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U Stendahl

Publications and source records attributed to U Stendahl.

At least 73 records · Page 4Linked to original sources
PubMed1980

Invasive squamous cell carcinoma of the uterine cervix. I. Definition of parameters in a histopathologic malignancy grading system.

A histologic malignancy grading system for invasive squamous cell carcinoma of the uterine cervix is presented. The method is based upon evaluation of the tumour cell population in terms cell differentiation, structure, nuclear polymorphism and the frequency of mitotic figures in terms of a 1 to 3 point scale. The tumour-host relationship was also estimated in terms of a 1 to 3 point scale, by the mode of invasion, stage of invasion, vascular invasion and degree of lymphoplasmocytic infiltration. These parameters permitted a grading with 8 to 24 points totally.

Carcinoma, Squamous Cell↗
PubMed1979

Classification and grading of invasive squamous cell carcinoma of the uterine cervix.

In 155 patients with invasive squamous carcinoma of the uterine cervix malignancy point grading was based on histologic examination of pretreatment biopsies. The observation time extended over 10 years. All patients received similar radiologic treatment. Tumour cell population and tumour-host relationship were estimated separately using eight parameters graded from 1 to 3. A fairly sharp border is distinguishable at 16 points, but an overlap occurred in both directions. The curable recurrences had 16 points or less. The necessity of deep biopsies for adequate grading was demonstrated.

Adult↗
PubMedDate not supplied

The clinicopathologic significance of laminin-5 gamma2 chain expression in cervical squamous carcinoma and adenocarcinoma.

Carcinoma of the uterine cervix is one of the most prevalent malignancies among women in developing countries and the third most common type worldwide. Squamous cell carcinoma predominates in the cervix uteri, while adenocarcinoma and adenosquamous carcinomas represent about 10-15% of all cervical cancers. Many studies have confirmed that the human papillomavirus (HPV) is the most important etiologic factor in the development of cervical cancer. The aim of our study was to investigate the expression of the laminin-5 gamma2 chain in primary malignancies of the cervix uteri and to focus on the clinicopathologic significance of the expression of the laminin-5 gamma2 chain in cervical squamous carcinoma and adenocarcinoma with respect to age and survival of the patients. The study consisted of a total of 89 cases of invasive cervical cancer (54 squamous carcinomas and 35 adenocarcinomas). The laminin-5 gamma2 chain was found in 80% of all the squamous carcinoma and in 66% of cervical adenocarcinoma. There was no correlation of the high expression of laminin-5 with survival. The univariate analysis in squamous cell carcinoma showed that factors such as the stage of the disease and positive lymph nodes had an impact on the survival of the patients, whereas in the multivariate analysis, only age at diagnosis was an independent prognostic factor. However, in cases with cervical adenocarcinoma, only the stage of the disease was an independent prognostic factor. There was no difference between HPV-positive and HPV-negative tumors concerning the high expression of laminin-5 gamma2 chain. Our results indicate that the majority of the primary cervical tumors, especially squamous cell carcinoma, showed expression of laminin-5 gamma2 chain immunoreactivity. Independent prognostic values for the survival of the patients were age and stage of the disease.

Adenocarcinoma↗
PubMedDate not supplied

Matrix metalloproteinases-2 and -9 in cervical cancer: different roles in tumor progression.

The incidence of uterine cervical cancer has increased slightly in Western countries, with an increase in relatively young women. Overexpression of matrix metalloproteinases (MMPs)-2 and -9 has turned out as a prognostic factor in many cancers. We compared the expression of the proteins MMP-2 and MMP-9 in cervical primary tumors with clinical outcome and risk factors of cervical cancer. One hundred sixty-one patients with cervical cancer treated in Umeå University Hospital or Sahlgrenska University Hospital, Sweden, between 1991 and 1995 were included in the study. Paraffin-embedded tissue samples obtained prior to treatment were examined immunohistochemically by specific antibodies for MMP-2 and MMP-9. Forty-two percent of the tumors were intensively positive for MMP-2 and 31% for MMP-9. Nineteen percent of the samples were intensively positive for both proteinases and 47% negative or weak for both. Overexpression of MMP-2 seemed to predict unfavorable survival under Kaplan-Meier analysis and in the multivariate analysis. Early sexual activity and low parity seemed to correlate to overexpression of MMP-2. MMP-9 was not associated with survival or sexual behavior. Intensive MMP-9 was noted in grade 1 tumors. We conclude that MMP-2 and MMP-9 have different roles in uterine cervical cancer. MMP-2 could be associated with aggressive behavior, but MMP-9 expression diminishes in high-grade tumors.

Adult↗
PubMedDate not supplied

Association between orosomucoid types and cancer.

Orosomucoid (ORM) is a polymorphic acute-phase reactant with immunosuppressive properties. Previous investigations have suggested that ORM and other acute-phase reactants may act as blocking factors protecting tumor cells against immunological attack, thereby contributing to the 'immune escape' of the tumor. ORM types were studied by isoelectric focusing and immunoprinting in patients with carcinoma of the breast, lung, ovary and endometrium and in population controls. In accordance with a previous study, the frequencies of the ORM1*2 allele and the ORM1 2 phenotype were found to be significantly increased in patients with different types of carcinomas. The results suggest that the ORM1 2 variant may influence the progression of cancer by being more immunosuppressive than the ORM1 1 variant. The relative risk for carcinoma in patients with the ORM1 2 type was 1.56 (95% confidence interval:1.16-2.09).

Alleles↗
PubMedDate not supplied

Invasive squamous cell carcinoma of the uterine cervix. VIII. Survival and malignancy grading in patients treated by irradiation in Lund 1969-1970.

The correlation between certain prognostic factors and the 10-year survival/lethality rate was analysed in 168 patients with invasive squamous cell carcinoma of the uterine cervix stage I A-II B treated by radiation therapy from 1969 through 1970. These factors included a malignancy grading system (MGS) consisting of 8 items: structure (P1), differentiation into cell type (P2), nuclear polymorphism (P3), mitosis (P4), mode of invasion (P5), stage of invasion (P6), vascular invasion (P7), and host-cellular response (P8). Histologic differentiation (1) and differentiation into cell type (11), the patient's age, the year of admission, the clinical stage (FIGO), and irradiation were also analysed. Many of these factors were correlated to the prognosis. However, the MGS system was superior as a predictive factor. Patients with a low MGS score had an extremely good survival rate at both the 5- and 10-year controls. The patients with a high MGS score had approximately 55 per cent lethality at 10 years. The MGS was significantly superior to each separate item as well as to each predictive factor (p less than 0.05). Further, no other important predictive factor could be identified after the MGS had been included in the multivariate analyses.

Adult↗
PubMedDate not supplied

Comparison between flow cytometry and single cell cytophotometry for DNA content analysis of the uterine cervix.

The DNA content of tumor cells in imprints and biopsies from 33 patients with invasive squamous cell carcinoma and 5 patients with adenocarcinoma of the uterine cervix were analyzed by flow cytometric and single cell cytophotometric methods. A correlation of r = 0.83 was found between the modal DNA values obtained by the two methods. Both methods discriminated between diploid and aneuploid tumors and gave comparable but not identical results. Single cell cytophotometric measurements were in this study more reliable than flow cytometric measurements in diploid tumors. Multiple stemlines, small aneuploid peaks and the so called S-phase rate could only be determined by the flow cytometric technique. Flow cytometry seems to be the method of choice in determination of the DNA content in cervical carcinoma cells and cytophotometric single cell measurements are of complementary value.

Adenocarcinoma↗
PubMedDate not supplied

Flow cytometric DNA patterns in cervical carcinoma.

Flow cytometric measurements of the DNA content were performed in a prospective study of 167 women with invasive squamous cell carcinoma of the uterine cervix. Ploidy level and the proportion of S-phase cells were correlated to age, menopausal age, staging according to FIGO and histopathology. With increasing age a successive shift from a dominance of peri-diploid and peri-tetraploid values to marked aneuploidy was found. Peri-diploid and peri-tetraploid tumors were more often found in premenopausal than in post-menopausal women (p less than 0.001). The mean S-phase rate was significantly higher in women aged 60-89 years than in women aged 20-59 years (p less than 0.01). More aneuploid tumors were found in stages III and IV than in stages IB and II (p less than 0.01). The mean S-phase rate was higher in stages III and IV (20.8%) than in stages IB and II (17.2%) (p less than 0.01). No statistically significant correlation was shown between ploidy level and histopathology or between S-phase rate and histopathology. In 37 patients polyclonal tumors were found. The reproducibility of the method was good (r = 0.99).

Adult↗
PubMedDate not supplied

Correlations between serum progesterone and smoking, and the growth fraction of cervical squamous cell carcinoma.

BACKGROUND: Possible correlations between growth fraction of squamous cervical carcinomas and serum progesterone (se-P) concentrations, smoking habits and DNA ploidy were studied. MATERIALS AND METHODS: The DNA S-phase fraction (SPF), measured by flow cytometry was used as a marker of tumour growth in 103 cases of squamous cervical cancer stage IB-IV. DNA-ploidy (peridiploidy vs. aneuploidy), Se-P, se-Estradiol, smoking habits, parity, menopausal status, clinical stage and histopathological grading were compared to SPF < 14% vs. SPF > or = 14%. RESULTS: Aneuploidy, (odds ratio (OR) 10.0), se-P > or = 2.6 nmol/l (OR 7.5) and smoking (OR 3.0) were significantly associated with SPF > or = 14%, after adjustments for all factors included in the study. The association with se-P and smoking was attributed to an increased risk for the premenopausal women in the study. DISCUSSION: In this study an increased tumour growth was associated with increased leves of se-P, smoking and aneuploidy in women with invasive squamous cervical carcinoma. This study seems to experimentally confirm epidemiological studies, where smoking and long-term use of oral contraceptives have been linked to cervical neoplasms.

Adult↗
PubMedDate not supplied

Prognostic significance of flow cytometric and clinical variables in endometrial adenocarcinoma stages I and II.

In a prospective study comprising 447 women with endometrial carcinoma stages I-II, the prognostic significance of clinical and flow cytometric variables was evaluated in univariate and multivariate analyses. The parameters studied included age, uterine cavity depth, clinical stage, histopathologic grade, myometrial invasion, weight, body mass index (BMI), parity, diabetes, oestrogen treatment, DNA - content and S-phase fraction. Patient selection for surgery influenced prognosis with a better survival in operated patients. In the univariate analysis the following parameters correlated with survival: age, grade, myometrial invasion, DNA - content and S- phase fraction. In the multivariate analyses which included clinical variables only, age, grade and myometrial invasion remained significant, but when flow cytometric variables were added, only S-phase fraction and myometrial invasion contained prognostic information. S-phase fraction also generally correlated with time of recurrence.

Adenocarcinoma↗
PubMedDate not supplied

Preliminary experience with intraperitoneal catheters in the treatment of ovarian cancer.

Twenty-nine patients with ovarian carcinoma were treated with intraperitoneal cisplatin. Insertion of an intraabdominal catheter was performed during second-look laparotomy. Only one serious complication occurred with abdominal pain, ileus and local peritonitis. Otherwise, the major problems were of a technical nature with separation of the plastic tube from the metallic part of the catheter in 3 cases. In 8 of 29 patients intraperitoneal treatment was discontinued mainly due to local problems at the site of the pot. The procedure is otherwise safe and well tolerated by patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Prognostic indices in endometrial adenocarcinoma stages I and II. A study based on clinical, histopathological and flow cytometric variables.

In a prospective study including 447 patients with endometrial adenocarcinoma stages I and II, clinical and flow cytometric variables were studied in univariate and multivariate analyses. During the follow-up period of 3 to 65 months, 41 patients died of their disease and 26 patients died of intercurrent disease. Based on the results of multivariate analyses, five different prognostic indices were constructed. Using these indices, individual index values were calculated for each patient. The index values were correlated with survival and were used to identify a small high-risk group (10% of the patients) and a large low-risk group (90% of the patients). Indices 1 and 2 were constructed for pre-treatment situations. Index 1 included age and histopathologic grade and identified a small high-risk group and a large low-risk group with a 3-year survival of 62% and 91% respectively. Index 2 also comprised S-phase fraction and distinguished a high-risk group with a 3-year survival of 54% from a low-risk group with a 3-year survival of 93%. Indices 3 and 4 were constructed for patients after surgery, when the degree of residual myometrial tumor invasion was known. Index 3 included age, histopathologic grade and residual myometrial invasion rendering a 3-year survival of 44% and 93% for the high- and low-risk groups respectively. Index 4 also comprised S-phase fraction and identified a high-risk group and a low-risk group with 3-year survival figures of 59% and 96%, respectively. Index 5 included age and histopathologic grade and was constructed for post-treatment situations in unoperated patients. The index separated a high-risk group from a low-risk group with a 3-year survival of 56% and 88%, respectively. In summary, the results from our study show that the prognostic indices made it possible to identify high and low-risk groups in different clinical situations which may prove useful in selecting candidates for future trials with adjuvant or reduced treatment.

Adenocarcinoma↗
PubMedDate not supplied

Progesterone androstenedione testosterone and clinical characteristics in endometrial carcinoma.

Serum concentrations of progesterone (P), androstenedione (A) and testosterone (T) were measured in 128 postmenopausal women with endometrial adenocarcinoma. The correlations between these hormones were studied and related to such clinical parameters as: stage, histopathology, age, gynaecological history, body mass index and related diseases. In previous studies we have shown the relations between oestron (E1) and oestradiol (E2) serum concentration and clinical parameters. A clear correlation was seen between E1 and E2. Both E1 and E2 also strongly correlated with BMI. In this study androstenedione is found to correlate with E1 and E2, p less than 0.03 and p less than 0.02 resp. Progesterone and E1 were correlated, p less than 0.01, but not P and E2. Testosterone correlated with E1, p less than 0.002, E2, p less than 0.003 and A, p less than 0.02. None of the hormones P, A or T correlate with BMI. Androstenedione and age, and A and menopausal years showed a negative correlation, p less than 0.01 for both. Testosterone correlated with menopausal years, p less than 0.03; and correlated negatively with years of menstruation, p less than 0.03. These results do not support the hypothesis that A is the exclusive precursor for conversion to E1 in fat tissue. The correlation between P and E1 could indicate a relation to steroids higher up in the synthesis chain. The influence of P, A and T on the investigated clinical factors can not be strong, since correlations are virtually missing.

Adenocarcinoma↗
PubMedDate not supplied

HPV 18 and cervical adenocarcinomas.

Using Southern blot or in situ hybridization, several studies have recently reported an association between HPV 18 and adenocarcinoma of the uterine cervix. In this study PCR was used to analyse the presence of HPV 16 and 18 in paraffin embedded biopsies of cervical adenocarcinoma in Northern Sweden. HPV DNA was confirmed in 11 (42%) of 26 cases. Seven (27%) were positive for HPV 18 and 4 (15%) for HPV 16. Nine of 13 premenopausal cases were HPV positive compared to only 2 of 13 postmenopausal cases (p less than 0.015). There was also a tendency towards previous negative cytology in HPV 18 positive premenopausal patients. The significance of these findings in relation to epidemiology of cervical adenocarcinoma is discussed.

Adenocarcinoma↗
PubMedDate not supplied

Double HPV infection in African cervical cancer detected by polymerase chain reaction.

Biopsy samples from 13 Kenyan patients with squamous cell carcinoma of the cervix were analysed for the presence of type specific HPV DNA by polymerase chain reaction (PCR). HPV 16 was confirmed in 11 (85%) and HPV 18 in 9 (69%) samples. HPV 6 DNA was detectable in only 3 (23%) samples and no HPV 33 was found. Infection with either HpV16 or 18 was seen in 12 (92%) and infection with both in 8 (62%) cases. The prevalence of double infection found is higher than in previous reports. The significance of this and possible effects of parity on cervical neoplastic changes are discussed.

Adult↗
PubMedDate not supplied

Flow cytometry and interactive image cytometry in endometrial carcinoma. A comparative and prognostic study.

Comparative DNA measurements were performed in 139 women with endometrial carcinoma using flow cytometry (FCM) and interactive image cytometry (ICM). Ploidy level and the percentage of S-phase cells were determined by FCM and ploidy level and the percentage of cells with a DNA content exceeding 2.5c, 3c, 4c and 5c, respectively, were calculated by ICM. The aim was to compare ploidy level obtained by the two methods and to evaluate the prognostic value of all the above-mentioned parameters. Recurrence or residual disease after completing treatment were used as end-points. Follow-up time was 18-48 months. An agreement was obtained in 85% of the cases as regards ploidy level, but in 15% the tumors were regarded as near-diploid by one method and as grossly aneuploid by the other. Both ploidy level (both methods) and S-phase rate (FCM) were correlated with histopathologic grade (p less than 0.001 and p less than 0.05, respectively). In univariate analysis, ploidy level (obtained either by FCM or ICM) correlated with recurrence rate, with a more favourable prognosis for near-diploid cases. When using multivariate models (Cox analysis) including clinical variables, ploidy level by FCM (but not ICM) was still significant as regards prognosis. In the multivariate analysis, S-phase fraction (as measured by FCM) also yielded independent prognostic information. In a separate analysis the proportion of cells with a DNA content greater than 5c gave independent prognostic information besides that of the S-phase fraction and ploidy level. We conclude that measurements of the percentage of cells exceeding 5c give prognostic information beyond the information obtained from flow cytometric determination of ploidy level and S-phase fraction.

Aged↗
PubMedDate not supplied

Antiestrogenic treatment of advanced and recurrent carcinoma corporis uteri--a phase II study of toremifene.

The antitumor efficacy and toxicity of a new anti-estrogenic substance--toremifene--were investigated in a phase II study. Twenty-six patients were eligible for final evaluation (6 primary and 20 recurrent disease). A daily dose of 200 mg toremifene was given orally. Treatment continued for at least 3 months, until progression or significant side-effects were encountered. The response rate was 35% (3 CR and 6 PR). Six patients had NC and 11 did not respond to the treatment. The median duration of responses for CR was 10+ months (range 3(+)-19) and for PR 4 months (range 3(+)-16). The treatment seems to be well tolerated and effective.

Aged↗