RESUMO
Three samples were submitted from women undergoing routine screening (n=910): two smears (one for routine cytology and one for DNA image cytometry) and a scrape for human papillomavirus (HPV) testing. DNA histograms were classified as suspect in cases of aneuploidy, polyploidy, and/or diploidy with a high proliferation rate. Follow-up was available in 239 cases. The primary end-point was the presence of a high-grade squamous intraepithelial lesion (HGSIL) at biopsy. Seventy women (7.7%) had a high-risk (HR) HPV infection and a suspect DNA profile. In 77 women with cytological abnormalities, 28 HGSILs were detected: four with a prior diagnosis of ASCUS (all HR-HPV infected including three with a suspect DNA profile), three with smears evocative of LGSIL (all with HR-HPV infection and a suspect DNA profile), and 21 with smears evocative of HGSIL (all with HR-HPV infection and 20 with a suspect DNA profile). During the follow-up period, out of 239 women with a cytologically normal smear at first entry, five developed a HGSIL; all were HR-HPV-positive and four had a suspect DNA profile at the first smear. HR-HPV detection alone gives a sensitivity of 100% for the detection of HGSIL, with a specificity of 84.3%, whereas DNA measurement associated with HPV testing significantly enhances the specificity to 95.4%. Thus, the combination of HPV testing and DNA measurement provides a highly sensitive and specific evaluation of the risk of HGSIL on cervical smears.
Assuntos
Colo do Útero/patologia , Colo do Útero/virologia , DNA/genética , Papillomaviridae/isolamento & purificação , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Distribuição de Qui-Quadrado , Técnicas Citológicas , Feminino , Seguimentos , Humanos , Citometria por Imagem , Hibridização In Situ , Ploidias , Valor Preditivo dos TestesRESUMO
Linkage of a 11beta-chloromethyl group to estradiol-17beta (E2) dramatically increases the binding affinity of the steroid for the estrogen receptor (ER) with the formation of a quasi-irreversible steroid-receptor complex. We have synthesized the two isomers of 11beta-chloromethyl-17alpha-iodovinyl-estradiol (E-CMIV and Z-CMIV) by a novel route. Both derivatives demonstrated high binding affinity and selectivity for ER (RBAs: ER = 820 and 1008; SHBG = 1.2 and 0.25, respectively; E2 = 100). On the basis of X-ray crystallographic data for Z-CMIV and its precursor, we have postulated that Z-CMIV might interact strongly with aromatic amino-acids within a hydrophobic groove of the ER hormone binding domain (HBD) that incorporates pockets corresponding to the 11beta and 17alpha steroid substituents. The binding properties of Z-CMIV labeled with 125I were investigated, especially its ability to detect and quantify altered ER forms with low binding affinity for E2. Sucrose density gradient analysis revealed that Z-CMIV has a higher activation potency than E2 as it converts a higher proportion of non-activated monomers in the cytosol into activated monomers with the potential to dimerize. In in vitro (MCF-7 cells) and in vivo (rat uterus) determinations of estrogenic activity, Z-CMIV was as potent as E2 in increasing progesterone receptor (PgR) concentrations and decreasing ER levels and in stimulating uterine growth. [125I]-Z-CMIV could open the way to new applications in the diagnosis and therapy of ER-positive breast cancers, especially those containing altered (variant) ERs.
Assuntos
Estradiol/análogos & derivados , Proteínas de Neoplasias/análise , Neoplasias Hormônio-Dependentes/química , Receptores de Estrogênio/análise , Adenocarcinoma/patologia , Animais , Sítios de Ligação/efeitos dos fármacos , Neoplasias da Mama/patologia , Cristalografia por Raios X , Citosol/química , Desenho de Fármacos , Estradiol/síntese química , Estradiol/química , Estradiol/farmacologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Camundongos , Modelos Moleculares , Estrutura Molecular , Proteínas de Neoplasias/metabolismo , Neoplasias Hormônio-Dependentes/patologia , Tamanho do Órgão/efeitos dos fármacos , Ligação Proteica , Ratos , Receptores de Estrogênio/genética , Receptores de Estrogênio/isolamento & purificação , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/biossíntese , Receptores de Progesterona/genética , Relação Estrutura-Atividade , Células Tumorais Cultivadas/efeitos dos fármacos , Útero/anatomia & histologia , Útero/química , Útero/efeitos dos fármacosRESUMO
Parallel cytophotometric ploidy studies and cytogenetic analysis were performed on 15 various human solid tumours. The quantification of DNA by image analysis was carried out on cytological imprints of fresh tumours and on smears obtained after cell culture. The results obtained by both sets of calculations were compared with each other and with the cytogenetic results. 6 cases (40%) showed concordance between the 3 techniques. One case was aneuploid for both DNA image analysis measurements but the cytogenetic data showed only a diploid stem line. In 3 cases out of 15 (20%), smears DNA analysis and cytogenetic results were concordant: in 2 tumours, the culture step failed to preserve aneuploid stem lines that were present in the imprint analysis. In the third one, a minority tetraploid peak observed after culture was absent on the imprint slide. Concordance between imprints and cytogenetic data and discordance with smears' analysis was observed in 3 cases (20%). These 3 cases were diploid or near diploid but the DNA analysis on the smears after culture showed an aneuploid stem line in each case. The last 2 cases showed a total disagreement between the 3 techniques. By measuring the DNA content with an image analyser, the observer can ensure that only tumoral cells are taken into account. The present study revealed that cytogenetic data represent only about 60% of the population that is effectively present in the culture dish and that the cultured population represents only 47% of the population present on the fresh tumour imprint.
Assuntos
Citogenética , DNA de Neoplasias/análise , Interpretação de Imagem Assistida por Computador , Neoplasias/genética , Células Cultivadas , Humanos , Ploidias , Estatística como AssuntoRESUMO
Vaginal smear cytology and hormonal tests were conducted in eleven patients in the natural menopause, before and after treatment with one capsule (100 mg) daily of veralipride alone for 20 days. Maturation of the vaginal epithelial cells unrelated to the degree of post-menopausal atrophy present was observed, without modification in plasma levels of gonadotropic LH, FSH and ovarian E2, E3 levels.