Xin Yu

Volume reduction rate and its influencing factors in solitary uterine fibroids classified as Funaki types I and II after ultrasonography-guided high intensity focused ultrasound ablation: a prospective cohort study

We aimed to explore the volume reduction rate (VRR) and its influencing factors in solitary uterine fibroids classified as Funaki type I and II after ultrasonography-guided high-intensity focused ultrasound (USgHIFU) ablation. We enrolled 191 patients with uterine fibroids who underwent USgHIFU ablation. To calculate the VRR, fibroid dimensions were measured using ultrasonography at 3, 6 and 12 post-treatment months. The primary endpoint was the VRR at 12 post-treatment months. The secondary endpoints included the non-perfused volume ratio (NPVR) and VRR at three and six months. The mean VRR for all 191 patients was 29.9%, 39.6% and 44.0% at 3, 6 and 12 post-treatment months, respectively. Subgroup analysis demonstrated a significant volume reduction across groups stratified by maximum fibroid diameter, Funaki type and NPVR. Univariable logistic analysis identified the following factors significantly associated with a higher VRR at 12 months: age ≥35 years (odds ratio [OR] 3.960, 95% confidence interval [CI] 1.405-11.159), presence of menstrual abnormalities (OR 1.936, 95% CI 1.075-3.485), moderate enhancement (OR 2.340, 95% CI 1.193-4.591), anteverted uterus (OR 2.020, 95% CI 1.034-4.025) and lymphocyte count <1.8 × 10 The uterine fibroid volume progressively decreased after USgHIFU ablation. Age ≥35 years and lymphocyte count <1.8 × 10

Analysis of risk factors for post-operative recurrence or progression of intravenous leiomyomatosis

To analyse the risk factors for post-operative recurrence or progression of intravenous leiomyomatosis and explore the impact of different treatment strategies on patient prognosis. Patients with intravenous leiomyomatosis who underwent surgery from January 2011 to December 2020 and who were followed for ≥3 months were included. The primary endpoint was recurrence (for patients with complete resection) or progression (for patients with incomplete resection). Kaplan-Meier survival analysis was used to analyse the factors affecting recurrence. A total of 114 patients were included. The median age was 45 years old (range 24-58). The tumors were confined to the uterus and para-uterine vessels in 48 cases (42.1%), while in 66 cases (57.9%) it involved large vessels (iliac vein or genital vein and/or proximal large veins). The median follow-up time was 24 months (range 3-132). Twenty-nine patients (25.4%) had recurrence or progression. The median recurrence or progression time was 16 months (range 3-60). Incomplete tumor resection (p=0.019), involvement of the iliac vein or genital vein (p=0.042), involvement of the inferior vena cava (p=0.025), and size of the pelvic tumor ≥15 cm (p=0.034) were risk factors for recurrence and progression. For intravenous leiomyomatosis confined to the uterus or para-uterine vessels, no post-operative recurrence after hysterectomy and bilateral oophorectomy occurred in this cohort. Compared with hysterectomy and bilateral oophorectomy, the risk of recurrence after tumorectomy (with the uterus and ovaries retained) was significantly greater (p=0.009), while the risk of recurrence after hysterectomy was not significantly increased (p=0.058). For intravenous leiomyomatosis involving the iliac vein/genital vein and the proximal veins, post-operative aromatase inhibitor treatment (p=0.89) and two-stage surgery (p=0.86) were not related to recurrence in patients with complete tumor resection. Incomplete tumor resection, extent of tumor lesions and size of the pelvic tumor were risk factors for post-operative recurrence and progression of intravenous leiomyomatosis.

Moderate Static Magnet Fields Suppress Ovarian Cancer Metastasis via ROS‐Mediated Oxidative Stress

Metastasis is the leading cause of cancer patient death, which is closely correlated with reactive oxygen species (ROS) levels. It is well known that the effects of ROS on tumors are diverse, depending on ROS concentration and cell type. We found that ovarian cancer cells have significantly lower levels of ROS than normal ovarian cells. Moreover, increased ROS levels in ovarian cancer cells can substantially inhibit their migration and invasion ability. Furthermore, the results show that moderate static magnetic field (SMF) can inhibit ovarian cancer cell migration, invasion, and stemness in a ROS‐dependent manner. RNA sequencing results confirm that SMFs increased the oxidative stress level and reduced the stemness of ovarian cancer cells. Consistently, the expressions of stemness‐related genes were significantly decreased, including hyaluronan receptor (CD44), SRY‐box transcription factor 2 (Sox2), and cell myc proto‐oncogene protein (C‐myc). Furthermore, moderate SMFs provided by a superconducting magnet and permanent magnet have good biosafety and can both inhibit ovarian cancer metastasis in mice. Therefore, our study demonstrates the effects of SMFs on oxidative stress and metastasis in the ovarian cancer cells, which reveals the potential of applying SMF as a physical method in cancer therapy in the future.

Progress in High Intensity Focused Ultrasound Ablation for Fertility Preservation Therapy of Uterine Fibroids and Adenomyosis

Abstract High intensity focused ultrasound (HIFU) is an effective and safe non-invasive treatment method, widely used in the treatment of uterine fibroids and adenomyosis in the field of gynecology. The side effects in HIFU is low in incidence and mild. HIFU can significantly alleviate the symptoms of patients, reduce lesion volumes, improve quality of life, and has good cost-effectiveness. HIFU can accurately ablate the uterine fibroids and adenomyosis lesions, without destroying normal myometrium and endometrium, and thus HIFU is a promising alternative to myomectomy in uterine fibroids patients with fertility desire. Several studies have shown that in terms of ovarian endocrine function protection, HIFU treatment is superior to uterine artery embolization, and similar to myomectomy. Existing limited researches show that patients with uterine fibroids have a favorable pregnancy rate and live birth rate, as well as a lower natural abortion rate after HIFU treatment. Pregnancy rate after HIFU treatment for uterine fibroids is not lower than myomectomy, and higher than uterine artery embolization. HIFU may have significant advantages in shortening pregnancy interval compared with myomectomy. However, the proportion of cesarean section delivery after HIFU treatment is relatively high, and gestational uterine rupture after HIFU treatment exist in literature. Higher quality clinical data is needed to confirm the pregnancy outcomes and safety after HIFU treatment in future.