Microscale endometrial sampling biopsy in detecting endometrial cancer and atypical hyperplasia in a population of 1551 women:a comparative study with hysteroscopic endometrial biopsy

Background:Endometrial cancer is one of the most common malignancies of the reproductive system.Effective and cost-effective screening method for populations at high risk is not available.This study aimed to investigate specimen adequacy and the influencing factors in microscale endometrial sampling biopsy and to evaluate the diagnostic accuracy and medical cost of biopsy in endometrial cancer and atypical hyperplasia screenings in comparison with hysteroscopic endometrial biopsy.Methods:A total of 1551 patients at high risk for endometrial lesions who required hysteroscopic endometrial biopsy from November 2017 to August 2018 were included.Microscale endometrial sampling biopsy was performed,followed by hysteroscopic endometrial biopsy.We evaluated the specimen adequacy and influencing factors of microscale endometrial sampling.Diagnostic consistency between microscale endometrial sampling biopsy and hysteroscopic endometrial biopsy was evaluated.The sensitivity,specificity,positive predictive value,and negative predictive value of microscale endometrial sampling biopsy in screening for endometrial cancer and atypical hyperplasia were analyzed,and the medical costs of the two procedures were compared.Results:The specimen adequacy was 81.2%.Patient age,menopausal status,endometrial thickness,and endometrial lesion type were correlated with specimen adequacy.There was good consistency in distinguishing benign and malignant endometrial diseases between microscale endometrial sampling biopsy and hysteroscopic biopsy(kappa 0.950,95%CI 0.925-0.975).The sensitivity,specificity,positive predictive value,and negative predictive value of microscale endometrial sampling biopsy were 91.7%,100.0%,100.0%,and 99.3%for endometrial cancer screening,respectively,and 82.0%,100.0%,100.0%,and 99.4%for atypical hyperplasia screening.The medical cost of endometrial sampling biopsy was only 22.1%of the cost of hysteroscopic biopsy.Conclusions:Microscale endometrial sampling biopsy is a minimally invasive alternative technique for obtaining adequate endometrial specimens for histopathological examination.It has the potential to be used in detecting endometrial cancer and atypical hyperplasia with high efficiency and low cost.

Genetic source tracking of an anthrax outbreak in Shaanxi province,China

Background:Anthrax is an acute zoonotic infectious disease caused by the bacterium known as Bacillus anthracis.From 26 July to 8 August 2015,an outbreak with 20 suspected cutaneous anthrax cases was reported in Ganquan County,Shaanxi province in China.The genetic source tracking analysis of the anthrax outbreak was performed by molecular epidemiological methods in this study.Methods:Three molecular typing methods,namely canonical single nucleotide polymorphisms(canSNP),multiple-locus variable-number tandem repeat analysis(MLVA),and single nucleotide repeat(SNR)analysis,were used to investigate the possible source of transmission and identify the genetic relationship among the strains isolated from human cases and diseased animals during the outbreak.Results:Five strains isolated from diseased mules were clustered together with patients’isolates using canSNP typing and MLVA.The causative B.anthracis lineages in this outbreak belonged to the A.Br.001/002 canSNP subgroup and the MLVA15-31 genotype(the 31 genotype in MLVA15 scheme).Because nine isolates from another four provinces in China were clustered together with outbreak-related strains by the canSNP(A.Br.001/002 subgroup)and MLVA15 method(MLVA15-31 genotype),still another SNR analysis(CL10,CL12,CL33,and CL35)was used to source track the outbreak,and the results suggesting that these patients in the anthrax outbreak were probably infected by the same pathogen clone.Conclusions:It was deduced that the anthrax outbreak occurred in Shaanxi province,China in 2015 was a local occurrence.

Prediction of chemotherapeutic resistance in serous ovarian cancer with low-density custom microarray

To the Editor:Ovarian cancer is the leading cause of death from gynecologic malignancies.The major limitation to the successful long-term treatment of ovarian cancer is the development of chemotherapeutic resistance,which involves thousands of genes.In this study,a single-channel low-density custom microarray was designed to compare gene expression profiles between chemotherapy-resistant and chemotherapy-sensitive ovarian cancer.Tfie 87 genes were identified to be differentially expressed in resistant and sensitive specimens that can be used to fairly accurately predict drug resistance in serous ovarian cancer.