Factors affecting platinum sensitivity in cervical cancer

Perspectives of ERCC1 in early-stage and advanced cervical cancer: From experiments to clinical applications

Cervical cancer is a public health problem of extensive clinical importance. Excision repair cross-complementation group 1 (ERCC1) was found to be a promising biomarker of cervical cancer over the years. At present, there is no relevant review article that summarizes such evidence. In this review, nineteen eligible studies were included for evaluation and data extraction. Based on the data from clinical and experimental studies, ERCC1 plays a key role in the progression of carcinoma of the uterine cervix and the therapeutic response of chemoradiotherapy. The majority of the included studies (13/19, 68%) suggested that ERCC1 played a pro-oncogenic role in both early-stage and advanced cervical cancer. High expression of ERCC1 was found to be associated with the poor survival rates of the patients. ERCC1 polymorphism analyses demonstrated that ERCC1 might be a useful tool for predicting the risk of cervical cancer and the treatment-related toxicities. Experimental studies indicated that the biological effects exerted by ERCC1 in cervical cancer might be mediated by its associated genes and affected signaling pathways (i.e., XPF, TUBB3, and. To move towards clinical applications by targeting ERCC1 in cervical cancer, more clinical, in-vitro, and in-vivo investigations are still warranted in the future.

Development of machine learning models integrating PET/CT radiomic and immunohistochemical pathomic features for treatment strategy choice of cervical cancer with negative pelvic lymph node by mediating COX-2 expression

Objectives: We aimed to establish machine learning models based on texture analysis predicting pelvic lymph node metastasis (PLNM) and expression of cyclooxygenase-2 (COX-2) in cervical cancer with PET/CT negative pelvic lymph node (PLN).

Methods: Eight hundred and thirty-seven texture features were extracted from PET/CT images of 148 early-stage cervical cancer patients with negative PLN. The machine learning models were established by logistic regression from selected features and evaluated by the area under the curve (AUC). The correlation of selected PET/CT texture features predicting PLNM or COX-2 expression and the corresponding immunohistochemical (IHC) texture features was analyzed by the Spearman test.

Results: Fourteen texture features were reserved to calculate the Rad-score for PLNM and COX-2. The PLNM model predicting PLNM showed good prediction accuracy in the training and testing dataset (AUC = 0.817, p < 0.001; AUC = 0.786, p < 0.001, respectively). The COX-2 model also behaved well for predicting COX-2 expression levels in the training and testing dataset (AUC = 0.814, p < 0.001; AUC = 0.748, p = 0.001). The wavelet-LHH-GLCM ClusterShade of the PET image selected to predict PLNM was slightly correlated with the corresponding feature of the IHC image (r = −0.165, p < 0.05). There was a weak correlation of wavelet-LLL-GLRLM LongRunEmphasis of the PET image selected to predict COX-2 correlated with the corresponding feature of the IHC image (r = 0.238, p < 0.05). The correlation between PET image selected to predict COX-2 and the corresponding feature of the IHC image based on wavelet-LLL-GLRLM LongRunEmphasis is considered weak positive (r = 0.238, p=<0.05).

Conclusion: This study underlined the significant application of the machine learning models based on PET/CT texture analysis for predicting PLNM and COX-2 expression, which could be a novel tool to assist the clinical management of cervical cancer with negative PLN on PET/CT images.

Cervical Carcinoma: Oncobiology and Biomarkers

Cervical cancer is one of the most common types of carcinomas causing morbidity and mortality in women in all countries of the world. At the moment, the oncology, oncobiology, and oncomorphology of cervical cancer are characterized by the accumulation of new information; various molecular biological, genetic, and immunohistochemical methods of investigation of the mechanisms of cervical carcinogenesis are tested and applied; targeted antitumour drugs and diagnostic, prognostic, and predictive biomarkers are being searched for. Many issues of the etiopathogenesis of cervical cancer have not been sufficiently studied, and the role of many biomarkers characterizing various stages of cervical carcinogenesis remains unclear. Therefore, the target of this review is to systematize and understand several problems in the pathogenesis of cervical cancer and to evaluate the significance and role of biomarkers in cervical carcinogenesis.

MRI of cervical cancer with a surgical perspective: staging, prognostic implications and pitfalls

LEARNING OBJECTIVES

Magnetic resonance imaging (MRI) of the pelvis is the most reliable imaging modality for staging, treatment planning, and follow-up of cervical cancer; and its findings may now be incorporated into the International Federation of Gynecology and Obstetrics Federation (FIGO) 2018 clinical staging of cervical cancer. It is imperative that radiologists are familiar with the imaging appearance of the different stages of cervical cancer as well as the post-treatment changes and imaging pitfalls given the respective clinical manifestations, treatment regimens, and prognosis of an accurate diagnosis. In addition to the different stages of cervical cancer, we address the imaging techniques for diagnosis, staging and treatment implications as well as the changes of the new FIGO staging system.

BACKGROUND

The use of MRI to diagnose and stage cervical cancer is steadily increasing and the new FIGO stagi ng system, previously based on clinical examination, now allows the staging or change of staging based on the imaging findings. MRI can evaluate the extent of disease because of its excellent contrast resolution for pelvic tissues and organs, high accuracy and detailed elaboration of the cervical/uterovaginal anatomy.

CONTENT

Relevant anatomy, including normal MRI appearance of the cervix, parametria and pelvic ligaments; different stages of cervical cancer on MRI with prognostic and therapeutic implications; MRI sequences, other imaging modalities used in the staging and follow-up, treatment of different stages and the appearance of the cervix and cervical cancer post-treatment. Since clinical implications and therapeutic strategies for cervical cancer treatment vary tremendously according to degree of tumor extension, familiarity with relevant MRI techniques and findings is essential for radiologists. It is important that radiologists interpreting pelvic MRI are aware with the different stages of cervical cancer to provide useful information regarding treatment and prognosis. Pitfalls regarding the interpretation of tumor extension can interfere with an accurate diagnosis and have significant therapeutic implications.

Using Health Belief Model Constructs to Examine Differences in Adherence to Pap Test Recommendations among Iranian Women

Despite documented successful Pap tests in routine care of women, screening levels are unfortunately often lower than recommended. This study aimed to assess differences in adherence to Pap test guidelines among a sample of Iranian women using the Health Belief Model (HBM). In this descriptive and analytical study, information was collected from a total of 305 women, (age range of 15-49) from Zarandieh health centers in Iran using a random multistage sampling method. The questionnaire covered demographic characteristics; health belief model constructs were gathered by a self-report method. The results were analyzed using the independent samples t test and logistic regression in SPSS-20. A total 32% of the subjects had a history of a Pap test and the score mean of the whole constructs model (knowledge, susceptibility, severity, benefits, barriers and self-efficacy) in these individuals was higher than those without a positive history. Among the predictive variables of HBM constructs, the highest weights were observed for perceived benefits ß)=0.36), perceived susceptibility =ß) 0.35) and self-efficacy ß)=0.29). Based on our finding of positive relationships for health belief model structures with performance of a pap smear test, designing educational interventions for changing the knowledge levels and beliefs of women is recommended.

Regulation of cytotoxicity and apoptosis-associated pathways contributes to the enhancement of efficacy of cisplatin by baicalein adjuvant in human A549 lung cancer cells

Scutellaria baicalensis (SB; Chinese name, huangqin) is widely used in Chinese medicine as a traditional adjuvant in the chemotherapy of lung and liver cancer. Baicalein is one of the bioactive flavonoid components isolated from the root of SB. The present study aimed to observe the effect of baicalein, in combination with platin-based systemic chemotherapy (cisplatin), on cytotoxicity and apoptosis of human A549 lung cancer cells. The cell cultures were treated with baicalein, cisplatin, or a combination of the two. Cell viability and cytotoxicity was assayed by XTT, and cell apoptosis was measured by flow cytometry. The apoptosis-associated proteins were detected by western blot analysis. The cytokines in the culture supernatant were detected by ELISA. The present study revealed that cisplatin and the baicalein-cisplatin combination inhibited viability and promoted cytotoxicity of A549 cells. Cisplatin, baicalein and baicalein-cisplatin combination treatments were effective in the promotion of apoptosis of A549 cells. Baicalein and baicalein-cisplatin combination treatments also inhibited B cell lymphoma-2 (Bcl-2) and increased Bcl-2-associated X protein (Bax) expression. Additionally, cisplatin, baicalein and the baicalein-cisplatin combination promoted caspase-3 expression. Furthermore, the baicalein-cisplatin combination suppressed the secretion of interleukin-6, and baicalein and the combination of baicalein cisplatin decreased the secretion of tumor necrosis factor-α of A549 cells. The present study concluded that baicalein combined with cisplatin induced cytotoxicity and apoptosis of A549 cells, and such activity may be associated with the regulation of Bcl-2, Bax and caspase-3, indicating a promising alternative method for lung cancer.