[Clinicopathological characteristics and prognosis of uterine malignant mixed Mullerian tumor].

OBJECTIVE: To evaluate the clinicopathological characteristics, treatment and prognosis of uterine malignant mixed mullerian tumor. METHODS: The clinical, pathologic and follow-up data of 16 patients with uterine malignant mixed Mullerian tumor treated in our hospital between March, 2003 and June, 2015 were analyzed. RESULTS: The 16 patients had a median age of 58 years at diagnosis, and 13 of them were postmenopausal. The number of patients with FIGO stage Ia, Ib, II, IIIa, IIIc2, and IV was 7, 3, 1, 3, 1, and 1, respectively. In 15 patients who received uterine segment diagnostic curettage, pathological examination all reported malignant results. Among the 15 patients having serum CA125 level test upon admission, 2 had elevated CA125 levels. The overall and disease-free survival rates of the 16 patients were 75% and 68.8%, respectively, and the 3-year survival rate of 13 patients who were followed up for at least 3 years was 72.7%. Two out of 12 patients receiving retroperitoneal lymph?node?dissection?had had postoperative recurrence, as compared with 3 out 4 who did not had the operation; tumor recurrence was found in 3 out of 13 patients receiving postoperative chemotherapy, as compared with 2 out of 3 patients who did not have chemotherapy; tumor recurrence occurred in 1 out of 10 patients receiving radiotherapy, as compared with 4 out of 6 patients without radiotherapy. The recurrence rates in 11 patients with FIGO stage I-II was 18.2%, and that among the 5 patients with FIGO stage III-IV was 60.0%. CONCLUSIONS: Uterine segment diagnostic curettage has a high diagnostic value for uterine malignant mixed Mullerian tumor. FIGO stage is the important prognostic factor for these patients, and early?diagnosis, accurate surgical staging, platinum-based chemotherapy and postoperative pelvic radiotherapy are all associated with a better prognosis.

Large animal model for retroperitoneal lymphatic and lung metastasis.

Retroperitoneal lymph node and lung metastasis are important prognostic factors for gynecologic cancer. The present study aimed to develop a new animal model for retroperitoneal lymph node and lung metastasis. VX2 squamous cell carcinoma tumor tissues were injected into the left gastrocnemius muscle of 38 healthy female New Zealand white rabbits. Animals were randomized into three groups according to day of sacrifice: 1, day 19; 2, day 22; and 3, day 25. Implanted primary tumor (IPTu), left and right retroperitoneal lymph node volumes and lung wet weights were measured on the day of sacrifice. The IPTu and left and right retroperitoneal lymph node volumes increased in a time­dependent manner. In addition, the proportion of animals with metastasis to the left peritoneal lymph nodes and the number of nodes involved increased over time. For days 19, 22 and 25, the proportion of animals with nodal metastasis was 58.3, 84.6 and 100%, respectively, and the number of affected nodes (range) was 3 (2­3), 3 (3­5) and 4 (4­5), respectively. No metastasis was detected in the right peritoneal lymph nodes. Metastasis to the lungs also increased with time, but was not statistically significant at days 19, 22 and 25 with metastasis present in 33.3, 38.5 and 76.9% of animals, respectively. Rates of metastases to the left retroperitoneal lymph nodes and lungs were found to positively correlate with the volumes (r=0.416 and 0.449, respectively). The current study assessed the characterization of a rabbit VX2 carcinoma model. This animal model is likely to be useful for evaluating retroperitoneal lymph node and lung metastasis.

[Study on cervical intraepithelial neoplasia in relation to human papillomavirus and co-factors: a case-control study in China and Australia].

OBJECTIVE: This study was to elucidate the role of human papillomavirus (HPV) types and cofactors in the development of cervical intraepithelial neoplasia (CIN). METHODS: Two hundred and twelve women with CIN and 427 women with normal cervical cytology (control group) were recruited from China and Australia. A questionnaire was administered to each participant to obtain the demographic and risk factor information. Cervical biopsies or smears were taken to detect HPV DNA by PCR and to identify HPV types by direct sequencing and/or Amplicor hybridisation. Data were analyzed by logistic regression. RESULTS: HPV prevalence rates of specimens from Chinese and Australian were 11% and 15% among controls (P >0.05), with 99% and 85% of CINs (P<0.001), respectively. The presence of any type of HPV DNA was strongly associated with CIN with OR 43.3 for Chinese and OR 541.6 for Australian women. The strongest risk was for HPV16,followed by HPV31 in Australians, but HPV58, 59 in Chinese women. The risk for multiple HPV infection was stronger in the Australians than that in the Chinese cohort. Except for HPV infection, educational attainment was unexpectedly associated with an increased risk for CIN in Chinese, and cancer history in family was a risk factor for Australians. For the combined cohorts, educational attainment, and frequency of vitamin consumption were identified to be risk factors for CIN. CONCLUSION: Cervical HPV DNA was a major risk factor, with the highest relative risk for type 16 HPV infection for CIN. There were variations in the distribution of HPV genotypes and cofactors in China versus Australia and in CIN.