ObjectiveTo investigate the expression of β-catenin and Galectin-3 protein in human cervical carcinoma and its clinical pathological significance. MethodsEighty-three cervical specimens were collected from January 2010 to June 2013. By immunohistochemical method, β-catenin and Galectin-3 expression of the 83 cases of cervical carcinoma, 45 cases of intraepithelial neoplasia (CIN) and 25 normal cervix tissue (control) were detected. ResultsThe positive expression rate in cervical carcinoma of β-catenin and Galectin-3 was respectively 74.70% and 81.93%, which was significantly higher than that in intraepithelial neoplasia (ⅠandⅡ) and normal cervical tissue (P<0.05). Compared with cervical cancer, the expression of β-catenin and Galectin-3 in CINⅢ had no statistical significance (P>0.05). The positive expression of β-catenin was significantly correlated with histological grade of cervical cancer tissue, International Federation of Gynecology and Obstetrics grade and lymph node metastasis (P<0.05). The positive expression of Galectin-3 was closely related to histological grade of cervical cancer tissue and lymph node metastasis (P>0.05). Both β-catenin and Galectin-3 expression had no relationship with other clinical pathological parameters, such as age of patients, tumor size and pathological pattern of tumor (P>0.05). β-catenin expression had significant positive correlation with that of Galectin-3 (r=0.327, P=0.002). ConclusionThe expression of Galectin-3 and β-catenin increases obviously and is associated with abnormal clinical parameters (invasion or metastasis) in patients with cervical cancer. Galectin-3 and β-catenin may act as cancer metastasis and prognostic indicators in these patients.
ObjectivesTo assess the methodological quality of clinical practice guidelines of cervical cancer in China published from 2014 to 2018.MethodsCNKI, WanFang Data, CBM, VIP, Medlive.cn, the National Guideline Clearinghouse, PubMed, The Cochrane Library and EMbase were searched for cervical cancer clinical practice guidelines published in China from January 1st, 2014 to December 31st, 2018. Four reviewers searched and selected the literature independently according to the inclusion and exclusion criteria and assessed the methodological quality of the included guidelines by using AGREE Ⅱ.ResultsA total of 9 guidelines were included. The average score for each area was: scope and purpose 75.47%, stakeholders’ involvement 35.09%, the rigor of development 43.70%, clarity of presentation 87.74%, applicability 80.76%, and editorial independence 0%.ConclusionsThe quality of cervical cancer clinical practice guidelines in China requires further improvement.
摘要:目的: 调查新疆地区维吾尔族与汉族子宫颈癌及癌前病变发病情况,分析宫颈癌高发原因。 方法 : 2000年1月至2005年12月新疆自治区人民医院妇产科门诊及病房行宫颈细胞学检查的维吾尔族、汉族妇女进行筛查,对宫颈病变阳性者(CINI以上)行病理组织学检查,对结果进行对比分析、综合评价。 结果 : 宫颈涂片人数共计23 205例,其中维吾尔族6 999例、汉族16 206例。宫颈病变阳性者237例,经阴道镜下病理活组织检查证实CINI以上(包括CINI、CINII、CINIII、原位癌、鳞癌、腺癌)病变人数173例,最小年龄31岁,原位癌(维吾尔族)、最大年龄76岁,宫颈磷癌(汉族)。维吾尔族105例(6069%)、汉族68例(3931%)。每年阳性例数中维吾尔族均高于汉族,其中2000年、2001年、2004年、2005年有极显著性差异(P lt;001),2002年、2003年有显著性差异(P lt;005),维吾尔族、汉族在各年龄组中的发病情况无显著性差异(P gt;005)。 结论 : 新疆地区宫颈癌及癌前病变的高发原因是由地区环境、医疗条件、医学发展、救助措施等因素综合作用的结果。Abstract: Objective: To investigate the incidence of cervical cancer and cervical precancerous lesion of uigur nationality and han nationality, in addition, to analysis the cause of cervical cancer’s high incidence. Methods : At first screen cervical cytology of Uigur and Han outpatient and inpatient of department of gynecology and obstetrics in the People’s Hospital of Xinjiang Uigur Autonomous Region from January 1, 2000 to December 31, 2004Secondly biopsy for those patients that cervix pathological change shows positive, then contrast analysis and comprehensive evaluation. Results : Cervix smears are 23205 samples. Uigur nation has 6999 samples and Han nation has 16206 samples. There are 237 patients whose cervix pathological changes shows positive. Among them 173 samples were over CINⅠ(include CINⅠ,CINⅡ,CIN Ⅲ,carcinoma in situ, squamous carcinoma and adenocarcinoma) through colposcopy. The youngest was 31 and diagnosed carcinoma in situ(Uigur), the eldest was 76 and diagnosed squamous carcinoma(Han).The samples of Uigur is 105(6069%) and Han is 68(3931%).The positive samples in Uigur is higher than Han each year, the incidence has extremely significant difference among 2000,2001 and 2004(P lt;001), while it has significant difference between 2002 and 2003 (P lt;005), but in each age group it has no significant difference between Uigur and Han (P gt;005). Conclusion : The high incidence of cervical cancer and cervical precancerous lesion in xinjiang is contribute to environment, medical condition, medical development and aid measures coaffect.
ObjectiveTo systematically review the correlation between the expression of survivin and cervical cancer and its clinical pathologic features. MethodsSystematic and comprehensive literature was searched in The Cochrane Library (Issue 1, 2013), PubMed, MEDLINE (Ovid), CNKI, CBM and WanFang Data from inception to May 2013, to retrieve case-control studies published in the foreign and domestic areas on the correlation between the expression of survivin and cervical cancer and its clinical pathologic features. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 13 studies involving 1 530 women (658 cervical cancer patients, 563 cervical intraepithelial neoplasis (CIN), 658 normal cervical. The results of meta-analysis showed that, a) as for the positive rate of survivin expression, significant differences were found between cervical cancer and CIN (OR=4.63, 95%CI 3.49 to 6.13, P < 0.000 01), cervical cancer and normal cervical tissues (OR=38.23, 95%CI 23.92 to 61.11, P < 0.000 01), and CIN and normal cervical tissues (OR=9.61, 95%CI 6.11 to 15.09, P < 0.000 01). b) Significant differences were found between clinical stages Ⅰ-Ⅱ and clinical stages Ⅲ-Ⅳ (OR=0.17, 95%CI 0.07 to 0.41, P < 0.000 1), cervical cancer with lymph node metastasis and that without lymph node metastasis (OR=3.57, 95%CI 2.20 to 5.78, P < 0.000 01), high and moderate/low differentiated ESCC tissues (OR=0.31, 95%CI 0.13 to 0.76, P=0.01), and shallow and deep muscular infiltration (OR=0.12, 95%CI 0.02 to 0.68, P=0.02). No significant difference was found between cervical cancer with laterouterus or haemal infiltration and that without latero-uterus or haemal infiltration (OR=24.15, 95%CI 0.07 to 8 199.76, P=0.28). ConclusionCurrent foreign and domestic evidence shows that, survivin expression is significantly correlated to cervical cancer and its clinically pathologic features, which may participate in the whole course of carcinogenesis of cervical cancer, but it is not considered to be an absolute factor for estimating the survival rate of patients with cervical cancer. Due to the quality limitation of the included studies, more large scale, well-designed and high quality studies are needed for further verifying the aforementioned conclusion.
ObjectiveTo analyze the trends of incidence, mortality, and burden of disease of cervical cancer in Chinese females from 1990 to 2019.MethodsThe global burden of disease database (GBD) and China health statistics yearbook data was used to analyze the incidence, standardized incidence, mortality, standardized mortality, urban and rural mortality, and burden of cervical cancer among Chinese females using Excel, SPSS 21.0 and Joinpoint Regression Program 4.8.0.1.ResultsThe standardized incidence of cervical cancer among Chinese females increased from 9.21/100 000 in 1990 to 12.06/100 000 in 2019, and the standardized mortality decreased from 8.40/100 000 to 7.36/100 000. The standardized mortality of cervical cancer in 2018 decreased when compared with 2015 in both urban and rural areas. Changes in age-group incidence and mortality indicated that there was a younger trend in cervical cancer. The disease burden indicators (DALY, YLL, and YLD) were increased from 86.49, 84.01, and 1.52 ten thousand person/years to 162.22, 157.40, and 4.83 ten thousand person/years, in which the YLD increased the most (217.76%). The APC of DALY, YLL and YLD were 2.39%, 2.56% and 4.25%, respectively. The proportion of cervical cancer disease burden in female cancer increased in 2019 compared with 1990. And DALY, YLL and YLD increased in the age group of 40 or over, in which DALY of the age group 50-54 increased 167.15%.ConclusionsThe situation of cervical cancer is not optimistic in China. Although the mortality of cervical cancer has decreased in recent years, the number of cases and mortalities is still increasing. Not only the burden of disease is continuously increasing, there is also a younger trend in cervical cancer. Active preventive measures should be taken to reduce the burden of cervical cancer.
ObjectiveTo systematically review the effectiveness and safety of laparoscopic radical hysterectomy (LRH) for cervical cancer. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 10, 2013), CBM, CNKI, VIP, WanFang Data (from inception to October, 2013) through computer, and manually searched related journals. Randomized controlled trials (RCTs) on LRH versus abdominal radical hysterectomy (ARH) in the treatment of cervical cancer were identified according to the inclusion and exclusion criteria, data were extracted, and methodological quality of the included studies was accessed by two reviewer independently. Meta-analysis was then performed using RevMan 5.2 software. ResultsSeven RCTs involving 462 patients were finally included. The results of meta-analysis showed that: there were significant differences between LRH and ARH in the operation time, intraoperative bleeding, recovery time of gastrointestinal function, postoperative pain, postoperative hospital stay, and surgical site infection (MD=20.25, 95%CI 0.26 to 40.24, P=0.05; MD=-56.18, 95%CI-74.84 to-37.52, P < 0.000 01; SMD=-1.54, 95%CI-2.92 to-0.16, P=0.03; MD=-1.37, 95%CI-1.85 to-0.89, P < 0.000 01; MD=-2.32, 95%CI-3.57 to-1.06, P=0.000 3; RR=0.42, 95%CI 0.18 to 0.97, P=0.04). But there was no significant difference in the number of lymph node biopsy (MD=1.34, 95%CI-4.26 to 6.94, P=0.64) and some operative complications (lymphocyte: RR=1.19, 95%CI 0.54 to 2.63, P=0.66; DVT: RR=1.23, 95%CI 0.48 to 3.20, P=0.67; urinary retention: RR=0.85, 95%CI 0.41 to 1.75, P=0.66; cystotomy: RR=1.91, 95%CI 0.49 to 7.51, P=0.35). ConclusionCurrent evidence shows that although applying LRH costs longer time, and with high-level technology, its safety and short-term efficacy are superior to ARH. Due to the limited quantity and quality of the included studies, its long-term efficacy still needs to be further confirmed by conducting more high-quality, multi-centre RCTs with large sample size.
目的:探讨宫颈癌体外放射治疗加后装腔内治疗的疗效和放射反应。方法:对76例宫颈癌患者均采用体外放射治疗加60Co 后装腔内治疗临床资料进行回顾性分析。结果:全组 5年总生存率为 63.7%,Ⅰ期生存率为88.9%,Ⅱ期为 71.9%,Ⅲ期为48.1%,Ⅳ期为 20.0%。10年总生存率为 31.6%,Ⅰ期生存率为 53.3%,Ⅱ期为33.3%,Ⅲ期为 22.0%,Ⅳ期为 0.0%,经Log Rank法检验各期生存率有显著差异(Plt;0.01)。放射治疗后发生阴道粘连 9例(11.8%),放射性膀胱炎 6例(7.9%),放射性直肠炎13例(17.1%)。放射性直肠炎按 RTOG 晚期放射损伤分级方案分级,1级7例(53.8%),2级4例(30.8%),3级 2例(15.4%),4级 0例(0.0%)。结论:体外放射治疗加60Co后装腔内治疗宫颈癌疗效肯定,副作用少。但如何进一步提高生存率,尽可能减少放射反应仍是今后研究的方向。
ObjectiveTo systematically review the correlation between mTOR protein expression and different clinical pathological features as well as the response to radiotherapy and chemotherapy of cervical cancer. MethodsWe electronically searched databases including The Cochrane Library (Issue 1, 2015), PubMed, EMbase, CNKI, CBM, VIP and WanFang Data from inception to April 2015 to collect case-control studies investigating the correlation between mTOR protein expression and different clinical pathological features as well as the response to radiotherapy and chemotherapy of cervical cancer. Two reviewers independently screened literature, extracted data and assessed the risk bias of the included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 8 case-control studies involving 591 patients were included. Among these cases, 365 cases were in the cervical cancer group, 135 cases were in the cervical intraepithelial neoplasia (CIN) group, and 91 cases were in the normal cervix tissue group. The results of meta-analysis showed that:(1) Compared with the normal cervix tissue group, mTOR protein was overexpressed in the cervical cancer group (OR=24.14, 95%CI 4.47 to 130.35, P=0.000 2) and the CIN group (OR=4.71, 95%CI 2.15 to 10.33, P=0.000 1); Compared with the CIN group, mTOR protein was overexpressed in the cervical cancer group (OR=5.12, 95%CI 2.96 to 8.86, P<0.000 01). (2) Compared with the non-lymphnode-metastasis group, mTOR protein was overexpressed in the lymph node metastasis group (OR=3.29, 95%CI 1.61 to 6.69, P=0.001); Compared with the FIGO I group, mTOR protein was overexpressed in the FIGO Ⅱ group (OR=3.00, 95%CI 1.49 to 6.04, P=0.002); Compared with the radiotherapy and chemotherapy responsive group, mTOR protein was overexpressed in the non-response group (OR=15.64, 95%CI 3.17 to 77.15, P=0.000 7). In addition, there was no significant difference between the medium/high differentiation group and low differentiation group (OR=1.70, 95%CI 0.75 to 3.81, P=0.20). ConclusionmTOR protein expression is associated with cervical cancer, and mTOR protein overexpression was associated with lymph node metastasis, higher FIGO and non-response to radiotherapy and chemotherapy. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.