Outcomes of endometrial-polyp treatment with hysteroscopy in operating room

To assess the results of using a resectoscope in the hysteroscopic resection of endometrial polyps that were previously diagnosed by office hysteroscopy and to demonstrate the necessity of extraction for histological study. A prospective long-term follow-up study (level of evidence II-2). University Hospital. 303 women presenting a hysteroscopic image of an endometrial polyp. Interventions: Office hysteroscopy, hysteroscopic resection of polyps by means of a resectoscope and an anatomopathological study of the polyps. Statistical analysis was performed. 303 diagnosed endometrial polyp formations were resected by means of hysteroscopy during surgery. In all cases, biopsies of the uterine cavity or of the polyp were negative. Resection of the polyps with hysteroscopy in the operating room using a resectoscope proved to be a safe technique. The anatomopathological study of the polyps showed hyperplasia with atypias in 10 cases (3.3%) and endometrial cancer in 9 women (3.0%). Our study data suggest that endometrial polyps should be resected because they may harbor malignant or premalignant lesions. Hysteroscopic surgery is recommended for its simplicity and scant complications.     

Single-port hysterectomy with pelvic lymph node dissection in the porcine model: feasibility and validation of a novel robotic lightweight endoscope positioner

The purpose of this study was to evaluate the feasibility and validity of a modified single-port robotic lightweight endoscope in the performance of single-port hysterectomy with pelvic lymph node dissection in the porcine model. Task completion times were recorded for each component of the procedure: port placement, docking of the surgical robot, operative time for the procedures. For each task, linear regression modeling was performed using SPSS to determine whether a correlation existed between task completion time and increasing surgeon experience. All robotic-assisted LESS procedures were performed successfully without the addition of laparoscopic ports or open conversion. Regression analysis demonstrated a strong correlation between the number of procedures and task completion time for robot docking and pelvic lymph node dissection, correlation coefficients 0.74 and 0.77, p = 0.001, respectively. This study demonstrated the feasibility and effectiveness of a new, compact single-port robotic voice-activated endoscope at improving laparoscope guidance during the performance of single-port hysterectomy with pelvic lymph node dissection in the porcine model. Further work is needed to better define the ideal operative procedure for single-site surgery in oncology and integration of new single-port robotic platforms into clinical practice.     

Enfermedad de Von Hippel Lindau: estudio familiar

Case reportThe case of 5 members of a family who suffer from Von Hippel-Lindau disease (VHL) is presented. It is shown that retinal capillary hemangioma was the main ophthalmic symptom, with hemovitreous and tractional retinal detachment as the main complications.DiscussionVHL disease is rare, but very serious, even fatal, thus it is important to obtain an early diagnosis by ophthalmoscopy, in order to change the visual prognosis and life expectancy, not only for the patient, but also for the family.     

Quantification of ER/PR expression in ovarian low-grade serous carcinoma

ObjectiveCase reports suggest that hormonal therapy may be a useful treatment option for low-grade serous carcinomas (LGSC) but the clinical value remains uncertain. We hypothesized that LGSCs show a constitutive high hormone receptor expression and that type diagnosis may be sufficient to initiate hormonal therapy.MethodsWe assessed ER and PR expression on 27 LGSC, 69 high-grade serous carcinomas (HGSC), 36 serous borderline tumors (SBOT), and five normal fallopian tubes using three different platforms/antibodies on tissue microarrays. Staining from the Leica Bond Max and DAKO PharmDx platforms was evaluated using the Allred score. Quantitative fluorescence immunohistochemistry was performed using the HistoRx AQUAnalysis platform. A second cohort of 12 LGSC and 183 HGSC was assessed using the HistoRx AQUAnalysis platform. Welch ANOVA or Fisher's Exact Test was used to compare differences in the histological types for each platform. Nonparametric bivariate density plots were used to graphically demonstrate the relationship between ER and PR for the various histological types.ResultsLGSC have higher ER and PR expression compared to HGSC but significantly less than FT and SBOT. Nonparametric bivariate density revealed two populations of LGSC: one fifth of LGSC are ER high/PR high expressers similar to SBOT but the majority show low ER/PR expression more like HGSC.ConclusionsQuantitative assessment of ER/PR expression using the HistoRx AQUAnalysis platform may be useful as a predictive diagnostic for hormonal therapy in LGSC, assuming that only the fraction of double high expressers benefit from hormonal treatment.     

Relationship between IL-10 and tumor markers in breast cancer patients

Tumor markers are expressed due to molecular alterations of the tumor cells, and we can relate them to the immune system to find new associations to improve prognosis. IL-10 inhibits the generation of immune responses at the tumor site. To determine IL-10 expression in the tumor microenvironment and to associate it with certain tumor markers, 27 breast cancer patients were monitored by immunohistochemistry. The results showed that 23 breast cancer samples exhibited a strong expression of IL-10. IL-10 was associated with some poor prognosis tumor makers. A direct association between IL-10, Bcl-2, and Bax was detected. The relationship between IL-10 and Bax was statistically significant (P=0.001). An inverse association of IL-10 with p53 was observed. IL-10 reflects a suppressive tumor microenvironment, and its relationship with apoptosis markers can suggest an increase in the aggressiveness of the tumor even if it still is at an early stage.