Digestive Diseases and Sciences

Magnifying Power: New Endoscopic Tools for the Diagnosis of Krukenberg Tumor

A Case of Uterine Adenosarcoma and Colonic Endometriosis Masquerading as Inflammatory Bowel Disease

Endometriosis is a prevalent gynecological condition that primarily affects women of reproductive age. When the gastrointestinal system is involved, it can lead to bowel dysfunction and pose diagnostic challenges. To present a rare case of gastrointestinal endometriosis with concurrent uterine adenosarcoma, highlighting the diagnostic complexities and therapeutic considerations. A 42-year-old female presented with refractory bloody diarrhea, abdominal pain, and significant unintentional weight loss for several months. Initial investigations, including stool studies and inflammatory markers, ruled out infectious and common inflammatory causes. Endoscopic evaluation revealed multiple polypoid lesions, prompting further imaging. Magnetic resonance enterography (MRE) identified a uterine mass with suspected extrauterine involvement and a rectal nodule, raising concerns for malignancy or extensive gastrointestinal endometriosis. The patient underwent surgical management, including total hysterectomy, bilateral salpingo-oophorectomy, and lower anterior resection. Histopathological analysis confirmed the coexistence of uterine adenosarcoma and rectal endometriosis. The patient fully recovered after surgery without complications. At her 12-month follow-up, she remained asymptomatic, with no evidence of recurrence or residual disease. This case underscores the diagnostic and therapeutic challenges of gastrointestinal endometriosis, particularly in the presence of coexisting malignancy. A multidisciplinary approach is essential for early recognition and prompt intervention, which are crucial for improving patient outcomes and quality of life.

MiR-525-5p Repressed Metastasis and Anoikis Resistance in Cervical Cancer via Blocking UBE2C/ZEB1/2 Signal Axis

Accumulating evidence indicated that miRNAs are important regulators involved in cancer biology. We aimed to investigate the biological functions and potentially underlying molecular mechanism of miR-525-5p in CC. RT-PCR and Western blot assay were performed to detect mRNA and protein expression. Cell proliferation, anoikis resistance, and cell invasion were analyzed. We observed that the expression of miR-525-5p was declined in several CC cell lines. Additionally, introduction of miR-525-5p dramatically hampered cell viability, invasiveness, and migration ability through modulating epithelial-to-mesenchymal transition (EMT) marked genes as reflected by the upregulation of E-cadherin, as well as the downregulation of vimentin and N-cadherin. Furthermore, administration of miR-525-5p markedly reduced anchorage-independent growth and anoikis resistance accompanied by a decrease in the expression of anti-apoptotic protein Bcl-2 and an increase in the expression of pro-apoptotic protein Bax, C-caspase 3, and C-PARP1. Most importantly, analysis using publicly available algorithms predicted that UBE2C was a direct and functional target of miR-525-5p. Luciferase assays coupled with RT-PCR and Western blot analysis further verified that miR-525-5p negatively regulated UBE2C expression. Interestingly, miR-525-5p modulated ZEB1/2 expression via targeting UBE2C. Mechanically, administration of UBE2C partially blunted the salutary effects of miR-525-5p on invasive ability, EMT, and anoikis resistance, indicating that miR-525-5p acts as a tumor suppressor in CC largely through repression of UBE2C/ZEB1/2 signaling. Taken together, our data identify a novel signaling axis of miR-525-5p/UBE2C/ZEB1/2 in repressing EMT and anoikis resistance, and likely serve as a potential therapeutic target for CC metastasis and prognosis as well as a therapeutic application.

Gas Bubbles: A Persistent Problem with Immunotherapy