Granzyme B as a prognostic marker of cervical intraepithelial neoplasia.

Granzyme B (GrB) is a serine protease synthesized in T lympocytes (CTL), released after T-cell activation resulting from exogenous stimulation. With perforin, GrB discharges apoptotic signals to a target cell and therefore constitutes a marker to identify activated CTL. We aimed to quantify GrB expression by immunohistochemistry staining in 12 tissue fragments of cervical carcinoma, 33 cervical intraepithelial neoplasias treated by LLTEZ and nine cervical pieces without disease. Activated cytotoxic lymphocyte mean values (20 HPF-400x) in both epithelial and stromal pars were 7.11 cells in tissue without neoplasia, 33.45 cells in cervical intraepithelial neoplasia and 139.75 cells in carcinoma samples, with a statistical difference between them. Comparative analysis in the CIN group showed an expressive difference between cases with disease recurrence (19.28 cells) and without recurrence (37.26 cells). Thus, the relation between number of activated CTLs found at the moment of treatment and clinical evolution determined in this study, suggest GrB use as a prognostic marker.

Angiogenesis in squamous intraepithelial neoplasia of the uterine cervix in HIV-seropositive women.

OBJECTIVES: This study aimed to quantify angiogenesis in squamous intraepithelial lesions of the uterine cervix in seropositive HIV patients as well as to establish a relationship between vascular density and variations in the CD4+ lymphocyte titer and the viral load of human immunodeficiency virus (HIV). METHODS: 125 patients, 55 HIV seropositive and 70 seronegative, were allocated with respect to grade of squamous intraepithelial lesion (SIL). The obtained samples were stained with an immunohistochemical marker for CD34 antigen and vessel counts were performed in ten consecutive fields at 400x magnification. The seropositive HIV patients were distributed into groups according to the CD4+ index and HIV viral load. RESULTS: Seropositive HIV patients presented a higher mean vascular density (MVD) than the control group, even in the absence of cervical intraepithelial lesions. High- and low-grade lesions in the presence of HIV seropositivity presented higher MVD than that found in seronegative HIV patients. There was no significant variation in the MVD and CD4+ count ratio or viral RNA-HIV load, except for high-grade (H)SIL. CONCLUSIONS: Infection with HIV influenced angiogenesis of uterine cervix in the presence of squamous intraepithelial lesions and more significantly in HSIL.

Importance of peniscopy, oncologic cytology and histopathology in the diagnosis of penile infection by human papillomavirus.

INTRODUCTION: Male genital infection by human papillomavirus is of particular importance since it is often asymptomatic. The patient generally presents no clinical lesion. Therefore, men represent an important reservoir of virus, playing a special role in the transmission and perpetuation of the disease. PATIENTS AND METHODS: In the present prospective clinical trial study, 190 sex partners of women with genital infection by human papillomavirus, associated or not with cervical intraepithelial neoplasia, were investigated. All patients were unaware of or denied the presence of a genital lesion. RESULTS: Cytologic examination revealed koilocytosis in 9 cases (4.7%) in the urethra and in 3 cases (1.6%) in the corona of the glans and the distal prepuce. Peniscopy with the previous use of 5% acetic acid revealed white lesions in 97.9% of the patients. Toluidine blue stained most of the lesions. At least one fragment revealed koilocytosis in the histopathologic study of 97 cases (51.05%). CONCLUSION: The three methods complement one another, allowing a more precise diagnosis of the infection in men.

Action of estrogen alone on the number of lysosomes in the rat endometrial epithelium

In order to determine the possible variations in the number of lysosomes in the glandular epithelium of endometrial cells of rats under estrogen action alone, the following groups of rats were studied: I, rats in estrous phase; II, oophorectomized rats; III, oophorectomized plus estrogen treated rats. Lysosomes were visualized by Gomori's method for acid phosphatase and counted by two researchers. The results obtained were statistically significant, with higher values in oophorectomized plus estrogen treated rats than in oophorectomized animals. Rats in estrous phase also presented a higher number of lysosomes than those of oophorectomized and not treated with estrogen

Peritumorous lymph-vascular invasion, grade of histologic differentiation, and myometrial infiltration as prognostic factors of endometrial carcinoma.

The authors evaluated 50 patients with endometrial carcinoma studying the prognostic parameters: histologic grade, myometrial invasion and lymph-vascular space invasion. The patients were divided into two groups: A--a good prognosis group (33 cases)--with no recurrences and/or metastasis occurring for five years; and B--a bad prognosis group (17 cases)--with recurrence and/or metastasis or death within five years. We concluded that lymph-vascular space invasion was more frequent in group B, and was a reliable parameter for bad prognosis. The lymph-vascular space invasion was always accompanied by myometrial invasion and patients whose myometrium had not been involved did not have lymph-vascular space invasion. In both groups, in well-differentiated tumors, there was no lymph-vascular space involvement. The well-differentiated tumors were statistically more frequent in the good prognosis group. Myometrial invasion was not statistically significant as a prognostic parameter.

[Treatment of human papillomavirus infection of the uterine cervix with gel interferon]. / Tratamento da infecção do colo uterino por papilomavírus humano com interferon gel.

Treatment of uterine cervix infection caused by human papillomavirus still is an enigma. Some drugs have been tested with cure rates between 60 to 70%. Most of such agents are substances which produce a strong epithelial desquamation and have shown strictly toxic side effects. The use of interferon in this infection has been studied, but different authors disagree in their therapeutic findings. A randomized, double blind trial was conducted to compare interferon to placebo. Preliminary results are presented in this article. 47 patients were followed so far. 18 of them were evaluated and the results are shown in this article.

[Diagnosis of cervicovaginal infection by human papillomavirus. Value of colposcopy, cytology and histopathology as methods of diagnosis]. / Diagnóstico da infecção cervicovaginal por papilomavírus humanos. Valor da colposcopia, citologia e da histopathologia como métodos diagnósticos.

The authors evaluated 476 patients to determine the accuracy of colposcopy, cytology, and histopathology as diagnostic methods for cervical and vaginal HPV infections. Results were treated by statistical analysis which showed significant disagreement among the methods tested. Colposcopy was positive in 87.8% of the cases. Abnormal transformation zone was the most frequent finding in the cervix, acetowhite epithelium being its main representative. Condylomatous vaginitis was the most frequent feature in the vaginal surface. Cytology was positive in 76.9% of the cases. To increase sensitivity of this method, the authors suggest that not only koilocytosis is important, but other major aspects are also important, such as minimal koilocytosis, dyskeratosis, karyopyknosis, binucleation, and multinucleation. Histopathology was positive in 81.9% of the cases. In conclusion, the three diagnostic methods studied presented statistical disagreement, however, they are supplementary and efficient.

Variacao do nimero de lisossomos no epitelio endometrial humano, nas fases proliferativa e secretora do ciclo menstrual. / Variation of lysosome number in human endometrial epithelium, in the proliferative and secretory phases of the menstrual cycle

Foi realizado um estudo do comportamento do numero de lisossomos no epitelio endometrial humano nas fases proliferativa e secretora do ciclo menstrual, pela tecnica preconizada por Pricoli (25). Apos submetidos os resultados a tratamento estatistico, verificou-se que: 1o) o numero de lisossomos e significativamente diferente nas diversas fases do ciclo menstrual; 2o) o maior numero e observado em torno da epoca provavel da ovulacao e, o menor, no inicio do ciclo menstrual

Tratamento cirurgico conservador nas neoplasias ovarianas de baixo potencial de malignidade. / Conservative surgical treatment of ovarian neoplasms of low potencial malignancy

Os autores analisam o comportamento do medico diante das neoplaisas ovarianas de baixo potencial de malignidade optando, dentro de rigidos limites, pela conduta cirurgica conservadora. Ressaltam a importancia dos exames pre-operatorios, da minuciosa avaliacao intracirurgica e do seguimento pos-operatorio adequado

Lesoes precursoras do cancer do colo uterino. / Precancerous lesions of the uterine cervix

Os autores descrevem o aspecto histologico do colo do utero e enfatizam a importancia da juncao escamocolunar (JEC) na genese da terceira mucosa ou zona de transformacao tipica.Definem a zona de transformacao atipica, sede inicial das lesoes precursoras; salientam a sua progressao ao cancer invasor, embora, as vezes, sejam passiveis de regressao sem tratamento. Sobrelevam no diagnostico o emprego da colposcopia, da citologia oncotica e da biopsia dirigida. Por fim, analisam a conduta terapeutica seguida no Posto de Prevencao do Cancer Ginecologico da Escola Paulista de Medicina

[Prevention of gynecological cancer: Socioeconomic, colposcopic and cyto-histological study].

PIP: Study of 600 patients at the Service for the Prevention of Gynecological Cancer of a maternity hospital in Brazil resulted in a correlation between socioeconomic conditions and the findings of routine examinations for cancer prevention (cytology, colposcopy, and histology). Positive findings of neoplasia were obtained in 7 cases, a much higher incidence than that found in the population generally. It is concluded that the greater incidence of cervical cancer is the result of socioeconomic conditions, such as early beginning of sexual relations (116 patients, i.e., 19.3%, began their sexual life before age 15), promiscuity, multiparity, and early pregnancies, which were found very frequently in the population studied. These findings confirm those reported by other authors.^ieng