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Wang D, Xiang Y, Wu M, Shen K, Yang J, Huang H, Ren T. Clinicopathological characteristics and prognosis of adult ovarian granulosa cell tumor: a single-institution experience in China. Onco Targets Ther 2018; 11:1315-1322. [PMID: 29563810 PMCID: PMC5846745 DOI: 10.2147/ott.s155473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objectives We aimed to demonstrate the clinical characteristics and risk factors associated with recurrence of adult granulosa cell tumor (AGCT), as well as the pregnancy and long-term outcomes among patients in a single institution in China. Patients and methods We reviewed 141 patients with AGCT in Peking Union Medical College Hospital between January 1983 and September 2015. Results The mean patient age was 45.1 years (16–78 years), and the mean tumor size was 8.8 cm (1–40 cm). The most common symptom was irregular menstruation (31.9%, n=45). The disease distribution was stage I in 136 patients, stage II in three patients, and stage III in two patients. Eighty-seven patients (61.7%) underwent radical surgery, while 54 (38.3%) underwent fertility-sparing surgery, of whom five subsequently had a total of five pregnancies. Fifty-two patients underwent pelvic and/or paraaortic lymphadenectomy, and none of them showed lymph node metastasis. The median follow-up period was 72.7 months (8.9–344 months). Twenty-six patients (18.4%) developed recurrence during the study period, with a median time to recurrence of 68 months (7–312 months). Initial stage (stage IC vs IA) and nonstaging surgery were independent risk factors for recurrence in both univariate and multivariate analyses for stage I AGCT patients. Conclusion Tumor stage is an independent risk factor for recurrence in patients with AGCT. Staging surgery is recommended for patients with AGCT, though lymphadenectomy may be omitted. Complete tumor resection is important for patient survival in patients with AGCT recurrence. Long-term follow-up is required, even in early-stage AGCT patients.
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Affiliation(s)
- Dan Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Ming Wu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Huifang Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Tong Ren
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
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Li W, Bai H, Liu S, Cao D, Wu H, Shen K, Tai Y, Yang J. Targeting stearoyl-CoA desaturase 1 to repress endometrial cancer progression. Oncotarget 2018; 9:12064-12078. [PMID: 29552293 PMCID: PMC5844729 DOI: 10.18632/oncotarget.24304] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 12/26/2017] [Indexed: 01/06/2023] Open
Abstract
Stearoyl-CoA desaturase 1 (SCD1) is an established molecular target in many primary tumors including breast, lung, pancreatic, colon and hepatocellular carcinomas. However, its potential role in supporting endometrial cancer growth and progression has not yet been determined. In this study, we evaluated the value of SCD1 as a candidate therapeutic target in human endometrial cancer. Compared with secretory and post-menopausal endometrium, SCD1 was highly expressed in normal endometrium of proliferative phase, endometrial hyperplasia and endometrial carcinoma, while was absent or low expression in non-malignant control stromal cells and adjacent normal endometrium. Knockdown of SCD1 significantly repressed endometrial cancer cell growth and induced cell apoptosis. Both short hairpin RNA targeted knockdown and chemical inhibitor of SCD1 suppressed the foci formation of AN3CA, a metastatic endometrial cell line. Xenograft model further demonstrated that reduced SCD1 expression impaired endometrial cancer growth in vivo. Taken together, these findings indicate that SCD1 is a potentially therapeutic target in human endometrial cancer. Inhibiting lipid metabolism in cancer cells would be a promising strategy for anti-cancer therapy.
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Affiliation(s)
- Weihua Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Wangfujing, Beijing 100730, China.,Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China
| | - Huimin Bai
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China
| | - Shiping Liu
- Departments of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Wangfujing, Beijing 100730, China
| | - Hongying Wu
- Institute of Radiation Medicine, The Chinese Academy of Medical Sciences, Tianjin 300192, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Wangfujing, Beijing 100730, China
| | - Yanhong Tai
- Department of Pathology, The Affiliated Hospital of Military Medical Science Academy of Chinese People's Liberation Army (307 Hospital of Chinese People's Liberation Army), Beijing 100071, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Wangfujing, Beijing 100730, China
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103
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Bai H, Sha G, Xiao M, Gao H, Cao D, Yang J, Chen J, Wang Y, Zhang Z, Shen K. The prognostic value of pretreatment CA-125 levels and CA-125 normalization in ovarian clear cell carcinoma: a two-academic-institute study. Oncotarget 2017; 7:15566-76. [PMID: 26863639 PMCID: PMC4941261 DOI: 10.18632/oncotarget.7216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 01/28/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The present study investigated the clinical implications of pretreatment carbohydrate antigen 125 (CA-125) levels and CA-125 normalization in patients with ovarian clear cell carcinoma (CCC), and it provides useful information for the improvement of monitoring strategies for this lethal disease. METHODS The medical records of patients with ovarian CCC who had undergone primary staging surgery or cytoreductive surgery followed by systemic chemotherapy were retrospectively reviewed. A range of clinico-pathological parameters were collected and examined. RESULTS A total of 375 women were included in the analysis. FIGO stage (p < 0.001) was identified as the only significant prognostic factor for relapse. Residual tumor and advanced stage (p = 0.001 and p < 0.001, respectively) were identified as independent adverse factors for survival. The potential risk factors associated with elevated pretreatment CA-125 levels included advanced-stage disease, positive residual tumors and negative endometriosis (p < 0.001, p = 0.001 and p <0.001, respectively). Pretreatment CA-125 levels were not associated with relapse-free survival (RFS) or overall survival (OS) (p = 0.060 and p = 0.176, respectively). CA-125 normalization after chemotherapy exhibited a positive linear correlation with advanced stage (r = 0.97, p = 0.001) and residual tumor (r = 0.81, p = 0.027) and a negative relationship with 5-year RFS (r = -0.97, p = 0.002) and 5-year OS (r = -0.97, p= 0.001). Patients with CA-125 levels that normalized before cycle 2 of chemotherapy had a similar prognosis as patients whose CA-125 levels normalized prior to chemotherapy (RFS: p = 0.327; OS: p = 0.654). By contrast, patients with CA-125 levels that normalized after cycle 2 of chemotherapy or never normalized were significantly more likely to experience disease progression. CONCLUSIONS Pretreatment CA-125 levels are not very useful for predicting clinical outcome. CA-125 levels following treatment are a valid indicator for treatment monitoring. CA-125 normalization after the completion of cycle 1 of chemotherapy represents a distinct inflection point for decreased RFS and OS.
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Affiliation(s)
- Huimin Bai
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guisha Sha
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Meizhu Xiao
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Huiqiao Gao
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jie Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yue Wang
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Bi X, Zhang J, Cao D, Sun H, Feng F, Wan X, Xiang Y, Qiu L, Cheng X, Yang J, Shen K. Anti-Müllerian hormone levels in patients with gestational trophoblastic neoplasia treated with different chemotherapy regimens: a prospective cohort study. Oncotarget 2017; 8:113920-113927. [PMID: 29371957 PMCID: PMC5768374 DOI: 10.18632/oncotarget.23027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose To assess the ovarian reserve of patients with gestational trophoblastic neoplasia (GTN) treated with chemotherapy by evaluating serum anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels before, during, and after chemotherapy. Results The basal AMH level (mean: 3.98 ± 3.20 ng/mL) negatively correlated with age, while the basal FSH level (mean: 5.71 ± 9.69 mIU/mL) had no correlation with age. After 3 chemotherapy cycles, serum AMH levels decreased and FSH levels increased. The magnitude of the AMH level decline was significantly greater for combination chemotherapy than for single-agent dactinomycin D therapy (61.80% vs. 27.57%) (p = 0.0004) and was higher in patients whose regimens included etoposide (73.69% vs 40.51%) (p = 0.0359). After chemotherapy completion, AMH levels showed a further decline, and cumulative AMH concentration change was associated with doses of vincristine (p = 0.009) and etoposide (p = 0.032). At the 3-month follow-up, AMH levels significantly increased in the dactinomycin D group (p = 0.0067). Materials and Methods This prospective study included 34 patients with GTN. Serum AMH and FSH levels were measured before chemotherapy, after the 3rd cycle, and at 2 weeks and 3 months after chemotherapy. Cumulative changes of serum AMH levels in patients who received different chemotherapy regimens were analyzed. Conclusions Chemotherapy for GTN affects the ovarian reserve, with substantial differences between chemotherapy protocols. The results improve our understanding of ovarian toxicity and support the use of fertility preservation strategies.
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Affiliation(s)
- Xiaoning Bi
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jingjing Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Hengzi Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Fengzhi Feng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xirun Wan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xinqi Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
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Wang C, Gao Z, Shen K, Shen Z, Jiang K, Liang B, Yin M, Yang X, Wang S, Ye Y. Safety, quality and effect of complete mesocolic excision vs non-complete mesocolic excision in patients with colon cancer: a systemic review and meta-analysis. Colorectal Dis 2017; 19:962-972. [PMID: 28949060 DOI: 10.1111/codi.13900] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/14/2017] [Indexed: 12/11/2022]
Abstract
AIM The application of complete mesocolic excision (CME) in colon cancer is controversial. We performed a meta-analysis to compare the safety, quality and effect of CME with non-complete mesocolic excision (NCME) in patients with colon cancer. METHOD We searched PubMed, ScienceDirect, the Cochrane Library and Scopus to identify studies comparing CME with NCME in colon cancer. We focused on three study outcome areas: safety (operation time, blood loss, complications, mortality); quality (large bowel length, distance from the tumour to the high vascular tie, area of mesentery, total lymph nodes); and effect (long-term survival). RESULTS A total of 8586 patients from 12 studies were included in the meta-analysis. CME was associated with greater intra-operative blood loss [weighted mean difference (WMD) 79.87, 95% CI: 65.88-93.86], more postoperative surgical complications (relative risk 1.23, 95% CI: 1.08-1.40), longer large bowel resection (WMD 47.06, 95% CI: 10.49-83.62), greater distance from the tumour to the high vascular tie (WMD 17.51, 95% CI: 15.16-19.87), larger area of mesentery (WMD 36.09, 95% CI: 18.06-54.13) and more lymph nodes (WMD 6.13, 95% CI: 1.97-10.28) than NCME. CME also had positive effects on 5-year survival [hazard ratio (HR) 0.33, 95% CI: 0.13-0.81], 3-year survival (HR 0.58, 95% CI: 0.39-0.86) and 3-year survival for Stage III disease (HR 0.69, 95% CI: 0.60-0.80) compared with NCME. CONCLUSION Limited evidence suggests that CME is a more effective strategy for improving specimen quality and survival but with a higher complication rate.
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Affiliation(s)
- C Wang
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - Z Gao
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing, China
| | - K Shen
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - Z Shen
- Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - K Jiang
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - B Liang
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - M Yin
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - X Yang
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - S Wang
- Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
| | - Y Ye
- Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China
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Qin Y, Yu Z, Yang J, Cao D, Yu M, Wang Y, Shen K. Oral Progestin Treatment for Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis. Int J Gynecol Cancer 2017; 26:1081-91. [PMID: 27177279 DOI: 10.1097/igc.0000000000000723] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the efficacy and safety of oral progestin treatment for early-stage endometrial cancer. METHODS We conducted a systematic review and meta-analysis of the proportions from observational studies. Original studies were selected if patients with early-stage endometrial cancer, especially those of reproductive age, were treated with oral progestin. We conducted searches on studies listed in MEDLINE, EMBASE, and Cochrane that were published through June 2014, and relevant articles were also searched. The methodological quality of the included studies was assessed using the Newcastle-Ottawa quality assessment scale. Funnel plots and metaregression analyses were used to assess bias. RESULTS The final sample included 25 articles involving 445 patients. Based on a random-effects model, patients achieved a disease regression rate of 82.4% (95% confidence interval [CI], 75.3%-88.7%), a relapse rate of 25.0% (95% CI, 15.8%-35.2%), a pregnancy rate of 28.8% (95% CI, 22.5%-35.5%), and a live birth rate of 19.6% (95% CI, 12.8%-27.4%). Body weight gain, liver dysfunction, and abnormal blood coagulation test results were the most common treatment-related adverse effects. Only 2 disease-related deaths were reported during the follow-up duration. CONCLUSIONS Based on the present systematic review and meta-analysis, oral progestin treatment is feasible and safe for patients of reproductive age.
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Affiliation(s)
- Yun Qin
- *Department of Obstetrics and Gynecology, Peking Union Medical College Hospital; and †Department of Epidemiology and Biostatistics, School of Basic Medicine Peking Union Medical College and Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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107
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Li L, Bai H, Yang J, Cao D, Shen K. Genome-wide DNA copy number analysis in clonally expanded human ovarian cancer cells with distinct invasive/migratory capacities. Oncotarget 2017; 8:15136-15148. [PMID: 28122348 PMCID: PMC5362473 DOI: 10.18632/oncotarget.14767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/10/2017] [Indexed: 01/26/2023] Open
Abstract
Ovarian cancer has the worst prognosis of any gynecological malignancy, and generally presents with metastasis at advanced stages. Copy number variation (CNV) frequently contributes to the alteration of oncogenic drivers. In this study, we sought to identify genetic targets in heterogeneous clones from human ovarian cancers cells. We used array-based technology to systematically assess all the genes with CNVs in cell models clonally expanded from A2780 and SKOV3 ovarian cancer cell lines with distinct highly and minimally invasive/migratory capacities. We found that copy number alterations differed between matched highly and minimally invasive/migratory subclones, differentially affecting specific functional processes including immune response processes, DNA damage repair, cell cycle and cell proliferation. We also identified seven genes as strong candidates, including DDB1, ERCC1, ERCC2, PRPF19, BCAT1, CDKN1B and MARK4, by integrating the above data with gene expression and clinical outcome data. Thus, by determining the molecular signatures of heterogeneous invasive/migratory ovarian cancer cells, we identified genes that could be specifically targeted for the treatment and prognosis of advanced ovarian cancers.
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Affiliation(s)
- Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huimin Bai
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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108
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Ren T, Wang S, Sun J, Qu JM, Xiang Y, Shen K, Lang JH. Endometriosis is the independent prognostic factor for survival in Chinese patients with epithelial ovarian carcinoma. J Ovarian Res 2017; 10:67. [PMID: 28974236 PMCID: PMC5627477 DOI: 10.1186/s13048-017-0363-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/25/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Clinico-pathological characteristics and possible prognostic factors among women with epithelial ovarian carcinoma (EOC) with or without concurrent endometriosis were explored. METHOD We retrospectively identified 304 patients with EOC treated primarily at Peking Union Medical College Hospital with median follow-up time of 60 months. RESULTS Of 304 patients with EOC, concurrent endometriosis was identified in 69 (22.7%). The patients with concurrent endometriosis were younger and more probably post-menopausal at onset, were less likely to have abdominal distension, with significantly lower level of pre-surgery serum Ca125 and less possibility of having the history of tubal ligation. The women with concurrent endometriosis group were more likely to have early stage tumors (88.41% versus 52.77%), receive optimal cytoreductive surgery (92.75% versus 71.06%), and less likely to have lymph node metastasis or to develop platinum resistance disease (7.25% versus 14.89%, and 7.35% versus 20%), when compared with women without coexisting endometriosis. The univariate analysis showed that concurrent endometriosis was a prognostic factor for overall survival (OS) and disease-free survival (DFS), but this association just remained in the DFS by multivariate analysis. Besides, multivariate analysis also showed that FIGO stage, residual disease, chemotherapy cycles, chemotherapy resistance and concomitant hypertension were the independent impact factors of OS for EOC patients; whereas FIGO stage, lymphadenectomy, residual disease, coexisting endometriosis and chemoresistance were independent impact factors of DFS for those patients. CONCLUSIONS EOC patients with concurrent endometriosis showed distinct characteristics and had longer overall survival and disease-free survival when compared with those without endometriosis. Endometriosis was the independent prognostic factor for DFS for patients in this series.
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Affiliation(s)
- Tong Ren
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Shuaifuyuan 1, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Shu Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Shuaifuyuan 1, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Jian Sun
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Ji-Min Qu
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Shuaifuyuan 1, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Shuaifuyuan 1, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jing He Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Shuaifuyuan 1, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
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Abstract
There are several ways that transpire in cell-to-cell communication,with or without cell contact. Exosomes play an important role in cell-to-cell communication,which do not need cell contact,as that can result in a relatively long-distance influence. Exosome contains RNA components including mRNA and micro-RNA,which are protected by exosomes rigid membranes. This allows those components be passed long distance through the circulatory system. The mRNA components are far different from their donor cells,and the micro-RNA components may reflect the cell they originated. In this article we review the role of exosomes in cell-to-cell communication,with particular focus on their potentials in both diagnostic and therapeutic applications.
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Affiliation(s)
- Wei Zhang
- Department of Obstetrics and Gynecology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Peng Peng
- Department of Obstetrics and Gynecology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
| | - Keng Shen
- Department of Obstetrics and Gynecology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
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Zhao Q, Cao D, Yu M, Yang J, Liu Y, Xiang Y, Wu M, Pan L, Lang J, Xu K, Han J, Shen K. Safety and efficacy of bleomycin/pingyangmycin-containing chemotherapy regimens for malignant germ cell tumor patients in the female genital system. Oncotarget 2017; 8:15952-15960. [PMID: 28160575 PMCID: PMC5362537 DOI: 10.18632/oncotarget.15021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/09/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives To comprehensively evaluate the safety and effectiveness of bleomycin/pingyangmycin-containing chemotherapy for female patients with malignant germ cell tumors in their genital system; to assess the diagnostic value of pulmonary function tests for bleomycin-induced pulmonary toxicity. Methods Data from a cohort of 120 patients, collected across 25 years, was reviewed. Chemotherapy-related adverse events were routinely monitored. Pulmonary toxicity was diagnosed and graded according to serial pulmonary function testing results, and potential impact factors were explored. Short-term remission probability and long-term prognosis were evaluated. Results Overall, 49.2% of the patients had pulmonary dysfunction, and the majority manifested as diffusion function impairment. A moderate reduction of carbon monoxide diffusion capacity was detected in 45.0% of all patients, and was severe in 3 patients. Thrombocytopenia, renal dysfunction, and accumulating dose of bleomycin/pingyangmycin significantly increased the risk of lung injury (P<0.05). Thorough surgical removal of tumors enhanced both remission and survival rate. Full-dose delivery of bleomycin/pingyangmycin and patients sensitivity to chemotherapy also improved long-term survival (P<0.05). Conclusions BPT could be sensitively detected and elaborately graded by PFTs, but the appropriate cut-off value for diagnosis needs further investigations. Timely recognition and control of renal dysfunction and thrombocytopenia could avail the patients of the opportunity to complete curative antineopalstic treatment. Prescriptive bleomycin/pingyangmycin-containing chemotherapy after optimal surgical resection could benefit MGCT patients maximally by improving both remission and survival rate.
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Affiliation(s)
- Qianying Zhao
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mei Yu
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yongjian Liu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Xiang
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ming Wu
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lingya Pan
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jinghe Lang
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kaifeng Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiangna Han
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Zhao Y, Wang S, Qu YM, Ji YT, Shen K, Lang JH. Prognostic analysis for Chinese patients with stage I ovarian endometrioid carcinoma. J Ovarian Res 2017; 10:63. [PMID: 28923080 PMCID: PMC5604507 DOI: 10.1186/s13048-017-0361-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/11/2017] [Indexed: 11/29/2022] Open
Abstract
Background This study aimed to identify the clinical and pathological characteristics and the possible prognostic factors for Chinese patients with early-stage ovarian endometrioid carcinoma. Methods The present study reviewed the medical records of patients who received initial treatment and a postoperative pathological diagnosis of ovarian endometrioid carcinoma at our center. In all, 78 patients had stage I ovarian endometrioid carcinoma. Results In this series, the 5-year overall survival rate and 5-year disease-free survival (DFS) rates of patients with stage I ovarian endometrioid carcinoma was 98.7% and 87.2%, respectively. Univariate analysis showed the factors that influence the DFS rates include menopausal status, FIGO stage, histological grade, lymphadenectomy, cytology of ascites. Multivariate analysis showed that grade 3 and lymphadenectomy were the independent prognostic factors of DFS for Stage I ovarian endometrioid carcinoma (P = 0.0259, 0.0276 respectively). However, the coexisting endometriosis, concomitant endometrial disorders, dissection of para-aortic lymph node and more courses of thermotherapy had no influence on DFS. Besides, it was found that 19.3% of patients in this series had synchronous early stage and well-to-moderate differentiated endometrial carcinoma. Conclusions Grade 3 and lymphadenectomy were indicated as the independent factors of DFS for stage I patients with ovarian endometrioid carcinoma. The endometrial changes should be considered seriously when fertility-sparing surgery was planned.
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Affiliation(s)
- Yu Zhao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, People's Republic of China.,Department of Gynecology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, People's Republic of China
| | - Shu Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, People's Republic of China.
| | - Yi-Min Qu
- School of Public Health, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yu-Ting Ji
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, People's Republic of China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, People's Republic of China
| | - Jing He Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, People's Republic of China
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Jiang X, Yang J, Yu M, Xie W, Cao D, Wu M, Pan L, Huang H, You Y, Shen K. Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age. World J Surg Oncol 2017; 15:154. [PMID: 28806962 PMCID: PMC5557507 DOI: 10.1186/s12957-017-1222-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/07/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fertility-sparing surgery is indicated for patients with stage I epithelial ovarian cancers. We sought to evaluate the clinical outcomes and oncofertility in a cohort of patients of reproductive age with stage I epithelial ovarian cancer (EOC). METHODS Overall, 108 patients of reproductive age (≤ 40 years) diagnosed with stage I EOC who were treated at Peking Union Medical College Hospital between 1999 and 2013 were included in the study. The Kaplan-Meier model and Cox regression analyses were used for the survival analysis. RESULTS The type of surgery included fertility-sparing surgery (FSS) (48.1%) and radical surgery (RS) (51.9%). After a median follow-up of 83 months, we observed that grade 3 or clear-cell carcinoma was the only independent risk factor for disease-free survival and tumor-specific survival in the multivariate analysis. Patients with grade 3 or clear-cell carcinoma tended to be older than 30 years, have endometriosis, and undergo RS (p < 0.05). Fertility-sparing surgery did not affect disease-free survival or tumor-specific survival among patients of reproductive age with stage I EOC and among high-risk patients with stage IC2-3, grade 3, or clear-cell carcinoma. Thirty-four out of 52 (65.4%) FSS patients attempted to get pregnant. Twenty-eight (82.4%) achieved a successful pregnancy with a full-term delivery. CONCLUSIONS Grade 3 or clear-cell carcinoma was the only independent risk factor for survival of patients of reproductive age with stage I EOC. FSS can be safely performed on patients of reproductive age with grade 1-2, stage I EOC. The safety of FSS for grade 3 and clear-cell carcinoma warrants further investigation.
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Affiliation(s)
- Xuan Jiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Mei Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Weimin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Ming Wu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Lingya Pan
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Huifang Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Yan You
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People's Republic of China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Shuai Fu Yuan No.1, Dongcheng District, Beijing, 100730, People's Republic of China
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He ZX, Shi HH, Fan QB, Zhu L, Leng JH, Sun DW, Li ZF, Shen K, Wang S, Lang JH. Predictive factors of ovarian carcinoma for women with ovarian endometrioma aged 45 years and older in China. J Ovarian Res 2017; 10:45. [PMID: 28716151 PMCID: PMC5514486 DOI: 10.1186/s13048-017-0343-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 07/07/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis (OEM) aged 45 years and above in China. METHODS This study reviewed the medical records of 1038 women in total who were aged 45 years and above, surgical-pathologically diagnosed with ovarian endometriosis, and were treated at Peking Union Medical College Hospital between December 1996 and December 2016. Histology evaluation was used to determine whether the ovarian endometriosis specimen was with (n = 30) or without (n = 1008) ovarian cancer. RESULTS 2.9% (30/1038) of women with the surgical-pathological diagnosis of ovarian endometriosis were found to have EAOC. Those patients with EAOC were prone to be in the postmenopausal status at the time of the diagnosis (OR 5.50, 95%CI 2.54-11.90, P < .001) and larger size of tumor (≥8 cm, OR 7.19, 95% CI 3.34-15.50, P < .001), and higher prevalence of coexisting with endometrial disorders (OR 4.11, 95%CI 1.73-9.73, P = .003). This study showed that patients of an older age when diagnosed with OEM, were at a higher risk of developing EAOC, respectively measuring of 1.7% (13/751) at 45-49 years, 5.6% (12/215) at 50-54 years, and 10.0%(5/50) at 55-59 years (P < 0.001). CONCLUSIONS This study showed that for women aged 45 years and above who were diagnosed with OEM, the independent risk factors of EAOC were menopausal status, tumor size of 8 cm or greater in diameter, and coexisting endometrial disorders. Therefore, intensive follow-ups or active interventions should be considered for them.
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Affiliation(s)
- Zheng-Xing He
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Hong-Hui Shi
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Qing-Bo Fan
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Lan Zhu
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Jin-Hua Leng
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China.
| | - Da-Wei Sun
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Zhan-Fei Li
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Keng Shen
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
| | - Shu Wang
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China.
| | - Jing-He Lang
- Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China
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Zhao Q, Yang J, Li L, Cao D, Yu M, Shen K. Germline and somatic mutations in homologous recombination genes among Chinese ovarian cancer patients detected using next-generation sequencing. J Gynecol Oncol 2017; 28:e39. [PMID: 28541631 PMCID: PMC5447142 DOI: 10.3802/jgo.2017.28.e39] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/21/2017] [Accepted: 03/03/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To define genetic profiling of homologous recombination (HR) deficiency in Chinese ovarian cancer patients. METHODS we have applied next-generation sequencing to detect deleterious mutations through all exons in 31 core HR genes. Paired whole blood and frozen tumor samples from 50 Chinese women diagnosed with epithelial ovarian carcinomas were tested to identify both germline and somatic variants. RESULTS Deleterious germline HR-mutations were identified in 36% of the ovarian cancer patients. Another 5 patients had only somatic mutations. BRCA2 was most frequently mutated. Three out of the 5 somatic mutations were in RAD genes and a wider distribution of other HR genes was involved in non-serous carcinomas. BRCA1/2-mutation carriers had favorable platinum sensitivity (relative risk, 1.57, p<0.05), resulting in a 100% remission probability and survival rate. In contrast, mutations in other HR genes predicted poor prognosis. However, multivariate analysis demonstrated that platinum sensitivity and optimal cytoreduction were the independent impact factors influencing survival (hazards ratio, 0.053) and relapse (hazards ratio, 0.247), respectively. CONCLUSION our results suggest that a more comprehensive profiling of HR defect than merely BRCA1/2 could help elucidate tumor heterogeneity and lead to better stratification of ovarian cancer patients for individualized clinical management.
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Affiliation(s)
- Qianying Zhao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mei Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Xie W, Bi X, Cao D, Yang J, Shen K, You Y. Primary endometrioid stromal sarcomas of the ovary: a clinicopathological study of 14 cases with a review of the literature. Oncotarget 2017; 8:63345-63352. [PMID: 28968994 PMCID: PMC5609926 DOI: 10.18632/oncotarget.18805] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/02/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose Primary endometrioid stromal sarcomas (ESS) of the ovary are rare mesenchymal tumors with scarce data on their behavior and optimal treatment. We aimed to describe the clinicopathologic features and outcome among patients with primary ovarian ESS. Results The age of the patients ranged from 34 to 61 years (mean: 49.1 years, median: 51.5 years). The most common symptoms were abdominal distention or pain or both. Nine (64.3%) and five patients (35.7%) had low-grade and high-grade disease, respectively. The median duration of follow-up was 65 months (range, 8–311 months). All 9 patients with low-grade ESS were alive, of these, 3 (33.3%) of them developed recurrence after surgery. Only 1 patient (20%) with high-grade ESS was alive with no evidence of disease in a short-term follow-up visit; the remaining 4 (80%) developed recurrence after surgery, and 2 (40%) died of progressive disease. Methods Medical records of 14 patients with primary ovarian ESS in our institution were collected and analyzed. Conclusions The behavior of primary ovarian ESS is similar to that of their uterine counterparts. Low-grade ESS is an indolent tumor with a propensity for late recurrences. The prognosis of high-grade ESS is poor.
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Affiliation(s)
- Weimin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaoning Bi
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yan You
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Xie W, Shen K, Yang J, Cao D, Yu M, Wang Y. Conservative management of primary vaginal endodermal sinus tumor and rhabdomyosarcoma. Oncotarget 2017; 8:63453-63460. [PMID: 28969004 PMCID: PMC5609936 DOI: 10.18632/oncotarget.18829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/04/2017] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to evaluate the conservative management and prognosis of primary vaginal endodermal sinus tumor and rhabdomyosarcoma in children. Medical records of children with vaginal endodermal sinus tumor and rhabdomyosarcoma between 1996 and 2015 were reviewed. A total of 24 patients (median age, 12 months; range, 7–44 months) were included in this study, comprising 17 patients with endodermal sinus tumor and 7 patients with rhabdomyosarcoma. Among the 17 patients with endodermal sinus tumor, 15 were initially treated at our hospital with chemotherapy alone, and 2 were initially treated in other hospitals with conservative surgery and chemotherapy. All 7 patients with botryoid rhabdomyosarcoma received chemotherapy without well-defined protocols. At a median follow-up of 51 months (range, 4–237 months), 3 patients (12.5%; 1 with endodermal sinus tumor and 2 with rhabdomyosarcoma) developed recurrence. At the last follow-up, 22 patients (91.7%) were alive without evidence of disease, 1 patient with botryoid rhabdomyosarcoma died of disease progression, and 1 patient with endodermal sinus tumor died of respiratory and circulatory failure. To allow preservation of sexual and reproductive function, conservative therapeutic strategies should be considered for children with vaginal endodermal sinus tumor and botryoid rhabdomyosarcoma.
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Affiliation(s)
- Weimin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Mei Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yao Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Yu X, Jiang J, Liu C, Shen K, Wang Z, Han W, Liu X, Lin G, Zhang Y, Zhang Y, Ma Y, Bo H, Zhao Y. Protocol for a multicentre, multistage, prospective study in China using system-based approaches for consistent improvement in surgical safety. BMJ Open 2017; 7:e015147. [PMID: 28619774 PMCID: PMC5734415 DOI: 10.1136/bmjopen-2016-015147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Surgical safety has emerged as a crucial global health issue in the past two decades. Although several safety-enhancing tools are available, the pace of large-scale improvement remains slow, especially in developing countries such as China. The present project (Modern Surgery and Anesthesia Safety Management System Construction and Promotion) aims to develop and validate system-based integrated approaches for reducing perioperative deaths and complications using a multicentre, multistage design. METHODS AND ANALYSIS The project involves collection of clinical and outcome information for 1 20 000 surgical inpatients at four regionally representative academic/teaching general hospitals in China during three sequential stages: preparation and development, effectiveness validation and improvement of implementation for promotion. These big data will provide the evidence base for the formulation, validation and improvement processes of a system-based stratified safety intervention package covering the entire surgical pathway. Attention will be directed to managing inherent patient risks and regulating medical safety behaviour. Information technology will facilitate data collection and intervention implementation, provide supervision mechanisms and guarantee transfer of key patient safety messages between departments and personnel. Changes in rates of deaths, surgical complications during hospitalisation, length of stay, system adoption and implementation rates will be analysed to evaluate effectiveness and efficiency. ETHICS AND DISSEMINATION This study was approved by the institutional review boards of Peking Union Medical College Hospital, First Hospital of China Medical University, Qinghai Provincial People's Hospital, Xiangya Hospital Central South University and the Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences. Study findings will be disseminated via peer-reviewed journals, conference presentations and patent papers.
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Affiliation(s)
- Xiaochu Yu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingmei Jiang
- Department of Epidemiology and Biotatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Changwei Liu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Keng Shen
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zixing Wang
- Department of Epidemiology and Biotatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biotatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Xingrong Liu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Guole Lin
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ye Zhang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Zhang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yufen Ma
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Haixin Bo
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yupei Zhao
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Jiang X, Yang J, Cao D, You Y, Shen K. Comparative study of epithelial ovarian cancer with or without fertility-sparing surgery in Chinese patients. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wang F, Liu J, Weng T, Shen K, Chen Z, Yu Y, Huang Q, Wang G, Liu Z, Jin S. The Inflammation Induced by Lipopolysaccharide can be Mitigated by Short-chain Fatty Acid, Butyrate, through Upregulation of IL-10 in Septic Shock. Scand J Immunol 2017; 85:258-263. [PMID: 27943364 DOI: 10.1111/sji.12515] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 11/29/2016] [Indexed: 12/13/2022]
Affiliation(s)
- F. Wang
- School of Basic Medicine Sciences; Wenzhou Medical University; Wenzhou Zhejiang China
| | - J. Liu
- School of Environmental Science and Public Health; Wenzhou Medical University; Wenzhou Zhejiang China
| | - T. Weng
- School of Basic Medicine Sciences; Wenzhou Medical University; Wenzhou Zhejiang China
| | - K. Shen
- School of Basic Medicine Sciences; Wenzhou Medical University; Wenzhou Zhejiang China
| | - Z. Chen
- School of Basic Medicine Sciences; Wenzhou Medical University; Wenzhou Zhejiang China
| | - Y. Yu
- Department of Intensive Care Unit; Zhujiang Hospital; Southern Medical University; Guangzhou China
| | - Q. Huang
- Department of Intensive Care Unit; Zhujiang Hospital; Southern Medical University; Guangzhou China
| | - G. Wang
- School of Basic Medicine Sciences; Wenzhou Medical University; Wenzhou Zhejiang China
| | - Z. Liu
- Department of Intensive Care Unit; Zhujiang Hospital; Southern Medical University; Guangzhou China
| | - S. Jin
- School of Basic Medicine Sciences; Wenzhou Medical University; Wenzhou Zhejiang China
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Zong Y, Wu J, Shen K. Abstract P5-16-29: Nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy of breast cancer: A meta-analysis. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nanoparticle albumin-bound paclitaxel (nab-Paclitaxel), a novel solvent-free taxane-based regimen, was hypothesized to have enhanced drug transport to tumors, shorter infusion schedules and no need for premedication. The value of nab-Paclitaxel in neoadjuvant systemic therapy (NST) for breast cancer remains uncertain. We performed a meta-analysis to assess efficacy and toxicity of nab-Paclitaxel compared to conventional taxane regimens (paclitaxel, docetaxel) within randomized clinical trials.
Methods: A systematic search was performed using the medical subject heading (MeSH) terms ''breast neoplasms'', as well as (1) breast cancer; AND (2) nab-Paclitaxel OR nanoparticle paclitaxel; AND (3) neoadjuvant OR preoperative OR primary systemic in both Pubmed databases and proceedings of oncologic meetings including ASCO, ESMO and SABCS. Pooled rates of pathological complete response(pCR), odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect model to determine the effect of neoadjuvant nab-paclitaxel.
Results: Twenty-one studies with 2357 patients were included, 3 of which (GeparSepto[1], ETNA[2], Showa trial[3]) were randomized clinical trials. The aggregate pCR rate (ypT0/is ypN0) was 32% (95% CI 25-38%) in unselected breast cancer patients and was 14%(95% CI 11-17%), 41%(95% CI 38-45%), 54%(95% CI 43-66%) in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-), triple negative breast cancer(TNBC), HER2+ patients, respectively. Within the HER2+ population, pCR rate was 61%(95% CI 47-74%) for HR- and 40%(95% CI 28-52%) for HR+ tumors. Regarding randomized clinical trials, the probability of achieving pCR was significantly higher in the nab-paclitaxel group than in the conventional taxanes group (OR=1.383, 95%CI 1.141-1.676, p=0.001). A funnel plot of the effect size for each randomized trial against the precision showed no asymmetry, which indicating no potential publication bias. In the safety analysis (GeparSepto[1], ETNA[2]), hematological toxic effects were generally equivalent in nab-paclitaxel and paclitaxel group. For non-hematological toxic effects, all grades and grade≥ 3 peripheral sensory neuropathy occurred more frequently with nab-paclitaxel compared to paclitaxel (all grades, OR=2.090, 95%CI 1.016-4.302, p=0.045; grade≥ 3, OR=3.766, 95%CI 2.324-6.100, p<0.001). Hypersensitivity was more common with paclitaxel than nab-paclitaxel at any grade and grade≥ 3. Other non-hematological toxic effects did not significantly differ between two groups.
Conclusion: nab-Paclitaxel is an effective antitumor drug in NST of breast cancer, especially for TNBC and HER2+ tumors, in terms of pCR. Exchange of nab-Paclitaxel for conventional taxanes could significantly improve pCR rate with reasonable toxicities.
Clinical trial information: 1.Lancet Oncol.2016,17:345-56.; 2.J Clin Oncol.2016,34(suppl; abstract 502).; 3.J Clin Oncol.2015,33(suppl; abstract 136).
Citation Format: Zong Y, Wu J, Shen K. Nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy of breast cancer: A meta-analysis [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-29.
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Affiliation(s)
- Y Zong
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medcine, Shanghai, China
| | - J Wu
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medcine, Shanghai, China
| | - K Shen
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medcine, Shanghai, China
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Chen X, Ye G, Zhang C, Li X, Shen K. Abstract P5-16-07: Non-anthracycline-containing docetaxel plus cyclophosphomide was inferior to docetaxel, anthracycline and cyclophosphomide in neoadjuvant treatment of triple negative or HER2 positive breast cancer: Long term follow-up result from NATT study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- X Chen
- Comprehensive Breast Health Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China; The First People's Hospital of Foshan, Foshan, Guangdong, China; Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong, China; Shanxi Provincical Cancer Hospital, Taiyuan, Shanxi, China
| | - G Ye
- Comprehensive Breast Health Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China; The First People's Hospital of Foshan, Foshan, Guangdong, China; Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong, China; Shanxi Provincical Cancer Hospital, Taiyuan, Shanxi, China
| | - C Zhang
- Comprehensive Breast Health Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China; The First People's Hospital of Foshan, Foshan, Guangdong, China; Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong, China; Shanxi Provincical Cancer Hospital, Taiyuan, Shanxi, China
| | - X Li
- Comprehensive Breast Health Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China; The First People's Hospital of Foshan, Foshan, Guangdong, China; Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong, China; Shanxi Provincical Cancer Hospital, Taiyuan, Shanxi, China
| | - K Shen
- Comprehensive Breast Health Center, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China; The First People's Hospital of Foshan, Foshan, Guangdong, China; Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong, China; Shanxi Provincical Cancer Hospital, Taiyuan, Shanxi, China
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Tao T, Yang JX, Shen K, Cao DY. [Clinical-based study of ovarian cancer patients with and without BRCA1/2 genes mutation: clinical features and pedigree analysis]. Zhonghua Fu Chan Ke Za Zhi 2017; 52:20-25. [PMID: 28190311 DOI: 10.3760/cma.j.issn.0529-567x.2017.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To compare the clinical and histological features and prognosis of patients with ovarian cancer from different genetic background, and to make further understanding of the genetic model of BRCA genes used pedigree analysis. Methods: There were 71 patients from 67 independent families enrolled in our study from Apr. 2000 to Jun. 2009 in Peking Union Medical College Hospital. All exons of BRCA1/2 genes were analyzed using denaturing high-performance liquid chromatography(DHPLC) followed by direct sequencing, and clinical features of patients were compared by statistical analysis. Pedigree analysis of two families with BRCA genes mutation were performed. Results: The mutation rate of BRCA genes was 28% (20/71). The frequency of BRCA1 and BRCA2 gene mutation was 23% (16/71) and 6% (4/71), respectively (P=0.004). Histology types of patients with and without BRCA genes mutation were different. The onset age between patients with and without BRCA genes mutation was similar (52.6 versus 54.6 years old, P=0.393), and tend to be early-onset breast or ovarian cancer in high-risk group. There was no significant difference of platinum-resistant rate, disease free survival and overall survival rate between patients with and without BRCA genes mutation (all P>0.05). According to the pedigree analysis, up to 100% of female offspring inherited pathogenic mutations, and male offspring could be a mutation carrier. Conclusions: The genetic screening and clinical intervention should be performed as early as possible for the members from families at risk of hereditary ovarian cancer. Genetic consulting is important for patients with high-grade papillary serous adenocarcinoma of ovary. It is still unknown that whether the patients with BRCA gene mutations have better prognosis than sporadic ones, and further perspective, randomized controlled trial is still needed.
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Affiliation(s)
- T Tao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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123
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Yang JX, Shen K, Wu LY. [BRCA genes detection of epithelial ovarian cancer in China]. Zhonghua Fu Chan Ke Za Zhi 2017; 52:8-10. [PMID: 28190309 DOI: 10.3760/cma.j.issn.0529-567x.2017.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Zhang G, Lang J, Shen K, Zhu L, Xiang Y. High-risk human papillomavirus infection clearance following conization among patients with cervical intraepithelial neoplasm grade 3 aged at least 45 years. Int J Gynaecol Obstet 2017; 136:47-52. [PMID: 28099704 DOI: 10.1002/ijgo.12000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To investigate high-risk human papillomavirus (HPV) infection clearance rates following successful cold knife conization and factors predictive of HPV clearance among patients with cervical intraepithelial neoplasm grade 3. METHOD The present retrospective study analyzed clinical data from patients aged at least 45 years with cervical intraepithelial neoplasm grade 3 who had undergone successful cold knife conization and attended regular follow-up at Peking Union Medical College Hospital, China, between January 1, 2002 and December 31, 2012. HPV clearance rates and potential indicators for HPV clearance were analyzed. RESULTS Data from 156 patients were included; persistent high-risk HPV infection was recorded in 78 (50.0%), 45 (28.8%), 35 (22.4%), 24 (15.4%), and 21 (13.5%) patients at 4, 8, 12, 18, and 24 months after conization, respectively. Clearance rates were significantly lower among patients aged at least 55 years compared with younger patients, with increased odds of persistent HPV infection at 8 months (odds ratio [OR] 4.038; 95% confidence interval [CI] 1.766-10.839), 12 months (OR 5.923; 95% CI 2.450-16.604), 18 months (OR 5.957; 95% CI 2.031-17.469), and 24 months (OR 5.327; 95% CI 1.909-17.971) compared with patients aged 45-49 years. CONCLUSION Age was a prognostic factor for post-operative high-risk HPV infection clearance. Lower clearance rates were observed among patients aged at least 55 years.
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Affiliation(s)
- Guorui Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhao Q, Yang J, Cao D, Han J, Xu K, Liu Y, Shen K. Tailored therapy and long-term surveillance of malignant germ cell tumors in the female genital system: 10-year experience. J Gynecol Oncol 2016; 27:e26. [PMID: 27029747 PMCID: PMC4823357 DOI: 10.3802/jgo.2016.27.e26] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To explore the appropriate treatment of malignant germ cell tumor (MGCT) in the female genital system, and to analyze the factors influencing both therapeutic response and survival outcome. METHODS A cohort of 230-Chinese women diagnosed with MGCT of the genital system was retrospectively reviewed and prospectively followed. The demographic and pathological features, extent of disease and surgery, treatment efficiency, recurrence and survival were analyzed. RESULTS MGCTs from different genital origins shared a similar therapeutic strategy and response, except that all eight vaginal cases were infantile yolk sac tumors. The patients' cure rate following the initial treatment, 5-year overall survival and disease-free survival (DFS) were 85.02%, 95.00%, and 86.00%, respectively. Although more extensive excision could enhance the remission rate; it did not improve the patients' survival. Instead, the level of the medical institution, extent of surgery and disease were independent prognostic factors for relapse (p<0.05). Approximately 20% of patients had recurrent or refractory disease, more than half of whom were in remission following secondary cytoreductive surgery with salvage chemotherapy. CONCLUSION Fertility-sparing surgery with or without standardized PEB/PVB (cisplatin, etoposide/vincristine, and bleomycin) chemotherapy is applicable for female MGCTs of different origins. Comprehensive staging is not required; nor is excessive debulking suggested. Appropriate cytoreduction by surgery and antineoplastic medicine at an experienced medical institution can bring about an excellent prognosis for these patients.
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Affiliation(s)
- Qianying Zhao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiangna Han
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kaifeng Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yongjian Liu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Liu SM, Zhou YZ, Wang HB, Sun ZY, Zhen JR, Shen K, Deng CY, Lang JH. Factors Associated with Effectiveness of Treatment and Reproductive Outcomes in Patients with Thin Endometrium Undergoing Estrogen Treatment. Chin Med J (Engl) 2016; 128:3173-7. [PMID: 26612292 PMCID: PMC4794872 DOI: 10.4103/0366-6999.170258] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Thin endometrium is associated with poor reproductive outcomes; estrogen treatment can increase endometrial thickness (EMT). The aim of this retrospective cohort study was to investigate the factors influencing the effectiveness of estrogen treatment and reproductive outcomes after the treatment in patients with thin endometrium. Methods: Relevant clinical data of 101 patients with thin endometrium who had undergone estrogen treatment were collected. Possible factors influencing the effectiveness of treatment were analyzed retrospectively by logistic regression analysis. Eighty-seven infertile women without thin endometrium who had undergone assisted reproduction served as controls. The cases and controls were matched for age, assisted reproduction method, and number of embryos transferred. Reproductive outcomes of study and control groups were compared using Student's t-test and the Chi-square test. Results: At the end of estrogen treatment, EMT was ≥8 mm in 93/101 patients (92.1%). Effectiveness of treatment was significantly associated with maximal pretreatment EMT (P = 0.017) and treatment duration (P = 0.004). The outcomes of assisted reproduction were similar in patients whose treatment was successful in increasing EMT to ≥8 mm and the control group. The rate of clinical pregnancy in patients was associated with the number of good-quality embryos transferred in both fresh (P = 0.005) and frozen-thawed (P = 0.000) embryo transfer cycles. Conclusions: Thinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful (i.e., achieves an EMT ≥8 mm) are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.
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Affiliation(s)
| | | | | | | | | | | | - Cheng-Yan Deng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Bai H, Cao D, Yuan F, Sha G, Yang J, Chen J, Wang Y, Zhang Z, Shen K. Prognostic value of endometriosis in patients with stage I ovarian clear cell carcinoma: Experiences at three academic institutions. Gynecol Oncol 2016; 143:526-531. [DOI: 10.1016/j.ygyno.2016.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/02/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
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128
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Li L, Wu M, Yang JX, Wan XR, Huang HF, Pan LY, Shen K, Lang JH, Xiang Y. [Clinical analysis of hypersensitivity reaction of platinum in ovarian cancer and cervical cancer patients]. Zhonghua Fu Chan Ke Za Zhi 2016; 51:825-831. [PMID: 27916065 DOI: 10.3760/cma.j.issn.0529-567x.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To investigate the incidence, risk factors, management and prognosis of hypersensitivity reaction (HSR) of platinum-based chemotherapy in patients of ovarian cancer and cervical cancer. Methods: Cases from Peking Union Medical College Hospital from Jan. 2013 to Jan. 2016 were checked for patients' data of epithelial ovarian cancer treated with carboplatin/paclitaxel (every 3 weeks) and patients of cervical cancer treated with concurrent radiochemotherapy using cisplatin (every week). General characters, pathological features, treatment and prognosis of patients were analyzed to determine the severity, symptoms, outcomes and risk factors of HSR. Results: (1) Prevalence of HSR: there were 860 cases of ovarian cancer and 580 cases of cervical cancer, among which HSR occurred in 8.8% (76/860) and 5.9% (34/580) patients, respectively. (2) Grading for HSR: most HSR were grade 1 or 2, with 78.9%(60/76) in ovarian cancer and 82.4%(28/34) in cervical cancer patients. In ovarian cancer patients, there were 7 cases of grade 1 HSR and 53 cases of grade 2 HSR, and in cervical cancer patients, there were 11 cases of grade 1 HSR and 17 cases of grade 2 HSR. (3) Symptoms of HSR: most of HSR happened during intravenous infusion of platinum agents, with 98.7% (75/76) in ovarian cancer and 97.1% (33/34) in cervical cancer patients. In ovarian and cervical cancer patients, most common symptom were tight chest and dyspnea, which happened in 92.1% (70/76) and 97.1% (33/34) patients, respectively. Secondary common symptom were skin reactions, which happened in 53.9% (41/76) and 88.2% (30/34) patients respectively. (4) Treatment after HSR: of 76 ovarian cancer cases with HSR, there were no significant difference in the ratio of HSR recurrence among patients of different treatment after HSR (χ2=0.517, P=0.915): 1 of 4 patients applying prior chemotherapy, 4 of 13 cases receiving desensitization, 3 of 11 cases separating medicine, 2 of 11 patients switching to cisplatin. In 34 cervical cancer cases of HSR, there were also no significant difference in the ratio of HSR recurrence among patients of different treatment after HSR (χ2=0.079, P=1.000): 2 of 9 patients applying prior chemotherapy, 3 of 17 cases receiving desensitization. (5) Risk factors of HSR and patients prognosis: in ovarian cancer patients of HSR, risk factors included relapse (P=0.010), courses of chemotherapy reaching seven or nine for patients of primary treatment or reaching six or seven for recurrent patients (all P<0.05). There were no significant risk factors for cervical cancer patients of HSR (all P>0.05). HSR had no impact on the progression- free survival for ovarian cancer (P=0.144) or cervical cancer (P=0.782). Conclusions: In ovarian cancer patients treated with carboplatin and cervical cancer patients treated with concurrent radiochemotherapy using cisplatin, most HSR of platinum are mild and favorable outcomes. Relapse and longer chemotherapy courses are risk factors for HSR of carboplatin for epithelial ovarian cancer.
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Affiliation(s)
- L Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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129
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Zhang W, Yang J, Cao D, You Y, Shen K, Peng P. Regulation of exosomes released from normal ovarian epithelial cells and ovarian cancer cells. Tumour Biol 2016; 37:10.1007/s13277-016-5394-2. [PMID: 27714673 DOI: 10.1007/s13277-016-5394-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 09/09/2016] [Indexed: 01/03/2023] Open
Abstract
As important cell to cell communicator, exosomes carry a range of bioactive molecules which can significantly influence phenotype of recipient cells. Inhibiting or removing cancer cell-derived exosomes are of therapeutic interest. However, regulation of secretion and release mechanism of exosomes is still unclear. To explore the regulation of exosomes released from normal ovarian epithelial cells and ovarian cancer cells, a normal ovarian epithelial cell line and three ovarian epithelial cancer cell lines were utilized to investigate their exosomes' release and regulation. A cervical cancer cell SiHa was used for identifying tissue specificity. NanoSight NS500 was used to quantify exosome numbers. Exosomes were labeled and observed by confocal microscopy to investigate their interaction with different ovarian cell lines. Exosomes released from normal or ovarian cancer cells were regulated by the extracellular exosomes. Exosome release was inhibited with the extracellular exosome concentration increase. Exosomes from normal ovarian cell and cervical cancer cell also inhibited ovarian cancer cell-derived exosome release, and there was no tissue specificity. PKH26-labeled exosomes from normal ovarian cell and cervical cancer cell were uptaken by ovarian cancer cells. Release of exosomes from ovarian cancer cell is regulated by a feedback mechanism without tissue specificity. This may provide a therapeutic approach to control the release of exosomes from ovarian cancer cells.
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Affiliation(s)
- Wei Zhang
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China
| | - Yan You
- Department of Pathology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing University of Chemical Technology, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China.
| | - Peng Peng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100730, People's Republic of China.
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Xie W, Cao D, Yang J, Yu M, Shen K, Zhao L. Single-Port vs Multiport Laparoscopic Hysterectomy: A Meta-Analysis of Randomized Controlled Trials. J Minim Invasive Gynecol 2016; 23:1049-1056. [PMID: 27590569 DOI: 10.1016/j.jmig.2016.08.826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 12/23/2022]
Abstract
Numerous studies have compared the surgical outcomes of single-port laparoscopic hysterectomy (LH) and conventional multiport LH, but the results are conflicting. The aim of this meta-analysis was to compare the safety and efficacy of single-port LH and multiport LH for benign gynecologic conditions based on published reports. PubMed, the Cochrane Central Register of Controlled Trials, and Embase were searched for relevant randomized controlled trials (RCTs). Outcome measures included intraoperative and postoperative complication rates, postoperative pain, conversion rate, operative time, estimated blood loss (EBL), and length of hospital stay. Pooled outcome measures (risk ratio [RR] and weighted mean difference [WMD]) were pooled with either a fixed-effects model or a random-effects model. Six RCTs encompassing 624 patients were included. There were no significant differences between single-port LH and multiport LH in terms of intraoperative complication rate (RR, 1.00; 95% confidence interval [CI], 0.14-7.05; p = .00), postoperative complication rate (RR, 0.95; 95% CI, 0.63-1.44; p = .82), postoperative pain (WMD, -0.42; 95% CI, -0.99 to 0.15; p = .15), conversion rate (p = .11), EBL (p = .51), or length of hospital stay (p = .27). However, single-port LH was associated with an average of 13.13 minutes longer operative time than multiport LH (p = .02). Our findings show that single-port LH is a safe and effective technique for benign gynecologic conditions, although it may require a longer operative time than multiport LH. Further large, prospective RCTs with long-term follow-up are needed to determine whether single-port LH really offers such benefits as better cosmetic outcome over multiport LH.
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Affiliation(s)
- Weimin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Mei Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Zhao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhao Q, Gui T, Qian Q, Li L, Shen K. B-cell-specific Moloney murine leukemia virus integration site 1: potential stratification factor and therapeutic target for epithelial ovarian cancer. Onco Targets Ther 2016; 9:5203-8. [PMID: 27578986 PMCID: PMC5001671 DOI: 10.2147/ott.s109443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Epithelial ovarian cancer, a vexing challenge for clinical management, still lacks biomarkers for early diagnosis, precise stratification, and prognostic evaluation of patients. B-cell-specific Moloney murine leukemia virus integration site 1 (BMI1), a member of the polycomb group of proteins, engages in diverse cellular processes, including proliferation, differentiation, senescence, and stem cell renewal. In addition, BMI1, as a cancer stem-cell marker, participates in tumorigenesis through various pathways. Rewardingly, recent studies have also revealed a relationship between BMI1 expression and the clinical grade/stage, therapy response, and survival outcome in a majority of human malignancies, including epithelial ovarian cancer. Therefore, BMI1 might serve as a potential stratification factor and treatment target for epithelial ovarian cancer, pending evidence from further investigations.
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Affiliation(s)
- Qianying Zhao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Ting Gui
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Qiuhong Qian
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing; Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Shandong, People's Republic of China
| | - Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
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Bai H, Li H, Li W, Gui T, Yang J, Cao D, Shen K. The PI3K/AKT/mTOR pathway is a potential predictor of distinct invasive and migratory capacities in human ovarian cancer cell lines. Oncotarget 2016; 6:25520-32. [PMID: 26267321 PMCID: PMC4694849 DOI: 10.18632/oncotarget.4550] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/04/2015] [Indexed: 12/21/2022] Open
Abstract
Objectives To explore the genetic and molecular events that control subclones exhibiting distinct invasive/migratory capacities derived from human epithelial ovarian cancer (EOC) cell line A2780 and SKOV3. Methods Single-cell subclones were isolated and established that were derived from the SKOV3 and A2780 cell lines through limiting dilution methodology. Transwell insert assays and MTT assays were performed to screen and identify the subclones exhibiting the highest and the lowest invasive/migratory capacities, and the selected subclones were renamed as A-H (A2780 high), A-L (A2780 low), S-H (SKOV3 high), and S-L (SKOV3 low). Their biological characteristics were evaluated. RNA-Seq was conducted on the targeted subclones. Results Compared with their corresponding counterparts, A-H/S-H cells exhibited significantly higher invasive/migratory capacities (P < 0.001 and = 0.001, respectively). A-H/S-H cells displayed a clear reduction in doubling time (P = 0.004 and 0.001, respectively), and a significant increase in the percentage of cells in S phase (P = 0.004 and 0.022, respectively). Additionally, the apoptotic rates of A-H/S-H cells were significantly lower than those of A-L/S-L cells (P = 0.002 and 0.026, respectively). At both mRNA and protein levels, caspase-3 and caspase-7 expression were reduced but Bcl-2 expression was increased in A-H/S-H cells. The TrkB (anoikis-related) and Beclin1 (autophagy-related) levels were consistently high and low, respectively, in both A-H/S-H cells. Resistance to chemotherapy in vitro and higher capacities on tumor formation in vivo was presented in both A-H/S-H cells. PI3K/AKT/mTOR pathway components, PIK3CA, PIK3CD, AKT3, ECM1, GPCR, mTOR and PRKCB were increased but that the Nur77 and PTEN were decreased in A-H/S-H cells, identified by RNA-Seq and consistently confirmed by RT-PCR and Western blot analyses. Conclusions Heterogeneous cell subpopulations exhibiting distinct invasive and migratory capacities co-exist within the SKOV3 and A2780 cell lines. PI3K/AKT/mTOR pathway activation is associated with higher invasive and migratory capacities in subpopulations of human ovarian cancer cell lines. Inhibiting this pathway may be useful for the chemoprevention or treatment of EOC.
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Affiliation(s)
- Huimin Bai
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China.,Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, China Capital Medical University, Beijing China
| | - Haixia Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China
| | - Weihua Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China
| | - Ting Gui
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing China
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Bai H, Cao D, Yuan F, Wang H, Chen J, Wang Y, Shen K, Zhang Z. Occult invasive cervical cancer after simple hysterectomy: a multi-center retrospective study of 89 cases. BMC Cancer 2016; 16:507. [PMID: 27439407 PMCID: PMC4955116 DOI: 10.1186/s12885-016-2480-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 07/01/2016] [Indexed: 11/11/2022] Open
Abstract
Background Occult invasive cervical cancer (OICC) is sometimes incidentally found in surgical specimens after a simple hysterectomy (SH). This study was aimed at identifying a subset of patients with OICC who have a favorable prognosis. This patient group may not require adjuvant radiotherapy and other procedures. Methods The medical records of women in whom OICC was detected after an inadvertent SH were retrospectively reviewed. The relevant data, including clinicopathological characteristics, treatment and clinical outcome were evaluated. The primary and secondary endpoints were overall survival (OS) and relapse-free survival (RFS), respectively. Results Eighty-nine patients who met the inclusion criteria were included for analysis, and the risk of OICC was found to be 1.9 %. Finding an invasive cancer in a hysterectomy specimen after a conization procedure that shows positive margins was the most common reason (41.6 %) for the performance of inadvertent SH. In the univariate analysis, a tumor width > 20 mm, deep stromal invasion, and lymph node metastasis (LNM) were adversely associated with relapse (P < 0.001, < 0.001, and = 0.001, respectively) and survival (P = 0.003, 0.004, and 0.027, respectively), although these parameters were not independently associated with patient prognoses in the multivariate analysis. In patients with a tumor width ≤ 20 mm and superficial stromal invasion in the observation subgroup, the 5-year RFS and 5-year OS were both 100 %, whereas they were 57.1 % and 66.7 %, respectively, in patients with a tumor size > 20 mm and deep stromal invasion in the radiotherapy or chemotherapy subgroup (P < 0.001, and = 0.008, respectively). Conclusions Simple observation after a lymphadenectomy procedure may be feasible in OICC patients with a tumor width ≤ 20 mm, superficial stromal invasion, a negative section margin in hysterectomy specimens, and no LNM.
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Affiliation(s)
- Huimin Bai
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fang Yuan
- Department of Obstetrics and Gynecology, the Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Huilan Wang
- Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jie Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yue Wang
- Department of Pathology, Beijing Chao-Yang Hospital Affiliated China Capital Medical University, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Bai H, Cao D, Yuan F, Wang H, Xiao M, Chen J, Cui Q, Shen K, Zhang Z. Accuracy of conization procedure for predicting pathological parameters of radical hysterectomy in stage Ia2-Ib1 (≤2 cm) cervical cancer. Sci Rep 2016; 6:25992. [PMID: 27181832 PMCID: PMC4867621 DOI: 10.1038/srep25992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 04/26/2016] [Indexed: 11/16/2022] Open
Abstract
The accuracy of conization for the prediction of radical hysterectomy (RH) pathological variables in patients with stage Ia2 to Ib1 (≤2 cm) cervical cancer was retrospectively evaluated in the present study. Endocervical or deep resection margin (RM) involvement in the conization specimens was found to be independently associated with residual disease in the hysterectomy specimens (P < 0.001, = 0.003, respectively). When a tumor width of >20 mm in the final RH pathology analysis was predicted by a tumor width of >2 mm or involvement of endocervical or deep RMs in the conization specimens, the sensitivity and negative predictive value (NPV) of conization were 98.2% and 95.2%, respectively. In addition, when deep stromal invasion in the final RH pathology analysis was predicted by deep stromal invasion or involvement of the endocervical or deep RMs in the conization specimens, the sensitivity and NPV of conization were 98.4% and 95.8%, respectively. The sensitivity and NPV of this prediction model for identifying LVSI in the final RH pathology analysis were both 100%. These findings suggest that conization variables and endocervical and deep resection margin statuses can be analyzed to effectively predict RH pathological parameters.
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Affiliation(s)
- Huimin Bai
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital affiliated with China Capital Medical University, Beijing, China.,Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, China
| | - Fang Yuan
- Department of Obstetrics and Gynecology, the Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Huilan Wang
- Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meizhu Xiao
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital affiliated with China Capital Medical University, Beijing, China
| | - Jie Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, China
| | - Quancai Cui
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, China
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital affiliated with China Capital Medical University, Beijing, China
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Bao L, Mohan G, Alexander J, Doo C, Shen K, Chan L. 495 The molecular mechanism for IL-4 down-regulation of loricrin expression in atopic dermatitis is through sequestration of the coactivator CBP in the Jak-Stat6 pathway. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhou W, Zhu L, Zhou H, Shen K, Lang J, Cui Q, Shi H. The efficacy of high-intensity, focused ultrasound treatment for non-neoplastic epithelial disorders of the vulva. Cell Mol Biol (Noisy-le-grand) 2016; 62:111-115. [PMID: 27188744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 04/19/2016] [Indexed: 06/05/2023]
Abstract
Non-neoplastic epithelial disorders of the vulva (NNEDV) are common types of vulval lesions. Although corticosteroids represent a first-line treatment for NNEDV, concerns exist about the safety associated with long-term topical corticosteroid use. Recently, several clinical trials have identified high-intensity focused ultrasound (HIFU) as a promising treatment modality for NNEDV. The aim of this multi-center, randomized, controlled clinical trial was to investigate the efficacy of HIFU therapy in women with NNEDV based on histological alterations. We enrolled patients who were clinically diagnosed with NNEDV. They were randomized into 2 treatment groups: 1) halcinonide for 3 months or 2) HIFU once. A total of 123 patients were biopsied both prior to and after the therapy, and 62 and 61 patients were assigned to the HIFU and halcinonide groups, respectively. The histological changes were then analyzed. After the treatments, the therapeutic effects were observed in both groups. Comparing the diagnosis and alterations in lichenoid and sclerotic patterns and in chronic inflammation, we found statistically significant differences. Furthermore, when compared with the halcinonide group, the HIFU group exhibited enhanced curative effects that were statistically significant (P = 0.039). Based on the histological evidence from this randomized, controlled trial, HIFU represents an effective method for the treatment of NNEDV.
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Affiliation(s)
- W Zhou
- Chinese Academy of Medical Sciences Department of Pathology, Peking Union Medical College Hospital Beijing China
| | - L Zhu
- Chinese Academy of Medical Sciences Department of Gynecology and Obstetrics, Peking Union Medical College Hospital Beijing China
| | - H Zhou
- Chinese Academy of Medical Sciences Department of Gynecology and Obstetrics, Peking Union Medical College Hospital Beijing China
| | - K Shen
- Chinese Academy of Medical Sciences Department of Gynecology and Obstetrics, Peking Union Medical College Hospital Beijing China
| | - J Lang
- Chinese Academy of Medical Sciences Department of Gynecology and Obstetrics, Peking Union Medical College Hospital Beijing China
| | - Q Cui
- Chinese Academy of Medical Sciences Department of Pathology, Peking Union Medical College Hospital Beijing China
| | - H Shi
- Chinese Academy of Medical Sciences Department of Gynecology and Obstetrics, Peking Union Medical College Hospital Beijing China
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137
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Yang J, Shen K, Wang J, Yang J, Cao D. Extrafascial hysterectomy after concurrent chemoradiotherapy in locally advanced cervical adenocarcinoma. J Gynecol Oncol 2016; 27:e40. [PMID: 27102248 PMCID: PMC4864516 DOI: 10.3802/jgo.2016.27.e40] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 02/02/2016] [Accepted: 03/29/2016] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate whether adjuvant simple hysterectomy after concurrent chemoradiotherapy (CCRT) improves progression-free survival (PFS) compared with current standard care in locally advanced cervical adenocarcinoma (LACAC). Methods We reviewed a cohort of 55 patients with LACAC (International Federation of Gynecology and Obstetrics [FIGO] stage IB2, IIA2, IIB, III without distant metastasis) diagnosed and treated with radical CCRT at Peking Union Medical College Hospital between January 2004 and October 2014. We compared 34 patients who underwent adjuvant extrafascial hysterectomy with 21 patients with standard care after CCRT. The primary outcome was PFS. Overall survivals (OS) between the two groups were also compared. Surgery feasibility, operative complications, and pathologic features after radiation therapy were also analyzed. Results PFS was significantly improved in surgery group (log-rank p=0.0097; hazard ratio [HR], 0.3431; 95% CI, 0.152 to 0.772), as were OS (log-rank p=0.0419; HR, 0.3667; 95% CI, 0.139 to 0.964). Analysis of stage IIB demonstrates a similar result. There were no severe complications related to postradiation surgery in this series. The mean blood loss was less in laparoscopic group than those in the open group (87 mL vs. 208 mL, p=0.036, Mann-Whitney U-test). Approximately 47% patients (16/34) had pathologic residue tumor on hysterectomy specimens. About 94% patients (32/34) got complete remission after adjuvant surgery. Conclusion Adjuvant hysterectomy after CCRT improves survival outcome for patients with LACAC compared with current standard care. Extrafascial hysterectomy is sufficient in tumor reduction and laparoscopic procedure may be more promising with lower blood loss and expedite recovery.
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Affiliation(s)
- Jie Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
| | - Jinhui Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
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138
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Liu S, Jiang X, Li W, Cao D, Shen K, Yang J. Inhibition of the long non-coding RNA MALAT1 suppresses tumorigenicity and induces apoptosis in the human ovarian cancer SKOV3 cell line. Oncol Lett 2016; 11:3686-3692. [PMID: 27313681 PMCID: PMC4888020 DOI: 10.3892/ol.2016.4435] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 03/18/2016] [Indexed: 12/26/2022] Open
Abstract
Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is a 8,000 nucleotide-long, spliced non-coding RNA, which has been reported to be deregulated in several tumors. However, to the best of our knowledge, the role of MALAT1 in ovarian cancer has not been previously investigated. The aim of the present study was to investigate the effect of MALAT1 inhibition on the tumorigenity of SKOV3 cells. First, stable MALAT1-knockdown ovarian cancer cells and control cells were established using lentivirus-mediated artificial micro RNA interference in order to investigate the effect of MALAT1 inhibition on cell viability, clonability, migration, invasion and apoptosis in vitro. In addition, the effect of MALAT1 on cell growth in nude mice was assessed. To identify the possible targets of MALAT1, total RNA was extracted from MALAT1-knockdown cells and control cells and a microarray analysis was performed. The results showed that MALAT1 inhibition significantly suppressed tumorigenity in vitro and in vivo (P<0.01). Compared with the control cells, 921 genes in the MALAT1-knockdown cells were deregulated by at least two-fold. The results of the reverse transcription-quantitative polymerase chain reaction showed that 19 of the 20 genes selected for validation confirmed the deregulation indicated by the microarray analysis. The findings define a major oncogenic role for MALAT1, which may offer an attractive novel target for therapeutic intervention in ovarian cancer.
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Affiliation(s)
- Shiping Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R China
| | - Xuan Jiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R China
| | - Weihua Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R China
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139
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Bai H, Cao D, Yang J, Li M, Zhang Z, Shen K. Genetic and epigenetic heterogeneity of epithelial ovarian cancer and the clinical implications for molecular targeted therapy. J Cell Mol Med 2016; 20:581-93. [PMID: 26800494 PMCID: PMC5125785 DOI: 10.1111/jcmm.12771] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 11/26/2015] [Indexed: 12/12/2022] Open
Abstract
Epithelial ovarian cancer (EOC) is the most lethal gynaecological malignancy, and tumoural heterogeneity (TH) has been blamed for treatment failure. The genomic and epigenomic atlas of EOC varies significantly with tumour histotype, grade, stage, sensitivity to chemotherapy and prognosis. Rapidly accumulating knowledge about the genetic and epigenetic events that control TH in EOC has facilitated the development of molecular-targeted therapy. Poly (ADP-ribose) polymerase (PARP) inhibitors, designed to target homologous recombination, are poised to change how breast cancer susceptibility gene (BRCA)-related ovarian cancer is treated. Epigenetic treatment regimens being tested in clinical or preclinical studies could provide promising novel treatment approaches and hope for improving patient survival.
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Affiliation(s)
- Huimin Bai
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Menghui Li
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Ye S, Yang J, You Y, Cao D, Huang H, Wu M, Chen J, Lang J, Shen K. Clinicopathologic Significance of HNF-1β, AIRD1A, and PIK3CA Expression in Ovarian Clear Cell Carcinoma: A Tissue Microarray Study of 130 Cases. Medicine (Baltimore) 2016; 95:e3003. [PMID: 26945423 PMCID: PMC4782907 DOI: 10.1097/md.0000000000003003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Ovarian clear cell carcinoma (CCC) is a distinct histologic subtype with relatively poor survival. No prognostic or predictive molecular marker is currently available. Recent studies have shown that AT-rich interactive domain 1A (ARID1A) and phosphatidylinositol 3-kinase catalytic subunit alpha (PIK3CA) mutations are common genetic changes in ovarian CCC. Hepatocyte nuclear factor-1β (HNF-1β) expression has been proven to be highly sensitive and specific for clear cell histology. However, the correlations between these biomarkers and clinicopathologic variables and survival outcomes are controversial. The immunohistochemical analysis for HNF-1β, ARID1A, and PIK3CA was performed on a tissue microarray (TMA) consisting of 130 cases of ovarian CCC (237 tissue blocks) linked with clinical information. The immunostaining results were interpreted in a manner consistent with previous publications. The associations between biomarker expression and clinical and prognostic features were examined. All statistical analyses were conducted using 2-sided tests, and a value of P < 0.05 was considered significant. HNF-1β was expressed in 92.8% of all primary ovarian tumors, while the loss of ARID1A and PIK3CA was noted in 56.2% and 45.0%, respectively. Early-stage tumors tended to have high levels of HNF-1β immunoreactivity and expression of ARID1A (P = 0.02 and P = 0.03). Most patients (76.9%, 20/26) with concurrent endometriosis stained negative for ARID1A (P = 0.02). No relation was found between PIK3CA expression and clinical features. Low-level HNF-1β expression and loss of ARID1A were more commonly observed in patients with tumor recurrence (P = 0.02 and P < 0.001). Antibody expression was not associated with platinum-based chemotherapy response. Patients with negative ARID1A expression had worse survival outcome in terms of both overall survival (OS) and progression-free survival (PFS) (P = 0.03 and P = 0.01, respectively). On the contrary, patients with high-level HNF-1β were associated with good prognosis (P = 0.02 for OS and P = 0.01 for PFS). PIK3CA expression had no impact on survival. For univariate and multivariate analyses, only HNF-1β expression seemed to be a prognostic factor for favorable OS (P = 0.04). The loss of ARID1A was correlated with late-stage and endometriosis-associated tumors. The measurement of ARID1A expression might be a method to predict the risk of recurrence. Among the 3 biomarkers, only high-level HNF-1β expression proved to be a positive predictor for OS.
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Affiliation(s)
- Shuang Ye
- From the Department of Obstetrics and Gynecology (SY, JY, DC, HH, MW, JL, KS) and Department of Pathology (YY, JC), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Isaacs C, O'Regan R, Xu B, Masuda N, Arena F, Yap YS, Papai Z, Lang I, Armstrong A, Lerzo G, White M, Shen K, Zhang Y, Jappe A, Pacaud LB, Taran T, Ozguroglu M. Abstract P4-13-12: Everolimus plus trastuzumab and vinorelbine for trastuzumab-resistant, taxane-pretreated, HER2+ advanced breast cancer: Overall survival results from BOLERO-3. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
PI3K/AKT/mTOR pathway activation due to PTEN loss may lead to trastuzumab (TRAS) resistance. mTOR inhibition has been shown to restore TRAS sensitivity in PTEN-deficient tumors. This provided the rationale for the BOLERO-3 trial which evaluated the combination of everolimus (EVE), an mTOR inhibitor, plus TRAS and a taxane in HER2+ advanced breast cancer (ABC). The addition of EVE to TRAS plus vinorelbine (VNB) led to a statistically significant prolongation of 1.2 months in median progression free survival (PFS) vs TRAS plus VNB in patients with TRAS-resistant and taxane-pretreated, HER2+ ABC (7.0 months vs 5.78 months; hazard ratio, 0.78; p=0.0067). The final overall survival (OS) analysis from this study is presented here.
Materials and methods
BOLERO-3 is a randomized, double-blind, placebo-controlled, phase 3 trial. Women with HER2+ ABC progressing on prior TRAS and taxane therapy were randomized (1:1) to receive either daily EVE (5 mg) or PBO plus weekly TRAS (2 mg/kg) and VNB (25 mg/m2), in 3-week cycles, stratified by previous lapatinib use. The primary endpoint was PFS by local investigator assessment. Overall survival was a key secondary endpoint.
Results
Overall, 569 patients were enrolled; 284 patients received EVE and 285 patients received PBO. As of April 1, 2015, after a median follow-up of 44.7 months, 388 deaths had occurred, 191 (67.3%) in the EVE arm and 197 (69.1%) in the PBO arm. The median OS in the EVE arm vs PBO arm was 23.5 months vs 24.1 months (HR = 0.96; 95% CI, 0.79-1.17; p = 0.3392). In the HR+ subgroup, the median OS with EVE was 23.5 months (vs 25.5 months with PBO; HR = 1.03; 95% CI, 0.79-1.35); in the HR subgroup, the median OS with EVE was 22.9 months (vs 23.1 months with PBO; HR = 0.86; 95% CI, 0.64-1.17). AEs leading to treatment discontinuation were reported in 81 (28.9%) vs 46 (16.3%) patients in the EVE vs PBO arms. Serious adverse events (SAEs) were reported in 122 (43.6%) vs 58 (20.6%) patients in the EVE vs PBO arms. Overall, 14 on-treatment deaths were observed, 7 (2.5%) in the EVE arm and 7 (2.5%) in the PBO arm; on-treatment deaths due to AEs were balanced between treatment arms (0.7% in each treatment arm). Types of post-progression therapies were balanced across both treatment arms.
Conclusions
In BOLERO-3, EVE showed a statistically significant prolongation of PFS. OS was similar in both treatment arms. The safety profile of EVE was comparable to that observed previously with EVE in breast cancer. (Funded by Novartis; BOLERO-3 ClinicalTrials.gov number, NCT01007942.)
Citation Format: Isaacs C, O'Regan R, Xu B, Masuda N, Arena F, Yap Y-S, Papai Z, Lang I, Armstrong A, Lerzo G, White M, Shen K, Zhang Y, Jappe A, Pacaud LB, Taran T, Ozguroglu M. Everolimus plus trastuzumab and vinorelbine for trastuzumab-resistant, taxane-pretreated, HER2+ advanced breast cancer: Overall survival results from BOLERO-3. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-12.
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Affiliation(s)
- C Isaacs
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - R O'Regan
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - B Xu
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - N Masuda
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - F Arena
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - Y-S Yap
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - Z Papai
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - I Lang
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - A Armstrong
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - G Lerzo
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - M White
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - K Shen
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - Y Zhang
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - A Jappe
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - LB Pacaud
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - T Taran
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
| | - M Ozguroglu
- Lombardi Comprehensive, Cancer Center, Georgetown, University, Washington, DC, DC; University of Wisconsin, Madison, Wisconsin; Cancer Hospital, and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; NHO Osaka National Hospital, Chuou-ku, Osaka, Japan; NYU Langone Arena Oncology, Lake Success, NY; National Cancer Centre Singapore, Singapore; Military Hospital, Budapest, Hungary; Orszagos Onkologiai Intezet, Budapest, Hungary; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; Sanatorio de la Providencia, Buenos Aires, Argentina; Monash Medical Center, Moorabbin Hospital, Bentleigh East, VIC, Australia; Cabrini Brighton Hospital, Brighton, VIC, Australia; Comprehensive Breast Health Center, RuiJin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; Novartis Pharmaceuticals Corporation, East Hanover; Novartis Pharma AG, Basel, Switzerland; Istanbul University, Istanbul, Turkey
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Huang J, Chen X, Shen K, Li Y, Chen W, He J, Zhu L, Huang O, Zong Y, Fei X, Jin X. Abstract P3-01-13: Risk factors of non-sentinel lymph node metastasis in breast cancer patients with metastatic sentinel lymph node. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-01-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective To study the factors influencing the non-sentinel lymph node(NSLN) status and to assess Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram performance in predicting SLN metastases in a sentinel lymph node(SLN) positive Chinese breast cancer population. Methods Data were collected from breast cancer patients who were diagnosed with pathological positive sentinel lymph node and received further axillary lymph node dissection(ALND) in Shanghai Ruijin Hospital from January 2011 to August 2014. Use MSKCC nomogram to calculate each patient's NSLN metastasis risk score. The receiver operator characteristic curve(ROC curve)and the area under the ROC curve(AUC)was used to assess the predictive accuracy of the model. Results Among the 1147 patients who received sentinel biopsy in our center, 150 SLN positive patients who received ALND were enrolled in this study. By univariate analysis, multifocal breast cancer (P = 0.017), SLN+/SLN ratio (P = 0.010) and axillary lymphadenopathy displayed by ultrasound(P = 0.005) are the influencing factors of NSLN metastases. By multivariate analysis, multifocal breast cancer (OR 7.25, 95% CI 1.73∼30.43, P = 0.007), SLN+/SLN ratio≥0.5 (OR 2.564, 95% CI 1.22∼5.39, P = 0.013) and axillary lymphadenopathy displayed by ultrasound (OR 2.471, 95% CI 1.18∼5.19, P = 0.017) are the independent influencing factors of NSLN metastases. The AUC of MSKCC nomogram in this population is 0.677. Conclusion For breast cancer patients with positive sentinel lymph node, multifocality, SLN+/SLN ratio and axillary lymphadenopathy displayed by ultrasound is related to NSLN metastasis. MSKCC has low accuracy in predicting NSLN status of this population.
Citation Format: Huang J, Chen X, Shen K, Li Y, Chen W, He J, Zhu L, Huang O, Zong Y, Fei X, Jin X. Risk factors of non-sentinel lymph node metastasis in breast cancer patients with metastatic sentinel lymph node. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-01-13.
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Affiliation(s)
- J Huang
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - X Chen
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - K Shen
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Y Li
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - W Chen
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - J He
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - L Zhu
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - O Huang
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Y Zong
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - X Fei
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - X Jin
- Comprehensive Breast Health Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
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Gui T, Qian Q, Cao D, Yang J, Peng P, Shen K. Computerized tomography angiography in preoperative assessment of intravenous leiomyomatosis extending to inferior vena cava and heart. BMC Cancer 2016; 16:73. [PMID: 26858203 PMCID: PMC4746779 DOI: 10.1186/s12885-016-2112-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 02/03/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intravenous leiomyomatosis (IVL) extending to inferior vena cava and heart is one of the most challenging conditions for surgical treatment. We explored the use of computerized tomography angiography (CTA) in preoperative assessment for this disease. METHODS A cohort of 31 patients with IVL extending to inferior vena cava and heart were reviewed from the year 2002 to 2014, focusing on the preoperative CTA imaging characteristics and the surgical procedures in clinical treatment. RESULTS All patients were diagnosed correctly combining the clinical medical history and CTA imaging. Thirteen patients had tumors confined within the inferior vena cava, and 18 patients had tumors intruding into the right heart. Furthermore, 15 tumors were located in the right atrium alone, and 3 tumors involved both the right atrium and the right ventricle. All patients had simple or multiple soft tissue masses from the pelvis, with 22 tumors extending into inferior vena cava through the iliac veins and 9 tumors through the ovarian veins. Three patients had tumors invading into lung and underwent tumor thrombus resection in the pulmonary artery. Patients received either one-stage surgery or two-stage surgery dependent on patient general condition and tumor status. All operations were successfully performed by multidisciplinary cooperation, including gynecology, cardiac surgery, and vascular surgery, without severe surgical-related complications or deaths. CONCLUSIONS CTA imaging can present location, size, and full-scale extension pathway of IVL lesions, and can be used as first-line imaging technique in preoperative assessment, having great significance in making surgical plan and obtaining successful outcome.
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Affiliation(s)
- Ting Gui
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Qiuhong Qian
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Ping Peng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Zong LJ, Zhang YZ, Yang XS, Jiang J, Cui BX, Qiao YB, Li L, Jiang K, Zhang WJ, Kong BH, Shen K. Evaluation of several screening approaches for detection of cervical lesions in rural Shandong, China. Asian Pac J Cancer Prev 2016; 16:1907-12. [PMID: 25773843 DOI: 10.7314/apjcp.2015.16.5.1907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The study was designed to: (1) investigate the prevalence of high-risk human papillomavirus (HR- HPV) infection and cervical neoplasia; and (2) evaluate clinical performance of visual inspection with acetic acid/ Lugol's iodine (VIA /VILI), Pap smear, high-risk human papillomavirus (HR-HPV) DNA test for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and (3) explore appropriate screening approach in rural areas of Shandong Province. MATERIALS AND METHODS A total of 3,763 eligible women from Yiyuan County in Yimeng mountainous areas of rural Shandong, China, were enrolled and underwent Pap smear, HR-HPV DNA testing by Hybrid Capture 2 (HC2), and VIA /VILI tests. Women positive in any test were referred to colposcopy and biopsy as indicated. RESULTS The prevalence of HR-HPV infection among all enrolled women was 11.1% and that in healthy women was 9.9%. In total 33 cases of CIN1, 16 cases of CIN2, 6 cases of CIN3 but none of cervical cancer were detected and the crude prevalence of CIN2+ was 0.58%. For detecting CIN2+, the sensitivity of HR-HPV DNA testing, VIA/VILI, Pap smear was 90.9%, 77.3%, 81.8%, respectively. Pap smear had the best specificity of 98.2%, followed by HR-HPV DNA testing with specificity of 89.4%, VIA/VILI had the lowest specificity of 81.2%. Colposcopy referral rate of HR-HPV DNA testing, VIA/VILI, Pap smear was 11.1%, 18.5%, 2.3%, respectively. CONCLUSIONS Our results suggest that HR-HPV DNA testing alone might be appropriate for primary cervical cancer screening in rural low-resource areas of Shandong Province, China.
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Affiliation(s)
- Li-Ju Zong
- Department of Gynecology and Obstetrics, Qilu Hospital of Shandong University, Jinan, People's Republic of China E-mail
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Ye S, Zhang W, Yang J, Cao D, Huang H, Wu M, Lang J, Shen K. Pattern of Venous Thromboembolism Occurrence in Gynecologic Malignancy: Incidence, Timing, and Distribution a 10-Year Retrospective Single-institutional Study. Medicine (Baltimore) 2015; 94:e2316. [PMID: 26683971 PMCID: PMC5058943 DOI: 10.1097/md.0000000000002316] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this single-institutional 10-year retrospective study was to investigate the clinical pattern (incidence, type, timing, and location) of venous thromboembolism (VTE) in Chinese patients with gynecologic cancer. Cases were identified by searching institutional Electronic Discharge Database. A comprehensive review of medical documentation was then performed to collect relevant data. The detection of VTE was symptom-triggered. A total of 155 VTE events were identified out of 7562 cases over the past 10-year period in our hospital. The incidence of clinically significant VTE was 2.0% in gynecologic malignancy, with vulvar cancer (3.7%) and ovarian cancer (2.5%) being the high-risk types (P = 0.01, Chi-square test). Perioperative period (35.1%) and preoperation (29.1%) were the 2 incidence peaks. Seventeen cases of pulmonary embolism (PE) occurred prior to surgery. Ovarian cancer patients were more likely to present preoperative PE compared to other site of cancer (76.4%; P = 0.01, Chi-square test). More preoperative VTE cases were complicated by PE than those in the perioperative period (39.5% vs 17.3%, P = 0.02, Chi-square test). Bilateral lower extremity deep vein thrombosis (DVT) accounted for 32.6% and there existed a preponderance of left-sided DVT (47.5% vs 17.0%, ratio 2.79:1). Femoral vein (36.6%) was the most common location for DVT. About 2.0% of the Chinese patients with gynecologic carcinoma developed clinical VTE, mostly during perioperative period and the time of diagnosis. The true incidence might have been under-estimated due to several reasons. The need for increased patient education and awareness of VTE is of importance.
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Affiliation(s)
- Shuang Ye
- From the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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146
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Xu Z, Li B, Zhang Y, Shen K. Long-term non-invasive ventilation at home in children: Beijing experience. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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147
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Zhang W, Zeng A, Yang J, Cao D, He X, Wang X, You Y, Chen J, Lang J, Shen K. Outcome of vulvar reconstruction in patients with advanced and recurrent vulvar malignancies. BMC Cancer 2015; 15:851. [PMID: 26542779 PMCID: PMC4635970 DOI: 10.1186/s12885-015-1792-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 10/15/2015] [Indexed: 11/10/2022] Open
Abstract
Background The use of flaps in vulvar cancer-related reconstruction has been increasing, but few studies have evaluated the outcome and quality of life of patients after this surgery. The purpose of this study was to evaluate the outcomes of vulvar reconstruction using musculocutaneous/skin flaps in patients with advanced and recurrent vulvar malignancies. Methods Patients with vulvar malignancies who underwent vulvar reconstruction using different types of flaps were retrospectively reviewed. Patient outcomes were evaluated with a focus on quality of life and prognosis. Results Thirty-six patients were enrolled, 58.33 % of them used anterolateral thigh flap (ALT), 16.67 % of them used pudendal thigh flap (PTF), 11.11 % of them used deep omferior epigastric perforator (DIEP) and gracilis myocutaneous flap were used in 2.78 % of the patients, the other 11.11 % patients used two types of flaps. Eleven patients (30.56 %) developed complications, including 5 patients (13.89 %) with partial necrosis, 5 (13.89 %) with minimal wound dehiscence and 1 (2.78 %) with flap cellulitis. All patients who developed partial necrosis (13.89 %) underwent reoperation. The mean verbal rating scale score was 1.44 before reconstruction and 0.17 after surgery (P < 0.0001). The mean performance status was 1.67 before surgery and improved to 0.31 after surgery (P < 0.0001). The median overall follow-up time after vulvar reconstruction was 9 months. Twenty-one patients (58.3 %) developed recurrence at a median interval of 5 months after vulvar reconstruction. After a median follow-up time of 14 months, 41.7 % of the patients were living and disease-free. The 5-year survival of the 36 patients was 53.8 %. Conclusion Soft tissue reconstruction in patients undergoing resection of advanced/recurrent vulvar malignances is associated with a low rate of postoperative complications, decreased pain, and improved functional status. Although the recurrence rate in this patient population is high, a reasonable proportion of patients who undergo resection for advanced/recurrent vulvar cancer and reconstructive surgery appear to benefit.
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Affiliation(s)
- Wei Zhang
- Departments of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No.1,Dongcheng District, Beijing, 100730, China.
| | - Ang Zeng
- Departments of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jiaxin Yang
- Departments of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No.1,Dongcheng District, Beijing, 100730, China.
| | - Dongyan Cao
- Departments of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No.1,Dongcheng District, Beijing, 100730, China.
| | - Xiaodong He
- Departments of General Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Xiaojun Wang
- Departments of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Yan You
- Departments of Pathology,
- Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jie Chen
- Departments of Pathology,
- Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jinghe Lang
- Departments of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No.1,Dongcheng District, Beijing, 100730, China.
| | - Keng Shen
- Departments of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shuaifuyuan No.1,Dongcheng District, Beijing, 100730, China.
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148
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Sun Y, Li S, Shen K, Ye S, Cao D, Yang J. DAPK1, MGMT and RARB promoter methylation as biomarkers for high-grade cervical lesions. Int J Clin Exp Pathol 2015; 8:14939-14945. [PMID: 26823825 PMCID: PMC4713611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/22/2015] [Indexed: 06/05/2023]
Abstract
Gene promoter methylation may be used a potential biomarker for detecting solid tumor including cervical cancer. Here, we used methylation sensitive-high resolution melting (MS-HRM) analysis to detecting promoter methylation ratios of DAPK1, MGMT and RARB gene in patients with different cervical disease grade. The detection of gene promoter methylation was conducted in two hundred fifty patients' samples including normal cytology (n=48), cervical intraepithelial neoplasia grade 1 (CIN1, n=54), cervical intraepithelial neoplasia grade 2 (CIN2, n=47), cervical intraepithelial neoplasia grade 3 (CIN3, n=56) and cervical squamous cell carcinomas (SCS, n=45). We found there were a significant positive correlation between the promoter methylation status of DAPK1 and cervical disease grade (P=0.022). In addition, the methylated promoters of DAPK1 combined with MGMT, MGMT combined with RARB, DAPK1 combined with RARB were positive correlated with cervical disease grade (P < 0.05). All three genes promoters methylated were positive correlated with cervical disease grade (P < 0.001). Receiver operating characteristic (ROC) curves was conducted to evaluate whether the three genes methylation could be used to be a potential marker for diagnosing high grade cervical disease (HSIL and SCC). The cutoff values for the methylation rates of all these genes were 0-5%. Regrettably, only the methylation of MGMT combined with DAPK1 gave 43.4% sensitivity and 68.6% specificity. The current results indicated that MS-HRM-based testing for DNA methylations of MGMT plus DAPK1 genes holds some promise for high grade cervical disease screening.
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Affiliation(s)
- Yin Sun
- Department of O&G, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science & Peking Union Medical CollegeChina
| | - Shu Li
- Department of O&G, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science & Peking Union Medical CollegeChina
| | - Keng Shen
- Department of O&G, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science & Peking Union Medical CollegeChina
| | - Shuang Ye
- Fudan University Shanghai Cancer Center, OncologyChina
| | - Dongyan Cao
- Fudan University Shanghai Cancer Center, OncologyChina
| | - Jiaxin Yang
- Fudan University Shanghai Cancer Center, OncologyChina
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149
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Li WH, Cao DY, Shen K, Yang JX. A Rare Case of Ovarian Cancer Presenting with Paraneoplastic Cerebellar Degeneration and Limbic Encephalitis. Chin Med J (Engl) 2015; 128:2685-7. [PMID: 26415811 PMCID: PMC4736848 DOI: 10.4103/0366-6999.166028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | | | - Jia-Xin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
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150
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Jiang Q, Huang H, Liu Q, Sun J, Zhou H, Fan Z, Zhang Y, Huang F, Chai Y, Xu D, Lu Y, Wei Q, Yu G, Li X, Dai M, Xu N, Zhou D, Zhao H, Shen K, Mai Q, Zhou Y, Meng F. Continuous IV infusion of MESNA can prevent hemorrhagic cystitis in HSCT and retain MESNA concentration in urine. Bone Marrow Transplant 2015; 50:1490-2. [PMID: 26367223 DOI: 10.1038/bmt.2015.197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Q Jiang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - H Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Q Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - J Sun
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - H Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Z Fan
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y Zhang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - F Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y Chai
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - D Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y Lu
- First Clinical Hospital, Southern Medical University, Guangzhou, China
| | - Q Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - G Yu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X Li
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - M Dai
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - N Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - D Zhou
- First Clinical Hospital, Southern Medical University, Guangzhou, China
| | - H Zhao
- First Clinical Hospital, Southern Medical University, Guangzhou, China
| | - K Shen
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Q Mai
- First Clinical Hospital, Southern Medical University, Guangzhou, China
| | - Y Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - F Meng
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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