Human papillomavirus type 18 DNA sequences in adenocarcinoma and adenosquamous carcinoma of the uterine cervix

Human papillomavirus (HPV) DNA sequences were detected by Southern blot hybridization and polymerase chain reaction (PCR) in 10 out of 19 patients (52.7%) with adenocarcinoma [15] and adenosquamous [4] carcinoma of the uterine cervix. HPV 18 DNA was detected in 8 of these 19 patients (42.1%), HPV 16 DNA in 1 patient (5.3%) and HPV type X (unknown) in another (5.3%). Of the 10 HPV positive samples HPV 18 was found in 6 out of 6 pure adenocarcinomas (100%), and in 2 of 4 (50%) adenosquamous carcinomas. HPV 16 and HPV X were each detected in 1 out of 4 (25%) adenosquamous carcinomas. The physical state of the viral DNA was investigated in 5 of the 10 HPV-positive cases. All the specimens from these 5 cases showed HPV to be integrated into the host genome, except for one adenosquamous specimen, which showed both episomal and integrated forms of HPV 16. Six of 8 HPV 18 DNA positive specimens were from cases of pure adenocarcinoma and it was found by PCR that five of these 6 specimens retained fragments of E6/E7, LCR/E7 and early sequence of E1 fragment (sequence: 1188–1373) but deleted most part of E1.     

Case reports: Giant malignant fibrous histiocytoma of the uterus

A case of giant (32 Kg) malignant fibrous histiocytoma (MFH) arising from the uterus and occupying the entire abdomen and the pelvis is reported. The patient had debulking surgery, followed by combination chemotherapy, but died 7 months after diagnosis.     

Uterine myomas and factors associated with hysterectomy in premenopausal women

OBJECTIVE: Our purpose was to describe clinical characteristics in premenopausal women with uterine myomas and to identify factors associated with hysterectomy.STUDY DESIGN: Data were collected by chart abstraction in 421 premenopausal women with myomas and analyzed by univariate and multivariable regression.RESULTS: Over a median follow-up period of 29 months, 86% of women had symptoms associated with myomas and 40% had an increase in uterine size of >2 gestational weeks. By multivariable regression, bleeding symptoms at presentation and previous surgical history of cholecystectomy and adhesiolysis were significantly associated with greater odds of hysterectomy. There was a significant interaction between age and uterine size, so that as age increased, uterine size had a greater impact on the likelihood of hysterectomy.CONCLUSIONS: In this cohort of premenopausal women myomas were associated with symptoms in almost all women over the follow-up period. Hysterectomy was performed in 22% of women overall. (Am J Obstet Gynecol 1997;176:1213-9.)     

绝经后阴道出血患者诊断性刮宫前B超检测子宫内膜的价值

目的：评估绝经后阴道出血患者应用Ｂ超检测子宫内膜，以减少不必要的诊断性刮宫术（诊刮术）的价值。方法：对１９２例绝经后阴道出血患者，于诊刮术前行Ｂ超检查，测量子宫大小及子宫内膜厚度，然后进行分段诊刮术，标本送病理检查。结果：７７例内膜厚度≤４ｍｍ者中，７４例（９６．１％）子宫内膜属生理性改变，３例为内膜癌；１１５例子宫内膜厚度≥５ｍｍ者中，９２例（８０．０％）子宫内膜属病理性改变，其中５９例（５１．３％）为内膜癌。结论：高分辨阴道Ｂ超检测，可作为绝经后出血患者进行诊刮术前的一种筛选手段，当超声检测内膜厚度≤４ｍｍ时，可考虑避免诊刮术。     

Expression of c-erbB-2 and PCNA in cervical adenocarcinoma and its signification

Objective: To investigate the significance of c-erbB-2 and PCNA expression in adenocarcinoma. Methods: Expression of c-erbB-2 and PCNA in 74 cases of adenocarcinoma of the uterine cervix was examined by immunohistochemistry. Results: The expression of c-erbB-2 was detected in 34 cases. The positive staining of c-erbB-2 was associated with increased lymph node metastasis (57.1% Vs 24.0%, P=0.041) and lower 5-year survival rate (32.4% Vs 58.9%, P=0.008). The average PCNA labeling index (PCNA LI) was 40.6% (0.1%–91.4%). High PCNA LI was associated with lymph node metastasis (56.4% Vs 38.5%, P=0.016) and lower 5-year survival rate (28.7% Vs 64.4%, P=0.005). Positive staining of c-erbB-2 were associated with high PCNA LI (44.7% Vs 34.6% P=0.003). Conclusions: c-erbB-2 and PCNA LI were associated with malignant biological behavior and poor prognosis of patients with cervical adenocarcinoma.     

子宫内膜癌42例临床分析

目的了解子宫内膜癌发病的高危因素，探讨其早期诊断的手段。方法对42例子宫内膜癌的病史、临床表现、诊断技术及病理类型进行分析。结果子宫内膜癌占同期生殖系统恶性肿瘤病人的38．1％，不规则子宫出血是子宫内膜癌的主要症状，其次是阴道排液增多。不孕病人及更年期功能性子宫出血长期受无孕激素桔抗的雌激素刺激是本病的高危因素。结论诊断性刮宫及超声波探查对诊断及分期是必不可少的方法。     

米非司酮配伍与不配伍甲基睾丸素治疗子宫肌瘤的临床研究

目的：评价米非司酮配伍与不配伍甲基睾丸素治疗子宫肌瘤的临床效果。方法：有症状的子宫肌瘤患者６０例，随机分为两组，每组３０例。Ａ组：口服米非司酮及甲基睾丸素。米非司酮２５ｍｇ，甲基睾丸素５ｍｇ，每日１次，连服９０天；Ｂ组：口服米非司酮及安慰剂，服药方法同Ａ组。结果：两组治疗后均使患者发生闭经。Ａ组治疗后经量减少４９３２％，瘤体缩小５２２０％；Ｂ组治疗后经量减少３９８０％，瘤体缩小４４１０％。结论：抗雌孕激素的联合治疗是保守性治疗子宫肌瘤较为理想的方法。     

造血干细胞移植治疗恶性血液病的临床观察

目的:观察我院骨髓移植治疗恶性血液病的疗效、探讨移植相关并发症的预防及处理等问题。方法:4例行HLA相合的同胞间异基因外周干细胞移植(Allo-PBSCT)、2例行自体外周干细胞移植(APBSCT)和1例行自体骨髓移植(Au-to-BMT)。结果:全部病例均成功造血重建。中性粒细胞≥0·5×109/L平均时间为11天;血小板≥20×109/L平均时间为16天;发生Ⅱ~Ⅲ度aGVHD1例,cGVHD1例,溶血性贫血2例,间质性肺炎2例,中位随访时间18(6~42)月,全部病例现均存活。结论:骨髓移植治疗恶性血液病有较好疗效。     

高能聚焦超声治疗子宫肌瘤300例疗效观察

目的 观察高能聚焦超声肿瘤治疗机对子宫肌瘤的治疗效果。方法 采用FEP—BY01型高能聚焦超声肿瘤治疗机对300例子宫肌瘤患者进行治疗；治疗3个月后，通过B超检验和患者临床症状对比对治疗效果进行评定。结果 子宫肌瘤体积缩小30％以上且B超回声明显增强者197例（65．67％）；瘤体缩小30％以下和（或）B超回声明显增强者94例（31．33％）；绝大多数患者临床症状改善。结论 高能聚焦超声对子宫肌瘤具有良好治疗效果。