox proportional hazard model were used to determine the factors affecting post-treatment survival. Results:Of the 65 cases, 12 were simple IMPC, 46 were IMPC with invasive ductal carcinoma, and 7 were other invasive carcinoma cases. The≤10%, 11%-30%, 31%-50%, and>50%micropapillary component groups comprised 7.69%(5/65), 44.62%(29/65), 26.15%(17/65), and 21.54%(14/65) of the total cases, re-spectively. Statistically significant differences were found in the four groups (P<0.01). IHC results showed that the positive rates of ER, PR, and HER-2 in the IMPC tissues were 76.92%(50/65), 67.69%(44/65), and 24.62%(16/65), respectively. Statistical differences ex-isted among the groups (P<0.05). Kaplan-Meier method indicated that positive rate of lymph node metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 significantly affect survival time of IMPC cases (P<0.05). Conclusion:Positive rate of nodal metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 are correlated with the prognosis of IMPC.

OBJECTIVETo summarize the disposal methods and the reasons of complications in operation of totally implantable central venous port (TICVP).

METHODSA total of 2 007 patients were enrolled in this observational, single-center study between December 2008 and March 2013. TICVP implantation was performed with one small skin incision and subcutaneous puncture of subclavian or jugular vein. Patient's profiles, indications of port system, early and delayed complications, and disposal methods were evaluated. There were 38 male and 1 969 female patients, aged from 21 to 85 years, with a mean of 47.6 years.

RESULTSThe mean duration of the TICVP system was (242 ± 12) days, ranging from 9 to 1 243 days. The achievement rate of puncture in the right jugular vein (99.76%) was the highest. Sonographic approach using the internal jugular vein were better than the external landmark-guided technique (99.80% vs. 96.34%, χ² = 29.905, P = 0.000). The rate of immediate complication was 0.80%, which included pneumothorax, hemothorax, lymphatic fistula and thrombosis. Early complications rate was 0.10%, which included pocket hematoma, catheter migration, venous thrombosis, port pocket infection, fibrin sheath formation. Late complications rate was 7.87%, which included catheter fracture, pinch-off syndrome, catheter-related bloodstream infection, fibrin sheath formation, catheter migration, extravasation, port inversion and port reveal. The rate of removal due to complications was 1.34% (27/2 007), and the early complication was higher (χ² = 8.053, P = 0.011).

CONCLUSIONSThe low incidence of complications suggests that TICVP is safe and reliable for long term intermittent venous access. The results support the use of TICVP in the oncology patients and patients requiring long-term intravenous therapy.

Adult ; Aged ; Aged, 80 and over ; Catheterization, Peripheral ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostheses and Implants ; Retrospective Studies ; Young Adult

Primary breast lymphoma (PBL) is a kind of rare primary extranodal lymphoma, which is of relatively poor prognosis and so far there is no unified treatment. In the case diagnosed by Our hospital where one patient recurring breast diffuse large B cell lymphoma (DLBCL) many times, has been treated with good therapeutic effect through surgery, chemotherapy, targeted drug therapy and radiotherapy. A multidisciplinary discussion is made concerning the treatment of the patient in this article for the purpose of further discussing the standard treatment procedure for PBL and promoting multi-disciplinary team.