Clearance of high-risk human papillomavirus (HPV) DNA and PAP smear abnormalities in a cohort of women subjected to HPV screening in the New Independent States of the former Soviet Union (the NIS cohort study).

BACKGROUND: We analysed the temporal relationships of the clearance of human papillomavirus (HPV) DNA and cytological abnormalities in women participating in a screening study in three NIS countries. METHODS: The 274 patients included in this analysis were prospectively followed-up for 21.6 months (range: 0.5-42.9). All 274 women had abnormal PAP test (ASC-US or higher) and high-risk HPV-positive test (HCII) at baseline. Two groups were compared: 132 women who cleared both tests (Group 1), and 142 women who cleared either HPV or abnormal PAP test (Group 2). The first clearance during the follow-up, and the last visit clearance were modeled using life-table techniques, and the predictive factors were analysed using univariate (Kaplan-Meier) and multivariate (Cox) survival analysis. RESULTS: There was no difference in the mean clearance time for the abnormal PAP test (14.4 months; 0.7-40.5 and 12.6 months; 0.5-35.0) and high-risk HPV DNA (12.67 months; 0.6-33.5 and 10.8 months; 0.7-33.4) in Group 1 and Group 2 (Mann-Whitney: P = 0.107 and P = 0.082, respectively). Clearance times for HPV DNA and abnormal PAP test did not deviate from each other in either groups (Wilcoxon: P = 0.063 and P = 0.088). The monthly clearance rates for the abnormal PAP test are 1.32 and 1.38%, and those for the HPV DNA 1.62 and 1.61%, in Groups 1 and 2, respectively. Of the factors predicting the last visit clearance, the issues related to smoking are of particular interest. CONCLUSIONS: The clearance of high-risk HPV type and abnormal PAP test shows a close temporal relationship, the former preceding the latter, however, by an interval of 1.0-2.0 months.

Influence of metastases on the prognosis of adenocarcinoma of uterine cervix.

95 cases of adenocarcinoma of the uterine cervix were analysed for the influence of metastasis on the prognosis. When there was penetration of cervical stroma, < 10 mm or > 10 mm, spread of the tumour to the uterine corpus, metastasis in the ovaries and no detection of metastasis in patients the differences in survival rates were not statistically significant. Local spread of adenocarcinoma to the uterine corpus, penetration of cervical stroma > 10 mm and metastasis to ovaries may not adversely influence the patients survival.

[Role of pathological dedifferentiation in the level of exfoliation of elements of the multilayer epithelium of the uterine cervix]. / Rol' patologicheskoi disdifferentsirovki v urovne éksfoliatsii élementov mnogosloinogo épiteliia sheiki matki.

In cervical dysplasias, dissociation of intercellular junctions occurs to a degree that depends directly on the severity of the dysplastic process which involves the entire epithelium from the basement membrane to the surface layer. The present cytologic studies have demonstrated that as the severity of dysplasia increases, smears taken from exfoliative cells of the stratified squamous epithelium show proportional decreases in the number of cells from the upper epithelial layers and increases in that of cells from the lower levels. The findings obtained indicate that morphologic characterization of exfoliative cellular material may help in the early cytologic diagnosis of cervical disorders.

[Role of surgical interventions in the treatment of patients with trophoblastic tumor resistant to chemotherapy]. / Rol' khirurgicheskogo vmeshatel'stva pri lechenii bol'nykh trofoblasticheskoi opukhol'iu, rezistentnoi k khimioterapii.

A retrospective evaluation of 85 case histories of chemotherapy-resistant trophoblastic disease treated at the Center's clinic (1975-1996) was carried out. Both therapy efficacy and survival rates were lower in patients operated on prior to chemotherapy and during medication. However, excision of resistant foci of trophoblastic tumor contributed to the effectiveness of chemotherapy.

[Monoclonal antibodies in the radioimmunological diagnosis of malignant tumors of the gastrointestinal tract and ovaries]. / Monoklonal'nye antitela v radioimmunologicheskoi diagnostike zlokachestvennykh opukholei zheludochno-kishechnogo trakta i iaichnikov.

The report deals with the clinical significance of application of two procedures of radioimmunologic assay of levels of monoclonal CA-19-9 and CA-125 antigens in diagnosing gastrointestinal and ovarian malignancies. The CA-19-9 antigen test appeared to be ineffective at the early stages of development of malignant tumors of the stomach, rectum and colon. The level of the antigen showed an increase in 37% of cases of hepatic metastases only. However, the test may be instrumental in differentiating between inflammatory processes and malignancies in the pancreatohepatoduodenal area. CA-125 antigen serves as a discriminating marker for tumor involvement of the ovaries. However, its specificity in differentiating between benign and malignant tumors of this organ is under 63%.

[Clinical evaluation of different methods of treatment in patients with endometrial stromal sarcoma of the uterus]. / Klinicheskaia otsenka razlichnykh metodov lecheniia bol'nykh éndometrial'noi stromal'noi sarkomoi matki.

The data on treatment of 50 patients with endometrial stromal sarcoma (Ess) are discussed. Mean age-46.5 years. The group included 28 patients with stage I tumor, 7-stage II, 8-stage III and 7-stage IV. The end results of surgical, combined and complex treatment were followed up in 45 cases. Surgery was given to 24 and combined and complex therapy-to 21 patients. Five- and ten-year survival was 55.6 and 26.7, respectively, whatever mode of therapy and stage.

[Malignancy of hormonally active ovarian tumors]. / K voprosu o zlokachestvennosti gormon-aktivnykh opukholei iaichnika.

401 cases of hormone-producing tumors of the ovary were studied (190 theca-cell, 169--granulose cell, 25--mixed thecagranulosa cell and 17--virilising tumors). Histological diagnosis, clinical stage and end results of their treatment were compared. Theca-granulosa cell tumor is considered to be the most malignant form of these neoplasms. Pure theca-cell tumor proved to be benign in most cases. Of special interest is a high percentage of patients being cured at stage 1 (FIGO classification) of neoplastic process, that stands, in the authors' opinion, in close relationship with comparatively good results obtained in these patients.

[Diagnosis and treatment of trophoblastic uterine tumors]. / Diagnostika i lechenie trofoblasticheskikh opukholei matki.

An evaluation of 801 cases of different forms of uterine trophoblastic tumors treated at the Center in 1960-1981 is given. Chorionepithelioma was confirmed histologically in 488 cases. Modern means of diagnosis of uterine trophoblastic tumors are discussed. A retrospective analysis of treatment of patients is presented. The result of up-to-date combination chemotherapy of patients with uterine chorionepithelioma are reported. The role of surgery in the treatment of trophoblastic tumors is discussed.

[Surgical treatment of patients with borderline serous tumors of the ovary]. / Khirurgicheskoe lechenie bol'nykh seroznymi pogranichnymi opukholiami iaichnikov.

The paper deals with the data on treatment of 63 patients with serous borderline tumors of the ovary (SBTO). Mean age was 40.2 years. The study included 30 patients (47.6%) with stage IA tumor, 15 (23.8%)--IB, 4 (6.3%)--II and 14 (22.2%)--stage III. Relapse frequency was 14.3%, irrespective of stage and method of therapy. Surgery was given to 18 patients (28.6%), combined therapy--by 45 (71.4%). Recurrent tumor was recorded after surgery in 2 (3.2%) and in 7 (14.8%) after combined therapy. Generally, surgery is the main treatment received by patients with SBTO. Adjuvant chemotherapy was not followed by decrease in relapse rates.

[Clinical importance of determining steroid hormone receptors in endometrial adenocarcinomas]. / Klinicheskoe znachenie opredeleniia retseptorov steroidnykh gormonov v adenokartsinomakh éndometriia.

Estradiol receptor (ER) and progesterone receptor (PR) levels were measured in 216 endometrial adenocarcinomas. Tumors containing more than 10 fmol/mg protein (for ER) and 20 fmol/mg (for PR) were considered receptor-positive. Tumors were both ER- and PR-positive in 75%. In stage I and II tumors, ER and PR levels were significantly higher than in stages III and IV. A similar relationship was established for minor (not deeper than 0.5 cm) and considerable involvement (deeper than 0.5 cm). There was an inverse correlation between ER and PR levels and ER- and PR-positive tumors incidence, on the one hand, and anaplasia, on the other. Adjuvant progestin therapy proved ineffective in tumors with a PR level under 100 mol/mg protein.

[Laser DNA flow cytometry in patients with ovarian epithelial tumors]. / Vozmozhnosti ispol'zovaniia lazernoi DNK-protochnoi tsitometrii u bol'nykh s épitelial'nymi opukholiami iaichnikov.

Despite the use of new drugs in therapy of ovarian cancer, remote results remain unsatisfactory. Traditional prognostic factors, which are often subjective, do not reflect the individual features of a tumor in a certain patient. The authors compare classical prognostic factors, the data of laser DNA flow cytometry, and the receptor status of the tumor. Tumor ploidy is the most informative independent prognostic factor: the period without relapses in patients with aneuploid tumors is significantly shorter in comparison with patients with diploid tumors. Study of tumor cell distribution by the cell cycle phases can also provide additional information for predicting the disease course in ovarian cancer.

[Clinical course of the disease in familial and non-familial forms of serous cystadenocarcinoma of the ovary]. / Klinicheskoe techenie zabolevaniia pri semeinykh i nesemeinykh formakh seroznoi tsistadenokartsinomy iaichnikov.

A retrospective analysis of the case histories of patients with familial and nonfamilial ovarian carcinomas has shown that patients with the familial condition develop a higher resistance of the body to tumor dissemination and their survival rate is better. This conclusion may be of interest for those who research carcinogenesis mechanisms.

[The immunocorrective therapy of cervix uteri diseases]. / Immunokorrigiruiushchaia terapiia zabolevanii sheiki matki.

Analyzes the results of comprehensive clinical and immunologic examinations of women with inflammatory and tumorous diseases of the cervix uteri. Demonstrates a reduction of the immunologic reactions in such diseases and in traditional antibiotic therapy thereof. Presents methods of immunocorrective therapy with vitamin E, thymactin, and sodium nucleinate to be carried out on an inpatient basis.

[The characteristics of prostaglandin E synthesis in epithelial ovarian tumors]. / Osobennosti sinteza prostaglandinov serii E v épitelial'nykh opukholiakh iaichnikov.

Comparative investigation of prostaglandin E (PGE) levels in primary malignant and benign epithelial tumors, metastases, and normal tissue of the ovaries has revealed more significant variations in PGE levels in malignant tumors than in benign ones. PGE content was reliably higher in adenocarcinomas as against benign tumors and normal ovarian tissue. No noticeable differences in PGE levels of benign tumors and normal tissue were revealed. The possibility of using arachidonic acid cyclooxygenase metabolism blockers in therapy of ovarian carcinoma, besides the common methods of treatment, is discussed.