Magnetic Resonance Imaging (MRI) and Three-Dimensional Transvaginal Ultrasonography Scanning for Preoperative Assessment of High Risk in Women with Endometrial Cancer.

BACKGROUND To evaluate the diagnostic performance of MRI and 3D-TVS for assessment of deep myometrial invasion (MI), cervical involvement (CI), and Lymph node metastases (LNM) in endometrial cancer staging before surgery. MATERIAL AND METHODS From January 2016 to December 2017, we reviewed data from 314 women with endometrial cancer who underwent preoperative MRI and 3D-TVS before surgery. The diagnostic sensitivity, specificity, PPV, NPV, and accuracy in detecting MI, CI, and LNM were estimated based on ultimate pathology results. RESULTS The sensitivity, specificity, PPV, NPV, and accuracy of MRI in the diagnosis of MI were 89.19%, 88.97%, 67.35%, 97.99%, and 89.01%, respectively, and the indexes of 3D-TVS for MI were 86.36%, 91.07%, 79.17%, 94.44%, and 89.74%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of MRI for CI were 75% and 92.35%, 40.9%, 98.13%, and 91.2%, respectively. The indicators of 3D-TVS were 77.78%, 94.29%, 63.63%, 97.06%, and 92.4%, respectively. There were no significant differences in sensitivity, specificity, NPV, and accuracy between MRI and 3D-TVS in the diagnosis of MI and CI. For MI and CI, the sensitivity of combined MRI and 3D-TVS was higher than any other single method (P<0.05). For LNM, the sensitivity, specificity, PPV, NPV, and accuracy of MRI were 58.33%, 96.26%, 63.63%, 95.37%, and 92.43%, respectively. CONCLUSIONS 3D-TVS is equivalent to MRI in predicting MI and CI. Combined MRI and 3D-TVS can improve the assessment sensitivity, and they are useful in optimizing individualized surgical procedures. The sensitivity of MRI for LNM prediction needs to be improved.

Prenatal assessment of pulmonary maturity on 3-D ultrasound.

AIM: The aim of this study was to assess the feasibility and accuracy of 3-D ultrasound indices to evaluate fetal lung maturity, and to establish a normal reference for fetal lung volume (FLV) and fetal lung-to-liver intensity ratio (FLLIR) in a Chinese population. METHODS: A total of 1022 pregnant women with singleton pregnancy were prospectively studied between June 2008 to June 2011. Ultrasound examination was performed. The breathing-related nasal fluid flow (BRNFF) spectrum, FLV, pulmonary artery blood flow parameters, and echo intensity of the lung were calculated. Phosphoglycerides in the amniotic fluid were measured on thin layer chromatography. RESULTS: FLLIR and FLV were positively and linearly correlated with gestational age (F = 0.915, 0.846). Indicators of fetal lung maturity included FLLIR >1.1, FLV >50 mL, and regular BRNFF spectrum, with positive likelihood ratios of 12.28, 11.78, and 11.63, independently. CONCLUSION: Ultrasound indices, including FLLIR, FLV and BRNFF may serve as useful alternatives to amniotic fluid phospholipids in analyzing fetal lung maturity in Chinese patients.

Hexokinase 2 Promotes Cell Proliferation and Tumor Formation through the Wnt/ß-catenin Pathway-mediated Cyclin D1/c-myc Upregulation in Epithelial Ovarian Cancer.

Background: HK2 is reported as a key mediator of aerobic glycolysis, associating with the malignant growth in many types of cancers. Methods: In this study, stimulation of HK2 expression was observed in ovarian carcinoma tissues, comparing with the normal ovarian tissues. Results: Both of in vitro and in vivo experiments demonstrated that HK2 expression promoted the proliferation and tumor formation by accelerating cell cycle progression in ovarian cancer cells. Further research showed that HK2 expression enhanced the activity of Wnt/ß-catenin signaling pathway, inducing the protein levels of ß-catenin, c-myc and CyclinD1 in HK2 over-expressing OVCA433 and SKOV3 cells. The positive correlation between HK2 and ß-catenin, c-myc, CyclinD1 in human ovarian cancer were confirmed from the GEPIA online database. When ß-catenin expression was blocked by an inhibitor (XAV939), reduced c-myc and CyclinD1 expression was observed in HK2 over-expressing cells, with inhibited cell growth. Conclusion: Our data demonstrated that hexokinase 2 promotes cell proliferation and tumor formation through the Wnt/ß-catenin pathway-mediated CyclinD1/c-myc upregulation in human ovarian cancer.

Hexokinase 2 promoted cell motility and proliferation by activating Akt1/p-Akt1 in human ovarian cancer cells.

BACKGROUND: Recently, increasing evidence has indicated that elevation of Hexokinase 2 (HK2) plays an important role in several cancers on regulating cell motility and growth. However, its role on regulating cell EMT in human ovarian cancer still less to known. METHODS: The transwell and wound-healing assay were used to detect the effective of HK2 on regulating motility of ovarian cancer cells. Real Time PCR and Western Blotting were used to explore the changing of EMT-related proteins in HK2-modified cells. The clonogenic formation, cell growth curves and MTT assays were used to evaluate the effective of HK2 on regulating cell proliferation in HK2-modified cells. The flow cytometry was used to detect the differences in the distribution of cells in the cell cycle between the HK2-modified cells and their control cells. The correlation of HK2 and Akt1/p-Akt1 was explored by using Western Blotting, Akt1 inhibitor (MK2206) and transient transfection of an Akt1 recombinant plasmid. The potential correlation between HK2 and EMT-related proteins in human ovarian cancer tissues and OV (ovarian serous cystadenocarcinoma) was confirmed by using Pearson correlation analysis and TIMER 2.0. RESULTS: In ovarian cancer cells, overexpressing of HK2 enhanced cell motility by inducing of EMT-related proteins, such as CDH2, fibronectin, MMP9, ZEB1, ZEB2 and vimentin. Moreover, overexpressing of HK2 promoted cell growth by reducing p21 and p27 expression in ovarian cancer cells. Further studies demonstrated that this promotion of cell motility and growth by HK2 was probably a result of it activating of Akt1 (p-Akt1) in ovarian cancer cells. Additionally, the positive correlation between HK2 and p-Akt1, fibronectin, MMP9 expression in human ovarian cancer samples was verified by using Pearson correlation analysis. The positive correlation between HK2 and CDH2, fibronectin, MMP9, ZEB1, ZEB2 and vimentin in OV (ovarian serous cystadenocarcinoma) was confirmed by using TIMER 2.0. CONCLUSION: This study demonstrated that HK2 could induce EMT-related proteins and reduce cell cycle inhibitor by activating Akt1 in human ovarian cancer cells, subsequently enhancing cell motility and growth, suggesting that HK2 participate in the malignant process of ovarian cancer by interacting with Akt1.

Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein.

BACKGROUND: Previous studies have yielded inconsistent results on the association between maternal dietary protein intake and birth weight. Moreover, little is known about the effects of dietary protein intake from different sources on fetal growth. This study aimed to investigate the associations of different dietary protein sources (total protein, animal protein, plant protein, and major dietary protein sources) during pregnancy with birth weight and the related adverse birth outcomes. METHODS: 7310 women were recruited using a stratified multistage random sampling method at 0-12 months (median: 3; 10-90th percentile: 0-7) after delivery in Shaanxi, China. Maternal diets were gathered by a validated FFQ and other characteristics were collected by a standard questionnaire. Multilevel linear or logistic regression models were used to estimate birth weight changes or ORs (95% CIs) for adverse birth outcomes associated with different dietary protein sources during pregnancy. RESULTS: The mean percentage of energy from total protein was 11.4% (SD 2.2), with only 27.4% of total protein derived from animal protein. Per 3% increase in energy from total protein, animal protein, and dairy protein was associated with birth weight increases of 19.4 g (95% CI 6.0-32.9), 20.6 g (4.8-36.5), and 18.2 g (4.7-31.7), respectively. Per 3% increase in energy from total protein, animal protein, and dairy protein was also associated with lower risks of low birth weight (LBW) (total protein: OR = 0.78, 95% CI 0.64-0.94; animal protein: 0.79, 0.65-0.96; dairy protein: 0.71, 0.56-0.91), small for gestational age (SGA) (total protein: 0.88, 0.79-0.98; animal protein: 0.87, 0.78-0.97; dairy protein: 0.81, 0.68-0.96), and intrauterine growth retardation (IUGR) (total protein: 0.84, 0.72-0.98; animal protein: 0.86, 0.75-0.98; dairy protein: 0.78, 0.66-0.92). We observed no associations of plant protein and other major dietary protein sources with birth weight and the above birth outcomes. The results did not change when maternal protein was substituted for fat or carbohydrate. CONCLUSIONS: Among Chinese pregnant women with low intake of protein, higher intake of dietary protein, in particular animal protein and dairy protein, is associated with higher birth weight and lower risks of LBW, SGA, and IUGR.

LncRNA-H19 regulates chemoresistance to carboplatin in epithelial ovarian cancer through microRNA-29b-3p and STAT3.

Background: Platinum-based chemotherapy is part of current standard treatment for epithelial ovarian cancer (EOC). However, chemoresistance often rapidly developed, leading to chemotherapy failure and unfavored prognosis. Increasing evidence has demonstrated the important role of oncogenic long noncoding RNA H19 in various cancers, including EOC. No current study is available in exploring the role of lncRNA-H19 in carboplatin resistance of EOC and its underlying mechanism. Methods: Levels of lncRNA-H19, miR-29b-3p, and STAT3 mRNA were measured by qRT-PCR. The 50% inhibitory concentration value was detected with Cell Counting Kit-8 (CCK8). Colony-formation and CCK8 assays were employed to measure cell viability. Cell migration and invasion ability was evaluated with transwells. Western blot assay was utilized to measure P-gp, MRP1, LRP, and STAT3 protein levels. The targeting between lncRNA-H19 and miR-29b-3p, as well as miR-29b-3p and STAT3, was verified by dual-luciferase, RNA immunoprecipitation, and RNA pull-down experiments. Results: lncRNA-H19 and STAT3 were sharply increased, while miR-29b-3p was decreased in carboplatin-resistant EOC. Carboplatin efficacy was enhanced by lncRNA-H19 silencing in chemo-resistant EOC cells. lncRNA-H19 served as a competing endogenous RNA of miR-29b-3p, causing the derepression of miR-29b-3p downstream target STAT3, leading to chemoresistance in carboplatin-tolerated EOC. Conclusions: The lncRNA-H19/miR-29b-3p axis improved carboplatin resistance of EOC by targeting STAT3, indicating a possible approach to improving chemotherapy for EOC.

Characteristics of Three-Dimensional Power Doppler in Gestational Trophoblastic Disease.

PURPOSE: In the present study, the three-dimensional power Doppler was used as a quantitative method to evaluate its reliability in detecting and assessing of gestational trophoblastic disease (GTD). METHODS: 52 GTD patients who received diagnosis and treatment at the first affiliated hospitals of Xi'an Jiaotong University in China between 2011 and 2013 were evaluated using Voluson E8 (GE Medical System). Demographic information, pathological characteristics, clinical history, sonographic images, and related indices (resistance index, vascularization index, and flow and vascularization index) were evaluated. RESULT: Three-dimension power Doppler indicated that there were significant differences in the resistance index, vascularization index, flow index, and vascularization-flow index between the healthy individuals and each subgroup of patients (P < 0.01). Further, in combining invasive hydatidiform mole and choriocarcinoma groups, there was a significant difference between hydatidiform mole and the combined malignant group (P < 0.01). And the abnormal sonographic and power Doppler findings in GTD were resolved when chemotherapy was done successfully. CONCLUSION: Combined with the clinical features, sonography and three-dimension power Doppler imaging were helpful in diagnosing GTD as a noninvasive method, distinguishing the invasive nature of disease, detecting the recurrence of the disease, and assessing the effectiveness of the chemotherapy.