RESUMEN
In the present paper, serum CA125 modifications in patients undergoing their first IVF cycle were compared with those of patients in their second attempt. A significant increase of this marker was detected in each group of patients at day 14 after embryo transfer. However, the level of CA125 monitored in the patients in their second attempt was significantly higher than that determined in patients undergoing their first ovarian stimulation. This condition does not influence either ovarian response or oocyte and embryo quality. Moreover similar IVF outcome was obtained. Therefore we propose that patients undergoing repeated assisted reproductive technology (ART) cycles may suffer from ovarian surface epithelial damage and/or altered cellular growth rate.
Asunto(s)
Antígeno Ca-125/sangre , Fertilización In Vitro , Adulto , Femenino , Humanos , Inducción de la Ovulación , Embarazo , Resultado del TratamientoRESUMEN
From January 1995 to January 2001, 40 patients with epithelial ovarian cancer were treated at our Institution. Fourteen of these, with a clinical CR after surgery and platinum-based chemotherapy, were evaluated monthly by gynecological examination, Ca-125 RIA assay, pelvic ultrasound with transabdominal and transvaginal probe and color Doppler. Six pelvic relapses, from 1.5 to 3.0 cm, were detected by transvaginal ultrasound (US). They showed a rich neovascularization with low resistance, high flow, PI from 0.3 to 1.0 and RI < 0.5 in all cases. US did not reveal any sign of relapse in the remaining eight patients. In all cases of pelvic relapses ultrasonic signs of recurrence preceded the increase of Ca-125 by one to six months (average 3.8).
Asunto(s)
Biomarcadores de Tumor/análisis , Antígeno Ca-125/análisis , Endosonografía/métodos , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias Pélvicas/diagnóstico , Ultrasonografía Doppler en Color/métodos , Anciano , Carcinoma/diagnóstico , Carcinoma/mortalidad , Carcinoma/terapia , Estudios de Cohortes , Terapia Combinada , Femenino , Humanos , Italia , Persona de Mediana Edad , Recurrencia Local de Neoplasia/mortalidad , Recurrencia Local de Neoplasia/terapia , Estadificación de Neoplasias , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/terapia , Neoplasias Pélvicas/mortalidad , Neoplasias Pélvicas/terapia , Pronóstico , Radioinmunoensayo , Estudios Retrospectivos , Sensibilidad y Especificidad , Tasa de SupervivenciaRESUMEN
BACKGROUND: Cervical Intraepithelial Neoplasia (CIN) is a dysplastic lesion that precedes cervical cancer. The diagnosis is made by colposcopic, cytologic and bioptic exams. Therapy may be physical, pharmacological or surgical. METHODS: We prepared a model of interview (consisting of 9 questions) for 33 colposcopic centers in the Lazio region. Our aim was to evaluate their therapeutic strategies for CIN and cervical condylomata. We referred to SIGO 1999 guidelines for CIN therapy and to European guidelines for cervical condylomata therapy. RESULTS: The centers used drugs more for HPV infections (57%) than for dysplasia (33%). Drug therapy was used more in the past (66.67%). Actually they prefer treating CIN I with electrocoagulation diathermy (DTC), CIN II with loop electrosurgical excision procedures (LEEP) or Laser, CIN III with cold knife conization or LEEP, cervical condylomata with laser or DTC. CONCLUSIONS: The results show that the centers prefer physical therapy. Therapeutic strategies comply with SIGO 1999 guidelines for therapy of CIN and with European guidelines for cervical condylomata partially.