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- Sukhin, V. S., et al.
(författare)
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Expression of mmp-9 as a prognostic factor of uterine sarcoma
- 2018
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Ingår i: Reports of morphology. - : Vinnytsia National Pyrogov Memorial Medical University. - 1818-1295 .- 2616-6194. ; 24:1, s. 21-27
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Tidskriftsartikel (refereegranskat)abstract
- Uterine sarcoma is a highly aggressive mesenchymal neoplasm with an extremely unfavorable prognosis. Up today there are still relevant issues concerning search for clinical-morphological and biomolecular criteria for prognosis relapse-free survival of uterine sarcoma patients. It is well-known, the increase of the expression level of MMP-9 in primary tumor or metastatic foci correlates with a low differentiation of tumor cells, high ability for invasiveness, high metastatic activity, and shortened life expectancy. It’s still unknown, whether it is possible to consider the expression of MMP-9 in uterine sarcoma cells as a convincing prognostic factor. For many types of epithelial malignant neoplasms, high metastatic rate is associated with an increase level of MMP-9 both in plasma and in tumor tissue. The purpose of this study is to investigate the features of MMP-9 expression in uterine sarcoma cells for development of the model for individual prediction of the disease course. The study of the surgical material of selected 54 cases of uterine sarcoma of stage I-II (according to FIGO criteria) with a known prognosis of the disease, which were distributed depending on the morphological type done: leiomyosarcoma (LMS) – 18 cases, endometrial stromal sarcoma (ESS) - 22 cases, undifferentiated sarcoma (US) – 14 (according to the classification of tumors of the uterus of the WHO). For histological examination, pieces of tissue were cut from different parts of the tumor nodes – central, peripheral, parts of the adjacent intact tissue of myometrium (total of 6-8 bits). The tumor cell phenotype was determined using low molecular weight cytokeratins (Cytokeratin PAN, AE1 / AE3), smooth muscle actin (Smooth Muscle Actin, 1A4), myogenin (Myogenin (F5D)), CD 10 and vimentin (Vimentin, V9). The histochemical label was evaluated in two parameters: the degree of prevalence and intensity of coloration. To assess the color intensity, a qualitative scale was used: 0 – no reaction, 1+ – weak cytoplasmic coloration to 30.0% of tumor cells, 2+ – moderate reaction, 30.0 to 60.0% of stained cells, 3+ – pronounced cytoplasmic reaction in 60,0-100,0% of tumor cells. Statistical processing of the data was performed using the “STATISTICA 10.0” program package. The conducted study has showed, the negative (0) and weak (1+) expression of matrix metalloproteinase-9 were observed in the most part of ESS and only partially in US. Despite the stage of the disease, with such a status of MMP-9, there was observed no signs of relapsed disease. The moderate (2+) and high (3+) expression of MMP-9 was detected in 44.5 % of uterine sarcoma, in the most part in LMS patients. However, if in LMS cases the progressive disease was observed only in one third of them (4 of 12 cases), in case of ESS and US, in all the patients with such tumors status there was observed relapsed disease. Such a reaction may be indicative for invasive and metastatic potential of ESS and US and cause of the hematogenous metastases.
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| 2. |
- Sukhin, V. S., et al.
(författare)
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The investigation of PD-L1 expression as a prognostic marker for uterine sarcoma
- 2018
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Ingår i: Морфологія. - : SE Dnipropetrovsk Medical Academy of Health Ministry of Ukraine. - 1997-9665. ; 12:2, s. 62-71
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Tidskriftsartikel (refereegranskat)abstract
- Background: The uterine sarcoma is a rare tumor with the unpredictable, aggressive clinical behavior. Medical science relies on the development of reliable tumor markers, on the basis of which the optimal treatment program can be chosen, and will be also possible to make a prognosis. The hyperexpression of PD-L1 in many cases correlates with unfavorable prognosis of the disease and is an important prognostic biomarker for some types of tumors: melanoma, kidney cancer, non-small cell lung cancer. The role of PD-L1 expression, as a tumor marker in sarcoma, remains unclear. Objective. The investigation of PD-L1 expression as a prognostic tumor marker for uterine sarcoma.Methods: There have been selected 30 uterine sarcoma patients stage I-II (T1-2NxM0), for immunohistochemistry analyze of PD-L1 expression. Depending on the morphological tumor types all the patients were distributed: leiomyosarcoma (LMS) - 20.0%, endometrial stromal sarcoma (ESS) - 46.7%, undifferentiated sarcoma (HC) - 33.3%.Results: Our results showed that 73.3 % of patients with uterine sarcoma exhibited low expression level of PD-L1. The moderate level and overexpression of PD-L1 were observed in undifferentiated and endometrial stromal sarcoma - 13.3 and 6.7 %, respectively. At further follow-up of patients with PD-L1 expression, the relapse of the disease was detected in 50.0 % of cases.Conclusion: The PD-L1 expression in tumor tissue, regardless of its level, is considered to be an unfavorable prognostic factor for uterine sarcoma patients. In case of moderate expression level of PD-L1, so as at its overexpression, the tumor progression was detected in 83.3% of uterine sarcoma patients.
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| 3. |
- Sukhin, V. S., et al.
(författare)
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The investigation of PD-L1 expression as a prognostic marker for uterine sarcoma
- 2018
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Ingår i: International Journal of Gynecological Cancer. - : BMJ Publishing Group Ltd. - 1048-891X .- 1525-1438. ; 28, s. 568-568
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Clinical medicine hopes for the development of reliable tumor markers, on the basis of which there can be chosen the optimal treatment program for uterine sarcoma patients, and also make a prognosis. The hyperexpression of PD-L1 in different tumors such as melanoma, kidney cancer, non-small cell lung cancer correlates with unfavorable prognosis of the disease. The role of PD-L1 expression, as a tumor marker in sarcoma, remains unclear.Objective: The investigation of PD-L1 expression as a prognostic tumor marker for uterine sarcoma.Methods: There have been selected 30 uterine sarcoma patients stage I-II (T1-2NxM0), for immunohistochemistry analyze of PD-L1 expression. Depending on the morphological tumor types all the patients were distributed: leiomyosarcoma (LMS) - 20.0%, endometrial stromal sarcoma (ESS) - 46.7%, undifferentiated sarcoma (HC) - 33.3%.Results: Our results showed that 73.3 % of patients with uterine sarcoma showed a low expression level of PD-L1. The moderate level and overexpression of PD-L1 were observed in the undifferentiated and endometrial stromal sarcoma (fig.1) – in 13.3 and 6.7 %, respectively. At further follow-up of patients with PD-L1 expression, the relapse of the disease was detected in 50.0 % of cases.Conclusion: The PD-L1 expression in tumor tissue, regardless of its level, is considered to be an unfavorable prognostic factor for the uterine sarcoma patients. In case of moderate expression level of PD-L1, so as at its overexpression, the tumor progression was detected in 83.3% of uterine sarcoma patients.
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| 4. |
- La Russa, M, et al.
(författare)
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Conservative management of endometrial cancer : a survey amongst European clinicians
- 2018
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Ingår i: Archives of Gynecology and Obstetrics. - : Springer Science and Business Media LLC. - 0932-0067 .- 1432-0711. ; 298, s. 373-380
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate differences and similarities in the clinical approach of young clinicians managing women with endometrial cancer (EC) conservatively.METHODS: A web-based survey was carried out. A platform of the European Network of Young Gynaecological Oncologists (ENYGO) database was used. A 38-item multiple-choice questionnaire was used to evaluate current practice in fertility-sparing management of EC. The survey covered investigations, treatment options, follow-up and management of recurrence and future family planning. Descriptive statistics were used.RESULTS: Overall, 116 out of 650 (17.84%) ENYGO members responded to the survey. In 92 (79.3%) centres, the caseload of early stage EC treated conservatively was less than 10 per year. One hundred and seven responders (93.8%) believe that treatment with progestins could be offered in grade 1 EC without myometrial invasion, but a minority would recommend it even for grade 2 tumours with no myometrial invasion or grade 1 with superficial invasion. The diagnostic tool for establishing grade of tumour was hysteroscopy with dilatation and curettage in 64 (55%) centres. Medroxyprogesterone acetate represents the most commonly prescribed progestogen (55, 47.4%). In 78 (67.2%) centres, a repeat endometrial biopsy was offered after 3 months of treatment commencement. Recurrences are treated mostly with hysterectomy (81, 69.9%) with only a small number of responders recommending to repeat progestin treatment. Lynch syndrome is a contraindication for conservative management in half of the responders (57, 49.1%). Most clinicians agree that patients should be referred promptly for assisted reproductive techniques once complete response has been achieved (68, 58.6%).CONCLUSIONS: Our study shows that conservative management is increasingly offered to women affected by early stage EC wishing to preserve their fertility. Further studies and joint registries are required to evaluate safety and effectiveness of this approach in this probably growing number of patients.
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| 5. |
- Lanner, M, et al.
(författare)
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Subspecialty training in Europe: a report by the European Network of Young Gynaecological Oncologists
- 2021
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Ingår i: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. - : BMJ. - 1525-1438. ; 31:4, s. 575-584
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Tidskriftsartikel (refereegranskat)abstract
- ESGO (European Society of Gynaecological Oncology) and partners are continually improving the developmental opportunities for gynaecological oncology fellows. The objectives of this survey were to evaluate the progress in the infrastructure of the training systems in Europe over the past decade. We also evaluated training and assessment techniques, the perceived relevance of ENYGO (European Network of Young Gynaecological Oncologists) initiatives, and unmet needs of trainees.MethodologyNational representatives of ENYGO from 39 countries were contacted with an electronic survey. A graduation in well/moderately/loosely-structured training systems was performed. Descriptive statistical analysis and frequency tables, as well as two-sided Fisher’s exact test, were used.ResultsNational representatives from 33 countries answered our survey questionnaire, yielding a response rate of 85%. A national fellowship is offered in 22 countries (66.7%). A logbook to document progress during training is mandatory in 24 (72.7%) countries. A logbook of experience is only utilized in a minority of nations (18%) for assessment purposes. In 42.4% of countries, objective assessments are recognized. Trainees in most countries (22 (66.7%)) requested additional training in advanced laparoscopic surgery. 13 (39.4%) countries have a loosely-structured training system, 11 (33.3%) a moderately-structured training system, and 9 (27.3%) a well-structured training system.ConclusionSince the last publication in 2011, ENYGO was able to implement new activities, workshops, and online education to support training of gynaecological oncology fellows, which were all rated by the respondents as highly useful. This survey also reveals the limitations in establishing more accredited centers, centralized cancer care, and the lack of laparoscopic training.
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