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According to the literature, there is no reliable and quantitative method available for the diagnosis and prognosis of early or potential temporomandibular joint (TMJ) condylar resorption (CR) thus far. The purpose of this study was to raise a new noninvasive method to quantitatively evaluate condylar quality using the signal intensity ratio (SIR) on magnetic resonance imaging (MRI) in order to assist in the diagnosis of TMJ CR. A retrospective exploratory study was performed to compare the condyle-to-cerebral cortex signal intensity ratios (SIR) on MRI among young female patients. We included 60 patients, and they were divided into three groups: the bilateral normal TMJ group (group 1), the bilateral TMJ anterior disc displacement (ADD) but without CR group (group 2), and the bilateral TMJ anterior disc displacement (ADD) with CR group (group 3). The SIR difference between the three groups was analyzed by the Kruskal–Wallis test (K-W test). The sensitivity, specificity, accuracy, and area under curve (AUC) were calculated by the receiver operating characteristic (ROC) curves. There was high consistency between the surgeon and the radiologist in the evaluation of the magnetic signal intensity with intraclass correlation coefficients of 0.939–0.999. The average SIR was 1.07 in the bilateral normal TMJ group (group 1), 1.03 in the ADD without CR group (group 2), and 0.78 in the ADD with CR group (group 3). It could be found by the K-W test that group 3 was significantly different from group 1 and group 2 (p < 0.05), while there was no significant difference between group 1 and group 2. The optimal critical SIR value was 0.96 for the diagnosis of CR according to the ROC curves and Youden index (p < 0.001, AUC = 0.9). The condyle-to-cerebral cortex SIR can be used as a noninvasive diagnostic tool for the quantitative evaluation of condylar quality and diagnosis and prognosis of CR. SIR ≥ 0.96 indicates a healthy condyle, while SIR < 0.96 is considered the optimal critical value for the diagnosis of CR. These findings are important for personalized and accurate treatment and prognosis prediction.

Background: Lymphopenia was often observed during follow-up for cancer patients, this study aimed to evaluate the prognostic value of prolonged lymphopenia for breast cancer patients. Methods: This was a retrospective cohort analysis of 296 patients with clinical stage I-III operable breast cancer, who had received chemotherapy and/or radiotherapy. Absolute lymphocyte count lower than 1.1×10^3/ul was defined as lymphopenia. Lymphopenia around the 6th month after chemo-radiotherapy was defined as cohort L, while normal Absolute lymphocyte count was defined as cohort N. Predictors of lymphopenia were assessed using univariate and multivariate logistic regression analyses. Kaplan–Meier and Cox regression analyses were used to evaluate the relationship between the two cohorts. Results: The baseline characteristics analysis: comparing to cohort N, cohort L had more Stage III(47.4% vs. 25.5%) and less Stage I cancer(12.3% vs. 20.1%)(p=0.005), more patients experienced combined chemotherapy regimen(86.0% vs. 69.5%, p=0.012), more patients experienced radiotherapy(78.9% vs. 64.9%, p=0.041), and less patients experienced endocrine therapy(54.4% vs. 68.2%, p=0.049). Multivariate logistic regression analysis revealed two negative independent factors associated with DFS: pTNM staging (stage II vs. I: HR=5.346, 95% CI: 2.286-12.504, pConclusion: Persistent lymphopenia after chemotherapy and/or radiotherapy was an independent predictor for breast cancer relapse and unfavorable survival.

To evaluate the post-operative condylar bone remodeling after the treatment of Yang’s arthroscopic surgery. Consecutive cases from Jan 2017 to May 2018 that received Yang’s arthroscopic surgery were included in this study, the TMJ MRI examinations were performed preoperatively and postoperatively (follow up for 1 year or more), and condylar bone remodeling was estimated. A total of 229 patients (29 male and 200 female) were included in the study, 161 patients had new bone formation, and the average age was 17.5 ± 2.1a. There was no new bone formation in 68 patients with an average age of 24.5 ± 0.7a. The percentage of new bone formation patients in 10–15 years of age was 94.33% and decreases as the age increases. In the position of new bone formation, the posterior slope of condyle was the most (129 joints), the second was the top of condyle (54 joints), the third was around condyle (33 joints), only 25 joints had new bone on the anterior slope of condyle. After TMJ arthroscopic surgery, the condyle has the ability to form new bone, and the younger the age, the stronger the ability of new bone formation. The formation of new bone was most in posterior slope and least in anterior slope of condyle.

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

Background: To evaluate the guiding effect of digital image based on cone-beam computed tomographic in improving the quality of single oval root canal preparation.Methods: A premolar was selected by CBCT and a 3D-printed root canal model was made. Twenty postgraduates from the Department of Stomatology of Shanghai Ninth People's Hospital were selected to perform root canal preparation on 3D printed oval root canal model teeth. They were randomly assigned to two groups(n=10) according to the guiding method received: CBCT original image (control group) and CBCT-based digital image (experimental group). CBCT scans were performed on the models before and after the guidance. The changes in root canal cleanliness, residual minimum thickness, transportation and over-preparation amount were analyzed.Results: The experimental group caused significantly more increased amount of cleanliness compared to control group(P0.05)： 0.0154mm±0.2110mm in the control group and 0.0362±0.0444mm in the experimental group. In the control group, the transportation after second preparation was generally increased (increased 0.0084mm on average). In the experimental group, the transportation was generally reduced after second preparation (reduced 0.0081mm on average). But there was no significant difference in the transportation change between the two groups (P>0.05). After the second preparation, there was no significant difference in the amount of increased over-preparation between the two groups（P＞0.05）: 1.7029%±3.6622% in the control group and 3.5144%±4.8075% in the experimental group.Conclusions: Compared with traditional CBCT image guidance, the digital image method can significantly improve the cleaning effect of the oval root canal preparation. It didn’t result in more over-preparation and the amount of residual wall thickness was ensured. At the same time, it has a certain effect on reducing transportation after the guidance.

BACKGROUND: Tumor apparent diffusion coefficient (ADC) measurements may be influenced by region of interest (ROI) sizes; however, this effect has not been systematically studied in parotid tumors. Our purpose was to determine the effects of ROI size on ADC measurements for the differentiation of pleomorphic adenoma (PA), Warthin tumor (WT), and normal parotid parenchyma. METHODS: Sixty-five patients including 37 with PA (lesions, n=37) and 28 with WT (lesions, n=36) were examined with diffusion-weighted imaging (DWI). Participants with normal contralateral parenchyma of the parotid gland constituted the control group (n=56). The mean ADC values and standard deviations (SDs) of the ADC (ADC(SD)) of 12 concentric round ROIs (areas: 9, 28, 34, 50, 60, 82, 93, 98, 115, 130, 136, and 149 mm(2)) for tumors and normal tissue were measured by using custom-made software. Homogeneity index, which was defined by the ADC(SD)/mean ADC, was also calculated. One-way repeated analyses of variance (ANOVAs) were performed on the mean ADCs, ADC(SD)s, and homogeneity indices of the 12 ROIs in each group. The three parameters at different ROIs among PA, WT, and normal parotid parenchyma were compared using Kruskal-Wallis tests. RESULTS: There was excellent agreement for the ADC measurements with the 12 ROIs for PA [intraclass correlation coefficient (ICC), 0.98], WT (ICC, 0.99), and normal parotid parenchyma (ICC, 0.95). No significant differences were observed in the mean ADCs of the 12 ROIs for each of the three groups (P=0.744–0.990). Among the three groups, the mean ADC of normal parotid parenchyma [(0.94±0.003)×10(−3) mm(2)/s] was significantly lower than that of both PA [(1.72±0.01)×10(−3) mm(2)/s] and WT [(1.16±0.01)×10(−3) mm(2)/s] in the 12 ROIs, whereas the PA group had the highest mean ADC values. No significant differences were found in the mean ADC(SD)s with each ROI between PA and WT (all P>0.017). PAs had lower homogeneity indices compared with WTs and normal parotid parenchyma (all P

BACKGROUND: To compare and analyze nine MRI sequences of the TMJ and determine the optimum sequence for the rapid diagnosis of TMDs so as to develop new clinical guidelines. METHODS: Twenty young volunteers (a total of 40 joints) aged 22–26 years were recruited. Three basic sequences, T(1)-weighted imaging (T(1)WI), T(2)-weighted imaging (T(2)WI), and proton density-weighted imaging (PDWI), together with three positions, oblique sagittal (OSag) with closed mouth, oblique coronal (OCor) with closed mouth, and OSag with opened mouth, were selected in combination for testing. In the OCor position, four regions of interest (ROIs), the condyle (C), the disc (D), the disc outside (DO), and fat (F), were analyzed. For the OSag with closed mouth position and the OSag with opened mouth position sequences, the four ROIs were the condyle (C), the disc (D), the disc ahead (DA), and the disc rear (DR). The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and signal intensity ratio (SIR) were calculated and analyzed using independent sample t-tests and one-way analysis of variance. Two senior radiologists scored the images of the nine MRI sequences subjectively and selected three optimal sequences. Using the three selected sequences, 1479 patients with anterior disc displacement with reduction (ADDwR) or anterior disk displacement without reduction (ADDwoR) were evaluated by comparing the preoperative TMJ MRI with the outcomes of the maxillofacial arthroscopy or open surgery. RESULTS: The T(1)WI sequence showed the highest SNR while the T(2)WI group had the lowest SNR. The ROIs of the T(2)WI group had the highest CNR and SIR values in the OCor and OSag sequences. In the OCor sequence, the value for the SIR F/DO group was higher than the SIR C/D and SIR C/DO values. Using subjective analysis to evaluate the quality of the scans, the highest total scores were obtained for the OSag T(2)WI with opened mouth and OSag PDWI with closed mouth sequences. From the objective and subjective analysis, the three optimal sequences selected were OSag PDWI, OCor T(2)WI with closed mouth, and OSag T(2)WI with opened mouth. In patients with anterior disc displacement, the comparisons of the surgery and the selected MRI sequences indicated that the total diagnostic accuracy of the MRI was 96.3% (1,425/1,479 cases). For patients with ADDwoR, the diagnostic accuracy was 98.5% (1,372/1,393 cases), and for those with ADDwR it was 61.6% (53/86 cases). There were significant differences between the ADDwoR and ADDwR groups (χ(2)=312.92, P

Supplemental material, sj-pdf-2-tam-10.1177_17588359211013626 for Apatinib in patients with recurrent or metastatic adenoid cystic carcinoma of the head and neck: a single-arm, phase II prospective study by Guopei Zhu, Lin Zhang, Shengjin Dou, Rongrong Li, Jiang Li, Lulu Ye, Wen Jiang, Minjun Dong, Min Ruan, Wenjun Yang and Chenping Zhang in Therapeutic Advances in Medical Oncology

Supplemental material, sj-pdf-1-tam-10.1177_17588359211013626 for Apatinib in patients with recurrent or metastatic adenoid cystic carcinoma of the head and neck: a single-arm, phase II prospective study by Guopei Zhu, Lin Zhang, Shengjin Dou, Rongrong Li, Jiang Li, Lulu Ye, Wen Jiang, Minjun Dong, Min Ruan, Wenjun Yang and Chenping Zhang in Therapeutic Advances in Medical Oncology

Background: Apatinib, a vascular endothelial growth factor receptor (VEGFR) blocker, has demonstrated encouraging antitumor activities and tolerable toxicities in various cancer types. Recurrent or metastatic adenoid cystic carcinoma of the head and neck (R/MACCHN) carries a poor prognosis, and treatment options are currently limited. This study was conducted to explore the antitumor activity and safety of apatinib in patients with R/MACCHN. Methods: In this phase II single-arm, prospective study, patients aged 15–75 years with incurable R/MACCHN received apatinib at a 500 mg dose once daily until intolerance or progression occurred. The primary endpoint was the 6-month progression-free survival (PFS) rate based on RECIST version 1.1. The secondary endpoints included response rate, overall survival (OS), and safety. Efficacy was assessed in all dosed patients with at least one post-baseline tumor assessment. Results: Among 68 patients treated with apatinib, 65 were evaluable for efficacy analysis, with a median follow-up time of 25.8 months. The 6-month, 12-month, and 24-month PFS rates were 92.3% [95% confidence interval (CI): 83–97.5%], 75.2% (95% CI: 61.5–84.0%) and 44.7% (95% CI: 32.3–57.5%), respectively. The objective response rate (ORR) and disease control rate (DCR), as assessed by investigators, were 46.2% (95% CI: 33.7–59.0%) and 98.5% (95% CI: 91.7–100.0%), respectively. The median duration of response was 17.7 months [interquartile range (IQR) 14.0–20.9]. The 12-month and 24-month OS rates were 92.3% (95% CI: 83.0–97.5%) and 82.3% (95% CI: 70–90.4%), respectively. The most common adverse events of grades 3–4 were hypertension (5.9%), proteinuria (9.2%), and hemorrhage (5.9%). One patient developed a fatal hemorrhage. Conclusion: An encouraging PFS, a high ORR, and a manageable safety profile were observed in this study. It seems that the administration of apatinib in R/MACCHN is likely to have a clinically meaningful therapeutic benefit and warrants further investigation. This study was prospectively registered in ClinicalTrials.gov (NCT02775370; date of registration: 17 May 2016; date of first patient enrollment: 25 May 2016)

Objective: To compare and evaluate the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) values between a 15-channel phased array head coil and 6-channel dS Flex M surface coil in the MRI of temporomandibular joint. Methods: 300 patients were randomly assigned to two groups: 150 patients were examined by using a 15-channel phased array head coil and the other 150 patients were scanned by using a 6-channel dS Flex M surface coil. All of the data were set in the same 6 regions of interest including the temporal lobe, condyle neck, lateral pterygoid muscle, parotid gland, the adipose area and an area of the background noise）. SNR and CNR values were measured respectively. Results: The numerical variation law of SNR and CNR values measured in regionsof interest of each group was similar, although different coils were used. There were statistically significant differences of SNR values in all of the oblique sagittal (OSag) proton density-weighted imaging, the part of OSag T 2 weighted image (T 2WI) except for SNR4 and SNR5. and oblique coronal (OCor) T 2WI sequence except for SNR2. On the contrary, SNR4 and SNR5 values in the OCor T 2WI and SNR5 values in OSag T 2WI sequences by using the surface coil were higher than those by using the head coil. There were no statistically significant intergroup differences of CNR values in OSag proton density-weighted imaging sequence except CNR1 and in OSag T 2WI sequence except CNR5. But, statistically significant differences of all the values in the OCor T 2WI sequence except for CNR1 were observed. Conclusion: Both the phased array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI.

Background: Apatinib, a vascular endothelial growth factor receptor (VEGFR) blocker, has demonstrated encouraging antitumor activities and tolerable toxicities in various types of cancer. Recurrent or metastatic adenoid cystic carcinoma of the head and neck (R/MACCHN) carries a poor prognosis, and treatment options are currently limited. The high VEGFR expression in R/MACCHN makes antiangiogenesis a potential effective treatment in patients with R/MACCHN. This study was conducted to explore the antitumor activity and safety of apatinib in patients with R/MACCHN. Methods: In this phase II single-arm, prospective study, patients aged 15-75 years with incurable R/MACCHN received apatinib at a dose of 500 mg once daily until intolerance or progression occurred. The primary endpoint was the 6-month progression-free survival (PFS) rate, which was based on RECIST version 1·1. The secondary endpoints included response rate, overall survival (OS) and safety. Efficacy was assessed in all dosed patients with at least one post-baseline tumor assessment. Findings: Among 68 patients treated with apatinib, 65 were evaluable for efficacy analysis, with a median follow-up time of 25·8 months. The 6-month, 12-month and 24-month PFS rates were 92·3% (95% confidence interval [CI]: 83–97·5%), 75·2% (95% CI: 61·5-84·0%) and 44·7% (95% CI: 32·3-57·5%), respectively. The objective response rate (ORR) and disease control rate (DCR), as assessed by investigators, were 46·2% (95% CI: 33·7–59·0%) and 98·5% (95% CI: 91·7–100·0%), respectively. The median duration of response was 17·7 months (interquartile range [IQR], 14·0-20·9). The 12-month and 24-month OS rates were 92·3% (95% CI: 83·0-97·5%) and 82·3% (95% CI: 70-90·4%), respectively. The most common adverse events of grades 3–4 were hypertension (5·9%), proteinuria (9·2%) and hemorrhage (5·9%). One patient developed a fatal hemorrhage. Interpretation: An encouraging PFS, a high ORR and a manageable safety profile were observed in this study. It seems that the administration of apatinib in R/MACCHN is likely to have a clinically meaningful therapeutic benefit and warrants further investigation. Trial Registration: Registered under http://www.clinicaltrials.gov (NCT02775370) Funding Statement: This work was supported by Shanghai Municipal Commission of Health and Family Planning (grant number 201640158)；the Clinical Research Program of 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine and the Shanghai Shenkang Hospital Development Center Refractory Diseases Project (project number 16CR2004A); Clinical Research Program of 9th People's Hospital, Shanghai Jiao Tong University School of Medicine (program number JYLJ201825). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: This investigator-initiated phase II study was approved by the ethics committee of Shanghai Ninth People’s Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, and performed according to Good Clinical Practice Guidelines. All patients provided written informed consent before enrollment.

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, Circulating tumor cells were successfully isolated in breast cancer (BC) patients using CytoSorter® system. Circulating tumor cells can be used to differentiate BC patients from the patients with benign breast diseases or healthy volunteers, and as a diagnostic aid for early cancer diagnosis and cancer staging.

Purpose The soft tissue healing patterns of mandibular intracapsular condylar fracture (ICF) after closed treatment have not been well characterized. The purpose of the present study was to classify the injury and healing patterns in adult patients using magnetic resonance imaging (MRI) evaluation. Patients and Methods The present study represents a retrospective review of MRI examinations performed on patients treated with closed reduction of an ICF from 2010 to 2013. The MRI scans used for comparison were taken at 1 week and at least 3 months after the injury. These studies were used to identify the common patterns of hard and soft tissue derangements. The predictor variable was the type of soft tissue injuries, categorized as anteromedial displacement of both the disc and the fractured bony fragment, anteromedial displacement of the bony fragment with the disc remaining over the residual ramus, tear of the retrodiscal tissue or capsule, and joint effusion. The outcome variables were the MRI comparisons of the disc position, healing status of the retrodiscal tissue and capsule, and resolution of joint effusions. Results Twelve patients, all with ICFs, were included in the present study. Immediately after injury, all 17 fractures (100%) showed anteromedial displacement of both the disc and the fractured condylar fragment, and 10 fractures (58.8%) showed anteromedial displacement of the condylar fragment with the disc remaining over the residual condyle. Also, 11 (64.7%) showed evidence of perforation of the retrodiscal tissue, and 7 (41.2%) showed tears in the capsule. Finally, all 17 (100%) exhibited joint effusions. At 3 months after injury, all 17 fractures (100%) continued to exhibit displacement of both the disc and the condylar segments. Also, 15 fractures (88.2%) showed elongation of the disc and thickening of the retrodiscal tissue, 2 fractures (11.8%) had developed osteoid hyperplasia and meniscal perforation, and 6 fractures (35.3%) showed resolution of previous joint effusions. Finally, 17 fractures (100%) showed reactive bone formation at the condylar head. Conclusions ICFs treated with closed reduction consistently result in a specific pattern of temporomandibular joint pathologic features. These pathologic features are characterized by anteromedial displacement of the articular disc, elongation and thickening of the retrodiscal tissue, and reactive bone formation at the condylar head. The presence of a portion of the disc between the residual condyle and the fossa prevented the development of osteoarthritis and ankylosis. Perforation of the bilaminar tissue and contact between the residual condyle and the fossa promoted osteoarthritic changes and ankylosis.

Temporomandibular joint (TMJ) ankylosis in growing patients can cause both mouth opening limitation and jaw bone deformity. Lateral arthroplasty (LAP) can restore the medially displaced condyle and thus keep its growth potential. But can the condyle grow as normal is unknown. This study was to evaluate the long-term result after LAP in growing children. Patients from 2010 to 2014 were evaluated. Their CT data within 1 week after operation and during at least 1-year follow-ups were measured by ProPlan CMF 1.4 software. The condyle-ramus length of both sides and angles and the chin deviation before and after operation were compared. SPSS 17.0 software was used for statistical analysis. A total of 9 patients with a mean age of 10.2 years were included in the study. The mean follow-up period was 1.94 years. The mean condyle-ramus growth was 2.90 mm in the affected side and 2.50 mm in the unaffected side (P = 0.31). All of the affected side exhibited growth and remodeling of the condyle and ramus. All 9 cases had a mean chin deviation of 3.69 mm before operation and 2.92 mm during follow-ups (P = 0.16). The residual condyle grows after LAP, which can reduce the gravity of jawbone deformity.

Acute traumatic temporomandibular joint disc displacement (ATDD) and its sequelae are not familiar for most surgeons. This study is to discuss its sequelae in cases without disc reduction after failed conservative treatment. From 2010 to 2015, 26 patients with 34 joints were included in the study. All patients had at least 3 months conservative treatment. Their maximal incisor opening (MIO) was measured during follow-ups and MRI examination was used to check the condylar bone degeneration. The mean follow-up for conservative treatment after admission was 8.69 months, the patients reached an average of 25.7 mm MIO. MRI showed condylar bone intact in 8 joints (23.5%), condylar surface bone destruction (Wilks IV, V stages) in 14 joints (41.2%), and severe bone resorption in 12 joints (35.3%). 15 patients with 23 joints were asked for surgical treatment after a mean conservative treatment of 5.4 months (3–12 months) to improve mouth opening and relieve chronic pain. 12 joints had total joint replacement (TJR). 11 joints had disc repositioning. Their mean MIO before operation was 19.8 mm and significantly improved to 33.9 mm after operation (p = 0.0000). ATDD may cause severe osteoarthritis or ankylosis. Disc repositioning and TJR could significantly improve MIO.

Resistance to chemotherapy is a major obstacle for the effective treatment of cancers. Lin28 has been shown to contribute to tumor relapse after chemotherapy; however, the relationship between Lin28 and chemoresistance remained unknown. In this study, we investigated the association of Lin28 with paclitaxel resistance and identified the underlying mechanisms of action of Lin28 in human breast cancer cell lines and tumor tissues. We found that the expression level of Lin28 was closely associated with the resistance to paclitaxel treatment. The T47D cancer cell line, which highly expresses Lin28, is more resistant to paclitaxel than the MCF7, Bcap-37 or SK-BR-3 cancer cell lines, which had low-level expression of Lin28. Knocking down of Lin28 in Lin28 high expression T47D cells increased the sensitivity to paclitaxel treatment, while stable expression of Lin28 in breast cancer cells effectively attenuated the sensitivity to paclitaxel treatment, resulting in a significant increase of IC50 values of paclitaxel. Transfection with Lin28 also significantly inhibited paclitaxel-induced apoptosis. We also found that Lin28 expression was dramatically increased in tumor tissues after neoadjuvant chemotherapy or in local relapse or metastatic breast cancer tissues. Moreover, further studies showed that p21, Rb and Let-7 miRNA were the molecular targets of Lin28. Overexpression of Lin28 in breast cancer cells considerably induced p21 and Rb expression and inhibited Let-7 miRNA levels. Our results indicate that Lin28 expression might be one mechanism underlying paclitaxel resistance in breast cancer, and Lin28 could be a potential target for overcoming paclitaxel resistance in breast cancer.