Prognostic value of steroid hormone receptors concentration in patients with endometrial carcinoma.

The concentrations of progesterone receptors in endometrial tumors of 160 patients were analyzed with respect to survival and presence of clinicopathologic prognostic factors. The concentration of 25 fmol/mg of proteins for progesterone receptors appeared to be most powerful for prediction of survival. The survival was also significantly correlated to age, depth of myometrial invasion and clinical stage of the tumor. Concentration of estrogen receptors could not be correlated with the probability of patients' actuarial survival.

Tumor cell cycle in patients with stage I endometrial carcinoma.

Flow cytometric cell cycle analysis was performed on paraffin-embedded blocks from 49 patients with stage I endometrial carcinoma. Care was taken to separate tumor tissue from normal tissue in each specimen; normal tissue was used as a control for each individual specimen. DNA index, proliferative activity, and cell DNA aneuploidy were correlated with known parameters of tumor malignancy. Increased DNA index corresponded well with the DNA aneuploid tumors, poor tumor differentiation (G3), myometrial invasion of more than one-third, more malignant histologic type of tumor, and low concentration of estrogen (< or = 10 fmole/mg) and progesterone (< or = 25 fmole/mg) receptors. Similar results were obtained for tumor cell proliferative activity (percentage of cells in S + G2/M phases) and for DNA aneuploid tumors. Since more than 90% of patients with stage I endometrial carcinoma survived the 5-year postoperation period, analyzed parameters could not be checked for survival-related prognostic significance. However, our data indicate that cell cycle analysis may be instrumental for objective ranking of several known prognostic parameters.

Prognostic impact of peritoneal cytology in patients with endometrial carcinoma.

In 169 patients with all stages of endometrial cancer peritoneal cytology was performed and the finding correlated to the stage of disease, histologic grade, depth of myometrial invasion, tumor site in the uterine cavity, menstrual status, frequency of recurrence and 5-year survival. In 23 (11.6%) patients malignant cells were found in the peritoneal washing. In patients with Stage I endometrial cancer 6.5%, Stage II 9.1%, and in those in whom disease had spread outside the uterus (Stage III and IV) in 68.0% (p < 0.001). Positive peritoneal cytology was found significantly more frequently in patients with maintained menstrual cycle (p < 0.01), patients with tumor localized in uterine horns and in those patients with low values of steroid receptors. With regard to the histologic grade no difference was found in peritoneal cytology regardless of the stage of the disease. With regard to the myometrial invasion difference in the finding of malignant cells was found only in those patients in whom the tumor had spread outside the uterus (p < 0.05). Regardless of the stage of the disease, the frequency of recurrence and 5-year survival did not correlate with the finding of malignant cells in peritoneal lavage. According to our results the finding of peritoneal cytology, as an isolated prognostic factor, or in correlation with other prognostic factors, does not play an important role in the prognosis of patients with endometrial cancer, particularly those in whom the tumor is localized only in the uterus.

[Clear cell carcinoma of the female genital tract]. / Klarocelularni karcinom zenskog spolnog sustava.

From 1980 to 1989 clear-cell carcinoma was diagnosed in 66(4.2%) out of 1562 adenocarcinomas of the female genital tract: in the ovary, 2.9% in the endometrium, 9.8% in the uterine cervix; 4.5% in the vagina, and 1.9% in the Fallopian tube. The diagnosis was made at clinical stage I in 26.9% of cases located in the ovary, 62.5% in the endometrium, and 42.8% in the uterine cervix. At stages III and IV the highest percentage of cases was diagnosed in the ovary -42.3% and 26.9%, respectively. The material was divided into the histological subtypes, and the glandular papillary was found in 54.5%, the tubulocystic in 31.8% and the solid in 13.6% of cases. The tubulocystic subtype showed the best prognosis, with the 50% five-year survival rate, while the glandular papillary subtype had 38.1%, and the solid subtype a 14.3 five-year survival rate was 66.6% for the ovary, 85% for the endometrium and 75% for the uterine cervix. For all other stages together (II, III, IV), the five-year survival rate was 0% for the ovary, 20% for the endometrium and 0% for the uterine cervix.

[Immunoglobulins in women with cancer of the uterine body (before treatment)]. / Imunoglobulini u zena s rakom trupa maternice (prije lijecenja).

Thirty-five women aged 40 to 79 years with the carcinoma of the body of the uterus were before treatment examined for humoral immunity to find out if the diminished function of the immunological system and immunodeficiency lead to an increased proneness to malignant diseases. Concentrations of total serum proteins, electrophoresis of proteins, and the quantitative determination of G-, A-, and M- immunoglobulins were performed. Lower mean values of IgG (11.94 g/L) and IgA (1.91 g/L) were observed, whereas IgM concentrations did not reveal a statistically significant difference compared with healthy women. The classes, light and heavy chains, as well as immunoglobulin fragments were investigated by immunoelectrophoresis with monospecific antisera. The results revealed a significant accumulation of certain parts of the immunoglobulin molecule, such as gamma heavy chains (in 63% of patients), kappa (77%) and lambda light chains (37%), and fragments--Fab (37%), Fc (57%) i Fd (40%), showing no antibody properties in comparison with the control group of healthy women.

Carcinomas of the cervix and corpus uteri in humans: stage-dependent blood levels of substance(s) immunologically cross-reactive with insulin.

Inasmuch as the elevated levels of substance(s) immunologically cross-reactive with insulin (SICRI) in a diabetic woman with carcinoma of the corpus uteri decreased following the surgical removal of the uterus and ovaries, 80 women with cervical carcinomas of various stages and 70 women with carcinomas of the corpus uteri of various stages were screened for the levels of SICRI and C-peptide. The levels of SICRI in the second, third, and fourth stages of the cancers were elevated (up to six times above the normal levels of immunoreactive insulin) and stage-dependent. The levels of C-peptide, which are related to the insulin-secreting activity of pancreatic beta-cells, were normal and independent of the stage of cancer.

[The value of the lymphocyte transformation index induced by mitogens in cervical carcinoma]. / Vrijednost indeksa blasticne transformacije limfocita izazvane mitogenom u bolesnica s karcinomom grla maternice.

Dynamics of immune reactivity in patients with the carcinoma of the cervix was determined. The transformation of their lymphocytes was induced in vitro by phytohemagglutinin (PHA), and the transformation index--a correlate of immunological reactivity--was determined at the following intervals: just before the start of the therapeutic procedure, at the end of the procedure, and every three months afterwards. Very low values of the transformation index, i. e. pronounced immunosuppression, characterized the initial period in all the patients, regardless of either the degree of the disease or the age of the patients. The suppression was prominent during 6 to 18 months following the therapeutic procedures and was overcome earlier in young patients bearing smaller tumors. The results indicate that in tumor-bearing patients a pronounced suppression of immune reactivity occurs after the PHA administration and that it could persist several months after the therapy.