ABSTRACT
OBJECTIVE@#To observe and verify the key anatomies of DeLancey's three levels of vaginal support theory through laparoscopic surgery by space dissection technique.@*METHODS@#The features and stress performance of related anatomies were observed and analyzed in laparoscopic type C hysterectomy and pelvic lymphadenectomy for cervical cancer by natural space exposures.@*RESULTS@#The main ligament-like structure at level Ⅰ was the uterosacral ligament, which acted as the main apical fixation in the sacral direction, while the cardinal ligament was mainly composed of vascular system, lymph-vessels and loose connective tissue around them, lacking the tough connective tissue structures, which was connected to the internal iliac vascular system. There were no strong ligaments connected to the tendinous arch of pelvic fascia (ATFP) at the lateral side of vaginal wall at level Ⅱ. ATFP was the edge of the superior fascia of pelvic diaphragm, which was bounded by the fascia of the obturator. Its surface was smooth and close to the levator ani muscle and fuses with the vaginal fascia in about one thirds of middle lower segments of the vagina. When the ureter tunnel is separated, dense connective structures can be found in both anterior and posterior walls near the intersection of the ureter across uterine artery, fixing the bilateral angle of the bladder triangle, starting from the cervix and vagina and ending in the tunica muscularis vesicae urinariae.@*CONCLUSIONS@#Based on the laparoscopic anatomy, the pelvic floor fascia ligament support above the levator ani muscle can be considered mainly around the vagina, and fascial ligament above the levator ani muscle can be simply considered as two parallel planes forming a "double hammock" structure, which may provide more anatomic data for pelvic floor reconstruction.
Subject(s)
Female , Humans , Laparoscopy , Ligaments , Pelvic Floor , Urinary Bladder , Vagina , General SurgeryABSTRACT
OBJECTIVES: We analyzed the chromosomal-arm-level copy number alterations (CNAs) in the cervical exfoliative cell and tissue samples by using the low-coverage whole genomic sequencing technique. METHODS: In this study, we retrospectively collected 55 archived exfoliated cervical cell suspension samples and the corresponding formalin-fixed and paraffin-embedded tissue section samples including 27 invasive cervical cancer and 28 control cases. We also collected 19 samples of the cervical exfoliative cells randomly from women to verify the new algorithm model. We analyzed the CNAs in cervical exfoliated cell and tissue samples by using the low-coverage next generation of sequencing. RESULTS: In the model-building study, multiple chromosomal-arm-level CNAs were detected in both cervical exfoliated cell and tissue samples of all cervical cancer cases. By analyzing the consistency of CNAs between exfoliated cells and cervical tissue samples, as well as the heterogeneity in individual patient, we also established a C-score algorithm model according to the chromosomal-arm-level changes of 1q, 2q, 3p, 7q. The C-score model was then validated by the pathological diagnosis of all 74 exfoliated cell samples (including 55 cases in model-building group and 19 cases in verification group). In our result, a cutoff value of C-score > 6 showed 100% sensitivity and 100% specificity in the diagnosis of cervical cancer. CONCLUSION: In this study, we found that CNAs of cervical exfoliated cell samples could robustly distinguish invasive cervical cancer from cancer-free tissues. And we have also developed a C-score algorithm model to process the sequencing data in a more standardized and automated way.
Subject(s)
Female , Humans , Diagnosis , DNA Copy Number Variations , Genome , High-Throughput Nucleotide Sequencing , Mass Screening , Population Characteristics , Retrospective Studies , Sensitivity and Specificity , Uterine Cervical NeoplasmsABSTRACT
BACKGROUND:Mesenchymal stem cels have the specific chemotaxis to the inflammation and tumor tissue, but the effect of mesenchymal stem cels on the growth of cervical cancer cels becomes an urgent problem. OBJECTIVE:To investigate the effect of human umbilical cord mesenchymal stem cels on the proliferation of cervical cancer Hela cels. METHODS:Hela cels were co-cultured with human umbilical cord mesenchymal stem cels at different number or its conditioned medium at different concentrations for 3 days. Then, cel counting kit-8 was used to detect the proliferation of Hela cels. RESULTS AND CONCLUSION:When Hela cels were co-cultured with human umbilical cord mesenchymal stem cels at ratios of 1:3, 1:2, 1:1, 2:1, 4:1, 8:1, the relative proliferation inhibition rates were 67.12%, 47.18%, 31.15%, 27.61%, 15.55% and 15.95%, respectively. When the Hela cels were co-cultured with human umbilical cord mesenchymal stem cel conditioned medium at 5, 10, 20, 40, 60, 100 mg/L, the relative proliferation inhibition rates were 0.61%, 40.1%, 63.47%, 80.61%, 93.56%, 90.65%, respectively. These findings indicate that the proliferation of Hela cels can be inhibited by co-culture with human umbilical cord mesenchymal stem cels at a certain concentration-dependent manner.