ObjectiveTo explore the relationship between p53 mutation in 5-8 exons and type of epithelial ovarian cancer (EOC) pathogenesis of Han nationality women. MethodsFrom August 2011 to December 2012, 45 patients with primary EOC (Han nationality women from Sichuan Province) diagnosed surgically and pathologically were selected. Using direct DNA sequencing, we analyzed the mutations of p53 in 5-8 exons of all cases, and the EOC patients were divided into two types according dualism and the pathogenesis results. The p53 mutation of the different types in EOC patients were analyzed. ResultsThe frequency and efficiency of p53 mutation in type-ⅡEOC patients were significantly higher than that in typeⅠ(P < 0.01). And the codon 175 might be a mutational hotspot of type-ⅡEOC. The malignant degree and oviduct involved frequency of type-ⅡEOC were obviously higher than that of type-I EOC; p53 mutation frequency in high malignant patients increased significantly. Conclusionsp53 mutation plays an important role in the development of type-ⅡEOC. The codon 175 might be a mutational hotspot of type-ⅡEOC.
Extracellular matrix (ECM) has been implicated in tumor progress and chemosensitivity. Ovarian cancer brings a great threat to the health of women with a significant feature of high mortality and poor prognosis. However, the potential significance of matrix stiffness in the pattern of long non-coding RNAs (lncRNAs) expression and ovarian cancer drug sensitivity is still largely unkown. Here, based on RNA-seq data of ovarian cancer cell cultured on substrates with different stiffness, we found that a great amount of lncRNAs were upregulated in stiff group, whereas SNHG8 was significantly downregulated, which was further verified in ovarian cancer cells cultured on polydimethylsiloxane (PDMS) hydrogel. Knockdown of SNHG8 led to an impaired efficiency of homologous repair, and decreased cellular sensitivity to both etoposide and cisplatin. Meanwhile, the results of the GEPIA analysis indicated that the expression of SNHG8 was significantly decreased in ovarian cancer tissues, which was negatively correlated with the overall survival of patients with ovarian cancer. In conclusion, matrix stiffening related lncRNA SNHG8 is closely related to chemosensitivity and prognosis of ovarian cancer, which might be a novel molecular marker for chemotherapy drug instruction and prognosis prediction.
The mortality rate of ovarian cancer is the highest among female reproductive tract malignancies. Although most patients have undergone recurrent treatments such as surgery, chemotherapy, and targeted therapy, the recurrence rate is still high. The exploration of scholars in this field has never stopped. In recent years, remarkable achievements have been made in the medical treatment of ovarian cancer. The research of poly adenosinediphosphate-ribose polymerase, immunotherapy (immunocheckpoint inhibitor monotherapy, immune checkpoint inhibitor combined with other drugs) and anti-angiogenic drugs have provided new methods for the treatment of this disease, and throughout the whole process of ovarian cancer treatment. This paper summarizes this, and aims to provide a reference for the clinical treatment of ovarian cancer.
Objective To systematically assess literature regarding the relationship between ovulation induction and the risk of ovarian cancer. Methods We searched MEDLINE, EMbase, The Cochrane Library, CBM and CNKI (from inception to Feb, 2012). Cohort or case-control studies were identified according to the inclusion and exclusion criteria. Then the quality of the included studies was assessed, and the data was extracted. Meta-analysis was performed by RevMan 5.0 software. The incorporated RR (relative risk) and 95%CI (confidence interval) of the included cohort studies and incorporated OR (odds ratio) and 95%CI of case-control studies were calculated, respectively. Results Four cohort studies and four case-control studies were included. Result of meta-analysis on cohort studies showed ovulation induction didn’t increase the risk of ovarian cancer (RR=1.07, 95%CI 0.81 to 1.42, P=0.63). Besides, result of meta-analysis on case-control studies showed ovulation induction was not associated with the incidence of ovarian cancer (OR=1.28, 95%CI 0.78 to 2.08, P=0.33). But the risk of borderline ovarian tumors increased when compared with general population controls (OR=1.71, 95%CI 1.05 to 2.79, P=0.03). Conclusion Ovulation induction does not increase the risk of ovarian cancer, but may relate to the incidence of borderline ovarian cancer. However, more high-quality studies, especially perspective cohort studies are required because of the limited quantity of the included studies.
Objective To use a meta-analysis method to establish quantitatively the association between the HER-2/neu gene amplification/enhanced protein expression status and the 5-year post-operative survival rate or median survival time in women with epithelial ovarian carcinoma. Methods We searched and screened Chinese and English literature published since 1989 to collect all retrospective cohort studies on the prognostic significance of HER-2/neu status in this population. The survival data were analyzed using Ludwig’s centered signed rank and the DerSimonian-Laird method. Results In total, 25 studies involving 3 251 patients were included. HER-2/neu was positive in 27.1% (95%CI 0 to 54.8%) of patients, which was not related to the pathological stage, type or grade of epithelial ovarian carcinoma. In HER-2/neu positive cases, the median survival time was shortened by 0.65 years, and the 5-year survival rate was lowered. The hazard ratio (HR) for mortality was 1.22 (95%C 1.09 to 1.36). By subgroup analysis, HER-2/neu protein expression was found to be most significant in prognostic assessment. Patients with a b positive value of HER-2/neu had an increased HR for the 5-year survival; and platinum-based chemotherapy was demonstrated to be less effective in HER-2/neu positive ovarian carcinoma. Conclusion In gynecological oncology, it is reasonable to measure HER-2/neu as a routine pathological marker to predict a patient’s prognosis and to determine the most appropriate adjuvant chemotherapy regimen.
目的 评价肿瘤细胞减灭术治疗复发上皮性卵巢癌（EOC）的作用，分析影响生存时间的因素。 方法 按Cochrane系统评价方法，计算机检索PubMed、EMbase、Medline、Cochrane Library、循证医学数据库（EBMR）、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CJFD）、清华同方等数据库，并手工检索相关领域杂志。检索时间从1985年1月1日－2011年11月30日，查找手术治疗复发EOC患者的回顾性、非随机前瞻性、病例对照研究，由两位研究者按照纳入排除标准筛选文献、评价质量并提取资料后，采用SPSS软件进行线性回归分析。 结果 共纳入48篇文献（回顾性文献40篇，非随机前瞻性文献7篇，病例对照研究1篇）共2 605例。简单线性回归分析结果显示满意切除比例与中位生存时间回归模型成立，有统计学意义（F=7.346，P=0.009），浆液性病理类型比例与中位生存时间回归模型成立，有统计学意义（F=5.537，P=0.025），残留病灶大小与中位生存时间回归模型成立，有统计学意义（F=4.249，P=0.045），多重逐步线性回归分析显示仅有满意切除比率对术后中位生存时间的影响有统计学意义（P=0.009）。 结论 二次肿瘤细胞减灭术主要适用于铂类敏感型可切除及孤立结节复发EOC患者，要获得明确二次肿瘤细胞减灭术治疗复发EOC对中位生存时间的影响，尚需进行大样本随机对照的研究。
Objective To systematically review the prognostic value of progesterone receptor (PR) for survival in ovarian cancer. Methods PubMed, EMbase, MEDLINE, The Cochrane Library (Issue 1, 2016), CNKI, VIP, CBM and WanFang Data databases were searched for cohort studies on the correlation between PR expression and prognosis of ovarian cancer from inception to June 1st 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 12 studies involving 1 881 patients were included. The results of meta-analysis showed that the PR positive patients was superior than the PR negative patients on overall survival (OS) (HR=0.64, 95%CI 0.44 to 0.93,P=0.02), disease free survival (DFS) (HR=0.64, 95%CI 0.48 to 0.85,P=0.002), progression free survival (PFS) (HR=0.62, 95%CI 0.47 to 0.82,P=0.000 9) and remission rate of chemotherapy (OR=1.91, 95%CI 1.28 to 2.86,P=0.002). When analysis based on the clinical pathogesis stages, PR expression was higher in clinical stages Ⅰ-Ⅱ than stage Ⅲ-Ⅳ (OR=2.38, 95%CI 1.71 to 3.32,P<0.000 01), and was higher in cell differentiation G1-G2 than G3 (OR=2.48, 95%CI 1.72 to 3.56,P<0.000 01), while no significant difference was found in groups of serous ovarian cancervs. non serous ovarian cancer (OR=1.28, 95%CI 0.89 to 1.83,P=0.18). Conclusion The current evidence shows that the expression of PR protein have predictive value for the prognosis of ovarian cancer. Due to limited quantity and quality of included studies, the above conclusions are still needed to verified by more high quality studies.
ObjectivesTo systematically review the efficacy of Chinese herbal medicine (CHM) combined with chemotherapy for ovarian cancer.MethodsCNKI, VIP, WanFang Data and PubMed databases were searched to collect randomized controlled trials on the CHM combined with chemotherapy for ovarian cancer from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsThirteen studies were included. Meta-analysis showed that, CHM combined with chemotherapy group was superior to the chemotherapy alone group in effective rate of TCM syndrome (RR=1.72, 95%CI 1.46 to 2.03, P<0.00.000 1), effective rate of tumor change (RR=1.40, 95%CI 1.21 to 1.63,P<0.000 01), physical condition score (MD=9.19, 95%CI 5.89 to 12.48,P<0.000 01), tumor markers (MD=–18.00, 95%CI –20.62 to –1.538,P<0.000 01), leukocyte reduction (RR=0.67, 95%CI 0.58 to 0.77,P<0.000 01), granulocy tedepletion (RR=0.67, 95%CI 0.55 to 0.81,P<0.000 1), thrombocytopenia (RR=0.55, 95%CI 0.45 to 0.69,P<0.000 01), and digestive tract reaction (RR=0.66, 95%CI 0.50 to 0.87,P=0.004).ConclusionsThe current evidence shows that CHM combined with chemotherapy is superior to chemotherapy alone in the treatment of ovarian cancer. Due to limited quality and quantity of included studies, the above conclusions are required to be verified by more high-quality studies.
Objective To estimate the diagnostic value of mesothelin in ovarian cancer. Methods PubMed, The Cochrane Library, CBM, CNKI and WanFang Data databases were searched from inception to October 2016 to collect relevant diagnostic accuracy studies of mesothelin in ovarian cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed using Meta-Disc 1.4, Stata 12.0 and RevMan 5.2 softwares. The pooled sensitivity, specificity and diagnostic odds ratio were calculated, the summary receiver operating characteristic curve (SROC) was drawn and the area under the curve (AUC) was calculated. Results Seventeen studies involving 2 052 patients were included. The pooled sensitivity, specificity, DOR were 0.63 (95%CI 0.60 to 0.67), 0.92 (95%CI 0.90 to 0.93) and 26.62 (95%CI 14.96 to 47.38), respectively. The AUC and Q index were 0.915 1 and 0.847 8, respectively. Conclusion The current evidence indicates that mesothelin has high specificity and low sensitivity, which can’t be used alone as a biomarker for the detection of ovarian cancer, but should be combined with other biomarkers.
至2002年2月,有关晚期卵巢癌的手术治疗效果和细胞毒性化疗效果的临床证据如下:⑴在改进生活质量方面的任何治疗效果的证据都不充分. ⑵晚期卵巢癌的手术治疗: ①先行手术加化疗与单用化疗相比较:缺乏相关RCT. ②先行手术与不手术比较:缺乏相关RCT. ③在初次手术加化疗后一定间隔期的缩瘤术:1个RCT发现,初次手术加化疗后一定间隔期的缩瘤术提高总的存活年限为3.5年;另1个RCT则认为该方法对存活率没有显著性作用,但可能系检验效能不够而没有发现潜在的临床重要作用. ④常规二次手术:2个RCT认为,在晚期卵巢癌初次手术后常规进行二探手术的存活率并不优于术后只进行化疗的对照组. ⑶晚期卵巢癌的细胞毒性药物化疗: ①铂剂+紫杉醇方案:1篇系统评价和另1个RCT认为,晚期卵巢癌初次手术后,以铂剂+紫杉醇为基础的化疗能延长存活时间和总存活率. ②含铂剂的化疗方案:1篇系统评价发现,铂剂加入任何不含铂剂的方案都能显著提高存活率,尤其是铂剂加入联合治疗方案. ③卡铂+紫杉醇与卡铂+多烯紫杉醇比较:未找到比较这两种方案疗效的高质量RCT. ④含铂剂的联合方案与不含铂剂的联合方案比较:7个RCT比较了这两种方案;大多数RCT发现含铂剂的方案能改善结局,其益处和危害依赖于具体方案;没有研究显示铂剂能显著减少存活时间和总存活率. ⑤联用铂剂与单用铂剂比较:1篇系统评价和另3个RCT认为没有证据表明,延长存活时间和总存活率上,联用铂剂优于单用铂剂. ⑥紫杉醇+顺铂与紫杉醇+卡铂比较:1个RCT表明在延长存活时间和总存活率上两者无显著性差异,虽然不足以排除临床上的重要作用.