QOL after RT or OP for uterine cervix cancer

This study aimed to research the post-treatment quality of life (QOL) between radiotherapy (RT)- and operation (OP)-treated early cervical cancer survivors, using separate questionnaires for physicians and patients. We administered an observational questionnaire to patients aged 20–70 years old with Stages IB1–IIB cervical cancer who had undergone RT or OP and without recurrence as outpatients for ≥6 months after treatment. We divided 100 registered patients equally into two treatment groups (n = 50 each). The average age was 53 and 44 years in the RT and OP groups, respectively. The RT group included 34 and 66% Stage I and II patients, respectively, whereas the OP group included 66 and 34% Stage I and II patients, respectively. The OP group included 58% of patients with postoperative RT. Combination chemotherapy was performed in 84 and 48% of patients in the RT and OP groups, respectively. On the physicians’ questionnaire, we observed significant differences in bone marrow suppression (RT) and leg edema (OP). On the patients’ questionnaire, significantly more patients had dysuria and leg edema in the OP group than in the RT group, and severe (Score 4–5) leg edema was significantly higher in the post-operative RT group than in the OP only group. The frequency of sexual intercourse decreased after treatment in both groups. On the patients’ questionnaire, there were no significant differences between the two groups regarding sexual activity. These findings are useful to patients and physicians for shared decision-making in treatment choices. The guidance of everyday life and health information including sexual life after treatment is important

Clinicopathologic and Immunohistochemical Study of Endometrial Carcinoma

子宮体癌84例(内膜型腺病高分化型33例・中分化型9例・低分化型7例,漿液性腺癌3例,腺扁平上皮癌12例,腺棘細胞癌20例)を対象として,臨床病理学的所見並びに各種腫疾関連抗原の免疫組織化学染色所見と予後(累積5年生存率)との関係を比較し,子宮体癌の予後推定因子について検討した。 1.臨床病理学的所見について検討した結果, (1)臨床進行期のⅠ期及びⅡ期は内膜型腺癌高分化型及び同中分化型が,Ⅲ期及びⅣ期は同低分化型及び菜液性腺癌が最も多かった。 (2)脈管侵襲は漿液性腺癌,ついで内膜型腺病低分化型に多く認められた。 (3)筋層浸潤は内膜型腺癌低分化型,漿液性腺癌及び腺扁平上皮癌の全例に認められ,とくに内膜型腺病低分化型及び腺扁平上皮癌の過半数が深遠度2/3以上であった。 (4)転移は,内膜型腺癌低分化型及び漿液性腺癌に最も多くみられた。 (5)閉経後の症例は漿液性腺癌,内膜型腺癌中分化型,同低分化型及び腺扁平上皮癌に多くみられた。 2.臨床病理学的所見と累積5年生存率(以下5生率)を比較検討した結果, (1)内膜型腺癌高分化型,腺棘細胞癌,臨床進行期Ⅰ期・Ⅱ期,脈管非侵襲,筋層非浸潤・浸潤1/3まで,閉経前並びに癌胞巣周囲のリンパ球浸潤高度の各症例は全例生存し,5生率は100%であった。 (2)内膜型腺病低分化型,漿液性腺癌,臨床進行期Ⅲ期・Ⅳ期,脈管侵襲,筋層浸潤2/3以上,転移,閉経後並びに癌胞巣周囲リンパ球浸潤中等度以下の症例には死亡例が多く,5生率が低下していた。 3.CA125, vimentin, SSEA-1, Searyl SSEA-1, Fucosyl SSEA-1, UEA-I Lectin, EMA並びにPLAPの免疫組織化学染色所見と臨床病理学的所見を比較検討した結果, (1)CA125の陽性率は,内膜型腺癌高分化型及び腺棘細胞癌の症例で高く,内膜型腺癌低分化型,臨床進行期Ⅳ期並びに筋層浸潤2/3以上の症例で低い傾向が認められた。 (2)Vimentinの陽性率は,内膜型腺癌高分化型,脈管非侵襲並びに筋層非浸潤・浸潤1/3未満の症例で高く,内膜型腺癌低分化型,臨床進行期Ⅳ期並びに筋層浸潤2/3以上の症例で低い傾向が認められた。 (3)Searyl SSEA-1の陽性率は内膜型腺癌高分化型,腺棘細胞癌,脈管非侵襲,筋層非浸潤,非転移並びに閉経前の症例で高く,内膜型腺癌低分化型,腺扇平上皮癌並びに筋層浸潤2/3以上の症例で低い傾向が認められたSSEA-1及びFucosyl SSEA-1については,陽性率の差は認められなかった。 (4)UEA-I Lectinの陽性率は,内膜型腺癌高分化型及び腺棘細胞癌で高く,内膜型腺癌低分化型で低い憤向が認められた。 (5)EMAの陽性率は,脈管侵襲及び筋層浸潤の症例で高い傾向が認められた。 (6)PLAPの陽性率は,臨床進行期Ⅰ期並びに閉経前の症例で高い傾向が認められ,筋層浸潤2/3以上の例では低い傾向が認められた。 4.各種庄癌関連抗原の免疫組織化学染色所見と累積5年生存率を比較検討した結果, (1)CA125陽性群の5生率は100%,陰性群の5生率は87.5%であり,両者の間に有意差を認めた(p<0.01)。 (2)Vimentin陽性群の5生率は100%,陰性群の5生率は88.0%であり有意差を認めた(p<0.01)。 (3)その他の腫蕩関連抗原の染色所見について札予後との間に明かな差異は認められず,子宮体癌の予後を推定する腫蕩関連抗原としては,CA125とvimentinが最も有用であることが示唆された。To evaluate prognostic factors of endometrial carcinoma, 84 cases were examined clinicopathologically and immunohistochemically. Results obtained were also compared with survival rate- The following results were obtained : (1) Clinicopathologically, histologic type of adenocarcinoma (G1) and adenoacanthoma, clinical stage I・II, no vessel permeation, no or lesser degree (<1/3) of myometrial invasion, pre-menopausal state and high degree of lymphocytic infiltration were regarded as good prognostic factors. Histologic type of adenocarcinoma (G3) and serous adenocarcinoma, clinical stage III・IV, higher degree (2/3<) of myometrial invasion and no-metastasis were regarded as poor prognostic factors. (2) Immunohistochemically, CA125 expression rate was high in adenocarcinoma (G1) and adenoacanthoma and low in adenocarcinoma (G3), clinical stage IV and myometrial invasion (2/3<) cases. Immunoreactivity of vimentin was observed at high percentage of cases in adenocarcinoma (G1), no vessel permeation, and no or lesser degree (<1/3)of myometrial invasion cases and low in adenocarcmoma (G3), clinical stage IV and myometrial invasion (2/3<) cases. Positive rate of searyl SSEA-1 was high in adenocarcinoma (G1), adenoacanthoma, no-vessel permeation, no-myometrial invasion, no-metastasis and pre-menopause cases and low in adenocarcinoma (G3), adenosquamous carcinoma and myometnal invasion (2/3<) cases. Positive rate of UEA-I Lectin was high in adenocarcinoma (G1) and adenoacanthoma and low in adenocarcinoma (G3) cases. Positive rate of EMA was high in vessel permeation and myometrial invasion cases. Positive rate of PLAP was high in clinical stage I and pre-menopause cases and low m myometrial invasion (2/3<) cases. Cumulative 5 year survival rate was high in positive cases of CA125 and vimentin.広島大学医学雑誌, 38(1), 169-196, 平2-2月(1990)広島大学(Hiroshima University)博士(医学)Medicinedoctora

Ovarian Clear Cell Adenofibroma of Borderline Malignancy : A Case Report

A case of ovarian clear cell adenofibroma of borderline malignancy in a 59-year-old woman is presented with histochemical and electron microscopic observation. The tumor was histologically composed of tubular component lined in part with flat or cuboidal clear as well as hobnail cells with mild cytologic atypia and abundant stromal component containing foci of calcification. The epithelial cells had diastase-digestive PAS-positive material in the cytoplasm, and occasionally the luminal surface and intraluminal substance were stained with mucicarmine. Some of the epithelial cells showed positive lipid staining with Sudan III stain. On ultrastructural study, the tumor featured a moderate number of small mitochondria, poorly developed rough endoplasmic reticulum (rER), short microvilli, intercellular tight junction and desmosome and small amount of glycogen granules. The patient is alive and well with no evidence of recurrence six and half years after the operation

Primary retroperitoneal cyst in pregnancy: A case report based on immunohistochemical analysis and literature review

Primary retroperitoneal cystic lesions (PRCLs) are extremely rare, and their histogenesis and clinical evolution remain unclear. Here, we report the case of a 38-years-old primigravida who was referred to our hospital for the delivery. Routine ultrasonographic examination at 36 weeks of gestation revealed the presence of a cystic mass close to the right side of the uterus. One month after the childbirth, we performed the surgery. The cystic mass was present on the right side of the retroperitoneal cavity. We successfully extracted the cyst without rupture. The cyst was 12 × 6 × 3 cm, unilocular, exhibited a thin wall, and contained mucinous liquid. Histological examination revealed that the lining of the cyst comprised two types of adjacent cells. The flat low cuboidal cells were positive for calretinin, cytokeratin (CK) 5/6, CK7, cancer antigen 125 (CA125), and D2-40, all of which are mesothelial markers. The tall columnar cells were also positive for the mesothelial marker CK7. However, the flat low cuboidal cells were negative for mucinous cell makers, while tall columnar cells were positive for these markers. The tall columnar cells contained mucin but were not positive for gastrointestinal epithelial-specific secreted mucin makers. This finding directly supports our hypothesis that the retroperitoneal cysts emerged from the mesothelium

CD133(+) cells from human umbilical cord blood reduce cortical damage and promote axonal growth in neonatal rat organ co-cultures exposed to hypoxia

To evaluate the effect of CD133(+) cells (endothelial progenitor cells) on the hypoxia-induced suppression of axonal growth of cortical neurons and the destruction of blood vessels (endothelial cells), we used anterograde axonal tracing and immunofluorescence in organ co-cultures of the cortex and the spinal cord from 3-day-old neonatal rats. CD133(+) cells prepared from human umbilical cord blood were added to the organ co-cultures after hypoxic insult, and axonal growth, vascular damage and apoptosis were evaluated. Anterograde axonal tracing with 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate was used to analyze axonal projections from the cortex to the spinal cord. Immunolabeling co-cultured tissues of the cortex and the spinal cord were used to investigate the effect of CD133(+). cells on the survival of blood vessels and apoptosis in the brain cortex. Hypoxia remarkably suppressed axonal growth in organ co-cultures of the cortex and the spinal cord, and this suppression was significantly restored by the addition of CD133(+). cells. CD133(+) cells also reduced the hypoxia-induced destruction of the cortical blood vessels and apoptosis. CD133(+) cells had protective effects on hypoxia-induced injury of neurons and blood vessels of the brain cortex in vitro. These results suggest that CD133(+) cell transplantation may be a possible therapeutic intervention for perinatal hypoxia-induced brain injury