Ye Q, et al. J Gynecol Oncol. 2018 Aug;30:e5. https://doi.org/10.3802/jgo.2019.30.e5

Ovarian cancer (OvCa) is an intractable gynecological malignancy due to the high recurrence rate. Several molecular biomarkers have been previously screened for early identifying patients with a high recurrence risk and poor prognosis. However, all the known studies focused on a single type of RNAs, not integrating various types. This study was to construct a new multi‐RNA‐based model to predict the recurrence and prognosis for OvCa patients by using the messenger RNA (mRNA, including long noncoding RNA (lncRNA)) and microRNA (miRNA) sequencing data of The Cancer Genome Atlas database. After univariate Cox regression and least absolute shrinkage and selection operator analyses, a multi‐RNA‐based signature (2 miRNAs: hsa‐miR‐508, hsa‐miR‐506; 1 lncRNA: TM4SF1‐AS1; 11 mRNAs: MAGI3, SLAMF7, GLI2, PDK1, ARID3A, PLEKHG4B, TNFAIP8L3, C1QTNF3, NDUFAF1, CH25H, TMEM129) was generated and used to establish a risk score model. The high‐ and low‐risk patients classified by the median risk score exhibited significantly different recurrence risks (89% versus 61%, p < 0.001) and survival time (the area under the receiver operating characteristic curve (AUC) = 0.901 for 5‐year disease‐free survival (DFS)). This risk model was independent of other clinical features and superior to pathologic staging for DFS prediction (AUC, 0.906 versus 0.524; C‐index, 0.633 versus 0.510). Furthermore, some new interaction axes were revealed to explain the possible functions of these RNAs (competing endogenous RNA: TM4SF1‐AS1‐miR‐186‐STEAP2, LINC00536‐miR‐508‐STEAP2, LINC00475‐miR‐506‐TMEM129; coexpression: LINC00598‐PLEKHG4B). In conclusion, this multi‐RNA‐based risk model may be clinically useful to stratify OvCa patients with different recurrence risks and survival outcomes and included RNAs may be potential therapeutic targets.

Background: Endometriosis is a prevalent gynecological disorder that is estimated to affect approximately 10% of women of childbearing age globally. However, the condition remains significantly under-or misrecognized, and the mean time to diagnosis is several years. These delays result in increased symptom severity, diminished quality of life, and adverse long-term reproductive outcomes. Therefore, the aim of this systematic review and meta-analysis was to estimate the sources of diagnostic delay and their effects.Methods: The articles were retrieved from PubMed, Cochrane, and Google Scholar databases after performing a rigorous literature search. The initial search yielded 2,348 records, and 10 articles were included in the final analysis. Causes of diagnostic delay were classified under patient, physician, and systems attributes. Random-effects analysis was used to estimate the overall SMDs with 95% confidence intervals (CIs). For the primary post hoc analysis, subgroup analyses and evaluation of heterogeneity (I² statistic) were conducted. Publication bias was checked using Egger’s test and funnel plots.Results: Patient-related factors demonstrated a significant pooled effect size (SMD: 1.94, 95% CI: 1.62–2.27, p < 0.001), with delays in seeking medical attention (SMD: 2.14, 95% CI: 1.36–2.92) contributing most prominently. Provider-related factors, including misdiagnosis and reliance on non-specific diagnostics, also had a substantial pooled effect size (SMD: 2.00, 95% CI: 1.72–2.28, p < 0.001), with low heterogeneity (I² = 3%). System-related factors, such as referral pathways and geographic disparities, were not analyzed separately due to insufficient data for the subgroup. Funnel plot analysis showed no significant publication bias (Egger’s test p = 0.57).Conclusion: The results indicate that diagnostic delays in endometriosis are a function of multiple factors, with key contributions from patient and provider-related barriers. To close these gaps, targeted interventions such as public education to combat symptom normalization and stigmatization, more comprehensive provider training, and streamlined diagnostic pathways are needed. Future research can evaluate system-level changes and non-invasive diagnostic tools to reduce systemic delays further.

Background. This study was to compare the efficacy and safety between neoadjuvant chemotherapy followed by radical surgery (NACT+RS) and radiotherapy only (RT) or concurrent chemoradiotherapy (CCRT) for treatment of patients with stage IB2, IIA, or IIB cervical cancer. Method. The electronic databases of PubMed, Embase, and the Cochrane Library were searched to screen relevant studies from their inception to October 2018. Clinical data including overall survival (OS), disease-free survival (DFS), and adverse events were extracted. Egger’s test was used to evaluate the publication bias, and sensitivity analysis was conducted to estimate the robustness of results. Results. Finally, three randomized controlled trials (RCTs) and two case-control studies consisting of 1,275 patients with stage IB2, IIA, or IIB cervical cancer were included in the current study. Overall, pooled results showed no significant differences in OS ((hazardratioHR=0.603, 95%CI=0.350−1.038) and DFS (HR=0.678, 95%CI=0.242−1.904) for patients treated with NACT+RS compared with RT only or CCRT, but the subgroup analysis showed that the OS and DFS were significantly longer in the NACT+RS groups than the RT or CCRT group (OS: HR=0.431, 95%CI=0.238−0.781, p=0.006; DFS: HR=0.300, 95%CI=0.187−0.482, p<0.001) for the population with median follow-up time of more than 60 months. For adverse events, the incidence of thrombocytopenia in the NACT+RS group was significantly higher than that in the RT only or CCRT group (relativeriskRR=3.240, 95% CI 1.575-6.662), while the incidence of diarrhea was significantly lower than that in the RT only or CCRT group (RR=0.452, 95% CI =0.230-0.890). Conclusion. These findings suggest that the short-term therapeutic effects of the two treatments may be possibly equal for patients with stage IB2-IIB cervical cancer, but the long-term effects for improving OS and DFS may be better using NACT+RS compared with the RT only or CCRT.

Cervical cancer ranks as the fourth most common cancer among women globally, mainly linked to persistent high-risk HPV infection. In China, significant challenges persist, notably the low rates of HPV vaccination and a substantial case burden. This study retrospectively examined HPV-related cervical cancer data from a tertiary hospital spanning the years 2013 to 2020, to evaluate annual and age-specific incidence trends and offer insights for prevention and treatment strategies. The retrospective analysis encompassed patients who utilized the gynecological outpatient and inpatient services at the Third Affiliated Hospital of Sun Yat-sen University from 2013 to 2020. HPV genotyping, covering 21 subtypes, was conducted using hybrid capture–based assays. The assessment of cervical biopsy disease etiology was performed by a senior pathologist. During the study period, a total of 9,194 cases of HPV-positive individuals were identified, among which 479 cases (5.21%) were diagnosed with cervical cancer. From 2013 to 2020, there was a statistically significant decline in the overall incidence of HPV-positive cervical cancer (Z=-4.061, P < 0.001), as well as in the incidence of squamous cell carcinoma (Z=-4.595, P < 0.001). However, the incidence of adenocarcinoma did not exhibit a significant change (Z = 0.118, P = 0.906). Regarding age distribution, a significant decrease in cervical cancer incidence was observed in patients aged 36 to 64 years (Z=-2.658, P = 0.008). In contrast, the incidence remained relatively stable in patients aged 65 years and older (Z = 0.071, P = 0.943). The incidence of squamous cell carcinoma increased with age, peaking at 27.06% in individuals over 65 years. The decline in HPV-positive cervical cancer cases highlights the success of China’s screening and post-2016 vaccination efforts. However, rising HPV infections in younger women and ongoing cancer risks in older groups emphasized the need to broaden adolescent vaccinations, sexual health education, and lifelong screening.

Introduction: Chronic gynecological condition endometriosis affects about 10 percent of reproductive aged women and imposes a heavy physical and psychological burden. The impact of pain and infertility is well documented, but the link between endometriosis and mental health (depressive and anxiety), in particular, is not well studied.Material and methods: PubMed, Cochrane Library and Google Scholar were searched comprehensively to identify studies that have reported the association of endometriosis and mental health outcomes. Nine studies were included after applying predefined inclusion and exclusion criteria from 1,632 articles screened.Relative Risk (RRs) for anxiety and depression among women with endometriosis were pooled as the primary outcomes.Results: The meta-analysis revealed a significant association between endometriosis and anxiety (pooled HR = 2.82; 95% CI: 1.69–4.68, p < 0.001) and depression (pooled HR = 2.93; 95% CI: 1.63–5.25, p < 0.001). Substantial heterogeneity was observed in both analyses (I² = 100%), reflecting variability in study designs and populations. Funnel plots showed moderate asymmetry, suggesting potential publication bias. Statistical heterogeneity was further quantified with τ² values of 0.6032 for anxiety and 0.794 for depression, indicating considerable between-study variability. These findings underscore the heightened mental health burden in women with endometriosis.Conclusions: This study stresses on the importance of integrated care, which involves screening and treatment for mental health problems in addition to conventional medical care. Future work should aim at decreasing heterogeneity and examine potential pathways through which these relationships exist in order to develop specific prevention strategies.