Gynecology and Obstetrics Clinical Medicine最新文献

{"title":"Molecular typing guiding treatment and prognosis of endometrial cancer","authors":"Junya Tabata,&nbsp;Masataka Takenaka,&nbsp;Aikou Okamoto","doi":"10.1016/j.gocm.2023.01.011","DOIUrl":"10.1016/j.gocm.2023.01.011","url":null,"abstract":"<div><p>Genetic abnormalities, such as <em>PTEN, PIK3CA</em>, <em>CTNNB1</em>, <em>ARID1A</em>, and <em>ERBB2</em>, which frequently occur in endometrial cancer (EC), are potential therapeutic targets. In 2013, integrated genomic analysis conducted by The Cancer Genome Atlas identified four molecular subtypes, including POLE ultra-mutated, microsatellite instability hypermutated, copy-number low, and copy-number high, which strongly correlate with prognosis. Surrogate markers-based molecular classification methods have been developed to make these molecular classifications accessible and affordable, achieving classification into POLEmut, mismatch repair deficient (MMRd), p53abn, and no specific molecular profile (NSMP) with normal p53 expression. Although POLEmut EC has aggressive pathologic features, there are few cases of advanced and/or recurrence. Therefore, the possibility of de-escalating adjuvant therapy can be considered. Additionally, immune checkpoint inhibitors (ICI) may be a candidate for treating advanced and recurrent POLEmut EC because of their high immunogenicity. MMRd EC shows an intermediate prognosis between those of POLEmut and p53abn EC. MMRd EC is generally characterized by high immunogenicity similar to POLEmut EC, suggesting that ICI can also be a potential therapeutic agent. Among the four molecular subtypes, p53abn EC has the worst prognosis. However, some p53abn tumors have the molecular hallmark of homologous recombination deficiency and could be treated with poly (ADP-ribose) polymerase inhibitors. In addition, some p53abn tumors overexpress the human epidermal growth factor receptor 2, which can also be a potential therapeutic target. NSMP EC are a heterogeneous population because they lack characteristic molecular biological features. Approximately half of the NSMP EC show high expression of estrogen receptor/progesterone receptor, suggesting the possibility of hormonal therapy. In addition, the PI3K/AKT/mTOR pathway frequently altered in EC may be a therapeutic target. This review summarizes the molecular biological characteristics and potential therapeutic agents in molecularly featured EC. Several clinical trials are in progress to stratify EC into molecular classifications and demonstrate the efficacy and safety of molecularly matched treatment and management strategies.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 7-17"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45204968","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 community strategy package on uptake of reproductive tract infections health services among young street females in the municipality of Eldoret, Kenya","authors":"C Violet Maritim ,&nbsp;Anthony Wanyoro ,&nbsp;John Maingi ,&nbsp;Jackim Nyamari ,&nbsp;Murima Ng'ang'a","doi":"10.1016/j.gocm.2023.01.009","DOIUrl":"10.1016/j.gocm.2023.01.009","url":null,"abstract":"<div><h3>Background</h3><p>Despite the intervention of free medical care services for street children by a dedicated clinic in Eldoret municipality, health care service of young street females (YSFs) is still deficient. The present study aimed to evaluate the impact of the community strategy package on the uptake of reproductive tract infections (RTI) health services among the target population.</p></div><div><h3>Materials and methods</h3><p>A pre-test-post-test quasi-experimental with a qualitative and quantitative approach was applied among the YSFs aged 10–24 years. The study used structured questionnaires and key informant interviews to collect data from the respondents.</p></div><div><h3>Results</h3><p>The study enrolled a total of 77 young street females in Eldoret municipality. A significantly higher proportion of respondents reportedly first sought treatment for RTI at a health facility after the implementation of the community strategy package (97.1%) when compared to the proportion of respondents who first sought treatment at a health facility in the pre-intervention phase (51.0%)(<em>p</em>＜0.001). Early seeking of treatment improved significantly after the introduction of the intervention; 72.0% and 94.1% of the respondents sought treatment early during the pre-intervention and post-intervention phase, respectively (<em>p ​= ​0.011</em>).</p></div><div><h3>Conclusion</h3><p>The study recommends the adoption of the community strategy as an intervention to increase the uptake of RTIs health services and promotion of the reproductive health of young street females.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 60-64"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45872951","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":"Corrigendum to “Incidental bilateral ovarian paraganglioma of uterine fibroid with widespread adenomyosis: A case report” [Gynecol Obstet Clin Med 2 (4) (2022) 208–210]","authors":"Zaibun Nisa,&nbsp;Dhafir Al-Okati,&nbsp;Olugbenga Duroshola,&nbsp;Deepali Bhatte","doi":"10.1016/j.gocm.2023.02.001","DOIUrl":"10.1016/j.gocm.2023.02.001","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Page 70"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43349873","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":"Cytogenetic analysis and family research for two cases of chromosome 6 microduplication and chromosome 9 microdeletion: Different clinical manifestations","authors":"Lin Zhang,&nbsp;Mei Hong Ren,&nbsp;Guining Song,&nbsp;Xuexia Liu,&nbsp;Yanhui Li,&nbsp;Chengling Zhang,&nbsp;Xiaohong Zhang","doi":"10.1016/j.gocm.2023.01.003","DOIUrl":"10.1016/j.gocm.2023.01.003","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 65-69"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47313008","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":"Update of sentinel lymph node mapping assessment in endometrial cancer","authors":"Se Ik Kim,&nbsp;Jae-Weon Kim","doi":"10.1016/j.gocm.2023.01.005","DOIUrl":"10.1016/j.gocm.2023.01.005","url":null,"abstract":"<div><p>Endometrial cancer is the most common gynecologic malignancy in developed countries. Pathologic confirmation of lymph node metastasis is important for risk stratification and the administration of adjuvant treatments. Therefore, comprehensive, systematic lymphadenectomy has been routinely performed but has been associated with various morbidities. Meanwhile, the concept of sentinel lymph node (SLN) mapping and biopsy has emerged and is now accepted as an alternative to conventional systematic lymphadenectomy in early-stage endometrial cancer. For better management of endometrial cancer, we conducted a literature review to summarize the role and diagnostic accuracy of the SLN mapping strategy in endometrial cancer. Evidence from the monumental and recent literature and ongoing clinical trials will be introduced.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41739147","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":"Clinical significance of extended high-risk human papillomavirus genotyping and viral load in cervical cancer and precancerous lesions","authors":"Pingping Su ,&nbsp;Jincheng Ma ,&nbsp;Lirui Yu ,&nbsp;Shuting Tang ,&nbsp;Pengming Sun","doi":"10.1016/j.gocm.2023.01.001","DOIUrl":"10.1016/j.gocm.2023.01.001","url":null,"abstract":"<div><p>Persistent infections with specific high-risk human papillomavirus (HR-HPV) strains are the leading cause of cervical cancer and precancerous lesions. HPV-16 and HPV-18 are associated with more than 70% of cervical cancer. However, with recent widespread vaccination efforts against cervical cancer, the infection rates of HPV-16 and HPV-18 have decreased across all age groups, while the infection rates of other HR-HPV strains have increased. The non-16/18 HR-HPV strains play an important role in cervical lesions. These strains can be identified with extended genotyping, and the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines recommended an HPV-based testing to assess the risk of cervical disease in patients. We reviewed and analyzed the clinical benefits of applying extended HR-HPV genotyping, which was published by the International Agency for Research on Cancer (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), to cervical cancer screening. This review concluded that cervical cancer screening needs to include extended HR-HPV genotyping. The examination of extended HR-HPV genotyping in cervical intraepithelial lesions and cervical cancers can help guide clinical practices.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 22-29"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45406191","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":"Influence of assisted reproductive technology and uterine leiomyoma on pregnancy outcomes in women with adenomyosis","authors":"Yi-Ling Wang ,&nbsp;Zhao Tian ,&nbsp;Xiao-Hong Chang,&nbsp;Hong-Lan Zhu,&nbsp;Heng Cui","doi":"10.1016/j.gocm.2023.01.008","DOIUrl":"10.1016/j.gocm.2023.01.008","url":null,"abstract":"<div><h3>Aim</h3><p>To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma (UL).</p></div><div><h3>Methods</h3><p>We performed a retrospective study. Fifty-three singleton pregnancy cases complicated with adenomyosis were included in this study. In the study group, 15 women became pregnant with assisted reproductive technology (ART) and 21 women combined with UL. Pregnancy outcomes were compared between ART and non-ART, UL and non-UL groups.</p></div><div><h3>Results</h3><p>The prevalence for such complications as hypertensive disorder complicating pregnancy (HDCP)and postpartum hemorrhage (PPH)were significantly higher in the women conceived by ART (33.3% vs. 5.3%, P ​= ​0.023) and (53.3% vs. 23.7%, P ​= ​0.037),respectively. And women concurrent with UL of which the diameter≥4 ​cm were more likely to have severe PPH (44.4% vs. 0%, P ​= ​0.021).</p></div><div><h3>Conclusion</h3><p>ART may increase the risk of adverse pregnancy outcomes such as HDCP and PPH in women with adenomyosis and UL of which the diameter≥4 ​cm may further increase the risk of severe PPH.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 56-59"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44903893","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":"Advances in diagnosis, clinical management and molecular characterization of ovarian Brenner tumors","authors":"Valentina Zanfagnin ,&nbsp;Tiffany Lee ,&nbsp;Chengquan Zhao ,&nbsp;Tiannan Wang","doi":"10.1016/j.gocm.2023.01.007","DOIUrl":"10.1016/j.gocm.2023.01.007","url":null,"abstract":"<div><p>Brenner tumors is a very uncommon ovarian epithelial neoplasm, morphologically resembling the transitional cell neoplasm of urinary tract. It is further classified into three subtypes as a disease spectrum based on histological examination and tumorigenesis: benign Brenner tumors, borderline Brenner tumors (BBTs), and malignant Brenner tumors (MBTs). The etiology of these tumors is not well understood, and literature is limited due to the rarity of this entity, but recent advances, particularly in molecular alterations, have emerged. The scope of this review is to provide an update on the clinical, histopathological, and most recently, molecular characterizations of ovarian Brenner tumors.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 18-21"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47543237","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":"Characteristics of molecular classification in 52 endometrial cancer and atypical hyperplasia patients receiving fertility-sparing treatment","authors":"Yiqin Wang ,&nbsp;Nan Kang ,&nbsp;Liwei Li ,&nbsp;Zhiqi Wang ,&nbsp;Rong Zhou ,&nbsp;Danhua Shen ,&nbsp;Jianliu Wang","doi":"10.1016/j.gocm.2023.01.006","DOIUrl":"10.1016/j.gocm.2023.01.006","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the molecular classification of endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) patients treated with fertility-sparing treatment (FST), and its relationship with clinicopathological factors and treatment efficacy. Methods: A total of 52 ​EC and AEH patients who received FST and molecular classification tested by next generation sequencing in Peking University People's Hospital from June 2020 to December 2022, were retrospectively collected. We analyzed the relationship between molecular classification and clinicopathological factors and treatment outcomes.</p></div><div><h3>Results</h3><p>(1) Of the 52 patients, including 46 ​EC and 6 AEH patients, 42 (80.8%) achieved complete remission (CR) after FST, with a median time to achieve CR of 9 months. Ten cases (23.8%) had recurrence. (2) Patients were distributed into 4 molecular subgroups as 39 cases (75%) of copy number low (CNL) , 7 cases (13.5%) of microsatellite instability-high (MSI-H) , 4 cases (7.7%) of POLE mutations (POLEmut), and 2 cases (3.8%) of copy number high (CNH). Patients with MSI-H subgroup had more family history of tumor (6/7), more with loss of expression of mismatch repair (MMR) protein (7/7), and higher expression level of Ki-67 (3/3). (3) Patients with MSI-H subgroup had the lowest CR rate at 6 months (0/7, P ​= ​0.014), and survival analysis showed that such patients were less likely to achieve CR than those with CNL (P ​= ​0.022). For CNL patients, median 6-month CR rate was 40.6%. In addition, CR was obtained in 3 (3/4) POLEmut patients and 2 (2/2) CNH patients, respectively.</p></div><div><h3>Conclusions</h3><p>Molecular classification relates with the treatment response in patients with EC and AEH receiving FST. Patients with MSI-H subgroup have poor treatment efficacy, and patients with CNL need to be further divided to predict treatment benefit. There are also a few successful cases in POLEmut and CNH subtgroups, which needs further research.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 38-43"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46556976","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":"Urban-rural differences in the pregnancy-related adverse outcome","authors":"Vahid Mehrnoush ,&nbsp;Amene Ranjbar ,&nbsp;Farzaneh Banihashemi ,&nbsp;Fatemeh Darsareh ,&nbsp;Mitra Shekari ,&nbsp;Malihe Shirzadfardjahromi","doi":"10.1016/j.gocm.2022.12.001","DOIUrl":"10.1016/j.gocm.2022.12.001","url":null,"abstract":"<div><h3>Background</h3><p>Little is known about potential urban-rural differences in adverse pregnancy outcomes. The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outcomes.</p></div><div><h3>Methods</h3><p>We retrospectively assessed the pregnancy outcome of singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups based on living residency: 1) urban groupand 2) rural group.Demographic factors, obstetrical factors, maternal comorbidities, and adverse maternal and neonatal outcomeswere extracted from the electronic data of each mother. The Chi-square testwas used to compare differences between the groups for categorical variables. Logistic regression models were used to assess the association of adverse pregnancy, childbirth, and neonatal outcome with living residency.</p></div><div><h3>Results</h3><p>Of 8888 mothers that gave birth during the study period, 2989 (33.6%) lived in rural areas. Adolescent pregnancy was more common in the rural area. Urban mothers had a higher education than rural mothers. Rural mothers were at higher risk for preterm birth aOR 1.81 (CI:1.24-2.99), post-term pregnancy aOR 1.5 (CI: 1.07-2.78), anemia aOR 2.02 (CI:1.07-2.34), low birth weight (LBW) aOR 1.89 (CI: 1.56-2.11), need for neonatal resuscitation aOR 2.66 (CI: 1.78-3.14), and neonatal intensive care unit (NICU) admission aOR 1.98 (CI:1.34-2.79). On the other hand, the risk of cesarean section was significantly lower compared to urban mothers aOR 0.58 (CI: 0.34-0.99).</p></div><div><h3>Conclusions</h3><p>Our study discovered that mothers living in rural areas had a higher risk of developing anemia, preterm birth, post-term pregnancies, LBW, need for neonatal resuscitation, and NICU admission, but a lower risk of cesarean section.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"3 1","pages":"Pages 51-55"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43914961","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}