Background: This study aimed to assess the efficacy and safety of laparoscopic and transvaginal cervical cerclage treatments in patients with cervical insufficiency before and during pregnancy. Methods: A total of 70 patients diagnosed with cervical insufficiency and undergoing cervical cerclage at the Second Affiliated Hospital of Xinjiang Medical University between January 2020 and December 2022 were included. The patients were divided into three groups based on different surgical methods: transvaginal loop during pregnancy (Group 1, n = 30), transabdominal loop before pregnancy (Group 2, n = 20), and transabdominal loop during pregnancy (Group 3, n = 20). The groups were compared in terms of general clinical data, operation time, intraoperative bleeding, hospital stay, delivery gestational weeks, preterm delivery rate, prolonged gestational weeks, and neonatal births. Results: (1) There were no statistically significant differences in age, pregnancy, delivery, number of miscarriages, cervical length, and history of midterm pregnancy loss among the three groups (p > 0.05). (2) Prolonged gestational week, delivery gestational week, term delivery, and neonatal birth weight were higher in Groups 2 and 3 compared to Group 1, with statistically significant differences (p < 0.05). There was no statistically significant difference (p > 0.05) when comparing Group 2 and Group 3. Premature rupture of membranes and preterm delivery were higher in Group 1 compared to Groups 2 and 3, with statistically significant differences (p < 0.05). There was no statistically significant difference when comparing Group 2 and Group 3 (p > 0.05). (3) The amount of surgical bleeding and surgical time showed statistically significant differences (p < 0.05) among the three groups. Group 1 had more surgical bleeding than Groups 2 and 3, with statistically significant differences (p < 0.05). When comparing Group 2 and Group 3, Group 3 had more surgical bleeding than Group 2, with a statistically significant difference (p < 0.05). Group 2 had a shorter surgical time than Group 1 and Group 3, with statistically significant differences (p < 0.05). When comparing Group 1 and Group 3, Group 3 had a longer surgical time than Group 1, with a statistically significant difference (p < 0.05). There was no statistically significant difference in hospital stay when comparing three groups (p > 0.05). Conclusions: Laparoscopic cervical cerclage is a safe and effective treatment option, yielding better pregnancy outcomes than transvaginal cervical cerclage, particularly for patients with previous failed transvaginal cerclage. Preconception laparoscopic cervical cerclage carries lower surgical risks and should be considered for clinical application.
{"title":"Efficacy Analysis of Cervical Cerclage in the Treatment of Cervical Insufficiencies","authors":"Qinghua Zhang, Yansong Liu, Changsheng Xu","doi":"10.31083/j.ceog5010207","DOIUrl":"https://doi.org/10.31083/j.ceog5010207","url":null,"abstract":"Background: This study aimed to assess the efficacy and safety of laparoscopic and transvaginal cervical cerclage treatments in patients with cervical insufficiency before and during pregnancy. Methods: A total of 70 patients diagnosed with cervical insufficiency and undergoing cervical cerclage at the Second Affiliated Hospital of Xinjiang Medical University between January 2020 and December 2022 were included. The patients were divided into three groups based on different surgical methods: transvaginal loop during pregnancy (Group 1, n = 30), transabdominal loop before pregnancy (Group 2, n = 20), and transabdominal loop during pregnancy (Group 3, n = 20). The groups were compared in terms of general clinical data, operation time, intraoperative bleeding, hospital stay, delivery gestational weeks, preterm delivery rate, prolonged gestational weeks, and neonatal births. Results: (1) There were no statistically significant differences in age, pregnancy, delivery, number of miscarriages, cervical length, and history of midterm pregnancy loss among the three groups (p > 0.05). (2) Prolonged gestational week, delivery gestational week, term delivery, and neonatal birth weight were higher in Groups 2 and 3 compared to Group 1, with statistically significant differences (p < 0.05). There was no statistically significant difference (p > 0.05) when comparing Group 2 and Group 3. Premature rupture of membranes and preterm delivery were higher in Group 1 compared to Groups 2 and 3, with statistically significant differences (p < 0.05). There was no statistically significant difference when comparing Group 2 and Group 3 (p > 0.05). (3) The amount of surgical bleeding and surgical time showed statistically significant differences (p < 0.05) among the three groups. Group 1 had more surgical bleeding than Groups 2 and 3, with statistically significant differences (p < 0.05). When comparing Group 2 and Group 3, Group 3 had more surgical bleeding than Group 2, with a statistically significant difference (p < 0.05). Group 2 had a shorter surgical time than Group 1 and Group 3, with statistically significant differences (p < 0.05). When comparing Group 1 and Group 3, Group 3 had a longer surgical time than Group 1, with a statistically significant difference (p < 0.05). There was no statistically significant difference in hospital stay when comparing three groups (p > 0.05). Conclusions: Laparoscopic cervical cerclage is a safe and effective treatment option, yielding better pregnancy outcomes than transvaginal cervical cerclage, particularly for patients with previous failed transvaginal cerclage. Preconception laparoscopic cervical cerclage carries lower surgical risks and should be considered for clinical application.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Uterine corpus endometrial carcinoma (UCEC) is a prevalent gynaecologic malignancy. It has been demonstrated that the immune cell infiltration (ICI) pattern plays a critical role in the tumour progression of UCEC. Methods: To further investigate the immune microenvironment landscape of UCEC, we analysed the gene expression data of 539 UCEC patients from The Cancer Genome Atlas (TCGA) database using CIBERSORT and ESTIMATE for consensus clustering of immune cells. We used the limma package to compare differentially expressed genes (DEGs) among ICI patterns and constructed a prognostic model using Cox regression to calculate the risk score of UCEC patients. The immunophenoscore was downloaded to explore the immunotherapeutic effect between low- and high-risk score patients. Finally, the tumour mutation burden (TMB) was calculated using the somatic mutation data. Results: We identified two different immune infiltration patterns in 539 UCEC samples, the immune-desert and immune-inflamed phenotypes, which had distinct prognostic and biological features. We obtained 29 DEGs to construct the ICI-related prognostic model and established a four ICI-related gene-based prognostic model comprising LINC01871, CXCL13, IGKJ5, and LINC01281. The risk score was associated with distinct clinical outcomes, ICI, and immunotherapeutic effects. Patients with a low risk score had higher effective immune cells, which could be classified into the immune-inflamed phenotype. Additionally, patients with a low risk score had a significantly higher immunophenoscore, suggesting a better immunotherapeutic outcome. Finally, TMB was confirmed to be associated with prognosis, which was synergistic with the risk score. Conclusions: This study comprehensively analysed the ICI pattern in UCEC patients and established a four ICI-related gene-based prognostic model to predict prognosis and guide precise immunotherapy strategies.
背景:子宫体子宫内膜癌是一种常见的妇科恶性肿瘤。研究表明，免疫细胞浸润(ICI)模式在UCEC的肿瘤进展中起关键作用。方法:为了进一步研究UCEC的免疫微环境景观，我们利用CIBERSORT和ESTIMATE对来自the Cancer Genome Atlas (TCGA)数据库的539例UCEC患者的基因表达数据进行分析，对免疫细胞进行共识聚类。我们使用limma包来比较不同ICI模式的差异表达基因(DEGs)，并使用Cox回归构建预后模型来计算UCEC患者的风险评分。下载免疫表型评分(immunophenoscore)，探讨低、高危评分患者的免疫治疗效果。最后，利用体细胞突变数据计算肿瘤突变负荷(TMB)。结果:我们在539例UCEC样本中发现了两种不同的免疫浸润模式，免疫荒漠表型和免疫炎症表型，它们具有不同的预后和生物学特征。我们获得了29个基因构建ici相关预后模型，并建立了包括LINC01871、CXCL13、IGKJ5和LINC01281在内的4个ici相关基因的预后模型。风险评分与不同的临床结果、ICI和免疫治疗效果相关。风险评分低的患者有效免疫细胞较高，可归类为免疫炎症表型。此外，低风险评分的患者免疫表型评分明显更高，表明免疫治疗结果更好。最后，证实TMB与预后相关，与风险评分有协同作用。结论:本研究全面分析了UCEC患者的ICI模式，建立了基于四种ICI相关基因的预后模型，预测预后，指导精准的免疫治疗策略。
{"title":"Identification of an Immune Cell Infiltration-Related Prognostic Model to Guide Immunotherapy in Endometrial Carcinoma","authors":"Haijun Zhu, Fangjia Luo, Wanhong He, Sufen Zhang, Jing Chen, Liyun Sun, Xiaohua Ni, Qihan Wu","doi":"10.31083/j.ceog5010204","DOIUrl":"https://doi.org/10.31083/j.ceog5010204","url":null,"abstract":"Background: Uterine corpus endometrial carcinoma (UCEC) is a prevalent gynaecologic malignancy. It has been demonstrated that the immune cell infiltration (ICI) pattern plays a critical role in the tumour progression of UCEC. Methods: To further investigate the immune microenvironment landscape of UCEC, we analysed the gene expression data of 539 UCEC patients from The Cancer Genome Atlas (TCGA) database using CIBERSORT and ESTIMATE for consensus clustering of immune cells. We used the limma package to compare differentially expressed genes (DEGs) among ICI patterns and constructed a prognostic model using Cox regression to calculate the risk score of UCEC patients. The immunophenoscore was downloaded to explore the immunotherapeutic effect between low- and high-risk score patients. Finally, the tumour mutation burden (TMB) was calculated using the somatic mutation data. Results: We identified two different immune infiltration patterns in 539 UCEC samples, the immune-desert and immune-inflamed phenotypes, which had distinct prognostic and biological features. We obtained 29 DEGs to construct the ICI-related prognostic model and established a four ICI-related gene-based prognostic model comprising LINC01871, CXCL13, IGKJ5, and LINC01281. The risk score was associated with distinct clinical outcomes, ICI, and immunotherapeutic effects. Patients with a low risk score had higher effective immune cells, which could be classified into the immune-inflamed phenotype. Additionally, patients with a low risk score had a significantly higher immunophenoscore, suggesting a better immunotherapeutic outcome. Finally, TMB was confirmed to be associated with prognosis, which was synergistic with the risk score. Conclusions: This study comprehensively analysed the ICI pattern in UCEC patients and established a four ICI-related gene-based prognostic model to predict prognosis and guide precise immunotherapy strategies.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Unwanted pregnancies cause some type of stress in women, which negatively impacts their way of life. It is important to recognize this type of stress and consider potential interventions. We aimed to comprehend the factors influencing married and parous women’s fertility decisions facing pregnant unintentionally, to provide a reference point for health care, and policy development. Methods: 44 married and parous women with unintended pregnancies who visited a tertiary hospital in Suzhou from May 2021 to July 2021 were chosen using a combination of purposive and theoretical sampling techniques for semi-structured, open-ended interviews. The Lazarus stress-coping model was used to construct the central theme of the analysis, which was “stress-coping style for fertility decision-making among married and parous women with unwanted pregnancy”. The model is divided into three stages: identifying re-fertility stressors, assessing re-fertility coping skills, and making decisions. Results: It takes the combined efforts of society, healthcare, families, and couples to ensure that married and parous women feel secure about having another child. Social support, medical care, and family sharing are all significant factors in the decision to have a child with an unwanted pregnancy. Conclusions: To increase people’s internal motivation to have more children and to support balanced population development, we must first create a healthy and favorable environment for fertility in society.
{"title":"Stress Response to Fertility Decisions of Married and Parous Women with Unexpected Pregnancy: A Three Month Study at Tertiary Suzhou Hospital, China","authors":"Ying Zhang, Aiying Jin, Jiao Zhu, Jinhua Zhou, Jianzheng Cai, Yuqing Liu, Wenjie Sui","doi":"10.31083/j.ceog5010208","DOIUrl":"https://doi.org/10.31083/j.ceog5010208","url":null,"abstract":"Background: Unwanted pregnancies cause some type of stress in women, which negatively impacts their way of life. It is important to recognize this type of stress and consider potential interventions. We aimed to comprehend the factors influencing married and parous women’s fertility decisions facing pregnant unintentionally, to provide a reference point for health care, and policy development. Methods: 44 married and parous women with unintended pregnancies who visited a tertiary hospital in Suzhou from May 2021 to July 2021 were chosen using a combination of purposive and theoretical sampling techniques for semi-structured, open-ended interviews. The Lazarus stress-coping model was used to construct the central theme of the analysis, which was “stress-coping style for fertility decision-making among married and parous women with unwanted pregnancy”. The model is divided into three stages: identifying re-fertility stressors, assessing re-fertility coping skills, and making decisions. Results: It takes the combined efforts of society, healthcare, families, and couples to ensure that married and parous women feel secure about having another child. Social support, medical care, and family sharing are all significant factors in the decision to have a child with an unwanted pregnancy. Conclusions: To increase people’s internal motivation to have more children and to support balanced population development, we must first create a healthy and favorable environment for fertility in society.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To investigate the effects of social factors including social support and social restriction on postpartum depression (PPD) during the COVID-19 pandemic. Methods: We conducted a systematic review with PubMed and Web of Science from 1 January 2020 to 1 April 2023. Articles focusing on social factors and PPD during COVID-19 pandemic were investigated. Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality Scale were used to evaluate quality of literatures. Results: We included 31 articles (22 cross-sectional studies and 9 cohort studies) with good quality. Edinburgh Postnatal Depression Scale (EPDS) was used as the preferred measure for defining PPD. Social support reduced the prevalence of developing PPD by 30%–40%. Social restriction increased the risk of PPD but there was lack of evidence or effective scales to define restriction. Conclusions: We found that social support acted as an important protective factor for PPD during the COVID-19 pandemic and that social restriction increased the risk of PPD. EPDS may be an optimal choice for researchers to define PPD. Obstetricians should underline social factors for both pregnancy women and their families. The study was registered on PROSPERO (https://www.crd.york.ac.uk/prospero/), registration number: CRD42023434485.
背景:探讨新冠肺炎大流行期间社会支持和社会限制等社会因素对产后抑郁的影响。方法:我们在2020年1月1日至2023年4月1日期间对PubMed和Web of Science进行了系统评价。对COVID-19大流行期间关注社会因素和PPD的文章进行了调查。采用纽卡斯尔-渥太华量表和卫生保健研究机构质量量表评价文献质量。结果:我们纳入了31篇质量较好的文章(22篇横断面研究和9篇队列研究)。爱丁堡产后抑郁量表(EPDS)被用作确定产后抑郁的首选测量标准。社会支持使产后抑郁症患病率降低了30%-40%。社会限制增加了PPD的风险，但缺乏证据或有效的量表来定义限制。结论:我们发现社会支持是COVID-19大流行期间PPD的重要保护因素，社会限制增加了PPD的风险。EPDS可能是研究人员定义PPD的最佳选择。产科医生应强调孕妇及其家庭的社会因素。本研究已在PROSPERO (https://www.crd.york.ac.uk/prospero/)上注册，注册号:CRD42023434485。
{"title":"Social Factors and the Risk of Postpartum Depression during the COVID-19 Pandemic: A Systematic Review","authors":"Haohui Chen, Bo Feng, Yuting Guo, Wei Luo, Yuxin Zhao, Shuying Liao, Jitong Zhao","doi":"10.31083/j.ceog5010203","DOIUrl":"https://doi.org/10.31083/j.ceog5010203","url":null,"abstract":"Background: To investigate the effects of social factors including social support and social restriction on postpartum depression (PPD) during the COVID-19 pandemic. Methods: We conducted a systematic review with PubMed and Web of Science from 1 January 2020 to 1 April 2023. Articles focusing on social factors and PPD during COVID-19 pandemic were investigated. Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality Scale were used to evaluate quality of literatures. Results: We included 31 articles (22 cross-sectional studies and 9 cohort studies) with good quality. Edinburgh Postnatal Depression Scale (EPDS) was used as the preferred measure for defining PPD. Social support reduced the prevalence of developing PPD by 30%–40%. Social restriction increased the risk of PPD but there was lack of evidence or effective scales to define restriction. Conclusions: We found that social support acted as an important protective factor for PPD during the COVID-19 pandemic and that social restriction increased the risk of PPD. EPDS may be an optimal choice for researchers to define PPD. Obstetricians should underline social factors for both pregnancy women and their families. The study was registered on PROSPERO (https://www.crd.york.ac.uk/prospero/), registration number: CRD42023434485.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To investigate the value of the artificial intelligence cervical cancer screening system TruScreen (TS) in high-risk human papillomavirus (HPV)-positive patients in a clinical setting. Methods: Three hundred and eighteen patients positive for high-risk HPV in the gynecological clinic of our hospital from May 2020 to June 2021 were analyzed retrospectively. Colposcopy was performed when it was clinically indicated. Results: Among the 318 patients, 203 were TS negative and 115 were TS positive, of whom 84 were referred for colposcopy and possible biopsy. Among the 318 patents, 74.53% (237/318) had a single type of HPV infection, and 25.47% (81/318) had more than two types of HPV infection. In terms of HPV types, the top 5 types were 52, 58, 51, 56 and 16. HPV52 accounted for 27.4% (87/318), followed by HPV58, accounting for 17.30% (55/318). A total of 84 patients underwent colposcopy. The negative predictive values of TS and thinprep cytology test (TCT) screening for cervical cancer and precancerous lesions were 33.33% and 16.90%, respectively. The positive predictive values were 88.41% and 92.31%, respectively. The sensitivity was 85.92% and 16.90%, respectively. The specificity was 38.46% and 92.31%, respectively. Among 251 non-16/18 high-risk HPV-positive patients with TCT negative intraepithelial lesion or malignancy (NILM) 49 underwent colposcopy. The positive predictive value of TS for cervical cancer and precancerous lesions was 84.78% and the sensitivity was 92.86%. Conclusions: This study demonstrated that in a clinical setting, TS had a better sensitivity than TCT in cervical cancer screening, but less specificity than TCT. In the non-16/18 HPV-positive population with TCT NILM, TS screening can be considered as having potential for clinical management. However, the current research sample size was small, and further research needs to be performed with a larger sample size.
{"title":"The Value of TruScreen (An Artificial Intelligence Cervical Cancer Screening System) in High-Risk HPV Positive Patients","authors":"Lianmei Luo, Jun Zhang","doi":"10.31083/j.ceog5010206","DOIUrl":"https://doi.org/10.31083/j.ceog5010206","url":null,"abstract":"Background: To investigate the value of the artificial intelligence cervical cancer screening system TruScreen (TS) in high-risk human papillomavirus (HPV)-positive patients in a clinical setting. Methods: Three hundred and eighteen patients positive for high-risk HPV in the gynecological clinic of our hospital from May 2020 to June 2021 were analyzed retrospectively. Colposcopy was performed when it was clinically indicated. Results: Among the 318 patients, 203 were TS negative and 115 were TS positive, of whom 84 were referred for colposcopy and possible biopsy. Among the 318 patents, 74.53% (237/318) had a single type of HPV infection, and 25.47% (81/318) had more than two types of HPV infection. In terms of HPV types, the top 5 types were 52, 58, 51, 56 and 16. HPV52 accounted for 27.4% (87/318), followed by HPV58, accounting for 17.30% (55/318). A total of 84 patients underwent colposcopy. The negative predictive values of TS and thinprep cytology test (TCT) screening for cervical cancer and precancerous lesions were 33.33% and 16.90%, respectively. The positive predictive values were 88.41% and 92.31%, respectively. The sensitivity was 85.92% and 16.90%, respectively. The specificity was 38.46% and 92.31%, respectively. Among 251 non-16/18 high-risk HPV-positive patients with TCT negative intraepithelial lesion or malignancy (NILM) 49 underwent colposcopy. The positive predictive value of TS for cervical cancer and precancerous lesions was 84.78% and the sensitivity was 92.86%. Conclusions: This study demonstrated that in a clinical setting, TS had a better sensitivity than TCT in cervical cancer screening, but less specificity than TCT. In the non-16/18 HPV-positive population with TCT NILM, TS screening can be considered as having potential for clinical management. However, the current research sample size was small, and further research needs to be performed with a larger sample size.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To explore the predictive value of vascular endothelial growth factor (VEGF)-C and D combined with ultrasonic pathological features for nonsentinel lymph node (NSLN) metastasis in positive sentinel lymph nodes (SLNs) early-stage breast cancer. Methods: To review the clinical data of 170 SLN-positive early breast cancer patients. We examined VEGF-C and D positive expression in cancerous and paraneoplastic tissues and counted ultrasound and pathological features. Results: The rate of VEGF-C and D positivity in cancer tissues was higher than that in paracancerous tissues (p < 0.05). The rates of VEGF-C and D positivity in the cancer tissues with vascular infiltration, number of SLN positives >2, proportion of SLN positives >0.5, burr sign on ultrasound, and NSLN metastasis were higher than those of patients without vascular infiltration, number of SLN positives ≤2, proportion of SLN positives ≤0.5, no burr sign, and no NSLN metastasis, respectively (p < 0.05). The results also showed that the presence of vascular infiltration and burr sign, a high number of SLN positivity, the percentage of SLN positivity >0.5, VEGF-C and D positivity were all NSLN metastasis independent risk factors for metastasis (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) for VEGF-C and D combined with ultrasound and pathological features to predict NSLN metastasis was the highest. Conclusions: The ultrasound and pathological features of SLN-positive early breast cancer patients, such as vascular infiltration, VEGF-C and D positivity, were all independent risk factors for NSLN metastasis, and VEGF-C and D combined with ultrasound and pathological features had high predictive efficacy for NSLN metastasis. It provides reliable indicators to screen for NSLN metastasis in a high-risk group from SLN-positive patients with early-stage breast cancer.
{"title":"Predictive Value of VEGF-C and D Combined with Ultrasound Pathological Features for Nonsentinel Lymph Node Metastasis in SLN-Positive Early-Stage Breast Cancer","authors":"Jianzhong Chen, Weifeng Li, Xinyuan Tang, Zhibin Wang, Liang Xu, Qiuming Liu","doi":"10.31083/j.ceog5009201","DOIUrl":"https://doi.org/10.31083/j.ceog5009201","url":null,"abstract":"Background: To explore the predictive value of vascular endothelial growth factor (VEGF)-C and D combined with ultrasonic pathological features for nonsentinel lymph node (NSLN) metastasis in positive sentinel lymph nodes (SLNs) early-stage breast cancer. Methods: To review the clinical data of 170 SLN-positive early breast cancer patients. We examined VEGF-C and D positive expression in cancerous and paraneoplastic tissues and counted ultrasound and pathological features. Results: The rate of VEGF-C and D positivity in cancer tissues was higher than that in paracancerous tissues (p < 0.05). The rates of VEGF-C and D positivity in the cancer tissues with vascular infiltration, number of SLN positives >2, proportion of SLN positives >0.5, burr sign on ultrasound, and NSLN metastasis were higher than those of patients without vascular infiltration, number of SLN positives ≤2, proportion of SLN positives ≤0.5, no burr sign, and no NSLN metastasis, respectively (p < 0.05). The results also showed that the presence of vascular infiltration and burr sign, a high number of SLN positivity, the percentage of SLN positivity >0.5, VEGF-C and D positivity were all NSLN metastasis independent risk factors for metastasis (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) for VEGF-C and D combined with ultrasound and pathological features to predict NSLN metastasis was the highest. Conclusions: The ultrasound and pathological features of SLN-positive early breast cancer patients, such as vascular infiltration, VEGF-C and D positivity, were all independent risk factors for NSLN metastasis, and VEGF-C and D combined with ultrasound and pathological features had high predictive efficacy for NSLN metastasis. It provides reliable indicators to screen for NSLN metastasis in a high-risk group from SLN-positive patients with early-stage breast cancer.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135538591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giselle Fachetti-Machado, Rosane Ribeiro Figueiredo-Alves, Marise Amaral Rebouças Moreira, Rita Maira Zanine, Maria José de Camargo, Eliana Pereira dos Reis
Background: Global strategies to eliminate cervical cancer will probably be followed by a drop in prevalence of precursor cervical neoplasias, leading to the need of improving colposcopic diagnostic performance that may negatively be affected. The aim of this study was to assess agreement among five colposcopists regarding the presence of three isolated colposcopic images, and different degrees of colposcopic findings. Methods: In this retrospective study, two original colposcopists examined colposcopic images of patients treated between 2005 and 2018, classified them following the International Federation for Cervical Pathology and Colposcopy terminology, and evaluated them for the presence of obstructed dilated grouped glands, aceto-white villi with invaginated borders fused or not, and atypical vessels in cylindrical epithelium area. Posteriorly, three independent colposcopists also classified those colposcopic findings. The degree of agreement between the findings of the three independent, and the two original colposcopists was assessed using the Kappa (κ) coefficient. Results: Among the 822 included patients, 67.4% had a diagnosis of cervical intraepithelial neoplasia (CIN) grades 2 or 3, 6.8% of adenocarcinoma in situ, and 11.8% of CIN 1. The agreement for each image ranged from κ 0.14 to 0.37 (p < 0.001). The highest agreements occurred for aceto-white villi with invaginated borders (κ 0.15–0.37), major (κ 0.29–0.46), and minor (κ 0.14–0.36) colposcopic findings (p ≤ 0.001). Conclusions: The agreement among the three independent, and the two original colposcopists was statistically significant, ranging from weak to regular for the identification of three isolated colposcopic images, and from weak to moderate for the identification of major and minor colposcopic findings.
{"title":"Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias","authors":"Giselle Fachetti-Machado, Rosane Ribeiro Figueiredo-Alves, Marise Amaral Rebouças Moreira, Rita Maira Zanine, Maria José de Camargo, Eliana Pereira dos Reis","doi":"10.31083/j.ceog5009200","DOIUrl":"https://doi.org/10.31083/j.ceog5009200","url":null,"abstract":"Background: Global strategies to eliminate cervical cancer will probably be followed by a drop in prevalence of precursor cervical neoplasias, leading to the need of improving colposcopic diagnostic performance that may negatively be affected. The aim of this study was to assess agreement among five colposcopists regarding the presence of three isolated colposcopic images, and different degrees of colposcopic findings. Methods: In this retrospective study, two original colposcopists examined colposcopic images of patients treated between 2005 and 2018, classified them following the International Federation for Cervical Pathology and Colposcopy terminology, and evaluated them for the presence of obstructed dilated grouped glands, aceto-white villi with invaginated borders fused or not, and atypical vessels in cylindrical epithelium area. Posteriorly, three independent colposcopists also classified those colposcopic findings. The degree of agreement between the findings of the three independent, and the two original colposcopists was assessed using the Kappa (κ) coefficient. Results: Among the 822 included patients, 67.4% had a diagnosis of cervical intraepithelial neoplasia (CIN) grades 2 or 3, 6.8% of adenocarcinoma in situ, and 11.8% of CIN 1. The agreement for each image ranged from κ 0.14 to 0.37 (p < 0.001). The highest agreements occurred for aceto-white villi with invaginated borders (κ 0.15–0.37), major (κ 0.29–0.46), and minor (κ 0.14–0.36) colposcopic findings (p ≤ 0.001). Conclusions: The agreement among the three independent, and the two original colposcopists was statistically significant, ranging from weak to regular for the identification of three isolated colposcopic images, and from weak to moderate for the identification of major and minor colposcopic findings.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mengchen Zhang, Haohui Xu, Yixin Zhang, Zhanfei Li, Wenqiang Meng, Jiayi Xia, Wentao Lei, Kai Meng, Yan Guo
Objective: This review aims to provide some theoretical guidance for the precise treatment of ovarian cancer and the development of estrogen-related drugs. Mechanism: Ovarian cancer is one of the leading causes of death in gynecological cancer patients, mainly affecting middle-aged and elderly women. It has the characteristics of hidden location, strong heterogeneity and lack of specific symptoms in the early stage. Numerous studies have shown that estrogen receptor (ER) plays an important role in different types of cancer, including ovarian cancer. Accordingly, the study of ER signaling pathways and related regulatory factors in ovarian cancer cells should help us understand the pathogenesis of ovarian cancer. Findings in Brief: The expression of estrogen receptor subtypes is related to ovarian cancer gene and leads to ovarian cancer. Estrogen receptor modulators appear to be an important factor in the prognosis of patients with ovarian cancer after hormone therapy. Conclusions: This review summarizes the regulatory mechanism of ER in the occurrence and development of ovarian cancer and outlines the specific role of estrogen receptor modulators (SERMs) in the treatment and prevention of ovarian cancer.
{"title":"Research Progress of Estrogen Receptor in Ovarian Cancer","authors":"Mengchen Zhang, Haohui Xu, Yixin Zhang, Zhanfei Li, Wenqiang Meng, Jiayi Xia, Wentao Lei, Kai Meng, Yan Guo","doi":"10.31083/j.ceog5009199","DOIUrl":"https://doi.org/10.31083/j.ceog5009199","url":null,"abstract":"Objective: This review aims to provide some theoretical guidance for the precise treatment of ovarian cancer and the development of estrogen-related drugs. Mechanism: Ovarian cancer is one of the leading causes of death in gynecological cancer patients, mainly affecting middle-aged and elderly women. It has the characteristics of hidden location, strong heterogeneity and lack of specific symptoms in the early stage. Numerous studies have shown that estrogen receptor (ER) plays an important role in different types of cancer, including ovarian cancer. Accordingly, the study of ER signaling pathways and related regulatory factors in ovarian cancer cells should help us understand the pathogenesis of ovarian cancer. Findings in Brief: The expression of estrogen receptor subtypes is related to ovarian cancer gene and leads to ovarian cancer. Estrogen receptor modulators appear to be an important factor in the prognosis of patients with ovarian cancer after hormone therapy. Conclusions: This review summarizes the regulatory mechanism of ER in the occurrence and development of ovarian cancer and outlines the specific role of estrogen receptor modulators (SERMs) in the treatment and prevention of ovarian cancer.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135925669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elif Cansu Gundogdu, Ahmet Kale, Metin Mercan, Vildan Yayla, Ugur Efe Ozcan, Taner Usta, Esra Keles
Background: This study aims to present a novel technique that integrates intraoperative neurophysiological monitoring (IONM) into laparoscopy for continuous monitoring of pelvic nerves at risk during surgery to ensure their protection. Methods: This is a prospective analysis of 10 consecutive patients receiving surgical treatment for proven diagnosis of lumbosacral plexus nerve entrapment. Patients with symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and severe, burning sharp pain on the lower extremity dermatomes were included. Laparoscopic decompression of lumbosacral plexus nerve entrapment with intraoperative neuromonitoring was performed between January 2021 and February 2022. Intraoperative neuromonitoring records (spontaneous electromyography (EMG), free-run EMG recordings, transcranial electrical motor-evoked potentials (TcMEP) recordings, direct nerve root stimulation recordings, and compound muscle action potentials (CMAPs) recordings) and preoperative and postoperative pain symptoms at one month were analyzed. Results: The median age of the patients was 29 (25–44) years. Neurovascular conflict, fibrosis, and abnormal piriformis muscle were identified as the three main etiologies of nerve entrapments. There were no statistically significant differences in transcranial motor evoked potential responses on the operated extremity side before and after decompression surgery or in the amplitude difference changes of TcMEP responses between the operated and non-operated extremity sides (p > 0.05). Dyspareunia visual analogue scale (VAS) scores showed a significant decrease at the first month postoperatively (p-value = 0.027). Conclusions: Integrating intraoperative neurophysiological monitoring into laparoscopy facilitates the monitoring of the patient’s motor function and prevents both permanent and transient nerve damage during pelvic nerve decompression surgery. This technique holds promise in enhancing surgical safety and preserving pelvic nerve function. The study was registered at https://clinicaltrials.gov (registration number NCT06009640).
{"title":"Integration of Intraoperative Neurophysiological Monitoring into Laparoscopic Pelvic Nerve Decompression Surgery: A Novel Technique for Protecting Pelvic Nerves","authors":"Elif Cansu Gundogdu, Ahmet Kale, Metin Mercan, Vildan Yayla, Ugur Efe Ozcan, Taner Usta, Esra Keles","doi":"10.31083/j.ceog5009198","DOIUrl":"https://doi.org/10.31083/j.ceog5009198","url":null,"abstract":"Background: This study aims to present a novel technique that integrates intraoperative neurophysiological monitoring (IONM) into laparoscopy for continuous monitoring of pelvic nerves at risk during surgery to ensure their protection. Methods: This is a prospective analysis of 10 consecutive patients receiving surgical treatment for proven diagnosis of lumbosacral plexus nerve entrapment. Patients with symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and severe, burning sharp pain on the lower extremity dermatomes were included. Laparoscopic decompression of lumbosacral plexus nerve entrapment with intraoperative neuromonitoring was performed between January 2021 and February 2022. Intraoperative neuromonitoring records (spontaneous electromyography (EMG), free-run EMG recordings, transcranial electrical motor-evoked potentials (TcMEP) recordings, direct nerve root stimulation recordings, and compound muscle action potentials (CMAPs) recordings) and preoperative and postoperative pain symptoms at one month were analyzed. Results: The median age of the patients was 29 (25–44) years. Neurovascular conflict, fibrosis, and abnormal piriformis muscle were identified as the three main etiologies of nerve entrapments. There were no statistically significant differences in transcranial motor evoked potential responses on the operated extremity side before and after decompression surgery or in the amplitude difference changes of TcMEP responses between the operated and non-operated extremity sides (p > 0.05). Dyspareunia visual analogue scale (VAS) scores showed a significant decrease at the first month postoperatively (p-value = 0.027). Conclusions: Integrating intraoperative neurophysiological monitoring into laparoscopy facilitates the monitoring of the patient’s motor function and prevents both permanent and transient nerve damage during pelvic nerve decompression surgery. This technique holds promise in enhancing surgical safety and preserving pelvic nerve function. The study was registered at https://clinicaltrials.gov (registration number NCT06009640).","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136096051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liuguang Zhang, Romualdo Sciorio, Yuhu Li, Ning Li
Background: Prolonged pretreatment time may be harmful to frozen embryo’s developmental potential. This study was conducted to evaluate the effect of different equilibration times on the clinical and neonatal outcomes of frozen-warmed blastocyst transfer. Methods: This is a retrospective study based on data collected from our medical records from March 2018 to March 2022 and including a total of 763 expanded blastocysts from 538 warming blastocyst cycles. These cycles were divided into two groups according to the equilibration time: (A) 6–7 minutes, and (B) 9–10 minutes. The survival rate, clinical, and neonatal outcomes were investigated. Results: The survival, implantation, and clinical pregnancy rates of vitrified-warmed shrinkage blastocyst were not different between the two groups. Other variables analyzed including live birth, multiple gestation, and neonatal outcomes were similar between the two groups. Conclusions: The results of this study illustrated that vitrification of artificially collapsed blastocysts with a shorter equilibration time (6–7 minutes) and pre-vitrification is able to lead to similar clinical and neonatal outcomes in patients undergoing assisted reproductive technology (ART).
{"title":"Effect of Shorter Pretreatment Time on Clinical and Neonatal Outcomes in Human Blastocysts Vitrification after Artificial Shrinkage","authors":"Liuguang Zhang, Romualdo Sciorio, Yuhu Li, Ning Li","doi":"10.31083/j.ceog5009197","DOIUrl":"https://doi.org/10.31083/j.ceog5009197","url":null,"abstract":"Background: Prolonged pretreatment time may be harmful to frozen embryo’s developmental potential. This study was conducted to evaluate the effect of different equilibration times on the clinical and neonatal outcomes of frozen-warmed blastocyst transfer. Methods: This is a retrospective study based on data collected from our medical records from March 2018 to March 2022 and including a total of 763 expanded blastocysts from 538 warming blastocyst cycles. These cycles were divided into two groups according to the equilibration time: (A) 6–7 minutes, and (B) 9–10 minutes. The survival rate, clinical, and neonatal outcomes were investigated. Results: The survival, implantation, and clinical pregnancy rates of vitrified-warmed shrinkage blastocyst were not different between the two groups. Other variables analyzed including live birth, multiple gestation, and neonatal outcomes were similar between the two groups. Conclusions: The results of this study illustrated that vitrification of artificially collapsed blastocysts with a shorter equilibration time (6–7 minutes) and pre-vitrification is able to lead to similar clinical and neonatal outcomes in patients undergoing assisted reproductive technology (ART).","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136096052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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