Role of optical coherence tomography angiography in the characterization of vascular network patterns of ocular surface squamous neoplasia

PurposeTo visualize and quantify vascular networks in individuals with ocular surface squamous neoplasia (OSSN) through optical coherence tomography angiography (OCTA).MethodCross-sectional study of OSSN patients. Vascular networks were measured by OCTA in the epithelium and sub-epithelial space in the tumors, adjacent tissue, and in the contralateral eye. Vessel area density (VAD, percent of blood vessels within 2.14 mm²), was calculated for each location. Total tumor density (TTD, percent of blood vessels within the entire tumor) was calculated. VAD was assessed separately for corneal and conjunctival locations and compared.ResultsFifteen patients with OSSN were included. The mean age was 61 ± 12 years and the majority were male (80%). The mean tumor area, volume, depth, and TTD were 28.0 ± 9.0 mm² (range, 10.9–39.7), 9.1 ± 4.1 mm³ (range, 3.4–18.8), 334 ± 125 μm (range, 177–571), and 33.2% ± 11.0% (range, 18.7–58.8), respectively. The VAD was highest within the tumor (28.9% ± 8.7%) followed by the adjacent sub-epithelial tissue and the tissue underneath the conjunctival component of tumor. These densities were higher than the VAD in the tissues of the non-involved eye (all P < 0.05). The VAD within conjunctival component of tumor was significantly higher than those with corneal component (29.8% ± 9.5% vs. 21.1% ± 5.5%, p = 0.006). The VAD under conjunctival tumor was also significantly higher than under corneal component (24.1% ± 7.8% vs. 17.0% ± 6.1%, p = 0.024).ConclusionsOCTA imaging allowed for visualization and quantification of vessel structure and density within, under, and surrounding OSSN.     

The HLA-DQB1 gene polymorphisms associated with cervical cancer risk: A meta-analysis

Human leukocyte antigens (HLA) alleles may affect the development of cervical cancer through immunologic control of human papillomavirus (HPV). The association between HLA-DQB1 alleles and risk of cervical cancer has been extensively studied, but the results obtained remain inconsistent. To explore a more extensive role of HLA-DQB1 alleles on cervical cancer risk, we carried out a meta-analysis including 4862 cases and 8988 controls from 22 published studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the association. The overall results suggested that HLA-DQB1*02 (OR = 0.91, 95% CI = 0.82–0.99), *03 (OR = 0.85, 95% CI = 0.74–0.97) and *0603 (OR = 0.62, 95% CI = 0.53–0.72) had a significantly association with decreased cervical cancer risk. In contrast, DQB1*05 (OR = 1.18, 95% CI = 1.01–1.38), *0301 (OR = 1.14, 95% CI = 1.06–1.23) and *0402 (OR = 1.31, 95% CI = 1.04–1.64) conferred a significantly higher risk to cervical cancer. Moreover, a significantly association with increased or decreased cervical cancer risk was found among Europeans and Asians after stratification of the HLA-DQB1 alleles by ethnicity. These findings supported that the HLA-DQB1 alleles may contribute to genetic susceptibility of cervical cancer. Further studies with a greater number of cases are expected to confirm our results.     

保妇康凝胶联合诺氟沙星治疗宫颈糜烂50例疗效观察

目的：探讨保妇康凝胶联合诺氟沙星治疗宫颈糜烂的临床效果。方法将100例宫颈糜烂患者根据随机数字表法分为观察组和对照组各50例。观察组给予保妇康凝胶和诺氟沙星联合治疗，对照组单独给予治糜灵栓治疗，比较两组患者临床症状的变化，并对临床疗效进行评价。结果观察组治愈率为86.00%，明显高于对照组的74.00%，临床症状评分改善较对照组明显，且其临床症状消失的时间短于对照组，差异均有统计学意义(P<0.05)。结论保妇康凝胶与诺氟沙星合用比治糜灵栓治疗宫颈糜烂效果更佳，且治愈时间上明显较优，值得临床上推广应用。     

Locally advanced cervical carcinoma patients treated with chemoradiation followed by radical surgery: clinical response and oncological outcomes according to histotype after propensity score analysis

IntroductionThe aims of this study were to analyze the pathological response, and survival outcomes of adenocarcinoma/adenosquamous (AC/ASC) versus squamous cell carcinoma (SCC) in patients with locally advanced cervical cancer (LACC) managed by chemoradiotherapy followed by radical surgery.MethodsRetrospective, multicenter, observational study, including patients with SCC and AC/ACS LACC patients treated with preoperative CT/RT followed by tailored radical surgery (RS) between 06/2002 and 05/2017. Clinical-pathological characteristics were compared between patients with SCC versus AC/ASC. A 1:3 ratio propensity score (PS) matching was applied to remove the variables imbalance between the two groups.ResultsAfter PS, 320 patients were included, of which 240 (75.0%) in the SCC group, and 80 (25.0%) in the AC/ASC group. Clinico-pathological and surgical baseline characteristics were balanced between the two study groups. Percentage of pathologic complete response was 47.5% in SCC patients versus 22.4% of AC/ASC ones (p < 0.001). With a median follow-up of 51 months (range:1–199), there were 54/240 (22.5%) recurrences in SCC versus 28/80 (35.0%) in AC/ASC patients (p = 0.027). AC/ASC patients experienced worse disease free (DFS), and overall survival (OS) compared to SCC patients (p = 0.019, and p = 0.048, respectively). In multivariate analysis, AC/ACS histotype, and FIGO stage were associated with worse DFS and OS.ConclusionIn LACC patients treated with CT/RT followed by RS, AC/ASC histology was associated with lower pathological complete response to CT/RT, and higher risk of recurrence and death compared with SCC patients. This highlights the need for specific therapeutic strategies based on molecular characterization to identify targets and develop novel treatments.     

Influence of Prior Psychiatric Disorders on the Treatment Course of Gynaecological Cancer – A Nationwide Cohort Study

Aims

To examine the influence of pre-existing psychiatric disorder on the choice of treatment in patients with gynaecological cancer.

Clinicopathological features,diagnosis, and treatment of sessile serrated adenoma/polyp with dysplasia/carcinoma

Sessile serrated adenoma/polyps (SSA/Ps) are early precursor lesions in the serrated neoplasia pathway, which results in BRAF‐mutated colorectal carcinomas with not only high levels of microsatellite instability but also microsatellite stable. SSA/Ps with advanced histology, including cytological dysplasia or minimally invasive carcinomas, are important lesions because SSA/Ps are considered major contributors to “interval cancers” and these lesions can rapidly become dysplastic or invasive carcinomas. Clinicopathologically, SSA/Ps with dysplasia or invasive carcinoma were associated with advanced age, female sex, and proximal colon. Although SSA/Ps with submucosal invasive carcinoma were smaller and invaded less deeply into the submucosal layer than conventional tubular adenomas with submucosal invasive carcinoma, SSA/Ps with submucosal invasive carcinoma frequently had a mucinous component and exhibited a higher potential for lymphatic invasion and lymph node metastasis. In an SSA/P series, endoscopic characteristics, including (semi)pedunculated morphology, double elevation, central depression, and reddishness, may help accurately diagnose SSA/Ps with advanced histology. Removal of SSA/Ps with dysplasia or invasive carcinoma was recommended. Endoscopic treatment such as endoscopic mucosal resection or endoscopic submucosal dissection is useful for those lesions. However, surgical resection with lymph node dissection might be indicated when SSA/Ps with invasive carcinoma are endoscopically suspected, because these have the high risk of lymph node metastasis. Greater awareness may promote further research into improving the detection, recognition, and complete resection rates of SSA/Ps with dysplasia or invasive carcinoma and reduce the interval cancer rates.     

妇科门诊子宫颈病变常识问卷调查

目的了解我院门诊就诊者对子宫颈病变相关知识的认识。方法自制问卷调查表，采用无记名，当面问卷调查方式。结果从调查100例就诊者中，未做过健康体检、妇科盆腔检查和宫颈刮片检查分别为34例、24例和52例。对宫颈癌的认识不知道者53例。结论建议相关部门加强对妇女的健康教育，提高其健康意识，强化临床医生的防癌意识和对子宫病变的规范化诊治。     

颈椎后纵韧带骨化症后路术后C5神经根麻痹

目的：探讨颈椎后纵韧带骨化症（OPLL）术后C5神经根麻痹的临床特点、治疗及预后。方法：2000年3月至2005年1月．采用后路减压手术治疗OPLL患者157例．其中9例术后卅现C5神经根麻痹。回顾性分析9例患者的临床资料，所有患者术后均进行功能康复训练，其中5例患者给予高压氧辅助治疗，随访观察预后情况。结果：本组C5神经根麻痹的发生率为5．7％．包括单开门椎管成形术2例、全椎板切除减压术7例。其临床表现为三角肌、肱二头肌肌力下降至1～2级，肩部及上臂外侧感觉障碍，肱二头肌腱反射减弱或消失。随访1～4年，9例患者的肌力均恢复至3～4级，7例感觉恢复正常。结论：C5神经根麻痹是颈椎后路手术治疗OPLL的并发症之一，经过功能康复训练等保守治疗后肌力、感觉均可获得一定恢复。