Objective: To assess the inhibitory effects of local injection of liposomal adriamycin (LADR) on the proliferation of lymph node metastases in rabbits bearing VX2 carcinoma in the mammary gland. Methods:Thirty female New Zealand white rabbits were divided into 3 groups, with 10 in each. VX2 tumor mass suspensions were injected into the breast tissues of rabbits. Treatment initiated once the axillary lymph node reached 5 mm in the maximum diameter. Group 1 received a sham treatment. Group 2 received a subcutaneous injection of LADR adjacent to tumor. Group 3 received an intravenous injection of free ADR (FADR) at the same dose and concentration to group 2. The breast tumors and axillary lymph nodes were resected after the treatment was repeated 3 times. The tumor and node sizes before and after treatment were measured. PCNA mRNA expressions in breast tumors and axillary nodes were determined using RT-PCR. Results: The mean growth ratios of lymph nodes after treatment were 3. 70, 1. 55, and 2. 89,respectively, in groups 1,2, and 3. The slowest node growth was observed in animals of group 2, with significant differences from group 1 (P<0. 001) and group 3 (P = 0. 002). The relative values of PCNA mRNA expression in lymph nodes were 0. 541, 0. 329,and 0. 450, respectively, in groups 1,2, and 3. Group 2 exhibited a significantly reduced PCNA mRNA expression in metastatic lymph node, as compared to group 1 (P<0. 001) and group 3 (P = 0. 004). Intravenous FADR injection effectively lowered the mRNA expressions of PCNA in breast tumors, which were not apparently altered after local LADR injection. Conclusion: Local injection of LADR holds a strong inhibitory effect on the proliferation of metastatic tumor cells in lymph nodes and appears to be an effective method for the treatment of lymphatic metastases of breast cancer.
背景与目的:既往研究表明,18F-FDGPET显像结果与肿瘤新辅助治疗后的临床或病理反应密切相关。本研究拟探讨乳腺癌新辅助化疗前后18F-FDGPET/CT融合显像与细胞凋亡间的关系,以求进一步明确PET/CT对乳腺癌新辅助化疗疗效的预测价值。方法:45例原发性乳腺癌患者细针穿刺确诊后给予新辅助化疗三个周期,新辅助化疗前后行PET/CT融合显像检查并计算肿瘤区与非肿瘤区放射性比值(tumor to non-tumor activity ratio,T/N),dTUP末端标记技术检测穿刺及手术标本的癌细胞凋亡指数(apoptoticindex,AI)。结果:新辅助化疗后临床疗效评价完全缓解4例(8.9%),部分缓解29例(64.4%),疾病稳定10例(22.2%),疾病进展2例(4.4%)。化疗前后肿瘤平均T/N值分别为3.23±0.63、2.31±0.49(P=0.006),下降6.4%～50.8%。化疗前后AI分别为(2.81±0.76)%、(17.31±6.85)%(P<0.001),增高1.9%～41.3%。T/N值下降率与AI变化值间存在直线相关关系(rs=0.850,P<0.001)。以化疗后T/N值下降≥20%为阈值,PET/CT预测肿瘤临床缓解的灵敏度、特异度分别为90.9%、83.3%,阳性、阴性预测值分别为93.8%、76.9%,准确率为92.1%。结论:18F-FDGPET/CT融合显像与乳腺癌新辅助化疗后的细胞凋亡状态密切相关,对预测化疗疗效具有一定的应用价值。
背景与目的:淋巴管生成在肿瘤经淋巴途径转移中所起的作用已成为近几年里新的研究热点,但目前的研究结果仍存在很多争议。本研究拟检测乳腺癌患者新辅助化疗前后的淋巴管密度(lymphatic vessel density,LVD)并与乳腺良性病变进行比较,以进一步明确淋巴管生成的意义及其在化疗过程中的变化。方法:45例原发性乳腺癌患者给予3个周期新辅助化疗并手术,免疫组化法标记肿瘤及26例纤维腺瘤标本中特异性淋巴管内皮标志物Podop lan in并计数LVD。结果:乳腺癌瘤周、瘤内的淋巴管阳性率分别为70.9%、19.8%。化疗前瘤周平均LVD为9.6,纤维腺瘤瘤周平均LVD为5.4,两者间差异有显著性(P=0.012)。化疗后瘤周平均LVD为3.3,与化疗前相比显著降低(P<0.001),化疗前、后瘤内平均LVD分别为1.9、0.9(P=0.055)。淋巴结转移阳性和阴性组的平均瘤周LVD分别为11.8、7.0(P=0.048)。化疗后客观缓解组化疗前后平均瘤周LVD值分别为9.8、2.0(P<0.001)。结论:与良性病变相比,乳腺癌瘤周LVD显著增高;有瘤内淋巴管存在;瘤周LVD与HER-2、腋淋巴结转移状态相关;化疗后瘤周LVD明显降低,而瘤内LVD无显著变化;化疗后瘤周LVD的降低程度与化疗疗效相关。
