Rationale:Primary squamous cell carcinoma of the endometrium (PSCCE) is a rare entity, and only sporadic cases have been reported in the literature since the 1st report in 1892. This report describes a case of a perimenopausal woman with PSCCE.Patient concerns:A 47-year-old, human papilloma virus type 16-positive, perimenopausal woman was admitted to our hospital with irregular vaginal bleeding for 6 months and secondary anemia.Diagnoses:The patient was diagnosed with stage IIIc primary and moderately differentiated endometrial squamous cell carcinoma.Interventions:The patient underwent diagnostic curettage twice and cold knife conization (CKC). Following this total abdominal hysterectomy combined with bilateral adnexectomy and pelvic lymph node, dissection was performed. After the surgery, the patient was treated with radiotherapy and chemotherapy. Tumor markers were followed up regularly after the operation to monitor tumor recurrence and therapeutic effect.Outcomes:Ninety-two days after the operation, there was tumor recurrence of the left pelvic cavity and the patient died after 11 months of follow-up.Lessons:Intrauterine pathology after the 1st diagnostic curettage suggests that high-grade squamous intraepithelial lesion should make the clinician vigilant and investigate the origin of the lesion. Magnetic resonance imaging scans and tumor markers can be used to confirm the diagnosis as soon as possible and avoid unnecessary interventions like CKC.
Rationale: Hepatic ectopic pregnancy is an extremely rare ectopic pregnancy. This study aimed to report a case of primary hepatic pregnancy in a patient with polycystic syndrome. Patient concerns: A 30-year-old woman presented with vaginal bleeding after 63 days of amenorrhea. Diagnosis: The patient was initially diagnosed with liver ectopic pregnancy using abdominal ultrasound and abdominal computed tomography (CT). Interventions: The patient underwent laparoscopic exploration to reconfirm the gestational sac in the liver and abdominal surgery to remove liver gestation. The postoperative review of abdominal CT and the level of serum human chorionic gonadotropin (hCG) was performed. Outcomes: The postoperative pathological examination revealed a fluffy tissue in the liver tissue and a blood clot. The patient's vital signs were normal, and she was advised regular follow-up after discharge from the hospital. One month later, the serum hCG level reduced to 0.32 mIU/mL (reference range 0–5 mIU/mL). Lessons: If the level of beta-human chorionic gonadotropin (β-HCG) is higher than normal in women of childbearing age and no gestational sac is found in the uterine cavity, the location of pregnancy and gestational sac should be positively confirmed. Also, the possibility of ectopic pregnancy in the abdominal cavity should be considered, and the relevant imaging and biochemical examinations should be improved to avoid delay in diagnosis and treatment.
Background In recent years, silver nanoparticles (AgNPs) have gradually been widely used, especially in the field of anticancer medicine. Ovarian cancer (OC) is the gynaecological malignancy with the highest mortality rate, and the current treatment is still based on surgery, chemotherapy and postoperative targeted therapy. Therefore, the development of safe and effective nanoparticles for targeted therapy of OC is very important. This study aimed to prepare a new type of triangular silver nanoparticles (tAgNPs) and evaluate the anticancer properties for OC in vitro and in vivo. Methods The tAgNPs were chemically synthesized and characterized using scanning electron microscopy (SEM), ultraviolet (UV) spectrophotometry and other techniques. By performing cell-based tests, such as cell counting kit-8 (CCK-8), plate colony formation, cell apoptosis, reactive oxygen species (ROS), and western blot (WB) assays, the inhibitory effects and related mechanisms of tAgNPs on OC cells were analysed.The anticancer effect of tAgNPs in vivo was verified by a SKOV3 tumor-bearing mouse model. Results Five types of tAgNPs with different colours were successfully synthesized, with a particle size of 25–50 nm and a good dispersion. The results of in vitro experiments showed that tAgNPs treatment reduced the viability and proliferation of SKOV3 cells, arrested the cell cycle in G0/G1 phase, inhibited the expression levels of proliferation-related factors and cyclins, and promoted cell apoptosis by producing ROS and increasing caspase-3 activity. Consistent with the results of in vitro experiments, in vivo animal experiments also showed that tAgNPs significantly inhibited the proliferation of ovarian cancer. More importantly, no obvious toxic and side effects were observed. Conclusions In this study, a novel triangular AgNPs was successfully prepared. tAgNPs are very stable, significantly inhibit the proliferation of OC cells and tumour growth in tumour-bearing mice, providing a promising nanotargeted therapy for OC.
Objective: To investigate the infection status of high-risk human papillomavirus (HR-HPV) E6/E7 mRNA in patients with a cytological diagnosis of "atypical squamous cells of undetermined significance" (ASCUS) and to analyze the pathogenic rate of different high-risk HPV subtypes combined with biopsy pathological results to provide a more accurate basis for managing ASCUS patients. Methods A total of 1387 patients with ASCUS and HPV E6/E7 mRNA positivity who were referred for colposcopy were retrospectively analyzed. They were divided into HPV16+, 18/45+ and other HR-HPV+ groups premenopausal and postmenopausal groups. The pathological results of the biopsy were divided into the LSIL- group (including normal and low-grade squamous intraepithelial lesions) and the HSIL+ group (including high-grade squamous intraepithelial lesions and higher lesions). SPSS was used for the analysis. Results The age group 31-40 years had the highest level of HPV16+, and HPV18/45+ was the highest in the 41-50 years group. The detection rates of HSIL+ in the HPV16+, HPV18/45+, HPV 16/18/45+ and Other HR-HPV+ groups were 48.4%, 18.8%, 43.9% and 15.0%, respectively. The infection rates of HPV16/18/45 in postmenopausal and premenopausal women were 42.4% and 34.3%, respectively. In the HPV18/45 group, the incidence of HSIL+ was 30.0% in postmenopausal women and 15.0% in premenopausal women (P < 0.01). In the HPV 16+ and Other HR-HPV+ groups, the incidence of HSIL+ in postmenopausal patients was not significantly different from that in premenopausal patients. The incidence of cervical cancer in postmenopausal patients is significantly higher than that in premenopausal patients. Conclusions Colposcopy referral or further biopsy is recommended for all ASCUS patients with HPV16/18/45E6/E7 mRNA positivity and postmenopausal patients with HR-HPVE6/E7 mRNA positivity. For premenopausal ASCUS patients with other HR-HPV E6/E7 mRNA positivity, colposcopy should be performed if possible, depending on the specific situation, to achieve early detection and diagnosis.
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