Weidong Zhao

Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification

AbstractAimTo establish a risk‐scoring system for lymph node metastasis (LNM) of early‐stage endometrial carcinoma (EC), and to stratify the preoperative risk of LNM.MethodsWe retrospectively analyzed the clinical data of 507 patients diagnosed with the early‐stage EC (i.e., confined to the uterine corpus). We determined the risk factors for LNM by logistic regression analysis; then constructed a simple logistic scoring system, and an additive scoring system based on the regression coefficient (β), and odds ratio, of each variable, respectively.ResultsThe overall rate of LNM was 9.1% (46/507). Multivariate analysis showed that preoperative serum cancer antigen 125 (CA125) ≥35 U/mL, histopathology of grade 3 and/or type II, depth of myometrial invasion ≥1/2 and positive immunostaining for Ki‐67 ≥50%, were independent risk factors for LNM (P < 0.05). The simple logistic and additive scoring systems exhibited good predictive ability (area under the curve [AUC] >0.8). Based on the additive scoring system, the risk of LNM in patients with early‐stage EC was classified into three groups: a low‐risk group (total score: <5), an intermediate‐risk group (total score: 5–10) and a high‐risk group (total score: >10). The incidence of LNM differed significantly across these three groups (P < 0.05).ConclusionThe risk‐scoring system constructed in this study can effectively predict the risk of LNM in patients with early‐stage EC, achieve preoperative risk stratification and provide a reference guideline for the use of lymphadenectomy.

Identifying Sequence Variants of 18 Hereditary Ovarian Cancer‐Associated Genes in Chinese Epithelial Ovarian Cancer Patients

Objectives. The causes of ovarian cancer (OC) have been confirmed to be closely related to genetic factors. Identifying sequence variants of hereditary ovarian cancer (HOC) susceptibility genes can increase clinical surveillance, facilitate early detection, and provide personalized treatment for patients. This study is aimed at investigating the variation frequency of HOC susceptibility genes in the Chinese population and providing information for the etiology and genetics of OC. Methods. 118 epithelial OC patients were recruited in this clinical study. Variants of 18‐gene panel were detected in blood samples by next‐generation sequencing (NGS) technology. Results. Overall, 36.44% (43/118) of patients carried at least one pathogenic variant. Among these, BRCA1 pathogenic variants were detected in 31 (26.27%) patients, and 5 (4.24%) patients carried pathogenic variants of BRCA2. Moreover, 27.12% (32/118) of patients carried variants of unknown significance (VUSs). Importantly, we detected eight variants that were not reported previously. Conclusions. Our study enlarged the spectrum of HOC‐associated gene sequence variants in the Chinese population and also proved the necessity of multigene testing in epithelial OC patients. The identification of patients with HOC will allow family members to undergo cascade testing where identification of unaffected carriers can facilitate early detection, risk reduction, or prevention of OC and ultimately improve long‐term outcomes.