Incidence and mortality of ovarian cancer at the global, regional, and national levels, 1990-2017.

BACKGROUND: Ovarian cancer (OC) is a commonly diagnosed gynecologic cancer. Knowing the incidence and mortality rates of OC is critical to understanding the disease burden and updating prevention strategies. METHODS: We retrieved the age-standardized incidence and mortality rates (ASIR and ASMR, respectively) of OC from the Global Burden of Disease study online database. Estimated average percentage change (EAPC) was used to quantify the trends of OC incidence and mortality from 1990 to 2017. RESULTS: Worldwide, the number of incident cases and deaths from OC increased from 152.1 and 95.5 thousand in 1990 to 286.1 and 176.0 thousand in 2017, respectively. Both the ASIR and ASMR decreased slightly during the study period (EAPC = -0.10, 95% CI, -0.16, -0.03; EAPC = -0.32, 95% CI, -0.38, -0.27). The greatest decreases of ASIR and ASMR were observed in Western Europe (EAPC = -1.22, 95% CI, -1.31, -1.14; EAPC = -1.31, 95% CI, -1.37, -1.25). A total of 137, 10, and 48 countries or territories experienced an increase, remained stable, and experienced a decrease in OC ASIR, respectively, between 1990 and 2017. For ASMR, a total of 129, 9, and 57 countries or territories experienced an increase, remained stable, and experienced a decrease, respectively, during the same period. The greatest increases in the ASIR and the ASMR were found in countries located in the Caribbean and Latin America. CONCLUSIONS: The incidence and mortality of OC significantly decreased in developed countries. However, remarkable increases were observed in more than two-thirds of all countries, suggesting that OC will be more frequently diagnosed in developing countries.

Diagnostic value of endometrial volume and flow parameters under 3D ultrasound acquisition in combination with serum CA125 in endometrial lesions.

OBJECTIVE: This study aims to discuss the differential diagnosis value of endometrial volume and flow parameters in combination with serum carbohydrate antigen 125 (CA125) in endometrial benign and malignant lesions. MATERIALS AND METHODS: The data of 250 patients with endometrial lesions were retrospectively analyzed. Carbohydrate antigen 125 (CA125) was determined before the operation. The morphology, hemodynamics, volume and flow parameters of the endometrium were measured by transvaginal three-dimensional-power Doppler angiography (3D-PDA). The endometrial volume (EV), 3D-PDA vascular index (VI), flow index (FI) and vascularization flow index (VFI) were calculated using the virtual organ computer-aided analysis software (VOCAL). RESULTS: According to the pathological results, 202 patients (80.8%) had benign endometrial lesions and 48 patients (19.2%) had endometrial cancer (EC). The endometrium of EC patients was thicker (15.64 ± 7.26 mm vs. 9.24 ± 5.06 mm, P < 0.001), the endometrial volume was larger (9.23 ± 4.08 ml vs. 2.26 ± 3.42 ml, P < 0.001), and the flow parameters VI, FI and VFI were higher, when compared to those of benign lesions (P < 0.001). The area under the receiver operating characteristic curve (AUROCC) of VI receptors was 0.86, while the AUC of endometrial thickness (ET) was only 0.66. Therefore, the best variable for distinguishing benign and malignant endometrial lesions was VI. The level of CA125 in the EC group significantly increased (40.57 ± 17.45 vs. 17.87 ± 7.64, P < 0.001), and the level of CA125 increased (P < 0.05) with the increase in clinical grade, degree of tumor differentiation, and pelvic lymph node metastasis (P < 0.05). However, the difference in myometrial invasion was not statistically significant (P > 0.05). CONCLUSION: Transvaginal 3D-PDA can clearly show the morphological and hemodynamic characteristics of endometrial lesions, and assist in the detection of EC in combination with serum CA125. This may have important clinical application value.

SOX17, ß-catenin and CyclinD1 expression in the endometrioid adenocarcinoma and influence of 5-AZA on expression.

The present study discusses the expression and effect of the SOX17 gene in endometrioid adenocarcinoma. MTT assay is performed to determine the growth inhibition ratio of the DNA methyltransferase inhibitor 5-AZA for endometrial carcinoma cells, and the real-time fluorescence quantification PCR (qRT-PCR) was used to detect the mRNA expression of SOX17, ß-catenin, and CyclinD1 in endometrial carcinoma tissues before and after using 5-AZA to treat the endometrial carcinoma cell line. There were 30 cases on endometrioid adenocarcinoma tissues and 10 cases on normal endometrial tissues. The results revealed that the expression of SOX17 in endometrioid adenocarcinoma tissues was downregulated (P < 0.05), the expression of ß-catenin and CyclinD1 was upregulated (P < 0.05), and the expression of SOX17, CyclinD1, and ß-catenin was negatively correlated (r = -0.353, P > 0.05; R = -0.463, P < 0.05). The higher the histological grade and FIGO staging were, the lower the expression level of SOX17 was (P < 0.05). After HEC1A cells were treated by 5-AZA, the cell growth inhibition was most obvious (IC50 = 12.033) at 72 h, as determined by MTT assay. After cell treatment by 5-AZA, the genetic expression of SOX17 significantly increased, when compared with that before treatment (P < 0.05), while the genetic expression of ß-catenin and CyclinD1 significantly declined (P < 0.05). These results indicate that the expression level of SOX17 in endometrioid adenocarcinoma declined, and the upregulated expression level of SOX17 in cells inhibited the growth of tumor cells.