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ABSTRACT: OBJECTIVE: To investigate the changes of CA(125) between primary cytoreductive surgery and interval debulking surgery for prediction the rate of optimal interval cytoreductive surgery and prediction the recurrence and the prognosis in patients with epithelial ovarian cancer. METHODS: A total of 39 cases with suboptimal primary cytoreductive surgery admitted from Jan. 1996 to Jan. 2009 were retrospectively analyzed. The median age of patients was 56 years (range: 41 - 68 years). Based on the changes in CA(125) level between primary cytoreductive surgery and interval debulking surgery, all cases were divided into four groups, group A (CA(125) reduced to normal after primary cytoreductive surgery, n = 6), group B (CA(125) reduced to normal after 1-2 cycles of chemotherapy, n = 11), group C (CA(125) reduced to normal after 3-4 cycles of chemotherapy, n = 14), and group D (CA(125) did not reduced to normal after the chemotherapy, n = 8), and all received platinum-based chemotherapy. The response to chemotherapy evaluated by pathological examination versus CA(125) level, and recurrence and prognoses were also analyzed. RESULTS: (1) The rate of optimal interval cytoreductive surgery in group A, B, C and D were 6/6, 8/11, 9/14 and 2/8 respectively, in which there were statistically different between group A or B and group D (P < 0.05). (2) The clinical benefit rates evaluated by the pathological examination in group A, B, C and D were 4/6, 4/11, 5/14 and 0, respectively and there were statistically different between group A and group D (P = 0.030). (3) There was significant difference in the recurrence rate between group A and group D (3/6 vs. 8/8, P = 0.024), while there were not significant differences between group B or C and group D (all P > 0.05). The rate of drug-resistant recurrence in group A, B, C and D were 1/6, 3/11, 5/14 and 7/8, respectively, in which there were significant differences between group A, B or C and group D (all P < 0.05). (4) The median progression-free survival (PFS) for patients in group A, B, C and D were 32, 10, 18 and 3 months, respectively, in which there were significant differences in the PFS between group A, B or C and group D (P = 0.012, P = 0.003, P = 0.032). The median overall survival (OS) were 44, 45, 44 and 16 months, respectively. There were significant differences in the OS between group A, B or C and group D (P = 0.022, P = 0.004, P = 0.000). CONCLUSION: The change of CA(125) between primary cytoreductive surgery and interval debulking surgery may be predict the recurrence type and the prognosis in patients with epithelial ovarian cancer.
Zhonghua fu chan ke za zhi 08/2012; 47(8):566-570.
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ABSTRACT: Phenotypic and genotypic heterogeneity is a known feature of many cancers. Whether serum tumor marker kinds vary and change following chemotherapy is still unclear. The aim of this study was to investigate whether there is a change in the expression of serum tumor markers following chemotherapy, and the potential clinical significance in patients with epithelial ovarian carcinoma (EOC) or primary serous peritoneal carcinoma (PSPC).
Samples were collected before surgery, during chemotherapy and during follow-up for enzyme-linked immunosorbent assay (ELISA)-based evaluation of serum CA-125, CA19-9 and CP2 levels in patients with EOC or PSPC who had received primary debulking surgery followed by adjuvant chemotherapy. In total, 72 patients were examined, including 37 patients with recurrent lesions and 35 patients receiving first-line chemotherapy.
In 35 de novo patients, 20% (7/35) demonstrated a significant changed serum tumor marker kinds among whom the patients with mucinous carcinoma (57.1%, 4/7) showed resistance to chemotherapy. In the 37 recurrent patients, 51.4% (19/37) had changed serum tumor markers, of whom 57.9% (11/19) presented with serous carcinoma. There was no significant difference in median progression-free survival or overall survival in patients with drug-sensitive or drug-resistant recurrence in patients with changed tumor marker kinds relative to those with unchanged markers. However, for patients with changed serum tumor markers there was a trend towards prolonged survival compared with the unchanged serum tumor marker group. In the 17 patients with secondary recurrence, 37.5% (6/17) had changed tumor marker levels. The ratios of CA-125/CP2 and CA-125/CA19-9 were significantly different after either chemotherapy or recurrence.
Serum tumor marker expression in patients with EOC or PSPC may change after chemotherapy or recurrence, indicating that in addition to the markers that are abnormal before surgery, those markers that are normal should also be monitored during chemotherapy and follow-up.
Chinese medical journal 02/2012; 125(3):410-5. · 0.86 Impact Factor
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ABSTRACT: To analyze the influence of type 2 diabetes mellitus on incidence and severity of lumbar disc herniation.
A total of 575 cases of lumbar disc herniation (40-70 years) from Orthopedic Department of Peking University First Hospital from October 1998 to October 2008 were retrospective studied, and the number and ratio of cases of type 2 diabetes mellitus identified. The control group included 219 cases of hallus valgus, carpal tunnel syndrome, cubital tunnel syndrome or ganglion. The number and ratio of cases of type 2 diabetes mellitus were also identified and the ratios of the two groups compared. Then we divided the lumbar disc herniation operation group into two subgroups, one with type 2 diabetes mellitus and the other without, and compared between the two subgroups the numbers of operation segments,the types of lumbar disc herniation (contained type and uncontained type) and the ratio of relapse with revision surgery by t test or χ² test.
The ratio of lumbar disc herniation group with type 2 diabetes mellitus was 15.3%(88/575) and significantly higher than 7.76%(17/219)of the control group (χ² =7.861,P=0.005), and also significantly higher than 9.94%(188/1892 ) of the incidence of type 2 diabetes mellitus in 40-70 years old people of Beijing (χ² =12.788, P=0.000 4). The operation segments were 1.19 in subgroup with type 2 diabetes mellitus and 1.15 in subgroup without type 2 diabetes mellitus(t=0.703, P=0.483);the ratios of different types of lumbar disc herniation were 65.7%(58/88)with contained type and 34.3% (30/88) with uncontained type in subgroup with type 2 diabetes mellitus as well as 70.5% (343/487) contained type and 29.5% (144/487) uncontained type in subgroup without type 2 diabetes mellitus(χ² =0.722, P=0.395); the ratios of relapse cases with revision surgery were 3.41%(3/88) in subgroup with type 2 diabetes mellitus and 3.89% (19/487) in subgroup without type 2 diabetes mellitus ( χ² =0.034,P=0.854).
People who received operation with lumbar disc herniation had the higher ratio concomitant with type 2 diabetes mellitus than the control group. Type 2 diabetes mellitus may increase the risk of suffering from lumbar disc herniation.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 10/2011; 43(5):696-8.
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ABSTRACT: Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectability of tumors, has recently evolved as a treatment for locally advanced cervical cancer. NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer. To further assess the effects of NACT on surgery and the pathologic characteristics of cervical cancer, we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or without NACT at the People's Hospital of Peking University between January 2006 and December 2010. Of 110 patients, 68 underwent platinum-based NACT prior to surgery (NACT group) and 42 underwent primary surgery treatment (PST group). Our results showed 48 of 68 (70.6%) patients achieved a complete response or partial response to NACT. Estimated blood loss, operation time, and number of removed lymph nodes during surgery, as well as complication rates during and after surgery were not significantly different between the NACT group and the PST group. The rates of deep stromal invasion, positive parametria, positive surgical vaginal margins, and lymph node metastasis were not significantly different between the two groups. However, the rate of lymph-vascular space involvement (LVSI) was significantly lower in the NACT group than in the PST group (P = 0.021). In addition, the response rate of NACT was significantly higher in the patients with chemotherapeutic drugs administrated via artery than via vein. Our results suggest that NACT is a safe and effective treatment for locally advanced cervical cancer and significantly decreases the rate of LVSI.
Chinese journal of cancer 09/2011; 30(9):645-54.
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Li Dong,
Xiao-Ping Li,
Heng Cui,
Jian-Liu Wang,
Li-Hui Wei,
Yan Zhao, Shi-Jun Wang,
Yue Wang,
Xiu-Li Sun,
Xu-Dong Liang,
Yi Li
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ABSTRACT: To investigate whether the change of serum tumor markers profile after chemotherapy in epithelial ovarian carcinoma and evaluate the clinical significance.
The levels of CA(125), CA(19-9) and CP2 before and after initial surgery, during primary chemotherapy and follow-up were serially measured and analyzed retrospectively in 28 cases of recurrent epithelial ovarian carcinoma patients and 20 cases of primary chemo-resistant ovarian carcinoma patients from Jan 1999 to July 2007. According to whether the change of serum tumor markers profile, all the patients were divided into two groups: marker changed-group and marker un-changed group. The average follow up period was 25 months.
(1) The changes of tumor marker profile were included the number and(or) types of markers, which included 13 cases (46%, 13/28) of the recurred cases and 9 cases (45%, 9/20) of the primary chemo-resistant cases. (2) For recurrent ovarian carcinoma changed tumor marker profile, the highest pathology type was serous histological type (77%, 10/13), while was mucinous histological type (4/9) for primary chemo-resistant patients. (3) For recurred patients, the median progression-free survival (PFS) and median overall survival (OS) in marker changed-group (22.2 and 60.0 months) were significantly longer than that in marker un-changed group (17.4, 46.0 months; P < 0.05). For primary chemo-resistant ovarian carcinoma patients, median OS in marker changed-group (15.9 months) was significantly shorter than that in marker un-changed group (25.0 months; P < 0.05).
The profile of serum tumor makers in epithelial ovarian carcinoma may be changed after chemotherapy, which should be concomitantly determinate different serum tumor markers for monitoring the response to chemotherapy and follow-up of patients.
Zhonghua fu chan ke za zhi 03/2009; 44(2):121-5.
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Xiao-Ping Li,
Heng Cui,
Jing-Wei Zhou,
Li-Hui Wei,
Jian-Liu Wang,
Yan Zhao,
Yue Wang, Shi-Jun Wang,
Hong-Lan Zhu,
Li Dong,
Hong Zhang
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ABSTRACT: To evaluate the efficacy and tolerability of the combination of oxaliplatin, ifosfamide and epirubicin (IAP) in treatment of recurrent or platinum-resistant ovarian cancer patients.
A total of 25 patients received the combined chemotherapy of ifosfamide (3 - 4 g/m(2)), epirubicin (50 - 60 mg/m(2)) and oxaliplatin (130 mg/m(2)). The cycles were repeated every 21 days. The efficacy and toxicity were evaluated in 21 patients who received more than 2 cycles of IAP chemotherapy.
The overall response rate was 71%, with a complete response in 10 (48%), partial response in 5 (24%), stable disease in one (5%), and disease progression in 5 (24%). The median progression-free and overall survival time were 11 (1 to 33) months and 31 (1 to 71) months. While overall response rate was 60% in 10 patients with primary platinum resistant, and 88% in 8 patients with secondary platinum-resistant. Grade III - IV myelosuppression rate was 30%. The most common non-hematologic toxicity was perineurotoxicity (38%).
The combination of oxaliplatin, ifosfamide and epirubicin appears to be effective for recurrent or platinum-resistant ovarian cancer patients as salvage chemotherapy and the toxicity is also tolerable. However, it needs to be evaluated by multiple clinical trials.
Zhonghua fu chan ke za zhi 11/2008; 43(10):724-7.
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ABSTRACT: To investigate the prevalence, clinical features, diagnosis, treatment and the influence on procreation of uterine malformation.
Totally 225 women with uterine malformation referred to our hospital from Mar 1990 to Jan 2005 were involved in this retrospective analysis. The constituent ratio, clinical feature, diagnosis, treatment and the influence on procreation were analyzed.
(1) Among 225 cases of uterine malformation, 125 cases (55.6%) were septate uterus; 122 (97.6%, 122/125) of these patients became pregnant, but always associated with a high risk of reproductive failure and obstetrical complications, such as abortion, abnormal fetal presentation, premature rupture of membrane. (2) Among 51 cases (22.7%, 51/225) of didelphia, 50 cases (98%, 50/51) became pregnant without any influence from this malformation. Five cases were combined with urinary system complication. (3) Among 26 cases (9.7%, 26/225) of rudimentary horn of uterus, 4 cases (15%, 4/26) became pregnant, and 1 case (4%, 1/26) presented with ipsilateral oviduct ectopic pregnancy; 2 cases (8%, 2/26) were combined with urinary deformities. (4) In 14 cases (6.2%, 14/225) of bicornuate uterus, 1 case (7%, 1/14) presented with urinary tract abnormalities; gestations were more common, but due to the uterine structural abnormality, recurrent miscarriage and premature delivery were unavoidable. (5) Others: none came up with sterility in 4 cases (1.8%, 4/225) of saddle shaped uterus. All the three cases (1.3%, 3/225) of ametria were with the chief complaint of primary amenorrhea. Two cases of unicornis uterus (0.9%, 2/225) were both complicated with sterility, while neither with urinary system deformities.
Among uterine malformations, septate uterine is the most common type. Septate uterus, didelphic uterus, bicornuate and rudimentary horn of uterus do not affect pregnancy, but can cause different complications. Unicornis uterus always causes sterility. Uterus malformations often come up with urinary system deformities.
Zhonghua fu chan ke za zhi 08/2008; 43(7):493-6.
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ABSTRACT: A new kind of marattialean raches are reported from the coal balls in Coal Seam No.7 in the upper part of the Taiyuan Formation (early Early Permian) from Taiyuan, Shanxi, China and are assigned to the genus Stipitopteris Grand'Eury (Psaroniaceae). The present specimens are different from all six reported species of the genus, and are therefore proposed as a new species: Stipitopteris shanxiensis. The raches of the new species are generally dorsi-ventrally flattened. The main raches usually exhibit scales of different forms on their surface. Beneath the epidermis is a zone of parenchymatous cells, some of which contain tannin-like contents. Inside this is a zone of small sclerenchymatous cells. Inward are the ground tissue and vascular bundles. The vascular bundles are continuous and are in two circles: the outer circle assumes a transversely elliptical shape with the gap and pinna trace, and the inner circle assumes a shallow C-shape with inrolled ends. The ground tissue located at the inner side of the vascular bundle is composed of thicker-walled parenchymatous cells. The cells of the ground tissue are vertically elongated in longitudinal sections. Subordered raches are smaller and have simpler structures than the main raches. The parenchyma zone beneath the epidermis is thinner, usually one to two cells wide and the sclerenchyma zone is usually absent. The scales are poorly developed and there is only one C-shaped vascular bundle. The new species is comparable to the crosiers of Psaroniaceae of the Euramerican Flora in some aspects, for example, it has a dorsi-ventrally flattened rachis and scales on the surface of the rachis. However, the other features and the preservative conditions of the present specimens indicate that they are not crosiers, but fully developed or mature raches. The new species is the first well-studied anatomically-preserved rachis of Psaroniaceae from the Cathaysian Flora and bears significance not only in understanding the anatomy and taxonomy of Psaroniaceae in the Cathaysian Flora, but also in the relationship between the Euramerican Flora and the Cathaysian Flora.
Journal of Integrative Plant Biology 02/2008; 50(1):119-27. · 2.53 Impact Factor
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ABSTRACT: To evaluate the function of transposed ovary and its affecting factors in young women with cervical cancer.
The patients of cervical cancer who were admitted into Peking University People's Hospital during September 1999 to January 2004 and underwent ovarian transposition in peritoneal cavity, were followed regularly and analyzed retrospectively. The questionnaire of climacteric symptoms and sexual activity were designed and delivered to all patients. Serum levels of estradiol and follicle-stimulating hormone (FSH) were measured and transposed ovaries were observed with B ultrasound post operation.
The climacteric symptoms of patients who received transposed ovary unilaterally or bilaterally were not difference significantly at the mean follow-up times of 14.2 and 17.4 months, respectively (P > 0.05). However, of the patients who underwent adjuvant radiotherapy and/or chemotherapy post-surgery, climacteric symptoms were significantly more common (85%) than without adjuvant therapy (13%) (P < 0.05). Serum estradiol, and FSH levels and climacteric symptoms of the patients, who received adjuvant radiotherapy, had no significant difference between the ovaries transposed 2 cm above and 2 cm below anterosuperior horizontal iliac spine.
Transposed ovary to peritoneal cavity could preserve the function of ovary. Once the patients undergo adjuvant radiotherapy, the function of transposed ovary will be affected wherever the transposed ovary locates 2 cm above or below anterosuperior horizontal iliac spine.
Zhonghua fu chan ke za zhi 04/2006; 41(4):229-32.
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ABSTRACT: To investigate the clinical management strategies and prognostic factors of primary peritoneal neoplasms.
We retrospectively reviewed the clinical and pathological records of 24 cases with primary peritoneal neoplasms treated in the People's Hospital, Peking University during May 1995 and April 2004.
Among 24 cases, 15 patients were diagnosed as serous papillary adenocarcinoma (9 highly and intermediately differentiated, and 6 lowly differentiated), 6 as mixed epithelial carcinoma and 3 as mixed malignant Mullerian tumor (MMMT). All patients underwent cytoreductive surgery, 21 cases having, suboptimal debulking one. Then they received a platinum-based chemotherapy. Thirteen cases received paclitaxel + cisplatin (TP) and 9 received cisplatin + doxorubicin + cyclophosphamide (PAC) combination chemotherapy. The primary response reached 80% (complete response 55% and partial response 25%). The median survival of all patients was 42 months (95% CI = 22-62 months). Survival for patients with primary peritoneal serous papillary carcinoma (PPSPC), mixed epithelial carcinoma and MMMT was 44, 19 and 13 months respectively, with a significant difference between PPSPC and MMMT (P < 0.05). Patients receiving TP combination also exhibited longer survival than those receiving PAC regimen (mean survival 75 vs 28 months, P < 0.05).
Patients with primary peritoneal neoplasms should be treated with appropriate cytoreductive surgery. A primary surgical protocol is bilateral salpingo-oophorectomy and omentectomy. Overestimating an optimal debulking surgery may have no benefit on the survival. TP combination therapy may bring longer survival than PAC regimen. Histopathologic types and chemotherapy regimens are the essential factors of the prognosis.
Zhonghua fu chan ke za zhi 07/2005; 40(7):464-8.
