Liquid‐based Papanicolaou test (SurePath) interpretations before histologic diagnosis of endometrial hyperplasias and carcinomas

BACKGROUND.

In addition to the reporting of atypical glandular cells (AGC) and adenocarcinoma (ADCA), the 2001 Bethesda System requires the reporting of benign‐appearing endometrial cells in women aged >40 years (BAEMC). In this study, the authors evaluated the contribution of each of these reporting categories to the sensitivity and specificity of a liquid‐based Papanicolaou test for endometrial carcinoma or hyperplasia.

METHODS.

Over the 3‐year study period, in the setting of a large, multihospital health care system, the authors analyzed the results from liquid‐based Papanicolaou tests that were performed within the 6 months that preceded a histologic diagnosis of endometrial carcinoma or hyperplasia and that were reported according to the 2001 Bethesda System.

RESULTS.

Two hundred seventy‐two women had a histologic diagnosis of endometrial hyperplasia (n = 199) or malignancy (n = 73) within 6 months after a Papanicolaou test. In total, 188,594 Papanicolaou tests (91,385 from women aged >40 years) were interpreted during the study period and resulted in 3810 diagnoses of BAEMC, 326 diagnoses of AGC, and 30 diagnoses of ADCA. Only 28 of 73 women (38.4%) with endometrial carcinoma had cytologically AGC or ADCA reported on a previous Papanicolaou test. The reporting of BAEMC increased this sensitivity by only 5.5% (4 additional tests) but decreased the specificity of the Papanicolaou test for endometrial malignancy from 99.8% to 96%. For endometrial hyperplasias, the sensitivity of the Papanicolaou test was even lower (39 of 198 tests; 19.7%), but BAEMC represented the majority of endometrial‐type cells reported (36 of 39 tests).

CONCLUSIONS.

The reporting of BAEMC led to an only marginal increase in sensitivity that had to be weighed against the significant loss in specificity of the Papanicolaou test for endometrial neoplasia. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.     

Severe paraneoplastic hypoglycemia in a patient with a gastrointestinal stromal tumor with an exon 9 mutation: a case report

Background  

Non-islet cell tumor induced hypoglycemia (NICTH) is a very rare phenomenon, but even more so in gastrointestinal stromal tumors. It tends to present in large or metastatic tumors, and can appear at any time in the progression of the disease. We present herein a case of NICTH in a GIST tumor and report an exon 9 mutation associated to it.     

Tissue- and gender-specific mRNA expression of UDP-glucuronosyltransferases (UGTs) in mice.

UDP-glucuronosyltransferases (UGTs) catalyze phase II biotransformation reactions in which lipophilic substrates are conjugated with glucuronic acid to increase water solubility and enhance excretion. Currently, little information regarding tissue- or gender-specific expression of mouse UGTs is available. Mice are increasingly popular models in biomedical research, and therefore, thorough characterization of murine drug metabolism is desired. The purpose of the present study was to determine both tissue- and gender-specific UGT gene expression profiles in mice. RNA from 14 tissues was isolated from male and female C57BL/6 mice and UGT expression was determined by the branched DNA signal amplification assay. UGTs highly expressed in mouse liver include Ugt1a1, Ugt1a5, Ugt1a6, Ugt1a9, Ugt2a3, Ugt2b1, Ugt2b5/37/38, Ugt2b34, Ugt2b35, and Ugt2b36. Several isoforms were expressed in the gastrointestinal (GI) tract, including Ugt1a6, Ugt1a7c, Ugt2a3, Ugt2b34, and Ugt2b35. In kidney, Ugt1a2, Ugt1a7c, Ugt2b5/37/38, Ugt2b35, and Ugt3a1/2 were expressed. UGT expression was also observed in other tissues: lung (Ugt1a6), brain (Ugt2b35), testis and ovary (Ugt1a6 and Ugt2b35), and nasal epithelia (Ugt2a1/2). Male-predominant expression was observed for Ugt2b1 in liver, Ugt2b5/37/38 in kidney, and Ugt1a6 in lung. Female-predominant expression was observed for Ugt1a1 and Ugt1a5 in liver, Ugt1a2 in kidney, Ugt2b35 in brain, and Ugt2a1/2 in nasal epithelia. UDP-glucose pyrophosphorylase was highly expressed in liver, kidney, and GI tract, whereas UDP-glucose dehydrogenase was highly expressed in the GI tract. In conclusion, marked differences in tissue- and gender-specific expression patterns of UGTs exist in mice, potentially influencing drug metabolism and pharmacokinetics.     

缺血性肠病CT检查与诊断

目的着重探讨45例缺血性肠病患者的病因、CT检查技术及其影像表现。资料与方法45例缺血性肠病均经螺旋CT扫描。26例经过手术证实,14例经过治疗痊愈,5例急性死亡。结果其中肠系膜动脉缺血24例,肝固有动脉缺血4例,肠系膜静脉缺血17例。结论严格掌握CT检查技术,根据CT影像表现并密切结合临床,对缺血性肠病患者可以作出确定诊断。