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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Regulation of Vascular Endothelial Growth Factor in endometrial cancer cells by food compounds

Dann, James MacBeth January 2008 (has links)
Endometrial cancer is one of the most significant gynaecological malignancies that affect women from New Zealand and the rest of the world. One of the critical stages in the development of a tumour is the onset of hypoxia. The malignancy responds by having raised levels of Hypoxia Inducible Factor (HIF) that in turn induces increased production of Vascular Endothelial Growth Factor (VEGF). VEGF is a potent angiogenic factor that will mediate vascular supply of nutrients and oxygen to the developing tumour. The aim of this study was to investigate whether two compounds found in extracts of plant materials, Resveratrol (Resveratrol) and Epigallocatechin gallate (EGCG), altered the levels of VEGF in the supernatant of cultured endometrial cancer cells. Resveratrol is a phytoalexin that is found in many foods, such as grapes, nuts and berries, as well as in high concentrations in some red wines. 100 µM of resveratrol was added to cell cultures for 24 hours. VEGF levels in the supernatant were then analysed using ELISA. Resveratrol was found to have significant inhibitory effects in both primary endometrial cancer cell cultures and immortalised endometrial cancer cell cultures. Resveratrol was also shown to reverse the increase in VEGF caused by the hypoxia mimic cobalt chloride (CoCl₂). Epigallocatechin gallate (EGCG) is an antioxidant catechin extracted from green tea. The effect of EGCG was analysed using the same method as for resveratrol. 100 µM of EGCG was also shown to have a significant inhibitory effect on the level of VEGF in the supernatant of cultured endometrial cancer cells, as well as reducing the effect of CoCl₂. These results suggest that selected food compounds, resveratrol and EGCG, can reduce VEGF levels by inhibiting HIF. Further investigation This may have anti-tumour effects in women with endometrial cancer.
2

Regulation of Vascular Endothelial Growth Factor in endometrial cancer cells by food compounds

Dann, James MacBeth January 2008 (has links)
Endometrial cancer is one of the most significant gynaecological malignancies that affect women from New Zealand and the rest of the world. One of the critical stages in the development of a tumour is the onset of hypoxia. The malignancy responds by having raised levels of Hypoxia Inducible Factor (HIF) that in turn induces increased production of Vascular Endothelial Growth Factor (VEGF). VEGF is a potent angiogenic factor that will mediate vascular supply of nutrients and oxygen to the developing tumour. The aim of this study was to investigate whether two compounds found in extracts of plant materials, Resveratrol (Resveratrol) and Epigallocatechin gallate (EGCG), altered the levels of VEGF in the supernatant of cultured endometrial cancer cells. Resveratrol is a phytoalexin that is found in many foods, such as grapes, nuts and berries, as well as in high concentrations in some red wines. 100 µM of resveratrol was added to cell cultures for 24 hours. VEGF levels in the supernatant were then analysed using ELISA. Resveratrol was found to have significant inhibitory effects in both primary endometrial cancer cell cultures and immortalised endometrial cancer cell cultures. Resveratrol was also shown to reverse the increase in VEGF caused by the hypoxia mimic cobalt chloride (CoCl₂). Epigallocatechin gallate (EGCG) is an antioxidant catechin extracted from green tea. The effect of EGCG was analysed using the same method as for resveratrol. 100 µM of EGCG was also shown to have a significant inhibitory effect on the level of VEGF in the supernatant of cultured endometrial cancer cells, as well as reducing the effect of CoCl₂. These results suggest that selected food compounds, resveratrol and EGCG, can reduce VEGF levels by inhibiting HIF. Further investigation This may have anti-tumour effects in women with endometrial cancer.
3

A Predictor of Tumor Recurrence in Patients With Endometrial Carcinoma After Complete Resection of the Tumor: The Role of Pretreatment Apparent Diffusion Coefficient / 完全切除後子宮体癌患者の術後再発予測における術前ADC値の有用性

Kuwahara, Ryo 25 May 2020 (has links)
京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22638号 / 医博第4621号 / 新制||医||1044(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 武藤 学, 教授 小川 誠司, 教授 小川 修 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
4

Regulation of apoptosis in the female reproductive system

Vaskivuo, T. (Tommi) 08 May 2002 (has links)
Abstract Apoptosis is a genetically programmed mechanism for a multicellular organism to remove cells that are unnecessary, or potentially harmful. The female reproductive system is characterised by a high rate of cellular proliferation. At the same time, apoptosis is also abundant during the normal physiological function of the ovary and endometrium. More than half of the 7 million oocytes that are produced during human ovarian development are deleted before birth and only about 400 oocytes reach the stage of ovulation during the female fertile lifespan. The fate of the non-ovulatory follicles is atresia, occurring through the mechanism of apoptosis. The endometrium goes through radical renewal processes during each menstrual cycle. Apoptosis has been suggested to participate in the regulation of endometrial cellular homeostasis. Errors in this mechanism can result in endometrial diseases such as hyperplasia and cancer. In this work, apoptosis and its regulation were studied in the human fetal and adult ovary, normal endometrium and endometrial pathologies. In fetal ovaries, apoptosis was already abundantly present in oocytes at 13 weeks of gestation. The maximum rate of apoptosis was seen between the 14th and 20th weeks, after which apoptosis decreased towards term. Ovarian Bcl-2 expression was detected in early fetal life during weeks 13 and 14. Bax expression was observed throughout the studied period, from week 13 to 40. The expression of transcription factor GATA-4, which is linked to follicular survival, was localised to the granulosa cells and was high in early fetal life and decreased somewhat towards term. In adult life apoptosis was located in the granulosa cells of the growing follicles. In ovarian biopsies from women homozygous for the inactivating C566T mutation of the FSH receptor, apoptosis or GATA-4 expression was not detected. During corpus luteum regression a peak in apoptosis was detected 10 - 12 days after the LH surge, and was preceded by an increase in 17HSD type 1 and TNF-α expression. During normal menstrual cycles, the highest rate of apoptosis was observed in the menstrual endometrium. This increase in apoptosis was preceded by a decreased Bcl-2/Bax ratio. In endometrial hyperplasia, the rate of apoptosis was similar to that seen during normal proliferation of the endometrium, but an apparent increase was observed in grade II endometrial carcinoma. In grade III carcinoma, the rate of apoptosis was lower than in grade II carcinoma but higher than in hyperplasia. These results indicate that apoptosis is the mechanism behind the substantial oocyte demise during ovarian development. During adult life, apoptosis was mainly localised to the granulosa cells of the growing follicles which do not reach the stage of a dominant follicle. In ovaries where FSH action is abolished, folliculogenesis was impaired and ovarian apoptosis was negligible. Apoptosis is also the underlying mechanism of corpus luteum regression. In the endometrium, apoptosis has a role in rejuvenating the endometrium for growth during the next endometrial cycle and in regulating cellular homeostasis.
5

Avaliação da concordância da expressão imuno-histoquímica da proteína p53 entre a amostra endometrial pré-operatória e a peça uterina nos carcinomas de endométrio

Silveira, Razyane Audibert January 2017 (has links)
Objetivo: avaliar a concordância da expressão imuno-histoquímica (IMH) da proteína p53 (p53) na amostra endometrial e na peça cirúrgica de histerectomia, associando-a a fatores como tipo histológico, grau tumoral e estadiamento, bem como analisar a concordância interobservador para expressão e intensidade de expressão da p53 entre biópsia diagnóstica e peça cirúrgica. Métodos: estudo transversal retrospectivo, no qual foram incluídas pacientes com carcinoma endometrial submetidas à biópsia de endométrio e tratamento cirúrgico primário na Unidade de Oncologia Genital do HCPA. As lâminas foram lidas por dois patologistas. O percentual de expressão da p53 foi avaliado em três categorias (<10%, 10-50% e >50%). A intensidade foi avaliada como fraca, média ou forte. Foram extraídos dados do prontuário eletrônico das pacientes. A concordância foi avaliada através do coeficiente Kappa ponderado. Resultados: 72 pacientes foram incluídas, com idade média de 65,5 anos. O percentual de expressão da p53 entre biópsia e peça cirúrgica apresentou uma taxa de concordância de 70,8%, com um índice de Kappa ponderado de 0,64 e a intensidade de expressão apresentou uma taxa de concordância de 69,4%, com Kappa ponderado de 0,65. A avaliação da concordância do percentual de expressão da p53 conforme tipo histológico e grau tumoral apresentou coeficientes de Kappa ponderado de 0,64 e 0,72, nos carcinomas não endometrioides e G3, respectivamente. Tais dados, com diferença estatística significativa. A concordância interobservador para a expressão e intensidade da p53 na biópsia apresentou índices de Kappa 9 ponderado de 0,77 e 0,75, respectivamente. Na peça cirúrgica, os índices de kappa ponderado foram de 0,85 e 0,88, para a expressão e intensidade, respectivamente. Conclusões: as taxas de concordância para a expressão e intensidade de expressão IMH da p53 entre biópsia endometrial e peça cirúrgica foram boas, podendo ser útil em tempo pré-operatório, para a seleção de pacientes candidatas a uma cirurgia mais extensa, principalmente quando os dados anatomopatológicos da biópsia forem insuficientes para tal decisão. Devemos, no entanto, levar em consideração que existem muitos outros marcadores moleculares para a neoplasia endometrial, sendo provável futuramente o estudo da concordância deles em associação ao da p53. / Objective: To evaluate the agreement of the immunohistochemical (IMH) expression of the p53 protein (p53) in preoperative endometrial tissues and in surgical specimens obtained during hysterectomy, to determine the association of this agreement with factors such as histological type, tumor grade and stage and to evaluate interobserver agreement for the expression and intensity of p53 between the diagnostic biopsy and the surgical specimen. Methods: Retrospective cross-sectional study. Patients with endometrial carcinoma who submitted to endometrial biopsy and primary surgical treatment at the HCPA Genital Oncology Unit were included. The slides were assessed by two pathologists. The percentage of p53 expression was evaluated and categorized into one of three groups (<10%, 10-50% and >50%). The intensity was evaluated as weak, medium or strong. The agreement was assessed by the weighted Kappa coefficient. Results: 72 patients with a mean age of 65.5 years were included. The percentage of p53 expression between the biopsy and the surgical specimen presented an agreement rate of 70.8%, with a weighted Kappa index of 0.64. The intensity of expression had an agreement rate of 69.4% with a weighted Kappa of 0.65. When evaluated according to histological type and tumor grade, the agreement for p53 expression showed weighted Kappa indexes of 0.64 and 0.72 in non-endometrioid and G3 carcinomas, respectively (p<0.001). With respect to the biopsy, the interobserver agreement for the expression and intensity of p53 had weighted Kappa indexes of 0.77 and 0.75, respectively. With respect to the surgical specimen, the weighted Kappa indexes were 0.85 and 0.88 for expression and intensity, respectively. 11 Conclusions: This study found good agreement rates for the expression and intensity of p53 IMH expression between the endometrial biopsy specimen and the surgical specimen, which may be useful in a preoperative setting for the selection of patients who are candidates for more extensive surgery, especially when anatomopathological biopsy data are insufficient for such a decision.
6

Biomarkery epiteliálních nádorů ovaria a endometria / Biomarkers of epithelial ovarian tumors and of the endometrium

Presl, Jiří January 2013 (has links)
Structured abstract Study objectives: Ovarian carcinoma 1/ comparison of sensitivities among monitored markers CA 125, HE4, CA 19-9, CEA, TK, TPS, MonoTotal 2/ comparison of false positivity of markers CA 125 and HE4 3/ use of CA 125, HE4 and ROMA index in the diagnostics of ovarian carcinoma 4/ use of CA 125 and HE4 in the follow-up of ovarian cancer Endometrial carcinoma 1/ feasibility of use of biomarkers CA125 and HE4 in patients with endometrial cancer in pre- operative management Study design: Retrospective data analysis Settings: Department of Obstetrics and Gynecology, Medical Faculty and Teaching Hospital in Pilsen Patients and Methods: Ovarian cancer 1/ Sensitivity of markers CA 125, HE4, CA 19-9, CEA, TK, TPS, and MonoTotal was assessed in 266 patients - 19 with ovarian cancer and 247 with benign disorders. 2/ False positivity of markers CA125 and HE4 was evaluated in a total of 390 patients with benign diagnoses - 60 women with endometriosis, 70 pregnant patients, 67 patients with ascites, 60 with pleural effusion, 25 with cardiac failure , 80 with renal insufficiency and 28 with hepatic failure. 3/ As a part of this objective we evaluated 552 patients with abnormal pelvic abnormality - 30 women had a histologically confirmed malignant ovarian tumor. Other 522 women had a benign condition. The...
7

Avaliação da concordância da expressão imuno-histoquímica da proteína p53 entre a amostra endometrial pré-operatória e a peça uterina nos carcinomas de endométrio

Silveira, Razyane Audibert January 2017 (has links)
Objetivo: avaliar a concordância da expressão imuno-histoquímica (IMH) da proteína p53 (p53) na amostra endometrial e na peça cirúrgica de histerectomia, associando-a a fatores como tipo histológico, grau tumoral e estadiamento, bem como analisar a concordância interobservador para expressão e intensidade de expressão da p53 entre biópsia diagnóstica e peça cirúrgica. Métodos: estudo transversal retrospectivo, no qual foram incluídas pacientes com carcinoma endometrial submetidas à biópsia de endométrio e tratamento cirúrgico primário na Unidade de Oncologia Genital do HCPA. As lâminas foram lidas por dois patologistas. O percentual de expressão da p53 foi avaliado em três categorias (<10%, 10-50% e >50%). A intensidade foi avaliada como fraca, média ou forte. Foram extraídos dados do prontuário eletrônico das pacientes. A concordância foi avaliada através do coeficiente Kappa ponderado. Resultados: 72 pacientes foram incluídas, com idade média de 65,5 anos. O percentual de expressão da p53 entre biópsia e peça cirúrgica apresentou uma taxa de concordância de 70,8%, com um índice de Kappa ponderado de 0,64 e a intensidade de expressão apresentou uma taxa de concordância de 69,4%, com Kappa ponderado de 0,65. A avaliação da concordância do percentual de expressão da p53 conforme tipo histológico e grau tumoral apresentou coeficientes de Kappa ponderado de 0,64 e 0,72, nos carcinomas não endometrioides e G3, respectivamente. Tais dados, com diferença estatística significativa. A concordância interobservador para a expressão e intensidade da p53 na biópsia apresentou índices de Kappa 9 ponderado de 0,77 e 0,75, respectivamente. Na peça cirúrgica, os índices de kappa ponderado foram de 0,85 e 0,88, para a expressão e intensidade, respectivamente. Conclusões: as taxas de concordância para a expressão e intensidade de expressão IMH da p53 entre biópsia endometrial e peça cirúrgica foram boas, podendo ser útil em tempo pré-operatório, para a seleção de pacientes candidatas a uma cirurgia mais extensa, principalmente quando os dados anatomopatológicos da biópsia forem insuficientes para tal decisão. Devemos, no entanto, levar em consideração que existem muitos outros marcadores moleculares para a neoplasia endometrial, sendo provável futuramente o estudo da concordância deles em associação ao da p53. / Objective: To evaluate the agreement of the immunohistochemical (IMH) expression of the p53 protein (p53) in preoperative endometrial tissues and in surgical specimens obtained during hysterectomy, to determine the association of this agreement with factors such as histological type, tumor grade and stage and to evaluate interobserver agreement for the expression and intensity of p53 between the diagnostic biopsy and the surgical specimen. Methods: Retrospective cross-sectional study. Patients with endometrial carcinoma who submitted to endometrial biopsy and primary surgical treatment at the HCPA Genital Oncology Unit were included. The slides were assessed by two pathologists. The percentage of p53 expression was evaluated and categorized into one of three groups (<10%, 10-50% and >50%). The intensity was evaluated as weak, medium or strong. The agreement was assessed by the weighted Kappa coefficient. Results: 72 patients with a mean age of 65.5 years were included. The percentage of p53 expression between the biopsy and the surgical specimen presented an agreement rate of 70.8%, with a weighted Kappa index of 0.64. The intensity of expression had an agreement rate of 69.4% with a weighted Kappa of 0.65. When evaluated according to histological type and tumor grade, the agreement for p53 expression showed weighted Kappa indexes of 0.64 and 0.72 in non-endometrioid and G3 carcinomas, respectively (p<0.001). With respect to the biopsy, the interobserver agreement for the expression and intensity of p53 had weighted Kappa indexes of 0.77 and 0.75, respectively. With respect to the surgical specimen, the weighted Kappa indexes were 0.85 and 0.88 for expression and intensity, respectively. 11 Conclusions: This study found good agreement rates for the expression and intensity of p53 IMH expression between the endometrial biopsy specimen and the surgical specimen, which may be useful in a preoperative setting for the selection of patients who are candidates for more extensive surgery, especially when anatomopathological biopsy data are insufficient for such a decision.
8

Avaliação da concordância da expressão imuno-histoquímica da proteína p53 entre a amostra endometrial pré-operatória e a peça uterina nos carcinomas de endométrio

Silveira, Razyane Audibert January 2017 (has links)
Objetivo: avaliar a concordância da expressão imuno-histoquímica (IMH) da proteína p53 (p53) na amostra endometrial e na peça cirúrgica de histerectomia, associando-a a fatores como tipo histológico, grau tumoral e estadiamento, bem como analisar a concordância interobservador para expressão e intensidade de expressão da p53 entre biópsia diagnóstica e peça cirúrgica. Métodos: estudo transversal retrospectivo, no qual foram incluídas pacientes com carcinoma endometrial submetidas à biópsia de endométrio e tratamento cirúrgico primário na Unidade de Oncologia Genital do HCPA. As lâminas foram lidas por dois patologistas. O percentual de expressão da p53 foi avaliado em três categorias (<10%, 10-50% e >50%). A intensidade foi avaliada como fraca, média ou forte. Foram extraídos dados do prontuário eletrônico das pacientes. A concordância foi avaliada através do coeficiente Kappa ponderado. Resultados: 72 pacientes foram incluídas, com idade média de 65,5 anos. O percentual de expressão da p53 entre biópsia e peça cirúrgica apresentou uma taxa de concordância de 70,8%, com um índice de Kappa ponderado de 0,64 e a intensidade de expressão apresentou uma taxa de concordância de 69,4%, com Kappa ponderado de 0,65. A avaliação da concordância do percentual de expressão da p53 conforme tipo histológico e grau tumoral apresentou coeficientes de Kappa ponderado de 0,64 e 0,72, nos carcinomas não endometrioides e G3, respectivamente. Tais dados, com diferença estatística significativa. A concordância interobservador para a expressão e intensidade da p53 na biópsia apresentou índices de Kappa 9 ponderado de 0,77 e 0,75, respectivamente. Na peça cirúrgica, os índices de kappa ponderado foram de 0,85 e 0,88, para a expressão e intensidade, respectivamente. Conclusões: as taxas de concordância para a expressão e intensidade de expressão IMH da p53 entre biópsia endometrial e peça cirúrgica foram boas, podendo ser útil em tempo pré-operatório, para a seleção de pacientes candidatas a uma cirurgia mais extensa, principalmente quando os dados anatomopatológicos da biópsia forem insuficientes para tal decisão. Devemos, no entanto, levar em consideração que existem muitos outros marcadores moleculares para a neoplasia endometrial, sendo provável futuramente o estudo da concordância deles em associação ao da p53. / Objective: To evaluate the agreement of the immunohistochemical (IMH) expression of the p53 protein (p53) in preoperative endometrial tissues and in surgical specimens obtained during hysterectomy, to determine the association of this agreement with factors such as histological type, tumor grade and stage and to evaluate interobserver agreement for the expression and intensity of p53 between the diagnostic biopsy and the surgical specimen. Methods: Retrospective cross-sectional study. Patients with endometrial carcinoma who submitted to endometrial biopsy and primary surgical treatment at the HCPA Genital Oncology Unit were included. The slides were assessed by two pathologists. The percentage of p53 expression was evaluated and categorized into one of three groups (<10%, 10-50% and >50%). The intensity was evaluated as weak, medium or strong. The agreement was assessed by the weighted Kappa coefficient. Results: 72 patients with a mean age of 65.5 years were included. The percentage of p53 expression between the biopsy and the surgical specimen presented an agreement rate of 70.8%, with a weighted Kappa index of 0.64. The intensity of expression had an agreement rate of 69.4% with a weighted Kappa of 0.65. When evaluated according to histological type and tumor grade, the agreement for p53 expression showed weighted Kappa indexes of 0.64 and 0.72 in non-endometrioid and G3 carcinomas, respectively (p<0.001). With respect to the biopsy, the interobserver agreement for the expression and intensity of p53 had weighted Kappa indexes of 0.77 and 0.75, respectively. With respect to the surgical specimen, the weighted Kappa indexes were 0.85 and 0.88 for expression and intensity, respectively. 11 Conclusions: This study found good agreement rates for the expression and intensity of p53 IMH expression between the endometrial biopsy specimen and the surgical specimen, which may be useful in a preoperative setting for the selection of patients who are candidates for more extensive surgery, especially when anatomopathological biopsy data are insufficient for such a decision.
9

Ressonancia magnetica resumida na avaliação da extensão do carcinoma de endometrio / Limited-sequences of magnetic resonance imaging in assessing the extent of endometrial carcinoma

Lombardelli, Karen Vicencia Pingarilho 27 August 2008 (has links)
Orientador: Luiz Carlos Zeferino / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T20:18:21Z (GMT). No. of bitstreams: 1 Lombardelli_KarenVicenciaPingarilho_M.pdf: 1393759 bytes, checksum: 03f9bf792d32993984a7a2ab742d670a (MD5) Previous issue date: 2008 / Resumo: Introdução: A ressonância magnética (RM) é um exame que pode auxiliar no estadiamento pré-cirúrgico da paciente com carcinoma de endométrio, o que permite planejar mais adequadamente a cirurgia, principalmente quando há evidências de doença avançada e em mulheres com comorbidades clínicas relevantes. Todavia, é um exame demorado, exige cooperação e imobilidade, emite ruído e o espaço físico é restrito, ocasionando desconforto e claustrofobia. Motivos referidos, inclusive como justificativa de interrupção do exame. A mobilidade durante o exame, incluindo movimentos respiratórios acentuados, assim como o alto índice de obesidade em mulheres com carcinoma de endométrio podem gerar artefatos que comprometem a qualidade da imagem, prejudicado o diagnóstico final. Simplificar o exame com redução do tempo de duração sem prejudicar a qualidade do diagnóstico seria muito útil. Objetivos: O objetivo deste estudo foi avaliar se a subtração das seqüências T1 FS sagital e T2 TSE coronal, sem contraste e com aquisições de alta resolução, comprometeria o desempenho diagnóstico na avaliação da extensão do carcinoma de endométrio. Material e Métodos: Este estudo foi observacional e descritivo, de corte transversal. Foram incluídas 62 mulheres com diagnóstico histológico de carcinoma de endométrio. As pacientes fizeram RM da pelve que foi analisada por dois médicos especialistas, sendo que um avaliou o exame completo e o outro o exame resumido, sem troca de informações entre eles. Os achados da RM completa e resumida foram comparados com os laudos anatomopatológicos. Para testar a associação entre as variáveis qualitativas foi utilizado o teste qui-quadrado. A concordância diagnóstica entre os exames completo e resumido da RM foi analisada pelo Coeficiente de Kappa. Resultados: As medianas, médias, desvios-padrão e valores máximos das medidas do maior diâmetro do tumor avaliadas pelas RMC, RMR e patologia foram muito próximas. As medianas, médias, desvios-padrão, valores mínimos e valores máximos do volume do tumor avaliado pelas RMC e RMR foram muito próximos. A mediana do volume do tumor avaliado pela patologia foi muito próxima das medianas obtidas pela ressonância magnética, enquanto que a média, desvio-padrão e valor máximo apresentaram valores maiores. Conclusões: A RMR apresenta desempenho semelhante ao da RMC na avaliação da extensão do carcinoma do endométrio. A concordâncJa observada para avaliação da invasão, miometrial, do colo do útero e dos linfonodos pélvicos foi classificada como muito boa ou excelente. A concordância na avaliação da invasão do colo do útero entre a patologia e as RMC e RMR foi classificada como muito boa (Tabela 2). A concordância observada para avaliação das invasões miometrial e do colo do útero entre os exames de RM foi classificada como muito boa ou excelente. Portanto, é possível utilizar o exame de RM sem as seqüências T1 SE sagital sem contraste e T2 TSE caronal, pois não haverá prejuízo na qualidade do diagnóstico / Abstract: Background: Magnetic resonance imaging (MRI) is an exam that may be helpful in establishing presurgical staging of patients with endometrial carcinoma, allowing a more appropriate surgical procedure to be planned, principally in the case of advanced disease or in women with relevant clinical comorbidities. However, it is a protracted exam that requires cooperation and immobility. In addition, it is noisy and physical space is restricted, often causing discomfort, anxiety and claustrophobia that may lead to interruption of the exam. Movements including accentuated breathing may generate artifacts that compromise the quality of images. Simplifying the exam by reducing the time required to carry it out without affecting the quality of diagnosis would be extremely useful. Objectives: To evaluate whether modification to the routine MRI (complete MRI) by eliminating the non contrast high resolution sagittal T1-weighted FS and caronal T2-weighted TSE sequences (resumed MRI), negatively affects performance of this exam in the diagnosis of the extent of endometrial carcinoma. Methods: A cross sectional, observational, descriptive study was carried out in 62 women with endometrial carcinoma. All underwent pelvic MRI, which was analyzed by two radiologists. Complete and rapid MRI findings were compared with anatomopathology reports. The chi-square test was used to test the association between qualitative variables. Diagnostic agreement between complete and resumed MRI was analyzed using the kappa coefficient. Results: There were no statistically significant differences in the medians, means, standard deviations or maximum values of the measurements of the greatest diameter and of tumor volume as evaluated by complete MRI, resumed MRI and pathology. With respect to myometrial invasion, agreement between complete and resumed MRI was classified as very good, with a kappa coefficient of 0.73 (0.54 - 0.93). Agreement in the evaluation of myometrial invasion between pathology and complete or resumed MRI was classified as good. With respect to cervical invasion, agreement between complete and rapid MRI was classified as excellent, with a kappa coefficient of 0.96 (0.87 - 1.00). Agreement in the evaluation of cervical invasion between pathology and complete and resumed MRI was classified as very good. With respect to pelvic Iymph nodes, agreement between complete and resumed MRI was classified as excellent, with kappa coefficients of 0.93 (0.84 - 1.00) and 0.96 (0.90 - 1.00), respectively. Conclusions: MRI without the non-contrast sagittal T1-weighted SE and coronal T2-weighted TSE sequences maintains the same performance as complete MRI in evaluating the extent of endometrial carcinoma. The shorter time required to carry out the exam would, therefore, be beneficial to the patients, reducing their discomfort and, principally, decreasing reactions of anxiety and claustrophobia. Moreover, costs to healthcare services, and indirectly to the patients, would also be reduced, since the productivity of the equipment and the team would be higher / Mestrado / Ciencias Biomedicas / Mestre em Tocoginecologia
10

Biomarkery epiteliálních nádorů ovaria a endometria / Biomarkers of epithelial ovarian tumors and of the endometrium

Presl, Jiří January 2013 (has links)
Structured abstract Study objectives: Ovarian carcinoma 1/ comparison of sensitivities among monitored markers CA 125, HE4, CA 19-9, CEA, TK, TPS, MonoTotal 2/ comparison of false positivity of markers CA 125 and HE4 3/ use of CA 125, HE4 and ROMA index in the diagnostics of ovarian carcinoma 4/ use of CA 125 and HE4 in the follow-up of ovarian cancer Endometrial carcinoma 1/ feasibility of use of biomarkers CA125 and HE4 in patients with endometrial cancer in pre- operative management Study design: Retrospective data analysis Settings: Department of Obstetrics and Gynecology, Medical Faculty and Teaching Hospital in Pilsen Patients and Methods: Ovarian cancer 1/ Sensitivity of markers CA 125, HE4, CA 19-9, CEA, TK, TPS, and MonoTotal was assessed in 266 patients - 19 with ovarian cancer and 247 with benign disorders. 2/ False positivity of markers CA125 and HE4 was evaluated in a total of 390 patients with benign diagnoses - 60 women with endometriosis, 70 pregnant patients, 67 patients with ascites, 60 with pleural effusion, 25 with cardiac failure , 80 with renal insufficiency and 28 with hepatic failure. 3/ As a part of this objective we evaluated 552 patients with abnormal pelvic abnormality - 30 women had a histologically confirmed malignant ovarian tumor. Other 522 women had a benign condition. The...

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