P 53 as an indicator for severity of human papilloma viral infection and cervical neoplasia

The tumor suppressor gene p53, located on the short arm of chromosome 17, encodes for a nuclear protein which regulates cell proliferation. Functional disturbance of p53 contributes to uncontrolled cell growth and alleges to be the commonest genetic abnormality in human cancer. Human papilloma virus [HPV] E[6] oncoproteins bind to wild type p53 and disturb its function. Our objective was to compare p53 expression in HPV genital warts and cervical neoplasia. [Cervical intraepithelial neoplasia and cancer cervix]. 45 women were selected from gynecological and Dermatology and Venerology Departments of Tanta University Hospital. They were divided according to their lesions into 15 women with anogenital warts and 15 patients with cervical intraepithelial neoplasia [CIN] and 15 cases with squamous cell carcinoma of the cervix at stage II and III. Based on the affected area skin or cervical biopsies were taken from every patient. Polymerase Chain Reaction [PCR] for HPV 16 DNA, histopathology and Immunohistochemical studies were performed to each biopsy. It was observed that the positive rate for HPV-16 DNA was higher in cases with cervical cancer than those of CIN and genital warts groups. Also, among cases with different stages of cancer cervix it was found that the positivity for HPV-16 DNA was more in cases with stage III compared to those with stage II. As regards to p53 immunostaining results, both nuclear and cytoplasmic keratinocyte were detected more in cases with cancer cervix [89%] than those with CIN [73%] and genital wart [53%]. According the obtained results, we can conclude that the existence of mutant p53 oncogene expression in HPV-16 DNA positive genital lesions is associated with a higher risk of developing malignancy. Moreover, its pattern of expression might be a predictor for the future behavior of the neoplasm

Revivification of direct trocar insertion technique at laparoscopy in Tanta University Hospital

A technique using direct trocar insertion for laparoscopy was used in 114 cases in Department of Obstetrics and Gynaecology, Unit A, of Tanta University Hospital. Critical surgical points were emphasized: adequate relaxation, sharp trocars, elevation of the abdominal wall and proper trocar insertion. The technique was safe and no complications were encountered except failure of the procedure in 3 cases only. It has had the following advantages one puncture less, time saving, pneumoperitoneum was done under vision, less amount of gas and proper steadiness of the sleeve in situ