Expression of selected molecular factors in two types of endometrial cancer

BACKGROUND

Endometrial cancers (EC) are a heterogeneous group of malignant neoplasms differing in etiology, clinical-pathological features and prognosis.

OBJECTIVES

To determine the differences between the expression of selected molecular factors and find connections between them in order to isolate possible biomarkers influencing treatment options.

MATERIAL AND METHODS

The investigated data involved archival histological preparations obtained from uterine EC samples taken from 137 patients, treated surgically between 2007 and 2014. The immunohistochemical Dako EnVisionTM Flex+ method was applied.

RESULTS

The expression of ERβ, MLH1 and BRCA1 was lower in ECI than in ECII patients. The ERα expression was higher in early Fédération internationale de gynécologie et d'obstétrique (FIGO) (IA) stages than in advanced (IB-IV) stages, while ERβ expression was significantly higher in advanced stages compared to stage IA and increased with grading. The BRCA1 expression also increased with grading. In both type I and type II EC patients, ERα expression correlated with MYH9 and BRCA1, while ERβ expression correlated with BAP expression. High expression of BRCA1 correlated with several proteins: BAP, MYH9 and FAK. High BAP expression also correlated with high MYH9 expression. A correlation in the expression of these proteins was also demonstrated in the group consisting only of patients with ECI. A significant correlation was found between BAP expression and MYH9 among patients diagnosed with ECI. In the ECII group, no correlation was found between the tested proteins.

CONCLUSIONS

The ECI and ECII patients differed in the studied molecular factors, mainly in terms of ER and BRCA1 expression. Changes in BRCA1 expression were linked to alterations in BAP expression, but were also associated with the proteins MYH9 and FAK.

Streptococcus agalactiae and Chlamydia trachomatis detection in women without symptoms of infection

BACKGROUND

Chlamydia trachomatis (C. trachomatis) and Streptococcus agalactiae (GBS) may be present in the female cervical canal without any symptoms of infection. Chronic chlamydial infections lead to many serious complications and perinatal infections, while the presence of GBS is a reservoir for infections of newborns or invasive streptococcal infection in adults.

OBJECTIVES

To examine healthy women for C. trachomatis without symptoms from the reproductive system, assess the frequency of asymptomatic infections, detect GBS in the cervical canal, demonstrate differences in drug susceptibility, and determine the serotype of S. agalactiae strains and correlations among the ones present in the cervical canal.

MATERIAL AND METHODS

A total of 315 cervical swabs were collected for genetic and microbiological analysis for the presence of C. trachomatis and S. agalactiae. Latex and diffusion-disk methods were used to determine the serotype and susceptibility of streptococci.

RESULTS

Ten out of 315 women (3.2%) were C. trachomatis-positive. Using traditional methods of microscopy, culture and serology, 42 strains (13.3% of the subjects) obtained from patients were identified as S. agalactiae and further analyzed. The most common serotypes identified were II (18/42, 42.9%), V (11/42, 26.2%) and III (10/42, 23.8%). The less common serotypes found were VII (2/10, 4.8%), and Ib (1/10, 2.4%); no Ia, IV or VII serotypes were found. All the strains were susceptible to penicillin, while 71.4% of them were susceptible to erythromycin and 81.0% were susceptible to clindamycin. Seven isolates (16.7%) were concomitantly resistant to erythromycin and clindamycin.

CONCLUSIONS

Chlamydia trachomatis was confirmed in 3.2% of the respondents, and GBS was found in 13.3%, despite a lack of symptoms of infection. The incidence of C. trachomatis infections and GBS colonization in Poland is similar to those in other European countries.

Significance of BRCA1 expression in breast and ovarian cancer patients with brain metastasis - A multicentre study

PURPOSE

Cerebral metastases develop in 10-30% of patients with breast cancer (BC) and in around 3.3 to 4% of patients with ovarian cancer (OC). The aim of the multicenter study is to investigate the correlation between the expression of estrogen alpha receptors (ERα), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), stromal cell-derived factor 1 (SDF1) and its receptor C-X-C chemokine receptor type 4 (CXCR4), breast cancer metastasis suppressor 1 (BRMS1), astrocyte elevated gene 1 (AEG1), depending on the status of BRCA1 protein, in patients suffering from OC and BC with brain metastases.

PATIENTS AND METHODS

The analysis included 51 patients: 29 with BC and 22 with OC, in whom brain metastases were disclosed.

RESULTS

In most patients (65.5% of BC patients and 68.2% of patients with OC tumors) BRCA1 protein loss was found. No correlation was disclosed between the levels of ERα, PR receptors, HER2, SDF1, CXCR4, AEG1, BRMS1 and BRCA1 status, patient age, stage of disease advancement, grade of histological maturity of the cells, presence of metastases to lymph nodes. A statistically significant correlation was disclosed between the negative expression of PR receptors and a high expression of CXCR4 in patients with BC. High values of the AEG1 protein (linked to metastases) were detected alongside a high expression of BRMS1 (a suppressor of metastases).

CONCLUSIONS

Patients with BC and OC and brain metastases have a frequent loss of BRCA1 expression. The role of ERα, PR, HER2, SDF1, CXCR4, AEG1, BRMS1 in metastatic process needs further studies.

PCR diagnostics of Chlamydia trachomatis in asymptomatic infection by women

OBJECTIVES

Chlamydial infection is often asymptomatic. The lack of symptoms may result in the infection developing into a chronic. Chlamydial infections of the genitourinary system in women can lead to serious complications like PID, fallopian tubes infertility, ectopic pregnancy, and chronic pelvic pain. An infection of the genitourinary system does not cause any lasting immune resistance and does not protect against re-infection. The aim of this research was to conduct tests for Chlamydia trachomatis on healthy women without any genital system symptoms and to estimate the frequency of asymptomatic infections.

MATERIAL AND METHODS

During preventive examinations a cervical smear was obtained from the patients n = 100. The aver-age age of the patients was 24.86 ± 3.15. The swabs were sampled by gynecologists. During the examinations Geneproof PathogenFree DNA isolation Kit and GeneProof Chlamydia trachomatis PCR kit which detects 16S rRNA conservative coding sequence, conservative region of cryptic plasmid DNA, including deletion mutation in cryptic plasmid (Swedish variant).

RESULTS

Swabs were sampled from 100 women aged 18-32 who had no symptoms of chlamydial genitourinary system infection. Within the study group 4% of women received a positive result, i.e. 4/100.

CONCLUSIONS

The study confirmed asymptotic infection in 4% of women. In own research it was not possible to confirm cor-relation between the presence of Chlamydia trachomatis and the number of partners or the number of sexual intercourses.

Does Metformin affect ER, PR, IGF-1R, β-catenin and PAX-2 expression in women with diabetes mellitus and endometrial cancer?

OBJECTIVE

Diabetes mellitus, as a risk factor for endometrial cancer (EC), causes an increase in insulin and IGF-1 concentrations in the blood serum. The increase in insulin and IGF-1 are considered mitogenic factors contributory to cancer development. Studies suggest that metformin has preventive activity, decreasing mortality and the risk of neoplasms. Since estrogen (ER), progesterone (PR) and IGF-1 (IGF-1R) receptor expression and β-catenin and PAX-2 mutations are significant in the development of endometrial cancer, it was decided to study these factors in patients with endometrial cancer and type 2 diabetes mellitus (DM2), and to establish the effects of metformin on their expression.

METHODS

The expression of ER, PR, IGF-1R, β-catenin and PAX-2 have been immunohistochemically investigated in 86 type I endometrial cancer specimens. Patients were grouped according to the presence of DM2 and the type of hypoglycemic treatment administered.

RESULTS

Comparing EC patients with DM2 and normal glycemic status, we found increased IGF-1R expression in women with DM2. A decrease in ER expression was noted in women with EC and DM2 receiving metformin as compared to women treated with insulin (p = 0.004). There was no statistically significant difference in PR, IGF-1R, β-catenin and PAX-2 expression among women receiving metformin and other hypoglycemic treatment.

CONCLUSION

Although epidemiological studies suggest the beneficial role of metformin in many human cancers, there are still few studies confirming its favorable effect on endometrial cancer. Decreased ER expression in patients receiving metformin needs further research to allow evaluation of its clinical significance.

The association between the p53/topoisomerase I and p53/ topoisomerase IIalpha immunophenotypes and the progression of ovarian carcinomas

BACKGROUND

In in vitro studies it has been revealed that p53 protein expression might regulate topoisomerase I (topo I) and topoisomerase IIalpha (topo IIalpha) levels in tumor cells. So far, the association between the p53 protein and topo I and topo IIalpha expression and its impact on ovarian carcinoma progression has not been analyzed.

OBJECTIVES

The aim of the study was to examine the association between topo I and topo IIalpha expression and p53 protein overexpression with respect to the morphological features and progressive growth of ovarian tumors.

MATERIAL AND METHODS

The expression of the studied biomarkers was estimated by immunohistochemical staining in tumor sections from 136 malignant and 30 benign ovarian neoplasms.

RESULTS

Significant differences for topo I, topo IIalpha and p53 expression between malignant and benign tumors were observed (p < 0.01). The expression of topo IIalpha and p53 protein was associated with advanced stages of ovarian carcinomas (p < 0.01). Differences between topo I-positive cases and low (G1) and high (G3) tumor grade had only borderline significance (p = 0.07). In ovarian carcinomas, positive correlations between topo I and topo IIalpha, topo I and p53 and topo Ilalpha and p53 protein expression were revealed (p = 0.001). No relationship between the studied biomarkers was found in benign ovarian tumors (p > 0.05). p53/topo I and p53/topo IIalpha immunophenotypes were associated with advanced stages of ovarian carcinoma (p = 0.045 and p = 0.009, respectively), p53/topo IIalpha positive ovarian carcinomas were more frequently observed in high than in low tumor grades and the differences were only of borderline significance (p = 0.07).

CONCLUSIONS

Current findings suggest that on the one hand, cooperation between topo I, topo IIalpha and p53 protein participates in the progressive growth of ovarian tumors. On the other hand, simultaneous expression of the studied proteins identifies the subgroup of ovarian cancers with aggressive biological features which might be considered in therapy.

HLA-C C1C2 heterozygosity may protect women bearing the killer immunoglobulin-like receptor AA genotype from spontaneous abortion

Spontaneous abortion is the most common complication of human pregnancy. Natural killer (NK) cells expressing killer immunoglobulin-like receptors (KIRs), which may recognize HLA-C (i.e. its C1 or C2 groups) on trophoblast cells, constitute a large leukocyte population in the endometrium. This study investigated whether genetic polymorphisms in the KIR and HLA-C genes are risk factors for spontaneous abortion. One hundred and twenty-five couples with at least two spontaneous abortions, including eighty-five couples with idiopathic recurrent abortion (RSA; three or more abortions), and 117 control couples (with two or more healthy-born children) were tested. The frequencies of the individual KIR genes in the patients were similar to those in the controls. In the group of KIR AA women with HLA-C C2C2 partners, the HLA-C C1C2 heterozygotes were present in the controls but not in the patients (p=0.015 for all patients and p=0.0048 for RSA, but both comparisons lost significance after Bonferroni correction), whereas both homozygotes, C1C1 and C2C2, were absent in the control women but present among the aborting ones. Therefore, our results suggest that among KIR AA women who have HLA-C C2C2 partners, HLA-C heterozygous females show a trend towards an increased chance of successful pregnancy.

Does the KIR2DS5 gene protect from some human diseases?

Background

KIR2DS5 gene encodes an activating natural killer cell receptor whose ligand is not known. It was recently reported to affect the outcome of hematopoietic stem cell transplantation.

Methodology/Principal Findings

In our studies on KIR2DS5 gene associations with human diseases, we compared the frequencies of this gene in patients and relevant controls. Typing for KIR2DS5 gene was performed by either individual or multiplex polymerase chain reactions which, when compared in the same samples, gave concordant results. We noted an apparently protective effect of KIR2DS5 gene presence in several clinical conditions, but not in others. Namely, this effect was observed in ankylosing spondylitis (p = 0.003, odds ratio [OR] = 0.47, confidence interval [CI] = 0.28–0.79), endometriosis (p = 0.03, OR = 0.25, CI = 0.07–0.82) and acute rejection of kidney graft (p = 0.0056, OR = 0.44, CI = 0.24–0.80), but not in non-small-cell lung carcinoma, rheumatoid arthritis, spontaneous abortion, or leukemia (all p>0.05). In addition, the simultaneous presence of KIR2DS5 gene and HLA-C C1 allotype exhibited an even stronger protective effect on ankylosing spondylitis (p = 0.0003, OR = 0.35, CI = 0.19–0.65), whereas a lack of KIR2DS5 and the presence of the HLA-C C2 allotype was associated with ankylosing spondylitis (p = 0.0017, OR = 1.92, CI = 1.28–2.89), whereas a lack of KIR2DS5 and presence of C1 allotype was associated with rheumatoid arthritis (p = 0.005, OR = 1.47, CI = 1.13–1.92). The presence of both KIR2DS5 and C1 seemed to protect from acute kidney graft rejection (p = 0.017, OR = 0.47, CI = 0.25–0.89), whereas lack of KIR2DS5 and presence of C2 seemed to favor rejection (p = 0.0015, OR = 2.13, CI = 1.34–3.37).

Conclusions/Significance

Our results suggest that KIR2DS5 may protect from endometriosis, ankylosing spondylitis, and acute rejection of kidney graft.

Expression of p53 protein phosphorylated at serine 20 and serine 392 in malignant and benign ovarian neoplasms: correlation with clinicopathological parameters of tumors

INTRODUCTION

The modification of p53 protein by phosphorylation plays an important role in its stabilization and the regulation of its biological properties. The study investigated the expression of p53 protein phosphorylated at serine 20 (Ser20) and Ser392 and the association between clinicopathological parameters of ovarian neoplasms with respect to p53 protein overexpression.

METHODS

p53 protein expression was evaluated on tissues from malignant and benign ovarian tumors. Protein expression was measured in a subset of the specimens using immunohistochemistry.

RESULTS

The correlation between p53 protein overexpression and p53-Ser392 phosphorylation was found in ovarian carcinomas (P = 0.001, r = +0.27). In the total group of ovarian carcinomas, significant differences were observed in p53 protein overexpression between well (G1) and poor (G3) tumor grades (P = 0.005) and between serous and endometrioid types of tumor (P = 0.04), whereas p53-Ser20 phosphorylation was associated with advanced International Federation of Gynecology and Obstetrics stage (P = 0.004) and high tumor grade (P = 0.02). In p53-positive ovarian carcinomas, p53-Ser392 phosphorylation was associated with advanced tumor stage (P = 0.02) and high tumor grade (P = 0.049). p53-Ser20 phosphorylation was associated with low tumor grade of p53-positive ovarian carcinomas (P = 0.02) and with high tumor grade of p53-negative ovarian carcinomas (P = 0.02).

CONCLUSIONS

These results revealed that p53 phosphorylation at Ser20 and Ser392 is an early event in ovarian tumor development. The authors suggest that the expression of p53 protein phosphorylated at Ser20 and Ser392 in ovarian carcinomas determines their individual clinical features depending on p53 protein status and may be useful biological biomarkers characterizing their behavior.

[Antiphospholipid syndrome in pregnancy--contemporary opinions concerning pathogenesis and diagnostic criteria]

Antiphospholipid syndrome is an autoimmunological disease, characterized by coexistence of antiphospholipid antibodies in serum and vascular thrombosis or characteristic obstetrical complications. In spite of numerous clinical trials concerning antiphospholipid syndrome in pregnancy, performed in Poland as well as abroad, there are still some unclear aspects connected with this disease. In the paper, authors pay particular attention to patomechanism and contemporary diagnostic trends of antiphospholipid syndrome in pregnancy.

[Antiphospholipid syndrome in pregnancy--actual therapeutic methods]

Considering multidirectional mechanism of antiphospholipid antibodies activity, resulting in fetal loss, various therapeutic methods of antiphospholipid syndrome (APS) in pregnant women have been used until now. The paper is a review of literature concerning therapeutic methods of APS in pregnancy currently used or being clinically and experimentally investigated. Their efficacy, in particular, forms of the disease as well as risk of side effects occurrence were presented.

[Chlamydia trachomatis as an etiological factor of marital infertility--is a routine diagnostics worth to perform?]

Chlamydia trachomatis is one of the most common sexually transmitted human pathogens. Chlamydial infection is a problem concerning about 12% of young, sexually active persons at reproductive age. Because of subtle or, particularly at women, asymptomatic course, the disease may be imperceptible by patients and untreated until complications occur. When the infection spreads outside cervix and urethra,W irreversible damages in the range of genital-urinary system are often. Fever and leucocytosis can confirm the complications, occurring in the form of pelvic inflammatory disease, causing infertility. Health education, screening programs for high risk patients and proper early treatment of both sexual partners could contribute to decreasing dangerous results of chlamydial infections, especially in aspect of marital infertility problem.

Evaluation of superoxide dismutase activity and its impact on semen quality parameters of infertile men

The evaluation of superoxide dismutase (SOD) activity, as one of the most important antioxidative defence enzymes, in seminal plasma of patients consulting for male infertility was presented in the article. The study included also the determination of its influence on selected human semen quality parameters. The material represents semen samples obtained from 15 men, which were divided into two groups: Group I (n=10) including patients consulting for infertility and Group II (n=5) containing healthy sperm donors as a control. All of the semen samples were cryopreserved and stored in liquid nitrogen. The frozen samples were thawed at the same time and then SOD activity was determined spectrophotometrically. The analysis of the investigations results indicates a significantly lower semen SOD activity detected in oligoasthenozoospermic patients, comparing to the activity found in normospermic men. The study showed a positive correlation between SOD activity in seminal plasma and semen quality parameters--sperm concentration and overall motility, which are regarded as the most important for normal fertilizing ability of the spermatozoa. Significantly lower SOD activity in seminal plasma of infertile patients, comparing to healthy sperm donors, as well as positive correlation and beneficial impact of SOD activity on human semen quality parameters seem to confirm the observations, that decreased seminal plasma scavenger antioxidant capacity, particularly in form of low SOD activity, can be responsible for male infertility. This trial shows that SOD activity survey in seminal plasma could be a useful tool for determining sperm fertilization potential and could improve the diagnosis of male infertility.

[Mycoplasmatic infections and their role in marital infertility]

Mycoplasmas belong to the large group of microbes and may cause pathologic symptoms in different human organs and systems. The most of them are commensals. They are mostly detected in sexually active persons. Only few of mycoplasmatic species are unquestionable etiological factors of different human infections. They cause illness of respiratory system and kidneys. They are frequently connected with nongonococcal urethritis, epididymitis, prostatitis as well as female pelvic inflammatory disease. Mycoplasmas as etiological factors of genital organ infections have been kept in background of other pathogens for a long time. Recently, the connection between mycoplasmatic infections and marital infertility has been noticed more often. Nowadays this problem is frequently described in Polish as well as foreign scientific literature. The article is an attempt to introduce the problem of mycoplasmatic infections of urogenital male and female system. Simultaneously, it tries to answer the question whether and how they can be an essential cause of marital infertility.

[A case of Edwards' syndrome in pregnancy complicated by serologic incompatibility and preeclampsia]

A case of Edwards' syndrome (trisomy 18) diagnosed in the third pregnancy trimester is described. The diagnosis was based on sonographic examination and cytogenetic amniocentesis. Lethal genetic fetal malformation determined the medical indication to preterm delivery. Additionally, serologic incompatibility during pregnancy was observed, as well as pregnancy induced hypertension turning into preeclampsia after the labour action was evoked. A caesarean section due to obstetric indications was done. Phenotype and lethal congenital malformations in the newborn have confirmed of the chromosome aberration prenatally diagnosed.

[The outcome of pregnancy and delivery in primigravid pregnancy with Kearn-Sayre's syndrome]

The Kearn-Sayre's syndrome is an uncommon, non-hereditary disease which belongs to the group of mitochondrial myopathy. The characteristic symptoms of this syndrome often appear before the age of 20. In this report we describe the outcome of primigravid pregnancy of a 33 year old woman with early diagnosed Kearn-Sayre's syndrome.

[Total and ionized magnesium concentration in the blood plasma and erythrocytic magnesium concentration of women in the third trimester of pregnancy with imminent preterm labor]

OBJECTIVES

There are some data concerning magnesium concentration influence on the risk of preterm labor. The estimation of magnesium concentration changes may be useful in prevention of preterm labor.

DESIGN

Therefore the aim of our study was to find out the correlation between magnesium concentration and the risk of preterm labor.

MATERIALS AND METHODS

Total magnesium concentration and ionized magnesium concentration in blood plasma and erythrocytic magnesium concentration ware examined in the three groups of: 23 women in the third trimester of pregnancy with imminent preterm labor under tocolytic therapy; 20 women in the third trimester of physiologic pregnancy and 19 non-pregnant healthy women in the reproductive age.

RESULTS

We discovered statistically confirmed differences (p < 0,05 ) in ionized magnesium concentration as well between the group of women in physiologic pregnancy and non-pregnant women and between the group of pregnant women with imminent preterm labor and non-pregnant women.

CONCLUSIONS

Although there were no statistically confirmed differences in total magnesium concentration and erythrocytic magnesium concentration between the three groups of examined women, there were statistically confirmed differences in ionized magnesium concentration between the pregnant and non-pregnant women. Our results suggest that ionized magnesium concentration is better indicator of magnesium balance in human's body than total magnesium concentration.

[Immunosuppressive drug therapy during pregnancy after kidney transplantation]

The authors expounded present state of knowledge concerning immunosuppressive drugs therapy during pregnancy after kidney transplantation. Pregnancy is uncommon in women with end-stage renal disease treated with dialysis and in most cases it ends with pregnancy failure. Resuming the normal function of the ovaries after kidney transplantation substantially increases the chances of conception and successful pregnancy. The immunosuppression scheme and dosage of drugs used in pregnant women are vital to both the normal course of pregnancy and delivery of a healthy child. Considering the safety of the fetus it is acceptable to use prednisone, azathioprine, cyclosporine and tacrolimus. Due to the necessity to administer immunosuppressive drugs in relatively small doses, an important factor conditioning the normal course of pregnancy is maintaining a 1- or 2-year interval between the kidney transplantation and the conception.

[Mental disorders during pregnancy and postpartum period--epidemiology, etiology, classification and treatment]

The paper presents current knowledge about the prevalence of mental disorders during pregnancy and postpartum period and its' classification. Possible pathomechanisms of its incidence, risk factors and therapeutic possibilities based on the newest research were described.

[Assessment of cell proliferation based on group analysis of Ki-67 index in serous ovarian cancers]

OBJECTIVES

Ovarian neoplasms are very important problems in medicine, because they account for 23% of all female genital neoplasms, and they are the cause of 47% deaths among women suffering from cancers of the female reproductive organs. Growth of the neoplasms depends on the speed of cells' reproduction. Monoclonal antibody Ki-67 detects specific antigen--nonhistonic protein of cellular nucleus, which is characteristic for dividing cells. It gives the possibility of using Ki-67 to establish proliferating index, especially in intensely proliferating neoplasm tissues.

PURPOSE

The aim of the study was the evaluation of clinical parameters compared with histological and laboratory findings in serous carcinomas. The research analysed the level of proliferating index Ki-67 in patients with ovarian cancers and in control group.

MATERIALS

The material used consisted of 41 cases of serous ovarian cancer. For clinical examinations we chose only patients who underwent primary surgical operation. The control group for Ki-67 levels were 15 patients with benign serous ovarian adenomas.

METHODS

For showing Ki-67 reacting antigen in paraffin samples of ovarian cancer we used DAKO Serum (Rabbit Anti Human Ki-67 Antigen N 1574 LSAB). Tissue proliferation activity called proliferation index--IP Ki-67 was measured as a proportion of numbers of cells reacting with antigen to the total number of cells in the sample.

RESULTS

Mean level of IP Ki-67 in examined group was 29.01%, compared to 5.84% in the control group and that was statistically significantly higher (p<0.05).

CONCLUSIONS

The analysis of cells' proliferative activity differentiates benign adenomas from ovarian serous carcinomas. But I didn't find this kind of correlation among analysed clinical and laboratory parameters and the level of Ki-67 index in ovarian serous cancers.

Regulation of cathepsin B and L expression in vitro in gastric cancer tissues by egg cystatin

BACKGROUND

Degradation of the basement membrane and surrounding extracellular matrix is likely to represent a key step in cancer invasion and metastasis. The purpose of this study was to determine whether gastric cancer tissues demonstrate higher cysteine proteases activities: cathepsins B and L during cancer progression in compression with non-cancerous tissues.

METHODS

We measured the expression of both cathepsins B and L in 30 patients with gastric cancer tissues and non-cancerous tissues activities by a fluorescence assay and immunohistochemical staining. We attempted to regulate cathepsin B and L expression using egg white cystatin.

RESULTS

The activities of cathepsins B and L were significantly higher in cancerous than in non-cancerous tissues (P </= 0.0001). Activities of these enzymes decreased 18-fold after treatment of tissue homogenates with 5 nM of purified egg white cystatin. Immunohistochemical staining was significant and positive expression of low molecular weight cystatin was observed on the tumor cell surface in gastric carcinoma. It was found that non-cancerous tissues (control) were not stained with anti-egg white antibody.

CONCLUSION

Our experiment demonstrated that the cysteine peptidases cathepsins B and L may be useful for the early detection of gastric cancer. The results suggest that addition of egg white cystatin reduces the activities of cathepsins B and L to that of non-cancerous values.

[Analysis of prognostic factors for the extent of vascularity of serous ovarian cancer on the basis of CD34 antigen expression]

OBJECTIVES

Ovarian neoplasms are very important problem in medicine, because they account for 23% of all female genital neoplasms, and they are the cause of 47% deaths among women suffering from gynecological cancers. Progression of neoplasmatic disease depends also on dynamism of angiogenesis, because better oxygen and nutrition substances supply increase tumor growth. To increase the tumor volume of 1 mm3, the development of new vessels is needed, and that also increases the risk of distant metastases.

AIM

The aim of the study was the evaluation of clinical parameters compared with histological and laboratory findings in serous carcinomas. The research analyzed of angiogenesis level (antigen CD34) in patients with ovarian cancers and in control group.

MATERIALS AND METHODS

The material consisted of 41 cases of serous ovarian cancer. For clinical examinations we chose only patients who underwent primary surgical operation. The control group for CD34 levels were 15 patients with benign serous adenomas. The microscopic (200x) evaluation of blood vessel in paraffin samples were made by showing the reaction of endothelial CD34 antigen with DAKO serum (Monoclonal Mouse Anti Human CD34 class 1-N 1574 LSAB).

RESULTS

The level of statistical significance for grading and total vessels' area was p = 0.01 (G1--0.037 mm2, G2--0.019 mm2, G3--0.015 mm2). No difference in vascularity was observed at the level of total vascularisation of serous ovarian cancers (0.021 mm2) and in benign serous adenomas (0.023 mm2).

CONCLUSIONS

Among analysed clinical and laboratory parameters only histological grade (G) correlates significantly with the level of vascularisation of ovarian serous cancers.

[Analysis of labor methods after cesarean sections in the last 50 years]

The aim of the work was to analyze the incidence and changes in the labors after previous cesarean section in the last 50 years. The study was conducted on the basis of the labors documented in our Clinic between 1946 and 1996 year. Cesarean sections are more and more frequent in these years and the amount of the patients with previous cesarian section elevates. We observed the increase rate of repeat cesarean delivery in comparison to vaginal birth after cesarean section. The trial of vaginal labor after cesarean section is usually successful in young patients (under 25 years old), repeat cesareans is mainly observed in patients older than 35. The permanent decrease in the incidence of instrumental deliveries in comparison with cesarean section was observed. The trial of vaginal labor after cesarean section, after exclusion of contraindicatins, should be routine procedure decreasing the amount of cesarean sections.

Expression of high molecular weight cysteine proteinase inhibitor in ovarian cancer tissues: regulation of cathepsin B expression by placental CPI

Mouse polyclonal antibodies against placental cysteine proteinase inhibitor (CPI) react with the placental 67 kDa CPI on Western blots, and CPI present in ovarian cancer homogenate and serum was shown by double immunodiffusion to react with the same antiserum. By immunohistochemical staining, positive expression of high molecular weight CPI was observed on the tumour cell surface in serous and endometrioid ovarian carcinomas with metastasis. Normal endometrioid tissue was not stained with anti-placental CPI antibodies. Cathepsin B and pro-cathepsin B median levels in ovarian cancer tissue homogenates increased progressively with FIGO stage of the disease. The enzyme level decreased 22-fold after treatment of tissue homogenates with 5 nM purified CPI. These results provide evidence that addition of CPI reduces the levels of cysteine-type cathepsins to those of normal non-cancerous values.

[Evaluation of congenital infection risk on the basic of cytokines Il-1 beta, Il-6 and TNF alpha levels in blood serum and amniotic liquid in pregnant women and in umbilical blood of neonates]

OBJECTIVE

The aim of the study was to evaluate congenital infection risk on the basic of cytokines IL-1 beta, IL-6 and TNF alpha levels in blood serum and amniotic liquid in pregnant women and in umbilical blood of neonates.

MATERIALS AND METHODS

The study was carried out on 37 women in labor including 17 mothers with normal pregnancy (group A-test) and 20 suspected of intrauterine infection (group C). There have been indicated cytokines IL-1 beta, IL-6 and TNF alpha in amniotic liquid and in blood serum collected in the second stage of labor and in umbilical blood serum. The accepted procedure used in our study resulted from the assumption that the analysis of cytokines in amniotic liquid collected without amniocentesis was beneficial.

RESULTS

It has been proved that among women in labor from group C there is a high concentration of IL-6 and TNF alpha in amniotic liquid that has statistic significance as far as markers for women with normal pregnancy are concerned (group A). Lower levels of IL-6 than in amniotic liquid but statistically meaningful in relation to the markers in group A have been detected in serum collected from pregnant women and in the umbilical blood of the neonates. Among 18 neonates delivered by mothers from group C the symptoms of congenital infection have appeared.

CONCLUSION

Extending diagnostics of congenital infection on the basis of the analyzed cytokines, mainly IL-6 in the second stage of labor, is of prognostic significance.

[Antibiotic prophylaxis after abdominal hysterectomy--comparative analysis of two treatment patterns]

OBJECTIVES

The aim of the study was to evaluate the efficacy of antibiotic prophylaxis after abdominal hysterectomy. Additionally we compared costs of the treatment patterns and the periods of hospitalization.

MATERIALS AND METHODS

We studied 70 cases of women operated in I Obstetrics and Gynaecology Clinic in Wroclaw without serious internal diseases, divided in two groups: on the basis of the treatment patterns.

RESULTS

We showed that: Antibiotic prophylaxis decreases the risk of infectious complications after surgery in patients with abdominal hysterectomy. We did not observe any essential therapeutic differences between short-term monotherapy and longterm combined antibiotic treatment in perioperative prophylaxis.

CONCLUSIONS

Monotherapy should be a method of choice in antibiotic perioperative prophylaxis. Monotherapy essentially reduces the cost of surgery procedure.

Inhibition of cathepsin B activity in human breast cancer tissue by cysteine peptidase inhibitor isolated from human placenta: immunohistochemical and biochemical studies

Cysteine peptidases and their endogenous inhibitors (CPI) have been shown to be involved in tumor progression and metastasis. Since their activity has been found to be changed in tumor tissue and/or body fluids of cancer patients, the determination of the peptidase/inhibitor levels is considered as a procedure of diagnostic value. Determination of cathepsin B, its precursor and inhibitor activity in homogenates of tumors and control breast tissue samples of patients with invasive ductal and lobular breast carcinoma and with benign breast disease (BBD) was performed using fluorometric assay. Immunohistochemical staining of the breast tissue samples was carried out using polyclonal antibody against cysteine peptidase inhibitor isolated from human placenta. Procathepsin B and cathepsin B were found to be significantly increased and their endogenous inhibitors decreased in homogenates of tumors from patients with breast cancer. A correlation between procathepsin B or cathepsin B activities as well as cysteine peptidase inhibitor activity and the histopathological grading of the tumor was observed. All samples of the tumor tissue showed positive immunostaining with antibody raised against cysteine peptidase inhibitor, while in the control tissue samples the immunostaining was much weaker. Significant difference observed between the activities of cathepsin B and/or its precursor in malignant and benign tumors might serve as a useful clinical indicator in discrimination between benign and invasive tumors.

Accumulation of CD45RO(+) cells in peritoneal carcinomatous fluid favours survival of ovarian carcinoma patients

In 44 patients with advanced ovarian carcinoma (OC) a fraction of CD45RO(+) lymphocytes in the blood and peritoneal carcinomatous fluid (PCF) was investigated. Thirty-one patients received cisplatinum with cyclophosphamide +/- doxorubicin. This group was followed from 2.2 to 9 years (mean: 45 months). In 23 out of 31 patients, the percentage of CD45RO(+) lymphocytes was higher in the PCF than in the blood samples. Patients with these higher lymphocyte levels experienced longer survival than those who did not show any excess of CD45RO(+) lymphocytes in PCF ( P=0.02). This was further verified by the use multivariate Cox analysis which included an assessment of the percentage of CD45RO(+) lymphocytes in PCF, age, FIGO status, histology, treatment (CAP or CP) and residual disease (RD) post-surgery. This analysis revealed that two factors had an independent power of prediction: RD ( P=0.02) and the percentage of CD45RO(+) cells in PCF ( P=0.04). Therefore, CD45RO(+) lymphocytes were studied in further detail in a group of 20 patients. This study revealed that PCF CD45RO(+) lymphocytes were characterized by: (1) a higher proportion of cells co-expressing activation markers (HLA-DR, CD28) and higher levels of mRNA for CXC chemokines (IP-10, IL-8) and for IL-10, but with lower levels for IL-2; (2) higher levels of Ki67, bcl-2 and p53 mRNA as compared to those in blood. In conclusion, in the present study it was found that an accumulation of activated CD45RO(+) cells in PCF had a beneficial effect on the survival of patients receiving platinum-based chemotherapy.

IL-6 production in ovarian carcinoma is associated with histiotype and biological characteristics of the tumour and influences local immunity

The presence of interleukin (IL)-6 in peritoneal carcinomatous fluid (PCF) and its effect on immune cells composition in PCF in patients with advanced ovarian carcinoma was studied. In 21 out of 30 ovarian carcinoma patients, PCF IL-6 levels were found to exceed those seen in PCFs of patients with gastrointestinal cancer. IL-6 activity was higher in serous/mucinous than in endometrioid and undifferentiated ovarian carcinoma PCF (P = 0.05). Ovarian carcinoma PCF IL-6 activities were correlated with serum C-reactive protein levels (r = 0.65, P = 0.0000, n = 25). Ovarian carcinoma PCF leucocyte profile differed from that in blood with respect to: (i) lower percentage of NK and CD8+ and (ii) higher percentage of B and CD45RO+, CD14+ and HLA-DR+ cells. The proportions of CD45RO+ in blood were correlated with IL-6 levels in PCF. Corresponding to PCF ovarian carcinoma tumours were stained for the presence of Ki-67 antigen and p53. The highest proportions of Ki-67+ cells and cells showing accumulation of p53 were seen in undifferentiated tumours. A low grade of p53 staining was seen in tumours associated with high IL-6 levels in PCF. It was evident that IL-6 production (i) depended on the histiotype of the tumour, (ii) influenced the local immune system in favour of accumulation of B, and T memory cells, and (iii) was higher in patients lacking p53 accumulation.