Tissue and serum CA125 expression in endometrial cancer.

Serum CA125 is elevated in some endometrial cancer patients. The purpose of the present study was to assess the correlation between the presence of CA125 in endometrial cancer tissue and elevated CA125 serum levels. Serum levels of CA125 were examined in 39 patients with endometrial cancer prior to definitive surgery. After diagnosis reconfirmation, additional slides were prepared from each case for immunohistochemical staining for anti-CA125 antigens. Of the 39 patients, 28 had endometrioid endometrial carcinoma (EEC) and 11 had mixed mesodermal sarcoma (MMS). In EEC, 21.4% of the patients had an elevated CA125 serum level, and that correlated with stage (P = 0.02) but not with grade. The percentage of EEC patients with positive tissue staining was significantly higher than the percentage with elevated serum levels (89.3% vs. 21.4%, P < 0.0001). No correlation between positive tissue staining and stage or grade was observed. In MMS the percentage of positive tissue staining was also higher than that with elevated serum CA125 levels and the percentage with elevated serum levels was higher than in EEC. However, the differences were statistically not significant. Our study indicates that the majority of EEC tissues contain CA125 and that the percentage of positive CA125 tissue staining is significantly higher than that of elevated CA125 serum levels. This indicates the presence of some mechanism that prevents the access of CA125 into the circulation. This mechanism is probably less effective in more advanced EEC's and in MMS.

p53 expression in tissue adjacent to endometrial carcinoma.

OBJECTIVE: Since several investigations did not demonstrate the presence of altered p53 in endometrial hyperplasias, it has been concluded that these alterations constitute a relatively late event in endometrial carcinoma. The aim of the present study was to assess the presence of p53 in the tissue adjacent to endometrial carcinoma in attempt to elucidate the relationship between these tissues. METHODS: New slides were prepared from paraffin-embeded tissue blocks of 49 endometrial endometrioid carcinoma hysterectomy specimens so that in each case tumor tissue and adjacent uninvolved endometrium were represented. Immunohistochemical staining for p53 detection was then performed. RESULTS: In 43 of the 49 hysterectomy specimens evaluated, the tissue adjacent to the endometrial carcinoma was non hyperplastic and in six it was hyperplastic. Positive immunohistochemical staining was found in 22 (44.9%) of endometrial carcinomas and in eight (16.3%) of the adjacent tissues. A statistically significant higher percentage of hyperplastic adjacent tissues than non-hyperplastic adjacent tissues were immunohistochemically p53 positive (50.0% vs 11.3%; p = 0.047). CONCLUSIONS: Our findings may indicate that p53 alterations are not necessarily a late event in endometrial endometrioid carcinogenesis. Since a large proportion of tissues adjacent to endometrial carcinoma do not show p53 alterations, other early cellular events may also play a role.

The presence of HPV 16, 18 and p53 immunohistochemical staining in tumor tissue of Israeli Jewish women with cervical and vulvar neoplasia.

The incidence of cervical neoplasia in Israeli Jewish women is persistently lower, while that of vulvar carcinoma is comparable to that in other populations. The aim of the present investigation was to assess the prevalence of HPV and of immunohistochemically detected mutant p53 in Israeli Jewish women with cervical and vulvar neoplasia compared with other populations. Tissue sections from formalin-fixed paraffin-embedded blocks of ten patients with CIN III, 29 with invasive squamous cell carcinoma, three with adenocarcinoma and 14 with invasive vulvar carcinoma, were examined for the presence of HPV 16 and HPV 18 DNA by PCR amplification, and for mutant p53 protein by immunohistochemical staining. HPV negative cases were re-examined with a sensitive primer. HPV DNA was detected in eight patients with CIN III and in 23 patients with invasive squamous carcinoma. In the remaining cervical squamous neoplasia tissue analysis with the sensitive primer could not be done. HPV DNA was also detected in two patients with adenocarcinoma and in nine (64.2%) patients with vulvar carcinoma. Positive p53 immunohistochemical staining was found only in one CIN III patient, in six (20.7%) squamous carcinoma and in 11 (78.6%) vulvar carcinoma patients. Of the p53 immunohistochemical staining positive tissues, two with cervical carcinoma and six with vulvar carcinoma were also HPV-positive. The prevalence of HPV and of positive p53 immunohistochemical staining in our series of Israeli Jewish women with cervical and vulvar neoplasia is similar to that in other populations, suggesting that the etiological factors are probably also alike.

Sarcoidosis and giant midesophageal diverticulum.

Traction diverticula of the midesophagus result from granulomatous inflammation of mediastinal lymph nodes. Tuberculosis and histoplasmosis are known etiologies of this condition. To the best of our knowledge, this is the first report of a traction diverticulum caused by sarcoidosis.

Peripheral neuropathy associated with temporal arteritis.

Peripheral neuropathy is described in a patient with biopsy proven giant cell arteritis. Sural nerve biopsy showed myelin and axonal degeneration. Such an uncommon manifestation was resolved with corticosteroid therapy.

Cervical koilocytosis in hysterectomy specimens of Israeli residents and new immigrants.

There is an impression that the prevalence of cervical squamous cell carcinoma (SCC) among new immigrants from the former Soviet Union, is higher than among Israeli residents. Etiologically, SCC is associated with human papilloma virus infection (HPV). The purpose of the present study was to assess the prevalence of cervical HPV infection in new immigrants from the Soviet Union and in Israeli residents as indicated by the presence of koilocytosis in hysterectomy specimens. The study group consisted of 304 women (60 new immigrants and 244 Israeli residents who underwent hysterectomy for benign reasons). The original histological slides of the cervix were reviewed with special attention to the presence of koilocytosis. The two study subgroups differed, as expected, with regard to some characteristics, but koilocytosis was not present in any of the cervical specimens of new immigrants nor of residents. Although the study subgroups may be too small or selective, our findings do not support a possible higher HPV infection rate among new immigrants, yet may indicate a low reservoir of HPV in new immigrants and residents, in line with the low SCC incidence in Israeli women.

Human immunodeficiency virus infection among intravenous drug addicts in Israel--stable low prevalence over 34 months.

A serological survey of 300 Israeli intravenous drug addicts in 1988-1989, showed a 2.3% prevalence of antibodies to human immunodeficiency virus (HIV), very similar to the finding of a previous study (2%) performed in the same population in 1986. Travel and drug injection abroad continue to be the most significant predictors of HIV seropositivity in this group. The relatively uncommon use of cocaine and the absence of 'shooting galleries' in Israel, appears to explain best the stable low prevalence of HIV infection among parenteral drug addicts in this country.

Prevalence of sexually transmitted pathogens among women attending a methadone clinic in Israel.

OBJECTIVE: To assess the prevalence of sexually transmitted pathogens in drug-addicted women in Tel Aviv, Israel. DESIGN: A prospective study conducted between March and July 1987. SETTING: A methadone clinic in Tel Aviv, Israel. SUBJECTS: Sixty four asymptomatic female drug addicts were studied; 38 of them were declared practising prostitutes. METHODS: Cervical specimens were obtained for cultures, and blood samples were drawn for serological tests. Demographic data and sexual histories were obtained using a standard questionnaire. RESULTS: Chlamydia trachomatis was detected in the cervix of 25% of women; 98% had antibody titres (greater than 1:64). Mycoplasma hominis and Ureaplasma urealyticum were isolated in 57% and 65% respectively. Gardnerella vaginalis was detected in 17% of women, and herpes simplex virus was cultured from two prostitutes. Five per cent of women were carriers of HBsAg, while 57% had HBSs and/or HBc antibodies. Only one prostitute had specific treponemal antibodies. In no case were gonococci or group B streptococci isolated, and HIV serology was invariably negative. CONCLUSION: Chlamydia and genital mycoplasmas appear to be the prevailing pathogens in Israeli drug-addicted women, while gonococci and Treponema pallidum occur only rarely.