Natural killer (NK) cell activity of women with gross cystic disease is inhibited in vitro by breast cyst fluid.

Gross cystic disease (GCD) represents an advanced form of fibrocystic disease of the breast. Bearers of macrocysts have been reported to be at risk of developing breast cancer. Natural killer (NK) cells are a lymphocyte subset deeply involved in immunosurveillance against neoplasia. We investigated whether breast cyst fluid (BCF) aspirated from patients with GCD could affect in vitro the spontaneous and lymphokine-inducible NK activity of peripheral blood mononuclear (PBM) cells concomitantly drawn from the same patients. PBM cells exposed to BCF were evaluated by a standard cytotoxic assay, using K562 cells as a target, in the presence or absence of lymphokines. In vitro incubation of PBM cells with BCF resulted in a consistent decrease of NK cell activity (mean level of suppression about 50%; p < 0.001). Furthermore, exposure of PBM cells to BCF completely prevented the IFN-gamma-dependent enhancement and consistently reduced the IL-2-induced NK activity (p < 0.01). The phenomenon was more apparent for type II cyst BCF. Our data are compatible with an immunosuppressive effect of BCF, potentially leading to altered "local immunosurveillance".

[Statistical study of the risk of cardiovascular disease in hysterectomized patients]. / Indagine statistica sul rischio di malattie cardiovascolari in pazienti isterectomizzate.

The risk of atherosclerotic or hypertensive cardiovascular disease increases after physiological or surgical menopause, irrespective of whether or not the ovaries are removed. In order to evaluate the direct contribution of the uterus in cutting down the incidence of cardiovascular diseases, the clinical records of 1551 cardiovascular patients and 296 healthy women were examined. All subjects were divided into 8 different groups according to their age. The following data were considered: 1) the incidence of cardiovascular diseases; 2) the number of subjects in physiological or surgical menopause; 3) the number of women hysterectomised in premenopause; 4) the number of women who underwent hysterectomy and bilateral salpingo-oophorectomy in premenopause; 5) the number of women who underwent either operation before or after the menopause. It was found that both in hysterectomised and not hysterectomised women the hypertensive and ischaemic cardiovascular pathologies prevailed in the younger and older groups respectively. Among the patients with cardiovascular diseases the percentage of subjects who had undergone hysterectomy or hysterectomy with bilateral oophorectomy was significantly higher (p less than 0.05) than in the controls. The difference was particularly marked in the younger groups. These data indicate that when the uterus is properly stimulated by the oestrogens, is able to produce a protective factor against cardiovascular diseases. It has been suggested that this factor may be prostacyclin, a potent vasodilator and the most potent inhibitor of platelet aggregation yet discovered. The epidemiological evidence alone that premenopausal hysterectomy increases the risk of cardiovascular disease should be an important consideration in weighing the risks and benefits of the procedure. If the epidemiological data can be supported by a definite mechanism of action via prostacyclin, then current indications for hysterectomy must be carefully reconsidered.