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The Detection of the p53 Protein in Cervical Cancer and CIN by Immunohistochemistry.

Heung Gon KIM ; Gi Uk CHOI ; Gi Youn HONG ; Hee Sub RHEE ; Bu Kie MIN ; Ki Suck KIM ; Hyung Bae MOON

Korean Journal of Gynecologic Oncology and Colposcopy.1995;6(1):23-30.

The cell cycle is composed of a series of steps which can be negatively or positively regulated by various factors. p53 gene aberrations are common in human malignancies, and recent studies suggest that in cervical carcinoma p53 function is inactivated either by complex formation wilh human papilloma virus (HPV) E6 product or by gene mutation. To study the expression of p53 gene in the cervical cancer and cervical intraepithebal neoplasia, immunohistochemistry for the p53 protein was done in the 47 cases of squamous cell carcinoma, 6 cases of adenocarcinoma and 32 cases of cervical intraepithelial neoplasia. I. The p53 protein was detected in the 31% of cervical intraepithelial neoplasia (10/32 cases). 2. The p53 protein was detected in the 55% of invasive cervical cancer (29/53 cases). 3. By the histologic type of cervieal cancer, the p53 protein was detected in the 57% of squamous cell carcinoma (27/47 cases) and 33% of(2/6 cases) adenocarcinoma. The p53 protein wes more frequently detected in the squamous cell carcinoma than in the adenocarcinoma. 4. By the staging in cervical cancer, the p53 protein was detected in the 31% of stage 0, 50% of Stage Ia, 50% of stage I b, 75% of IIa and 50% of stage II b.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cervical Intraepithelial Neoplasia ; Genes, p53 ; Humans ; Immunohistochemistry* ; Papilloma ; Uterine Cervical Neoplasms*

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Invasive Cervical Cancer in Women Aged 35 or Less.

Eun Hee CHYU ; Won Gue KIM ; Un Dong PARK

Korean Journal of Gynecologic Oncology and Colposcopy.1995;6(1):13-22.

The incidence in women less than 35 years of age is increasing despite an overall decrease in newly diagnosed invasive cervieal cancer among all age groups. However the influence of young age on prognosis remains controversial. So 163 patients of invasive cervical cancer in women aged 35 or less treated from Jan. 1, 1984 to Dec. 31. 1993 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea, were studied retrospectively. We obtained the following results; The 5-year survival rates by clinical stage were 88.7Y% in stage I b, 71.5% in stage IIa, 31.2% in stage IIb and O% in stage III or above. The lymph node metastasis rates by stage in RAH group, were 21.3% in stage I b and 31.8% in stage IIa. The lymph nodc metastasis rates by lesion size in RAH group, were 19.2% in 2cm below, 20.7% in 2-4cm and 40.0% in 4cm above. The 5-year survival rates in RAH group were 74,9% in lymph node positive group and 89.0% in lymph node negative group. The recurrenee rates by clinieal stage were 0% in stage Ia, 20.6% in stage I b, 22.2% in stage IIa, 50.0% in stage Ilb and 90.9% in stage III or above.
Busan ; Female ; Gynecology ; Humans ; Incidence ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

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Clinical Significance of p53 Gene Expression with Immunohistochemical Staining in Ovarian Cancer.

Jae Wook KIM ; Yeun Hae LEE ; Young Tae KIM ; Chung Pil LEE ; Dong Kyu KIM ; Chan Ho SONG

Korean Journal of Gynecologic Oncology and Colposcopy.1995;6(1):7-12.

Mutation of p53 gene is one of t.he commonest genetic changes in the development of human cancer including ovary. We intvestigated the diagnostic usefulness of the demonstration of p53 gene immunoreactivity in ovarian cancers, because immunochemical demonstration of p53 immunoreactivity is inexpensive, easily controlled and can be applied in routine pathology laboratories. p53 immunoreactivity was not identified in any patients in whom there was no morphological evidence of neoplasia. ln contrast, in contrast, in 46% of patients of ovarian cancer, p53 immunoreactivity was identified. Overexpression of gene correlated with advanced stage but did not corre1ate with grade, cell type and tumor size.
Female ; Genes, p53* ; Humans ; Immunohistochemistry ; Ovarian Neoplasms* ; Ovary ; Pathology

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A Case of Small Cell Carcinoma of the Ovary.

Jin Hak KIM ; Kwang Rae KIM ; Jong Il BAIK ; Yong Sang SONG ; Soon Beom KANG ; Hyo Pyo LEE

Korean Journal of Gynecologic Oncology and Colposcopy.1993;4(2):82-87.

Small cell carcinoma of the ovary has been identified as a specific histopathologic entity. The first II cases were reported by Dickersin et a1, 1982, Since then only 80 cases were reported in literature. This rare and highly aggresive melignancy primarily affeets ehildren and young women(10-40) and grows rapidly, with hypercalcemia occuring frequently. Abscence of effective treatment results in early mortality. Recently we have experienced one case of primary sma11 cell carcinoma of the ovary, which is presented with a brief review of the literature.
Carcinoma, Small Cell* ; Female ; Hypercalcemia ; Mortality ; Ovary*

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Pelvic Exenteration in Treatment of Pelvic Malignancy : 3 Years Experience.

Seung Kew BAIK ; Sun Ha YANG ; Hye Won JEON ; Jong Hoon KIM ; Yong Sang SONG ; Soon Beom KANG ; Hyo Pyo LEE

Korean Journal of Gynecologic Oncology and Colposcopy.1993;4(2):38-47.

Treatment of pelvic malignancy persistent or recurrent after surgery, radiation therapy or chemot-herapy presents a difficult therayeutie challenge. Those patients with central recurrence can be considered as candidate for radical resection. However we must consider many factors for the choice of treatment modality for advanced or recurrent pelvic rnalignancy as follows; the size and location of the recurrent cancer, dose of radiation therapy given, general conditions of the patient and the experience of the surgeon. Pelvie exenteration, when appropriate, is suecessful treatment for recurrent or persistent pelvic malignancy; 5-year survivai has been reported to be as high as 50%. We experienced seven cases of pelvic exepteration for pelvic malignancy between Mar. 1990 and Feb. 1993, Accordingly we present the cases with a brief review of the literatures. Seung Kew Baik, et al..: PeIlvic Exenteration in Treatment of Pelvic Malignancy: 3 Years Experience
Humans ; Pelvic Exenteration* ; Recurrence

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The Clinical value of Z-Sampler in Endometrial Sampling : A ComParative Study of Z-aspirator Versus Dilatation and Curettage.

Chang Suk SEO ; Eun Hwan JEONG ; Jong Hoon KIM ; Hye Sung MOON ; Yong Sang SONG ; Soon Beom KANG ; Hyo Pyo LEE

Korean Journal of Gynecologic Oncology and Colposcopy.1993;4(2):22-29.

For more than 20 years, many cytologic techniques have been developed for endometrial sampling such as Gravlee jet aspirator, Isaacs cell sampler, Vabra aspirator, Pipelle, etc. But none of the techniques received general acceptanee as a replacement for dilatation and curettage. Hence dilatation and curettage is still used to evaluate women at high risk for endometrial cancer and infertility, to manage abnormal uterine bleeding and to follow womeh on hormone replacement therapy, But biopsy methods produce enough pain to lower patients acceptance, Z-sarnpler is a new simple plastic endornetrial suction curette that provides a histologic diagnosis like Pippelle, This study compared the clinical usability of the Z-sampler to that of endometrial biopsy by dilatation and eurettage. The Z-sampler obtained sufficient tissues for histologic diagnosis in 45 cases(45/50, 90.0%), it was lower than that of end.ometrial biopsy(49/50, 98,0%), But the accuracy of tissue diagnosis was almost equal to that of endometrial biopsy. In addition. Z-sempler cau less pain(94.1%) and the duration of this procdure was shorter than that of endometrial biopsy by dilatation and curettage. These results suggest that the Z-sampler may be efficieot technique in endometrial tissue diagnosi, like dilatation and curettage and it has greater patient acceptability due to less pain, less bleeding and shorter duration of procedure.
Biopsy ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Endometrial Neoplasms ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Infertility ; Plastics ; Suction ; Uterine Hemorrhage

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An Expression of HER-2/neu Oncoprotein in Endometrial Cancer.

Kyung Tai KIM

Korean Journal of Gynecologic Oncology and Colposcopy.1993;4(2):1-9.

It has been reported that overexpression of HER-2/neu occurs in one third of breast and ovarian cancers and that overexpression is associated with poor prognosis. A polyclonal antibedy against HER-2/ neu oncoprotein was used to assess immunohistachemically the level of HER-2/neu expression in normal and malignant endometrial carcinoma. In 8 normal endometrial samples light to moderate(0- +2) staining for HER-2/neu was seen in the giands, and there was no variation in intensity of staining during the menstrual cycle, Among 15 endometrial adenocarcinomas. three(20%) were found to have heavier staiaing (+3) for HER-2/neu than was seen in normal endometrium. High expression of HER-2/neu was found in 50%(1/2) of patients with metastatic disease(stages III or more) compared with 15%(2/13) of patients with disease confined to the uterus(stage I). Survival of the 3 patients with high HER-2/neu expression was significantly worse than that of the 1.2 patients with normal HER-2/neu expression. (Median survival: 49. I vs 28. 7 months (p=0.0348)) Further studies are needed to determine the significance of HER-2/ neu overexpression in endometrial cancer.
Adenocarcinoma ; Breast ; Endometrial Neoplasms* ; Endometrium ; Female ; Humans ; Menstrual Cycle ; Ovarian Neoplasms ; Prognosis

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Two Cases of Sclerosing Stromal Tumor of the Ovary.

Chang Nam KIM ; Seon Kyung LEE ; Seung Bo KIM ; Moon Ho YANG

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):70-76.

Sclerosing stromal tumor of the avary(SST) is a rare benign tumor first described as a distinct neoplasm by Chalvardjian and Scully(1973) and confirmed as such by Scully(1977) and Gee and Russell(1979). This tumor was separated from the thecoma fibroma group on the basis of characteristic histolog ic features. We present two caaes of postmenopausal women in seuentieth decades with SST, other reported cases of SSTs are discused.
Female ; Fibroma ; Humans ; Ovary* ; Thecoma

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Comparative Study of the Cervical Cytology, Colposcopic Impression and Directed Biopsy on the Role of the Diagnostic Approach to the Cervical Carcinoma.

Ho Suk SUH ; Joon MOON

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):56-63.

A total of 369 patients with abnoirmal cervical eytology and suspicious lesions of the cervix were colposcoped end 356 patients of whom were, taken directed biopsy to assess the lesions preeisely and compare the aeeuracy of the eaeh methods. The results of cervical cytology were elso compared with the colpoacopic impression and colposcopically directed biopsies. 252 patients with abnr;irmal colyoaeopie findings were performl conization, simple hiysterectomy or radical hysterectomy depending on their current idisease statua. The rate of one grade less or more advanced correlation between the cervical cytology and directed biopsy was 72.4% and thiat of two grade less wns 80.3% and as for the correletion between the colposcopic imprwssions and the colposcopically directed biopsies, the rate of ciompatibility was 91.5%. Bases on the hetopathologic findings of the surgical apeeimen, the eompatibility rotcs of eervical cytology, colposcopic impressions and colposcopilIy divected hiopsies were 70.2%, 90.6% and 98.0% respectively. With these results, we can reach a conclusion that the colpnscopic impression itself is almost as accurate as the colposcopicolly directed biosy and the directed biopsy can take the place of conization so far as the diagnostic accuracy is concerned.
Biopsy* ; Cervix Uteri ; Conization ; Female ; Humans ; Hysterectomy

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Adenoma Malignum(Minimal deviation adenocarcinoma) Resembling Benign Lesions of the Uterine Cervix: A Clinicopathological Analysis of six cases.

Tae Jin KIM ; Kyung Taek LIM ; Hee Soo BAEK ; Jae Uk SHIM ; Chong Taek PARK ; Hy Sook KIM

Korean Journal of Gynecologic Oncology and Colposcopy.1994;5(1):45-55.

Six cases of a rare variant of endocervieal adenocarcinoma (Adenoma maligum, AM) were collected for clinicopethologic analysis. The everage age of six patients was 49.3 years, and their chief com plaints were persis(ent mucid or watery discharge and intermittent vaginal spotting, The clinical im presaion was carcioma of The uterine cervix in faur out, of six cases. All except one were pathologically confirmed by initia1 biupey. two cases by colposcopic biopsies, two by cone biopsies, one by cone biopsy after suggested AM in calposcopic hiopsy. One case was incidentally found from hysterectnmised speeimen, which waas suspected as adennmyosis. On gross examination, the cervix usualty appeared either firm or indurated with thickening af the wall excepl one which was presented es a fungnting mass. The characteristic histologic feetures were ext,ensive arborizing endeervical glands with marked variation in size and shape, and the glands lined by mucin conyaining columnar epithelial cells with basal bland looking nuclei but with occasional cytologic atypia and rare mitose. The nenplasi.ic glands were characterized by deep stronml invasion be yond normal enddcervical glands, assosiated with loose edematous periglandular desmaplastic stromal reaction in moat cases. Immunohistochemical stainnings for carcinoembryonie antigen (CEA) revealed ey- toplasmic positivity in five cases. The clinical stage for all exeept one incidental case were : four Ib and one II b. In three cases, the radical hysterectomy with unilateral salpingooophorectomy plus dissection of bilateral pelvic and paraaortic lymph nodes was performed, and in one case radiotherapy was done prior to radical hysterectomy with bilateral salpingoophorectomy plus the dissection of left pelvic lymph nodes followed by chemotherapy. Total abdominal hysterectomy with bilateral salpingooophorectomy plus Burch's operation followed by radiation therapy was performed in on case. The remaining one case was treated with radiation therapy. Metastasis to the left obturator lymph node was discovered in one case with state IIb, and the patient expired 29 months after the radiotherapy. The remaining five cases are being carefully followed up. From our experience, we conclude that the early diagnosis of AM can be made based on comprehensive analysis concerning the clinical features, histopathological and immunohistochemical findings. The early diagnosis and proper therapy can lead to the better prognosis.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Drug Therapy ; Early Diagnosis ; Epithelial Cells ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Metrorrhagia ; Mucins ; Neoplasm Metastasis ; Prognosis ; Radiotherapy

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