Uterus corpus endometrial cancer (UCEC) is associated with a high mortality rate. In this study, we examined the impact of long intergenic non-protein coding RNA 01234 (LINC01234) in the diagnosis and survival of UCEC using an open high-throughput sequencing database. The association between LINC01234 expression and UCEC clinical features was determined using the Wilcoxon rank sum test, logistic regression and Cox regression. To assess the classification effectiveness of LINC01234 in UCEC, the area under the receiver operating characteristic (ROC) curve (AUC) was performed. Then, Kaplan-Meier analysis was performed to determine the prognostic significance of LINC01234 in UCEC. The underlying regulatory mechanisms of LIN01234 were assessed using the Gene set enrichment analysis (GSEA), and the influence on immune infiltration cells was tested by the Spearman correlation method. Datebases showed LINC01234 was up-regulated in UCEC and associated with poor clinicopathologic characteristics. What’s more quantitative real time polymerase chain reaction (qRT-PCR) analyse of clinical tissue specimens, LINC01234 was actually high expression in UCEC. The results showed an AUC of 0.726, indicating that LINC01234 had a significant diagnostic value. Further, Kaplan-Meier analysis showed that high LINC01234 expression was associated with poorer progress free interval (PFI) (hazard ratio (HR): 1.68, 95% confidence interval (CI): 1.18–2.39, p = 0.004), disease-specific survival (DSS) (HR: 2.17, 95% CI: 1.29–3.67, p = 0.004), overall survival (OS) (HR: 1.81, 95% CI: 1.19–2.75, p = 0.005). Cox regression analysis showed LINC01234 expression was an independent factor for DSS. Pathway enrichment and immune infiltration analysis showed the most likely mechanisms that LINC01234 promoted tumor progression. LINC01234 demonstrated diagnostic and prognostic potential in UCEC and was shown to exert its effects via various mechanisms, including cell proliferation, spermatogenesis, angiogenesis and immune response in the tumor microenvironment, to promote tumor progression; thus, indicating that it could be a target for treating UCEC.
子宫内膜癌(UCEC)具有很高的死亡率。在这项研究中，我们使用开放的高通量测序数据库检测了长基因间非蛋白编码RNA 01234 (LINC01234)在UCEC诊断和生存中的影响。采用Wilcoxon秩和检验、logistic回归和Cox回归确定LINC01234表达与UCEC临床特征的相关性。为评价LINC01234在UCEC中的分类效果，采用受试者工作特征(ROC)曲线下面积(AUC)法。然后进行Kaplan-Meier分析以确定LINC01234在UCEC中的预后意义。通过基因集富集分析(GSEA)评估LIN01234的潜在调控机制，并通过Spearman相关法检测其对免疫浸润细胞的影响。数据库显示，LINC01234在UCEC中表达上调，并与较差的临床病理特征相关。通过对临床组织标本的定量实时聚合酶链反应(qRT-PCR)分析，发现LINC01234在UCEC中确实是高表达的。结果显示，AUC为0.726，表明LINC01234具有显著的诊断价值。此外，Kaplan-Meier分析显示，LINC01234高表达与较差的无进展间期(PFI)(风险比(HR): 1.68, 95%可信区间(CI): 1.18-2.39, p = 0.004)、疾病特异性生存(DSS) (HR: 2.17, 95% CI: 1.29-3.67, p = 0.004)、总生存(OS) (HR: 1.81, 95% CI: 1.19-2.75, p = 0.005)相关。Cox回归分析显示，LINC01234表达是影响DSS的独立因素。途径富集和免疫浸润分析显示LINC01234促进肿瘤进展的可能机制。LINC01234在UCEC中具有诊断和预后潜力，并通过肿瘤微环境中的细胞增殖、精子发生、血管生成和免疫应答等多种机制发挥作用，促进肿瘤进展，提示其可能是治疗UCEC的靶点。
{"title":"Overexpression of LINC01234 in uterus corpus endometrial cancer correlated with poor clinicopathological characteristics: a study based on TCGA data","authors":"","doi":"10.22514/ejgo.2023.057","DOIUrl":"https://doi.org/10.22514/ejgo.2023.057","url":null,"abstract":"Uterus corpus endometrial cancer (UCEC) is associated with a high mortality rate. In this study, we examined the impact of long intergenic non-protein coding RNA 01234 (LINC01234) in the diagnosis and survival of UCEC using an open high-throughput sequencing database. The association between LINC01234 expression and UCEC clinical features was determined using the Wilcoxon rank sum test, logistic regression and Cox regression. To assess the classification effectiveness of LINC01234 in UCEC, the area under the receiver operating characteristic (ROC) curve (AUC) was performed. Then, Kaplan-Meier analysis was performed to determine the prognostic significance of LINC01234 in UCEC. The underlying regulatory mechanisms of LIN01234 were assessed using the Gene set enrichment analysis (GSEA), and the influence on immune infiltration cells was tested by the Spearman correlation method. Datebases showed LINC01234 was up-regulated in UCEC and associated with poor clinicopathologic characteristics. What’s more quantitative real time polymerase chain reaction (qRT-PCR) analyse of clinical tissue specimens, LINC01234 was actually high expression in UCEC. The results showed an AUC of 0.726, indicating that LINC01234 had a significant diagnostic value. Further, Kaplan-Meier analysis showed that high LINC01234 expression was associated with poorer progress free interval (PFI) (hazard ratio (HR): 1.68, 95% confidence interval (CI): 1.18–2.39, p = 0.004), disease-specific survival (DSS) (HR: 2.17, 95% CI: 1.29–3.67, p = 0.004), overall survival (OS) (HR: 1.81, 95% CI: 1.19–2.75, p = 0.005). Cox regression analysis showed LINC01234 expression was an independent factor for DSS. Pathway enrichment and immune infiltration analysis showed the most likely mechanisms that LINC01234 promoted tumor progression. LINC01234 demonstrated diagnostic and prognostic potential in UCEC and was shown to exert its effects via various mechanisms, including cell proliferation, spermatogenesis, angiogenesis and immune response in the tumor microenvironment, to promote tumor progression; thus, indicating that it could be a target for treating UCEC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115082","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}
Endometrial cancer (EC) is one of the most common malignancies of the female reproductive system, but our understanding of the tumor microenvironment of EC remains unclear. Programmed cell death (PCD) plays an important role in the genesis and progression of tumors. Necroptosis is a novel form of PCD that does not rely on the caspase system. However, the role of necroptosis in EC is unclear. Transcriptome data of endometrial cancer were downloaded from The Cancer Genome Atlas (TCGA) database and log2 conversion was performed. Expression analysis and correlation analysis were performed to explore necroptosis gene expression and interaction in EC. Lasso regression was used to construct necroptosis-related prognostic signature. Finally, immunocorrelation analysis and single cell sequencing analysis were used to explore the significance of this signature in EC tumor microenvironment. A total of 15 of the 17 necroptosis genes were differentially expressed in EC. Subsequently, necroptosis related prognostic signature was constructed through Lasso regression. Riskscore = (−0.0999) × Toll-likereceptor4 (TLR4) + (−0.0528) × tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) + (0.1208) × Enhancer of Zeste Homolog 2 (EZH2) + (−0.004) × N-myc Down-stream Regulated Gene 2 (NDRG2). EC patients can be divided into high-risk group and low-risk group based on the median riskscore and the high-risk group has a worse prognosis. Survival analysis showed a worse prognosis for patients in the high-risk group (p < 0.05). Immunomicroenvironment analysis showed a significant negative correlation between risk score and infiltration levels of B cells, CD4+ T cells, CD8+ T cells, Endothelial cells, macrophages, and NK cells. Subsequent cell experiments showed that knockdown of the key gene EZH2 in signature significantly reduced the invasion, migration and healing abilities of EC cell lines, proving that EZH2 is a promising marker of EC.
{"title":"Transcriptome analysis constructed the necroptosis associated prognostic signature in endometrial cancer and identified EZH2 as a potential biomarker","authors":"","doi":"10.22514/ejgo.2023.060","DOIUrl":"https://doi.org/10.22514/ejgo.2023.060","url":null,"abstract":"Endometrial cancer (EC) is one of the most common malignancies of the female reproductive system, but our understanding of the tumor microenvironment of EC remains unclear. Programmed cell death (PCD) plays an important role in the genesis and progression of tumors. Necroptosis is a novel form of PCD that does not rely on the caspase system. However, the role of necroptosis in EC is unclear. Transcriptome data of endometrial cancer were downloaded from The Cancer Genome Atlas (TCGA) database and log2 conversion was performed. Expression analysis and correlation analysis were performed to explore necroptosis gene expression and interaction in EC. Lasso regression was used to construct necroptosis-related prognostic signature. Finally, immunocorrelation analysis and single cell sequencing analysis were used to explore the significance of this signature in EC tumor microenvironment. A total of 15 of the 17 necroptosis genes were differentially expressed in EC. Subsequently, necroptosis related prognostic signature was constructed through Lasso regression. Riskscore = (−0.0999) × Toll-likereceptor4 (TLR4) + (−0.0528) × tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) + (0.1208) × Enhancer of Zeste Homolog 2 (EZH2) + (−0.004) × N-myc Down-stream Regulated Gene 2 (NDRG2). EC patients can be divided into high-risk group and low-risk group based on the median riskscore and the high-risk group has a worse prognosis. Survival analysis showed a worse prognosis for patients in the high-risk group (p < 0.05). Immunomicroenvironment analysis showed a significant negative correlation between risk score and infiltration levels of B cells, CD4+ T cells, CD8+ T cells, Endothelial cells, macrophages, and NK cells. Subsequent cell experiments showed that knockdown of the key gene EZH2 in signature significantly reduced the invasion, migration and healing abilities of EC cell lines, proving that EZH2 is a promising marker of EC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115276","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}
To assess long-term results of surgical resections of the sporadic extra-large pelvi-perineal soft tissue tumors, a retrospective series of patients referred to the National Cancer Institute 2001–2022 (tertiary care cancer university hospital in Egypt) was designed. Thirteen patients (3 males) averaged age 57 years had large 29 cm (18–38) pelvi-perineal tumors (10 to the paraanal ischiorectal spaces and 3 to the vulva) plus upper intra-abdominal extensions in 9 patients (69%). Symptoms were nonspecific with delayed presentation that averaged 22-month. The entire underwent combined open abdomino-perineal approach to widely en masse resect tumors plus infiltrated organs. No downsizing hormonal treatment was offered preoperative. Main outcome measures were disease free survival, recurrence pattern and salvage. Extensive pelvic and perineal tumor resection is tough and meticulous but straightforward with minor (Clavien-Dindo Classification (CDC) grade I & II) early and delayed morbidity. Resection extends to hysterectomy, vaginectomy and vascular resection. Histopathology plus immunohistochemistry showed 9-aggressive angiomyxoid tumors (AA), 2-fibromatosis and 2-neurofibromas (NF). Margins of resection are all adequate (R0) except for 2 (Resection margin 1 (R1)). After 50-month median follow up, 8/13 total series (61.5%) were surviving free of disease. 4/9 of AA (44%) had local perineal and/or pelvic recurrences (13–37 months) and all were amenable to curative salvage resections; while, 1/2 patients with fibromatosis died of disseminated peritoneal relapses. No systemic metastases are noticed. Extensive tumors meticulous surgery with experienced pelvic dissection and resection could offer alone long term cure even after recurrences with minor morbidity in a good percent. Fertility sparing resection is not oncologically safe because of the frequent uterine and ovarian invasions.
{"title":"The infrequent large pelvi-perineal tumors as a surgical dilemma: en bloc resection and long-term results","authors":"","doi":"10.22514/ejgo.2023.052","DOIUrl":"https://doi.org/10.22514/ejgo.2023.052","url":null,"abstract":"To assess long-term results of surgical resections of the sporadic extra-large pelvi-perineal soft tissue tumors, a retrospective series of patients referred to the National Cancer Institute 2001–2022 (tertiary care cancer university hospital in Egypt) was designed. Thirteen patients (3 males) averaged age 57 years had large 29 cm (18–38) pelvi-perineal tumors (10 to the paraanal ischiorectal spaces and 3 to the vulva) plus upper intra-abdominal extensions in 9 patients (69%). Symptoms were nonspecific with delayed presentation that averaged 22-month. The entire underwent combined open abdomino-perineal approach to widely en masse resect tumors plus infiltrated organs. No downsizing hormonal treatment was offered preoperative. Main outcome measures were disease free survival, recurrence pattern and salvage. Extensive pelvic and perineal tumor resection is tough and meticulous but straightforward with minor (Clavien-Dindo Classification (CDC) grade I & II) early and delayed morbidity. Resection extends to hysterectomy, vaginectomy and vascular resection. Histopathology plus immunohistochemistry showed 9-aggressive angiomyxoid tumors (AA), 2-fibromatosis and 2-neurofibromas (NF). Margins of resection are all adequate (R0) except for 2 (Resection margin 1 (R1)). After 50-month median follow up, 8/13 total series (61.5%) were surviving free of disease. 4/9 of AA (44%) had local perineal and/or pelvic recurrences (13–37 months) and all were amenable to curative salvage resections; while, 1/2 patients with fibromatosis died of disseminated peritoneal relapses. No systemic metastases are noticed. Extensive tumors meticulous surgery with experienced pelvic dissection and resection could offer alone long term cure even after recurrences with minor morbidity in a good percent. Fertility sparing resection is not oncologically safe because of the frequent uterine and ovarian invasions.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135828090","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}
Primary vaginal adenocarcinoma associated with human papillomavirus (HPV) infection is extremely rare. We report a case of primary adenocarcinoma of the vagina associated with human papilloma virus successfully treated with anterior pelvic exenteration and adjuvant concurrent chemoradiation therapy. A 51-year-old postmenopausal woman (gravida 1, para 1) presented with intermittent vaginal bleeding and pelvic pain. She was found to have a 5 × 5 cm necrotic tumor took up the vaginal. She had no previous history of antenatal exposure to diethylstilbestrol (DES). Pelvic magnetic resonance imaging (MRI) demonstrated a 4.8 × 6.0 cm mass in the vaginal canal, an 1.1 × 2.6 cm mass at the urinary bladder dome and a 1.1 cm irregular lymph node at the right external iliac chain with increased fluorodeoxyglucose (FDG) uptake from Fused whole-body positron emission tomography-computed tomography (PET-CT). Based on clinical investigations, the patient was diagnosed with a primary adenocarcinoma of vagina, staged International Fedestration of Gynecology and Obstetrics (FIGO) IVa. Anterior pelvic exenteration, simple vulvectomy, total vaginectomy, both pelvic lymph node dissection, and para-aortic lymph node dissection with ileal conduit urinary diversion (Bricker’s operation) was done. Histologically primary vaginal HPV type 16-associated adenocarcinoma was confirmed. Both obturator lymph node was positive for metastasis. Postoperatively, the patient received weekly cisplatin regimen administered with a dose of 40 mg/m2 on day 1 of external radiation therapy (RT), 1 to 4 hours before RT initiation. External beam pelvic RT dose prescription to the whole pelvis was 59.4 Gy in 33 fractions at the isocenter. But, after total dose of 43.2 Gy, patient complained severe bowel habit change and discontinued further treatment. The patient remains free from recurrence 8 months after initial surgery. In the lack of information and comparative analysis of management options for the more unusual and rare varieties of primary vaginal neoplasms in the literature, this suggests the possibility that surgical treatment may be preferentially selected on a case-by-case basis.
{"title":"Human papilloma virus associated primary vaginal adenocarcinoma","authors":"","doi":"10.22514/ejgo.2023.091","DOIUrl":"https://doi.org/10.22514/ejgo.2023.091","url":null,"abstract":"Primary vaginal adenocarcinoma associated with human papillomavirus (HPV) infection is extremely rare. We report a case of primary adenocarcinoma of the vagina associated with human papilloma virus successfully treated with anterior pelvic exenteration and adjuvant concurrent chemoradiation therapy. A 51-year-old postmenopausal woman (gravida 1, para 1) presented with intermittent vaginal bleeding and pelvic pain. She was found to have a 5 × 5 cm necrotic tumor took up the vaginal. She had no previous history of antenatal exposure to diethylstilbestrol (DES). Pelvic magnetic resonance imaging (MRI) demonstrated a 4.8 × 6.0 cm mass in the vaginal canal, an 1.1 × 2.6 cm mass at the urinary bladder dome and a 1.1 cm irregular lymph node at the right external iliac chain with increased fluorodeoxyglucose (FDG) uptake from Fused whole-body positron emission tomography-computed tomography (PET-CT). Based on clinical investigations, the patient was diagnosed with a primary adenocarcinoma of vagina, staged International Fedestration of Gynecology and Obstetrics (FIGO) IVa. Anterior pelvic exenteration, simple vulvectomy, total vaginectomy, both pelvic lymph node dissection, and para-aortic lymph node dissection with ileal conduit urinary diversion (Bricker’s operation) was done. Histologically primary vaginal HPV type 16-associated adenocarcinoma was confirmed. Both obturator lymph node was positive for metastasis. Postoperatively, the patient received weekly cisplatin regimen administered with a dose of 40 mg/m2 on day 1 of external radiation therapy (RT), 1 to 4 hours before RT initiation. External beam pelvic RT dose prescription to the whole pelvis was 59.4 Gy in 33 fractions at the isocenter. But, after total dose of 43.2 Gy, patient complained severe bowel habit change and discontinued further treatment. The patient remains free from recurrence 8 months after initial surgery. In the lack of information and comparative analysis of management options for the more unusual and rare varieties of primary vaginal neoplasms in the literature, this suggests the possibility that surgical treatment may be preferentially selected on a case-by-case basis.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366312","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}
Ovarian cancer (OC) is the 3rd most common type of the gynecological malignancy. Although current treatment strategies have greatly improved, there is still a need to develop new biomarkers for OC diagnosis and treatment. Microtubule affinity regulated kinase 2 (MARK2) is a kinase involved in the progression of multiple tumors. However, whether abnormal expression of MARK2 is associated with OC progression needs further analysis. We here revealed its role in OC. We found high expression of MARK2 in OC. Knockdown of MARK2 inhibited proliferation of OC cells, stimulated apoptosis of OC cells, and restrained glucose metabolism of OC cells. Furthermore, MARK2 regulated phosphatidylinositol 3-kinase/PKB (protein kinase B)/tumor suppressor protein 53 (PI3K/AKT/p53) axis in OC, therefore affecting the progression of OC. In summary, MARK2 knockdown suppressed cell proliferation by regulating PI3K/AKT/p53 axis.
{"title":"Inhibition of MARK2 inhibits ovarian cancer cell proliferation by regulating PI3K/AKT/p53 axis","authors":"","doi":"10.22514/ejgo.2023.088","DOIUrl":"https://doi.org/10.22514/ejgo.2023.088","url":null,"abstract":"Ovarian cancer (OC) is the 3rd most common type of the gynecological malignancy. Although current treatment strategies have greatly improved, there is still a need to develop new biomarkers for OC diagnosis and treatment. Microtubule affinity regulated kinase 2 (MARK2) is a kinase involved in the progression of multiple tumors. However, whether abnormal expression of MARK2 is associated with OC progression needs further analysis. We here revealed its role in OC. We found high expression of MARK2 in OC. Knockdown of MARK2 inhibited proliferation of OC cells, stimulated apoptosis of OC cells, and restrained glucose metabolism of OC cells. Furthermore, MARK2 regulated phosphatidylinositol 3-kinase/PKB (protein kinase B)/tumor suppressor protein 53 (PI3K/AKT/p53) axis in OC, therefore affecting the progression of OC. In summary, MARK2 knockdown suppressed cell proliferation by regulating PI3K/AKT/p53 axis.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368243","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}
Vulvar cancer is rare with incidence of 45,240 new cases globally which account for 4% of all genitourinary tract neoplasma. It is considered as a postmenopausal disease, however incidence age has decreased over the years because of high prevalence of persistent high-risk human papillomavirus (hrHPV) infection. Vulvar cancer diagnosis in young women is challenging. Prompt and adequate diagnosis, and treatment can ensure the life quality. A 23 years old patient was admitted to Department of Operative Gynecology for treating malignant vulvar neoplasma. She was reffered to our clinic for electrocauterization after being diagnosed of condylomata accuminata. Physical examination revealed vulva atrophy with smooth discolored skin patches on both sides. A 2 cm exophytic lesion was noted ~10 mm from clitoris on right labia majora. Multifocal biopsy was performed for suspect finding which proved invasive vulvar squamous keratinizing cancer. Positron emission tomography-computed tomography (PET/CT) scan showed individual lymph nodes on right inguinofemoral region which were moderately metabolically active. Wide excision of cancer was performed with unilateral inguinofemoral lymphadenectomy. Macroscopic evaluation of entire specimen depicted 2.4 × 2.2 × 0.5 cm HPV associated invasive vulvar squamous keratinizing cancer, vulvar high grade squamous intraepithelial lesion (vHSIL) or usual type vulvar intraepithelial neoplasia (uVIN3) and lichen sclerosus. Healthcare professionals in primary care centers should be adequately trained, aware of and familiar with vulvar malignancies in younger women despite their rarity. Early diagnosis can improve outcomes in vulvar cancer via reducing morbidity and mortality. The individualized surgical treatment is the preferred strategy for patients at present.
{"title":"Vulvar cancer in young woman—case report","authors":"","doi":"10.22514/ejgo.2023.070","DOIUrl":"https://doi.org/10.22514/ejgo.2023.070","url":null,"abstract":"Vulvar cancer is rare with incidence of 45,240 new cases globally which account for 4% of all genitourinary tract neoplasma. It is considered as a postmenopausal disease, however incidence age has decreased over the years because of high prevalence of persistent high-risk human papillomavirus (hrHPV) infection. Vulvar cancer diagnosis in young women is challenging. Prompt and adequate diagnosis, and treatment can ensure the life quality. A 23 years old patient was admitted to Department of Operative Gynecology for treating malignant vulvar neoplasma. She was reffered to our clinic for electrocauterization after being diagnosed of condylomata accuminata. Physical examination revealed vulva atrophy with smooth discolored skin patches on both sides. A 2 cm exophytic lesion was noted ~10 mm from clitoris on right labia majora. Multifocal biopsy was performed for suspect finding which proved invasive vulvar squamous keratinizing cancer. Positron emission tomography-computed tomography (PET/CT) scan showed individual lymph nodes on right inguinofemoral region which were moderately metabolically active. Wide excision of cancer was performed with unilateral inguinofemoral lymphadenectomy. Macroscopic evaluation of entire specimen depicted 2.4 × 2.2 × 0.5 cm HPV associated invasive vulvar squamous keratinizing cancer, vulvar high grade squamous intraepithelial lesion (vHSIL) or usual type vulvar intraepithelial neoplasia (uVIN3) and lichen sclerosus. Healthcare professionals in primary care centers should be adequately trained, aware of and familiar with vulvar malignancies in younger women despite their rarity. Early diagnosis can improve outcomes in vulvar cancer via reducing morbidity and mortality. The individualized surgical treatment is the preferred strategy for patients at present.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135311277","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}
The presence of lymph node (LN) positivity in endometrial adenocarcinoma (EAC) patients guides adjuvant treatment, but recommendations regarding LN evaluation at the time of primary surgery remain variable. Primary pathologic tumor characteristics may predict risk of LN involvement in EAC patients with limited LN evaluation. Patients diagnosed between 2004–2016 with pathologic T1–T2 EAC in the National Cancer Database who had at least one lymph node sampled at the time of surgery were included. Pathologic primary tumor predictors of LN involvement were identified using logistic regression. To predict overall, pelvic only, and paraaortic and/or pelvic LN involvement, nomograms were generated. Among 57,810 EAC patients included, 4002 were node positive. On multivariable analysis, increasing pathologic tumor category (pT2 versus pT1a, odds ratio (OR) 5.43, 95% confidence interval (CI) 4.89–6.02, p < 0.001), increasing pathologic tumor grade (grade 3 versus grade 1, OR 1.62, 95% CI 1.47–1.79, p < 0.001), increase in tumor size per centimeter (OR 1.05, 95% CI 1.04–1.06, p < 0.001), and presence of lymphovascular invasion (LVI) (OR 6.33, 95% CI 5.87–6.83, p < 0.001) were predictive of overall LN positivity. The presence of LVI was a stronger predictor of paraaortic LN involvement (OR 6.43, 95% CI 5.55–7.47, p < 0.001) than pelvic LN involvement (OR 5.42, 95% CI 4.98–5.90, p < 0.001) in multivariable analysis. For patients with limited LN evaluation, pathologic tumor features can be used to estimate the risk of pelvic or paraaortic LN involvement. This information may inform adjuvant treatment decisions and guide future studies.
子宫内膜腺癌(EAC)患者淋巴结(LN)阳性的存在指导了辅助治疗，但关于初次手术时淋巴结评估的建议仍然存在差异。原发性病理肿瘤特征可以预测有限LN评估的EAC患者LN累及的风险。纳入了2004-2016年期间在国家癌症数据库中诊断为病理性T1-T2 EAC的患者，这些患者在手术时至少有一个淋巴结样本。使用逻辑回归确定LN累及的病理原发肿瘤预测因子。为了预测总体、仅盆腔、主动脉旁和/或盆腔淋巴结受累情况，生成了图。在57810例EAC患者中，4002例为淋巴结阳性。在多变量分析中，增加病理肿瘤类别(pT2 vs pT1a)，优势比(OR) 5.43, 95%可信区间(CI) 4.89-6.02, p <0.001)，增加病理肿瘤分级(3级对1级，OR 1.62, 95% CI 1.47-1.79, p <0.001)，每厘米肿瘤大小增加(OR 1.05, 95% CI 1.04-1.06, p <0.001)，存在淋巴血管侵犯(LVI) (OR 6.33, 95% CI 5.87-6.83, p <0.001)预测总体LN阳性。LVI的存在是主动脉旁淋巴结受累的一个更强的预测因子(OR 6.43, 95% CI 5.55-7.47, p <0.001)比盆腔淋巴结受累(OR 5.42, 95% CI 4.98-5.90, p <0.001)。对于LN评估有限的患者，可使用病理肿瘤特征来评估盆腔或主动脉旁LN累及的风险。这些信息可以为辅助治疗决策提供信息，并指导未来的研究。
{"title":"Pathologic primary tumor factors associated with risk of pelvic and paraaortic lymph node involvement in patients with endometrial adenocarcinoma","authors":"","doi":"10.22514/ejgo.2023.056","DOIUrl":"https://doi.org/10.22514/ejgo.2023.056","url":null,"abstract":"The presence of lymph node (LN) positivity in endometrial adenocarcinoma (EAC) patients guides adjuvant treatment, but recommendations regarding LN evaluation at the time of primary surgery remain variable. Primary pathologic tumor characteristics may predict risk of LN involvement in EAC patients with limited LN evaluation. Patients diagnosed between 2004–2016 with pathologic T1–T2 EAC in the National Cancer Database who had at least one lymph node sampled at the time of surgery were included. Pathologic primary tumor predictors of LN involvement were identified using logistic regression. To predict overall, pelvic only, and paraaortic and/or pelvic LN involvement, nomograms were generated. Among 57,810 EAC patients included, 4002 were node positive. On multivariable analysis, increasing pathologic tumor category (pT2 versus pT1a, odds ratio (OR) 5.43, 95% confidence interval (CI) 4.89–6.02, p < 0.001), increasing pathologic tumor grade (grade 3 versus grade 1, OR 1.62, 95% CI 1.47–1.79, p < 0.001), increase in tumor size per centimeter (OR 1.05, 95% CI 1.04–1.06, p < 0.001), and presence of lymphovascular invasion (LVI) (OR 6.33, 95% CI 5.87–6.83, p < 0.001) were predictive of overall LN positivity. The presence of LVI was a stronger predictor of paraaortic LN involvement (OR 6.43, 95% CI 5.55–7.47, p < 0.001) than pelvic LN involvement (OR 5.42, 95% CI 4.98–5.90, p < 0.001) in multivariable analysis. For patients with limited LN evaluation, pathologic tumor features can be used to estimate the risk of pelvic or paraaortic LN involvement. This information may inform adjuvant treatment decisions and guide future studies.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115074","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}
Endometrial cancer (EC) includes several epithelial malignancies existed in the endometrium tissues. To improve the prognosis of EC, it is greatly needed to find new drugs. Dezocine, a organic compound, is an κ agonist and a µ receptor antagonist, is used in clinical anesthesia after cancer surgery with few side effects, and its anti-tumor effects have also been demonstrated in several tumors. However, the effects of Dezocine on EC progression have not been elusidated. Herein, we investigated the role of Dezocine in EC cell functions. Through a series of cellular assays, such as cell counting kit-8 (CCK-8), flow cytometry (FCM), transwell assays, we found that Dezocine suppressed the EC cell proliferation, and stimulated EC cell apoptosis in vitro. Furthermore, results revealed Dezocine restrained the motility, including migration and invasion of EC cells. Mechanically, Dezocine suppressed the Akt (protein kinase B, PKB)/mammalian target of rapamycin (mTOR) pathway in EC cells, thereby suppressing EC cell proliferation as well as migration in vitro. In conclusion, Dezocine inhibits proliferation as well as migration of EC in vitro.
子宫内膜癌(EC)包括存在于子宫内膜组织中的几种上皮恶性肿瘤。为了改善EC的预后，迫切需要寻找新的治疗药物。Dezocine是一种有机化合物，是一种κ受体激动剂和µ受体拮抗剂，用于癌症手术后的临床麻醉，其副作用很少，其抗肿瘤作用也已在几种肿瘤中得到证实。然而，地佐辛对EC进展的影响尚未明确。在此，我们研究了Dezocine在EC细胞功能中的作用。通过细胞计数试剂盒-8 (CCK-8)、流式细胞术(FCM)、transwell等一系列细胞实验，我们发现地佐辛在体外抑制EC细胞增殖，刺激EC细胞凋亡。此外，研究结果显示，地佐辛抑制了EC细胞的运动，包括迁移和侵袭。机械上，Dezocine抑制EC细胞中Akt (protein kinase B, PKB)/哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)通路，从而抑制EC细胞体外增殖和迁移。综上所述，地佐辛在体外可抑制EC的增殖和迁移。
{"title":"Dezocine inhibits proliferation as well as migration of endometrial carcinoma in vitro","authors":"","doi":"10.22514/ejgo.2023.081","DOIUrl":"https://doi.org/10.22514/ejgo.2023.081","url":null,"abstract":"Endometrial cancer (EC) includes several epithelial malignancies existed in the endometrium tissues. To improve the prognosis of EC, it is greatly needed to find new drugs. Dezocine, a organic compound, is an κ agonist and a µ receptor antagonist, is used in clinical anesthesia after cancer surgery with few side effects, and its anti-tumor effects have also been demonstrated in several tumors. However, the effects of Dezocine on EC progression have not been elusidated. Herein, we investigated the role of Dezocine in EC cell functions. Through a series of cellular assays, such as cell counting kit-8 (CCK-8), flow cytometry (FCM), transwell assays, we found that Dezocine suppressed the EC cell proliferation, and stimulated EC cell apoptosis in vitro. Furthermore, results revealed Dezocine restrained the motility, including migration and invasion of EC cells. Mechanically, Dezocine suppressed the Akt (protein kinase B, PKB)/mammalian target of rapamycin (mTOR) pathway in EC cells, thereby suppressing EC cell proliferation as well as migration in vitro. In conclusion, Dezocine inhibits proliferation as well as migration of EC in vitro.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366299","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}
The clinical data of 119 patients with triple-negative breast cancer (TNBC) were retrospectively analyzed, and comparisons revealed that the differences between those who developed axillary lymph node metastasis and those who did not were statistically significant when comparing the age, histological grading of the lesions, expression of Ki-67, and information about the morphology of the lesions, internal blood flow, and the ultrasonographic manifestations of axillary lymph nodes on ultrasonography of the distribution of the lesions in the lesions’ quadrants (p < 0.05). Multifactorial regression analysis suggested that age, histological grade, lesion quadrant, and axillary lymph node ultrasound performance were all relevant factors affecting axillary lymph node metastasis in TNBC patients; the predictive model of axillary lymph node metastasis in TNBC was constructed with the results of multifactorial regression analysis, and the results of the ROC curve analysis showed that the logistic regression model had an AUC of 0.761 and the sensitivity and specificity were 0.824 and 0.714, respectively, for predicting the metastasis of the axillary lymph nodes in TNBC patients. This suggests that ultrasound combined with pathological parameters has some value in helping clinical judgment of axillary lymph node metastasis in TNBC patients.
{"title":"The value of ultrasonic parameters combined with clinicopathological parameters in predicting axillary lymph node metastasis in triple-negative breast cancer","authors":"","doi":"10.22514/ejgo.2023.084","DOIUrl":"https://doi.org/10.22514/ejgo.2023.084","url":null,"abstract":"The clinical data of 119 patients with triple-negative breast cancer (TNBC) were retrospectively analyzed, and comparisons revealed that the differences between those who developed axillary lymph node metastasis and those who did not were statistically significant when comparing the age, histological grading of the lesions, expression of Ki-67, and information about the morphology of the lesions, internal blood flow, and the ultrasonographic manifestations of axillary lymph nodes on ultrasonography of the distribution of the lesions in the lesions’ quadrants (p < 0.05). Multifactorial regression analysis suggested that age, histological grade, lesion quadrant, and axillary lymph node ultrasound performance were all relevant factors affecting axillary lymph node metastasis in TNBC patients; the predictive model of axillary lymph node metastasis in TNBC was constructed with the results of multifactorial regression analysis, and the results of the ROC curve analysis showed that the logistic regression model had an AUC of 0.761 and the sensitivity and specificity were 0.824 and 0.714, respectively, for predicting the metastasis of the axillary lymph nodes in TNBC patients. This suggests that ultrasound combined with pathological parameters has some value in helping clinical judgment of axillary lymph node metastasis in TNBC patients.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366594","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}
We aimed to investigate the mechanism of action of Zhimu in the treatment of ovarian cancer (OC) using network pharmacology. OC targets were screened using the DisGeNET and Online Mendelian Inheritance in Man databases. Common OC and Zhimu targets were identified using the Traditional Chinese Medicine System Pharmacology, UniProt databases, and Venny 2.1.0. The protein-protein interaction (PPI) network in the Search Tool for the Retrieval of Interacting Genes/Proteins database was created using Zhimu/OC targets and a Zhimu active ingredient-target-pathway network in the Cytoscape 3.9.1 software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were conducted using the Metascape database. And overall, 15 active ingredients in addition to 93 related targets were identified. The PPI network had 52 targets that overlapped with it, with the 10 most relevant targets being the tumour protein p53, tumour necrosis factor, serine/threonine kinase 1, vascular endothelial growth factor A, caspase-3, prostaglandin G/H synthase-2, hypoxia-inducible factor-1 alpha, interleukin-1 beta, heat-shock protein 90-alpha, and progesterone receptor. According to GO and KEGG analyses, Zhimu and OC had the nuclear factor NF-kappaB signalling pathway, oxidative stress, and the advanced glycation end product (AGE)/the receptor for the advanced glycation end product (RAGE) signalling pathway as common targets. This study highlighted the active ingredients in Zhimu and identified potential molecular therapeutic mechanisms for the treatment of OC. It also provided suggestions and directions for future research into molecular mechanisms.
{"title":"Study on the mechanism of Zhimu in the treatment of ovarian cancer based on network pharmacology","authors":"","doi":"10.22514/ejgo.2023.059","DOIUrl":"https://doi.org/10.22514/ejgo.2023.059","url":null,"abstract":"We aimed to investigate the mechanism of action of Zhimu in the treatment of ovarian cancer (OC) using network pharmacology. OC targets were screened using the DisGeNET and Online Mendelian Inheritance in Man databases. Common OC and Zhimu targets were identified using the Traditional Chinese Medicine System Pharmacology, UniProt databases, and Venny 2.1.0. The protein-protein interaction (PPI) network in the Search Tool for the Retrieval of Interacting Genes/Proteins database was created using Zhimu/OC targets and a Zhimu active ingredient-target-pathway network in the Cytoscape 3.9.1 software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were conducted using the Metascape database. And overall, 15 active ingredients in addition to 93 related targets were identified. The PPI network had 52 targets that overlapped with it, with the 10 most relevant targets being the tumour protein p53, tumour necrosis factor, serine/threonine kinase 1, vascular endothelial growth factor A, caspase-3, prostaglandin G/H synthase-2, hypoxia-inducible factor-1 alpha, interleukin-1 beta, heat-shock protein 90-alpha, and progesterone receptor. According to GO and KEGG analyses, Zhimu and OC had the nuclear factor NF-kappaB signalling pathway, oxidative stress, and the advanced glycation end product (AGE)/the receptor for the advanced glycation end product (RAGE) signalling pathway as common targets. This study highlighted the active ingredients in Zhimu and identified potential molecular therapeutic mechanisms for the treatment of OC. It also provided suggestions and directions for future research into molecular mechanisms.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115275","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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