1.Short-term influence on ovarian reserve in premenopausal women with hysterectomy plus salpingectomy
Cuiying CHEN ; Keli YOU ; Guandi CHEN ; Shuyan WU ; Zhigang LI
Journal of Medical Postgraduates 2017;30(1):83-87
Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P<0.05) , though with no significant difference between 1 and 3 months ( P>0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .
2.Risk factor analyses of positive margins of conization specimen and post-cone residual disease in patients with cervical intraepithelial neoplasia grade 3
Yang YANG ; Keli YOU ; Cuiying CHEN ; Zhigang LI
Journal of Medical Postgraduates 2015;(6):613-617
[Abstract ] Objective Positive margins of conization specimen for cervical intraepithelial neoplasia grade (CIN)3 is a high risk factor of continuous cervical lesions or progress to early invasive carcinoma .The aim of this study was to evaluate the risk factors of positive margins of conization specimen and post-cone residual disease in hysterectomy specimens following conization for CIN 3. Methods Clinical data from 218 patients with CIN 3 underwent hysterectomy after conization from 2001 to 2013 were analyzed retro-spectivly.Multi-factors logistic regression was performed to determine the independent risk factors for positive margins of conization specimen and post-cone residual disease. Results Fifty five cases(25.2%) had positive margin of conization specimen , and the independent risk factors were unsatisfactory colposcopy (OR:5.18,95%CI:2.49-11.10), width of conization specimen smaller than 2 cm (OR:7.68,95%CI:2.31-28.10) and pathology of CIN3 with carcinoma in situ (OR:4.38,95%CI:1.67 -12.10).Forty seven patients (21.6%) had post-cone residual disease , and the independ-ent risk factors were length of conization specimen smaller than 1.5 cm (OR:2.45,95%CI:1.12-5.69), pathology of CIN3 with carci-noma in situ (OR:4.96,95%CI:2.17-11.70) and status of coniza-tion margins (OR:4.34,95%CI:1.95-9.78). Conclusion The satisfaction of colposcopic examination, conization specimen di-ameters including width and length , CIN3 with carcinoma in situ and status of conization margins could contribute to positive margins of conization or residual disease in subsequent hysterectomy specimens .More attention should be paid to such a group of CIN 3 patients clinically.
3.The regulatory effect of 5-aza-2,-deoxycytidine in cervical cancer cells
Guandi CHEN ; Geying FAN ; Keli YOU ; Deying QIAN ; Jinmin CEN ; Yanhong SHU ; Zhigang LI
The Journal of Practical Medicine 2016;32(18):2995-2999
Objective To discuss the regulatory effect of 5-aza-2 ,-deoxycytidine on P16 and MGMT in cervical cancer cells. Methods After four kinds of cervical cancer cells (HeLa, SiHa, C33A and CaSki) were treated with 5-Aza-dC , MSP was used to detect the methylation variation of P16 and MGMT , and fluorogenic quantitative PCR and Western blot were employed for determination of P16 and MGMT expression. MTT and Annexin V-FITC/PI double staining were adopted for detection of cell proliferation and apoptosis. Results Both P16 and MGMT exhibited methylation in four kinds of cervical cancer cells , and after treatment with 5-Aza-dC ,their methylation levels were reversed. 5-Aza-dC was able to inhibit p16 and MGMT expression in the cervical cancer cells, and can also suppress cell proliferation and promote apoptosis. Conclusions Although methylation of P16 and MGMT are present in cervical cancer cells, their expression level was still high. Therefore, regulation of P16 and MGMT expression may be affected by other factors. 5-Aza-dC can suppress the growth of cervical cancer cells. Although 5-Aza-dC reverse the methylation levels of P16 and MGMT, it inhibits their gene expression. More experiments are needed to verify the hidden reasons and mechanisms.