Takafumi Oshita

Are DNA ploidy and epidermal growth factor receptor prognostic factors for untreated ovarian cancer? A prospective study.

&NA; To identify prognostic factors for untreated ovarian cancer, DNA ploidy, proliferative index (P.I.) and epidermal growth factor receptor (EGFR) expression were analyzed in a prospective series of 40 patients with ovarian cancer and 7 patients with borderline malignant ovarian tumor followed up for 5 years or more (median, 77 months). The frequency of aneuploid cells was 53.8% (21/39) in ovarian cancer and 14.3% (1/7) in borderline malignancy. There was no significant association between DNA ploidy and the clinicopathologic findings, in which aneuploid ovarian cancer was more common among advanced tumors. The S‐phase fraction and P.I. value were higher in the patients with aneuploid tumors (p = 0.076). EGFR expression was detected in 76.9% (30/39) of ovarian cancers and 42.9% (3/7) of borderline malignant ovarian tumors, and the mean EGFR level was 5.8 ± 12.1 (range: 0–49.5) and 28.3 ± 71.1 (range: 0–189.4) fmol/mg protein, respectively. There was no correlation between EGFR expression and DNA ploidy, P.I., and clinicopathologic findings analyzed. The 5‐year survival rate in patients with aneuploid tumors was significantly worse in patients with ovarian cancer (p = 0.0165, log‐rank test). No significant relationship was shown between P.I., EGFR expression, and 5‐year survival. Cox multivariate analysis showed that DNA ploidy, P.I., and EGFR expression are not associated with the risk of death (p = 0.5917, p = 0.9924, and p = 0.6840, respectively), although clinical stage shows a significant relationship (p = 0.0027). Our data showed that DNA ploidy is significantly related to the prognosis by univariate analysis, but DNA ploidy, P.I., and EGFR expression were not independent prognostic factors for the untreated ovarian cancer.

Measurement of endometrial thickness in premenopausal women in office gynecology

To define the median endometrial thickness (ET) in office gynecology is thought to be important for clinical practice. However, there are few reports about ET that have included the general female population on a large scale. The median ET was determined prospectively in premenopausal women who attended office gynecology for cervical cancer screening.

Endometrial cytology and subsequent uterine malignancies in patients treated with long-term tamoxifen for breast cancer

目的:乳癌術後タモキシフェン (TAM) 投与が2年から5年に延長されたことから, TAM長期投与の子宮内膜への影響を解析した.方法:1995-2000年のTAM内服患者を対象に, maturation index (MI), 内膜細胞像の推移, TAM内服中に診断された子宮内膜癌を臨床病理学的に検討した.成績:1995-2000年の対象は, 順に86, 76, 72, 107, 130, 147, 計618例あり, 頸管ポリープ11例 (1.8%), 子宮内膜ポリープ9例 (1.5%), 子宮内膜癌 (癌肉腫1例) 4例 (0.6%) が続発した. MIは小型から中型の中層細胞主体となった. TAM開始後の内膜細胞診は, 類円形で細顆粒状の核を有する分泌期類似の内膜細胞がシート状に出現, 4, 5年目は同所見に加え, 細胞や核の大小不同, 小型濃染核の萎縮細胞, 内膜細胞の重積や扁平上皮化生細胞が混在した. 子宮内膜癌は, Ia期類内膜腺癌 (G1) 3例と癌肉腫1例が2年以内に診断され, 前回細胞診で内膜細胞の3次元構造や土管様配列の強い増殖所見を認めた.結論:TAM開始後は, 早期からの子宮がん検診が重要で, 内膜細胞診では3次元細胞配列などの強い増殖像は注意を要する.