Early detection of malignant changes in premalignant endometrial and cervical lesions using P53 immunostaining and cytophotometric study of DNA nuclear content

Early detection of malignant changes in premalignant lesions of both endometrium and cervix, using P53 nuclear immunostaining and cytophotometric technique for DNA nuclear contents. Forty seven endometrial and cervical biopsies from patients suffering of pre or postmenopausal bleeding [18 simple and complex endometrial hyperplasia with atypia 10 CIN, 12 endometrial carcinoma, and 7 cervical carcinoma] and 12 control cases were evaluated by histopathology, P53 immunostaining and DNA cytophotometric study. Three cases [one simple, 2 complex] out of 18 atypical endometrial hyperplasia [16.7%] were aneuploid and showed positive P53 immunostaining [malignant criteria]. Two cases out of 10 CIN [20%] were aneuploid and 4 were positive P53 immuno-staining [40%]. Aneuploidy and P53 immunostaining were directly proportional to the tumour grade in both endometrial and cervical carcinoma with increasing aneuploidy and staining positivity in higher than lower tumour grades. Adding P53 immunostaining or cytophotometric study to histopathology in cases of atypical simple and complex endometrial hyperplasia and CIN will help in early detection of malignant changes for better operative and post operative management. Both methods may help in measurement of the power of invasion and tumour aggressiveness in frank endometrial and cervical malignancy for better evaluation of operative and postoperative management

Spinal bone density in women using Depot Medroxy progesterone acetate, Norplant implants or oral contraceptives

The objective of this study was to evaluate and compare bone mineral density [BMD] in long term users of depot medroxy progesterone acetate [DMPA], norplant implants or combined oral contraceptive pills [COCs]. One hundred women aged 30-39 years who are currently using different contraceptives for two to three years were recruited in the present study in four groups, twenty five women in each group. Group I included women who are using DMPA, group II included women who are using norplant implant, group III included women who are using COCs and group IV included women who are using intrauterine contraceptive device as control group. They were recruited between September 1998 till October 1999. Quantitative computed tomography [QCT] was used for measurement of BMD of the lumber spine for each woman in the study. The demographic and clinical characteristics of women were similar in all groups except that 44% of the women in the DMPA group were amenorrheic and this was significantly higher than the control. The mean bone mineral density [BMD] was slightly lower [153.2 mg/cc] in the DMPA group than the control group [166.9 mg/cc] but the difference was not significant in the norplant group The mean BMD [165.3 mg/cc] was more or less similar to that of the control group. The highest mean BMD was in women using COCs [188.3 mg/cc] but this was not significantly higher either in the control group or the other two studied groups