ABSTRACT
Ovarian cancer is one of the common gynecological malignant tumors. In China, there are more than 50 000 new cases diagnosed as ovarian cancer each year, and more than 30 000 death cases every year. In recent years, with the rapid development of gene detection technology, the establishment of ideal surgery concept, the specification of chemotherapy, the attention of recurrent ovarian cancer, and the application of targeted drugs, the diagnosis and treatment system of ovarian cancer is gradually standardized and improved. This article reviews the current status of ovarian cancer treatment and the latest research progress.
ABSTRACT
Ovarian cancer is one of the common gynecological malignant tumors. In China, there are more than 50000 new cases diagnosed as ovarian cancer each year, and more than 30000 death cases every year. In recent years, with the rapid development of gene detection technology, the establishment of ideal surgery concept, the specification of chemotherapy, the attention of recurrent ovarian cancer, and the application of targeted drugs, the diagnosis and treatment system of ovarian cancer is gradually standardized and improved. This article reviews the current status of ovarian cancer treatment and the latest research progress.
ABSTRACT
Objective To investigate epigenetic inactivation of SPOCK2 gene in the malignant transformation of ovarian endometriosis ( EM ) by comparing the methylation status and protein expression of SPOCK2 gene in the malignant tissues,ectopic endometria and the eutopic endometria of endometriosis.Methods From Jan.2005 to Jan.2011,22 paraffin-embedded specimens diagnosed as malignant transformation of ovarian endometriosis ( EAOC ) including 11 cases with ovarian endometrioid carcinoma,8 cases with clear cell carcinoma,2 cases with serous cystadenocarcinoma and 1 case with mucous cystoadenocarcinoma matched with 22 cases with ovarian endometriosis and 16 cases with normal endometrium form cervical intraepithelial neoplasia(CIN) patients as controls in Department of Obstetrics and Gynecology of Shengjing Hospital.Twenty-two malignant tissues,15 ectopic endometria and 10 eutopic endometria were captured by microdissection in EAOC group; 22 eetopic endometria and 17 eutopic endometria were captured in EM group; 22 endometrium were captured in the NE group.The methylation statue of SPOCK2 was determined by combined bisulfite restriction analysis,and the protein expression of SPOCK2 was evaluated by immunohistochemistry.Results ( 1 ) Methylation of SPOCK2:in the EAOC group,the frequency of SPOCK2 hypermethylation in malignant tissue was 45％ (10/22),which was significantly higher than 1/15 in the ectopic endometrium (P＜0.05).There was no statistical difference of the frequency of SPOCK2 hypermethylation in ectopic endometrium in the EAOC group(1/15) and EM group (5％,1/22) (P＞0.05).(2) SPOCK2 protein:the loss rate of SPOCK2 was 44％ (11/22) in malignant tissue in EAOC group,which were significantly higher than 2/15 of in ectopic endometrium of EAOC (P ＜ 0.05).However,there was no remarkable difference in loss rate of SPOCK2 protein between ectopic endeometrium of EAOC and endometrium of EM [ 2/15 vs.5％ ( 1/22 ),P ＞ 0.05 ].No significantly difference in loss rate of SPOCK2 in eutopic endometrium was observed among three groups ( P ＞ 0.05 ).(3) The abnormal methylation of SPOCK2 could lead to loss expression of protein ( P ＜ 0.05 ).Conclusion Epigenetic inactivation of SPOCK2 gene is involved in the malignant transformation of ovarian endometriosis.
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Objective To investigate the relationship between expression of eofilin-1 and in vivo implantation capacity of eutopic endometrium of endometriosis.Methods Eutopic endometrium of 20 cases with stage Ⅲ or Ⅳ endometriosis were obtained by laparoscopic or laparotomy surgery (endometriosis group) matched with 20 cases of eutopic endometrium from patients with cervical cancer in situ (control group) in Department of Obstetrics and Gynecology,ShengJing Hospital.All cases' eutopic endometrium were collected and injected into abdominal cavity of nude mice to establish endometriosis animal model, then the successful rate of animal model and volume of endometriosis lesion were calculated.The expression and positive rate of eofilin-1 protein were measured by western blot and immunohistochemistry staining.Results The mean volume of endometriosis lesions (2.38 ± 0.22)mm~3 in endometriosis group was significantly bigger than (0.36 ± 0.08) mm~3 in control group (P < 0.05).The successful rate of establishing endometriosis model was 95% (19/20) in endometriosis group and 5% (1/20)in control group, which reached statistical difference(P <0.05).The expression and positive rate of cofilin-1 protein in eutopic endometrium and the expression of cofilin-1 protein in endometriosis lesion of animal model were 0.82±0.06, 90% (18/20), 0.85 ± 0.03 and 0.21 ± 0.03, 20% (4/20), 0.22 ± 0.02 in control group, which reached statistical difference(P <0.05).The successful rate of establishing endometriosis model with positive cofilin-1 in endometrium 86% (19/22) was significantly higher than 6% (1/16) of model's endometrium with negative cofilin-1 expression(P <0.05).Conclusions Implanting capacity and cofilin-1 expression level of eutopic endometrium of endometriosis were more intensive than that of normal endometrium.High cofilin-1 expression was probably related with implanting capacity of eutopic endometrium of endometriosis.
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Objective To evaluate the clinical value of laparotomy,transvaginal surgery,and lapaioscopic surgery in treating benign ovarian cyst.Methods We retrospectively analyzed 227 patients with benign ovarian cyst who underwent laparotomy,transvaginal surgery,or laparoscopic surgery.The duration of the operation,amount of blood loss,hospitalization time,anal exhaust time,temperature recovery time.outof-bed time,usage of analgesics,postoperative morbidity,and hospitalization cost were analyzed.Results There were significant differences in above indicators between the patients undergoing transvaginal surgery or laparoscopic surgery and those undergoing laparotomy.Conclusion Transvaginal surgery and laparoscopic surgery are minimally invasive and safe in treating benign ovarian cyst.These 3 surgical approaches have distinct advantages and disadvantages.The clinicians should choose the appropriate surgical approach for benign ovarian cyst according to the patient's condition.
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Objective To compare the effects of transabdominal hysterectomy(TAH),transvaginal hysterectomy(TVH),and laparoscopic total hysterectomy(LTH)on sexual function and psychological health.Methods A total of 100 patients undergoing TAH,100 patients undergoing TVH,and 40 patients undergoing LTH were followed up for 1 year.All the patients were aged between 45 and 54 years.The Results of the questionnaire on sexual function and psychological health were analyzed and compared with those from 100 control subjects undergoing hysteromyomectomy.Results In pateints under 50 years of age,no significant difference in the sexual function and psychological health was found between control group and any one of TAH,TVH,and LTH goups.In patients aged 50 yeare and older.ESFI score decreased from control group to TVH group to LTH group to TAH group;CHQ-12 score increased from control group to TVH group to LTH group to TAH group;and there was significant difference in the FSFI and CHQ-12 scores both between TAH and control groups and between TAH and TVH groups(P＜0.05).Conclusion There is no obvious effect of these 3 surgical approches to hysterectomy on the sexual function and psychological health in patients under 50 years of age,and there is no significant difference in the sexual function and psychological health among these 3 surgcial approaches.In patients aged 50 yean;and older,TAH has a negative impact on the psychological health and sexual function.