The prognostic significance of cervico-vaginal cytology in endometrial cancer.

In patients with endometrial cancer, preoperative identification of certain poor prognostic factors is helpful in planning therapy. To determine the place of cervico-vaginal cytology in this respect, we have studied the relationship between cervico-vaginal cytology and the well-known prognostic factors of endometrial cancer such as grade, myometrial invasion, peritoneal cytology, stage and histological subtype. A hundred and sixty two patients, all of whom underwent surgical therapy in our clinic, were included in this study in order to correlate the cytological results with the pathological findings. Cervico-vaginal cytology was negative in 88 patients (54%), suspicious in 26 patients (16%) and malignant in 48 patients (30%). Twenty four per cent of cases with adenocarcinoma and adenoachantoma, and fifty two per cent of patients with adenosquamous carcinoma, papillary adenocarcinoma and clear cell carcinoma had positive cervicovaginal cytology (p < 0.001). Seventy four per cent of patients with negative cervico-vaginal cytology had grade I tumor, while 5% of patients with negative cytology had grade III tumor. On the other hand, only 9% of patients with positive cervico-vaginal cytology had grade I tumor, while 55% had grade III tumor (p < 0.001). 8% of patients with inner 1/2 myometrial invasion had positive cytology, whereas 51% of patients with 1/2 outer myometrial invasion had malignant cells in their smear (p < 0.001). As for the staging of the endometrial cancer according to FIGO, 19% of patients with Stage I disease had positive cervico-vaginal cytology while 60% of patients in Stage II and 66% of patients in Stage III-IV had positive cytology (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Electron microscopic study of the amniotic epithelium in polyhydramnios and oligohydramnios]. / Die elektronenmikroskopische Untersuchung des Amnionepithels bei Polyhydramnion und Oligohydramnion.

Totally 25 cases without any fetal anomaly, 10 with polyhydramnios, 10 with oligohydramnios and 5 with normal volume of amniotic fluid were taken into consideration. Their amnion covering the placenta and umbilical cord were examined under electron microscope. In the group with polyhydramnios the microvilli facing the amniotic cavity were denser in certain regions. The intercellular space was widened and the terminal bars were opened. Within the cells the number of vesicles were increased and there were large cysternas within these vesicles. It was postulated that the large cysternas found in the basal and apical parts of the cell were composed of macropinocytotic vesicles of the basal membrane. In the group with oligohydramnios the microvilli on the apical side were diminished. The intercellular space of the lateral side was narrowed. The electron density of the basal lamina was increased. The cellular structures were apparently reduced having just a few vesicles and lipid granules. Both in polyhydramnios and oligohydramnios the amniotic epithelium cells covering the placenta and umbilical cord are responsible for the transfer of the fluid into the amniotic cavity. Possibly they control the amount of fluid by reducing or increasing its passage.