BackgroundAdenocarcinoma is a common histological subtype of cervical cancer, accounting for 10–15% of all cases. The prognosis of cervical adenocarcinoma with distant organ metastases remains unclear. Therefore, our study aimed to investigate the patterns and prognosis of distant organ metastasis in cervical adenocarcinoma.MethodsWe obtained data from the Surveillance, Epidemiology, and End Results (SEER) database spanning from 2010 to 2019. Cox regression, Kaplan–Meier, and log-rank analyses were conducted.ResultsWe observed that adenocarcinoma (AC) of the cervix primarily metastasizes to single organs, with a rate of 73.3%. The lungs are the most common organs of metastasis, followed by the liver and bones. Patients with bone metastases have a median survival period of 12 months, which is slightly longer compared to metastasis in other organs. Distant organ metastasis, age, positive lymph nodes, higher AJCC stages, larger tumor diameter, and higher cell grades are related to poor prognosis (p < 0.001). Furthermore, we have observed that surgical intervention, radiotherapy, and chemotherapy can potentially provide benefits for patients with distant organ metastases.ConclusionMetastasis is an independent prognostic factor for cervical adenocarcinoma patients. Surgery, radiotherapy, and chemotherapy can provide an overall survival advantage for patients with distant organ metastases.

Cervical cancer (CC) is the most common malignancy of the female reproductive system, among which cervical squamous cell carcinoma (CESC) is the most common type. The demethylase ALKBH5 has been previously revealed to be downregulated in CC tissue. N6 methyladenine (m6A) is the most common modification in eukaryotic RNAs and is involved in modulating tumour progression. Therefore, we attempted to clarify the ALKBH5 role and mechanism underlying CESC progression. In CESC, patient tissue and control tissue m6A levels were measured. Reverse transcription quantitative real-time polymerase chain reaction, western blotting and immunochemistry were used to measure ALKBH5 levels. A correlation between CESC patient survival and ALKBH5 levels was evaluated. Wound healing, transwell and colony formation assays were used to detect CESC cellular behaviours. Corresponding kits and BODIPY staining were used to detect CESC lipid metabolism. Bioinformatics, immunoprecipitation, RNA pulldown and RNA immunoprecipitation assays as well as half-life measurements were used to assess the association and mechanism of ALKBH5 with silent mating type information regulation 2 homologue 3 (SIRT3), acetyl-CoA carboxylase 1 (ACC1) and insulin-like growth factor 2 mRNA binding protein 1 (IGF2BP1). The m6A demethylase ALKBH5 was depleted in CESC tissue and cells, and a low level of ALKBH5 predicted an unfavourable prognosis in CESC patients. ALKBH5 overexpression suppressed CESC growth and lipid metabolism in vitro and CESC tumour growth in vivo, and ACC1 overexpression rescued these changes. ALKBH5 downregulated ACC1 levels in CESC cells by facilitating SIRT3 methylation to repress ACC1 deacetylation. ALKBH5 destabilized SIRT3 to downregulate SIRT3 levels in CESCs in an m6A-IGF2BP1-dependent manner. ALKBH5 demethylates and destabilizes SIRT3 in an m6A-IGF2BP1-dependent manner, repressing CESC growth, lipid metabolism and tumorigenesis by downregulating ACC1.

目的 分析宫颈病变组织中磷脂酰肌醇3激酶(PI3K)-蛋白激酶B(Akt)信号通路相关蛋白的表达及与人乳头瘤病毒(HPV)感染的关系.方法 选择2019年2月-2021年12月福建省妇幼保健院收治的子宫颈鳞状细胞癌患者87例纳入子宫颈鳞状细胞癌组,另选择同期慢性子宫颈炎患者96例纳入慢性子宫颈炎组、子宫颈上皮内瘤变患者92例纳入子宫颈上皮内瘤变组;比较三组患者PI3K、Akt、核因子κB(NF-κB)阳性表达情况,检测不同病理情况子宫颈鳞状细胞癌患者PI3K、Akt、NF-KB阳性表达及HPV感染情况.通过Spearman相关性分析法分析PI3K-Akt信号通路相关蛋白的表达(PI3K、Akt、NF-κB)与HPV感染的相关性.结果 慢性子宫颈炎组、子宫颈上皮内瘤变组、子宫颈鳞状细胞癌组宫颈组织PI3K、Akt、NF-κB阳性表达情况呈升高趋势(P＜0.05);国际妇产科联盟(FIGO)分期Ⅲ～Ⅳ级、组织学分级低分化的宫颈癌患者宫颈组织中PI3K、Akt、NF-κB阳性表达率更高,淋巴结转移NF-κB阳性表达率更高(P＜0.05);子宫颈鳞状细胞癌患者87例,其中HPV阳性74例,阳性率85.06％;FIGO分期Ⅲ～Ⅳ级、组织学分级低分化患者HPV感染率更高(P＜0.05);Spearman相关性分析法结果显示,HPV 与 PI3K、Akt、NF-κB 表达呈正相关(r=0.681、0.639、0.877,P 均＜0.05),PI3K 与 Akt、NF-κB表达呈正相关(r=0.708、0.742,P 均＜0.05);Akt 与 NF-κB 表达呈正相关(r=0.637,P=0.009).结论 PI3K-Akt信号通路可参与慢性子宫颈炎-子宫颈上皮内瘤变-子宫颈鳞状细胞癌的病情发展,宫颈组织PI3K-Akt信号通路相关蛋白表达及与HPV感染密切相关,可能作为临床诊治的新靶点.

A small-molecule reactive oxygen species (ROS) called hypochlorous acid or hypochlorite (HClO/ClO-) plays important roles in both healthy physiological functions and the development of numerous illnesses. On the basis of the imidazo-1,10-phenanthroline skeleton, we have created a new probe for the detection of ClO-. The novel probe demonstrated high selectivity and sensitivity for the detection of ClO-. While other investigated analytes failed to elicit the fluorescence augmentation, the emission spectra after treatment with ClO- showed a dramatic alteration with an approximately 4-fold increase in fluorescence. The emission spectrum is also blue-shifted with a sizable Stokes shift (from 520 nm to 418 nm). In par-ticular, the probe had a fast response time to ClO- (2 min) and a detection limit of up to 0.011 M. The probe could also capture images of HClO in the living cells. The above extraordinary properties illustrated that the probe was able to determine HClO in the living cells. (c) 2023 Elsevier Ltd. All rights reserved.

Objective:To compare the effect of traditional open surgery and laparoscopic radical surgery for ovarian tumors in the treatment of benign ovarian tumors.Method:Retrospective analysis was made on 100 patients with benign ovarian tumors admitted to Fujian Maternal and Child Health Hospital from January 2020 to January 2022.They were divided into control group （traditional open surgery） and study group （laparoscopic radical ovarian tumor surgery） according to different surgical methods,with 50 cases in each group.The clinical efficacy,neuroendocrine function,sex hormone level and complication rate of the two groups were compared.Result:The total effective rate in the study group was 96.00%,which was higher than 82.00%in the control group （P＜0.05）.Three days after operation,the levels of β-endorphin,glucagon and cortisol in the study group were higher than those before operation,but the levels in the study group were lower than those in the control group （P＜0.05）.Three days after operation,the levels of follicle-stimulating hormone （FSH）,luteinizing hormone （LH） and FSH/LH in the study group were lower than those in the control group,and the level of estradiol （E 2 ） in the study group was higher than that in the control group （P＜0.05）.The total postoperative complication rate in the study group was 4.00%,which was lower than 16.00%in the control group （P＜0.05）.Conclusion:Laparoscopic radical resection of ovarian tumors has a good effect on the treatment of patients with benign ovarian tumors.It can effectively improve the neuroendocrine function and sex hormone level of patients,enhance the clinical treatment effect,reduce the occurrence of complications,and facilitate the recovery of ovarian function.

妊娠滋养细胞肿瘤(GTN)是一种特殊类型的妇科恶性肿瘤,其组织学来源为胎盘的滋养细胞,与妊娠相关,好发于育龄妇女中,尤其在葡萄胎清宫、流产、异位妊娠中发生率较高.根据GTN的转移情况分为转移性与无转移性两种.化疗是GTN最主要的治疗方法,且该疾病对化疗极其敏感,是一种可通过化疗而治愈的疾病.但对于部分耐药患者,高危甚至极高危患者的治疗仍然是难点,这类患者往往容易反复发作,病情进展快,预后差.随着免疫治疗在子宫内膜癌、宫颈癌等疾病治疗上取得的显著疗效,其在GTN方面的研究也不断深入.因此,本综述分析GTN的诊断和分期,探讨GTN免疫治疗及分子靶向治疗的机制、方法及疗效,并针对免疫诊疗中存在的不良反应及采取的相应干预措施进行总结,以期为GTN诊疗提供新思路.

目的 研究影响宫颈癌患者术后下肢深静脉形成的相关因素,以此因素建立风险概率预测模型,以协助判断宫颈癌患者术后发生下肢深静脉血栓形成的风险,为临床实践提供参考.方法 回顾性分析2012年5月—2020年12月收治于福建省妇幼保健院的203例宫颈癌病例的临床病理资料,用Logistic回归法筛选出影响下肢深静脉血栓形成相关因素,建立Logistic风险概率预测模型,并算出该模型ROC曲线下面积.结果 经过单因素分析显示,年龄、总胆固醇、血浆D-二聚体、血浆纤维蛋白原、病理类型、抗凝为影响宫颈癌患者术后下肢深静脉血栓形成的因素,差异有统计学意义(t=-4.420、-2.020;Z=3.405、2.621;χ2=28.769、7.836,P<0.05);经过Logistic回归分析,结果显示,>55岁,D-二聚体>2 mg/L促进宫颈癌患者术后下肢深静脉血栓形成(OR=4.746、4.407,P<0.01),而使用抗凝剂则抑制宫颈癌患者术后下肢深静脉血栓形成(OR=0.274,P<0.01),由前述3个因素构建的风险预测模型的ROC曲线下面积为0.772(P<0.01),表明该模型预测能力良.结论 对于宫颈癌患者术后,年龄、血浆D-二聚体水平、抗凝是用于构建预测下肢深静脉血栓形成风险概率预测模型的相对最优因素,由此构建的风险概率预测模型具有良好的拟合优度和实用性,可为临床实践提供参考.

目的:研究影响患病宫颈高级别鳞状上皮内病变(HSIL)风险的相关因素并构建患病风险预测模型,为临床实践提供参考.方法:选取2019年6月至2021年1月于福建省妇幼保健院诊治的慢性宫颈炎、低级别鳞状上皮内病变(LSIL)、HSIL及宫颈癌病例为研究对象,回顾性收集其阴道镜检查结果(醋酸白色上皮、镶嵌、点状血管等)、HPV检测结果(HPV16、31、33、58型是否阳性)及病理诊断结局等资料,分析罹患HSIL或宫颈癌的风险与阴道镜检查结果及HPV检测结果间的关联性,运用SAS9.4软件的logistic逐步回归分析方法筛选影响患病风险的相关因素并构建患病风险预测模型.结果:共纳入研究对象5147例,其中慢性宫颈炎占59.74％(3075/5147),LSIL占23.33％ (1201/5147),HSIL占15.00％ (772/5147),宫颈癌占1.92％ (99/5147).研究对象患HSIL或宫颈癌的风险与其临床症状,醋酸白色上皮、镶嵌或点状血管,HPV16、31、33或58型阳性情况等8个纳入因素在单因素分析时均存在显著关联(P均＜0.001).研究因素间,仅镶嵌与点状血管间的列联系数值相对较大(0.36).采用逐步回归法构建多变量logistic模型,则依次纳入点状血管、HPV16型阳性情况、醋酸白色上皮、HPV33型阳性情况、HPV58型阳性情况、镶嵌、HPV31型阳性情况,无剔除变量,该模型对训练样本预测的正确率为71.7％,模型的拟合优度良好.利用该模型可对不同HPV检测结果和(或)阴道镜检查结果患者的患病风险进行预测.结论:阴道镜检查结果及HPV检测结果均与患HSIL或宫颈癌风险存在关联性;综合阴道镜检查结果及HPV检测结果构建的患病风险预测模型可为临床实践提供参考;HPV16、31、33、58型的多重感染与宫颈病变严重程度间关系密切.

目的 观察紫杉醇联合顺铂新辅助化疗治疗早中期宫颈癌的临床效果.方法 选取医院就诊的早中期宫颈癌患者78例进行分析,根据治疗方法 的不同分为对照组38例和观察组40例.对照组术前不采用辅助化疗,直接实施广泛性子宫切除术与盆腔淋巴清扫术,观察组采用紫杉醇联合顺铂新辅助化疗,比较2组临床疗效、KPS评估量表和健康(SF-36)评分及不良反应发生率.结果 观察组总有效率为72. 50% ,高于对照组的34. 21% (P<0. 01);治疗前,2组KPS和SF-36评分比较差异无统计学意义(P>0. 05),治疗后,观察组KPS和SF-36评分均高于对照组(P<0. 01);2组不良反应发生率比较差异无统计学意义(P>0. 05).结论 早中期宫颈癌患者术前实施紫杉醇联合顺铂新辅助化疗,可提高总有效率,降低不良反应发生率,改善患者健康水平及生活质量,值得临床推广应用.

目的 探讨口服避孕药治疗青春期功能失调性子宫出血(功血)的止血效果.方法 回顾性分析我院诊治的62例青春期功能失调性子宫出血患者临床资料.根据用药的不同分为3组:雌激素组(21例)、孕激素组(19例)及口服避孕药组(22例).对3组控制出血时间、完全止血时间、不良反应、减量后出血情况进行记录和评价.结果 口服避孕药组、孕激素组控制出血时间和完全止血时间低于雌激素组,口服避孕药组不良反应及减量后出血少于雌、孕激素两组.口服避孕药组内去氧孕烯炔雌醇与炔雌醇醋酸环丙孕酮疗效相近,差异无统计学意义.结论 在青春期功能失调性子宫出血止血效果方面,口服避孕药优于雌激素、孕激素.