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Based on the Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3) signaling pathway, this study investigated the effect of medicated serum of Sparganii Rhizoma(SR) and Curcumae Rhizoma(CR) on the proliferation, apoptosis, migration, and secretion of inflammatory factors of ectopic endometrial stromal cells(ESCs). Specifically, human ESCs were primary-cultured. The effect of different concentration(5%, 10%, 20%) of SR-, CR-, and SR-CR combination-medicated serum, and AG490 solution(50 μmol·L~(-1)) on the proliferation of ESCs was detected by methyl thiazolyl tetrazolium(MTT) assay, and the optimal dose was selected accordingly for further experiment. The cells were classified into normal serum(NS) group, SR group(10%), CR group(10%), combination(CM) group(10%), and AG490 group. The apoptosis level of ESCs was detected by flow cytometry, and the migration ability was examined by wound healing assay. The secretion of interleukin(IL)-1β, IL-6, and tumor necrosis factor(TNF)-α was determined by enzyme-linked immunosorbent assay(ELISA). The protein levels of cysteinyl aspartate specific protei-nase-3(caspase-3), B-cell lymphoma(Bcl-2), and Bcl-2-associated X protein(Bax) and the levels of phosphorylated(p)-JAK2 and p-STAT3 were detected by Western blot. The results showed that the viability of ESCs cells was lowered in the administration groups compared with the blank serum group(P<0.01), especially the 10% drug-medicated serum, which was selected for further experiment. The 10% SR-medicated serum, 10% CR-medicated serum, and 10% CM-medicated serum could increase the apoptosis rate(P<0.01), up-regulate the protein expression of caspase-3 and Bax in cells(P<0.05 or P<0.01), down-regulate the expression of Bcl-2(P<0.01), decrease the cell migration rate(P<0.05 or P<0.01), and reduce the secretion levels of IL-1β, IL-6, and TNF-α(P<0.05 or P<0.01), and levels of p-JAK2 and p-STAT3(P<0.05 or P<0.01). Compared with the SR and CR groups, CM group showed low cell viability(P<0.01), high protein expression of caspase-3 and Bax(P<0.05 or P<0.01), and low protein expression of Bcl-2 and p-JAK2(P<0.05). After incubation with CM, the apoptosis rate was higher(P<0.05) and the migration rate was lower(P<0.01) than that of the CR group. The p-STAT3 protein level of CM group was lower than that of the RS group(P<0.05). The mechanism of SR, CR, and the combination underlying the improvement of endometriosis may be that they blocked JAK2/STAT3 signaling pathway, inhibited ESC proliferation, promoted apoptosis, weakened cell migration, and reduced the secretion of inflammatory factors. The effect of the combination was better than that of RS alone and CR alone.
Subject(s)
Female , Humans , Janus Kinase 2 , Caspase 3 , bcl-2-Associated X Protein , Interleukin-6/genetics , Apoptosis , Signal Transduction , Cell Proliferation , STAT3 Transcription Factor/geneticsABSTRACT
Objective:To investigate the effects of ursolic acid (UA) on proliferation, migration and iron death of ectopic endometrial stromal cells (EESCs) and its mechanism.Methods:Mouse model of endometriosis was established and the primary EESCs were isolated. The cells were treated with UA at different concentrations (0, 2.5, 5, 10, 20, 40, 50, 80, 100, 200 μmol/L). The cells were divided into Control group (normal culture), 2.5 μmol/L UA group (2.5 μmol/L UA treatment), 5.0 μmol/L UA group (5.0 μmol/L UA treatment), 10.0 μmol/L UA group (10 μmol/L UA treatment), and UA+DUSP19 group (10 μmol/L UA+50 μmol/L JAK2/STAT3 signal pathway activator DUSP19 treatment). Cell survival rate was detected by CCK-8 method. Cell proliferation was detected by plate cloning method. Transwell chamber assay was used to detect cell migration. The levels of Fe 2+ and the contents of malondialdehyde (MDA), reactive oxygen species (ROS) and superoxide dismutase (SOD) were detected by kit. Protein expression levels of Ki67, PCNA, CyclinD1, p-JAK2, p-STAT3, JAK2 and STAT3 were detected by western blot. Results:The number of clones in Control, 2.5 μmol/L UA, 5.0 μmol/L UA and 10.0 μmol/L UA groups were as follows: 152.22±15.47, 121.22±11.54, 92.00±5.54, 66.44±6.88; Ki67 protein expression was 1.08±0.10, 0.73±0.07, 0.61±0.06, 0.45±0.02, respectively; The expression of PCNA protein was 0.85±0.07, 0.64±0.05, 0.41±0.03, 0.31±0.05, respectively; CyclinD1 protein expression levels were 0.98±0.11, 0.65±0.06, 0.51±0.05, 0.42±0.07, respectively. The migration numbers were 92.78±6.27, 62.22±2.20, 50.22±4.59 and 39.11±4.33, respectively; Fe 2+ levels were (1.06±0.07) μmol/g, (1.21±0.11) μmol/g, (1.33±0.08) μmol/g, (1.47±0.09) μmol/g, respectively; MDA content was (0.48±0.06) μmol/g, (0.65±0.07) μmol/g, (0.85±0.08) μmol/g, (1.03±0.11) μmol/g, respectively; ROS contents were (19.85±1.21) %, (24.83±2.79) %, (29.04±1.86) %, (33.87±2.45) %, respectively; SOD content were (36.41±3.56) U/mg, (31.03±2.81) U/mg, (25.63±2.84) U/mg, (19.62±1.67) U/mg, respectively; p-JAK2 protein expression was 0.85±0.10, 0.75±0.06, 0.53±0.05, 0.31±0.03, respectively; p-STAT3 protein expression was 1.08±0.11, 0.79±0.06, 0.63±0.07, 0.42±0.03, respectively. The p-JAK2 protein content in UA group and UA+DUSP19 group was 0.38±0.05 and 0.75±0.08, respectively; p-STAT3 protein expression was 0.46±0.04 and 0.80±0.03, respectively; The cell survival rates were (52.55±2.44) % and (82.18±4.72) %, respectively; Fe 2+ levels were (1.57±0.06) μmol/g and (1.21±0.13) μmol/g, respectively. The differences in the above indicators between the Control group and the 2.5 μmol/L UA group, 5.0 μmol/L UA group and 10.0 μmol/L UA group were statistically significant ( P<0.05). There were statistically significant differences among 2.5 μmol/L UA group, 5.0 μmol/L UA group and 10.0 μmol/L UA group ( P<0.05). There were statistically significant differences in p-JAK2, p-STAT3, cell survival rate and Fe 2+ levels between UA group and UA+DUSP19 group ( P<0.05) . Conclusion:Ursolic acid can inhibit the proliferation and migration of EESCs cells and induce iron death by regulating JAK2/STAT3 signaling pathway, thus playing a protective role in endometriosis.
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El sarcoma del estroma endometrial es una neoplasia maligna poco frecuente que se origina en el estroma endometrial. Puede tener varias formas de diferenciación, entre ellas del músculo liso y del cordón sexual. El sarcoma del estroma endometrial de bajo grado es un tipo de tumor endometrial raro, que constituye solo el 0,2% de todas las neoplasias uterinas. Su etiología es desconocida, pero algunos casos se asocian con obesidad, síndrome de ovario poliquístico, diabetes mellitus, menarquia temprana y terapia de sustitución de estrógenos o al tamoxifeno. La sintomatología es inespecífica, varía desde el dolor pélvico hasta el sangrado genital anormal progresivo y es difícil de reconocer por las imágenes radiológicas. En la mayoría de los casos, el diagnóstico se realiza mediante una evaluación anatomopatológica. La tinción inmunohistoquímica también puede ayudar a diferenciarlo de otras neoplasias. Por lo tanto, es importante tener un alto índice de sospecha para este tipo de neoplasia rara. Su tratamiento es quirúrgico y su seguimiento debe ser a largo plazo, debido al alto riesgo de recidivas tardías y metástasis. Se presenta un caso de sarcoma estromal endometrial de bajo grado.
Endometrial stromal sarcoma is a rare malignant neoplasm that originates in the endometrial stroma. It can have several forms of differentiation, including smooth muscle and sex cord. Low-grade endometrial stromal sarcoma is a rare type of endometrial tumor, constituting only 0.2% of all uterine neoplasms. Its etiology is unknown, but some cases are associated with obesity, polycystic ovary syndrome, diabetes mellitus, early menarche, and estrogen replacement therapy or tamoxifen. Symptomatology is nonspecific, ranging from pelvic pain to progressive abnormal genital bleeding, and is difficult to recognize by radiological imaging. In most cases, the diagnosis is made by pathological evaluation. Immunohistochemical staining can also help differentiate it from other neoplasms. Therefore, it is important to have a high index of suspicion for this type of rare neoplasm. Its treatment is surgical and its follow-up should be long term, due to the high risk of late recurrences and metastasis. A case of low-grade endometrial stromal sarcoma is presented.
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Introduction: Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. A 42 year old female admitted in obstetrics and gynecology department withCase History: complain of abdominal pain for 5 days and history of abdominal hysterectomy before 10 year. Scar endometriosisUSG: Discussion: Uterine sarcomas are rare tumours of mesodermal origin. They constitute 2 to 6% of uterine malignancy. Of these, endometrial stromal sarcomas are rare
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Introducción: Los tumores del estroma endometrial representan menos del 2% de los tumores uterinos, estando dentro de las neoplasias menos comunes del cuerpo uterino. Se pueden dividir en cuatro categorías principales: nódulo del estroma endometrial, sarcoma del estroma endometrial de bajo grado, sarcoma del estroma endometrial de alto grado y sarcoma uterino indiferenciado. En el presente trabajo se describe el caso de un paciente con diagnóstico de nódulo del estroma endometrial. Caso clínico : Paciente femenino de 50 años de edad, quien refiere inicio de enfermedad en marzo de 2022, caracterizado por presentar sangrado uterino anormal anemizante y aumento de volumen abdominal, por lo que acude a facultativo foráneo, donde indican paraclínicos. Para el día 12 de julio de 2022, presentó dolor abdominal de aparición brusca de moderada a severa intensidad. Motivo por el cual acudió a nuestro centro. Se determina anemia y leucocitosis. Estudios de imagen reportan masa voluminosa, densidad mixta, bien delimitada. Otra lesión hiperecogénica, que corresponde a quiste unicameral de ovario derecho. Se decide resolución quirúrgica, mediante la realización de laparotomía exploradora más protocolo de endometrio, con evolución satisfactoria de la paciente. Conclusión : La histerectomía es el tratamiento de elección. El estudio anatomopatológico es fundamental para su diagnóstico final y diferenciación de los sarcomas estromales, ya que su pronóstico, tratamiento y seguimiento es diferente(AU)
Introduction: Endometrial stromal tumors represent less than 2% of uterine tumors, being among the least common neoplasms of the uterine body. They can be divided into four main categories: endometrial stromal nodule, low-grade endometrial stromal sarcoma, high-grade endometrial stromal sarcoma and undifferentiated uterine sarcoma. This paper describes the case of a patient with a diagnosis of endometrial stromal nodule.Clinical case : A 50-year-old female patient, who reported the onset of the disease in March 2022, characterized by abnormal uterine bleeding with anemia and increased abdominal volume, for which she went to a foreign physician, where they indicated paraclinical tests. On July 12, 2022, he presented abdominal pain of sudden onset of moderate to severe intensity. Which is why she came to our center. Anemia and leukocytosis are determined. Imaging studies report a voluminous mass, mixed density, well delimited. Another hyperechoic lesion, which corresponds to a unicameral cyst of the right ovary. Surgical resolution was decided by performing an exploratory laparotomy and endometrial protocol, with satisfactory evolution of the patient.Conclusion : Hysterectomy is the treatment of choice. The anatomopathological study is fundamental for its final diagnosis and differentiation of stromal sarcomas, since its prognosis, treatment and follow-up are different(AU)
Subject(s)
Humans , Female , Middle Aged , Uterine Neoplasms , Stromal Cells , Endometrial Stromal Tumors , Sarcoma, Endometrial StromalABSTRACT
OBJECTIVE@#To explore the expression of CCN5 in endometriotic tissues and its impact on proliferation, migration and invasion of human endometrial stromal cells (HESCs).@*METHODS@#We collected ovarian endometriosis samples from 20 women receiving laparoscopic surgery and eutopic endometrium samples from 15 women undergoing IVF-ET for comparison of CCN5 expression. Cultured HESCs were transfected with a recombinant adenovirus Ad-CCN5 for CCN5 overexpression or with a CCN5-specific siRNA for knocking down CCN5 expression, and the changes of cell proliferation, migration and invasion were evaluated using CCK-8 assay, wound healing assay and Transwell chamber assay. RT-qPCR and Western blotting were used to examine the expression levels of epithelial-mesenchymal transition (EMT) markers including E-cadherin, N-cadherin, Snail-1 and vimentin in HESCs with CCN5 overexpression or knockdown.@*RESULTS@#CCN5 expression was significantly decreased in ovarian endometriosis tissues as compared with eutopic endometrium samples (P < 0.01). CCN5 overexpression obviously inhibited the proliferation, migration and invasion of HESCs, significantly increased the expression of E-cadherin and decreased the expressions of N-cadherin, Snail-1 and vimentin (P < 0.01). CCN5 knockdown significantly enhanced the proliferation, migration and invasion of HESCs and produced opposite effects on the expressions of E-cadherin, N-cadherin, Snail-1 and vimentin (P < 0.01).@*CONCLUSION@#CCN5 can regulate the proliferation, migration and invasion of HESCs and thus plays an important role in EMT of HESCs, suggesting the potential of CCN5 as a therapeutic target for endometriosis.
Subject(s)
Female , Humans , Cell Movement , Cell Proliferation , Endometriosis/metabolism , Endometrium/metabolism , Epithelial Cells , Epithelial-Mesenchymal Transition , Stromal CellsABSTRACT
ObjectiveThis study investigated the mechanism of Wenjingtang in the prevention and treatment of endometriosis （EMT） from the perspective of regulating hypoxia stress and mitochondrial function. MethodPrimary human endometrial stromal cells （ESCs） form ectopic endometrial tissues were isolated and cultured， the cells were divided into control group （Control）， 5% control serum group （5% KBXQ）， 10% control serum group （10% KBXQ）， 5% Wenjingtang serum group （5% WJTXQ） and 10% Wenjingtang serum group （10% WJTXQ）. ESCs in different groups were detected for proliferation by methyl thiazolyl tetrazolium （MTT） assay， mRNA and protein expression of hypoxia inducible factor-1α （HIF-1α） by real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） and Western blot analysis， mitochondrial ultrastructure by transmission electron microscope， mitochondrial function ［mitochondrial membrane potential， mitochondrial membrane potential（MMP） and cytochrome C（Cyt C） content］ and apoptosis （cell membrane permeability， nuclear fluorescence intensity， nuclear size and cell counts） by high content screening （HCS） assay， apoptosis rate by flow cytometry， and proteins of B-cell lymphoma-2 （Bcl-2） associated X （Bax）， Bcl-2 and cleaved cysteinyl aspartate specific proteinase-3 （cleaved Caspase-3） by Western blot. ResultCompared with Control group， the 5% KBXQ and 10% KBXQ groups showed increased cell viability （P<0.01）， there was no significant change in HIF-1α mRNA and protein expression， transmission electron microscopy showed that the mitochondrial cristae were obvious and the inner and outer membranes of mitochondria were clear， HCS multichannel fluorescence staining showed that there were no significant changes in the expression of MMP， Cyt C and cell membrane permeability， and the nuclei showed uniform light staining， there were no significant changes in apoptosis rate， cleaved Caspase-3 protein expression and Bax/Bcl-2 ratio. Compared with Control group and corresponding concentration KBXQ group， the 5% WJTXQ and 10% WJTXQ group showed decreased cell viability （P<0.01） and HIF-1α mRNA and protein levels （P<0.05，P<0.01）， the ultrastructure of mitochondria was destroyed， some mitochondria were swollen and the cristae were blurred， moreover， decreased MMP and up-regulated Cyt C release （P<0.05，P<0.01）， increased cell membrane permeability （P<0.01）， and apoptosis characteristics included nuclear pyknosis， DNA agglutination in nucleus and decrease of cell numbers were observed （P<0.05，P<0.01）， increased apoptosis rate （P<0.01）， which was consistent with the results of HCS analysis， and up-regulated expression levels of cleaved Caspase-3 protein and Bax/Bcl-2 ratio （P<0.05，P<0.01）. ConclusionIn conclusion， the results suggest that Wenjingtang can improve hypoxia stress via down-regulating HIF-1α expression in ectopic ESCs， and inhibit cell proliferation， reduce mitochondrial biological activity and induce apoptosis， which might be the internal mechanism of Wenjingtang in preventing and treating EMT.
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Endometrial stromal tumors (ESTs) include endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS). Since these are rare tumor types, there is an unmet clinical need for the systematic therapy of advanced LG-ESS or HG-ESS. Cytogenetic and molecular advances in ESTs have shown that multiple recurrent gene fusions are present in a large proportion of LG-ESSs, and HG-ESSs are identified by the tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein epsilon (
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Endometrial stromal nodules (ESN) are benign tumours of mesenchymal origin with features reminiscent of proliferative phase endometrial stroma. Diagnosis of ESNs can be established only by light microscopy and no preoperative diagnostic methods are available. Although ESNs are benign and rare, distinguishing it from other types of invasive stromal tumours is of utmost importance since prognosis and management change considerably with the diagnosis. This was a rare case report of endometrial stromal nodule in a nulliparous woman, 30 years old who presented with complaint of menorrhagia and primary infertility and had a preoperative diagnosis of large leiomyoma with cystic degeneration. She underwent a fertility preserving conservative surgery i.e. myomectomy via abdominal route, histopathology reports of which revealed endometrial stromal nodule that changed the final diagnosis and follow up regime of the patient.
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OBJECTIVE@#To observe the expression of HELQ and RAD51C in normal endometrial and endometrial stromal sarcoma (ESS) and analyze their correlation with the clinical features of the patients.@*METHODS@#The expressions of HELQ and RAD51C proteins were detected by immunohistochemical staining in normal endometrial tissues (14 cases) and tumor tissues from patients with ESS (37 cases) treated in Hunan Provincial Cancer Hospital from January, 2013 to December, 2016. The correlations of the expressions of the two proteins with the patients'age, FIGO staging, tissue type, tumor size, and lymph node metastasis were analyzed.@*RESULTS@#Immunohistochemical staining showed that the expressions of HELQ and RAD51C were both decreased in ESS patients compared with the normal group, and there was a positive correlation between HELQ and RAD51C expression ( < 0.05). HELQ expression in ESS was correlated with the tumor size and type. The expressions of HELQ and RAD51C were not correlated with the patients' age, FIGO stage and status of lymph node metastasis ( > 0.05).@*CONCLUSIONS@#Homologous recombination- directed DNA repair involving HELQ and RAD51C may participate in the occurrence and progression of ESS.
Subject(s)
Female , Humans , DNA Helicases , DNA-Binding Proteins , Endometrial Neoplasms , Endometrium , Lymphatic Metastasis , Sarcoma, Endometrial StromalABSTRACT
Uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are very rare tumors that occur mainly in the uterine fundus of women in reproductive age. These tumors can be classified into group 1 and group 2 by histological results. In group 1, epithelial-like differentiation is partially observed in the tumors. In group 2, sex-cord elements are predominant in uterine mural mass. We experienced UTROSCT group 1 in a 29-year-old woman who complained of severe abdominal pain that started one week after delivery and UTROSCT group 2 case in a 49-year-old woman who complained of dysfunctional uterine bleeding. We report two different types of UTROSCT cases that we experienced.
Subject(s)
Adult , Female , Humans , Middle Aged , Abdominal Pain , Metrorrhagia , Sex Cord-Gonadal Stromal Tumors , Uterine Diseases , Uterine NeoplasmsABSTRACT
Uterine sarcomas are tumors of poor prognosis characterized by a great histopathological heterogeneity. High endometrial stromal sarcomas (ESS) occurring at a late age, with high mitotic activity and / or tumor necrosis, are very poorly prognostic tumors.If it is accepted that the standard treatment of uterine sarcomas is surgical, the place of adjuvant treatment remains controversial.We report a case of a high-grade ESS referred to initially on MRI and diagnosed on pathological examination of a hysterectomy performed in a 64-year-old postmenopausal woman with postmenopausal bleeding.
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Objective: To investigate the clinical characteristics of uterine sarcoma and clinical application of color Doppler ultrasonography in the sarcoma. Methods: We conducted a retrospective analysis on the clinical and ultrasonographic features in 128 surgically and pathologically confirmed uterine sarcoma patients from December 2011 to May 2018 in Tongji Hospital. The clinical features included age, clinical manifestation, serum tumor marker CA125 and clinical stage, and the features of ultrasonography included the size, boundary, echo type of the lesion and characteristics of blood flow signals. Results: The majority of uterine sarcoma in this study were endometrial stromal sarcoma and leiomyosarcoma. Endometrial stromal sarcoma occurred mostly in women in reproductive period, while leiomyosarcoma occurred mainly in perimenopausal and postmenopausal women. The predilection age of uterine sarcoma was 49.6 ± 13.4 years. The main clinical manifestations were abnormal uterine bleeding, including postmenopausal vaginal bleeding or irregular vaginal bleeding (47.7%), and abdominal pain (32.0%). About 20.3% of patients had no symptoms. Serum CA125 was detected before operation in all the patients, and it was in normal range (≤ 35 U/ml) in 59 patients, slightly higher than normal level (35-100 U/ml) in 51 women and significantly higher than normal range (>100 U/ml) in 18 women. Pelvic three-dimensional ultrasonography was usually characterized by large uterine tumors with solid, unclear boundary, heterogeneous echo structures with or without cystic degeneration and rich blood flow signals, which can be roughly classified as malignant tumors. Conclusion: Combined with clinical manifestations such as vaginal bleeding, abdominal pain, abdominal distension, ultrasonograms can help us identify and early predict large, ill-defined, hypoechoic or heterogeneous hypoechoic tumors with rich blood flow signals, and grasp the treatment opportunity reasonably and formulate treatment plans.
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OBJECTIVE: To investigate the diagnosis and clinical treatment of endometrial stromal nodules(ESN).METHODS: The clinical data of 7 cases of patients with endometrial stromal nodule in our hospital from 2011 January to2018 January were retrospectively analyzed.RESULTS: The median age of 7 patients was 46 years(29-60 years).The clinical manifestations were irregular menstruation and abdominal pain,and a few were asymptomatic.In 5 cases,no echo area was found in the tumor by color Doppler ultrasound,and in 2 cases,the boundary of the tumor was not clear and the blood flow signal was found in the tumor.Four patients underwent MRI and all had high signal on DWI,3 patients showed T2 WI high signal,and 1 patient had slightly lower T2 WI signal.All patients underwent total hysterectomy and were followed up to February 2018,with an average follow-up time of 30 months(1-96 months).No recurrence or malignant change was found in 7 patients.CONCLUSION:s ESN is a benign tumor.DWI shows obvious high signal and clear boundary in MRI,and Doppler ultrasound shows low echo mass in uterus with no echo area or abnormal blood flow signal.Curettage and biopsy under hysteroscopy are helpful for diagnosis.Patients of childbearing age can choose simple tumor resection and should be followed up closely after operation.For postmenopausal women or those with no desire children,hysterectomy and postoperative routine physical examination are recommended.
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Objective To: observe CT and MRI features of endometrial stromal sarcoma (ESS). Methods: Plain and enhanced imaging data, including CT (n=5) and MRI (n=6) of 11 patients with ESS confirmed by postoperative pathology were analyzed retrospectively. Results: There were 9 cases of singe low-grade ESS and 2 cases of single undifferentiated sarcoma. The lesions located in the uterine cavity in 7 cases, in the myometrium in 4 cases, manifested as circular masses in 8 cases and as irregular masses in 3 cases. The mean maximum diameter of lesions was (9.18±1.36)cm. The boundaries of lesions were clear in 4 cases and unclear in 7 cases. Based on CT and MRI findings, there were 4 patients with solid masses, 6 patients with solid-cystic masses and 1 case with cystic mass. Solid component of lesions manifested as iso- or hypo-attenuation compared with myometrium on plain CT images in 5 patients, including 4 cases with nonuniform density lesions and 1 case with uniform density lesion. MRI showed signal reducing on ADC images in 6 patients. Among them, lesions in 5 cases manifested as iso- or hypo-signal on T1WI, hyper-signal or slightly high signal on T2WI, and slightly high signal on DWI, lesion in another case (cystic mass) manifested as hyper-signal on T1WI, high signal on T2WI and high signal in central area of lesion on DWI. Incremental and continuous enhancement were found in 10 cases, while no enhancement was found in the rest one case (cystic mass). Cystic and necrosis changes were found in 8 cases, and invasions of deep layer myometrium were found in 6 cases. Some of the patients had complications, including adenomyosis in 2 cases, uterine fibroid in 5 cases, pelvic effusion in 5 cases, intrauterine hemorrhage in 1 case and salpingian dropsy in 2 cases. Conclusion: ESS has characteristic CT and MRI findings, which can provide useful references for diagnosis.
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Objective@#To investigate clinicopathological, cytogenetic features and differential diagnoses of high grade endometrial stromal sarcoma (HGESS) with BCOR gene rearrangement.@*Methods@#Five cases of HGESS with BCOR rearrangement were collected from consultant files (2016-2018) at Fudan University Shanghai Cancer Center. Interphase FISH was performed using a dual color break-apart probe. The clinical data, histologic features and immunohistochemical findings were reviewed.@*Results@#All 5 cases occurred in adult women with a median age of 48 (range, 45-55) years. Abdominal pain and abnormal vaginal bleeding were the most common symptoms. Microscopically, the tumors showed mainly tongue-like and/or intersecting myometrial invasion. Stromal myxoid matrix and/or collagen plaques were prominent in all the cases. Most tumors consisted of uniform, haphazard fascicles of short spindle cells with mild to moderate nuclear atypia. Mitotic figures and necrosis were easily identified. Significant nuclear pleomorphism was not seen. Most tumors were rich in thick-walled small vessels. Prominent perivascular tumor cell whorling seen in conventional low-grade endometrial stromal sarcoma was not seen. All tumors expressed CD10 with only focal or absent desmin, SMA and/or h-caldesmon staining. ER or PR expression was seen in 4 tumors and 1 tumor showed both marker expression. Diffuse cyclin D1 was present in 2 tumors. BCOR immunoreactivity was present with strong staining in 3 cases and moderate staining in 1 case respectively. Ki-67 index ranged from 10% to 30%. Fluorescence in situ hybridization confirmed chromosomal aberration of BCOR gene in all tumors, that were previously diagnosed as myxoid leiomyosarcoma (2 cases), spindle cell uterine sarcoma (2 cases) and low-grade endometrial stromal sarcoma (1 case). Limited follow-up information revealed that 3/5 patients developed tumor recurrence, metastasis or death within one year.@*Conclusion@#BCOR rearranged HGESS has distinct morphological features and aggressive clinical behavior. In the presence of significant overlapping morphologic features between BCOR rearranged HGESS and other myxoid uterine mesenchymal tumors, especially myxoid leiomyosarcoma, molecular analysis is essential for accurate diagnoses.
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BACKGROUND: Provision of optimal endometrial stromal cells is essential in uterine tissue engineering. Culture of these cells is significantly influenced by gonadotropin hormones. This investigation attempted to define the proliferation profiles of murine uterine endometrial stromal cells during in vitro culture with recombinant follicle stimulating hormone (rFSH), urinary follicle stimulating hormone (uFSH), and human chorionic gonadotropin (hCG). METHODS: Murine uterine endometrial stromal cells were collected from 8-week-old mice and cultured in vitro up to 72 h, with rFSH, uFSH, or hCG. Cell cycles were analyzed by BrdU assay, and cyclin D1 expression was evaluated according to dose and duration of gonadotropin treatment. RESULTS: BrdU assay showed a further inhibitory effect on murine uterine endometrial stromal cell proliferation when cultured with rFSH compared to uFSH, and a similar inhibitory proliferation profile when cultured with hCG at a specific range of concentrations. The expression of cyclin D1 of murine uterine endometrial stromal cells was down-regulated when cultured with rFSH, uFSH, or hCG, compared to control. CONCLUSIONS: FSH may inhibit the proliferation of murine uterine endometrial stromal cells during in vitro culture. rFSH may have more significant inhibitory effects on the proliferation of endometrial stromal cells than uFSH. Establishing an optimal endocrine milieu is necessary using more advanced combination of female hormones for in vitro culture of this type of cells.
Subject(s)
Animals , Female , Humans , Mice , Bromodeoxyuridine , Cell Cycle , Chorionic Gonadotropin , Cyclin D1 , Follicle Stimulating Hormone , Gonadotropins , In Vitro Techniques , Stromal Cells , Tissue Engineering , UterusABSTRACT
Background & objectives: CD9 and CD146 are important adhesion molecules that play a role in the implantation of an embryo. This study was undertaken to correlate the expression of these markers in fertile and infertile women's endometrial stromal cells. Methods: Human endometrial stromal cell culture from endometrial biopsies of fertile (n=50) and infertile females (n=50) was performed and primary cell lines were established. Expression of CD9 and CD146 was studied for all the 100 cell lines with the help of flow cytometry. Gene expression of CD9 and CD146 was performed by real-time polymerase chain reaction. Results: There was a significant difference in endometrial stromal cells of fertile and infertile females. Flow cytometric results revealed significantly lower expression of CD9 (P=0.0126) and CD146 (P=0.0006) in the infertile endometrial stromal cells as compared to fertile endometrial stromal cells. These results were comparable with real-time data. Interpretation & conclusions: This study showed that endometrial stromal cells from infertile females had lower expression of adhesion molecules, CD9 and CD146. Our findings suggest that CD9 and CD146 may have a role in infertility. Infertile female's endometrial stromal cells have decreased expression of CD9 and CD146 which can be the cause of infertility related to implantation failure.
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Background Endometrial stromal sarcomas (ESSs) are the second most common uterine sarcomas. Although ESSs are often indolent, they have metastatic potential. To the best of our knowledge, there are only three reports of brain metastasis, and the present report is the first to describe a late skull metastasis of an ESS. Case Report We describe the case of a 51-year-old woman who presented abnormal vaginal bleeding 14 years ago; she was diagnosed with an uterine mass and submitted to a hysterectomy. One year ago she presented ESS lung metastasis followed by a left parietal calvarial metastasis. The optimal treatment for metastatic ESS is controversial, but the use of progesterone and aromatase inhibitors is advisable.
Introdução Sarcoma endometrial estromal (SEE) é a segunda lesão mais frequente dentre os sarcomas uterinos. Geralmente são lesões indolentes, mas com potencial de desenvolver metástase. Até o momento há apenas três relatos de metástase cerebral, sendo este o primeiro estudo a descrever uma metástase craniana tardia dessas lesões. Relato de caso Nós descrevemos o caso de uma paciente de 51 anos de idade que apresentou há 14 anos um quadro de sangramento vaginal anormal, sendo diagnosticada uma massa uterina; a paciente foi submetida a uma histerectomia. Há um ano ela evoluiu com metástase pulmonar, seguida por metástase craniana parietal esquerda. O tratamento ideal do SEE metastático ainda é controverso, mas o uso de inibidores de aromatase é aconselhável.
Subject(s)
Humans , Female , Middle Aged , Sarcoma, Endometrial Stromal , Neoplasm Metastasis , Sarcoma, Endometrial Stromal/pathologyABSTRACT
Endometrial uterine sarcoma is a very rare tumour of the uterine cavity with an incidence of 1-2 cases per 100,000 women. Low grade Endometrial stromal sarcoma (LGESS) is an occasional diagnosis in a patient presenting as leiomyoma uterus. The symptoms are nonspecific, mostly abnormal uterine bleeding in perimenopausal women. Clinically and radiologically it is difficult to diagnose this entity. Histopathological examination and immunohistochemistry confirmed the diagnosis of LGESS. In addition of surgery chemotherapy, radiotherapy and immunotherapy treatments will be quite useful in all cases of LGESS. This case report of Low grade Endometrial stromal sarcoma (LGESS) is presented here because of its rarity.