Laparoscopic radical hysterectomy and tension-free vaginal tape-obturator (TVT-O) combined to treat cervical cancer complicating pelvic organ prolapse (POP) and stress urinary incontinence (SUI): A case report

Abstract Background: Combined cervical cancer and pelvic organ prolapse (POP) is extremely uncommon and there is no standard treatment guideline for the complex comorbidity. We attempted to provide a treatment strategy and explore possible reasons for the comorbidities.Case presentation: We presented a 62-year-old patient seeking treatment for postmenopausal tissue prolapse and leakage of urine. Physical examination revealed procidentia with a 2.5 cm papillary and erosive lesion that was pathologically confirmed as cervical squamous cell carcinoma in stage Ib2. Clinical diagnosis included cervical squamous cell carcinoma in stage Ib2, prolapse of the anterior and posterior walls of the vagina and uterine, stress urinary incontinence (SUI). Then she was performed radical surgery for cervical cancer and tension-free vaginal tape-obturator (TVT-O). The urine function was good after operation. The surgery solved two diseases, which improved the quality of life (QOL) of patient and radically cured cervical malignancies at the same time.Conclusions: Surgical-based treatment seems to be more suitable that can cure the two diseases and improve the QOL. We should pay attention to the potential high incidence of HPV infection and HPV-related cervical cancer so that we should not ignore the screening for cervical cancer in the prolapse group and initiate surgery treatment strategies of cervical cancer or pre-cancerous lesions as early as possible to reach an optimal outcome of patient.

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Laparoscopic Radical Hysterectomy and Tension-Free Vaginal Tape-Obturator (TVT-O) Combined to Treat Cervical Cancer Complicating Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI): A Case Report

10.21203/rs.3.rs-265039/v1 ◽

2021 ◽

Author(s):

Yu Ran ◽

Qiang Yi ◽

Cong Li ◽

Qin Zhou

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Stress Urinary Incontinence ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cervical Squamous Cell Carcinoma ◽

Pelvic Organ ◽

Vaginal Tape Obturator

Abstract Background: Combined cervical cancer and pelvic organ prolapse (POP) is extremely uncommon and there is no standard treatment guideline for the complex comorbidity. We attempted to provide a treatment strategy and explore possible reasons for the comorbidities.Case presentation: We presented a 62-year-old patient seeking treatment for postmenopausal tissue prolapse and leakage of urine, physical examination revealed procidentia with a 2.5 cm papillary and erosive lesion that was pathologically confirmed as cervical squamous cell carcinoma in stage Ib2. Clinical diagnosis included cervical squamous cell carcinoma in stage Ib2, prolapse of the anterior and posterior walls of the vagina and uterine, stress urinary incontinence (SUI), and then she was performed radical surgery for cervical cancer and tension-free vaginal tape-obturator (TVT-O), the urine function was good after operation. The surgery solved two diseases at the same time that improve the QOL of patients while radically curing cervical malignancies.Conclusions: Surgical-based treatment seems to be more suitable that can cure the two diseases and improve the QOL. We should pay attention to the potential high incidence of HPV infection and HPV-related cervical cancer so that don't ignore the screening for cervical cancer in the prolapse group and initiate surgery treatment strategies of cervical cancer or pre-cancerous lesions as early soon as possible to reach an optimal outcome of patient.

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Expression of Angiopoietin and VEGF in cervical cancer and its clinical significance

Open Life Sciences ◽

10.1515/biol-2018-0063 ◽

2018 ◽

Vol 13 (1) ◽

pp. 527-532

Author(s):

Qingyuan Lv ◽

Weijuan Zhong ◽

Xiabin Ye ◽

Yang Lv ◽

Haiying Liu ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Clinical Significance ◽

Squamous Cell ◽

Tumor Tissue ◽

Neoadjuvant Chemoradiotherapy ◽

Lymphatic Vessels ◽

Cervical Squamous Cell Carcinoma ◽

Positive Expression

AbstractObjectiveThe aim of this study was to evaluate the expression of Angiopoietin-1 (Ang-1), Angiopoietin-2 (Ang-2) and vascular endothelial growth factor (VEGF) in cervical cancer and its clinical significance.MethodsImmunohistochemical assay was used to examine the expression of Ang-1/2 and VEGF in tumor tissue from 56 cervical squamous cell carcinoma patients treated with operation only (SCC-O group), as well as 51 subjects with cervical squamous cell carcinoma treated with neoadjuvant radiotherapy (SCC-RCO group, n=28) or neoadjuvant chemotherapy (SCC-CO group, n=23). Both microvessel density (MVD) and lymphatic vessel density (LVD) were examined in the three groups through detection of CD34 and D2-40 expression in respective tissue samples.ResultsWith the progression of cervical cancer, the positive expression scores of Ang-2 and VEGF were significantly increased (p<0.05). Compared with surgical intervention, neoadjuvant chemoradiotherapy significantly reduced the positive expression scores of Ang-1, Ang-2, and VEGF in cervical cancer tissues (p<0.05). The MVD values of the SCC-CO and SCC-RO groups were significantly reduced as compared to the SCC-O group (p<0.05). Similarly, the LVD values of the SCC-CO and SCC-RO groups were also significantly reduced when compared to those of the SCC-O group (p<0.05). However, LVD values of the SCC-CO and SCC-RO groups were not statistical different (p>0.05).ConclusionAng-1, Ang-2 and VEGF may play an important role in the development of cervical cancer. Mutual synergism of Ang-2 and VEGF demonstrated a close relationship with the generation of cervical blood and lymphatic vessels. Cervical cancer radiotherapy and chemotherapy could significantly inhibit the formation of blood vessels and lymphatic vessels in tumor tissue.

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Acetyl Coenzyme A Synthase 2 Acts as a Prognostic Biomarker Associated with Immune Infiltration in Cervical Squamous Cell Carcinoma

Cancers ◽

10.3390/cancers13133125 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3125

Author(s):

Chia-Jung Li ◽

Yi-Han Chiu ◽

Chung Chang ◽

Yuan-chin Ivan Chang ◽

Jim Jinn-Chyuan Sheu ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Coenzyme A ◽

Prognostic Biomarker ◽

Cervical Squamous Cell Carcinoma ◽

Acetyl Coenzyme A ◽

Immune Infiltration ◽

Acetyl Coenzyme A Synthase

Cervical squamous cell carcinoma (CESC) is one of the most common malignant tumors in women worldwide with a low survival rate. Acetyl coenzyme A synthase 2 (ACSS2) is a conserved nucleosidase that converts acetate to acetyl-CoA for energy production. Our research intended to identify the correlations of ACSS2 with clinical prognosis and tumor immune infiltration in CESC. ACSS2 is highly expressed in many tumors and is involved in the progression and metastasis of these tumors. However, it is not clear how ACSS2 affects CESC progression and immune infiltration. Analysis of the cBioPortal, GEPIA2, UALCAN, and TCGA databases showed that ACSS2 transcript levels were significantly upregulated in multiple cancer types including CESC. Quantitative RT-PCR analysis confirmed that ACSS2 expression was significantly upregulated in human cervical cancer cells. Here, we performed tissue microarray analysis of paraffin-embedded tissues from 240 cervical cancer patients recorded at FIGO/TNM cancer staging. The results showed that ACSS2 and PDL1 were highly expressed in human CESC tissues, and its expression was associated with the clinical characteristics of CESC patients. TIMER database analysis showed that ACSS2 expression in CESC was associated with tumor infiltration of B cells, CD4+ and CD8+ T cells, and cancer-associated fibroblasts (CAF). Kaplan–Meier survival curve analysis showed that CESC with high ACSS2 expression was associated with shorter overall survival. Collectively, our findings establish ACSS2 as a potential diagnostic and prognostic biomarker for CESC.

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Challenges in Diagnosis and Treatment of a Cervical Carcinoma Complicated by Genital Prolapse

Case Reports in Obstetrics and Gynecology ◽

10.1155/2021/5523016 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Aikaterini-Eirini Evangelopoulou ◽

Konstantinos Zacharis ◽

Konstantina Balafa ◽

Alexandros Daponte ◽

Ourania Koukoura

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Elderly Women ◽

Clinical Stage ◽

Genital Prolapse ◽

Cervical Squamous Cell Carcinoma ◽

Pelvic Organ ◽

Clinical Staging ◽

Uterovaginal Prolapse

Cervical squamous cell carcinoma of the uterus associated with pelvic organ prolapse is very rare and usually occurs in elderly women. We hereby present an 81-year-old postmenopausal woman presented to the outpatient department with an ulcerated irreducible uterine procidentia. The prolapse was reduced under general anesthesia and biopsy of the lesions confirmed a cervical squamous cell carcinoma. Pretreatment clinical staging revealed a 16 cm enlarged uterus and mild to moderate unilateral hydroureteronephrosis, secondary to periureteric infiltration, clinical stage IIIB. The patient was disqualified from surgery, and palliative chemotherapy plus radiotherapy was recommended. Patient’s general condition was rapidly deteriorated, and three months after the diagnosis, the patient passed away. Therapeutic management of cervical cancer associated with uterovaginal prolapse is not well established. Hence, this article presents the clinical concerns that arise in such rare and neglected cases.

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Radiation-Induced Uterine Carcinosarcoma after Concurrent Chemoradiotherapy for Cervical Squamous Cell Carcinoma

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0038-1673678 ◽

2018 ◽

Vol 40 (12) ◽

pp. 800-802 ◽

Cited By ~ 2

Author(s):

Joana Moreira-Barros ◽

Kuan-Gen Huang ◽

Tsung-Hsun Tsai

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Uterine Cavity ◽

Figo Stage ◽

Cervical Squamous Cell Carcinoma ◽

Cervical Canal ◽

Uterine Carcinosarcoma ◽

Radiation Induced

Objective To describe a case of radiation-induced uterine carcinosarcoma 6 years after a cervical squamous cell carcinoma treatment, which imposed some diagnostic and management challenges. Case Report A 57-year-old woman with a history of pelvic chemoradiotherapy ∼ 6.5 years before the event described in this study, following an International Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical cancer, presented with a cervical mass, involving the uterine cavity, the cervical canal and the upper two thirds of the vagina. The biopsy showed a poorly differentiated carcinoma, and a positron emission tomography (PET) scan excluded distant metastasis, although it was unable to define the origin of the tumor as either a new primary malignancy of the endometrium/cervix or as a cervical recurrence. Surgical staging procedure was performed, and the diagnosis was endometrial carcinosarcoma, FIGO stage IIB. The patient was not able to complete the adjuvant therapy, and the progression of the disease was remarkable. Conclusion The present case highlights one of the less common but more serious consequences of radiotherapy for cervical cancer, which has an increasing incidence in younger women, raising concerns about the long-term consequences of its management.

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Exploration of potential therapeutic and prognostic value of CXC chemokines in cervical squamous cell carcinoma and endocervical adenocarcinoma based on bioinformatics analysis

Mathematical Biosciences and Engineering ◽

10.3934/mbe.2021407 ◽

2021 ◽

Vol 18 (6) ◽

pp. 8201-8222

Author(s):

Caiyun Wu ◽

◽

Cong Ma ◽

Jing Yuan ◽

Pei Zhou ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

T Cells ◽

Cell Carcinoma ◽

Squamous Cell ◽

Strong Correlation ◽

Prognostic Value ◽

Cervical Squamous Cell Carcinoma ◽

Expression Levels ◽

Endocervical Adenocarcinoma

<abstract> <p>Cervical cancer, as the second most common female malignancy, brings a great health burden to women worldwide. Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) are the most common histological subtypes of cervical cancer. CXC chemokines (CXCLs) within the tumor microenvironment can modulate carcinogenesis and progression. The present study aimed to explore the therapeutic and prognostic value of different CXCLs in CESC. ONCOMINE, GEPIA, cBioPortal, TRRUST, GeneMANIA, STRING and TIMER were utilized to explore the expression, mutation and function of CXCLs in CESC, as well as their correlation with pathological and survival features of CESC patients. We found that the mRNA expression levels of CXCL1/8/9/10/11/13/16/17 in CESC were upregulated compared with normal cervical tissues, whereas CXCL12 was downregulated. No significant correlation was found between the expression levels and pathological stage of CESC patients. CESC patients with high expression of CXCL1/2/3/4/5/8 were significantly associated with poor overall survival, additionally, low mRNA level of CXCL3 was associated with better disease-free survival. Besides, a high mutation rate (43%) of CXCLs in CESC was observed. Depicted by co-expression analysis, the expression of CXCL1/2/3/6/8 showed a modest to strong correlation, while that of CXCL9/10/11/13 showed a very strong correlation. Differentially expressed CXCLs primarily functioned in chemokine signaling pathway and inflammation response, such as cell chemotaxis, chemokine activity and chemokine receptor binding. We also found the association of CXCLs with the tumor-infiltration of six types of immune cells (B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils and dendritic cells) in CESC patients. The present study elucidated that CXCLs may have the potential to be novel therapeutic targets and prognosis predictors of CESC patients.</p> </abstract>

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Methylation-Based Classification of Cervical Squamous Cell Carcinoma into Two New Subclasses Differing in Immune-Related Gene Expression

International Journal of Molecular Sciences ◽

10.3390/ijms19113607 ◽

2018 ◽

Vol 19 (11) ◽

pp. 3607 ◽

Cited By ~ 1

Author(s):

Xia Li ◽

Yunpeng Cai

Keyword(s):

Gene Expression ◽

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Immune Cell ◽

Cervical Squamous Cell Carcinoma ◽

Related Gene ◽

Immune Related Gene

Cervical cancer is traditionally classified into two major histological subtypes, cervical squamous cell carcinoma (CSCC) and cervical adenocarcinoma (CA). However, heterogeneity exists among patients, comprising possible subpopulations with distinct molecular profiles. We applied consensus clustering to 307 methylation samples with cervical cancer from The Cancer Genome Atlas (TCGA). Fisher’s exact test was used to perform transcription factors (TFs) and genomic region enrichment. Gene expression profiles were downloaded from TCGA to assess expression differences. Immune cell fraction was calculated to quantify the immune cells infiltration. Putative neo-epitopes were predicted from somatic mutations. Three subclasses were identified: Class 1 correlating with the CA subtype and Classes 2 and 3 dividing the CSCC subtype into two subclasses. We found the hypomethylated probes in Class 3 exhibited strong enrichment in promoter region as compared with Class 2. Five TFs significantly enriched in the hypomethylated promoters and their highly expressed target genes in Class 3 functionally involved in the immune pathway. Gene function analysis revealed that immune-related genes were significantly increased in Class 3, and a higher level of immune cell infiltration was estimated. High expression of 24 immune genes exhibited a better overall survival and correlated with neo-epitope burden. Additionally, we found only two immune-related driver genes, CARD11 and JAK3, to be significantly increased in Class 3. Our analyses provide a classification of the largest CSCC subtype into two new subclasses, revealing they harbored differences in immune-related gene expression.

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