Guided Imagery and Music in the Treatment for Breast and Gynecologic Cancer: An RCT Pilot.

The primary aim of this randomized controlled trial pilot was to investigate the potential effectiveness of the music psychotherapy method, Guided Imagery and Music (GIM), to assist female patients who are undergoing chemotherapy treatment for breast or gynecologic cancer. A secondary aim was to suggest performance improvements regarding the protocol and the resources required to undertake a future larger scale study. The researchers randomized participants (n = 20) into two groups: Intervention group (n = 10) and Control group (n = 10). The Intervention group received a series of six individual, short GIM sessions whereas the Control group received two verbal counseling sessions that took place at Week 1 and at Week 6 of treatment. All participants in the study completed the Profile of Mood States (POMS-Brief); Cancer Fatigue Scale (CFS); and Herth Hope Index (HHI) before the beginning of Week 1 and again after Week 6 or, in the case of the Intervention group, after the last GIM session. All participants also completed two Visual Analogue Scales (VAS-Hope; VAS-Fatigue) weekly or after each session throughout the duration of the trial. The results of the Intervention group receiving GIM showed medium pre-post effect sizes for the CFS, HHI, and POMS questionnaires, and significant positive changes for the VAS-H and VAS-F questionnaires. As seen from this initial data outcome, a brief series of GIM sessions shows promise to be beneficial for increasing hope, decreasing fatigue, and mitigating distressed mood for female patients undergoing treatment for breast or gynecologic cancer.

Mucinous epithelial lesions in endometrial curettage material: a diagnostic challenge.

AIM: To evaluate the immunohistochemical expression of several benign or malignant mucinous lesions that can be encountered in endometrial curettage material. MATERIALS AND METHODS: Nineteen well-differentiated mucinous endometrial carcinomas, 12 papillary mucinous metaplasias, 11 cervical microglandular hyperplasias, 11 endocervical adenocarcinomas, 2 goblet cell metaplasias, 1 minimal-deviation adenocarcinoma, and 1 lobular endocervical glandular hyperplasia entered the study. Immunohistochemistry was performed with the following antibodies against: estrogen receptors, progesterone receptors, vimentin, p16, p63, carcinoembryonic antigen, and Ki-67. RESULTS: Immunohistochemistry could easily distinguish endocervical adenocarcinoma of usual type from all other lesions under study. A Vim(-)/p16(-)/p63(high) signature was found to favor a cervical microglandular hyperplasia, whereas both mucinous endometrial carcinoma and mucinous papillary metaplasia would be preferentially characterized by a Vim(+)/p16(+)/p63(low) immunophenotype. A high Ki-67 expression would be of help in differentiating the latter 2 conditions. Statistically, the expression of estrogen receptors, progesterone receptors, and carcinoembryonic antigen did not aid in the differential diagnosis of these 3 conditions. For the 4 cases representing goblet cell metaplasia, minimal-deviation adenocarcinoma and lobular endocervical glandular hyperplasia, no results could be drawn. CONCLUSIONS: In endometrial curettage material, the differential diagnosis of lesions comprising mucinous epithelium might be rendered by combining the immunohistochemical expression of vimentin, p16, p63, and Ki-67. Of all lesions, endocervical adenocarcinoma of usual type is the most easily identified.

A pre-tailored panel of antibodies in the study of cervical mesonephric remnants.

AIMS: To investigate the immunohistochemical profile of cervical mesonephric remnants. METHODS AND RESULTS: Cases of mesonephric remnants, microglandular hyperplasia, tunnel clusters, tuboendometrioid metaplasia and cervical adenocarcinomas were immunohistochemically stained with Ki-67, CD10, bcl2 and p16. All 26 cases of mesonephric remnants were strongly positive for bcl2 and weakly to moderately positive for p16. CD10 was positive in 19 cases. Seven cases were negative and 19 weakly positive for Ki-67. All 10 cases of tuboendometrioid metaplasia showed high positivity for bcl2. Two cases were negative for p16; seven cases presented low and one case moderate positivity. Five cases were negative for CD10, while in five the staining was low. Six cases of tuboendometrioid metaplasia were negative for Ki-67, while four showed low staining. Tunnel clusters were negative for all antibodies, except one, which showed focal positivity for Ki-67 and p16. All cases of microglandular hyperplasia were negative for bcl2, p16 and CD10 and only 5/12 showed focal positivity for Ki-67. All adenocarcinomas were negative for bcl2 and CD10, and highly positive for p16 and Ki-67. CONCLUSIONS: bcl2 is more constantly and strongly expressed in mesonephric remnants than CD10. p16 is weakly to moderately positive, while Ki-67 is negative to weakly positive.

Human papillomavirus infection in malignant and benign gynaecological conditions: a study in Greek women.

HPV infection is by far the most frequent sexually transmitted disease. Our aim in this prospective nonrandomized study was to investigate the frequency with which different subtypes of the human papillomavirus (HPV) are found in gynaecological malignant and benign conditions and to compare the rate of infection between them. Detailed data of 195 women were selected and divided into three groups. The first group consisted of specimens from 68 women with cervical cancer. The second group consisted of specimens from 43 women with endometrial and ovarian cancer. The third group consisted of 84 specimens from women who were operated on for benign gynaecological diseases. Seven oncogenic types of HPV (6, 11 [low-risk subtypes] 16, 18, 31, 33, and 51 [high-risk subtypes]) were investigated by using the in situ hybridization technique. The HPV detection rate was higher in the cervical cancer group (74.8%), compared with the second (27.9%) and third (45.2%) groups. The most common HPV subtypes in the first group were 16 and 18. The most common subtypes in the second group were the 31, 33, and 51, and in the third group the 6 and 11 subtypes. Women developed cervical cancer at a younger age than endometrial or ovarian cancer. Smoking and exposure to multiple sexual partners appeared related to the development of cervical cancer. The use of contraceptive pill, dietary habits, and diabetes did not seem to increase the risk of HPV infection in this population. As it is common in other populations, in this selected population of Greek women we were able to confirm that in women with cervical cancer the most common HPV subtypes are 16 and 18. Education of adolescents on the epidemiological association of smoking and unprotected intercourse with cervical cancer will certainly help to reduce the rates of development of preinvasive and invasive cancer of the cervix in young women.