Über die Wirkung von 4-Hydroxypentenal auf die nicht karzinomatös und die karzinomatös veränderte Portio uteri

Abstract

4-hydroxy-2,3-transpentenal (HPE) represents the 5-C-homologue of a series of hitherto unknown alpha,beta-unsaturated aldehydes. The marked inhibition of DNA-biosynthesis by these chemical compounds, particularly by HPE, suggests blocking of mitosis by HPE due to direct action on the S-phase. It is known that DNA-biosynthesis as well as energy metabolism are generally more disturbed by HPE in animal tumor cells (Ehrlich ascites and solid tumors, NK/Ly sarcoma 37, sarcoma 180, plasmocytoma G, murine Harding-Passey melanoma) than in normal cells (liver, kidney, jejunum, spleen, thymus); for details see BICKIS et al. 1969; RINDLER et al. 1970; KAPFER et al. 1972). After systemic administration of HPE the concentration of the cytotoxic agent in the blood caysed a bituceabke but merely selective inhibition of the metabolism in experimental animal tumors; however, it was not sufficient to produce therapeutic results. The low stability of HPE in the blood and in the peritoneal cavity is to be attributed to its affinity to SH-groups. Therefore the biological tests had to be confined to the local administration of HPE. In this histological study of the action of HPE the substance was administered directly to the human portio vaginalis uteri (ecto- and endocervix) in cases of carcinomatous alterations, in cases of non-carcinomatous affections as well as in normal portions. In this test 42 women were treated with HPE. 3 patients were observed clinically only, the other 39 cases were investigated also histologically. The histological studies were performed on the extirpated uterus (36 cases), the resected portio (1 case) and only on a conus (2 cases). In 17 of these patients examined histologically the portio was clinically free of pathological symptoms. They suffered from such more or less commonplace gynecological disorders as displacement of the uterus, incontinentia urinae relativa, uterus myomatosus, endometriosis and cystical adnexal tumors. 7 patients suffered from ectopies, 8 from Ca coli uteri, 7 were affected by invasive cancer of the cervix. 8 of the patients were older than 50 years, the others were aged between 25 and 50 years. Mode of HPE administration: 1. Application of a small HPE-soaked linen patch fixed on a Sta Seal impression of the vagina (Sta Seal=dental silicon impression paste). 2. Application by means of a small linen patch in a portio cap. The inner surface of a portio cap corresponding to the vaginal uterus in shape and size was coated with a circular linen patch. The unneeded segment was cut off. After moistening with the aldehyde (HPE) it was fit tightly to the inner surface of the cap and, in situ, to the portio surface as well. In several cases the portio did not fill the cap completely and did not contact the tissue in the region of the os uteri. Consequently, there the aldehyde effect was lower than in the lateral regions of the portio. Therefor 3...