Does completion of radical hysterectomy improve oncological outcomes of women with clinical early-stage cervical cancer and intraoperative detection of nodal involvement?: protocol for a systematic review and meta-analysis.

INTRODUCTION: The management of women with clinical early-stage cervical cancer and lymph node involvement detected intraoperatively is heterogeneous and controversial. This paper presents the protocol of a systematic review and meta-analysis regarding the management of this specific population of patients. This proposed study aims to answer the question: does completion of radical hysterectomy improve the oncological outcomes of women with clinical early-stage cervical cancer and intraoperatively detected nodal involvement? METHODS AND ANALYSIS: This protocol is drafted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines, and the proposed study will be conducted in accordance with the standard guidelines of 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' and 'Meta-analysis of Observational Studies in Epidemiology reporting guideline'. Comprehensive literature searches will be performed in PubMed, Embase, Scopus, and Web of Science. The screening of the eligible studies, the extraction of data of interest, and the quality assessment of the included studies will all be independently performed by different members of our team. The primary outcome of this proposed study will be comparing the risk of recurrence or death from cervical cancer and the risk of all-cause death in patients with two different treatments (completion of radical hysterectomy or abandonment of radical hysterectomy); the secondary outcome of this proposed study will be comparing the risk of the grade 3/4 toxicities associated with the two types of management. Given the clinical heterogeneity among the included studies, data on outcomes will be pooled by random-effects models. Heterogeneity will be evaluated using the I2 statistic. The risk of bias for the included studies will be evaluated using the Newcastle-Ottawa Scale or the Cochrane collaboration's tool. The grade of evidence will be evaluated by two independent members of our team using the Grading of Recommendations, Assessment, Development and Evaluations approach. ETHICS AND DISSEMINATION: Ethical approval is not required because there will no primary data collected. The findings of this proposed study will be published in an international peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021273527.

Oncological safety of hysteroscopy in the diagnosis of stage I endometrial cancer: protocol for a systematic review and meta-analysis.

BACKGROUND: The oncological safety of diagnostic hysteroscopy in patients with stage Ⅰ endometrial cancer remains uncertain and conflicting. The aim of the proposed systematic review and meta-analysis is to summarise the available evidence examining the association between diagnostic hysteroscopy and the prognosis of stage Ⅰ endometrial cancer and to statistically synthesise the results of relevant studies. METHODS AND ANALYSIS: Systematic searches of PubMed/MEDLINE, Embase, Cochrane Library and Web of Science will be undertaken using prespecified search strategies. Two authors will independently conduct eligible studies selection process, perform data extraction and appraise the quality of included studies. Original case-control studies, cohort studies and randomised controlled trails published in English will be considered for inclusion. The outcomes of interest will be 5-year recurrence-free survival, disease-specific survival and overall survival. Meta-analyses will be performed to calculate pooled estimates. ETHICS AND DISSEMINATION: Our study will be based on published data, and thus there is no requirement for ethics approval. The results will be shared through publication in a peer-reviewed journal and presentations at academic conferences. PROSPERO REGISTRATION NUMBER: CRD42020193696.

[High Mobility Group Chromosomal Protein N2 Inhibit Cervical Cancer Transplanted in Nude Mice].

OBJECTIVES: To study the effect of high mobility group chromosomal protein N2 on inhibiting cervical cancer in nude mice. METHODS: Model of cervical cancer were established in nude mice. They were randomly divided into 4 groups including negative control group, HMGN2 group, cisplatin group and HMGN2 with cisplatin group. After 4 injections, the tumor size were calculated and tumor tissues were stained by haematoxylin eosin (HE) staining. RESULTS: Transplated tumor models were established successfully. The tumor sizes of negative control group [(0.38±0.12) cm³] were significantly lower than those of HMGN2 group [(0.14±0.07)cm³, cisplatin group [(0.11±0.06) cm³] and HMGN2 combined with cisplatin group[(0.11±0.07) cm³]. No differences were detected in HMGN2 group, cisplatin group and HMGN2 with cisplatin group in tumor sizes. The tumor inhibition rates of HMGN2 group, cisplatin group and HMGN2 with cisplatin group were 0.62±0.18, 0.71±0.17 and 0.70±0.18, respectively. The necrosis area were smaller in negative control group than in other three groups by HE staining. CONCLUSIONS: HMGN2 has a significant inhibitory effect on transplanted cervical cancer in nude mice.

[Expression and clinical signification of IL-10 and IL-17 in endometrial cancer].

OBJECTIVE: To explore the expression of IL-10 and IL-17 in endometrial cancer and their relationships with tumor progression. METHODS: The sera levels of IL-10 and IL-17 were detected by enzyme-linked immune-sorbent assay in 15 benign hysterectomies and 15 endometrial cancers, the expressions of IL-10 and IL-17 in the tissue were measured by immunohistochemistry assay (SABC) with the evaluation of IOD value, clinic-pathological characteristics were retrieved and analyzed. RESULTS: Both sera expression and tissue IOD value of IL-10 were significantly higher in endometrial cancer than those in benign uterine, while no difference was found in IL-17 between the two groups. Sera IL-10 of I B-II stage, G2-G3, with myoinvasion, with vas tumor emboli was higher than that of I A stage, G1, without myoinvasion, and without vas tumor emboli, while no difference was found among tissue types. Sera IL-17 of I B-II stage, with myoinvasion, with vas tumor emboli was lower than that of IA stage, without myoinvasion, and without vas tumor emboli, while no difference was found among tumor grades nor tissue types. CONCLUSION: High expression of IL-10 may participate in the genesis and development of uterine endometrial cancer, while low expression of IL-17 may participate in its development.

BiClamp(®) forceps was significantly superior to conventional suture ligation in radical abdominal hysterectomy: a retrospective cohort study in 391 cases.

OBJECTIVE: To evaluate the efficacy and security of ERBE BiClamp(®) forceps in radical abdominal hysterectomy for managing those cervical cancers, extending to other gynecologic cancers such as endometrial cancer and ovarian cancer as well. METHODS: A retrospective cohort study was made in 391 cases from 450 FIGO IA2-IIB cervical cancers between November 2005 and September 2010. After baseline character analysis, the conventional group (n = 195) was compared with the BiClamp group (n = 196) on the basis of surgical outcome and complications. Data analysis was based on intention to treat with statistics software SPSS17.0. RESULTS: Comparison between conventional suture ligation and BiClamp(®) forceps is as follows: the operation time was 247.7 ± 47.7 min for the conventional suture ligation versus 224.1 ± 36.2 min (P < 0.001) for BiClamp(®) forceps, estimated blood loss was 769.2 ± 310.4 ml versus 534.8 ± 232.5 ml (P < 0.001), gauze consumption was 35.3 ± 10.6 sheets versus 28.2 ± 7.4 sheets (P < 0.001), intra-operative blood transfusion rate was 75.9 versus 28.1% (P < 0.001), hemoglobin decline was 29.2 ± 10.1 g/L versus 26.5 ± 9.2 g/L (P = 0.085), postoperative blood transfusion rate was 17.0 versus 15.6% (P = 0.818), closed suction drainage was 268.8 ± 162.0 ml versus 208.3 ± 141.7 ml (P < 0.001), hospital stay was 8.8 ± 2.5 days versus 7.1 ± 2.2 days (P < 0.001), postoperative complications was 23.6 versus 14.8% (P = 0.027). CONCLUSION: With obvious decrease of operation time, blood loss, postoperative complications, hospital stay and particularly, intra-operative blood transfusion rate, BiClamp(®) forceps has been proved more efficient and controllable in radical abdominal hysterectomies of cervical cancers than conventional suture ligations, extending to endometrial cancers and ovarian cancers, hence deserves to be popularized.

[Effects of proteasome inhibitor MG132 on cell proliferation, apoptosis, and cell cycle in HEC-1B and Ishikawa cells].

OBJECTIVE: To study the anti-cancer activities of Z-Leu-Leu-Leu-cho (MG132) against human endometrial carcinoma HEC-1B and Ishikawa cells and the potential of MG132 in human endometrial cancer therapy. METHODS: HEC-1B and Ishikawa cells were treated with MG132. Cell proliferation was assessed by MTT while cell apoptosis rate and cell-cycle distribution were assessed by flow cytometry. RESULTS: The proliferation of HEC-1B and Ishikawa cells was inhibited by MG132 and cell proliferation was significantly inhibited with the raised concentration of MG132 (P<0.01), Ishikawa cells were more sensitive than HEC-1B cells to MG132. MG132 could induce the apoptosis of HEC-1B and Ishikawa cells (P = 0.000). Cell cycle analysis indicated that the percentage of HEC-1B cells was increased in G2 phase (P<0.05) while Ishikawa cells' was increased in G1 and G2 phase (P<0.05). CONCLUSION: Proteasome inhibitor MG132 could inhibit the proliferation, promote cell apoptosis, and block the cell cycle of HEC-1B and Ishikawa cells. MG132 may be a potential treatment for endometrial cancer.

[Study on the susceptibility of the cervical carcinoma cells to CTL lysis under the stimulation of rSIFN-co and its mechanism].

OBJECTIVE: To investigate the susceptibility of cervical carcinoma cells (HPV16+) to CTL lysis affected by rSIFN-co, consensus Interferon (Infergen), IFNalpha-2b and DDP. METHODS: After CaSki cervical cancer cells were induced by rSIFN-co, Infergen, IFNalpha-2b and DDP at the concentration of 0.156 microg/mL, 0.625 microg/mL, 2.500 microg/mL for 72 hours, CaSki cells which had been induced were effected by CTL, the cytotoxicity was determined and calculated by MTT assay. The expression intensity of adhesion molecules on Caski cell such as CD54 and CD40 was also determined by flow cytometry. RESULTS: The susceptibility of CaSki cell to CTL lysis under the stimulation of rSIFN-co was better than Infergen, IFNalpha-2b and DDP induced. The expression of CD54 and CD40 on cervical cancer cell was also increased. And this effect had positive correlation to the drug concentration. CONCLUSION: rSIFN-co can increase the expression of CD54 and CD40 on the cervical cancer cell surface, and increase the susceptibility of CaSki cell to specific effective cell lysis in a dose-dependent manner. The effect of rSIFN-co is better than same type interferon, general I type interferon and chemotherapeutic drug induced.

[Study on antimicrobial activity of human hemoglobin and its fragments both in vitro and in vivo].

OBJECTIVE: To isolate human hemoglobin and its fragrments, compare their antimicrobial activity in vitro and pilot study of their antimicrobial activity in vivo. METHODS: The alpha and beta chains of hemoglobin were separated by cation exchange chromatography and gel chromatography; The alpha and beta chains were cleaved by cyanogens bromide respectively. The cleaved fragments were purified by reverse phase high performance liquid chromatography. Antimicrobial activity of hemoglobin and its fragments was determined by agrose radial diffusion assay. After establishment of E. coli vaginal infection model, the rats were randomized into the experimental group (hemoglobin group) and the control group. The histologically pathological section was observed. RESULTS: Hemoglobin, alpha/beta chain and their fragments had similar antibacterial activities in vitro, which were mainly against Gram-negative bacteria E. coli; except alpha1-32 had a comparatively lower activity. Antimicrobial activity in vivo: a comparison of the hemoglobin group with the matrix control group (no treatment after infection), the surface layer of vaginal stratified squamous epithelium was smoother, inflammatory cells were significantly reduced in the lamina propria and congestion was obviously decreased. CONCLUSION: Human hemoglobin and its fragments had antibacterial activity in vitro, hemoglobin might relieve the inflammation of E. coil vaginal infection in rats moreover.

[Effect of lymphokine activated killer from umbilical blood on human ovarian cancer in nude mouse models].

OBJECTIVE: To explore the possibility of using lymphokine activated killer (LAK) from cord blood as an adoptive immunotherapy for ovarian cancer. METHODS: The nude mouse models with human ovarian cancer were treated with the LAK from cord blood and compared with those treated with the LAK from the pheripheral blood. RESULTS: The LAK from the cord blood inhibited the growth of human ovarian cancer. The average size of the tumor was 6.0 mm3 23 days after the cord blood LAK treatment, with an average weight of (0.674 +/- 0.45 g). CONCLUSION: Cord blood can be a source of adoptive cellular immunotherapy for the treatment of ovarian cancer.

[The expression of matrix metalloproteinase-2 and -9 in cervical cancer and a study of their relationship].

OBJECTIVE: To detect the expressions of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in cervical cancer and their correlation with clinicopathologic features. METHODS: With the use of specific monoclonal antibody to human MMP-2 and MMP-9, the formalin-fixed and paraffin-embedded specimens of 62 invasive carcinomas of cervix uteri, 5 carcinomas in situ, 10 normal cervical epithelia and 10 lymph node metastases were detected by immunohistochemical method. RESULTS: MMP-2 and MMP-9 protein expressions in tumor and peritumoral stromal cells were enhanced in invasive carcinoma, compared to those in carcinoma in situ and controls (P < 0.05). There was a low correlation between MMP-2 and MMP-9 (r = 0.34, P < 0.01); the expression level of MMP-9 was higher than MMP-2. The protein expressions of MMP-2 and MMP-9 did not correlate with tumor stage, histological grade or pathological subtype. MMP-9 was correlated with lymph node metastasis and lymphovascular space invasion. CONCLUSION: The over-expression of matrix metalloproteinase-2 and -9 was correlated with invasive behaviour of cervical cancer, MMP-9 was significantly correlated with the lymph node metastasis, it might become a useful prognostic indicator for early cervical cancer.