Publications by authors named "Lukasz Wicherek"

69 Publications

The association between lymph node metastases and long-term survival in patients with epithelial ovarian cancer.

Contemp Oncol (Pozn) 2020 20;24(3):163-171. Epub 2020 Sep 20.

nd Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Introduction: A key survival prognosis factor for patients treated for ovarian cancer is complete cytoreductive surgery where all macroscopic neoplastic implants, including enlarged metastatic lymph nodes, are removed. We presume that investigating the involvement of the lymphatic system can result in a more individualized approach to the treatment of ovarian cancer patients. The main aim of our study was to analyze the relationship between the presence, number and types of lymph node metastases and ovarian cancer patient prognosis.

Material And Methods: We carried out a retrospective analysis of patients who underwent cytoreduction due to primary ovarian cancer, between 2010 and 2015. We analyzed the number of metastatic lymph nodes, the lymph node ratio defined as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes removed, extracapsular involvement, and the histopathological pattern of metastases.

Results: The study group included 651 patients. Of these, 377 had lymphadenectomy, 144 presented with lymph node metastases, and 233 had no lymph node metastases. We also included a group of 274 patients who did not have lymphadenectomy. Patients with more than 4 metastatic lymph nodes and a lymph node ratio of ≥ 0.1 had significantly poorer overall survival. Extracapsular involvement had no relation to patient overall survival. Multivariant survival analysis indicated that a lymph node ratio of ≥ 0.1 was an independent predictor of poor survival.

Conclusions: The analysis of lymph node metastases in ovarian cancer patients can have predictive value for patient overall survival.
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http://dx.doi.org/10.5114/wo.2020.99029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670182PMC
September 2020

Analysis of long-term outcomes in 44 patients following pelvic exenteration due to cervical cancer.

World J Surg Oncol 2020 Sep 2;18(1):234. Epub 2020 Sep 2.

2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Bielanski Hospital, Ceglowska 80 St, 01-809, Warsaw, Poland.

Background: Pelvic exenteration (PE) may be associated with prolonged overall survival (OS) in selected patients with advanced or recurrent cervical cancer. However, the factors related to improved survival following PE are not clearly defined. The aim of this study was to perform a retrospective analysis of OS rates in a group of patients undergoing PE in order to identify the factors related to improved long-term outcomes.

Methods: Our study group consisted of 44 patients, including 21 squamous cell cancer (SCC) patients, 22 patients with adenocarcinomas (AC) of the cervix, and one patient with undifferentiated cervical carcinoma. The patients were categorized according to the type of surgery, namely, primary surgery (12 patients) or surgery due to cancer recurrence (32 patients).

Results: In the group of patients with recurrent cervical cancer, we found that improved OS correlated with the SCC histological type and the presence of vaginal fistula. The need for reoperation within 30 days and the presence of severe adverse events significantly worsened the prognosis. We found a non significant trend toward improved survival in those patients with tumor-free margins. Lymph node metastases, the initial stage of the disease, the time to recurrence, and a history of hysterectomy had no impact on patients' OS. In the group of patients undergoing primary PE, we observed a trend toward improved survival among those diagnosed with vaginal fistula.

Conclusions: Pelvic exenteration seemed to improve the long-term outcomes for patients with SCC cancer recurrence and vaginal fistula whose surgery was unrelated to severe adverse events.
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http://dx.doi.org/10.1186/s12957-020-01997-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7469312PMC
September 2020

High post-treatment serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) levels is associated with poor survival of patients with cervical cancer.

J Obstet Gynaecol Res 2020 Mar 17;46(3):499-506. Epub 2020 Jan 17.

2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Aim: Receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) is responsible for induction of selective immunosuppression. In addition, preclinical studies have shown that sRCAS1 levels may reflect cancer aggressiveness. The main aim of our study was to analyze pre- and post-treatment levels of sRCAS1 in the sera of patients treated for cervical cancer and to evaluate whether the levels change during treatment and their impact on patient prognosis.

Methods: The study included 49 patients suffering from cervical cancer. The early stage cervical cancer patients (14) were treated surgically, while the advanced stage patients (35) underwent radiochemotherapy. Serum sRCAS1 levels were evaluated both before and after intervention with the use of the ELISA method.

Results: We have found that median serum sRCAS1 levels of patients before intervention were not significantly different from the levels assessed after intervention. There were also no differences when pre- and post-treatment levels were compared within the group of early and of advanced stage patients. Serum sRCAS1 levels were not influenced by either the histopathological type of the tumor or the methods of treatment. High post-intervention sRCAS1 levels indicated shortened OS when compared to low sRCAS1 levels. Neither pre-intervention sRCAS1 levels nor the alteration in sRCAS1 levels during treatment were associated with patient prognosis. In multivariate analysis, post-treatment sRCAS1 levels and clinical stage of cervical cancer remained as independent predictors of survival.

Conclusion: High post-treatment serum sRCAS1 level in cervical cancer patients seems to be a negative prognostic factor for patient overall survival.
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http://dx.doi.org/10.1111/jog.14178DOI Listing
March 2020

Maternal Serum Placental Growth Factor, Soluble Fms-Like Tyrosine Kinase-1, and Soluble Endoglin in Twin Gestations and the Risk of Preeclampsia-A Systematic Review.

J Clin Med 2020 Jan 9;9(1). Epub 2020 Jan 9.

Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland.

Multiple gestation is one of the key risk factors for the occurrence of preeclampsia (PE). Soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin are molecules involved in the process of angiogenesis with a proven role in the pathogenesis of PE. The aim of the review was to summarize available data on maternal serum levels of the above-mentioned factors and their usefulness in predicting PE in twin pregnancies. Only original research articles written in English were considered eligible. Reviews, chapters, case studies, conference papers, experts' opinions, editorials, and letters were excluded from the analysis. No publication date limitations were imposed. The systematic literature search using PubMed/MEDLINE, Scopus, Embase, and Cochrane Library databases identified 338 articles, 10 of which were included in the final qualitative analyses. The included studies showed significant differences in maternal serum levels of the discussed factors between women with twin pregnancies with PE and those who did not develop PE, and their promising performance in predicting PE, alone or in combination with other factors. The identification of the most effective algorithms, their prompt introduction to the clinical practice, and further assessment of the real-life performance should become a priority.
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http://dx.doi.org/10.3390/jcm9010183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019581PMC
January 2020

The analysis of Treg lymphocyte blood percentage changes in patients with head and neck cancer during combined oncological treatment: a preliminary report.

Cent Eur J Immunol 2020 30;45(4):409-413. Epub 2021 Jan 30.

nd Department of Obstetrics and Gynaecology, Center of Postgraduate Medical Education (CMKP), Warsaw, Poland.

Introduction: In patients with cancer, Treg lymphocytes seem to play an important role in promoting tumour growth. The number of circulating Treg cells has been associated with poor survival among patients suffering from various types of cancers. The aim of the present study was to evaluate the changes in the percentage levels of Treg lymphocytes in the blood samples of patients with head and neck cancer during combined treatment with respect to the stage of the disease and the intensity of the radiation reaction as monitored using the Dische scale.

Material And Methods: Peripheral blood samples were collected from 20 head and neck cancer patients prior to the combined oncological treatment, during, and then one week after the completion of the therapy.

Results: A statistically significantly higher percentage of CD3/CD4/CD25/FoxP3/CD127(/low) T cells within the CD3/CD4 T cell population was detected in patients during radiotherapy (RTH), chemotherapy (CTH), and chemoradiotherapy (CRT) than before the treatment began (p < 0.0001). A statistically significantly higher percentage of CD3/CD4/CD25/FoxP3/CD127(/low) T cells within the CD3/CD4 T cell population was detected after RTH/CRT than before treatment, with respect to the radiation reaction as evaluated using the Dische scale (p = 0.0150).

Conclusions: The increase in the percentage of Treg cells correlated with an increase in the intensity of the radiation reaction measured using the Dische scale which indicates the advance of the oral mucositis reaction to RTH. In conclusion, because the role of Treg lymphocytes in cancer patients is complex, it is necessary to monitor the percentages of these cells in patients during combined oncological therapies.
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http://dx.doi.org/10.5114/ceji.2020.103417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882406PMC
January 2021

Performance of Selected Models for Predicting Malignancy in Ovarian Tumors in Relation to the Degree of Diagnostic Uncertainty by Subjective Assessment With Ultrasound.

J Ultrasound Med 2020 May 29;39(5):939-947. Epub 2019 Nov 29.

Division of Gynecologic Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Objectives: The study's main aim was to evaluate the relationship between the performance of predictive models for differential diagnoses of ovarian tumors and levels of diagnostic confidence in subjective assessment (SA) with ultrasound. The second aim was to identify the parameters that differentiate between malignant and benign tumors among tumors initially diagnosed as uncertain by SA.

Methods: The study included 250 (55%) benign ovarian masses and 201 (45%) malignant tumors. According to ultrasound findings, the tumors were divided into 6 groups: certainly benign, probably benign, uncertain but benign, uncertain but malignant, probably malignant, and certainly malignant. The performance of the risk of malignancy index, International Ovarian Tumor Analysis assessment of different neoplasias in the adnexa model, and International Ovarian Tumor Analysis logistic regression model 2 was analyzed in subgroups as follows: SA-certain tumors (including certainly benign and certainly malignant) versus SA-probable tumors (probably benign and probably malignant) versus SA-uncertain tumors (uncertain but benign and uncertain but malignant).

Results: We found a progressive decrease in the performance of all models in association with the increased uncertainty in SA. The areas under the receiver operating characteristic curve for the risk of malignancy index, logistic regression model 2, and assessment of different neoplasias in the adnexa model decreased between the SA-certain and SA-uncertain groups by 20%, 28%, and 20%, respectively. The presence of solid parts and a high color score were the discriminatory features between uncertain but benign and uncertain but malignant tumors.

Conclusions: Studies are needed that focus on the subgroup of ovarian tumors that are difficult to classify by SA. In cases of uncertain tumors by SA, the presence of solid components or a high color score should prompt a gynecologic oncology clinic referral.
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http://dx.doi.org/10.1002/jum.15178DOI Listing
May 2020

An Analysis of Long-Term Outcomes in Patients Treated by Extensive Bowel Resection Due to Advanced Ovarian Cancer Relative to the Effectiveness of Surgery.

Gynecol Obstet Invest 2020 20;85(2):159-166. Epub 2019 Nov 20.

2nd Department of Obstetrics and Gynecology, Medical Center for Postgraduate Education, Warsaw, Poland,

Introduction: Surgery for advanced ovarian cancer (AOC) often requires bowel resections. However, the impact of bowel surgery on patient overall survival (OS) has not yet been precisely determined.

Objective: The aim of the study was to analyze the OS rates in a group of AOC patients undergoing bowel resection.

Methods: We carried out a retrospective analysis of patients who had undergone low anterior resection of the rectum (LAR) during primary or interval debulking surgery for AOC. We divided the patients into 2 groups: Group 1 included 69 patients who underwent only LAR; Group 2 included 66 patients who underwent LAR and additional bowel resection. The control group included 71 AOC patients who did not required bowel resection.

Results: In the subgroup of patients with no gross residual disease (NGR), there were no differences in OS between Groups 1 and 2. In the subgroup of "optimally" (tumors <1 cm) debulked patients, Group 1 patients had a higher median OS than Group 2 patients. Additionally, there was no difference between Groups 1 and 2 as far as the number of severe adverse events.

Conclusions: Multiple bowel resections seem to improve OS in patients when NGR is achieved but should be avoided when complete resection is not possible.
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http://dx.doi.org/10.1159/000504538DOI Listing
September 2020

Cytoplasmic and membranous receptor-binding cancer antigens expressed on SiSo cells (RCAS1) immunoreactivity in epithelial ovarian cancer cells represent differing biological function of RCAS1.

Folia Histochem Cytobiol 2019 7;57(3):116-126. Epub 2019 Aug 7.

Department of Chemotherapy, The Franciszek Lukaszczyk Oncological Center, Bydgoszcz, Poland.

Introduction: Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) is a selective suppressor of the immune response that has been linked to the evasion of immune surveillance by cancer cells. However, the exact prognostic impact of RCAS1 on epithelial ovarian cancer (EOC) has not been fully elucidated. The main aim of our study was to evaluate the influence of RCAS1 immunoreactivity (RCAS1-Ir) in EOC cells and in tumor stroma cells on patient overall survival. We also focused on RCAS1-Ir and the structure of the tumor stroma.

Material And Methods: RCAS1-Ir was evaluated by means of immunohistochemistry in 67 patients with EOC. We distinguished cytoplasmic and membranous immunoreactivity patterns.

Results: We found that high cytoplasmic RCAS1-Ir in cancer cells was associated with more than a two-time shortened period of overall survival. Membranous RCAS1-Ir in cancer cells, as well as in tumor stroma macrophages and fibroblasts, did not correlate with patient survival. RCAS1-Ir in the cytoplasm of cancer cells was positively correlated with the degree of tumor stroma infiltration by fibroblasts and macrophages, but not with RCAS1-Ir in these cells. On the other hand, membranous RCAS1-Ir in cancer cells was positively correlated with RCAS1-Ir in fibroblasts and macrophages, but not with their quantity.

Conclusions: Due to their different impacts on patient prognosis and tumor stroma structure, it seems that cytoplasmic and membranous RCAS1-Ir in EOC cells may have different biological functions.
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http://dx.doi.org/10.5603/FHC.a2019.0012DOI Listing
December 2019

Analysis of the treg cell population in the peripheral blood of ovarian cancer patients in relation to the long-term outcomes.

Ginekol Pol 2019 ;90(4):179-184

Chair of Oncology, Radiotherapy and Gynecologic-Oncology of the Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland.

Objectives: There is growing evidence that Treg cell infiltration into the cancer nest is associated with poor prognosis. How- ever, the Treg cell population in the peripheral blood may change when a different type of anticancer therapy is applied. Since Treg cells may support tumor growth by enhancing the suppressive profile of the cancer microenvironment, the assessment of Treg cells can bring to light important information regarding prognosis. Thus we decided to analyze the Treg cell population in the peripheral blood in relation to long-term outcomes in the group of patients with ovarian cancer.

Material And Methods: The 80 patients included in the study were treated surgically followed by chemiotherapy for ovar- ian cancer between October 2010 through May 2011.The peripheral blood samples from the patients were collected directly prior to chemotherapy. Information on any patients who died was retrieved from the database of the Cuiavia-Pomerania Regional Office of the National Health System of Poland. CD4+CD25+FOXP3+ lymphocytes T were assed by flow cytometry. We have analyzed the long term outcomes of treatment regarding to the level of Treg cells in peripheral blood.

Results: We found that patients with serous adenocarcinomas had significantly higher Treg levels compared to those patients with non-serous types. Patients who had a higher percentage of Treg cells within the CD4+ cell population prior to the beginning of the treatment had worse long-term outcomes from the applied therapy.

Conclusions: The assessment of Treg levels prior to the start of chemotherapy is clinically useful and may predict overall survival in ovarian cancer patients.
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http://dx.doi.org/10.5603/GP.2019.0032DOI Listing
February 2020

Bilateral pseudocyst of the auricles in a 4-week neonate-case report and world literature review.

Int J Pediatr Otorhinolaryngol 2019 Jul 22;122:1-5. Epub 2019 Mar 22.

Jagiellonian University, Department of Pediatrics, Rheumatology and Environmental Diseases, Poland.

Pseudocyst of the auricle is a rare, idiopathic disease clinically manifesting as a painless edema of the upper-lateral parts of the auricle. Due to the rarity of the disease, auricular pseudocyst is often misdiagnosed. The confirmation of a diagnosis of auricular pseudocyst is most commonly made on the basis of clinical manifestations. The etiology of the disease remains unknown, and this frequently hinders both proper diagnosis and prevention. We report a case of a 4-week neonate admitted to the Department of Pediatrics, Rheumatology and Environmental Diseases of the Chair of Pediatry, Jagiellonian University, Medical College in Krakow with bilateral pseudocyst with very early presentation that was less prominent after birth and well presented in the second week of life. The surgical treatment was successful. One month after treatment the infant was admitted again to the hospital with hypertension and edema of feet and hands. Treatment with amlodipine was implemented resulting in a normalization of blood pressure. The diagnosis of pseudohypoaldosteronism type I was confirmed.
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http://dx.doi.org/10.1016/j.ijporl.2019.03.027DOI Listing
July 2019

An analysis of the influence of infection on overall survival rates, following modified posterior pelvic exenteration for advanced ovarian cancer.

Ginekol Pol 2018;89(11):618-626

Clinical Department of Gynecological Oncology, Professor Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland; Department of Oncology, Radiotherapy and Oncological Gynecology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.

Objectives The aim of our study has been to determine the association between the appearance of infection after modified posterior pelvic exenteration (MPE) and TTC (time to adjuvant chemotherapy) and to examine whether the infection impacts clinical results by delaying the start of chemotherapy. Material and methods The present, retrospective study analyzed 77 patients who had undergone MPE followed by adjuvant chemotherapy. Either no residual tumor or tumor less than 2.5 mm was achieved in 76.7% of these patients. Patients were divided into two subgroups for comparison; the first group consisted of 41 patients with infections, the second group of 36 patients without infections. Infection after surgery was monitored within a 90-day postoperative period. Median TTC and OS (overall survival) was determined for those patients who developed infection as well as for those who did not. Results The expected 5-year survival rate was 0.40 (SD=0.09) for those patients without infection and 0.17 (SD=0.07) for those patients with infection. The survival curves of patients with infection and those without infection were statistically significantly different (p=0.038). Median TTC differed significantly for those patients who developed infection vs those patients who did not develop infection (37days vs 27.5 days, p=0.024), and patients without infection were statistically more likely to receive chemotherapy within 25 days following surgery than in the subsequent 25-42-day period compared to those patients who did develop infection (p=0.048). No statistically significant differences were found between the groups in relation to the initiation of chemotherapy within 42 days (p=0.445). Conclusions The absence of postoperative infection was associated with a better survival. Patients with infection were noted a longer time interval from surgery to start of chemotherapy without negative impact to OS.
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http://dx.doi.org/10.5603/GP.a2018.0106DOI Listing
February 2019

Soluble B7-H4 blood serum levels are elevated in women at high risk for preeclampsia in the first trimester, as well as in patients with confirmed preeclampsia.

Am J Reprod Immunol 2018 09 24;80(3):e12988. Epub 2018 May 24.

Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany.

Problem: B7-H4 negatively regulates T-cell-mediated immunity and might play an important role in preeclampsia (PE). Here, we have investigated the association between PE and maternal soluble B7-H4 (sB7-H4) serum levels and B7-H4 mRNA expression in the placenta.

Method Of Study: Maternal serum levels of sB7-H4 were determined by enzyme-linked immunosorbent assay in women between 11 and 13 weeks' gestation with elevated risk for PE (n = 48) and women without elevated risk for PE (n = 47). In the third trimester, sB7-H4 serum levels (n = 166) and B7-H4 mRNA expression in the placenta (n = 54) were determined in women with early-onset PE, late-onset PE, fetal growth restriction (FGR), and in healthy controls.

Results: In the first trimester, significant higher levels of sB7-H4 were detected in women at elevated risk for PE compared to women without risk for PE (P < .0001). sB7-H4 has some predictive ability to identify cases with an elevated risk of developing PE with area under the curve (AUC) value of 0.88 (95% CI 0.8-0.94). Using a specificity of 90.0% led to a sensitivity of 47.9% and a threshold of 3.63 ng/mL. In the third trimester, the highest serum levels of sB7-H4 and B7-H4 mRNA expression in the placenta were observed in early-onset PE. Significant higher serum levels of sB7-H4 and B7-H4 mRNA expression in the placenta were observed in women with early-onset PE (P = .01 and P = .006, respectively) and late-onset PE (P = .03 and P = .004, respectively) compared to healthy controls, but not compared to FGR.

Conclusion: sB7-H4 is involved in the regulation of immune tolerance in women with PE in the third trimester. In the first trimester of pregnancy, sB7-H4 might serve as a predictive immunological biomarker for women who are at elevated risk of developing PE.
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http://dx.doi.org/10.1111/aji.12988DOI Listing
September 2018

Circulating endothelial cells, circulating endothelial progenitor cells, and von Willebrand factor in pregnancies complicated by hypertensive disorders.

Am J Reprod Immunol 2017 Mar;77(3)

Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.

Problem: We tested the hypothesis that the number of both CECs and CEPCs as well as the vWf blood plasma concentration are altered in pregnant women with hypertensive disorders.

Method Of Study: Seventy-five pregnant women were enrolled in our study. We used multicolor flow cytometry for CEC and CEPC analysis and the commercial human VWF ELISA kit to measure vWf blood plasma concentration.

Results: The highest number of CECs was found in the chronic hypertension group and the lowest number in the healthy pregnant control group. The highest number of CEPCs was found in the control group and the lowest number in the chronic hypertension group. The vWf blood plasma concentration was the highest in the pre-eclampsia group. The CEPC/CEC ratio reached its lowest value in the chronic hypertension group and its highest value in the control group.

Conclusion: The number of both CECs and CEPCs as well as the vWf blood plasma concentration depends on the type of hypertension complicating the pregnancy.
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http://dx.doi.org/10.1111/aji.12625DOI Listing
March 2017

Serum concentrations of soluble B7-H4 in early pregnancy are elevated in women with preterm premature rupture of fetal membranes.

Am J Reprod Immunol 2016 08 15;76(2):149-54. Epub 2016 Jun 15.

Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany.

Problem: To determine the association between maternal soluble B7-H4 (sB7-H4) and the preterm premature rupture of the amniotic membranes (pPROM), the blood serum concentration levels of sB7-H4 were studied.

Method Of Study: Maternal serum levels of sB7-H4 were determined with enzyme-linked immunosorbent assay (ELISA) in patients between 11 and 13 weeks' gestation who later on in the pregnancy developed pPROM (n=21), premature rupture of the amniotic membranes at term (n=18), and in control group (n=27).

Results: The highest serum levels of sB7-H4 were found in patients who developed pPROM. An OR of 1.39 (95%-CI: 1.17-1.77; P=.002) per ng/mL sB7-H4 indicated an increased risk for developing pPROM, with some predictive ability to discriminate between pPROM cases and controls (AUC=.81).

Conclusion: Increased serum levels of sB7-H4 in early pregnancy in pPROM cases may indicate the dynamics of the immune response at the feto-maternal interface and, thus, may serve as a predictive marker for this pregnancy complication.
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http://dx.doi.org/10.1111/aji.12527DOI Listing
August 2016

Changes in the Blood Serum Levels of the Costimulatory Soluble B7-H4 Molecule in Pregnant Women During the Peripartal Phase.

Am J Reprod Immunol 2015 Sep 24;74(3):209-15. Epub 2015 Apr 24.

Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany.

Problem: B7-H4, a transmembrane protein that negatively regulates T lymphocytes, seems to play a role in the suppression of the im\mune response at the maternal-fetal interface. The aim of this study was to compare the blood serum concentration levels of soluble B7-H4 (sB7-H4) prepartal and postpartal in both women who experienced spontaneous onset of labor and those who underwent elective cesarian section.

Method Of Study: Blood was obtained from 30 prepartal and postpartal women who delivered at the University Hospital of Essen between 2011 and 2012. These patients were further divided into two subgroups depending on the advancement of labor. The sB7-H4 blood serum concentration levels of the women in the groups were then determined by ELISA (BIOZOL, Eching, Germany).

Results: In women who underwent elective cesarian section, a significant increase in sB7-H4 blood serum concentration levels occurred postpartal, while in women who experienced spontaneous onset of labor, no differences between prepartal and postpartal concentration levels were observed. The sB7-H4 blood serum concentration levels on the day after delivery in the women who experienced spontaneous labor and those who underwent elective cesarian section were comparable; however, higher blood serum concentration levels of sB7-H4 were observed prepartal in women with spontaneous onset of labor compared to those found in the women about to undergo elective cesarian section.

Conclusion: These changes in sB7-H4 blood serum concentration levels suggest that this protein is involved in immunological changes associated with the spontaneous onset of labor and post-delivery homeostasis.
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http://dx.doi.org/10.1111/aji.12392DOI Listing
September 2015

Analysis of the intensity of immune cell infiltration and immunoreactivity of RCAS1 in diffuse large B-cell lymphoma of the palatine tonsil and its microenvironment.

Cell Tissue Res 2015 Sep 17;361(3):823-31. Epub 2015 Mar 17.

Department of Otolaryngology and Oncological Laryngology with Subdivision of Audiology and Phoniatry, Jurasz's University Hospital, Bydgoszcz, Poland.

Non-Hodgkin lymphoma of Waldeyer's ring constitutes a small percentage of cases of palatine tonsil malignancies and its precise etiology remains unknown. RCAS1 (receptor cancer-binding antigen expressed on SiSo cells) has been demonstrated to be associated with poor prognosis, the development of lymph node metastases and participation in tumor microenvironment remodeling. Our aim is to analyze the potential role of RCAS1 expression in the tumor and tumor microenvironment in the development of early-stage palatine tonsil B-cell lymphomas. We selected 20 patients and analyzed tissue samples from the lymphoma and tumor microenvironment of each patient and from a reference group of 20 patients with chronic tonsillitis. The presence of RCAS1 protein immunoreactivity was demonstrated in 65% of the examined tissue samples of diffuse large B-cell lymphoma and in 25% of the analyzed stromata in which it was exhibited by CD68-positive cells identified as macrophages and dispersed throughout the stroma. RCAS1 immunoreactivity in the lymphoma tissue samples remained at a level comparable with that of the reference and was significantly higher in these samples than in those from the stroma. Chronic inflammation of the palatine tonsils thus results in intensive infiltration by various types of immune system cells and in excessive RCAS1 immunoreactivity, both of which confirm the important regulatory role of RCAS1 in the immune response in the mucosa-associated lymphatic tissue of Waldeyer's ring. RCAS1 seems to be involved in creating tumor-induced inflammation in the tumor and its microenvironment.
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http://dx.doi.org/10.1007/s00441-015-2157-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550658PMC
September 2015

Perineural space invasion in cervical cancer (FIGO IB1-IIB) accompanied by high-risk factors for recurrence.

J Cancer Res Ther 2014 Oct-Dec;10(4):957-61

Department of Clinical Obstetrics and Gynecology, Rzeszow State Hospital, 35-055; Medical Department, Institute of Obstetrics and Emergency Medicine, University of Rzeszow, Rzeszow, Poland.

Background: Perineural space invasion (PSI) represents a poor prognostic factor in various carcinomas. Studies on PSI in cervical cancer patients are scarce and report discrepant results regarding its incidence and prognostic value.

Aims: The aim of the following study was to evaluate the occurrence rate and prognostic significance of parametrial PSI in patients cervical cancer (FIGO IB1-IIB), accompanied by high-risk factors for recurrence.

Materials And Methods: We reviewed clinical records and pathology slides of patients with cervical cancer after radical hysterectomy. Only patients with at least one of following factors: Depth of invasion of ≥15 mm, parametrial and lymph node involvement, were enrolled in the study.

Results: A total of 50 patients fulfilled the above mentioned criteria. Parametrial PSI was found in 9 (18%) patients (Group I), whereas the remaining 41 (82%) subjects constituted group II. The presence of PSI proved to correlate with the depth of invasion of ≥15 mm (P=0.006) and tumor size of ≥40 mm (P=0.01), as well as a more advanced stage of the disease (P=0.04). No statistically significant differences in recurrence-free survival rate between the two groups were observed.

Conclusions: We were able to correlate parametrial PSI with the depth of invasion, tumor size and more advanced stage of the disease in early-stage cervical cancer with high-risk of recurrence. No association with a worse prognosis was observed.
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http://dx.doi.org/10.4103/0973-1482.138126DOI Listing
November 2015

The biological role of Treg cells in ectopic endometrium homeostasis.

Histol Histopathol 2014 Oct 15;29(10):1217-33. Epub 2014 May 15.

Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, and Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.

Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only 15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance.
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http://dx.doi.org/10.14670/HH-29.1217DOI Listing
October 2014

The analysis of metallothionein immunoreactivity in stromal fibroblasts and macrophages in cases of uterine cervical carcinoma with respect to both the local and distant spread of the disease.

Am J Reprod Immunol 2013 Sep 17;70(3):253-61. Epub 2013 Apr 17.

Department of Obstetrics and Gynecology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland.

Problem: The tumor microenvironment is made up of tissue that is responsible for the growth and progression of the tumor as well as its ability to initiate metastases. The cancer cells on the front of the tumor together with the macrophages and fibroblasts help to constitute the aggressive phenotype of the tumor. The presence of this aggressive phenotype is indicated by the local infiltration of cancer cells and by the development of lymph node metastases. In cases of uterine cancer, the extent of the local and distant spread of the disease is crucial for determining the type of therapeutic strategy to be applied - surgery alone, surgery followed by radio-chemotherapy, or radio-chemotherapy alone. In the interest of trying to improve the patient's quality of life, different studies supporting the therapeutic model of surgery alone have been conducted. While the cancer cells on the tumor front together with the macrophages and the fibroblasts help to constitute the aggressive phenotype of the tumor, metallothionein (MT) has been shown to have both pro-proliferative and anti-apoptotic activities and to participate in microenvironment remodeling. The aim of the current study was to determine the levels of MT immunoreactivity in the uterine cervical cancer cells as well as in the stromal fibroblasts and macrophages of the tumor microenvironment with respect to the depth of the local invasion and the extent of the distant metastases, so that its potential predictive value as a therapeutic strategy for cervical cancer can be ascertained.

Methods: We determined the levels of immunoreactivity of MT in a total of 57 carcinoma tissue samples (in the tumor front, in its central part, and in the macrophages and fibroblasts present within the tumor microenvironment). The patients from whom the samples derived were divided into groups with respect to the presence of lymph node metastases (distant spread) and to the depth of invasion (local spread) in relation to the FIGO stage.

Results: Metallothionein immunoreactivity was observed in uterine cervical cancer cells; it was also identified in the fibroblasts and macrophages found within the microenvironments of the tumors of patients suffering from the disease. The MT immunoreactivity level significantly increased within the whole cancer nest in relation to the FIGO stage (intensity of the local spread of the disease). Similarly, the infiltration of MT-positive CAFs and TAMs statistically significantly increased in relation to the FIGO stage.

Conclusion: The level of MT immunoreactivity found in the fibroblasts and macrophages within the tumor microenvironment seems to be indicative of the intensity of the remodeled cervical tumor microenvironment, and this in turn may be related to the local advancement of the disease. Moreover, it appears that the intensity of the metallothionein immunoreactivity in the immunoreactivity profile of the cervical tumor may be linked to both the depth of the local invasion and the extent of the distant advancement of the disease.
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http://dx.doi.org/10.1111/aji.12120DOI Listing
September 2013

Analysis of metallothionein and vimentin immunoreactivity in pharyngeal squamous cell carcinoma and its microenvironment.

Cell Tissue Res 2013 May 9;352(2):341-9. Epub 2013 Feb 9.

Outpatient Unit of Otolaryngology, Lukaszczyk Oncological Center, Bydgoszcz, Poland.

Metallothionein (MT) has been shown to have pro-proliferative anti-apoptotic activity and to be involved in microenvironment remodeling. The aim of this study has been to determine whether the changes in MT and vimentin immunoreactivity observed in cancer and its microenvironment are related to the local spread of the disease. The immunoreactivity levels of both MT and vimentin were evaluated together with CD56 and CD57 antigens in 49 tissue samples taken from patients with squamous cell carcinoma originating from the palatine tonsils and in 20 tissue samples derived from patients with chronic tonsillitis (the reference group). MT immunoreactivity levels were statistically significantly higher in the tissue samples from squamous cell carcinoma than in those of the reference group and also higher in the squamous cell carcinoma samples compared with the stromal samples. Moreover, stromal fibroblasts exhibited high vimentin and MT immunoreactivity levels. Statistically significantly higher MT immunoreactivity levels within the tumor cells were identified in patients with the presence of lymph node metastases in contrast to those patients without such metastases. Vimentin was detected in both the tumor and the stromal tissue samples and presented an interesting pattern of staining strongly expressed within the stroma and the septal architecture of the tumor. The number of CD56- and CD57-positive lymphocytes identified in tissue samples both from squamous cell carcinoma and from the stroma was statistically significantly lower than that in the reference group. MT expression by tumor cells is thus associated with an aggressive phenotype of the tumor and the ability to create metastases.
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http://dx.doi.org/10.1007/s00441-013-1566-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637648PMC
May 2013

The immunohistochemical analysis of antigens such as RCAS1 and B7H4 in the cervical cancer nest and within the fibroblasts and macrophages infiltrating the cancer microenvironment.

Am J Reprod Immunol 2012 Jul 24;68(1):85-93. Epub 2012 Apr 24.

Department of Pathomorphology, Jagiellonian University, Krakow, Poland.

Introduction: The presence of the aggressive phenotype of the tumor seems to be indicated by the local infiltration of cancer cells and by the development of metastases in the lymph nodes. This phenotype is related to the intensity of the suppressive profile of the tumor microenvironment. The aim of our study has been to gather information about the expression of both RCAS1 and B7H4 proteins in the macrophages and fibroblasts present within both the microenvironment of cervical cancer tumors and the cancer cells present on the front of the cancer nest.

Methods: We analyzed the immunoreactivity levels of such antigens as B7H4 and RCAS1 in the macrophages and fibroblasts of the cancer microenvironment and within the cancer nest in the tissue samples derived from patients on whom both a radical hysterectomy and a lymphadenectomy had been performed following a diagnosis of uterine cervical carcinoma. These patients were then divided into two subgroups according to the extent of the local and distant advancement of the cancer - that is, according to the FIGO stage and the presence or absence of lymph node metastases.

Results: RCAS1 immunoreactivity levels on the front of the cancer nest statistically significantly increase according to the FIGO stage or the extent of the local spread of the disease while B7H4 immunoreactivity levels on the tumor front increase in relation to the extent of the distant spread of the disease or the presence of lymph nodes metastases.

Conclusion: The intensity of the suppressive profile of the cervical cancer microenvironment indicated by the presence of both RCAS1 and B7H4 on the front of the tumor and in the macrophages and fibroblasts infiltrating the cancer stroma seems to correlate with the extent of both the local and distant advancement of the disease.
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http://dx.doi.org/10.1111/j.1600-0897.2012.01134.xDOI Listing
July 2012

Analysis of RCAS1 immunoreactivity within hydatidiform mole cells and decidual cells according to the applied therapeutic strategy: surgery or surgery followed by chemotherapy.

Gynecol Obstet Invest 2012 24;73(2):106-12. Epub 2012 Jan 24.

Departments of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, Poland.

Introduction: Trophoblast cells cooperate with both maternal immune cells and decidual cells to help develop the suppressive microenvironment of the endometrium. The maternal immune response against hydatidiform mole depends on this suppressive endometrial profile. Since RCAS1 is one of the molecular factors participating in the development of the suppressive profile of the endometrium we decided to examine the immunoreactivity of the RCAS1 within both the trophoblast and decidual cells during the development of hydatidiform mole.

Methods: We analyzed the immunoreactivity of RCAS1 on both trophoblast and decidual cells derived from patients who underwent curettage because of hydatidiform mole. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure.

Result: We observed significantly lower immunoreactivity levels of both RCAS1 within the complete molar lesions of the patients on whom surgery alone was performed when compared to the levels found in those for whom surgery was followed by chemotherapy.

Conclusion: RCAS1 staining may provide information regarding the intensity of the immunosuppressive microenvironment of both the molar lesion and the endometrium. This information can prove significant in determining the clinical course of hydatidiform mole.
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http://dx.doi.org/10.1159/000328509DOI Listing
August 2012

The analysis of receptor-binding cancer antigen expressed on SiSo cells (RCAS1) immunoreactivity within the microenvironment of the ovarian cancer lesion relative to the applied therapeutic strategy.

Cell Tissue Res 2011 Sep 16;345(3):405-14. Epub 2011 Aug 16.

Department of Tumor Pathology and Pathomorphology of the Franciszek Lukaszczyk Oncology Center, the Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.

RCAS1 is involved in generating the suppressive profile of the tumor microenvironment that helps cancer cells evade immune surveillance. The status of the cells surrounding the cancer nest may affect both the progression of the cancer and the development of metastases. In cases of ovarian cancer, a large number of patients do not respond to the applied therapy. The patient's response to the applied therapy is directly linked to the status of the tumor microenvironment and the intensity of its suppressive profile. We analyzed the immunoreactivity of RCAS1 on the cells present in the ovarian cancer microenvironment in patients with the disease; these cells included macrophages and carcinoma-associated fibroblasts. Later we analyzed the immunoreactivity levels within these cells, taking into consideration the clinical stage of the cancer and the therapeutic strategy applied, such as the number of chemotherapy regiments, primary cytoreductive surgery, or the presence of advanced ascites. In the patients who did not respond to the therapy we observed significantly higher immunoreactivity levels of RCAS1 within the cancer nest than in those patients who did respond; moreover, in the non-responsive patients we found RCAS1 within both macrophages and carcinoma-associated fibroblasts. RCAS1 staining may provide information about the intensity of the immuno-suppressive microenvironment profile found in cases of ovarian cancer and its intensity may directly relate to the clinical outcome of the disease.
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http://dx.doi.org/10.1007/s00441-011-1216-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168756PMC
September 2011

Analysis of Treg cell population alterations in the peripheral blood of patients treated surgically for ovarian cancer - a preliminary report.

Am J Reprod Immunol 2011 Nov 30;66(5):444-50. Epub 2011 May 30.

Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, Poland.

Problem: Treg cells constitute the main cell population that enables cancer cells to evade immune surveillance. An alteration in the Treg cell population might correspond to the diminishment of the tumour mass in patients with cancer and could therefore be a useful marker of the intensity of the selective suppression of the host immune system and also of the degree of radicalism of a procedure. Certainly, it is well known that in order for anti-cancer therapy to succeed the proper immune response against cancer cells must be restored. Furthermore, monitoring the level of selective immune system suppression during cancer therapy might yield information that would support a decision to supplement standard therapy by immunotherapy or to increase the degree of radicalism of the applied therapy.

Method Of Study: We examined the Treg cell populations in the peripheral blood of a group of patients treated surgically for ovarian cancer. In each patient, the peripheral blood samples were collected both prior to and 1 day after the surgical procedure, and then again 5 days after the procedure. The presence of regulatory T cells in the samples was analyzed by means of flow cytometry.

Results: In our study, the percentages of FOXP3(+) cells in the subpopulation of CD4(+) T lymphocytes found in the peripheral blood of the patients before the surgical intervention were statistically significantly higher than those observed in the peripheral blood of these same patients after the surgical procedure.

Conclusion: It would seem that the alteration in the Treg cell subpopulation could be a key factor in determining the status of the tumour microenvironment. Most likely, it could provide information about whether the proper level of anti-cancer immune response could be restored. The possibility of restoring the immune response may directly correspond to the degree of radicalism of the surgical intervention.
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http://dx.doi.org/10.1111/j.1600-0897.2011.01024.xDOI Listing
November 2011

The frequency of CD25+CD4+ and FOXP3+ regulatory T cells in ectopic endometrium and ectopic decidua.

Reprod Biol Endocrinol 2010 Oct 5;8:116. Epub 2010 Oct 5.

Department of Gynecology and Oncology of the Jagiellonian University, Krakow, Poland.

Background: The presence of regulatory T (Treg) cells in human endometrium is crucial for maintaining immunological homeostasis within the uterus. For this study we decided to evaluate the subpopulations of Treg cells in conditions where a disturbance in the immunological equilibrium in ectopic endometrium and decidua has been observed, such as in cases of ovarian endometriosis (involving local immune cell suppression) and ectopic pregnancy (involving an increase in local immune system activity). We then compared these findings to what we observed in the normal eutopic endometrium of women during the secretory phase of the menstrual cycle (with immune cells under individual control).

Methods: The endometrium tissue samples evaluated in our study were obtained from 47 women during one of two kinds of laparoscopic procedures. 16 of the women underwent laparoscopies due to Fallopian tube pregnancies (EP), and 16 due to ovarian endometrioma, while 15 women made up a control group. The presence of regulatory T cells in these tissue samples was evaluated by FACS.

Results: In our study, the percentages of FOXP3+ cells within the subpopulation of CD4+ T lymphocytes found in the decidua of the patients treated for Fallopian tube pregnancies were statistically significantly lower than both those observed in the ovarian endometriosis tissue samples and those found in the secretory eutopic endometrium samples of the control group.

Conclusion: The disturbance in the immunological equilibrium observed in ectopic endometrium and decidua would seem to be related to the alteration in the Treg cell population that occurs in these ectopic tissues.
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http://dx.doi.org/10.1186/1477-7827-8-116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958978PMC
October 2010

The immunohistochemical analysis of RCAS1, HLA-G, and B7H4-positive macrophages in partial and complete hydatidiform mole in both applied therapeutic surgery and surgery followed by chemotherapy.

Am J Reprod Immunol 2011 Feb;65(2):164-72

Gynecology, Obstetrics and Oncology of the Jagiellonian University, Krakow, Poland.

Introduction: The suppressive microenvironment developing around the implantating ovum in normal pregnant women may correlate with the development in cancer patients of a suppressive microenvironment of neoplasmatic cells derived from trophoblasts, such as occurs in molar lesions. Macrophages are suitable candidates for mediating not only the balance of the maternal defensive immune responses to external antigens, but also a tolerance to tumor cells. The aim of our study has been to gain information about the expression of RCAS1, B7H4, and HLA-G within the macrophages present in the microenvironment of the molar lesion.

Methods: We analyzed the immunoreactivity of such antigens as B7H4, RCAS1, and HLA-G on the macrophages present in tissue samples derived from patients on whom curettage was performed after a diagnosis of molar pregnancy. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure.

Results: We observed a statistically significant increase in the RCAS1-positive macrophage infiltration within the microenvironment of the molar lesions in patients with partial hydatidiform mole in comparison with those patients who exhibited complete hydatidiform mole. There were no such differences, however, in the infiltration of HLA-G- and B7H4-positive macrophages between the two groups of patients. Additionally, we showed that RCAS1- and HLA-G-positive macrophages are more distinct in those cases of complete molar pregnancy where chemotherapy was necessary after surgical treatment while no such differences with respect to B7H4-positive macrophages were observed.

Conclusion: The immune-suppressive endometrial microenvironment represented by suppressive macrophages may have an influence on the clinical course of hydatidiform mole.
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http://dx.doi.org/10.1111/j.1600-0897.2010.00897.xDOI Listing
February 2011

The evaluation of metallothionein expression in nasal polyps with respect to immune cell presence and activity.

BMC Immunol 2010 Mar 9;11:10. Epub 2010 Mar 9.

Otolaryngology Head and Neck Surgery Department, Jagiellonian University, Sniadeckich 2, Krakow 31-531, Poland.

Background: The expression of metallothionein (MT) is involved in acquiring resistance to immune-mediated apoptosis; it is also a negative regulator of the immune response. Nasal polyps are typified by a resistance to immune-mediated apoptosis as well as by excessive immune cell infiltration. RCAS1 (receptor-binding cancer antigen expressed on SiSo cells) is a membrane protein capable of inducing the apoptosis of CTLs and NK cells. The aim of the present study has been to explore the expression of metallothionein with respect to immune cell presence and immune cell activity. In our study, we identified immune cells using CD4 and CD68 antigen expression and evaluated their activity using CD25 antigen expression. We then analyzed metallothionein, RCAS1, CD25, CD4, and CD68 in a sampling of 50 nasal polyps using the immunohistochemistry method. We were able to divide the nasal polyps into three main groups according to their predominant immune cell infiltration: eosinophilic nasal polyps (21 cases), lymphocytic nasal polyps (17 cases), and neutrophilic nasal polyps (12 cases).

Results: In the present study, statistically significant differences between the MT expression in the epithelium and that in the stroma of the nasal polyps along with the accompanying alterations in activation markers on immune cells were found and the number of macrophages in both the eosinophilic and the lymphocytic nasal polyps was assessed. RCAS1-expressing macrophages were found only in the eosinophilic nasal polyps.

Conclusion: MT expression seems to favor the survival of nasal polyp epithelial cells in the adjacent area of increasingly cytotoxic immune activity. RCAS1-expressing macrophages seem to participate in creating the immune suppressive microenvironment and so help to sustain local inflammation.
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http://dx.doi.org/10.1186/1471-2172-11-10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848203PMC
March 2010

Differences in the soluble HLA-G blood serum concentration levels in patients with ovarian cancer and ovarian and deep endometriosis.

Am J Reprod Immunol 2010 May 8;63(5):387-95. Epub 2010 Feb 8.

Department of Gynecology, Obstetrics and Oncology of the Jagiellonian University, Krakow, Poland.

Problem: The relationship between endometriosis and cancer has been widely discussed in the literature but is still not well clarified. Perhaps significantly, soluble human leukocyte antigen-G (sHLA-G) has been identified in the microenvironment of both ovarian cancer and endometrioma. The aim of this study has been to evaluate the sHLA-G levels in the blood sera of women with deep endometriosis and ovarian endometrioma over the course of the menstrual cycle and to compare to the levels of sHLA-G in the blood sera of women with ovarian cancer.

Method Of Study: In our study, we examined the blood sera obtained from 123 patients operated on because of ovarian cancer (65 cases), ovarian endometrioma (30 cases), and deep endometriosis (28 cases). We decided to compare the levels of sHLA-G in patients with endometriosis to those found in patients with ovarian cancer with respect to the menstrual cycle phases. The sHLA-G concentration level was measured by enzyme-linked immunosorbent assay kit.

Results: The level of sHLA-G concentration in the blood serum of patients with deep endometriosis fluctuates over the course of the menstrual cycle, and during the proliferative and secretory phases, it remains at a high level comparable to that found in patients with ovarian cancer. By contrast, the level of sHLA-G concentration in the blood serum of patients with ovarian endometrioma fluctuates minimally over the course of the different menstrual cycle phases and, as in patients with ovarian cancer, it remains at high level during the proliferative phase.

Conclusion: sHLA-G blood serum concentration levels would seem to provide important information regarding the degree of immune system regulation disturbance in both ectopic endometrial cells and the cancer cell suppressive microenvironment.
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http://dx.doi.org/10.1111/j.1600-0897.2009.00806.xDOI Listing
May 2010

Radical hysterectomy during the transition period from traditional to nerve-sparing technique.

Gynecol Oncol 2010 Mar 11;116(3):502-5. Epub 2009 Dec 11.

Clinical Department of Obstetrics and Gynecology, Rzeszow State Hospital, Rzeszow, Poland.

Objective: The aim of the study was to compare peri- and postoperative data from patients operated on using the new nerve-sparing technique of radical hysterectomy with data gathered from those who underwent traditional radical hysterectomy.

Materials And Methods: A total of 20 patients with cervical cancer were included in the study. The study was carried out at a time when the authors had started to perform the nerve-sparing technique by using the descriptions from the literature. During the study period 10 patients underwent the nerve-sparing procedure while the other 10 patients underwent traditional radical hysterectomy. The two groups of patients were comparable in terms of mean age, body mass index, FIGO stage, and histological type; additionally, the follow-up period was similar for both groups.

Results: On the one hand, the mean total operative time (197.5+/-51.4 vs. 155.5+/-39.6 min) and the mean time for the hysterectomy itself (154.5+/-35.4 vs. 123.0+/-29.8 min) were significantly longer in the group operated on with nerve-sparing technique (p=0.05). Postoperatively, on the other hand, a post-void residual urine volume of less than 50 ml was noted to occur significantly faster in the patients who had undergone the nerve-sparing technique (3.5+/-1.4 vs. 9.1+/-4.2 days, p=0.00078).

Conclusions: Although during the introductory period nerve-sparing technique brings about an improvement in voiding function, it prolongs the total operative time in comparison to traditional radical hysterectomy.
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http://dx.doi.org/10.1016/j.ygyno.2009.11.013DOI Listing
March 2010

[Ectopic pregnancy rupture--can it be prevented?].

Ginekol Pol 2009 Oct;80(10):734-9

Klinika Ginekologii i Onkologii Uniwersytetu Jagiellońskiego w Krakowie.

Objectives: To determine risk factors for ectopic pregnancy (EP) rupture based on the patients history and preoperative tests.

Materials And Methods: The retrospective study consisted of 175 women operated on due to EP in the Department of Gynecology and Oncology of the Jagiellonian University between 2000-2008. Tubal rupture was diagnosed at the time of surgery. The patients were then divided into three groups: those who had unruptured EP without bleeding, those who had unruptured EP with hemorrhage into peritoneal cavity and those who suffered ruptured tubal pregnancy Analysis was performed based on the following parameters: patient history preoperative laboratory tests (Hb, Hct, betaHCG), and ultrasound exam.

Results: Of the 175 cases of ectopic pregnancy included in the study 20% were unruptured without bleeding (A) and 40.6% unruptured with hemorrhage (B) while 39.4% were ruptured (C). There was a positive correlation between the diameter of the tubal lesion measured ultrasonographically and rupture (37.4 +/- 16 for C vs 29.7 +/- 12.9 for A; p=0.04). The gestational age of the groups differed significantly (p=0,001): C (56 +/- 1), A (49 +/- 3), and B (42 +/- 2). There was also a positive correlation between rupture and gravidity (1 +/- 1 for A vs 2 +/- 2 for C; p=0.02). Moreover a positive correlation of borderline significance was discerned between rupture and parity (p=0.06). Additionally the preoperative hemoglobin and hematocrit values were significantly lower in the rupture group (p=0.001). There was no significant difference among the three groups in age, number of abortions, serum betaHCG, endometrial thickness, length of hospital stay or the time elapsed since the most recent pregnancy.

Conclusions: Low hemoglobin and hematocrit values, together with higher gravidity at the time of admission, may indicate an increased risk of tubal rupture.
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October 2009