ObjectiveTo systematically review the prognostic efficacy and safety of patients with ovarian cancer treated with systemic lymphadenectomy (SL). MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on the prognostic outcomes of patients with ovarian cancer treated with SL from inception to December 16th, 2020. Six reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 5 RCTs and 23 cohort studies involving 6 166 patients were included. The results of meta-analysis showed that there were no significant differences in the 3-year survival rate, 5-year survival rate, 3-year progression-free survival rate, and 5-year progression-free survival rate between SL group and the no systemic lymphadenectomy (NSL) group. The results of the subgroup analysis showed that pelvic and para-aortic lymph node dissection combined with large omentum resection had a better prognosis for patients. ConclusionsCurrent evidence shows that SL has no significant efficacy on survival and progression-free survival in patients with ovarian cancer. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Objective To make an individualized therapeutic regimen for a patient with stage III relapsed ovarian cancer guided by evidence-based medicine.Methods According to the clinical problems this patient showed and the PICO (patient, intervention, comparison and outcome) principle, the best clinical evidence associated with relapsed ovarian cancer was retrieved and evaluated. Results The current evidence showed that the relapsed ovarian cancer with platinum resistance tended to be treated by pharmacotherapy. Consequently, on the basis of combining the recommended guidelines, randomized controlled trials (RCTs), systematic reviews or meta-analyses on RCTs, clinical experience from doctors and willingness of patient, the regimen of Irinotecan plus Pegylated Liposomal Doxorubicin for interventional chemotherapy was recommended for this patient. After three courses of the treatment, the disease got some relieved; the medical team would like to keep conducting the same regimen for another six to eight courses, and the follow-up visit was undergoing. Conclusion For patients with relapsed ovarian cancer with platinum resistance, an individualized therapeutic regimen under the guidance of evidence-based methods can not only improve the therapeutic efficacy but also guide both doctors and patients to take the indeterminate risk of medicine.
ObjectiveTo explore the prevalence rate of gynecologic diseases and its character of age distribution of women in Chengdu, China. MethodsWe retrospectively analyzed gynecologic examination reports of women who underwent physical examination from December 2011 to November 2012. ResultsThis study included 23 389 women; the overall detection rate of cervix erosion was 20.98%. The detection rate of cervix erosion of women aged from 20 (included) to 30 was 44.81%, ranking first. The overall rate of abnormal cervical cytology was 0.93%, and the rate of women aged 41 to 50 was 1.20%, ranking first. The overall detection rate of uterine myoma, uterine adenomyosis, and ovarian tumor was 11.12%, 1.33%, and 3.60%, respectively. Fourty-one to 50 was the peak age of uterine myoma, uterine adenomyosis, and ovarian tumor; the detection rate was 19.95%, 2.46%, and 4.76%, respectively. The difference was significant in different age (P<0.05). ConclusionThe detection rate of gynecological common disease is high in childbearing aged women. Women aged 41-50 is the high-risk population of gynecological common disease.
ObjectiveTo systematically review the efficacy and safety of intravenous calcium infusion for preventing ovarian hyperstimulation syndrome (OHSS). MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 7, 2015), CNKI, Sinomed and WanFang Data were searched from inception to July 2015 to collect randomized controlled trials (RCTs) and non-RCTs about intravenous calcium infusion for OHSS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of six studies involving 1 061 women were included. The results of meta-analysis showed that intravenous calcium infusion could reduce the incidence of moderate OHSS (RR=0.27, 95% CI 0.11 to 0.65, P=0.003), but not the incidence of severe OHSS (RR=0.77, 95% CI 0.23 to 2.63, P=0.68). In addition, intravenous calcium infusion had a tendency to increase the pregnant rate (RR=1.19, 95% CI 0.94 to 1.50, P=0.15). The subgroup analysis showed that, compared with placebo/no treatment, intravenous calcium infusion reduced the incidence of moderate OHSS, but not the incidence of severe OHSS. There were no statistical differences between intravenous calcium infusion and other positive control (cabergoline and hydroxyethyl starch) in the incidence of OHSS and pregnant rate. No side effect was reported in the studies included. ConclusionsCurrent evidence indicates that intravenous calcium infusion can reduce the incidence of OHSS without influence pregnant outcomes. Due to the quantity and quality limitations of included studies, more high quality case-control or cohort studies are needed to verify the above conclusions.
OBJECTIVE To determine the effect of basic fibroblast growth factor (bFGF) on the biological behaviour of ovarian epithelial neoplasm. METHODS Ten cases of normal ovarian tissues and eighty cases of ovarian epithelial tumor tissues were detected by immunohistochemical methods. Mias-2000 Picture Analysis System was used to study the relationship of bFGF expression intensity and microvessel count, FIGO stage, pathological grade and classification of ovarian epithelial neoplasm. RESULTS 1. Expression of bFGF was mainly in cytoplasm and nucleus in several cells of borderline and malignant tumor. 2. The expression intensity of bFGF was closely related to the malignant degree of ovarian epithelial neoplasm. The density of bFGF expression was (3.35 +/- 3.52)% in normal ovarian epithelium, (19.25 +/- 21.73)% in benign tumor, (33.78 +/- 10.86)% in borderline tumor and (48.18 +/- 12.93)% in malignant tumor. The results indicated that bFGF might play an important role in carcinogenesis of ovarian epithelial neoplasm. 3. The expression intensity of bFGF was increased with the FIGO stage of ovarian tumor. 4. The expression intensity of bFGF was increased accompanying with the decrease of differentiation degree in ovian neoplasm. 5. In borderline tumor, expression intensity of bFGF in serous cystadenoma was significantly higher than in mucinous cystadenoma, which indicated bFGF might be an important factor in canceration of ovarian epithelial neoplasm. CONCLUSION bFGF may play important roles in carcinogenesis, development, invasion and metastasis of ovarian epithelial neoplasm.
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.
Ovarian cancer is one of the common malignant tumors of female genital organs. In gynecological tumors, the incidence rate of ovarian cancer ranks the third after cervical cancer and uterine body cancer, but the death rate of ovarian cancer ranks the first, posing a serious threat to women’s life and health. In recent years, the National Comprehensive Cancer Network (NCCN) clinical practice guidelines for ovarian cancer has become an important basis for diagnosis and treatment of ovarian cancer. In this paper, we interpret the latest version (version 4. 2017) of NCCN clinical practice guidelines for ovarian cancer for its better clinical application.
ObjectiveTo systematiclly review the correlation between physical activity and the risk of ovarian cancer. MethodsSuch databases as CBM, CNKI, WanFang Data, VIP, The Cochrane Library (Issue 10, 2013), PubMed, EMbase were searched from database establishment to October 2013 to collect prospective cohort studies about physical activities and the risk of ovarian cancer. Relevant magazines and references of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 8 cohort studies involving 580 581 subjects, of which there were 2 444 cases of patients with ovarian cancer. The results of meta-analysis showed that, women who participated in moderate level physical activities tended to have a lower incidence of ovarian cancer, compared with those who participated in low level physical activities (age-adjusted:RR=0.87, 95%CI 0.75 to 1.01, P=0.06; multivariate-adjusted:RR=0.97, 95%CI 0.83 to 1.14, P=0.71) but with no significant difference; while women who participated in high level physical activities tended to have a higher incidence of ovarian cancer with a significant difference found in the multivariate-adjusted results (age-adjusted:RR=1.19, 95%CI 0.91 to 1.56, P=0.21; multivariate-adjusted:RR=1.35, 95%CI 1.08 to 1.67, P=0.008). Along with the increase of sedentariness, the incidence of ovarian cancer rose, but with no significant difference. ConclusionCurrent evidence shows that, compared with low level physical activities, high level ones increase the risk of ovarian caner; while the effects of moderate level ones and sedentariness on the risk of ovarian caner still remain uncertain. However, more high-quality studies are required to verify the conclusion of this study because of the limited quantity of the included studies as well as many confounding factors.
ObjectiveTo explore the value of ultrasonic score, blood vessels and vascular resistance index in predicting and diagnosing benign and malignant ovarian tumor. MethodsA total of 157 patients with ovarian tumors (77 benign and 80 malignant) aged from 19 to 68 years old (average 56 years) between January 2008 and June 2012 were enrolled in the research. The ultrasonic score, blood vessels and vascular resistance index were recorded, and the differences between benign and malignant tumor were compared according to the pathological diagnosis; Their sensitivities and specificities were analyzed with the preoperative prediction. ResultsIn benign ovarian tumor, ultrasound scores and blood vessels index were obviously lower than that in the malignant tumor (P<0.05); the vascular resistance index was much higher than that in the malignant tumor (P<0.05). The sensitivities and specificities in diagnosing malignant tumor were high when the ultrasonic score was ≥ 2, vascular index was>0.02/cm3, and blood flow resistance index was ≤ 0.6. The sensitivities were 92.5%, 90.0%, 87.5%, respectively; while the specificities were 90.9%, 89.6%, 84.4%, respectively. ConclusionUltrasonic score, blood vessels and vascular resistance index have significance for identifying benign and malignant ovarian tumors; ultrasonic score is more accurate which has high value of clinical application and popularization.
ObjectiveTo systematically review the efficacy of umbilical cord mesenchymal stem cells in the treatment of premature ovarian failure. MethodsCNKI, WanFang Data, SinoMed, PubMed and EMbase databases were electronically searched to collect animal experiments of the efficacy of umbilical cord mesenchymal stem cells in the treatment of premature ovarian failure from inception to September 17th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.4.1 software. ResultsA total of 9 studies involving 302 mice were included. The results of meta-analysis showed that: umbilical cord mesenchymal stem cell transplantation could increase primal follicles (SMD=1.51, 95%CI 0.80 to 2.22, P<0.000 1), primary follicles (SMD=1.43, 95%CI 0.76 to 2.09, P<0.000 1), secondary follicles (SMD=1.39, 95%CI 0.78 to 2.01, P<0.000 01) and sinus follicles (SMD=1.15, 95%CI 0.49 to 1.82, P=0.000 7). It significantly increased the concentration of estradiol in rats with premature ovarian failure (SMD=2.38, 95%CI 1.75 to 3.01, P<0.000 01), and decreased serum follicle-stimulating hormone concentration (SMD=?1.98, 95%CI ?2.80 to ?1.17, P<0.000 01). ConclusionCurrent evidence shows that umbilical cord mesenchymal stem cell transplantation can repair ovarian tissue and improve ovarian endocrine function in mice. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.