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Detection of Telomerase RNA Component Gene Amplification in Cervical In- traepithelial Neoplasia and Cervical Cancer with Fluorescence in Situ Hybridization and Its Clinical Significance

Wei LIU ; Lijun SUN

Journal of Practical Obstetrics and Gynecology.2010;26(2):124-127,插1.

Objective:To investigate the amplification of the telomerase RNA component (TERC) gene in cervical cancer and cervical intraepithelial neoplasia (CIN) using dual-color interphase fluorescence in situ hybridization (FISH) and its significance in screening of cervical lesion. Methods:Cervical cast-off cell specimens were screened from 120 outpatients with cervical lesion, including normal cell from liquid based cytology (20 cases), CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer cell from liquid based cytology (each of 25 cases). The amplification of TERC gene in cervical cast-off cells was detected by dual-color interphase FISH. The results of normal samples were used to set up the threshold. Results:①The percentages of abnormal cells in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer were significantly higher than threshold value ( P<0.05), and the percentage of abnormal cells was increased with the serious degree of pathological grade (P<0.01) ; ②The percentagesof 2:3,2:4,2:5 and great than or equal to 4:4 types in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer were significantdifferences (all P<0.01). The percentages of 2:4,2:5 and great than or equal to 4:4 types in cervical cancer were significant higher than that in CIN Ⅰ (P<0.001) while the percentage of 2:3 type was significant lower than that in it (P<0.001);③The percentage of abnormal cells was increased with the serious degree of cytological grade (P<0.01) in different cytological grades. The percentages of 2:3,2:5 and great than or equal to 4:4 types in atypical squamous cell of undetermined significance (ASCUS), low-grade squamous intraepithe-lial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) were significant differences (all P <0.01), and the percentages of 2:5 and great than or equal to 4:4 types in HSIL were significant higher than that in ASCUS( P <0.01) while the percentage of 2:3 type was significant lower than that in it ( P <0.01);④The detection rates of LSIL and HSIL with cytological examination in low grade and high grade CIN were 40% (10/25) and 62% (31/50) respectively, which were significant lower than the detection rates of FISH which was 100%(P<0.05).Conclusions:There is an abnormal amplification of TERC gene in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer, and its copy numbers are increased with the serious degree of pathological and cytological grades. Detection of amplification of TERC gene in cervical cast-off cells with FISH has a certain value for screening cervival lesion and prediction of lesion progression.

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Expression of PR and Bcl-2,Bax in Ectopic and Eutopic Endometrium in Patients with Endometriosis

Jun WANG ; Bin LI ; Ying FAN

Journal of Practical Obstetrics and Gynecology.2010;26(1):45-48,后插1.

Objective:The pathogenesis of endometriosis(EMT)was explored by detecting the relationship of progesterone receptors(PR)and apoptosis-associated factors with EMT.Methods:Immunohistochemical imaging analysis was used to quantify the expression of PR,Bcl-2 and Bax in ectopic and eutopic endometrium in patients with EMT.Results:Expressions of PR and Bcl-2 in eutopic endometrium are higher than those in ectopic endometrium(P<0.05).Expression of Bax in ectopic endometrium is higher than that in eutopic endometrium(P<0.05).There is no statistical difference of PR,Bcl-2 and Bax expression between proliferative and secretary endometrium.Conclusions:Either in proliferative or secretary phase,expressions of PR in eutopic endometrium are higher than those in ectopic endometrium,thus eutopic endometrium is more liable to proliferate in low level continuously,migrate and implant.Expressions of Bcl-2 and Bax in eutopic and ectopic endometrium have no relationship with endometrium cycling.The apoptosis of ectopic endometrium is weakened and its proliferative power is continuously enhanced.

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Surgery Intervention of Pregnancy Heart Disease

Fengzhen HAN ; Yang ZHAO ; Cong LU

Journal of Practical Obstetrics and Gynecology.2010;26(3):225-228.

Objective:Surgery intervention and its effect on pregnancy heart disease were explored. Meth-ods:Retrospective review of 34 cases of pregnancy heart disease who needed surgery intervention from Jan, 2000 to Dec,2007 was done. Results:17 patients had percutaneous balloon mitral valve (PBMV) dilatation, the area of mitral valve enlarged markedly postoperatively ( P <0.01 ). 9 patients had open chest surgery un-der extracorpory circulation,7 of them had re-replacement mechanical valve due to mechanical valve throm-bosis. One patient had left atrium mucomamectomy. One patient had Wad's sinus breakout and repairmen. 5 patients had Radiofrequency catheter ablation (RFCA) for supraventricular tachycardia. 3 patients had int-racardiac device (ICD) for Ⅲ grade atrioventicular block. 22 patients had cardiac function as grade Ⅲ～Ⅳ and postoperatively recovered to grade Ⅰ～Ⅱ . All 34 patients were alive after treatment, 23 fetus were alive (67.6%), and no adverse results were found during the follow-up. Conclusions:When patients who had pregnancy heart disease need surgery intervention, individualized treatment plan should be made by multidis-cipline experienced doctors according to different heart disease and cardiac function.

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Analyzing Complications of 73 Cases of Laparoscopic Gynecologic Surgery

Jun QIU ; Yuna GUO ; Huifang ZHONG

Journal of Practical Obstetrics and Gynecology.2010;26(3):212-215.

Objective:The causes, management, and prevention of complications in laparoscopic gyneco-logic surgery were investigated. Methods:A retrospective analysis was done based on clinical data of 8279 cases of laparoscopic gynecologic surgery from January 1996 to December 2008 in this hospital. Results:The complication rate was 0.88% (73/8279). These included five cases intraperitoneal bleeding, five cases injury of ureter, 20 cases abdominal vessel damage, 10 cases vulva emphysema, 25 cases wound healing delay and each one case respectively for stomach injury, bladder injury, secondary abdominal cavity preg-nancy,infection and incision hernia. The occurrence rates of complications between hysteroscopy combined with laparoscopic surgery and pure adnexal surgery were no difference( P >0.05). Compared to adnexal op-erations, there was a significantly higher complication rate in myomectomy and laparoscopic assistant vaginal hysterectomy (P < 0.01 ). Conclusions:Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operators. In order to reduce complications, careful oper-ation and avoiding over self -confidence are essential.

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Nerve Fibres Distribution in Eutopic Endometrium of Women with Endometriosis

Guangling GUO ; Chunlian ZHANG ; Lihua FENG ; Zhentong WEI ; Li ZHOU ; Shuangyun CHEN

Journal of Practical Obstetrics and Gynecology.2010;26(1):68-70.

Objective:Nerve fibres distribution in the functional layer of endometrium of women with endometdosis was investigated.Methods:Histological sections of endometrial tissue were prepared from endometrialcurettings and hysterectomies performed on women with endometnosis(n=25)and without endometriosis(n=40).Immunohistochemistry was used to detect nerve fibres by highly specific polyclonal rabbit antibody PGP 9.5.The assessment of nerve fibre density was performed bv Image Pro Plus Discovery.Results:Nerve fibres were identified throughout the functional layers of the endometrium in all endometriosis patients,but not found in the functional layer of the endometrium in women without endometriosis(P<0.01).Conclusions:Nerve fibres detectad in the functional layer in all women with endometriosis may have important implications for understanding the generation of pain in these patients.

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Clinical Analysis of 83 Cases of Hyperosmolar Glucose in Prevention of Persistent Ectopic Pregnancy after Laparoscopic Salpingostomy

Xiuqing WEI ; Lan GAO ; Hong LIANG

Journal of Practical Obstetrics and Gynecology.2010;26(1):63-65.

Objective: Medical therapy to prevent persistent ectopic pregnancy (PEP) after conservative laparoscopic operation was investigated. Methods:236 patients with ectopic pregnancy were divided into three groups according to the time of hospitalization. 83 cases were in group A, hyperosmolar glucose was injected into the fallopian tube lumen after laparoscopic salpingostomy. 81 cases were in group B, MTX was injected in the same way, 72 cases were in group C as control group. Serum β-HCG was tested for four times, before the operation, the first, third and a week after the operation respectively. Results:There were 6 patients of PEP in this study. One patient in group A, one patient in group B, the rest four patients in group C. The incidence of PEP was not statistically significant between group A and B( P>0. 05), while the difference was significant between group A and C ( P<0. 05). Serum β-HCG in three groups descended significantly in the first 24 hours after operation, but there were no differences among these groups. As for the descending of β-HCG in day 3 and 7, there was no difference between group A and B, but the difference was magnificent between group A and C( P < 0.05). Conclusions: Compared with the MTX, hyperosmolar glucose is an effective and safer method to prevent PEP.

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The Effect of Cervical Canal Mucosa Ring Excision on Cervical Columnar Eversion in Loop Electrosurgical Excision Procedure

Jieying CHEN ; Hongmei ZHOU ; Hong CHEN

Journal of Practical Obstetrics and Gynecology.2010;26(1):61-63.

Objective:To study the effect of cervical canal mucosa dng excision on cervical columnar eversion in Loop electrosurgical excision procedure(LEEP).Methods:A prospective randomized control trail was performed in 125 cervical intraepithelial neoplasia(CIN)patients.Cervix and cervical canal were conically excised with triangle electrode in 62 patients in the control group;in the study group,a small ring electrode was put into the cervical canal and the cervical canal mucosa was excised about 0.5～0.8cm,after excision as the control group.Follow-up was performed postoperatively in 1,3,6 months respectively.The operation time,the bleeding volume,the rate of cervical columnar eversion and cervical adhesion or stenosis were compared between the two groups.Results:The rate of cervical columnar eversion in the study group (1/63,1.59%)was lower than that in the control group(9/62,14.52%).There was significantly statistical difference between them(P=0.008).There was no statistical differences between them in the operation time,the bleeding volume,and the rate of cervical adhesion or stenosis (P>0.05).Conclusions:The cervical canal mucosa ring excision in LEEP can effectively prevent postoperative cervical columnar eversion.

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Short Term Results of Laparoscopic or Laparotomy Radical Hysterectomy and Pelvic Lymphadenectomy for Early Uterine Malignancy

Yi SHEN ; Zehua WANG

Journal of Practical Obstetrics and Gynecology.2010;26(1):48-51.

Objective:The short term results of laparoscopic radical hysterectomy and pelvic lymph nodes dissection for early uterine malignancy were investigated.Methods:70 patients with eady malignant uterine tumor who underwent a laparoscopic radical hysterectomy and pelvic lymph nodes dissection(TLRH+LPL)were retrospectively reviewed.At the samt time,48 patients were recruited to be the control group who had laparotomy radical hysterectomy and pelvic lymph nodes dissection(ARH+APL).Intraoperative and postoperative situations and complications between these two groups were analyzed.Results:70 patients underwent laparoscopic operation,but two cases changed to laparotomy(transfer rate 2.9%).The mean operation time,blood loss,number of dissected pelvic lymph nodes and postoperative temperature recovery time of TLRH+LPL group was significantly different from ARH+APL group(P<0.01),while there were no difference between these two groups on bladder function recovery time and occurance of postoperative complications.Conclusions:TLRH+LPL has the same feasibility and safety with ARH+APL,less invasive to the tissue,thus offers a good option of microinvasive therapy for female malignant tumor.

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Clinical Analysis of Late Pregnancy Complicated with Uterine Leiomyoma

Xinwei SHI ; Yuanyuan WU ; Xun GONG ; Fuyuan QIAO ; Haiyi LIU

Journal of Practical Obstetrics and Gynecology.2010;26(1):40-43.

Objective:The treatment of late pregnancy complicated with utedne leiomyoma was investigated.Methods:193 Cases of Iate pregnancy complicated with uterine leiomyoma from January 2003 to August 2008 were recruited in our hospital.According to the delivery route,size and subtype of fibroid,blood loss,operation hours and postoperative inpatient period were compared.Results:104 cases of pregnancy complicated with uterine leiomyoma were diagnosed before cesarean section(CS).No significant differences on blood losses and operation hours were found between CS group and CS+myomectomy group(P>0.05).The operation heurs of leiomyoma in corpus uteri was significantly shorter than leiomyoma in lower uterine segment and cervix(P=0.007).Leiomyoma bigger than 8 cm needed significantly Ionger operative hours and lose more blood than the smaller leiomyoma.Operation hours,blood loss and postoperative inpatient period were significantly different between submucous leiomyoma and subserosal leiomyoma(P<0.05).Conclusions:Pregnancy complicated with uterine leiomyoma should be diagnosed as early as possible.During cesarean section on when leiomyoma is bigger than 8 cm,locating at lower uterine segment or cervix or submucous,the treatment should be cautious.

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Clinical Assessment of Fluorescence in Situ Hybridization for Prenatal Diagnosis of Chromosomal Abnormalities

Keling LIU ; Bei JIA ; Liping WANG ; Lanlin SONG ; Chaoqun XIAO ; Mei ZHONG

Journal of Practical Obstetrics and Gynecology.2010;26(1):36-39.

Objective:To investigate the clinical efficacy of fluorescence in situ hybridization(FISH)in prenatal diagnosis of chromosomal aneuploidy.Methods:FISH and karyotyping analysis were done in 120 samples of amniotic fluid from pregnant women.Results:FISH analysis results were consistent with those of karyotyping,the dectecting rate can reach 100%for chromosomal aneuploidies.There was no significant difference in the preference for FISH or karyotying for prenatal diagnosis when facing high matemal age,multi-indications and other factors(P>0.05).FISH was better when biochemical datafor down's syndrome were positive (P=0.029),however karyotyping was better when there was abnormal fetal ultrasound scan(P=0.000).Conclusions:FISH can detect the chromosomal aneuploidy quickly and accurately,especially when biochemical data for down's syndrome were positive.FISH could be the first choice for prenatal diagnosis in the third trimester of high-risk pregnancy.

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