Immune Cell Infiltration as Signatures for the Diagnosis and Prognosis of Malignant Gynecological Tumors.

Background Malignant gynecological tumors are the main cause of cancer-related deaths in women worldwide and include uterine carcinosarcomas, endometrial cancer, cervical cancer, ovarian cancer, and breast cancer. This study aims to determine the association between immune cell infiltration and malignant gynecological tumors and construct signatures for diagnosis and prognosis. Methods We acquired malignant gynecological tumor RNA-seq transcriptome data from the TCGA database. Next, the "CIBERSORT" algorithm calculated the infiltration of 22 immune cells in malignant gynecological tumors. To construct diagnosis and prognosis signatures, step-wise regression and LASSO analyses were applied, and nomogram and immune subtypes were further identified. Results Notably, Immune cell infiltration plays a significant role in tumorigenesis and development. There are obvious differences in the distribution of immune cells in normal, and tumor tissues. Resting NK cells, M0 Macrophages, and M1 Macrophages participated in the construction of the diagnostic model, with an AUC value of 0.898. LASSO analyses identified a risk signature including T cells CD8, activated NK cells, Monocytes, M2 Macrophages, resting Mast cells, and Neutrophils, proving the prognostic value for the risk signature. We identified two subtypes according to consensus clustering, where immune subtype 3 presented the highest risk. Conclusion We identified diagnostic and prognostic signatures based on immune cell infiltration. Thus, this study provided a strong basis for the early diagnosis and effective treatment of malignant gynecological tumors.

Mesonephric adenocarcinoma of the uterine cervix with rare lung metastases: A case report and review of the literature.

BACKGROUND: Mesonephric adenocarcinoma (MNA) of the female reproductive system is a rare tumor arising from remnants of the mesonephric duct, which is mainly located in the cervix. MNA often occurs in adult women. Due to the rarity of the disease and few reports, the specific clinical features have not been established. CASE SUMMARY: We present a case of a cervical MNA in a 48-year-old woman with an incidental intra-operative diagnosis who received postoperative chemotherapy. Rare lung metastases were detected during follow-up. The existing literature is reviewed. CONCLUSION: The clinical manifestations, pathological characteristics, diagnosis, treatment, and prognosis of MNA have been summarized through the review of the existing literature and the case in this paper. Due to the rarity of this disease, it is very important for the research of MNA in the future.

Visfatin derived from ascites promotes ovarian cancer cell migration through Rho/ROCK signaling-mediated actin polymerization.

Ovarian cancer is characterized by a rapid intraperitoneal spread combination with ascites accumulation. However, the exact mechanisms for ovarian cancer intraperitoneal dissemination remain unknown. Visfatin has recently been established as a novel adipokine and its serum level is increased in various cancers. Here, we identified that the elevated level of visfatin in ascites was associated with ovarian cancer intraperitoneal dissemination. Using the transwell cell migration assay and the wound-healing assay, we found that ascites-derived visfatin could promote migration of Caov-3 cells. Meanwhile, visfatin could induce the aggregation of actin stress fibers and the formation of lamellipodia and filopodia in Caov-3 cells, concomitant with a shift of G-actin to F-actin. Inhibition of actin polymerization with cytochalasin D obviously abolished the effects of visfatin on the migration of Caov-3 cells. Further results showed that visfatin triggered Rho activation and its downstream cofilin phosphorylation in a time-dependent manner, which led to actin polymerization. More importantly, visfatin-induced Caov-3 cell migration was effectively blocked by C3 exoenzyme and Y27632, Rho, and ROCK inhibitor, respectively. Thus, our study showed that ascites-derived visfatin promoted migration of ovarian cancer cells through Rho/ROCK signaling-mediated actin polymerization, which was required for ovarian cancer intraperitoneal dissemination. These findings offered a novel molecular mechanism responsible for ovarian cancer intraperitoneal dissemination, which might be a potential target for ovarian cancer management.

Inducing malignant transformation of endometriosis in rats by long-term sustaining hyperestrogenemia and type II diabetes.

This study aimed to induce malignant transformation of endometriosis in Sprague-Dawley rats by hyperestrogenemia and type II diabetes and evaluate its similarity with human disease in biological features. Rats with surgically induced endometriosis were randomized into two groups: those treated with estradiol (5 mg/kg three times/week after surgery), streptozotocin (25 mg/kg, 1 month after surgery), and high carbohydrate-and-fat feed (Es group); and those treated with placebo saline and standard feed (control group). All rats were randomly killed 2, 4, or 8 months after surgery. The endometriosis lesions and the corresponding eutopic endometria were subjected to morphological evaluation, TUNEL, and immunohistochemical analysis for the expressions of proliferating cell nuclear antigen, phosphatase and tensin homolog, phosphorylated protein kinase B, and phosphorylated mammalian target of rapamycin proteins. In the Es group, three cases (6.0%) of endometriosis showed atypical hyperplasia accompanied by simple hyperplastic eutopic endometria, and two cases (4.0%) of endometriosis showed endometrioid carcinoma accompanied by atypical hyperplastic eutopic endometria. In the Es group, the activity of organelles and the expressions of proliferating cell nuclear antigen, phosphorylated protein kinase B, and phosphorylated mammalian target of rapamycin increased, and the level of phosphatase and tensin homolog and TUNEL positivity decreased progressively in the order of endometriosis, atypical endometriosis, and malignant endometriosis. The same tendency was found in the corresponding eutopic endometria. The induced malignant endometriosis showed similarities with human disease in the pathological process and histomorphological and molecular biological features. The method is feasible. The malignant transformations of endometriosis and eutopic endometria may have correlations and similarities, but the former may suffer a higher risk of canceration.

Evaluation of the transvaginal resection of low-segment cesarean scar ectopic pregnancies.

OBJECTIVE: To evaluate the transvaginal approach for exogenous cesarean scar ectopic pregnancy (CSEP) lesion resection, according to our experience. DESIGN: Retrospective study. SETTING: University hospital. PATIENT(S): Twenty-three patients with confirmed exogenous CSEP treated with transvaginal resection of the lesions at the Shengjing Hospital of China Medical University. INTERVENTION(S): Lesion resection by the transvaginal approach. MAIN OUTCOME MEASURE(S): Surgery time, intraoperative blood loss, postoperative drainage volume, and average days of postoperative hospitalization were compared between the transvaginal procedure group and the transabdominal procedure group. RESULT(S): Significant differences were found. No significant differences were found in the drop of serum hCG level after 48 hours and the postoperative recurrence rate between the two groups. The rate of successful treatment was 96%. CONCLUSION(S): The transvaginal approach for exogenous CSEP lesion resection possesses many advantages. In the hands of a skilled surgeon it can readily address the treatment problems posed by an exogenous CSEP without imposing an increase in surgical risk or technical difficulty.