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Objective:To evaluate the surgery combined chemotherapy and radiation in locally advanced neuroendocrine carcinoma of the cervix (NECC) .Methods:This is a single-center retrospective cohort study. Locally advanced NECC patients admitted to Peking Union Medical College Hospital, Chinese Acadmy of Medical Sciences from January 2011 to April 2022 were enrolled. They were divided into concurrent chemoradiotherapy group, and surgery combined with chemotherapy and radiation group. The Kaplan-Meier method was used to analyze the progression free survival (PFS), overall survival (OS), recurrence rate, and mortality rate.Results:(1) Forty-six cases were included, 22 in concurrent chemoradiotherapy group, 24 in surgery combined chemotherapy and radiation group. With 16 patients (35%, 16/46) received neoadjuvant chemotherapy (NACT), the NACT effective rate was 15/16. (2) The median follow-up time was 27.5 months (range: 10-106 months), with 26 (57%, 26/46) experienced recurrences. There were 4 (9%, 4/46) pelvic recurrences and 25 (54%, 25/46) distant recurrences, and 3 (7%, 3/46) both pelvic and distant recurrences. Compared with concurrent chemoradiotherapy group, surgery combined chemotherapy and radiation group had lower pelvic recurrence rate [14% (3/22) vs 4% (1/24); χ2=1.296, P=0.255] but without statistic difference. Both groups had similar distant recurrence rate [55% (12/22) vs 54% (13/24); χ2=0.001, P=0.979] and overall recurrence rate [59% (13/22) vs 54% (13/24); χ2=0.113, P=0.736]. (3) During the follow-up period, 22 cases (48%, 22/46) died, with 11 cases (50%, 11/22) in concurrent chemoradiotherapy group and 11 cases (46%, 11/24) in surgery combined chemotherapy and radiation group, without significant difference ( χ2=0.080, P=0.777). The postoperative 3-year and 5-year OS rates were 62.3% and 36.9%. Compared with concurrent chemoradiotherapy group, the patients in surgery combined chemotherapy and radiation group showed an extended trend in PFS (17.0 vs 32.0 months) and OS (37.0 vs 50.0 months) but without statistic differences ( P=0.287, P=0.125). Both groups had similar 3-year OS rate (54.2% vs 69.9%; P=0.138) and 5-year OS rate (36.1% vs 38.8%; P=0.217). Conclusions:Our study supports the multi-modality treatment strategy (including surgery, chemotherapy and radiation) as an important component in the treatment of locally advanced NECC. The combination of surgery, chemotherapy and radiation seems to have advantages in the treatment of locally advanced NECC, but needs to be confirmed by further multicenter studies.
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<p><b>BACKGROUND</b>Numerous studies have described the association between polymorphisms in the tumor necrosis factor (TNF) gene and risk of endometriosis. However, the results remain controversial. Here we reviewed studies reporting the association between TNF gene polymorphisms and endometriosis risk in Asians.</p><p><b>METHODS</b>PubMed and Embase were searched. Twelve case-control studies assessing the role of multiple TNF gene polymorphisms in endometriosis were included. If no less than two articles evaluated one variant, meta-analysis was conducted; otherwise, narrative analysis was chosen. A fixed- or random-effects model was employed according to the heterogeneity among studies. The strength of the association between TNF gene polymorphisms and endometriosis risk was assessed by odds ratios and 95% confidence intervals.</p><p><b>RESULTS</b>For TNF-α -238G>A, -308G>A, -857C>T, and -863C>A, no significant associations were identified from all genetic models. For TNF-a -850T>C, results from one study showed that patients harboring the heterozygote TC were less susceptible to endometriosis than patients harboring the homozygote TT. For TNF-a -1031T>C, a mild increase in endometriosis risk was found in the Asian population. Meta-analysis from two studies found that the TNF-β +252>G polymorphism had a protective effect in Chinese individuals. Due to the limitations of the included studies, it is necessitated to perform more studies to elucidate the possible roles of TNF gene polymorphisms in the pathogenesis of endometriosis.</p><p><b>CONCLUSIONS</b>TNF-α -1031T>C and TNF-β +252A>G were significantly associated with the risk of endometriosis in Asian and Chinese populations, respectively. To further evaluate these associations, more large-scale, rigorously designed studies are needed.</p>
Subject(s)
Female , Humans , Asian People , Case-Control Studies , Endometriosis , Epidemiology , Genetics , Genetic Predisposition to Disease , Genetics , Polymorphism, Genetic , Genetics , Polymorphism, Single Nucleotide , Genetics , Tumor Necrosis Factor-alpha , GeneticsABSTRACT
Objective To understand information of initial sexual behavior age of females in Linxiang district of Yunnan province and investigate HPV and HPV vaccine awareness of rural women ,health workers and government staff .Methods During Decem-ber 2009 to December 2010 ,750 cases aged from 15 to 59 years included rural women ,government officials and medical staff in Linxiang district were randomly selected and investigated .Results The age of first sex was (22 .4 ± 2 .3) years old .The number of sexual partners was (1 .2 ± 0 .3) and proportion of premarital sex was low (8 .8% ) .HPV vaccine awareness of rural women was 8 .59% .The proportion of people who knew HPV vaccine could prevent cervical cancer was 6 .57% .The proportion of people who wanted to be vaccinated was 97 .66% .The cost of HPV vaccine which rural women could accept was 300 yuan .Conclusion Women in Linxiang area of Yunnan province have less premarital sex and lack of awareness in HPV .
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Objective To determine the effect of dihydroartiminisin on the proliferation and phosphorylation of mitogen-activated protein kinase (MAPK) in SKOV3 and OVCAR3 ovarian cancer cell lines.Methods Methyl thiazolyl tetrazolium assay was performed to evaluate the anti-proliferative effect of dihydroartiminisin in SKOV3 and OVCAR3 cells,and Western blot was used to determine its effect on phosphorylation level of MAPK,including extra-cell regulated kinase (ERK)1/2 and p38 protein kinase,in the two cell lines.Results Dihydroartiminisin inhibited the proliferation of ovarian cancer cells in vitro,with a mean of 50% inhibition concentration (IC50) at 72 h of (9.0 ±1.4) μmol/L for SKOV3 and (5.5 ±1.2)μmol/L for OVCAR3 respectively. Compared to cells without dihydroartiminisin treatment,phosphorylation level of ERK 1/2 in SKOV3 and OVCAR3 cells treated with dihydroartiminisin decreased by 64.2% and 75.3% respectively (P＜0.05),while phosphorylation of p38 protein kinase in SKOV3 and OVCAR3 only decreased by 8.5% and 6.4% respectively (P ＞0.05).Conclusion Dihydroartiminisin can inhibit the proliferation of ovarian cancer cell in vitro, probably through down-regulation of the phosphorylation of ERK 1/2 in ovarian cancer cells.
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Objective To analyze the correlation of preoperative serum vascular endothelial growth factor(VEGF)level with serum CA125 level in patients with epithelial ovarian cancer(EOC),and to evaluate the prognostic value of preoperative serum VEGF in these patients.Methods Forty-one patients with EOC were included as study group,while 20 healthy women were selected as control group.Enzymelinked immunosorbent assay(ELISA)and chemiluminescence assay were used to measure serum VEGF and CA125 level respectively.The correlations of serum VEGF with CA125 level,postoperative recurrence rate and survival time were analyzed retrospectively.Resuits Serum VEGF levels in patients with EOC were higher than those in healthy women,with the median of 415 and 165 ng/L,range 110-2120 and 100-735 ng/L respectively(P＜0.01).No correlation was found between preoperative serum VEGF and CA125 level (Spearman test,P=0.989).High preoperative serum VEGF was positively correlated with postoperative recurrence.Serum VEGF level in patients with postoperative recurrence was higher than that in patients without recurrence,with the median of 490 and 315 ng/L respectively(P=0.035).Univariate analysis showed that higher serum level was reversely correlated with shorter survival.Median overall survival time in patients with higher serum VEGF level and lower serum VEGF level was 18 months and＞35 months respectively(P=0.010).Multivariate Cox model analysis showed that high VEGF level was an independentfactor for the prognosis of EOC(P=0.042).Conclusion Preoperative serum VEGF level is not correlated with CA125 concentration in patients with EOC,and it is an independent risk factor for prognosis.