Plasma-derived exosomal miR-15a-5p as a promising diagnostic biomarker for early detection of endometrial carcinoma.

Endometrial cancer (EC) is a major cause of death among gynecologic malignancies. To improve early detection of EC in patients, we carried out a large plasma-derived exosomal microRNA (miRNA) studies for diagnostic biomarker discovery in EC. Small RNA sequencing was performed to identify candidate exosomal miRNAs as diagnostic biomarkers in 56 plasma samples from healthy subjects and EC patients. These miRNA candidates were further validated in 202 independent plasma samples by droplet digital PCR (ddPCR), 32 pairs of endometrial tumors and adjacent normal tissues by quantitative real-time PCR (qRT-PCR), and matched plasma samples of 12 patients before and after surgery by ddPCR. miR-15a-5p, miR-106b-5p, and miR107 were significantly upregulated in exomes isolated from plasma samples of EC patients compared with healthy subjects. Particularly, miR-15a-5p alone yielded an AUC value of 0.813 to distinguish EC patients with stage I from healthy subjects. The integration of miR-15a-5p and serum tumor markers (CEA and CA125) achieved a higher AUC value of 0.899. There was also a close connection between miR-15a-5p and clinical manifestations in EC patients. Its exosomal expression was not only associated with the depth of muscular infiltration and aggressiveness of EC, but also correlated with levels of reproductive hormones such as TTE and DHEAS. Collectively, plasma-derived exosomal miR-15a-5p is a promising and effective diagnostic biomarker for the early detection of endometrial cancer.

[Gestational trophoblastic diseases in cesarean scar: an analysis of 20 cases].

OBJECTIVE: To analyze the clinical features, diagnosis and treatment of gestational trophoblastic diseases in cesarean scar. METHODS: Clinical data of three cases of gestational trophoblastic diseases in cesarean scar diagnosed in Women's Hospital, Zhejiang University School of Medicine during December 2011 and December 2016 were collected. And literature search was performed in Wanfang data, VIP, CNKI, PubMed, ISI Web of Knowledge and EMbase database. RESULTS: A total of 20 cases of gestational trophoblastic diseases were included in the analysis. Clinical features were mainly abnormal vaginal bleeding after menopause, artificial abortion or medical abortion, which might be accompanied by abdominal pain. Serum ß-human chorionic gonadotropin (ß-hCG) levels were increased in 19 patients. The sonographic features were increase of uterine volume, honeycomb-like abnormal intrauterine echo (or described as multiple cystic dark area, multiple anechoic area and multiple liquid dark area) or heterogeneity echo conglomeration, and no clear bound with muscular layer in some cases. There were abundant blood flow signals inside or around the lesions. The ultrasonography indicated that the lesions were located in the anterior side of the uterine isthmus with the involvement of cesarean section scar. In 12 cases with lesions in cesarean scar shown by preliminary diagnosis, 9 underwent uterine artery embolization (UAE) for pretreatment; the blood loss greater than 1500 mL was observed in only one case without UAE; no patient received hysterectomy. In 8 patients whose lesions were not shown in cesarean scar, only one case received UAE pretreatment, and hysterectomy was performed in 3 cases due to blood loss greater than 1500 mL. Two cases were lost in follow-up and no death was reported in remaining 18 cases. The serum ß-hCG levels returned to normal or satisfactory level during the follow-up in 17 cases with increased ß-hCG levels before treatment and no recurrence was observed. CONCLUSIONS: The misdiagnosis rate and missed diagnosis rate of gestational trophoblastic diseases in cesarean section scar are high. The identification of cesarean section scar involvement and UAE may reduce the bleeding and avoid hysterectomy.

Iatrogenic parasitic leiomyoma and leiomyomatosis peritonealis disseminata following uterine morcellation.

AIM: To assess the impact of morcellation on the spread of uterine leiomyoma. METHODS: Cases of parasitic leiomyoma involving prior laparoscopy were collected between 2012 and 2015 in a tertiary women's hospital in China. Their clinicopathological features and the associated reports were reviewed. RESULTS: All six patients with parasitic leiomyoma had laparoscopic myomectomy or hysterectomy with power morcellation 39-132 months previously. Patient 1 had widely disseminated tumors in the peritoneum and pelvis, in keeping with leiomyomatosis peritonealis disseminata (LPD). She received debulking of peritoneal tumors and lived with disease for 22 months. The implanting sites of the other parasitic tumors (patients 2-6) included the mesentery (n = 2), intestine (n = 1), pelvic parietal (n = 1), bladder (n = 1), and musculus rectus abdominis (n = 1). The diameter varied from 1 cm to 6 cm. The patients underwent abdominal subtotal hysterectomy, cervicectomy or tumor debulking and the postoperative course was unremarkable for a period of 2-32 months. Pathologically, these disseminated or parasitic leiomyomas did not show any evidence of malignancy. There were no morphological or immunohistochemical differences between the original tumor and the following seeding tumors. On literature review, 11 iatrogenic LPD have been reported after laparoscopic surgery for uterine leiomyoma. These cases may provide an alternative pathogenic mechanism for a distinct variant of LPD. CONCLUSIONS: Laparoscopic hysterectomy with tumor morcellation may increase the chance of tumor implantation and dissemination. Both clinicians and pathologists should be alert to this rare complication.

Analyses of functional and oncologic outcomes following supracricoid partial laryngectomy.

To review the functional and oncologic outcomes of patients who received supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) in our institution. A total of 208 patients who received SCPL with CHEP or CHP from our institution from 1995 to 2007 were involved. Among them, 190 cases were patients with squamous cell carcinoma of the larynx (T1-T4, N0-N2), 14 cases were patients with recurrent larynx cancer and 4 cases were patients with laryngeal stenosis. Forty-four patients also received unilateral neck dissection, and 41 patients received a bilateral neck dissection. All patients were assessed at functional outcome and complications of their treatment. Also, the oncologic outcomes, such as disease-specific survival, total survival, and local recurrence, were measured for patients with tumor. Decannulation was achieved in nearly all patients, with the average time to decannulation being 20 ± 11.52 days in CHEP patients and 28 ± 8.92 days in CHP patients (P < 0.05). The average nasogastric tubes were removed, days postoperation, was 18 ± 7.39 days in CHEP patients and 25 ± 13.87 days in CHP patients (P < 0.05). The 5-year local recurrence rate was 5.77%, the 5-year disease-specific survival was 82.7%, and the 5-year overall survival was 84.1%. The patients with CHEP had a better recovery than the patients with CHP. SCPL was a well-tolerated procedure with generally good functional outcomes for patients with advanced laryngeal cancer, also for some patients with laryngeal stenosis.

Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stage cervical cancer: a randomized, non-inferiority, multicenter trial.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.

Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-course methotrexate for low-risk gestational trophoblastic neoplasia: a multi-centric randomized clinical trial.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

Retrospective analysis on coexisting ovarian cancer in 976 patients with clinical stage I endometrial carcinoma.

AIM: To evaluate the safety of ovarian preservation at the time of operation in clinical stage I endometrial carcinoma. MATERIAL AND METHODS: The data of patients with and without coexisting ovarian cancers were retrospectively collected and clinic-pathologic parameters were analyzed. RESULTS: In total, 20 (2.05%) were histologically diagnosed as coexisting ovarian cancer, including 17 (1.74%) ovarian metastases and three (0.31%) synchronous ovarian primary cancers in 976 patients. Fifty percent (10 of 20) were microscopic ovarian involvements. Ovarian involvement was significantly associated with histological type, depth of myometrial invasion, cervical invasion, uterine serosa extension, fallopian tube involvement, retroperitoneal lymph node metastasis, positive peritoneal cytology and CA125 level by univariate analysis (all P<0.05); while cervical invasion, uterine serosa extension, and fallopian tube involvement were independent high-risk factors by multivariate analysis (both P<0.05). CONCLUSION: The incidence of coexisting ovarian cancer in clinical stage I endometrial carcinoma is low, but the decision for ovary preservation at the time of operation still needs to be made with caution because of occult ovarian metastasis, especially for patients with high-risk factors.

[Accuracy of preoperative tumor grading and intraoperative gross examination of myometrial invasion in clinical stage I endometriod adenocarcinoma].

OBJECTIVE: To evaluate accuracy of preoperative tumor grade and intraoperative gross examination of myometrial invasion in patients with clinical stage I endometriod adenocarcinoma for lymphadenectomy. METHODS: Clinic-pathological data were retrospectively collected from 687 patients with clinical stage I endometriod adenocarcinoma who underwent operation in Women's Hospital, Zhejiang University School of Medicine from January 1999 to December 2008. According to postoperative histology diagnosis, accuracy of preoperative tumor grade by curettage and depth of myometrial invasion by intraoperative gross examination was evaluated, and clinic-pathological factors associated with accuracy were analyzed. RESULTS: Sensitivity, specificity, accuracy, false negative rate, false positive rate, and positive and negative predictive value for the prediction of needing for intraoperative lymphadenectomy in patients with clinical stage I endometriod adenocarcinoma were 70.4%, 80.2%, 77.6%, 12.0%, 43.0%, 57.0% and 88.0%, respectively. Analysis of muti-factors shown that patient age, tumor size, lymph node metastasis and extrauterine spread lesions were independent factors affected the accuracy of prediction (P < 0.05). CONCLUSION: Prediction of needing for lymphadenectomy by preoperative tumor grade and intraoperative gross examination of myometrial invasion is reliable in clinical stage I endometriod adenocarcinoma patients, while there is a highly false negative rate in prediction of not needing for lymphadenectomy, while other prognostic factors such as patient age, tumor size, lymph node metastasis and extrauterine spread lesion should be together considered.

Analysis of curative effects on laryngeal carcinoma patients in the northeast region of China.

CONCLUSIONS: In the past 20 years, the level of laryngeal carcinoma treatment in our country has been significantly improved. Early diagnosis is the key for increasing the ratio of larynx preservation surgeries and improving survival rates. The main causes of death within 5 years are local recurrence and metastasis. OBJECTIVE: To describe the main treatment methods for laryngeal carcinoma in China in the 1980s and 1990s and their prospective effects and investigate the prognostic factors. PATIENTS AND METHODS: A retrospective investigation was performed on the 1115 laryngeal carcinoma patients receiving treatment in the department of ENT of the First Affiliated Hospital of China Medical University during 1983-1996 and the survival rates and causes of death were analyzed statistically. RESULTS: There were 780 patients surviving for more than 5 years, 260 dead patients, and 75 patients lost to follow-up. According to the cumulative survival rate curve, the 5-year survival rate was 77% (94% for stage I, 89% for stage II, 82% for stage III, and 66% for stage IV). Glottic cancer has the highest 5-year survival rate, followed by supraglottic cancer, subglottic cancer, and transglottic cancer. The 5-year survival rate of patients receiving partial laryngectomy was 85%, while the 5-year survival rate of those receiving total laryngectomy was 68%. The leading causes of death within 5 years were local recurrence and metastasis (70%), and the causes of death were unknown in 14% of cases.

BRCA mutations in the manifestation and treatment of ovarian cancer.

BRCA genes are important for the integrity and stability of genetic material and play key roles in repairing DNA breaks via high fidelity homologous recombination. BRCA mutations are known to predispose carriers to gynecological malignancies, accounting for a majority of hereditary OC cases. Known to be lethal, OC is difficult to detect and control. Testing for BRCA mutations is a key step in the risk assessment, prognosis, treatment and prevention of OC and current clinical guidelines recommend BRCA mutation testing for all OCs of epithelial origin. Studies have established that ovarian tumors harboring BRCA mutations have distinct molecular and histo-pathological features that can be exploited for effective, targeted treatment. Deficiencies in DNA repair pathways that arise as a result of BRCA mutations make them hypersensitive to DNA-damaging treatments such as platinum chemotherapy and PARP inhibitors. Different combinations of treatment regimens which have the potential to greatly improve prognosis and disease outcomes are currently being evaluated. However, the issue of developing resistance to these treatments remains unresolved. This review emphasizes unique features of BRCA mutated OC and outlines the lay of the land in terms of diagnosis and treatment, while aiming to unravel the challenges that are part of its management.

Extracapsular spread in ipsilateral neck metastasis: an important prognostic factor in laryngeal cancer.

OBJECTIVE: To evaluate the impact of extracapsular spread (ECS) in ipsilateral neck metastasis on prognosis and its related factors in laryngeal cancer. METHODS: The study included 184 patients who underwent laryngectomy and simultaneous radical or modified radical neck dissection between January 1994 and December 1997 for laryngeal cancer. All of them had a complete 5-year follow-up. We used transparent lymph node detection and continuous slicing method on all neck dissection specimens. Kaplan-Meier model was used for survival analysis and the log-rank test was used to assess significance. RESULTS: We found pathological neck metastases in 80 patients. Among them, 26 cases (32.5%) had ECS in ipsilateral neck. ECS incidence increased with advanced pathological N (pN) stages (pN1 3.7%, pN2a 25.0%, pN2b 50.0%, and pN2c 55.6%; P = 0.001). ECS incidence also increased with number of positive nodes (1 positive node 8.6%, 2 positive nodes 33.3%, 3 and more positive nodes 66.7%; P < 0.001). Incidences of contralateral neck metastases and ipsilateral neck recurrence in patients with ECS were higher than those in patients without ECS (46.2% vs. 24.1%, P = 0.046; 34.6% vs. 7.4%, P = 0.002). The 5-year survival rate of patients with ECS was significantly lower than that of patients without ECS (23.1% vs. 57.4%, P = 0.013). CONCLUSION: ECS is an important prognostic factor in laryngeal cancer. Patients with ECS have a higher incidence of contralateral neck metastasis, so bilateral neck dissection should be selected.

[Impact of extracapsular lymph node spread in the ipsilateral neck on contralateral neck metastasis and prognosis of laryngeal cancer].

OBJECTIVE: To evaluate the impact of extracapsular lymph node spread (ECS) in the ipsilateral neck on the contralateral neck metastasis and prognosis of laryngeal cancer. METHODS: The data of 184 laryngeal cancer patients who underwent laryngectomy and simultaneous radical or modified radical neck lymph node dissection between Jan. 1994 and Dec. 1997 were retrospectively analyzed. Of these 184 patients, 144 underwent unilateral neck lymph node dissection and 40 bilateral; 159 had supraglottic lesion and 25 transglottic. All had squamous cell carcinoma. The clinical T stage was T1 in 3, T2 63, T3 77, T4 41; N stage: NO in 123, N1 38, N2a 5, N2b 11, N2c 7. Transparent lymph node detection and continuous sectioning method were applied to all dissected neck lymph nodes. Statistical analysis was carried out using SPSS software package ( version 11.5). Survival curves were calculated through the Kaplan-Meier model. Impact of extracapsular lymph node spread in the ipsilateral neck on prognosis was assessed using the Log rank test. RESULTS: Of these 184 patients, neck lymph node metastasis was pathologically proven in 80, 26 had ECS in the ipsilateral neck with a ECS rate of 32.5% (26/80). The ECS incidence was positively correlated with advanced pathological N stage and metastatic lymph nodes (P < 0.01). The incidence of the contralateral neck metastasis and ipsilateral neck recurrence with ECS were higher than those without ECS, which was 46.2% versus 24.1%, and 34.6% versus 7.4%, respectively (P < 0.05). The 3- and 5-year survival rates of patients with ECS were significantly lower than those of patients without ECS, which was 53.9% versus 70.4%, and 23.1% versus 57.4%, respectively (P = 0.0125). CONCLUSION: Extracapsular lymph node spread is found to be an important prognostic factor in the laryngeal cancer. Bilateral neck dissection may be mandatory due to patients with ECS have a higher incidence of contralateral neck metastasis. The capsule of metastatic lymph nodes should be pathologically checked and reported in order to determine the extra-capsular spread status.

Identification of Cathepsin K in the Peritoneal Metastasis of Ovarian Carcinoma Using In-silico, Gene Expression Analysis.

Ovarian carcinomas (OC) are often found in the advanced stage with wide peritoneal dissemination. Differentially-expressed genes (DEGs) between primary ovarian carcinoma (POC) and peritoneal metastatic ovarian carcinomas (PMOC) may have diagnostic and therapeutic values. In this study, we identified 246 DEGs by in-silico analysis using microarrays for 153 POCs and 57 PMOCs. Pathway analysis shows that many of these genes are associated with lipid metabolism. Microfluidic, card-based, quantitative PCR validated 19 DEGs in PMOCs versus POCs (p<0.05). Immunohistochemistry confirmed overexpression of MMP13, CTSK, FGF1 and GREM1 in PMOCs (p<0.05). ELISA detection indicated that serum CTSK levels were significantly increased in OCs versus controls (p<0.001). CTSK levels discriminated between OCs and healthy controls (ROC 0.739; range 0.685-0.793). Combining CA125 and HE4 with CTSK levels produced an improved specificity in the predictive of OCs (sensitivity 88.3%, specificity 92.0%, Youden's index 80.3%). Our study suggests that CTSK levels may be helpful in the diagnosis of primary, ovarian carcinoma.

[Expression of KAI1 gene in human laryngeal carcinoma and its clinical significance].

OBJECTIVE: To explore the mRNA expression of KAI1 gene in laryngeal squamous-cell carcinoma and its clinical significance. METHODS: Fresh laryngeal cancer samples taken from 40 laryngeal carcinoma cases and normal control laryngeal tissues from 9 subjects were examined with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Moderate, low and negative expression rates of KAI1 gene mRNA in nine normal laryngeal tissues were 33.3% (3/9), 33.3% (3/9) and 33.3% (3/9), respectively. The high, moderate, low and negative expression rates of KAI1 mRNA in 25 laryngeal cancers without lymph node metastasis were 40.0% (10/25), 28.0% (7/25), 20.0% (5/25) and 12.0% (3/25), respectively. The moderate, low and negative expression rates of KAI1 mRNA in 15 laryngeal cancers with lymph node metastasis were 20.0% (3/15), 26.7% (4/15) and 53.3% (8/15), respectively. The KAI1 mRNA expression in the laryngeal cancers without lymph node metastasis was higher than that in normal laryngeal tissues (P < 0.05). The KAI1 mRNA expression in the laryngeal cancers with lymph node metastasis was lower than that in the laryngeal cancers without lymph node metastasis (P < 0.05). The high, moderate and low expression rates of KAI1 mRNA in 10 highly differentiated laryngeal cancers were 50.0% (5/10), 30.0% (3/10) and 20.0% (2/10), respectively. The high, moderate, low and negative expression rates of KAI1 mRNA in 12 low differentiation laryngeal cancers were 8.3% (1/12), 16.7% (2/12), 16.7% (2/12) and 58.3% (7/12), respectively. The differences of KAI1 mRNA expression between high and low differentiation laryngeal cancers were statistically significant (P < 0.05). CONCLUSION: The decrease of KAI1 mRNA expression may be related to lymph node metastasis and low differentiation of laryngeal squamous-cell carcinoma.

[Feasibility of University of Washington-Quality of Life questionnaire for follow up of laryngeal cancer in China].

OBJECTIVE: To assess the feasibility of University of Washington Quality of Life (UW-QOL) questionnaire in laryngeal cancer patients treated by total or partial laryngectomy and their prognostic factors in China. METHODS: With UW-QOL questionnaire, a survey was conducted in patients treated by partial (81, Group A) or total (37, Group B) laryngectomy for laryngeal cancer. RESULTS: The composite QOL scores of group A (692.34 +/- 127.94) were higher than those of group B (636.35 +/- 139.97), with a difference statistically significant (P < 0.05). Group A (74.32 +/- 23.82; 80.86 +/- 20.26) was better than group B (40.27 +/- 25.76; 69.59 +/- 27.09) in speech and appearance (P < 0.001; P < 0.05); but group B (92.57 +/- 13.00) was superior to group A (83.02 +/- 20.47) in pain (P < 0.01). Six factors including stage, operative, modality, complication, postoperative radiotherapy or chemotherapy, with whom to live, chronic disease before or after operation were related to postlaryngectomy QOL. CONCLUSION: Partial laryngectomy is superior to total laryngectomy in speech, appearance and overall QOL. UW-QOL questionnaire is suitable for QOL research in laryngeal cancer in China.

Cloning of hTERT cDNA fragment and application of anti-hTERT monoclonal antibody in mechanism of laryngeal carcinogenesis.

The mechanism of telomerase activation is still not clear till now. In order to understand the expressional mode of telomerase and the mechanism of telomerase activation in laryngeal carcinogenesis, we cloned a fragment of hTERT cDNA and prepared a monoclonal antibody against hTERT. We performed immuno-histochemical staining in laryngeal cancer tissues using this antibody. We found that the frequencies of hTERT positive cells were positively correlated with undifferentiation of cancer tissues and that the expression of hTERT was positively correlated with levels of c-Myc, which suggested that c-Myc might play an important role in activation of telomerase. These results revealed that overexpression of c-Myc upregulated telomerase, which in turn resulted in immortalization of laryngeal squamous cells, and this mechanism existed not only in the initiation of laryngeal carcinogenesis but also in the whole process of cancer development.

[Antiangiogenesis of ginsenoside Rg3 in severe combined immunodeficient mice with human ovarian carcinoma].

OBJECTIVE: To investigate the antiangiogenesis of ginsenoside Rg3 in severe combined immunodeficient (SCID) mice with human ovarian carcinoma by detecting vascular endothelial growth factor (VEGF) mRNA, VEGF protein level and microvascular density (MVD). METHODS: The SCID mice with human ovarian carcinoma SKOV3 cells were treated with Rg3 (300 microgram 400 microl(-1) mouse(-1)), mice with phosphate buffered solution (PBS) and without Rg3 and PBS were used as control. Tumor volume, metastasis, ascites, VEGF mRNA, VEGF protein and MVD were detected. The level of VEGF mRNA in tumor tissue was determined by relative quantative reverse transcription polymerase chain reaction. VEGF protein level in sera and ascitic fluids were determined by enzyme-linked immunosorbent assay. MVD was calculated by immunohistochemistry (anti-CD34). RESULTS: (1) No ascites was formed and the size of metastasis decreased in SKOV3/Rg3 group. (2) Expression of VEGF mRNA level in SKOV3/Rg3 group (119 +/- 16) was lower significantly than those of the control groups (254 +/- 4, 273 +/- 44, respectively, P < 0.05). (3) Serum VEGF level in SKOV3/Rg3 group [(14.6 +/- 0.7) pg/ml] was lower significantly than those of SKOV3 group and SKOV3/PBS group [(18.5 +/- 2.1) and (20.5 +/- 1.7) pg/ml, respectively, P < 0.05]. (4) MVD in tumor tissues of SKOV3/Rg3 group (43 +/- 7) was lower than that of each control group (65 +/- 12, 73 +/- 10, respectively, P < 0.05). CONCLUSION: Ginsenoside Rg3 can block angiogenesis and inhibit tumor growth and metastasis by down regulating the expression of VEGF mRNA and protein and reducing microvascular density.

[Biologic characteristics of intraperitoneal transplantation model of human ovarian carcinoma in severe combined immunodeficiency mice].

OBJECTIVE: To develop a human ovarian carcinoma SKOV3 model in severe combined immunodeficiency (SCID) mouse and to study its biologic characteristics. METHODS: Human ovarian carcinoma SKOV3 cells were injected intraperitoneally into female SCID mouse to establish a transplantation model of human ovarian carcinoma. The biological characteristics, metastasis and morphology of transplanted tumors were studied. RESULT: All tumors grew progressively with no sign of regression. The tumor cells spread around the peritoneal cavity and mainly on the diaphragm, mesentery, peritoneum and around the liver, which was confirmed by histopathology. The morphology, growth pattern and CA125 secretion of primary culture of transplanted cells remained as same as those of ovarian carcinoma cell line SKOV3. CONCLUSION: An intraperitoneal transplantation model of human ovarian carcinoma SKOV3 in SCID mice has been developed successfully, which can simulate the biological behavior of peritoneal metastasis of human ovarian carcinoma.

Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective study of 251 cases.

A total of 251 patients with epithelial ovarian cancer (EOC) treated between 2002 and 2008 was retrospectively analyzed to investigate the long-term outcomes and prognostic factors of these patients, particularly those who underwent primary debulking surgery followed by platinum-based chemotherapy. Clinicopathological parameters, including progression-free survival (PFS) and overall survival (OS), were also analyzed. The median follow-up period from the end of initial treatment to June 2010 was 58 months. The three-year PFS rate was 61.7% for International Federation of Gynecology and Obstetrics (FIGO) I-II, 19.9% for FIGO III-IV, and 33.9% for all stages. By comparison, the five-year PFS rate was 44.6% for FIGO I-II, 17.7% for FIGO III-IV, and 28.3% for all stages. The three-year OS rate was 67.9% for FIGO I-II, 41.7% for FIGO III-IV, and 50.2% for all stages. The five-year OS rate was 52.7% for FIGO I-II, 30.8% for FIGO III-IV, and 39.2% for all stages. Univariate analysis revealed that advanced FIGO stage, serum CA125, and suboptimal debulking were significant factors affecting PFS and OS. In multivariate analysis, PFS was significantly influenced by FIGO stage and suboptimal debulking. However, OS was significantly influenced by advanced FIGO stage only. Our study confirms the efficacy of surgery followed by platinum-based chemotherapy for EOC. FIGO stage is considered as one of the most reliable predictors of the prognosis of patients with EOC.

[The relationship between different types of lymph node metastasis and contralateral neck metastasis and their impact on prognosis].

OBJECTIVE: To study the relationship between different types of lymph node metastasis and contralateral neck metastasis and their impacts on prognosis. METHOD: Two hundred and forty-eight patients with supraglottic carcinomas and complete follow-up were analyzed retrospectively. Transparent lymph node detection and continuous sectioning methods were applied on postoperative neck specimens. RESULT: Cervical lymph node metastases were found in 115 patients and the lymph node metastatic rate was 46.4%. There were three types of lymph node metastases, 39 cases with single type, 34 with multiple type, 42 with fusion type. Contralateral metastatic rates were 5.1%, 44.1% and 61.9% in single, multiple and fusion type respectively. Contralateral metastasis was also related with tumor extension across midline and clinical N stages. The 3- and 5-year survival rates were 79.5% and 74.4% in single type, 61.8% and 41.2% in multiple type, 61.9% and 35.7% in fusion type. CONCLUSION: Bilateral neck dissections should be undertaken in multiple and fusion types of lymph node metastasis. The lymph node metastatic type should be an important criteria to judge prognosis.