Atypical polypoid adenomyomas of the uterus

We performed a clinicopathological immunohistochemical, ultrastructural, and flow cytometric study on six cases of atypical polypoid adenomyoma of the uterus including one with an adenocarcinoma within it. The tumours occurred in nulliparous women aged 22–48 years (average, 33.0 years); three arose in the uterine corpus, and three in the endocervix. Histologically, they were composed of endometrial glands admixed with a stromal component of interlacing bundles of smooth muscle cells. The glands exhibited varying degrees of architectural and cytological atypia. Most of the stromal cells showed strong staining for HHF35, alpha-smooth muscle actin, and vimentin, and some cells contained desmin. Electronmicroscopy, in one case, confirmed the presence of a well-differentiated smooth muscle component. The stromal component may arise as a result of extensive metaplasia of endometrial stromal cells. Uninvolved endometrium showed ciliated cell metaplasia in three patients, and atypical complex hyperplasia in two. One patient had a well-differentiated adenocarcinoma of endometrioid type arising in an endocervical atypical polypoid adenomyoma. All tumours had a diploid DNA content and relatively small S phase fraction (average, 6.23%). The follow-up periods ranged from 4 to 42 months (average, 13.5 months), and all patients were alive and well. Although the histogenesis of atypical polypoid adenomyoma of the uterus remains uncertain, it is suggested that it may arise because of oestrogen-related factors.     

靶向ANG-2的shRNA重组载体抑制人子宫内膜癌Ishikawa生长和侵袭的研究

目的 探讨采用RNA干扰(RNA interference,RNAi)抑制血管生成素-2(angiopoietin-2,ANC-2)基因的表达对人子宫内膜癌细胞Ishikawa细胞的影响.方法 采用脂质体LipofectamineTM 2000介导的方法将针对ANG-2基因的短发卡状RNA(short hairpin RNA,ahRNA)表达载体转染到人子宫内膜癌Ishikawa细胞中,逆转录聚合酶链反应及Western印迹法检测ANG-2 mRNA及蛋白的表达;噻唑蓝比色法检测Ishikawa细胞的增殖;荧光显微镜观察细胞形态;流式细胞仪检测细胞周期及凋亡;侵袭实验检测其对侵袭能力的影响.结果 人子宫内膜癌Ishikawa细胞ANG-2 mRNA及其蛋白质表达水平均显著降低;增殖被抑制,抑制率63.11%;细胞凋亡增加,细胞凋亡率与空白对照组和阴性对照组相比明显增高;细胞生长减慢,阻滞于G1期的增多,S期细胞减少;侵袭能力明显下降.结论 靶向ANG-2的shRNA能成功下调ANG-2基因的表达,抑制人子宫内膜癌Ishikawa细胞生长和侵袭.     

Cervicovaginal (Papanicolaou) smear findings in patients with malignant mixed Müllerian tumors

Malignant mixed Müllerian tumor is a rare neoplasm that occurs most frequently in elderly patients. It is characterized by a mixture of malignant epithelial and sarcomatous components. Little has been published about Papanicolaou smear findings pertaining to malignant mixed Müllerian tumors. We present our experience, with an emphasis on cytologic detail. Nine patients (median age, 65 yr) met our study criteria. All available smears and surgical specimens were reviewed. Four smears were positive for malignancy, with a sensitivity of 44% (3 adenocarcinoma, and 1 squamous-cell carcinoma, small-cell type). The results of our study showed that Papanicolaou smear findings pertaining to malignant mixed Müllerian tumors are seen in patients with advanced-stage disease with involvement of the lower uterine segment or cervix. The usual finding is large numbers of high-grade epithelial malignant cells in a necrotic background. The mesenchymal component rarely sheds cells visible on Papanicolaou smear.     

子宫内膜不典型息肉状腺肌瘤5例临床病理分析

目的探讨子宫内膜不典型息肉状腺肌瘤(atypical polypoid adenomyomas,APA)的临床与病理学特点。方法分析5例APA的临床资料、病理学形态、免疫组化标记及4例随访资料。结果5例APA中,1例合并子宫内膜样腺癌,1例局部分布分化良好的腺癌成分;免疫组化显示:间质SMA( ),desmin( )或局部( ),vimentin局部( )或(-);腺上皮ER、PR均( );p53、Ki-67(-)。随访的4例患者均健在(3~60个月)。结论APA需与高分化的子宫内膜样腺癌鉴别,后者可与APA并存,或起源于子宫内膜不典型息肉状腺肌瘤,具有低恶性潜能和潜在的复发性,长期随访十分必要。     

Nuclear and cytoplasmic bcl-2 expression in endometrial hyperplasia and adenocarcinoma

The bcl-2 proto-oncogene, which inhibits programmed cell death (apoptosis), has recently been found to be cyclically expressed in human endometrium. In order to investigate its role in endometrial hyperlasia and neoplasia, bcl-2 expression was studied in 25 cases of endometrial carcinoma and 20 cases of endometrial hyperplasia (eight simple, two complex, and ten atypical hyperplasias). Uniform intense cytoplasmic bcl-2 expression was found in all cases of non-atypical hyperplasia, and less strong positivity in eight out of ten cases of atypical hyperplasia. In well-differentiated carcinomas, nine out of ten showed weak to moderate bcl-2 expression, whereas six out of seven poorly differentiated carcinomas were bcl-2-negative. Moderately differentiated tumours were an intermediate group, with six out of eight being positive. Widespread localization of bcl-2 protein to the chromosomes of dividing cells was also demonstrated, regardless of cytoplasmic bcl-2 expression, with rare staining of interphase nuclei. Our findings suggest a role for bcl-2 in the natural history of endometrial neoplasia and studies are needed to determine its usefulness as a prognostic marker. The finding of bcl-2 localization to chromosomes has important implications for its mode and site of action.     

Hypothalamic knife cuts dissociate maternal behaviors, sexual receptivity, and estrous cyclicity in female hamsters

Female hamsters were tested for their response to pups as virgins, then received sagittal cuts either lateral to the medial preoptic area-medial anterior hypothalamus (anterior cuts) or lateral to the medial anterior hypothalamus-ventromedial nucleus (posterior cuts). Postoperatively females were tested: (a) as virgins, for changes in pup retrieval and cannibalism, (b) for mating behavior, (c) for maternal care and cannibalism of their own pups, and (d) for object hoarding. Anterior cuts converted retrieving virgins to cannibalistic ones and reduced nest builing. All females with anterior cuts cannibalized their litters within a few days of parturition. Half of these females did retrieve pups in home cage tests during the first 3 days postpartum. However, unlike controls, when tested in a neutral arena 5–6 weeks later, no pup retrieval was seen, although most would hoard objects. In contrast, posterior cuts reduced pup retrieval and cannibalism in virgins, and disrupted object hoarding. These cuts did not reduce postpartum pup retrieval, but did reduce postpartum cannibalism. Anterior cuts did not reduce sexual receptivity; posterior cuts reduced sexual receptivity without eliminating ovulation. Anterior cuts are interpreted as having a somewhat selective effect of reducing maternal responsiveness by cutting the lateral connections of neurons in the medial anterior hypothalamus and adjacent medial preoptic area, while posterior cuts disrupt sexual receptivity by cutting lateral connections of the ventromedial hypothalamus which travel in the region of the supraoptic commissures     

Facilitation of lordosis behavior in rats by social isolation: Adrenal mediation

Ovariectomized rats were housed either singly or in groups of three, with housing density kept constant. Subcutaneous injections of 0.8 μg estradiol benzoate (EB) were administered daily, beginning 6 days after surgery. The first two experiments provided evidence that isolation facilitated lordosis within 3 days of initial EB administration. Other behavioral components of female sexual receptivity were not affected. The third experiment involved comparison of the effects of isolation in ovariectomized and adrenalectomized-ovariectomized rats. Isolation again significantly facilitated lordosis in ovariectomized rats but no such trend was apparent in adrenalectomized rats even though high levels of lordosis were evident in these animals. One possible interpretation of this latter finding is that isolation of female rats facilitates estrogen-induced lordosis by increasing adrenocortical secretion. The present series of experiments demonstrate that social isolation can influence sexual receptivity in rodents.     

Flow-Cytometric Characterization of Hematopoietic Cells in Non-Pregnant Human Endometrium

Lachapelle M-H, Miron P, Hemmings R, Baron C, Roy DC. Flow-cytometric characterization of hematopoietic cells in non-pregnant human endometrium. Am J Reprod Immunol 1996; 35:5–13 cP Munksgaard, Copenhagen PROBLEM: Immunologic evaluation and quantitation of hematopoietic cells in human endometrium has been difficult to perform, particularly in nonpregnant subjects. In this study, we describe a method for the flow-cytometric characterization of hematopoietic cells present in the endometrium of non-pregnant women. METHOD: Endometrial biopsy samples from normal donors were first mechanically disrupted and filtered to generate a single-cell suspension of leukocyte-enriched endometrial cells. Cells were labeled with a panel of monoclonal antibodies, stained with propidium iodide (PI), and one- or two-color flow-cytometric analysis performed on cells excluding PI. RESULTS: The methodology described in this study was highly reproducible in experiments evaluating the interrun and intrarun variability. We then determined the immunophenotypic profile of endometrial leukocytes from 12 normal females. The majority of leukocytes were T cells (CD3: 47%; CD4: 24%; CD8: 28%) with an important contingent of NK cells (CD56: 32%), the majority of which harbored the unusual CD16-CD56 bright phenotype, and a minority of B cells (CD20: 6%) and monocytes (CD14: 7%). CONCLUSIONS: Flow cytometry can be used to assess antigen expression on the surface of endometrial leukocytes from nonpregnant women. In future studies, it will be possible to use this approach to investigate the role of immune cell populations in the endometrium of patient experiencing reproductive failure.     

Replicative MCM7 protein as a proliferation marker in endometrial carcinoma: a tissue microarray and clinicopathological analysis

AIMS: To assess, in tissue microarray (TMA), the proliferative activity of endometrial carcinoma using one of the minichromosome maintenance (MCM) proteins (MCM7), and to explore its potential value for prognosis. MCM proteins are essential for eukaryotic DNA replication and have recently been used to define the proliferative compartments in human tissues. METHODS AND RESULTS: Immunohistochemistry for MCM7 and Ki67 was performed on TMAs constructed from 212 cases of endometrial carcinoma. MCM7 and Ki67 expression was quantified according to the extent of nuclear staining. An analysis was carried out of the association between MCM7 expression and that of Ki67 and the clinicopathological characteristics of endometrial carcinoma. MCM7 and Ki67 immunoreactivity was clearly evident in the nuclei of tumour cells. MCM7 and Ki67 labelling indices in endometrial carcinomas correlated with each other (P < 0.001). A significant correlation existed between the MCM7 labelling index and histological grade (P = 0.008) and patients' age at diagnosis (P < 0.001). Well-differentiated carcinomas and younger patients had a lower MCM7 index. Poor survival was observed in patients with endometrial carcinoma with a high MCM7 index (P = 0.03) and MCM7 was found to be an independent prognostic factor by multivariate analysis (P = 0.04). The Ki67 labelling index correlated with histological grade (P = 0.01) but had no significant prognostic impact (P = 0.50). CONCLUSIONS: In this TMA study on endometrial carcinoma, MCM7 was found to be a more reliable and useful marker than Ki67 in assessing tumour proliferation and in the prognosis of patients.     

Secretory role for human uterodomes (pinopods): secretion of LIF

The differentiation of human endometrial epithelium is a dynamic event, which occurs throughout the menstrual cycle in preparation for pregnancy. The appearance of uterodomes (pinopods) in this regard was first introduced in rodents with an established pinocytotic function, whereas little evidence was available in humans in this context. This study was undertaken to identify the potential physiological roles of uterodomes in the implantation process. To address this, endometrial biopsies from early, mid- and late luteal phases of the menstrual cycle of 23 fertile female patients with regular menses were used. Scanning and transmission electron microscopies (SEM and TEM) as well as immunofluorescence and immunogold TEM were performed to study the morphological changes and the expression pattern of leukaemia inhibitory factor (LIF) at uterodomes. Our results illustrated a high level of LIF expression in the human uterodomes, which was colocalized with the well-known biochemical markers of exocytosis, including syntaxin-1, 25-kDa synaptosomal protein (SNAP-25) and vesicle-associated membrane protein-2 (VAMP-2). Our morphological and immunocytochemical findings illustrated a secretory function for human uterodomes for the first time. In conclusion, this novel function for uterodomes provides an important clue in detection of their physiological function(s) during the process of the plasma membrane transformation.