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Objective To explore the difference in chemotherapy completion and reasons for discontinuation between older (≥70 years) and younger (

Objective: To determine whether serum angiopoietin-1/angiopoietin-2 ratio can predict preeclampsia in women at 16–18 weeks of gestation, or not. Material and Methods: This was a prospective observational study that was conducted in pregnant women with gestational age of 16-18 weeks. Serum angiopoietin-1 and angiopoietin-2 levels were acquired. The predictive values of these tests were calculated. Results: Data from 269 pregnant women were analyzed. Twenty-two cases developed preeclampsia, and five of these cases had early onset preeclampsia. When the angiopoietin-1/angiopoietin-2 ratio was above 6.2, the sensitivity, specificity, positive predictive value and negative predictive values to predict preeclampsia were 50.0%, 72.9%, 14.1% and 94.2%, respectively. When angiopoietin-1 was used to predict preeclampsia, the sensitivity, specificity, positive predictive value and negative predictive values were 59.1%, 65.2%, 13.1% and 94.7%, respectively. When angiopoietin-2 was used to predict preeclampsia, the sensitivity, specificity, positive predictive value and negative predictive values were 63.6%, 50.2%, 10.2% and 93.9%, respectively. Conclusion: This study demonstrated that serum angiopoietin-1/angiopoietin-2 ratio at 16-18 weeks of gestation was not effective in predicting preeclampsia. However, angiopoietin-2 may be used to predict preeclampsia.

Objective: to evaluate the role of microsatellite genotyping in discordant results between morphologic examination and p57Kip2 staining in hydatidiform mole. Materials and methods: 127 cases of hydatidiform mole who had morphologic examination and p57Kip2immunohistochemical staining were evaluated. Six discrepant cases between morphologic examination and p57Kip2 staining were recruited. DNA was extracted from chorionic villi and paired maternal decidual tissue in Formalin fixed paraffin embedded tissue sections. The STR DNA genotyping was performed by Applied Biosystems 3500 Genetic Analyzer. Genetic data analysis was performed by Gene mapper ID-X software. Three concordant cases were used as control. Results were compared to histopathology, p57Kip2 stain and development of post-molar GTN. Results: All controlled cases were confirmed PHM. Two cases of histologic CHM with positive p57Kip2and 2 cases of PHM with negative p57Kip2 were reported as PHM from microsatellite. Other 2 cases of histologic diagnosis PHM with negative p57Kip2 reported as CHM from microsatellite test and both of them developed post-molar GTN. Conclusion: Microsatellite genotyping is a high accuracy method for differential diagnosis from complete and partial hydatidiform moles. However, cost of microsatellite genotyping is still too high to use routinely. Therefore, selected use in discrepancy cases may be suitable.

Objective To determine the predictive value of plasma soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) ratio for detection of preeclampsia in elderly gravida at 16–18 weeks of gestation and to identify whether abnormalities of this ratio are associated with any other pregnancy complications or not. Methods Blood samples of 300 cases were collected. Plasma sFlt-1 and PlGF levels were measured using an automated immunoassay. Results Sensitivity and specificity for plasma sFlt-1/PlGF ratio above 9.8 for preeclampsia prediction were 85.7% and 61.2%, respectively. The sensitivity and specificity to predict early onset preeclampsia were 100% and 61.1%, respectively. Women with abnormal plasma sFlt-1/PlGF ratio were not associated with any other pregnancy complications. Conclusion sFlt-1/PlGF ratio at 16–18 weeks of gestation in elderly gravida has a high sensitivity for predicting preeclampsia, especially early onset preeclampsia.

Objectives: The primary aim of the study was to identify miRNAs that were differentially expressed between complete hydatidiform moles (CHMs) that turned out to be gestational trophoblastic neoplasia (GTN) [GTN moles] and CHMs that regressed spontaneously after evacuation [remission moles]. The secondary aim was to study the profiles of miRNA expressions in CHMs. Methods: A case-control study was conducted on GTN moles and remission moles. We quantitatively assessed the expression of 800 human miRNAs from molar tissues using Nanostring nCounter. Results: From a pilot study, 21 miRNAs were significantly downregulated in GTN moles compared to the remission moles. Five of them (miR-566, miR-608, miR-1226-3p, miR-548ar-3p and miR-514a-3p) were downregulated for >4 folds. MiR-608 was selected as a candidate for further analysis on 18 CHMs (9 remission moles and 9 GTN moles) due to its striking association with malignant formation. MiR-608 expression was slightly lower in GTN moles compared to the remission moles, that is, 2.22 folds change [p = 0.063]. Conclusion: We identified 21 miRNAs that were differentially expressed between GTN moles and remission moles suggesting that miRNA profiles can distinguish between the two groups. Although not reaching statistically significant, miR-608 expression was slightly lower in GTN moles compared to remission moles.

Background: Gestational trophoblastic neoplasia (GTN) can derive either from molar or non-molar pregnancy. Our primary objective is to compare clinical presentation and outcome of treatment of non-molar and post-molar GTN. Our secondary outcome is to evaluate and compare the prognostic factors of non-molar GTN compare to post-molar GTN in subgroup classification of GTN patients by stage and by low-risk and high-risk groups. Methods: Retrospective chart review of GTN patients treated from 2007 to 2016 was done. General characteristics, clinical data, treatment options and treatment outcomes were collected. The cases with missing significant data were excluded. Statistics analysis of the data was performed with SPSS version 22.0. Mean, mode, median and percent were used to present the data. Student t-test, Mann Whitney-U test and Kaplan Meier were used to analyze the data. The results were presented in Tables or graphs where appropriate. Results: Total of 71 GTN patients were recruited into the study. Fifty-one patients were post-molar GTN and 20 were non-molar GTN patients. The mean age of the patients was not different (p=0.25). Median duration from previous pregnancy and time to achieve remission were longer in non-molar GTN (292 days vs. 42 days and 163 vs. 64 days, respectively). Mortality rate of the non-molar GTN is higher that of the post-molar GTN (15% vs. 1.9%). Comparison of stage to stage showed no differences between the post-molar and the non-molar GTN. According to previous pregnancy type, post-abortion had higher resistant to treatment rate than post-term delivery. Conclusion: Non-molar GTN is different form post-molar GTN in several aspects, such as the duration from previous pregnancy, stage and score at diagnosis, treatment resistance and mortality rate. Comparison between the non-molar and post-molar GTN stage by stage and risk scores could not identify the difference between the two groups.

Partial trisomy 22 is a rare condition that is found in live birth. In most cases, diagnosis of partial trisomy 22 was made after birth. Herein, we report a prenatal diagnosis of fetal partial trisomy 22 in a 28-year-old pregnant woman presented with fetal cystic hygroma. Structural abnormalities were detected at 16 weeks of gestation: left cleft lip and ventricular septal defect. The G-banding karyotype analysis and fluorescence in situ hybridization showed partial trisomy 22. It is recommended that pregnant women with fetal anomalies should have prenatal genetic diagnosis to ascertain whether the fetus has partial trisomy 22 or other rare chromosomal abnormalities.

Aim: To identify the frequency of somatic BRCA mutation in epithelial ovarian cancer (EOC), particularly those with high grade subtypes. Methods: Patients diagnosed with EOC included fallopian tube cancer or peritoneal cancer who had surgery during January 2015 to December 2016 were included. High grade subtypes included high grade serous carcinoma, poorly differentiated endometrioid carcinoma, and clear cell carcinoma. BRCA1 and BRCA2 mutations were tested using DNA extracted from formalin-fixed paraffin embedded block or a fresh tumor specimen then analyzed by next generation sequencing system. Patients who had no germline BRCA mutation in their peripheral blood DNA investigated by bi-directional Sanger sequencing were diagnosed as having somatic BRCA mutation. Results: 36 patients were enrolled; majority of the patients (33patients; 97.2%) had EOC, 1 patient (2.8%) had fallopian tube cancer and 2 patients (5.6%) had peritoneal cancer. 28 patients (77.8%) had high grade serous carcinoma, 6 (16.7%) had poorly differentiated endometrioid carcinoma, and 2 (5.6%) had clear cell carcinoma. BRCA1 mutation was detected in tumor tissues of 2 patients (5.6%). These two patients had high grade serous carcinoma and significant family history of breast and/or ovarian cancers. However, BRCA1 mutations were detected in the peripheral blood in both of them. Conclusion: Only 5.6% of BRCA1 mutation was detected in ovarian tumor tissues, all mutations were found in high grade serous subtype. However, BRCA mutations were detected in the peripheral blood in both of them. Germline BRCA mutation was diagnosed, thus there were no somatic mutations in this study.