Journal of Gynecologic Oncology最新文献

{"title":"Adjuvant concurrent chemoradiotherapy for early-stage cervical cancer patients with intermediate-risk factors in the era of intensity-modulated radiation therapy.","authors":"Sitong Wang, Gui-Fen Ma, Chunli Xiao, Juan Liu, Tingyan Shi, Li Ma, Gen-Lai Lin","doi":"10.3802/jgo.2026.37.e93","DOIUrl":"10.3802/jgo.2026.37.e93","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether adjuvant concurrent chemotherapy with pelvic intensity-modulated radiotherapy (IMRT) improves the outcome of patients with early-stage cervical cancer with intermediate risk factors (IRFs) compared with IMRT alone.</p><p><strong>Methods: </strong>This study included a cohort of 244 women from January 2012 to October 2023 who underwent radical hysterectomy along with pelvic lymph node dissection (PLND) for stage IB-IIA cervical cancer with IRFs. One hundred thirty-nine patients were postoperatively treated with pelvic IMRT (45.0-50.4 Gy) and adjuvant concurrent chemoradiotherapy (CCRT) (weekly cisplatin or weekly or triweekly combination of paclitaxel and cisplatin). One hundred five patients were treated with pelvic IMRT alone. The significance of clinical parameters, overall survival (OS), and recurrence-free survival (RFS) of each arm were analyzed.</p><p><strong>Results: </strong>The median follow-up period was 61.2 months, with a range spanning from 6.3 to 144.4 months. The 5-year OS rates in the patients in the radiotherapy (RT) and CCRT arms were 96.7% and 94.4%, respectively (p=0.271). Five-year RFS was 88.1% in the RT arm and 86.9% in the CCRT arm (p=0.740). Multivariate analysis identified adenocarcinoma (AC) histology as the only significant prognostic factor affecting OS and RFS.</p><p><strong>Conclusion: </strong>This study demonstrates that even in the era of IMRT, CCRT is not more effective than RT alone in patients with stage IB-IIA cervical cancer with IRFs following radical hysterectomy with PLND.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e93"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of peritoneal washing cytology as a predictive factor for the long-term benefit of secondary debulking surgery in ovarian cancer.","authors":"Hiroaki Nagano, Akimasa Ichinoe","doi":"10.3802/jgo.2026.37.e94","DOIUrl":"10.3802/jgo.2026.37.e94","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the significance of peritoneal washing cytology (PWC) as a predictive factor of the long-term benefits of secondary debulking surgery (SDS) for ovarian cancer (OC).</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical records of patients with OC who underwent SDS for intraperitoneal recurrence (IPR). Various clinical data points were investigated, including the residual tumor size at SDS, PWC results at SDS, progression-free survival (PFS), and overall survival (OS).</p><p><strong>Results: </strong>Between 2007 and 2022, 207 patients with ovarian, fallopian, or peritoneal cancers were treated at our institution. IPR occurred in 49 patients, 20 of whom underwent SDS. This study included 18 patients, excluding 2 patients with squamous cell carcinoma. Complete resection of the SDS was achieved in 15 patients. PWC was negative in 12 patients but positive in 6; ascites was not observed in any patient. IPR occurred in all PWC-positive patients after SDS, although 3 patients had no residual tumors. In contrast, only 4 of the 12 PWC-negative patients (all without residual tumors) experienced IPR during follow-up (median: 78 months), 2 of whom had secondary IPR at SDS. The association between PWC and IPR after SDS was significant (p=0.009, Fisher's exact test). The PFS and OS after SDS were significantly higher in the PWC-negative group than in the PWC-positive group.</p><p><strong>Conclusion: </strong>PWC is a significant predictor of the long-term benefit of SDS in patients with OC and IPR.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e94"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an homologous recombination deficiency scoring algorithm for unmatched ovarian tumor sample based on next-generation sequencing.","authors":"Zhizhong Wang, XinXin Yang, Taoran Cheng, Junnan Feng, Jinxiang Zheng, Tingjie Wang, Mingye Zhang, Hongxue Meng, Cai Jiang, Bing Wei","doi":"10.3802/jgo.2026.37.e97","DOIUrl":"10.3802/jgo.2026.37.e97","url":null,"abstract":"<p><strong>Objective: </strong>Poly (ADP-ribose) polymerase inhibitors (PARPis) have emerged as a novel targeted therapy, necessitating the development of PARPi sensitivity tests for clinical application. However, the requirement for matched normal tissue complicates clinical testing procedures and increases the burden on patients. In this study, we optimized a bioinformatics algorithm utilizing the Panel of Normals to accommodate tumor-only scenarios.</p><p><strong>Methods: </strong>Paired samples from both clinical (Chinese population) and International Cancer Genome Consortium (ICGC) databases (Caucasian population) were employed to establish training cohorts. The tumor-only algorithm was developed based on these cohorts. The performance of the tumor-only algorithm was evaluated through linear regression against the paired sample algorithm. The validity of both algorithms was tested using progression-free survival data from patients treated with PARPis. Additionally, clinical samples from an independent institution were utilized to further validate the tumor-only algorithm.</p><p><strong>Results: </strong>In the training sets, we observed high correlations between the tumor-only and paired sample algorithms regarding tumoral purity and homologous recombination deficiency (HRD) scores, with most R² values exceeding 0.9. In the validation set, a slight decrease in correlation was noted, although the majority of R² values remained close to 0.9. Both algorithms effectively distinguished PARPi-sensitive patients. No statistically significant differences were identified between the training and validation cohorts concerning clinical characteristics. Cross-racial validation yielded similar results.</p><p><strong>Conclusion: </strong>The tumor-only algorithm demonstrated an equivalent capacity to the paired sample algorithm for classifying HRD status in ovarian cancer. This algorithm also showed cross-racial applicability, highlighting its potential for clinical use.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e97"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of HER2 status in endometrial carcinoma using endometrial, gastric, and breast cancer criteria: focus on HER2-low.","authors":"Heesoo Yoon, Yeon Bi Han, Dong Hoon Suh, Kidong Kim, Jae Hong No, Yong Beom Kim, Hyojin Kim","doi":"10.3802/jgo.2026.37.e86","DOIUrl":"10.3802/jgo.2026.37.e86","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate human epidermal growth factor receptor 2 (HER2) status in endometrial carcinoma (EC) using 3 different criteria, assess its association with clinicopathological and molecular characteristics, and investigate intertumoral heterogeneity and prognostic significance, focusing on HER2-low.</p><p><strong>Methods: </strong>HER2 immunohistochemistry was performed on whole-slide sections from 365 EC and interpreted using EC, gastric cancer (GC), and breast cancer (BC) criteria. Silver in situ hybridization was performed for 2+/3+ cases. Intertumoral heterogeneity was assessed in 30 matched primary and recurrent/metastatic tumors.</p><p><strong>Results: </strong>Among 365 ECs, HER2-positive tumors (2.0%) were strongly associated with serous histology, high-grade, and the p53-abnormal (p53-abn) subgroup (p<0.001). HER2-low (45.7% by EC criteria and 18% by GC/BC criteria) was associated with advanced stage (p=0.045) and high-grade tumors (p=0.009), respectively. HER2-expression was enriched in p53-abn (60.4%, 37.7%), high-/advanced-risk (56.2%, 60.0%), and International Federation of Gynecology and Obstetrics III-IV (60.0%, 62.5%) tumors. Intertumoral heterogeneity was substantial (40.0%, 30.0%), reflecting dynamic changes, particularly in serous histology (p=0.018) and high-grade tumors (p=0.034). Based on GC/BC criteria, HER2-low status was an independent prognostic factor for recurrence in high- and advanced-risk groups compared with HER2-0 (p=0.040).</p><p><strong>Conclusion: </strong>HER2 status in EC varies across scoring criteria, supporting the need for standardized interpretation. HER2 expression, including HER2-low, was more prevalent in biologically aggressive subsets, and HER-low showed prognostic relevance in high-/advanced-risk patients, supporting its potential value as a therapeutic target for antibody-drug conjugate therapy. The dynamic nature of HER2 across disease progression further supports the need for reassessment in recurrent or metastatic lesions.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e86"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Annual hazard rates for early-stage endometrial carcinoma after postoperative radiotherapy under FIGO 2023 staging system: results from a population-based single-center cohort study.","authors":"Lingxia Xin, Kang Ren, Zihan Yan, Jiabin Ma, Wenhui Wang, Yunlong Sheng, Yaqi Wang, Xiaorong Hou, Fuquan Zhang","doi":"10.3802/jgo.2026.37.e107","DOIUrl":"10.3802/jgo.2026.37.e107","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether early-stage endometrial carcinoma (EC) patients have survival outcomes comparable to those of the general population, and further explore the dynamic recurrence/death surveillance value of International Federation of Gynecology and Obstetrics(FIGO) 2023 staging system.</p><p><strong>Methods: </strong>This retrospective study analyzed FIGO 2009 stage I-II patients receiving postoperative radiotherapy at Peking Union Medical College Hospital in China (2000-2020), re-staged per FIGO 2023 staging system. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan-Meier methods; mortality was compared to age-/sex-matched Chinese controls using standardized mortality ratios (SMRs); recurrence/death trajectories were modeled through annual hazard rates; FIGO 2023 recurrence prediction accuracy was assessed via receiver operating characteristics analysis.</p><p><strong>Results: </strong>This study of 1222 EC patients revealed upstaging from FIGO 2009 to 2023 (IA→II: 27.2%; IB→II: 26.4%). OS rates were 97.7% (3-year), 94.9% (5-year), and 91.0% (10-year), with corresponding DFS rates of 93.4%, 87.4%, and 82.8%. Under FIGO 2023 staging system, recurrence risk peaked at 1.3 years (3.5%) and declined after 3 years. Mortality risk increased within 4 years, stabilizing at about 1.0% thereafter. IC/IIC stages showed the earliest/highest risk peaks. Stage IA1-IA2 required monitoring for late recurrences (>3 years), while IIC needed vigilance for delayed mortality (>3 years). FIGO 2023 staging system was an independent prognostic factor for recurrence prediction (area under the curve: 1-year=0.644; 3-year=0.612; 5-year=0.611).</p><p><strong>Conclusion: </strong>Early-stage EC patients had favorable prognosis. FIGO 2023 staging system exhibit excellent recurrence surveillance and prognostic prediction for these patients after postoperative radiotherapy.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e107"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The triglyceride-glucose index as a measure of insulin resistance and risk of incident endometrial cancer: a prospective analysis in UK Biobank.","authors":"Yufei Shen, Ziye Yang, Tongtong Zhang, Rui Mao","doi":"10.3802/jgo.2026.37.e102","DOIUrl":"10.3802/jgo.2026.37.e102","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the impact of the triglyceride-glucose (TyG) index and TyG index combined with body mass index (BMI) on risk of incident EC and to estimate the proportion of risk of incident EC mediated by BMI through the TyG index.</p><p><strong>Methods: </strong>Using the UK Biobank cohort, we included a sample of 168,431 participants for primary analysis. The risk of incident EC was evaluated using multivariable Cox proportional-hazards models. We applied a 2-stage regression approach to investigate the mediation effects. Polygenic risk scores were derived from established single nucleotide polymorphisms associated with EC.</p><p><strong>Results: </strong>The study found that a higher TyG index is associated with an increased risk of incident EC (hazard ratio [HR]=1.322; p<0.001, per 1 standard deviation [SD] increment), and subgroup analysis revealed a significant trend in the overweight and obesity subgroups (p-value for the quartile trend <0.001). The TyG-BMI index exhibited a notable association with risk of incident EC (HR=1.741; p<0.001, per 1 SD increment). Mediation analysis indicated that 11.97% and 7.77% proportion of the effect of BMI on the risk of incident EC is mediated by the TyG index in overweight and obese individuals. High genetic susceptibility could increase the risk of incident EC (HR=1.455; p<0.001), with the relationship between increased TyG index levels.</p><p><strong>Conclusion: </strong>The TyG index demonstrates a significant association with the risk of incident EC and mediates the influence of BMI, thereby implicating insulin resistance as a potential contributor to the pathogenesis of EC.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e102"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase II basket trial of Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors (DART) SWOG S1609: vaginal cancer sub cohort results.","authors":"Young Kwang Chae, Josie Czeskleba, Sandip Pravin Patel, Alex Mentor, William Robinson, Nathaniel L Jones, Murtuza Rampurwala, Aung Naing, Joseph M Beck, Carolyn Moloney-Lineen, Liam Il-Young Chung, Christine M McLeod, Helen X Chen, Elad Sharon, Sara Threlkel, Megan Othus, Christopher W Ryan, Charles D Blanke, Razelle Kurzrock","doi":"10.3802/jgo.2026.37.e92","DOIUrl":"10.3802/jgo.2026.37.e92","url":null,"abstract":"<p><strong>Objective: </strong>The SWOG S1609 Dual Anti-CTLA-4 & Anti-PD-1 blockade in Rare Tumors (DART) trial is the first basket study to include a sub-cohort assessing ipilimumab and nivolumab in patients with primary vaginal cancers with differing histology.</p><p><strong>Methods: </strong>DART is a prospective, open-label, multicenter, multi-cohort phase II clinical trial of ipilimumab (1 mg/kg intravenously) 6 weekly plus nivolumab (240 mg intravenously) 2 weekly across multiple rare tumor cohorts, with the vagina cohort (any vaginal histology) reported here. The primary endpoint was objective response rate (ORR) per RECISTv1.1; progression-free survival (PFS), overall survival (OS), clinical benefit rate (CBR; overall response plus stable disease [SD] ≥6 months), and toxicity are secondary endpoints.</p><p><strong>Results: </strong>Seven evaluable patients (median age, 60 years; performance status 0-1; no prior exposure to immunotherapy) were analyzed, of whom 3 had adenocarcinoma, 2 had squamous cell carcinoma (SCC), one had small-cell carcinoma and one had undifferentiated histology. The ORR was 29%, with 1 patient (14%) with undifferentiated histology achieving complete response (lasting 14.8 months) and 1 patient with SCC histology (14%) attaining a partial response (lasting 45.2 months). The CBR was 43%. The 6-month PFS rate was 43% and the median OS was 11.7 months. Five patients (71.4%) experienced an adverse event (AE) with 4 (57.1%) having grade 3-4 AE's.</p><p><strong>Conclusion: </strong>Ipilimumab plus nivolumab showed efficacy (ORR was 29% and CBR of 43%) and durability (one patient with prolonged SD >6 months) in a sub cohort of patients with vaginal cancer of differing histology without new safety signals.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02834013.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e92"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy plus camrelizumab for fertility preservation (NACI-F) in FIGO stage IB1 cervical cancer: a multicenter, single-arm, phase 2 trial.","authors":"Yingjie Hu, Shuting Chen, Hanxu Cheng, Yingyan Han, Chaoyang Sun, Gang Chen, Jing Chen, Kezhen Li","doi":"10.3802/jgo.2026.37.e98","DOIUrl":"10.3802/jgo.2026.37.e98","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of cervical cancer in younger women highlights the need for personalized fertility-preserving treatment strategies. Current fertility preservation approaches for early-stage cervical cancer primarily involve cervical conization and radical trachelectomy. However, removing part or all of the cervix can negatively impact reproductive outcomes. These procedures increase the risk of preterm birth and miscarriage, and sometimes require additional surgery due to positive margins. Combined chemotherapy and immune checkpoint inhibitor (ICI) therapy has demonstrated promising efficacy and tolerability in treating locally advanced cervical cancer. However, its role as a non-surgical, fertility-sparing treatment for stage IB1 disease remains unclear.</p><p><strong>Methods: </strong>This multicenter, single-arm, phase II trial is designed to evaluate the efficacy and safety of combining chemotherapy with camrelizumab as a fertility-preserving strategy for patients with International Federation of Gynecology and Obstetrics 2018 stage IB1 cervical cancer. Key inclusion criteria include: 1) pathologically confirmed cervical squamous cell carcinoma, 2) transformation zone of TZ1 or TZ2, 3) programmed death-ligand 1 combined positive score ≥1, and 4) age 18-45 with a desire to preserve fertility. Key exclusion criteria include being unable to achieve pregnancy even with assisted reproductive technology; autoimmune disease requiring systemic therapy; and prior exposure to ICIs or contraindications to study drugs. A total of 40 patients will be recruited from multiple centers across China. Enrolled patients will receive 1 cycle of chemotherapy (nab-paclitaxel + cisplatin), 2 cycles of chemotherapy combined with camrelizumab, and 3 cycles of camrelizumab alone. Those who achieve tumors ≤2 cm, no new lesions, and a biopsy-proven pathological response will undergo cervical conization combined with pelvic lymphadenectomy or pelvic lymphadenectomy alone. The primary endpoint is the pathological complete response rate. Secondary endpoints include the negative human papillomavirus conversion rate, pregnancy rate, miscarriage rate, live birth rate, preterm birth rate, adverse events, quality of life, event-free survival, and overall survival.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06289062.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e98"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV E6/E7 mRNA vs. HPV DNA in co-testing with ThinPrep cytology for cervical cancer screening: a prospective observational diagnostic accuracy study of methylation biomarkers.","authors":"Xinling Zhao, Lei Chang, Wenyan Duan, Lijuan Liu, Yange Shi, Xiaoling Fan, Yu Bai, Yanli Wang, Jingya Li","doi":"10.3802/jgo.2026.37.e109","DOIUrl":"10.3802/jgo.2026.37.e109","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) gene transcription activity and methylation could be promising tools for cervical cancer (CC) screening. This study compared HPV E6/E7 messenger RNA (mRNA) + ThinPrep cytology test (TCT) vs. HPV genotyping + TCT in screening CC and explored the relationship between gene methylation and cervical lesions.</p><p><strong>Methods: </strong>Women who visited gynecology outpatient clinics between January 2023 and November 2024 were enrolled and assigned to 2 screening strategies based on their wishes: HPV DNA + TCT or HPV E6/E7 mRNA + TCT. Methylation testing of <i>FAM19A4</i>, <i>ZNF582</i>, <i>EPHA7</i>, <i>SOX17</i>, <i>PAX1</i>, and <i>JAM3</i> genes was performed on the biopsy specimens from 100 patients.</p><p><strong>Results: </strong>Ultimately, 1,399 and 991 women underwent HPV DNA + TCT and HPV E6/E7 mRNA + TCT screening, respectively. The sensitivity, specificity, and accuracy in diagnosing high-grade squamous intraepithelial lesion (HSIL)+ were 72.09%, 83.05%, and 81.7% for HPV DNA + TCT, and 77.97%, 86.37%, and 85.37% for HPV E6/E7 mRNA + TCT, respectively. The areas under the receiver operating characteristic curves were 0.777 for HPV DNA + TCT and 0.822 for HPV E6/E7 mRNA + TCT. No HSIL+ lesions were observed in 65 patients with HPV 16/18 (+) but HPV E6/E7 mRNA (-). In cases with HPV 16/18 (+) and HPV E6/E7 mRNA (+), the immediate risks for cervical intraepithelial neoplasia (CIN) 2+ and CIN3+ were 64.06% and 50%, respectively. Methylation levels of <i>FAM19A4</i>, <i>ZNF582</i>, <i>EPHA7</i>, <i>SOX17</i>, <i>PAX1</i>, and <i>JAM3</i> genes increased with lesion severity.</p><p><strong>Conclusion: </strong>The sensitivity and specificity of HPV E6/E7 mRNA + TCT appeared higher than HPV DNA + TCT. Simultaneous positivity for HPV 16/18 and HPV E6/E7 mRNA suggests a high immediate risk of CIN2+ and CIN3+. These results may improve CC screening.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e109"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the relationship between cesarean section scar and endometrial cancer.","authors":"Keiichiro Nakamura, Yoshinori Tani, Hironori Itou, Miyuki Shimizu, Thi Hai Ly Dao, Hikari Nakato, Kazuhiro Okamoto, Chikako Ogawa, Eriko Eto, Hisashi Masuyama","doi":"10.3802/jgo.2026.37.e96","DOIUrl":"10.3802/jgo.2026.37.e96","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of endometrial cancer (EC) has been increasing annually. Studies have reported that cesarean section (CS) is associated with a higher risk of developing EC than vaginal delivery (VD). However, few studies have examined the relationship between CS and EC development.</p><p><strong>Methods: </strong>Data were extracted from the medical records of patients with EC and a history of childbirth who underwent EC treatment at 3 institutions. Factors contributing to EC development were analyzed between April 2010 and December 2024.</p><p><strong>Results: </strong>Among patients EC and a history of childbirth, 8.7% (69/794) had undergone CS, and 50.7% (35/69) developed a CS scar. Compared with patients who had a VD or those without a CS scar, patients with a CS scar showed significantly shorter intervals from delivery to EC onset (VD: p=0.013; non-CS scar: p=0.031). A narrower residual myometrial thickness/adjacent myometrial thickness (RMT/AMT) ratio of the CS scar was significantly associated with a shorter interval from the last delivery to EC onset (p=0.034) and was independently associated with earlier EC onset after the last delivery in both univariate and multivariate analyses (p<0.001 and p=0.030, respectively).</p><p><strong>Conclusion: </strong>A narrower RMT/AMT ratio in the CS scar was considerably associated with a shorter interval from the last delivery to EC onset.</p>","PeriodicalId":15868,"journal":{"name":"Journal of Gynecologic Oncology","volume":" ","pages":"e96"},"PeriodicalIF":4.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}