BackgroundAdjuvant chemotherapy and targeted therapy have become standard postoperative therapeutic modalities for human epidermal growth factor receptor 2 (HER2)-positive breast cancer(HER2-positive,HR-negative), including triple-positive breast cancer(HER2-positive,HR-positive). However, these two types of breast cancer differ in terms of pathogenesis. This article analyzes these two types of breast cancer by comparing their prognoses.MethodsThe clinicopathological characteristics of 135 patients, including 60 patients with triple-positive breast cancer and 75 patients with HER2-positive breast cancer, were analyzed to compare the disease-free survival (DFS) and overall survival (OS) of the two groups over a 5-year period. A multifactorial Cox risk model was constructed by grouping age, menstrual status, maximum tumor diameter, number of lymph node metastases, pathological staging, and Ki-67 staining results. All statistical data were analyzed in detail using SPSS25.0 statistical software.ResultsThe 5-year OS rates of patients with breast cancer in the triple-positive and HER2-positive groups were 96.7% and 82.7%, respectively, and the 5-year DFS rates were 90% and 73.3%, respectively. The Cox results revealed that molecular staging was an independent factor affecting recurrent metastasis and survival of breast cancer patients (hazard ratio [HR] =2.199, 95% confidence interval [CI], 1.296-8.266; HR = 9.994, 95% CI, 2.019-49.465).ConclusionThe 5-year DFS and OS rates were significantly better in the triple-positive group than in the HER2-positive group. Subgroups received different prognosis for different chemotherapy regimens. Breast cancer patients should be treated according to the risk of recurrence with symptomatic treatment and precise regulation.
The harsh conditions of the gastrointestinal tract limit the potential health benefits of oral probiotics. It is promising that oral bioavailability is improved by strengthening the selfprotection of probiotics. Here, we report the encapsulation of a probiotic strain by endogenous production of hyaluronan to enhance the effects of oral administration of the strain. The traditional probiotic Streptococcus thermophilus was engineered to produce hyaluronan shells by using traceless genetic modifications and clustered regularly interspaced short palindromic repeat interference. After oral delivery to mice in the form of fermented milk, hyaluronan-coated S. thermophilus (204.45 mg/L hyaluronan in the milk) exhibited greater survival and longer colonization time in the gut than the wild-type strain. In particular, the engineered probiotic strain could also produce hyaluronan after intestinal colonization. Importantly, S. thermophilus self-encapsulated with hyaluronan increased the number of goblet cells, mucus production, and abundance of the microorganisms related to the biosynthesis of short-chain fatty acids, resulting in the enhancement of the intestinal barrier. The coating formed by endogenous hyaluronan provides an ideal reference for the effective oral administration of probiotics.
Background: Bronchiolar adenoma (BA) is a rare benign tumor arising from the bronchiolar mucosal epithelium that mainly occurs in the periphery of lung. The most prominen histopathologic feature of BA is a bilayered bronchiolar-type epithelium containing a continuous basal cell layer. However, due to the high mutation frequency of driven genes, it is still controversial whether BA has malignant transformation potential. In frozen sections, basal cells are difficult to identify by microscopically, making it difficult to distinguish from non-mucinous adenocarcinoma, especially when malignant transformation of BA into invasive mucinous adenocarcinoma (IMA) occurs, it is only differentiated by histomorphology criteria, which greatly improves the difficulty of diagnosis. Case presentation: This paper, we report a case of a 59-year-old man. The chest computed tomography (CT) showed a high-density nodular gradually increased during 4 years in the outer basal segment of the right lower lobe, followed by thoracoscopic wedge resection of the right lower lobe. Postoperative pathological diagnosis was BA, with mucous gland structure formation combined with basal cell loss in partial region, considering malignant transformation into invasive mucinous adenocarcinoma. Regular postoperative follow-up showed no recurrence or metastasis. Hybridization Capture-based next-generation sequencing (NGS) eventually detected driver gene KRAS and CDK6 mutations in the case, and the results suggested the occurrence of malignant transformation from BA to IMA.Conclusion: In the nodular, the loss of continuity of the basal cell layer in the area of mucous glandular structures and the driver gene KRAS mutation indicate a malignant transformation of BA into IMA in this case, so we infer that BA has malignant potential.
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