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Correlation between body fat distribution and steroid hormone receptor expression in endometrial carcinoma
THURSDAY,
SEPTEMBER
7
There was a sustained increase in attendance of women for cervical cancer screening form 0.7% to 6% over a 3 months period. This was sustained for 2 months after discontinuation of the program before a decline to 2% was noticed at 6 months. A secondary attempt at reintroduction of health education produced another rise to 8% which remained sustained while health education continued. We concluded that for health education to be effective in developing countries, it must be sustained and intensive to ensure maximum impact.
P4.06 ENDOMETRIUM P4.06.01 CARCINOMA ENDOMETRIUM IS DIAGNOSED BY EXPLORATIVE CURETTAGE OF PHA FOR A PERIOD OF ONE YEAR A. SPangovska, Dept. GYN, Health Center Bit Pazar, Skopje, Macedonia. Objectives: Carcinoma Endometrium is frequent and serious malignant disease of the uterus and its incidence shows significant growth within the last decades. Most frequently it appears in the post menopause period and causes an extensive bleed mg. The purpose of this work is to present how many of the patents, who suffered uterus bleeding, actually had adenocarcinoma endornetrium. Study Methods: The study is a retrospective analysis of one year records from 870 PHA from samples of endometrium, acquired by fractional explorative curettage. Results: Carcinoma endometrium lifts been discovered in the PHA of 86 Adenocarcinoma
in relation to age of the patients:
~
The disease is mostly present in the age group in the age group from 60 to 70 years. The youngest patient has 42 and the oldest 78 years. Conclusions: The high percentage of women with carcinoma endometrium- 9,98%, from those who have suffered extensive bleeding, requires a fractional curettage for acquiring of a PFI verification and diagnosis, as well as for an appropriate treatment.
P4.06.02 CORRELATION BETWEEN BODY FAT DISTRIBUTION AND STEROID HORMONE RECEmOR EXPRESSION IN ENDOMETRIAL CARCINOMA Y.Fuiie, T.Tsuji, T.Douchi, Y.Nagata, Kagoshima University Hospital, 8-35-l Sakuragaoka, Kagoshima, Japan, 890-8520. Objectives: This study investigated whether body fat distribution in postmenopausal women with endometrial carcinoma correlates with steroid hormone receptor expression in endometrial carcinoma specimens. Study Methods: We analyzed estrogen receptor(ER) and progesteron receptor(PR) expression using immunohistochemical methods in formaline-fixed, paraffin embedded endometrial specimens obtained from 48 postmenopausal women with endometrial carcinoma. Baseline characteristics in including age, years since menopause(YSM), weight, height and body mass index(BM1) were recorded for each subject. Four body fat indices [total fat mass(g), percentage of body fat (total fat mass/BW,%),trunk fat mass(g),and the ratio of trunk fat mass to leg fat mass(trunkleg fat ratio)] were measured by dual-energy X-ray absorptiometry. These variables were compared by ER expression or PR expression. In all subjects, the correlation of these variables with steroid hormone receptor expression in endometrial carcinoma specimens was investigated by univariate regression analysis. Results: Baseline characterics and body fat indices the other than trunk leg ratio did not differ with ER expression. The trunk-leg fat ratio in the ER-positive group (n=35) was significantly higher than that in ERnegative group(n=13)(p<0.05). The trunk-leg fat ratio was significantly correlated with ER receptor expression(p=0.0275), while there was no significant correlation between trunk-leg fat ratio and PR expression. Conclusion: ER expression in endometrial carcinoma specimens may be correlated with body fat distribution rather than overall adiposity.
101
P4.06.03 CYTOKERATIN EXPRESSION SUGGESTING OCCULT METASTASES IN REGIONAL LYMPH NODES OF ENDOMETRIAL CANCER H. M. Shimazu, K. Hiratake, H. Yamada, H. Narumiya, K. Sawaguchi, M. Noguchi, M. Nakanishi, Dept. OBIGYN, Aichi Medical University, Aichi, Japan. Objectives: The clinicopathological significance of cytokeratin expression in lymph nodes unconfirmed metastasis by hematoxylin eosin (H&E) staining was evaluated retrospectively in patients with endometrial carcinoma. Study Methods: We studied 304 pelvic lymph nodes and 46 primary tumors removed from 46 patients with endometrial cancer, consisting of 36 stage I and 10 stage 111~cases. Formalin-fixed paraffin-embedded tissue sections were stained immunohistochemically using antibodies against cytokeratin, CA125, ~53 and macrophage, and also stained with H&E. Results: All of the primary tumors had the cytokeratin expression. In 10 stage 111~cases, the cytokeratin expression in cells other than tumor cells was found in all 13 lymph nodes with metastasis and in 20 (30.3%) of 66 lymph nodes without metastasis. In 36 stage I cases unconfirmed metastases in any lymph nodes, 37 (16.4%) of 225 lymph nodes expressed cytokeratin, and 5 of 14 cases with lymph nodes expressing cytokeratin had recurrent disease in pelvic retroperitoneal cavity, while all 22 cases without those had no recurrence. The cytokeratin was detected on macrophages and on the sites observed CA125 or ~53 expression. In 70 lymph nodes expressed cytokeratin, CA125 was expressed in 56 specimens (80%) and ~53 was expressed in 25 specimens (35.7%) simultaneously. These cytokeratin expressions in regional lymph nodes had a close relationship with a lymph-vascular space involvement in primary tumor, while they had no relation to the grade of histological differentiation and depth of myometrial invasion. Conclusions: Even when metastasis was not detected in sections stained with H&E, the immunohistochemical expression of cytokeratin in regional lymph nodes suggests the presence of occult metastasis to them and is one of the risk factors for recurrence in endometrial cancer.
P4.06.04 CYTOLOGY ASPIRATION STUDY IN ENDOMETRIAL CARCINOMA DIAGNOSIS AND HIGH RISK GROUP PATIENTS DETECTION. E.V. Elnogarr, U.U. Tabakman, A.E. Ivanov, Z.M. Vahturova,A.G. Solopova, Department of Obstetrics and Gynecology, Laboratory of Hemostasis Pathology, Sechenov Moscow Medical Academy, Bolshaya Pirogovskaya St. 216, Moscow, 119881, Russia. Cytology aspiration study is considered the method of first choice in evaluation of pre- and postmenopausal women with anomaly uterine bleeding. We studied 15000 patients with AUB in pre- and postmenopausal period. After cytology aspiration as first line diagnosis approach, histology-aspiration (“Pipelle”) or hysteroscopy were performed for diagnosis verification. Endometrial carcinoma was detected in 1200 cases. Result of cytology aspiration was positive in 60% of cases, questionable in 18% and false negative in 16% of cases. Accuracy of cytology study depended on degree of histological differentiation. In case of high-grade carcinoma positive results reached 48%, questionable 27% and false negative 25%. In case of low-grade carcinoma 81%, 16% and 6% respectively. In 7% of cases cytology aspiration gave false positive results. Following patients in group with false-positive results of cytology aspiration allowed to diagnosed endometrial carcinoma without any clinical manifestations in 18% during 1,5-3,5 years after first evaluation. Cytology aspiration is adequate approach as first line method of endomenrial carcinoma diagnosis. Patients with false-positive results of cytology aspiration represent high risk group for carcinoma development and must be observed carefully.
SEPTEMBER
7
There was a sustained increase in attendance of women for cervical cancer screening form 0.7% to 6% over a 3 months period. This was sustained for 2 months after discontinuation of the program before a decline to 2% was noticed at 6 months. A secondary attempt at reintroduction of health education produced another rise to 8% which remained sustained while health education continued. We concluded that for health education to be effective in developing countries, it must be sustained and intensive to ensure maximum impact.
P4.06 ENDOMETRIUM P4.06.01 CARCINOMA ENDOMETRIUM IS DIAGNOSED BY EXPLORATIVE CURETTAGE OF PHA FOR A PERIOD OF ONE YEAR A. SPangovska, Dept. GYN, Health Center Bit Pazar, Skopje, Macedonia. Objectives: Carcinoma Endometrium is frequent and serious malignant disease of the uterus and its incidence shows significant growth within the last decades. Most frequently it appears in the post menopause period and causes an extensive bleed mg. The purpose of this work is to present how many of the patents, who suffered uterus bleeding, actually had adenocarcinoma endornetrium. Study Methods: The study is a retrospective analysis of one year records from 870 PHA from samples of endometrium, acquired by fractional explorative curettage. Results: Carcinoma endometrium lifts been discovered in the PHA of 86 Adenocarcinoma
in relation to age of the patients:
~
The disease is mostly present in the age group in the age group from 60 to 70 years. The youngest patient has 42 and the oldest 78 years. Conclusions: The high percentage of women with carcinoma endometrium- 9,98%, from those who have suffered extensive bleeding, requires a fractional curettage for acquiring of a PFI verification and diagnosis, as well as for an appropriate treatment.
P4.06.02 CORRELATION BETWEEN BODY FAT DISTRIBUTION AND STEROID HORMONE RECEmOR EXPRESSION IN ENDOMETRIAL CARCINOMA Y.Fuiie, T.Tsuji, T.Douchi, Y.Nagata, Kagoshima University Hospital, 8-35-l Sakuragaoka, Kagoshima, Japan, 890-8520. Objectives: This study investigated whether body fat distribution in postmenopausal women with endometrial carcinoma correlates with steroid hormone receptor expression in endometrial carcinoma specimens. Study Methods: We analyzed estrogen receptor(ER) and progesteron receptor(PR) expression using immunohistochemical methods in formaline-fixed, paraffin embedded endometrial specimens obtained from 48 postmenopausal women with endometrial carcinoma. Baseline characteristics in including age, years since menopause(YSM), weight, height and body mass index(BM1) were recorded for each subject. Four body fat indices [total fat mass(g), percentage of body fat (total fat mass/BW,%),trunk fat mass(g),and the ratio of trunk fat mass to leg fat mass(trunkleg fat ratio)] were measured by dual-energy X-ray absorptiometry. These variables were compared by ER expression or PR expression. In all subjects, the correlation of these variables with steroid hormone receptor expression in endometrial carcinoma specimens was investigated by univariate regression analysis. Results: Baseline characterics and body fat indices the other than trunk leg ratio did not differ with ER expression. The trunk-leg fat ratio in the ER-positive group (n=35) was significantly higher than that in ERnegative group(n=13)(p<0.05). The trunk-leg fat ratio was significantly correlated with ER receptor expression(p=0.0275), while there was no significant correlation between trunk-leg fat ratio and PR expression. Conclusion: ER expression in endometrial carcinoma specimens may be correlated with body fat distribution rather than overall adiposity.
101
P4.06.03 CYTOKERATIN EXPRESSION SUGGESTING OCCULT METASTASES IN REGIONAL LYMPH NODES OF ENDOMETRIAL CANCER H. M. Shimazu, K. Hiratake, H. Yamada, H. Narumiya, K. Sawaguchi, M. Noguchi, M. Nakanishi, Dept. OBIGYN, Aichi Medical University, Aichi, Japan. Objectives: The clinicopathological significance of cytokeratin expression in lymph nodes unconfirmed metastasis by hematoxylin eosin (H&E) staining was evaluated retrospectively in patients with endometrial carcinoma. Study Methods: We studied 304 pelvic lymph nodes and 46 primary tumors removed from 46 patients with endometrial cancer, consisting of 36 stage I and 10 stage 111~cases. Formalin-fixed paraffin-embedded tissue sections were stained immunohistochemically using antibodies against cytokeratin, CA125, ~53 and macrophage, and also stained with H&E. Results: All of the primary tumors had the cytokeratin expression. In 10 stage 111~cases, the cytokeratin expression in cells other than tumor cells was found in all 13 lymph nodes with metastasis and in 20 (30.3%) of 66 lymph nodes without metastasis. In 36 stage I cases unconfirmed metastases in any lymph nodes, 37 (16.4%) of 225 lymph nodes expressed cytokeratin, and 5 of 14 cases with lymph nodes expressing cytokeratin had recurrent disease in pelvic retroperitoneal cavity, while all 22 cases without those had no recurrence. The cytokeratin was detected on macrophages and on the sites observed CA125 or ~53 expression. In 70 lymph nodes expressed cytokeratin, CA125 was expressed in 56 specimens (80%) and ~53 was expressed in 25 specimens (35.7%) simultaneously. These cytokeratin expressions in regional lymph nodes had a close relationship with a lymph-vascular space involvement in primary tumor, while they had no relation to the grade of histological differentiation and depth of myometrial invasion. Conclusions: Even when metastasis was not detected in sections stained with H&E, the immunohistochemical expression of cytokeratin in regional lymph nodes suggests the presence of occult metastasis to them and is one of the risk factors for recurrence in endometrial cancer.
P4.06.04 CYTOLOGY ASPIRATION STUDY IN ENDOMETRIAL CARCINOMA DIAGNOSIS AND HIGH RISK GROUP PATIENTS DETECTION. E.V. Elnogarr, U.U. Tabakman, A.E. Ivanov, Z.M. Vahturova,A.G. Solopova, Department of Obstetrics and Gynecology, Laboratory of Hemostasis Pathology, Sechenov Moscow Medical Academy, Bolshaya Pirogovskaya St. 216, Moscow, 119881, Russia. Cytology aspiration study is considered the method of first choice in evaluation of pre- and postmenopausal women with anomaly uterine bleeding. We studied 15000 patients with AUB in pre- and postmenopausal period. After cytology aspiration as first line diagnosis approach, histology-aspiration (“Pipelle”) or hysteroscopy were performed for diagnosis verification. Endometrial carcinoma was detected in 1200 cases. Result of cytology aspiration was positive in 60% of cases, questionable in 18% and false negative in 16% of cases. Accuracy of cytology study depended on degree of histological differentiation. In case of high-grade carcinoma positive results reached 48%, questionable 27% and false negative 25%. In case of low-grade carcinoma 81%, 16% and 6% respectively. In 7% of cases cytology aspiration gave false positive results. Following patients in group with false-positive results of cytology aspiration allowed to diagnosed endometrial carcinoma without any clinical manifestations in 18% during 1,5-3,5 years after first evaluation. Cytology aspiration is adequate approach as first line method of endomenrial carcinoma diagnosis. Patients with false-positive results of cytology aspiration represent high risk group for carcinoma development and must be observed carefully.