Clinical impact of integrated PET/CT on the management of suspected cervical cancer recurrence

OBJECTIVES: To assess the value and clinical impact of integrated PET/CT using (18)F-FDG in the diagnosis and management of women with suspected cervical cancer recurrence. METHODS: Fifty-two patients with cervical cancer with suspected recurrence because of clinical, cytological, biochemical and radiological findings were retrospectively evaluated. A final diagnosis of recurrence was confirmed by histologic tissue biopsy or by further clinical or radiological evidence. The clinical impact of information provided by PET/CT on patient management was assessed on the basis of clinical follow-up data concerning further diagnostic or therapeutic approach. RESULTS: Twenty-eight of 32 positive PET/CT scans (87.5%) were proven to have recurrent disease. Seventeen of 20 negative PET/CT scans (85.0%) had no evidence of disease. The sensitivity, specificity, and accuracy of PET/CT for detecting recurrence were 90.3%, 81.0%, and 86.5% respectively. PET/CT changed the management of 12 patients (23.1%) by changing treatment plan (5 patients), by initiating unplanned treatment strategy (4 patients), or by obviating the need for planned diagnostic procedures (3 patients). Median duration after performing PET/CT and last follow-up was 12 (range: 6-27) months, and the 2-year disease-free survival rate of patients with negative PET/CT scan for recurrence was significantly better than that of patients with positive PET/CT (85.0% vs. 10.9%, P=0002). CONCLUSIONS: In patients with a suspected recurrence of cervical cancer, integrated PET/CT using (18)F-FDG provides good anatomic and functional localization of suspicious lesions, and the better diagnostic interpretation has an impact not only on clinical management and treatment planning of patients, but also on disease-free survival.     

Three-vessel view of the fetal heart: in utero development of the great vessels

OBJECTIVES: The purpose of our study is to provide reference values for the great vessels obtained from images of the three-vessel view of the fetal heart, with an emphasis on the size discrepancy of the great vessels. METHODS: From February 2003 to May 2003, the main pulmonary artery (MPA), ascending aorta (AA), and SVC were measured in well-dated, nonanomalous fetuses scanned at 14-38 weeks of gestation. RESULTS: The size of each great vessel had a significant positive relationship with advance in gestation (P < 0.001); MPA (mm) = -2.76 + 0.34 x GA, ascending aorta (AA) (mm) = -1.73 + 0.26 x GA - 1.18E - 05 x GA(3), and SVC (mm) = 0.33 + 0.01 x GA(2) - 4.12E - 05 x GA(3). The AA/MPA ratio was significantly decreased with advance in gestation, while the SVC/AA ratio was significantly increased; AA/MPA ratio = -1.24 - 0.03 x GA + 3.88E - 04 x GA(2); P < 0.001, SVC/AA ratio = 0.63 - 5.43E - 03 x GA + 1.96E - 04 x GA(2); P < 0.001. CONCLUSION: On the three-vessel view of the fetal heart, the interpretation of the size discrepancy of the great vessels needs to be adjusted according to fetal growth.     

Matrix metalloproteinase-1 promoter polymorphism and epithelial ovarian cancer: does ethnicity matter?

AIM: To estimate the relationship between matrix metalloproteinase (MMP)-1 promoter -1607 bp polymorphism and the risk of epithelial ovarian cancer (EOC) in Korean women and to clarify the ethnic difference in genotype distribution of this polymorphism. METHODS: Single nucleotide polymorphism (SNP) of MMP-1 promoter -1607 region in 133 EOC patients and 332 cancer-free patients were investigated. Then the associations of this polymorphism with EOC or its clinicopathological parameters were analyzed. In addition, genotype distributions of this polymorphism in Korean women were compared with those of other races by extracting data from the previously published literature. RESULTS: We found no relationship between MMP-1 promoter -1607 bp polymorphism and epithelial ovarian cancer in a Korean population. Furthermore, we found ethnicity-dependent differences in genotype distributions and allele frequencies by comparison with previous articles on this topic. We report significant ethnic differences in the genotype distributions and allele frequencies of the MMP-1 promoter -1607 bp polymorphism. CONCLUSION: Our results indicate that MMP-1-1607 bp polymorphism shows ethnic diversity, and that the hypothesis that this polymorphism is associated with epithelial ovarian cancer is not supported by this study in a Korean population. Moreover, this finding concurs with results obtained in white Americans and Europeans.     

Studies on the interrelationship among serum estrogen levels, estrogen receptors (unbound cytoplasmic, bound cytoplasmic and bound nuclear), RNA syntheses and protein syntheses in the normal endometrial tissues (author's transl)

The physiological effects of estrogen on normal and human endometrial tissues were investigated. In the experimental animal uterus, it was well established that the 1st response to estrogen required RNA synthesis which then led to protein synthesis. The aim of this investigation was to study the interrelationships between serum estrogen levels, (ER) estrogen receptors (unbound cytoplasmic, bound cytoplasmic, and bound nuclear), RNA syntheses, and protein syntheses in normal human endometrial tissues. The unbound cytoplasmic ER were measured by the D.C.C. method, and bound cytoplasmic and nuclear ER were measured by the protamine exchange method. The following results were obtained. 1) The unbound and bound ER concentrations of the cytoplasmic fraction of normal human endometrial tissues were progressively increased throughout the proliferative phase, and were at their highest during the secretory and late secretory phases of the cycle. 2) The bound ER concentrations of the nuclear fraction were highest during the late proliferative phase and lowest during the early secretory phase, but increased throughout the secretory phase. 3) RNA syntheses were increased progressively throughout the proliferative phase and were highest in the late proliferative phase and lowest in the late secretory phase. 4) Protein syntheses were also highest in the late proliferative phase and lowest in the early secretory phase, but increased throughout the secretory phase. 5) The serum estrogen levels displayed a positive correlation with unbound cytoplasmic receptors (r=0.85), bound cytoplasmic receptors (r=0.79), and unbound nuclear receptors (r=0.70) in the proliferative phase, and a low positive correlation with RNA syntheses (r=0.86) and protein syntheses (r=0.84) in the proliferative phase, but no correlation was found in the secretory phase. 7) RNA syntheses in the endometrium have a positive correlation with unbound cytoplasmic receptors (r=0.88), bound cytoplasmic receptors (r=0.80), and bound nuclear receptors (r=0.79) in the proliferative phase, but in the secretory phase these have a positive correlation with unbound cytoplasmic receptors (r=0.61), bound cytoplasmic receptors (r=0.68), and bound nuclear receptors (r=0.83) in the proliferative phase, and a positive correlation only with bound nuclear receptors (r=0.61) in the secretory phase. (Author's modified)