Angiogenesis is one of the hallmarks of cancer and plays a crucial role in carcinogenesis and progression of epithelial ovarian cancer. Antiangiogenic agent is the first approved targeted agent in ovarian cancer. Anti-angiogenic agents mainly include agents target VEGF/VEGFR pathway, such as bevacizumab and agents target receptor tyrosine kinase, and non-VEGF/VEGFR targets of angiogenesis. Antiangiogenic agents demonstrate certain effects in ovarian cancer treatment either as monotherapy or combined with chemotherapy. Unfortunately, antiangiogenic agents, such as bevacizumab, integrated into the ovarian cancer treatment paradigm do not increase cures. Thus, the benefits of anti-angiogenic agents must be carefully weighed against the cost and associated toxicities. Antiangiogenic agents drug resistance and short of predictive biomarkers are main obstacles in ovarian cancer treatment. A combination of poly (ADP-ribose) polymerase inhibitors or immune checkpoint inhibitors might be great strategies to overcome resistance as well as enhance anti-tumor activity of anti-angiogenic drugs. Predictive biomarkers of antiangiogenic agents are in urgent need.

Background: Cervical cancer is the fourth most frequent gynecological malignancy across the world. Immunotherapies have proved to improve prognosis of cervical cancer. However, few studies on immune-related prognostic signature had been reported in cervical cancer.Methods: Raw data and clinical information of cervical cancer samples were downloaded from TCGA and UCSC Xena website. Immunophenoscore of immune infiltration cells in cervical cancer samples was calculated through the ssGSEA method using GSVA package. WGCNA, Cox regression analysis, LASSO analysis, and GSEA analysis were performed to classify cervical cancer prognosis and explore the biological signaling pathway.Results: There were eight immune infiltration cells associated with prognosis of cervical cancer. Through WGCNA, 153 genes from 402 immune-related genes were significantly correlated with prognosis of cervical cancer. A 15-gene signature demonstrated powerful predictive ability in prognosis of cervical cancer. GSEA analysis showed multiple signaling pathways containing Programmed cell death ligand-1 (PD-L1) expression and PD-1 checkpoint pathway differences between high-risk and low-risk groups. Furthermore, the 15-gene signature was associated with multiple immune cells and immune infiltration in tumor microenvironment.Conclusion: The 15-gene signature is an effective potential prognostic classifier in the immunotherapies and surveillance of cervical cancer.

Background: Tubal choriocarcinoma is an extremely rare but highly malignant trophoblastic tumor, which may be either gestational or non-gestational in origin. Due to atypical clinical manifestations and symptoms similar to ectopic pregnancy, it is easily to be confused with ectopic pregnancy. In addition, inadequate understanding of this rare disease by clinicians often leads to misdiagnosis or missed diagnosis, which in turn results in delayed treatment or even tumor metastasis.Case presentation: This report summarized a case of a woman who was finally diagnosed as tubal choriocarcinoma through the follow-up of serum β hCG levels and histopathological results after undergoing salpingectomy for being misdiagnosed as ectopic pregnancy. Five courses of adjuvant chemotherapy (5-fluorouracil, actinomycin-D, vinorelbine regime) have been administered to the patient in the prevention of any recurrences. During 1-year follow-up, the patient was asymptomatic and presented no evidence of recurrence.Conclusions: Tubal choriocarcinoma is easily to be confused with ectopic pregnancy. By analyzing this case and previous related cases, we aimed to provide references for clinicians in the diagnosis and treatment of tubal choriocarcinoma.

Background: Whether neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) against primary debulking surgery (PDS) has a differential effect on prognosis due to Breast Cancer Susceptibility Genes (BRCA)1/2 mutations has not been confirmed by current studies.Methods: All patients included in this retrospective study were admitted to Qilu Hospital of Shandong University between January 2009 and June 2020, and germline BRCA1/2 mutation were tested. Patients in stage IIIB, IIIC, and IV, re-staged by International Federation of Gynecology and Obstetrics (FIGO) 2014, were selected for analysis. All patients with NAC received 1-5 cycles of platinum-containing (carboplatin, cisplatin, or nedaplatin) chemotherapy. Patients who received maintenance therapy after chemotherapy were not eligible for this study. All relevant medical records were collected.Results: A total of 322 patients were enrolled, including 112 patients with BRCA1/2 mutations (BRCAmut), and 210 patients with BRCA1/2 wild-type (BRCAwt). In the two groups, 40 BRCAmut patients (35.7%) and 69 BRCAwt patients (32.9%) received NAC. The progression-free survival (PFS) of BRCAmut patients was significantly reduced after NAC (median: 14.9 vs. 18.5 months; p=0.023); however, there was no difference in overall survival (OS) (median: 75.1 vs. 72.8 months; p=0.798). Whether BRCAwt patients received NAC had no significant effect on PFS (median: 13.5 vs. 16.0 months; p=0.780) or OS (median: 54.0 vs. 56.4 months; p=0.323). Multivariate analyses in BRCAmut patients showed that the predictors of prolonged PFS were PDS (p=0.001), the absence of residual lesions (p=0.012), and FIGO III stage (p=0.020); Besides, PARP inhibitor was the independent predictor for prolonged OS in BRCAmut patients (p=0.000), for BRCAwt patients, the absence of residual lesions (p=0.041) and history of PARP inhibitors (p=0.000) were beneficial factors for OS prolongation.Conclusions: For ovarian cancer patients with FIGO IIIB, IIIC, and IV, NAC-IDS did not adversely affect survival outcomes due to different BRCA1/2 germline mutational status.

We aimed to evaluate the effects of COVID-19 social restrictions on maternal and newborn outcomes in Shanghai from April 1 to May 31 of 2022. We conducted a retrospective, cross-sectional analysis of all Live deliveries between April 1 and September 30 for the years 2021 and 2022 at our hospitals. Patients were assigned to three groups: “pre-lockdown” (April 1 to September 30, 2021), “during lockdown” (April 1 to May 31, 2022), and “post-lockdown” (June 1 to September 30, 2022). Cesarean delivery rate, pregnancy complications and neonatal outcomes were evaluated. Linear regression was used to model the continuous outcomes of birth weight and birth length, and logistic regression was implemented to model the binary outcomes of delivery mode, gestational diabetes mellitus (GDM), hypertension in pregnancy, neonatal asphyxia, fetal growth restriction (FGR), and preterm birth. A total of 2891 patients were enrolled in our study. Upon multivariate regression analysis and after adjustment for study epoch and patient characteristics, the lockdown period was associated with lower GDM (Exp(B) = 0.498; 95%CI, 0.379–0.655). The post-lockdown period was associated with a higher birth length (β = 0.040; 95%CI, 0.032–0.317) and more hypertension in pregnancy (Exp(B) = 1.683; 95%CI, 1.087–2.604) than the pre-lockdown period. The overall rates of cesarean delivery, preterm birth, neonatal asphyxia and FGR were not associated with the lockdown; however, maternal COVID-19 infection during lockdown was associated with a mean reduction of 150 g (95% CI, 11–288 g) in birth Weight at 37–39 weeks of gestation (p = 0.035). The lockdown period was associated with a diminution in GDM, and unlike the pre-lockdown period, the post-lockdown period was associated with an increase in birth weight and hypertension in pregnancy. Maternal COVID-19 infection during lockdown was also associated with lower neonatal birth Weight in deliveries at 37–39 weeks of gestation. Lockdown played a certain degree of impact on pregnancy complications and neonatal outcomes.

Background: To investigate the clinicopathological and etiological characteristics for urinary tract infections in cervical cancer radical surgery with indwelling ureteral stents. Methods: A total of 24 patients received cervical cancer radical surgery and retained ureteral stents in Shanghai General Hospital from July 2018 to December 2022 were recruited, the medical data were retrospectively collected and analyzed. Results: Total 15 patients complicated with urinary tract infections, with the infection rate reaching up to 62.5%. Postoperative adjuvant chemotherapy might be the risk factor for urinary tract infections, although with no significant statistic difference (P = 0.074). A total of 30 strains of pathogens were isolated, with Escherichia coli ranking the most common pathogen. Two strains of CRE were identified. 70.83% patients were inserted ureteral stents for 3 to 12 months. With the placement time of ureteral stents exceeding 2 months, antibiotics sensitivity against the same pathogen decreased. Fungi infection occurred more frequently when placement time of ureteral stents reaching more than 4 months. Conclusions: Ureteral tract infections were extremely high in LACC with radical surgery with ureteral stents insertion. The Escherichia coli are relatively resistant to Penicillins and Cephalosporins. With the prolongation of ureteral stents placement, antibiotics sensitivity targeting the same pathogen decreased and the pathogenic microbes changed from bacteria into fungi. This study could provide basis for determining appropriate time to remove or replace ureteral stents and selecting effective antibiotics for urinary tract infections during ureteral stents indwelling, to prevent severe infections and reduce disease burden.