Parametrial Lymph Node Research Articles

Serum Carcinoembryonic Antigens in Patients With Carcinoma of the Cervix

Serum levels of carcinoembryonic antigen (CEA) were measured by a radioimmunoassay technique. The mean CEA level for 80 controls was 2.03 ng/ml with a standard deviation of 0.49 ng/ml. Hence, the upper limit of normal for serum CEA levels was considered to be 3.01 ng/ml, ie, two standard deviations above the mean. Serum CEA levels were measured in 86 patients with cervical squamous cell carcinoma, Stages 0 through IV. Thirty-five of the 74 patients with invasive cervical carcinoma were CEA-positive (serum levels above normal); patients with cervical dysplasia or carcinoma in situ were all CEA-negative. Study of the distribution of these patients together with the extent of their disease leads to the following conclusions: a) determination of serum CEA levels cannot serve as a test for the early diagnosis of cervical cancer or precancerous lesions; b) in patients with clinical Stage I or II cervical cancer, an elevated serum CEA level indicates a greater likelihood of parametrial invasion or lymph node metastasis; c) in patients with treated carcinoma of the cervix, continued normal levels of serum CEA affirm continued absence of the disease, whereas development of an elevated level is highly suspicious of occult residual or recurrent cancer. The authors urge periodic determinations of serum CEA levels in patients with treated cervical cancer.

The fate of uterine spermatozoa in the mouse post coitum.

Observations have been made on the fate of sperm remaining in the uterus of the mouse following coitus. The uterine contents were found to undergo two fates both of which resulted in the emptying of the organ within 36 hr. The first was degradation of the sperm by phagocytes and its subsequent absorption by the uterus, the second was the evacuation of the contents per vaginam at about the 16th hour post coitum. The process of degradation by phagocytes was arbitrarily divided into three stages, a first stage lasting until the 8th hour post coitum with no evidence of phagocytic activity, a second stage lasting until the 18th hour post coitum with very active phagocytosis both by polymorphonuclear neutrophil leucocytes and monocytes, and a terminal or absorptive phase lasting until the 36th hour post coitum when an active phagocytosis of the degraded phagocytes and other granular debris occurs through the uterine epithelial cells to the subepithelial lymphatic vessels. The similarity of the first phase to the concept of capacitation of sperm in connection with fertilization is discussed from the viewpoint of a proposed obligatory prephagocytic conditioning of the sperm surface, possibly of antibody nature. The involvement of polymorphonuclear neutrophil lysosomes in the degradation process of sperm is demonstrated, thereby supporting suggestions of a similar role for these particles as in microbial degradation. Examination of parametrial and abdominal lymph nodes shows a change in histology when the first is compared with the third stage. The follicle structure is less obvious and there is an increase in reticulo-endothelial cells and lymphoblasts, especially in the hilar region. The nodes contain debris reminiscent of the debris found in the uterine lumen, in the uterine epithelium, and subepithelial lymphatics. The presence of foreign protein, including foreign nucleoprotein, within the cytoplasm of uterine epithelial cells and lymph nodes which drain them is discussed from the perspectives of their genetic and immunological (e.g. homograft reaction) consequences.

Carcinomatous infiltration into the uterine body in carcinoma of the uterine cervix

This report deals with the infiltration of the uterine body by carcinoma of the uterine cervix in 162 surgically treated cases. 1.1. Infiltration of the uterine body was found in 42 cases (25.9 per cent) out of 162, and its incidence parallel the stage.2.2. Infiltration showed a higher incidence in the group beyond 51 years of age, in cases with a long lapse before treatment, when the carcinoma was of the endophytic type, and in the presence of parametrial infiltration and lymph node metastases.3.3. The prognosis was unfavorable in cases with involvement of the corpus uteri and the 5 year cure rate was unfavorable in proportion to the height of infiltration, and also in proportion to the distance of infiltration outward from the uterine cavity.