The value of tumor marker and cytokine analysis for the assessment of regional lymph node status in cervical cancer patients.

The aim of the study was to evaluate the utility of the measurements of the circulating tumor markers, squamous cell carcinoma antigen (SCCA), CA125, carcinoembryonic antigen (CEA), cytokeratin fragment 19 (CYFRA 21.1), and the cytokines, interleukin-6 and vascular endothelial growth factor (VEGF), to estimate regional lymph node involvement in patients with cervical cancer. The study comprised 182 untreated patients with cervical cancer. The regional lymph node status was assessed either by the postsurgical histopathologic examination or by the computed tomography (CT). Concentrations of SCCA, CEA, and CA125 were determined using the Abbott Instruments system, of CYFRA 21.1 by the Roche kits, and of IL-6 and VEGF by the ELISA of R&D Systems (Minneapolis, MN). For the statistical analyses, Mann-Whitney U test and chi(2) test were applied. Serum levels of SCCA, CEA, CA125, CYFRA 21.1, IL-6, and VEGF were measured in patients with specified pelvic and para-aortic lymph node status. SCCA, CA125, and IL-6 levels were found to be significantly higher in patients with lymph node metastases than in those with no lymph node involvement. Also, the percentage of patients with simultaneously elevated concentrations of SCCA and CA125 or SCCA and IL-6 differed depending on the lymph node status and was significantly higher in the series of patients with lymph node metastases. Simultaneous assessment of serum levels of SCCA and CA125 or SCCA and IL-6 in patients with cervical cancer may be useful for the regional lymph node evaluation, especially in patients with advanced stages, when the lymph nodes are examined only by CT, with no histologic confirmation.

Ureaplasma urealyticum and Mycoplasma hominis infection in women with urogenital diseases.

PURPOSE: The aim of the study was to assess the incidence of Ureaplasma urealyticum (U. urealyticum) and Mycoplasma hominis (M. hominis) infection in women with urogenital diseases. MATERIAL AND METHODS: M. hominis and U. urealyticum was assessed in 541 women from gynaecological and STD outpatient clinics, aged 18-55 years. A Mycoplasma IST 2 kit was used for biochemical determination of mycoplasmal infections (BioMerieux). Additionally, 248 of patients were examined for Chlamydia trachomatis (C. trachomatis), Trichomonas vaginalis (T. vaginalis) and Candida albicans (C. albicans) infection. C. trachomatis was detected by direct immunofluorescence method. The standard culture methods (Biomed) were applied to detect T. vaginalis and C. albicans. RESULTS: U. urealyticum was detected in 161 (29.8%), and M. hominis in 20 (3.7%) women. U. urealyticum infection alone was observed in 37/79 (46.8%), and 1/8 (12.5%) patient had only M. hominis infection. The U. urealyticum infection showed most frequent coexistence with C. albicans (29.1%), and less frequent with C. trachomatis (13.9%) and M. hominis infection (10.1%). The highest percentage of mycoplasma-positive cultures was found in patients of STD clinic and in infertile women. In patients with ureaplasmal infection only the most common clinical symptom was vaginal discharge and vulval/vaginal irritation. In 8.1% of the women, the course of U urealyticum infection was asymptomatic. CONCLUSIONS: The incidence rate of genitourinary infections due to U urealyticum was significantly higher as compared to M. hominis infection. Sexual mycoplasmal infections were most frequently reported in the group of patients of STD clinic and correlated with age and sexual activity.

Mycoplasma hominis and Ureaplasma urealyticum infections in male urethritis and its complications.

PURPOSE: The aim of this study was to estimate the incidence of M. hominis and U. urealyticum infections among men with urethritis and its complications. MATERIAL AND METHODS: Material for analysis were urethral swabs and EPS. Mycoplasma IST 2 kit was applied to diagnose mycoplasmal infections. All patients were additionaly tested for C. trachomatis, C. albicans and T. vaginalis and Gram stain specimens were obtained to identify the presence of PMN. RESULTS: U. urealyticum was detected in 57/390 (14.6%), and M. hominis in 4/390 (1%) men. Exclusive U. urealyticum infection was found in 45 (11.5%) men, and only 2 patients had exclusive M. hominis infection. U. urealyticum infection the most frequently coexisted with C. trachomatis--5 (8.8%), next with C. albicans--4 (7%) and M. hominis--2 (3.5%) infections. Mycoplasmal infections were the most frequently found in patients aged 30 to 39 (35.1%) diagnosed with epididymitis (29.2%). The most commonly reported symptom was dysuria. CONCLUSIONS: U. urealyticum is the common pathogen among men with urethritis and its complications. The most common symptoms in U urealyticum patients were: dysuria, hypogastric pains and urethrorrhoea, however, clinical symptoms are not frequently observed.