Identification of autophagy-associated miRNA signature for the cervical squamous cell cancer and high-grade cervical intraepithelial lesions

Cervical cancer markedly threatens women's health worldwide and currently ranks fourth leading cause of cancer mortality in women according to recent global cancer statistics. Recent advances have proven that not only tumor suppressor and oncogenes but also non-coding RNAs including micro RNAs (miRNAs) have significant impact in the development and progression of cervical cancers. Previous studies have identified many cancer-specific miRNAs for the early detection of cervical cancers. However, the diagnostic and prognostic use of autophagy-associated miRNAs for the cervical squamous cell cancer (SCC) cases and high-grade squamous intraepithelial lesion (HSIL) have not been uncovered. In the present study, we revealed that miRNAs are differentially expressed in both cervical SCC and HSIL. A total of 35 HSIL, 35 cervical SCC and 30 healthy controls were enrolled for the present study. Total RNA including miRNAs were isolated from the FFPE tissue samples and miRNA expression levels were quantified by quantitative PCR. Predicted miRNA targets of autophagy related genes were determined using miRNA-target prediction algorithms. MiR-143, miR-372, miR-375 and miR-30c were markedly downregulated in HSIL and cervical SCC. MiR-130a was significantly upregulated in the cervical SCC group compared to HSIL and control groups. MiR-30a, miR-520e, miR-548c and miR-372 were significantly associated with the overall survival of cervical SCC patients and these miRNAs were determined to be significant diagnostic markers as revealed by ROC analysis. Together, these results indicate that autophagy-associated miRNAs are potentially valuable for the differential diagnosis and targeted therapy to cervical cancer.

Identification of microRNA expression signature for the diagnosis and prognosis of cervical squamous cell carcinoma

Cervical cancer is the fourth leading cause of cancer death among women globally. The prognosis of cervical cancer patients differs considerably, and clinical outcomes are difficult to predict. Given the significant roles of miRNAs in human cancers, identification of novel and reliable miRNA biomarkers is important for targeted cervical cancer therapy. In the present study, we aimed to reveal biological significance of miR-200a, miR-423, miR-34a, miR-193a, and miR-455 for the prognosis and diagnosis of cervical cancer and their association with the clinical outcomes of patients. Distinct expression profiles of miRNAs in formalin-fixed paraffin-embedded tissue samples of patients and healthy controls were evaluated using qRT-PCR. We identified miR-200a, miR-455, and miR-34a were significantly downregulated in cervical squamous cell carcinoma tissues compared to normal cervix tissue from healthy controls. Both miR-455 and miR-34a confer a promising diagnostic factor for the cervical cancer while miR-200a showed no significance in ROC analysis. Notably, low expression of miR-34a was markedly associated with the poor overall survival of cervical cancer patients as revealed by Kaplan-Meier survival analysis. Also, univariate and multivariate analysis indicated miR-34a expression as an independent prognostic factor. Consequently, our results underline the importance of distinct expression miRNAs in cervical squamous cell carcinoma.

Comparison of the Kelly's plication and TOT simultaneously with vaginal hysterectomy, on the incontinence, and sexual functions

PURPOSE

To compare the effect of vaginal hysterectomy-anterior/posterior colporrhaphy with Kelly's plication(VH-KP), versus vaginal hysterectomy-anterior/posterior colporrhaphy-transobturator tape(VH-TOT) surgeries on incontinence, quality of life, and sexual functions in patients with pelvic organ prolapse(POP), and concurrent obvious stress urinary incontinence(SUI).

MATERIALS AND METHODS

Between 2013 and 2017, fifty patients treated with VH-KP(n = 25), and VH-TOT(n = 25) due to POP and SUI, were evaluated prospective consecutively. Age, parity, duration of urinary incontinence,and the daily pad use were recorded. Patients were filled "rinary Distress Inventory-6(UDI-6)", "Incontinence Impact Questionnaire 7(IIQ-7)" and "Index of Female Sexual Function(IFSI)" questionnaire forms at preoperatively,and postoperative 6th month. No usage of pads was accepted as subjective cure rate.Intraoperative,and postoperative complications were noted.

RESULTS

There was no statistically significant difference between two groups, for the mean age of the patients, parity, duration of SUI, and the daily pad use, preoperatively (p > 0.05). Decreased UDI-6 scores, IIQ-7 scores and daily pad usage, and increased IFSF scores were found statistical significantly in each group, at the postoperative 6 th month (p < 0.05). However, VH-TOT group had higher improvement rates, on UDI-6 scores (69.5% vs 63.0%, p = 0.04). In addition, it was notable that the the rates of the patients had IFSF scores ≥ 25 was higher in VH-KP group (p = 0.05). Four (16%) patients had recurrent SUI in the VH-KP group (p = 0.039) and vaginal extrusion occurred in 2 (8%) patients in the VH-TOT group (p = 0.153), postoperatively.

CONCLUSIONS

Although the effects of VH-TOT surgery are superior to conventional methods for incontinence and quality of life; negative effects on sexual functions are notable. In addition, although recurrence rates of TOT are low, complications such as vaginal extrusion are accompanied by drawbacks of mesh usage.