[Cervical intraepithelial neoplasia combined in pregnancy: diagnosis, management, outcomes].

Cervical cancer is the leading gynecological tumor associated with pregnancy accounting for 1.2-4.5 cases per 10,000 births. Precancerous diseases of the cervix, which include cervical intraepithelial neoplasia of high severity (H-SIL) combined with pregnancy, are even more relevant since the frequency of their occurrence can achieve 5.0%. Besides the peak of dysplastic cervical changes occurs in the mean age at delivery in the Russian Federation (28 years). The features of diagnosis and management of these patients during pregnancy, delivery and postpartum require a multidisciplinary approach from doctors of different specialties.

[Fallopian tube carcinoma: clinical and morphological features, analysis of 69 cases].

Primary fallopian tube carcinoma (PFTC) is a rare gynecological malignancy accounting 0.14-1.8% cases. The purpose of the study was to assess clinical, morphological and immunohistochemical features of PFTC. All the cases of PFTC were detected during 1980-2005. 31 cases of PFTC were analyzed as to Ki-67, HER-2 expression, estrogen receptors (ER), progesterone receptors (PR), grade and stage. 69 cases of PFTC were detected with an average age of 55, 6 years (range 21-73 years). Stage I detected in 34.2% cases, Stages II and III--32.8%, Ca in situ--10%. Among 31 patients ER were positive in 75% (n = 23), PR were positive in 46% (n = 14): ER+PR+ in 12 (38%) cases, ER+PR- in 11 (36%) cases, ER-PR+ in 2 (6%) cases, ER-PR- in 6 (19.4%) cases. Only 2 cases were HER-2 positive with ER+PR+ and ER-PR- status. Ki-67 labeling index (LI, %) values ranged from 15 to 95% (median 60) with average rate 58.03% +/- 4.08. Ki-67 LI values > or = 60% were graded as high and < 60% as low. We did not find any significant differences in Ki-67 LI values among tumors of various Receptor Status. However Ki-67 L1 > 60% was associated with poor 5-year survival (14%), vs 75% in Ki-67 L1 < 60%. Primary fallopian tube carcinoma is mainly HER-2 negative, receptor positive in 79.6%. Ki-67 rate is irrespective of ER PR status. However the level of Ki-67 (> 60%) was a significant survival prognostic factor.

[Mesonephric (clear cell) cervical cancer].

Mezonefric cervical cancer was more prevalent in younger women (mean age 42.2 +/- 1.2 years) with no classic predisposing factors. In most cases (62.1%) the localized stage of the disease (I, II stages) dominated. Regional metastases correlated with depth of tumor invasion (with a depth of invasion of more than 10 mm--57.8%). There was marked low expression of HER2/neu (only in 1 of 14 samples it was revealed light positive reaction. Proliferation index Ki-67 was 37.5% and the signs of mutation in the p53 gene were found in 28.4% of cases. Estimating that two thirds of patients with clear-cervical cancer revealed localized forms of the disease, and that most of the women had received the combination treatment (51.8%)--a 5-year survival rate was quite high and was 79.3%.

[Quality of life in patients with cervical carcinoma (stage I-II) after radical treatment].

Quality of life after radical surgery, radiotherapy and combined therapy for cervical carcinoma (stage I-II) was studied. An evaluation of 4,900 questionnaires (FACT-G, Spielberger-Hanin) from 180 patients pointed to deterioration in all clinical groups undergoing treatment. It was restored in cases of surgery and combined treatment by the of therapy while, in those receiving complex radiotherapy alone, it was at its lowest level at the same period. In that group, quality of life failed to recover until 6 months after treatment.

[Serous-papillary endometrial carcinoma (clinico-morphological features)]. / Serozno-papilliarnyi rak éndometriia (kliniko-morfologicheskie osobennosti).

The share of seroso-papillary endometrial carcinoma (SPEC) for the past 4 years has been 6.4%--101 out of 1,567 endometrial cancers. There has been lower incidence of obesity, diabetes mellitus and infertility in cases of SPEC than endometrioid carcinoma (EEC)--18.8 and 53.7; 12.9 and 23.3; 8.8 and 20.6%, respectively, (p < 0.05). Only 60.4% of SPEC patients had locally-advanced tumors (stage I--35.6; stage II--24.8%) while tumor dissemination was reported in 39.6% (stage III--27.7 and stage IV--11.9%). Among EEC patients, locally-advanced tumors were detected in 89.6% (stage I--62.9 and stage II--26.7%) and disseminated tumor incidence was 3 times lower than in SPEC--10.4% (stage III--8.1 and stage IV--2.3%). Deep invasion into the stroma (more than 10 mm) was registered in 27.7% (SPEC) while in EEC--6.0% (p(0.05). Lymphogenous metastasis was much more common in SPEC (13.9%) as compared with less than 4.1% in EEC patients. There was no correlation between its presence and depth of invasion in the myometrium (p(0.05). High incidence of association of metastasis and superficial or deep invasion was reported for SPEC. This tumor should be classified as pathogenetic variant II of clinico-morphological changes.