- Email: [email protected]
E7 mRNA expression as possible biomarker in preneoplastic cervical lesions at risk of progression
S696
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
Results: Met staining showed significant differences on analysis of histological subtypes (H(3) = 16.45, p = 0.001), higher in clear cell tumours. There was no association with stage, grade, residual, recurrent disease, or survival (p > 0.05). HGF staining had no statistically significant association with stage, grade, residual or recurrent disease (p > 0.05). Data clearly showed better survival with high HGF scores (H(1) = 4.608, p = 0.034, HR 1.761). High scores conferred a 25 month survival advantage. Phosphorylated met had no association with stage, grade, histological subtype, residual, recurrent disease, or survival (p > 0.05). Neither met, HGF nor p-met were independent prognostic variables (p > 0.05. Conclusions: A functional HGF/met axis was demonstrated in ovarian cancer and high HGF scores conferred a significant survival advantage. These findings warrant further investigation of this pathway as a potential therapeutic target in women with ovarian cancer. P1008 HPV E6/E7 mRNA expression as possible biomarker in preneoplastic cervical lesions at risk of progression A. Frega1 , A. Lukic2 , V. Fabiano3 , M. Mauro3 , M. Giovagnoli3 , M. Moscarini2 , D. French3 . 1 Dipartimento di Ginecologia, Perinatologia e Puericultura, Universita’ Sapienza, Roma, 2 Dipartimento di Ginecologia, Perinatologia e Puericultura, Universita’ Sapienza, Roma, 3 Dipartimento di Patologia, Universita’ Sapienza, Roma Objectives: Several markers are proposed to predict the risk of progression of cervical lesions (p16, HPV DNA HR, etc.). Neoplastic progression of cervical lesions is based on persistent HPV RNA expression, futhermore persistent infection is considered fundamental for progression and mantinance of the neoplastic state. Materials and Methods: We analyzed a total of 164 patients, aged from 20 to 50 years, HPV-HR positive with hytological diagnosis of CIN2− (127) and CIN2+ (37). Identification of E6/E7 mRNA fulllength transcripts from HPV 16, 18, 31, 33, 45 was performed with the Pre Tect HPV-Proofer assay (NorChip AS). Results: Our results indicated that are HPV RNA positive 27% of CIN2− and 73% of CIN 2+. After one year 51 patients (32 CIN2− and 19 CIN2+) underwent follow-up control, 78% of CIN2− HPV RNA – patients regressed to a negative Pap test, whereas only 44% of CIN2− HPV RNA+ regressed. 80% of patients CIN2+ HPV RNA – regressed, whereas only 7% of HPV RNA+ after one year showed a negative cytological diagnosis. Conclusions: We suggest that HR-HPV RNA expression may used in CIN2− lesions to improve sensibility of evaluation of citological diagnosis. This work was partially supported by Faculty projects 2006 and 2007. P1009 Risk factors for compromised surgical margins following LEEP and prevalence of residual lesions after early reintervention and conservative management J. Fregnani, F. Barbieri, M. Vital, M. Vieira, A. Tsunoda, J. Oliveira, M. Alencar. Barretos Cancer Hospital, Brazil Objectives: To assess the risk factors for positive surgical margins (PSM) following the loop electrosurgical excision procedure (LEEP) for treating cervical intraepithelial neoplasia (CIN) and to evaluate the prevalence of residual disease after early reintervention (ER) and conservative management (CM). Methods: This retrospective analysis was performed on women with CIN who were admitted to Barretos Cancer Hospital (Brazil) between 2000 and 2007. Two hundred and forty-two women were selected by means of a simple sampling technique. PSM occurred in 50 women (20.7%). The PSM group was significantly older (44 vs. 35 yo; P = 0.001). Age and extent in the endocervical gland (EEG)
were independent risk factors for PSM in the logistic regression: age 35–44 yo (OR = 1.8 P = 0.229), 45–54 yo (OR = 4.9 P = 0.003), ≥55 yo (OR = 6.3 P = 0.003) and EEG (OR = 11.6 P < 0.001). Among the women with PSM, 28 (56%) underwent ER (24 hysterectomies + 4 additional LEEP) and 22 underwent CM (44%). Prevalence rates of residual lesion were statistically different between the groups: ER = 53.6% and CM = 13.6% (P = 0.003). Residual lesions were found in 15 of the women who underwent ER: 13 had HSIL and 2 had invasive cancer. In the CM group with PSM, delayed hysterectomy was necessary in 3 cases: 1 case had HSIL and 2 had invasive cancer. Conclusion: Age and EEG were risk factors for PSM. ER following PSM detection gave rise to a high residual tumor rate. On the other hand, patients with CM had a lower rate. P1010 A case of primary uterine atypical polypoid adenomyoma (APA) recurring after pregnancy and delivery S. Fujita, Y. Oka, T. Waseda, R. Mosfeque, R. Fujii, S. Makinoda. Kanazawa Medical University Obstetrics and Gynecology Objectives: Only 100 cases of uterine atypical polypoid adenomyoma (APA) have been documented since Mazur’s first report in 1981. Many APA were misdiagnosed as uterine endometrial cancer or cervical adenocarcinoma and many young patients were forced to receive hysterectomy. Thefore, it is worth to demonstrate a case who deliver the child and recurred after pregnancy. Materials and Methods: The patient is a 22-year-old Japanese woman (G = 0). In Oct. 2003, she experienced irregular vaginal bleeding and consulted a physician. Bloody discharge and a cervical polyp were observed and polyp was histopathologically diagnosed as a Grade I cervical adenocarcinoma. The patient was referred to our hospital. Transvaginal ultrasound confirmed a 20 mm mass, and a biopsy was highly suggestive of APA of low malignant potential (APA-LMP). Results: The patient was monitored on an outpatient basis due to localization of tumor and our pathologic diagnosis. At the same time, we strongly recommended to conceive as early as possible. She became pregnant with a LMP of 10/12/2003. The pregnancy continued almost uneventfully, and the patient vaginally delivered a girl weighing 3894 g in the 41st week of gestation. The follow up was performed after delivery and recurrence of APA was diagnosed in Oct. 2007. After careful consideration with the patient, total hysterectomy was performed. At present, she is uneventful and followed up every 6 month. Conclusions: Even diagnosed uterine endometrial cancer or cervical adenocarcinoma, the possibility of APA must be considered to keep fertility in young patients. P1011 Expression of p21Cip1/Waf1 and p27Kip1 in small cell neuroendocrine carcinoma of the uterine cervix K. Fujiwara1 , T. Kataoka2 , A. Miyake3 , S. Kamiura1 , Y. Nishizawa4 . 1 Department of Gynecology, Osaka medical center for cancer and cardiovascular diseases, 2 Laboratory of Allergic Diseases, National Institutes of Allergy and Infectious Diseases National Institues of Health, 3 Department of Obstetrics and Gynecology, Osaka University, Graduate school of Medicine, Faculty of Medicine, 4 Research Institute, Osaka medical center for cancer and cardiovascular diseases Objectives: Small-cell neuroendocrine carcinoma of the uterine cervix (SCCC), a rare cervical neoplasm, has a highly aggressive phenotype that requires more intensive treatment than other cervical tumors. Loss of p21 and p27, cell cycle regulators, has been observed in many types of cancer, but the status of these proteins has not been determined in SCCC. In this study, we examined the expression of p21 and p27 in SCCC and compared with squamous cell carcinoma.
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
Results: Met staining showed significant differences on analysis of histological subtypes (H(3) = 16.45, p = 0.001), higher in clear cell tumours. There was no association with stage, grade, residual, recurrent disease, or survival (p > 0.05). HGF staining had no statistically significant association with stage, grade, residual or recurrent disease (p > 0.05). Data clearly showed better survival with high HGF scores (H(1) = 4.608, p = 0.034, HR 1.761). High scores conferred a 25 month survival advantage. Phosphorylated met had no association with stage, grade, histological subtype, residual, recurrent disease, or survival (p > 0.05). Neither met, HGF nor p-met were independent prognostic variables (p > 0.05. Conclusions: A functional HGF/met axis was demonstrated in ovarian cancer and high HGF scores conferred a significant survival advantage. These findings warrant further investigation of this pathway as a potential therapeutic target in women with ovarian cancer. P1008 HPV E6/E7 mRNA expression as possible biomarker in preneoplastic cervical lesions at risk of progression A. Frega1 , A. Lukic2 , V. Fabiano3 , M. Mauro3 , M. Giovagnoli3 , M. Moscarini2 , D. French3 . 1 Dipartimento di Ginecologia, Perinatologia e Puericultura, Universita’ Sapienza, Roma, 2 Dipartimento di Ginecologia, Perinatologia e Puericultura, Universita’ Sapienza, Roma, 3 Dipartimento di Patologia, Universita’ Sapienza, Roma Objectives: Several markers are proposed to predict the risk of progression of cervical lesions (p16, HPV DNA HR, etc.). Neoplastic progression of cervical lesions is based on persistent HPV RNA expression, futhermore persistent infection is considered fundamental for progression and mantinance of the neoplastic state. Materials and Methods: We analyzed a total of 164 patients, aged from 20 to 50 years, HPV-HR positive with hytological diagnosis of CIN2− (127) and CIN2+ (37). Identification of E6/E7 mRNA fulllength transcripts from HPV 16, 18, 31, 33, 45 was performed with the Pre Tect HPV-Proofer assay (NorChip AS). Results: Our results indicated that are HPV RNA positive 27% of CIN2− and 73% of CIN 2+. After one year 51 patients (32 CIN2− and 19 CIN2+) underwent follow-up control, 78% of CIN2− HPV RNA – patients regressed to a negative Pap test, whereas only 44% of CIN2− HPV RNA+ regressed. 80% of patients CIN2+ HPV RNA – regressed, whereas only 7% of HPV RNA+ after one year showed a negative cytological diagnosis. Conclusions: We suggest that HR-HPV RNA expression may used in CIN2− lesions to improve sensibility of evaluation of citological diagnosis. This work was partially supported by Faculty projects 2006 and 2007. P1009 Risk factors for compromised surgical margins following LEEP and prevalence of residual lesions after early reintervention and conservative management J. Fregnani, F. Barbieri, M. Vital, M. Vieira, A. Tsunoda, J. Oliveira, M. Alencar. Barretos Cancer Hospital, Brazil Objectives: To assess the risk factors for positive surgical margins (PSM) following the loop electrosurgical excision procedure (LEEP) for treating cervical intraepithelial neoplasia (CIN) and to evaluate the prevalence of residual disease after early reintervention (ER) and conservative management (CM). Methods: This retrospective analysis was performed on women with CIN who were admitted to Barretos Cancer Hospital (Brazil) between 2000 and 2007. Two hundred and forty-two women were selected by means of a simple sampling technique. PSM occurred in 50 women (20.7%). The PSM group was significantly older (44 vs. 35 yo; P = 0.001). Age and extent in the endocervical gland (EEG)
were independent risk factors for PSM in the logistic regression: age 35–44 yo (OR = 1.8 P = 0.229), 45–54 yo (OR = 4.9 P = 0.003), ≥55 yo (OR = 6.3 P = 0.003) and EEG (OR = 11.6 P < 0.001). Among the women with PSM, 28 (56%) underwent ER (24 hysterectomies + 4 additional LEEP) and 22 underwent CM (44%). Prevalence rates of residual lesion were statistically different between the groups: ER = 53.6% and CM = 13.6% (P = 0.003). Residual lesions were found in 15 of the women who underwent ER: 13 had HSIL and 2 had invasive cancer. In the CM group with PSM, delayed hysterectomy was necessary in 3 cases: 1 case had HSIL and 2 had invasive cancer. Conclusion: Age and EEG were risk factors for PSM. ER following PSM detection gave rise to a high residual tumor rate. On the other hand, patients with CM had a lower rate. P1010 A case of primary uterine atypical polypoid adenomyoma (APA) recurring after pregnancy and delivery S. Fujita, Y. Oka, T. Waseda, R. Mosfeque, R. Fujii, S. Makinoda. Kanazawa Medical University Obstetrics and Gynecology Objectives: Only 100 cases of uterine atypical polypoid adenomyoma (APA) have been documented since Mazur’s first report in 1981. Many APA were misdiagnosed as uterine endometrial cancer or cervical adenocarcinoma and many young patients were forced to receive hysterectomy. Thefore, it is worth to demonstrate a case who deliver the child and recurred after pregnancy. Materials and Methods: The patient is a 22-year-old Japanese woman (G = 0). In Oct. 2003, she experienced irregular vaginal bleeding and consulted a physician. Bloody discharge and a cervical polyp were observed and polyp was histopathologically diagnosed as a Grade I cervical adenocarcinoma. The patient was referred to our hospital. Transvaginal ultrasound confirmed a 20 mm mass, and a biopsy was highly suggestive of APA of low malignant potential (APA-LMP). Results: The patient was monitored on an outpatient basis due to localization of tumor and our pathologic diagnosis. At the same time, we strongly recommended to conceive as early as possible. She became pregnant with a LMP of 10/12/2003. The pregnancy continued almost uneventfully, and the patient vaginally delivered a girl weighing 3894 g in the 41st week of gestation. The follow up was performed after delivery and recurrence of APA was diagnosed in Oct. 2007. After careful consideration with the patient, total hysterectomy was performed. At present, she is uneventful and followed up every 6 month. Conclusions: Even diagnosed uterine endometrial cancer or cervical adenocarcinoma, the possibility of APA must be considered to keep fertility in young patients. P1011 Expression of p21Cip1/Waf1 and p27Kip1 in small cell neuroendocrine carcinoma of the uterine cervix K. Fujiwara1 , T. Kataoka2 , A. Miyake3 , S. Kamiura1 , Y. Nishizawa4 . 1 Department of Gynecology, Osaka medical center for cancer and cardiovascular diseases, 2 Laboratory of Allergic Diseases, National Institutes of Allergy and Infectious Diseases National Institues of Health, 3 Department of Obstetrics and Gynecology, Osaka University, Graduate school of Medicine, Faculty of Medicine, 4 Research Institute, Osaka medical center for cancer and cardiovascular diseases Objectives: Small-cell neuroendocrine carcinoma of the uterine cervix (SCCC), a rare cervical neoplasm, has a highly aggressive phenotype that requires more intensive treatment than other cervical tumors. Loss of p21 and p27, cell cycle regulators, has been observed in many types of cancer, but the status of these proteins has not been determined in SCCC. In this study, we examined the expression of p21 and p27 in SCCC and compared with squamous cell carcinoma.