Ya Li

Evaluation of American College of Radiology Ovarian‐Adnexal Reporting and Data System ultrasound to predict malignancy risk in adnexal lesions

AbstractAimsTo validate the diagnostic performance of Ovarian‐Adnexal Reporting and Data System (O‐RADS) ultrasound for preoperative adnexal lesions in an external center. The secondary aim was to evaluate the performance of a strategy test including O‐RADS ultrasound evaluation and subjective assessment of higher malignant risk lesions.MethodsOne hundred thirty patients with 158 ovarian‐adnexal lesions were enrolled in the study. Each lesion was assigned an O‐RADS score after real‐time ultrasound examination by one experienced radiologist. A second subjective assessment by an expert was performed for O‐RADS 4 and O‐RADS 5 lesions. The histopathological diagnosis was used as the reference standard.ResultsA total of 126 benign and 32 malignant adnexal masses were included in the study. The area under the receiver operating characteristic curve of O‐RADS ultrasound was 0.950, with a cutoff value > O‐RADS 3. The sensitivity, specificity, and negative and positive predictive values were 100% (95% confidence interval [CI], 0.867–1), 83.3% (95% CI, 0.754–0.892), 60.4% (95% CI, 0.460–0.732), and 100% (95% CI, 0.956–1), respectively. For the strategy test, the sensitivity, specificity, negative and positive predictive values were 100% (95% CI, 0.867–1), 92.1% (95% CI, 0.855–0.959), 76.2% (95% CI, 0.602–0.874), and 100% (95% CI, 0.960–1), respectively. In comparison with O‐RADS ultrasound, the specificity and negative predictive value of the strategy test were slightly higher (p < 0.05).ConclusionsGood diagnostic performance of the O‐RADS ultrasound in adnexal lesions can be achieved by experienced radiologists in clinical practice. A second subjective assessment of sonographic findings can be applied to O‐RADS 4 and 5 lesions.

Safety and efficacy of radical hysterectomy based on embryo development-originated in the treatment of early cervical cancer: a single-arm meta-analysis

Cervical cancer is the leading malignancy in terms of both incidence and mortality among cancers of the female reproductive system, and initial surgical treatment is still one of the main treatments. However, for many years, radical hysterectomy based on traditional anatomical principles has failed to substantially improve oncological outcomes for cervical cancer patients or reduce the incidence of perioperative complications. In recent years, radical surgery grounded in the membrane anatomy concept of embryonic development has demonstrated promising oncological outcomes in colorectal cancer surgery. Research in the field of cervical cancer, however, remains in its early stages, although it is steadily garnering increased attention. Consequently, this meta-analysis seeks to systematically assess the safety and efficacy of radical hysterectomy, rooted in embryonic developmental principles, for the treatment of early-stage cervical cancer. This study systematically searched PubMed, Embase, Cochrane Library, Web of Science, Wanfang, and CNKI databases for relevant studies published from their inception to October 2024. Data on 5-year recurrence-free survival (RFS), overall survival (OS), and surgical complications were collected for further analysis. Eight studies involving 1,226 patients were included in the meta-analysis. The surgical complication rate was 35.2%. Two studies reported a 5-year RFS of 86% and an OS of 88%. Radical hysterectomy based on embryo development-originated shows good safety and efficacy in treating early-stage cervical cancer. PROSPERO Identifier: CRD42024602098.

Gonadoblastoma in Turner syndrome with puberty delay: A case report and literature review

AbstractBackgroundY chromosome material stands as an independent risk determinant for the onset of gonadoblastoma (GB) and subsequent gonadal germ cell tumours in individuals with Turner syndrome (TS). However, the delayed and underestimated identification of Y chromosome material through karyotyping within primary care settings exacerbates the intricacies of managing these patients over the long term.MethodsWe present a case involving TS accompanied by Y chromosome material, wherein puberty delay and GB were identified during prophylactic gonadectomy. Subsequently, we delve into the literature to explore the GB‐related malignancy risk in TS patients with Y chromosome material, the incidence of Y chromosome presence in TS patients using methodologies beyond routine chromosomal testing, and the diagnosis and treatment of puberty delay in TS patients, all based on our case.ResultsA spectrum of more sensitive molecular techniques, including polymerase chain reaction (PCR) and fluorescence in situ hybridisation, effectively augments the detection of Y chromosome material alongside karyotyping. In addition to gonadectomy, the implementation of appropriate oestrogen therapy and a holistic, multidisciplinary approach to care can enhance the quality of life, while mitigating the long‐term morbidity and mortality risks for TS patients harbouring Y chromosome material.ConclusionsBeyond gonadectomy, adopting a multifaceted approach the Y chromosome material detection, prompt initiation of puberty, tailored oestrogen therapy, and coordinated multidisciplinary management significantly contributes to the comprehensive health oversight of TS patients with Y chromosome material.