Histopathological and biochemical assessment of a novel diagnostic method for ovarian torsion.

Ovarian torsion is agynecologic emergency that affects females of all ages. Early diagnosis is important to preserve ovarian function. The false positive rate for sonographic diagnosis of ovarian torsion is 50%; therefore, a new real-time approach is required to improve diagnostic accuracy. We investigated diffuse reflectance spectroscopy for diagnosing ovarian torsion. Spectroscopic measurements were performed in vivo prior to, during and after detorsion. After bilateral oophorectomy, hemoxygenase and myeloperoxidase enzyme activity in ovarian tissue was evaluated and the tissues were examined for pathology. Spectroscopic data were compared to histopathological and biochemical data to assess the diagnostic value of the spectroscopic method for differentiating healthy and damaged ovarian tissue. We found a good correlation between spectroscopy and histopathology. We also found a correlation between the spectroscopic data and heme oxygenase enzyme activity. We found no correlation between the histopathological tissue damage score and myeloperoxidase enzyme activity. Diffuse reflectance spectroscopy may be of prognostic and diagnostic value for ovarian torsion in vivo.

Laparoscopic surgery compared to traditional abdominal surgery in the management of early stage cervical cancer.

UNLABELLED: The purpose of the study was to compare laparoscopic total radical hysterectomy with classic radical hysterectomy regarding parametrial, and vaginal resection, and lymphadenectomy. METHODS: Laparoscopic or laparotomic total radical hysterectomy with advantages and disadvantages was offered to the patients diagnosed as having operable cervical cancer between 2007 and 2010. Lymph node status, resection of the parametria and vagina, and margin positivity were recorded for both groups. Data were collected prospectively. Statistical analysis was performed with the SPSS statistical software program. RESULTS: Totally, 53 cases had classical abdominal radical hysterectomy and 35 laparoscopic radical hysterectomy, respectively. Parametrial involvement was detected in four (11.4%) cases in laparoscopic radical surgery versus nine (16.9%) in laparatomic surgery. All the cases with parametrial involvement had free surgical margins of tumor. Also there were no significant statistical differences in lymph node number and metastasis between the two groups. CONCLUSION: There is no difference in anatomical considerations between laparoscopic and laparatomic radical surgery in the surgical management of cervical cancer.

Expression of c-erbB-2 and p53 in breast carcinoma patients: comparison with traditional prognostic factors and survival.

We aimed to determine the correlations between standard clinicopathological factors and expression of c-erbB-2 and p53 proteins, and to investigate the significance of these variables in relapse and disease-free survival (DFS) in breast carcinoma patients. Data from 200 patients who had undergone mastectomy for breast carcinoma were evaluated. Significant correlations were found between c-erbB-2 positivity and high histological grade (grade 3) tumour, p53 positivity and high grade tumour, and age < 60 years and oestrogen receptor negativity. Twenty-six patients (13%) developed a recurrence. Disease relapse was more frequent in patients who had axillary lymph node (ALN) metastasis, high grade tumour, c-erbB-2 positivity and p53 positivity; these variables were also associated with a shorter DFS. The effects of ALN metastasis and p53 positivity were significant. In conclusion, ALN metastasis and p53 positivity were important factors for predicting disease relapse in mastectomy-treated breast carcinoma patients; other clinicopathological criteria and c-erbB-2 positivity were not predictive.

Predictors of distant metastasis at presentation in breast cancer: a study also evaluating associations among common biological indicators.

BACKGROUND: To investigate the correlation among some of the commonly used clinical, pathological factors and newer biological indicators, and to identify the independent predictors of distant metastasis at presentation in patients with breast cancer. METHODS: The pathological specimens from 73 patients with breast cancer were retrospectively evaluated by immunohistochemistry. Data on 13 biological indicators; ER, PR, P53, c-erbB-2, PCNA, CEA, Ki-67, Vimentin, Ulex, Nm23, Cathepsin D, Factor VIII, PS2 together with clinical and pathological factors were collected. RESULTS: A number of highly significant correlations were found among the biological indicators studied. By logistic regression analysis, the predictors of distant metastasis at presentation in univariate tests were tumor diameter, number of lymph nodes involved, P53, c-erbB-2 and grade. In multivariate analysis, tumor diameter (P = 0.042, HR: 1.88(1.02-3.44)), c-erbB-2 expression (P=0.035, HR: 18.20 (1.23-268.66)) and grade (P=0.010, HR: 8.05(1.66-39.00)) retained their significance. CONCLUSION: Our findings show that inactivation of suppressor genes, expression of oncogenes, loss of differentiation, augmentation of proliferative activity, metastatic potential, angiogenesis and hormone receptor status are all interrelated facets of breast cancer pathogenesis. Patients with tumors overexpressing c-erbB-2 or with bigger or higher-grade tumors probably need to be more carefully evaluated for the presence of distant metastasis, thus be better staged, at presentation. This may be a new reason to test c-erbB-2 routinely in all patients with breast cancer in addition to its well-known prognostic and predictive uses.