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15 August 2020, Volume 47 Issue 4
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Advances in the Role of Neutrophil Activation in Vascular Endothelial Function Damage in the Pathogenesis of Pre-Eclampsia XU Zhen-hua, MA Ting-xue, WANG Yong-hong 2020, 47 (4):  365-368.  Abstract ( 1139 )   PDF (478KB) ( 7751 )   Pre-eclampsia (PE) is a polygenic and multi-system damaging disease unique to the second and third trimester of pregnancy. If the disease progresses severely, it can lead to complications such as placental abruption, diffuse intravascular coagulation (DIC), eclampsia, and HELLP syndrome. It is the main cause of rising maternal and neonatal morbidity and mortality worldwide. Due to the dynamic progress of PE, and the clinical manifestations are diversified, the principle of treatment is mainly antispasmodic, antihypertensive, sedative and so on. The timely termination of pregnancy is the most effective clinical treatment. At present, studies on its etiology are still controversial. Most studies show that vascular endothelial function damage caused by immune and hormone response during pregnancy is the main pathophysiological change of PE. Among them, the inflammatory cascade caused by neutrophil activation plays an important role in the occurrence and development of PE. This article reviews the research progress on the role of neutrophil activation in vascular endothelial function damage in the pathogenesis of PE. Related Articles | Metrics

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Research Progress of Microparticles Induced Neutrophils Activation Leading to Vascular Endothelial Injury HU Meng-ting, WANG Yong-hong 2020, 47 (4):  369-372.  Abstract ( 1096 )   PDF (585KB) ( 7506 )   Pre-eclampsia is a special disease in pregnancy, which can cause multiple organ and system damage, and is a common cause of maternal and perinatal death. The pathogenesis of pre-eclampsia is not clear. At present, it is considered to be related to multiple factors, mechanisms and pathways, mainly related to inadequate recasting of uterine spiral arterioles, over activation of inflammation and immunity, damage of vascular endothelial cells and so on. Recent studies have shown that microparticles (MPs) of pre-eclampsia patients can activate neutrophils through a variety of ways, which can cause neutrophils to release a variety of proteases and inflammatory factors, form neutrophil extracellular traps, and then lead to vascular endothelial cell damage. In this paper, the mechanism of MPs induced neutrophil activation and vascular endothelial injury was reviewed. Related Articles | Metrics

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The Role of Microparticles in Regulating the Expression of Neutrophil Extracellular Traps in the Pathogenesis of Pre-Eclampsia CUI Jia-lei, WANG Yong-hong 2020, 47 (4):  373-377.  Abstract ( 996 )   PDF (486KB) ( 7242 )   Pre-eclampsia is one of the idiopathic diseases that cause maternal and perinatal deaths, and the specific pathogenesis is not elucidated. Current research suggests that pre-eclampsia is mainly related to the obstruction of uterine spiral arterioles due to abnormal invasion of placental trophoblasts, vascular endothelial cell damage, and excessive activation of inflammatory immune response. Recent studies have shown that microparticles can cause systemic inflammatory responses in patients with pre-eclampsia and participate in the pathogenesis of pre-eclampsia by regulating the release of neutrophil extracellular traps. At the same time, related studies have shown that neutrophil activation and adhesion to vascular endothelial cells stimulate inflammation, which is the key link of vascular endothelial injury in pre-eclampsia patients. When activated neutrophils form neutrophil extracellular traps that are excessive or not cleared by the body in time, neutrophil extracellular traps attach to the vascular endothelium, causing endothelial cells to undergo apoptosis, leading to vascular endothelial cells damage. This article reviews the research progress on the role of microparticles in regulating the release of neutrophil extracellular traps in the pathogenesis of pre-eclampsia. Related Articles | Metrics

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Advances and Prospect in First Trimester Prediction for Pre-Eclampsia HE Yun-ting, WANG Xiao-jin, WANG Bing-shun 2020, 47 (4):  378-383.  Abstract ( 1494 )   PDF (676KB) ( 8478 )   As a common obstetric disease, pre-eclampsia (PE) remains a significant cause of maternal and neonatal morbidity and mortality. The pathophysiological processes of the disease  remains unclear. Improved prediction strategies of PE would allow for identification of high-risk population and timely clinical intervention. This paper reviews recent advances in first trimester prediction for PE, including the use of maternal characteristics, mean arterial pressure, genetic markers, biochemical markers, and Doppler markers. Among all the prediction models, the most promising one involves multi-parametric approaches. However, the fact that most indicators in current models are difficult to measure and lack of validation, restrict the possible clinical applications. There is an urgent need for establishing a PE prediction model at early pregnancy stage suitable for domestic use in accounting for local setting of antenatal examination and model validation. Related Articles | Metrics

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Progress of Pregnancy-Associated Plasma Protein A and Placental Growth Factor in Predicting Pre-Eclampsia ZHU Dan-mo, LIU Xue-qiong, LU Dan 2020, 47 (4):  384-387.  Abstract ( 1152 )   PDF (468KB) ( 7780 )   Pre-eclampsia is a pregnancy-specific disease, which is one of the important causes of maternal and perinatal deaths. The pathogenesis of pre-eclampsia has not yet been fully clarified. In recent years, studies have shown that pregnancy-related plasma protein-A (PAPP-A) and placental growth factor (PlGF) play an important role in the occurrence and development of pre-eclampsia. In the peripheral blood of patients with pre-eclampsia, the decrease of PAPP-A and PlGF results in vascular damage, inhibits the growth of placenta, further aggravates the ischemia and anoxia of placenta, promotes and aggravates the occurrence of organ dysfunction and maternal infant complications. The decrease level of PAPP-A and PlGF is also related to the severity of the disease according to the biological properties of PAPP-A, PlGF and their expression level in maternal serum, they can be used as one of the relevant indexes to predict the occurrence and development of pre-eclampsia. The data analysis indicates that the combination of them is more effective in prediction, which can provide the basis for early prevention and early treatment of pre-eclampsia. Related Articles | Metrics

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Pre-Eclampsia and Maternal Diseases Later in Life JIA Yan-ju, CUI Hong-yan, FENG Hua, CHEN Xu 2020, 47 (4):  388-393.  Abstract ( 1111 )   PDF (711KB) ( 7684 )   Pre-eclampsia is an idiopathic disease during pregnancy, affecting 2%-8% of pregnancies, and remains the leading cause of maternal and perinatal morbidity and mortality worldwide, which can lead to hypertension and multiple organ dysfunction. So far, no effective treatment measure but termination of pregnancy. Although maternal clinical indicators and vascular lesions may gradually returns to normal after childbirth, but the transient, temporary acute gestational complication leads to vascular endothelial injury and inflammation immune overactivation. There is growing evidence that the maternal effects of pre-eclampsia are not limited to pregnancy and puerperium. Women with pre-eclampsia have an increased risk of cardiovascular disease, kidney disease, metabolic syndrome and diabetes, hypothyroidism and thromboembolism, as well as cognitive impairment and malignancies in many years. This paper reviews the impact of pre-eclampsia on long-term maternal disease and analyzes whether pre-eclampsia can lead to an increased risk of these diseases, so as to contribute to the establishment of a reasonable and comprehensive postpartum management program for women with a history of pre-eclampsia, timely health guidance and intervention, and the improvement of long-term health. Related Articles | Metrics

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Advances in Study of Methylenetetrahydrofolate Reductase Gene Polymorphisms in Obstetrics and Gynecology Field ZHANG Ya-li, JIN Shuang-ling, ZHANG Chun-yan, WANG Guo-ping 2020, 47 (4):  394-398.  Abstract ( 963 )   PDF (662KB) ( 7586 )   Methylenetetrahydrofolate reductase (MTHFR) is a rate limiting enzyme involved in folate metabolism and DNA methylation, which participates in a variety of physiological and biochemical reactions. There are many types of MTHFR gene mutation, but C677T is the most studied and common type of mutation. The gene mutation can decrease enzymatic activity, thereby affecting processes of folate metabolism, DNA synthesis and methylation, which increases susceptibilities to the gene-related disease utimately. Due to the regional and ethnic differences in MTHFR C677T gene polymorphism, the same disease has different results in different regions and races. In recently years, more and more attention has been paid to gene polymorphisms and related diseases. Researches revealed that polymorphisms of MTHFR C677T gene can lead to hyperhomocysteinemia, resulting in embryonic development disorder and damage to vascular endothelium，which leads to recurrent abortion and hypertensive disorders of pregnancy, while the occurrence of gynecologic tumor may be mainly related to DNA methylation obstruction. This article presents an overview on advances in studies of MTHFR C677T gene polymorphisms in obstetrics and gynecology field. Related Articles | Metrics

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The Obstetrics Outpatient Service Construction and Maternal Management Strategy in the COVID-19 Epidemic Area WU Qian, CHEN Ying, YANG Sai-hua, SONG Cheng-wen, LI Liang, TONG Ming 2020, 47 (4):  399-401.  Abstract ( 1203 )   PDF (577KB) ( 7559 )   Corona virus disease 2019 (COVID-19) is a highly infectious disease that can induce severe disease. There is no effective treatment for COVID-19 at present. The COVID-19 was classified as class B infectious disease by the Chinese Health Committee on January 20, 2020 and managed it as a class A infectious disease. Due to the low immunity, the pregnant women are easy to be infected by upper respiratory tract infection affected by estrogen. Once combined with COVID-19, it is easy to lead to adverse outcomes for mothers and infants. Our hospital is located in the severe disaster area of the outbreak. How to take into account the prevention and control of COVID-19 and the diversion of COVID-19 on the premise of completing the obstetrical work is a close concern of the obstetrical out-patient doctors during the epidemic prevention and control period. The obstetrics clinic of our hospital has formulated outpatient management and prevention and control measures for pregnant and lying-in women under the epidemic situation, providing experience for the safe and effective operation of obstetric clinics in public health emergencies. Related Articles | Metrics

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Analysis of the Correlation between Laterality of Absent Umbilical Artery and Fetal Congenital Malformations LI Qiao-rong, LONG Xiang-dang, YAO Sui, WANG Li-ping, SHEN Jian-hua, XIANG Li-qun, ZHONG Xin, ZENG Xuan 2020, 47 (4):  402-404.  Abstract ( 1215 )   PDF (4359KB) ( 7940 )   Objective：To explore the proportion of the absence of umbilical artery (AUA) in singleton pregnancy and its correlation with the fetal malformations of various systems. Methods：Data of 130 cases of singleton pregnancies confirmed as single umbilical artery (SUA) by postpartum pathology were retrospectively analyzed. According to the results of prenatal ultrasound examination, they were divided into the left AUA group and the right AUA group, and the incidence of malformations of different systems between the two groups was compared. Results：The incidence of SUA in singleton pregnancy was 0.59% (130/22 055). Among the 130 cases of SUA, the incidence of isolated SUA was 70% (91/130) and the incidence of non-isolated SUA was 30% (39/130). Among them, 30 cases (30/130, 23.1%) complicated with cardiovascular malformations were the most common. Among the 130 cases of SUA, there were 82 cases of left AUA and 48 cases of right AUA (63.1% vs. 36.9%); The incidence of multiple malformations and complex cardiovascular malformations in the left AUA group was significantly higher than that in the right AUA group (24.4% vs. 8.3%, P=0.023; 23.2% vs. 6.3%, P=0.013). Conclusions：In singleton pregnancy with SUA fetus, the left AUA is more common，and it is more likely to be associated with multiple malformations and complex cardiovascular malformations. Related Articles | Metrics

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A Case Report on Twin Pregnancies with Torsion of Ovarian Cyst Pedicle after Embryo Transfer and Literature Review QIU Li-na, WANG Hua, DONG Qu-long 2020, 47 (4):  405-408.  Abstract ( 923 )   PDF (621KB) ( 7290 )   Torsion of ovarian cyst pedicle in intrauterine twin pregnancies after embryo transfer is extremely rare, and there is no clinical guideline for reference. It needs to be diagnosed and treated as early as possible, and the clinical treatment is difficult. If the treatment is not timely, it may endanger the health and safety of the mother. Even if the diagnosis and treatment is successful, follow-up and health care during pregnancy still need to be conducted. This paper reviews one case of intrauterine twin pregnancies combined with torsion of ovarian cyst pedicle after embryo transfer in the gynecology and obstetrics department of the Characteristic Medical Center of the Chinese People′s Armed Police Forces. We hope that the awareness of gynecologists and obstetricians on the disease can be improved so as to better protect the reproductive health of women. Related Articles | Metrics

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Emergency Cervical Cerclage in Twin Pregnancies：A Case Report and Literature Review CHEN Jia, LI Ying-tao, ZHONG Cai-juan, LIANG Li-xuan, HUANG Ying-min, WANG Yan, ZENG Li-zhu 2020, 47 (4):  408-412.  Abstract ( 1103 )   PDF (6149KB) ( 7941 )   Preterm birth is the leading cause of perinatal mortality. The incidence of preterm birth in twin pregnancies is high, and one of the reasons is cervical incompetence(CIC). Now there are no guidelines recommended in the world to predict CIC in twin pregnancies. The diagnosis is also based on medical history and physical examination. Prediction and diagnosis by ultrasound are difficult. The treatment methods and evaluation of effects are also controversial. We report a case for twin pregnancies which undergo emergency cervical cerclage with suture W6977 at 22+4 weeks gestation with the cervix dilated by 4 cm and infection is ruled out. The time from cerclage placement to delivery were 50 days with 2 live babies were born. The current research of the diagnosis and treatment for CIC in twin pregnancies is reviewed. Related Articles | Metrics

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The Clinical Evaluation for Women with Asymptomatic Endometrial Thickening after Menopause SHI Zan, XUE Xue, SHI Pan-pan, HE Yong-yan, WANG Xiao-lin, Lyu Shu-lan 2020, 47 (4):  413-416.  Abstract ( 1327 )   PDF (512KB) ( 8126 )   The incidence of endometrial cancer is increasing year by year. Early and accurate diagnosis can greatly improve the prognosis of patients. Women with postmenopausal endometrial thickening should actively go through the screening process of endometrial lesions when they have symptoms such as vaginal bleeding. However, it is still controversial whether it is necessary and how to actively conduct the screening process for asymptomatic women. Most studies have proved that endometrial lesions can be assessed using the combination of transvaginal ultrasound (TVUS) and endometrial histopathological examination, but the relationship between endometrial thickness and endometrial cancer or precancerous lesions remains controversial. For people with asymptomatic endometrial thickening after menopause, the specificity of TVUS is low, which causes clinical problems and it is still being argued whether TVUS screening can improve the overall 5-year survival rate of endometrial cancer. With the development of medical examination techniques, some new endometrial lesion screening methods, such as transvaginal water injection ultrasound and endometrial cytology test seem to be able to replace TVUS to evaluate the endometrial condition of this population, or make up for the shortage of TVUS. This article analyzes the implementation status of several commonly used clinical examination methods in women with asymptomatic endometrial thickening after menopause, summarizes the pathological endometrium thickness threshold of postmenopausal asymptomatic endometrial thickening, and reviews the evaluation strategy of clinical treatment for these people. Related Articles | Metrics

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Research Progress of Vaginal Laxity Syndrome in Etiology BAI Jun, HAO Yu-jing, GAO Yan-ping 2020, 47 (4):  417-421.  Abstract ( 1118 )   PDF (710KB) ( 7539 )   Vaginal laxity syndrome (VLS) is a common and frequently-occurring disease in gynecology, which can lead to decreased sexual satisfaction and/or sexual dysfunction and often combines with stress urinary incontinence and female genital tract inflammation and other diseases, severely affecting physical and mental health of women. However, its etiology and pathogenesis have not been disclosed. At present, studies found that factors like pregnancy, delivery, chronic obstructive pulmonary disease, constipation, obesity, long-term weight bearing, abnormal anatomical structure, physiological aging, iatrogenic injury, genetic and organ system dysfunction based on traditional Chinese medicine theories can cause the damage of vagina and its supporting tissues that sustain vagina′s four-dimensional anatomical structure. They can also cause blood supply disorders, abnormal innervation and organ tissue remodeling, resulting in a decline on physiological functions such as vaginal contraction, self-purification, inducing VLS development. This paper reviews the etiological progress of VLS, so as to reveal the mechanism and characteristics of VLS more comprehensively and accurately, and better guide the further clinical research and treatment. Related Articles | Metrics

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Advances in the Prevention and Treatment of PCOS Complications by Omega-3 Fatty Acids LI Wei, CHEN Jing, KUANG Hong-ying, WU Xiao-ke, AI Wen-xia 2020, 47 (4):  421-424.  Abstract ( 1522 )   PDF (450KB) ( 7903 )   Polycystic ovary syndrome (PCOS) is considered to be one of the most common female endocrine diseases. In addition to the abnormal reproductive function caused by this disease, the metabolic disorders and related complications caused by PCOS are also important factors affecting the quality of life of PCOS patients. Current research results indicate that although omega-3 fatty acids are one of the effective drugs to alleviate PCOS -related complications, how to use omega-3 fatty acids in the diet to systematically control the complications in PCOS patients still needs further research. This paper reviews the effects of omega-3 fatty acids on BMI, insulin resistance index, abnormal inflammatory factors and steroid hormone levels in PCOS patients. We summarize the results of clinical efficacy on the treatment of PCOS complications with omega-3 fatty acids. Related Articles | Metrics

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Research Progress of EZH2 in Ovarian Cancer JIANG Mei, YUE Wen-tao 2020, 47 (4):  425-428.  Abstract ( 1252 )   PDF (441KB) ( 8293 )    Ovarian cancer is a common malignant cancer of the female reproductive system. It is usually diagnosed at a late stage and thus becomes the most lethal gynecological maligancy. Therefore, finding specific molecular biomarkers and effective molecular targets is of great significance for the diagnosis, evaluation of the therapy effect and prognosis of ovarian cancer. Studies have shown that epigenetic modification plays a key role in the development of ovarian cancer. The histone methyltransferase enhancer of zeste homolog 2(EZH2) is the enzymatic catalytic subunit of the polycomb repressive complex 2 (PRC2) and is commonly involved in transcriptional repression by trimethylating lysine 27 on histone 3 (H3K27). EZH2 plays a pivotal role in many biological processes such as cell apoptosis, cell cycle, and cell differentiation. In ovarian cancer, EZH2 is significantly overexpressed and the high expression of EZH2 in ovarian malignant tumors is closely related with the poor prognosis of patients. In addition, as an epigenetic modifier, EZH2 affects biological behaviors such as cell proliferation, metastasis and drug resistance of ovarian cancer cells and plays a crucial role in regulating tumor progression. Therefore, EZH2 may provide a new effective target for the treatment of ovarian malignancies.  Related Articles | Metrics

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Research Progress of Regulatory T Cells and Tumor Immunity of Ovarian Cancer FENG Xue, WANG Li-qun, LU Mei-song 2020, 47 (4):  429-432.  Abstract ( 895 )   PDF (497KB) ( 7218 )   Regulatory T cell is a kind of special T cell subpopulation with immunoregulatory function. Among them, CD4+CD25+Treg cell subpopulation is the most widely studied, and its important role is to regulate the immune tolerance function of the body. It can inhibit the activation and proliferation of CD8+ and CD4+ effector T cells by direct contact, and then prevent the occurrence of autoimmune diseases. In the field of tumor, more and more studies have found that the proliferation of cancer cells is closely related to the invasion and the imbalance of patients′ autoimmune regulation. Ovarian cancer is one of the most common gynecological malignancies. With the incidence ranking the third, the death rate of ovarian cancer accounts for the first place in gynecological malignant tumors. It has the characteristics of occult incidence, strong invasion, rapid metastasis, and lack of powerful treatment. The purpose of this article is to seek new methods for the early diagnosis and treatment of ovarian cancer at the immunological level, so as to improve the survival rate of patients through the overview of CD4+CD25+Treg and the review of the current progress of studies on CD4+CD25+Treg and ovarian cancer. Related Articles | Metrics

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Research Progress on Malignant Mechanism of Atypical Ovarian Endometriosis WANG Xue, SHI Qiao-rui, WANG Xiao-hui 2020, 47 (4):  433-436.  Abstract ( 1094 )   PDF (556KB) ( 7257 )   Endometriosis (EMs) refers to the appearance of endometrial tissue outside the uterine body, with the ovaries and uterine ligaments being the most common. Atypical endometriosis (aEM) refers to the abnormal shape of endometrial glands that are located in the ovary, and its histology appears to be "borderline" or "transitional", which is a precancerous lesion. aEM is closely related to the occurrence and development of endometriosis associated ovarian cancer (EAOC), but its severity has not been paid enough attention, which makes the disease easily missed in clinical diagnosis. The research progress of the mechanism of ovarian aEM malignant transformation is described here, hoping to improve the clinician′s understanding of ovarian aEM and bring some help to clinical work. Related Articles | Metrics

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Research Progress of DNA Damage Response Pathway Inhibitors in the Treatment of Ovarian Cancer WANG Ke-ruo, LI Hui-kai, QIN Yu 2020, 47 (4):  437-442.  Abstract ( 1021 )   PDF (1385KB) ( 7291 )   Ovarian cancer is a cancer with second highest morbidity and highest fatality of all gynecological malignant tumors all over the world. About 70% of the cases were diagnosed with advanced stage and the prognosis of them was poor. Surgery combined with chemotherapy is the standard treatment for ovarian cancer and lots of new drugs targeting different kinds of molecular pathways are under developing now. DNA damage response (DDR) plays a key role in maintaining genomic integrity by repairing DNA damage, and is regarded as a key to tumor drug resistance. Compared with normal cells, cancer cells usually have DDR defects and DNA damage repair disorder. Therefore, designing specific inhibitors targeting specific DDR defects in cancer cells provides a new direction for the treatment of ovarian cancer. This article reviews the mechanism and research progress of five kinase inhibitors of DDR pathway to identify a new way for the therapy of ovarian cancer. Related Articles | Metrics

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Advances in Diagnosis and Treatment of Early Low-Risk Cervical Cancer ZHAO Jian-guo, QU Peng-peng 2020, 47 (4):  443-446.  Abstract ( 1060 )   PDF (467KB) ( 7381 )   Due to the application of cervical cytology and HPV combined screening technology, the detection rate of early cervical cancer has been increased, and the surgical effect of early low-risk cervical cancer is satisfactory. The criteria of low-risk cervical cancer included: the maximum diameter of cervical tumor was not more than 2 cm; the depth of infiltrating interstitial was not more than 10 mm; no lymph vascular space invasion. Low-risk cervical cancer with parametrial involvement, lymph node metastasis and margin-positive probability is low, the overall prognosis is better. Therefore, it is suggested that conservative surgery can be used for low-risk cervical cancer patients. The nerve-sparing radical resection of cervical cancer does not affect the defecation and urination function of the patients and improves the quality of life of the patients after operation. The sensitivity of preoperative magnetic resonance imaging in predicting postoperative parametrial involvement is high. Patients with early low-risk cervical cancer found after hysterectomy can avoid radical hysterectomy, and the incidence of residual diseases and the probability of adjuvant treatment are very low. The fertility-sparing procedures include simple trachelectomy, cervical conization, and radical trachelectomy, with a same recurrence rate comparable to radical hysterectomy and favorable pregnancy outcomes. For minimally invasive cervical adenocarcinoma, the surgical treatment procedure should be the same as for squamous cell carcinoma.  Related Articles | Metrics

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Controversy over Surgical Treatment of Early-Stage Cervical Cancer and Causes Analysis WANG Qing-xuan, WANG Tian, HU Yuan-jing 2020, 47 (4):  447-450.  Abstract ( 1103 )   PDF (492KB) ( 7193 )   Cervical cancer is one of the most common malignant tumors in gynecology. The main treatment methods for early cervical cancer include abdominal surgery and minimally invasive surgery. Abdominal radical hysterectomy, a traditional surgical procedure for early-stage cervical cancer, has disadvantages of large surgical trauma, large amount of bleeding, and slow recovery of postoperative organ functions. Minimally invasive surgery is praised by most gynecologists for its advantages of less trauma, less blood loss, and rapid recovery. Although it is suggested that laparoscopy ensures the endpoints of safety, feasibility and efficacy, no mature data on oncologic results exists. A prospective study and a large retrospective study of early-stage cervical cancer, which published in the New England Journal of Medicine in 2018, have shown that laparoscopic applications led to an increased recurrence rates and a decline in long-term prognosis, leading to international controversy. It is important to analyze the factors that may affect the prognosis of minimally invasive surgery for cervical cancer, providing the most effective and advanced surgical treatment for cervical cancer patients. Related Articles | Metrics

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Research Progress of Long Non-Coding RNA CCAT1 in Gynecologic Oncology  GUO Xue-wang, XU Yan-ying 2020, 47 (4):  451-455.  Abstract ( 1045 )   PDF (573KB) ( 7172 )   The incidence of gynecological malignant tumor is increasing year by year, and the key to improve its prognosis is early diagnosis and early treatment. In the future development of medicine, the diagnosis and treatment of diseases will be located at the level of gene. At present, the research on the regulation mechanism of non-coding RNA on cell phenotype is gradually unfolding. Since the abnormal expression of long non-coding RNA (lncRNA) colon cancer associated transcription 1 (CCAT1) in colorectal cancer was found in 2012, its regulatory role in a variety of other malignant tumors has been studied in succession. At present, studies on the mechanism of lncRNA mainly focus on the interactions between lncRNA and miRNA, and lncRNA is associated with the occurrence and development of malignant tumors through the tumorigenic effect of the downstream effectors regulated by miRNA. This paper reviews the mechanism of CCAT1 in gynecological cancer, and analyze research status and future development. Related Articles | Metrics

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Progress in Diagnosis and Treatment of Vulvar Paget Disease FANG Yuan-yuan, XIE Man-xin, FANG Qin, XING Yan 2020, 47 (4):  456-461.  Abstract ( 1568 )   PDF (755KB) ( 8284 )   Vulvar Paget disease is a rare malignant tumor of the skin that usually occurs in postmenopausal women. It causes symptoms such as itching, local pain or burning sensation of the vulva. It usually presents as erythema or eczema-like changes of the skin of the vulva. The diagnosis is confirmed by pathological biopsy. Vulvar Paget disease can be classified into primary and secondary vulvar Paget disease. Immunohistochemical stains can be used to make a relatively clear differential diagnosis of vulvar Paget disease. Due to its non-specific clinical manifestations and atypical pathological features, the rate of misdiagnosis and delayed diagnosis is high. Surgical treatment is the first choice for the treatment of vulva Paget disease. However, the formulation of surgical scope is a difficulty of current treatment. If the surgical scope is too large, it may cause serious tissue damage and dysfunction. Topical imiquimod cream and photodynamic therapy have provided new ideas for the conservative treatment in recent years. Regardless of surgical treatment or conservative treatment, the recurrence rate of vulvar Paget disease is high. Its prognosis is closely related to pathological type, lymph node metastasis and infiltration depth. It is necessary to conduct long-term follow up for patients with the disease. This article will review the progress in diagnosis and treatment of vulva Paget disease. Related Articles | Metrics

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The Value of Exosome Biomarkers in the Diagnosis and Prognostic Evaluation of Ovarian Cancer--Systematic Review LI Yao-wei, LI Li 2020, 47 (4):  462-468.  Abstract ( 986 )   PDF (830KB) ( 7420 )   Objective: To systematically evaluate the value of exosome biomarkers in the diagnosis and prognosis of ovarian cancer (OC). Methods: The databases of CNKI, VIP, WanFang, PubMed, EMBASE, Web of Knowledge and Cochrane Library were searched to collect relevant researches on the diagnosis and prognosis of OC with exosome biomarkers by computers. Dated from the establishments of the databases to 20th December, 2019. Two reviewers screened research papers according to the inclusion and exclusion criteria, extracted data and assessed the risk bias of included studies. For diagnostic evaluation, the differences in the expression of exosome biomarkers between OC patients and non-OC controls were analyzed. For prognosis prediction, the correlation between the expression levels of exosome biomarkers and overall survival (OS) and disease free survival (DFS) of OC was analyzed. Results: A total of 10 studies were included. The exosomes extraction kit method was the most common method for purifying exosomes. Transmission electron microscope observation of morphology and detection of exosomal marker proteins were the basic methods for identifying exosomes. For diagnostic evaluation, serum-derived exosomes containing miR-200a, miR-145 showed high diagnostic value (the AUC of miR-200a was 0.91, sensitivity and specificity of which reached 83.9% and 90.0%, respectively; the AUC of miR-145 was 0.91, sensitivity and specificity of which reached 91.7% and 75.0%, respectively). Plasma-derived exosomes containing proteins fibrinogen alpha chain (FGA), gelsolin (GSN), and fibrinogen gamma chain (FGG) also had certain diagnostic values (the AUC of FGA, GSN, and FGG can reach 0.85, 0.83 and 0.74, respectively). For prognosis prediction, the high expression of miR-373, miR-200b and miR-200c from serum-derived exosomes was closely related to poorer OS in OC patients (HR was 2.1, 2.7, and 2.4; 95%CI were 1.0-4.3, 1.3-5.7 and 1.2-4.9); Similarly, the high expression of miR-200c in OC patients was also closely related to poorer PFS (HR=2.0, 95%CI: 1.1-3.6). Serum-derived exosomes containing long non-coding RNA aHIF was closely related to poorer OS in patients with OC (HR=3.70, 95%CI: 1.83-7.50). Conclusions: Exosome biomarkers could be used for early diagnosis and prognostic evaluation of patient with OC. Related Articles | Metrics

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The Mechanism and Clinical Value of CD24 in Early Cervical Cancer SUN Pei-song, LI Bo-han, SHEN Yan, ZHANG Wen-wen, QU Peng-peng 2020, 47 (4):  469-473.  Abstract ( 988 )   PDF (6353KB) ( 7253 )   Objective: To explore the role and clinical value of CD24 in the development of early cervical cancer. Methods: Differential gene analysis, gene selecting and clinical prognostic analysis are conducted through the TCGA portal. Immunohistochemistry was used to screen gene expression difference between patients with cervical lesion and early cervical cancer. Protein interaction relationship were analysis through string database. Protein interaction network was made and core genes were pick up by cytoscape. GO enrichment analysis and KEGG enrichment analysis were completed through R language. Results: According to the differential analysis of TCGA, there was a significant difference between the early cervical cancer group and normal group (P＜0.05). However, there was no significant difference between the early cervical group and vaginal parauterine infiltration group, the same as the early cervical group and the distant metastasis group(P＞0.05). The expression of CD24 gene could affect the overall survival of patients with cervical cancer (P＜0.05). The expressions of CD24 in cervical lesion group and early cervical cancer patients were postive and that in normal group was negative. There was a protein interaction network relationship between this gene expression and more than 20 groups of genes. The functions of these genes are mainly enriched in the signal positive regulation and proliferation, which are closely related to the regulation of PI3K-Akt and cancer signal pathway (P＜0.05). Conclusions: CD24 plays an important role in the process of early cervical carcinogenesis, and plays a positive role in the proliferation of early cervical cancer cells by acting on the pathways related to epidermal growth factor signal regulation, which may be an important clinical predictor of cervical carcinogenesis. Related Articles | Metrics

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Superficial Cervical Vaginal Myofibroblastoma in 3 Cases and Literature Review YANG Chao, YANG Yu-ni, XIE Yu-xin, WANG Jing-ying, CHEN Xiao-xu, JIANG Ting, LU Ying-li 2020, 47 (4):  474-477.  Abstract ( 1594 )   PDF (526KB) ( 7406 )   Superficial cervical vaginal myofibroblastoma is a rare and newly recognized benign tumor. The clinical data of 3 patients with superficial cervical vaginal myofibroblastoma treated in the Department of Obstetrics and Gynecology of the Second Hospital of Jilin University were reviewed retrospectively. Of the 3 patients, 2 were postmenopausal and clinically manifested as a vaginal mass. In general, the mass was round, with clear boundaries, and the size of the mass was about 3.0-4.0 cm. Under the microscope, the tumor was composed of uniform spindle and stellate cells. The tumor cells in the peripheral area were relatively sparse and the tumor cells in the central area were relatively dense. Immunohistochemical staining showed: Vimentin (+), Desmin (+), CD34 (-), ER (+), PR (+), SMA (-), S-100 (-). Through the elaboration of such cases, it is suggested that superficial cervical vaginal myofibroblastoma mainly affects the vulva, vagina and cervical area, and is easily confused with fibrous epithelial polyps, solitary fibrous tumors, and vascular myofibroblastoma. The definite diagnosis needs to be combined with pathological morphology, immunohistochemistry and clinical data. Related Articles | Metrics

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Cervical Basaloid Squamous Cell Carcinoma Patient Combined with Multiple Primary Malignant Tumors: A Case Report and Literature Review WEN Xian-ping, LU Xin-yi, YANG Jun-wen 2020, 47 (4):  478-480.  Abstract ( 962 )   PDF (447KB) ( 7225 )   Basaloid squamous cell carcinoma (BSCC) is a special subtype of squamous cell carcinoma, which is rare to occur in the cervix. Due to the small number of cases and insufficient understanding of them, no standard diagnosis and treatment protocol has been established. BSCC with multiple primary malignant tumors (MPMT) is more rare. This article reports a case of BSCC of the cervix after 4 years of transabdominal resection of rectal cancer (Dixon), and reviews related literature to increase the understanding of the disease, and arouse clinical attention to MPMT at the same time. Related Articles | Metrics