Weimin Kong

Current and future burden of gynecological cancers attributable to high body-mass index: A comprehensive global analysis and projection study

Background High body-mass index (BMI) is a major modifiable risk factor for gynecological cancers, yet its contribution to the global cancer burden remains incompletely characterized. This study provides a comprehensive analysis of the current burden of gynecological cancers attributable to high BMI and projects future trends through 2050. Methods We analyzed data from the Global Burden of Disease (GBD) 2021 study, examining uterine and ovarian cancers attributable to high BMI across 204 countries and territories. Burden was quantified using deaths and disability-adjusted life years (DALYs). Temporal trends were identified using joinpoint regression analysis, while future burden was projected using Bayesian Age-Period-Cohort (BAPC) models. We evaluated relationships between socio-demographic index (SDI) and cancer burden to identify development-associated patterns. Results Between 1990 and 2021, global deaths from gynecological cancers attributable to high BMI increased by 143.4% (from 20,743–50,479), with corresponding DALYs rising by 141.7% (from 561,515–1,357,395). Rising age-standardized rates indicated increasing individual-level risk. While burden was highest in high-SDI regions, the most rapid increases occurred in low- and middle-SDI settings. Cancer-specific patterns varied, with uterine cancer showing consistent increases across all SDI quintiles, while ovarian cancer exhibited decreasing trends in high-SDI regions after 2003. Projections indicate a 2.6-fold increase in deaths by 2050, with differential growth by cancer type: a 3.2-fold increase for ovarian cancer versus 2.3-fold for uterine cancer. Conclusions The global burden of gynecological cancers attributable to high BMI has increased substantially and is projected to accelerate through 2050, particularly in developing regions. These findings underscore the urgent need for targeted obesity prevention strategies within comprehensive cancer control programs to avert a substantial proportion of future gynecological cancer cases.

Diagnostic value of contrast-enhanced ultrasound in ovarian cancer: a meta-analysis

Background Ovarian cancer has been reported to be the eighth most common cancer among women worldwide. Purpose To assess the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) in distinguishing between benign and malignant ovarian tumors. Material and Methods A comprehensive search of scientific literature databases, including PubMed, Cochrane Library, Web of Science, Wanfang, and CNKI, was conducted from their inception to November 2019 to identify relevant studies on the use of CEUS in the differential diagnosis of benign and malignant ovarian tumors. Sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (LR+/LR–), diagnostic odds ratios (DORs), and their corresponding 95% confidence intervals (CIs) were retrieved and analyzed using Stata 15.0. Results After rigorous screening, a total of 15 high-quality clinical studies encompassing 934 patients with ovarian cancer, comprising 969 ovarian tumors (403 malignant tumors and 566 benign tumors), were included in the analysis. Data analysis revealed significant correlations between CEUS and various diagnostic indices for ovarian tumors: the combined SEN and SPE were 0.93 (95% CI = 0.88–0.96) and 0.93 (95% CI = 0.90–0.96), respectively, and the combined LR+ and LR– were 14.07 (95% CI = 9.46–20.92) and 0.08 (95% CI = 0.05–0.13), respectively, with a combined DOR of 185.15 (95% CI = 93.31–367.41). The area under the summary receiver operating characteristic curve (AUC) was 0.98 (95% CI = 0.96–0.99). No publication bias was detected in the meta-analysis ( P  = 0.62). Conclusion CEUS demonstrates significant value in the diagnosis and differential diagnosis of benign and malignant ovarian tumors.

Effects of vaginal dilation therapy on vaginal condition and sexual function of endometrial cancer patients treated with radiotherapy after surgery

AbstractObjectiveThis study aimed to evaluate the effect of vaginal dilation therapy on vaginal length, vaginal stenosis, vaginal elasticity, and sexual function of endometrial cancer patients treated with radiotherapy after surgery.MethodsA total of 117 women were enrolled in this study. They received 6 months of vaginal dilation therapy. We evaluated their vaginal length, vaginal diameter, vaginal elasticity, and sexual function before radiotherapy, after radiotherapy, and after 6 months of vaginal dilation therapy. Their vaginal condition was assessed by customized vaginal dilating molds. Their sexual function was assessed by female sexual function index. The SPSS 25 software was used to analyze all the data.ResultsAccording to multivariate analysis, vaginal diameter (β = 0.300, 95% CI [0.217–1.446], p = 0.010) and sexual intercourse frequency before diagnosis (β = 0.424, 95% CI [0.164–0.733], p = 0.006) were significantly correlated with female sexual function after radiotherapy. Vaginal dilation therapy helped increase vaginal length, improve vaginal stenosis and sexual function (p < 0.05), though most of the figures at the end of the intervention did not fully return to those before radiotherapy. Noticeably, vaginal dilation therapy was ineffective in improving vaginal elasticity and the incidence rate of female sexual dysfunction (p > 0.05). Moreover, patients with medium or good vaginal elasticity benefited more from vaginal dilation therapy than patients with poor vaginal elasticity (p < 0.05).ConclusionVaginal dilation therapy should be carried out timely and preventatively in endometrial cancer patients treated with radiotherapy after surgery to improve their vaginal condition and sexual function.

Effects of vaginal dilation therapy on vaginal length, vaginal stenosis, vaginal elasticity and sexual function of cervical cancer survivors

Cervical cancer survivors can experience vaginal length shortening, vaginal stenosis, vaginal elasticity deterioration, sexual frequency reduction and sexual dysfunction. This prospective, uncontrolled, monocentric clinical interventional study aimed to evaluate the effect of vaginal dilation therapy on vaginal condition and sexual function of cervical cancer survivors who had not received timely vaginal dilation. A total of 139 patients completed the study. They received 6 months of vaginal dilation therapy. We evaluated their vaginal elasticity, vaginal diameter, vaginal length and sexual function before and after vaginal dilation therapy. Their vaginal conditions were evaluated by customised vaginal moulds, and the sexual function was assessed by female sexual function index. The SPSS 25 software was used to analyse all the data. Age, vaginal diameter and sexual intercourse frequency before diagnosis were significantly associated with female sexual dysfunction of the patients after cancer treatment. Vaginal dilation therapy improved vaginal stenosis, vaginal length and sexual function in all the patients; however, the vaginal elasticity and incidence of sexual dysfunction did not improve significantly. Sexual intercourse frequency before diagnosis, vaginal elasticity, time interval from last treatment and treatment modalities were significantly associated with the change in female sexual function index score before and after vaginal dilation therapy. Patients with a time interval from the last treatment less than 24 months or those who had moderate or good vaginal elasticity, benefitted more from vaginal dilatation therapy. Cervical cancer survivors who had not received timely vaginal dilation still benefitted from vaginal dilation therapy, irrespective of the treatment methods they received. Moreover, vaginal dilation therapy should be performed as early as possible after cervical cancer treatment.

PMEPA1 Serves as a Prognostic Biomarker and Correlates with Immune Infiltrates in Cervical Cancer

Emerging studies have demonstrated that Prostate transmembrane protein androgen induced 1 (PMEPA1) plays crucial roles in the carcinogenesis of many developing human tumors. However, the clinical significance of PMEPA1 expression in cervical cancer (CC) and its contribution to cancer immunity have not been investigated. In this study, we identified PMEPA1 as a survival-related gene in CC based on TCGA datasets. Univariate and multivariate analysis showed that PMEPA1 expression was an independent predictor for overall survival in CC patients. We could observe a strong negative correlation between PMEPA1 expression and PMEPA1 methylation. Two CpG sites of PMEPA1 were associated with overall survival, and one CpG site of PMEPA1 was associated with progression-free survival. The low level of PMEPA1 methylation was associated with advanced clinical stage of CC patients. KEGG assays revealed the genes associated with PMEPA1 expression were mainly enriched in several tumor-related pathways. Increased PMEPA1 expressions were observed to be positively related to high immune infiltration levels in several immune cells. Finally, the pan-cancer assays revealed that PMEPA1 expression was associated with the overall survival of UVM, PAAD, LUSC, BLCA, CESC, and LUAD. Taken together, PMEPA1 is a prognosis-related biomarker for multiple cancer types, especially CC. PMEPA1 is involved in tumor immunity, suggesting PMEPA1 may be a potential immunotherapeutic target in CC.