RESUMO
PURPOSE: To determine a valid and practical routine for glomerular filtration rate measurement in gynaecologic cancer patients. MATERIAL AND METHODS: The established method, endogenous creatinine clearance, was compared to 51Cr-EDTA clearance and contrast medium clearance in 68 women with various gynaecologic carcinomas. Contrast medium clearance was determined in association with conventional urography (iohexal 300 mg I/ml, 40 ml) for evaluation of urinary tract involvement by the tumour. Automated X-ray fluorescence analysis equipment was used for the plasma analysis of iohexol and clearance calculations. Endogenous creatinine clearance and 51Cr-EDTA clearance were determined according to standard routine procedures. Simultaneous determinations of contrast medium clearance and 51Cr-EDTA clearance (n = 33), contrast medium clearance and endogenous creatinine clearance (n = 50), as well as 51Cr-EDTA clearance and endogenous creatinine clearance (n = 30) were compared. RESULTS AND CONCLUSION: The mean differences were -2.8 (SD 6.6), -1.8 (SD 22.3), and 2.7 (SD 18.3) ml/min/1.73 m2, respectively. It is concluded that contrast medium clearance is as adequate as 51Cr-EDTA clearance for glomerular filtration rate measurement. We suggest that contrast medium clearance should replace endogenous creatinine clearance, especially in patients referred for urography.
Assuntos
Meios de Contraste , Neoplasias dos Genitais Femininos/fisiopatologia , Taxa de Filtração Glomerular , Iohexol , Adulto , Idoso , Idoso de 80 Anos ou mais , Creatinina/metabolismo , Ácido Edético , Feminino , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Espectrometria por Raios X , UrografiaRESUMO
Radioimmunoscintigraphy (RIS) was performed in 20 patients with gynecologic tumors, 14 ovarian, 5 cervical, and one endometrial carcinoma. One murine monoclonal antibody (mab) against placental alkaline phosphatase (H7) was used after radiolabeling with 131I. The labeling procedure yielded antibodies with specific activity varying between 60 and 73 MBq/mg mab. Each patient received 57 to 100 MBq of the preparation. RIS was performed 7 to 35 days later. Patients with ovarian adenocarcinoma had an accumulation of activity on RIS at tumor sites (79%, 11/14) verified by ultrasonography, CT, and clinical examination. A low or absent accumulation of activity was seen in patients with cervical tumors. The patient with an endometrial adenocarcinoma was seen to have an activity accumulation at RIS corresponding to tumor sites determined by ultrasound and/or CT. It is concluded that RIS using monoclonal antibodies against placental alkaline phosphatase can provide information which will supplement that gained from other investigations of patients with ovarian adenocarcinomas.
Assuntos
Fosfatase Alcalina/imunologia , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Radioisótopos do Iodo , Placenta/enzimologia , Radioimunodetecção , Adulto , Idoso , Neoplasias do Endométrio/diagnóstico por imagem , Feminino , Neoplasias dos Genitais Femininos/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , RadiografiaRESUMO
22 cases of vulvovaginal melanoma seen in Umea between 1963 and 1989 were retrospectively reviewed. According to FIGO, 11 were in Stage I, 6 in Stage II, 3 in Stage IV and 2 in Stage VI. Most patients received only conservative surgery and/or radiotherapy. 8 patients (36%) were alive at 5 years and 4 survived more than 10 years. The longest survivor at 17 years is still alive without evidence of disease. Conservative surgery seems to give as good results as radical operation for vulvovaginal melanomas and FIGO clinical staging appears to be of limited prognostic value.
