Gynecologic Cancer Cases Research Articles

Validity and completeness of registration of surgically treated malignant gynaecological diseases in the Danish National Hospital Registry.

The increasing tendency to acquire data by linkage to registries not designed for research has introduced a problem into epidemiological research. The data is often crude or possibly incomplete and, in some cases, it has been proposed to use these registries in the routine acquisition of data for existing epidemiological research registries. This study estimates the validity and completeness of the registration of surgically treated malignant gynaecological diseases in the Danish National Hospital Registry 1977-88. Completeness was estimated by the method of independent case ascertainment, by comparison with the registration of surgically treated gynaecological cancer cases registered in the Danish Cancer Registry. The validity of the diagnoses was analysed by comparison with the recoding of discharge summaries describing the admission of a 5% random sample. The completeness of registration was 87% overall. Ovarian cancer, cervical cancer and cancer of the uterus were registered with a positive predictive value (PPV) of 89-90%. The results of the study emphasise the need to consider the validation of Danish Hospital Registry data before linkage and analysis. In epidemiological cancer research the Danish Cancer Registry is the better alternative when information on malignant tumours is needed.

Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: A series of 10 cases

Abstract.Bilgin T, Karabay A, Dolar E, Develioğlu OH. Peritoneal tuberculosis with pelvic abdominal mass, ascites, and elevated CA 125 mimicking advanced ovarian carcinoma.Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 ± 6.1 (median 37; range 18–72). Ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40–560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. Tuberculosis was diagnosed at laparotomy in all. Patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.

Immunohistochemical versus Molecular Detection of RAK Antigens in Breast Cancer

RAK antigens p120, p42, and p25 exhibit molecular and immunological similarity to the proteins encoded by HIV-1 and are expressed by 95% of breast and gynecological cancer cases in women and prostate cancer cases in men. Binding of the monoclonal antibody (MAb) RAK-BrI to cancer RAK antigens has been found to be inhibited by a peptide derived from the variable loop V3 of HIV-1. Since MAb RAK-BrI has been developed against denatured froms of breast cancer proteins, and it binds to a short epitope, GRAF, this MAb does not recognize the native, three-dimensional structure of proteins. Subsequently Western blot, after electrophoretic separation in gels with SDS, has been used to detect these unique cancer markers. The current studies were focused on the immunohistochemical evaluation of the novel marker RAK. Serial sections, 5 μm thick, were cut from frozen or Formalin-fixed, paraffin-embedded tissue blocks and immunostained with MAb RAK-BrI. All of the 53 cases of breast cancer tested RAK positive and no differences were observed in the immunohistochemical staining of lobular and ductal carcinoma cases. In contrast, MAb RAK-BrI antigens were detected in only 3 of 15 cases of macroscopically normal breast removed during mastectomy for breast cancer. It is noteworthy that Western blots of breast samples from the same series demonstrated a high expression of three RAK antigens in 20/20 of invasive breast carcinomas, while there was only a very weak expression of RAK antigens in 2/7 of the macroscopically “normal” breast samples. Due to the suspected viral origin of RAK markers, immunohistochemical staining with MAb RAK-BrI might be a useful tool in the early detection of malignant changes occurring in breast tissues.

Human immunodeficiency virus type 1-like DNA sequences and immunoreactive viral particles with unique association with breast cancer.

RAK antigens p120, p42, and p25 exhibit molecular and immunological similarity to the proteins encoded by human immunodeficiency virus type 1 (HIV-1) and are expressed by 95% of breast and gynecological cancer cases in women and prostate cancer cases in men. The binding of an epitope-specific anti-HIV-1 gp120 monoclonal antibody (MAb) (amino acids 308 to 322) to cancer RAK antigens has been found to be inhibited by a peptide derived from variable loop V3 of HIV-1. Breast cancer DNAs of 40 patients were PCR amplified with HIV-1 gp41-derived primers, and all of the samples were found to be positive. The DNA fragments amplified in seven blindly selected breast cancer samples were sequenced. The breast cancer DNA sequences showed at least 90% homology to the HIV-1 gene for gp41. Antisense oligonucleotides complementary to the HIV-1-like sequences inhibited reverse transcriptase activity and inhibited the growth of breast cancer cells in vitro. Viral particles detected in breast cancer cell lines were strongly immunogold labeled with the anti-HIV-1 gp120 MAb. The results obtained strongly suggest that the long-postulated breast cancer virus may, in fact, be related to HIV-1.

Ligation of internal iliac arteries in pelvic haemorrhage.

To study the value of bilateral ligation of internal iliac arteries in the management of intractable postpartum haemorrhage and to curtail blood transfusion during operations for gynaecological cancers. Internal iliac arteries were ligated in 15 cases of PPH, 4 cases of secondary haemorrhage after hysterectomy and in 27 cases of gynaecological cancers during surgery, over a period of 5 years in a general hospital at Calcutta. The method controlled PPH in all cases except one who required hysterectomy. Secondary haemorrhage was arrested in all. No blood transfusion was necessary during operations for gynaecological cancers except one. The method was effective in 75% of atonic PPH and in majority of PPH due to other causes including caesarean section. It almost entirely avoid blood transfusion during operation for gynaecological cancers. The procedure was simple and did not involve any hazard.

Treatment for gynecologic cancer: A review of the effects on female sexuality.

Approximately 75,000 new cases of gynecologic cancer are diagnosed in the United States each year. Since few women can be treated by chemotherapy alone, most undergo extensive treatments that directly alter their sexuality either by causing specific anatomic changes or by generating concerns about continued responsiveness or activity. The major treatments for gynecologic malignancies including radiation therapy or radical hysterectomy for cervical carcinoma, radical vulvectomy for vulvar carcinoma, and pelvic exenteration for recurrent disease, are outlined. Research relating to their effects on female sexuality is critically reviewed. Also discussed are the relevant domains of treatment and patient characteristics that need assessment and investigation in this new and important research area.

Synopsis of Gynecologic Oncology

The first edition of this book was published in 1975, but since then the volume of gynecologic cancer cases, the interest in this subject, and the changes in the field certainly justify the publication of a new edition. The proliferation of new data and concepts and the rapid changes in the handling of obstetric and gynecologic cancer require frequent revisions and editions, so that this book definitely fulfills a need within the field. The information about and the applicability of the new chemotherapeutic agents, in themselves, make it necessary to revise the book. Further illustrative of the book's currency is the information regarding computed scanning and the use of needle aspiration biopsies, which are well illustrated in the text. The book is well written, is in excellent, understandable English, with easy-to-read print, and I, for one, enjoyed reading it through, cover to cover. The use of paragraph headings is an

THE SECOND PRIMARY MALIGNANT TUMOR IN GYNECOLOGY A REVIEW OF THE LITERATURE AND A SERIES PRESENTATION

Abstract 1.1. The literature has been reviewed in an attempt to evaluate the incidence and significance of the second primary cancer in the gynecological patient. There are differences of opinion as to what constitutes a second primary and as to its frequency. It does seem to be generally agreed that there is a tendency to a second primary in the bowel, skin, urinary tract, and in paired organs such as breast and ovary. 2.2. In 1,237 cases of gynecological cancer seen over the last 5½ years, 35 instances of a second primary were found. An additional 4 cases were discovered at postmortem examination. This gives an over-all incidence of second primary cancer of 3.15 per cent. 3.3. The site of the second primary is discussed in the cases presented, with an evaluation of its possible significance.