Cell proiferative actitiy and mutation of P53 suppressor gene in human gestational trophoblastic disease

Cell proliferative activity and the over accumulation of P53 suppressor gene were evaluated in 26 cases of gestational trophoblastic disease and five cases with normal placentae. Formalin-fixed, paraffin-embedded histological sections were used for immunohistochemistry, utilizing the avidin-biotin-peroxidase technique and antibodies to PCNA (proliferative cell nuclear antigen) and to P53 (product of suppressor gene). Positive reactions for PCNA were graded from 1+ to 3+ (1+ - less than 10 per cent of cells; 2+ - 10 - 50 per cent ; 3+ - more than 50 per cent ). Eight of 10 cases of choriocaricinoma (80 per cent ) showed moderate to strong reactivity for PCNA (2+ and 3+). All 9 cases with hydatidiform mole and 6 of 7 cases with partial mole also demonstrated 2+ and 3+ reactions for PCNA. There was minimal or no PCNA straining in the trophoblastic cells of normal placentae. Five of 10 cases with choriocarcinoma (50 per cent ) exhibited P53 overaccumulattion as did 7 of 9 cases with hydatidiform mole (78 per cent ). In hydatidiform moles, P53 staining was limited to the areas of trophoblastic proliferation separate from chorionic villi. None of the partial moles or normal placentae showed P53 overaccumlation. It is concluded that the cell proliferative activity of choriocarcinomas as well as complete and partial hydatidiform moles are comparable. On the other hand, the mutation of P53 suppressor gene, as demonstrated by the overaccumulation of P53 protein, is seen only in true trophoblastic neoplasms, namely choriocarcinomas and hydatidiform moles.

Cell proliferative activity and mutation of P53 suppressor gene in human gestational trophoblastic disease

Cell proliferative activity and the over accumulation of P53 suppressor gene were evaluated in 26 cases of gestational trophoblastic disease and five cases with normal placentae. Formalin-fixed, paraffin-embedded histological sections were used for immunohistochemistry, utilizing the avidin-biotin-peroxidase technique and antibodies to PCNA (proliferative cell nuclear antigen) and to P53 (product of suppressor gene). Positive reactions for PCNA were graded from 1+ to 3+ (1+ - less than 10 percent of cells; 2+ - 10 - 50 percent; 3+ - more than 50 percent). Eight of 10 cases of choriocaricinoma (80 percent) showed moderate to strong reactivity for PCNA (2+ and 3+). All 9 cases with hydatidiform mole and 6 of 7 cases with partial mole also demonstrated 2+ and 3+ reactions for PCNA. There was minimal or no PCNA straining in the trophoblastic cells of normal placentae. Five of 10 cases with choriocarcinoma (50 percent) exhibited P53 overaccumulation as did 7 of 9 cases with hydatidiform mole (78 percent). In hydatidiform moles, P53 staining was limited to the areas of trophoblastic proliferation separate from chorionic villi. None of the partial moles or normal placentae showed P53 overaccumlation. It is concluded that the cell proliferative activity of choriocarcinomas as well as complete and partial hydatidiform moles are comparable. On the other hand, the mutation of P53 suppressor gene, as demonstrated by the overaccumulation of P53 protein, is seen only in true trophoblastic neoplasms, namely choriocarcinomas and hydatidiform moles (AU)

Tumours of the central nervous system: analysis of 476 cases observed at the University Hospital of the West Indies

A statistical survey of the incidence, age and sex distribution, and preferential sites of occurrence of tumours of the central nervous system observed at the University Hospital of the West Indies during a 15-year period is presented. Four hundred and seventy-six histologically confirmed neoplasms were recorded. Intracranial tumours were 7 times as common as those of the spinal cord. Of 416 intracranial neoplasms, there were 40 percent neuropithelial tumours, 21 percent meningiomas, 15 percent pituitary adenomas, 9 percent metastatic lesions, 6 percent congenital tumours, 5 percent vasoformative tumours, 3 percent nerve sheath tumours and 1 percent unclassified neoplasms. Men and women were equally affected. Meningiomas and pituitary adenomas were more frequent than in other reported series. Metastases were relatively more frequent in the spinal than in the intracranial group. Of the primary spinal tumours, those of nerve sheath origin were nearly three times as common as the meningiomas (AU)

Risk factors for carcinoma of the uterine cervix in Jamaican women

Risk factors of cervical cancer include early age at coitus, multiple sexual partners and antibodies to herpes simplex virus, type 2 (HSV-2). To examine the interrelationships of these risk factors, a comparison was made between 78 histologically confirmed cancer cases (stages O-IV) and 151 control women in Jamaica. The rank of order of the percentages of control women with low socioeconomic status, first coitus before 20 years of age, first pregnancy before 20 years of age and more than two sexual partners were: 77, 97, 65, and 76 respectively. The percentage of women with cancer who had first coitus before 20 years of age (77) and 2 or more partners (55) were lower than that of controls. A third factor associated with cervical cancer is the presence of HSV-2 antibodies. The age-specific prevalence of HSV-2 antibodies varied from 7 percent to 32 percent in women aged 21-69 years. An increase in prevalence of HSV-2 was observed with increasing age. The age-adjusted prevalence was 11 per cent. The age-specific occurrence of HSV-2 antibodies in cancer cases were not statistically significant as compared with matched controls (p> 0.01). The data suggest that infection with HSV-2 is a covariable of venereal factors, and the role of the virus in the genesis of some cases of cervical cancer in Jamaican women may not be excluded (AU)

Asymptomatic microadenomas of the pituitary gland in an unselected autopsy series

Three hundred and fifty pituitary glands were studied in an selected autopsy series. The ages of the cases ranged from newborn to 104 years. None had clinical manifestations of pituitary dysfunction. Thirty-five glands (10 percent) showed 40 microadenomas which were distributed equally among males and females, occuring most frequently in the 8th decade. The clinical and autopsy records and X-ray films of the patients with microadenomas were reviewed. Of these, 50 percent were hypertensive, 20 percent were known diabetics and 14 percent were mildly to moderately obese. Two of the eight available X-ray films showed minor abnormalities of the sella turcica. The tumours were less than 5 mm in diameter and half of them were located away from the periphery of the gland. The findings were compared with those of other series (AU)

Massive congenital intracranial teratoma: report of a case in an hydrocephalic foetus

A large intracranial teratoma which replaced the entire brain is described in an hydrocephalic foetus which was aborted at the 25th week of gestation. This very rare condition is reported for the first time in the Caribbean literature (AU)

Berry aneurysms of the circle of Willis: results of an autopsy study at the University Hospital of the West Indies

A detailed study of berry aneurysms of the Circle of Willis, in a consecutive autopsy series, was conducted at the University Hospital during the 10-year period 1973 to 1982. There were 70 patients with berry aneurysms in a total of 3,650 autopsies, giving a prevalence of 1.9 percent. Of 70 cases, 66 had ruptured, all of which were fatal. In 75 percent of cases, the diagnosis was made at post-mortem. Sixty percent of patients had associated hypertension. Physical stress did not appear to be a precipitating factor in causing rupture. Aneurysms occurred equally in men and women but multiple aneurysms occurred most commonly in elderly hypertensive women. The peak age at occurrence was in the third and fourth decades. The majority of aneurysms (91 percent) were located in the anterior circulation, and 37 percent of those that had ruptured were situated in the middle cerebral artery. The results of our study are similar to those found in other autopsy series, thus defying the general opinion that berry aneurysms are uncommon in our population since many of the cases were undiagnosed during life (AU)

Isolated torsion of the fallopian tube

Isolated torsion of the fallopian tube is an uncommon and ill-understood condition which presents as an acute abdominal emergency. It has not been previously reported from this region. The diagnostic difficulties, pathophysiology and management are discussed. It is suggested that better awareness of the condition may result in earlier diagnosis and treatment, with possible salvage of the affected tube (AU)

Antibodies to herpes simplex virus (types 1 and 2) in Jamaican patients with cervical dysplasia and neoplasia

Antibody activity to Herpes simplex virus (HSV) types 1 and 2 was measured in sera from women with cervical dysplasia (19 cases), squamous-cell carcinoma, stages 0-4 (54 cases), other genital tumours (15 cases) and matched controls (60 cases) by the indirect immunofluorescent (IFA) test. The frequency of HSV-2 antibody activity was significantly greater in women with cervical cancer than in those with other genital tumours and in matched controls (p<0.05). No significant difference was observed for the HSV-2 antibody activity between women with cervical dysplasia and matched controls. The mean antibody titres to HSV-1 and HSV-2 were significantly higher in cancer cases than the respective titres in control groups (p<0.05). The cervical cancer cases were also analysed according to their clinical stage (Stages 0-4), and there was no significant variation either in frequency of antibody activity, or mean HSV-2 antibody titres. These preliminary findings suggest that there may be an association between HSV-2 and squamous cell carcinoma of uterine cervix in Jamaican women but further studies are required for meaningful conclusions to be drawn (AU)

Endometriosis in Jamaica: report on a 15-year study at the University Hospital of the West Indies (1968-1982)

A clinical and pathological study on 108 cases of endometriosis observed at the University Hospital of the West Indies during a 15-year period (1968-1982) is reported. A low incidence was found when compared with similar studies conducted elsewhere. The peak age at occurence was 36 years. Common clinical manifestations were pelvic pain, infertility, dysmenorrhoea, menorrhagia and dyspareunia. A preoperative diagnosis of endometriosis was made very infrequently. A high index of suspicion, careful clinical examination, including family history, pelvic examinatiuon and laparoscopy are required to improve the accuracy of the clinical diagnosis. The ovaries and the pelvic peritoneum were the commonest sites affected. There was a relatively high frequency of involvement of the fallopian tubes, laparotomy scars, umbilicus, uterine cervix and the vagina (AU)

Primary infantile haemangioendothelioma of the liver

A three-week-old female infant who was admitted to the University Hospital of the West Indies in severe congestive cardiac failure developed haematological abnormalities and died two days later. At autopsy, she was found to have multicentric haemangioendotheliomas of the liver. Intractable cardiac failure and haematological abnormalities are typical manifestations of this infantile vascular tumour of the liver which may obscure the diagnosis (AU)