Kkl Chan

Acceptability of human papillomavirus vaccination among Chinese women: concerns and implications

Objective  To explore Chinese women’s perceptions of human papillomavirus (HPV) vaccination and their intention to be vaccinated.

Natural history of pelvic lymphocysts as observed by ultrasonography after bilateral pelvic lymphadenectomy

To determine, in patients who have undergone bilateral pelvic lymphadenectomy for gynecological cancer, the incidence of lymphocyst formation, their change in size with time, risk factors and correlation with symptoms.

The use of vaginal antimicrobial after large loop excision of transformation zone: a prospective randomised trial

Objective To investigate whether the use of an antibacterial vaginal pessary containing tetracycline and amphotericin B would reduce complications from large loop excision of the transformation zone (LLETZ).

GRO-α and IL-8 enhance ovarian cancer metastatic potential via the CXCR2-mediated TAK1/NFκB signaling cascade

Intraperitoneal metastasis is a common occurrence and is usually involved in the poor prognosis of ovarian cancer. Its specific metastatic pattern implies that certain indispensable microenvironmental factors secreted in the peritoneal cavity can direct metastatic ovarian cancer cells to permissive niches for secondary lesion formation. However, the underlying molecular mechanisms are ill defined. Herein, we report that GRO-α and IL-8 are predominately upregulated in culture media derived from either normal or cancerous omenta and are associated with increased ovarian cancer aggressiveness. Methods: OCM was established from culture medium of fresh human omental tissues. Primary and metastatic ovarian cancer cell lines were generated from human tumor tissues and verified by specific antibodies. The functional roles of GRO-α, IL-8, and their specific receptor CXCR2 were examined by neutralizing antibodies, shRNA gene knockdown, CRISPR/Cas9 gene knockout and pharmaceutical CXCR2 inhibitor SB225002. The oncogenic properties of ovarian cancer cells were examined by in vitro and in vivo mouse models. Results: Both GRO-α and IL-8 can activate TAK1/NFκB signaling via the CXCR2 receptor. Intriguingly, TAK1/NFκB signaling activity was higher in metastatic ovarian cancer cells; this higher activity makes them more susceptible to OCM-induced tumor aggressiveness. Treatment of ovarian cancer cells with GRO-α and IL-8 neutralizing antibodies or ablation of CXCR2 by shRNA gene knockdown, CRISPR/Cas9 gene knockout, or CXCR2 inhibitor SB225002 treatment significantly attenuated TAK1/NFκB signaling and decreased in vitro and in vivo oncogenic and metastatic potential, suggesting CXCR2 plays a key role in the GRO-α and IL-8-governed metastatic spreading of ovarian cancer cells in the intraperitoneal cavity. Conclusion: This study highlights the significance of GRO-α and IL-8 as the key chemokines in the peritoneal tumor microenvironment and suggests the utility of targeting their receptor CXCR2 as a potential target-based therapy for peritoneal metastases of ovarian cancer.

A case of “familial atretic encephalocele”

This is the first pregnancy of a 22 years old healthy women from non-consanguineous marriage. A small 6 to 7mm occipital cystic mass was noted on anomaly scan at 17wk (figure 1). Amniocentesis was performed at 20 weeks gestation for conventional cytogenetics revealed normal karyotype 46,XX. Array comparative genomic hybridization (aCGH) showed arr[GRCh37] 5q35.2(173909361_175173029)x1 of maternal inheritance. This article is protected by copyright. All rights reserved.

EP07.04: Prenatal diagnosis of Cri-du-Chat syndrome: five cases: Electronic Poster Abstracts

Objectives: Maternal serum markers in 1st and 2nd trimesters are widely used for screening test of aneuploidy. Although demised fetus may affect the serum markers, vanishing twin (VT) is not considered as an adjustment factor for risk assessment. The purpose of this study was to evaluate the effect of VT on 1st and 2nd trimester maternal serum markers and nuchal translucency (NT). Methods: This is a secondary analysis of a multicenter prospective cohort study, which was designed to evaluate the cost-effectiveness of various prenatal test strategies for Down’s syndrome. Pregnant women were enrolled in 12 institutions. Among 5,188 cases, 3,616 cases adopted serum markers, including 56 cases with VT(1.55%) and 3,560 cases with normal singleton controls. All VT was found during 1st trimester (range; 7.29-9.13). We used pregnancy associated plasma protein A (PAPP-A) as 1st trimester serum marker and α-fetoprotein (aFP), total β-human chorionic gonadotrophin (beta-hCG), unconjugated estriol (uE3), and inhibin A as 2nd trimester serum marker and NT in the 1st trimester. All markers were compared between two groups with multiple of the median (MoM). Results: Compared with controls, cases with VT had higher MoM of aFP[median MoM(range) 1.260(0.940-1.515) for VT; medican MoM(range) 0.980(0.809-1.220), p=.001] and inhibin A[(median MoM(range) 1.120(0.868-1.370) for VT; medican MoM(range) 1.010(0.766-1.291), p=.045). The other markers did not show significant difference between two groups (table). These findings were remained significant after adjustment for confounding variables including maternal age, prepregnancy BMI, and mode of conception. Conclusions: In conclusion, VT can be considered as an adjustment factor for risk assessment in the 1st and 2nd trimester serum screening test.

Recommendations on prevention and screening for breast cancer in Hong Kong

In Hong Kong, breast cancer is the most common cancer among women and poses a significant health care burden. The Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) was set up in 2002 by the Cancer Coordinating Committee to review and assess local and international scientific evidence, and to formulate recommendations for cancer prevention and screening. After considering the local epidemiology, emerging scientific evidence, and local and overseas screening practices, the CEWG concluded that it was unclear whether population-based breast cancer screening did more harm than good in local asymptomatic women at average risk. The CEWG considers that there is insufficient evidence to recommend for or against population-based mammography screening for such individuals. Women who consider breast cancer screening should be adequately informed about the benefits and harms. The CEWG recommends that all women adopt primary preventive measures, be breast aware, and seek timely medical attention for suspicious symptoms. For women at high risk of breast cancer, such as carriers of confirmed BRCA1/2 deleterious mutations and those with a family history of breast cancer, the CEWG recommends that they seek doctors advice for annual mammography screening and the age at which the process should commence. Additional annual screening by magnetic resonance imaging is recommended for confirmed BRCA1/2 mutation carriers or women who have undergone radiation therapy to the chest between the age of 10 and 30 years. Women at moderate risk of breast cancer should discuss with doctors the pros and cons of breast cancer screening before making an informed decision about mammography screening every 2 to 3 years.

HPV-E6 protein enriches the CD55(+) population in cervical cancer cells promoting radio-resistance and cancer aggressiveness

Accumulating evidence indicates that the human papillomavirus (HPV) E6 protein plays a crucial role in the development of cervical cancer. Subpopulations of cells that reside within tumours are responsible for tumour resistance to cancer therapy and recurrence. However, the identity of such cells residing in cervical cancer and their relationship with the HPV‐E6 protein have not been identified. Here, we isolated sphere‐forming cells, which showed self‐renewal ability, from primary cervical tumours. Gene expression profiling revealed that cluster of differentiation (CD) 55 was upregulated in primary cervical cancer sphere cells. Flow‐cytometric analysis detected abundant CD55(+) populations among a panel of HPV‐positive cervical cancer cell lines, whereas few CD55(+) cells were found in HPV‐negative cervical cancer and normal cervical epithelial cell lines. The CD55(+) subpopulation isolated from the C33A cell line showed significant sphere‐forming ability and enhanced tumourigenicity, cell migration, and radioresistance. In contrast, the suppression of CD55 in HPV‐positive CaSki cells inhibited tumourigenicity both in vitro and in vivo, and sensitized cells to radiation treatment. In addition, ectopic expression of the HPV‐E6 protein in HPV‐negative cervical cancer cells dramatically enriched the CD55(+) subpopulation. CRISPR/Cas9 knockout of CD55 in an HPV‐E6‐overexpressing stable clone abolished the tumourigenic effects of the HPV‐E6 protein. Taken together, our data suggest that HPV‐E6 protein expression enriches the CD55(+) population, which contributes to tumourigenicity and radioresistance in cervical cancer cells. Targeting CD55 via CRISPR/Cas9 may represent a novel avenue for developing new strategies and effective therapies for the treatment of cervical cancer. Copyright

Treatment and Survival Outcomes in Women Treated with Malignant Ovarian Germ Cell Tumours

Objectives: To evaluate the accuracy and safety of sentinel lymph node (SLN) mapping in patients with endometrial cancer using TC99m colloid and blue dye, and to evaluate the contribution of preoperative mapping by planar lymphoscintigraphy (PLSG) and SPECT/CT. Methods: Retrospective analysis of patients who underwent SLN mapping as part of their primary surgery for endometrial cancer from January 2013 until November 2014. Patients underwent preoperative SLN mapping by PLSG and later with additional SPECT/CT. Intraoperative mapping was performed by using both Tc99m colloid and blue dye by cervical injections. SLNs were sent separately to pathologic evaluation with ultrastaging. Results: Fifty three patients were included in this study. Successful preoperative mapping was achieved in 31 of 37 patients (84.5%) undergoing SPECT/CT, compared to only 30 of 45 patients (67%) undergoing PLSG. SPECT/CT localizations of SLNs were accurate in 91% of cases. Intraoperative detection of at least one SLN was 77%, while bilateral detection rate was 49%. Failed mapping was more prevalent in patients with advanced age (p=o.o41).Six cases of nodal metastasis were diagnosedFour by positive SLN, including two cases by ultrastaging only, and two more cases with failed mapping were diagnosed using side-specific full dissection according to the SLN algorithm. There were no cases of false negative results. Conclusions: SLN mapping using a cervical injection with combined Tc99m colloid and blue dye is feasible, safe and accurate in patients with endometrial cancer. Preoperative SPECT/CT has high detection rate and provides accurate anatomic location of the SLN. Copyright