Human epididymis protein 4(HE4)is one of the most focused tumor markers in the research of gynecology malignancy.Increasing number of studies have shown that HE4 has a good application prospect in early diagnosis,differentiential diagnosis,and diseased surveillance of ovarian cancer.HE4 combined with CA125 can improve the sensitivity and specificity of the diagnosis,and may be helpful in the prognosis assessment of ovarian cancer.It may have wider application field.

The International Federation of Gynecology and Obstetrics(FIGO)staging system does not include lymph node status.But in surgically treated patients with early cervical cancer,lymph node metastasis is the most important risk factor for recurrence and death.Accurate knowledge of lymph node status is essential to tailor adjuvant treatment.In operable early stage cervical cancer,prevalence of lymph node metastasis is low.It suggests that majority of these patients may undergo lymphadenectmy for no direct benefit while being subjected to the potential risk of associated morbidities.Over the last decade,the use of sentinel lymph node(SLN)mapping procedure in cervical cancer has been studied by multiple groups in hundreds of patients.Nevertheless,it has not yet been adopted as a standard of care.Recently,two institutes developed different systematic algorithms for SLN mapping in cervical cancer with encouraging data from their studies.This review will focus on these algorithms which may give new approaches to apply SLN in cervical cancer lymph node status evaluation.

To sum up the developments in the treatment of endometrial carcinoma to have a new orientation in the therapyt.We demonstrated in surgery of endometrial carcinoma,chemotherapy,radiotherapy and endocrinotherapy separately.Surgery is the main way to treat endometrial carcinoma,chemotherapy and radiotherap are assisted methods,and there is limits of the endocrinotherapy.Mastering the indications and scope of the surgery for endometrial carcinoma and evaluating the value of chemotherapy,radiotherapy and endocrinotherapy in the treatment of endometrial carcinoma appreciately have great meaning in improving the prognosis and life quality for the patients.

Ovarian cancer is the highest mortality in the female genital malignancies.Because no obvious symptoms of early ovarian cancer,it is found 70% of patients with advanced.Therefore,early detection of ovarian cancer,early treatment and personalized treatment programs is the development direction of cancer treatment.Metabolomics as an emerging technology for the early diagnosis of ovarian cancer,the efficacy evaluation and prognosis has opened up a new window.Metabolomics can make a comprehensive evaluation of changes in metabolism,screened valuable biomarker for early diagnosis and treatment of tumors,treatment and prognosis.In this paper,we reviewed the concepts and Methods of metabolomics as well as metabolomics in the early diagnosis of ovarian cancer,pathological type and targeted therapy applications.

Ovarian cancer has a high morbidity and recurrence rate in gynecological tumors.It has great significance to clinical program development and the patient's survival and quality of life that the early detection of local recurrence or distant metastasis.The ¹⁸F-FDG PET/CT has higher sensitivity and specificity than CT or MRI in the detection of ovarian cancer recurrence and metastasis,early monitoring and evaluation the effect of after radiotherapy and chemotherapy.It is significance for follow-up treatment of ovarian cancer.This paper reviewed the principle and clinical utility of ¹⁸F-FDG PET/CT in recurrence,metastasis,therapeutic response as well as prognosis of ovarian cancer.

Objective Cervical cancer is the most common malignancy in females,of which the proportion of young women is increasing and 5-year survival rate of patients with early stage almost reaches 90%.Thus,it is the focus of patients′ concern which reducing complications and improving quality of life.In recent years,with minimally invasive concept of the proposed and the development of laparoscopic technique,laparoscopic nerve-sparing radical hysterectomy gradually becomes a hot spot of early cervical cancer clinical research.

Cervical cancer is one of the malignant tumors which serious threat to women′s health.The main route of cervical cancer metastasis is lymphatic metastasis.The sentinel lymph node is the first station of lymphatic metastasis.Because of the limitations of traditional histopathological examination,some micrometastasis exists in sentinel lymph node,or isolated tumor cells are ignored which develops clinical metastasis.How to combine sentinel lymph node tracking with micrometastasis detection is the hotspot recently.The clinical significance is important,because it can make some cervical cancer patients avoiding unnecessary pelvic lymph node dissection,accordingly reducing operation complications.This article reviewed the research progress and using of sentinel lymph node micrometastasis in cervical cancer.

Objective To explore the expressions of AEG-1 and DLL4 in endometrial carcinoma and detect their clinical significance and pathologic parameters.Methods The expressions of AEG-1 and DLL4 were measured by immunohistochemical method,including 40 cases with normal endometrium specimens and 152 cases with malignant tumor.The relationship between AEG-1,DLL4 expression and clinicopathological factors was also assessed in these patients.Results The positive expression rate was significantly higher in malignant than that in benign group(P＜0.01).The positive expression rate of AEG-1 was not associated with age and pathologic types(P＞0.05),but with the clinical stage FIGO stage and metastasis(P＜0.05).The positive expression rate of AEG-1 was high in those low differentiation degree,advanced stage and metastasis present cases.Conclusion AEG-1 and DLL4 play a key role in endometrial carcinoma occurrence and development.The expressions of AEG-1 and DLL4 are quite helpful in diagnosis and clinicopathologic grade of endometrial carcinoma.

Objective To explore the expressions of MTDH and VEGF-C in epithelial ovarian carcinoma and detect their clinical significance and pathologic parameters.Methods The expressions of MTDH and VEGF-C in epithelial ovarian neoplasm were measured by immunohistochemical method,including 19 cases with benign tumor,25 cases with borderline tumor and 112 cases with malignant tumor.Further analysis was took on the expressions of MTDH and VEGF-C in epithelial ovarian carcinoma to detect the clinical significance and pathologic features.Results The positive expression rate was significantly high in malignant and borderline groups than that in benign group(P＜0.01).The positive expression rate of MTDH is not associated with age and pathologic types(P＞0.05),but with the clinical stage FIGO stage and metastasis(P＜0.05).The positive expression rate of MTDH is high in those low differentiation degree,advanced stage and metastasis cases,and also correlated with the rate of CA125 closely.Conclusion MTDH and VEGF-C play a key role in ovarian cancer occurrence and prosression.The expressions of MTDH and VEGF-C are quite helpful and meaningful in diagnosis and clinicopathologic grade of epithelial ovarian neoplasm.

Objective To investigate the expression of AEG-1 and MMP-9 in epithelial ovarian carcinoma and find out their clinical significance and pathologic features,which could provide certain theoretical basis of the etiology and the way of how these tumors transfer.Methods The positive expressions of AEG-1 and MMP-9 in epithelial ovarian neoplasm were measured by immunohistochemical SP method,including 19 cases with benign tumor,25 cases with borderline tumor and 112 cases with malignant tumor.Further analysis was took on the expressions of AEG-1 and MMP-9 in epithelial ovarian carcinoma to find out the clinical significance and pathologic features.Results The positive expression rate was significantly higher in malignant and borderline groups than that in benign group(P＜0.01).The positive expression rate of AEG-1 is not associated with age and pathologic types(P＞0.05),but with the clinical stage FIGO stage and metastasis(P＜0.05).The positive expression rate of AEG-1 is high in those low differentiation degree,advanced stage and metastasis present cases.Conclusion AEG-1 and MMP-9 play an extremely important role in ovarian cancer occurrence,progression and transfaction.The expressions of AEG-1 and MMP-9 are quite helpful and meaningful in diagnosis,clinicopathologic grading and prognostic judgment of epithelial ovarian neoplasm.

Ovarian cancer is one of the most common tumors of the female reproductive organs,only after cervical and uterine cancer,ranking the third place.However,the fatality rate of ovarian cancer takes the first place among all types of gynecological tumors,which threaten the women′s life greatly^[1].In the early period,ovarian cancer patients is generally asymtomatic,most of which have advanced stage disease(stage Ⅲ~Ⅳ),direct extension and lymphatic metastasis is the important way for metastasis of ovarian cancer.Whereas Hematogenous metastasis is very rare,and ovarian carcinoma metastasis to the parenchyma of the stomach at the time of diagnosis has been reported abroad for only one case.Whereas the domestic has not been reported,and our department treated a case of ovarian cancer metastasis to the stomach report as follows in 2012.

Objective To observe the effect of anti-angiogenesis drug Endostar on the expressions of hypoxia inducible factor-1α(HIF-1α)and glucose transporter-1(GLUT-1).Methods The transplantation tumor models of Lewis lung carcinoma were randomly divided into 4 groups,namely control group,ES group,RT group and ES+RT group.We measured the longest diameter of the tumor(a)and shortest diameter(b).The tumor volume was calculated by V=ab2/2.The tumor body was for detection.Detection was performed by western blot method.Results (1)There was significant difference between ES+RT group and ES group(P＜0.05).The combined group inhibited the best.(2)ES+RT group decreased obviously compared with ES group and RT group.The difference was statistically significant(P＜0.05).RT group,compared with ES group,is lower with statistics differences(P＜0.05).(3)ES+RT group has statistical significance(P＜0.05).ES group,the difference was not significant(P＞0.05).There was significant difference between group RT and group ES+RT(P＜0.05).(4)HIF-1α was positively correlated with GLTU-1 expression(P＜0.01).Conclusion Endostar combined with radiotherapy can inhibit Lewis mice tumor growth.Endostar can improve the hypoxic tumor which inhibiting the expression of HIF-1α and GLTU-1.It may be one of the mechanism for increasing radiosensitization.

Objective To discuss the protection mechanism of intestinal mucosal injury by Celecoxib and glutamine of cancer cachexia mice.Methods 28 mice were divided into four groups randomly.The weight loss,the height and width of intestinal villi as well as the thickness of muscular layer and basal layer were compared in these groups.The inflammatory cytokines in the mucous membrane and blood serum were tested.Results The body weight loss and mucous membrane of small intestine atrophy were inhibited by Celecoxib and glutamine.TNF and IL-6 expressions decreased,and sTNFRⅠand IL-10 expressions increased in blood serum.INFγ lerel increased in mucous membrane after treated by the Celecoxib and glutamine.Conclusion Celecoxib and glutamine can protect the weight loss by inhibiting the inflammation in cancer cachexia mice.

Objective STAT5 activation(Phospho-STAT5,P-STAT5)has been observed in a variety of human tumors.Many studies have found that poor prognosis is associated with the expression of phospho-STAT5.However,it is not clear how activated STAT5 is expressed in colon cancer.In this study,we aimed to investigate phospho-STAT5 expression and its relationship with clinicopathological factors and overall survival in Stage Ⅱ colonic adenocarcinoma.Methods 122 histological samples of Stage Ⅱ colonic adenocarcinoma were selected for this study.Immunohistochemistry was used to detect the expression of phospho-STAT5.Results Phospho-STAT5 expression was observed in the cytoplasm of colonic adenocarcinoma cells.A significant relationship was found between phospho-STAT5 expression and tumour differentiation(P=0.033).Univariate analysis showed that shorter overall survival was correlated with phospho-STAT5 immunoreactivity(P=0.047,log-rank test).Multivariate analysis showed that phospho-STAT5 was not an independent predictor in relation with shorter overall survival(P=0.053,hazard ratio=2.41).Conclusion Expression of phospho-STAT5 is correlated with shorter survival in patients with Stage Ⅱ colonic adenocarcinoma.It may be of great value in evaluating the expression of phospho-STAT5 for adjuvant systemic therapy in surgically treated patients with Stage Ⅱ colonic adenocarcinoma.

Objective To investigate the expression of KLF6 protein in human gastic adenocarcinoma and analyze its clinical pathological significance.Methods The expression of KLF6 protein was detected with immunohistochemistry method in 90 gastic adenocarcinoma and 60 normal gastic mucosa specimens.Results The positive rates of KLF6 protein expression were significant difference between gastic adenocarcinoma and normal gastic mucosa(28.9%,46.7%,P＜0.05).The expression of KLF6 protein was found to be associated with lymph node metastasis in gastic adenocarcinoma(P＜0.05).Kaplan-Meier method survival analysis showed that patients with gastric adenocarcinoma KLF6 protein expression positive and negative cumulative survival(P＜0.05),as well as 2 years survival difference.Conclusion Down-regulation of KLF6 expression may be related with gastic adenocarcinoma development,progress,metastasis and prognosis,and may be one of the important markers which may determine the prognosis of gastric adenocarcinoma.

Objective In non-small cell lung cancer(NSCLC)radiotherapy,probe target delineation and subsequent influence on target volume(TV)and exposed dose of normal tissues(NT)were based on PET/CT.Methods We selected 21 patients with NSCLC stage T3-4N₀M₀,and obtained TV and NT by CT images and PET/CT images,respectively.IMRT treatment plans were designed for PTVCT and PTVPET,respectively.We compared the deviation of two target volumes and exposed dose of normal tissues when target-volume-dose receives the clinical requirements.The NT′s parameters included Vx and MLD of lung,V40 of heart and maxdose of spinal cord.T-test and correlation analysis were used in the paper.Results TV of CT was greater than that of PET/CT in 85.7% cases,P=0.001(CTV),P=0.001(PTV)(statistically significant deviation).There was significant correlation between the target volume deviaton and the target volume,correlation coefficient(r)=0.96(GTV),r=0.82(CTV),r=0.61(PTV).The parameters in IMRTPET were optimizor in IMRTCT.P=0.017(V20),P=0.004(MLD)in lung and P=0.02(heartV40)in heart were statistically significant deviation.Conclusion PET/CT image has beneficial effect on target volume and normal tissues protection.

Objective To study the clinical significance of glutathione-s-trannsferase(GST-π)expression in gastric carcinoma with peritoneal metastasis.Methods The GST-π protein expression of resected speciments from 56 cases of primary gastric cancer with peritoneal metastasis and 24 peritoneal metastasis in contrast with 40 cases of primary gastric cancer without peritoneal metastasis were detected by immunohistochemistry,and their clinical data were also investigated.Results The positive GST-π expression rate in paratumor normal tissues,in primary gastric cancer without peritoneal metastasis,in primary gastric cancer with peritoneal metastasis and peritoneal metastasis was 30.0%(6/20),72.5%(29/40),89.3%(50/56),66.7%(16/24),respectively.The positive GST-π expression rate in group without peritoneal metastasis was lower than that in group with peritoneal metastasis.The difference was statistically significant.The positive GST-π expression rate in peritoneal metastasis was lower than that in primary gastric cancer.The GST-π protein expression was correlated with the histology type of the patients with peritoneal metastasis(P＞0.05),but not related to age,sex,organ infiltration,Borrmann types,serous infiltration,lymph node metastasis and peritoneal metastasis(P＜0.05).Kaplan-Meier survival statistical Results showed that the high expression of GST-π of the patients with peritoneal metastasis was related to the life span(P＞0.05).Conclusion The expression of GST-π had correlation with the histological category of primary gastric cancer with peritoneal metastasis.The determination of GST-π expression by immunohistochemistry may be useful for the estimation of prognosis and the establishment of chemical therapy regimen for gastric carcinoma patients with peritoneal metastasis.The high expression of GST-π in gastric carcinoma may have correlation with the incidence of peritoneal metastasis.

Objective To discuss the value of CT perfusion imaging(CTPI)in determining the effet of primary hepatic carcinoma(PHC)after intervention treatment.Methods 33 patients with hepatocellular carcinoma who agreed to accept transcatheter arterial chemoembolization(TACE)were involved in this study.Lesions were solitary.CTPI,enhanced CT and digital subtraction angiography(DSA)were performed one week before and one month after treatment.Taking DSA as the “gold standard”,the acquired blood perfusion colour-picture and the perfusion parameters were analyzed and compared to access the value of CTPI in determining the effect of PHC after TACE.Results Compared with preoperative tumor tissue,the values of the hepatic arterial perfusion(HAP),the hepatic perfusion index(HPI)and the total hepatic blood flow(THBF)of the postoperative one were decreased significantly(P＜0.01).The portal vein perfusion(PVP)showed no significant change(P＞0.05),and there was no blood supply in the lipiodol deposition or tumor necrosis area,the time density curve(TDC)of which showed a horizontal line,and compared with preoperative surrounding normal liver tissue.The CTPI value of the postoperative one had no significant change(P＞0.05).CTPI diagnosis accuracy was 93.94%;sensitivity was 100%,and specificity was 77.78%.CTPI on the detection of residual or recurrent hepatocellular carcinoma had a good agreement with DSA(kappa = 0.836,P=0.000).Conclusion CTPI can well reflect the blood supply of the local lesion and the surrounding normal hepatic tissue after TACE.It can partly replace DSA to evaluate the effect of PHC after TACE.

Objective To compare the difference of the CT,MRI and CT-MRI fusion imaging,investigate the advantages of CT-MRI fusion imaging for delineation of target areas in head and neck tumor.Methods The two images for per patient in 35 patients with head and neck cancer were received through CT,MRI scans and image fusion software,and the same physician on the same patient at the same time period delineated the target areas based on CT,MRI and image fusion to compare their tumor target volume(Gross Tumor Volume,GTV)of the primary lesion.Results GTV_CT,GTV_MRI,GTV_CT-MRI average were 21.22 ± 1.56,23.64 ± 1.30,29.08 ± 2.09cm³,GTV_CT compared with GTV_MRI(t=7.05,P＜0.01),GTV_CT-MRI compared with GTV_CT(t=-17.82,P＜0.01); GTV_CT-MRI compared with GTV_MRI(t=13.08,P＜0.01).Conclusion The delineation of CT-MRI fusion for the tumor target areas was broader than the MRI or CT images alone in the head and neck cancer,CT-MRI fusion imaging technology can improve the accuracy of the target outline and more conducive to guide the implementation of precise radiotherapy.

Esophageal carcinoma is a common upper gastrointes-tinal malignancies.Surgical treatment is the most important therapy.Eonsidercay enat the trauma is big,and the time is long.It may have adverse effects on many organs and systems.It always accompanies many complications after surgery.Arrhythmia is one of the common complications.It seriously affects patients′ postoperative recovery.How to reduce the occurrence of arrhythmia after operation of esophagus cancer has always been an international hot issue.In recent years,epidural anesthesia combined with general anesthesia have been widely used in esophageal carcinoma operation.Research proves that thoracic epidural anesthesia can reduce the dosage of opioid analgesics,inhalation anesthetics and muscle relaxants,provide excellent postoperative analgesia,and promote the patients′ pulmonary function after surgery.At the same time,thoracic epidural anesthesia can inhibit the excitability of sympathetic nerve.Thereby,it can reduce the incidence of arrhythmia.The review will focus on the effect and mechanism of thoracic epidural anesthesia on esophageal carcinoma postoperative arrhythmia.

Cancer is a killer to be an inevitable challenge of cancer prevention and treatment in human health.Although there has been significant progress in cancer research,it is still a long journey to go to prevent and radical thrapy for cancer.The “early detection,early diagnosis and early treatment” is the core of enhancing the cure rate,and conservative treatment is an important measure to ensure the “core”.There are still certain deficiencies in the three major cancer therapies,such as a variety of complications and toxic reactions.Without conservative treatment,it would be difficult to complete the treatment plan successfully.So conservative treatment,not only to the completion of the treatment plan with good results,but also it will become an emerging medical model of cancer cure.