简介：AbstractBackground:Breast cancer with low-positive human epidermal growth factor receptor 2 (HER2) expression has triggered further refinement of evaluation criteria for HER2 expression. We studied the clinicopathological features of early-stage breast cancer with low-positive HER2 expression in China and analyzed prognostic factors.Methods:Clinical and pathological data and prognostic information of patients with early-stage breast cancer with low-positive HER2 expression treated by the member units of the Chinese Society of Breast Surgery and Chinese Society of Surgery of Chinese Medical Association, from January 2015 to December 2016 were collected. The prognostic factors of these patients were analyzed.Results:Twenty-nine hospitals provided valid cases. From 2015 to 2016, a total of 25,096 cases of early-stage breast cancer were treated, 7642 (30.5%) of which had low-positive HER2 expression and were included in the study. After ineligible cases were excluded, 6486 patients were included in the study. The median follow-up time was 57 months (4-76 months). The disease-free survival rate was 92.1% at 5 years, and the overall survival rate was 97.4% at 5 years. At the follow-up, 506 (7.8%) cases of metastasis and 167 (2.6%) deaths were noted. Multivariate Cox regression analysis showed that tumor stage, lymphvascular invasion, and the Ki67 index were related to recurrence and metastasis (P < 0.05). The recurrence risk prediction model was established using a machine learning model and showed that the area under the receiving operator characteristic curve was 0.815 (95% confidence interval: 0.750-0.880).Conclusions:Early-stage breast cancer patients with low-positive HER2 expression account for 30.5% of all patients. Tumor stage, lymphvascular invasion, and the Ki67 index are factors affecting prognosis. The recurrence prediction model for breast cancer with low-positive HER2 expression based on a machine learning model had a good clinical reference value for predicting the recurrence risk at 5 years.Trial registration:ChiCTR.org.cn, ChiCTR2100046766.

简介：摘要 探讨逆行性肾内输尿管软镜碎石术（Retrograde Intrarenal Stone Surgery，RIRS）与经皮肾镜碎石术（percutaneous nephrolithotomy,PCNL）在治疗肾结石中的临床价值方法：回顾分析贵黔国际总医院泌尿外科在2019年10月18日至2021年3月20日治疗的100名结石大小范围在1CM-2CM，单发肾下盏结石患者，均接受肾结石碎石手术。根据不同的术式，逆行性肾内输尿管软镜碎石术50例为对照组，经皮肾镜碎石术50例为观察组。分析两种手术方式在临床中对于肾下盏结石的治疗价值。结果：对照组与观察组的清石率为分别为23/50（46%）与38/50（76%），对照组（RIRS）术后出现并发症为（感染7例，出血12例，疼痛14例,），观察组（PCNL）出现并发症为（感染9例，出血10例，疼痛19例，），比较两组清石率，观察组大于对照组（P＜0.05）具有统计学意义。结论：在治疗肾下盏结石中，逆行性肾内输尿管软镜碎石术比经皮肾镜碎石术更具患者接受，患者的舒适性更高，创伤性更小。而在结石方面，结石的直径越小，且位置越好肾结石可选择逆行性肾内输尿管软镜碎石术，如患者的结石越大，且位置过于狭隘，经皮肾镜碎石术效果则更好，两种术式均可有效的治疗肾结石，可依据患者病情而定。