Surgical treatment and outcome of early invasive adenocarcinoma of the uterine cervix (FIGO stage IA1)

Oncologic and obstetric outcomes after conization for adenocarcinoma in situ or stage IA1 cervical cancer

This study aims to reveal the risk factors associated with recurrence or new-onset high-grade squamous intraepithelial lesions (HSILs) or more severe lesions (HSILs +) and analyze obstetrical outcomes in patients with adenocarcinoma in situ (AIS) or stage IA1 cervical cancer patients after conization. A retrospective cohort study was developed from January 1, 2002, and July 1, 2018, in a single center, where all patients with AIS or stage IA1 cervical cancer who accepted conization for primary surgery were reviewed and followed up until July 1, 2019, for the pathological findings of HSILs + and obstetric outcomes. Two hundred and seventeen patients were identified, including 114 cases of AIS, 76 cases of stage IA1 squamous cell carcinoma (SCC) and 27 cases of stage IA1 adenocarcinoma (ADC). A total of 88 (40.6%) patients had an intact uterus without radiotherapy. Five patients experienced HSIL+ recurrence. The cumulative 3-, 5- and 10-year incidence rates of HSILs + were 1.0%, 1.5% and 2.0%, respectively. No significant risk factors, including primary disease, margin status and hysterectomy, were associated with recurrence. Twenty (66.7%) of 30 patients who attempted pregnancy had 23 successful pregnancies, which result in 7 miscarriages, 16 live births and 5 preterm births. Age at conization was the only independent risk factor associated with pregnancy, live births and preterm births. In conclusion, conization is safe for young women with AIS, stage IA1 SCC and ADC who desire future fertility, and the associated HSIL recurrence rate is low. Increased age significantly lowered the conception or live birth rate.

Analysis of CASP12 diagnostic and prognostic values in cervical cancer based on TCGA database

The present study aims to find a differential protein-coding gene caspase 12 (CASP12) in cervical cancer (CC) based on the (TCGA) database and verify its clinical diagnostic and prognostic values. The transcriptome and clinicopathological data of CC were downloaded from the TCGA database and through screening, we found that PDE2A and CASP12 were independent prognostic factors for CC patients. According to the median expression, the patients were divided into groups with high and low CASP12 and PDE2A expression. There was no difference in survival between PDE2A high and low expression groups (P=0.099), whereas there was a significant difference between CASP12 high and low expression groups (P=0.033). The serum from 68 CC patients (experimental group) and 50 healthy people (control group) was collected to detect the relative expression of CASP12 using qRT-PCR and plotted the ROC curve. The relative expression of CASP12 in the experimental group was significantly lower than in the control group (P<0.05). The area under the curve (AUC) of CASP12 was 0.865. There were statistically significant differences between CASP12 groups with high and low expression in terms of differentiation, lymph node metastasis, tumor size, FIGO staging, and clinical outcomes (P<0.05), but not in terms of age, HPV types and pathological types (P>0.05). The 3-year survival in the CASP12 low expression group was significantly worse than in the CASP12 high expression group (P=0.028). In conclusion, the expression level of CASP12 can be used as a diagnostic and prognostic biomarker for patients with CC.