RESUMEN
BACKGROUND: Prior studies evaluating the impact of hysteroscopy on outcomes in endometrial cancer have predominantly evaluated type I tumors. We sought to evaluate whether hysteroscopy worsens prognosis in type II endometrial cancer. METHODS: A retrospective cohort analysis of 140 patients from two institutions with type II endometrial cancer was performed. Women who underwent either diagnostic hysteroscopy (HSC) or dilation and curettage (D&C) for cancer diagnosis from June 2001 until June 2010 were included. The clinical and pathologic characteristics, including peritoneal cytology results were reviewed. The primary endpoint was disease-specific survival (DSS). The exposure of interest was hysteroscopy. Survival curves were projected using the Kaplan-Meier method and compared using the log-rank test. RESULTS: There was no difference in age, histology, stage, depth of myometrial invasion, adnexal involvement, or nodal metastasis between HSC and D&C patients. Positive cytology was found in 16/54 (30%) patients following HSC and in 10/86 (12%) following D&C (p = 0.008). Fourteen patients with stage I and II disease had positive peritoneal cytology, with 11/40 (27.5%) patients in the HSC group and 3/59 (5%) patients in the D&C group(p = 0.002). Median DSS was clinically different for the HSC and D&C groups, but statistical significance was not reached (53 versus 63.5 months, p = 0.34). For stage I and II patients, 18/99 (18%) were dead of EC, with a median DSS of 60 months for HSC and 71 months for D&C (p = 0.82). Overall 46 (33%) patients developed a recurrence, with 18/54 (33%) in the HSC group compared to 28/86 (32%) in the D&C group (p = 0.92). There was no difference in recurrence location between groups. CONCLUSIONS: Diagnostic hysteroscopy significantly increased the rate of positive peritoneal cytology at the time of surgical staging in this cohort of patients with type II EC. However, we were unable to detect a difference in prognosis as measured by DSS.
Asunto(s)
Neoplasias Endometriales/mortalidad , Histeroscopía/efectos adversos , Adenocarcinoma/diagnóstico , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Supervivencia sin Enfermedad , Neoplasias Endometriales/diagnóstico , Neoplasias Endometriales/patología , Femenino , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
PURPOSE: To determine the negative conversion regularity of high-risk human papillomavirus (HR-HPV) and to evaluate the prognostic implications of HR-HPV testing in patients with cervical cancer after treatment. METHODS: A retrospective post-treatment analysis of 173 patients with cervical cancer was performed from January 2011 to December 2012. Patients who had HR-HPV infection before treatment were included. Clinical and pathological characteristics, as well as follow-up information, were reviewed. RESULTS: The negative conversion rate of HR-HPV reached 68.9 % within half a year and increased most rapidly within the first 2 years after treatment. Univariate and multivariate analyses suggested that the negative conversion rate of HR-HPV was significantly correlated with clinical stage, treatment regimens, and HR-HPV type (P < 0.05). In our analysis of 173 patients, we found that HR-HPV status was predictive of 3-year survival rate and disease recurrence (P < 0.05). Pelvic recurrence, but not distant metastasis, was influenced by HR-HPV status (P < 0.05). Through 2 × 2 table analysis, we found that HR-HPV was more sensitive (71.43 %) and specific (94.20 %) than cervical cytology (sensitivity 62.86 % and specificity 78.26 %). CONCLUSIONS: The negative conversion rate of HR-HPV increased most rapidly within the first 2 years of cervical cancer surveillance. Persistent HPV infection was associated with a poor prognosis and had an impact on recurrence sites. Further large and multi-center prospective studies should be performed, but these results of this study suggested that HR-HPV monitoring is necessary to be used as a means of cervical cancer surveillance.
Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/patología , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/complicaciones , Infecciones por Papillomavirus/virología , Pronóstico , Estudios Retrospectivos , Sensibilidad y Especificidad , Frotis VaginalRESUMEN
In the present study, the eutrophic level of 30 water samples collected from Lake hongze in August 2014 were analyzed, and the abundance of toxic and non-toxic Microcystis sp., together with their spatial distribution, was investigated by quantitative real-time PCR techniques. The results showed that the average concentrations of total nitrogen and total phosphorus were 1.63 and 0.11 mg x L(-1), respectively. The trophic state index ( TSI) ranged from 58.1 to 73.6, and the water quality was in the state of eutrophication based on TSI. Toxic Microcystis was widely distributed in Lake Hongze, and its abundance varied sharply, from 1. 13 x 10(4) to 3.51 x 10(6) copies x mL(-1), and the abundance of total Microcystis ranged from 1.06 x 10(5) to 1.10 x 10(7) copies x m(-1), meanwhile, the proportion of toxic Microcystis in the total Microcystis ranged from 8.5% to 38.5%, with the average value of 23.6%. Correlation analysis indicated that there was a significant positive correlation among total Mirocystis, toxic Microcystis and the toxic proportion (P < 0.01). The abundance of total and toxic Microcystis was significantly positively correlated to chlorophyll a ( Chl-a) concentrations and TSI (P < 0.01), but was negatively correlated to transparency (SD) (P < 0.01). The ratio of toxic Microcystis to total Microcystis was significantly positively correlated to Chl-a, TN, TP and TSI (P < 0.01), but significantly negatively correlated to the ratio of TN to TP and SD (P < 0.01). Therefore, reducing total nitrogen and phosphorus concentrations could not only lower the eutrophication level of Lake Hongze, but also inhibit the competition advantage of the toxic Microcystis over non-toxic Microcystis.
Asunto(s)
Monitoreo del Ambiente , Eutrofización , Lagos , Microcystis/aislamiento & purificación , Calidad del Agua , China , Clorofila/análisis , Clorofila A , Microcystis/clasificación , Nitrógeno , Fósforo/análisis , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
OBJECTIVE: To investigate the clinical effects of cervical disc prosthesis in patients of cervical spondylosis early, compared with the anterior cervical interbody fusion. METHODS: Bryan disc prosthesis replacement applied in 21 case (22 levels) of cervical spondylosis, 27 patients (32 levels) were treated by the anterior interbody fusion. Clinic (JOA grade) and radiological (X-ray of bending, extending; left and right bending position) follow-up of 48 patients was performed preoperatively and postoperatively. Systemic radiographic study about stability and rang of movement (ROM) of replaced levels postoperatively was measured; meantime the ROM of adjacent levels of all cases was observed. CT or MRI scan were applied in 21 patients postoperatively to find out the pressure of the spine and heterotopic ossification in the replaced level. RESULTS: There was no complication. Improvement in all case increased obviously, JOA score increased and stabilized postoperatively in all cases (P < 0.01). Replaced segment achieved stability and restored partial of ROM. There was no prosthesis subsidence or excursion. The adjacent ROM of the case treated by the anterior interbody fusion increased obviously (P < 0.01). No heterotopic ossification was found in the replaced level, but the deteriorated adjacent level of 1 case applied by the anterior interbody fusion occurred. CONCLUSIONS: Bryan cervical disc prosthesis restore stability and partial motion to the level of the intact segment in flexion-extension and lateral bending in postoperational images; The adjacent ROM has not increased obviously. At the same time, it can achieve good short-term clinic effect in replaced level, compared with the anterior interbody fusion.