Analysis of risk factors for residual lesion of HSIL after loop electrosurgical excision procedure / 中国实用妇科与产科杂志

OBJECTIVE: To analyze clinical outcome of high-grade squamous intraepithelial lesion(HSIL)half a year after loop electrosurgical excision procedure(LEEP).METHODS: The retrospective study was carried out on 752 patients who underwent LEEP,with HSIL in the LEEP histopathology from January 2018 to December 2018 at Shanghai First Maternity and Infant Hospital Affiliated to Tongji University to confer the difference between residual group and non-residual group after 6 months of the LEEP conization.TCT,cervical biopsy and high risk HPV test were performed on all patients.RESULTS: Among 752 cases,57(7.6%)cases suffered HSIL residual disease while 695 cases in non-residual group. Before LEEP,HR-HPV 16/18 positive were less in HSIL lesion group showed no difference than those in non-residual group(P>0.05).The residual rate of post-LEEP specimens:CIS and invasive cancer identified only microscopically was higher than that in the AIS group(P<0.05).After LEEP,238 cases with positive margins and 514 cases with negative margins.The residual rate in patients with positive margin and negative margin were 21.1% and 1.4%,(P<0.05).The residual rate in patients with positive endocervical margin,ectocervical margin,unilateral margin and fibrous margin were28.7%,18.9%,17.2% and 26.3%,respectively(P<0.05). The residual rate in patients with second LEEP and non-second LEEP were 29.7% and 6.4%,respectively(P<0.05).The residual rate in patients with TCT≥ ASCUS and normal were 21.9% and 4.4%,respectively(P<0.05).Multivariate regression analysis using the logistic regression model showed CIS,abnormal cytology TCT≥ ASCUS and LEEP with positive margins to be independent risk factors for residual lesions after LEEP(P<0.05).CONCLUSION: Histopathology CIS after LEEP,abnormal cytology(TCT≥ ASCUS)and positive margin are predictors of residual lesion after LEEP with HSIL.

Dual-specificity Phosphatase 1 Deficiency Induces Endometrioid Adenocarcinoma Progression via Activation of Mitogen-activated Protein Kinase/Extracellular Signal-regulated Kinase Pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previously, we reported that dual-specificity phosphatase 1 (DUSP1) was differentially expressed in endometrioid adenocarcinoma (EEA). However, the role of DUSP1 in EEA progression and the relationship between DUSP1 and medroxyprogesterone (MPA) are still unclear.</p><p><b>METHODS</b>The expression of DUSP1 in EEA specimens was detected by immunohistochemical analysis. The effect of DUSP1 on cell proliferation was analyzed by Cell Counting Kit 8 and colony formation assay, and cell migration was analyzed by transwell assay. MPA-induced DUSP1 expression in EEA cells was measured by Western blot.</p><p><b>RESULTS</b>DUSP1 expression was deficient in advanced International Federation of Gynecology and Obstetrics stage, high-grade and myometrial invasive EEA. In EEA cell lines (Hec1A, Hec1B, RL952, and Ishikawa), the DUSP1 expression was substantially higher in Ishikawa cells than in other cell lines (P < 0.05). Knockdown of DUSP1 promoted Ishikawa cells proliferation, migration, and activation of mitogen-activated protein kinases/extracellular signal-regulated kinase (MAPK/Erk) pathway. MPA-induced DUSP1 expression and inhibited MAPK/Erk pathway in Ishikawa cells.</p><p><b>CONCLUSIONS</b>Our data suggest that DUSP1 deficiency promotes EEA progression via MAPK/Erk pathway, which may be reversed by MPA, suggesting that DUSP1 may serve as a potential therapeutic target for the treatment of EEA.</p>

Efficacy of Postoperative Hormone Replacement Therapy on Prognosis of Patients with Serous Ovarian Carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Ovarian cancer is the most common cause of gynecological cancer-associated death. Iatrogenic menopause might adversely affect the quality of life and health outcomes in young female cancer survivors. We evaluated whether postoperative hormone replacement therapy (HRT) had a negative influence on the progression-free survival (PFS) of patients with papillary serous ovarian cancer (SOC).</p><p><b>METHODS</b>We retrospectively reviewed the medical records of patients with papillary SOC, treated from January 1980 to December 2009, who suffered from menopause with or without HRT. Clinical characteristics of patients were compared between the two groups (HRT and non-HRT). Blood samples were collected from all the participants to detect serum cancer antigen (CA) 125. Hazard ratios with 95% confidential intervals for each variable were calculated by univariable and multivariable conditional Logistic regression analyses.</p><p><b>RESULTS</b>Among 112 identified patients, 31 were HRT users and 81 were not. The two groups did not significantly differ in median age at diagnosis (t = 0.652, P = 0.513), International Federation of Gynecology and Obstetrics (FIGO) stage (χ2 = 0.565, P = 0.754), differentiation (χ2 = 1.728, P = 0.422), resection status (χ2 = 0.070, P = 0.791), relapse (χ2 = 0.109, P = 0.741), chemotherapy course (t = -1.079, P = 0.282), follow-up interval (t = 0.878, P = 0.382), or PFS (t = 0.580, P = 0.562). Median Kupperman score at the onset of HRT was 30.81 and 12.19 after the therapy (t = 3.302, P = 0.001). According to the analysis, the strongest independent variables in predicting PFS were FIGO stage and disease that was not optimally debulked.</p><p><b>CONCLUSIONS</b>Postoperative HRT is not a prognostic factor for PFS of patients with papillary SOC. However, multicenter studies are needed to verify and extend our findings.</p>

Dehydroepiandrosterone indirectly inhibits human osteoclastic resorption via activating osteoblastic viability by the MAPK pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Dehydroepiandrosterone (DHEA) is widely known for its beneficial effect on postmenopausal osteoporosis, although the underlying mechanisms remain mainly unclear. In this study, we tried to determine the activation of mitogen-activated protein kinase signal pathways during DHEA treatment and the indirect role of osteoblasts (OBs) on osteoclasts under the DHEA treatment of postmenopausal osteoporosis.</p><p><b>METHODS</b>Primary human OBs and osteoclast-like cells were cultured and, we pretreated OBs with or without U0126 (a highly selective inhibitor of both MEK1 and MEK2). The OBs were treated with DHEA. We then tested the effects of DHEA on human osteoblastic viability, osteoprotegerin production and the expression of phosphor-ERK1/2 (extracellular signal-regulated kinase). In the presence or absence of OBs, the function of osteoclastic resorption upon DHEA treatment was calculated.</p><p><b>RESULTS</b>DHEA promoted the human osteoblastic proliferation and inhibited the osteoblastic apoptosis within the concentration range of 10(-8) - 10(-6) mol/L (P < 0.05, P < 0.01, respectively). Within the effective concentration range, the expression of phosphor-ERK1/2 and osteoprotegerin was increased by DHEA and blocked by U0126. In the presence of OBs, DHEA could significantly decrease the number and the area of bone resorption lacuna (P < 0.05 and P < 0.01, respectively). Without OBs, however, the effects of DHEA on the bone resorption lacuna were almost completely abolished.</p><p><b>CONCLUSIONS</b>DHEA could indirectly inhibit the human osteoclastic resorption through promoting the osteoblastic viability and osteoprotegerin production, which is mediated by mitogen-activated protein kinases signal pathway involving the phosphor-ERK1/2.</p>

Analysis of 261 Postmenopausal Ovarian Masses / 上海第二医科大学学报

Objective To study the characteristics,diagnosis and therapeutic principles of postmenopausal ovarian masses. Methods The clinical data of 261 postmenopausal women were reviewed to understand the characteristics,best diagnostic measures and therapeutic principles of postmenopausal ovarian masses. Results Among the post-(menopausal) ovarian masses,27.9% were malignant and 5.36% were boundary.No symptoms were found in(44.4%) of the patients.Before operation,the characteristics of masses can be identified by B-mode sonography,color Doppler sonography and CA-125 detection.Simple adnexectomy was performed for most of the benign ovarian masses and cytoreductive surgery for malignancies. Conclusion Regular examinations should be performed on postmenopausal women for ovarian masses,and B-mode sonography,color Doppler sonography and CA-125 detection be employed in the case of necessity.Once the ovarian masses are confirmed,surgeries may be the best choice for patients.

Expression of tyrosine kinase receptor B in OVCAR-3 ovarian cancer cells and its significance / 中国癌症杂志

Background and purpose:TrkB,a neurotrophic tyrosine kinase receptor,serves as a potent and specific suppressor of anoikis of non-malignant epithelial cells,and induces high invasion capacity in these cells.TrkB over-expression has been associated with chemotherapy resistance and poor survival in neuroblastoma and some other highly aggressive cancers.However,the relationship of the expression of TrkB to anoikis resistance in ovarian cancer cells has rarely been reported in literature.This study investigated the expression and significance of anoikis- suppressor TrkB in OVCAR-3 ovarian cancer cells.Methods:The expression of TrkB and its ligand BDNF was evaluated in OVCAR-3 ovarian cancer cells under different culture conditions by RT-PCR and Western blot.Results: TrkB mRNA was overexpressed in multicellular spheroids(cell-spheroids,anchorage-independent culture,AIC)as compared to that in OVCAR-3 cells(adhesive-cells,adhesive culture,AC),(35.3?0.7)% versus(23.5?0.5)%;but BDNF mRNA expression was the opposite to the above situation,(41.4?0.6)% versus(32.24?0.7)%(P