Biomedical subjects

S Ozalp

Publications and source records attributed to S Ozalp.

At least 19 recordsLinked to original sources

PubMed2007

Benign clear cell adenofibroma of the ovary. A case report with literature review.

Most clear cell neoplasms of the ovaries are carcinomas; benign and borderline clear cell tumors are uncommon. To date, only 12 cases of benign clear cell adenofibroma have been reported in the literature. Here we report a case of benign clear cell adenofibroma of the left ovary in a 51-year-old postmenopausal woman. Histological examination revealed widely spaced simple glands embedded in a dense fibrous stroma. The glands were lined by one to two layers of cells with abundant clear cytoplasm. The nuclei were bland and uniform in size and shape. There was minimal cytologic atypia in some areas. In this article we discussed the criteria for the diagnosis of benign and borderline clear cell adenofibromas and reviewed the literature.

Adenofibroma↗

PubMed2006

F18-FDG coincidence-PET in patients with suspected gynecological malignancy.

PURPOSE: To assess the role of F18-FDG imaging with a dual-head coincidence mode gamma camera (Co-PET) in identifying malignant tumors in patients with a suspicious adnexal mass depicted by conventional imaging methods. MATERIAL AND METHODS: F18-FDG Co-PET was performed preoperatively in 18 women (mean age 56.38 years) with suspected malignant gynecologic tumors according to clinical and abdomino-pelvic/transvaginal ultrasound or computed tomography findings. Exploratory laparotomy was performed in all patients within the 10 days post-F18-FDG Co-PET study, and the definitive diagnosis of the adnexal masses was established by histopathological examination. RESULTS: Histopathological examinations of the surgically excised adnexal masses revealed eight malignant, one borderline, and nine benign neoplastic tumors. Four benign tumors had no F18-FDG uptake, while the remaining five tumors, all leiomyomas, showed mild FDG accumulation. Eight malignant tumors showed intense F18-FDG uptake. Sensitivity, specificity, PPV, and NPV of F18-FDG co-PET in differentiating benign from malign adnexal masses were 88%, 44%, 61%, and 80%, respectively. Tumor to background ratios (T/B) in benign lesions (2.04 +/- 0.27) were significantly lower than in malignant lesions (7.4 +/- 0.99). CONCLUSION: F18-FDG Co-PET is of clinical value when assessing suspicious malignant adnexal masses. False-negative F18-FDG results might arise from borderline disease. Moderate F18-FDG uptake in leiomyomas can result false-positive, but T/B ratios may be helpful in such cases.

Adenocarcinoma↗

PubMed2006

Gynecologic problems among elderly women in comparison with women aged between 45-64 years.

BACKGROUND: As women age, they face a variety of co-morbid medical problems as well as gynecologic problems that may differ from those of younger women. Clinicians should know how to screen and manage those problems among elderly women. OBJECTIVE: With this background, the study was designed to assess the gynecologic problems on admission among elderly women and women aged between 45-64 years. METHODS: A retrospective analysis of symptom distribution of 200 women aged over 65 years and 200 women aged between 45-64 years from January 1999 to December 2003 was performed in an university clinic. PARTICIPANTS: Geriatric women and women aged between 45-64 years with gynecologic complaints on admission to outpatient clinics between January 1999 and December 2003. Analyses of demographic data and data related to symptom distribution, using appropriate parametric and non-paramertic statistical tests, were performed. RESULTS: Geriatric women had a higher number of pregnancies (p < 0.01) but lower percentage of hormone replacement therapy use (p < 0.1) compared to women aged 45-64 years. No significant difference was observed in terms of the age at menopause. Vaginal fullness was felt most commonly by elderly women (p < 0.01) in contrast to menopausal vasomotor symptoms which were relevant in the younger age group (p < 0.01). As a clinical diagnosis, pelvic relaxation with uterine prolapse and genital malignancies were the common two diagnoses among geriatric women (p < 0.05). Postmenopausal vaginal bleeeding was observed more often among geriatric women compared to women aged 45-64 years (19.5% vs 12%, p = 0.03). Endometrial and ovarian cancer distribution did not differ among the two groups when the initial complaint was postmenopausal bleeding. CONCLUSION: Type and management of gynecologic problems in women aged over 65 can be challenging and differ from those for younger women. Thus, caring for these women in their reproductive years as well as in later life should be an aim for all obstetrician-gynecologists.

Age Factors↗

PubMed2005

Genetic imbalances in endometrial hyperplasia and endometrioid carcinoma detected by comparative genomic hybridization.

OBJECTIVE: To evaluate the sequential genomic copy alterations related to the development of precursor lesions and endometrioid-type endometrial carcinomas, and its association with cellular atypia. STUDY DESIGN: Paraffin-embedded tissue specimens from 32 cases of endometrial hyperplasia, 15 of endometrial carcinoma, and 20 of normal endometrial tissue were retrospectively evaluated by the comparative genomic hybridization (CGH) technique. The average number of copy alterations (ANCA) index was used to define the incidence of genomic imbalances in each tissue group. Identified sequential genetic abnormalities were compared with the final histopathological diagnosis and the cellular atypia. RESULTS: Detectable and consistent chromosomal imbalances were found in 13 hyperplasia and 9 carcinoma specimens. There was a significant correlation between ANCA value and degree of cellular atypia and tumor grade. While 1p36-pter, 20q deletions, and 4q overrepresentation were the most prevalent imbalances detected in both complex hyperplasia and complex atypical hyperplasia, 17q22-qter deletion and amplification of 2p34 were only seen in hyperplasia with atypical cells. Overrepresentations of chromosomes 8q, 1q, and 3q are the most frequent aberrations in endometrial carcinomas, but were absent from all the precursor lesions except one. Underrepresentations of chromosomes 1p36-pter and 10q are the other commonly seen aberrations in carcinomas, the latter being more frequent in moderately differentiated than in poorly differentiated lesions. CONCLUSIONS: Different patterns of chromosomal aberrations are seen in precursor lesions than in endometrial carcinomas, except for the loss of 1p36-pter. The presence of 1p deletion in both endometrial hyperplasia and cancer specimens suggests that this is an early event in the development of carcinoma. These results support a stepwise mode of tumorigenesis with accumulation of a series of genomic copy alterations in endometrial carcinogenesis.

Chromosome Aberrations↗

PubMed2005

Pelvic abscess in intrauterine device users.

OBJECTIVE: To assess the causality between pelvic abscess formation and intrauterine device (IUD) use through a clinical study in a hospital. METHOD: Sixty-two pelvic abscesses were retrospectively evaluated over a 7-year period. Patient records retrieved for the women enrolled in this study consisted of demographic characteristics, duration of IUD use and clinical management details. RESULTS: All the women were monogamous Muslim women without any suspicious sexual contacts, immunosupressive states, or drug use at the time of IUD insertion. In 10 cases (16.1%), a history of pelvic surgery was present. The mean age of the women was 36.1 +/- 2.3 years (range 19-50 years). Of the 62 women, 14 (22.6%) were current IUD users. The mean time interval for women using IUD prior to the diagnosis of pelvic abscess was 5.7 +/- 1.2 years (range 1-14 years). In all cases, a pelvic mass and abdominal pain constituted the referral signs and symptoms. All women received an initial antibiotic regimen comprising penicillin (24 mU/day), clindamycin (900 mg/day) and gentamycin (240 mg/day) in divided doses. In 38 cases (61.3%), medical treatment yielded a satisfactory clinical outcome, defined as a decreas in mass volume together with pain relief and a decrease in leukocytosis. Twenty-four cases (38.7%) underwent a subsequent surgical procedure, either laparotomy (n = 19) or laparoscopy (n = 5). The type of surgery ranged from abscess drainage to more radical approaches such as total abdominal hysterectomy and/or unilateral or bilateral salpingo-oophorectomy. There were no differences between those women responding to medical therapy and those who did not respond in terms of mean age, percentage of past pelvic surgery, gravidity, parity and the size of pelvic abscess. CONCLUSIONS: A substantial number of women with an IUD were diagnosed as having a pelvic abscess within a 7-year period at the university clinic. Despite current knowledge that pelvic inflammatory disease and pelvic abscess are rarely encountered in long-term IUD users, the presence of an IUD should be investigated in cases with an initial diagnosis of pelvic abscess based on clinical and ultrasonographic evaluation, demonstrating mostly acquisition via sexually transmitted disease.

Abscess↗

PubMed2005

Accessibility and availability of abortion in six European countries.

OBJECTIVES: The accessibility and availability of abortion are a reflection of abortion law and the accessibility and availability of abortion services. Experiences from six European countries with different political, cultural, social and religious backgrounds (the Netherlands, France, Great Britain, Slovenia, Hungary and Turkey) are presented. RESULTS: Abortion laws in Europe range from complete prohibition to complete liberalization of abortion. Some countries demand a waiting period for the procedure, pre-abortion counseling, parental approval for minors, and in the others there are no mandatory requirements. Abortions are generally performed in authorized facilities by gynecologists or general practitioners. Abortion services are easily accessible, in terms of the law, availability of facilities and health insurance coverage of the procedure in the Netherlands, France and Slovenia. Abortion service is less accessible in United Kingdom, Hungary and Turkey, as a result of limited accessibility to abortion services or a relatively high abortion fee. In some Eastern European countries there has been a tendency in the last decade to limit the availability and access to abortion. CONCLUSIONS: In Europe abortion is generally well accessible in terms of abortion laws. There are differences in accessibility to abortion services between the countries, and in some countries, also between different areas of the country.

Abortion, Induced↗

PubMed2005

Mixed serous and endometrioid carcinoma of the fallopian tube: a case report with literature review.

Malignant neoplasms of the fallopian tube are the rarest of the gynecologic cancers. The frequency of histologic subtypes has been difficult to ascertain from the literature because most authors have not classified these tumors according to their cell types. Papillary serous adenocarcinoma appears to be the most common histologic type. On the contrary, mixed cell types of fallopian tube carcinoma have rarely been reported in the literature. A case of mixed serous and endometrioid carcinoma of the fallopian tube is presented and the related literature is reviewed.

Adult↗

PubMed2003

Efficacy of gemcitabine in heavily pretreated advanced ovarian cancer patients.

Single agent gemcitabine was used in recurrent epithelial ovarian cancer patients after standard treatment with debulking surgery and platin-paclitaxel based chemotherapy. Response rates and toxicity results were evaluated retrospectively. Gemcitabine was given in 1000 mg/m2 intravenous infusion over 30 minutes at 1, 8, 15 days of every 28 days. Clinical response was evaluated with clinical findings, serum CA 125 levels, and computerized tomography. Twenty-two patients--ten as second-line, 11 as third-line, and one as fourth line--received gemcitabine. Seven patients received six courses, nine cases three, five cases two and one case one course of treatment. There were four (18.2%) partial and two (9.1%) complete responses with an overall response rate of 27.3%. Stable disease was also observed in three more cases. The progression-free interval was found to be a median of three months. Grade 3-4 neutropenia was seen in two (9.1%) and grade 3-4 thrombocytopenia was seen in four (18.2%) cases. Pancytopenia was observed in one (4.5%) patient. There was no grade 3-4 non-hematological toxicity. Antitumoral activity is encouraging in heavily pretreated ovarian cancer patients. A short progression-free interval is noticeable in responding cases. Toxicity is mainly hematologic and moderate.

Adult↗

PubMed2003

Should endometrial hyperplasia be regarded as a reason for abnormal uterine bleeding in users of the intrauterine contraceptive device?

OBJECTIVE: Histopathological evaluation of the endometrium in cases having an intrauterine device (IUD) removed for abnormal uterine bleeding. METHODS: Fifty-eight consecutive patients with a complaint of uterine bleeding leading to IUD removal were recruited for this study. Endometrial sampling, via Novak curette, was performed during IUD removal for histopathological evaluation of the endometrium. RESULTS: A total of 58 current IUD users, presenting with uterine bleeding, were retrospectively analyzed. Mean age of the women was 37.1 +/- 2.1 years (range 25-43). Mean duration of IUD use was 4.2 +/- 1.3 years (range 1-10). Out of 58 cases, 21 (36.2%) did not harbor any endometrial pathology. In eight cases (13.8%), hyperplastic endometrial changes were apparent, six of which were simple hyperplasia (four of them were focal). Two cases of complex hyperplasia were detected (one was diffuse with atypia and one was focal without atypia). In this series, there was one case with an endometrial polyp. Mean age of cases with hyperplastic endometrium was found to be statistically high compared to those with normal endometrial histology (42.4 +/- 3.2 vs. 37.6 +/- 2.1, p = 0.04). In cases with IUD use of > 5 years, chronic endometritis was more prevalent, compared to those with < 5 years of use (chi(2) 5.08, p = 0.02). CONCLUSIONS: IUD use is a risk factor for chronic endometritis. Nevertheless, in 13.8% of cases in this series, as a reason for abnormal uterine bleeding, other than endometritis, endometrial hyperplasia constituted the second most common endometrial pathology among cases over the age of 40, on current IUD use and having complaints of abnormal uterine bleeding. Hence, this finding should prompt the physician to perform endometrial sampling in users of an IUD over the age of 40, presenting with abnormal uterine bleeding.

Adult↗

PubMed2003

Preoperative serum vascular endothelial growth factor (VEGF) in ovarian masses.

PURPOSE OF THE INVESTIGATION: To determine the diagnostic value of serum vascular endothelial growth factor (VEGF) in the preoperative assessment of the nature of ovarian masses. MATERIALS AND METHODS: A prospective cohort study was conducted from August 2001 to September 2002 on 40 premenopausal and 23 postmenopausal patients with ovarian masses. During preoperative workup, patient age, serum Ca-125 levels, serum VEGF levels, and tumor volume based on ultrasonographic examination were determined. Laparoscopic (n=23) or laparotomic (n=39) approaches were undertaken to obtain the final pathologic result. According to the final ovarian pathology, follicular cysts, corpus luteum cysts and endometriomas were grouped as non-neoplastic ovarian masses (n=40, group I). Serous or mucinous cyctadenomas, dermoid tumors and fibromas were allocated into the neoplastic benign ovarian mass group (n=10, group II). Primary malignant ovarian neoplasms were categorized into the neoplastic-malign group (n=12, group III). RESULTS: Mean ages of cases among groups I, II and III were 39.0 +/- 2.0, 42.2 +/- 5.2 and 56.9 +/- 4.2, respectively. As age of the cases enrolled in this sudy increased, the more likely was the occurrence of neoplastic malign ovarian pathologies (p < 0.001). Among postmenopausal cases diagnosed with an ovarian mass, serum Ca-125 levels were 113.5 +/- 20 IU/ml compared to those in premenopausal cases (85.8 +/- 16.0, p = 0.05). The values for serum VEGF values among pre- and postmenopausal ovarian masses were 46.2 +/- 6.7 pg/ml and 68.2 +/- 7.9, respectively (p = 0.04). In group I, serum VEGF levels of endometriomas (56.5 +/- 1.5 pg/ml) were higher compared to those of follicular or corpus luteum cysts (30.6 +/- 2.8, p = 0.05). In contrast, tumor size appeared to be larger in non-endometriotic. non-neoplastic cysts (10.1 +/- 2.0 cm), compared to endometriomas (6.4 +/- 0.6 cm, p < 0.01). Serum VEGF levels of group III were higher than other groups (p < 0.001). With respect to the discriminating benign or malign nature of the mass, with a specific cut-off value of serum VEGF level of 68.7 pg/ml, the sensitivity, specificity, positive and negative likelihood ratios were 92.3%, 88.0%, 3.3 and 0.1, respectively. For serum Ca-125 levels, the sensitivity, specificity, positive and negative likelihood ratio with a statistically relevant cut-off value of 102 IU/ml were, 76.9%, 76.0%, 3.21 and 0.3, respectively. Area under curve (AUC) for serum VEGF and Ca-125 values were 0.938 (95% CI: 0.81-0.96) and 0.769 (95% CI: 0.64-0.86), respectively (p = 0.02). Among the postmenopausal group, AUC for serum VEGF and Ca-125 was detected as 0.902 (95% CI: 0.70-0.98) and 0.873 (95% CI: 0.66-0.91) (p = 0.14). CONCLUSION: Serum VEGF has the potential to be considered as a tumor marker with a good diagnostic relevance in differentiating the nature of ovarian masses.

Adult↗

PubMed2003

p53 overexpression as a prognostic indicator in endometrial carcinoma.

PURPOSE: To investigate the prognostic value of p53 overexpression in endometrial adenocarcinoma cases of different stages and histologic subtypes. METHODS: One hundred and eleven surgically staged endometrial carcinoma (EC) cases from 1996 to 2000 constituted this retrospective study group. Prognostic factors determined through the evaluation of surgery specimens by co-author pathologist, were surgical stage, tumor size, histology, histologic and nuclear grade, myometrial invasion, adnexal/serosal metastasis, peritoneal cytology, retroperitoneal lymph node involvement p53 overexpression was assessed via immunohistochemical staining. Tissues that expressed p53 were considered as positive p53 staining. In terms of degree of staining, 1-29%, 30-90% and 80-100% of tumoral tissue stained with p53 were considered to be mild, moderate and high p53 staining, respectively. RESULTS: Mean age and follow-up period of the study group were 58.2 +/- 10.6 years and 33.4 +/- 2.7 months, respectively. Percentages of cases surgically staged as early (I-II) and advanced (III-IV) FIGO stages were 65.8% (n: 73) and 34.2% (n: 38), respectively. Cases with positive p53 staining had a significantly high mean survival period compared with those with negative p53 staining (86.6 +/- 6.0 vs 49.1 +/- 8.1, p < 0.001). p53 overexpression was statistically detected to be high in Stage III-IV tumors, non-endometrioid histologic subtypes (p = 0.019), histologic and nuclear grade 2-3 tumors (p < 0.001), adnexal/serosal metastasis (p = 0.001), lymph node involvement (p = 0.012), and positive peritoneal cytology (p = 0.017). The degree of p53 staining was remarkably correlated with survival. In cases with mild and high p53 staining, mean survival times were 47.1 +/- 7.0 months and 57.0 +/- 13.1 months, respectively (p = 0.0003) compared to those with high p53 staining. On univariate analysis, all of the prognosticators, including p53 staining (p < 0.001) and degree of p53 staining (p < 0.001) appeared to be independent risk factors for poor prognosis. On multivariate analysis, only pelvic lymph node involvement (p = 0.03), serosal/adnexal involvement (p = 0.004), and positive peritoneal cytology (p = 0.01) were found to be independent prognosticators of survival while p53 expression (p = 0.743) and degree of p53 staining (p = 0.802) were not detected as independent prognosticators. CONCLUSION: p53 overexpression is strongly related to poor prognostic indicators in endometrial adenocarcinoma. Although in this study p53 overexpression was not detected as an independent prognosticator, additional studies with large data set are needed to evaluate the prognostic value of p53 expression.

Adenocarcinoma↗

PubMed2003

Microvessel density (MVD) as a prognosticator in endometrial carcinoma.

PURPOSE: To assess microvessel density (MVD) as a marker for angiogenesis in endometrial carcinoma (EC) and normal endometrium at the proliferative and secretory phase, and to determine its prognostic value on survival among cases with EC. METHODS: Forty-three endometrial carcinoma cases were surgically staged and recruited for this case-control study. Tissue specimens from hysterectomies due to benign conditions (uterine descensus, myoma uteri, chronic pelvic pain, adenomyosis), that belonged to proliferative (n = 10) and secretory (n = 10) endometrium (n = 10), were studied as the control group (n = 20). MVD was assessed in hot areas where a high density of microvessels were detected within tumoral tissue and normal endometrium at proliferative and secretory phases. Among EC, various prognosticators such as tumor stage, histological and nuclear grade, tumor size, lympho-vascular space involvement (LVSI), cervical involvement, myometrial invasion, adnexal and lymph node involvement, peritoneal cytology and MVD were analysed in regard to survival. RESULTS: The mean age of cases with EC was 58.3 +/- 1.4. MVD was apparently high in EC cases (p < 0.05). Among control cases, endometrium from proliferative and secretory phases of the menstrual cycle was not statistically different (48.5 +/- 3.6 vs 47.4 +/- 3.8, respectively). MVD was correlated with high surgical stage (p < 0.001), cervical involvement (p = 0.01), adnexal involvement (p = 0.04), lympho-vascular space involvement (p = 0.02), pelvic and para-aortic lymph node metastasis (p < 0.001) and positive peritoneal cytology (p < 0.001). On univariate analysis, with a MVD cut-off value of 81/0.739 mm2, surgical stage (p < 0.001), LVSI (p < 0.001), retroperitoneal lymph node involvement (p < 0.001), adnexal metastasis (p < 0.001), peritoneal cytology (p = 0.005) and MVD count (p < 0.001) appeared to be independent factors for survival. On multivariate analysis, only pelvic lymph node involvement (p = 0.03) and MVD (p = 0.02) were found to be independent prognosticators on survival. CONCLUSIONS: Angiogenesis is apparent in both initial and further evolution of a tumoral process. MVD appears to have a substantial prognostic value on survival in EC cases.

Adult↗

PubMed2003

Frequency of hydatidiform mole in the rural part of Eskişehir: the first community-based epidemiological study in Turkey.

This epidemiological study was performed in order to determine the frequency of hydatidiform mole (HM) in the rural part of Eskişehir, Turkey. Four mole cases and 6,274 pregnancies were determined in 2,032, women aged 15-49 which was 85% of the target population. Mean age, mean marriage age and mean marriage duration of the interviewed women were 34.7, 19.1 and 15.6 years, respectively. The frequency of HM per 1,000 live births and per 1,000 pregnancies was 0.83 and 0.64, respectively. The frequency of HM was lower than the frequencies reported by most of the hospital-based studies. We concluded that there appears to be a need to conduct properly designed community-based studies with well-established case registry systems to find the real incidence of HM in Turkey.

Adolescent↗

PubMed2003

Prognostic value of matrix metalloproteinase-9 (gelatinase-B) expression in epithelial ovarian tumors.

PURPOSE OF INVESTIGATION: To determine the expression of matrix metalloproteinase-9 (MMP-9) expression in malignant and borderline ovarian tumors and its correlation to prognosis. METHODS: Forty-five patients with primary epithelial ovarian tumors were enrolled in this retrospective study from 1988 to 2002. Only malignant (n = 30) and borderline (n = 15) ovarian tumors constituted the study group. All cases were surgically staged according to FIGO criteria. Patient characteristics and clinico-pathological findings were obtained from hospital records. Paraffin-embedded tissue blocks were treated with MMP-9 immunohistochemical stain. The percentage of the total number of tumors staining positively was categorised and awarded a score of 0 to 4: < 5% as 0, < or = 6-25% as 1, 26-50% as 2, 51-75% as 3 and 76-100% as 4. The intensity of immunostaining was scored on a 3-point scale: 1, weak; 2, moderate and 3, intense. A weighed score for each tumor specimen was produced by multiplying the percentage score with the intensity score and was defined as the 'epithelial MMP-9 score'. Stromal staining was also assessed as weak, moderate and intense. Cases with final epithelial MMP-9 scores < or = 6 and > 6 were then recategorised into two groups, accordingly. Based on degree of stromal staining, cases were recategorised into two final groups as mildly stained and intense or moderately stained. Tumor stages were regrouped as early (Stage I-II) and late (Stage III-IV), respectively. RESULTS: Mean ages of cases with malignant and borderline ovarian tumors were 57.2 +/- 3.1 and 49.7 +/- 2.1 years, respectively. Epithelial MMP-9 scores were higher in malignant tumors compared to borderline tumors (p = 0.014). However, with regard to stromal MMP-9 staining, no significant difference was observed among malignant and borderline tumors (p = 0.113). Among malignant ovarian tumors, epithelial MMP-9 scores did not differ between early versus late-staged and well versus poorly differentiated tumors. Median survival time of cases with epithelial MMP-9 scores < or = 6 and > 6 were 24 months and 32 months, respectively (log-rank: 0.93, p = 0.335). Cases with weak stromal MMP-9 staining had a longer median survival (48 months) compared to cases with moderate or intense stromal MMP-9 staining (24 months, log-rank: 4.46, p = 0.03). CONCLUSION: Epithelial MMP-9 expression generally appears in the malignant form of ovarian tumors compared to borderline tumors. MMP-9 expression in the stroma but not in the epithelium contributes to poor survival in ovarian cancers.

Biomarkers, Tumor↗

PubMed2003

Microvessel density as a prognostic factor in preinvasive and invasive cervical lesions.

OBJECTIVE: To assess angiogenesis in preinvasive and invasive cervical lesions and its prognostic value in squamous cell carcinoma (SCC). METHODS: Twenty-seven cervical intraepithelial lesions (CIN I, II and III), 27 Stage Ib-IIa SCC and 12 normal cervical epithelium were included in the study. Clinico-pathological prognostic factors were re-evaluated from the patients' files and previous tissue sections. Microvessel density (MVD), a marker for angiogenesis, was assessed from new tissue blocks by an immunohistochemical staining method. Statistical tests included Kruskall-Wallis analysis, the Mann-Whitney U-test, Fisher's exact t-test to analyse the categorical data and Cox regression and Kaplan-Meier survival analyses to define the effect of prognosticators on survival. RESULTS: CIN II and III lesions had significantly higher MVD counts than normal epithelium and CIN I lesions, both of which had similar MVD count. Compared to preinvasive lesions invasive SCC had significantly higher MVD counts. Among SCC cases, only pelvic lymph node involvement appeared to be independent risk factor on unvariate analysis. However, MVD, as a cut-off value of 21 determined by ROC analysis, was found to be an independent prognosticator in early stage SCC cases by multivariate analysis. CONCLUSION: Despite the small number of enrolled cases, the results of this study suggest that angiogenesis involved in the development and progression of cervical neoplasms and MVD might be used as a prognostic factor.

Adult↗

PubMed2001

Pelvic tuberculosis mimicking signs of abdominopelvic malignancy.

We discuss the clinical presentation and consequences of pelvic tuberculosis in the context of 3 cases having developed typical signs and symptoms of ascites and abdominal mass. These cases are reported to emphasize the difficulty of early diagnosis and treatment of the disease.

Abdominal Neoplasms↗

PubMed2001

Effect of cellular DNA content on the prognosis of epithelial ovarian cancers.

OBJECTIVE: To assess the cellular DNA status of epithelial ovarian cancers with regard to clinicopathological findings and its effect on prognosis. MATERIALS AND METHODS: Twenty-six consecutive patients with a diagnosis of epithelial ovarian cancer who had been treated by primary surgery and six courses of platinum-based chemotherapy were enrolled in this study. Second-look laparotomy (SLL) was performed in all cases following confirmation of the clinical remission state. Surgical stage, tumor grade, initial tumor volume, residual tumor volume, histopathologic differentiation, and SLL findings were analyzed in correlation with DNA ploidy and DNA index. DNA analysis was performed via DNA flow cytometry through paraffin-embedded tissue specimens. RESULTS: Of 26 patients, flow cytometric studies revealed 16 aneuploidy cases (61.5%). DNA index values ranged from 1.1 to 1.82 (average 1.29 +/- 0.28). The flow cytometry coefficient of variation mean value was set to 6.7. Taking the cutoff value of 1.2 for DNA indices, a fairly good correlation was detected between DNA ploidy and DNA indices (p < 0.001). The aneuploidy incidence was found to be high in advanced and poorly differentiated tumors (p < 0.05). There was statistically more residual tumor volume in aneuploid tumors during primary cytoreductive surgery and also higher recurrence rates following six courses of chemotherapy compared with diploid tumors (p < 0.05). No significant correlation was detected between the histopathologic subtypes and tumor volume (p > 0.05). Residual tumor volumes were larger in cases with DNA indices of 1.2 yielding higher residual tumor volume following surgery and being in good correlation with SLL results (p < 0.05). The mean survival rates of cases with aneuploid tumor and a DNA index of >1.2 were low compared to those with diploid tumors and DNA indices of <1.2 tumors (p < 0.05). CONCLUSION: DNA ploidy and DNA indices are important prognosticators for malignant epithelial ovarian tumors. They should be evaluated together with the patient's clinical status and other prognostic factors.

Adult↗

PubMed2001

Recurrent molar pregnancy: report of a case with seven consecutive hydatidiform moles.

A case of seven consecutive hydatidiform moles is presented. All of her pregnancies revealed a molar pregnancy, 4 of which were demonstrated histopathologically. In the context of this study, the potential risk for malignant transformation and the obstetric outcome are highlighted. The literature regarding recurrent molar pregnancies is reviewed.

Adult↗