The amount of preoperative endometrial tissue surface in relation to final endometrial cancer classification.

OBJECTIVE: To evaluate whether the amount of preoperative endometrial tissue surface is related to the degree of concordance with final low- and high-grade endometrial cancer (EC). In addition, to determine whether discordance is influenced by sampling method and impacts outcome. METHODS: A retrospective cohort study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC). Surface of preoperative endometrial tissue samples was digitally calculated using ImageJ. Tumor samples were classified into low-grade (grade 1-2 endometrioid EC (EEC)) and high-grade (grade 3 EEC + non-endometroid EC). RESULTS: The study cohort included 573 tumor samples. Overall concordance between pre- and postoperative diagnosis was 60.0%, and 88.8% when classified into low- and high-grade EC. Upgrading (preoperative low-grade, postoperative high-grade EC) was found in 7.8% and downgrading (preoperative high-grade, postoperative low-grade EC) in 26.7%. The median endometrial tissue surface was significantly lower in concordant diagnoses when compared to discordant diagnoses, respectively 18.7 mm2 and 23.5 mm2 (P = 0.022). Sampling method did not influence the concordance in tumor classification. Patients with preoperative high-grade and postoperative low-grade showed significant lower DSS compared to patients with concordant low-grade EC (P = 0.039). CONCLUSION: The amount of preoperative endometrial tissue surface was inversely related to the degree of concordance with final tumor low- and high-grade. Obtaining higher amount of preoperative endometrial tissue surface does not increase the concordance between pre- and postoperative low- and high-grade diagnosis in EC. Awareness of clinically relevant down- and upgrading is crucial to reduce subsequent over- or undertreatment with impact on outcome.

The role of hormonal therapy in patients with uterine carcinoma.

OBJECTIVE: The aim of the study was to describe the role of hormonal therapy in the treatment of malignant uterine tumors, indications, the effect of the treatment and to verify its safety in our study cohort. We also present an overview of recent studies on that topic. DESIGN: Unicentric retrospective observational study and review of recent literature. SETTING: Department of Obstetrics and Gynecology, Masaryk University, University Hospital Brno. METHODS: The results of recent relevant studies and reviews published in English until December 2017 were used for the review. The publications were searched using the PubMed server. All patients diagnosed in our oncogynecological center between 2010 and 2016 and who were treated hormonally - either in primary therapy or in relapse settings, were included in our study. We were interested in age, BMI, stage of disease, histological type and grade of tumor, occurrence of adverse effects, duration of survival, reasons for choosing hormonal therapy. Medroxyprogesterone-acetate or megestrol-acetate was used in the treatment. RESULTS: Between 2010 and 2016, 415 malignant tumors of the uterus were diagnosed in our oncology center. Recurrence of the disease occurred in 31 patients (8%), on average 16 months after primary treatment. Primary hormonal therapy was used in only 19 patients (5%), mostly because of contraindications of another treatment due to high age, comorbidities or obesity. Median age of patients was 83 years, mean BMI 41, median survival of patients who died was 8 months. Five patients (16%) were treated hormonally for the recurrence. Median survival from diagnosis of recurrence was 20 months. One patient (4%) experienced partial pulmonary embolism. CONCLUSION: Hormonal therapy plays an irreplaceable role in uterine cancer patients, especially in primary non-operable patients, in treatment of a relapse, or in a fertility-sparing procedure. This treatment option is safe, with minimal adverse effects.

[Postoperative administration of octreotide to reduce lymphorrhea, lymphocele, lymphedema and lymphatic ascites after lymphadenectomy in gynecological malignancies]. / Vliv pooperacního podání oktreotidu na redukci lymforey a následne vzniku lymfocyst, lymfedému a lymfatického ascitu po lymfadenektomii u gynekologických malignit.

INTRODUCTION: Octreotide is a synthetic analogue of natural somatostatin. Octreotide effect on lymphorrhea reduction in gynecological malignancies has only been assessed in case studies. DESIGN: Original work. SETTING: Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno. METHODS: In 2014 there was a prospective, randomized, one-institution study. Patients underwent surgery including pelvic or pelvic and paraaortic lymphadenectomy for cervical, uterine and ovarian cancer. The informed consent was signed. Octreotide was evaluated in relation to diagnosis, surgery (laparoscopy versus laparotomy), pelvic and/or paraaortic lymphadenectomy, number of removed lymph nodes and their positivity, neoadjuvant chemotherapy, adjuvant chemotherapy, adjuvant radiotherapy, albumin, BMI, number of days with drains postoperatively, number of days in hospital, blood loss during surgery, time of surgery, total number of drains placed into abdominal cavity. In follow up period, within 1 year after surgery, we searched for lymphocele, lymph-edema of lower extremities and lymphatic ascites in relation to lymphorrhea. RESULTS: 44 patients (9 cervical, 19 endometrial and 16 ovarian cancer) were enrolled in two statistically comparable randomized groups. "Octreotide group", which paradoxically showed lymphorrhea of 4082 ml on average, (without 1992 ml, p = 0.001), needed drainage for more days (p = 0.001). The diagnosis had no influence on lymphorrhea in both groups (p = 0.966). The neoadjuvant chemotherapy was administered (p = 0.026), the more lymph nodes were removed (p = 0.018), the more days the drainage was in place (p < 0.001), the bigger the lymphorrhea; no relationship between lymphorrhea and age (p = 0.631), albumin level (p = 0.584), BMI ( p= 0.966) or number of positive nodes (p = 0.259), length of surgery (p = 0.206), blood loss (p = 0.494). Nor lymphedema (p = 0.404), nor lymphocele (p = 0.086), correlated with postoperative lymphorrhea. Lymphatic ascites was associated with lymphorrhea (p = 0.048). CONCLUSION: Octreotide did not reduce lymphorrhea and the incidence of lymphocele, lymphedema of lower extremities and lymphatic ascites within one year of follow-up period after surgery. According to our results, we do not recommend to administer the octreotide in oncogynecological patients after pelvic and/or paraaortic lymphadenectomy.

[Current FIGO staging classification for cancer of ovary, fallopian tube and peritoneum]. / Novinky ve FIGO stagingu karcinomu ovaria, tuby a peritonea.

INTRODUCTION: Pelvic high-grade serous carcinomas (HGSCs) include carcinoma of ovary, fallopian tube, and peritoneum. Five-year survival, irrespective of the stage, is between 35-40%. Most patients are diagnosed in advanced stages of the disease. The new revised and expanded dualistic model of ovarian carcinogenesis shows that type II tumors are composed for the most part of high-grade serous ovarian carcinoma, carcinosarcoma, undifferentiated carcinoma and can be further subdivided into morphologic and molecular subtypes. Many type II carcinomas develop from STIC predominantly in the distal portion of the fallopian tube and it is very likely the point of the origin of a significant subset of the pelvic high-grade serous carcinomas. OBJECTIVE: To provide an overview of major changes in our understanding of the origin of ovarian cancer, that led to the revision of FIGO (International Federation of Gynecology and Obstetrics) classification and its unification for the ovary, fallopian tube and peritoneum. We summarize the new classification, main changes compared to the former one and their clinical impact. METHODS: For this review, we have used the results of studies and review articles on the subject published in English up to October 2016. They were identified through a search of literature using PubMed, MEDLINE-Ovid, Scopus and Cochrane Library with the keywords ("serous tubal intraepithelial carcinoma" or "high-grade serous ovarian carcinoma" or "FIGO ovarian cancer staging 2014"). We retrieved and assessed potentially relevant studies, and checked the reference lists of all papers of interest to identify additional relevant publications. CONCLUSION: The origin of most cases of pelvic HGSC (carcinoma of ovary, the fallopian tube, and peritoneum) is expected in the fallopian tube epithelium. The main changes in the revised FIGO classification for extrauterine pelvic serous carcinomas were subdivision of stages IC, III and IV and elimination of the stage IIC, based on new knowledge and prognostic data. A prerequisite for the proper treatment of patients is to perform adequate surgical and pathological staging, including determining the grade of carcinoma. These factors, coupled with appropriately performed operation with zero postoperative residuum (R0), are the most important prognostic factors for patients with carcinoma of the ovary, fallopian tube, and peritoneum.

Is human epididymis protein 4 an effective tool for the differential diagnosis of benign and malignant endometrial tumours?

PURPOSE OF INVESTIGATION: This study was designed to evaluate the use of human epididymis protein 4 (HE4) as a biomarker in the differential diagnosis of malignant and benign endometrial tumours. MATERIALS AND METHODS: The study, conducted between July 2009 and June 2014, included a total of 150 patients with endometrioid adenocarcinoma and a control group of 150 patients with benign endometrial lesions. The serum of all patients was analyzed with respect to HE4 and CA125 levels. The median and ranges of serum levels were determined in relation to histological results. The statistical analysis procedure employed in this study utilized logarithmic-transformed values of biomarkers and logistic regression. RESULTS: An analysis of two groups of patients with different histologies yielded a statistically significant difference (p-value < 0.05) only in the case of HE4, in which case a cut-off value of 48.5 pmol/l resulted in an achieved sensitivity of 87.8%, a specificity of 56.6%, and a negative predictive value of 81.1%. CONCLUSION: In combination with clinical and ultrasound findings, HE4 could help with the differentiation of prognostically varied patient groups as well as with the decision-making process associated with the development of individual treatment plans. However, the optimal cut-off for HE4 has not been established yet and further studies are needed.

Supernatant versus exosomal urinary microRNAs. Two fractions with different outcomes in gynaecological cancers.

MicroRNAs (miRNAs) are key regulatory molecules implicated in fundamental cell processes. Recent investigations have been focused to investigate their diagnostic potential also in various body fluids. Plasma and serum are widely used for these purposes. Urinary miRNAs, as the easily available type of sample, have been explored particularly in urological diseases recently. However, we have shown previously that differential expression of urinary cell-free miRNAs may be observed also in gynaecological cancers, such as ovarian and endometrial cancers. In the present article, we focus on the differences in particular urine cell-free miRNA abundance among different samples including particularly ovarian and endometrial cancers and rare gynaecological diagnoses involved in the study. Using raw abundance miRNA expression data, we confirmed significant up-regulation of miR-92a in ovarian cancer, and significant down-regulation of miR-106b in endometrial cancers. As miR-21 appeared up-regulated in the endometrial cancer similarly as in the verification process, where also miR-106b resulted in significant down-regulation in ovarian cancer, these miRNAs may be good candidates for further evaluation as novel diagnostics. To find out why supernatant but not exosomal urine miRNAs fraction resulted in significant results in regards to de-regulation of expression, we performed a comparison of the same urine samples isolated by these two manners. We show that diagnostic potential of cell-free urinary miRNAs may depend on the urine fraction used for the isolation. While particular urinary miRNAs may be enriched, other may reveal unchanged or diminished expression in the exosomal fraction in comparison with supernatant fraction, giving differences also between cancer and control samples. More research will be needed to further explore which kind of cell-free samples would give better results for diagnostic purposes in various diagnoses using urinary samples and investigating cell-free miRNAs expression. Meanwhile, different urine fractions should be explored for their miRNA expression to establish novel diagnostic urinary miRNA markers.

[Histological types of uterine fibroids in reproductive age and postmenopausal women]. / Histologické typy delozních myomu u pacientek v reprodukcním veku a postmenopauze.

OBJECTIVE: To review the incidence of histologic variants of uterine fibroids of patients in reproductive age and postmenopause. Analysis of potential relations between histological fibroids variants and hormonal activity of the patient. DESIGN: Retrospective analysis. SETTING: Department of Obstetrics and Gynecology, Masaryk University and University Hospital Brno. MATERIAL AND METHODS: Retrospective analysis of 2,397 women who underwent myomectomy or hysterectomy at the Department of Obstetrics and Gynecology, Masaryk University and University Hospital Brno in years 2008-2014. According to input criteria - age of patients between 18-65 years, ultrasound confirmed uterine fibroid. Exclusion criteria was irregular menstrual cycle, hormonal therapy in history or hysterectomy performed for tumors of the small pelvis or for cancer of the uterus or cervix.Group A consisted of 235 patients with regular menstrual cycles, between ages 18-40. Myomectomy was chosen for these patients.Group B consisted of 433 postmenopausal patients between ages 50-65. Laparoscopic and abdominal hysterectomy was performed to these patients. RESULTS: A statistically significant difference was observed in the occurrence of epithelioid type of leiomyoma between women age groups 18-40 and 50-65. In the group of postmenopausal women four malignant forms of leiomyoma were recorded, which were not statistically relevant. CONCLUSION: After evaluating statistical analysis it was found, that there is a statistically significant difference in epithelioid type of uterine leiomyoma. Four patients were detected malignant variant of leiomyoma - leiomyosarcoma in the group of postmenopausal women.

[The importance of HE4 in differential diagnosis of endometrial cancer]. / Význam HE4 v diferenciální diagnostice patologií endometria.

OBJECTIVE: The aim of the present study was to evaluate the use of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) biomarkers in differential diagnosis of malignant and benign endometrial tumours in a population of Czech women. DESIGN: Prospective study. SETTING: Department of Gynaecology and Obstetrics, Faculty of Medicine at Masaryk University and Faculty Hospital in Brno. METHODS: Our prospective study includes 115 patients with endometrioid adenocarcinoma and 106 patients with benign endometrial tumours in the control group. They were diagnosed with endometrial biopsy in the period from 7/2010 to 6/2013. The patients with cancer underwent definitive surgical treatment to determine the stage of disease. The median and ranges of serum levels were determined in relation to the histological result (benign vs malignant disease). Statistical analysis operates with logarithm values of markers because their distribution is not normal and uses logistic regression. RESULTS: While analysing two groups of patients with different histology, there was demonstrated a statistically significant difference (p < 0.05), only in HE4, by cut-off 48,5 pmol/l there was achieved sensitivity of 87.8%, specificity of 56.6% and negative predictive value of 81.1%. COCLUSION: Diagnostic benefit of HE4 can be considered especially in patients with increased risk of endometrial cancer and in patients with serious internal co-morbidities. HE4 could help in combination with clinical and ultrasound finding in the differentiation of prognostically various groups of patients and in decision-making in relation to the individualization of the treatment plan. However, the optimal cut-off for HE4 has not been solved yet, and to do so, it will require more research with larger studies and their comparative analysis..

Patient with inoperable pheochromocytoma.

Malignant pheochromocytoma is a tumour with a very low incidence that occurs sporadically or in the presence of multiple endocrine neoplasia. We present the case of a woman with a sporadic occurrence of pheochromocytoma diagnosed in the phase of multiple dissemination in the abdominal cavity and overexpressing adrenaline, noradrenaline, and dopamine. Local transarterial chemoembolization and systemic treatment with lanreotide resulted in a very good response, a decrease in the production of catecholamines for 12 months and a partial decrease for another 8 months, with stabilization of disease determined by imaging. Systemic treatment with tegafur resulted in disease stabilization lasting 50 months, after which the drug was discontinued because of adverse effects. Maintenance therapy with lanreotide continues, and no disease progression has been observed for 4 months. The treatment algorithm for such patients is multidisciplinary and must always take into account the current scope of the disease, intercurrence, and the general condition of the patient.

New perspectives in diagnosis of gynaecological cancers: Emerging role of circulating microRNAs as novel biomarkers.

Early diagnosis is a prerequisite of the more successful treatment of cancer. In gynaecological cancers, such as ovarian, endometrial and cervical cancers, the recent efforts are aimed at finding novel diagnostic biomarkers to help reduce the worldwide health burden associated with these cancers. In this review, we focus on the recent research progress in circulating, particularly cell-free microRNAs expression achieved in ovarian, endometrial and cervical cancers showing an opportunity to find novel diagnostic biomarkers for these malignant diseases. With the onset of microRNAs investigations showing their diagnostic potential in many diseases, their role in gynaecological cancers has been examined as well. However, similarly as in many other diseases, the vast majority of research on microRNAs expression has been dealing with tissue samples and cell lines. Recently, as the novel approaches focused on cell-free microRNAs expression have emerged, several studies identified their potential diagnostic and prognostic value in gynaecological cancers using blood, serum/plasma or urine samples. More research will be needed to establish circulating and extracellular microRNAs as the novel diagnostic markers for gynaecological malignancies. Inconsistency of results across the studies due to technical and biological variation, and a low number of this kind of investigations are the main potential pitfalls remaining to be resolved.

[Ovarian epithelial malignant tumors in adolescence]. / Ovariální epiteliální malignity v adolescentním veku.

OBJECTIVE: Ovarian epithelial malignant tumors in adolescence. DESIGN: Literature review with case reports. SETTING: Department of Gynaecology and Obstetrics, Faculty of Medicine at Masaryk´s University and Fakulty Hospital Brno. METHODS: Literature review on ovarian epithelial malignant tumors in adolescence, their epidemiology, diagnosis and therapy with illustrative case reports. CONCLUSION: The ovarian epithelial malignant tumors in the adolescence represent rare group of these diseases according to the data from the National Cancer Registry. However, it is a very sensitive area of oncogynecology, that requires highly personalized approach and the cooperation with patient´s family. The ovarian epithelial malignant tumors in the age group of 15-19 years show some differences from these diseases of adults and older women. The differences concern the extent of the disease at the time of the diagnosis, the histopathological characteristics of the tumors and the proportion surgical therapy and chemotherapy. The diagnostic algorithm requires the cooperation with the colleagues from pediatric gynecology and oncology. Due to the occurrence of localizated stages and good tumor differentiation prevails the monotherapy presented the surgical treatment, especially in the form of the radical fertility-preserving procedures. The care of the patients should be concentrated into the oncogynecological centres.

[Cancer stem cells and ovarian cancer Characteristics, importance and potential applications in clinical practice]. / Kmenové bunky a karcinom ovaria Charakteristika, význam a potenciální aplikacev klinické praxi.

Ovarian cancer is the most malignant and the second most common gynecological cancer which encompasses a heterogeneous group of tumors with a different etiology. Extra-ovarian tissues may play a role in the development of ovarian cancer, despite this issue is still debated. This disease is associated with a strong chemoresistance and tendency to recurrence, and asymptomatic behaviour at early stages. Effective screening markers have not been established yet. Cancer stem cells have been postulated to play a role within tumor formation and by the establishment of chemotherapy-resistant population of malignant cells after the surgery and application of chemotherapy. These cells are multipotent cells capable of un-limited divisions and have potential to induce tumorigenesis in immune-suppressed mice. Their detailed characterization is still an open issue, however there have been identified several markers associated with ovarian cancer stem cells. The major markers of ovarian cancer stem cells identified so far are CD133, ALDH, CD44, CD117, CD24 and EpCAM. Their occurrence in primary tumors may be associated with patients´ prognosis; however there are insufficient data for definite conclusions. Dynamic processes of carcinogenesis result also in changes of cancer stem cells phenotypes based on the microenvironmental changes within the tumor. The markers may thus be acquired, or lost, as it has been proven experimentally. As regards the possibility to use targeted, specific therapy approaches, there are some promising studies, suggesting this may be a method of potential treatment. Further characterization and functional studies of cancer stem cells will be necessary for the elucidation of carcinogenesis, chemoresistance and metastases formation-associated processes. Such studies will be the basis for establishment of novel diagnostic, prognostic and therapeutic approaches for the ovarian cancer treatment. The most recent results on ovarian cancer stem cells research are presented in this paper.

[Triple negative breast cancer--prognostically highly unfavourable group cancer of breast]. / Triple negativní karcinom prsu--prognosticky vysoce závazná skupina mamárních malignit.

OBJECTIVE: Presentation of the file prognostically highly unfavourable group cancers of breast. DESIGN: Retrospective analysis. SETTING: Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno. METHODS: In the study, we retrospectively analyzed 47 patients with triple negative breast cancer, who have undergone in the period 2005-2008 complete treatment and then follow-up in Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno. 2/3 patients underwent primary surgery followed by adjuvant therapy, 1/3 patients underwent neoadjuvant chemotherapy followed by surgery and eventually adjuvant therapy. Then patients were transferred to follow-up. RESULTS: Approximatelly 2/3 patients were diagnosed in early stages I and IIA FIGO, other patients in advanced stages, even though almost 90% of women participated regularly in mammography screening. With neoadjuvant chemotherapy was achieved complete pathological remission in 15% patients, in 70% patients reduction volume of the tumor at least 50%, other patients were resistant to chemotherapy. Recurrence of disease was detected by almost 39% of patients on condition follow-up at least 30 months after completion of primary treatment. Patients, who were diagnosed and treated in early stages, suffered more frequently from local recurrence and interval of recurrence from completion of primary treatment was longer. Patients, who were diagnosed and treated in advanced stages, suffered more frequently from remote metastasis and interval of recurrence from completion primary treatment was shorter. CONCLUSION: Triple negative cancers of breast are highly aggressive tumors with poor prognosis. They often are associated with lymphadenopathy and characterized by frequent occurrence of local recurrences and high risk of remote metastases. These tumors represent a large part of so-called interval cancers. Tumors often occurs in young women with BRCA1 mutations. Elementary systemic treatment is chemotherapy. Together continues the effort of highly targeted therapy, based on new findings in genomics and proteomics and on detection of many markers expressed by this version of breast cancer.

[Secondary malignant tumors of the female genital tract]. / Sekundární malignity zenského genitálu.

OBJECTIVE: Information sheet about metastatic tumors of the female genital tract. DESIGN: Literature review with case reports. SETTING: Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk's University and Fakulty Hospital, Brno. METHODS: Literature review about metastatic tumors of the female genital tract with illustrative case reports. CONCLUSIONS: Secondary gynecological malignant tumors are much less common than primary tumors of the female genital tract with the exception cancer of the fallopian tube and the vagina. Primary malignant tumors of the fallopian tube and the vagina are rare, the primary location of the tumor usually is in other areas of the female genital tract and the tumor grows directly into the above-mentioned organs secondarily. There is talking about metastatic malignant tumors of the female genital tract in the strict sense in the case of extragenital primary origin the cancer. Metastases can be caused by direct penetration of the tumor from anatomically adjacent organs, particularly from the bladder and the rectum, or are going through the lymph or the blood vessels. The most common primary location of the tumor are the breast, the stomach and the bowel in this case. Secondary laesions of the female genital tract can be sometimes the first clinical manifestation of the primary extragenital malignant tumor, simultaneously represent clearly negative prognostic factor for the disease. Differential diagnostic algorithm for solving the secondary laesions of the female genital tract requires a multidisciplinary approach and cooperation with the pathologist and the clinical oncologist. Surgical treatment, the indication and extent based on adequately performed staging, is essential for the diagnosis of the primary tumor and is necessary as the palliative treatment for the elimination event, clinical symptoms and for the improving quality of the life.

[Malignant fibrous histiocytoma of the breast: report of two cases]. / Maligní fibrózní histiocytom prsu--popis 2 prípadu.

Two cases of malignant fibrous histiocytoma (MFH) of the breast are presented. The first case was a 63-year-old patient with MFH of myxoid type, the second case was a 79-year-old patient with MFH of pleiomorphic type. MFH is one of the most common tumors of the soft tissues, but its primary occurrence in the breast is rare. Immunohistochemical detection of antigens in the cytoplasm of histiocytes by antibdy LN 5 (Anti-Macrophage, BioGenex) can be helpful in rendering of the right diagnosis.

Bone marrow and peripheral blood leptin levels in lymphoproliferative diseases--relation to the bone marrow fat and infiltration.

Leptin is a nonglycosylated protein produced mostly by adipocytes. The role ofleptin in body weight regulation through its anorectic effect in hypothalamus is very well known. Less known are other leptin effects such as the stimulation of hematopoesis and some parts of immunity system. The role of leptin in the pathogenesis of some malignant tumors is discussed. Only a little is known about bone marrow adipocyte leptin production. We examined leptin concentrations in the sera from peripheral blood and bone marrow, the percentage of bone marrow fat, the degree of bone marrow infiltration, the body mass index (BMI) in 42 patients with lymphoproliferative diseases. We found that bone marrow has significantly lower leptin levels (6,6+/-10,9 ng/ml) than peripheral blood (9,1+/-11,5 ng/ml) (p < 0.0001). Bone marrow and peripheral blood leptin levels have also a significant thin correlation (r = +0.91, p < 0.0001). Bone marrow (r = +0.55, p < 0.0005) and peripheral blood (r = +0.52, p < 0.0005) leptin concentrations are significantly correlated to BMI. Blood serum leptin (r = +0.46, p < 0.003) and bone marrow leptin (r = +0.40, p < 0.01) are related to the bone marrow fat percentage. In addition we found a negative correlation of blood serum leptin (r = -0.59, p < 0.0001) and bone marrow leptin (r = -0.42, p < 0.005) to bone marrow malignant infiltration. When we divided the patients into groups with bone marrow infiltration more than 10% and without or less than 10% infiltration, the first group had significantly lower peripheral blood (p < 0.001) and bone marrow (p < 0.02) leptin. We also confirmed a relation of bone marrow fat and infiltration (r = +0.49, p < 0.001). Our results suggest a relationship among leptin levels in blood or bone marrow and bone marrow infiltration in lymphoproliferative diseases. This fact needs further investigation and an evaluation of its application in clinical practice.

p53 status in breast carcinomas revealed by FASAY correlates well with p53 protein accumulation determined by immunohistochemistry.

The prognostic and predictive value of p53 mutation in breast cancer is still conflicting. The choice of the p53 status detection method may account for some discrepancies. In this pilot study we compared two differently-based methods for detection of p53 alteration in 32 breast carcinoma samples: the immunohistochemical method using Bp53, DO1 and DO11 monoclonal antibodies for analysis of the p53 protein accumulation in cell nuclei and the functional method FASAY. FASAY - functional analysis of the separated alleles in yeast - tests the capability of the human p53 to transactivate a reporter with a p53 binding site RGC driving the ADE2 gene in yeast. In our group the percentage of breast cancers with accumulated p53 protein was 50%, as well as percentage of mutant p53 scored by FASAY was 50%. Although the agreement of both methods, when comparing the results of individual patients was high (94%), our results show that immunohistochemistry does not reflect the p53 status quite exactly.