Villitis of unknown aetiology: Clinical implications in preterm population.

Villitis of unknown aetiology (VUE) is a chronic inflammatory process of chorionic villi which is reported to occur in up to 15% of term placentas. The present study aimed to investigate the association between VUE and perinatal complications in a population who delivered before term. Patients with VUE had a significantly higher rate of intrauterine growth restriction than the control group (47.1% vs. 20.6%, p < 0.01). In addition patients with VUE had a higher rate of deliveries due to absent diastolic flow on umbilical artery doppler than the control group (17.6% vs. 4.4%, p: 0.03). The rate of spontaneous preterm birth or pre-eclampsia was similar in patients with VUE and control groups. The present study provides some evidence that VUE is associated with abnormal perinatal outcomes in pregnant women who give birth before term.

Factors affecting recurrence after surgery for ovarian mature cystic teratoma.

We aimed to evaluate the risk factors for recurrence of surgically managed ovarian mature cystic teratoma (MCT). A total of 178 women with MCT managed surgically at our clinic were included in this retrospective study. The cases were followed for a minimum of 34 months. Risk factors recorded were age, gravidity, diameter of MCT, tumour markers, bilaterality, operation time and recurrence time. One hundred forty-one women (79.2%) underwent laparoscopy and the other thirty-seven patients (20.8%) underwent laparotomy. The mean age of patients with cyst recurrence was significantly lower than that of patients without recurrence (p = 0.02). There was a significantly lower median gravidity and parity in this group. The capacity of younger age, lower gravidity and parity in predicting the recurrence of ovarian MCT was analysed using receiver operating characteristic curve analysis. The cut-off value of age, number of gravidity and parity was 26, 1 and 0, respectively. In conclusion, younger age and lower gravidity and parity were predictive of recurrence due to a more conservative approach in young and nulliparous patients. Therefore, we suggest regular follow-up visits during the postoperative period, especially for younger patients and those with lower numbers of gravidity and parity.

CD31 and Factor VIII in angiogenesis of normal and pre-eclamptic human placentas.

We aimed to evaluate normal and pre-eclamptic placental vasculature by using CD31 and Factor VIII. We evaluated placentas of 37 pre-eclamptic women by using immunohistochemical staining with CD31 and Factor VIII antibodies. Individual microvessels in the placental tissues were counted at × 100 and × 400 magnification. Microvessel counts were lower in placentas of pre-eclamptic patients compared with healthy controls after staining with CD31 (26.5 ± 5.7 vs 103.9 ± 8.2, p < 0.001) and Factor VIII (24.8 ± 6.7 vs 98.7 ± 10.3, p < 0.001). Balance between proangiogenic and antiangiogenic factors seems to be shifted in favour of anti-angiogenic factors in pre-eclampsia.

PCNA and Ki-67 in endometrial hyperplasias and evaluation of the potential of malignancy.

OBJECTIVE: The aim of this study was to investigate malignancy potential in endometrial hyperplasias and association with PCNA and Ki-67. METHODS: Hysterectomy or probe curettage materials of 62 patients (20 simple hyperplasias (SH), six SH with atypical changes, five complex hyperplasias (CH), 11 CH with atypical changes, ten proliferative endometrium (PE) and ten secretory endometrium) were included in our study. Immunohistochemical staining for PCNA and Ki-67 protein was performed on formalinfixed and paraffin-embedded tissue samples. RESULTS: Immunoreactivity of PCNA was found to be significantly higher in atypical CH as compared to all other groups (p < 0.05). Also immunoreactivity of PCNA was significantly lower in SH as compared to atypical CH, and PE (p < 0.05). Average values showed that Ki-67 immunoreactivity is highest for atypical CH, and PE. Immunoreactivity of Ki-67 was found to be significantly higher in atypical CH as compared to other groups except PE (p < 0.05). CONCLUSION: PCNA immunoreactivity can be useful in patients with endometrial CH showing mild or moderate atypical changes in terms of prefering more conservative treatment modalities in those with low PCNA index. Also we suggest that Ki-67 could be insufficient to determine the potential of malignancy.

The diagnostic significance of hCG and hPL via immunohistochemistry of placental tissues in pregnancies diagnosed with IUGR and IUD.

Placentas of patients diagnosed with intrauterine growth restriction (IUGR) and intrauterine death (IUD) were examined by immunohistochemistry for alpha-beta subunits of human chorionic gonadotropin (hCG) and human placental lactogen (hPL) antibodies, and compared with placentas from women with healthy pregnancies. In total, 114 subjects were evaluated. The patient group comprised 27 cases of IUGR and 57 of IUD, and the control group consisted of 30 women with normal pregnancies. Placental specimens were examined for primary antibodies using immunohistochemical techniques. Placentas from 22 cases of IUGR were stained positively for alpha-hCG. All 27 specimens obtained from this group were stained positively for beta-hCG and hPL. Among the cases of IUD, 44 placentas were stained positively for alpha-hCG, and all 57 specimens were stained positively for beta-hCG and hPL.

The prognostic importance of proliferative activity and oestrogen receptor expression in stage I endometrial carcinomas.

The purpose of this study was to evaluate the prognostic significance of steroid hormone receptor proliferation index in endometrial adenocarcinoma. In this study, the correlation between oestrogen receptor expression, proliferation index and FIGO grade, age, myometrial invasion, tumour size and menopause status was evaluated in 40 patients with endometrial carcinoma. For this purpose, all tumours were stained immunohistochemically with oestrogen receptor and Ki-67 monoclonal antibodies. Oestrogen receptor expression and proliferation indices were found to be statistically associated with grade, age, menopausal status, vascular invasion and tumour size ( p < 0.001). Quantitative assessment of tumour proliferation and expression of oestrogen receptor were found to be important prognostic indicators in endometrial adenocarcinoma.

Prognostic importance of the nucleolar organizer region score in ovarian epithelial tumors.

OBJECTIVE: The score of the silver-stained nucleolar organizer region (AgNOR) is frequently found to be high in malignant tumors. We studied AgNOR in ovarian epithelial tumors diagnosed in our hospital between 1993 and 1998. MATERIALS AND METHOD: In our study 67 ovarian epithelial tumors (18 cystadenoma, 16 borderline type, 34 cystadenocarcinoma) were stained using the method previously described by Crocker. One-way ANOVA and logistic regression tests were used to find the statistical relationship between grade, recurrence, mortality rates and AgNOR scores in tumors (p values of <0.05 were considered statistically significant). RESULTS: The mean AgNOR scores of 28 mucinous and 39 serous ovary tumors were calculated. The lowest AgNOR score of 1.33 was found in cystadenomas and the highest AgNOR score of 4.92 was found in serous and mucinous cystadenocarcinomas. In addition the relationship between mortality rate, recurrence and AgNOR score in carcinomas were studied. CONCLUSION: AgNOR scores in carcinomas were found to be higher than adenomas, and the highest AgNOR score was found in grade-III carcinomas. This shows that the AgNOR score can be used as a prognostic index in malignancies.