We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopia... more We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopian tube in a 69-year-old woman presenting with abdominal pain and an adnexal mass. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, received adjuvant chemotherapy and is without evidence of disease 12 months postoperatively. The tumor involved the fallopian tube and was composed of in situ and invasive high-grade serous and undifferentiated carcinoma, leiomyosarcoma, rhabdomyosarcoma and undifferentiated sarcoma. Immunohistochemically, the epithelial and mesenchymal cells expressed CD56, Leu-7 and p53. The epithelial elements expressed nuclear WT1 and calretinin while the mesenchymal cells showed negative nuclear and strong cytoplasmic staining. HBME was observed focally in carcinoma. The expression of mesothelial-associated antigens WT1, calretinin and HBME in MMMT likely reflects the common embryologic derivation of the mesothelium and ur...
We report a case of a 40-year-old primipara Caucasian woman with Turner syndrome (TS) and Hashimo... more We report a case of a 40-year-old primipara Caucasian woman with Turner syndrome (TS) and Hashimoto thyroiditis who had underwent a successful IVF-ET cycle with oocyte donation and single embryo transfer. All pregnancies in women with TS are considered as high risk, with cardiovascular complications being the most dangerous. Our case represents a typical case of fetal growth restriction with gradual slowing down of fetal growth after 28 weeks. At 37 + 3 gestational weeks, a healthy male newborn weighing 2240 g, with artery pH of 7.32 was delivered by cesarean section. The neonate was small for gestational age. Women with TS who become pregnant need close surveillance from a multidisciplinary team of cardiologists, obstetricians and endocrinologists. The primary goal is to prevent maternal complications and to improve perinatal outcome. In doing so, a thorough evaluation of fetal growth and uteroplacental and fetal circulation should by no means be omitted, after 26-28 weeks of gestation. The examinations should be at monthly or even shorter intervals to find early signs of growth restriction and act accordingly.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013
Endometrial cancer is the most common malignancy of the female genital tract. Based on clinical a... more Endometrial cancer is the most common malignancy of the female genital tract. Based on clinical and pathological features, endometrial cancer is classified into two types. The aim of our study was to describe the expression and the potential clinical role of ErbB receptors in Greek patients with type II endometrial cancer. Between 1991 and 2008, 10 women with histologically confirmed type II endometrial cancer were referred to the Department of Gynecologic Oncology of the University of Patras Medical School. Tissue specimens from endometrial lesions were immunostained for EGFR, ErbB-2, ErbB-3 and ErbB-4. For EGFR, 5 cases were positive (50%) and 5 cases were negative. For ErbB-2, 9 cases were positive (90%) and 1 case was negative. For ErbB-3, all cases were positive. For ErbB-4, 7 cases were positive (70%) and 3 cases were negative. Also for all ErbB receptors, 5 cases were positive (50%). During follow up, 3 patients died from their disease. All of them had papillary serous endometrial cancer and 2 of them were positive for all ErbB receptors. Although our study was based on a small number of cases, it is obvious that we had high expression levels of ErbB receptors in patients with type II endometrial cancer. Also the majority of patients with dismal outcome were positive for all ErbB receptors. This is very important, as ErbB-targeted therapies may be clinically active as adjuvant therapy in well-defined subgroups of type II EC patients with EGFR and ErbB-2 overexpression.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1995
A randomised prospective clinical trial was conducted over a 7-year period (1987–1993) in the Dep... more A randomised prospective clinical trial was conducted over a 7-year period (1987–1993) in the Department of Obstetrics and Gynaecology, University of Patras. The purspose of this study was to compare two management protocols of Preterm Premature Rupture of Membranes (PPROM). Two-hundred forty-one women entered the study and were assigned randomly to one of two groups. Group A consisted of 105 subjects who were managed expectantly (tocolysis used for 48 h only, if necessary, to permit full course of steroid therapy), while Group B consisted of 136 subjects, in whom aggressive tocolysis was utilised. The differences in the latency period (time from rupture of membranes to the onset of labour) were not statistically significant between the two groups. On the contrary, statistically significant differences in the incidence of chorioamnionitis and postpartum endomyometritis were found between the two groups (higher in Group B). Twelve subjects in Group A (12105, 11.4%) and 40 in Group B (40136, 29.4%) had choriamnionitis. The relative risk (RR) was 2.47 (95% C.I. 1.42-4.66, P < 0.001). Endomyometritis was diagnosed in 20 subjects in Group A (20105, 19%) and in 45 in Group B (45136, 33.3%). The RR was 1.74 (95% C.I. 1.10-2.75, P < 0.05). These data suggest that long term prophylactic tocolytic therapy in patients with PPROM, while without demonstrated benefit, may result in an increased risk of maternal infectious morbidity, and raise the cost of treatment.
The aim of this retrospective study was to analyze the clinical characteristics, management and p... more The aim of this retrospective study was to analyze the clinical characteristics, management and prognosis of five patients with fallopian tube primary cancer (FTPC) who were diagnosed and treated in our departments. A review of the current literature is also presented. Between January 2000 and August 2009, five cases with histologically confirmed FTPC were diagnosed in our departments and were then evaluated retrospectively. All patients underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and total omentectomy. We had two patients in Stage IA (40%), two patients in Stage IC (40%) and one patient in Stage IIIA (20%). All patients received adjuvant chemotherapy with platinum-based combinations and two of them received additional radiotherapy. FTPC, compared with ovarian primary cancer (OPC), is more likely to present at an early stage and have an overall more favourable outcome. More extensive clinical research must be performed to have definite aetiologic, dia...
To present experience with the percutaneous management of iatrogenic ureteral injuries. Eighteen ... more To present experience with the percutaneous management of iatrogenic ureteral injuries. Eighteen women and six men with a mean age of 59.3 years (range 33-80 years) received a diagnosis of ureteral injury sustained during gynecologic, urologic, and general surgical procedures. In a total of 25 injured ureters, 12 had interruption of continuity of their lumen, 10 were associated with contrast extravasation, and 3 were related to both. A standard percutaneous nephrostomy tract was established on the side of the afflicted kidney. Combined use of hydrophilic guidewires and balloon dilations were performed to achieve antegrade recanalization of the ureteral lesion. Then, a ureteral stent was inserted to assure patency. Average stricture length was 1.21 (range 0.5-1.9 cm). Success of the aforementioned technique was possible in 18 ureters. Successful management in one session took place in 14 ureters. Average hospitalization time was 1.8 days (range 0-5 d). The follow-up period ranged between 12 and 18 months, with mean follow-up time of 12.9 months. Ureteral patency was evident at 1 week follow-up in six patients with obstructed ureters. In the remaining patients, balloon dilation of the stricture was repeated, and another stent was placed. Extravasation of contrast was observed in two patients with extravasating ureters in the same period. Nephrostomy tubes were removed after a mean indwelling period of 5.9 weeks (range 1-12 wks). Two patients treated by the described method died during their hospitalization in the intensive care unit because of sepsis from peritonitis that was related to colon injury and multiple concomitant injuries. Major complications were not observed in the remaining 22 patients during the follow-up period. The minimally invasive management of ureteral injuries is a safe and efficient method for both ureteral obstruction and/or laceration in a wide range of iatrogenic ureteral injuries.
The Akt/mTOR and MAPK pathways are frequently activated in various tumor types but data on endome... more The Akt/mTOR and MAPK pathways are frequently activated in various tumor types but data on endometrial carcinoma are limited. The aim of the present study was to investigate the clinical significance of the expression of phosphorylated MAPK, Akt and mTOR (p-MAPK, p-Akt, p-mTOR) in type I endometrial carcinoma. The study comprised of 103 formalin-fixed paraffin-embedded (FFPE) type I endometrial carcino ma cases, retrospectively retrieved and assessed by immuno histochemistry for p-MAPK, p-Akt and p-mTOR expression. The expression of these proteins was also studied in non-neoplastic endometrial tissue adjacent to the tumor. The expression patterns of these molecules differed between malignant and non-tumorous tissue specimens. The immuno reactivity for p-Akt was exclusively detected in the neoplastic tissues. Expression levels of p-MAPK were higher in tumors compared to non-neoplastic endometrium (p<0.001), while p-mTOR was found to be over-expressed in non-neo plastic endometrium...
Malignant transformation of sex-steroid dependent tissues is associated with the loss of expressi... more Malignant transformation of sex-steroid dependent tissues is associated with the loss of expression of sex steroid receptors as well as of the tumor suppression gene p53. The aim of this study is to evaluate the expression of sex-steroid receptors, p53 and Ki-67 in specimens from pre-malignant and malignant cervical epithelial lesions throughout the menstrual cycle. Immunohistochemical staining was performed on formalin fixed, paraffin embedded tissue sections of normal squamous cervical epithelium, cervical intraepithelial neoplasia and invasive squamous cervical carcinoma, specimens utilizing antibodies against estrogen receptors, progesterone receptors, p53 protein and Ki-67 antigen. In the samples taken from the normal cervical tissue, basal cells were usually estrogen receptor-positive, progesterone receptor-negative, p53-negative and Ki-67-negative throughout the menstrual cycle. In contrast, para-basal cells were estrogen receptor-positive and progesterone receptor-negative i...
Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates... more Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. A 15-year-old primigravid woman, at 28 weeks of gestation with no significant previous medical history, was admitted to our hospital complaining of severe left lower extremity pain and high fever the last 72 hours. During clinical examination, she had a swollen, erythematous and tender to palpation inflamed skin over the medial aspect of the upper thigh without any evidence of injury. Incision drainage was performed immediately and she received broad spectrum antibiotics. During initial laboratory examinations, diabetes mellitus was diagnosed. There was no clinical improvement over the following days. Magnetic resonance imaging (MRI) revealed subcutaneous tissue inflammation and edema of infected tissues confirming the disease entity. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intens...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
Previous studies have shown that elevated preoperative serum CA 125 levels strongly correlate wit... more Previous studies have shown that elevated preoperative serum CA 125 levels strongly correlate with various clinical and pathological variables and prognosis of patients with endometrial carcinoma (EC). The aim of the present study was to evaluate the clinical significance of preoperative serum CA 125 levels in patients with EC. A retrospective study of all EC patients treated at our institution between 1995 and 2010 with available follow-up was conducted. The preoperative serum level of CA 125 was measured in 99 patients and evaluated in relation to various clinical and pathological variables and outcome. We used the cut-off level of 20 U/ml for CA 125 on chi-square test for categorical variables. Survival analysis was performed with the use of Kaplan Meier method, the log rank test and Cox proportional hazards regression analysis. In the early stages of disease the mean values of CA 125 were 35 U/ml (SD±70) for stages IA-IB and 21 U/ml (SD±29) for stage IC (Mann-Whitney test for co...
Clinical and experimental obstetrics & gynecology, 2009
In a prospective study, we investigated the association between mid-trimester maternal serum AFP ... more In a prospective study, we investigated the association between mid-trimester maternal serum AFP (ms-AFP), maternal serum hCG (ms-hCG) levels and adverse pregnancy outcome in a South-Western Greek population. 126 healthy Greek women with spontaneous pregnancies were investigated for ms-AFP and ms-hCG levels between the 13th and 24th weeks of gestation and followed for adverse pregnancy outcome. Abnormal outcomes were considered as ms-AFP levels or ms-hCG levels > 2.0 multiples of the median value for gestation (MoM). Statistical analysis was performed by Pearson's chi-square test. Elevated ms-AFP levels were detected in a total of 25 out of the 126 women studied (19.84%). Elevated ms-hCG levels were detected in a total of ten of the 126 women studied (7.93%). Elevated ms-AFP and ms-hCG levels were detected in a total of four of the 126 women studied (3.17%). Multiparameter testing of placental function in the mid-trimester (uterine artery Doppler, placental morphology, ms-AFP...
We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopia... more We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopian tube in a 69-year-old woman presenting with abdominal pain and an adnexal mass. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, received adjuvant chemotherapy and is without evidence of disease 12 months postoperatively. The tumor involved the fallopian tube and was composed of in situ and invasive high-grade serous and undifferentiated carcinoma, leiomyosarcoma, rhabdomyosarcoma and undifferentiated sarcoma. Immunohistochemically, the epithelial and mesenchymal cells expressed CD56, Leu-7 and p53. The epithelial elements expressed nuclear WT1 and calretinin while the mesenchymal cells showed negative nuclear and strong cytoplasmic staining. HBME was observed focally in carcinoma. The expression of mesothelial-associated antigens WT1, calretinin and HBME in MMMT likely reflects the common embryologic derivation of the mesothelium and ur...
Clinical and experimental obstetrics & gynecology, 2008
In this prospective study, we investigated the association between mid-trimester maternal serum a... more In this prospective study, we investigated the association between mid-trimester maternal serum alpha-fetoprotein AFP (MSAFP) levels and adverse pregnancy outcome in a South-Western Greek population. 110 healthy Greek women with spontaneous pregnancies, investigated for MSAFP levels between the 13th and 24th week of gestation and followed for adverse pregnancy outcome. AFP levels > 2.0 multiples of the median value for gestation were considered abnormal. Statistical analysis was performed by Pearson's chi-square test. Elevated MSAFP levels were detected in a total of 27 of the 110 women studied (24.5%). Among them, only four women (14.8%) developed pregnancy complications. Multiparameter testing of placental function in the mid-trimester (uterine artery Doppler, placental morphology and MSAFP screening) may allow us to identify women with increased risk of developing severe placental insufficiency and pregnancy complications.
We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopia... more We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopian tube in a 69-year-old woman presenting with abdominal pain and an adnexal mass. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, received adjuvant chemotherapy and is without evidence of disease 12 months postoperatively. The tumor involved the fallopian tube and was composed of in situ and invasive high-grade serous and undifferentiated carcinoma, leiomyosarcoma, rhabdomyosarcoma and undifferentiated sarcoma. Immunohistochemically, the epithelial and mesenchymal cells expressed CD56, Leu-7 and p53. The epithelial elements expressed nuclear WT1 and calretinin while the mesenchymal cells showed negative nuclear and strong cytoplasmic staining. HBME was observed focally in carcinoma. The expression of mesothelial-associated antigens WT1, calretinin and HBME in MMMT likely reflects the common embryologic derivation of the mesothelium and ur...
We report a case of a 40-year-old primipara Caucasian woman with Turner syndrome (TS) and Hashimo... more We report a case of a 40-year-old primipara Caucasian woman with Turner syndrome (TS) and Hashimoto thyroiditis who had underwent a successful IVF-ET cycle with oocyte donation and single embryo transfer. All pregnancies in women with TS are considered as high risk, with cardiovascular complications being the most dangerous. Our case represents a typical case of fetal growth restriction with gradual slowing down of fetal growth after 28 weeks. At 37 + 3 gestational weeks, a healthy male newborn weighing 2240 g, with artery pH of 7.32 was delivered by cesarean section. The neonate was small for gestational age. Women with TS who become pregnant need close surveillance from a multidisciplinary team of cardiologists, obstetricians and endocrinologists. The primary goal is to prevent maternal complications and to improve perinatal outcome. In doing so, a thorough evaluation of fetal growth and uteroplacental and fetal circulation should by no means be omitted, after 26-28 weeks of gestation. The examinations should be at monthly or even shorter intervals to find early signs of growth restriction and act accordingly.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013
Endometrial cancer is the most common malignancy of the female genital tract. Based on clinical a... more Endometrial cancer is the most common malignancy of the female genital tract. Based on clinical and pathological features, endometrial cancer is classified into two types. The aim of our study was to describe the expression and the potential clinical role of ErbB receptors in Greek patients with type II endometrial cancer. Between 1991 and 2008, 10 women with histologically confirmed type II endometrial cancer were referred to the Department of Gynecologic Oncology of the University of Patras Medical School. Tissue specimens from endometrial lesions were immunostained for EGFR, ErbB-2, ErbB-3 and ErbB-4. For EGFR, 5 cases were positive (50%) and 5 cases were negative. For ErbB-2, 9 cases were positive (90%) and 1 case was negative. For ErbB-3, all cases were positive. For ErbB-4, 7 cases were positive (70%) and 3 cases were negative. Also for all ErbB receptors, 5 cases were positive (50%). During follow up, 3 patients died from their disease. All of them had papillary serous endometrial cancer and 2 of them were positive for all ErbB receptors. Although our study was based on a small number of cases, it is obvious that we had high expression levels of ErbB receptors in patients with type II endometrial cancer. Also the majority of patients with dismal outcome were positive for all ErbB receptors. This is very important, as ErbB-targeted therapies may be clinically active as adjuvant therapy in well-defined subgroups of type II EC patients with EGFR and ErbB-2 overexpression.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1995
A randomised prospective clinical trial was conducted over a 7-year period (1987–1993) in the Dep... more A randomised prospective clinical trial was conducted over a 7-year period (1987–1993) in the Department of Obstetrics and Gynaecology, University of Patras. The purspose of this study was to compare two management protocols of Preterm Premature Rupture of Membranes (PPROM). Two-hundred forty-one women entered the study and were assigned randomly to one of two groups. Group A consisted of 105 subjects who were managed expectantly (tocolysis used for 48 h only, if necessary, to permit full course of steroid therapy), while Group B consisted of 136 subjects, in whom aggressive tocolysis was utilised. The differences in the latency period (time from rupture of membranes to the onset of labour) were not statistically significant between the two groups. On the contrary, statistically significant differences in the incidence of chorioamnionitis and postpartum endomyometritis were found between the two groups (higher in Group B). Twelve subjects in Group A (12105, 11.4%) and 40 in Group B (40136, 29.4%) had choriamnionitis. The relative risk (RR) was 2.47 (95% C.I. 1.42-4.66, P < 0.001). Endomyometritis was diagnosed in 20 subjects in Group A (20105, 19%) and in 45 in Group B (45136, 33.3%). The RR was 1.74 (95% C.I. 1.10-2.75, P < 0.05). These data suggest that long term prophylactic tocolytic therapy in patients with PPROM, while without demonstrated benefit, may result in an increased risk of maternal infectious morbidity, and raise the cost of treatment.
The aim of this retrospective study was to analyze the clinical characteristics, management and p... more The aim of this retrospective study was to analyze the clinical characteristics, management and prognosis of five patients with fallopian tube primary cancer (FTPC) who were diagnosed and treated in our departments. A review of the current literature is also presented. Between January 2000 and August 2009, five cases with histologically confirmed FTPC were diagnosed in our departments and were then evaluated retrospectively. All patients underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and total omentectomy. We had two patients in Stage IA (40%), two patients in Stage IC (40%) and one patient in Stage IIIA (20%). All patients received adjuvant chemotherapy with platinum-based combinations and two of them received additional radiotherapy. FTPC, compared with ovarian primary cancer (OPC), is more likely to present at an early stage and have an overall more favourable outcome. More extensive clinical research must be performed to have definite aetiologic, dia...
To present experience with the percutaneous management of iatrogenic ureteral injuries. Eighteen ... more To present experience with the percutaneous management of iatrogenic ureteral injuries. Eighteen women and six men with a mean age of 59.3 years (range 33-80 years) received a diagnosis of ureteral injury sustained during gynecologic, urologic, and general surgical procedures. In a total of 25 injured ureters, 12 had interruption of continuity of their lumen, 10 were associated with contrast extravasation, and 3 were related to both. A standard percutaneous nephrostomy tract was established on the side of the afflicted kidney. Combined use of hydrophilic guidewires and balloon dilations were performed to achieve antegrade recanalization of the ureteral lesion. Then, a ureteral stent was inserted to assure patency. Average stricture length was 1.21 (range 0.5-1.9 cm). Success of the aforementioned technique was possible in 18 ureters. Successful management in one session took place in 14 ureters. Average hospitalization time was 1.8 days (range 0-5 d). The follow-up period ranged between 12 and 18 months, with mean follow-up time of 12.9 months. Ureteral patency was evident at 1 week follow-up in six patients with obstructed ureters. In the remaining patients, balloon dilation of the stricture was repeated, and another stent was placed. Extravasation of contrast was observed in two patients with extravasating ureters in the same period. Nephrostomy tubes were removed after a mean indwelling period of 5.9 weeks (range 1-12 wks). Two patients treated by the described method died during their hospitalization in the intensive care unit because of sepsis from peritonitis that was related to colon injury and multiple concomitant injuries. Major complications were not observed in the remaining 22 patients during the follow-up period. The minimally invasive management of ureteral injuries is a safe and efficient method for both ureteral obstruction and/or laceration in a wide range of iatrogenic ureteral injuries.
The Akt/mTOR and MAPK pathways are frequently activated in various tumor types but data on endome... more The Akt/mTOR and MAPK pathways are frequently activated in various tumor types but data on endometrial carcinoma are limited. The aim of the present study was to investigate the clinical significance of the expression of phosphorylated MAPK, Akt and mTOR (p-MAPK, p-Akt, p-mTOR) in type I endometrial carcinoma. The study comprised of 103 formalin-fixed paraffin-embedded (FFPE) type I endometrial carcino ma cases, retrospectively retrieved and assessed by immuno histochemistry for p-MAPK, p-Akt and p-mTOR expression. The expression of these proteins was also studied in non-neoplastic endometrial tissue adjacent to the tumor. The expression patterns of these molecules differed between malignant and non-tumorous tissue specimens. The immuno reactivity for p-Akt was exclusively detected in the neoplastic tissues. Expression levels of p-MAPK were higher in tumors compared to non-neoplastic endometrium (p<0.001), while p-mTOR was found to be over-expressed in non-neo plastic endometrium...
Malignant transformation of sex-steroid dependent tissues is associated with the loss of expressi... more Malignant transformation of sex-steroid dependent tissues is associated with the loss of expression of sex steroid receptors as well as of the tumor suppression gene p53. The aim of this study is to evaluate the expression of sex-steroid receptors, p53 and Ki-67 in specimens from pre-malignant and malignant cervical epithelial lesions throughout the menstrual cycle. Immunohistochemical staining was performed on formalin fixed, paraffin embedded tissue sections of normal squamous cervical epithelium, cervical intraepithelial neoplasia and invasive squamous cervical carcinoma, specimens utilizing antibodies against estrogen receptors, progesterone receptors, p53 protein and Ki-67 antigen. In the samples taken from the normal cervical tissue, basal cells were usually estrogen receptor-positive, progesterone receptor-negative, p53-negative and Ki-67-negative throughout the menstrual cycle. In contrast, para-basal cells were estrogen receptor-positive and progesterone receptor-negative i...
Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates... more Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. A 15-year-old primigravid woman, at 28 weeks of gestation with no significant previous medical history, was admitted to our hospital complaining of severe left lower extremity pain and high fever the last 72 hours. During clinical examination, she had a swollen, erythematous and tender to palpation inflamed skin over the medial aspect of the upper thigh without any evidence of injury. Incision drainage was performed immediately and she received broad spectrum antibiotics. During initial laboratory examinations, diabetes mellitus was diagnosed. There was no clinical improvement over the following days. Magnetic resonance imaging (MRI) revealed subcutaneous tissue inflammation and edema of infected tissues confirming the disease entity. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intens...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
Previous studies have shown that elevated preoperative serum CA 125 levels strongly correlate wit... more Previous studies have shown that elevated preoperative serum CA 125 levels strongly correlate with various clinical and pathological variables and prognosis of patients with endometrial carcinoma (EC). The aim of the present study was to evaluate the clinical significance of preoperative serum CA 125 levels in patients with EC. A retrospective study of all EC patients treated at our institution between 1995 and 2010 with available follow-up was conducted. The preoperative serum level of CA 125 was measured in 99 patients and evaluated in relation to various clinical and pathological variables and outcome. We used the cut-off level of 20 U/ml for CA 125 on chi-square test for categorical variables. Survival analysis was performed with the use of Kaplan Meier method, the log rank test and Cox proportional hazards regression analysis. In the early stages of disease the mean values of CA 125 were 35 U/ml (SD±70) for stages IA-IB and 21 U/ml (SD±29) for stage IC (Mann-Whitney test for co...
Clinical and experimental obstetrics & gynecology, 2009
In a prospective study, we investigated the association between mid-trimester maternal serum AFP ... more In a prospective study, we investigated the association between mid-trimester maternal serum AFP (ms-AFP), maternal serum hCG (ms-hCG) levels and adverse pregnancy outcome in a South-Western Greek population. 126 healthy Greek women with spontaneous pregnancies were investigated for ms-AFP and ms-hCG levels between the 13th and 24th weeks of gestation and followed for adverse pregnancy outcome. Abnormal outcomes were considered as ms-AFP levels or ms-hCG levels > 2.0 multiples of the median value for gestation (MoM). Statistical analysis was performed by Pearson's chi-square test. Elevated ms-AFP levels were detected in a total of 25 out of the 126 women studied (19.84%). Elevated ms-hCG levels were detected in a total of ten of the 126 women studied (7.93%). Elevated ms-AFP and ms-hCG levels were detected in a total of four of the 126 women studied (3.17%). Multiparameter testing of placental function in the mid-trimester (uterine artery Doppler, placental morphology, ms-AFP...
We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopia... more We report a case of malignant mixed müllerian tumor (MMMT) (carcinosarcoma) of the right fallopian tube in a 69-year-old woman presenting with abdominal pain and an adnexal mass. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, received adjuvant chemotherapy and is without evidence of disease 12 months postoperatively. The tumor involved the fallopian tube and was composed of in situ and invasive high-grade serous and undifferentiated carcinoma, leiomyosarcoma, rhabdomyosarcoma and undifferentiated sarcoma. Immunohistochemically, the epithelial and mesenchymal cells expressed CD56, Leu-7 and p53. The epithelial elements expressed nuclear WT1 and calretinin while the mesenchymal cells showed negative nuclear and strong cytoplasmic staining. HBME was observed focally in carcinoma. The expression of mesothelial-associated antigens WT1, calretinin and HBME in MMMT likely reflects the common embryologic derivation of the mesothelium and ur...
Clinical and experimental obstetrics & gynecology, 2008
In this prospective study, we investigated the association between mid-trimester maternal serum a... more In this prospective study, we investigated the association between mid-trimester maternal serum alpha-fetoprotein AFP (MSAFP) levels and adverse pregnancy outcome in a South-Western Greek population. 110 healthy Greek women with spontaneous pregnancies, investigated for MSAFP levels between the 13th and 24th week of gestation and followed for adverse pregnancy outcome. AFP levels > 2.0 multiples of the median value for gestation were considered abnormal. Statistical analysis was performed by Pearson's chi-square test. Elevated MSAFP levels were detected in a total of 27 of the 110 women studied (24.5%). Among them, only four women (14.8%) developed pregnancy complications. Multiparameter testing of placental function in the mid-trimester (uterine artery Doppler, placental morphology and MSAFP screening) may allow us to identify women with increased risk of developing severe placental insufficiency and pregnancy complications.
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