Comparative study between preoperative and operative staging in endometrial cancer patients

Background: endometrial cancer is the most common gynecological cancer in developed countries and is primarily treated surgically. This study aimed to compare between preoperative findings by Vaginal U/S and MRI with postoperative pathological data regarding Endometrial thickening, Myometrial Invasion Depth and Lymph Node Metastasis

Methods: It is a prospective cohort study of 20 consecutive patients with endometrial cancer, in the Department of General Surgery at Al-Azhar University Hospitals. To assess the depth of myometrial invasion, we performed a pelvic MR. Subsequently; myometrial invasion was detected with MRI by the recognition of the disruption, whilst transvaginal sonography was performed by experienced sonographers who used a 5.0- to 7.5-MHz curvilinear-array transducer probe

Results: Our results showed that the employment of magnetic resonance imaging to detect the myocardial invasion established that the sensitivity, specificity, positive and negative predicted values of MRI was 92.3%, 76.5%, 60.0% and 96.3% subsets, respectively. US was accurate in 12 of 20 cases and overestimated the depth of invasion in 2 cases. In comparison with histopathological findings; the results of MRI images were accurate in 13 patients whilst TVUS images were accurate in 12 patients [60%] with 3 patients underestimated and two patients over estimated

Conclusion: MRI and TVUS detect myocardial invasion with accurate results that help the surgeon to make the appropriate decision. Brings to light that, MRI and TVUS perform best in the pretreatment evaluation of endometrial cancer and differentiating deep from superficial myometrial invasion

Cytokeratins as useful serum markers in the diagnosis and monitoring of Egyptian bladder cancer. A comparative study between TPA and TPS

Cytokeratins [CKs] have been shown to he over expressed in bladder cancer and to be valuable as tumor markers in urology. The present study was designed to evaluate the diagnostic value of Tissue Polypeptide Antigen [TPA] and tissue Polypeptide Specific Antigen [TPS], as serum markers exploring some specific CKS, in the diagnosis and monitoring of bladder cancer. For this purpose, a cohort of 174 case were allocated into three groups; group 1 included 64 histologically confirmed primary bladder cancer patients scheduled for different treatment modalities, group 2 comprised 75 cases with benign urologic conditions and group 3 were 35 healthy volunteers. Serum TPA and TPS were estimated in all cases after initial evaluation as well as postoperatively in group 1 using an Enzyme Limbed Immuno Sorbant Assay[ELISA] technique. Results showed that serum TPA and TPS levels were significantly higher in group 1 as compared to the other groups, P<0.01. Evaluation by histologic findings declared a higher sensitivity of TPA [55.7%] at a specificity 95% in transitional cell carcinoma [TCC] as compared to 39% for TPS. A high percentage of Egyptian bladder cancer [+30%] is represented by- squamous cell carcinoma [SCC]; in this population TPS showed the highest sensitivity reaching up to 66% followed by TPA [48%]. The sensitivity of either marker increased with advancing tumor stage and grade in all histologic types as well as with nodal stage and metastases, p< 0.01. In all treated malignant conditions there was no statistically significant difference between serum TPA and TPS levels in free disease states. Cases showing tumor relapse exhibited a steady rise in both serum TPA and TPS levels before any detectable clinical recurrence with no statistically significant difference between either marker. In conclusion, serum levels of TPA and TPS in bladder cancer patients correlated well with initial tumor stage and grade and served for detecting and monitoring tumor relapse