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Pelvic masses in obese women
Pelvic Masses in Obese Women Jason D. Wright, MD Washington University, St. Louis, MO
Matthew A. Powell, MD, Randall K. Gibb, MD, David G. Mutch, MD, Janet S. Rader, MD, and Thomas J. Herzog, MD OBJECTIVE: Although obesity complicates the evaluation and treatment of pelvic masses in women, the influence of obesity on the type of ovarian neoplasms remains uncertain. We investigated obesity among women presenting with pelvic masses. METHODS: A review of patients diagnosed with a pelvic mass between 1996 and 2002 was performed. Clinical and pathologic information was reviewed. Women were stratified as obese, overweight, and normal weight based upon body mass index (BMI). Appropriate statistical analyses were performed. RESULTS: Follow-up was available on 668 patients of the 1096 identified. Overall, 248 (37%) were classified as obese, 176 (26%) overweight, and 244 (37%) normal. Benign neoplasms (epithelial, germ cell, and stromal) were found in 24% of the obese, 25% of the overweight, and 20% of the normal weight women (NS). Benign cystic neoplasms were more common in the obese women (73% versus 48%) (P ⫽ .01). Normal weight women were more likely to have benign solid neoplasms than obese women (21% versus 5%) (P ⫽ .017). Neoplasm size was similar among the groups. Borderline tumors were more common in obese than in normal weight women (11% versus 6%) (P ⫽ .049). Women in the normal weight group were more commonly found to have invasive ovarian tumors (35%) than women in the overweight (24%) and obese groups (26%) (P ⫽ .02). CONCLUSIONS: Significant differences exist in the types of ovarian neoplasms among women with different BMIs. Cystic neoplasms and borderline tumors were more common in obese women. Thus, body mass index may be an important factor in preoperative counseling and risk assessment.
tive of this study was to determine the levels of AT and AT quinine (ATQ), the oxidized product of AT, in plasma and red blood cells (RBCs) obtained from patients with cervical intraepithelial neoplasia (CIN) and cervical cancer. RBC AT levels reflect membrane AT concentrations, and altered levels may suggest membrane damage. METHODS: Seventy-two women with various cervical histological diagnoses were studied. AT and ATQ levels were determined in RBCs and plasma by high-pressure liquid chromatography. RESULTS: Table 1. data: mean ⫾ SD; P value by one-way ANOVA using the SAS system (SAS Institute Inc., Cary, NC). There was a significant decrease with a quadratic trend (concave upward curve; U-shaped pattern) for plasma AT levels among the groups. RBC levels of AT and ATQ were not significantly altered. Table 1. Group
Control (n)
CIN (n)
Cervical cancer (n)
P
Plasma AT 8.41 ⫾ 3.4 (21) 6.67 ⫾ 1.7 (37) 8.61 ⫾ 4.0 (14) .026 (mg/L) 0.16 ⫾ 0.09 (16) 0.15 ⫾ 0.08 (34) 0.14 ⫾ 0.1 (14) .640 RBC AT (g/mg protein) 0.06 ⫾ 0.06 (15) 0.04 ⫾ 0.04 (28) 0.03 ⫾ 0.02 (14) .133 RBC ATQ (g/mg protein)
CONCLUSIONS: Lower AT levels observed in this study are consistent with previous reports of decreased antioxidant concentrations and increased oxidative stress in women with CIN. Unaltered RBC AT and ATQ levels suggest undamaged cell membrane. Further studies are needed to investigate the potential role of oxidative stress in CIN.
Cold Knife Cone Superior to Loop Electrosurgical Excision Procedure for Conservative Management of Cervical Adenocarcinoma In Situ
␣-Tocopherol and ␣-Tocopherol Quinone Levels in Cervical Intraepithelial Neoplasia and Cervical Cancer
Karen Purcell, MD, PhD
Prabhudas R. Palan, PhD
OBJECTIVE: To assess surgicopathologic predictors of residual disease after conization for adenocarcinoma in situ (ACIS). METHODS: Patients who underwent conization for ACIS between 1996 and 2001 were identified through pathology databases. Cases followed by a second surgery or at least 2 years of serial cervical cytology were included. Variables assessed as predictors of residual disease (ACIS or invasive adenocarcinoma) included conization procedure, cone dimensions, margin status and lesion proximity, lesion size, focality, number of
Bronx-Lebanon Hospital Center/Albert Einstein College of Medicine, Bronx, NY
Angela L. Woodall, MD, Patrick Anderson, MD, and Magdy S. Mikhail, MD OBJECTIVE: ␣-tocopherol (AT) is a potent antioxidant that protects cell membranes against oxidative damage. The objec-
104S
WEDNESDAY POSTERS
UCLA Medical Center, Los Angeles, CA
Ilana Cass, Sathima Natarajan, Farnaz Dadmanesh, Chisa Aoyama, and Christine H. Holschneider
OBSTETRICS & GYNECOLOGY
Matthew A. Powell, MD, Randall K. Gibb, MD, David G. Mutch, MD, Janet S. Rader, MD, and Thomas J. Herzog, MD OBJECTIVE: Although obesity complicates the evaluation and treatment of pelvic masses in women, the influence of obesity on the type of ovarian neoplasms remains uncertain. We investigated obesity among women presenting with pelvic masses. METHODS: A review of patients diagnosed with a pelvic mass between 1996 and 2002 was performed. Clinical and pathologic information was reviewed. Women were stratified as obese, overweight, and normal weight based upon body mass index (BMI). Appropriate statistical analyses were performed. RESULTS: Follow-up was available on 668 patients of the 1096 identified. Overall, 248 (37%) were classified as obese, 176 (26%) overweight, and 244 (37%) normal. Benign neoplasms (epithelial, germ cell, and stromal) were found in 24% of the obese, 25% of the overweight, and 20% of the normal weight women (NS). Benign cystic neoplasms were more common in the obese women (73% versus 48%) (P ⫽ .01). Normal weight women were more likely to have benign solid neoplasms than obese women (21% versus 5%) (P ⫽ .017). Neoplasm size was similar among the groups. Borderline tumors were more common in obese than in normal weight women (11% versus 6%) (P ⫽ .049). Women in the normal weight group were more commonly found to have invasive ovarian tumors (35%) than women in the overweight (24%) and obese groups (26%) (P ⫽ .02). CONCLUSIONS: Significant differences exist in the types of ovarian neoplasms among women with different BMIs. Cystic neoplasms and borderline tumors were more common in obese women. Thus, body mass index may be an important factor in preoperative counseling and risk assessment.
tive of this study was to determine the levels of AT and AT quinine (ATQ), the oxidized product of AT, in plasma and red blood cells (RBCs) obtained from patients with cervical intraepithelial neoplasia (CIN) and cervical cancer. RBC AT levels reflect membrane AT concentrations, and altered levels may suggest membrane damage. METHODS: Seventy-two women with various cervical histological diagnoses were studied. AT and ATQ levels were determined in RBCs and plasma by high-pressure liquid chromatography. RESULTS: Table 1. data: mean ⫾ SD; P value by one-way ANOVA using the SAS system (SAS Institute Inc., Cary, NC). There was a significant decrease with a quadratic trend (concave upward curve; U-shaped pattern) for plasma AT levels among the groups. RBC levels of AT and ATQ were not significantly altered. Table 1. Group
Control (n)
CIN (n)
Cervical cancer (n)
P
Plasma AT 8.41 ⫾ 3.4 (21) 6.67 ⫾ 1.7 (37) 8.61 ⫾ 4.0 (14) .026 (mg/L) 0.16 ⫾ 0.09 (16) 0.15 ⫾ 0.08 (34) 0.14 ⫾ 0.1 (14) .640 RBC AT (g/mg protein) 0.06 ⫾ 0.06 (15) 0.04 ⫾ 0.04 (28) 0.03 ⫾ 0.02 (14) .133 RBC ATQ (g/mg protein)
CONCLUSIONS: Lower AT levels observed in this study are consistent with previous reports of decreased antioxidant concentrations and increased oxidative stress in women with CIN. Unaltered RBC AT and ATQ levels suggest undamaged cell membrane. Further studies are needed to investigate the potential role of oxidative stress in CIN.
Cold Knife Cone Superior to Loop Electrosurgical Excision Procedure for Conservative Management of Cervical Adenocarcinoma In Situ
␣-Tocopherol and ␣-Tocopherol Quinone Levels in Cervical Intraepithelial Neoplasia and Cervical Cancer
Karen Purcell, MD, PhD
Prabhudas R. Palan, PhD
OBJECTIVE: To assess surgicopathologic predictors of residual disease after conization for adenocarcinoma in situ (ACIS). METHODS: Patients who underwent conization for ACIS between 1996 and 2001 were identified through pathology databases. Cases followed by a second surgery or at least 2 years of serial cervical cytology were included. Variables assessed as predictors of residual disease (ACIS or invasive adenocarcinoma) included conization procedure, cone dimensions, margin status and lesion proximity, lesion size, focality, number of
Bronx-Lebanon Hospital Center/Albert Einstein College of Medicine, Bronx, NY
Angela L. Woodall, MD, Patrick Anderson, MD, and Magdy S. Mikhail, MD OBJECTIVE: ␣-tocopherol (AT) is a potent antioxidant that protects cell membranes against oxidative damage. The objec-
104S
WEDNESDAY POSTERS
UCLA Medical Center, Los Angeles, CA
Ilana Cass, Sathima Natarajan, Farnaz Dadmanesh, Chisa Aoyama, and Christine H. Holschneider
OBSTETRICS & GYNECOLOGY