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The incidence of ovarian cancer ranks the third among female malignancies. Mesenchymal stem cells (MSC) are an important part of the tumor microenvironment. Studies have shown that MSC can inhibit or promote the proliferation, invasion and metastasis of ovarian cancer cells by secreting various cytokines, promoting epithelial-mesenchymal transformation (EMT) and increasing the proportion of tumor stem cells. MSC can produce a large number of exosomes, and the exosomes derived from MSC have biological functions similar to MSC, which are important factors mediating the communication and transmission of information between cells. However, the effect of MSC-derived exosomes on tumors and its mechanism are still unclear. Therefore, the study of the mechanism of interaction between MSC and its exosomes in ovarian cancer may reveal a new approach to the treatment of ovarian cancer.
ABSTRACT
Ovarian cancer is a common fatal malignant tumor in women. The most common pathological type is epithelial ovarian cancer (EOC) originating from the ovary or fallopian tube epithelium, accounting for 85%-90%. The standard treatment for EOC is tumor cytoreductive surgery. Postoperative platinum/paclitaxel chemotherapy, cell chemoresistance has become an important cause of recurrence and death in EOC patients. At present, many scholars believe that the tumor environment of ovarian cancer is rich in a broad spectrum of tumor pro-inflammatory cytokines and chemokines. Inflammation can increase the division and differentiation of epithelial cells. The long-term exposure of normal epithelial tissues to the inflammatory environment will gradually turn to malignant transformation. The inflammatory tumor microenvironment promotes the invasion and metastasis of transformed malignant tumor cells, and eventually develops drug resistance.
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Neutrophils are the most abundant leukocytes in the peripheral blood and play an important role in the immune response. However, there is growing evidence indicating that in addition to the immune response, neutrophils also have a crucial role in tumor development, especially in the process of invasion and metastasis. According to current research, depending on their phenotype, neu-trophils appear to be either anti-metastasis (N1) or pro-metastasis (N2). However, the role of tumor-associated neutrophils (TANs) in the metastasis of tumors is relatively complex and lacks a systematic introduction. This review mainly introduces TANs and focuses on the mechanism of TANs in promoting tumor invasion and metastasis. Finally, the possibility of TANs as an anti-tumor treatment strate-gy is discussed.
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Objective:To investigate the effect of ultrasound-guided transversus abdominis plane block on intraoperative and postoper-ative analgesia in laparoscopic abdominal surgery.Methods:Sixty ASAⅠ-Ⅱpatients with abdominal tumor,undergoing laparoscopic/robotic surgery were randomly assigned into two groups:one group undergoing general anesthesia(G group)and the other undergo-ing general anesthesia combined with transversus abdominis plane block(G+T group).After induction of general anesthesia in the G+T group,the patients received transversus abdominis plane block with injection of 15 Ml of 0.25% ropivacaine on each side,guided by ultrasound.The operation time,resuscitation time,orientation recovery time,and the dosage of remifentanyl were recorded and com-pared.During surgery,the MAP and HR at different time points(5 min before,after surgical incision;30 min after the surgery begin-ning;surgery finished)between the two groups were recorded and compared.Additionally,the VAS scores at different postoperative time points were compared between the two groups.Results:Compared to the G group,the resuscitation time,orientation recovery time and the dosage of remifentanyl in the G+T group were significantly decreased(P<0.05).In G group,compared to the basic value, the MAP and HR at 5 min and 30 min after surgical incision were significantly increased(P<0.05);whereas in the G+T group,the MAP and HR remained stable at different time points(P>0.05).Moreover,compared to the G group,the VAS score in the G+T group was sig-nificantly lower at 2,6,and 12 hours postoperatively(P<0.05).Conclusions:General anesthesia combined with transversus abdominis plane block in patients undergoing laparoscopic abdominal surgery reduces the intraoperative and postoperative remifentanil con-sumption,improves the efficacy of perioperative analgesia,and enhances the patient's recovery after surgery.
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In recent years,the relationship between fatty acid metabolism and tumor has become a hot topic and widely recognized.In tumor cell,fatty acid metabolism is important to its growth and metastasis.About synthesis,fatty acid can participate in the synthesis of phospholipids on the membrane of cancer cells and take part in important signal transduction pathways,such as PI3K-AKT-mTOR;in fatty acid catabolism,tumor cells can produce ATP to maintain its growth by β-oxidation;what's more,it could be kept redox homeostasis by producing nicotinamide adenine dinucleotide phosphate hydrogen (NADPH).So,anabolism and catabolism of fatty acid may promote occurrence and development of tumors,but the mechanisms are unclear.This review highlights the effects of fatty acid metabolism on the occurrence,development and metastasis of tumors.
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The complexities in necroptosis are pivotal signal molecules in the pathway.Its formation is regulated by a series of factors such as necrosome and ripoptosome.The studies have found that the complexities in necroptosis are closely related to multiple neoplasms,such as pancreatic ductal adenocarcinoma and glioma.Further study on the regulatory mechanism of them will provide a new idea for molecular cancer therapeutics.
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The tumor-associated neutrophils (TANs) are thought to be important and complicated character in tumor microenvironment.TANs play dual roles of anti-tumor or tumor-promoting in tumor microenvironment under different factors.TANs can not only play the anti-tumor effect by killing tumor cells directly and promoting immune response,but also can act as tumor promotors by promoting tumor angiogenesis and mediating tumor invasion and metastasis.Recent researches find that TANs are closely related to pre-metastatic niche (PMN),which can promote the construction and maintenance of PMN by means of changing the content of cell factors like interferon-γ.
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Objective To evaluate the middle-term effect of laparoscopic uterine artery occlusion combined with ascendant myomectomy (LUAO-M) for multiple uterine myomas. Methods The uterine artery was isolated and occluded with Kleppinger bipolar forceps (Sabre 2400,ASPEN LABS USA) or PK forceps (Gyrus Medical Limited Inc UK) under a laparoscope. Then dissection was performed on the surface of pseudo capsule with Kleppinger unipolar needle (Sabre 2400,ASPEN LABS USA) or PK needle (Gyrus Medical Limited Inc UK),and the target myoma was stripped out of the tumor bed with the Separate-Scoop device. Afterwards,repair of the incision was carried out in one layer with interrupted single stitch by Absorbable VICRYL suture (Johnson VICRYL ETHICON USA). Results The mean operation time was (102?36) min and mean blood loss was (88.7?58.4) ml. The mean hospital stay after the operation was (7.9?0.2) d,and febrile morbidity was 5.1% (5/98). Complications included two cases of subcutaneous emphysema and one case of ileus;no other severe complications occurred. Of the patients,98 cases were followed-up for 21 to 52 months (mean,36.3 months),during the period they were visited by a mean of 3.6 times,which showed a correction rate of menstruation abnormality of 95.9% (4/98),rate of uterine volume reduction of 57.7%,and rate of recurrent myoma of 3.1% (3/98). Conclusion LUAO-M shows a good clinical outcome and middle-term effect for multiple uterine myomas.
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Objective To investigate the surgical indications and techniques of laparoscopic operations for benign ovarian cysts. Methods A total of 112 patients underwent laparoscopic operations of cyst decollement, ovariotomy and adnexectomy. Results There were 104 cases (92 9%) of decollement, 5 cases (4 5%) of adnexectomy and 3 cases (2 7%) of ovariotomy.The operation time was (61 9?23 7) min, the intraoperative blood loss (37 0?40 7) ml, the postoperative hospital stay (6 8?2 4) days, the postoperative peak temperature of patients (37 8?0 5)℃, the duration of postoperative temperature beyond 37 5℃ (2 0?1 1) days and the time to first passing flatus (1 9?0 5) days. Pathological diagnoses showed 54 cases (48 2%) of ovary endometrial cyst, 30 (26 8%) of benign teratoma, 16 (14 3%) of mesonephroma, 8 (7 1%) of corpus luteum cyst, 3 (2 7%) of serous tumor and 1 (0 9%) fibroma. Conclusions Laparoscopic operations for benign ovarian cysts have advantages of minimally invasive surgery. However, indications must be strictly followed before operations, in the view of avoiding meeting malignant tumors in operations.
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Objective To investigate the surgical techniques and clinical effect of laparoscopic improved myomectomy. Methods After the surgical techniques and instruments were improved, laparoscopic myomectomies were performed in 91 patients with uterine myoma. The maximum diameter of myoma was (60 4?11 9) mm (range, 25 mm～110 mm), and in 35 cases the myomas were ≥7 0 cm and in 56 cases 0 05). Conclusions After the surgical techniques and instruments were improved, the operation time and the blood loss can be reduced, and better clinical effect obtained, even in patients with somewhat larger uterine myoma.