Prognostic significance of CD34 expression in early cervical squamous cell carcinoma.

The aim of the study was to evaluate angiogenesis as an independent prognostic factor and to determine the correlation of the microvessel density (MD) with lymph node metastases and survival rate in 73 women operated because of invasive squamous cell carcinoma (SCC) of the uterine cervix at clinical stages lb and IIa (FIGO). The patients were divided into two groups: I--25 (34.4%) with survival rate <5 years and II--48 (65.6%) with survival rate >5 years. Angiogenesis was quantified in light microscope using an assay for CD34. The CD34 antibody intensely immunostained single endothelial cells as well as larger microvessels. In the study. differences were revealed by comparing the MD between both groups. The 5-year overall survival rate for patients with high MD was significantly worse than for those with low MD (p<0.003). A correlation was found between angiogenesis intensity and vascular involvement as well as the incidence of lymph node metastases. Thus, tissue expression of CD34 in SCC appears to be a significant prognostic indicator.

Expression of nucleolar organizer regions (NORs) in ovarian epithelial tumors.

AgNOR staining technique was tested in ovarian epithelial tumors to evaluate its diagnostic potential in distinguishing between borderline tumors and well-differentiated carcinomas. In our opinion, the AgNOR count appears useful for assessing differences only between borderline and well-differentiated serous ovarian tumors at stage I of FIGO clinical advancement.

Proliferative activity in endometrial hyperplasia and adenocarcinoma.

Studies on the proliferative activity of cells in endometrial hyperplasia and adenocarcinoma were performed using techniques detecting Proliferating Cell Nuclear Antigen (PCNA) and Nucleolar Organizer Regions (NORs). PCNA expression was defined as the percentage of nuclei showing reactivity in 200 cells per sample. The mean AgNOR count per cell was calculated following the analysis of at least 100 nuclei per sample at a magnification of x 400. Student-t test was used for the statistical analysis. The results obtained indicate that the evaluation of cell proliferative activity expressed by AgNOR count and PCNA index can help in the distinction between atypical hyperplasia and well-differentiated adenocarcinoma, and thus can serve as a useful pathological criterion.

Angiogenesis as a prognostic factor in invasive carcinoma of the uterine cervix.

The aim of the study was to evaluate angiogenesis as an independent prognostic factor and to determine the correlation between the angiogenic index (AI) and histologic grade of the neoplastic process in patients operated on for invasive carcinoma of the uterine cervix. Angiogenesis was assessed with immunohistochemical technique using a monoclonal antibody against human factor VIII--(F8/86 M0616, DAKO, Denmark). A positive correlation was revealed between the intensification of angiogenesis and the incidence of lymph node involvement and survival rate.

Tissue expression of VEGF as a prognostic factor in early cervical squamous cell carcinoma.

The purpose of this retrospective study was to determine whether the intensity of tumor angiogenesis, expressed as microvessel density (MD), is indeed an important parameter predicting lymph node metastasis and survival rate in 73 women operated on for early invasive squamous cell carcinoma of the uterine cervix in stages Ib and IIa (FIGO). Angiogenesis was quantified by light microscope (LM) using an assay for vascular endothelial growth factor (VEGF). In the study, differences were revealed by comparing the MD between both groups. The patient survival with high MD was significantly worse than for those with low MD (p<0.01). A correlation was found between MD and the incidence of lymph node metastases. Hence, quantitative analysis of MD used as the expression of VEGF in the each cervical squamous cell carcinomas could be useful as a significant prognostic indicator.

Patterns of immunohistochemical staining for p53 expression in hyperplastic endometrium and adenocarcinoma.

The p53, a tumour suppressor gene, is the most commonly mutated gene human cancer. In this study, we performed immunohistochemical investigations of the expression of p53 protein in hyperplastic endometrium and adenocarcinoma. Positive immunostaining was detected in 7 (30%) cases of invasive adenocarcinoma, 2 (12%) cases of simple hyperplasia with atypia and 2 (14%) cases of complex hyperplasia with atypia. In simple and complex hyperplasia without atypia staining was seen in occasional cells. The results suggested that endometrial hyperplasia is not always accompanied by p53 protein accumulation, hence its expression is not an early exponent of the neoplastic process.

Small cell carcinoma of the uterine cervix--an uncommon variant of cervical cancer with neuroendocrine features.

Small cell carcinoma (SCC) of the uterine cervix represents an uncommon variant of cervical cancer with an extremely aggressive biologic behavior, minimum survival chances and rapid and fatal clinical course. This retrospective study included 73 cases of patients treated for invasive squamous carcinoma of the uterine cervix at stages Ib and IIa at the Department of Gynecology in the years 1996-2000. Six patients (8%) with SCC were identified among all cases, sharing the clinical features of young age and early failure of appropriate radical treatment in the presence of apparently low stage disease. Neuroendocrine cellular characteristics were assessed by the biotin-streptavidin-peroxidase (LSAB) method using antibodies against neuron-specific enolase (NSE; DAKO), chromogranin A (CGA; DAKO) and synaptophysin (SYN; DAKO). All tumors examined were positive for NSE and/or CGA and/or SYN. Although the presence of neuroendocrine features appears to correlate with decreased survival, the number of patients is not large enough to determine statistical significance. However, the results confirm that SCC of the uterine cervix is one of the most aggressive tumors of the female genital tract.

[Serum lipid levels in hypercholesterolemic post-menopausal women treated with transdermal sequential combined hormone replacement therapy only or in combination with simvastatin]. / Osoczowe stezenie lipidów u kobiet z hipercholesterolemia w trakcie przezskórnej sekwencyjnej zlozonej hormonalnej terapii zastepczej skojarzonej z podawaniem statyn.

The aim of the study was to evaluate the effects of transdermal sequential combined hormone replacement therapy alone or combined with simvastatin on the serum lipid profile in hypercholesterolaemic post-menopausal women.

[Expression of PCNA antigen in cellular proliferative activity of cervical carcinoma]. / Ekspresja antygenu PCNA w ocenie aktywnosci proliferacyjnej komorek raka szyjki macicy.

The proliferative activity of cervical carcinoma was examined using proliferating cell nuclear antigen (PCNA) staining. Labelling index (LI) have been counted in sections of routinely processed paraffin embedded tissue blocks. Significant variation in PCNA LI were observed between study groups (p < 0.0235). The results obtained indicate that the evaluation of proliferative activity of cells expressed by high PCNA LI is assessed with worse prognosis.

[Heterogeneity of ovarian epithelial tumors in analysis of nucleolar organizer regions (NORs) expression]. / Heterogennosc nowotworów nablonkowych jajnika w analizie ekspresji bialek regionów organizatorów jaderkowych (NORS).

Nonhistone proteins associated with the nucleolar organizer regions (NORs) can be visualized by a silver-staining technique on paraffin-embedded tissues. The number of black dots (AgNORs) appearing on the nuclei are thought to reflect cell differentiation and can be used as a measurement of cellular proliferative activity. In this study we tested AgNOR staining in ovarian epithelial tumors to evaluate its diagnostic potential in distinguishing between borderline tumors and carcinomas.

Nucleolar organizer regions in differentiated preneoplastic and neoplastic endometrial lesions.

The aim of the study was the quantitative assessment of nucleolar organizer regions (NORs) in the cells of preneoplastic and neoplastic endometrial lesions. Retrospective analysis included tissue material obtained from 87 patients with simple and complex hyperplasia with or without atypia and well-differentiated stage-I endometrial adenocarcinoma. Sections were made from routine paraffin blocks and stained with AgNO3. The mean number of AgNORs per cell was determined. The results obtained indicate that the evaluation of proliferative activity of cells expressed by AgNOR count can help in the distinction between atypical hyperplasia and well-differentiated adenocarcinoma, and thus can serve as a useful pathological criterion.

[Analysis of the frequency of prevalence of endometrial hyperplasia and endometrial adenocarcinoma based on own material in the year 1975, 1985 and 1995]. / Analiza czestosci wystepowania rozrostów blony sluzowej trzonu macicy i raka gruczolowego w materiale Kliniki w latach 1975, 1985 i 1995.

We analysed the frequency of prevalence of endometrial hyperplasia and endometrial adenocarcinoma in the years 1975, 1985 and 1995. Significant differences between endometrial simple hyperplasia and complex hyperplasia with atypia was found. There were no statistic differences in the frequency of the prevalence of endometrial adenocarcinoma between analysed years.

[Immunohistochemically expression of the protein p53 evaluated in invasive squamous cell carcinoma of the cervix]. / Immunohistochemiczna ocena ekspresji bialka p53 w inwazyjnym plaskonablonkowym raku szyjki macicy.

The p53 protein expression in the invasive squamous cell carcinoma of the cervix was evaluated immunohistochemically. Its predictive role in the correlation with histological grading and staging was analyzed. 13.7% of examined cases (10/73) presented positive protein expression. There was no correlation between the intensified protein p53 expression and particular prognostic histological factors.

Study of borderline and invasive mucinous ovarian tumors using Ki-67 (MIB 1) antibodies and nucleolar organizer region (NOR) staining.

Extensive application of new methods in histopathology has resulted in large quantities of data on molecular markers in different types of human tumors. The main purpose has been to obtain additional parameters for the characterization of various types of malignancy to give more precise information on their biological behavior. In this study we tested AgNOR and Ki-67 (MIB 1) staining in 39 ovarian mucinous tumors to evaluate its diagnostic potential in distinguishing between borderline tumors and well-differentiated carcinomas at stage I of FIGO classification. In general, there was an increase in AgNOR median values from benign (1.83 +/- 0.8) to well-differentiated carcinomas (2.91 +/- 1.3) with an intermediate value in borderline (2.3 +/- 1.6). The lowest Ki-67 labeling index (LI) was found in benign cystadenomas (5.7% +/- 3.4%) and papillary mucinous cystadenomas (7.9 +/- 5.8%). In borderline tumors mean LI was 12.2 +/- 10.9% whereas well-differentiated carcinomas had higher LI (16.8 +/- 10.2%). There were no statistically significant differences between the evaluated tumors and techniques applied. In our opinion the AgNOR count and Ki-67 LI do not appear useful for assessing differences between borderline and well-differentiated mucinous ovarian tumors at stage I of clinical advancement.

[Amniotic fluid disease: a case report]. / Zespól pasm owodniowych--opis przypadku.

A rare case of amniotic disease with extensive malformations of fetus was described. A data obtained from literature was done with special consideration of etiopathology.

[Diagnostic value of nucleolus organizer regions (NORs) in premalignant and malignant lesions of the cervix]. / Wartosc diagnostyczna ekspresji regionów organizatorów jaderkowych (NORS) w stanach przedrakowych i raku szyjki macicy.

The proliferative activity of CIN and SCC lesion was examined using silver-binding argyrophilic nucleolar organizer region (AgNOR) staining. AgNORs have been counted in sections of routinely processed paraffin embedded tissue blocks. The specimens consisted punch biopsies, cones or surgery. The number of black dots (AgNORs) appearing on the nuclei were counted. Significant variation in AgNOR counts were observed between CIN III and SCC compared with the other study groups (p < 0.001). These results suggest that AgNOR counts may be of significance in the evaluation of cervical lesions and could elaborate histopathological diagnosis.

[Surgical treatment of uterine leiomyomas in infertile patients]. / Leczenie operacyjne miesniaków macicy u kobiet z nieplodnoscia.

Retrospective analysis of the results of operative treatment for uterine leiomyomas was carried out. Our screening included the total of 186 patients. One hundred and eight women responded to the questionnaire /58%/. Respondens were treated for sterility in the period between 1990-1995. Successful operative treatment, expressed as pregnancy rate reached 29.7%.

[The evaluation of the use of transvaginal ultrasonography in the diagnosis of endometrial carcinoma]. / Ocena przydatnosci ultrasonografii przezpochwowej w diagnostyce raka endometrium.

In our study we estimated the uses of transvaginal ultrasonography in the diagnostic of endometrial carcinoma. There was noted that the most characteristic symptoms of this neoplasma in USG is the thickening of the endometrium and the absence or distortion of "central echo" (imaging of the endometrial cavity). We confirmed the co-existence of common epidemiologic factors of carcinoma endometrium too.

Prevention of high-order multiple gestations in an in vitro fertilization program.

The aim of this study was to assess the benefits of the transfer of only two of the best quality embryos, three if a woman was over 35 years of age, in terms of pregnancy rate and the incidence of multiple gestations. In 1993-94, when we were replacing three embryos when available and up to five when the woman was over 35 years of age, 217 clinical pregnancies were obtained (25% per embryo transfer). Among them there were 34 (15.6%) twins and 8 (3.7%) triplet pregnancies. Eighty-one patients had surplus embryos cryopreserved. In 1995, with the new policy of transferring only two embryos and three when the woman was over 35 years of age, 170 patients became pregnant (23.9% per embryo transfer). There were 31 (18.2%) twins and no triplet pregnancies. One hundred and forty-four patients had surplus embryos cryopreserved. Although limiting the number of transferred embryos slightly decreases the pregnancy rate, this small reduction can be considered acceptable if the social, health and financial problems associated with high-order multiple gestations are taken into account.

The outcome of an in vitro fertilization program in women with polycystic ovary syndrome.

The objective of this study was to examine the efficacy of D-triptorelin in the long protocol and follicle-stimulating hormone (FSH) in an IVF-embryo transfer program in a group of patients with polycystic ovary syndrome (PCOS) who had earlier failed to respond or did not conceive after clomiphene citrate (CC)/human menopausal gonadotropin (hMG) or 'flare up' gonadotropin-releasing hormone agonist (GnRHa)/hMG stimulation. Eighty-nine women with PCOS (based on typical ultrasound criteria) had 1-3 treatment cycles without success. The stimulation protocol was changed to D-triptorelin given in midluteal phase and when pituitary desensitization was achieved, FSH administration was started. The clinical pregnancy rate per transfer in this 'negatively selected' group of PCOS patients was 29%. This was the same as the rate for a group of women with tubal factor, as was the spontaneous miscarriage rate. Although the use of GnRH agonists in the long protocol increases the costs of treatment, the number of cancelled cycles is reduced. The pregnancy rate increased in this group of women with PCOS.