An Analysis of ESR2 and CYP19A1 Gene Expression Levels in Women With Endometriosis.

AIM: The analysis of oestrogen receptor (ESR2) and cytochrome P450 family 19 subfamily A member (CYP19A1) gene expression in the context of the risk for endometriosis development. MATERIALS AND METHODS: Tissue specimens, collected from patients with endometriosis (n=100) and from control patients (n=100) embedded into paraffin blocks, provided the material for genetic studies, oriented towards the expression of ESR2 and CYP19A1 genes. The gene expression was assessed by the reverse transcription-polymerase chain reaction technique. RESULTS: Higher expression levels of ESR2 gene were demonstrated in the patients with endometriosis in comparison with the healthy controls. The expression intensity of CYP19A1 gene was associated with endometriosis, manifested as abdominal wall nodules. A relationship was observed between CYP19A1 gene expression and the Revised American Society for Reproductive Medicine classification in the group with ovarian endometrioid cysts, as well as in the group with peritoneal endometriosis. CONCLUSION: This study suggests the significant role of ESR2 and CYP19A1 gene expression in the pathogenesis of endometriosis.

New variants near RHOJ and C2, HLA-DRA region and susceptibility to endometriosis in the Polish population-The genome-wide association study.

OBJECTIVE: Endometriosis is a common gynaecological disease, associated with severe pelvic pain and reduced fertility; however, molecular mechanisms remain largely unknown. Genome-wide association studies (GWAS) are able to identify genetic loci, which can play significant role during endometriosis development. AIM: The study aimed at localisation of new genes and chromosomal loci, the nucleotide variants of which determine the level of susceptibility to endometriosis. STUDY DESIGN: Blood samples from 171 patients with endometriosis were used as material for studies. The patients were recruited to the study at the Department of Operative Gynaecology of the Institute of the Polish Mother's Memorial Hospital in Lodz. A control group (n=2934) came from the POPULOUS collection registered at Biobank Lab, Department of Molecular Biophysics, University of Lodz. DNA of the patients with endometriosis was compared with DNA of women free from that disease, the comparison being supported by GWAS. RESULTS: Genome-wide significant correlation was identified between one new, not previously described, single nucleotide polymorphism (SNP), rs10129516, localised on chromosome 14 in intergenic region between PARP1P2 and RHOJ genes (p=1.44×10-10, OR=3.104, 95% CI=2.329-4.136) and endometriosis. We have also identified significant association with endometriosis of 18 SNPs localised on chromosome 6 in position range 31883957 - 32681631 (C2 and HLA-DRA genes region) with the lowest observed p value for rs644045 in C2 gene (p=2.04×10-8, OR=1.955, 95% CI=1.541-2.480). CONCLUSION: Reported GWAS identified the novel loci associated with endometriosis in Polish women, not previously reported. The most interesting observation shown in our study are regions associated with susceptibility to endometriosis of loci located near C2, HLA-DRA and RHOJ genes. RESULTS: of that study did not correspond to previously published data about polymorphism in that regions and further evaluations are necessary in groups with higher numbers of patients to explain whether the above-mentioned genetic variant may be the risk factor for pathogenesis of endometriosis.

[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.

[Economic aspects of using selected biomarkers in cervical cancer screening]. / Aspekt ekonomiczny wykorzystania wybranych biomarkerów w badaniach przesiewowych raka szyjki macicy.

Increasing knowledge about the cervical cancer etiology, combined with the development of molecular diagnostics technology using DNA matrix and mRNA matrix, introduced a new quality in cervical cancer screening. Moving the diagnostics from the cellular level into the molecular level allowed not only to identify the existing precancerous states, but also to foresee these pathologies in the stage of cellular or molecular changes using oncogenesis biomarkers. The new diagnostic tools give hope for the improvement of effectiveness of cervical cancer screening and for a significant reduction of costs.

[Colposcopy of the vagina--a frequently omitted part of the colposcopic examination]. / Kolposkopia pochwy--czesto pomijany element badania kolposkopowego.

Colposcopy of the vagina is a part of the colposcopic examination which is often omitted. It is an extremely serious mistake that makes the colposcopic examination less valuable. The instrumentarium, technique of the examination and distinctive features of colposcopic images showing vaginal changes have been presented in detail.

[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.

[The risk of endometrial cancer appearance and CYP19 and COMT gene polymorphism]. / Ryzyko wystepowania raka endometrium w kontekscie wplywu polimorfizmów genów CYP19 i COMT.

THE AIM: Women with high circulating estrogens concentration have increase risk of breast, endometrium and ovarian cancer, thus it is important to identify factors, including environmental and genetic variability that may be alter estrogen concentration. MATERIAL AND METHODS: In the present work the distribution of genotypes and frequencies of alleles of the T/C polymorphism of CYP19 and G/A polymorphism of COMT gene in subjects with endometrial cancer were investigated. Paraffin embedded tumour tissues was obtained from 151 postmenopausal women with endometrial cancer. The polymorphism's were determined by PCR-RFLP methods. RESULTS: The distribution of the genotypes of the T/C and G/A polymorphism in both control and patients did not differ significantly (p > 0.05) from those predicted by the Hardy-Weinberg distribution. Additionally, there were no significant differences (p > 0.05) in genotype distributions and allele frequencies between subgroups assigned to histological stage. CONCLUSION: The results suggest that the CYP19 and COMT polymorphism may not be linked with appearance and development of endometrial cancer but further research, conducted on larger population, are needed to clarify this point.

[Laparoscopic dissection of uterine artery and coagulation utero-ovarian ligament for the treatment of symptomatic myomas]. / Laparoskopowe przeciecie tetnic macicznych oraz koagulacja wiezadel wlasciwych jajników w leczeniu objawowych miesniaków macicy.

OBJECTIVES: Our purpose was to evaluate the effects and safety of laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament in treating symptomatic myomas. MATERIAL AND METHODS: We studied 40 women, aged 31 to 50, with symptomatic uterine fibroids undergoing laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament Ultrasound examination of uterus and dominant fibroid were performed. Their volume reduction was measured. Clinical response was evaluated according to questionnaire assessing the level of menstrual bleeding, pain and urgency. RESULTS: There were no complications during operations. Within 6 months after the surgery the mean uterus volume was reduced by 22% and mean volume of dominant fibroid was reduced by 51%. Six months after the surgery menstrual bleeding was reduced in case of 34/38 patients (85%), completed pain relief has been observed in case of 19/25 patients (76%). In case of 11/15 (73%) patients, a regression of urgency has been observed. CONCLUSIONS: Laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament is a safe and effective method of treating symptomatic myomas. It is an alternative to hysterectomy, especially for women who wish to preserve their uterus.