BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adj...BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.展开更多
Introduction: Gynecologic tumors represent less than 5% of all solid tumors in children. Patients and Method: Through a prospective and descriptive study over 4-years, we included girls aged less than 15 years admitte...Introduction: Gynecologic tumors represent less than 5% of all solid tumors in children. Patients and Method: Through a prospective and descriptive study over 4-years, we included girls aged less than 15 years admitted for a gynecologic tumor. We collected and analyzed the medical data, and paid particular attention to the pre-diagnosis history. Results: Eleven girls met our criteria with a mean age of 8.5 years (2 - 13 years). Abdominal pain, abdominal distension or protrusion of a vaginal mass was the main symptoms. The patients were seen at least by one doctor outside the surgical structure [1] [2] [3]. Four of eleven were received by two different doctors before carrying out the evocative radiological assessment. The average consultation delay was 7-months (24 hours to 18 months). There were nine ovarian tumors and two vaginal tumors. The histological study revealed five of eleven (45%) malignant tumors. Conclusion: Gynecological tumors in children are rare. However, there is a significant proportion of malignant tumors. All doctors can be confronted with it and should not delay the radiological assessment.展开更多
BACKGROUND Few relevant literature reports on applying acupoint press-needle embedding combined with emotional nursing in patients with a gynecological malignant tumor.AIM To explore the effect of traditional Chinese ...BACKGROUND Few relevant literature reports on applying acupoint press-needle embedding combined with emotional nursing in patients with a gynecological malignant tumor.AIM To explore the effect of traditional Chinese medicine acupoint needle embedding combined with emotional nursing on chemotherapy-related nausea and vomiting(CINV),cancer-related fatigue(CRF)and psychological state in patients with gynecological malignant tumors.METHODS Retrospective analysis of the clinical information of 84 patients with gynecological malignant tumors treated in our hospital from August 2020 to December 2022 Led to the development of an observation group(n=42)and a control group(n=42)based on various nursing approaches.Ondansetron hydrochloride injection was administered to the individuals in the control group.However,the observation group received emotional nursing based on the control group and acupoint pressneedle embedding of traditional Chinese medicine.Patients in both groups received the chemotherapy regimen of paclitaxel liposome+carbo-platin/cisplatin.For four weeks,both groups intervened.The CINV grade,quality of life,CRF,psychological status and sleep quality scores of the two groups before and RESULTS After intervention,the degree of CINV in the observation group was significantly better than that in the control group.After intervention,the scores of each dimension and total score of FLIE scale were significantly higher than those in the control group.After intervention,the scores of each dimension and total score of Piper Fatigue Scale were significantly lower than those in the control group(P<0.05).After intervention,the scores of avoidance and yield dimensions in the observation group were significantly lower than those in the control group,and the scores of confrontation dimension were significantly higher than those in the control group(P<0.05).After intervention,the sleep quality score of the observation group was significantly lower than that of the control group,and the Karnofsky Performance Status scale score was significantly higher than that of the control group(P<0.05).CONCLUSION The acupuncture point needle embedding of traditional Chinese medicine combined with emotional nursing can further reduce the incidence of chemotherapy-related nausea and vomiting in patients with gynecological malignant tumors,improve the quality of life and the degree of CRF,alleviate the bad psychological state,adopt a positive way to face the disease and treatment,and improve the quality of sleep and quality of life.展开更多
Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the development of hamartomatous polyposis in the gastrointestinal tract and melanin-pigmented macules on the skin mucosa. The responsibl...Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the development of hamartomatous polyposis in the gastrointestinal tract and melanin-pigmented macules on the skin mucosa. The responsible gene is a tumor suppressor, STK11/LKB1, on chromosome 19p13.3. PJS complicates with benign and malignant tumors in various organs. In gynecology, there has been a particular focus on complications of PJS with sex cord tumor with annular tubules (SCTAT) and minimal deviation adenocarcinoma (MDA), which are rare diseases. Approximately 36% of patients with SCTAT are complicated with PJS and these patients are characterized by multifocal, bilateral, small and benign lesions that develop into tumors with mucinous to serous ratios of 8:1. In addition, 10% of cases of MDA are complicated with PJS and mutation of STK11, the gene responsible for PJS, has a major effect on onset and prognosis. The disease concept of lobular endocervical glandular hyper-plasia (LEGH) has recently been proposed and LEGH is thought to be a potential premalignant lesion of MDA, however, the relationship between PJS and LEGH remains unclear. Several case reports of PJS patients complicated with gynecological tumors have been published and further studies are needed to determine the underlying展开更多
Emainly includes deep venous thrombosis(DVT)and pulmonary thromboembolism(PTE).DVT is caused by the thrombogenesis of red blood cells,platelets and fibrous protein which obstructs the venous backflow leading to inflam...Emainly includes deep venous thrombosis(DVT)and pulmonary thromboembolism(PTE).DVT is caused by the thrombogenesis of red blood cells,platelets and fibrous protein which obstructs the venous backflow leading to inflam-matory changes in the wall of the vein.PTE is caused by the caducous blood clots of DVT that runs with the blood to the lungs.Because DVT and PTE are the venous thromboembolic disease process in two stages,the prevention of DVT and PTE is very important for preventing the rapid onset of PTE and high mortality rate of the postoperative complications.The changes of female hormones and the blood concentration and lipid metabolism disorders make venous thromboembolism more likely to occur during pregnancy.Once the pulmonary vessels were blocked,the patients’life would be threatened severely.To find a more effective way to prevent postoperative venous thrombosis in gynecology we review the prevention and treatment of deep venous thrombosis after gynecological surgery in this paper.展开更多
Efficient functioning of the endoplasmic reticulum(ER) is very important for most cellular activities, such as protein folding and modification. The ER closely interacts with other organelles, including the Golgi body...Efficient functioning of the endoplasmic reticulum(ER) is very important for most cellular activities, such as protein folding and modification. The ER closely interacts with other organelles, including the Golgi body, endosome, membrane, and mitochondria, providing lipids and proteins for the repair of these organelles. ER stress can be induced by various abnormal materials in the cell. ER stress is a compensatory intracellular environment disorder that occurs during areaction. ER can sense the stress and respond to it through translational attenuation, upregulation of the genes for ER chaperones and related proteins, and degradation of unfolded proteins by a quality-control system, but excessive ER activation can cause cell death. The Pubmed and Web of Science databases were searched for full-text articles, and the terms "endoplasmic reticulum stress/unfolded protein response/gynecologic tumor cell apoptosis" were used as key words. Thirty-five studies of ER stress and unfolded protein response published from 2000 to 2016 were analyzed. Stress triggers apoptosis through a variety of signaling pathways. Increasing evidence has shown that the ER plays an important role in tumor cell diseases. The present review discusses the molecular mechanisms underlying unfolded protein response and its ability to promote survival and proliferation in gynecologic tumor cells.展开更多
Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of...Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.展开更多
Objectives:To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor.Methods:120 patients with gynecologic malignancies were selected as subjects...Objectives:To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor.Methods:120 patients with gynecologic malignancies were selected as subjects.According to the nursing method,these patients were divided into intervention group and control group,with 60 cases in each group.The patients in the control group were given routine care,and the patients in the observation group were given psychological intervention care on the basis of routine nursing.Before and after treatment,the anxiety and depression of the two groups were compared using the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS).The satisfaction and adverse reactions of the two groups were compared.The results were statistically analyzed.Results:After nursing intervention,the anxiety and depression scores of the intervention group were lower than those of the control group(P<0.05).The incidence of nausea,vomiting and fatigue in the intervention group was significantly lower than that in the control group(P<0.01).There was no significant difference in the symptoms of diarrhea between the two groups(P>0.05).After the treatment,the satisfaction of the intervention group was significantly higher than that of the control group(P<0.05).Conclusions:During the chemotherapy of gynecological malignant tumor patients,psychological intervention nursing can alleviate the anxiety and depression of patients,improve the complications,and improve the satisfaction of patients.It is worthy of clinical application.展开更多
Originating but free from chromosomal DNA,extrachromosomal circular DNAs(eccDNAs)are organized in circular form and have long been found in unicellular and multicellular eukaryotes.Their biogenesis and function are po...Originating but free from chromosomal DNA,extrachromosomal circular DNAs(eccDNAs)are organized in circular form and have long been found in unicellular and multicellular eukaryotes.Their biogenesis and function are poorly understood as they are characterized by sequence homology with linear DNA,for which few detection methods are available.Recent advances in high-throughput sequencing technologies have revealed that eccDNAs play crucial roles in tumor formation,evolution,and drug resistance as well as aging,genomic diversity,and other biological processes,bringing it back to the research hotspot.Several mechanisms of eccDNA formation have been proposed,including the breakage-fusion-bridge(BFB)and translocation-deletion-amplification models.Gynecologic tumors and disorders of embryonic and fetal development are major threats to human reproductive health.The roles of eccDNAs in these pathological processes have been partially elucidated since the first discovery of eccDNA in pig sperm and the double minutes in ovarian cancer ascites.The present review summarized the research history,biogenesis,and currently available detection and analytical methods for eccDNAs and clarified their functions in gynecologic tumors and reproduction.We also proposed the application of eccDNAs as drug targets and liquid biopsy markers for prenatal diagnosis and the early detection,prognosis,and treatment of gynecologic tumors.This review lays theoretical foundations for future investigations into the complex regulatory networks of eccDNAs in vital physiological and pathological processes.展开更多
AIM To investigate the prognostic value of preoperative fbri-nogen concentration (FIB) and D-dimer-fibrinogen ratio (DFR) in gastrointestinal stromal tumors (GISTs).METHODS The purpose of this study was to retro...AIM To investigate the prognostic value of preoperative fbri-nogen concentration (FIB) and D-dimer-fibrinogen ratio (DFR) in gastrointestinal stromal tumors (GISTs).METHODS The purpose of this study was to retrospectively ana-lyze 170 patients with GISTs who were admitted to our hospital from January 2010 to December 2015. The op-timal cutoff values of related parameters were estimated by receiver operating characteristic (ROC) curve analysis. The recurrence free survival (RFS) rate was evaluated using Kaplan-Meier curves. Univariate analysis and multivariate Cox regression models were used to analyze the prognostic factors of GISTs. The relationship between the FIB, D-dimer, DFR, platelet count (PLT), and the clinicopathological features of GISTs was described by the chi-square test or nonparametric rank sum test (Mann-Whitney test).RESULTS In ROC analysis, the optimal cutoff values of FIB, D-dimer, DFR, and PLT were 3.24 g/L, 1.24 mg/L, 0.354, and 197.5 (× 109/L), respectively. Univariate analysis and the Kaplan-Meier survival curve showed that FIB, D-dimer, DFR, PLT,National Institutes of Health (NIH) risk category, tumor size, tumor location, and mitotic index were signifcantly relevant to the 3-year and 5-year survival rate of patients ( P 〈 0.05). Cox multivariate regression analysis illustrated that FIB (RR: 0.108, 95%CI: 0.031-0.373), DFR (RR: 0.319, 95%CI: 0.131-0.777), and NIH risk category ( RR: 0.166, 95%CI: 0.047-0.589) were independent prognostic factors of the RFS rate ( P 〈 0. 05). Moreover, FIB, D-dimer, DFR, and PLT were correlated with the clinical features of GISTs.CONCLUSIONFIB, D-dimer, DFR, and PLT are all related to the prognosis of GISTs. Moreover, FIB and DFR may be independent risk factors for predicting the prognosis of resectable GISTs.展开更多
文摘BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.
文摘Introduction: Gynecologic tumors represent less than 5% of all solid tumors in children. Patients and Method: Through a prospective and descriptive study over 4-years, we included girls aged less than 15 years admitted for a gynecologic tumor. We collected and analyzed the medical data, and paid particular attention to the pre-diagnosis history. Results: Eleven girls met our criteria with a mean age of 8.5 years (2 - 13 years). Abdominal pain, abdominal distension or protrusion of a vaginal mass was the main symptoms. The patients were seen at least by one doctor outside the surgical structure [1] [2] [3]. Four of eleven were received by two different doctors before carrying out the evocative radiological assessment. The average consultation delay was 7-months (24 hours to 18 months). There were nine ovarian tumors and two vaginal tumors. The histological study revealed five of eleven (45%) malignant tumors. Conclusion: Gynecological tumors in children are rare. However, there is a significant proportion of malignant tumors. All doctors can be confronted with it and should not delay the radiological assessment.
文摘BACKGROUND Few relevant literature reports on applying acupoint press-needle embedding combined with emotional nursing in patients with a gynecological malignant tumor.AIM To explore the effect of traditional Chinese medicine acupoint needle embedding combined with emotional nursing on chemotherapy-related nausea and vomiting(CINV),cancer-related fatigue(CRF)and psychological state in patients with gynecological malignant tumors.METHODS Retrospective analysis of the clinical information of 84 patients with gynecological malignant tumors treated in our hospital from August 2020 to December 2022 Led to the development of an observation group(n=42)and a control group(n=42)based on various nursing approaches.Ondansetron hydrochloride injection was administered to the individuals in the control group.However,the observation group received emotional nursing based on the control group and acupoint pressneedle embedding of traditional Chinese medicine.Patients in both groups received the chemotherapy regimen of paclitaxel liposome+carbo-platin/cisplatin.For four weeks,both groups intervened.The CINV grade,quality of life,CRF,psychological status and sleep quality scores of the two groups before and RESULTS After intervention,the degree of CINV in the observation group was significantly better than that in the control group.After intervention,the scores of each dimension and total score of FLIE scale were significantly higher than those in the control group.After intervention,the scores of each dimension and total score of Piper Fatigue Scale were significantly lower than those in the control group(P<0.05).After intervention,the scores of avoidance and yield dimensions in the observation group were significantly lower than those in the control group,and the scores of confrontation dimension were significantly higher than those in the control group(P<0.05).After intervention,the sleep quality score of the observation group was significantly lower than that of the control group,and the Karnofsky Performance Status scale score was significantly higher than that of the control group(P<0.05).CONCLUSION The acupuncture point needle embedding of traditional Chinese medicine combined with emotional nursing can further reduce the incidence of chemotherapy-related nausea and vomiting in patients with gynecological malignant tumors,improve the quality of life and the degree of CRF,alleviate the bad psychological state,adopt a positive way to face the disease and treatment,and improve the quality of sleep and quality of life.
文摘Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the development of hamartomatous polyposis in the gastrointestinal tract and melanin-pigmented macules on the skin mucosa. The responsible gene is a tumor suppressor, STK11/LKB1, on chromosome 19p13.3. PJS complicates with benign and malignant tumors in various organs. In gynecology, there has been a particular focus on complications of PJS with sex cord tumor with annular tubules (SCTAT) and minimal deviation adenocarcinoma (MDA), which are rare diseases. Approximately 36% of patients with SCTAT are complicated with PJS and these patients are characterized by multifocal, bilateral, small and benign lesions that develop into tumors with mucinous to serous ratios of 8:1. In addition, 10% of cases of MDA are complicated with PJS and mutation of STK11, the gene responsible for PJS, has a major effect on onset and prognosis. The disease concept of lobular endocervical glandular hyper-plasia (LEGH) has recently been proposed and LEGH is thought to be a potential premalignant lesion of MDA, however, the relationship between PJS and LEGH remains unclear. Several case reports of PJS patients complicated with gynecological tumors have been published and further studies are needed to determine the underlying
文摘Emainly includes deep venous thrombosis(DVT)and pulmonary thromboembolism(PTE).DVT is caused by the thrombogenesis of red blood cells,platelets and fibrous protein which obstructs the venous backflow leading to inflam-matory changes in the wall of the vein.PTE is caused by the caducous blood clots of DVT that runs with the blood to the lungs.Because DVT and PTE are the venous thromboembolic disease process in two stages,the prevention of DVT and PTE is very important for preventing the rapid onset of PTE and high mortality rate of the postoperative complications.The changes of female hormones and the blood concentration and lipid metabolism disorders make venous thromboembolism more likely to occur during pregnancy.Once the pulmonary vessels were blocked,the patients’life would be threatened severely.To find a more effective way to prevent postoperative venous thrombosis in gynecology we review the prevention and treatment of deep venous thrombosis after gynecological surgery in this paper.
文摘Efficient functioning of the endoplasmic reticulum(ER) is very important for most cellular activities, such as protein folding and modification. The ER closely interacts with other organelles, including the Golgi body, endosome, membrane, and mitochondria, providing lipids and proteins for the repair of these organelles. ER stress can be induced by various abnormal materials in the cell. ER stress is a compensatory intracellular environment disorder that occurs during areaction. ER can sense the stress and respond to it through translational attenuation, upregulation of the genes for ER chaperones and related proteins, and degradation of unfolded proteins by a quality-control system, but excessive ER activation can cause cell death. The Pubmed and Web of Science databases were searched for full-text articles, and the terms "endoplasmic reticulum stress/unfolded protein response/gynecologic tumor cell apoptosis" were used as key words. Thirty-five studies of ER stress and unfolded protein response published from 2000 to 2016 were analyzed. Stress triggers apoptosis through a variety of signaling pathways. Increasing evidence has shown that the ER plays an important role in tumor cell diseases. The present review discusses the molecular mechanisms underlying unfolded protein response and its ability to promote survival and proliferation in gynecologic tumor cells.
文摘Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.
文摘Objectives:To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor.Methods:120 patients with gynecologic malignancies were selected as subjects.According to the nursing method,these patients were divided into intervention group and control group,with 60 cases in each group.The patients in the control group were given routine care,and the patients in the observation group were given psychological intervention care on the basis of routine nursing.Before and after treatment,the anxiety and depression of the two groups were compared using the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS).The satisfaction and adverse reactions of the two groups were compared.The results were statistically analyzed.Results:After nursing intervention,the anxiety and depression scores of the intervention group were lower than those of the control group(P<0.05).The incidence of nausea,vomiting and fatigue in the intervention group was significantly lower than that in the control group(P<0.01).There was no significant difference in the symptoms of diarrhea between the two groups(P>0.05).After the treatment,the satisfaction of the intervention group was significantly higher than that of the control group(P<0.05).Conclusions:During the chemotherapy of gynecological malignant tumor patients,psychological intervention nursing can alleviate the anxiety and depression of patients,improve the complications,and improve the satisfaction of patients.It is worthy of clinical application.
基金supported by the National Natural Science Foundation of China [Grant Nos.32170493,32170656]the National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital)[Grant No.BYSYSZKF2022005]the Clinical Medicine Plus X-Young Scholars Project,Peking University,the Fundamental Research Funds for the Central Universities (PKU2023LCXQ036)。
文摘Originating but free from chromosomal DNA,extrachromosomal circular DNAs(eccDNAs)are organized in circular form and have long been found in unicellular and multicellular eukaryotes.Their biogenesis and function are poorly understood as they are characterized by sequence homology with linear DNA,for which few detection methods are available.Recent advances in high-throughput sequencing technologies have revealed that eccDNAs play crucial roles in tumor formation,evolution,and drug resistance as well as aging,genomic diversity,and other biological processes,bringing it back to the research hotspot.Several mechanisms of eccDNA formation have been proposed,including the breakage-fusion-bridge(BFB)and translocation-deletion-amplification models.Gynecologic tumors and disorders of embryonic and fetal development are major threats to human reproductive health.The roles of eccDNAs in these pathological processes have been partially elucidated since the first discovery of eccDNA in pig sperm and the double minutes in ovarian cancer ascites.The present review summarized the research history,biogenesis,and currently available detection and analytical methods for eccDNAs and clarified their functions in gynecologic tumors and reproduction.We also proposed the application of eccDNAs as drug targets and liquid biopsy markers for prenatal diagnosis and the early detection,prognosis,and treatment of gynecologic tumors.This review lays theoretical foundations for future investigations into the complex regulatory networks of eccDNAs in vital physiological and pathological processes.
文摘AIM To investigate the prognostic value of preoperative fbri-nogen concentration (FIB) and D-dimer-fibrinogen ratio (DFR) in gastrointestinal stromal tumors (GISTs).METHODS The purpose of this study was to retrospectively ana-lyze 170 patients with GISTs who were admitted to our hospital from January 2010 to December 2015. The op-timal cutoff values of related parameters were estimated by receiver operating characteristic (ROC) curve analysis. The recurrence free survival (RFS) rate was evaluated using Kaplan-Meier curves. Univariate analysis and multivariate Cox regression models were used to analyze the prognostic factors of GISTs. The relationship between the FIB, D-dimer, DFR, platelet count (PLT), and the clinicopathological features of GISTs was described by the chi-square test or nonparametric rank sum test (Mann-Whitney test).RESULTS In ROC analysis, the optimal cutoff values of FIB, D-dimer, DFR, and PLT were 3.24 g/L, 1.24 mg/L, 0.354, and 197.5 (× 109/L), respectively. Univariate analysis and the Kaplan-Meier survival curve showed that FIB, D-dimer, DFR, PLT,National Institutes of Health (NIH) risk category, tumor size, tumor location, and mitotic index were signifcantly relevant to the 3-year and 5-year survival rate of patients ( P 〈 0.05). Cox multivariate regression analysis illustrated that FIB (RR: 0.108, 95%CI: 0.031-0.373), DFR (RR: 0.319, 95%CI: 0.131-0.777), and NIH risk category ( RR: 0.166, 95%CI: 0.047-0.589) were independent prognostic factors of the RFS rate ( P 〈 0. 05). Moreover, FIB, D-dimer, DFR, and PLT were correlated with the clinical features of GISTs.CONCLUSIONFIB, D-dimer, DFR, and PLT are all related to the prognosis of GISTs. Moreover, FIB and DFR may be independent risk factors for predicting the prognosis of resectable GISTs.