The accuracy of ultrasound-estimated fetal weight in extremely preterm infants: a comparison of small for gestational age and appropriate for gestational age.

OBJECTIVES: To compare the accuracy of estimated fetal weight (EFW) in extremely preterm small for gestational age (SGA) and appropriate for gestational age (AGA) infants and report other significant factors influencing the accuracy of EFW. METHODS: A retrospective cohort study of singleton pregnancies 22(+0) -27(+6)  weeks. Women were included in the study if an ultrasound scan had been performed within seven days of delivery, with no major fetal anomaly and data available to calculate customised birthweight (BW) centiles. Mean error of EFW and actual BW and mean % error of EFW and actual birthweight were compared for SGA and AGA infants. A stepwise backward elimination linear regression model was used to determine the significant factors influencing the accuracy of EFW. RESULTS: A total of 134 cases (51 SGA and 83 AGA) were analysed. The mean gestational age at delivery was 25(+2)  weeks (SD 11.5 days) and mean BW 711 g (SD 227 g). Overall mean percentage error of EFW and actual BW was 8.8% (range 0-34.6%). There was a significant difference in mean error of EFW and actual BW for SGA and AGA deliveries (mean +16 g versus -23 g, respectively, P = 0.01) and in mean % error of EFW (11.2%, 95%CI 9.1-13.3 versus 7.4%, 95% CI 6.2-8.6 P = 0.009). Factors that significantly influenced the accuracy of EFW included SGA (P = 0.001, coeff. = -3.73, 95% CI -5.94/-1.52), scan to delivery interval (P = 0.02, coeff. = 0.66, 95% CI 0.12/1.21) and reduced amniotic fluid (P = 0.008, coeff = 3.61, 95% CI -5.47/-0.85). CONCLUSIONS: Ultrasonographic EFW for extreme preterm SGA fetuses is less accurate than AGA fetuses and is more likely to overestimate EFW. This should be considered when counselling women with growth restricted fetuses at the limits of viability.

A retrospective study of preoperative CA 125 levels in 82 patients with ovarian cancer.

INTRODUCTION: The aim of our study was to investigate preoperative serum CA 125 as a prognostic factor in patients with ovarian carcinoma. METHODS: A retrospective analysis was conducted on 82 patients with ovarian carcinoma treated at our Unit between 1998 and 2000 who had a serum CA 125, evaluated by a commercially available radioimmunoassay, prior to cytoreductive surgery. We looked for an association between preoperative CA 125 and known prognostic factors of ovarian cancer. We compared outcomes of patients with preoperative CA 125 at or below to 500 U/ml with outcomes of patients with preoperative CA 125 above 500 U/ml. RESULTS: A significant ( p<0.002) correlation between stage and CA 125 serum levels was found as 16 out of 18 stage I-II patients (89%) had CA 125 level 500 U/ml. Among stage III and IV patients there was nonstatistically significant relation between serum CA 125 and histologic grade (G1+G2 vs. G3) and residual disease (<1 cm vs. >1 cm) after primary cytoreductive surgery. Preoperative serum CA-125 level did not predict either recurrences or disease free interval. CONCLUSION: Preoperative CA 125 correlated well with FIGO stage but not with age, grade, residual disease after primary surgery, relapse and disease free interval.

beta 1C Integrin expression in human endometrial proliferative diseases.

Integrins are ubiquitous cell adhesion molecules that are involved in maintaining normal tissue morphology and have been implicated in the aggressive behavior of several malignancies. beta 1C integrin is an alternatively spliced variant of the beta 1A integrin subunit that, at variance with beta 1A, inhibits epithelial cell proliferation. beta 1C integrin is expressed in non-proliferative, benign prostatic epithelium and is down-regulated in prostatic adenocarcinoma. In the current study, we examined beta 1C expression at mRNA and protein levels in 18 endometrial adenocarcinoma and in 20 endometrial hyperplastic tissues, using Northern and Western blotting analysis and immunohistochemistry. The pattern of integrin expression was compared to that of the endometrium of 14 normal cycling women. The results of this study document inhibited beta 1C integrin expression in endometrial adenocarcinoma, both at the mRNA and protein levels, at variance with significantly up-regulated beta 1C mRNA expression in endometrial hyperplasia, in comparison with normal proliferative endometria. Our data suggest a key role of the regulation of beta 1C integrin expression in the pathogenesis of endometrial proliferative diseases: beta 1C integrin may act as growth modulator in cancer cells, playing a role in downstream intracellular signaling.