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Background and purpose: Both domestic and foreign guidelines recommend the use of radionuclide as sentinel lymph node (SLN) biopsy (SLNB) tracer, however this technique has not been popularized in China for a variety of reasons. Mitoxantrone hydrochloride injection for tracing (MHI), a new strategy to identify lymph nodes, has not been tested for axillary node staging in breast cancer. This multicenter, self-controlled, non-inferiority trial aimed to evaluate the differences between MHI and radionuclide in SLNB tracing. Methods: The trial was conducted across 7 hospitals from December 2019 to December 2020. Patients with early-stage breast cancer received MHI and radionuclide (technetium 99 labeled sulfur colloid, 99mTc-Sc) as SLN tracers during the surgery. The number of SLNs detected and sentinel node detection rates of MHI and radionuclide were counted to evaluate differences in the tracing effects between the two tracers. Results: SLN detection rates of MHI and radionuclide were 96.9% (370/382) and 97.4% (372/382), respectively, with no significant difference (P>0.05). SLNs were co-detected by both tracers in 362 (94.7%) patients; 16 (4.1%) had adverse events possibly related to the trial drugs. Conclusion: In this study, it was found that the lymphatic tracing ability of MHI was not inferior to that of radionuclide. Meanwhile, the use of MHI does not require special instrument/equipment assistance.

The purpose of this article was to explore the correlation between the grafts, surrounding structures and the stability of the knee joint after reconstruction of the knee joint anterior cruciate ligament (ACL) injury caused by the CT three-dimensional reconstruction technology combined with MRI. According to the stability of the knee joint after the operation. A total of 238 patients with knee ACL injury caused by exercise were divided into unstable group (31 cases) and stable group (207 cases). Through comparative analysis, it was found that the positive rate of graft continuity, the rate of graft loosening, the positive rate of screw, the positive rate of bone around the tunnel, and the positive rate of intra-articular cavity of the situation in the unstable group was higher than those of the stable group. The postoperative graft signal strength, tibia anterior movement, and Blumensaat angle in the unstable group were higher than those in the stable group, while the ACL angle was lower than that in the stable group (P<0.05). Graft continuity, graft orientation, screws, bone around the tunnel, intra-articular conditions, postoperative graft signal intensity, postoperative tibial anterior movement, postoperative ACL angle, and postoperative Blumensaat angle were all the influencing factors of postoperative knee instability after reconstruction (P<0.05). The area under the curve (AUC) of the Logistic regression model for predicting postoperative knee instability was 0.909. It shows that CT three-dimensional reconstruction technology combined with MRI has a significant correlation with the stability of knee joint in the detection of the postoperative graft status and surrounding structures in patients with knee ACL, and has a certain value in predicting the stability of knee joint. [ABSTRACT FROM AUTHOR]

Purpose: In this study, we aimed to investigate the viability of utilizing CytoSorter® system to detect circulating tumor cells (CTCs) and to evaluate the diagnostic value of CTCs in breast cancer (BC). Methods: A total of 366 females patients suspected of having BC and 30 healthy female volunteers were enrolled in this study. CTCs were enriched by CytoSorter®, a microfluidic‐based CTCs capturing platform. CTC detection was performed before operation or biopsy. Based on the biopsy results, patients were divided into two groups, namely patients with BC and patients with benign breast diseases (BBD). Patients with BBD and healthy volunteers were serving as controls. The correlation between CTC enumeration and patients' clinicopathological characteristics was evaluated. The receiver operating characteristic (ROC) curve was plotted to assess the diagnostic potency of CytoSorter® system in BC. Results: Based on the biopsy results, 130 BC patients at different cancer stages and 236 patients with BBD were enrolled in the study. Seven subjects were dropped out from the study. CTCs were detected in 109 of 128 BC patients, in one of 29 healthy volunteers, and in 37 of 232 patients with BBD. Maximum CTC counts detected in BC patients, healthy volunteers, and patients with BBD were 8, 1, and 4, respectively. Statistical analysis showed CTCs could be used to distinguish BC patients from healthy volunteers and patients with BBD (P <.0001). Circulating tumor cells were statistically associated with patients' cancer stage (P =.0126), tumor size (tumor node metastasis [TNM] T stage, P =.0253), cancer type (invasive vs noninvasive, P =.0141), and lymph node metastasis (P =.0436). More CTCs were found in patients at advanced cancer stage or TNM T stage and in patients with invasive tumor or lymph node metastasis. Furthermore, CTC detection rates in BC patients at Tis and T1‐4 stages were 50%, 81.67%, 91.07%, 100%, and 100%, respectively. When the CTC cut‐off value was set to 2, the ROC curve gave an area under the curve (AUC) of 0.86 with a specificity and sensitivity of 95.4% and 76.56%, respectively. Taken together, CTCs could be used as a diagnostic aid in assistance of cancer screening and staging. Conclusion: Circulating tumor cells were successfully isolated in BC patients using CytoSorter® system. CTCs can be used to differentiate BC patients from the patients with BBD or healthy volunteers, and as a diagnostic aid for early cancer diagnosis and cancer staging. [ABSTRACT FROM AUTHOR]

Purpose: Circulating tumor cells (CTCs) are known to be associated with late recurrence and poor prognosis in breast cancer (BC). Different CTC enrichment platforms have different CTC cut-off values for poor prognosis. This study aimed to evaluate whether preoperative CTCs could be a prognostic factor for early recurrence of disease in BC patients with resectable tumors, and to ascertain the CTC cut-off value for early recurrence with CytoSorter ® CTC system., Methods: Thirty-six stage II and III BC patients who had preoperative (pre-op) CTC detection and underwent a mastectomy or lumpectomy for curative intent between January and May 2018 were enrolled in this retrospective study. CTC detection was performed using CytoSorter ® CTC system. Correlations of patients' demographics, clinicopathological characteristics, adjuvant therapies and CTCs with relapse and survival were evaluated., Results: CTCs were detected in 32 out of 36 patients before surgery. Nine patients developed relapses during follow-up, and seven of them were distant recurrence. Univariate analysis showed that CTCs were correlated with two-year recurrence free survival (RFS) and distant RFS (D-RFS) ( P = 0.013 and 0.029, respectively). Two-year RFS and D-RFS were 85.2% and 88.9%, respectively, for patients with <4 CTCs, while 44.4% and 55.6%, respectively, for patients with ≧4 CTCs. In multivariate analysis, only CTC was shown to be correlated with two-year RFS (HR: 0.219, 95% CI: [0.058-0.82], P = 0.024) and D-RFS (HR: 0.218, 95% CI [0.048-0.977], P = 0.047)., Conclusion: BC patients with pre-op CTCs ≥4 per four mL of blood have significantly reduced two-year RFS and D-RFS. A pre-op CTC cut-off of four per four mL of blood was found for CytoSorter ® to identify BC patients with a higher risk for early recurrence., Competing Interests: Wan-Hung Fan and Meiqiong Wu are currently employees of Hangzhou Watson Biotech. The authors declare that they have no competing interests., (© 2021 Jin et al.)