Racial disparities in treatment and survival from ovarian cancer

BackgroundBlack women with ovarian cancer in the U.S. have lower survival than whites. We aimed to identify factors associated with racial differences in ovarian cancer treatment and overall survival (OS).MethodsWe examined data from 365 white and 95 black ovarian cancer patients from the Hollings Cancer Center Cancer Registry in Charleston, S.C. between 2000 and 2015. We used unconditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between race and receipt of surgery and chemotherapy, and Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs between race and OS. Model variables included diagnosis center, stage, histology, insurance status, smoking, age-adjusted Charlson comorbidity index (AACI) and residual disease. Interactions between race and AACI were assessed using −2 log likelihood tests.ResultsBlacks vs. whites were over two-fold less likely to receive a surgery-chemotherapy sequence (multivariable-adjusted OR 2.46, 95% CI 1.43–4.21), particularly if they had a higher AACI (interaction p = 0.008). In multivariable-adjusted Cox models, black women were at higher risk of death (HR 1.81, 95% CI 1.35–2.43) than whites, even when restricted to patients who received a surgery-chemotherapy sequence (HR 1.79, 95% CI 1.10–2.89) and particularly for those with higher AACI (HR 4.70, 95% CI 2.00 − 11.02, interaction p = 0.01).ConclusionsAmong blacks, higher comorbidity associates with less chance of receiving guideline-based treatment and also modifies OS. Differences in receipt of guideline-based care do not completely explain survival differences between blacks and whites with ovarian cancer. These results highlight opportunities for further research.     

宫腔镜手术对子宫黏膜下肌瘤患者卵巢功能、免疫功能及炎症因子水平的影响

目的:探讨宫腔镜手术对子宫黏膜下肌瘤患者卵巢功能、免疫功能及炎症因子水平的影响。方法:选取2017年1月～2018年4月期间我院收治的子宫黏膜下肌瘤患者107例为研究对象。根据不同的手术治疗方式将患者分为腹腔镜组(n=55,行腹腔镜子宫肌瘤切除术)和宫腔镜组(n=52,行宫腔镜子宫肌瘤切除术),比较两组患者围术期指标;比较两组术前、术后3个月卵巢功能[促卵泡生长素(FSH)、雌二醇(E2)、黄体生成素(LH)、窦卵泡数量(AFC)]、细胞免疫指标(CD3+、CD4+、CD8+)、体液免疫指标(Ig G、Ig A、Ig M)水平;比较两组术前、术后7 d炎症因子[白介素-2(IL-2)、白介素-6(IL-6)、C反应蛋白(CRP)]指标水平;记录两组术后并发症发生情况。结果:两组患者手术时间、术中出血量比较差异无统计学意义(P0.05);宫腔镜组术后下床时间、肛门排气时间、住院时间以及抗生素使用时间均短于腹腔镜组(P0.05)。两组患者术后3个月E2、LH、AFC比较差异无统计学意义(P0.05);腹腔镜组术后3个月FSH水平高于术前及宫腔镜组(P0.05)。腹腔镜组患者术后3个月细胞免疫指标低于术前及宫腔镜组(P0.05),但体液免疫指标与术前比较差异无统计学意义(P0.05);宫腔镜组术后3个月各项免疫指标与术前比较差异无统计学意义(P0.05)。两组患者术后7d IL-2、IL-6以及CRP水平均升高,但宫腔镜组低于腹腔镜组(P0.05)。腹腔镜组术后并发症发生率为10.91%(6/55),与宫腔镜组的9.62%(5/52)比较差异无统计学意义(P0.05)。结论:宫腔镜子宫肌瘤切除术对子宫黏膜下肌瘤患者卵巢功能、免疫功能影响较轻,同时可降低炎性因子水平,未出现严重并发症,具有一定的临床应用价值。     

Let-7e enhances the radiosensitivity of colorectal cancer cells by directly targeting insulin-like growth factor 1 receptor

Abnormal expression of various microRNAs (miRNAs), as regulators of biological signaling pathways, has a strong association with cancer resistance to chemotherapy and radiotherapy. The let-7 family of miRNAs as tumor suppressors have shown to be downregulated in different types of human malignancies including colorectal cancer (CRC). However, the biological function of let-7 members in the processes of resistance to radiation in CRC has not yet been completely elucidated. Insulin-like growth factor 1 receptor (IGF-1R) signaling pathway is amplified in CRC and leads to its progression, development, and also radiation resistance. So, it seems like an attractive target for anticancer therapy. In this study, by using bioinformatics analysis, it has been revealed that IGF-1R is a direct target of the let-7e member. Consistent with this, we identified that increased levels of let-7e in CRC cells reduced IGF-1R protein level and subsequently its downstream signaling pathways, which resulted in the G1 cell cycle arrest and a significant reduction in the proliferation, survival and also resistance to radiation of CRC cells. Altogether, these results suggested that let-7e by targeting the IGF-1R signaling pathway might serve as therapeutics in anticancer therapy.     

Premature progesterone rise in ART-cycles

Premature rise of progesterone during the late follicular phase in stimulated IVF cycles is a frequent event and its effect on the endometrial receptivity and on the ART (Assisted Reproductive Technique) – outcome has become a matter of intense debate and research. An emerging body of evidence demonstrates that premature progesterone rise does have a negative impact on the outcome of the ART-success. Until now, the exact cause of progesterone elevation is not fully clear, however lately published studies points to the fact, that premature progesterone elevation might be caused by enhanced FSH stimulation. The impact of elevated peripheral progesterone levels seems to be mainly on the endometrium and the window of implantation, leading to an asynchrony between the endometrium and the developing embryo. Hence, new data show additional an influence on the embryo quality. This review aims to summarize the up-to-date knowledge on the causes of premature progesterone rise during hormonal stimulation, on its influence on endometrial receptivity and embryo quality, on the impact on pregnancy and live birth rates as well as on the possible strategies to prevent this event or to deal with premature progesterone elevation in case it could not be avoided.     

艾迪注射液联合化疗对卵巢癌患者血清HE4，CA125，CA19-9，AFP，CEA水平及T细胞亚群的影响

目的:探讨艾迪注射液联合化疗对卵巢癌患者血清人附睾蛋白4(HE4)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、甲胎蛋白(AFP)、癌胚抗原(CEA)及T细胞亚群的影响。方法:选取我院2014年8月至2016年2月收治的78例卵巢癌患者,按照随机数表法将其分为观察组(n=39)和对照组(n=39),对照组患者给予化疗,观察组患者给予艾迪注射液联合化疗,比较两组患者的临床疗效、治疗前后血清HE4、CA125、CA19-9、AFP、CEA水平及T细胞亚群的变化。结果:治疗后,观察组的总有效率(94.87%)显著高于对照组(76.92%)(P0.05)。治疗后,两组患者血清HE4、CA125、CA19-9、AFP、CEA水平均较治疗前明显下降,且观察组显著低于对照组(P0.05)。治疗后,两组患者CD3~+、CD4~+、CD8~+较治疗前均显著降低,且观察组患者CD3~+、CD4~+、CD8~+低于对照组(P0.05)。结论:艾迪注射液联合化疗对卵巢癌治疗效果显著,能有效降低血清HE4、CA125、CA19-9、AFP、CEA水平并改善患者免疫功能。     

Clinicopathological and prognostic value of lncRNA PANDAR expression in solid tumors: Evidence from a systematic review and meta-analysis

PANDAR (promoter of CDKN1A antisense DNA damage activated RNA) has been shown to be aberrantly expressed in many types of cancer. Considering conflicting data, the current study was aimed to assess its potential role as a prognostic marker in malignant tumors. A comprehensive literature search of PubMed, Medline, and Web of Science was performed to identify all eligible studies describing the use of PANDAR as a prognostic factor for different types of cancer. Data related to overall survival (OS) and clinicopathologic features were collected and analyzed. The pooled hazard ratio (HR) and odds radio (OR) with a 95% confidence interval (CI) were used to estimate associations. Ten original studies containing 1,231 patients were included. The results showed that in patients with cancer, high PANDAR expression is correlated with lymph node metastasis (LNM; OR = 2.57; 95% CI, 1.76–3.81; p < 0.001), tumor stage (OR = 2.90; 95% CI, 1.25–6.75; p = 0.013), and tumor size (OR = 1.79; 95% CI, 1.11–2.91; p = 0.018). However, sensitivity analysis further demonstrated a significant association between high PANDAR expression and OS, both in multivariate and univariate analysis models (pooled HR 2.01; 95% CI, 1.17–3.44 and pooled HR 2.62; 95% CI, 1.98–3.47, respectively), after omitting one study. These results suggested that PANDAR expression might be indicative of advanced disease and poor prognosis in patients with cancer. Further studies are necessary to determine the value of this risk stratification biomarker in clinical management of patients with cancer.     

Early onset of cabergoline therapy for prophylaxis from ovarian hyperstimulation syndrome (OHSS): A potentially safer and more effective protocol

Vascular endothelial growth factor (VEGF) is the most important angiogenic mediator in ovarian hyperstimulation syndrome OHSS. Studies proved that cabergoline administration blocks the increase in vascular permeability via dephosphorylation of VEGF receptors and hence can be used as prophylactic agent against OHSS. This study aimed at evaluating the effectiveness of early administration of cabergoline in the prevention of OHSS in high risk cases prepared for ICSI. This case series study was conducted on 126 high risk patients prepared for ICSI using the fixed antagonist protocol. High risk patients were defined as having more than 20 follicles >12 mm in diameter, and/or E2 more than 3000 pg/ml when the size of the leading follicle is more than 15 mm. When the size of the leading follicle reached 15 mm, cabergoline was administered (0.5 mg/day) for 8 days. Patients were followed up clinically, ultrasonographically and hematologically. The final E2 was 6099.5 ± 2730 and the mean number of retrieved oocytes was 19.7 ± 7.8. The clinical pregnancy rate was 62/126 (49.2%). There were no significant changes (p > 0.05) comparing hematological parameters, renal function tests and liver function tests between the day of HCG and the day of blastocyst transfer. The incidence of severe OHSS in this group was 1/126 (0.9%), while moderate OHSS was 12 (9.5%) and there were no cases of critical OHSS. We concluded that early administration of cabergoline is a safe and potentially more effective approach for prophylaxis against OHSS in high risk cases.     

Evaluation of PAPNET-assisted cervical rescreening

Evaluation of PAPNET-assisted cervical rescreening
We have compared the results of targeted manual rescreening of 1211 randomly selected smears with the results of PAPNET-assisted rescreening of 1613 cervical smears, containing at least 6.3% low-grade squamous intraepithelial lesion (SIL). PAPNET diagnosis and the targeted rescreening diagnosis were compared with the initial report, issued on the corresponding smear. Reproducibility scores for inadequacy, presence of endocervical and endometrial cells, specific infections and squamous cell abnormalities were determined. The reproducibility scores for the diagnosis of inadequate smears and specific infections were lower with the PAPNET-assisted rescreening. The detection of squamous cell abnormalities was excellent for both methods (>0.95), with a higher detection rate for false-negative smears with the PAPNET testing system.     

FSH通过SATB1调控上皮性卵巢癌ES-2细胞的增殖和侵袭活性

目的：探讨特异AT序列结合蛋白1（special AT-rich sequence-bindingprotein,SATB1）在卵泡刺激素（Follicle stimulating hor-mone,FSH）诱导的上皮性卵巢癌ES-2细胞增殖和侵袭中的作用。方法：以Real-timePCR检测不同浓度FSH（0、10、20、40、80mlU／ml）处理后sATB1基因mRNA表达水平的变化。实验分4组：①siCon组,转染si-阴性对照（si-Negativecontrol）序列的实验组,对SATBl无干扰作用;②siSATB1组：转染特异性干扰下调SATB1的siSATB1序列;（3）FSH＋siCon组：以FSH处理的siCon组;（4）FSH＋siSATBl组：以FSH处理的sisATB1组。MTT法检测4组细胞的增殖情况,Westernblotting技术检测4组细胞细胞周期蛋白（CyclinDl）,基质金属蛋白酶2（MMP．2）的蛋白表达情况,Transwell侵袭实验检测4组细胞侵袭能力的变化。结果：1．FSH＋siCon组的细胞增殖能力明显高于siCon组的细胞增殖能力,FSH＋siCon组的CyclinD1蛋白相对表达量0．90＋0．08明显高于siCon组的0．37＋0．01（P均〈0．01）,提示FSH具有促进ES．2细胞增殖的作用。2．FSH＋siCon组的穿膜细胞数（30212）个明显高于siCon组（13919）个,FSH＋siCon组的MMP．2蛋白相对表达量0．40＋0．01明显高于siCon组的0．28＋0．02,提示FSH具有促进ES．2细胞侵袭能力的作用。3．随着FsH浓度的增高,SATBlmRNA的表达量逐渐增加,分别为1,1．66±0．04,1．79±0．21,2.31±0．03,以FsH浓度为80mlU／m1时最显著（P〈0．05）。4．FSH＋siSATBl组的细胞增殖能力明显低于FSH＋siCon组的细胞增殖能力,FSH＋siSATBl组的CyclinD1蛋白相对表达量0．22±0．02明显低于FSH＋siCon组的0．90±0．08（P均〈0．01）;FSH＋siSATB1组的穿膜细胞数（5216）个低于FSH＋siCon组的（30212）个,FSH＋siSATB1组的MMP-2蛋白相对表达量0．15±0．00明显低于FSH＋siCon组的0．40±0．01（P均〈0．01）,FSH促进ES-2细胞增殖和侵袭的能力由于SATB1基因表达的下降而被阻断。结论：SATBl是FSH作用的重要靶分子,介导FSH对上皮性卵巢癌ES-2细胞系增殖、侵袭活性的调控。