Relation between insulin resistance and insulin receptor gene methylation in the endometrium of patients with polycystic ovary syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the relationship between insulin resistance and methylation of insulin receptor (INSR) gene in the endometrium of women with polycystic ovary syndrome (PCOS).</p><p><b>METHODS</b>Based on the HOMA index, 35 patients with PCOS were divided into insulin resistant group (IR group, n=18) and non-resistant group (NIR group, n=18). The patients age, serum estriol, testosterone, FSH and LH, fasting insulin and fasting blood glucose were compared between the two groups. The endometrial samples were obtained from the patients to examine DNA methylation status of INSR gene in the endometrial cells using methylation-specific PCR.</p><p><b>RESULTS</b>The BMI, WHR, fasting glucose, fasting insulin, and HOMA index differed significantly between the two groups (P<0.05). PCR analysis showed partial methylation in the promoter region of INSR gene in 13 samples in IR group and 11 samples in NIR group, without detection of full methylation of the INSR gene in either group. The methylation status showed no significant difference between the two groups (P=0.328).</p><p><b>CONCLUSION</b>Partial methylation of the INSR gene occurs in the endometria of PCOS patients, but this study does not provide a strong evidence supporting the relationship between insulin resistance and INSR gene methylation in women with PCOS.</p>

Timing of pregnancy after surgery for tubal pregnancy / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the outcome of pregnancy in women after surgical treatment of tubal pregnancy and measures to improve the rate of successful postoperative pregnancy.</p><p><b>METHODS</b>A retrospective study was conducted among 424 women who underwent surgical treatment for tubal pregnancy between Jan 1999 and Jan 2004. All patients desiring a second pregnancy were followed up for 18-72 months for the outcome. Cumulative fertility and recurrence curve were compared and calculated by life-table.</p><p><b>RESULTS</b>Of the 424 women with tubal pregnancy, 177 (41.7%) had intrauterine pregnancy after the operation, while 102 (24.1%) had recurrent ectopic pregnancy. Among the 177 women with intrauterine pregnancy, 85 (48.02%) became pregnant within 6 months after the operation, 133 (75.14%) within one year, and the cumulative intrauterine pregnancy rate approached 94.92% within 2 years. But among the 102 women with recurrent ectopic pregnancy, only 10 (9.8%) were pregnant within 6 months after the operation, and 49 (48.04%) within 18 months, with a cumulative ectopic pregnancy rate of 67.65%.</p><p><b>CONCLUSION</b>For women receiving surgery for ectopic pregnancy, the chance for intrauterine pregnancy can be the greatest within 6 months after operation and reduced markedly after 2 years, when recurrent ectopic pregnancy can be likely. Early plans for pregnancy and hydrotubation following the surgery may prove beneficial for raising the chances for postoperative intrauterine pregnancy.</p>

Endometrial carcinoma in patients below 45 years of age: clinical analysis of 53 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of endometrial carcinoma in patients below 45 years of age.</p><p><b>METHODS</b>The clinical data were collected from 53 patients with endometrial carcinoma below 45 years of age, who were divided into less than 40 year group (group A, 28 cases) and 40 to 45 year group (group B, 25 cases) and their clinical data were compared.</p><p><b>RESULTS</b>A rate of 57.1% (16/28) of the patients in group A were infertile, and 78.5% (22/28) reported irregular menstruation. In group B, the infertility rate was 28.0% (7/25), and 48% (12/25) of the patients were obese, 56% (14/25) had abnormal vaginal bleeding, and 32% (8/25) had diabetes and hypertension. The two groups differed significantly in the infertility rate, number of pregnancies and deliveries and the incidences of obesity, hypertension and diabetes. The pathological classification, grade of differentiation, pathological staging, depth of myometrial invasion, and cervical infiltration status were comparable between the two groups (P>0.05). All the 53 patients received surgical interventions and follow. up for two years, during which 1 patients in group B had relapse.</p><p><b>CONCLUSION</b>Patients with endometrial carcinoma at 40 years of age or below often have infertility, and those over 40 years are exposed to such high-risk factors as obesity, diabetes, and hypertension. Its major clinical symptom of endometrial carcinoma is menstrual disorders. The differentiation, pathological staging, pathological classification of the malignancy are not associated with age in patients below 45 years of age. Early diagnosis often warrants more favorable prognosis.</p>