Brunella Pasinetti

Correlation between serological immune response analyzed by a new ELISA for HPV-16/18 E7 oncoprotein and clinical characteristics of cervical cancer patients.

Summary.Human papillomaviruses (HPVs), particularly HPV-16/18, are linked to cervical cancer development. Full-length, recombinant HPV-16/18 E7 oncoproteins were used in a new streptavidin-biotin capture ELISA method to investigate anti-HPV E7 antibody prevalence in serum. Sera from 99 healthy women, 70 cervical cancer patients, and 30 patients with cervical pre-invasive neoplasia were analyzed. Anti-HPV-16/18 E7 positivity was found in 53% of cervical cancer patients, in 40% with cervical pre-invasive neoplasia, and in 8% of healthy women. Serum samples from 12 cervical cancer patients were obtained at different time intervals during the treatment. Eleven out of 12 showed a correspondence between HPV-E7 antibody levels (decreasing versus increasing) and the type of response (clinically complete or partial response versus progression or stable disease) at each serological evaluation. Five patients with recurrent HPV-16/18-positive cervical carcinoma were analyzed before and after vaccination with HPV-16/18 E7-pulsed autologous dendritic cells; anti-HPV-16/18 E7 positivity was found in 3 out of 5 women.In conclusion, this assay could potentially be used as an adjunctive tool to monitor the type of response to treatment and possibly to detect antibody induction in cervical cancer patients after vaccination, as a potential marker to evaluate its efficacy.

Bowel obstruction and survival in patients with advanced ovarian cancer: analysis of prognostic variables.

Intestinal obstruction in patients with ovarian cancer is a severe complication affecting survival and, moreover, quality of life. According to the literature, bowel obstruction occurs in 5% to 35% of all patients with ovarian cancer. The etiology of intestinal obstruction, in most of these patients, is progressive intra-abdominal tumor growth that leads to extrinsic occlusion of the bowel lumen and/or intraluminal occlusion due to pelvic recurrences or mesenteric or omental masses and intestinal motility disorders due to the infiltration of the mesentery or bowel muscle and nerves. Treatment of such a complication is restricted to palliative measures, either surgical or conservative. Palliative surgery should be considered when relief from symptoms is not obtained within 3 to 7 days after nasogastric tube decompression, intravenous fluid hydration, and drug administration, and life expectancy is longer than 8 weeks. Significant morbidity and mortality are related to the surgical procedure in this group of patients, and although successful surgical relief of bowel obstruction can be achieved, selection of those patients who will benefit from this palliative surgery is not easy. Krebs and Goplerud have suggested a prognostic index based on 6 criteria: patients’ age, nutritional status, tumor spread, presence of ascites, and the type and amount of prior chemotherapy and/or radiation therapy. This score system has shown to be useful to select those patients that would benefit from surgical intervention. The objectives of this study were to retrospectively review patients who had ovarian cancer complicated by bowel obstruction and to analyze objective prognostic variables predictive of patient outcome that would aid in the clinical selection of those patients who would take advantage of surgical treatment.