Prognostic value of preoperative peripheral blood mean platelet volume/platelet count ratio (MPV/PC) in patients with resectable cervical cancer.

BACKGROUND: The mean platelet volume/platelet count ratio (MPV/PC) ratio based on the preoperative peripheral MPV and PCcan be used to predict the prognosis of multiple malignant tumors. OBJECTIVE: To evaluate the prognostic value of MPV/PC in cervical cancer patients. METHODS: This study enrolled 408 patients who had undergone radical surgery for cervical cancer and evaluated the correlation of MPV/PC with patient prognosis in the primary cohort and validation cohort. Additionally, independent prognostic factors were incorporated to construct the prognostic nomogram, and the area under the receiver operating characteristic (ROC) curve (AUC) value was calculated to analyze the prognostic predictive ability of the nomogram. RESULTS: In the primary cohort, Kaplan-Meier survival analysis indicated that the overall survival (OS) for patients with MPV/PC ≤ 0.41 was significantly lower than that in patients with MPV/PC > 0.41. MPV/PC was an independent prognostic factor for resectable cervical cancer patients. Compared with neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) or monocyte/lymphocyte ratio (MLR), the AUC values of MPV/PC in predicting the 3- and 5-year survival rates for cervical cancer patients were greater. Similar results were verified in the validation cohort. Subsequently, the nomogram constructed based on MPV/PC, International Federation of Gynecology and Obstetrics (FIGO) classification and lymphovascular invasion performed well to accurately predict the prognosis of cervical cancer patients. The 3- and 5-year survival rates predicted by the nomogram were highly consistent with the real observations. Similar results were also displayed in the validation cohort. CONCLUSIONS: MPV/PC may be used as a novel independent prognostic factor for patients with resectable cervical cancer. Compared with the FIGO classification system, the nomogram integrating MPV/PC maybe reliably predict the survival of cervical cancer patients after radical surgery.

Identification of uterine leiomyosarcoma-associated hub genes and immune cell infiltration pattern using weighted co-expression network analysis and CIBERSORT algorithm.

BACKGROUND: While large-scale genomic analyses symbolize a precious attempt to decipher the molecular foundation of uterine leiomyosarcoma (ULMS), bioinformatics results associated with the occurrence of ULMS based totally on WGCNA and CIBERSORT have not yet been reported. This study aimed to screen the hub genes and the immune cell infiltration pattern in ULMS by bioinformatics methods. METHODS: Firstly, the GSE67463 dataset, including 25 ULMS tissues and 29 normal myometrium (NL) tissues, was downloaded from the public database. The differentially expressed genes (DEGs) were screened by the 'limma' package and hub modules were identified by weighted gene co-expression network analysis (WGCNA). Subsequently, gene function annotations were performed to investigate the biological role of the genes from the intersection of two groups (hub module and DEGs). The above genes were calculated in the protein-protein interaction (PPI) network to select the hub genes further. The hub genes were validated using external data (GSE764 and GSE68295). In addition, the differential immune cell infiltration between UL and ULMS tissues was investigated using the CIBERSORT algorithm. Finally, we used western blot to preliminarily detect the hub genes in cell lines. RESULTS: WGCNA analysis revealed a green-yellow module possessed the highest correlation with ULMS, including 1063 genes. A total of 172 DEGs were selected by thresholds set in the 'limma' package. The above two groups of genes were intersected to obtain 72 genes for functional annotation analysis. Interestingly, it indicated that 72 genes were mainly involved in immune processes and the Neddylation pathway. We found a higher infiltration of five types of cells (memory B cells, M0-type macrophages, mast cells activated, M1-type macrophages, and T cells follicular helper) in ULMS tissues than NL tissues, while the infiltration of two types of cells (NK cells activated and mast cells resting) was lower than in NL tissues. In addition, a total of five genes (KDR, CCL21, SELP, DPT, and DCN) were identified as the hub genes. Internal and external validation demonstrated that the five genes were over-expressed in NL tissues compared with USML tissues. Finally, the correlation analysis results indicate that NK cells activated and mast cells activated positively correlated with the hub genes. However, M1-type macrophages had a negative correlation with the hub genes. Moreover, only the DCN may be associated with the Neddylation pathway. CONCLUSION: A series of evidence confirm that the five hub genes and the infiltration of seven types of immune cells are related to USML occurrence. These hub genes may affect the occurrence of USML through immune-related and Neddylation pathways, providing molecular evidence for the treatment of USML in the future.

Expression of Sox2 in cervical squamous cell carcinoma.

PURPOSE: Sox2, one of the genes that maintains self-renewal of embryonic stem cells and relates to the differentiation potential of these cells, is abnormaly expressed in various human tumors. We investigated the expression Sox2 in normal cervix and cervical squamous cell carcinoma (SCC), and we also assessed the prognostic significance of Sox2 expression in FIGO stage I-II cervical SCC. METHODS: Immunohistochemistry was performed to define the expression of Sox2 in 20 normal cervical tissue samples and 55 samples of cervical SCC. Correlations with clinicopathological characteristics were determined by chi-square test. The prognostic impact of Sox2 expression with regard to overall disease-free survival (DFS) was determined by the Kaplan-Meier method. RESULTS: The positive expression rate in cervical SCC was 74.5% (41/55), while in normal cervix it was 20.0% (4/20; p=0.000. In addition, the expression of Sox2 did not correlate with clinical factors (p>0.05). The overall DFS rates with negative and positive expressions of Sox2 were 35.7 and 29.3%, respectively (p=0.360). CONCLUSIONS: Our results show that Sox2 was overexpressed in FIGO stage I-II cervical SCC, indicating that overexpressed Sox2 may play an important role in the carcinogenesis of cervical SCC. Besides, we found that the expression of Sox2 had no relation to clinical factors and prognosis.

Prognostic Value and Immune-Infiltration Pattern of KIF4A in Patients with Endometrial Carcinoma.

BACKGROUND: With the development of sequencing technology, an increasing number of biomarkers has been identified in endometrial carcinoma (EC). However, there have been few comprehensive analyses of the KIF4A gene in patients with EC. METHODS: Based on raw data in public databases, the KIF4A gene and protein expression in EC were validated. Logistic regression analysis was conducted to analyze the correlations between clinical characteristics and the KIF4A expression. Kaplan-Meier analysis was used to explore the difference in survival in clinical subgroups. Meanwhile, we used meta-analysis in multiple datasets to investigate the prognostic value of KIF4A. In addition, Cox regression analysis was used to confirm the independent prognostic value of KIF4A, and we constructed a nomogram based on KIF4A expression. Subsequently, we used ESTIMATE and ssGSEA algorithms to excavate the correlation between KIF4A, tumour-infiltrating immune cells, and related gene markers of immune cells. Moreover, the potential biological functions of KIF4A were investigated by gene function annotation. Finally, we identified the hub genes interacting with KIF4A by constructing a protein-protein interaction (PPI) network and screening differential genes (DEGs). RESULTS: In the pan-cancer analysis, KIF4A was upregulated in most tumors (21/33). Similarly, the overexpression of KIF4A in EC patients was confirmed in the TCGA cohort, the GEO cohort, and immunohistochemistry. In addition, upregulated KIF4A is associated with age, survival status, grade, FIGO stage, histological type, tumour invasion, and TCGA molecular subtypes (p < 0.05). KIF4A overexpression was correlated with the grade, histological type, and pathological stage according to logistic regression analysis (p < 0.05). Meanwhile, survival analysis and meta-analysis revealed that KIF4A was associated with a poor prognosis and acted as an independent prognostic marker in EC patients (p < 0.05). KIF4A is associated to immune response and may have a function in controlling immune cell infiltration in EC (20/24, p < 0.05). This is noteworthy given that gene enrichment analysis suggested KIF4A may be involved in the neuroactive ligand-receptor interaction pathway, etc. Finally, we identified transcription factors which have a potential interaction with KIF4A. CONCLUSION: We provided robust evidences that KIF4A is an indicator of poor prognosis and a potential target for immunotherapy in patients with EC.

Performance of Aptima HPV E6/E7 mRNA Test for Detection of Cervical Lesions in a Large Chinese Population.

Background: We aimed to examine the effectiveness of Aptima HPV E6/E7 mRNA test for detection of cervical lesions in a large Chinese population. Methods: Overall, 4,350 women, who received simultaneously Aptima HPV E6/E7 mRNA test and HPV DNA test, followed by cervical biopsy in the Department of Gynecology of the Second Affiliated Hospital of Soochow University, Jiangsu Province, China from 2016-2020, were recruited. The detection of cervical lesions was compared between Aptima HPV E6/E7 mRNA test and HPV DNA test. Results: Overall, HPV DNA test exhibited a higher detection of all cervical lesions than Aptima HPV E6/E7 mRNA test (P<0.05), and showed a higher efficacy for detection of normal tissues and chronic cervicitis (P<0.05) and low-grade squamous intraepithelial lesions (LSILs) (P<0.05) than Aptima HPV E6/E7 mRNA test; while Aptima HPV E6/E7 mRNA test showed a greater detection of high-grade squamous intraepithelial lesions (HSILs) (P<0.05) and invasive cervical carcinoma than HPV DNA test. Aptima HPV E6/E7 mRNA test exhibited a higher specificity P<0.05), positive and negative prediction rates than HPV DNA test for detection of cervical lesions, and the sensitivity was comparable between the two tests (P>0.05). Conclusion: Aptima HPV E6/E7 mRNA test gradually improves the detection of cervical lesions with disease severity, and shows a higher specificity, positive and negative prediction rates and comparable sensitivity for detection of clinical cervical lesions as compared with HPV DNA test.

Expression and prognostic significance of TAp73 and ΔNp73 in FIGO stage I-II cervical squamous cell carcinoma.

The purpose of the present study was to investigate the expression of TAp73 and ΔNp73 in cervical squamous cancer cells, and to evaluate the prognostic significance of TAp73 and ΔNp73 expression in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-II cervical squamous cell carcinoma (SCC). The immunohistochemical expression of TAp73 and ΔNp73 was evaluated in 59 FIGO stage I-II cervical SCC tumor samples. Correlations with clinicopathological characteristics were determined by χ2 test. The prognostic impact of TAp73 and ΔNp73 expression with regard to overall survival (OS) was determined by the Kaplan-Meier method. High TAp73 and ΔNp73 expression was detected in 79.7% (47/59) and 76.3% (45/59) of patients, respectively. The expression of TAp73 and ΔNp73 was not associated with age, FIGO stage, pathological differentiation or lymph node metastasis. The 3-year OS rates associated with low and high TAp73 expression were 75.0 and 83.0%, respectively (χ2=0.33; P=0.568), whereas those associated with low and high ΔNp73 expression were 100.0 and 75.6%, respectively (χ2=3.90; P=0.048). High expression levels of TAp73 and ΔNp73 were frequently observed in the cervical squamous cancer cells. Overall, high expression levels of ΔNp73 may indicate an unfavorable prognosis in patients with early-stage cervical SCC.