![]() ![]() In addition to miRNAs, another type of sRNAs has emerged as critical regulators of gene expression - tRNA-derived small RNAs (tDRs). The potential of miRNAs in cancer diagnosis is increasingly recognized. Micro RNAs are 20-25nts in length and play an important role in multiple biological processes, mainly via post-transcriptional regulation of gene expression. Small RNAs (sRNAs) have been the focus of many researches in the last decades, among which are micro RNAs (miRNAs) with great potential for biomarker utility. In the field of cancer, small molecules have been applied in numerous clinical scenarios to assist making diagnoses or evaluating prognosis. Although this new Silva pattern can refine treatment strategies, it relies on postoperative histopathologic examinations in most cases and thus a preoperative biomarker to predict Silva patterns is urgently needed.īiomarkers, such as proteins, metabolites and small molecules, are able to indicate specific processes, events or conditions. The treatment of pattern B patients should be personalized based on the issue of lymphovascular invasion, while for pattern C patients, lymph node assessment and radical hysterectomy are required, if applicable, with additional adjuvant or preoperative therapy. ![]() For Silva pattern A patients, adjuvant treatment and nodal sampling can be exempted with negative excision margins. ![]() Moreover, the treatment modality for each pattern has been proposed, and may help to develop a precise treatment-decision system based on different Silva patterns. This new system was then validated in several subsequent studies and showed better performance in predicting nodal metastasis and prognosis. Pattern A is characterized by well-demarcated glands with no destructive invasion or lymph-vascular space invasion (LVSI), pattern B represents localized destructive invasion, and pattern C demonstrates diffusely infiltrative glands. To overcome such deficiencies and provide clinically meaningful means of stratifying EAC, a novel Silva system was developed in 2013 based on the pattern of stromal invasion morphology. Thus, these systems have limited reproducibility for staging EAC and may lead to inappropriate treatment decision making. In addition, although EAC and squamous cervical carcinoma have different histological morphology, sites of origin and spreading patterns, they are staged and treated equally in accordance with NCCN guidelines. The FIGO staging usually takes into account the tumor size and extent of invasion, which are hard to measure in occult EAC. However, these systems aren’t yet comprehensive in clinical practice when applied to EAC. The management of EAC is currently based on International Federation of Gynecology and Obstetrics (FIGO) staging and National Comprehensive Cancer Network (NCCN) guidelines. Endocervical adenocarcinoma (EAC) comprises 10–25% of cervical carcinoma, and has been increasing in incidence in recent years. Our work provided new insights into EAC pathogenesis and successfully identified several small RNAs as candidate biomarkers for diagnosis and prognosis of EAC.Īs the fourth most frequently diagnosed cancer and the fourth leading cause of cancer-related death, cervical cancer accounted for 570,000 new cases and 311,000 deaths in 2018 worldwide. Gene ontology and pathway analyses revealed that these molecules were involved in the pathogenesis of EAC. From the key modules, we identified 9 small RNAs that were significantly related to clinical characteristics in EAC patients. To explore the correlations between small RNAs expression and EAC with different clinical characteristics, we performed the weighted gene co-expression network analysis (WGCNA) and screened for hub small RNAs. MiRNAs and tRNA-derived RNAs (tDRs) accounted for the majority of mapped reads and the total number of miRNAs and tDRs maintained a relative balance. Here, we systematically explored small RNAs in 14 EAC patients with different subtypes using small RNA sequencing. At present, molecular research on EAC mainly focuses on the genome and mRNA transcriptome, the investigation of small RNAs in EAC has not been fully described. Endocervical adenocarcinoma (EAC) is an aggressive type of endocervical cancer. ![]()
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