BackgroundAccumulating studies have reported indispensable functions of circular RNAs (circRNA) in tumor progression through regulation of gene expression. However, circRNA expression profiles and functions in human ovarian carcinoma (OC) are yet to be fully established.MethodsIn this research, deep sequencing of circRNAs from OC samples and paired adjacent normal tissues was performed to establish expression profiles and circ-PHC3 levels between the groups further compared using RT-qPCR. The effects of ectopic overexpression of miR-497-5p and SOX9 and siRNA-mediated knockdown of circ-PHC3 and an miR-497-5p inhibitor were explored to clarify the regulatory mechanisms underlying circ-PHC3 activity in OC proliferation and metastasis. Information from public databases and the luciferase reporter assay were further utilized to examine the potential correlations among circ-PHC3, miR-497-5p and SOX9.ResultsOur results showed significant upregulation of circ-PHC3 in both OC cell lines and tissues. In the luciferase reporter assay, downregulation of circ-PHC3 led to suppression of metastasis and proliferation, potentially through targeted effects on the miR-497-5p/SOX9 axis in OC. SOX9 overexpression or miR-497-5p suppression rescued OC cell proliferation and invasion following silencing of circ-PHC3. Moreover, SOX9 inhibition induced restoration of OC cell invasion and proliferation under conditions of overexpression of miR-497-5p. Thus, circ-PHC3 appears to exert effects on cancer stem cell differentiation through regulation of the miR-497-5p/SOX9 axis.ConclusionTaken together, our findings suggest that circ-PHC3 enhances OC progression through functioning as an miR-497-5p sponge to promote SOX9 expression, supporting its potential as a promising candidate target for OC therapy.

AIM:The aim of the study was to assess the incidence of tumor recurrence, iatrogenic peroneal nerve injury, and wound healing problems in a small cohort of patients with proximal fibular tumors who had undergone surgery, and to determine the relative risk of pre-operative biopsies on these outcome variables.METHODS:The study entailed a retrospective single-center analysis of patients with a histologically confirmed tumor in the proximal fibula who had undergone surgery at our institute between 2004 and 2019 (n = 66). The accuracy of diagnosis based on pre-operative biopsy (n = 10) was compared to the histological diagnosis based on resection specimens. The association between pre-operative biopsy and patient demographics and medical history as well as tumor recurrence, iatrogenic peroneal nerve injury, and impaired wound healing was analyzed statistically. The data were presented against a backdrop of bone cancer incidence and 5-year survival rates in China.RESULTS:Recurrence, iatrogenic peroneal nerve, and wound healing issues were identified in 5 (7.6%), 8 (12.1%), and 6 patients (11.0%), respectively. A biopsy was acquired from ten of 66 patients. The pre-operative biopsy diagnostic accuracy rate was 100%. Males had an 11.2-fold higher risk of undergoing pre-operative biopsy than females (95% CI, 1.3-94.1; P = 0.013). Pre-operative biopsies were 11.2 times more likely to be obtained from patients with malignant and benign aggressive tumors in the proximal fibula compared to benign tumors (95% CI, 1.1-63.1; P = 0.013). Patients who had undergone biopsy were 12.4 times more likely to receive Type I or Type II en bloc resection (95% CI, 1.5-104.3; P = 0.006) and had a 7.6-fold greater chance to have impaired wound healing (95% CI, 1.3-45.1; P = 0.040), which was observed mainly in osteosarcoma patients. There were no significant associations of biopsy with tumor recurrence (P = 0.162) and iatrogenic peroneal nerve injury (P = 0.095).CONCLUSIONS:Biopsy of proximal fibular lesions does not increase the risk for tumor recurrence and iatrogenic peroneal nerve injury but may be associated with post-surgical wound healing problems. This is particularly relevant for male patients and malignant and aggressive benign lesions, where biopsies are considerably more likely to be acquired to guide diagnosis and clinical management. Due to the relatively low incidence of this cancer type and the scarcity of pre-operative biopsies, larger cohort studies are warranted to validate the results.RELEVANCE FOR PATIENTS:Patients who present with proximal fibular tumors are often young. Depending on the diagnosis of the bone cancer subtype, the surgical intervention may entail highly invasive and risky procedures. Taken together, it is imperative to ensure accurate diagnosis of the bone cancer subtype to prevent unnecessary procedures. Diagnostic accuracy can be increased by acquiring a histological specimen of the malignant bone tissue. However, it is currently not completely established whether bone biopsies in the proximal fibula can be safely performed and whether such biopsies lead to seeding metastases. Because of the rarity of these tumors and procedures, studies are needed even when these entail a small sample size.

Abstract This study aimed to assess the prevalence and occult rates of uterine leiomyosarcoma (ULMS) in women with smooth-muscle tumors undergoing gynecological surgery. A retrospective study was performed at an academic cancer center from 2008 to 2015. Patients undergoing either hysterectomy or myomectomy via laparoscopic, abdominal, vaginal, and hysteroscopic approaches were identified with the validated pathology diagnosis of either ULMS or leiomyomas. All patients initially operated at our institute were included and reviewed. The prevalence and occult rates of ULMS were calculated and compared between different age groups. Twenty-eight patients with original ULMS were identified in 9556 gynecological surgeries. The prevalence of overall and occult ULMS in our study was 0.25% (1 in 345 patients) and 0.07% (1 in 1429 patients). The proportion of occult in all ULMSs was 25%. The prevalence rates of overall ULMS were 0.21%, 0.13%, 0.52%, 2.12%, and 6.67% in the 30 to 39, 40 to 49, 50 to 59, 60 to 69, and ≥70-year age groups, respectively. There was a significantly increased risk of ULMS after 50 years of age. The prevalence rates of occult ULMS were 0.05%, 0.08%, and 0.12% for the 30 to 39, 40 to 49, and 50 to 59 year age groups, respectively. There was no statistically significant difference among age the groups. The prevalence of ULMS was 0.41% and 0.16% for solitary and multiple tumor masses, respectively. Patients with solitary uterine tumors were at a significantly increased risk of ULMS (OR = 2.601, 95% CI = 1.108–6.141). Our retrospective data in part reflects the clinical characteristics of overall and occult ULMS and forms the basis for further prevention of occult ULMS.

This study aimed to identify the biological processes associated with long-term survival in high-grade serous ovarian cancer (HGSOC). HGSOC cases obtained from The Cancer Genome Atlas Ovarian Cancer (TCGA-OV) database were divided into long-term survivors (LTS) and normal-term survivors (NTS) based on survival cutoffs defined by the HGSOC cohort in the SEER database. Differentially expressed genes (DEGs) were screened using the generalized linear modeling (GLM) method. Gene Ontology (GO) functional and KEGG pathway enrichment analyses were performed using DAVID Bioinformatics Resources. DEG-related protein-protein interactions (PPI) were extracted from the STRING database and hub genes were identified using CytoHubba in the Cytoscape program. In total, 157 DEGs, including 155 upregulated and 2 downregulated genes, were identified. Upregulated genes were statistically enriched in 80 GO terms and 11 KEGG pathways related to energy and substrate metabolism, such as protein absorption, digestion, and metabolism as well as signaling pathways, including chromatin silencing, regulation of ERK1 and ERK2 cascade, and regulation of MAPKKK. ALB and POMC were the common hub genes. These findings reveal that protein anabolism is crucial to long-term survival, regulated by activation of the MAPK/ERK signaling pathway and chromatin silencing. Comprehensive understanding of the molecular mechanisms via further exploration may contribute toward an effective treatment for ovarian cancer.

Ossification timeline is a critical issue in studies regarding sesamoid bones at metatarsophalangeal (MTP) joints, but actual knowledge is still incomplete. The present study determines the cutoff age of sesamoids ossification at MTP joints. We conducted a retrospective review of radiographs of the feet from 5553 males and 3225 females between November 2005 and September 2012 to identify presence of sesamoids at 5 MTP joints and 3 variations of hallucal sesamoids. Age-specific prevalence of each presence and variations was calculated and clustered to produce latent age groups corresponding to the sesamoid ossification process in males and females, respectively. Males older than 7 years of age were divided into 5 age groups (8–11, 12–15, 16–29, 30–76, and 77–92 years), while females were classified into 4 age groups (8–11, 12–26, 27–76, and 77–92 years). According to the characteristics of sesamoid prevalence in each age group, the pre-ossification stage was defined at age 1–7 years in both genders and the ossifying stage was defined at age 8–29 years in males and 8–26 years in females. We also defined ossified stage as age 30–92 years in male and 27–92 years in females. The ossifying and ossified stages include 2 or 3 substages in both genders. A clustering analysis provided novel cutoff age points as ossification timelines for the sesamoid bones at MTP joints in males and females, which may have an impact on future sesamoid and skeletal development research.

Objectives The aim of this study was to identify patient- and treatment-specific independent risk factors for the recurrence of proximal fibular tumors and complications of their surgical management. Methods Patients who underwent surgical treatment of proximal fibular tumors at our institution from 2004 to 2015 were retrospectively reviewed. All patients had a pathologically confirmed diagnosis and were followed up for at least 12 months for recurrence and complications. All patients were evaluated with respect to seven patient-, disease-, and treatment-specific variables. Results In the univariate analysis, peroneal nerve palsy at presentation and malignancy were associated with an increased risk of recurrence, iatrogenic peroneal nerve injury, and wound healing problems. The multivariate analysis showed that peroneal nerve palsy at presentation was an independent risk factor for recurrence and iatrogenic peroneal nerve injury and that malignancy was an independent risk factor for wound healing problems. Conclusions Peroneal nerve palsy and malignant potential are independent risk factors for complications of surgical treatment of proximal fibular tumors. The recognition of these factors may contribute to proper management and help to prevent recurrence and postoperative complications.

目的 术前栓塞应用于骨科骨盆肿瘤手术对切口愈合的影响.方法 此次实验对象52例患者,按照随机表法分成试验组(n=26)和对照组(n=26),对照组应用明胶海绵条进行栓塞,试验组应用球囊进行栓塞,分析比较两种材质栓塞后的恢复情况和并发症发生情况.结果 试验组患者的住院时间、手术切口愈合时间、术中出血量均优于对照组,组间对比差异较大,差异存有统计学意义(P＜0.05);试验组患者术后切口愈合并发症发生率为11.38％,对照组为42.31％,显示差异有统计学意义(P＜0.05).结论 术前栓塞应用于骨科骨盆肿瘤手术会延迟患者切口愈合时间,但是选用球囊栓塞对术后切口愈合影响较小,且并发症较少,具有一定的安全性.

Objective: To examine the association of coexistence of adenomyosis and endometrial carcinoma on tumor characteristics and survival outcome of patients. Methods: Clinical and pathological data were retrospectively reviewed from 1584 patients who underwent surgical treatment of endometrial carcinoma. Statistical analyses were performed to evaluate associations of the presence or absence of adenomyosis with demographics, clinical parameters, histopathological factors, and survival outcomes. Results: Adenomyosis was found in 150/1584 patients, and was significantly associated with premenopausal status (46% vs. 35.15%, P = 0.008), younger age (60.67% vs. 41.92% < 55 years old, P < 0.001), lower positive p53 expression (53.36% vs. 63.32%, P = 0.034), earlier disease stage (I-II) (92.67% vs. 85.56%, P = 0.016), lower grade of the tumors (1-2) (91.33% vs. 84.52%, P = 0.025), lower likelihood of outer-half myometrial invasion (10% vs. 22.25%, P < 0.001), and absence of pelvic lymph node metastasis (97.04% vs. 92.09%, P = 0.037). The presence of adenomyosis was also associated with better survival outcomes, with a higher 5-year survival rate (92.1% vs. 84.1%, P = 0.045). In multivariate analysis, age, BMI, stage/grade of tumors, and myometrial invasion were independent prognostic factors associated with survival outcomes. Conclusion: The presence of adenomyosis was associated with less aggressive behavior of endometrial cancer and is a protective factor associated with better outcomes of patients.

目的 分析负压封闭冲洗引流技术在骨科肿瘤术后应用的临床价值.方法 选取本院收治的62例骨科肿瘤行手术治疗患者为研究对象,采用双盲法将所选患者随机分为常规组和研究组,各31例,对常规组患者实施传统创面护理,对研究组患者实施负压封闭冲洗引流技术处理创面,对比2组患者术后平均住院时间、创面坏死情况.结果 研究组患者平均住院时间明显短于常规组,同时研究组患者创面坏死率均显著少于常规组,P ＜0.05,差异显著有统计学意义.结论 通过对骨科肿瘤术后实施负压封闭冲洗引流技术不仅能够有效改善患者术后愈合情况,同时对促进患者早日出院有积极作用.

ABSTRACT Partite hallux sesamoids are clinically meaningful but their association with other sesamoids is not clear. The objective was to relate the prevalence of the partite hallux sesamoid bones to sesamoid bones at other metatarsophalangeal (MTP) joints. We conducted a retrospective review of plain radiographs of 7946 adult feet between November 2005 and September 2012 to identify partite hallux sesamoids and sesamoids at other MTP joints. Coexistence patterns of the partition and extra sesamoids were studied. Presence or absence of sesamoids at other MTP joints as well as sex and laterality were compared between the feet with and without partite hallux sesamoids using Pearson Chi‐square test. Association between age and partition was evaluated using Spearman's correlation coefficient. Overall partite prevalence rate is 6.82%, and coexistence with extra MTP sesamoids was 0.42%. One pattern was partition in hallux sesamoid only, and 4 patterns were coexistence with extra sesamoids. The prevalence rates of partite hallux sesamoids were 7.17% (508/7081) and 3.93% (34/865) in feet without and with extra sesamoids, respectively. The relative risk of 1.889 (95% CI, 1.325–2.693) of partite hallux sesamoids was noted in feet without than with extra sesamoids ( Χ 2 = 12.759, P < 0.001). A negative correlation between age and distribution of partition was identified (r = −0.061, P < 0.001). Partition of hallux sesamoid bones is a developmental variation, it can coexist with sesamoids at other MTP joints following a certain pattern; and its prevalence rate is almost twice higher in feet without than with extra MTP sesamoids. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 301:34–38, 2018. © 2017 Wiley Periodicals, Inc.

Our aim was to identify the incidence and distribution of sesamoid bones plantar to the metatarsophalangeal (MTP) joints in adults, and to evaluate patterns of coincidence among these sesamoid bones.

Background: Malignant tumors in the proximal fibula are rare but life-threatening; however, biopsy is not routine due to the high risk of peroneal nerve injury. Our aim was to determine preoperative clinical indicators of malignancy.Methods: Between 2004 and 2016, 52 consecutive patients with proximal fibular tumors were retrospectively reviewed. Details of the clinicopathological characteristics including age, gender, location of tumors, the presenting symptoms, the duration of symptoms, and pathological diagnosis were collected. Descriptive statistics were calculated, and univariate and multivariate regression were performed.Results: Of these 52 patients, 84.6% had benign tumors and 15.4% malignant tumors. The most common benign tumors were osteochondromas (46.2%), followed by enchondromas (13.5%) and giant cell tumors (13.5%). The most common malignancy was osteosarcomas (11.5%). The most common presenting symptoms were a palpable mass (52. 0%) and pain (46.2%). Pain was the most sensitive (100%) and fourth specific (64%); both high skin temperature and peroneal nerve compression had the highest specificity (98%) and third sensitivity (64%); change in symptoms had the second highest specificity (89%) while 50% sensitivity. Using multivariate regression, palpable pain, high skin temperature, and peroneal nerve compression symptoms were predictors of malignancy.Conclusions: Most tumors in the proximal fibula are benign, and the malignancy is rare. Palpable pain, peroneal nerve compression symptoms, and high skin temperature were specific in predicting malignancy.

Background and Aim: Previous studies provided evidence of a genetic basis for the occurrence of sesamoids bone in the foot among different ethnic populations.However, information for the Chinese population has not been previously reported.Therefore, the aim of our study was to determine the distribution, morphological variation and ossification timeline of sesamoid bones of the forefoot in a large sample of the Chinese population.Methods: Antero-posterior (AP) and oblique radiographs of 4,417 left and 4,299 right feet obtained from 8,716 patients in the Hebei province of Northern China, and retrospectively examined for the presence of sesamoid bones, identified as a small oval bone plantar to each metatarsophalangeal (MTP) joint and the first interphalangeal (IP) joint. Results and Conclusions:The prevalence rate of a sesamoid bone associated with the first to fifth MTP joints and the first IP joint was 99.96%, 3.08%, 0.39%, 0.69%, 8.94%, and 59.22%, respectively.Moreover, a morphological variation in hallucal sesamoids was identified in 12.09% of feet, with variations classified into three distinct types according to bone size and the number of ossification centers.Ossification begins in the hallucal MTP and IP joints at approximately 8 years of age, with the final ossification center being evidence for the sesamoid bone of the fourth MTP joint at 28 years of age.Relevance for patients: Our study provides important anatomical data regarding the prevalence of sesamoid bones in the forefoot of a large population of Chinese adult and pediatric patients for use in clinical practice and research in forensic science and anthropology.