中华妇产科杂志最新文献

{"title":"[Landscape and challenges of PARPi in the treatment of epithelial ovarian carcinoma].","authors":"N Li, L Y Wu","doi":"10.3760/cma.j.cn112141-20250627-00300","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250627-00300","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 8","pages":"585-589"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Metabolic signatures of niraparib-resistant ovarian cancer cells based on non-target metabolomics].","authors":"H Lin, H Y Jin, W G Lyu","doi":"10.3760/cma.j.cn112141-20250113-00023","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250113-00023","url":null,"abstract":"<p><p><b>Objective:</b> To establish a niraparib-resistant ovarian cancer cell line and preliminarily explore its biological characteristics and metabolic signatures. <b>Methods:</b> (1) Using ovarian adenocarcinoma cell line A2780 as parental cells, the niraparib-resistant cell line A2780-NiraR was established by the method of concentration gradient increased induction, and its morphological characteristics were observed using inverted phase-contrast microscope. The half-inhibitory concentration (IC₅₀) of niraparib was determined by cytotoxicity assay. (2) Cell proliferation was determined by cell count kit-8 (CCK-8) assay and direct cell counting assay, cell cycle distribution was analyzed by flow cytometry. (3) The differential metabolites between A2780 and A2780-NiraR cells were detected by non-target metabolomics based on ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC/HRMS). Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was conducted on the above differential metabolites to explore related metabolic pathways. <b>Results:</b> (1) Compared with the parental A2780 cells, A2780-NiraR cells exhibited predominantly short-spindle or oval morphology with reduced cellular projections and indistinct cell borders. The IC₅₀ values of niraparib were 3.17 and 26.19 μmol/L against A2780 cells and A2780-NiraR cells, respectively (<i>F</i>=98.50, <i>P</i><0.001). (2) A2780-NiraR cells had a slower proliferation rate compared with A2780 cells (<i>F</i>=146.80, <i>P</i><0.001). The doubling time of A2780-NiraR cells [(37.5±1.9) hours] was significantly longer than that of A2780 cells [(14.5±1.0) hours; <i>t</i>=10.50, <i>P</i><0.001]. Compared with the parental A2780 cells, A2780-NiraR cells had a significantly lower S phase fraction [(44.5±0.7)% in A2780 cells, (30.2±2.9)% in A2780-NiraR cells; <i>t</i>=4.78, <i>P</i><0.001] and higher G₀/G₁ phase fraction [(35.4±1.2)% in A2780 cells, (52.2±3.1)% in A2780-NiraR cells; <i>t</i>=5.10, <i>P</i><0.001]. (3) The metabolites of A2780 and A2780-NiraR cells were analyzed by non-target metabolomics. Forty-four differential metabolites between A2780 and A2780-NiraR cells were screened using the orthogonal partial least squares-discriminant analysis (OPLS-DA) model, the majority of which were significantly increased, such as pyrrolidone carboxylic acid, L-lysine and 1-pyrroline-4-hydroxy-2-carboxylate. Pathway enrichment analysis indicated that the arginine metabolism, purine metabolism, and pyrimidine metabolism were the most significantly enriched pathways. <b>Conclusion:</b> A2780-NiraR cells have acquired a stable niraparib resistance phenotype, and metabolic pathways including arginine metabolism may serve as potential therapeutic targets for enhancing niraparib efficacy in ovarian cancer.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 8","pages":"608-616"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy of cervical cerclage in singleton pregnancies with short cervix and stratified analysis of cervical length: a retrospective matched cohort study].","authors":"L P Qiu, M Lyu, C Chen, Q Luo","doi":"10.3760/cma.j.cn112141-20250429-00183","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250429-00183","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the clinical efficacy of cervical cerclage in singleton pregnancy with different degrees of short cervix. &lt;b&gt;Methods:&lt;/b&gt; The clinical data of singleton pregnant women who underwent transvaginal ultrasound examination at 18-24&lt;sup&gt;+6&lt;/sup&gt; weeks of gestation and found cervical dilation with cervical length (CL) ≤20 mm, and without history of spontaneous preterm delivery or late abortion in Women's Hospital, Zhejiang University School of Medicine from January 2021 to September 2023 were collected and retrospectively analyzed. According to the case control matching, 78 pregnant women in the cerclage group and 78 women in the conservative treatment group were finally included. The pregnancy outcomes and neonatal prognosis of the two groups were compared. Meanwhile, the two groups of pregnant women were divided into three subgroups for stratification (CL≤10, 11-15, 16-20 mm). Multivariate logistic regression analysis and Kaplan-Meier curve were used to evaluate the effect of cervical cerclage on pregnancy outcomes in different subgroups. &lt;b&gt;Results:&lt;/b&gt; (1) Compared with the conservative treatment group, the gestational age at delivery (median: 36 vs 37 weeks) and the duration of pregnancy extension (median: 90 vs 97 days) in the cerclage group were not significantly prolonged (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). There was no significant difference in the cumulative non-delivery rate between the cerclage group and the conservative treatment group (&lt;i&gt;P&lt;/i&gt;=0.143). The rate of neonatal intensive care unit (NICU) admission in the cerclage group was significantly higher than that in the conservative treatment group (46.1% vs 31.2%, &lt;i&gt;P&lt;&lt;/i&gt;0.001), but there were no significant differences in other neonatal outcomes between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). (2) CL 16-20 mm subgroup: compared with the conservative treatment group (28 cases), the cerclage group (18 cases) had a significantly higher rate of preterm birth before 37 weeks of gestation (3.6% vs 6/18, &lt;i&gt;P&lt;/i&gt;&lt;0.001) and a significantly lower neonatal birth weight (median: 3 370 vs 2 925 g, &lt;i&gt;P&lt;/i&gt;&lt;0.001). There was no significant difference in the cumulative non-delivery rate between the cerclage group and the conservative treatment group (&lt;i&gt;P&lt;/i&gt;=0.168). (3) CL 11-15 mm subgroup: compared with the conservative treatment group (26 cases), the gestational age of delivery in the cerclage group (32 cases) was later (median: 36 and 37 weeks, respectively), and the difference was statistically significant (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The cumulative non-delivery rate in the cerclage group was significantly higher than that in the conservative treatment group (&lt;i&gt;P&lt;/i&gt;=0.001). (4) CL≤10 mm subgroup: compared with the conservative treatment group (24 cases), the pregnant women in the cerclage group (28 cases) had a later gestational age at delivery (median: 34 vs 37 weeks), a longer duration of pregnancy (median: 74 vs 97 days), and a larger newborn birth weight (median: 2 300 vs 3 165","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 8","pages":"617-626"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Real world clinical data analysis of fuzuloparib for the treatment of ovarian epithelial cancer patients].","authors":"D H Weng, J Jiang, Y J Yang, M Q Lu, J Y Bai, M Liu, X L Li, J Tian, Y T Guan, Q Li, L Chen, Q P Lyu, L X Ma, Y L Wang, H C Xu, H L Guo, L Sun, D Ma, Q L Gao","doi":"10.3760/cma.j.cn112141-20241119-00614","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241119-00614","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting. <b>Methods:</b> A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed. <b>Results:</b> (1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205). <b>Conclusions:</b> The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 8","pages":"590-599"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Safety and long-term efficacy of transvaginal reconstructive pelvic surgery for severe pelvic organ prolapse in elderly women aged 70 years and over].","authors":"X L Zhang, Y X Lu, W J Shen, Y Zhao, K Niu, W Y Wang, L Qin, J J Yan","doi":"10.3760/cma.j.cn112141-20250220-00058","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250220-00058","url":null,"abstract":"<p><p><b>Objective:</b> To explore the safety and long-term efficacy of transvaginal reconstructive pelvic surgery (TVRPS) in ≥70-year-old women with severe pelvic organ prolapse (POP). <b>Methods:</b> A single-center, prospective cohort study was conducted on 343 elderly women patients with severe POP who received TVRPS at the Fourth Medical Center, Chinese PLA General Hospital, Medical School of Chinese PLA from March 2007 to September 2024. There were 297 cases (86.6%, 297/343) of Ⅲ degree and 46 cases (13.4%, 46/343) of Ⅳ degree prolapse respectively. Among them, anterior pelvic prolapse accounted for 80.8% (277/343), and those with prolapse in two or more sites accounted for 30.0% (103/343). The age was (74.2±3.4) years (range: 70 to 89 years old). There were 300 cases (87.5%, 300/343) with more than one internal medicine disease. Preoperative general conditions were assessed using American Society of Anesthesiologists physical status classification system (ASA) and American College of Surgeons National Surgical Quality Improvement Program-frailty index (ACS NSQIP-FI). TVRPS surgeries included transvaginal hysterectomy, salpingooophorectomy, high uterosacral ligament suspension, sacrospinous ligament fixation, native tissue and mesh repair of the anterior and posterior vaginal walls, mid-urethral sling for anti-urinary incontinence, and levator anal muscle folding suture and perineal repair. Perioperative complications were evaluated using Clavien-Dindo classification system. The objective effect of TVRPS was determined based on pelvic organ prolapse quantification system (POP-Q), and the subjective results were evaluated using pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form 7 (PFIQ-7) and patient global impression of improvement (PGI-I). <b>Results:</b> All patients had a preoperative ASA grade of ≤gradeⅡ, and ACS NSQIP-FI score of ≤0.27. All patients safely and successfully underwent all TVRPS surgeries. The operation time was (154.2±43.2) minutes. The perioperative morbidity and mortality rate were 0.6% (2/343) and 0 (0/343) respectively. None of the patient needed blood transfusion. The follow-up time was (7.5±4.3) years, with the longest being 17 years. Thirty-four cases (9.9%, 34/343) were lost to follow-up, and 22 cases (6.4%, 22/343) died of internal diseases during the follow-up period. The point values of Aa, Ba, C, Ap and Bp in the POP-Q system were significantly decreased after the operation (all <i>P</i><0.01), the genital hiatus was significantly shortened (all <i>P</i><0.01), and the perineal body was significantly elongated (all <i>P</i><0.01). The scores of PFDI-20 and PFIQ-7 were significantly lower than those before the operation (all <i>P</i><0.01). There were 332 cases (96.8%, 332/343) with an overall symptom impression improvement score of PGI-I≤2. <b>Conclusion:</b> The results on 343 elderly women with severe POP aged an average of 74.2 years show that for elderly ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 8","pages":"627-636"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Safety and efficacy of secondary cytoreductive surgery in patients with platinum-sensitive recurrent ovarian cancer after first-line PARPi maintenance therapy].","authors":"Y X Zhao, H W Yao, J Zeng, Y C Sun, N Li, G W Yuan, N Li, L Y Wu","doi":"10.3760/cma.j.cn112141-20241106-00591","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241106-00591","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the effectiveness and safety of secondary cytoreductive surgery (SCS) in patients with platinum-sensitive recurrent epithelial ovarian cancer who progressed after first-line maintenance therapy with poly adenosine diphosphate ribose polymerase inhibitor (PARPi). &lt;b&gt;Methods:&lt;/b&gt; Clinical pathological data and prognostic information were retrospectively collected from 30 ovarian cancer patients who underwent SCS between January 2018 and June 2024. The Kaplan-Meier method was used to analyze the second progression-free survival (PFS2) time and 3-year overall survival (OS) rate. &lt;b&gt;Results:&lt;/b&gt; (1) Primary treatment: the median age at diagnosis was 51.3 years. A total of 40% (12/30) patients underwent primary debulking surgery with an expectation of achieving no gross residual disease (R0), while 60% (18/30) received neoadjuvant chemotherapy and interval debulking surgery. Optimal cytoreduction was achieved in 93% (28/30) of patients. BRCA1/2 gene testing was performed in 29 patients (testing rate 97%, 29/30), identifying 11 BRCA-mutated (37%, 11/30) and 18 BRCA wild-type (60%, 18/30) patients. The median duration of PARPi maintenance therapy among the 30 patients was 11.9 months; patients with BRCA gene mutations had a median duration of 19.2 months, while those with BRCA wild-type had a median duration of 10.1 months. (2) Secondary surgery: pathologically confirmed recurrence patterns, single lesion in 9 patients (30%, 9/30), oligo-lesion (2 lesions) in 3 patients (10%, 3/30), and multi-lesion (≥3 lesions) in 18 patients (60%, 18/30). Among the 30 patients, optimal cytoreduction was achieved in 97% (29/30) of SCS patients, with suboptimal cytoreduction in 1 patient (3%, 1/30). Adjuvant chemotherapy included platinum+paclitaxel in 24 (80%, 24/30) patients and platinum+liposomal doxorubicin in 6 (20%, 6/30) patients. PARPi re-treatment was administered to 17 patients (57%, 17/30) after chemotherapy. (3) Efficacy and safety: as of the follow-up cutoff in June 2024, the median follow-up time was 28.0 months. A total of 19 (63%, 19/30) patients experienced the next recurrence. The median PFS2 time after SCS was 18.5 months. Recurrence occurred in 7 BRCA-mutated and 12 BRCA gene wild-type patients. Median PFS2 time was significantly longer in BRCA-mutated patients compared to BRCA wild-type patients (25.7 vs 14.1 months; &lt;i&gt;P&lt;/i&gt;=0.028). Three deaths occurred during follow-up, resulting in a 3-year OS rate of 90%. Among the 30 patients, postoperative complications occurred in 4 patients (13%, 4/30). One patient developed a ureteral fistula on 7 days post-SCS requiring ureteral stenting, and one patient was transferred to the intensive care unit on 1 day post-SCS due to hypovolemic shock. No deaths occurred within 30 days after SCS. &lt;b&gt;Conclusion:&lt;/b&gt; For platinum-sensitive recurrent ovarian cancer patients progressed after first-line PARPi maintenance therapy who are anticipated to achieve R0 resection, SCS represen","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 8","pages":"600-607"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of the number of cesarean deliveries on adverse pregnancy outcomes of cesarean section in a single-center cohort study].","authors":"M Hu, L Lin, L L Du, Z P Yan, S J Luo, W Sun, S Lu, Y T He, F He, D J Chen","doi":"10.3760/cma.j.cn112141-20250121-00032","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250121-00032","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of the number of cesarean deliveries on adverse maternal and neonatal outcomes. <b>Methods:</b> A retrospective analysis was conducted on 11 904 singleton pregnant women who underwent cesarean delivery at the Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2019 to December 31st, 2023. The women were grouped according to the number of cesarean deliveries: those undergoing their first cesarean delivery (1CD group, 7 231 cases), those undergoing their second cesarean delivery (2CD group, 3 749 cases), those undergoing their third cesarean delivery (3CD group, 841 cases), and those undergoing their fourth or more cesarean deliveries (4CD group, 83 cases). Differences in clinical characteristics, related surgical procedures, and adverse maternal and neonatal outcomes among the groups were compared. Binary logistic regression analysis was used to assess the impact of the number of cesarean deliveries on related surgical procedures and adverse maternal and neonatal outcomes. <b>Results:</b> (1) During the 5-year period, the total number of women undergoing cesarean delivery in our hospital showed a slight downward trend, while the proportion of women undergoing three or more cesarean deliveries increased. (2) Compared with women undergoing their first cesarean delivery, women in each repeat cesarean delivery group were older, had higher proportions of advanced maternal age and pre-pregnancy body mass index, and had more pregnancies, deliveries, and induced abortions; the incidence of placenta previa, placental implantation, antepartum hemorrhage, gestational hyperglycemia, and failed trial of labor requiring conversion to surgery was higher, while the incidence of premature rupture of membranes was lower; the proportions of ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and postoperative intestinal obstruction were higher, and the amount of postpartum hemorrhage was greater; the gestational age at delivery of neonates was earlier, but the rates of preterm birth at 28-31⁺⁶ and 32-33⁺⁶ weeks of gestation were lower; the differences were statistically significant (<i>P</i><0.05) for all comparisons. (3) The number of cesarean deliveries was not an independent risk factor for the dose-dependent occurrence of placenta previa (a<i>OR</i>=0.99, 95%<i>CI</i>: 0.98-1.01; <i>P</i>=0.261). In women without placenta previa, the number of cesarean deliveries was not a risk factor for placental implantation (a<i>OR</i>=1.12, 95%<i>CI</i>: 0.90-1.39; <i>P</i>=0.320). However, in women with placenta previa, the number of cesarean deliveries was a risk factor for placental implantation (a<i>OR</i>=4.01, 95%<i>CI</i>: 3.08-5.22; <i>P</i><0.001). In the overall population, the number of cesarean deliveries was a risk factor for ureteral stent ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 6","pages":"430-438"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Endometriosis-associated ovarian mesonephric-like adenocarcinoma:a clinicopathological analysis of 9 cases].","authors":"H Wang, J Liu, Y Cheng, S N Wang, F F Zhong, W Y Gu","doi":"10.3760/cma.j.cn112141-20241217-00675","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241217-00675","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the clinical and pathological characteristics, treatment and prognosis of endometriosis (EM)-associated ovarian mesonephric-like adenocarcinoma (MLA). &lt;b&gt;Methods:&lt;/b&gt; Clinical and pathological data were collected from nine patients diagnosed with EM-associated ovarian MLA at the Obstetrics and Gynecology Hospital of Fudan University between January 2022 and December 2024. Histological slides were re-reviewed, immunohistochemical examination and molecular testing were performed, and patient follow-up was conducted. &lt;b&gt;Results:&lt;/b&gt; (1) Clinical characteristics: the median age of the nine patients was 54 years (range: 38-69 years). All patients presented with a pelvic mass; five cases also reported abdominal pain. Tumor location included five cases in the right ovary, two in the left ovary, and two involving both ovaries. International Federation of Gynecology and Obstetrics (FIGO) staging showed 3 cases at stage Ⅰ, 4 at stage Ⅱ, and 2 at stage Ⅲ. (2) Pathological features: gross examination revealed mixed solid-cystic masses with solid areas appearing gray-white or yellow-brown; the median maximum tumor diameter was 9.0 cm (range: 2.6-13.0 cm). Microscopically, tumors exhibited various architectural patterns, including tubular, glandular, papillary, slit-like, sex cord-like, glomeruloid, and solid structures, with tubular and glandular patterns being most common. Tumor cells demonstrated mild to moderate nuclear atypia. Of the 11 tumor foci in the 9 cases, 8 showed coexistence of MLA with other tumor components, such as endometrioid carcinoma, borderline endometrioid or borderline seromucinous tumors. In 1 case of MLA mixed with a borderline endometrioid tumor, both components exhibited squamous metaplasia. Immunohistochemistry showed variable expression of GATA-binding protein 3, thyroid transcription factor-1, CD&lt;sub&gt;10&lt;/sub&gt;, and calretinin, with positive rates of 9/11, 8/11, 5/11, and 3/6, respectively. Two tumor foci (2/11) exhibited focal expression of estrogen receptor and progesterone receptor. All cases displayed wild-type p53 expression. Molecular testing via next-generation sequencing in five patients revealed pathogenic mutations in the KRAS gene (5/5), with 3 cases (3/5) harboring additional pathogenic mutations in other genes. (3) Treatment and prognosis: all patients underwent surgery, supplemented by chemotherapy and (or) targeted therapy. Five patients underwent comprehensive staging surgery, four received cytoreductive surgery, and one patient received targeted therapy. The median follow-up duration was 7 months (range: 2-27 months). Three patients (3/9) experienced recurrence, and no deaths were reported during the follow-up period. &lt;b&gt;Conclusions:&lt;/b&gt; EM-associated ovarian MLA demonstrates diverse morphological patterns and frequently coexists with other tumor types. Accurate diagnosis relies on an integrated evaluation of histomorphology, immunohistochemistry, and molecular testing. The pr","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 6","pages":"469-476"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on gynecologic laparoendoscopic single port surgery (including vNOTES) 2025 edition].","authors":"","doi":"10.3760/cma.j.cn112141-20250127-00039","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250127-00039","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 6","pages":"417-421"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of pre-pregnancy BMI on the cumulative live birth rate and perinatal outcomes in patients with PCOS undergoing first IVF/ICSI].","authors":"X Y Wang, J N Xu, M Li, C L Zhang, S D Zhang","doi":"10.3760/cma.j.cn112141-20250312-00087","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250312-00087","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effect of pre-pregnancy body mass index (BMI) on the cumulative live birth rate (CLBR) and perinatal outcomes in women with polycystic ovary syndrome (PCOS) undergoing first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). <b>Methods:</b> The clinical data of 1 013 patients with PCOS who received first IVF/ICSI treatment in Reproductive Medicine Center, Henan Provincial People's Hospital from January 2017 to June 2020 were retrospectively analyzed. According to BMI China standard, they were divided into: normal weight group (18.5≤BMI<24.0 kg/m², 388 cases), overweight group (24.0≤BMI<28.0 kg/m², 367 cases), obese group (BMI≥28.0 kg/m², 258 cases). The effect of BMI on CLBR was analyzed by univariate analysis, multivariate logistic regression analysis and smooth curve fitting. The role of homeostasis model assessment of insulin resistance index (HOMA-IR) in the process of BMI on CLBR was analyzed by mediation analysis. <b>Results:</b> Among three groups, female age, basal level of follicle stimulating hormone, type of infertility and ovulation induction regimens were similar (all <i>P</i>>0.05). The infertility duration, basal testosterone level, HOMA-IR, the ovulation induction time and the total gonadotropin dosage increased with BMI (all <i>P</i><0.01), anti-Müllerian hormone, basal luteinizing hormone level, the number of retrieved oocytes and available embryos decreased with BMI (all <i>P</i><0.05). CLBR decreased with BMI increasing [84.08% (301/358) vs 74.26% (251/338) vs 71.88% (161/224); <i>P</i><0.001]. The incidence of hypertensive disorder in pregnancy was highest in obese group, while premature rupture of membranes rate, premature delivery rate, low birth weight rate and macrosomia birth rate were the lowest in normal weight group. After adjusting for confounding factors, both smooth curve fitting and multiple logistic regression analysis revealed a significant trend: CLBR declined with increasing BMI (<i>OR</i>=0.93, 95%<i>CI</i>: 0.89-0.97; <i>P</i>=0.002), with a reduction of 41% (<i>OR</i>=0.59, 95%<i>CI</i>: 0.39-0.91; <i>P</i>=0.020) in overweight group, and a reduction of 48% (<i>OR</i>=0.52, 95%<i>CI</i>: 0.32-0.83; <i>P</i>=0.010) in obese group. HOMA-IR mediated the effect of BMI on CLBR by 27.5% (<i>P</i><0.05). <b>Conclusions:</b> High BMI before IVF/ICSI in PCOS patients negatively impacts CLBR and raises maternal and infant risks during pregnancy and the perinatal period. 27.5% of the effect of BMI on CLBR is mediated by HOMA-IR. Thus, PCOS patients should manage their BMI and enhance insulin sensitivity prior to pregnancy.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 6","pages":"439-449"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}