A Combination of Serum Tumor Markers Identifies High-Risk Patients with Early-Stage Squamous Cervical Cancer

ABSTRACT Objectives To determine the correlation between cytology, colposcopy and histopathology, individually and in combination, in high-risk patients for detection of early cancer of the cervix. Materials and methods A total of 200 high-risk patients in the age groups of 35 to 60 years were included in the study. Pap smear, colposcopy and colposcopically directed biopsies were taken from the suspicious area. Results Sensitivity, specificity and positive predictive value of Pap smear are 65.2, 96.3 and 89.3% respectively. Correlation between cytology and colposcopy was 81%, between colposcopy and histopathology was 90.6%, between cytology, colposcopy and histopathology was 90.6% and between cytology, colposcopy and histopathology was 87.3%. Conclusion Combination of various methods increases the diagnostic accuracy over that of each method separately. How to cite this article Jyothi R, Gupta P, Rao R, Sood PL, Parasher N. Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India. J South Asian Feder Menopause Soc 2013;1(1):21-23.

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Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Frontiers in Oncology ◽

10.3389/fonc.2021.701758 ◽

2021 ◽

Vol 11 ◽

Author(s):

Lirong Zhai ◽

Xiwen Zhang ◽

Manhua Cui ◽

Jianliu Wang

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Sentinel Lymph Node ◽

Early Stage ◽

Sentinel Lymph Node Mapping ◽

Lymph Node Status ◽

Lymph Node Mapping ◽

High Risk Patients ◽

Risk Patients

Endometrial cancer (EC) is known as a common gynecological malignancy. The incidence rate is on the increase annually. Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2; (2) myometrial invasion< 1/2; (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). However, conventional LAD shows high complication incidence and uncertain survival benefits. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic metastasis of the primary malignant tumor through the regional lymphatic drainage pathway and can indicate the involvement of lymph nodes across the drainage area. Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node mapping (SLNM) with pathologic ultra-staging. Meanwhile, SLNM did not compromise the patient’s progression-free survival (PFS) and overall survival (OS) with low operative complications. However, the application of SLNM in early-stage high-risk EC patients remains controversial. As revealed by the recent studies, SLNM may also be feasible, effective, and safe in high-risk patients. This review aims at making a systematic description of the progress made in the application of SLNM in the treatment of EC and the relevant controversies, including the application of SLNM in high-risk patients.

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Identification of an Individualized Metabolism Prognostic Signature and Related Therapy Regimens in Early Stage Lung Adenocarcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.650853 ◽

2021 ◽

Vol 11 ◽

Author(s):

Junjie Hu ◽

Huansha Yu ◽

Liangdong Sun ◽

Yilv Yan ◽

Lele Zhang ◽

...

Keyword(s):

High Risk ◽

Adjuvant Therapy ◽

Lung Adenocarcinoma ◽

In Silico ◽

Early Stage ◽

Stage I ◽

Stage Ii ◽

Related Gene ◽

High Risk Patients ◽

Risk Patients

ObjectiveThe choice of adjuvant therapy for early stage lung adenocarcinoma (LUAD) remains controversial. Identifying the metabolism characteristics leading to worse prognosis may have clinical utility in offering adjuvant therapy.MethodsThe gene expression profiles of LUAD were collected from 22 public datasets. The patients were divided into a meta-training cohort (n = 790), meta-testing cohort (n = 716), and three independent validation cohorts (n = 345, 358, and 321). A metabolism-related gene pair index (MRGPI) was trained and validated in the cohorts. Subgroup analyses regarding tumor stage and adjuvant chemotherapy (ACT) were performed. To explore potential therapeutic targets, we performed in silico analysis of the MRGPI.ResultsThrough machine learning, MRGPI consisting of 12 metabolism-related gene pairs was constructed. MRGPI robustly stratified patients into high- vs low-risk groups in terms of overall survival across and within subpopulations with stage I or II disease in all cohorts. Multivariable analysis confirmed that MRGPI was an independent prognostic factor. ACT could not improve prognosis in high-risk patients with stage I disease, but could improve prognosis in the high-risk patients with stage II disease. In silico analysis indicated that B3GNT3 (overexpressed in high-risk patients) and HSD17B6 (down-expressed in high-risk patients) may make synergic reaction in immune evasion by the PD-1/PD-L1 pathway. When integrated with clinical characteristics, the composite clinical and metabolism signature showed improved prognostic accuracy.ConclusionsMRGPI could effectively predict prognosis of the patients with early stage LUAD. The patients at high risk may get survival benefit from PD-1/PD-L1 blockade (stage I) or combined with chemotherapy (stage II).

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