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As one of the most severe malignant tumors, cervical cancer poses a significant threat to women. In 2020, the World Health Organization (WHO) introduced the "Global Strategy to Accelerate the Elimination of Cervical Cancer" in response to well-established tertiary prevention measures. Primary prevention measures prioritize health education and the administration of prophylactic human papillomavirus (HPV) vaccines. China currently offers five HPV vaccines supported by extensive research data specific to the Chinese population. This paper discusses the application of HPV vaccines in China and related issues that need to be paid attention to.
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Cervical cancer is still a serious threat to the health of women in China. The current strategy is a three-level prevention strategy, among which the diversion of screening and screening abnormalities in the secondary prevention is an important link in preventing cervical cancer. For more than 20 years, China has implemented diversified screening methods such as cytological examination, high-risk human papillomavirus (HPV) testing, and naked eye screening. With the discovery that high-risk HPV infection is closely related to the occurrence of cervical cancer, the screening method for cervical cancer has shifted from cytological examination to HPV testing as the preferred screening method. This article introduces the advantages and disadvantages of high-risk HPV testing and cytological examination as screening methods, and proposes the issues that need to be paid attention to in screening; The principle of diverting screening abnormalities was proposed, and it was proposed that in the process of diverting, individualized and refined management principles should be implemented for screening abnormality projects based on the patient′s age and fertility requirements.
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Objective:Evaluation of the clinical value of the BioPerfectus multiplex real time (BMRT)-HPV for cervical cancer screening.Methods:Physician-collected specimens of 1 495 women who were positive of Cobas 4800 HPV (Cobas-HPV), HPV genotyping based on SEQ uencing (SEQ-HPV), and (or) cytology ≥low grade squamous intraepithelial lesion (LSIL) in the primary screening of Chinese Multiple-center Screening Trial (CHIMUST), and 2 990 women selected from those who were negative of primary screening in the same project through nested control randomization with age-matching were tested for BMRT-HPV, which reported type-specific viral loads/10 000 cells in each specimen. With comparing to Cobas-HPV results and taking cervical histopathological diagnosis as the endpoint, the concordance of high-risk (HR)-HPV subtypes among the three assays was explored ,and the sensitivity and specificity of BMRT-HPV for cervical cancer screening were evaluated.Results:(1) The overall agreenment of HR-HPV subtypes between BMRT-HPV and Cobas-HPV, or SEQ-HPV test sample was 94.8%, 94.4%, with Kappa values 0.827, 0.814. (2) The sensitivity and specificity for cervical intraepithelial neoplasia (CIN) Ⅱ + of BMRT-HPV, Cobas-HPV and SEQ-HPV were 92.62%, 94.26%, 93.44% and 84.67%, 83.25%, 82.76%, respectively. There were no significant difference in sensitivity among the three HPV assays (all P>0.05), but the specificity of BMRT-HPV for CIN Ⅱ + was higher than those of Cobas-HPV and SEQ-HPV ( P<0.01). The sensitivity for CIN Ⅲ + of three HPV assays were all 100.00%, and the specificity for CIN Ⅲ + of BMRT-HPV was higher than those of Cobas-HPV and SEQ-HPV (83.40% vs 81.95%, 83.40% vs 81.50%; P<0.01). The number of pathological examinations of colposcopy for cervical biopsy detected in 1 case of CIN Ⅱ + or CIN Ⅲ + in BMRT-HPV was less than those in Cobas-HPV and SEQ-HPV ( P<0.01). When using HPV 16/18 + cytology ≥atypical squamous cell of undetermined signification (ASCUS) to triage HPV positive women among three assays, there was no different in the sensitivities of detecting CIN Ⅱ + and CIN Ⅲ + ( P>0.05). The specificity BMRT-HPV was slightly higher than those in Cobas-HPV or SEQ-HPV (all P<0.05), and the colposcopy referral rate was lower than those in Cobas-HPV and SEQ-HPV (all P<0.05). Conclusions:BMRT-HPV is as sensitive as Cobas-HPV or SEQ-HPV for primary cervical cancer screening, and has higher specificity. Therefore it could be used as a primary screening method for cervical cancer, which is worthy of clinical application.
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The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.
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The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.
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Objective To evaluate the clinical outcomes and feasibility of multi-modality adjuvant chemotherapy and radiation, which was conducted as postoperative chemotherapy, radiation, and consolidation chemotherapy (CRC) mode for the treatment of advanced endometrial cancer. Methods A retrospective analysis of 124 patients with International Federation of Gynecology and Obstetrics (FIGO) stages Ⅲ and Ⅳ endometrial cancer from Jan. 2004 to Oct. 2012 was conducted in Peking University People′s Hospital and Beijing Obstetrics and Gynecology Hospital. Inclusion criteria were comprehensive staging procedure including hysterectomy, bilateral salpingo-oophorectomy, and (or) selective pelvic aortic lymphadenectomy, and treatment with adjuvant chemotherapy and (or) radiation. The average age of these patients was (55.9 ± 8.4) years old (range from 23 to 79 years old). According to different postoperative adjuvant treatment modes, the patients were divided into CRC group, chemotherapy-radiotherapy (CR) group and single chemotherapy (C) group. The survival and side effects of the three groups were compared. Results (1) One hundred and twenty-four patients with advanced stage endometrial cancer were identified and received postoperative adjuvant therapies.Sixty-one (49.2％, 61/124) cases of them received postoperative CRC fashion, 19 (15.3％, 19/124) received postoperative CR and 44 (35.5％, 44/124) cases received C. The age, stage, grade and type of surgery of the three groups were not significantly different (all P>0.05);while, the pathology, chemotherapy cycles and chemotherapy regimens differed significantly (all P<0.05). (2) The progression-free survivals (PFS) of the patients with CRC, CR, and C group were (121±7), (68± 15), and (100±11) months, respectively. The 3-year PFS rates were 87.9％, 43.7％, and 61.4％, respectively. The 5-year PFS rates were 82.2％, 36.4％, and 61.4％, respectively. The above indicators were significantly higher in the CRC group than in the CR group (all P<0.01), and there was no difference between the CRC group and the C group (P=0.037). The overall survival (OS) of patients with CRC, CR, and C group were (128 ± 6), (80 ± 12), and (99 ± 10) months, respectively. The 3-year OS rates were 87.8％, 72.4％, and 67.1％, the 5-year OS rate were 84.2％, 54.3％, and 64.1％, respectively. The above indicators were significantly higher in the CRC group than those in the CR group and C group (all P<0.01). (3) There was no difference in the frequency of adverse effects either chemotherapy, such as severe bone suppression or radiotherapy;hepatotoxicity,blood transfusion, dose modifications;or cycle delays between the CRC, CR and C group (all P>0.05). (4) In the univariate analysis shown that, stage, the fashion of postoperative adjuvant therapy and type of surgery were risk factors for tumor progression in patients with advanced endometrial cancer (P<0.05). After adjusted for FIGO stage and type of surgery, the tumor progression hazard ratio (HR) was 3.931 (95％CI:1.734-8.914, P=0.001) for the CR group and 2.188 (95％CI:1.010-4.741, P=0.047) for the C group, compared to the CRC group. Conclusion Sequential CRC delivered in a"sandwich"fashion for the treatment in advanced endometrial cancer could significantly improve the 3-year and 5-year OS rates and have a similar adverse effect profile compared with other sequencing modalities.
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Objective To investigate the acceptance of HPV self-sampling mode in cervical cancer screening population and explore its feasibility. Methods From March 5 to 15, 2018, researchers investigated women who participated in cervical cancer screening organized by Beijing Shunyi Women＇s and Children＇s Hospital in the form of questionnaires. Questionnaires were conducted on their acceptance status and the factors that affect the self-sampling experience. The specific contents of the questionnaires were as follows: (1) the experience of using self-sampling included operability, comfortable, sample time-consuming, bleeding or not after sampling; (2) psychological changes after self-sampling, including the willingness to accept self-sampling again, the worrying problems during self-sampling process. According to whether or not have operating video guidance, the self-sampling experience and psychological changes after self-sampling were compared. Results (1) There were 1 375 women participated in the questionnaire survey, and 86.55% (1 190/1 375) of them thought the self-sampling was convenient, 78.40% (1 078/1 375) thought it was not uncomfortable, 88.58% (1 218/1 375) thought the sampling time was fast (less than 5 minutes), 94.04% (1 293/1 375) self-sampling without bleeding; and 83.27% (1 145/1 375) were willing to self-sampling for cervical cancer screening again, 85.82% (1 180/1 375) were afraid of inaccurate sampling. (2) Among the 1 375 women, 1 202 were in the video guidance group and 173 were in the non-guidance group. The self-sampling experience of women in video guidance group was better than those of non-guidance group in operability, comfortable, sampling time-consuming and bleeding after sampling. The proportion of women who willing to self-sampling again was higher than that of non-guidance group (86.69% vs 59.54%, respectively). The proportion of women who worried operating incorrectly was lower than that of non-guidance group (11.23% vs 32.37%, respectively). The differences were significant (all P<0.05). Conclusions Self-sampling for HPV testing in cervical cancer screening is easy to operate and has little discomfort complaint. It is feasible in cervical cancer screening. Operational video guidance during the screening process could effectively improve the women＇s experience and willingness to self-sampling again in the future.
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Objective With the rapid development of network information technology,media convergence is deepening from simple application to media transformation.This article explores the application of virtual reality technology (VR)in clinical medical research management through media virtual reality,so that medical researchers or clinicians can understand the "reasonable resource integration" of media VR technology in clinical medicine,Application of scientific researchers play an innovative role.Methods Through the literature review to understand the use of VR technology for clinical research or surgical operation of the three-dimensional simulation of the scene to achieve the feeling of exposure to the scene,so as to achieve a richer environment than the real observation angle of thinking space.And then the use of VR media (including magazines,etc.) to create a simulation platform to make medical research magazine more adapt to the development trend of network information technology.Results Media VR technology is changing the traditional mode of paper journals in medical journals and bringing a whole new way of narration to the media.Journal journals,for example,use the new media convergence method to make use of smart phones such as mobile phones to enable the users of information Participate in live and interactive video at any time,and use VR technology and magazine's virtual platform to train and discuss virtual resources through clinical research and manage ment,so that medical researchers or clinicians (including clinical researchers and clinicians) can learn from others on their own,In the virtual space can be freely discussed,thereby enhancing the medical researchers or clinicians interested in learning and clinical research innovation effect.Conclusions Medical and scientific research institutions and their magazines,which promote the achievements of medical research,need to adapt to the development trend of network informa tion technology,learn VR technology,update the scientific research management and publishing concepts,and on the one hand do a good job in the dissemination of scientific research management and scientific and technological paper media.On the other hand,Computer and Internet technologies,and strive to create a relaxed and comfortable knowledge for medical researchers to gain the reverie of space and technological innovation so that medical researchers or clinicians can enhance their interest in diverse services,increase their desire for information needs and enhance their learning Clinical research thinking and practical skills.
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Objective To study the clinical management way for HPV+/papanicolaou (Pap)-during cervical cancer screening.Methods To analyze retrospectively the data from the patients who had loop electrical excision procedure (LEEP) for biopsy confirmed cervical intraepithelial neoplasia (CIN)Ⅱ in Peking University People's Hospital from Jan.2010 to Dec.2014.Results (1) For biopsy confirmed CINⅡ,HPV positive rate was 98.5％ (135/137),Pap test positive [≥atypical squamous cell of undetermined significance (ASCUS)] rate was 69.3％ (95/137),there was significant difference between them (x5=43.32,P＜0.01).(2) For the 42 patients with HPV+/Pap-,whose cytology slides were reviewed again.Among them,the interpretations of there were 16 cases confirmed as the same before,while 26 cases were changed to abnormal (≥ASCUS).Cytology be misdiagnosed was 19.0％ (26/137) at the first review.Among the 26 cases,13 (50.0％) cases were missed for the little amount of abnormal cells,8 (30.8％) cases for mild atypical morphology changed;the other 5 (19.2％) cases missed for stain problems.(3) For the cervical LEEP samples,37 cases of the pathology diagnosis were upgrade to CIN Ⅲ+,among them,2 cases of microinvasive cervical carcinoma,1 case of invasive cancer,34 cases of CIN Ⅲ;37 cases were CINⅠ or no lesion found;63 cases were still CIN Ⅱ.Four to six months later after LEEP,the cytology abnormal rate was 11.7％ (16/137),and the HR-HPV positive rate was 34.3％ (47/137).Conclusions Compared with cytology alone,cytology combined with HPV testing increase the sensitivity of cervical high grade lesion.For the cases of HPV+/Pap-cases,the cytology slides should be reviewed.The quality control of cervical exfoliate sample collection and interpretation should be strengthened.LEEP procedure is not only a treatment method,but also it could provide samples to confirm the diagnosis.
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Objective To explore the quality of clinical trial papers published in medical SCI-tech journal.Methods A total of 1201 original research projects were published in 6 medical journals from Mar.2012 to Mar.2014 in China.Fifty-four of them were selected according to the key words randomizedcontrolled,and they were evaluated using 2010 CONSORT statement.Results In 54 articles,the section of background and abstract were described clearly and standardize.Fifty-one (94.44 ％)papers described intervention method in details.Thirty-five (64.81％) papers described the experimental design method.Thirty-one (57.41％) papers defined the primary and secondary outcome indicators,only 3 (5.56％)of them described distribution order,and the method of blindness.Four (7.41％) papers provides the information on sample size calculation.The using of flow chart accounted for 7.41％.Ten (18.52％) papers described the reason of drop out.Two (3.70％) papers evaluated the effect and accuracy,and the trial results were explained clearly and consider other evidences.Only 18 (33.33％) papers wrote the limitation of the studies.For other information of the studies,5 (9.26％) of them was registered somewhere,the information on funding support was on 20 (37.04％)papers.Conclusions The description on most RCT papers were clear and complete,but close attention should be paid to the method of blindness and sample size determine.
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The knowledge economy development depends on knowledge and innovation.Prime Minister,Keqiang Li,proposed that the development of Internet + action plan in the government's report of the Twelfth National People's Congress third meeting of,which made the whole China's Businesses animate.In such rapid development situation in terms of big data,cloud computing,Internet +,and other modern technology,integrate Internet resources,transfer big data into required da ta after analysis,change the magazine service mode,then promote clinical science and technology magazine to make it more humane-oriented as well as satisfy the need of each reader.This study proposed certain ideas on the development of the Internet + and medical technology magazines.
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Objective To investigate the clinical significance of transvaginal ultrasound, hysteroscopy and MRI in the assessment of endometrial cancer lesions size. Methods Data from 56 patients who successively underwent transvaginal ultrasound, MRI and hysteroscopy inspection preoperative endometrial carcinoma were retrospectively analyzed to assess the accuracy of lesions size. Results The pathologic lesions size measured mean maximum diameter of 56 cases was (3.05 ± 0.23) cm, while the mean maximum diameter measured by vaginal ultrasound, MRI and hysteroscopy were respectivelly (2.46±0.31) cm, (3.12± 0.08) cm, and (3.18 ± 0.21) cm. Compared with the pathologic measured values, the compliance rates of transvaginal ultrasound, hysteroscopy and MRI were respectively 54%(30/56), 71%(40/56)and 75%(42/56), which vaginal ultrasound measurement value was significantly different than that by pathologic measured ( P=0.031), while there were significant difference between the hysteroscopy measured lesion size and pathologic measured, or between MRI measured values and pathologic measured (all P>0.05). Conclusion Preoperative assess the endometrial cancer lesions size, significance of vaginal ultrasound examination is limited, and MRI and hysteroscopy examination is accurate, but easy to over-estimated lesion size.
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The rapid development of Internet offers a new place for public opinion exchange,which have become part of the frontier in the contemporary social management studies.Internet not only helps to facilitate information exchange and expanding the knowledge horizon,but also provides a platform to express opinions for public.It is a new norm for the public to engage online opinion discussions in the age of wide Internet coverage and raising number of Internet users.Medical opinion on the Internet,as a new platform for opinion exchange,becomes an important channel of information dissemination.Positive media expression and information may help to create a healthier environment for the medical market and public relations.As a new topic in the field of medical studies,the analysis of opinions on medical services has gained importance among many medical intelligence agencies and journals.It may potentially help journals to understand the trend in public opinions and offers academics and technicians related up-to-date information.It is an innovative medical intelligence gathering and analysis method,and will have important implications.
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Objective To discuss the clinical significance of Federation International of Gynecology and Obstetrics (FIGO) 2009 staging Ⅰ and its prognostic related factors in endometrial carcinoma.Methods A retrospective analysis was carried out on 233 cases with FIGO 2009 staging Ⅰ endometrial carcinoma who were admitted to Department of Obstetrics and Gynecology,Peking University People's Hospital from Dec.1998 to Dec.2009 and were carried with complete staging operation then compared with FIGO 1988 staging.All follow-up data were complete.Results Of the 233 cases,including FIGO 1988 staging Ⅰ a 41 cases,Ⅰ b 146 cases,Ⅰ c 29 cases and Ⅱ a 17 cases.The univariate analysis revealed that there were no significant difference between staging Ⅰ a and Ⅰ b group in histological grade,pathological type,intravascular vessel cancer embolus,the expression of ER,PR,postoperative chemotherapy or postoperative chemoradiotherapy (all P＞0.05).The univariate analysis revealed that there were no significant difference between staging Ⅰ and Ⅱ a group in histological grade,pathological type,intravascular vessel cancer embolus,the depth of myometrial invasion,the expression of ER and PR postoperative chemotherapy or postoperative chemoradiotherapy (all P＞0.05).Conclusion FIGO 2009 staging Ⅰ in endometrial carcinoma is more consistent with the patient's clinical status than that in FIGO 1988 stage Ⅰ and Ⅱa.
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<p><b>BACKGROUND</b>Endometrial carcinoma is one of the most common gynecological cancers and the incidence has been increasing. This study was to identify the relationship of estrogen receptor (ER), progestrone receptor (PR), P53 protein, Ki-67 and phosphatase and tensin homolog deleted on chromosome ten (PTEN) with endometrial carcinoma, the assessment of these biomarkers and their association with clinicopathological parameters was performed.</p><p><b>METHODS</b>A total of 198 cases of primary endometrial carcinoma were investigated for ER, PR, Ki-67, P53, and PTEN antigens by immunohistochemical methods. The association of these markers with age, menopause status, histological type, FIGO stage, grading, depth of invasion, lymph node involvement and serum tumor marker was examined.</p><p><b>RESULTS</b>The percentages of Ki-67- and P53-negative endometrial tumors were significantly higher in ER-positive compared with ER-negative tumors (both P = 0.000). The same trend was evident with PR status. The percentage of PTEN-positive tumors was significantly higher in PR-positive compared with PR-negative tumors (P = 0.021), but was no difference in tumors with different ER status. There was no clear association between PTEN positivity and clinicopathological parameters except more relevance with endometrioid histotype (P = 0.013). There was a statistically significant difference in the distribution of the different combined biological factors examined in disease-free survival.</p><p><b>CONCLUSIONS</b>ER and PR status were significant predictors with staging, grading and recurrence. P53 and Ki-67 expression were inversely correlated with both ER and PR expression and have more aggressive clinicopathological features. PTEN expression was inversely correlated with PR expression but not with ER expression. The combined type of ER+PR+P53-PTEN+ was in the majority in endometrial cancer and seemed to be related to better clinical outcome. The combination of ER-PR-P53+PTEN- represented the worst disease-free survival and was strongly associated with poorest survival rate.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Biomarkers, Tumor , Metabolism , Endometrial Neoplasms , Metabolism , Pathology , Immunohistochemistry , Ki-67 Antigen , Metabolism , PTEN Phosphohydrolase , Metabolism , Receptors, Estrogen , Metabolism , Receptors, Progesterone , Metabolism , Tumor Suppressor Protein p53 , MetabolismABSTRACT
Objective To explore the high-risk clinicopathological features for the recurrence and prognosis of endometrial carcinoma diagnosed as International Federation of Gynecology and Obstetrics (FIGO) stages Ⅰ and Ⅱ.Methods Three hundreds ninety-eight consecutive patients with clinical stage I,Ⅱ endometrial adenocarcinoma underwent primary surgical therapy between Oct.1990 to Oct.2010 were studied retrospectively to analyze the correlation between clinicopathological risk factors and the disease recurrence or prognosis.Results Thirty-six patients (9.0％,36/398) developed recurrence,21 of them (58.3％,21/36) relapsed within 5 years of treatment.The results shown that the disease recurrence were significantly associated with clinicopathological factors including:age [≤50 years versus ＞ 50 years,1.9％ (2/103) versus 11.5％ (34/295) ; P =0.004] ; histologic types [adenocarcinoma versus serous papillary adenocarcinoma,8.0％ (27/338) versus 6/14; P =0.000] ; tumor grade [grade 1,2 (7.4％,25/338) versus grade 3 (17.9％,10/56) ;P =0.022] ; depth of myometrial invasion [none (3.4％,2/59) versus ＜ 1/2 (7.5 ％,18/240) versus ≥ 1/2 (16.2％,16/99) ; P =0.011] ; tumor size [≤ 2 cm (5.9％,17/287) versus ＞ 2 cm (17.1％,19/111) ; P =0.000].peritoneal cytology [negative (6.9％,22/317) versus positive (23.8％,5/21) ;P =0.019] ;ER status[negative (20.8％,11/53) versus positive (5.5％,16/293) ; P =0.000] ; PR status [negative (30.0％,15/50) versus positive (4.1％,12/295) ; P =0.031].But lympho vascular space invasion (LVSI),p53 or PTEN status were not significant effect on recurrence and prognosis.Univariate analysis of survival indicated that age,histology,tumor grade,depth of myometrial invasion,tumor size,peritoneal cytology and PR status were correlated with overall survival(OS) and disease free survival (DFS ; all P ＜ 0.05),while ER status only impact on DFS (P ＜ 0.05).Conclusions The results showed that age,histologic type of carcinoma,myometrial invasion,tumor grade,peritoneal cytology,tumor size,ER and PR status are significant predictors for recurrence and prognosis of FIGO Ⅰ,Ⅱ stage endometrial carcinoma.Regular follow-up after treatment is essential for patients within 5 years.
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Objective To investigate the clinicopathologic characteristics of premalignant and malignant endometrial polyps (EP) in premenopausal and postmenopausal women.Methods A retrospective analysis was conducted in 42 cases of premalignant and malignant EP from 1993 to 2012.Polyps were classified into premenopausal (group A,10 cases) and menopausal (group B,32 cases),including 26 cases of endometrioid adenocarcinoma,4 of clear cell carcinoma,9 of serous adenocarcinoma,and 3 of atypical hyperplasia.Results The prevalence rate of premalignant and malignant EP was 1.42％ (42/2 965),the prevalence rate of malignancy in postmenopausal and postmenopausal women was 0.48％ (10/2 064) and 3.55％ (32/901),respectively.The mean size of EP was (1.6 ± 0.8) cm,abnormal uterine bleeding was positive in 90％ (38/42) of cases.The EP pathological diagnosis showed all were endometrioid adenocarcinoma in group A,while there were 4 of clear cell carcinoma,9 of serous adenocarcinoma in group B.The mean size of EP was (1.1 ± 0.6) and (1.7 ± 0.9) cm in group A and B respectively (P ＜0.05).According to immunohistochemistry,all cases of group A were ER positive,but 41％ (11/27) of group B were ER negative (P =0.059).The PR positive rate was 8/9 and 56％ (15/27) in group A and B,respectively (P =0.169).Conclusions The risk of the EP malignancy rate is higher,while ER,PR positive rate are lower in postmenopausal womcn.Postmenopausal EP,especially accompanied by abnormal uterine bleeding and large polyps should be removed as soon as possible.
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With the development of 3G/4G mobile communication technology and the rapid growing Internet use,a variety of multimedia and media contents will be consumed on the phone,which potentially gives the population more opportunities to interact with media.Traditional paperbased journals can increase their influences by cooperating with the new media,like Weibo,mobile website/app.In the next decade,traditional journals and new media will likely to grow interdependencies instead of one being replaced by the other.If journals can utilize the strength of the new media through mobile websites/app or Weibo etc.,they could better serve for translational medicine.
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Medical scientific journals play an important role in medical technology innovation and dissemination of scientific ideas.It is the main channel for medical academic communication,and also an important platform for translation of novel scientific ideas to clinical practice.Therefore,medical scientific journals needs to develop themselves to better serve the clinical practice,medical education and research,and to play a leading role in the innovation of information dissemination,to provide fast and convenient platform for medical communication,so as to accelerate the spread of medical technological achievements,and to promote the advancement of medical technology.
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Objective To explore the mechanism resistance of medroxyprogesterone 17-acetate (MPA) on the endometrial cancer side-population (SP) cells.Methods (1) Ishikawa-SP cells from endometrial cancer cell lines Ishikawa were be separated by Hoechst 33342 dyeing method and flow cytometry analysis.The clone formation efficiency between Ishikawa-SP cells and Ishikawa-non-SP cells were performed by clone formation assay.Breast cancer resistance protein (BCRP) was examined by immunocytochemistry method.(2)Ishikawa,Ishikawa-SP,Ishikawa-non-SP cells were treated with various concentrations of MPA at 5,10,15,20 μmoL/L.After cultured for 24,48,and 72 hours,cells growth were measured by methanethiosulfomate(MTS) assay.(3) The groups of Ishikawa,Ishikawa-SP,Ishikawa-non-SP cells incubated with MPA at the half maximal inhibitory concentration(IC50) were selected for cell apoptosis assay by using flow cytometry.After MPA treatment,the expression of caspase-3 was examined by immunocytochemistry method.Results (1)There were few proportion of Ishikawa-SP cells in Ishikawa endometrial carcinoma,which were 2.7％.There were stronger clone formation efficiency for Ishikawa-SP cells than that for Ishikawa-non-SP cells in Ishikawa [(6.02 ± 1.17)％ vs.(0.53 ±0.20)％,P =0.001].And there were higher level expression of BCRP (P =0.001)and also more resistant Taxol and radiation between Ishikawa-SP cells and Ishikawa-non-SP cells.(2)The inhibitory effect of MPA was concentrationdependent and time-dependent.(3)After MPA treatment,the apoptosis rates of Ishikawa-SP,Ishikawa-nonSP,Ishikawa were (4.01 ± 0.43) ％,(9.30 ± 0.67) ％,and (4.64 ± 0.18) ％,respectively (P ＜ 0.05).The level expression of caspase-3 in Ishikawa group after MPA treated were higher than that in Ishikawa-SP group.Conclusion MPA may be inhibit the growth of endometrial cancer,Ishikawa-SP and Ishikawa-nonSP cells,while Ishikawa-SP may be more resistant to MPA than Ishikawa-non-SP,which mechanism of resistance on MPA may be related to the properties of cancer stem-like cells and cell apoptosis.