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Analysis of risk factors and construction and validation of a predictive model for determining the risk of endometrial cancer in postmenopausal patients with abnormal uterine bleeding 绝经后子宫异常出血患者发生子宫内膜癌的危险因素分析及预测模型的构建与验证
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.077
The data of 174 postmenopausal patients with abnormal uterine bleeding admitted were assessed to determine associated risk factors and develop and validate a prediction model to evaluate the risk of endometrial cancer in these patients. The patients were divided into a study group and a control group, among which 62 patients were diagnosed with endometrial cancer. A binary logistic regression analysis model using multifactorial regression analysis was established, and a column line graph of the prediction model was created using the R software. The model’s goodness-of-fit test was performed using the Hosmer-Lemeshow test, and SPSS (version 27, International Business Machines Corporation, Armonk, NY, USA) was used to plot the receiver operating characteristic (ROC) curve to evaluate the model’s predictive value. Binary logistic multifactorial regression analysis revealed that elevated body mass index (BMI), human epididymal protein 4 (HE4), cancer antigen 125 (CA125), combined fibroids and thickened endometrial cancer were risk factors for endometrial cancer in patients with abnormal postmenopausal uterine bleeding, based on which a probability model for predicting the risk of developing endometrial cancer in patients with abnormal postmenopausal uterine bleeding was constructed, and represented as P = 1/[1 + exp (4.227 − 4.594X1 − 2.029X5 − 1.165X6 − 1.817X7 − 2.080X8)]. In addition, the goodness-of-fit test, assessed using Hosmer and Lemeshow, yielded an χ2 value of 14.253 and a p-value of 0.075. Furthermore, the ROC curve analysis demonstrated an area under the curve (AUC) of 0.993 (95% confidence interval (CI), 0.892–0.974; p < 0.05). In conclusion, elevated BMI, HE4 and CA125, along with the presence of combined fibroids and thickened endometrial lining, were identified as significant risk factors for endometrial cancer in postmenopausal patients with abnormal uterine bleeding. The risk prediction model developed in this study provides a scientifically sound approach to assess the risk of endometrial cancer in these patients.
对174例绝经后子宫异常出血患者的资料进行评估,以确定相关危险因素,并建立和验证预测模型,以评估这些患者发生子宫内膜癌的风险。将患者分为研究组和对照组,其中诊断为子宫内膜癌的患者62例。采用多因素回归分析建立二元logistic回归分析模型,并利用R软件绘制预测模型的柱线图。采用Hosmer-Lemeshow检验对模型进行拟合优度检验,并采用SPSS(第27版,International Business Machines Corporation, Armonk, NY, USA)绘制受试者工作特征(ROC)曲线来评价模型的预测值。二元logistic多因素回归分析结果显示,体质指数(BMI)升高、人附睾蛋白4 (HE4)、癌抗原125 (CA125)、合并肌瘤和子宫内膜癌增厚是绝经后异常子宫出血患者发生子宫内膜癌的危险因素,并在此基础上构建了绝经后异常子宫出血患者发生子宫内膜癌的概率模型。用P = 1/[1 + exp(4.227−4.594X1−2.029X5−1.165X6−1.817X7−2.080X8)]表示。此外,采用Hosmer和Lemeshow进行拟合优度检验,其χ2值为14.253,p值为0.075。此外,ROC曲线分析显示曲线下面积(AUC)为0.993(95%置信区间(CI), 0.892-0.974; p <0.05)。综上所述,BMI、HE4、CA125升高以及合并肌瘤和子宫内膜增厚是绝经后子宫异常出血患者发生子宫内膜癌的重要危险因素。本研究建立的风险预测模型为评估这些患者发生子宫内膜癌的风险提供了一种科学合理的方法。
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引用次数: 0
iTRAQ-based proteomics analysis reveals novel candidates for platinum resistance of epithelial ovarian cancer 基于itraq的蛋白质组学分析揭示了上皮性卵巢癌铂耐药的新候选物
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.074
Platinum-based chemotherapy is commonly used in the treatment of various cancers, including epithelial ovarian cancer (EOC). However, in EOC, chemotherapy failure is mainly caused by platinum resistance. In this present study, we aimed to identify novel biomarkers for predicting platinum chemosensitivity. Fresh specimens of 16 serous high-grade ovarian cancer (HGSC) cases were collected during cytoreductive surgery. Isobaric tags were used to identify differentially expressed proteins in platinum-resistant samples (n = 8) and platinum-sensitive samples (n = 8). Compared to platinum-sensitive samples, 741 significantly differentially expressed proteins were detected, of which 325 were upregulated and 416 were downregulated. To validate the isobaric tags for relative and absolute quantification (iTRAQ) method, western blotting was performed on two upregulated proteins, angiomotin-like protein 1 (AMOTL1) and Lumican. The results showed that platinum-resistant tumor samples expressed significantly higher levels of AMOTL1 and Lumican than platinum-sensitive tumor samples. Altogether, we identified candidate proteins related to platinum resistance in ovarian cancer. Both AMOTL1 and Lumican seem to be promising biomarkers that could distinguish between platinum-resistant and platinum-sensitive EOC.
铂基化疗通常用于治疗各种癌症,包括上皮性卵巢癌(EOC)。然而,在EOC中,化疗失败主要是由铂耐药性引起的。在本研究中,我们旨在寻找新的生物标志物来预测铂的化学敏感性。本文收集了16例浆液性高级别卵巢癌(HGSC)的新鲜标本。利用等压标签对铂耐药样品(n = 8)和铂敏感样品(n = 8)中的差异表达蛋白进行鉴定,与铂敏感样品相比,检测到741个显著差异表达蛋白,其中325个表达上调,416个表达下调。为了验证相对和绝对定量等压标记(iTRAQ)方法,对两个上调蛋白,血管平动素样蛋白1 (AMOTL1)和Lumican进行了western blotting。结果显示,铂耐药肿瘤样品的AMOTL1和Lumican表达水平明显高于铂敏感肿瘤样品。总之,我们确定了与卵巢癌铂耐药相关的候选蛋白。AMOTL1和Lumican似乎都是有前途的生物标志物,可以区分铂耐药和铂敏感的EOC。
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引用次数: 0
Development of a novel transcription factor signature for accurate cervical cancer prognosis 一种新的转录因子特征的发展,准确的宫颈癌预后
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.079
Cervical cancer (CC) is a leading cause of cancer-related deaths in women. During tumor development, transcriptional factors regulate the transcription of proto-oncogenes and tumor suppressor genes. We examined the possibility of using transcription factors as prognostic biomarkers for patients with cervical cancer. Single-cell RNA-sequencing data were downloaded from the Gene Expression Omnibus database to identify specific activated transcription factors in different types of cells from CC. Publicly available bulk RNA-sequencing and clinical data of CC were obtained to identify associated prognostic transcription factors using survival analysis and the random survival forest methods. Accuracy and effectiveness of the established transcription factor-related predictive random survival forest model were verified using training and test datasets. We identified specific activated transcription factors in tissue cells of cervical cancer. A 3-transcription factors (PBX4 (PBX Homeobox 4), EBF2 (EBF Transcription Factor 2) and ZNF696 (Zinc Finger Protein 696)) prognostic signature for patients with cervical cancer was constructed showing good survival prediction. Gene function enrichment analysis indicated a correlation between the prognostic characteristics and different signaling pathways associated with cancer. Using the random survival forest model based on the 3-transcription factor signature, patients with cervical cancer were stratified into low- and high-risk groups with significant variations in overall survival (p < 0.001). The area under the curve of the time-dependent receiver operator characteristic revealed a strong predictive accuracy for training and test datasets of the corresponding signature. CC has cellular heterogeneity of transcriptional activation. Our analyses provide a novel transcription factor-associated prognostic model for CC. These transcription factors could be used as effective prognostic biomarkers and potential therapeutic targets for patients with cervical cancer.
宫颈癌(CC)是妇女癌症相关死亡的主要原因。在肿瘤发展过程中,转录因子调控原癌基因和抑癌基因的转录。我们研究了使用转录因子作为宫颈癌患者预后生物标志物的可能性。从Gene Expression Omnibus数据库下载单细胞rna测序数据,以鉴定不同类型CC细胞中的特异性活化转录因子,并获得公开的CC大量rna测序和临床数据,以使用生存分析和随机生存森林方法鉴定相关的预后转录因子。使用训练和测试数据集验证了所建立的转录因子相关预测随机生存森林模型的准确性和有效性。我们在宫颈癌组织细胞中发现了特异性的活化转录因子。构建了3个转录因子(PBX4 (PBX Homeobox 4)、EBF2 (EBF转录因子2)和ZNF696(锌指蛋白696))对宫颈癌患者的预后特征,显示出良好的生存预测。基因功能富集分析提示预后特征与不同的肿瘤相关信号通路之间存在相关性。采用基于3-转录因子特征的随机生存森林模型,将宫颈癌患者分层为低危组和高危组,总生存率存在显著差异(p <0.001)。随时间变化的接收机算子特征曲线下面积对相应特征的训练和测试数据集具有较强的预测精度。CC具有转录激活的细胞异质性。我们的分析提供了一种新的与CC相关的转录因子预后模型,这些转录因子可以作为宫颈癌患者有效的预后生物标志物和潜在的治疗靶点。
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引用次数: 0
Chikusetsusaponin Iva induces apoptosis and inhibits proliferation in endometrial cancer via promoting reactive oxygen species (ROS) production 菊糖皂苷Iva通过促进活性氧(ROS)的产生诱导子宫内膜癌细胞凋亡和抑制细胞增殖
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.068
Endometrial carcinoma (EC) is an epithelial malignant tumor that occurs in the endometrium. It is of great significance to explore new targets for improving the prognosis of endometrial cancer. Chikusetsusaponin Iva (CHI) is a plant compound extracted from Panacis japonica which has multiple biological activities, including anti-inflammation and anti-tumor effects. However, its possible effects on EC are unclear. Herein, we found that CHI inhibited EC cell proliferation and cell cycle, confirmed by colony formation and flow cytometry (FCM) assays. The results further confirmed that CHI stimulated the apoptosis of EC cells. Furthermore, we noticed that CHI treatment induced reactive oxygen species (ROS) in EC cells. In addition, it could suppress the Microtubule-Associated Protein Kinase (MAPK) pathway in EC cells, thereby affecting cell proliferation and apoptosis. Therefore, CHI could serve as a potential drug for EC treatment.
子宫内膜癌(EC)是发生在子宫内膜的上皮性恶性肿瘤。探索改善子宫内膜癌预后的新靶点具有重要意义。Chikusetsusaponin Iva (CHI)是从日本人参中提取的一种具有抗炎、抗肿瘤等多种生物活性的植物化合物。然而,它对EC的可能影响尚不清楚。在此,我们发现CHI抑制EC细胞的增殖和细胞周期,通过集落形成和流式细胞术(FCM)实验证实了这一点。结果进一步证实了CHI刺激EC细胞凋亡。此外,我们注意到CHI处理诱导EC细胞的活性氧(ROS)。此外,它可以抑制EC细胞的微管相关蛋白激酶(microtubuleassociated Protein Kinase, MAPK)通路,从而影响细胞的增殖和凋亡。因此,CHI可作为治疗EC的潜在药物。
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引用次数: 0
The role of proteasome inhibitor MG132 in cisplatin resistant ovarian cancer 蛋白酶体抑制剂MG132在顺铂耐药卵巢癌中的作用
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.055
Platinum based combined chemotherapy have been proved to be the most effective drugs for the ovarian cancer treatment, but it is difficult to treat cisplatin resistant ovarian cancer. Carbobenzoxy-L-leucy-L-Leucyl-L-Leucinal (MG132) is a reversible tripeptide aldehyde proteasome inhibitor, the purpose of this study was to observe the effect of MG132 on cisplatin resistant ovarian cancer SKOV3 cell and OVCAR-3 cell the expression of autophagy and apoptosis related factors. The cells were divided into four groups: control, MG132, cisplatin, MG132 and cisplatin combination groups. Cell growth was detected by cell counting kit-8 (CCK-8) assay. The apoptotic rates of cells and the cell cycle were detected by a flow cytometer (FCM). The Beclin1, Light chain 3 (LC3) and Caspase3 was detected by western blotting and reverse transcription-polymerase chain reaction (RT-PCR). Detection of apoptotic bodies by 4,6-Diamidino-2-phenylindole dihydrochloride (DAPI) staining. CCK-8 assay demonstrated that cell survival rate in the combination groups was lower than monotherapy group. FCM showed that apoptotic rates in the combination groups was higher than monotherapy group (p < 0.05). Western blotting and RT-PCR detected that Beclin1, LC3 and Caspase3 in the combination group were higher than monotherapy group (p < 0.05). DAPI staining showed the production of apoptotic bodies in the combination group and MG132 group. In conclusion, MG132 can inhibit the growth of cisplatin resistant ovarian cancer SKOV3 and OVCAR-3 cells, its inhibitory effect is related to apoptosis and autophagy, and it is expected to be a synergistic antitumor effect with cisplatin.
铂类联合化疗已被证明是治疗卵巢癌最有效的药物,但难以治疗顺铂耐药的卵巢癌。Carbobenzoxy-L-leucy-L-Leucyl-L-Leucinal (MG132)是一种可逆性三肽醛蛋白酶体抑制剂,本研究旨在观察MG132对顺铂耐药卵巢癌SKOV3细胞和OVCAR-3细胞自噬和凋亡相关因子表达的影响。将细胞分为4组:对照组、MG132、顺铂组、MG132与顺铂联合组。细胞计数试剂盒-8 (CCK-8)法检测细胞生长情况。流式细胞仪检测细胞凋亡率和细胞周期。采用western blotting和逆转录聚合酶链反应(RT-PCR)检测Beclin1、轻链3 (LC3)和Caspase3。4,6-二氨基-2-苯基吲哚二盐酸盐(DAPI)染色检测凋亡小体。CCK-8检测显示,联合治疗组细胞存活率低于单药治疗组。FCM显示,联合用药组细胞凋亡率高于单药治疗组(p <0.05)。Western blotting及RT-PCR检测联合治疗组Beclin1、LC3、Caspase3水平高于单药治疗组(p <0.05)。DAPI染色显示联合组和MG132组均有凋亡小体产生。综上所述,MG132可抑制顺铂耐药卵巢癌SKOV3和OVCAR-3细胞的生长,其抑制作用与细胞凋亡和自噬有关,有望与顺铂协同抗肿瘤。
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引用次数: 0
Identification of a 3-cuproptosis-associated-lncRNA-signature that predicts the prognosis of endometrial cancer patients 鉴定预测子宫内膜癌患者预后的3- cuproplasia -associated- lncrna标记
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.073
Endometrial carcinoma is a common malignancy among peri-menopausal and menopausal females, even among some women of reproductive age. The treatment approach to endometrial cancer is a platinum-based regimen combined with paclitaxel, which may be unsatisfactory. A copper-mediated binding of lipoylated constituents of tricarboxylic acid cycle has been found recently, which brings about lethal protein stress and cell death, a phenomenon termed cuproptosis. As an innovative method of cell death, cuproptosis could be designed for cancer treatment and many aspects remain unaddressed. In our study, clinical, genomic, and mutational profiles of uterine corpus endometrial carcinoma (UCEC) patients were obtained from The Cancer Genome Atlas and cuproptosis-related genes and long non-coding RNAs (lncRNAs) were acquired thereafter. Co-expression and Cox regression analyses led to the development of a prognostic signature. Patients were separated into two groups (high- and low-risk groups) and survival analysis, risk score calculation, multivariate Cox analysis, and subgroup validation were implemented to determine the utility of the signature. Differentially expressed genes (DEGs) between the two groups were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses. Immune-related functional analysis and tumor mutation burden (TMB) analysis were performed. Three independent high-risk cuproptosis-related lncRNAs were finally confirmed and incorporated into the prognostic model, including BX322234.1, LINC01545 and LINC01224. Areas under the curve for 1-, 3- and 5-year survival were 0.717, 0.688 and 0.714, respectively. The risk model served as an independent factor to predict prognosis. Patients with high-risk and low TMB tended to have poor prognoses. Enrichment analysis demonstrated that DEGs were mostly associated with immune responses. In conclusion, the three high-risk cuproptosis-related lncRNAs could predict the prognosis of UCEC patients with higher power, where patients with high-risk and low TMB are prone to have the worst prognosis, which broadens the pattern of clinical treatment and applications.
子宫内膜癌是一种常见的恶性肿瘤在围绝经期和绝经期女性,甚至在一些育龄妇女。子宫内膜癌的治疗方法是铂基方案联合紫杉醇,这可能不令人满意。最近发现了一种铜介导的三羧酸循环脂酰化成分的结合,这种结合会导致致命的蛋白质应激和细胞死亡,这种现象被称为铜还原。作为一种创新的细胞死亡方法,铜增生可以设计用于癌症治疗,但许多方面仍有待解决。在我们的研究中,我们从癌症基因组图谱中获得了子宫肌体子宫内膜癌(UCEC)患者的临床、基因组和突变谱,并获得了cuprosiosis相关基因和长链非编码rna (lncRNAs)。共表达和Cox回归分析导致预后特征的发展。将患者分为两组(高风险组和低风险组),并进行生存分析、风险评分计算、多变量Cox分析和亚组验证,以确定签名的效用。对两组差异表达基因(DEGs)进行基因本体和京都基因与基因组百科全书富集分析。进行免疫相关功能分析和肿瘤突变负荷(TMB)分析。最终确认了3个独立的高风险铜增生相关lncrna,并将其纳入预后模型,分别为BX322234.1、LINC01545和LINC01224。1年、3年和5年生存曲线下面积分别为0.717、0.688和0.714。风险模型是预测预后的独立因素。高风险和低TMB患者往往预后较差。富集分析表明,deg主要与免疫应答相关。综上所述,这3种高风险铜肾病相关lncrna能够以较高的功率预测UCEC患者的预后,其中高风险、低TMB的患者往往预后最差,拓宽了临床治疗和应用的模式。
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引用次数: 0
Evaluation of colposcopy and LEEP results performed in gynecology and gynecological oncology surgery services 妇科和妇科肿瘤外科服务中阴道镜检查和LEEP结果的评估
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.071
The diagnostic performances of colposcopy and Loop Electrosurgical Excision Proce-dure (LEEP) results in gynecology and gynecological oncology surgical services were evaluated. Their differences regarding biopsy numbers were investigated. The other objective was to examine factors associated with recurrence and residual lesions after LEEP. This study included the cytology results of 1217 women undergone colposcopy at our hospital colposcopy unit between 2012 and 2017. The colposcopicsensitivity, specificity, positive predictive value and negative predictive value were calculated based on LEEP results. The qualitative data were compared by employing Chi-square and Fisher’s exact tests. χ2 predicted the relation between age and number of involved margins with recurrent disease. Moreover, it predicted the link between age, cytology and number of relevant margins with residual disease. There was no significant difference regarding the diagnostic performance of two groups when LEEP was determined as the gold standard against colposcopy. The diagnostic accuracy rate was 1.83 times higher when more than 2 biopsies were taken compared to 2 or fewer. A significant increase was observed in the residual rate among women having pre-LEEP high-risk human papillomavirus (HR-HPV) positive tests compared to those with HR-HPV negative tests (48.0% vs. 15.4%, p = 0.04). Women with ≥ High grade squamous intraepithelial lesion (HSIL)-positive margins in the first conization exhibited higher residual rates compared to those with High grade squamous intraepithelial lesion (LSIL)-positive margins (50.7% vs. 9.5%, p < 0.001). Patients ofpositive surgical margins, residual lesions and cervical intraepithelial neoplasia (CIN) with HPV 16 had higher probability of persistent HPV infection after conization. There was no significant difference pertaining to the diagnostic performance of two groups. HPV 16+ and the positive surgical margin were the predictive of recurrence.
评价阴道镜和环形电切术(LEEP)结果在妇科和妇科肿瘤外科服务中的诊断性能。研究了他们在活检次数方面的差异。另一个目的是检查与LEEP后复发和残留病变相关的因素。本研究纳入2012 - 2017年在我院阴道镜科室行阴道镜检查的1217例女性的细胞学结果。根据LEEP结果计算阴道镜敏感性、特异性、阳性预测值和阴性预测值。采用卡方检验和Fisher精确检验对定性资料进行比较。χ2预测年龄、受累切缘数与复发的关系。此外,它预测了年龄、细胞学和与残留疾病相关的边缘数量之间的联系。当LEEP被确定为对阴道镜检查的金标准时,两组的诊断性能无显著差异。2例以上活检的诊断准确率是2例以下活检的1.83倍。leep前高危人乳头瘤病毒(HR-HPV)检测阳性的妇女的残留率显著高于HR-HPV阴性的妇女(48.0%对15.4%,p = 0.04)。与高级别鳞状上皮内病变(LSIL)边缘阳性的女性相比,第一次穿刺时具有≥高级别鳞状上皮内病变(HSIL)阳性边缘的女性表现出更高的残留率(50.7% vs 9.5%, p <0.001)。手术切缘阳性、残留病变和宫颈上皮内瘤变(CIN)合并HPV 16的患者在锥形化后持续感染HPV的可能性更高。两组在诊断表现上无显著差异。HPV 16+和手术切缘阳性是复发的预测因素。
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引用次数: 0
Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy 超声引导下胸椎旁神经阻滞在乳房根治术中的应用
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.083
This research aims to investigate the effect of ultrasound-guided continuous thoracic paravertebral nerve block in patients undergoing radical mastectomy. Ninety-six patients who underwent radical mastectomy were equally divided into a study group (administered with a continuous thoracic paravertebral nerve block and general anesthesia) and a control group (given conventional general anesthesia) with a random number table. At T2–T4 (T2: immediate tracheal intubation; T3: at skin incision; T4: at extubation), mean artery pressure (MAP) and hear rate (HR) were significantly lower in the study group (p < 0.05); however, there was no significant difference in blood oxygen saturation (SpO2) between the two groups at different time points. At T2–T4, cortisol (Cor) levels were significantly lower in the study group (p < 0.05). At T0–T2, there was no significant difference in the levels of adrenocorticotropic hormone (ACTH) between the two groups. At T3–T4, the levels of ACTH in the study group were significantly lower (p < 0.05). There were no significant differences in blood pressure between the two groups at any time point. At the moment of discharge from the resuscitation room and 2 hours after surgery, the numerical rating scale (NRS) score in the study group was significantly reduced (p < 0.05). The incidence of adverse reactions in the study group was 10.42%; this was lower than that in the control group (33.33%) (p < 0.05). Finally, the use of fentanyl and propofol, and the frequency of analgesic pump use, were significantly lower in the study group (p < 0.05). Ultrasound-guided thoracic paravertebral nerve block can effectively maintain hemodynamic stability, improve the stress response, reduce postoperative pain, reduce the use of anesthetic drugs, and effectively control the incidence of adverse reactions in patients undergoing radical mastectomy.
本研究旨在探讨超声引导下连续胸椎旁神经阻滞在乳房根治术患者中的应用效果。96例接受根治性乳房切除术的患者平均分为研究组(给予连续胸椎旁神经阻滞和全身麻醉)和对照组(给予常规全身麻醉),采用随机数字表。在T2 - T4 (T2:立即气管插管;T3:皮肤切开;T4:拔管),研究组平均动脉压(MAP)和心率(HR)显著降低(p <两组在不同时间点血氧饱和度(SpO2)差异无统计学意义(p < 0.05)。T2-T4时,研究组皮质醇(Cor)水平显著降低(p <0.05)。T0-T2时,两组促肾上腺皮质激素(ACTH)水平差异无统计学意义。T3-T4时,研究组ACTH水平显著降低(p <0.05)。两组在任何时间点的血压均无显著差异。在复苏室出院时及术后2 h,研究组的数值评定量表(NRS)评分显著降低(p <0.05)。研究组不良反应发生率为10.42%,低于对照组的33.33% (p <0.05)。最后,研究组芬太尼和异丙酚的使用以及镇痛泵的使用频率均显著低于对照组(p <0.05)。超声引导下胸椎旁神经阻滞能有效维持血流动力学稳定,改善应激反应,减轻术后疼痛,减少麻醉药物的使用,有效控制乳房根治术患者不良反应的发生。
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引用次数: 0
Effects of different doses of esketamine on hemodynamic indexes, pain stress indexes, and VAS scores in patients with benign ovarian tumors undergoing laparoscopic resection induced by remifentanil 不同剂量艾氯胺酮对瑞芬太尼致卵巢良性肿瘤腹腔镜切除术患者血流动力学指标、疼痛应激指标及VAS评分的影响
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.082
This study aimed to investigate the effects of different doses of esketamine on hemodynamic indicators, pain stress indicators and Visual Analog Scale (VAS) scores in patients undergoing laparoscopic resection for benign ovarian tumors induced by remifentanil. A total of 110 patients with benign ovarian tumors scheduled for laparoscopic resection between June and December 2023 were included in the study and divided into three groups: Group A (35 cases), Group B (37 cases), and Group C (38 cases), based on their anesthesia regimen. Anesthesia induction for all groups included propofol, remifentanil, and cisatracurium. Group A received an intravenous dose of 0.8 mg/kg esketamine, Group B received 0.6 mg/kg esketamine and Group C did not receive esketamine. The results revealed statistically significant differences in average arterial pressure and heart rate at various time points within each group (p < 0.05), and significant differences were observed in Substance P (SP) and Prostaglandin E2 (PEG2) at three different time points within each group (p < 0.05). VAS scores during and after surgery at 6 and 12 hours significantly differed among the three groups (p < 0.05). There was a significant difference in awakening time among the three groups (p < 0.05). However, there were no statistically significant differences in the incidence of adverse reactions among the three groups (p > 0.05). In conclusion, both 0.6 mg/kg and 0.8 mg/kg doses of esketamine effectively prevented remifentanil-induced hyperalgesia in patients undergoing laparoscopic resection for benign ovarian tumors, significantly reducing patient pain. Notably, the 0.6 mg/kg dose of esketamine demonstrated better hemodynamic stability, promoted patient recovery, and showed superior clinical utility compared to the 0.8 mg/kg dose.
本研究旨在探讨不同剂量艾氯胺酮对瑞芬太尼致卵巢良性肿瘤腹腔镜切除术患者血流动力学指标、疼痛应激指标和视觉模拟评分(VAS)的影响。本研究将于2023年6月至12月行腹腔镜卵巢良性肿瘤切除术的患者共110例纳入研究,根据麻醉方案分为A组(35例)、B组(37例)和C组(38例)。所有组的麻醉诱导包括异丙酚、瑞芬太尼和顺阿曲库铵。A组静脉滴注艾氯胺酮0.8 mg/kg, B组静脉滴注艾氯胺酮0.6 mg/kg, C组不滴注艾氯胺酮。结果显示,各组各时间点平均动脉压和心率差异有统计学意义(p <P物质(SP)和前列腺素E2 (PEG2)在各组内3个不同时间点差异均有统计学意义(P <0.05)。三组患者术后6、12小时VAS评分差异有统计学意义(p <0.05)。三组患者苏醒时间差异有统计学意义(p <0.05)。但三组患者不良反应发生率比较,差异无统计学意义(p >0.05)。综上所述,0.6 mg/kg和0.8 mg/kg剂量的艾氯胺酮均能有效预防腹腔镜卵巢良性肿瘤切除术患者瑞芬太尼致痛觉过敏,显著减轻患者疼痛。值得注意的是,与0.8 mg/kg剂量相比,0.6 mg/kg剂量的艾氯胺酮表现出更好的血流动力学稳定性,促进了患者的康复,并显示出更好的临床效用。
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引用次数: 0
Identification of an immune-related metabolic gene signature to predict possible prognosis in endometrial cancer and reveals immune landscape feature 鉴定免疫相关代谢基因标记以预测子宫内膜癌可能的预后并揭示免疫景观特征
4区 医学 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 DOI: 10.22514/ejgo.2023.072
The immunotherapy of endometrial cancer (EC) has gradually attracted attention and metabolic reprogramming is associate with tumor immune infiltration. Our goal was to use proteome analysis to examine the role of immune-related metabolic genes (IRMGs) in EC. Data-independent acquisition mass spectrometry (DIA-MS) was performed on 20 EC patients, consisting of 10 high-grade and 10 low-grade cancer tissues. IRMGs were screened using Spearman correlation, and an immune-related metabolic prognosis signature (IRMPS) was constructed based on the Cancer Genome Atlas-Uterine Corpus Endometrioid Carcinoma (TCGA-UCEC) cohort using the least absolute shrinkage and selection operator (LASSO) regression analysis. We also investigated differences between different risk groups in terms of prognostic value, clinical potency, immune characteristics and therapy response. In total, 285 differentially expressed genes (DEGs) were acquired via DIA-MS. Subsequently, metabolic-DEGs and immune-DEGs were analyzed by Spearman correlation to identify 41 IRMGs. Finally, seven IRMGs, including NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 2 (NDUFA2), AMPK-alpha2 (PRKAA2), syntaxin binding protein 1 (STXBP1), NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 9 (NDUFB9), ribosomal protein S27-like (RPS27L), lysolecithin acyltransferase 2 (LPCAT2) and uridine monophosphate synthetase (UMPS) were identified to establish a prognosis signature. The risk score was determined as an independent prognostic indicator, and patients in the IRMPS-high group was strong linked with adverse prognosis for EC. Additionally, IRMPS was closely related with tumor immune infiltration. Notably, the IRMPS-low group had better immune checkpoint inhibitors (ICI) treatment response and more sensitive to chemotherapy drugs. In conclusion, IRMPS can serve as a precise prognostic tool to guide the personalized treatment of EC patients.
子宫内膜癌的免疫治疗逐渐受到重视,代谢重编程与肿瘤免疫浸润有关。我们的目标是使用蛋白质组学分析来检查免疫相关代谢基因(irmg)在EC中的作用。数据独立采集质谱(DIA-MS)分析了20例EC患者,包括10例高级别癌组织和10例低级别癌组织。采用Spearman相关筛选irmg,并基于Cancer Genome atlas - Endometrioid Carcinoma (TCGA-UCEC)队列,采用最小绝对收缩和选择算子(LASSO)回归分析构建免疫相关代谢预后特征(IRMPS)。我们还研究了不同风险组在预后价值、临床效力、免疫特性和治疗反应方面的差异。共获得285个差异表达基因(deg)。随后,通过Spearman相关分析代谢- deg和免疫- deg,鉴定出41个irmg。最后,鉴定出NADH脱氢酶(泛素)1 α亚复合物亚基2 (NDUFA2)、AMPK-alpha2 (PRKAA2)、合成素结合蛋白1 (STXBP1)、NADH脱氢酶(泛素)1 β亚复合物亚基9 (NDUFB9)、核糖体蛋白s27样(RPS27L)、溶索磷脂酰基转移酶2 (LPCAT2)和尿苷单磷酸合成酶(UMPS)等7个irmg,以建立预后标志。风险评分被确定为独立的预后指标,irmps高组患者与EC的不良预后密切相关。此外,IRMPS与肿瘤免疫浸润密切相关。值得注意的是,irmps低组有更好的免疫检查点抑制剂(ICI)治疗反应,对化疗药物更敏感。综上所述,IRMPS可以作为一种精确的预后工具来指导EC患者的个性化治疗。
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European journal of gynaecological oncology
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