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Sample records for assessing endometrial lesions

  1. Diffusion-Weighted Magnetic Resonance Imaging of Endometrial Cancer: Differentiation from Benign Endometrial Lesions and Preoperative Assessment of Myometrial Invasion

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    Takeuchi, M.; Matsuzaki, K.; Nishitani, H. (Dept. of Radiology, Univ. of Tokushima, Tokushima (Japan))

    2009-10-15

    Background: Uterine endometrial cancer is the most common gynecologic malignancy, and benign endometrial hyperplasia or polyps should be differentiated from endometrial cancer. In evaluating endometrial cancer on magnetic resonance imaging (MRI), the assessment of the depth of myometrial invasion is important because it closely correlates with the patient's prognosis. Purpose: To verify the feasibility of diffusion-weighted magnetic resonance imaging (DWI) to distinguish benign and malignant endometrial lesions, and to evaluate myometrial invasion of endometrial cancer. Material and Methods: Sixty-seven endometrial lesions including 45 cancers and 22 benign lesions (hyperplasia and polyps) were evaluated by DWI with apparent diffusion coefficient (ADC) measurement. The staging accuracies of DWI and gadolinium-enhanced T1-weighted images in the assessment of myometrial invasion were evaluated in 33 patients with endometrial cancer. Results: The ADC values (x10-3 mm2/s) in cancer and benign lesions were 0.84+-0.19 and 1.58+-0.36, respectively (P<0.01). The staging accuracy (superficial or deep myometrial invasion) was 94% for DWI and 88% for gadolinium-enhanced T1-weighted images. Coexisting adenomyosis and infiltrative myometrial invasion caused staging errors on gadolinium-enhanced T1-weighted images, whereas DWI could demonstrate the tumor extent correctly. Conclusion: DWI provides helpful information in evaluating benign and malignant endometrial lesions.

  2. Hysteroscopy as a standard procedure for assessing endometrial lesions among postmenopausal women

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    Camila Toffoli Ribeiro

    Full Text Available CONTEXT AND OBJECTIVES: Endometrial cancer is the most prevalent type of malignant neoplasia of the genital tract. The objective of this study was to calculate the sensitivity, specificity, accuracy and positive and negative predictive values for diagnostic hysteroscopy, in comparison with histopathological tests, for all lesions of the endometrial cavity. DESIGN AND SETTING: Retrospective descriptive study at the public tertiary-level university hospital of Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Diagnostic hysteroscopy was indicated in the following instances: endometrial thickness > 4 mm in asymptomatic patients; postmenopausal bleeding; and irregular endometrium or endometrium difficult to assess from ultrasound, with or without vaginal bleeding. Ultrasound evaluations were carried out no more than three months prior to hysteroscopy. RESULTS: There were 510 patients, with a mean age of 61.1 ± 2.0 years and mean time elapsed since the menopause of 12.7 ± 2.5 years. Endometrial biopsies were performed on 293 patients (57.5%. Histopathological analysis showed that 18 patients presented endometrial carcinoma or typical or atypical hyperplasia, and none of them presented endometrial thickness of less than 8 mm. No significant differences were found between the median thicknesses of the various benign lesions (p > 0.05. In our data, the sensitivity, specificity, accuracy and positive and negative predictive values for cancer or hyperplasia were 94.4%, 97.0%, 96.8%, 68% and 99.6%, respectively. CONCLUSIONS: Our results suggest that hysteroscopy is valuable as a diagnostic tool for malignant/hyperplastic and benign lesions, except for submucous myomas, for which the sensitivity was only 52.6%.

  3. Detection of endometrial lesions by degree of linear polarization maps

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    Kim, Jihoon; Fazleabas, Asgerally; Walsh, Joseph T.

    2010-02-01

    Endometriosis is one of the most common causes of chronic pelvic pain and infertility and is characterized by the presence of endometrial glands and stroma outside of the uterine cavity. A novel laparoscopic polarization imaging system was designed to detect endometriosis by imaging endometrial lesions. Linearly polarized light with varying incident polarization angles illuminated endometrial lesions. Degree of linear polarization image maps of endometrial lesions were constructed by using remitted polarized light. The image maps were compared with regular laparoscopy image. The degree of linear polarization map contributed to the detection of endometriosis by revealing structures inside the lesion. The utilization of rotating incident polarization angle (IPA) for the linearly polarized light provides extended understanding of endometrial lesions. The developed polarization system with varying IPA and the collected image maps could provide improved characterization of endometrial lesions via higher visibility of the structure of the lesions and thereby improve diagnosis of endometriosis.

  4. Endometrial Glandular Dysplasia (EmGD): morphologically and biologically distinctive putative precursor lesions of Type II endometrial cancers.

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    Fadare, Oluwole; Zheng, Wenxin

    2008-02-08

    In this article, the authors briefly review the historical evolution of the various putative precursor lesions for Type II endometrial cancers, with an emphasis on the newly defined "Endometrial Glandular Dysplasia (EmGD)". The evidentiary basis for delineating serous EmGD as the most probable precursor lesions to endometrial serous carcinoma is reviewed in detail. An argument is advanced for the discontinuation of the term serous "endometrial intraepithelial carcinoma (EIC)" as a descriptor for a supposedly intraepithelial, precancerous lesion. Preliminary evidence is also presented that suggests that there is a morphologically recognizable "clear cell EmGD" that probably represents a precancerous lesion to endometrial clear cell carcinomas.

  5. Endometrial Glandular Dysplasia (EmGD): morphologically and biologically distinctive putative precursor lesions of Type II endometrial cancers

    OpenAIRE

    Zheng Wenxin; Fadare Oluwole

    2008-01-01

    Abstract In this article, the authors briefly review the historical evolution of the various putative precursor lesions for Type II endometrial cancers, with an emphasis on the newly defined "Endometrial Glandular Dysplasia (EmGD)". The evidentiary basis for delineating serous EmGD as the most probable precursor lesions to endometrial serous carcinoma is reviewed in detail. An argument is advanced for the discontinuation of the term serous "endometrial intraepithelial carcinoma (EIC)" as a de...

  6. Role of Liquid-based Cytology and Cell Block in the Diagnosis of Endometrial Lesions

    OpenAIRE

    Hui Zhang; Jia Wen; Pi-Li Xu; Rui Chen; Xi Yang; Lian-Er Zhou; Ping Jiang; An-Xia Wan; Qin-Ping Liao

    2016-01-01

    Background: Liquid-based cytology (LBC) offers an alternative method to biopsy in screening endometrial cancer. Cell block (CB), prepared by collecting residual cytological specimen, represents a novel method to supplement the diagnosis of endometrial cytology. This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions. Methods: A total of 198 women with high risks of endometrial carcinoma (EC) from May 2014 to April 2015...

  7. SALINE INFUSION SONOGRAPHY IN ASSESSMENT OF ENDOMETRIAL PATHOLOGIES IN PATIENTS WITH THICKENED ENDOMETRIUM PRESENTING WITH AUB

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    Poornima

    2016-05-01

    Full Text Available Abnormal Uterine Bleeding (AUB is one of the commonest complaint of adult females presenting into the gynaecologic departments. In most of the patients the bleeding is due to the functional endometrial lesion, while the cause is hormonal in rest of the patients. These patients usually need invasive procedures like hysteroscopy or HSG for evaluation of intracavitary lesion. The aim of this study is to assess the role of Saline Infusion Sonography (SIS in detecting the intracavitary (endometrial lesions of uterus in patient with abnormal uterine bleeding and thickened endometrium on Transvaginal Ultrasound (TVS and establishing its diagnostic accuracy. METHOD This prospective hospital-based study includes SIS examination of 80 adult female patients who presented with abnormal uterine bleeding and demonstrated thickened endometrium on transvaginal ultrasound at Department of Radiodiagnosis and Imaging, Gandhi Medical College and Hamidia Hospital, Bhopal (Madhya Pradesh, for the period of six months. Written informed consent from all the patients taken. All patients were evaluated on the same day and findings were recorded. RESULT 60 patients out of 80 showed presence of functional endometrial lesion. Most common endometrial pathology was submucosal myoma followed by endometrial polyps. Most rare cases were of Uterine Synechiae {2 in number}. SIS yielded high sensitivity and specificity for intracavitary lesions and diagnostic accuracy for submucosal myoma and endometrial polyp was 100%. CONCLUSION SIS proved to be highly sensitive and specific method to diagnose intracavitary lesion of uterus. The method is minimally invasive, well tolerated and easy to carry out under hospital settings with very less incidence of post-procedural complications (No major complication in this study. It can be used to replace hysteroscopy to diagnose various intracavitary (endometrial lesion of uterus.

  8. Role of Liquid-based Cytology and Cell Block in the Diagnosis of Endometrial Lesions

    Institute of Scientific and Technical Information of China (English)

    Hui Zhang; Jia Wen; Pi-Li Xu; Rui Chen; Xi Yang; Lian-Er Zhou; Ping Jiang

    2016-01-01

    Background:Liquid-based cytology (LBC) offers an altemative method to biopsy in screening endometrial cancer.Cell block (CB),prepared by collecting residual cytological specimen,represents a novel method to supplement the diagnosis of endometrial cytology.This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions.Methods:A total of 198 women with high risks of endometrial carcinoma (EC) from May 2014 to April 2015 were enrolled in this study.The cytological specimens were collected by the endometrial sampler (SAP-1) followed by histopathologic evaluation of dilatation and curettage or biopsy guided by hysteroscopy.The residual cytological specimens were processed into paraffin-embedded CB after LBC preparation.Diagnostic accuracies of LBC and CB for detecting endometrial lesions were correlated with histological diagnoses.Chi-square test was used to compare the specimen adequacies of LBC and CB.Results:The specimen inadequate rate of CB was significantly higher than that of LBC (22.2% versus 7.1%,P < 0.01).There were 144 cases with adequate specimens for LBC and CB preparation.Among them,29 cases were atypical endometrial hyperplasia (11 cases) or carcinoma (18 cases) confirmed by histology evaluation.Taking atypical hyperplasia and carcinoma as positive,the diagnostic accuracy of CB was 95.1% while it was 93.8% in LBC.When combined LBC with CB,the diagnostic accuracy was improved to 95.8%,with a sensitivity of 89.7% and specificity of 97.4%.Conclusions:CB is a feasible and reproducible adjuvant method for screening endometrial lesions.A combination of CB and LBC can improve the diagnostic accuracy of endometrial lesions.

  9. Lesion activity assessment

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    Ekstrand, K R; Zero, D T; Martignon, S;

    2009-01-01

    . The literature suggests that there is a fair agreement between visual/tactile external scripts of caries and the severity/depth of the lesion. The reproducibility of the different systems is, in general, substantial. No single clinical predictor is able to reliably assess activity. However, a combination......This chapter focusses on the probability of a caries lesion detected during a clinical examination being active (progressing) or arrested. Visual and tactile methods to assess primary coronal lesions and primary root lesions are considered. The evidence level is rated as low (R...... in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...

  10. P53 and Murine Double Mimute 2 (MDM2) Expression Changes and Significance in Different Types of Endometrial Lesions

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    Jiang, Zhongyong; Xu, Wanqing; Dan, Gang; Liu, Yuan; Xiong, Jie

    2016-01-01

    Background Endometrial lesions are common in obstetrics and gynecology, including endometrial polyps, uterine adenomyosis, and malignant endometrial adenocarcinoma. Endometrial lesions seriously affect women’s health, fertility, quality of life, and life safety. As a pro-apoptosis gene, p53 is considered to be closely related with human tumors. Murine double mimute 2 (MDM2) is an oncogene that can promote tumor occurrence and development. P53 and MDM2 expression and significance in different types of endometrial lesions have not been fully elucidated. Material/Methods Normal endometrium, endometrial polyps, uterine adenomyosis, and endometrial adenocarcinoma tissue samples were collected. Real-time PCR was used to detect p53 and MDM2 mRNA expression. Immunohistochemical staining and Western blot analysis were applied to test p53 and MDM2 protein expression. Their correlation with clinical staging of endometrial adenocarcinoma was analyzed. Results P53 and MDM2 mRNA and protein expression were significantly elevated in the endometrial polyps group and the endometrial adenocarcinoma group compared with the normal control group (Pendometrial adenocarcinoma compared with endometrial polyps (P0.05). P53 and MDM2 mRNA and protein level showed a positive correlation. Significantly higher expression of p53 or MDM2 was observed in patients with stage III compared to those in patients with stage II. Higher expression was also observed in patients with stage II than in patients with stage I. Conclusions P53 and MDM2 mRNA and protein were elevated in endometrial polyps and endometrial adenocarcinoma and their expressions were correlated with clinical staging of endometrial adenocarcinoma. They can promote cancer occurrence and development, and can be treated to assist diagnosis and provide a reference for treatment. PMID:27924072

  11. A Structured Assessment to Decrease the Amount of Inconclusive Endometrial Biopsies in Women with Postmenopausal Bleeding

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    M.C. Breijer; N.C.M. Visser; N. Van Hanegem; A.A.M. Van Der Wurff (A. A M); B.C. Opmeer (Brent); H.C. van Doorn (Helena); B.W.J. Mol (Ben W.J.); J.M.A. Pijnenborg (Johanna); A. Timmermans

    2016-01-01

    textabstractObjective. To determine whether structured assessment of outpatient endometrial biopsies decreases the number of inconclusive samples. Design. Retrospective cohort study. Setting. Single hospital pathology laboratory. Population. Endometrial biopsy samples of 66 women with postmenopausal

  12. Luminal epithelium in endometrial fragments affects their vascularization, growth and morphological development into endometriosis-like lesions in mice

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    Dilu Feng

    2014-02-01

    Full Text Available In endometriosis research, endometriosis-like lesions are usually induced in rodents by transplantation of isolated endometrial tissue fragments to ectopic sites. In the present study, we investigated whether this approach is affected by the cellular composition of the grafts. For this purpose, endometrial tissue fragments covered with luminal epithelium (LE+ and without luminal epithelium (LE− were transplanted from transgenic green-fluorescent-protein-positive (GFP+ donor mice into the dorsal skinfold chamber of GFP− wild-type recipient animals to analyze their vascularization, growth and morphology by means of repetitive intravital fluorescence microscopy, histology and immunohistochemistry during a 14-day observation period. LE− fragments developed into typical endometriosis-like lesions with cyst-like dilated endometrial glands and a well-vascularized endometrial stroma. In contrast, LE+ fragments exhibited a polypoid morphology and a significantly reduced blood perfusion after engraftment, because the luminal epithelium prevented the vascular interconnection with the microvasculature of the surrounding host tissue. This was associated with a markedly decreased growth rate of LE+ lesions compared with LE− lesions. In addition, we found that many GFP+ microvessels grew outside the LE− lesions and developed interconnections to the host microvasculature, indicating that inosculation is an important mechanism in the vascularization process of endometriosis-like lesions. Our findings demonstrate that the luminal epithelium crucially affects the vascularization, growth and morphology of endometriosis-like lesions. Therefore, it is of major importance to standardize the cellular composition of endometrial grafts in order to increase the validity and reliability of pre-clinical rodent studies in endometriosis research.

  13. Luminal epithelium in endometrial fragments affects their vascularization, growth and morphological development into endometriosis-like lesions in mice.

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    Feng, Dilu; Menger, Michael D; Wang, Hongbo; Laschke, Matthias W

    2014-02-01

    In endometriosis research, endometriosis-like lesions are usually induced in rodents by transplantation of isolated endometrial tissue fragments to ectopic sites. In the present study, we investigated whether this approach is affected by the cellular composition of the grafts. For this purpose, endometrial tissue fragments covered with luminal epithelium (LE(+)) and without luminal epithelium (LE(-)) were transplanted from transgenic green-fluorescent-protein-positive (GFP(+)) donor mice into the dorsal skinfold chamber of GFP(-) wild-type recipient animals to analyze their vascularization, growth and morphology by means of repetitive intravital fluorescence microscopy, histology and immunohistochemistry during a 14-day observation period. LE(-) fragments developed into typical endometriosis-like lesions with cyst-like dilated endometrial glands and a well-vascularized endometrial stroma. In contrast, LE(+) fragments exhibited a polypoid morphology and a significantly reduced blood perfusion after engraftment, because the luminal epithelium prevented the vascular interconnection with the microvasculature of the surrounding host tissue. This was associated with a markedly decreased growth rate of LE(+) lesions compared with LE(-) lesions. In addition, we found that many GFP(+) microvessels grew outside the LE(-) lesions and developed interconnections to the host microvasculature, indicating that inosculation is an important mechanism in the vascularization process of endometriosis-like lesions. Our findings demonstrate that the luminal epithelium crucially affects the vascularization, growth and morphology of endometriosis-like lesions. Therefore, it is of major importance to standardize the cellular composition of endometrial grafts in order to increase the validity and reliability of pre-clinical rodent studies in endometriosis research.

  14. Cytological assessment of endometrial washings obtained with an insemination cannula and its histological correlation

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    Malik Reeni

    2008-01-01

    Full Text Available Background: Endometrial cytopathology is a powerful tool for the detection of a wide variety of benign atypias, inflammatory changes, and infectious organisms. It is also helpful for the cytohormonal evaluation of patients and the detection of endometrial malignancies. Aims: The present study was carried out to assess the sensitivity and specificity of endometrial cytology performed by using an insemination cannula. Materials and Methods: Endometrial aspiration using an insemination cannula was done in 60 cases who presented with dysuterine bleed, infertility, or postmenopausal bleed. The cytological evaluation of endometrial smears was correlated with histopathological findings with reference to cyclic endometrium, atypical hyperplasia, and endometrial malignancies. Results: There were 35 patients in the reproductive and 25 in the menopausal age groups. The sample was inadequate in four cases but there was an overall 100% correlation between cytological and histological findings of cyclic endometrium, atypical hyperplasia, and endometrial malignancy. The sensitivity and specificity of endometrial aspiration was 83.3 and 95.4% respectively, with two false negative and false positive cases. Conclusions: Endometrial aspiration cytology was found to be a safe outpatient procedure in the diagnosis of normal and abnormal endometrium for patients of all ages.The present study emphasizes the need for endometrial screening in postmenopausal patients to enable the detection of endometrial malignancies at an early stage.

  15. Sonohysterographic findings of endometrial abnormalities in women with polycystic ovarian disease

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    Lee, Eun Ju [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2004-06-15

    To describe the sonohysterographic findings of endometrial abnormalities, and to determine the usefulness of sonohysterography (SH) for predicting endometrial abnormalities in women with polycystic ovarian disease(PCOD). 82 patients with PCOD who had vaginal bleeding or endometrial thickening and lesion mass on baseline transvaginal sonography were prospectively examined with SH. The SH findings were evaluated for endometrial thickness, the presence of endometrial thickening and lesion mass, echogenicity and surface contour, distensibility of the endometrial cavity, and disruption of endometrial-myometrial interface. These findings were compared with the pathologic findings and the diagnostic accuracy of SH for predicting endometrial abnormalities was assessed. Endometrial abnormalities were identified in 47 (57.3%) of 82 PCOD patients, and their pathologic diagnosis included endometrial carcinoma in 7 cases, hyperplasia in 19 cases (atypical hyperplasia, n=5), and polyp in 21 cases. Of the 35 patients who did not have endometrial abnormalities, there was disordered proliferative endometrium in 18 cases and normal proliferative or secretory endometrium in 17 cases. The SH findings of endometrial carcinoma were endometrial thickening in 5 cases, endometrial thickening and lesion mass in 2 cases, and the endometrial thickness ranged from 6 mm to 15 mm (mean 9.5 mm). They were characterized as a diffuse polyploid endometrial thickening or a sessile endometrial mass with irregular surface, homogeneous hyperechogenicity, and obliteration of the endometrial cavity. Endometrial hyperplasia appeared as endometrial thickening in 14 cases, endometrial lesion mass in 3 cases, and endometrial thickening and lesion mass in 2 cases, and the endometrial thickness was between 6.5-10.7 mm (mean 8.2 mm). They showed a diffuse uniform endometrial thickening or a polyploid endometrial lesion mass with homogeneous hyperechogenicity and a regular surface. Endometrial polyps appeared as

  16. Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding

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    F Behnamfar

    2004-06-01

    Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.

  17. Diagnostic value of color doppler ultrasound in endometrial lesions%彩超在子宫内膜病变鉴别诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    王敏; 朱建慧

    2012-01-01

    Objective To evaluate the differential diagnostic value of color doppler ultrasound in endometrial lesions.Methods Sixty-seven patients with endometrial lesions were examined by abdominal and transvaginal ultrasound preoperatively,observing endometrial condition,all of the operation or diagnostic curettage pathological results were compared and analyzed.Results The coincidence of ultrasound diagnosis was 91.6% for endometrial polyps,90.0% for endometrial hyperplasia,87.5% for submucous myoma of uterus,93.7% for endometrial carcinoma,0% for endometrial stromal sarcoma,100% for atrophic endometritis.Conclusions The diagnostic value of color doppler ultrasound in endometrial lesions can not be replaced.%目的 探讨彩色多普勒超声对子宫内膜病变的鉴别诊断价值.方法 术前应用腹部及阴道超声观察67例子宫内膜病变患者的病灶情况,并与术后病理进行对照分析.结果 超声诊断符合率:子宫内膜息肉为91.6%,子宫内膜增生为90.0%,子宫黏膜下肌瘤为87.5%,子宫内膜癌为93.7%,子宫内膜间质肉瘤为0%,萎缩性子宫内膜炎为100%.结论 彩色多普勒超声检查对子宫内膜病变的鉴别诊断有不可替代的作用.

  18. Endometrial polyp surveillance in premenopausal breast cancer patients using tamoxifen

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    Jeon, Se Jeong; Lee, Jae Il; Kim, Hee Seung; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang

    2017-01-01

    Objective To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. Methods We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. Results Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma. Conclusion For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients. PMID:28217668

  19. Pure compared with mixed serous endometrial carcinoma: two different entities?

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    Roelofsen, T.; Ham, M.A. van; Wiersma van Tilburg, J.M.; Zomer, S.F.; Bol, M.; Massuger, L.F.A.G.; Bulten, J.

    2012-01-01

    OBJECTIVE: : To analyze whether mixed compared with pure uterine papillary serous carcinoma histology affects clinical outcome, and to assess uterine papillary serous carcinoma for its association with the precursor lesion endometrial intraepithelial carcinoma. METHODS: : A multi-institution observa

  20. 腹部超声检查子宫内膜病变的临床诊断价值%Clinical diagnostic value of abdominal ultrasonography endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    潘俊腾; 马晓静

    2014-01-01

    Objective:To explore the clinical value of abdominal ultrasonography in the diagnosis of endometrial lesions.Methods:80 cases with endometrial lesions were selected from March 2003 to April 2014.They were examined by color doppler ultrasound. Results:The ultrasound diagnosis of endometrial lesions was in 69 cases,and the diagnostic accordance rate was 86.25%.In 69 cases,35 cases were endometrial carcinoma,and the diagnosis coincidence rate was 92.1%;12 cases were endometrial polyp,and the diagnosis coincidence rate was 85.7%;13 cases were endometrial hyperplasia,and the diagnosis coincidence rate was 81.25%;9 cases were submucosal myoma of uterus,and the diagnosis coincidence rate was 75%.The pathological diagnosis:38 cases were endometrial carcinoma;14 cases were endometrial polyps;16 cases were endometrial hyperplasia;12 cases were submucosal myoma of uterus.Conclusion:The abdominal ultrasonography endometrial lesions has clear image.Check is painless and other advantages.The clinical diagnostic value in the diagnosis of abdominal diseases is high.%目的:探讨腹部超声检查对子宫内膜病变的临床诊断价值。方法:2003年3月-2014年4月收治子宫内膜病变患者80例,均采用彩色超声诊断仪进行检查。结果:本组超声诊断为子宫内膜病变69例,诊断符合率86.25%。其中子宫内膜癌35例,诊断符合率92.1%;子宫内膜息肉12例,诊断符合率85.7%;子宫内膜增生13例,诊断符合率81.25%;子宫黏膜下肌瘤9例,诊断符合率75.0%。病理诊断为子宫内膜癌38例,子宫内膜息肉14例,子宫内膜增生16例,子宫黏膜下肌瘤12例。结论:腹部超声检查子宫内膜病变具有图像清晰、检查无痛苦等优点,对诊断腹部疾病有较高的临床诊断价值。

  1. 宫腔镜联合子宫内膜病理检查在子宫内膜病变诊断中的价值%Value of hysteroscopic combined with endometrial pathology on the diagnosis of endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    刘松鸽; 赵维楠

    2015-01-01

    Objective To investigate the value of hysteroscopic combined with endometrial pathology on the diagnosis of endometrial lesions.Methods Forty-two cases of suspected endometrial lesions were given hysteroscopy,hysteroscopic combined with endometrial pathology,compare the detection accuracy.Results The pathological examination results:20 patients with endometrial hyperplasia,10 patients with endometrial polyps,12 patients with endometrial cancer.The positive predictive value of hysteroscopy endometrial lesions was 79.41%,the negative predictive value was 11.11%,the sensitivity was 76.92%,the specificity was 90.00%.The positive predictive value of hysteroscopy combined with endometrial biopsy endometrial lesions was 94.59%,the negative predictive value was 57.14%,the sensitivity was 89.74%,the specificity was 80.00%.The differences were statistically significant of the two methods in the positive predictive value,negative predictive value and sensitivity (P < 0.05),but in terms of specificity,there was no significant difference (P > 0.05).Conclusions Hysteroscopy combined with endometrial pathology has important value on the diagnosis of endometrial lesions,it can significantly improve the sensitivity of the diagnosis,it is worthy for further clinical application.%目的 探讨宫腔镜联合子宫内膜病理检查在子宫内膜病变诊断中的价值.方法 对42例疑为子宫内膜病变的患者分别进行宫腔镜、宫腔镜联合子宫内膜病理检查,比较两者检测的准确性.结果 病理检查结果为:子宫内膜增生20例,子宫内膜息肉10例,子宫内膜癌12例.宫腔镜检查子宫内膜病变的阳性预测值为79.41%,阴性预测值为11.11%,灵敏度为76.92%,特异度为90.00%.宫腔镜联合子宫内膜病理检查子宫内膜病变的阳性预测值为94.59%,阴性预测值为57.14%,灵敏度为89.74%,特异度为80.00%.两种检查方法在阳性预测值、阴性预测值及灵敏度方面比

  2. 经阴道超声诊断子宫内膜病变的临床价值%Clinical value of transvaginal ultrasound diagnosis of endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    王佳; 王堃

    2015-01-01

    Objective:To discuss the clinical value of transvaginal ultrasound diagnosis of endometrial lesions.Methods:112 patients with endometrial lesions were selected,transvaginal color Doppler ultrasound examination,analysis of ultrasonic diagnosis and pathological diagnosis rate.Results:The coincidence rate of transvaginal color Doppler ultrasound in diagnosis of endometrial hyperplasia was 80%,endometrial polyps was 97.3%,uterine submucosal myoma was 92.3%,endometrial carcinoma was 90%, endometrial hyperplasia,endometrial polyps,uterine mucous fibroids,endometrial cancer,the blood flow signals rates were 13.3%, 13.5%,38.5% and 60%.Conclusion:Transvaginal color Doppler ultrasound has a high diagnostic rate of endometrial lesions,which has the advantages of small damage,repeatability and so on.%目的:探讨经阴道彩色多普勒超声诊断子宫内膜病变的临床价值。方法:收治子宫内膜病变患者112例,经阴道彩色多普勒超声检查,分析超声诊断与病理诊断的符合率。结果:经阴道彩色多普勒超声诊断的符合率分别为子宫内膜增生80%,子宫内膜息肉97.3%,子宫黏膜下肌瘤92.3%,子宫内膜癌90%;子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、子宫内膜癌的血流信号显示率分别为13.3%、13.5%、38.5%、60%。结论:经阴道彩色多普勒超声对子宫内膜病变有较高的诊断率,具有损伤小,可重复性等优点。

  3. Subendometrial enhancement and peritumoral enhancement for assessing endometrial cancer on dynamic contrast enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Shinya [Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago (Japan); Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Kido, Aki, E-mail: akikido@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Baba, Tsukasa [Departments of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Fujimoto, Koji; Daido, Sayaka [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Matsumura, Noriomi; Konishi, Ikuo [Departments of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Togashi, Kaori [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Japan)

    2015-04-15

    Highlights: •We have assessed the peritumoral enhancement (PTE), which mimics SEE on DCE. •We evaluated the diagnostic accuracy of SEE for the myometrial invasion and the frequency of PTE. •We assessed the relationship between these enhancements and important pathologic factors. •PTE Type 1 is the main factor causing the overestimation of myometrial invasion using SEE on DCE. •PTE Type 2 correlates the myometrial invasion and may play an important role in the diagnosis of LVSI. -- Abstract: Objectives: To evaluate the diagnostic accuracy of subendometrial enhancement (SEE) in assessing the myometrial invasion in endometrial cancer, the frequency and clinical significance of peritumoral enhancement (PTE) on dynamic contrast enhanced (DCE) imaging. Materials and methods: MR images of 147 patients with endometrial cancer were retrospectively analyzed for intact SEE and PTEs: Type 1, a focal early enhancement peritumorally, and Type 2, an irregular thin-layered early intense enhancement peritumorally. Two radiologists independently assessed intact SEE and PTEs on DCE imaging and compared the lesions by the presence and depth of myometrial invasion, grade, lymphovascular space involvement (LVSI), and lymph node metastasis. The relationship between SEE, PTEs, and each factor was analyzed using univariate and multivariate analyses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for SEE. Results: The sensitivity, specificity, PPV, NPV and diagnostic accuracy for myometrial invasion based on SEE disruption on DCE were 96.6%, 32.1–46.4%, 85.8–88.5%, 69.2–76.5%, and 84.4–87.1%. According to multivariate analysis, SEE significantly predicted myometrial invasion (p < 0.0001). PTE Type 2 significantly predicted myometrial invasion presence (p < 0.05) and depth (p < 0.01). Conclusion: Diagnosis of myometrial invasion only by using SEE might be difficult on DCE-MRI due to the

  4. Three-dimensional ultrasound assessment of endometrial receptivity: a review

    Directory of Open Access Journals (Sweden)

    Alcázar Juan

    2006-11-01

    Full Text Available Abstract Three-dimensional ultrasound (3D US is a new imaging modality, which is being introduced into clinical practice. Although this technique will not probably replace two-dimensional ultrasound, it is being increasingly used. It has been reported that 3D US is a very high reproducible technique. The endometrium has been paid special attention when using this technique. The aim of this paper is to address some technical aspects of 3D US and to review critically its current status in evaluating endometrial function with special focus in its role in predicting pregnancy in assisted reproductive techniques. In spontaneous cycles endometrial volume grows during follicular phase remaining constant through the luteal phase. Endometrial vascularization increases during follicular phase peaking 2–3 days before ovulation, decreasing thereafter and increasing again during mid and late luteal phase. Data from studies analysing the role of 3D US for predicting IVF outcome are controversial. An explanation for these controversial findings might be different design of reported studies, specially the timing of ultrasound evaluation.

  5. Endometrial Stromal Hyperplasia: An Underrecognized Condition

    OpenAIRE

    Efthimios Sivridis; Gerasimos Koutsougeras; Alexandra Giatromanolaki

    2013-01-01

    Hyperplasia of the endometrial stroma is a poorly recognized lesion, lacking widespread recognition with most, if not all, such cases sequestrated in the literature as endometrial stromal nodules or low-grade endometrial stromal sarcomas. In this paper, we describe three examples of “endometrial stromal hyperplasia” which have a remarkable morphological similarity with the normally proliferating endometrial stroma and the endometrial stromal neoplasms, but which also possess subtle, but suffi...

  6. Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

    Directory of Open Access Journals (Sweden)

    Suna Kabil Kucur

    2013-01-01

    Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium

  7. Differentiation of the various lesions causing an abnormality of the endometrial cavity using MR imaging: emphasis on enhancement patterns on dynamic studies and late contrast-enhanced T1-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan; Kim, Bohyun; Park, Jong Min; Ryu, Jeong Ah [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Center for Imaging Science, Seoul (Korea); Kim, Mi Sung [Kwandong University College of Medicine, Department of Radiology, Myongji Hospital, Seoul (Korea); Bae, Duk Soo [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea); Ahn, Geung Hwan [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Pathology, Seoul (Korea)

    2006-07-15

    The objectives of this study were to determine the usefulness of magnetic resonance (MR) imaging in the differentiation of various lesions causing an abnormality of the endometrial cavity by evaluating the imaging features on dynamic contrast-enhanced study and late contrast-enhanced T1-weighted images (T1WI). Contrast-enhanced MR imaging of 59 pathologically proven lesions that showed an abnormality of the endometrial cavity, including 32 endometrial cancers, five sarcomas, nine hyperplastic polyps, nine submucosal myomas, three hyperplasia, and one adenomyoma, were retrospectively reviewed. The enhancement degree and patterns on dynamic contrast-enhanced study and late contrast-enhanced T1WI were compared among different pathologies. On dynamic contrast-enhanced study, 72% (23/32) of endometrial cancers showed early peak enhancement to be reached within 1 min following intravenous administration of contrast material. On late-contrast-enhanced T1WI, lesions showed weak enhancement with gradual washout. Ninety-five percent (21/22) of benign lesions and 100% (5/5) of sarcomas showed late peak enhancement to be reached in 2-3 min following intravenous administration of contrast material. On late contrast-enhanced T1WI, both of these lesions showed persistent strong enhancement. Different enhancement patterns on dynamic contrast-enhanced MR imaging and late contrast-enhanced T1WI can provide a useful clue in the differentiation of various lesions causing an abnormality of the endometrial cavity. (orig.)

  8. Effectiveness of Application of TVCDS in Diagnosis of Endometrial Lesions%经阴道彩色多普勒超声对子宫内膜病变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    潘菊花; 何晖

    2015-01-01

    目的:探讨经阴道彩色多普勒超声在诊断子宫内膜病变中的应用价值。方法回顾性分析我院收治的167例经手术病理证实的子宫内膜病变患者的经阴道彩色多普勒超声检查资料。结果子宫内膜增生过长及子宫内膜癌患者内膜厚度均>10 mm,最厚达27 mm;子宫内膜癌均伴有宫腔积液;子宫内膜增生过长、子宫内膜息肉、子宫粘膜下肌瘤之间的动脉阻力指数(RI)无显著差异(P>0.05),而这些良性病变与子宫内膜癌患者的RI值有显著差异(P10 mm with the maximum thickness of 27 mm. All the endometrial carcinoma were accompanied with endometrial effusions. No statistically significant differences were found between the arterial RI (Resistance Index) of endometrial hyperplasia, endometrial polyps and submucous myoma (P>0.05). There were statistically signiifcant differences between the RI of benign lesions and patients with endometrial carcinoma (P<0.05). In contrast with the pathologically-conifrmed results, the accurate diagnostic rate of TVCDS in endometrial polyps, submucous myoma, endometrial hyperplasia and endometrial carcinoma were 91.3%, 95.1%, 96.9% and 92.0% respectively.ConclusionTVCDS demonstrated itself as a diagnostic method with the high detection rate of endometrial lesions and minimal damage to patients’ uteruses, which deserved wider clinical promotion.

  9. The value of transvaginal in the diagnosis of postmenopausal uterine endometrial lesions%经阴道超声诊断绝经后子宫内膜病变应用价值

    Institute of Scientific and Technical Information of China (English)

    刘晓婷; 于韬; 邬晓明

    2014-01-01

    Objective:To study the diagnostic value of transvaginal color doppler ultrasonography examination for postmenopausal womens' uterine endometrial lesions. Methods:The features of ultrasonography and color doppler flow imaging from 125 postmenopausal patients with uterine endometrial lesions were analysed retrospectively. All lesions were confirmed by endometrial biopsy or curetage pathology. Results:The detection rate of transvaginal color doppler ultrasound for uterine endometrial polyps was 86. 57%(58/67),the detection rate for endometrial hyperplasia was 90. 00%(27/30),for endometrial cancer was 82. 35%(14/17),RI in lesions was 0. 42 ± 0. 15,the detection rate for submucous myomas was 54. 55%(6/11). Conclusion:Transvaginal color doppler ultrasonography examination is an effectve method for postmenopausal womens' uterine endometrial lesions.%目的:探讨经阴道彩色多普勒超声对绝经后妇女子宫内膜病变的诊断价值。方法:对125例绝经后出现阴道出血症状患者的子宫内膜声像图及彩色多普勒血流显像进行回顾性分析。所有病灶以子宫内膜活检或刮宫病理证实。结果:经阴道彩色多普勒超声子宫内膜息肉诊断符合率为86.57%(58/67),子宫内膜增生过长诊断符合率为90.00%(27/30),子宫内膜癌诊断符合率为82.35%(14/17),病灶内RI值平均为0.42

  10. Endometrial Intraepithelial Neoplasia (EIN) in endometrial biopsy specimens categorized by the 1994 World Health Organization classification for endometrial hyperplasia.

    Science.gov (United States)

    Li, Xiao-Chao; Song, Wen-Jing

    2013-01-01

    Our study is to determine the presence of endometrial intraepithelial neoplasia (EIN) in endometrial biopsy specimens classified by the 1994 World Health Organization (WHO) criteria for endometrial hyperplasia. Endometrial biopsy specimens that were stained with hematoxylin and eosin (HE) were examined and categorized by the WHO 1994 criteria and for the presence of EIN as defined by the International Endometrial Collaborative Group. β-catenin expression was examined by immunohistochemistry. A total of 474 cases of HE stained endometrial biopsy tissues were reviewed. There were 379 cases of simple endometrial hyperplasia, 16 with simple atypical endometrial hyperplasia, 48 with complex endometrial hyperplasia, and 31 with complex atypical endometrial hyperplasia. Among the 474 endometrial hyperplasia cases, there were 46 (9.7%) that were classified as EIN. Of these 46 cases, 11(2.9%) were classified as simple endometrial hyperplasia, 1 (6.3%) as simple atypical endometrial hyperplasia, 6 (12.5%) as complex endometrial hyperplasia, and 28 (90.3%) as complex atypical endometrial hyperplasia. EIN was associated with a higher rate of β-catenin positivity than endometrium classified as benign hyperplasia (72% vs. 22.5%, respectively, P hyperplasia, high β-catenin expression was noted in the cell membranes, whereas in EIN and endometrial adenocarcinoma high expression was noted in the cytoplasm. In conclusion, EIN is more accurate than the WHO classification for the diagnosis of precancerous lesions of the endometrium.

  11. "Assessment of endometrial cancer risk factors in a pilot study at Vali-e-Asr unit, Imam Khomeini hospital "

    Directory of Open Access Journals (Sweden)

    "Ghaemmaghamei F

    2001-05-01

    Full Text Available This study was performed to identify endometrial Cancer risk factors. In a case series study on 1989-1996 , we assessed endometrial cancer in 52 patients whose age range was 32-80 years, with 73% over fifty years. Obesity was seen in 68% at time of cancer detection , and 69% were in the postmenopausal age, with a history of late menopause in 21%. As a matter of parity 13% were nulliparous, and 52% were grandmultiparous. There was a history of hypertension in 37% and ovarian tumors and polyeystic ovaian disease in 2%. The most common symptom in our patients was vaginal bleeding and the most frequent histology was endometrioid adenocarcinoma. Endometrial cancer was most common in the sirth decade of age. The two most common risk factors in this population were obesity and hypertension. The next important risk factor was late menopause.

  12. 磁共振扩散加权成像在子宫内膜病变鉴别诊断中的价值%Value of Diffusion-weighted MRI Imaging in Differential Diagnosis of Uterine Endometrial Lesions

    Institute of Scientific and Technical Information of China (English)

    相世峰; 项剑瑜; 王为知; 张淑平; 金鑫行; 王廷昱

    2012-01-01

    Objective To investigate the value of diffusion - weighted imaging( DW1) and apparent diffusion coefficient (ADC) in the differentiation of endometrial carcinomas, endometrial hyperplasia and endometrial polyps and degeneration of uterine sub mucous. Methods Conventional MRI and DWI were preformed in 25 patients with endometrial carcinomas, 6 patients with endometrial hyperplasi-a,4 patients with endometrial polyps-and 1 patients with degeneration of uterine sub mucous. All images were reviewed and apparent diffusion coefficient (ADC) values were measured in all the lesions shown in all endometrial lesions. Results High signal intensity in DWI was showed in 25 cases of endometrial carcinomas, and the mean ADC value was (0.78±0.06)×10-3 mm2/s. 6 cases of endometrial hyperplasia had slightly high signal in DWI,and the average ADC value was (1.41 ± 0. 12)×103 mm2/s.4 cases of endometrial polyps in DWI had slightly high signal, and the average ADC value was (1.33±0.07)×103 mm2/s. 1 cases of degeneration of uterine sub mucous in DWI had the signals,and the ADC value was (2. 19 ±0.25)×103 mm /s. There was no statistically significant difference between endometrial hyperplasia and endometrial polyps is ADC value (P>0.05) ,and the remaining had statistically significant differences (P< 0. 05). Conclusions DWI and ADC value can effectively reflect the diffusion properties of water in different lesions. So it has great value in the differentiation all endometrial lesions.%目的 探讨磁共振扩散加权成像( DWI)以及表观扩散系数(ADC)在子宫内膜癌、子宫内膜增生、子宫内膜息肉及子宫黏膜下肌瘤变性鉴别诊断中的价值.方法 收集经病理证实的子宫内膜癌25例、子宫内膜增生6例、子宫内膜息肉4例、子宫黏膜下肌瘤变性1例,所有病例行常规MRI及DWI检查,测量并比较所有子宫内膜病变的ADC值.结果 25例子宫内膜癌在DWI上均呈明显高信号,平均ADC值为(0.78±0.06)

  13. Evaluation of the clinical pathway for the diagnosis of endometrial lesions in postmenopausal women%绝经后妇女子宫内膜病变的临床诊断路径探讨

    Institute of Scientific and Technical Information of China (English)

    王金娟; 成九梅; 段华

    2012-01-01

    目的 探索超声检测子宫内膜厚度≥5 mm的绝经后妇女,常规采用宫腔镜活检和病理检查这一临床路径对绝经后妇女子宫内膜病变的诊断价值.方法 回顾性分析我院2007年1月至2010年1月B超提示子宫内膜厚度≥5 mm并完成了宫腔镜活检及病理检查的绝经后妇女232例,探讨子宫内膜厚度与子宫内膜病变的关系,并比较宫腔镜检查结果与病理检查结果诊断的一致性.结果 本组232例中,子宫内膜厚度5~7 mm组87例,子宫内膜厚度≥8 mm组145例.经宫腔镜活检和病理检查,子宫内膜厚度5~7 mm组诊断为子宫内膜癌4例,子宫内膜非典型增生5例:子宫内膜厚度≥8 mm组诊断为子宫内膜癌23例,子宫内膜非典型增生24例.经x2检验,子宫内膜厚度5~7 mm组与≥8 mm组子宫内膜病变分布有显著性差异(x2=14.497,P=0.001).同时,宫腔镜检查结果与病理检查结果诊断符合率,子宫内膜息肉为82%,黏膜下肌瘤为100%,内膜增生为87%,内膜癌为100%.经kappa检验显示,二者诊断存在较好的一致性(K=0.8037,P< 0.05).结论 对于超声检测子宫内膜厚度≥5rnm的绝经后妇女,常规采用宫腔镜活检和病理检查这一临床路径,在早期发现子宫内膜癌前病变及子宫内膜癌方面更具优势.%Objective To explore the value of conventional hysteroscopy biopsy and pathological examination clinical pathway for the diagnosis of endometrial disease in postmenopausal women whose endometrial thickness ≥ 5 mm in ultrasonographic examination. Methods 232 cases of postmenopausal patients whose endometrial thickness ≥5 mm in the ultrasonographic examination and underwent hysteroscopy biopsy and pathological examination from January 2007 to January 2010 was retrospectively studied. The relationship between endometrial thickness and endometrial lesions was calculated by x2 test. And kappa test was used to evaluate the diagnostic agreement between the

  14. 经阴道彩色多普勒超声诊断绝经后子宫内膜病变%Transvaginal color Doppler ultrasonography in diagnosis of postmenopausal uterine endometrial cavity ;lesions

    Institute of Scientific and Technical Information of China (English)

    刘晓婷; 于韬; 罗娅红

    2015-01-01

    目的:探讨经阴道彩色多普勒超声(TV-CDU)检查对绝经后阴道出血患者子宫内膜病变的诊断价值。方法:对93例绝经后出现阴道出血症状患者子宫内膜的超声声像图进行回顾性分析,所有病灶以子宫内膜活检或刮宫病理证实。结果:TV-CDU诊断子宫内膜病变与病理结果的符合率为90.32%(84/93),灵敏度为84.62%,特异度为91.25%,病灶内阻力指数(RI)平均值为0.39±0.17。结论:TV-CDU对绝经后出现阴道出血患者子宫内膜病变的诊断具有一定的临床应用价值。%Objective:To observe the value of transvaginal color Doppler ultrasonography (TV-CDU) in diagnosis of uterine endometrial cavity lesions in postmenopausal women. Methods:TV-CDU manifestations of 93 patients with uterine endometrial cavity lesions conifrmed pathologically were retrospectively analyzed. Results:The detection rate of TV-CDU for uterine endometrial cavity lesions was 90.32%(84/93), the sensitivity was 84.62%, and the speciifcity was 91.25%. The mean resistance index (RI) value of the lesions was 0.39±0.17. Conclusion:TV-CDU is useful in diagnosis of uterine endometrial cavity lesions in postmenopausal women.

  15. Transvaginal color Doppler ultrasound in the diagnosis of endometrial lesions%经阴道彩色多普勒超声在子宫内膜病变诊断的应用价值

    Institute of Scientific and Technical Information of China (English)

    高鸣

    2015-01-01

    目的 探讨经阴道彩色多普勒超声在子宫内膜病变诊断中的应用价值,总结其应用经验.方法 对90例不规则阴道流血患者行经阴道彩色多普勒超声检查,分析其超声影像学资料,并将超声检查结果与诊刮以及患者术后病理诊断结果相对照.结果 本研究90例患者经阴道彩色多普勒超声检查确诊86例,其中子宫内膜增生36例、子宫内膜息肉42例,子宫内膜癌8例,确诊率为95.64%;漏诊4例,漏诊率为4.36%,其中1例子宫内膜癌病变,3例子宫内膜增生病变.结论 经阴道彩色多普勒超声检查子宫内膜病变操作简便、准确性高,超声检查时应注意测量子宫内膜厚度,观察内膜形态、内膜与肌层的关系、内膜回声特点以及子宫内膜内血流情况及阻力指数,作为诊断子宫内膜病变的重要检查方法,还需要结合患者的临床表现及其他影像学检查手段,以提高其确诊率.%Objective To investigate the application value of transvaginal color Doppler ultrasound in the diagnosis of endometrial lesions,and summarize the application experience.Methods Ninety patients with irregular vaginal bleeding underwent transvaginal color Doppler ultrasound examination,the ultrasound image data were analyzed,and the ultrasonic inspection results and curettage and postoperative pathological diagnosis results were compared.Results Among the 90 cases,86 cases were diagnosed by transvaginal color Doppler ultrasound,of which 36 cases of endometrial hyperplasia,42 cases of endometrial polyps,endometrial carcinoma in 8 cases,the diagnosis rate was 95.64% ; 4 cases of missed diagnosis,the missed diagnosis rate was 4.36%,in which l case of endometrial carcinoma lesions,3 cases of uterus hyperplasia lesions.Conclusions Transvaginal color Doppler ultrasonography for endometrial lesions has simple operation,high accuracy,we should pay attention to measure the thickness of endometrium,endometrial morphology

  16. Detection activity assessment and diagnosis of dental caries lesions

    DEFF Research Database (Denmark)

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-01-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment...... and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process...

  17. Endometrial receptivity: clinical assessment in relation to fertility, infertility, and antifertility.

    Science.gov (United States)

    Makker, Annu; Singh, M M

    2006-11-01

    Fertility in humans and other mammalian species depends absolutely on synchronous events that render the developing blastocyst and the receiving uterus competent for implantation. Endometrial receptivity is defined as the period during which the endometrial epithelium acquires functional, but transient, ovarian steroid-dependent status supportive to blastocyst acceptance and implantation. Once inside the uterus, the blastocyst is surrounded by an intact luminal epithelium, which is considered to act as barrier to its attachment, except for this short period of high endometrial receptivity to blastocyst signal(s). Its transport and permeability properties, in conjunction with cellular action of the endometrium and the embryo, have been suggested to influence creation and maintenance of informational and nutritional status of uterine luminal milieu. This period, also termed as the 'window of implantation,' is limited to days 20-24 of menstrual cycle in humans. However, establishment of endometrial receptivity is still a biological mystery that remains unsolved despite marked advances in our understanding of endometrial physiology following extensive research associated with its development and function. This review deals with various structural, biochemical, and molecular events in the endometrium coordinated within the implantation window that constitute essential elements in the repertoire that signifies endometrial receptivity and is aimed to achieve a better understanding of its relationship to fertility, infertility, and for the development of targeted antifertility agents for human use and welfare.

  18. The study of transvaginal color doppler ultrasound in the diagnosis of endometrial lesions%经阴道彩色多普勒超声在子宫内膜病变诊断中的应用研究

    Institute of Scientific and Technical Information of China (English)

    刘津; 杜宇

    2013-01-01

    目的 探讨阴道彩色多普勒超声在子宫内膜病变诊断中的临床价值.方法 选取2006年1月~2011年12月期间在某院妇科门诊及住院部病理检查确诊为子宫内膜病变的患者82例,均行阴道彩色多普勒超声检查及腹部超声多普勒超声检查,分析超声诊断与病理检查结果间诊断符合率.结果 阴道超声检查诊断符合者76例,诊断符合率92.68%,误诊6例,误诊率7.32%,子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、萎缩性子宫内膜、子宫内膜癌的诊断符合率分别为92.11%、95.65%、100.00%、80.00%、75.00%,腹部超声检查诊断符合者47例,诊断符合率57.32%,误诊35例,误诊率42.68%,子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、萎缩性子宫内膜、子宫内膜癌的诊断符合率分别为60.53%、56.52%、58.33%、40.00%、50.00%,子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤诊断符合率、整体诊断符合率在不同超声检查方法间比较(萎缩性内膜与子宫内膜癌例数太少未作统计学比较),差异均有统计学意义(P<0.05).阴道超声检查良性病变血流信号显示率21.92%,动脉阻力指数(0.72±0.13),恶性病变血流信号显示率100.00%,动脉阻力指数(0.38±0.09),差异有统计学意义(P<0.05).结论 经阴道彩色多普勒超声检查子宫内膜病变诊断准确性明显高于腹部超声检查,建议作为已婚妇女检查子宫内膜病变的常规方法.%OBJECTIVE To investigate vaginal color doppler ultrasound in the diagnosis of endometrial lesions clinical value. METHODS Between 2006 January and December 2011, 82 patients with endometrial lesions in outpatient and inpatient department of gynecological pathologic were performed with vaginal color doppler ultrasound examination and abdominal ultrasound doppler ultrasound examination, the analysis of the diagnosis coincidence rate between ultrasonic diagnosis and

  19. Detection activity assessment and diagnosis of dental caries lesions.

    Science.gov (United States)

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-07-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process, additional methods could aid the dentist in reaching a more appropriate treatment decision in some cases. The ICDAS, including the activity assessment system or the Nyvad system, seems to be the best option to reach final diagnoses for managing lesions. The radiographic method is the most recommended additional method available for daily clinical practice.

  20. Assessing Elementary Lesions in Gout by Ultrasound

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Christensen, Robin;

    2015-01-01

    OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients. METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first......, respectively. The best reliability was seen for erosions (κ 0.74, 95% CI 0.65-0.81) and lowest for aggregates (κ 0.21, 95% CI 0.04-0.37). CONCLUSION: This is the first step to test consensus-based US definitions on elementary lesions in patients with gout. High intraobserver reliability was found when applying...

  1. Avaliação de morfologia e histologia endometrial de mulheres após a menopausa Assessment of endometrial morphology and histology in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Luis Paulo Galvao Wolff

    2010-01-01

    Full Text Available OBJETIVO: Avaliar ambulatorialmente a morfologia e histologia endometrial de mulheres sem sangramento genital após a menopausa. MÉTODOS: Em estudo descritivo foram selecionadas 52 mulheres, após a menopausa, entre 50 e 60 anos, sem terapia hormonal nos últimos seis meses. Todas foram submetidas a exame ultrassonográfico, histeroscópico e biópsias endometriais. RESULTADOS: Das 52 mulheres selecionadas 32 (61,5% apresentaram ultrassonografia normal, cavidade uterina normal com endométrio atrófico à histeroscopia, confirmada pela biópsia endometrial. Vinte (38,4% apresentaram achados histeroscópicos ou histológicos anormais, sendo que apenas cinco destas mostraram endométrio com espessura superior a cinco milímetros ao ultrassom. CONCLUSÃO: A histeroscopia diagnóstica associada à biópsia aspirativa (Pipelle pode evidenciar alterações não observadas ao ultrassom transvaginal.OBJECTIVE: Evaluate in outpatients , the endometrial morphology and histology of non- bleeding postmenopausal women. METHODS: We conducted a descriptive study where 52 menopausal women were selected, between 50 and 60 years of age, who had not used hormone replacement therapy in the last six months and did not present any kind of vaginal bleeding after menopause. These women underwent ultrasound examination, hysteroscopy and biopsy, and then endometrial findings were analyzed. RESULTS: Of the 52 women selected, thirty two (61,5% had normal ultrasound, normal uterine cavity with atrophic endometrium, hysteroscopy, confirmed by endometrial biopsy. Twenty (38,4% had hysteroscopuc and histologic alterations and only five women showed by ultrasound an endometrial thickness of more than five millimeters. CONCLUSION: Diagnostic Hysteroscopy associated with aspiration biopsy (Pipelle performed in the day care facility can reveal endometrial alterations that cannot be diagnosed by transvaginal ultrasound.

  2. MR findings of ruptured endometrial cyst: Comparison with tubo-ovarian abscess

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Shigeru, E-mail: shig.suz@gmail.com [Department of Radiology, Saitama Red Cross Hospital, 8-3-33 Kamiochiai, Chuo-ku, Saitama, 338-8553 (Japan); Yasumoto, Mayumi, E-mail: Mayumihoo@yahoo.co.jp [Department of Radiology, Saitama Red Cross Hospital, 8-3-33 Kamiochiai, Chuo-ku, Saitama, 338-8553 (Japan); Matsumoto, Reiko, E-mail: rad@saitama-med.jrc.or.jp [Department of Radiology, Saitama Red Cross Hospital, 8-3-33 Kamiochiai, Chuo-ku, Saitama, 338-8553 (Japan); Andoh, Akihiko, E-mail: a-andoh@silk.plala.or.jp [Department of Obstetrics and Gynecology, Saitama Red Cross Hospital, 8-3-33 Kamiochiai, Chuo-ku, Saitama, 338-8553 (Japan)

    2012-11-15

    Objective: To evaluate the MR findings of ruptured endometrial cyst, focusing on the differentiation from tubo-ovarian abscess (TOA). Patients and methods: We reviewed the records of 21 patients who underwent preoperative MR examinations for TOAs (n = 15) or ruptured endometrial cysts (n = 6). We evaluated the presence of hyper-intense ascites and hyper-intense peritoneum in T1-weighted sequences, strong enhancement of the peritoneum, hyper-intense content and hyper-intense rim of the ovarian lesion in T1-weighted sequences, and strong wall enhancement of the ovarian lesion. {chi}{sup 2} test was used to assess the relationship between TOA cases versus cases with ruptured endometrial cysts, and the three MR peritoneal findings. We evaluated the relationship between TOA versus non-infected endometrial cysts, and the ovarian MR peritoneal findings, too. Results: Hyper-intense ascites was found in all of the patients with ruptured endometrial cyst and none with TOA (p < 0.0001). Hyper-intense peritoneum was observed in only TOAs cases (4 of 8). Strong peritoneal enhancement was seen in 3 of the 3 patients with ruptured endometrial cyst and 7 of the 13 patients with TOA (p = 0.1366). Hyper-intense content of the ovarian lesion was seen more often in the non-infected endometrial cysts than in the TOAs (p = 0.001607), while hyper-intense rim was more frequent in TOAs (p = 0.000402). Strong wall enhancement was observed only in TOAs (11 of 15) (p = 0.001355). Conclusions: MR images are useful to differentiate ruptured endometrial cyst from TOA.

  3. Optical Assessment of Caries Lesion Structure and Activity

    Science.gov (United States)

    Lee, Robert Chulsung

    New, more sophisticated diagnostic tools are needed for the detection and characterization of caries lesions in the early stages of development. It is not sufficient to simply detect caries lesions, methods are needed to assess the activity of the lesion and determine if chemical or surgical intervention is needed. Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface lesion structure and measure the thickness of the highly mineralized surface zone. Other studies have demonstrated that the rate of dehydration can be correlated with the lesion activity and that the rate can be measured using optical methods. The main objective of this work was to test the hypothesis that optical methods can be used to assess lesion activity on tooth coronal and root surfaces. Simulated caries models were used to develop and validate an algorithm for detecting and measuring the highly mineralized surface layer using PS-OCT. This work confirmed that the algorithm was capable of estimating the thickness of the highly mineralized surface layer with high accuracy. Near-infrared (NIR) reflectance and thermal imaging methods were used to assess activity of caries lesions by measuring the state of lesion hydration. NIR reflectance imaging performed the best for artificial enamel and natural coronal caries lesion samples, particularly at wavelengths coincident with the water absorption band at 1460-nm. However, thermal imaging performed the best for artificial dentin and natural root caries lesion samples. These novel optical methods outperformed the conventional methods (ICDAS II) in accurately assessing lesion activity of natural coronal and root caries lesions. Infrared-based imaging methods have shown potential for in-vivo applications to objectively assess caries lesion activity in a single examination. It is likely that if future clinical trials are a success, this novel imaging

  4. Thalidomide in Treating Patients With Recurrent or Persistent Endometrial Cancer

    Science.gov (United States)

    2013-01-23

    Endometrial Adenoacanthoma; Endometrial Adenocarcinoma; Endometrial Adenosquamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma

  5. CYTO - HISTO CORRELATION OF ATYPICAL GLANDULAR CELLS OF ENDOMETRIAL ORIGIN ON CERVICAL CYTOLOGY IN ABNORMAL UTERINE BLEEDING CASES

    Directory of Open Access Journals (Sweden)

    Lopa Mudra

    2015-02-01

    Full Text Available BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology , t he 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases . SETTINGS AND DESIGN : The study was conducted at JSS hospital , Mysore in the department of pathology. This was a descriptive type of study. The sample was collected fro m patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital . MATERIALS AND METHODS : Smears for cervical cytology are collected using either pap smear or manual liquid based smear from 82 patients in the age grou p of 20 - 75 years with complaints of abnormal bleeding history. The results of cervical cytology were compared and confirmed with the endometrial pathology. RESULTS : Out of 82 abnormal uterine bleeding cases 14 showed atypical endometrial cells. On follow u p of these cases , the results indicated an association between atypical endometrial cells in cervical cytology with endometrial carcinoma in 8 cases (60% , 1 case with complex hyperplasia with atypia (10% . CONCLUSION : Presence of atypical endometrial cell s in all women with abnormal uterine bleeding has considerable clinical implications & further diagnostic evaluation by endometrial sampling is of utmost importance.

  6. 不孕患者子宫内膜病变的临床病理分析%Clinical and pathological analysis of infertile patients with endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    叶松; 曹凤妹; 詹永春; 汤琪乐

    2014-01-01

    目的:探讨不孕患者子宫内膜病变的病理类型以及对治疗效果的影响。方法:选取不孕患者104例,于月经来潮后12h内行诊断性刮宫并进行病理分析。分泌反应类患者给予活血补肾为主的中医治疗,增生反应类患者给予克罗米芬口服。结果:子宫内膜病变中以分泌类反应较多,其中尤其以分泌欠佳所占比例最大,而增生类反应中以增生反应较多见。不同程度分泌异常患者随着病变严重程度增加,治疗效果也越来越差,组间比较差异明显,具有统计学意义(P<0.05)。不同类型增生异常患者治疗效果差别不大,无统计学意义(P>0.05)。结论:分泌类反应患者的病理诊断有助于对患者预后作出判断;增生类反应者虽然不同类型预后差别不大,但是治疗手段却不同,因此病理诊断也十分必要。%Objectives:To investigate the pathological type of infertility patients with endometrial lesions and their impact on the treatment effect.Methods:1 04 infertile patients were selected and applied diagnostic curet-tage within 1 2h since the beginning of menstrual period for pathological analysis.Patients in the secretory reaction class received Chinese medicine treatment highlighting Huoxue tonifying the kidney;patients in the proliferative re-sponse class were given oral clomiphene citrate.Results:Of the endometrial lesions,secretion response took the majority,especially poor secretion;while for the proliferation class,proliferative reaction was the majority.With the increasing severity degrees of diacrisis,treatment effect was getting worse and worse,with statistically significant differences between groups (P0.05).Conclusion:The pathological diagnosis of patients in the secretory response class is helpful to judge the prognosis;while for patients with proliferative response;al-though prognostic difference is not significant,treatment methods are different,so it is

  7. Endometrial cancer

    Science.gov (United States)

    ... to be at a higher risk of endometrial cancer: Colon or breast cancer Diabetes Gallbladder disease High blood ... laparoscopic - discharge Hysterectomy - vaginal - discharge Pelvic radiation - discharge Review Date 4/5/2016 Updated by: Irina Burd, ...

  8. Endometrial biopsy

    Science.gov (United States)

    ... chap 10. Read More Cancer Endometrial cancer Endometritis Infertility Menopause Uterine fibroids Vaginal bleeding - hormonal Review Date 9/26/2015 Updated by: Daniel N. Sacks MD, FACOG, obstetrics & gynecology in private practice, West Palm Beach, FL. Review ...

  9. Perimenopausal vaginal bleeding caused by endometrial lesions%围绝经期子宫内膜病变所致阴道流血

    Institute of Scientific and Technical Information of China (English)

    梁海燕; 凌斌

    2012-01-01

    For perimenopausal women, abnormal u-terine bleeding mostly resulted from endometrial disorders including dysfunctional uterine bleeding, endometrial polyp, endometritis, endometrial hyperplasia and endometrial cancer. This article summarized the salient literature on the etiology, pathology, diagnosis and management of these disorders or introduced some improvements.%围绝经期异常子宫出血的主要原因之一是子宫内膜病变,包括功能失调性子宫出血、子宫内膜炎、子宫内膜息肉、子宫内膜增殖症和子宫内膜癌等.该文总结了这些疾病的病因、病理、诊断和治疗以及相关的研究进展.

  10. Endometrial cancer arising from atypical complex hyperplasia: The significance in an endometrial biopsy and a diagnostic challenge

    OpenAIRE

    Byun, Jung Mi; Jeong, Dae Hoon; Kim, Young Nam; Cho, En Bee; Cha, Ju Eun; Sung, Moon Su; Lee, Kyung Bok; Kim, Ki Tae

    2015-01-01

    Objective We investigated the features of endometrial hyperplasia with concurrent endometrial cancer that had been diagnosed by endometrial sampling. Further, we attempted to identify an accurate differential diagnostic method. Methods We retrospectively studied 125 patients who underwent a diagnostic endometrial biopsy or were diagnosed after the surgical treatment of other gynecological lesions, such as leiomyoma or polyps. Patients were diagnosed between January 2005 and December 2013 at B...

  11. Strain Assessment in Surgically Resected Inflammatory and Neoplastic Bowel Lesions

    DEFF Research Database (Denmark)

    Havre, R F; Leh, S; Gilja, O H;

    2014-01-01

    or stenotic lesions from Crohn's disease were prospectively examined with ultrasonography using a Hitachi HV 900 US scanner with real-time elastography (RTE). Three different methods were applied to assess tissue strain: A four-level categorical visual classification, a continuous visual analog scale (VAS, 0...... methods. All adenocarcinomas had significantly higher strain ratios than adenomas. The categorical classification differentiated poorly between Crohn's lesions, adenocarcinomas and adenomas. Categorical evaluation and VAS score showed fair interobserver agreement. SR measurements provided semi...

  12. Stathmin protein level, a potential predictive marker for taxane treatment response in endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Henrica M J Werner

    Full Text Available Stathmin is a prognostic marker in many cancers, including endometrial cancer. Preclinical studies, predominantly in breast cancer, have suggested that stathmin may additionally be a predictive marker for response to paclitaxel. We first evaluated the response to paclitaxel in endometrial cancer cell lines before and after stathmin knock-down. Subsequently we investigated the clinical response to paclitaxel containing chemotherapy in metastatic endometrial cancer in relation to stathmin protein level in tumors. Stathmin level was also determined in metastatic lesions, analyzing changes in biomarker status on disease progression. Knock-down of stathmin improved sensitivity to paclitaxel in endometrial carcinoma cell lines with both naturally higher and lower sensitivity to paclitaxel. In clinical samples, high stathmin level was demonstrated to be associated with poor response to paclitaxel containing chemotherapy and to reduced disease specific survival only in patients treated with such combination. Stathmin level increased significantly from primary to metastatic lesions. This study suggests, supported by both preclinical and clinical data, that stathmin could be a predictive biomarker for response to paclitaxel treatment in endometrial cancer. Re-assessment of stathmin level in metastatic lesions prior to treatment start may be relevant. Also, validation in a randomized clinical trial will be important.

  13. Stathmin protein level, a potential predictive marker for taxane treatment response in endometrial cancer.

    Science.gov (United States)

    Werner, Henrica M J; Trovik, Jone; Halle, Mari K; Wik, Elisabeth; Akslen, Lars A; Birkeland, Even; Bredholt, Therese; Tangen, Ingvild L; Krakstad, Camilla; Salvesen, Helga B

    2014-01-01

    Stathmin is a prognostic marker in many cancers, including endometrial cancer. Preclinical studies, predominantly in breast cancer, have suggested that stathmin may additionally be a predictive marker for response to paclitaxel. We first evaluated the response to paclitaxel in endometrial cancer cell lines before and after stathmin knock-down. Subsequently we investigated the clinical response to paclitaxel containing chemotherapy in metastatic endometrial cancer in relation to stathmin protein level in tumors. Stathmin level was also determined in metastatic lesions, analyzing changes in biomarker status on disease progression. Knock-down of stathmin improved sensitivity to paclitaxel in endometrial carcinoma cell lines with both naturally higher and lower sensitivity to paclitaxel. In clinical samples, high stathmin level was demonstrated to be associated with poor response to paclitaxel containing chemotherapy and to reduced disease specific survival only in patients treated with such combination. Stathmin level increased significantly from primary to metastatic lesions. This study suggests, supported by both preclinical and clinical data, that stathmin could be a predictive biomarker for response to paclitaxel treatment in endometrial cancer. Re-assessment of stathmin level in metastatic lesions prior to treatment start may be relevant. Also, validation in a randomized clinical trial will be important.

  14. Megestrol Acetate or Levonorgestrel-Releasing Intrauterine System in Treating Patients With Atypical Endometrial Hyperplasia or Endometrial Cancer

    Science.gov (United States)

    2014-09-09

    Atypical Endometrial Hyperplasia; Endometrial Adenocarcinoma; Recurrent Endometrial Carcinoma; Stage IA Endometrial Carcinoma; Stage IB Endometrial Carcinoma; Stage II Endometrial Carcinoma; Stage IIIA Endometrial Carcinoma; Stage IIIB Endometrial Carcinoma; Stage IIIC Endometrial Carcinoma; Stage IVA Endometrial Carcinoma; Stage IVB Endometrial Carcinoma

  15. Assessment of spatial information for hyperspectral imaging of lesion

    Science.gov (United States)

    Yang, Xue; Li, Gang; Lin, Ling

    2016-10-01

    Multiple diseases such as breast tumor poses a great threat to women's health and life, while the traditional detection method is complex, costly and unsuitable for frequently self-examination, therefore, an inexpensive, convenient and efficient method for tumor self-inspection is needed urgently, and lesion localization is an important step. This paper proposes an self-examination method for positioning of a lesion. The method adopts transillumination to acquire the hyperspectral images and to assess the spatial information of lesion. Firstly, multi-wavelength sources are modulated with frequency division, which is advantageous to separate images of different wavelength, meanwhile, the source serves as fill light to each other to improve the sensitivity in the low-lightlevel imaging. Secondly, the signal-to-noise ratio of transmitted images after demodulation are improved by frame accumulation technology. Next, gray distributions of transmitted images are analyzed. The gray-level differences is constituted by the actual transmitted images and fitting transmitted images of tissue without lesion, which is to rule out individual differences. Due to scattering effect, there will be transition zones between tissue and lesion, and the zone changes with wavelength change, which will help to identify the structure details of lesion. Finally, image segmentation is adopted to extract the lesion and the transition zones, and the spatial features of lesion are confirmed according to the transition zones and the differences of transmitted light intensity distributions. Experiment using flat-shaped tissue as an example shows that the proposed method can extract the space information of lesion.

  16. Endometrial Hyperplasia

    Science.gov (United States)

    ... If your menstrual periods are irregular, birth control pills (oral contraceptives) may be recommended. They contain estrogen along with progestin. Other forms of progestin also may be taken. If you are overweight, losing weight may help. The risk of endometrial cancer increases with the degree of ...

  17. Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Mayumi; Matsuzaki, Kenji; Yoshida, Shusaku; Nishitani, Hiromu [University of Tokushima, Department of Radiology, Tokushima (Japan); Uehara, Hisanori [University of Tokushima, Department of Molecular and Environmental Pathology, Tokushima (Japan); Shimazu, Hideki [Oe Kyoudo Hospital, Department of Radiology (Japan)

    2005-11-01

    The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis. (orig.)

  18. Maspin expression, subcellular localization and clinicopathological correlation in endometrial hyperplasia and endometrial adenocarcinoma.

    Science.gov (United States)

    Blandamura, Stella; Alessandrini, Lara; Saccardi, Carlo; Giacomelli, Luciano; Fabris, Alberta; Borghero, Angela; Litta, Pietro

    2014-06-01

    Maspin expression in endometrial hyperplasia and endometrial endometrioid adenocarcinomas was assessed and its correlation with p53 and Ki67 expressions and clinical outcome, as well as its potential to distinguish typical from atypical endometrial hyperplasia, were assessed in this study. Histological sections from 114 cases of endometrial endometrioid adenocarcinoma, 75 cases of endometrial hyperplasia (typical and atypical), and 23 normal endometrial tissue samples were examined. The most representative hematoxylin-eosin slides were selected and 2-3 micron-thick sections were cut for immunohistochemical staining with maspin, p53, and Ki67 antibodies. While there was no maspin expression in normal endometrial cells, it was present in 14.5% of the patients with endometrial hyperplasia without atypia. Staining for maspin was positive in atypical hyperplasia and endometrial adenocarcinoma in, respectively, 45% and 49.1% of the cases studied. No statistically significant correlations were found between maspin and Ki-67 antibodies or p53 expression. Our findings showed that maspin expression, which generally correlates with a less aggressive behavior, is significantly higher in atypical hyperplasia and in endometrial endometrioid adenocarcinoma. Maspin positivity in endometrial hyperplasia could be used to identify pseudo-atypical hyperplasia and could be considered a potentially useful prognostic parameter in those cases in which adenocarcinomas are well differentiated.

  19. Endometrial Cancer Prevention

    Science.gov (United States)

    ... risk of endometrial cancer: Endometrial hyperplasia Estrogen Tamoxifen Obesity, weight gain, metabolic syndrome, and diabetes Genetic factors The following protective factors decrease the risk of ...

  20. Endometrial cancer--current state of the art therapies and unmet clinical needs: the role of surgery and preoperative radiographic assessment.

    Science.gov (United States)

    Hunn, Jessica; Dodson, Mark K; Webb, Joel; Soisson, Andrew P

    2009-08-10

    Endometrial carcinoma is the fourth most common cancer among women in the United States. Surgical pathologic staging has been the standard of care since 1988, which consists of analysis of collected peritoneal fluid, hysterectomy/oophorectomy, and pelvic and para-aortic lymphadenectomy. In 2005, it was further recommended that essentially all women with endometrial cancer who choose to undergo surgery have pelvic and para-aortic lymph node analysis. Despite this recommendation, there still remains controversy as to whether all patients with endometrial cancer should undergo full lymph node dissection. In this review, we assess the evidence surrounding this controversy and conclude that women with endometrial cancer should undergo complete lymphadenectomy at the time of surgery. Furthermore, we evaluate the evidence regarding laparoscopic surgical staging as a safe and effective alternative to the more invasive traditional laparotomy. Finally, for those patients who a gynecologic oncologist is not readily available to perform a complete lymph node dissection, we evaluate the various imaging studies and their utility as preoperative triage modalities.

  1. Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Breijer, M. C.; Peeters, J. A. H.; Opmeer, B. C.; Clark, T. J.; Verheijen, R. H. M.; Mol, B. W. J.; Timmermans, A.

    2012-01-01

    Objectives Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding, but the role of endometrial thickness measurement by ultrasound in asymptomatic women is unclear. The aims of this study were to determine: (1) the normal endometrial thickne

  2. Endometrial stromal sarcoma of the uterus: MR and US findings

    Energy Technology Data Exchange (ETDEWEB)

    Gandolfo, N. [Ist. di Radiologia, Univ. di Genova (Italy); Gandolfo, N.G.; Serafini, G. [Servizio di Radiologia, Pietra Ligure (Italy); Martinoli, C. [Servizio di Radiologia, Azienda Ospedale S. Martino e Cliniche Universitarie Convenzionate, Genova (Italy)

    2000-05-01

    We describe the MRI and US features of two patients with endometrial stromal sarcoma of the uterus. Both lesions appeared as voluminous polypoid masses within an expanded endometrial cavity on both US and MRI. They had mixed echotexture and heterogenous signal intensity on both T1- and T2-weighted sequences. T2-weighted images were most helpful in detecting the endometrial nature of the disease and its relationships with surrounding myometrium. (orig.)

  3. Physical activity for an ethnically diverse sample of endometrial cancer survivors: a needs assessment and pilot intervention

    Science.gov (United States)

    Rossi, Amerigo; Moadel-Robblee, Alyson; Garber, Carol Ewing; Kuo, Dennis; Goldberg, Gary; Einstein, Mark

    2015-01-01

    Objective To determine the physical activity (PA) behavior, needs and preferences for underserved, ethnically diverse women with a history of endometrial cancer (EC). Methods Women with a history of EC (41 non-Hispanic black, 40 non-Hispanic white, and 18 Hispanic) completed a needs assessment during their regular follow-up appointments at Montefiore Medical Center in Bronx, NY, USA. An 8-week pilot PA intervention based on the results of the needs assessment was conducted with 5 EC survivors. Results Mean body mass index (BMI) among the 99 respondents was 34.1±7.6 kg/m2, and 66% did not exercise regularly. Self-described weight status was significantly lower than actual BMI category (p<0.001). Of the 86% who were interested in joining an exercise program, 95% were willing to attend at least once weekly. The primary motivations were improving health, losing weight, and feeling better physically. Despite the high interest in participation, volunteer rate was very low (8%). However, adherence to the 8-week pilot PA intervention was high (83%), and there were no adverse events. Body weight decreased in all pilot participants. Conclusion These data show that ethnically diverse EC survivors have a great need for, and are highly interested in, PA interventions. However, greater care needs to be taken to assess and identify barriers to increase participation in such programs. PMID:25872894

  4. The utility of endometrial thickness measurement in asymptomatic postmenopausal women with endometrial fluid.

    Science.gov (United States)

    Seckin, B; Ozgu-Erdinc, A S; Dogan, M; Turker, M; Cicek, M N

    2016-01-01

    The aim of this study was to assess the clinical usefulness of sonographic endometrium thickness measurement in asymptomatic postmenopausal women with endometrial fluid collection. Fifty-two asymptomatic postmenopausal women with endometrial fluid, who underwent endometrial sampling were evaluated. Histopathological findings revealed that 25 (48.1%) women had insufficient tissue, 20 (38.4%) had atrophic endometrium and 7 (13.5%) had endometrial polyps. No case of malignancy was found. There was no statistically significant difference between the various histopathological categories (insufficient tissue, atrophic endometrium and polyp) with regard to the mean single-layer endometrial thickness (1.54 ± 0.87, 2.04 ± 1.76 and 1.79 ± 0.69 mm, respectively, p = 0.436). Out of 44 patients with endometrial thickness of less than 3 mm, 38 (86.4%) had atrophic changes or insufficient tissue and 6 (13.6%) had endometrial polyps. In conclusion, if the endometrial thickness is 3 mm or less, endometrial sampling is not necessary in asymptomatic postmenopausal women with endometrial fluid.

  5. Stromal p16 expression is significantly increased in endometrial carcinoma.

    Science.gov (United States)

    Yoon, Gun; Koh, Chang Won; Yoon, Nara; Kim, Ji-Ye; Kim, Hyun-Soo

    2017-01-17

    p16 is a negative regulator of cell proliferation and is considered a tumor suppressor protein. Alterations in p16 protein expression are associated with tumor development and progression. However, the p16 expression status in the peritumoral stroma has not been investigated in the endometrium. Therefore, we evaluated stromal p16 expression in different types of endometrial lesions using immunohistochemistry. Differences in the p16 expression status according to the degree of malignancy and histological type were analyzed. This study included 62, 26, and 36 cases of benign, precancerous, and malignant endometrial lesions, respectively. Most benign lesions showed negative or weak expression, whereas precancerous lesions showed a variable degree of staining proportion and intensity. Atypical hyperplasia/endometrial intraepithelial neoplasia (AH/EIN) and serous endometrial intraepithelial carcinoma (SEIC) had significantly higher stromal p16 expression levels than benign lesions. Endometrioid carcinoma (EC), serous carcinoma (SC), and carcinosarcoma showed significantly elevated stromal p16 expression levels compared with benign and precancerous lesions. In addition, there were significant differences in stromal p16 expression between AH/EIN and SEIC and between EC and SC. In contrast, differences in stromal p16 expression among nonpathological endometrium, atrophic endometrium, endometrial polyp, and hyperplasia without atypia were not statistically significant. Our observations suggest that stromal p16 expression is involved in the development and progression of endometrial carcinoma, and raise the possibility that p16 overexpression in the peritumoral stroma is associated with aggressive oncogenic behavior of endometrial SC.

  6. Immunohistochemical Assessment of O(6)-Methylguanine-DNA Methyltransferase (MGMT) and Its Relationship with p53 Expression in Endometrial Cancers.

    Science.gov (United States)

    Lee, Kyung Eun

    2013-12-01

    O(6)-Methylguanine-DNA methyltransferase (MGMT) is a DNA repair protein, the loss of MGMT expression was commonly known due to hypermethylation of CpG islands in its promoter region. Overexpression of p53 protein may be associated with downregulated MGMT expression in brain tumors. The aims of this study were to investigate the role of MGMT expression loss and its correlation with p53 overexpression in endometrial cancers. MGMT and p53 expression was examined in formalin-fixed, paraffin-embedded tissues from 36 endometrial cancer cases using immnunohistochemical staining. The loss of MGMT expression was detected in 11 (30.6%) out of the 36 endometrial cancers and p53 immunoreactivity was detected in 23 (63.9%) out of the 36 endometrial cancers. Ten (90.9%) of the 11 cases with negative MGMT immunoreactivity showed positive p53 expression, so the loss of MGMT expression was significantly associated with the p53 overexpression (P=0.03). These findings suggest that the loss of MGMT expression may be one of factors capable of p53 overexpression in endometrial cancer. Further studies are needed to define the relation between MGMT and p53 for examining the mechanisms of tissue-specific MGMT expression.

  7. Affinity cytochemistry analysis of mast cells in skin lesions: a possible tool to assess the timing of lesions after death.

    Science.gov (United States)

    Bonelli, A; Bacci, S; Norelli, G A

    2003-12-01

    The histamine content in vital wounds is known to increase, with a zenith after 3 h, and then decrease until 24 h after wounding. We addressed whether this biochemical alteration has a morphological counterpart. Since the main source of skin histamine are mast cells, the distribution and number of these cells was assessed upon labeling with fluorescent avidin and with antibodies to the mast cell specific enzymes, chymase and tryptase. Analyses were performed on skin from 15 healthy controls (from surgical biopsies), from 15 post-mortem lesions and 75 vital lesions, obtained at autopsy from subjects who had survived from a few seconds to 24 h. The number of mast cells per unit area of section surface increased progressively with survival time, up to a maximum in subjects who survived 1-3 h ( pdeath ( paffinity cytochemistry can help to discriminate vital from post-mortem lesions and to estimate survival time after lesions.

  8. Value of modern sonography in the assessment of meniscal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wareluk, Pawel, E-mail: pwareluk@wum.edu.pl [Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw (Poland); Szopinski, Kazimierz T., E-mail: kszopinski@wum.edu.pl [Department of Dental and Maxillofacial Radiology, First Faculty of Medicine, Medical University of Warsaw, ul. Nowogrodzka 59, 02-006 Warsaw (Poland)

    2012-09-15

    The aim of this prospective study was to assess the accuracy of modern ultrasonography in diagnostic imaging of meniscal tears. One hundred and sixty menisci were evaluated in 80 patients (42 females, 38 males, mean age = 36.2 years, range = 16–70 years). Inclusion criteria for the study were twofold: clinical suspicion of meniscal injury and clinical indication for arthroscopy. Knee examination was performed with the Voluson 730 Expert ultrasound system (General Electric). After sonographic examination, all patients underwent arthroscopic procedures within 1–4 days. The final diagnosis of meniscal tears was taken from surgical reports. The overall sensitivity, specificity, positive predictive value and negative predictive value of sonographic examination in the assessment of meniscal tears amounted to 85.4%, 85.7%, 67.3% and 94.4%, respectively. The statistical parameters were not statistically different in medial and lateral menisci. Age, sex, body mass index (BMI), weight, physical activity, mechanism on injury, and time lapse from injury did not have a statistically significant impact on the usefulness of ultrasonography. The highest sensitivity (>90%) was obtained in medial menisci and in patients with a BMI > 25. The highest specificity (>90%) was obtained in lateral menisci, in patients after twisting injuries, in sports injuries, and in recent injuries (time lapse from the injury <1 month). The positive predictive value (PPV) of sonographic examination was higher than 90% only in recent injuries (<1 month), however, the negative predictive value of ultrasound is high, being less than 90% in males with lesions of lateral menisci and in sequelae of sports injuries.

  9. 子宫内膜容受性的无创性评价%Non-invasive Assessment of Endometrial Receptivity

    Institute of Scientific and Technical Information of China (English)

    张平贵; 牛志宏; 冯云

    2013-01-01

    子宫内膜容受性是胚胎着床、成功妊娠的必要条件.对子宫内膜容受性进行评估是辅助生育技术中重要的一环.其评价指标有很多,目前应用较为广泛的包括内膜活检、超声检查、内分泌检查和内膜分泌物分析等.内膜活检法因其创伤性使临床应用受到限制;超声虽能简便有效地预测内膜容受性,但存在很大的争议;激素及分子生物学指标从分子生物学方面阐明了影响内膜容受性的重要因素,具有其独特的临床应用价值:内膜分泌物分析在评价子宫内膜容受性方面,具有无创性、信息量大等优势,近年来正在成为生殖领域研究的热点.%Endometrial receptivity plays a critical role in embryo implantation and achieving a successful early pregnancy, of which the successful evaluation is the key link of assisted reproductive technology (ART). There are many evaluation indexes for endometrial receptivity including various endomeitrial biopsy, ultrasonic parameters, endocrine examination, analysis of uterine secretions which are widely applied nowadays. Endometrial biopsy is invasive, which clinical application is limited. Ultrasound examination can make an easy and efficient forecast of endometrial receptivity, however, with the more controversy. Hormone traits and molecular biological parameters have unique clinical application values with their elucidation of the important factors affecting endometrial receptivity. Analysis of uterine secretions in the evaluation of endometrial receptivity, with the advantages of non-invasive, large-scale of information, becomes a hot spot in reproductive medicine research in recent years.

  10. In vivo assessment of experimental neonatal excitotoxic brain lesion with USPIO-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Alison, Marianne; Azoulay, Robin; Chalard, Francois [INSERM U676,Hopital Robert Debre, AP-HP, Paris (France); Universite Paris 7, Faculte de Medecine Denis Diderot, IFR02 et IFR25, Paris (France); Hopital Robert Debre, AP-HP, Service d' Imagerie Pediatrique, Paris (France); Gressens, Pierre [INSERM U676,Hopital Robert Debre, AP-HP, Paris (France); Universite Paris 7, Faculte de Medecine Denis Diderot, IFR02 et IFR25, Paris (France); Hopital Robert Debre, AP-HP, Service de Neurologie Pediatrique, Paris (France); PremUP, Paris (France); Sebag, Guy [INSERM U676,Hopital Robert Debre, AP-HP, Paris (France); Universite Paris 7, Faculte de Medecine Denis Diderot, IFR02 et IFR25, Paris (France); Hopital Robert Debre, AP-HP, Service d' Imagerie Pediatrique, Paris (France); PremUP, Paris (France)

    2010-09-15

    To assess the feasibility of magnetic resonance imaging (MRI) enhanced with ultrasmall superparamagnetic particles of iron oxide (USPIO) for assessing excitotoxic brain lesions in an experimental model of neonatal periventricular white matter (PWM) lesions. Brain lesions were induced by intracerebral injection of ibotenate in 14 newborn rats. Pre- and post-USPIO T2-weighted MRI was performed in seven of them (group A) and in five control newborns (group C). In seven newborns with induced cerebral lesions, USPIO-enhanced MRI was not performed (group B). We compared the signal intensity of the lesion to the contralateral unaffected brain (lesion-to-brain contrast, LBC) and the lesion signal-to-noise ratio (SNR) before and after USPIO injection. MR imaging was correlated with histology. USPIO injection significantly (P < 0.05) decreased LBC and SNR of brain lesion but induced no changes in normal controls. The densities of macrophages and iron-laden cells were higher on the lesion side than on the contralateral side (P < 0.05). Neither lesion size nor the surrounding macrophage infiltrate was significantly different between groups A and B. Post-USPIO T2-weighted MRI demonstrated negative enhancement of neonatal excitotoxic brain lesion. USPIO injection does not appear to exacerbate brain lesions. (orig.)

  11. 多囊卵巢综合征合并不孕与子宫内膜病变关系的临床探讨%Clinical study on the relationship between polycystic ovary syndrome combined with infertility and endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    陈彩蓉; 王秋香; 邱佩嫦; 金燕; 覃碧芳

    2012-01-01

    目的:探讨多囊卵巢综合征(PCOS)合并不孕与子宫内膜病变的关系及诊刮术在PCOS合并不孕患者中的临床意义.方法:PCOS合并不孕患者(观察组)68例,输卵管因素不孕患者(对照组)43例,分析两组诊刮术病理结果及内分泌代谢的差异.结果:①观察组病理诊断子宫内膜器质性病变55例:其中子宫内膜癌1例、子宫内膜不典型增生3例、子宫内膜复杂型增生症5例、子宫内膜单纯型增生症38例、增生期子宫内膜15例(合并子宫内膜息肉8例)、分泌期子宫内膜6例.对照组43例中增生期子宫内膜36例(合并子宫内膜息肉5例);分泌期子宫内膜7例.②观察组体质指数(BMI)、腰臀比(WHR)、空腹血糖、血脂、空腹胰岛素(FINS)、胰岛素曲线下面积(AUCI)及血雌激素(E2)、睾酮(T)水平均高于对照组(P<0.05).结论:PCOS合并不孕患者子宫内膜异常增生及癌变率高,肥胖、胰岛素抵抗(IR)、高雄激素与高雌激素是子宫内膜病变的重要因素,应重视诊刮术在此类患者中的应用.%Objective: To explore the relationship between polycystic ovary syndrome (PCOS) combined with infertility and endometrial lesions, analyze the clinical significance of endocervical curettage for patients with PCOS combined with infertility. Methods: A total of 68 patients with PCOS combined with infertility were selected as observation group, and 43 patients with tubal infertility were selected as control group; the pathological results after endocervical curettage and the differences of endocrine metabolism in the two groups were analyzed. Results: In observation group, 55 patients with endometrial organic diseases were diagnosed by pathological examination, including one patient with endometrial cancer, three patients with atypical hyperplasia of endometrium, five patients with endometrial complex hyper-plasia, 38 patients with simple endometrial hyperplasia, 15 patients with endometrium during

  12. Endometrial stromal sarcoma with selective polyvinyl alcohol embolization of a pulmonary metastasis after recurrent hemoptysis and expansive growth

    OpenAIRE

    Thula Walter; Ulf Teichgräber; Florian Streitparth; Maximilian de Bucourt

    2010-01-01

    A 63-year-old female with a well-vascularized pulmonary metastasis of an endometrial stromal sarcoma (ESS) of 6x6 cm received selective embolization with 150-250 mm polyvinyl alcohol (Contour; Boston Scientific, Natick, MA, USA) via a bronchial artery. Post-interventional loss of perfusion was qualitatively estimated to be >80%. The lesion was located in direct proximity to the pulmonary hilar vessels. Owing to recurrent and sudden hemoptyses, an interdisciplinary tumor board assessed the ris...

  13. Reproducibility determination of WHO classification of endometrial hyperplasia/well differentiated adenocarcinoma and comparison with computerized morphometric data in curettage specimens in Iran

    Directory of Open Access Journals (Sweden)

    Meysamie Ali

    2009-03-01

    Full Text Available Abstract Background Management of endometrial precancerous lesions has been of much debate due to inconsistencies in their classification, natural history and histologic diagnosis. Endometrial hyperplasia constitutes a wide range of histomorphologic features associated with high intra and interobserver diagnostic variability. Although traditional microscopic diagnosis is by far the most applicable method and the gold standard for histomorphologic diagnosis, digitized image analysis has been used as a powerful adjunct to maximize the histologic data retrieval and to add some detailed objective criteria for correct diagnosis in difficult cases. Methods A series of 100 endometrial curettage specimens with diagnosis of endometrial hyperplasia or well differentiated adenocarcinoma were blindly reviewed by 5 pathologists; their intra and interobserver reproducibility determined and further compared to the objective morphometric data i.e. D-score and volume percent of stroma (VPS. Results The results were assessed using the weighted kappa statistics. Mean intraobserver kappa value was 0.8690 (99.44% agreement. Mean interobserver kappa values by diagnostic category were: simple hyperplasia without atypia: 0.7441; complex hyperplasia without atypia: 0.3379; atypical hyperplasia: 0.3473, and well-differentiated endometrioid carcinoma: 0.6428; with a kappa value of 0.5372 for all cases combined. Interobserver agreement was in substantial rate for simple hyperplasia (SH and well differentiated adenocarcinoma (WDA but was in fair limit for complex hyperplasia (CH and atypical hyperplasia (AH. Intraobserver agreement was almost perfect. The specimens were divided in two groups according to the computerized morphometric analysis: Endometrial Hyperplasia (EH ( D Score ≥ 1 or VPS ≥ 55% and Endometrial Intraepithelial Neoplasia (EIN (D-Score Conclusion It may be necessary to make some revisions in WHO classification for endometrial hyperplasia and

  14. Sonographic Findings of Uterine Endometrial Stromal Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Lee, Myung Sook; Choi, Jong Sun [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2006-12-15

    The study was performed to present the sonographic findings of uterine endometrial stromal sarcoma (ESS). We conducted a retrospective review of sonographic findings of 10 cases that were diagnosed as uterine ESS. The patients ages ranged from 25 to 51 years (mean age: 36.1 years). The reviews focused on the location, margin, size, number and echotexture of the lesions. Hysterectomy (n = 9) and myomectomy (n = 1) were performed and a pathologic diagnosis was obtained in all cases. The masses were located in the uterine wall (n = 6), or they presented as a polypoid mass protruding into the endometrial cavity from the myometrium (n = 3) or as a central cavity mass (n = 1). The lesion margins were smooth (n = 5), ill defined (n = 2), or smooth with partially nodular extensions (n = 3). The maximal mass length was 38 mm to 160 mm with a mean mass length of 83.5 mm. There were single lesions in eight cases and multiple lesions in two cases. The lesion echotextures were hypoechoic solid (n = 3), heterogeneously intermediate echoic (n = 5), diffuse myometrial thickening with heterogeneous echogenicity (n = 1) and septated cystic (n = 1). Endometrial stromal sarcoma presents with four patterns of its sonographic appearance; a polypoid mass with nodular myometrial extension, an intramural mass with an ill defined margin and heterogeneous echogenicity, an ill defined large central cavity mass or, diffuse myometrial thickening.

  15. Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Kim, Min Jung; Ryu, Hee Sug [Aju University School of Medicine, Suwon (Korea, Republic of)

    1999-06-15

    To characterize the sonohysterographic (SH) findings of endometrial hyperplasia and cancer and to determine the role of SH in differentiating endometrial cancer from hyperplasia. The clinical, pathologic and SH findings of 38 patients with histologically confirmed endometrial hyperplasia (n=21), atypical hyperplasia 9n=6), and cancer (n=11) were reviewed retrospectively. We evaluate the presence and morphologic characteristics 9 surface contour ehcogenicity, echotexture) of endometrial thickening and mass, obliteration of endometrial cavity, and disruption of endometrial-myometrial interface on SH. SH findings of endometrial hyperplasia were endometrial thickening in 17 cases (81%), mass in 8 cases (38%), and regular surface of endometrium and mass in 16 (76%) and 6 cases (75%) respectively. Obliteration of endometrial cavity was seen only in 3 cases (14%) of endometrial hyperplasia and 1 case (17%) of atypical hyperplasia and disruption of endometrial-myometrial interface was not seen. Endometrial cancer showed endometrial thickening in 6 cases (55%), mass in 7 cases (64%), irregular surface of endometrium and mass in 10 (91%) and 7 cases (100%) respectively, obliteration of endometrial cavity in 10 cases(91%), and disruption of endometrial-myometrial interface in 4 of 8 cases with myometrial invasion. Using endometrial thickening or mass with irregular surface and obliteration of endometrial cavity as the positive findings for SH diagnosis of endometrial cancer, we observed sensitivity of 90.9%, specificity of 85.2%, and accuracy of 86.8%. The demonstration of the irregular surface with endometrial thickening or mass and obliteration of endometrial cavity through SH were suggestive of endometrial cancer.

  16. Oral malignant acanthosis nigricans associated with endometrial adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Han-Wen Chu; Jing-Min Li; Guan-Fu Chen; Jing-Yuan Ma

    2014-01-01

    We report a 59-year-old patient with malignant acanthosis nigricans associated with metastasis of endometrial carcinoma. The patient presented papillomatosis lesions that appeared to be benign on multiple skins of body folds, particularly on lips. The lesions in lips and axilla had histological characteristic appearances of acanthosis nigricans, while the masses in abdomen and pelvis were metastasis endometrial adenocarcinoma. The article highlights the importance of biopsy and histopathological diagnosis in presumed benign lesions and the role of doctors in screening for body internal tumors.

  17. Are Imaging and Lesioning Convergent Methods for Assessing Functional Specialisation? Investigations Using an Artificial Neural Network

    Science.gov (United States)

    Thomas, Michael S. C.; Purser, Harry R. M.; Tomlinson, Simon; Mareschal, Denis

    2012-01-01

    This article presents an investigation of the relationship between lesioning and neuroimaging methods of assessing functional specialisation, using synthetic brain imaging (SBI) and lesioning of a connectionist network of past-tense formation. The model comprised two processing "routes": one was a direct route between layers of input and output…

  18. Proton MR Spectroscopy in Metabolic Assessment of Musculoskeletal Lesions

    Science.gov (United States)

    Subhawong, Ty K.; Wang, Xin; Durand, Daniel J.; Jacobs, Michael A.; Carrino, John A.; Machado, Antonio J.; Fayad, Laura M.

    2014-01-01

    OBJECTIVE The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report additional cases that have been analyzed with recently developed quantitative methods. CONCLUSION Proton MR spectroscopy can be used to identify key tissue metabolites and may serve as a useful adjunct to radiographic evaluation of musculoskeletal lesions. A pooled analysis of 122 musculoskeletal tumors revealed that a discrete choline peak has a sensitivity of 88% and specificity of 68% in the detection of malignancy. Modest improvements in diagnostic accuracy in 22 of 122 cases when absolute choline quantification was used encourage the pursuit of development of choline quantification methods. PMID:22194493

  19. Stance disturbance in multiple sclerosis: brainstem lesions and posturographic assessment

    Directory of Open Access Journals (Sweden)

    Peter Schalek

    2012-01-01

    Full Text Available

    Background. Balance disorders are commonly evidenced during the course of multiple sclerosis (MS. The aim of this study is to report characteristics of MS patient stance control disorders, measured by means of posturography and related to the brainstem lesions.

    Methods. Thirty-eight patients affected by MS, mildly to moderately disable according to Kurtzke’s Expanded Disability Status Scale, underwent a complete clinical neurological and vestibular evaluation and brain MRI scanning. All patients were then tested on a static posturography platform (Tetrax, Israel in four conditions: eyes open and closed standing on a firm surface and on a foam pad.

    Results. Clinical and/or MRI evidence of brainstem involvement was observed in 55.3 % of patients. When brainstem lesion was detected, Fourier analysis showed a typical pattern characterized by inversion of the  0- 0.1 Hz and  0.1 - 0.25 Hz. frequency bands.

    Conclusions. MS leads to pervasive postural disturbances in the majority of subjects, including the visuo-vestibular loops and proprioception involving vestibulo-spinal pathways in at least 55.3 % of patients. Our results may also suggest the presence of Fourier inversion in patients with brainstem lesions.


  20. Concordance between preoperative and postoperative assessments of primary caries lesion depth: results from the Dental PBRN

    DEFF Research Database (Denmark)

    Nascimento, Marcelle M; Bader, James D; Qvist, Vibeke

    2010-01-01

    This study investigated the concordance between pre- and postoperative assessments of primary caries lesion depths by dentists from The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org). A total of 229 DPBRN dentists collected data on 8,351 consecutive restorations inserted due...... was at an advanced stage: 88% concordance at the D3 depth, compared to 54% concordance at the E1 depth. DPBRN dentists can discriminate caries lesions at different depths, but the accuracy of their depth assessments was higher for dentin than for enamel lesions. In general, DPBRN dentists were more likely...

  1. Assessment of culprit lesions by intravascular ultrasound in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    LIU Jian; LIU Chuan-fen; LU Ming-yu; MA Yu-liang; WANG Long; CHEN Hong; WANG Wei-min

    2009-01-01

    Background Intravascular ultrasound has become the standard invasive method for diagnosing coronary artery disease. The aim of the present study was to evaluate the ability of intravascular ultrasound for assessment of culprit lesion morphology during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods We performed 18 intravascular ultrasound assessments preintervention during the primary PCI for AMI. intravascular ultrasound analysis included qualitative and quantitative measurements of reference and lesion extemal elastic membrane (EEM), lumen, and plaque plus media (P&M) area. Positive remodeling was defined as lesion/mean reference EEM >1.0. Culprit lesions were identified by a combination of electrocardiogram (ECG) and coronary angiography.Results There was an average of 1.44 infarct-related artery (IRA) plaques per patient. The incidences of thrombus and plaque ruptures were 28% (5) and 33% (6), respectively. Hypoechoic plaque was observed in 72% (13) of AMI patients. Calcified lesions could be found in 33% (6) of culprit lesions. Sixty percent of the culprit lesion sites presented with positive remodeling.Conclusions Intravascular ultrasound is a safe and feasible imaging modality in patients with AMI and can help identify plaque rupture, intracoronary thrombus or calcification. The culprit lesion site in AMI cases often presents with positive remodeling.

  2. Sonographic Findings of Uterine Endometrial Stromal Sarcoma

    OpenAIRE

    Kim, Jeong-Ah; Lee, Myung Sook; Choi, Jong-Sun

    2006-01-01

    Objective The study was performed to present the sonographic findings of uterine endometrial stromal sarcoma (ESS). Materials and Methods We conducted a retrospective review of sonographic findings of 10 cases that were diagnosed as uterine ESS. The patients' ages ranged from 25 to 51 years (mean age: 36.1 years). The reviews focused on the location, margin, size, number and echotexture of the lesions. Hysterectomy (n = 9) and myomectomy (n = 1) were performed and a pathologic diagnosis was o...

  3. Hyperplasia and endometrial precancer

    Directory of Open Access Journals (Sweden)

    O. A. Gornikh

    2011-01-01

    Full Text Available Hyperplastic process is nothing but excessive proliferation determining by histological or cytological method. Extending of theprecancer" conception including not only atypical endometrial hyperplasia but also other pathological changes of the endometriu m (glandu- lar-cystic hyperplasia, polyposis, with the marked endocrine and metabolic disorders background is of some scientific interest and encour- ages a search for a wide range of hypothetical pathogenetic mechanisms and w ays to prevent precancer and endometrial cancer . However, such an extension of the view on the endometrial precancer is not an equivalent of the nosological diagnosis which involves anexact morpho- logic substrate of the pathological process and a specific treatment policy.

  4. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  5. Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Obiective To evaluate endometrial and Subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment.Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited.Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection.Group A,endometrial and subendometrial blood flows were 2 branches and below,group B,endometrial and subendometrial blood flows were between 3 and 4 branches;group C, endometrial and subendometrial blood flows were 5 branches and above.Patients were transferred 1-3 embryos each.Demographic data,ovarian responses.endometrial thickness,PI,RI,development of embryo and IVF result among groups were compared.Results Demographic data,ovarian responses,endometrial thickness,PI,RI and development of embryo among groups have no significant difference.The pregnancy rate of group A was significantly lower than that of group B(P<0.05) and group C(P<0.01).The implantation rate of group A was significantly lower than than of group C (P<0.01).There was no significant difference of the rate of pregnancy and implantation between group B and group C (P>0.05).Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment.A good endometrial and subendometrial blood flows is benefit for the result of IVF.

  6. T2 weighted MRI for assessing renal lesions in transgenic mouse models of tuberous sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Kalogerou, Maria; Zhang, Yadan; Yang, Jian; Garrahan, Nigel [Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN (United Kingdom); Paisey, Stephen; Tokarczuk, Paweł; Stewart, Andrew [School of Bioscience, Cardiff University, Museum Avenue, Cardiff CF10 3AX (United Kingdom); Gallacher, John [Department of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS (United Kingdom); Sampson, Julian R. [Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN (United Kingdom); Shen, Ming Hong, E-mail: shenmh@cf.ac.uk [Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN (United Kingdom)

    2012-09-15

    Objective: Transgenic mouse models of tuberous sclerosis (TSC) develop renal cysts, cystadenomas, solid adenomas and carcinomas. Identification and characterisation of these lesions in vivo may help in TSC pre-clinical trials. This study was to evaluate T2 weighted MRI for assessment of renal lesions in two Tsc mouse models. Materials and Methods: Tsc1{sup +/−}, Tsc2{sup +/−} and wild type mice were subjected to a first MRI scan at 12 months of age and a second scan 2 months later. One Tsc2{sup +/−} mouse was treated with rapamycin for two months after the initial scan. Immediately following the second scan, mice were sacrificed and MRI images were compared to renal histological findings. Results: MRI identified all types of Tsc-associated renal lesions in both Tsc1{sup +/−} and Tsc2{sup +/−} mice. The smallest detectable lesions were <0.1 mm{sup 3}. Eighty three percent of all renal lesions detected in the first scan were re-identified in the second scan. By MRI, these lesions demonstrated significant growth in the 9 untreated Tsc1{sup +/−} and Tsc2{sup +/−} mice but shrinkage in the rapamycin treated Tsc2{sup +/−} mouse. Between the two scans, MRI also revealed significant increase in both the total number and volume of lesions in untreated mice and decrease in the rapamycin treated mouse, respectively. In comparison to histological analysis MRI detected most cysts and cystadenomas (66%) but only a minority of solid tumours (29%). Conclusion: These results suggest that T2 weighted MRI may be a useful tool for assessing some renal lesions in pre-clinical studies using Tsc mouse models. However, improved sensitivity for T2 weighted MRI is required, particularly for solid renal lesions.

  7. NAC1, a potential stem cell pluripotency factor expression in normal endometrium, endometrial hyperplasia and endometrial carcinoma.

    Science.gov (United States)

    Ishikawa, Masako; Nakayama, Kentaro; Yeasmin, Shamima; Katagiri, Atsuko; Iida, Kouji; Nakayama, Naomi; Miyazaki, Kohji

    2010-05-01

    The purpose of this study was to investigate the role of NAC1 in the development of endometrial cancer. NAC1 expression and localization were assessed with immunohistochemistry in the normal cyclic human endometrium, hyperplastic endometrium, and endometrial cancer. Expression of NAC1 in the glandular cells was significantly higher in the early and mid proliferative phases than in the other menstrual phases, endometrial hyperplasia, and endometrial carcinoma. NAC1 expression was down-regulated during endometrial carcinogenesis. There were significant correlations between positive NAC1 expression and pathological grade (P=0.037). No significant associations were found between NAC1 expression and the other clinicopathological characteristics including patient age, FIGO staging, depth of myometrial invasion, pelvic lymph node metastasis, lymphovascular space invasion, menopause, or body mass index. NAC1 gene knockdown inhibited cell growth and induced apoptosis in Ishikawa, HHUA, and JHEM2 cell lines, all of which overexpressed NAC1. Ectopic overexpression of the NAC1 gene stimulated cell proliferation in the HEC1B, and JHEM1 endometrial cancer cell lines, which have lower endogenous NAC1 expression. Endometrial carcinomas with NAC1 overexpression are clinically aggressive, high-grade carcinomas. Therefore, detection of NAC1 overexpression in endometrial cancers may identify patients who will benefit from NAC1 targeted therapy.

  8. Uterine/Endometrial Cancer: Chemotherapy

    Science.gov (United States)

    ... Types of Gynecologic Cancers Uterine/Endometrial Cancer Chemotherapy Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for endometrial cancer is usually given intravenously (injected ...

  9. Assessment of epigenetic alterations in early colorectal lesions containing BRAF mutations

    Science.gov (United States)

    Nojima, Masanori; Harada, Taku; Maruyama, Reo; Ashida, Masami; Aoki, Hironori; Matsushita, Hiro-o; Yoshikawa, Kenjiro; Harada, Eiji; Tanaka, Yoshihito; Wakita, Shigenori; Niinuma, Takeshi; Kai, Masahiro; Eizuka, Makoto; Sugai, Tamotsu; Suzuki, Hiromu

    2016-01-01

    To clarify the molecular and clinicopathological characteristics of colorectal serrated lesions, we assessed the DNA methylation of cancer-associated genes in a cohort of BRAF-mutant precancerous lesions from 94 individuals. We then compared those results with the lesions' clinicopathological features, especially colorectal subsites. The lesions included hyperplastic polyps (n = 16), traditional serrated adenomas (TSAs) (n = 15), TSAs with sessile serrated adenomas (SSAs) (n = 6), SSAs (n = 49) and SSAs with dysplasia (n = 16). The prevalence of lesions exhibiting the CpG island methylator phenotype (CIMP) was lower in the sigmoid colon and rectum than in other bowel subsites, including the cecum, ascending, transverse and descending colon. In addition, several cancer-associated genes showed higher methylation levels within lesions in the proximal to sigmoid colon than in the sigmoid colon and rectum. These results indicate that the methylation status of lesions with BRAF mutation is strongly associated with their location, histological findings and neoplastic pathways. By contrast, no difference in aberrant DNA methylation was observed in normal-appearing background colonic mucosa along the bowel subsites, which may indicate the absence of an epigenetic field defect. PMID:27145369

  10. Dynamic Assessment of the Focal Hepatic Lesion in Rats Using Ultrasonic Contrast Agent

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chao; DENG Youbin; HUANG Daozhong; ZHANG Qingping

    2006-01-01

    The focal hepatic lesion caused by local injection of absolute alcohol in rats was evaluated with ultrasonic contrast agent and pathologic examination. Twenty adult Wistar rats weighing about 200 g were injected with absolute alcohol (0.05-0.1 mL each one) on the exterior left lobe of the liver under the monitoring of ultrasound. Pulse inversion harmonic imaging was used to evaluate the focal lesion after bolus injection of ultrasonic contrast agent (0.05 mL/200 g) through caudal vein.Seven days later, the focal lesion was studied again as before. The exterior left lobe of liver with focal lesion was incised and underwent pathologic examination. The results showed that all of the focal lesions could be defined clearly after bolus injection of the ultrasonic contrast agent under the mode of pulse inversion harmonic imaging. There was good correlation between the size of the focal lesion measured by ultrasound on the 7th day after the "ablation" under the mode of pulse inversion harmonic imaging and that gotten by pathologic examination (P=0.39). The focus size measured by ultrasound right after the ablation was larger than that gotten by pathologic examination (P= 0.002). It was concluded that ultrasonic contrast agent plus pulse inversion harmonic imaging could be used to assess the size of the focal hepatic lesion caused by local injection of absolute alcohol in rats.

  11. Assessment of remineralized dentin lesions with thermal and near-infrared reflectance imaging

    Science.gov (United States)

    Lee, Robert C.; Darling, Cynthia L.; Fried, Daniel

    2016-02-01

    Accurate detection and measurement of the highly mineralized surface layer that forms on caries lesions is important for the diagnosis of lesion activity. Previous studies have demonstrated that optical imaging methods can be used to measure the degree of remineralization on enamel lesions. The purpose of this study was to determine if thermal and near-IR reflectance imaging could be used to assess the remineralization process in simulated dentin lesions. Artificial bovine (n=15) dentin lesions were prepared by immersion in a demineralization solution for 24 hours and they were subsequently placed in an acidic remineralization solution for up to 12 days. The samples were dehydrated using an air spray for 30 seconds and imaged using thermal and InGaAs cameras. The area enclosed by the time-temperature curve, ΔQ, from thermal imaging decreased significantly with longer periods of remineralization. However, near-IR reflectance intensity differences, ΔI, before and after dehydration failed to show any significant relationship with the degree of remineralization. This study shows that thermal imaging can be used for the assessment of the remineralization of dentin lesions.

  12. Improved Risk Assessment by Integrating Molecular and Clinicopathological Factors in Early-stage Endometrial Cancer-Combined Analysis of the PORTEC Cohorts

    NARCIS (Netherlands)

    Stelloo, Ellen; Nout, Remi A.; Osse, Elisabeth M.; Juergenliemk-Schulz, Ina J.; Jobsen, Jan J.; Lutgens, Ludy C.; van der Steen-Banasik, Elzbieta M.; Nijman, Hans W.; Putter, Hein; Bosse, Tjalling; Creutzberg, Carien L.; Smit, Vincent T. H. B. M.

    2016-01-01

    Purpose: Recommendations for adjuvant treatment for women with early-stage endometrial carcinoma are based on clinicopathologic features. Comprehensive genomic characterization defined four subgroups: p53-mutant, microsatellite instability (MSI), POLE-mutant, and no specific molecular profile (NSMP)

  13. Observer variability in the histologic assessment of oral premalignant lesions

    DEFF Research Database (Denmark)

    Karabulut, A; Reibel, J; Therkildsen, M H

    1995-01-01

    Histopathologic examination of oral leukoplakias has a major impact on the assessment of prognosis and treatment planning. We investigated the extent of agreement in grading epithelial dysplasia between pathologists with the same or different educational backgrounds. Two general pathologists...... and two oral pathologists were each given 100 sections of oral leukoplakia to grade from no dysplasia to carcinoma in-situ. The interobserver agreement rates were in the range of 49% to 69%. The calculated kappa values were in the range of 27% to 45%, showing poor to moderate agreement between...

  14. Genetics of Endometrial Cancers

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Okuda

    2010-01-01

    Full Text Available Endometrial cancers exhibit a different mechanism of tumorigenesis and progression depending on histopathological and clinical types. The most frequently altered gene in estrogen-dependent endometrioid endometrial carcinoma tumors is PTEN. Microsatellite instability is another important genetic event in this type of tumor. In contrast, p53 mutations or Her2/neu overexpression are more frequent in non-endometrioid tumors. On the other hand, it is possible that the clear cell type may arise from a unique pathway which appears similar to the ovarian clear cell carcinoma. K-ras mutations are detected in approximately 15%–30% of endometrioid carcinomas, are unrelated to the existence of endometrial hyperplasia. A β-catenin mutation was detected in about 20% of endometrioid carcinomas, but is rare in serous carcinoma. Telomere shortening is another important type of genomic instability observed in endometrial cancer. Only non-endometrioid endometrial carcinoma tumors were significantly associated with critical telomere shortening in the adjacent morphologically normal epithelium. Lynch syndrome, which is an autosomal dominantly inherited disorder of cancer susceptibility and is characterized by a MSH2/MSH6 protein complex deficiency, is associated with the development of non-endometrioid carcinomas.

  15. Diagnostic value of endometrial thickness determined by transvaginal sonography in infertile women with endometrial polyps

    Institute of Scientific and Technical Information of China (English)

    SONG Yong; SHEN Li-cong; HUANG Wei; LEI Hai-ke; WANG Qiu-shi; ZHU Hui-li

    2012-01-01

    Background Endometrial polyps (EPs) occur in approximately 34.9% of infertile women.Transvaginal sonography (TVS) is a routine,non-invasive component of fertility evaluation.Most ultrasonographic studies of EPs have focused on abnormal uterine bleeding; few have assessed EPs in infertile women.Furthermore,no studies have explored endometrial thickness and its correlation with EPs in infertile women.This study aimed to assess transvaginal sonographic assessment of endometrial thickness and its value in diagnosis and prediction of EPs in infertile women.Methods A retrospective study on 314 infertile women was conducted from June to December 2010.After TVS,endometrial biopsies were obtained by hysteroscopy.Pathologically confirmed EPs were taken as the gold standard.Results Based on recognized criteria,TVS had a sensitivity of 37.04%,specificity of 98.71%,positive predictive value of 90.91%,negative predictive value of 81.85%,and accuracy of 82.80% for diagnosing EPs.Mean endometrial thickness was significantly different in patients with and without EPs (P=0.0001).In women in the mid and late-proliferative phase,the endometrial thickness was significantly greater in those with EPs than in those without them (P=0.0001 and 0.024).Receiver operating characteristic analysis showed that endometrial thickness had a sensitivity of 85.2% and specificity of 38% in the diagnosis of EPs,the area under the curve being 0.64.In the mid-proliferative phase,sensitivity was up to 90.9%,the area under the curve being 0.70.Conclusions rvs is poor at detecting EPs in infertile women; however,transvaginal sonographic measurement of endometrial thickness is helpful.It is suggested that the diagnostic value of TVS for EPs in infertile women could be improved by adding the measurement of endometrial thickness to the variables that are routinely assessed.

  16. Assessment of lesion pathology in a new animal model of MS by multiparametric MRI and DTI.

    Science.gov (United States)

    Boretius, Susann; Escher, Angelika; Dallenga, Tobias; Wrzos, Claudia; Tammer, Roland; Brück, Wolfgang; Nessler, Stefan; Frahm, Jens; Stadelmann, Christine

    2012-02-01

    Magnetic resonance imaging (MRI) is the gold standard for the detection of multiple sclerosis (MS) lesions. However, current MRI techniques provide little information about the structural features of a brain lesion with inflammatory cell infiltration, demyelination, gliosis, acute axonal damage and axonal loss. To identify methods for a differentiation of demyelination, inflammation, and axonal damage we developed a novel mouse model combining cuprizone-induced demyelination and experimental autoimmune encephalomyelitis. MS-like brain lesions were assessed by T1-weighted, T2-weighted, and magnetization transfer MRI as well as by diffusion tensor imaging (DTI). T2-weighted MRI differentiated control and diseased mice, while T1-weighted MRI better reflected the extent of inflammation and axonal damage. In DTI, axonal damage and cellular infiltration led to a reduction of the axial diffusivity, whereas primary demyelination after cuprizone treatment was reflected by changes in radial but not axial diffusivity. Importantly, alterations in radial diffusivity were less pronounced in mice with demyelination, inflammation, and acute axonal damage, indicating that radial diffusivity may underestimate demyelination in acute MS lesions. In conclusion, the combined information from different DTI parameters allows for a more precise identification of solely demyelinated lesions versus demyelinated and acutely inflamed lesions. These findings are of relevance for offering individualized, stage-adapted therapies for MS patients.

  17. Accuracy of MRI volume measurements of breast lesions: comparison between automated, semiautomated and manual assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rominger, Marga B.; Fournell, Daphne; Nadar, Beenarose Thanka; Figiel, Jens H.; Keil, Boris; Heverhagen, Johannes T. [Philipps University, Department of Radiology, Marburg (Germany); Behrens, Sarah N.M. [MeVis GmbH, Bremen (Germany)

    2009-05-15

    The aim of this study was to investigate the efficacy of a dedicated software tool for automated and semiautomated volume measurement in contrast-enhanced (CE) magnetic resonance mammography (MRM). Ninety-six breast lesions with histopathological workup (27 benign, 69 malignant) were re-evaluated by different volume measurement techniques. Volumes of all lesions were extracted automatically (AVM) and semiautomatically (SAVM) from CE 3D MRM and compared with manual 3D contour segmentation (manual volume measurement, MVM, reference measurement technique) and volume estimates based on maximum diameter measurement (MDM). Compared with MVM as reference method MDM, AVM and SAVM underestimated lesion volumes by 63.8%, 30.9% and 21.5%, respectively, with significantly different accuracy for benign (102.4%, 18.4% and 11.4%) and malignant (54.9%, 33.0% and 23.1%) lesions (p<0.05). Inter- and intraobserver reproducibility was best for AVM (mean difference {+-}2SD, 1.0{+-}9.7% and 1.8{+-}12.1%) followed by SAVM (4.3{+-}25.7% and 4.3{+-}7.9%), MVM (2.3{+-}38.2% and 8.6{+-}31.8%) and MDM (33.9{+-}128.4% and 9.3{+-}55.9%). SAVM is more accurate for volume assessment of breast lesions than MDM and AVM. Volume measurement is less accurate for malignant than benign lesions. (orig.)

  18. Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Lian-Ming [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Renji Hospital, Shanghai (China); Wayne State University, Department of Radiology, Detroit, MI (United States); Xu, Jian-Rong; Gu, Hai-Yan; Hua, Jia [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Renji Hospital, Shanghai (China); Haacke, E.M.; Hu, Jiani [Wayne State University, Department of Radiology, Detroit, MI (United States)

    2013-02-15

    To obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January1995 to March 2012. Pooled estimation data were obtained by statistical analysis. Eleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05). CE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making. (orig.)

  19. Consequences of neurologic lesions assessed by Barthel Index after Botox® injection may be underestimated

    Directory of Open Access Journals (Sweden)

    Dionyssiotis Y

    2012-10-01

    Full Text Available Y Dionyssiotis,1,2 D Kiourtidis,3 A Karvouni,3 A Kaliontzoglou,3 I Kliafas31Medical Department, Rehabilitation Center Amyntaio, General Hospital of Florina, Amyntaio, Florina, 2Physical Medicine and Rehabilitation Department, Rhodes General Hospital, Rhodes, Dodecanese, 3Neurologic Department, Rhodes General Hospital, Rhodes, Dodecanese, GreecePurpose: The aim of this study was to investigate whether the consequences of neurologic lesions are underestimated when the Barthel Index (BI is used to assess the clinical outcome of botulinum toxin injection.Patients and methods: The records for all in- and outpatients with various neurologic lesions (stroke, multiple sclerosis, spinal cord injury, traumatic brain injury, and so forth who had been referred to the authors’ departments and who had received botulinum toxin type A (Botox® for spasticity within a 4-year period (2008–2011 were examined retrospectively. BI data were collected and analyzed.Results: The BI score was found to have increased in follow-up assessments (P = 0.048. No correlation was found between the degree of spasticity and the BI score.Conclusion: The specific injection of Botox in patients with neurologic lesions was not strongly correlated with a significant functional outcome according to the BI. The results of this study suggest that clinicians need to look at other measurement scales for the assessment of significant outcomes of Botox in the rehabilitation process after neurologic lesions.Keywords: botulinum toxin type A, spasticity, stroke, multiple sclerosis

  20. Cyclin E gene (CCNE) amplification and hCDC4 mutations in endometrial carcinoma.

    Science.gov (United States)

    Cassia, Raúl; Moreno-Bueno, Gema; Rodríguez-Perales, Sandra; Hardisson, David; Cigudosa, Juan C; Palacios, José

    2003-12-01

    Cyclin E overexpression occurs in a subset of endometrial carcinomas (ECs), but the molecular mechanisms underlying this alteration remain to be established. The present study has analysed amplification of the cyclin E gene (CCNE) and mutation in hCDC4, the gene coding for the F-box protein, which tags phosphorylated cyclin E for proteosomal degradation, to ascertain whether these alterations might be responsible for cyclin E overexpression in ECs. Cyclin E and p53 expression was studied by immunohistochemistry in eight atypical endometrial hyperplasias (AEHs), 51 endometrioid endometrial carcinomas (EECs), and 22 non-endometrioid endometrial carcinomas (NEECs). CCNE amplification was analysed by fluorescence in situ hybridization (FISH). Mutations in exons 2-11 of the hCDC4 gene were screened by PCR-SSCP-sequencing. Finally, the polymorphic marker D4S1610 was used to assess loss of heterozygosity (LOH) in the hCDC4 gene. Cyclin E overexpression was found in 26/81 (32%) cases and was associated with the histological type of the lesion, since it was not found in any AEHs but was present in 27% of EECs and 54.5% of NEECs (p=0.035). Cyclin E overexpression was associated with histological grade (p=0.011) and p53 immunostaining in EECs (p=0.033). CCNE amplification was found in 6 of 37 (16%) ECs examined. There was a significant association between CCNE amplification and the histological type of the lesion, since five (83%) of the six cases with amplification were NEECs (p=0.008). One EEC harboured an hCDC4 mutation: a CGA to CAA (Arg/Gln) change at codon 479. In addition, D4S1610 LOH was found in 7 of 23 (30%) informative cases analysed, but no correlation with cyclin E overexpression was found. However, the tumour with hCDC4 mutation also showed LOH. This is the first study demonstrating that cyclin E overexpression is associated with gene amplification in ECs, these alterations being more frequent in NEECs. Although hCDC4 exhibits a low mutation frequency in ECs

  1. Oxidative stress enzyme and histopathological lesions in Colossoma macropomum (pisces, ariidae) for environmental impact assessment

    Science.gov (United States)

    Andrade, Ticianne de Sousa de Oliveira Mota; Sousa, Debora Batista Pinheiro; Dantas, Janaina Gomes; Castro, Jonatas da Silva; Neta, Raimunda Nonata Fortes Carvalho

    2015-12-01

    This study used oxidative stress enzyme (Glutathione S-Transferase and Catalase), histopathological lesions (Branchial lesions) and biometric data in the freshwater fish tambaqui, Colossoma macropomum, to assess environmental impacts in an Environmental Protection Area at São Luis, Brazil. Fish were sampled from two locations (A1 = contaminated area and A2 = reference site) within the protected area on four occasions. The activity of catalase (CAT) and glutathione S-transferase (GST) in C. macropomum was compared with biometric data and histopathological lesions. Results have shown that biometric data decreased significantly in fish (p<0.05) at the contaminated site. The activity of CAT was higher in fish specifically caught in A1. A significant difference was observed in the GST activity in the liver of C. macropomum when comparing fish from the contaminated site and those from the reference site (p<0.05).

  2. Laparoscopic surgery for endometrial cancer: a review.

    Science.gov (United States)

    Hauspy, Jan; Jiménez, Waldo; Rosen, Barry; Gotlieb, Walter H; Fung-Kee-Fung, Michael; Plante, Marie

    2010-06-01

    Uterine cancer is the fourth most common cancer in Canadian women, with an estimated 4200 new cases and 790 disease-related deaths in 2008. We investigated the domains that are important for further implementation of minimally invasive surgery for the management of endometrial cancer by performing a literature review to assess the available data on overall and disease-free survival in laparoscopic versus open surgery. We also investigated the influence of patient- related factors, surgical factors, quality of life, and cost implications. Among the 23 articles reviewed, five were randomized controlled trials (RCTs), four were prospective reviews, and 14 were retrospective reviews. The RCTs showed no difference in overall and disease-free survival for patients with endometrial cancer who had undergone laparoscopic hysterectomy compared with open surgery. Morbid obesity is a limiting factor for the feasibility of complete laparoscopic staging. Laparoscopy seems to decrease complications and decrease blood loss. It also shortens hospital stay, with improved short-term quality of life and cosmesis, while yielding similar lymph node counts. Overall, laparoscopy is cost-effective, because the increased operation cost of laparoscopy is offset by the shorter hospital stay and faster return to work. On the basis of currently available data, patients with endometrial cancer should be offered minimally invasive surgery as part of their treatment for endometrial cancer whenever possible.

  3. Improvement of endometrial biopsy over transvaginal ultrasound alone for endometrial surveillance in women with Lynch syndrome.

    NARCIS (Netherlands)

    Gerritzen, L.H.; Hoogerbrugge-van der Linden, N.; Oei, A.L.M.; Nagengast, F.M.; Ham, M.A.P.C. van; Massuger, L.F.A.G.; Hullu, J.A. de

    2009-01-01

    In women with hereditary non polyposis colorectal carcinoma (HNPCC) an annual gynaecological surveillance has been recommended because of an increased lifetime risk of developing endometrial and ovarian carcinoma. The aim of this study was to assess the efficacy of gynaecological surveillance with r

  4. Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ianculescu, Victor; Ciolovan, Laura Maria [Radiology Department, Gustave Roussy, Villejuif (France); Dunant, Ariane [Department of Statistics, Gustave Roussy, Villejuif (France); Vielh, Philippe [Department of Biopathology, Gustave Roussy, Villejuif (France); Mazouni, Chafika [Department of Surgery, Gustave Roussy, Villejuif (France); Delaloge, Suzette [Department of Oncology, Gustave Roussy, Villejuif (France); Dromain, Clarisse [Radiology Department, Gustave Roussy, Villejuif (France); Blidaru, Alexandru [Department of Surgery, Bucharest Institute of Oncology, Bucharest (Romania); Balleyguier, Corinne, E-mail: corinne.balleyguier@gustaveroussy.fr [Radiology Department, Gustave Roussy, Villejuif (France); UMR 8081, IR4M, Paris-Sud University, 91405 Orsay (France)

    2014-05-15

    Purpose: To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions. Materials and methods: Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration. Results: BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann–Whitney U test, p < 0.0001). By selecting a lesion cut-off value of 3.31 m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity. Conclusion: VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies.

  5. Two-way communication between endometrial stromal cells and monocytes.

    Science.gov (United States)

    Klinkova, Olga; Hansen, Keith A; Winterton, Emily; Mark, Connie J; Eyster, Kathleen M

    2010-02-01

    Immune system cells and cells of the endometrium have long been proposed to interact in both physiological and pathological processes. The current study was undertaken to examine communication between cultured monocytes and endometrial stromal cells and also to assess responses of endometrial stromal cells for treatment with estradiol (E) in the absence and presence of medroxyprogesterone acetate (P). A telomerase-immortalized human endometrial stromal cell (T-HESC) line and the U937 monocyte cell line were used. Telomerase-immortalized human endometrial stromal cells were treated with E +/- P +/- monocyte conditioned medium; U937 were treated +/- T-HESC conditioned medium. Gene expression in response to treatment was examined by DNA microarray. Bidirectional communication, as demonstrated by changes in gene expression, clearly occurred between U937 monocytes and T-HESC.

  6. Squamous morules are functionally inert elements of premalignant endometrial neoplasia.

    Science.gov (United States)

    Lin, Ming-Chieh; Lomo, Lesley; Baak, Jan P A; Eng, Charis; Ince, Tan A; Crum, Christopher P; Mutter, George L

    2009-02-01

    Squamous morules are a common component of premalignant glandular lesions that are followed by glandular, rather than squamous, carcinomas. We tested the hypothesis that the appearance of glands associated with morules predicts cancer risk, and undertook molecular testing to determine the clonal and hormonal response properties of admixed squamous and glandular elements. A total of 66 patients with squamous morules in an index endometrial biopsy had follow-up clinical data (average follow-up: interval 31 months, 2.5 biopsies) showing development of carcinoma in 11% (7/66) of cases. The histological appearance of morule-associated glands in the index biopsy was significantly associated with this clinical outcome, with the majority (71%, 5/7) of cancer occurrences following an overtly premalignant lesion (endometrial intraepithelial neoplasia) with squamous morules. Eight endometrial intraepithelial neoplasias with squamous morules were examined by immunohistochemistry for estrogen and progesterone receptors and mitotic activity (Ki-67 antigen percent stained). Glandular components had abundant estrogen and progesterone receptors, and high levels of mitotic activity in all cases. In sharp contrast, all squamous morules were devoid of sex hormone receptors and had undetectable or extremely low-proliferation rates. When mutated, the same specific PTEN mutation was detected in squamous and glandular elements, indicating that both are of common lineage. The clinical and laboratory data are consistent with a model of morule biology in which squamous morules are a hormonally incompetent subpopulation of endometrial glandular lesions. Isolated morules might result from artifactual displacement from their native glandular context, or selective hormonally induced regression of the glandular but not squamous components over time. Subsequent cancer risk, as promoted by estrogens, is greatest when the glandular component has the appearance of endometrial intraepithelial

  7. Endometrial metaplasias and reactive changes: a spectrum of altered differentiation.

    Science.gov (United States)

    Nicolae, Alina; Preda, Ovidiu; Nogales, Francisco F

    2011-02-01

    Endometrial metaplasias and changes (EMCs) are conditions frequently overlooked and misdiagnosed. The aim of this review is to update current issues and provide a classification with a practical clinicopathological approach. Hormonal or irritative stimuli are the main inducing factors of EMCs, although some metaplasias have a mutational origin. EMCs vary from reactive, degenerative lesions to those able to associate with malignancy or those having a preneoplastic potential. The most common types of EMCs are ciliated tubal metaplasia (CTM) and mucinous metaplasia (MM), which occur in simple and complex glands, and possibly these architectural changes hold the same prognostic significance as they do in hyperplastic endometrioid lesions. Immunohistochemically, CTM is positive for LhS28, bcl-2, PAX2 and p16(INK4A). Complex CTM is likely to be a precursor of ciliated endometrioid-type carcinomas. MMs should be evaluated architecturally, taking into account that their atypicality is minimal. The differentiation between complex MM and mucinous carcinoma may be extremely difficult. Surface complex, papillary MM in endometrial polyps can be considered as benign. Intestinal-type endometrial MM is rare and its presence should prompt further investigation of associated lesions in the endocervix. Endometrial squamous metaplasia (ESS) is often linked to chronic irritative situations. It should be differentiated from secondary involvement by a human papilomavirus-related cervical lesion. Morular metaplasia is a mutational phenomenon with a distinct phenotype that helps to differentiate it from ESS. Morules are benign, hormonally inert structures that are often markers of complex endometrioid glandular architecture, and they are associated with an attenuated malignancy. Endometrial reactive changes are commonly associated with desquamation or hormonal imbalance. The frequent, p16(INK4A) positive, benign surface papillary syncytial change may be misdiagnosed, in some cases, as

  8. Computation of realistic virtual phantom images for an objective lesion detectability assessment in digital mammography.

    Science.gov (United States)

    Perez-Ponce, Hector; Daul, Christian; Wolf, Didier; Noel, Alain

    2011-12-01

    Image quality assessment is required for an optimal use of mammographic units. On the one hand, there are objective image quality assessment methods based on the measurement of technical parameters such as modulation transfer function (MTF), noise power spectrum (NPS) or detection quantum efficiency (DQE) describing performances of digital detectors. These parameters are, however, without direct relationship with lesion detectability in clinical practice. On the other hand, there are image quality assessment methods involving time consuming procedures, but presenting a direct relationship with lesion detectability. This contribution describes an X-ray source/digital detector model leading to the simulation of virtual contrast-detail phantom (CDMAM) images. The virtual image computation method requires the acquisition of only few real images and allows for an objective image quality assessment presenting a direct relationship with lesion detectability. The transfer function of the proposed model takes as input physical parameters (MTF* and noise) measured under clinical conditions on mammographic units. As presented in this contribution, MTF* is a modified MTF taking into account the effects due to X-ray scatter in the breast and magnification. Results obtained with the structural similarity index prove that the simulated images are quite realistic in terms of contrast and noise. Tests using contrast detail curves highlight the fact that the simulated and real images lead to very similar data quality in terms of lesion detectability. Finally, various statistical tests show that quality factors computed for both the simulated images and the real images are very close for the two data sets.

  9. p16 is Consistently Expressed in Endometrial Tubal Metaplasia

    Directory of Open Access Journals (Sweden)

    N. Horree

    2007-01-01

    Full Text Available Background: Cell cycle proteins and HIF-1α with downstream factors are often abberrantly expressed in (preneoplastic tissue. Methods: Paraffin-embedded specimens of inactive endometrium with TM (n=15, ovarian inclusion cysts (n=6, cervix with TM (tubal metaplasia (n=3, Fallopian tubes (n=7, cycling endometrium (n=9 and a ciliated cell tumor of the ovary were stained for p16 and LhS28. 39 Endometrioid endometrial carcinomas and 5 serous endometrial carcinomas were stained for p16. Additionally, inactive endometrium (n=15 was immunohistochemically stained for p21, p27, p53, cyclin A, cyclin D1, cyclin E, HIF-1α, CAIX, Glut-1 and MIB-1. Results: A mosaic pattern of expression of p16 was seen throughout in all cases of endometrial TM (15/15, in 2/6 of the ovarian inclusion cysts with TM, in all (3/3 cervical TM and focal in 5/7 of Fallopian tube cases. Mosaic expression was also seen in a ciliated cell tumor of the ovary and in 18/39 of endometrioid endometrial carcinomas, and diffuse p16 expression was seen in 5/5 serous carcinomas. In comparison with normal endometrium, TM areas in the endometrium showed significantly increased expression of HIF-1α, cyclin E, p21 and cyclin A, and decreased expression of p27. Membranous expression of CAIX and Glut-1 was only seen in TM areas, pointing to functional HIF-1α. Conclusion: As p16 is consistently expressed in TM, less and only patchy expressed in the normal Fallopian tube, is paralleled by aberrant expression of cell cycle proteins, HIF-1α, CAIX and Glut-1 and resembles the pattern of p16 expression frequently seen in endometrial carcinomas, we propose endometrial TM to be a potential premalignant endometrial lesion.

  10. Do Endometrial Movements Affect The Achievement of Pregnancy during Intrauterine Insemination?

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    Ari Kim

    2015-02-01

    Full Text Available Background: This study was aimed to assess the effect of endometrial movements on pregnancy achievement in intrauterine insemination (IUI cycles. Materials and Methods: The population of this observational study was composed of unexplained infertility couples undergoing first-time IUI with clomiphene citrate between September 2010 and October 2011. Not only endometrial movements, but also thickness, volume, pattern, and echogenic change of endometrium were analyzed prospectively in prediction of pregnancy. Results: The total number of 241 cycles of IUI with 49 intrauterine pregnancies (20.3% was analyzed. Pregnancy was not related to endometrial thickness and endometrial volume, but significantly related to endometrial movements associated with the number of contraction, strong movement, cervicofundal direction, and hyperechoic change (p<0.05. Pregnant group showed higher cervicofundal movement rate (89.8 vs. 75.5%. Conclusion: For IUI cycles stimulated by clomiphene citrate in unexplained infertility women, endometrial movements on the day of IUI could be a predictor of pregnancy.

  11. Computer morphometry: experience in the study of clinical value in endometrial precancer

    Directory of Open Access Journals (Sweden)

    A. Kh. Bishtavi

    2014-01-01

    Full Text Available The differential diagnosis of simple endometrial hyperplasia (SEH, complex endometrial hyperplasia (CEH, atypical endometrial hyper- plasia (AEH, and endometrial cancer (EC is associated with a number of difficulties, frequently giving rise to different interpretations of the same histology specimens.Objective: to assess the possibilities of computed morphometry in endometrial hyperplasia.Subjects and methods. The investigation included 35 patients, including 12 with SEH, 11 with CEH, 7 with AEH, and 5 with EC. Endome- trial computed morphometry was performed using the ImageScope Color.Conclusion. The morphometric changes in endometrial hyperplasia, which are expressed in quantitative indicators, are much more diverse than their schematic image in the current classification, which may be a reason for a difference between the diagnoses.

  12. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Alexandre Perez; Perrella, Andreia; Arita, Emiko Saito; Pereira, Marlene Fenyo Soeiro de Matos; Cavalcanti, Marcelo de Gusmao Paraiso, E-mail: alexperez34@gmail.co [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia

    2010-10-15

    There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: axial, coronal and sagittal multiplanar reconstruction (MPR); and sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill no.1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis. (author)

  13. Analysis of abnormally thickened endometrial patterns on transvaginal sonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Sook; Cho, Hyeun Cha [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    1999-06-15

    To determine whether the transvaginal sonographic appearance of the thickened endometrium can help to predict the underlying endometrial pathologic process. The sonogram reports of fall 41 pre- and 21 postmenopausal women who underwent transvaginal sonogram were retrospectively analyzed. The women undergoing estrogen replacement therapy, tamoxifen therapy or having abnormal cervical cytology were excluded from this study. The analysis of sonographic and histologic results was performed in all patients. Three distinct sonographic patterns were encountered. Type I consisted of heterogeneous endometrial thickening with internal hypoechoic areas (normal [n=4], polyp [n=1] and cancer [n=4] in premenopausal women and cancer [n=4] in postmenopausal women). Type II consisted of echogenic endometrial thickening with or without tiny cysts (normal[n=5], and hyperplasia [n=7] in premenopausal women and normal [n=4], polyp [n=2], and hyperplasia [n=1] in postmenopausal women). Type III consisted of localized well defined endoluminal lesion (normal [n=1], polyp [n=14], hyperplasia [n=1], cancer [n=1], and submucosal mass [n=3] in premenopausal women and normal [n=4], polyp [n=2],submucosal mass [n=3], and hematoma [n=1] in postmenopausal women). The measurement of the endometrial thickness combined with analysis of sonographic echo patterns may be helpful in prediction and differentiation of endometrial disease in pre- and postmenopausal women. Also it can contribute to avoiding unnecessary D and C.

  14. Análises histoquímica e morfométrica de lesões endometrióticas induzidas em ratas e tratadas com dexametasona Histochemical and morphometric analysis of endometriotic lesions induced in female rats and treated with dexamethasone

    Directory of Open Access Journals (Sweden)

    Ana Paula Castor Batista

    2009-04-01

    Full Text Available INTRODUÇÃO: A literatura relata que os implantes endometriais possuem receptores para hormônios esteroides, sendo estimulados principalmente pelo estrógeno, e que algumas estratégicas de tratamento têm sido propostas em modelos experimentais, tais como a utilização de glicocorticoides sintéticos, como a dexametasona. OBJETIVO: analisar histoquímica e morfometricamente lesões endometrióticas induzidas em ratas e tratadas com 0,8 mg/kg/dia de dexametasona. MATERIAL E MÉTODOS: Quarenta ratas albinas (linhagem Wistar com 90 dias de vida, pesando aproximadamente 150 g, foram induzidas à endometriose e divididas em grupos: 1. ratas com endometriose e avaliadas após 34 dias (G1; 2. ratas com endometriose e avaliadas após 47 dias (G2; 3. ratas com endometriose e, após 21 dias do pós-operatório, tratadas com dexametasona por 13 dias (G3 e 4. ratas com endometriose e, após 21 dias do pós-operatório, tratadas com dexametasona por 13 dias e eutanasiadas após um período de 13 dias, contados a partir do término do tratamento com dexametasona (G4. Os fragmentos dos implantes endometriais foram fixados em Bouin, incluídos em paraplast e corados por hematoxilina-eosina e tricrômico de Mallory. As médias do número de glândulas foram submetidas ao teste não-paramétrico de Tukey-Kramer (p INTRODUCTION: The literature reports that endometrial implants have receptors for steroid hormones primarily stimulated by estrogen and that some treatment strategies have been proposed in experimental models such as the use of synthetic glucocorticoids, for example, dexamethasone. OBJECTIVE: to analyze histochemically and morphometrically endometriotic lesions induced in rats and treated with dexamethasone (0.8 mg/kg/day. MATERIAL AND METHODS: Forty albino female rats (Wistar strain, with 90 days of age, weighing approximately 150 g, were induced with endometriosis and divided into groups: I - rats with endometriosis and evaluated after 34 days, II

  15. Focused assessment with sonography for trauma in patients with confirmed liver lesions

    DEFF Research Database (Denmark)

    Nielsen, Solveig Kärk; Ewertsen, C; Svendsen, L B

    2012-01-01

    Background and Aims: The objective was to determine the sensitivity and specificity of Focused Assessment with Sonography for Trauma (FAST) in patients with confirmed liver lesions and also to compare results from surgeons trained in FAST with results from radiologists trained in general abdominal...... and surgeons trained in FAST. Conclusion: FAST remains an important screening tool in abdominal trauma including liver lesions, and can be performed at a satisfactory level by surgeons trained in the FAST procedure only....... patients were eligible for analysis. Seventy-two patients were examined by ra-diologists and 63 by surgeons. Results: We found FAST to have a sensitivity, specificity, PPV, and NPV of 79.6%, 100%, 100%, and 68.9%. There was no statistically significant difference between FAST performed by radiologists...

  16. Interobserver Agreement for Endometrial Cancer Characteristics Evaluated on Biopsy Material

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    S. Nofech-Mozes

    2012-01-01

    Full Text Available A shift toward a disease-based therapy designed according to patterns of failure and likelihood of nodal involvement predicted by pathologic determinants has recently led to considering a selective approach to lymphadenectomy for endometrial cancer. Therefore, it became critical to examine reproducibility of diagnosing the key determinants of risk, on preoperative endometrial tissue samples as well as the concordance between preoperative and postresection specimens. Six gynaecologic pathologists assessed 105 consecutive endometrial biopsies originally reported as positive for endometrial cancer for cell type (endometrioid versus nonendometrioid, tumor grade (FIGO 3-tiered and 2-tiered, nuclear grade, and risk category (low risk defined as endometrioid histology, grade 1 + 2 and nuclear grade <3. Interrater agreement levels were substantial for identification of nonendometrioid histology (κ = 0.63; SE = 0.025, high tumor grade (κ = 0.64; SE = 0.025, and risk category (κ = 0.66; SE = 0.025. The overall agreement was fair for nuclear grade (κ = 0.21; SE = 0.025. There is agreement amongst pathologists in identifying high-risk pathologic determinants on endometrial cancer biopsies, and these highly correlate with postresection specimens. This is ascertainment prerequisite adaptation of the paradigm shift in surgical staging of patients with endometrial cancer.

  17. Endometrial Intraepithelial Neoplasia (EIN In An Endometrial Polyp

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    Devic Ana

    2015-12-01

    Full Text Available Endometrial intraepithelial neoplasia (EIN is a monoclonal neoplastic cell proliferation of the endometrium associated with a significantly increased risk of endometrioid endometrial adenocarcinoma. We herein present the case of a 58-year-old female patient who underwent a hysterectomy with bilateral salpingo-oophorectomy because of the existence of endometrial intraepithelial neoplasia in an endometrial polyp. The patient had irregular uterine bleeding, which lasted 10 days. An endometrial polyp was diagnosed by ultrasound examination. The polyp was located in the isthmus of the uterus, on the back wall, and measured 32 mm × 25 mm. The patient underwent fractional dilation and curettage, and the specimens were subjected to a histopathological examination. The histopathological findings were EIN, endometrioid type, a focus of which was found within the endometrial polyps, as well as the endometrial polyp and proliferative endometrium. The endocervical tissue was normal. Given the age of the patient and the histopathological findings, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The final histopathological findings were EIN, endometrioid type with a focus found within the endometrial polyp; endometrial polyp; simple hyperplasia; chronic inflammation of the uterine cervix; hyperkeratosis of the cervical squamous epithelium; and cervicitis chronica. There was also hydrosalpinx of the left fallopian tube, and cystic follicles in the left ovary. There was no significant morphological change in the right ovary or fallopian tube. The surgical and postoperative course were normal. The patient was sent home on the fifth postoperative day in good general condition. A check-up performed one month after surgery showed normal findings.

  18. Computerized self-assessment of automated lesion segmentation in breast ultrasound: implication for CADx applied to findings in the axilla

    Science.gov (United States)

    Drukker, K.; Giger, M. L.

    2008-03-01

    We developed a self-assessment method in which the CADx system provided a confidence level for its lesion segmentations. The self-assessment was performed by a fuzzy-inference system based on 4 computer-extracted features of the computer-segmented lesions in a leave-one-case-out evaluation protocol. In instances where the initial segmentation received a low assessment rating, lesions were re-segmented using the same segmentation method but based on a user-defined region-of-interest. A total of 542 cases with 1133 lesions were collected in this study, and we focused here on the 97 normal lymph nodes in this dataset since these pose challenges for automated segmentation due to their inhomogeneous appearance. The percentage of all lesions with satisfactory segmentation (i.e., normalized overlap with the radiologist-delineated lesion >=0.3) was 85%. For normal lymph nodes, however, this percentage was only 36%. Of the lymph nodes, 53 received a low confidence rating (confidence levels demonstrated potential to 1) help radiologists decide whether to use or disregard CADx output, and 2) provide a guide for improvement of lesion segmentation.

  19. Improved assessment of multiple sclerosis lesion segmentation agreement via detection and outline error estimates

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    Wack David S

    2012-07-01

    Full Text Available Abstract Background Presented is the method “Detection and Outline Error Estimates” (DOEE for assessing rater agreement in the delineation of multiple sclerosis (MS lesions. The DOEE method divides operator or rater assessment into two parts: 1 Detection Error (DE -- rater agreement in detecting the same regions to mark, and 2 Outline Error (OE -- agreement of the raters in outlining of the same lesion. Methods DE, OE and Similarity Index (SI values were calculated for two raters tested on a set of 17 fluid-attenuated inversion-recovery (FLAIR images of patients with MS. DE, OE, and SI values were tested for dependence with mean total area (MTA of the raters' Region of Interests (ROIs. Results When correlated with MTA, neither DE (ρ = .056, p=.83 nor the ratio of OE to MTA (ρ = .23, p=.37, referred to as Outline Error Rate (OER, exhibited significant correlation. In contrast, SI is found to be strongly correlated with MTA (ρ = .75, p  Conclusions The DE and OER indices are proposed as a better method than SI for comparing rater agreement of ROIs, which also provide specific information for raters to improve their agreement.

  20. BIOPSIA ENDOMETRIAL AMBULATORIA: EXPERIENCIA PRELIMINAR

    OpenAIRE

    Domínguez C,Claudio; Zamora F,Jessica; Barrera P,Sandra; Tacla F,Ximena

    2006-01-01

    Objetivo: Presentar la experiencia inicial en el diagnóstico histológico con biopsia endometrial ambulatoria obtenida con pipelle de Cornier. Material y método: Se efectuó biopsia endometrial ambulatoria con pipelle de Cornier en 144 pacientes con sospecha clínica y/o ecográfica de patología endometrial difusa. Resultados: Se logró realizar el procedimiento a 131 pacientes (91%), obteniéndose diagnóstico histológico satisfactorio en 110 casos (76,4%). De las 110 muestras analizadas, se diagno...

  1. Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

    Directory of Open Access Journals (Sweden)

    Longwen Chen

    2014-01-01

    Full Text Available The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap interpretations of atypical endometrial cells (AEMs or AGC favor endometrial origin (AGC-EM. More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05% were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7. On follow-up histology, 27 (20.3% had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal, 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial

  2. Drugs Approved for Endometrial Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for endometrial cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  3. Therapeutic options for management of endometrial hyperplasia.

    Science.gov (United States)

    Chandra, Vishal; Kim, Jong Joo; Benbrook, Doris Mangiaracina; Dwivedi, Anila; Rai, Rajani

    2016-01-01

    Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH.

  4. Quantitative immunohistochemical assessment of blood and lymphatic microcirculation in cutaneous lichen planus lesions.

    Science.gov (United States)

    Výbohová, Desanka; Mellová, Yvetta; Adamicová, Katarína; Adamkov, Marián; Hešková, Gabriela

    2015-06-01

    Latest advances have brought to light the hypothesis that angiogenesis and lymphangiogenesis are tightly connected to some chronic inflammatory diseases. The present study focuses on immunohistochemical assessment of the quantitative changes in the blood and lymphatic microcirculatory bed in common chronic dermatosis - cutaneous lichen planus. Double immunohistochemistry with CD34 and podoplanin antibodies was used to detect blood and lymphatic endothelium, while anti-human VEGF was used for the observation of a key angiogenesis and lymphangiogenesis inducer. Morphometric analysis was performed with QuickPhoto Micro image analysis software. Results confirmed statistically significant enlargement of both the blood and lymphatic microcirculatory beds. Compared to healthy skin, cutaneous lichen planus lesions revealed 1.6 times enlarged blood microcirculatory bed and 1.8 times enlarged lymphatic microcirculatory bed. Vascular endothelial growth factor (VEGF) expression in lesional skin was significantly higher in the epidermis (19.1 times increase) than in the dermis (10.3 times increase). These findings indicate a tight association of angiogenesis and lymphangiogenesis with the pathogenesis of cutaneous lichen planus.

  5. SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients

    DEFF Research Database (Denmark)

    Antonsen, Sofie Leisby; Loft, Annika; Fisker, Rune Vincents;

    2013-01-01

    To evaluate SUVmax in the assessment of endometrial cancer preoperatively with particular focus on myometrial invasion (MI), cervical invasion (CI), FIGO stage, risk-stratification and lymph node metastases (LNM).......To evaluate SUVmax in the assessment of endometrial cancer preoperatively with particular focus on myometrial invasion (MI), cervical invasion (CI), FIGO stage, risk-stratification and lymph node metastases (LNM)....

  6. NI-79RAPID ASSESSMENT OF LESION VOLUMES FOR PATIENTS WITH GLIOMA USING THE SMARTBRUSH SOFTWARE PACKAGE

    Science.gov (United States)

    Vaziri, Sana; Lafontaine, Marisa; Olson, Beck; Crane, Jason C.; Chang, Susan; Lupo, Janine; Nelson, Sarah J.

    2014-01-01

    The increasing interest in enhancing the RANO criteria by using quantitative assessments of changes in lesion size and image intensities has highlighted the need for rapid, easy-to-use tools that provide DICOM compatible outputs for evaluation of patients with glioma. To evaluate the performance of the SmartBrush software (Brainlab AG), which provides computer-assisted definitions of regions of interest (ROIs), a cohort of 20 patients with glioma (equal number having high and low grade and treated and un-treated) were scanned using a 3T whole-body MR system prior to surgical resection. The T2-weighted FLAIR, pre- and post-contrast T1-weighted gradient echo DICOM images were pushed from the scanner to an offline workstation where analysis of lesion volumes was performed using SmartBrush. Volumes of the T2Ls ranged from 7.9 to 110.2cm3 and the volumes of the CELs was 0.1 to 28.5 cm3 with 19/20 of the subjects having CELs and all 20 having T2Ls. the computer-assisted analysis was performed rapidly and efficiently, with the mean time for defining both lesions per subject was 5.77 (range 3.5 to 7.5) minutes. Prior analysis of ROIS with the SLICER package (www.slicer.org) took approximately 30 minutes/subject. SmartBrush provides lesion volumes and cross-sectional diameter as a PDF report, which can be stored in DICOM. The ROIs were also saved as DICOM objects and transferred to other packages for performing histogram analysis from ADC or other functional parameter maps. Ongoing studies that will be reported in this presentation are performing a similar analysis with multiple users in order to compare the relative intra- and inter-operator variations in terms of both the speed of analysis and the ROIs that are identified. Acknowledgements: The authors would like to acknowledge Rowena Thomson and Natalie Wright from Brainlab for helping to set up this study.

  7. The Role of Endocrine and Endometrial Factors in Cases of Recurrent Miscarriage: A Tertiary Center Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Uysal

    2014-03-01

    Full Text Available Aim: To investigate endocrinologic and endometrial factors in cases of recurrent abortions. Material and Method: In cases of recurrent abortions, clinical and ultrasonographic features, genetic, anatomic and immunologic factors, hormonal profiles and endometrial samplings were assessed. Chromosomal abnormalities and uterine anomalies were excluded. Results: In 8 (14% of 57 cases with recurrent abortions, there were low progesterone levels. In 1 (1.75% case there was a high androgen level. In 2 (3.5% cases there was hyperprolactinemia and in another 2 (3.5% cases there were high insulin levels. In 4 (7% cases two scores of OGTT were high. In 51 cases where endometrial sampling was performed, only one (1.75% case had delayed endometrial development. Discussion: We conclude that recurrent abortions have a complex etiology related to endocrinologic and endometrial factors.

  8. CCNE1 amplification is associated with aggressive potential in endometrioid endometrial carcinomas

    OpenAIRE

    Nakayama, Kentaro; RAHMAN, MOHAMMED TANJIMUR; Rahman, Munmun; NAKAMURA, Kohei; Ishikawa, Masako; Katagiri, Hiroshi; Sato, Emi; Ishibashi, Tomoka; IIDA, KOUJI; Ishikawa, Noriyuki; Kyo, Satoru

    2015-01-01

    The clinicopathological significance of amplification was investigated of the gene encoding cyclin E (CCNE1) and we assessed whether CCNE1 was a potential target in endometrioid endometrial carcinomas. CCNE1 amplification and CCNE1 or F-box and WD repeat domain-containing 7 (FBXW7) expression in endometrial endometrioid carcinoma was assessed by immunohistochemistry and fluorescence in situ hybridization. CCNE1 knockdown by small interfering RNA (siRNA) was used to assess the CCNE1 function. ...

  9. Superior labrum anterior to posterior lesion type II with accompanied findings: assessment of shoulder MR arthrographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Young; Chun, Kyung Ah; Kwon, Oh Soo; Kim, Ki Tae [The Catholic University of Korea, Uijeongbu St. Mary' s Hospital, Uijeongbu (Korea, Republic of)

    2006-12-15

    To describe the pattern of various shoulder abnormalities with an associated superior labrum anterior to posterior (SLAP) lesion type II using magnetic resonance (MR) arthrography, and to assess the clinical significance of the associated abnormalities. A retrospective review of the MR arthrographic findings of 92 cases of a shoulder with an arthroscopically confirmed SLAP lesion type II was performed. The MR arthrography images were reviewed and analyzed. MR arthrographic analysis noted the presence of a rotator cuff abnormality, acromioclavicular arthritis, adhesive capsulitis, glenohumeral arthritis, a labral abnormality besides the SLAP lesion, and a paralabral cyst. The patients with SLAP lesions were divided into two age groups: those over 40 years of age and those forty years old or younger. Statistical analysis was performed to evaluate the influence of age on the various shoulder abnormalities with associated SLAP lesion. Of the 92 SLAP lesions type II, there were 7 cases (8%) of isolated SLAP lesions without any associated any shoulder abnormality. Eighty-five (92%) SLAP lesions were associated with various shoulder abnormalities including rotator cuff tendinosis (30/92, 33%), partial-thickness tear (36/92, 39%), full-thickness tear (2/92, 2%), acromioclavicular arthritis (46/92, 50%), adhesive capsulitis (7/92, 8%), glenohumeral arthritis (15/92, 16%), labral abnormality (26/92, 28%) and paralabral cyst (7/92, 8%). The SLAP lesions (60/92, 65%) in patients over forty years of age were accompanied by a significantly high number of rotator cuff abnormalities ({rho} < 0.001), glenohumeral osteoarthritis ({rho} = 0.001), and acromioclavicular osteoarthritis ({rho} < 0.001). In contrast, the SLAP lesions (32/92, 35%) in patients forty years old or younger had a significantly high number of anterior or posterior labral lesions ({rho} < 0.001). Isolated SLAP lesions type II without other associated shoulder abnormalities are uncommon, and the age of the patient

  10. ATM may be a protective factor in endometrial carcinogenesis with the progesterone pathway.

    Science.gov (United States)

    Shan, Weiwei; Wang, Chao; Zhang, Zhenbo; Luo, Xuezhen; Ning, Chengcheng; Yu, Yinhua; Feng, Youji; Gu, Chao; Chen, Xiaojun

    2015-03-01

    The purpose of the study was to explore the role and mechanism of ataxia-telangiectasia mutated (ATM) protein in endometrial carcinogenesis. A reverse-phase protein array (RPPA) was used to analyze the expression of ATM signal pathway proteins in Ishikawa and progesterone-insensitive Ishikawa. ATM expression was detected in endometrium specimens by immunohistochemistry, including 8 cases with proliferative endometrium, 6 cases with secretory endometrium, 10 cases with simple hyperplasia (SH), 13 cases of complex hyperplasia (CH), 11 cases of endometrial atypical hyperplasia (EAH), and 83 cases with type I endometrial cancer. The relationship between ATM expression and other clinicopathological indicators was also examined in type I endometrial cancer patients. The mechanisms of ATM were explored in vitro with the endometrial cell lines Ishikawa and RL95-2. A cell counting kit-8 (CCK-8) test and Western blot analysis were performed to test proliferation and protein expression. Statistical analysis was performed with SPSS19.0. The significance level was set at 0.05. ATM was increased with medroxyprogesterone acetate (MPA) stimulation in Ishikawa in RPPA. ATM expression gradually decreased in endometrial hyperplasic lesions compared with the normal proliferative and secretory endometrium and was the lowest in type I endometrial cancer. ATM expression was negatively correlated with pathological grades in type I endometrial cancer. In vitro, ATM silencing retarded proliferation inhibition in Ishikawa and RL95-2 treated with MPA. ATM silencing could down-regulate the MPA-stimulated signal proteins, including Chk2, P53, and caspase-3 in vitro. MPA might exert its role through activating the ATM-associated pathway, ATM-Chk2-P53-caspase-3 (active), preserving normal endometrium and protecting it from malignancies. ATM might be a promising indicator for endometrial hyperplasia and cancer.

  11. Contribution of nuclear morphometric features to differentiation of atypical complex type endometrial hyperplasia and low grade endometrial carcinoma

    Directory of Open Access Journals (Sweden)

    Onder Onguru

    2011-08-01

    Full Text Available Objective: The differentiation of atypical complex type endometrial hyperplasia (ACEH and low grade endometrial carcinoma (EC may be problematic in endometrial biopsy materials. Desmoplasia and stromal invasion are diagnostic for EC but they are not always demonstrated in endometrial biopsies. In this study, we investigated the contribution of nuclear morphometry to distinction of ACEH and low grade EC. Methods: Ten low grade EC and eight ACEH cases retrieved from the archives of the Department of Pathology. For each case at least 100 nuclei (totally 1000 for both groups were selected using hematoxylen-eosine stained sections and evaluated by a computer assisted system. Measured nuclear morphometric features were nuclear area, nuclear perimeter, circular form factor, diameter equivalent circle, minimum feret, maximum feret, area convex hull, perimeter convex hull. Results: There was no significant differences between these two groups for circular form factor (P=0.871. But all other morphometric features were statistically significant (P<0.05. Conclusion: Our findings suggest that nuclear morphometric features may be used as an ancillary diagnostic tool in addition to conventional histopathological findings in borderline lesion. These findings should be confirmed with expanded case series. [J Exp Integr Med 2011; 1(4.000: 277-280

  12. The prevalence of endometrial hyperplasia and endometrial cancer in women with polycystic ovary syndrome or hyperandrogenism

    DEFF Research Database (Denmark)

    Holm, Nina Sofie Lillegaard; Glintborg, Dorte; Andersen, Marianne Skovsager;

    2012-01-01

    Polycystic ovary syndrome may be associated with an increased risk of endometrial hyperplasia and endometrial cancer, but substantial evidence for this remains to be established. We investigated the prevalence of endometrial hyperplasia and endometrial cancer in a well characterized group of wome...

  13. Hormone replacement therapy and the risk of endometrial cancer

    DEFF Research Database (Denmark)

    Sjögren, Lea; Mørch, Lina S; Løkkegaard, Ellen

    2016-01-01

    progestin therapy according to the risk of endometrial cancer, while considering both regimen and type of progestin. METHODS: PubMed, EMBASE and the Cochrane Library were searched, resulting in the identification of 527 published articles on menopausal women with intact uteri treated with estrogen only......BACKGROUND: In 1975, estrogen only was found to be associated with an increased risk of endometrial cancer. In November 2015, NICE guidelines on hormone therapy were published that did not take this risk into account. AIM: This systematic literature review assesses the safety of estrogen plus......, estrogen plus progestin or tibolone for a minimum of one year. Risk of endometrial cancer was compared to placebo or never users and measured as relative risk, hazard or odds ratio. RESULTS: 28 studies were included. The observational literature found an increased risk among users of estrogen alone...

  14. EFFECT OF MIFEPRISTONE (RU486) ON MARKERS OF ENDOMETRIAL RECEPTIVITY

    Institute of Scientific and Technical Information of China (English)

    武捷; 王龙生; 程捷; 王介东

    2003-01-01

    Objective To study the effect of single and low dose of RU486 on endometrial receptivity of healthy women. Methods A total of 5 healthy women were followed for one control and one treatment cycle. In the treatment cycle, a dose of 10 mg RU486 was administered on day luteinizing hormone (LH)-2. In both the control and treatment cycle, an endometrial biopsy was obtained on LH+7. These biopsies were assessed by immunohistochemical analysis to find the difference in expression of integrins and progesterone receptor (PR) between the control and treatment cycle. Results The treatment with RU486 increased the expression of α1 and α4 subunits of integrin in glandular epithelial cells, but did not influence β3 subunit. Moreover, the normal down-regulation of PR in epitherial cell nuclei was inhibited by 10 mg RU486. Conclusion Single dose of 10 mg RU486 impairs the establishment of endometrial receptivity on time.

  15. Endometrial cancer risk prediction including serum-based biomarkers

    DEFF Research Database (Denmark)

    Fortner, Renée T; Hüsing, Anika; Kühn, Tilman;

    2017-01-01

    Endometrial cancer risk prediction models including lifestyle, anthropometric, and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case......-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum...... concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines, and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at pdiscrimination was assessed using...

  16. Reduced artefacts and improved assessment of hyperintense brain lesions with BLADE MR imaging in patients with neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    Kalle, Thekla von; Fabig-Moritz, Claudia; Mueller-Abt, Peter; Zieger, Michael; Winkler, Peter [Department of Paediatric Radiology, Stuttgart (Germany); Blank, Bernd [Haematology and Immunology, Department of Paediatric Oncology, Stuttgart (Germany); Wohlfarth, Katrin [Siemens Healthcare Sector, Erlangen (Germany)

    2009-11-15

    Assessment of small brain lesions in children is often compromised by pulsation, flow or movement artefacts. MRI with a rotating blade-like k-space covering (BLADE, PROPELLER) can compensate for these artefacts. We compared T2-weighted FLAIR images that were acquired with different k-space trajectories (conventional Cartesian and BLADE) to evaluate the impact of BLADE technique on the delineation of small or low-contrast brain lesions. The subject group comprised 26 children with neurofibromatosis type 1 (NF 1), who had been routinely scanned at 1.5 T for optic pathway gliomas with both techniques and who had the typical hyperintense brain lesions seen in NF 1. Four experienced radiologists retrospectively compared unlabelled 4-mm axial images with respect to the presence of artefacts, visibility of lesions, quality of contour and contrast. Both techniques were comparable in depicting hyperintense lesions as small as 2 mm independent of contrast and edge definition. Pulsation and movement artefacts were significantly less common with BLADE k-space trajectory. In 7 of 26 patients (27%), lesions and artefacts were rated as indistinguishable in conventional FLAIR, but not in BLADE FLAIR images. BLADE imaging significantly improved the depiction of lesions in T2-W FLAIR images due to artefact reduction especially in the posterior fossa. (orig.)

  17. Role of transvaginal contrast-enhanced ultrasound in the early diagnosis of endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    LIU Ying; TIAN Jia-wei; XU Yi; CHENG Wen

    2012-01-01

    Background Endometrial carcinoma is one of the most common gynecological malignancies among women.Early diagnosis and correct preoperative evaluation of myometrial invasion are necessary to improve the prognosis.This study aimed to determine whether features and time-intensity curves (TIC) of transvaginal contrast-enhanced ultrasound (CEUS) differ from those of conventional ultrasound for endometrial carcinoma,and to further explore the clinical role of transvaginal CEUS in the early diagnosis of endometrial carcinoma.Methods Forty women with a normal uterus and seventy-nine patients with endometrial carcinoma were examinedby the transvaginal CEUS with SonoVue (Bracco,Imaging B.V,Switzerland).The enhancement patterns and TIC of lesions were analyzed.The results of CEUS were compared with those of conventional ultrasound and pathology.Results In the early and late enhanced stages,the intensity of enhancement of the normal endometrium was always lower than that in the myometrium,and the boundary between normal endometrium and myometrium was clear.A total of 65.8% (52/79) of lesions presented with inhomogeneous enhancement,34.2% (27/79) presented with homogeneous enhancement; 60.8% (48/79) presented with hyperechoic enhancement,27.8% (22/79) presented with isoechoic enhancement,and 11.4% (9/79) presented with hypoechoic enhancement.The average arrival time,time to peak,rise time,half-wash out time of lesions were shorter than of normal endometrium (P <0.05).The average peak intensity,relative rise in intensity,half-wash out intensity of lesions were higher than of normal endometrium (P<0.05).There were 49 (must be and may be present) cases of endometrial carcinoma by ultrasound (US); 24 cases were consistent with pathology results,16 cases were underestimated and 9 cases were overestimated.There were 72 (must be and may be present) cases of endometrial carcinoma by CEUS; 53 cases were consistent with pathology results,12 cases were underestimated and 7

  18. Endometrial histology and predictable clinical factors for endometrial disease in women with polycystic ovary syndrome

    OpenAIRE

    Park, Joon Cheol; Lim, Su Yeon; Jang, Tae Kyu; Bae, Jin Gon; Kim, Jong In; Rhee, Jeong Ho

    2011-01-01

    Objective This study was aimed to investigate endometrial histology and to find predictable clinical factors for endometrial disease (hyperplasia or cancer) in women with polycystic ovary syndrome (PCOS). Methods We investigated the endometrial histology and analyzed the relationship between endometrial histology and clinical parameters, such as LH, FSH, estradiol, testosterone, fasting and 2 hours postprandial glucose and insulin, insulin resistance, body mass index, endometrial thickness, m...

  19. Optical detection of cancer and precancerous lesions of the upper aerodigestive tract: methods for assessment of vertical extensions

    Science.gov (United States)

    Kraft, Marcel; Arens, Christoph

    2013-06-01

    Introduction: Endoscopic imaging can be used in the assessment of cancer and precancerous lesions of the upper aerodigestive tract. The objective of this presentation is to describe vertical imaging methods. Methods: The working principle and technique of optical coherence tomography (OCT) as well as endosonography (EUS) are briefly illustrated. Results: The main indications, normal and pathologic findings of each method, frequent pitfalls, and clinical results up to now are presented in detail. Conclusions: Endosonography helps in determining the exact extension of advanced carcinomas beyond 3 mm, while OCT, due to its better resolution, is superior in the assessment of precancerous and early cancerous lesions up to 2 mm thickness.

  20. Magnifying endoscopy in upper gastroenterology for assessing lesions before completing endoscopic removal

    Institute of Scientific and Technical Information of China (English)

    Ning-Li Chai; En-Qiang Ling-Hu; Yoshinori Morita; Daisuke Obata; Takashi Toyonaga; Takeshi Azuma; Ben-Yan Wu

    2012-01-01

    Any prognosis of gastrointestinal (GI) cancer is closely related to the stage of the disease at diagnosis.Endoscopic submucosal dissection (ESD) and en bloc endoscopic mucosal resection (EMR) have been performed as curative treatments for many early-stage GI lesions in recent years.The technologies have been widely accepted in many Asian countries because they are minimally invasive and supply thorough histopathologic evaluation of the specimens.However,before engaging in endoscopic therapy,an accurate diagnosis is a precondition to effecting the complete cure of the underlying malignancy or carcinoma in situ.For the past few years,many new types of endoscopic techniques,including magnifying endoscopy with narrow-band imaging (MENBI),have emerged in many countries because these methods provide a strong indication of early lesions and are very useful in determining treatment options before ESD or EMR.However,to date,there is no comparable classification equivalent to "Kudo's Pit Pattern Classification in the colon",for the upper GI,there is still no clear internationally accepted classification system of magnifying endoscopy.Therefore,in order to help unify some viewpoints,here we will review the defining optical imaging characteristics and the current representative classifications of microvascular and microsurface patterns in the upper GI tract under ME-NBI,describe the accurate relationship between them and the pathological diagnosis,and their clinical applications prior to ESD or en bloc EMR.We will also discuss assessing the differentiation and depth of invasion,defying the lateral spread of involvement and targeting biopsy in real time.

  1. Assessment of chemomechanical removal of carious lesions using Papacarie Duo ™: Randomized longitudinal clinical trial

    Directory of Open Access Journals (Sweden)

    Simone Ferreira Borges Matsumoto

    2013-01-01

    Full Text Available Background: Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. Aim: The aim of the present study was to assess the effectiveness of Papacarie Duo ® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur. Settings and Design: A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. Materials and Methods: Two teeth were treated in each child (split-mouth design, with the randomization of two methods: Group 1 - chemomechanical caries removal with Papacarie Duo™; and Group 2 - removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale; rtention of the restorative material in the cavity; and the presence of secondary caries after 30 days. Statistical Analysis Used: Chi-squared test, Student′s t-test, and Wilcoxon test. Results: No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13, the occurrence of pain (P = 0.585, or restoration status at the 30-day clinical evaluation (P = 0.713. Conclusion: The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.

  2. Can endometrial arylsulfatase A activity predict the onset of endometrial polyps over the years? A atividade da arilsulfatase endometrial A pode prever a aparição de pólipos endometriais ao longo dos anos?

    Directory of Open Access Journals (Sweden)

    Ugo Indraccolo

    2013-01-01

    Full Text Available PURPOSE: To assess if arylsulfatase A activity (ASA and sulfatide (SL concentration in the human endometrium can be predictive of the development of endometrial polyps over the years, since ASA activity reflects the endometrial sensitivity to hormones. METHODS: ASA activity and SL concentration were determined by biochemical procedures on endometrial samples collected between 1990 and 1994 in non-menopausal women. These women underwent a new endometrial sampling following the clinical indication some years after the first endometrial sampling. The histological assessment of the second endometrial specimens found four patients with normal endometrial pattern and 10 patients with one or more endometrial polyps. ASA activity/years elapsed and SL concentration/years elapsed were compared using two tailed Mann-Whitney test for unpaired data between patients with normal pattern and patients with endometrial polyps. RESULTS: Median ASA activities were 2.62 (normal pattern versus 1.85 (endometrial polyps nmol hydrolized substrate/min. Median activity/years elapsed is higher in patients with second endometrial sample presenting normal pattern (p=0.006 and median SL concentration/years elapsed does not differ significantly among groups, even if median SL concentration seems to be higher in patients who subsequently developed polyps (1031 µg/g of fresh tissue versus 341,5 µg/g of fresh tissue. CONCLUSIONS: ASA activity can predict the onset of endometrial polyps over the years.OBJETIVO: Avaliar se a atividade da arilsulfatase A (ASA e a concentração de sulfatida (SL no endométrio humano pode ser preditivo em relação ao desenvolvimento de pólipos endometriais ao longo dos anos, posto que atividade da ASA reflete a sensibilidade do endométrio aos hormônios. MÉTODOS: A atividade da ASA, assim como a concentração de SL, foi determinada por meio de procedimentos bioquímicos em amostras de endométrio coletadas entre 1990 e 1994, em mulheres que n

  3. Understanding visual search patterns of dermatologists assessing pigmented skin lesions before and after online training.

    Science.gov (United States)

    Krupinski, Elizabeth A; Chao, Joseph; Hofmann-Wellenhof, Rainer; Morrison, Lynne; Curiel-Lewandrowski, Clara

    2014-12-01

    The goal of this investigation was to explore the feasibility of characterizing the visual search characteristics of dermatologists evaluating images corresponding to single pigmented skin lesions (PSLs) (close-ups and dermoscopy) as a venue to improve training programs for dermoscopy. Two Board-certified dermatologists and two dermatology residents participated in a phased study. In phase I, they viewed a series of 20 PSL cases ranging from benign nevi to melanoma. The close-up and dermoscopy images of the PSL were evaluated sequentially and rated individually as benign or malignant, while eye position was recorded. Subsequently, the participating subjects completed an online dermoscopy training module that included a pre- and post-test assessing their dermoscopy skills (phase 2). Three months later, the subjects repeated their assessment on the 20 PSLs presented during phase I of the study. Significant differences in viewing time and eye-position parameters were observed as a function of level of expertise. Dermatologists overall have more efficient search than residents generating fewer fixations with shorter dwells. Fixations and dwells associated with decisions changing from benign to malignant or vice versa from photo to dermatoscopic viewing were longer than any other decision, indicating increased visual processing for those decisions. These differences in visual search may have implications for developing tools to teach dermatologists and residents about how to better utilize dermoscopy in clinical practice.

  4. Assessment of T2- and T1-weighted MRI brain lesion load in patients with subcortical vascular encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gass, A.; Oster, M.; Cohen, S.; Daffertshofer, M.; Schwartz, A.; Hennerici, M.G. [Neurologische Universitaetsklinik, Klinikum Mannheim der Universitaet Heidelberg (Germany)

    1998-08-01

    Previous cross-sectional studies in patients with subcortical vascular encephalopathy (SVE) have shown little or no correlation between brain lesion load and clinical disability, which could be due to the low specificity of T2-weighted MRI. Recent studies have indicated that T1-weighted MRI may be more specific than T2-weighted MRI for severe tissue destruction. We studied 37 patients with a diagnosis of SVE and 11 normal controls with standardised T1- and T2-weighted MRI. All patients underwent detailed clinical assessment including a neuropsychological test battery and computerised gait analysis. Both the T2- and T1-weighted total MRI lesion loads different between patients and controls different, particularly T1. The ratio of T2-/T1-weighted lesion load was lower in controls than in patients. There was no overall correlation of T1- or T2-weighted lesion load with clinical disability, but group comparison of patients with severe and mild clinical deficits showed different lesion loads. We suggest that T1- and T2-weighted MRI lesion loads demonstrate relevant structural abnormality in patients with SVE. (orig.) With 1 fig., 25 refs.

  5. Body mass index and the quality of life of endometrial cancer survivors-A systematic review and meta-analysis

    NARCIS (Netherlands)

    Smits, A.; Lopes, A.; Bekkers, R.L.; Galaal, K.

    2015-01-01

    BACKGROUND: Obesity is a risk factor for developing endometrial cancer and known to negatively affect outcomes and survival. However, the association between obesity and quality of life of endometrial cancer survivors (ECS) remains unclear. OBJECTIVES: To assess the association between body mass ind

  6. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care

    NARCIS (Netherlands)

    Wagemakers, H.P.; Luijsterburg, P.A.; Boks, S.S.; Heintjes, E.M.; Berger, M.Y.; Verhaar, J.A.; Koes, B.W.; Bierma-Zeinstra, S.M.

    2010-01-01

    Wagemakers HP, Luijsterburg PA, Boks SS, Heintjes EM, Berger MY, Verhaar JA, Koes BK, Bierma-Zeinstra SM. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care. Arch Phys Med Rehabil 2010;91:1452-9. Objective: To a

  7. The accuracy of physical diagnostic tests for assessing meniscal lesions of the knee: a meta-analysis.

    NARCIS (Netherlands)

    Scholten, R.J.P.M.; Devillé, W.L.J.M.; Opstelten, W.; Bijl, D.; Plas, C.G. van der; Bouter, L.M.

    2001-01-01

    OBJECTIVE. Our systematic review summarizes the evidence about the accuracy of physical diagnostic tests for assessing meniscal lesions of the knee. SEARCH STRATEGY. We performed a literature search of MEDLINE (1966-1999) and EMBASE 1988- 1999) with additional reference tracking. SELECTION CRITERIA

  8. Lung, liver and lymph node metastases in follow-up MSCT. Comprehensive volumetric assessment of lesion size changes

    Energy Technology Data Exchange (ETDEWEB)

    Wulff, A.M.; Fischer, S.; Biederer, J.; Heller, M.; Fabel, M. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Diagnostische Radiologie; Bolte, H. [Universitaetsklinikum Muenster (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Freitag-Wolf, S. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Inst. fuer Medizinische Informatik und Statistik; Soza, G.; Tietjen, C. [Siemens AG (Germany). Imaging and IT Div. Computed Tomography

    2012-09-15

    Purpose: To investigate measurement accuracy in terms of precision and inter-rater variability in the simultaneous volumetric assessment of lung, liver and lymph node metastasis size change over time in comparison to RECIST 1.1. Materials and Methods: Three independent readers evaluated multislice CT data from clinical follow-up studies (chest/abdomen) in 50 patients with metastases. A total of 117 lung, 77 liver and 97 lymph node metastases were assessed manually (RECIST 1.1) and by volumetry with semi-automated software. The quality of segmentation and need for manual adjustments were recorded. Volumes were converted to effective diameters to allow comparison to RECIST. For statistical assessment of precision and interobserver agreement, the Wilcoxon-signed rank test and Bland-Altman plots were utilized. Results: The quality of segmentation after manual correction was acceptable to excellent in 95 % of lesions and manual corrections were applied in 21 - 36 % of all lesions, most predominantly in lymph nodes. Mean precision was 2.6 - 6.3 % (manual) with 0.2 - 1.5 % (effective) relative measurement deviation (p <.001). Inter-reader median variation coefficients ranged from 9.4 - 12.8 % (manual) and 2.9 - 8.2 % (volumetric) for different lesion types (p <.001). The limits of agreement were {+-} 9.8 to {+-} 11.2 % for volumetric assessment. Conclusion: Superior precision and inter-rater variability of volumetric over manual measurement of lesion change over time was demonstrated in a whole body setting. (orig.)

  9. Assessment of oral mucosal lesions among eunuchs residing in Bhopal city, Madhya Pradesh, India: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nilesh Arjun Torwane

    2015-01-01

    Full Text Available Aim: The present cross-sectional study following the STROBE guidelines was conducted to assess the prevalence of oral mucosal lesions among males, females, and eunuchs residing in Bhopal city, Madhya Pradesh India. Materials and Methods: Based on convenient non-probability snowball sampling technique, all the self-identified eunuchs residing in the city of Bhopal who were present at the time of examination and who fulfilled the selection criteria were examined. A cross section of the general population (males and females residing in the same locality where these eunuchs live was also examined. The World Health Organization (WHO oral health assessment proforma (1997 was used to collect the information on oral mucosal lesions. All the obtained data were analyzed by using a Statistical Package for Social Sciences version 20. Results: Overall prevalence of oral mucosal lesions was 127 (19.9% among the study subjects. Fifty-nine (28.5% eunuchs, 56 (25.7% males, and 12 (5.6% females were observed to have some oral mucosal lesions. Oral submucous fibrosis (6.4%, leukoplakia (5.5%, and traumatic ulceration (4.2% were the major oral mucosal conditions observed. Conclusion: The information presented in this study adds to our understanding of the common oral mucosal lesions occurring in the eunuch population. Efforts to increase patient awareness of the oral effects of tobacco use and to eliminate the habit are needed to improve the oral and general health of eunuchs.

  10. Complex cystic lesions of the breast on ultrasonography: Feature analysis and BI-RADS assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Hsian-He, E-mail: hsianhe@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Yu, Jyh-Cherng [Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Lee, Herng-Sheng [Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Lin, Wen-Chiung; Chang, Wei-Chou [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taiwan (China); Huang, Guo-Shu; Hsu, Giu-Cheng [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan (China)

    2011-07-15

    Purpose: To analyze the features of breast complex cystic lesions at ultrasonography (US) and to determine appropriate Breast Imaging Reporting and Data System (BI-RADS) categories and management recommendations for these lesions based on US findings with pathologic correlation. Materials and methods: From July 2001 to June 2007, 152 consecutive pathologically proven complex cystic lesions on US were retrospectively reviewed. All lesions at US were evaluated for size, lesion characteristics, margins, and presence of abnormal axillary nodes. US features of lesions were classified into four types, and positive predictive values (PPVs) were calculated for each type. Clinical, imaging, and histopathological findings were reviewed. Results: Of the 152 lesions based on US appearance, 36 (24%) were classified as type I, 49 (32%) as type II, 28 (18%) as type III, and 39 (26%) as type IV. The PPVs for malignancy in each type were 14% for type I, 16% for type II, 14% for type III, and 41% for type IV. There was a significantly higher frequency of malignancy among lesions of type IV compared with the other three types (16/39 = 41% vs 5/36 = 14%, p = 0.0089; 16/39 = 41% vs 8/49 = 16%, p = 0.0098; and 16/39 = 41% vs 4/28 = 14%, p = 0.018 [Chi-squared test]). Lesions with maximum diameter equal to or larger than 20 mm, not circumscribed margins, or a mammographic finding of suspected malignancy had a high probability of malignancy (p < 0.05 for each). Conclusion: US is useful in evaluating the complex cystic lesions and in clarifying the indication for biopsy of these lesions. The four types of US classifications used in our study establish accepted benchmarks for these breast abnormalities when stratified according to BI-RADS categories.

  11. Non-mass-like breast lesions at ultrasonography: Feature analysis and BI-RADS assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kai-Hsiung [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Hsu, Hsian-He, E-mail: hsianhe@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Yu, Jyh-Cherng [Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Peng, Yi-Jen [Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC (China); Chu, Chi-Ming [Section of Health Informatics, Institute of Public Health, National Defense Medical Center and University, Taipei, Taiwan, ROC (China); Chang, Tsun-Hou; Chang, Wei-Chou; Wu, Yu-Cheng; Lin, Yu-Pang; Hsu, Giu-Cheng [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China)

    2015-01-15

    Highlights: • The positive predictive value of an NML lesion on ultrasound ranges from 10 to 79%. • A sizable number of NML malignant lesions are pure DCIS or ILC. • Biopsy is indicated for histopathological diagnosis when an ultrasound NML lesion is recognized. - Abstract: Objective: To analyze the features of non-mass-like (NML) breast lesions on ultrasound (US) and determine their corresponding malignancy rate and to stratify these lesion patterns according to US BI-RADS categories. Materials and methods: One hundred sixty-four consecutive lesions were retrospectively classified into four types according to the US features, the corresponding positive predictive values (PPVs) were obtained. Clinical, imaging, and histopathological findings were reviewed. Results: Among the 164 lesions, 39 (24%) were classified as type Ia, 14 (8%) as type Ib, 39 (24%) as type IIa, 19 (12%) as type IIb, 19 (12%) as type III, and 34 (21%) as type IV. The PPVs for malignancy were 21% for type Ia, 79% for type Ib, 10% for type IIa, 58% for type IIb, 16% for type III, and 21% for type IV. All NML lesions were classified as BI-RADS category 4a (type IIa), 4b (type Ia, III and IV) and 4c (type Ib and IIb) according to their PPVs. There was a significantly higher frequency of malignancy among lesions of type Ib and type IIb compared with the other types (P < 0.01 for each). Lesions with associated calcifications, presence of abnormal axillary nodes, or a mammographic finding of suspected malignancy had a higher probability of malignancy (P < 0.05 for each). Conclusion: US is useful in clarifying the indication for biopsy of NML lesions. The types of US classifications used in our study establish reliable references for the NML patterns when stratified according to the BI-RADS categories.

  12. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dreisler, E; Sorensen, S Stampe; Ibsen, P H;

    2009-01-01

    modulators (n = 2). Thus, 375 women without AUB were included (217 pre- and 158 postmenopausal). Receiver-operating characteristics (ROC) curves for endometrial thickness and focal lesion were analyzed. RESULTS: Focal intrauterine pathology was confirmed in 41 women (35 with polyps, five with submucosal...

  13. Computed tomography assessment of bone lesions in patients with POEMS syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Glazebrook, K.; Johnson, Adam; Leng, S.; Dispenzieri, A. [Mayo Clinic, Rochester, MN (United States); Guerra Bonilla, Francis L. [Hospital Regional Rafael Hernandez, Hematology Division, David, Chiriqui (Panama)

    2014-09-25

    To describe the imaging findings on computed tomography (CT) and skeletal survey (SS) in patients with POEMS syndrome. We retrospectively reviewed, with institutional review board approval, the dysproteinemia database at our institution for patients with new diagnosis of POEMS syndrome between January 1998 and December 2008. Twenty-four patients were identified with PET/CT or CT and had skeletal survey (SS) available for review. Twenty-four patients were included in the study group with median age of 47 years. All CTs demonstrated at least one sclerotic lesion. The most common pattern was multiple small lesions, with 18 patients (75 %) having at least 5 lesions less than 1 cm. The larger lesions had a central lytic component and were FDG avid. SS had a false negative rate of 36 % (8 patients). Serial CT after treatment showed a decrease in size and number of sclerotic lesions in 53 % of cases (13 patients), the majority showing increased sclerosis. Two patients had complete resolution of sclerotic lesions. CT identified sclerotic lesions in all study patients with POEMS syndrome, the majority being less than 1 cm in size, which were not identified radiographically. CT may demonstrate increased sclerosis or even resolution of sclerotic lesions corresponding to treatment response. (orig.)

  14. Role of emmprin in endometrial cancer

    Directory of Open Access Journals (Sweden)

    Nakamura Keiichiro

    2012-05-01

    Full Text Available Abstract Background Extracellular matrix metalloproteinase inducer (Emmprin/CD147 is a transmembrane glycoprotein that belongs to the immunoglobulin superfamily. Enriched on the surface of many tumor cells, emmprin promotes tumor growth, invasion, metastasis and angiogenesis. We evaluated the clinical importance of emmprin and investigated its role in endometrial cancer. Methods Emmprin expression was examined in uterine normal endometrium, endometrial hyperplasia and cancer specimens by immunohistochemistry. In addition, the biological functions and inhibitory effects of an emmprin knockdown were investigated in HEC-50B and KLE endometrial cancer cell lines. Results The levels of emmprin expression were significantly increased in the endometrial cancer specimens compared with the normal endometrium and endometrial hyperplasia specimens (p p p  Conclusions The present findings suggest that low emmprin expression might be a predictor of favorable prognosis in endometrial cancer patients, and that emmprin may represent a potential therapeutic target for endometrial cancer.

  15. Optical coherence tomography assessment of a complex bifurcation lesion treated with double kissing Crush technique

    Science.gov (United States)

    Cai, Jin-Zan; Zhang, Yao-Jun; Xu, Tian; Zhu, Yong-Xiang; Mao, Chen-Yu; Bourantas, Christos V.; Crake, Tom; Chen, Shao-Liang

    2017-01-01

    Abstract The DEFINITION (Impact of the complexity of bifurcation lesions treated with drug-eluting stents) study has provided a novel classification to evaluate the complexity of coronary bifurcation lesion according to coronary angiography, but angiographic imaging due to its low resolution and inherited limitation may result in an inaccurate adjudication. We used optical coherence tomography (OCT) to further evaluate the coronary characteristics in a patient with “simple” bifurcation lesion which was classified by the DEFINITION criteria. However, a “complex” bifurcation lesion was defined and confirmed according to the OCT results. A double kissing Crush stenting approach was adopted to treat this “complex” case finally. The immediate and long-term angiographic and OCT results were excellent. OCT may be useful imaging modality to classify complexity of coronary bifurcation lesion and subsequently guide its treatment strategy. PMID:28072714

  16. Assessing Heterogeneity of Osteolytic Lesions in Multiple Myeloma by 1H HR-MAS NMR Metabolomics

    Directory of Open Access Journals (Sweden)

    Laurette Tavel

    2016-10-01

    Full Text Available Multiple myeloma (MM is a malignancy of plasma cells characterized by multifocal osteolytic bone lesions. Macroscopic and genetic heterogeneity has been documented within MM lesions. Understanding the bases of such heterogeneity may unveil relevant features of MM pathobiology. To this aim, we deployed unbiased 1H high-resolution magic-angle spinning (HR-MAS nuclear magnetic resonance (NMR metabolomics to analyze multiple biopsy specimens of osteolytic lesions from one case of pathological fracture caused by MM. Multivariate analyses on normalized metabolite peak integrals allowed clusterization of samples in accordance with a posteriori histological findings. We investigated the relationship between morphological and NMR features by merging morphological data and metabolite profiling into a single correlation matrix. Data-merging addressed tissue heterogeneity, and greatly facilitated the mapping of lesions and nearby healthy tissues. Our proof-of-principle study reveals integrated metabolomics and histomorphology as a promising approach for the targeted study of osteolytic lesions.

  17. Study of Endometrial Receptivity during Implantation in Implantation Dysfunction Mouse

    Institute of Scientific and Technical Information of China (English)

    Yan-juan LIU; Guang-ying HUANG; Ming-wei YANG; Fu-er LU

    2008-01-01

    Objective To establish the mice model of implantation dysfunction and to study the endometrial receptivity during implantation in implantation dysfunction mouse. Methods Sexually mature female virgin, Kunming mice were randomly assigned to the control group and the model group postcoitally. The model mice at 9 : 00 AM on d 4 of pregnancy(d 4) were injected subcutaneously with mifepristone. All animals were sacrificed at 9:00 PM on d 4 and their uterine horns were examined for the presence of implanted embryos. Histopathology of uterine endometrium was observed by light-microscope. The endometrial expressions of estrogen receptor (ER) and progesterone receptor (PR) assessed by immunnohistochemical SP method. The endometrial expressions of ER mRNA and PR mRNA were assessed by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR).Results Compared with control group, implantation rates and average embryo number significently decreased in model group, the development of endometrium was inhibited. In model group, absorbency and area rate of ER and PR in the gland and stroma were lower than those in control group (P<0.05). Expressions of ER mRNA and PR mRNA in model uterus were significantly lower than those in the control.Conclusion The endometrial receptivity and implantation decreased in mifepristoneinduced implantation dysfunction mouse.

  18. Distal Pancreatectomy for Isolated Metastasis of Endometrial Carcinoma to the Pancreas

    Directory of Open Access Journals (Sweden)

    Dan G Blazer III

    2008-01-01

    Full Text Available Context The majority of oncological pancreatic resections involve resection of primary pancreatic tumors. Pancreaticresection for metastatic disease is rare but can produce durable palliation or even cure in carefully selected patients. Herein, we report what to our knowledge is the first description of pancreatic resection of metastatic endometrial carcinoma.Case report We evaluated a patient who developed a mass in the distal pancreas as identified by screening computed tomography nearly three years after radical abdominal hysterectomy, bilateral salpingooophorectomy, and bilateral pelvic and paraaortic lymph node dissection for an International Federation of Gynecology and Obstetrics stage IIIA, grade 2 endometrial cancer. Findings on cytopathologic examination of tissue obtained by fine needle aspiration of the lesion were consistent with etastatic endometrial carcinoma. Radiographic imaging and physical examination failed to identify additional sites of disease. After receiving counseling as to the risks and projected benefits of surgical resection, the patient underwent a distal pancreatectomy, splenectomy, and partial gastrectomy with en bloc excision of the tumor. On final pathologic examination, all margins were free of tumor. At the time of this report, the patient remains without evidence of disease. Conclusion Metastasis to the pancreas from endometrial cancer is uncommon; however, this possibility should be considered in patients with a new pancreatic lesion and a history of endometrial cancer as pancreatic resection of metastatic disease can benefit selected patients.

  19. Magnetic resonance imaging assessment of brain maturation in preterm neonates with punctate white matter lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ramenghi, Luca A.; Fumagalli, Monica; Bassi, Laura; Groppo, Michela; Mosca, Fabio [University of Milan, Neonatal Intensive Care Unit - Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, Milan (Italy); Righini, Andrea; Parazzini, Cecilia; Bianchini, Elena; Triulzi, Fabio [Ospedale Pediatrico ' ' Buzzi' ' -ICP, Department of Radiology and Neuroradiology, Milan (Italy)

    2007-02-15

    Early white matter (WM) injury affects brain maturation in preterm infants as revealed by diffusion tensor imaging and volumetric magnetic resonance (MR) imaging at term postmenstrual age (PMA). The aim of the study was to assess quantitatively brain maturation in preterm infants with and without milder forms of WM damage (punctate WM lesions, PWML) using conventional MRI. Brain development was quantitatively assessed using a previously validated scoring system (total maturation score, TMS) which utilizes four parameters (progressive myelination and cortical infolding, progressive involution of glial cell migration bands and germinal matrix tissue). PWML were defined as foci of increased signal on T1-weighted images and decreased signal on T2-weighted images with no evidence of cystic degeneration. A group of 22 preterm infants with PWML at term PMA (PWML group) were compared with 22 matched controls with a normal MR appearance. The two groups were comparable concerning gestational age, birth weight and PMA. TMS was significantly lower in the PWML group than in the control group (mean TMS 12.44 {+-} 2.31 vs 14.00 {+-} 1.44; P = 0.011). Myelination (mean 2.76 {+-} 0.42 PWML group vs 3.32 {+-} 0.55 control group, P = 0.003) and cortical folding (3.64 {+-} 0.79 vs 4.09 {+-} 0.43, P = 0.027) appeared to be significantly delayed in babies with PWML. Conventional MRI appears able to quantify morphological changes in brain maturation of preterm babies with PWML; delayed myelination and reduced cortical infolding seem to be the most significant aspects. (orig.)

  20. The value of high-field MRI (3 T) in the assessment of sellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Pinker, K. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Ba-Ssalamah, A. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Wolfsberger, S. [Department of Neurosurgery, Medical University Vienna (Austria); Mlynarik, V. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Knosp, E. [Department of Neurosurgery, Medical University Vienna (Austria); Trattnig, S. [Department of Diagnostic Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)]. E-mail: siegfried.trattnig@univie.ac.at

    2005-06-01

    The aim of this study was the evaluation of the normal sellar anatomy in vitro and in vivo with high-field MRI and its application in the diagnosis of sellar pathologies in comparison to standard MRI. All high-field MR images were obtained using a 3 T Bruker Medspec 30/80 Scanner with a head birdcage transmit/receive coil and an actively shielded gradient system with a maximum gradient strength of 45 mT/m. Firstly an in vitro study of the sella turcica was performed to depict normal pituitary and sellar anatomy at high field. After a pilot-study this sequence-protocol was established: A RARE sequence (TR/TE = 7790/19 ms; matrix size, 512 x 512; RARE factor = 8, FOV, 200 mm) was used for T2-weighted coronal, axial and sagittal images. A 3D gradient echo sequence with magnetization-preparation (MP-RAGE, TR/TE/TI 33.5/7.6/800 ms, matrix size, 512 x 512; FOV, 200 mm, effective slice thickness, 1.88 mm; 3 averages) was used for acquisition of T1-weighted pre- and post-contrast images. Between January 2002 and March 200458 patients were enrolled in this study. Seven patients were examined for suspected microadenoma and in 51 patients 3T MRI was used to obtain additional information about the sellar lesion already known to be present from standard MRI. In 21 cases the accuracy of the imaging findings was assessed afterwards by comparison with intraoperative findings. The infiltration of the medial cavernous sinus wall was suspected on standard MRI on 15 sides (47%), on high-field MRI on 9 sides (28%) and could be verified by intraoperative findings on 6 sides (19%). Accordingly, sensitivity to infiltration was 83% for 3 T and 67% for standard MRI. Specificity was 84% for 3 T and 58% for standard MRI. Moreover, high-field MRI revealed microadenomas in 7 patients with a median diameter of 4 mm (range 2-9 mm). The segments of the cranial nerves were seen as mean 4 hypointense spots (range 2-5 spots) on high-field MRI in contrast to 3 spots (range 0-4 spots) on standard MRI

  1. Endometrial carcinoma; Endometriumkarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Engelhard, K. [Krankenhaus Martha-Maria, Nuernberg (Germany)

    2011-07-15

    Magnetic resonance imaging (MRI) is the method of choice in staging endometrial cancer. Using MRI early tumor invasion (stage IA) can be differentiated from a deep tumor growth (stage IB) of the myometrium with reported sensitivities of 85-95%.Tumor invasion of the uterine cervix can be depicted with a sensitivity of 80% and specificity of 96%. In demonstrating lymph node metastases MRI shows a sensitivity of 50%, a specificity of 95% and and accuracy of 90%. These diagnostic criteria are decisive for the choice of therapy procedures. So a simple hysterectomy will be performed in early stage IA disease while an extended surgical procedure with pelvic lymphadenectomy and radiotherapy will be considered in advanced stages IB and II disease. Vaginal ultrasound shows lower values in tumor staging with accuracies of 73-95%. Staging accuracies of computed tomography also show lower results with 61-76%. For planning radiotherapy and detection of cancer recurrence MRI is the most valuable tool. (orig.) [German] Fuer die Stadieneinteilung des Endometriumkarzinoms ist die Magnetresonanztomographie Methode der Wahl. Die Sensitivitaeten zur Differenzierung einer oberflaechlichen (Stadium IA) von einer tiefen myometrialen Invasion des Tumors (Stadium IB) liegen bei 85-95%, bei Spezifitaeten von 80-85%. Eine Infiltration der Zervix (Stadium II) kann mit Sensitivitaeten von 80% und Spezifitaeten von 96% nachgewiesen werden. Bei der Detektion von Lymphknotenmetastasen liegen die Sensitivitaeten der MRT bei 50%, bei Spezifitaeten von 95% und Treffsicherheiten von 90%. Die genannten diagnostischen Kriterien bestimmen das therapeutische Vorgehen. Werden fruehe Stadien mit einfacher Hysterektomie behandelt, erfordern die Stadien IB und II kombinierte erweiterte chirurgische Techniken und eine Radiotherapie. Die Treffsicherheiten des vaginalen Ultraschalls (73-93%) und der Computertomographie (61-76%) fuer die Stadieneinteilung des Tumors liegen deutlich niedriger als die Werte fuer

  2. Structural lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis - definitions, assessment system, and reference image set

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Maksymowych, Walter P; Pedersen, Susanne J;

    2009-01-01

    are assessed at each vertebral endplate at all 23 spinal levels from C2/3 to L5/S1, whereas facet joint lesions are to be assessed by segmental level (cervical, thoracic, and lumbar). CONCLUSION: An anatomy-based set of definitions and an assessment system for structural lesions in the spine of patients......OBJECTIVE: There is no reliable and sensitive magnetic resonance imaging (MRI) assessment system for structural lesions in patients with spondyloarthritis (SpA). We sought to develop and illustrate a detailed anatomy-based set of MRI definitions and an assessment system for structural lesions...... in the spine of patients with SpA. METHODS: MRI definitions of different structural ("chronic") lesions at various anatomical locations in the spine, and an accompanying assessment system, were agreed by consensus within the Canada-Denmark MRI working group. Subsequently, a reference image set...

  3. Sentinel lymph node detection following the hysteroscopic peritumoural injection of {sup 99m}Tc-labelled albumin nanocolloid in endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Maccauro, Marco; Aliberti, Gianluca; Villano, Carlo; Castellani, Maria Rita; Bombardieri, Emilio [Istituto Nazionale Tumori, Nuclear Medicine Division, Milan (Italy); Lucignani, Giovanni [University of Milan, Institute of Radiological Sciences, Unit of Molecular Imaging, Division of Radiation Oncology, European Institute of Oncology, Milan (Italy); Solima, Eugenio [Istituto Nazionale Tumori, Gynaecologic Oncology Division, Milan (Italy)

    2005-04-01

    The purpose of this study was to assess the feasibility of sentinel lymph node (SLN) detection in endometrial cancer patients with a dual-tracer procedure after hysteroscopic peritumoural injection. Twenty-six women with previously untreated endometrial adenocarcinoma underwent the hysteroscopic injection of 111 MBq{sup 99m}Tc-Nanocoll and blue dye administered subendometrially around the lesion. On the same day, all 26 patients underwent lymphoscintigraphy, followed 3-4 h later by hysterotomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Para-aortic lymphadenectomy was also performed in cases of either serous or papillary carcinoma (n=7/26). All SLNs were removed and examined with haematoxylin and eosin staining and immunohistochemical techniques. The procedure was well tolerated by patients, only two experiencing transient vagal symptoms. The sensitivity of this technique for correct identification of SLNs was 100%. Lymph node metastases were found in 4 out of the 26 patients (15%), bilaterally in the external iliac region (n=1), unilaterally in the external iliac region (n=1), unilaterally in the common iliac region (n=1) and unilaterally in the para-aortic region (n=1). In all four cases, nodal metastases were located within SLNs detected by lymphoscintigraphy. Only 10 of the 26 patients (38%) had significant blue dye staining. All blue-stained SLNs were radioactive. In patients with endometrial cancer, it is feasible to use lymphatic mapping and SLN biopsy to define the topographic distribution of the lymphatic network and also to accurately detect lumbo-aortic and pelvic metastases within SLNs. In the majority of patients with early stage endometrial cancer, this procedure may avoid unnecessary radical pelvic lymphadenectomy. It may also guide para-aortic lymph node dissection on the basis of the SLN status. (orig.)

  4. Noninvasive Assessment of Early Dental Lesion Using a Dual-Contrast Photoacoustic Tomography

    Science.gov (United States)

    Cheng, Renxiang; Shao, Jiaojiao; Gao, Xiaoxiang; Tao, Chao; Ge, Jiuyu; Liu, Xiaojun

    2016-02-01

    Dental hard tissue lesions, including caries, cracked-tooth, etc., are the most prevalent diseases of people worldwide. Dental lesions and correlative diseases greatly decrease the life quality of patients throughout their lifetime. It is still hard to noninvasively detect these dental lesions in their early stages. Photoacoustic imaging is an emerging hybrid technology combining the high spatial resolution of ultrasound in deep tissue with the rich optical contrasts. In this study, a dual-contrast photoacoustic tomography is applied to detect the early dental lesions. One contrast, named B-mode, is related to the optical absorption. It is good at providing the sharp image about the morphological and macro-structural features of the teeth. Another contrast, named S-mode, is associated with the micro-structural and mechanical properties of the hard tissue. It is sensitive to the change of tissue properties induced by the early dental lesions. Experiments show that the comprehensive analysis of dual-contrast information can provide reliable information of the early dental lesions. Moreover, the imaging parameter of S-mode is device-independent and it could measure tissue properties quantitatively. We expect that the proposed scheme could be beneficial for improving safety, accuracy and sensitivity of the clinical diagnosis of the dental lesion.

  5. Utility of immunohistochemistry in predicting microsatellite instability in endometrial carcinoma.

    Science.gov (United States)

    Modica, Ippolito; Soslow, Robert A; Black, Destin; Tornos, Carmen; Kauff, Noah; Shia, Jinru

    2007-05-01

    Identification of the microsatellite instability (MSI) phenotype in endometrial carcinoma is important given that such tumors are the most common noncolorectal tumors to occur in hereditary nonpolyposis colorectal cancer syndrome, and may bear prognostic relevance. The objective of this study was to assess the utility of immunohistochemistry (IHC), a simple and fast technique, in detecting MSI in endometrial carcinoma. The study subjects consisted of 90 endometrial carcinoma patients with equal representation of MSI-high (MSI-H) and non-MSI-H tumors. MSI was tested using the standard polymerase chain reaction-based method and the 5 NCI-recommended markers. Overall, IHC with MLH1 and MSH2 antibodies detected 69% of MSI-H tumors with a specificity of 100%. Adding PMS2 and MSH6 to the antibody panel increased the sensitivity to 91% but decreased the specificity to 83%. The most common IHC abnormality in MSI tumors was concurrent loss of MLH1/PMS2. Assessment of staining was straightforward in most cases but not in all. Staining inadequacies existed. Five stains (4 MLH1 and 1 MSH6) were not interpretable because of the lack of any internal positive control. Two percent to 10% of the cases (depending on the antibody assessed) had only focal weak staining; the highest frequency (10%) occurred with MLH1 antibody. PMS2 staining detected 7 MLH1-staining present MSI-H cases, thus partly accounting for the increased sensitivity with the 4-antibody panel. MSH6 staining identified 9 cases with loss of MSH6 alone, 6 of 9 were non-MSI-H, thus partly accounting for the decreased specificity with the 4-antibody panel. In conclusion, our results suggest that IHC is useful in detecting MSI in endometrial carcinoma. Although IHC has a lower sensitivity with more apparent staining inadequacies in detecting MSI in endometrial carcinoma than it does in colorectal carcinoma, its use in endometrial carcinoma may be an important adjunct when screening for hereditary cases. In the future, as

  6. Elevated Electrochemical Impedance in the Endoluminal Regions with High Shear Stress: Implication for Assessing Lipid-Rich Atherosclerotic Lesions

    Science.gov (United States)

    Yu, Fei; Lee, Juhyun; Jen, Nelson; Li, Xiang; Zhang, Qian; Tang, Rui; Zhou, Qifa; Kim, Eun. S.; Hsiai, Tzung K.

    2012-01-01

    Background Identifying metabolically active atherosclerotic lesions remains an unmet clinical challenge during coronary intervention. Electrochemical impedance (EIS) increased in response to oxidized low density lipoprotein (oxLDL)-laden lesions. We hereby assessed whether integrating EIS with intravascular ultrasound (IVUS) and shear stress (ISS) provided a new strategy to assess oxLDL-laden lesions in the fat-fed New Zealand White (NZW) rabbits. Methods and Results A micro-heat transfer sensor was deployed to acquire the ISS profiles at baseline and post high-fat diet (HD) in the NZW rabbits (n=8). After 9 weeks of HD, serum oxLDL levels (mg/dL) increased by 140-fold, accompanied by a 1.5-fold increase in kinematic viscosity (cP) in the HD group. Time-averaged ISS (ISSave) in the thoracic aorta also increased in the HD group (baseline: 17.61±0.24 vs. 9 weeks: 25.22±0.95 dyne/cm2, n=4), but remained unchanged in the normal diet group (baseline: 22.85±0.53 dyne/cm2 vs. 9 weeks: 22.37±0.57 dyne/cm2, n=4). High-frequency Intravascular Ultrasound (IVUS) revealed atherosclerotic lesions in the regions with augmented ISSave, and concentric bipolar microelectrodes demonstrated elevated EIS signals, which were correlated with prominent anti-oxLDL immuno-staining (oxLDL-free regions: 497±55 Ω, n = 8 vs. oxLDL-rich lesions: 679±125 Ω, n = 12, P < 0.05). The equivalent circuit model for tissue resistance between the lesion-free and ox-LDL-rich lesions further validated the experimental EIS signals. Conclusions By applying electrochemical impedance in conjunction with shear stress and high-frequency ultrasound sensors, we provided a new strategy to identify oxLDL-laden lesions. The study demonstrated the feasibility of integrating EIS, ISS, and IVUS for a catheter-based approach to assess mechanically unstable plaque. PMID:23318546

  7. Assessment of the impact of application of singlephoton emission computed tomography and SPECT-CT on lesion categorisation in bone scintigraphy

    Directory of Open Access Journals (Sweden)

    Garba H. Yunusa

    2016-03-01

    Full Text Available Objectives: To assess initial experience with the use of a new single-photon emission computed tomography-computed tomography (SPECT-CT in the evaluation of lesions.Methods: The folder number, radiopharmaceutical used and type of scan of patients examined with a new Siemens T6 SPECT-CT between 02 April 2016 and 31 December 2013 were retrieved. The number of 99mTc-MDP bone scans was sufficient for a detailed analysis. The scans were re-processed and reported by the observer before he was given any clinical information. Whole body planar, whole body planar plus SPECT and whole body planar plus SPECT-CT images were assessed successively in three separate sessions at least 2 weeks apart. At each session, the certainties of detection, localisation and categorisation of each lesion were recorded.Results: A total of 539 lesions were seen on the whole body, SPECT and computed tomography (CT images in 133 patients. The whole body images showed no lesions in 3 patients and 378 lesions in 130 patients. SPECT detected 122 additional lesions in 79 patients. Thirty-nine (12.2% lesions were seen only on CT in 32 (24.1% patients. For the 261 lesions seen on the planar images in the SPECT field of view, lesion detection was definite in 233 (89.3%, localisation definite in 151 (57.9% and categorisation definite in 123 (47.1% lesions. On the SPECT, definite lesion detection, localisation and categorisation were recorded, respectively, for 259 (99.2%, 228 (87.4% and 176 (67.4% of the 261 lesions. Lesion detection, localisation and categorisation certainties were definite for 100%, 99.1% and 94.7% of the SPECT-CT lesions, respectively.Conclusion: SPECT markedly improves lesion detection and localisation, and CT enhances lesion categorisation.

  8. Targeted Therapies in Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Selen Dogan

    2014-04-01

    Full Text Available Endometrial cancer is the most common genital cancer in developed world. It is generally diagnosed in early stage and it has a favorable prognosis. However, advanced staged disease and recurrences are difficult to manage. There are some common genetic alterations related to endometrial carcinogenesis in similar fashion to other cancers. Personalized medicine, which means selection of best suited treatment for an individual, has gain attention in clinical care of patients in recent years. Targeted therapies were developed as a part of personalized or %u201Ctailored%u201D medicine and specifically acts on a target or biologic pathway. There are quite a number of molecular alteration points in endometrial cancer such as PTEN tumor suppressor genes, DNA mismatch repair genes, PI3K/AKT/mTOR pathway and p53 oncogene which all might be potential candidates for tailored targeted therapy. In recent years targeted therapies has clinical application in ovarian cancer patients and in near future with the advent of new agents these %u201Ctailored%u201D drugs will be in market for routine clinical practice in endometrial cancer patients, in primary disease and recurrences as well.

  9. Malignant versus benign mediastinal lesions: quantitative assessment with diffusion weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Guemuestas, Sevtap; Inan, Nagihan; Sarisoy, Hasan Tahsin; Anik, Yonca; Arslan, Arzu; Ciftci, Ercuement; Akansel, Guer; Demirci, Ali [University of Kocaeli, Department of Radiology, School of Medicine, Umuttepe Kocaeli (Turkey)

    2011-11-15

    We aimed to evaluate the performance of diffusion-weighted magnetic resonance imaging in differentiating malignant from benign mediastinal lesions. Fifty-three mediastinal lesions were examined with T1- and T2-weighted (W) conventional images. Then, two diffusion-weighted images were obtained with b = 0 and 1000 s/mm{sup 2} values and apparent diffusion coefficients (ADC) were calculated. The statistical significance of differences between measurements was tested using the Student-t test. The mean ADC of malignant lesions was significantly lower than that of the benign masses (p < 0.001). The cut-off value of {<=} 1.39 x 10{sup -3} mm{sup 2}/s indicated a malignant lesion with a sensitivity of 95% and specificity of 87%. Diffusion-weighted imaging may be helpful in differentiating benign from malignant mediastinal masses. (orig.)

  10. Risk factors for atypical endometrial hyperplasia in infertile women:possible association with polycystic ovarv syndrome

    Institute of Scientific and Technical Information of China (English)

    Lu Qun; Shen Huan; Tian Li; Zhu Sainan; Chen Xi

    2008-01-01

    Objective:Endometrial hyperplasia is considered as a precursor of endometrial carcinoma,in which oncogenic potential is low in hyperplasia without atypia,but high in a-typical hyperplasia.The objective of this study was to identify the risk factors for atypical endo-metrial hyperplasia in infertile women.Methods:Fifty four infertile women with endometrial hy-perplasia,which were selected from a large cohort of 2 098 women who desired for the future childbearing in our center,were diagnosed by hysteroscopy with directed biopsies or dilation and curettage(D&C),including 44 with hyperplasia without atypia,10 with atypical hyperplasia.Clinical characteristics were recorded in terms of age,body mass index(BMI),parity,insulin resistance,polycystic ovary syndrome(PCOS).Statistical comparison was made between women with hyperplasia without atypia and atypical hyperplasia.Logistic regression analysis Was em-ployed to assess the contribution of PCOS,obesity and insulin resistance to atypical hyperplasia.Results:The incidence of endometrial hyperplasia in infertile women Was 2.57%(54/2098),which included 1 0 women(0.48%)were diagnosed as atypical hyperplasia.PCOS in women with atypical hyperplasia(70%,7/10)was significantly higher than those of hyperplasia with-out atypia(27.27%,12/44).Stepwise regression analysis showed that PCOS contributed maximally to atypical endometrial hyperplasia in infertile women.Conclusion:PCOS is an independent risk factor for atypical endometrial hyperplasia in women with infertility.The infertile women with PCOS are at an increased risk for atypical endometrial hyperplasia and endometrial cancer.

  11. Use of Second generation contrast-enhanced ultrasound in the assessment of focal liver lesions

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions.The role of US in the characterisation of focal liver lesions has been transformed with the introduction of specific contrast media and the development of specialized imaging techniques. Ultrasound now can fully characterise the enhancement pattern of hepatic lesions, similar to that achieved with contrast enhanced multiphasic computed tomography (CT) and magnetic resonance imaging (MRI). US contrast agents are safe,well-tolerated and have very few contraindications.Furthermore, real-time evaluation of the vascularity of focal liver lesions has become possible with the use of the newer microbubble contrast agents. This article reviews the enhancement pattern of the most frequent liver lesions seen, using the second generation US contrast media. The common pitfalls for each type of lesion are discussed. The recent developments in US contrast media and specific imaging techniques have been a major advance and this technique, in view of the intrinsic advantages of US, will undoubtedly gain popularity in the years to come.

  12. Assessing algorithms for defining vascular architecture in subharmonic images of breast lesions.

    Science.gov (United States)

    Eisenbrey, John R; Joshi, Neha; Dave, Jaydev K; Forsberg, Flemming

    2011-02-21

    The ability to accurately and non-invasively characterize breast lesions and their vasculature would greatly limit the number of unneeded biopsies performed annually. Subharmonic ultrasound imaging (SHI) allows exclusive imaging of vasculature in real time, while completely suppressing tissue signals. Previously, cumulative maximum intensity (CMI) projections of SHI data were shown to be useful for characterization, but lacked means of quantification. In this study we investigate three potential thinning algorithms for defining breast lesion architecture. Sequential thinning, parallel thinning, and distance transformation algorithms were compared using 40 in vitro test images. Sequential thinning was selected due to superior connectivity, minimal rotational variance, and sufficient data reduction. This algorithm was then applied to 16 CMI SHI images of breast lesions, out of which 13 were successfully skeletonized. Average bifurcations were 9.8 ± 8.18 and 6.9 ± 6.50 in malignant and benign lesions, respectively (p > 0.60). Average vessel-chain length was 88.9 ± 79.10 pixels versus 63.2 ± 45.65 pixels in malignant versus benign lesions (p > 0.40). While the sequential thinning algorithm was promising for quantifying breast vasculature, its ability to significantly differentiate between malignant and benign lesions in this study was limited by a high degree of variability and limited sample size.

  13. Assessing algorithms for defining vascular architecture in subharmonic images of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Eisenbrey, John R; Joshi, Neha; Dave, Jaydev K; Forsberg, Flemming, E-mail: Flemming.Forsberg@jefferson.edu [Department of Radiology, Thomas Jefferson University, 137 South 10th St, Philadelphia, PA 19107 (United States)

    2011-02-21

    The ability to accurately and non-invasively characterize breast lesions and their vasculature would greatly limit the number of unneeded biopsies performed annually. Subharmonic ultrasound imaging (SHI) allows exclusive imaging of vasculature in real time, while completely suppressing tissue signals. Previously, cumulative maximum intensity (CMI) projections of SHI data were shown to be useful for characterization, but lacked means of quantification. In this study we investigate three potential thinning algorithms for defining breast lesion architecture. Sequential thinning, parallel thinning, and distance transformation algorithms were compared using 40 in vitro test images. Sequential thinning was selected due to superior connectivity, minimal rotational variance, and sufficient data reduction. This algorithm was then applied to 16 CMI SHI images of breast lesions, out of which 13 were successfully skeletonized. Average bifurcations were 9.8 {+-} 8.18 and 6.9 {+-} 6.50 in malignant and benign lesions, respectively (p > 0.60). Average vessel-chain length was 88.9 {+-} 79.10 pixels versus 63.2 {+-} 45.65 pixels in malignant versus benign lesions (p > 0.40). While the sequential thinning algorithm was promising for quantifying breast vasculature, its ability to significantly differentiate between malignant and benign lesions in this study was limited by a high degree of variability and limited sample size.

  14. Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hryhorczuk, Anastasia L. [University of Michigan, Department of Radiology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States); Harvard University School of Medicine, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Strouse, Peter J. [University of Michigan, Department of Radiology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States); Biermann, J.S. [University of Michigan, Department of Orthopaedic Surgery, Ann Arbor, MI (United States)

    2011-07-15

    CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies. To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign. From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed. Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies. Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions. (orig.)

  15. Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

    DEFF Research Database (Denmark)

    Huisman, Jennifer; Egede, Rasmus; Rdzanek, Adam

    2012-01-01

    To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibili...... on average the highest measurement reproducibility. A central analysis for VH-IVUS multicenter studies of lesions prior to PCI should be pursued. Moreover, it may be problematical to pool VH-IVUS data of individual trials analyzed by independent centers.......To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility...... of volumetric VH-IVUS measurements, experienced analysts of 4 European IVUS centers performed independent analyses (in total 8,052 cross-sectional analyses) to obtain volumetric data of 40 coronary segments (length 20.0 ± 0.3 mm) from target lesions prior to percutaneous intervention that were performed...

  16. Concurrent Endometrial Carcinosarcoma and Thyroid Papillary Carcinoma: PET CT Imaging Findings

    Directory of Open Access Journals (Sweden)

    Mine Genc

    2015-06-01

    Full Text Available The aim of this study is to report a patient who was diagnosed with a concurrent primary tumor by 18-fluoro-2-deoxy-glucose positron emission tomography (FDG PET imaging performed for staging of an endometrial cancer. FDG uptake was detected in the uterus, where the primary cancer was located, and in the left lobe of the thyroid gland. The biopsy sample from the hypermetabolic nodular lesion in thyroid gland revealed intermediate cytology according to Bethesda Classification. The patient underwent hysterectomy and thyroidectomy. An endometrial carcinoma in the uterus and a multicentric thyroid papillary carcinoma in the thyroid gland were diagnosed.

  17. Endometrial aspiration biopsy: a non-invasive method of obtaining functional lymphoid progenitor cells and mature natural killer cells.

    LENUS (Irish Health Repository)

    McMenamin, Moya

    2012-09-01

    The aim of this study was to compare the efficacy of endometrial aspiration biopsy (EAB) with the more traditional dilatation and curettage (D&C) for the procurement of lymphoid progenitor cells and uterine natural killer (NK) populations in endometrial tissue. This prospective observational study conducted in a tertiary referral university hospital examined endometrium obtained from 32 women admitted for laparoscopic gynaecological procedures. Each participant had endometrium sampled using both EAB and D&C. Both methods were assessed as a source of uterine NK and lymphoid progenitor cells. Similar proportions of mature CD45+CD56+ NK cells (range 25.4-36.2%) and CD45+CD34+ lymphoid progenitors (range 1.2-2.0%) were found in tissue obtained using both EAB and D&C. These cells were adequate for flow cytometric analysis, magnetic bead separation and culture. Colony formation by the CD34+ population demonstrated maturational potential. Tissues obtained via endometrial biopsy and D&C are equivalent, by analysis of uterine NK and lymphoid progenitor cells. The aim of this study was to compare two methods of endometrial sampling - endometrial aspiration biopsy and traditional dilatation and curettage - for the procurement of haematopoietic stem cells and uterine natural killer (NK) populations in endometrial tissue. Thirty-two women who had gynaecological procedures in a tertiary referral hospital participated in this study and had endometrial tissue collected via both methods. Similar populations of mature NK cells and haematopoietic stem cells were found in tissue obtained using both endometrial aspiration biopsy and dilatation and curettage. Tissue obtained via endometrial aspiration biopsy was adequate for the culture and growth of haematopoietic stem cells. We conclude that tissue obtained via endometrial biopsy and dilatation and curettage is equivalent, by analysis of uterine NK and haematopoietic stem cells using flow cytometry. This has implications for further

  18. Ultrasonographic findings of low-grade endometrial stromal sarcoma of the uterus with a focus on cystic degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ga Eun; Rha, Sung Eun; Oh, Soon Nam; Lee, Ah Won; Lee, Keun Ho; Kim, Mee Ran [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to perform a retrospective analysis of the ultrasonographic findings associated with low-grade endometrial stromal sarcoma. Ten pathologically confirmed cases of low-grade endometrial stromal sarcoma at our institution from January 2007 to April 2014 were retrospectively reviewed. All patients underwent a preoperative transvaginal ultrasound. Two radiologists came to a consensus regarding the location, size, margin, and echogenicity of the tumor, as well as the presence of intratumoral cystic degeneration and its extent and configuration. Low-grade endometrial stromal sarcoma manifested as an intramural mass protruding into the endometrial cavity (n=6) or as a purely intramural mass (n=4). The maximal diameter of the lesion ranged from 4 to 9.1 cm (mean, 6.2 cm). The imaging features of low-grade endometrial stromal sarcoma were variable: six cases involved predominantly solid masses containing cystic degeneration, one was a predominantly unilocular cystic mass, two were ill-defined infiltrative solid masses, and one was a well-defined solid mass. Among the seven cases with internal cystic degeneration, five patients showed a multiseptated cystic area or a cystic area with multiple small clusters, while a unilocular cystic area within the tumor was found in two patients. Low-grade endometrial stromal sarcoma is associated with variable ultrasonographic findings with regard to the location, margin, and configuration of the lesion. Multiseptated cystic areas and multiple small areas of cystic degeneration are common.

  19. Vertebral lesion distribution in multiple myeloma - assessed by reduced-dose whole-body MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Bier, Georg; Kloth, Christopher; Schabel, Christoph; Bongers, Malte; Nikolaou, Konstantin; Horger, Marius [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-01-15

    To observe the distribution and potential distribution patterns of osteolytic and sclerotic vertebral involvement in a representative collective of multiple myeloma patients. A total of 66 consecutive patients with a diagnosis of multiple myeloma at initial diagnosis or during follow-up were examined by multidetector reduced-dose computed tomography to evaluate the distribution of bone lesions along the spine with focus on size, location, and lesion character. Confirmation of diagnosis was performed by comparison to follow-up computed tomography or magnetic resonance tomography. If >50 % of all detected malignant lesions occurred in one spinal segment, the distribution pattern was called cervical, thoracic, lumbar, or sacral, otherwise a ''mixed'' pattern was classified. Of a total number of 933 osseous spine lesions, 632 (67.7 %) were classified as malignant (98.9 % of them osteolytic) and 293 (31.5 %) as benign. The distribution pattern analysis yielded two patients (3.8 %) with a cervical, 26 (50 %) with a thoracic, 4 (7.7 %) with a lumbar, one (1.9 %) with a sacral pattern, and 19 cases (36.6 %) showed a mixed distribution pattern. Segment-wise, the mean lesion size was 6.52 ± 2.76 mm (cervical), 8.97 ± 5.43 mm (thoracic), 11.97 ± 7.11 mm (lumbar), and 17.5 ± 16.465 (sacral), whilst, related to the vertebra size, the lesion/vertebra size ratio is decreasing through the whole spine beginning from the top. Multiple myeloma bone lesions occur preferably and are larger in the thoracic and lumbar spine. Moreover, a specific distribution pattern is present in about 60 %. (orig.)

  20. Trans-vaginal sono-elastography in the differentiation of endometrial hyperplasia and endometrial carcinoma

    OpenAIRE

    Mahmoud Abdel Latif; Magda Shady; Hanan Nabil; Yasser Mesbah

    2016-01-01

    Aim: To evaluate efficiency of sono-elastography in differentiation of endometrial hyperplasia and endometrial carcinoma. Patients and methods: Between January 2014 and January 2015, 45 perimenopausal female patients with endometrial thickness more than 6 mm were examined by TV sono-elastography procedure. Results of ultrasound and elastography were compared with pathological data (reference standard). Strain ratios were compared between typical, atypical endometrial hyperplasia and endome...

  1. Predicting the coexistence of an endometrial adenocarcinoma in the presence of atypical complex hyperplasia: immunohistochemical analysis of endometrial samples

    NARCIS (Netherlands)

    Robbe, E.J.; Kuijk, S.M. van; Boed, E.M. de; Smits, L.J.; Wurff, A.A. van der; Kruitwagen, R.F.P.M.; Pijnenborg, J.M.A.

    2012-01-01

    OBJECTIVE: This study aimed to determine whether immunohistochemical markers in complex atypical endometrial hyperplasia could predict the presence of a concurrent endometrial carcinoma. METHODS: Endometrial biopsies of 39 patients with complex atypical hyperplasia were selected retrospectively betw

  2. The usefulness of c-Kit in the immunohistochemical assessment of melanocytic lesions

    Science.gov (United States)

    Pilloni, L.; Bianco, P.; Difelice, E.; Cabras, S.; Castellanos, M.E.; Atzori, L.; Ferreli, C.; Mulas, P.; Nemolato, S.; Faa, G.

    2011-01-01

    C-Kit (CD117), the receptor for the stem cell factor, a growth factor for melanocyte migration and proliferation, has shown differential immunostaining in various benign and malignant melanocytic lesions. The purpose of this study is to compare c-Kit immunostaining in benign nevi and in primary and metastatic malignant melanomas, to determine whether c-Kit can aid in the differential diagnosis of these lesions. c-Kit immunostaining was performed in 60 cases of pigmented lesions, including 39 benign nevi (5 blue nevi, 5 intra-dermal nevi, 3 junctional nevi, 15 cases of primary compound nevus, 11 cases of Spitz nevus), 18 cases of primary malignant melanoma and 3 cases of metastatic melanoma. The vast majority of nevi and melanomas examined in this study were positive for c-Kit, with minimal differences between benign and malignant lesions. C-Kit cytoplasmatic immunoreactivity in the intraepidermal proliferating nevus cells, was detected in benign pigmented lesions as well as in malignant melanoma, increasing with the age of patients (P=0.007) in both groups. The patient’s age at presentation appeared to be the variable able to cluster benign and malignant pigmented lesions. The percentage of c-Kit positive intraepidermal nevus cells was better associated with age despite other variables (P=0.014). The intensity and percentage of c-Kit positivity in the proliferating nevus cells in the dermis was significantly increased in malignant melanocytic lesions (P=0.015 and P=0.008) compared to benign lesions (compound melanocytic nevi, Spitz nevi, intradermal nevi, blue nevi). Immunostaning for c-Kit in metastatic melanomas was negative. Interestingly in two cases of melanoma occurring on a pre-existent nevus, the melanoma tumor cells showed strong cytoplasmatic and membranous positivity for c-kit, in contrast with the absence of any immunoreactivity in pre-existent intradermal nevus cells. C-Kit does not appear to be a strong immunohistochemical marker for distinguishing

  3. Assessment of HIFU lesions by shear-wave elastography: Initial in-vivo results

    Science.gov (United States)

    Anquez, Jeremie; Corréas, Jean-Michel; Criton, Aline; Lacoste, François; Yon, Sylvain

    2012-11-01

    The aim of this work was to evaluate Shear Wave Elastography (SWE) as a tool to visualize HIFU lesions in an acute in-vivo setting. Extracorporeal HIFU sonications of liver were performed on 14 rabbits in 19 consecutive, adjacent pulses, with in situ energies between 75 J and 228 J. A set of images of the sonicated area was acquired prior and post HIFU ablation: 2 orthogonal SWE images (transverse and sagittal) and contrast enhanced CT scan. SWE images were acquired with theAixplorer® device (SuperSonic Imagine, Aix, France). Prior to the treatment, the liver elasticity appeared homogeneous, with a elasticity comprised between 5 and 11 kPa. The lesion extents were manually segmented on post-treatment SWE images and their areas A(SWE)T (transverse) and A(SWE)S (sagittal) were computed. On 3D CT the lesions were segmented as a hypo intense (devascularized) region on 3D CT images, and considered as "ground truth". The transverse and sagittal planes passing by their centers of mass were extracted. The lesion areas were computed for each plane, respectively A(CT)T and A(CT)S. The ratios A(CT)T/A(SWE)T and A(CT)S/A(SWE)S were computed for all the 14 cases. SWE appear to underestimate the lesion extent in the sagittal orientation with respect to CT images, while a good matching is obtained in the transverse orientation.

  4. Endometrial thickness predicts endometrial hyperplasia in patients with polycystic ovary syndrome.

    Science.gov (United States)

    McCormick, Betsy A; Wilburn, Rochelle D; Thomas, Michael A; Williams, Daniel B; Maxwell, Rose; Aubuchon, Mira

    2011-06-30

    Body mass index is predictive of sonographic endometrial stripe thickness, which in turn is predictive of endometrial hyperplasia in patients with polycystic ovary syndrome. For every 1-mm increase in endometrial stripe, the odds ratio of hyperplasia increased by 1.48 (95% confidence interval, 1.04-2.10).

  5. Assessment of exercise-induced minor muscle lesions: the accuracy of Cyriax's diagnosis by selective tension paradigm.

    Science.gov (United States)

    Franklin, M E; Conner-Kerr, T; Chamness, M; Chenier, T C; Kelly, R R; Hodge, T

    1996-09-01

    The Cyriax selective tension assessment paradigm is commonly used by clinicians for the diagnosis of soft tissue lesions; however, studies have not demonstrated that it is a valid method. The purpose of this study was to examine the construct validity of the active motion, passive motion, resisted movement, and palpation components of the Cyriax selective tension diagnosis paradigm in subjects with an exercise-induced minor hamstring muscle lesion. Nine female subjects with a mean age of 23.6 years (SD = 4.7) and a mass of 57.3 kg (SD = 10.7) performed two sets of 20 maximal eccentric isokinetic knee flexor contractions designed to induce a minor muscle lesion of the hamstrings. Active range of motion, passive range of motion, knee extension end-feel pain relative to resistance sequence, knee flexor isometric strength, pain perception during knee flexor resisted movement testing, and palpation pain of the hamstrings were assessed at 0, 5, 2, 12, 24, 48, and 72 hours postexercise and compared with Cyriax's hypothesized selective tension paradigm results. Consistent with Cyriax's paradigm, passive range of motion remained unchanged, and perceived pain of the hamstrings increased with resistance testing at 12, 24, 48, and 72 hours postexercise when compared with baseline. In addition, palpation pain of the hamstrings was significantly elevated at 48 and 72 hours after exercise (p Cyriax's paradigm, active range of motion was significantly reduced over time (p Cyriax, when a minor muscle lesion is tested, it should be strong and painful; however, none of the postexercise time frames exhibited results that were strong and painful. This study suggests that the validity of using Cyriax's selective tension testing for the diagnosis of exercise-induced minor muscle lesions is questionable.

  6. Endometrial stromal sarcoma with selective polyvinyl alcohol embolization of a pulmonary metastasis after recurrent hemoptysis and expansive growth

    Directory of Open Access Journals (Sweden)

    Maximilian de Bucourt

    2010-05-01

    Full Text Available A 63-year-old female with a well-vascularized pulmonary metastasis of an endometrial stromal sarcoma (ESS of 6x6 cm received selective embolization with 150-250 mm polyvinyl alcohol (Contour; Boston Scientific, Natick, MA, USA via a bronchial artery. Post-interventional loss of perfusion was qualitatively estimated to be >80%. The lesion was located in direct proximity to the pulmonary hilar vessels. Owing to recurrent and sudden hemoptyses, an interdisciplinary tumor board assessed the risk of life-threatening blood loss to be greater than that of angiography with particle embolization and agreed on an endovascular approach. Hemoptysis did not recur in a follow-up period of six months. Initial clinical symptoms were noted 25 years ago. However, establishing a definite diagnosis has, for a long time, remained a histopathological challenge.

  7. Assessing the risk of central post-stroke pain of thalamic origin by lesion mapping.

    Science.gov (United States)

    Sprenger, Till; Seifert, Christian L; Valet, Michael; Andreou, Anna P; Foerschler, Annette; Zimmer, Claus; Collins, D Louis; Goadsby, Peter J; Tölle, Thomas R; Chakravarty, M Mallar

    2012-08-01

    Central post-stroke pain of thalamic origin is an extremely distressing and often refractory disorder. There are no well-established predictors for pain development after thalamic stroke, and the role of different thalamic nuclei is unclear. Here, we used structural magnetic resonance imaging to identify the thalamic nuclei, specifically implicated in the generation of central post-stroke pain of thalamic origin. Lesions of 10 patients with central post-stroke pain of thalamic origin and 10 control patients with thalamic strokes without pain were identified as volumes of interest on magnetic resonance imaging data. Non-linear deformations were estimated to match each image with a high-resolution template and were applied to each volume of interest. By using a digital atlas of the thalamus, we elucidated the involvement of different nuclei with respect to each lesion. Patient and control volumes of interest were summed separately to identify unique areas of involvement. Voxelwise odds ratio maps were calculated to localize the anatomical site where lesions put patients at risk of developing central post-stroke pain of thalamic origin. In the patients with pain, mainly lateral and posterior thalamic nuclei were affected, whereas a more anterior-medial lesion pattern was evident in the controls. The lesions of 9 of 10 pain patients overlapped at the border of the ventral posterior nucleus and the pulvinar, coinciding with the ventrocaudalis portae nucleus. The lesions of this area showed an odds ratio of 81 in favour of developing thalamic pain. The high odds ratio at the ventral posterior nucleus-pulvinar border zone indicates that this area is crucial in the pathogenesis of thalamic pain and demonstrates the feasibility of identifying patients at risk of developing central post-stroke pain of thalamic origin early after thalamic insults. This provides a basis for pre-emptive treatment studies.

  8. High Glucose-Mediated STAT3 Activation in Endometrial Cancer Is Inhibited by Metformin: Therapeutic Implications for Endometrial Cancer

    Science.gov (United States)

    Wallbillich, John J.; Josyula, Srirama; Saini, Uksha; Zingarelli, Roman A.; Dorayappan, Kalpana Deepa Priya; Riley, Maria K.; Wanner, Ross A.; Cohn, David E.; Selvendiran, Karuppaiyah

    2017-01-01

    Objectives STAT3 is over-expressed in endometrial cancer, and diabetes is a risk factor for the development of type 1 endometrial cancer. We therefore investigated whether glucose concentrations influence STAT3 expression in type 1 endometrial cancer, and whether such STAT3 expression might be inhibited by metformin. Methods In Ishikawa (grade 1) endometrial cancer cells subjected to media with low, normal, or high concentrations of glucose, expression of STAT3 and its target proteins was evaluated by real-time quantitative PCR (qPCR). Ishikawa cells were treated with metformin and assessed with cell proliferation, survival, migration, and ubiquitin assays, as well as Western blot and qPCR. Expression of apoptosis proteins was evaluated with Western blot in Ishikawa cells transfected with a STAT3 overexpression plasmid and treated with metformin. A xenograft tumor model was used for studying the in vivo efficacy of metformin. Results Expression of STAT3 and its target proteins was increased in Ishikawa cells cultured in high glucose media. In vitro, metformin inhibited cell proliferation, survival and migration but induced apoptosis. Metformin reduced expression levels of pSTAT3 ser727, total STAT3, and its associated cell survival and anti-apoptotic proteins. Additionally, metformin treatment was associated with increased degradation of pSTAT3 ser727. No change in apoptotic protein expression was noticed with STAT3 overexpression in Ishikawa cells. In vivo, metformin treatment led to a decrease in tumor weight as well as reductions of STAT3, pSTAT3 ser727, its target proteins. Conclusions These results suggest that STAT3 expression in type 1 endometrial cancer is stimulated by a high glucose environment and inhibited by metformin. PMID:28114390

  9. MR imaging of endometrial cancer that occurs after radiation therapy for cervix cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Youn Jeong [Inha University Hospital, Incheon (Korea, Republic of); Jeong, Yong Yeon; Lim, Nam Yeol [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Ko, Seok Wan [Kwangju Christian Hospital, Kwangju (Korea, Republic of); Kim, Bo Hyun [Mayo Clinic College of Medicine, Rochester, Minnesota (United States)

    2007-05-15

    We wanted to describe the MR imaging findings of endometrial cancer in patients with a history of prior radiation therapy for cervical cancer (ECRT) and we compare them to the MR imaging findings of patients with spontaneously occurring endometrial cancer (SEC). Twenty-two patients with endometrial cancer that was diagnosed by operation or endometrial biopsy were included in the study. The patients were divided into two groups according to the presence of past RT for cervical cancer: ECRT (n = 4) and SEC (n = 18). The MR images were retrospectively analyzed by consensus of two experienced radiologists. The MR imaging findings were analyzed by the size, shape and signal intensity of the mass, distension of the uterine cavity, the presence of cervical stenosis and the nature of the fluid collection. For the mass shape, all the ECRT lesions were polypoid masses. However, the SEC patients had 5 polypoid masses and 13 wall thickenings. The maximal diameter, signal intensity and enhancement pattern of the masses were not different between the ECRT and SEC patients. The width of the endometrial cavity varied between 3.9 cm in the ECRT patients and 0.4 cm in the SEC patients ({rho} = 0.002). All the ECRT patients had cervical stenosis. However, none of the SEC patients had cervical stenosis. MR imaging of ECRT patients demonstrated prominent distension of their uterine cavity and cervical stenosis, which may be the result of radiation fibrosis in the uterus.

  10. Detecting uterine glandular lesions: Role of cervical cytology

    Directory of Open Access Journals (Sweden)

    Baneet Bansal

    2016-01-01

    Full Text Available Background: The sensitivity of cervical cytology for detection of glandular lesions is reported to be low. We conducted this study to assess the diagnostic accuracy of cervical Papanicolaou (Pap smears for uterine glandular lesions and to compare the diagnostic utility of conventional and liquid-based cytology (LBC smears for glandular lesions. Materials and Methods: Archived histopathology records of all cases reported as endocervical and endometrial adenocarcinoma in the study period were identified and the available corresponding Pap smears (in preceding 1 year were retrieved. In addition, the Pap smears reported as glandular cell abnormalities (GCA during the same study period were retrieved. The overall prevalence of GCA, sensitivity, and specificity of Pap smears for the detection of GCA was calculated. The diagnostic accuracy of conventional and LBC smears for the diagnosis of GCA was also compared. Results: The prevalence of GCA in our study was 0.32%. The overall specificity of Pap smears for the diagnosis of GCA was 60.8%, this was not significantly different between conventional and LBC smears (P = 0.4. The overall sensitivity of Pap smears for the detection of GCA was 41.8%; LBC smears had significantly better sensitivity as compared to conventional smears for the detection of endometrial as compared to endocervical adenocarcinoma (P < 0.05. Conclusions: The prevalence of GCA in Pap smears is low. The specificity of Pap smears, for diagnosis of GCA, was found to be moderate. However, the overall sensitivity of Pap smears for the detection of GCA was low, though better for LBC as compared to conventional smears.

  11. Diagnostic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia.

    Science.gov (United States)

    Mittal, Khush; Salem, Amira; Lo, Andy

    2014-01-01

    Morphologic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia have been described previously, but they have not been examined extensively for their individual ability for predicting endometrial adenocarcinoma as determined by subsequent hysterectomy. We examined endometrial biopsies diagnosed in the spectrum of complex atypical endometrial hyperplasia to well-differentiated endometrial adenocarcinoma for various morphologic features that may be predictive for the presence of myoinvasive endometrial adenocarcinoma in subsequent hysterectomy. Cases diagnosed as FIGO grade I endometrial adenocarcinoma or complex atypical endometrial hyperplasia in endometrial biopsies seen at New York University Medical Center from 2003 to 2006 were analyzed for the presence of various morphologic features without the knowledge of hysterectomy findings. Only those cases with subsequent hysterectomy were included in the study. The data were analyzed to identify features with high specificity for a finding of myoinvasive endometrial adenocarcinoma in subsequent hysterectomy. Extreme glandular crowding (95% or greater area with glands, aggregate size 3 mm or greater) and cribriform foci of any size were found to have high sensitivity and specificity for the finding of myoinvasive carcinoma in subsequent hysterectomy (P < .0001).

  12. Dietary carbohydrate intake, glycemic index, and glycemic load and endometrial cancer risk: a prospective cohort study.

    Science.gov (United States)

    Coleman, Helen G; Kitahara, Cari M; Murray, Liam J; Dodd, Kevin W; Black, Amanda; Stolzenberg-Solomon, Rachael Z; Cantwell, Marie M

    2014-01-01

    Endometrial cancer risk has been directly associated with glycemic load. However, few studies have investigated this link, and the etiological role of specific dietary carbohydrate components remains unclear. Our aim was to investigate associations of carbohydrate intake, glycemic index, and glycemic load with endometrial cancer risk in the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Recruitment took place in 1993-2001. Over a median of 9.0 years of follow-up through 2009, 386 women developed endometrial cancer among 36,115 considered in the analysis. Dietary intakes were assessed using a 124-item diet history questionnaire. Cox proportional hazards models were applied to calculate hazard ratios and 95% confidence intervals. Significant inverse associations were detected between endometrial cancer risk and total available carbohydrate intake (hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.49, 0.90), total sugars intake (HR = 0.71, 95% CI: 0.52, 0.96), and glycemic load (HR = 0.63, 95% CI: 0.46, 0.84) when women in the highest quartile of intake were compared with those in the lowest. These inverse associations were strongest among overweight and obese women. No associations with endometrial cancer risk were observed for glycemic index or dietary fiber. Our findings contrast with previous evidence and suggest that high carbohydrate intakes and glycemic loads are protective against endometrial cancer development. Further clarification of these associations is warranted.

  13. Pathologic fracture of the femur due to endometrial adenocarcinoma metastasis in a female pet rabbit (Oryctolagus cuniculi).

    Science.gov (United States)

    Haist, Verena; Hirschfeld, Simon Gonzales; Mallig, Carolin; Fehr, Michael; Baumgärtner, Wolfgang

    2010-01-01

    This case report describes the clinical, pathomorphological and histopathological findings in a 12-year-old female pet rabbit with a pathologic fracture of the femur due to a metastasising endometrial adenocarcinoma. The animal was presented due to a history of right hindlimb lameness and inappetence. A fracture of the right femur with adjacent lyric bone lesions was detected by clinical and X-ray examination. Necropsy and histopathology revealed an endometrial adenocarcinoma with metastasis to the right femoral bone, resulting in the pathologic fracture. In both locations, tumour cells were immunohistochemically positive for pan-cytokeratin. Additionally, the animal suffered from an Encephalitozoon cuniculi infection which manifested itself in a multifocal granulomatous encephalitis and bilateral chronic inflammatory lesions in the kidneys.The report shows that in case of bone fractures in female pet rabbits the possibility of a pathologic fracture due to metastasising endometrial adenocarcinoma has to be considered.

  14. Assessment of hemodynamics in precancerous lesion of hepatocellular carcinoma: Evaluation with MR perfusion

    Institute of Scientific and Technical Information of China (English)

    Sheng Guan; Wei-Dong Zhao; Kang-Rong Zhou; Wei-Jun Peng; Feng Tang; Jian Mao

    2007-01-01

    AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC).METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR)perfusion. The changes induced by diethylnitrosamine (DEN) developed into liver nodular lesions due to hepatic cirrhosis during the progression of carcinogenesis.The MR perfusion data [positive enhancement integral (PEI)] were compared between the nodular lesions corresponding well with MR images and pathology and their surrounding hepatic parenchyma.RESULTS: A total of 46 nodules were located by MR imaging and autopsy, including 22 dysplastic nodules (DN), 9 regenerative nodules (RN), 10 early HCCs and 5 overt HCCs. Among the 22 DNs, 6 were low-grade DN (LGDN) and 16 were high-grade DN (HGDN). The average PEI of RN, DN, early and overt HCC was 205.67± 31.17, 161.94 ± 20.74, 226.09 ± 34.83, 491.86 ±44.61 respectively, and their liver parenchyma nearby was 204.84 ± 70.19. Comparison of the blood perfusion index between each RN and its surrounding hepatic parenchyma showed no statistically significant difference (P = 0.06). There were significant differences in DN (P = 0.02). During the late hepatic arterial phase, the perfusion curve in DN declined. DN had an iso-signal intensity at the early hepatic arterial phase and a low signal intensity at the portal venous phase. Of the 10early HCCs, 4 demonstrated less blood perfusion and 6 displayed minimally increased blood flow compared to the surrounding parenchyma. Five HCCs showed significantly increased blood supply compared to the surrounding parenchyma (P = 0.02).CONCLUSION: Non-invasive MR perfusion can detect changes in blood supply of precancerous lesions.

  15. Examestane in advanced or recurrent endometrial carcinoma

    DEFF Research Database (Denmark)

    Lindemann, Kristina; Malander, Susanne; Christensen, René dePont;

    2014-01-01

    We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma.......We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma....

  16. Can magnetic resonance spectroscopy differentiate endometrial cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jie; Cai, Shifeng; Han, Xue; Liu, Qingwei; Xin, Yinghui [Shandong University, Department of Radiology, Shandong Provincial Hospital, Jinan (China); Li, Changzhong; Yang, Chunrun [Shandong University, Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Jinan (China); Sun, Xichao; Zong, Yuanyuan [Shandong University, Department of Pathology, Shandong Provincial Hospital, Jinan (China); Fu, Caixia [Siemens Shenzhen Magnetic Resonance Ltd., Siemens MRI Center, Shenzhen (China)

    2014-10-15

    To investigate whether the choline-containing compounds (Cho) obtained from three-dimensional {sup 1}H magnetic resonance (MR) spectroscopy can differentiate endometrial cancer (ECa) from benign lesions in endometria or in submucosa (BLs-ESm) and is associated with the aggressiveness of ECa. Fifty-seven patients (ECa, 38; BLs-ESm, 19) underwent preoperative multi-voxel MR spectroscopy at 3.0 T. The ratio of the sum of the Cho peak integral to the sum of the unsuppressed water peak integral (Cho/water) and the coefficient of variation (CV) used to describe the variability of Cho/water in one lesion were calculated. Mean Cho/water (±standard deviation [SD]) was (3.02 ± 1.43) x 10{sup -3} for ECa and (1.68 ± 0.33) x 10{sup -3} for BLs-ESm (p < 0.001). Mean Cho/water was (4.42 ± 1.53) x 10{sup -3} for type II ECa and (2.65 ± 1.17) x 10{sup -3} for type I ECa (p = 0.001). There were no significant differences among different stages of ECa (p = 0.107) or different grades of ECa (p = 0.142). The Cho/water was positively correlated with tumour stage (r = 0.386, p = 0.017) and size (r = 0.333, p = 0.041). The CV was also positively correlated with tumour stage (r = 0.537, p = 0.001) and size (r = 0.34, p = 0.037). The Cho/water can differentiate ECa from BLs-ESm and differentiate type II from type I ECa, but cannot differentiate different stages of ECa or different grades of ECa. Cho/water increased with the increase of tumour stage and size. (orig.)

  17. OVARIAN METASTASIS IN PATIENT WITH ENDOMETRIAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    ZHOU Feng-zhi; CHEN Yi-nan; ZHANG Guo-nan

    2005-01-01

    Objective: To study the clinical pathological characteristics of ovarian metastasis of endometrial carcinoma and the factors affecting prognosis. Methods: Retrospective analysis was made to the clinical pathological outcome of endometrial carcinoma patients receiving surgical treatment in our hospital from January 1990 to December 2002. Results:Among the 191 cases of endometrial carcinoma patients, 17 cases (8.9%) had ovarian metastasis and young patients were more likely to have ovarian metastasis. The multiple factor analysis showed that the independent risk factors of ovarian metastasis in endometrial carcinoma included the depth of myometrial invasion, lymph node metastasis and pathological types. Conclusion: Ovarian metastasis in patients with endometrial carcinoma is associated with poor prognosis, the depth of myometrial invasion, lymph node metastasis and histologic types are independent risk factors affecting the prognosis. For young patients at early stage of the disease, it should be prudent as to whether to retain the ovary.

  18. Statin use and risk of endometrial cancer

    DEFF Research Database (Denmark)

    Sperling, Cecilie D.; Verdoodt, Freija; Friis, Søren

    2017-01-01

    (HRT), obesity, diabetes, chronic obstructive pulmonary disease and education. We evaluated whether the association between statin use and endometrial cancer varied with duration and intensity of statin use, type of endometrial cancer or patient characteristics. RESULTS: The study population comprised......INTRODUCTION: Laboratory and epidemiological evidence have suggested that statin use may protect against the development of certain cancers, including endometrial cancer. In a nationwide registry-based case-control study, we examined the association between statin use and risk of endometrial cancer....... MATERIAL AND METHODS: Cases were female residents of Denmark with a primary diagnosis of endometrial cancer during 2000-2009. For each case, we selected 15 female population controls matched on date of birth (±one month) using risk-set sampling. Ever use of statin was defined as two or more prescriptions...

  19. Evaluation of endometrial cancer epidemiology in Romania.

    Science.gov (United States)

    Bohîlțea, R E; Furtunescu, F; Dosius, M; Cîrstoiu, M; Radoi, V; Baroș, A; Bohîlțea, L C

    2015-01-01

    Endometrial cancer represents the most frequent gynecological malignant affection in the developed countries, in which the incidence of cervical cancer has significantly decreased due to the rigorous application of screening methods and prophylaxis. According to its frequency, endometrial cancer is situated on the fourth place in the category of women's genital-mammary malignant diseases, after breast, cervical and ovarian cancer in Romania. The incidence and mortality rates due to endometrial cancer have registered an increasing trend worldwide and also in Romania, a significant decrease of the age of appearance for the entire endometrial pathology sphere being noticed. At the national level, the maximum incidence is situated between 60 and 64 years old, the mortality rate of the women under 65 years old being high in Romania. The study evaluates endometrial cancer, from an epidemiologic point of view, at the national level compared to the international statistic data.

  20. Psychometric validation of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24)

    DEFF Research Database (Denmark)

    Greimel, Elfriede; Nordin, Andy; Lanceley, Anne

    2011-01-01

    A validation study was conducted to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24). This module was designed to assess disease and treatment specific aspects...... of the quality of life (QoL) of patients with endometrial cancer....

  1. Association between Breastfeeding and Endometrial Cancer Risk: Evidence from a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Lianlian Wang

    2015-07-01

    Full Text Available Quantification of the association between breastfeeding and risk of endometrial cancer is still conflicting. We therefore conducted a meta-analysis to assess the association between breastfeeding and endometrial cancer risk. Pertinent studies were identified by a search of PubMed and Web of Knowledge through April 2015. A random effect model was used to combine the data for analysis. Sensitivity analysis and publication bias were conducted. Dose-response relationships were assessed by restricted cubic spline and variance-weighted least squares regression analysis. Fourteen articles involving 5158 endometrial cancer cases and 706,946 participants were included in this meta-analysis. Pooled results suggested that breastfeeding significantly reduced the risk of endometrial cancer (summary relative risk (RR: 0.77, 95% CI: 0.62–0.96, I2: 63.0%, especially in North America (summary RR: 0.87, 95% CI: 0.79–0.95. A linear dose-response relationship was found, with the risk of endometrial cancer decreased by 2% for every one-month increase in the duration of breastfeeding (summary RR: 0.98, 95% CI: 0.97–0.99. Our analysis suggested that breastfeeding, particularly a longer duration of breastfeeding, was inversely associated with the risk of endometrial cancer, especially in North America, but not in Europe and Asia, probably due to the small number of cases included. Due to this limitation, further studies originating in other countries are required to assess the association between breastfeeding and endometrial cancer risk.

  2. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sudo, Satoko; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan); Hattori, Naoya; Manabe, Osamu; Hirata, Kenji; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Kitaku, Sapporo (Japan); Kato, Fumi; Mimura, Rie; Magota, Keiichi; Sugimori, Hiroyuki [Hokkaido University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Sapporo (Japan)

    2015-04-01

    The staging of endometrial cancer requires surgery which carries the risk of morbidity. FDG PET/CT combined with anatomical imaging may reduce the number of unnecessary lymphadenectomies by demonstrating the risk of extrapelvic infiltration. The purpose of this study was to optimize FDG PET/CT diagnostic criteria for risk assessment in endometrial cancer after first-line risk triage with MRI. The study population comprised 37 patients who underwent curative surgery for the treatment of endometrial cancer. First, the risk of extrapelvic infiltration was triaged using MRI. Second, multiple glucose metabolic profiles of the primary lesion were assessed with FDG PET/CT, and these were correlated with the histopathological risk of extrapelvic infiltration including lymphovascular space invasion (LVSI) and high-grade malignancy (grades 2 and 3). The results of histological correlation were used to adjust FDG PET/CT diagnostic criteria. Presurgical assessment using MRI was positive for deep (>50 %) myometrial invasion in 17 patients. The optimal FDG PET/CT diagnostic criteria vary depending on the results of MRI. Specifically, SUVmax (≥16.0) was used to indicate LVSI risk with an overall diagnostic accuracy of 88.2 % in patients with MRI findings showing myometrial invasion. High-grade malignancy did not correlate with any of metabolic profiles in this patient group. In the remaining patients without myometrial invasion, lesion glycolysis (LG) or metabolic volume were better indicators of LVSI than SUVmax with the same diagnostic accuracy of 80.0 %. In addition, LG (≥26.9) predicted high-grade malignancy with an accuracy of 72.2 %. Using the optimized cut-off criteria for LVSI, glucose metabolic profiling of primary lesions correctly predicted lymph node metastasis with an accuracy of 73.0 %, which was comparable with the accuracy of visual assessment for lymph node metastasis using MRI and FDG PET/CT. FDG PET/CT diagnostic criteria may need adjustment based on the

  3. Pólipos endometriais Endometrial polyps

    Directory of Open Access Journals (Sweden)

    Antonio Alberto Nogueira

    2005-05-01

    Full Text Available Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento anormal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis.Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there is an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive

  4. Assessment of the natural course and treatment of premalignant uterine cervical lesions in pregnancy

    Directory of Open Access Journals (Sweden)

    Šljivančanin Dragiša

    2013-01-01

    Full Text Available Introduction. Premalignant changes of the uterine cervix occur with similar frequency during pregnancy and in non­pregnant women. Due to the fact that any surgery on the cervix can jeopardize pregnancy, it is important to define the protocol of procedures for the treatment of these changes during pregnancy. Objective. The aim of the study was to investigate the natural course of premalignant cervical changes during pregnancy and the impact of their treatment on the pregnancy course. Methods. Study involved all patients with colposcopically, cytologically and hystopathologically diagnosed premalignant cervical changes during pregnancy from 2002 to 2008. Patients were divided into two groups according to the applied treatment during pregnancy: surgery or monitoring by regular colposcopic and cytological examinations. The two groups were compared concerning treatment outcome, persistence or regression of changes and pregnancy duration. Results. Study involved 58 patients. Spontaneous remission of lesions occurred after pregnancy in 63.79% of cases. Highgrade squamous intraepithelial lesion (H­SIL demonstrated a higher rate of persistency in comparison with low­grade squamous intraepithelial lesion (L­SIL (χ2=25.115; p<0.05. Only one finding of L­SIL progressed into H­SIL in the monitored group. Patients who underwent conization during pregnancy had a significantly more frequent preterm deliveries (χ2=14.369; p<0.05. Conclusion. The obtained high rate of spontaneous regression of cervical changes after pregnancy as well as the lower incidence of preterm births in patients who were not treated by conization during pregnancy, confirm that patients with premalignant cervical changes should be, if invasion is excluded, under follow­up throughout pregnancy by regular colposcopic and cytological examinations. Therapeutic conization, due to numerous complications, should be performed only when there is a suspected presence of a more severe form of

  5. The value of Pap test in women with endometrial cancer

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    Aleksandra Petrić

    2011-12-01

    Full Text Available Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer.Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status, histopathological findings after surgery (type and stage of the disease and a preoperative Pap smear. The chi squared and Fisher’s test were used.Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II was not statistically significant.Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot beused to assess cervical involvement.

  6. Expressions of estrogen receptor subtypes and c-met proto-oncogene in endometrial carcinoma and their correlation

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To investigate the expressions of estrogen receptor(ER)subtypes and c-met proto-oncogene in human endometrial carcinomas and to assess the clinical significance of ER and c-met in this carcinoma.Methods Reverse transcription PCR(RT-PCR)was used to detect the expressions of ERα,ERβ and c-met proto-oncogene mRNA in 30 samples of endometrial carcinoma and 11 samples of normal endometrium.Results The expression of ERα in endometrial carcinoma(0.70±0.40)was significantly reduced in comparison to that i...

  7. Locked nucleic acid-inhibitor of miR-205 decreases endometrial cancer cells proliferation in vitro and in vivo.

    Science.gov (United States)

    Torres, Anna; Kozak, Joanna; Korolczuk, Agnieszka; Rycak, Dominika; Wdowiak, Paulina; Maciejewski, Ryszard; Torres, Kamil

    2016-11-08

    Pathogenesis of endometrial cancer has been connected with alterations of microRNA expression and in particular miR-205 up-regulation was consistently reported in this carcinoma. Presented study aimed to investigate if inhibition of miR-205 expression using LNA-modified-nucleotide would attenuate endometrial cancer cells proliferation in vitro and in vivo.In the course of the study we found that the proliferation of endometrial cancer cells (HEC-1-B, RL-95, KLE, Ishikawa) transfected with LNA-miR-205-inhibitor and evaluated using real time cell monitoring as well as standard cell proliferation assay, was significantly decreased. Next, LNA-miR-205-inhibitor was used to assess the in vivo effects of miR-205 inhibition of endometrial cancer growth. Cby.Cg-Foxn1/cmdb mice bearing endometrial cancer xenografts were intraperitoneally injected with nine dosages of 25mg/kg of miR-205-LNA-inhibitor or scramble control or phosphatase buffered saline and were observed for 32 days. We found that systemic administration of miR-205-LNA-inhibitor was technically possible, and exerted inhibitory effect on endometrial cancer xenograft growth in vivo with only mild toxic effects in treated animals.In conclusion our results suggest that systemic delivery of miR-205-LNA-inhibitor is feasible, devoid of significant toxicity, and could be a promising treatment strategy for endometrial cancer. Therefore it warrants further studies in other animal models.

  8. Coronary lesion complexity assessed by SYNTAX score in 256-slice dual-source MDCT angiography

    Science.gov (United States)

    Yüceler, Zeyneb; Kantarcı, Mecit; Tanboğa, İbrahim Halil; Sade, Recep; Kızrak, Yeşim; Pirimoğlu, Berhan; Bayraktutan, Ümmügülsüm; Oğul, Hayri; Aksakal, Enbiya

    2016-01-01

    PURPOSE The SYNTAX Score (SS) has an important role in grading the complexity of coronary artery disease (CAD) in patients undergoing revascularization. Noninvasive determination of SS prior to invasive coronary angiography (ICA) might optimize patient management. We aimed to evaluate the agreement between ICA and multidetector computed tomography (MDCT) while testing the diagnostic effectiveness of SS-MDCT. METHODS Our study included 108 consecutive patients who underwent both MDCT angiography with a 256-slice dual-source MDCT system and ICA within 14±3 days. SS was calculated for both ICA and MDCT coronary angiography. Spearman’s rank correlation coefficient was used to evaluate the association of SS-MDCT with SS-ICA, and Bland-Altman analysis was performed. RESULTS The degree of agreement between SS-ICA and SS-MDCT was moderate. The mean SS-MDCT was 14.5, whereas the mean SS-ICA was 15.9. After dividing SS into three groups (high [≥33], intermediate [23–32], and low [≤22] subgroups), agreement analysis was repeated. There was a significant correlation between SS-MDCT and SS-ICA in the low SS group (r=0.63, P = 0.043) but no significant correlation in the high SS group (r=0.036, P = 0.677). The inter-test agreement analysis showed at least moderate agreement, whereas thrombotic lesions and the type of bifurcation lesion showed fair agreement. CONCLUSION The calculation of SS-MDCT by adapting SS-ICA parameters achieved nearly the same degree of precision as SS-ICA and was better than SS-ICA, especially in the low SS group. PMID:27328718

  9. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in non-atopic asthmatic patients

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis; Lindenberg, Svend;

    2015-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women ...... endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.......Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women...... (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower...

  10. The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Nikki L. Neubauer

    2011-01-01

    Full Text Available Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the International Federation of Gynecology and Obstetrics (FIGO in 1988 based on reports demonstrating diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis, risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade 1 tumors with superficial myometrial invasion, however, a systematic lymph node dissection should be performed in most other patients with endometrial cancer. In the future, molecular markers may be useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an approach of surgical staging with selective lymph node dissection will improve survival and spare patients additional surgical complications or unnecessary postoperative exposure to radiation and/or chemotherapy.

  11. In vitro comparison of Nyvad's system and ICDAS-II with Lesion Activity Assessment for evaluation of severity and activity of occlusal caries lesions in primary teeth

    DEFF Research Database (Denmark)

    Braga, M M; Mendes, F M; Martignon, S;

    2009-01-01

    This in vitro study of occlusal surfaces on primary molars aimed to: (1) evaluate the reproducibility of the Nyvad and ICDAS-II visual systems in detecting caries; (2) to test the accuracy of the systems in estimating lesion depth, and (3) to examine the association between the Nyvad system and t...

  12. Retinoic acid inhibits endometrial cancer cell growth via multiple genomic mechanisms.

    Science.gov (United States)

    Cheng, You-Hong; Utsunomiya, Hiroki; Pavone, Mary Ellen; Yin, Ping; Bulun, Serdar E

    2011-04-01

    Previous studies have indicated that retinoic acid (RA) may be therapeutic for endometrial cancer. However, the downstream target genes and pathways triggered by ligand-activated RA receptor α (RARα) in endometrial cancer cells are largely unknown. In this study, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, flow cytometry, and immunoblotting assays were used to assess the roles of RA and the RA agonist (AM580) in the growth of endometrial cancer cells. Illumina-based microarray expression profiling of endometrial Ishikawa cells incubated with and without AM580 for 1, 3, and 6 h was performed. We found that both RA and AM580 markedly inhibited endometrial cancer cell proliferation, while knockdown of RARα could block AM580 inhibition. Knockdown of RARα significantly increased proliferating cell nuclear antigen and BCL2 protein levels. Incubation of Ishikawa cells with or without AM580 followed by microarray expression profiling showed that 12 768 genes out of 47 296 gene probes were differentially expressed with significant P values. We found that 90 genes were the most regulated genes with the most significant P value (PAM580 highly regulated these genes, whereas chromatin immunoprecipitation-PCR assay demonstrated that ligand-activated RARα interacted with the promoter of these genes in intact endometrial cancer cells. AM580 also significantly altered 18 pathways including those related to cell growth, differentiation, and apoptosis. In conclusion, AM580 treatment of Ishikawa cells causes the differential expression of a number of RARα target genes and activation of signaling pathways. These pathways could, therefore, mediate the carcinogenesis of human endometrial cancer.

  13. [Assessment and correction of psychophysiological features in adolescents at the information science lesions].

    Science.gov (United States)

    Shentsov, A A; Markina, L D

    2008-01-01

    The adaptation of teenagers to an educational process in a computer class with the optimum hygienic parameters was studied. The modified procedure "Examinees' emotional assessment of musical tracks" was established to efficiently prevent autonomic dysfunctions and emotional disorders.

  14. DCE-MRI and DWI Integration for Breast Lesions Assessment and Heterogeneity Quantification

    Directory of Open Access Journals (Sweden)

    C. Andrés Méndez

    2012-01-01

    Full Text Available In order to better predict and follow treatment responses in cancer patients, there is growing interest in noninvasively characterizing tumor heterogeneity based on MR images possessing different contrast and quantitative information. This requires mechanisms for integrating such data and reducing the data dimensionality to levels amenable to interpretation by human readers. Here we propose a two-step pipeline for integrating diffusion and perfusion MRI that we demonstrate in the quantification of breast lesion heterogeneity. First, the images acquired with the two modalities are aligned using an intermodal registration. Dissimilarity-based clustering is then performed exploiting the information coming from both modalities. To this end an ad hoc distance metric is developed and tested for tuning the weighting for the two modalities. The distributions of the diffusion parameter values in subregions identified by the algorithm are extracted and compared through nonparametric testing for posterior evaluation of the tissue heterogeneity. Results show that the joint exploitation of the information brought by DCE and DWI leads to consistent results accounting for both perfusion and microstructural information yielding a greater refinement of the segmentation than the separate processing of the two modalities, consistent with that drawn manually by a radiologist with access to the same data.

  15. Clonality assessment of lymphoproliferative lesions using the polymerase chain reaction: An analysis of two methods

    Directory of Open Access Journals (Sweden)

    Nikhil Moorchung

    2011-01-01

    Full Text Available Background: Lymphoid malignancies are a heterogeneous group of disorders which may be difficult to differentiate from reactive proliferations even after immunohistochemistry. Polymerase chain reaction (PCR is believed to be a good adjunct tool for diagnosis. Materials and Methods: We examined 24 cases of neoplastic and non-neoplastic lymphoproliferative lesions in this study and evaluated the PCR as an additional tool in the confirmation of the diagnosis. Two different PCR methodologies were evaluated. Results: In the evaluation of the T-cell PCR, it was seen that the correlation using both the commercial kits and the custom-synthesized primers was highly significant at a P value of 0.05. Conclusions: Both the methods showed an excellent concordance for T-cell γ gene rearrangements, However, the same was not seen in the B-cell receptor rearrangements. This may be because of the small sample size or the inability of consensus V primers to recognize complementary DNA sequences in all of the V segments.

  16. Genistein reduces angiogenesis and apoptosis in women with endometrial hyperplasia

    Directory of Open Access Journals (Sweden)

    Granese R

    2015-01-01

    Full Text Available Roberta Granese,1,* Alessandra Bitto,2,* Francesca Polito,2 Onofrio Triolo,1 Domenico Giordano,1 Angelo Santamaria,1 Francesco Squadrito,2 Rosario D’Anna1 1Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences, 2Department of Clinical and Experimental Medicine, Section of Pharmacology, University of Messina, Messina, Italy*These authors contributed equally to this workAbstract: Endometrial hyperplasia without cytological atypia is commonly treated with progestins, but other treatments may be available with equivalent efficacy and reduced side effects. Here, we evaluate the effect of genistein aglycone on angiogenesis and apoptosis-related markers women with endometrial hyperplasia. Premenopausals (n=38 with nonatypical endometrial hyperplasia were administered either genistein aglycone (54 mg/day, n=19 or norethisterone acetate (10 mg/day, n=19 on days 16–25 of the menstrual cycle and evaluated for 6 months. Biopsies were taken during hysteroscopy at baseline and 6 months, and symptoms including excessive uterine bleeding were assessed at baseline and 3 and 6 months following recruitment. The expression of angiogenesis (Vegf, epithelial (Egf and Tgfb, and apoptosis-related (Bax, Bcl-2, and Casp-9 molecules, were assessed in uterine biopsies at baseline and after 6 months of therapy. Follicle-stimulating hormone, luteinizing hormone, estradiol, SHBG, and progesterone levels were also measured. After 6 months, 42% of genistein aglycone-administered patients had a significant improvement of symptoms compared to 47% of norethisterone acetate subjects. No significant differences were noted in hormone levels for any treatment. Gene expression revealed a significant reduction in Vegf, Egf, and Tgfb (P<0.05 versus baseline, and an increase in proapoptotic molecules (Bax and Casp-9, with a concomitant decrease in Bcl-2 values (P<0.05 in both groups. These results suggest that genistein aglycone might be useful for the

  17. Coronary plaque characterization of nonculprit or nontarget lesions assessed by analysis of in vivo intracoronary ultrasound radio-frequency data

    Institute of Scientific and Technical Information of China (English)

    LIU Hui-liang; ZHANG Jiao; MA Dong-xing; LUO Jian-ping; YANG Sheng-li; HAN Wei; LIU Ying; JING Li-min; MENG Rong-ying

    2009-01-01

    Background Unheralded sudden death and acute myocardial infarction are common manifestations of coronary atherosclerosis. Such events are related to thrombotic occlusion at the site of non-flow limiting atheroscterotic plaques in epicardial coronary arteries. This study aimed to assess plaque characterization of nonculprit lesions in patients with acute coronary syndrome (ACS) compared with those with stable angina pectoris (SAP) determined by analysis of intravascular ultrasound (IVUS) radiofrequency (RF) data.Methods In 81 patients, nonculprit vessels with <50% diameter stenosis and nontarget segment of culprit vessels with <50% diameter stenosis were studied with IVUS. Tissue maps were reconstructed from RF data using IVUS-Virtual Histology software.Results Mean lipid core percentage was significantly higher in patients with ACS than in those with SAP ((25.78±6.30)% vs (9.11±4.90)%, P <0.001). In addition, patients with SAP showed more fibrotic vessels ((59.66±16.87)% vs (49.07±10.20)%, P <0.001). There was no significant difference in either mean calcium ((4.37±2.40)% vs (5.12±3.00)%, P=0.225) or fibrolipid ((24.94±9.40)% vs (25.82±13.60)%, P=0.731) percentages in nonculprit vessels, but the mean calcium percentage was significantly higher in nontarget lesions of culprit vessels ((5.51±3.29)% vs (3.57±2.10)%, P=0.003). In addition, there was a positive correlation between lipid core and remodeling index (RI) (r=0.847, P<0.001) and a negative correlation between fibrous tissue and RI (r=-0.946, P<0.001).Conclusions In this study, in both nonculprit vessels and nontarget lesion of culprit vessels, plaque characterization of nonculprit lesions determined by spectral analysis of IVUS RF data was significantly different in patients with ACS. The percentage of lipid core was significantly higher in patients with ACS than in those with SAP. Conversely, SAP patients showed more fibrotic content. In vivo plaque composition and morphological changes were

  18. A 5 year retrospective study of biopsied jaw lesions with the assessment of concordance between clinical and histopathological diagnoses

    Directory of Open Access Journals (Sweden)

    Elif Peker

    2016-01-01

    Full Text Available Introduction: The jaw can be affected by several lesions that manifest in the oral cavity, but little is known about their distribution patterns in various populations. Aims and Objectives: This study presents the frequency and distribution of biopsied jaw lesions recorded in Faculty of Dentistry and gathers the information including provisional and final diagnosis of the lesions. Material and Methods: Biopsy of 1938 lesions (2008-2013 was reviewed and 1473 lesions were included in this study. The provisional diagnosis and histopathological validations of lesions were compared. Data on the location of the lesion, as well as patient demographics, were also evaluated. The lesions were divided into three major groups as 1 - developmental/reactive and inflammatory lesions of the jaw, 2 - cystic lesion and 3 - tumor and tumor-like lesions. Statistical Analysis: The variables were recorded and analysed using descriptive statistics. Results and Observations: Three hundred and ninety-six lesions were in Group 1 and periapical granuloma was the most frequent diagnosis. Seven hundred and eighty-nine lesions were in Group 2 and the radicular cyst was the most frequent diagnosis. Two hundred and eighty-eight lesions were in Group 3 and the keratocystic odontogenic tumor was the most frequent. Two hundred and ninety-one biopsied lesions were in disagreement with respect to the diagnoses on clinical and histopathological examination. Conclusion: Consequently, a provisional diagnosis of some of the malignant lesions was reactive, inflammatory, cystic or benign lesions, therefore the importance of evaluation of the specimen is emphasized.

  19. Assessment of dysphonia due to benign vocal fold lesions by acoustic and aerodynamic indices: a multivariate analysis.

    Science.gov (United States)

    Cantarella, Giovanna; Baracca, Giovanna; Pignataro, Lorenzo; Forti, Stella

    2011-04-01

    The goal was to identify acoustic and aerodynamic indices that allow the discrimination of a benign organic dysphonic voice from a normal voice. Fifty-three patients affected by dysphonia caused by vocal folds benign lesions, and a control group were subjected to maximum phonation time (MPT) measurements, GRB perceptual evaluations and acoustic/aerodynamic tests. All analyzed variables except the airflow variation coefficient were significantly different between the two groups. The unique significant factors in the discrimination between healthy and dysphonic subjects were the aerodynamic indices of MPT and Glottal efficiency index, and the acoustic index Shimmer. These results show that a combination of three parameters can discriminate a voice deviance and highlight the importance of a multidimensional assessment for objective voice evaluation.

  20. Leptin receptor expression during the progression of endometrial carcinoma is correlated with estrogen and progesterone receptors

    Science.gov (United States)

    Méndez-López, Luis Fernando; Zavala-Pompa, Angel; Cortés-Gutiérrez, Elva I.; Cerda-Flores, Ricardo M.

    2016-01-01

    Introduction The hormone leptin, which is produced in the adipose tissue, may influence tumorigenesis directly via its receptor (Ob-R). Thus, a role for Ob-R in endometrial carcinogenesis has been proposed. However, most studies neither included samples of the entire histological progression of endometrial carcinoma nor examined Ob-R jointly with the estrogen and progesterone receptors (ER and PR, respectively). Material and methods To determine the fluctuations of Ob-R, ER, and PR during the histological progression of endometrial carcinoma, we assessed their expression via immunohistochemistry (IHC) in six histological types of endometrium (proliferative, secretory, nonatypical and atypical hyperplasia, and endometrioid and nonendometrioid endometrial carcinoma), in which we performed histopathological and digital scoring for the quantification of receptors. Results We found that Ob-R expression was positively correlated with that of ER and PR (r = 1, p hyperplasias, and carcinomas, according to their relative digitally scored Ob-R expression (p endometrial carcinogenesis in correlation with ER and PR, suggesting that Ob-R expression in vivo is highly dependent on estrogen and progesterone activities in the endometrium and on its ER and PR status, as suggested previously by in vitro studies. PMID:28144276

  1. Three-dimensional cultures of human endometrial cells on Matrigel mimic in vivo morphology

    Institute of Scientific and Technical Information of China (English)

    ZHU Hai-yan; WANG Jun-xia; TONG Xiao-mei; XU Wei-hai; JIANG Ling-ying; JING Xiao-ying; YANG Ling-yun; ZHOU Feng; ZHANG Song-ying

    2012-01-01

    Background The regulation of endometrial physiology and morphogenesis by the paracrine effectors has been well established using in vivo studies.A more complete understanding of the endometrial function has been delayed due,in part,to a lack of appropriate culture models.In this study,we aimed to simulate the in vivo three-dimensional (3-D) growth pattern of endometrial cells using a 3-D in vitro culture system.Methods Isolated endometrial epithelial cells,stromal cells and RL95-2 cells were seeded into culture chambers coated with the extracellular matrix Matrigel and observed using light microscopy.Fluorescence staining and immunohistochemistry were used to assess the morphology.Results Depending on the culture conditions,epithelial cells and RL95-2 cells formed multicellular structures on Matrigel; stromal cells remained individually distinguishable or grew together to form 3-D lattice-like structures.Conclusions Matrigel provided a good microenvironment for culturing endometrial cells.The cells cultured in the Matrigel-coated chambers closely resembled those seen in vivo.

  2. Effect of hysteroscopic adhesiolysis combined with growth hormone on endometrial blood flow and volume as well as Smad2/3 expression

    Institute of Scientific and Technical Information of China (English)

    Xing-Chan Li; Cui-Xia Liang; Jing Li; Pei-Feng Li; Yu Zhao

    2016-01-01

    Objective:To study the effect of hysteroscopic adhesiolysis combined with growth hormone on endometrial blood flow and volume as well as Smad2/3 expression.Methods: A total of 64 patients with moderate or severe intrauterine adhesions who received hysteroscopic adhesiolysis in our hospital from May 2013 to October 2015 were selected as the research subjects and randomly divided into two groups who received different postoperative drug treatment, observation group received postoperative manual cycle intervention combined with growth hormone treatment and control group only received manual cycle intervention. Transvaginal ultrasonography was conducted after treatment to assess endometrial thickness, volume and blood flow, and endometrium was collected to determine Smad2, Smad3 and TGF-β1 levels.Results:After treatment, endometrial blood flow signal of observation group was more abundant than that of control group, ultrasound parameters RI and PI were significantly lower than those of control group, and VI, FI and VFI as well as endometrial thickness and endometrial cavity volume were significantly higher than those of control group; Smad2, Smad3 and TGF-β1 levels in endometrial tissue of observation group after treatment were significantly lower than those of control group.Conclusions:Hysteroscopic adhesiolysis combined with growth hormone therapy can promote endometrial repair and growth, increase endometrial blood flow and volume and also suppress the expression of Smad2/3 and TGF-β1 in patients with intrauterine adhesions.

  3. Thermal balloon endometrial ablation: safety aspects evaluated by serosal temperature, light microscopy and electron microscopy

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Rygaard, Carsten

    1998-01-01

    subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. RESULTS: The highest temperature measured on the uterine serosa was 39.1 degrees C. Coagulation of the myometrium adjacent to the endometrium could be demonstrated by light microscopy...... in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium...

  4. Thermal Balloon Endometrial Ablation: Safety Aspects Evaluated by Serosal Temperature, Light Microscopy and Electron Microscopy

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Junge, Jette

    1998-01-01

    subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. RESULTS: The highest temperature measured on the uterine serosa was 39.1 degrees C. Coagulation of the myometrium adjacent to the endometrium could be demonstrated by light microscopy...... in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium...

  5. Self-reported stress and risk of endometrial cancer: a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Strandberg-Larsen, Katrine; Grønbaek, Morten;

    2007-01-01

    OBJECTIVES: To assess a possible relationship between perceived stress and first-time incidence of primary endometrial cancer. Psychological stress may affect the synthesis and metabolism of estrogens and thereby be related to risk of endometrial cancer. METHODS: The 6760 women participating...... in the Copenhagen City Heart Study were asked about their stress level at baseline from 1981 to 1983. These women were prospectively followed up in the Danish nationwide cancer registry until 2000 and ... cancer observed among stressed women in this study. Despite these results, stress may still be a risk factor for a range of other diseases and should therefore not be considered a healthy response....

  6. Diagnostic utility of hepatocyte nuclear factor 1-beta immunoreactivity in endometrial carcinomas: lack of specificity for endometrial clear cell carcinoma.

    Science.gov (United States)

    Fadare, Oluwole; Liang, Sharon X

    2012-12-01

    Hepatocyte nuclear factor 1-beta (HNF1β) has recently emerged as a relatively sensitive and specific marker for ovarian clear cell carcinoma. The purpose of this study is to assess the diagnostic utility of this marker for endometrial clear cell carcinoma. Immunohistochemical analysis was performed on 75 endometrial tissues using a goat polyclonal antibody raised against a peptide mapping at the C-terminus of human HNF1β protein. The 75 cases included 15 clear cell carcinomas, 20 endometrioid carcinomas, 15 endometrial serous carcinomas/uterine papillary serous carcinomas, 20 cases of normal endometrium, 2 cases of clear cell metaplasia, and 3 cases of Arias Stella reaction. Staining interpretations were based on a semiquantitative scoring system, a 0 to 12+ continuous numerical scale that was derived by multiplying the extent of staining (0 to 4+ scale) by the intensity of staining (0 to 3+ scale) for each case. HNF1β expression was found to be present in a wide spectrum of tissues. Twenty-seven (54%) of the 50 carcinomas displayed at least focal nuclear HNF1β expression, including 11 (73%) of 15, 9 (60%) of 15, and 7 (35%) of 20 clear cell, serous, and endometrioid carcinomas, respectively. The average nuclear staining scores for clear cell carcinomas, endometrioid carcinomas, and serous carcinomas were 5.2, 1.4, and 4.1, respectively. Clear cell carcinomas and endometrioid carcinomas displayed statistically significant differences regarding their nuclear staining scores (P = 0.0027), but clear cell carcinomas and endometrial serous carcinomas did not (P = 0.45). The calculated sensitivity of any nuclear HNF1β expression in classifying a carcinoma as being of the clear cell histotype was 73%, whereas the specificity was 54%. Nineteen of 20 normal endometrium samples displayed at least focal nuclear expression of HNF1β, and this expression was often diffuse. The 5 cases of benign histologic mimics of clear cell carcinomas (Arias Stella reaction and clear

  7. Role of endometrial and subendometrial blood flow index assessment in predicting pregnancy outcome of freezing embryo transfer cycles%子宫内膜及内膜下血流参数对冷冻胚胎移植周期妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    张少娣; 路锦; 耿嘉瑄; 李萌; 张翠莲

    2014-01-01

    distribution patterns were 31.0%,62.5%,79.0% respectively.In the pregnancy group,the S/D,PI,and RI of endometrium were significantly lower than those in the nonpregnant group (P < 0.05),and there was no significant difference between the pregnant group and nonpregnant group in endometrial thickness(P >0.05).Conclusions Endometrium and subendometrial blood distribution patterns and flow index measured with transvaginal color Doppler ultrasound could assess endometrial receptivity and guide the time selecting of FET transplantation.

  8. EXPRESSION AND SIGNIFICANCE OF PTEN IN ENDOMETRIAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    GE Xiu-jun; LIU Zhi-hui; LI Ying-yong; Gao Rui-ping

    2005-01-01

    Objective: To investigate the expression of PTEN in endometrial carcinoma and its clinical significance. Methods: Reverse transcriptase-polymerase chain reaction and Western-blot methods were used to detect PTEN expression in 28 cases of endometrial carcinoma. Results: mRNA and protein expression levels of PTEN in endometrial carcinomas were significantly lower than those in normal endometrium (P<0.01). Conclusion: PTEN may play an important role in the tumorigenesis of endometrial carcinoma.

  9. Determination of Heavy Metal Concentrations in Normal and Pathological Human Endometrial Biopsies and In Vitro Regulation of Gene Expression by Metals in the Ishikawa and Hec-1b Endometrial Cell Line

    Science.gov (United States)

    Tomkiewicz, Céline; Leblanc, Alix; Pierre, Stéphane; El Balkhi, Souleiman; Le Frère-Belda, Marie-Aude; Lecuru, Fabrice; Poupon, Joël; Barouki, Robert; Aggerbeck, Martine; Coumoul, Xavier

    2015-01-01

    It is well known that several metals, such as lead, mercury, cadmium, and vanadium, can mimic the effects of estrogens (metallo-estrogens). Nevertheless, there are only a few studies that have assessed the effects of toxic metals on the female genital tract and, in particular, endometrial tissue. In this context, we measured the concentrations of several trace elements in human endometrial tissue samples from individuals with hyperplasia or adenocarcinoma and in normal tissues. Hyperplasic endometrial tissue has a 4-fold higher concentration of mercury than normal tissue. Mercury can affect both the AhR and ROS signaling pathways. Thus, we investigated the possible toxic effects of mercury by in vitro studies. We found that mercury increases oxidative stress (increased HO1 and NQO1 mRNA levels) and alters the cytoskeleton in the human endometrial Ishikawa cell line and to a lesser extent, in the “less-differentiated” human endometrial Hec-1b cells. The results might help to explain a potential link between this metal and the occurrence of endometrial hyperplasia. PMID:26600472

  10. Determination of Heavy Metal Concentrations in Normal and Pathological Human Endometrial Biopsies and In Vitro Regulation of Gene Expression by Metals in the Ishikawa and Hec-1b Endometrial Cell Line.

    Directory of Open Access Journals (Sweden)

    Erwan Guyot

    Full Text Available It is well known that several metals, such as lead, mercury, cadmium, and vanadium, can mimic the effects of estrogens (metallo-estrogens. Nevertheless, there are only a few studies that have assessed the effects of toxic metals on the female genital tract and, in particular, endometrial tissue. In this context, we measured the concentrations of several trace elements in human endometrial tissue samples from individuals with hyperplasia or adenocarcinoma and in normal tissues. Hyperplasic endometrial tissue has a 4-fold higher concentration of mercury than normal tissue. Mercury can affect both the AhR and ROS signaling pathways. Thus, we investigated the possible toxic effects of mercury by in vitro studies. We found that mercury increases oxidative stress (increased HO1 and NQO1 mRNA levels and alters the cytoskeleton in the human endometrial Ishikawa cell line and to a lesser extent, in the "less-differentiated" human endometrial Hec-1b cells. The results might help to explain a potential link between this metal and the occurrence of endometrial hyperplasia.

  11. Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

    Science.gov (United States)

    Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

    2010-07-01

    The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (pequipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

  12. Omega-3 polyunsaturated Fatty acids suppress the cystic lesion formation of peritoneal endometriosis in transgenic mouse models.

    Directory of Open Access Journals (Sweden)

    Kensuke Tomio

    Full Text Available Omega-3 polyunsaturated fatty acids (omega-3 PUFAs play a role in controlling pathological inflammatory reactions. Endometriosis is characterized by the presence of endometrial tissue on the peritoneum and an exaggerated inflammatory environment around ectopic tissues. Here peritoneal endometriosis was reproduced using a mouse model in which murine endometrial fragments were inoculated into the peritoneal cavity of mice. Fat-1 mice, in which omega-6 can be converted to omega-3 PUFAs, or wild type mice, in which it cannot, were used for the endometriosis model to address the actions of omega-3 PUFAs on the development of endometriotic lesions. The number and weight of cystic endometriotic lesions in fat-1 mice two weeks after inoculation were significantly less than half to those of controls. Mediator lipidomics revealed that cystic endometriotic lesions and peritoneal fluids were abundant in 12/15-hydroxyeicosapentaenoic acid (12/15-HEPE, derived from eicosapentaenoic acid (EPA, and their amount in fat-1 mice was significantly larger than that in controls. 12/15-Lipoxygenase (12/15-LOX-knockout (KO and control mice with or without EPA administration were assessed for the endometriosis model. EPA administration decreased the number of lesions in controls but not in 12/15-LOX-KO mice. The peritoneal fluids in EPA-fed 12/15-LOX-KO mice contained reduced levels of EPA metabolites such as 12/15-HEPE and EPA-derived resolvin E3 even after EPA administration. cDNA microarrays of endometriotic lesions revealed that Interleukin-6 (IL-6 expression in fat-1 mice was significantly lower than that in controls. These results suggest that both endogenous and exogenous EPA-derived PUFAs protect against the development of endometriosis through their anti-inflammatory effects and, in particular, the 12/15-LOX-pathway products of EPA may be key mediators to suppress endometriosis.

  13. Comparação do ultrassom transvaginal e da histeroscopia ambulatorial no diagnóstico das doenças endometriais em mulheres menopausadas Comparative study of transvaginal sonography and outpatient hysteroscopy for detection of pathologic endometrial lesions in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Daniela Angerame Yela

    2009-01-01

    Full Text Available OBJETIVO: Comparar a eficácia do ultrassom transvaginal e da histeroscopia diagnóstica ambulatorial no diagnóstico das doenças intrauterinas em mulheres menopausadas. MÉTODOS: Foram selecionadas 243 mulheres menopausadas que se submeteram a uma histeroscopia diagnóstica no ano de 2006. Todas essas mulheres vieram encaminhadas da rede básica de saúde após terem realizado um ultrassom transvaginal para avaliar a cavidade endometrial. RESULTADOS: As mulheres tinham em média 61±9,4 anos e encontravam-se na menopausa em média há 11±8,3 anos. Observamos 6,6% de casos de hiperplasia endometrial e câncer de endométrio. O ultrassom apresentou uma sensibilidade de 95,6%, uma especificidade de 7,4%, um valor preditivo positivo de 53,3% e valor preditivo negativo de 60%, enquanto a histeroscopia apresentou 95,7%; 83%; 82,2% e 95,9%, respectivamente. CONCLUSÃO: A histeroscopia apresentou maior acurácia que o ultrassom no diagnóstico das doenças endometriais.OBJECTIVE: To compare the efficiency of transvaginal sonography and outpatient hysteroscopy in the diagnosis of intrauterine pathology in postmenopausal women. METHODS: Two-hundred and forty-three postmenopausal women were selected. All women had undergone outpatient hysteroscopy in the year 2006. These women were referred from the Basic Healthcare Units in Campinas, where they underwent ultrasonography for the evaluation of the endometrial cavity. RESULTS: The mean age of these women was 61±9.4 years. These women were menopausal for 11±8.3 years.. We observed 6.6% cases of endometrial hyperplasia and cancer. The ultrasonography had a sensitivy of 95.6%, a specificity of 7.4%, a positive predictive value of 53.3% and a negative predictive value of 60%, while the hysteroscopy had 95.7%, 83%, 82.2% and 95.9% respectively. CONCLUSION: Hysteroscopy was a more accurate method for the detection of intrauterine pathology than ultrasonography.

  14. Hormonal and molecular aspects of endometrioid endometrial cancer

    NARCIS (Netherlands)

    Jongen, Vincentius Hubertus Willibrordus Maria

    2008-01-01

    This thesis concerns the expression and prognostic value of various hormones and molecular markers playing a role n endometrioid endometrial cancer. Especially we were interested in the enzyme aromatase, its expression and (prognostic) role in endometrioid endometrial cancer. Endometrial cancer is t

  15. Preoperative and postoperative histopathological findings in patients with endometrial hyperplasia

    OpenAIRE

    Đorđević Biljana; Stanojević Zorica; Živković Vesna; Lalošević Dušan; Gligorijević Jasmina; Krstić Miljan

    2007-01-01

    Introduction. The aim of this study was to analyze and compare the histopathological findings in curettage and hysterectomy specimens, to evaluate the accuracy of histopathological diagnosis in curettage specimens, and to determine the frequency of coexisting endometrial carcinoma in patients with histopathological diagnosis of endometrial hyperplasia. Material and methods. Curettage and hysterectomy specimens of 135 female patients with initially diagnosed endometrial hyperplasia were retros...

  16. Toll-Like Receptor (TLR and Nucleosome-binding Oligomerization Domain (NOD gene polymorphisms and endometrial cancer risk

    Directory of Open Access Journals (Sweden)

    McEvoy Mark

    2010-07-01

    Full Text Available Abstract Background Endometrial cancer is the most common gynaecological malignancy in women of developed countries. Many risk factors implicated in endometrial cancer trigger inflammatory events; therefore, alterations in immune response may predispose an individual to disease. Toll-like receptors (TLRs and nucleosome-binding oligomerization domain (NOD genes are integral to the recognition of pathogens and are highly polymorphic. For these reasons, the aim of the study was to assess the frequency of polymorphic variants in TLR and NOD genes in an Australian endometrial cancer population. Methods Ten polymorphisms were genotyped in 191 endometrial cancer cases and 291 controls using real-time PCR: NOD1 (rs2075822, rs2907749, rs2907748, NOD2 (rs5743260, rs2066844, rs2066845, TLR2 (rs5743708, TLR4 (rs4986790 and TLR9 (rs5743836, rs187084. Results Haplotype analysis revealed that the combination of the variant alleles of the two TLR9 polymorphisms, rs5743836 and rs187084, were protective for endometrial cancer risk: OR 0.11, 95% CI (0.03-0.44, p = 0.002. This result remained highly significant after adjustment for endometrial cancer risk factors and Bonferroni correction for multiple testing. There were no other associations observed for the other polymorphisms in TLR2, TLR4, NOD1 and NOD2. Conclusions The variant 'C' allele of rs5743836 causes greater TLR9 transcriptional activity compared to the 'T' allele, therefore, higher TLR9 activity may be related to efficient removal of microbial pathogens within the endometrium. Clearly, the association of these TLR9 polymorphisms and endometrial cancer risk must be further examined in an independent population. The results point towards the importance of examining immune response in endometrial tumourigenesis to understand new pathways that may be implicated in disease.

  17. Preoperative risk stratification using metabolic parameters of {sup 18}F-FDG PET/CT in patients with endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro [Kobe University School of Medicine, Department of Radiology, Kobe (Japan); Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Suenaga, Yuko; Ueno, Yoshiko; Maeda, Tetsuo; Sofue, Keitarou; Sugimura, Kazuro [Kobe University School of Medicine, Department of Radiology, Kobe (Japan); Ebina, Yasuhiko; Yamada, Hideto [Kobe University School of Medicine, Department of Obstetrics and Gynecology, Kobe (Japan); Okunaga, Takashi; Kubo, Kazuhiro [Kobe University Hospital, Department of Radiology Division, Kobe (Japan); Kanda, Tomonori [Teikyo University School of Medicine, Department of Radiology, Tokyo (Japan); Tamaki, Yukihisa [Shimane University School of Medicine, Department of Radiation Oncology, Shimane (Japan)

    2015-07-15

    To evaluate the usefulness of metabolic parameters obtained by {sup 18}F-FDG PET/CT for preoperative stratification of high-risk and low-risk endometrial carcinomas. Preoperative {sup 18}F-FDG PET/CT was performed in 56 women with endometrial cancer. Maximum standardized uptake values (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of primary tumours were compared with clinicopathological features of surgical specimens. Diagnostic performance in terms of differentiation of low-risk disease (endometrioid histology, histological grade 1 or 2, invasion of less than half of the myometrium, and FIGO stage I) from high-risk disease was assessed. MTV and TLG were significantly higher in patients with higher histological grade (p = 0.0026 and p = 0.034), larger tumour size (p = 0.002 and p = 0.0017), lymphovascular space involvement (LVSI; p = 0.012 and p = 0.0051), myometrial invasion (p = 0.027 and p = 0.031), cervical stromal invasion (p = 0.023 and p = 0.014), ovarian metastasis (p = 0.00022 and p = 0.00034), lymph node metastasis (p < 0.0001 and p < 0.0001), and higher FIGO stage (p = 0.0011 and p = 0.00048). SUVmax was significantly higher in patients with larger tumour size (p = 0.0025), LVSI (p = 0.00023) and myometrial invasion (p < 0.0001). The areas under the ROC curves (AUCs) for distinguishing high-risk from low-risk carcinoma were 0.625, 0.829 and 0.797 for SUVmax, MTV and TLG, respectively. AUCs for both MTV and TLG were significantly larger than that for SUVmax (p = 0.0049 and p = 0.021). The optimal TLG cut-off value of 70.2, determined by ROC analysis, was found to have 72.0 % sensitivity and 74.2 % specificity for risk stratification. MTV and TLG of primary endometrial cancer show better correlations with clinicopathological features and are more useful for differentiating high-risk from low-risk carcinoma than SUVmax. (orig.)

  18. Fenretinide: a novel treatment for endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Navdha Mittal

    Full Text Available Resistance to progestin treatment is a major hurdle in the treatment of advanced and reoccurring endometrial cancer. Fenretinide is a synthetic retinoid that has been evaluated in clinical trials as a cancer therapeutic and chemo-preventive agent. Fenretinide has been established to be cytotoxic to many kinds of cancer cells. In the present study, we demonstrate that fenretinide decreased cell viability and induced apoptosis in Ishikawa cells, which are an endometrial cancer cell line, in dose dependent manner in-vitro. This effect was found to be independent of retinoic acid nuclear receptor signaling pathway. Further, we have shown that this induction of apoptosis by fenretinide may be caused by increased retinol uptake via STRA6. Silencing of STRA6 was shown to decrease apoptosis which was inhibited by knockdown of STRA6 expression in Ishikawa cells. Results of an in-vivo study demonstrated that intraperitoneal injections of fenretinide in endometrial cancer tumors (created using Ishikawa cells in mice inhibited tumor growth effectively. Immunohistochemistry of mice tumors showed a decrease in Ki67 expression and an increase in cleaved caspase-3 staining after fenretinide treatment when compared to vehicle treated mice. Collectively, our results are the first to establish the efficacy of fenretinide as an antitumor agent for endometrial cancer both in-vitro and in-vivo, providing a valuable rationale for initiating more preclinical studies and clinical trials using fenretinide for the treatment of endometrial cancer.

  19. Pesquisa da prevalência do papilomavírus humano em amostras de tecido endometrial normal e com carcinoma pela técnica de PCR Search for human papillomavirus in samples of normal endometrial tissue and tissue with carcinoma by the PCR technique

    Directory of Open Access Journals (Sweden)

    Edison Natal Fedrizzi

    2004-05-01

    tissue, and tissue with endometrial carcinoma of women submitted to surgical treatment (hysterectomy, or between endometrial carcinoma and benign disease, through the PCR technique. METHODS: this is an observational control-case study where 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue were analyzed for the detection of HPV DNA in samples of endometrial tissue kept in paraffin blocks by the PCR technique. The cases of endometrial carcinoma with uncertain primary site of the lesion as well as the cases with previous or current history of pre-neoplasic lesions or carcinoma of the lower genital tract were excluded. Variables as age, smoking habit, endometrial trophism, squamous differentiation and degree of tumor differentiation were also evaluated. RESULTS: the estimated relative risk of the presence of HPV in the endometrial carcinoma and in the normal endometrial tissue was the same. HPV was detected in 8% of the cases of carcinoma and 10% in the normal endometrial tissue. In spite of HPV having been 3.5 times more detected in women with smoking habit in the group without carcinoma, there was no statistical difference. The presence of HPV was also not correlated with the women's age, endometrial trophism, squamous differentiation and degree of tumor differentiation. The HPV types 16 (5 cases and 18 (4 cases were the viruses most frequently found both in the normal endometrial tissue or in the tissue with carcinoma. No oncogenic low risk virus was detected in the samples. CONCLUSION: The same proportion of HPV is present in the endometrial tissue of women with endometrial cancer and with normal endometrium. It could not be demonstrated a possible correlation of DNA of HPV with the development of endometrial carcinoma.

  20. White spot lesions after orthodontic treatment assessed by clinical photographs and by quantitative light-induced fluorescence imaging; a retrospective study

    NARCIS (Netherlands)

    Beerens, M.W.; Boekitwetan, F.; van der Veen, M.H.; ten Cate, J.M.

    2015-01-01

    Objective. White spot lesions (WSL) are an important side-effect of orthodontic multi-bracket (MB) treatment. Standardized monitoring of such WSL may help in caries management. Materials and methods. In this retrospective study the discriminatory power of caries assessment on routine digital oral ph

  1. Endometrial stem cells in regenerative medicine.

    Science.gov (United States)

    Verdi, Javad; Tan, Aaron; Shoae-Hassani, Alireza; Seifalian, Alexander M

    2014-01-01

    First described in 2004, endometrial stem cells (EnSCs) are adult stem cells isolated from the endometrial tissue. EnSCs comprise of a population of epithelial stem cells, mesenchymal stem cells, and side population stem cells. When secreted in the menstrual blood, they are termed menstrual stem cells or endometrial regenerative cells. Mounting evidence suggests that EnSCs can be utilized in regenerative medicine. EnSCs can be used as immuno-modulatory agents to attenuate inflammation, are implicated in angiogenesis and vascularization during tissue regeneration, and can also be reprogrammed into induced pluripotent stem cells. Furthermore, EnSCs can be used in tissue engineering applications and there are several clinical trials currently in place to ascertain the therapeutic potential of EnSCs. This review highlights the progress made in EnSC research, describing their mesodermal, ectodermal, and endodermal potentials both in vitro and in vivo.

  2. Multivariate analysis of endometrial tissue fluorescence spectra

    Science.gov (United States)

    Vaitkuviene, Aurelija; Auksorius, E.; Fuchs, D.; Gavriushin, V.

    2002-10-01

    Background and Objective: The detailed multivariate analysis of endometrial tissue fluorescence spectra was done. Spectra underlying features and classification algorithm were analyzed. An effort has been made to determine the importance of neopterin component in endometrial premalignization. Study Design/Materials and Methods: Biomedical tissue fluorescence was measured by excitation with the Nd YAG laser third harmonic. Multivariate analysis techniques were used to analyze fluorescence spectra. Biomedical optics group at Vilnius University analyzed the neopterin substance supplied by the Institute of Medical Chemistry and Biochemistry of Innsbruck University. Results: Seven statistically significant spectral compounds were found. The classification algorithm classifying samples to histopathological categories was developed and resulted in sensitivity of 80% and specificity 93% for malignant vs. hyperplastic and normal. Conclusions: Fluorescence spectra could be classified with high accuracy. Spectral variation underlying features can be extracted. Neopterin component might play an important role in endometrial hyperplasia development.

  3. Laparoscopic surgery for early endometrial cancer

    DEFF Research Database (Denmark)

    Bennich, Gitte; Rudnicki, M.; Lassen, P. D.

    2016-01-01

    IntroductionThe purpose of the present study was to evaluate learning curves and short-term outcomes following laparoscopic surgery for early endometrial cancer in women of different body mass index (BMI) classes. Material and methodsData from 227 women planned for laparoscopic surgery for presumed...... stage I endometrial cancer were collected retrospectively from a Danish gynecologic oncology unit. Surgery included laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy (PLA). ResultsMedian length of operations was 60 min (range, 30-197) and 120 min (range...... peri- and postoperative outcomes were independent of BMI classes. ConclusionsOur data suggest that laparoscopic surgery for early endometrial cancer is feasible and safe. With increasing surgeon's experience there is a significant decrease in operative time and increase in the number of lymph nodes...

  4. Endometrial stromal sarcoma: a rare tumour

    Directory of Open Access Journals (Sweden)

    Amrit Pal Kaur

    2014-02-01

    Full Text Available Endometrial stromal sarcomas (ESS are rare endometrial tumours arising from stroma of endometrium i.e. connective tissue of endometrium rather than glands. Usually a pre-operative diagnosis is difficult. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is main line of treatment. Adjuvant hormone therapy in the form of progesterones, GnRH analogues, aromatase inhibitors are effective for prevention of recurrences as these tumours are invariably positive for oestrogen & progesterone receptors. Surgical excision, radiotherapy, hormone therapy are recommended for recurrences. We report a 52 yrs widow with undifferentiated endometrial stromal sarcoma weighing 3.75 kg with a short history of 3 months diagnosed only after histopathology. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 276-278

  5. [Comparative assessment of immediate outcomes of surgical treatment of patients with coronary artery disease and lesion of the brachiocephalic arteries].

    Science.gov (United States)

    Drozhzhin, E V; Ibragimov, O R; Koval'chuk, D N; Efanov, Iu M; Zor'kin, A A; Ibragimova, E A; Urvantseva, I A

    2014-01-01

    From 2000 to 2011, a total of 52 patients with combined atherosclerotic lesions of the coronary and brachiocephalic arteries were subjected to a single-stage operation. Depending on the type of operative intervention, all patients were subdivided into two groups: Group One comprising 13 patients who underwent coronary artery bypass grafting (CABG) in a combination with simultaneous stenting of the internal carotid artery, and Group Two consisting of 39 patients subjected to CABG with simultaneous carotid endarterectomy. Assessing the intraoperative parameters revealed that in Group One patients the average duration of operations was significantly lower (179.6±6.4 minutes versus 273.2±5.6 minutes in Group Two, partery with the development of intestinal gangrene and peritonitis. In the structure of hospital complications cardiac insufficiency was prevalent (23.1% and 59.0% for Groups One and Group Two patients, respectively, pcoronary and brachiocephalic arteries makes it possible to increase the overall survival rate in patients suffering this disease and to decrease the incidence rate of ischaemic impairments of the coronary and cerebral circulation. The hybrid method of treatment on arteries of various vascular basins may be an alternative to carotid endarterectomy and CABG, especially in patients running high surgical risk.

  6. Odds ratio analysis in women with endometrial cancer

    Directory of Open Access Journals (Sweden)

    Katarzyna Plagens-Rotman

    2016-03-01

    Full Text Available Introduction : Despite the progress in diagnosis and treatment of malignant tumours, the effects of treatment are insufficient. Reduction of the risk of cervical, ovarian, and endometrial cancer is possible by introducing preventative actions. Aim of the study: The aim of the thesis is the analysis of selected risk factors that may affect the increase or decrease in the odds ratio of developing endometrial cancer. Material and methods: The study was conducted among patients of the Gynaecology and Obstetrics Hospital of Poznań University of Medical Sciences in the years 2011-2013. The research included a total of 548 female respondents aged between 40 and 84 years. Women responded to questions assessing elements of lifestyle such as consumption of alcohol, smoking, and eating certain groups of foods. Results: The respondents consuming fruits and vegetables several times a week have a reduced risk of odds ratio and the OR is 0.85; 95% CI: 0.18-4.09, compared to the women who rarely consume vegetables and fruits. Consumption of whole-wheat bread several times a week reduces the risk of developing the cancer, OR = 0.59; 95% CI: 0.14-2.47, compared to women not consuming wholegrain bread at all. Respondents who consumed red meat, such as veal, pork, and lamb in the amount of 101-200 g per day have an increased risk of developing the disease: OR = 2.16; 95% CI: 1.09-4.28, compared to women not consuming red meat at all. Conclusions : A diet rich in fruit and vegetables, onions, garlic, whole grains, and beans should be introduced in order to reduce the risk of endometrial cancer. The consumption of red meat and white pasta should be reduced or even eliminated.

  7. Outcome of conservative treatment and subsequent assisted reproductive technology for patients with early-stage endometrial adenocarcinoma and poor fertility potential

    Institute of Scientific and Technical Information of China (English)

    TONG Xiao-mei; ZHU Hai-yan; LIN Xiao-na; JIANG Ling-ying; XU Wei-hai; LIU Liu; ZHANG Song-ying

    2012-01-01

    Conservative treatment with high doses of progestin is an alternative to standard hysterectomy for young patients with early-stage endometrial adenocarcinoma who desire to preserve their fertility.Here we report a patient with well-differentiated early-stage endometrial adenocarcinoma and poor fertility potential who failed to become pregnant in two in vitro fertilization-embryo transfer cycles and suffered a relapse after conservative treatment.This case illustrates that assessment of fertility potential is critical at the time of initial evaluation and conservative treatment planning for patients with endometrial adenocarcinoma.Chin Med J 2012; 125(19):3578-3580

  8. Coexisting atypical polypoid adenomyoma and endometrioid endometrial carcinoma in a young woman with Cowden Syndrome: Case report and implications for screening and prevention.

    Science.gov (United States)

    Edwards, James M; Alsop, Skylar; Modesitt, Susan C

    2012-01-01

    ► Cowden Syndrome is a rare hereditary cancer syndrome, which confers an increased risk of breast, thyroid, endometrial and colon cancer. ► Atypical polypoid adenomyoma does not generally represent a premalignant lesion, but must be carefully screened for foci of malignancy. ► Cancer screening must be intensified for patients who meet the diagnostic criteria for Cowden Syndrome.

  9. Value of T cell receptor gamma alternate reading frame protein and keratin 5 in endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li-jun; LI Xiao-ping; QI Wen-juan; WANG Jian-liu; WEI Li-hui

    2013-01-01

    Background Tumors with different gene expression develop and progress in different ways.To deepen our understanding of the progression in endometrial cancer,and provide a useful tool for accurate diagnosis and prognosis assessment,we identified the new molecular prognostic markers in endometrial carcinoma and analyzed the relationship of them with clinical and pathological features of endometrial carcinoma.Methods Ninety-four cases of endometrial endometrioid adenocarcinoma with complete data from the Peking University People's Hospital from 2000 to 2008 and 40 cases of normal endometrium were enrolled.Among these,30 endometrial endometrioid adenocarcinoma samples of different International Federation of Gynecology and Obstetrics (FIGO) stage were selected for further Agilent genome-wide microarray analysis.Significance analysis of microarrays (SAM) was used to identify genes that are significantly associated with tumor progress.Immunohistochemistry was utilized to identify the genes of interest in endometrial carcinoma and normal endometrium.The relationship between the genes and the age,clinical stage,histological grade,myometrium invaded depth,lymph node metastasis status,and the expression of ER,PR,P53,and PTEN were analyzed by x2 test.Results Analysis between FIGO 1988 stage Ⅰ and stage Ⅲ identified a 362-gene "progress signature"; 171 downregulated and 191 up-regulated genes.Among the alterative genes,TARP (T cell receptor gamma alternate reading frame protein) and KRT5 (keratin 5) decreased 3.57 fold and 5.8 fold in FIGO stage Ⅲ patients.The expression of TARP in endometrial carcinoma increased compared to normal endometrium,while that of KRT5 decreased (P<0.05).The expression of TARP and KRT5 decreased when stage,histological grading,myometrium invaded depth increased (P<0.05).In the cases with lymph node metastasis,the expression of TARP decreased,while the expression of KRT5 did not differ (both P<0.05) both.The expression of P53 had a

  10. Assessment of long-term effects of treating endriometrium changes by means of resection using electric loop and laser

    Science.gov (United States)

    Sajdak, Stefan; Wilczak, Maciej; Wozniak, Jakub; Opala, Tomasz; Rabiega, Dorota

    2000-11-01

    Hysteroscopic endometrial resection with the use of electric loop or lasersurgery is the alternative method of treatment of irregular uterine bleedings and endometrial hyperplasia. The effects of endometrial resection with the electric loop and lasersurgery are comparable. The long-term effects of treatment of endometrial lesions with the method of resection are better in case of simple hyperplasia than in atypic ones. The endometrial resection with the use of electric loop or lasersurgery is the safe procedure either for the patient or for medical staff.

  11. Different imaging methods in the comparative assessment of vascular lesions: color-coded duplex sonography, laser Doppler perfusion imaging, and infrared thermography

    Science.gov (United States)

    Urban, Peter; Philipp, Carsten M.; Weinberg, Lutz; Berlien, Hans-Peter

    1997-12-01

    Aim of the study was the comparative investigation of cutaneous and subcutaneous vascular lesions. By means of color coded duplex sonography (CCDS), laser doppler perfusion imaging (LDPI) and infrared thermography (IT) we examined hemangiomas, vascular malformations and portwine stains to get some evidence about depth, perfusion and vascularity. LDI is a helpful method to get an impression of the capillary part of vascular lesions and the course of superficial vessels. CCDS has disadvantages in the superficial perfusion's detection but connections to deeper vascularizations can be examined precisely, in some cases it is the only method for visualizing vascular malformations. IT gives additive hints on low blood flow areas or indicates arterial-venous-shunts. Only the combination of all imaging methods allows a complete assessment, not only for planning but also for controlling the laser treatment of vascular lesions.

  12. Metformin Use and Endometrial Cancer Survival

    Science.gov (United States)

    Nevadunsky, Nicole S.; Van Arsdale, Anne; Strickler, Howard D.; Moadel, Alyson; Kaur, Gurpreet; Frimer, Marina; Conroy, Erin; Goldberg, Gary L.; Einstein, Mark H.

    2013-01-01

    Objective Impaired glucose tolerance and diabetes are risk factors for the development of uterine cancer. Although greater progression free survival among diabetic patients with ovarian and breast cancer using metformin have been reported, no studies have assessed the association of metformin use with survival in women with endometrial cancer (EC). Methods We conducted a single-institution retrospective cohort study of all patients treated for uterine cancer from January 1999 through December 2009. Demographic, medical, social, and survival data were abstracted from medical records and the national death registry. Overall survival (OS) was estimated using Kaplan-Meier methods. Cox models were utilized for multivariate analysis. All statistical tests were two-sided. Results Of 985 patients, 114 (12%) had diabetes and were treated with metformin, 136 (14%) were diabetic but did not use metformin, and 735 (74%) had not been diagnosed with diabetes. Greater OS was observed in diabetics with non-endometrioid EC who used metformin than in diabetic cases not using metformin and non-endometrioid EC cases without diabetes (log rank test (p=0.02)). This association remained significant (hazard ratio = 0.54, 95% CI: 0.30–0.97, p<0.04) after adjusting for age, clinical stage, grade, chemotherapy treatment, radiation treatment and presence of hyperlipidemia in multivariate analysis. No association between metformin use and OS in diabetics with endometrioid histology was observed. Conclusion Diabetic EC patients with non-endometrioid tumors who used metformin had lower risk of death than women with EC who did not use metformin. These data suggest that metformin might be useful as adjuvant therapy for non-endometrioid EC. PMID:24189334

  13. The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles

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    Zhao Jing

    2012-11-01

    Full Text Available Abstract Background To study the effect of endometrial thickness and pattern measured using ultrasound upon pregnancy outcomes in patients undergoing IVF-ET. Method One thousand nine hundred thirty-three women undergoing IVF treatment participated in the study. We assessed and recorded endometrial patterns and thickness on the day of human chorionic gonadotropin (hCG administration. Receiver operator curves (ROC were used to determine the predictive accuracy of endometrial thickness. Cycles were divided into 3 groups depending on the thickness (group 1: ≤ 7 mm; group 2: > 7 mm to ≤ 14 mm; group 3: > 14 mm. Each group was subdivided into three groups according to the endometrial pattern as follows: pattern A (a triple-line pattern consisting of a central hyperechoic line surround by two hypoechoic layers; pattern B (an intermediate isoechogenic pattern with the same reflectivity as the surrounding myometrium and a poorly defined central echogenic line; and pattern C (homogenous, hyperechogenic endometrium. Clinical outcomes such as implantation and clinical pregnancy rates were analyzed. Results The endometrial thickness predicts pregnancy outcome with high sensitivity and specificity. The cutoff value was 9 mm. The implantation rate and clinical pregnancy rate in group 3 were 39.1% and 63.5%, respectively, which were significantly higher than those in group 2 (33.8% and 52.1%, respectively and group 1 (13% and 25.5%, respectively. Among those with Pattern A, the implantation rate and clinical pregnancy rate were 35.3% and 55.2%, respectively, which were significantly higher than among women with Pattern B (32.1% and 50.9%, respectively and Pattern C (23.4% and 37.4%, respectively. In groups 1 and 3, clinical pregnancy and implantation rates did not show any significant differences between different endometrial patterns (P > 0.05, whereas in group 2, the clinical pregnancy rate and implantation rate in women with pattern A were

  14. The Role of Endoscopic Ultrasound in the Diagnostic Assessment of Subepithelial Lesions of the Upper Gastrointestinal Tract

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    Francisca Dias de Castro

    2016-11-01

    Conclusion: EUS is the method of choice in the study of subepithelial lesions of the upper gastrointestinal tract, in most cases defining a diagnosis. The need for a definitive diagnosis or therapeutic approaches can be based on ultrasound risk features, presented, in the majority, at presentation. This study shows that EUS is capable of safely and accurately define those subepithelial lesions that can be managed only with surveillance ultrasound while waiting for better results with fine needle aspiration.

  15. Molecular Biology and Prevention of Endometrial Cancer

    Science.gov (United States)

    2009-07-01

    of the oral contraceptive pill (OCP). Project 1: Objectives completed and data previously submitted with 2004 report. Data published this past year...molecular aberrations associated with endometrial carcinogenesis and the biologic mechanisms underlying the protective effect of oral contraceptive (OC...not been altered appreciably. Despite the known protective effect of oral contraceptives , little has been learned regarding the underlying mechanism

  16. Prevalence of Human Papillomavirus in endometrial cancer

    DEFF Research Database (Denmark)

    Olesen, Tina Bech; Svahn, Malene Frøsig; Faber, Mette Tuxen;

    2014-01-01

    HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer....

  17. Oral contraception and risk of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2011-10-01

    Full Text Available Alfred O Mueck1, Harald Seeger1, Xiangyan Ruan2 1Department of Endocrinology and Menopause, University Women's Hospital of Tuebingen, Tuebingen, Germany; 2Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China Abstract: No placebo-controlled studies concerning hormonal contraception in general have been published, and only investigations on biological mechanisms and observational clinical studies are available. Thus, associations can be described but not their causality. Experimental studies strongly suggest protective effects of the progestagen component of hormonal contraception against development of estrogen-related (type 1 endometrial cancer. In light of this research, it seems biologically plausible that, in more than 20 published studies, a reduction in endometrial cancer risk was achieved in up to 50% of users of combined oral contraceptives (COC, compared with nonusers. Few data exist for progestin-only oral preparations. However, in view of the mechanisms involved, a reduction in cancer risk should also be expected. Whereas hormonal dose-dependency has been investigated in only a few studies, which showed a stronger risk reduction with increasing progestagenic potency, a decreased risk dependent on duration of use has been clearly demonstrated, and after stopping COC this effect has persisted for up to 20 years. Possible confounders, including family history, parity, and smoking, have been investigated in a few studies, with only a minor impact on hormonal effect of endometrial cancer risk, with the exception of obesity, which was a strong risk factor in most but not all studies. There are obvious differences in the incidence of endometrial cancer in women using COC when evaluated in absolute numbers for Western and Asian countries, being about 3–5-fold higher in the US than in Asia. Further research should include the noncontraceptive benefit of COC

  18. Retrospective analysis of cases with Endometrial Cancer

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    Bulat Aytek Şık

    2016-12-01

    Full Text Available We planned this study with the aim of determining histological types, clinical, surgical stage and grade of endometrial cancer cases which were followed-up and operated on in our clinic and giving an opinion on epidemiological features. Our study was a retrospective study consisted of 298 patients who had medical operations with the diagnosis of endometrial cancer. Endometrial cancer was diagnosed via dilatation and curettage. Routine preoperative examinations were wanted from the cases. Clinical stage was determined. After the diagnosis, total abdominal hysterectomy and bilateral salpingo-ooforectomy (TAH+BSO were applied; while only pelvic lymph node dissection was applied on the patients who had good prognostic data, total pelvic and paraaortic lymph node dissection were applied to the group with bad prognostic data. All materials were examined in the pathology laboratory of our hospital. In endometrial cancer staging, FIGO surgical staging system -2009 was used. FIGO was used in grade classification and World Health Organization Classification of Tumors system was used for the histological classification. Our study was composed of 298 patients who had endometrial cancer. Of the patients who were included in the study, average age was 56.54±9.69, BMI average was 31.47±6.20, gravida average was 4.16±2.59, and parity average was 3.41±2.15. Distributions of the patients by surgical stages were as follows; there were 32 patients whose tumor stage was in 1A (%10.7, 127 patients in 1B  (42.6%, 47 patients in 1C  (15.8%, 18 patients in 2A  (6.0%, 7 patients in 2B   (2.3%, 30 patients in 3A  (10.1%, 2 patients in 3B  (0.7%, 30 patients in 3C  (10.1%, 2 patients in 4A  (0.7% and 3 patients in 4B  (1.0%. Of the patients with endometrial cancer in our study, tumors of 102 patients were (34.2% in grade I, 139 were (46.6% in grade II and 57 were (19.1% in grade III. Because endometrial cancer shows earlier symptoms than the other

  19. Polymorphisms in cyclooxygenase-2 gene in endometrial cancer patients.

    Science.gov (United States)

    Torricelli, Federica; Mandato, Vincenzo Dario; Farnetti, Enrico; Abrate, Martino; Casali, Bruno; Ciarlini, Gino; Pirillo, Debora; Gelli, Maria Carolina; Costagliola, Luigi; Nicoli, Davide; Palomba, Stefano; La Sala, Giovanni Battista

    2015-09-01

    The enzyme cyclooxygenase 2 is an inducible enzyme expressed at sites of inflammation and in a variety of malignant solid tumors such as endometrial cancer (EC). In EC patients, its over-expression is correlated with progressive disease and poor prognosis. The expression is encoded by a polymorphic gene, called PTGS2. The aim of the current study was to test the hypothesis that rs5275 polymorphism of PTGS2 influence the prognosis of EC patients. This paper is a retrospective cohort study. Clinical and pathological data were extrapolated and genotypes were assessed on formalin-fixed and paraffin-embedded non-tumor tissues. A total of 159 type I EC patients were included in the final analysis. Univariate analysis indicated that patients with rs5275 genotype CC have a lower risk to develop a grade (G) 2-3 endometrial cancer. rs5275 effect on EC grading was confirmed by multivariate analysis also after data adjusting for age, BMI, parity, hypertension, and diabetes. Adjusted odds ratio (OR) confirmed that patients with rs5275 genotype CC have a risk 80 % lower (OR = 0.20, P = 0.009) to develop a G2 and/or G3 EC in comparison with patients with TT or TC genotype. Differentiation of the type 1 EC is significantly and independently influenced by rs5275 polymorphism. rs5275 CC patients have a lower risk to present a G2-G3 EC.

  20. Immunohistochemical expression of PTEN in normal, hyperplastic and endometrial carcinoma of endometrium

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    IzadiMood

    2008-08-01

    Full Text Available "nBackground: Endometrial carcinoma is the most common malignancy of the female genital tract. Different molecular alterations have been described in endometrioid endometrial carcinoma that, the most frequently altered gene is mutations of PTEN. Up to 50-83% of endometrioid carcinoma reveal altered PTEN characterized by loss of expression. In endometrial hyperplasia, which are precursors of endometrioid carcinoma, loss of PTEN expression is 30-63%."n"nMethods: Immunohistochemical staining was performed on 90 cases of endometrial curettage including: 30 proliferative endometrium, 30 hyperplastic endometrium and 30 endometroid carcinoma."n"nImmunohistochemical specimens were graded semiquatitatively by considering the percentage of staining with two cut-point 10% & 50% on the whole section for each specimen."n"nResults: loss of PTEN expression was observed 0%, 0%, 30% of 51.7% in proliferative, simple hyperplasia, complex hyperplasia and endometrioid carcinoma respectively with cut-point 10% and 0%, 5.3%, 30%, 52.2% in endometrioid carcinoma respectively with cut-point 50%. Also there was no difference in PTEN expression between atypical complex hyperplasia and endometrioid carcinoma but there was significant difference between simple hyperplasia and proliferative with endometrioid carcinoma & atypical complex hyperplasia."n"nConclusion: These results show loss of PTEN expression in endmetrioid carcinoma and no differences between endometrioid carcinoma and atypical complex hyperplasia. Therefore, assessment of PTEN expression by negative immunostaining and matched with routine hematoxylin and eosin stained can be a new tool for diagnosis of endometrioid carcinoma.

  1. Presence of a polymicrobial endometrial biofilm in patients with bacterial vaginosis.

    Directory of Open Access Journals (Sweden)

    Alexander Swidsinski

    Full Text Available OBJECTIVE: To assess whether the bacterial vaginosis biofilm extends into the upper female genital tract. STUDY DESIGN: Endometrial samples obtained during curettage and fallopian tube samples obtained during salpingectomy were collected. Endometrial and fallopian tube samples were analyzed for the presence of bacteria with fluorescence-in-situ-hybridisation (FISH analysis with probes targeting bacterial vaginosis-associated and other bacteria. RESULTS: A structured polymicrobial Gardnerella vaginalis biofilm could be detected in part of the endometrial and fallopian tube specimens. Women with bacterial vaginosis had a 50.0% (95% CI 24.0-76.0 risk of presenting with an endometrial Gardnerella vaginalis biofilm. Pregnancy (AOR  = 41.5, 95% CI 5.0-341.9, p<0.001 and the presence of bacterial vaginosis (AOR  = 23.2, 95% CI 2.6-205.9, p<0.001 were highly predictive of the presence of uterine or fallopian bacterial colonisation when compared to non-pregnant women without bacterial vaginosis. CONCLUSION: Bacterial vaginosis is frequently associated with the presence of a structured polymicrobial Gardnerella vaginalis biofilm attached to the endometrium. This may have major implications for our understanding of the pathogenesis of adverse pregnancy outcome in association with bacterial vaginosis.

  2. Phosphocalcic Markers and Calcification Propensity for Assessment of Interstitial Fibrosis and Vascular Lesions in Kidney Allograft Recipients

    Science.gov (United States)

    Berchtold, Lena; Ponte, Belen; Moll, Solange; Hadaya, Karine; Seyde, Olivia; Bachtler, Matthias; Vallée, Jean-Paul; Martin, Pierre-Yves; Pasch, Andreas; de Seigneux, Sophie

    2016-01-01

    Renal interstitial fibrosis and arterial lesions predict loss of function in chronic kidney disease. Noninvasive estimation of interstitial fibrosis and vascular lesions is currently not available. The aim of the study was to determine whether phosphocalcic markers are associated with, and can predict, renal chronic histological changes. We included 129 kidney allograft recipients with an available transplant biopsy in a retrospective study. We analyzed the associations and predictive values of phosphocalcic markers and serum calcification propensity (T50) for chronic histological changes (interstitial fibrosis and vascular lesions). PTH, T50 and vitamin D levels were independently associated to interstitial fibrosis. PTH elevation was associated with increasing interstitial fibrosis severity (r = 0.29, p = 0.001), while T50 and vitamin D were protective (r = -0.20, p = 0.025 and r = -0.23, p = 0.009 respectively). On the contrary, fibroblast growth factor 23 (FGF23) and Klotho correlated only modestly with interstitial fibrosis (p = 0.045) whereas calcium and phosphate did not. PTH, vitamin D and T50 were predictors of extensive fibrosis (AUC: 0.73, 0.72 and 0.68 respectively), but did not add to renal function prediction. PTH, FGF23 and T50 were modestly predictive of low fibrosis (AUC: 0.63, 0.63 and 0.61) but did not add to renal function prediction. T50 decreased with increasing arterial lesions (r = -0.21, p = 0.038). The discriminative performance of T50 in predicting significant vascular lesions was modest (AUC 0.61). In summary, we demonstrated that PTH, vitamin D and T50 are associated to interstitial fibrosis and vascular lesions in kidney allograft recipients independently of renal function. Despite these associations, mineral metabolism indices do not show superiority or additive value to fibrosis prediction by eGFR and proteinuria in kidney allograft recipients, except for vascular lesions where T50 could be of relevance. PMID:28036331

  3. Clinical Outcomes in Patients with Deferred Coronary Lesions according to Disease Severity Assessed by Fractional Flow Reserve.

    Science.gov (United States)

    Won, Ki Bum; Nam, Chang Wook; Cho, Yun Kyeong; Yoon, Hyuck Jun; Park, Hyoung Seob; Kim, Hyungseop; Han, Seongwook; Hur, Seung Ho; Kim, Yoon Nyun; Park, Sang Hyun; Han, Jung Kyu; Koo, Bon Kwon; Kim, Hyo Soo; Doh, Joon Hyung; Lee, Sung Yun; Yang, Hyoung Mo; Lim, Hong Seok; Yoon, Myeong Ho; Tahk, Seung Jea; Kim, Kwon Bae

    2016-12-01

    Data on the clinical outcomes in deferred coronary lesions according to functional severity have been limited. This study evaluated the clinical outcomes of deferred lesions according to fractional flow reserve (FFR) grade using Korean FFR registry data. Among 1,294 patients and 1,628 lesions in Korean FFR registry, 665 patients with 781 deferred lesions were included in this study. All participants were consecutively categorized into 4 groups according to FFR; group 1: ≥ 0.96 (n = 56), group 2: 0.86-0.95 (n = 330), group 3: 0.81-0.85 (n = 170), and group 4: ≤ 0.80 (n = 99). Primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction, and target vessel revascularization. The median follow-up period was 2.1 years. During follow-up, the incidence of MACE in groups 1-4 was 1.8%, 7.6%, 8.8%, and 13.1%, respectively. Compared to group 1, the cumulative rate by Kaplan-Meier analysis of MACE was not different for groups 2 and 3. However, group 4 had higher cumulative rate of MACE compared to group 1 (log-rank P = 0.013). In the multivariate Cox hazard models, only FFR (hazard ratio [HR], 0.95; P = 0.005) was independently associated with MACE among all participants. In contrast, previous history of percutaneous coronary intervention (HR, 2.37; P = 0.023) and diagnosis of acute coronary syndrome (ACS) (HR, 2.35; P = 0.015), but not FFR, were independent predictors for MACE in subjects with non-ischemic (FFR ≥ 0.81) deferred coronary lesions. Compared to subjects with ischemic deferred lesions, clinical outcomes in subjects with non-ischemic deferred lesions according to functional severity are favorable. However, longer-term follow-up may be necessary.

  4. Overexpression of progesterone receptor A isoform in mice leads to endometrial hyperproliferation, hyperplasia and atypia.

    Science.gov (United States)

    Fleisch, M C; Chou, Y C; Cardiff, Robert D; Asaithambi, A; Shyamala, G

    2009-04-01

    A delicate balance in estrogen and progesterone signaling through their cognate receptors is characteristic for the physiologic state of the endometrium, and a shift in receptor isotype expression can be frequently found in human endometrial pathology. In this study, using a transgenic mouse model, we examined the mechanisms whereby alterations in progesterone receptor (PR) isotype expression leads to endometrial pathology. For an experimental model, we used transgenic mice (PR-A transgenics) carrying an imbalance in the native ratio of the two PR isoforms A and B (PR-A and PR-B) through the expression of additional A form and examined their uterine phenotype under different hormonal regimens, using various criteria. Uterine epithelial cell proliferation was augmented in PR-A transgenics and was abolished by PR antagonists. In particular, proliferative response to progesterone, independent of signaling through estrogen, was enhanced. Upon continuous exposure to estradiol and progesterone, the uteri in PR-A transgenics displayed gross enlargement, endometrial hyperplasia including atypical lesions, endometritis and pelvic inflammatory disease. Imbalanced expression of the two isoforms of PR in a transgenic model reveals multiple derangements in the regulation of uterine physiology, resulting in various pathologies including hyperplasias.

  5. Assessment of dopamine (DA) synthesis rate in selected parts of the rat brain with central noradrenergic lesion after administration of 5-HT3 receptor ligands

    OpenAIRE

    Wojciech Roczniak

    2013-01-01

    Introduction: The study objective was to determine the effect of central noradrenergic system lesions performed in the early extrafetal life period on dopamine synthesis in the rat brain. The content of L-dihydroxyphenylalanine (L-DOPA) was assessed in the frontal lobe, thalamus, hypothalamus and brain stem of rats by high-pressure chromatography with electrochemical detection (HPLC/ED) after administration of 5-HT3 receptor ligands.Material and Methods: Adult male Wistar rats which underwent...

  6. Lesiones laborales

    OpenAIRE

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  7. Endometrial carcinoma occuring from polycystic ovary disease : A case report

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Su Ok; Jeon, Woo Ki [Inje Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-12-01

    Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of 40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 year old woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imaging and showed multiple small peripheral cysts and low signal-intensity central stroma.

  8. Post-Ablation Endometrial Carcinoma (PAEC) Following Radiofrequency Endometrial Ablation: A Case Report and Its Implications for Management of Endometrial Ablation Failures.

    Science.gov (United States)

    Wortman, Morris; Dawkins, Josette C

    2016-10-26

    Endometrial ablation (EA) has become one of the most commonly performed gynecologic procedures in the United States and other developed countries. Global endometrial ablation (GEA) devices have supplanted resectoscopic ablation primarily because they have brought with them technical simplicity and unprecedented safety. These devices, all of which received FDA approval between 1997 and 2001, are typically used to treat abnormal uterine bleeding (AUB) in premenopausal women. Several million women in the US who have undergone a previous EA procedure are about to enter the risk pool for the development of endometrial cancer (EC). Ours is the 18th reported case of post-ablation endometrial carcinoma (PAEC) in the English literature. This case underscores the diagnostic challenges faced in evaluating women with a history of a previous EA who cannot be properly evaluated with conventional techniques such as endometrial biopsy and sonohysterography.

  9. PTEN Sequence Analysis in Endometrial Hyperplasia and Endometrial Carcinoma in Slovak Women

    Directory of Open Access Journals (Sweden)

    H. Gbelcová

    2015-01-01

    Full Text Available Phosphatase and tensin homolog (PTEN is a protein that acts as a tumor suppressor by dephosphorylating the lipid second messenger phosphatidylinositol 3,4,5-trisphosphate. Loss of PTEN function has been implicated in the pathogenesis of a number of different tumors, particularly endometrial carcinoma (ECa. ECa is the most common neoplasia of the female genital tract. Our study evaluates an association between the morphological appearance of endometrial hyperplasia and endometrial carcinoma and the degree of PTEN alterations. A total of 45 endometrial biopsies from Slovak women were included in present study. Formalin-fixed and paraffin-embedded tissue samples with simple hyperplasia (3, complex hyperplasia (5, atypical complex hyperplasia (7, endometrioid carcinomas G1 (20 and G3 (5, and serous carcinoma (5 were evaluated for the presence of mutations in coding regions of PTEN gene, the most frequently mutated tumor suppressor gene in endometrial carcinoma. 75% of the detected mutations were clustered in exons 5 and 8. Out of the 39 mutations detected in 24 cases, 20 were frameshifts and 19 were nonsense, missense, or silent mutations. Some specimens harboured more than one mutation. The results of current study on Slovak women were compared to a previous study performed on Polish population. The two sets of results were similar.

  10. PTEN sequence analysis in endometrial hyperplasia and endometrial carcinoma in Slovak women.

    Science.gov (United States)

    Gbelcová, H; Bakeš, P; Priščáková, P; Šišovský, V; Hojsíková, I; Straka, Ľ; Konečný, M; Markus, J; D'Acunto, C W; Ruml, T; Böhmer, D; Danihel, Ľ; Repiská, V

    2015-01-01

    Phosphatase and tensin homolog (PTEN) is a protein that acts as a tumor suppressor by dephosphorylating the lipid second messenger phosphatidylinositol 3,4,5-trisphosphate. Loss of PTEN function has been implicated in the pathogenesis of a number of different tumors, particularly endometrial carcinoma (ECa). ECa is the most common neoplasia of the female genital tract. Our study evaluates an association between the morphological appearance of endometrial hyperplasia and endometrial carcinoma and the degree of PTEN alterations. A total of 45 endometrial biopsies from Slovak women were included in present study. Formalin-fixed and paraffin-embedded tissue samples with simple hyperplasia (3), complex hyperplasia (5), atypical complex hyperplasia (7), endometrioid carcinomas G1 (20) and G3 (5), and serous carcinoma (5) were evaluated for the presence of mutations in coding regions of PTEN gene, the most frequently mutated tumor suppressor gene in endometrial carcinoma. 75% of the detected mutations were clustered in exons 5 and 8. Out of the 39 mutations detected in 24 cases, 20 were frameshifts and 19 were nonsense, missense, or silent mutations. Some specimens harboured more than one mutation. The results of current study on Slovak women were compared to a previous study performed on Polish population. The two sets of results were similar.

  11. Osteoporosis is less frequent in endometrial cancer survivors with hypertriglyceridemia.

    Science.gov (United States)

    Hirasawa, Akira; Makita, Kazuya; Akahane, Tomoko; Yamagami, Wataru; Makabe, Takeshi; Yokota, Megumi; Horiba, Yuko; Ogawa, Mariko; Yanamoto, Shigehisa; Deshimaru, Rhota; Tominaga, Eiichiro; Banno, Kouji; Susumu, Nobuyuki; Aoki, Daisuke

    2015-01-01

    We previously reported an association between dyslipidemia and endometrial cancers. Osteoporosis is also reported to relate with some cancers. A common etiologic event has been proposed between dyslipidemia and osteoporosis. However, the pattern of interrelationships among dyslipidemia, osteoporosis and endometrial cancer is not well understood. To improve the quality of life of endometrial cancer survivors, these relationships should be determined. This study included 179 Japanese menopausal women who underwent bilateral salpingo-oophorectomy, including 114 women with incident endometrial cancer and 65 without endometrial cancer. The women were categorized according to dyslipidemia status. Bone mineral density was measured and compared between groups. Osteoporosis was statistically more frequent in women with hypertriglyceridemia who did not have endometrial cancer. In contrast, osteoporosis was statistically less frequent in women with hypertriglyceridemia who had endometrial cancer. In this cross-sectional study in a Japanese population, osteoporosis was associated with hypertriglyceridemia in post-menopausal women without endometrial cancer, but was less frequent in endometrial cancer survivors with hypertriglyceridemia.

  12. Needs and priorities of women with endometrial and cervical cancer

    DEFF Research Database (Denmark)

    Jeppesen, Mette Moustgaard; Mogensen, Ole; Dehn, Pernille

    2015-01-01

    and 34.7% of endometrial cancer patients. Both the patient groups experienced significant lymphedema post-treatment [endometrial cancer (p = 0.006) and cervical cancer (p = 0.002)]. Further, urological problems were more prevalent post-treatment in endometrial cancer patients (p = 0.018), while sexual...... with endometrial and cervical cancer experience emotional problems prior to therapy and lymphedema, and urological and sexual problems following treatment. An awareness of these problems may facilitate early identification of women with unmet needs and enable individualized follow-up adjusted for such patient...

  13. Liquid-based endometrial cytology: the Florence and Bari experience.

    Science.gov (United States)

    Buccoliero, A M; Resta, L; Napoli, A; Taddei, G L

    2009-04-01

    Several diagnostic procedures are available to investigate the endometrium, i.e. sonography, hysteroscopy, biopsy, endometrial curettage and cytology. Among these, endometrial cytology is less commonly utilized. Although the use of cytology in the diagnosis of endometrial adenocarcinoma has already been proposed due to its low cost and simple execution, a general consensus has not been reached. The improvement of the diagnostic capacity of endometrial cytology following the introduction of a liquid-based method suggests that this test should be routinely used in endometrial diagnosis. The main advantages of this method are the reduction in confounding factors, the distribution of cells on a thin layer and the possibility to obtain more slides from the same sample. The aim of this article is to focus on the methodological procedures and diagnostic criteria in liquid-based endometrial cytology based on the experience in two Italian centres: Department of Pathology, University of Bari and Department of Human Pathology and Oncology, University of Florence. The sampling method used by the Bari authors consists in the collection of liquid for uterine distension during hysteroscopy, while the Florence group used an endometrial brush. The sensitivity and specificity at Bari were 75% and 83%, respectively, and were 94-100% and 95-100% at Florence, respectively. Endometrial cytology provided sufficient diagnostic material significantly more often than biopsy. We thus propose that endometrial cytology can be used in routine diagnosis either alone or in association with other diagnostic procedures in order to improve diagnostic accuracy.

  14. p21-Activated Kinases 1, 2 and 4 in Endometrial Cancers: Effects on Clinical Outcomes and Cell Proliferation.

    Directory of Open Access Journals (Sweden)

    Michelle K Y Siu

    Full Text Available p21-activated kinases (Paks are serine/threonine protein kinases involved in biological events linked to malignant tumor progression. In this study, expression of Pak1, p-Pak2 Ser20, Pak4, pPak4 Ser474 in 21 normal endometrium, 16 hyperplastic endometrium without atypia, 17 atypical complex hyperplasia and 67 endometrial cancers was assessed by immunohistochemistry and correlated with clinicopathological parameters. We also accessed the proliferative role and downstream targets of Pak1 in endometrial cancer. Pak1 was expressed in cytoplasm whereas Pak4 and p-Pak4 were expressed in both cytoplasm and nucleus of endometrial tissues. In normal endometrium, significantly higher Pak1 (P = 0.028 and cytoplasmic p-Pak2 (P = 0.048 expression was detected in proliferative endometrium than secretory endometrium. Pak1, cytoplasmic and nuclear Pak4 and nuclear p-Pak4 was significantly overexpressed in endometrial cancer when compared to atrophic endometrium (all P<0.05. Moreover, type I endometrioid carcinomas showed significantly higher Pak1 expression than type II non-endometrioid carcinomas (P<0.001. On the other hand, Pak1, Pak4 and p-Pak4 expression negatively correlated with histological grade (all P<0.05 while p-Pak2 and cytoplasmic Pak4 expression inversely correlated with myometrial invasion (all P<0.05. Furthermore, patients with endometrial cancers with lower cytoplasmic Pak4 expression showed poorer survival (P = 0.026. Multivariate analysis showed cytoplasmic Pak4 is an independent prognostic factor. Functionally, knockdown of Pak1, but not Pak4, in endometrial cancer cell line led to reduced cell proliferation along with reduced cyclin D1, estrogen receptor (ERα and progestogen receptor (PR expression. Significant correlation between Pak1 and PR expression was also detected in clinical samples. Our findings suggest that Pak1 and cytoplasmic p-Pak2 may promote cell proliferation in normal endometrium during menstral cycle. Pak1, cytoplasmic

  15. Assessment of Optical Coherence Tomography Imaging in the Diagnosis of Non-Melanoma Skin Cancer and Benign Lesions Versus Normal Skin:

    DEFF Research Database (Denmark)

    Mogensen, Mette; Jørgensen, Thomas Martini; Nürnberg, Birgit Meincke;

    2009-01-01

    BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess the diagn......BACKGROUND Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC). OBJECTIVES To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess...... the diagnostic accuracy of OCT in differentiating NMSC from benign lesions and normal skin. METHODS AND MATERIALS OCT and polarization-sensitive (PS) OCT from 104 patients were studied. Observer-blinded evaluation of OCT images from 64 BCCs, 1 baso-squamous carcinoma, 39 AKs, two malignant melanomas, nine benign......-defined layering in OCT and PS-OCT images and dark lobules in BCC. Discrimination of AK from BCC had an error rate of 50% to 52%. CONCLUSION OCT features in NMSC are identified, but AK and BCC cannot be differentiated. OCT diagnosis is less accurate than clinical diagnosis, but high accuracy in distinguishing...

  16. Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: A comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences

    Directory of Open Access Journals (Sweden)

    Jakicic John M

    2011-09-01

    Full Text Available Abstract Background Choice of appropriate MR pulse sequence is important for any research studies using imaging-derived data. The aim of this study was to compare semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts using intermediate-weighted (IW fat-suppressed (fs spin echo and Dual Echo Steady State (DESS sequences on 3 T MRI. Methods Included were 201 subjects aged 35-65 with frequent knee pain. 3T MRI was performed with the same sequence protocol as in the Osteoarthritis Initiative (OAI. In a primary reading subchondral bone marrow edema-like lesions were assessed according to the WORMS system. Two hundred subregions with such lesions were randomly chosen. The extent of subchondral bone marrow edema-like lesions was re-evaluated separately using sagittal IW fs and DESS sequences according to WORMS. Lesion size and confidence of the differentiation between subchondral bone marrow edema-like lesions and subchondral cysts located within or adjacent to them was rated from 0 to 3. Wilcoxon signed-rank tests and chi-square statistics were used to examine differences between the two sequences. Results Of 200 subchondral bone marrow edema-like lesions detected by IW fs sequence, 93 lesions (46.5% were not depicted by the DESS sequence. The IW fs sequence depicted subchondral bone marrow edema-like lesions to a larger extent than DESS (p Conclusions In direct comparison the IW fs sequence depicts more subchondral bone marrow edema-like lesions and better demonstrate the extent of their maximum size. The DESS sequence helps in the differentiation of subchondral bone marrow edema-like lesions and subchondral cysts. The IW fs sequence should be used for determination of lesion extent whenever the size of subchondral bone marrow edema-like lesions is the focus of attention.

  17. Intraoperative visualization, frozen section, and permanent pathology in endometrial cancer

    Directory of Open Access Journals (Sweden)

    Soheila Aminimoghaddam

    2014-12-01

    Conclusion: Although the sample size of the studied population was small but our study results support the previous data and suggest that in early stages and low grade tumors, gross examination and frozen section diagnosis are conveniently predictive of lymph node metastasis. These data might be useful for prediction of tumor invasion using frozen section and gross examination in low grade tumors and early stages and for doing complete surgical staging and lymph node sampling. However the im-portance of surgical staging always must be considered in patients who need systemat-ic lymphadenectomy. In overall these data might help to come up with new guidelines for surgical risk assessment in endometrial cancer.

  18. Controversies in Surgical Staging of Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    R. Seracchioli

    2010-01-01

    Full Text Available Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. In 1998, international federation of gynaecologists and obstetricians (FIGO required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy. This staging requirement raised controversies around the importance of determining nodal status and impact of lymphadenectomy on outcomes. There is agreement about the prognostic value of lymphadenectomy, but its extent, therapeutic value, and benefits in terms of survival are still matter of debate, especially in early stages. Accurate preoperative risk stratification can guide to the appropriate type of surgery by selecting patients who benefit of lymphadenectomy. However, available preoperative and intraoperative investigations are not highly accurate methods to detect lymph nodes and a complete surgical staging remains the most precise method to evaluate extrauterine spread of the disease. Laparotomy has always been considered the standard approach for endometrial cancer surgical staging. Traditional and robotic-assisted laparoscopic techniques seem to provide equivalent results in terms of disease-free survival and overall survival compared to laparotomy. These minimally invasive approaches demonstrated additional benefits as shorter hospital stay, less use of pain killers, lower rate of complications and improved quality of life.

  19. Imaging assessment of isolated lesions affecting cranial nerve III; Avaliacao por imagem das lesoes isoladas do III par craniano

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Marcelo de Mattos [Colegio Brasileiro de Radiologia e Diagnostico por Imagem (CBR), Sao Paulo, SP (Brazil)]. E-mail: cidbh@cidbh.com.br; Martins, Jose Carlos Tadeu [Sociedade Brasileira de Neuroradiologia, Sao Paulo, SP (Brazil)

    2005-05-15

    The aim of this study is to review the anatomy and main pathologic conditions affecting cranial nerve III using imaging studies, particularly magnetic resonance imaging. Imaging methods are essential in the evaluation of patients with suspected lesions of the oculomotor nerve once signs and symptoms are unspecific and a large number of diseases can affect cranial nerve III. A brief review of the literature is also presented. (author)

  20. Pink lesions.

    Science.gov (United States)

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  1. The importance of a full clinical examination: assessment of index lesions referred to a skin cancer clinic without a total body skin examination would miss one in three melanomas.

    Science.gov (United States)

    Aldridge, R Benjamin; Naysmith, Lisa; Ooi, Ee Ting; Murray, Caroline S; Rees, Jonathan L

    2013-11-01

    Traditional clinical teaching emphasises the importance of a full clinical examination. In the clinical assessment of lesions that may be skin cancer, full examination allows detection of incidental lesions, as well as helping in the characterisation of the index lesion. Despite this, a total body skin examination is not always performed. Based on two prospective studies of over 1,800 sequential patients in two UK centres we show that over one third of melanomas detected in secondary care are found as incidental lesions, in patients referred for assessment of other potential skin cancers. The majority of these melanomas occurred in patients whose index lesion turned out to be benign. Alternative models of care--for instance some models of teledermatology in which a total body skin examination is not performed by a competent practitioner--cannot be considered equivalent to a traditional consultation and, if adopted uncritically, without system change, will likely lead to melanomas being missed.

  2. Endometrial Adenocarcinoma Presenting in a Premenopausal Patient with Tuberous Sclerosis

    Science.gov (United States)

    Jaffe, J. S.; Chambers, J. T.

    2005-01-01

    Background: Endometrial adenocarcinoma is very uncommon in women under 40 years of age. Case: A 39-year-old woman with tuberous sclerosis and severe intellectual disability presented with irregular bleeding unresponsive to oral contraceptive therapy. She was subsequently found to have a deeply invasive endometrial adenocarcinoma. Conclusion:…

  3. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  4. Hypoxia and cell cycle deregulation in endometrial carcinogenesis

    NARCIS (Netherlands)

    Horrée, N.

    2007-01-01

    Because uterine endometrial carcinoma is the most common malignancy of the female genital tract and 1 of every 5 patients dies of this disease, understanding the mechanisms of carcinogenesis and progression of endometrial carcinoma is important. In general, this thesis can be summarized as a study o

  5. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G;

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  6. Three-dimensional volumetric MRI with isotropic resolution: improved speed of acquisition, spatial resolution and assessment of lesion conspicuity in patients with recurrent soft tissue sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Ahlawat, Shivani [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Morris, Carol [The Johns Hopkins Medical Institutions, Department of Orthopedic Surgery, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Oncology, Baltimore, MD (United States); Fayad, Laura M. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Orthopedic Surgery, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Oncology, Baltimore, MD (United States)

    2016-05-15

    To assess the acquisition speed, lesion conspicuity, and inter-observer agreement associated with volumetric T{sub 1}-weighted MR sequences with isotropic resolution for detecting recurrent soft-tissue sarcoma (STS). Fifteen subjects with histologically proven recurrent STS underwent MRI, including axial and coronal T{sub 1}-weighted spin echo (T{sub 1}-WSE) (5-mm slice thickness) and coronal 3D volumetric T{sub 1}-weighted (fat-suppressed, volume-interpolated, breath-hold examination; repetition time/echo time, 3.7/1.4 ms; flip angle, 9.5 ; 1-mm slice thickness) sequences before and after intravenous contrast administration. Subtraction imaging and multiplanar reformations (MPRs) were performed. Acquisition times for T{sub 1}-WSE in two planes and 3D sequences were reported. Two radiologists reviewed images for quality (>50 % artifacts, 25-50 % artifacts, <25 % artifacts, and no substantial artifacts), lesion conspicuity, contrast-to-noise ratio (CNR{sub muscle}), recurrence size, and recurrence-to-joint distance. Descriptive and intraclass correlation (ICC) statistics are given. Mean acquisition times were significantly less for 3D imaging compared with 2-plane T{sub 1}-WSE (183.6 vs 342.6 s; P = 0.012). Image quality was rated as having no substantial artifacts in 13/15 and <25 % artifacts in 2/15. Lesion conspicuity was significantly improved for subtracted versus unsubtracted images (CNR{sub muscle}, 100 ± 138 vs 181 ± 199; P = 0.05). Mean recurrent lesion size was 2.5 cm (range, 0.7-5.7 cm), and measurements on 3D sequences offered excellent interobserver agreement (ICC, 0.98 for lesion size and 0.96 for recurrence-to-joint distance with MPR views). Three-dimensional volumetric sequences offer faster acquisition times, higher spatial resolution, and MPR capability compared with 2D T{sub 1}-WSE for postcontrast imaging. Subtraction imaging provides higher lesion conspicuity for detecting recurrent STS in skeletal muscle, with excellent interobserver

  7. The influence of single nucleotide polymorphisms on the association between dietary acrylamide intake and endometrial cancer risk

    Science.gov (United States)

    Hogervorst, Janneke G. F.; van den Brandt, Piet A.; Godschalk, Roger W. L.; van Schooten, Frederik-Jan; Schouten, Leo J.

    2016-01-01

    It is unclear whether the association between dietary acrylamide intake and endometrial cancer risk as observed in some epidemiological studies reflects a causal relationship. We aimed at clarifying the causality by analyzing acrylamide-gene interactions for endometrial cancer risk. The prospective Netherlands Cohort Study on diet and cancer includes 62,573 women, aged 55–69 years. At baseline, a random subcohort of 2589 women was selected for a case cohort analysis approach. Acrylamide intake of subcohort members and endometrial cancer cases (n = 315) was assessed with a food frequency questionnaire. Single nucleotide polymorphisms (SNPs) in genes in acrylamide metabolism, sex steroid systems, oxidative stress and DNA repair were assessed through a MassARRAY iPLEX Platform. Interaction between acrylamide and SNPs was assessed with Cox proportional hazards analysis, based on 11.3 years of follow-up. Among the results for 57 SNPs and 2 gene deletions, there were no statistically significant interactions after adjustment for multiple testing. However, there were nominally statistically significant interactions for SNPs in acrylamide-metabolizing enzymes: CYP2E1 (rs915906 and rs2480258) and the deletions of GSTM1 and GSTT1. Although in need of confirmation, the interactions between acrylamide intake and CYP2E1 SNPs contribute to the evidence for a causal relationship between acrylamide and endometrial cancer risk. PMID:27713515

  8. Translational Study on Correlation Between Disturbance of Estrogen and Lipid Metabolism and Occurrence and Progression of Endometrial Adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    YU Cui-ge; HUANG Jian-feng; JIANG Xiang-yang

    2016-01-01

    Objective: To explore the correlation between disturbance of estrogen and lipid metabolism and occurrence and progression of endometrial adenocarcinoma so as to seek the early-warning markers for endometrial adenocarcinoma. Methods:Seventy-nine patients initially diagnosed as endometrial adenocarcinoma were collected as research group, and 70 healthy people with normal endometrium at the same term were as control group. The levels of fasting blood glucose (FBG), serum total triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), estradiol (E2), progesterone (P), testosterone (T) and fasting insulin (FINS) were all detected in two groups, and the risk factors of endometrial carcinoma were analyzed by non-conditional Logistic regression model. Results: The age, body mass index (BMI), FINS and homeostasis model assessment for insulin resistance (HOMA-IR) in research group were all higher than those in control group dramatically (P=0.0000). The level of HDL-C was signiifcantly lower, while that of E2 was markedly higher in premenopausal patients in research group than in control group, and there was statistical significance (P=0.0000). The levels of TC, TG, LDL-C, E2 and T in menopausal patients were all higher, while that of HDL-C was lower in research group than in control group, and all the differences were statistically signiifcant (P<0.05). The risk factors of endometrial adenocarcinoma included increase of BMI, E2, TG, and FIN as well as presence of HOMA-IR (OR=6.535,P=0.010; OR=7.796,P=0.011; OR=4.371,P=0.006; OR=6.392,P=0.020; OR=3.711, P=0.021). Conclusion:Women with increase of BMI, E2, TG, and FIN as well as presence of HOMA-IR can be considered as a high-risk population for developing endometrial adenocarcinoma.

  9. Hormone therapy for patients with advanced or recurrent endometrial cancer.

    Science.gov (United States)

    Lee, Wen-Ling; Yen, Ming-Shyen; Chao, Kuan-Chong; Yuan, Chiou-Chung; Ng, Heung-Tat; Chao, Hsiang-Tai; Lee, Fa-Kung; Wang, Peng-Hui

    2014-05-01

    The "gold standard" treatment for endometrial cancer is completely staged surgery, followed by radiation or chemotherapy, based on the final pathological surgical stage and requirements. In the primary treatment of endometrial cancers, hormones are rarely taken into consideration after primary surgery. Primary treatment with hormones to preserve fertility in younger women with endometrial cancer is an attractive option, and many successful cases have been reported, although the majority of them finally received definite therapy, including total hysterectomy. The role of hormone therapy is often delayed in recurrent disease; response rates to progestins and tamoxifen or aromatase inhibitors in advanced/recurrent endometrial cancers are approximately 15-20% and nearly ≤ 10%, respectively. This review is focused on updated information and recent knowledge on the use of hormones in the management of women with advanced or recurrent endometrial cancers.

  10. Renoscintigraphy in assessment of renal lesions in children after hemolytic-uremic syndrome; Renoscyntygrafia w ocenie skutkow uszkodzenia nerek u dzieci po przebytym zespole hemolityczno-mocznicowym

    Energy Technology Data Exchange (ETDEWEB)

    Lass, P.; Marczak, E.; Romanowicz, G. [Akademia Medyczna, Gdansk (Poland); and others

    1994-12-31

    The aim of the study was to assess the role of renoscintigraphic examination in monitoring of patients after the hemolytic-uremic syndrome. 27 children mean 9 years the hemolytic-uremic syndrome underwent the complex of biochemical, ultrasound and renoscintigraphic examinations. The abnormal renoscintigraphic was seen in 85.1% of children, while the alternative test described the renal lesion in 29-66%. Renoscintigraphic examination seems to be the most sensitive in monitoring of remote sequel in patients after HUS. Those patients should undergone long-lasting observation, for the sake of possibility of development of renal insufficiency. (author). 14 refs.

  11. Glycodelin in endometrial flushing fluid and endometrial biopsies from infertile and fertile women

    DEFF Research Database (Denmark)

    Bentin-Ley, Ursula; Lindhard, Anette; Skovlund, Vibeke Ravn;

    2011-01-01

    To investigate in the natural cycle just before IVF, whether glycodelin levels in endometrial flushing fluid obtained days LH+1 and LH+7 can be used in predicting pregnancy in the following IVF cycle, and whether there are differences in women with tubal factor infertility compared to women with ...

  12. Endometrial Cancer and a Family History of Cancer

    Science.gov (United States)

    Cook, Linda S.; Nelson, Harold E.; Stidley, Christine A.; Dong, Yan; Round, Pamela J.; Amankwah, Ernest K.; Magliocco, Anthony M.; Friedenreich, Christine M.

    2014-01-01

    Objective Lynch Syndrome (LS), an inherited genetic syndrome, predisposes to cancers such as colorectal and endometrial. However, the risk for endometrial cancer (EC) in women not affected by LS, but with a family history of cancer, is currently unknown. We examined the association between a family history of cancer and the risk for EC in non-LS patients. Methods This population-based case-control study included 519 EC cases and 1015 age-matched controls and took place in Alberta, Canada between 2002 and 2006. Information about risk factors, including family history of cancer in first and second degree relatives, was ascertained via in-person interviews. Microsatellite instability (MSI) status of tumor tissue was assessed to determine involvement of DNA mismatch repair genes. Results A first or second degree family history of uterine cancer was modestly associated with the risk for overall EC [odds ratio (OR), 1.3; 95% confidence interval (CI), 0.9,1.9], and the risks were similar for MSI+ cancer (OR= 1.5, 95%CI=0.7, 3.3) and MSI- cancer (OR= 1.3, 95%CI=0.8, 2.4). Although consistent, these associations were modest and not significant. In contrast, the risk for MSI+ cancer was elevated with a reported family history of colorectal cancer (OR= 1.4, 95%CI=1.0, 2.2), but not for MSI- cancer. Conclusions A family history of uterine cancer may be modestly associated with EC risk in non-LS patients regardless of MSI status, suggesting that risk was not related to inherited defects in the MMR gene pathway. These results provide preliminary support for an EC-specific genetic syndrome. PMID:23632205

  13. Renin-angiotensin system gene polymorphisms and endometrial cancer.

    Science.gov (United States)

    Pringle, Kirsty G; Delforce, Sarah J; Wang, Yu; Ashton, Katie A; Proietto, Anthony; Otton, Geoffrey; Blackwell, C Caroline; Scott, Rodney J; Lumbers, Eugenie R

    2016-05-01

    Endometrial cancer (EC) is the most common gynaecological malignancy and its incidence is increasing. Dysregulation of the endometrial renin-angiotensin system (RAS) could predispose to EC; therefore, we studied the prevalence of RAS single nucleotide polymorphisms (SNPs) in Australian women with EC. SNPs assessed were AGT M235T (rs699); AGTR1 A1166C (rs5186); ACE A240T and T93C (rs4291, rs4292) and ATP6AP2 (rs2968915). They were identified using TaqMan SNP Genotyping Assays. The C allele of the AGTR1 SNP (rs5186) was more prevalent in women with EC (odds ratio (OR) 1.7, 95% confidence interval (CI) (1.2-2.3), P=0.002). The CC genotype of this SNP is associated with upregulation of the angiotensin II type 1 receptor (AGTR1). The G allele of AGT rs699, which is associated with higher angiotensinogen (AGT) levels, was less prevalent in women with EC (OR 0.54, 95% CI (0.39-0.74), P<0.001) compared with controls. AGT and AGT formed by removal of angiotensin I (des(Ang I)AGT) are both anti-angiogenic. In women with EC who had had hormone replacement therapy (HRT), the prevalence of the AGTR1 SNP (rs5186) and the ACE SNPs (rs4291 and rs4292) was greater than in women who had no record of HRT; SNP rs4291 is associated with increased plasma ACE activity. These data suggest there is an interaction between genotype, oestrogen replacement therapy and EC. In conclusion, the prevalence of two SNPs that enhance RAS activity was different in women with EC compared with healthy controls. These genetic factors may interact with obesity and hyperoestrogenism, predisposing ageing, obese women to EC.

  14. Expression of retinoic acid receptors in human endometrial carcinoma.

    Science.gov (United States)

    Tanabe, Kojiro; Utsunomiya, Hiroki; Tamura, Mitsutoshi; Niikura, Hitoshi; Takano, Tadao; Yoshinaga, Kohsuke; Nagase, Satoru; Suzuki, Takashi; Ito, Kiyoshi; Matsumoto, Mitsuyo; Hayashi, Shin-ichi; Yaegashi, Nobuo

    2008-02-01

    The retinoids (vitamin A and its biologically active derivatives) are essential for the health and survival of the individual. Several studies have reported a strong rationale for the use of retinoids in cancer treatment and chemoprevention. It has been discovered that expression of retinoic acid receptor (RAR) beta is frequently silenced in epithelial carcinogenesis, which has led to the hypothesis that RAR beta could act as a tumor suppressor. However, the status of RAR beta in human endometrial carcinoma has not been examined. In the present study, we initially studied the effects of retinoic acid on cell proliferation and the expression of RAR alpha, RAR beta, and RAR gamma using AM580 (a RAR-specific agonist) in the Ishikawa endometrial cancer cell line. We also examined the expression of RAR in human eutopic endometrium (30 cases), endometrial hyperplasia (28 cases), and endometrial carcinoma (103 cases) using immunohistochemistry. Finally, we correlated these findings with the clinicopathological parameters. In vitro, cell growth was inhibited and RAR beta and RAR gamma mRNA was significantly induced by AM580, compared with vehicle controls, whereas RAR alpha mRNA was significantly attenuated by AM580, compared with vehicle. RAR beta was detected predominantly in endometrial hyperplasia, compared with endometrial carcinoma. No statistically significant correlation was obtained between the expression of any other RAR subtypes and clinicopathological parameters in human endometrial carcinoma. The results of our study demonstrate that AM580 inhibits cell growth and induces RAR beta mRNA expression in the Ishikawa cell line, and the expression level of RAR beta in endometrial carcinoma is significantly lower than that in endometrial hyperplasia. AM580 might therefore be considered as a potential treatment for endometrial carcinoma.

  15. Parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J. [Hospital Sant Pau, Radiology Department, Neuroradiology, Barcelona (Spain)

    2005-03-01

    The sellar and parasellar region is an anatomically complex area that represents a crucial crossroad of important adjacent structures, e.g. orbits, cavernous sinus and its content, polygon of Willis, hypothalamus through the pituitary stalk and dural reflections forming the diaphragm sellae and the walls of the cavernous sinuses. Although the cavernous sinus represents the most relevant parasellar structure, from the practical and clinical point of view all the structures that surround the sella turcica can be included in the parasellar region. CT and, mainly, MRI are the imaging modalities to study and characterise the normal anatomy and the majority of processes in this region. We present a practical short review of the most relevant CT and MRI characteristics, such as location, nature of contrast enhancement and presence of cystic components, together with clinical findings, which permit differentiation of the most frequent and less common lesions found in the parasellar region. Learning objectives: A short review of the anatomy and clinical symptoms related to the parasellar region. Radiological characterisation, mainly by MRI, of the many lesions that alter the structure and function of sellar and parasellar anatomy. Description of the MRI features that permit differentiation among less common lesions. (orig.)

  16. ERCC1 and XRCC1 but not XPA single nucleotide polymorphisms correlate with response to chemotherapy in endometrial carcinoma

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    Chen L

    2016-11-01

    Full Text Available Liang Chen,1 Mei-Mei Liu,1 Hui Liu,1 Dan Lu,2 Xiao-Dan Zhao,3 Xue-Jing Yang4 1Department of Gynecology and Obstetrics, 2Department of Oncology, 3Department of Clinical Laboratory, The 2nd Affiliated Hospital, Harbin Medical University, 4Nursing Department, Harbin Chest Hospital, Harbin, People’s Republic of China Abstract: Our study aimed to investigate the correlation between single nucleotide polymorphisms of ERCC1/XRCC1/XPA genes and postoperative chemotherapy efficacy and prognosis of endometrial carcinoma. Our study included 108 patients with endometrial carcinoma and 100 healthy participants. ERCC1 rs11615/XRCC1 rs25487/XPA rs1800975 gene polymorphisms were detected by polymerase chain reaction–restriction fragment length polymorphism. Then the chemotherapy efficacy and toxic effects of the patients were assessed. The genotype and allele frequency of ERCC1 rs11615/XRCC1 rs25487 in the case group were significantly different from that in the control group (all P<0.05. The patients with AA + GA in ERCC1 rs11615 had an increased risk of endometrial carcinoma than those with GG, and the risk of endometrial carcinoma for patients with AA + GA was also higher in comparison with patients with GG genotype in XRCC1 rs25487 (all P<0.05. GG on both ERCC1 rs11615/XRCC1 rs25487 had a higher effective rate of chemotherapy than GA + AA (all P<0.05. ERCC1 rs11615/XRCC1 rs25487 gene polymorphisms were linked with toxic effects in liver, kidney, and nervous system. ERCC1 rs11615/XRCC1 rs25487, muscular invasion, and tumor stage were independent risk factors for the prognosis of endometrial carcinoma (all P<0.05. However, no significant associations were observed between XPA rs1800975 polymorphism and chemotherapy efficacy and prognosis of endometrial carcinoma (all P>0.05. These results indicated that ERCC1 and XRCC1 but not XPA polymorphisms correlate with response to chemotherapy in endometrial carcinoma. Keywords: ERCC1, XRCC1, XPA, single nucleotide

  17. Isolated humeral recurrence in endometrial carcinoma

    Science.gov (United States)

    Devdas, Santosh Kumar; Digumarti, Leela; Digumarti, Raghunadharao; Patro, Kunha Charan; Nutakki, Ramakoteswararao

    2016-01-01

    Isolated skeletal metastasis in endometrial carcinoma at recurrence is very rare. We report a 52-year-old woman diagnosed to have FIGO Stage 1b, Grade 1 endometrioid adenocarcinoma, presenting with isolated distal humerus metastasis, 2 years after surgery and adjuvant radiotherapy for primary disease. Imaging, bone scintigraphy, and cytology confirmed the diagnosis of poorly differentiated metastatic adenocarcinoma. She was treated with local radiotherapy followed by six cycles of paclitaxel and carboplatin chemotherapy along with zoledronic acid, monthly. She is symptom-free after the treatment and at a first follow-up visit after 3 months. PMID:27688615

  18. A STUDY ON THE ROLE OF MICRO NUCLEI IN ASSESSING THE PROGRESSION OF PRECANCEROUS LESIONS OF CERVIX AND THE DIAGNOSIS OF CARCINOMA OF CERVIX

    Directory of Open Access Journals (Sweden)

    Anitha

    2015-06-01

    Full Text Available BACKGROUND: Invasive squamous cell carcinoma of cervix remains the most common malignant neoplasm of the female genital tract in many countries. The Papanicolaou stained cervical smear is an excellent and effective method in the diagnosis of invasive carcinoma and precancerous lesions of the cervix. This study was conducted to assess the value of Feulgen stained cervical smears in elucidating nuclear features help ful in the diagnosis of malignancy over conventional Pap stained smears and also to look for micronucleated cells in suspected cases of carcinoma of cervix. AIM: To analyse the distribution of cases of invasive squamous cell carcinoma and intraepithelial n eoplasia (squamous intraepithelial lesion of cervix over a period of 3 years, to elucidate additional nuclear features helpful in diagnosis of carcinoma using Feulgen stained cervical smears and to study the distribution of micronuclei in Feulgen stained smears from suspected cases of Carcinoma cervix. MATERIALS AND METHODS: A three year analysis of all cases of dysplasia and invasive carcinoma of cervix was done by reviewing Papanicolaou stained cervical smears from all the diagnosed cases of invasive car cinoma and precancerous lesions of the cervix. Cervical smears from sixty clinically suspected cases of carcinoma of cervix and smears from 10 normal women collected during a period of 12 months were studied in detail using Papanicolaou stained and Feulgen Stained Smears and micronuclei analysis (MN analysis was done. RESULTS : A total of 24343 cervical smears were screened during the 3 year period of study. Out of these 24343 cases there were 267(1.09% cases of cervical intraepithelial neoplasia and 144(0 .592% cases of invasive squamous cell carcinoma. Micronuclei analysis done using Feulgen Stained Smears demonstrated a consistent increase in micronucleated cells proportional to the increase in severity of th e lesion from normal to invasive carcinoma. CO NCLUSION : This study

  19. Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis

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    Schulze, Ralf K.W., E-mail: rschulze@mail.uni-mainz.de [Poliklinik fuer Zahnaerztliche Chirurgie, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, D-55131 Mainz (Germany); Grimm, Stefanie, E-mail: StefanieGrimm@gmx.de [Poliklinik fuer Zahnaerztliche Chirurgie, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, D-55131 Mainz (Germany); Schulze, Dirk, E-mail: dirk.schulze@uniklinik-freiburg.de [Klinik fuer Mund,- Kiefer- und Gesichtschirurgie, Sektion Roentgen, Universitaetsklinikum Freiburg, Hugstetterstr. 55, D-79106 Freiburg (Germany); Voss, Kai, E-mail: zahnarzt@drvoss.eu [Zahnaerztekammer Schleswig-Holstein, Vorstand fuer Praxisfuehrung, Westring 496, D- 24106 Kiel (Germany); Keller, Hans-Peter, E-mail: hans-peter.keller@din.de [NA Dental (NADENT) im DIN, Alexander-Wellendorff-Str. 2, D-75172 Pforzheim (Germany); Wedel, Matthias, E-mail: matthias.wedel@siemens.com [Siemens AG, Medical Solutions, Postfach 32 60, D-91050 Erlangen (Germany)

    2011-08-15

    Aims: To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection. Materials and methods: A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17'' cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding {+-}2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves. Results: Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P = 0.172). Neither significant (range mean z: -0.40 (S520) and -0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor. Conclusions: Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment.

  20. Regression of latent endometrial precancers by progestin infiltrated intrauterine device.

    Science.gov (United States)

    Ørbo, Anne; Rise, Cecil E; Mutter, George L

    2006-06-01

    PTEN tumor suppressor inactivation is the earliest step in endometrial carcinogenesis, occurring in morphologically unremarkable endometrial glands in half of normal women. We test the hypothesis that sex hormones positively or negatively select for these "latent precancers" by examining their emergence, persistence, and regression rates under differing hormonal conditions. Perimenopausal and postmenopausal women had an intake endometrial biopsy and underwent hormonal therapy with progestin-impregnated intrauterine device (IUD; n = 21), cyclic oral progestins (n = 28), or surveillance only (n = 22) with follow-up biopsies. For comparison, premenopausal naturally cycling endometrial biopsies were studied as single time points in 87 patients and multiple surveillance time points in 34 patients. Biopsies in which any PTEN protein-null glands were found by immunohistochemistry were scored as containing a latent endometrial precancer. All groups had a similar proportion of latent precancers at intake but differed after therapy. Emergence rates were highest (21%) for the naturally cycling premenopausal group compared with just 9% for untreated perimenopausal women. The IUD group had the highest rate of regression, with a 62% pretherapy and 5% post-therapy rate of latent precancers. This contrasted to nonsignificant changes for the oral progestin and untreated control groups. Delivery of high doses of progestins locally to the endometrium by IUD leads to ablation of preexisting PTEN-inactivated endometrial latent precancers and is a possible mechanism for reduction of long-term endometrial cancer risk known to occur in response to this hormone.

  1. [Environmental and genetic risk factors for endometrial carcinoma].

    Science.gov (United States)

    Sénéchal, Claire; Cottereau, Edouard; de Pauw, Antoine; Elan, Camille; Dagousset, Isabelle; Fourchotte, Virginie; Gauthier-Villars, Marion; Lae, Marick; Stoppa-Lyonnet, Dominique; Buecher, Bruno

    2015-03-01

    In France, endometrial cancer is at the first rank of gynecological cancers for cancer incidence, before ovarian and cervical cancers. In fact, the number of incident cases has been estimated to 7275 for the year 2012; the number of death due to endometrial cancer to 2025. This cancer is hormone-dependent and endogenous (reproductive factors) or exogenous (oral combined contraceptives, hormone replacement therapy) causes of exposition to estrogens are the major environmental risk factors for both types of endometrial cancers: type I or well-differentiated endometrioid adenocarcinomas; and type II including all other histological types: papillary serous adenocarcinomas, clear cell adenocarcinomas and carcinosarcomas, also known as malignant mixed Mullerian tumor, MMMT. Obesity, diabetes mellitus and adjuvant treatment of breast cancer with tamoxifen are also associated with an increased risk of endometrial cancer. Genetic factors may also be implicated in the pathogenesis of endometrial cancer either as "minor genetic factors" (susceptibility factors), which remain largely unknown and are responsible for the increased observed risk in relatives of women affected with endometrial cancer; or as major genetic factors responsible for hereditary forms and namely for Lynch syndrome whose genetic transmission is of autosomic dominant type. The appropriate recognition of Lynch syndrome is of critical importance because affected patients and their relatives should benefit from specific care. The aims of this review is to describe major environmental and genetic risk factors for endometrial cancer with specific attention to most recent advances in this field and to describe recommendations for care of at-risk women.

  2. The Feasibility of Societal Cost Equivalence between Robotic Hysterectomy and Alternate Hysterectomy Methods for Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Neel T. Shah

    2011-01-01

    Full Text Available Objectives. We assess whether it is feasible for robotic hysterectomy for endometrial cancer to be less expensive to society than traditional laparoscopic hysterectomy or abdominal hysterectomy. Methods. We performed a retrospective cohort analysis of patient characteristics, operative times, complications, and hospital charges from all (=234 endometrial cancer patients who underwent hysterectomy in 2009 at our hospital. Per patient costs of each hysterectomy method were examined from the societal perspective. Sensitivity analysis and Monte Carlo simulation were performed using a cost-minimization model. Results. 40 (17.1% of hysterectomies for endometrial cancer were robotic, 91 (38.9%, were abdominal, and 103 (44.0% were laparoscopic. 96.3% of the variation in operative cost between patients was predicted by operative time (=0.963, <0.01. Mean operative time for robotic hysterectomy was significantly longer than other methods (<0.01. Abdominal hysterectomy was consistently the most expensive while the traditional laparoscopic approach was consistently least expensive. The threshold in operative time that makes robotic hysterectomy cost equivalent to the abdominal approach is within the range of our experience. Conclusion. It is feasible for robotic hysterectomy to be less expensive than abdominal hysterectomy, but unlikely for robotic hysterectomy to be less expensive than traditional laparoscopy.

  3. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Thropay John P

    2010-07-01

    Full Text Available Abstract Background A modified form of high dose rate (HDR brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT. EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. Methods A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. Results The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. Conclusions EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.

  4. Effect of Adding Human Chorionic Gonadotropin to The Endometrial Preparation Protocol in Frozen Embryo Transfer Cycles

    Directory of Open Access Journals (Sweden)

    Maryam Eftekhar

    2012-01-01

    Full Text Available Background: Human chorionic gonadotropin (HCG, one of the initial embryonic signals, isprobably a major regulator of the embryo-endometrial relationship. This study aims to assess theadvantage of HCG supplementation during the secretory phase of hormonally prepared cycles forthe transfer of cryopreserved-thawed embryos.Materials and Methods: This study was a randomized clinical trial. Infertile women who werecandidates for frozen-thawed embryo transfers entered the study and were divided into two groups,HCG and control. The endometrial preparation method was similar in both groups: all women receivedestradiol valerate (6 mg po per day from the second day of the menstrual cycle and progesteronein oil (100 mg intramuscular (I.M. when the endometrial thickness reached 8 mm. Estradiol andprogesterone were continued until the tenth week of gestation. In the HCG group, patients received anHCG 5000 IU injection on the first day of progesterone administration and the day of embryo transfer.Results: In this study, 130 couples participated: 65 in the HCG group and 65 in the control group.There was no statistically significant difference between groups regarding basic characteristics.Implantation rate, chemical pregnancy, clinical pregnancy, ongoing pregnancy, and abortion rateswere similar in both groups.Conclusion: Although HCG has some advantages in assisted reproductive technology (ARTcycles, our study did not show any benefit of HCG supplementation during the secretory phase offrozen cycles (Registration Number: IRCT201107266420N4.

  5. High-risk endometrial cancer may be benefit from adjuvant radiotherapy plus chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Jin-Wei Miao; Xiao-Hong Deng

    2012-01-01

    Objective:To present patterns of practice and outcomes in the adjuvant treatment of intermediate-and high-risk endometrial cancer.Methods:Retrospective data on 224 women with intermediate-risk and high-risk endometrial cancer from 1999 to 2006 were reviewed.All patients underwent surgical staging.Patterns of adjuvant treatment,consisting of pelvic radiotherapy,chemotherapy,and radiotherapy plus chemotherapy,were assessed.The 3-and 5-year disease-specific survival (DSS) rates were calculated using the Kaplan-Meier method.Results:The difference in 5-year DSS rate was statistically significant between adjuvant group and non-adjuvant group (80.65% vs.63.80%,P=0.040).In 110 high-risk patients who underwent adjuvant treatment,both 5-year DSS rate and recurrent rate were significantly different in combined radiotherapy and chemotherapy group compared with radiotherapy alone and chemotherapy alone groups (DSS rate,P=0.049; recurrent rate,P=0.047).In 83 intermediate-risk women who underwent adjuvant treatment,there was no significant difference in 5-year DSS rate and recurrence rate among the combined radiotherapy and chemotherapy,radiotherapy alone and chemotherapy alone groups (DSS rate,P=0.776; recurrent rate,P=0.937).Conclusions:Adjuvant radiotherapy plus chemotherapy is associated with a higher 5-year DSS rate and lower recurrence rate compared with radiotherapy alone and chemotherapy alone in high-risk endometrial cancer patients.Patients with intermediate-risk endometrial cancer may be not likely to benefit from adjuvant combined radiotherapy and chemotherapy.

  6. IL-1β up-regulates expression of IL-8 in endometrial stromal cells in vitro

    Institute of Scientific and Technical Information of China (English)

    Zhang Guiyu; Ren Shuwen; Zhang Youzhong; Yang Xingsheng

    2005-01-01

    Objective:To investigate the effects of interleukin-1beta (IL-1β) on expression of IL-8 in endometrial stromal cells (ESC) and evaluate the relationship between IL1 β and IL-8 ,and the significance of IL-1β in the development of endometriosis. Methods:The endometrial stromal cells obtained from patient with and without endometriosis cultured within 3 ~5 passage were exposed to various concentrations of IL-1β. The amount of IL-8 protein was assessed by ELISA. The expression of IL-8 mRNA was determined by RT-PCR. Results: 1. IL-8 protein was detected in culture supernatant of which the cells were not treated with IL-1β. The amount of IL-8 protein secretion increased obviously after stimulation with IL-1β at 1.0ng/ml for 4h and the peak of secretion was at 12h. 2. Expression of IL-8 mRNA was positive in unstimulated endometrial stromal cells. However, after stromal cells were incubated with IL-1β, the intensity of expression of IL-8 mRNA was obviously increased and demonstrated a dose-and timedependent manner. Increase of IL-8 mRNA was observed following stimulation with IL-1β for 4h ,and the peak at 12h. Conclusions:IL-1β induces endometrial stromal cell of endometriosis to express IL-8 not only at transcription level but also at post-transcription level. This up-regulation is dose-and time-dependent. IL-1β may play an important role in the onset of endometriosis.

  7. Ten-year literature review of global endometrial ablation with the NovaSure® device

    Directory of Open Access Journals (Sweden)

    Gimpelson RJ

    2014-03-01

    Full Text Available Richard J Gimpelson Mercy Clinic, Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Mercy Hospital St Louis, St Louis, MO, USA Abstract: This review examines the peer-reviewed literature describing prospective studies that report amenorrhea rates, patient satisfaction, and surgical reintervention rates following the NovaSure® endometrial ablation procedure. A search of the English-language literature published from 2000 to 2011 was conducted using PubMed. Ten prospective studies, six single-arm NovaSure trials, and four randomized controlled trials comparing the NovaSure procedure with other global endometrial ablation modalities met the inclusion criteria and were reviewed. The follow-up periods ranged from 6 to 60 months. Amenorrhea rates for the NovaSure procedure ranged from 30.0% to 75.0%. Patients who reported being satisfied with the NovaSure procedure ranged from 85.0% to 94.0%. In randomized controlled trials with other global endometrial ablation modalities, amenorrhea rates at 12 months with the NovaSure procedure ranged from 43.0% to 56.0%, while other modalities ranged from 8% to 24%. In addition, this manuscript reviews the following: the NovaSure technology; use of the NovaSure procedure in the office setting; intraoperative and postoperative pain; effects on premenstrual syndrome (PMS; dysmenorrhea; special circumstances, including presence of uterine disease, history of cesarean delivery, coagulopathy, or use of anticoagulant medication; post-procedure uterine cavity assessment and cancer risk; contraception and pregnancy; and safety. Keywords: abnormal uterine bleeding, menorrhagia, endometrial ablation, NovaSure®

  8. Hypoxia and Angiogenesis in Endometrioid Endometrial Carcinogenesis

    Directory of Open Access Journals (Sweden)

    Nicole Horrée

    2007-01-01

    Full Text Available Background: Hypoxia-inducible factor 1α (HIF-1α plays an essential role in the adaptive response of cells to hypoxia, triggering biologic events associated with aggressive tumor behavior. Methods: Expression of HIF-1α and proteins in the HIF-1α pathway (Glut-1, CAIX, VEGF in paraffin-embedded specimens of normal (n = 17, premalignant (n = 17 and endometrioid endometrial carcinoma (n = 39 was explored by immunohistochemistry, in relation to microvessel density (MVD. Results: HIF-1α overexpression was absent in inactive endometrium but present in hyperplasia (61% and carcinoma (87%, with increasing expression in a perinecrotic fashion pointing to underlying hypoxia. No membranous expression of Glut-1 and CAIX was noticed in inactive endometrium, in contrast with expression in hyperplasia (Glut-1 0%, CAIX 61%, only focal and diffuse and carcinoma (Glut-1 94.6%, CAIX 92%, both mostly perinecrotically. Diffuse HIF-1α was accompanied by activation of downstream targets. VEGF was significantly higher expressed in hyperplasias and carcinomas compared to inactive endometrium. MVD was higher in hyperplasias and carcinomas than in normal endometrium (p < 0.001. Conclusion: HIF-1α and its downstream genes are increasingly expressed from normal through premalignant to endometrioid adenocarcinoma of the endometrium, paralleled by activation of its downstream genes and increased angiogenesis. This underlines the potential importance of hypoxia and its key regulator HIF-1α in endometrial carcinogenesis.

  9. Dilatation and Curettage Effect on the Endometrial Thickness

    Science.gov (United States)

    Davar, Robab; Dehghani Firouzabadi, Razieh; Chaman Ara, Kefayat

    2013-01-01

    Background Endometrial receptivity is required for successful implantation and pregnancy. Despite the remaining controversy, many studies have shown that ultrasonographic endometrial thickness can be considered as an indicator of endometrial receptivity. Objective The study objective was to investigate the effect of dilatation and curettage on the endometrial thickness. Materials and Methods Enrolled in the study were 444 patients visited in Obstetrics & Gynecology clinic of Shahid Sadoughi hospital between Jan. 2011 to Sep. 2012. Only patients whose menstrual cycle was regular were included in study. Patients with myoma, adenomyosis, endometrial polyps or other uterine anomaly, those who smoked, whose BMI was greater than 30 and who were taking medications that could affect endometrial thickness were excluded. Endometrial thickness was measured one day before evolution (n = 444) and 5-7 days after it (n = 444) using transvaginal ultrasonography. The endometrial thicknesses were correlated to the patients’ history of dilatation and curettage. Data analysis was done through SPSS software version 16 and using descriptive statistics, independent T-test and Anova. Results Endometrial thickness in patients who had 0, 1, 2, 3 and 4 D&C were 10.00 ± 0.58, 9.83 ± 0.47, 8.90 ± 0.92, 7.42 ± 0.18 and 7.40 ± 0.07, respectively one day before ovulation (spearman’s correlation coefficient = -0.33) and 10.62 ± 0.68, 9.64 ± 0.49, 8.48 ± 0.96, 6.32 ± 0.15 and 6.90 ± 0.04, respectively, 5-7 days after ovulation (spearman’s correlation coefficient = -0.66) estradiol and progesterone levels, measured in the day of 2nd ultrasonography had not statistic relation with endometrial thickness (P = 0.27 and 0.31). The relation of endometrial thickness and age was not significant (P = 0.54 and 0.06). Conclusions Dilatation and curettage has a significant effect on the endometrial thinning. PMID:24083012

  10. Results of surgical treatment of atypical endometrial hyperplasia

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    O. A. Gornykh

    2014-01-01

    Full Text Available The results of surgical treatment in 132 patients with atypical endometrial hyperplasia have been studied. Post-operative diagnosis was: en- dometrial cancer – in 19 %, atypical hyperplasia – in 35 %, simple and complex hyperplasia – in 33 %, only atrophic endometrial changes – in 13 % of patients. The tumor was within the endometrium in 5 patients, the superficial invasion of the myometrium (1–2 mm were in 8 patients, invasion to half of the myometrium – in 9 patients, invasion of more than half of the myometrium – in 3 patients. The questions of tactics of treatment of atypical endometrial hyperplasia is under discussion.

  11. ESMO-ESGO-ESTRO consensus conference on endometrial cancer

    DEFF Research Database (Denmark)

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic;

    2015-01-01

    panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following four areas: Prevention and screening, surgery, adjuvant treatment and advanced and recurrent......The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary...

  12. Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group

    OpenAIRE

    Chen, Yu-Li; Wang, Kung-Liahng; Chen, Min-Yu; Yu, Mu-Hsien; Wu, Chen-Hsuan; Ke, Yu-Min; Chen, Yi-Jen; Chang, Yin-Yi; Hsu, Keng-Fu; Yen, Ming-Shyen

    2013-01-01

    Objective To evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia. Methods Between January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients w...

  13. Correlação dos aspectos laparoscópicos com as alterações histológicas glandulares das lesões endometrióticas peritoneais Correlation between laparoscopic aspects and glandular hystological findings of peritoneal endometriotic lesions

    Directory of Open Access Journals (Sweden)

    Francesco Antonio Viscomi

    2004-09-01

    evolutiva da endometriose peritoneal.OBJECTIVE: To evaluate the correlation between laparoscopic aspects and glandular hystological findings of peritoneal endometriosis to understand the theory of evolution of endometriosis. METHODS: Sixty seven women with peritoneal endometriosis were submitted to laparoscopy. Peritoneal biopsy was taken from the typical (puckered black and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (group V, black lesions (group N and white lesions (group B. Hystological sections were examined according to a standardized protocol. The hystological parameters used were: functional characteristics of glandular epithelium, presence of intraluminal debris, occurrence of mitosis and stroma/gland ratio. RESULTS: Functional characteristics of glandular epithelium showed statistically significant association among groups. Secretory epithelium was found in 68.4 % of group V, in 15.8% of groups N & B, while not characteristic epithelium was found in 19.4% of red lesions, 38.7% of black lesions and 41.9% of white lesions. Proliferative epithelium was found in 50% of group B patients and in 25% of groups V & N (p=0.011. Regarding intraluminal debris, there were also statistically significant differences among the groups, present in 58.4% of group N, 33.3% of group B and 8.3% of group V (p=0.016. There was no statistical difference between occurrence of mitosis (P=0.428, nor in the stroma/gland ratio (p=0.159. CONCLUSION: Association between functional activity and red lesions and low activity in black and white lesions, regarding the hystological characteristics of the glandular epithelium analyzed in this study shows the importance of the theory of evolution of endometriosis. This was also demonstrated by presence of intraluminal debris in the study groups.

  14. Hormonal treatments in metastatic endometrial stromal sarcomas: the 10-year experience of the sarcoma unit of Royal Marsden Hospital

    OpenAIRE

    2015-01-01

    Background Hormonal manipulation is sometimes recommended in the treatment of metastatic endometrial stromal sarcoma, but there are few data assessing the efficacy of endocrine therapies in this subtype of uterine sarcomas. Methods We performed a retrospective electronic medical record review of patients with metastatic ESS treated with a hormonal agent at Royal Marsden Hospital between 1999 and 2011. We assessed progression-free survival (PFS), objective response and toxicity profile among p...

  15. Development and comparative assessment of Raman spectroscopic classification algorithms for lesion discrimination in stereotactic breast biopsies with microcalcifications.

    Science.gov (United States)

    Dingari, Narahara Chari; Barman, Ishan; Saha, Anushree; McGee, Sasha; Galindo, Luis H; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-04-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. Here, we develop and compare different approaches for developing Raman classification algorithms to diagnose invasive and in situ breast cancer, fibrocystic change and fibroadenoma that can be associated with microcalcifications. In this study, Raman spectra were acquired from tissue cores obtained from fresh breast biopsies and analyzed using a constituent-based breast model. Diagnostic algorithms based on the breast model fit coefficients were devised using logistic regression, C4.5 decision tree classification, k-nearest neighbor (k -NN) and support vector machine (SVM) analysis, and subjected to leave-one-out cross validation. The best performing algorithm was based on SVM analysis (with radial basis function), which yielded a positive predictive value of 100% and negative predictive value of 96% for cancer diagnosis. Importantly, these results demonstrate that Raman spectroscopy provides adequate diagnostic information for lesion discrimination even in the presence of microcalcifications, which to the best of our knowledge has not been previously reported.

  16. Patient assessment based on a theory of visual attention (TVA): subtle deficits after a right frontal-subcortical lesion.

    Science.gov (United States)

    Habekost, Thomas; Bundesen, Claus

    2003-01-01

    We report on a patient who complained of reduced awareness in the left visual field, but showed no visual neglect or extinction in clinical testing. By MR scanning, the brain damage was localized to the right basal ganglia, also involving structures in right frontal cortex. Using psychophysical testing and mathematical modeling based on Bundesen's theory of visual attention [TVA; Psychol. Rev. 97 (1990) 523], the patient's subjective experience of attentional disturbance was confirmed, and the deficit was specified into several components. At very short exposure durations, two effects were shown. The detection threshold was elevated, particularly in the left visual field, and stimuli in this side were given less attentional weight. In addition, the capacity of visual short-term memory (VSTM) was markedly reduced in both visual fields. The robustness of the test results was evaluated by bootstrap analysis. The study demonstrates the sensitivity and specificity gained by combining psychophysical testing with TVA modeling in the analysis of visual attention disorders. Extending the results of a pioneer study of parietal neglect patients by Duncan et al. [J. Exp. Psychol.: Gen. 128 (1999) 450], this study demonstrates the strength of the method in a single case, with a lesion outside parietal cortex, and only minor clinical symptoms.

  17. Assessment of coronary artery lesions in children with Kawasaki disease: evaluation of MSCT in comparison with 2-D echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Xing, Yanlin; Wang, Hong; Yu, Xianyi; Chen, Rui [Shengjing Hospital of China Medical University, Department of Pediatrics, Shenyang (China); Hou, Yang [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang (China)

    2009-11-15

    Transthoracic two-dimensional echocardiography is an effective method for detecting coronary arterial injury in Kawasaki disease. However, its accuracy in the diagnosis of coronary arterial lesions is limited. To investigate the value of multislice spiral CT for coronary angiography for observing the coronary arterial injury caused by infantile Kawasaki disease. Coronary angiography, using a 64-slice spiral CT scanner, and 2-D echocardiography were performed in 48 children with Kawasaki disease in whom the position, internal diameter, and length of each coronary artery were measured. MSCT showed coronary artery injury in 15 of the 48 children. Among these 15 children, 20 coronary artery branches showed complications, including the left coronary artery branches in 15 (31.2%) and the right coronary artery branches in 5 (10.4%). Complications in the left coronary artery branches included dilation in 12 (25.0%) and stenosis, calcification and the combination of the two in one each, and the right coronary artery branches showed dilation; two branches also showed beaded changes. MSCT also showed dilation in the left anterior descending arteries in two children. These children showed no abnormality on 2-D echocardiography. MSCT is a valuable examination method for detecting coronary artery injury in Kawasaki disease. (orig.)

  18. Differential Expression and Clinical Significance of DNA Methyltransferase 3B (DNMT3B), Phosphatase and Tensin Homolog (PTEN) and Human MutL Homologs 1 (hMLH1) in Endometrial Carcinomas.

    Science.gov (United States)

    Li, Wenting; Wang, Ying; Fang, Xinzhi; Zhou, Mei; Li, Yiqun; Dong, Ying; Wang, Ruozheng

    2017-02-21

    BACKGROUND The aim of this study was to investigate the expression and the clinicopathologic significance of DNA methyltransferase 3B (DNMT3B), phosphatase and tensin homolog (PTEN) and human MutL homologs 1 (hMLH1) in endometrial carcinomas between Han and Uygur women in Xinjiang. MATERIAL AND METHODS The expression of DNMT3B, PTEN, and hMLH1 in endometrial carcinomas were assessed by immunohistochemistry, followed by an analysis of their relationship to clinical-pathological features and prognosis. RESULTS There were a 61.7% (95/154) overexpression of DNMT3B, 50.0% (77/154) loss of PTEN expression and 18.2% (28/154) loss of hMLH1 expression. The expression of DNMT3B and PTEN in endometrial carcinomas was statistically significantly different between Uygur women and Han women (p=0.001, p=0.010, respectively). DNMT3B expression was statistically significant based on the grade of endometrial carcinomas (p=0.031). PTEN loss was statistically significant between endometrioid carcinomas (ECs) and non endometrioid carcinomas (NECs) (p=0.040). DNMT3B expression was statistically significant in different myometrial invasion groups in Uygur women (p=0.010). Furthermore, the correlation of DNMT3B and PTEN expression was significant in endometrial carcinomas (p=0.021). PTEN expression was statistically significant in the overall survival (OS) rate of women with endometrial cancers (p=0.041). CONCLUSIONS Our findings suggest that PTEN and DNMT3B possess common regulation features as well as certain ethnic differences in expression between Han women and Uygur women. An interaction may exist in the pathogenesis of endometrial carcinoma. DNMT3B was expressed differently in cases of myometrial invasion and PTEN was associated with OS, which suggested that these molecular markers may be useful in the evaluation of the biological behavior of endometrial carcinomas and may be useful indicators of prognosis in women with endometrial carcinomas.

  19. GATA3 Is a Sensitive and Specific Marker of Benign and Malignant Mesonephric Lesions in the Lower Female Genital Tract.

    Science.gov (United States)

    Howitt, Brooke E; Emori, Megan M; Drapkin, Ronny; Gaspar, Cynthia; Barletta, Justine A; Nucci, Marisa R; McCluggage, W Glenn; Oliva, Esther; Hirsch, Michelle S

    2015-10-01

    GATA3 is a transcription factor critical for embryogenesis, development, and cell differentiation. Recent studies have suggested that GATA3 is a sensitive and relatively specific biomarker for urothelial and breast carcinomas, with most Müllerian carcinomas being negative. We investigated GATA3 expression in mesonephric/Wolffian remnants and tumors in the female genital tract. A western blot was performed to assess specificity for the GATA3 antibody. GATA3 immunohistochemistry was performed on 59 formalin-fixed paraffin-embedded mesonephric samples, including 17 mesonephric remnants (MR; 11 cervical and 6 fallopian tube), 15 mesonephric hyperplasias, 21 mesonephric carcinomas, and 6 female adnexal tumors of probable Wolffian origin. Thirty conventional endocervical adenocarcinomas (ENDO-CA), 9 gastric-type cervical adenocarcinomas, and 165 endometrial adenocarcinomas (EM-CA) were also evaluated. GATA3 nuclear intensity and extent of staining was evaluated. The western blot revealed GATA3 expression in seminal vesicle and cell lines derived from breast and urothelial carcinomas, but not in other cell lines including ovarian, cervical, and endometrial cancers. All cervical MRs and mesonephric hyperplasias, 5/6 (83%) fallopian tube MRs, and 20/21 (95%) mesonephric carcinomas were GATA3 positive, although with great variability in both intensity (weak to strong) and extent (1+ to 3+) of staining. Only 1/6 (17%) female adnexal tumors of probable Wolffian origin showed weak multifocal staining. One of 30 (3%) usual-type ENDO-CAs and 3/165 EM-CAs exhibited weak-moderate GATA3 immunoreactivity; all gastric-type cervical adenocarcinomas were negative. GATA3 is a highly sensitive and specific marker for mesonephric lesions in the lower genital tract; however, its utility in the upper genital tract may be more limited. In addition, GATA3 can aid in distinguishing lower genital mesonephric lesions from usual-type and gastric-type ENDO-CAs and uterine EM-CAs.

  20. Coffee consumption and risk of endometrial cancer: findings from a large up-to-date meta-analysis.

    Science.gov (United States)

    Je, Youjin; Giovannucci, Edward

    2012-10-01

    Several epidemiological studies have examined the association between coffee drinking and risk of endometrial cancer. To provide a quantitative assessment of this association, we conducted a meta-analysis of observational studies published up to October 2011 through a search of MEDLINE and EMBASE databases and the reference lists of retrieved article. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model, and generalized least square trend estimation was used to assess dose-response relationships. A total of 16 studies (10 case-control and six cohort studies) on coffee intake with 6,628 endometrial cancer cases were included in the meta-analysis. The pooled RR of endometrial cancer for the highest versus lowest categories of coffee intake was 0.71 (95% CI: 0.62-0.81; p for heterogeneity = 0.13). By study design, the pooled RRs were 0.69 (95% CI: 0.55-0.87) for case-control studies and 0.70 (95% CI: 0.61-0.80) for cohort studies. By geographic region, the inverse association was stronger for three Japanese studies (pooled RR = 0.40; 95% CI: 0.25-0.63) than five studies from USA/Canada (pooled RR = 0.69; 95% CI: 0.60-0.79) or eight studies from Europe (pooled RR = 0.79; 95% CI: 0.63-0.99). An increment of one cup per day of coffee intake conferred a pooled RR of 0.92 (95% CI: 0.90-0.95). In conclusion, our findings suggest that increased coffee intake is associated with a reduced risk of endometrial cancer, consistently observed for cohort and case-control studies. More large studies are needed to determine subgroups to obtain more benefits from coffee drinking in relation to endometrial cancer risk.

  1. Dynamic Contrast-Enhanced MRI Parameters as Biomarkers in Assessing Head and Neck Lesions After Chemoradiotherapy Using a Wide-Bore 3 Tesla Scanner.

    Science.gov (United States)

    Lerant, Gergely; Sarkozy, Peter; Takacsi-Nagy, Zoltan; Polony, Gabor; Tamas, Laszlo; Toth, Erika; Boer, Andras; Javor, Laszlo; Godeny, Maria

    2015-09-01

    Pilot studies have shown promising results in characterizing head and neck tumors (HNT) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), differentiating between malignant and benign lesions and evaluating changes in response to chemoradiotherapy (CRT). Our aim was to find DCE-MRI parameters, biomarkers in evaluating the post-CRT status. Two hundred and five patients with head and neck lesions were examined with DCE-MRI sequences. The time intensity curves (TIC) were extracted and processed to acquire time-to-peak (TTP), relative maximum enhancement (RME), relative wash-out (RWO), and two new parameters attack and decay. These parameters were analyzed using univariate tests in SPSS (Statistical Package for the Social Sciences, version 17, SPSS Inc. Chicago, USA) to identify parameters that could be used to infer tumor malignancy and post-CRT changes. Multiple parameters of curve characteristics were significantly different between malignant tumors after CRT (MACRT) and changes caused by CRT. The best-performing biomarkers were the attack and the decay. We also found multiple significant (p < 0.05) parameters for both the benign and malignant status as well as pre- and post-CRT status. Our large cohort of data supports the increasing role of DCE-MRI in HNT differentiation, particularly for the assessment of post-CRT status along with accurate morphological imaging.

  2. Assessing consequences of untreated carious lesions using pufa index among 5-6 years old school children in an urban Indian population

    Directory of Open Access Journals (Sweden)

    Abhishek Mehta

    2014-01-01

    Full Text Available Background: Dental caries is a major chronic noncommunicable disease affecting whole of mankind. Nontreatment of caries can have severe consequences such as pain, abscess formation, space infection, etc., which leads to loss of function, working hours or absence from school in children. These consequences are equally important, while planning dental care program for a community. Aim: The aim of this study is to assess the prevalence and severity of consequences of untreated carious lesions using pufa index that is, pulpal involvement, and ulcer due to root fragments, fistula, and abscess index among 5-6 year old school children in an urban Indian population. Materials and Methods: A cross-sectional survey was conducted on 603 school going children of 5-6 year age group in mainly an urban Indian population. Children from 12 randomly selected schools were examined for pufa and decayed extracted filled indices. Results and Conclusions: Overall mean pufa value was 0.9 ± 1.93 and prevalence was 38.6% with major contribution from P component of index. Untreated caries ratio was 35%, suggesting that more than one-third of the developed carious lesions cause adverse events in a population. This study emphasis the need for treating dental caries at its earliest possible stage to avoid severe consequences. The pufa index can be used as tool to highlight these adverse consequences to dental professionals and health authorities.

  3. Assessment of effectiveness of different dosage regimens of pantoprazole in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis

    Directory of Open Access Journals (Sweden)

    MORETZSOHN Luciana Dias

    2002-01-01

    Full Text Available Background - Gastroesophageal reflux disease is a very common affection, and esophageal involvement is particularly frequent. The means to effectively control symptoms and improve esophageal inflammation in these patients is to reduce esophageal acid exposure. For this purpose, we use gastric proton pump inhibitor, that can suppress gastric acid secretion. Aim - To compare the effectiveness of two different pantoprazole dosage regimens (20 and 40 mg/day, in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis. Material and Methods - Fifty-seven patients with endoscopically confirmed mild erosive esophagitis characterized as non-confluent erosions in the distal esophagus, were randomly to be treated either with pantoprazole 20 mg/day (group I, 28 patients or 40 mg/day (group II, 29 patients over a period of 4 weeks. After treatment completion, the patients were assessed for clinical and endoscopic outcome, i.e., absence of erosions in distal esophagus and improvement of gastroesophageal reflux symptoms. Results - At the end of the treatment, 73.1% of the patients in group I and 85.7% of the patients in group II had endoscopic improvement. We also observed, that 88.5% of the patients in group I and 92.9% of the patients in group II had complete elimination of heartburn and regurgitation. Conclusion - Pantoprazole dosage regimens of 20 mg/day and 40 mg/day provide equivalent effectiveness in controlling symptoms and healing esophageal lesions of mild esophagitis.

  4. To study the correlation between endometrial thickness on transvaginal sonography and endometrial histopathology in women with postmenopausal bleeding

    Directory of Open Access Journals (Sweden)

    Leena Chaudhari

    2016-05-01

    Conclusions: Postmenopausal bleeding, should always be taken seriously, no matter how minimal or nonpersistent it is, because though majority of causes underlying postmenopausal bleeding are benign, endometrial carcinoma may be seen in around 10% cases. So, patients with PMB must undergo thorough evaluation by endometrial sampling which cannot be replaced by transvaginal sonography which though has more sensitivity to detect endometrial thickening, at the same time, has low specificity for detection of malignancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1309-1315

  5. Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Ayesha; Ellenson, Lora Hedrick, E-mail: lora.ellenson@med.cornell.edu

    2011-07-01

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten{sup +/-} mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten{sup +/-} mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER{alpha} as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

  6. Microscopic endometrial perivascular epithelioid cell nodules: a case report with the earliest presentation of a uterine perivascular epithelioid cell tumor

    Directory of Open Access Journals (Sweden)

    Fang Chia-Lang

    2012-09-01

    Full Text Available Abstract Perivascular epithelioid cell (PEC tumors (PEComas are a family of related mesenchymal tumors composed of PECs which co-express melanocytic and smooth muscle markers. Although their distinctive histologic, immunohistochemical, ultrastructural, and genetic features have been clearly demonstrated, their histogenesis and normal counterpart remain largely unknown. Precursor lesions of PEComas have rarely been reported. We herein describe a tuberous sclerosis patient with microscopic PEC nodules in the endometrium of adenomyosis, pelvic endometriosis, an ovarian endometriotic cyst, and the endometrium of the uterine cavity. The nodules showed a mixture of spindle-shaped and epithelioid cells concentrically arranged around small arteries. The cells exhibited uniform nuclei, light eosinophilic cytoplasm, and immunoreactivity with HMB-45 and CD10. Some nodules revealed continuity with a PEComa in the myometrium. These findings support microscopic endometrial PEC nodules possibly being precursor lesions of uterine PEComas. The wide distribution of the nodules in the pelvis may be related to the multicentricity of PEComas in tuberous sclerosis patients. Owing to the immunoreactivity with CD10, microscopic endometrial PEC nodules may be misinterpreted as endothelial stromal cells unless melanocytic markers are stained. To the best of our knowledge, this is a case with the earliest manifestation of PEC lesions occurring in the endometrium. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9658280017862643

  7. Endometrial and acute myeloid leukemia cancer genomes characterized

    Science.gov (United States)

    Two studies from The Cancer Genome Atlas (TCGA) program reveal details about the genomic landscapes of acute myeloid leukemia (AML) and endometrial cancer. Both provide new insights into the molecular underpinnings of these cancers.

  8. Endometrial cancer, types, prognosis, female hormones and antihormones

    DEFF Research Database (Denmark)

    Ulrich, L S G

    2011-01-01

    . Prognosis is also dependent on tumor differentiation and stage, and treatment should be adjusted accordingly. In this paper, the different types of endometrial cancer, staging, prognosis, diagnosis, prevention, treatment and their relationship to estrogen and other female hormones are reviewed....

  9. Endometrial Adenocarcinoma and Mucocele of the Appendix: An Unusual Coexistence

    Directory of Open Access Journals (Sweden)

    Ioannis Kalogiannidis

    2013-01-01

    Full Text Available Appendiceal mucocele is a rare clinical entity, which is however quite often associated with mucinous ovarian tumor. The coexistence of mucinous cystadenoma of the appendix and endometrial adenocarcinoma has not been reported before. A 49-year-old woman presented to our clinic with postmenopausal bleeding and no other symptom. Endometrial biopsy revealed endometrial adenocarcinoma of endometrioid type (grade I. Preoperative CT scanning revealed an appendiceal mucocele, and a colonoscopy confirmed the diagnosis. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and appendectomy. The final histopathological examination showed a mucinous cystadenoma of the appendix and confirmed the diagnosis of endometrioid endometrial adenocarcinoma. The coexistence of appendiceal mucocele and female genital tract pathology is rare. However, gynecologists should keep a high level of suspicion for such possible coexistence. Both the diagnostic approach and the therapeutic management should be multidisciplinary, most importantly with the involvement of general surgeons.

  10. miR-200 Regulates Endometrial Development During Early Pregnancy.

    Science.gov (United States)

    Jimenez, Patricia T; Mainigi, Monica A; Word, R Ann; Kraus, W Lee; Mendelson, Carole R

    2016-09-01

    For successful embryo implantation, endometrial stromal cells must undergo functional and morphological changes, referred to as decidualization. However, the molecular mechanisms that regulate implantation and decidualization are not well defined. Here we demonstrate that the estradiol- and progesterone-regulated microRNA (miR)-200 family was markedly down-regulated in mouse endometrial stromal cells prior to implantation, whereas zinc finger E-box binding homeobox-1 and -2 and other known and predicted targets were up-regulated. Conversely, miR-200 was up-regulated during in vitro decidualization of human endometrial stromal cells. Knockdown of miR-200 negatively affected decidualization and prevented the mesenchymal-epithelial transition-like changes that accompanied decidual differentiation. Notably, superovulation of mice and humans altered miR-200 expression. Our findings suggest that hormonal alterations that accompany superovulation may negatively impact endometrial development and decidualization by causing aberrant miR-200 expression.

  11. Sentinel Lymph Node Identification in Endometrial Cancer

    Institute of Scientific and Technical Information of China (English)

    Bin Li; Lingying Wu; Xiaoguang Li; Haizhen Lu; Ping Bai; Shumin Li; Wenhua Zhang; Juzhen Gao

    2009-01-01

    OBJECTIVE To evaluate the feasibility of intra-operative detection of sentinel lymph nodes (SLN) in the patient with endometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrial cancer, who underwent a hysterectomy and a lymphadenectomy,were enrolled in the study. At laparotomy, methylene blue dye tracer was injected into the subserosal myometrium of corpus uteri at multiple sites, and dye uptake into the lymphatic channels was observed. The blue nodes which were identified as SLNs were traced and excised. The other nodes were then removed. All of the excised nodes were submitted for pathological hematoxylin and eosin (H&E) staining examination.RESULTS Failure of dye uptake occurred in 4 of the 31 cases (12.9%) because of spillage, and no lymphatic coloration was observed there. Lymphatic staining was clearly observable as blue dye diffused to the lymphatic channels of the uterine surface and the infundibulopelvic ligaments in 27 (87.1%) cases. Concurrent coloration in the pelvic lymphatic vessels was also observed in 22of the 27 patients. The SLNs were identified in 23 of the 27 (85.2%)cases with a lymphatic staining, with a total number of 90 SLNs,and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%)in the para-aortic area, the other 89 (98.9%) were in the nodes of the pelvis. The most dense locations of SLNs included obturator in 38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelvic lymphadenectomy was conducted in 27 (87.1%) patients and pelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrent abdominal para-aortic lymph node sampling was conducted in 7. A total of 926 nodes were harvested, with an average of 39.8 in each case (range, 14-55). Nodal metastases occurred in 3 patients (9.7%), 2 of them with SLN involvement and the other without SLN involvement. Adverse reactions or injury related to the study was not found.CONCLUSION Application of methylene blue dye is feasible in an intra

  12. Comparison of assessment tools to score recovery of function after repair of traumatic lesions of the median nerve

    NARCIS (Netherlands)

    Wong, K. H.; Coert, J. H.; Robinson, P. H.; Meek, M. F.

    2006-01-01

    In this paper the recovery after repair of the median nerve has been used to compare different assessment tools for evaluation of peripheral nerve function: touch ( moving 2-point discrimination (2PD); Semmes-Weinstein ( SW) monofilament, motor ( Medical Research Council (MRC) scale), combined motor

  13. Case Report of Undifferentiated Endometrial Sarcoma in Association with Osteoclast-Like Giant Cells

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    Svetoslav Bardarov

    2011-01-01

    Full Text Available We describe the clinical, gross and microscopic features of undifferentiated uterine stromal sarcoma associated with osteoclast-like giant cells. A case of low-grade endometrial stromal sarcoma is already described in association with osteoclast-like giant cells; however, the current case differs in that the tumor was a high grade and did not show any evidence of smooth muscle or epithelioid differentiation and was shown to be strongly positive for CD10 and focally for WT-1 and Inhibin supporting an endometrial stromal origin. The associated osteoclast-like giant cells were abundant, evenly distributed within the tumor and showed strong positivity for CD68. Interestingly, rare (less than 2% giant cells also showed weak cytoplasmic positivity for b-hCG. The tumor infiltrated deep into the myometrium and had marked lymphovascular invasion. Although the regional lymph nodes and peritoneal washings were negative, the lesion showed a highly aggressive clinical course. Despite treatment, the tumor disseminated within the abdominal cavity and lungs and ultimately led to the patient's demise within 9 months of the diagnosis.

  14. Effects of sulpiride and ethylene glycol monomethyl ether on endometrial carcinogenicity in Donryu rats.

    Science.gov (United States)

    Taketa, Yoshikazu; Inoue, Kaoru; Takahashi, Miwa; Sakamoto, Yohei; Watanabe, Gen; Taya, Kazuyoshi; Yoshida, Midori

    2016-06-01

    Sulpiride and ethylene glycol monomethyl ether (EGME) are known ovarian toxicants that stimulate prolactin (PRL) secretion, resulting in hypertrophy of the corpora lutea and increased progesterone (P4) production. The purpose of the present study was to investigate how the PRL stimulatory agents affected uterine carcinogenesis and to clarify the effects of PRL on endometrial adenocarcinoma progression in rats. Ten-week-old female Donryu rats were treated once with N-ethyl-N'-nitro-N-nitrosoguanidine (20 mg kg(-1) ), followed by treatment with sulpiride (200 ppm) or EGME (1250 ppm) from 11 weeks of age to 12 months of age. Sulpiride treatment inhibited the incidence of uterine adenocarcinoma and precancerous lesions of atypical endometrial hyperplasia, whereas EGME had no effect on uterine carcinogenesis. Sulpiride markedly prevented the onset of persistent estrus throughout the study period, and EGME delayed and inhibited the onset of persistent estrus. Moreover, sulpiride-treated animals showed high PRL and P4 serum levels without changes in the levels of estradiol-17β, low uterine weights and histological luteal cell hypertrophy. EGME did not affect serum PRL and P4 levels. These results suggest that the prolonged low estradiol-17β to P4 ratio accompanied by persistent estrous cycle abnormalities secondary to the luteal stimulatory effects of PRL may explain the inhibitory effects of sulpiride on uterine carcinogenesis in rats. Copyright © 2015 John Wiley & Sons, Ltd.

  15. GLUT1与PCNA蛋白在子宫内膜样腺癌组织中的表达及相关研究%Significance of testing GLUT1 with PCNA in pathological tissues of endometrial hyperplasia and endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    张颖; 陈海玲; 梁艳红

    2011-01-01

    Objective To explore the significance of testing GLUT1 with PCNA in pathological tissues ofendometrial hyperplasia and endometrial carcinoma. Methods Collecting 1 I0 lesion specimens of endometrial hyperplasia and endometrial carcinoma, testing GLUT1 and PCNA by SP method, and analyzing their correlation. Results The positive rate of GLUT1 was 26.67%, 57.78%, 81.54% respectively in normal proliferative endometrium, atypical endometrial hyperplasia and endometrial carcinoma, showing an increasing trend, and the positive rate of PCNA also showed the same increasing trend. There were significant differences (P<0.01), and the two indicators had positive correlation (r=0.41, P<0.01). Conclusion GLUT1 and PCNA have close relationship with endometrial hyperplasia and endometrial carcinoma, and they can reflect the progression of lesions, even testing GLUT1 with PCNA can be used to evaluate the proliferation index and biological behavior of the lesion.%目的 探讨葡萄糖转运蛋白1(GLUT1)与增殖细胞抗原(PCNA)联合检测在子宫内膜增殖症及癌变组织中的意义.方法 收集110例子宫内膜增殖症及子宫内膜样腺癌病变标本,采用SP法检测其GLUT1与PCNA含量,分析二者的相关性.结果 在正常增生期子宫内膜、非典型增生子宫内膜、子宫内膜癌中,GLUT1阳性表达率分别为26.67%、57.78%、81.54%,呈递增趋势,PCNA蛋白的表达亦呈递增趋势,差异均具有统计学意义(P<0.01),且两者具有正相关性(r=0.41,P<0.01).结论 GLUT1、PCNA与子宫内膜增殖症及癌变组织密切相关,可以间接反映病变的发展程度,联合检测可用于评价病变的增殖指数和生物学行为.

  16. Magnetic resonance arthrography assessment of the superior labrum using the BLC system: age-related changes mimicking SLAP-2 lesions

    Energy Technology Data Exchange (ETDEWEB)

    Koziak, Adrian [Queen' s School of Medicine, Kingston, Ontario (Canada); Chuang, Michael J.; Jancosko, Jason J.; Nottage, Wesley M. [The Sport Clinic Orthopedic Medical Associates, Inc., Laguna Hills, CA (United States); Burnett, Keith R. [Saddleback Valley Radiology, Laguna Hills, CA (United States)

    2014-08-15

    The purpose of the study was to describe the variation of the superior labrum with increasing age by assessing magnetic resonance (MR) arthrograms. Inclusion criteria were used to include only the MR arthrograms of patients devoid of clinical labral pathology. Two hundred thiry-six MR arthrograms were blindly assessed for biceps-labral complex (BLC) type 1-3 and sublabral recess size by a musculoskeletal radiologist. We have chosen the BLC system, which defines normal superior labral variants, since it is established in the literature and is used by reporting musculoskeletal (MSK) radiologists. The MR arthrograms demonstrated that the majority of patients <40 years old were BLC type 1 and showed a steady increase in BLC types 2 and 3 with increasing age. Assessments demonstrated significantly greater (p < 0.01) mean BLC types (1.62 vs 1.29) and recess size (1.35 vs 0.66 mm) in those over 40 compared with those less than 40 years of age. Furthermore, significant differences (p < 0.05) were noted between mean BLC assessments between different decades of age. There appears to be a physiologic deepening of the superior labrum sulcus with age, which becomes significant after the age of 40. These findings can contribute to whether the superior labrum is considered abnormal when assessed radiographically. The differentiation of normal age-related changes in the shoulder, from those of a type 2 SLAP tear can reduce the rates of unnecessary SLAP-2 repairs. This is the first reported series to use the BLC system; we believe it provides a common nomenclature to allow clear communication between specialists. (orig.)

  17. Inverse Relationship between Progesterone Receptor and Myc in Endometrial Cancer.

    Directory of Open Access Journals (Sweden)

    Tamar Kavlashvili

    Full Text Available Endometrial cancer, the most common gynecologic malignancy, is a hormonally-regulated disease. Response to progestin therapy positively correlates with hormone receptor expression, in particular progesterone receptor (PR. However, many advanced tumors lose PR expression. We recently reported that the efficacy of progestin therapy can be significantly enhanced by combining progestin with epigenetic modulators, which we term "molecularly enhanced progestin therapy." What remained unclear was the mechanism of action and if estrogen receptor α (ERα, the principle inducer of PR, is necessary to restore functional expression of PR via molecularly enhanced progestin therapy. Therefore, we modeled advanced endometrial tumors that have lost both ERα and PR expression by generating ERα-null endometrial cancer cell lines. CRISPR-Cas9 technology was used to delete ERα at the genomic level. Our data demonstrate that treatment with a histone deacetylase inhibitor (HDACi was sufficient to restore functional PR expression, even in cells devoid of ERα. Our studies also revealed that HDACi treatment results in marked downregulation of the oncogene Myc. We established that PR is a negative transcriptional regulator of Myc in endometrial cancer in the presence or absence of ERα, which is in contrast to studies in breast cancer cells. First, estrogen stimulation augmented PR expression and decreased Myc in endometrial cancer cell lines. Second, progesterone increased PR activity yet blunted Myc mRNA and protein expression. Finally, overexpression of PR by adenoviral transduction in ERα-null endometrial cancer cells significantly decreased expression of Myc and Myc-regulated genes. Analysis of the Cancer Genome Atlas (TCGA database of endometrial tumors identified an inverse correlation between PR and Myc mRNA levels, with a corresponding inverse correlation between PR and Myc downstream transcriptional targets SRD5A1, CDK2 and CCNB1. Together, these data

  18. Inhibition of Adhesion, Proliferation, and Invasion of Primary Endometriosis and Endometrial Stromal and Ovarian Carcinoma Cells by a Nonhyaluronan Adhesion Barrier Gel

    Directory of Open Access Journals (Sweden)

    Stefan P. Renner

    2015-01-01

    Full Text Available Endometriosis is a chronic disease of women in the reproductive age, defined as endometrial cells growing outside of the uterine cavity and associated with relapses. Relapses are hypothesized to correlate with incomplete surgical excision or result from nonrandom implantation of new endometrial implants in adjacent peritoneum. Thus, surgical excision could lead to free endometriotic cells or tissue residues, which readhere, grow, and invade into recurrent lesions. Barrier agents are frequently used to prevent postoperative adhesions. We tested if the absorbable cell adhesion barrier gel Intercoat consisting of polyethylene oxide and sodium carboxymethyl cellulose could inhibit cellular adhesion, proliferation, and invasion of primary endometriosis and endometrial cells. Due to an association of endometriosis with ovarian carcinoma, we tested two ovarian carcinoma cell lines. Prior to cell seeding, a drop of the barrier gel was placed in cell culture wells in order to test inhibition of adherence and proliferation or coated over a polymerized collagen gel to assay for prevention of invasion. Results showed that the barrier gel significantly inhibited cell adherence, proliferation, and invasion of endometriosis and endometrial stromal cells as well as ovarian carcinoma cells in culture. Our findings could help to prevent local cell growth/invasion and possible consequent recurrences.

  19. DCE-MRI defined subvolumes of a brain metastatic lesion by principle component analysis and fuzzy-c-means clustering for response assessment of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Farjam, Reza; Tsien, Christina I.; Lawrence, Theodore S. [Department of Radiation Oncology, University of Michigan, 1500 East Medical Center Drive, SPC 5010, Ann Arbor, Michigan 48109-5010 (United States); Cao, Yue, E-mail: yuecao@umich.edu [Department of Radiation Oncology, University of Michigan, 1500 East Medical Center Drive, SPC 5010, Ann Arbor, Michigan 48109-5010 (United States); Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Med Inn Building C478, Ann Arbor, Michigan 48109-5842 (United States); Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, Michigan 48109-2099 (United States)

    2014-01-15

    Purpose: To develop a pharmacokinetic modelfree framework to analyze the dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data for assessment of response of brain metastases to radiation therapy. Methods: Twenty patients with 45 analyzable brain metastases had MRI scans prior to whole brain radiation therapy (WBRT) and at the end of the 2-week therapy. The volumetric DCE images covering the whole brain were acquired on a 3T scanner with approximately 5 s temporal resolution and a total scan time of about 3 min. DCE curves from all voxels of the 45 brain metastases were normalized and then temporally aligned. A DCE matrix that is constructed from the aligned DCE curves of all voxels of the 45 lesions obtained prior to WBRT is processed by principal component analysis to generate the principal components (PCs). Then, the projection coefficient maps prior to and at the end of WBRT are created for each lesion. Next, a pattern recognition technique, based upon fuzzy-c-means clustering, is used to delineate the tumor subvolumes relating to the value of the significant projection coefficients. The relationship between changes in different tumor subvolumes and treatment response was evaluated to differentiate responsive from stable and progressive tumors. Performance of the PC-defined tumor subvolume was also evaluated by receiver operating characteristic (ROC) analysis in prediction of nonresponsive lesions and compared with physiological-defined tumor subvolumes. Results: The projection coefficient maps of the first three PCs contain almost all response-related information in DCE curves of brain metastases. The first projection coefficient, related to the area under DCE curves, is the major component to determine response while the third one has a complimentary role. In ROC analysis, the area under curve of 0.88 ± 0.05 and 0.86 ± 0.06 were achieved for the PC-defined and physiological-defined tumor subvolume in response assessment. Conclusions: The PC

  20. Imaging of Chest Wall Lesions in Children

    Directory of Open Access Journals (Sweden)

    A. Hekmatnia

    2008-01-01

    Full Text Available Chest wall lesions in childhood include a wide range of pathologies; Benign lesions include lipoma, neurofibroma, lymphangioma, hemangioma, and mesenchymal hamartoma."nMalignant lesions include Neuroblastoma, Rhabdo-myosarcoma, Ewing sarcoma, and Askin tumor."nSystemic diseases such as leukemia, lymphoma, Langerhans cell histiocytosis, and also infections such as tuberculosis, and actinomycosis may also cause chest wall lesions."nThe imaging characteristics of these lesions are re-viewed, but only a minority of the lesions shows diagnostic imaging features, and most of lesions re-quire biopsy and histopathological examination for "ndefinitive diagnosis."nThe role of different modalities is discussed with an emphasis on magnetic resonance imaging for demonstrating lesion morphology and local spread. Computed tomography and neuclear medicine being used mainly to assess remote disease."nIn this lecture, we discuss about imaging of chest wall lesions in children.

  1. Aqueous Extract of Solanum nigrum Leaf Activates Autophagic Cell Death and Enhances Docetaxel-Induced Cytotoxicity in Human Endometrial Carcinoma Cells

    Directory of Open Access Journals (Sweden)

    Cheng-Jeng Tai

    2012-01-01

    Full Text Available Chemotherapy is the main approach in dealing with advanced and recurrent endometrial cancer. An effective complementary ingredient can be helpful in improving the clinical outcome. Aqueous extract of Solanum nigrum leaf (AE-SN is a principal ingredient for treating cancer patients in traditional Chinese medicinal practice but lacks sufficient evidence to verify its tumor suppression efficacy. This study evaluated the antitumor effects of AE-SN and also assessed the synergistic effects of AE-SN with docetaxel On the human endometrial cancer cell lines, HEC1A, HEC1B, and KLE. The activation of apoptotic markers, caspase-3 and poly-ADP-ribose polymerase, and autophagic marker, microtubule-associated protein 1 light chain 3 A/B, wAS determined to clarify the cell death pathways responsible for AE-SN induced tumor cell death. Results indicated that AE-SN-treatment has significant cytotoxicity on the tested endometrial cancer cells with accumulation of LC3 A/B II and demonstrated a synergistic effect of AE-SN and docetaxel in HEC1A and HEC1B cells, but not KLE cells. In conclusion, AE-SN treatment was effective in suppressing endometrial cancer cells via the autophagic pathway and was also capable of enhancing the cytotoxicity of docetaxel in human endometrial cancer cells. Our results provide meaningful evidence for integrative cancer therapy in the future.

  2. Endometrial cancer in relation to coffee, tea, and caffeine consumption: a prospective cohort study among middle-aged women in Sweden.

    Science.gov (United States)

    Weiderpass, Elisabete; Sandin, Sven; Lof, Marie; Oh, Jin-Kyoung; Inoue, Manami; Shimazu, Taichi; Tsugane, Shoichiro; Adami, Hans-Olov

    2014-01-01

    This study aimed to add to prospective data on the possible inverse association between coffee consumption and endometrial cancer risk, already supported by several case-control studies. Coffee and tea consumption and possible confounding factors were assessed among 42,270 women aged 30-49 years at enrollment in 1991-1992 in the Swedish Women's Lifestyle and Health cohort study, with complete follow-up through 2009. We calculated caffeine intake per day; Cox proportional hazard models were used to estimate multivariable relative risks (mRR) for endometrial cancer with 95% confidence intervals (CIs). One hundred forty-four endometrial cancers were diagnosed during follow-up. Women with and without endometrial cancer had a similar mean daily coffee consumption (549 vs. 547 g), tea consumption (104 vs. 115 g), and caffeine intake (405 vs. 406 mg). Compared to those consuming 3 cups had a mRR of 1.56 (95% CI: 0.94-2.59; P for trend = 0.17). Compared with the lowest tertile of caffeine intake, the highest tertile had a mRR of 1.32 (95% CI: 0.87-1.99; P for trend = 0.27). Our study provides no convincing evidence of an association between coffee consumption, tea consumption, or caffeine intake and endometrial cancer risk among middle-aged women.

  3. Endometrial MicroRNA Signature during the Window of Implantation Changed in Patients with Repeated Implantation Failure

    Science.gov (United States)

    Shi, Cheng; Shen, Huan; Fan, Li-Juan; Guan, Jing; Zheng, Xin-Bang; Chen, Xi; Liang, Rong; Zhang, Xiao-Wei; Cui, Qing-Hua; Sun, Kun-Kun; Zhao, Zhu-Ran; Han, Hong-Jing

    2017-01-01

    Background: At present, a diagnostic tool with high specificity for impaired endometrial receptivity, which may lead to implantation failure, remains to be developed. We aimed to assess the different endometrial microRNA (miRNA) signatures for impaired endometrial receptivity by microarray analysis. Methods: A total of 12 repeated implantation failure (RIF) patients and 10 infertile patients, who conceived and delivered after one embryo transfer attempt, were recruited as RIF and control groups, respectively. Endometrial specimens from the window of implantation (WOI) were collected from these two groups. MiRNA microarray was conducted on seven and five samples from the RIF and control groups, respectively. Comparative, functional, and network analyses were performed for the microarray results. Quantitative real-time polymerase chain reaction (PCR) was performed on other samples to validate the expression of specific miRNAs. Results: Compared with those in the control group, the expression levels of 105 miRNAs in the RIF group were found to be significantly up- or down-regulated (at least 2-fold) by microarray analysis. The most relevant miRNA functional sets of these dysregulated miRNAs were miR-30 family, human embryonic stem cell regulation, epithelial-mesenchymal transition, and miRNA tumor suppressors by tool for annotations of microRNA analysis. Network regulatory analysis found 176 miRNA-mRNA interactions, and the top 3 core miRNAs were has-miR-4668-5p, has-miR-429, and has-miR-5088. Expression levels of the 18 selected miRNAs in new samples by real-time PCR were found to be regulated with the same trend, as the result of microarray analysis. Conclusions: There is a significant different expression of certain miRNAs in the WOI endometrium for RIF patients. These miRNAs may contribute to impaired endometrial receptivity. PMID:28229988

  4. Transendoscopic Nd:YAG ablation of cystic lesions in 27 large animals: 1986-1995

    Science.gov (United States)

    Tate, Lloyd P.

    1997-05-01

    Hospital medical surgery records and laser logs were examined to determine the population of large animals presented to the College of Veterinary Medicine treated by laser and conventional means for cystic lesions. Cystic lesions were most frequently found in 2 anatomical locations: endometrial cysts and upper respiratory cysts. The majority of endometrial cysts were considered to be acquired, whereas the most frequently encountered upper respiratory cysts were believed to be congenital due to the fact they were most frequently seen in young animals. Nine mares, totaling 42 endometrial cysts, were presented to the Veterinary Teaching Hospital (VTH), all of which had been treated by transendoscopic Nd:YAG laser ablation. Eighteen of the respiratory cysts in the same time period were presented to the VTH, of which 10 received conventional surgery and 8 were laser photoablated. Respiratory cysts treated by conventional surgery were generally found in locations inaccessible to visualization by transendoscopic technique, and thus required a surgical approach under general anesthesia. All mares with endometrial cysts were presented with a history of conception failure. After laser ablation, a majority of the mares were able to carry a foal to term and none represented with recurrence of endometrial cysts. Horses that presented with upper respiratory cysts also did not experience recurrence of cysts; although several horses, 1 treated by laser ablation and 4 treated by conventional surgery for frontal and/or maxillary sinus cysts, had transitory sinusitis. Transendoscopic Nd:YAG photoablation of cysts appears to be a very satisfactory means of treating this particular form of lesion in large animals with minimal complications and it can be performed with the animal in a standing position as an outpatient.

  5. Comparison of diagnostic accuracy between endometrial curettage and pipelle aspiration biopsy in patients treated with progestin for endometrial hyperplasia: a Korean Gynecologic Oncology Group Study (KGOG 2019).

    Science.gov (United States)

    Kim, Mi Kyoung; Seong, Seok Ju; Lee, Taek Sang; Ki, Kyung-Do; Lim, Myong Cheol; Kim, Yun Hwan; Kim, Kidong; Joo, Won Duk

    2015-10-01

    A prospective multicenter trial has been started in Korea to evaluate the diagnostic accuracy of endometrial aspiration biopsy compared with dilatation and curettage in patients treated with progestin for endometrial hyperplasia. For conservative treatment of endometrial hyperplasia, orally administered progestins are most commonly used method with various treatment regimens and more recently, the levonorgestrel-releasing intrauterine system also has been used successfully to treat endometrial hyperplasia. However, there is no report about the accuracy of endometrial sampling during hormonal treatment for follow-up evaluation of endometrial hyperplasia. Patients with histologically confirmed endometrial hyperplasia are offered hormonal treatment with any one of the following three options: oral medroxyprogesterone acetate 10 mg/day for 14 days per cycle, continuous oral medroxyprogesterone acetate 10 mg/day or insertion of levonorgestrel-releasing intrauterine system. Histological surveillance is performed at 3 months or 6 months following initial treatment. Endometrial tissues are obtained via endometrial aspiration biopsy using a pipelle and dilatation and curettage. In the case of levonorgestrel-releasing intrauterine system, endometrial aspiration biopsy will be done with levonorgestrel-releasing intrauterine system in uterus and then, after the removal of levonorgestrel-releasing intrauterine system, dilatation and curettage will be done. The biopsy findings will be compared. The primary endpoint is to compare the pathological outcome of endometrial aspiration with dilatation and curettage. The secondary endpoint is the response rate with three types of progestin treatment at 6 months.

  6. Role of transvaginal sonography (TVS) in the detection of endometrial hyperplasia.

    Science.gov (United States)

    Showkat, M S; Khondker, L; Nabi, S; Bhowmik, B

    2014-07-01

    Transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology. A cross sectional study was done with forty patients to evaluate the clinical usefulness of transvaginal ultrasonography (TVS) in pre, peri and post menopausal women suspected to have endometrial hyperplasia.. The study was carried out January 2007 to November 2008 for a period of two years. The patients having endometrial hyperplasia diagnosed by TVS were correlated with histopathological diagnosis. Of total 40 cases, 18(45.0%) cases were endometrial hyperplasia and 22(55.0%) were negative for endometrial hyperplasia respectively in TVS findings. Only 2 cases were found as negative for endometrial hyperplasia in histopathology among the all suspected endometrial hyperplasia, which were diagnosed by TVS. On the other hand 17(42.5%) cases were endometrial hyperplasia and 23(57.5%) cases were negative for endometrial hyperplasia in histopathological findings. Among 22 negative for endometrial hyperplasia cases which were diagnosed by TVS, 1 case was endometrial hyperplasia and the rest 21 cases were negative for endometrial hyperplasia in histopathological findings. The validity of TVS in diagnosis of endometrial hyperplasia were studied by calculating sensitivity, specificity, accuracy, positive predictive value, which were 94%, 92%, 93%, 89% and 96% respectively. As the TVS findings of the present study correlated well with the histopathology findings and the validity test values were higher than observed by others, it can be concluded that TVS is sensitive and accurate modality in the evaluation of endometrial hyperplasia.

  7. Research Progress of Correlation between Progesterone Receptor and Endometrial Cancer%孕激素受体与子宫内膜癌关系的研究进展

    Institute of Scientific and Technical Information of China (English)

    杨达平

    2011-01-01

    孕激素受体与子宫内膜癌关系密切,其在子宫癌组织中的表达水平可以综合反映病程、病变性质,同时可作为预测预后的指标.癌变的子宫内膜中,孕激素受体含量显著低于正常子宫内膜,且随子宫内膜增生的程度呈下降趋势.孕激素对内膜细胞和内膜癌细胞的作用是多环节的,但具体机制不明.在此旨在更深入地了解孕激素受体与子宫内膜癌的关系,以及应用孕激素治疗子宫内膜癌的可能机制.%Progesterone receptor and endometrial cancer are closely related,the expression level of which in endometrial cancer tissue is a comprehensive reflection of the disease course, nature of the lesion and a prognostic index. Progesterone receptor content in cancerous endometrium is significantly lower than in the normal,and decline trend is seen as the endometrial hyperplasia degree increases. Progesterone function on the endometrial cells and endometrial cancer cells is a multi-link,however the specific mechanism is still not clear. Here is to make a deeper understanding of progesterone receptors in endometrial carcinoma, as well as possible mechanisms of the application of progesterone treating endometrial cancer.

  8. Preserving fertility in young patients with endometrial cancer: current perspectives

    Directory of Open Access Journals (Sweden)

    Kalogera E

    2014-07-01

    Full Text Available Eleftheria Kalogera, Sean C Dowdy, Jamie N Bakkum-Gamez Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, USA Abstract: Endometrial cancer (EC is the most common gynecologic malignancy in developed countries and affects predominantly postmenopausal women. It is estimated, however, that 15%–25% of women will be diagnosed before menopause. As more women choose to defer childbearing until later in life, the feasibility and safety of fertility-sparing EC management have been increasingly studied. Definitive treatment of total hysterectomy and bilateral salpingo-oophorectomy precludes future fertility and may thus be undesirable by women who wish to maintain their reproductive potential. However, the consideration of conservative management carries the oncologic risks of unstaged EC and the risk of missing a synchronous ovarian cancer. It is further complicated by the lack of consensus regarding the initial assessment, treatment, and surveillance. Conservative treatment with progestins has been shown to be a feasible and safe fertility-sparing approach for women with low grade, early stage EC with no myometrial invasion. The two most commonly adopted regimens are medroxyprogesterone acetate at 500–600 mg daily and megestrol acetate at 160 mg daily for a minimum of 6–9 months, with initial response rates commonly reported between 60% and 80% and recurrence rates between 25% and 40%. Photodynamic therapy and hysteroscopic EC excision have recently been reported as alternative approaches to progestin therapy alone. However, limited efficacy and safety data exist. Live birth rates after progestin therapy have typically been reported around 30%; however, when focusing only on those who do pursue fertility after successful treatment, the live birth rates were found to be higher than 60%. Assisted reproductive technology has been associated with a higher live birth rate compared with spontaneous conception, most likely reflecting the

  9. Endometrial regeneration using autologous adult stem cells followed by conception by in vitro fertilization in a patient of severe Asherman′s syndrome

    Directory of Open Access Journals (Sweden)

    Chaitanya B Nagori

    2011-01-01

    Full Text Available In a woman with severe Asherman′s syndrome, curettage followed by placement of intrauterine contraceptive device (IUCD (IUCD with cyclical hormonal therapy was tried for 6 months, for development of the endometrium. When this failed, autologous stem cells were tried as an alternative therapy. From adult autologous stem cells isolated from patient′s own bone marrow, endometrial angiogenic stem cells were separated using immunomagnetic isolation. These cells were placed in the endometrial cavity under ultrasound guidance after curettage. Patient was then given cyclical hormonal therapy. Endometrium was assessed intermittently on ultrasound. On development of endometrium with a thickness of 8 mm and good vascularity, in vitro fertilization and embryo transfer was done. This resulted in positive biochemical pregnancy followed by confirmation of gestational sac, yolk sac, and embryonic pole with cardiac activity on ultrasound. Endometrial angiogenic stem cells isolated from autologous adult stem cells could regenerate injured endometrium not responding to conventional treatment for Asherman′s syndrome.

  10. Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia

    Directory of Open Access Journals (Sweden)

    George S. Karagiannis

    2011-01-01

    Full Text Available An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomyosis, and cystic endometrial hyperplasia. Interestingly, such combination was never encountered before in dogs. Although uterine leiomyoma is quite usual in the reproductive system of female dogs, this case resembled relevant cases of human uterine adenomyomas in morphology, and thus it was offered a similar tentative diagnosis.

  11. Effect of serum HE4 and CP2 contents on expression of clinical pathological molecules and proliferation molecules in tumor tissue of patients with endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Zhe Zhou; Xin Jiang; Ji-Cheng Song; Hong-Yan Jia

    2016-01-01

    Objective:To study the effect of serum HE4 and CP2 contents on the expression of clinical pathological molecules and proliferation molecules in tumor tissue of patients with endometrial carcinoma.Methods:A total of 40 cases of patients who were diagnosed with endometrial carcinoma in our hospital from May 2013 to March 2016 as well as 40 cases of healthy volunteers who received physical examination in our hospital during the same period were selected for study, serum samples were collected to detect HE4, c-myc, ZEB1, CP2, sTn, CA125, CA199 contents, and endometrial carcinoma tissue as well as para-carcinoma tissue were collected to detect P53, E-cad, EpCAM, C-erbB-2, Ki-67 and MACC1 contents.Results:Serum CP2 and HE4 contents of patients with endometrial carcinoma were significantly higher than those of healthy volunteers, and serum CP2 and HE4 contents of endometrial carcinoma patients with FIGO III-IV stage, low differentiation, muscular layer involvement more than 1/2 and cervical involvement were significantly higher than those of endometrial carcinoma patients with FIGO I-II stage, middle and high differentiation, muscular layer involvement less than 1/2 and without cervical involvement; serum CA125, CA199, c-myc, sTn and ZEB1 contents of patients with endometrial carcinoma were significantly higher than those of healthy volunteers and positively correlated with serum HE4 and CP2; P53 and E-cad contents in endometrial carcinoma tissue were significantly lower than those in para-carcinoma tissue and negatively correlated with serum HE4 and CP2, and EpCAM, C-erbB-2, Ki-67 and MACC1 contents were significantly higher than those in para-carcinoma tissue and positively correlated with serum HE4 and CP2.Conclusions:Serum HE4 and CP2 contents abnormally increase in patients with endometrial carcinoma, and serum HE4 and CP2 can be used to assess the clinical pathology of tumor as well as the degree of tumor tissue proliferation.

  12. Valoración de las lesiones oculares producidas en los accidentes de tráfico Assessment of ocular injuries due to traffic accidents

    Directory of Open Access Journals (Sweden)

    J.A. Menéndez

    2008-01-01

    Full Text Available Objetivo: Analizar cómo se realiza, desde el punto de vista pericial, la valoración de las lesiones y secuelas oculares de los accidentes de tráfico en nuestro medio. Método: Hemos realizado un estudio retrospectivo de 127 informes sobre lesiones oculares realizados en la Sección de Oftalmología de la Clínica Médico Forense de Madrid durante cinco años (del 2002 al 2006, analizando las siguientes variables: la proporción que representan los accidentes de tráfico (ATF, el tipo de lesión producida en el ATF, la duración media de la baja, las secuelas más frecuentes y la puntuación total media asignada a estas secuelas oculares. Resultados: Los ATF son la causa de la cuarta parte de las secuelas oculares que vemos. Las lesiones más frecuentemente producidas son traumatismos cráneo-encefálicos, contusiones oculares directas y esguinces cervicales. Hemos hallado un alto porcentaje de casos (22%, en los que no encontramos lesiones objetivas que justifiquen las molestias alegadas por el lesionado, o bien estas no guardan relación evidente con el accidente de tráfico sufrido. Conclusiones: Que los ATF son una de las causas más frecuentes de secuelas oculares (diplopias, disminuciones de agudeza visual…, con una puntuación media de 15 puntos y una duración media de la baja de 71 días, hay un importante porcentaje de reclamaciones injustificadas. Considera necesario revisar el actual Baremo de la Ley 34/2003, subsanando los errores y deficiencias que presenta, e incluyendo secuelas oculares típicamente postraumáticas que actualmente no recoge, para facilitar la valoración de las secuelas oculares.Aim: To analyse how it is performed, from expert evidence view point, the assessment of ocular injuries and after-effects due to traffic accidents in our area. Method: We have accomplished a retrospective study of 127 reports on ocular injuries, carried out in the Ophthalmologic Section of the Medical Forensic Clinic of Madrid for

  13. Study to assess the acceptability and feasibility of cervical cancer screening using visual inspection with acetic acid and treatment of precancerous lesions using cryotherapy in low resource settings

    Directory of Open Access Journals (Sweden)

    Tosha M. Sheth

    2014-06-01

    Full Text Available Background: Objective of current study was to assess the acceptability and feasibility of cervical cancer screening using VIA, and treatment of precancerous lesions using cryotherapy in low resource settings Methods: 526 women from three primary health centers of Shinor taluka (population based approach and 250 women of Medical College, Vadodara (facility based approach were sensitized and screened for cervical cancer. Visual Inspection with Acetic acid (VIA was performed as the screening test. In the population based approach, VIA positive women were referred to a Community Health Centre (CHC for colposcopy and biopsy. Ablative treatment in the form of cryotherapy was offered. Patients requiring higher forms of treatment were referred to medical college, Vadodara. In the facility based approach, VIA positive women underwent colposcopy. Guided biopsy was performed in those with positive lesions on colposcopy. Cryotherapy was offered in the same sitting. Those not suitable for cryotherapy were offered loop electrosurgical excision procedure. Women found to have invasive cancer were offered definitive management. Results: VIA positivity rate was 18.8% in the population based approach and 27.2% in the facility based approach.58.8% women in the population based approach and 77.77% women in the facility based approach were treated with cryotherapy on the same day as screening and none reported any severe side effects. Dropout rate in the community approach was 32.32% whereas in the facility it was 0.4%. Conclusions: VIA and cryotherapy procedures were well tolerated by all screened women. This project has shown that the and ldquo;screen and treat and rdquo; approach can be successfully implemented in the existing health setup. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 615-621

  14. Long-term impact of preeclampsia on maternal endometrial cancer risk

    DEFF Research Database (Denmark)

    Hallum, Sara; Pinborg, Anja; Kamper-Jørgensen, Mads

    2016-01-01

    BACKGROUND: Endometrial cancer is mainly dependent on oestrogen exposure. Preeclampsia has shown to reduce oestrogen levels hence preeclampsia may affect later endometrial cancer risk. METHODS: We conducted a case-control study of 523 Danish women with endometrial cancer and 52 299controls during...... 1978-2010. The association between preeclampsia and later endometrial cancer was evaluated overall and according to preeclampsia onset and type of endometrial cancer in conditional logistic regression models. RESULTS: We observed no overall association between preeclampsia and endometrial cancer risk...... (OR=1.11 (95% CI 0.68-1.81)). This was true for all endometrial cancer subtypes. In an analysis of preeclampsia onset, however, we report a markedly increased risk of endometrial cancer following early-onset preeclampsia (OR=2.64 (95% CI 1.29-5.38)). CONCLUSIONS: Although we report no obvious...

  15. FREQUENT DELETION OF MTS1/p16 GENE AND CORRELATION WITH CLINICOPATHOLOGICAL PARAMETERS IN ENDOMETRIAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    Zhou Chunxiao; Sun Jianheng; Lu Shixin; Jin Shunqian; Liu Hailing; Sheng Xiugui

    1998-01-01

    Objective:To investigate the possible relationship between deletion of MTS/p16 gene and progression of endometrial carcinoma. Methods: Forty-six primary endometrial carcinoma, 7 tumor-adjacent endometrial tissue, 10 normal endometrial tissue specimen and 5 xenografts from patients with endometrial carcinoma were examined for homozygous deletion of MTS/p16 gene by polymerase chain reaction-based analysis. Results: Of 46 endometrial cancer specimens, 9 showed homozygous deletion, no deletion was detected in the tumor-adjacent and normal endometial tissues. Nor was it detected in well-differentiated endometrial carcinoma and all xenografts. Conclusions: Deletion of MTS1/p16 gene might contribute to the progression of endometrial carcinoma and could be served as indicator for predicting prognosis.

  16. Reproducibility of current classifications of endometrial endometrioid glandular proliferations : further evidence supporting a simplified classification

    NARCIS (Netherlands)

    Ordi, Jaume; Bergeron, Christine; Hardisson, David; McCluggage, W. Glenn; Hollema, Harry; Felix, Ana; Soslow, Robert A.; Oliva, Esther; Tavassoli, Fattaneh A.; Alvarado-Cabrero, Isabel; Wells, Michael; Nogales, Francisco F.

    2014-01-01

    AimsTo compare the reproducibility of the current (2003) World Health Organization (WHO), endometrial intraepithelial neoplasia (EIN) and European Working Group (EWG) classifications of endometrial endometrioid proliferations. Methods and resultsNine expert gynaecological pathologists from Europe an

  17. The expression and significance of mucin in Endometrial Hyperplasia%粘蛋白在子宫内膜增生性病变的表达及意义

    Institute of Scientific and Technical Information of China (English)

    李化敏; 焦宇飞

    2013-01-01

    子宫内膜增生性病变(Endometrial hyperplasia,EH)是女性常见病,可经增生、不典型增生,最后发展为子宫内膜癌.已报道粘蛋白在不同器官的肿瘤中表达且与肿瘤的发生、进展及预后相关.粘蛋白的表达与子宫内膜癌的发生、进展有一定的相关性,本文对粘蛋白在子宫内膜增生性病变和子宫内膜癌中的表达及意义做简要介绍.%Endometrial hyperplasia is a common entity which may result in endometrial carcinoma through atypical hyperplasia.It has been repoted that mucins (MUC) expressed in tumors of various organs and its expression in tumors is related to the carcinogenesis,progression and prognosis of various cancers.We review the expression of MUC and its significance in endometrial hyperplasia lesion and endometrial carcinoma.

  18. Factitious lesions of the hand

    Directory of Open Access Journals (Sweden)

    Ricardo Kaempf de Oliveira

    2013-08-01

    Full Text Available OBJECTIVE: The presence of a lesion with atypical presentation, obscure clinical history, which does not improve with classic treatments, shall raise the red flag of the medical team. In such cases, the hypothesis of a factitious lesion shall be considered. Many times the correct diagnosis on the initial assessment may avoid high-cost diagnostic tests, unnecessary treatments, and time consumption of the medical team. We present here two classic cases of factitious lesions that, similar to those described in the literature, is difficult to diagnose and difficult to treat.

  19. Virtual histology-intravascular ultrasound assessment of lesion coverage after angiographically-guided stent implantation in patients with ST Elevation myocardial infarction undergoing primary percutaneous coronary intervention.

    Science.gov (United States)

    Legutko, Jacek; Jakala, Jacek; Mintz, Gary S; Wizimirski, Marcin; Rzeszutko, Lukasz; Partyka, Lukasz; Mrevlje, Blaz; Richter, Angela; Margolis, Pauliina; Kaluza, Grzegorz L; Dudek, Dariusz

    2012-05-15

    An occlusion or severe stenosis (angiographic culprit lesion) of the infarct-related artery is frequently located at the site of the maximum thrombus burden, whereas the origin of the plaque rupture (the true culprit) can be situated proximal or distal to it. The aim of this study was to examine stent coverage of true culprit lesions in 20 patients who underwent primary percutaneous coronary intervention and had Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow restored in the infarct-related artery by angiographically guided direct stenting. Images of lesions were obtained using virtual histology-intravascular ultrasound before and after intervention (blinded to the operator). Plaque rupture sites were identified by intravascular ultrasound in 12 lesions (60%), 11 proximal and 1 distal to the minimum luminal area (MLA). Maximum necrotic core sites were found proximal to the MLA in 16 lesions, at the MLA in 3 lesions, and distal to the MLA in 1 lesion. Plaque rupture sites were fully covered by stents in 11 lesions. Virtual histology-intravascular ultrasound-derived thin-cap fibroatheroma longitudinal geographic misses were found in 10 lesions, 7 in the proximal reference segment and in 3 patients in the proximal and distal reference segments. In conclusion, in about 50% of patients who undergo primary percutaneous coronary intervention for ST-segment elevation myocardial infarction with optimal angiographic results, the stent does not fully cover the maximum necrotic core site related to the culprit lesion.

  20. Prognostic significance of miR-205 in endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Mihriban Karaayvaz

    Full Text Available PURPOSE: microRNAs have emerged as key regulators of gene expression, and their altered expression has been associated with tumorigenesis and tumor progression. Thus, microRNAs have potential as both cancer biomarkers and/or potential novel therapeutic targets. Although accumulating evidence suggests the role of aberrant microRNA expression in endometrial carcinogenesis, there are still limited data available about the prognostic significance of microRNAs in endometrial cancer. The goal of this study is to investigate the prognostic value of selected key microRNAs in endometrial cancer by the analysis of archival formalin-fixed paraffin-embedded tissues. EXPERIMENTAL DESIGN: Total RNAs were extracted from 48 paired normal and endometrial tumor specimens using Trizol based approach. The expression of miR-26a, let-7g, miR-21, miR-181b, miR-200c, miR-192, miR-215, miR-200c, and miR-205 were quantified by real time qRT-PCR expression analysis. Targets of the differentially expressed miRNAs were quantified using immunohistochemistry. Statistical analysis was performed by GraphPad Prism 5.0. RESULTS: The expression levels of miR-200c (P<0.0001 and miR-205 (P<0.0001 were significantly increased in endometrial tumors compared to normal tissues. Kaplan-Meier survival analysis revealed that high levels of miR-205 expression were associated with poor patient overall survival (hazard ratio, 0.377; Logrank test, P = 0.028. Furthermore, decreased expression of a miR-205 target PTEN was detected in endometrial cancer tissues compared to normal tissues. CONCLUSION: miR-205 holds a unique potential as a prognostic biomarker in endometrial cancer.

  1. Differentiation of the endometrial macrophage during pregnancy in the cow.

    Directory of Open Access Journals (Sweden)

    Lilian J Oliveira

    Full Text Available BACKGROUND: The presence of conceptus alloantigens necessitates changes in maternal immune function. One player in this process may be the macrophage. In the cow, there is large-scale recruitment of macrophages expressing CD68 and CD14 to the uterine endometrium during pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, the function of endometrial macrophages during pregnancy was inferred by comparison of the transcriptome of endometrial CD14(+ cells isolated from pregnant cows as compared to that of blood CD14(+ cells. The pattern of gene expression was largely similar for CD14(+ cells from both sources, suggesting that cells from both tissues are from the monocyte/macrophage lineage. A total of 1,364 unique genes were differentially expressed, with 680 genes upregulated in endometrial CD14(+ cells as compared to blood CD14(+ cells and with 674 genes downregulated in endometrial CD14(+ cells as compared to blood CD14(+ cells. Twelve genes characteristic of M2 activated macrophages (SLCO2B1, GATM, MRC1, ALDH1A1, PTGS1, RNASE6, CLEC7A, DPEP2, CD163, CCL22, CCL24, and CDH1 were upregulated in endometrial CD14(+ cells. M2 macrophages play roles in immune regulation, tissue remodeling, angiogenesis and apoptosis. Consistent with a role in tissue remodeling, there was over-representation of differentially expressed genes in endometrium for three ontologies related to proteolysis. A role in apoptosis is suggested by the observation that the most overrepresented gene in endometrial CD14(+ cells was GZMA. CONCLUSIONS: Results indicate that at least a subpopulation of endometrial macrophages cells differentiates along an M2 activation pathway during pregnancy and that the cells are likely to play roles in immune regulation, tissue remodeling, angiogenesis, and apoptosis.

  2. Psychometric validation of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24)

    DEFF Research Database (Denmark)

    Greimel, Elfriede; Nordin, Andy; Lanceley, Anne;

    2011-01-01

    A validation study was conducted to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24). This module was designed to assess disease and treatment specific aspects...

  3. HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL

    OpenAIRE

    García Ayala,Ernesto; Cárdenas Mastrascusa,Laura; Sandoval Martínez,Diana; Mayorga Anaya,Henry

    2010-01-01

    Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/biopsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en leg...

  4. Is aromatase cytochrome P450 involved in the pathogenesis of endometrioid endometrial cancer?

    NARCIS (Netherlands)

    Jongen, VHWM; Thijssen, JHH; Hollema, H; Donker, GH; Santema, JG; Van Der Zee, AGJ; Heineman, MJ

    2005-01-01

    Prospectively, the relationship between androgen levels in the utero-ovarian circulation, aromatase activity in endometrial and body fat tissue, and the presence or absence of endometrioid endometrial cancer was studied in postmenopausal women. In 43 women with endometrioid endometrial cancer and 8

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  9. Nuclear characteristics of the endometrial cytology: liquid-based versus conventional preparation.

    Science.gov (United States)

    Norimatsu, Yoshiaki; Shigematsu, Yumie; Sakamoto, Shingo; Ohsaki, Hiroyuki; Yanoh, Kenji; Kawanishi, Namiki; Kobayashi, Tadao K

    2013-02-01

    The aim of this study was to assess the utility of liquid-based cytologic preparation (LP) compared with conventional preparation (CP) for the assessment of nuclear findings in endometrial glandular and stromal breakdown (EGBD) which may be misdiagnosed as carcinoma in EGBD cases. The material consists of cytologic smears including 20 cases of proliferative endometrium (PE), 20 cases of EGBD, and 20 cases of endometrioid adenocarcinoma grade1 (G1) for which histopathological diagnosis was obtained by endometrial curettage at the JA Suzuka General Hospital. Nuclear findings were examined in PE cells, EGBD-stromal cells, EGBD-metaplastic cells, and G1 cells, respectively. It was examined about the following items; (1) nuclear shape; (2) A long/minor axis ratio in cell nuclei; (3) an area of cell nuclei; (4) overlapping nuclei. Results are as follows: (1) nuclear shape; as for the reniform shape of EGBD-stromal cells and spindle shape of EGBD-metaplastic cells, the ratio of the LP method was a higher value than the CP method. (2) The long axis and area of cell nuclei; LP in all groups was a recognizable tendency for nuclear shrinkage. (3) The long/minor axis ratio in cell nuclei; only EGBD-metaplastic cells recognize a significant difference between CP and LP. (4) Overlapping nuclei; LP was a higher value in comparison with CP in the other groups except PE cells, and the degree of overlapping nuclei was enhanced about three times. Therefore, although a cell of LP has a shrinking tendency, (1) it is excellent that LP preserves a characteristic of nuclear shape than CP; (2) a cellular characteristic becomes clearer, because three-dimensional architecture of LP is preserved of than CP. As for the standard preparation method for endometrial cytology samples, we considered that a concrete introduction of the LP method poses no problems.

  10. Endoglin, VEGF, and its receptors in predicting metastases in endometrial carcinoma.

    Science.gov (United States)

    Saarelainen, Sami K; Staff, Synnöve; Peltonen, Nina; Lehtimäki, Terho; Isola, Jorma; Kujala, Paula M; Vuento, Maarit H; Mäenpää, Johanna U

    2014-05-01

    Preoperative evaluation of the risk for metastases in endometrial carcinoma is challenging. The growth of new vessels, angiogenesis, is important for tumor growth and purported to be involved in the metastatic process. The aim of this study was to evaluate the significance of preoperative serum levels and immunohistochemical expression of angiogenic markers in predicting a metastasized disease. Preoperative sera from 98 consecutive women presenting with endometrial carcinoma were collected. Serum concentrations of VEGF, sFLT1, and CD105 were assessed by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry was used to assess the expression of CD105, VEGF, FLT1, and KDR. The results were correlated to the presence of metastases, presence of deep (≥50%) myometrial invasion, and the histological grade of the tumor. Tumors with other than endometrioid histology were excluded. Of the 80 evaluable patients, 11 had a metastasized disease. The serum concentration of VEGF was higher in the group with metastases than in the group without metastases (median [range], 743 pg/mL [546-1,183 pg/mL] vs. 383 pg/mL [31-1,524 pg/mL], p < 0.001, respectively). In the multivariable analysis, the concentration of VEGF was the sole independent, albeit weak predictive factor for the presence of metastases (odds ratio, 1.004, 95% confidence interval, 1.002-1.007; p = 0.001). The immunohistochemical expression of the markers was not associated with any of the clinicopathological features of the tumors. The results of the present study suggest that preoperative serum VEGF concentration correlates with the presence of metastases in endometrioid endometrial carcinoma.

  11. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    Directory of Open Access Journals (Sweden)

    Adriana Bittencourt Campaner

    2004-02-01

    with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2 was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%; atrophic endometrium in 15 patients (12.4%; senile synechia in 15 patients (12.4%, focal thickening in 13 patients (10.7%; cerebroid lesion in 6 patients (5.0%; proliferative endometrium in 5 patients (4.1%; mucus in 5 patients (4.1%; myoma in 4 patients (3.3%; secreting endometrium in 3 patients (2.5%; endometrial hyperplasia in 3 patients (2.5%; and cystic atrophy in 1 patient (0.8%. Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

  12. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Directory of Open Access Journals (Sweden)

    Jennifer Prescott

    Full Text Available Genome-wide association studies (GWAS have identified common variants that predispose individuals to a higher body mass index (BMI, an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002. For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%. However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78. Heterogeneity by BMI did not reach statistical significance (P = 0.06, and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58. In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5. Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  13. DISTINGUISHING FEATURES OF ENDOMETRIAL PATHOLOGY FOLLOWING EXPOSURE TO THE PROGESTERONE RECEPTOR MODULATOR MIFEPRISTONE

    Science.gov (United States)

    Fiscella, Julietta; Bonfiglio, Thomas; Winters, Paul; Eisinger, Steven H; Fiscella, Kevin

    2011-01-01

    There is growing interest in use of progesterone receptor modulators (PRM) such as mifepristone for treatment of gynecological and other conditions, but interest in PRMs is dampened by effects of the agents on the endometrium. In this study, we examined the endometria of women exposed to mifepristone for treatment of leiomyomas in doses of 2.5 mg and 5 mg and compared them to unexposed endometria. We assessed the reliability of these features by comparing agreement in ratings between pathologists who were blinded to each other's readings. We assessed distinguishing features between exposed and unexposed groups by comparing frequency of features between groups. We found that key features could be reliably assessed by pathologists experienced in endometrial pathology. We observed several features (non synchronous endometrium, large fluid filled glands and abnormal blood vessels) that distinguished endometrial samples that were and were not exposed to the drug. These findings suggest several features that can be tracked during studies involving mifepristone and potentially other PRMs. PMID:21315422

  14. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

    Science.gov (United States)

    Vaidya, S; Lakhey, M; Vaidya, S; Sharma, P K; Hirachand, S; Lama, S; KC, S

    2013-03-01

    Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

  15. The role of body weight in the relationship between physical activity and endometrial cancer: results from a large cohort of US women.

    Science.gov (United States)

    Patel, Alpa V; Feigelson, Heather Spencer; Talbot, Jeffrey T; McCullough, Marjorie L; Rodriguez, Carmen; Patel, Roshni C; Thun, Michael J; Calle, Eugenia E

    2008-10-15

    Factors influencing circulating estrogen levels, insulin-mediated pathways or energy balance through obesity-related mechanisms, such as physical activity, have been proposed as potential risk factors for endometrial cancer. We examined measures of physical activity in relation to endometrial cancer risk in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, a prospective study of cancer incidence and mortality, using information obtained at baseline in 1992. From 1992 to 2003, 466 incident endometrial cancers were identified among 42,672 postmenopausal women with intact uteri who were cancer-free at enrollment. Cox proportional hazards modeling was used to compute hazard rate ratios (RR) while adjusting for potential confounders. To assess the role of body mass index (BMI) in this relationship, we computed multivariate RR with and without adjustment for BMI and stratifying by BMI. All measures of physical activity and the avoidance of sedentary behavior were associated with lower endometrial cancer risk. Baseline recreational physical activity was associated with 33% lower risk (RR = 0.67, 95% CI 0.44-1.03 for 31.5+ vs. <7 MET-hr/week, trend p = 0.007) in the multivariate model without BMI. However, the trend was attenuated after further adjustment for BMI (trend p = 0.18). BMI significantly modified the association between physical activity and endometrial cancer risk (heterogeneity of trends p = 0.01). The inverse relationship was seen only among overweight or obese women (trend p = 0.003) and not in normal weight women (trend p = 0.51). In summary, light and moderate physical activity including daily life activities were associated with lower endometrial cancer risk in our study, especially among women who are overweight or obese.

  16. Association of the Apolipoprotein E 2 Allele with Concurrent Occurrence of Endometrial Hyperplasia and Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    Tatiana I. Ivanova

    2015-01-01

    Full Text Available Genes encoding proteins with antioxidant properties may influence susceptibility to endometrial hyperplasia (EH and endometrial carcinoma (ECa. Patients with EH (n = 89, EH concurrent with ECa (n = 76, ECa (n = 186, and healthy controls (n = 1110 were genotyped for five polymorphic variants in the genes involved in metabolism of lipoproteins (APOE Cys112Arg and Arg158Cys, iron (HFE Cys282Tyr and His63Asp, and catecholamines (COMT Val158Met. Patients and controls were matched by ethnicity (all Caucasians, age, body mass index (BMI, and incidence of hypertension and diabetes. The frequency of the APOE E 2 allele (158Cys was higher in patients with EH + ECa than in controls (P = 0.0012, PBonferroni = 0.018, OR = 2.58, 95% CI 1.49–4.45. The APOE E 4 allele (112Arg was more frequently found in patients with EH than in controls and HFE minor allele G (63Asp had a protective effect in the ECa group, though these results appeared to be nonsignificant after correction for multiple comparisons. The results of the study indicate that E 2 allele might be associated with concurrent occurrence of EH and ECa.

  17. Metastatic endometrial stromal sarcoma: a case report

    Directory of Open Access Journals (Sweden)

    Shobha S. Pillai

    2014-06-01

    Full Text Available Endometrial Stromal Sarcoma (ESS is a rare slow growing tumour of mesodermal origin arising from the stroma of the endometrium and accounting for less than 1% of all uterine cancers. It is characterized by late recurrences and distant metastases. This report presents a case of ESS in a 40 year old nulliparous woman who had a myomectomy for a clinically suspected Leiomyoma uterus in a local hospital. The histopathological examination of the specimen revealed ESS and the patient was referred to our tertiary institute. Here after investigations including a CT scan which also revealed pulmonary metastases, patient underwent Modified Radical Hysterectomy with Bilateral Salpingo-oophorectomy with pelvic lymph node sampling. Histopathological Examination of the uterine specimen confirmed the diagnosis. The patient was given the option of referral to a thoracic surgeon for resection of the isolated lung metastasis, but she refused this and opted instead for hormone therapy which she is presently undergoing. ESS is a very rare tumour often presenting with clinical and examination findings suggestive of leiomyoma of the uterus and hence misdiagnosed. In cases of rapidly growing tumours and suspicious radiological features, suspect sarcoma and initiate timely diagnosis and proper treatment. Recommended long-term follow up in view of late recurrences. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 812-815

  18. Lower Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Promotes the Proliferation and Migration of Endometrial Carcinoma

    Science.gov (United States)

    Xia, Xian; Wang, Jie; Liu, Yuan; Yue, Ming

    2017-01-01

    Background The incidence and death rates of endometrial cancer are alarmingly increasing. The diagnosis and treatment of endometrial cancer is crucial to decreasing mortality. Cystic fibrosis transmembrane conductance regulator (CFTR) belongs to the adenosine triphosphate (ATP)-binding cassette transporter family and plays an essential role in anion regulation and tissue homeostasis of various epithelia. This study explored the expression of CFTR in endometrial carcinoma and the role of CFTR in proliferation and migration of endometrial carcinoma cells. Material/Methods Immunohistochemistry and real-time (RT)-PCR were used to test the expression of CFTR in normal endometrium and endometrial carcinoma. CFTR inhibitor was used to restrain the expression of CFTR on the endometrial carcinoma, the effects on the proliferation and migration of endometrial carcinoma cells were also studied. RT-PCR was performed to test the expression of mir-125b after restraining CFTR. Proliferation and migration capability of endometrial carcinoma cells were detected after transfection of endometrial carcinoma cells with mir-125b mimic. Results Compared with cells from normal endometrium, the expression of CFTR was significantly upregulated in endometrial carcinoma cells. After adding CFTR(inh)172, the capability for proliferation and transfer of endometrial carcinoma cells was strengthened, the expression of mir-125b was reduced, and after transfection with mir-125b mimics entering the endometrial carcinoma cells, the ability of the proliferation and transfer of endometrial carcinoma cells was also reduced. Conclusions The high expression of CFTR in the endometrial carcinoma cells played a pivotal role in restraining the proliferation and transfer of endometrial carcinoma cells. PMID:28225751

  19. Lower Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Promotes the Proliferation and Migration of Endometrial Carcinoma.

    Science.gov (United States)

    Xia, Xian; Wang, Jie; Liu, Yuan; Yue, Ming

    2017-02-22

    BACKGROUND The incidence and death rates of endometrial cancer are alarmingly increasing. The diagnosis and treatment of endometrial cancer is crucial to decreasing mortality. Cystic fibrosis transmembrane conductance regulator (CFTR) belongs to the adenosine triphosphate (ATP)-binding cassette transporter family and plays an essential role in anion regulation and tissue homeostasis of various epithelia. This study explored the expression of CFTR in endometrial carcinoma and the role of CFTR in proliferation and migration of endometrial carcinoma cells. MATERIAL AND METHODS Immunohistochemistry and real-time (RT)-PCR were used to test the expression of CFTR in normal endometrium and endometrial carcinoma. CFTR inhibitor was used to restrain the expression of CFTR on the endometrial carcinoma, the effects on the proliferation and migration of endometrial carcinoma cells were also studied. RT-PCR was performed to test the expression of mir-125b after restraining CFTR. Proliferation and migration capability of endometrial carcinoma cells were detected after transfection of endometrial carcinoma cells with mir-125b mimic. RESULTS Compared with cells from normal endometrium, the expression of CFTR was significantly upregulated in endometrial carcinoma cells. After adding CFTR(inh)172, the capability for proliferation and transfer of endometrial carcinoma cells was strengthened, the expression of mir-125b was reduced, and after transfection with mir-125b mimics entering the endometrial carcinoma cells, the ability of the proliferation and transfer of endometrial carcinoma cells was also reduced. CONCLUSIONS The high expression of CFTR in the endometrial carcinoma cells played a pivotal role in restraining the proliferation and transfer of endometrial carcinoma cells.

  20. MRI for local staging of endometrial carcinoma: Is endovenous contrast medium administration still needed?

    Energy Technology Data Exchange (ETDEWEB)

    Bonatti, Matteo, E-mail: matteobonatti@hotmail.com [Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Stuefer, Josef [Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Oberhofer, Nadia [Department of Physics of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Negri, Giovanni [Department of Pathology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Tagliaferri, Tiziana [Department of Gynecology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Schifferle, Günther [Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Messini, Sergio [Department of Gynecology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy); Manfredi, Riccardo [Department of Radiology of the University of Verona, Piazzale L.A. Scuro 10, 37134 Verona (Italy); Bonatti, Giampietro [Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano (Italy)

    2015-02-15

    Highlights: • Intravenous contrast material administration is not routinely indicated for MRI local staging of endometrial carcinoma. • The combination of T2-weighted images with diffusion-weighted images warrants at least the same accuracy as the combination of T2-weighted images with contrast-enhanced T1-weighted images in recognizing deep myometrial invasion and cervical stromal infiltration by endometrial carcinoma. - Abstract: Purpose: To compare the diagnostic performance of T2-weighted images (T2-WI) + contrast-enhanced T1-weighted images (CE T1-WI) with the one of T2-WI + diffusion-weighted images (DWI) in the assessment of myometrial and cervical stromal infiltration by endometrial carcinoma (EC). Materials and methods: Institutional review board approved our retrospective study; requirement for informed consent was waived. 56 patients with histologically proven EC who underwent preoperative MRI and surgery at our Institution over a 34 months period were included. Two radiologists independently evaluated T2-WI + CE T1-WI and T2-WI + DWI of each patient. Confidence in imaging evaluation (0–3), depth of myometrial invasion (assessed. MRI findings were compared with pathological ones. Results: Confidence in imaging evaluation was higher for T2-WI + CE T1-WI (2.83/3) than for T2-WI + DWI (2.62/3). T2-WI + DWI showed a better diagnostic performance than T2-WI + CE T1-WI in recognizing deep myometrial infiltration by EC (accuracy, sensitivity and specificity of 0.89, 0.89 and 0.89 vs. 0.86, 0.84, 0.86; p > 0.05) whereas both imaging sequences combinations showed the same diagnostic performance in recognizing cervical stromal infiltration (accuracy, sensitivity and specificity of 0.95, 0.98 and 0.80, p > 0.05). Conclusion: T2-WI + DWI can reliably replace the “classical” combination T2-WI + CE T1-WI for local staging of endometrial carcinoma.

  1. Mutations of the KRAS oncogene in endometrial hyperplasia and carcinoma.

    Directory of Open Access Journals (Sweden)

    Wiesława Niklińska

    2009-05-01

    Full Text Available The aim of this study was to examine the prevalence and clinicopathological significance of KRAS point mutation in endometrial hyperplasia and carcinoma. We analysed KRAS in 11 cases of complex atypical hyperplasia and in 49 endometrial carcinomas using polymerase chain reaction associated with restriction fragment length polymorphism (PCR-RFPL. Point mutations at codon 12 of KRAS oncogene were identified in 7 of 49 (14,3% tumor specimens and in 2 of 11 (18,2% hyperplasias. No correlation was found between KRAS gene mutation and age at onset, histology, grade of differentiation and clinical stage. We conclude that KRAS mutation is a relatively common event in endometrial carcinogenesis, but with no prognostic value.

  2. Childhood BMI growth trajectories and endometrial cancer risk

    DEFF Research Database (Denmark)

    Aarestrup, Julie; Gamborg, Michael; Tilling, Kate;

    2017-01-01

    cancer and its sub-types. A cohort of 155,505 girls from the Copenhagen School Health Records Register with measured weights and heights at the ages of 6 to 14 years and born 1930-89 formed the analytical population. BMI was transformed to age-specific z-scores. Using linear spline multilevel models......Previously, we found that excess weight already in childhood has positive associations with endometrial cancer, however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometrial......, each girl's BMI growth trajectory was estimated as the deviance from the average trajectory for three different growth periods (6.25-7.99, 8.0-10.99, 11.0-14.0 years). Via a link to health registers, 1020 endometrial cancer cases were identified, and Cox regressions were performed. A greater gain...

  3. Endometrial Shedding Effect on Conception and Live Birth in Women With Polycystic Ovary Syndrome

    Science.gov (United States)

    Diamond, Michael P.; Kruger, Michael; Santoro, Nanette; Zhang, Heping; Casson, Peter; Schlaff, William; Coutifaris, Christos; Brzyski, Robert; Christman, Gregory; Carr, Bruce R.; McGovern, Peter G.; Cataldo, Nicholas A.; Steinkampf, Michael P.; Gosman, Gabriella G.; Nestler, John E.; Carson, Sandra; Myers, Evan E.; Eisenberg, Esther; Legro, Richard S.

    2013-01-01

    Objective To estimate whether progestin-induced endometrial shedding, prior to ovulation induction with clomiphene citrate, metformin, or a combination of both, affects ovulation, conception, and live birth rates in women with polycystic ovary syndrome (PCOS). Methods A secondary analysis of the data from 626 women with PCOS from the National Institutes of Child Health and Human Development Cooperative Reproductive Medicine Network trial was performed. Women had been randomized to up to six cycles of clomiphene citrate alone, metformin alone, or clomiphene citrate plus metformin. Women were assessed for occurrence of ovulation, conception, and live birth in relation to prior bleeding episodes (after either ovulation or exogenous progestin-induced withdrawal bleed). Results While ovulation rates were higher in cycles preceded by spontaneous endometrial shedding than after anovulatory cycles (with or without prior progestin withdrawal), both conception and live birth rates were significantly higher after anovulatory cycles without progestin-induced withdrawal bleeding (live birth per cycle: spontaneous menses 2.2%; anovulatory with progestin withdrawal 1.6%; anovulatory without progestin withdrawal 5.3%; p<0.001). The difference was more marked when rate was calculated per ovulation (live birth per ovulation: spontaneous menses 3.0%; anovulatory with progestin withdrawal 5.4%; anovulatory without progestin withdrawal 19.7%; p < .001). Conclusion Conception and live birth rates are lower in women with PCOS after a spontaneous menses or progestin-induced withdrawal bleeding as compared to anovulatory cycles without progestin withdrawal. The common clinical practice of inducing endometrial shedding with progestin prior to ovarian stimulation may have an adverse effect on rates of conception and live birth in anovulatory women with PCOS. PMID:22525900

  4. Association of insulin resistance with breast, ovarian, endometrial and cervical cancers in non-diabetic women.

    Science.gov (United States)

    Sun, Wanwan; Lu, Jieli; Wu, Shengli; Bi, Yufang; Mu, Yiming; Zhao, Jiajun; Liu, Chao; Chen, Lulu; Shi, Lixin; Li, Qiang; Yang, Tao; Yan, Li; Wan, Qin; Liu, Yan; Wang, Guixia; Luo, Zuojie; Tang, Xulei; Chen, Gang; Huo, Yanan; Gao, Zhengnan; Su, Qing; Ye, Zhen; Wang, Youmin; Qin, Guijun; Deng, Huacong; Yu, Xuefeng; Shen, Feixia; Chen, Li; Zhao, Liebin; Wang, Tiange; Sun, Jichao; Xu, Min; Xu, Yu; Chen, Yuhong; Dai, Meng; Zhang, Jie; Zhang, Di; Lai, Shenghan; Li, Donghui; Ning, Guang; Wang, Weiqing

    2016-01-01

    Hyperinsulinemia and insulin resistance were reported to play a crucial role in diabetes-cancer relationship. This study aimed to explore the associations between insulin resistance and several female cancers in a non-diabetic population. This cross-sectional study was conducted in 121,230 middle-aged and elderly non-diabetic women. Cancer diagnosis was self-reported and further validated by medical records. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 2.50. The prevalence of both premenopausal and postmenopausal breast cancer, postmenopausal ovarian cancer and premenopausal endometrial cancer were higher in insulin-resistant participants than in insulin-sensitive participants (premenopausal breast cancer, 0.45 vs 0.28%; postmenopausal breast cancer, 0.86 vs 0.63%; postmenopausal ovarian cancer, 0.17 vs 0.09%; premenopausal endometrial cancer, 0.43 vs 0.25%, respectively, all P insulin resistance had higher odds ratio (OR) of breast cancer, both premenopausal and postmenopausal (OR 1.98, 95% confidence interval (CI) 1.19-3.32; OR 1.29, 95% CI 1.01-1.63), postmenopausal ovarian cancer (OR 2.17, 95% CI 1.10-3.40) as well as total endometrial cancer (OR 1.47, 95% CI 1.02-2.12). Subgroup analysis revealed that the possitive association between insulin resistance and risk of prevalent breast cancer was observed in popualtion with younger age, overweight or obesity, higher education and impaired glucose tolerance (IGR). No relationships were observed for the risk of prevalent cervical cancers with insulin resistance. Non-diabetic women with insulin resistance had higher risk of prevalent breast, ovarian and endomatrial cancer, which suggests special attentions to these female cancer screening and prevention.

  5. Pilot study on molecular quantitation and sequencing of endometrial cytokines gene expression and their effect on the outcome of in vitro fertilization (IVF cycle

    Directory of Open Access Journals (Sweden)

    D. Sabry

    2014-09-01

    Full Text Available Human trophoblast invasion and differentiation are essential for successful pregnancy outcome. The molecular mechanisms, however, are poorly understood. Interleukin (IL-11, a cytokine, regulates endometrial epithelial cell adhesion. Leukemia inhibitory factor (LIF is one of the key cytokines in the embryo implantation regulation. The present study aimed to assess the levels of LIF, IL-11, and IL-11 α receptor gene expression in the endometrium of women undergoing IVF and correlate their levels with the IVF pregnancy outcome. Also, the study aimed to detect any mutation in these three genes among IVF pregnant and non-pregnant women versus control menstrual blood of fertile women. Endometrial tissue biopsies were taken from 15 women undergoing IVF on the day of oocyte retrieval. The quantitative expression of IL-11, IL-11Rα, and LIF genes was assessed by real-time PCR and PCR products were sequenced. Menstrual blood from 10 fertile women was used as control to compare the DNA sequence versus DNA sequence of the studied genes in endometrial biopsies. LH, FSH, and E2 were assessed for enrolled patients by ELISA. Endometrial thickness was also assessed by pelvic ultrasonography. No significant difference was detected between quantitative expression of the three studied genes and pregnancy IVF outcome. Although DNA sequence changes were found in IL-11 and LIF genes of women with negative pregnancy IVF outcome compared to women with positive pregnancy IVF outcome, no DNA sequence changes were detected for IL-11Rα. Other studied parameters (e.g., age, LH, FSH, E2, and endometrial thickness showed no significant differences or correlation of quantitative expression of the three studied involved genes. Data suggested that there were no significant differences between quantitative expression of IL-11, IL-11Rα, and LIF genes and the IVF pregnancy outcome. The present study may reveal that changes in IL-11 and LIF genes sequence may contribute in

  6. Stem cell-like differentiation potentials of endometrial side population cells as revealed by a newly developed in vivo endometrial stem cell assay.

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    Kaoru Miyazaki

    Full Text Available BACKGROUND: Endometrial stem/progenitor cells contribute to the cyclical regeneration of human endometrium throughout a woman's reproductive life. Although the candidate cell populations have been extensively studied, no consensus exists regarding which endometrial population represents the stem/progenitor cell fraction in terms of in vivo stem cell activity. We have previously reported that human endometrial side population cells (ESP, but not endometrial main population cells (EMP, exhibit stem cell-like properties, including in vivo reconstitution of endometrium-like tissues when xenotransplanted into immunodeficient mice. The reconstitution efficiency, however, was low presumably because ESP cells alone could not provide a sufficient microenvironment (niche to support their stem cell activity. The objective of this study was to establish a novel in vivo endometrial stem cell assay employing cell tracking and tissue reconstitution systems and to examine the stem cell properties of ESP through use of this assay. METHODOLOGY/PRINCIPAL FINDINGS: ESP and EMP cells isolated from whole endometrial cells were infected with lentivirus to express tandem Tomato (TdTom, a red fluorescent protein. They were mixed with unlabeled whole endometrial cells and then transplanted under the kidney capsule of ovariectomized immunodeficient mice. These mice were treated with estradiol and progesterone for eight weeks and nephrectomized. All of the grafts reconstituted endometrium-like tissues under the kidney capsules. Immunofluorescence revealed that TdTom-positive cells were significantly more abundant in the glandular, stromal, and endothelial cells of the reconstituted endometrium in mice transplanted with TdTom-labeled ESP cells than those with TdTom-labeled EMP cells. CONCLUSIONS/SIGNIFICANCE: We have established a novel in vivo endometrial stem cell assay in which multi-potential differentiation can be identified through cell tracking during in vivo

  7. Expressions of claudin-4 and claudin-1 in endometrial cancer and their significance

    Institute of Scientific and Technical Information of China (English)

    Duan Zhao; Zhang Xin; Gao Ya

    2008-01-01

    Objective: To observe the expressions of claudin-4 and claudin-1 in endometrial cancer and explore their correlations with clinicopathological parameters of endometrial cancer. Methods: Immunohistochemical methods (SP)were used to detect the expressions of claudin-4 and claudin-1 in 52 tissue samples of endometrial cancer, 24 of atypical hyperplasia, 20 of pericancerous endometrium, and 19 of endometrium at proliferative phase. And then the expressions were analyzed statistically to find out the correlations with clinicopathological parameters of endometrial cancer. Results: Positive rate of claudin-4 was 36.8%, 70.8% and 90.4% in endometrium at proliferative phase, atypical hyperplasia and endometrial cancer, respectively, with significantly differences between them (P<0.05), and it was statistically different between pericancer endometrium and endometrial cancer (P<0.05). Positive rate of claudin-1 was89.5%, 66.7% and 63.5%, respectively showing a descending tendency and significantly differences betweenen dometrium at proliferative phase and endometrial caner (P<0.05), and it was also statistically significantly different between pericancer endometrium and endometrial cancer (P<0.05). The high expression rate of claudin-4 was related to invasion depth, but not to histological grading, pathological staging or lymph node metastasis of endometrial cancer,and the low expression of claudin-1 in endometrial cancer was not associated with histological grading, pathological staging, invasion depth or lymph node metastasis. Conclusion: The expression levels of claudin-4 and claudin-1 are correlated with onset and development of endometrial cancer.

  8. Use of nonsteroidal anti-inflammatory drugs and risk of endometrial cancer

    DEFF Research Database (Denmark)

    Brøns, Nanna; Baandrup, Louise; Dehlendorff, Christian

    2015-01-01

    PURPOSE: We examined the association between use of low-dose aspirin and non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) and endometrial cancer risk in a nationwide case-control study. METHODS: Cases were all women in Denmark diagnosed with endometrial cancer during 2000-2009. Age...... for potential confounders. Analyses were stratified by endometrial cancer type, and potential effect modification by parity, obesity, and hormone replacement therapy (HRT) use was investigated. RESULTS: We identified 5,382 endometrial cancer cases and 72,127 controls. Endometrial cancer was not associated...... with use of low-dose aspirin (OR 0.97, 95 % CI 0.89-1.05) or non-aspirin NSAIDs (OR 0.96, 95 % CI 0.91-1.02) compared with nonuse. The ORs did not vary with increasing duration or intensity of NSAID use or with type of endometrial cancer. Interaction analyses showed reduced endometrial cancer risk...

  9. Endometrial Hyperplasia and Endometrial Cancer%子宫内膜增生与癌变

    Institute of Scientific and Technical Information of China (English)

    俞梅; 甄璟然; 陈蓉; 郁琦

    2009-01-01

    子宫内膜增生(endometrial hyperplasia)是指子宫内膜增生性病变,属于子宫内膜癌癌前病变。1994年WHO修订子宫内膜增生分类标准,依据是否存在细胞异型性分为:单纯增生(Simple hyperplasia,SH)、复杂增生(complex hyperplasia,CH)及不典型增生(atypia hyperplasia,AH),后者根据腺体增生程度又分为单纯不典型增生及复杂不典型增生,又根据其组织学病变程度不同分为轻度、中度、重度不典型增生。

  10. Simulation of spiculated breast lesions

    Science.gov (United States)

    Elangovan, Premkumar; Alrehily, Faisal; Pinto, R. Ferrari; Rashidnasab, Alaleh; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2016-03-01

    Virtual clinical trials are a promising new approach increasingly used for the evaluation and comparison of breast imaging modalities. A key component in such an assessment paradigm is the use of simulated pathology, in particular, simulation of lesions. Breast mass lesions can be generally classified into two categories based on their appearance; nonspiculated masses and spiculated masses. In our previous work, we have successfully simulated non-spiculated masses using a fractal growth process known as diffusion limited aggregation. In this new work, we have extended the DLA model to simulate spiculated lesions by using features extracted from patient DBT images containing spiculated lesions. The features extracted included spicule length, width, curvature and distribution. This information was used to simulate realistic looking spicules which were attached to the surface of a DLA mass to produce a spiculated mass. A batch of simulated spiculated masses was inserted into normal patient images and presented to an experienced radiologist for review. The study yielded promising results with the radiologist rating 60% of simulated lesions in 2D and 50% of simulated lesions in DBT as realistic.

  11. Tumor Extension in High-Grade Gliomas Assessed with Diffusion Magnetic Resonance Imaging: Values and Lesion-to-Brain Ratios of Apparent Diffusion Coefficient and Fractional Anisotropy

    Energy Technology Data Exchange (ETDEWEB)

    Westen, D. van; Laett, J.; Englund, E.; Brockstedt, S.; Larsson, E.M. [Lund Univ. Hospital (Sweden). Depts. of Radiology, of Medical Radiation Physics and of Pathology and Cytology

    2006-04-15

    Purpose: To determine whether the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) can distinguish tumor-infiltrated edema in gliomas from pure edema in meningiomas and metastases. Material and Methods: Thirty patients were studied: 18 WHO grade III or IV gliomas, 7 meningiomas, and 5 metastatic lesions. ADC and FA were determined from ROIs placed in peritumoral areas with T2-signal changes, adjacent normal appearing white matter (NAWM), and corresponding areas in the contralateral healthy brain. Values and lesion-to-brain ratios from gliomas were compared to those from meningiomas and metastases. Results: Values and lesion-to-brain ratios of ADC and FA in peritumoral areas with T2-signal changes did not differ between gliomas, meningiomas, and metastases (P = 0.40, P = 0.40, P = 0.61, P 0.34). Values of ADC and FA and the lesion-to-brain ratio of FA in the adjacent NAWM did not differ between tumor types (P = 0.74, P = 0.25, and P = 0.31). The lesion-to-brain ratio of ADC in the adjacent NAWM was higher in gliomas than in meningiomas and metastases (P = 0.004), but overlapped between tumor types. Conclusion: Values and lesion-to-brain ratios of ADC and FA in areas with T2-signal changes surrounding intracranial tumors and adjacent NAWM were not helpful for distinguishing pure edema from tumor-infiltrated edema when data from gliomas, meningiomas, and metastases were compared.

  12. A prospective randomized controlled study comparing two doses of gestodene in cyclic combined HRT preparations on endometrial physiology.

    Science.gov (United States)

    Okon, M A; Lee, S; Laird, S M; Li, T C

    2001-06-01

    Postmenopausal women taking oestradiol 17-beta 2 mg daily were randomized to receive either 25 or 50 microg gestodene from day 17 to 28 of the cycle in a double-blind study. Placental protein P14 (PP14) and CA 125 concentrations in uterine flushing, endometrial morphology and irregular bleeding after 12 cycles of study were observed. Eleven and 12 women in the 25 and 50 microg groups respectively completed the study. There were no significant differences in pre-treatment biochemical and morphological indices between the groups. The median PP14 concentration increased from 332 to 5800 ng/ml (P gestodene groups respectively. No between-group significant rise of PP14 was observed. Similarly, no significant change was seen between the initial and post-treatment concentrations of CA 125 for either group. All biopsies were atrophic at inception of the study, and both regimens produced secretory endometrial transformation in the majority of biopsies. No between-group difference was observed in the morphometric indices measured, or any significant correlation between the concentrations of PP14 or CA 125 and morphology. The mean number of days of withdrawal bleeding (3.8 and 4.2 days for 25 and 50 microg respectively) were similar. In conclusion, both regimens produced a significant rise in uterine flushing concentrations of PP14, but not CA 125. PP14 is a sensitive biochemical marker in the assessment of endometrial response to hormone replacement therapy.

  13. A prospective evaluation of insulin and insulin-like growth factor-I as risk factors for endometrial cancer.

    Science.gov (United States)

    Gunter, Marc J; Hoover, Donald R; Yu, Herbert; Wassertheil-Smoller, Sylvia; Manson, Joann E; Li, Jixin; Harris, Tiffany G; Rohan, Thomas E; Xue, Xiaonan; Ho, Gloria Y F; Einstein, Mark H; Kaplan, Robert C; Burk, Robert D; Wylie-Rosett, Judith; Pollak, Michael N; Anderson, Garnet; Howard, Barbara V; Strickler, Howard D

    2008-04-01

    Obesity is a major risk factor for endometrial cancer, a relationship thought to be largely explained by the prevalence of high estrogen levels in obese women. Obesity is also associated with high levels of insulin, a known mitogen. However, no prospective studies have directly assessed whether insulin and/or insulin-like growth factor-I (IGF-I), a related hormone, are associated with endometrial cancer while accounting for estrogen levels. We therefore conducted a case-cohort study of incident endometrial cancer in the Women's Health Initiative Observational Study, a prospective cohort of 93,676 postmenopausal women. The study involved all 250 incident cases and a random subcohort of 465 subjects for comparison. Insulin, total IGF-I, free IGF-I, IGF-binding protein-3, glucose, and estradiol levels were measured in fasting baseline serum specimens. Cox models were used to estimate associations with endometrial cancer, particularly endometrioid adenocarcinomas, the main histologic type (n = 205). Our data showed that insulin levels were positively associated with endometrioid adenocarcinoma [hazard ratio contrasting highest versus lowest quartile (HR(q4-q1)), 2.33; 95% confidence interval (95% CI), 1.13-4.82] among women not using hormone therapy after adjustment for age and estradiol. Free IGF-I was inversely associated with endometrioid adenocarcinoma (HR(q4-q1), 0.53; 95% CI, 0.31-0.90) after adjustment for age, hormone therapy use, and estradiol. Both of these associations were stronger among overweight/obese women, especially the association between insulin and endometrioid adenocarcinoma (HR(q4-q1), 4.30; 95% CI, 1.62-11.43). These data indicate that hyperinsulinemia may represent a risk factor for endometrioid adenocarcinoma that is independent of estradiol. Free IGF-I levels were inversely associated with endometrioid adenocarcinoma, consistent with prior cross-sectional data.

  14. Hormone contraception before the first birth and endometrial cancer risk.

    Science.gov (United States)

    Cook, Linda S; Dong, Yan; Round, Pamela; Huang, Xun; Magliocco, Anthony M; Friedenreich, Christine M

    2014-02-01

    There is a well-documented reduction in endometrial cancer risk with combined oral contraceptive (COC) use. COC use before the first full-term pregnancy may affect breast cancer risk for decades, but this relationship has not been investigated in endometrial cancer. We investigated the risk for endometrial cancer with COC use before the first full-term pregnancy. Cases (n = 524) from a population-based cancer registry and age-matched controls (n = 1,032) were recruited between 2002 and 2006 in Alberta, Canada. Participants completed an in-person interview and provided detailed information on exogenous hormone use and other risk factors. Risk reductions in endometrial cancer with COC use over the premenopausal years were consistent with the published literature. We also found evidence of a long-term, significant risk reduction in parous women with COC use before the first full-term pregnancy. Among parous women, ≥5 years of COC use before a first full-term pregnancy was associated with a significant reduction in risk [adjusted OR, 0.42; 95% confidence interval (CI), 0.25-0.72], even if this exposure was a woman's only use of COCs (adjusted OR, 0.35; 95% CI, 0.18-0.68). Further understanding of the long-term effects of COC use may help guide the timing of chemoprevention efforts via COCs.

  15. Molecular Biology and Prevention of Endometrial Cancer. Addendum

    Science.gov (United States)

    2008-07-01

    gain insight into the biologic mechanism underlying the chemopreventive effect of the oral contraceptive pill (OCP). Project 1: Objectives completed...oral contraceptive pill and hormone replacement therapy on reproductive organs. This objective has been completed and the results were submitted...protective effect of oral contraceptive (OC) therapy. Methods: 1) Oligonucleotide microarray analysis was performed on a panel of endometrial cancers

  16. Magnetic resonance imaging of the uterus after endometrial resection

    Energy Technology Data Exchange (ETDEWEB)

    Turnbull, L.; Jumaa, A.; Dhawan, S.; Horsman, A.; Killick, S

    1998-02-01

    The majority of amenorrhoeic and all menstruating women have residual endometrium after endometrial resection. The lack of communication of islands of residual endometrium with the uterine cavity results in haematometra formation, fallopian tube dilatation and possibly free intraperitoneal fluid. (N.C.)

  17. Progesterone receptors in development and metatstais of endometrial cancer

    NARCIS (Netherlands)

    E.E. Hanekamp (Eline)

    2004-01-01

    textabstractMany women may acquire endometrial cancer during their life. The vast majority of these women will be cured because of early detection of the disease. As in most types of cancer however, the main cause of death lies in metastasis of the primary tumor to other sites in the body. In approx

  18. [Sentinel lymph node biopsy in endometrial cancer - methods].

    Science.gov (United States)

    Yordanov, G; Gorchev, S; Tomov, N; Hinkova

    2014-01-01

    Endometrial canceris the most common gynaecological malignancy after brest cancer. The lymph node status is with great prognostic value and it is important for postoperative treatment and survival. That is why it is looking for methods giving information for the lymph node status and not increasing postoperative complications.

  19. Efectos del tratamiento con agonistas dopaminérgicos sobre las lesiones endometriósicas

    OpenAIRE

    Tamarit Bordes, Sílvia

    2014-01-01

    La prolactina (PRL) es una hormona hipofisaria que desempeña un papel fundamental en diversas funciones reproductivas, fundamentalmente en la lactancia. En situaciones patológicas que están relacionadas con la presencia de adenomas hipofisarios o ingesta de fármacos psicotropos, los niveles de PRL están elevados y afectan a la función gonadal, pues inhiben la secreción de hormonas hipofisarias como la LH o FSH, ocasionando amenorrea (9%), galactorrea (25%) o ambas (70%) (1).La hiperprolacti...

  20. Endometrial mesenchymal stem cells as a cell based therapy for pelvic organ prolapse.

    Science.gov (United States)

    Emmerson, Stuart J; Gargett, Caroline E

    2016-05-26

    Pelvic organ prolapse (POP) occurs when the pelvic organs (bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells (MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned.

  1. Uterine epithelial cell proliferation and endometrial hyperplasia: evidence from a mouse model.

    Science.gov (United States)

    Gao, Yang; Li, Shu; Li, Qinglei

    2014-08-01

    In the uterus, epithelial cell proliferation changes during the estrous cycle and pregnancy. Uncontrolled epithelial cell proliferation results in implantation failure and/or cancer development. Transforming growth factor-β (TGF-β) signaling is a fundamental regulator of diverse biological processes and is indispensable for multiple reproductive functions. However, the in vivo role of TGF-β signaling in uterine epithelial cells remains poorly defined. We have shown that in the uterus, conditional deletion of the Type 1 receptor for TGF-β (Tgfbr1) using anti-Müllerian hormone receptor type 2 (Amhr2) Cre leads to myometrial defects. Here, we describe enhanced epithelial cell proliferation by immunostaining of Ki67 in the uteri of these mice. The aberration culminated in endometrial hyperplasia in aged females. To exclude the potential influence of ovarian steroid hormones, the proliferative status of uterine epithelial cells was assessed following ovariectomy. Increased uterine epithelial cell proliferation was also revealed in ovariectomized Tgfbr1 Amhr2-Cre conditional knockout mice. We further demonstrated that transcript levels for fibroblast growth factor 10 (Fgf10) were markedly up-regulated in Tgfbr1 Amhr2-Cre conditional knockout uteri. Consistently, treatment of primary uterine stromal cells with TGF-β1 significantly reduced Fgf10 mRNA expression. Thus, our findings suggest a potential involvement of TGFBR1-mediated signaling in the regulation of uterine epithelial cell proliferation, and provide genetic evidence supporting the role of uterine epithelial cell proliferation in the pathogenesis of endometrial hyperplasia.

  2. Endometrial mesenchymal stem cells as a cell based therapy for pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    Stuart; J; Emmerson; Caroline; E; Gargett

    2016-01-01

    Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman’s quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells(MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned.

  3. Fat accumulation in adipose tissues as a risk factor for the development of endometrial cancer.

    Science.gov (United States)

    Nakamura, Keiichiro; Hongo, Atsushi; Kodama, Junichi; Hiramatsu, Yuji

    2011-07-01

    Fat accumulation in adipose tissues is a risk factor for the development of human cancers. However, there are no studies describing the fat accumulation in adipose tissue or its distribution in human endometrial cancer. We first examined fat accumulation in adipose tissues separately on CT images of 122 patients with endometrial cancer, and investigated the correlation of these findings with various histological types of endometrial cancers. Fat accumulation in adipose tissues [subcutaneous fat area (SFA) and/or visceral fat areas (VFA)] was strongly correlated with the group of obesity-related biological parameters (weight, body mass index (BMI), waist and body surface area (BSA)) in endometrial cancer. The incidence of type I endometrial cancer was more closely correlated with an increase in obesity-related parameters such as weight (p=0.011), BMI (p=0.006), waist circumference (p=0.038), BSA (p=0.016), SFA (p=0.005), total fat area (TFA) (p=0.006) and total cholesterol (T.Cho) (P=0.010) than type II endometrial cancer. In particular, the SFA was most strongly correlated with obesity-related biological parameters of type I endometrial cancer. The present findings indicate that type I endometrial cancer has a statistically significant increase in obesity-related biological parameters than type II endometrial cancer. We propose that the subcutaneous fat accumulation in adipose tissue is a strong risk factor for developing type I endometrial cancer.

  4. PTEN coding product:a new marker for tumorigenesis and progession of endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Gao Qinglei; Li Jing; Xing Hui; Lu Yunping; Zhou Jianfeng; Ma Ding

    2008-01-01

    Objective :To investigate the expression of PTEN in carcinogenesis and development of endometrial carcinoma.Methods: The expression of PTEN was detected by reverse transcription-polymerase chain reaction(RT-PCR) methods from 24 cases with endometrial carcinoma,10 cases with endometrial atypical hyperplasia,I0 eases with endometrial hyperplasia and I0 cases with normal endometrium and by SP immunohistochemical methods from 73 cases with endometrial carcinoma,25 cases with endometrial atypical hyperplasia,71 cases with endometrial hyperplasia and 31 cases with normal endometrium.Results:PTEN expression of both RNA and protein in patients with endometrial carcinoma and endometrial atypical hyperplasia was significantly lower than that of patients with endometrial hyperplasia and normal endometriurn.mRNA relative value was 0.35±0.13,0.46±0.11,2.32±0.32,2.45±0.51,respectively.Loss of PTEN expression rates were 66.67% (38/57) ,76.00% ( 19/25 ) ,5.63% (4/71 ) ,0 (0/31 ),repeetively.The results were also compared with clinical parameters.Loss of PTEN expression in patients with endometrial carcinoma was significantly related to histological classification ( P < 0.0001 ) and differentiation ( P < 0.05 ).It was not related to depth of myometrium invasion and clinical stage( P >0.05 ).Conclusion:Loss of PTEN expression is an early event in endometrial tumorigenesis.Detection of PTEN protein may be a diagnostic biomarker for endometrial precancers and adenocareinoma.

  5. Naturally occurring and melengestrol acetate-associated reproductive tract lesions in zoo canids.

    Science.gov (United States)

    Moresco, A; Munson, L; Gardner, I A

    2009-11-01

    As husbandry practices have improved, safe and effective contraception for captive wildlife management has become a necessity. Melengestrol acetate (MGA), a synthetic progestin, is highly effective and has been used in many zoo species. Long-term use of MGA has been associated with uterine lesions in zoo felids, but effects in zoo canids have not been evaluated. This retrospective study documented spontaneously occurring lesions and investigated the impact of MGA on the reproductive health of zoo canids. Reproductive tracts from adult females were submitted by US zoos to the Association of Zoos & Aquariums' Wildlife Contraception Center Health Surveillance Program. Reproductive tracts were sampled and processed for histopathologic examination following standard protocols. Microscopic evaluations were performed without prior knowledge of MGA treatment status. Prevalence of uterine lesions was evaluated and compared between MGA-treated animals (n = 20) and control (untreated) animals (n = 61). Common lesions within the study population as a whole included endometrial hyperplasia (predominantly cystic) (53%), hydrometra (33%), and adenomyosis (25%). Treatment with MGA was a risk factor for endometrial hyperplasia, hydrometra, fibrosis, and adenomyosis. Uterine mineralization occurred exclusively in MGA-treated animals. Results indicate that MGA contraception can lead to lesions that may permanently impair the fertility of females. Therefore, if long-term contraception of zoo canids is necessary, the use of alternate methods of reproductive control such as gonadotropin-releasing hormone (GnRH) analogs or GnRH vaccines that reduce gonadal hormone exposure should be pursued.

  6. PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study, pre-operative recognition of high risk endometrial carcinoma: a multicentre prospective cohort study

    NARCIS (Netherlands)

    Visser, N.C.M.; Bulten, J.; Wurff, A.A. van der; Boss, E.A.; Bronkhorst, C.M.; Feijen, H.W.; Haartsen, J.E.; Herk, H.A. van; Kievit, I.M. de; Klinkhamer, P.J.; Pijlman, B.M.; Snijders, M.P.M.L.; Vandenput, I.; Vos, M.C.; Wit, P.E.J. de; Poll-Franse, L.V. van de; Massuger, L.F.A.G.; Pijnenborg, J.M.A.

    2015-01-01

    BACKGROUND: Endometrial carcinoma is the most common gynaecologic malignancy in industrialised countries and the incidence is still rising. Primary treatment is based on preoperative risk classification and consists in most cases of hysterectomy with bilateral salpingo-oophorectomy. In patients with

  7. PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study, pre-operative recognition of high risk endometrial carcinoma : A multicentre prospective cohort study

    NARCIS (Netherlands)

    Visser, N.C.M.; Bulten, J.; van de Wurff, A.A.; Boss, E.A.; Bronkhorst, C.M.; Feijen, H.W.F.; Haartsen, J.E.; van Herk, H.A.D.M.; de Kievit, I.M.; Klinkhamer, P.J.J.M.; Pijlman, B.M.; Snijders, M.P.; Vandenput, I.; Vos, M.C.; de Wit, P.E.J.; van de Poll-Franse, L.; Massuger, L.F.A.G.; Pijnenborg, J.M.A.

    2015-01-01

    Background Endometrial carcinoma is the most common gynaecologic malignancy in industrialised countries and the incidence is still rising. Primary treatment is based on preoperative risk classification and consists in most cases of hysterectomy with bilateral salpingo-oophorectomy. In patients with

  8. Effect of Endometrial Injury on Secretion of Endometrial Cytokines and IVF Outcomes in Women with Unexplained Subfertility

    Directory of Open Access Journals (Sweden)

    Yu Liang

    2015-01-01

    Full Text Available In order to determine the effect of endometrial injury (EI on in vitro fertilization (IVF outcomes in women with unexplained subfertility and explore the relationship between EI and endometrial inflammatory cytokines, 66 women with unexplained subfertility undergoing IVF treatment were recruited. 38 patients in the EI group underwent EI in the mid-luteal phase of the cycle and 28 patients in the non-EI (NEI group. According to the pregnancy outcome, the NEI and EI groups were divided into NEI-nonpregnant (NEI-NP, NEI-pregnant (NEI-P, EI-NP, and EI-P. All patients underwent aspiration of endometrial secretions immediately before embryo transfer. The concentrations of ten mediators were measured using Milliplex Magnetic Bead assay. The clinical pregnancy was significantly higher in the EI than in the NEI group. The concentrations of interleukin- (IL- 6, IL-8, IL-12 (p70, IL-13, interferon- (IFN- γ, monocyte chemotactic protein- (MCP- 1, and vascular endothelial growth factor (VEGF were significantly higher in the EI than the NEI group. The expression of IFN-γ and VEGF in the EI-P was significantly increased compared to the EI-NP group. These findings suggest that, in women with unexplained subfertility, endometrial injury might be a potential method to improve clinical pregnancy rates by promoting the expression of IFN-γ and VEGF.

  9. In vitro effects of a small-molecule antagonist of the Tcf/ß-catenin complex on endometrial and endometriotic cells of patients with endometriosis.

    Directory of Open Access Journals (Sweden)

    Sachiko Matsuzaki

    Full Text Available BACKGROUND: Our previous studies suggested that aberrant activation of Wnt/ß-catenin signaling might be involved in the pathophysiology of endometriosis. We hypothesized that inhibition of Wnt/ß-catenin signaling might result in inhibition of cell proliferation, migration, and/or invasion of endometrial and endometriotic epithelial and stromal cells of patients with endometriosis. OBJECTIVES: The aim of the present study was to evaluate the effects of a small-molecule antagonist of the Tcf/ß-catenin complex (PKF 115-584 on cell proliferation, migration, and invasion of endometrial and endometriotic epithelial and stromal cells. METHODS: One hundred twenty-six patients (78 with and 48 without endometriosis with normal menstrual cycles were recruited. In vitro effects of PKF 115-584 on cell proliferation, migration, and invasion and on the Tcf/ß-catenin target genes were evaluated in endometrial epithelial and stromal cells of patients with and without endometriosis, and in endometrial and endometriotic epithelial and stromal cells of the same patients. RESULTS: The inhibitory effects of PKF 115-584 on cell migration and invasion in endometrial epithelial and stromal cells of patients with endometriosis prepared from the menstrual phase were significantly higher than those of patients without endometriosis. Levels of total and active forms of MMP-9 were significantly higher in epithelial and stromal cells prepared from menstrual endometrium in patients with endometriosis compared to patients without endometriosis. Treatment with PKF 115-584 inhibited MMP-9 activity to undetectable levels in both menstrual endometrial epithelial and stromal cells of patients with endometriosis. The number of invasive cells was significantly higher in epithelial and stromal cells of endometriotic tissue compared with matched eutopic endometrium of the same patients. Treatment with PKF 115-584 decreased the number of invasive endometriotic epithelial cells by 73

  10. The molecular genetics and morphometry-based Endometrial Intraepithelial Neoplasia classification system predicts disease progression in Endometrial hyperplasia more accurately than the 1994 World Health Organization classification system

    NARCIS (Netherlands)

    Baak, JP; Mutter, GL; Robboy, S; van Diest, PJ; Uyterlinde, AM; Orbo, A; Palazzo, J; Fiane, B; Lovslett, K; Burger, C; Voorhorst, F; Verheijen, RH

    2005-01-01

    BACKGROUND. The objective of this study was to compare the accuracy of disease progression prediction of the molecular genetics and morphometry-based Endometrial Intraepithelial Neoplasia (EIN) and World Health Organization 1994 (WHO94) classification systems in patients with endometrial hyperplasia

  11. Unique psoriatic lesion versus multiple lesions

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2014-10-01

    Full Text Available Aim: To evaluate the number of lesions of psoriasis and to find risk factors for multiple lesions. Material and Methods: 1,236 patients (male 54.13%, female 45.87% with psoriasis were seen over a period of 8 years in an Outpatient Clinic. Patients filled out questionnaires containing age at onset, number of lesions and location at the beginning of the disease, gender, type and localization of psoriasis at the time of clinical examination, psoriasis family history, previous treatment, comorbidities, and social status. Results: The number of psoriasis lesions correlates with: onset age of psoriasis (F=8.902, p=0.0029; age at the moment of clinical examination (F=8.902, p=0.0029; residence in rural area (χ2=8.589, p=0.00338, 95%CI; alcohol intake (χ2=16.47, p=0.00005, 95%CI; smoking (χ2=8.408, p=0.00373, 95%CI; occupation: workers/pupils/students (χ2=14.11, p=0.0069, 95%CI. Conclusions: There is a correlation between number of psoriatic lesions and some factors. Multiple lesions were observed in older patients, smokers and drinkers, coming from rural area and social active (workers and pupils/students. No correlation was statistically proved between number of lesions and gender, comorbidities and family history of psoriasis.

  12. Recurrent endometrial hyperplasia as a presentation of estrogen-secreting thecoma - case report and minireview of the literature.

    Science.gov (United States)

    Podfigurna-Stopa, Agnieszka; Czyzyk, Adam; Katulski, Krzysztof; Moszynski, Rafal; Sajdak, Stefan; Genazzani, Andrea Riccardo; Meczekalski, Blazej

    2016-01-01

    Thecoma is a rare ovarian tumor, presenting usually in postmenopausal women as unilateral, benign, solid lesion. About 15% of affected patients develop endometrial hyperplasia (EH) and 20% are diagnosed with endometrial cancer. In this case report, we present 60-year-old women admitted because of recurrent spotting of 5 years duration, which started 1 year after menopause. In history, the patient underwent three times curettage procedures and once (1 year before admission) had estradiol levels typical for reproductive-age women. At admission, we found elevated serum levels of estradiol (222.5 pg/ml) and a small mass in the right ovary. The markers of germ cell tumors were negative. After the initial diagnosis, the patient was qualified for total abdominal hysterectomy with bilateral salpingo-oophorectomy. The histopathological examination and immunohistochemical staining confirmed the thecoma diagnosis. In follow-up examination after 8 weeks, we found decreased serum estradiol levels and relief of the symptoms. In conclusion, we want to underline that in cases of EH, especially in patients with a history of recurrences, the special attention should be paid for differential diagnosis. In such cases, the estrogen-secreting tumors should be excluded.

  13. Short-term effect of erythropoietin on brain lesions and aquaporin-4 expression in a hypoxic-ischemic neonatal rat model assessed by magnetic resonance diffusion weighted imaging and immunohistochemistry.

    Science.gov (United States)

    Brissaud, Olivier; Villega, Frédéric; Pieter Konsman, Jan; Sanchez, Stéphane; Raffard, Gérard; Franconi, Jean-Michel; Chateil, Jean-François; Bouzier-Sore, Anne-Karine

    2010-08-01

    Erythropoietin (Epo) is an endogenous cytokine that regulates hematopoiesis and is widely used to treat anemia. In addition, it has recently increased interest in the neurosciences since the new concept of Epo as a neuroprotective agent has emerged. The potential protective effect of human recombinant Epo (r-hu-Epo) on a hypoxic-ischemic (HI) pup rat model was studied. Cerebral HI was obtained by permanent left carotid artery ligature of pups followed by a 2-h hypoxia. Three hours after carotid occlusion, brain lesions were assessed by magnetic resonance diffusion weighted imaging. Intraperitoneal administration of r-hu-Epo (30,000 U/kg dose) limited both the HI-induced brain lesion area and the decrease in apparent diffusion coefficient (ADC) in the lesion. To identify potential mechanisms underlying the effects of Epo, immunohistochemical detection of caspase-3 and water channel protein aquaporin-4 (AQP4) were performed. No early apoptosis was detected, but up-regulation of AQP4 expression was observed in HI pups that received r-hu-Epo compared with HI animals without treatment. This study demonstrates an early neuroprotective effect of Epo with regard to brain lesion area and ADC values. One possible mechanism of Epo for decreasing brain edema and cellular swelling could be a better clearance of water excess in brain tissue, a process possibly mediated by AQP4.

  14. Assessment of Agreement between Clinical Diagnosis and Pathologic Report in the Soft Tissue Lesions of the Patients Referring to Pathology Department of Dental School, Tehran and Shahid Beheshti University of Medical Sciences During 2005-2008

    Directory of Open Access Journals (Sweden)

    S Ravaei

    2013-01-01

    Full Text Available Introduction: Agreement between clinical and pathologic diagnoses plays an important role in an appropriate treatment plan and it may also prevent serious side effects and problems in patients. This study was conducted to assess the agreement between clinical diagnoses and pathologic reports in soft tissue lesions of patients referring to pathology department of dental school, Tehran and shahid Beheshti university of medical sciences during 2005-2008. Methods: In this retrospective and descriptive study, 300 soft tissue lesions of patients referring to pathology department were selected by census sampling method and then were analyzed. The lesions were classified according to the criteria proposed by reference pathology textbooks and the data records regarding the patients age, gender and clinical and pathologic diagnoses were noted. Concordance between two diagnoses was determined by descriptive statistics. Results: In this study, pathologic findings were golden standard (definitive diagnoses. The results showed the concordance between two clinical and pathologic diagnoses were more than 0/7 except POF and pemphigus. Conclusion: The results showed that the surgeons of oral and maxillofacial surgery in dental departments of Tehran and shahid Beheshti university of medical science provided acceptable diagnoses regarding pathologic lesions during 2005-2008. However, even the slight differences between two diagnoses necessitate all patients to be evaluated clinically and paraclinically in order to propose an accurate scientific diagnosis and prevent the harmful outcomes of the disease. Furthermore most efforts must be done to make more agreements between clinical and pathological diagnoses.

  15. EXPRESSION AND SIGNIFICANCE OF SMAD4 AND p21WAF1 IN ENDOMETRIAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    葛秀君; 李英勇

    2003-01-01

    Objective: To investigate the expression of Smad4 and p21WAF1 in endometrial carcinoma and its clinical significance. Methods: Immunohistochemical method was used to detect Smad4 and p21WAF1 expression in 56 cases of endometrial carcinoma. Results: The positive rate of Smad4 was 80.36% in endometrial carcinoma. The Samd4 expression was significantly correlated with histological grade (P0.05). Conclusion: Smad4 may play an important role in the tumorigenesis, differentiation and progression of endometrial carcinoma. The expression of p21WAF1 was associated with the tumorigenesis of endometrial carcinoma, but the association between p21WAF1 and differentiation and progression of endometrial carcinomas needs to be further investigated.

  16. [Immunomorphologic features of epithelial-stromal relationships at hyperplasia and endometrial carcinoma].

    Science.gov (United States)

    Bantysh, B B; Paukov, v S; Kogan, E A

    2012-01-01

    The results of a immunomorphologic comprehensive study of epithelial-stromal relationships in the uterus hyperplasia and endometrial cancer suggest that the suppressor gene of cancer (PTEN) plays a key role in the process of neoplastic transformation of endometrial hyperplasia and adenocarcinoma development. For the first time the existence of two highly differentiated endometrial adenocarcinoma immunophenotype were detected The first one is a PTEN-negative endometrial aedenocarcinoma, characterized by an almost complete inhibition of tumor suppressor gene PTEN in the epithelium of the glands and stromal cell of the tumor The second type is a PTEN-positive endometrial adenocarcinoma, in which epithelial and stromal tumor suppressor gene PTEN activity has retained Based on these results we have formulated a hypothesis about the different types of endometrial hyperplasia morphogenesis and its possible transfer to cervical cancer associated with features of tumor suppressor gene PTEN.

  17. Endometrial Cancer: Hidden Pathology in a Patient with Abnormal Uterine Bleeding and Known Leiomyoma.

    Science.gov (United States)

    Sri, Trisha; Steren, Albert J; Stratton, Pamela

    2015-01-01

    Uterine leiomyomas and endometrial pathology are both associated with abnormal uterine bleeding. We report a case in which a nulliparous woman with heavy uterine bleeding and leiomyomas had undergone two prior hysteroscopic myomectomies for benign leiomyomas. She was evaluated, but was ineligible for a clinical trial of a novel Magnetic Resonance guided High Intensity Focused Ultrasound (MRgx200B;HIFU) device. The 8 cm, prolapsed submucosal leiomyoma hindered endometrial sampling and was inaccessible to HIFU treatment. Preoperatively, neither endometrial sampling nor saline sonohysterography was technically feasible. She underwent hysterectomy, and on histological examination of specimen, stage 1A grade 1 endometrial carcinoma was found on the endometrial side of the prolapsing fibroid. Endometrial pathology is an important consideration in the evaluation of abnormal uterine bleeding, even in women with large prolapsing leiomyoma.

  18. Sampling in Atypical Endometrial Hyperplasia: Which Method Results in the Lowest Underestimation of Endometrial Cancer? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Bourdel, Nicolas; Chauvet, Pauline; Tognazza, Enrica; Pereira, Bruno; Botchorishvili, Revaz; Canis, Michel

    2016-01-01

    Our objective was to identify the most accurate method of endometrial sampling for the diagnosis of complex atypical hyperplasia (CAH), and the related risk of underestimation of endometrial cancer. We conducted a systematic literature search in PubMed and EMBASE (January 1999-September 2013) to identify all registered articles on this subject. Studies were selected with a 2-step method. First, titles and abstracts were analyzed by 2 reviewers, and 69 relevant articles were selected for full reading. Then, the full articles were evaluated to determine whether full inclusion criteria were met. We selected 27 studies, taking into consideration the comparison between histology of endometrial hyperplasia obtained by diagnostic tests of interest (uterine curettage, hysteroscopically guided biopsy, or hysteroscopic endometrial resection) and subsequent results of hysterectomy. Analysis of the studies reviewed focused on 1106 patients with a preoperative diagnosis of atypical endometrial hyperplasia. The mean risk of finding endometrial cancer at hysterectomy after atypical endometrial hyperplasia diagnosed by uterine curettage was 32.7% (95% confidence interval [CI], 26.2-39.9), with a risk of 45.3% (95% CI, 32.8-58.5) after hysteroscopically guided biopsy and 5.8% (95% CI, 0.8-31.7) after hysteroscopic resection. In total, the risk of underestimation of endometrial cancer reaches a very high rate in patients with CAH using the classic method of evaluation (i.e., uterine curettage or hysteroscopically guided biopsy). This rate of underdiagnosed endometrial cancer leads to the risk of inappropriate surgical procedures (31.7% of tubal conservation in the data available and no abdominal exploration in 24.6% of the cases). Hysteroscopic resection seems to reduce the risk of underdiagnosed endometrial cancer.

  19. Assessment of the corticospinal tract alterations before and after resection of brainstem lesions using Diffusion Tensor Imaging (DTI) and tractography at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Kovanlikaya, Ilhami, E-mail: ilk2002@med.cornell.edu [Department of Radiology, Weill Cornell Medical College, New York, NY (United States); Firat, Zeynep [Department of Radiology, Yeditepe University Hospital, Istanbul (Turkey); Kovanlikaya, Arzu [Department of Radiology, Weill Cornell Medical College, New York, NY (United States); Ulug, Aziz M. [Department of Radiology, Weill Cornell Medical College, New York, NY (United States); Department of Biomedical Engineering, Yeditepe University, Istanbul (Turkey); Cihangiroglu, M. Mutlu [Department of Radiology, Yeditepe University Hospital, Istanbul (Turkey); John, Majnu [Department of Public Health, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, NY (United States); Bingol, Canan Aykut; Ture, Ugur [Institute of Neurological Sciences, Yeditepe University Hospital, Istanbul (Turkey)

    2011-03-15

    The purpose of the study was to investigate the role of Diffusion Tensor Imaging (DTI) and Diffusion Tensor Tractography (DTT) on the corticospinal tract alterations due to space occupying lesions in the brainstem before and after surgical resection. Pre- and post-surgical DTI data were acquired in 14 patients undergoing surgical resection of brainstem lesions. Patterns of corticospinal tract (CST) alteration on DTT were compared with the neurological exams of the patients pre- and post-operatively. DTT, especially in 3D movie format, seemed very helpful for evaluating the relationship of the lesions with the corticospinal tracts for surgical approach. None of the patients developed additional motor deficit related to surgery except one patient who presented with cerebellar ataxia after surgery. All of the patients with normal CST on DTT presented without motor deficit on neurological exam. The sensitivity, specificity, positive predictive and negative predictive values of DTT before surgery were 100%, 63.6%, 42.9% and 100%, and the corresponding values after surgery were 100%, 96%, 75% and 100% respectively. Although it has low specificity before surgery, DTT is a potentially useful technique in evaluating the effects of brainstem lesions and surgical resection on the relevant corticospinal tracts with high negative predictive value and higher specificity after surgery.

  20. Assessment of the healing activity of jucá pods [Libidibia ferrea (Mart. ex Tul. L. P. Queiroz] in cutaneous lesions of rats

    Directory of Open Access Journals (Sweden)

    Frascisca Gomes Carvalho

    2016-04-01

    Full Text Available The study aimed to evaluate the healing activity of the powdered pod of L. ferrea in cutaneous wound healing in preclinical test in rats. Eighteen rats were divided into two groups: the positive control group (PCG treated with Kollagenase® and the experimental group (EG treated with an ointment prepared with the powder of Libidibia ferrea. The lesions were clinically evaluated on 0 - 21st days, when histopathological analysis was also performed. In this study, the clinical analysis showed that although the rate of contraction of the lesions in EG was lower than in PCG, there was significant reduction in the wound of the group treated with ointment obtained from the powder of L. ferrea. Furthermore, the morphometric data showed that from the 3rd to 21st day after operation, the EG presented significant reduction in the rate of contraction of the skin lesions. Histological analysis revealed that the clinical and histological parameters of EG were similar to PCG. Although the biological activity of the powder remains unclarified, our results clearly showed the wound healing with the use of the powder of the pod of Libidibia ferrea in skin lesions. These finds provide subsidies for a similar research.

  1. Regulation of endometrial cancer cell growth by luteinizing hormone (LH) and follicle stimulating hormone (FSH)

    OpenAIRE

    Davies, S.; Bax, C M R; Chatzaki, E; Chard, Tim; Iles, Ray K.

    2000-01-01

    Gonadotrophin releasing hormone analogues (GnRHa) have been used to treat recurrent endometrial cancer. However, the mode of action is uncertain. Our previous studies showed no direct effect of GnRHa on endometrial cancer cell growth in vitro. We have now examined the effect of luteinizing hormone (LH) and follicle stimulating hormone (FSH) on endometrial cancer cell growth. The aim was to determine whether suppression of pituitary LH and FSH by GnRHa could explain the tumour regression seen ...

  2. Stathmin Protein Level, a Potential Predictive Marker for Taxane Treatment Response in Endometrial Cancer

    OpenAIRE

    Werner, Henrica M.J.; Jone Trovik; Halle, Mari K.; Elisabeth Wik; Akslen, Lars A; Even Birkeland; Therese Bredholt; Tangen, Ingvild L.; Camilla Krakstad; Salvesen, Helga B.

    2014-01-01

    Stathmin is a prognostic marker in many cancers, including endometrial cancer. Preclinical studies, predominantly in breast cancer, have suggested that stathmin may additionally be a predictive marker for response to paclitaxel. We first evaluated the response to paclitaxel in endometrial cancer cell lines before and after stathmin knock-down. Subsequently we investigated the clinical response to paclitaxel containing chemotherapy in metastatic endometrial cancer in relation to stathmin prote...

  3. Common genetic variability in ESR1 and EGF in relation to endometrial cancer risk and survival

    OpenAIRE

    Einarsdóttir, K; Darabi, H; Czene, K.; Li, Y; Low, Y.L.; Y. Q. Li; Bonnard, C.; Wedrén, S.; Liu, E. T.; Hall, P; Liu, J; Humphreys, K.

    2009-01-01

    We investigated common genetic variation in the entire ESR1 and EGF genes in relation to endometrial cancer risk, myometrial invasion and endometrial cancer survival. We genotyped a dense set of single-nucleotide polymorphisms (SNPs) in both genes and selected haplotype tagging SNPs (tagSNPs). The tagSNPs were genotyped in 713 Swedish endometrial cancer cases and 1567 population controls and the results incorporated into logistic regression and Cox proportional hazards models. We found five a...

  4. [Vaginal sonography: a screening method for early detection of ovarian tumors and endometrial cancers?].

    Science.gov (United States)

    Osmers, R; Völksen, M; Rath, W; Kuhn, W

    1989-01-01

    In total we performed a vaginosonographic measurement of 212 patients with or without a postmenopausal bleeding. Altogether 424 ovaries were sonographically examined. An endometrial thickness greater than 4 mm was histologically clarified by means of a curettage and all detectable ovarian tumors by means of a laparotomia. In total we found seven asymptomatic endometrial carcinomas, one cervical carcinoma and two ovarian cancers. The vaginosonography showed to be a very sensitive and acceptable method for the early detection of postmenopausal ovarian and endometrial tumors.

  5. Human epidermal growth factor receptor-2 overexpression and amplification in metastatic and recurrent high grade or type 2 endometrial carcinomas

    Directory of Open Access Journals (Sweden)

    Kato R

    2013-08-01

    Full Text Available Rina Kato,1 Kiyoshi Hasegawa,1 Risa Ishii,1 Akiko Owaki,1 Yutaka Torii,1 Shuko Oe,1 Hiroshi Hirasawa,2 Yoichi Kobayashi,3 Yasuhiro Udagawa1 1Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan; 2Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan; 3Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Mitaka, Japan Introduction: Human epidermal growth factor receptor (HER-2 overexpression or gene amplification is more common in high-grade or type 2 endometrial carcinomas. We assessed the discordance of HER-2 expression between primary and metastatic or recurrent endometrial carcinomas. Materials and methods: Thirty-six primary, along with 14 metastatic and five recurrent tumors (matched to primaries, pathologically confirmed as high-grade or type 2 endometrial carcinomas, were submitted for immunohistochemistry (IHC for HER-2. Fluorescence in situ hybridization was performed when the tumors showed HER-2 overexpression (≥2+ IHC score. The results of the IHC and fluorescence in situ hybridization assays were compared between the primary and metastatic or recurrent tumors. The relationships between HER-2 expression and clinicopathological factors or prognosis were investigated. Results: HER-2 overexpression and HER-2 amplification (a ratio of HER-2 copies to chromosome 17 [CEP17] copies ≥2.2 were detected in 33.3% (twelve of 36 patients and 5.6% (two of 36 patients of primary tumors, respectively. HER-2 overexpression was not associated with clinicopathological factors or prognosis. In 19 tumor specimens obtained from metastatic or recurrent tumors, HER-2 overexpression and HER-2 amplification were detected in 57.9% (eleven patients and 15.8% (three patients, respectively. HER-2 overexpression tended to predict a worse prognosis. Conclusion: HER-2 expression in metastatic or recurrent tumors was more frequent than in matched primary high

  6. Endometrial polyps and associated factors in Danish women aged 36-74 years

    DEFF Research Database (Denmark)

    Dreisler, Eva; Sorensen, Soren Stampe; Lose, Gunnar

    2008-01-01

    , the following was positively associated with endometrial polyps: current use of hormone therapy (odds ratio, 2.81; 95% CI, 1.29-6.13) and being overweight (body mass index > 25 kg/m(2)) (odds ratio, 2.06; 95% CI, 1.12-3.79) (postmenopausal women). Negatively associated was use of oral contraceptive pills (odds...... women were positively associated, whereas the use of oral contraceptive pills was negatively associated with endometrial polyps. Hypertension and cervical polyps were not associated with endometrial polyps. Endometrial polyps were infrequently related to premalignant and malignant disease....

  7. Correlation between PTEN Expression and PI3K/Akt Signal Pathway in Endometrial Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Qinglei GAO; Fei YE; Xi XIA; Hui XING; Yunping LU; Jianfeng ZHOU; Ding MA

    2009-01-01

    In order to investigate the role of the PTEN expression in carcinogenesis and develop-ment of endometrial carcinoma and clarify whether and how PTEN and PI3K/Akt pathway relate to endometrial carcinoma,the expression of PTEN and phospho-Akt was detected by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) methods and Western-blot from 24 cases of endomctrial carcinoma,10 cases of endometrial atypical hyperplasia,10 cases of endometrial hy-perplasia,and 10 cases of normal endometrium.SP immunohistochemical methods were used to measure levels of PTEN protein expression in following 5 study groups:31 cases of endometrium in proliferative phase,30 cases of endometrium in secretory phase,71 cases of endometrial hyperplasia,25 cases of atypical hyperplasia and 73 cases of endometrial carcinoma.Immunostaining score of PTEN was 3.39±0.15 in proliferative phase,1.90±0.21 in secretory phase,3.34~0.29 in endometrial hyperplasia,0.624±0.11 in atypical hyperplasia,and 0.74±0.19 in endometrial carcinoma,respectively.PTEN mRNA relative value in normal endometrium,endometrial hyperplasia,endometrial atypical hyperplasia,and endometrial carcinoma was 2.45±0.51,2.32±0.32,0.46±0.11,and 0.35±0.13 respec-tively.The expression levels of PTEN mRNA and protein in patients with endometrial carcinoma and atypical hyperplasia were significantly lower than in those of proliferative phase and with endo-metrial hyperplasia.The level of PTEN expression in patients with endometrial carcinoma was sig-nificantly related to tissue type (P0.05).Western blot analysis revealed that Phospho-Akt level in PTEN negative cases was significantly higher,and there was a negative correlation between PTEN and phospho-Akt (r=- 0.8973,P<0.0001).It was suggested that loss of PTEN expression was an early event in endometrial tumorigenesis.The phosphorylation of Akt induced by the loss of PTEN took part in the tumorigenesis and development of endometrial carcinoma.

  8. Expression of matrix metalloproteinase-7 and tissue inhibitor of metalloproteinase-2 in human endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Chen Mei; Bo Nai-xiu; Huang Ya-jun; Dai Qi; Gong Li-mei

    2010-01-01

    Objective: To investigate the expression of matrix metalloproteinase-7 (MMP-7) and its tissue inhibitor (TIMP-2) in endometrial carcinoma and analyze their significance in endometrial cancer′s invasion and metastasis. Methods: Endometrial tissues were collected from 64 patients with endometrial carcinoma, 20 patients with endometrial hyperplasia and 20 normal women. The expressions of MMP-7, TIMP-2 in endometrium were measured by immuohistochemistry. Results: Expressions of MMP-7, TIMP-2 in endometrium of patients with endometrial carcinoma were significantly higher than those in normal endometrium (P<0.05). MMP-7 expression increased with surgical-pathological staging, depth of myometrial invasion, histologic grades and lymph node metastasis (P<0.05), while TIMP-2 expression was related to lymph node metastasis (P<0.05). TIMP-2 expression in endometrial cancer was significantly higher than that in hyperplastic endometrium (P<0.05). Expressions of TIMP-2 and MMP-7 in endometrium of patients with endometrial carcinoma were positively correlated (r=0.654, P<0.001). Conclusion: Highly expressed MMP-7 and TIMP-2 in endometrium may be related to development, invasion and metastasis of endometrial cancers.

  9. Endometrial exosomes/microvesicles in the uterine microenvironment: a new paradigm for embryo-endometrial cross talk at implantation.

    Science.gov (United States)

    Ng, York Hunt; Rome, Sophie; Jalabert, Audrey; Forterre, Alexis; Singh, Harmeet; Hincks, Cassandra L; Salamonsen, Lois A

    2013-01-01

    Exosomes are nanoparticles (∼100 nm diameter) released from cells, which can transfer small RNAs and mRNA via the extracellular environment to cells at distant sites. We hypothesised that exosomes or the slightly larger microvesicles (100-300 nm) are released from the endometrial epithelium into the uterine cavity, and that these contain specific micro (mi)RNA that could be transferred to either the trophectodermal cells of the blastocyst or to endometrial epithelial cells, to promote implantation. The aim of this study was to specifically identify and characterise exosomes/microvesicles (mv) released from endometrial epithelial cells and to determine whether exosomes/mv are present in uterine fluid. Immunostaining demonstrated that the tetraspanins, CD9 and CD63 used as cell surface markers of exosomes are present on the apical surfaces of endometrial epithelial cells in tissue sections taken across the menstrual cycle: CD63 showed cyclical regulation. Exosome/mv pellets were prepared from culture medium of endometrial epithelial cell (ECC1 cells) and from uterine fluid and its associated mucus by sequential ultracentifugation. Exosomes/mv were positively identified in all preparations by FACS and immunofluorescence staining following exosome binding to beads. Size particle analysis confirmed the predominance of particles of 50-150 nm in each of these fluids. MiRNA analysis of the ECC1 cells and their exosomes/mv demonstrated sorting of miRNA into exosomes/mv: 13 of the 227 miRNA were specific to exosomes/mv, while a further 5 were not present in these. The most abundant miRNA in exosomes/mv were hsa-miR-200c, hsa-miR-17 and hsa-miR-106a. Bioinformatic analysis showed that the exosome/mv-specific miRNAs have potential targets in biological pathways highly relevant for embryo implantation. Thus exosomes/mv containing specific miRNA are present in the microenvironment in which embryo implantation occurs and may contribute to the endometrial-embryo cross talk

  10. Endometrial exosomes/microvesicles in the uterine microenvironment: a new paradigm for embryo-endometrial cross talk at implantation.

    Directory of Open Access Journals (Sweden)

    York Hunt Ng

    Full Text Available Exosomes are nanoparticles (∼100 nm diameter released from cells, which can transfer small RNAs and mRNA via the extracellular environment to cells at distant sites. We hypothesised that exosomes or the slightly larger microvesicles (100-300 nm are released from the endometrial epithelium into the uterine cavity, and that these contain specific micro (miRNA that could be transferred to either the trophectodermal cells of the blastocyst or to endometrial epithelial cells, to promote implantation. The aim of this study was to specifically identify and characterise exosomes/microvesicles (mv released from endometrial epithelial cells and to determine whether exosomes/mv are present in uterine fluid. Immunostaining demonstrated that the tetraspanins, CD9 and CD63 used as cell surface markers of exosomes are present on the apical surfaces of endometrial epithelial cells in tissue sections taken across the menstrual cycle: CD63 showed cyclical regulation. Exosome/mv pellets were prepared from culture medium of endometrial epithelial cell (ECC1 cells and from uterine fluid and its associated mucus by sequential ultracentifugation. Exosomes/mv were positively identified in all preparations by FACS and immunofluorescence staining following exosome binding to beads. Size particle analysis confirmed the predominance of particles of 50-150 nm in each of these fluids. MiRNA analysis of the ECC1 cells and their exosomes/mv demonstrated sorting of miRNA into exosomes/mv: 13 of the 227 miRNA were specific to exosomes/mv, while a further 5 were not present in these. The most abundant miRNA in exosomes/mv were hsa-miR-200c, hsa-miR-17 and hsa-miR-106a. Bioinformatic analysis showed that the exosome/mv-specific miRNAs have potential targets in biological pathways highly relevant for embryo implantation. Thus exosomes/mv containing specific miRNA are present in the microenvironment in which embryo implantation occurs and may contribute to the endometrial

  11. Application of three-dimensional power Doppler ultrasound for differential diagnosis of endometrial polyps and endometrial hyperplasia%三维能量多普勒超声对子宫内膜息肉和子宫内膜增生的鉴别诊断价值

    Institute of Scientific and Technical Information of China (English)

    王一凡; 王兴田; 王荣; 梁慧; 李鹏; 黄辉

    2016-01-01

    Objective To assess the application of three -dimensional power Doppler ultrasound for differential di-agnosis of endometrial polyps and endometrial hyperplasia .Methods A total of 99 patients who were diagnosed as thick and inhomogeneous endometrium or hyperechogenic focal intrauterine structures by 2D ultrasound were enrolled in the current study .They underwent three -dimensional power Doppler ultrasound examination followed by hysteroscopy or dil -atation and curettage within 48 hours.Among them were 33 patients with endometrial polyps ( Group endometrial pol-yps), 30 patients with endometrial hyperplasia (Group endometrial hyperplasia ) and 36 patients with normal hyperplasia ( Group control ) .These groups were compared for endometrial volume , and the vessel index ( VI) , flow index ( FI) and vessel and flow index ( VFI) within the endometrium and tissues 2 mm below the endometrium surface measured by VO-CAL software.Results These parameters (endometrial volume, VI, FI and VFI) were all statistically different among these three groups .Conclusion Endometrial volume and three -dimensional power doppler can be applied for differen-tial diagnosis of endometrial polyps and endometrial hyperplasia .%目的:探讨经阴道三维能量多普勒超声对子宫内膜息肉和子宫内膜增生的鉴别诊断价值。方法选择二维超声提示宫腔占位和内膜增厚不均的患者99例,经阴道三维能量多普勒检查,并于48 h内行宫腔镜检查或诊刮手术,术后均取材送病理检查,其中子宫内膜息肉33例(内膜息肉组),子宫内膜增生30例(内膜增生组),其他36例(其中病理为正常增生期的30例为对照组)。运用VOCAL软件测量3组患者的内膜体积,内膜内和包含内膜下2 mm组织测到的血管指数( VI)、血流指数( FI)、血管-血流指数( VFI)。结果子宫内膜息肉组、子宫内膜增生组和对照组患者的内膜体积以及VI、FI和VFI比较

  12. Effect of Celecoxib on Apoptosis of Endometrial Carcinoma Cell

    Institute of Scientific and Technical Information of China (English)

    SHENG Xiu-jie; FANG Zhao

    2007-01-01

    Objective: To investigate the effect of Celecoxib on proliferation and apoptosis of the endometrial carcinoma cell HEC-1B and the effect on the expression of Fas and Survivin mRNA. Methods: The inhibition on the growth of human endometrial carcinoma cell HEC-1B was investigated by cell culture and MTT experiment when treated with different concentrations of Celecoxib. The cell apoptosis was detected by flow cytometry and DNA Ladder Electrophoresis. The change of the expression of Fas and Survivin mRNA after the treatment of Celecoxib was detected With RT-PCR. Results: Celecoxib could effectively inhibit the growth of HEC-1B cells and induce apoptosis. Survivin mRNA expression was decreased and Fas mRNA expression was increased after treating with Celecoxib. Conclusion: Celecoxib could inhibit HEC-1B cell proliferation and induce its apoptosis.

  13. Proteasome activity and subunit composition in endometrial hyperplasia and cancer

    Directory of Open Access Journals (Sweden)

    L. V. Spirina

    2011-01-01

    Full Text Available In endometrial hyperplasia the total proteasome activity was not changed however the 26S proteasome activity was increased in comparison with the normal tissues. In endometrial cancer the high total proteasome activity and activities of 26S and 20S proteasomes wer e revealed. The changes in proteasome activities were correlated with the decreased content of α1α2α3α5α6α7 proteasome subunits and increased con- tents of LMP2, LMP7 and PA28β proteasome subunits compared to that in nonaltered tissues. Low content of α1α2α3α5α6α7 proteasome subunits was revealed at the second stage of cancer patients in comparison with that at the first stage.

  14. Expression of epidermal growth factor receptors in human endometrial carcinoma

    DEFF Research Database (Denmark)

    Nyholm, H C; Nielsen, Anette Lynge; Ottesen, B

    1993-01-01

    Little data exist on the expression of epidermal growth factor receptors (EGF-Rs) in human endometrial cancer. EGF-R status was studied in 65 patients with endometrial carcinomas and in 26 women with nonmalignant postmenopausal endometria, either inactive/atrophic endometrium or adenomatous...... hyperplasia. EGF-R was identified on frozen tissue sections by means of an indirect immunoperoxidase technique with a monoclonal antibody against the external domain of the EGF-R. Seventy-one percent of the carcinomas expressed positive EGF-R immunoreactivity. In general, staining was most prominent....../inactive endometria and seven of 13 (54%) endometria with adenomatous hyperplasia were EGF-R positive, with an immunostaining pattern rather similar to that of the carcinomas....

  15. 应用子宫内膜细胞采集器获取微量子宫内膜组织行组织病理学诊断的临床分析%Clinical analysis of histopathology diagnosis of micro endometrial tissues obtained by endometrial cell collector

    Institute of Scientific and Technical Information of China (English)

    任玲; 王海燕; 魏媛; 杨静; 周健

    2016-01-01

    Objective To evaluate the feasibility and application of histopathology diagnosis of endometrial tissues obtained by endometrial cell collector (Jingyou, SAP-1). Methods One hundred and ninety-three patients whose endometrial lesions should be excluded were selected. First, endometrial tissue were obtained from the patients by Jingyou, then they underwent comprehensive curettage under hysteroscopy. The histopathology diagnosis was performed respectively. The specimen satisfaction rate and diagnostic accuracy was analyzed and compared. Results The specimen satisfaction rate of curettage under hysteroscopy was 95.85%(185/193). The specimens of 8 cases were not satisfied because the tissues were not enough. The specimen satisfaction rate of Jingyou was 82.38% (159/193). The specimens of 34 cases were not satisfied, among whom in 10 cases scratches did not throughout the whole palace antrum, and in 24 cases tissues quality were poor. The endometrial thickness in unsatisfactory specimen by Jinyou was significantly thinner than that in satisfactory specimen:(0.64 ± 0.18) cm vs. (0.97 ± 0.43) cm, and there was statistical difference (P<0.05). The diagnostic accordance rate between Jingyou and curettage under hysteroscopy was 79.87%(127/159). The sensitivity of Jingyou from high to low was 94.19% (81/86) in normal menstrual endometrial, 7/10 in endometrial carcinoma/ atypical hyperplasia, 67.86%(38/56) in endometrial hyperplasia and 1/7 in endometrial polyps. Missed diagnosis of jingyou inluded 2 cases of endometrial carcinoma and 4 cases of endometrial atypical hyperplasia. The misdiagnosed rate of high grade endometrial lesions was 6/16, and the patients were misdiagnosed because the tissues were not enough. Four cases of endometrial atypical hyperplasia had underwent conservative treatment of repeated curettage. Conclusions Application of Jingyou can obtain micro endometrial tissues, and the accordance rate of histopathology diagnosis is high with curettage under

  16. Metal status in human endometrium: Relation to cigarette smoking and histological lesions

    Energy Technology Data Exchange (ETDEWEB)

    Rzymski, Piotr, E-mail: rzymskipiotr@ump.edu.pl [Department of Biology and Environmental Protection, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznań (Poland); Rzymski, Paweł; Tomczyk, Katarzyna [Department of Mother' s and Child' s Health, Gynecologic and Obstetrical University Hospital, Poznan University of Medical Sciences, Poznań (Poland); Niedzielski, Przemysław; Jakubowski, Karol [Department of Analytical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Umultowska 89, 61-614 Poznań (Poland); Poniedziałek, Barbara [Department of Biology and Environmental Protection, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznań (Poland); Opala, Tomasz [Department of Mother' s and Child' s Health, Gynecologic and Obstetrical University Hospital, Poznan University of Medical Sciences, Poznań (Poland)

    2014-07-15

    Human endometrium is a thick, blood vessel-rich, glandular tissue which undergoes cyclic changes and is potentially sensitive to the various endogenous and exogenous compounds supplied via the hematogenous route. As recently indicated, several metals including Cd, Pb, Cr and Ni represent an emerging class of potential metalloestrogens and can be implicated in alterations of the female reproductive system including endometriosis and cancer. In the present study, we investigated the content of five metals: Cd, Cr, Ni, Pb and Zn in 25 samples of human endometrium collected from Polish females undergoing diagnostic or therapeutic curettage of the uterine cavity. The overall mean metal concentration (analyzed using microwave induced plasma atomic emission spectrometry MIP-OES) decreased in the following order: Cr>Pb>Zn>Ni>Cd. For the first time it was demonstrated that cigarette smoking significantly increases the endometrial content of Cd and Pb. Concentration of these metals was also positively correlated with years of smoking and the number of smoked cigarettes. Tissue samples with recognized histologic lesions (simple hyperplasia, polyposis and atrophy) were characterized by a 2-fold higher Cd level. No relation between the age of the women and metal content was found. Our study shows that human endometrium can be a potential target of metal accumulation within the human body. Quantitative analyses of endometrial metal content could serve as an additional indicator of potential impairments of the menstrual cycle and fertility. - Highlights: • Cd, Cr, Ni, Pb and Zn are detectable in human endometrium. • Mean metal content in human endometrium decreases in Cr>Pb>Zn>Ni>Cd order. • Cigarettes smoking increases endometrial content of Cd and Pb. • Lesioned endometrial tissue was characterized by higher metal contents.

  17. Single-cell transcriptome analysis of endometrial tissue

    OpenAIRE

    Krjutškov, K.; Katayama, S .; Saare, M; Vera-Rodriguez, M.; Lubenets, D.; Samuel, K.; Laisk-Podar, T.; Teder, H.; Einarsdottir, E.; Salumets, A.; Kere, J.

    2016-01-01

    STUDY QUESTION How can we study the full transcriptome of endometrial stromal and epithelial cells at the single-cell level? SUMMARY ANSWER By compiling and developing novel analytical tools for biopsy, tissue cryopreservation and disaggregation, single-cell sorting, library preparation, RNA sequencing (RNA-seq) and statistical data analysis. WHAT IS KNOWN ALREADY Although single-cell transcriptome analyses from various biopsied tissues have been published recently, corresponding protocols fo...

  18. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

  19. Reconstruction of endometrium from human endometrial side population cell lines.

    Directory of Open Access Journals (Sweden)

    Irene Cervelló

    Full Text Available Endometrial regeneration is mediated, at least in part, by the existence of a specialized somatic stem cell (SSC population recently identified by several groups using the side population (SP technique. We previously demonstrated that endometrial SP displays genotypic, phenotypic and the functional capability to develop human endometrium after subcutaneous injection in NOD-SCID mice. We have now established seven human endometrial SP (hESP cell lines (ICE 1-7: four from the epithelial and three from the stromal fraction, respectively. SP cell lines were generated under hypoxic conditions based on their cloning efficiency ability, cultured for 12-15 passages (20 weeks and cryopreserved. Cell lines displayed normal 46XX karyotype, intermediate telomerase activity pattern and expressed mRNAs encoding proteins that are considered characteristic of undifferentiated cells (Oct-4, GDF3, DNMT3B, Nanog, GABR3 and those of mesodermal origin (WT1, Cardiac Actin, Enolase, Globin, REN. Phenotype analysis corroborated their epithelial (CD9+ or stromal (vimentin+ cell origin and mesenchymal (CD90+, CD73+ and CD45⁻ attributes. Markers considered characteristic of ectoderm or endoderm were not detected. Cells did not express either estrogen receptor alpha (ERα or progesterone receptor (PR. The hESP cell lines were able to differentiate in vitro into adipocytes and osteocytes, which confirmed their mesenchymal origin. Finally, we demonstrated their ability to generate human endometrium when transplanted beneath the renal capsule of NOD-SCID mice. These findings confirm that SP cells exhibit key features of human endometrial SSC and open up new possibilities for the understanding of gynecological disorders such as endometriosis or Asherman syndrome. Our cell lines can be a valuable model to investigate new targets for endometrium proliferation in endometriosis.

  20. Metastatic endometrial stromal sarcoma masquerading as pulmonary lymphangioleiomyomatosis.

    OpenAIRE

    Mahadeva, R; Stewart, S.; Wallwork, J

    1999-01-01

    A 39 year old female presented with bilateral pneumothoraces and interstitial shadowing on chest x ray. A diagnosis of lymphangioleiomyomatosis was made following an open lung biopsy. Over the next eight years she developed respiratory failure leading to single lung transplantation but she died in the immediate postoperative period. Necropsy examination and review of the previous open lung biopsy revealed multiple pulmonary metastases from a low grade endometrial stromal sarcoma of the uterus...

  1. The role of robotic surgery in endometrial cancer.

    Science.gov (United States)

    O'Malley, David M; Smith, Blair; Fowler, Jeffrey M

    2015-12-01

    Robotic surgery for endometrial cancer has less blood loss, shorter hospital stays, and less postoperative complications compared to laparotomies. Robotic technologic advantages over laparoscopic technique are most pronounced in obese patients. The shorter learning curve may explain the greater utilization of the robotic technique. Robotic surgery will continue as a mainstay in the treatment of uterine cancers as we become more efficient and cost conscious while maintaining the high quality outcomes that have been reported.

  2. Differentially Gene Expression Profile Related to Inflammation in Endometrial Cells Induce by Lipopolysaccharide

    Institute of Scientific and Technical Information of China (English)

    Li-hua QIN; Ruo-guang WANG; Sheng LI; Chun-mei LI

    2009-01-01

    Objective To investigate differentially expressed genes related to inflammation in endometrial cells induced by Lipopolysaccharide(LPS).Methods Normal endometrium in the proliferative phase of specimen from 3 cases for the experiment was collected. The LPS group were treated with 50 μg/ml LPS. Total RNA was extracted using Trizol reagent from cells. RNA quality was assessed by determining the OD260/280 ratio by agarose gel electrophoresis, the chip was scanned by laser scanner. The acquired was analyzed. Results A total of differentially expressed genes were found, these genes were relative to many aspects. Among them, the expression of genes involved in inflammation were up-regulated by LPS, such as overexpression of lL-lβ, 8, etc.Conclusion The results indicates that inflammation-related genes may be one of the mechanisms of abnormal uterine bleeding by LPS-induced.

  3. Acupuncture on the Endometrial Morphology, the Serum Estradiol and Progesterone Levels, and the Expression of Endometrial Leukaemia-inhibitor Factor and Osteopontin in Rats

    Directory of Open Access Journals (Sweden)

    Houju Fu

    2011-01-01

    Full Text Available Although it is well known that acupuncture has beneficial effects on a variety of medical conditions especially in pain relief, nausea, and vomiting, it remains controversial whether it has positive impact on the female reproduction. The present study aimed to evaluate whether the following endometrial receptivity factors: the endometrial morphology, the hormone concentrations, and the protein expression of endometrial leukaemia-inhibitory factor (LIF and osteopontin (OPN could be improved by the acupuncture in clomiphene citrate(CC-induced rat model during implantation period. Results showed that, compared with the CC group, glandular development advanced, the serum estradiol levels decreased significantly, and the glandular area and endometrial LIF and OPN expression were significantly higher in acupuncture group. There were no significant differences in serum progesterone levels, endometrial thickness, and stromal area between groups. These results suggest that acupuncture can improve certain aspects of endometrial receptivity in CC-induced rat model during implantation period, which might result in endometrial state better to female reproduction.

  4. 绝经后阴道出血患者的子宫内膜厚度分析%Endometrial thickness for invasive investigations in women with postmenopausal bleeding

    Institute of Scientific and Technical Information of China (English)

    郭广玲; 张春莲; 陈双郧; 方彩云; 何琳; 苏华荣

    2012-01-01

    Objective To determine the prevalence of endometrial hyperplasia and endometrial cancer in postmeno-pausal women with endometrial thickness of 4. 0-8.0mm on transvaginal ultrasound scan. Design: Prospective observational study carried out in the Heart of Union Taihe Hospital of Hubeiyiyao Medical College in a population of 58 women with postmenopausal bleeding. Methods Prospective analysis of all women referred to the Rapid Access Clinic in the Heart with a history of postmenopausal bleeding period (January 2010-October 2010). Endometrial histology was taken as the final diagnosis. The main outcome measure was endometrial histology in women with postmenopausal bleeding with endometrial thickness of 4. 0~8.0mm. Results All women (n = 58) diagnosed with endometrial thickness of 4. 0~ 8.0mm on transvaginal sonography were included in the analysis. Out of these, a histological diagnosis was available in 17 women (29.3%). In total, three (5.2%) women were diagnosed with complex endometrial hyperplasia and three (5. 2%) women were diagnosed with endometrial carcinoma. Conclusion There is a significant prevalence of endometrial hyperplasia and endometrial cancer in postmenopausal women with a history of postmenopausal bleeding and who had endometrial thickness of 4. 0~8.0mm. Therefore, the current recommendation of histological assessment on all women with endometrial thickness 4.0mm should remain unchanged.%目的 研究子宫内膜厚度(4.0~8.0mm)在绝经后阴道出血的患者进行有创检查的必要性.方法 选取2010年1月~10月在十堰市太和医院妇科就诊的绝经后阴道出血的患者,通过问卷调查、进行阴道超声波扫描及宫腔镜检查,将子宫内膜厚度为4.0~8.0mm的患者58例刮取子宫内膜进行病理诊断.结果 58例患者中29.3%(17/58)未能获得子宫内膜样本,子宫内膜增生13.8%(8/58),慢性子宫内膜炎15.5%(9/58),子宫内膜息肉22.4%(13/58),子宫内膜癌5.2%(3/58),

  5. Independent prognostic value of peritoneal immunocytodiagnosis in endometrial carcinoma.

    Science.gov (United States)

    Benevolo, M; Mariani, L; Vocaturo, G; Vasselli, S; Natali, P G; Mottolese, M

    2000-02-01

    Among the clinical parameters that play a pivotal role in predicting the outcome of patients with endometrial carcinoma, intraperitoneal microscopic dissemination represents an important cause of recurrences. To date, peritoneal cytology has been incorporated into the current surgical staging system (International Federation of Gynecology and Obstetrics 88), although its predictive value remains a controversial issue. In this study the authors investigated the possibility of applying immunocytochemistry (ICC) to the diagnosis of peritoneal washing (PW) aimed at improving conventional cytology and verifying the prognostic value of peritoneal malignant cells. The authors analyzed 182 PWs sampled from endometrial cancer patients. The ICC analysis was performed using two monoclonal antibodies (MAbs)--AR-3 and B72.3--that in combination recognize more than 95% of endometrial carcinomas. The presence of peritoneal-free cancer cells was identified morphologically in 27 of 182 lavages (14.8%) and ICC in 50 of 182 (27.5%), with a significant improvement (p <0.0001). Five-year survival analysis, comparing results of ICC and cytodiagnosis, demonstrated a significant decrease of disease-free survival in patients with peritoneal microscopic disease. Furthermore, multivariate analysis showed that ICC diagnosis of PWs is an independent prognostic factor. Data indicate that the use of selected MAbs allows one to identify cytologically false-negative cases, providing results that are highly predictive of a worse clinical outcome.

  6. The Inflammation Response to DEHP through PPARγ in Endometrial Cells

    Directory of Open Access Journals (Sweden)

    Qiansheng Huang

    2016-03-01

    Full Text Available Epidemiological studies have shown the possible link between phthalates and endometrium-related gynecological diseases, however the molecular mechanism(s behind this is/are still unclear. In the study, both primary cultured endometrial cells and an endometrial adenocarcinoma cell line (Ishikawa were recruited to investigate the effects of di-(2-ethylhexyl phthalate (DEHP at human-relevant concentrations. The results showed that DEHP did not affect the viability of either type of cell, which showed different responses to inflammation. Primary cultured cells showed stronger inflammatory reactions than the Ishikawa cell line. The expression of inflammatory factors was induced both at the mRNA and protein levels, however the inflammation did not induce the progress of epithelial-mesenchymal transition (EMT as the protein levels of EMT markers were not affected after exposure to either cell type. Further study showed that the mRNA levels of peroxisome proliferator-activated receptor gamma (PPARγ wereup-regulated after exposure. In all, our study showed that human-relevant concentrations of DEHP could elicit the inflammatory response in primary cultured endometrial cells rather than in Ishikawa cell line. PPARγ may act as the mediating receptor in the inflammation reaction.

  7. The role of adhesive molecules in endometrial cancer: part II

    Directory of Open Access Journals (Sweden)

    Andrzej Malinowski

    2010-12-01

    Full Text Available The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutationin a gene encoding protein that is essential for cellular function. The subsequent cascade of eventsleads to accumulation of mutations and loss of cellular function. The cell loses its tissue-specific morphology,disconnects from other cells and extracellular matrix and migrates – the invasion begins. It is now clear thatadhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsiblefor attachment of the cells to each other and to the extracellular matrix. These interactions are crucial forboth structural and functional tissue organization. Lack of this homeostasis destroys the tissue architectureand impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in allexamined cancers, including endometrial cancer.Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many casesdiagnosed and treated in early stages, and thus with good results, some patients cannot be cured. Completeknowledge of the pathogenesis of the disease will be helpful in identifying the patients with negative prognosticfactors, increased risk of recurrence and, perhaps, to find other therapeutic options. In the paper we are trying tosum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer.

  8. The role of adhesive molecules in endometrial cancer: part I

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski

    2010-10-01

    Full Text Available The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutation in a gene encoding protein that is essential for cellular function. The subsequent cascade of events leads to accumulation of mutations and loss of cellular function. The cell loses its tissue-specific morphology, disconnects from other cells and extracellular matrix and migrates – the invasion begins. It is now clear that adhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsible for attachment of the cells to each other and to the extracellular matrix. These interactions are crucial for both structural and functional tissue organization. Lack of this homeostasis destroys the tissue architecture, impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in all examined cancers, including endometrial cancer.Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many cases it is diagnosed and treated in early stages, and thus with good results, some patients cannot be cured. A complete knowledge of the pathogenesis of the disease will be helpful in identifying patients with negative prognostic factors, increased risk of recurrence and, perhaps, finding other therapeutic options. In the paper we are trying to sum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer.

  9. Assessment of illness-related indicators in peripheral blood and skin lesion tissue of patients with vitiligo after NB-UVB, triamcinolone acetonide and vitiligo granules triple treatment

    Institute of Scientific and Technical Information of China (English)

    Wei-Liang Wang; Yan Chen; Feng-Bin Liu; Yuan-Zuo Huang; Ju-Zhen Lin; Guan-Biao Lyu

    2016-01-01

    Objective:To study the changes of illness-related indicators in peripheral blood and skin lesion tissue of patients with vitiligo after NB-UVB, triamcinolone acetonide and vitiligo granules triple treatment.Methods: Patients with vitiligo were selected as research subjects and randomly divided into two groups, observation group received NB-UVB, triamcinolone acetonide and vitiligo granules triple treatment, control group received combined therapy of NB-UVB and triamcinolone acetonide, and then the contents of lymphocyte subsets and cytokines in peripheral blo