Endometrioid adenocarcinoma: combined multiparametric MRI and tumour marker HE4 to evaluate tumour grade and lymphovascular space invasion.

AIM: To assess the value of semi-quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and quantitative diffusion-weighted imaging parameters combined with human epididymis protein 4 (HE4) in predicting the pathological grade and lymphovascular space invasion (LVSI) of endometrioid adenocarcinoma (EAC). MATERIALS AND METHODS: Between October 2018 and December 2021, 60 women (mean age, 55 [range, 32-77] years) with EAC underwent preoperative pelvic MRI and HE4 level measurements. The positive enhancement integral (PEI), time to peak, maximum slope of increase (MSI), and maximum slope of decrease were measured by manually drawing a region of interest on the neoplastic tissue. The receiver operating characteristic curve was used to calculate the diagnostic efficiency of the single parameter and combined factors. RESULTS: Lower apparent diffusion coefficients (ADCs) were observed in high-grade tumours (G3) than in low-grade tumours (G1/G2). PEI, MSI, and HE4 levels were higher in the high-grade tumours than in the low-grade tumours (p<0.05). The area under the curve (AUC) for G3 diagnosis using multiparametric MRI combined with HE4 was 0.929. ADC values were significantly lower in the EAC with LVSI than in those without LVSI. Tumours with LVSI showed higher PEI and HE4 levels than those without LVSI (p<0.05). The AUC for LVSI-positive diagnosis using multiparametric MRI combined with HE4 was 0.814. CONCLUSION: Semi-quantitative DCE-MRI, ADC values, and serum HE4 levels can be used to predict tumour grade and LVSI, and the prediction efficiency of multiparametric MRI combined with serum HE4 is better than that of any single factor.

Gene conversions can generate sequence variants in the late chorion multigene families of Bombyx mori.

The 140-kbp late chorion locus of Bombyx mori strain 703 contains 15 divergently oriented gene pairs encoding the high cysteine (Hc) eggshell proteins. Sequence homology is approximately 91% for the 2-kb region of each gene pair, including the 5' flanking region, intron and exons. The homology rapidly disappears within a few hundred basepairs of the 3' end of most genes. Here we present the results of the nucleotide sequence and genomic blot comparison of Hc genes from different races of B. mori. Comparison of the nucleotide sequences of the same gene pair in two different races reveals that most of the nucleotide differences occur in clusters or patches and correspond to sequences present in other Hc genes in the locus. The number of nucleotide differences that have accumulated in the highly conserved regions of the gene pair (2.3/100 bp), most of which are attributable to patchwork exchanges, is significantly higher than the number of differences in the poorly conserved 3' flanking regions (0.6/100 bp), due primarily to new mutations. These data are consistent with a gene conversion process, which in the short-term generates new combinations of sequence variants, but in the long-term results in concerted evolution. Genomic blot analyses of different geographical races of B. mori reveal that there is variation in the number of Hc gene pairs (14-19 gene pairs), indicating that unequal crossovers also occur in the locus.