Primary malignant melanoma of uterine cervix: a suggestion of new scheme of treatment combination

Historically, the lack of melanocytes in the vaginal and cervical mucus membranes has deterred the findings of primary melanomas. Mainly due to its rarity, difficulty to diagnose, and poor prognosis, there has been no absolute agreement on comprehensive treatment so far. In this case report, we present a case of a 46-year-old woman with primary malignant melanoma of uterine cervix. She underwent neo-adjuvant chemotherapy initially followed by a radical hysterectomy. After adjuvant concurrent chemo-radiation, the patient has been followed up for 24 months. So far, she has not shown any symptoms or signs of recurrence. Further studies with more cases based on variable combinations of treatment regimen have been on the way.

Effects of antisense oligonucleotides targeting VEGF on radio sensitivity of uterine cervix cancer Hela cells

Objective： To determine the impact of antisense oligonucleotides targeting vascular endothelial growth factor （VEGF） on radiosensitivity of uterine cervix cancer Hela cells. Methods： VEGF antisense oligodeoxynucleotides （ASODN） was transfected into Hela cells by liposome-mediated method. Cells transfected with the oligodeoxynuclecotide and saline were used as control groups. Cells were irradiated by 6 MV X ray at the dose of 0 Gy, 2 Gy, 4 Gy and 6 Gy respectively. The expression of VEGF mRNA was determined by RT-PCR. Apoptosis were evaluated using FCM. Cloning efficiency was determined by colony formation assay. Results： The expression of VEGF mRNAwas inhibited by ASODN （P 〈 0.01） in Hela cells. The inhibited activation which was influenced by radiation resulted in increasing apoptosis （P 〈 0.01） and inhibiting plating efficiency （P 〈 0.01）. Conclusion： The expression of VEGF induced by X irradiation in Hela cells can be blocked by VEGF ASODN. Treatment with VEGF might increase apoptosis in HeLa cells and enhance radiosensitivity.

Detection and localization of the hemoglobin and collagen distribution of the uterine cervix

Changes of the blood vessels and collagen are associated with the development of abnormal cervical cells.Recently,optical coberence tomography and Mueller polarization images were 1used to provide information regarding the presence of collagen fibers in the cervical tissue.However,most of these methods need a lot of time for image recording and are expensive.In addition,the general survey on the absorption and distribution characteristics of collagen and blood in the cervical is still lacking.In this study,we developed a colposcopy combining cross-polarized inage and image procssing algorithm with an fficient analytical model to map the distribution of blood and collagen in the uterine.For this system's proof of concept,we captured and processed the case of cervical ectopy and Nabothian cyst.The results show that the distribution of blood and collagen maps matched with anatomical and physiological when compared with Lugol's iodline images.This technology has some advantages,such as low cost,real time,and can replace the 11se of acetic acid or Lugol's iodine in the future.

ROLE OF COLPOSCOPY IN THE DIAGNOSIS OF HUMAN PAPI- LLOMAVIRUS INFECTION OF THE UTERINE CERVIX

Among 6706 women screened by cytology, only 9 (0.13%) showed evidence of human pppillomavirus infection (HPVI). In 133 women examined by colposcopy for abnormal cytology or/ and suspected lestions on the cervix, 41.(30. 8%) showed subclinical papillomavirus infection (SPI), while 17. 4% and 5. 3% showed HPVI by histopathology and cytology, respectively. The conformation rate between colposcopy and pathology was 69. 6%. Sixty-nine specimens out of 133 colposcopy piled biopaies were assayed by HPV-DNA dot hybridization with 6B/11, 16, 18 probes to detect the presence of HPV-DNA In the cervical specimens. Thirty-nine (56.5%) gave a positive result. The colposcopic predictive value of positive result for HPVI was 76.7%. The difference between colposcopy (59%) and pathology (20. 5%) is statistically significant (P<0. 01). These results suggest that colposcopy is superior to cytology and hjstopathology for the detection of SPI in the cervix. In colposcopy HPV-DNA positive women, aceto while epithelium was most common (28. 2%) . As it is difficult to differentiate SPI from cervical intraepithelial neoplasia especially the Grade Ⅰ lesion by colposcopy, discrimination criteria are proposed together with the chief colposcopic features of SPI.

STAGE IB, HA AND PROXIMAL IIB, CARCINOMA OF THE UTERINE CERVIX, TREATED BY IRRADIATION ALONE OR IN COMBINATION WITH SURGERY

This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of radiation and surgery. The five-year tumor free acturial survival for the patients with stage IB either with irradiation alone (RT) or combined with surgery (RS) was approximately 87%. For stage Ⅱ the tumor free actuarial five-year survival 79% with patients of RS, and 76% with RT. In the 113 patients treated with RS there were 18 (16%). In the 139 patients treated by RT there were 18 (13%) recurrences of pelvic, 4 local recurrences, 11 combined with parametrial, and free parametrial recurrences. There was no significant difference in the survival and recurrence rate of the patients treated with either method. Major complications were comparable in both groups (RT approximately 25% and RS approximately 10%), but 2/3 of those complications recovered without sequelae. The most frequent minor complication in the patients treated with RT was rectosigmoiditis.

Primary choriocarcinoma of uterine cervix treated by uterine artery drug pouring and embolism: one case report

Primary choriocarcinoma of the uterine cervix (PCC) is an extremely rare disease. The conventional treatment of PCC is a combination of hysterectomy and chemotherapy. We present one rare case proved by cervical biopsy. The patient was an 36-year-old Chinese woman with irregular vaginal bleeding for 60 days. A cervical tumoral mass was seen in the pelvic examination and biopsy revealed active hyperplasia of trophoblastic cell. Because of massive vaginal haemorrhage, the patient accepted uterine artery drug pouring and embolism emergently. This management had gained a satisfactory effect. Thus, Uterine artery drug pouring and embolism is one new and effective weapon for PCC, which can preserve the patient’s productive ability.

COMPREHENSIVE TREATMENT FOR SARCOMA BOTRYOIDES OF UTERINE CERVIX

Seven cases of sarcoma botryoides of the uterine cervix are reviewed. The age of the patients ranged from 19 to 40 years, with a median age of 23 years. Four patients were diagnosed as stage Ia, two as Ib and one as Ⅱ a, 6 cases were treated with surgery, chemotherapy and/or radiotherapy, and 1 with surgery only, 5 cases in this group survived more than 5 years with a mean 7.9 years of follow-up. The prognosis for cervical sarcoma botryoides is similar to that of other female genital tract embryonal rhabdomyosarcomas. Primary therapy should consist of vincristine and dactinomycin based chemotherapy. Surgery should be guided by the response to initial chemotherapy and should attempt to conserve the function of the bladder, rectum, vagina, and ovaries. Radiotherapy was used for involved surgical margins or positive nodes. The effect of radiotherapy is unclear for stage Ia cases.

Analysis of the Curative Effect of Preoperative Intra-Arterial Infusion Chemoembolization on Stage IB2-IIB Uterine Cervix Cancer

OBJECTIVETo investigate the short-term and long-termtherapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB_2-IIB uterine cervix cancer (UCC).METHODS A total of 143 patients with Stage IB_2-IIB UCCwere divided into a clinical trial group and a control group.Thepatients in the clinical trial group(n=86)were treated with acombined therapy,i.e.,preoperative intra-arterial infusion chemo-embolization,surgical therapy and postoperative radiotherapy,and those in the control group (n=57) were given surgical therapyand post-operative radiotherapy.The adverse effects,changes inlocal lesion and pathological examinations of the cancer,and thestate during the surgery were observed after the intra-arterialinfusion chemo-embolization.The survival rate and recurrencerate between the two groups were compared.RESULTS The total effective rate of the intra-arterial infusionchemo-embolization on Stage IB_2-IIB UCC was 93.02%.Thetreatment could reduce tumor size,bring about retro-conversionsof the clinical stage of the tumors and pathological grade of thecancer cells,and decrease the quantity of intra-operative bloodloss as well as the operating time.It could significantly improvethe 5-year survival rate (P<0.05),and reduce the 2 and 5-yeartumor recurrence rates (P<0.05).Moreover,its side effects werelittle.CONCLUSION Preoperative intra-arterial infusion chemo-embolization can create conditions for radical operation,lower thepostoperative recurrence rate,and improve the prognosis in thepatients with UCC.It is an effective therapy in treating UCC.

Clear Cell Carcinoma of the Uterine Cervix Arising from an Interstitial Cyst Complicated with Endometriosis: A Case Report

Clear cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In this case report of a 78-year-old postmenopausal Japanese woman with pelvic endometriosis, cervical CCC presented as a deep interstitial tumor, strongly suggesting the patient suffered from cervical endometriosis for a long time. A cystic lesion without solid components was detected in the uterine cervix. Although the patient had regular gynecological examinations every 6 months, she presented 5 years later with a complaint of watery vaginal discharge. Ultrasonography and magnetic resonance imaging (MRI) detected a uterine cervical cystic mass with a solid component. Although no malignancy was confirmed preoperatively, surgery was performed under a high suspicion of cervical cancer. Intraoperative pathology revealed CCC in a solid tumor, so debulking surgery, including lymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor, strongly suggesting the tumor arose from cervical endometriosis. Because endometriosis in ectopic sites carries a risk of carcinogenesis, as is the case in ovarian endometriosis, it may be recommended that a cervical cystic lesion with pelvic endometriosis should be followed up regularly for the early detection of uterine cancer.

Clinical Significance of CENP-H Expression in Uterine Cervical Cancer

Objective This work aims to investigate the expression pattern and clinicopathologic significance of centromere protein H(CENP-H) in uterine cervical cancer(UCC). Methods The level of CENP-H expression in the paraffin sections of 62 UCC cases was determined by the SP immunohistochemical method,with complete clinicopathologic data in all cases.Statistical analysis was conducted to evaluate the prognostic and diagnostic significance of CENP-H using SPSS13.0 software package. Results Immunohistochemical assay showed strong CENP-H expression in 61.29% (38/62) of the paraffin-embedded cervical cancer tissues.Statistical analysis revealed a strong correlation between the CENP-H expression and the clinical classification(P=0.038) of the cervical carcinoma.The expression increased with rise of the stages.The analysis of Cox proportional hazards regression model suggested that CENP-H expression(P=0.002) and tumor stage(P=0.001) were independent prognostic markers for the survival of UCC patients.The survival analysis showed that the survival rate was significantly lower in patients with high expression of CENP-H than in those with low expression of CENP-H(P=0.001). Conclusions CENP-H is likely to be a valuable marker for carcinogenesis and progression of UCC.It might be used as the important diagnostic and prognostic marker for cervical carcinoma patients,especially for those at early stage.

A case report of double-protein expression in primary uterine cervical diffuse large B cell lymphoma and a review of the literature

Primary non-Hodgkin’s lymphoma of the uterine cervix is rarely observed.Here,we report a case of"double-protein"expression in a primary uterine cervical diffuse large B-cell lymphoma that was detected based on cervical biopsies at Sichuan Cancer Hospital in December 2016 in a 53-year-old woman with a 1-month history of postmenopausal vaginal bleeding.She was diagnosed with stage IVA cervical cancer after workup and treated with six cycles of rituximab+cyclophosphamide+epirubicin+vindesine+prednisone.She showed a positive partial response after two cycles;however,response assessment revealed a progressive disease after six cycles.Based on the current condition,a treatment regimen comprising a combination of second-line chemotherapy and radiotherapy was advised for the patient.Unfortunately,she discontinued her treatment because of various factors.We conclude that"double-protein"expression in primary uterine cervical diffuse large B-cell lymphoma is difficult to treat and has a poor prognosis.Therefore,improving the diagnosis and treatment of this disease should be considered.

Analysis of Prognosis and Prognostic Factors of Cervical Adenocarcinoma and Adenosqumous Carcinoma of the Cervix

OBJECTIVE To analyze clinical characteristics and treatment methods of the patients with adenocarcinoma of the uterine cervix （AUC） and adenosquamous carcinoma of the cervix （ASCC）. To compare the survival time of the patients in 2 groups and analyze the prognostic factors. METHODS Clinical data of both 123 patients with AUC and 32 patients with ASCC treated at the Cancer Hospital, Chinese Academy of Medical Science （CAMS） ＆ Peking Union Medical College （PUMC）, were retrospectively analyzed. RESULTS The median age of the AUC patients was 50 years, and that of the ASCC patients was 44, P = 0.019. Poorly-differentiated （grade 3） cases accounted for 59.5% of the total ASCC patients, while only 32.5% of the AUC patients were in grade 3, P = 0.002. In 123 AUC patients, relapse or failure of the treatment occurred in 63 of the patients （51.2%）, and the median relapse time was 6 months （0-59 months）. In 32 ASCC patients, relapse or failure of the treatment occurred in 8 of these patients （51.2%）, with a median relapse time of 4.5 months （0-52 months）. The overall 5-year survival rate of the AUC patients was 49.8%, which was significantly lower than that of the ASCC patients （74.1%）, P = 0.015. The 5-year survival rates of the ASCC patients in Stage Ⅰ-Ⅲ were higher than that of the AUC patients with the same stages. However, statistical significant difference could only be found among the patients in Stage II, P = 0.006. The 5-year survival rates of the ASCC patients with various differential grade were higher than those of the AUC patients with the same differential grade, but statistical significant difference could only be found among the patients in the two groups with moderately differentiation, P = 0.039. It was found by Cox regression analysis that only clinical stage （P 〈 0.001） and histological type （P = 0.046） were the independent prognostic factors. CONCLUSION Clinical stage and histological type were the independent prognostic factors of the AUC and ASCC patients. The prOgnosis of ASCC patients is better than that of the AUC patients.

宫颈原发性成熟性畸胎瘤2例临床病理分析并文献复习

畸胎瘤是妇科常见的生殖细胞肿瘤,好发于卵巢,其中95%为成熟性囊性畸胎瘤[1]。性腺外畸胎瘤占生殖细胞肿瘤的2%~5%,较常发生于近中线部位。发生于宫颈的畸胎瘤罕见,其发生机制并不清楚。本研究报道2例原发于宫颈的成熟性畸胎瘤,并结合近年来国内外相关文献对宫颈原发性畸胎瘤的临床病理特点进行讨论。1材料与方法1.1材料收集在解放军总医院第七医学中心会诊的2例原发于宫颈的成熟性畸胎瘤。

Potential Anti-cancer Activity of Furanodiene

Objective： To study the isolated from the essential oil VIVO anti-tumor activities of furanodiene of the rhizome of Curcuma wenyujin （C15H200）, a primary sesquiterpene compound YH Chen et C. Ling（Wen Ezhu）, in vitro and in Methods： In vitro MTT assay was used to further study the effects of time and dosage on anti-proliferation of furanodiene against the sensitive Hela, Hep-2, HL-60, U251 cells, based on the cytotoxic effects of furanodiene on 12 human malignant tumor cell lines with the essential oil of Wen Ezhn as control., and the half-inhibitory concentration （IC50） was observed. In vivo uterine cervix （U14） tumor cell was selected and the conventional assay method of anti-tumor activity was employed. Furanodiene liposome was administered intraperitoneally, and tumor-inhibitory rate, thymus and spleen indexes were observed. Results： The inhibitive effects on cell proliferation were shown in all of the twelve cell lines and the cytotoxic effects of furanodiene against Hela, Hep-2, HL-60, U251 cells were observed after 12 h of administration, the effect could last for at least 48 h in a dose dependent manner, and the IC50 values were 0.6, 1.7, 1.8, 7.0μg/ml, respectively. Furanodiene was also found to show inhibitive effects on the proliferation of uterine cervix （U14） tumor induced in mice. The tumor inhibition rates were 36.09% （40 mg/kg）, 41.55% （60 mg/kg）, 58.29% （80 mg/kg）, respectively. Conclusion： Furanodiene is one of primary anti-cancer active components in the essential oil of Wen Ezhu, and also a very effective agent against uterine cervix cancer, and has protection effect on the immune function.

EXPRESSION OF c-erbB-2 AND PCNA IN CERVICAL ADENOCARCINOMA AND ITS SIGNIFICATION

Objective: To investigate the significance of cerbB2 and PCNA expression in adenocarcinoma. Methods: Expression of cerbB2 and PCNA in 74 cases of adenocarcinoma of the uterine cervix was examined by immunohistochemistry. Results: The expression of cerbB2 was detected in 34 cases. The positive staining of cerbB2 was associated with increased lymph node metastasis (57.1% Vs 24.0%, P=0.041) and lower 5year survival rate (32.4% Vs 58.9%, P=0.008). The average PCNA labeling index (PCNA LI) was 40.6% (0.1% 91.4%). High PCNA LI was associated with lymph node metastasis (56.4% Vs 38.5%, P=0.016) and lower 5year survival rate (28.7% Vs 64.4%, P=0.005). Positive staining of cerbB2 were associated with high PCNA LI (44.7% Vs 34.6% P=0.003). Conclusions: cerbB2 and PCNA LI were associated with malignant biological behavior and poor prognosis of patients with cervical adenocarcinoma.