Objective: To explore the relationship between the expression of the T-cell activation suppressor-immunoglobulin variable region (VISTA) and the development of cervical squamous cell carcinoma (CSCC), and the impact on the prognosis of CSCC patients. Methods: Cervical tissue samples from 116 CSCC, including 23 cervical intraepithelial neoplasia (CIN) grade I, 23 CIN grade Ⅱ-Ⅲ, and 23 chronic cervicitis patients, were collected from the First Hospital of Soochow University between March 2014 and April 2019. The expression of VISTA in each group was detected by immunohistochemistry (IHC). Survival data of CSCC patients were obtained by follow-up. The survival analysis was performed by Kaplan-Meier method, and survival differences between groups were compared by Log rank test. Prognostic impact factors were analyzed using a multifactorial Cox proportional hazards model. Results: The positive rate of VISTA expression in CSCC group was 32.8% (38/116), and which of grade Ⅱ-Ⅲ was 17.4% (4/23). VISTA expression results showed no positive expression patients in the cervical intraepithelial neoplasia grade I and chronic cervicitis groups. The differences between the CSCC group and other groups were statistically significant (P<0.01). In 116 CSCC patients, VISTA expression was associated with International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis (P<0.01). The mean survival time of patients in the VISTA positive expression group was 30.7 months, and the 3-year survival rate was 44.7% (17/38). However, the mean survival time of the patients in the VISTA negative expression group was 49.1 months, and the 3-year survival rate was 87.2% (68/78). The Cox regression model found that VISTA expression positivity (P=0.001) and FIGO stage (P=0.047) were prognostic factors for CSCC, and patients with VISTA-positive CSCC had a 4.130-fold risk of death higher than those with VISTA-negative expression. Conclusions: The VISTA protein is highly expressed in CSCC tissues, and its expression level is closely related to the occurrence and development of CSCC. The expression of VISTA can be used as an independent predictor of CSCC prognosis and can provide a strong basis for the treatment of CSCC with immune checkpoint inhibitors.
Female ; Humans ; Carcinoma, Squamous Cell/pathology* ; Clinical Relevance ; Neoplasm Staging ; Prognosis ; Uterine Cervical Dysplasia/pathology* ; Uterine Cervical Neoplasms/pathology* ; Uterine Cervicitis/pathology*

Adult ; Carcinoma, Small Cell ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Leukosialin ; metabolism ; Lymphoma ; metabolism ; pathology ; Peroxidase ; metabolism ; Sarcoma, Myeloid ; metabolism ; pathology ; surgery ; Uterine Cervical Neoplasms ; metabolism ; pathology ; surgery ; Uterine Cervicitis ; metabolism ; pathology

Adult ; Aged ; Capsid Proteins ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Oncogene Proteins, Viral ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology ; Uterine Cervicitis ; metabolism ; pathology ; Young Adult

AIMTo investigate the expressions of main subtypes of heat shock protein (HSP) in cervical cancer and precancerosis tissues.

METHODSAccording to the pathological diagnosis, 478 cases of cervical biopsy specimen were divided into invasive carcinoma of cervix group (63 cases), cervical intraepithelial neoplasia group (CIN, 106 cases), chronic cervicitis group (293 cases) and normal uterine cervix (16 cases).The expression levels of HSP70, HSP90a and HSP90beta3 mRNA were detected by quantitative RT-PCR with specific complex cRNA as internal control.

RESULTS(1) The expressions of HSP70, HSP90a and HSP90beta mRNA were significantly down-trended stepwise in invasive carcinoma of cervix, CIN, chronic cervicitis and normal cervix tissue (P < 0.01, respectively). (2) In the invasive carcinoma of cervix group, the expression level of HSP90beta mRNA was higher in advanced stage (FIGO II b) compared with incipient(FIGO-II a) carcinoma of the cervix (P < 0.05). (3) The expressions of HSP70 and HSP90 mRNA were each higher in poorly differentiated tumor than in well-differentiated tumor (P < 0.05, respectively). (4) The expression levels of all three HSP mRNA had no significant differences, it was observed with different histological types of cervical cancer (P > 0.05).

CONCLUSIONHeat shock protein may play some important roles in malignant transformation of cervix cell and aggravation of cervix cancer. HSP70 and HSP90alpha may promote cancer cell transition and proliferation, and HSP90beta may participate in cell differentiation.

Carcinoma ; metabolism ; pathology ; Female ; HSP70 Heat-Shock Proteins ; metabolism ; HSP90 Heat-Shock Proteins ; metabolism ; Humans ; Precancerous Conditions ; metabolism ; pathology ; Tumor Cells, Cultured ; Uterine Cervical Neoplasms ; metabolism ; pathology ; Uterine Cervicitis ; metabolism ; pathology

OBJECTIVETo investigate the value of fluorescence in situ hybridization (FISH) detection of human telomerase RNA component (hTERC) gene amplification in screening of cervical lesions.

METHODSA total of 146 post-thinPrep cytology test (TCT) samples were analyzed using FISH by two-color interphase probe targeting hTERC gene at chromosome 3q26 and the data were compared with the cytological and histological results.

RESULTSFISH analysis was successful in 120 cases (20 cases of normal and 100 abnormal cases by TCT). Gene amplification of hTERC by FISH had a positive correlation with the cytological (r = 0.465, P < 0.01) and histological grade results (r = 0.610, P < 0.01). Extra copies of hTERC were seen in 28.6% (6/21) of CINI, 61.1% (11/18) of CINII, 75.0% (18/24) of CINIII and 91.7%(22/24) of squamous cell carcinoma, respectively. None (0/13) of the inflammation cases showed hTERC amplification. The sensitivity and specificity for detecting high grade lesions by FISH were 77.3% (51/66) and 82.4% (28/34); and the positive and negative predictive values were 89.5% and 65.1%, respectively. The rate of hTERC gene gain in high grade lesions was significantly higher than that in the low grade lesions (χ(2) = 32.550, P < 0.01). Combined with the high copy numbers, the sensitivity for detecting high grade lesions was increased to 81.2%.

CONCLUSIONSDetection of hTERC gene amplification by FISH improves the screening efficiency of high-risk cervical epithelial lesions. The presence of high copy numbers of hTERC correlates with the presence of high grade cervical dysplasia.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnosis ; genetics ; pathology ; Cervical Intraepithelial Neoplasia ; diagnosis ; genetics ; pathology ; Female ; Gene Amplification ; Humans ; In Situ Hybridization, Fluorescence ; Middle Aged ; RNA ; genetics ; Telomerase ; genetics ; Uterine Cervical Neoplasms ; diagnosis ; genetics ; pathology ; Uterine Cervicitis ; diagnosis ; genetics ; pathology ; Young Adult

OBJECTIVE: We have performed Classic Intrafascial Supracervical Hysterectomy (CISH) since April 1993, so we are to report the clinical results of CISH for 10 years, and introduce the technical aspects of new CISH. METHODS: A retrospective analysis on 470 cases of CISH (conventioal and new method) was carried out including age, parity, operating time, blood loss, uterine weight, pathologic results, complications and postoperative recovery. RESULTS: The mean age was 44.8 years (range 25-68), parity 2.23 (0-9), operating time 131 minutes (70-310), mean blood loss 148 mL (20-1000) and mean uterine weight was 306 gram (90-880). The most common uterine pathology was uterine leiomyoma (49.3%) and there were adenomyosis (15.5%), leiomyoma with adenomyosis (12.5%), chronic cervicitis (5%) and so on. Intraoperative complications included one case of bladder injury due to thick adhesion and 6 cases of bleeding requiring transfusion. Postoperative complications included 5 cases of cervical coring site bleeding, 2 cases of febrile complications, 2 cases of trocar site bleeding, 1 case of transient nerve injury of lower extremity, and 1 case of urinary tract infection. The mean hospital stay was 5.3 days (3-10). two hundreds and seventy eight patients of 470 had been followed for cervical pathology, and no pathologic findings except 3 cases of mild dysplasia were shown. CONCLUSION: Classic intrafascial supracervical hysterectomy, a minimally invasive organ-preserving procedure indicated for benign uterine disease, is associated with few operative complications and low morbidity, and the disadvantages of conventional Semm's CISH technique can be overcome by new CISH technique using triple ligation method.
Adenomyosis ; Female ; Hemorrhage ; Humans ; Hysterectomy* ; Intraoperative Complications ; Leiomyoma ; Length of Stay ; Ligation ; Lower Extremity ; Parity ; Pathology ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments ; Urinary Bladder ; Urinary Tract Infections ; Uterine Cervicitis ; Uterine Diseases

OBJECTIVETo investigate the clinicopathological significance of p16(INK4A) expression and DNA ploidy status in HPV-negative uterine cervical cancers and their precursors.

METHODSHPV-negative cervical lesions, including 20 cases of cervicitis, 20 cases of cervical intraepithelial neoplasm (CIN), 3 cases of cervical glandular intraepithelial neoplasm (CGIN), 38 cases of invasive squamous cell carcinoma (SCCs) and 15 cases of invasive adenocarcinoma were selected and subject to screening for HPV infection by PCR method. The p16(INK4A) protein expression and DNA ploidy status were studied by immunohistochemistry and flow cytometry respectively.

RESULTSSpecific expression of p16(INK4A) was seen in both the nucleus and cytoplasm of the dysplastic and malignant cells of CIN, CGIN, cervical SCC and adenocarcinoma. In contrast, no expression was present in normal and inflammatory squamous or glandular epithelium. DNA aneuploidy was significantly more frequent in invasive SCCs and adenocarcinomas than in CIN (P < 0.01). Aneuploid was also more frequent in the lymph node positive group than lymph node negative group, although no statistic significance was found. Among the 8 cases of p16(INK4A) negative SCCs, two showed DNA aneuploidy.

CONCLUSIONSImmunohistochemical detection for p16(INK4A) can be an early diagnostic marker for HPV-negative cervical SCC and adenocarcinoma. DNA ploidy analysis may further assist the diagnosis of cervical malignancies.

Adenocarcinoma ; genetics ; metabolism ; pathology ; Aneuploidy ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; DNA, Neoplasm ; genetics ; Female ; Flow Cytometry ; Humans ; Immunohistochemistry ; Papillomaviridae ; genetics ; isolation & purification ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms ; genetics ; metabolism ; pathology ; Uterine Cervicitis ; genetics ; metabolism ; pathology

OBJECTIVETo assess the clinicopathologic characteristics of cervical glandular intraepithelial neoplasia (CGIN) and to evaluate the usefulness of EnVision immunohistochemistry of various markers in identifying early invasive cervical adenocarcinoma (ICA) and its precursor lesions.

METHODSClinical and pathological characteristics of 80 cases of high grade CGIN (HCGIN), 20 ICA, and 20 cervicitis were reviewed along with immunohistochemical studies of p16, Ki-67, CEA, CA125 and bcl-2.

RESULTSThe clinical features of HCGIN were similar to those of high grade cervical intraepithelial neoplasia (CIN). Fourty four cases (55.0%) accompanied with CIN and 9 cases (11.3%) accompanied with early cervical squamous cell carcinoma (SCC). The positive rates of p16, CEA and Ki-67 in 80 cases of HCGIN were 100.0%, 63.8% and 73.8%, respectively. The positive rates of p16, CEA and Ki-67 in 20 ICA were 18/20, 16/20 and 20/20, respectively. The positive rates of p16, CEA and Ki-67 in 20 cervicitis were 1/20, 1/20 and 3/20, respectively. There was a significantly increased expression of p16, CEA and Ki-67 in ICA and HCGIN compared with cervicitis (P < 0.01). Ki-67 expression increased in ICA compared to HCGIN (P < 0.05). There was no statistical difference in CEA expression between ICA and HCGIN (P > 0.05). CA125 showed strong but nonspecific expression. Bcl-2 was negative or occasionally positive in each groups.

CONCLUSIONSHCGIN is frequently accompanied with CIN and SCC. The combined staining of p16, CEA and Ki-67 provides additional aid in the diagnosis of early stage cervical adenocarcinoma and its precursor lesions. The sensitivity of p16 and Ki-67 markers for HCGIN is higher than that of CEA. CA125 and bcl-2 immunostains offer no helpful in identifying HCGIN.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Middle Aged ; Uterine Cervical Neoplasms ; metabolism ; pathology ; Uterine Cervicitis ; metabolism ; pathology

OBJECTIVETo explore significance of high-risk human papillomavirus (HR-HPV) testing in atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion (ASC-H).

METHODSPresence of HR-HPV DNA was examined in 45 patients with ASC-H using hybrid capture II (HC-II) test. Colposcopic examination and biopsy were taken all results were evaluated.

RESULTSOverall, 33 of 45 (73.3%) ASC-H cases were biopsy proven cervical intraepithelial lesion (CIN). 36 of 45 ASC-H cases were HPV-DNA positive, including 19 cases of HSIL and over lesion; whereas no HSIL or over was found in 9 HR-HPV negative cases. Sensitivity and negativity predictive value of HR-HPV in ASC-H with HSIL and over lesion were both 100%.

CONCLUSIONSASC-H strongly predicts the presence of HSIL, HR-HPV may serve as a predict select whether a patient with ASC-H should take colposcopic examination immediately, patients with positive HR-HPV should undergo immediate colposcopic examination, while negative HR-HPV is an excellent predictor of the absence of HSIL.

Adult ; Aged ; Biopsy ; Carcinoma, Squamous Cell ; pathology ; virology ; Cervical Intraepithelial Neoplasia ; pathology ; virology ; Colposcopy ; DNA, Viral ; analysis ; Female ; Humans ; Middle Aged ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; Precancerous Conditions ; pathology ; virology ; Uterine Cervical Neoplasms ; pathology ; virology ; Uterine Cervicitis ; pathology ; virology ; Vaginal Smears ; Young Adult

Adult ; Asian Continental Ancestry Group ; ethnology ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; pathology ; CpG Islands ; genetics ; DNA Methylation ; Estrogen Receptor alpha ; genetics ; metabolism ; Female ; Humans ; Middle Aged ; Promoter Regions, Genetic ; genetics ; Uterine Cervical Neoplasms ; genetics ; metabolism ; pathology ; Uterine Cervicitis ; genetics ; metabolism ; pathology