Usefulness of human epididymis protein 4 in predicting optimal cytoreductive therapy in patients with advanced ovarian cancer.

PURPOSE: Human Epididymis Protein 4 (HE4) is a novel promising serum biomarker of high sensitivity and specificity for ovarian cancer (OC). We investigated the usefulness of HE4 in predicting the outcome of surgery of advanced OC. METHODS: Fifty patients with OC (FIGO stage III and IV) entered the study. Serum concentrations of HE4 and CA125 were evaluated preoperatively. All patients had been operated between January 2014 - January 2016. RESULTS: Preoperatively, the mean concentration of HE4 was 628pmol/L. Optimal cytoreduction was achieved in 44% of the patients, accompanied with decline of the mean values to HE4 478pmol/L, while in patients with suboptimal cytoreduction these values were 756pmol/L (p<0.001). Optimal cytoreduction was achieved in 52.9% of the patients with ascites ≤1,000 ml and in 48% of those with ascites >1,000 ml (p=0.023). These patients had preoperative values of HE4 405 and 713pmol/L, respectively (p=0.001). Optimal debulking was achieved in those patients with positive lymph nodes and ascites >1000ml, whose preoperative values of HE4 and CA125 were <413pmol/L and <500U/ mL, respectively. Our results indicated that the significant predictor of optimal cytoreduction was the value of HE4≤413pmol/L. In patients whose preoperative values HE4 were ≥413pmol/L the optimal cytoreduction was less probable (odds ratio 4.921, p=0.021). CONCLUSION: Preoperative concentrations of HE4 can be of predictive value for the achievement of optimal debulking of OC. Additional research in larger populations is necessary to prove the ability of preoperative values of HE4 in helping answer the question of whether or not optimal cytoreduction would be achieved.

Association of human papillomavirus infection with cytology, colposcopy, histopathology, and risk factors in the development of low and high-grade lesions of the cervix.

PURPOSE: Persistent human papilloma virus (HPV) infection is fundamental for the development of intraepithelial neoplasia and cervical cancer. The aim of this study was to examine the association between HPV infection and cervical cytology, colposcopy, biopsy and the risk factors entailed. METHODS: The study included 784 patients tested by in situ hybridization for HPV type 6/11, 16/18 and 31/33/35 infection. The participants were divided into three categories according to the presence of high squamous intraepithelial lesions (H-SIL), low squamous intraepithelial lesions (L-SIL) and benign histologic findings. RESULTS: Patients that had L-SIL and H-SIL demonstrated a significantly higher percentage of HPV infection than patients with benign histologic findings. The percentage of H-SIL was highest in patients infected with high risk (HR)-HPV types 16/18, who had sexual intercourse before the age of 16 years, with two to five sexual partners. CONCLUSION: Among high-grade intraepithelial neoplasia, there is a high prevalence of HR-HPV types 16/18, which is associated with the number of sexual partners and early sexual activity. There was a significant association between the presence of abnormal cytology and HR-HPV 16/18 in both groups (H-SIL and L-SIL). Benign colposcopic findings were not found in any patient with H-SIL, where no patient had only one sexual partner.