Expression of p16 in serous ovarian neoplasms.

PURPOSE: We aimed to examine p16 protein expression in ovarian serous neoplasms along with normal ovarian tissues. MATERIALS AND METHODS: P16 expression was immunhistochemically evaluated in 86 ovarian serous neoplasms (21 cystadenomas, 20 borderline tumors and 45 carcinomas) and 21 non-neoplastic ovarian tissue. The results were also compared with histopathological grade in serous adenocarcinomas. RESULTS: P16 expression rates for benign, borderline ovarian tumors and ovarian cancer were 14.2%, 85% and 86.6%, respectively. It was significantly higher in carcinomas (p < 0.001) and borderline tumors (p < 0.001) compared to cystadenomas. No immunoreactivity was found in the non-neoplastic ovarian surface epithelial cells. The percentage of p16 expression did not change significantly with histological grade in carcinomas. CONCLUSION: P16 expression is strong and widespread involving most tumor cells in serous papillary ovarian carcinomas, and is probably an early event.

Perineural invasion in early-stage cervical carcinoma.

PURPOSE: Evaluation of the association between perineural invasion (PNI) and predictive and prognostic factors in early-stage cervical carcinoma patients treated with surgery. METHODS: Fifteen PNI (+) and 21 PNI (-) early-stage cervical carcinoma patients, primarily treated by surgery, were evaluated retrospectively. Patients' complete blood counts and biochemistry tests, tumoral prognostic parameters, PNI status, postoperative treatment, recurrence and survival data were obtained from the records. RESULTS: The percentage of mean depth of stromal invasion was significantly higher in the PNI (+) group (p < or = 0.05). Vaginal (p < or = 0.05) and uterine (p < or = 0.01) invasion of the tumor were significantly more prevalent in the PNI (+) group. Lymphovascular space invasion, in particular lymphatic invasion (p < or = 0.05), but not vascular invasion (p > 0.05) was significantly more prevalent in the PNI (+) group. CONCLUSION: PNI is closely related with stromal invasion in percentage, vaginal and uterine involvement and lymphatic invasion of the tumor.

Expression of cyclooxygenase-2 in ovarian serous carcinoma: correlation with angiogenesis, nm23 expression and survival.

OBJECTIVE: To evaluate the expression of cyclooxygenase (COX)-2 in ovarian serous carcinomas (OSC) and its correlation with microvessel density (MVD), nm23 expression, clinicopathologic prognostic factors and survival. METHODS: Specimens from 44 patients with OSC were evaluated by immunohistochemistry for COX-2 and nm23 expression. Tumor MVD was assessed with CD34 immunostaining. The survival data of the patients were found from data files. RESULTS: 40 specimens (90.1%) showed positive COX-2 staining. Patients with high COX-2-expressed tumors had shorter overall survival, but it was not statistically significant. No correlation was found between COX-2 expression and clinicopathologic variables. There was no significant correlation between COX-2 and nm23 expression or MVD. CONCLUSIONS: COX-2 is frequently expressed in OSC. Although we could not confirm the prognostic significance of Cox-2 expression in the present cohort of OSC patients, the p value for overall survival was just slightly greater than alpha, and this result can be referred as almost significant. We considered that the limited number of cases in our study might affect the statistical analysis of our results. Further studies involving a larger number of patients are needed to clarify the prognostic significance of COX-2 expression in ovarian carcinomas.

A case of hepatoid carcinoma of the ovary.

A 50-year-old female was admitted with abdominal distention. Her serum CA125 level was elevated. Ultrasonography and computerized tomography showed adnexal tumoral masses with intraperitoneal metastases but no hepatic parenchymal involvement. She was operated on and histopathological and immunohistochemistry findings indicated ovarian hepatoid tumor. We present this case of ovarian hepatoid tumor and discuss the two-year disease progression from diagnosis to death.

Nm23 expression in node-positive and node-negative endometrial cancer.

OBJECTIVE: To examine the relationships between the expression of protein Nm23 and surgical stage, histologic grade, histopathologic findings, and survival in women with endometrial carcinoma. METHODS: 19 patients with lymph node involvement were matched with 24 patients without lymph node involvement and the best paraffin-embedded blocks were selected for Nm23 immunohistochemical staining. The slides were evaluated semiquantitatively according to their degree of cytoplasmic staining. Statistical analysis was performed to determine whether there was a relationship between Nm23 expression and surgical stage, histologic grade, depth of myometrial invasion, lymph node metastasis, and/or lymphovascular space involvement. Survival analysis was also performed. RESULTS: Slides from 15 patients (79%) with lymph node involvement and 22 patients (88%) without lymph node involvement were found to be positive for Nm23 (P=0.01). No significant relations were observed between Nm23 expression and surgical stage, histologic grade, depth of myometrial invasion, or lymphovascular space involvement. Nm23 expression was found to be significantly related to lower rates of lymph node metastasis and longer survival (P=0.02). CONCLUSION: Elevated Nm23 expression is related to lower rates of lymph node metastasis and longer survival.

Primary psammocarcinoma of the peritoneum.

Psammocarcinoma is a rare type of serous carcinoma arising from the ovaries or the peritoneum. Histopathologically, it has large deposits of psammoma bodies, invasion to surrounding tissues, and low-grade cytologic atypia. Biologic behavior is similar to borderline serous tumors with a favorable survival time. Primary surgical debulking with complete resection of the tumor should be the main surgical approach, while the benefit of postoperative chemotherapy remains unknown. A new case of primary peritoneal psammocarcinoma with survival after an initial diagnosis of 5.5 years is presented with a literature review.

Effects of Taxol plus radiation on the apoptotic and mitotic indices of mouse intestinal crypt cells.

PURPOSE: In this study we investigated the effect of Taxol, radiation, or Taxol plus radiation on highly proliferative normal tissue--the intestinal crypt cells of Swiss albino mice. MATERIALS AND METHODS: Swiss-albino mice, 3-4 months old, were used in this study. Taxol was administered by bolus intravenously through the tail vein. Radiation was given using a linear accelerator. There were four treatment categories, which comprised a total of 34 groups. Each group consisted of five animals. The first category was a control category which comprised one group (n = 5). The second treatment category was Taxol alone which comprised three groups (n = 15). The third treatment category was radiation alone which comprised three groups (n = 15). The fourth treatment category was Taxol plus radiation which comprised 27 groups (n = 135). Mice were killed 24 h after Taxol or radiation or combined administration using ether anesthesia. Using a light microscope, apoptotic and mitotic indices were counted on jejunal crypt cells of mice that were stained with hematoxylin-eosin. Differences between groups were statistically evaluated with Student's t-test. RESULTS: Taxol caused a dose-dependent increase in apoptosis (P = 0.045) and decreased the mitotic index (P = 0.006) at high doses. Similarly, radiation caused a dose-dependent increase in apoptosis (P = 0.046) and decreased the mitotic index (P = 0.299) at higher radiation doses. Compared to radiation alone, Taxol caused a significant induction of apoptosis (P = 0.010). In combination, no significant radiosensitizing effect of Taxol was observed (enhancement ratio < 1), when compared to radiation alone. However, an increase in apoptosis was observed after 24 h of Taxol exposure when compared to 12 or 48 h of Taxol exposure (P = 0.0001 and P = 0.0001). CONCLUSION: These findings suggest that Taxol did not cause a radiosensitizing effect in intestinal crypt cells. However, a 24-hour pretreatment of Taxol exposure followed by radiation caused significant induction of apoptosis and reduction of the mitotic index when compared to other Taxol timing sequences. Thus, the lack of a radiosensitizing effect of Taxol in these proliferative cells may be due to enhanced mitotic death rather than apoptotic death.

Chloroquine in idiopathic pulmonary hemosiderosis. A case report.

This report describes an 11-year-old boy with idiopathic pulmonary hemosiderosis. His only presenting symptom was severe anemia due to iron deficiency. Idiopathic pulmonary hemosiderosis was diagnosed nine years after the onset of symptoms. During this period many invasive and non-contributory investigations were performed. This report describes the patient's diagnostic problems, clinical features and dramatic improvement with chloroquine (250 mg/day) after failing to respond to megadose methylprednisolone (30 mg/kg). One year later, chloroquine was discontinued. The patient has remained in remission since March 1994. Chloroquine should be used for this life-threatening condition since it is less toxic than other immunosuppressive drugs.