Background: Pelvic floor ultrasound (PFU) lacks a consistently stable horizontal reference line for quantitative pelvic organ prolapse (POP) assessment. We investigated whether the anatomically defined pubic symphysis caudal angle (∠C) could serve as a standardized, ultrasound-visible reference line. Methods: This three-stage observational study integrated cadaveric dissection (n=9), pelvic MRI analysis of adult women (n=456, including 154 with POP), and transperineal 3D ultrasound validation (n=103). We defined the anatomical basis of ∠C, validated its stability on MRI across demographic subgroups, and compared a fixed 30° ∠C-based horizontal line against the MRI gold standard (Pelvic Inclination Correction System, PICS) and conventional ultrasound reference lines during Valsalva. Findings: The anatomical ∠C was 27.39° (SD 2.81) with confirmed dense collagen continuity at the ligament–disc interface. On MRI, ∠C was 31.46° (SD 4.30; ICC>0.85), independent of BMI, and stable during Valsalva (p=0.254). In POP patients, the 30° fixed ∠C-line detected significantly greater caudal descent than PICS for the bladder, cervix, and rectum during Valsalva (mean differences 5.8, 5.3, and 3.9 mm respectively; all p<0.001). On ultrasound, the novel reference line was visualized in 100% of cases and detected significantly larger caudal displacements across all pelvic compartments compared with conventional horizontal lines (all p<0.001). Interpretation: The 30° ∠C-based line is a biomechanically stable reference that outperforms the PICS gold standard during Valsalva. It successfully translates MRI rigor into routine ultrasound, establishing a standardized coordinate framework essential for accurate POP staging and future AI-driven quantitative assessments.

To explore the effect of preoperative conization on the prognosis of patients with stage IB1 (FIGO 2018) cervical cancer and to compare the prognosis between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) following conization. This multicentre, retrospective, case-paired cohort study compared the 5-year overall survival (OS) and disease-free survival (DFS) between the conization group and the non-conization group under the condition of propensity score matching. Further subgroup analysis was conducted to compare OS and DFS between laparoscopic surgery and abdominal surgery after conization. A total of 1319 patients with stage IB1 cervical cancer were included in this study, and there was no significant difference in oncological prognosis between the conization group (n = 383) and the non-conization group (n = 936) (OS: 94.3

Esophageal squamous cell carcinoma (ESCC) remains a major cause of cancer mortality, largely because most patients are diagnosed at an advanced stage. High-grade intraepithelial neoplasia (HGIN) represents an important and clinically actionable precancerous stage in the ESCC pathway, during which timely detection and endoscopic therapy can be curative. However, population screening with endoscopy is resource-intensive and has limited acceptability. Accumulating observational evidence suggests that ESCC and its precancerous stages are accompanied by alterations in the esophageal, oral, and tumor-associated microbiome, although the reproducibility and clinical significance of these findings vary across cohorts, sample types, and analytical methods. These microbial changes are shaped by shared risk factors, including smoking, alcohol consumption, hot beverages, poor oral hygiene, local mucosal injury and host immunity. Dysbiosis involves not only bacteria but also fungi and cross-kingdom interactions, which may be associated with barrier disruption, chronic inflammation, and malignant transformation. In this review, we summarize current evidence on the bacteriome and mycobiome across the normal squamous mucosa-HGIN-ESCC, focusing on microbial candidates, potential host-microbe mechanisms, and early-detection relevance. We also discuss saliva-based testing, non-endoscopic esophageal sampling, blood-derived microbial signals, and AI-assisted risk models. At present, microbiome-based biomarkers should be regarded as promising but not yet clinically implementation-ready tools. Further longitudinal validation, standardized methodology, and external cohort testing are required before they can be integrated into routine ESCC early-detection or risk-stratification pathways.

The placenta plays a pivotal role in human pregnancy, yet research into placental development has been hindered by limited access to early-stage embryos and ethical constraints. Although human trophoblast stem cells (hTSCs) have been established from blastocysts, deriving these cells efficiently from primed human pluripotent stem cells (hPSCs) remains challenging. Here, we developed a simplified and efficient strategy that enables direct, efficient conversion of primed hPSCs into stable, self-renewing hTSCs by transiently inhibiting the MEK/ERK signaling pathway using the inhibitor PD0325901 in a simplified basal medium. This approach significantly enhanced the generation of trophoblast cells expressing the critical trophoblast marker GATA3 and led to the establishment of homogeneous hTSC lines with robust capacities to differentiate into functional extravillous trophoblast (EVT) and syncytiotrophoblast (STB) lineages. Transcriptomic and chromatin accessibility analyses confirmed that these hTSCs closely resembled blastocyst-derived trophoblast cells and clearly differed from amnion lineages, confirming authentic trophoblast identity distinct from amnion. Additionally, precise modulation of WNT signaling activity was essential for optimal trophoblast induction efficiency, highlighting the importance of signaling equilibrium in trophoblast differentiation. Collectively, our optimized protocol offers an accessible and reproducible platform for modeling early placental development and understanding the pathogenesis of trophoblast-associated disorders in vitro.

Background/aim:Cervical cancer (CC) is a malignant gynecologic tumor. Small RNAs derived from tRNAs (tsRNAs) have been reported to play regulatory roles in tumor progression and suppression. However, the functional role of tsRNAs in CC remains largely unclear. Materials and methods:Small RNA sequencing was performed on normal, cervical intraepithelial neoplasia (CIN), and CC clinical samples to identify differentially expressed tsRNAs (DEtsRNAs). qRT-PCR was used to validate the selected DEtsRNAs. The effects of tsRNA-05020 on HeLa cell proliferation, apoptosis, and epithelial-to-mesenchymal transition were assessed. Results:Compared with the normal group, 215 tsRNAs were significantly differentially expressed in CIN tissues, of which 196 were upregulated and 19 were downregulated. A total of 184 DEtsRNAs were identified between CC and CIN tissues, including 81 upregulated and 103 downregulated in CC. In total, three candidate DEtsRNAs were validated, among which tsRNA-05020 exhibited the largest fold change and was significantly downregulated in CC compared with CIN. Target gene network analysis identified 278 putative target mRNAs of tsRNA-05020 in CC. Overexpression of tsRNA-05020 significantly inhibited HeLa cell proliferation and promoted apoptosis. Moreover, overexpression of tsRNA-05020 significantly reduced vimentin expression and increased ZO-1 expression. Conclusion:This study identifies a previously uncharacterized role of tsRNA-05020 in CC progression, expands the current understanding of tsRNA-associated regulatory networks, and suggests that tsRNA-05020 may serve as a potential molecular regulator in CC.

Abstract To compare oncological outcomes between HPV-positive and HPV-negative cervical cancer patients in a large Chinese multicenter cohort. This retrospective study included cervical squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma. Propensity score matching (PSM, 2:1) was used to balance baseline characteristics. Kaplan–Meier method and Cox proportional hazards regression were applied to compare 5-year overall survival (OS) and disease-free survival (DFS). The proportional hazards assumption was tested. Multicenter heterogeneity was adjusted using center stratification. Missing data were managed by complete-case analysis and multiple imputation sensitivity analysis. A total of 11,215 eligible patients were included. Before PSM, the HPV-positive group showed significantly better 5-year OS (92.3% vs. 84.3%, P < 0.001) and DFS (88.0% vs. 79.6%, P < 0.001) than the HPV-negative group. Multivariable Cox analysis confirmed HPV negativity as an independent risk factor for OS (HR = 1.545, 95%CI 1.091–2.188, P = 0.014) and DFS (HR = 1.556, 95%CI 1.212–1.997, P < 0.001). After 2:1PSM, HPV-positive patients still had superior 5-year OS (88.4% vs. 84.3%, P = 0.004) and DFS (85.3% vs. 79.6%, P < 0.001). Among 7,998 patients who underwent radical surgery, similar results were observed before and after PSM. HPV-negative status is associated with inferior 5-year OS and DFS and serves as an independent adverse prognostic factor in cervical cancer, including patients treated with radical surgery.

Persistent infection with high-risk HPV in women can progress to cervical intraepithelial neoplasia and even cervical cancer. This study investigated the cytotoxic and immunomodulatory effects of the TBTCN-TDG photodynamic therapy (PDT) probe in treating HPV-associated cervical lesions. The TBTCN-TDG probe was designed by integrating a donor-acceptor-π-acceptor 1 (D-A-π-A1) structure (TBTCN) with TDG, a moiety targeting Galectin-1, and its targeting ability in HPV-positive SiHa cells was confirmed. The in vitro results demonstrated that TBTCN-TDG combined with light treatment significantly inhibited SiHa cell proliferation, increased apoptosis, and activated immune responses by stimulating dendritic cells, macrophages, and NK cells, through enhanced NF-κB pathway signaling. In vivo, this targeted photosensitizer exhibited substantial therapeutic effects under laser excitation, as evidenced by TUNEL staining, which showed increased apoptosis in lesions. Immune analysis indicated that TBTCN-TDG enhanced NK cell viability and elevated the levels of pro-inflammatory cytokines under laser excitation, such as TNF-α, IFN-γ, and IL-6, confirming immune response activation. In conclusion, the combination of TBTCN-TDG and PDT effectively targets cells infected with HPV, enhances immune responses, and suppresses HPV infection. This suggests a novel therapeutic strategy for photodynamic immunotherapy in patients with cervical high-risk HPV infections.

Objectives: This study aimed to combine dynamic magnetic resonance imaging (MRI) with three-dimensional (3D) reconstruction and form a plane based on osseous structures to evaluate the degree of pelvic organ prolapse (POP). The correlation of this novel evaluation approach with the POP-Q system was assessed. METHODS:A retrospective analysis was conducted on 71 POP patients with POP-Q stage ≥II. The dynamic MRI images of those patients were reconstructed in three dimensions. A plane was created by using the midpoint of the line between the inferior margins of the two pubic bones and the starting points of the superior margins of the bilateral sacrotuberous ligaments (the pubic inferior midpoint - sacrotuberous ligament starting point superior edge plane). Distances from the lowest point of the anterior vaginal wall, cervix, and rectal ampulla to this evaluation plane were measured, modeled, and categorized. The consistency and correlation of the categorized results with POP-Q scores were verified by performing a kappa analysis and Spearman's rank correlation analysis, respectively. RESULTS:The highest consistency with POP-Q scores was found in the prolapse of the central pelvic cavity (kappa = 0.713, p < 0.05), followed by the anterior POP (kappa = 0.427, p < 0.05), and posterior POP (kappa = 0.261, p < 0.05), with all showing statistically significant differences. The strongest positive correlation was observed between central POP and POP-Q scores (r = 0.864, p < 0.01), followed by posterior POP and POP-Q scores (r = 0.710, p < 0.01), with both exhibiting a strong positive correlation. Anterior POP and POP-Q scores showed a moderate positive correlation (r = 0.586, p < 0.01). CONCLUSIONS:The results of the proposed evaluation method were highly consistent in the anterior and central pelvic cavities and strongly correlated in the central and posterior pelvic cavities. In particular, the assessment of the posterior cavity showed a strong positive correlation with that of the POP-Q system. The evaluation plane demonstrated high consistency and correlation with the POP-Q system. .

OBJECTIVES:We compared the predictive performance of apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters in assessing small for gestational age (SGA) pregnancies. METHODS:Perspective study. Twenty-eight normal controls and 30 SGA pregnancies underwent IVIM scans on a 3.0 T MRI scanner. The diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were calculated from the IVIM, and the ADC was derived from the IVIM sequence with monoexponential fitting of the IVIM data at b-values of 0 and 800 s/mm. All 4 parameters and AUC within the placenta were compared between normal and SGA pregnancies. RESULTS:All of mean ADC ([1.69 ± 0.19] × 10-3 mm2/s vs [1.42 ± 0.28] × 10-3 mm2/s), D (1901.08 ± 199.77 µm2/s vs 1635.17 ± 244.18 µm2/s), D* (56 445.78 ± 8125.91 µm2/s vs 47 600.62 ± 7642.15 µm2/s), and f (33.35% ± 3.36% vs 27.30 ± 3.48%) were significantly decreased in SGA pregnancies (P < .001 for all). The diagnostic performance of f (AUC = 0.896; sensitivity, 80.00%; specificity, 92.86%; cut-off value, 29.28%) was significantly better than ADC (AUC = 0.788; sensitivity, 86.67%; specificity, 70.83%; cut-off value, 1.63 × 10-3 mm2/s; P = .035), D (AUC = 0.798; sensitivity, 70.00%; specificity, 82.14%; cut-off value, 1708.17 µm2/s; P = .041), and D* (AUC = 0.800; sensitivity, 63.33%; specificity, 89.29%; cut-off value, 48181.97 µm2/s; P = .044). CONCLUSIONS:Our study suggested that f, a perfusion parameter derived from IVIM, was a more powerful independent predictor than ADC and other IVIM parameters of SGA pregnancies. ADVANCES IN KNOWLEDGE:This study compared the ADC and IVIM in diagnosing SGA.

OBJECTIVE:To compare the long-term survival outcomes, recurrence patterns and morbidity of type B and type C radical hysterectomy (RH) for stage IB2 cervical cancer (FIGO 2018). METHODS:Based on FOUR-C database, patients who underwent type B or C RH in 47 hospitals from 2004 to 2018 were reviewed. Univariate and multivariate analyses were performed to compare 5-year overall survival (OS) and recurrence-free survival (RFS), recurrence patterns and morbidity between the two groups after propensity score matching (PSM). RESULTS:A total of 1308 patients were enrolled in this study, 840 and 468 patients underwent type B and type C. There was no difference in 5-year survival outcomes between groups type B and type C, either before or after matching (OS: unmatched 95.6% vs. 93.3%, matched 95.6 vs. 93.0%, P>0.05; RFS: unmatched: 90.5% vs. 90.1%, matched: 91.2% vs. 89.7%, P>0.05). Type B group had a shorter operative time, less blood loss, earlier recovery of intestinal function, eariler removal of catheter and shorter hospitalization (P<0.01). Intraoperative complications were similar (0.1% vs. 0.2%, P>0.05), but postoperative complications occurred more frequently in the type C group (8.3% vs. 12.1%, P < 0.05), especially lymphocysts and urinary retention. The surgical dissection does not appear to influence tumor recurrences significantly (P>0.05). CONCLUSIONS:For cervical cancer patients with stage IB2, type B RH demonstrated comparable long-term oncological outcomes and recurrence patterns to type C RH, while being associated with fewer intra-and postoperative complications. Type B RH is a feasible and appropriate surgical option, but the conclusions need to be confirmed by prospective studies.

BACKGROUND:To compare oncological outcomes of radical hysterectomy (RH) and radiochemotherapy (R-CT) for stage IIIC1 (FIGO 2018) cervical adenocarcinoma patients. METHODS:Based on the Chinese Cervical Cancer Clinical Diagnosis and Treatment Project Database, we retrospectively reviewed 236 cases of FIGO stage IIIC1 cervical adenocarcinoma diagnosed between 2005 and 2019. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) rates were compared between the two treatment groups using multivariate Cox regression models and the log-rank test, both in the overall study population and after propensity score matching (PSM). RESULTS:From 63 926 patients, we selected 236 cases, including 203 in the RH group and 33 in the R-CT group. In the overall study population, R-CT was associated with significantly worse 5-year OS (51.8% vs. 67.2%, p < 0.05) and 5-year DFS (43.1% vs. 60.1%, p < 0.05) compared to RH. Multivariate analysis revealed that R-CT was an independent risk factor for 5-year DFS (hazard ratio [HR] = 2.226, 95% confidence interval [CI] 1.141-4.343, p < 0.05) but not for 5-year OS (HR = 1.834, 95% CI: 0.829-4.061, p > 0.05) in FIGO stage IIIC1 cervical adenocarcinoma. After matching (n = 26 in R-CT group vs. 73 in RH group), the R-CT group showed significantly lower 5-year OS (50.3% vs. 77.4%, p < 0.05) and DFS (38.2% vs. 65.0%, p < 0.05) compared to the RH group. In the matched cohort, R-CT remained an independent risk factor for 5-year DFS (HR = 2.299, 95% CI: 1.113-4.750, p < 0.05) but not for 5-year OS (HR = 1.926, 95% CI: 0.792-4.682, p > 0.05). CONCLUSION:Among patients with stage FIGO 2018 IIIC1 cervical cancer adenocarcinoma, R-CT was not associated with better oncological outcomes than RH. Radiotherapy should not be the only recommended treatment.

Objective To compare the 5-year oncological outcomes of different adjuvant treatment modalities in patients with FIGO 2018 stage IA-IIA cervical adenocarcinoma who underwent open radical hysterectomy and one intermediate-risk pathological factor. Methods Based on the Four C database (between 2004 and 2018, n =63,926), patients with FIGO 2018 stage IA-IIA cervical adenocarcinoma and only one intermediate-risk pathological factor underwent open extensive hysterectomy. All patients were divided into three groups, namely, the simple surgery group (radical hysterectomy, RH), postoperative adjuvant chemotherapy group (radical hysterectomy and chemotherapy, RH + CT), and postoperative adjuvant chemoradiotherapy group (radical hysterectomy and radiotherapy/concurrent chemoradiotherapy, RH + RT/CCRT). The 5-year OS and DFS rates were compared among the three groups. Results Of the 219 cervical adenocarcinoma patients with only one intermediate-risk pathological factor, 50 patients had RH; 54 patients had RH + CT; and 115 patients had RH + RT/CCRT. There were no significant differences in 5-year OS and 5-year DFS rates among the three groups (RH vs. RH + CT: 92.7% vs. 90.3%, P = 0.749; 88.5% vs. 85.1%, P = 0.680, RH vs. RH + RT/CCRT: 90.7% vs. 82.3%, P = 0.484; 84.4% vs. 90.1%, P = 0.494, RH + CT vs. RH + RT/CCRT: 89.9% vs. 90.6%, P = 0.815; 90.5% vs. 90.8%, P = 0.905). Conclusion Postoperative adjuvant chemotherapy or chemoradiotherapy did not significantly improve the outcomes of FIGO 2018 IA-IIA cervical adenocarcinoma patients with only one intermediate risk factor.

Accurately evaluating lymph node (LN) status is essential for cervical cancer staging and making treatment decisions. However, the current preoperative imaging modalities for diagnosing LN metastasis in patients with cervical cancer are suboptimal, and the existing radiochemotherapy methods lack specificity, which leads to increased toxicity and side effects. To overcome these limitations, we aimed to develop a theranostic strategy for LN metastases with a galectin-1-targeted nanoprobe for dual-modal magnetic resonance imaging (MRI)/near-infrared (NIR) imaging and photothermal therapy (PTT). The PEG@MnPb-IR820 nanoparticles were synthesized through an integrated approach combining microemulsion, thin-film hydration, and esterification coupling methods. The nanoparticles were synthesized and characterized for their physicochemical properties and biosafety. After extensive in vitro and in vivo experiments, the TDG@PMI NPs demonstrated low biological toxicity, excellent stability, and a diameter of 74 nm, which is suitable for LN accumulation. With effective MRI and NIR imaging guidance, this nanoprobe displayed outstanding anticancer activity in tumors and metastatic sentinel LNs upon single NIR laser irradiation by inducing mitochondrial apoptosis in tumor cells.

Cervical cancer is a major public health issue in China, characterized by rising incidence and mortality rates over the past years. This study aims to analyze the epidemiological trends of cervical cancer from 2005 to 2018, providing valuable insights for public health policy and intervention strategies. Data were extracted from the publicly available China Cancer Registry Annual Reports (2005-2018), employing joinpoint log-linear regression models to evaluate changes in incidence and mortality rates. The analysis focused on geographic disparities between urban and rural areas, examining how these differences influence overall trends. Incidence and mortality rates were age-standardized using the the Segi's world population and the fifth Chinese national census of 2000 as references. The incidence of cervical cancer in China increased significantly, rising from 9.10 per 100,000 women in 2005 to 18.10 per 100,000 in 2018, with an average annual percent change (AAPC) of 5.38%. Notably, rural areas exhibited a higher AAPC of 6.28%, compared to 4.54% in urban settings, highlighting the disparities in healthcare access. In 2018, there were 46,626 new cases of cervical cancer in Chinese cancer registry areas, representing 6.63% of all newly diagnosed cancers among women, with 14,737 deaths, making it the seventh leading cause of cancer deaths among females. The age-standardized incidence rate by Segi's world standard population was 12.00 per 100,000, while the age-standardized mortality rate was 3.49 per 100,000. The incidence was low until age 20, then increased sharply, peaking at 50-54 years, while mortality remained low until age 25 and rose steadily, peaking in the 80-84 age group. Geographic disparities were significant, with the highest incidence and mortality rates found in central and rural regions. The accelerating burden-particularly in rural and Central China-underscores the need to expand organised screening, improve HPV-vaccination uptake, and narrow urban-rural health disparities. Targeted efforts for middle-aged and underserved populations are essential to advance China toward WHO cervical‑cancer‑elimination goals.

Objective: To identify 3D MRI-derived biomarkers of the cardinal ligament (CL) and uterosacral ligament (USL) for pelvic organ prolapse (POP) risk and stress urinary incontinence (SUI), and to evaluate their correlations with prolapse severity. Methods: Female patients undergoing pelvic MRI at *** Hospital (2021-2023) were grouped into POP and control cohorts. MRI data underwent 3D reconstruction (Mimics software) and modeling (Geomagic/Solidworks) to precisely measure ligament parameters. Results: Women with POP had longer postmenopausal intervals, and higher parity but similar age, Body Mass Index (BMI), Lean Body Mass (LBM) and Body Surface Area (BSA). CL volume, surface area, mass, and maximal thickness were significantly reduced in POP (all p < 0.001); USL metrics did not differ. Total CL mass achieved the highest discrimination for POP (AUC 0.78; sensitivity 73%, specificity 80%). CL dimensions correlated inversely with prolapse severity and SUI (r = -0.368 to-0.442; p < 0.01), whereas USL metrics showed no significant correlations. Bulbospongiosus muscle thickness was included due to its potential role in urethral support and continence mechanisms. Multivariate modeling retained parity (OR 4.5), CL thickness and bulbospongiosus muscle thickness (strong protective OR < 0.01), left levator ani defects (OR 0.13), and levator ani asymmetry (OR 24) as independent predictors. Conclusion: 3D MRI quantification of CL metrics (volume, area, mass) offers noninvasive biomarkers for POP and SUI risk prediction, unlike USL morphology. These markers improve pelvic floor failure understanding and enable early POP risk identification.

Rationale:Osteomyelitis of the skull following the endoscopic resection of multiple nasopharyngeal cysts is extremely rare. Postoperative headache, in the absence of fever or ear pain, may no be typically present and could be easily overlooked, potentially leading to a delay in diagnosis and treatment.Patient concerns:In this case report, we present the case of a 57-year-old male patient who developed persistent headache symptoms 1 week after undergoing endoscopic resection of nasopharyngeal cysts under general anesthesia and was diagnosed with skull base osteomyelitis (SBO).Diagnoses:SBO.Interventions:After the diagnosis of SBO, the patient was treated with a full course of antibiotics, including 2.0 g ceftriaxone for intravenous infusion for 1 week, 2.5 g of piperacillin sodium and sulbactam for intravenous infusion 12 hours for 2 weeks, and 0.6 g of linezolid tablets for oral administration twice a day for 2 weeks. Under local conditions, endoscopic nasopharyngeal incision and drainage were performed, during which necrotic tissue and pus were removed, and deep tissue secretions were taken.Outcomes:In the follow-up 6 months at the outpatient clinic after discharge, the patient's headache improved, no complications occurred, and no symptoms of cranial nerve palsy were observed.Lessons:Magnetic resonance imaging revealed 3 deep cysts in the nasopharynx. During surgery, when using plasma to resect cysts, it is necessary to avoid excessive exposure or damage to the bone, which would increase the risk of postoperative SBO.

Previous female pelvic organ models have predominantly been solid models, which do not accurately reflect the true anatomical structure of the human body. To construct anatomically accurate cavity three-dimensional reconstruction models of female pelvic cavity organs based on in vivo human magnetic resonance imaging (MRI). Based on pelvic MRI from 120 patients, we measured organ wall thickness and anatomical variation to obtain population-averaged wall-thickness parameters (mean ± SD). Using these parameters, we constructed a single representative cavity model through segmentation, Non-Uniform Rational B-Spline surface reconstruction, and Boolean operations. This model represents an instance informed by population metrics rather than a voxel-by-voxel composite of all 120 scans. The present study focuses on visceral organ cavities (uterus, vagina, bladder, and rectum) and does not include pelvic body-wall musculature or bony structures. This was combined with Non-Uniform Rational B-Spline surface reconstruction in Ge-omagic Wrap and Boolean operations in SolidWorks to construct 4 major cavity entities: an irregular wall-thickened myometrial cavity with endometrial resection, a cervically enveloped upper semi-closed (lower open vaginal cavity, a semi-closed bladder cavity with an open urethral end, and an open-ended rectal cavity). A standardized wall thickness parameter table (accuracy 0.01 mm) was established through double measurements by 2 independent operators, with final values derived from the mean of measurements. Anatomically characteristic cavity models were generated, forming an assembly that reflects the adjacency relationships of multiple organs. Measurement results of organ wall thickness, bladder wall 1.52 ± 0.28 mm (intraclass correlation coefficient [ICC] = 0.781), vaginal wall 3.97 ± 0.56 mm (ICC = 0.876), rectal wall 1.38 ± 0.19 mm (ICC = 0.824). This study used MRI-derived, population-averaged wall thickness to construct representative cavity models of female pelvic organs. The inputs showed good reproducibility (ICC), but external validation, such as cadaveric comparison or independent imaging, is still needed. These models provide a basis for teaching, preliminary simulations, and future finite-element analyses.

OBJECTIVE:To compare the pathological findings and survival outcomes of patients with 2009 FIGO stage IA-IIA2 cervical cancer between groups with adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using the Chinese Cervical Cancer Clinical (FOUR-C) study database. METHODS:Patients from 2004 to 2018 with cervical ADC and SCC who underwent radical hysterectomy were identified through the FOUR-C database. Propensity score matching (PSM) was conducted to balance baseline clinicopathological characteristics. The Kaplan-Meier method and Cox regression analysis were used to evaluate the prognostic effect of ADC on the 5-year overall survival (OS). RESULTS:We identified 1611 (9.8%) patients with ADC and 14 894 (90.2%) patients with SCC. Compared with SCC, ADC was significantly associated with an increased risk of death (odds ratio [OR] 1.40, 95% CI 1.12-1.74) and disease progression (OR 1.34, 95% CI 1.14-1.57). ADC had a greater propensity for lymph node metastasis, uterine corpus invasion, perineural invasion, and ovarian metastases than SCC (P < 0.05). After 1:2 PSM, significant differences were still observed between these two histology subtypes (OS: OR 1.43, 95% CI 1.10-1.86; DFS: OR 1.45, 95% CI 1.19-1.76). The subgroup analysis further showed a worse prognosis for patients with ADC than for patients with SCC among patients with any of the high- or intermediate- risk factors (OR 1.60, 95% CI 1.21-2.12), but no significant differences were observed for the patients with no risk factors (OR 0.71, 95% CI 0.32-1.58). CONCLUSION:ADC is an independent prognostic factor for shorter survival in surgically treated patients with cervical cancer presenting intermediate- or high-risk factors but does not affect survival outcomes in patients without any risk factors.

Introduction and hypothesis: To compare 3D models based on magnetic resonance imaging (MRI) and 3D models based on computed tomography (CT) in pelvimetry. Methods: A retrospective analysis of 141 patients who underwent both pelvic 3D MRI and 3D CT pelvimetry for gynecological diseases from December 2009 to October 2020 was performed. The two pelvimetry methods were compared by paired Student's t test, Pearson's correlation coefficient, Bland-Altman analysis and intraclass correlation coefficient (ICC). Results: The differences between methods for each diameter were statistically significant, except for those of the posterior sagittal diameter of the pelvic inlet (t:-0.71, P = 0.5) and the anteroposterior pelvic outlet diameter (t:0.02, P = 0.98). 3D MRI and 3D CT pelvimetry strongly correlated with each other (r: min 0.7, max: 0.96, P < 0.01). The Bland-Altman results indicate that the difference points of each pelvic diameter line greater than 95 % are within the 95 % limits of agreement. The ICC was good to very good for all pelvimetric measurements using either MRI-3D (ICC: 0.64-0.98) or CT-3D (ICC: 0.72-0.98) between the two readers. Conclusions: 3D MRI and 3D CT pelvimetry have good agreement and reproducibility, indicating that 3D MRI is reliable for pelvimetry.