The chemokine thymus-expressed chemokine(TECK),which regulates T-cell development and tissue-specific homing,has been identified as a potential contributor to the pathogenesis and progression of endometriosis.Dioxin(2...The chemokine thymus-expressed chemokine(TECK),which regulates T-cell development and tissue-specific homing,has been identified as a potential contributor to the pathogenesis and progression of endometriosis.Dioxin(2,3,7,8-tetrachlorodibenzo-p-dioxin,TCDD),an air pollutant,and estrogen also appear to be involved in endometriosis.Both endometrial stromal cells(ESCs)and the combination of 17b-estradiol and TCDD increase the secretion of TECK in the endometriosis-associated cells and promote the invasiveness of ESCs by increasing expression of matrix metalloproteinase(MMP)-2 and MMP-9.Anti-TECK neutralizing antibodies can effectively inhibit the invasiveness of ESCs and the expression of MMP-2 and MMP-9 in the cells.Interestingly,the expression of chemokine C receptor 9(CCR9)and its ligand TECK increases significantly in the endometriotic milieu of patients with endometriosis.Therefore,the over-expressed TECK interacts with CCR9 on the ESCs in the endometriotic milieu,which may contribute to the onset and progression of endometriosis.展开更多
Purpose Myometrial invasion of endometrial cancer(EC)impairs the effectiveness of progestin-based treatment and results in high risks of disease progression and relapse.However,it is difficult to decide whether myomet...Purpose Myometrial invasion of endometrial cancer(EC)impairs the effectiveness of progestin-based treatment and results in high risks of disease progression and relapse.However,it is difficult to decide whether myometrial invasion exists when suspected endometrial invasion is detected on magnetic resonance imaging(MRI).This study developed an MRI-guided hysteroscopic precise en bloc resection method to actually diagnose myometrial inva-sion in patients with EC and suspected myometrial invasion on MRI.The fertility-preserving outcomes of patients with EC and suspected myometrial invasion on MRI but negative pathological findings after en bloc resection was also evaluated.Materials and methods EC patients with suspected myometrial invasion on MRI(n=38)were prospectively enrolled and evaluated.Suspected myometrial invasion was identified on MR images and resected via an en bloc resection technique(resecting the endometrial lesion,basal layer,and underneath myometrium en bloc)under hysteroscopy for pathological examination.Patients with negative pathological findings received progestin-based conservative therapy.The clinical characteristics and fertility-preserving outcomes of these patients were compared with those of patients without any evidence of myometrial invasion on MRI(n=98,reference group).Results Among patients with suspected myometrial invasion on MRI,myometrial invasion was pathologically excluded in 29 patients(non-MI group).The cumulative complete response rate was lower in the non-MI group than in the reference group at the 8th month(43.4%vs.64.9%,P=0.040)and was not significant at the 18th month(87.5%vs.96.8%,P=0.11).The 24-month cumulative relapse rate was 31.2%in the non-MI group,versus 0%in the ref-erence group(P<0.0001).Conclusion Myometrial invasion was pathologically confirmed in approximately one-fourth of patients with sus-pected myometrial invasion on MRI.However,suspected myometrial invasion on MRI with negative pathological findings was correlated with worse fertility-preserving outcomes in young women with endometrial cancer.展开更多
基金This work was supported by the National Basic Research Program of China(2006CB944007,to DJ Li)the National and Shanghai Leading Academic Discipline Project(211XK22,to DJ Li)the Program for Outstanding Medical Academic Leader of Shanghai(to DJ Li).
文摘The chemokine thymus-expressed chemokine(TECK),which regulates T-cell development and tissue-specific homing,has been identified as a potential contributor to the pathogenesis and progression of endometriosis.Dioxin(2,3,7,8-tetrachlorodibenzo-p-dioxin,TCDD),an air pollutant,and estrogen also appear to be involved in endometriosis.Both endometrial stromal cells(ESCs)and the combination of 17b-estradiol and TCDD increase the secretion of TECK in the endometriosis-associated cells and promote the invasiveness of ESCs by increasing expression of matrix metalloproteinase(MMP)-2 and MMP-9.Anti-TECK neutralizing antibodies can effectively inhibit the invasiveness of ESCs and the expression of MMP-2 and MMP-9 in the cells.Interestingly,the expression of chemokine C receptor 9(CCR9)and its ligand TECK increases significantly in the endometriotic milieu of patients with endometriosis.Therefore,the over-expressed TECK interacts with CCR9 on the ESCs in the endometriotic milieu,which may contribute to the onset and progression of endometriosis.
基金Supported by the National Key Technology R&D Program of China(Grant No 2019YFC1005200 and 2019YFC1005203)in the trial design and all data collection,management,and analysis the National Key Technology R&D Program of China,Grant No 2019YFC1005200,Xiaojun Chen,2019YFC1005203,Xiaojun Chen。
文摘Purpose Myometrial invasion of endometrial cancer(EC)impairs the effectiveness of progestin-based treatment and results in high risks of disease progression and relapse.However,it is difficult to decide whether myometrial invasion exists when suspected endometrial invasion is detected on magnetic resonance imaging(MRI).This study developed an MRI-guided hysteroscopic precise en bloc resection method to actually diagnose myometrial inva-sion in patients with EC and suspected myometrial invasion on MRI.The fertility-preserving outcomes of patients with EC and suspected myometrial invasion on MRI but negative pathological findings after en bloc resection was also evaluated.Materials and methods EC patients with suspected myometrial invasion on MRI(n=38)were prospectively enrolled and evaluated.Suspected myometrial invasion was identified on MR images and resected via an en bloc resection technique(resecting the endometrial lesion,basal layer,and underneath myometrium en bloc)under hysteroscopy for pathological examination.Patients with negative pathological findings received progestin-based conservative therapy.The clinical characteristics and fertility-preserving outcomes of these patients were compared with those of patients without any evidence of myometrial invasion on MRI(n=98,reference group).Results Among patients with suspected myometrial invasion on MRI,myometrial invasion was pathologically excluded in 29 patients(non-MI group).The cumulative complete response rate was lower in the non-MI group than in the reference group at the 8th month(43.4%vs.64.9%,P=0.040)and was not significant at the 18th month(87.5%vs.96.8%,P=0.11).The 24-month cumulative relapse rate was 31.2%in the non-MI group,versus 0%in the ref-erence group(P<0.0001).Conclusion Myometrial invasion was pathologically confirmed in approximately one-fourth of patients with sus-pected myometrial invasion on MRI.However,suspected myometrial invasion on MRI with negative pathological findings was correlated with worse fertility-preserving outcomes in young women with endometrial cancer.
