Endometrial cancer is one of the common malignant tumors in female genital tract.The incidence of endometrial cancer is increasing,even the top one in the developed country and bigger cities in China.The screening of endometrial cancer should be performed in the high risk population.In the recent years,the popular screening methods for endometrial cancer include ultrasound,endometrial biopsy,and endometrial cytology (ECT),etc.This review introduces briefly above methods.

Objective:To study the mechanism on extracellular signal-regulate kinases ( ERK) signal transduction by calcium influx initiated by combination of estrogen with calcium channels or estrogen re-ceptor in endometrial cancer cell Ishikawa. Methods: Confocal test was used to determine the relative calcium mobilization by stimulation of estrodiol together with and without the inhibition of ICI182780 and nifedipine. Western-blotting was used to detect the protein expression of phosphorylated ERK1/2 (P-ERK1/2) in the same condition. Results:The transient calcium flux initiated by 17β-estrodiol (E2) and a membrane-impermeable conjugate of estrogen and bovine serum albumin ( E2-BSA ) , and the calcium mobilization could be inhibited by ICI182780 and nifedipine in 1 min. In Ishikawa cells, phosphorylation of ERK1/2 was stimulated by E2 , and the phosphorylation could not be inhibited by E2 after the combination with ICI182780 in 5 min and in 30 min. The phosphorylation also could not be in-hibited by E2-BSA after the combination with nifedipine in 5 min, but in 30 min the phosphorylation was decreased. The phosphorylation of ERK by E2-BSA was decreased by the combination with nifedipine in 30 min. Conclusion:The transient calcium flux initiated by estrogen has an effect on the activation of ERK signal pathway in endometrial carcinoma cells.

Objective To compare patients' quality of life followed by Prolift operation and the revised total pelvic floor reconstruction with Gynemesh.Methods Thirty one patients underwent total pelvic floor reconstruction surgery were divided into two groups,including 14 cases treated by Prolift surgery and 17 cases treated by the revised total pelvic floor construction with Gynemesh.The body weight index(BWI),menopausal age and gravidity history did not show significant difference between two groups(P ＞0.05).The patients' age with 63±9 in Prolift group was significantly lower than 69±5 in Gynemesh group (P ＜0.05).Questionnair score of quality of life were collected and evaluated pre-and post-operation.Result (1) Preoperative scores:there was no significantly different scores of the following index between two groups (P ＞0.05),which were 91±42 in pelvic floor impact query,100±59 in pelvic floor distress query and 77±26 in sexual life query in Prolift group,65±56 in pelvic floor impact query,89±73 in pelvic floor distress query and 75±18 in sexual life query in Gynemesh group.(2) Postoperative scores:similarly,there was also no significantly different scores in the following index between two groups (P ＞ 0.05),which were 7±15 in pelvic floor impact query,27±24 in pelvic floor distress query and 79±43 in sexual life query in Prolift group,13±24 in pelvic floor impact query,24±21 in pelvic floor distress query and 74±15 in sexual life query in Gynemesh group.Conclusions The patients' quality of life were improved after Prelift operation and the revised total pelvic floor construction with Gynemesh.However,about quality of sexual life,Prolift operation did much better than revised pelvic surgery with Gynemesh.

0 05) The radiotherapy and chemotherapy ratio of them was significantly higher than the control ( P 0 05). Multivariate analysis showed that the prognosis were related to the stage and tumor cell differentiation affected the prognosis remarkable But the prognosis was independent of age and associated medical disorders Conclusions The endometrial carcinoma often associates with hypertension, diabetes mellitus, coronary heart disease, and so on The incidence rate of medical disorders increases with the aging of the patients The medical disorders might affect the therapy to a certain extent But they do not affect the prognosis remarkably

Objective To investigate clinical treatment and outcome of mesh-related pain after pelvic floor reconstruction. Methods Twelve patients were referred to Peking University People′s Hospital for post-operation pain related to polypropylene mesh or tape used in pelvic floor reconstruction and received reoperation from January 2007 to December 2014. The demographic characteristics, clinical manifestation, operation method and follow-up outcome were retrospectively analyzed, and current literature was also reviewed. Results (1)General information:the median age was 54 years old(range 43-74 years old). The median vaginal delivery times was 2 (range 1-5). Initial pelvic floor operation procedures included 4 cases vaginal mesh, 5 cases vaginal mesh plus tension-free vaginal tape (TVT), 1 case rectal surface mesh implantation, and 2 cases sacrocolpopexy. (2) Related complications:all 12 patients had pain-related post-operation symptoms including dyspareunia, perineal pain, urination and defecation difficulty. Seven patients also complicated with other symptoms including discharge and bleeding. Mean time from first operation to medical consultation was 30 months (range 1-72 months). (3) Reoperation results:all 12 patients received reoperation on mesh revision or tape, 10 cases of them reoperated by vaginal approach, while the other 2 cases by laparoscopy. The range of the mesh or tape depended on tender or firm tissue and scar by palpation. The visual analogue scale (VAS) was significantly improved, which was 7.1 ± 2.2 pre-operation, and 0.9 ± 1.9 post-operation (95%CI: 4.48-7.86, P<0.01). Conclusions Pain is one of the reason why patients was removal of the mesh or tape after pelvic floor reconstruction operation. The surgery procedure may be considered as partial or entire mesh or tape excision by vaginal or abdominal way. Mesh or tape removal surgery could relieve related pain and other complications, and the VAS score was significantly improved after surgical management.

Objective To compare the expressions of p16~(ink4a) and Ki-67 in human cervical lesions. Methods The expressions of p16~ink4a and Ki-67 protein were measured with immunhistochemical staining in 42 human normal uterine cervical tissues,21 with human cervical intraepitheial neoplasia(CIN) Ⅰ,21 with CINⅡ,and 36 with CINⅢ.The relevance of the expressions of the two proteins to CIN grades was analyzed by Spearman Correlation.The sensitivity,specificity,positive/negative predictive values,and youden's index of p16~(ink4a) and Ki-67 were also studied. Results For p16~(ink4a),the sensitivity and specificity were 83.3% and 90.5%;the positive and negative predictive values were 94.2% and 74.5%;Youden's index was 0.738.For ki-67,the sensitivity and specificity were 98.7% and 16.7%;the positive and negative predictive values were 68.75% and 87.5%;Youden's index was 0.154.Both the sensitivity and specificity for the combined Ki-67 and p16~(ink4a) are 83.3%.Conclusion p16~(ink4a) has higher specificity and positive predictive value,and is a good diagnostic marker for cervical lesion.By contrast,Ki-67 has higher sensitivity and negative predictive value.Even with its poor specificity,it can still be regarded as a supplementary test for early diagnostic cervical lesion.The overall performance of p16~(ink4a) is better than that of Ki-67.

Objective To investigate the role of two isoforms of human progesterone receptor A (hPR-A) and B(hPR-B) in the development of uterine leiomyoma, their distribution and expression in leiomyoma were detected. Methods The tissues of leiomyoma and normal myometrium from 30 uteri, which were excised for leiomyoma, were used for the localization and quantification of protein of the two isoforms. Immunohistochemistry and Western blot were applied respectively. Results Both hPR-A and hPR-B were nuclear receptors. Concentrations of hPR-(A+B) and hPR-A in leiomyoma were higher than those in normal myometrium (295 796? 90 856,256 275?98 560; P =0 042, P =0 000 563). Both isoforms were presented in leiomyoma and normal myometrium, with a consistent dominance of hPR-B over hPR-A. More expression of hPR-A was found during secretive phase than proliferative phase, not only in leiomyoma but also in normal myometrium ( P =0 037, P =0 024). Conclusions The development of uterine leiomyoma seems to be related with the progesterone receptor isoforms, especially hPR-A.

Atlas Human cDNA expression array technique was employed to study the differences in gene expression in normal and endometrial cancer tissues. In this technique, dATP? 32 P labeled cDNA from normal and tumor tissues was hybridized to identical human cDNA expression array membranes (containing 588 known genes). The results showed that the expression of endometrial cancer associated genes including IRP, Wnt 5, 5T4 oncofetal antigen precusor , and CD147, were higher compared with controls. It suggested that the differential hybridization technique of Atlas Human cDNA expression array can be a useful method to identify genes differentially expressed either in normal or endometrial cancer tissue.

Objective To evaluate status of female pelvic floor function and sexual life after total hysterectomy.Methods From March 2001 to January 2004,92 patients with undergoing hysterectomy due to benign gynecological diseases were enrolled in this study.They were followed up at outpatient department,including pelvic examination,filling in female sexual quality questionnaire,pelvic floor distress inventory short form 20 ( PFDI-20 ),pelvic floor distress impact questionnaire short form 7 ( PFIQ-7 ) and quality of sexual life of chinese women questionnaire.Results At 6 years after total hysterectomy,it was observed that 7 cases (7/92,7.6％ ) were pelvic organ prolapse and 62 cases (62/92,67.4％ ) were urinary incontinence.A median score of PFDI-20 were 4.67.A median score of PFIQ-7 were 0.Symptoms of pelvic floor dysfunction concentrated in lower urinary tract ( 58 cases with cough leak,32 cases with spot urine leakage,31 cases with frequent micturition,24 cases with urgent urination)and bowel symptoms (26 cases with constipation,24 cases with defecation urgency,21 cases without fully drained stool).In the 68 patients filling in female sexual quality questionnaire,an average score were (127 ± 20) points.Female sexual quality questionnaire score,sexual satisfaction,sexual communication and adjustment,sexual response and sexual body image were positively correlated with the patients' income ( r = 0.432,P = 0.007 ; r = 0.356,P =0.028;r=0.475,P=0.003;r=0.421,P=0.009;r=0.324,P=0.047).Conclusions Hysterectomy may have long-term effect on female pelvic floor function and sexual life.Quality of sexual life in those patients was positively correlated with income.

Objective To make sure whether or not Bcrp1 is the marker of cervical cancer stem cells or not by studying the invasive ability and formation of tumors of Bcrp1 + phenotype HeLa cells.Methods The tumor cell migration and invasion assay were used by boyden chamber to identify the invasive ability of Bcrp1 + phenotype HeLa cells.The formation of tumors in vivo experiments were completed,in which the two groups of cells with different concentrations were inoculated in non obese diabetes-severe combined immunodeficiency disease ( NOD/SCID ) mice ( 1 × 104,1 × 105,1 × 106/ml ) and the differences of time,rate and volume in the formation of tumors between two groups were observed.Results ( 1 ) In the invasion assay,the amount of cells that invaded through the artificial basement membrane in Bcrp1 + group were 99 ± 14,which was significantly greater than those in Bcrp1- group ( 57 ± 13,P ＜ 0.05 ) ; the length of the Bcrp1 + group was ( 366 ± 52 ) μm,which was significantly greater than the Bcrp1 - group ( 301 ± 54) μm ( P ＜ 0.05 ).( 2 ) Following transplantation of 1 × 104 cells,only the Bcrp1 + cells formed tumors in NOD/SCID mice.When 1 × 105 or 1 × 106 cells were transplanted,the tumor incidence and the tumor mass were greater in the Bcrp1 + groups than those in the Bcrp1 - groups ( P ＜ 0.05 ).Conclusion Bcrp1 + HeLa cell have the greater capacity of invasive and the tumorigenicity,which may contain cancer stem cells.