BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of ...BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of cases and limited clinical experience,treatments vary greatly around the world and no standardized treatment has yet been established.AIM To investigate the clinicopathological features,psychological status and prognostic features of patients with OBC.METHODS The clinicopathological data of 33 OBC patients diagnosed and treated in the Affiliated Hospital of Xuzhou Medical University and Xuzhou Central Hospital from November 2015 to November 2022 were retrospectively analyzed.The psychological status of OBC patients was evaluated by the Self-rating Anxiety Scale and Self-rating Depression Scale.Patients’emotions,stress perception and psychological resilience were evaluated by the Positive and Negative Affect Schedule,the Chinese Perceived Stress Scale,and the Connor-Davidson Resilience Scale(CD-RISC),respectively.Patient survival was calculated using the Kaplan-Meier method,and survival curves were plotted for analysis with the log-rank test.Univariate and multivariate survival analyses were performed using the Cox regression model.RESULTS The 33 OBC patients included 32 females and 1 male.Of the 33 patients,30(91%)had axillary tumors,3(9%)had a neck mass as the primary symptom;18(54.5%)had estrogen receptor-positive tumors,17(51.5%)had progesterone receptor-positive tumors,and 18(54.5%)had Her-2-positive tumors;24(72.7%)received surgical treatment,including 18 patients who underwent modified radical mastectomy,1 patient who underwent breast-conserving surgery plus axillary lymph node dissection(ALND),and 5 patients who underwent ALND alone;12 patients received preoperative neoadjuvant therapy.All 30 patients developed anxiety and depression,with low positive affect scores and high negative affect scores,accompanied by a high stress level and poor psychological resilience.There were no differences in the psychological status of patients according to age,body mass index,or menopausal status.The overall survival and disease-free survival(DFS)of all the patients were 83.3%and 55.7%,respectively.Univariate analysis demonstrated that the initial tumor site(P=0.021)and node stage(P=0.020)were factors that may affect patient prognosis.The 5-year DFS rate of OBC patients who received radiotherapy was greater(P<0.001),while the use of different surgical methods(P=0.687)had no statistically significant effect on patient outcomes.Multivariate analysis revealed that radiotherapy(P=0.031)was an independent prognostic factor.Receiving radiotherapy had a significant effect on the CD-RISC score(P=0.02).CONCLUSION OBC is a rare breast disease whose diagnosis and treatment are currently controversial.There was no significant difference in the efficacy of other less invasive surgical procedures compared to those of modified radical mastectomy.In addition,radiotherapy can significantly improve patient outcomes.We should pay attention to the psychological state of patients while they receive antitumor therapy.展开更多
Objective To explore the association between perceived mental stress(MS),lymphocyte subset variations,and coronary lesion severity in patients with coronary artery disease(CAD).Methods Patients with CAD were enrolled ...Objective To explore the association between perceived mental stress(MS),lymphocyte subset variations,and coronary lesion severity in patients with coronary artery disease(CAD).Methods Patients with CAD were enrolled in this study from September 2023 to May 2024.Perceived Stress Scale-14(PSS-14)was used to evaluate MS during the last 1 month.Lymphocyte subsets were analyzed,including the percentage and absolute counts of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD3^(-)CD19^(+),CD3^(-)CD56^(+)16^(+),and the Th/Ts ratio.Statistical analysis was conducted using SPSS 24.0.Results This study recruited patients with 323 CAD,with an average age of 61(56,68)years,including 203 males and 120 females.According to the PSS-14,a score of 14-42 and 43-70 were categorized as normal and increased MS,respectively.Patients with CAD with increased MS had significantly higher Gensini scores than those with normal MS[37(19,64)vs.28(12,50),Z=-2.19,P=0.029].Male CAD patients with increased MS exhibited significantly higher Gensini scores[39(20,58)vs.26(12,45),Z=-2.37,P=0.018],levels of CD3^(+)CD8^(+)%[28.3%(23.6%,36.6%)vs.25.9%(21.0%,32.4%),Z=-2.05,P=0.041],and CD3^(+)CD8^(+)absolute value[485(346,675)vs.396(309,510)cells/μl,Z=-2.55,P=0.011]than those with normal MS.In male patients with CAD,a positive correlation was observed between Gensini scores(correlation coefficient:O.181,P=0.011),PSS-14 scores,and CD3^(+)CD8^(+)absolute value(correlation coefficient:0.162,P=0.038).Conclusion This study reveals a positive correlation between MS and coronary stenosis severity,with notable sex differences.In male patients with CAD,higher levels of MS are associated withmore severe coronarystenosis.The potential underlying mechanism may involve the regulation of lymphocyte subsets.展开更多
基金Supported by Jiangsu Provincial Health Commission’s 2020 High-Level Health Talents“Six Ones Project”Top-Notch Talent Research Project,No.LGY20200062021 Youth Medical Science Innovation Project of Xuzhou Health Commission,No.XWKYHT20210580.
文摘BACKGROUND Occult breast cancer(OBC)has traditionally been considered to be a carcinoma of unknown primary origin with a favorable prognosis and can be treated as stage II-III breast cancer.Due to the small number of cases and limited clinical experience,treatments vary greatly around the world and no standardized treatment has yet been established.AIM To investigate the clinicopathological features,psychological status and prognostic features of patients with OBC.METHODS The clinicopathological data of 33 OBC patients diagnosed and treated in the Affiliated Hospital of Xuzhou Medical University and Xuzhou Central Hospital from November 2015 to November 2022 were retrospectively analyzed.The psychological status of OBC patients was evaluated by the Self-rating Anxiety Scale and Self-rating Depression Scale.Patients’emotions,stress perception and psychological resilience were evaluated by the Positive and Negative Affect Schedule,the Chinese Perceived Stress Scale,and the Connor-Davidson Resilience Scale(CD-RISC),respectively.Patient survival was calculated using the Kaplan-Meier method,and survival curves were plotted for analysis with the log-rank test.Univariate and multivariate survival analyses were performed using the Cox regression model.RESULTS The 33 OBC patients included 32 females and 1 male.Of the 33 patients,30(91%)had axillary tumors,3(9%)had a neck mass as the primary symptom;18(54.5%)had estrogen receptor-positive tumors,17(51.5%)had progesterone receptor-positive tumors,and 18(54.5%)had Her-2-positive tumors;24(72.7%)received surgical treatment,including 18 patients who underwent modified radical mastectomy,1 patient who underwent breast-conserving surgery plus axillary lymph node dissection(ALND),and 5 patients who underwent ALND alone;12 patients received preoperative neoadjuvant therapy.All 30 patients developed anxiety and depression,with low positive affect scores and high negative affect scores,accompanied by a high stress level and poor psychological resilience.There were no differences in the psychological status of patients according to age,body mass index,or menopausal status.The overall survival and disease-free survival(DFS)of all the patients were 83.3%and 55.7%,respectively.Univariate analysis demonstrated that the initial tumor site(P=0.021)and node stage(P=0.020)were factors that may affect patient prognosis.The 5-year DFS rate of OBC patients who received radiotherapy was greater(P<0.001),while the use of different surgical methods(P=0.687)had no statistically significant effect on patient outcomes.Multivariate analysis revealed that radiotherapy(P=0.031)was an independent prognostic factor.Receiving radiotherapy had a significant effect on the CD-RISC score(P=0.02).CONCLUSION OBC is a rare breast disease whose diagnosis and treatment are currently controversial.There was no significant difference in the efficacy of other less invasive surgical procedures compared to those of modified radical mastectomy.In addition,radiotherapy can significantly improve patient outcomes.We should pay attention to the psychological state of patients while they receive antitumor therapy.
文摘Objective To explore the association between perceived mental stress(MS),lymphocyte subset variations,and coronary lesion severity in patients with coronary artery disease(CAD).Methods Patients with CAD were enrolled in this study from September 2023 to May 2024.Perceived Stress Scale-14(PSS-14)was used to evaluate MS during the last 1 month.Lymphocyte subsets were analyzed,including the percentage and absolute counts of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD3^(-)CD19^(+),CD3^(-)CD56^(+)16^(+),and the Th/Ts ratio.Statistical analysis was conducted using SPSS 24.0.Results This study recruited patients with 323 CAD,with an average age of 61(56,68)years,including 203 males and 120 females.According to the PSS-14,a score of 14-42 and 43-70 were categorized as normal and increased MS,respectively.Patients with CAD with increased MS had significantly higher Gensini scores than those with normal MS[37(19,64)vs.28(12,50),Z=-2.19,P=0.029].Male CAD patients with increased MS exhibited significantly higher Gensini scores[39(20,58)vs.26(12,45),Z=-2.37,P=0.018],levels of CD3^(+)CD8^(+)%[28.3%(23.6%,36.6%)vs.25.9%(21.0%,32.4%),Z=-2.05,P=0.041],and CD3^(+)CD8^(+)absolute value[485(346,675)vs.396(309,510)cells/μl,Z=-2.55,P=0.011]than those with normal MS.In male patients with CAD,a positive correlation was observed between Gensini scores(correlation coefficient:O.181,P=0.011),PSS-14 scores,and CD3^(+)CD8^(+)absolute value(correlation coefficient:0.162,P=0.038).Conclusion This study reveals a positive correlation between MS and coronary stenosis severity,with notable sex differences.In male patients with CAD,higher levels of MS are associated withmore severe coronarystenosis.The potential underlying mechanism may involve the regulation of lymphocyte subsets.
