Publications by authors named "Zhengyu Li"

107 Publications

Comparison of Laparoscopic and Open Surgery for Women With Early-Stage Epithelial Ovarian Cancer.

Front Oncol 2022 29;12:879889. Epub 2022 Apr 29.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Objective: This study evaluated the oncologic outcomes of laparoscopy and laparotomy in the management of early-stage ovarian cancer patients.

Methods: We conducted an observational study of women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) 2014 stage I ovarian cancer who underwent surgery at the West China Second University Hospital from 2012 to 2020. Patients who received adjuvant chemotherapy before surgery, those with non-epithelial histopathological types, or those with insufficient data were excluded. Using propensity score matching, data from consecutive laparoscopic patients treated by laparoscopy were matched 1:2 with a cohort of patients undergoing open surgery. The operative and survival outcomes among the matched cohorts were examined using the Kaplan-Meier method.

Results: Among 200 eligible patients, 74 patients undergoing laparoscopy were compared with a cohort of 126 patients undergoing open surgery. Baseline characteristics were similar between groups after matching. Patients who had laparoscopy had a shorter operative time (P = 0.001), a shorter hospital stay (P <0.001), and lower blood loss (P = 0.001) than patients who had open surgery. The median (range) follow-up period was 43.0 (38.8-47.2) and 45.0 (36.0-54.0) months for cases and controls, respectively (P <0.001). There are no significant differences in progression-free survival (P = 0.430, log-rank test) and overall survival (P = 0.067, log-rank test) between the two groups.

Conclusions: There is no difference in prognosis between laparoscopic and open surgery in women with stage I epithelial ovarian cancer. Laparoscopic treatment of early-stage ovarian cancer is safe and feasible for stage I epithelial ovarian cancer patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2022.879889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098929PMC
April 2022

The clinical features and management of Lynch syndrome-associated ovarian cancer.

J Obstet Gynaecol Res 2022 Apr 27. Epub 2022 Apr 27.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P.R. China.

Aim: Lynch syndrome (LS) is one of the most common hereditary cancer syndromes, characterized by mutations in mismatch repair genes and autosomal dominant inheritance. Women with LS have an additional increased risk of gynecologic malignancies, including endometrial cancer (EC) and ovarian cancer (OC). Compared with EC, OC is relatively under investigation. This review thoroughly summarizes the current clinical evidence of surveillance, screening, and prevention strategies, and describes the molecular and clinical characteristics of LS-associated OC.

Methods: An electronic search from databases of PubMed and Google Scholar was carried out using key words pertaining to Lynch syndrome and ovarian cancer. A review of the literatures including review articles, experimental, and observational studies published between 2000 and 2021 was conducted.

Results: The lifetime risk of OC in women with LS of MLH1, MSH2, and MSH6 mutations is approximately 7%, with the median age at onset being 46 years, 10-15 years earlier than that in sporadic cases. Histologically, LS-associated OCs are primarily endometrioid (40%), high-grade (25%), and low-grade (11%) serous, or clear cell (6%) in nature. Eighty-five percent of patients are diagnosed at an early stage, presenting with a good prognosis at 84% 5-year survival. Optimal screening strategies for OC in LS are controversial; combined screening of patients' clinical and family history, immunohistochemical analysis, and microsatellite instability testing for mismatch repair deficiency have been proven efficient.

Conclusion: The clinical features were different between ovarian cancer in Lynch syndrome and sporadic cases. More research are needed for a greater understanding of the prevention and medical treatment of LS-associated OC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jog.15273DOI Listing
April 2022

Repair of distal fibular and lateral malleolus defects with individualized 3D-printed titanium alloy prosthesis: The first case report from China.

Int J Surg Case Rep 2022 Apr 13;94:107057. Epub 2022 Apr 13.

Orthopaedic Department, Xi Jing Hospital, Air Force Military Medical University, No. 127 Changle West Road, Xincheng District, Xi'an 710032, Shaanxi, PR China. Electronic address:

Introduction And Importance: This case report describes the reconstruction of the traumatic distal fibular and lateral malleolus defects with a novel method of using individualized 3D printed titanium prosthesis for the first time.

Case Presentation: A 63-year-old male farmer was hospitalized in emergency because of open injury and distal fibular and lateral malleolus defects in the left leg caused by a car accident. 3 months after debridement and latissimus dorsi muscle flap transplantation and skin graft operation, the patient re-hospitalized because of distal fibular and lateral malleolus defect and local pain. We examined the bilateral ankle joint with three-dimensional CT, obtained data about the missing left distal fibular and lateral malleolus through the mirror principle. The corresponding titanium alloy prosthesis then was designed and printed using a 3D metal printer. The patient had no obvious contraindication for surgery, so the prosthesis was surgically implanted. The patient was followed up for 2 years. There was no discomfort at the surgical site. The function of the operated ankle was satisfied by the patient, the AOFAS (American Orthopaedic Foot & Ankle Society) score was 85 (Kitaoka et al., 1994 [1]).

Clinical Discussion: Individualized 3D printed titanium alloy prosthesis consistent with the anatomical structure of lost distal fibula and lateral malleolus. The proximal end of the prosthesis was designed with four nail holes to install screws to fix the fibula together with it. The lower tibiofibular and talofibular joint surfaces of the prosthesis were designed smoothly. In order to improve the stability of the lower tibiofibular joint, anchors were placed at the attachment of the anterior and posterior tibiofibular ligaments to reconstruct these ligaments.

Conclusion: The structure and function of the reconstructed distal fibular and the lateral malleous were close to normal. Individualized 3D printed prosthesis might have considerable advantages over traditional treatment methods. The individualized 3D printed titanium alloy prosthesis provides a new method for the repair and reconstruction of similar bone defects. The use of 3D printed prosthesis for surgical repair needs to be further examined in the future through long-term follow-up studies and in more cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijscr.2022.107057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048154PMC
April 2022

Trends in Surgical Morbidity and Survival Outcomes for Radical Hysterectomy in West China: An 11-Year Retrospective Cohort Study.

Front Oncol 2022 10;12:836481. Epub 2022 Feb 10.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Objectives: To vertically analyze the trend of surgical approaches, demographics, surgical morbidity, and long-term survival outcomes of early-stage cervical cancer over the past 11 years and to determine whether there have been any significant changes.

Methods: A total of 851 patients with consecutive International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IIA cervical cancer diagnosed between January 2008 and June 2018 at a single center in China were included in this retrospective study. Trends in the rate of minimally invasive surgery (MIS), demographics, surgical morbidities, and long-term survival outcomes were determined. We categorized patients into two groups according to their year of operation. The demographics, pathological factors, surgical morbidity, and long-term survival outcomes were compared between these two groups.

Results: Regarding the surgical approach, there was a significant increase in the rate of laparoscopic radical hysterectomy (LRH) performed over the study period, from 7.8% in 2008 to 72.5% in 2018 (p < 0.0001). The mean age of patients who underwent abdominal radical hysterectomy (ARH) has increased slightly from 2008 to 2018, and those who underwent ARH in the second half of the study period (2014-2018) were significantly older (45.01 vs. 47.50 years; p = 0.001). The most impressive changes over the past 11 years have occurred in the surgical morbidity in both the ARH and LRH groups. The overall surgical morbidity decreased from 29.2% in 2008 to 11.9% in 2018, with an annual rate of 1.57%. The median estimated blood loss volume of the ARH group was 500 ml (range 50-2,000) in the first few years compared to 400 ml (30-2500) in the last few years of the study period (p < 0.0001), which in the LRH group was 350 ml (range 150-800) and 150 ml (range 5-1,000), respectively (p < 0.0001). Similarly, allogeneic blood transfusions and hospital stay have all decreased dramatically over time in both approaches. On the other hand, our study did not reveal any significant statistical changes in long-term survival outcomes over the follow-up period in either group.

Conclusions: The findings of our study demonstrate that great progress in surgically managed cervical cancer has been made over the last decade in West China. Our retrospective study demonstrated that the year of operation does not appear to influence the long-term survival, but the surgical morbidity impressively decreased over the study period in both the ARH and LRH groups, which reflects that the higher hospital surgical volume for radical hysterectomy (RH) was not associated with lower survival outcomes but related to the reduction of surgical morbidity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2022.836481DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8866646PMC
February 2022

Inhibiting microRNA-142-5p improves learning and memory in Alzheimer's disease rats via targeted regulation of the PTPN1-mediated Akt pathway.

Brain Res Bull 2022 Feb 24. Epub 2022 Feb 24.

Department of Rehabilitation Medicine, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China. Electronic address:

Objective: MicroRNAs (miRNAs) have been recognized as possible biomarkers for Alzheimer's disease (AD). MiR-142-5p has been reported to be abnormally expressed in brain tissues. However, the role of miR-142-5p in AD pathogenesis keeps unclear. This study aimed to investigate the effect of miR-142-5p on the learning and memory of AD rats via regulation of protein tyrosine phosphatase nonreceptor type 1 (PTPN1)-mediated protein kinase B (Akt) pathway.

Methods: The AD model was established by injection of Aβ oligomer once into the lateral ventricle of rats, and the spatial learning and memory ability of rats was measured. AD rats were injected with miR-142-5p or PTPN1 vectors to explore their functions in inflammation, Aβ, p-tau protein, apoptosis in brain tissues, and the effects on Akt pathway. The targeting relationship between miR-142-5p and PTPN1 was detected.

Results: Overexpressed miR-142-5p, down-regulated PTPN1 and inactivated Akt pathway were exhibited in AD. MiR-142-5p targeted PTPN1 to mediate Akt pathway. Reduced miR-142-5p and elevated PTPN1 improved the behavior of AD rats. MiR-142-5p targeted PTPN1 to effectively inhibit Aβ formation and abnormal phosphorylation of p-tau protein, suppress the inflammation in the brain tissues of AD rat, and improve the survival rate of brain tissue cells. MiR-142-5p regulated PTPN1 to activate the Akt pathway, further inhibiting the apoptosis of brain neurons in AD rats.

Conclusion: Down-regulating miR-142-5p targets PTPN1 to activate Akt pathway, thus improving the learning and memory of AD rats and playing an anti-AD role.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.brainresbull.2022.02.016DOI Listing
February 2022

Automatic quantification and classification of microplastics in scanning electron micrographs via deep learning.

Sci Total Environ 2022 Jun 19;825:153903. Epub 2022 Feb 19.

Department of Materials Science and Engineering, University of Toronto, ON M5S 3H5, Canada; Department of Chemical Engineering and Applied Chemistry, University of Toronto, ON M5S 3E5, Canada.

Microplastics quantification and classification are demanding jobs to monitor microplastic pollution and evaluate the potential health risks. In this paper, microplastics from daily supplies in diverse chemical compositions and shapes are imaged by scanning electron microscopy. It offers a greater depth and finer details of microplastics at a wider range of magnification than visible light microscopy or a digital camera, and permits further chemical composition analysis. However, it is labour-intensive to manually extract microplastics from micrographs, especially for small particles and thin fibres. A deep learning approach facilitates microplastics quantification and classification with a manually annotated dataset including 237 micrographs of microplastic particles (fragments or beads) in the range of 50 μm-1 mm and fibres with diameters around 10 μm. For microplastics quantification, two deep learning models (U-Net and MultiResUNet) were implemented for semantic segmentation. Both significantly outmatched conventional computer vision techniques and achieved a high average Jaccard index over 0.75. Especially, U-Net was combined with object-aware pixel embedding to perform instance segmentation on densely packed and tangled fibres for further quantification. For shape classification, a fine-tuned VGG16 neural network classifies microplastics based on their shapes with high accuracy of 98.33%. With trained models, it takes only seconds to segment and classify a new micrograph in high accuracy, which is remarkably cheaper and faster than manual labour. The growing datasets may benefit the identification and quantification of microplastics in environmental samples in future work.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.scitotenv.2022.153903DOI Listing
June 2022

Authors' Reply.

J Minim Invasive Gynecol 2022 04 12;29(4):578. Epub 2022 Jan 12.

Chengdu, Sichuan, People's Republic of China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jmig.2022.01.001DOI Listing
April 2022

Update on Poly ADP-Ribose Polymerase Inhibitors in Ovarian Cancer With Non-BRCA Mutations.

Authors:
Qin Xu Zhengyu Li

Front Pharmacol 2021 29;12:743073. Epub 2021 Nov 29.

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Poly ADP-ribose polymerase inhibitor (PARPi) has become an important maintenance therapy for ovarian cancer after surgery and cytotoxic chemotherapy, which has changed the disease management model of ovarian cancer, greatly decreased the risk of recurrence, and made the prognosis of ovarian cancer better to certain extent. The three PARPis currently approved by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of ovarian cancer are Olaparib, Niraparib and Rucaparib. With the incremental results from new clinical trials, the applicable population of PARPi for ovarian cancer have expanded to population with non-BRCA mutations. Although BRCA mutated population are still the main beneficiaries of PARPi, recent clinical trials indicated PARPis' therapeutic potential in non-BRCA mutated population, especially in homologous recombination repair deficiency (HRD) positive population. However, lack of unified HRD status detection method poses a challenge for the accurate selection of PARPi beneficiaries. The reversal of homologous recombination (HR) function during the treatment will not only cause resistance to PARPis, but also reduce the accuracy of the current method to determine HRD status. Therefore, the development of reliable HRD status detection methods to determine the beneficiary population, as well as rational combination treatment are warranted. This review mainly summarizes the latest clinical trial results and combination treatment of PARPis in ovarian cancer with non-BRCA mutations, and discusses the application prospects, including optimizing combination therapy against drug resistance, developing unified and accurate HRD status detection methods for patient selection and stratification. This review further poses an interesting topic: the efficacy and safety in patients retreated with PARPis after previous PARPi treatment---"PARPi after PARPi".
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2021.743073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667582PMC
November 2021

The Surgeon's Proficiency Affected Survival Outcomes of Minimally Invasive Surgery for Early-Stage Cervical Cancer: A Retrospective Study of 851 Patients.

Front Oncol 2021 16;11:787198. Epub 2021 Nov 16.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Purpose: To compare the clinical outcomes of patients with early-stage cervical cancer who underwent minimally invasive surgery (MIS) by surgeons in different phases and evaluate whether the proficiency of surgeons affects the survival outcomes.

Materials And Methods: A total of 851 patients with early-stage cervical cancer who underwent radical hysterectomy between January 2008 and June 2018 (every year from January to June) at a tertiary hospital were retrospectively analyzed. We categorized patients into four phases according to their sequence (phase one, 1-10 cases; phase two: 11-20 cases; phase three: 21-30 cases; phase four: > 30 cases). Demographics and clinical and pathological data were collected and analyzed.

Results: There were no statistical differences between the open surgery and MIS groups regarding three- and five-year overall survival (OS) and disease-free survival (DFS). The OS and DFS of patients in the MIS group in phase one were significantly lower than those in later phases and those in the open surgery group after adjustment (OS, = 0.009; HR, 2.896; 95%CI, 1.303-6.435; DFS, = 0.009; HR, 2.712; 95%CI, 1.289-5.706). Survival outcomes were not statistically significant when comparing different surgeons.

Conclusion: The phase one cases of MIS had lower OS and DFS than those in later phases and those in the open surgery group. Thus, we suggest that the proficiency of surgeons is associated with survival outcomes of MIS. Favorable outcomes can be obtained after a certain number of MIS cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2021.787198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635243PMC
November 2021

Extracellular Polymeric Substances Facilitate the Adsorption and Migration of Cu and Cd in Saturated Porous Media.

Biomolecules 2021 11 17;11(11). Epub 2021 Nov 17.

Key Laboratory of Groundwater Resources and Environment, Jilin University, Ministry of Education, Changchun 130021, China.

Heavy metal contamination in groundwater is a serious environmental problem. Many microorganisms that survive in subsurface porous media also produce extracellular polymeric substances (EPS), but little is known about the effect of these EPS on the fate and transport of heavy metals in aquifers. In this study, EPS extracted from soil with a steam method were used to study the adsorption behaviors of Cu and Cd, employing quartz sand as a subsurface porous medium. The results showed that EPS had a good adsorption capacity for Cu (13.5 mg/g) and Cd (14.1 mg/g) that can be viewed using the Temkin and Freundlich models, respectively. At a pH value of 6.5 ± 0.1 and a temperature of 20 °C, EPS showed a greater affinity for Cu than for Cd. The binding force between EPS and quartz sand was weak. The prior saturation of the sand media with EPS solution can significantly promote the migration of the Cu and Cd in sand columns by 8.8% and 32.1%, respectively. When treating both metals simultaneously, the migration of Cd was found to be greater than that of Cu. This also demonstrated that EPS can promote the co-migration of Cu and Cd in saturated porous media.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/biom11111715DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615540PMC
November 2021

Prediction Models for Complete Resection in Secondary Cytoreductive Surgery of Patients With Recurrent Ovarian Cancer.

Front Oncol 2021 23;11:674637. Epub 2021 Sep 23.

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

The most advanced epithelial ovarian cancer develops recurrent disease despite maximal surgical cytoreduction and adjuvant platinum-based chemotherapy. Treatment with secondary cytoreductive surgery (SCS) combined with chemotherapy or with chemotherapy alone for patients with platinum-sensitive recurrent ovarian cancer (ROC) is currently under heated discussion. Encouragingly, the results of the AGO DESKTOP III Study and the SOC1/SGOG-OV2 trial, which have been published recently, showed a striking advantage in terms of overall survival (OS) and progression-free survival (PFS) of ROC patients undergoing SCS compared to chemotherapy alone; moreover, a benefit of SCS exclusively for patients with complete gross resection (CGR) was particularly highlighted. CGR is considered the ultimate goal of SCS, on condition that the balance between maximal survival gain and minimal operative morbidity is maintained. Several models have been proposed to predict the rate of CGR, such as the MSK criteria, the AGO score, and the Tian model, over the last 15 years. This summary is mainly about the several previously published prediction models for CGR in SCS of ROC patients and discusses the effectiveness and limitations of these prediction models.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2021.674637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496933PMC
September 2021

A prognostic index model for predicting long-term recurrence of uterine leiomyoma after myomectomy.

PLoS One 2021 1;16(7):e0254142. Epub 2021 Jul 1.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China.

Introduction: Uterine leiomyoma (UL) is a common benign pelvic tumor in women that has a high recurrence rate. Our aim is to propose a prognostic index (PI) model for predicting the long-term recurrence risk of uterine leiomyoma (UL).

Methods: A total of 725 women who underwent myomectomy were enrolled in this retrospective multicenter study. Patients were contacted for follow-up. A PI model was proposed based on the multivariate Cox regression analysis in the model group. The predictive value of this model was tested in both internal and external validation group.

Results: PI formula = 1.5(if 3-5 leiomyomas) or 2(if >5 leiomyomas)+1(if residue)+1(if not submucosal)+1(if combined endometriosis). The PI value was divided into low-risk, intermediate-risk, and high-risk group by cut-off values 1.25 and 3.75. In the model group, the high-risk group had a significantly 4.55 times greater recurrence risk of UL than that in the low-risk group [cumulative recurrence rate (CR): 82.1% vs 29.5%, HR = 4.55, 95% CI 2.821-7.339]; the intermediate-risk group had a significantly 2.81 times greater recurrence risk of UL than that in the low-risk group (CR: 62.3% vs 29.5%, HR = 2.81, 95% CI 2.035-3.878). The differences between any two risk groups were also significant (P< 0.05) in both internal and external validation groups.

Conclusion: The model was proved to be effective in predicting recurrence of UL after myomectomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254142PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248613PMC
November 2021

Performance validation of the Mayo triage algorithm applied to individualize surgical management of advanced epithelial ovarian cancer.

Gynecol Oncol 2021 08 17;162(2):339-344. Epub 2021 Jun 17.

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China,; Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China,. Electronic address:

Objective: To externally validate the performance of the Mayo triage algorithm applied to treatment strategy management in advanced epithelial ovarian cancer (AEOC) patients.

Methods: AEOC patients who underwent primary debulking surgery (PDS) were included and were divided into two groups based on the Mayo triage algorithm: "high risk" and "triage appropriate". The surgery outcomes and complications of the patients were compared between the two groups.

Results: 179 consecutive AEOC patients were enrolled for analysis, including 32 patients in the high-risk group and 147 patients in the triage-appropriate group. The results showed that patients in the high-risk group were older, had worse physical status and had lower preoperative serum albumin than those in the triage-appropriate group (P<0.01). The high-risk group had a lower proportion of women who underwent intermediate/high complexity surgery (38% vs. 72%, P<0.01) as well as a lower proportion of women who underwent optimal resection (50% vs. 71%, P<0.05). Furthermore, the incidence of 30-day complications (28% vs. 5%, P<0.01) and the proportion of patients who were unable to undergo adjuvant chemotherapy after PDS (22% vs. 2%, P<0.01) were both significantly higher in the high-risk group than in the triage-appropriate group. In addition, compared to the triage-appropriate group, the 90-day mortality rate in the high-risk group was also notably higher, but the difference was not statistically significant (6% vs. 1%, P=0.15).

Conclusion: The validity of the Mayo triage algorithm for treatment decision-making in AEOC was externally confirmed in this study. This short-term complication assessment tool could be effectively used for the individualized primary management of high-risk AEOC patients. The feasibility of the Mayo triage algorithm for use in long-term management should be further explored.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ygyno.2021.06.003DOI Listing
August 2021

Application of novel tumor-free techniques in laparoscopic radical hysterectomy for early cervical cancer.

Asian J Surg 2021 08 30;44(8):1069-1072. Epub 2021 May 30.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People's Republic of China. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.asjsur.2021.05.001DOI Listing
August 2021

Dienogest as a Maintenance Treatment for Endometriosis Following Surgery: A Systematic Review and Meta-Analysis.

Front Med (Lausanne) 2021 7;8:652505. Epub 2021 Apr 7.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.

This study aimed to comprehensively assess the value of Dienogest (DNG) as a maintenance treatment following conservative surgery for endometriosis in terms of the outcomes of disease and pregnancy. We searched for relevant studies and trials up to November 2020 from PubMed, Cochrane Library, Medline, and EMBASE databases as well as the Web of Science. Patients who received DNG maintenance treatment were compared to those who received other treatments (OT), including the levonorgestrel-releasing intrauterine system (LNG-IUS) and gonadotropin-releasing hormone analogs (GnRH-a), or non-treatment (NT). The primary outcomes were disease recurrence and pregnancy rates. Eleven studies were included in this meta-analysis. The pooled analysis indicated that DNG maintenance treatment was associated with a lower rate of disease recurrence. A significant difference was observed in DNG maintenance treatment compared with NT, but not with OT, in the pregnancy rates postoperatively. Moreover, DNG maintenance treatment was related to a significant increase in vaginal bleeding and weight gain. DNG can be recommended as a maintenance treatment for patients with endometriosis to decrease the rates of disease recurrence following conservative surgery. However, DNG maintenance treatment has no advantage in improving pregnancy rates compared to OT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmed.2021.652505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058209PMC
April 2021

Tuning the reactivity of alkoxyl radicals from 1,5-hydrogen atom transfer to 1,2-silyl transfer.

Nat Commun 2021 Apr 9;12(1):2131. Epub 2021 Apr 9.

The Institute for Advanced Studies, Engineering Research Center of Organosilicon Compounds and Materials, Ministry of Education, Wuhan University, Wuhan, People's Republic of China.

Controlling the reactivity of reactive intermediates is essential to achieve selective transformations. Due to the facile 1,5-hydrogen atom transfer (HAT), alkoxyl radicals have been proven to be important synthetic intermediates for the δ-functionalization of alcohols. Herein, we disclose a strategy to inhibit 1,5-HAT by introducing a silyl group into the α-position of alkoxyl radicals. The efficient radical 1,2-silyl transfer (SiT) allows us to make various α-functionalized products from alcohol substrates. Compared with the direct generation of α-carbon radicals from oxidation of α-C-H bond of alcohols, the 1,2-SiT strategy distinguishes itself by the generation of alkoxyl radicals, the tolerance of many functional groups, such as intramolecular hydroxyl groups and C-H bonds next to oxygen atoms, and the use of silyl alcohols as limiting reagents.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41467-021-22382-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035221PMC
April 2021

High L1CAM expression predicts poor prognosis of patients with endometrial cancer: A systematic review and meta-analysis.

Medicine (Baltimore) 2021 Apr;100(13):e25330

Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University.

Backgroud: Previous studies have reported that the levels of L1 cell adhesion molecule (L1CAM) indicate poor prognosis of patients with various solid tumors. However, the prognostic significance of L1CAM in endometrial cancer has remained controversial. Herein, we conducted a systematic review and meta-analysis to evaluate the prognostic value of L1CAM in endometrial cancer.

Methods: All studies related to the association between L1CAM expression and clinical characteristics of endometrial cancer were identified by searching the PubMed, MEDLINE, EMBASE, and Web of Science databases. Primary outcomes of the meta-analysis were the hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS). Secondary outcomes were odds ratios (ORs) for clinicopathological characteristics. Publication bias and sensitivity analysis were conducted to ensure reliability of the results.

Results: Overall, 17 studies encompassing 7146 patients were eligible for the meta-analysis. Results showed L1CAM overexpression to be significantly associated with decreased overall survival (HR = 2.87, 95% CI; 1.81-4.55, P < .001) and disease-free survival (HR = 3.32, 95% CI; 1.99-5.55, P < .001) in patients with endometrial cancer. High L1CAM expression was also related to adverse clinicopathological characteristics.

Conclusion: This systematic review demonstrated that high L1CAM expression is correlated with poor survival outcomes and adverse clinicopathological parameters in patients with endometrial cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000025330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021316PMC
April 2021

Prevalence and screening of specific aeroallergens in Chinese male patients with chronic obstructive pulmonary disease: A retrospective cross-sectional observational study.

Clin Respir J 2021 Jun 14;15(6):691-698. Epub 2021 Mar 14.

Department of Respiratory and Critical Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Introduction: Sensitization to aeroallergens was linked to severe symptoms and frequent exacerbations in chronic obstructive pulmonary disease (COPD) patients. Elevated serum total immunoglobulin E (tIgE) level is a hallmark of allergic COPD patients. Phadiatop test exhibited high sensitivity for predicting specific aeroallergens (SAs) sensitization. However, the prevalence of aeroallergens, the value of Phadiatop test, alone or combined with tIgE, for predicting aeroallergens sensitization in male COPD patients have not been explored in China.

Objectives: To explore the prevalence and predictors of aeroallergens in the context of COPD.

Methods: The predictive value of Phadiatop test for SAs sensitization in male COPD patients was analyzed via the area under receiver operating characteristic curves (AUCs).

Results: The top five SAs in the context of COPD were d2, mx2, i6, d1, and tx5, of which the seasonal distribution showed no significant differences. Allergic group showed higher levels of blood eosinophils, total Phadiatop IgE and tIgE than the nonallergic group (all P ≤ 0.001). The AUCs of total Phadiatop IgE and tIgE for predicting the sensitization to SAs, SAs excluding mx2 (AEM) and mx2 were ((0.921 vs. 0.879, P = 0.2522), (0.967 vs. 0.807, P = 0.0003), and (0.780 vs. 0.883, P < 0.05)) (AUC vs AUC ), respectively. The combined application of these two parameters (model) increased the AUC of SAs, significantly higher than the single parameter used (P < 0.05 for all).

Conclusion: d2, mx2, i6, and d1 were the top four SAs sensitized in male COPD patients; Phadiatop test was valuable for predicting the sensitization to SAs when it was > 0.13 kAU/L.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/crj.13350DOI Listing
June 2021

The 5-year overall survival of cervical cancer in stage IIIC-r was little different to stage I and II: a retrospective analysis from a single center.

BMC Cancer 2021 Feb 27;21(1):203. Epub 2021 Feb 27.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.

Background: The 2018 International Federation of Gynecology and Obstetrics (FIGO) staging guideline for cervical cancer includes stage IIIC recognized by preoperative radiology (IIIC-r) to state there are lymph nodes metastases (LNM) identified by imaging tools. We aim to explore the reasonability and limitations of stage IIIC-r and try to explore the potential reasons.

Methods: Electronic medical records were used to identify patients with cervical cancer. According to the new staging guidelines, patients were reclassified and assigned into five cohorts: stage I, stage II, stage IIIC-r, LNM confirmed by pathology (IIIC-p) and LNM detected by radiology and confirmed by pathology (IIIC r + p). Five-year overall survivals were estimated for each cohort. The diagnosis accuracy of computed tomography (CT), magnetic resonance imaging (MRI) and diameter of detected lymph nodes were also evaluated.

Results: A total of 619 patients were identified. The mean follow-up months were 65 months (95% CI 64.43-65.77) for all patients. By comparison, the 5-year overall survival rates were not statistically different (p = 0.21) among stage IIIC-r, stage I and stage II. While, the rates were both statistical different (p<0.001) among stage IIIC-p, IIIC r + p and stage I and stage II. The sensitivities of CT and MRI in detecting LNM preoperatively were 51.2 and 48.8%. The mean maximum diameter of pelvic lymph nodes detected by CT cohort was 1.2 cm in IIIC-r cohort, and was 1.3 cm in IIIC r + p cohort. While, the mean maximum diameter of pelvic lymph nodes detected by MRI was 1.2 cm in IIIC-r cohort, and was 1.48 cm in IIIC r + p cohort. When the diagnosis efficacy of the diameter of pelvic lymph nodes in detecting LNM were evaluated, the area under the receiver operating characteristic curve (ROC curve) was 0.58 (p = 0.05).

Conclusions: It seems that the FIGO 2018 staging guideline for cervical cancer is likely to has certain limitations for the classification of those with LNM. CT or MRI, however, has limitations on detecting LNM. It would be better to use more accurate imaging tools to identify LNM in the clinical practices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12885-021-07890-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912513PMC
February 2021

Surgical Approach and Use of Uterine Manipulator Are Not Associated with LVSI in Surgery for Early-stage Cervical Cancer.

J Minim Invasive Gynecol 2021 09 23;28(9):1573-1578. Epub 2021 Jan 23.

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China (all authors). Electronic address:

Study Objective: In 2018, the Laparoscopic Approach to Cervical Cancer trial reported that patients undergoing minimally invasive surgery for cervical cancer (CC) had poorer outcomes than patients undergoing open surgery. Several hypotheses have been made to explain the results. We aimed to investigate whether laparoscopic procedures and use of a uterine manipulator increase the risk of lymphovascular space invasion (LVSI) in early-stage CC.

Design: A retrospective study.

Setting: A Chinese women's and children's hospital.

Patients: Patients with early-stage CC who underwent radical hysterectomy in West China Second University Hospital between April 2019 and May 2020.

Interventions: Laparoscopic surgery (with uterine manipulator and uterine manipulator-free) and open surgery.

Measurements And Main Results: A total of 979 patients diagnosed with CC were registered in West China Second University Hospital for surgical treatment. Of these, 525 patients underwent laparoscopic surgery and 454 patients underwent open surgery. In total, 735 patients with early-stage cancer underwent radical hysterectomy and pelvic lymphadenectomy, including 357 by laparoscopic surgery and 378 by open surgery. For those who underwent radical hysterectomy and pelvic lymphadenectomy, the incidence of LVSI was 48.41% and 47.34% in laparoscopic and open groups, respectively (p = .771). After 1:1 propensity score matching with age, International Federation of Gynecology and Obstetrics stage, pathology, and tumor size, the incidence of LVSI was 45.54% and 51.79% in laparoscopic and open groups, respectively (p = .186). Subdividing the laparoscopic group into uterine manipulator and uterine manipulator-free groups, the incidence of LVSI was 45.22% and 48.35%, respectively (p = .580). After propensity score matching with age, International Federation of Gynecology and Obstetrics stage, pathology, and tumor size, the incidence of LVSI was 45.78% and 55.42% in these 2 groups, respectively (p = .214). Multiple factor analysis revealed that lymph node metastasis and deep stromal invasion were associated with LVSI (p value <.05 in both groups).

Conclusion: The surgical approach and use of a uterine manipulator are not associated with LVSI in surgery for early-stage CC. Lymph node metastasis and deep stromal invasion are associated with LVSI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jmig.2021.01.013DOI Listing
September 2021

Histological Characteristics and Early-Stage Diagnosis Are Associated With Better Survival in Young Patients With Epithelial Ovarian Cancer: A Retrospective Analysis Based on Surveillance Epidemiology and End Results Database.

Front Oncol 2020 23;10:595789. Epub 2020 Dec 23.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Purpose: To analyze the potential prognostic factors of epithelial ovarian cancer (EOC) in women aged under 35 compared to those aged 60-79.

Methods: Cases were retrospectively obtained from SEER database. Clinical characteristics, such as race, histological type, AJCC stage, laterality of tumors, CA125 results, and surgical strategies, were analyzed in < 35 years group and 60-79 years group. Kaplan-Meier survival curves were used to evaluate overall survival (OS) and cause-specific survival (CSS). Cox proportional hazard model was used to identify the predictors for CSS.

Results: Sixteen thousand eight hundred forty-seven EOC patients diagnosed in 2004-2015 were identified from SEER database, with 1,015 aged under 35 and 15,833 aged 60-79. In < 35 years group, mucinous (32.2%) was the most common histological type, followed by high-grade serous (26.6%) and endometrioid (18.3%), while in 60-79 years group, high-grade serous (68.3%) represented the leading histological type. Most young women were diagnosed at stage I (57.7%), while most old women were diagnosed at stage (48.1%). Both 5-year OS and 5-year CSS were higher in < 35 years group (5-year OS: 76.00% vs 40.18%, p < 0.001; 5-year CSS: 83.56% vs 55.18%, p < 0.001). The multivariate analysis identified histological type and stage as prognostic factors for CSS in both groups. Endometrioid represented a positive predictor for CSS, while carcinosarcoma and malignant Brenner were related to a worse CSS. (< 35 years group: carcinosarcoma vs endometrioid: HR 5.630, p=0.024; malignant Brenner vs endometrioid: HR 4.005, p < 0.001; 60-79 years group: carcinosarcoma vs endometrioid: HR 3.606, p < 0.001; malignant Brenner vs endometrioid: HR 2.291, p < 0.001). Tumors laterality, CA125 levels, surgery and lymphadenectomy failed to be associated with the CSS in < 35 years group, while found to be independent risk factors in 60-79 years group.

Conclusion: EOC women aged under 35 had a better survival outcome over EOC women aged 60-79, owing to high proportion of endometrioid and mucinous types in histology, as well as early-stage diagnosis. Identification of histological types and gene profiles should be underscored in young EOC patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2020.595789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787102PMC
December 2020

Neutrophil-to-lymphocyte ratio is an independent predictor for survival outcomes in cervical cancer: a systematic review and meta-analysis.

Sci Rep 2020 12 14;10(1):21917. Epub 2020 Dec 14.

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, No. 20 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, People's Republic of China.

This updated meta-analysis sought to explore whether pretreatment neutrophil-to-lymphocyte ratio (NLR) could serve as an independent predictor for survival outcomes in patients with cervical cancer. We searched PubMed, Embase, Web of science and Scopus for studies on the association of pretreatment serum NLR with overall survival (OS) and progression-free survival (PFS) among patients with cervical cancer. Included studies with a hazard ratio (HR) and 95% confidence interval (CI) or a p-value were weighted by generic inverse-variance and pooled in a random effects meta-analysis. Subgroup analyses were conducted according to regions, NLR cut-off values and treatments. Publication bias was analyzed by Egger's and Begg's tests. A total of 14 studies comprising 6041 patients were included. The median cut-off value for NLR was 2.46 (range from 1.60 to 3.80). The higher NLR was associated to worse OS (HR 1.86, 95% CI 1.44-2.40) and PFS (HR 1.67, 95% CI 1.25-2.23), compared with lower NLR. This association still exited when analyzed according to regions, NLR cut-off values. Moreover, Significant association between NLR and OS was observed in studies which included patients with early stage disease and receiving radical surgeries. High NLR is independently associated with decreased OS and PFS in patients with cervical cancer. Pretreatment NLR is of independent value to predict the survival outcomes in patients with cervical cancer, regardless of regions and primary treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-79071-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736351PMC
December 2020

Effect of C-phycocyanin on HDAC3 and miRNA-335 in Alzheimer's disease.

Transl Neurosci 2020 29;11(1):161-172. Epub 2020 May 29.

Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.

Background: Amyloid-beta (Aβ) plaque deposits and neurofibrillary tangles containing tau proteins are the key pathognomonic manifestations of Alzheimer's disease (AD). Lack of holistic drugs for AD has reinvigorated enthusiasm in the natural product-based therapies. In this study, our idea to decipher the beneficial effects of C-phycocyanin (CPC) in the management of AD is buoyed by its multifaceted and holistic therapeutic effects.

Methods: We evaluated the effect of CPC treatment on epigenetic factors and inflammatory mediators in a mouse with oligomeric Aβ-induced AD. Besides, the cognitive function was evaluated by the spatial memory performance on a radial arm maze.

Results: The results showed cognitive deficit in the mice with AD along with upregulated HDAC3 expression and diminished miRNA-335 and brain-derived neurotrophic factor (BDNF) expressions. In addition, inflammation was provoked (manifested by increased interleukins (IL)-6 and IL-1β) and neuronal apoptosis was accelerated (indicated by increased Bax, caspase-3, and caspase-9 along with decreased Bcl2) in the hippocampus of the mice with AD. Interestingly, CPC treatment in the mice with AD improved spatial memory performance and decreased the perturbations in the epigenetic and inflammatory biofactors.

Conclusion: These results underscore that mitigation of inflammation via regulation of epigenetic factors might be the key pathway underlying the ameliorative effect of CPC against the aberrations in AD. Our findings provide the rationale for considering CPC as a viable therapeutic option in the management of AD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1515/tnsci-2020-0101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705988PMC
May 2020

Effects of ionic strength and cation type on the transport of perfluorooctanoic acid (PFOA) in unsaturated sand porous media.

J Hazard Mater 2021 02 13;403:123688. Epub 2020 Aug 13.

State Key Laboratory of Pollution Control and Resource Reuse, Key Laboratory of Surficial Geochemisty, Ministry of Education, School of Earth Sciences and Engineering, Hydrosciences Department, Nanjing University, Nanjing 210023, China. Electronic address:

Current understanding of perfluorooctanoic acid (PFOA) transport in unsaturated porous media is still limited with significant variability in solution chemistry. Column experiments were conducted to systematically evaluate the impacts of ionic strength (1.5-30 mM) and cation type (Na and Ca) on PFOA transport in unsaturated quartz sand. The results showed that an increase in ionic strength (1.5-30 mM) led to greater PFOA retardation in unsaturated columns. Meanwhile, Ca caused more PFOA retardation than Na at the same unsaturated conditions. These findings were supported by bubble column experiments, which indicated greater PFOA adsorption at the air-water interface with increasing ionic strength or in the presence of Ca in comparison to Na. Furthermore, the air-water interfacial (AWI) adsorption coefficients calculated from surface tension isotherms also increased with increasing ionic strength or in the presence of Ca in comparison to Na. These results clearly confirm that higher ionic strength or cation valence significantly promoted PFOA adsorption at the air-water interface, and thus caused greater PFOA retardation during transport in unsaturated porous media. This work points out the importance of considering solution ionic strength and cation type in assessing the transport behavior of PFOA in unsaturated porous media.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jhazmat.2020.123688DOI Listing
February 2021

REBACIN® is an optional intervention for persistent high-risk human papillomavirus infection: A retrospective analysis of 364 patients.

Int J Gynaecol Obstet 2021 Jan 13;152(1):82-87. Epub 2020 Oct 13.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China.

Objective: To evaluate the therapeutic efficacy of REBACIN® in patients with persistent high-risk HPV (hrHPV) infection. Persistent hrHPV infection is a crucial cause of cervical cancer, for which optimal pharmacological intervention remains unavailable.

Methods: A retrospective analysis and a meta-analysis were carried out. The retrospective analysis included 364 patients who were persistently infected with HPV for at least 12 months, between September 2015 and February 2019, and only received the REBACIN® intervention. HPV DNA typing, HC2 hrHPV DNA, and ThinPrep cytologic tests were performed before and after the REBACIN® intervention, to evaluate the therapeutic efficacy. The meta-analysis included trials evaluating the therapeutic efficacy of interferons.

Results: After a follow-up period of 3-6 months, the overall rate of efficacy of REBACIN® was 74.73% (272/364), which was higher than that of interferon (61.50%). The efficacy of REBACIN® was correlated with HPV type (odds ratio [OR] 0.549, 95% confidence interval [CI] 0.367-0.822, P=0.004) and pretreatment cytology (OR 0.358, 95% CI 0.173-0.739, P=0.005).

Conclusion: REBACIN® is potently efficacious at clearing persistent hrHPV infection; hence, it can serve as an optional intervention for persistent hrHPV infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ijgo.13385DOI Listing
January 2021

SNHG1 represses the anti-cancer roles of baicalein in cervical cancer through regulating miR-3127-5p/FZD4/Wnt/β-catenin signaling.

Exp Biol Med (Maywood) 2021 01 3;246(1):20-30. Epub 2020 Sep 3.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Sichuan 610041, China.

Impact Statement: Baicalein exhibits anti-cancer roles in several cancers. However, the factors influencing the antitumorigenic efficiencies of baicalein in CC remain largely unclear. Here, we provide convincing evidences that lncRNA SNHG1 attenuates the tumor-suppressive roles of baicalein in CC cell viability, apoptosis, migration, and CC tumor growth. This study further demonstrates that the influences of SNHG1 in the antitumorigenic process of baicalein are achieved through modulating the miR-3127-5p/FZD4Wnt/β-catenin axis. SNHG1 attenuates the repressive role of baicalein on Wnt/β-catenin. Therefore, SNHG1 is a novel modulator of the tumor-suppressive roles of baicalein and SNHG1 represents a therapeutic intervention target to reinforce the tumor-suppressive roles of baicalein in CC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1535370220955139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798002PMC
January 2021

Poly (ADP-ribose) polymerase (PARP) inhibitor regimens for ovarian cancer in phase III randomized controlled trials: a network meta-analysis.

Int J Gynecol Cancer 2020 10 19;30(10):1576-1582. Epub 2020 Aug 19.

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China

Introduction: We aimed to evaluate poly (ADP-ribose) polymerase (PARP) inhibitor (PARPi) regimens in BRCA-mutated ovarian cancer for patients responsive to front-line platinum (bevacizumab and olaparib, veliparib and chemotherapy, olaparib) or platinum-sensitive relapsed (olaparib, rucaprib, niraparib) patients in phase III randomized controlled trials.

Methods: A network meta-analysis was utilized to generate the direct and indirect comparisons. The primary outcomes for network meta-analysis were efficacy (hazard ratios for progression-free survival in BRCA mutation cohort) and toxicity (odds ratios for all grade 3-4 adverse events). The American Society of Clinical Oncology (ASCO) value framework was used to assess the cost-effectiveness of the PARPi regimens.

Results: Network meta-analysis indicated no statistically significant differences in efficacy and toxicity among the assessed upfront or relapsed PARPi regimens (95% CI included 1). The ASCO value framework indicated that current PARPi regimens were similar in clinical benefits, toxicity, and net health benefit in the upfront (bevacizumab and olaparib, veliparib and chemotherapy, olaparib) and relapsed setting (olaparib, rucaprib, niraparib). The addition of bevacizumab to olaparib ($353.72) increased the cost per unit net health benefit for patients compared with olaparib monotherapy ($260.57). The upfront PARPi regimens had lower toxic scores than the regimens used at relapse.

Conclusions: The choice of PARPi regimens both in the upfront and relapsed setting should consider not only efficacy and toxicity but also costs in BRCA mutation patients. Current combining PARPi regimens are not recommended for such patients in the upfront setting from the cost-effective perspective. Upfront PARPi regimens are less toxic than those used at relapse.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/ijgc-2020-001373DOI Listing
October 2020

Staging procedures fail to benefit women with borderline ovarian tumours who want to preserve fertility: a retrospective analysis of 448 cases.

BMC Cancer 2020 Aug 17;20(1):769. Epub 2020 Aug 17.

Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China.

Background: To evaluate the effect of clinicopathologic factors on the prognosis and fertility outcomes of BOT patients.

Methods: We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from 2008 to 2015. The DFS outcomes, potential prognostic factors and fertility outcomes were evaluated.

Results: Four hundred forty-eight patients were included; 52 recurrences were observed. Ninety-two patients undergoing FSS achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups. Staging surgery was not an independent prognostic factor for DFS. Laparoscopy resulted in better prognosis than laparotomy in patients with stage I tumours and a desire for fertility preservation.

Conclusion: Patients with BOT fail to benefit from surgical staging. Laparoscopy is recommended for patients with stage I disease who desire to preserve fertility. Physicians should pay more attention to risk of recurrence in patients who want to preserve fertility.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12885-020-07262-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433083PMC
August 2020

Targeting Six Hallmarks of Cancer in Ovarian Cancer Therapy.

Curr Cancer Drug Targets 2020 ;20(11):853-867

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.

Normal cells must overcome multiple protective mechanisms to develop into cancer cells. Their new capabilities include self-sufficiency in growth signals and insensitivity to antigrowth signals, evasion of apoptosis, a limitless replicative potential, sustained angiogenesis, and tissue invasion and metastasis; these are also termed the six hallmarks of cancer. A deep understanding of the genetic and protein alterations involved in these processes has enabled the development of targeted therapeutic strategies and clinical trial design in the search for ovarian cancer treatments. Clinically, significantly longer progression-free survival has been observed in the single use of PARP, MEK, VEGF and Chk1/Chk2 inhibitors. However, the clinical efficacy of the targeted agents is still restricted to specific molecular subtypes and no trials illustrate a benefit in overall survival. Exploring novel drug targets or combining current feasible biological agents hold great promise to further improve outcomes in ovarian cancer. In this review, we intend to provide a comprehensive description of the molecular alterations involved in ovarian cancer carcinogenesis and of emerging biological agents and combined strategies that target aberrant pathways, which might shed light on future ovarian cancer treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1568009620999200816130218DOI Listing
November 2021

MSC-derived exosomes protect against oxidative stress-induced skin injury via adaptive regulation of the NRF2 defense system.

Biomaterials 2020 10 28;257:120264. Epub 2020 Jul 28.

Mini-invasive Neurosurgery and Translational Medical Center, Xi'an Central Hospital, Xi'an Jiaotong University, No. 161, West 5th Road, Xincheng District, Xi'an, 710003, PR China. Electronic address:

Oxidative stress is a major cause of skin injury induced by damaging stimuli such as UV radiation. Currently, owing to their immunomodulatory properties, mesenchymal stem cell-derived exosomes (MSC-Exo), as a nanotherapeutic agent, have attracted considerable attention. Here, we investigated the therapeutic effects of MSC-Exo on oxidative injury in HO-stimulated epidermal keratinocytes and UV-irradiated wild type and nuclear factor-erythroid 2-related factor-2 (Nrf2) knocked down cell and animal models. Our findings showed that MSC-Exo treatment reduced reactive oxygen species generation, DNA damage, aberrant calcium signaling, and mitochondrial changes in HO-stimulated keratinocytes or UV-irradiated mice skin. Exosome therapy also improved antioxidant capacities shown by increased ferric ion reducing antioxidant power and glutathione peroxidase or superoxide dismutase activities in oxidative stress-induced cell and skin injury. In addition, it alleviated cellular and histological responses to inflammation and oxidation in cell or animal models. Furthermore, the NRF2 signaling pathway was involved in the antioxidation activity of MSC-Exo, while Nrf2 knockdown attenuated the antioxidant capacities of MSC-Exo in vitro and in vivo, suggesting that these effects are partially mediated by the NRF2 signaling pathway. These results indicate that MSC-Exo can repair oxidative stress-induced skin injury via adaptive regulation of the NRF2 defense system. Thus, MSC-Exo may be used as a potential dermatological nanotherapeutic agent for treating oxidative stress-induced skin diseases or disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.biomaterials.2020.120264DOI Listing
October 2020
-->