Feasibility, tolerability, and safety of hysterosalpingo-foam sonography (hyfosy). multicenter, prospective Spanish study.

OBJECTIVE: To determine the feasibility,tolerability, and safety of the ultrasound assessment of tubal patency using foam as contrast. METHODS: This was a prospective multicenter study of 915 infertile nulliparous women scheduled for sonohysterosalpingography with foam instillation (HYFOSY) for tubal patency testing as a part of the fertility workup. Clinical and sonographic data were recorded into a web-shared database. Tubal patency, cervical catheterization, pain during the procedure and post-procedural complications were collected. Patients reported discomfort or pain experienced during the procedure with a visual analogue scale (VAS) score. RESULTS: Nine hundred fifteen women were included in the final analysis. Median age was 34 (range, 21-45) years and median body mass index was 23 (range, 16-41) kg/m2. Of 839 women, only 8(0.95 %) cases were abandoned due to impossibility of introducing the intracervical catheter. Most of the cervical os were easily cannulated with either paediatric nasogastric probes or special catheter for intrauterine insemination / sonohysterosalpingography 688/914(75.3 %). With a median instillation of 4 mL (range 1-16) of foam, both tubes were identified in 649/875 (70.9 %) patients, while unilateral patency was observed in 190/875 (20.8 %). Only 36/875 (3.9 %) of the women had bilateral tubal obstruction. The median VAS score for perception of pain during HyFoSy examination was 2 (range 0-10), and only 17 (1.9 %) of women reported severe pain (VAS ≥ 7). Pain was unrelated to tubal patency or tubal blockage. Unexpectedly, difficult cervical catheterizations that needed tenaculum, were more likely associated with mild pain during procedure [nasogastric probe group 176/289 (70.9 %) vs. insemination catheter group 166/399 (41.6 %) vs. tenaculum group 190/218(87.2 %) p < 0.001]. Finally, among 915 patients, we only noticed 3 (0.32 %) complications of the technique: two vasovagal episodes and a mild urinary infection. CONCLUSION: HYFOSY is a feasible, well-tolerated and safe technique for the evaluation of tubal patency in infertile women.

MRI guided ROLL/SNOLL in breast cancer patients treated with neoadjuvant chemotherapy. / ROLL/SNOLL guiado por resonancia magnética en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante.

PURPOSE: To describe the results of MRI (magnetic resonance image) guided ROLL (radioguided occult lesion localization) and SNOLL (sentinel node occult lesion localization) in the localization of residual disease after neoadjuvant chemotherapy for breast cancer, as well as assessing the surgical results obtained and disease free survival. METHODS: Prospective observational analysis of 132 patients with 136 tumors, treated with neoadjuvant chemotherapy at our hospital between 2011-2017. Residual disease was located presurgically with MRI guided ROLL/SNOLL technique. We analyzed technical aspects of localization, and variables corresponding to surgical procedures and events occurred during follow-up. RESULTS: The median tumor size was of 20.5mm (interquartilic range [IQR]: 14-28). The majority (96.3%) were invasive ductal carcinomas. Sentinel lymph node detection rate was 98.9%. Complete pathological response (CPR) in the breast was achieved in 58.1% of cases. The rate of affected margins in 89 cases operated by conservative surgery was 2.2%. With a median follow-up of 50 months (IQR: 37-61) we found a 7.4% rate of relapses. Of these, seven were loco-regional and three at distant sites. The estimated mean of disease-free survival time was 83.2 months (Confidence Interval [CI] 95%: 79.6-86.6). CONCLUSIONS: MRI guided ROLL/SNOLL is a great tool for breast cancer residual disease localization following neoadjuvant chemotherapy. In addition, this technique attains good loco-regional control of the diseases and has excellent surgical results.

[Boussignac continuous positive airway pressure device during inter-hospital transportation in infants aged less than three months]. / Dispositivo de presión positiva continua en la vía aérea de Boussignac durante el transporte interhospitalario en lactantes menores de tres meses.

BACKGROUND: The present study aims to evaluate the safety and effectiveness of the Boussignac continuous positive airway pressure device (CPAPB) when used during the transportation of infants under three months of age with bronchiolitis. METHODS: Transversal analytical observational study of four years duration. Data was collected on 25 infants who needed inter-hospital transportation to the reference Paediatric Intensive Care Unit (PICU), with CPAPB and Helmet interface. The epidemiological characteristics of the transportation and evolution in the PICU were registered, as well as the cardiorespiratory gastronomic parameters prior to transfer and on arrival at the PICU. RESULTS: The median level of continuous airway pressure (CPAP) used during the transfer was 7 cm H2O (6-7.25). No patient required endotracheal intubation during transportation, while one patient required this during the first six hours of admission in the PICU. The following cardiorespiratory parameters presented a statistically significant improvement on arrival at the PICU: modified Wood-Downes score [8.40 (2.1) vs 5.29 (1.68)], respiratory frequency [60.72 (12.73) vs 47.28 (10.31)], cardiac frequency [167.28 (22.60) vs 154.48 (24.83)] and oxygen saturation [92.08 (5.63) vs 97.64 (2.27)]. CONCLUSIONS: Application of CPAPB proved to be a safe method of respiratory support in infants under three months of age. Its use during transportation brought an improvement in cardiorespiratory parameters.

Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma.

Benign multicystic mesothelioma is a rare tumour that originates from the abdominal peritoneum with a predisposition to the pelvic peritoneum. It typically affects women of reproductive age. There have been less than 200 cases of this rare neoplasia reported to date. We present the case of a 35-year-old woman who was referred to our centre because of the detection of a peritoneal carcinomatosis during a gynaecological exam. A diagnostic laparoscopy was performed. The findings included multiple cysts appearing as 'a bunch of grapes' occupying the omentum. Biopsies were taken during the surgery and the results showed benign multicystic peritoneal mesothelioma. Benign multicystic mesothelioma can simulate other conditions, such as malignant ovarian tumours or cystic lymphangioma. It is often diagnosed accidentally during surgery performed for another reason. The diagnosis is interoperative, observing multicystic structures grouped as a 'bunch of grapes' containing clear fluid with thin walls made of connective tissue. Immunohistochemistry confirmed mesothelial origin. Surgery is considered the treatment of choice and is based on the removal of the cysts from the abdominal cavity. Hyperthermic intraperitoneal chemotherapy can be considered as a primary treatment in patients with recurrences or even as a part of primary treatment associated with surgery. Survival at 5 years is 100% and invasive or malignant progression is extraordinary. The treatment approach should be multidisciplinary, and the patient should be referred to a referral centre.

Evolución del desarrollo neurosensorial de los recién nacidos de peso extremadamente bajo (<1.000g) en nuestro medio / Evolution of neurosensory development of very low weight newborns (<1.000 g) in our setting

Objetivo. Estudiar la situación y evolución neurológica de los recién nacidos de peso extremadamente bajo (<1.000g) en nuestro medio. Material y métodos. Estudio retrospectivo sobre la evolución de 148 RNMBP nacidos entre 1993-2004 después de un período de seguimiento de aproximadamente 27,5 meses. Se realizó estudio estadístico con el programa SPSS 15.0 para Windows de un amplio número de variables correspondientes a gestación, parto, edad gestacional, peso al nacimiento, complicaciones postnatales y evolución neurológica. Las secuelas se clasificaron leves, moderadas y graves según las alteraciones funcionales y necesidades del paciente y las alteraciones ecográficas por la gravedad de las lesiones. Se analizaron también la incidencia y mortalidad de los recién nacidos de peso extremadamente bajo. Resultados. La incidencia de los RNEBP se ha ido incrementado en los últimos años, alcanzándose un máximo de 11,3% en el 2007 así como su supervivencia, siendo esta del 45% en el 2005, 62,5% en 2006 y del 82% en el 2008. Resaltaba alto porcentaje de pretérmino de bajo peso gestacional (BPEG), gestaciones múltiples, embarazos por reproducción asistida, patología obstétrica, cesáreas, complicaciones neurológicas y extraneurológicas y tratamiento recibidos. El porcentaje global de secuelas fue del 42%, clasificándose como leves el 55,9%, moderadas el 25,5%, y graves el 18,6%. En relación al tipo de secuela, predominaron las motoras puras (45%), seguidas por las mixtas 824%) y plurideficiencias (14%). Hipoacusia neurosensorial en un 4% de la población y de retinopatía en el 43,2%. El 27% cumplían criterios de parálisis cerebral, predominando la tetraparesia. El 53,7% presentó alteraciones en la ecografía transfontanelar (HPIV 31,7%, LPV 12,8%, ventriculomegalia 26,3%, hidrofelaia posthemorragica (4,1%). Tuvieron alta correlación estadística con la aparición de secuelas especialmente la edad gestacional y las alteraciones ecográficas, así como los días de ventilación mecánica y de ingreso en UCI, la membrana hiailina, displasia broncopulmonar, persistencia de ductus arterioso, enterocolitis necrotizante y diversos tratamientos. Conclusiones. Se observa un incremento en la incidencia y supervivencia de los prematuros de pesio extremadamente bajo en nuestro medio. La proporción de secuelas es alta en relación con otras series, predominando las leves o no discapacitantes y se relacionan principalmente con la edad gestacional y la patología que presentan, principalmente del sistema nervioso central (AU)

Objective. To study the neurological evolution and situation of extremely low birth weight (<1.000 g) newborn in our area. Patients and Methods. Retrospective study of the evolution of 148 ELBW born between 1993-2004 after a follow up period of approximately 27.5 months. The statistical study was done with SPSS 15.0 and Windows. Many variables were studied related to pregnancy, delivery, gestational age, birth weights, postnatal complications and neurodevelopmental evolution. The disability was classified as mild, moderate and severe according to functional alterations and patient needs; and ultra sound abnormalities depending on severity of injuries. The prevalence and mortality of ELBW newborn were also analyzed. Results. The ELBW incidence has increased during the last years, reaching a maximum of 11,3% in 2007 and as well as their survival, this being 45% in 2005, 62,5% in 2006 and 82% in 2008. It is remarkable the high percentage of low weight, multiple gestations, assisted reproduction, obstetric pathology, caesareans, neurological and extraneurological complications and treatments received. Neurodevelopmental disability was detected in 42%, being mild in 55,9%, moderate in 25,5% and severe in 18,6%. In relation to the type of disability, pure motor predominated (45%), followed by mixed disabilities (24%) and multiple disabilities (14%). Neurosensorial deafness in 4% of the population and premature retinopathy in 43.2%. Cerebral palsy in 27%, being the most frequent the tetraparesis. 52,7% had abnormalities on transfontanelle ultrasound (intraventricular hemorrhage 31.7%, 12.8% leukomalacia, ventriculomegaly 26.3%, post-hemorrhages hydrocephalus (4.1%). Te sequelae had high statistical correlation with the gestational age, the ultrasound abnormalities and the days of mechanical ventilation and ICU stay, membrane hyaline disease and bronchopulmonary dysplasia. Conclusions. We have observed an increment in the incidence and survival of the ELBW newborn in our area. The proportion of sequelae is high in relation to other series with a predominance of mild sequelae. The most predictive variables are gestacional age and pathology, especially in the central nervous system (AU)

Expression of the beta-chain of the complement regulator C4b-binding protein in human ovary.

Human C4b-binding protein (C4BP) is an important regulator of the complement system that also binds and inactivates the anticoagulant vitamin K-dependent protein S. These two activities are performed by two distinct polypeptides of 70 kDa and 45 kDa known as alpha and beta chains, respectively. C4BP is present in plasma in various isoforms with different alpha/beta composition. We report here that C4BPbeta, but not C4BPalpha, is expressed in adult human ovary. Expression of C4BPbeta was detected in all ovarian biopsies analyzed (n = 15), independently of age and phase of the menstrual cycle. In situ hybridization and immunostaining analyses on cryostat sections demonstrated expression of C4BPbeta in both regressing corpus luteum and corpus albicans, but not in the follicles, the corpus luteum, the ovary stroma or the vascular cells. In addition, we noted that the expression pattern of the C4BPbeta mRNA resembles that described for the connective tissue that invades the degenerating corpus luteum and causes a progressive fibrosis that gradually converts it into a scar, the corpus albicans. RT-PCR and immunostaining analyses of primary cultures derived from human ovaries demonstrated the presence of fibroblast-like cells that express C4BPbeta. As a whole, these data suggest a role for the C4BPbeta in human ovary during the healing and scar resorption processes that leads to the formation of the corpus albicans and its replacement by ovarian stroma.

Tissue quantification of CA 125 in epithelial ovarian cancer.

The objectives of this study were the determination of CA 125 in the cytosol of healthy and carcinomatous ovarian tissue by immunoanalysis, analysis of its correlation with the biological characteristics of ovarian carcinoma, determination of serum CA 125 levels, and study of the prognostic value of the marker in cytosol. The levels of the marker depend not only on the tumor's production rate, so its determination in tissue can indicate more accurately if the tumor is a producer of the marker and establish its value for the prognosis of the disease. Determination of CA 125 in tissue was performed by immunoanalysis in 50 ovarian epithelial cancer samples, 13 benign pathology samples and 32 healthy ovary samples. The presurgical serum level of the marker was also obtained. The correlation between the CA 125 level in the cytosol and the different biological characteristics of the ovarian carcinoma, the serum levels of the marker and survival were analyzed. The CA 125 level proved to be higher in malignant tissue (p < 0.0001). There was a significant association between the tissue marker and histological type (high CA 125 was associated with serous and endometrioid tumors) and between the marker and survival. No relation with stage was found. There was a correlation between the CA 125 level in the cytosol and serum both variables being dependent, with a correlation coefficient of 0.44. This good correlation speaks in favor of the usefulness of CA 125 determination in serum in the follow-up of ovarian cancer. Tumors having high tissue expression of CA 125 were found to have a double relative risk of death, independently of tumor stage.

Ultrasonographic appearance of an echinococcus ovarian cyst.

BACKGROUND: We describe the ultrasonographic pattern of a pelvic echinococcus cyst, visualized using a vaginal probe and color Doppler. CASE: A 27-year-old woman presented with an asymptomatic right adnexal mass. Vaginal ultrasonography revealed a cyst in the posterior cul-de-sac, adjacent to the right ovary, with internal septae resembling a maze or an onion slice structure. Color Doppler revealed peripheral vascularization with a low resistance pattern (resistance index 0.6; pulsatility index 0.93). Benign cysts usually have a simple echogenic pattern. In contrast, ovarian carcinomas have a complex internal structure. CONCLUSION: Ovarian echinococcus cysts may have a peculiar ultrasonographic pattern at high-frequency (7.5-MHz) vaginal ultrasonography. Such high-frequency ultrasonography can be a useful tool in the diagnosis of the disease.

En bloc pelvic peritoneal resection of the intraperitoneal pelvic viscera in patients with advanced epithelial ovarian cancer.

PURPOSE: We report the results of 30 patients who underwent en bloc resection of the pelvic peritoneum and all intraperitoneal pelvic viscera in the management of advanced epithelial ovarian cancer. MATERIALS AND METHODS: Between 1989 and 1993, 30 consecutive patients with advanced epithelial ovarian cancer underwent en bloc resection of the pelvic peritoneum and all pelvic viscera, except for the bladder, with a rectosigmoid reanastomosis below the peritoneal reflection. All 30 patients were managed with gastrostomy and hyperalimentation. All patients received six cycles of platinum-based combination chemotherapy; the first cycle was administered prior to discharge. RESULTS: All patients underwent cytoreduction to the largest residual mass less than 1 cm. No major complications were attributed to the gastrointestinal surgery itself. The median hospital stay was 11 days (range, 7-23). We found 26 recurrences (87%) and 14 deaths (47%). The median times to recurrence and death were 12.5 months (range, 8-24) and 23 months (range, 8-63), respectively. Sixteen of the 26 relapses (62%) were found in extraperitoneal locations and 10 (38%) in intraperitoneal locations. Only 3 (12%) of the 26 relapses presented with bowel obstruction. CONCLUSIONS: En bloc resection of the uterus, ovaries, pelvic peritoneum, and rectosigmoid followed by low anterior anastomosis is a safe operation that facilitates complete cytoreductive surgery in poor prognosis patients with advanced epithelial ovarian cancer.

Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease.

Between 1982 and 1992, 24 women with Stage III clear cell ovarian cancer were identified from the tumor registry. Thirty-four women with Stage III papillary serous tumors treated between 1987 and 1989 were used as a comparison. All patients underwent cytoreductive surgery followed by conventional platinum-based chemotherapy. In the women with clear cell histology, nine (37.5%) had endometriosis in the surgical specimen compared with one (3%) in the papillary serous group (P = 0.002). Ten women (42%) with clear cell histology experienced a thromboembolic event during the course of treatment, compared to six (18%) in the papillary serous group (P = 0.05). In the group with clear cell histology, overall, 70% of women had progressive disease. Fifty-two percent experienced clinical progression while receiving platinum-based chemotherapy. In addition, four patients were found to have progressive disease at second-look laparotomy. Only two patients had a pathologic complete response. In the group with papillary serous histology, 29% overall had progressive disease while on chemotherapy (P = 0.005). The median survival for the women with clear cell histology was 12 months compared to 22 months for those with papillary serous (P = 0.02). For women with clear cell histology, univariate analysis was used to evaluate prognostic factors. Age less than 50 was a poor prognostic factor (P = 0.045). The presence of endometriosis, thromboembolic event, or optimal cytoreduction were not prognostic factors (P = 0.67, P = 0.34, P = 0.39). Patients with advanced clear cell ovarian cancer have a poor response to conventional platinum-based chemotherapy and overall prognosis is poor.

Histologic transformation of benign endometriosis to early epithelial ovarian cancer.

Between 1975 and 1990, 79 patients with Stage I epithelial ovarian cancer were treated at Massachusetts General Hospital. Patients were identified from the tumor registry and medical records were retrospectively reviewed. Pathological slides were evaluated for the presence of endometriosis, specifically looking for malignancy arising in endometriosis. Evidence of endometriosis was found in 22 of the 79 cases (28%). In the 23 cases of endometrioid histology, 9 cases (39%) were associated with endometriosis and, in the 17 cases of clear cell tumors, 7 (41%) were associated with endometriosis. All 8 cases of mixed histology had clear cell and/or endometrioid components and 4 cases (50%) were associated with endometriosis. Endometrioid adenocarcinoma accounted for 41% of the tumors associated with endometriosis, clear cell carcinoma 31%, mixed (endometrioid and/or clear cell types) 18%, and other types 9%. Among the 22 patients with associated endometriosis, we found 7 carcinomas (32%) arising in endometriosis. In these 7 cases a spectrum of benign and atypical endometriosis with a transition to clear cell or endometrioid adenocarcinoma were identified. These premalignant changes were characterized by cytologic atypia and architectural proliferation. Endometriosis was frequently encountered among patients with Stage I epithelial ovarian cancer of endometrioid and clear cell histologies. Endometriosis may play a role in the pathogenesis of some early stage malignant ovarian epithelial neoplasms.

Postoperative management of patients with stage Ib endometrial carcinoma.

Between 1980 and 1990, 124 patients with Stage Ib endometrioid adenocarcinoma of the endometrium were treated at Massachusetts General Hospital (MGH). Patients were identified from the tumor registry and medical records were retrospectively reviewed. Of the 124 patients, four (3%) developed a recurrence. Eighty-six patients had grade 1 tumors, 32 grade 2 and 6 grade 3. Recurrences developed in two (2%) of the grade 1 tumors, one (3%) of the grade 2, and one (17%) of the grade 3. Of the 86 patients with grade 1 carcinomas, 58 received no adjuvant radiation, 25 received vaginal vault brachytherapy and 3 whole pelvic radiation (WPR). Of the 32 patients with grade 2 tumors, 13 received no adjuvant therapy, 10 vaginal brachytherapy, and 9 WPR. Of the six patients with grade 3 tumors, one received no adjuvant therapy, two vaginal brachytherapy, and three WPR. Of the four women that relapsed, only the patient with grade 3 tumor had been treated with adjuvant radiation (WPR). Three of the four patients recurred at the vaginal vault and all three were salvaged. Stage Ib, grade 1 and 2, endometrioid adenocarcinomas have a good prognosis and adjuvant radiotherapy is not clearly beneficial.

Cleavage of Müllerian inhibiting substance activates antiproliferative effects in vivo.

Müllerian inhibiting substance (MIS), an inhibitor of growth and development of the female reproductive ducts in male fetuses, requires precise proteolytic cleavage to yield its biologically active species. Human plasmin is now used to cleave and, thereby, activate immunoaffinity-purified recombinant human MIS at its monobasic arginine-serine site at residues 427-428. To avoid the need for exogenous enzymatic cleavage and to simplify purification, we created an arginine-arginine dibasic cleavage site (MIS RR) using site-directed mutagenesis to change the serine at position 428 (AGC) to an arginine (cGC). The mutant cDNA was then stably transfected into a MIS-responsive ocular melanoma cell line, OM431, followed by cloning for amplified expression to test its biological activity in vitro and in vivo. Media from each clone were assayed for production of MIS RR by a sensitive ELISA for holo-MIS, and high- and low-producing clones were selected for further study. Media from the highest MIS RR producer caused Müllerian duct regression in an organ culture bioassay. Other transfections were done with an empty vector (pcDNAI Neo) or a construct lacking the leader sequence and thus failing to secrete MIS, to serve as controls. The OM431 clones containing the MIS RR mutant were growth inhibited in monolayer culture. The high- and low-producing MIS RR OM431 clones, along with transfected OM431 controls, were injected into the tail veins of immunosuppressed severe combined immunodeficiency mice for in vivo analyses. Four to 6 weeks later, pulmonary metastases were counted in uniformly inflated lungs. OM431 clones containing the more easily cleaved MIS RR displayed a significant dose-dependent reduction in pulmonary metastases when compared to the lungs of animals given injections of OM431 clones containing empty vector, leaderless MIS, or wild-type MIS that requires activation by plasmin cleavage. Since the purification protocol of MIS RR is less complicated than that for wild-type MIS, which requires subsequent enzymatic activation, MIS RR can be used for scale-up production with increased yields for further therapeutic trials against MIS-sensitive tumors.

Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms.

OBJECTIVE: To determine whether rupture of malignant ovarian epithelial tumors at the time of operation influences the patient's overall prognosis. METHODS: Between 1975 and 1990, 79 patients with stage I invasive epithelial ovarian cancer were treated at Massachusetts General Hospital. Patients were identified from the tumor registry, and charts were reviewed retrospectively. In 71 of the 79 cases, pathologic slides were evaluated. Of the 79 patients, 36 had stage Ia tumors, 20 stage Ic secondary to intraoperative rupture (Ic-rupture), and 17 stage Ic secondary to capsular invasion-serosal disease or positive ascites or washings (stage Ic-other). Survival analysis was performed to compare the three groups of patients. RESULTS: There were four recurrences and deaths among the 20 women with stage Ic-rupture tumors (20%), compared to one (3%) among the 36 women with stage Ia. The recurrence-free survival at the median follow-up time for the two groups was 97 +/- 3 and 78 +/- 10 months, respectively (P = .03); overall survival was 97 +/- 3 and 73 +/- 12 months (P = .04). There were two recurrences (12%) and one death (6%) among the 17 women with stage Ic-other, giving recurrence-free and overall survivals of 88 +/- 8 and 94 +/- 6 months, respectively. The survival experience of this last group was not significantly different from that in the Ic-rupture group (P = .2). The hazard ratios for overall survival associated with stage Ic-rupture and each potential confounder, except for bloating, exceeded 6.5, with P < or = .10. All deaths occurred in the 28 patients with grade 2 or 3 tumors. Even in this smaller group, the hazard ratio for stage Ic-rupture was 6.8 (P = .09). CONCLUSION: Intraoperative rupture of malignant epithelial ovarian neoplasms may worsen the prognosis of patients with stage I ovarian cancer.

Analysis for steroid production of a Sertoli-Leydig cell tumor.

Sex cord stromal tumors of the ovary can be characterized by the production of virilizing steroid hormones. The authors present a case of a poorly differentiated Sertoli-Leydig cell tumor in which ascitic fluid was found to have a high concentration of androgenic hormones and precursors from the delta steroid pathway (17-OH progesterone, testosterone, and androstenedione). These values correlated with samples taken from the right ovarian vein, draining the ovarian neoplasm, but not with those taken from the left ovarian vein or the peripheral blood sample. Selective peritoneal fluid sampling may aid in the diagnosis of hormonally active tumors.

LA-1 oncogene. A possible new prognostic index for evaluating cervical squamous intraepithelial lesions.

Cervical biopsies from 96 patients referred to the Union Memorial Hospital Colposcopy Clinic were analyzed for the expression of the LA-1 oncogene by using an antibody directed against a 13 amino acid epitope of the oncogene product. The expression of the oncogene was found to correlate with the grade of the cervical intraepithelial lesion. A trend was suggested even though chi 2 analysis was not significant (P = .08). Further studies are warranted to determine whether the LA-1 test predicts persistence or progression of the disease.