Objective:This study investigated the prognostic significance of age at diagnosis, stage, tumor subtype, pelvic lymph node metastasis (PLNM), lymph-vascular space involvement (LVSI), presence or absence of deep cervical stromal invasion (DCSI) in stage ⅠB-ⅡA cervical cancer patients. It also investigated the inter-relationship among these factors. Methods: 152 patients treated with radical hysterectomy plus pelvic lymphadenectomy were followed up for a median of 49 months and were evaluated retrospectively. Results: The 5-year overall survival rate was 84.8%. The distribution of age at diagnosis is of bimodal shape, peaking at 42 and 68 years, respectively. Tumor subtype, PLNM, DCSI, and LVSI were found to be significant prognostic factors individually. After multivariate analysis, only tumor subtype and PLNM were found to be independent, significant prognostic factors for survival. The prognostic importance of LVSI appeared to be eclipsed by the presence of PLNM. DCSI was statistically related with FIGO stage, LVSI and PLNM. Conclusion: Tumor subtype and PLNM are the two most important independent prognostic factors for stages ⅠB-ⅡA cervical cancer. Some prognostic factors are inter-related and may reflect different facets of tumor progression.

Objective To investigate clinicopathological features of endometriosis-associated epithelial ovarian carcinoma.Methods Retrospective follow-up study,clinicopathological data from patients with ovarian epithelial carcinoma were retrieved,analyzed and compared.Among the 727 cases,34 were found to originate from endometriosis (group A),33 were found to have co-existing ovarian endometriosis (group B),and the remaining 660 had no ovarian endometriosis at all (group C).Result Seven hundred and twenty-seven epithelial ovarian carcinoma patients were identified and their ehnicopathological data retrieved.Sixty-seven (9.2%) of these cases were found to have coexisting endometriosis.The frequency of malignant tumors arising from ovarian endometriosis in this case series was estimated to be 0.87% (34/3890).The mean (standard deviation) age in groups A,B,and C were(47.2±1.3),(47.8±1.2),(51.2±0.4) years,respectively,with patients in group C being significantly older (P = 0.013).Patients with coexisting ovarian endometriosis were mostly diagnosed at stage Ⅰ (P = 0.000)and having subtype of clear-cell (P =0.000),while other patients were mostly diagnosed at stage Ⅲ (P =0.001),and having subtype of serous carcinoma (P =0.000).The estrogen receptor (ER) positivity was significantly lower in groups A and B than that in group C (22.2%,31.6% vs 43.9%;P =0.018),but the difference in positivity of progestogen receptor among the three groups did not reach statistical significance (22.2%,15.8% vs 35.5%;P =0.082).While the five-year overall survival rate for all patients was 55.6%,significant difference in overall survival among the three groups was found 78.9%,92.8%,51.9%,respectively,for groups A,B and C (P =0.000).Conclusion Patients of endometriosis-associated epithelial ovarian carcinoma,especially patients with tumors arising from endometriosis,were found to be younger,having a significant lower stage and a better survival,and were mostly diagnosed with the subtype of clear-cell.

Objective To profile methylation alterations of cytosine-phosphate-guanosine islands (CGI)in epithelial ovarian cancer and investigate its applications for finding new candidate tumor markers.Methods Cancer cells were obtained by lager microdissection from 20 tissues of frozen-preserved epithelial ovarian tumors.Primary cultured epithelial cells were isolated from 5 tissues of normal ovaries.Differential methylation hybridization(DMH)based on microarray assay Was conducted using DNA to construct the aberrant DNA methylation pattern of epithelial ovarian cancer.MethyLight was conducted to verify the methylation status of 7 hypomethylated promoter CGI detected by DMH in tumor tissues of 87 patients with epithelial ovarian cancer and 42 patients with benigh ovarian diseases.Results The aberrant DNA methylation pattem of epithelial ovarian cancer were included 182 hypermethylated loci and 64 hypomethylated loci,of which the positive loci located more than 25%arrays were 18 and 31,respectively.The methylation ratio of gene LSM2,EGFLAM and CDKN2A in tissue DNA of patients with epithelial ovarian cancer and benign ovarian diseases Was 11%(10/87)versus 33%(14/42),8%(7/87)versus 21%(9/42),9%(8/87)versus 31%(13/42),respectively,which Was significantly decreased in tissues DNA of ovarian cancer than that from benigh ovarian diseases(P＜0.05).Conclusions The aberrant DNA methylation pattern of epithelial ovarian cancer is important for finding new cancer related genes.The promoter CGI of gene ISM2,EGFIAM and CDKN2A may be Hovel candidate for ovarian cancerspecific hypomethylated tumor markers.