ABSTRACT
OBJECTIVE: GM-CSF is produced in female reproductive tract and may play an important role in the process of implantation. Body of evidence suggests that GM-CSF could improve pregnancy rate in many species of mammals when it was added in culture media. The aim of this study is to assess how GM-CSF affects the expression of implantation-related genes in mouse embryo. METHODS: Two hundred mouse embryos were divided into control and GM-CSF treated groups. The embryos were treated with or without 10 ng/ml of GM-CSF for 72 hours. Total RNA was isolated and compared with oligo microarray. The implantation-related genes influenced by GM-CSF were repeatedly analyzed by real-time PCR. RESULTS: After oligo microarray, 64 genes were increased and 35 genes were decreased by GM-CSF. Among those genes, MMP2, FABP3, Dppa5 and TAS1 were selected for real-time PCR analysis. Four integrins and FAK were also selected. We confirmed the increase of MMP2 and FABP3 by GM-CSF with real-time RT-PCR (1.687 and 1.580 fold, respectively). Other genes were found to be minimally increased. CONCLUSION: GM-CSF induces the increased expression of MMP2 mRNA in mouse embryo, and then increases the invasiveness of the trophoblast. The role of FABP3 in the process of implantation remained to be elucidated.
Subject(s)
Animals , Female , Humans , Mice , Culture Media , Embryonic Structures , Granulocyte-Macrophage Colony-Stimulating Factor , Integrins , Mammals , Pregnancy Rate , Real-Time Polymerase Chain Reaction , RNA , RNA, Messenger , TrophoblastsABSTRACT
PURPOSE: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelviclymph node dissection. MATERIALS AND METHODS: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study.The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy.All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy.The radiation dose from the external beam to the whole pelvis was 45 50 Gy.Vagina cuffirradiation was performed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of 4488 4932 chy (median:4500 chy)at 5 mm depth from the vagina surface.The median follow-up period was 44 months (15 108 months). RESULTS: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95%and 94%, respectively.A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002)andparametrial extension (p=0.0001)affected the disease-free survival.From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival.Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients)and lymphedema of the leg (1 patient).No patient had grade 3 or 4 complications. CONCLUSION: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings.The prognostic factor for disease-free survival was invasion of the parametrium.The prognostic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and chemotherapy.
Subject(s)
Female , Humans , Cervix Uteri , Cystitis , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Hysterectomy , Incidental Findings , Leg , Lymph Nodes , Lymphedema , Multivariate Analysis , Neoplasm Metastasis , Pelvis , Proctitis , Radiotherapy , Survival Rate , Treatment Failure , Uterine Cervical Neoplasms , VaginaABSTRACT
PURPOSE: The locoregional failure rate remain high in advanced cervical carcinoma. Chemotherpy(CT) was added to radiotherapy(RT) in order to improve therapeutic result. We performed this study to evaluate the response rate, toxicities and survival benefit of neoadjuvant chemotherapy and to investigate potential role of neoadjuvant chemotherapy in treatment of cervical cancer. METHODS AND MATERIALS: The patients(68 cases of cervical cancer) were divided into two groups ; The one group was neoadjuvant chemotherapy followed by radiotherapy(n=30) and the other was the radiotherapy(n=38) group. The patients were maintained by regular follow-up and evaluated with regards to treatment related toxicity and effectiveness by response using World Health Organization criteria and 5-year survival rate. RESULTS: 30 patients were assigned to receive neoadjuvant chemotherapy. After chemotherpy, the overall clinical response rate was 46.7%. The response rate of neoadjuvant chemotherapy followed radiotherapy was higher than that of the radiotherapy in cervical cancer (100% vs 84.2%). The 5-year survival rate of patients was not different between two groups(p>0.05). Toxicities of chemotherapy were generally tolerable and usually well resolved with conservative treatment. CONCLUSION: Neoadjuvant chemotherapy followed radiotherapy help to improve response rate but did not affect survival benefit in the cervical cancer in this study. However, well controlled long-term prospective study will be need to get firm conclusion.