Piotr Bodzek

Comparison of prenatal and postnatal treatments of spina bifida in Poland – a non-randomized, single-center study

Abstract Objective: The aim of this study was a comparison of the outcomes of intrauterine myelomeningocele (MMC) repairs (IUMR) in type II Chiari malformation (II CM) fetuses with clinical data of newborns and infants operated on postnatally. Methods: The study group (SG) comprised 46 pregnant women whose type II CM children underwent IUMR, while 47 pregnant women whose type II CM children were operated on postnatally constituted the control group (CG). A total of 24 SG and 20 CG patients reached the endpoint of the study. Results: High incidence of prelabor rupture of membranes (24 (52.2%), CI: 3.74 (1.69–8.26) (p < 0.001) was noted in the group of prenatal surgeries as compared to controls. The need for ventriculoperitoneal shunt implantation was statistically significantly lower (p < 0.008) in the group of children after IUMR as compared to controls (5 (27.8%) and 16 (80%), respectively, CI: 0.35 (0.16–0.75). None of the postnatally treated CG children can walk without adaptive equipment. In contrast, two children from the SG (2 (11.1%) CI: 1.86 (1.00–3.48) p < 0.05) are able to walk independently. Conclusions: Prenatal MMC closure significantly lowers further adverse evolution of the II CM. Further studies are needed, especially on preventive measures for preterm labor and iatrogenic preterm prelabor rupture of membranes (iPPRM) in the postoperative course of IUMR.

Concentrations of antibodies against heat shock protein 27 in the sera of women with ovarian carcinoma.

Introduction: Heat shock proteins (Hsp) are highly expressed in many malignant human tumors, including tumors of the genital tract. One of the Hsps strongly associated with the process of cancerogenesis is Hsp27. The presence of Hsp27 and anti-Hsp27 in the sera of patients with ovarian carcinoma is still a new research field, and papers contain contradictory results. The aim of this work was to study the concentrations of anti-Hsp27 immunoglobulin G antibodies in the sera of women with ovarian cancer at different clinical stages and with different histopathological types of this cancer. Methods: Serum samples from 158 patients with ovarian carcinoma and 80 healthy women were investigated. The concentrations of anti-Hsp27 antibodies were determined by the enzyme-linked immunosorbent assay technique. Results: The mean concentration of anti-Hsp27 antibodies in the patients with ovarian carcinoma was significantly higher than that in the control group. Analysis in relation to the stage of clinical progression showed that the less advanced the cancerogenesis process, the higher the concentration of the anti-Hsp27 antibodies is. The mean concentrations of the anti-Hsp27 antibodies in the patients with ovarian carcinoma were not significantly different in relation to the histological type of the cancer. The use of chemotherapy as a primary anticancer treatment in ovarian carcinoma did not cause a significant decrease in the concentration of anti-Hsp27 antibodies. Conclusions: An immunological response to Hsp27 is increased in women with ovarian carcinoma. Although the diagnostic concentrations of anti-Hsp27 antibodies have not been precisely defined yet, we believe that this may be a helpful diagnostic parameter particularly to detect early stages of clinical advancement of the disease.

Antibodies against Hsp60 and Hsp65 in the sera of women with ovarian cancer

BackgroundThe aim of this study was to evaluate the concentrations of IgG antibodies against Hsp60 and Hsp65 in sera of patients with ovarian cancer at various stages of clinical progress and for different histopathological types of disease.MethodsSerum samples from 149 patients with ovarian carcinoma and 80 healthy women were investigated. The concentrations of anti-Hsp60 and anti-Hsp65 antibodies were determined using the enzyme-linked immunosorbent assay technique.ResultsThe mean concentrations of anti-Hsp60 and anti-Hsp65 antibodies in the patients with ovarian cancer did not differ significantly from the mean levels in healthy women. Analysis in relation to the clinical progression stage showed that the concentrations of these antibodies were higher when the neoplastic process was less advanced and at early stages significantly higher than in control group. Mean concentrations of both antibodies were not significantly different in relation to the histological type of the ovarian cancer. The use of chemotherapy as a primary anticancer treatment did not cause a significant change in the concentration of anti-Hsp60 antibodies, but the mean level of anti-Hsp65 after this treatment was significantly higher than in control group.ConclusionsThe immunological response to Hsp60/65 is increased in early clinical stages of ovarian cancer and the level of anti-hsp60/65 antibodies may be then a helpful diagnostic marker. Even antibodies against highly homologous Hsps may be cross-reactive only partially and differ by some functional properties.

Galanin concentrations in maternal circulation, amniotic fluid and umbilical cord blood during term labor: Relationship with maternal body mass and neonatal birth weight

Background. Galanin is a hypothalamic regulatory peptide involved in the regulation of appetite. It is synthesized by the nervous system, anterior pituitary gland, adrenal medulla, pancreas, intestine and placenta. Placental secretion of galanin has until now only been investigated in animals. Additionally, galanin concentration has not been assessed in umbilical cord blood and amniotic fluid. Patients and methods. Galanin concentrations were measured in maternal circulation before term delivery, in cord blood and in amniotic fluid of 45 healthy pregnant women (gestational age 38 – 40 gestational weeks). The control group consisted of 26 normally menstruating healthy women. Results. Plasma galanin concentrations were found to be similar in pregnant healthy women before term delivery (20.8 ± 1.9 pg/ml) and non-pregnant women (19.0 ± 1.7 pg/ml). Galanin concentration in umbilical cord blood (26.5 ± 2.2 pg/ml) was significantly higher (p < 0.05) than in maternal circulation. Galanin concentration in amniotic fluid (20.4 ± 1.0 pg/ml) was similar to that observed in maternal plasma, but significantly (p < 0.01) lower than in umbilical cord blood. A significant correlation was found between maternal body mass index and plasma galanin concentration (τ = 0.246; p < 0.05) and between birth weight and cord blood galanin concentration (τ = 0.345; p = 0.01). There was no significant correlation between placental mass and cord blood galanin concentration (τ = 0.124; p = 0.26). Conclusions. Plasma galanin concentration in pregnant women before term delivery is similar to that in non-pregnant women. The fetus rather than the placenta is the source of the high galanin concentration in umbilical cord blood. The role of galanin in the regulation of newborn weight is uncertain.

Cervical Cancer Histology, Staging and Survival before and after Implementation of Organised Cervical Screening Programme in Poland

A population-based organised cervical cancer screening programme (OCCSP) was introduced in Poland in 2006. In this study we have aimed to analyse whether selected parameters related to invasive cervical cancer (ICC) of patients diagnosed in two distant gynaecological oncology centres changed after the first screening round of the programme run between 2006–2008. We have run a retrospective cross-sectional analysis of 189 women diagnosed with ICC between 2002–2005 (directly before introduction of the programme) and 165 patients diagnosed between 2009–2012 (just after the first screening round of the programme) and compared their age at diagnosis, histology, stage of tumours and overall survival (OS). Mean age of patients diagnosed in years 2002–2005 and 2009–2012 was 52.1 and 52.6 years respectively. Squamous cell carcinomas constituted 90.5% and 86.1% of tumours diagnosed in years 2002–2005 and 2009–2012 respectively and the rest of tumours had glandular and other histologies. 74.5% and 61.0% of women diagnosed in years 2002–2005 and 2009–2012 respectively had early ICC (FIGO—International Federation of Gynaecology and Obstetrics stages I-IIA) and the rest had advanced disease (FIGO IIB-IV). We have noticed no significant differences in mean age of patients, histology of tumours and OS of patients with ICC diagnosed before and after the first screening round of OCSSP in Poland. Advanced stages of ICC were more commonly diagnosed after the introduction of OCSSP. Changes only in some clinical parameters of patients with ICC were noticed before and after the first screening round of OCSSP in Poland but OS of patients remained the same.

Expression of tumor suppressor genes related to the cell cycle in endometrial cancer patients

PURPOSE Endometrial cancer is the most common gynecological malignancy in developed countries. The role of tumor suppressor genes (TSG) in endometrioid endometrial adenocarcinoma (EEC) has an important impact on patient survival prognosis. Thus, it is important to identify TSG transcripts that differentiate endometrial adenocarcinoma into various pathomorphological grades. The aim of this study was to analyze the expression profile of tumor suppressor genes related to the cell cycle in patients with endometrial adenocarcinoma across histological differentiation and to identify transcripts which differentiate endometrium into various pathomorphological grades. MATERIAL AND METHODS Gene expression analysis was completed for 19 endometrial endometrioid adenocarcinomas and 5 normal specimens (obtained from women with diagnosed uterine fibroids, benign ovarian tumors and a prolapsed uterus with histopathologically confirmed endometrium in the proliferative phase) using Affymetrix HG-U133A oligonucleotide microarrays. The statistical analysis was performed using the GeneSpring13.0 software and PANTHER classification system. RESULTS Significant changes in gene expression were observed across histological differentiation. The WT-1, CYR 61, TSPYL5 genes were statistically and biologically significant in all cancer grades, and were considered to be primary for the G1 grade in endometrial cancer. The G2 cancer specific genes were BCL2L2 and HNRNPA0, whereas in G3 there was only BAK. CONCLUSION In conclusion, the WT-1, CYR61 and TSPYL5 gene expressions are potentially correlated with patient survival in all endometrial cancer grades. The TSGs identified are considered to be important in EEC pathogenesis and further research is needed to confirm this.

Current views on fetal surgical treatment of myelomeningocele — the Management of Myelomeningocele Study (MOMS) trial and Polish clinical experience

Myelomeningocele (MMC) is the most frequent congenital defect of the central nervous system for which there is no satisfactory alternative to postnatal treatment. On the contrary prenatal MMC surgery is conducting before birth and is aimed at protecting from Chiari II malformation. The main goal of fetal MMC repair is to improve development and life quality of children with Chiari II malformation. Management of Myelomeningocele Study (MOMS) which was published in 2011 clearly confirmed effectiveness of prenatal surgery. In this paper we compare MOMS results with our own clinical experience. Thanks to high effectiveness and significant improvement in safety of maternal-fetal surgery prenatal MMC surgery become a new standard of treatment.