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en: Extreme leanness, lower skeletal muscle quality, and loss of muscle mass during treatment are predictors of poor prognosis in cervical cancer treated with concurrent chemoradiation therapy

en: Human papillomavirus vaccination is not widespread in Japan, and the low screening rates result in many cases of locally advanced cervical cancer. We investigated the prognostic significance of sarcopenia in patients with cervical cancer to guide healthcare policies to improve treatment outcomes. This retrospective study included 83 patients with cervical cancer without distant metastasis who underwent primary concurrent chemoradiotherapy between 2013 and 2018. We analyzed the indicators of physical condition and muscle quantity using the SYNAPSE VINCENT software. Muscle mass and the relationship between treatment toxicity and prognosis were evaluated. The patients' median age was 60 (range 33-80) years. Cancer stage distribution was as follows: cT2b or higher, 84.3%; N1, 65.1%; and MA, 27.7%. The overall sarcopenia (skeletal muscle index [SMI] < 38.5) rate was 30.1%, and the rate was 33.9 and 22.2% in patients aged < 64 and ≥ 65 years, respectively. No correlation was observed between clinical stage and musculoskeletal indices. Treatment resulted in decreased body weight and SMI; after treatment, the sarcopenia rate increased to 37.3%. A higher intramuscular adipose tissue content (IMAC) reduced the number of chemotherapy cycles needed. Treatment-associated SMI decreases of ≥ 7% indicated poor prognosis, with significant differences in progression-free survival and overall survival (p = 0.013 and p = 0.012, respectively). Patients who were very lean (body mass index < 18.5 kg/m) before treatment had a poor prognosis (p = 0.016 and p < 0.001). Our findings emphasize the importance of assessing original nutritional status and maintaining muscle mass and quality during the treatment of patients with cervical cancer.

en: International Journal of Clinical Oncology


en: A novel PCOS rat model and an evaluation of its reproductive, metabolic, and behavioral phenotypes.

en: Although animal models of PCOS have been used in many studies, none of them can reproduce both the reproductive and metabolic phenotypes of PCOS. In addition, behavioral parameters have not been evaluated in PCOS animal models. We tried to produce an improved rat model of PCOS, and the reproductive, metabolic, and behavioral phenotypes of the model rats were evaluated. Female rats were implanted with silicon tubes containing oil-dissolved dihydrotestosterone (Oil-DHT) as a new PCOS model. Their phenotypes were compared with those of conventional PCOS model rats (DHT), into which tubes containing crystalline DHT were implanted, and non-DHT-treated rats (control). Both the Oil-DHT and DHT rats showed greater body weight gain, food intake, and fat depot weight than the control rats. Furthermore, these groups showed fewer estrous stages and increased numbers of cystic follicles. The DHT rats exhibited lower ovarian and uterine weights than the control rats, whereas no such changes were observed in the Oil-DHT rats. The Oil-DHT and DHT rats showed less locomotor activity in the light phase than the control rats. Our proposed PCOS model reproduced both the reproductive and metabolic phenotypes of PCOS and may have potential for PCOS research.

en: Reproductive Medicine and Biology

ja: Reproductive Medicine and Biology


en: Resveratrol suppresses proliferation and induces apoptosis of uterine sarcoma cells by inhibiting the Wnt signaling pathway.

en: Resveratrol, a natural product and peroxisome proliferator-activated receptor (PPAR) agonist, has been reported to exert anti-cancer effects in several tumor models. A previous study by our group reported that prostaglandin J2, a PPARγ ligand, inhibited cell proliferation in a uterine sarcoma cell line. The aim of the present study was to investigate the role of the Wnt signaling pathway in resveratrol-induced apoptosis and inhibition of cell proliferation in the MES-SA human uterine sarcoma cell line. A WST-1 assay demonstrated that resveratrol inhibited cell proliferation in the MES-SA cell line, and flow cytometry revealed that the number of apoptotic cells increased in a resveratrol dose-dependent manner. The mechanisms underlying these effects of resveratrol were speculated to involve the expression of β-catenin and its target gene, c-myc, which were examined using western blot analysis. The results revealed a dose-dependent downregulation of this β-catenin and c-myc. This effect was blunted by a pharmacological inhibitor of glycogen synthase kinase 3β. Therefore, it is likely that resveratrol inhibited the cell proliferation and increased the number of apoptotic cells, at least partially, via the Wnt signaling pathway. The present results suggest that resveratrol is a potential candidate for the treatment of uterine sarcoma.

en: Experimental and Therapeutic Medicine

ja: Experimental and Therapeutic Medicine


en: 術前に卵巣原発胚細胞性腫瘍を疑ったが, 傍卵巣の平滑筋肉腫であった一例

ja: 術前に卵巣原発胚細胞性腫瘍を疑ったが, 傍卵巣の平滑筋肉腫であった一例

en: Modern Trends in Obstetrics & Gynecology

ja: 現代産婦人科


en: Mismatch repair deficiency in young patients of reproductive age with endometrial cancer and atypical endometrial hyperplasia

ja: 生殖年齢期に発生した子宮内膜癌・異型内膜増殖症におけるミスマッチ修復蛋白発現に関する検討

en: MPA therapy is widely administered to patients with early-stage endometrial cancer and atypical endometrial hyperplasia (AEH) who desire a fertility-preserving treatment modality. We examined the relationship between MMR protein expression and the effects of MPA therapy, risk of relapse, prognosis, and familial history in 21 patients. We observed MMR deficiency in 7 patients (MLH1: 4, PMS2: 5, MSH2: 2, and MSH6: 2). All patients with lymph node metastasis or who died had MLH1 deficiency. In 13 of 21 patients, we performed MPA therapy for fertility preservation and confirmed MMR deficiency in 2. After the initial treatment, ovarian cancer developed in 2 patients, one of whom had Peutz-Jeghers syndrome. Due to the small sample size of this study, we found no significant association between MMR deficiency and the effects of MPA therapy or the risk of relapse. Many young patients with endometrial tumors may have inherited diseases, although not necessarily with MMR deficiency. Therefore, clinical assessment considering their past history and family history should be performed prior to each treatment. Our findings will serve as a catalyst for future studies with larger sample sizes.

ja: 妊孕性温存療法希望の早期子宮体癌および異型内膜増殖症症例にMPA療法を行うも不応や再燃症例も経験する．徳島大学産科婦人科で初回治療を行った若年子宮体癌および異型内膜増殖症21症例を対象にミスマッチ修復(mismatch repair;MMR)蛋白発現と，MPA療法の効果，再燃リスク，および予後との関連について検討した．MMR蛋白の発現欠失は7例で認め，MLH1欠失4例，PMS2欠失5例，MSH2欠失2例，MSH6欠失2例であった．リンパ節転移例と再発原病死例はいずれもMLH1欠失例であった．MPA療法施行13例中，MMR欠失を2例で認めたが，いずれもMPA奏効・無病生存例であった．初回治療後，異時性卵巣癌発症を2例に認め，このうちの1例はPeutz-Jeghers症候群であった．本検討では対象例が少なく，MMR蛋白発現とMPA療法の効果および再燃リスクとの間に有意な関連は確認できなかった．しかしMMR欠失を認めなくとも， 遺伝性疾患を背景にもつハイリスク症例もあり，家族歴を考慮した適切な医学的管理が必要であると考えられた．

en: Journal of Hereditary Tumors

ja: 遺伝性腫瘍


en: 嚢胞状帝王切開瘢痕部が着床部結節から成っていた一例

ja: 嚢胞状帝王切開瘢痕部が着床部結節から成っていた一例