Effect of Quality Control Program in Surgical Management of Early Cervical Cancer.

BACKGROUND: Regular assessments of clinical performance in gynecologic cancer surgery is important for the safety of patients. We evaluated the effects of quality control (QC) program on the treatment pattern and clinical outcomes of early cervical cancer. METHODS: Medical records of cervical cancer patients who received operation in our institution from January 2007 to December 2018 were retrospectively reviewed. Cases were divided into 2 groups, before and after the initiation of QC program, group 1 (2007-2013) and group 2 (2014-2018), based on the operation date. Two groups were compared in clinicopathologic variables, surgical methods, operative details, adjuvant treatments, recurrence and survival. RESULTS: A total of 305 cervical cancer patients were included in the analysis, 210 in group 1 and 95 in group 2. In group 2, minimally invasive surgery (MIS) was more frequently performed (60.0% vs. 76.8%, P = 0.004), especially in earlier stages (stage IA, 72.6% vs. 100.0%; stage IB, 52.2% vs. 69.5%). However, the median tumor size treated by MIS was decreased in stage IB (20 mm vs. 17 mm, P = 0.015). Frequency of adjuvant treatment was also reduced in stage IB (56.5% vs. 37.3%, P = 0.016). Recurrence within 3 years, 3-year disease free survival and overall survival did not show significant difference; however, 3-year recurrence after MIS was significantly reduced in stage IB. CONCLUSION: QC program enforced stricter patient selection criteria for MIS and positively affected clinical outcomes in cervical cancer patients who underwent surgery. Systemic monitoring should be considered for patient safety.

Disparities between Uptake of Germline BRCA1/2 Gene Tests and Implementation of Post-test Management Strategies in Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer Patients.

BACKGROUND: To assess the rate of germline BRCA gene tests in epithelial ovarian cancer (EOC) patients and uptake of post-test risk management strategies in BRCA1/2-mutated patients. METHODS: Institutional databases were searched to identify patients who were diagnosed with epithelial ovarian, fallopian tube, or primary peritoneal cancer (EOC) between 2009 and 2019 in two academic hospitals. Retrospective review on medical records was performed to collect clinico-pathologic variables, including performance of germline BRCA gene test and its results, as well as conduct of breast cancer screening tests and cascade testing. If annual mammography +/- breast ultrasonography was performed, it was considered that regular breast cancer surveillance was done. RESULTS: A total of 840 women with EOC were identified during the study period. Of these, 454 patients (54.0%) received BRCA gene testing and 106 patients (106/454, 23.3%) were positive for BRCA1/2 mutations. The rate of BRCA tests has markedly increased from 25.8% in 2009-2012 to 62.7% in 2017-2019. Among the 93 patients with BRCA1/2 mutation without previous personal breast cancer history, 20 patients (21.5%) received annual mammography with or without breast ultrasonography for regular surveillance. Among the 106 BRCA1/2-mutated EOC patients, cascade testing on family members was performed only in 13 patients (12.3%). CONCLUSION: Although BRCA1/2 gene tests have been substantially expanded, the uptake of post-test risk management strategies, including breast cancer screening for BRCA1/2-mutated patients and cascade testing for family members, has remained low. Strategies to increase its uptake and education about the importance of post-test risk managements are needed.

SPSB1 enhances ovarian cancer cell survival by destabilizing p21.

SPRY domain-containing SOCS box protein 1 (SPSB1) is an E3 ligase adaptor protein with unknown functions in cancer cells. In this study, we found that SPSB1 knockdown markedly decreased the viability and migration of ovarian cancer cells, while ectopic SPSB1 overexpression in IL-3-dependent Ba/F3 cells significantly increased their proliferation rate compared with empty vector-transfected cells. SPSB1 knockdown significantly elevated p21 protein and mRNA levels and induced apoptosis in ovarian cancer cells, as evidenced by increased levels of cleaved PARP and decreased levels of Bcl-2. Notably, mechanistic investigations revealed that SPSB1 accelerated p21 destabilization by directly interacting with p21 and promoting its ubiquitin-mediated proteasomal degradation. Taken together, our findings provide novel insights into the role of SPSB1 in ovarian cancer cells.

Preoperative assessment of lymph node metastasis in endometrial cancer: A Korean Gynecologic Oncology Group study.

BACKGROUND: Previously proposed criteria for preoperatively identifying endometrial cancer patients at low risk for lymph node metastasis remain to be verified. For this purpose, a prospective, multicenter observational study was performed. METHODS: Eligible patients with histologically confirmed endometrial cancer underwent magnetic resonance imaging (MRI) and serum cancer antigen 125 (CA 125) testing before surgery. The following criteria were used to identify low-risk patients: 1) endometrioid-type cancer, 2) no evidence of deep myometrial invasion on MRI, 3) no enlarged lymph nodes on MRI, 4) no suspicious metastasis out of the uterine corpus, and 5) serum CA 125 levels less than 35 U/mL. Systematic pelvic and/or para-aortic lymphadenectomy was performed for all patients. The primary endpoint was estimation of the negative predictive value (NPV). RESULTS: From January 2012 to December 2014, 529 patients from 20 hospitals in 3 Asian countries were consecutively enrolled. According to our criteria, 272 patients (51.4%) were categorized into the low-risk group. Fifty-three of the 529 patients (10.0%) had lymph node metastases; these patients included 8 (2.9%) falsely categorized as low-risk. The sensitivity and specificity of the criteria were 84.9% and 55.5%, respectively. The NPV of 97.1% was higher than the predefined target endpoint of 96%. CONCLUSIONS: The low-risk criteria based on preoperative tests were confirmed to be reliable and accurate for identifying patients at low risk for lymph node metastasis. These criteria may facilitate patient counseling and surgical decision making. Cancer 2017;123:263-272. © 2016 American Cancer Society.

Dopamine dependent setting of a circadian oscillator underlying the memory for time of day.

Animals learn and remember the time of day that significant conditions occur, and anticipate recurrence at 24-h intervals, even after only one exposure to the condition. On several place-conditioning tasks, animals show context avoidance or preference only near the time of day of the experience. The memory for time of day is registered by a circadian oscillator that is set at the time of the training. We show that manipulations of dopamine (DA) neurotransmission can set a time memory in place preference and avoidance tasks, indicating that time of day is part of the context that is learned. Single injections of the DA agonist, d-amphetamine sulfate given without further exposure to the conditioning apparatus, can reset the timing of anticipatory behavior evoked by previously acquired place-event associations. The data support a model for time memory in which DA signaling sets the phase of a circadian oscillator, which returns to the same state at regular 24-h intervals. The data also raise the possibility that some apparent impairments of memory formation or retention could reflect post-experience resetting of the optimal retrieval time rather than impairment of memory or retrieval per se.

Two-step chromatographic purification of glutathione S-transferase-tagged human papillomavirus type 16 E6 protein and its application for serology.

Human papillomavirus (HPV) E6 protein is an oncoprotein with a pivotal role in cervical carcinogenesis. Expression and purification of HPV E6 from Escherichia coli (E. coli) has been difficult because of its strong hydrophobicity even when expressed as a fusion protein with glutathione S-transferase (GST). There has been no protocol suggested for purifying GST-tagged HPV E6 protein with high purity so far. Herein, we provide efficient protocol for purifying GST-HPV16 E6 protein for the first time. In the current study, the GST-tagged protein was expressed in E. coli and a purification method was designed using cation-exchange chromatography followed by GST-affinity chromatography. Using physiological pH buffer during cell lysis and first cation-exchange chromatography significantly reduced yield of full-length GST-HPV16 E6 protein. It was found that using an alkaline buffer during cation-exchange chromatography was needed to obtain full length GST-HPV16 E6 protein. GST-HPV16 E6 protein recovered from the purification using alkaline condition retained its inherent p53-binding ability. Moreover, we were able to detect anti-HPV16 E6 antibodies with high sensitivity in sera from patients with cervical cancer using the GST-HPV16 E6 protein. It was found that the GST-HPV16 E6 protein could be used as a coating agent to enhance the sensitivity of detection of serum anti-HPV16 E6 antibodies when treated with ethylene glycol-bis (ß-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA). These results indicate that the two-step chromatographic purification allows obtaining high purity of GST-HPV16 E6 protein and the GST-HPV16 E6 is suitable to be used as an antigen of serology assay.

A lectin-based diagnostic system using circulating antibodies to detect cervical intraepithelial neoplasia and cervical cancer.

In the present study, we developed serological strategies using immunoglobulin fractions obtained by protein A chromatography to screen for cervical cancer and cervical intraepithelial neoplasia I (CIN I). The reactivities of the immunoglobulins purified from sera of women with normal cytology, CIN I and cervical cancer were compared in enzyme-linked immunosorbent assays (ELISA) and enzyme-linked lectin assays (ELLAs). To capture the immunoglobulins, ELISAs and ELLAs were performed in protein A immobilized microplates. The reactivity of immunoglobulin in ELISA was in the increasing order normal cytology, CIN I and cervical cancer, while that in ELLAs for detecting fucosylation was in the decreasing order normal cytology, CIN I and cervical cancer. It was confirmed that women with CIN I were distinguishable from women with normal cytology or women with cervical cancer in the ELISA or the ELLA for detecting fucosylation with considerable sensitivity and specificity. Women with cervical cancer were also distinguishable from women with normal cytology with high sensitivity (ELISA: 97%, ELLA: 87%) and specificity (ELISA: 69%, ELLA: 72%). Moreover, the logistic regression model of the ELISA and the ELLA discriminated cervical cancer from normal cytology with 93% sensitivity and 93% specificity. These results indicate that the ELISAs and the ELLAs have great potential as strategies for primary screening of cervical cancer and CIN. It is expected that the ELISA and the ELLA can provide new insights to understand systemic changes of serum immunoglobulins during cervical cancer progression.

Slim-structured electro-floating display system based on the polarization-controlled optical path.

A new slim-type electro-floating display system based on the polarization-controlled optical path is proposed. In the proposed system, the optical path between the input plane and Fresnel lens can be made recursive by repetitive transmission and reflection of the input beam by employing a new polarization-based optical path controller (P-OPC), which is composed of two quaterwave plates, a half mirror and a reflective polarizer. Based on this P-OPC, the absolute optical path between the input plane and Fresnel lens, virtually representing the physical depth of the display system, can be reduced down to one third of its original path, which results in the same rate of decrease in the volume size of the display system. The operational principle of the proposed system is analyzed with the Jones matrix. In addition, to confirm the feasibility of the proposed system, experiments with test prototypes are carried out, and the results are comparatively discussed with those of the conventional system.

Increased sialylation and reduced fucosylation of exfoliated cervical cells are potential markers of carcinogenesis in the cervix.

BACKGROUND: The Pap test has been used for over 50 years for primary screening of cervical cancer. There has been no study of glycosylation changes in Pap test samples despite considerable potential of the glycosylation changes as biomarkers for detecting cancerous lesions. In this study, we developed a 96-well platform for enzyme-linked lectin assays (ELLAs) to evaluate glycosylation levels in cervical cells. METHODS: A total of 117 samples of exfoliated cervical cells (ECCs) from 37 individuals with normal cytology, 20 with cervical intraepithelial neoplasia (CIN) 1, 19 with CIN 2, 26 with CIN 3 and 15 with cervical cancer were analyzed by ELLAs. The wells of 96-well plates were coated with lysates of the cervical cells, and sialylation and fucosylation levels were compared between the groups. RESULTS: Sialylation levels increased and fucosylation levels decreased with increasing grade of cervical dysplasia. ELLAs for sialylation [ELLA-Sambucus nigra (SNAs)] and fucosylation [ELLA-Aleuria aurantia lectin (AAL)] discriminated not only CIN 2 and worse (CIN 2+: CIN 2, CIN 3, and cancer) from normal cytology but also CIN 3 and worse (CIN 3+: CIN3 and cancer) from normal cytology. ELLA-SNAs and ELLA-AALs distinguished cancer from normal cytology with a high true-positive rate (TPR) (ELLA-SNAs: 87%; ELLA-AALs: 87%) and low false-positive rate (FPR) (ELLA-SNAs: 19%; ELLA-AALs: 11%). CONCLUSIONS: The sialylation and fucosylation levels of ECCs as measured by ELLAs have great potential as biomarkers for primary screening of cervical cancer.

Three-directional motion-compensation mask-based novel look-up table on graphics processing units for video-rate generation of digital holographic videos of three-dimensional scenes.

A three-directional motion-compensation mask-based novel look-up table method is proposed and implemented on graphics processing units (GPUs) for video-rate generation of digital holographic videos of three-dimensional (3D) scenes. Since the proposed method is designed to be well matched with the software and memory structures of GPUs, the number of compute-unified-device-architecture kernel function calls can be significantly reduced. This results in a great increase of the computational speed of the proposed method, allowing video-rate generation of the computer-generated hologram (CGH) patterns of 3D scenes. Experimental results reveal that the proposed method can generate 39.8 frames of Fresnel CGH patterns with 1920×1080 pixels per second for the test 3D video scenario with 12,088 object points on dual GPU boards of NVIDIA GTX TITANs, and they confirm the feasibility of the proposed method in the practical application fields of electroholographic 3D displays.

Anti-Inflammatory and Antinociceptive Activities of Anthraquinone-2-Carboxylic Acid.

Anthraquinone compounds are one of the abundant polyphenols found in fruits, vegetables, and herbs. However, the in vivo anti-inflammatory activity and molecular mechanisms of anthraquinones have not been fully elucidated. We investigated the activity of anthraquinones using acute inflammatory and nociceptive experimental conditions. Anthraquinone-2-carboxylic acid (9,10-dihydro-9,10-dioxo-2-anthracenecarboxylic acid, AQCA), one of the major anthraquinones identified from Brazilian taheebo, ameliorated various inflammatory and algesic symptoms in EtOH/HCl- and acetylsalicylic acid- (ASA-) induced gastritis, arachidonic acid-induced edema, and acetic acid-induced abdominal writhing without displaying toxic profiles in body and organ weight, gastric irritation, or serum parameters. In addition, AQCA suppressed the expression of inflammatory genes such as cyclooxygenase- (COX-) 2 in stomach tissues and lipopolysaccharide- (LPS-) treated RAW264.7 cells. According to reporter gene assay and immunoblotting analyses, AQCA inhibited activation of the nuclear factor- (NF-) κB and activator protein- (AP-) 1 pathways by suppression of upstream signaling involving interleukin-1 receptor-associated kinase 4 (IRAK1), p38, Src, and spleen tyrosine kinase (Syk). Our data strongly suggest that anthraquinones such as AQCA act as potent anti-inflammatory and antinociceptive components in vivo, thus contributing to the immune regulatory role of fruits and herbs.

Fast one-step calculation of holographic videos of three-dimensional scenes by combined use of baseline and depth-compensating principal fringe patterns.

As a new approach for rapid generation of holographic videos, a so-called compressed novel-look-up-table(C-NLUT), which is composed of only two principal fringe patterns (PFPs) of baseline and depth-compensating PFPs (B-PFP, DC-PFP), is proposed. Here, the hologram pattern for a 3-D video frame are generated by calculating the fringe patterns for all depth layers only by using the B-PFP, and then transforming them into those for their depth layers by being multiplied with corresponding DC-PFPs. With this one-step calculation process, the computational speed (CS) of the proposed method can be greatly enhanced. Experimental results show that the CS of the proposed method has been improved by 30.2% on the average compared to that of the conventional method. Furthermore, the average calculation time of a new hybrid MC/C-NLUT method, in which both of motion-compensation (MC) and one-step calculation schemes are employed, has been reduced by 99.7%, 65.4%, 60.2% and 30.2%, respectively compared to each of the conventional ray-tracing, LUT, NLUT, and MC-NLUT methods. In addition, the memory size of the proposed method has been also reduced by 82 × 10(6)-fold and 128-fold compared to those of the conventional LUT and NLUT methods, respectively.

Three-directional motion compensation-based novel-look-up-table for video hologram generation of three-dimensional objects freely maneuvering in space.

A new three-directional motion compensation-based novel-look-up-table (3DMC-NLUT) based on its shift-invariance and thin-lens properties, is proposed for video hologram generation of three-dimensional (3-D) objects moving with large depth variations in space. The input 3-D video frames are grouped into a set of eight in sequence, where the first and remaining seven frames in each set become the reference frame (RF) and general frames (GFs), respectively. Hence, each 3-D video frame is segmented into a set of depth-sliced object images (DOIs). Then x, y, and z-directional motion vectors are estimated from blocks and DOIs between the RF and each of the GFs, respectively. With these motion vectors, object motions in space are compensated. Then, only the difference images between the 3-directionally motion-compensated RF and each of the GFs are applied to the NLUT for hologram calculation. Experimental results reveal that the average number of calculated object points and the average calculation time of the proposed method have been reduced compared to those of the conventional NLUT, TR-NLUT and MPEG-NLUT by 38.14%, 69.48%, and 67.41% and 35.30%, 66.39%, and 64.46%, respectively.

MPEG-based novel look-up table for rapid generation of video holograms of fast-moving three-dimensional objects.

A new robust MPEG-based novel look-up table (MPEG-NLUT) is proposed for accelerated computation of video holograms of fast-moving three-dimensional (3-D) objects in space. Here, the input 3-D video frames are sequentially grouped into sets of four, in which the first and remaining three frames in each set become the reference (RF) and general frames (GFs). Then, the frame images are divided into blocks, from which motion vectors are estimated between the RF and each of the GFs, and with these estimated motion vectors, object motions in all blocks are compensated. Subsequently, only the difference images between the motion-compensated RF and each of the GFs are applied to the NLUT for CGH calculation based on its unique property of shift-invariance. Experiments with three types of test 3-D video scenarios confirm that the average number of calculated object points and the average calculation time of the proposed method, have found to be reduced down to 27.34%, 55.46%, 45.70% and 19.88%, 44.98%, 30.72%, respectively compared to those of the conventional NLUT, temporal redundancy-based NLUT (TR-NLUT) and motion compensation-based NLUT (MC-NLUT) methods.

Time-sequential autostereoscopic 3-D display with a novel directional backlight system based on volume-holographic optical elements.

A novel directional backlight system based on volume-holographic optical elements (VHOEs) is demonstrated for time-sequential autostereoscopic three-dimensional (3-D) flat-panel displays. Here, VHOEs are employed to control the direction of light for a time-multiplexed display for each of the left and the right view. Those VHOEs are fabricated by recording interference patterns between collimated reference beams and diverging object beams for each of the left and right eyes on the volume holographic recording material. For this, self-developing photopolymer films (Bayfol® HX) were used, since those simplify the manufacturing process of VHOEs substantially. Here, the directional lights are similar to the collimated reference beams that were used to record the VHOEs and create two diffracted beams similar to the object beams used for recording the VHOEs. Then, those diffracted beams read the left and right images alternately shown on the LCD panel and form two converging viewing zones in front of the user's eyes. By this he can perceive the 3-D image. Theoretical predictions and experimental results are presented and the performance of the developed prototype is shown.

Expression of phosphoenolpyruvate carboxykinase linked to chemoradiation susceptibility of human colon cancer cells.

BACKGROUND: Resistance to 5-fluorouracil (5-FU) in patients with colorectal cancer prevents effective treatment and leads to unnecessary and burdensome chemotherapy. Therefore, prediction of 5-FU resistance is imperative. METHODS: To identify the proteins linked to 5-FU resistance, two-dimensional gel electrophoresis-based proteomics was performed using the human colon cancer cell line SNU-C4R with induced 5-FU resistance. Proteins showing altered expression in SNU-C4R were identified by matrix-associated laser desorption/ionization-time-of-flight analysis, and their roles in susceptibility to 5-FU or radiation were evaluated in various cell lines by transfection of specific siRNA or creation of overexpression constructs. Changes in cellular signaling and expression of mitochondrial apoptotic factors were investigated by Western Blot analysis. A mitochondrial membrane potential probe (JC-1 dye) and a flow cytometry system were employed to determine the mitochondrial membrane potential. Finally, protein levels were determined by Western Blot analysis in tissues from 122 patients with rectal cancer to clarify whether each identified protein is a useful predictor of a chemoradiation response. RESULTS: We identified mitochondrial phosphoenolpyruvate carboxykinase (mPEPCK) as a candidate predictor of 5-FU resistance. PEPCK was downregulated in SNU-C4R compared with its parent cell line SNU-C4. Overexpression of mPEPCK did not significantly alter the susceptibility to either 5-FU or radiation. Suppression of mPEPCK led to a decrease in both the cellular level of phosphoenolpyruvate and the susceptibility to 5-FU and radiation. Furthermore, the cellular levels of phosphoenolpyruvate (an end product of PEPCK and a substrate of pyruvate kinase), phosphorylated AKT, and phosphorylated 4EBP1 were decreased significantly secondary to the mPEPCK suppression in SNU-C4. However, mPEPCK siRNA transfection induced changes in neither the mitochondrial membrane potential nor the expression levels of mitochondrial apoptotic factors such as Bax, Bcl-2, and Bad. Downregulation of total PEPCK was observed in tissues from patients with rectal cancer who displayed poor responses to preoperative 5-FU-based radiation therapy. CONCLUSION: Our overall results demonstrate that mPEPCK is a useful predictor of a response to chemoradiotherapy in patients with rectal cancer.

Functional roles of p38 mitogen-activated protein kinase in macrophage-mediated inflammatory responses.

Inflammation is a natural host defensive process that is largely regulated by macrophages during the innate immune response. Mitogen-activated protein kinases (MAPKs) are proline-directed serine and threonine protein kinases that regulate many physiological and pathophysiological cell responses. p38 MAPKs are key MAPKs involved in the production of inflammatory mediators, including tumor necrosis factor-α (TNF-α) and cyclooxygenase-2 (COX-2). p38 MAPK signaling plays an essential role in regulating cellular processes, especially inflammation. In this paper, we summarize the characteristics of p38 signaling in macrophage-mediated inflammation. In addition, we discuss the potential of using inhibitors targeting p38 expression in macrophages to treat inflammatory diseases.

Significant simultaneous changes in serum CA19-9 and CA125 due to prolonged torsion of mature cystic teratoma of the ovary.

Mature cystic teratoma is a common benign neoplasm of the ovary. Complications occur in approximately 20% of cases. Clinical manifestations, laboratory findings, and imaging studies can assist in making a diagnosis of ovarian torsion of mature cystic teratoma. Furthermore, serum tumor markers may be helpful for diagnosing mature cystic teratoma and its torsion and, thus, can lead to early surgical intervention. A 56-year-old woman presented with a huge pelvic mass and pelvic pain. Serum CA19-9, CA125, and carcinoembryonic antigen levels were abnormally elevated at >700 U/ml, 282.5 U/ml, and 3.94 U/ml, respectively. The tumor was surrounded by extensive adhesions and showed inflammatory changes. The serum levels of these markers returned to normal levels after surgery.

Decreased cellular levels of palmitic amide are linked to 5-fluorouracil resistance in human colon cancer cells.

BACKGROUND/AIMS: The aim of this study was to investigate whether profiling metabolic compounds in human colon cancer cells with induced 5-florouracil resistance enables identification of predictive biomarkers for 5-florouracil resistance. METHODOLOGY: 5-florouracil resistant and parental cells were extracted using methanol/chloroform solution, and analyzed by MALDI-TOF. Principal components analysis and discriminant analysis was performed to select low-mass ions with strong discriminating power between 5-florouracil resistant and parental cells. The correlation between the intensities of low-mass ions and intrinsic 5-florouracil resistance in 11 colon cancer cells was analyzed using the Spearman rank coefficient. RESULTS: Eleven low-mass ions had strong discrimi-nating power between 5-florouracil-resistant and parental cells. Of these, the intensity of a low-mass ion with 256.29 m/z was negatively correlated with intrinsic 5-florouracil resistance in 11 colon cancer cells (r = -0.6545, P = 0.0338). By searching the H+ adduct with 0.05 m/z tolerance in the Human Metabolome Database, a low-mass ion of 256.29 m/z was identified as palmitic amide. Interestingly, extracellular treatment with palmitic amide reduced 5-florouracil resistance and invasiveness in 5-florouracil-resistant cells. CONCLUSIONS: Palmitic amide showed potential not only as a predictor of 5-florouracil resistance, but also for reduction of 5-florouracil resistance in colon cancer cells.

Photochemical and Patternable Synthesis of 2D Covalent Organic Framework Thin Film Using Dynamic Liquid/Solid Interface.

2D covalent organic frameworks (COFs) are highly porous crystalline materials with promising applications in organic electronics. Current methods involve either on-surface synthesis (solid surface) or interfacial synthesis (liquid/liquid, liquid/gas interface) to create thin films for these applications, each with its drawbacks. On-surface synthesis can lead to contamination from COF powder or unreacted chemicals, while interfacial synthesis risks damaging the film during post-transfer processes. These challenges necessitate the development of alternative synthesis methods for high-quality 2D COF films. This study presents a novel approach for synthesizing homogeneous 2D COF thin films by combining photochemistry and a liquid-flowing system. Leveraging previous work on liquid flow systems to prevent contamination during solvothermal synthesis, this approach to the photochemical method, resulting in the synthesis of high-crystalline 2D COF films with tunable thickness is adopted. The photochemical approach offers spatially controllable energy sources, enabling patternable COF synthesis. Notably, it is successfully fabricated ultrasmooth patterned 2D COF films on hexagonal boron nitride, offering a streamlined process for optoelectronic device fabrication without additional pre, post-processing steps.