RESUMO
STUDY OBJECTIVE: To evaluate the detection rate and accuracy of sentinel lymph node (SLN) mapping using cervical and fundal injections of carbon nanoparticles (CNPs) in laparoscopic surgery of endometrioid endometrial cancer (EC) and to identify uterine lymphatic drainage pathways validated by mapping. DESIGN: A prospective consecutive study (Canadian Task Force classification II-2). SETTING: An academic research center. PATIENTS: Consecutive patients with a pathologic diagnosis of early-stage EC scheduled for primary laparoscopic-assisted staging surgery (laparoscopic hysterectomy, bilateral salpingo-oophorectomy, or comprehensive lymphadenectomy). INTERVENTIONS: Enrolled patients underwent laparoscopic SLN mapping with a 50-mg CNP tracer injection. Fifty patients received fundal subserosal injections at 4 sites (the fundal group), whereas 65 patients received cervical submucosal injections at 2 sites (the cervical group). After SLN mapping, all patients underwent laparoscopic staging surgery. MEASUREMENTS AND MAIN RESULTS: No allergic reactions to CNPs were observed in either group. The overall SLN detection rates were 100% and 92% in the cervical and fundal groups, and the bilateral SLN detection rates were 97% and 68% (p < .001), respectively. A total of 12 metastatic SLNs were accurately detected in 5 patients. The sensitivity of metastatic lymph node detection was 100% in the cervical group, which is higher than that in the fundal group (80%). The false-negative rates were 0% and 20%, respectively, in the cervical and fundal groups. Furthermore, we verified 3 uterine lymphatic pathways using the 2 injection methods. The upper paracervical pathway was the most common drainage pathway in both groups (91.4% in the cervical group vs 80.24% in the fundal group), whereas the infundibulopelvic pathway was observed only in the fundal group (15.11%). CONCLUSION: SLN mapping by CNPs in laparoscopic surgery for EC is a safe and effective alternative, with a higher detection rate and better accuracy with cervical injections than fundal injections. The upper paracervical pathway was the most common lymphatic pathway, whereas the infundibulopelvic pathway was only displayed in fundal injections.
Assuntos
Carbono , Carcinoma Endometrioide/patologia , Neoplasias do Endométrio/patologia , Laparoscopia/métodos , Nanopartículas , Estadiamento de Neoplasias/métodos , Linfonodo Sentinela/diagnóstico por imagem , Adulto , Idoso , Carbono/administração & dosagem , Carbono/farmacocinética , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/cirurgia , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Histerectomia/métodos , Linfonodos/patologia , Metástase Linfática , Vasos Linfáticos/diagnóstico por imagem , Vasos Linfáticos/patologia , Vasos Linfáticos/cirurgia , Pessoa de Meia-Idade , Nanopartículas/administração & dosagem , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Salpingo-Ooforectomia , Linfonodo Sentinela/patologia , Biópsia de Linfonodo Sentinela/métodosRESUMO
OBJECTIVE: To study the expression of LINC00673 in cervical cancer and cervical intraepithelial neoplasia (CIN) and to explore the role of LINC00673 in the development of cervical cancer. METHODS: The expression of LINC00673 in serum from cervical cancer patients, CIN patients, and healthy participants was detected by RT-qPCR. The function of LINC00673 in cervical cancer cells was analyzed using in vitro and in vivo experiments. RESULTS: Our results revealed that serum LINC00673 levels were highest in cervical cancer patients, followed by patients with CIN and healthy controls. In vitro experiments demonstrated that overexpression of LINC00673 enhanced the proliferation and cell cycle progression of HeLa and SiHa cells. In vivo experiments showed that the tumor weight and volume of nude mice subcutaneously injected with LINC00673-overexpressing HeLa cells were larger than those of nude mice injected with control cells (P < 0.05). Western blotting showed that cell cycle-related proteins cyclin A2 and cyclin E and interstitial-associated proteins Snail and N-cadherin were upregulated and p53 signaling pathway-related proteins were downregulated in LINC00673-overexpressing HeLa and SiHa cells. CONCLUSION: LINC00673 plays an important role in the development of cervical cancer and may serve as a new therapeutic target for cervical cancer.
RESUMO
OBJECTIVE: To investigate the relationship between lymph vascular space invasion (LVSI) and various clinicopathologic factors in early-stage cervical squamous carcinoma; to explore the expression of P53, COX2 and CD44V6 in early stage squamous carcinoma of cervix and its relationship with prognosis. METHODS: A case-controlled study was conducted to compare LVSI positive group (n = 44) in early stage squamous carcinoma of cervix with LVSI negative group (n = 44). Expression of P53, COX2 and CD44V6 were evaluated by immunohistochemical method to analyze the relationship between LVSI, P53, COX2 and CD44V6 and various clinicopathologic factors and to investigate their prognostic influences. RESULTS: LVSI positive was correlated with lymph node metastasis and deep stromal invasion. The 5-year disease-free survival was 68.9% in LVSI positive group versus 94.7% in LVSI negative group (P < 0.01). And the 5-year overall survival was 70.2% in LVSI positive group versus 100% in LVSI negative group (P < 0.01) with a significant difference. COX2 was correlated with clinical stage and tumor volume while there was no correlation with P53, CD44V6 and clinical factors. The overall survival of P53, COX2 and CD44V6 positive cases were significantly shorter than that of negative ones, especially in constant positive cases of 3 markers (disease-free survival 60.0 months shorter than constant negative cases with an overall survival of 91.3 months, but there was no significant difference). CONCLUSION: LVSI is correlated with lymph node metastasis and deep stromal invasion in the early-stage squamous carcinoma of cervix while it is negatively correlated with disease-free survival and overall survival. COX2 is correlated with clinical stage and tumor volume. Furthermore P53 and CD44V6 are not correlated with clinical factors. The overall survival of P53, COX2 and CD44V6 positive cases are significantly shorter than that of negative ones.
Assuntos
Carcinoma de Células Escamosas/patologia , Células Neoplásicas Circulantes/patologia , Neoplasias do Colo do Útero/patologia , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/metabolismo , Estudos de Casos e Controles , Ciclo-Oxigenase 2/metabolismo , Feminino , Humanos , Receptores de Hialuronatos/metabolismo , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Células Neoplásicas Circulantes/metabolismo , Prognóstico , Proteína Supressora de Tumor p53/metabolismo , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/metabolismoRESUMO
OBJECTIVE: To investigate the impact of danazol alginate microspheres used for uterine arterial embolization (UAE) on ovarian function and subsequent pregnancy using rabbit as a model. METHODS: A total of 32 female rabbits were divided into 3 groups: a control group, danazol alginate microspheres (DKMG) group and alginate microspheres (KMG) group. Basal serum estradiol (E(2)), follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) levels before UAE and 1 - 3 months after UAE were compared for all rabbits. In breeding field all rabbits mated after UAE. Estrus, and pregnancy rate were observed by veterinary. RESULTS: There were no significant changes from baseline FSH, LH, E(2), T levels measured at 1, 2 and 3 months after UAE (P > 0.05). The total pregnancy rate of DKMG or KMG group was 0 within 2 - 4 months after UAE. Compared to the control group (4/8), the difference was statistically significant (P < 0.05); the total pregnancy rate of DKMG, KMG and control groups within 5 - 7 months after UAE, respectively 17% (2/12), 25% (3/12) and 5/8 (P > 0.05); the total pregnancy rate was 42% (5/12), 50% (6/12) and 6/8 respectively within 8 - 10 months after UAE, there were also no significant differences between the three groups (P > 0.05). CONCLUSIONS: There is no obvious effect of danazol alginate microspheres used for uterine arterial embolization on ovarian function in rabbits. After UAE some animals are able to achieve pregnancies, while harmful effects are observed on short term pregnant rate.
Assuntos
Danazol/uso terapêutico , Embolização Terapêutica/métodos , Leiomioma/terapia , Ovário/efeitos dos fármacos , Neoplasias Uterinas/terapia , Alginatos/administração & dosagem , Alginatos/uso terapêutico , Animais , Danazol/administração & dosagem , Embolização Terapêutica/efeitos adversos , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Leiomioma/sangue , Hormônio Luteinizante/sangue , Microesferas , Ovário/fisiopatologia , Gravidez , Taxa de Gravidez , Coelhos , Resultado do Tratamento , Neoplasias Uterinas/sangue , Útero/irrigação sanguínea , Útero/efeitos dos fármacos , Útero/patologiaRESUMO
OBJECTIVE: To analyze the clinical characters and prognosis of postpartum choriocarcinoma. METHODS: Retrospective analysis of 103 patients diagnosed with postpartum choriocarcinoma in Peking Union Medical College Hospital between 1985 and 2005 was performed. RESULTS: In a total of 103 cases of postpartum choriocarcinoma treated with multiagent cytotoxic chemotherapy and combined modality therapy, 92 patients (89.3%) achieved a complete remission while 2 patients had a partial remission, and 9 patients died. Regarding 25 cases with chemorefractory choriocarcinoma and 4 relapsed cases, 18 and 3 cases achieved a complete remission respectively. According to the new International Federation of Gynecology and Obstetrics (FIGO) 2000 staging and risk factor scoring system, 17 cases were at FIGO stage I, 8 cases at stage II, 56 cases at stage III, and 22 cases at stage IV. Complete remission was achieved in 100%, 8/8, 95% and 64% respectively. Thirty-five cases in low risk group had FIGO scores < or = 6, and all achieved a complete remission. Of 68 cases in high risk group with FIGO scores > or = 7, 57 (84%) of them obtained a complete remission. There were significant differences in the two groups (P < 0.05). CONCLUSION: Postpartum choriocarcinoma could have an increasing probability of cure with early diagnosis and the use of modern multiagent cytotoxic chemotherapy and combined modality therapy.