2004, Vol 2, No 3
Hormones and carcinogenesis. An Overview
GIN ONKOL, 2004, 2 (3), p. 139-146
ABSTRACT

Recent progress in biological research and in particular in molecular biology has contributed to better understanding of oncogenesis. Hormone-related cancers share a unique mechanism of carcinogenesis, mainly because exogenous and endogenous hormones drive cell proliferation in these tumors. As a result of increased proliferation, random gene alterations can accumulate. Unfortunately, most of the genes regulated by hormones are currently unknown. Finally, growing number of genetic errors creates a malignant phenotype. This review presents current knowledge about the interrelations between hormones and hormone-related cancers with breast cancer as an example.

Keywords: hormones, growth factors, hormone-dependant tumors, hormone-dependant regulation of proliferation, breast cancer
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The comparison of the usefulness of two risk malignancy indicators (RMI) in preoperative diagnostic of ovarian cancer
GIN ONKOL, 2004, 2 (3), p. 147-155
ABSTRACT

Purpose: The comparison of the two risks of malignancy indicators (RMI) in preoperative diagnostic of ovarian cancer. Material and methods: The study of 224 ovarian cancer patients, hospitalized at Gynecological Department in Municipal Hospital No 2 in Ruda Śląska was performed. The bimanual examination, transvaginal ultrasound, the serum Ca 125 level estimation and detailed interview were accomplished. Verification of adnexal masses was based on postoperative histopathological examination. According to the data in the literature, the classification of the USG pictures was performed. The RMIs were calculated according to the algorithms presented in the literature. The performance of the indices was estimated by ROC curves. Results: In the analyzed group, 193 of the masses were benign and 31 malignant. ROC curves for both RMIs were similar. Conclusions: 1. The risk of malignancy indicators (RMIs) can be useful in preoperative diagnosis of ovarian tumors. 2. Both of compared indices were similar in sensitivity and specificity.

Keywords: risk of malignancy index, adnexal masses, ovarian cancer, ultrasound
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The usefulness of serum Ca 125 level in preoperative diagnosis of ovarian malignancies
GIN ONKOL, 2004, 2 (3), p. 156-164
ABSTRACT

Objectives: The purpose of the study was the assessment of the helpfulness of Ca 125 serum level in preoperative staging of ovarian malignancies. Material and methods: The group of 224 ovarian cancer patients, diagnosed and treated surgically at Gynecological Ward of Municipal Hospital No 2 in Ruda Śląska. All patients were examined bimanually, the transvaginal ultrasound with Doppler microvessel density assessment of the tumor was performed and the serum Ca 125 level was estimated. The precise interview was done. The diagnosis was based on the histopathological examination of the operative specimens. The range of the serum marker level in the groups of malignant and benign masses was assessed. The sensitivity and the specificity of the above factor were counted in dependency on the cut-off value. The classification possibility was introduced using the ROC curve. Results: Among the analyzed group there were 193 benign lesions and 31 malignant tumors. The most frequent cut-off value in the literature 30 U/ml achieved sensitivity of 67.7% and specificity of 83.9%. The area under ROC curve was 0.807. Conclusions: The preoperative serum Ca 125 level assessment in the diagnosis of ovarian malignancies may be helpful, but not decisive.

Keywords: Ca 125, adnexal masses, ovarian cancer, ultrasound
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The analysis of the treatment of ovarian cancer patients with neoadjuvant chemotherapy – preliminary results
GIN ONKOL, 2004, 2 (3), p. 165-173
ABSTRACT

Introduction: Primary surgery and adjuvant chemotherapy is the standard treatment protocol in ovarian cancer patients. Neoadjuvant chemotherapy is one of the mode of treatment in patients with poor condition or advanced disease, not applicable for primary surgery. The aim of this study was the evaluation of this new therapy option comparable with standard method. Patients and methods: 319 patients with FIGO stage III and IV of ovarian cancer have been analyzed. In this group 50 women were treated by using neoadjuvant chemotherapy. 18 patients were operated after 3 cycles of chemotherapy and the rest 32 patients after 6 cycles. Results of the treatment were evaluated, taking into consideration disease free survival and number of complications. Parameters affecting treatment results were also analyzed. Results: The median of disease free survival in the group treated with adjuvant chemotherapy and operated after 3 cycles of chemotherapy, were as follows: 19 and 20 months. In the group operated after 6 cycles, the median of disease free survival was 15 months (p=0.27). The following parameters influenced on treatment results: optimal cytoreduction and tumor grading. There was no difference in complications rate between these groups.

Keywords: ovarian cancer, interval debulking surgery
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Tissue expression of p53 protein and anti-p53 antibodies in serum of patients with carcinoma of the uterine cervix
GIN ONKOL, 2004, 2 (3), p. 174-180
ABSTRACT

p53 is the most commonly mutated gene in human neoplastic cells. The tissue expression of its product, p53 protein, may be assessed by means of immunohistochemical methods. Serum anti-p53 antibodies may be detected in 40% of individuals with mutated p53 gene. The key role in the humoral response to p53 protein is attributed to the prolonged half-life of the mutated protein and its accumulation within the cells. The anti-p53 antibodies occur very seldom in the population of healthy individuals. Therefore, they come in handy as markers. This paper assesses the tissue expression of p53 protein and the level of anti-p53 serum antibodies in the cervical cancer. Their prognostic value was analyzed, with respect to the histopathological parameters related, in turn, to the stage of the cancer. The correlation between the tissue expression of p53 protein as well as anti-p53 level and the histopathological prognostic factors was not established.

Keywords: squamous cell carcinoma of the uterine cervix, tissue expression of p53 protein, serum anti-p53 antibody
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The prognostic value of the cytokeratin 19 (CYFRA 21-1) fragments serum level in cervical cancer patients
GIN ONKOL, 2004, 2 (3), p. 181-185
ABSTRACT

The connection between overall survival and the serum level of the cytokeratin 19 (CYFRA 21-1) fragments in 73 cervical cancer patients FIGO stage IB and IIA was analyzed. The measurement was performed before surgical treatment. The dependency of the CYFRA 21-1 serum level on the clinical stage, grading and the overall survival was investigated. In 38% cases the serum level before surgery was >2.5 pg/ml. In cases of lower concentration, longer overall survival was observed. The results of this study suggest that early cervical cancer patients with serum presence of cytokeratin 19 fragments before surgery need a complementary treatment.

Keywords: squamous cell cervical cancer, CYFRA 21-1, cytokeratin 19 fragment
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Selected risk factors of endometrial cancer
GIN ONKOL, 2004, 2 (3), p. 186-194
ABSTRACT

Objectives: Endometrial carcinoma occurs most often in the sixth and seventh decades of life. Only 5% of the cases occur in patients below the age of 40. Many studies support the opinion that the long-term estrogenic stimulation of endometrium, late menopause, low fertility index, obesity and the socio-economic conditions play an important role in the development of endometrial cancer. Moreover, women with estrogen-secreting ovarian tumors are at high risk of this disease, as are women with myomas or breast cancer. Design: The aim of our study was to evaluate selected risk factors for endometrial cancer. Material and methods: From 1994 to 1998, a total of 366 women with endometrial cancer were retrospectively examined in Oncological Center in Bydgoszcz. Several factors that are possibly associated with the risk of endometrial cancer were analyzed: the age of the disease onset, menopausal status, parity, concomitant illnesses, first signs and symptoms of the disease. Results: 229 patients (62.6%) came from city environment (industrial region) and 137 (37.4%) from small towns and villages. In the study group only 11 women (3%) had a university degree, whereas 266 (72.7%) had a elementary education. Endometrial carcinoma occurred most often in patients over 60 years of age and menopausal age between 50 and 60. More than half of the patients were nulliparous or delivered less than 2 times (185 – 50.5%). We have noticed high rates of concomitant diseases (myomas – 7.1%, breast cancer – 9%, obesity – 28.4%, cholecystolithiasis – 34.6%) occurring with endometrial cancer. Conclusions: 1. Patients’ age is an independent risk factor of endometrial carcinoma. 2. Obese women with diabetes, hypertension and breast cancer are at a higher risk and therefore should undergo appropriate prophylaxis, especially if abnormal bleeding occurs. 3. Due to high rate (7.1%) of concomitant occurrence of myomas and endometrial cancer, curettage and endometrial biopsy should be performed before surgery.

Keywords: endometrial cancer, risk factors
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IUMPA-2: intrauterine medroxyprogesterone delivery system in endometrial hyperplasia treatment – first announcement
GIN ONKOL, 2004, 2 (3), p. 195-198
ABSTRACT

The aim of this study was the elaboration of the medroxyprogesterone acetate (MPA) delivery system employed in the treatment of abnormal uterine bleeding, especially in simplex endometrial hyperplasia. Gestagen therapy or surgical procedures were used in such cases till now. Material and methods: IUMPA-2 is the intrauterine device which have 2 grams of medroxyprogesterone acetate. The release of MPA from the carrier has been programmed as the line function within 30 days. The study was carried out in 30 postmenopausal women with histology proven simplex endometrial hyperplasia or ultrasonographical suspicion of endometrial hypertrophy. Results: The posttreatment histology examination performed in all patients revealed: secretion phase or pseudodecidual transformation. Conclusion: IUMPA-2 is the effective topical treatment system for simplex endometrial hyperplasia, offering potential benefits in patients with contraindication for general progesterone application.

Keywords: IUMPA, hormone treatment, endometrial hyperplasia
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