Objective To understand the latest research developments of the formation mechanism of psammoma body in human tumors and related issues. Methods Related domestic and foreign literatures were widely referred, analyzed, and reviewed. Results Psammoma body is unique pathological calcification in some tumors, which is arranged in concentric, laminar circles microscopically. Psammoma body is commonly seen in thyroid papillary carcinoma, meningiomas, ovarian serous papillary carcinoma, and so on. Conclusions Although arranged in concentric, laminar circles microscopically in tumor, the formation process of psammoma body is not entirely the same in different tumors. A comprehensive and objective understanding of psammoma body would be useful in cancer diagnosis and treatment.
ObjectiveTo analyze the reasons for misdiagnosis of gastrointestinal metastatic ovarian cancer, in order to increase the rate of correct diagnosis and treatment, and to investigate the prognostic factors. MethodsWe retrospectively analyzed the clinical features, pathological features and prognostic factors of 43 cases of metastatic ovarian carcinoma from gastrointestinal tract treated between 2004 and 2014. ResultsGastrointestinal metastatic ovarian cancer was characterized by the diversity of clinical manifestations and lack of specific symptoms. The common initial symptom was pelvic mass, frequently accompanied with gastrointestinal symptoms of ascites, anemia or weight loss, abdominal pain, bloating, gastrointestinal obstruction and bleeding. Signs and symptoms of primary and secondary tumor sites often coexisted with each other, leading to misdiagnosis. Univariate analysis showed that primary site, histological type, surgical treatment, the residual tumor debulking size, lymph node metastasis, tumor invasion and standard chemotherapy had significant impacts on the prognosis (P < 0.05). ConclusionsGastrointestinal metastatic ovarian cancer occurs in premenopausal women, often with ascites, abdominal pelvic masses as the first symptom. Primary tumor site is often ignored, and the initial correct diagnosis rate is low. Metastasis from stomach cancer is the most common, followed by colorectal cancer and esophageal cancer. Prognosis is correlated with the primary site, histological type, degree of differentiation, depth of invasion, lymph node metastasis and other factors. Radical surgery and chemotherapy can improve survival.
【摘要】 目的 了解青年早期宫颈癌患者在卵巢移位术后的卵巢功能。 方法 2001年1月-2009年12月收治53例年龄26~40岁宫颈癌Ⅰb~Ⅱa期患者，其中27例在宫颈癌根治术中行卵巢移位术为观察组，26例行宫颈癌根治术切除双侧卵巢的为对照组。术后应用血清卵泡刺激素（FSH）、黄体生成激素（LH）、雌二醇（E2），B超及Kuppermann评分进行卵巢功能测定，随访1~4年。 结果 观察组术后4年内卵巢功能基本正常，对照组术后1个月卵巢功能丧失。观察组术后4年内血FSH、LH、E2及Kuppermann评分与对照组比较有显著性意义（Plt;0.05）；两组复发率比较无显著性意义（P gt;0.05）。 结论 青年早期宫颈癌患者在宫颈癌根治术中行卵巢移位术对其卵巢功能无明显影响。【Abstract】 Objective To investigate the function of ovary after ovarian transposition among young patients with early-stage cervical cancer. Methods A total of 53 young females (26-40 years old) with early stage cervical cancer (FIGO ⅠB or ⅡA) from January 2001 to December 2009. Ovarian transposition was performed at the same time of radical hysterectomy and pelvic lymphadenectomy on 27 patients who were the experimental group. Radical hysterectomy and pelvic lymphadenectomy was done without ovarian transposition on other 26 patients who were the control group. The function of ovarian was evaluated by serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), the ultrasound examination and Kuppermann score system in all patients during 1- 4 years’ follow-up. Results The patients in the control group became climacteric in one month after the operation. However, among the patients in the experimental group, their normal ovarian function was preserved within 1- 4 years’ follow-up. There was statistically significant difference between the experimental group and the control group regarding to serum E2, FSH, LH level and Kuppermann score of the patients (Plt;0.05). However, there was no statistically significant difference between the two groups regarding to the recurrence rate (Pgt;0.05). Conclusion Ovarian transposition has statistical significant effect on protection of ovarian function in young patients with early stage cervical cancer, who undergoes radical hysterectomy and pelvic lymphadenectomy.
【摘要】 目的 研究肿瘤坏死因子相关凋亡诱导配体（TRAIL）蛋白对SKOV3移植瘤细胞半胱天冬氨酸蛋白酶-3（Caspase-3）表达的影响及其与肿瘤细胞凋亡的关系。 方法 建立雌性裸小鼠SKOV3移植瘤24只，随机分为4组，每组6只。TRAIL组单用重组人TRAIL蛋白（10 μg/kg），顺铂（DDP）组单用DDP（3 mg/kg），TRAIL+DDP组联合使用TRAIL蛋白（10 μg/kg）和DDP（3 mg/kg），空白对照组给予0.5 mL生理盐水。经处理后，各组的组织切片用免疫组织化学染色检测Caspase-3的表达和末端脱氧核苷酸转移酶介导核苷酸缺口标记技术（TUNEL）检测肿瘤细胞凋亡指数。 结果 Caspase-3的表达水平在TRAIL组（171.67±14.38）、DDP组（172.50±14.75）、联合组（230.00±40.99）中均明显高于对照组（135.83±16.25）（Plt;0.05）。SKOV3移植瘤细胞凋亡指数在空白对照组、TRAIL组、DDP组和联合组分别为16.67±5.43、33.17±8.42、24.33±4.59和40.50±6.16，TRAIL组和联合组细胞凋亡指数较空白对照组和DDP组明显增高（Plt;0.05）。 结论 TRAIL蛋白使卵巢癌移植瘤细胞的Caspase-3表达增强，TRAIL蛋白促进肿瘤细胞凋亡发生。【Abstract】 Objective To investigate the effects of Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on the expression of Cysteine/aspartic acid specific protease- 3 (Caspase-3) in SKOV3 ovarian tumor cells and its relationship with the apoptosis of the ovarian tumor xenografts in nude mice. Methods Twenty-four nude mice with SKOV3 cell line ovarian tumor were randomly divided into four groups with 6 in each group. TRAIL (10 μg/kg) was given to the mice in the TRAIL group; DDP (3 μg/kg) was given to the mice in the DDP group; TRAIL (10 μg/kg) and DDP (3 μg/kg) were given to the mice in the TRAIL+DDP group; and 0.5 mL of saline solution was give to the mice in the control group. The expression of Caspase-3 was detected with immunohistochemistry. The apoptosis index (AI) of cells was determined by Terminal deoxynucleotidyl transferase mediated-dUTP nick end labeling (TUNEL). Results The expression of Caspase-3 in the TRAIL group (171.67±14.38), DDP group (172.50±14.75), and TRAIL+DDP group (230.00±40.99) was significantly higher than that in the control group (135.83±16.25) (Plt;0.05). The apoptosis index for the control group, TRAIL group, DDP group and TRAIL+DDP group was 16.67±5.43, 33.17±8.42, 24.33±4.59, and 40.50±6.16, respectively. The apoptosis index for the TRAIL group and the TRAIL+DDP group was significantly higher than that in the control group and the DDP group (Plt;0.05). Conclusion Soluble TRAIL has an effect on enhancing the expression of Caspase-3 in implanted tumor in nude mice. TRAIL protein can inhibit the growth of SKOV3 cells in nude mice by inducing cell apoptosis.
ObjectiveTo improve clinicians' understanding of severe cytokine release syndrome (CRS) through reporting the clinical manifestation, diagnosis, treatment, and prognosis of CRS after chimeric antigen receptor T (CAR-T) cell therapy in a patient with solid tumor. Methods A patient with ovarian cancer who suffered severe CRS after CAR-T cell therapy in the Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University was reviewed. Relevant studies were searched for literature review. Results The patient, a 55-year-old woman, was diagnosed with ovarian cancer in early 2016 and continued to progress despite multiple lines of treatment, so she received CAR-T cell therapy on September 16, 2022. The patient developed a fever 2 days after infusion, and developed dyspnea and shortness of breath with oxygen desaturation 2 days later. Her condition kept deteriorating with respiratory distress and severe hypoxia 6 days after infusion, and the level of interleukin-6 and interferon-gamma continued to be elevated. Chest CT showed pleural effusion and massive exudation of both lungs. Considered to have acute respiratory distress syndrome (ARDS) due to severe CRS, she was transferred to the intensive care unit (ICU). The patient was treated with tocilizumab, high-dose intravenous glucocorticoid pulses, mechanical ventilation, and sivelestat sodium for ARDS. Her symptoms were gradually relieved, and the results of laboratory tests were gradually stabilized. The patient was extubated 6 days after ICU admission and discharged from ICU a week later. Six patients were screened out with ARDS or acute respiratory failure caused by CRS after CAR-T cell therapy, whose treatments were mainly anticytokine agents combined with high-flow oxygen therapy or invasive mechanical ventilation. One of them died. ConclusionsClinicians should be alert to severe CRS during the administration of CAR-T cell. Rapid interruption of the inflammation development is the key to all treatments. If respiratory and/or circulatory dysfunction occurs, patients should be transferred to ICU in time for organ support therapy.
Polycystic ovary syndrome (PCOS) affects many women of reproductive age, including ovarian and metabolic dysfunction. Major therapeutic goals include weight loss and improved insulin resistance. The effects of weight loss and increased insulin sensitivity of glucagon-like peptide-1 (GLP-1) receptor agonists provide another opportunity and pathway for the treatment of PCOS patients, especially those with metabolic abnormalities. This paper reviews the metabolism and reproductive outcomes about GLP-1 receptor agonists for PCOS by searching for literatures of clinical trials from PubMed in the past 10 years, in oder to provide new ideas and clinical evidence for clinical treatment of PCOS.
【摘要】 目的 探讨超声引导介入治疗卵巢囊肿的经验和方法。 方法 回顾性分析2004年8月－2009年12月超声引导下治疗卵巢囊肿180例，抽出囊肿内液后注入无水乙醇，观察临床疗效。 结果 179例（99.4%）治疗成功，无严重并发症发生，术后2年随访，3例（1.7%）复发。 结论 超声引导介入治疗卵巢囊肿疗效满意。【Abstract】 Objective To investigate the experiences and methods of interventional ultrasound treatment of ovarian cysts. Methods We retrospectively analyze the clinical data of 180 patients with ovarian cysts undergoing ultrasound-guided treatment. The clinical effect was observed after alcohol sclerosis therapy. Results A total of 179 patients (99.4%) were successfully treated by the ultrasound-guided aspiration without severe significant complications. Three patients (1.7%) recurred during the 24-month follow-up. Conclusion The clinical effect of ultrasound-guided aspiration and alcohol sclerosis was satisfactory.
ObjectiveTo systematically review the prognostic efficacy and safety of patients with ovarian cancer treated with systemic lymphadenectomy (SL). MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on the prognostic outcomes of patients with ovarian cancer treated with SL from inception to December 16th, 2020. Six reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 5 RCTs and 23 cohort studies involving 6 166 patients were included. The results of meta-analysis showed that there were no significant differences in the 3-year survival rate, 5-year survival rate, 3-year progression-free survival rate, and 5-year progression-free survival rate between SL group and the no systemic lymphadenectomy (NSL) group. The results of the subgroup analysis showed that pelvic and para-aortic lymph node dissection combined with large omentum resection had a better prognosis for patients. ConclusionsCurrent evidence shows that SL has no significant efficacy on survival and progression-free survival in patients with ovarian cancer. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Objective To compare the efficacy and incidence of complications between laparoscopic surgery and laparotomy on women with polycystic ovarian syndrome (PCOS). Methods We did a systematic literature search for studies from Ovid Database, MEDLINE, EMbase, Cochrane Library (Issue 2, 2008), Chinese Biological Medicine Database, CNKI, Chinese VIP Database, and WANFANG Database on internet. The search time was from establishment of each database to December, 2008. Randomized controlled trials and non-randomized controlled trials were collected. The search was no limitation in language. We manually searched current and conference abstracts, and searched relevant reviews and their reference. RevMan 5.0 software was used for meta-analysis. Results Five non-randomized trials involving 417 patients were included. The results of meta-analyse showed that the short-term pregnancy rate in patients underwent laparoscopic surgery was significantly higher than that in patients underwent laparotomy (RR=1.42, 95% CI 1.13 to 1.80, P=0.003). The long-term pregnancy rate in patients underwent laparoscopic surgery and laparotomy was comparable (RR=0.85, 95%CI 0.68 to 1.07, P=0.17). The regular menstruation in patients underwent laparoscopic surgery and laparotomy was comparable (RR=0.91, 95%CI 0.79 to 1.05, P=0.18). The uterine adhesions in patients underwent laparoscopic surgery was significantly lower than that in patients underwent laparotomy (RR=0.02, 95%CI 0.00 to 0.18, P=0.000 2). The intra-abdominal adhesions of patients underwent laparoscopic surgery was significantly lower than that in patients underwent laparotomy (RR=0.02, 95%CI 0.00 to 0.13, Plt;0.000 1).Conclusions The limited evidence at present shows that the incidence and degree of pelvic adhesions occurred in patients with PCOS after laparoscopic surgery is much lower than those after laparotomy. It is not quite sure at this point about whether the pregnancy rate and regular menstruation of laparoscopic surgery are better than those of lararotomy or not. More evidence from high qualified multi-center studies is needed.
Objective To explore the status of women’s quality of life and analyze risk factors related diminished ovarian reserve (DOR). Methods We applied the method of convenient sampling to investigate 61 patients with DOR (DOR group) and 60 women with normal ovarian reserve function (control group) who visited a reproductive centre of a Triple-A hospital from February to May 2013, using a questionnaire which included basic information table, Menopausal Quality of Life Scale (MENQOL) and SF-36 Health Survey for quality of life, and Kupperman Index Scale (KI) for the degree of clinical symptoms. Then, statistical analysis was performed using SPSS 17.0 software. Results Compared with the control group (43.60±16.82), the level of women’s quality of life in the DOR group (73.42±24.15) was significantly lower (Plt;0.01), while the degree of clinical symptoms was significantly higher (Plt;0.01). There were positive associations between quality of life and degree of clinical symptoms. The risk factors related to DOR were various such as age, weight, quality of sleep, menstrual disorders, number of abortion, age of the first pregnancy, gynecologic surgery, economic income, education, family relationship, unsatisfactory sexual life, and psychological factors. Conclusion In order to improve women’s quality of life, effective treatment should be conducted to relieve clinical symptoms of women with DOR. Good life style, harmonious family relationship, healthy mind and avoiding the risk factors, which could effectively help the prevention and treatment of the disease.