Usefulness of saline infusion sonohysterography and feeding artery imaging in endometrial polyp diagnosis.

OBJECTIVES: The aim of this study was to assess the usefulness of sonohysterography with feeding artery visualization using transvaginal sonography to diagnose endometrial polyps. MATERIAL AND METHODS: We conducted an observational study of 60 perimenopausal patients referred to the Department of Fetal Medicine and Gynaecology, Medical University of Lodz with abnormal uterine bleeding or suspicion of endometrial pathology based on sonography scan. In all 60 patients transvaginal sonography scan showed a possibility of an endometrial polyp. Of these, 46 underwent saline infusion sonohysterography with sonography visualization of a feeding artery. Pathological examination was performed on material collected during hysteroscopy. RESULTS: Sonography detection of endometrial polyp based on feeding artery visualization had a 40% sensitivity, whereas sonohysterographic polyp detection had a sensitivity of 75% and a specificity of 100%. The positive and negative predictive values of saline infusion sonohysterography in diagnosing endometrial polyps were estimated at 75% and 72% (95% CI: 52-86%), respectively. The combination of sonohysterography and feeding artery imaging in transvaginal sonography was 84% sensitive and 95% specific in detecting endometrial polyps. The positive and negative predictive values were: PPV = 96% and NPV = 89%. CONCLUSION: Saline infusion sonohysterography with feeding artery visualization may become a standard method in the diagnostics of endometrial polyps in perimenopausal women.

[Noninvasive prenatal test in the first trimester of pregnancy (NT and estimation of beta-hCG and PAPP-A) in the diagnosis of fetal abnormalities in Polish population--comparison of the biochemistry own normal ranges and literature reported data]. / Nieinwazyjny test prenatalny w I trymestrze ciazy (pomiar NT oraz oznaczenia beta-hCG i PAPP-A) w diagnostyce wad plodu w populacji polskiej--porównanie biochemicznych norm wlasnych i danych swiatowych.

THE AIM OF STUDY: Estimation of Polish population standards of the concentrations of pregnancy-associated plasma protein--A (PAPP-A) and free beta--human chorionic gonadotropin (beta-HCG) in the maternal blood between 10.0 and 13.6 week of pregnancy and comparison of the biochemistry own normal ranges and literature reported data. Estimation the sensitivity of the fetal nuchal translucency measurement, biochemical concentrations of PAPP-A and free beta-HCG in detection of the fetal chromosomal abnormalities. MATERIAL AND METHODS: 582 women in the age 14 to 46 years old with singleton pregnancies were included to the study The screening was performed between 10.0 and 13.6 week of gestation. The fetal nuchal translucency serum concentrations of PAPP-A and free beta-HCG were measured. The specific risk was calculated using the Fetal Medicine Foundation software (FTS) by accredited sonographers. RESULTS: Standards for serum concentrations of PAPP-A and free beta-HCG in normal pregnancies were determined. The measurement sensitivity of the fetal nuchal translucency in detection of the fetal chromosomal abnormalities was 80% and sensitivity of serum concentrations of PAPP-A and free beta-HCG was 40% and 80%. CONCLUSIONS: There is no significant differences between estimated biochemistry standards (PAPP-A and free beta-HCG) for Polish population and literature reported data. Observed differences in measurements of fetal NT, serum concentrations of PAPP-A and free beta-HCG in a control group and the group with the aneuploidies confirmed usefulness of these methods for the first trimester prenatal screening.

[Computer analysis of ultrasound scans of the endometrium in menopausal women]. / Komputerowa analiza obrazu ultrasonograficznego blony sluzowej macicy u kobiet po menopauzie.

UNLABELLED: Ultrasound evaluation of the endometrium in menopausal women undergoing hormone replacement therapy is a classic diagnostic procedure. Subjective evaluation of ultrasound texture and echogenicity of the endometrium is a deceptive method, moreover the repetition of the procedure does not necessarily yield identical results. Due to computer analysis of an ultrasound scan, the investigator's subjective sensation, which might lead to the suspicion of pathology, was replaced with objective computer analysis, which is a comparable method, producing repeatable results. OBJECTIVES: The aim of the analysis was to ascertain whether endometrial diseases are coded in the texture parameters of an ultrasound scan. MATERIAL AND METHODS: Endometrial ultrasound scans of three groups of patients were analyzed. First group included scans of patients suffering from endometrial cancer, second group scans of patients with abnormal uterine bleeding or abnormal endometrium (thickness > 5 mm during continous hormone replacement therapy (hrt), or > 8 mm during sequentional hrt, or abnormal echostructure) and benign endometrial diseases diagnosed by histopatology, third control-group scans of patients during hrt, without any abnormality in ultrasound examinations and bleeding profile. RESULTS: Endometrial diseases are coded in the texture parameters of an ultrasound scan. In particular, on the grounds of these features it is possible to distinguish a scan of carcinoma from benign endometrial diseases and from the scans obtained in the control group. CONCLUSIONS: Computer analysis of ultrasound scans of the endometrium in menopausal women shows that the texture parameters code endometrial diseases. The results are promising, albeit provisional and it is required to verify them on the basis of a bigger number of cases with particular attention devoted to the issue repeatability of the results of an ultrasound examination.

Microsatellite instability (MSI) analysis in patients with endometrial cancer.

Microsatellite instability (MSI) seems to be important for the development of various human cancers including sporadic endometrial cancer. The aim of this study was evaluation of microsatellite instability in 20 postmenopausal women with endometrial adenocarcinoma in DNA samples obtained from cancer tissue and blood of the same patients. Control DNA was obtained from normal endometrial tissue (n=25). MSI was studied at five loci containing single- or dinucleotide repeat sequences and mapping to different chromosomal locations: BAT-25 (at locus 4q12), BAT-26 (2pl6), D2S123 (2pl6-p21), D5S346 (5q21-q22) and D17S250 (17q11.2-q12). No differences in the MSI frequencies between blood and cancer tissue obtained from patients were detected. The microsatellite instability status was significantly higher in endometrial cancer tissue [5/20 (25%)] as compared to control [3/25 (12%)] (p < 0.05). There were no significant differences between MSI presence in the subgroups assigned to the histological grades (p > 0.05). The results suggest that the microsatellite instability seems to be important in the development of sporadic endometrial cancer.