[Some kinetic characteristics of cervical cancer].

Proliferation parameters such as mitotic index, tumor growth rate and cell loss were identified in 1,048 squamous cervical carcinoma patients treated at the Center's Clinic (1951-1996). Mitotic indices ranged 0.2-5.1% (average 1.13 +/- 0.03%), Ki-67--4.1-97.8% (average 49.97 +/- 3.02%). A direct and significant correlation between the two latter parameters was established. Cell loss levels ranged 59-99.9% (average 97.2 +/- 0.002%). Our results suggest that the correlation between tumor growth rate and cell loss might be of the utmost importance among the other prognostic factors.

[Immunohistochemical markers as prognosticators in gynecologic oncology].

Cyclooxygenase and particularly COX-2 expression impaired survival in patients operated on for endometrial adenocarcinoma of the uterus: 5-year overall and relapse-free survival in absence of expression was 92% and 88%, respectively, while in cases of distinct expression, it fell down to 52% and 48%, respectively (p = 0.0004; 0.0005). Similar correlations were observed for COX-1, although with lower significance (p = 0.02). Particularly unfavorable prognosis is associated with high expression of combination of COX-2 and COX-1. The end-results of radiotherapy were associated with proliferative levels of squamous cell cervical carcinoma: for Ki-67--below median of < or = 50%, 5-year survival rate was 77%, mean survival--80 months; for Ki-67 above median of > or = 50%, the indices were 47% and 47 months, respectively, (p = 0.002). There were similar correlations for mutated suppressor-gene 53: 67%--for absence of expression and 53%--for its presence (p = 0/03). Immunohistochemical markers COX-2, Ki-67 and p53 can be used as sole prognosticators and their predictive significance is higher than that of either stage (II or III) or cell differentiation grading.

[Immunohistochemical study of the predictive value of oncoproteins p53, HER-2 and c-myc during radiotherapy for squamous cell carcinoma of the cervix].

Out of 80 patients with squamous cell cervical carcinoma (stage II-III), p53 expression was observed in 30% of tumors prior to treatment and 49% in the course of radiotherapy. A correlation between degree of p53 expression before treatment, on the one hand, and overall and recurrence-free survival, on the other, was identified: high expression of mutated gene-suppressor p53 was 53% while for absence or low expression, it rose to 67% (p=0.03). For overexpression, 20-month survival was 65%; absence--81% (p=0.01). Hence, p53 expression may be used as a predictive factor in radiotherapy for cervical carcinoma. No correlation was found between p53 expression, on the one hand, and such basal clinico-morphological parameters as stage, morphological pattern and tumor cell differentiation, on the other. HER2(3t) overexpression occurred in 2 (2.5%) which seems to point to its insignificant role in squamous cell cervical carcinoma. There was no relationship between c-myc expression and long-term results.

[Ki-67 expression as a predictor of the effectiveness of radiotherapy and of outcome in locally advanced squamous cell carcinoma of the uterine cervix (immunohistochemical study)].

Retrospective immunohistochemical assay of antigen Ki-67 in tumor tissue was carried out prior to and in the course of radiotherapy (TFD - 14-20Gy) in 89 patients with squamous cervical carcinoma. Index of proliferation, i.e. number of Ki-67-positive cells per 1,000 of all cells, was found. Prior to therapy, the index was on the average 49.7%, during irradiation it decreased and its mean value was 24%. There was a correlation between proliferation level tumor progression and the former influenced the immediate effect of radiotherapy. Ki-67 expression in cervical carcinoma exceeded the median. It correlated with unfavorable end-results and was followed by higher relapse incidence. No significant proliferation index difference was reported visa-vis histological pattern, tumor cell differentiation or age. Yet, the drop in proliferative activity during therapy was significant, regardless of outcome. Our results pointed to the high prognostic significance of proliferative activity as far as therapy and outcome were concerned.