Gynecologic Oncology Reports最新文献_第5页

Considering homologous recombination deficiency status in HIPEC: could molecular testing someday drive “targeted” surgery? 考虑到HIPEC中同源重组缺陷的状况：分子检测有朝一日能推动“靶向”手术吗？

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 DOI: 10.1016/j.gore.2025.102001

Sarah P. Huepenbecker , Katherine C. Fuh

引用次数: 0

Attitudes towards opportunistic salpingectomy among patients planned to undergo non-gynecologic intra-abdominal surgery 计划行非妇科腹腔手术患者对机会性输卵管切除术的态度

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 DOI: 10.1016/j.gore.2025.102000

Monali S. Ardeshna , Lauren Dori , Benjamin Margolis

Objective

To evaluate the knowledge of and interest in opportunistic salpingectomy (OS) in patients undergoing non-gynecologic abdominal surgery.

Methods

English-speaking patients aged 18 or older with fallopian tubes who were scheduled for upcoming abdominal general, colorectal, or bariatric surgery were approached. A phone-administered questionnaire was used to collect demographics, clinical history, knowledge of OS, and likelihood to undergo OS if offered. Chi-square tests, Fisher’s exact tests, and odds ratios were calculated in R.

Results

153 patients were contacted, of which 68 were eligible and agreed to participate (44.4 % response rate). Of the 68 participants, 60 (88.2 %) were considered OS candidates (not interested in future fertility). The average age was 58, and 97 % of respondents self-identified as White. Forty-five respondents (75.0 %) were post-menopausal, 11 (18.3 %) had undergone a hysterectomy, and 16 (26.7 %) had undergone permanent contraception. Only 12 (20.0 %) knew OS reduces ovarian cancer risk. Among OS candidates, 15 (25.0 %) were likely to undergo OS during their upcoming surgery if offered. Predictors of likelihood to undergo OS during surgery include awareness of OS (50.0 % vs 19.0 %, OR 4.33, 95 % CI: 1.13–16.61, p = 0.025), family history of ovarian cancer (66.7 % vs 20.4 %, OR 7.82, 95 % CI: 1.26–48.35, p = 0.030), and interest in permanent contraception (100 % vs 25 %, p = 0.044).

Conclusion

Among patients with fallopian tubes undergoing non-gynecologic abdominal surgery, most were appropriate candidates for OS. Prior awareness of OS, family history of ovarian cancer, and interest in permanent contraception were associated with a greater interest in OS.

目的评价非妇科腹部手术患者对机会性输卵管切除术（OS）的认知和兴趣。方法：研究对象为年龄在18岁及以上的输卵管患者，这些患者计划进行腹部手术、结直肠手术或减肥手术。使用电话管理问卷收集人口统计资料、临床病史、OS知识以及接受OS的可能性。结果联系了153例患者，其中68例符合条件并同意参与（有效率44.4%）。在68名参与者中，60名（88.2%）被认为是OS候选人（对未来生育不感兴趣）。平均年龄为58岁，97%的受访者自认为是白人。45例（75.0%）为绝经后患者，11例（18.3%）为子宫切除术患者，16例（26.7%）为永久性避孕患者。只有12人（20.0%）知道OS可以降低卵巢癌风险。在手术候选者中，有15人（25.0%）可能在即将进行的手术中接受手术。手术期间发生OS的可能性预测因素包括对OS的了解（50.0% vs 19.0%, OR 4.33, 95% CI: 1.13-16.61, p = 0.025）、卵巢癌家族史（66.7% vs 20.4%, OR 7.82, 95% CI: 1.26-48.35, p = 0.030）和对永久避孕的兴趣（100% vs 25%, p = 0.044）。结论输卵管行非妇科腹腔手术的患者中，绝大多数为合适的手术对象。先前对卵巢癌的认识、卵巢癌家族史和对永久避孕的兴趣与对卵巢癌的更大兴趣相关。

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引用次数: 0

Robot-assisted transvaginal staging surgery using da Vinci SP for suspected ovarian borderline tumor: a case report 机器人辅助经阴道分期手术使用达芬奇SP怀疑卵巢交界性肿瘤：1例报告

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-17 DOI: 10.1016/j.gore.2025.101987

Naofumi Higuchi, Kiyoshi Kanno, Tomoka Kashiwabara, Taisuke Iwata, Yudai Sawai, Hiroshi Onji, Ryo Taniguchi, Masaaki Andou

Background

Minimally invasive surgery is increasingly being applied in selected cases of ovarian borderline tumors and ovarian cancer. With the introduction of the da Vinci SP (SP) system, our institution began robot-assisted vNOTES (RAvNOTES) in 2023. This approach may overcome the limitations of conventional vNOTES, particularly limited triangulation (Lowenstein et al., 2020, Hurni et al., 2022, Hurni and Huber, 2023). We describe staging surgery for a suspected ovarian borderline tumor, performed using RAvNOTES.

背景：微创手术越来越多地应用于卵巢交界性肿瘤和卵巢癌的治疗。随着达芬奇SP （da Vinci SP）系统的引入，我们的机构于2023年开始了机器人辅助vNOTES （RAvNOTES）。这种方法可以克服传统vNOTES的局限性，特别是有限的三角测量（Lowenstein等人，2020年，Hurni等人，2022年，Hurni和Huber， 2023年）。我们描述分期手术的怀疑卵巢交界性肿瘤，进行了使用RAvNOTES。

引用次数: 0

MECOM amplified endometrial cancer, a novel subset of copy number high tumors associated with poor prognosis MECOM扩增子宫内膜癌，一个新的亚群的拷贝数高的肿瘤相关的不良预后

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-16 DOI: 10.1016/j.gore.2025.101993

Shariska P. Harrington , Jacqueline Romani , Aminah Jatoi , S.John Weroha , Andrea Mariani , William A. Cliby , Jamie N. Bakkum-Gamez , Dineo Khabele , Alexandre Gaspar-Maia

Objective

Copy number high (CNH) endometrial cancer (EC) is an aggressive molecular subgroup characterized by TP53 mutations and relative chemoresistance. CNH EC with cyclin E1 gene (CCNE1) amplification and erythroblastic oncogene B (ERBB2) amplification are associated with poor clinical outcomes. MECOM, a complex locus of MDS1 (myelodysplasia syndrome 1) and EVI1 (ecotropic virus integration site 1), has recently been associated with poor prognosis in ovarian cancer. Our objective was to evaluate clinical outcomes of MECOM, CCNE1 and ERBB2 amplified ECs and to provide a literature review on the role of MECOM in gynecologic cancers.

Methods

Copy number variation and molecular subtype classification were extracted from The Cancer Genome Atlas for 529 ECs. Amplification status was determined for MECOM, CCNE1 and ERBB2. Measured clinical outcomes were overall and progression-free survival, covariates included race, stage at diagnosis, and tumor histology. A comprehensive search of peer-reviewed articles was undertaken to summarize evidence on the role of MECOM in gynecologic cancers.

Results

Of all ECs profiled, MECOM was the most frequently amplified gene. Notably, 35% of CNH ECs were MECOM amplified. In multivariate analysis, MECOM amplification without co-amplification of CCNE1 or ERBB2 was associated with an increased risk of death and recurrence, HR 2.3 [1.17–4.62], p = 0.0163 and HR 2.07 [1.08–3.98], p = 0.0282, respectively. The literature review identified 19 relevant studies with inconsistent evidence on MECOM’s role in carcinogenesis.

Conclusions

ECs with MECOM amplification are associated with poor clinical outcomes, even in the absence of CCNE1 or ERBB2 amplification. The current literature is limited, and further studies are warranted to determine the role of MECOM amplification in ECs.

目的高拷贝数（CNH）子宫内膜癌（EC）是一种以TP53突变和相对化疗耐药为特征的侵袭性分子亚群。伴有细胞周期蛋白E1基因（CCNE1）扩增和红母细胞癌基因B （ERBB2）扩增的CNH EC与较差的临床结果相关。MECOM是MDS1（骨髓增生异常综合征1）和EVI1（亲生态病毒整合位点1）的复杂位点，最近发现与卵巢癌预后不良相关。我们的目的是评估MECOM、CCNE1和ERBB2扩增的ECs的临床结果，并对MECOM在妇科癌症中的作用进行文献综述。方法从肿瘤基因组图谱中提取529例ECs的数量变异和分子亚型分类。测定MECOM、CCNE1和ERBB2的扩增情况。测量的临床结果是总生存期和无进展生存期，协变量包括种族、诊断阶段和肿瘤组织学。我们对同行评议的文章进行了全面检索，总结了MECOM在妇科癌症中作用的证据。结果在所分析的ECs中，MECOM是扩增频率最高的基因。值得注意的是，35%的CNH ec是MECOM扩增的。在多因素分析中，MECOM扩增而不同时扩增CCNE1或ERBB2与死亡和复发风险增加相关，HR分别为2.3 [1.17-4.62],p = 0.0163； HR为2.07 [1.08-3.98],p = 0.0282。文献综述确定了19项有关MECOM在致癌作用方面证据不一致的相关研究。结论即使没有CCNE1或ERBB2扩增，伴有MECOM扩增的sc也与较差的临床结果相关。目前的文献是有限的，需要进一步的研究来确定MECOM扩增在ECs中的作用。

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引用次数: 0

Contribution of laparoscopic surgery to the diagnosis of ovarian metastasis from thymoma: A rare case and review of the literature 腹腔镜手术对胸腺瘤卵巢转移诊断的贡献：一例罕见病例及文献回顾

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-16 DOI: 10.1016/j.gore.2025.101992

Yui Sejimo , Kenichi Makino , Masato Waga , Enami Kaneko , Takeo Hirakawa , Tae Sugawara , Taichi Yoshida , Hiroyuki Shibata , Hiroshi Nanjo , Yukihiro Terada

Background

Thymoma is a rare mediastinal tumor that usually remains confined to the thoracic cavity. Extrathoracic metastasis is uncommon, and ovarian involvement is extremely rare. Only a few cases have been reported. Laparoscopic surgery provides a minimally invasive option for diagnosis and treatment in such unusual presentations.

Case presentation

A 53-year-old woman with a history of thymoma treated with surgery, chemotherapy, and radiotherapy was found to have a mildly enlarged right ovary and a nodule in the pouch of Douglas five years after initial therapy. Because peritoneal dissemination of thymoma is rare, a primary ovarian tumor was suspected. Diagnostic laparoscopy was performed, resulting in bilateral salpingo-oophorectomy and resection of peritoneal nodules. Histopathology confirmed bilateral ovarian metastases and peritoneal dissemination from thymoma. The patient recovered uneventfully and resumed systemic chemotherapy.

Conclusion

Ovarian metastasis from thymoma is extremely rare but should be considered in patients with a history of thymoma presenting with adnexal masses. This case underscores the diagnostic and therapeutic utility of laparoscopic surgery. Our findings add to the limited literature on extrathoracic spread of thymoma and highlight the role of minimally invasive techniques in such diagnostic challenges.

背景胸腺瘤是一种罕见的纵隔肿瘤，通常局限于胸腔。胸外转移不常见，累及卵巢极为罕见。只有少数病例被报道。腹腔镜手术为诊断和治疗这种不寻常的症状提供了微创的选择。一例53岁女性，胸腺瘤病史，经手术、化疗、放疗治疗，首次治疗5年后发现右卵巢轻度增大，道格拉斯眼袋内有结节。由于胸腺瘤腹膜播散罕见，因此怀疑为原发性卵巢肿瘤。诊断性腹腔镜下行双侧输卵管卵巢切除术及腹膜结节切除术。组织病理学证实双侧卵巢转移和腹膜播散从胸腺瘤。病人平静地恢复并恢复全身化疗。结论胸腺瘤卵巢转移极为罕见，但在有胸腺瘤病史并伴有附件肿物的患者中应予以考虑。本病例强调了腹腔镜手术的诊断和治疗效用。我们的发现增加了胸腺瘤胸外扩散的有限文献，并强调了微创技术在此类诊断挑战中的作用。

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引用次数: 0

Alectinib as salvage therapy for metastatic UIMT following misdiagnosis: A case enabling definitive surgery and prolonged remission 阿勒替尼作为转移性UIMT误诊后的补救性治疗：一例使最终手术和延长缓解

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-15 DOI: 10.1016/j.gore.2025.101994

Ting Shuang , Xiao lin Wang , Yuanyuan Wang , Bao li Jun

Background

Uterine inflammatory myofibroblastic tumor (UIMT) is a rare, aggressive tumor often mistaken for uterine fibroids. This case report discusses managing advanced UIMT after a misdiagnosis and assesses the effectiveness of the anaplastic lymphoma kinase (ALK) inhibitor, alectinib, as a targeted treatment.

Case presentation

A 29-year-old woman had a laparoscopic myomectomy for presumed uterine fibroids. Three months later, she developed abdominal distension, vaginal bleeding, and fever. Pathological evaluation confirmed a diagnosis of UIMT with aggressive behavior, and imaging showed extensive abdominal metastases. She received supportive therapies including hepatoprotection, infection control, and hemostasis. Due to the substantial tumor burden and malnutrition, targeted therapy with the ALK inhibitor alectinib was initiated, informed by ALK-p80 positivity on IHC. Her symptoms relieved significantly, and pelvic masses reduced by 53.9 % after two treatment cycles. She subsequently underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and resection of pelvic and abdominal lesions. Post-surgery, she continued alectinib with no recurrence for over 10 months till now. Next-generation sequencing (NGS) revealed an FN1-ALK fusion and a novel MTAP-CDKN2A fusion.

Conclusions

This case highlights the significant efficacy and safety of alectinib in the management of advanced, recurrent, and aggressive UIMT, while also emphasizing the essential role of multidisciplinary management. It provides valuable insights and serves as a reference for the management of similar rare cases.

背景：原发性炎性肌纤维母细胞瘤是一种罕见的侵袭性肿瘤，常被误认为是子宫肌瘤。本病例报告讨论了误诊后晚期UIMT的管理，并评估了间变性淋巴瘤激酶（ALK）抑制剂阿勒替尼作为靶向治疗的有效性。病例介绍：一名29岁女性因推测子宫肌瘤行腹腔镜子宫肌瘤切除术。3个月后，患者出现腹胀、阴道出血和发热。病理评估证实了UIMT的诊断，并伴有侵袭性行为，影像学显示广泛的腹部转移。患者接受保肝、控制感染和止血等支持性治疗。由于严重的肿瘤负担和营养不良，在IHC上ALK-p80阳性的通知下，开始了ALK抑制剂alectinib的靶向治疗。两个治疗周期后，患者症状明显缓解，盆腔肿块减少53.9%。随后，她接受了腹部全子宫切除术、双侧输卵管-卵巢切除术、网膜切除术以及盆腔和腹部病变切除术。术后继续使用阿勒替尼治疗，10个多月无复发。新一代测序（NGS）揭示了FN1-ALK融合和MTAP-CDKN2A融合。结论该病例强调了alectinib在晚期、复发性和侵袭性UIMT治疗中的显著有效性和安全性，同时也强调了多学科治疗的重要作用。为类似罕见病例的管理提供了有价值的见解和参考。

{"title":"Alectinib as salvage therapy for metastatic UIMT following misdiagnosis: A case enabling definitive surgery and prolonged remission","authors":"Ting Shuang , Xiao lin Wang , Yuanyuan Wang , Bao li Jun","doi":"10.1016/j.gore.2025.101994","DOIUrl":"10.1016/j.gore.2025.101994","url":null,"abstract":"<div><h3>Background</h3><div>Uterine inflammatory myofibroblastic tumor (UIMT) is a rare, aggressive tumor often mistaken for uterine fibroids. This case report discusses managing advanced UIMT after a misdiagnosis and assesses the effectiveness of the anaplastic lymphoma kinase (ALK) inhibitor, alectinib, as a targeted treatment.</div><div>Case presentation</div><div>A 29-year-old woman had a laparoscopic myomectomy for presumed uterine fibroids. Three months later, she developed abdominal distension, vaginal bleeding, and fever. Pathological evaluation confirmed a diagnosis of UIMT with aggressive behavior, and imaging showed extensive abdominal metastases. She received supportive therapies including hepatoprotection, infection control, and hemostasis. Due to the substantial tumor burden and malnutrition, targeted therapy with the ALK inhibitor alectinib was initiated, informed by ALK-p80 positivity on IHC. Her symptoms relieved significantly, and pelvic masses reduced by 53.9 % after two treatment cycles. She subsequently underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and resection of pelvic and abdominal lesions. Post-surgery, she continued alectinib with no recurrence for over 10 months till now. Next-generation sequencing (NGS) revealed an FN1-ALK fusion and a novel MTAP-CDKN2A fusion.</div></div><div><h3>Conclusions</h3><div>This case highlights the significant efficacy and safety of alectinib in the management of advanced, recurrent, and aggressive UIMT, while also emphasizing the essential role of multidisciplinary management. It provides valuable insights and serves as a reference for the management of similar rare cases.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"62 ","pages":"Article 101994"},"PeriodicalIF":1.3,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case report of total epidermal necrosis following mirvetuximab soravtansine extravasation mirvetuximab soravtansine外溢致全表皮坏死1例

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-14 DOI: 10.1016/j.gore.2025.101991

Oriana Krivenko, Jenna Scott Powers, Connor C. Wang, Olivia W. Foley, Emily Hinchcliff, Emma Barber, Dario Roque

Background

Mirvetuximab soravtansine (MIRV) is an antibody–drug conjugate (ADC) approved for the treatment of platinum-resistant ovarian cancer. We report the first known case of total epidermal necrosis secondary to MIRV extravasation, representing an unreported adverse event.

Case

A 74-year-old woman with recurrent high-grade serous carcinoma of the peritoneum who developed extensive soft tissue injury following peripheral intravenous extravasation of MIRV. Despite immediate cessation of the MIRV infusion and conservative management, the patient developed progressive cutaneous toxicity, including full-thickness epidermal necrosis, requiring an 18-day hospitalization and wound care at a regional burn center. No surgical intervention was required. Management included topical therapies, reduced dressing changes, systemic antibiotics, and vitamin D3. Following discharge, a central venous access device was placed, and she completed subsequent MIRV cycles without further complications.

Conclusion

This case underscores the potential for severe soft tissue injury from MIRV extravasation, despite its lack of vesicant labeling. Contributing factors may include the instability of its disulfide linker and the cytotoxicity of the DM4 payload. As MIRV and other ADCs become more widely used in clinical settings, establishing clear protocols for recognizing and managing extravasation is essential. Central venous access and standardized documentation may mitigate risk. Increased awareness and reporting are needed to inform clinical guidelines and ensure safe administration of ADC therapies.

mirvetuximab soravtansine （MIRV）是一种被批准用于治疗铂耐药卵巢癌的抗体-药物偶联物（ADC）。我们报告第一例已知的完全性表皮坏死继发于MIRV外渗，代表一个未报道的不良事件。病例：74岁女性复发性高级别浆液性腹膜癌，周围静脉内MIRV外渗后发生广泛的软组织损伤。尽管立即停止MIRV输注并进行保守治疗，患者仍出现进行性皮肤毒性，包括全层表皮坏死，需要住院18天并在区域烧伤中心进行伤口护理。不需要手术干预。治疗包括局部治疗、减少换药次数、全身抗生素和维生素D3。出院后，放置中心静脉通路装置，她完成了随后的MIRV周期，没有进一步的并发症。结论该病例强调了MIRV外渗造成严重软组织损伤的可能性，尽管其缺乏囊泡标记。影响因素可能包括其二硫连接体的不稳定性和DM4有效载荷的细胞毒性。随着MIRV和其他adc在临床环境中得到更广泛的应用，建立明确的识别和管理外渗的方案至关重要。中心静脉通路和标准化文件可以降低风险。需要提高认识和报告，为临床指南提供信息，并确保ADC治疗的安全管理。

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引用次数: 0

From intractable hiccups to optic neuritis: paraneoplastic neuromyelitis optica with leptomeningeal carcinomatosis in the setting of immature ovarian teratoma 从顽固性呃逆到视神经炎：未成熟卵巢畸胎瘤伴轻脑膜癌的副肿瘤性视神经脊髓炎

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.gore.2025.101990

Shannon Zhou , Julie Szczygielski , Boris Winterhoff , Jordan Mattson

Background

Paraneoplastic syndromes are associated with 10% of ovarian cancers. Neuromyelitis optica spectrum disorders (NMOSD), which can present with vision changes, paraplegia, vomiting, and/or intractable hiccups, are rarely associated with ovarian cancers. We present the first recorded case of NMOSD in the setting of malignant immature ovarian teratoma, with concurrent leptomeningeal carcinomatosis contributing to clinical presentation.

Case

We describe a 27-year-old patient with Stage IVB Immature Ovarian Teratoma complicated by leptomeningeal carcinomatosis, who initially presented with intractable hiccups, nausea, and vomiting, and eventually developed attenuated vision. Neurological workup revealed AQP4-IgG antibodies, suggesting neuromyelitis optica (NMO) as a paraneoplastic syndrome (PNS). The patient’s cancer was treated with tumor resection, BEP (bleomycin, etoposide, cisplatin) therapy, maintenance bevacizumab, and brain radiation. While symptoms suspicious for NMO presented early on, it was not until after tumor resection and the development of double vision that NMO was diagnosed. NMO was promptly treated with plasma exchange and high dose steroids. While therapies did lead to disease stabilization, she was left with residual neurologic deficits requiring gait assistance.

Conclusion

Early symptoms such as intractable hiccups, nausea, or vomiting may precede optic neuritis or myelitis and serve as initial warning signs of NMOSD. Clinicians should maintain a high index of suspicion and low threshold for neurology consultation and AQP4-IgG antibody titers, especially when neurologic symptoms are not fully explained by metastatic disease.

研究背景：10%的卵巢癌与副肿瘤综合征有关。视神经脊髓炎谱系障碍（NMOSD）可表现为视力改变、截瘫、呕吐和/或顽固性打嗝，很少与卵巢癌相关。我们提出了第一例记录在案的NMOSD在恶性未成熟卵巢畸胎瘤的背景下，并发轻脑膜癌导致临床表现。我们描述了一位27岁的IVB期未成熟卵巢畸胎瘤合并脑膜轻癌的患者，他最初表现为顽固性打嗝、恶心和呕吐，最终发展为视力减弱。神经学检查显示AQP4-IgG抗体，提示视神经脊髓炎（NMO）为副肿瘤综合征（PNS）。患者的癌症接受肿瘤切除、BEP（博来霉素、依托泊苷、顺铂）治疗、维持贝伐单抗和脑放疗。虽然早期出现了疑似NMO的症状，但直到肿瘤切除并出现复视后才被诊断为NMO。NMO立即接受血浆置换和大剂量类固醇治疗。虽然治疗确实导致疾病稳定，但她留下了残余的神经功能缺陷，需要步态辅助。结论顽固性呃逆、恶心、呕吐等早期症状可能是视神经炎或脊髓炎的前兆，是NMOSD的早期预警信号。临床医生对神经内科会诊和AQP4-IgG抗体滴度应保持高怀疑指数和低阈值，特别是当转移性疾病不能完全解释神经内科症状时。

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引用次数: 0

Exploratory study of a long-term hospital-based cervical cancer screening program in a high HIV prevalence area of rural Malawi 马拉维农村艾滋病毒高发地区长期医院宫颈癌筛查方案的探索性研究

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-08 DOI: 10.1016/j.gore.2025.101986

Nora Badiner , Laurel Guthrie , Emily Stevenson , Andrew Folkerts , Joseph Mkandawire , Roslyn YX Ghui , Cassandra Graybill , Ryan Hayton , Moses Kasumba , Linda Hong , Sharon Lum , Mark Reeves , Yevgeniya Ioffe

Introduction

Malawi has the second-highest incidence and highest cervical cancer-attributed mortality worldwide. National HIV prevalence is 7.7%. Malawi implemented the Cervical Cancer Control Plan in 1999. We conducted an exploratory study of a non-government, hospital-based cervical cancer screening program established in the Southern Region.

Methods

We performed a retrospective review of outcomes from a cervical cancer screening program at a 275-bed rural mission hospital from 1/2016 – 12/2021. Female patients 18 years and older presenting for cervical cancer screening were included. Outcomes included trends in screening modality, return screening rates, abnormal screening rates, and the COVID pandemic impact. Data abstracted included demographics, HIV status, screening modality, and follow-up information.

Results

15,432 patients were screened for cervical cancer during the study period, with an overall increase in annual number of patients screened, despite the COVID-19 pandemic. Screening was initially performed via Pap testing; Visual inspection with acetic acid became the most common screening modality in 2019 (69.4%).

HIV prevalence among screened patients increased over the study period to 82.0% in 2021 and was higher among return screening patients (89.0%). 4.3% of HIV-negative and 7.2% of HIV-positive women demonstrated abnormal screening results.

Conclusion

Despite the COVID-19 pandemic, the number of patients screened for cervical cancer annually increased over the study period. HIV prevalence in this study was much higher than the national prevalence. These results emphasize the successful collaboration between a national program, private hospital, and HIV treatment centers, and highlight the need to increase screening among healthy women in the community.

马拉维是世界上宫颈癌发病率和死亡率第二高的国家。全国艾滋病毒感染率为7.7%。马拉维于1999年实施了子宫颈癌控制计划。我们对南方地区建立的一个非政府的、以医院为基础的宫颈癌筛查项目进行了探索性研究。方法回顾性分析2016年1月至2021年12月在一家拥有275个床位的农村教会医院开展的宫颈癌筛查项目的结果。包括18岁及以上的女性宫颈癌筛查患者。结果包括筛查方式、返回筛查率、异常筛查率和COVID大流行影响的趋势。提取的数据包括人口统计数据、艾滋病毒状况、筛查方式和随访信息。结果在研究期间，15432例患者接受了宫颈癌筛查，尽管2019冠状病毒病大流行，但每年筛查的患者总数仍在增加。筛查最初是通过巴氏试验进行的；醋酸目视检查成为2019年最常见的筛查方式（69.4%）。在研究期间，接受筛查的患者的艾滋病毒感染率在2021年增加到82.0%，在返回筛查的患者中更高（89.0%）。4.3%的hiv阴性妇女和7.2%的hiv阳性妇女表现出筛查结果异常。结论尽管2019冠状病毒病大流行，但在研究期间，每年接受宫颈癌筛查的患者人数有所增加。在这项研究中，艾滋病毒的流行率远远高于全国的流行率。这些结果强调了国家计划、私立医院和艾滋病毒治疗中心之间的成功合作，并强调了在社区健康妇女中增加筛查的必要性。

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引用次数: 0

Inverse correlation between Lamin A/C and survival in ovarian cancer: implications for predicting responsiveness to taxane-based chemotherapy Lamin A/C与卵巢癌患者生存的负相关：预测紫杉烷化疗反应的意义

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-11-07 DOI: 10.1016/j.gore.2025.101978

Elizabeth R. Smith , Isaac R.L. Xu , Kathy Qi Cai , Sophia H.L. George , Matthew P. Schlumbrecht , Tian-Li Wang , Ie-Ming Shih , Xiang-Xi Xu

Objective

Although paclitaxel is widely used to treat several solid cancers, the initial response rate in ovarian cancer is ∼60 %, but only ∼30 % in recurrent ovarian cancer. The basis of resistance remains poorly understood, and predictive biomarkers are currently unavailable. Nuclear Lamin A/C proteins determine the sturdiness of the nuclear envelope and were suggested to influence the sensitivity of the malignant cells to undergo paclitaxel-induced micronucleation and cell death. The relationship between Lamin A/C expression in ovarian cancer tissues and progression free survival (PFS) and overall survival (OS) in advanced ovarian cancer patients, most of whom had been treated at least once with platinum and taxane, was investigated.

Methods

Ovarian cancer samples in tumor microarrays were immunostained for Lamin A/C and analyzed for Lamin A/C expression in tumor cells. On the basis of this expression, tumors were stratified as either Lamin A/C-low or Lamin A/C-high. Overall survival and PFS were assessed using Kaplan-Meier plots.

Results

Both age and Lamin A/C expression correlate with OS, where older (> 60 years) and higher Lamin A/C expression aligned with lower survival. Lamin A/C expression was a predictor of OS independently of age. The median OS for the Lamin A/C-low group was 58 months versus 34.5 months for the high-expression group.

Conclusions

A significant correlation was found between Lamin A/C expression and OS, which implies that strong, widespread Lamin A/C expression in primary tumor tissues may be a predictive marker for paclitaxel sensitivity and thus survival, supporting a proposed paclitaxel mechanism in inducing micronucleation of cancer cells.

虽然紫杉醇被广泛用于治疗多种实体癌，但在卵巢癌中的初始缓解率为~ 60%，而在复发性卵巢癌中仅为~ 30%。耐药的基础仍然知之甚少，目前还没有预测性的生物标志物。核Lamin A/C蛋白决定核膜的坚固性，并被认为影响恶性细胞对紫杉醇诱导的微核和细胞死亡的敏感性。研究了晚期卵巢癌患者中Lamin A/C表达与无进展生存期（PFS）和总生存期（OS）的关系，其中大多数患者至少接受过一次铂和紫杉烷治疗。方法采用肿瘤微阵列对卵巢癌标本进行Lamin A/C免疫染色，分析肿瘤细胞中Lamin A/C的表达情况。在此基础上，将肿瘤分层为Lamin A/ c低或Lamin A/ c高。采用Kaplan-Meier图评估总生存期和PFS。结果年龄和Lamin A/C表达均与OS相关，其中年龄较大（60岁）和较高的Lamin A/C表达与较低的生存率相关。Lamin A/C表达与年龄无关，是OS的预测因子。Lamin A/ c低表达组的中位生存期为58个月，而高表达组为34.5个月。结论Lamin A/C表达与OS有显著相关性，提示在原发肿瘤组织中广泛表达的Lamin A/C可能是紫杉醇敏感性和生存率的预测指标，支持了紫杉醇诱导癌细胞微核的机制。

{"title":"Inverse correlation between Lamin A/C and survival in ovarian cancer: implications for predicting responsiveness to taxane-based chemotherapy","authors":"Elizabeth R. Smith , Isaac R.L. Xu , Kathy Qi Cai , Sophia H.L. George , Matthew P. Schlumbrecht , Tian-Li Wang , Ie-Ming Shih , Xiang-Xi Xu","doi":"10.1016/j.gore.2025.101978","DOIUrl":"10.1016/j.gore.2025.101978","url":null,"abstract":"<div><h3>Objective</h3><div>Although paclitaxel is widely used to treat several solid cancers, the initial response rate in ovarian cancer is ∼60 %, but only ∼30 % in recurrent ovarian cancer. The basis of resistance remains poorly understood, and predictive biomarkers are currently unavailable. Nuclear Lamin A/C proteins determine the sturdiness of the nuclear envelope and were suggested to influence the sensitivity of the malignant cells to undergo paclitaxel-induced micronucleation and cell death. The relationship between Lamin A/C expression in ovarian cancer tissues and progression free survival (PFS) and overall survival (OS) in advanced ovarian cancer patients, most of whom had been treated at least once with platinum and taxane, was investigated.</div></div><div><h3>Methods</h3><div>Ovarian cancer samples in tumor microarrays were immunostained for Lamin A/C and analyzed for Lamin A/C expression in tumor cells. On the basis of this expression, tumors were stratified as either Lamin A/C-low or Lamin A/C-high. Overall survival and PFS were assessed using Kaplan-Meier plots.</div></div><div><h3>Results</h3><div>Both age and Lamin A/C expression correlate with OS, where older (> 60 years) and higher Lamin A/C expression aligned with lower survival. Lamin A/C expression was a predictor of OS independently of age. The median OS for the Lamin A/C-low group was 58 months versus 34.5 months for the high-expression group.</div></div><div><h3>Conclusions</h3><div>A significant correlation was found between Lamin A/C expression and OS, which implies that strong, widespread Lamin A/C expression in primary tumor tissues may be a predictive marker for paclitaxel sensitivity and thus survival, supporting a proposed paclitaxel mechanism in inducing micronucleation of cancer cells.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"62 ","pages":"Article 101978"},"PeriodicalIF":1.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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