子宫内膜样腺癌组织中microRNA差异表达谱分析

目的 探讨子宫内膜样腺癌组织与正常内膜组织中的microRNA(miRNA)表达谱及表达差异,分析差异miRNA在子宫内膜样腺癌发病过程中的作用。方法 使用microRNA芯片筛选出子宫内膜样腺癌组织中差异表达明显的miRNA,使用实时定量逆转录聚合酶链反应(real time RT-PCR)验证后,通过预测网站预测其靶基因。应用微阵预测分析(PAM)工具预测一组可用于区分不同分化子宫内膜样腺癌的miRNA。结果 共有18个miRNA在子宫内膜样腺癌中表达明显上调,31个明显下调。PTEN、FOX家族等52种基因被预测为差异表达的miRNA的靶基因。mir-200c等9种miRNA被预测为一组可区分不同分化子宫内膜样腺癌的生物标记。结论 筛选出多种子宫内膜样腺癌中有特殊研究价值的miRNA预测靶基因,为子宫内膜样腺癌的进一步研究提供了有效的依据。     

Simultaneous endometrioid carcinoma of the uterine corpus and ovary

The carcinoma with simultaneous involvement of the endometrium and the ovary is an uncommon but well recognized event. The determination of clinical stage depends on which of the two sites is considered to be the primary. Combined involvement may occasionally represent independent primary neoplasm. A review of all cases with a tissue diagnosis of endometrioid ovarian carcinoma and concomitant endometrial carcinoma was undertaken to identify those cases which possibly had independent primaries. Three such cases with disease confined to the pelvis were identified on the basis of pathologic features. The incidence of endometrial carcinoma in patients with endometrioid ovarian carcinoma was 15.8% (3/19). They were treated surgically with adjuvant therapy. Two patients died of disseminated carcinoma 1 and 4 years later respectively. The only one patient alive had been free of disease for 25 months after initial therapy. These endometrioid neoplasms simultaneously occurring in ovary and endometrium are considered to be primary tumors. The morphologic reasons for this view are discussed.     

5例卵巢宫内膜样癌的CT回顾分析

目的 思考卵巢宫内膜样癌的CT诊断思路,减少卵巢宫内膜样癌的误诊.方法 对5例经手术、病理证实卵巢宫内膜样癌患者的CT图像回顾分析.结果 5例肿瘤CT影像共同点：病灶均为多房,囊壁不光滑、分隔厚薄不均,没有钙化灶,周围结构粘连、分界不清,增强扫描可见持续性环形强化、分隔强化.结论 卵巢宫内膜样癌呈囊实性病变,排除囊腺癌特征的病例应提示诊断.     

Endometrioid carcinoma of uterus and ovary

A thirty-two-year-old married woman presented with pain abdomen and polymenorrhoea. Her uterus was bulky and one of the fornices was full. USG of abdomen revealed unilateral ovarian tumour associated with a mass in the uterus. Histopathological report revealed synchronous endometrioid carcinoma of the uterus and the ovary with morphological evidences in favour of independent primary carcinomas. With these perspectives the present case is reported where endometrioid carcinomas of uterus and ovary are two separate primary tumours.     

子宫内膜增生与高分化宫内膜样腺癌葡萄糖转运蛋白1型表达及其鉴别诊断意义

目的 葡萄糖转运蛋白1型（GLUT1）在子宫内膜增生及高分化宫内膜样腺癌组织中的表达及其鉴别诊断意义。方法 收集60例刮宫标本,包括诊断明显的各种类型内膜增生和高分化宫内膜样腺癌,采用单克隆抗体GLUT1的免疫组化SP方法进行染色。结果 不伴有非典型性的单纯性增生（12例）和复杂性增生（7例）的内膜组织分别只有2例和1例局灶化生细胞表达GLUT1;13例复杂性非典型增生全部呈不同程度的GLUT1阳性表达;28例高分化宫内膜样腺癌中,26例GLUT1异常表达。结论 GLUT1异常表达是宫内膜非典型增生和宫内膜样腺癌的特征性生化改变,免疫组化检测GLUT1表达有助于鉴别宫内膜增生与非典型增生。     

Molecular subtypes identified by gene expression profiling in early stage endometrioid endometrial adenocarcinoma

Background Early stage （FIGO stage Ⅰ-Ⅱ） endometrioid endometrial adenocarcinoma （EEA） is very common in clinical practice.However,patients with the early stage EEA show various clinical behaviors due to biological heterogeneity.Hence,we aimed to discover distinct classes of tumors based on gene expression profiling,and analyze whether the molecular classification correlated with the histopathological stages or other clinical parameters.Methods Hierarchical clustering was performed for class discovery in 28 eady stage EEA samples using a special cDNA microarray chip containing 492 genes designed for endometrial cancer.Correlations between clinicopathologic parameters and our classification were analyzed.And the significance analysis of microarrays （SAM） array was used to identify the signature genes according to the tumor grade and myometrial invasion.Results Three tumor subtypes （subtypes Ⅰ,Ⅱ and Ⅲ） were identified by hierarchical clustering,each subtype had different clinicopathological factors,such as tumor grade,myometrial invasion status,and FIGO stage.Moreover,SAM analysis showed 34 up-regulated genes in high grade tumors,and 38 up-regulated genes and 1 down-regulated in deep myometrial invasive tumors.The overlap genes between these two high-risk factors were markedly up-regulated in subtype Ⅰ,but down-regulated in subtype Ⅲ.Conclusion We have identified novel molecular subtypes in early stage EEA.Differential gene signatures characterize each tumor subtype,which could be used for recognizing the tumor risk and providing a basis for further treatment stratification.     

宫颈原位腺癌的临床诊断及其治疗方式

目的:探讨宫颈原位腺癌(AIS)的临床诊断及治疗方式。方法:选取2018年9月至2021年3月江苏省徐州市妇幼保健院收治的31例宫颈原位腺癌患者,分析其临床表现、诊断方法、治疗方式及病理情况。结果:患者平均年龄(41.48±7.60)岁。25例患者无异常症状;细胞学异常者13例;高危型HPV阳性者28例;阴道镜图像5例评估为AIS。多点活检病理发现AIS 11例,锥切术后病理发现20例。6例因生育要求仅行锥切术,25例进一步行全子宫切除术,1例病理升级为浸润性腺癌。结论:宫颈原位腺癌临床症状极少见,联合细胞学、HPV检测及阴道镜检查可提高诊断的敏感度,确诊依靠病理。完成生育后尽早行全子宫切除术,以降低宫颈腺癌的发生率。     

PTEN, Her-2和Glut-1在子宫内膜上皮内瘤变和癌中的表达及意义

目的 探讨子宫内膜上皮内瘤变(endometrial intraepithelial neoplasia,EIN)和子宫内膜样腺癌(endometrioid adenocarcinoma,EC)的组织学特征及PTEN、Her-2和Glut-1在子宫内膜样腺癌发生过程中的表达及意义.方法 根据EIN的诊断标准,对84例子宫内膜增生病变进行再分类分组,并采用免疫组织化学法对84例子宫内膜增生和60例EC组织中的PTEN、Her-2和Glut-1蛋白进行检测.结果 (1)在84例子宫内膜增生病例检出50例EIN,34例良性子宫内膜增生.(2)PTEN在良性子宫内膜增生、EIN和EC的阳性表达率分别为35.3%、64.0%和66.7%,PTEN在EIN和EC间的差异无统计学意义(P＞0.05),但在良性子宫内膜增生和EIN间及良性子宫内膜增生和EC间的差异均有统计学意义(P＜0.05).Her-2和Glut-1在良性子宫内膜增生、EIN和EC的阳性表达率分别为0%、26.0%、61.7%和8.8%、80.0%、100.0%,分别在实验各组之间的差异有统计学意义(P＜0.05).结论 EIN的诊断标准强调了病变的大小、结构和细胞学特征,在诊断中可重复性较好,更易于病理诊断标准趋向一致;PTEN、Her-2和Glut-1三者可能在子宫内膜样腺癌的发生中共同发挥着重要的作用,三者联合检测与EIN组织学诊断标准联合应用在EC及EIN的诊断和鉴别诊断具有较高的价值.     

子宫内膜腺癌组织中miRNA的差异表达

目的 探讨miRNA在子宫内膜腺癌及其癌旁组织中的表达差异.方法 收集子宫内膜腺癌患者癌灶和癌旁内膜组织,分别采用Trizol一步法提取总RNA,利用含有miRNA探针的芯片检测系统进行miRNA表达谱差异分析.结果 子宫内膜腺癌与癌旁组织中111个miRNA表达存在显著差异,其中腺癌组织中68个miRNA表达上调,43个表达下调.结论 miRNA可能参与子宫内膜腺癌的发生发展过程,这为进一步揭示子宫内膜腺癌发生的分子机制提供了依据.     

Cigarette smoking and dysplasia and carcinoma in situ of the uterine cervix

We conducted a case-control study of cigarette smoking and dysplasia and carcinoma in situ of the uterine cervix. Cases were black women 17 to 55 years of age who were attending a dysplasia clinic and had biopsy-confirmed cervical pathologic conditions. Controls were women who were attending the family planning clinic at the same hospital and who had at least two normal Papanicolaou smears. Results were adjusted for age, number of sexual partners, age at first intercourse, socioeconomic status, and oral contraceptive use. Cigarette smoking was significantly associated with carcinoma in situ, severe dysplasia, and mild-moderate dysplasia (relative risks, 3.6, 3.3, and 2.4, respectively). Cumulative exposure to cigarette smoking (as measured by pack-years smoked) was strongly related to the risk of these conditions; women with 12 or more pack-years of exposure had relative risks of 12.7, 10.2, and 4.3, respectively, for the three conditions. There was some evidence that the risk was greatest in women who began smoking in their early teenage years. A reduction in the risk of cervical cancer appears to be another inducement for young women not to smoke.     

林奇综合征相关性子宫内膜癌病理学研究进展

林奇综合征(Lynch syndrome,LS)是一种常染色体显性遗传性癌症易感性综合征,既往被称为遗传性非息肉病性结直肠癌,由DNA错配修复(mismatch repair,MMR)基因胚系突变引起.LS是遗传性结直肠癌最常见的表现.研究发现, MMR基因突变也导致了相当比例子宫内膜癌的发生.目前对LS相关性子宫内膜癌的认识非常有限,有些观点还存在争议.本综述总结了LS相关性子宫内膜癌的临床病理研究新进展及对所有子宫内膜癌患者进行LS筛查的意义.     

心理干预对宫颈癌患者心理问题的作用

宫颈癌是严重危害妇女健康的恶性肿瘤之一,当前的治疗方法是以手术为主,切除患者子宫不同部位,会导致患者周期性例假消失,性生活质量降低,身体激素分泌失衡,加上术后全身性的治疗,给患者带来心理上不同程度的创伤,出现很多心理问题。暴怒、悲伤、焦虑等可以引起免疫力的降低,这对于治病是不利的。有一些病人能正确对待疾病,配合医师进行治疗,情绪稳定,与疾病斗争的意志较强,往往比那些被癌症吓得不知所措的病人治疗效果要好得多。     

NF-κB和eIF4E在子宫内膜上皮内瘤变和子宫内膜样癌中的表达及意义

目的 :探讨NF-κB和eIF4E在子宫内膜上皮内瘤变（EIN）和子宫内膜样癌（EC）中的表达规律及意义。 方法:免疫组织化学SP法检测NF-κB和eIF4E在增殖期子宫内膜、子宫内膜增生、EIN及EC中的表达,应用Mann－WhitneyU检验及Wilcoxon检验进行数据统计分析。结果:（1）NF-κB在5组中呈递增性表达,EIN组与EC组间无显著差异性（P＞0. 05）,与其余两组组间表达均有统计学意义（P < 0. 05）。（2）eIF4E在EC中的表达明显高于增殖期子宫内膜、子宫内膜增生及EIN,且EIN组与各组间差异有统计学意义（P < 0. 05）。（3）NF-κB和eIF4E在EIN及相关病变中的表达有显著相关性（r = - 0.949,P＜0. 05）。结论:NF-κB和eIF4E在EIN及EC中高表达,在EIN发展为EC的过程中逐渐被激活,进而加速转录、翻译,增大EIN进展为子宫内膜样癌的可能性。