OC-125 immunostaining in endometriotic lesion samples.

PURPOSE: To determine the presence of OC-125 staining in endometriotic lesions and to verify whether there is an association with endometriosis stage. METHODS: Thirteen patients from the Family Planning programs (group I) and 53 patients from the Chronic Pelvic Pain outpatient clinic (group II) were studied. Endometriotic lesions were excised from areas of endometriosis incidence and studied by histopathological assay and by immunohistochemistry for OC-125 staining. RESULTS: The histopathological study disclosed that all patients from group I had minimal/mild endometriosis. In group II, 39.6% had minimal/mild endometriosis, and 60.4% had moderate/severe endometriosis. OC-125 staining was negative in all samples from group I. In group II, OC-125 staining was positive in 52.4% patients with minimal/mild endometriosis and in 81.2% with moderate/severe endometriosis. CONCLUSION: The data suggest that the OC-125 antibody is probably related to endometriosis activity and, consequently, to the progression and severity of the illness.

Heparanase-2 expression in normal ovarian epithelium and in benign and malignant ovarian tumors.

INTRODUCTION: Studies have highlighted the changes that take place in the environment between the cell and the extracellular matrix during the process of neoplastic expansion. Several papers have associated the expression of heparanase 1 with various malignant tumors. Heparanase 2 is probably related to loss of cell adhesion. OBJECTIVE: The aim of this study was to evaluate the expression of heparanase 2 in epithelial neoplasia of the ovaries and in samples of normal ovarian tissue. METHODS: Seventy-five ovary specimens were analyzed and divided into 3 groups: 23 malignant and 35 benign epithelial ovarian neoplasia and 17 without ovarian disease. We used 2 methodological techniques for evaluating the immunoexpression of heparanase 2. The first followed the qualitative criterion of positive or negative in relation to enzymatic expression, and the second involved computerized quantification of this expression, performed on the same slides. RESULTS: In the quantitative analysis, we found positivity indices for heparanase 2 expression of 72.2% and 87.3% in the samples of benign and malignant neoplasias, respectively. In these, the intensity of expression and the expression index were 147.2 and 121.2, respectively, for the benign neoplasia and 134.1 and 118.0 for the malignant neoplasia. Qualitatively, its expression was strong or moderate in 44.2% of the benign and 78.2% of the malignant tumors; its expression in all of the nonneoplastic samples was negative, with the exception of one that was weakly positive. CONCLUSIONS: Heparanase 2 is involved in neoplastic proliferation, but it was not exclusively associated with the malignant process. Furthermore, there was no difference in its expression between benign and malignant ovarian epithelial neoplasia.

The catechol-O-methyltransferase (COMT) gene polymorphism and prevalence of uterine fibroids.

OBJECTIVE: To assess the possible association between the catechol-O-methyltransferase (COMT) polymorphism and uterine fibroids in Brazilian women. DESIGN: Case-control study. SETTING: Department of Gynecology; teaching hospital. PATIENT(S): One hundred twenty-four premenopausal women with fibroids, and 193 postmenopausal controls not presenting the disease. INTERVENTION(S): The subjects were classified as white or non-white (black and mulatto), and COMT genotypes were determined. DNA was extracted from the uterus of cases and from peripheral blood of controls and submitted to polymerase chain reaction (PCR) and agarose gel electrophoresis. MAIN OUTCOME MEASURE(S): The presence of the COMT polymorphism was recorded for all patients, and the frequency and distribution among cases and controls were compared according to race. Binomial log regression models were used to estimate odds-ratios (OR) for uterine volumes of <290 cm(3) (small fibroids) vs. those >290 cm(3) (large fibroids). Potential confounding variables (age, race and parity) were added to the model. RESULTS: Genotypes positive for the COMT polymorphism (heterozygous or mutant homozygous) were found in 45% of white and 28.9% of non-white women (p = .013) and the polymorphic allele frequencies in these groups were 27.2% and 16.3%, respectively (p = .006). However, there were no clear differences between patients and controls within the white subgroup with regard to the presence of COMT polymorphism-containing genotypes (41.5% vs. 46.0%, respectively) (p = .60), or for the polymorphic allele frequency (26.8% vs. 27.3%, respectively) (p = .92). For non-white women, there were also no differences between cases and controls for the frequency of polymorphic genotypes (28.9% vs. 28.9%, respectively) (p = .995), or for the polymorphic allele frequency (17.8 vs. 14.5, respectively) (p = .565). Estimated OR for small or large fibroids in association with the polymorphic allele revealed a positive association between the allele with lower activity and large fibroids (vs. small) (OR = 3.3; 95% confidence interval [CI] = 1.31-8.46). The adjusted OR was 4.35 (95% confidence interval [CI] = 1.58-11.9). CONCLUSIONS: The catechol-O-methyltransferase polymorphism is a risk factor for the development of large uterine fibroids in Brazilian women suffering from fibroids.

Does gestrinone antagonize the effects of estrogen on endometrial implants upon the peritoneum of rats?

OBJECTIVE: To evaluate the effects of estrogen treatment in combination with gestrinone on an experimental rat model of endometriosis. METHODS: Uterine transplants were attached to the peritoneum of female Wistar rats via a surgical autotransplantation technique. The implanted area was measured during the proestrus phase and after hormonal treatment. We performed morphometric analysis and examined the macroscopic and morphometric alterations of endometrial implants after hormonal treatment in ovariectomized rats. RESULTS: The high dose of estrogen caused macroscopic increases in the endometrial implant group compared with other groups, which were similar to increases in the proestrus phase. The low dose showed morphometric development of implants, such as an increase in number of endometrial glands, leukocyte infiltration and mitosis. Gestrinone antagonized both doses of estrogen. CONCLUSION: Our findings suggest that gestrinone antagonizes estrogen's effects on rat peritoneal endometrial implants.

Gene analysis in patients with premature ovarian failure or gonadal dysgenesis: a preliminary study.

OBJECTIVE: The aim of this study was to evaluate the presence of mutations in the coding region of the QM gene and fragile X in patients with premature ovarian failure and gonadal dysgenesis. METHODS: After approval by the local Ethics Committee, blood samples, in EDTA, of 100 normally ovulating women, 23 with premature ovarian failure (POF) and 14 with gonadal dysgenesis 46XX, aged less than 40 years, were screened for mutation in the QM gene coding region. All patients with POF have 46, XX karyotype and serum levels of follicle-stimulating hormone (FSH) over 30 mIU/mL. In addition, all samples from patients with premature ovarian failure underwent analysis for fragile X. RESULTS: The QM gene located at a hotspot region (Xq28) showed five points of mutations in a patient with premature ovarian failure. Four of them were able to change the amino acid sequence of the protein. None of our patients were diagnosed as having pre or mutant X fragile syndrome. CONCLUSION: Our study suggests that Xq28 (QM gene) may be involved in ovary failure. However, further studies are needed to confirm this hypothesis.

Uterine volume and menstrual patterns in users of the levonorgestrel-releasing intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas.

BACKGROUND: A prospective cohort study was carried out to evaluate uterine volume and the volume of uterine leiomyomas in women using the levonorgestrel intrauterine system (LNG-IUS) to treat idiopathic menorrhagia (n=32) and menorrhagia due to leiomyomas (n=27). A control group used the device as a contraceptive method (n=28). METHODS: Clinical and ultrasonographic evaluations were carried out at insertion and at 3, 6, 12, 24 and 36 months later. Total uterine volume and the volume of the leiomyomas were calculated using the ellipsoid formula (anteroposterior diameter)x(transverse diameter)x(longitudinal diameter)x(4/3)x(pi). In the case of multiple leiomyomas, the volume of each myoma was added to calculate the total volume of leiomyomas in each patient. Menstrual bleeding episodes were recorded. RESULTS: Uterine volume decreased significantly in both groups of menorrhagic patients but not in the control group. In the group of women with idiopathic menorrhagia, a mean reduction of 36.4+/-15.3 (S.D.) cm3 (from 127.1 cm3 to 90.7 cm3) was observed (p=.041), and a greater and more significant mean reduction of 63.6+/-19.0 (S.D.) cm3 (from 156.6 cm3 to 93 cm3) occurred in the group of women with leiomyomas (p=.014). In the contraception group, the reduction was of only 2.9+/-5.4 (S.D.) cm3 in mean uterine volume (from 70.3 cm3 to 67.4 cm3), which was not statistically significant (p=.085). The mean volume of leiomyomas decreased by 5.2+/-3.1 (S.D.) cm3 (from 12.8 cm3 to 7.6 cm3 after 3 years of use, but this difference was not significant (p=.4099). After 36 months of use, amenorrhea and oligomenorrhea were the most frequent bleeding patterns, occurring in 45-57% and 33-39% of users in the three groups, respectively. Amenorrhea was higher in the contraception group (57.1%) and in women with idiopathic menorrhagia (53.4%) than women in the group with menorrhagia due to leiomyomas (44.5%) (p=.027). Moreover, the prevalence of spotting was almost three times higher (11%) in women with menorrhagia caused by leiomyomas and nearly double (7.7%) in the idiopathic menorrhagia group when compared with 4% in the control contraception group (p=.024). CONCLUSION: The LNG-IUS significantly reduces uterine volume in women with menorrhagia with and without leiomyoma; however, it does not significantly reduce the volume of leiomyomas.

The progesterone receptor gene polymorphism, PROGINS, may be a factor related to the development of uterine fibroids.

OBJECTIVE: To assess the possible association between the polymorphic allele of the progesterone receptor gene, named PROGINS, and uterine leiomyomas. DESIGN: Case-control study. SETTING: Department of Gynecology. Teaching hospital. PATIENT(S): One hundred twenty-two premenopausal women with fibroids and 125 postmenopausal controls not presenting the disease. INTERVENTION(S): The subjects were classified as White or non-White (Black and Mulatto) and the progesterone receptor genotyping was performed, with DNA extracted from uterus in cases and from peripheric blood in controls and submitted to polymerase chain reaction (PCR) and agarose gel electrophoresis. MAIN OUTCOME MEASURE(S): The presence of the PROGINS allele was recorded, and its frequency as well as the genotypic distribution among cases and controls were compared according to race. RESULT(S): PROGINS-positive genotypes (heterozygous or mutant homozygous) were found in 19% of White and 11% of non-White women, and allelic frequency of PROGINS in the groups was 10.4% and 6.2%, respectively. Comparing patients and controls, we observed a significant difference among non-White women, both regarding presence of PROGINS-positive genotypes (4.9% vs. 25%, respectively), and PROGINS allele frequency (3.3% vs. 12.5%, respectively). There was no significant difference in PROGINS-positive genotypes among White cases and controls (16.4% vs. 20.6%, respectively), and in their allelic frequency (8.2% vs. 11.9%, respectively). The odds ratio showed reduced risk of fibroids related to PROGINS-positive genotypes in non-White women (odds ratio = 0.16, 95% confidence interval: 0.04-0.66), but not among White subjects (odds ratio = 0.76, 95% confidence interval: 0.33-1.74). CONCLUSION(S): The PROGINS polymorphism revealed to be protective in terms of uterine fibroids in Brazilian non-White women.

The benefits of androgens combined with hormone replacement therapy regarding to patients with postmenopausal sexual symptoms.

OBJECTIVE: To evaluate the benefits and risks of hormone replacement therapy (HRT) combined with methyltestosterone (MT) in postmenopausal women with sexual dysfunction. DESIGN: This study was a randomized, double-blind, placebo-controlled and crossover trial. Eighty-five women using HRT were divided into four treatment groups: GI-HRT plus placebo for 4 months; GII-HRT plus MT 2.5mg/day for 4 months; GIII-HRT plus placebo for 2 months and then replaced with HRT plus MT 2.5mg/day for 2 months; GIV-HRT plus MT 2.5mg/day and then replaced with HRT plus placebo for 2 months. Blood was collected at baseline, after 2 months (T1) and 4 months (T2) of treatment for hormone determinations of estradiol, FSH, total and free testosterone, GOT, GPT, glucose, total and fractions of cholesterol and triglycerides. All participants answered clinical questions and a validated questionnaire of modified McCoy's sex scale. RESULTS: The association of HRT with MT 2.5mg/day did not significantly change liver enzymes or increase cardiovascular risk factors. The patients of GII, GIIII and GIV when using MT presented amelioration of sex symptoms, mainly satisfaction and desire (p<0.01); however, GIII at T1 (1.3+/-0.3) presented similar problem score results as compared to GIII at T2 (1.5+/-0.6). CONCLUSION: All data suggest that combined HRT-androgen therapy may be beneficial for postmenopausal women receiving HRT who continue to complain of sexual difficulties or for postmenopausal women with sexual complaints who are not undergoing estrogen therapy.

Latin American position on the current status of hormone therapy during the menopausal transition and thereafter.

OBJECTIVE: Data from placebo-controlled, randomized clinical trials conducted during the past few years resulted in critical re-evaluation of the overall health benefits of hormone therapy (HT) in women during the menopausal transition and thereafter. These data stimulated vigorous debate among experts and produced several position papers by North American and European authorities providing guidance on the use of HT. It is well known that cultural, geographic and ethnic differences influence the acceptance and risk perception of HT. Therefore, it was considered essential to present a position specifically relevant to Latin American countries. METHODS: A Latin American Expert Panel, convening in Salvador, Bahia, Brazil, obtained consensus on recommendations for HT that incorporated the findings of the most recently published reports. The panelists' opinions were surveyed by means of the Likert scale along five categories ranging from complete agreement to complete disagreement. RESULTS: The Panel presented 13 recommendations and considered three additional issues relevant to HT use. There was consensus that HT during the perimenopause and thereafter is warranted in Latin American women in particular for the management of vasomotor symptoms. HT may also be an option for osteoporosis prevention in women at significant risk, after evaluation of risks/benefits and after consideration of alternative therapies. HT should be individualized and prescribed at the lowest effective dose. CONCLUSIONS: The Panel concluded that HT remains a safe and effective treatment option for peri- and postmenopausal Latin American women.

Long-term evaluation of lipid profile and oral glucose tolerance test in Norplant users.

PURPOSE: This study reports the results of the lipid profile and oral glucose tolerance test (OGTT) in 46 normal patients tested before and after 5 years of Norplant use. RESULTS: After 5 years, there was a substantial decrease of 28.9% in high-density lipoprotein cholesterol levels and a similar but less pronounced fall of 7.1% in the total cholesterol levels. The Castelli 1 index did not vary, and the triglycerides and low-density lipoprotein cholesterol levels remained normal and unchanged throughout the study period. All the mean values of OGTT were significantly lower after 5 years, except for the 90-min glycemia. CONCLUSION: These findings indicate that long-term Norplant use does not increase cardiovascular risks.

Human papillomavirus DNA detection in male sexual partners of women with genital human papillomavirus infection.

OBJECTIVES: To determine the prevalence of human papillomavirus (HPV) DNA in the male partners of HPV-infected women, assess the concordance of the viral group in the infected pair, define the most affected sites in the male genitalia, and compare diagnostic methods in men. METHODS: Fifty male, stable sexual partners of women positive for HPV DNA by the Hybrid Capture 2 (hc2) test had material brushed from six different anogenital areas for hc2 testing. One week later, patients underwent classic peniscopy, and the lesions were biopsied for histologic analysis and hc2 testing. RESULTS: The brushings were HPV DNA positive in 35 (70%) of the 50 men: 32% in the high-risk HPV group, 14% in the low-risk HPV group, and 24% in both groups. HPV detection per anatomic site was 24% in the glans, 44% in the prepuce internal surface, 30% in the distal urethra, 24% in the prepuce external surface, 12% in the scrotum, and 8% in the anus. Acetowhite lesions were seen in 44 (88%) of the 50 patients. Overall, HPV DNA was detected in 27 (26%) of the 104 biopsy specimens, but histologic examination showed evidence of HPV infection in only 14 (13.5%) of 104 biopsy specimens. In 3 (6%) of 50 patients, hc2 was positive only in the histologic examination. Overall, the prevalence of detectable high-risk HPV DNA among male partners was 60% (30 of 50). CONCLUSIONS: Of the 50 male partners studied, 76% were HPV DNA positive. Histologic examination was an inaccurate method to diagnose HPV DNA infection in men; however, brushings detected HPV in 92.1% of the infected men.

Effects of tamoxifen on Doppler velocimetry parameters of periurethral vessels in postmenopausal women.

The purpose of the present study was to assess the effect of tamoxifen on periurethral vessels by Doppler velocimetry examination. Increase in the number of these vessels as well as decrease in resistance and pulsatility indices by tamoxifen were observed.

Sulfated glycosaminoglycans of the vagina and perineal skin in pre- and postmenopausal women, according to genital prolapse stage.

The aim of this study was to analyze the amount and types of sulfated glycosaminoglycans (GAGs) of the extracellular matrix (ECM) in the posterior vaginal wall and perineal skin in menacme and postmenopausal women, according to genital prolapse stage. Samples of vaginal tissue and perineal skin were obtained from 40 women who underwent vaginal surgery. Sulfated glycosaminoglycans were extracted by extensive tissue maxatase digestion, submitted to electrophoresis on agarose gel, and their concentrations were determined by densitometry. Dermatan sulphate (DS) was the predominant GAG, followed by chondroitin sulfate (CS) and heparan sulfate (HS). In the vagina there was a significant decrease in total GAGs, CS, DS and HS in postmenopausal women with prolapse stage 2 and 3 compared to the premenopausal group, independent of the stage. In stage 2 and 3 postmenopausal patients there was a significant decrease of DS and HS compared to the stage 1 postmenopausal group. In perineal skin there was no significant difference between total GAG amount, DS and HS. However, the amount of CS in premenopausal stage 1 patients was significantly than that in postmenopausal patients stage 1 and stages 2 and 3. In conclusions, there are quantitative and qualitative differences in GAGs of the ECM in vaginal wall and perineal skin between women in menacme and the postmenopause, according to genital prolapse stage.

Correlation between valsalva leak point pressure and maximal urethral closure pressure in women with stress urinary incontinence.

This study analyzed the relationship between valsalva leak point pressure (VLPP) and maximal urethral closure pressure (MUCP) in women with stress urinary incontinence. One hundred sixty-one patients were selected with diagnosis of mixed or stress urinary incontinence. During urodynamics we measured VLPP and MUCP. Patients were gathered according to VLPP and analysis of variance (ANOVA) was performed. Pearson's correlation coefficient and linear regression were also utilized. The group with VLPP under 60 cm H(2)O had mean MUCP of 44.5 cm H(2)0; the group with VLPP between 60 and 90 cm H(2)O had mean MUCP of 54.3 cm H(2)O; and the group with VLPP over 90 cm H(2)O had mean MUCP of 60.1 cm H(2)O. We observed correlation between MUCP and VLPP when we used Pearson's correlation coefficient (r=0.22) and linear regression ( p<0.05). There was weak correlation between MUCP and VLPP, and MUCP was significantly lower in patients with leak point pressure inferior to 60 cm H(2)O.

A comparative study of MMP-2 in vulvar neoplasms.

OBJECTIVE: To investigate differences in MMP-2 protein expression in VIN, vulvar invasive carcinoma, and lichen sclerosus, we performed an immunohistochemical study in which tissue samples from individuals affected by these conditions were compared with normal vulvar tissue. METHODS: A total of 57 cases were selected, as follows: 14 cases of vulvar invasive carcinoma, 22 of vulvar intraepithelial neoplasia (6 of VIN I, 5 of VIN II, and 11 of VIN III), 9 of vulvar lichen sclerosus, and 12 samples of normal vulvar tissue. Immunohistochemistry was done with primary monoclonal antibodies against MMP-2 and quantification of the immunostaining was done by counting the number of antigen-positive stromal cells per 1000 stromal cells. RESULTS: Normal vulvar tissue had a median score of 37.99 stromal cells positive for MMP-2. The median scores for VIN I/II and lichen sclerosus were 41.98 and 46.51, respectively, with no statistical differences when compared to the normal group. Invasive cancer had a score statistically higher (160.36) than any of the other groups. CONCLUSION: Invasive vulvar carcinoma had a score statistically higher of MMP-2 than normal tissue, VIN, and lichen sclerosus.

Lipid profile in women over 35 years old using triphasic combined oral contraceptives.

Twenty-nine women aged 35 years old or more, using triphasic combined oral contraceptive (COC) were evaluated during six cycles for the following parameters: total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and its subfraction HDL2, triglycerides, apoproteins A and B, Castelli risk index I and II (cholesterol/HDL-C and LDL-C/HDL-C) and apoprotein ratio (apoprotein B/apoprotein A). The same laboratory measurements were done in a control group of 49 non-COC-user women. The results showed that there were no differences on most of the studied parameters between user and nonuser women. There was a significant reduction of HDL-C and HDL2-C, although within the normal range. In addition, it was observed a significant increment of triglycerides and apoprotein B at 6 months of follow-up only in user group (p < 0.05), although within the normal range. It is concluded that the use of levonorgestrel triphasic COC appeared to have no additional adverse impact when used by women aged over 35 years. Further studies are needed to obtain conclusive data.

Nonobese women with polycystic ovary syndrome respond better than obese women to treatment with metformin.

OBJECTIVE: To determine the clinical, hormonal, and biochemical effects of metformin therapy in obese and nonobese patients with polycystic ovary syndrome (PCOS). DESIGN: Controlled clinical study. SETTING: Department of Gynecology of Federal University of São Paulo, São Paulo, Brazil. PATIENT(S): Twenty-nine patients with PCOS. INTERVENTION(S): Patients were treated with 500 mg of p.o. metformin t.i.d. for 6 months. MAIN OUTCOME MEASURE(S): Clinical data as well as serum concentrations of sex steroids, sex hormone-binding globulin (SHBG), gonadotropins, leptin, GH, lipids, insulin, and glucose levels were assessed before and after treatment. RESULT(S): In the metformin group of nonobese patients, the mean fasting serum insulin concentration decreased from a pretreatment value of 12.1 +/- 2.4 to 6.3 +/- 0.6 microU/mL after treatment, and the area under the curve of insulin decreased from 5,189.1 +/- 517.4 to 3,035.6 +/- 208.9 microU/mL per minute. Also in the metformin group of nonobese patients, the mean basal serum total testosterone, free testosterone, and androstenedione concentrations decreased by 38%, 58%, and 30%, respectively. In the obese patients treated with metformin, only free testosterone showed a statistically significant decrease (1.7 +/- 0.2). CONCLUSION(S): Our data suggest that nonobese patients respond better than obese patients to a 1.5 g/day metformin regimen.

Analysis of type I collagen in the parametrium of women with and without uterine prolapse, according to hormonal status.

The content and quality of type I collagen in the parametrium of women with and without uterine prolapse was evaluated. Forty-four consecutive patients were selected and divided into two groups: A, 21 women without uterine prolapse, and B, 23 with uterine prolapse. Patients in group A had uterine leiomyoma and were submitted to abdominal hysterectomy; in those from group B, vaginal hysterectomy was performed for correction of the uterine prolapse. During surgery, fragments of the parametrium were removed and processed for immunohistochemical analysis using polyclonal antibodies for type I collagen. A system of computerized digital imaging analysis was used for the quantification of collagen fibers. There was no difference between collagen content in patients either with or without prolapse, nor between pre- and postmenopausal women with prolapse. A modification of the quality of the collagen fiber was observed, it being longer and more compact in the group without uterine prolapse. In contrast, in the group with prolapse, the fibers were shorter and thinner and areas with large spaces between fibers were found at several points of the parametrium. The conclusion was that patients with uterine prolapse have the same type I collagen content as those without, but the quality of the fiber is modified. The hormonal status also did not affect collagen content.

[Histopathological and immunohistochemical analysis (proliferating cel nuclear antigen) of patients with invasive cervical carcinoma before and after radiotherapy and surgery]. / Análise histopatológica e imuno-histoquímica (antígeno nuclear de proliferação cellular) de pacientes com carcinoma cervical invasor antes e após radioterapia e cirurgia.

OBJECTIVE: To search for residual disease and to analyse the Proliferating Cellular Nuclear Antigen (PCNA) status, in patients with cervical squamous cell carcinoma, treated with both radiotherapy and surgery. METHODS: Histological slides from 16 patients with uterine cervix cancer, treated between April 1986 and August 1998, with preoperative radiotherapy and surgery, were reviewed. PCNA immunohistochemical reactivity of these samples was evaluated, using the IMAGELAB 2.3 computer image analysis system. RESULTS: Residual carcinoma were found in eight cases (50%) and no malignant features was found in eight cases (50%). The mean value of PCNA before radiotherapy in patients with residual cancer was 61.56% and in cases without residual cancer was 60%. Its expression before radiotherapy was between 27.91% and 89.93% (60% average), while after radiotherapy it varied between 55.80% and 86.73% (74% average). CONCLUSIONS: The association between preoperative radiotherapy followed by surgery is adequate to treat patients with cervical cancer, when radical treatment is not possible. Meanwhile, exclusive radiotherapy shows a significant failure rate, detected after surgery and PCNA analysis.

Benefits of soy isoflavone therapeutic regimen on menopausal symptoms.

OBJECTIVE: To examine the change in menopausal symptoms and cardiovascular risk factors in response to 4 months of daily 100-mg soy isoflavone in postmenopausal women. METHODS: In this double-blind, placebo-controlled study, 80 women were randomly assigned to isoflavone (n = 40) and placebo (n = 40) treatment. The menopausal Kupperman index was used to assess change in menopausal symptoms at baseline and after 4 months of treatment. Cardiovascular risk factors were assessed by evaluating plasma lipid levels, body mass index, blood pressure, and glucose levels in the participants. To examine the effects of this regime on endogenous hormone levels, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and 17 beta-estradiol were measured. Transvaginal sonography was performed to quantify endometrial thickness. RESULTS: The data showed a decrease in menopausal symptoms (P <.01, paired t test, two-tailed, between baseline and isoflavone groups, and P <.01, unpaired t test, between placebo and isoflavone groups). Total cholesterol and low-density lipoprotein decreased significantly in the isoflavone group compared with the baseline or placebo group (P <.001, paired t test, two-tailed, between baseline and isoflavone groups, and P <.01, unpaired t test, between placebo and isoflavone groups). The isoflavone treatment appeared to have no effect on blood pressure, plasma glucose, and high-density lipoprotein and triglyceride levels. CONCLUSION: This study suggests that isoflavone 100-mg regime treatment may be a safe and effective alternative therapy for menopausal symptoms and may offer a benefit to the cardiovascular system.