High–dose rate brachytherapy in the treatment of carcinoma of uterine cervix: twenty-year experience with cobalt after-loading system

This retrospective analysis aims to report results of patients with cancer of uterine cervix treated with external-beam radiotherapy (EBR) and high-dose rate (HDR) brachytherapy, using manual treatment planning. From 1975 to 1995, 237 patients with FIGO stages IIB-IVA and mean age of 54.31 years were treated. EBR dose to the whole pelvis was 50 Gy in 25 fractions. Brachytherapy with HDR after-loading cobalt source (Cathetron) was performed following EBR completion with a dose of 30 Gy in three weekly fractions of 10 Gy to point A. Survival, local control, and genitourinary and gastrointestinal complications were assessed. In a median follow-up of 60.2 months, the 10-year overall and disease-free survival rate was 62.4%. Local recurrence was seen in 12.2% of patients. Distant metastases to the lymph nodes, peritoneum, lung, liver, and bone occurred in 25.3% of patients. Less than 6% of patients experienced severe genitourinary and/or gastrointestinal toxicity that were relieved by surgical intervention. No treatment-related mortality was seen. This series suggests that 50 Gy to the whole pelvis together with three fractions of 10 Gy to point A with HDR brachytherapy is an effective fractionation schedule in the treatment of locally advanced cancer of cervix. To decrease the complications, newer devices and treatment planning may be beneficial.     

Mortality predictions for Ireland, 2001–2015: cancers of the breast, ovary, and cervix and corpus uteri

Abstract.   O'Lorcain P, Comber H. Mortality predictions for Ireland, 2001–2015: cancers of the breast, ovary, cervix and corpus uteri. Int J Gynecol Cancer 2006; 16(Suppl. 1): 1–10.
Linear and log-linear Poisson regression models of Irish breast, ovarian, and cervical and corpus uterine cancer mortality data for the years 1953–2000 were used to predict European age standardized mortality rates (EASMRs) per 100,000 person years and numbers of deaths for the period 2001–2015. Rates for the whole population and for those under 65 are expected to fall from their current levels for breast and corpus uterine cancers but not for ovarian and cervical uterine cancers. EASMRs for postmenopausal women aged between 55 and 69 years are predicted to fall for breast, ovarian, and cervical and corpus uterine cancers. The continuing expansion of the Irish female population is the primary reason why the numbers of deaths arising from breast, ovarian, and cervical uterine cancer are predicted to increase in all of the above age groups. It is not exactly clear why the numbers of corpus uterine cancer deaths are expected to continue to decline, but it may be a matter of improvement in overall death-certificate coding or their diagnoses as cervical cancer deaths.     

Ⅱb期子宫颈鳞癌术后淋巴结局部置管化疗12例分析

[目的]探讨Ⅱb期子宫颈鳞癌术后未切除的转移淋巴结局部置管化疗的效果.[方法]12例有转移呈团块的淋巴结无法切除,共20处.每处置管,术后第3、15d,术后1、2个月,每处注射5-Fu 500mg,共2000mg.后2次每次加注30%碘海醇10ml,X线检查置管是否通畅和部位是否改变.术后3个月CT复查.『结果112例病人术后均按计划完成化疗,无明显毒副反应.20条置管术后2个月时仅有2条从后腹膜脱入腹腔.CT可监测到的16处转移淋巴结术后3个月时6处消失,6处缩小,无一例增大.有效率75%(12/16).[结论]Ⅱb期子宫颈鳞癌术中有转移的淋巴结不能剥除者可行局部置管化疗.     

介入化疗治疗子宫颈癌49例分析

[目的]评价经子宫动脉介入灌注化疗对子宫颈癌的疗效及并发症.[方法]49例子宫颈癌采用Seldinger技术,经右侧股动脉穿刺并分别插管至左、右子宫动脉行灌注化疗.[结果]介入治疗后症状缓解率为100.0%,均行根治术.46例患者可观察到肿块体积明显缩小,总有效率为93.8%.[结论]经子宫动脉灌注化疗可作为根治术前常规的辅助方法.     

重组人表皮生长因子对大鼠宫颈鳞状上皮细胞体外增殖的影响

目的　研究重组人表皮生长因子(rhEGF)是否促进大鼠宫颈鳞状上皮细胞(RCEC)增殖及有关机制。方法　分离培养RCEC并用免疫组织化学技术鉴定细胞纯度;MTT法检测细胞增殖;流式细胞术分析细胞周期;逆转录聚合酶链反应检测细胞周期蛋白D1(cyclinD1)mRNA表达水平。结果　rhEGF刺激RCEC的增殖呈时间及剂量依赖性,且明显提高S期细胞分数。rhEGF 0 .1,1.0 ,10和10 0 μg·L- 1明显提高cyclinD1mRNA表达,以10 μg·L- 1于d 3的作用最强,最高可达5 0 .7%。结论　rhEGF对RCEC有促进增殖的作用,其机制与增强cyclinD1mRNA表达,以及刺激细胞从G0 /G1期进入S期有关。     

宫颈小细胞癌9例报告并文献复习

目的：提高对宫颈原发性小细胞癌的认识。方法：收集9例宫颈原发性小细胞癌病例进行临床病理学观察,其中5例为全子宫切除标本,另外4例为宫颈活检标本。结果：患者年龄34-60岁,平均43岁。患者主要以阴道不规则出血,有或无阴道异常排液,伴有头晕、低热或乏力等为主要症状。专科检查：阴道通畅,可见少量的血性分泌物,宫颈管扩张、增大,宫颈管内或宫颈外口处可见新生物。结论：宫颈原发性小细胞癌是一种宫颈罕见的高度恶性肿瘤,免疫组织化学染色有助于诊断与鉴别诊断。     

宫颈小细胞癌诊治临床案例分析

目的:探讨宫颈小细胞癌临床诊治体会。方法:对19例宫颈小细胞癌患者临床资料进行回顾性分析,内容包括临床影像检查结果、病理诊断结果、治疗方案、治疗效果以及随访结果等。结果:19例宫颈小细胞癌患者中,全部患者病理检查标本均对Syn标记结果呈阳性,73.68%的患者医学影像检查结果可知体内肿瘤形态呈菜花型,对比结果具有统计学意义。13例患者实施手术治疗,所有患者均实施新辅助化疗（NAC）,其中6例患者接受了同步放、化疗治疗方案。6例患者治疗后发生淋巴结转移,复发部位大多为肺部,其中2例患者出现1枚淋巴结转移、4例患者出现2~6枚淋巴结转移。结论:对宫颈小细胞癌患者进行全面检查并准确判断病情,根据患者实际情况选择合适的治疗方案,可有效延长患者生存期。     

AQP1、AQP3和AQP8在子宫颈癌中的表达研究

Objective: To probe expression and significance of AQP1, AQP3 and AQP8 in cervical carcinoma. Methods: The expressions of AQP1, AQP3 and AQP8 in SiHa cell line were examined by RT-PCR and immunofluorescence and in 35 cases of cervical carcinoma, 15 cases of CIN3 and 15 cases of control group by immunohistochemistry. Results: (1) AQP1, AQP3 and AQP8 expressed in SiHa cell line; (2)MVD of AQP1 were 43.6±17.8, 56.2±11.6, 70.8±21.1 in control group, CIN3 and cervical carcinoma group, respectively. The difference among three groups was significant(P<0.05). Positive rates of AQP3 were 13.3%, 26.7%, 48.6%, respectively, in control group, CIN3 and cervical carcinoma group. The difference between cervical carcinoma and control group was significant(P<0.05). Positive rates of AQP8 were 46.7%, 86.7%, 54.3%, respectively, in three groups. The difference among three groups was significant(P<0.05). Conclusion: Expression of AQP1, AQP3 and AQP8 in cervical carcinoma might be related with cervical carcinogenesis and development.     

Timely follow‐up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium

Timely follow‐up for positive cancer screening results remains suboptimal, and the evidence base to inform decisions on optimizing the timeliness of diagnostic testing is unclear. This systematic review evaluated published studies regarding time to follow‐up after a positive screening for breast, cervical, colorectal, and lung cancers. The quality of available evidence was very low or low across cancers, with potential attenuated or reversed associations from confounding by indication in most studies. Overall, evidence suggested that the risk for poorer cancer outcomes rises with longer wait times that vary within and across cancer types, which supports performing diagnostic testing as soon as feasible after the positive result, but evidence for specific time targets is limited. Within these limitations, we provide our opinion on cancer‐specific recommendations for times to follow‐up and how existing guidelines relate to the current evidence. Thresholds set should consider patient worry, potential for loss to follow‐up with prolonged wait times, and available resources. Research is needed to better guide the timeliness of diagnostic follow‐up, including considerations for patient preferences and existing barriers, while addressing methodological weaknesses. Research is also needed to identify effective interventions for reducing wait times for diagnostic testing, particularly in underserved or low‐resource settings. CA Cancer J Clin 2018;68:199–216 . © 2018 American Cancer Society .     

子宫颈鳞癌患者放疗前后血清铜、锌的变化

目的检测子宫颈癌患者放疗前后血清铜、锌的变化，检测子宫颈癌患者与正常人血清铜、锌水平的比较。材料与方法采用三电极直流等离子原子发射光电直读光谱仪法检测。结果子宫颈鳞癌患者血清铜（ＳＣｕ）、铜锌比值（Ｃｕ／Ｚｎ）显著高于正常对照组（Ｐ＜０．００１），Ⅲ期患者又显著高于Ⅱ期患者（Ｐ＜０．００１）；放疗后癌灶完全消退者（ＣＤ）ＳＣｕ、Ｃｕ／Ｚｎ明显下降（Ｐ＜０．０１）；部分消退者（ＰＤ）二值仍处于高水平。结论：ＳＣｕ和Ｃｕ／Ｚｎ可以检测放疗疗效，估计预后，有一定临床意义。