High tumor cell vimentin expression indicates prolonged survival in patients with ovarian malignant tumors

Objectives: The main aims of the study were to investigate the expression of vimentin and its correlation with the overall survival (OS) of patients with malignant ovarian tumors, and the correlation between vimentin expression and tumor stroma characteristics. Material and methods: The study focused on 94 malignant ovarian tumors that had been collected from women who were treated in the Department of Gynecology and Oncology of the Lukaszczyk Oncological Center, Bydgoszcz, Poland. Vimentin expression was assessed in both the cancer cells (expression intensity and quantitative analysis) and the tumor stroma (expression intensity). Vimentin expression was analyzed according to both stromal cellularity and the clinicopatho- logical features of the disease. Results: Both high cancer cell vimentin expression intensity and high quantitative vimentin expression (up to and includ- ing 30% of cells) indicated a significantly prolonged OS. Low vimentin stromal expression was associated with prolonged OS, although the difference did not reach the level of significance. High tumor cell vimentin expression intensity was as- sociated with significantly higher vimentin stromal expression. High vimentin expression in the tumor stroma indicated a significantly higher cellularity of the tumor stroma. Vimentin expression in cancer cells and the tumor stroma were not dependent on the histopathological type, the tumor grade or the FIGO stageof the disease. Conclusions: High cancer cell vimentin expression is associated with an improved OS of patients with malignant ovar- ian tumors. The expression of vimentin in ovarian malignancies may influence the structure of the tumor stroma

The potential predictive value of serum sRCAS1 levels for overall survival in endometrial cancer

Objectives: The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease.  Material and methods: The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method.  Results: In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients’ age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients’ OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group.  Conclusions: High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer.

Endometrioza i mięsakorak – hipotetyczny związek czy udowodniona wspólna ścieżka patogenetyczna? Opis przypadku mięsakoraka jelita grubego wychodzącego z ogniska endometriozy

We present the first case of a patient with a synchronic occurrence of three neoplasms: non-small cell lung cancer, serous cancer of the ovary, and carcinosarcoma of the colon. Moreover, the possible origin of the carcinosarcoma is an endometriotic focus, which is an extremely rare occurrence, especially in women with no history of endometriotic treatment. Immunohistochemical staining of the carcinosarcoma was positive for CD10, estrogen receptors and desmin – typical markers for endometriotic foci. The growth of endometriosis depends on estrogen, which is produced at reduced levels after menopause. However, in some cases endometriosis could be diagnosed de novo in postmenopausal women. On the basis of the reported patient we discuss possible correlations between endometriosis and carcinosarcoma, as well as treatment methods of carcinosarcoma.Prezentujemy pierwszy na świecie przypadek pacjentki, u której rozpoznano synchroniczne występowanie trzech nowotworów: niedrobnokomórkowego raka płuc, raka surowiczego jajnika oraz mięsakoraka jelita grubego. Co więcej, najbardziej prawdopodobnym punktem wyjścia mięsakoraka jelita grubego jest ognisko endometriozy. Niesłychanie rzadko opisuje się karcynogenezę związaną z endometriozą u pacjentek, które wcześniej nie leczyły się z powodu endometriozy. Badanie immunohistochemiczne mięsakoraka ujawniło ekspresję CD10, desminy oraz receptorów dla estrogenów – typowych markerów endometriozy. Aktualnie uznaje się, że endometrioza – mająca podłoże estrogenne, może być diagnozowana de novo nawet po menopauzie. Na podstawie przedstawionego opisu przypadku przedyskutowaliśmy możliwy związek endometriozy i mięsakoraka oraz dostępne opcje terapeutyczne mięsakoraków

Nieprawidłowy wynik testu podwójnego jako pierwszy objaw współistnienia prawidłowej ciąży z zaśniadem groniastym

Współistnienie prawidłowej ciąży z zaśniadem jest bardzo rzadkim zjawiskiem. Wczesnym objawem zaśniadu jest zazwyczaj stwierdzenie patologicznego obrazu łożyska w USG lub wystąpienie krwawienia z dróg rodnych. Prezen- tujemy przypadek ciąży z płodem o prawidłowym kariotypie i współistniejącym zaśniadem, którego najwcześniej- szą manifestacją był nieprawidłowy test PAPPA, a zmiany wykrywane w USG ujawniły się dopiero po 5 tygodniach od diagnostyki prenatalnej. Na podstawie opisu przypadku przeprowadzono analizę cech ultrasonograficznych mogących ułatwić wcześniejsze wykrycie ciąży z patologicznym rozwojem trofoblastu oraz przedstawiono sposób postępowania z ciężarną u której współistnieje zaśniad i ciąża o prawidłowym rozwoju.

The possible use of the blood serum concentration measurements of sHLA-G in women with endometrial and cervical cancers during radiotherapy as an indicator of the status of the tumour microenvironment

Background: The selective suppression of cytotoxic immune cells constitutes a crucial event in the development of malignancy. This phenomenon increases in accordance with the growth of a tumor and is just one result of the increased expression in the cancer milieu of those proteins, such as human leukocyte antigen G (HLA-G) and its soluble form (sHLA-G). Given that radiotherapy may influence immune system activity, we aimed to measure (sHLA-G) serum levels both before and after the radiotherapy due to endometrial or cervical cancer.   Methods: We assessed the sHLA-G blood serum concentration levels in a group of 43 patients (28 and 15 diagnosed with cervical cancer and endometrial cacer respectively), who received primary or adjuvant radiotherapy. We assessed the blood serum concentrations of the sHLA-G through a series of measurements taken before and four days after the latest radiation dosage using an ELISA kit.   Results: Median serum sHLA-G levels significantly decreased after radiotherapy (5.63 U/ml; range 0.00 – 344.55; vs 5.57 U/ml; 0.00 –94.02; P = 0.045). The changes of sHLA-G levels didn’t influence patients’ survival. Pretreatment and post-treatment sHLA-G levels were negatively correlated with patients’ age (R Spearman = -0.45, P = 0.041; R Spearman = -0.46. P = 0.038).   Conclusions: The detected levels of sHLA-G blood serum concentrations may supply clinically applicable information regarding the status of the tumor microenvironment — that is, the size and  the degree of  suppression of the tumor environment — where the tumor-immune cell interaction is realized. Finally, this information may also prove helpful in the treatment of cancer

Analysis of the treg cell population in the peripheral blood of ovarian cancer patients in relation to the long-term outcomes

Objectives: There is growing evidence that Treg cell infiltration into the cancer nest is associated with poor prognosis. How- ever, the Treg cell population in the peripheral blood may change when a different type of anticancer therapy is applied. Since Treg cells may support tumor growth by enhancing the suppressive profile of the cancer microenvironment, the assessment of Treg cells can bring to light important information regarding prognosis. Thus we decided to analyze the Treg cell population in the peripheral blood in relation to long-term outcomes in the group of patients with ovarian cancer.  Material and methods: The 80 patients included in the study were treated surgically followed by chemiotherapy for ovar- ian cancer between October 2010 through May 2011.The peripheral blood samples from the patients were collected directly prior to chemotherapy. Information on any patients who died was retrieved from the database of the Cuiavia-Pomerania Regional Office of the National Health System of Poland. CD4+CD25+FOXP3+ lymphocytes T were assed by flow cytometry. We have analyzed the long term outcomes of treatment regarding to the level of Treg cells in peripheral blood.  Results: We found that patients with serous adenocarcinomas had significantly higher Treg levels compared to those patients with non-serous types. Patients who had a higher percentage of Treg cells within the CD4+ cell population prior to the beginning of the treatment had worse long-term outcomes from the applied therapy.  Conclusions: The assessment of Treg levels prior to the start of chemotherapy is clinically useful and may predict overall survival in ovarian cancer patients.

The association between imbalances in vaginal microflora and duration of pregnancy as well as selected maternal and neonatal parameters

Objectives: Abnormal vaginal flora (AVF) is a result of excessive growth of some aerobic bacteria and fungi in relation to the scarce presence of Lactobacillus spp. It has been suggested that AVF is responsible for preterm birth and such neonatal conditions as infections or sepsis.The aim of the study was to assess the influence of excessive vaginal colonization with aerobic bacteria and fungi on the selected postnatal parameters of newborns, duration of pregnancy and length of hospitalisation of neonates.Material and methods: Retrospective data of all 1057 patients who delivered between 01.2019 and 06.2019 in the Department of Perinatology of Medical University of Lodz was analyzed. Eight hundred nine patients were included in this retrospective study. The study group consisted of 396 patients with abundant growth of aerobic bacteria and fungi obtained between 26 and 42 weeks of gestation, while 413 patients with physiologic vaginal biocenosis constituted the control group. Two hundred forty-eight patients (23.46%) were excluded from the study due to incomplete data.Results: Patients with abnormal vaginal flora (AVF) gave birth prematurely (9.09%) more often than patients with balanced microflora (5.31%), p = 0.038. Newborns of mothers with AVF obtained an Apgar score under four more frequently (1.21% vs 0%; p = 0.024). Eutrophic neonates were born less frequently in the study group (82.08% vs 88.65%; p = 0.025). Hospitalisation period was longer for children of mothers with AVF (mean of 6.30 ± 9.87 days) than those of mothers from the control group (mean of 5.06 ± 5.30), p = 0.025. Newborns of mothers with AVF developed perinatal infections more often (23.97% vs 15.94%; p = 0.004). Four infants died in the study group whereas no deaths were recorded in the control group (p = 0.045). The most prevalent pathogens were: Streptococcus agalactiae (GBS) 57.32%, Candida spp. 39.64%, Klebsiella spp. 9.85%, Staphylococcus aureus 7.32%. Signs of infection were more frequently recorded in newborns of mothers infected with Klebsiella spp. (35.90% vs 19.16%; p = 0.011). Premature birth was more prevalent in GBS carriers (11.81% vs 6.28%; p = 0.022).Conclusions: Abundant growth of aerobic bacteria in the 3rd trimester of gestation contributes to preterm birth, causes the development of infection signs in newborns, increases their mortality rate and prolongs hospitalisation period

Body mass changes during pregnancy and concentration of insulin and neuropeptide Y in women with regard to the BMI

Summary Introduction: Obesity poses a serious problem to human population as it increases the risk of diabetes, hypertension, metabolic syndrome. In pregnancy, obesity increases the frequency of its complications. Aim: The main aim of the study was to estimate the increase of body mass and insulin and neuropeptide Y concentrations in pregnant women. Material and methods: The changes of body mass and BMI in women before pregnancy and before delivery and the concentrations of insulin and neuropeptide Y in blood were estimated. Results. The increase of body mass and BMI during the pregnancy period was higher in the group with high body mass and I stage obesity and increase of insulin concentration depended on increase of the body mass. Higher concentration of NPY was found in the group of women with normal body mass and obese if compared to stages II and III of obesity. No correlation between insulin increase and concentration of NPY was found. Conclusions: In most pregnant women body mass gain is excessive and leads to obesity of different stages. Insulin concentration increases as BMI increases. Neuropeptide Y concentration in the obese women group was lower than in the normal weight group

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines