Cohesive scientific evidence from molecular, animal, and human investigations supports the hypothesis that constitutive overexpression of cyclooxygenase-2(COX-2) is a ubiquitous driver of mammary carcinogenesis, and r...Cohesive scientific evidence from molecular, animal, and human investigations supports the hypothesis that constitutive overexpression of cyclooxygenase-2(COX-2) is a ubiquitous driver of mammary carcinogenesis, and reciprocally, that COX-2 blockade has strong potential for breast cancer prevention and therapy. Key findings include the following:(1) COX-2 is constitutively expressed throughout breast cancer development and expression intensifies with stage at detection, cancer progression and metastasis;(2) essential features of mammary carcinogenesis(mutagenesis, mitogenesis, angiogenesis, reduced apoptosis, metastasis and immunosuppression) are linked to COX-2-driven prostaglandin E2(PGE-2) biosynthesis;(3) upregulation of COX-2 and PGE-2 expression induces transcription of CYP-19 and aromatase-catalyzed estrogen biosynthesis which stimulates unbridled mitogenesis;(4) extrahe-patic CYP-1B1 in mammary adipose tissue converts paracrine estrogen to carcinogenic quinones with mutagenic impact; and(5) agents that inhibit COX-2 reduce the risk of breast cancer in women without disease and reduce recurrence risk and mortality in women with breast cancer. Recent sharp increases in global breast cancer incidence and mortality are likely driven by chronic inflammation of mammary adipose and upregulation of COX-2 associated with the obesity pandemic. The totality of evidence clearly supports the supposition that mammary carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive overexpression of COX-2 and the prostaglandin cascade in the "inflammogenesis of breast cancer".展开更多
目的:探讨炎性乳腺癌(inflammatory breast cancer,IBC)患者临床病理特征与新辅助化疗疗效及预后的相关关系。方法:回顾性分析天津医科大学肿瘤医院2010年1月至2013年12月收治且接受新辅助化疗的81例IBC患者临床资料,应用单因素及多因...目的:探讨炎性乳腺癌(inflammatory breast cancer,IBC)患者临床病理特征与新辅助化疗疗效及预后的相关关系。方法:回顾性分析天津医科大学肿瘤医院2010年1月至2013年12月收治且接受新辅助化疗的81例IBC患者临床资料,应用单因素及多因素统计学方法分析其临床病理特征对化疗疗效及预后的影响。结果:所有患者3年总生存(OS)率和无病生存(DFS)率分别为53.1%和37.0%,患者接受新辅助化疗后的病理完全缓解(pathologic complete response,pCR)率为13.6%(11/81)。新辅助化疗后是否达到pCR与患者的病理类型和分子分型有关(P<0.05),但获得pCR并不会改善其预后(P>0.05),而IBC患者的术前淋巴结分期是OS和DFS的独立影响因素(均P<0.05),新辅助化疗方案和淋巴管癌栓情况是影响患者DFS的独立因素(P<0.05)。结论:IBC的临床病理特征影响患者对化疗的敏感性,同时通过对术前淋巴结分期和淋巴管癌栓状态的评估,可以预测疾病的预后,合理使用新辅助化疗方案,以期达到最佳的治疗效果。展开更多
目的:研究16例炎性乳腺癌(Inflammatory breast cancer,IBC)患者钼靶X线表现及病理结果,为该病患者的早期诊治提供参考依据。方法:回顾性分析从2019年1月至2021年10月于我院接受诊治的16例IBC患者病历资料。分析患者钼靶X线表现、病理...目的:研究16例炎性乳腺癌(Inflammatory breast cancer,IBC)患者钼靶X线表现及病理结果,为该病患者的早期诊治提供参考依据。方法:回顾性分析从2019年1月至2021年10月于我院接受诊治的16例IBC患者病历资料。分析患者钼靶X线表现、病理结果以及免疫组化检查结果,并以病理结果为金标准,将所有IBC患者按照钼靶X线诊断结果的差异分为真阳性组12例以及假阴性组4例。比较两组患者临床病理特征及免疫组化检查结果。结果:16例IBC患者钼靶X线表现:(1)5例患者皮肤增厚,后缘模糊不清,且伴有乳头内陷;(2)皮下脂肪层密度明显增高,9例患者可见显著增粗的Cooper’s韧带;(3)腺体增厚,结构紊乱,3例在腺体内见明显形态不规则的肿块,其中1例伴有沙粒样钙化,10例未发现显著肿块,4例伴有弥漫分布的沙粒样钙化灶;(4)同侧腋窝均伴有淋巴结肿大,结构致密,边缘相对清晰。16例IBC患者均经病理诊断确诊为浸润性导管癌;其中6例皮肤内可见明显淋巴管癌栓;钼靶X线诊断炎性乳腺癌真阳性12例,假阴性4例。16例IBC患者经免疫组化检查结果显示:雌激素受体(Estrogen receptor,ER)阳性8例,占比50.00%,孕激素受体(Progesterone receptor,PR)阳性7例,占比43.75%,P53阳性10例,占比62.50%。钼靶X线假阴性IBC患者肿块大小≤5 cm、TNM分期为Ⅰ~Ⅱ期以及无淋巴结转移人数占比均高于真阳性患者(P均<0.05)。钼靶X线假阴性及真阳性IBC患者ER、PR及P53阳性人数占比差异无统计学意义(P均>0.05)。结论:IBC患者钼靶X线表现及病理结果均有一定的特征性,两者可为IBC的临床诊断提供参考。展开更多
文摘Cohesive scientific evidence from molecular, animal, and human investigations supports the hypothesis that constitutive overexpression of cyclooxygenase-2(COX-2) is a ubiquitous driver of mammary carcinogenesis, and reciprocally, that COX-2 blockade has strong potential for breast cancer prevention and therapy. Key findings include the following:(1) COX-2 is constitutively expressed throughout breast cancer development and expression intensifies with stage at detection, cancer progression and metastasis;(2) essential features of mammary carcinogenesis(mutagenesis, mitogenesis, angiogenesis, reduced apoptosis, metastasis and immunosuppression) are linked to COX-2-driven prostaglandin E2(PGE-2) biosynthesis;(3) upregulation of COX-2 and PGE-2 expression induces transcription of CYP-19 and aromatase-catalyzed estrogen biosynthesis which stimulates unbridled mitogenesis;(4) extrahe-patic CYP-1B1 in mammary adipose tissue converts paracrine estrogen to carcinogenic quinones with mutagenic impact; and(5) agents that inhibit COX-2 reduce the risk of breast cancer in women without disease and reduce recurrence risk and mortality in women with breast cancer. Recent sharp increases in global breast cancer incidence and mortality are likely driven by chronic inflammation of mammary adipose and upregulation of COX-2 associated with the obesity pandemic. The totality of evidence clearly supports the supposition that mammary carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive overexpression of COX-2 and the prostaglandin cascade in the "inflammogenesis of breast cancer".
文摘目的:探讨炎性乳腺癌(inflammatory breast cancer,IBC)患者临床病理特征与新辅助化疗疗效及预后的相关关系。方法:回顾性分析天津医科大学肿瘤医院2010年1月至2013年12月收治且接受新辅助化疗的81例IBC患者临床资料,应用单因素及多因素统计学方法分析其临床病理特征对化疗疗效及预后的影响。结果:所有患者3年总生存(OS)率和无病生存(DFS)率分别为53.1%和37.0%,患者接受新辅助化疗后的病理完全缓解(pathologic complete response,pCR)率为13.6%(11/81)。新辅助化疗后是否达到pCR与患者的病理类型和分子分型有关(P<0.05),但获得pCR并不会改善其预后(P>0.05),而IBC患者的术前淋巴结分期是OS和DFS的独立影响因素(均P<0.05),新辅助化疗方案和淋巴管癌栓情况是影响患者DFS的独立因素(P<0.05)。结论:IBC的临床病理特征影响患者对化疗的敏感性,同时通过对术前淋巴结分期和淋巴管癌栓状态的评估,可以预测疾病的预后,合理使用新辅助化疗方案,以期达到最佳的治疗效果。
