Table of Contents
1
UI - 11552718
AU - Liu AY; Chan WY; Ng EK; Zhang X; Li BC; Chow JH; Chung SC
TI -
Gastric choriocarcinoma shows characteristics of adenocarcinoma and
gestational choriocarcinoma: a comparative genomic hybridization and
fluorescence in situ hybridization study.
SO - Diagn Mol Pathol 2001 Sep;10(3):161-5
AD - Department of Anatomical & Cellular Pathology, Chinese University of
Hong Kong, Prince of Wales Hospital, Shatin, NT.
The authors report two cases of the rare primary gastric
choriocarcinoma. These tumors showed an overwhelming predominance of
cytotrophoblast- and syncytiotrophoblast-like tumor cells that were
positive for beta-human chorionic gonadotrophin, with small foci of
glandular differentiation. Beta-human chorionic gonadotrophin was also
detected serologically in one patient. Comparative genomic hybridization
study was performed on one specimen. Copy number gains of chromosomes
12, 17, 20, 22, and X, together with losses on 18q, were the major
findings. Except for the gain of chromosome 12, which is known to be
uncommon in primary gastric adenocarcinoma but frequently associated
with choriocarcinoma, the remaining genomic imbalances were among the
most common comparative genomic hybridization findings reported in
primary gastric adenocarcinoma. Fluorescence in situ hybridization on
paraffin sections of both specimens confirmed the presence of polysomy
17 and trisomy 12. These results suggest that primary gastric
choriocarcinoma genetically possesses characteristics of both
adenocarcinoma and gestational choriocarcinoma. The authors believe this
is the first interphase cytogenetics study on this rare tumor, and that
the results support the theory that gastric choriocarcinoma arises from
alternate differentiation pathways of adenocarcinoma.
2
UI - 11759139
AU - Celeski D; Micho J; Walters L
TI -
Anesthetic implications of a partial molar pregnancy and associated
complications.
SO - AANA J 2001 Feb;69(1):49-53
AD - Naval Hospital, Okinawa, Japan.
In the United States, molar pregnancy occurs between 1 in 1,200 and 1 in
2,500 pregnancies. The critical nature of complications associated with
a molar pregnancy requires advanced perioperative anesthetic management.
This case report details the perioperative events of a 34-year-old
gravida 5, para 3, with a partial molar pregnancy who underwent general
anesthesia for a dilatation and curettage procedure, following
therapeutic termination of a coexisting fetus at 18 weeks' gestation.
Her initial presentation, anesthetic and operative management, and
postoperative course are described clearly. The medical and anesthetic
interventions required for treatment of molar pregnancy are reviewed. Of
molar pregnancies, 80% are uncomplicated and follow an unremarkable
course. However, for the remaining 20%, complications can be severe and
may lead to substantial morbidity and mortality in otherwise healthy
women.
3
UI - 11769671
AU - Cui Z; Xiang Y; Yang X
TI -
[Establishment of the drug resistant cell line of choriocarcinoma and
the reversal of drug resistance by transfection of human interleukin 2
gene]
SO - Zhonghua Fu Chan Ke Za Zhi 2001 Sep;36(9):549-53
AD - Department of Gynecology, Affiliated Hospital, Medical College of
Qingdao University, Qingdao 266003, China.
OBJECTIVE: To establish the drug-resistant cell line of choriocarcinoma
and to study the transfection of the human interleukin 2 (hIL-2) gene
into the established drug resistant cell line and investigate the
reversal of the multidrug resistance. METHODS: The resistant cell line
was established by pulse exposed choriocarcinoma cell line JEG-3 to
etopside (VP-16) for ten months. The recombinant plasmid containing
pcDNA3.1(+)-hIL-2 gene was constructed. The drug resistant cell line was
transfected with the constructed plasmid by lipofectin, and the tumor
cell colonies containing the IL-2 sequence were selected by genetin. The
expression of hIL-2 and drug resistant-related genes was detected by
reverse transcript polymerase chain reaction. The chemosensitivity of
the gene-transfected tumor cells and the non transfected cell lines to
methetraxate, VP-16, kengshengmycine, paclitaxol and 5-fluorouracil was
determined by the methyl thiazolyl tetrazolium cytotoxicity assay.
RESULTS: The transfected cells expressed human hIL-2 gene, and showed
the reversal of multidrug resistance by methyl thiazolyl tetrazolium
assay. The transfected cells expressed no multidrug resistance gene-1
(MDR1) on mRNA level. Drug resistance index to VP-16 decreased from 38.7
to 6.0 and 6.1, the index to methetraxate decreased from 14.5 to 2.6 and
2.5, to methetraxate from 13.0 to 2.0. CONCLUSION: The transfection of
hIL-2 gene into the drug resistance cell line of choriocarcinoma can
modulate the MDR1 expression on the mRNA level, and reverse the drug
resistance.
4
UI - 11587021
AU - Curtin WM; Marcotte MP; Myers LL; Brost BC
TI -
Trisomy 13 appearing as a mimic of a triploid partial mole.
SO - J Ultrasound Med 2001 Oct;20(10):1137-9
AD - Department of Obstetrics and Gynecology, Medical College of Ohio,
Toledo, USA.
5
UI - 11603223
AU - Kommoss F; Schmidt D; Coerdt W; Olert J; Muntefering H
TI -
Immunohistochemical expression analysis of inhibin-alpha and -beta
subunits in partial and complete moles, trophoblastic tumors, and
endometrial decidua.
SO - Int J Gynecol Pathol 2001 Oct;20(4):380-5
AD - Institut fur Pathologie, A 2, 2, 68159 Mannheim, Germany.
The expression of inhibin-alpha subunit has been described in normal
placentas, hydatidiform moles, and trophoblastic tumors. We performed a
double immunohistochemical expression analysis of inhibin-alpha and
inhibin-beta subunits in a cytogenetically well characterized series of
21 complete and 22 partial hydatidiform moles, 2 placental site
trophoblastic tumors, and one choriocarcinoma. Syncytiotrophoblastic
cells were consistently inhibin-alpha and inhibin-beta positive in all
hydatidiform moles and in the one choriocarcinoma. Cytotrophoblast was
negative for both subunits in all trophoblastic lesions studied. While
villous intermediate trophoblastic cells were consistently inhibin-alpha
negative in all hydatidiform moles, focal inhibin-beta immunoreactivity
was detected in villous intermediate trophoblast in approximately one
third of complete and partial hydatidiform moles. Decidual stromal cells
in 40 hydatidiform moles were inhibin-alpha and inhibin-beta positive in
approximately one third of cases. Both placental site trophoblastic
tumors were inhibin-alpha positive but inhibin-beta negative. Our
findings indicate that inhibin-alpha and -beta subunits are consistently
coexpressed in syncytiotrophoblast in complete and partial moles.
Immunohistochemical detection of inhibin subunits may be useful in the
differential diagnosis of trophoblastic lesions.
6
UI - 11759958
AU - Benjapibal M; Wataganara T; Senawong S; Boriboonhirunsarn D; Suphanit I
TI -
The correlation of beta-subunit human chorionic gonadotropin level in
the serum and first morning urine of patients with gestational
trophoblastic disease.
SO - J Med Assoc Thai 2001 Jul;84(7):1000-5
AD - Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj
Hospital, Mahidol University, Bangkok, Thailand.
The purpose of this cross-sectional study was to determine the
correlation of beta subunit human chorionic gonadotropin (beta-hCG)
level in the serum and first morning urine samples of patients with
gestational trophoblastic disease (GTD). A total of 81 paired serum and
first morning urine samples from 24 patients diagnosed with GTD, who had
their follow-up at the Division of Gynecologic Oncology, Department of
Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol
University. The paired serum and first morning urine samples were
measured for beta-hCG level, using enzyme-linked immunosorbent assay
(ELISA). After logarithmic transformation, serum beta-hCG level was
strongly and significantly correlated to those of first morning urine
samples, with the correlation coefficient of 0.97 (p < 0.01). Among the
disease-remission group (serum beta-hCG of less than 5 mIU/ml), the
correlation coefficient was 0.52 (p < 0.01), which was still
statistically significant. Stronger statistical significance was found
in the disease-active group (serum beta-hCG of 5 mIU/ml or higher), with
the correlation coefficient of 0.95 (p < 0.01). We concluded that the
level of serum beta-hCG was strongly and significantly correlated with
those of first morning urine samples, especially in patients with active
disease. Determination of beta-hCG level using first morning urine
samples can be used as an effective mean in the follow-up of patients
with GTD.
7
UI - 11422477
AU - Burton JL; Lidbury EA; Gillespie AM; Tidy JA; Smith O; Lawry J; Hancock
TI -
BW; Wells M
Over-diagnosis of hydatidiform mole in early tubal ectopic pregnancy.
SO - Histopathology 2001 May;38(5):409-17
AD - Section of Oncology and Pathology, Division of Genomic Medicine,
University of Sheffield Medical School, Beech Hill Road, Sheffield S10
2RX, UK. j.l.burton@shef.ac.uk
AIMS: Tubal ectopic hydatidiform moles are rare lesions, and only 40
cases have been reported in the world literature. We investigated the
apparently high incidence of tubal ectopic hydatidiform moles in women
referred for treatment to a Supraregional Trophoblastic Tumour Screening
and Treatment Centre between 1986 and 1996. METHODS AND RESULTS: Of 4261
women referred during the study period, 25 (0.6%) had a suspected tubal
ectopic hydatidiform mole and paraffin-embedded tissue was available in
20 (80%) of these. Each case was reviewed by two pathologists and DNA
flow cytometric analysis was undertaken when the histological diagnosis
was initially deemed equivocal or suggestive of hydatidiform mole. On
review, 17 cases (85%) showed no evidence of hydatidiform mole
(circumferential trophoblastic proliferation, hydrops, scalloped villi,
and stromal karyorrhexis). Of these, 11 cases (65%) showed features of
early placentation and six (35%) showed hydropic abortion. DNA flow
cytometry was performed in 14 (82%) of these cases and revealed a
diploid population in each case. Three cases of molar pregnancy (15%)
were identified. Each of these cases had the histological features of an
early complete hydatidiform mole. Sufficient tissue was available for
DNA flow cytometric analysis in two of these cases and confirmed the
presence of diploidy in each. CONCLUSION: Our results show that tubal
ectopic hydatidiform mole is a rare entity and demonstrate that it is
over-diagnosed. Polar trophoblastic proliferation and hydropic villi are
features of early placentation and of hydropic abortion. Sheets of
extravillous trophoblast may be particularly prominent in tubal ectopic
gestation. In the absence of circumferential trophoblastic proliferation
combined with hydropic change a diagnosis of gestational trophoblastic
disease should be avoided.
8
UI - 11532043
AU - Rees HC; Paradinas FJ
TI -
The diagnosis of hydatidiform mole in early tubal ectopic pregnancy.
SO - Histopathology 2001 Sep;39(3):320-1
AD - Charing Cross Department of Histopathology, The Hammersmith Hospitals
NHS Trust, London, UK.
9
UI - 11695810
AU - Su WH; Wang PH; Chang SP
TI -
Successful treatment of a persistent mole with myometrial invasion by
direct injection of methotrexate.
SO - Eur J Gynaecol Oncol 2001;22(4):283-6
AD - Department of Obstetrics and Gynecology, Yee-Zen General Hospital,
Tao-Yuan, Taiwan.
For patients with persistent or invasive gestational trophoblastic
disease (GTD), systemic injection of chemotherapy is the treatment of
choice if fertility is to be preserved. To prevent serious adverse
effects after systemic use and possibly achieve better effects, direct
local injection of chemotherapy into the tumor site, especially when in
the myometrium, seems a reasonable alternative. A patient with a
persistent molar pregnancy with myometrial invasion is presented. A
plateau of beta-hCG (human chorionic gonadotropin) level around 550
mIU/mL was noticed for three weeks though systemic methotrexate (MTX)
injection and repeat suction curettage had been performed. During the
same period, a well-defined invasive complex with multiple vesicles in
the myometrium was documented using transvaginal ultrasound (TVUS).
Sonar-guided injection to the tumor using 50 mg MTX was performed
uneventfully. An obvious shrinkage of the mass and declining beta-hCG
level were demonstrated after the procedure. The patient restored her
menses after the operation and a fertility evaluation including serial
beta-hCG levels and hysterosalpingography showed them to be within the
reference ranges. The successful outcome of this case encouraged us to
treat localized invasive GTD using direct injection of MTX with the
guidance of TVUS. Since no identical cases were found in our review of
the English literature, more cases and similar regimens are needed to
establish the safety and efficacy of this procedure.
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