血管内皮生长因子与血小板源性生长因子在卵巢上皮性癌淋巴管形成中的作用

目的 探讨血管内皮生长因子(VEGF)和血小板源性生长因子(PDGF)在卵巢上皮性癌(卵巢癌)淋巴管形成中的作用.方法 RT-PCR技术检测淋巴管内皮细胞核标志物Proxl和淋巴管形成相关因子VEGF-A、VEGF-C、VEGF-D及PDGF-A、PDGF-B、PDGF-C、PDGF-D在卵巢癌细胞株SKOV3、70例卵巢上皮性肿瘤(卵巢良性肿瘤15例、卵巢交界性肿瘤10例、卵巢癌45例)和20例正常卵巢组织中的表达情况.实时定量PCR技术检测卜述90例卵巢组织中Proxl、VEGF-A、-C、-D及PDGF-A、-B、-C、-D的表达水平,并进行相关性分析.结果 (1)Proxl在各种卵巢组织中均有表达,而在SKOV3细胞中无表达;VEGF-A、-C、-D及PDGF-A、-B、-C、-D在SKOV3细胞和各种卵巢组织中均有表达.(2)卵巢癌组织中Proxl(2.2±1.3)、VEGF.A(3.5±1.5)、VEGF-C(19 ±14)、VEGF-D(3.0±1.8)及PDGF-A(3.3±3.3)、PDGF-C(6.9±4.6)的表达水平高于卵巢良性肿瘤和交界性肿瘤(P均＜0.05).(3)Proxl、VEGF-A和PDGF-A在卵巢癌Ⅲ～Ⅳ期(Proxl:2.6±1.3,VEGF-A:4.0± 1.4.PDGF-A:4.1±3.7)、淋巴结转移阳性(Proxl:3.0±1.4,VEGF-A:4.1±1.7,PDGF-A:4.9±4.1)及腹膜转移阳性(Proxl:2.8±0.9,VEGF-A:4.0±1.8,PDGF-A:4.5±4.0)的组织中的表达水平,分别高于Ⅰ～Ⅱ期、淋巴结转移阴性和腹膜转移阴性者(P均＜0.05);VEGF-C、VEGF-D在淋巴结转移阳性卵巢癌组织中的表达水平(VEGF-c:24± 13,VEGF-D:3.9±2.0)高于淋巴结转移阴性者(P均＜0.05).(4)卵巢癌组织中Proxl的表达水平与VEGF-D(r=0.62,P＜0.01)、PDGF-C(r=0.91,P＜0.01)、PDGF-D(r=0.61,P＜0.01)的表达水平呈正相关关系.结论 VEGF-A、VEGF-C和PDGF-A可能通过参与淋巴管形成之外的机制促进卵巢癌的淋巴结转移;VEGF-D可以促进卵巢癌的淋巴管形成及淋巴结转移;PDGF-B与卵巢癌的淋巴管形成及淋巴结转移无关;PDGF-C、PDGF-D参与卵巢癌淋巴管形成,但无促进淋巴结转移的作用.     

CXCR4、VEGF-C、CK19和EMA在宫颈癌病灶和淋巴结中的表达及意义

目的探讨趋化因子受体4（CXCR4）、血管内皮生长因子-C（VEGF-C）、上皮膜抗原（EMA）和细胞内角蛋白19（CK19）在宫颈癌原位灶及淋巴结组织中的表达，并探讨各因子之间的关系。方法采用实时荧光定量聚合酶链反应技术（Real TimePCR），对40例宫颈癌患者的原位病灶组织中的CXCR4基因进行定量检测。用免疫组化方法（SP法）和HE染色法检测40例宫颈癌患者的原位灶组织中及淋巴结组织中的VEGF-C、CK19和EMA表达。结果宫颈癌原位灶表达CXCR4和VEGF—C，淋巴结高表达CK19和EMA。CK19与VEGF-C间呈正相关（r=0．489，P-0．014），CXCR4与VEGF-C呈正相关（r=0．521，P=0．000），用逻辑回归的方法分析EMA与VEGF-C间无明显相关性（P=0．272）。结论CXCR4、VEGF-C及CK19、EMA的表达可能与宫颈癌的发生发展有关。     

血管内皮生长因子C及其受体3在宫颈癌组织中的表达及意义

目的探讨血管内皮生长因子-C(VEGF-C)及其受体3在宫颈癌中的表达及其与癌周淋巴管生成、淋巴结转移的关系。方法采用免疫组化二步法检测55例宫颈癌组织中VEGF-C、VEGFR-3的表达情况。结果宫颈癌组织VEGF-C、VEGFR-3阳性率分别为69.1%、61.8%。VEGF-C与VEGFR-3阳性率在淋巴结转移、低分化组织中均明显升高(均P<0.05)。淋巴结转移的宫颈癌组织中淋巴管密度(LMVD)明显升高(P<0.01)。VEGF-C、VEGFR-3阳性的患者有明显预后不良的趋势。结论VEGF-C通过受体VEGFR-3在宫颈癌发生盆腔淋巴结转移中发挥重要作用。     

VEGF-C及受体VEGFR-3在宫颈癌中的表达及临床意义

目的:研究宫颈癌组织中血管内皮生长因子C(VEGF-C)及其受体VEGFR-3的表达并探讨其与淋巴结转移、预后的关系。方法:采用免疫组化SP法,分析59例石蜡标本中VEGF-C、VEGFR-3蛋白表达情况,并应用计算机辅助图象分析系统对脉管的面积进行定量分析。结果:宫颈癌组织中VEGF-C蛋白表达率为66.1%(39/59),与淋巴结转移显著正相关(P=0.005)。VEGF-C阳性组5年生存率显著低于阴性组(P=0.006)。VEGFR-3表达主要定位在脉管结构,VEGFR-3阳性脉管密度在VEGF-C表达阳性组明显高于阴性组(P=0.015),淋巴结转移组明显高于无转移组(P=0.001)。结论:VEGF-C通过促进宫颈癌内淋巴管形成,促进淋巴转移并与患者的预后有关。     

环氧合酶-2对宫颈癌淋巴管生成及预后的影响

目的:研究环氧合酶-2(Cox-2)在宫颈癌中的表达并探讨其对淋巴管生成及预后的影响。方法:用免疫组化SP法,分析59例宫颈癌石蜡标本中Cox-2、血管内皮生长因子-C(VEGF-C)及其受体VEGFR-3蛋白表达,并对微淋巴管密度行定量分析。结果:Cox-2蛋白在86.4%(51/59)的病例中呈阳性表达,与VEGF-C表达[66.1%(39/59)]呈显著正相关(r=0.424,P<0.001),且与淋巴结转移、术后生存期缩短有关;在Cox-2表达阳性组淋巴管密度明显高于阴性组(P=0.013)。结论:在宫颈癌中Cox-2可能上调VEGF-C表达,通过促进淋巴管生成与淋巴结转移有关。检测Cox-2可作为预测宫颈癌患者预后的一项指标。     

VEGFR-3在早期宫颈癌进展过程中的作用

目的:探讨VEGFR-3在早期宫颈癌进展过程中的作用。方法:免疫组织化学法检测41例早期子宫颈癌(ⅠA～ⅡA)组织中VEGF-C、VEGF-D、VEGFR-3的表达,同时检测VEGFR-3标记的脉管密度(MVD),分析其与临床病理因素的关系。结果:(1)VEGFR-3除于淋巴管内皮细胞表达外,部分血管内皮细胞也有表达。形态学上VEGFR-3阳性脉管部分为血管,部分为淋巴管,主要分布于肿瘤组织周围间质中。肿瘤细胞中可见VEGF-C、VEGF-D、VEGFR-3蛋白表达,其表达阳性率分别为48.7%(20/41)、58.5%(24/41)、63.4%(26/41);(2)肿瘤细胞中VEGFR-3蛋白表达与宫颈癌患者月经状态、组织学分级、组织学类型无关,与临床分期、淋巴结转移、淋巴管浸润及VEGF-C、D蛋白表达相关;MVD与月经状态、组织学分级、组织学类型、淋巴结转移、淋巴管浸润均无关,与临床分期及VEGF-C、D蛋白表达相关。结论:VEGFR-3可能通过促进肿瘤血管生成和淋巴管生成,参与了早期宫颈癌的恶性进展。     

Expression of IGF-1R, VEGF-C and D2-40 and their correlation with lymph node metastasis in endometrial adenocarcinoma

Insulin-like growth factor-1 receptor (IGF-1R) regulates carcinogenesis and tumor development and is expressed in normal endometrium. Vascular endothelial growth factor C (VEGF-C) promotes lymph node metastasis. We investigated IGF-1R, VEGF-C and D2-40 in endometrial adenocarcinoma and the association between IGF-1R and lymphatic metastasis, using an immunohistochemical S-P method with 40 cases of endometrial adenocarcinoma and 14 of normal endometrium. IGF-1R expression differed significantly between normal endometrium and adenocarcinoma; it was associated with histological grade but not surgical stage. IGF-1R overexpression was associated with metastasis, but expression was not. VEGF-C expression was greater in normal endometrium than in adenocarcinoma and was associated with metastasis but not with surgical stage or histological grade. IGF-IR and VEGF-C expression were correlated in endometrial adenocarcinoma, and lymphatic vessel density was closely related to both. Abnormal IGF-IR and VEGF-C expression may be important in lymph node metastasis of endometrial adenocarcinoma and might be used to evaluate the prognosis.     

Prognostic factors in uterine cervical carcinoma: a clinicopathological analysis

Abstract. A clinicopathological analysis of 235 patients with stage IB/IIA cervical carcinoma was performed. These patients represent all those treated between 1975 and 1989 inclusive by primary Wertheim's hysterectomy at St Mary's Hospital, Manchester. We found that a significantly higher proportion of tumors from patients under 40 years of age contained mucin and that overall the adenosquamous carcinomas had a significantly greater incidence of lymph node metastases ( P = 0.00049). Pelvic lymph node metastases had no effect on prognosis in these adenosquamous carcinomas but did in squamous carcinomas ( P = 0.0004) and adenocarcinomas ( P = 0.0001). Univariate log-rank analysis showed that variables associated with survival were: pregnancy at diagnosis ( P = 0.0238), lymphatic permeation ( P < 0.0001), vascular permeation ( P < 0.0001), lymph node metastases ( P < 0.0001), tumor volume ( P < 0.0001), canal length of tumor ( P = 0.0009), cervical stromal tumor-free rim ( P = 0.0027), parametrial extension ( P = 0.0008) and adequacy of excision ( P = 0.0389). In a multivariate regression analysis (Cox's regression model) lymphatic permeation, tumor volume, pregnancy at diagnosis and lymph node metastases were independent prognostic variables.     

宫颈癌VEGF-C表达和淋巴管、血管生成关系的探讨

目的:检测宫颈癌组织中血管内皮生长因子-C(VEGF-C)、受体VEGFR-3和CD34的表达,探讨VEGF-C与癌周淋巴管、血管生成和肿瘤转移的关系。方法:采用免疫组化法检测55例宫颈癌组织中VEGF-C、VEGFR-3和CD34的表达。结果:55例宫颈癌组织VEGF-C阳性率为69.1%(38/55),VEGFR-3阳性率为61.8%(34/55),二者表达高度一致(P<0.01)。淋巴结转移组中VEGF-C与VEGFR-3阳性表达明显高于无转移组(P<0.05)。低分化组VEGF-C和VEGFR-3的表达明显高于高、中分化组(P<0.05)。随着临床分期增加,VEGFR-3表达的阳性率增高(P<0.01)。淋巴结转移组中淋巴管密度(LMVD)明显高于无转移组(P<0.01)。VEGF-C表达阳性的组织中血管密度(MVD)明显升高(P<0.05)。VEGF-C和VEGFR-3表达阳性的患者生存率有降低的趋势。结论:宫颈癌中VEGF-C通过受体VEGFR-3促进组织生长、抑制分化,促进肿瘤细胞间质淋巴管和血管生成,是促使宫颈癌发生扩散和转移的重要原因。二者阳性表达可预示预后不良。     

早期子宫颈鳞癌盆腔淋巴结转移的影响因素

目的 探讨早期(Ⅰ b～Ⅱa期)宫颈鳞癌盆腔淋巴结转移的影响因素.方法 回顾性分析2004年2月-2007年1月在浙江大学医学院附属妇产科医院接受治疗、资料完整的135例早期宫颈鳞癌患者的临床病理资料.选择10个非重复的特征性因素,包括患者年龄、临床期别、肿瘤直径、病理分化程度、深肌层浸润、脉管浸润、治疗前血清鳞状细胞癌抗原水平,以及治疗前血小板数量、血浆纤维蛋白原和血红蛋白水平,通过单因素和多因素分析研究这些特征性因素与盆腔淋巴结转移之间的关系.结果 135例宫颈鳞癌患者中,术后病理检查证实共切除盆腔淋巴结3996枚,平均每例29.6枚(20～47枚).其中,病理检查证实盆腔淋巴结转移的患者有17例,盆腔淋巴结转移率为12.6%(17/135).单因素分析结果 显示,肿瘤直径(P=0.003)、深肌层浸润(P=0.004)、脉管浸润(P<0.01)、血小板数量(P=0.006)、血浆纤维蛋白原水平(P<0.01)是与盆腔淋巴结转移明显相关的因素.多因素分析结果 显示,脉管浸润(OR=3.674,95%CI:1.825～7.393,P<0.01)和血浆纤维蛋白原水平(OR=4.568,95%CI:1.779～11.725,P=0.002)是与盆腔淋巴结转移明显相关的因素.结论 脉管浸润和高血浆纤维蛋白原水平是影响早期宫颈鳞癌患者盆腔淋巴结转移的高危因素.     

Intratumoral blood flow characteristics and prognostic factors in patients with endometrial carcinoma

Purposes of the study were to evaluate the correlation between intratumoral blood flow and stage, histologic grade, depth of myometrial invasion and lymph node metastasis in endometrial carcinoma and to assess if vascular/lymphatic spaces invasion is predictable by Doppler ultrasound. Fifty-three patients with endometrial carcinoma were enrolled before surgical treatment. Transvaginal Color Doppler Ultrasound was performed to detect the areas of increased vascularity (≥3) and to record the lowest resistance index (RI) from the blood flow signals within the tumour. Formalin fixed, paraffin embedded pathology slides were reviewed by a senior pathologist to evaluate histologic grading, depth of myometrial invasion, presence of lymph node metastasis and vascular/lymphatic spaces invasion. The number of patients with positive lymph node metastasis was too small to perform any statistical evaluation. Significantly lower RI was noted in tumours of advanced stage (>FIGO Stage I), tumours with higher histologic grade (Grade 3) and with presence of vascular invasion. No correlation was found for myometrial invasion (>50%). A high number of vascular areas was positively correlated with all the prognostic signs. Assessment of tumour changes in vascularity using colour Doppler ultrasound provides useful information for the preoperative prediction regarding stage and histologic grade. The good correlation between Doppler ultrasound results and histological finding of vascular/lymphatic spaces invasion is another point in favour of routine colour Doppler studies in patients with endometrial carcinoma. We believe this technique is useful both for preoperative staging and that recording of tumour recurrence pattern may lead to early selection of those patients that need additional therapy. Received: 5 February 2001 / Accepted: 14 July 2001 Correspondence to P. Greco     

早期宫颈鳞癌患者盆腔淋巴结转移的相关因素分析

目的:探讨早期宫颈鳞状细胞癌患者盆腔淋巴结转移的危险因素。方法:回顾分析152例行手术治疗的ⅠB~ⅡA期宫颈鳞癌患者的临床资料,分析患者的年龄、临床分期、肿瘤细胞分化程度、宫颈间质浸润深度、肿瘤直径大小、脉管癌栓、术前血清宫颈鳞状上皮抗原(SCC-Ag)水平、治疗前血浆纤维蛋白原(FⅠB)水平及D-二聚体水平9个指标与盆腔淋巴结转移的关系。结果:152例ⅠB~ⅡA期宫颈鳞癌患者中20例存在盆腔淋巴结转移(13.16%)。单因素分析结果显示,宫颈间质浸润深度、肿瘤直径、脉管癌栓、术前血清SCC-Ag水平及血浆FⅠB水平与盆腔淋巴结转移有关,差异有统计学意义(P0.05);淋巴结阳性患者的血浆D-二聚体水平高于阴性患者,但差异无统计学意义(P0.05)。多因素分析结果显示,脉管癌栓、术前血清SCC-Ag及血浆FⅠB水平与盆腔淋巴结转移相关,差异有统计学意义(P0.05)。结论:脉管癌栓、术前血清SCC-Ag水平及治疗前血浆FⅠB水平是ⅠB~ⅡA期宫颈鳞癌患者盆腔淋巴结转移的独立危险因素,而术前D-二聚体水平与盆腔淋巴结转移之间的关系,尚需进一步研究。     

The prognostic value of histopathologic grading parameters and microvessel density in patients with early squamous cell carcinoma of the uterine cervix.

Abstract. Graflund M, Sorbe B, Hussein A, Bryne M, Karlsson M.
The purpose of this study was to investigate the prognostic importance of clinical and histopathologic factors, including malignancy grading systems (MGS), partial index (PI), invasive front grading (IFG), and microvessel density. A complete geographic series of 172 early stage (FIGO I–II) cervical carcinomas treated by Wertheim-Meigs surgery during the period 1965–1990 was studied. The patients were followed up for at least 10 years. Significant prognostic factors for disease-free survival were lymph node status ( P < 0.0000001), radical surgical margins ( P = 0.00003), and tumor size ( P = 0.008). In a multivariate Cox analysis it was shown that lymph node status was the single most important prognostic factor with regard to disease-free survival. The total MGS and the PI scores were highly significantly ( P = 0.0001) associated with pelvic lymph node metastases and disease-free survival rate in squamous cell carcinomas. The MGS and the PI systems were superior to the IFG system in predicting lymph node metastases. The total IFG score was also a statistically highly significant ( P = 0.003) prognostic factor with regard to disease-free survival in both univariate and multivariate analyses. Microvessel density was a nonsignificant prognostic factor. There was a highly significant ( P = 0.002) association between vascular space invasion of tumor cells and the presence of lymph node metastases. In conclusion, histopathologic malignancy grading systems provide valuable prognostic information in patients with early stage squamous cell carcinomas of the uterine cervix.     

Nm23 expression in node-positive and node-negative endometrial cancer.

OBJECTIVE: To examine the relationships between the expression of protein Nm23 and surgical stage, histologic grade, histopathologic findings, and survival in women with endometrial carcinoma. METHODS: 19 patients with lymph node involvement were matched with 24 patients without lymph node involvement and the best paraffin-embedded blocks were selected for Nm23 immunohistochemical staining. The slides were evaluated semiquantitatively according to their degree of cytoplasmic staining. Statistical analysis was performed to determine whether there was a relationship between Nm23 expression and surgical stage, histologic grade, depth of myometrial invasion, lymph node metastasis, and/or lymphovascular space involvement. Survival analysis was also performed. RESULTS: Slides from 15 patients (79%) with lymph node involvement and 22 patients (88%) without lymph node involvement were found to be positive for Nm23 (P=0.01). No significant relations were observed between Nm23 expression and surgical stage, histologic grade, depth of myometrial invasion, or lymphovascular space involvement. Nm23 expression was found to be significantly related to lower rates of lymph node metastasis and longer survival (P=0.02). CONCLUSION: Elevated Nm23 expression is related to lower rates of lymph node metastasis and longer survival.     

Prognostic significance of progesterone receptor immunohistochemistry for lymph node metastases in endometrial carcinoma

OBJECTIVE: The aim of this study was to determine whether progesterone receptor (PR), estrogen receptor (ER), p53 protein, and proliferating cell nuclear antigen (PCNA) expression constitute independent prognostic factors for lymph node metastases in endometrial carcinoma using immunohistochemical techniques on hysterectomy and biopsy specimens. METHODS: We evaluated the correlation between lymph node metastases and PR/ER immunohistochemistry, p53/PCNA expression, age, tumor grade, myometrial tumor invasion, cervical involvement, and ovarian metastases in a series of 99 cases of primary endometrial carcinoma surgically staged with systemic pelvic lymphadenectomy and para-aortic lymph node biopsy. RESULTS: Lymph node metastases from endometrial carcinoma were statistically correlated with negative PR immunohistochemistry (P = 0.001), intense p53 expression (66% or more of the tumor cells stained, P = 0.003), deep myometrial tumor invasion (greater than one-half, P = 0.001), and cervical involvement (P = 0.001). Tumor grade showed borderline statistical significance for lymph node metastases (P = 0.058). On multivariate analysis, negative PR, intense p53 expression, and cervical involvement were significant prognostic variables for lymph node metastases (P = 0.0001, 0.0023, and 0.002, respectively). Immunohistochemical study indicated that the PR status on preoperative biopsy specimens and hysterectomy specimens was in good agreement, but p53 status was not. Age, ovarian metastases, ER immunohistochemistry, and PCNA expression were not significantly related to lymph node metastases. CONCLUSION: PR immunohistochemistry appeared to be the most powerful prognostic factor associated with lymph node metastases in endometrial carcinoma, independent of other clinicopathological parameters.     

Endometrial tumor invasiveness is related to metalloproteinase 2 and tissue inhibitor of metalloproteinase 2 expressions

Matrix metalloproteinase (MMPs) expression has been linked to gynecological tumor aggressiveness. The objective of this study was to determine MMP-2, MMP-7, and MMP-9 and tissue inhibitors of metalloproteinases (TIMP)-1 and TIMP-2 expression in endometrial malignancies and their relation to clinical and histologic parameters. Formalin-fixed, paraffin-embedded tumor samples from 50 patients with endometrial carcinoma treated between 1999 and 2004 were stained with specific monoclonal antibodies. The tumors were grouped according to the FIGO classification. The staining results were compared to histologic and clinical data. Semiquantitative analysis of MMP and TIMP expression showed a significant difference in TIMP-2 expression according to the histologic subtype (P = 0.03) and also a trend towards a difference in MMP-9 expression (P = 0.05). MMP-2 expression increased and TIMP-2 expression fell as the histologic grade increased (P = 0.0007, P < 0.0001, respectively). MMP-2 expression correlated with lymph node metastasis (P = 0.04), while TIMP-2 expression correlated with the depth of myometrial invasion (P = 0.01), vasculolymphatic space involvement (P = 0.02), and lymph node metastasis (P = 0.0003). These results support the involvement of MMPs and TIMPs in endometrial tumor growth and progression. High MMP-2 and low TIMP-2 expression were the most potent markers of endometrial tumors with a high risk of local and distant spread.     

Ⅰ型子宫内膜癌患者盆腔淋巴结转移危险因素分析

目的:探讨Ⅰ型子宫内膜癌患者盆腔淋巴结转移相关危险因素,为制定合理手术范围提供依据。方法:对136例Ⅰ型子宫内膜癌患者淋巴结转移的危险因素进行分析。单因素采用χ~2检验或Fisher确切概率法。多因素采用Logistic回归模型。结果:136例Ⅰ型子宫内膜癌患者盆腔淋巴结阳性率9.56%(13/136)。单因素分析表明Ⅰ型子宫内膜癌的组织学分级、癌灶直径大小、肌层浸润深度、脉管浸润与淋巴结转移有关(P0.05);多因素Logistic回归模型分析显示组织低分化、肌层浸润深度≥1/2、癌灶直径≥2 cm、有脉管浸润是Ⅰ型子宫内膜癌盆腔淋巴结转移的独立危险因素(P0.05)。结论:Ⅰ型子宫内膜癌患者盆腔淋巴结转移率低。组织低分化、肌层浸润深度≥1/2、癌灶直径≥2 cm、有脉管浸润的Ⅰ型子宫内膜癌患者更易发生盆腔淋巴结转移。     

Association between CD31 expression and histopathologic features in stage IB squamous cell carcinoma of the cervix

This study was undertaken to evaluate the association between the expression of CD31 in the tumor and the histopathologic findings in patients with carcinoma of the cervix. This study included prospectively 30 women, aged 46.6 +/- 10.7 years, with stage IB squamous cell carcinoma of the cervix submitted to radical hysterectomy from November 2001 to September 2002. Samples from the tumor were taken and immunohistochemically evaluated by a monoclonal antibody for CD31. Clinicopathologic characteristics such as stage, tumor size, grade of differentiation, lymphatic vascular space invasion (LVSI), parametrial involvement, and status of pelvic lymph nodes were also recorded. The clinical stage (FIGO) was IB1 in 22 patients (73.3%) and IB2 in 8 patients (26.7%). The expression of CD31 was significantly associated with tumor size and the presence of LVSI, but not with grade of differentiation and vaginal or parametrial involvement (P= 0.03, P= 0.032, P= 0.352, P= 0.208, and P= 0.242, respectively). On univariate analysis, the presence of pelvic lymph node metastasis was influenced by LVSI (P= 0.003) and CD31 expression (P= 0.032). However, on multivariate analysis, the presence of LVSI (P= 0.007) was the only independent predictor of pelvic lymph node metastasis. The CD31 expression in tumor is significantly associated with LVSI and tumor size in patients with early-stage squamous cell carcinoma of the cervix.     

Heparanase expression in both normal endometrium and endometrial cancer

The aim of this study was to investigate the relationship between heparanase expression and prognostic factors in endometrial cancer, as well as the relationship between heparanase expression during phases of the normal endometrial cycle. Immunohistochemical analysis of 166 endometrial cancers and 34 normal endometria in various phases of growth was performed. The heparanase expression in the late-proliferative phase of normal endometria was found to be significantly higher than in either the early-proliferative or the secretory phases (P= .012 and P= .044, respectively). Heparanase expression was also significantly higher in endometrial cancer patients with tumors of an advanced FIGO stage (P= .0003) and high FIGO grade (P= .004) and with cancers showing either deep myometrial invasion (P= .023), lymph node metastasis (P= .006), lymphvascular space involvement (P= .048), or positive peritoneal cytology (P= .010). The disease-free and overall survival rates of patients with intense heparanase expression were significantly lower than those of patients with absent or moderate heparanase expression (P= .004 and P= .002, respectively). Heparanase may participate in normal endometrial remodeling and can serve as an indicator of the aggressive potential and poor prognosis of endometrial cancers.     

基于云技术和人工智能的自动化细胞学诊断平台在703 103名女性宫颈癌筛查中的应用研究#br# #br#

目的探讨低危子宫内膜癌的淋巴结转移情况、相关因素及预后。方法回顾性分析2013年1月至2018年9月在郑州大学第一附属医院行分期手术的452例低危子宫内膜癌患者的临床资料,采用单因素分析淋巴结转移的危险因素。结果 452例低危子宫内膜癌患者盆腔和(或)腹主动脉旁淋巴结转移率2.65%(12/452),复发率0.66%(3/452),死亡率0.44%(2/452)。单因素分析显示,浸润表浅肌层、组织学分级G2、低体质指数与淋巴结转移的关联有统计学意义(P 0.05)。年龄、CA125水平、淋巴脉管间隙浸润、肿瘤大小、腹水细胞学阳性等与淋巴结转移的关联无统计学意义(P0.05)。269例浅肌层浸润患者G1组与G2组淋巴结转移率[1.00%(1/100)、6.51%(11/169)]比较,差异有统计学意义(P 0.05)。结论病变局限于子宫内膜的低危子宫内膜癌患者,无论肿瘤大小及分级,淋巴结转移率低,复发率低,预后好,可不行腹膜后淋巴结切除术;低体质指数、浅肌层浸润且组织学G2的患者淋巴结转移率较高,建议评估淋巴结转移情况。