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BackgroundPrimary perivascular epithelioid cell tumors (PEComas) of the female reproductive tract have been primarily reported as case reports owing to their clinical rarity. Limited incidence rates and clinical case data hinder a comprehensive understanding of the risks and invasiveness of this disease. We discuss herein the diagnosis, treatment, and prognosis of this disease to enhance comprehension and therapeutic strategies.MethodsWe conducted a clinical analysis of patients with PEComa treated at the Gynecology Department of The West China Second University Hospital of Sichuan University between May 2018 and January 2024. Diagnosis and treatment were evaluated based on pertinent literature.ResultsOverall, eight patients (seven patients with tumors in the uterus and one patient with tumors in the pelvic cavity) were evaluated. One patient with PEComa of unknown malignant potential and two patients with malignant PEComa underwent hysterectomy and bilateral adnexectomy with or without adjuvant therapy and did not develop recurrence. Meanwhile, three patients who underwent lesion resection only exhibited radiological evidence of new lesions. Furthermore, postoperative imaging identified new pulmonary nodules in three patients.ConclusionAlthough the current criteria are generally effective in assessing the tumor invasiveness of PEComa, emphasizing the significance of complete lesion resection remains crucial. Inadequate treatment significantly increases the risks of recurrence and metastasis. Additionally, the prevalence of pulmonary metastases may have been underestimated. Refining risk stratification to prevent overtreatment of low-grade malignancies or overlooking highly aggressive tumors is an important area for further study.

Background Few patients with prostate cancer benefit from current immunotherapies. Therefore, we aimed to explore new strategies to change this paradigm.Methods Human tissues, cell lines and in vivo experiments were used to determine whether and how N-cadherin impacts the production of programmed death ligand-1 (PD-L1) and indole amine 2,3-dioxygenase (IDO-1) and whether N-cadherin can increase the production of effector (e)Treg cells. Then, we used PC3-bearing humanized non-obese diabetic/severe combined immunodeficiency IL2Rγnull (hNSG) mice with an intravenous injection of human CD34+ hematopoietic stem cells into the tail vein to evaluate whether the N-cadherin antagonist N-Ac-CHAVC-NH2 (designated ADH-1) could improve the therapeutic effect of tumor-infiltrating lymphocyte (TIL)-related treatment.Results N-cadherin dramatically upregulated the expression of PD-L1 and IDO-1 through IFN-γ (interferongamma) signaling and increasing the production of free fatty acids that could promote the generation of eTreg cells. In preclinical experiments, immune reconstitution mediated by TILs slowed tumor growth and extended the survival time; however, this effect disappeared after immune system suppression by PD-L1, IDO-1 and eTreg cells. Furthermore, ADH-1 effectively reduced immunosuppression and enhanced TIL-related therapy.Conclusions These data show that the N-cadherin antagonist ADH-1 promotes TIL antitumor responses. This important hurdle must be overcome for tumors to respond to immunotherapy.

Objective: Cervical cancer classification based on human papillomavirus (HPV) infection status is necessary, as the popularity of HPV vaccination is increasing. Hence, this study aimed to explore the clinicopathological features, diagnosis, treatment, and prognosis of gastric-type endocervical adenocarcinoma (GAS) in west China. Methods: We performed a retrospective analysis and follow-up of patients with GAS who were hospitalized in West China Second University Hospital, a tertiary care center in west China, between September 2019 and April 2021. Results: A total of 16 cases were pathologically diagnosed as GAS at the hospital, most of which had no specific clinical manifestations. Among the 16 cases, 3 cases were confirmed preoperatively. The occurrence of full-layer cervix stroma infiltration, lymphatic vessel infiltration, and lymph node metastasis were 87.5%, 100%, and 50%, respectively. Among all cases, 8 cases were classified as stage III according to the International Federation of Gynecology and Obstetrics 2018 Clinical Staging Standard for cervical cancer. A total of 15 patients underwent a transabdominal or laparoscopic extensive hysterectomy, and the remaining 1 patient was pathologically diagnosed with GAS after a total hysterectomy and afterward underwent bilateral oophorectomy and pelvic lymph node dissection as supplementary surgeries. The follow-up data presented the survival of the 16 patients receiving concurrent chemoradiotherapy after surgery. However, GAS recurred in 3 non-medically-controlled patients among the 16 patients in 3 to 6 months after the treatment. Conclusions: GAS is a rare but highly malignant cancer that usually results in a poor prognosis. A few reports of GAS diagnosis and treatment, especially from developing countries, are available. Hitherto clinical routine screening methods might be insufficient to fulfill the requirements of GAS diagnosis owing to the difficulties in preoperative diagnosis and the probability of misdiagnosis. To reduce the rate of misdiagnosis, repeated deep multisite biopsies, cervical curettage, cervical conization, and hysteroscopy might be helpful in suspicious GAS cases.

Interleukin-17 (IL-17) is a proinflammatory cytokine that is associated with inflammation, autoimmune disorders, and even tumors. Previous studies revealed that a large group of human malignant tumors have abnormally high IL-17 expression. In the present study, we analyzed two single-nucleotide polymorphisms (SNPs) in the IL17A (rs2275913) and IL17F (rs763780) in 311 cervical cancer patients and 463 controls using TaqMan assays. Our results indicated that the frequencies of AA genotype and A allele of rs2275913 were significantly different between the cervical cancer patients and controls (P=0.008, OR = 1.32, 95% CI, 1.07–1.62). Stratified analyses revealed that the polymorphism of rs2275913 was also associated with positive peritumor intravascular cancer emboli and high clinical stage. The genotype and allele frequencies of rs763780 did not show any difference between patients and controls or relate to patient clinical characteristics. Collectively, these findings suggested that IL17 gene polymorphism rs2275913 was associated with the susceptibility as well as positive peritumor intravascular cancer emboli and high clinical stage of cervical cancer in Chinese women.

Background: Eisenmenger's syndrome (ES) consists of pulmonary hypertension with a reversed or bidirectional shunt at the atrioventricular, or aortopulmonary level. The cardiovascular changes that occur during the pregnancy contribute to the high maternal morbidity and mortality in patients with ES. This study is to assess maternal and fetal outcomes in patients with ES. Methods: This study is a retrospective analysis of 11 pregnancies in women with ES who delivered at a tertiary care center in west China between 2010 and 2014. Cases were divided into group I (maternal survival) and group II (maternal death). Clinical data were noted and analyzed. Results: All ES patients presented with severe pulmonary arterial hypertension (PAH). Four maternal deaths were recorded (maternal mortality of 36%). Only one pregnancy continued to term. Ventricular septal defect diameter in group II was larger than that in group I (2.93 ± 0.76 cm vs. 1.90 ± 0.54 cm, p < 0.05). Arterial oxygen saturation and pre-delivery arterial oxygen tension during oxygen inhalation were significantly lower in group II (p < 0.05). Pulmonary arterial blood pressure (PABP) in both groups were high while ejection fractions (EF) were significantly lower in group II (p < 0.05). The incidence of pre-delivery heart failure in group II was substantially higher than in survivors (100 vs.14.3%, p < 0.05). Fetal complications were exceptionally high: preterm delivery (88%), small for gestational age (83%), fetal mortality (27%) and neonatal mortality (25%). Conclusions: In west China, the perinatal outcome of pregnant women with ES is poor, especially when complicated with high pulmonary arterial hypertension (PAH). Pregnancy remains strongly contraindicated in ES. Effective contraception is essential, and the option of terminating pregnancy in the first trimester should be presented to pregnant women with ES. [ABSTRACT FROM AUTHOR]