Seiichiro Fujimoto

Cytogenetic analysis of uterine leiomyoma: the size, histopathology and GnRHa-response in relation to chromosome karyotype

OBJECTIVE The aim of this study was to elucidate the clinical characteristics of uterine leiomyomas having abnormal chromosome karyotype. STUDY DESIGN A total of 394 myomas were obtained from 213 patients for cytogenetic analysis. The size (number of nodules=144), histopathology (n=302), and gonadotropin-releasing hormone analogue (GnRHa)-response (n=58) were investigated in relation to chromosome karyotype in myomas. RESULTS 302 myomas from 166 patients were successfully karyotyped. A total of 21 myomas from 21 patients showed abnormal chromosome karyotype. The high frequencies of involved chromosomes 12, 14, 1, 7 were observed. The diameters of myomas with abnormal karyotype were significantly larger than those of myomas with normal karyotype. The frequency of the degeneration in myomas with abnormal karyotype was significantly higher than that with normal karyotype. The reduction rate in size of myomas by GnRHa treatments did not differ between the two types (karyotype normal versus abnormal) of nodules. CONCLUSIONS Chromosomally abnormal myomas were larger in diameter and showed a higher frequency of degeneration, suggesting that the cytogenetic background in uterine leiomyoma affects a tumors growth potential.

CHAPTER 33 – Ovarian Function and Survival of Patients with Cervical Carcinoma Treated with Radical Hysterectomy and Ovarian Transposition

This chapter investigates the long-term prognosis of the physiologic function of transposed ovaries in patients with cervical cancer and the risk factors of impairment of ovarian function after radical hysterectomy (RH), and analyzes the survival of patients treated with RH with ovarian transposition. The hormonal function of transposed ovaries and survival of patients treated with RH and ovarian transposition in cervical carcinoma is followed up prospectively. In the treatment of cervical cancer, gynecologists should make an effort to maintain the quality of life (QOL) of patients by maximally preserving the physiologic functions of the pelvic organs while pursuing a cure of the disease. Bilateral oophorectomy and resultant loss of ovarian function in young patients will cause climacteric-like symptoms, decrease in bone mineral density, hypercholesterolemia, increased risk of ischemic heart disease, and adverse psychological effects. In cervical cancer, especially in squamous cell carcinoma, risk of ovarian metastasis is quite low, while there are several reports of ovarian metastasis in adenocarcinoma of the cervix.