Chinese expert consensus on the clinical applications of aminolevulinic acid-based photodynamic therapy in female lower genital tract diseases (2022).

INTRODUCTION: With the younger onset age of female lower genital tract diseases, there are increasing demands for protecting organ and tissue structures to preserve fertility and, therefore, effective fertility-sparing treatments that cause minimal normal tissue damage and less adverse reactions are urgently needed. OBJECTIVE: This study is aimed at reviewing information and achieving consensus on recommendations on the clinical applications of aminolevulinic acid-based photodynamic therapy (ALA-PDT) in female lower genital tract diseases. METHODS: Members of the expert panel held online and in-person meetings to discuss and revise drafts created by the steering committee based on the literature review and the clinical experiences of the expert panel. Opinions of the experts were transcribed and discussed in detail to ensure that the consensus statement best reflects the current advances in the field and the experts' view. RESULTS: After numerous rounds of meetings, experts unanimously agreed on the importance of ALA-PDT in the treatment of cervical squamous intraepithelial lesions (SIL), vaginal SIL, vulvar SIL, vulvar lichen sclerosus (VLS), and condyloma acuminatumon (CA). Experts also reached consensus on the recommended treatment regimen and treatment methods. CONCLUSION: This consensus aimed to provide practical basis and guidance for the clinical applications of ALA-PDT in female lower genital tract diseases in China. Of note, this is the only expert consensus prepared by board-certified specialists in gynecology and obstetrics in China. More evidence-based clinical studies should be made to update and expand the current recommendations.

Application value of different transformation zone types and its genetic relationship with high-risk HPV type in diagnosis and therapy of cervical disease.

This study aims to discuss the influence of different types of transformation zone (TZ) on positive surgical margin of loop electrosurgical excision procedure (LEEP) and the significance of infection of different genetic high-risk HPV for cervical intraepithelial neoplasm. The clinical data of patients who had CIN2+ and received LEEP during January to December 2013 was investigated. The conditions of positive surgical margin of patients of different transformation zone (type I, II, III) were analyzed. The clinical high-risk types of HPV were divided into three groups, including A5/6, A7 and A9, compared with the pathological conditions of pre-operation and post-operation of the patients in respective group. The results indicated that type III transformation zone is more likely to cause positive cutting margin. For CIN2+ patients, sensitivity and specificity are 0.89% and 79.56% in group A5/6, and negative and positive predicted value (NPV, PPV) are 40% and 5%. The sensitivity, specificity, NPV, PPV in group A7 is 12.5%, 44.08%, 29.49% and 21.21%, respectively. The sensitivity, specificity, NPV, PPV in group A9 is 88.99%, 87.09%, 85.26%, 81.51%, respectively. Transformation zone type was correlated positively with positive cutting margin percentage (r = 0.8732, P < 0.05). Compared with type I, type II and III transformation zone is more likely to cause pathological upgrades. In conclusion, different types of transformation zone and high-risk HPV have clinical significance in causing positive cutting margin of surgery and disease extent.

[Cyr61 expression influences cancer cell proliferation and apoptosis via PI3K pathway in human ovarian carcinoma cells].

OBJECTIVE: To investigate the relationship between cysteine-rich protein 61 (Cyr61) and phosphatidylinositol 3-kinase (PI3K) signal pathway on cell proliferation and apoptotic in human ovarian carcinoma cells. METHODS: Recombinant human Cyr61 (rhCyr61) was pretreated with ovarian carcinoma cells. The expression of Cyr61 protein was detected by confocal spectral microscopy. Then treated the ovarian carcinoma cells with PI3K transduction inhibitors (LY294002) for 24 hours. Cell apoptosis was detected by flow cytometry (FCM). Cell viability was determined by methyl thiazolyl tetrazolium (MTT) method. The mRNA expressions of Cyr61, the protein levels of protein kinase B (PKB), phospho-PKB and Cyr61 were assayed by real time-PCR and western blot analysis, respectively. RESULTS: The Cyr61 and phospho-PKB protein expression in two ovarian carcinoma cells (OV2008 and OVCAR-3) were increased in rhCyr61 pretreated group. The decreasing of cell apoptosis [(1.4 ± 0.9)%, (2.1 ± 1.0)%] and increasing of cell proliferation [(124.0 ± 1.8)%, (133.0 ± 2.2)%] was detected in the same time, compared with negative control group, there were significant difference (P < 0.05). After exposed to LY294002 for 24 hours, the apoptosis rate of OV2008 and OVCAR-3 in pretreated with rhCyr61 group exposed to LY294002 were (21.1 ± 1.6)% and (26.4 ± 1.5)%, respectively. Cells viability [(59.0 ± 2.3)%, (51.0 ± 2.0)%] was also significantly decreased in OV2008 and OVCAR-3 pretreated with rhCyr61 cells. Meanwhile, the mRNA expressions of Cyr61 (3.2 ± 0.8, 6.2 ± 1.1) and the protein levels of phospho-PKB and Cyr61 were greatly decreased. Compared with negative control group, there were significant difference in OV2008 and OVCAR-3 cells (all P < 0.01). CONCLUSIONS: The activation of PI3K intracellular signaling pathways may lead to up-regulation of Cyr61 expression. Block PI3K signal pathway could significantly inhibit the expression of Cyr61, and may promote the apoptotic effects and inhibit the cell growth of ovarian carcinoma cells.

Expression of COX-2 and Bcl-2 in primary fallopian tube carcinoma: correlations with clinicopathologic features.

The aim of this study was to evaluate the expression of COX-2 and Bcl-2 in primary fallopian tube carcinoma (PFTC), as well as their correlations with clinicopathologic features. We studied a cohort of 33 patients with a pathological diagnosis of PFTC. Thirty normal tubal tissues used for controls were obtained from patients diagnosed with uterine myomas. Expression analysis for COX-2 and Bcl-2 was performed using the immunohistochemical technique. The rate of preoperative diagnosis was 18.2%. With a median survival of 61.0 months (95% CI: 43.2 to 78.8 months), the estimated five-year overall survival rate in the 33 patients was 39.0%. Increased expression of COX-2 and Bcl-2 was observed in tumor specimens compared to normal controls (p = 0.026; p = 0.003). The expression rate of COX-2 in node-positive tumors was significantly higher than that of node-negative tumors (p = 0.024). Moreover, the expression rate of COX-2 was statistically significantly higher in patients with infiltration through the serosa (p = 0.019). Positive significant associations were observed between Bcl-2 staining index and FIGO stage (p = 0.015), and between Bcl-2 staining and lymph node metastasis (p = 0.010). There was a significant correlation between COX-2 expression and Bcl-2 staining index (r = 0.517, p = 0.002). We conclude that COX-2 and Bcl-2 may potentially be useful prognostic markers for PFTC. The exact molecular mechanism for correlations between COX-2 and Bcl-2 remains to be elucidated.