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【Objective】 To explore the effectiveness of an image recognition system based on artificial intelligence (AI) in diagnosing benign and malignant endometrial cell clumps. 【Methods】 We selected endometrial cytological specimens from The First Affiliated Hospital of Xi’an Jiaotong University and Xi’an Daxing Hospital from August 2021 to February 2023; histopathology was used as the gold standard. We compared and analyzed the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and diagnostic time of AI image recognition system (AI diagnosis) and professional pathologists’ manual diagnosis (manual diagnosis) of benign and malignant endometrial cell clumps. 【Results】 Among the 126 patients included in the analysis, the overall coincidence rate of AI diagnosis and histological diagnosis was 92.1% (116/126), which was highly consistent with histopathological results (Kappa=0.841). The overall coincidence rate of manual diagnosis and histological diagnosis was 94.4% (119/126), which was highly consistent with histopathological results (Kappa=0.889). There was no statistically significant difference between AI diagnosis and manual diagnosis methods (χ2=0.568, P=0.451). The sensitivity, specificity, positive predictive value, and negative predictive value of AI diagnosis were 91.8%, 92.3%, 91.8%, and 92.3%, respectively. There were 126 cytology sections, each of which required 6.67 minutes for manual diagnosis and 5.00 minutes for AI diagnosis. 【Conclusion】 The AI image recognition system has high diagnostic accuracy, sensitivity and specificity, which is equivalent to the manual diagnosis level of professional pathologists. Therefore, this system has application value in the diagnosis of benign and malignant endometrial cell clumps.
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【Objective】 To retrospectively analyze the average carboplatin dosage and calculate the area under the curve (AUC) using the Calvert formula in first-line chemotherapy in patients with epithelial ovarian cancer in The First Affiliated Hospital of Xi’an Jiaotong University so as to evaluate the effect of the AUC difference in the Chinese population on therapeutic efficacy and safety. 【Methods】 We enrolled patients who underwent first-line chemotherapy with paclitaxel and carboplatin 3-week regimen in our hospital from January 1, 2012 to January 1, 2022. According to the median of AUC, the patients were divided into high-dose group and low-dose group. The overall response rate (ORR), disease control rate (DCR), progression free survival (PFS), overall survival (OS), and the incidence of adverse events (AEs) were compared. 【Results】 A total of 153 patients were enrolled in this study and the median AUC of carboplatin was 3.981 (range 2.314-5.446). Only 10.46% patients (16/153) had an AUC above 5. There were 77 patients with the AUC0.05). The ORR in the low-dose group and the high-dose group was 59.74% and 57.89%, respectively, and the DCR was 87.01% and 85.53%, respectively. The median PFS of the two groups was 14 and 15.5 months, respectively, and the median OS was 50 and 55 months, respectively. None of the above outcomes were statistically different between the two groups (P>0.05). The two groups showed significant differences in the incidence of anemia, neutropenia, and thrombocytopenia (P<0.05). The incidence of nausea and vomiting, grade 1-2 diarrhea or constipation, and grade 1-2 fever showed significant differences (P<0.05). In addition, the incidence of dose limiting toxicity (DLT), including grade 4 thrombocytopenia and febrile neutropenia (FN), was significantly increased in the high-dose group (P<0.05). 【Conclusion】 Compared with the recommended AUC 5-6 of carboplatin abroad, the actual carboplatin dosage in the first-line chemotherapy for patients with epithelial ovarian cancer was generally insufficient in our hospital. There was no difference in therapeutic efficacy between the patients with AUC<4 and AUC≥4. However, considering the increased risk of some AEs and DLT in the high-dose group, it is not recommended to increase the carboplatin AUC blindly.
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Objective@#Traditional uterine manipulator is considered as the main reason for short survival of patients with early-stage cervical cancer during minimally invasive surgery. This study aims to assess the sealing effect of magnetic-sealing uterine manipulators (MUMs) in isolated uteruses. @*Methods@#The study was performed on isolated uterus from patients with early-stage cervical cancer who underwent open abdominal radical hysterectomy between November 2019 to April 2021. Right-angle forceps closure tests (groups 1 and 3) were defined as control tests. One experimental MUM closure test (group 2) and 2 control tests were respectively carried out in each of the isolated uterus. DNA ploidy analysis system was used to observe exfoliated cells. Statistical analysis was performed using Wilcoxon signed-rank test to assess the sealing effect of MUM. @*Results@#We identified 36 patients. No regional node metastasis was discovered and only one tumor was larger than 4.0 cm in diameter. The mean of exfoliated tumor cells in groups 1, 2, and 3 were 1, 1, and 2, respectively. There was no significant difference in the quantity of exfoliated cells between groups 1 and 3 (p=0.476), so the results of the 2 groups were merged. Subsequently, a significant difference was observed between combined right-angle forceps closure tests and MUM closure tests (p=0.022). @*Conclusion@#The sealing effect of MUM was better than that of right-angle forceps. MUM can effectively seal cervical cancer cells in the cup cover, avoiding the dissemination of tumor cells.
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Objective To explore the mechanisms and effects of adoptive immunotherapy with ovarian cancer vaccine modified by GM-CSF gene which was used after immunologic reconstitution during lymphopenia induced by chemotherapy.Methods Lymphopenia was induced by chemotherapy with cyclophosphamide.The immune reconstituted model was built in rats.The tumor vaccine draining lymph nodes were harvested after the ovarian cancer cells NUTU-19 modified by GM-CSF gene were injected.The effector T cells (T_E) were got after being stimulated and amplified.Enzyme-linked immunosorbent assay was used to detect the level of interleukin (IL)-2 and IL-4 secreted by T_E.Intracellular cytokine staining was used to determine frequency of tumor-specific T_E.Fluorescence-activated cell sorting (FACS) was used to detect the special cytotoxicity ofT_E killing target cells.The survival period of rats bearing pre-established abdominal ovariam carcinoma after being adoptively transferred byT_E.was observed.Results Compared with those in control group,the significant higher levels IL-2[(65.7±4.0) pg/ml]and lower levels IL-4 [(277±49) pg/ml]were observed in chemotherapy-immune recunstitution-vaccine immunization group.The amount of CD_4~+ T cells secreting interferon-γ (13.0±2.1)% were also significantly increased.The rate of the special cytotoxicity of killing T cells (86.5±1.1) % was markedly improved.The survival period of rats (110±16) days was increased in chemotherapy-immune reconstitution-vaccine immunization group.Conclusions The combined immunotherapy of chemotherapy-immune reconstitution-tumor vaccine immunotherapy may increase the frequency and function of specific tumor T_E.The specific cytotoxicity is increased and the weak reaction of T_E to tumor is improved,which showed that this therapy can enhance immune reaction.
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To determine whether TGF*"β1 has any possible correlation with occurrence and development of gestational trophoblastic disease. Methods Immunohistologic staining for TGF*"β1 was performed on archival materials from 10 cases of first trimester villi, 40 hydatidiform mole, 10 invasive mole and 6 gestational choriocarcinoma. Results It was shown that the positive rate of TGF*"β1 was 100% in the first trimester villi, 95% in hydatidiform mole, 80% in invasive mole and 66.7% in gestational choriocarcinoma. In hydatidiform mole group, the staining intensity on TGF*"β1 wasn't associated with histologic grade (P＞0.05). Conclusion As a negative regulator of cell proliferation, TGF*"β1 may play an important role in the inhibition of proliferation and invasion of trophoblastic cells and of GTD malignant transformation process. TGF*"β1 isn't associated with prognostic of hydatidiform mole.
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Objective To obtain exosomes from the cell culture supernatants of 8910,TC-1,SKOV_(3),CAOV and 3AO ovarian cancer cell lines.Methods 8910,TC-1,SKOV_(3),CAOV and 3AO ovarian cancer cell lines were cultured separately and the cell culture supernatants were collected to seperate exosomes with multiple centrifugation and ultrafiltration.Morphology of exosomes were observed with electron microscopy.Results Exosomes were purified in 8910 and 3AO cell culture supernatants.Exosoems exhibited heterogenous round or elliptic microvesicles ranging from 30 to 90 nm in diameter with intact membrane.Exosomes were not purified in TC-1,SKOV_(3),and CAOV cell culture supernatants.Conclusion 8910 and 3AO cell lines may secrete exosomes,which are potential specific antigens for immunotherapy against ovarian cancer cells.