Telomerase activity as a biological marker in some gynecological tumors: comparison with tissue and serum CA 125.

BACKGROUND: Since telomerase activity is detectable in cancer cells but not in some normal somatic cells, it has been considered as a potential diagnostic marker as well as a target for possible anticancer strategies. The purpose of this study was to assess the value of telomerase activity determination in some gynecological tumors and to compare it with the CA 125 tissue and serum profile. PATIENTS AND METHODS: The telomerase activity was determined in 11 gynecological tumors: 7 ovarian carcinomas, 2 carcinomas of the fallopian tube and 2 cervical carcinomas, and compared to the activity in the normal peritoneal tissue of the same patients. Additionally, the levels of CA 125 were measured in the tumor and normal peritoneum tissue samples as well as in the patients' sera. RESULTS: In ovarian tumors, the telomerase activity was detected in 71.4% (5 out of 7), while in the carcinomas of the fallopian tube and cervical carcinomas such activity was not observed. Negative for telomerase activity were also all samples of peritoneum. The range of CA 125 in the tumor tissue was 99 U/g-803667 U/g of tissue and in the normal peritoneum 71 U/g-4925 U/g of tissue. CONCLUSION: In conclusion, telomerase activity could be detected in some of the gynecological tumors, but for clinical use as a diagnostic marker it is inferior to CA 125.

Endometrial and other primary cancers after tamoxifen treatment of breast cancer -- results of retrospective cohort study.

OBJECTIVES: The aim of the retrospective cohort study was to evaluate the relationship between the influence of tamoxifen on the development of endometrial and other second primary cancers in the patients with invasive breast cancer. STUDY DESIGN: A cohort of 630 women diagnosed with breast cancer from 1987 to 1994 was selected from a population-based registry; 440 patients were treated with tamoxifen and 190 patients without it. The observation period was 8.5 years (range 5-12 years). The data were analysed by the relative risk (RR) calculation at a confidence interval (CI) of 95%, using a Mantel-Haenszel chi(2)-test and Fisher's p-test to evaluate statistical significance. RESULTS: There were no statistically significant differences between the group of breast cancer patients treated with tamoxifen and without it as regards the age at the breast cancer diagnosis, family medical histories, body mass, age at menopause, fertility, diabetes, hormone replacement therapy and oestrogen-hormone replacement therapy. In 41/440 (9.3%) tamoxifen-treated patients and in 8/190 (4.2%) non-users of tamoxifen, diagnostic curettage was performed due to benign endometrial changes and endometrial cancer (EC). The difference in the proportions of patients with diagnostic curettage in both group was statistically significant (chi(2)=4.45, p=0.03). In the group of patients treated with tamoxifen, with the median treatment duration of 40 months (range 1-97 months) and in the group of patients without tamoxifen, EC was diagnosed in 11 and in two patients, respectively. The evaluated RR was 2.38 (0.53-10.61, 95% CI). The second primary cancer, excluding contralateral breast cancer and EC, was diagnosed in the group of breast cancer patients treated with tamoxifen and without it in almost the same percentage, i.e. in 12 patients (3%) in the group of patients who were treated with tamoxifen and in 10 patients (5%) in the group of patients without tamoxifen treatment. CONCLUSION: Despite the fact that the calculated RR of EC in our study (2.4) was not statistically significant, due to a small number of patients, our results support the IARC evaluation that tamoxifen is carcinogenic to humans. Our data also suggest that tamoxifen does not increase the risk of other second primary cancers. However, the risk of individual second primary cancers cannot be reliably assessed due to a limited number of patients.

Endometrial cancer after tamoxifen treatment of breast cancer. Results of a retrospective cohort study.

PURPOSE: The aim of the present retrospective study was to evaluate the relationship between the use of Tamoxifen (TAM) and development of endometrial carcinoma (EC) in Slovenia women patients (pts). METHODS. This retrospective study included 408 pts, aged 55 years or more, treated for invasive breast cancer (285 pts were treated with TAM, 123 pts without it) at our Institute from 1988 to 1992. The pts who had had hysterectomy were not included. The observation period was 5 to 9 years. The Mantel-Haenszel chi2 test and Fisher p test were used. Survival was computed by Kaplan-Meier estimates. RESULTS: As to the most common risk factors of EC no statistically significant difference was observed. The daily dose of TAM was 20 mg, median treatment period was 38 months (1-97). In 15% of pts, TAM-related side-effects were noted 30 months later; the most common was uterine bleeding. EC was detected in 10/30 pts with curettage, while others had polypous changes and cystic hyperplasia. In the group of pts without TAM, curettage was performed in 4 pts. In view of curettage, the difference between the two groups was statistically significant (p=0.014). In the group of pts without TAM, EC was detected in 2 pts. Evaluated relative risk (RR) was 2.16 (0.48-9.70). Between the TAM groups of pts with and without EC, the difference in survival was minimal, statistically nonsignificant (p=0.41). CONCLUSION: Treatment with TAM increases the risk of benign endometrial changes and EC. In EC cases treatment with TAM does not influence the pts survival. Pts using TAM need to know what symptoms and signs should be reported.

[Massive bleeding during laparoscopy from varicose changes in the minor pelvis]. / Masivno krvarenje pri laparoskopiji iz varikoznih promena u maloj karlici.

In a patient aged 53, with metastatic adenocarcinoma in lymph nodes of the neck, laparoscopy was performed on suspicion of the presence of ovarian primary carcinoma. Laparotomy revealed a bluish tumour in the region of the right adnexa. A small part of the tumour was excised, producing profuse bleeding from the varicose swelling in the mesosalpinx, the size of a fist. The bleeding was stopped only by laparotomy. Here, too, a metastatic carcinoma was diagnosed histologically.

[Experimental evaluation of a double-layer anastomosis of the large bowel in the dog following irradiation]. / Eksperimentalna evaluacija eno--in dvoslojne anastomoze debelega crevesa pri psu po obsevanju

In our experiments on dogs we study the influence of irradiation on large bowel surgery. 24 dogs were divided in two groups: the control and the irradiated group. The dogs were irradiated and after 4 months the resections of 5 cm of the irradiated large intestine was performed. We used single and double layer anastomosis. Two weeks after the operation the dogs were sacrified and morphological, tensiometric and histological studies were applied to the operated and irradiated large intestine. Conclusion of our experiments is the statement, that the single layer intestinal suture satisfies in a greater degree the requirements of an ideal suture in the irradiated bowel than the double layer intestinal suture.