ABSTRACT
The aim of the study was to compare the expression of oestrogen receptor alpha (ERα) in neovaginal tissue of patients with vaginal agenesis following neovaginoplasty using regenerated, oxidised cellulose in premenopausal women. A prospective, observational case-control study was performed on eight patients with vaginal agenesis following modified Abbé-McIndoe neovaginoplasty and 10 control premenopausal women following benign gynaecologic surgery. 6F11 monoclonal antibody was used to determine ERα expression in the vaginal mucosa. Quantitative and qualitative evaluations were performed, respectively, in vaginal epithelium and stroma. The thickness of the vaginal epithelium was determined as the vertical distance between the basal layer cells and the apical surface of the superficial layer. The percentage of ERα-expressing cells was higher in the control group, except in the superficial zone of the epithelium. In the stromal tissue, ERα was detected in only one patient from the neovagina group compared with nine women in the control group. The neovagina group had a statistically thinner epithelium. Our study suggests that women with vaginal agenesis following modified Abbé-McIndoe neovaginoplasty using regenerated oxidised, cellulose experience relatively local hypo-oestrogenism in the first year after surgery, with repercussion in vaginal trophism.
Subject(s)
46, XX Disorders of Sex Development/surgery , Congenital Abnormalities/surgery , Estrogen Receptor alpha/metabolism , Gene Expression Regulation , Guided Tissue Regeneration , Gynecologic Surgical Procedures , Mucous Membrane/metabolism , Mullerian Ducts/abnormalities , Vagina/metabolism , 46, XX Disorders of Sex Development/metabolism , 46, XX Disorders of Sex Development/pathology , Adolescent , Adult , Atrophy , Biopsy , Brazil , Case-Control Studies , Cellulose, Oxidized/therapeutic use , Congenital Abnormalities/metabolism , Congenital Abnormalities/pathology , Estrogen Receptor alpha/genetics , Female , Follow-Up Studies , Guided Tissue Regeneration/adverse effects , Gynecologic Surgical Procedures/adverse effects , Hospitals, University , Humans , Mucous Membrane/pathology , Mucous Membrane/surgery , Mullerian Ducts/metabolism , Mullerian Ducts/pathology , Mullerian Ducts/surgery , Premenopause , Prospective Studies , Stromal Cells/metabolism , Stromal Cells/pathology , Tissue Scaffolds , Vagina/abnormalities , Vagina/pathology , Vagina/surgery , Young AdultABSTRACT
INTRODUCTION AND HYPOTHESIS: The purpose of this study was to evaluate the expression of estrogen receptor alpha (ERα) on the neovaginal tissue of patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome submitted to modified Abbé-McIndoe neovaginoplasty using oxidized regenerated cellulose. METHODS: The current study involved eight subjects with MRKH syndrome. Serial samples of the neovagina were obtained after the surgery and immunohistochemical detection of ERα was performed using antibody NCL-L-ER-6F11. RESULTS: The operation was performed successfully in all subjects without complications. A total of 22 samples of neovaginal tissue were analyzed. The expression of ERα was detected only 6 months after the surgery, when the neovagina acquired characteristics of normal vagina. CONCLUSION: In our study, the expression of ERα occurred when complete epithelialization of vaginal tissue was observed. Other mechanisms may be involved in the formation of vaginal epithelium in patients with MRKH syndrome.
Subject(s)
46, XX Disorders of Sex Development/surgery , Abnormalities, Multiple/surgery , Cellulose, Oxidized , Estrogen Receptor alpha/physiology , Gynecologic Surgical Procedures/methods , Plastic Surgery Procedures/methods , Vagina/physiology , Vagina/surgery , Adolescent , Adult , Biopsy , Congenital Abnormalities , Epithelium/pathology , Epithelium/physiology , Estrogens , Female , Humans , Kidney/abnormalities , Mullerian Ducts/abnormalities , Retrospective Studies , Somites/abnormalities , Spine/abnormalities , Treatment Outcome , Uterus/abnormalities , Uterus/surgery , Vagina/abnormalities , Vagina/pathology , Young AdultABSTRACT
Introducao: O aumento de casos em nosso meio, bem como sua alta morbimortalidade faz com que o cancer colorretal seja motivo de grande numero de estudos. Nesse sentido buscou-se uma analise epidemiologica do comportamento dessa patologia no Setor de Oncologia da Disciplina de Gastroenterologia da Unifesp-EPM, para melhor cuidado do proprio paciente. Metodos: atraves de um estudo retrospectivo no periodo entre 1988 e 1998 avaliou-se o numero de doentes com cancer colorretal atendidos no setor. foram analisados a idade, sexo, localizacao tumoral, histologia, estadio clinico, foco de metastases e tratamento realizado. Os dados foram comparados com os da literatura. Resultados? Entre os 162 pacientes, a idade media foi de 58 anos, sendo 88 do sexo feminino. os locais mais frequentemente acometidos foram reto e colo descendente. Quanto ao estagio clinico, 9,9por cento eram Dukes A, 35,8por cento Dukes B, 29,6por cento Dukes C e 24,7 por cento a radioterapia. Discussao: Os resultados dos exames foram mais semelhantes aos de outros quanto ao sexo idade media e topografia. Quanto ao estadio A, os resultados foram mais semelhantes aos de estudos norte-americanos e europeus que aos dos vizinhos latino-americanos. no entanto, o percentual de individuos estadio D foi superior, indicado a necessidade de implantar programas de diagnostico precoce de cancer colorretal em nosso meio
