Biomedical subjects

Yang Xiang

Publications and source records attributed to Yang Xiang.

At least 37 records · Page 2Linked to original sources

PubMed2006

[Factors related to recurrence of choriocarcinoma and evaluation of treatment outcomes].

OBJECTIVE: To analyse the factors associated with recurrence of choriocarcinoma and to evaluate the treatment outcomes of choriocarcinoma. METHODS: The records of 490 patients with choriocarcinoma treated at Peking Union Medical College Hospital (PUMCH) were reviewed and evaluated for recurrent episodes of choriocarcinoma. RESULTS: Three hundred and ninety-four women achieved primary remission; 17 (4.3%) developed one or more episodes of recurrent choriocarcinoma. Recurrent rate in low-risk patients was 2.4% (5/208), while in high-risk patients 6.5% (12/186). Recurrent rates among those without and with 1 course of maintenance chemotherapy patients were 6.1% (3/49) and 9.8% (6/61) respectively, while in 2, 3, and >3 courses of maintenance therapy patients were 1.4% (1/70), 3.9% (2/51) and 3.1% (5/163) respectively. Thirteen (76.5%, 13/17) patients with recurrent choriocarcinoma recurred within 3 years and 4 patients after 3 years. Sixteen (94.1%) of 17 patients achieved secondary remission; 6 (37.5%) of 16 developed a second recurrence, and one was lost to follow-up after partial remission. In addition, 21 patients were referred to PUMCH from other hospitals for salvage therapy at the time of recurrence. Totally 38 patients of recurrent choriocarcinoma were treated at our hospital; 29 recurred once, 7 recurred twice and 2 recurred 4 times. There were totally 51 instances treated for recurrent choriocarcinoma. The complete remission rates in patients using chemotherapy only was 69.2% (18/26), the second recurrent rates of these patients was 50.0% (9/18); the complete remission rates in patients using chemotherapy combined with surgery was 92.0% (23/25), the second recurrent rates of these patients was 17.4% (4/23). CONCLUSIONS: Factors related to development of recurrent choriocarcinoma include high-risk at initial evaluation and less than two courses of maintenance chemotherapy beyond the primary remission. Most patients of recurrent choriocarcinoma recur within 3 years; the recurrent choriocarcinoma is of poor prognosis and should be treated aggressively. Chemotherapy combined with surgery is the most important method to increase cure rates and to decrease recurrent rates.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2006

[Analysis of death causes of gestational trophoblastic neoplasia patients].

OBJECTIVE: To analyze retrospectively the causes of death in gestational trophoblastic neoplasia (GTN) patients. The prognostic risk factors were also discussed. METHODS: One thousand one hundred and thirty GTN patients were hospitalized and treated at Peking Union Medical College Hospital from 1985 to 2004. Sixty-four of them died later and retrospective analyses were carried out on these patients. RESULTS: Fifty-eight out of the 64 patients died during initial treatment. The other six died from disease relapse and progression of the disease (PD). The major causes of death were multi-organ failure, intracranial haemorrhage, cerebral herniation, side-effects of chemotherapy, and PD after relapse. The result of multivariate analysis indicated the adverse prognostic factors included the interval between antecedent pregnancy and chemotherapy treatment (OR = 2.857, P < 0.01), the titer of beta subunit of human chorionic gonadotropin (beta-hCG, P < 0.05), the diagnosis of choriocarcinoma (OR = 3.635, P < 0.05), clinical stage (P < 0.05), multiple metastases (OR = 2.201, P < 0.01) and drug resistance (OR = 0.181, P < 0.01). CONCLUSIONS: A proper evaluation of a GTN patient before initial treatment is important. More attention should be paid to the death-related prognostic risk factors to improve the prognosis of high risk GTN patients.

Adult↗

PubMed2006

[Genetic heterogeneity for familial recurrent hydatidiform mole].

OBJECTIVE: To determine the parental origin of the genome in the molar pregnancies of two familes with familial recurrent hydatidiform mole (FRHM) and to investigate whether the gene responsible for FRHM is likely to be located within the 19q13.4 region in these familes. METHODS: The features of complete hydatidiform mole (CHM) were confirmed by pathological examination. DNA of CHM was prepared from sections of formalin-fixed paraffin-embedded blocks of molar tissue following laser capture microdissection. The polymerace chain reaction was used to amplify microsatellite polymorphisms in DNA from the patients, their husbands and the captured molar tissue. Parental contributions to the molar tissue were determined using ABI 310 GeneScan software. Genotyping and haplotype analysis of the candidate region on 19q13.4 was performed for members of both families using 25 microsatellite markers. RESULTS: One CHM from each family was identified as a biparental complete hydatidiform mole. All patients were heterozygous for most of the markers in the chromosome region of interest. In addition the two affected sisters in one of the families had different genotypes for the 19q13.4 region, suggesting that mutations in a different locus might be responsible for the disorder in this family. CONCLUSION: The location of the gene responsible for FRHM is unlikely to be located in the 19q13.4 chromosomal region in these two families suggesting that FRHM shows genetic heterogeneity.

Family Health↗

PubMed2006

[Clinical features and treatment options for aggressive angiomyxoma].

OBJECTIVE: To discuss the clinical features and treatment options for aggressive angiomyxoma (AAM). METHODS: We retrospectively analyzed the clinical data of 4 patients with AAM treated at PUMC Hospital from January 1990 to December 2004. RESULTS: There were 1 man and 3 women with an average age of 34 years. The average age of the female patients were 27 years. Two patients (50%) had urinary or enteric compressive complaints, while another 2 patients had no clinical symptoms. Two patients underwent transvaginal surgeries, 1 patient underwent transabdomenal surgery, and 1 patient underwent subcurtaneouly local excision. Three patients (75%) experienced recurrences after operation and the median relapse time was 2.5 years. CONCLUSIONS: AAM usually occurs in female pelvic cavity and the soft tissues of female perineum. AAM is huge in capacity, and easy to infiltrate or recur locally.

Adolescent↗

PubMed2006

[Management and prognosis in stage IV gestational trophoblastic neoplasia patients].

OBJECTIVE: To analyze the management and prognosis in stage IV gestational trophoblastic neoplasia (GTN) patients. METHODS: One thousand one hundred and thirty GTN patients were hospitalized and treated at Peking Union Medical College Hospital from year 1985 to 2004. Ninety-two of them were diagnosed as stage IV of GTN. Retrospective analyses were carried out on these patients in terms of management and prognosis. RESULTS: Of the 92 patients who had undergone treatment, complete remission (CR) was achieved in 33, partial remission in 37, and progress of the disease was seen in 22. Among all the CR patients, three had recurrence later. Thirty-three out of all the patients died during or after treatment. Among the 92 cases, 70 had one or two metastases, of whom 27 had CR, and 20 died. Of the 17 cases who had three metastases, 5 achieved CR, and 10 died. Of the five cases with >or= 4 metastases, one had CR, and three died. The number of metastatic organs was correlated with prognosis (P = 0.034) and death (P = 0.018). CONCLUSIONS: Multi-drug and multi-route chemotherapy and (or) combined surgical intervention may improve the survival rate of the stage IV GTN patients. The management should be individualized for different patients with metastases. With the increase in the number of metastatic organs, the remission rate decreases.

Adult↗

PubMed2005

Identification of a novel testis-specific gene mtLR1, which is expressed at specific stages of mouse spermatogenesis.

A novel testis-specific gene termed mtLR1 was identified by digital differential display. Sequence analyses revealed that mtLR1 protein contains an amino terminus leucine-rich repeat domain and shows 33% similarities to PIDD which functions in p53-mediated apoptosis. Northern blot analysis showed that mtLR1 mRNA was specifically expressed in adult mouse testis, and RT-PCR results also showed that mtLR1 was exclusively expressed in adult testis and not in spermatogonial cells. The expression of mtLR1 mRNA was developmentally upregulated in the testes during sexual maturation and was, conversely, downregulated by experimental cryptorchidism in vivo. We also showed that the expression of mtLR1 mRNA was relatively highly sensitive to heat stress in vitro. The green fluorescent protein produced by pEGFP-C3/mtLR1 was only detected in the cytoplasm of spermatogonia cell line GC-1 after 24 h posttransfection. Immunohistochemical analysis revealed that the protein is most abundant in the cytoplasm of spermatocytes and round spermatids within seminiferous tubules of the adult testis. The time-dependent expression pattern of mtLR1 in postnatal mouse testes suggested that mtLR1 gene might be involved in the regulation of spermatogenesis and sperm maturation.

Aging↗

PubMed2005

PACS-2 controls endoplasmic reticulum-mitochondria communication and Bid-mediated apoptosis.

The endoplasmic reticulum (ER) and mitochondria form contacts that support communication between these two organelles, including synthesis and transfer of lipids, and the exchange of calcium, which regulates ER chaperones, mitochondrial ATP production, and apoptosis. Despite the fundamental roles for ER-mitochondria contacts, little is known about the molecules that regulate them. Here we report the identification of a multifunctional sorting protein, PACS-2, that integrates ER-mitochondria communication, ER homeostasis, and apoptosis. PACS-2 controls the apposition of mitochondria with the ER, as depletion of PACS-2 causes BAP31-dependent mitochondria fragmentation and uncoupling from the ER. PACS-2 also controls formation of ER lipid-synthesizing centers found on mitochondria-associated membranes and ER homeostasis. However, in response to apoptotic inducers, PACS-2 translocates Bid to mitochondria, which initiates a sequence of events including the formation of mitochondrial truncated Bid, the release of cytochrome c, and the activation of caspase-3, thereby causing cell death. Together, our results identify PACS-2 as a novel sorting protein that links the ER-mitochondria axis to ER homeostasis and the control of cell fate, and provide new insights into Bid action.

Adaptor Proteins, Signal Transducing↗

PubMed2005

Phosphodiesterase 4D is required for beta2 adrenoceptor subtype-specific signaling in cardiac myocytes.

beta adrenoceptor (betaAR) signaling is finely regulated to mediate the sympathetic nervous system control of cardiovascular function. In neonatal cardiac myocytes, beta1AR activates the conventional Gs/cAMP pathway, whereas beta2AR sequentially activates both the Gs and Gi pathways to regulate the myocyte contraction rate. Here, we show that phosphodiesterase 4D (PDE4D) selectively impacts signaling by beta2AR in neonatal cardiac myocytes, while having little or no effect on beta1AR signaling. Although beta2AR activation leads to an increase in cAMP production, the cAMP generated does not have access to the protein kinase A-dependent signaling pathways by which the beta1AR regulates the contraction rate. However, this restricted access is lost in the presence of PDE4 inhibitors or after ablation of PDE4D. These results not only suggest that PDE4D is an integral component of the beta2AR signaling complex, but also underscore the critical role of subcellular cAMP regulation in the complex control of receptor signaling. They also illustrate a mechanism for fine-tuned betaAR subtype signaling specificity and intensity in the cardiac system.

3',5'-Cyclic-AMP Phosphodiesterases↗

PubMed2005

Cloning, characterization and primary function study of a novel gene, Cymg1, related to family 2 cystatins.

Cystatins are cysteine proteinase inhibitors. We found two expression sequence tags (ESTs), CA463109 and AV042522, from a mouse testis library using Digital differential display (DDD). By electrical hybridization, a novel gene, Cymg1 (GenBank accession No. AY600990), which has a full length of 0.78 kb, and contains four exons and three introns, was cloned from a mouse testis cDNA library. The gene is located in the 2G3 area of chromosome 2. The full cDNA encompasses the entire open reading frame, encoding 141 amino acid residues. The protein has a cysteine protease inhibitor domain that is related to the family 2 cystatins but lacks critical consensus sites important for cysteine protease inhibition. These characteristics are seen in the CRES subfamily, which are related to the family 2 cystatins and are expressed specifically in the male reproductive tract. CYMG1 has a 44% (48/108) identity with mouse CRES and 30% (42/140) identity with mouse cystatin C. Northern blot analysis showed that the Cymg1 is specifically expressed in adult mouse testes. Cell location studies showed that the GFP-tagged CYMG1 protein was localized in the cytoplasm of HeLa cells. Immunohistochemistry revealed that the CYMG1 protein was expressed in mouse testes spermatogonium, spermatocytes, round spermatids, elongating spermatids and spermatozoa. RT-PCR results also showed that Cymg1 was expressed in mouse testes and spermatogonium. The Cymg1 expression level varied in different developmental stages: it was low 1 week postpartum, steadily increased 2 to 5 weeks postpartum, and was highest 7 weeks postpartum. The expression level at 5 weeks postpartum was maintained during 13 to 57 weeks postpartum. The Cymg1 expression level in the testes over different developmental stages correlates with the mouse spermatogenesis and sexual maturation process. All these indicate that Cymg1 might play an important role in mouse spermatogenesis and sexual maturation.

Amino Acid Sequence↗

PubMed2005

Molecular cloning of a novel mouse testis-specific spermatogenic cell apoptosis inhibitor gene mTSARG7 as a candidate oncogene.

A novel mouse gene, mTSARG7 (GenBank accession No. AY489184), with a full cDNA length of 2279 bp and containing 12 exons and 11 introns, was cloned from a mouse expressed sequence tag (GenBank accession No. BE644543) that was significantly up-regulated in cryptorchidism. The gene was located in mouse chromosome 8A1.3 and encoded a protein containing 403 amino acid residues that was a new member of the acyltransferase family because the sequence contained the highly conserved phosphate acyltransferase (PlsC) domain existing in all acyltransferase-like proteins. The mTSARG7 protein and AU041707 protein shared 83.9% identity in 402 amino acid residues. Expression of the mTSARG7 gene was restricted to the mouse testis. The results of the in situ hybridization analysis revealed that the mTSARG7 mRNA was expressed in mouse spermatogonia and spermatocytes. Subcellular localization studies showed that the EGFP-tagged mTSARG7 protein was localized in the cytoplasm of GC-1 spg cells. The mTSARG7 mRNA expression was initiated in the mouse testis in the second week after birth, and the expression level increased steadily with spermatogenesis and sexual maturation of the mouse. The results of the heat stress experiment showed that the mTSARG7 mRNA expression gradually decreased as the heating duration increased. The pcDNA3.1 Hygro(-)/mTSARG7 plasmid was constructed and introduced into GC-1 spg cells by liposome transfection. The mTSARG7 can accelerate GC-1 spg cells, causing them to traverse the S-phase and enter the G2-phase, compared with the control group where this did not occur as there was no transfection of mTSARG7. In conclusion, our results suggest that this gene may play an important role in spermatogenesis and the development of cryptorchid testes, and is a testis-specific apoptosis candidate oncogene.

Amino Acid Sequence↗

PubMed2005

[Growth-inhibiting effect of psoralen plus ultraviolet-A light therapy on K562 cells].

OBJECTIVE: To observe the effects of psoralen plus ultraviolet-A light (PUVA) on K562 cells and the relative mechanism. METHODS: The effects of psoralen, ultraviolet-A light and PUVA on K562 cells were assayed by monotetrazolium test (MTT). DNA content was analyzed by flow cytometry (FCM). The apoptotic rates of K562 cells treated with 40 and 80 microg/ml psoralen for 24 and 48 hours were assayed by Annexin-V-FITC/PI reagent kit on FCM respectively. The ultrastructures of apoptotic cells were observed by a transmission electron microscope (TEM). RESULTS: Either single psoralen therapy or single ultraviolet-A irradiation had inhibiting effect on K562 cells. The inhibiting effect of PUVA on K562 cells was stronger than that of the single psoralen therapy or single ultraviolet-A light irradiation (P<0.05). Apoptotic peak (AP) was detected by FCM. TEM test showed that K562 cells treated with PUVA were smaller, having condensed cell nucleus, assembled chromatin, disintegrated nucleus body and the majority of the cells appeared to be apoptotic conformation. CONCLUSION: Psoralen has inhibiting effect on K562 cells, and the effect of PUVA is more significant. It is suggested that 10 min irradiation and 40 microg/ml terminal concentration of psoralen be probably the best choice for PUVA. The inhibiting effect of PUVA is due to apoptosis.

Apoptosis↗

PubMed2005

[Etopside, methotrexate, kengshengmycin/etopside, cisplatin chemotherapy for chemorefractory gestational trophoblastic tumour].

OBJECTIVE: To evaluate the results of etopside, methotrexate, kengshengmycin/etopside, cisplatin (EMA/EP) chemotherapy in patients with chemorefractory gestational trophoblastic tumour. METHODS: Fifteen patients with chemorefractory gestational trophoblastic tumour were treated by EMA/EP chemotherapy schedule. RESULTS: Twelve of the fifteen cases were choriocarcinoma, and the other three were metastatic placental site trophoblastic tumour (PSTT). International Federation of Gynecology and Obstetrics (FIGO), 2 cases stage I, 10 cases stage III, 3 cases stage IV. Eight cases had FIGO score of 7 to 12, the score of the other 7 cases was over 12. Fifteen patients received a total of 93 cycles of the study regimen. The median number of courses for each patient was 6.2. Eleven cases (73%) achieved a complete remission while 3 patients (20%) had a partial remission, 1 case (7%) showed nonresponse. The main complications for EMA/EP chemotherapy were myelosuppression and gastrointestinal symptoms. CONCLUSIONS: The EMA/EP regimen is an effective treatment for chemorefractory gestational trophoblastic tumour, and the chemotherapeutic results can be further improved while combined with surgery and arterial infusion chemotherapy in the selected patients. Meanwhile, EMA/EP regimen should be considered in the primary management of patients with metastatic PSTT.

Adult↗

PubMed2005

[Study on the indication of surgical resection of pulmonary metastasis of malignant trophoblastic tumor].

OBJECTIVE: To investigate the indication of lung lobectomy in patients of malignant trophoblastic tumor with lung metastasis. METHODS: Data on a total of 629 cases of malignant trophoblastic tumor of stage III-IV in Peking Union Medical College Hospital from 1990 to 2003 were reviewed. Ninety-five cases including those that underwent lung lobectomy and cases with normal level of serum human chorionic gonadotropin-beta subunit (beta-hCG, < 2 IU/L) and residual pulmonary nodules after chemotherapy were selected and studied. RESULTS: Lung lobectomies were performed on six cases of invasive mole with lung metastasis and the pathological results were all necrotic nodules;another 35 cases of invasive mole with normal level of serum beta-hCG but residual pulmonary nodules after chemotherapy have been followed up for 6 months to 11 years and all were stable of diseases (SD). Lung lobectomies were performed on 29 cases of choriocarcinoma with lung metastasis. Among them, there were 17 cases whose pathological results were hemorrhage and necrotic tissue without trophoblastic cells (negative pathological results), while trophoblastic cells could still be detected in 12 cases of resected lung specimens (positive pathological results). Twenty-five cases of choriocarcinoma with normal serum beta-hCG but residual pulmonary nodules after chemotherapy were followed up, five cases had progress of disease (PD) and 20 were SD. There were no significant differences of age, stage and the last pregnancy between the positive and negative pathological results, SD and PD groups, respectively. However, the number of chemotherapeutic courses for decreasing beta-hCG from 10 IU/L to 2 IU/L and the total courses in the group of positive pathological results and PD group were significantly more than that of negative pathological results group and SD group (P = 0.01, P = 0.001). CONCLUSIONS: For invasive mole, lung metastasis can be successfully treated by chemotherapy alone. Patients with residual pulmonary nodules but normal serum beta-hCG after chemotherapy can be followed up and spared lung lobectomy. For choriocarcinoma, slowly decreasing of beta-hCG from 10 IU/L to 2 IU/L is a high risk for chemoresistance, and it is an indication for thoracotomy. Progression of disease after multiple chemotherapy courses should be treated with lung lobectomy.

Adult↗

PubMed2005

Improving P-gp expression in human mononuclear cells in vitro transfected by multidrug resistance-1 mRNA.

OBJECTIVE: To evaluate the expression and function activity of P-glycoprotein (P-gp) in human mononuclear cells (MNCs) in vitro transfected by multidrug resistance-1 (MDR1) mRNA. METHODS: Two MDR1 cDNA vectors, pT7TS_MDR1 and pGEM5Zf(+)_MDR1, were constructed and transcripted in vitro. Vector pGEM5Zf(+)_MDR1 only contained the coding region of mdr1 cDNA, and pT7TS_MDR1 also included Xeponus beta-globin 5' and 3' untranslated region. MNCs were prepared from peripheral blood of parvicellular lung cancer patient. The two human mdrl mRNAs were then transferred into human MNCs in vitro by DOTAP. And the expression efficiency and pump function of P-gp were measured with flow cytometry. RESULTS: Expression of P-gp significantly elevated in both transferred cells compared with untransferred cells (P < 0.01). And pT7TS_MDR1 showed higher capability in elevating the expression of P-gp than pGEM5Zf(+)_MDR1 (P < 0.01). The P-gp function was elevated in both pT7TS_MDR1 and pGEM5Zf(+) MDR1 groups. The survival ratio of MNCs in erythrocyte-lysis-solution (ELS, 86.07%) and lymphocyte-isolation-solution (LIS, 83.67%) had no significant difference. The CD34+ cells content of the MNCs used for transfection was 2.65% and 1.01% in ELS and LIS group, respectively (P < 0.01). CONCLUSIONS: It is a feasible approach to improve P-gp expression in human MNCs by transfection of MDR-1 mRNA. And the ELS may be more suitable for purifing MNCs for mRNA transfection than LIS.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2005

[Evaluation of emergency craniotomy for the treatment of patients with intracranial metastases of choriocarcinoma].

OBJECTIVE: To study the diagnosis, management and prognosis of intracranial metastases of gestational trophoblastic tumour (GTT) patients who had emergency surgical decompression due to highly increased intracranial pressure. METHODS: Ninety-three patients with intracranial metastases of gestational trophoblastic tumour were hospitalized in our department of Peking Union Medical College Hospital from 1985 to 2004. Thirteen of them who underwent emergency craniotomy were retrospectively analyzed, and all of them presented with raised intracranial pressure and intracerebral haemorrhagic mass. RESULT: Of the thirteen patients who underwent surgery in combination with multiagent systemic chemotherapy, seven achieved complete remission (CR), five had partial remission (PR), and one died of disease progression. CONCLUSIONS: Emergency surgical treatment is the important method of choice for brain metastasis in patients displaying rapidly deteriorating signs. An undetermined intracranial haemorrhage in young female patients of reproductive age group should raise the suspicion of cerebral metastatic choriocarcinoma.

Adult↗

PubMed2005

Molecular cloning and primary functional analysis of a novel human testis-specific gene.

In this study, a new data mining tool called Digital Differential Display (DDD) from the NCBI was used to predict testis-specific expressed genes from the expressed sequence tag (EST) database. DDD (digital differential display) was performed between nine testis libraries and seventy libraries derived from other tissues. We identified a new contig of ESTs (HS. 326528) which was from testis libraries. To validate the use of bioinformatic approaches in gene discovery, the ESTs (HS. 326528), which were predicted to be testis-specific, were chosen for further study. Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) analysis of matched sets of cDNAs from testis and other tissues indicated that the ESTs were specifically expressed in testis. This result was further validated by multi-tissue Northern blot. The full-length cDNA encompassing the entire open reading frame was cloned and, in view of its apparent specificity to testis, the gene was termed homo sapiens spermatogenesis-related gene 8---SRG8 (GenBank accession number: AY489187). The gene whose full cDNA length is 1 044 bp containing 3 exons and 2 introns is located in human chromosome 15q26.2, the cDNA encodes a novel protein of 105 amino acides with a theoretical molecular weight of 11.7 kD and isoelectric point of 10.09 which shares no significant homology with any known proteins in database. Real time PCR analysis of testis of different developmental periods revealed that SRG8 gene is significantly expressed in adult testis. The green fluorescent protein produced by pEGFP-C3/SRG8 was detected in the nucleus of HeLa cells after 24 h post-transfection. Cell cycle analysis showed that SRG8 can accelerate HeLa cells to traverse the S-phase and enter the G2-phase compared with the control without transfection of SRG8, which suggested that this gene plays an important role in the development of testis. The discovery of SRG8 showed that DDD combined with experiments is a feasible, time-saving strategy to identify new candidate genes for testis-specific development

Adult↗

PubMed2005

[Clinical characteristics and management of gestational trophoblastic disease in women aged 50 years or more].

OBJECTIVE: To investigate the clinical characteristics, management and prognosis of gestational trophoblastic disease in women aged 50 years or more. METHODS: Thirty-eight cases of gestational trophoblastic disease in women aged 50 years or more, who were treated in Peking Union Medical College Hospital between 1992 and 2002, were reviewed retrospectively. RESULTS: The median age was 52 years (range from 50 to 58 years). The lesions included 5 hydatidiform moles (13%), 19 invasive moles (50%), 12 choriocarcinomas (32%) and 2 placenta site trophoblastic tumors (5%). All of 38 cases presented with abnormal vaginal bleeding. Twenty-three cases of hydatidiform moles were diagnosed at their first visit to the hospital, and 15 of them received prophylactic chemotherapy, of whom 10 progressed to invasive mole, 3 developed lung metastasis. All of the other 8 cases without prophylactic chemotherapy progressed to malignant changes with metastasis of lung. The use of prophylactic chemotherapy reduced the incidence of subsequent metastasis. All of 38 cases received chemotherapy. Thirty-two cases underwent hysterectomy, complete remission was achieved in 91% of patients; complete remission was achieved in 2 of 6 patients without hysterectomy. CONCLUSIONS: The diagnosis of pregnancy and pregnancy-related disease should be considered in the elderly women presenting with abnormal vaginal bleeding. Once gestational trophoblastic disease in women aged 50 years or more is diagnosed, chemotherapy should be given as soon as possible. Hysterectomy is frequently required to improve the prognosis of gestational trophoblastic disease in the elderly women.

Choriocarcinoma↗

PubMed2005

[Role of hysteroscopy in the diagnosis of endometrial carcinoma].

With the apparently increasing incidence of endometrial carcinoma, much importance has been attached to the early and exact diagnosis of endometrial carcinoma. This article mainly focuses on diagnostic techniques of endometrial carcinoma, especially diagnostic hysteroscopy and its assessment of myometrial invasion as well as stage of endometrial carcinoma. Whether hysteroscopy increases the risk of microscopic extrauterine spread is also discussed in this article.

Endometrial Neoplasms↗