Epidermal growth factor receptor and human epidermal growth factor receptor 2 gene polymorphisms in endometrial cancer in a Japanese population.

Endometrial cancer is associated with both EGFR and HER2 receptor activation. The EGFR and HER2 genes could be disease susceptibility candidate genes for this cancer. This study was conducted to investigate a possible association between EGFR and HER2 gene polymorphisms and endometrial cancer and the influence of these polymorphisms on the clinical outcome of endometrial cancer patients in a Japanese population. The authors compare the genotype distributions and allele frequencies of the EGFR +2073 A/T and HER2 +655 A/G polymorphisms in 116 endometrial cancer patients and 213 controls using polymerase chain reaction-restriction fragment length polymorphism (RFLP) analysis. RFLP results were confirmed by direct DNA sequencing. Of the 116 patients, 76 (65.5%) could be followed up. Disease-free survival estimates were computed using the Kaplan-Meier method, and differences between survival periods were assessed using the log-rank test. No significant differences were observed in either genotype distributions or allele frequencies in the EGFR +2073 A/T and HER2 +655 A/G polymorphisms between endometrial cancer patients and controls. The stratification by histological types and staging failed to identify significant differences between endometrial cancer patients and controls. No statistical differences were noted between these polymorphisms and disease-free survival (Kaplan-Meier log-rank test P = .55 and .66, for the EGFR +2073 A/T and HER2 +655 A/G, respectively). These results suggest that the EGFR +2073 A/T and HER2 +655 A/G polymorphisms are not associated with endometrial cancer in a Japanese population. These conclusions are based on relatively small numbers and will require verification from additional independent studies.

Pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp.

OBJECTIVE: To evaluate the pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp. METHODS: Thirteen patients of placental polyp with abundant blood flow, which was diagnosed by ultrasound with color Doppler imaging, were studied. They underwent uterine arterial embolization followed by selective hysteroscopic removal of the polyp. Uterine arterial embolization was carried out using an absorbable gelatin sponge. Selective removal via hysteroscopy was performed on the following day, using the cutting loop with or without electrical stimulation. The polyp was gradually resected to the level of the surrounding endometrium. RESULTS: Complete removal of the placental polyp was achieved in all patients. The presence of placental polyp was confirmed by pathologic examination. The operative time ranged from 20 to 53 min. In all cases, no complications were noted and the bleeding was minimal during and immediately after the procedure. Postoperative ultrasound demonstrated a uterine cavity free of residual mass in each case. The seven patients with complete gestation gave birth to health babies. No recurrence of placental polyp was observed. CONCLUSIONS: Selective removal directed via hysteroscopy after reduction of blood supply by uterine arterial embolization provides a safe and effective method to minimize bleeding, and can preserve future fertility and successful uneventful pregnancies in the treatment of placental polyp with abundant blood flow.

Noncompaction of the left ventricular myocardium diagnosed in pregnant woman and neonate.

Noncompaction of the left ventricular myocardium (NCLV) is an uncommon congenital cardiomyopathy with poor prognosis. We describe a case of NCLV that developed in a pregnant woman and her neonate. A nulliparous woman was referred at 24 weeks' gestation due to dyspnea and fetal hydrops. Maternal echocardiography demonstrated NCLV with characteristic findings of prominent and excessive ventricular trabeculations and deep intertrabecular recesses in the left ventricle. An M-mode echocardiography suggested depressed left ventricular systolic function. A fetal echocardiography at 24 weeks' gestation demonstrated cardiomegaly, but morphologic findings were not definitive for NCLV. An emergency cesarean section was performed due to maternal heart failure. A neonatal echocardiography diagnosed NCLV with depressed left ventricular systolic function. The neonate died of cardiac failure on the second day of life. Autopsy confirmed the echocardiographic findings. Since patients with NCLV may develop heart failure, multidisciplinary management is mandatory. In addition, awareness of familial occurrence of NCLV should be kept in mind for early diagnosis in the fetus and neonate.