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Objective To evaluate the clinical application of perforator flap in extended radical vulvectomy of vulvar carcinoma.Methods Retrospectively,twelve cases of vulva carcinoma were treated by radical extensive excision,and the defects were repaired with perforator flap.Results All the flaps were survived and healed with first intention except one infection.The wound infection patient was treated with change of the dressing and antibiotics.The reconstructed vulvae were plump and elastic.It appeared like the normal vulvae and there was no contraction of the vagina.Conclusions Vulvar reconstruction with the perforator flap after the radical vulvectomy could make the patients recover easily,which produces almost normal appearance and function of the vulvae,reduces the time of wound healing,the patient could get the next therapy more quickly and the quality of life improving.It has wide clinical application value.
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Objective To study the expression of Notch 1,Jagged1 and Notch intracellular domain (NICD) in epithelial ovarian carcinoma tissues and analyze the clinical significance.To explore the activity of γ-secretase in epithelial ovarian carcinoma cell line SKOV3 and the effect of N-[N-(3,5-dil uorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester (DAPT),a γ-secretase inhibitor on the activity of γ-secretase in SKOV3.Methods Immunohistochemistry staining method was performed in 43 patients with epithelial ovarian carcinoma and 11 patients with benign epithelial ovarian tumor to detect the expression of Notch1,Jagged1 and NICD.The differences of expressionof Notch1,Jagged1 and NICD between malignant and benign ovarian tumors was compared and alsoanalyzed the correlation with clinicopathological parameters of ovarian carcinoma.Human serous ovarian cancer cell line SKOV3 and immortalized nontumorigenic ovarian epithelial cell line T29 were incubated in vitro.The activities of γ-secretase in SKOV3 and T29 with dimethyl sulfoxide (DMSO) and DAPT were detected respectively by Gal4VP16/UAS and dual luciferase reporter assay system.Results (1) The immunohistochemical composite scores (ICS) of Notch1 in epithelial ovarian carcinoma (6.7±2.2) were not significantly different with those in benign epithelial ovarian tumor (5.4± 2.7,P=0.153),while the ICS of Jagged 1 and NICD in epithelial ovarian carcinoma (5.3± 2.4,5.3± 2.3) were higher than those in benign epithelial ovarian tumor (1.6± 1.4,3.1± 1.7; all P＜0.01).The expression of Notch 1,Jagged 1 and N ICD had no correlation with patients' aged,history of carcinoma,ascites,the level of serum CA125,maximum length of ovarian tumor,Federation International of Gynecology and Obstetrics (FIGO) stage,grade and pathology subtypes (all P＞0.05).The hazard ratio between the high expression of Notch1,Jagged1,or NICD and the moderate to low expression of Notch1,Jagged1,or NICD,and Jagged1 were 0.771,1.648 and 1.316,respectively (all P＞0.05).The 5-year survival rate and median survival time between the high expression of Notch,Jagged 1 or NICD in subgroup and moderate to low expression in subgroup were of no difference (all P＞0.05).The activity of γ-secretase in SKOV3 was significantly higher than that in T29 [(12.2± 1.4)％,P=0.019].(2)After DAPT treated,the relative activity of γ-secretase in SKOV3 (50 μmol/L) was declined from (100.0±5.3)％ to (6.6±0.8)％ (P=0.001).Conclusions Jagged1 and NICD in Notch1 pathway may play a key role in the occurrence of ovarian carcinoma.The activity of γ-secretase in epithelial ovarian carcinoma was higher than that in ovarian epithelial cell which suggest that DAPT,γ-secretase inhibitor,may become the target of ovarian carcinoma treatment.
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Objective To investigate the effects of postoperative adjuvant chemotherapy (CT) and chemoradiotherapy (CRT) or radiotherapy(RT) for Ⅰ b-Ⅱ a cervical cancer with risk factors.Methods From March 1995 to June 2010,there were 137 patients underwent radical hysterectomy and systematic pelvic lymphadenectomy for stage Ⅰ b-Ⅱ a cervical cancer admitted at Peking University First Hospital.These patients had risk factors,intermediate risk factors including bulky tumor (＞4 cm),lymph vascular space invasion,deep stromal invasion; high risk factors including positive surgical margin,parametrial invasion,lymph node involvement.Of the all patients,79 cases of them were treated with CT,58 of them were treated with RT or CRT.The 5-year survival and prognosis factors were analyzed retrospectively,the prognosis was compared between two adjuvant therapy groups.Results The univariate analysis shown that types of pathology,different grade of risk factors,stroma invasion and lymph node involvement were prognostic factors of 5-year overall survival Patients with squamous cell carcinoma,intermediate risk factors,no parametrial invasion,and no lymph node involvement had better prognosis (P ＜ 0.05).Whether patients with high-risk factors or intermediate-risk factors,the 5-year overall survival and 3-year disease-free survival had no difference between CT and RCT or RT groups respectively.Cox regression multivariate analysis of survival indicated that clinical stages,types of histology,different grade of risk factors were independent prognostic indicator.Patients with early stage,squamous cell carcinoma,intermediate risk factors had better prognosis.Univariate and multivariate analysis indicated that different postoperative adjuvant therapies had no effects on the prognosis.The 5-year overall survival was 88.6％ in patients treated with CT,and 89.7％ in patients treated with RT or CRT (P =0.455).Conclusion There are equivalent therapeutic results between CT and RT or CRT for patients with risk factors after radical surgery,CT may be as one choice of postoperative adjuvant therapy for stage Ⅰ b-Ⅱ a cervical carcinoma with risk factors.
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Objective To study the expression and clinical significance of Notch3 and Notch intracellular domain (NICD) in ovarian carcinoma and the effects of N-[N-(3 ,5-difluorophenyl) acetyl-L-alanyl]-S-phenyl glycine t-butyl ester (DAPT), a γ-secretase inhibitor on the proliferation and apoptosis in OVCAR3, A2780 ovarian carcinoma cell lines. Methods Western blot was used to detect the expression of NICD in the tissues from 58 ovarian carcinomas patients and 21 normal ovarie, who were admitted in Peking University First Hospital from July 2006 to June 2009. Immunohistochemistry was also used to detect the expression of Notch3 in these tissues. The relationship with clinical features of ovarian carcinoma was also analyzed. Proliferation of OVCAR3 and A2780 ovarian cancer cells was determined by methyl thiazolyl tetrazolium (MTT) assay, cell cycles and apoptosis and index of proliferation were detected by flow cytometry method. The expression of NICD in OVCAR3 and A2780 cells incubated with DAPT was detected by western blot. Results (1)The expression level of NICD in ovarian carcinomas was significantly higher than that in normal ovarian tissues (1.64 ±0. 19 vs. 0.98 ±0.20;P <0.05). The NICD expression was higher in ovarian cancers with low grade or advanced stage than those in high-middle grade or early stage,respectively (1.90 ± 0. 22 vs. 1.25 ± 0. 21,1.80 ± 0. 21 vs. 1.21 ± 0. 15; all P < 0. 05). The Notch3 protein was stained positively in cytoplasm, nuclear and cell membrane. The expression of Notch3 was higher in ovarian carcinomas than that in normal ovaries [78% (45/58) vs. 24% (5/21); P < 0. 01]. While,there were no stasistical difference in different pathological types, stages, differentiation of ovarian carcinoma. There was no difference between the patients with adjuvant chemotherapy or not. (2)After OVCAR3 and A2780 cells incubated with DAPT 24, 48, 72 hours, NICD expression was significantly lower than that in control group (P < 0. 05). The effects of DAPT inhibited the proliferation and prompted the apoptosis of OVCAR3 and A2780 cells were depended on the concentrations and times. Conclusions Notch3 and NICD may play a key role in the occurrence and progress of ovarian carcinoma. The mechanism of DAPT inhibited the proliferation and prompted the apoptosis of OVCAR3 and A2780 cells may be due to decreased the formation of NICD.
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Objective To study the expression and clinical significance of Notch intracellular domain (NICD) in cervical cancer and the effects of N-[N-(3,5-difluorophenyl)acetyl-L-alanyl]-S-phenyl glycine t-butyl ester (DAPT), a γ-secretase inhibitor on the proliferation and apoptosis of cervical cancer cell lines. Methods Western blot was used to detect the expression of NICD in the tissues of 40 cervical cancers and 21 normal cervix and its relationship with clinical features of cervical cancer was also analyzed. Proliferation of SiHa and HeLa cervical cells was determined by methyl thiazolyl tetrazolium (MTT) assay, cell cycles and apoptosis and index of proliferation were detected by flow cytometry method. The expression of NICD in SiHa and HeLa cells incubated with DAPT was detected by western blot. Results The expression level of NICD in cervical cancers was significantly higher than that of normal cervical tissues (1.237±0.353 vs 0.938±0.105, P<0.05). The NICD expression was higher in cervical cancers with high grade,lymph node involvement and parametrial invasion than that with low-middle grade (1.496±0.540 vs 1.150±0.216), without lymph node involvement (1.419±0.532 vs 1.159±0.210) and no parametrial invasion (1.718±0.710 vs 1.183±0.258), respectively (all P<0.05). The expression of NICD in cervical adenocarcinoma was higher than that of squamous cell cancer (1.463±0.395 vs 1.162±0.187, P<0.05). After SiHa and HeLa cells were incubated with DAPT, NICD expression was significantly lower than that in control (P<0.05). The effects of DAPT inhibited the proliferation and prompted the apoptosis of SiHa and HeLa cells was depended on its concentrations and times. Conclusions NICD may play a key role in the occurrence and progress of cervical cancer. The mechanism of DAPT inhibited the proliferation and prompted the apoptosis of SiHa and HeLa cells may be due to decreased the formation of NICD.
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ObjectiveTo study the associated factors with pelvic lymph node metastasis of endometrial carcinoma and the effect of pelvic lymphadenectomy on prognosis of the disease MethodsTotally 102 patients with endometrial carcinoma who underwent pelvic lymphadenectomy (90 patients) or lymph node biopsy (12 patients) in our hospital from Jan 1981 to Dec 2002 were recruited The relationship between various clinicopathologic factors and pelvic lymph node metastasis was analyzed Prognosis of ninety patients with pelvic lymphadenectomy was compared with 90 patients without pelvic lymphadenectomy (control group) in the same period The 5-year survival was calculated by life table method Results The incidence of pelvic lymph node metastasis increased in patients with low grade(46%),deep myometrium invasion(42%), cervical involvement(44%), positive peritoneal cytology(52%), adenexal metastasis(75%) and distant spread(100%) The 5-year survival was lower in patients with lymph node metastasis (37%) than that without lymph node metastasis (89%, P
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Objective To investigate the expression of estrogen receptor ? (ER? ) mRNA and its significance in endometrial carcinoma. Methods Thirty six normal and 45 cancer tissue samples of endometrium were obtained, and the RNA was isolated from the tissues by the acid guanidium thiocyanate phenol chloroform extraction method. Reverse transcription polymerase chain reaction (RT PCR) was used to amplify the ER? exon 5 wild type mRNA (ER? WT) and splicing variant mRNA (ER? E5SV). Electrophoresis of polymerase chain reaction product was performed and the ratio of ER? E5SV/ER? WT was calculated. The sequencing of ER? E5SV and ER? WT was carried out by express DNA sequencer. Results ER? E5SV and ER? WT were both expressed in normal endometrium and endometrial cancer tissues. A region of 139 bp from base pair 812 to 950 (the hormone binding domain) was found to be deleted in ER? E5SV sequence as compared to ER? WT. The quantity of ER? E5SV was more than that of ER? WT in every normal endometrium, and was less in every endometrial cancer, the ratio of ER? E5SV/ER? WT was 2 47?0 99 in normal endometrium, and 0 55?0 12 in endometrial cancer ( P
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Objective To investigate the expression of estrogen receptor β (ERβ ) mRNA and its significance in endometrial carcinoma. Methods Thirty-six normal and 45 cancer tissue samples of endometrium were obtained, and the RNA was isolated from the tissues by the acid guanidium thiocyanate-phenol-chloroform extraction method. Reverse-transcription polymerase chain reaction (RT-PCR) was used to amplify the ERβ exon 5 wild type mRNA (ERβ WT) and splicing variant mRNA (ERβ E5SV). Electrophoresis of polymerase chain reaction product was performed and the ratio of ERβ E5SV/ERβ WT was calculated. The sequencing of ERβ E5SV and ERβ WT was carried out by express DNA sequencer. Results ERβ E5SV and ERβ WT were both expressed in normal endometrium and endometrial cancer tissues. A region of 139 bp from base pair 812 to 950 (the hormone-binding domain) was found to be deleted in ERβ E5SV sequence as compared to ERβ WT. The quantity of ERβ E5SV was more than that of ERβ WT in every normal endometrium, and was less in every endometrial cancer, the ratio of ERβ E5SV/ERβ WT was 2.47±0.99 in normal endometrium, and 0.55±0.12 in endometrial cancer (P<0.000 1). The ratio of ERβ E5SV/ERβ WT decreased with the grade from 1 to 3 (P<0.01). Conclusion Overexpression of ERβ WT relative to ERβ E5SV may correlate with the genesis of endometrial carcinoma.