Centromeric AA motif in KIR as an optimal surrogate marker for precision definition of alloimmune reproductive failure.

Throughout pregnancy, the decidua is predominantly populated by NK lymphocytes expressing Killer immunoglobulin-like receptors (KIR) that recognize human leukocyte antigen-C (HLA-C) ligands from trophoblast cells. This study aims to investigate the association of KIR-HLA-C phenotypes in couples facing infertility, particularly recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF), in comparison to a reference population and fertile controls. This observational, non-interventional retrospective case-control study included patients consecutively referred to our Reproductive Immunology Unit from 2015 to 2019. We analyzed the frequencies of KIR and HLA-C genes. As control groups, we analyzed a reference Spanish population for KIR analysis and 29 fertile controls and their male partners for KIR and HLA-C combinations. We studied 397 consecutively referred women with infertility and their male partners. Among women with unexplained RPL (133 women) and RIF (176 women), the centromeric (cen)AA KIR genotype was significantly more prevalent compared to the reference Spanish population (p = 0.001 and 0.02, respectively). Furthermore, cenAA was associated with a 1.51-fold risk of RPL and a 1.2-fold risk of RIF. Conversely, the presence of BB KIR showed a lower risk of reproductive failure compared to non-BB KIR (OR: 0.12, p < 0.001). Women and their partners with HLA-C1C1/C1C1 were significantly less common in the RPL-Group (p < 0.001) and RIF-Group (p = 0.002) compared to the control group. Moreover, the combination of cenAA/C1C1 in women with C1C1 partners was significantly higher in the control group than in the RPL (p = 0.009) and RIF (p = 0.04) groups, associated with a 5-fold increase in successful pregnancy outcomes. In our cohort, the cenAA KIR haplotype proved to be a more accurate biomarker than the classic AA KIR haplotype for assessing the risk of RPL and RIF, and might be particularly useful to identify women at increased risk among the heterogeneous KIR AB or Bx population. The classification of centromeric KIR haplotypes outperforms classical KIR haplotypes, making it a better indicator of potential maternal-fetal KIR-HLA-C mismatch in patients.

[Ovarian mature teratoma. Clinico-pathological study of 112 cases and review of the literature]. / Teratoma maduro de ovario. Estudio clínico-patológico de 112 casos y revisión de la literatura.

A retrospective, descriptive study of 112 patients diagnosed and treated of mature ovarian teratoma, between January 1995 and September 2001, at Reina Sofía University Hospital, was carried out. The patient's mean age is 36.2 years old (SD = 13.8). The most frequently symptom was abdominal pain (50.9%) though a high percentage of the cases (41.1%) the patients were asymptomatic. The mean size of the tumor was 76.2 mm (SD = 35.8) and 9.8% were bilateral. The most used diagnostic procedure was ultrasound with a right diagnostic of 47.6%, though 81.3% of the cases a surgery was performed, with a preview diagnostic of ovarian tumor and the 53.8% with the right diagnostic of benign teratoma. 18.7% of the tumors was found in a laparotomy for other cause. From the 123 tumors, 96% were benign ovarian cyst, 1.6% mature solids teratomas and 2.4% struma ovarii. The most frequent surgery was unilateral oophorectomy (54.5%) and 19.6% was total hysterectomy with bilateral oophorectomy, with the mean age of this last ones of 54.8 years old (SD = 12.0). The preservation of the ovarian function was in 75% of the patients. We will analyze our results and compare with the bibliography.

[Breast cancer and pregnancy. Analysis of our casuistry and literature review]. / Cáncer de mama y embarazo. Análisis de nuestra casuística y revisión de la literatura.

The results of 14 cases of breast cancer and pregnancy observed in 1261 breast carcinoma, diagnosed and in treatment between January 1980 and March 2001 were analysed. The results were compared with 122 cases of not pregnant patients with similar ages (< or = 40). The pregnant patients had a medium following of 58.6 months and controls of 73.9 months. Otherwise the results are not significant; it shows a higher incidence of disseminate carcinomas diagnose in the pregnant patients (14.3% vs. 4.9%), a higher recidives (50% vs. 37.4%) and a higher mortality (50% vs. 30.3).