Tianjin Central Hospital for Gynecology and Obstetrics

Tianjin, China

Tianjin Central Hospital for Gynecology and Obstetrics

Tianjin, China
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Shi Y.,Huazhong University of Science and Technology | Shi Y.,Shanghai Genome Pilot Institutes for Genomics and Human Health | Shi Y.,Changning Mental Health Center | Li L.,Guangxi Province Tumor Hospital | And 86 more authors.
Nature Genetics | Year: 2013

To identify new genetic risk factors for cervical cancer, we conducted a genome-wide association study in the Han Chinese population. The initial discovery set included 1,364 individuals with cervical cancer (cases) and 3,028 female controls, and we selected a 'stringently matched samples' subset (829 cases and 990 controls) from the discovery set on the basis of principal component analysis; the follow-up stages included two independent sample sets (1,824 cases and 3,808 controls for follow-up 1 and 2,343 cases and 3,388 controls for follow-up 2). We identified strong evidence of associations between cervical cancer and two new loci: 4q12 (rs13117307, Pcombined, stringently matched = 9.69 × 10-9, per-allele odds ratio (OR)stringently matched = 1.26) and 17q12 (rs8067378, Pcombined, stringently matched = 2.00 × 10-8, per-allele ORstringently matched = 1.18). We additionally replicated an association between HLA-DPB1 and HLA-DPB2 (HLA-DPB1/2) at 6p21.32 and cervical cancer (rs4282438, Pcombined, stringently matched = 4.52 × 10-27, per-allele ORstringently matched = 0.75). Our findings provide new insights into the genetic etiology of cervical cancer. © 2013 Nature America, Inc. All rights reserved.

Zhou H.,Huazhong University of Science and Technology | Zhou H.,Nanjing Medical University | Li X.,Huazhong University of Science and Technology | Zhang Y.,Huazhong University of Science and Technology | And 34 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

Hu T.,Huazhong University of Science and Technology | Li S.,Huazhong University of Science and Technology | Chen Y.,Hunan Province Tumor Hospital | Shen J.,Central Hospital of Wuhan | And 27 more authors.
European Journal of Cancer | Year: 2012

Objective: Neoadjuvant chemotherapy (NACT) for cervical cancer still remains controversial. NACT was evaluated to establish selection criteria. Methods: A matched-case comparison was designed for the NACT group (n = 707) and primary surgery treatment (PST; n = 707) group to investigate short-term responses and high/intermediate risk factors (HRFs/IRFs). The 5-year disease-free survival (DFS) and overall survival (OS) rates were stratified by NACT response, HRFs/IRFs, International Federation of Gynecology and Obstetrics (FIGO) stage and tumour size, respectively. Results: The clinical and pathological response rates were 79.3% and 14.9% in the NACT group. In comparison to the PST group, IRFs but not HRFs were significantly decreased (P < 0.05), and the 5-year DFS rate was significantly improved in the NACT group (88.4% versus 83.1%, P = 0.021). Moreover, the 5-year DFS and OS rates were favourably increased in the clinical responders in comparison to the PST group and the clinical non-responders (P < 0.05). Compared to those of clinical non-responders, the 5-year DFS and OS rates of clinical responders, with or without HRFs, were also significantly increased (P < 0.01). In stage IB2, the 5-year DFS and OS rates were significantly increased, whereas operation duration declined in the NACT group (P < 0.05). For patients with stage IB tumours of 2-5 cm, the 5-year DFS and OS rates of clinical responders were significantly improved (P < 0.05). Conclusions: NACT is a suitable option for patients with cervical cancer, especially for NACT responders and patients with stage IB, which provides a new concept of fertility preservation for young patients. © 2012 Elsevier Ltd. All rights reserved.

Hu T.,Huazhong University of Science and Technology | Wu L.,Central South University | Xing H.,Huazhong University of Science and Technology | Yang R.,Huazhong University of Science and Technology | And 17 more authors.
Annals of Surgical Oncology | Year: 2013

Background: There is no consensus on the selection criteria for ovarian preservation in cervical cancer, and the role of neoadjuvant chemotherapy (NACT) on ovarian metastasis (OM) is also unknown. Methods: A total of 1,889 cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIB who underwent radical hysterectomy, pelvic lymphadenectomy, and bilateral salpingo-oophorectomy with or without NACT were enrolled. Clinicopathologic variables were studied by univariate and multivariate analyses. Meta-analyses of published data for risk factors of OM were also performed. Results: Twenty-two (1.2 %) of 1,889 patients were diagnosed as OM: 12 squamous cell carcinomas (SCC, 0.7 %), five adenocarcinomas (2.7 %), four adenosquamous carcinomas (5.6 %), and one small cell carcinoma (7.7 %). Multivariate analysis revealed that lymph node metastasis (LNM; odds ratio 5.75, 95 % confidence interval 2.16-15.28), corpus uteri invasion (CUI; 5.53, 2.11-14.53), parametrial invasion (PMI; 8.24, 3.01-22.56), and histology and NACT (0.40, 0.13-1.22) were associated with OM. Furthermore, OM in patients with SCC was associated with PMI (5.67, 1.63-19.72), CUI (3.25, 0.88-12.01), and LNM (9.44, 2.43-36.65). FIGO stage (IIB vs. IB; 31.78, 1.41-716.33), bulky tumor size (12.71, 1.31-123.68), PMI (51.21, 4.10-639.19), NACT (0.003, 0.00-0.27), and CUI (44.49, 2.77-714.70) were independent clinicopathologic factors for OM in adenocarcinomas. In the meta-analysis, we identified six risk factors for OM: LNM, CUI, PMI, adenocarcinoma, large tumor size, and lymphovascular space involvement. Conclusions: Ovarian preservation surgery may be safe in SCC patients without suspicious LNM, PMI, and CUI, and in adenocarcinomas in patients who received NACT without FIGO stage IIB disease, bulky tumor size (>4 cm), suspicious PMI, and CUI. © 2012 Society of Surgical Oncology.

Li S.,Huazhong University of Science and Technology | Li X.,Huazhong University of Science and Technology | Li X.,The Central Hospital of Wuhan | Zhang Y.,Huazhong University of Science and Technology | And 40 more authors.
Oncotarget | Year: 2016

Background: Most cervical cancer patients worldwide receive surgical treatments, and yet the current International Federation of Gynecology and Obstetrics (FIGO) staging system do not consider surgical-pathologic data. We propose a more comprehensive and prognostically valuable surgical-pathologic staging and scoring system (SPSs). Methods: Records from 4,220 eligible cervical cancer cases (Cohort 1) were screened for surgical-pathologic risk factors. We constructed a surgical-pathologic staging and SPSs, which was subsequently validated in a prospective study of 1,104 cervical cancer patients (Cohort 2). Results: In Cohort 1, seven independent risk factors were associated with patient outcome: lymph node metastasis (LNM), parametrial involvement, histological type, grade, tumor size, stromal invasion, and lymph-vascular space invasion (LVSI). The FIGO staging system was revised and expanded into a surgical-pathologic staging system by including additional criteria of LNM, stromal invasion, and LVSI. LNM was subdivided into three categories based on number and location of metastases. Inclusion of all seven prognostic risk factors improves practical applicability. Patients were stratified into three SPSs risk categories: zero-, low-, and high-score with scores of 0, 1 to 3, and ≥4 (P=1.08E-45; P=6.15E-55). In Cohort 2, 5-year overall survival (OS) and disease-free survival (DFS) outcomes decreased with increased SPSs scores (P=9.04E-15; P=3.23E-16), validating the approach. Surgical-pathologic staging and SPSs show greater homogeneity and discriminatory utility than FIGO staging. Conclusions: Surgical-pathologic staging and SPSs improve characterization of tumor severity and disease invasion, which may more accurately predict outcome and guide postoperative therapy.

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