Immunohistochemical expression of PARP-1 in triple-negative endometrial cancer - a comparison of different score systems

Endometrial cancer is the most common malignant neoplasm of the female reproductive system. The number of diagnosed cases is increasing every year. In recent years, the triple-negative phenomenon (TNP) has been identified as one of the determinants of shorter survival in endometrial cancer patients. The aim of the study was to compare the PARP-1 protein expression in triple-negative (TNEC) and non-triple-negative (NTNEC) endometrial cancer patients and determine the relationship between the PARP-1 protein expression in endometrial cancer cells and patient's overall survival depending on the adopted scale (H-SCORE < 75, H-SCORE < 50, Allred scale). The study involved 265 patients with histopathologically confirmed endometrial cancer. The patients were divided into 2 groups: patients with TNEC and patients with NTNEC. The study was conducted using a tissue microarray technique. Expression of PARP-1 protein was determined by immunohistochemistry. Protein expression evaluation was performed using virtual microscopy and the Image Scope computer image analysis system. The following conclusions were reached: total and individual levels of nuclear or cytoplasmic PARP-1 expression varied with the presence or absence of TNP, and PARP-1 nuclear expression at the 2+ level had a significant effect on the increased risk of death (according to H-SCORE < 75).

Adherence to Gluten-Free Diet in Children with Celiac Disease

Celiac disease (CD) can only be treated by rigorous life-long gluten-free diet (GFD). The study included 102 mothers and their CD children treated with GFD for at least two years. Frequency and cause of diet failure in children treated at present (54 children) and 10 years ago (48 children) were compared. Dietary adherence was evaluated serologically (tTG), while diet management difficulties were examined by means of a questionnaire. The study shows that one-third of patients fail to follow GFD, more often 10 years ago than now (40% vs. 26%; p < 0.05), mainly children aged 13⁻18 (54% vs. 40% now; p < 0.05). Younger children (up to 12) are less likely to abandon the diet (27% vs. 8%; p < 0.05). In this age group non-intentional diet failure prevails, while teenagers interrupt their diet intentionally (45% vs. 33%; p = ns (small population of children in this groups)). Currently, the most common causes of teenage diet failure are the absence of symptoms after consuming a small amount of gluten and, even more often, troublesome diet administration. Previously, the absence of peer acceptance prevailed. With this study we found that: 1. In West Pomerania, every fourth CD child does not follow GFD. 2. For years, teenagers have failed to follow GFD due to the absence of symptoms after consuming small amounts of gluten. 3. The incidence of non-intentional failure to follow GFD has significantly decreased over years, which indicates better dietary care.

Triple negative endometrial cancer

Endometrial cancer (EC) is the most common malignancy of the female genital tract in the developed countries. In Poland, EC incidence increased from 3.496 to 5.251 between 2000 and 2011, with 5.251 new cases were diagnosed in 2011 alone, and this upward trend is expected to continue. There are two types of endometrial cancer: estrogen- related type I (approximately 80% of the cases) and unrelated to estrogen type II. Type I includes adenocarcinomas which grow slowly, have better prognosis, superficially infiltrate the myometrium, originate from endometrial hyperplasia without atypia, and occur before and after menopause. The most common type I mutations include PTEN, KRAS and microsatellite instability. Type II is represented by serous, mucinous, clear-cell carcinomas, with aggressive behavior associated with poor prognosis, high risk of distant metastases at diagnosis, deeper infiltration of the uterine muscle, often to serosa, originating from the atrophic endometrium, and typically presenting after menopause. The most common type II mutations include TP53, HER-2 and P16.

What Do We Know Now about IgE-Mediated Wheat Allergy in Children?

IgE-mediated wheat allergy is a gluten-related disorder. Wheat is one of the five most common food allergens in children. However, the natural history of IgE-mediated wheat allergy has seldom been described in the research literature. This study presents the current state of knowledge about the IgE-mediated wheat allergy in children.

Food IgG4 antibodies are elevated not only in children with wheat allergy but also in children with gastrointestinal diseases

BACKGROUND

Food sIgG and sIgG4 are highly individually versatile. We put a hypothesis that one of the responsible factors is the presence of gastrointestinal inflammatory diseases. The objectives were: 1. An analysis of wheat and rice sIgG and sIgG4 in healthy children, children with IgE-mediated wheat allergy (WA), coeliac disease (CD) and Helicobacter pylori infection (HP). 2. Usability of wheat sIgG and sIgG4 in the WA diagnostics.

METHODS

We compared 388 each wheat and rice sIgG and sIgG4 in a group of 200 children: 50 WA (diagnosis, diet treatment, tolerance), 50 CD (diagnosis and remission), 50 HP and 50 healthy. SIgE, sIgG, sIgG4 were determined with the FEIA method (Pharmacia CAP System).

RESULTS

In healthy children food sIgG were the lowest; no sIgG4 were found. In the CD diagnosis group wheat and rice sIgG and rice sIgG4 were the most common and their concentrations were the highest (p < .001, p < .05). Wheat sIgG4 were the highest in WA children (diagnosis and tolerance) to fall during the elimination diet (p < .05). Wheat and rice sIgG remained the same in all allergy phases. Rice sIgG also did not differ in the class G4.

CONCLUSIONS

1. Serum concentrations of wheat and rice sIgG and sIgG4 are elevated in children with CD, HP and WA. 2. Sub-clinical incidence of some gastrointestinal inflammatory diseases may be responsible for high individual versatility of food sIgG and sIgG4 concentrations in serum. 3. Wheat sIgG and sIgG4 in children do not correlate with WA clinical picture.

The natural history of IgE mediated wheat allergy in children with dominant gastrointestinal symptoms

Background

Wheat is one of the most common food allergens in children. The purpose of this study is to define the natural course of wheat allergy in children with dominant gastrointestinal symptoms and identify factors that help predict development of tolerance.

Methods

The prospective analysis covered 50 children with positive food challenge results (DBPCFC) and positive wheat IgE test result. Resolution of wheat allergy was determined on the basis of food challenge results (open challenge). The impact of each of the studied factors on the age when tolerance developed was assessed by means of the Cox proportional hazard regression model.

Results

The median age of tolerance development was 69.5 months (37-192 mo.). The rates of resolution were 20% by the age of 4 years, 52% by the age of 8 years, and 66% by 12 years, and 76% by 18 years. The median age of the tolerance development in children with peak wheat IgE level below10 kU/L was 41.4 months, with peak wheat IgE from 10 to 19.9 kU/L was 44.5 months, with peak IgE from 20 to 49.9 kU/L – 84,9 months and with peak IgE ≥ 50 kU/L – 190.5 months. The median of the age when the highest levels of IgE for wheat were reached was 33 months (2-52 mo.) in children with resolved wheat allergy and 67 months (36-178 mo.) in children with persistent allergy (p = .001).

Conclusions

1. The majority of children with wheat allergy can tolerate wheat by adolescence. 2. The age when tolerance to wheat developed depended on the level and the age of reaching the highest levels of specific IgE for wheat. The higher the values of the above parameters, the older a child was when they developed tolerance to wheat.

[Operative treatment of developmental abnormalities of sexual organs in girls]

DESIGN

The aim of our study was a clinical analysis of operative treatment of developmental abnormalities of sexual organs.

MATERIALS AND METHODS

The authors describe developmental abnormalities of sexual organs in girls aged 12-19 79(1.4%) girls were treated from among 5432 surgically treated patients in the course 6 years. Among these abnormalities were the following: agenesia of vagina, agenesia of cervical canal, absence of cervix of uterus, obstructed normal or rudimental vagina, occlusion of hymen. There were complex abnormalities too. Congenital abnormalities were subject to the reconstructive operative treatment.

CONCLUSIONS

We recommend that developmental defects should be treated in specialist centres well equipped and experience of in operative procedures and postoperative monitoring.

[Most common neoplasms of female genital organs and hypo-thalamic-hypophysial-ovarian regulation in the postmenopausal period]

Levels of FSH, LH and E2 were evaluated by means of EIA methods in 62 post-menopausal women qualified for operation treatment. In 46 cases neoplasms of uterus body and in 16 cases neoplasms of uterus cervix and an ovary were stated. Higher level of estradiol and lower levels of gonadotrophins were shown in cases with uterus body neoplasms and opposite, lower estradiol levels and higher gonadotrophins values in cases with cervix and ovarian neoplasms. The outcome suggests possibility of function of hypothalamic-hypophysial-ovarian axis in post-menopausal period. Level of estradiol can be also used as a diagnostic marker to uterus body neoplasms.

[Follow up results of treatment for premature puberty (central origin)]

Distant treatment results of premature central origin puberty with chlormadinone (Polfa) were described. Premature central origin puberty was diagnosed at 19% (38/202) of patients examined with premature puberty as a initial diagnosis. Annual medium height intake 5.5 cm +/- 1.2 cm and puberty inhibition testify to proper drug doses. Hormonal treatment should be employed till patients height is 150 cm, what is usually obtained at the age 9 at half. It makes possible to obtain final height of 162 cm +/- 4.2 cm. The average menarche age of treated girls was 10- and 11 months, and the first menstruation approximately 15 months after hormonal treatment.

[Effect of surgery involving ovaries on the level of estradiol and gonadotropins in blood serum, with indications for hormonal treatment in early post-operative period being taken into consideration]

The studies cover 124 women operated on at the Clinic of Operative Gynaecology IOG--PMA in Szczecin from 1981 to 1991. The blood for testing was collected prior to operation as well as in II and VIII 24-hours after the procedure. The material was divided into 5 groups: group I--31 patients, in whom one ovary or adnexa were removed in the first phase of cycle; group II--31 patients, whose uteri without adnexa were removed in the first phase of cycle; group III--31 post-menopausal patients, in whom uterus and adnexa were excised; group IV--comprised 31 post-menopausal patients, in whom uterus with adnexa was excised and subsequently estrogenic agents were given; group V--62 patients divided into subgroups A--16 patients with carcinoma of uterine cervix and ovary, and B--46 patients with neoplasm of uterine body. In all the patients FSH, LH, E2 were determined by RIA and EIA methods. The results were subjected to statistical analysis and elaborated by Student's t-test. The following has been disclosed: a) statistical significant diminution of E2 concentration with tendency to an increase in concentration of gonadotropins in the reproductive period after the excision of ovary and also uterus without adnexa; b) significant decrease in concentration of E2 and an increase of gonadotropins after excision of uterus with adnexa in patients operated on in the post-menopausal period, which supports the existence of ovarian steroidogenesis at this period of life. It has been disclosed that there was a significant rise in E2 concentration and a fall in concentration of gonadotropins following the application of Oestradiolum dépôt drug, which additionally confirms the activity of the hypothalamo-pituitary-ovarian system after menopause. A relation was found between the studied hormones and the basic disease, which also proves the function of hypothalamo-pituitary-ovarian system after menopause. The results of the studies fully substantiate the use of normal prophylaxis of consequences due to wavering of hypothalamo-pituitary-ovarian system in the reproductive period, as well as the metabolic consequences after menopause. They, however, fail to specify the period of time, at which the hormonal treatment may be applied best and most beneficially.