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Background This study aimed to evaluate the effect of clinicopathologic and surgical factors on the prognosis and fertility outcomes of patients with borderline ovarian tumour (BOT). Methods We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from January 2008 to January 2015. The disease-free survival (DFS) outcomes and potential prognostic factors were evaluated using the Kaplan-Meier method and Cox regression analysis, respectively. Furthermore, fertility outcomes were analysed using Pearson Χ 2 and Fisher’s correlation tests. Results A total of 448 patients were included, with a median age of 37.1 years and a median follow-up time of 113 months; 52 (11.6%) recurrences were observed, with a mean recurrence interval of 80.2 months and four (0.9%) deaths; 118 (26.3%) patients underwent staging surgery and the remaining 330 (73.7%) underwent unstaged surgery. In total, 233 patients undergoing fertility-sparing surgery (FSS) attempted to conceive, and 92 (39.48%) of them achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups ( P = 0.691). In univariate analysis, staging surgery was associated with DFS (hazard ratio [HR] = 2.191; P = 0.005), but it was not an independent prognostic factor ( P = 0.600) for DFS on multivariate analysis. Multivariate Cox analysis revealed that advanced FIGO stage (≥stage II), positive ascites\pelvic washings, and laparotomy approach were independent prognostic factors for DFS in patients with BOT, whereas advanced stage (≥stage II), laparotomy approach, cystectomy-related procedures, invasive implants, and bilateral tumours were independent prognostic factors for DFS in patients undergoing FSS. In addition, laparoscopy resulted in better prognosis than laparotomy in patients with early-stage (stage I) tumours and a desire for fertility preservation. Conclusion Patients with BOT fail to benefit from surgical staging in terms of prognosis and fertility outcomes. Laparoscopy is recommended for patients with stage I disease who desire to preserve their fertility. Physicians should pay more attention to the risk of recurrence in patients who want to preserve fertility with advanced stage (≥stage II) disease, invasive implants, and bilateral tumours, and choose FSS carefully.

Background Homeobox B4 (HOXB4) is correlated with poor prognosis of various cancer types. However, how HOXB4 promotes ovarian cancer (OV) progression remains unclear. Methods The Cancer Genome Atlas (TCGA) database indicated that a high level of HOXB4 in OV was correlated with poor prognosis. The biological functions of HOXB4 were confirmed by colony formation, migration, and invasion assays. The effect of HOXB4 on the expression of EMT cell markers was determined. The transcriptional target of HOXB4 was DHDDS, which was detected by a ChIP assay. A xenograft tumor model was generated in nude mice to detect the role of HOXB4 in tumor proliferation and metastasis. Results The results showed that HOXB4 protein levels were higher in OV tissues than in normal tissues and correlated with poor prognosis of OV. HOXB4 reduction inhibited the proliferation and invasion ability of OV cells in vitro. Conversely, these effects were enhanced by the upregulation of HOXB4 in OV cells. The binding of HOXB4 to two DNA motifs regulated DHDDS expression and contributed to the malignant progression of OV. The role of HOXB4 in contributing to tumor development in vivo was verified in mice. Further results indicated that HOXB4 induced Snail and Zeb1 expression. Conclusion Overall, HOXB4 overexpression was remarkably correlated with poor prognosis of OV. Mechanistically, HOXB4 enhances the proliferation and invasion of tumor cells by activating DHDDS, thereby promoting the malignant progression of OV.

Background The clinical behaviors and cytogenetics of solitary uterine leiomyomas (SUL) and multiple uterine leiomyomas (MUL) vary, which greatly affects the choice of treatments for reproductive-aged patients with leiomyomas. Our previous study demonstrated that a series of microRNAs, including miR-146b-5p, are dysregulated and play important roles in the development of SUL and MUL. Long non-coding RNAs (lncRNAs) can participate in the pathogenesis of several diseases by regulating the expression of microRNAs; however, their roles in regulating miR-146b-5b and in the pathology of leiomyomas are unclear. Methods Pair-matched uterine leiomyoma and adjacent normal myometrium tissue samples were collected from 37 patients with leiomyomas, including 15 with SUL and 22 with MUL. Six paired samples (three SUL and three MUL samples) were used for lncRNAs microarray analysis. Targeted lncRNAs were selected by bioinformatics analysis, and were verified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and a dual-luciferase reporter assay. Growth curve analysis and qRT-PCR were used to evaluate the effect of silencing the lncRNA lnc-AL445665.1–4 on cell proliferation and miR-146b-5p expression, respectively. Results There were 245 up-regulated and 243 down-regulated lncRNAs in SUL, and 119 up-regulated and 447 down-regulated lncRNAs in MUL. Fifty-five of the selected lncRNAs were predicted to target miR-146b-5p, which is up-regulated in SUL and down-regulated in MUL. Four lncRNAs were selected after Venn diagram analysis showing common dysregulation in the three groups. Lnc-AL445665.1–4 was selected for further exploration. qRT-PCR showed that lnc-AL445665.1–4 expression was significantly up-regulated in MUL compared with SUL in an additional 12 and 19 paired SUL-normal and MUL-normal samples, respectively. The dual-luciferase reporter assay demonstrated the presence of binding sites on lnc-AL445665.1 for miR-146b-5p. Silencing lnc-AL445665.1–4 not only inhibited cell proliferation but also negatively regulated the expression of miR-146b-5p. Conclusions Our results suggest that lnc-AL445665.1–4 may be involved in the development of MUL by interacting with miR-146b-5p. Further investigation of the roles of lncRNAs and miRNAs may help to optimize the clinical management of leiomyoma patients. Lnc-AL445665.1–4 could be a novel target for genetic therapy or serve as a biomarker for predicting the recurrence of MUL in patients that have undergone myomectomy. Electronic supplementary material The online version of this article (10.1186/s12885-019-5775-1) contains supplementary material, which is available to authorized users.

Background Several previous studies have confirmed that thrombocytosis was related to reduced survival in many solid tumors. However, the prognostic significance of thrombocytosis in endometrial carcinoma (EC) was still controversy. Therefore, we conducted this study to assess the prognostic value of thrombocytosis in EC. Methods The database including PubMed, MEDLINE, EMBASE, and Web of Science was searched to explore available literature. Above all, the hazard ratio (HR), odds ratios (OR) with 95% confidence intervals (CIs) was used to investigate the correlation between thrombocytosis and overall survival (OS) and disease-free survival (DFS). Moreover, the association between thrombocytosis and patient clinicopathological characteristics was explored. Publication bias and sensitivity analysis also were conducted in this study. Results Overall, 11 studies involving 3439 patients were contained in this study. The results revealed that pretreatment thrombocytosis was significantly related to a decreased OS (pooled HR = 2.99; 95% CI = 2.35–3.8; P