[Evaluation of the effect of fertility-saving surgery on young patients with malignant ovarian tumors].

OBJECTIVE: To evaluate the impact of fertility-saving surgery and adjuvant chemotherapy on survival and fertility of young patients with ovarian malignant tumors. METHODS: A retrospective analysis was done on 38 patients with ovarian malignant germ cell tumors, 22 patients with malignant epithelial tumors and 4 patients with sexual cord mesenchymal tumors receiving conservative treatments. Outcomes such as menstruation and reproduction ability were assessed. RESULTS: Fifty-nine among 64 patients have been alive up to now (92%). The overall survival rate for ovarian epithelial malignancies, malignant germ cell tumors and sexual cord mesenchymal tumors were 95% (21/22), 89% (34/38) and 4/4, respectively. Fifteen patients received second operation and recurrence was found in 6 patients. Among the 59 surviving patients, 53 had normal menstruation. Thirteen patients among 20 patients who wanted to get pregnant had 15 pregnancies and 9 successful deliveries. CONCLUSIONS: The management of fertility-saving surgery on patients with ovarian malignant germ cell tumors, whatever the stagings are, is a safe option. For patients with ovarian epithelial carcinomas, fertility-saving surgery is only indicated for low-stage (stage I), high-grade (G1), and patients who hope to maintain fertility function eagerly. Cisplatinum-based combination chemotherapy is necessary. Standardized chemotherapy has no effect on fertility function.

[Study on the relationship between LOH and MI of FHIT gene and the development of cervical carcinoma].

OBJECTIVE: To explore the relationship of loss of heterozygosity (LOH) and microsatellite instability (MI) of fragile histidine triad (FHIT) gene to the development of cervical carcinoma. METHODS: Two sites of microsatellite polymophism in FHIT gene were selected to detect LOH and MI in 60 cases of primary invasive cervical carcinoma and 35 cases of cervical intra-epithelial neoplasia (CIN). RESULTS: At D3S1234 and D3S1300, the LOH rates of primary invasive cervical carcinomas were 45.0% (27/60) and 38.3% (23/60), the MI rates were 18.3% (11/60) and 11.7% (7/60), respectively. The LOH rates of CINs were 42.9% (15/35) and 37.1% (13/35), the MI rates were 11.4% (4/35), 8.6% (3/35), respectively. There were no significant differences between invasive cervical carcinomas and CINs in respect to their positive rates of LOH and MI at D3S1234 and D3S1300 (P>0.05). There were significant differences in LOH rates at D3S1234 and D3S1300 between the well/moderately differentiated cervical carcinomas and the poorly differentiated invasive cervical carcinomas (P<0.05). Significant differences were noted between the invasive cervical carcinomas with lymph node metastasis and those without lymph node metastasis in regard to their LOH and MI at the two sites (P < 0.05). The positive rates of LOH and MI for CIN III and noninvasive cervical carcinomas were higher than those for CIN I-II. CONCLUSION: The FHIT gene change is a relatively late event in CINs. The detection of the LOH of FHIT gene might be helpful to the early diagnosis and the screening of cervical carcinoma. It might also be useful for predicting the prognosis of cervical carcinoma.

[Comparison of therapeutical effect between arterial interventional chemotherapy and venous chemotherapy on bulky or locally advanced cervical cancer].

OBJECTIVE: To investigate the therapeutical effect of arterial interventional chemotherapy and venous chemotherapy on bulky or locally advanced cervical cancer. METHODS: A retrospective study was carried out on 174 patients with bulky or locally advanced cervical cancers admitted to our hospital from Sept 1997 to Sept 2003. The therapeutical, toxic and adverse effects of either arterial interventional or venous chemotherapy were analyzed and compared. RESULTS: Among those 174 patients, 69 were given arterial interventional chemotherapy. Patients with cervical adenocarcinoma received cisplatin, fluorouracil, mitomycin C, and patients with squamous carcinoma of cervix were treated with bleomycin, cisplatin. The effective rate was 81%, and the rate of surgery after chemotherapy was 67%. While in the venous chemotherapy group, 105 patients were treated with the same chemotherapeutical schemes and doses as in arterial interventional chemotherapy group. The effective rate was 83% and the rate of surgery after chemotherapy was 70%. The differences between these two groups showed no significance (P > 0.05). No intolerable toxic and adverse effects were noticed during neoadjuvant chemotherapy. The 3- and 5-year survival rates of arterial interventional chemotherapy group were 76%, 70% respectively, and those of venous chemotherapy group were 78%, 71% respectively, without significant difference (P > 0.05). CONCLUSIONS: Neoadjuvant chemotherapy is a safe and effective means for treating patients with bulky or locally advanced cervical cancer. The therapeutical effects of venous and arterial interventional chemotherapy are similar. And no intolerable toxic and adverse effects were noticed during neoadjuvant chemotherapy. Venous administration is easy and inexpensive and less demanding for special equipment. It shows promising prospect in clinical application.