An analysis of the significance of the lymph node ratio and extracapsular involvement in the prognosis of endometrial cancer patients.

Introduction: The primary aim of our study was to analyse the impact of the lymph node ratio (LNR) and extracapsular involvement (ECI) on the prognosis of endometrial cancer (EC) patients. Material and methods: We carried out a retrospective analysis of 886 patients surgically treated for EC between 2000 and 2015. In the subgroup of patients with lymph node metastases (LNM), we evaluated the impact of the number and localization of the LNM, LNR, and ECI on patients' overall survival (OS). Results: In the group of patients with LNM, 0.3 was the optimal LNR cut-off for differentiating between short- and long-term survivors [HR = 2.94 (95% CI: 1.49-5.80)]. Patients with a LNR ≥ 0.3 had a significantly shorter OS period (35.0 months, range 0.2-175 months) compared to patients with a LNR < 0.3 [median OS - mOS, was 143, range 15-169 months; (p = 0.003]. We observed significant differences in the mOS of EC patients without LNM compared to patients with LNM, as well as those with both LNM and ECI (p < 0.0001). In the group of patients with LNM, we also found that a poorer prognosis depended on the extension of the primary tumour. Conclusions: Our results suggest that when LNM are found, the long-term outcomes of EC patients are worse in those who have a LNR ≥ 0.3, the presence of ECI, and a more advanced extension of the primary tumour.

[Aberrant right subclavian artery (ARSA)--a new sonographic marker for chromosomal aberrations in the second trimester--preliminary observations]. / Bladzaca prawa tetnica podobojczykowa--nowy marker aberracji chromosomowych w badaniu USG drugiego trymestru--wstepne obserwacje na materiale wlasnym.

OBJECTIVES: Presentation of our own, preliminary experiences in the assessment of the right subclavian artery's (RSA) position during the second trimester scan. MATERIAL AND METHODS: Since January 2012 our center has started to conduct the assessment of the position of the right subclavian artery in the second trimester scan. Patients who were diagnosed with an aberrant right subclavian artery (ARSA) were referred to invasive method of prenatal diagnosis. Abnormal karyotype and microdeletion 22q11 were analyzed. Detailed echocardiography was conducted in each case. RESULTS: Between January 2012 and September 2013 we diagnosed 19 cases of ARSA. There were three cases of congenital heart defect (15.8%; 3/19) (ventricular septal defect--VSD, n=2, atrioventricular septal defect--AVSD, n=1). Two out of 17 cases showed an abnormal karyotype (11.8%; 2/17)--46,XY del(5) (q15q31) and 47,XX+18. No 22q11.2 deletions were observed. Two patients did not consent to invasive methods of prenatal diagnosis. CONCLUSIONS: The position of the right subclavian artery (RSA) should be routinely assessed during the second trimester of ultrasound screening. The presence of ARSA increases the risk for abnormal karyotype in the fetus and therefore, all patients who are diagnosed with ARSA should be referred to the reference center.

[Non-invasive prenatal diagnosis of the most common aneuploidies with cell-free fetal DNA in maternal serum--preliminary results]. / Nieinwazyjna diagnostyka prenatalna najczestszych aneuploidii na podstawie plodowego DNA we krwi matki --doniesienie wstepne.

OBJECTIVES: The aim of the study was to present initial results of non-invasive prenatal diagnosis of common aneuploidies of chromosomes 21, 18 and 13 based on cell-free fetal DNA in maternal serum in high-risk patients, and to compare the results with routine karyotyping. MATERIAL AND METHODS: Before the invasive procedure, 10 ml of peripheral blood from 10 patients was collected to isolate cell-free fetal DNA and to perform a non-invasive fetal trisomy test (NIFTY provided by Beijing Genomics Institute, BGI, Shenzen, China). RESULTS: Three out of 10 samples showed an abnormal karyotype in traditional karyotyping. There were 9 conclusive NIFTY results. NIFTY detected 1 out of 2 trisomies 18. The quantity of cell-free fetal DNA in maternal plasma in the second probe with trisomy 18 was unsatisfactory fora conclusive NIFTY result. In 1 case traditional karyotyping revealed mosaicism impossible to detect with NIFTY

[Noninvasive prenatal diagnosis of trisomy 21, 18 and 13 using cell-free fetal DNA]. / Nieinwazyjna diagnostyka prenatalna trisomii 21,18 i 13 z wykorzystaniem wolnego pozakomórkowego DNA plodu.

Trisomy 21, 18 and 13 are the most common trisomies diagnosed in newborns. Screening methods consist of ultrasound and maternal serum markers. High risk for fetal aneuploidies is an indication for routine karyotyping, which requires collection of fetal tissue through amniocentesis or chorionic villous sampling. They are invasive procedures and carry a potential risk of miscarriage. The discovery of cell free fetal DNA (cffDNA) in maternal blood offered new opportunities for noninvasive prenatal diagnosis. The fraction of cell-free fetal DNA in total pool of cell-free DNA in maternal plasma is very low, therefore the analysis of cffDNA is very challenging. The introduction of massive parallel sequencing has enabled the application of noninvasive prenatal testing in the clinical practice and a variety of recent studies have proven its high efficacy in diagnosing common aneuploidies.

Expression of B7-H4 in endometrial cancer and its impact on patients' prognosis.

OBJECTIVES: The aim of the study was to evaluate the B7-H4 expression in endometrial cancer cells and to investigate its relationship with patient prognosis and clinicopathological features of the disease. MATERIAL AND METHODS: We performed a single-center, retrospective cohort study that included endometrial cancer patients treated between 2012 and 2019. B7-H4 expression in specimens obtained from 63 patients was examined by immunohistochemical staining. The evaluation of B7H4 immunoreactivity was assessed using Immunoreactivity Scoring (IRS) system. RESULTS: B7-H4 reactivity was observed in all, except one, endometrial cancer patients (98%). Staining intensity: no reaction in one case, weak in 16 (24%) patients, moderate in 25 (37%), and strong in 22 (35%). Twenty-nine (46%) patients showed B7-H4 immunoreactivity in more than 60% of cells, while, in 18 (29%) cases and 16 (25%) patients, the percentages were 30-60% and < 30% respectively. Median IRS was 2 (range 0-6). We found a significantly worse overall survival (OS) rate for patients with high versus low B7-H4 IRS (p = 0.03), however, in multivariate analysis, the difference in patient survival was close to the significance level (p = 0.052). B7-H4 expression was not related to histopathological type of the tumor, tumor grade, lymph node metastases, or the FIGO stage of the disease. CONCLUSIONS: Our result suggests that B7-H4 expression might be a useful prognostic factor in endometrial cancer.