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Qu W, Hua C, Wang Y, Wang Y, Zhang L, Wang Z, Shi W, Chen F, Wu Z, Wang Q, Lu L, Jiang S, Sui L, Li Y. Lineage Replacement and Genetic Changes of Four HR-HPV Types during the Period of Vaccine Coverage: A Six-Year Retrospective Study in Eastern China. Vaccines (Basel) 2024; 12:411. [PMID: 38675793 PMCID: PMC11053858 DOI: 10.3390/vaccines12040411] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE This study aimed to provide clinical evidence for lineage replacement and genetic changes of High-Risk Human Papillomavirus (HR-HPV) during the period of vaccine coverage and characterize those changes in eastern China. METHODS This study consisted of two stages. A total of 90,583 patients visiting the Obstetrics and Gynecology Hospital of Fudan University from March 2018 to March 2022 were included in the HPV typing analysis. Another 1076 patients who tested positive for HPV31, 33, 52, or 58 from November 2020 to August 2023 were further included for HPV sequencing. Vaccination records, especially vaccine types and the third dose administration time, medical history, and cervical cytology samples were collected. Viral DNA sequencing was then conducted, followed by phylogenetic analysis and sequence alignment. RESULTS The overall proportion of HPV31 and 58 infections increased by 1.23% and 0.51%, respectively, while infection by HPV33 and 52 decreased by 0.42% and 1.43%, respectively, within the four-year vaccination coverage period. The proportion of HPV31 C lineage infections showed a 22.17% increase in the vaccinated group, while that of the HPV58 A2 sublineage showed a 12.96% increase. T267A and T274N in the F-G loop of HPV31 L1 protein, L150F in the D-E loop, and T375N in the H-I loop of HPV58 L1 protein were identified as high-frequency escape-related mutations. CONCLUSIONS Differences in epidemic lineage changes and dominant mutation accumulation may result in a proportional difference in trends of HPV infection. New epidemic lineages and high-frequency escape-related mutations should be noted during the vaccine coverage period, and regional epidemic variants should be considered during the development of next-generation vaccines.
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Affiliation(s)
- Wenjie Qu
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
| | - Chen Hua
- Shanghai Institute of Infection Disease and Biosecurity, Shanghai Medical College, Fudan University, Shanghai 200032, China; (C.H.)
| | - Yaping Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
| | - Yan Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
- Qingpu Branch of the Yangtze River Delta Integrated Demonstration Zone, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200090, China
| | - Lu Zhang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
| | - Zhiheng Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
- Qingpu Branch of the Yangtze River Delta Integrated Demonstration Zone, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200090, China
| | - Wenqian Shi
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
| | - Fang Chen
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
| | - Zhiyong Wu
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
- Qingpu Branch of the Yangtze River Delta Integrated Demonstration Zone, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200090, China
| | - Qian Wang
- Shanghai Public Health Clinical Center, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, School of Basic Medical Sciences, Fudan University, Shanghai 201508, China
| | - Lu Lu
- Shanghai Public Health Clinical Center, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, School of Basic Medical Sciences, Fudan University, Shanghai 201508, China
| | - Shibo Jiang
- Shanghai Institute of Infection Disease and Biosecurity, Shanghai Medical College, Fudan University, Shanghai 200032, China; (C.H.)
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
| | - Yanyun Li
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China; (W.Q.)
- Qingpu Branch of the Yangtze River Delta Integrated Demonstration Zone, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200090, China
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Zhong F, Wang T, Li W, Zhang H, Zeng X, Geisler D, Zhou X, Cong Q, Sui L, Tao X, Zhao C. Associations of Single Versus Multiple Human Papillomavirus Infections With the Prevalence of Cervical Intraepithelial Neoplasia 2/3 and Squamous Cell Carcinoma Lesions: Human Papillomavirus Type-Specific Attribution. J Transl Med 2024; 104:100328. [PMID: 38237737 DOI: 10.1016/j.labinv.2024.100328] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/26/2023] [Accepted: 01/07/2024] [Indexed: 02/12/2024] Open
Abstract
The risk of developing cervical squamous lesions in women with multiple high-risk human papillomavirus (hrHPV) infections is uncertain. The aim of this retrospective study was to investigate the type-specific attribution and phylogenetic effects of single and multiple hrHPV subtypes in cervical squamous lesions. All cases with cervical histopathologic diagnosis and human papillomavirus (HPV) genotyping results in the 6 months preceding biopsy from October 2018 to December 2022 were studied and analyzed. Over the study period, 70,361 cases with histopathologic follow-up and prior HPV genotyping were identified. The hrHPV-positive rate was 55.6% (39,104/70,361), including single hrHPV detected in 27,182 (38.6%), 2 types of hrHPV detected in 8158 (11.6%), and 3 types of hrHPV detected in 2486 (3.5%). Among 16,457 cases with a histologically diagnosed squamous lesion (cervical intraepithelial neoplasia 1: 11411; cervical intraepithelial neoplasia 2/3: 4192; squamous cell carcinoma: 854 cases), the prevalence of single hrHPV infection increased, but the rate of multiple concomitant hrHPV infections showed negative association as the degree of squamous lesions increased. Among women with a single HPV16 infection, cervical intraepithelial neoplasia 2/3 and squamous cell carcinoma (CIN2+) diagnostic rate was 30.6%, and it increased to 47.6% when coinfected with HPV33 (P < .001) but significantly decreased when coinfected with all other hrHPV types (P < .05). By comparing CIN2+ diagnostic rates in 40 most common 2 types of hrHPV infections with related single hrHPV infection, CIN2+ rates were decreased in 12 combinations (30.0%), equivalent in 26 combinations (65.0%), and increased in 2 combinations (5.0%). The cases with 3 types of HPV infections reduced the risk for CIN2+ compared with related single HPV infections. HPV16+52+53, HPV16+52+68, HPV16+52+51, HPV16+39+52, and HPV16+58+53 significantly decreased the risk of CIN2+ compared with HPV16 single infection (P < .05). This study demonstrates that multiple hrHPV infections are not associated with cumulatively higher risk for CIN2+ development, suggesting that oncogenic progression of multiple hrHPV-associated cervical squamous lesions is neither synergistic nor a cumulative effect at the phylogenetic level, possibly a way of competitive interference.
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Affiliation(s)
- Fangfang Zhong
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Tiannan Wang
- Department of Pathology, University of Southern California, Los Angeles, California
| | - Wenzhi Li
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, New York
| | - Xianxu Zeng
- Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Daniel Geisler
- Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Xianrong Zhou
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiang Tao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
| | - Chengquan Zhao
- Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Zhou Q, Bai Y, Chen F, Zhang H, Chen L, Zhang G, Wang Y, Sui L. 3D reconstruction of the uterus and automatic segmentation of the uterine cavity on 3D magnetic resonance imaging: A preliminary study. Heliyon 2024; 10:e23558. [PMID: 38170061 PMCID: PMC10758877 DOI: 10.1016/j.heliyon.2023.e23558] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 12/02/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose To determine the differences in 3D shape features between septate uterus (SU) and normal uterus and to train a network to automatically delineate uterine cavity on 3D magnetic resonance imaging (MRI). Methods A total of 43 patients (22 cases of partial septate uterus and 21 cases of complete septate uterus) were included in the experimental group. Nine volunteers were recruited as a control group. The uterine cavity (UC), myometrium (UM), and cervical canal of the uterus were segmented manually using ITK-SNAP software. The three-dimensional shape features of the UC and UM were extracted by using PyRadiomics. The recurrent saliency transformation network (RSTN) method was used to segment the UC. Results The values of four 3D shape features were significantly lower in the control group than in the partial septate group and the complete septate group, while the values of two features were significantly higher (p < 0.05). The UCs of the three groups were significantly different in terms of flatness and sphericity. The values of six features were significantly lower in the UMs of the control group than in those of the partial septate group and the complete septate group (p < 0.05). After the deep learning networks were trained, the Dice similarity coefficient (DSC) scores of the four folds for different thresholds were all over 80 %. The average volume ratio between predictions and manual segmentation was 101.2 %. Conclusions Based on 3D reconstruction, 3D shape features can be used to comprehensively evaluate septate uterus and provide a reference for subsequent research. The UC can be automatically segmented on 3D MRI using the RSTN method.
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Affiliation(s)
- Qing Zhou
- Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Yunhao Bai
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, 200241, China
| | - Fang Chen
- Cervical Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Limei Chen
- Cervical Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Guofu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Yan Wang
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, 200241, China
| | - Long Sui
- Cervical Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
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Zhou Q, Chen F, Wang Y, Qu W, Gong Y, Cao Y, Zhang H, Wang Q, Chen L, Cong Q, Lin L, Mo J, Bi T, Ding J, Sui L, Li Y. Application of a diagnosis flow draft based on appearance impression for detection of vulvar disease. Diagnosis (Berl) 2023; 0:dx-2023-0146. [PMID: 38143236 DOI: 10.1515/dx-2023-0146] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES The aims of this retrospective study were to evaluate the clinical applicability of the latest International Society for the Study of Vulvovaginal Disease (ISSVD) and International Federation for Cervical Pathology and Colposcopy (IFCPC) terminology for vulvar diseases, and to explore a new evaluation flow to optimize decision-making on diagnosis. METHODS 1,068 patients with 5,340 qualified vulvar images were evaluated by observers using 2011 ISSVD and 2011 IFCPC terminology systems. The sensitivity, specificity, positive predictive value, negative predictive value, Youden Index and Overall Diagnostic Value (ODV) were calculated for each finding in the two systems. Then the disease diagnosis order and a diagnosis flow draft (DFD) were obtained. RESULTS A total of 15 kinds of vulvar diseases were diagnosed. The proportion of patients accompanied with cervical or vaginal intraepithelial neoplasia was highest (83.3 %) in vulvar Paget's disease group (p<0.001). Total area of lesions was larger in vulvar Paget's disease, lichen simplex chronicus and lichen sclerosus group (p<0.001). Among the top five findings of ODV, some findings inferred several (≥6) kinds of diseases, while some findings only exist in a certain disease. When the DFD was used, the agreement between the initial impression and histopathology diagnosis was 68.8 %, higher than those when ISSVD an IFCPC terminology systems used (p=0.028), and it didn't change with the experience of the observer (p=0.178). CONCLUSIONS Based on the findings in ISSVD and IFCPC terminology systems, we explored a DFD for observers with different experience on the detection of vulvar disease.
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Affiliation(s)
- Qi Zhou
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Fang Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan Wang
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Wenjie Qu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yingxin Gong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yuankui Cao
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Hongwei Zhang
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Wang
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Limei Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Lin Lin
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jiayin Mo
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Tianyi Bi
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jingxin Ding
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yanyun Li
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Qu W, Sui L, Li Y. Vaccine escape challenges virus prevention: The example of two vaccine-preventable oncogenic viruses. J Med Virol 2023; 95:e29184. [PMID: 37943176 DOI: 10.1002/jmv.29184] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/06/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
Over the years, the pace of developing vaccines for HBV and HPV has never stopped. After more than 30 years of application, the HBV vaccine has reduced 80% of hepatocellular carcinoma (HCC). However, vaccine escape variants occur under selective pressure induced by widespread vaccination and antiviral therapy, which results in fulminant infection and horizontal transmission. Several mechanisms have been studied to explain HBV vaccine escape, including vaccine escape mutations (VEMs) in the major hydrophilic region, which leads to a decrease in the binding ability to neutralize antibodies and is the primary escape mechanism, protein conformational and N-linked glycosylation sites changes caused by VEMs, differences in genotype distribution, gene recombination, and some temporarily unknown reasons. However, effective solutions are still being explored. The HPV vaccine has also been proven to prevent 70%-90% of cervical cancer worldwide. Cases of HPV infection after being vaccinated have been observed in clinical practice. However, few researchers have paid attention to the mechanism of HPV vaccine escape. Thus, we reviewed the literature on vaccine escape of both HBV and HPV to discuss the mechanism of the virus escaping from vaccine protection and possible solutions to this problem. We analyzed the gap between studies of HPV and HBV and made prospects for further research in HPV vaccine escape.
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Affiliation(s)
- Wenjie Qu
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yanyun Li
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Chen F, Gong Y, Xie Y, Zhu L, Chen L, Xiao J, Jiang N, Sun L, Sui L. Assessment of key parameters of normal uterus in women of reproductive age. Sci Rep 2023; 13:17794. [PMID: 37852992 PMCID: PMC10584964 DOI: 10.1038/s41598-023-44489-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
Currently, the precise and detailed anatomical data of the normal uterus, especially the myometrium thickness in various parts of the uterus, are lacking. This study aims to provide normal references for uterine size in healthy reproductive-aged Chinese women to facilitate the application of hysteroscopic surgery. A total of 298 women of reproductive age with normal uterine were included. Parity was significantly correlated with uterine measurements (P < 0.05), and age impacted several measurements (P < 0.05). At each uterine site examined, the myometrium was thinner in nulliparous women than in parous or primiparous women (P < 0.001). Similarly, the extrauterine measurements for parous or primiparous women were larger than those for nulliparous women. Weight affected some external measurements but not myometrial thicknesses, while height did not affect uterine measurements (P > 0.05). There was a positive correlation between body mass index (BMI) and extrauterine measurements as well as myometrial thickness (P < 0.05). The mathematical model of the uterine size for women of reproductive age was constructed stratified by parity. The study is the first to provide a detailed statistical description of the accurate anatomical parameters of the uterus in Chinese reproductive-aged women and has great significance for improving the safety and effectiveness of hysteroscopic surgery for patients.
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Affiliation(s)
- Fang Chen
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yingxin Gong
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yu Xie
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Lei Zhu
- Ultrasound Diagnosis Center, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
| | - Limei Chen
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jingjing Xiao
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ninghong Jiang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Li Sun
- Ultrasound Diagnosis Center, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China.
| | - Long Sui
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, No.419 Fangxie Road, Shanghai, 200011, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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Xiao J, Chen Z, Xiao Y, Sui L, Wang C, Cong Q. Vulvar squamous intraepithelial neoplasia epithelial thickness in hairy and non-hairy sites: a single center experience from China. Front Oncol 2023; 13:1254820. [PMID: 37854683 PMCID: PMC10579793 DOI: 10.3389/fonc.2023.1254820] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction A large-sample study focusing on VIN lesions of a more precise thickness is needed to help guide clinical treatment. This study aimed to investigate the depth of vulvar intraepithelial neoplasia (VIN) and involved skin appendages to provide evidence for laser surgery. Methods The study retrospectively enrolled and analyzed the clinical characteristics of VIN patients in the obstetrics and gynecology department of a university hospital between January 1, 2019 and December 30, 2021. The study further explored the thickness of epithelium and skin appendages of 285 women with low-grade VIN (VIN1) and 285 women with high-grade VIN (VIN2/3). Results The study included 1,139 (80%) VIN1 and 335 (20%) VIN2/3 cases. The VIN1 and VIN2/3 groups showed a significant difference in human papillomavirus infection (P<0.01) but not in cytology (P = 0.499). Most (89.90%, 1,325) cases occurred in one area of the vulva, whereas 10.11% were multifocal. VIN commonly occurred on the posterior fourchette (76.85%), labia majora (11.61%), and labia minora (9.92%). The VIN2/3 group reported a significantly higher positive rate for concurrent cervical and vaginal intraepithelial neoplasia (160 of 285) than the VIN1 group (321 of 953) (P=0.000). The involved epithelial thicknesses in VIN2/3 and VIN1 were 0.69 ± 0.44 and 0.49 ± 0.23 mm, respectively, both of which were greater than the corresponding noninvolved epithelial thickness (0.31 ± 0.19 and 0.32 ± 0.10 mm, P<0.001 and P<0.001, respectively). In cases of appendage involvement, the VIN thickness was 1.98 ± 0.64 mm. Conclusions VIN thickness was generally ≤1 mm for the superficial lesions in non-hairy areas. However, for lesions extending onto hairy areas, the thickness was approximately 3 mm, leading to the destruction of involved skin appendages.
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Affiliation(s)
- Jingjing Xiao
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ziren Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yinping Xiao
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chao Wang
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Chen LM, Cong Q, Wu D, Chen Y, Qiu LH, Hong ZB, Yang YB, Xu L, Wang LF, Huang LX, Li WR, Tang JP, Cao YG, Sui L. A prospective multicentre controlled study of Gaoweikang (Chinese multiherb extract-based tincture) used in high-risk HPV infections. Eur Rev Med Pharmacol Sci 2023; 27:8985-8992. [PMID: 37843310 DOI: 10.26355/eurrev_202310_33922] [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: 10/17/2023]
Abstract
OBJECTIVE The aim of the study was to investigate the safety and antiviral efficacy of a Chinese multiherb extract-based tincture (GWK) on a population of patients with high-risk human papilloma (hrHPV) infections and hrHPV-caused cervical low-grade squamous intraepithelial lesions (LSILs). PATIENTS AND METHODS Patients with persistent hrHPV infection were enrolled in Group A, including A1 subjects, who received the intervention, and A2 subjects, who received the control. Patients with hrHPV infection causing cervical LSIL were enrolled in Group B, which included B1 subjects, who received the intervention, and B2 subjects, who served as the control. For Groups A1 and B1, hrHPV was tested at 3 months (M3) and 6 months (M6) after the intervention. The side effects were also analyzed. RESULTS At baseline (D0), a total of 99 patients were enrolled in Group A, with 50 subjects in Group A1 and 49 subjects in Group A2. A total of 91 patients were enrolled in Group B, with 45 subjects in Group B1 and 46 subjects in Group B2. There was no significant difference in the characteristics, including average age, age stratification, and HPV genotype. At M6, both Group A1 and Group B1 had a higher hrHPV clearance rate than the control group (A1/A2: 80.0% vs. 20.4%; B1/B2: 64.4% vs. 15.2%, p<0.001). At M6, the effective rates of Group A1 and Group B1 were 84% (42/50) and 68.9% (31/45), respectively. The side effect rates of Groups A1 and B1 were 11.5% (6/52) and 11.1% (5/45), respectively. Most adverse reactions involved local discomfort, including vulvar erythema, vulvar itch, increased vaginal discharge, cervical bleeding, and mild pain in the lower abdomen. Univariate logistic regression analysis showed that the intervention had an OR of 12 (95% CI 4.431-32.50) for clearing persistent HPV infection (p<0.001). For cervical LSIL, the intervention had an OR of 10.1 for clearing persistent HPV infection (95% CI 3.68-27.7) (p<0.001). CONCLUSIONS The results of this study suggest that the Chinese multiherb extract-based tincture GWK is safe and well tolerated. Furthermore, this preliminary study showed that this Chinese multiherb extract-based tincture is helpful for promoting HPV clearance in cases of persistent HPV and HPV-induced LSIL.
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Affiliation(s)
- L-M Chen
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.
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Zhang L, Xiao YP, Tao X, Cao YK, Sui L, Cong Q. [Detection rate and clinical characteristics of vulvar squamous intraepithelial lesion]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:603-610. [PMID: 37599258 DOI: 10.3760/cma.j.cn112141-20230607-00255] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Objective: To explore the detection rate, clinical characteristics of vulvar squamous intraepithelial lesion (SIL). Methods: Women diagnosed with vulvar high-grade squamous intraepithelial lesions (HSIL) through colposcopy-guided biopsy from January 1, 2018 to August 31, 2022 in Obstetrics and Gynecology Hospital of Fudan University were included in a 1∶1 ratio with patients diagnosed with vulvar low-grade squamous intraepithelial lesions (LSIL) during the same period. Clinical characteristics including human papillomavirus (HPV) infection rate, genotype, cytology result, colposcopy impression, and lesion location were retrospectively analyzed. Results: (1) The proportion of vulvar SIL detected by colposcopy-guided biopsy increased annually from 2018 to 2022, with rates of 1.64% (740/45 057), 2.34% (1 110/47 402), 2.68% (1 108/41 335), 3.26% (1 536/47 078), 3.31% (667/20 155), with an average rate of 2.57% (5 161/201 027). (2) A total of 1 096 cases of vulvar HSIL and 1 096 cases of vulvar LSIL were included. The overall infection rate of HPV was 92.7% (1 993/2 150), with higher infection rate in vulvar HSIL patients than that in vulvar LSIL patients [96.0% (1 012/1 054) vs 89.5% (981/1 096); χ2=33.62, P<0.001]. Among vulvar HSIL patients, the common HPV genotype from high to low were HPV 16 (66.7%), HPV 52 (14.3%), and HPV 58 (10.0%). For vulvar LSIL patients, the most common HPV genotype were respectively HPV 16 (24.9%), HPV 6 (20.1%) and HPV 52 (17.1%). The overall sensitivity rate of cytology was 53.6%, with no significance difference between vulvar LSIL and HSIL groups (54.3% vs 52.9%; χ2=0.40, P=0.526). The accuracy of colposcopy impression for vulvar HSIL was lower than that for vulvar LSIL [40.2% (163/405) vs 81.7% (380/465); χ2=158.72, P<0.001]. About 57.3% (1 257/2 192) of the patients had concomitant cervical and vaginal lesions, with a higher rate in vulvar HSIL group than that in vulvar LSIL group [62.6% (686/1 096) vs 52.1% (571/1 096); χ2=24.67, P<0.001]. Unifocal lesion was the main type, with no significance difference between vulvar LSIL and HSIL groups [81.4% (381/468) vs 82.5% (386/468); χ2=0.18, P=0.671]. The most common lesion locations were the posterior commissure, followed by labia minora, vaginal vestibule, labia majora, perianal and clitoris. Conclusions: The detection rate of vulvar SIL under colposcopy is about 3%, and the infection rate of HPV is 92.7%. Vulvar SIL, especially vulvar HSIL, is likely to cause concomitant cervical and vaginal lesions. The accuracy of colposcopy in diagnosing vulvar HSIL is low. Therefore a comprehensive and careful examination of the vulva is necessary and suspicious vulvar lesions should be undergone colposcopy-guided biopsy for diagnosis.
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Affiliation(s)
- L Zhang
- Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Y P Xiao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - X Tao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Y K Cao
- Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - L Sui
- Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Q Cong
- Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
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Bi T, Gong Y, Mo J, Wang Y, Qu W, Wang Y, Shi W, Zhang F, Sui L, Li Y. Analysis of publications on HPV genotype co-infection: a bibliometric study on existing research. Front Oncol 2023; 13:1218744. [PMID: 37554156 PMCID: PMC10406125 DOI: 10.3389/fonc.2023.1218744] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE To identify the bibliometric information of Human papillomavirus (HPV) genotype co-infection in certain literature database over the past two decades. METHODS Web of Science was used as the main database to identify all eligible articles focusing on HPV genotype co-infection at the date of October 16, 2022. From this journal database, we identified 463 articles on HPV genotype co-infection, conducted statistical analysis according to the author, journal, publication year and month, country or region, keyword and impact factor. RESULTS The articles included in our analysis were published between 1994 and 2022. The index of citations per year ranged from 170.4 to 13.1. These articles were from 78 countries or regions, with most publications from the United States (n = 73), followed by China (n = 65) and Italy (n = 50). The journal that contributed the most publications on HPV heterotypic gene co-infection was PLOS ONE with a total of 29 articles, followed by JOURNAL OF MEDICAL VIROLOGY (n = 28), INFECTIOUS AGENTS AND CANCER (n = 14) and JOURNAL OF CLINICAL VIROLOGY (n = 12). Among existing research in the field of HPV co-infection, we found that epidemiological distribution and infection mechanism has been the two major topics for scholars, and studies on detection methods for HPV multiple genotypes were also included. CONCLUSION Over decades, epidemiological studies and mechanism investigationhas been the central topics when it comes to HPV genotypes co-infection. Studies on HPV co-infection remained relatively insufficient, mainly stays in qualitative level while detailed infection data and high quality literature publications were still lack of valuable discussion.
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Affiliation(s)
- Tianyi Bi
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yingxin Gong
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jiayin Mo
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Wenjie Qu
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yaping Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Wenqian Shi
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Feifei Zhang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yanyun Li
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
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Cui C, Chen Z, Luo L, Zeng J, Sun X, Sui L, Xu C, Fu Z, Cong Q. Value of loop electrosurgical excision procedure conization and imaging for the diagnosis of papillary squamous cell carcinoma of the cervix. Front Oncol 2023; 13:1166818. [PMID: 37476381 PMCID: PMC10354288 DOI: 10.3389/fonc.2023.1166818] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Background Loop electrosurgical excision procedure (LEEP) conization and hysterectomy are performed for some patients with papillary squamous cell carcinoma (PSCC), whereas only hysterectomy is performed for others. We aimed to determine the optimal management for PSCC. Methods Patients diagnosed with PSCC by colposcopy-directed biopsy between June 2008 and January 2020 who underwent LEEP conization and hysterectomy or only hysterectomy at our hospital were enrolled. Results of cervical cytology, high-risk human papillomavirus testing, transvaginal sonography, pelvic magnetic resonance imaging, LEEP, hysterectomy, and pathology testing of colposcopy-directed biopsy samples were analyzed. Results A total of 379 women were diagnosed with PSCC by colposcopy-directed biopsy; 174 underwent LEEP before hysterectomy and 205 underwent only hysterectomy. Patients underwent and did not undergo LEEP were aged 47 ± 11 years and 52 ± 11 years, respectively. Among women who underwent LEEP, the agreement between LEEP and hysterectomy pathology was 85.1%. For women who underwent only hysterectomy, the agreement between preoperative clinical staging and pathological staging after hysterectomy was 82.4%. For patients with preoperative imaging indicative of malignancy, the accuracy of LEEP for diagnosing and staging PSCC was 88.5%, whereas for the hysterectomy-only group, it was 86.2%. For patients without malignancy detected with imaging, the accuracy of LEEP for diagnosing and staging PSCC was 81.6%; however, for those who did not undergo LEEP, it was 70.0%. Conclusion For women diagnosed with PSCC by colposcopy-directed biopsy, LEEP conization is necessary for an accurate diagnosis when imaging does not indicate cancer; however, LEEP is not necessary when imaging indicates cancer.
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Affiliation(s)
- Can Cui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ziren Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Lingxiao Luo
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jianping Zeng
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaoyi Sun
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Congjian Xu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Zhongpeng Fu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Qing Cong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
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Xiao J, Gong Y, Chen F, Chen L, Xie Y, Sui L. Clinical Diagnostic Value of Atypical Glandular Cells in Cervical Cytology: A Single Center Experience From China. J Low Genit Tract Dis 2023; 27:202-206. [PMID: 36946382 DOI: 10.1097/lgt.0000000000000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This study aimed to investigate the diagnostic value of atypical glandular cells (AGCs) by analyzing the prevalence and histopathology of AGCs according to cervical cytology. METHODS The authors retrospectively reviewed and analyzed the demographic characteristics and histopathological outcomes including pathological diagnosis, pathological site, and epithelial distribution of the AGC cases that were diagnosed by cervical cytology. RESULTS A total of 387 AGC patients with follow-up records were included. Among them, the prevalence of AGC-not otherwise specified (NOS) and AGC-favor neoplastic (FN) was 73.39% (284/387) and 26.62% (103/387), respectively. The high-risk human papillomavirus (hr-HPV)-positive rate was higher in AGC-FN than in AGC-NOS ( p = .002). The difference in pathological severity was statistically significant between hr-HPV-positive and negative AGC patients ( p = .010). Hr-HPV-positive AGC mainly occurs in cervical diseases, whereas hr-HPV-negative AGC is mainly related to endometrial lesions. Precancerous or malignant lesions were found in 36.43% (141/387) of AGC cases and were more commonly seen in AGC-FN than AGC-NOS ( p < .001). The histopathological severity and the incidence of uterine disease were higher among AGC women aged 40 years and older than those younger than 40 years ( p < .05). The possibility of the abnormal origin of glandular epithelial was higher than that of squamous epithelial in AGC patients aged 40 years and older ( p = .0003). CONCLUSIONS The management of AGC women by age triage is reasonable because the incidence of the glandular epithelial lesion and uterine disease increases in AGC patients 40 years or older. Standardized clinical diagnosis and regular follow-up are recommended for all AGC patients.
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Cong Q, Yu Y, Xie Y, Li Y, Sui L. Risk factors of LEEP margin positivity and optimal length of cervical conization in cervical intraepithelial neoplasia. Front Oncol 2023; 13:1209811. [PMID: 37427119 PMCID: PMC10324658 DOI: 10.3389/fonc.2023.1209811] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background The conization length for cervical precancerous lesions is essential for treatment but is left undetermined. This study aims to explore the reasonable and optimal conization length in patients with different types of cervical transformation zones (TZs) to reach the treatment outcome of margin negative in the surgery. Methods From July 2016 to September 2019, a multi-center prospective case-control study with or suspicion of cervical precancer was enrolled from five medical centers in Shanghai, China. The clinical characteristics, cytology, human papillomavirus (HPV), histopathology, and details of cervical conization were recorded. Results A total of 618 women were enrolled in this study; 6.8% (42/618) had positive internal (endocervical and stromal) margins and 6.8% (42/618) had positive external (ectocervical) margins of loop electrosurgical excision procedure (LEEP) specimen. Comparing the positive internal margin group with the negative group, age (p = 0.006) and cytology (p = 0.021) were significantly different. Multivariate logistic regression analysis showed that the risk factors for positive internal margin were cytology ≥ high-grade squamous intraepithelial lesion (HSIL) (odds ratio (OR) 3.82, p = 0.002) and age (OR 1.11, p < 0.001). The positive internal margin rate was 2.7%, 5.1%, and 6.9% in TZ1, TZ2, and TZ3, respectively, while the positive external margin was 6.7%, 3.4%, and 1.4%, respectively. In the TZ3 group, the HSIL positive internal margin of the 15-16-mm group (10.0%, 19/191) was significantly greater than in TZ1 (2.7%, 4/150) (p = 0.010) and TZ2 (5.0%, 9/179) (p = 0.092); when excision length increases to 17-25 mm, the positive internal margin rate dramatically decreased to 1.0% (1/98). Conclusion A cervical excision length of 10-15 mm is reasonable for TZ1 and TZ2 patients, while 17-25 mm is optimal for TZ3 excision with more negative internal margins.
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Li B, Hua C, Tian P, Sha Y, Zhang L, Wang Q, Lu L, Jiang S, Sui L. 25-hydroxycholesterol inhibits human papillomavirus infection in cervical epithelial cells by perturbing cytoskeletal remodeling. J Med Virol 2023; 95:e28834. [PMID: 37254637 DOI: 10.1002/jmv.28834] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023]
Abstract
Persistent high-risk human papilloma virus (HR-HPV) infection is the main risk factor for cervical cancer, threatening women's health. Despite growing prophylactic vaccination, annual cervical cancer cases are still increasing and show a trend of younger onset age. However, therapeutic approaches towards HPV infection are still limited. 25-hydrocholesterol (25HC) has a wide-spectrum inhibitory effect on a variety of viruses. To explore efficient interventions to restrict HPV infection at an early time, we applied different pseudoviruses (PsV) to evaluate anti-HPV efficacy of 25HC. We tested PsV inhibition by 25HC in cervical epithelial-derived HeLa and C-33A cells, using high-risk (HPV16, HPV18, HPV59), possibly carcinogenic (HPV73), and low-risk (HPV6) HPV PsVs. Then we established murine genital HPV PsV infection models and applied IVIS to evaluate anti-HPV efficacy of 25HC in vivo. Next, with the help of confocal imaging, we targeted 25HC activity at filopodia upon HPV exposure. After that, we used RNA-seq and Western blot analysis to investigate (1) how 25HC disturbs actin cytoskeleton remodeling during HPV infection and (2) how prenylation regulates the cytoskeletal remodeling signaling pathway. Our findings suggest that 25HC perturbs F-actin rearrangement by reducing small GTPase prenylation. In this way, the phenomenon of HPV virion surfing was restricted, leading to failed infection.
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Affiliation(s)
- Boning Li
- The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chen Hua
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Pu Tian
- The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yiou Sha
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Lu Zhang
- The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qian Wang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Lu Lu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Shibo Jiang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Long Sui
- The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Chen F, Gong YX, Xiao JJ, Jiang NH, Chen LM, Sui L. Construction and evaluation of intrauterine adhesion model in rats by different methods of mechanical injury. Arch Gynecol Obstet 2023; 308:281-290. [PMID: 37142833 DOI: 10.1007/s00404-023-06926-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/10/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The study aimed to establish a stable and effective animal model for the experimental study of intrauterine adhesion (IUA) by evaluating various mechanical injury methods. METHODS A total of 140 female rats were divided into four groups according to the extent and area of endometrial injury: group A (excision area: 2.0 × 0.5 cm2), group B (excision area: 2.0 × 0.25 cm2), group C (endometrial curettage) and group D (sham operation). On the 3rd, 7th, 15th and 30th day after the operation, the tissue samples of each group were collected, and the uterine cavity stenosis and histological changes were recorded by HE and Masson staining. Immunohistochemistry of CD31 was applied to visualize microvessel density (MVD). The pregnancy rate and the number of gestational sacs were used to evaluate the reproductive outcome. RESULTS The results showed that endometrium injured by small-area endometrial excision or simple curettage could be repaired. The ratio of fibrosis in groups A and B was higher than that in groups C and group D 30 days after modeling (P < 0.001). The number of endometrial glands and MVD in group A was significantly lower than those in groups B, C and D (P < 0.05). The pregnancy rate in group A was 20%, which was lower than that in groups B (33.3%), C (89%) and D (100%) (P < 0.05). CONCLUSION Full-thickness endometrial excision has a high rate of success in constructing stable and effective IUA models in rats.
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Affiliation(s)
- Fang Chen
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
| | - Ying-Xin Gong
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
| | - Jing-Jing Xiao
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
| | - Ning-Hong Jiang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China
| | - Li-Mei Chen
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China.
| | - Long Sui
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China.
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Gong Y, Wang Y, Zhou Q, Qu W, Chen F, Wang Y, Mo J, Zhang H, Lin L, Bi T, Wang X, Gu J, Sui L, Li Y. The possible impact of novel mutations in human papillomavirus 52 on the infection characteristics. Microb Genom 2023; 9. [PMID: 37103992 DOI: 10.1099/mgen.0.000962] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Human papillomavirus 52 (HPV52) infection is prevalent in the Chinese population, and variations in HPV52 show correlations with oncogenicity. However, no specific variation in HPV52 was reported to show relevancy to infection characteristics. In this study, we retrieved 222 isolates of E6 and L1 full-length genes from 197 Chinese women with HPV52 infection. After sequence alignment and phylogenetic tree construction, we found that 98.39 % of the collected variants belonged to the sublineage B2 and two variants displayed incongruence between the phylogenetic tree of E6 and L1. The analysis of the infection pattern showed that the presence of C6480A/T mutation in the L1 gene was associated with single infection (P=0.01) and persistent infection (P=0.047) of HPV52, while the A6516G nucleotide change was relevant to transient infection (P=0.018). Our data also indicated that variations T309C in the E6 gene and C6480T, C6600A in L1 were more commonly presented in patients with high-grade cytology (P<0.05). One HPV52 breakthrough infection after vaccination was identified, which hinted at the immune escape post-vaccination. Young coitarche age and non-condom usage were correlated to multiple infections. This study provided insight into the polymorphism of HPV52 and revealed the impact of variations in HPV52 on its infection characteristics.
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Affiliation(s)
- Yingxin Gong
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Yan Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Qi Zhou
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Wenjie Qu
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Fang Chen
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Yaping Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Jiayin Mo
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Hongwei Zhang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Lin Lin
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Tianyi Bi
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Xujie Wang
- Department of Obstetrics and Gynecology, Shanghai Changning Maternity and Infant Health Hospital, Shanghai, PR China
| | - Jiashi Gu
- Department of Obstetrics and Gynecology, Shanghai Pudong Hospital of Fudan University, Shanghai, PR China
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Yanyun Li
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
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Zhong F, Li Z, Sun Y, Xiao Y, Li J, Zhou X, Cong Q, Sui L, Tao X, Zhao C. HPV genotyping of cervical histologic specimens of 61, 422 patients from the largest women hospital in China. Front Oncol 2023; 13:1161631. [PMID: 37064129 PMCID: PMC10090690 DOI: 10.3389/fonc.2023.1161631] [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] [Received: 02/08/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
ObjectivesWe investigated HPV genotypes in a large cohort of patients with definitive cervical histologic diagnosis.MethodsHPV testing was performed by real-time PCR assay, including 18 high-risk HPV (hrHPV) and 3 low-risk HPV (lrHPV). Totally 61,422 patients with documented HPV genotyping results within 6 months before cervical histologic diagnoses were included.ResultsHrHPV positive rate was 55.1% among all tested cases with the highest in adenosquamous carcinoma (94.1%), followed by squamous cell carcinoma (SCC) (93.7%), cervical intraepithelial neoplasia 2/3 (CIN2/3) (92.8%). HrHPV positive rates were significantly higher in high-grade squamous lesions than in those in glandular lesions. HPV16 was the most common genotype followed by HPV52 and HPV58 in CIN2/3. The most frequent hrHPV genotype in adenocarcinoma in situ (AIS) was HPV18, followed by HPV16, HPV45 and HPV52. In SCC cases, HPV16 was the most common type followed by HPV58, HPV52, HPV18 and HPV33. However, HPV18 showed significantly higher prevalence in adenocarcinoma and adenosquamous carcinoma than in that in SCC. Theoretically, the protective rates of 2/4-valent and 9-valent vaccine were 69.1% and 85.8% for cervical cancers.ConclusionsThe prevalence of HPV genotypes in Chinese population was different from that in Western population. Some hrHPV types were identified in cervical precancerous lesions and cancers, which are not included in current HPV vaccines. These data provide baseline knowledge for future HPV vaccine development.
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Affiliation(s)
- Fangfang Zhong
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zaibo Li
- Department of Pathology, The Ohio State University, Columbus, OH, United States
| | - Yihua Sun
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yaoxing Xiao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Juan Li
- Department of Pathology, Jinan Maternity and Child Care Hospital, Jinan, Shandong, China
| | - Xianrong Zhou
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Center for Diagnosis and Treatment of Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Center for Diagnosis and Treatment of Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiang Tao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- *Correspondence: Xiang Tao, ; Chengquan Zhao,
| | - Chengquan Zhao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- *Correspondence: Xiang Tao, ; Chengquan Zhao,
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Tong JL, Zhu GH, Sun DW, Lu D, Cheng YF, Chen H, Pei LJ, Yin X, Zhou WD, Zhang W, Ling D, Xie X, Tan X, Zhu YJ, Wu XM, Hu CY, Li H, Wang Y, Fan JY, Jia XM, Zhu TY, Chen LM, Guo HY, Zhao SJ, Wang S, Feng SW, He XY, Chi YG, Sun XL, Lang JH, Sui L, Zhu L. [Consensus of Chinese experts on hysteroscopy day surgery center set-up and management process]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:891-899. [PMID: 36562222 DOI: 10.3760/cma.j.cn112141-20220925-00594] [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: 12/24/2022]
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19
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Sui L, Tang C, Cheng K, Yang F. Biochar addition regulates soil phosphorus fractions and improves release of available phosphorus under freezing-thawing cycles. Sci Total Environ 2022; 848:157748. [PMID: 35926613 DOI: 10.1016/j.scitotenv.2022.157748] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Currently, the shortage of phosphorus resources is becoming more and more serious. In general, phosphorus fertilizer is poorly utilized in soil and tends to gradually accumulate. Freezing-thawing cycles (FT) are seasonal phenomenon occurring in high latitudes and altitudes regions, which have obvious influence on the form of phosphorus in soil. This study investigates the effect of biochar on soil physicochemical properties, phosphorus form and availability under FT and thermostatic incubation (TH) condition. Compared with treatment without biochar, 4 % biochar addition increased the soil pH value, electrical conductivity, organic matter and Olsen-P of soil by a maximum of 0.76, 285.55 μS/cm, 28.60 g/kg and 139.27 mg/kg, respectively. Moreover, according to Hedley-P classification results, under FT condition, the content of labile phosphorus pool is always higher than those under TH. FT may promote the conversion of phosphorus from other fractions to labile phosphorus pool. Redundancy analysis results show that biochar addition and FT can not only directly change the soil phosphorus pool, but also alter the soil physicochemical properties and microbial community, which further affect the adsorption and mineralization of phosphorus in soil. The results of this study will be devoted to understanding the changes in soil phosphorus fractions under the effects of biochar addition and FT, providing references for agricultural production in areas where FT occur.
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Affiliation(s)
- Long Sui
- School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China
| | - Chunyu Tang
- School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China
| | - Kui Cheng
- College of Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China
| | - Fan Yang
- School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China.
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20
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Chen LM, Zhang HW, Xie Y, Wang Q, Sui L. [Clinical study of hysteroscopical electroresection of FIGO type 3 myoma]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:746-752. [PMID: 36299177 DOI: 10.3760/cma.j.cn112141-20220517-00329] [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: 06/16/2023]
Abstract
Objective: To analyze the clinical application and to evaluate the efficiency of hysteroscopical electroresection of International Federation of Gynecology and Obstetrics (FIGO) type 3 myoma. Methods: The clinical data of patients who underwent hysteroscopical electroresection single FIGO type 3 myoma in Obstetrics and Gynecology Hospital of Fudan University from January 2019 to October 2021 were collected retrospectively. The clinical symptoms, myoma size, location, operation time, intraoperative bleeding, surgical complications and postoperative follow-up were recorded, and the subsequent pregnancy outcomes were followed-up. Results: Totally 35 patients with FIGO type 3 myoma were included in this study. The average age was (36.6±4.7) years old, the diameter of myoma was (4.0±1.2) cm (range: 2.0-5.8 cm). The rate of complete resection of myoma in one operation was 86% (30/35), the average operation time was (41±15) minutes (range: 20-65 minutes), and the average intraoperative bleeding was (24±18) ml (range: 5-150 ml). No complications such as uterine perforation, massive hemorrhage, hyperhyderation syndrome and infection occurred in all patients perioperation. There were 20 cases with significant increase of menstruation before operation, the cure rate and effective rate of hysteroscopical electroresection of FIGO type 3 myoma were 75% (15/20) and 95% (19/20). There were 24 patients with fertility requirements, their average follow-up time was (14.5±6.8) months, the pregnancy rate within 1 year after operation was 79% (19/24), and the average postoperative pregnancy time was (5.8±3.4) months. There were 15 cases who had completed delivery after operation, including 10 cases of vaginal delivery and 5 cases of cesarean section, and none of them had uterine rupture. Conclusions: Hysteroscopy could effectively resect FIGO type 3 myoma. Hysteroscopical electroresection of FIGO type 3 myoma is minimally invasive with rapid postoperative recovery and could achieve pregnancy in a short time, which is not only helpful to reduce the amount of menstruation, but also beneficial for the prognosis of fertility. It should be carried out by the experienced hysteroscopists.
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Affiliation(s)
- L M Chen
- Hysteroscopy Centre, Obstetrics and Gynecology Hospital of Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - H W Zhang
- Hysteroscopy Centre, Obstetrics and Gynecology Hospital of Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Y Xie
- Hysteroscopy Centre, Obstetrics and Gynecology Hospital of Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Q Wang
- Hysteroscopy Centre, Obstetrics and Gynecology Hospital of Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - L Sui
- Hysteroscopy Centre, Obstetrics and Gynecology Hospital of Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
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21
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Li B, Zhang L, Xie Y, Lei L, Qu W, Sui L. Evaluation of pharmacokinetics and safety of a long-term estradiol-releasing stent in rat uterine. Regen Ther 2022; 21:494-501. [PMID: 36313395 PMCID: PMC9596602 DOI: 10.1016/j.reth.2022.10.001] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/15/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Intrauterine adhesion (IUA), often leading to gynecological complications including amenorrhea, abdominal pain and infertility, is frequently induced by injuries to the endometrium. Hence it would be of great benefit to take efforts to prevent adhesion after intrauterine operations. Orally administration of 17β-estradiol (E2) is commonly used to promote endometrium regeneration, but is limited by low concentrations at the injured sites. We aim at preparing an E2-releasing uterine stent, which could improve the efficiency of E2 therapy and be utilized for IUA prevention. Methods We designed a silicone rubber stent, which could be implanted in the uterine cavity and continuously release E2 in long term. Stents were placed in rodent uterine, and removed at different time points. Remaining E2 in stent was measured by high performance liquid chromatography (HPLC), and organ E2 concentrations were detected by enzyme-linked immuno sorbent assay (ELISA). Endometrium morphology was examined by histological staining of paraffin sections. Results Our stent showed a controlled release of E2 in rodent uterine for over 60 days, and significantly increased E2 concentration in serum and in situ uterine. After the stent was removed from uterine, E2 rapidly reverted to a normal level. Also, the stent did not induce pathological changes in endometrium. Conclusions The uterine stent provided abundant local E2 in uterine cavity with satisfactory safety. The silicone rubber based E2-releasing uterine stent could be further advanced by adjusting its shape and E2 load for its clinical application, and might promisingly help lowering the incidence of IUA. The silicone rubber uterine stent continuously released E2 in long term. The E2-releasing uterine stent revealed more efficient E2 delivery capacity than orally administrated E2. The E2-releasing uterine stent is safe for endometrium and remote organs.
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Affiliation(s)
- Boning Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Lu Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Obstetrics and Gynecology Hospital, Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Yu Xie
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Lei Lei
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Wenjie Qu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Long Sui
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Obstetrics and Gynecology Hospital, Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China,Corresponding author. Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
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22
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Chen F, Gong Y, Jiang N, Xiao J, Wang Y, Chen L, Sui L. Transplantation of bFGF-transfected bone mesenchymal stem cells on collagen scaffolds promotes the regeneration of injured rat endometrium. Am J Transl Res 2022; 14:6712-6725. [PMID: 36247308 PMCID: PMC9556468] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study aimed to verify the role of basic fibroblast growth factor (bFGF)-bone mesenchymal stem cells (BMSCs) loaded on collagen scaffolds for the repair of injured endometrium. METHODS We established an intrauterine adhesion (IUA) model in rats by endometrial resection and implanted BMSCs and bFGF-BMSCs loaded on collagen scaffolds into uteri. A total of 100 IUA model rats were divided into five groups: the control group, scaffold group, BMSC+scaffold group, vector-BMSC group, and bFGF-BMSC+scaffold group. The rats were sacrificed on the 3rd, 7th, 15th, and 45th days. The endometrium thickness, number of glands, and microvascular density were measured by hematoxylin and eosin staining, Masson staining, and immunohistochemistry staining of CD31. The expression of bFGF, vascular endothelial growth factor (VEGF), vimentin, and Ki67 was assayed by immunohistochemistry staining. RESULTS The bFGF-BMSCs loaded on the collagen scaffold significantly increased the endometrial thickness, gland number, and microvascular density, which greatly promoted the regeneration of the injured endometrium (P<0.0001). In addition, the expression levels of bFGF, VEGF, vimentin, and Ki67 were significantly higher in the bFGF-BMSC+scaffold group than in the BMSC+scaffold group (P<0.05). CONCLUSIONS Our findings indicated that bFGF-BMSCs loaded on collagen scaffolds have the ability to prompt the regeneration of the endometrium after injury, contributing to a better understanding of stem cell treatment for intrauterine adhesion.
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Affiliation(s)
- Fang Chen
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
| | - Yingxin Gong
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
| | - Ninghong Jiang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
| | - Jingjing Xiao
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
| | - Yaping Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
| | - Limei Chen
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
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23
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Lei L, Tan L, Sui L. A novel cuproptosis-related gene signature for predicting prognosis in cervical cancer. Front Genet 2022; 13:957744. [PMID: 36092887 PMCID: PMC9453033 DOI: 10.3389/fgene.2022.957744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/22/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose: Cuproptosis, a form of copper-induced cell death, can be a promising therapeutic target for refractory cancers. Hence, we conducted this research to explore the association between cuproptosis and prognosis in cervical cancer (CC).Methods: For constructing a prognostic signature based on cuproptosis-related genes from TCGA database, the least absolute shrinkage and selection operator Cox regression was utilized. The GSE44001 cohort was utilized for validation.Results: A total of nine cuproptosis-related genes showed distinct expression in CC and normal samples in TCGA-GTEx cohort. Two risk groups were identified based on a seven-gene signature. A significant decrease in overall survival was observed in the high-risk group (p < 0.001). The risk score (HR = 2.77, 95% CI = 1.58–4.86) was an autocephalous predictor with a better predictive ability than the clinical stage. Functional analysis indicated that immune activities were suppressed more in the high-risk group than in the low-risk group. A total of 11 candidate compounds targeting the signature were identified.Conclusion: A total of seven cuproptosis-related gene signatures were constructed to predict prognosis and propose a new therapeutic target for patients with CC.
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Affiliation(s)
- Lei Lei
- Cervical and Vaginal Precancerous Lesion Diagnosis and Treatment, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Liao Tan
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Long Sui
- Cervical and Vaginal Precancerous Lesion Diagnosis and Treatment, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- *Correspondence: Long Sui,
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Xiao JJ, Chen ZR, Wang Q, Sui L, Cong Q. [Stratified research on related risk factors of CINⅡ + in CINⅠ patients diagnosed by endocervical curettage under colposcopy]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:608-617. [PMID: 36008288 DOI: 10.3760/cma.j.cn112141-20220520-00338] [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: 06/15/2023]
Abstract
Objective: To estimate risks of cervical intraepithelial neoplasia (CIN) Ⅱ or worse (CINⅡ+) on loop electrosurgical excisional procedure (LEEP) specimens with the diagnosis of endocervical curettage (ECC) CINⅠ compared with biopsy CINⅠ, and also to investigate the hierarchical management scheme of ECC CINⅠ based on the relevant factors of CINⅡ+ risk. Methods: (1) A retrospective computer-based research for subjects enrolled in the Obstetrics and Gynecology Hospital, Fudan University from Jan. 2013 to Jun. 2021 was performed. The case group comprised women with an ECC CINⅠ (ECC results of CINⅠ with colposcopy-directed biopsy results ≤CINⅠ), and the control group comprised women with a biopsy CINⅠ (colposcopy-directed biopsy results of CINⅠ with negative ECC findings) were divided after LEEP surgery and diagnosis in the next three months. The clinical data of all patients before LEEP were analyzed, and the pathological diagnosis between two groups after LEEP was compared. (2) Variables, including age, cytology, high-risk human papillomavirus (HR-HPV), ECC results, cervical transformation zone (TZ) and colposcopy impression, were included to describe the characteristics and compare the incidence of LEEP CINⅡ+. (3) Univariate analysis and Multivariate logistic regression method were used to analyze the related factors that affect the LEEP CINⅡ+ in CINⅠ patients. Further, the specific risks caused by related factors and conduct a stratified study in LEEP CINⅡ+ were analyzed. Results: (1) Overall, 2 581 women with ECC CINⅠ or biopsy CINⅠ diagnosis who underwent LEEP participated in the study with the mean age (43.6±9.5) years old. Chi square test found that the age and cytology of patients in ECC CINⅠ group were statistically different from those of biopsy CINⅠ group (all P<0.05). There was no significant difference in HR-HPV detection, TZ type and colposcopy impression between the two groups (all P>0.05). ECC CINⅠ comprised 957 women, with LEEP histopathology results revealing 288 (30.1%, 288/957) CINⅡ+, which was significantly higher than that of biopsy CINⅠ which was comprised 1 624 women, with LEEP histopathology results showing 333 (20.5%, 333/1 624) CINⅡ+ (χ2=30.31, P<0.001). (2) Compared by LEEP CINⅡ+ with LEEP ≤CINⅠ group, there were no significant difference in the age, HR-HPV, colposcopy impression (all P>0.05); but there were significantly differences in cytology, ECC CINⅠ, type Ⅲ TZ (all P<0.001). Multivariate logistic regression analysis showed that atypical squamous epithelial cells (ASC-H; OR=2.77, 95%CI: 2.04-3.77), high-grade squamous intraepithelial lesions and worse (HSIL+; OR=2.93, 95%CI: 2.24-3.81), ECC CINⅠ (OR=1.89, 95%CI: 1.56-2.29) and type Ⅲ of TZ (OR=1.76, 95%CI: 1.45-2.11) were independent risk factors for LEEP CINⅡ+ (all P<0.05). (3) When cytology was ≤low-grade squamous intraepithelial lesion (LSIL) and ≥ASC-H, the detection rate of CINⅡ+ in ECC CINⅠ was significantly higher than that of biopsy CINⅠ (all P<0.001). In ECC CINⅠ, the rate of CINⅡ+ with cytology ≤LSIL was significantly lower than that in cytology ≥ASC-H (56.0% vs 25.9%; χ2=49.38, P<0.001). In type Ⅰ/Ⅱ of TZ, the detection rate of CINⅡ+ between ECC CINⅠand biopsy CINⅠ had no significantly different; while in type Ⅲ of TZ, there was significantly different (72.7% vs 46.2%; χ2=4.02, P=0.045). In ECC CINⅠ, type Ⅲof TZ was significantly higher in the rate of CINⅡ+ than that of type Ⅰ/Ⅱ of TZ (72.7% vs 21.7%; χ2=16.38, P<0.001). When cytology ≥ASC-H, type Ⅲ of TZ and colposcopy impression of HSIL were combined, the rate of CINⅡ+ in ECC CINⅠ was 6/6 while 1/3 in biopsy CINⅠ. Conclusions: Cytology ≥ASC-H, ECC CINⅠ and type Ⅲ TZ are the risk factors of LEEP CINⅡ+. However, cytology ≥ASC-H is more valuable in predicting LEEP CINⅡ+ than ECC CINⅠ. For patients with ECC CINⅠ to perform LEEP, it is recommended that cytology ≥ASC-H is taken as the first level stratification, and type Ⅲ TZ is taken as the second level stratification. The colposcopy impression of patients is recommended for a reference parameter.
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Affiliation(s)
- J J Xiao
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Z R Chen
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Q Wang
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - L Sui
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Q Cong
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
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Zhang D, Song KJ, Ren YZ, Sui L, Yao Q. [Effect of exosome derived from ovarian cancer cell on the differentiation of fibroblast]. Zhonghua Zhong Liu Za Zhi 2022; 44:737-742. [PMID: 35880340 DOI: 10.3760/cma.j.cn112152-20200110-00021] [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: 06/15/2023]
Abstract
Objective: To study the effects of exosome secreted by ovarian cancer (OC) cell on the differentiation and metastasis of normal fibroblasts (NFs). Methods: NFs were collected from patients who underwent hysteromyoma resection in the Affiliated Hospital of Qingdao University from May to December 2019. Exosome was extracted from the culture supernatant of SKOV3 cells by using ultra-high-speed centrifugation. The NFs were co-cultured with condition medium (CM), exosome of SKOV3 (SKOV3-exo) and control medium. The expression levels of fibroblast activation protein (FAP) and α-smooth muscle actin (α-SMA) were detected by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot. The metastatic ability of NFs was detected by Transwell array. Results: Under the transmission electron microscope, the extracellular vesicles extracted from the culture supernatant of SKOV3 were 30-100 nm in diameter with cup holder-like bilayer membrane structure, and the protein expression levels of TSG101 and HSP27 in exosomes (1.00±0.05 and 1.12±0.13) were higher than those of ovarian cancer SKOV3 cells (0.22±0.21 and 0.36±0.14, respectively, P<0.05). PKH67 fluorescently labeled exosomes could be taken up by NFs. The expression levels of α-SMA and FAP mRNA in CM group(2.91±0.15 and 3.21±0.33)and SKOV3-exo group (3.50±0.21 and 4.63±0.24, respectively) were higher than that in blank group (1.00±0.06 and 1.00±0.13, P<0.05). The protein expression levels of α-SMA and FAP in CM group and SKOV3-exo group (0.89±0.11 and 1.25±0.09, 0.81±0.09 and 1.20±0.12) were higher than those in the blank group (0.12±0.31 and 0.11±0.19, respectively, P<0.05). The migrated numbers of cells in the CM group and SKOV3-exo group [(215.01±14.80) and (389.72±19.43), respectively] were higher than that in the blank group [(113.73±4.70), P<0.05]. Conclusion: The exosome secreted by SKOV3 cells can be taken up by NFs, which makes it to differentiate into cancer associated fibroblasts (CAFs) and significantly enhances its metastatic ability, indicating that OC cells may promote the transformation of normal ovarian mesenchymal fibroblasts to CAFs through exosome pathways, and then promote the development of ovarian cancer.
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Affiliation(s)
- D Zhang
- Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao 266555, China
| | - K J Song
- Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao 266555, China
| | - Y Z Ren
- Department of Emergency Trauma Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471000, China
| | - L Sui
- Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao 266555, China
| | - Q Yao
- Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao 266555, China
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Abstract
OBJECTIVES Although carbon dioxide laser vaporization is frequently used for treating vaginal intraepithelial neoplasia (VaIN), the optimal depth of epithelial destruction with laser vaporization requires elucidation. We aimed to evaluate VaIN depth and better illustrate epithelial destruction during laser vaporization. MATERIALS AND METHODS We included 246 women diagnosed with VaIN (low-grade VaIN [VaIN 1], 123 women; high-grade VaIN [VaIN 2/3], 123 women) using colposcopy-directed biopsy at our hospital from January 1, 2019, to April 30, 2020. The thickness of the noninvolved epithelium, if available, was determined. All available data, including cytology and histological information, were recorded. The t test and Pearson χ 2 test were used for statistical analysis. Statistical significance was set at p < .05. RESULTS The involved epithelial thicknesses in VaIN 2/3 and VaIN 1 were 0.41 ± 0.21 and 0.40 ± 0.19 mm, respectively, which were both greater than their noninvolved epithelial thickness values (0.17 ± 0.10 and 0.17 ± 0.08 mm, p < .01 and p < .01, respectively). In subgroup comparisons between the VaIN 2/3 and VaIN 1 groups, the involved epithelial thickness did not differ between premenopausal patients, postmenopausal women receiving estrogen, and postmenopausal women who did not receive estrogen ( p > .05). In the VaIN 2/3 group, the lesion thickness in premenopausal was greater than that in postmenopausal women receiving estrogen ( p = .016) and those who were not receiving estrogen ( p = .017). CONCLUSIONS The thickness of VaIN is generally less than 1 mm for women of all ages, except in rare cases of visible lesions with papillary hyperplasia.
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Affiliation(s)
- Can Cui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yaoxing Xiao
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - E. Lin
- Translational Oncology & Urology Research (TOUR) Team, School of Cancer and Pharmaceutical Studies, King’s College London, London, United Kingdom
| | - Lingxiao Luo
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaoyi Sun
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jianping Zeng
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Xiang Tao
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Qing Cong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
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Qiu L, Li J, Chen F, Wang Y, Wang Y, Wang X, Lv Q, Li C, Li M, Yang Q, Wu D, Zhang Y, Zhang Y, Zhang M, Zhang Y, Qie M, Zhou H, Zhou J, Zhao W, Xia B, Liang X, Cai Y, Teng Y, Huang Z, Sui L, Wei L, Di W. Chinese Expert Consensus on the Clinical Applications of Aminolevulinic Acid-Based Photodynamic Therapy in Female Lower Genital Tract Diseases (2022). Photodiagnosis Photodyn Ther 2022; 39:102993. [PMID: 35781093 DOI: 10.1016/j.pdpdt.2022.102993] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 05/17/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION With the younger onset age of female lower genital tract diseases, there are increasing demands for protecting organ and tissue structures to preserve fertility and, therefore, effective fertility-sparing treatments that cause minimal normal tissue damage and less adverse reactions are urgently needed. OBJECTIVE This study is aimed at reviewing information and achieving consensus on recommendations on the clinical applications of aminolevulinic acid-based photodynamic therapy (ALA-PDT) in female lower genital tract diseases. METHODS Members of the expert panel held online and in-person meetings to discuss and revise drafts created by the steering committee based on the literature review and the clinical experiences of the expert panel. Opinions of the experts were transcribed and discussed in detail to ensure that the consensus statement best reflects the current advances in the field and the experts' view. RESULTS After numerous rounds of meetings, experts unanimously agreed on the importance of ALA-PDT in the treatment of cervical squamous intraepithelial lesions (SIL), vaginal SIL, vulvar SIL, vulvar lichen sclerosus (VLS), and condyloma acuminatumon (CA). Experts also reached consensus on the recommended treatment regimen and treatment methods. CONCLUSION This consensus aimed to provide practical basis and guidance for the clinical applications of ALA-PDT in female lower genital tract diseases in China. Of note, this is the only expert consensus prepared by board-certified specialists in gynecology and obstetrics in China. More evidence-based clinical studies should be made to update and expand the current recommendations.
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Affiliation(s)
- Lihua Qiu
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jingran Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Fei Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Yifeng Wang
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Wang
- Department of Obstetrics and Gynecology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xinyu Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qiubo Lv
- Department of Obstetrics and Gynecology, Beijing Hospital, Beijing, China
| | - Changzhong Li
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Mingzhu Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Qiuyun Yang
- Department of Obstetrics and Gynecology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Dan Wu
- Department of Obstetrics and Gynecology, International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai, China
| | - Youzhong Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China
| | - Yuquan Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital, Nantong University, Nantong, China
| | - Mengzhen Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Yu Zhang
- Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha, China
| | - Mingrong Qie
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Huaijun Zhou
- Department of Obstetrics and Gynecology, Naijing Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Jiade Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Weidong Zhao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Bairong Xia
- Department of Obstetrics and Gynecology, Anhui Provincial Cancer Hospital, Hefei, China
| | - Xuefang Liang
- Department of Obstetrics and Gynecology, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, China
| | - Yunlang Cai
- Department of Obstetrics and Gynecology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Yincheng Teng
- Department of Obstetrics and Gynecology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zheng Huang
- MOE Key Laboratory of OptoElectronic Science and Technology for Medicine, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou, China.
| | - Long Sui
- Department of Obstetrics and Gynecology, Obstetrics & Gynecology Hospital, Fundan University Shanghai, China.
| | - Lihui Wei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
| | - Wen Di
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
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Chen F, Novák Z, Dannecker C, Mokráš C, Sui L, Zhang Y, You Z, Han L, Lang J, Hillemanns P. Multicentre, prospective, randomised controlled trial to evaluate hexaminolevulinate photodynamic therapy (Cevira) as a novel treatment in patients with high-grade squamous intraepithelial lesion: APRICITY phase 3 study protocol. BMJ Open 2022; 12:e061740. [PMID: 35667715 PMCID: PMC9171256 DOI: 10.1136/bmjopen-2022-061740] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION High-risk human papilloma virus (HPV)-associated cervical cancer is the fourth most common cancer in women worldwide. Current treatments of high-grade squamous intraepithelial lesion (HSIL) of the cervix are based on invasive surgical interventions, compromising cervical competence and functionality. APRICITY is a multicentre, prospective, double-blind, randomised controlled phase 3 study further evaluating the efficacy and safety of Cevira, an integrated drug-delivery and light-delivery device for hexaminolevulinate photodynamic therapy, which shows promise as a novel, non-invasive outpatient therapy for women with HSIL. METHODS AND ANALYSIS Patients with biopsy-confirmed HSIL histology are invited to participate in the study planned to be conducted at 47 sites in China and 25 sites in Ukraine, Russia and the European Union. The aim is to include at least 384 patients, which will be randomised to either Cevira or placebo group (2:1). All patients will be assessed 3 months after first treatment and a second treatment will be administered in patients who are HPV positive or have at least low-grade squamous intraepithelial lesion. Primary endpoint is the proportion of the responders 6 months after first treatment. Secondary efficacy and safety endpoints will be assessed at 6 months, and data for secondary performance endpoints of the Cevira device will be collected at 3 months and 6 months, in case second treatment was administered. All patients in the Cevira group will be enrolled in an open, long-term extension study for 6 months to collect additional efficacy and safety data (study extension endpoints). ETHICS AND DISSEMINATION The study was approved by the ethics committee of the Peking Union Medical College Hospital and Hannover Medical University, Germany. Findings will be disseminated through peer review publications and conference presentations. TRIAL REGISTRATION NUMBER NCT04484415; clinicaltrials.gov.
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Affiliation(s)
- Fei Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Zoltán Novák
- Aranyklinika Gynecology, Budapest, Hungary
- Department of Gynaecology, National Institute of Oncology, Budapest, Hungary
| | - Christian Dannecker
- Department of Obstetrics and Gynaecology, University Hospital Augsburg, Augsburg, Germany
| | | | - Long Sui
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Youzhong Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhixue You
- Department of Obstetrics and Gynecology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Ling Han
- Asieris Pharmaceuticals (Shanghai) Co., Ltd, Shanghai, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
- Comprehensive Cancer Center Niedersachsen, Hannover, Germany
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Sui L, Zeng J, Ye L, Martin T, Jiang W, Hargest R. P-282 Impact of death-associated protein-3 (DAP3) and DAP3 binding cell death enhancer 1 (DELE1) on drug sensitivity in colorectal cancer cells. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.371] [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: 11/16/2022] Open
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Tao X, Zhang H, Zhang H, Xiao Y, Zhong F, Zhou X, Cong Q, Sui L, Zhao C. The clinical utility of extended high-risk HPV genotyping in risk-stratifying women with L-SIL cytology: A retrospective study of 8726 cases. Cancer Cytopathol 2022; 130:542-550. [PMID: 35312217 DOI: 10.1002/cncy.22573] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND The value of extended high-risk human papillomavirus (hrHPV) genotyping for cervical cancer screening in women with low-grade squamous intraepithelial lesion (L-SIL) cytology has been recognized, but few studies have investigated this. METHODS Women with L-SIL Papanicolaou results who underwent human papillomavirus (HPV) genotyping between October 2017 and October 2021 at the Obstetrics and Gynecology Hospital of Fudan University were identified. Their HPV results were correlated with immediate histopathologic follow-up findings. RESULTS In total, 8726 women who had L-SIL cytology and extended HPV genotyping results were analyzed. The overall hrHPV-positive rate was 84% in women with L-SIL, and the most prevalent hrHPV genotypes were type 52 (HPV52) (20.7%), HPV53 (15.7%), and HPV16 (14.3%). Single and multiple coinfections of hrHPV genotypes were detected in 57.2% and 42.8% of women with positive hrHPV results, respectively. Cervical intraepithelial neoplasia grade ≥2 (CIN2+) was identified in 8.5% of hrHPV-positive women. The CIN2+ detection rate in women who had multiple hrHPV infections (9.9%) was significantly higher than the rate in those who had infection with a single HPV type (7.2%). The top 5 CIN2+-associated HPV infections were HPV16 (25.2%), HPV82 (17.8%), HPV33 (16.3%), HPV31 (14.6%), and HPV26 (13.8%). For the composite group with HPV types HPV16, HPV26, HPV82, HPV31, HPV18, HPV33, HPV58, HPV35, HPV52, and HPV51, the risk of CIN2+ was 11.5% and represented 97.1% of all CIN2+ in biopsied, hrHPV-positive patients. The composite group of 8 remaining HPV genotypes (HPV39, HPV45, HPV53, HPV56, HPV59, HPV66, HPV68, and HPV73) was identified in 29.7% of hrHPV-positive patients, and the risk of CIN2+ for this composite group was similar to the risk of CIN2+ in hrHPV-negative patients. CONCLUSIONS This large retrospective study in a predominantly unvaccinated cohort demonstrated that extended hrHPV genotyping improves genotype-specific risk stratification in women with L-SIL.
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Affiliation(s)
- Xiang Tao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, New York
| | - Hao Zhang
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yaoxing Xiao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Fangfang Zhong
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xianrong Zhou
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chengquan Zhao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Gong Y, Xie Y, Chen L, Sui L. Cervical Cancer in a Septate Uterus with Double Cervix and Double Vagina: A Case Report and Review of the Literature. Int J Womens Health 2022; 14:345-351. [PMID: 35300285 PMCID: PMC8921829 DOI: 10.2147/ijwh.s350768] [Citation(s) in RCA: 1] [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] [Received: 11/23/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Septate uterus with duplicate cervices and double vagina is a rare Müllerian duct anomaly mostly found in labor or gynecological examination. We present a case of a 40-year-old asymptomatic parous patient diagnosed with double cervix and complete vaginal septum. She was admitted to hospital due to abnormal histopathology of suspicious cervical squamous papillary carcinoma post-salpingectomy. Her genital malformation was seriously addressed due to the cervical lesion. The diagnosis of cervical cancer in the left cervix and LSIL in the right cervix was made after LEEP conization. She received laparoscopic hysterectomy with salpingectomy and partial vagina wall resection for radical resection of the lesion. We report this case to present irregular findings during colposcopy, hysterectomy, and histopathology.
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Affiliation(s)
- Yingxin Gong
- Cervical Diseases Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yu Xie
- Cervical Diseases Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Limei Chen
- Cervical Diseases Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China
| | - Long Sui
- Cervical Diseases Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China
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Zhou Q, Gong Y, Qiu X, Sui L, Zhang H, Wang Y, Lin L, Diao W, Li Y. Visual appearance of the uterine cervix differs on the basis of HPV type status in high-grade squamous intraepithelial lesion: the results of a reliable method. BMC Womens Health 2022; 22:24. [PMID: 35094702 PMCID: PMC8801095 DOI: 10.1186/s12905-021-01565-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to evaluate the differences in cervical appearance among different human papillomavirus (HPV) genotypes in patients with high-grade squamous intraepithelial lesions (HSILs). Methods
A total of 239 histopathological HSIL patients were included and divided into eight groups on the basis of HPV genotype in this prospective study. We present a reliable imaging method that provides reproducible, sensitive and unbiased assessments of cervical appearance characteristics. Colorimetric and morphometric data of colposcopic patterns after the application of acetic acid and iodine were acquired using ImageJ software and the surrounding normal regions were used as controls. Results The differences in red, green, blue and mean greyscale values in acetowhite epithelium obtained from ImageJ were not significant between the HPV16 and HPV18 groups (P < 0.05). The differences in red, green, and mean greyscale values in iodine staining were significant between the HPV18 and the other groups (P < 0.05). The frequency of the occurrence of the coarse mosaic patterns was significantly different among groups (P < 0.05), reducing in sequence were the HPV16, HPV-negative, HPV18, HPV31/33 and HPV52/58 groups. For the lesion area of HSILs, the HPV-negative group was the largest. The sensitivity of colposcopic impression varied among HPV genotypes (P < 0.01), being lowest in the HPV52 group. Conclusions Although being nonspecific, iodine negativity should be concerned in HPV18-positive lesions which is closely related to glandular epithelium. Vascular patterns in HPV52/58-positive HSIL are quite occult and tend to be missed by colposcopists. HPV-negative lesions are prone to be large and present typical vascular patterns despite being rare.
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Affiliation(s)
- Qi Zhou
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Yingxin Gong
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Xiangmei Qiu
- The First Affiliated Hospital of Zunyi Medical College, Guizhou, 563000, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Hongwei Zhang
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Yan Wang
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Lin Lin
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Wenjing Diao
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China
| | - Yanyun Li
- Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, China.
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Gong Y, Xie Y, Chen L, Li Y, Sui L. Research trends and hotspots on human papillomavirus: a bibliometric analysis of 100 most-cited articles. Ann Transl Med 2022; 10:816. [PMID: 36034987 PMCID: PMC9403931 DOI: 10.21037/atm-22-463] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/08/2022] [Indexed: 12/01/2022]
Abstract
Background The study aimed to investigate the research trends and hotspots in the field of human papillomavirus (HPV) from the top-cited articles. Methods The database Web of Science (WOS) was utilized to retrieve articles closely related to HPV, and 100 articles with the most citations were selected. Bibliometric analysis along with visualization tools was applied to analyze citation, publication time, journal, author, geographic distribution, institutional and international cooperation, title, abstract, and keyword co-occurrence cluster. Results The articles were mainly published from 2003 to 2012 (56%) and most articles were published in 2007 (13 papers). The citations ranged from 506 to 6,426, with a median citation of 798.5. The United States contributed 68% of the papers, and most articles were published in North America and Europe continent. Boash FX, Meijer CLJM, and Munoz N owned most authorship (13 papers). The most highlighted research category was oncology (34%), and the most aggregated topics were epidemiology (34%) and etiology (32%). The emerging trends on subtopics including vaccination, intention, screening, and man, were raising. Conclusions Emerging trends in epidemiology, etiology, and HPV-related cancers remained central to the field. For decades, the focus of HPV research has shifted from identification to screening and prevention. With the implementation of vaccination, future studies may focus on its practice as well as public intention.
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Affiliation(s)
- Yingxin Gong
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Yu Xie
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Limei Chen
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yanyun Li
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Tao X, Austin RM, Yu T, Zhong F, Zhou X, Cong Q, Sui L, Zhao C. Risk stratification for cervical neoplasia using extended high-risk HPV genotyping in women with ASC-US cytology: A large retrospective study from China. Cancer Cytopathol 2021; 130:248-258. [PMID: 34874615 DOI: 10.1002/cncy.22536] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Extended high-risk human papillomavirus (hrHPV) genotype testing (hrHPVGT) has emerged as a new strategy to help optimize the efficiency of hrHPV triage. METHODS Women with an atypical squamous cells of undetermined significance (ASC-US) cervical Papanicolaou test result who underwent hrHPVGT between October 2017 and May 2021 at the Obstetrics and Gynecology Hospital of Fudan University in Shanghai, China, were studied. For hrHPVGT, a proprietary multiplex real-time polymerase chain reaction assay was used. hrHPVGT and viral load test results in selected patients were correlated with histopathologic follow-up findings available within 6 months. RESULTS In total, 17,235 women with ASC-US cytology who had hrHPVGT results were identified in the Obstetrics and Gynecology Hospital of Fudan University database. The hrHPV-positive rate was 61.8%, and the most prevalent hrHPV genotypes were type 52 (HPV52) (16%), HPV16 (11.3%), HPV58 (10.2%), and HPV53 (8.4%). Single hrHPV genotypes were detected in 65.9% of women with hrHPV-positive results, and multiple genotypes were detected in 34.1%. Histopathologic cervical findings within 6 months were available in 5627 hrHPV-positive women and 2223 hrHPV-negative women. High-grade cervical intraepithelial lesions or cervical cancer (cervical intraepithelial neoplasia 2 or greater [CIN2+]) were identified in 7.5% of hrHPV-positive women who had ASC-US cytology and in 0.9% of hrHPV-negative women who had ASC-US cytology. The greatest risk for CIN2+ was in single hrHPV genotype infections with HPV16 (21.1%), HPV33 (15.2%), HPV82 (10%), and HPV18 (9.9%). hrHPVGT for genotypes HPV16, HPV33, HPV82, HPV18, HPV31, HPV45, HPV58, and HPV52 identified 95% of CIN2+ cases with 90.8% sensitivity, 53.8% specificity, a positive predictive value of 10.2%, and a negative predictive value of 99%. A significantly increased viral load was associated only with women who had HPV16-related CIN2+. CONCLUSIONS hrHPVGT for women who have ASC-US cytology allows for risk stratification capable of optimizing the efficiency of triage for hrHPV-positive women.
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Affiliation(s)
- Xiang Tao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - R Marshall Austin
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ting Yu
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Fangfang Zhong
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xianrong Zhou
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chengquan Zhao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Zhang L, Wang Q, Zhang H, Xie Y, Sui L, Cong Q. Screening History in Vaginal Precancer and Cancer: A Retrospective Study of 2131 Cases in China. Cancer Manag Res 2021; 13:8855-8863. [PMID: 34858059 PMCID: PMC8631831 DOI: 10.2147/cmar.s335701] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/23/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine the screening history of vaginal intraepithelial neoplasia (VaIN) and vaginal cancer. Patients and Methods We included women with histologically confirmed VaIN or vaginal cancer by colposcopy-directed biopsy between 1 January 2019 and 31 December 2019. The results of cytology, hrHPV, colposcopic examination and history of hysterectomy were retrospectively analysed. Results A total of 26,432 colposcopies were performed during the study period, among which 2131 women (1835 [86.1%] with VaIN 1; 268 [12.6%] with VaIN 2/3; and 28 [1.3%] with vaginal cancer) were retrospectively studied. hrHPV test positivity was significantly higher than that of cytology for VaIN 1 (84.4% vs 67.3%; P < 0.001) and VaIN 2/3 (92.0% vs 79.9%; P < 0.001) but not for vaginal cancer (84.6% vs 78.6%; P = 0.73). Additionally, the concordance rates for colposcopic impression were 79.5%, 54.5%, and 92.8% for VaIN1, VaIN2/3, and vaginal cancer, respectively. All 372 patients had a history of hysterectomy, and 81.0% (282/348) of indications were related to cervical precancer and cancer. Although cytology test positivity was significantly higher in patients with hysterectomy than in patients without hysterectomy (76.2% vs 67.5%; P < 0.001), cytology combined with hrHPV can help to detect more than 95% of VaIN and vaginal cancer cases in both groups (96.2% for patients with hysterectomy and 96.5% for patients without hysterectomy). Conclusion VaIN and vaginal cancer are not rare diseases. Although cytology was sensitive (67.5%-76.2%) for detecting vaginal lesions regardless of hysterectomy, cytology combined with hrHPV improves detection accuracy up to 95% in both groups.
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Affiliation(s)
- Lu Zhang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qing Wang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Hongwei Zhang
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yu Xie
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Long Sui
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qing Cong
- Medical Center of Diagnosis and Treatment for Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
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Li Y, Gong YX, Wang Q, Gao S, Zhang H, Xie F, Cong Q, Chen L, Zhou Q, Hong Z, Qiu L, Li F, Xie Y, Sui L. Optimizing the Detection of Occult Cervical Cancer: A Prospective Multicentre Study in China. Int J Womens Health 2021; 13:1005-1015. [PMID: 34737649 PMCID: PMC8558636 DOI: 10.2147/ijwh.s329129] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Early-stage cervical cancer is usually diagnosed by colposcopy-directed biopsy (CDB) and/or endocervical curettage (ECC), but some neglected lesions must be detected by conization because they are occult. This study aimed to explore the optimal method for detecting these "occult" cervical cancers. Patients and Methods A total of 1299 patients who were high-risk for early-stage cervical cancer from five centres in China were prospectively included. We evaluated the diagnostic performance of cytology, HPV testing, colposcopy and CDB&ECC for detecting "occult" cervical cancer and discussed the diagnostic importance of transformation zone (TZ) type, conization length and the proportion of cervical cone excision. Results The diagnostic agreement between colposcopy impression and conization was 64.5% and 72.4% between CDB&ECC and conization. Forty-two patients were finally diagnosed with pathologic cancer, and the sensitivities of cytology, colposcopy, CDB&ECC were 4.8%, 7.1%, and 47.4%, respectively. Twenty cases were neglected by CDB&ECC but further diagnosed as cancer by conization, considered to be occult cervical cancer, accounting for 1.6%. Cytologic high-grade squamous intraepithelial lesion (HSIL)+, positive HPV, biopsy HSIL+ and cervical TZ type 3 were considered risk factors for developing HSIL+, while colposcopy impression HSIL+ was not. There was a significant difference between cancerous and HSIL patients in the proportion of cervical cone excision (P<0.001), which was recognized as a risk factor (P<0.001) for detecting cancer, while the length of cervical cone excision was not. The average proportion was 0.62, and the minimal effective proportion was 0.56. Conclusion Since the incidence of occult cervical cancer neglected by CDB&ECC, colposcopy and cytology was far beyond expectations, conization is necessary, especially in patients with TZ type 3, high-grade cytology and biopsy results. As the cervical length varies in patients, the proportion of cervical cone excision might be a better indicator for detecting occult cervical cancer.
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Affiliation(s)
- Yanyun Li
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Ying-Xin Gong
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qing Wang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Shujun Gao
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Hongwei Zhang
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Feng Xie
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qing Cong
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Limei Chen
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qi Zhou
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Zubei Hong
- Department of Gynecology and Obstetrics, Renji Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lihua Qiu
- Department of Gynecology and Obstetrics, Renji Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Fang Li
- Department of Gynecology and Obstetrics, Shanghai Dongfang Hospital of Tongji University, Shanghai, People's Republic of China
| | - Yu Xie
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Long Sui
- Department of Gynecology and Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
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Xie Y, Zhou Q, Chen L, Sui L. Pathology Behind Constant Watery Vaginal Discharge: A Rare Case of Uterine Cervical Minimal Deviation Adenocarcinoma. Cancer Manag Res 2021; 13:7929-7935. [PMID: 34703314 PMCID: PMC8541879 DOI: 10.2147/cmar.s334660] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/03/2021] [Indexed: 11/23/2022] Open
Abstract
Minimal deviation adenocarcinoma (MDA) of uterine cervix is a rare malignant disease with rather poorer prognosis partially due to the early misdiagnosis. Hence, better understanding of early-stage symptoms is critical. We report a case of a 39-year-old woman came to hospital with a chief complaint of "a watery vaginal discharge for 9 months". She was further diagnosed as having uterine cervical minimal deviation adenocarcinoma in cervical LEEP specimen and MDA stage IIIC1 (FIGO 2018 staging-after correction) in post-hysterectomy histopathology. Currently, the definitive treatment is hysterectomy with adjuvant therapy based on staging. This article gives concise symptoms, history, and images of MDA colposcopy finding and histopathology, through the whole process of diagnosis and treatment for future clinical reference.
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Affiliation(s)
- Yu Xie
- Cervical Diseases Diagnosis and Treatment Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qi Zhou
- Cervical Diseases Diagnosis and Treatment Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Limei Chen
- Cervical Diseases Diagnosis and Treatment Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
| | - Long Sui
- Cervical Diseases Diagnosis and Treatment Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China
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Abstract
Cumulative studies have shown that metabolic reprogramming is a hallmark of malignant tumors. The emergence of technological advances, such as omics studies, has strongly contributed to the knowledge of cancer metabolism. Cervical cancer is among the most common cancers in women worldwide. Because cervical cancer is a virus-associated cancer and can exist in a precancerous state for years, investigations targeting the metabolic phenotypes of cervical cancer will enhance our understanding of the interference of viruses on host cells and the progression of cervical carcinogenesis. The purpose of this review was to illustrate metabolic perturbations in cervical cancer, the role that human papillomavirus (HPV) plays in remodeling cervical cell metabolism and recent approaches toward application of metabolomics in cervical disease research. Cervical cancer displays typical cancer metabolic profiles, including glycolytic switching, high lactate levels, lipid accumulation and abnormal kynurenine/tryptophan levels. HPV, at least in part, contributes to these alterations. Furthermore, emerging metabolomics data provide global information on the metabolic traits of cervical diseases and may aid in the discovery of biomarkers for diagnosis and therapy.
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Affiliation(s)
- Boning Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Long Sui
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China. .,Obstetrics and Gynecology Hospital, Center of Diagnosis and Treatment for Cervical Diseases, stetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China. .,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China.
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Huang SS, Sui L, Chen LM, Zhang HW, Tao X. [Risk stratified management of cervical adenocarcinoma in situ based on cone margin state]. Zhonghua Fu Chan Ke Za Zhi 2021; 56:622-629. [PMID: 34547863 DOI: 10.3760/cma.j.cn112141-20210802-00417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the hierarchical management scheme of cervical adenocarcinoma in situ (AIS) based on cervical conization margin state. Methods: All medical records of 249 patients diagnosed as AIS by loop electrosurgical excision procedure (LEEP) conization from Jan. 2010 to Dec. 2015 in Obstetrics and Gynecology Hospital of Fudan University were retrospectively reviewed, to explore the relationship between the status of the resection margin and the residual lesion after LEEP, and the multivariate logistic regression method was used to analyze the related factors that affect the residual lesion after LEEP in cervical AIS patients. Results: (1) The age of 249 cervical AIS patients was (40±8) years old (range: 23-71 years old). Of the 249 patients, 19 (7.6%, 19/249) had residual lesions; 69 cases were pathologically diagnosed as AIS after LEEP, and the residual lesion rate was 13.0% (9/69), which was significantly higher than that of AIS + high-grade squamous intraepithelial lesion [5.6% (10/180); χ2=3.968,P=0.046]; 33 cases were multifocal lesions, the residual rate of lesions was 21.2% (7/33), which was significantly higher than that of single focal lesions patients [5.6% (12/216); χ2=7.858, P=0.005]; 181 patients underwent endocervical curettage (ECC) before surgery, the residual rate of lesions in ECC-positive patients was 14.0% (14/100) , significantly higher than that of ECC-negative patients [4.9% (4/81); χ2=4.103, P=0.043]. (2) Among 249 cases of AIS patients, the positive rate of resection margins after LEEP was 35.3% (88/249); the residual rate of lesions in patients with positive resection margins (14.8%, 13/88) was significantly higher than those with negative margins [3.8%(6/156); χ2=9.355, P=0.002]. The age of patients underwent total hysterectomy after LEEP was (43±7) years old, which was significantly higher than that of patients who did not undergo total hysterectomy [(37±8) years old; t=6.518, P<0.01].Among the patients underwent total hysterectomy after LEEP, 3 cases (2.0%, 3/152) had fertility requirements, while 38 cases (39.2%, 38/97) did not underwent total hysterectomy, the difference between the two groups was statistically significant (χ2=59.579, P<0.01). Among the 152 patients who underwent total hysterectomy after LEEP, the residual rate of lesions was 11.8% (18/152); the residual rate of lesions in patients with positive resection margins was significantly higher than that of patients with negative resection margins [18.8% (12/64) vs 7.0% (6/86); χ2=4.861, P=0.028]. The median follow-up time of 97 patients who did not undergo total hysterectomy after LEEP was 32 months (range: 4-70 months). During the follow-up period, 3 cases of cervical AIS recurrence (3.1%, 3/97) and were followed by hysterectomy,no invasive adenocarcinoma were seen. (3) Multivariate logistic regression analysis showed that the positive resection margin (OR=4.098, 95%CI: 1.235-13.595, P=0.021), multifocal lesions (OR=5.464, 95%CI: 1.494-19.981, P=0.010) were independent risk factors that affected the residual lesions in patients with cervical AIS after LEEP. Conclusions: The cervical AIS patients after LEEP conization suggested be stratified by cone margin state as the first-line stratified index, age and fertility needs as the second-line stratified management index. The individualized management plan should be developed based on comprehensive assessment of high-risk factors of residual lesions.
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Affiliation(s)
- S S Huang
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - L Sui
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - L M Chen
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - H W Zhang
- Cervical Disease Center, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - X Tao
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, ShangHai 200011, China
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Sui L, Tang C, Du Q, Zhao Y, Cheng K, Yang F. Preparation and characterization of boron-doped corn straw biochar: Fe (Ⅱ) removal equilibrium and kinetics. J Environ Sci (China) 2021; 106:116-123. [PMID: 34210427 DOI: 10.1016/j.jes.2021.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 06/13/2023]
Abstract
Nowadays, iron ions as a ubiquitous heavy metal pollutant are gradually concerned and the convenient and quick removal of excessive iron ions in groundwater has become a major challenge for the safety of drinking water. In this study, boron-doped biochar (B-BC) was successfully prepared at various preparation conditions with the addition of boric acid. The as-prepared material has a more developed pore structure and a larger specific surface area (up to 897.97 m²/g). A series of characterization results shows that boric acid effectively activates biochar, and boron atoms are successfully doped on biochar. Compared with the ratio of raw materials, the pyrolysis temperature has a greater influence on the amount of boron doping. Based on Langmuir model, the maximum adsorption capacity of 800B-BC1:2 at 25 °C, 40 °C, 55 °C are 50.02 mg/g, 95.09 mg/g, 132.78 mg/g, respectively. Pseudo-second-order kinetic model can better describe the adsorption process, the adsorption process is mainly chemical adsorption. Chemical complexation, ions exchange, and co-precipitation may be the main mechanisms for Fe2+ removal.
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Affiliation(s)
- Long Sui
- Joint laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Chunyu Tang
- Joint laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Qing Du
- Joint laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Ying Zhao
- Joint laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Kui Cheng
- Joint laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; College of Engineering, Northeast Agricultural University, Harbin 150030, China.
| | - Fan Yang
- Joint laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China.
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Li Q, Zhang HW, Sui L, Hua KQ. Diagnostic discrepancy between colposcopy and vaginoscopy: A case report. World J Clin Cases 2021; 9:5943-5947. [PMID: 34368312 PMCID: PMC8316953 DOI: 10.12998/wjcc.v9.i21.5943] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/07/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colposcopy currently plays a vital role in the diagnosis and treatment of lower genital diseases. Exposure and biopsy are two key steps in colposcopy. When the whole transformation zone or all lesions cannot be observed, we judge colposcopy as unsatisfactory. Unsatisfactory colposcopic examination may lead to the misdiagnosis of more severe diseases. The combination of colposcopy and vaginoscopy may contribute to accurate diagnosis and clinical decisions.
CASE SUMMARY Here, we introduce a case of posthysterectomy deep vaginal apex not fully exposed by colposcopy, and the biopsy result was a vaginal precancerous lesion. We adopted vaginoscopy to extend the observed area and expose the lesion thoroughly, and the biopsy result was vaginal squamous cancer.
CONCLUSION The patient received a precise diagnosis and early surgery due to the combination of colposcopy and vaginoscopy.
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Affiliation(s)
- Qing Li
- Diagnosis and Treatment Center of Cervical Disease, OBG Hospital of Fudan University, Shanghai 200000, China
| | - Hong-Wei Zhang
- Diagnosis and Treatment Center of Cervical Disease, OBG Hospital of Fudan University, Shanghai 200000, China
| | - Long Sui
- Diagnosis and Treatment Center of Cervical Disease, OBG Hospital of Fudan University, Shanghai 200000, China
| | - Ke-Qin Hua
- Department of Gynecology, Obstetrics and Gyncology Hospital of Fudan University, Shanghai 200090, China
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Almazyad AM, Gao Y, Shahrabi-Farahani S, Gartung A, Sui L, Das R, Costea DE, Watnick RS, Panigrahy D, Adam RM, Bielenberg DR. NOVEL NEUROPILIN 2-TARGETING BIOLOGIC FOR THE TREATMENT OF ORAL SQUAMOUS CELL CARCINOMA. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.035] [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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Gong YX, Xie Y, Chen L, Sui L. Intravascular Papillary Endothelial Hyperplasia Mimicking Vaginal Malignant Tumor in a Post-Radiotherapy Patient: A Case Report and Literature Review. Onco Targets Ther 2021; 14:3945-3948. [PMID: 34234463 PMCID: PMC8254599 DOI: 10.2147/ott.s317160] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign lesion that occurs in the soft tissue of any site, including the central nervous system, extremities, head, and female reproductive system. But no case occurred in vagina was reported previously. Here, we report a case of vaginal IPEH in a 54-year-old woman who has a history of radical hysterectomy for endometrial cancer with postoperative radiotherapy. She was positive for high-risk human papillomavirus (HR-HPV) with cytology result as low-grade squamous intraepithelial lesion (LSIL), and pathology from colposcopy-directed biopsy (CDB) presented suspicious high-grade squamous intraepithelial lesion (HSIL). The colposcopy showed an 8mm neoplasm at the right apical angle of vagina. The diagnosis of IPEH was confirmed by biopsy pathology and immunohistochemistry. As the lesion was benign and rather small, we discharged the patient with annual follow-up. The case illuminated that attention should be paid to "HSIL" patients after radiotherapy to exclude the incidence of benign IPEH.
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Affiliation(s)
- Ying-Xin Gong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, People’s Republic of China
| | - Yu Xie
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, People’s Republic of China
| | - Limei Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, People’s Republic of China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, People’s Republic of China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, People’s Republic of China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, People’s Republic of China
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Dong S, Lu Q, Xu P, Chen L, Duan X, Mao Z, Zhang B, Sui L, Wang Y, Yu W. Hypermethylated PCDHGB7 as a universal cancer only marker and its application in early cervical cancer screening. Clin Transl Med 2021; 11:e457. [PMID: 34185407 PMCID: PMC8214855 DOI: 10.1002/ctm2.457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Shihua Dong
- Research and Development Department, Shanghai Epiprobe Bio-Technology Co., Ltd, Shanghai, China
| | - Qi Lu
- Department of Obstetrics and Gynecology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Peng Xu
- Shanghai Public Health Clinical Center, Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Laboratory of RNA Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China
| | - Limei Chen
- Medical Center for Diagnosis and Treatment of Cervical Disease, Obstetrics and Gynecology Hospital, Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Xiaoling Duan
- Department of Obstetrics and Gynecology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Zhanrui Mao
- Research and Development Department, Shanghai Epiprobe Bio-Technology Co., Ltd, Shanghai, China
| | - Baolong Zhang
- Shanghai Public Health Clinical Center, Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Laboratory of RNA Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China
| | - Long Sui
- Medical Center for Diagnosis and Treatment of Cervical Disease, Obstetrics and Gynecology Hospital, Fudan University, Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Yudong Wang
- Department of Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenqiang Yu
- Shanghai Public Health Clinical Center, Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Laboratory of RNA Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China
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Cong Q, Guo X, Zhang S, Wang J, Zhu Y, Wang L, Lu G, Zhang Y, Fu W, Zhou L, Wang S, Liu C, Song J, Yang C, Luo C, Ni T, Sui L, Huang H, Li J. HCV poly U/UC sequence-induced inflammation leads to metabolic disorders in vulvar lichen sclerosis. Life Sci Alliance 2021; 4:4/8/e202000906. [PMID: 34145025 PMCID: PMC8321666 DOI: 10.26508/lsa.202000906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/14/2020] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 01/03/2023] Open
Abstract
Multi-omics analysis reveals the elevation of HCV poly U/UC sequences, which induces abnormal inflammation and related metabolic disorder in vulvar lichen sclerosis. Vulvar lichen sclerosis (VLS) is a dermatologic disorder that affects women worldwide. Women with VLS have white, atrophic papules on the vulva. They suffer from life-long intense pruritus. Corticosteroids are the first-line of treatments and the most effective medicines for VLS. Although VLS has been speculated as an autoimmune disease for a long time, its pathogenesis and the molecular mechanism is largely unknown. We performed a comprehensive multi-omics analysis of paired samples from VLS patients as well as healthy donors. From the RNA-seq analysis, we found that VLS is correlated to abnormal antivirus response because of the presence of Hepatitis C Virus poly U/UC sequences. Lipidomic and metabolomic analysis revealed that inflammation-induced metabolic disorders of fatty acids and glutathione were likely the reasons for pruritus, atrophy, and pigment loss in the vulva. Thus, the present study provides an initial interpretation of the pathogenesis and molecular mechanism of VLS and suggests that metabolic disorders that affect the vulva may serve as therapeutic targets for VLS.
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Affiliation(s)
- Qing Cong
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Xiao Guo
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Shengwei Zhang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Jinhui Wang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Yi Zhu
- Institute of Environmental Medicine and Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lili Wang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Guangxing Lu
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Yufeng Zhang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Wei Fu
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Liying Zhou
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Shuaikang Wang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Cenxi Liu
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Jia Song
- Institute of Molecular Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chaoyong Yang
- Institute of Molecular Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,The Ministry of Education Key Laboratory of Spectrochemical Analysis and Instrumentation, State Key Laboratory for Physical Chemistry of Solid Surfaces, Key Laboratory for Chemical Biology of Fujian Province, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, China
| | - Chi Luo
- Institute of Environmental Medicine and Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Ni
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - He Huang
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
| | - Jin Li
- Obstetrics and Gynecology Hospital, State Key Laboratory of Genetic Engineering, Institute of Metabolism and Integrative Biology and School of Life Sciences, Fudan University, Shanghai, China
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Cong Q, Luo L, Fu Z, Lu J, Jiang W, Sui L. Histopathology of women with non-uniform endometrial echogenicity and risk factors for atypical endometrial hyperplasia and carcinoma. Am J Transl Res 2021; 13:4500-4509. [PMID: 34150030 PMCID: PMC8205758] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE In sonography, homogeneous endometrium is defined as uniform endometrial echogenicity and heterogeneous, asymmetrical or cystic endometrium is defined as non-uniform. However, the relationship between the non-uniform endometrial echogenicity and the presence or absence of pathology is not known. A retrospective study of the patients with ultrasound non-uniform endometrium who underwent hysteroscopy-directed biopsy was performed to explore its clinical meaning in the diagnosis of endometrial lesions. MATERIALS AND METHODS Patients with non-uniform endometrial echogenicity who underwent hysteroscopy-directed biopsy were enrolled in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to May 2018 as the primary cohort. In total, 692 patients with non-uniform endometrial echogenicity were diagnosed and underwent hysteroscopy-directed biopsy. Characteristics were assessed using univariate logistic regression between patients with and without atypical endometrial hyperplasia and carcinoma (atypical EH+). Multivariate analyses were used to develop the predicting model. We incorporated statistically significant variables and presented with nomogram. Internal validation was assessed. An independent validation cohort consisted of 237 consecutive patients from June 2018 to February 2019. RESULTS Hysteroscopy-directed biopsy showed that 55.20% (382/692) of the patients with non-uniform endometrium had normal endometrium, while 44.80% (310/692) had endometrial lesions, including 39.31% (272/692) benign lesions and 5.49% (38/692) atypical EH+. Univariate logistic analysis showed that older age (P=0.027), abnormal uterine bleeding (AUB) before menopause (P=0.011), postmenopausal bleeding (P<0.001) and endometrial thickness ≥7 mm (P=0.013) were statistically significant for atypical EH+. Multivariate logistic regression analysis showed that age ≥50 years old (OR: 3.97, 95% CI: 1.17-13.43, P=0.027), endometrial thickness ≥7 mm (OR: 8.08, 95% CI: 1.86-35.08, P=0.005) and postmenopausal bleeding (OR: 8.98, 95% CI: 3.26-24.76, P<0.001) were risk factors for atypical EH+. Predictors in the individualized predicted nomogram included age ≥50 years old, AUB before menopause, postmenopausal bleeding and endometrial thickness ≥7 mm. The model showed good discrimination with area under curve (AUC) of 77.09%. With cutoff value of 0.0089267, the recall of atypical EH+ is 100% with precision 6.52% and 6.22% in both primary and validation cohort, respectively. Conclusion Non-uniform endometrial echogenicity is clinically meaningful in assessment of atypical EH+ with risk factors of age ≥50 years old, postmenopausal bleeding and endometrial thickness ≥7 mm. The model can help clinician to predicate the probability of atypical EH+ and make clinical decision.
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Affiliation(s)
- Qing Cong
- Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghai, China
| | - Lingxiao Luo
- Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghai, China
| | - Zhongpeng Fu
- Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghai, China
| | - Jiaqi Lu
- Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghai, China
| | - Wei Jiang
- Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghai, China
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Yang F, Sui L, Tang C, Li J, Cheng K, Xue Q. Sustainable advances on phosphorus utilization in soil via addition of biochar and humic substances. Sci Total Environ 2021; 768:145106. [PMID: 33736348 DOI: 10.1016/j.scitotenv.2021.145106] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
The intervention of human in phosphorus pool seems to be a vicious circle. The rapid population growth leads to the global food shortage, which leads to the massive use of phosphate fertilizer and the continuous exploitation of phosphate rocks. With the massive loss and fixation of phosphate fertilizer in the soil, the unavailable phosphorus in the soil becomes superfluous, while the phosphate mineral resources turn to scarce. Interestingly, exogenous carbonaceous materials, notably, biochar and humic substances, have been widely used as soil conditioners in agricultural production up to date, among other actions to interfere with the balance between the different phosphate species, which offer effective roles for increasing soil available phosphorus. This article reviews the regulation mechanisms of biochar and humic substances on phosphorus availability and circulation, including improving soil physicochemical characteristics, regulating microbial community structure, and directly interacting with phosphorus to affect the fate of phosphorus in soil. Finally, the prospects for future research directions are made, and it is hoped that the review of this article can arouse people's attention to the current plight of agricultural production and provide some methods for improving the efficiency of phosphate fertilizer use in the future.
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Affiliation(s)
- Fan Yang
- State Key Laboratory of Geomechanics and Geotechnical Engineering, Institute of Rock and Soil Mechanics, Chinese Academy of Sciences, Wuhan 430071, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China.
| | - Long Sui
- Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Chunyu Tang
- Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Jiangshan Li
- State Key Laboratory of Geomechanics and Geotechnical Engineering, Institute of Rock and Soil Mechanics, Chinese Academy of Sciences, Wuhan 430071, China
| | - Kui Cheng
- Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; College of Engineering, Northeast Agricultural University, Harbin 150030, China
| | - Qiang Xue
- State Key Laboratory of Geomechanics and Geotechnical Engineering, Institute of Rock and Soil Mechanics, Chinese Academy of Sciences, Wuhan 430071, China.
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Yang F, Du Q, Sui L, Cheng K. One-step fabrication of artificial humic acid-functionalized colloid-like magnetic biochar for rapid heavy metal removal. Bioresour Technol 2021; 328:124825. [PMID: 33609885 DOI: 10.1016/j.biortech.2021.124825] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
A novel functional colloid-like magnetic biochar (Col-L-MBC) with high dispersibility is prepared by the one-step method with the prepared porous biochar as the skeleton. Notably, A-HA obtained from waste biomass through hydrothermal humification (HTH) technology has rich functional groups (i.e., phenolic-OH, -COOH, etc.), which is conducive to the uniform dispersion of magnetic nanoparticles on the porous biochar skeleton, providing rich active sites for heavy metal ion removal. Interestingly, the introduction of A-HA can also lead to the formation of new iron species. Besides, A-HA coated on the surface of the magnetic substance also improves the dispersion of the magnetic biochar (Col-L-MBC) in the solution, forming a colloid-like magnetic biochar adsorbent, bringing superior removal performance for Cd2+ (maximum removal capacity up to 169.68 mg/g). Various removal mechanisms, including Cd-π interaction, complexation, ion exchange, and precipitation are introduced, making a great contribution to rapid removal performance.
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Affiliation(s)
- Fan Yang
- School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China.
| | - Qing Du
- School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China
| | - Long Sui
- School of Water Conservancy and Civil Engineering, Northeast Agricultural University, Harbin 150030, China; Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China
| | - Kui Cheng
- Joint Laboratory of Northeast Agricultural University and Max Planck Institute of Colloids and Interfaces (NEAU-MPICI), Harbin 150030, China; College of Engineering, Northeast Agricultural University, Harbin 150030, China
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Cong Q, Guo X, Liu C, Zhong F, Li J, Sui L. Alteration of gene expression related to vulvar smooth muscle, extracellular matrix and innervation in vulvar lichen sclerosus: A pilot study. Health Sci Rep 2020; 3:e208. [PMID: 33313423 PMCID: PMC7695304 DOI: 10.1002/hsr2.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Qing Cong
- Obstetrics and Gynecology Hospital, School of Life SciencesFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghaiChina
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghaiChina
| | - Xiao Guo
- Obstetrics and Gynecology Hospital, School of Life SciencesFudan UniversityShanghaiChina
| | - Cenxi Liu
- Obstetrics and Gynecology Hospital, School of Life SciencesFudan UniversityShanghaiChina
| | - Fangfang Zhong
- Obstetrics and Gynecology Hospital, School of Life SciencesFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghaiChina
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghaiChina
| | - Jin Li
- Obstetrics and Gynecology Hospital, School of Life SciencesFudan UniversityShanghaiChina
| | - Long Sui
- Obstetrics and Gynecology Hospital, School of Life SciencesFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghaiChina
- Shanghai Medical Center of Key Programs for Female Reproductive DiseasesShanghaiChina
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Chen L, Guo L, Chen F, Xie Y, Zhang H, Quan P, Sui L. Transplantation of menstrual blood-derived mesenchymal stem cells (MbMSCs) promotes the regeneration of mechanical injuried endometrium. Am J Transl Res 2020; 12:4941-4954. [PMID: 33042399 PMCID: PMC7540145] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 08/01/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The ultimate cause of intrauterine adhesions (IUAs) is the substantial destruction of the endometrium, which makes the regeneration of endometrium difficult. The purpose of this study was to observe menstrual blood-derived mesenchymal stem cells (MbMSCs)'s effect on the endometrial regeneration with different methods of transplantation. We also studied whether MbMSCs transfected with the FGF2 gene can improve the regenerative effect. METHODS 75 female SD rats with endometrium removed were used as IUA models. These IUA models were divided into 5 groups: group A was the IUA control, group B received a scaffold transplant, group C received a scaffold+MbMSC transplant, group D received a scaffold+FGF2-MbMSC transplant, and group E received FGF2-MbMSCs injected via the tail vein. After the intervention, 5 rats from each group were sacrificed on the 7th day and the 28th day respectively. The distribution of MbMSCs in endometrium was traced using enhanced green fluorescent protein. The endometrial morphology, number of endometrial glands, area of endometrial fibrosis and immunohistochemistry (IHC) of Ki67, VEGF, and CD31 were evaluated. In addition, the fertility of all groups was tested. RESULTS On the 7th day after transplantation, enhanced green fluorescent protein showed that there were more MbMSCs in the uterine cavity of group D than that of group E. The endometrial morphology of groups A and B was atrophic and thinned with a high proportion of fibrosis in the endometrium. The endometrium of groups C, D and E was thickened, contained more glands, exhibited reduced fibrosis, and had increased expression of Ki67, VEGF and CD31. The endometrial regenerative effect from high to low was D > C > E with significant differences between each two groups. The fertility test verified the regenerative effect. CONCLUSIONS These results suggest that the injection of MbMSCs into the tail vein was an effective way to stimulate endometrial regeneration, but the effect was not so well as the intrauterine transplant of MbMSCs with scaffold. The FGF2-transfected MbMSCs exhibited enhanced regenerative effect.
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Affiliation(s)
- Limei Chen
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
| | - Luopei Guo
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
| | - Fang Chen
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
| | - Yu Xie
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
| | - Hongwei Zhang
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
| | - Peiqing Quan
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
| | - Long Sui
- Medical Center of Hysteroscopy, Obstetrics and Gynecology Hospital, Fudan UniversityShanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai, China
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