Prognostic value of local relapse for patients with endometrial cancer

Background

The objective of our study was to determine survival and prognostic factors associated with isolated local recurrence of endometrial cancer.

Expression of apoptosis-related proteins in peritoneal, ovarian and colorectal endometriosis

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. Apoptosis, a physiological process by which multicellular organisms eliminate superfluous cells, is altered in tumor tissue. Here we studied the expression of the apoptosis-related proteins p53, bcl-2, bax, p21 and fas in proliferative (n = 9) and secretory (n = 9) endometrium, and in peritoneal (n = 11), ovarian (n = 20) and colorectal (n = 20) endometriosis, by qualitative and semi-quantitative immunohistochemical methods using the percentage of positive cells and HSCORE analysis.

In endometrium, p53, p21 and fas expression was low, whereas bax and bcl-2 expression was elevated. Using HSCORE analysis, only bcl-2 expression varied during the menstrual cycle (48.9 ± 34.2% in the proliferative phase, 11.5 ± 24.7% in the secretory phase, p = 0.01).

Using HSCORE analysis, p53 expression was higher in ovarian endometriosis than in peritoneal (p < 0.0001) and colorectal endometriosis (p = 0.03). P21 expression was higher in ovarian endometriosis than in peritoneal (p = 0.01) and colorectal endometriosis (p = 0.01). Bcl-2 expression was lower in ovarian endometriosis than in peritoneal (p = 0.0002) and colorectal endometriosis (p < 0.0001). Fas expression was higher in peritoneal endometriosis than in ovarian (p = 0.02) and colorectal endometriosis (p = 0.008).

In conclusion, these results confirm the involvement of apoptosis in the pathogenesis of endometriosis. Moreover, expression of apoptosis-related proteins varies according to the location of endometriosis suggesting the involvement of different apoptotic pathways.     

A plea for the biopsy marker: how,why and why not clipping after breast biopsy?

In the last decade, percutaneous breast biopsies have become a standard for the management of breast diseases. Biopsy clips allow for precise lesion localization, thus minimizing the volume of breast to be resected at the time of surgery. With the development of many imaging techniques (including mammography, sonography, and breast magnetic resonance imaging), one of the challenges of the multidisciplinary became to synthesize all informations obtained from the various imaging procedures. The use of biopsy markers after percutaneous biopsy is one of the keys for optimal patient management, helping the radiologist to deal with multiple lesions, to insure correlation across different imaging modalities and to follow-up benign lesions, helping the oncologist by marking a tumor prior to neoadjuvant chemotherapy, helping the surgeon by facilitating preoperative needle localization, to precisely mark the margins of extensive disease and to guide intraoperative tumor resection, and helping the pathologist to insure the lesion of interest has been removed and to identify the region of interest in a mastectomy specimen. We believe biopsy clip markers should be deployed after all percutaneous interventions and present in this review the arguments to support this statement. Minimal indications for clip deployment will also be detailed.