Genetic analysis of uterine aspirates improves the diagnostic value and captures the intra-tumor heterogeneity of endometrial cancers.

Endometrial cancer is the most common cancer of the female genital tract in developed countries. Although the majority of endometrial cancers are diagnosed at early stages and the 5-year overall survival is around 80%, early detection of these tumors is crucial to improve the survival of patients given that the advanced tumors are associated with a poor outcome. Furthermore, correct assessment of the pre-clinical diagnosis is decisive to guide the surgical treatment and management of the patient. In this sense, the potential of targeted genetic sequencing of uterine aspirates has been assessed as a pre-operative tool to obtain reliable information regarding the mutational profile of a given tumor, even in samples that are not histologically classifiable. A total of 83 paired samples were sequenced (uterine aspirates and hysterectomy specimens), including 62 endometrioid and non-endometrioid tumors, 10 cases of atypical hyperplasia and 11 non-cancerous endometrial disorders. Even though diagnosing endometrial cancer based exclusively on genetic alterations is currently unfeasible, mutations were mainly found in uterine aspirates from malignant disorders, suggesting its potential in the near future for supporting the standard histologic diagnosis. Moreover, this approach provides the first evidence of the high intra-tumor genetic heterogeneity associated with endometrial cancer, evident when multiple regions of tumors are analyzed from an individual hysterectomy. Notably, the genetic analysis of uterine aspirates captures this heterogeneity, solving the potential problem of incomplete genetic characterization when a single tumor biopsy is analyzed.

[Immunity and cancer associated thrombosis].

In cancer patients, thrombosis is commonly found complication. There are many established risk factors which may be responsible for thrombosis in this group of patients. Especially the factors connected with treatment and the cancer itself, seem to be significant in the pathogenesis of thromboembolism. On the other hand, the reactions between cancer, hemostasis and immunological system seem to be important in initiation of the thrombotic process. In this review, on the basis of current literature, we have analyzed the relationship between neoplasmatic thrombosis and immunological disorders. The lack of balance between immunological system and haemostasis in neoplasms is the key issue to solve, in order to correct the long term cancer survival.

[Ovarian teratomas as the cause of diseases of the nervous, endocrine and haematology system].

Teratomas are the most common tumors of the ovary occurring in girls and young women. Derived from primordial germ cell and embryonic gonads have the ability to differentiate into the three germ layers. In about 95% of cases are benign, and their most common form is a dermoid cyst of the ovary. This paper aims to present the relationship described tumors of autoimmune hemolytic anemia, anti-NMDA-dependent autoimmune inflammation of the brain and thyroid disease. It reminds us that teratomas are not always insulated disease entities and may have a significant impact on the course of coexisting diseases and their treatment.

The presence of particular criteria and noncriteria antiphospholipid antibodies in patients with uterine malignancies.

INTRODUCTION: Currently, there have been limited data on the presence of antiphospholipid antibodies (aPLs) in patients with uterine malignancies (UMs). OBJECTIVES: We aimed to determine whether criteria and noncriteria aPLs are present in patients with UMs and associated with the thrombotic risk, as compared with patients with noncancerous gynecological diseases (NCGDs). PATIENTS AND METHODS: The study involved 151 women scheduled for gynecological surgery. The patients were divided into the UM group (n = 70) and the NCGD group (n = 81). The Antiphospholipid 10 Dot assay was used to detect criteria and noncriteria aPLs before surgery. The study patients were considered positive for thrombosis if they exhibited signs of thrombosis within the 2­year follow­up period after surgery. RESULTS: Positive results for aPLs were obtained in 17/70 patients with UMs (24.3%) and in 6/81 patients with NCGDs (7.4%) (P = 0.008). Particular noncriteria aPLs (antiphosphatidic acid, antiphosphatidylserine, anti-annexin V, and antiprothrombin antibodies) yet no criteria aPLs (anticardiolipin and anti-ß2­glycoprotein I antibodies) were more frequently found in patients with UMs than in those with NCGDs. Thrombosis was diagnosed in 9/70 patients (12.9%) in the UM group and in 3/81 patients (3.7%) in the NCGD group (P = 0.03). CONCLUSIONS: Antiphospholipid antibodies were present at significant levels in patients with UMs. Noncriteria aPLs yet no criteria aPLs were more frequently found in patients with UMs than in those with NCGDs. The incidence of thrombosis was significantly higher in patients with UMs.