Choriocarcinoma is one of the malignant tumors of trophoblastic cells characterized by the secretion of human chorionic gonadotrophin (hCG) (1-3). Cutaneous metastasis is a rare presentation of choriocarcinoma but a poor prognostic sign because it is associated only with widespread disease (3-5). A 52-yr-old female complaining of dyspnea for 2 months, presented with fingertip sized erythematous nodules on the left side of the neck and the right side of the upper back of 1 month duraton. She has suffered from Behcet's disease since 1999. Microscopic examination of a nodule of upper back demonstrated biphasic pattern of cytotrophoblasts and hCG-positive syncytiotrophoblasts, and the typical histologic features of choriocarcinoma. She was referred to the gynecological oncology department. After 17 cycles of combination chemotherapy, the serum hCG level has fallen from 700,000 to under 2.0 mIU/mL and the skin lesions have almost disappeared. However, after 3 months, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed due to elevated serum hCG level (4,447.7 mIU/mL), and she is scheduled to receive post-operative adjuvant chemotherapy.
Choriocarcinoma/blood/*pathology ; Chorionic Gonadotropin/blood ; Female ; Humans ; Middle Aged ; Pregnancy ; Skin Neoplasms/*secondary ; Uterine Neoplasms/blood/*pathology

It is to observe the therapeutic action of Guizhi Fuling capsule and the combination of active ingredients on model rats with uterine leiomyoma. The hysteromyoma rats models was established in rats by loading eatrogen, to observe the effect on pathological condition of uterus, uterus wet weight, the content of estradiol and progesterone. Guizhi Fuling capsule and the combination of active ingredients remarkably decreased uterus weight, restrained the excess proliferation of the smooth muscle of uterus, decreased the estraiol and progesterone in blood serum. Guizhi Fuling capsule and the combination of active ingredients can restrain the formation of hysteromyoma in a dose-dependent manner. Perhaps the combination of active ingredients is the material foundation of antihysteromyoma.
Animals ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Leiomyoma ; blood ; drug therapy ; pathology ; Progesterone ; blood ; Rats ; Rats, Wistar ; Uterine Neoplasms ; blood ; drug therapy ; pathology

Adult ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Leiomyomatosis ; pathology ; surgery ; Sarcoma, Endometrial Stromal ; pathology ; Uterine Neoplasms ; pathology ; surgery ; Uterus ; blood supply ; Vascular Neoplasms ; pathology ; surgery

Adenocarcinoma ; pathology ; surgery ; Adult ; Blood Loss, Surgical ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Middle Aged ; Neoplasm Staging ; Uterine Cervical Neoplasms ; pathology ; surgery

OBJECTIVETo study the thymidine phosphorylase (TP) expression in different types of cancer and its correlation with tumor microvessel density (MVD).

METHODSThe expression of TP and MVD was detected by immunohistochemistry method. In a series of 251 cancer patients there were 48 patients with gastric cancer, 53 with colorectal cancer, 47 with breast cancer, 56 with cervical cancer, 47 with lung cancer. Normal gastric (n = 25), colorectal (n = 25), cervical (n = 17) and lung (n = 25) tissues around the cancer were also examined.

RESULTSThe TP expression rate was 64.6% in gastric cancer, 67.9% in colorectal cancer, 80.9% in breast cancer, 82.1% in cervical cancer, and 63.8% in lung cancer, which was significantly higher than that in normal tissues (P = 0.0000). TP expression was positively correlated with MVD in gastric, colorectal, breast, and cervical cancers. The correlation was not statistically significant in lung cancer.

CONCLUSIONThis study indicates that TP overexpression in cancer may be associated with tumor angiogenesis.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; blood supply ; enzymology ; Colorectal Neoplasms ; blood supply ; enzymology ; Female ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; pathology ; Stomach Neoplasms ; blood supply ; enzymology ; Thymidine Phosphorylase ; metabolism ; Uterine Cervical Neoplasms ; blood supply ; enzymology

OBJECTIVETo investigate the correlations of serum interleukin-18 (IL-18) level and IL-18 gene promoter polymorphisms to the development of cervical cancer (CC).

METHODSFive single nucleotide polymorphisms (SNPs) of the IL-18 gene promoter region at position rs5744224, rs1946519, rs1946518, rs5744225 and rs5744226 were detected by means of sequences analysis in 50 CC patients and 50 normal subjects that matched for age and residence, and their serum IL-18 level was tested using enzyme-linked immunosorbent assay (ELISA).

RESULTSTwo linkage SNP sites (rs1946519 and rs1946518) in the up-stream of IL-18 gene were identified to present 3 genotypes, namely TT-AA, GG-CC, and TG-AC. A significant difference in the frequency of the 3 genotypes was observed between the CC patients and the normal controls (chi 2=17.497, P=0.000). The frequency of T (A)/G (C) alleles was 42% (42/100) in normal controls and 73% (73/100) in patients, showing significant diference (chi 2=19.662, P=0.000). Serum IL-18 concentrations of the CC patients was significantly lower than that of the normal controls (95.470-/+18.827 vs 116.756-/+16.262 pg/ml, F=14.445, P=0.000). In the cancer patients, serum IL-18 was 90.668-/+20.363 pg/ml for TT-AA genotype, 119.641-/+15.338 pg/ml for GG-CC genotype, and 112.793-/+13.326 pg/ml for TG-AC genotype, showing significant differences (F=11.307, P=0.000). A significant interaction effect was suggested between IL-18 genotype and CC (F=4.223, P=0.018).

CONCLUSIONIL-18 gene polymorphisms and serum IL-18 level are related to the development of CC, and two SNPs, rs1946518 and rs1946519, can be important genetic factors for the susceptibility of cervical neoplasms.

Adult ; Alleles ; Base Sequence ; Carcinoma, Squamous Cell ; blood ; genetics ; pathology ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Interleukin-18 ; blood ; genetics ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; genetics ; Uterine Cervical Neoplasms ; blood ; genetics ; pathology

OBJECTIVE: Angiogenesis, the formation of blood vessels by sprouting from pre-existing ones, is essential for the growth of solid tumors beyond 2-3mm in diameter and for tumor metastasis. Vascular endothelial growth factor (VEGF), is known as vascular permeability factor(VPF) and mediates vascularization and tumor-induced angiogenesis. This study examined the potential of growth, invasion, and metastasis of uterine cervical carcinomas associated with neovascularization. METHODS: From January 1996 to December 1999, at the Department of Obstetrics and Gynecology, Kyung-Hee University Hospital, 37 uterine cervical carcinomas and 7 normal cervical tissues were obtained and the samples were immediately frozen and stored at -70 degrees C. Immunohistochemical staining for VEGF was carried out to study VEGF localization, and the levels of VEGF subtype mRNAs were determined by quantitative RT-PCR in specimens. The relation between VEGF subtypes expression of cervical cancers was analysed. RESULTS: The positive staining for VEGF is seen dominantly in the cytoplasm of the cancer cells, and faintly in interstitial cells. The intensity of staining was stronger in squamous carcinomas than in adenocrcinomas, but there was no significant difference (p>0.05). Quantitative RT-PCR analysis demonstrated significantly increased VEGF121/VEGF165 mRNA expression levels (>0.56 / >0.72) in 21 (56.8%) and 15 (40.5%) of 37 cervical carcinomas comparing to control groups (mean: 0.28 / 0.36). There was no obvious relationship between VEGF121/VEGF165 mRNA expression levels and the clinical parameters examined including age, pathology, differentiation, tumor size, lymphovascular space invasion, LN involvement and invasion depth except clinical stage (p<0.05). CONCLUSIONS: The overexpression of VEGF mRNA may be an important contributing factor in cervical carcinomas. There is no significant differenece of VEGF mRNAs levels according to clinical parameters, so it seems that the expression of VEGF is involved in the promotion of angiogenesis on cervical cancer and plays an important role in early invasion.
Blood Vessels ; Capillary Permeability ; Carcinoma, Squamous Cell ; Cytoplasm ; Gynecology ; Neoplasm Metastasis ; Obstetrics ; Pathology ; RNA, Messenger* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

BACKGROUND AND OBJECTIVEPelvic lymph node metastasis is an important prognostic factor of cervical cancer. The prognosis of cervical cancer patients with common iliac lymph node metastasis is poor, but few systematic studies have been reported . This study was to investigate the characteristics, risk, treatment and prognosis of stage IB-IIB cervical carcinoma patients with common iliac lymph node metastasis.

METHODSA total of 960 patients with cervical cancer receiving radical hysterectomy and bilateral pelvic lymphadenectomy were selected from the hospitalized patients in the Cancer Center of Sun Yat-sen University between January 1995 and December 2005, and analyzed retrospectively.

RESULTSOf the 960 patients, 288 (30.0%) had pelvic lymph node metastasis, and 45 (4.7%) had positive common iliac lymph node. The 5-year overall survival rate (OS) of patients with common iliac lymph node metastasis was 46.1%, and 67.5% in patients with other pelvic lymph node metastasis (P < 0.05). Univariate analysis showed that clinical stage, serum level of squamous cell carcinoma antigen (SCC-Ag) > 4 microg/L before treatment, depth of cervical invasion > or =2/3 and positive parametrial margin were associated with common iliac lymph node metastasis (P < 0.05). Patients with > or =3 pelvic lymph node metastasis (excluding common iliac lymph node) or recurrence had poor prognosis (P < 0.05). Factors predictive of common iliac lymph node metastasis on Logistic forward regression were SCC-Ag > 4 microg/L (P = 0.026, OR = 2.303) before treatment and positive parametrial margin (P = 0.045, OR = 2.634).

CONCLUSIONSCervical cancer patients with common iliac lymph node metastasis had poorer prognosis compared with patients with other pelvic lymph node metastasis. SCC-Ag >4 microg/L before treatment and positive parametrial margin were the independent predictive factors for common iliac lymph node metastasis of cervical carcinoma. Pelvic lymph node metastasis (excluding common iliac lymph node) > or = 3 or recurrence was prognostic factors for patients with common iliac lymph node metastasis.

Adenocarcinoma ; blood ; pathology ; surgery ; Adult ; Antigens, Neoplasm ; blood ; Carcinoma, Squamous Cell ; blood ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Iliac Artery ; Iliac Vein ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Pelvis ; Retrospective Studies ; Risk Factors ; Serpins ; blood ; Survival Rate ; Uterine Cervical Neoplasms ; blood ; pathology ; surgery

OBJECTIVETo explore the interaction between folate deficiency and aberrant expression related to fragile histidine triad (FHIT) gene in the progression of cervical cancerization.

METHODSA total number of 80 patients with histological diagnosis of cervix inflammation (CI), 55 cervical intraepithelial neoplasm I (CIN I), 55 cervical intraepithelial neoplasm II/III (CIN II/III) and 64 cervical squamous cell carcinoma (SCC) were included in this study. Levels of serum folate were detected by microbiological assay method and the methylation status of FHIT gene CpG islands was tested by methylation-specific PCR (MSP). FHIT protein levels were measured by Western blot. In vitro, cervical cancer cell lines CaSki (HPV16-positive) was treated with different concentrations of folate. Proliferation and apoptosis of cells, methylation of FHIT gene and the levels of FHIT protein expression were measured in each group. All analyses were performed with SPSS (version 17.0) statistical software. Differences among groups were assessed by chi-square test, Kruskal-Wallis test. Spearman correlation, and the interaction effects were evaluated by additive model.

RESULTSThe levels of serum folate (H = 59.08, P < 0.001) and FHIT protein expression (H = 50.93, P < 0.001) decreased gradually along with the severity of cervix lesions, while the methylation rates of FHIT gene CpG islands increased (trend χ² = 28.34, P < 0.001). Both levels of serum folate levels and FHIT protein expression were positively correlated (r = 0.213, P = 0.001), with an additive interaction seen between them in CIN I, CIN II/III, SCC groups. In vitro, both rates related to proliferation inhibition (r = 0.98, P < 0.001) and apoptosis (r = 0.99, P < 0.001) together with the levels of FHIT protein expression (r = 0.97, P < 0.001) were all increased gradually with the increase of folate concentration while the methylation status of FHIT gene CpG islands all changed from positive to negative gradually.

CONCLUSIONResults from our study revealed that both folate deficiency and FHIT protein aberrant low expression might increase the risk of developing cervical cancer and cervix precancerous lesions, and thus play a synergistic action in the progression of cervical cancerization.

Acid Anhydride Hydrolases ; metabolism ; Apoptosis ; Carcinoma, Squamous Cell ; pathology ; Cervical Intraepithelial Neoplasia ; pathology ; Disease Progression ; Female ; Folic Acid ; blood ; Folic Acid Deficiency ; epidemiology ; Human papillomavirus 16 ; Humans ; Neoplasm Proteins ; metabolism ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms ; pathology

OBJECTIVETo investigate the improvement effects of Jincao tablet on immune function of the model of hysteromyoma in rat and the relationship between the model and pathogenesis.

METHODRats were randomly divided into 6 groups: normal group, model group, treatment groups including low,middle and high dosage groups of Jincao tablet and Guizhi Fuling pill. Rats were injected respectively with diethyl stilbestrol and progesterone. The immune apparatus of rats were measured. The levels of CD3, CD4 and CD4/ CD8 in serum were determined by flow cytometer. The estrogen and receptor were measured by radioligand binding assay and pathologic changes of womb tissue were observed microscopically.

RESULTCompared with normal group, the weight of thymus, the levels of CD3, CD4 and CD4/CD8 of model group were significantly decreased, and the levels of estrogen, estrogen receptor and CD8 were obviously increased. Jincao tablet groups were significant difference compared with model group and could alleviate the pathological changes of womb tissue.

CONCLUSIONJincao tablet could improve the levels of immune function of the model of hysteromyoma in rat, and it might play a role in the pathogenesis of leiomyoma.

Ajuga ; chemistry ; Animals ; CD3 Complex ; blood ; CD4 Antigens ; blood ; CD4-CD8 Ratio ; CD8 Antigens ; blood ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Estradiol ; blood ; Female ; Flow Cytometry ; Leiomyoma ; blood ; immunology ; pathology ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Estrogen ; blood ; Tablets ; Uterine Neoplasms ; blood ; immunology ; pathology