ABSTRACT
RATIONALE: Endometrial stromal sarcoma (ESS) is rare, representing only approximately 0.2% of all uterine malignancies. Mixed type endometrial carcinomas (MT-ECs) are rare tumors with both type I and II features, and are difficult to diagnose. Cases of ESS and MT-ECs coexisting in the same patient are extremely rare. This study aimed to describe a case of ESS in combination with MT-ECs in a 47-year-old premenopausal woman. PATIENT CONCERNS: A woman presented to the hospital complaining of occasional abdominal pain and had high tumor markers: cancer antigen (CA) 19-9 (263.6âU/mL) and CA 125 (428.0âU/mL). Transvaginal ultrasound examination revealed a complex mass (12.3 × 9.1 × 6.3âcm) with solid and cystic components on the right rear wall of the uterus. Abdominopelvic computed tomography images showed a pelvic cystic-solid mixed mass. The patient underwent an exploratory midline laparotomy. The mass was hypothesized to be malignant on the uterine posterior wall. Tumor deposits were found on bilateral parametrium. On peritoneal implantation, multiple metastases were seen on the serosal surface of the bowel and greater omentum. A frozen section revealed a spindle cell sarcoma. DIAGNOSES: Pathological reports following surgery revealed concurrent ESS and MT-ECs. INTERVENTIONS: The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, and macroscopic clearance of the tumor. Adjuvant chemotherapy was given. OUTCOMES: The patient was still alive when this report was written. LESSONS: Considering the rarity of ESS in combination with MT-ECs, this study presented an overview of the literature and discussed a number of histological and clinical issues. Nevertheless, etiology and pathogenesis of these tumors need further investigation.
Subject(s)
Endometrial Neoplasms/diagnosis , Sarcoma, Endometrial Stromal/diagnosis , Sarcoma/diagnosis , Uterine Neoplasms/diagnosis , Biomarkers, Tumor/blood , Diagnosis, Differential , Endometrial Neoplasms/pathology , Endometrial Neoplasms/surgery , Female , Humans , Hysterectomy , Middle Aged , Ovariectomy , Salpingo-oophorectomy , Sarcoma/pathology , Sarcoma/surgery , Sarcoma, Endometrial Stromal/pathology , Sarcoma, Endometrial Stromal/surgery , Tomography, X-Ray Computed , Ultrasonography , Uterine Neoplasms/pathology , Uterine Neoplasms/surgeryABSTRACT
<p><b>OBJECTIVE</b>To study the effect of RNA interference (RNAi) targeting E6AP on the proliferation and apoptosis of HeLa cells.</p><p><b>METHODS</b>HeLa cells were cultured and divided into 3 groups: blank control group, cells transfected with nonsense siRNA (small interference RNA), and cells transfected with specific E6AP siRNA. The expressions of E6AP mRNA and protein were detected by RT-PCR and Western blot before and after the transfection respectively. Cell proliferation was determined by methylthiazolyl tetrazolium (MTT). The cell apoptosis index was assessed by flow cytometry.</p><p><b>RESULTS</b>Upon treatment with E6AP siRNA for 24, 48 and 72 h, the expression level of E6AP mRNA decreased 33%, 72% and 70% than siRNA treated group. The protein expression levels in 48 h and 72 h E6AP siRNA groups decreased 38%, 59% comparing with those of the nonsense siRNA treated group (P < 0.05). The proliferative capacity of cells transfectd with E6AP siRNA was significantly lower than blank control group (F = 101.38, P < 0.05) and siRNA treated group (F = 38.64, P < 0.05). The apoptosis index of HeLa cells treated with E6AP siRNA was significantly higher than that of the nonsense siRNA (F = 41.48, P < 0.05) and the blank control group (F = 86.36, P < 0.05).</p><p><b>CONCLUSION</b>SiRNA targeting can effectively suppress the expression levels of E6AP mRNA, corresponding with a proliferation inhibition and an enhanced apoptosis of HeLa cells.</p>
