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Bai M, Sun D, Shu J, Wei D, Yuan M, Yuan Z, Liu S, Kang M, Zhang Z, Chen X, Zheng W, Feng Y, Bao S, Zhang Z, Liao H. Assisted reproductive technology treatment failure and the detection of intrauterine HPV through spent embryo transfer media sample. J Med Virol 2024; 96:e29468. [PMID: 38415499 DOI: 10.1002/jmv.29468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/02/2024] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
Cervical human papillomavirus (HPV) infection is believed to increase the risks of pregnancy failure and abortion, however, whether the uterine cavity HPV infection reduces pregnancy rate or increases miscarriage rate remains unclarified in infertile women undergoing assisted reproductive technology (ART) treatment. Therefore, we aimed to assess ART outcomes in the presence of intrauterine HPV. This was a hospital-based multicenter (five reproductive medicine centers) matched cohort study. This study involved 4153 infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment in five reproductive medicine centers between October 2018 and 2020. The spent embryo transfer media sample with endometrium tissue were collected and performed with flow-through hybridization and gene chips to detect HPV DNA. According to basic characteristics, HPV-positive and negative patients were matched in a ratio of 1:4 by age, body mass index transfer timing, transfer type, and number of embryos transferred. The primary outcome was pregnancy and clinical miscarriage rates in the transfer cycle underwent HPV detection. 92 HPV-positive and 368 HPV-negative patients were screened and analyzed statistically. Univariate analysis showed uterine cavity HPV infection resulted in lower rates of ongoing pregnancy (31.5% vs. 44.6%; p = 0.023), implantation (32.3% vs. 43.1%; p = 0.026), biochemical pregnancy (47.8% vs. 62.5%; p = 0.010), and clinical pregnancy (40.2% vs. 54.3%; p = 0.015) compared with HPV negative group. The infertile female with positive HPV also had a slightly higher frequency of biochemical miscarriage (15.9% vs. 13.0%; p = 0.610) and clinical miscarriage (24.3% vs. 15.5%; p = 0.188). These findings suggest that HPV infection in the uterine cavity is a high risk for ART failure. HPV screening is recommended before ART treatment, which may be benefit to improving pregnancy outcome.
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Affiliation(s)
- Mingzhu Bai
- Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China
| | - Di Sun
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
- School of Medicine, Center for Reproductive Medicine & Fertility Preservation Program, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jinhui Shu
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Guangxi, Guangxi, China
| | - Dong Wei
- Center for Reproductive Medicine, Liuzhou Worker's Hospital, Liuzhou, China
| | - Mu Yuan
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China
| | - Zhenya Yuan
- Center for Reproductive Medicine, Maternal and Child Health Hospital in Xuzhou, Xuzhou Medical University, Xuzhou, China
| | - Suying Liu
- Center for Reproductive Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mei Kang
- Center of Clinical Research, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zikai Zhang
- Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiong Chen
- Department of Obstetrics and Gynecology, Shanghai Wusong Hospital, Shanghai, China
| | - Wenxin Zheng
- Department of Pathology and Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Youji Feng
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shihua Bao
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenbo Zhang
- Reproductive Medicine Center, Department of Obstertrics and Gynecology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Hong Liao
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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Song L, Wu Q, Bai S, Xu R, Wang X, Yang Y. Treatment of primary squamous cell carcinoma of the endometrium and review of previous literature: A case report. Medicine (Baltimore) 2023; 102:e33667. [PMID: 37115065 PMCID: PMC10145803 DOI: 10.1097/md.0000000000033667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/13/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
RATIONALE Primary squamous cell carcinoma of the endometrium (PSCCE) has been occasionally reported. Treatment of this disease poses a challenge to clinicians because of its rarity. Herein, we report the case of a 56-year-old woman with typical clinical manifestations and a pathological diagnosis classified by molecular typing as having high microsatellite instability (MSI-H) PSCCE. Based on a review of the previous literature, we summarized the treatment options for this rare disease and proposed new opinions. PATIENT CONCERNS A 56-year-old woman was admitted to our hospital with irregular vaginal bleeding and lower abdominal swelling. DIAGNOSIS The patient was diagnosed with squamous cell carcinoma of the endometrium (stage IIIC1; MSI-H). INTERVENTIONS The patient underwent total abdominal hysterectomy, bilateral salpingo-ovariectomy (bso), and pelvic lymph node dissection. Following the surgery, the patient received adjuvant chemoradiotherapy. OUTCOMES The patient was followed up regularly. No recurrence or metastasis has been reported to date. LESSONS Curettage specimens may show only well-differentiated squamous epithelium, which is indistinguishable from normal squamous epithelium. It is difficult to infer from the histological morphology that the curettage specimens originate from the uterine cavity, which makes it difficult to diagnose PSCCE before the operation. We suggest that when an imaging examination indicates a tumor in the uterine cavity, even if multiple curettage specimens indicate normal or well-differentiated squamous epithelium, it indicates the possibility of PSCCE.
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Affiliation(s)
- Liyun Song
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Qi Wu
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Suning Bai
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Ren Xu
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Xiaona Wang
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Yanyan Yang
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, China
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PAX8 Positivity, Abnormal p53 Expression, and p16 Negativity in a Primary Endometrial Squamous Cell Carcinoma: A Case Report and Review of the Literature. Int J Gynecol Pathol 2021; 41:431-435. [PMID: 34420026 DOI: 10.1097/pgp.0000000000000820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary endometrial squamous cell carcinoma (PESCC) is a rare entity. As the clinicopathologic features and the immunophenotype have not been completely defined yet, here we report our experience and review of the literature on this topic. A 73-yr-old nulliparous woman presented with pelvic pain and vaginal bleeding. Endometrial biopsy showed a carcinoma with squamous differentiation infiltrating the myometrium. Total hysterectomy with bilateral salpingo-oophorectomy and selective pelvic lymphadenectomy was performed. Definitive diagnosis was squamous carcinoma of the endometrium, with one lymph node metastasis (stage IIIC1). Immunohistochemistry evidenced immunoreactivity of the tumor cells for cytokeratin 5, p63, cytokeratin 7, PAX8, PTEN, and cyclin D1, aberrant p53 overexpression, and Ki-67 reactivity in ~70% of the tumor cells. Estrogen and progesterone receptor, PAX2, WT1, and p16 were negative. Our case was the first PAX8-positive PESCC in the literature, underlining the Mullerian system origin of this neoplasm. Abnormal p53 expression of this case confirmed its role in the pathogenesis of PESCC. Further studies on a large number of cases are needed to better understand the pathologic features and the immunophenotype of PESCC.
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