经阴道彩色多普勒超声在宫颈癌诊断中的应用分析

目的:探讨宫颈管及内生型癌的声像图特征及血流阻力指数对临床诊治的价值。方法:应用经阴道彩色多普勒超声探查分析宫颈管癌的声像图及其血流阻力情况。结果:22例宫颈管癌中,15例探及肿块,内有高、低回声;2例宫颈回声不均匀;5例超声检查无异常。应用彩色多普勒可探及血流信号14例,未测及明显血流信号5例。血流指数RI(阻力指数)测值:0.35～0.74,平均为0.55。结论:经阴道彩色多普勒超声检查可为临床提供辅助诊断早期宫颈管癌(0-I期)及内生型宫颈癌的信息。

Intensity-modulated radiation therapy with concurrent chemotherapy for locally advanced cervical and upper thoracic esophageal cancer

AIM： To evaluate the dosimetry, efficacy and toxicity of intensity-modulated radiation therapy （IMRT） and concurrent chemotherapy for patients with locally advanced cervical and upper thoracic esophageal cancer. METHODS： A retrospective study was performed on 7 patients who were definitively treated with IMRT and concurrent chemotherapy. Patients who did not receive IMRT radiation and concurrent chemotherapy were not included in this analysis. IMRT plans were evaluated to assess the tumor coverage and normal tissue avoidance. Treatment response was evaluated and toxicities were assessed. RESULTS： Five- to nine-beam IMRT were used to deliver a total dose of 59.4-66 Gy （median： 64.8 Gy） to the primary tumor with 6-MV photons. The minimum dose received by the planning tumor volume （PTV） of the gross tumor volume boost was 91.2%-98.2% of the prescription dose （standard deviation [SD]： 3.7%-5.7%）. The minimum dose received by the PTV Of the clinical tumor volume was 93.8%-104.8% （SD： 4.3%-11.1%） of the prescribed dose. With a median follow-up of 15 rno （range： 3-21 too）, all 6 evaluable patients achieved complete response. Of them, 2 developed local recurrences and 2 had distant metastases, 3 survived with no evidence of disease. After treatment, 2 patients developed esophageal stricture requiring frequent dilation and 1 patient developed tracheal-esophageal fistula. CONCLUSION： Concurrent IMRT and chemotherapy resulted in an excellent early response in patients with locally advanced cervical and upper thoracic esophageal cancer. However, local and distant recurrence and toxicity remain to be a problem. Innovative approaches are needed to improve the outcome.

Overexpression of p53 Gene in Esophageal and Cervical Cancer and the Relationship with Radiotherapy Effects

Objective :To investigate the relationship between p53 -protein overexpression in esophageal and cervical squamous cell cancer and their clinical radiosensitivity. Methods: The immuno-histochemical assays were done for 52 cases with esophageal and cervical squamous cell cancer. The relationship between the assay results and short-term radiotherapy was investigated. Results: p53 overexpression was 52. 38% and 35. 48% respectively, in esophageal cancer and cervical cancer; p53 over-expression in high differentiated squamous cell cancer was lower than those in moderate and poor differentiated cases(P<0. 05). There was no relationship between p53 overexpression and stages(P> 0. 05). In the cases of cervical cancer, p53 overexpression had the less short-term effect(P< 0. 05), and In esophageal cancers, there was no relationship with radiotherapy effect(P>0. 05). Conclusion:This study suggests that y53 gene lias the certain relationship with tumor radiosensitivity.

Effect of intraarterial chemotherapy on vascular endothelial growth factor expression and microvessel density in carcinoma of the cervix

Objective: To clarify the effect of intraarterial chemotherapy on vascular endothelial growth factor (VEGF) expres- sion and microvessel density (MVD) count in carcinoma of the cervix. Methods: Before intraarterial chemotherapy and after 2–3 weeks of therapy, the expression of VEGF and MVD count in 36 carcinoma tissues of locally advanced cervical cancer were determined by CD34. Results: Before intraarterial chemotherapy and after 2–3 weeks, the expression of VEGF were 75% (27/36) and 30.6% (11/36) respectively, and MVD were reduced obviously (P<0.001). Conclusion:?The intraarterial chemotherapy can reduce the expression of VEGF and MVD, and adjust malignancy of cervical cancer, and cut down the postoperative metastasis.

RNA interference against hypoxia inducible factor-1α inhibited growth of cervical cancer by limiting vascularization

Objective:Cervical cancer has become a major public health problem.The development of effective,systemic therapies for cervical cancer is highly desired.We show here that hypoxia inducible factor-1α(HIF-1α) was indicated as an attractive therapeutic molecular target for cervical cancer.Methods:Firstly,we observed the expressional level of HIF-1α in cervical cancer and Hela and Siha cell lines.Secondly,by constructuring HIF-1α shRNA targeting human HIF-1α mRNA common sequence and transfecting it with plasmid to cervical cell,we detected the changes of HIF-1α and its downstream genes levels VEGF.Then we injected selected stably transfected cell line into athymic nude mice to estimate its' antitumor effects.Results:We observed that HIF-1α inhibition was related to down-regulated VEGF resulting in prevention of angiogenesis,then leading to slower-growing tumors.Conclusion:The underlying concept of transfecting a HIF-1α shRNA expression vector to block the HIF-1α holds promise as the clinical potential of gene therapy for cervical cancer.

Case Report:Liquid-based cytology aids in primary fallopian tube cancer diagnosis

Primary fallopian tube carcinoma(PFTC) is a rare malignant carcinoma among all genital tract malignancies.It occurs most commonly in postmenopausal women and is similar to ovarian malignancy historically and clinically.Because of its insidious onset and silent course,the diagnosis is made usually postoperatively.Liquid-based cytology(LBC) is a type of method for cervical cancer screening,but sometimes it may aid in making PFTC diagnosis.We report a 47-year-old woman with PFTC,whose diagnosis was made with the aid of LBC.