Objective: To compare the safety between conization alone and hysterectomy for patients with adenocarcinoma in situ (AIS) of the cervix. Design: A cohort study of AIS patients during 2007-2021. Setting: Women’s Hospital of Zhejiang University School of Medicine. Population: A total of 453 AIS patients diagnosed by conization who underwent cervical conizations only (n=153) or conization followed by hysterectomy(n=300). Methods: The clinicopathological and follow-up data were reviewed. Univariate analysis was examined by chi-square test and multivariate analysis was performed by logistic regression analysis. Main outcome measure: The rates of residual disease in specimens of hysterectomy and repeated conization were compared between positive and negative margin of conization. And the rates of recurrence were compared between patients treated by conization(s) alone and hysterectomy. The factors influencing residual disease and recurrence were assessed, respectively. Results: Among 310 specimens of hysterectomy or repeated conization, the rates of residual disease were 50.56% (45/89) for positive margin and 2.26% (5/221) for negative margin, with a significant difference (p=0.000). Totally 4 patients recurred as vaginal intraepithelial neoplasia（VAIN）in those treated by hysterectomy and 1 recurred as cervical squamous intraepithelial neoplasia (CIN) in those treated by conization(s) alone. The rates of recurrence were 0.65% (1/153) for conization(s) alone and 1.33 % (4/300) for hysterectomy, with no significant difference (p=0.431). Hysterectomy was a factor influencing neither residual disease nor recurrence. Conclusions: Conization is an effective and safe option for patients with AIS of the cervix, provided the margin is negative. Keywords: adenocarcinoma in situ, conization, hysterectomy, margins.

Objective To investigate the relationship between single nucleotide polymorphisms (SNPs) in human papillomavirus (HPV) receptor gene and HPV susceptibility and the outcomes in Chinese women. Study design A cohort study. Setting Lishui, Zhejiang, China. Population 3066 women were recruited. Methods 29 SNP sites of HPV receptor gene on women with available cytology residual samples were detected. Main outcome measures Develop to cervical intraepithelial neoplasia 2 and worse (CIN2+). Results: 2938 women with sufficient cytology samples performed SNP sites detection. Rs16894821 [GG vs. AA: OR =1.71 (1.08-2.69)] and rs724236 [TT vs. AA: OR=1.73 (1.14-2.62)] in SDC2 increased the HPV susceptibility. TT genotype of rs2575712 in SDC2 was associated with an increased HPV 16/18 susceptibility [OR=2.78 (1.22-6.36)]. Four SNPs (rs1047057 and rs10510097, rs2575735, and rs878949) were significantly associated with HPV persistent infection. In addition, the frequencies of genotype of rs16894821 under recessive model [OR=2.40 (1.12-5.15)] in SDC2, and rs11199993 under dominant model [OR=1.64 (1.01-2.68)] in FGFR2 were significantly associated with the disease progression. Importantly, we found that HPV test in combination with SNPs with sensitivity of 0.51 (0.36-0.66) and specificity of 0.96 (0.96-0.97) in predicting CIN2+ on women with non-HPV16/18+, which had similar performance to HPV test combined with cytology test with sensitivity of 0.44 (0.30-0.60) and specificity of 0.98 (0.97-0.99). Conclusion: Gene variants in HPV receptor related gene may influence the HPV susceptibilities and the outcome of HPV infection. HPV combined with SNPs is a promising alternative to HPV test combined with cytology test in patients with non-HPV16/18 infection.

How important is the hCG value for predicting dactinomycin failure after methotrexate failure for the low-risk gestational trophoblastic neoplasia: a commentary.hCG for predicting dactinomycin failure in ChinaXiaodong Wu,1 Weiguo Lu,1,2Tao Shen,1Weidong Fei, 3 Lili Chen,1 Xing Xie,1,4 Jiale Qin,2,5 1Department of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, China2Center for Uterine Cancer Diagnosis & Therapy Research of Zhejiang Province, Hangzhou, China3Department of pharmaceutics, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, China4Women’s Reproductive Health Research Laboratory of Zhejiang Province, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China5Department of Ultrasound, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaCorrespondence to: Jiale Qin, PhDAddress: Department of Ultrasound, Women’s Hospital, Zhejiang University School of Medicine, No. 1, Xueshi Road, Hangzhou 310006, ChinaTelephone number: 86-0571-87061501E-mail: [email protected]