[Present and future of basic studies on endometriosis].
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Biomedical Research↗
Biomedical subjects
Jing-He Lang
Publications and source records attributed to Jing-He Lang.
[Clinical evaluation of high-risk HPV detection by hybrid capture II in screening cervical intraepithelial neoplasma].
OBJECTIVE: To evaluate the value of high-risk HPV (hrHPV) detection by Hybrid Capture II (HC2) in screening cervical intraepithelial neoplasm (CIN). METHODS: Totally 723 patients who had received a dual screening with thinprep cytologic test (TCT) and HC2 in our department were analyzed retrospectively. Among them, 350 patients received a triple examination with TCT, HC2, and colposcopic biopsy. RESULTS: Among the 723 patients, the incidences of hrHPV infection with atypical squamous cell (ASC), low squamous intraepithelial lesion, and high squamous intraepithelial lesion were 70.7% (94/133), 88.9% (249/280), and 90.9% (90/99), respectively, significantly higher than 55.5% (117/211), the incidence of hrHPV infection with normal cytological results (P = 0.005, P < 0.001, P < 0.001, respectively). Among 350 cases who were received triple examination, the incidence of hrHPV infection with cervical intraepithelial neoplasia (CIN) 1 and CIN 2 were 88.9% (72/81) and 96.3% (52/54), significantly higher than 77.7% (153/197), the incidence of hrHPV infection with normal pathological results (P = 0.03, P = 0.002); The incidence of hrHPV infection with CIN 3 and squamous cancer were 91.7% (11/12) and 100.0% (6/6), also higher than normal cases. Among these 350 cases, the incidence of hrHPV infection with ASC was 79.3% (69/87). The incidence of CIN 2-3 with ASC and hrHPV infection was 38.0%, significantly higher than the incidence of CIN 2-3 with ASC and without hrHPV infection (5.9%) (P = 0.04). CONCLUSION: hrHPV infection has a close relation with CIN, and the incidence of hrHPV infection increases along with the severity of CIN.
Adolescent↗
[Comparison of clinical characteristics of extraovarian peritoneal serous papillary carcinoma with papillary serous ovarian carcinoma].
OBJECTIVE: To study the differences of clinical characteristics between patients with extraovarian peritoneal serous papillary carcinoma (EPSPC) and those with papillary serous ovarian carcinoma (PSOC). METHODS: Fourteen patients with EPSPC and 50 patients with PSOC who were admitted to Peking Union Medical College Hospital from 1984 to 2002 were retrospectively analyzed, and their clinical features, chemosensitivities and survival rate were compared. RESULTS: Patients with EPSPC were significantly older than those with PSOC (mean age 62.7 years versus 53.6 years, P < 0.01). The chemo-resistant rate (83%) in EPSPC was significantly higher than that (38%) of the PSOC (P < 0.05). The 1-, 2-, and 3-year survival rates (72%, 10%, 0%) in the EPSPC were significantly lower than those (95%, 79%, 62%) of the PSOC (P < 0.05). CONCLUSION: EPSPC are likely to occur in older women, have higher chemo-resistance and poorer prognosis compared with PSOC.
Adult↗
Diagnostic delay in women with endometriosis.
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Adolescent↗
[Laparoscopic operation in the new century].
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Female↗
[Clinical aspects of mature ovarian teratoma: result of 695 cases].
OBJECTIVE: To evaluate the clinical aspects of mature ovarian teratoma. METHOD: We retrospectively studied 695 patients operated in PUMC Hospital between January 1990 and December 2000. RESULTS: Laparoscopy surgery had shorter hospitalization day, less blood loss during surgery, shorter operation time compared with laparotomy (P < 0.001). Routine contralateral wedge resection was done in 601 cases, among which 459 had normal inspection and palpatation. Only one (0.22%) was pathologically confirmed bilateral tumor. Torsion was the major complication (7.5%). Average tumor size of torsion was (10.2 +/- 4.5) cm. Probability of torsion increased as the tumor enlarged, which was less than 4.4% when the tumor size was less than 6 cm and greater than 10% if size greater than 8 cm. Rupture, infection, and malignant transformation were rare. CONCLUSIONS: Laparoscopy is superior to laparotomy in the treatment of mature ovarian teratoma. If the contralateral ovarian is within normal configuration, contralateral wedge resection is unnecessary. When the tumor size is greater than 8 cm in diameter, it will have more chance to twist.
Adolescent↗
Expression of P450 aromatase and 17beta-hydroxysteroid dehydrogenase type 1 at fetal-maternal interface during tubal pregnancy.
Steroidogenesis in the placenta has been studied widely, but little is known about steroid metabolism in ectopic pregnancy. Previous studies have indicated that trophoblast invasion and placentation in the uterus and the fallopian tube may be controlled by similar mechanisms. As far as 17beta-estradiol (E(2)) production is concerned, it has been well demonstrated that its biosynthesis in the placenta involves the action of P450 aromatase (P450arom) and 17beta-hydroxysteroid dehydrogenase type 1 (17HSD1). The purpose of this study was to characterize the expression pattern of P450arom and 17HSD1 at the fetal-maternal interface, particularly in various trophoblast cells, in tubal pregnancy. Using in situ hybridization, P450arom mRNA was localized in syncytiotrophoblast (ST) cells, which are mainly responsible for hormone production during pregnancy, whereas no signal was detected in villous cytotrophoblast (VCT), column CT and extravillous CT (EVCT) cells. Immunohistochemical assays revealed that 17HSD1 is present in ST cells, a large portion of EVCT cells and 20% of column CT cells. On the other hand, no expression of 17HSD1 was detected in VCT cells. In addition, 17HSD1 was found in epithelial cells of the fallopian tube. Interestingly, the expression level of 17HSD1 in fallopian tube epithelium during tubal pregnancy was significantly higher than that during normal cycle. Our data provide the first evidence that normal and tubal pregnancies possess identical expression of P450arom and 17HSD1 in ST cells and therefore, similar E(2) production in the placenta. Further, the association of 17HSD1 with EVCT cells indicates that 17HSD1 perhaps play a role in trophoblast invasion. Finally, increased expression of 17HSD1 in epithelial cells of fallopian tube may lead to a local E(2) supply sufficient for the maintenance of tubal pregnancy.
17-Hydroxysteroid Dehydrogenases↗
[Treatment opportunity and strategy for recurrent ovarian cancer].
BACKGROUND & OBJECTIVE: Recurrent ovarian cancer is associated with a poor prognosis, and optimal management for this problem is not well defined. The purpose of the study was to evaluate treatment opportunity for patients with recurrent ovarian cancer. METHODS: Fifty-four cases of recurrent ovarian cancer during 1990 to 2000 were randomly selected to compare the effect of treatment opportunity on the outcome. All the clinical data related to the recurrent ovarian cancer were collected. The difference in survival was calculated by the Cox model. RESULTS: The multivariate analysis showed that the platinum-free-interval >6 months and the surgery followed salvage chemotherapy were associated with a significant prolongation of survival for the patients with recurrent ovarian cancer(P< 0.05). The odds ratio was 0.389 for the patients whose platinum-free-interval was more than 6 months as compared to that of the platinum-free-interval < 6 months. The OR was 4.194 for the patients who were only with salvage chemotherapy as compared to that with surgery followed salvage chemotherapy. The numbers of chemotherapy cycles may offer some effect on the survival (P=0.07). The odds ratio(OR) was 0.346 for the patients whose chemotherapy cycles were more than 10 as compared to that of chemotherapy cycles < 6. The timing of the beginning of the retreatment and chemotherapy regiments were failed to demonstrate an improvement in survival(P >0.05). CONCLUSION: The treatment opportunity for patients with recurrent ovarian cancer is depend on the platinum-free-interval of the patients. A strategy of secondary surgical cytoreduction followed salvage chemotherapy is suggested for the patients whose platinum-free-interval >6 months. The goal of the treatment for platinum-resistant patients is to improve the quality of life.
Adult↗
Expression of vascular endothelial growth factor and thrombospondin-1 mRNA in patients with endometriosis.
OBJECTIVE: To investigate the expression of vascular endothelial growth factor (VEGF) mRNA and thrombospondin-1 (TSP-1) mRNA in endometriosis. DESIGN: Molecular studies in human tissue. SETTING: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P. R. China. PATIENT(S): Patients undergoing laparoscopy for infertility or other benign gynecologic conditions. INTERVENTION(S): Biopsies were taken from endometriotic lesions (red peritoneal lesion, ovarian endometrioma, and unterosacral ligament nudule) and eutopic endometrium during laparoscopy. MAIN OUTCOME MEASURE(S): mRNA expression from endometriotic lesion and eutopic endometrium was analyzed by reverse transcriptase polymerase chain reaction (PCR) and Northern blotting. RESULT(S): Among the endometriotic lesions, red peritoneal lesions expressed higher levels of VEGF mRNA and lower levels of TSP-1 mRNA, whereas ovarian endometrioma expressed lower levels of VEGF mRNA and higher levels of TSP-1 mRNA. Eutopic endometrium of women with endometriosis had higher expression levels of VEGF mRNA and lower expression levels of TSP-1 mRNA than that of women without endometriosis. CONCLUSION(S): The expression of VEGF and TSP-1 in endometriotic lesions appears to be associated with the extent of their neovascularization. The imbalance in expression of VEGF and TSP-1 in the endometrium may play a role in the development of endometriosis.
Adult↗