High-throughput metabolomics identifies new biomarkers for cervical cancer.

BACKGROUND: Cervical cancer (CC) is a danger to women's health, especially in many developing countries. Metabolomics can make the connection between genotypes and phenotypes. It provides a wide spectrum profile of biological processes under pathological or physiological conditions. METHOD: In this study, we conducted plasma metabolomics of healthy volunteers and CC patients and integratively analyzed them with public CC tissue transcriptomics from Gene Expression Omnibus (GEO). RESULT: Here, we screened out a panel of 5 metabolites to precisely distinguish CC patients from healthy volunteers. Furthermore, we utilized multi-omics approaches to explore patients with stage I-IIA1 and IIA2-IV4 CC and comprehensively analyzed the dysregulation of genes and metabolites in CC progression. We identified that plasma levels of trimethylamine N-oxide (TMAO) were associated with tumor size and regarded as a risk factor for CC. Moreover, we demonstrated that TMAO could promote HeLa cell proliferation in vitro. In this study, we delineated metabolic profiling in healthy volunteers and CC patients and revealed that TMAO was a potential biomarker to discriminate between I-IIA1 and IIA2-IV patients to indicate CC deterioration. CONCLUSION: Our study identified a diagnostic model consisting of five metabolites in plasma that can effectively distinguish CC from healthy volunteers. Furthermore, we proposed that TMAO was associated with CC progression and might serve as a potential non-invasive biomarker to predict CC substage. IMPACT: These findings provided evidence of the important role of metabolic molecules in the progression of cervical cancer disease, as well as their ability as potential biomarkers.

Clinical value of the ThinPrep cytologic test with E6/E7 mRNA detection for cervical cancer screening in disease diagnosis.

BACKGROUND: To investigate the clinical value of the ThinPrep cytologic test (TCT) with the E6/E7 mRNA test for cervical cancer screening in disease diagnosis. METHODS: A total of 405 samples from Dazhou Central Hospital from April 2017 to July 2020 were collected, and we conducted a comparative analysis of the diagnostic performance of several test methods both individually andcombination. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the curve (AUC) were compared by single TCT, E6/E7 mRNA test, and combination methods. The TCT+E6/E7mRNA test was confirmed to have a relatively higher specificity of 80.32% (95% CI: 75.40%-84.48%, both P < 0.001), and AUC value (0.78, 95% CI: 0.73-0.83, and P < 0.001). CONCLUSION: The relative diagnostic value may be further improved by the combined detection of TCT and E6/E7 mRNA test. The combined detection of TCT and the E6/E7 mRNA test is expected to become a potential indicator for cervical lesions.

Pregnancy outcomes in patients with tubal infertility following laparoscopic treatment: a multivariate predictive study.

BACKGROUND: Tubal infertility represents a large portion of female infertility. This study analyzed the pregnancy outcomes of patients with tubal infertility after laparoscopic treatment. A multivariate predictive analysis was also conducted. METHODS: The clinical data of 92 patients admitted in our hospital from March 2015 to March 2018 with tubal infertility were analyzed. According to the inclusion and exclusion criteria, 87 patients were finally included, and all patients were treated with laparoscopy. The clinical data of all study subjects were collected, including age, years of infertility, type of infertility, history of pelvic surgery, history of tubal pregnancy, history of artificial abortion, and lowest tubal function score. The patients were followed up for two years, and multiple logistic regression was used to analyze the factors affecting the pregnancy outcomes of patients with tubal infertility after laparoscopic treatment. The receiver operating characteristic (ROC) curve was used to analyze the predictive values. RESULTS: Among the 87 patients, 63 cases (72.41%) had successful pregnancies at follow-up, and 24 cases (27.58%) were not pregnant. The time of follow up (half a year, 1 year, and 2 years) was not significantly different between the pregnant and the non-pregnant groups. There were no significant differences in the infertility types, pelvic surgery history, and induced abortion history between two groups (P>0.05), However, there were differences in the age, years of infertility, tubal pregnancy history, and lowest tubal function score (P<0.05). Multivariate analyses showed that the patient's age over 35 years, a lowest tubal function score indicating severe injury, and a history of tubal pregnancy were independent risk factors for the pregnancy outcome of patients with tubal infertility after laparoscopic treatment (P<0.05). The area under the ROC curve for age, lowest tubal function score, tubal pregnancy history, and the three combined curves were 0.792, 0.852, 0.816, and 0.949, respectively. CONCLUSIONS: The age of the patient, the lowest tubal function score, and the tubal pregnancy history are independent risk factors for the pregnancy outcome of patients with tubal infertility after laparoscopic treatment. Furthermore, the combination of the three risk factors can be used as a predictor of the pregnancy outcome in patients with tubal infertility after laparoscopic treatment.

Short- and long-term outcomes of laparoscopic radical hysterectomy for obese patients with cervical cancer.

PURPOSE: To perform a preliminary comparison of the short- and long-term outcomes of laparoscopic hysterectomy (LH) between obese and non-obese patients with cervical cancer. METHODS: A total of 243 cases of cervical cancer patients were treated with LH between April 2009 and January 2016. Based on their body mass index (BMI) at the time of surgery, patients were divided into an obese group (BMI ≥ 25 kg/m2) and a non-obese group (BMI < 25 kg/m2). The short- and long-term outcomes of the two groups were retrospectively analyzed. RESULTS: Sixty-four patients were classified as obese and 179 as non-obese. There were no statistically significant differences in age, clinical stage, pathological type, pathological grade, and American Society of Anesthesiologists (ASA) score between the two groups. The proportion of patients with type-2 diabetes mellitus (p=0.006), hypertension (p=0.021), and hyperlipidemia (p=0.008) in the obese group was significantly higher than that in the non-obese group. Compared with the non-obese group, the obese patients had longer operative time (p=0.039), more intraoperative blood loss (p=0.025), and a higher rate of conversion (p=0.025). There was no significant difference between the two groups in terms of intraoperative and postoperative 30-day complications. Pathology data of the two groups were similar. Both groups had similar tumor recurrence rates, 5-year overall survival rates, and 5-year disease-free survival rates.