Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(株)メジカルビュー社  

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Language：English   Publishing type：Research paper (scientific journal)  

We previously reported that L63X and Q934X are BRCA1 common founder variants in Japan. So far, there have been no reports of a correlation between such BRCA common variants and the risk of BRCA-related cancers. In this analysis, we investigated the correlation between the risk of ovarian cancer (OC) and BRCA recurrent pathogenic variants. We examined the database of the Japanese organization of hereditary breast and ovarian cancer. The database contained 3517 probands who underwent BRCA genetic testing. Among them, 11.1% (392/3517) had germline BRCA1 pathogenic variant, and 8.3% (293/3517) had BRCA2 pathogenic variant. We calculated the OC prevalence, breast cancer (BC) prevalence, and the ratio of OC to BC within second-degree relatives. The ratio of OC to BC in Q934X family members was significantly higher than that in the overall BRCA1 family members (0.80 vs.0.52: p = 0.038), and the ratio in STOP799 was 0.42, which was relatively lower than the overall BRCA1 value. Both Q934X and STOP799 are located in the ovarian cancer cluster region (OCCR), however there seems to be a difference in the risk of OC. R2318X family members had a significant higher ratio of OC to BC at 0.32 than the overall BRCA2 value of 0.13 (p = 0.012). R2318X is known to be located in the OCCR. This is the first report to investigate the correlation between BRCA recurrent variants and the risk of OC in Japan. The family members of probands with Q934X or R2318X have a higher risk of OC than that with other BRCA variants.

DOI： 10.1038/s10038-021-01002-z

PubMed

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Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞●卵巣がんに対するBRCA遺伝学的検査は,その目的により(1)PARP阻害薬適応判断のためのコンパニオン検査,(2)遺伝性乳がん卵巣がん(HBOC)を診断するための検査,に大別される.●卵巣がんの約15%はHBOCであり,その診断を目的としたBRCA遺伝学的検査は,すべての卵巣がんに対して保険診療として実施可能である.●BRCA遺伝学的検査により,発端者へのPARP阻害薬による治療や,がん未発症家系員へのサーベイランス・リスク低減手術の提供が可能となる場合があり,卵巣がん全例に対する検査実施を考慮すべきである.

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞●卵巣がんの約15%は遺伝性乳がん卵巣がん(HBOC)である.HBOCを診断することのベネフィットは大きく,卵巣がん全例に対してBRCA遺伝学的検査の実施を考慮すべきである.●HBOCは,診断法や病的バリアント保持者に対する対応(サーベイランス・リスク低減手術など)が定まっている数少ない遺伝性疾患の1つである.●HBOCを診断することは,発端者へのPARP阻害薬による治療のみならず,家系員のバリアント保持者の診断やサーベイランス・リスク低減手術の提供を可能とし,健康維持に大きく貢献する.

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Language：Japanese   Publisher：(株)メディカルドゥ  

卵巣癌に対するゲノム医療は,BRCA1/2遺伝子の生殖細胞系列病的バリアント(gBRCAm)を原因とする遺伝性乳癌卵巣癌(hereditary breast and ovarian cancer:HBOC)を主な対象として行われた臨床試験により,PARP阻害薬の有効性が証明され大きく変貌を遂げた。PARP阻害薬は,今では臓器横断的に相同組換え修復異常(homologous recombination deficiency:HRD)を示すがんに対して有効性が示されている。再発卵巣癌の維持療法においては,PARP阻害薬の感受性を予測する臨床的なサロゲートマーカーとしてプラチナ感受性が用いられ,さらに初回治療における維持療法を中心としたコンパニオン診断としてgBRCA1/2遺伝子検査と腫瘍におけるMyriad myChoice HRD検査が保険適応となった。さらに,HBOCの乳癌あるいは卵巣癌患者に対する予防診療が2020年4月より保険収載され,HBOCに対する診断と治療が日々変化している状況となっている。本稿ではHBOCの卵巣癌患者をターゲットとしたゲノム医療と,ゲノム情報に基づく先制医療の現状と展望について解説する。(著者抄録)

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Language：Japanese   Publisher：新潟産科婦人科学会  

当院でBevacizumab(Bev)を導入した進行・再発卵巣癌・卵管癌・腹膜癌125例を対象に有害事象について検討を行った。その結果、Grade3以上の有害事象として高血圧16例(12.8%)、蛋白尿5例(4.0%)、血栓塞栓症3例(2.4%)、消化管穿孔2例(1.6%)が認められた。消化管穿孔例はともにGrade4で緊急手術を要し、それぞれ腫瘍と直腸癒着・浸潤部分の穿孔、高度癒着部分の穿孔であった。

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Language：Japanese   Publisher：新潟産科婦人科学会  

当院でBevacizumab(Bev)を導入した進行・再発卵巣癌・卵管癌・腹膜癌125例を対象に有害事象について検討を行った。その結果、Grade3以上の有害事象として高血圧16例(12.8%)、蛋白尿5例(4.0%)、血栓塞栓症3例(2.4%)、消化管穿孔2例(1.6%)が認められた。消化管穿孔例はともにGrade4で緊急手術を要し、それぞれ腫瘍と直腸癒着・浸潤部分の穿孔、高度癒着部分の穿孔であった。

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Hereditary breast and ovarian cancer is caused by a germline mutation in BRCA1 or BRCA2 genes. The frequency of germline BRCA1/2 gene mutation carriers and the ratio of germline BRCA1 to BRCA2 mutations in BRCA-related cancer patients vary depending on the population. Genotype and phenotype correlations have been reported in BRCA mutant families, however, the correlations are rarely used for individual risk assessment and management. BRCA genetic testing has become a companion diagnostic for PARP inhibitors, and the number of families with germline BRCA mutation identified is growing rapidly. Therefore, it is expected that analysis of the risk of developing cancer will be possible in a large number of BRCA mutant carriers, and there is a possibility that personal and precision medicine for the carriers with specific common founder mutations will be realized. In this review, we investigated the association of ovarian cancer risk and BRCA mutation location, and differences of other BRCA-related cancer risks by BRCA1/2 mutation, and furthermore, we discussed the difference in the prevalence of germline BRCA mutation in ovarian cancer patients. As a result, although there are various discussions, there appear to be differences in ovarian cancer risk by population and BRCA mutation location. If it becomes possible to estimate the risk of developing BRCA-related cancer for each BRCA mutation type, the age at risk-reducing salpingo-oophorectomy can be determined individually. The decision would bring great benefits to young women with germline BRCA mutations.

DOI： 10.3390/genes12071050

PubMed

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：English   Publishing type：Research paper (scientific journal)  

In the field of gynecology, the approval of the PARP inhibitors (PARPi) has been changing the treatment of ovarian cancer patients. The BRCA genetic test and the HRD test are being used as a companion diagnosis before starting PARPi treatment. BRACAnalysis CDx® and Myriad myChoice® HRD test are widely used as a BRCA genetic test and HRD test, respectively. In addition, FoundationOne®CDx is sometimes used as a tumor BRCA test and HRD test. In clinical practice, gynecologists treating ovarian cancer are faced with making decisions such as whether to recommend the gBRCA test to all ovarian cancer patients, whether to perform the gBRCA test first or HRD test first, and so on. Regarding the judgment result of the HRD test, the cutoff value differs depending on the clinical trial, and the prevalence of gBRCA pathogenic variant rate is different in each histological type and country. A prospective cohort study showed that RRSO reduced all-cause mortality in both pre- and postmenopausal women; however, RRSO significantly reduced the risk of breast cancer for BRCA2 pathogenic variant carriers, but not for BRCA1 pathogenic variant carriers. Moreover, salpingectomy alone is said to not decrease the risk of developing ovarian or breast cancer, so further discussion is evidently required. We discuss the current situation and problems in doing BRCA genetic test and RRSO in this review article.

DOI： 10.3390/cancers13112562

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

BACKGROUND: Mesenteric lymph node (MLN) involvement is often observed in ovarian cancer (OC) with rectosigmoid invasion. This study aimed to investigate the clinical significance of MLN involvement in the pattern of liver metastasis in patients with OC. METHODS: We included 85 stage II-IV OC patients who underwent primary or interval debulking surgery. Twenty-seven patients underwent rectosigmoid resection, whose status of MLN involvement was judged from hematoxylin and eosin (H&E) staining of resected specimens. The prognostic significance of clinicopathological characteristics, including MLN involvement, was evaluated using univariate and multivariate analyses. RESULTS: MLN involvement was detected in 14/85 patients with stage II-IV OC. Residual tumor status, cytology of ascites, and MLN involvement were independent prognostic factors for progression-free survival (PFS; p = 0.033, p = 0.014, and p = 0.008, respectively). When patients were classified into three groups (no MLN, one MLN, two or more MLNs), the number of MLNs involved corresponded to three distinct groups in PFS (p = 0.001). The 3-year cumulative incidence of liver metastasis of patients with MLN involvement was significantly higher than that of patients without MLN involvement (61.1% vs. 8.9%, p < 0.001). MLN involvement was significantly associated with liver metastasis of hematogenous origin (p < 0.001) compared with peritoneal disseminated origin. CONCLUSION: MLN involvement is an important prognostic factor in OC, predicting poor prognosis and liver metastasis of hematogenous origin.

DOI： 10.1245/s10434-021-09899-8

PubMed

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Other Link： http://link.springer.com/article/10.1245/s10434-021-09899-8/fulltext.html

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The standard treatment for stage IB-IIB cervical cancer is radiotherapy or radical hysterectomy; after radical hysterectomy, adjuvant concurrent chemoradiotherapy is recommended for patients with high risk factors. However, adjuvant concurrent chemoradiotherapy can cause severe gastrointestinal and urinary toxicity. PRIMARY OBJECTIVE: To assess whether postoperative adjuvant chemotherapy is not inferior to adjuvant concurrent chemoradiotherapy for overall survival in patients with high risk cervical cancer. STUDY HYPOTHESIS: Adjuvant chemotherapy is not inferior to adjuvant concurrent chemoradiotherapy for overall survival and will reduce severe toxicities. TRIAL DESIGN: Patients with high risk factors after radical hysterectomy will be randomized 1:1 to receive adjuvant concurrent chemoradiotherapy or adjuvant chemotherapy. Treatment will be started within 6 weeks of surgery. The concurrent chemoradiotherapy group will receive whole pelvis irradiation (50.4 Gy) and cisplatin (40 mg/m2/week). The chemotherapy group will receive paclitaxel (175 mg/m2) plus cisplatin (50 mg/m2) or carboplatin (AUC=6) every 3 weeks for six cycles. MAJOR INCLUSION/EXCLUSION CRITERIA: Patients with high risk stage IB-IIB cervical cancer (squamous cell carcinoma, adenocarcinoma, and adenosquamous cell carcinoma) who underwent radical hysterectomy are eligible for the study. High risk is defined as the presence of pelvic lymph node metastasis and/or parametrial invasion. PRIMARY ENDPOINT: The primary endpoint is overall survival. SAMPLE SIZE: 250 patients in total are required. ESTIMATED DATES FOR COMPLETING ACCRUAL: This study began in November 2019, and 250 patients will be accrued within 5 years. TRIAL REGISTRATION NUMBER: The study has been registered with the Japan Registry of Clinical Trials (jRCTs041190042).

DOI： 10.1136/ijgc-2020-002344

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1245/s10434-021-09919-7

PubMed

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Other Link： http://link.springer.com/article/10.1245/s10434-021-09919-7/fulltext.html

Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

症例1は80歳で、約2年前から子宮下垂感を自覚し、約1年前から排便時に直腸脱を認めるようになった。今回、Stage IVの子宮脱および完全直腸脱の診断で一期的根治手術を行う方針となり、腹腔鏡下にWells直腸後方固定術+子宮腟上部切断+両側付属器切除+シングルメッシュによる仙骨腟固定術を施行し、術後経過良好であった。症例2は78歳で、約2年前から子宮脱を自覚し、間欠的自己還納で対応していた。半年前に排尿困難感が出現し、手術目的で当科を紹介受診した。初回受診時は子宮脱のみであったが、2回目の診察で直腸脱の併発を認めた。今回、Stage IVの子宮脱および完全直腸脱の診断で症例1と同様の手術を行い、術後経過良好であった。

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：新潟県医師会  

新しい分子標的薬であるPARP阻害薬は、生殖細胞系列のBRCA1/2遺伝子変異を原因とする遺伝性乳癌卵巣癌(Hereditary Breast and Ovarian Cancer:HBOC)患者に高い感受性を示すことから多くの臨床試験が行われた結果、今では臓器横断的に相同組換え修復異常(homologous recombination deficiency:HRD)を示す癌に対して臨床現場で普及し始めている。再発卵巣癌治療では、PARP阻害薬オラパリブの感受性を予測する臨床的な感受性サロゲートマーカーとしてプラチナ感受性が用いられ、卵巣癌の初回治療ではBRCA1/2遺伝子検査がコンパニオン診断として保険適応となっている。さらに、HBOCの乳癌あるいは卵巣癌患者に対する予防診療が2020年4月より保険収載された。上記の保険承認により婦人科癌の治療が一気に変化しつつある。本稿ではHBOCをターゲットにしたゲノム医療の進展と、ゲノム情報に基づく先制医療の現状と展望について概説する。(著者抄録)

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Language：Japanese   Publisher：新潟産科婦人科学会  

骨盤臓器脱に対して2018年6月〜2020年2月に腹腔鏡下仙骨腟固定術を行った31例のうち、直腸脱の同時手術を行った2例を除く29例を対象とし、「手術時間」「術中出血量」「術中・術後合併症」「再発の有無」「術前後の排尿機能」などについて検討した。手術時間は128〜256分(中央値199分)、出血量は5〜10mL(中央値5mL)であった。術中合併症は認めなかった。術後合併症として腹腔内感染を1例に認めたが保存的治療で改善した。再発は1例に認め、再発部位はメッシュ固定部位以外の後壁であり、追加手術は要しなかった。排尿機能はOABSSとIPSSで評価し、術前のOABSSは軽症(5点以下)5例、中等症(6〜11点)6例、術後のOABSSは軽症1例、中等症1例、重症(12点以上)1例であった。術前のIPSSは軽症(0〜7点)50%、中等症(8〜19点)35%、重症(20〜35点)15%、術後のIPSSは軽症81%、中等症15%、重症4%であった。

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(一社)日本内分泌外科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title>Molecular characteristics of carcinoma arising from mature cystic teratoma of the ovary (MCT) remain unclear due to its rarity. We analyzed RNA-sequencing data of 2322 pan-cancer [1378 squamous cell carcinomas (SCC), 6 adenosquamous carcinomas (ASC), and 938 adenocarcinomas (AC)] including six carcinomas arising from MCT (four SCCs, one ASC, and one AC). Hierarchical clustering and principal component analysis showed that gene expression profiles of carcinomas arising from MCT were different between each histological type and that gene expression profiles of SCCs arising MCT (MCT-SCCs) was apparently similar to those of lung SCCs. By epidermis-associated pathways activity based on gene set enrichment analysis, 1030 SCCs were divided into two groups: epidermis-signature high (head and neck, esophagus, and skin) and low (cervix, lung, and MCT). In addition to pan-SCC transcriptome analysis, cytokeratin profiling based on immunohistochemistry in the independent samples of 21 MCT-SCCs clarified that MCT-SCC dominantly expressed CK18, suggesting the origin of MCT-SCC was columnar epithelium. Subsequently, we investigated differentially expressed genes in MCT-SCCs compared with different SCCs and identified <italic>XCL1</italic> was specifically overexpressed in MCT-SCCs. Through immunohistochemistry analysis, we identified XCL1 expression on tumor cells in 13/24 (54%) of MCT-SCCs but not in MCTs. XCL1 expression was also significantly associated with the number of tumor-infiltrating CD8-positive T cells and PD-L1 expression on tumor cells. XCL1 produced by tumor cells may induce PD1/PD-L1 interaction and dysfunction of CD8-positive T cells in tumor microenvironment. XCL1 expression may be a novel biomarker for malignant transformation of MCT into SCC and a biomarker candidate for therapeutic response to an anti-PD1/PD-L1 therapy.

DOI： 10.1038/s41388-020-1237-0

Web of Science

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Other Link： http://www.nature.com/articles/s41388-020-1237-0

Language：Japanese   Publisher：(株)診断と治療社  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：English   Publisher：(一社)日本癌治療学会  

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Language：Japanese   Publisher：(一社)日本女性医学学会  

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Language：Japanese   Publisher：(公社)日本臨床細胞学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

3歳女児。性器出血と外陰から突出する腫瘤に母親が気づき近医を受診後、精査目的で当科へ紹介となった。初診時、静脈麻酔下に腫瘤生検を行ったが、病理組織診断では悪性所見を認めず、良性の処女膜ポリープとして経過観察していた。しかし、その後も性器出血が持続したため、初診5ヵ月目に全身麻酔下にて硬性子宮鏡を用い腟内を観察したところ、腟壁から無数のポリープ様腫瘤がブドウの房状に発育しており、鏡視下に腫瘤を切除したが、完全切除には至らなかった。病理組織学的に胎児型横紋筋肉腫と確定診断され、術後は4剤併用化学療法と放射線療法を行った。その結果、残存病変は消失し、治療から4年以上経過現在、再発所見は認められていない。

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology and Colposcopy  

DOI： 10.3802/jgo.2019.30.e114

PubMed

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Other Link： https://synapse.koreamed.org/DOIx.php?id=10.3802/jgo.2019.30.e114

Language：Japanese   Publisher：新潟産科婦人科学会  

腹腔鏡下子宮全摘術(TLH)を施行した既往帝王切開31例を対象とし、定型化した帝王切開術後の膀胱剥離法を開始前の3例(42〜51歳)と開始後28例(41〜62歳)であった。手術適応では、開始後で子宮体癌の症例数が11例と多かった。開腹への移行、膀胱損傷など、手技に関係する術中・術後の合併症は認めなかった。入院期間、手術時間に顕著な差は認めなかったが、出血量は開始後で少ない傾向にあった。

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：American Society of Clinical Oncology (ASCO)  

<sec><title>Purpose</title> Clear cell carcinoma (CCC) is a rare histologic subtype that demonstrates poor outcomes in epithelial ovarian cancer. The Japanese Gynecologic Oncology Group conducted the first randomized phase III, CCC-specific clinical trial that compared irinotecan and cisplatin (CPT-P) with paclitaxel plus carboplatin (TC) in patients with CCC.

</sec><sec><title>Patients and Methods</title> Six hundred sixty-seven patients with stage I to IV CCC of the ovary were randomly assigned to receive irinotecan 60 mg/m² on days 1, 8, and 15 plus cisplatin 60 mg/m² on day 1 (CPT-P group) every 4 weeks for six cycles or paclitaxel 175 mg/m² plus carboplatin area under the curve 6.0 mg/mL/min on day 1 every 3 weeks for six cycles (TC group). The primary end point was progression-free survival. Secondary end points were overall survival, overall response rate, and adverse events.

</sec><sec><title>Results</title> Six hundred nineteen patients were clinically and pathologically eligible for evaluation. With a median follow-up of 44.3 months, 2-year progression-free survival rates were 73.0% in the CPT-P group and 77.6% in TC group (hazard ratio, 1.17; 95% CI, 0.87 to 1.58; P = .85). Two-year overall survival rates were 85.5% with CPT-P and 87.4% with TC (hazard ratio, 1.13; 95% CI, 0.80 to 1.61; one-sided P = .76). Grade 3/4 anorexia, diarrhea, nausea, vomiting, and febrile neutropenia occurred more frequently with CPT-P, whereas grade 3/4 leukopenia, neutropenia, thrombocytopenia, peripheral sensory neuropathy, and joint pain occurred more frequently with TC.

</sec><sec><title>Conclusion</title> No significant survival benefit was found for CPT-P. Both regimens were well tolerated, but the toxicity profiles differed significantly. Treatment with existing anticancer agents has limitations to improving the prognosis of CCC.

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DOI： 10.1200/jco.2016.66.9010

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ  

<sec><title>Objective</title>The differential diagnosis between uterine sarcoma and benign leiomyoma is difficult when made only by magnetic resonance imaging (MRI); it usually requires an additional preoperative diagnostic procedure. We report our results using ultrasound-guided needle biopsy for these types of uterine tumors.

</sec><sec><title>Methods</title>Ultrasound-guided needle biopsy was performed on 63 patients with uterine smooth muscle tumors suspected of malignancy by MRI. We compared the results of presurgical biopsy against the postsurgical pathology of the tumor.

</sec><sec><title>Results</title>Among 63 patients with a high signal intensity of the uterine tumor on T2-weighted MRI (1 case was undetermined), 12 cases (19.3%) were diagnosed by the needle biopsy as malignant, and 51 cases (80.6%) were benign. Among the 12 diagnosed as malignant tumors, 11 had surgery performed, and one was treated with chemotherapy. Among the 51 patients diagnosed with a benign tumor, 27 had surgery performed, and 24 were put on a wait-and-see clinical follow-up schedule. One of the 27 surgical patients with a benign tumor had a postsurgical diagnosis of a low-grade endometrial stromal sarcoma. In the 38 cases where surgery was performed, we found the sensitivity, specificity, and the positive and negative predictive values of the needle biopsy were 91.7%, 100%, 100%, and 96.2%, respectively.

</sec><sec><title>Conclusions</title>Ultrasound-guided needle biopsy may be a reliable preoperative diagnostic procedure for uterine tumors with suspected malignancy.

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DOI： 10.1097/igc.0000000000000189

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

BACKGROUND AND OBJECTIVES: Aberrant DNA methylation contributes to the malignant phenotype in virtually all types of human cancer. This study explored the relationship between promoter methylation and inactivation of the DAPK1, FHIT, MGMT, and CDKN2A genes in cervical cancer. METHODS: The promoter methylation of DAPK1, FHIT, MGMT, and CDKN2A was investigated by using a methylation-specific polymerase chain reaction in 53 specimens of cervical cancer (42 squamous cell carcinoma, 11 adenocarcinoma), 22 specimens of intraepithelial neoplasia tissues, and 24 control normal cervical tissue specimens. The correlation of promoter methylation with the clinicopathological features of cervical cancer was analyzed. The expressions of DAPK1, FHIT, MGMT, and CDKN2A were detected by measuring relative mRNA levels. RESULTS: The promoter methylation of DAPK1, FHIT, MGMT, and CDKN2A in cervical cancer vs. intraepithelial neoplasia vs. normal cervical tissue was 75.5 vs. 31.8 vs. 4.2 % (p < 0.0001), 66.0 vs. 59.1 vs. 25.0 % (p = 0.0033), 34.0 vs. 27.3 vs. 20.8 % (p = 0.76), and 17.0 vs. 31.8 vs. 8.3 % (p = 0.11), respectively. The methylation of the promoter region significantly decreased the expression of only DAPK1 (p = 0.03). The methylation rate of the DAPK1 gene promoter was significantly higher in cervical cancer tissues than in cervical intraepithelial neoplasia and normal cervical tissues. CONCLUSION: Promoter methylation may therefore lead to the inactivation of the DAPK1 gene, and may be related to the progression of cervical oncogenesis.

DOI： 10.1007/s10147-013-0530-0

PubMed

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Other Link： http://link.springer.com/article/10.1007/s10147-013-0530-0/fulltext.html

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

BACKGROUND: Endometriotic cells display invasive characteristics, despite their benign histological appearance. Recently, the epithelial-mesenchymal transition, in which epithelial cells acquire mesenchymal and migratory properties, has attracted attention as a mechanism of tumor invasion. We aimed to investigate the association between endometriosis and polymorphisms of the E-cadherin gene, a central player in the epithelial-mesenchymal transition, in Japanese women. METHODS: Twelve single-nucleotide polymorphisms (SNPs) in the E-cadherin gene were identified by real-time polymerase chain reaction using a TaqMan assay in 511 women with endometriosis (the majority in Stages III and IV) and 498 healthy controls. RESULTS: Allele frequency analysis indicated that there was a marginally higher frequency of the rs4783689 C allele in women with endometriosis compared with controls (corrected P = 0.007; odds ratio = 1.37; 95% confidence interval, 1.14-1.64). No significant associations with endometriosis were found for the other 11 SNPs. CONCLUSIONS: Although this study was limited by sample size, the E-cadherin gene polymorphism rs4783689 was marginally associated with endometriosis in the Japanese population, suggesting that E-cadherin might be involved in genetic susceptibility to endometriosis.

DOI： 10.1093/humrep/des080

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ  

<sec><title>Objectives:</title>The adenocarcinoma of the uterine cervix tends to arise in women of childbearing age. Conservative treatment by conization is an alternative to a hysterectomy that allows future pregnancy; however, much less is known about the management of adenocarcinoma because of its rarity and relatively short time frame of follow-up. The purpose of this study was to determine the long-term outcome of patients treated by conization alone.

</sec><sec><title>Methods:</title>All patients diagnosed to have FIGO (International Federation of Gynecology and Obstetrics) stage IA1 cervical adenocarcinoma between 1990 and 2004 with more than 5 years' follow-up at 2 institutions were reviewed. Information was abstracted on clinical data including margin status of conization and recurrence.

</sec><sec><title>Results:</title>Twenty-seven patients were identified, and 10 patients who expressed a strong desire to preserve fertility were offered a conization and careful surveillance without hysterectomy. The median age was 35 years, and 40% were nulliparous. All tumors were endocervical-type adenocarcinoma, and all tumors were grade 1. None had lymphovascular space invasion. Two patients had a repeated conization because of a positive margin. No recurrence was observed during an average follow-up of 75 months.

</sec><sec><title>Conclusions:</title>Although further studies on the management of microinvasive cervical adenocarcinoma are desirable, conization seems to be acceptable treatment modality for patients with stage IA1 cervical adenocarcinoma who desire to preserve their fertility. A careful and long-term follow-up is needed because of lack of sufficient evidence for the safety of this treatment.

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DOI： 10.1111/igc.0b013e3181e768b6

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

AIM: To elucidate the role of tobacco smoking and polymorphisms of carcinogen metabolism genes in cervical carcinogenesis. METHODS: We analyzed genotypes of nine genes, 11 polymorphisms encoding carcinogen metabolizing enzymes, information on smoking, and the presence of human papillomavirus in 124 Japanese cervical cancer patients and 125 healthy controls. RESULTS: The incidence of human papillomavirus infection (95.5% vs 9.9%; P < 0.001; odds ratio (OR), 231.98; 95% confidence interval [CI], 57.17-941.22), and smoking (41.1% vs 18.4%; P < 0.001; OR, 3.40; 95% CI, 1.88-6.17) were both significantly higher in patients than in controls. The genotype distributions of CYP1A1, CYP2E1, CYP2A6, NQO1, NAT2, mEH, MPO and GSTT1 genes were not statistically different; however, the ratio of the GSTM1 null genotype was significantly higher in patients than in controls (62.1% vs 47.2%; P = 0.019; OR, 1.83; 95% CI, 1.11-3.04). The incidence of GSTM1 null was significantly higher in the non-smoking group (63.0% vs 47.1%; P = 0.038; OR, 1.92; 95% CI, 1.04-3.54), and not in the smoking group (60.8% vs 47.8%; P = 0.300; OR, 1.69; 95% CI, 0.63-4.56). CONCLUSIONS: In the current study, risk factors for developing cervical cancer were tobacco smoking and GSTM1 null; however, no association was observed between these two factors. We could not prove that smoking-GSTM1 null interaction was responsible for the increase in cervical cancer among young Japanese, and further studies with more detailed smoking status, not only active but passive smoking, will be required.

DOI： 10.1111/j.1447-0756.2008.00798.x

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ygyno.2005.09.010

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Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ygyno.2005.03.009

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Publishing type：Research paper (scientific journal)   Publisher：S. Karger AG  

DOI： 10.1159/000326542

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Language：Japanese   Publisher：(株)メジカルビュー社  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：金原出版(株)  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00535&link_issn=&doc_id=20180130210014&doc_link_id=10.18888%2Fsp.0000000314&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000000314&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：医学書院  

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Other Link： http://search.jamas.or.jp/link/ui/2017406834

Language：Japanese   Publisher：金原出版  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

完全型アンドロゲン不応症(AIS)に対し腹腔鏡下性腺摘出術を施行した4例について検討した。年齢は16歳が2例、19歳が2例であった。性腺が鼠径管内に存在した1例も含めて、全例で腹腔鏡下に性腺摘出が可能であった。全例、術後経過は良好で、外来通院にてエストロゲン補充療法中である。今回の検討から、術前画像診断(特にMRI所見)により性腺の存在位置を予測し、鼠径管内に存在が疑われる場合には開腹手術への移行に備えることで、腹腔鏡下手術をAISに対する予防的性腺摘出術に適応することが可能であると考えられた。

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Language：Japanese   Publisher：(一社)日本癌治療学会  

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Language：Japanese   Publisher：(一社)日本癌治療学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

婦人科悪性腫瘍手術の周術期予防的抗菌薬投与について検討した。開腹による悪性腫瘍根治術を施行し、術後の抗生剤を使用せず周術期のみセファゾリン(CEZ)を使用した140例を対象とした。手術部位感染(SSI)を発症した感染例6例、非感染例134例であった。6例でSSIを認めたが、6時間以上の手術20例では3例でSSIを発症した。術後1日目のCRP値は、感染群で高値の傾向があった。発症率は、腸管切除施行83%、施行していない32%であったが、有意差を認めなかった。抗菌剤投与が適正に行われていた60例中1例、適正投与されなかった44例中3例でSSIを発症していたが、有意差は認めなかった。腸管切除を施行した12例のうち8例に3時間毎の適正な抗菌剤投与が施行された。

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Other Link： http://search.jamas.or.jp/link/ui/2016398677

Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：新潟産科婦人科学会 ; 2011-  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(一社)日本産科婦人科内視鏡学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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Language：Japanese  

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Language：Japanese   Publisher：日本産科婦人科学会  

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Other Link： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=442477

Language：Japanese   Publisher：日本産科婦人科学会  

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Other Link： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=438916