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Comparatively Analysis on Clinicopathological Characteristics and Prognosis of Small Cell Carcinoma of the Cervix(SCCC) and Non-SCCC-A Single Center of Clinical Research

Xin YUAN ; Yangmei SHEN ; Xia ZHAO

Journal of Practical Obstetrics and Gynecology.2017;33(4):281-285.

Objective:To investigate the differences between patients with small cell carcinoma of the cervix and other type of cervical cancer on clinicopathological characteristics,treatment,prognosis through the retrospective analysis,also study the prognostic factors in patients with SCCC.Methods:The patients with SCCC(63 cases,research group) and patients with Non-SCCC(60 cases,control group) such as squamous cell carcinoma and adenocarcinoma of cervix were chosen during May 2003 and June 2015 in department of obstetrics and gynecology,west China second university hospital.The clinical pathological and survival data were collected,sort out,checked and analyzed.Chi-square test or Fisher's exact probability method was used to compare the differences of clinical features between the two groups.The 5-year disease-free survival(DFS) rate and 5-year overall survival(OS) rate were generated using the Kaplan-Meier method.Univariate and multivariate analysis were applied to research the prognostic factors.Results:①The median age of the patients in research group was 40 years old,younger than control group whose median age was 44 years old (P =0.001).The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in research group were significantly higher than those of control group (P ＜ 0.05).There were no significantly differences between two groups in clinical symptoms,FIGO stage,therapeutic schedule.②In the survival analysis,the research group estimated 5-year overall survival (OS) rate (29.2％) and estimated 5-year disease-free survival rate (DFS)(26.6％) was significantly lower than those of the control group(82.6％,and 76.7％,respectively) P ＜ 0.05.③In the COX multivariate regression analysis,the results showed that the lymph node metastasis was the independent factor influencing overall survival rate and disease-free survival rate(HR =4.784、3.067,P ＜ 0.05).In addition,the tumor size was the independent factor influencing overall survival rate (HR =3.610,P ＜ 0.05),and advanced FIGO staging was the independent factor influencing disease-free survival rate (HR =2.793,P ＜ 0.05).Conclusions:The patients with SCCC were younger than other cervical cancer,and the clinical symptoms,cervical appearance,treatment between the two types are almost the same.However,The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in patients with SCCC were significantly higher than other cervical cancer,and the prognosis of the patients with SCCC was very poor.The main prognostic factors were lymph node metastasis,advanced FIGO stage and tumor size.

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Emergency Cervical Cerclage Combined Mesh Patch Suture in the Treatment Caused by Cervical Incompetence Clinical Analysis of 32 Cases

Yurong JIANG ; Yiping YOU ; Yabing TANG

Journal of Practical Obstetrics and Gynecology.2017;33(4):307-310.

Objective:To investigate the clinical value of emergency cervical cerclage combined mesh patch suture in the treatment of cervical incompetence.Methods:From January 2011 to August 2016 in our hospital 65 cases of pregnant women with inevitable abortion,32 cases of they had carried out emergency cervical cerclage combined mesh patch suture(group A),33 cases of they had carried out cervical cerclage only(group B),The prolongation of gestation time,delivery gestational age,neonatal outcome,delivery mode and postoperative complications were compared between the two groups.Results:The operation time of A group was higher than that of group B,surgical complications of cervical laceration in group A was less than B group,the difference was statistically significant(P ＜ 0.05);there was no significant difference in the incidence of chorioamnionitis between the two groups(P＞0.05);the gestational age of group A was extended to 84.45 ±35.77 days,and the gestational age of B group was extended to 51.86 ±29.93 days,there was statistically significant difference between the two groups(P＜0.05);there was more than 28 weeks delivery in 23 cases(71.88％) in group A,and 17 cases (51.52％) in group B,the difference was statistically significant(P ＜ 0.05);there were no statistically significant differences in the delivery mode between the two groups(P ＞ 0.05);neonatal birth weight,birth Apgar 1 minutes score of group B were significantly lower than those of group A,the difference was statistically significant (P ＜0.05).Conclusions:Emergency cervical cerclage combined mesh patch suture can effectively prolong the gestational age,improve neonatal outcome,no obvious complication and has certain clinical applicative value.

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Influence Factor Analysis of Postoperative Pregnancy in Patients of Endometriosis Associated Infertility after Laparoscopy Combined with Hysteroscopy Treatment

Hongxue LIU ; Jian LI ; Ping LUO

Journal of Practical Obstetrics and Gynecology.2017;33(2):144-147.

Objective:To analyze the influence factors of postoperative pregnancy in patients of endometriosis associated infertility after laparoscopy combined with hysteroscopy treatment.Methods:340 patients with endometriosis associated infertility who underwent laparoscopy combined with hysteroscopy treatment in Maternal and Child Health Care Hospital of Xiamen from April in 2012 to April in 2014 were followed up for 18 ～ 42 months to assess fertility outcomes.The relative factors of postoperative pregnancy rate were analyzed.Results:85.88％ (292/340) of patients were followed up,and the overall postoperative pregnancy rate was 56.51％.Among which the postoperative pregnancy caseswere 115 cases (39.38％),40 cases (13.70％),8 cases (2.74％),2 cases (0.68％) in the 1 ～ 6 months,7 ～ 12 months,13 ～ 24 months,25 ～ 42 months,respectively.There were significant differences among the four groups(x 2 =11.76,P ＜ 0.05).The multy-factors analysis showed that age ≥35,infertility time ≥3,r-AFS stage relatively high were risk factors of postoperative pregnancy(OR =10.45,3.03,3.74,P ＜0.05),and secondary infertility,applying ovarian stimulation treatment were the protective factors of postoperative pregnancy(OR =0.23,0.33,P ＜ 0.05).Conclusions:Laparoscopy combined with hysteroscopy treatment can increase postoperative pregnancy rate,and the best time to pregnancy is the first one year after treatment.The age ≥35,infertility time≥3,r-AFS stage relatively high are the important causes for the postoperative infertility,while applying ovarian stimulation treatment can promote pregnancy rate.

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MG132 Affects on the Nude Mice Transplanted Tumor Tissues of Ovarian Epithelial Carcinoma and the Relationship with Cisplatin Combination

Na GUO ; Zhilan PENG

Journal of Practical Obstetrics and Gynecology.2017;33(2):114-118.

Objective:To investigate the potential value and feasibility of MG132 as a new therapy method for the ovarian cancer and a cisplatin chemotherapy-synergistic agent.Methods:The mode of the nude mice transplanted tumor tissues of ovarian epithelial carcinoma were established,20 nude mice were randomly divided into four groups and were all intrapedtoneal injected,once a day,a total of seven days:①Control group(0.2 ml saline),②MG132 group(2 mg/kg),③Cisplatin group(1 mg/kg),④Combination group[MG132(2 mg/kg) + cisplatin (1 mg/kg)].The weight inhibitory rates of tumors in each group were compared after four weeks.The expressions of Caspase3,Beclin1 in each group were detected by IHC,FIA,western blot and RT-PCR.Results:①The inhibitory rate of tumors in cisplatin group,MG132 group,and combination group was 53.85％,15.38％,88.46％,respectively,the additive effect of cisplatin and MG132 combination therapy was 60.95％.②IHC,FIA,western blot detected that compared to control group,the positive expressions of Beclin1,Caspase3 were increased in cisplatin group,MG132 group,and combination group,among which combination group increased more.③RT-PCR detected that the mRNA relative quantity of Beclin1 in cisplatin group,MG132 group,combination group respectively were higher than that of control group(P＜0.05);and it was higher in combination group than that of cisplatin group and MG132 group(P＜0.05).Conclusions:The growth of nude mice transplanted tumor tissues of ovarian epithelial carcinoma can be inhibited by MG132,and has a synergistic effect for treating ovarian cancer by combination with cisplatin,it is expected to be an effective anti-tumor drug for platinum resistant refractory ovarian cancer.

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The Expression and Significance of LGR5 in Endometrial Cancer

Xinran TANG ; Xiaomao LI

Journal of Practical Obstetrics and Gynecology.2017;33(2):128-131.

Objective:To investigate the expression of Leucine-rich repeat-containing G protein-coupled receptor 5(LGR5) in endometrial cancer(EC) and their relationship with clinicopathological characteristics.Methods:Immunohistochemistry were performed to measure the LGR5 expression in EC(n =90) and normal endometrium tissue(n =30).The expression of LGR5 and its relationship with clinicopathological characteristics were analyzed.Results:The expression of LGR5 was significantly higher in EC than that in normal tissue (63.3％ vs 23.3％,P＜0.001).The expression of LGR5 in ＜ 1/2 myometrium infiltration group was higher than in ≥1/2 myometrium infiltration group(72.5％ vs 33.3％,P =0.001).There was no significant difference between the expression of LGR5 in different group of age,histological type,histological differentiation,cervical stroma invasion,lymph node metastasis,FIGO stage(P ＞ 0.05).Multivariate analysis showed that LGR5 was an independent influential factor of myometrium infiltration (OR =0.163,95％ CI 0.034 ～ 0.772,P =0.022).Conclusions:LGR5 is up-regulated in EC,and is correlated to myometrium infiltration.LGR5 may play an important role in EC tumorigenesis.

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Expression of Vascular Cell Adhesion Molecule 1 and Intercellular Adhesion Molecule 1 in Endometrium and Serum in Endometriosis

Suhong FAN ; Junyan MA ; Jun LIN

Journal of Practical Obstetrics and Gynecology.2017;33(2):119-123.

Objective:To study the expressions of Vascular Cell Adhesion Molecule 1 (VCAM-1) and Intercellular Adhesion Molecule 1 (iCAM-1) in patients with endometriosis and to explore its effect on the onset of endometriosis.Methods:VCAM-1 mRNA and ICAM-1 mRNA were detected by real-time PCR method in 15 specimens of eutopic endometrium and 15 specimens of ectopic endometrium from patients with endometriosis(EMT group)and 15 specimens of endometrium from patients without endometriosis(control group).VCAM-1 and ICAM-1 protein were detected by Western-Blot method.Soluble VCAM-1 and soluble ICAM-1 in 44 serum of patients with endometriosis(EMT group) and 28 serum of patients without endometriosis(control group) were tested by ELISA.Meanwhile the correlation of expressions of VCAM-1 and ICAM-1 were analyzed in different groups.Results:①The expressions of VCAM-1 mRNA and ICAM-1 mRNA in ectopic endometrium were significantly higher than those of eutopic endometrium and the controls(P ＜0.01).There was no significant different mRNA expression between eutopic group and control group(P＞0.05).②The protein expressions of VCAM-1 and ICAM-1 in eutopic group were significantly higher than those of ectopic group and the control group(P ＜0.01).The protein expression of VCAM-1 in eutopic group were higher than those in the controls group(P＜0.01).There was no significant different protein expression of ICAM-1 between eutopic group and the controls group(P ＞0.05).③The concentration of sVCAM-1 and sICAM-1 in serum from patients with EMT were significantly higher than those in the control group(P＜0.01).The concentration of slCAM-1 in serum from patients with EMT in stage Ⅲ-Ⅳ were significantly higher than those in stage Ⅰ-Ⅱ (P ＜ 0.01).④There was no significant correlation in the expression of mRNA,protein and serum between VCAM 1 and ICAM-1 in ectopic group and eutopic group(P ＞ 0.05).Conclusions:The abnormal expressions of VCAM-1 and ICAM-1 in ectopic endometrium may play an important role in the development of endometriosis.The signaling pathways and protein expression way may be different between VCAM 1 and ICAM 1 in endometriosis.

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Observe and Analyze the Rehabilitation of Multiparous Pelvic Floor Muscles in Postpartum

Yichao QIU ; Ke ZHANG ; Liqian QIU

Journal of Practical Obstetrics and Gynecology.2017;33(2):101-104.

Objective:To analyze the effects of mutiparity on the pelvic floor muscle and the best time of postpartum for pelvic floor rehabilitation intervention.Methods:By questionnaire survey and pelvic floor functional checking on women with 42 days postpartum clinic routine health checking,and following up pelvic floor muscles force exam in postpartum 3 months,6 months and 1 year,426 cases were included in the puerpera group,including primipara 325 cases as primiparous group,two birth multipara 101 cases as multiparous group,the damage of pelvic floor muscles(≤level Ⅱ) was compared between the two groups,the difference between multiparity and primiparity were compared.Results:①In postpartum 42 days,type Ⅰ muscle fiber damage rate was lower in multiparous group than that in primiparous group(P ＜0.05),there was no significant difference on the muscle fiber damage ratio (muscles force below Ⅲ) between the two groups (P ＞ 0.05).②)In postpartum 3 months,6 months,1 year there was no significant difference in proportion of muscle damage between the two groups (P ＞ 0.05).③Multiparous group pelvic floor muscle damage ratio decreased slowly and gradually in the four periods,there was no statistical difference between adjacent period (P ＞ 0.05),the pelvic muscle damage ratio appeared significant statistical difference between postpartum 6 months and postpartum 42 days(P ＜ 0.01).④In primiparous group,pelvic floor muscle damage ratio decreased significantly in postpartum 6 months,postpartum 42 days、3 months,6 months,the differces were statistically significant among the three times(P ＜ 0.05),there was no statistical difference between postpartum 6 months and 1 year(P＞0.05).Conclusions:Type Ⅰ muscle fibers suffer injury more in Primipara than that in multipara,multiparous pelvic floor muscle recovery process is more slowly than primipara's,we should pay attention to pelvic muscle recovery within 6 months after delivery.

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Expression and Clinical Significance of ALDH1 and ABCG2 in Cervical Cancer Cells

Yan LIU ; Jing BAI ; Aijun LI

Journal of Practical Obstetrics and Gynecology.2017;33(3):206-209.

Objective:To detect the expression of ALDH1 and ABCG2 in the specimens from different levels of cervical lesions.Methods:Use SP immunohistochemistry to detect the expression of ALDH1 and ABCG2 in 76 cases of cervical squamous cancers,52 cases of HSIL,and 37 cases of chronic cervicitis tissues,and analyze the results.Results:①The positive expression rates of ALDH1 and ABCG2 in chronic cervicitis tissues were 5.41％ (2/37) and 8.11％ (3/37),in HSIL tissues were 23.08％ (12/52) and 28.85％ (15/52),and in cervical cancers tissues were 53.95％ (41/76) and 61.84％ (47/76),respectively.The positive expression rates in cervical cancers tissues were significantly higher than in HSIL and Cc hronic cervicitis tissues,(P ＜ 0.05).②The positive expression of ALDH1 in cervical cancer tissues had correlation with tumor grade and lymphnode metastasis (P ＜0.05),while the positive expression of ABCG2 in cervical cancer tissues had correlation with tumor grade,clinical stage and lymph-node metastasis(P ＜0.05).③The expressions of ALDH1 and ARCG2 in cervical cancer were positive relative(r =0.535,P ＜ 0.05).Conclusions:The increased expressions of ALDH1 and ABCG2 in cervical squamous cancer may play a role in the occurrence,development and metastasis of cervical squamous cell carcinoma.ALDH1 and ABCG2 may have synergistic effect in occurrence of cervical cancer.

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Analysis of Diagnostic Differences between Colposcopy Beginner and Pathologic Report in Cervical Disease

Xia TAO

Journal of Practical Obstetrics and Gynecology.2017;33(3):198-202.

Objective:To evaluate the consistency of colposcopy diagnosis performed by a single examiner with pathologic diagnosis and to analyze the factors related with colposcopy over-and under diagnosis.Methods:A retrospective study was performed.The initial 200 cases diagnosed by a single colposcopy beginner at Peking University first Hospital out-patient clinic from March 2015 to October 2015 were included in this study.The consistency rate and bias rate of colposcopy diagnosis versus pathologic diagnosis as well as the causes of such differences were analyzed.Results:Of 174 cases with pathologic diagnosis,the consistency rate was 59.2％.The underdiagnosis rate and overdiagnosis rate were 18.4％ and 22.4％ separately.Of HSIL underdiagnosis group,the rate of TCT NILM was 78.6％ which was higher than 18.1％ in HSIL consistency group,P ＜ 0.05.Re-evaluation of the colposcopy pictures revealed that acetowhite epithelium were present in all 14 cased of HSIL underdiagnosis group.The rate of post-menopausal women was higher in HSIL underdiagnosis group than in HSIL consistency group(21.4％ vs 0％),P ＜0.05.The medium numbers of biopsy were higher in HSIL consistency group when compared with HSIL underdiagnosis group,P ＜0.05.The medium numbers of biopsy was higher in overdiagnosis group when compared with consistency group,P ＜ 0.05.Conclusions:Underdiagnosis of colposcopy was related with TCT-overdependent,insufficient understanding of acetowhite epithelium and post-menopausal women.Increasing biopsy numbers may improve the consistency rate of colposcopy and pathologic diagnosis.However,the increasing numbers of biopsy often results from overdiagnosis.

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Correlation between Weight Gain during Late Pregnancy and Glycated Albumin,Visfatin Level and Neonatal Body Composition in Gestational Diabetes Mellitus Patients

Lijun SU ; Hong SUN ; Shaofang HUA

Journal of Practical Obstetrics and Gynecology.2017;33(3):194-197.

Objective:To evaluate the association between weight gain in late gestation and glycated albumin (GA),visfatin level and neonatal body composition in gestational diabetes mellitus (GDM) patients who are non-obese.Methods:200 pregnant women were enrolled.The preconception body mass index(BMI) of all the research object was less than 25 kg/m2.According to the speed of body mass growth from 28th week of gestation to delivery,the subjects were divided into two groups:excessive weight gain group (n =77) and appropriate weight gain group(n=123).Variance of serum GA,visfatin levels and neonatal birth weight(BW),the percent of body fat in newborn(F％) between two groups were compared,and the relationship between weight gain in late pregnant GDM patients and above values was analyzed.Results:①Serum GA,HbA1 c,visfatin and total cholesterol,triglyceride,low density lipoprotein,very low density lipoprotein levels in excessive weight gain group were higher than those in appropriate weight gain group(P ＜ 0.05).②Mean gestational age,newborn Apgar score immediately,the ratio of baby boys and vaginal delivery rate in two group had no significant difference(P＞0.05).Compared with the appropriate weight gain group,the excessive weight gain group had higher average birth weight and lower blood glucose levels.The proportion of large for gestational ages(LGA) was increased in appropriate weight gain group,and the ratio of abdomen circumference (AC) and head circumference (HC) and the percent of body fat in newborn(F％) were significantly increased in this group(P ＜0.01).③The speed of body mass growth in late pregnancy in GDM patients was positively related with serum GA,visfatin,HbA1c levels and newborn birth weight and the percent of body fat in newborn(r=0.524,0.470,0.456,0.329,0.473,P＜0.001).Conclusions:The monitoring of the serum GA and visfatin levels may have certain clinical value to evaluate the weight gain in late pregnancy of GDM patients.The rapid body mass growth in those patients may accelerate the visceral fat accumulation and worsen existing glucolipid metabolic disorders,and is also closely related to the increase of neonatal BW and F％.

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