Objective: To explore the relationship between the expression of the T-cell activation suppressor-immunoglobulin variable region (VISTA) and the development of cervical squamous cell carcinoma (CSCC), and the impact on the prognosis of CSCC patients. Methods: Cervical tissue samples from 116 CSCC, including 23 cervical intraepithelial neoplasia (CIN) grade I, 23 CIN grade Ⅱ-Ⅲ, and 23 chronic cervicitis patients, were collected from the First Hospital of Soochow University between March 2014 and April 2019. The expression of VISTA in each group was detected by immunohistochemistry (IHC). Survival data of CSCC patients were obtained by follow-up. The survival analysis was performed by Kaplan-Meier method, and survival differences between groups were compared by Log rank test. Prognostic impact factors were analyzed using a multifactorial Cox proportional hazards model. Results: The positive rate of VISTA expression in CSCC group was 32.8% (38/116), and which of grade Ⅱ-Ⅲ was 17.4% (4/23). VISTA expression results showed no positive expression patients in the cervical intraepithelial neoplasia grade I and chronic cervicitis groups. The differences between the CSCC group and other groups were statistically significant (P<0.01). In 116 CSCC patients, VISTA expression was associated with International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis (P<0.01). The mean survival time of patients in the VISTA positive expression group was 30.7 months, and the 3-year survival rate was 44.7% (17/38). However, the mean survival time of the patients in the VISTA negative expression group was 49.1 months, and the 3-year survival rate was 87.2% (68/78). The Cox regression model found that VISTA expression positivity (P=0.001) and FIGO stage (P=0.047) were prognostic factors for CSCC, and patients with VISTA-positive CSCC had a 4.130-fold risk of death higher than those with VISTA-negative expression. Conclusions: The VISTA protein is highly expressed in CSCC tissues, and its expression level is closely related to the occurrence and development of CSCC. The expression of VISTA can be used as an independent predictor of CSCC prognosis and can provide a strong basis for the treatment of CSCC with immune checkpoint inhibitors.
Female ; Humans ; Carcinoma, Squamous Cell/pathology* ; Clinical Relevance ; Neoplasm Staging ; Prognosis ; Uterine Cervical Dysplasia/pathology* ; Uterine Cervical Neoplasms/pathology* ; Uterine Cervicitis/pathology*

OBJECTIVETo assess the clinicopathologic characteristics of cervical glandular intraepithelial neoplasia (CGIN) and to evaluate the usefulness of EnVision immunohistochemistry of various markers in identifying early invasive cervical adenocarcinoma (ICA) and its precursor lesions.

METHODSClinical and pathological characteristics of 80 cases of high grade CGIN (HCGIN), 20 ICA, and 20 cervicitis were reviewed along with immunohistochemical studies of p16, Ki-67, CEA, CA125 and bcl-2.

RESULTSThe clinical features of HCGIN were similar to those of high grade cervical intraepithelial neoplasia (CIN). Fourty four cases (55.0%) accompanied with CIN and 9 cases (11.3%) accompanied with early cervical squamous cell carcinoma (SCC). The positive rates of p16, CEA and Ki-67 in 80 cases of HCGIN were 100.0%, 63.8% and 73.8%, respectively. The positive rates of p16, CEA and Ki-67 in 20 ICA were 18/20, 16/20 and 20/20, respectively. The positive rates of p16, CEA and Ki-67 in 20 cervicitis were 1/20, 1/20 and 3/20, respectively. There was a significantly increased expression of p16, CEA and Ki-67 in ICA and HCGIN compared with cervicitis (P < 0.01). Ki-67 expression increased in ICA compared to HCGIN (P < 0.05). There was no statistical difference in CEA expression between ICA and HCGIN (P > 0.05). CA125 showed strong but nonspecific expression. Bcl-2 was negative or occasionally positive in each groups.

CONCLUSIONSHCGIN is frequently accompanied with CIN and SCC. The combined staining of p16, CEA and Ki-67 provides additional aid in the diagnosis of early stage cervical adenocarcinoma and its precursor lesions. The sensitivity of p16 and Ki-67 markers for HCGIN is higher than that of CEA. CA125 and bcl-2 immunostains offer no helpful in identifying HCGIN.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Middle Aged ; Uterine Cervical Neoplasms ; metabolism ; pathology ; Uterine Cervicitis ; metabolism ; pathology

OBJECTIVETo observe antisepsis, anti-swelling, and therapeutic effects of Fuxiye (FXY), a Chinese medical lotion for external wash in treating vaginitis model rats.

METHODSThe cervicitis rat model was induced by agar plate diffusion, ear auricle swelling induced by dimethylbenzene, and chemical stimulus. The in vitro antibiotic actions of FXY were observed. Besides, its effects on the swelling and inflammation in model rats were also observed.

RESULTSFXY at 25 mg/mL could completely inhibit the growth of Pseudomonas aeruginosa, Escherichia coli, pyogenic Streptococcus, and Streptococcus agalactiae. FXY at 50 mg/mL could completely inhibit the growth of Staphylococcus aureus and Candida albicans. It obviously restrained dimethylbenzene induced ear auricle swelling. It significantly alleviated cervicitis induced by chemical stiumli.

CONCLUSIONFXY showed better effects on antisepsis, anti-inflammation, and treating cervicitis.

Animals ; Anti-Infective Agents ; administration & dosage ; pharmacology ; Anti-Inflammatory Agents ; administration & dosage ; pharmacology ; Dosage Forms ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Female ; Rats ; Rats, Sprague-Dawley ; Uterine Cervicitis ; drug therapy ; Vaginitis ; drug therapy

Adult ; Asian Continental Ancestry Group ; ethnology ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; pathology ; CpG Islands ; genetics ; DNA Methylation ; Estrogen Receptor alpha ; genetics ; metabolism ; Female ; Humans ; Middle Aged ; Promoter Regions, Genetic ; genetics ; Uterine Cervical Neoplasms ; genetics ; metabolism ; pathology ; Uterine Cervicitis ; genetics ; metabolism ; pathology

OBJECTIVETo study the relationship between TAP (transporter associated with antigen processing) gene promoter regional methylation level and cervical lesions with HPV infection in Uyghur women.

METHODSA specialized software was used to design specific primers of CpG island fragments of TAP1 and TAP2 gene promoter for PCR amplification, bisulfitemodified SiHa cancer cell DNA for PCR amplification, cloning and sequencing analysis to obtain the relevant information on the gene base sequence methylation of CpG sites. Seventy-eight fresh cervical tissue samples from Uyghur women with cervicitis (number = 15), cervical intraepithelial neoplasia (CIN, number = 30) and cervical squamous cell carcinoma (number = 33) were collected. The methylation level of TAP1 and TAP2 gene promoter regions was detected using MassArray DNA technology. HPV infection status was determined by HPV gene chips. The relationship between CpG-island methylation of gene promoter regions and HPV infection was then analyzed.

RESULTSEach TAP1 and TAP2 gene corresponding target fragment contained 23 and 8 CpG sites. There were 5 and 8 CpG sites methylation occurred in SiHa cervical cancer cells genomic DNA respectively. The TAP1 methylation level increased steadily with the severity of cervical lesions. The methylation levels in cervical squamous cell carcinoma and CIN (0.048 ± 0.039 and 0.037 ± 0.026, respectively) were higher than that of normal cervical tissue (0.035 ± 0.029, P < 0.05). Although TAP2 gene methylation level also demonstrated similar changes, the difference however was not statistically significant (P > 0.05). HPV gene chip detected 13 HPV genotypes, with HPV16 infection rate being 66.7% (52/78). The methylated proportion of TAP1 positively correlated with HPV16 infection (χ(2) = 6.08, P = 0.039).

CONCLUSIONTAP1 methylation is a remarkable phenomenon occurring in a range of cervical lesions and significantly associated with cervical HPV infection.

ATP-Binding Cassette Sub-Family B Member 2 ; ATP-Binding Cassette Transporters ; genetics ; ATP-Binding Cassette, Sub-Family B, Member 3 ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Carcinoma, Squamous Cell ; genetics ; virology ; Cervical Intraepithelial Neoplasia ; genetics ; virology ; CpG Islands ; genetics ; DNA Methylation ; Female ; Human papillomavirus 16 ; Humans ; Middle Aged ; Papillomavirus Infections ; Promoter Regions, Genetic ; Uterine Cervical Neoplasms ; genetics ; virology ; Uterine Cervicitis ; genetics ; virology

OBJECTIVETo investigate the methylation levels of death-associated protein kinase (DAPK) in Uyghur female patients with different cervical lesions in Xinjiang, and to discuss the relationship of the expression and significance of DAPK in normal cervix, chronic cervicitis, cervical intraepithelial neoplasia (CINI, CIN II/III) and invasive cervical squamous cell carcinoma.

METHODS30 cases of normal cervix and chronic cervicitis, 30 cases of CINI, 30 cases of CINII/III and 30 cases of cervical squamous cell carcinoma were tested by methylation specific PCR (MSP). Expressions of DAPK in 30 cases of normal cervix and chronic cervicitis, 30 cases of CINI, 30 cases of CINII/III and 30 cases of cervical squamous cell carcinoma were assayed using immunohistochemical SP staining.

RESULTSThe methylation rate of DAPK gene in normal cervix and chronic cervicitis was 3.33%, 10% in cervical intraepithelial neoplasia CINI, 36.7% in CINII/III, and 63.3% in invasive cervical squamous cell carcinoma. The methylation rate of DAPK in the SCC group was significantly higher than that in the other groups (P < 0.05). Aberrant promoter methylation of the DAPK gene was positively correlated with the degree of cervical lesions. The positive rate of DAPK protein in normal cervix and chronic cervicitis was 93.3%, 83.3% in cervical intraepithelial neoplasia CINI, 60.0% in CINII/III, and 33.3% in invasive cervical squamous cell carcinoma. The expression of DAPK in the SCC group was significantly lower than that in the other groups (P < 0.05). The positive rate of DAPK protein was negatively correlated with the degree of cervical lesions (r(s) = -0.603, P < 0.001).

CONCLUSIONSMethylation of DAPK is involved in the cervical carcinogenesis and DAPK gene promoter methylation occurs in the early development of cervical cancer in Uyghur women in Xinjiang. Detection of DAPK gene methylation may provide a basis for use in early detection of cervical cancer. DAPK protein expression is decreasing even disappears along with the progression of cervical lesions.

Adult ; Aged ; Apoptosis Regulatory Proteins ; genetics ; metabolism ; Calcium-Calmodulin-Dependent Protein Kinases ; genetics ; metabolism ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; pathology ; China ; ethnology ; DNA Methylation ; Death-Associated Protein Kinases ; Disease Progression ; Female ; Humans ; Middle Aged ; Promoter Regions, Genetic ; genetics ; Uterine Cervical Neoplasms ; genetics ; metabolism ; pathology ; Uterine Cervicitis ; genetics ; metabolism ; pathology

PURPOSE: Diagnosis of pelvic inflammatory disease (PID) is based on clinical history and examination; however, it may be difficult to distinguish from other disease entities. Multidetector computed tomography (MDCT) is a useful radiologic modality, which can be performed in an emergency department (ED). The aim of the current study was to clarify the MDCT characteristics of clinically severe PID by comparison of patients with clinically more severe and less severe forms of PID. In addition, we evaluated the independent predictors of MDCT findings in the severe PID group. METHODS: We conducted a retrospective study of female patients with symptoms and signs of PID who visited the ED at our institution during a five-year period. Patients who underwent abdominal MDCT and were diagnosed with PID were retrospectively enrolled in the study. For determination of CT characteristics, each patient was evaluated for pelvic edema, amount of ascites, Hounsfield units (HU) of ascites, salpingitis, oophoritis, intrauterine devices, peritoneal fat infiltration, cervicitis, abnormal endometrial enhancement, tubo-ovarian abscess, adjacent bowel wall thickening, localized ileus, and perihepatitis. Patients were divided into two groups: clinically more severe and less severe forms of PID. Patients having the clinically more severe form of PID were defined as follows: (1) initial body temperature over 38.3degrees C, (2) initial systolic blood pressure < 90 mmHg, (3) intractable abdominal pain, or (4) uncontrollable nausea or vomiting despite medication. We compared data between the two groups. RESULTS: A total of 136 patients were enrolled in this study. Thirty eight patients had the clinically more severe form (28%) and 98 patients had the less severe form (72%). In comparison with subjects in the group having the less severe form, the amount of ascites (p<0.001), salpingitis (p<0.05), and tubo-ovarian abscess (p<0.01) differed statistically between the groups. The HU value of ascites in the more severe group, 19.56+/-11.14 HU, was significantly greater, compared with that of the group having the less severe form. Results of multivariate logistic regression analysis revealed an association of the amount of ascites, a high HU value, and atubo-ovarian abscess with increased odds of the more severe form (adjusted OR 3.25, 95% CI 1.01-10.45; adjusted OR 5.84, 95% CI 1.80-18.95; and adjusted OR 8.42, 95% CI 1.73-40.96, respectively). CONCLUSION: Patients with clinically more severe PID show more clinically important findings on MDCT, such as a greater amount of ascites, higher HU value of ascites, and tubo-ovarian abscess. Leukocytosis, increased neutrophil percentage, and elevated CRP were observed in patients with severe PID.
Abdominal Pain ; Abscess ; Ascites ; Blood Pressure ; Body Temperature ; Edema ; Emergencies ; Female ; Humans ; Ileus ; Intrauterine Devices ; Leukocytosis ; Logistic Models ; Multidetector Computed Tomography ; Nausea ; Neutrophils ; Oophoritis ; Pelvic Inflammatory Disease ; Pelvic Pain ; Retrospective Studies ; Salpingitis ; Uterine Cervicitis ; Vomiting

BACKGROUND: The grey zone of cervical cytology, and in particular atypical squamous cells, cannot exclude HSIL (ASC-H) causes diagnostic difficulties and increases medical expenses. We analyzed p16INK4a expression in ASC-H liquid-based cytology specimens (LBCS) to develop more effective methods for the management of ASC-H patients. METHODS: We carried out p16INK4a immunostaining with 57 LBCS of ASC-H diagnostic categories, all of which were histologically cofirmed and 43 cases of which were compared with the results of a human papillomavirus (HPV) chip test. RESULTS: p16INK4a immunostaining with ASC-H LBCS was positive in 20% (3/15) of cervicitis, 25.0% (3/12) of tissue-low-grade squamous intraepithelial lesion, 75.0% (18/24) of tissue-high grade squamous intraepithelial lesion (HSIL), and 100% (6/6) of invasive cancer cases. The positivity of p16INK4a in LBCS was correlated with higher grade of histologic diagnosis (r=0.578, p=0.000). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of p16INK4a immunostaining for the prediction of tissue-HSIL+ were 80.0%, 77.8%, 80.0%, and 77.8%, respectively. The sensitivity, specificity, PPV, and NPV of p16INK4a immunostaining plus HPV chip test for predicting tissue-HSIL+ were 71.2%, 86.4%, 84.2%, and 79.2%. CONCLUSIONS: p16INK4a immunostaining as well as HPV chip testing with remaining LBCS with ASC-H are useful objective markers for the prediction of tissue-HSIL+.
Cervical Intraepithelial Neoplasia ; DNA Probes ; Humans ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Cervicitis

OBJECTIVETo investigate the value of fluorescence in situ hybridization (FISH) detection of human telomerase RNA component (hTERC) gene amplification in screening of cervical lesions.

METHODSA total of 146 post-thinPrep cytology test (TCT) samples were analyzed using FISH by two-color interphase probe targeting hTERC gene at chromosome 3q26 and the data were compared with the cytological and histological results.

RESULTSFISH analysis was successful in 120 cases (20 cases of normal and 100 abnormal cases by TCT). Gene amplification of hTERC by FISH had a positive correlation with the cytological (r = 0.465, P < 0.01) and histological grade results (r = 0.610, P < 0.01). Extra copies of hTERC were seen in 28.6% (6/21) of CINI, 61.1% (11/18) of CINII, 75.0% (18/24) of CINIII and 91.7%(22/24) of squamous cell carcinoma, respectively. None (0/13) of the inflammation cases showed hTERC amplification. The sensitivity and specificity for detecting high grade lesions by FISH were 77.3% (51/66) and 82.4% (28/34); and the positive and negative predictive values were 89.5% and 65.1%, respectively. The rate of hTERC gene gain in high grade lesions was significantly higher than that in the low grade lesions (χ(2) = 32.550, P < 0.01). Combined with the high copy numbers, the sensitivity for detecting high grade lesions was increased to 81.2%.

CONCLUSIONSDetection of hTERC gene amplification by FISH improves the screening efficiency of high-risk cervical epithelial lesions. The presence of high copy numbers of hTERC correlates with the presence of high grade cervical dysplasia.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnosis ; genetics ; pathology ; Cervical Intraepithelial Neoplasia ; diagnosis ; genetics ; pathology ; Female ; Gene Amplification ; Humans ; In Situ Hybridization, Fluorescence ; Middle Aged ; RNA ; genetics ; Telomerase ; genetics ; Uterine Cervical Neoplasms ; diagnosis ; genetics ; pathology ; Uterine Cervicitis ; diagnosis ; genetics ; pathology ; Young Adult

Multilocular cystic lesions in the uterine cervix can vary widely from benign to malignant. Pseudoneoplastic glandular lesions are benign lesions that are often histologically and radiographically confused with adenoma malignum, which is a rare variant of mucinous adenocarcinoma of the uterine cervix. The benign lesions include uterine cervicitis, tunnel cluster, deep endocervical glands, deep nabothian cysts, endocervical hyperplasia, infectious and reactive atypias. It is crucial but difficult to differentiate between an adenoma malignum and the benign cystic lesions. We report two cases of large nabothian cysts mimicking adenoma malignum. Radiologic findings, signs, and symptoms of these cases are described.
Adenocarcinoma, Mucinous ; Adenoma ; Cervix Uteri ; Female ; Hyperplasia ; Uterine Cervicitis