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Objective:To compare the long-term oncological outcomes between laparoscopic and abdominal surgery in stage Ⅰa1 （lymph-vascular space invasion-positive, LVSI +）- Ⅰb1 cervical cancer patients with different tumor sizes. Methods:Based on the Big Database of Clinical Diagnosis and Treatment of Cervical Cancer in China (1538 project database), patients with stage Ⅰa1 （LVSI +）-Ⅰb1 cervical cancer who treated by laparoscopic or abdominal surgery were included. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) between the two surgical approaches were compared under 1∶1 propensity score matching (PSM) in different tumor diameter stratification. Results:(1) A total of 4 891 patients with stage Ⅰa1 （LVSI +）-Ⅰb1 cervical cancer who underwent laparoscopy or laparotomy from January 1, 2009 to December 31, 2016 were included in the 1538 project database. Among them, 1 926 cases in the laparoscopic group and 2 965 cases in the abdominal group. There were no difference in 5-year OS and 5-year DFS between the two groups before matching. Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS ( HR=1.367, 95% CI: 1.105-1.690, P=0.004). After 1∶1 PSM matching, 1 864 patients were included in each group, and there was no difference in 5-year OS between the two groups （94.1% vs 95.4%, P=0.151）. While, the inferior 5-year DFS was observed in the laparoscopic group (89.0% vs 92.3%, P=0.004). And the laparoscopic surgery was associated with lower 5-year DFS ( HR=1.420, 95% CI: 1.109-1.818, P=0.006). (2) In stratification analysis of different tumor sizes, and there were no difference in 5-year OS and 5-year DFS between the laparoscopic group and abdominal group in tumor size ≤1 cm, >1-2 cm and >2-3 cm stratification (all P>0.05). Cox multivariate analysis showed that laparoscopic surgery were not related to 5-year OS and 5-year DFS ( P>0.05). In the stratification of tumor size >3-4 cm, there was no difference in 5-year OS between the two groups ( P>0.05). The 5-year DFS in the laparoscopic group was worse than that in the abdominal group (75.7% vs 85.8%, P=0.025). Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS ( HR=1.705, 95% CI: 1.088-2.674, P=0.020). Conclusions:For patients with stage Ⅰa1 （LVSI +）-Ⅰb1 cervical cancer, laparoscopic surgery is associated with lower 5-year DFS, and the adverse effect of laparoscopic surgery on oncology prognosis is mainly reflected in patients with tumor size >3-4 cm. For patients with tumor sizes ≤1 cm, >1-2 cm and >2-3 cm, there are no difference in oncological prognosis between the two surgical approaches.
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Objective To investigate the effect of mifepristone on the expression of β-endorphin in the ectopic focus of adenomyosis.Methods The expression of β-endorphin was measured by the immunochemistry method.Results During proliferative phase and secretory phase,the β-endorphin of mild dysmenorrhea were higher than that of midrange dysmenorrhea(t=2.672,2.711,all P＜0.05),the β-endorphin of midrange dysmenorrhea was higher than that of severe dysmenorrhea(t=2.341,2.365,all P＜0.05),the difference was significant.After being cured by mifepfistone,the expression of β-endorphin in the ectopic focus of adenomyosis was higher than that of control group (t=2.478,2.356,all P＜0.05),still lower than that of normal endometrial tissue,(t=2.123,2.233,all P＜0.05),the difference was significant.Conclusion The expression of β-endorphin in the ectopic focus of adenomyosis decreased significandy accompanied with the aggravation of the dysmenorrhea,and the mifepfistone could upregulate the β-endorphin and relieve the dysmenorrhea.
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Objective To investigate the effect and significance of cinobufagin on the expression of survivin of HHUA cells in the endometrial carcinoma cultured in vitro. Methods HHUA cells of endometrial carcinoma were cultured in vitro. After being intervened by cinobufagin with different concentration, the expression of survivin was measured by RT-PCR and the cellular apoptosis was tested by flow cytometry. Results In the control group: mRNA expression of survivin of HHUA cells in endometrial carcinoma was (1.22±0.23), cellular apoptutic rate was (2.31± 0.98)%; cinobufagin of 0.25 mg/ml didn't affect the survivin and cellular apoptotic rate (q=2.89, P>0.05: q=3.12, P>0.05) ; after being exposed to einobufagin of 2.5 mg/ml, the expression of survivin was (0.73± 0.26), and cellular apoptotic rate was (26.50± 6.36) %, with all of these data being different from the control group significantly (q=5.68, P<0.05; q= 10.23, P<0.05) ; the actions of cinobufagin of 25 mg/ml on mRNA expression of survivin and apoptotic rate were similar to cinobufagin of 2.5 mg/ml (q=3.49, P>0.05; q=4.35, P>0.05) . Conclusion Cinobufagin of 2.5 mg/ml inhibit the mRNA expression of survivin and proliferation of HHUA cells in endometrial carcinoma.
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Objegtive To investigate the effect and significance of cinobufagin on the expression of CD44s in ovarian carcinoma 3AO cells cultured in vitro.Methods Ovarian carcinoma 3AO cells were cultured in vitro;after the intervention of tinobufagin with different concentration,the expression of CD44s was measured by RT-PCR,and the cellular apoptosis was tested by flow cytometry.Results Ovarian carcinoma 3AO cells expressed CD44S mRNA of 1.3±0.1 and the cellular apoptofic rate was(2.31±0.98)%:0.25 mg/ml cinobufagin did not affect CD44s mRNA and cellular apoptofic rate(P ＞0.05):when 2.5 mg/ml cinobufagin was intervened,the expression of CD44s mRNA was 1.0±0.1 and the cellular apoptotic rate Was(28.69±4.16)%,showing significant difference comparing with the control group of ovarian carcinoma 3AO ceils(P＜0.05):the intervention of 25 mg/ml cinobufagin was similar to that of 0.25 mg/ml cinobuhgin(P＞0.05).3AO cells.