PCDHGB7 hypermethylation-based Cervical cancer Methylation (CerMe) detection for the triage of high-risk human papillomavirus-positive women: a prospective cohort study.

BACKGROUND: Implementation of high-risk human papillomavirus (hrHPV) screening has greatly reduced the incidence and mortality of cervical cancer. However, a triage strategy that is effective, noninvasive, and independent from the subjective interpretation of pathologists is urgently required to decrease unnecessary colposcopy referrals in hrHPV-positive women. METHODS: A total of 3251 hrHPV-positive women aged 30-82 years (median = 41 years) from International Peace Maternity and Child Health Hospital were included in the training set (n = 2116) and the validation set (n = 1135) to establish Cervical cancer Methylation (CerMe) detection. The performance of CerMe as a triage for hrHPV-positive women was evaluated. RESULTS: CerMe detection efficiently distinguished cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) from cervical intraepithelial neoplasia grade 1 or normal (CIN1 -) women with excellent sensitivity of 82.4% (95% CI = 72.6 ~ 89.8%) and specificity of 91.1% (95% CI = 89.2 ~ 92.7%). Importantly, CerMe showed improved specificity (92.1% vs. 74.9%) in other 12 hrHPV type-positive women as well as superior sensitivity (80.8% vs. 61.5%) and specificity (88.9% vs. 75.3%) in HPV16/18 type-positive women compared with cytology testing. CerMe performed well in the triage of hrHPV-positive women with ASC-US (sensitivity = 74.4%, specificity = 87.5%) or LSIL cytology (sensitivity = 84.4%, specificity = 83.9%). CONCLUSIONS: PCDHGB7 hypermethylation-based CerMe detection can be used as a triage strategy for hrHPV-positive women to reduce unnecessary over-referrals. TRIAL REGISTRATION: ChiCTR2100048972. Registered on 19 July 2021.

A self-developed contained bag for laparoscopic myomectomy morcellation.

OBJECTIVES: Open power morcellation during a laparoscopic myomectomy (LM) can result in the dissemination of benign or occult malignant tumor cells in the abdominopelvic cavity. The development of a new contained collection bag for power morcellation is now favored by gynecologic surgeons worldwide. MATERIAL AND METHODS: This study was a single-arm trial comprising 20 women who consecutively underwent an LM involving the use of a newly designed contained collection bag for power morcellation between November 3rd 2017 and April 31st 2018. There was also a historical control group consisting of 30 women who underwent open power morcellation during an LM between May 1st 2017 and October 31st 2017. All the essential information concerning the patients and surgically related data, including the myoma size, the operation duration, and the cell count of the intraperitoneal irrigating fluid, were collected and analyzed. RESULTS: The uterus size and the maximum diameters of the uterus and the myoma of the two groups were not significantly different (p = 0.65, p = 0.71, and p = 0.31, respectively). Pseudopneumoperitoneum was established and clear visualization was guaranteed in all 20 cases in the experimental group. The remaining fragment tissue amount (mean ± SD) and weight (mean ± SD) in the collection bag after morcellation in the experimental group were 5.00 ± 1.48 and 3.87 ± 1.31 (g). All the collection bags were routinely examined after the LM using normal saline, and no leaks or lesions were found. The cell counts of the intraperitoneal irrigating fluid both before and after morcellation were less than 105-106/L. The pathology of all the tissues confirmed that there were no malignant tumors. The operation of the experimental group was 18 mins longer than that of the historical control group (p = 0.00). CONCLUSIONS: This newly designed collection bag system for LM morcellation is effective, feasible, and safe.

Establishment of reference intervals for maternal blood and umbilical cord blood procalcitonin in healthy Chinese women in late pregnancy.

AIM: To establish reference intervals (RIs) for maternal blood and umbilical cord blood procalcitonin (PCT) in healthy Chinese women in late pregnancy. METHODS: One hundred and twenty-seven healthy Chinese women in late pregnancy, including 70 vaginal deliveries and 57 cesarean section deliveries, were retrospectively analyzed. These pregnant women gave birth to 58 male infants and 69 female infants. Another 127 age-matched healthy women who were not pregnant were enrolled as the control group. PCT levels in maternal blood, umbilical cord blood and control blood were determined using electrochemiluminescence immunoassay. The RIs of PCT were defined using an intermediate 95% interval. RESULTS: The RIs for maternal blood and umbilical cord blood PCT were 0.020-0.075 ng/mL and 0.020-0.159 ng/mL, respectively. The cord blood PCT level was not significantly different between different delivery methods (P > 0.05). In contrast, the umbilical cord blood PCT in female newborns was higher than that in male newborns (0.088 ± 0.046 ng/mL vs 0.072 ± 0.030 ng/mL, P < 0.05). CONCLUSION: Maternal blood and umbilical cord blood PCT of Chinese women in late pregnancy have different RIs, and umbilical cord blood PCT level is affected by the gender of newborns.

Analysis of risk factors for intraoperative hemorrhage of cesarean scar pregnancy.

The current commonly used treatments for cesarean scar pregnancy (CSP) include multiple treatments such as medication, uterine artery embolization, curettage and surgery, and their combinations. However, every treatment option has risks of excessive hemorrhage from uterus. In this study, we retrospectively analyzed the risk factors for intraoperative hemorrhage of different treatments for CSP patients, with the hope to provide the guidance for CSP treatment.Fifty-eight cases of CSP patients who were treated with curettage after medication, curettage after uterine artery embolization, or surgery were retrospectively analyzed and compared for the clinical efficacy, length of hospital stay, and hemorrhage rate. Further, they were divided into the bleeding group (≥200 mL, 15 cases) and the control group (<200 mL, 43 cases). The hemorrhage-related risk factors were subjected to univariate analysis, including age, pregnant times, delivery times, abortion times or curettage times, the time from last cesarean section, menolipsis time, serum human chorionic gonadotropin level, ultrasound typing, maximum diameter of gestational sac or mass under ultrasound, peritrophoblastic blood flow around the mass, and the distance of gestational sac or mass from the uterine serosa layer. The significant indexes in univariate analysis were further analyzed using both receiver operating characteristic (ROC) analysis and multivariate logistic regression analysis.The success rate, length of hospital stay, and hemorrhage rate were not significantly different among the 3 treatment groups (P > .05). Univariate analysis found that patients in the bleeding group had significantly longer menolipsis time and greater maximum diameter than patients in the control group (P < .05). ROC analysis showed that the optimal cutoff for menolipsis time and maximum diameter were 51 days and 27 mm, respectively, and the areas under their corresponding ROC were 0.680 and 0.787, respectively. Multivariate analysis showed that only the maximum diameter in the retrospective equation was of significance (P < .05, odds ratio: 1.067, 95% confidence interval: 1.014∼1.123].All treatments have high success rates and no significant effects on intraoperative bleeding. Both menolipsis time and maximum diameter can be used to predict the risk of intraoperative bleeding, and the latter have a greater predictive value.