1.Extra-Ovarian Brenner Tumor of the Cervix in a 43-Year-Old Woman: A Rare Entity with Uncommon Location, Case Report
Christian Soga-ang ; Louella Tan
Philippine Journal of Pathology 2026;(75th PSP Research Competition Abstracts):1-
Introduction:
Brenner tumors are uncommon epithelial-stromal neoplasms that
usually arise in the ovary and comprise a small proportion of ovarian tumors. Extraovarian Brenner tumors are exceedingly rare, and cervical involvement is exceptional.
Because of their unusual location and histologic resemblance to other cervical epithelial
lesions, accurate diagnosis can be challenging on limited biopsy material.
Case Description:
A 43-year-old woman presented with prolonged menstrual
bleeding and a clinically suspicious cervical mass. An initial cervical punch biopsy
demonstrated benign inflammatory and metaplastic changes. Due to persistent
symptoms, a repeat biopsy was performed. Histopathologic examination revealed
well-defined nests and cords of urothelial-like epithelial cells with focal cystic change
embedded in a dense fibrous stroma. The tumor cells showed elongated nuclei
with dense chromatin, inconspicuous nucleoli, and clear cytoplasm with distinct cell
borders. Occasional mitotic figures were present without significant cytologic atypia.
Immunohistochemical studies demonstrated tumor cell positivity for GATA-3, CK7,
p63, and p16, with estrogen receptor positivity in the surrounding stroma, supporting
the diagnosis of a borderline extra-ovarian Brenner tumor of the cervix.
Discussion:
Cervical Brenner tumors are extremely rare and may closely mimic
squamous cell carcinoma, transitional cell carcinoma, or benign squamous metaplasia,
particularly in small biopsy specimens. Recognition of the characteristic nested
urothelial-like architecture, together with a focused immunohistochemical panel,
is essential for accurate classification and to prevent misdiagnosis and unnecessary
aggressive management.
Conclusion
This case highlights a rare borderline extra-ovarian Brenner tumor
arising in the cervix and emphasizes the importance of correlating histomorphologic
features with immunohistochemistry in establishing the correct diagnosis of unusual
cervical neoplasms.
Brenner Tumor
;
Immunohistochemistry
;
Urothelium
;
Uterine Cervical Neoplasms
2.Aurora-A overexpression promotes cervical cancer cell invasion and metastasis by activating the NF-κBp65/ARPC4 signaling axis.
Yaqing YUE ; Zhaoxia MU ; Xibo WANG ; Yan LIU
Journal of Southern Medical University 2025;45(4):837-843
OBJECTIVES:
To investigate the regulatory effects of Aurora-A in regulating proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of cervical cancer cells and the role of actin-related protein 2/3 complex subunit 4 (ARPC4) in mediating its effects.
METHODS:
The plasmids pCDH-NC, pCDH-Aurora-A, and shRNA-ARPC4 were used for inducing Aurora-A overexpression or ARPC4 knockdown in HeLa cells. The cells were divided into vector group, Aurora-A overexpression group, Aurora-A overexpression+ARPC4 knockdown group, and Aurora-A overexpression+NF‑κBp65 inhibitor group and transfected with the corresponding plasmids. The proliferation, colony-forming ability, migration and invasion of the treated Hela cells was evaluated using EdU immunofluorescence assay, crystal violet staining, scratch assay, Transwell assay, and Matrigel assay. Western blotting was performed to detect the changes in cellular expressions of EMT-related proteins and expression levels of NF-κBp65 and ARPC4.
RESULTS:
The expression of ARPC4 was significantly decreased in HeLa cells with Aurora-A knockdown and increased in Aurora-A-overexpressing cells. Aurora-A overexpression obviously promoted proliferation, migration, and invasion abilities of HeLa cells, and these effects was significantly antagonized by ARPC4 knockdown. In Aurora-A-overexpressing cells, the phosphorylation level of NF-κBp65 and the expression level of ARPC4 were increased significantly, and application of the NF‑κBp65 inhibitor obviously lowered the expression level of ARPC4.
CONCLUSIONS
Aurora-A overexpression upregulates the expression of ARPC4 by activating the NF-κBp65 signaling pathway, thereby promoting migration, invasion and EMT of HeLa cells.
Humans
;
Uterine Cervical Neoplasms/metabolism*
;
Female
;
HeLa Cells
;
Epithelial-Mesenchymal Transition
;
Signal Transduction
;
Cell Movement
;
Neoplasm Invasiveness
;
Cell Proliferation
;
Aurora Kinase A/metabolism*
;
Transcription Factor RelA/metabolism*
;
Neoplasm Metastasis
3.CRISPR-Cas9-mediated CDC20 gene knockout inhibits cervical cancer cell proliferation, invasion and metastasis.
Yanxiu MO ; Yang SHU ; Yulan MO ; Juntong LIU ; Ouou XU ; Huafei DENG ; Qiben WANG
Journal of Southern Medical University 2025;45(6):1200-1211
OBJECTIVES:
To study the effect of CDC20 knockdown on proliferation, migration and invasion of cervical cancer cells and its underlying mechanism.
METHODS:
CDC20 expression in cervical cancer tissues was analyzed using the TCGA database, and the protein expressions of CDC20 and β-Catenin in clinical specimens of cervical cancer and adjacent tissues were detected using immunohistochemistry. A dual target sgRNA2&7 sequence for CDC20 gene was designed for CDC20 gene knockdown in cervical cancer C33A cells using CRISPR/Cas9 technology, and CDC20 mRNA and protein expression levels in the transfected cells were detected using qRT-PCR and Western blotting. The changes in proliferation, cell cycle, apoptosis, migration and invasiveness of the transfected cells were evaluated using colony-forming assay, fluorescence activated cell sorting (FACS) and Transwell assay. In the animal experiment, naïve C33A cells and the cells with CDC20 knockdown were injected subcutaneously into the left and right axillae of nude mice (n=5) to observe tumor growth. The expressions of CDC20 and β-Catenin proteins in transfected cells and the xenograft were analyzed using Western blotting, and their interaction was confirmed by co-immunoprecipitation (CoIP) and immunofluorescence co-localization assays.
RESULTS:
Cervical cancer tissues expressed significantly higher CDC20 and β‑Catenin levels than the adjacent tissues. C33A cells with CDC20 knockdown showed reduced proliferation, increased apoptosis, and lowered migration and invasion abilities. CDC20 knockdown significantly suppressed the growth of C33A cell xenograft in nude mice, and the tumor-bearing mice did not exhibit obvious body mass changes. CDC20 and β-Catenin levels were both significantly lowered in C33A cells with CDC20 knockdown. Co-immunoprecipitation and co-localization assays confirmed the interaction between CDC20 and β‑Catenin.
CONCLUSIONS
CDC20 is highly expressed in cervical cancer tissues, and CDC20 knockdown can suppress proliferation, invasion, and metastasis while enhancing apoptosis of C33A cells, which is closely related with the regulation of the Wnt/β-Catenin signaling pathway.
Humans
;
Uterine Cervical Neoplasms/metabolism*
;
Female
;
Cdc20 Proteins/genetics*
;
Cell Proliferation
;
Animals
;
Cell Movement
;
Neoplasm Invasiveness
;
Apoptosis
;
Mice, Nude
;
beta Catenin/metabolism*
;
CRISPR-Cas Systems
;
Mice
;
Cell Line, Tumor
;
Gene Knockout Techniques
;
Neoplasm Metastasis
4.Therapeutic mechanism of hederagenin, an active component in Guizhi Fuling Pellets, against cervical cancer in nude mice.
Yinfu ZHU ; Yiran LI ; Yi WANG ; Yinger HUANG ; Kunxiang GONG ; Wenbo HAO ; Lingling SUN
Journal of Southern Medical University 2025;45(7):1423-1433
OBJECTIVES:
To explore the therapeutic mechanism of Guizhi Fuling (GZFL) Pellets against cervical cancer.
METHODS:
Publicly available databases were used to identify the targets of GZFL Pellets and cervical cancer to construct the protein-protein interaction (PPI) network, followed by GO biological process and KEGG pathway enrichment analysis of the hub genes. The "Traditional Chinese Medicine-Active Ingredients-Targets-Pathways" network for GZFL Pellets in cervical cancer treatment was generated using Cytoscape v10.0.0, and molecular docking of the drug and potential targets was performed to predict the specific targets of active components in Guizhi Fuling Pellets. The inhibitory effects of hederagenin, an active ingredient in GZFL Pellets, was tested in cultured cervical cancer cells and in nude mice bearing cervical cancer xenografts.
RESULTS:
GZFL Pellets contain 338 active components targeting 247 action sites. A total of 10127 cervical cancer-related targets were obtained, and among them 195 were identified as potential therapeutic targets of GZFL Pellets for cervical cancer treatment, including the key targets of GABRA1, PTK2, JAK2, HTR3A, GSR, and IL-17. Molecular docking study showed low binding energies of the active components such as hederagenin, campesterol, and stigmasterol for protein-molecule interaction. GO enrichment analysis suggested that GZFL Pellets inhibited cervical cancer primarily by regulating responses to steroid hormones, oxidative stress, and lipopolysaccharides. Among the active components of GZFL Pellets, hederagenin was found to inhibit cervical cancer cells in vitro and significantly reduced STAT3 phosphorylation level in the cancer cells. In nude mice bearing cervical cancer xenografts, hederagenin effectively inhibited tumor growth rate without causing obvious adverse effects.
CONCLUSIONS
GZFL Pellets inhibit cervical cancer cell growth through its multiple active components that target different pathways. Among these components, hederagenin inhibits tumor cell growth possibly by directly binding to JAK2 protein to inhibit STAT3 phosphorylation.
Female
;
Animals
;
Uterine Cervical Neoplasms/pathology*
;
Mice, Nude
;
Humans
;
Mice
;
Oleanolic Acid/therapeutic use*
;
Drugs, Chinese Herbal/therapeutic use*
;
Molecular Docking Simulation
;
Xenograft Model Antitumor Assays
;
Cell Line, Tumor
;
STAT3 Transcription Factor/metabolism*
;
Protein Interaction Maps
;
Janus Kinase 2/metabolism*
5.Oncolytic virus-mediated base editing for targeted killing of cervical cancer cells.
Huanhuan XU ; Siwei LI ; Xi LUO ; Zuping ZHOU ; Changhao BI
Chinese Journal of Biotechnology 2025;41(4):1382-1394
Conventional cancer therapies, such as radiotherapy and chemotherapy, often damage normal cells and may induce new tumors. Oncolytic viruses (OVs) selectively target tumor cells while sparing normal cells. Most OVs used in clinical trials have been genetically engineered to enhance their ability to target tumor cells and activate immune responses. To develop a specific OV-based approach for treating cervical cancer, this study constructed an oncolytic adenovirus that delivered a base editor targeting oncogenes to achieve efficient killing of tumor cells through inhibiting tumor growth and directly lysing tumor cells. We utilized the human telomerase reverse transcriptase (TERT) promoter to drive the expression of adenovirus early region 1A (E1A) and successfully constructed the P-hTERT-E1A-GFP vector, which was validated for its activity in cervical cancer cells. Given the critical role of the MYC oncogene in the research of oncology, identifying efficient editing sites for the MYC oncogene is a key step in this study.Three MYC-targeting gRNAs were engineered and co-delivered with ABE8e base editor plasmids into HEK293T cells. Following puromycin selection, Sanger sequencing demonstrated differential editing efficiencies: MYC-1 (43%), MYC-2 (25%), and MYC-3 (35%), identifying MYC-1 as the most efficient editing locus. By constructing the P-ABEs-hTERT-E1A-GFP and P-MYC gRNA-hTERT-E1A-GFP vectors, we successfully packaged the virus and confirmed its specificity and efficacy. The experimental results demonstrate that this novel oncolytic adenovirus effectively inhibits the growth of HeLa cells in vitro, providing new experimental evidence and potential strategies for treating cervical cancer based on the HeLa cell model.
Humans
;
Uterine Cervical Neoplasms/pathology*
;
Oncolytic Viruses/genetics*
;
Female
;
HEK293 Cells
;
Oncolytic Virotherapy/methods*
;
Adenoviridae/genetics*
;
Gene Editing/methods*
;
Telomerase/genetics*
;
Adenovirus E1A Proteins/genetics*
;
Genetic Vectors/genetics*
;
HeLa Cells
6.Effectiveness of an educational intervention in increasing knowledge and willingness to vaccinate on human papillomavirus among women in barangay West Fairview, Quezon City
Lesly Mae D. Mara ; Camilla Thea S. Paraino ; Jebb Patrick Molina Delos Santos
Philippine Journal of Health Research and Development 2025;29(4):8-16
BACKGROUND
Cervical cancer, caused by human papillomavirus (HPV), is the second most common cancer among Filipino women. Despite vaccine availability, the Philippines has a low 60% immunization rate, driven by hesitancy and poor public awareness.
AIMS AND OBJECTIVESThis study assessed how 100 women (ages 18–45) in Quezon City understood HPV and their willingness to vaccinate.
MATERIALS AND METHODSResearchers used a pre–post interventional study and purposive sampling and Cochran’s formula for size calculation. Participants completed a pretest, a Department of Health/World Health Organization/Centers for Disease Control and Prevention-based digital educational intervention, a posttest, and a satisfaction survey. Data were gathered confidentially under informed consent.
RESULTSResults showed significant improvement in knowledge and willingness to vaccinate (P < 0.001), with almost all respondents expressing willingness. The intervention received high satisfaction ratings, proving the digital tool was effective and well-received.
CONCLUSION AND RECOMMENDATIONIn conclusion, this study demonstrated that a structured digital educational tool effectively bridges knowledge gaps and addresses vaccine hesitancy in a community setting. Findings emphasize the importance of targeted, community-level initiatives to reduce cervical cancer risk. Future research should include teens and males and use a larger randomized sample for definitive evidence.
Human ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Uterine Cervical Neoplasms ; Human Papillomavirus Viruses ; Vaccination ; Women
7.Psychosocial and sexual function of young women less than 40 years old treated with concurrent chemoradiation for cervical cancer: A cross-sectional study testing quality of life
Maria Rowena G. Bascos ; Rey H. Delos Reyes
Philippine Journal of Obstetrics and Gynecology 2025;49(4):209-216
BACKGROUND OF THE STUDY
The treatment for cervical cancer among young women can result in adverse effects that contribute to a negative quality of life (QOL). The literature shows varied studies on the QOL of cervical cancer patients, but evidence on the local context is limited, particularly in young patients.
OBJECTIVESThis study aimed to determine the QOL of young women with cervical cancer treated with concurrent chemoradiation.
MATERIALS AND METHODSA prospective cross-sectional research design was employed. A total of 72 cervical cancer patients who were 40 years old and younger and treated with chemoradiation were recruited using complete enumeration. The study locale was in a tertiary government hospital, which is a training center for gynecologic oncology in the Philippines. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and EORTC QLQ of women with Cervical Cancer (CX24) served as data collection instruments. Descriptive statistics were utilized to describe and synthesize the data.
RESULTSSeventy-two young women with cervical cancer treated with concurrent chemoradiation reported a mean global health status score of 4.75, indicating a moderate QOL. However, functional domains were generally low, with the lowest scores in cognitive (1.71), social (1.64), and physical interference with social activities (1.96). The average symptom score was 2.10, reflecting moderate symptomatology. On the EORTC QLQ-CX24, most QOL aspects were rated low, except for body image (2.01), menopausal symptoms (2.31), and sexual worry (2.79). Sexual enjoyment scored the lowest at 1.16, with an overall average of 1.71.
CONCLUSIONSThe study highlights low-to-moderate QoL among young cervical cancer patients post-chemoradiation, underscoring the need for improved supportive care addressing physical, psychological, and social challenges caused by the disease and treatment modality.
Human ; Female ; Uterine Cervical Neoplasms ; Quality Of Life
8.A rare path in a common symptom: A case report on serous carcinoma of the cervix
Reimalyn Doton Agustin ; Ana Victoria Vallido Dy Echo
Philippine Journal of Obstetrics and Gynecology 2025;49(4):241-248
Although commonly seen in the ovary, fallopian tube, peritoneum, and endometrium, the serous carcinoma histology is considered a rare subtype when seen in the cervix. The prevalence of cervical adenocarcinoma, including serous carcinoma, varies between 5% and 15% of all cervical malignancies. A thorough literature study revealed only 113 cases of serous carcinoma of the cervix, highlighting its infrequency relative to other cervical cancer variants. As a subtype of adenocarcinoma, serous carcinoma of the cervix has aggressive characteristics and usually unfavorable prognosis, more so its clinicopathological characteristics are relatively unclear because of its rarity and limited number of cases and reviews seen in literature. This is a case of a 44-year-old G3P3 with a primary complaint of heavy vaginal bleeding. The diagnosis of serous carcinoma of the cervix was made by histopathological evaluation, confirmed by immunostaining. With physical examination and diagnostic imaging confirming an early stage disease, the patient successfully underwent primary surgical management.
Human ; Female ; Uterine Cervical Neoplasms
9.The influence of knowledge, attitude, and motivational factors on the willingness of mothers for their female children to undergo human papillomavirus vaccination
Philippine Journal of Obstetrics and Gynecology 2025;49(1):18-42
BACKGROUND
Cervical cancer remains to be the second leading cancer and cause of cancer-related deaths among Filipino women despite the use of the Papanicolaou screening. Latest research has shown that the human papillomavirus (HPV) is a necessary cause of cervical cancer. With major morbidity and high mortality rates associated with HPV infection and cervical cancer, several modes of primary and secondary forms of prevention have to be implemented. Among the primary modes of prevention is the administration of the preventive vaccine, which has consistently shown to decrease substantially HPV disease and cervical cancer rates in developed countries. In our country, before a successful vaccination, program is implemented, several sociocultural issues have to be addressed. Knowledge, attitude, and motivational factors are vital in determining acceptance of the vaccine. One relevant setting is exploring the willingness of mothers to get their female children vaccinated even before they become sexually active.
OBJECTIVESThe aim of the study was to determine the association of the knowledge, attitude, and motivational factors of mothers on their willingness for their female children aged 9–13 years to undergo HPV vaccination at a tertiary government hospital.
STUDY DESIGNThis was a cross-sectional study that was carried out at a government institution.
POPULATIONThe population consisted of 352 mothers with female children aged 9–13 years consulting the outpatient clinics at the department of obstetrics and gynecology at a tertiary government hospital.
MATERIALS AND METHODSA pretested and validated survey was given to 352 respondents. They were asked to answer a self-administered questionnaire that included sociodemographic, reproductive, sexual history variables, knowledge, and attitude, and motivational factors toward the disease and the associated vaccine.
RESULTSUsing the survey proportion estimation methods, the prevalence of women who were willing to enroll their daughters for HPV vaccination was 97.18% (n = 42, 95% confidence interval [CI]: 94.91 to 98.46%). It can be noted that only a third of the sample had high knowledge on the vaccine and its use 34.93% (n = 124, 95% CI: 30.25 to 39.92%). More women who reached college level (χ2: 5.67) and also those whose youngest child was between 11 and 13 years old (χ2: 8.82)-had higher knowledge scores than otherwise. Those who have an annual income of greater than or equal to P 60,000 (χ2: 16.55) and are non-Catholic (χ2: 18.77) – also appeared to have higher knowledge ratings on the questionnaire. Women who never to a few times a year attend church-related activities had higher knowledge scores compared to women who were more frequent goers (χ2: 16.33). For the attitude toward the vaccine, more mothers believed that getting the vaccine would not have an effect on a girl’s sexual activity and most agreed that they would not be viewed as bad parents. Most women also did not believe that religion would affect their willingness to vaccinate their children. There was an association in the degree of agreement between negative and positive attitudes from the Chi-square test performed (χ2: 7.44, P: 0.01). There were more agreeing responses from factors determining positive attitude and more disagreeing responses in the factors determining negative attitude. With regard to motivational factors, more women agreed that the cost was prohibitive and that they were more willing if only two doses would be required for their daughters. They were also not concerned about what other parents may think about getting the vaccine. Most answered that they were willing to follow their doctors’ recommendations and they have trust in vaccine manufacturers. Most women were also concerned that their daughters may get cervical cancer in the future. There was no difference in the proportion of agreeing responses between positive and negative motivating factors among the study participants (Z: 0.30, P: 0.79). This suggested that these factors could be important predictors of willingness to use vaccination on their children. Based on the crude odds ratios from the logistic regression, the likelihood of being willing to administer HPV vaccine to their children was almost twice as the knowledge score and scores on the positive attitude items increased, and was found to be statistically significant. At the same time, the odds of willingness increased by more than twice as the score on the negative attitude items decreased, and was also significant. There was no noted association for the other predictors of the association.
CONCLUSIONThe role of knowledge and attitudes on the negative perceptions on the vaccine were important predictors of the willingness of mothers to have their female children vaccinated against HPV infection.
Human ; Cervical Cancer ; Uterine Cervical Neoplasms ; Human Papillomavirus ; Human Papillomavirus Viruses ; Vaccination
10.Expert consensus on immunoprophylaxis of cervical cancer and other human papillomavirus- related diseases (2025 edition).
Chinese Journal of Epidemiology 2025;46(7):1107-1141
There have been recent, significant changes in strategies and policies for elimination of cervical cancer and advances in research of human papillomavirus (HPV)-related diseases and their prevention and control. Based on the latest national and international research, and building on a consensus published in 2019, we developed an expert consensus on immunoprophylaxis of cervical cancer and other human papillomavirus-related diseases (2025 edition) in order to provide clinicians, disease prevention and control professionals, and vaccination staff a reference for the prevention and control of cervical cancer and other HPV-related diseases and systematic, comprehensive evidence-based support for the scientific use of HPV vaccines to optimize their prevention effectiveness.
Humans
;
Uterine Cervical Neoplasms/virology*
;
Papillomavirus Vaccines/therapeutic use*
;
Papillomavirus Infections/prevention & control*
;
Female
;
Consensus
;
Papillomaviridae/immunology*
;
Vaccination
;
Human Papillomavirus Viruses


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