Taiwanese Journal of Obstetrics & Gynecology最新文献

英文中文

Introduction of the single-lumen oocyte retrieval needle in an assisted reproductive technology center: Propensity score matching analysis of grouping 辅助生殖技术中心单腔卵母细胞回收针的介绍：分组倾向评分匹配分析。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.03.027

Tian-Jeau Huang , Hsiao-Chin Huang , Horng-Der Tsai , Chew-Teng Kor , Chueh-Ko Yang , Hsin-Hung Wu

Objective

To evaluate the effectiveness of oocyte retrieval using a single-lumen aspiration needle compared to a double-lumen aspiration needle in IVF (in vitro fertilization) patients.

Materials and methods

This retrospective cohort study included all IVF cycles between 1st January, 2020 and 31st December, 2022 in Changhua Christian Hospital, Taiwan. Pairwise comparisons were conducted through propensity score matching analysis at a 1:3 ratio according to patients’ age, anti-Müllerian hormone levels, and body weight. The cycles were divided into two groups: the single-lumen needle group, who utilized a single-lumen 18-gauge needle and the double-lumen needle group, who underwent follicular aspiration and flushing using a double-lumen 17-gauge needle. Outcomes included oocytes retrieved, matured oocytes (MII), normal zygotes (2-PN), viable embryos, procedure duration and pregnancy rate.

Results

A total of 2211 oocyte retrieval procedures were recorded. After propensity score matching, 912 IVF cycles were included for the analysis, comprising 228 and 684 cycles in the single-lumen and double-lumen needle groups, respectively. The single-lumen needle group had more oocytes retrieved (12.84 vs. 11.56, P < 0.05) and normal zygotes (7.79 vs. 6.98, P < 0.05) than the double-lumen needle group. The median procedure duration was also shorter in the single-lumen needle group (14.23 vs. 17.68 min, P < 0.05).

Conclusions

Oocyte retrieval using a single-lumen aspiration needle not only reduced the procedure duration but also increased the number of oocytes retrieved and the number of normal zygotes (2-PN). Therefore, the single-lumen aspiration needle exhibits higher efficiency in oocyte retrieval and is more affordable than the double-lumen aspiration needle.

目的：评价单腔吸母针与双腔吸母针在体外受精患者中取卵的效果。材料与方法：本回顾性队列研究包括2020年1月1日至2022年12月31日在台湾彰化基督教医院进行的所有IVF周期。根据患者年龄、抗勒氏杆菌激素水平、体重，采用倾向评分匹配分析，按1:3比例两两比较。这些周期被分为两组：单腔针头组，他们使用单腔18号针头；双腔针头组，他们使用双腔17号针头进行滤泡抽吸和冲洗。结果包括获得的卵母细胞、成熟卵母细胞（MII）、正常受精卵（2-PN）、活胚、手术时间和妊娠率。结果：共记录了2211例卵母细胞提取过程。倾向评分匹配后，纳入912个试管婴儿周期进行分析，其中单腔针组228个周期，双腔针组684个周期。结论：单腔吸卵针取卵不仅缩短了手术时间，而且增加了取卵数和正常受精卵数（2-PN）。因此，单腔抽吸针在卵母细胞回收方面具有更高的效率，并且比双腔抽吸针更便宜。

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引用次数: 0

Primary endometrial squamous cell carcinoma (PESCC): Review of the literature and case report 原发性子宫内膜鳞状细胞癌（PESCC）：文献回顾及病例报告。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.03.029

Kuang-Han Liu , Chia-Chin Tsai , Krystal Baysan Lin , Pei-Shen Huang

Objective

Primary endometrial squamous cell carcinoma (PESCC) is an extremely rare type of endometrial cancer with limited research and understanding. This report presents a case of PESCC and reviews 37 cases from 1997.

Case report

A 61-year-old menopausal woman presented with abnormal vaginal bleeding. Despite no prior Papanicolaou smears and normal Pap results this time, transvaginal sonography revealed 7 mm endometrial thickening and elevated cancer antigen 125 (CA-125). Dilatation and curettage revealed atypical glands with squamous metaplasia. On May 3, 2017, she underwent robot-assisted staging surgery (stage IB) and pelvic radiotherapy. No disease recurrence observed till now.

Conclusion

Early diagnosis of PESCC is crucial for management. Although guidelines are lacking due to the rarity of PESCC, increased reporting and research are expected to shed light on this condition and facilitate the establishment of treatment protocols.

目的：原发性子宫内膜鳞状细胞癌（PESCC）是一种极为罕见的子宫内膜癌，研究和认识有限。本报告介绍一例PESCC，并回顾了1997年以来的37例病例。病例报告：一61岁绝经妇女表现为阴道异常出血。尽管没有既往的巴氏涂片检查和正常的巴氏涂片检查结果，经阴道超声检查显示7mm子宫内膜增厚和癌抗原125 （CA-125）升高。扩张和刮除显示非典型腺体鳞状化生。2017年5月3日，她接受了机器人辅助分期手术（IB期）和盆腔放疗。至今未见疾病复发。结论：PESCC的早期诊断对治疗至关重要。尽管由于PESCC的罕见性，缺乏指导方针，但预计将增加报告和研究，以阐明这种情况，并促进建立治疗方案。

引用次数: 0

Pregnancy complicated by fetal goiter following lung transplantation for idiopathic pulmonary arterial hypertension: A case study 特发性肺动脉高压肺移植术后妊娠合并胎儿甲状腺肿一例研究。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.08.007

Asuka Hamuro , Yoshifumi Kasuga , Saki Saito , Hiroshi Uchida , Takahiro Hiraide , Yohei Yamada , Takeshi Arimitsu , Hiroshi Date , Hiroyuki Fukushima , Mamoru Tanaka

Objective

We report a case of pregnancy following lung transplantation (LT) for idiopathic pulmonary arterial hypertension (IPAH) in Japan.

Case Report

A female developed IPAH at 14 years of age and underwent a successful bilateral living-donor lobar LT from her parents at 19 years of age (gravida 2, para 0). At the age of 40 years, the patient became pregnant via artificial insemination. At 28 weeks of gestation, polyhydramnios and a fetal goiter were detected on transabdominal ultrasound. The patient was diagnosed with deep vein thrombosis and pulmonary embolism. The patient underwent emergency cesarean section to deliver a male neonate weighing 1340 g (−0.41SD) at 30 weeks of gestation, with an Apgar score of 5/5 (1/5 min).

Conclusion

To our knowledge, this is the first reported case of a successful pregnancy following LT in Japan. Specialists should work together to manage pregnancies following LT.

目的：我们报告一例日本特发性肺动脉高压（IPAH）患者肺移植（LT）后妊娠。病例报告：一名女性在14岁时患上IPAH，并在19岁时成功接受了父母的双侧活体肝移植（妊娠2，第0段）。在40岁时，患者通过人工授精怀孕。妊娠28周时，经腹超声检查发现羊水过多和胎儿甲状腺肿大。患者被诊断为深静脉血栓形成和肺栓塞。患者于妊娠30周行紧急剖宫产术，生下体重1340 g （-0.41SD）的男婴，Apgar评分为5/5 （1/5 min）。结论：据我们所知，这是日本首次报道的肝移植后妊娠成功的病例。专家们应该共同努力来管理术后妊娠。

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引用次数: 0

Difficulty in genetic counseling of an asymptomatic carrier woman with a de novo 15q13.2q13.3 microdeletion encompassing CHRNA7 and OTUD7A and recurrent 15q13.2q13.3 microdeletion in the fetus 无症状携带15q13.2q13.3微缺失（包括CHRNA7和OTUD7A）和胎儿复发性15q13.2q13.3微缺失的女性遗传咨询困难

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.10.004

Chih-Ping Chen

引用次数: 0

Lymphedema and sentinel lymph node mapping 淋巴水肿和前哨淋巴结测图。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.11.004

Peng-Hui Wang

引用次数: 0

Polypoid endometriosis in a young female with systemic lupus erythematosus, mimicking ovarian and pelvic malignancy, a case report 息肉样子宫内膜异位症的年轻女性与系统性红斑狼疮，模仿卵巢和盆腔恶性肿瘤的病例报告。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.04.022

Yu-Min Fan , Tao-Yeuan Wang , Jen-Ruei Chen

Objective

Polypoid endometriosis is a rare mass-like variant of endometriosis. Mass-like content with indistinct margins between the uterus and pelvic side wall mimics characteristics of pelvic malignancy. Systemic lupus erythematosus (SLE) has also been associated with higher incidences of endometriosis. However, SLE cases with polypoid endometriosis have never been reported in English literature.

Case report

A 33-year-old female presented with SLE and polypoid endometriosis. Initially, she received a left salpingo-oophorectomy due to suspicion of ovarian malignancy, but only endometrioma with polypoid feature was diagnosed. Repeated second surgery was conducted because of a new-growth complex mass between the uterus and the pelvic side wall, causing myometrial invasion and left hydroureter/hydronephrosis. Finally, polypoid endometriosis of the pelvic side wall was diagnosed pathologically.

Conclusion

Polypoid endometriosis is still a diagnostic challenge before pathological confirmation. This case of SLE and polypoid endometriosis may be the first reported worldwide.

目的：息肉样子宫内膜异位症是一种罕见的肿块样子宫内膜异位症。子宫和盆腔侧壁之间的肿块样内容物边界不清，与盆腔恶性肿瘤的特征相似。系统性红斑狼疮（SLE）也与子宫内膜异位症的高发病率有关。然而，SLE合并息肉样子宫内膜异位症在英文文献中从未报道过。病例报告：一名33岁女性SLE合并息肉样子宫内膜异位症。最初，由于怀疑卵巢恶性肿瘤，她接受了左侧输卵管卵巢切除术，但仅诊断为具有息肉样特征的子宫内膜瘤。由于子宫与盆腔侧壁之间新生长的复杂肿块，导致子宫肌层浸润和左侧输尿管/肾积水，再次进行手术。最后病理诊断为盆腔侧壁息肉样子宫内膜异位症。结论：在病理证实之前，息肉样子宫内膜异位症的诊断仍是一个挑战。本例SLE合并息肉样子宫内膜异位症可能是全球首例报道。

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引用次数: 0

Instruction for Authors

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/S1028-4559(25)00011-7

引用次数: 0

Challenging and continuing laparoscopic radical hysterectomy for more than 30 Years at a single institution. After the LACC trial, should minimally invasive surgery for early-stage cervical cancer really be discarded? 挑战和持续腹腔镜根治性子宫切除术在一个机构超过30年。在LACC试验之后，早期宫颈癌的微创手术真的应该被抛弃吗？

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.08.006

Kohei Omatsu, Chyi-Long Lee, Kuan-Gen Huang

Objective

The laparoscopic approach to cervical cancer (LACC) trial highlighted the necessity of an open approach for radical hysterectomy due to its negative impact on oncological outcomes. While minimally invasive surgery is an option for other organ cancers, its application in cervical cancer remains a challenge for surgeons. In this study, we aimed to assess the oncological outcomes of patients with early-stage cervical cancer who underwent minimally invasive radical hysterectomy performed by experienced oncologic endoscopists in gynecology at a single institution.

Materials and methods

This study was a retrospective chart review conducted at Chang Gung Memorial Hospital, Linkou, between 2014 and 2023. We retrospectively analyzed clinical data from patients diagnosed with the International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IA1 to IB1 cervical cancer. Patients underwent laparoscopic radical hysterectomy performed by experienced oncologic endoscopists in gynecology.

Results

Our analysis included 22 patients, with 5 at FIGO stage IA1, 3 at IA2, and 14 at IB1. The median operation time was 274 min (range: 173–410 min), with an estimated blood loss of 125 mL (range: 50–300 mL). While no major intraoperative complications were observed, one patient reported a poor sensation of urination postoperatively. No recurrences or mortality occurred during the follow-up period.

Conclusion

Our findings suggest that minimally invasive radical hysterectomy performed by experienced oncologic endoscopists in gynecology is a viable treatment option for early-stage cervical cancers with a diameter of ≤2 cm.

目的：腹腔镜宫颈癌入路（LACC）试验强调开放入路根治性子宫切除术的必要性，因为它对肿瘤预后有负面影响。虽然微创手术是治疗其他器官癌症的一种选择，但它在宫颈癌中的应用对外科医生来说仍然是一个挑战。在这项研究中，我们旨在评估在单一机构由经验丰富的妇科肿瘤内窥镜医师实施微创根治性子宫切除术的早期宫颈癌患者的肿瘤预后。材料与方法：本研究采用2014 - 2023年在林口市长庚纪念医院进行的回顾性图表综述。我们回顾性分析了国际妇产科联合会（FIGO） 2018年诊断为IA1至IB1期宫颈癌的患者的临床资料。患者接受腹腔镜根治性子宫切除术，由经验丰富的妇科肿瘤内窥镜医师进行。结果：我们的分析包括22例患者，5例FIGO分期为IA1, 3例为IA2, 14例为IB1。中位手术时间为274分钟（范围：173-410分钟），估计失血量为125毫升（范围：50-300毫升）。虽然没有观察到主要的术中并发症，但有1例患者报告术后排尿感觉差。随访期间无复发或死亡。结论：我们的研究结果表明，由经验丰富的妇科肿瘤内镜医师进行微创根治性子宫切除术是治疗直径≤2 cm的早期宫颈癌的可行选择。

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引用次数: 0

Comment on “natural conception and term pregnancy after hysteroscopic incision of complete septate uterus with septate cervix: A case report and literature review” “宫腔镜切开完全分隔子宫并分隔宫颈后自然受孕足月妊娠1例并文献复习”一文评论。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.08.011

Sivalakshmi Ramu, Rinchen Zangmo

引用次数: 0

Fatty acid metabolism-related signature suggests an oncogenic role of TEKT1 in endometrial cancer 脂肪酸代谢相关信号提示TEKT1在子宫内膜癌中的致癌作用。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.10.002

Zhikai Xiahou , Hong Xiao , Yafeng Song , Xin Xu

Objective

The study aims to construct a prognostic signature to detect the molecular interaction between the fatty acid metabolism and the progression of endometrial cancer.

Materials and methods

A total of 309 fatty acid metabolism relative genes were analyzed in the endometrial cancer cohort from The Cancer Genome Atlas. Dataset GSE216872 was applied for external validation. The R program was chosen to detect the expression of FAMRGs and execute GO/KEGG analysis. Considering the clinical information and pathological features, a prognostic gene signature was constructed using LASSO Cox regression analysis. According to FAM risk score, endometrial cancer patients were divided into high and low FAM-risk score groups. By differential expression analysis and cytoscape, TEKT1 was identified as the hub gene. Functional enrichments explored the biological process TEKT1 participated. Cellular proliferation, clone formation, migration, invasion, cycle, and apoptosis were assessed to detect the effect of TEKT1 in endometrial cancer. Co-immunoprecipitation and Western blot were performed to determine the mechanism of TEKT1.

Results

A prognostic signature based on 10 FAMRGs (ACACB, PTGIS, BMPR1B, DHCR24, FAAH, GPX1, GPX4, INMT, PON3, PPT2) was generated using Lasso Cox hazards regression analysis in TCGA. TEKT1 was identified as the gene related to fatty acid metabolism. Next, we demonstrated that TEKT1 was highly expressed in endometrial cancer tissues in CPTAC and was mainly involved in the cell cycle and biosynthesis of unsaturated fatty acids. Ex-vivo experiments revealed that TEKT1 promoted proliferation, migration, and invasiveness while inhibiting apoptosis. Further experiments demonstrated that TEKT1 might promote fatty acid synthesis by binding to AMPK-γ for ACC and FASN downregulation.

Conclusion

A reliable predictive signature based on genes related to fatty acid metabolism in endometrial cancer was conducted, wherein TEKT1 was mainly implicated as the primary gene of interest. TEKT1 showed affinity to AMPK-γ and probably promoted FA synthesis in endometrial cancer.

目的：构建子宫内膜癌预后标志物，检测脂肪酸代谢与子宫内膜癌进展之间的分子相互作用。材料与方法：对来自the cancer Genome Atlas的子宫内膜癌队列中309个脂肪酸代谢相关基因进行分析。使用数据集GSE216872进行外部验证。采用R程序检测FAMRGs的表达并进行GO/KEGG分析。结合临床资料和病理特征，采用LASSO Cox回归分析构建预后基因特征。根据FAM风险评分将子宫内膜癌患者分为FAM高、低风险评分组。通过差异表达分析和细胞图分析，TEKT1被确定为枢纽基因。功能富集研究了TEKT1参与的生物过程。检测TEKT1在子宫内膜癌中的增殖、克隆形成、迁移、侵袭、周期和凋亡的影响。采用免疫共沉淀法和Western blot检测TEKT1的作用机制。结果：采用Lasso Cox风险回归分析，基于10个FAMRGs （ACACB、PTGIS、BMPR1B、DHCR24、FAAH、GPX1、GPX4、INMT、PON3、PPT2）生成TCGA的预后特征。TEKT1被鉴定为脂肪酸代谢相关基因。接下来，我们证明了TEKT1在CPTAC的子宫内膜癌组织中高表达，主要参与细胞周期和不饱和脂肪酸的生物合成。离体实验显示TEKT1促进细胞增殖、迁移和侵袭性，同时抑制细胞凋亡。进一步的实验表明TEKT1可能通过与AMPK-γ结合促进ACC和FASN下调来促进脂肪酸合成。结论：基于脂肪酸代谢相关基因的子宫内膜癌预测信号可靠，其中TEKT1是主要的感兴趣基因。TEKT1与AMPK-γ有亲和力，可能促进了子宫内膜癌中FA的合成。

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