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1.
Clin Transl Oncol ; 25(3): 662-672, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36422798

RESUMO

PURPOSE: Aberrant activation of STAT3 signal pathway promotes tumor progression in many solid tumor types, including cervical cancer and endometrial cancer. BBI608, the STAT3 inhibitor had been reported in previous studies for restraining cancer stem cells. However, whether BBI608 is available for inhibiting the proliferation of cervical cancer or endometrial cancer remains poorly understood. This study investigated the anti-tumor effect and molecular mechanism of BBI608 on the patient-specific primary cells (PSPC) generated from cervical and endometrial cancer in vitro. METHODS: PSPCs were obtained from four patients via biopsy. The cell viability was analyzed by the CCK8 assay. The PSPCs were treated with various concentrations of BBI608 or/and paclitaxel; and then, western blot was applied to investigate the expression of phosphorylated STAT3 (pSTAT3). RESULTS: The PSPCs cell viability was reduced after treated with BBI608 at a lower concentration. Western blot results showed a reduction trend of pSTAT3 after PSPCs treated with BBI608. Our results demonstrated that BBI608 at the certain concentrations worked well in reducing the cell viability of PSPC from the patients who suffered from cervical cancer and endometrial cancer. CONCLUSIONS: In this study, the patient-specific primary cell (PSPC) was used as the pre-clinical model for investigating the efficiency of BBI608 in reducing cancer cells viability. BBI608, at a clinical-relevant concentration, had valid efficiency in PSPCs from the patients. The dose of drugs treatment and the measured results were more valuable for further guiding clinical trials.


Assuntos
Neoplasias do Endométrio , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/tratamento farmacológico , Sobrevivência Celular , Neoplasias do Endométrio/patologia , Paclitaxel/farmacologia , Fator de Transcrição STAT3/metabolismo , Linhagem Celular Tumoral , Proliferação de Células
2.
Arch Gynecol Obstet ; 305(2): 449-458, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34406459

RESUMO

PURPOSE: To compare oncological outcomes of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for low-risk cervical cancer. METHOD: We retrospectively compared the 3-year overall survival (OS) and 3-year disease-free survival (DFS) of 1269 low-risk cervical cancer patients with FIGO 2009 stage IA2, IB1 and IIA1 with a tumour size < 2 cm, no lymphovascular space invasion (LVSI), superficial stromal invasion and no lymph node involvement on imaging, and who received LRH (n = 672) and ARH (n = 597) between 2009 and 2018 at 47 hospitals. RESULTS: In the total study population, LRH and ARH showed similar 3-year OS (98.6% vs. 98.9%, P = 0.850) and DFS rates (95.7% vs. 96.4%, P = 0.285). LRH was not associated with worse 3-year OS (HR 0.897, 95% CI 0.287-2.808, P = 0.852) or DFS (HR 0.692, 95% CI 0.379-1.263, P = 0.230) as determined by multivariable analysis. After propensity score matching in 1269 patients, LRH (n = 551) and ARH (n = 551) still showed similar 3-year OS (98.4% vs. 98.8%, P = 0.704) and DFS rates (95.5% vs. 96.3%, P = 0.249). LRH was still not associated with worse 3-year OS (HR 0.816, 95% CI 0.262-2.541, P = 0.725) or DFS (HR 0.694, 95% CI 0.371-1.296, P = 0.251). CONCLUSION: Among patients with low-risk cervical cancers < 2 cm, no LVSI, superficial stromal invasion, and no lymph node involvement on imaging, no significant differences were observed in 3-year OS or DFS rates between LRH and ARH.


Assuntos
Laparoscopia , Neoplasias do Colo do Útero , Intervalo Livre de Doença , Feminino , Humanos , Histerectomia/métodos , Laparoscopia/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia
3.
Future Oncol ; 18(2): 149-161, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34643088

RESUMO

Background: Chemoresistance usually occurs in ovarian cancer. We aimed to explore the mechanisms of chemoresistance. Methods: Western blotting assay was used to detect the expression of GALNT14. Further cell function experiments were performed to investigate the effect of GALNT14 in ovarian cancer. Results: GALNT14 is significantly upregulated in ovarian cancer. Downregulation of GALNT14 significantly inhibits both apoptosis and ferroptosis of ovarian cancer cells. A further mechanism assay illustrated that downregulation of GALNT14 suppresses the activity of the mTOR pathway through modifying O-glycosylation of EGFR. Finally, an additive effect promoting cell death occurs with a combination of an mTOR inhibitor and cisplatin. Conclusion: Our study might provide a promising method to overcome cisplatin resistance for patients with ovarian cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Cisplatino/farmacologia , Resistencia a Medicamentos Antineoplásicos/genética , N-Acetilgalactosaminiltransferases/metabolismo , Neoplasias Ovarianas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Apoptose/efeitos dos fármacos , Apoptose/genética , Linhagem Celular Tumoral , Cisplatino/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Receptores ErbB/metabolismo , Feminino , Ferroptose/efeitos dos fármacos , Ferroptose/genética , Regulação Neoplásica da Expressão Gênica , Glicosilação/efeitos dos fármacos , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Ovário/patologia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Sirolimo/análogos & derivados , Sirolimo/farmacologia , Sirolimo/uso terapêutico , Serina-Treonina Quinases TOR/antagonistas & inibidores , Serina-Treonina Quinases TOR/metabolismo , Regulação para Cima
4.
Int J Clin Oncol ; 27(3): 619-625, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34837596

RESUMO

AIM: This study aimed to compare the 5-year overall survival (OS) and 5-year DFS disease-free survival (DFS) of abdominal radical hysterectomy (ARH) and radiochemotherapy (R-CT) for stage IIA2 (FIGO 2018) cervical cancer patients. METHODS: Based on this multicenter, retrospective cohort study based on data from the clinical diagnosis and treatment of cervical cancer in China (Four C) database, 609 cases with 2018 FIGO stage IIA2 cervical cancer from 2004 to 2018 were reviewed. The 5-year OS and 5-year DFS of patients with either of the two treatment methods were compared by means of a multivariate Cox regression model and the log-rank method in the total study population and after propensity score matching (PSM). RESULTS: We selected 609 of 63,926 patients and found that R-CT was associated with a significantly worse 5-year OS (71.8% vs. 95.3%, P < 0.001; hazard ratio (HR) = 6.596, 95% CI 3.524-12.346) and 5-year DFS (69.4% vs. 91.4%, P < 0.001; HR = 4.132, 95% CI 2.570-6.642, P < 0.001) than ARH in the total study population. After matching (n = 230/230), among FIGO 2018 IIA2 patients, the 5-year OS and DFS were lower in the R-CT group than in the ARH group (OS: 73.9% vs. 94.7%, P < 0.001; HR = 5.633, 95% CI 2.826-11.231, P < 0.001; DFS: 69.2% vs. 91.1%, P < 0.001; HR = 3.978, 95% CI 2.336-6.773, P < 0.001, respectively). CONCLUSIONS: In patients with stage FIGO 2018 IIA2 cervical cancer, ARH offers better 5-year OS and DFS outcomes than R-CT; however, due to the inherent biases of retrospective studies, this needs to be confirmed by randomized trials.


Assuntos
Neoplasias do Colo do Útero , Quimiorradioterapia , China/epidemiologia , Feminino , Humanos , Histerectomia/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia
5.
Eur J Surg Oncol ; 47(8): 2125-2133, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33781626

RESUMO

OBJECTIVE: To compare the oncological outcomes and major complications of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for stage IB1 cervical cancer (FIGO 2009) with a tumour size less than 2 cm. METHODS: We retrospectively compared the oncological outcomes and major complications of 1207 stage IB1 cervical cancer patients with a tumour size less than 2 cm who received LRH (n = 546) or ARH (n = 661) in 37 hospitals. RESULTS: (1) There was no significant difference in 3-year overall survival (OS; 97.3% vs. 98.5%, P = 0.288) or 3-year disease-free survival (DFS; 95.1% vs. 95.4%, P = 0.792) between LRH (n = 546) and ARH (n = 661).(2) The rate of any 1 complication refers to the incidence of one or more complications in a patient, which was higher with LRH than ARH (OR = 4.047, 95% CI = 2.035-8.048, P < 0.001). Additionally, intraoperative complications occurred with LRH (OR = 12.313, 95% confidence intervals [CI] = 1.571-96.493, P = 0.017), and postoperative complications (OR = 3.652, 95% CI = 1.763-7.562, P < 0.001) were higher with LRH than ARH. The ureteral injury rate was higher with LRH than with ARH (1.50% vs. 0.20%, OR = 9.814, 95% CI = 1.224-78.712, P = 0.032). The ureterovaginal fistula rate was higher with LRH than ARH. The rates of obturator nerve injury, bladder injury, vesicovaginal fistula, rectovaginal fistula, venous thromboembolism, bowel obstruction, chylous leakage, pelvic haematoma, and haemorrhage were similar between the groups. CONCLUSIONS: The oncological outcomes of LRH and ARH for stage IB1 cervical cancer patients with a tumour size less than 2 cm do not differ significantly. However, incidences of any 1 complication, intraoperative complications, and postoperative complications were higher with LRH than ARH, with complications manifesting mainly as ureteral injury and uterovaginal fistula.


Assuntos
Adenocarcinoma/cirurgia , Carcinoma de Células Escamosas/cirurgia , Histerectomia/métodos , Complicações Intraoperatórias/epidemiologia , Laparoscopia/métodos , Excisão de Linfonodo/métodos , Complicações Pós-Operatórias/epidemiologia , Neoplasias do Colo do Útero/cirurgia , Adenocarcinoma/patologia , Adulto , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Feminino , Humanos , Obstrução Intestinal/epidemiologia , Margens de Excisão , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Nervo Obturador/lesões , Hemorragia Pós-Operatória/epidemiologia , Modelos de Riscos Proporcionais , Fístula Retovaginal/epidemiologia , Carga Tumoral , Ureter/lesões , Doenças Ureterais/epidemiologia , Bexiga Urinária/lesões , Neoplasias do Colo do Útero/patologia , Fístula Vaginal/epidemiologia , Tromboembolia Venosa/epidemiologia , Fístula Vesicovaginal/epidemiologia
6.
Arch Gynecol Obstet ; 304(2): 495-501, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33392721

RESUMO

BACKGROUND: Successful neoadjuvant chemotherapy (NACT) could improve the surgical resection rate and radical curability of patients with cervical cancer, but only a subset of patients benefits. Therefore, identifying predictive biomarkers are urgently needed. The aim of this study was to evaluate the predictive value of CD34 and Bcl-2 in the NACT effectiveness of cervical cancer. METHODS: Sixty-seven patients with locally advanced cervical cancer (FIGO stages IB3, IIA2 or IIB) were classified into two groups based on effective (n = 48) and ineffective (n = 19) response to NACT. Immunohistochemistry was employed to identify CD34 and Bcl-2 expression before and after NACT. We analyzed the associations between the pre-NACT expression of these two biomarkers and the response of NACT. The expression of these two biomarkers before and after NACT was also assessed and compared. RESULTS: More patients were CD34 positive expression before NACT in effective group compared to ineffective group (p = 0.005). However, no statistically significant difference in Bcl-2 expression before NACT were found between two groups (p = 0.084). In NACT effective group, the expression of both CD34 and Bcl-2 after NACT are down-regulated (p < 0.001 and p < 0.001, respectively), while there are no statistical differences between the pre- and post-NACT expression of CD34 and Bcl-2 in NACT ineffective group (p = 0.453 and p = 0.317, respectively). CONCLUSION: The positive CD34 expression before NACT may serve as a predictive biomarker for NACT of cervical cancer, but the pre-NACT expression of Bcl-2 is not an independent predictor. The down-regulated expression of these two indicators after NACT may indicate effective NACT.


Assuntos
Antígenos CD34/efeitos dos fármacos , Quimioterapia Adjuvante/métodos , Genes bcl-2/efeitos dos fármacos , Terapia Neoadjuvante , Neoplasias do Colo do Útero/tratamento farmacológico , Antígenos CD34/genética , Protocolos de Quimioterapia Combinada Antineoplásica , Quimioterapia Adjuvante/efeitos adversos , Feminino , Genes bcl-2/genética , Humanos , Estadiamento de Neoplasias , Gravidez , Proteínas Proto-Oncogênicas c-bcl-2/uso terapêutico , Neoplasias do Colo do Útero/patologia
7.
ANZ J Surg ; 91(1-2): E20-E24, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32338816

RESUMO

BACKGROUND: This study aimed to evaluate the technical feasibility and outcomes of total laparoscopic sigmoid vaginoplasty (TLSV) in women with congenital absence of the vagina. METHODS: We investigated 10 women with congenital absence of the vagina, who underwent TLSV at Guangdong Provincial People's Hospital between April 2013 and July 2016. RESULTS: All 10 women were unmarried, the mean age was 22.8 (range 17-33) years, mean estimated blood loss was 149.2 ± 54.8 (60-170) mL, mean operative time was 108.4 ± 52.6 (130-210) min, mean post-operative hospital stay was 8.0 ± 2.8 (6-12) days and the mean neovaginal length was 13.4 ± 3.0 (12-16) cm. Eight of the 10 women were heterosexually active. Trocar port site infection and neovaginal stenosis occurred 3 months after TLSV in one patient; a vaginal mould was used to relieve the stenosis. CONCLUSION: TLSV is an optimal minimally invasive procedure to treat women with congenital absence of the vagina and is associated with rapid recovery and acceptable cosmetic effects.


Assuntos
Laparoscopia , Procedimentos de Cirurgia Plástica , Adolescente , Adulto , Colo Sigmoide/cirurgia , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Duração da Cirurgia , Vagina/cirurgia , Adulto Jovem
8.
Aging (Albany NY) ; 12(22): 23337-23350, 2020 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-33197886

RESUMO

Growing evidence suggests that microbes can influence the onset of cancer and its consequent development. By researching samples from patients afflicted by cervical cancer, we aimed to explore the associated dynamics and prognostic value of intratumoral levels of F. nucleatum. We used qPCR to analyze tumor tissues obtained from 112 cervical cancer patients in order to characterize the levels and influences of intratumoral levels of the F. nucleatum. Especially for recurrent tissues, there was a distinct observation of higher levels of F. nucleatum in cervical cancer. Patients with high burdens of F. nucleatum intratumoral infiltration exhibited correspondingly poor rates of both overall survival and progression-free survival. Measures of the levels of F. nucleatum were found to have been reliable independent prognostic factors that could predict rates of PFS for afflicted patients (HR = 4.8, 95%CI = 1.2-18.6, P = 0.024). Notably, the levels ofF. nucleatum were positively correlated with tumor differentiation. Cancer cells from patients with relatively high levels of F. nucleatum were observed to possess the characteristics of cancer stem cells (CSCs). We propose that F. nucleatum might be one potential cervical cancer diagnostic and prognostic biomarker, and these findings will help to provide a sound rationale and merit for further study of this bacterium.


Assuntos
Fusobacterium nucleatum/isolamento & purificação , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/microbiologia , Adulto , Feminino , Humanos , Células-Tronco Neoplásicas/microbiologia , Prognóstico , Análise de Sobrevida , Neoplasias do Colo do Útero/mortalidade
9.
Front Mol Biosci ; 7: 183, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32903653

RESUMO

OBJECTIVE: To obtain molecular information in slides directly from H&E staining slides, which apparently display morphological information, to show that some differences in molecular level have already encoded in morphology. METHODS: In this paper, we selected Ki-67-expression as the representative of molecular information. We proposed a method that can predict Ki-67 positive cells directly from H&E stained slides by a deep convolutional network model. To train this model, we constructed a dataset containing Ki-67 negative or positive cell images and background images. These images were all extracted from H&E stained WSIs and the Ki-67 expression was acquired from the corresponding IHC stained WSIs. The trained model was evaluated both on classification performance and the ability to quantify Ki-67 expression in H&E stained images. RESULTS: The model achieved an average accuracy of 0.9371 in discrimination of Ki-67 negative cell images, positive cell images and background images. As for evaluation of quantification performance, the correlation coefficient between the quantification results of H&E stained images predicted by our model and that of IHC stained images obtained by color channel filtering is 0.80. CONCLUSION AND SIGNIFICANCE: Our study indicates that the deep learning model has a good performance both on prediction of Ki-67 positive cells and quantification of Ki-67 expression in cancer samples stained by H&E. More generally, this study shows that deep learning is a powerful tool in exploring the relationship between morphological information and molecular information. AVAILABILITY AND IMPLEMENTATION: The main program is available at https://github.com/liuyiqing2018/predict_Ki-67_from_HE.

10.
Biomed Pharmacother ; 127: 110209, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32559848

RESUMO

Genome regions that do not for code for proteins are generally transcribed into long non-coding RNAs. Growing evidence reveals that lncRNAs, defined as transcripts longer than 200 nucleotides, are commonly deregulated in cervical malignancies. New sequencing technologies have revealed a complete picture of the composition of the human transcriptome. LncRNAs perform diverse functions at transcriptional, translation, and post-translational levels through interactions with proteins, RNA and DNA. In the past decade, studies have shown that lncRNAs participate in the pathogenesis of many diseases, including cervical cancer. Hence, illuminating the roles of lncRNA will improve our understanding of cervical cancer. In this work, we summarize the current knowledge on lncRNAs in cervical cancer. We describe the emerging roles of lncRNAs in cervical cancer, particularly in cancer progression, metastasis, treatment resistance, HPV regulation, and metabolic reprogramming. The great promises of lncRNAs as potential biomarkers for cervical cancer diagnosis and prognosis are also discussed. We discuss current technologies used to target lncRNAs and thus control cancers, such as antisense oligonucleotides, CRISPR-Cas9, and exosomes. Overall, we show that lncRNAs hold great potentials as therapeutic agents and innovative biomarkers. Finally, further clinical research is necessary to advance our understanding of the therapeutic value of lncRNAs in cervical cancer.


Assuntos
Regulação Neoplásica da Expressão Gênica/fisiologia , Terapia de Alvo Molecular/métodos , RNA Longo não Codificante/fisiologia , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/fisiopatologia , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico
11.
Ann Transl Med ; 8(4): 79, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32175372

RESUMO

Adhesion is a postoperative complication that has plagued gynecologists for many years, as 60-90% of gynecological patients develop adhesions after abdominopelvic surgeries. Abdominopelvic adhesions could lead to chronic pelvic pain, infertility, intestinal obstruction, and complicated reoperations. Adhesions might also increase the risk of postoperative chemoradiotherapy failure and endanger patients' lives, especially after surgeries for gynecological malignant tumors. The aim of this consensus was to review the pathogenesis and clinical consequences of adhesions and to summarize various surgical procedures and preventive measures that can reduce the occurrence of adhesions after gynecological tumor surgeries based on a discussion among well-known domestic gynecology specialists.

12.
BMJ Open ; 10(2): e032331, 2020 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-32066600

RESUMO

OBJECTIVE: We aimed to evaluate the safety, efficiency and preferred indication for laparoendoscopic single-site surgery (LESS) compared with conventional laparoscopic (CL) surgery for benign ovarian masses. DESIGN: A systemic review and cumulative meta-analysis were performed in line with the criteria of Grading of Recommendations Assessment, Development and Evaluation: levels of evidence and grades of recommendation. DATA SOURCES: We comprehensively searched the electronic databases including PubMed, Medline, Embase and the Cochrane Library in November 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included all randomised controlled trials (RCTs) and retrospective studies published in recent 10 years, which investigated the performance of LESS versus CL in patients at all ages with benign ovarian masses. RESULTS: Four RCTs and nine retrospective studies published in recent decade including 1542 cases (744 cases for LESS and 798 cases for CL) were identified. Perioperative complication was consisted of intraoperative and postoperative complications, including ileus, wound infection or dehiscence and incisional hernia. Although LESS has less postoperative analgesic consumption (46.78% and 79.25%; OR: 0.49; 95% CI: 0.33 to 0.74, p<0.001) and shorter hospital stay (weighted mean difference (WMD): -0.24 days; 95% CI: -0.35 to -0.14; p<0.001), CL has less perioperative complications (6.59% and 2.85%; OR: 2.08; 95% CI: 1.05 to 4.11, p=0.04) and shorter operative time (WMD: 3.43 min; 95% CI: -0.03 to 6.88; p=0.05). Body mass index, history of previous abdominal surgery, size of adnexal mass, estimated blood loss and postoperative pain scores did not differ significantly between two techniques. CONCLUSIONS: The indications of LESS for benign ovarian masses are similar to CL and it has better postoperative recovery. However, with less perioperative complications, CL surgery is safer than LESS.


Assuntos
Laparoscopia/métodos , Neoplasias Ovarianas/cirurgia , Endoscopia/métodos , Feminino , Humanos , Duração da Cirurgia , Ovário/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Resultado do Tratamento
13.
World J Clin Cases ; 7(3): 347-356, 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30746376

RESUMO

BACKGROUND: Intravenous leiomyomatosis (IVL) is a rare and complicated disease, which requires surgery by a multidisciplinary team. However, the optimal surgical approach has not been determined. CASE SUMMARY: Here we report three cases of IVL treated with different surgical approaches. All patients presented with circulation symptoms. Two patients had lower extremity edema and the other had cardiopalmus. The diagnosis of IVL was confirmed based on the imagining examinations and pathological findings. All patients underwent surgical treatment and were discharged without any complications. CONCLUSION: Preoperative examination is crucial for surgical planning and surgical approach is dependent on the patient's condition and tumor involvement.

14.
Int J Gynaecol Obstet ; 143(3): 306-312, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30129038

RESUMO

OBJECTIVE: To compare the efficacy of transcervical resection of the cervix (TCRC) and loop electrosurgical excision procedure (LEEP) in the treatment of high-grade cervical squamous intraepithelial lesions (HSIL). METHODS: A retrospective case record review was conducted of patients with HSIL treated with TCRC or LEEP at Guangdong General Hospital, Guangdong Academy of Medical Sciences and Zhujiang Hospital, Guangzhou, China, from 2009 to 2015. The clinical characteristics, cone margin statuses, clinical outcomes, and adverse events were compared between the two groups. RESULTS: Among 647 included patients, 292 (45.1%) were treated with TCRC and 355 (54.9%) with LEEP. The incidences of positive margins, persistent and recurrent lesions, and intraoperative bleeding were lower in the TCRC group than in the LEEP group (P<0.001 for all comparisons). The rates of cervical adhesions were comparable between the two groups. During TCRC, 78 (26.7%) intrauterine lesions were diagnosed; most of these had been missed by transvaginal sonography. CONCLUSION: TCRC may be an alternative method to LEEP in the treatment of HSIL. Compared with LEEP, TCRC has comparable clinical efficacy without additional adverse events. Moreover, TCRC is useful for detecting and/or removing intrauterine lesions during surgery.


Assuntos
Eletrocirurgia/métodos , Recidiva Local de Neoplasia , Traquelectomia/métodos , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Perda Sanguínea Cirúrgica , Eletrocirurgia/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasia Residual , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Aderências Teciduais/etiologia , Traquelectomia/efeitos adversos , Resultado do Tratamento , Neoplasias do Colo do Útero/patologia , Adulto Jovem , Displasia do Colo do Útero/patologia
15.
Taiwan J Obstet Gynecol ; 56(2): 139-142, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28420496

RESUMO

OBJECTIVE: With the incidence of cesarean scar pregnancy (CSP) rising, the reports of serious adverse outcomes of it have increased gradually. The management of CSP remains an inadequately explored clinical field, and there is no consensus on it presently. The present study was performed to investigate the efficacy and safety of operative hysteroscopy in the diagnosis and treatment of CSP. MATERIALS AND METHODS: Forty-four patients with CSP underwent operative hysteroscopy for removal of scar ectopic pregnancy in our institution. Among them, hysteroscopy was combined with laparoscopy in two patients, three cases with massive hemorrhage were pretreated with bilateral uterine artery embolization before hysteroscopic surgery, and four patients were pretreated with mifepristone (200 mg for 3 days) and methotrexate (25 mg for 2 days). Clinical data, serum ß-human chorionic gonadotropin, myometrial thickness, residual conceptus, cesarean scar defect, operation time, blood loss, and hospital stay were recorded. RESULTS: All of the ectopic gestations were removed entirely by operative hysteroscopy. Mean operation time was 34.8±16.5 minutes (range 20-120 minutes), and mean blood loss was 35.3±24.4 mL (range 5-100 mL). The mean hospital stay was 5.0±3.01 days (range 1-19 days). Cesarean scar defect could be diagnosed in 70% (31/44) of patients, while in 20/32 cases (63%), a conceptus remained after uterine curettage only was performed. CONCLUSION: Operative hysteroscopy might be recommended as a first-line treatment modality for patients with a cesarean scar ectopic pregnancy, especially when myometrium thickness between bladder and gestational sac is more than 3 mm.


Assuntos
Cesárea/efeitos adversos , Histeroscopia/métodos , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/cirurgia , Abortivos não Esteroides/uso terapêutico , Adulto , Perda Sanguínea Cirúrgica , Cicatriz/complicações , Feminino , Humanos , Laparoscopia , Tempo de Internação , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Duração da Cirurgia , Gravidez , Gravidez Ectópica/etiologia , Cuidados Pré-Operatórios , Embolização da Artéria Uterina , Adulto Jovem
16.
Medicine (Baltimore) ; 95(14): e3211, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27057851

RESUMO

To compare the outcomes of transumbilical laparoendoscopic single-site surgery (TU-LESS) versus traditional laparoscopic surgery (TLS) for early stage endometrial cancer (EC).We retrospectively reviewed the medical records of patients with early stage EC who were surgically treated by TU-LESS or TLS between 2011 and 2014 in a tertiary care teaching hospital. We identified 18 EC patients who underwent TU-LESS. Propensity score matching was used to match this group with 18 EC patients who underwent TLS.All patients underwent laparoscopic-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy by TU-LESS or TLS without conversion to laparoscopy or laparotomy. Number of pelvic lymph nodes retrieved, operative time and estimated blood loss were comparable between 2 groups. Satisfaction values of the cosmetic outcome evaluated by the patient at day 30 after surgery were significantly higher in TU-LESS group than that in TLS group (9.6 ±â€Š0.8 vs 7.5 ±â€Š0.7, P < 0.001), while there was no statistical difference in postoperative complications within 30 days after surgery, postoperative hospital stay, and hospital cost.For the surgical management of early stage EC, TU-LESS may be a feasible alternative approach to TLS, with comparable short-term surgical outcomes and superior cosmetic outcome. Future large-scale prospective studies are needed to identify these benefits.


Assuntos
Neoplasias do Endométrio/cirurgia , Laparoscopia/métodos , Neoplasias Uterinas/cirurgia , Neoplasias do Endométrio/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Umbigo , Neoplasias Uterinas/patologia
17.
Zhonghua Fu Chan Ke Za Zhi ; 50(1): 48-53, 2015 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-25877425

RESUMO

OBJECTIVE: To observe the therapeutic effect of NF-κB gene short hairpin RNA (shRNA) on endometriosis and identify the function of NF-κB on the maintenance and development of endometriosis in Macaca fascicularis. METHODS: The Macaca fascicularis model of endometriosis was developed, which divided into experimental group, negative control group and simple model group. The high specificity adenovirus vector mediated shRNA targeting NF-κB gene and negative control shRNA adenovirus with no-load NF-κB gene were synthesised. The experimental group injected the adenovirus which carried the NF-κB shRNA into the endometriosis lesions under laparoscopy surgery, the negative control group with no-load shRNA adenovirus and the simple models group injected with normal saline. Four weeks later after the injection, an observed operation was performed through laparoscopy and some lesions were collected. The CD34 immunohistochemistry of these lesions were done to detect the microvessel density, then the variation of the microvessel density among each group were observed. The expression of the NF-κB and proliferating cell nuclear antigen (PCNA) were detected through western blot. RESULTS: First, the Macaca fascicularis model of endometriosis was successful developed, and the experimental group has an evident atrophy in ectopic lesions compared with the previous. The lesions' microvessel density in experimental group decreased evidently compared with the negative control group and simple model group (0.002 0±0.000 3 versus 0.021 9±0.002 6 versus 0.024 5±0.003 3), and the differences was statistically significant (P < 0.01). The expression of PCNA (0.37±0.17 versus 0.57±0.26 versus 0.57±0.28) and NF-κB (0.338±0.174 versus 0.678±0.021 versus 0.645±0.098) in experiment group was lower than the negative control group and simple model group, the differences were statistically significant (all P < 0.01). CONCLUSION: Through targeting suppressed the NF-κB gene expression by NF-κB shRNA, we can inhibit the development of endometriosis through reducing the ability of angiogenesis and cell proliferation of ectopic endometrial cells.


Assuntos
Endometriose/genética , Endometriose/metabolismo , Macaca fascicularis/genética , NF-kappa B/metabolismo , Antígeno Nuclear de Célula em Proliferação/metabolismo , RNA Interferente Pequeno , Animais , Proliferação de Células , Feminino , Expressão Gênica , Vetores Genéticos , Humanos , NF-kappa B/genética , Neovascularização Patológica , Antígeno Nuclear de Célula em Proliferação/genética
18.
Nan Fang Yi Ke Da Xue Xue Bao ; 35(3): 390-6, 2015 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-25818787

RESUMO

OBJECTIVE: To assess the effect of a high specific adenovirus vector-mediated shRNA targeting nuclear factor-κB (NF-κB) on cell proliferation of the endometrium of Macaca fascicularis. METHODS: The adenoviral vector NF-κB-p65-shRNA and the empty vector were separately trasnfected in cultured endometrial cells of Macaca fascicularis. The changes in the expression of the target gene protein and apoptotic proteins, cell proliferation, and cell cycle distribution were observed after the transfection. RESULTS: Compared with the control cells, infection of the endometrial cells with the NF-κB-p65-shRNA adenovirus significantly increased the expression levels of apoptotic proteins, promoted apoptosis of the endometrial cells, and reduced the cells in division?stage. CONCLUSIONS: NF-κB-p65 shRNA adenovirus can effectively promote apoptosis of endometrial cells and inhibit the proliferation of endometrial cells of Macaca fascicularis.


Assuntos
Apoptose , Endométrio/citologia , Vetores Genéticos , RNA Interferente Pequeno/genética , Fator de Transcrição RelA/genética , Adenoviridae , Animais , Proliferação de Células , Células Cultivadas , Feminino , Macaca fascicularis , Transfecção
19.
Nan Fang Yi Ke Da Xue Xue Bao ; 34(3): 410-3, 2014 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-24670460

RESUMO

OBJECTIVE: To study the effect of interleukin-1ß (IL-1ß) on the expressions activin A, follistatin, and cripto in cultured human endometrial stromal cells (HESCs) form patients with endometriosis. METHODS: Cultured HESCs were stimulated with 250, 500, and 750pg/ml IL-1ß, and the mRNA and protein expressions of activin A, follistatin, and cripto were assayed using real-time reverse transcriptase-polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS: IL-1ß treatment caused significant dose-dependent increments of the mRNA and protein expressions of activin A and follistatin and of the mRNA expression of cripto in cultured HESCs. CONCLUSION: IL-1ß can affect the expressions of activin A, follistatin and cripto in HESCs from patients with endometriosis.


Assuntos
Ativinas/metabolismo , Endometriose/metabolismo , Interleucina-1beta/farmacologia , Células Estromais/efeitos dos fármacos , Células Cultivadas , Endométrio/citologia , Feminino , Humanos , Células Estromais/metabolismo
20.
Int J Gynecol Cancer ; 24(2): 352-7, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24407575

RESUMO

OBJECTIVE: The aim of this study is to investigate the safety and efficacy of laparoscopy in the treatment of early-stage ovarian cancer (EOC). METHODS: We retrospectively analyzed the clinical data of patients who underwent laparoscopy (35 patients) or laparotomy (40 patients) for the comprehensive surgical staging of EOC in Zhujiang Hospital during the period of 2002 to 2010 and compared the 2 surgical approaches in operative time, intraoperative blood loss, number of dissected lymph nodes, tumor rupture rate, length of hospital stay, time of gastrointestinal function recovery, wound healing condition, complication rate, upstaging rate, rate of postoperative chemotherapy, and postoperative follow-up condition. RESULTS: The laparoscopy group had significantly shorter hospital stay and time of first postoperative flatus and had significantly lower rate of poor wound healing than the laparotomy group. The 2 groups did not show significant differences in operative time, intraoperative blood loss, number of dissected lymph nodes, tumor rupture rate, complication rate, upstaging rate, and rate of postoperative chemotherapy. CONCLUSIONS: Laparoscopy is safe and effective for the comprehensive surgical staging of EOC and has the advantages of shorter hospital stay, faster recovery of gastrointestinal function, and good wound healing.


Assuntos
Carcinoma/cirurgia , Laparoscopia/estatística & dados numéricos , Laparotomia/estatística & dados numéricos , Neoplasias Ovarianas/cirurgia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
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