ABSTRACT
Objective:To analyze the predictive value of soluble cytotoxic T lymphocyte-associated antigen 4 (sCTLA-4) and RAD51 paralogous gene C (RAD51C) protein in the recurrence of cervical cancer patients after interventional therapy.Methods:A total of 107 patients with cervical cancer who underwent interventional surgery in our hospital from May. 2015 to Apr. 2019 were selected as the research group. postoperative recurrence were recorded. Another 107 patients with benign cervical disease during the same period were selected as the control group. The protein expressions of sCTLA-4 and RAD51C were compared between the two groups and patients with or without recurrence. Logistic regression was used to analyze the influencing factors of postoperative recurrence of cervical cancer patients, and a nomogram model of postoperative recurrence of cervical cancer patients was constructed and verified by calibration curve. The postoperative recurrence rate of cervical cancer patients with different sCTLA-4 and RAD51C protein expressions was compared.Results:The level of sCTLA-4 and the high expression rate of RAD51C protein in the study group were higher than those in the control group ( P<0.05). High-risk human papillomavirus positive, vascular infiltration, interstitial infiltration ≥1/2, paracterine infiltration, high expression of RAD51C protein and high SCTLA-4 level were independent risk factors for postoperative recurrence of cervical cancer ( P<0.05). High-risk human papillomavirus, vascular invasion, interstitial invasion, parametrial invasion, RAD51C protein and sCTLA-4 levels were used to construct a nomogram prediction model for postoperative recurrence of cervical cancer patients. The consistency indices were 0.610 (95% CI: 0.511-0.702), 0.616 (95% CI: 0.517-0.708), 0.640 (95% CI: 0.541-0.730), 0.609 (95% CI: 0.510-0.702), 0.728 (95% CI ranged from 0.633 to 0.809), 0.817 (95% CI ranged from 0.731 to 0.885), and the calibration curve validation showed high consistency. The net benefit rate of combined detection of sCTLA-4 and RAD51C proteins was greater than that of single detection. Conclusions:sCTLA-4 and RAD51C proteins are highly expressed in cervical cancer patients, and the high expression of both indicates that cervical cancer patients have a higher risk of recurrence after surgery. Clinically, the detection of sCTLA-4 and RAD51C protein expression can be used to screen patients with high recurrence risk.
ABSTRACT
Objective To investigate the application and effect of hydrocortisone during perioperation of retroperitoneum laparoscopic surgery for Cushing's syndrome.Methods Data of 56 cases of Cushings's syndrome treated by hormone replacement therapy of hydrocortisone were retrospectively analyzed .The hormone replacement therapy was as the following:no hormone before surgery, intravenous drip of hydrocortisone during and the 1st and 2nd day after surgery, oral intake of hydrocortisone from the 2nd after surgery.Clinical symptoms were observed and plasma,24h urine cortisol levels were intermittently measured after the surgery to evaluate the effects of treatment . Results 2 cases had slight cortical dysfunction symptoms, then back to normal after receiving larger dose of hydro-cortisone.6 cases had blood cortisol levels below the normal range , but they did not have cortical dysfunction symp-toms, and at the same time their 24h urine cortisol levels were normal .Urine cortisol concentration significantly de-creased on the 7th day after surgery, and had significant difference compared with that before surgery .Plasma cortisol concentration significantly decreased on the 6th, 7th day after surgery, and had significant difference compared with that before operation.All the cases recovered well.Conclusion Perioperative hydrocortisone replacement in retroper-itoneum laparoscopic surgery for Cushing's syndrome is safe.