Immunoexpression of the PTEN protein and matrix metalloproteinase-2 in endometrial cysts, endometrioid and clear cell ovarian cancer.

OBJECTIVES: Endometrioid and clear cell ovarian adenocarcinomas are suspected to derive from ectopic endometrial foci. The aim of the study was to determine PTEN and MMP-2 immunoexpression in endometrial ovarian cysts, endometrioid and clear cell ovarian carcinomas and to assess the relationship between the abovementioned values and clinical data of patients in order to find the marker of increased risk of malignant proliferation based on ovarian endometriotic lesions. Detailed analysis of the collected data was conducted to investigate the correlation between immunohistochemical expression of the examined antigens, histopathological diagnosis and clinical condition of patients. MATERIAL AND METHODS: 20 endometrial adenocarcinomas, 21 clear cell ovarian cancers and 26 endometrial cysts were included in the study The control group consisted of 29 specimens of physiological endometrium: 16 samples of the proliferative phase and 13 samples of the secretory phase. Protein expression of PTEN and MMP-2 was evaluated by immunohistochemistry Protein immunoexpression in the collected specimens was estimated with the use of light microscope and MultiScan software. Immunoreactivity of the PTEN antigen was assessed by the quantitative method, whereas MMP-2 immunoexpression was evaluated by the semi-quantitative method. Two-sided tests were used for statistical inference. Generalized linear models were used to compare the studied groups. Error distributions were selected using the Akaike criterion (AIC). Statistical analysis was conducted with the use of the R Statistical Package. RESULTS: MMP-2 immunoreactivity differed significantly between the study groups and controls (p<0.001). PTEN immunoexpression was the strongest in endometrial cysts (53.7 %), lower in clear cell cancers (50.2%) and the lowest in endometrioid adenocarcinomas (43.88%), but the differences were not statistically significant (p=0.17). PTEN reactivity in the group of endometrioid carcinomas was significantly higher (p=0.02), while MMP-2 expression had a falling tendency (p=0.076) in obese women. CONCLUSIONS: Increased MMP-2 expression in the successive groups may imply a rising invasive potential of the epithelial cells in endometrial cysts, endometrioid and clear cell adenocarcinomas. Strong immunoreactivity for PTEN in proliferative endometrium implies its role in the regulation of endometrial proliferation. PTEN activity may reduce MMP-2 expression in insulin resistant women suffering from endometrial ovarian cancer Simultaneous evaluation of PTEN and MMP-2 immunoexpression in ectopic endometrial foci cannot be used to identify women with an increased risk of neoplastic transformation.

[The statement of Polish Society's Experts Group concerning diagnostics and methods of endometriosis treatment]. / Stanowisko Zespolu Ekspertów Polskiego Towarzystwa Ginekologicznego dotyczace diagnostyki i metod leczenia endometriozy.

Endometriosis is defined by endometrial glands and stroma outside of the endometrial cavity Three types of endometriosis have been described: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis. Endometriosis afflicts 6-15% of women population. It occurs mainly in the group of women in reproductive age, but also in the group of minors and approximately 3% of women after menopause. Within the group of women suffering from infertility the frequency of endometriosis increased to 35-50% of cases. Endometriosis is associated with pain symptoms which can bear the character of pain occurring periodically and altering into constant pain, dysmenorrhea, dyspareunia, dysuria and dyschezia. The correlation between the stage of endometriosis and intensity of pain symptoms not always has to be proportionate. Laparoscopy can be perceived as a standard procedure in endometriosis diagnostics as it allows simultaneous treatment. Profound interview as well as visual diagnostics (USG, MRI) should precede laparoscopy Treatment of endometriosis can be divided into pharmacological and surgical treatment, which can be invasive or non-invasive. The type of treatment depends on patient's age and her procreation plans, occurring ailments and endometriosis type. Important role is played by adjuvant treatment such as appropriate diet and lifestyle. Treatment of advanced endometriosis should be conducted in reference centres that are appointed with adequate equipment and have the possibility of interdisciplinary treatment. Presented standards can digest and outline the order of proceedings both in diagnostics and endometriosis treatment. The research group believes that the above compilation will facilitate undertaking appropriate decision in diagnosis and treatment of the disease, which will subsequently contribute to therapeutic success.

[Comparative analysis of abnormal Pap smear and the results of histopathological examination of specimens from the cervix of the programme in-depth diagnosis cervical cancer conducted at the of Operational Gynecology Department ICZMP in Lodz]. / Analiza porównawcza nieprawidlowych wyników badania cytologicznego z wynikami badania histopatologicznego wycinków z szyjki macicy w ramach Programu Poglebionej Diagnostyki Raka Szyjki Macicy realizowanego w Klinice Ginekologii Operacyjnej ICZMP w Lodzi.

INTRODUCTION: Cervical Cancer Screening Program has been operational in Poland for over four years. Colposcopy and guided biopsy methods constitute an essential part of population-based screening, enable stating right diagnosis and planning treatment procedures. AIM: The aim of the following study was to analyse the diagnostic acuity of cyto- and histopathological examination. RESULTS: We examined 510 patients with the following result of cytological smear: ASCUS--265 women (51.96%), LSIL--167 cases (35.75%), HSIL--78 women (15.29%). Complete agreement between cytological smear and guided biopsy histopathology was observed among 81.13% cases of ASCUS, in 88.02% of women with LSIL and in 76.92% cases with the diagnosis of HSIL. As with cytology-biopsy comparisons, discordant cases were significantly more frequent in the group with stated HSIL than among patients with the diagnosis of ASCUS or LSIL (p<0.001). CONCLUSIONS: 1. High cyto-histopathological accordance (82%) has been obtained, what is comparable with the data in literature. 2. The highest cyto- histopathological compatibility was obtained in the group of patients with LSIL--over 88%, and the lowest in the group of patients with HSIL--less than 77%. 3. Failure to confirm the histopathological diagnosis of cytological HSIL requires further molecular and morphological evaluation.

Immunohistochemical pattern of protein P21, cyclin D1 and cyclin E in endometrial hyperplasia.

PURPOSE: In our research we investigated immunohistochemical expression of cell cycle proteins protein p21, cyclin D1 and cyclin E in physiological endometrium (n = 15), hyperplastic endometrium (n = 61), and post hormone replacement therapy endometrium (n = 24). MATERIAL AND METHODS: We performed immunohistochemical analysis of selected cell cycle proteins in 100 specimens of human endometrium. RESULTS: The average immunoexpression index scores in glandular endometrial cells (GES) and stromal endometrial cells (SEC) were respectively: for p21- GES: 11.8 +/- 17.19%; SEC: 9.31 +/- 17.15%; for cyclin D1- GES: 9.25 +/- 18.41%; SEC: 3.22 +/- 11.46%; for cyclin E: GES: 26.42 +/- 27.47%; SEC: 4.61 +/- 7.90%. Statistical analysis disclosed more intense p21 glandular immunoreactivity among women with endometrial hyperplasia in comparison to other subpopulations. In the case of assessment of cyclin D1 immunoreactivity, there was no statistical correlation between analysed parameters. The average cyclin E immunoreactivity in endometrial glandular cells was significantly higher (p = 0.003) in women with endometrial hyperplasia and correlated with age. CONCLUSIONS: Intensive immunoreactivity of cyclin E in glandular cells is typical for endometrial hyperplasia and can be treated as an objective indicator of this pathological process during histopathological diagnostic procedures. Immunoreactivity index of p21 and cyclin D1 is independent of the morphological pattern of human endometrium, patients' age and gynaecological history of patients.

Evaluation of retinoblastoma protein expression in endometrial hyperplasia.

UNLABELLED: In our study we investigated immunohistochemical expression of retinoblastoma protein (pRb) in physiological endometrium (n = 15), hyperplastic endometrium (n = 61) and post-hormone replacement therapy (HRT) endometrium (n = 24). METHODS: We performed an immunohistochemical analysis of pRb expression in 100 specimens of human endometrium. RESULTS: The average pRb immunoexpression index score in glandular endometrial cells and stromal endometrial cells were 57,699 and 21,191 respectively. The less intense pRb immunostaining for the glandular cells was displayed in women over 49 years old. The most intense staining effect of glandular cells was observed among patients with physiological endometrium, no older than 49 years of life. There was no statistically significant correlation between the obtained pRb immunoexpression and clinical data of the examined patients. CONCLUSIONS: We conclude that immunohistochemistry is not sensitive and specific enough to reveal pRb alterations resulting in endometrium pathologies. Alternatively, pathological rearrangements of endometrium may be independent from the accuracy of the pRb control over restriction point in cell-cycle pathway.