A rapid prognostic electrophoretic assay for serum lipid conjugates in carcinoma uterine cervix and breast

The levels of cholesterol and lipid associated sialic acid in sera of patients with carcinoma uterine cervix and breast cancer were determined using agarose electrophoresis and precipitation method. Elevated level of lipid associated sialic acid was found, that was specifically reflected only in LDL and VLDL fractions. In carcinoma uterine cervix patients, cholesterol in low density lipoprotein increased with corresponding decrease in high density lipoprotein and there was no change in total as well as VLDL cholesterol content. But breast cancer patients were found to have higher concentrations of both total and high density lipoprotein cholesterol. A good positive correlation was found between electrophoresis and precipitation methods for the lipoprotein analysis. We recommend electrophoretic method for rapid routine analysis.     

Psammoma bodies in neuroendocrine carcinoma of the uterine cervix

A case of neuroendocrine carcinoma of the uterine cervix with focal papillary clusters and psammoma bodies, features not previously seen in this tumor, is documented. Papanicolaou-stained cervicovaginal smears and pelvic washings are correlated with tissue sections of endocervical curettage, hysterectomy and cul-de-sac biopsy specimens. Although there was some variation in the cytologic features, the tumor cells were generally distinguished by nuclear molding, indistinct nucleoli, finely granular chromatin and scant cytoplasm. Argyrophil-positive intracytoplasmic granules were identified in tissue sections of the tumor. These granules were positive for ACTH and neuron-specific enolase using the immunoperoxidase technique. Ultrastructural studies were consistent with these findings. Neuroendocrine carcinoma of the cervix is therefore a cytologically distinctive tumor in which psammoma bodies may occur.     

Cytology of microinvasive squamous-cell carcinoma of the uterine cervix

The cervical cytology in 53 cases with histologically confirmed microinvasive squamous-cell carcinoma of the uterine cervix was studied. The smears were originally correctly diagnosed as showing microinvasion in 42% of the cases and were underinterpreted in 45%. On review, four of the underdiagnosed smears did show features of microinvasion. The depth of invasion did not have much influence on the cellular features. The patients underdiagnosed by cytology showed a tendency to have a smaller surface lesion and to have a history of a prior cervical manipulation within four weeks of the cytologic examination. The mean age of the overdiagnosed cases was distinctly higher than that of other cases. The colposcopic diagnosis correlated well with the cytologic diagnosis; both diagnostic modalities were considered to reflect well the change within the surface epithelium but to be less sensitive in recognizing the subtle changes of early invasion.     

Tumor volume estimation by the percentage carcinoma method in uterine cervix carcinoma

OBJECTIVE: To assess the capacity of the percentage carcinoma method to predict tumor volume in cervical carcinoma and generate a mathematical equation for calculation of tumor volume. STUDY DESIGN: Thirteen radical hysterectomy specimens were studied. The actual tumor volume was assessed by stereology. A factor was generated by the formula tumor volume = factor x percentage carcinoma x number of blocks. The percentage carcinoma was calculated by the grid method. Then tumor volume was estimated by the same formula. The relationship between actual and estimated tumor volumes was analyzed by Spearman's correlation. RESULTS: Correlation of the tumor volumes assessed by the two methods was excellent (r = .945) and statistically significant (P = .01). CONCLUSION: Percentage carcinoma assessed by the grid ratio method is highly predictive of tumor volume, but care must be taken not to overstate the importance of our results due to the small number of patients. The prediction of outcome in cervical carcinoma by means of percentage carcinoma should be evaluated in large clinical studies.     

Previous cytology in patients with invasive carcinoma of the cervix

The cytologic history of 346 patients presenting with invasive carcinoma of the cervix was reviewed. A total of 74 patients (21%) reported that cervical cytology had been performed in the five years prior to presentation; confirmation of the cytologic history was obtained in 65 cases. Smears were available for review in 34 cases; of 28 smears originally reported as negative, 20 were found to be abnormal on review. The possible reasons for the failure of cytologic detection in these patients are discussed.     

The prognostic significance of the DNA distribution in squamous-cell carcinomas of the uterine cervix

To establish the prognostic parameters of DNA distributions of squamous-cell carcinomas of the uterine cervix, cervical smears from 30 patients were examined cytomorphometrically ten years after the diagnosis had been made. Most of the patients had stage II cervical carcinomas that had been treated with primary combined irradiation. In the DNA histograms, the position of the stemline proved to be the prognostically significant factor. All of the patients with diploid or euploid-polyploid stemlines were still alive after ten years while only 17.6% of those with aneuploid stemlines have survived. No correlation between the ten-year survival rate and the proliferation rate of the tumors could be established.     

Treatment of carcinoma of the uterine cervix; a commentary on current methods

Cancer detection examinations by physicians in their private offices were performed as a county medical society project for a period of one year.In a series of 6,765 patients examined, approximately 600 were found to have lesions clinically suspect for tumor. The total number of proven cancers discovered was 280 and the number of lesions classified as precancerous was 87. This percentage of tumors discovered compares favorably with reports from special cancer detection centers formerly utilized in other parts of the country. The Cancer Commission believes that periodic health examinations of persons over the age of 40 in the offices of private physicians is a practical approach to the problem of earlier detection of tumors at accessible sites-the tumors that are the most readily curable by current surgical and radiotherapeutic techniques.     

Pemphigus vulgaris and microinvasive squamous-cell carcinoma of the uterine cervix

Although patients with disseminated pemphigus vulgaris may have involvement of the uterine cervix, such involvement is often detected only after vaginal discharge or bleeding. When a cervical smear is obtained, distinctive cytologic abnormalities may be observed; these may be attributed to the changes of pemphigus or to an associated reparative/inflammatory reaction. This study documents the first two cases of microinvasive squamous-cell carcinoma of the uterine cervix developing in association with uterine cervical pemphigus. The gross pathologic, cytologic and histologic features of these lesions are illustrated. The cytologic criteria that may be helpful in distinguishing between cells derived from microinvasive squamous-cell carcinoma and pemphigus of the uterine cervix are described.     

Adenoid cystic carcinoma of the uterine cervix. Cytologic features

A case of primary cervical adenoid cystic carcinoma in a 75-year-old woman is reported. Two cervical smears taken at the time of initial presentation for vaginal spotting were negative; a third smear, taken a year later prior to laparotomy, was diagnosed as positive. The cytologic findings in the positive cervical smear are described and illustrated. The differential diagnosis of the cytologic findings is discussed, and the literature on this lesion is briefly reviewed. The results in this case and others suggest that the diagnosis of cervical adenoid cystic carcinoma in an asymptomatic patient may be missed by routine smear examination.     

Verrucous carcinoma of the uterine cervix. A case report

The cytohistopathologic features of a verrucous cervical carcinoma are reported. The presence in a cervical smear of two distinct types of dyskaryotic cells, with regularity of size and shape, and of occasional vacuolated cells set in a bright, eosinophilic background should suggest the lesion. With the cytologic suggestion and the typical warty clinical appearance of the tumor, an accurate preoperative diagnosis may be established.     

Tissue expression of VEGF as a prognostic factor in early cervical squamous cell carcinoma

The purpose of this retrospective study was to determine whether the intensity of tumor angiogenesis, expressed as microvessel density (MD), is indeed an important parameter predicting lymph node metastasis and survival rate in 73 women operated on for early invasive squamous cell carcinoma of the uterine cervix in stages Ib and IIa (FIGO). Angiogenesis was quantified by light microscope (LM) using an assay for vascular endothelial growth factor (VEGF). In the study, differences were revealed by comparing the MD between both groups. The patient survival with high MD was significantly worse than for those with low MD (p<0.01). A correlation was found between MD and the incidence of lymph node metastases. Hence, quantitative analysis of MD used as the expression of VEGF in the each cervical squamous cell carcinomas could be useful as a significant prognostic indicator.     

Chromogranin A (CgA) as poor prognostic factor in patients with small cell carcinoma of the cervix: results of a retrospective study of 293 patients

Background

Small cell carcinoma of the cervix (SCCC) is a very rare tumor. Due to its rarity and the long time period, there is a paucity of information pertaining to prognostic factors associated with survival. The objective of this study was to determine whether clinicopathologic finings or immunohistochemical presence of molecular markers predictive of clinical outcome in patients with SCCC.

Methodology and Findings

We retrospectively reviewed a total of 293 patients with SCCC (47 patients from Cancer Center of Sun Yat-sen University in china, 71 patients from case report of china journal, 175 patients from case report in PubMed database). Of those 293 patients with SCCC, the median survival time is 23 months. The 3-year overall survival rates (OS) and 3-year disease-free survival rates (DFS) for all patients were 34.5% and 31.1%, respectively. Univariate and multivariate analysis showed that FIGO stage (IIb–IV VS I–IIa, Hazard Ratio (HR) = 3.08, 95% confidence interval (CI) of ratio = [2.05, 4.63], P<0.001), tumor mass size (≥4 cm VS <4 cm, HR = 2.37, 95% CI = [1.28, 4.36], P = 0.006) and chromogranin A (CgA) (Positive VS Negative, HR = 1.81, 95% CI = [1.12, 2.91], P = 0.015) were predictive of poor prognosis. CgA stained positive was found to be highly predictive of death in early-stage (FIGO I–IIa) patient specifically.

Conclusions

Patients with SCCC have poor prognosis. FIGO stage, tumor mass size and CgA stained positive may act as a surrogate for factors prognostic of survival. CgA may serve as a useful marker in prognostic evaluation for early-stage patients with SCCC.