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1.
Article | WPRIM | ID: wpr-834451

ABSTRACT

Background@#In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. @*Methods@#SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.

2.
Article in English | WPRIM | ID: wpr-17917

ABSTRACT

OBJECTIVE: The aim of this study was to build a model to predict the risk of lymphovascular space invasion (LVSI) in women with endometrial cancer (EC). METHODS: From December 2010 to June 2013, 211 patients with EC undergoing surgery at Shanghai First Maternity and Infant Hospital were enrolled in this retrospective study. Those patients were divided into a positive LVSI group and a negative LVSI group. The clinical and pathological characteristics were compared between the two groups; logistic regression was used to explore risk factors associated with LVSI occurrence. The threshold values of significant factors were calculated to build a risk model and predict LVSI. RESULTS: There were 190 patients who were negative for LVSI and 21 patients were positive for LVSI out of 211 patients with EC. It was found that tumor grade, depth of myometrial invasion, number of pelvic lymph nodes, and International Federation of Gynecology and Obstetrics (FIGO) stage (p0.05) were not associated with LVSI. Receiver operating characteristic (ROC) curves revealed that the threshold values of the following factors were correlated with positive LVSI: 28.1 U/mL of CA19-9, 21.2 U/mL of CA125, 2.58 mg/dL of fibrinogen (Fn), 1.84 U/mL of carcinoembryonic antigen (CEA) and (6.35×10⁹)/L of white blood cell (WBC). Logistic regression analysis indicated that CA125 ≥21.2 (p=0.032) and Fn ≥2.58 mg/dL (p=0.014) were significantly associated with LVSI. CONCLUSION: Positive LVSI could be predicted by CA125 ≥21.2 U/mL and Fn ≥2.58 mg/dL in women with EC. It could help gynecologists better adapt surgical staging and adjuvant therapies.


Subject(s)
CA-125 Antigen , Carcinoembryonic Antigen , Endometrial Neoplasms , Female , Fibrinogen , Gynecology , Humans , Infant , Leukocytes , Logistic Models , Lymph Nodes , Obstetrics , Retrospective Studies , Risk Factors , ROC Curve
3.
Article in Chinese | WPRIM | ID: wpr-478440

ABSTRACT

Objective To explore the clinical effect of transvaginal repair of cesarean scar diverticulum (CSD). Methods Totally 64 patients of CSD in the First Maternity and Infant Hospital, Tongji University between Mar. 2013 and Sept. 2014 underwent transvaginal repair of CSD were reviewed retrospectively and followed. Result All the patients had a prolonged period, and the duration was (14.8± 3.5) days; all the patients were received the transvaginal repair of CSD, there was no intra-operative complications, the procedures were successfully performed in all patients. The mean operation time was (67± 12) minutes, the mean blood loss was (53±32) ml, and the mean length of hospital stay was (4.0±1.1) days. All patients were followed after the operation, the duration of menstruation was (8.1 ± 3.5) days shorter in average, which was statistically significant (P<0.01);the operation effective rate was 94%(60/64) to assess the clinic syptoms, the operation effective rate was 95%(61/64) for anatomic assessment. The distance of the CSD from the serosa became thicker after surgery significantly, the distance was thicker (3.4 ± 0.4) mm compared with preoperation (P<0.01). Conclusions Transvaginal repair of CSD offers minimal invasiveness, good exposure and accurate resection. It is worth to be popularized in the treatment of patients with CSD.

4.
Article in Chinese | WPRIM | ID: wpr-467430

ABSTRACT

Objective To assess the cesarean section scar morphology and size with transvaginal ultrasound and the healing of incision diverticulum after the repairing operation.Methods Forty cases with cesarean section scar defects needed repairing operation,40 cases of cesarean section without symptoms and 40 cases of vaginal delivery were involved.The scar condition and measured the size of cesarean section defects were observed.For the 40 cases needed repairing operation,the healing of the scar and measured the size of the defects were observed which still existed before and after the surgery.For the transvaginal delivery cases the thickness of uterine isthmus were measured.Results After the scar defects repairing operation,there were 9 cases who still had diverticulum,but the defects were smaller than that before operation (P <0.05).The symptoms were relieved.Among the 40 asymptomatic cases,there were 1 1 cases had defects,but the diverticulum were smaller than that of needed operation patients (P < 0.05 ). Conclusions The transvaginal ultrasound is a noninvasive and convenient method to observe the cesarean section scar.

5.
Chinese Journal of Immunology ; (12): 1585-1590, 2014.
Article in Chinese | WPRIM | ID: wpr-457549

ABSTRACT

Objective:To investigate the impact and mechanisms of TAM to the imbalance of Treg /Th17 in the Eoc microenvi-ronment.Mte hods:Build the in vitro M2 macrophage model ,which was like TAMs .Use flow cytometry to detect the difference of the Treg/Th17 before and after the co-culture of M2 macrophage and CD 4+T cells.Use Western bolt to detect the change of T cell transcription factor and ELISA to detect the IL-10 levels in the supernatant after co-culture.Use crystal violet methods to detect the influence to the ovarian tumor cell proliferation between the different co-culture supernatants and the Transwell to detect the influence to the ovarian tumor cell migration.Thus to analysis the how TAMs influence the imbalance of Treg/Th17 in Eoc microenvironments.R esults:①After coc-ultured with M2 macrophage ,the ratio of Treg/Th17 was( 0.76 ±0.33 ) significant increased compared with control (0.41±0.25) ,M0( 0.40±0.32) and M1(0.31±0.16) (P<0.05).②After co-cultured,the supernatant of M2 group has a significant ability to promote the proliferation of Skov-3 cells.After co-cultured for 1 day, the Skov-3 cell number of M2 group was 14 942.43 ±434.19 , which was significantly higher than the control group ( 12 445.57 ±179.34 ) and CD3/28 group (12 470.32±434.18)(P<0.001).After co-cultured for 2 days,the Skov-3 cell number of M2 group was 30 129.09±520.53 ,which was significantly higher than the control group (25 622.81±897.07) and CD3/28 group(25 721.62±1 808.60) (P<0.05).③After co -cultured with M2 macrophage , the Treg-specific transcription factor Foxp 3 increased ( P=0.047 ) compared with control and M 1 group .④After co-cultured with M2 macrophage for 3 days,the concentration of IL1-0 in the supernatant was(264.04±75.9)pg/ml, which was significantly higher than CD 3/28 group ( 60.89 ±46.54 ) pg/ml,M 0 group ( 44.81 ±32.93 ) pg/ml, M1 group ( 42.71 ± 26.09)pg/ml(P=0.001).Conclusion: M2 macrophage induces the increase of the radio of Treg /Th17 as well as the increase of Treg-specific transcription factor Foxp 3 and the decrease of Th17 -specific transcription factor ROR-γt.Meanwhile , the co-culture supernatant of M2 macrophage and CD4+T cell have the ability to promote the proliferation and migration of ovarian cancer cell ,the mechanism which ,may related to the IL -10 in the supernatant .

6.
Article in Chinese | WPRIM | ID: wpr-379916

ABSTRACT

Objective To explore the effect of blocking BTLA-HVEM (herpesvirus entry mediator-B and T lymphocyte attenuator) pathway on dendritic cell function and the related immunological mechanisms. Methods Murine BTLA extracellular domain eukaryotic expression vector psBTLA was constructed by gene recombination and transfected CHO by Lipofection method. Mouse bone marrow cells were induced to differentiate into DCs by GM-CSF plus IL-4. Expression of BTLA and HVEM on DCs was detected after HSPT0-TC-1 peptide complex stimulation by FACS. Expression of BT-1 and secretion of IL-12 were detected after HSP70-TC-1 peptide complex plus psBTLA transfected CHO culture supernatant stimulation on DCs. Pretreated DCs co-cultured with the same genetic background mouse splenocytes and lymphocytes proliferation and cytokine secretion were detected. Effect of psBTLA gene transfer in vivo on BT-1 expression of DCs and tumor growth on tumor-bearing mice was detected. Results Extracellular domain of murine BTLA was successfully constructed, psBTLA stable transfection CHO cells were obtained and expression of BTLA extracellular domain(sBTLA) was detected the in its culture supernatant. BTLA and HVEM expression of DCs were increased after stimulation by the antigen peptide complex. When DCs were treated with antigen peptide complex plus culture supernatant containing sBTLA, B7-1 expression and IL-12 secretion were increased. Co-cultured with splenocytes, lymphocytes proliferation and cytokine secretion, such as IL-2 and IFN-γ,, were also increased. Gene transfection with psBTLA in vivo promoted B7-1 expression on DCs and inhibited cervical cancer cells growth. Conclusion Blockade of BTLA-HVEM inhibitory pathway with sBTLA can further improve DCs function, activation of lymphocytes and promote antitumor immune response.

7.
Article in Chinese | WPRIM | ID: wpr-398413

ABSTRACT

Objective To investigate T cell receptor(TCR)variable β(BV)chain usage at the maternal-fetal interface and explore the relationship between the skewed TCR BV usage and unexplained recurrent spontaneous abortion(BSA).Methods Eighteen cases with unexplained RSA,together with matched 41 women with normal pregnancies in first trimester from Renji Hospital,Shanghai Jiao Tong University were studied.A high-resolution spectrum typing analysis of complementarity-determining region 3 (CDR3)was used to detect and compare the degree and frequency of TCR BV family expression in deciduas between RSA patients and normal controls.Results(1)The expression degree of BV19(0.029±0.031 vs.0.013±0.010,P=0.038)in RSA group showed a higher usage,while BV5.2(0.040±0.035 vs.0.067±0.052,P=0.046)showed a significantly lower usage when compared with normal controls.No significant difference in the expression of the other TCR BV families between RSA and controls were observed(P>0.05).(2),TCR BV2,3,6,and 7 were the four most common BV families in deciduas of patients with RSA and normal controls,whose frequencies were all mors than 50%.In RSA group,higher frequencies of BV15 (33.3%vs.7.3%,P=0.018),BV19(38.9%vs.14.6%,P=0.049)and BV20(33.3%vs.7.3%,P=0.018)were observed;meanuhile lower frequencies of BV4(33.3%vs.65.9%,P=0.026)and BV7 (66.7%vs.92.7%.P=0.018)distributions were observed.The other TCR BV families did not display significantly different freqencies of distribution(P>0.05).Conclusions It is suggested that a significant skewed TCR BV family occurs at the maternal-fetal interface in patients who undergo abortion.The specific skewed usages of TCR BV might be associated with the susceptibility to unexplained pregnancy loss.

8.
Article in Chinese | WPRIM | ID: wpr-538845

ABSTRACT

Objective:To investigate if DQB1 promotor allele polymorphism is associated with the susceptibility to unexplained habitual abortion (UHA).Methods:Polymerase chain reaction-sequence specific oligonucleotide (PCR-SSO) genotyping method was performed to detect HLA-DQB1 promotor (QBP) alleles in 32 cases of unexplained habitual abortion and 53 women with normal pregnancy history.Results:The frequency of QBP alleles was not different between two groups. The frequency of QBP6 2-DQB1*0604/0605 haplotype was 12 5% in patients group and 2 83% in control group, which got statistical significance. Meanwhile, six new haplotypes were first observed in Chinese population.Conclusion:No direct association was found between QBP polymorphism and UHA, but QBP-DQB1 haplotype might play a role in the susceptibility to UHA.

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