Chromogranin A (CgA) as poor prognostic factor in patients with small cell carcinoma of the cervix: results of a retrospective study of 293 patients.

BACKGROUND: Small cell carcinoma of the cervix (SCCC) is a very rare tumor. Due to its rarity and the long time period, there is a paucity of information pertaining to prognostic factors associated with survival. The objective of this study was to determine whether clinicopathologic finings or immunohistochemical presence of molecular markers predictive of clinical outcome in patients with SCCC. METHODOLOGY AND FINDINGS: We retrospectively reviewed a total of 293 patients with SCCC (47 patients from Cancer Center of Sun Yat-sen University in china, 71 patients from case report of china journal, 175 patients from case report in PubMed database). Of those 293 patients with SCCC, the median survival time is 23 months. The 3-year overall survival rates (OS) and 3-year disease-free survival rates (DFS) for all patients were 34.5% and 31.1%, respectively. Univariate and multivariate analysis showed that FIGO stage (IIb-IV VS I-IIa, Hazard Ratio (HR) = 3.08, 95% confidence interval (CI) of ratio = [2.05, 4.63], P<0.001), tumor mass size (≥ 4 cm VS <4 cm, HR = 2.37, 95% CI = [1.28, 4.36], P = 0.006) and chromogranin A (CgA) (Positive VS Negative, HR = 1.81, 95% CI = [1.12, 2.91], P = 0.015) were predictive of poor prognosis. CgA stained positive was found to be highly predictive of death in early-stage (FIGO I-IIa) patient specifically. CONCLUSIONS: Patients with SCCC have poor prognosis. FIGO stage, tumor mass size and CgA stained positive may act as a surrogate for factors prognostic of survival. CgA may serve as a useful marker in prognostic evaluation for early-stage patients with SCCC.

[Clinical significance of counting follicles in diagnosis of polycystic ovary syndrome by the three-dimensional ultrasound imaging with sonography based automated volume calculation method].

OBJECTIVE: To investigate clinical significance of counting follicles classification by three-dimensional imaging with sonography based automated volume calculation (SonoAVC) in the diagnosis of polycystic ovary syndrome (PCOS). METHODS: Eighty cases with PCOS were counted classified follicles and determined ovarian volume by three-dimensional (3D) imaging with SonoAVC method matched with 60 infertile women with fallopian tube or male factors as control. Main clinical, biological and other ultrasonographic markers were assessed during the early follicular phase, and the relationship between the follicle number range per ovary or the volume per ovary and the major hormonal features of PCOS was studied. RESULTS: Three-dimensional ultrasound imaging with SonoAVC method provides a new path for objective quantitative assessment of follicle count, ovarian volume, total follicle numbers. The volume of (11 ± 8) ml, total numbers of 27 ± 14 follicle and number of 22 ± 19 follicle with diameter of ≥ 2 - < 6 mm in PCOS patients were significantly higher than (6 ± 4) ml in ovarian volume, 6 ± 4 in total follicles and 2 ± 3 in follicle with diameter of ≥ 2 - < 6 mm in controls (P < 0.05), while follicles were similar for the ≥ 6 - ≤ 9 mm range (P > 0.05). Total follicle numbers and follicles ≥ 2 - < 6 mm had significantly positive relationships with ovarian volume (r = 0.600, 0.618, P < 0.01) and level of testosterones (r = 0.364, 0.291, P < 0.05), follicles ≥ 2 - < mm also had significantly positive relationships with total follicle number (r = 0.916, P < 0.01). The follicles within the ≥ 6 - ≤ 9 mm range was significantly and negatively related to ovarian volume and total follicle numbers (r = -0.618, -0.263, all P = 0.001), but no significantly related to the major hormonal features of PCOS. The ovarian volume was significantly positively related with luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio (r = 0.282, P = 0.010) but negatively related to FSH level (r = -0.226, P = 0.042). CONCLUSIONS: Ovarian volume, total follicle numbers and follicles ≥ 2 - < 6 mm in PCOS patients were significantly higher than those in controls. The larger ovarian volume might produce more total follicle and follicles ≥ 2 - < 6 mm. The higher level of testosterone might produce more total follicle probably, which mainly result in more follicles ≥ 2 - < 6 mm. These morphologically ultrasonographic characteristics could reflect pathophysiological changes in PCOS. Obviously, it has important clinical significance to count follicles in patients with PCOS by the three-dimensional ultrasound imaging with SonoAVC method.

[Changes in the sonographic appearance of the endometrium after different premenopausal tamoxifen therapies].

OBJECTIVE: To assess the effect of different schemes of premenopausal tamoxifen therapy on the endometrium. METHODS: Totally 109 normal premenopausal women positive for high-risk factors of breast cancer were divided into two groups, namely periodic and consecutive tamoxifen treatment groups. Endometrial thickness as examined by vaginal sonography was assessed in relation to duration of tamoxifen use and time from discontinuation of the drug. RESULTS: After one year of tamoxifen use, the mean endometrial thickness in periodic treatment group was 6.5-/+1.4 mm, and 10.2-/+2.0 mm in consecutive treatment group. Endometrial thickness increased with the duration of tamoxifen use at the rate of 0.51 mm/year in the periodic treatment group, and 0.73 mm/year in consecutive treatment group. After discontinuation of tamoxifen, the endometrial thickness in the former group decreased by 1.29 mm/year, and by 1.33 mm/year in the latter. CONCLUSIONS: Endometrial hyperplasia is obviously milder in premenopausal women receiving periodic tamoxifen treatment who are at risk for breast cancer than that in women with consecutive treatment. After discontinuation of the drug, the endometrial thickness decreases at a roughly equal slow rate in the two groups.