Importance of basal fibroblast growth factor levels in patients with ovarian tumor.

OBJECTIVE: Evaluation of importance of serum levels of basic fibroblast growth factor (bFGF) in patients with ovarian cancer, patients with border-line ovarian tumor, patients with benign ovarian cyst and women with normal ovarian tissue. DESIGN: Prospective clinical study. SETTING: Department of Gynecology and Obstetrics, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove. METHODS: Measurement of serum levels of bFGF by ELISA using reagents of company R&D Systems prior to treatment in a total of 74 consecutive coming women. RESULTS: Serum level of bFGF from peripheral blood before treatment was significantly higher (p < 0.05) in patients with newly diagnosed ovarian cancer (n = 22), Med = 10.35 pg/ml (1.2-46.2 pg/ml) compared to patients with a border-line ovarian tumor (n = 9), Med = 5.4 pg/ml (1.6-6.8 pg/ml), patients with benign ovarian cyst (n = 24), Med = 5.2 pg/ml (0.1-67.2 pg/ml), and to women with normal ovarian tissue (n = 19) Med = 4.3 pg/ml (0.9-13.4 pg/ml). There isnt strong linear correlation (Spearmans rank correlation coefficient = 0.208791) between the serum level of bFGF and CA125 collected from peripheral blood before primary surgery or neoadjuvant chemotherapy in a group of patients with ovarian cancer (n = 14). We have not found significance correlation between age and serum levels of bFGF in patients with ovarian cancer, with border-line ovarian tumor, with benign ovarian cyst and in women with normal ovarian tissue. CONCLUSION: Serum levels of bFGF in patients with ovarian cancer are significantly higher than in patients with a border-line ovarian tumor, with benign ovarian cyst and in women with normal ovarian tissue regardless of age of patients.

[Expression of ATP-binding Cassette Proteins Pgp, MRP1, and MRP3 in Malignant and Benign Ovarian Lesions]. / Exprese ABC transportéru Pgp, MRP1 a MRP3 u maligních a benigních zmen vajecníku.

BACKGROUND: This study was designed to compare the expression of PgP (P-glycoprotein), MRP1 (multidrug related protein), and MRP3 in ovarian cancer patients, patients with benign ovarian tumors, and healthy women, and to evaluate the correlation between the expression of ATP-binding cassette proteins Pgp, MRP1, and MRP3 with stage, grade, and histological type. PATIENTS AND METHODS: Tissue specimens from 212 women who underwent surgery at the Department of Obstetrics and Gynecology at University Hospital Hradec Králové were subjected to immunohistochemical staining for Pgp, MRP1, and MRP3. RESULTS: The expression of Pgp and MRP1 was higher in ovarian tumor cells than in the cells lining the ovarian cyst. The lowest level of expression was found in normal ovarian tissue (p < 0.001). Histological subtype of epithelial ovarian cancer correlated with the expression of PgP, MRP1, and MRP3. The lowest level of Pgp and MRP1 expression was found in endometrioid ovarian cancers (p = 0.151; p = 0.013). Patients with advanced ovarian cancer (FIGO III + IV) had higher MRP1 expression than those with early stage ovarian cancer (median MRP1 FIGO I + II 80%; CI 60-100; FIGO III + IV 100%; CI 90-100; p = 0.100). An association was observed between MRP1 and tumor grade (p < 0.001). CONCLUSION: Pgp and MRP1 expression was higher in ovarian tumor cells than in cells lining the ovarian cyst. The lowest level of expression was found in normal ovarian tissue. ATP-binding cassette proteins play an important role in ovarian cancer pathogenesis.Key words: ATP-binding cassette proteins - ovarian cancer - P-glycoprotein (Pgp) - multidrug related protein 1 (MRP1) - multidrug related protein 3 (MRP3) - drug resistanceThis work was supported by the Czech Ministry of Health NT 14107-3/2013.The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 9. 11. 2015Accepted: 30. 8. 2016.

[Prognostic significance of Pgp, MRP1, and MRP3 in ovarian cancer patients]. / Prognostický význam Pgp, MRP1 a MRP3 u pacientek s karcinomem ovaria.

OBJECTIVE: To evaluate the correlation of resistance proteins Pgp (P-glycoprotein), MRP1 (Multidrug Related Protein, Multidrug Resistance-Associated Protein) and MRP3 with clinical - pathological factors and to find the clinical outcome of these data in ovarian cancer patients. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Charles University in Prague, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové. METHODS: 133 patients with epithelial ovarian cancer who underwent primary surgery from 2006-2010 had specimens stained with imunohistochemistry for Pgp, MRP1, MRP3. RESULTS: The histological subtype of epithelial ovarian cancer correlated with the expression of PgP, MRP1, and MRP3. The lowest incidence of Pgp and MRP1 expression was documented in endometrioid ovarian cancers (P = 0.151, P = 0.013). Patients with advanced ovarian cancer (FIGO III+IV) had higher MRP1 expression than those with early stage ovarian cancer (Med MRP1 FIGO I+II 80%; CI: 60-100; FIGO III+IV 100%; CI: 90-100; P = 0.100). An association was observed between MRP1 and tumor grade (Med MRP1 G1 80% (CI: 0-100), G2 80% (CI: 30-100), G3 100% (CI: 90-100); P < 0.001). There was no relationship between the size of the residual tumor after primary surgery and any resistance proteins. Patients with complete response after primary treatment had lower levels of LRP, Pgp, and MRP1 expression than other patients. Patients with higher Pgp and MRP1 expression had relapse of disease during the following 24 months more often than patients with lower Pgp and MRP1 expression. FIGO stage, histological type, debulking efficiency, and Pgp and MRP1 expression correlated with poor patient survival (P < 0.001, P < 0.001, P < 0.001, P = 0.040, P = 0.026). CONCLUSION: We found prognostic significance of Pgp, MRP1 and MRP3 expression in ovarian cancer patients. MRP1 have some additional prognostic value for the clinical outcome of patients with ovarian carcinoma.

Steroids pretreatment in assisted reproduction cycles.

The objective is to present an overview of trials and appreciate the relevant data on the effect of steroids pretreatment (oral contraceptives, 17ß-estradiol and estradiol valerate) in assisted reproduction cycles. The subject of the study is to evaluate the clinical characteristics during steroids pretreatment cycles focused on the prevention of ovarian cysts, the positive contraceptive effect on the onset of regular period during long gonadotropin releasing hormone agonist protocol. In gonadotropin releasing hormone antagonist protocol the review is interested in supporting ovarian stimulation in low responders, the idea of cycle scheduling and improving treatment outcomes. The method is a review from MEDLINE/Pubmed database between 1994 and July 2012. We identified 15 randomised controlled trials (n=3069 patients). One trail (n=83 patients) assessed GnRH agonist protocol with or without steroids pretreatment, 8 trials (n=1884 patients) assessed GnRH antagonist protocols with or without steroids pretreatment and 6 trials (n=1102 patients) assessed GnRH antagonist protocols versus agonist ones with steroid pretreatment. Data demonstrates that oral contraceptives offer the effective prevention of functional ovarian cysts, the predictable onset of period during desensitisation. Existing data suggest that pretreatment with oral contraceptive pills or estradiol valerate give no advantage concerning number of oocytes or pregnancy rate. Pretreatment with oral contraceptive pills aiming to avoid weekend oocytes retrievals has to be more elucidated. In low responders oral contraceptive pill pretreatment may be beneficial in improving ovarian responses by reducing the amount of gonadotropins and the number of days required for ovarian stimulation. Current research indicates that also 17ß-estradiol may be encouraging pretreatment in low responders and in cycle scheduling. This article is part of a Special Issue entitled 'Pregnancy and Steroids'.

[Hypersensitivity reactions to carboplatin and paclitaxel - our five-years experiences]. / Hypersenzitivní reakce po podání karboplatiny a paklitaxelu - nase petileté zkusenosti.

OBJECTIVE: To analyze hypersensitivity reactions to carboplatin and paclitaxel in patients treated with systemic administration of chemotherapy (carboplatin and/or paclitaxel). DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove. METHODS: One hundred-forty patients treated with systemic administration of chemotherapy were enrolled to our study between years 2008 and 2012. The presence and the grade [grade (G) 1-5; 1 = moderate, 5 = death] of hypersensitivity reactions (HSRs) were evaluated, as well as the influence of some clinical parameters on development of HSR. RESULTS: In total 29 HSRs in 21 patients were analyzed. To carboplatin were reported 19 (66%) HSRs: 13 (45%) HSRs of G1-G3 and 6 (21%) HSRs of G4. To paclitaxel were reported 10 (34%) HSRs: 9 (31%) HSRs of G1-G3 and 1 (3%) HSR of G4. The number of administered cycles of carboplatin to develop G1-G4 resp. G1-G3 HSR was higher in comparison with number of cycles to develop HSR of the same grade to paclitaxel(p = 0.001, resp. p = 0.01). CONCLUSION: HSR to carboplatin is unlike paclitaxel affected by the number of administered cycles. This fact should be included in the clinical management of patients treated with intravenous chemotherapy using carboplatin.

[Drug resistance proteins LRP, Pgp, MRP1, MRP3 and MRP5 in ovarian cancer patients]. / Proteiny rezistence LRP, Pgp,MRP1, MRP3 a MRP5 u pacientek s karcinomem ovaria.

OBJECTIVE: To evaluate the correlation of drug resistance proteins LRP (Lung Resistance Protein), Pgp (P-glycoprotein), MRP1 (Multidrug Related Protein, Multidrug Resistance-Associated Protein), MRP3 a MRP5 with clinical - pathological factors and to find the clinical outcome of these data in ovarian cancer patients. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove. METHODS: 111 patients with epithelial ovarian cancer who underwent primary surgery from 2006-2010 had specimens stained with imunohistochemistry for LRP, Pgp, MRP1, MRP3, MRP5. RESULTS: The histological subtype of epithelial ovarian cancer correlated to the LRP, Pgp, MRP1 and MRP3 expression. Patients with late ovarian cancer had a higher MRP1 compared to early stage ovarian cancer (I+II 71.6% (CI 60-100), III+IV 83.6% (CI 100-100),p = 0.03). Correlation of MRP1 with grading was found(G1 60.83% (CI 10-100), G2 36.80% (CI 20-100),G3 88.87% (CI 100-100), p = 0.039). Patients with high Pgp, MRP1 and MRP3 expression had significantly shorter progression-free survival. (Kaplan-Meier test - PFS, Pgp < 85% Med PFS 23 months (CI 8-37) vs > 85% Med PFS 11 months (CI 7-17), p = 0.054), (MRP1 < 85% Med PFS 33 months (CI 11-49) vs > 85% Med PFS 11 months(CI 7-16), p = 0.046). CONCLUSION: We found clinical significance of LRP, Pgp, MRP1 and MRP3 expression in ovarian cancer patients. MRP5 expression did not correlate with neither histo-pathological parameters nor progression free survival. MRP1 have some additional predictive and prognostic value for the clinical outcome of patients with ovarian carcinoma.

[Doctors specialty training in obstetrics and gynecology at university medical schools: 2012-2013]. / Specializacní vzdelávání v gynekologii a porodnictví na lékarských fakultách: 2012-2013.

OBJECTIVE: The paper addresses transfer of doctors specialty training from the national Institute of postgraduate medical education (IPVZ) to University Medical Schools (UMS) with the special focus to Obstetrics and Gynecology (OG). METHODS: The National Specialty Board (NSB) has been established. NSB tasks include definition of inclusion criteria and process of specialty choice at UMS. In OG specialty there are defined mid-term and final postgraduate training courses and other requirements for final specialty exam (FSE) - in particular trainees scientific work and surgery done with the supervision of NTB member. The system of FSE, its content, application, reimbursement and mechanisms are described in details. RESULTS: In the whole country in 2012 there have been done 864 FSE in all basic medical specialties, which took place at seven UMS. Autumn semester terms has been utilized significantly more than spring terms (57% vs. 43%). There have been differences in the numbers of specialties and also numbers of candidates in each specialty among different UMS. In total 94% of applicants succeed in the FSE. In 2012 within OG specialty training there has been held 56 FSE - 24 exams on five UMS in spring term and 32 (57%) exams only on two UMS in autumn term. In the spring 2013 FSE were organized on 1st LF UK in Prague with 23 applicants, from which 22 successfully passed. During autumn 2013 the FSE in OG will be held on LF UP in Olomouc with 44 applicants for final postgraduate training course and 39 candidates for FSE. CONCLUSION: Within OG specialty the transfer of doctors specialty training from IPVZ to UMS has been successfully managed. The NSB in OG specialty closely cooperates with past IPVZ and the Accreditation Commission of the Czech Ministry of Health. Thus continuity, quality and continuous enhancement of specialty training program in OG in Czech Republic is assured.

[Vascular endothelial growth factor in ovarian cancer patients]. / Cévní endotelový rustový faktor u pacientek s karcinomem ovaria.

OBJECTIVE: To compare plasma VEGF (vascular endothelial growth factor) levels in ovarian cancer patients, in patients with benign ovarian tumors and healthy women. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. Department of Immunology and Alergology, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. METHODS: VEGF was estimated by ELISA (R&D Systems). RESULTS: We found that plasma VEGF levels were associated with the International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO I+II, n=8) Med = 425,53 pg/ml (range 142,30-982,40 pg/ml), (FIGO III+IV, n=29) Med = 941,48 pg/ml (range202,10-2857,80 pg/ml) (p=0,03). Patients with primary ovarian cancer (n=37) had a significantly higher plasma VEGF level Med = 829,93 pg/ml (range142,30-2857,80 pg/ml), compared with patients with benign ovarian tumors (n=15) Med = 426,28 pg/ml (range 32,00-922,20 pg/ml) and healthy women (n=21) Med = 283,13 pg/ml (range 80,50-735,20 pg/ml) (p=0,0003). VEGF levels were lower in plasma (n=79) Med = 575,49 pg/ml (range 55,80-2185,00 pg/ml) compared with VEGF levels in ascitic fluid (n=37) Med = 745,74 pg/ml (range 142,30-2185,00 pg/ml) (p=0,04) in ovarian cancer patients. CONCLUSION: Plasma VEGF assay before primary treatment and the changes during the other treatment should contribute to better understanding of angiogenesis in ovarian cancer patients. Plasma VEGF correlates with the stage of primary ovarian cancer.

[Proteins of resistance and drug resistance in ovarian carcinoma patients]. / Proteiny rezistence a chemorezistence u pacientek s karcinomem ovaria.

BACKGROUND: To evaluate the correlation of resistance proteins LRP (Lung Resistance Protein), Pgp (P-glycoprotein), MRP (Multidrug Resistance-Associated Protein), MRP3 a MRP5 with stage, grade and histological type. To asses correlation of these resistance proteins with drug resistance/drug sensitivity in vitro by means of the MTT assay in ovarian cancer patients. To find the clinical outcome of these data. PATIENTS AND METHODS: 64 women with epithelial ovarian cancer who underwent primary surgery in 2006-2010 had specimens stained with immunohistochemistry for LRP, MRP, MRP3, MRP5 and Pgp and MTT assay (MTT-(3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide). RESULTS: Patients with late ovarian cancer had a higher Pgp, MRP, MRP3 and MRP5 level compared to ovarian cancer patients with early stage ovarian cancer. No correlation of resistance proteins with grading was found. Patients with high Pgp and MRP expression had significantly shorter progression-free survival. Patients with drug resistance in vitro by means of the MTT assay had higher Pgp and MRP expression. CONCLUSION: P-glycoprotein and MRP may be useful predictor for outcome of primary chemotherapy in patients with ovarian cancer.

[Primary drug resistance/sensitivity in vitro and clininical outcome in ovarian cancer patients]. / Primární rezistence/senzitivita in vitro a klinický prubeh onemocnení u pacientek s karcinomem ovaria.

OBJECTIVE: To assay correlation between primary resistance/sensitivity in vitro by MTT test in solid tumor and ascitic fluid and clininical outcome in ovarian cancer patients. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. METHODS: MTT - (3-(4,5 - Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) chemosensitivity assay was performed in 45 samples of ovarian cancer tissue and 26 samples of ascitic fluid in ovarian cancer patients. We studied the in vitro drug resistance profiles of ovarian cancer specimens exposed to cisplatin, carboplatin, paclitaxel, topotecan, gemcitabin, etoposid. RESULTS: The highest incidence of primary drug resistance in vitro had gemcitabin and carboplatin and the lowest incidence of primary drug resistance had cisplatin and topotecan. Cisplatin had lower incidence of primary drug resistance in vitro than carboplatin. Grade and stage of epithelial ovarian cancer did not correlate to the primary drug resistance/sensitivity in vitro in ovarian cancer patients. The histological subtype of epithelial ovarian cancer correlated to the resistance and sensitivity to chemotherapeutic agents in vitro. Ovarian cancer patients with primary drug resistance to paclitaxel and carboplatin in vitro had more complications during primary chemotherapy, shorter progression free interval and worse prognosis of the disease. CONCLUSION: The lowest incidence of primary drug resistance in vitro had cisplatin. Ovarian cancer patients with in vitro resistance to paclitaxel and carboplatin had significantly higher risk for progression of disease when treated with standard platinum-paclitaxel based regimens. The primary resistance/sensitivity assay would contribute to the targeted treatment and better prognosis of ovarian cancer patients.

[Proteomics and biomarkers for detection of preterm labor: a systematic review]. / Proteomika a biomarkery predcasného porodu: systematický prehled literatury.

OBJECTIVE: To review the published articles about identification of biomarkers of spontaneous preterm birth using a proteomic approach and to create a list of potential biomarkers. DESIGN: Systematic review of literature. SETTING: Department of Obstetrics and Gynecology, Medical Faculty Charles University Hradec Kralove. METHODS: The following databases were accessed in search of relevant citation: MEDLINE, SCOPUS and PubMed. Totally 101 references were identified and relevant 37 abstracts were screened. As appropriated were pointed 16 studies. Finally, the data were extracted from five articles. CONCLUSION: The implementation of high-throughput technologies is necessary in the field of spontaneous preterm birth research. A compelling option is the use of proteomics in the area spontaneous preterm birth biomarkers identification in amniotic fluid, maternal serum/plasma, cervical-vaginal fluid and placental tissue. The data was extracted from published articles and a list of 72 proteins was created.

[Resistance/sensitivity in vitro in ovarian cancer patients]. / Rezistence/senzitivita in vitro u pacientek s karcinomem ovaria.

OBJECTIVE: To assay resistance/sensitivity by MTT test in solid tumor or ascitic fluid in ovarian cancer patients. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. METHODS: MTT - (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) chemosensitivity assay was performed in 32 samples of ovarian cancer tissue and 26 samples of ascitic fluid in ovarian cancer patients. We studied the in vitro drug resistance profiles of ovarian cancer specimens exposed to cisplatin, carboplatin, paclitaxel, topotecan, gemcitabin, etoposid. RESULTS: The highest frequency of resistance in vitro occured for etoposid, gemcitabin and paclitaxel and the most effective chemotherapeutical agents in vitro were cisplatinum and topotecan. Cisplatin had the lowest incidence of drug resistance in vitro than carboplatin. CONCLUSION: Resistance/sensitivity assay would improve the treatment and prognosis of ovarian cancer patients.

Chemoresistance testing of human ovarian cancer cells and its in vitro model.

Ovarian carcinoma represents the most common cause of death from gynecological malignancies in Europe and North America, being the third most frequent and the first as to the mortality. The standard chemotherapeutical regimen for ovarian cancer involves the administration of platinum derivate (carboplatin, cisplatin), in advanced stage is platinum derivate combined with paclitaxel. Introducing chemoresistance testing of ovarian tumour cells may help to choose optimal chemotherapeutic drug and customize the individual chemotherapeutical regimens in patients. One of approaches of individualization of chemotherapy is in vitro chemosensitivity testing. In our study, we evaluated the cytotoxic effects of selected chemotherapeutics in cells isolated from ovarian tumours and ascites of individual patients. Panel of chemotherapeutics used in the study included cisplatin, paclitaxel, carboplatin, topotecan, gemcitabine and etoposide and their effects on cell viability were determined by the MTT assay. In the total number of 32 clinical samples of tumour and ascites cells, the highest sensitivity showed cells to topotecan, sensitivity to cisplatin was higher than to carboplatin and paclitaxel used in clinical practice showed most often only the marginal reactivity. Resistance to carboplatin and most of the time to gemcitabine and etoposide was commonly present. When the same test on cells that have been frozen for several weeks was repeated it was found that in 20 cases chemosensitivity increased while in 18 cases decreased. In remaining cases there was no change in reactivity to cytostatics. Moreover, chemosensitivity of cells isolated from solid tumour and ascites from the same patient did not show any significant difference with exaption of paclitaxel.

[Proteomics and biomarkers for detection of ovarian cancer]. / Proteomika a biomarkery karcinomu ovaria.

OBJECTIVE: The purpose of this study was to focuse on recent developments on the evolving field of biomarker discovery and validation techniques using proteomics platforms for ovarian cancer. DESIGN: Review. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. Institute of Molecular Pathology. Faculty of Military Health Sciences, University of Defense, Hradec Kralove. METHODS: The last decade has seen major changes in the technologies used to identify markers for diagnosing early stages of ovarian cancer. Currently the major developments were made in three distinct areas: protein profilig, highthroughput validation techniques and solid and liquid phase protein microarray platforms for analyzing candidate markers across stages hold significant of ovarian cancer. These new technologies hold significant promise in identifying more robust markers for ovarian cancer. CONCLUSION: The present review summarizes the results of clinical and experimental research on biomarkers of ovarian cancer.

[Long GnRH agonist vs. GnRH antagonist protocol in randomized controlled trial in unselected patients--hormonal and cycle characteristics--pilot study]. / Randomizované srovnání dlouhého GnRH agonistického cs 0ynek7 vs. GnRH antagonistického protokolu--hormonální parametry a charakteristiky cyklui--pilotní studie.

OBJECTIVE: To evaluate hormonal and cycle characteristics (estradiol and LH level on day 5 and on the day of hCG administration) comparing long GnRH agonist vs. GnRH antagonist protocol for unselected patients. SUBJECT: Randomized prospective pilot study. SETTING: Sanatorium Pronatal, Praha. SUBJECT AND METHOD: From January 2006 to June 2006 we randomized 40 unselected patients into GnRH agonist (triptorelin 0.1 mg) and GnRH antagonist (cetrorelix 0.25 mg) group. We recommended starting dose from 150 to 225 IU of rFSH or hMG based on the response to clomifencitrate treatment. We examined follicular growth on day 5 and on day 8 by transvaginal ultrasound and estradiol (E2) level on day 5 and on the day of hCG administration. RESULTS: We randomized 21 patients in GnRH agonist and 19 patients in GnRH antagonist group. We proved E2 on day 5 (pg/ml) 269 +/- 243 vs. 385 +/- 293, LH on day 5 (IU/l) 1.7 +/- 1.2 vs. 2.8 +/- 1.4, E2 on the day of hCG administration (pg/ml) 1548 +/- 1167 vs. 1397 +/- 1076 (p < 0.05) and LH on the day of hCG administration (IU/l) 2.2 +/- 1.9 vs. 1.4 +/- 1.1 (ns), endometrial thickness (mm) 10.6 +/- 1.8 vs. 9.2 +/- 0.9 (ns), total dose of FSH (IU) 1865 +/- 517 vs. 1513 +/- 357 (p < 0.001), duration of FSH stimulation (days) 9.3 +/- 1.6 vs. 7.8 +/- 1.2 (p < 0.001) in GnRH agonist vs. GnRH antagonist group, resp. CONCLUSIONS: There are significant differences in hormonal characteristics and cycle characteristics comparing both protocols (longer duration of treatment and higher consumption of gonadotropins, higher E2 levels on the day of hCG administration in GnRH agonist compared to GnRH antagonist group).

[Amniotic fluid heat shock protein 70 concentration in preterm premature rupture of membranes]. / Heat shock protein 70 v plodové vode u pacientek s predcasným odtokem plodové vody.

OBJECTIVE: The purpose of this study was to determinate the changes of amniotic fluid HSP 70 concentrations in patiens with preterm premature rupture of the membranes, and in the presence of intraamniotic infection and histological changes of inflammations. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Králové. METHODS: We studied 30 women between 24 and 36 weeks of gestation with preterm premature rupture of the membranes. Samples of amniotic fluid were collected by transabdominal amniocentesis. These patients were divided into 2 groups. In group 1 were patiens with intraamniotic infection. In group 2 were patiens without intraamniotic infection. Among 76% (35/30) patients placenta were collected and assessed for presence or absence acute inflammatory lesions. HSP70 concentration in amniotic fluid were determined using a sensitive and specific diagnostic kit Hsp 70- ELISA kit manufactered Assay Desings, USA. RESULTS: There was no significant difference in the median amniotic fluid HSP70 concentration between patients with preterm rupture of the membranes with IAI and without IAI (patients with IAI: median 5.12 ng/ml, range 3.01-90.37 ng/ml vs. patients without IAI: median 4.68 ng/ml, range 0.58-84.28 ng/ml; p = 0.56). There was no significant difference in the median amniotic fluid HSP70 concentration between patients with preterm rupture of the membranes with presence and absence histological of acute inflammatory lesions in the placenta and membranes (patients with presence: median 6.97 ng/ml, range 2.61-90.37 ng/ml vs. patients with absence: median 4.63 ng/ml, range 0.58-84.28 ng/ml; p = 0.68). CONCLUSION: Intraamniotic levels HSP70 were not associated with intraamniotic infection and acute inflammatory lessions in the placenta and membranes.

[Proteomics and biomarkers for detection of endometrial carcinoma]. / Proteomika a biomarkery karcinomu endometria.

OBJECTIVE: The purpose of this study was to focuse on recent developments on the evolving field of biomarker discovery and validation techniques using proteomics platforms for endometrial carcinoma. DESIGN: Review. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. METHODS: The last decade has seen major changes in the technologies used to identify markers for diagnosing endometrial carcinoma. Currently the major developments were made in proteomics area. This new technology hold significant promise in identifying more robust markers for endometrial carcinoma. CONCLUSION: The present review summarizes the results of clinical and experimental research on biomarkers of endometrial carcinoma.

[Proteomics and biomarkers for detection of cervical cancer]. / Proteomika a biomarkery karcinomu delozního hrdla.

OBJECTIVE: The purpose of this study was to focus on recent developments in the rapidly evolving field of biomarker discovery and validation techniques using proteomics platform with respect to cervical cancer. DESIGN: Review. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. METHODS: The last decade has seen major changes in the technologies used to identify diagnostic markers for early stages of cervical cancer. Significant advances were achieved in three key areas: protein profilling, multidimensional liquid chromatography combined with cutting edge mass spectrometry and high-throughput validation techniques. These new technologies hold significant promise in identifying more robust, sensitive and specific markers for cervical cancer. CONCLUSION: The present review summarizes the results of clinical and experimental research on biomarkers of cervical cancer.

[Amniotic fluid interleukin 6 levels in preterm premature rupture of membranes]. / Interleukin 6 v plodové vode pacientek s predcasným odtokem plodové vody.

OBJECTIVE: The purpose of this study was to determinate the changes of amniotic fluid interleukin 6 (IL-6) concentrations in patients with preterm premature rupture of the membranes (PPROM), and in the presence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA). The aim was to examine amniotic fluid IL-6 in relation to MIAC and HCA. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Králové. METHODS: We studied 37 women between 24 and 36 weeks of gestation with PPROM. Samples of amniotic fluid were collected by transabdominal amniocentesis. Polymerase chain reaction for the genital mycoplasmas and culture for aerobic and anaerobic bacteria were performed. Twenty-eight of 37 patients placentas were collected and assessed for presence or absence HCA. IL-6 concentration in amniotic fluid were determined using a sensitive and specific diagnostic kit Human IL-6 Quantikine ELISA manufactured R&D Systems, USA. RESULTS: There was significant difference in the median amniotic fluid IL-6 concentration between patients with preterm rupture of the membranes with and without MIAC and HCA (patients with MIAC and HCA: median 915 pg/ml, range 651-1854 pg/ml vs. patients without MIAC and HCA: median 780 pg/ml, range 184-1059 pg/ml; p=0.047). There was no significant difference in the median amniotic fluid IL-6 concentration between patients with preterm rupture of the membranes with and without MIAC (patients with MIAC: median 915 pg/ml, range 195-1854 pg/ml vs. patients without MIAC: median 792 pg/ml, range 184-1993 pg/ml; p=0.53). There was no significant difference in the median amniotic fluid IL-6 concentration between patients with preterm rupture of the membranes with and without HCA (patients with HCA: median 829 pg/ml, range 195-1992 pg/ml vs. patients without HCA: median 768 pg/ml, range 184-1890 pg/ml; p = 0.31). CONCLUSION: Amniotic fluid IL-6 concentrations patients with PPROM with presence HCA and MIAC were significantly higher than IL-6 concentration patients without HCA and MIAC.

Lysophosphatidic acid: an ovarian cancer marker.

OBJECTIVE: To determine whether lysophosphatidic acid (LPA) can serve as an ovarian cancer marker, we compared plasma LPA levels in ovarian cancer patients, in women with no ovarian pathology, and in women with benign ovarian tumors. We determined the optimal plasma LPA level cutoff value and correlated clinicopathological parameters with plasma LPA levels. METHOD: Capillary electrophoresis with indirect ultraviolet detection was used to analyze the plasma LPA levels of 133 patients (60 patients with ovarian cancer, 43 women without ovarian pathologies and 30 patients with benign ovarian tumors) during a three-year period. RESULTS: Patients with ovarian cancer had a significantly higher plasma LPA level (n=60, median (med) 16.99 micromnol/l, range 4.53-43.21 micromol/l) compared with controls with no ovarian pathology (n=43, med 2.92 micromol/l, range 0.94-22.93 micromnol/l) and patients with benign ovarian tumor (n=30, med 7.73 micromol/l, range 1.12-28.84 micromol/l) (p < 0.001). We found that plasma LPA levels were associated with the International Federation of Gynecology and Obstetrics (FIGO) stage and ovarian cancer histological type. Patients with endometrial ovarian cancer had significantly higher plasma LPA levels in comparison with other histological types of epithelial ovarian carcinoma. CONCLUSION: The plasma LPA level can be a useful marker for ovarian cancer, particularly in the early stages of disease.