Objective To observe the changes of basement membrane (BM) during carcinogenic change of the atypical hyperplasia of the mammary. MethodsSP immunohistochemical method and two special stain method (Foot and PAS stain method) and the electron microscope were used to observe the changes of the BM. Results BM already changed in atypical hyperplasia grade Ⅱ, and more significantly changed in atypical hyperplasia grade Ⅲ. BM was thinner or thicker somewhere distinctively under the microscope, and some little deletions were observed under the electron microscope in atypical hyperplasia grade Ⅲ, and there was no BM in breast cancer.Conclusion The change procedure of BM was correlated with the changes of the epithelial, atypical hyperplasia. The changes of BM in the atypical hyperplasia are a part of the carcinogenic procedure from the epithelial atypical hyperplasia of the mammary.
To investigate the changes of tenascin (TN) expression during the course of canceration through atypical hyperplasia of breast epithelia. The SP immunohistochemical method was used to study TN expresson in 50 different breast tissues. Results: There was no TN expression in normal breast and grade Ⅰ hyperplasia; immunostaining of TN was detected in 2 cases with grade Ⅱ atypical hyperplasia; the expression of TN in grade Ⅲ atypical hyperplasia (80%) and infiltrating ductal breast cancer (90%) was significantly higher than that in grade Ⅱ atypical hyperplasia (20%); and immunostaining of TN was detected in part of the cancer cells. Conclusion: These results suggest that TN expression in the stroma of serious atypical hyperplasia may play a role in limiting the outgrowth of hyperplastic epithelia.
The DNA content, cellular ultrastructure and the expression of blood group Y antigen and immunosuppressive acidic protein-2(IAP-2) were observed in normal breast, cystic hyperplasia of breast and breast cancer. The results showed: the results observed in the cells of cystic hyperplasia with epithelial proliferation grade Ⅰ were similar to those in normal breast cells. The DNA content increased, the hypoplasia and dedifferentiation features in some structures of cellular membrane and nucleus were observed, and the abnormal antigens expressed in part of the atypical hyperplasic cells. The DNA content and ultrastructure in a part of cells with aypical hyperplasia grade Ⅲ were similar to those in the cells of breast cancer grade Ⅰ. The results indicated that in the couse of atypical hyperplasia, the biological abnormalities and its extent of those cells were closely related to the differentiation extent, the developing tendency and the risk of canceration of the cystic hyperplasia of breast.
The expression of C-erb B-2 oncogene protein in the tissues of normal breast, atypical cystic hyperplasia of breast and breast carcinoma were determined in order to analyse the significance of the changes of C-erb B-2 oncogene in the course from atypical hyperplasia to carcinoma of breast. Results: there were no expression of C-erb B-2 protein in the tissues of normal breast and cystic hyperplasia of breast with epithelia proliferation grade Ⅰ. The positive rates of the expressions of C-erb B-2 protein in the tissues of atypical hyperplasia grades Ⅱ, Ⅲ and carcinoma of breast were 20.0%, 40.0% and 54.2% respectively. The results indicated that the abnormal changes of C-erb B-2 nocogene might occured in the carcinomatous transformation phase along with the changes from normal breast epithelial cell through atypical hyperplasia to breast cancer, those changes could be the result or promotion factor of abnormal proliferation of atypical hyperplasia of breast and was one of the markers of malignant transformation of epithelia of breast.
Barrett’s esophagus is considered an important risk factor for the pathogenesis of esophageal adenocarcinoma. Treatment strategies for diseases from high-grade dysplasia （HGD） to adenocarcinoma are different. The recurrence rates of endoscopic treatment and anti-reflux surgery are comparatively higher. Abnormal lesions of the esophagus can be completely resected by esophagectomy for the treatment of HGD to adenocarcinoma, and treatment outcomes are confirmed.But appropriate surgical strategies and lymph node dissection scopes should be chosen according to different cancer staging.Lymph node metastasis is a major factor in determining prognosis.
目的 探讨不典型胎盘早剥的临床特点。 方法 对2008年5月－2009年5月收治的55例胎盘早剥患者的临床资料进行回顾性分析。其中产前漏诊30例，疑诊15例，确诊10例。胎盘早剥的产前确诊率为18.2%，漏诊率为54.5%。所有患者均经产后证实。 结果 重度子痫前期（25.5%）、胎膜早破（12.7%）是胎盘早剥的主要发病诱因；阴道流血（52.7%）、腰腹痛（47.3%）及胎心异常（36.4%）是其常见的临床表现。胎盘早剥者，剖宫产率、胎儿窘迫及早产率均增加。 结论 不典型胎盘早剥病情隐匿。后壁胎盘、早剥面积小及B型超声检查阴性是漏诊的主要原因。对此患者应提高认识，动态监测，及时处理，以改善母婴结局。
Objective To discuss the surgical indication of mammotome （MMT） operation and its auxiliary diagnosis value on breast cysts. Methods Seventy-eight patients with breast cysts from May 2010 to November 2011 in this hospital were enrolled. Excision and biopsy were performed according to the following guidelines：Single cyst with inhomogeneous interna echoes and diameter at least 1 cm；Multiple cysts associated with irregular megalgia， localized thickening of breast or ineffective drug treatment after three months；High risk of breast cancer；Hypoechoic nodules and laticifers exaggerated cysts；Ultrasonography showed disorderly echo and abundant blood supply in glandular tissues around the lesions. The result of preoperative ultrasound was compared with that of postoperative pathology diagnosis. Results In these 78 breast cysts patients with preoperative ultrasound diagnosis， 40 cases were breast multiple cysts， 38 cases were multiple cysts plus untouchable hypoecho nodules；42 cases were high risk lesions， and the other 36 cases were low risk lesions. Postoperative pathology diagnosis revealed 27 cases of cystic hyperplasia， 2 cases of atypical hyperplasia， and 1 case of breast cancer in the ultrasonic high risk lesions， and 19 cases of cystic hyperplasia in the ultrasonic low risk lesions. Ultrasound diagnostic accuracy rate was 60.26%（47/78）， sensitivity was 61.22%（30/49）， and specificity was 58.62%（17/29）. The number of resection lesions was 13.00±8.16， the time of operation was （74.25±22.68） min. The average hospital stay was 1 d after surgery. The local hematoma occurred in 2 cases and no other complications occurred during one month of follow-up. Conclusions The guidelines of MMT protocoled according to clinical manifestation of breast cyst patients and imaging of high-frequency ultrasound in author’s department are simple and utility. Minimal excision and biopsy via MMT can confirm the histological type and help for early diagnosis of breast cancer and precancerous lesion. It is important and necessary to standardize the surgical indications of MMT in the clinical work.