Endometrioid endometrial adenocarcinoma: an increase of G3 cancers?

PURPOSE: Endometrial cancer can be divided into two types: endometrioid Type 1 (G1, G2) has a hormonal driven etiology, while Type 2 is more aggressive (G3 endometrioid, clear cell and serous cancer type) and estrogen independent. We noticed an increase of more aggressive G3 endometrioid endometrial adenocarcinomas. This observation is of relevance for daily clinical practice because therapy depends on the histopathological grading and myometrial invasion. G3 cancers or myometrial invasion of more than 50% should be hysterectomized including bilateral adnexectomy with pelvine and paraaortal lymphadenectomy. In G1/G2 and lower infiltration levels, hysterectomy with adnexectomy without lymphadenectomy is sufficient. METHODS: Data of the ASF Statistic were used to analyze the changes in the incidences of patients with endometrioid cancer, grading groups and their first diagnosed stages between 2006 and 2014. RESULTS: 2611 patients, with 243-341 women per year, were analyzed. The number of diagnosed G1 tumors increased from 25 to 37% and the G3 tumors from 18 to 32%, whereas the G2 cancers decreased from 58 to 31%. Despite the rise of G3 tumors, an increase in age at diagnosis was not observed. The proportions of initial diagnosed stages (FIGO I-IV) in each grading remained constant over time. CONCLUSION: Potential consequences in treatment recommendations and prognosis urge attention to the detected increase of G3 endometrioid cancers.

PCR typing of Plasmodium falciparum in matched peripheral, placental and umbilical cord blood.

A study was carried out in Lambaréné, Gabon, to analyse malarial infections in pregnant women. Blood samples from peripheral circulation and term placentas from 37 women were diagnosed as parasite-positive by thick blood smears. Infection was confirmed by PCR, using single-copy merozoite surface protein 1 and 2 genes. Of the 37 matched cord blood samples, 17 were positive by PCR amplification, even though all but one were microscopically negative. Five of these 17 samples were verified as positive in an antigen detection assay for histidine-rich protein 2. A comparison of alleles from these compartments indicates that single clonal infections were predominant for the cord samples, while double and triple infections were more common for peripheral and placental samples. Knowledge of the occurrence of parasites in each blood sample type is important towards understanding population dynamics in pregnant women and the development of immunity in infants to selected genotypes.