Biomedical subjects
Publications and source records attributed to V Lamaina.
Ultrasound is a diagnostic method suitable for first level screening of ovarian cancer. The results in 4350 patients confirmed that ultrasound examination, both transabdominal and transvaginal, can be considered quite satisfactory because the sensibility was 100%.
A case of angular pregnancy was diagnosed by ultrasound examination after curettage of abortion hemorrhage. The rarity and clinical management of this condition are discussed, as well as the importance of ultrasound investigation for early diagnosis.
This report provides information regarding the relative importance of ER and PgR alone and both, as markers, in 352 breast cancers. We observed that the presence of ER not involves the presence of PgR, while the presence of PgR assumes an estrogenic action even if the lowest. In addition the presence of PgR+ depends also on ER negative-detectable (91.42% of the cases) such as we were able to observe that PgR+ was associated with ER negative-undetectable, only in 8.57% of cases. Moreover within the positivity of the couple of ER/PgR, the prognostic value is correlated at ER+ levels, while the predictive value is correlated at PgR+ levels.
From October 1982 through December 1986, standardized abdominal-pelvic sonography was performed on 257 patients with ovarian cancer scheduled to undergo surgery (laparoscopy, laparotomy). This U.S. test was evaluated by a gynaecologist who was informed of the clinical diagnosis and the findings of physical examination. The Authors selected 110 patients with ovarian cancer, underwent a second look laparotomy, for both diagnostic and therapeutic purposes. The sensitivity (53%), the specificity (68%), the predictive value (78%) and the accuracy 71.8%) of ultrasound for detecting disease have been evaluated to assess its usefulness as a non invasive diagnostic modality in these patients.
The Monoclonal Antibody technology has been used in 29 cases of ovarian cancer. The immuno-enzyme-assay detected positive levels of estrogen cytoplasmatic receptor in 51.8% of the cases as well as in the nuclear (51.8%). Moreover, the ER/EIA technique screened positive levels of Total ER (ER/t) in 72.4% versus 65.5% obtained by DCC-method. 24.1% of the cases had negative ER/t levels observed by EIA. The monoclonal antibody anti-ER is a very interesting method for studying hormone-dependent tissue, because it uses an immunological binding to antigenic protein (receptor).
The benign breast pathology embraces a wide variety of anatomo-clinical-pathological conditions producing confusion in nomenclature. The Authors collected three different types of BBP and investigated the hormonal receptor status for each. The following concentrations of ERc were found: 1-6 fmol/mg in BBD; less than 2 fmol/mg in GCD; 12-18 fmol/mg in the cytoplasm and 29-37.5 fmol/mg in the nucleus in FA. In FA, PgR was found in concentrations of 43.5-50 fmol/mg in the cytoplasm and 0.2-10 fmol/mg in the nucleus. Even if we consider these three histo-pathological entities (BBD, GCD, FA) separately, no correlation can be seen between the presence of receptors and benign breast disease. The only observation we can make is that the fibroadenomas contain more easily identifiable receptor concentrations than BBD and GCD.
The authors selected 263 ER cases and 224 ER/PgR cases for receptor status analysis from 1548 breast cancer tissues assayed. 30 Operating-theatres address their breast frozen specimens at our laboratory and thanks to this wide cooperation, we can perform the statistical analysis and relationship with very good reliability. In our experience we observed that the response to hormonal therapy is present in 50% of the cases containing ER concentrations up to 100 fmol/mg of proteins, and in 74% of the cases with ER concentrations more of 100 fmol/mg of proteins. Considering the presence of both receptors (ER+/PgR+) we observed the response rate to hormonal treatment in 76% of the cases while in 9% of the cases the status is ER/PgR negative. The cases classified ER negative and PgR positive demonstrated a response rate of 28%, 7 out of 26 cases ER+/PgR- responded to hormonal therapy. In this last situation, in addition to experienced hypotheses, the authors believe it is important to examine sonographically the ovaries, because the presence of a functional ovarian cyst could influence the saturation of receptorial sites.
Since 1982 we have been associating the study of hormonal receptors with the histological examination of the vulvar lesions in an attempt to interpret the action mechanism of steroids on the vulva, to find possible correlations between histological pictures and receptorial order and to find a possible predictive "marker" toward therapeutic and prognostic ends. In our Laboratory assays for androgen, estrogen and progesterone receptors were performed with the Dextran-Charcoal technique in 41 patients with vulvar dystrophy; 20 of whom had atrophic dystrophy and 21 with hypertrophic dystrophy. Another 24 patients with vulvar carcinoma were studied; 23 with epidermoid carcinoma of various differentiation grades and only one case of Paget's Disease. None of the three receptors assayed could be considered a predictive or prognostic marker in the approach to neoplastic forms. The levels of the progesterone receptor appears increased in the case of dystrophies. This justifies the hypothesis of a hormonal involvement in the pathogenesis of the lesion, as has already been documented by the beneficial effects of therapy with topical steroids.
The problem of progestin treatment for benign breast disease and mastodynia is still dividing Clinicians and Searchers: the traditional methods of clinical investigation and follow-up do not allow any further step in the debate. In this work we evaluated the role of E2/Progesterone R.I.A. and thermography in monitoring the effect of progestin on BBD and found that only the latter can give useful informations, insufficient, however, to direct the treatment. If we want to be able to select the patients suitable to be treated by progesterone, we must know the tissutal hormone receptivity and be able to reexamine it during the treatment to verify the effectiveness of the administered drug. These informations can be obtained through the assay of Estradiol and Progesterone Receptors in the most accessible hormone-dependent tissue: the endometrium. Our data point out a quite different behaviour of Estradiol and Progesterone cytoplasmic Receptors in the endometrium of women with mastodynia and controls. The knowledge of these informations in the single patient will let us come out from subjectivity when deciding about BBD therapy or when trying to correct unsatisfactory treatments.
As breast dysfunctional pathology does not appear constantly correlated to significant variations of steroid plasma levels, we purposed to verify whether the control of tissutal mechanism of hormone vehiculation can provide more reliable informations, in order to identify early endocrine disorders and to check more properly the effectiveness of the treatment from both a qualitative and a quantitative standpoint. In this view we assayed the receptors for estradiol and progesterone in the endometrium of women with mastodynia and healthy controls, to verify whether endometrial tissue receptivity may be useful in the control of breast tissue receptivity; in fact, both the tissues are hormone-dependent and equally exposed to the hormones of the menstrual cycle.