To investigate the involvement of expression of the Fragile Histidine Triad(FH1T) gene product in the process of carcinogenesis and progression in cervical carcinoma, we examined its expression by immunohistochemical method in 15 cervical invasive carcinomas, 10 low grade cervical intraepithelial neoplasias(CINs) and 30 high grade CINs(CMI and III). We detected expression of FHIT gene product in 4 of 15(27%) of invasive carcinomas, 3 of 10(30%) low grade CIN and 7 of 30(23%) of high grade CIN, while we detected expression of FHIT gene product in 28 of 45(62%) normal and metaplastic epithelium near the tumor. Thesc data indicate that loss of expression of FH1T gene product has some role in the early tumorigenesis of uterine cervical carcinoma, but not the consequence of the pregression of the tumor

This study evaluated the degree and the frequency of cervical lesions after treatment with LEEP(loop electrosurgical excision procedure) in patients with abnormal Pap smears according to the presence or absence of high-risk HPV infection. From June 1994 to May 1997, eighty patients who showed CIN or chronic cervicitis on LEEP specimens were followed up with Pap smears. The histologic results and follow-up Pap smear data were analyzed. In all cases HPV test by Hybrid Capture assay was performed. Those with neoplastic lesion underwent follow-up Pap smears at least for 1 year with 3 month interval after LEEP. In HPV-positive group(N 38), 63.2% of the cases revealed neoplastic lesion(CIN) on final histologic evaluation, and in HPV-negative group(N 42) 54.8% of the cases did(p 0.26). HPV-positive group represented 25.0%(6/24) of abnormal Pap smear result on follow-up, which is higher than that of HPV-negative group(4.3%; 1/23), showing significant difference (p<0.05). There was a significant difference in the rate of neoplastic lesion developed during follow-up between resection margin-positive group and resection margin-negative group on LEEP(p 0,04). Also, HPV-positive group had significantly higher chance to show abnormal Pap smear results during follow-up(p 0.02). In conclusion, HPV test and margin status were shown to be useful parameters to predict the recurrence or persistence of CIN lesion treated by LEEP.

Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor.

Microinvasive carcinoma of the uterine cervix(Stage Ia) is the earliest stage of squamous carcinoma. The transition from preinvasive to invasive disease is a crucial juncture in the development of cervical cancer. The clinical experience that microinvasive lesions carry a better prognosis justifies a separate diagnostic category. To investigate the clinical and pathological aspects of microinvasive cervical carcinoma, a retrospective study was made on 84 cases, histologically reconfirmed surgical specimens, which had been treated during the period from January, 1985 to December, 1996 at Department of Obstetrics and Gynecology, Kyung-pook National University Hospital. We defined microinvasive carcinoma as stromal invasion not exceeding a depth of Smm from the base of the epithelium presented by FIGO in 1985. The results obtained were as follows; 1. Mean age of 84 patients was 46.9 year old, all were parous women but not 1 patients. 60 cases(71.4%) belonged to stage Ial and 24 cases(28,6%) to stage Ia2. 2. Chief complaints were postcoital spotting and leukorrhea. 3, The corresponding rate of Pap. smear to histologic diagnosis was approximately 29.8%. However correponding rate within one histologic grade was about 33,3%. 4. According to the colposcopic examination, 26.4% of cases revealed suspected abnormal findings suggesting invasive lesion. 5. As to the reports of punch biopsy, 55.1% of cases showed microinvasive and/or invasive lesion. With additional diagnostic conization of cervix, the preoperative diagnosis were correct in 72%. 6. Operation performed were simple hysterectomy, extrafascial hysterectomy or modified radical hysterectomy with both pelvic LN dissection, Simple hysterectomy was most commonly performed. 7. Post-treatment complications were developed in 73.9% of patients who were done with modified radical hysterectomy with both pelvic LN dissection and bladder dysfunction was developed in 50% of the patients.

Objectives: This study was to determine whether drainage after radical hysterectomy and bilateral pelvic lymphadenectomy can reduce the risk of postoperative morbidity as compared with no drainage. Methods: 165 patients with stage Ia2 to Ilb underwent radical hysterectomy and bilateral pelvic lymphadenectomy between January 1995 and May 1997, and those medical records were analyzed, Closed suction drains were placed in group I (n 102), not in group II (n 67). All surgeries were perforrned by the same surgeon in a uniform method. Results: The characteristics of two groups were similar for mean age, preoperative weight, total protein, serum albumin, tumor cell histology, invasion depth, and tumor stage. There was no difference in mean operation time in two groups. But mean estimated blood loss was more in group I than group lI(p<0.05), Postoperative ileus and postoperative stay was similar in both groups. The incidence of pelvic lymphocyst and febrile morbidity in two groups were comparable with 17% in group I and 27% in poup II, but not statistically significant(p>0.05). Rehospitalization rate was higher in group I than in group II. Condusion: Pelvic drainage didn't reduce the postoperative febrile morbidity and lymphocyst formation. Therefore the author could not find any necessity to perform the drainage following radical hysterectomy and pelvic lymphadenectomy,

ICAM-l(Intercellular adhesion molecule-1) is an important early marker of immune activation and response. ICAM-1 is expressed on varous cell types and observed in a variety of diseases, including patients with asthma, melanoma, prostatic cancer, ovarian and colon cancer. Some authors demonstrated the expression of ICAM-1 protein in high-grade intraepithelial squamous neoplasia of cervix by immunohistochemistry and suggested that the expression was related to human papillomavirus infection. The aim of this study was to determine the serum levels of soluble intercellular adhesion molecule-1(sICAM-1) in patients with squamous cell carcinoma of the cervix, Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA), We evaluate invasive squamous cell carcinoma of the cervix (40), carcinoma in situ (16) and control (15) patients. Serum levels of sICAM-1 in healthy volunteers, in parients with carcinoma in situ and invasive cervical cancer were 150.1±41.3, 182.7±105.9, 189.8±60.0 ng/ml, respectively. Although the serum levels of sICAM-1 in patients with carcinoma in situ did not increase, serum levels of ICAM-1 in patients with invasive cervical cancer were significantly increased (control vs invasive cervical cancer, p < 0,05). From the above results, sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.

Objectr. The purpose of this study was to evaluate the relative usefulness of the morphologic scoring system and spectral doppler ultrasonographic analysis in differentiating between benign and malignant adnexal masses. Methods: All patients scanned between July 1995 and June 1998 with sonographically identified and pathologically confirmed adnexal masses formed the study group. The adnexal masses were scored as benign or malignant on the basis of their sonographic appearance. Specific categories included inner wall structure, wall thickness, septal structure, and echogenicity. Women whose morphologic findings were suspicious for malignancy underwent doppler sonography. A threshold pulsatility index of 1.0 and resistance index of 0.4 were used to differentiate benign from malignant lesions. The findings were correlated with the presence of malignancy. Results: Two hundred fifty one patients formed the study group; 215 patients were benign and 36 patients were malignant pathologically. Using the morphologic scoring system, 31 of the 36 malignant masses were classified as suggestive of malignant tumor, and 147 of the 215 benign masses were classified as not suggestive of malignant tumor (sensitivity, 86%; specificity, 68%; positive predictive value, 31%; negative predictive value, 97%). Doppler velocimetry was performed on a total of 62 patients, 19 patients with malignant tumors and 43 patients with benign tumors. A mean PI value of 0.85 and RI value of 0.52 for malignant tumors and mean PI value of 2.00 and RI value of 0.75 for benign tumors was shown. The PI value was significantly lower (p 0.001) in malignant than that of in benign masses, but RI value was not significant (p 0.184). The sensitivity and specificity in the detection of malignancy combined with doppler velocimetry was 86% and 67%, respectively. Conclusion: Doppler velocimetry studies did not add substantially to the prediction of malignancy using the morphologic scoring system.

Recently, the bcl-2 and p53 protein have been recognized as important factors that is contributed to programmed cell death. The objective of this study was to evaluate the prognostic significance of bcl-2 and p53 protein expression in uterine cervical carcinoma. The expression of bcl-2 and p53 in 59 cases of uterine cervical carcinoma (stage IB to IIB) were surgically treated from January 1993 to June 1994. The expression of bcl-2 and p53 was examined by immunohistochemical method using formalin fixed paraffin embedded tissue specimens. The 48 cases were squamous cell carcinoma and 11 cases were adenocarcinoma. The results were as follows: 1. The expression rate of bcl-2 protein was 28.8%(17/59) and there was no significant correlaltion between the expression of bcl-2 protein and the clinicopathologic parameters (histologic type, grade, FIGO stage, cervical invasion depth, lymph node metastasis, parametrial invasion, tumor size, neoadjuvant chemotherapy response, recurrence, survival). 2. The expression rate of p53 protein was 32.2%(19/59) and there was no significant correlation between expression of p53 protein and the clinicopathologic parameters. 3. There was significant correlation between and expression of bcl-2 and p53 protein (P 0.05). In conclusion, bcl-2 and p53 protein are thought to be possible factors in the carcinogenesis of uterine cervical carcinoma and correlate with progression of it. But further study will be required to clarify the role of bcl-2 and p53 in carcinogenesis of the uterine cervix.

Comparative Genomic Hybridization (CGH) is a recently developed molecular cytogenetic technique, which makes it possible to detect chromosomal alteration in solid tumors. To determine whether chromosome alterations are related to cervical carcinoma, we have analyzed 33 cases (24 squamous cell carcinomas and 9 adenocarcinomas, stage Ib-IIIb) from tumor tissues and paraffin embedded tissues by CGH. The cut off value of CGH profiles was 1.15 and 0.85 (green/red ratio). Chromosomal aberrations were detected in 30 out of 33 cases (90.9%). In 32 cases, chromosome 3q was most frequently affected and had greater copy numbers in 20 of tbe 33 cases (60.6%). Interestingly, out of those 20 cases, 10 cases were shown to have a high-level of amplification of chr 3q. In addition to chr 3q, chromosomal gains were observed in chr 1q, 1p, 5p, Sq, 12p, 15q, 19q, 20q, Xp, and Xq. Furthermore chromosomal loss was detected, most commonly in chromosome 11q (11/33). Although less frequent, common losses were also detected in chr 2q, 4p, 4q, Sq, 1 1p, 17p, and 18p. In addition, there were cases of gross chromosome loss for chr 4, 6, 10, 11, 13, 14, 16, 17, 18, 19, 20, 21, 22 and X. In cases involving whole arm deletion, we utilized fluorescence in situ hybridization (FISH) using specific probes a-satellite. We performed HPV typing for 16 and 18 usiag polymerase chain reaction (PCR) and Southem blot analyses. Out of 33 tumor samples, 24 cases (72,7%) were HPV 16 positive, while only 6 cases were positive for HPV 18. two cases were positive for both HPV 16 and 18. We believe that a gain of chromosome 3q as a reeurrent chromosomal aberration may contribute to the tumorigenesis of cervical cancer. However, we could not correlate a pattern of chromosomal aberration with tumor stage or histologic type in cervical cancer.

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.