Objective To estimate the diagnostic value of mesothelin in ovarian cancer. Methods PubMed, The Cochrane Library, CBM, CNKI and WanFang Data databases were searched from inception to October 2016 to collect relevant diagnostic accuracy studies of mesothelin in ovarian cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed using Meta-Disc 1.4, Stata 12.0 and RevMan 5.2 softwares. The pooled sensitivity, specificity and diagnostic odds ratio were calculated, the summary receiver operating characteristic curve (SROC) was drawn and the area under the curve (AUC) was calculated. Results Seventeen studies involving 2 052 patients were included. The pooled sensitivity, specificity, DOR were 0.63 (95%CI 0.60 to 0.67), 0.92 (95%CI 0.90 to 0.93) and 26.62 (95%CI 14.96 to 47.38), respectively. The AUC and Q index were 0.915 1 and 0.847 8, respectively. Conclusion The current evidence indicates that mesothelin has high specificity and low sensitivity, which can’t be used alone as a biomarker for the detection of ovarian cancer, but should be combined with other biomarkers.
Objective To investigate the effects of ovarian tissue cryopreservation by needle immersed vitrification (NIV) method and subsequently orthotopic transplantation on ovarian function reconstruction in chemotherapy-induced ovary damage rat model. Methods A total of 52 matured virginal female Wistar rats at age of 8-9 weeks housed in specific-pathogen-free facilities, weighing 250-300 g. Vaginal smears were obtained daily, 50 rats having at least 2 consecutive normal estrous cycles were included in the experiment. Ten rats were selected as donors randomly, and NIV method was used for cryopreserving ovarian tissues. The remaining 40 rats were divided into 3 groups according to different treatments: cyclophosphamide group (C group, n=14), cyclophosphamide/transplantation group (C/T group, n=12), and control group (NS group, n=14). In C group and C/T group, the rats received peritoneal injection of cyclophosphamide every day for 21 days to establish the chemotherapy-induced ovary damage models; and then the frozen-thawed ovarian tissues orthotopically transplanted into the left ovarian bursae in C/ T group. The rats received peritoneal injections of 0.9% saline solution every day for 21 days in NS group. Estrous cycle recovery time, ovary weight, morphology change of ovarian tissues, and follicle count were compared among 3 groups. Results One rat died at 2 days after transplantation in C/T group; the other rats survived to the completion of the experiment. At 4 weeks after the end of injection, no significant difference in body weight was found among 3 groups (P gt; 0.05). The rats of NS group had regular estrous cycle, but cyclic changes in vaginal smears were observed in C group and C/T group during cyclophosphamide treatment. The median estrous cycle recovery was 9 days (95%CI: 7.9-10.1 days) in C group, and was 6 days (95%CI: 4.9-7.1 days) in C/ T group, showing significant difference (χ2=6.571, P=0.010). The ovarian weight showed an obvious downtrend in C group at 4 weeks after cyclophosphamide treatment, and an upward trend was observed in C/T group. The ovarian grafts survived and grew well in C/T group. Primordium follicles and primary follicles in C/T group and NS group were significantly more than those in C group (P lt; 0.05), but no significant difference was found between NS group and C/T group (P gt; 0.05). There was no significant difference in secondary follicles and antral follicles among the 3 groups (P gt; 0.05). Conclusion The method of ovarian tissue cryopreservation by NIV and subsequently orthotopic transplantation can significantly shorten the estrous cycle recovery time in chemotherapy-induced ovary damage rat model. Ovarian grafts grow well, follicle count is similar to normal level. So it has the potential ability of ovarian endocrine and fertility reconstruction after chemotherapy.
Objective To investigate the effects and underlying mechanisms of human pituitary tumor-transforming gene 1 (hPTTG1) small interfering RNA (siRNA) on apoptosis of ovarian cancer cell line A2780. Methods hPTTG1 siRNA was transfected into A2780 with lipofectamine (the hPTTG1 siRNA group), and the normal group and the negative control group were set up. Detections were conducted 48 hours after transfection: the interfering efficiency of hPTTG1 mRNA was measured by real-time polymerase chain reaction, the expression of survivin gene and survivin protein was examined by semiquantitative reverse transcriptase-polymerase chain reaction and Western blot, cell apoptosis was detected by DNA fragmentation gel electrophoresis and propidium iodide staining kit, and the activity of caspase-3 was assayed by caspases colorimetric assay kit. Results The expression of hPTTG1 mRNA was expressly inhibited after hPTTG1 siRNA transfection. DNA ladder was observed in the hPTTG1 siRNA group. The apoptotic rate of hPTTG1 siRNA transfection in the hPTTG1 siRNA group was (17.53±2.17)%, higher than those in the normal group and the negative control group [(8.97±1.56)% and (9.64±1.31)%, respectively], with statistically significant differences between them (P<0.05). The expression levels of survivin mRNA and survivin protein were down-regulated. The activity of caspase-3 was raised. Conclusions siRNA targeting hPTTG1 could induce apoptosis of A2780 by inhibition of survivin expression and activation of caspase-3. It may be a potential target for gene therapy of ovarian cancer.
ObjectiveFertility preservation (FP) technology has gradually been concerned by scholars all over the world due to the increasing survival rate of cancer patients. To review the recent progress of mesenchymal stem cells (MSCs) in female FP. MethodsThe recent original literature about MSCs in female FP was extensively reviewed. ResultsMSCs have the advantages of rich source, easy isolation and amplification, and capacities for multipotential differentiation and migration so that they can be used to avoid the ethical and legal controversy which have great potential of FP for the damage of ovarian tissue and reproductive endocrine disorders. In addition, MSCs can be induced to differentiate into a specific condition, which is expected to be the resource in oocyte-like cells that can be used as a steady cell source for the future experiments and clinical application. ConclusionMSCs have great potential to provide new research ideas for future FP technology.
Objective To explore the clinical characteristics and management of ovarian tumor complicated by pregnancy and its influence on the pregnancy outcome, so as to provide diagnostic and therapeutic experiences. Methods A total of 248 cases were surgically and pathologically diagnosed as ovarian tumor complicated by pregnancy in The 202 Military Hospital from January, 2003 to December, 2009, and their clinical data were analyzed retrospectively. Results The incidence rate of ovarian tumor complicated by pregnancy was 0.49%. Among total 248 cases, 131 (52.82%) were benign tumors, of which 22.18% were ovarian mature teratomas; 113 (45.57%) were tumourlike lesions, of which most were ovarian chocolatecyst and lutealcyst, and 4 (1.61%) were malignant tumors. There were 212 cases treated by tumorectomy or salpingo-oophorectomy, and 3 of 4 cases with malignant tumors took postoperative chemotherapy. A total of 192 cases were diagnosed by regular antenatal care and ultrasound examination, accounting for 77.42% of the total sample size found during pregnancy. Among 14 cases receiving emergency operations, 9 were complicated by torsion, and the other 5 were by rupture. There were 67 cases receiving operation from the 14th to 18th gestational week, and 57 cases had full-time pregnancy. Conclusion Ultrasonography and pelvioscopy are of principal importance in the diagnosis and detection of ovarian tumor complicated by pregnancy which should be treated by tumorectomy, and suitable surgery intervention during second trimester is safe.
Ovarian cancer is one of the common malignant tumors of female genital organs. In gynecological tumors, the incidence rate of ovarian cancer ranks the third after cervical cancer and uterine body cancer, but the death rate of ovarian cancer ranks the first, posing a serious threat to women’s life and health. In recent years, the National Comprehensive Cancer Network (NCCN) clinical practice guidelines for ovarian cancer has become an important basis for diagnosis and treatment of ovarian cancer. In this paper, we interpret the latest version (version 4. 2017) of NCCN clinical practice guidelines for ovarian cancer for its better clinical application.
Objective To systematically review the relationship between the expression of Survivin mRNA and ovarian cancer. Methods PubMed, The Cochrane Library (Issue 11, 2016), CBM, CNKI, VIP and WanFang Data databases were searched to identify case-control studies concerning the association between the expression of Survivin mRNA and ovarian cancer up to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 10 studies were included. The positive of Survivin mRNA in ovarian cancer group was significantly higher than that in control group (OR=24.63, 95% CI 13.44 to 45.15,P<0.000 01). The positive of Survivin in low differentiated group was significantly higher than that in high differentiation group (OR=3.69, 95% CI 2.29 to 5.93,P<0.000 01). The positive of Survivin in clinical stage of Ⅲ-Ⅳ was significantly higher than that in clinical stage of Ⅰ-Ⅱ (OR=4.76, 95% CI 2.99 to 7.57,P<0.000 01), respectively. However, the expression of Survivin mRNA was not associated with lymph node metastasis, ascites and histological type. Conclusion The current evidence indicates that the expression of Survivin mRNA is significantly correlated with ovarian cancer and its clinicopathologic features. Due to the limited quantity and quality of includes studies, the above conclusions are needed to be verified by more high quality studies.
Objective To make an individualized therapeutic regimen for a patient with stage III relapsed ovarian cancer guided by evidence-based medicine.Methods According to the clinical problems this patient showed and the PICO (patient, intervention, comparison and outcome) principle, the best clinical evidence associated with relapsed ovarian cancer was retrieved and evaluated. Results The current evidence showed that the relapsed ovarian cancer with platinum resistance tended to be treated by pharmacotherapy. Consequently, on the basis of combining the recommended guidelines, randomized controlled trials (RCTs), systematic reviews or meta-analyses on RCTs, clinical experience from doctors and willingness of patient, the regimen of Irinotecan plus Pegylated Liposomal Doxorubicin for interventional chemotherapy was recommended for this patient. After three courses of the treatment, the disease got some relieved; the medical team would like to keep conducting the same regimen for another six to eight courses, and the follow-up visit was undergoing. Conclusion For patients with relapsed ovarian cancer with platinum resistance, an individualized therapeutic regimen under the guidance of evidence-based methods can not only improve the therapeutic efficacy but also guide both doctors and patients to take the indeterminate risk of medicine.
ObjectivesTo systematically review the efficacy of Chinese herbal medicine (CHM) combined with chemotherapy for ovarian cancer.MethodsCNKI, VIP, WanFang Data and PubMed databases were searched to collect randomized controlled trials on the CHM combined with chemotherapy for ovarian cancer from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsThirteen studies were included. Meta-analysis showed that, CHM combined with chemotherapy group was superior to the chemotherapy alone group in effective rate of TCM syndrome (RR=1.72, 95%CI 1.46 to 2.03, P<0.00.000 1), effective rate of tumor change (RR=1.40, 95%CI 1.21 to 1.63,P<0.000 01), physical condition score (MD=9.19, 95%CI 5.89 to 12.48,P<0.000 01), tumor markers (MD=–18.00, 95%CI –20.62 to –1.538,P<0.000 01), leukocyte reduction (RR=0.67, 95%CI 0.58 to 0.77,P<0.000 01), granulocy tedepletion (RR=0.67, 95%CI 0.55 to 0.81,P<0.000 1), thrombocytopenia (RR=0.55, 95%CI 0.45 to 0.69,P<0.000 01), and digestive tract reaction (RR=0.66, 95%CI 0.50 to 0.87,P=0.004).ConclusionsThe current evidence shows that CHM combined with chemotherapy is superior to chemotherapy alone in the treatment of ovarian cancer. Due to limited quality and quantity of included studies, the above conclusions are required to be verified by more high-quality studies.
Objective To retrospectively analyze the emergency complications of the patients after oocyte retrieval with assisted reproductive technology (ART), and analyze the corresponding strategies. Methods The clinical data of patients after oocyte retrieval with ART between January and December 2016 were retrospectively anayzed. The postoperative emergency complications were observed. Results A total of 5 013 patients were included in the study. The common emergency complications after oocyte retrieval included vaginal bleeding in 137 cases (2.73%) , ovarian hyperstimulation syndrome (OHSS) in 35 (0.69%), hematuria caused by bladder injury in 11 cases (0.21%), pelvic infection in 3 (0.06%), and vagal reflex in 2 (0.04%). OHSS was related to age, the number of basal follicles, the number of oviposaccharides and the estradiol level on the day of human chorionic gonadotropin injection, but not related to the body mass index and the number of days of gonadotropin use; which might be misdiagnosed most likely. Conclusions OHSS is one of the common and severe emergency complications after oocyte retrieval with ART, which should be concerned. Active treatment of complications is helpful to reduce the incidence of emergency complications after oocyte retrieval with ART.