endometrial cancer treatment adverse pregnancy outcome vaginal primary malignant melanoma Uterine myomas cervical cancer clinical characteristics molecular biology surgery synchronous primary cancers AFP levels ErbB receptors Factor II G20210A Factor V Leiden HPV MTHFR C677T cervical glandular lesions clinical significance colposcopy combined inherited thrombophilia cytology diagnosis diagnostic investigations endocytosis epidemiology epidermal growth factor system expression hCG levels infection intracellular trafficking maternal serum AFP levels maternal serum hCG levels maternal serum markers nuclear entry ovarian cancer ovarian leiomyosarcoma pathogenesis pregnancy pregnancy outcome receptors sentinel lymph node dissection systematic lymphadenectomy systematic surgical staging treatment options