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Objectives. Endometriosis is supported by hormonal, immunological, and environmental factors. No specific marker for endometriosis has yet been identified. ESR2 and CYP19A1 genes play a major role in the hormonal control of endometriosis women, the development of which largely depends on steroid hormones. Aim. An analysis of ESR2 and CYP19A1 allele-specific gene expressions in the context of the risk for endometriosis occurrence. Methods. The study material included paraffin-embedded tissue specimens, collected from patients ( n = 100 ) with endometriosis. Blood samples from age-matched, endometriosis-free women ( n = 100 ) served as a control. the RT-PCR technique was performed to observe the expression of ESR2 and CYP19A1 genes. Moreover, Sanger’s sequencing method was applied for polymorphism analysis. Results. A set of 4 single-nucleotide polymorphisms (SNPs) was determined; all of them most significantly associated with endometriosis: rs4986938 (G>A)(chromosome 14), rs928554 (A>G) (chromosome 14), rs10046 (C>T) (chromosome 15), and rs4646 (C>A) (chromosome 15). There were no differences in the distribution of genotypes and alleles in the studied groups, taking into account ESR2 and CYP19A1 gene expressions. Conclusion. The ESR2 and CYP19A1 polymorphisms may not be correlated with endometriosis susceptibility. Further analysis is needed to specify the role of these polymorphisms in the pathogenesis of endometriosis.

BACKGROUND Clinical cases have been reported with women who got pregnant with confirmed low serum anti-Mullerian hormone (AMH) concentrations, thus demonstrating that low serum AMH concentration cut-points could be fairly specific for poor ovarian response (POR) to gonadotrophin stimulation, but not for pregnancy. That observation prompted the question whether serum AMH concentration accurately corresponded to the whole amount of AMH secreted by granulosa cells. OBJECTIVES To measure AMH levels in peritoneal fluid and their correlations with serum AMH concentrations. MATERIAL AND METHODS The reported study involved 48 female patients, aged 18-40 years, diagnosed with benign ovarian cysts and qualified for a laparoscopic cystectomy. Prior to surgery, the ovarian reserve was assessed using serum AMH concentration assay. The peritoneal fluid was also collected during the laparoscopy and AMH concentrations in peritoneal fluid were measured. RESULTS The AMH present in the peritoneal fluid strongly correlated with AMH levels in blood serum (r = 0.54; p < 0.001) and higher serum AMH concentrations corresponded to higher AMH concentrations in the peritoneal fluid. There was also a significant correlation between AMH levels in serum and in peritoneal fluid, collected from patients with endometrioma and other benign cysts (r = 0.61; p = 0.001 vs r = 0.43; p = 0.03). CONCLUSIONS The AMH is present in the peritoneal fluid and its concentrations significantly correlate with AMH levels in serum. The assessment of AMH concentration in the peritoneal fluid may be a valuable complement to the evaluation of ovarian reserve and the diagnosis of infertility after adnexal surgery.

Background/Aim: This research was aimed to evaluate the association between three selected single nucleotide polymorphisms (SNPs) within the CDKN2A (P14ARF) tumour suppressor gene and the incidence of endometrial cancer (EC) in postmenopausal women. Patients and Methods: The study included 194 postmenopausal women; 144 with EC and 50 non-cancer controls. Genotypes in P14ARF rs3088440, rs3731217 and rs3731245 polymorphisms were assayed using PCR-RFLP and confirmed by sequencing. Results: Regarding the rs3088440 polymorphism, CT, and CT-TT genotypes, were more prevalent among EC patients than in controls (OR=5.55, p=0.023, OR=5.29, p=0.027; and OR=2.92, p=0.023, respectively). The T allele within rs3088440 was more prevalent in EC females than in controls (χ(2)=4.7, p=0.030). Considering rs3731217, TG and TG-GG genotypes were less prevalent among EC (OR=0.34, p=0.024 or p=0.023; and OR=0.38, p=0.035, respectively). Conclusion: Polymorphisms in the CDKN2A gene are associated with EC in postmenopausal women.

Aim The analysis of oestrogen receptor (ESR2) and cytochrome P450 family 19 subfamily A member (CYP19A1) gene expression in the context of the risk for endometriosis development. Materials and methods Tissue specimens, collected from patients with endometriosis (n=100) and from control patients (n=100) embedded into paraffin blocks, provided the material for genetic studies, oriented towards the expression of ESR2 and CYP19A1 genes. The gene expression was assessed by the reverse transcription-polymerase chain reaction technique. Results Higher expression levels of ESR2 gene were demonstrated in the patients with endometriosis in comparison with the healthy controls. The expression intensity of CYP19A1 gene was associated with endometriosis, manifested as abdominal wall nodules. A relationship was observed between CYP19A1 gene expression and the Revised American Society for Reproductive Medicine classification in the group with ovarian endometrioid cysts, as well as in the group with peritoneal endometriosis. Conclusion This study suggests the significant role of ESR2 and CYP19A1 gene expression in the pathogenesis of endometriosis.

Background: Endometriosis is a chronic disease of the genital organs that mainly affects women of reproductive age. The analysis of long non-coding RNA (lncRNA) in endometriosis is a novel field of science. Recently, attention has been drawn to SNHG4, which is incorrectly expressed in various human diseases, including endometriosis. Aim: The aim of this pilot study was to analyze the expression of lncRNA small nucleolar RNA host gene 4 (SNHG4) and to investigate its significance in endometriosis. Material and methods: LncRNA SNHG4 expression was investigated in paraffin blocks in endometriosis patients (n = 100) and in endometriosis-free controls (n = 100) using a real-time PCR assay. Results: This study revealed a higher expression of SNHG4 in endometriosis patients than in controls. A statistically significant relationship between expression level and SNHG4 was found in relation to The Revised American Society for Reproductive Medicine classification of endometriosis, 1996, in the group of patients with endometriosis. Conclusion: This pilot study has revealed that gene expression in SNHG4 plays an important role in the pathogenesis of endometriosis.

Endometriosis is a “mysterious” disease and its exact cause has not yet been established. Among the etiological factors, congenital, environmental, epigenetic, autoimmune and allergic factors are listed. It is believed that the primary mechanism of the formation of endometriosis foci is retrograde menstruation, i.e., the passage of menstrual blood through the fallopian tubes into the peritoneal cavity and implantation of exfoliated endometrial cells. However, since this mechanism is also observed in healthy women, other factors must also be involved in the formation of endometriosis foci. Endometriosis is in many women the cause of infertility, chronic pain and the deterioration of the quality of life. It also represents a significant financial burden on health systems. The article presents a review of the literature on endometriosis—a disease affecting women throughout the world.

Introduction Long-term infection with human papillomavirus (HPV) is the cause of cervical cancer and its precursor - cervical intraepithelial neoplasia (CIN). The presence of HPV infection can be presumed in more than 99% of cases of cervical cancer worldwide. The introduction of DNA testing for the presence of HPV has increased the effectiveness of screening programs for the detection of this cancer. This study aimed to analyze the prevalence of high risk HPV DNA (HR HPV) in females from Poland. Material and methods The study was performed on 280 cervical smear samples. In this work we used the Roche Cobas 4800 HPV test to detect the HR HPV in cervical smear samples. Results 56 patients (20%) proved to be positive regarding HPV-16 DNA and 40 patients (14.28%) regarding HPV-18 DNA. In overall assessment, in 94 patients (33.57%) we detected oncogenic HPV subtypes, other than the two mentioned above. In 90 patients (32.14%) no high risk HPV was detected. Conclusions The Roche Cobas 4800 HPV test is a viable, effective, easy and quick tool in detecting high risk HPV DNA.

Objectives. Endometriosis is supported by hormonal, immunological, and environmental factors. No specific marker for endometriosis has yet been identified. ESR2 and CYP19A1 genes play a major role in the hormonal control of endometriosis women, the development of which largely depends on steroid hormones. Aim. An analysis of ESR2 and CYP19A1 allele-specific gene expressions in the context of the risk for endometriosis occurrence. Methods. The study material included paraffin-embedded tissue specimens, collected from patients (n=100) with endometriosis. Blood samples from age-matched, endometriosis-free women (n=100) served as a control. the RT-PCR technique was performed to observe the expression of ESR2 and CYP19A1 genes. Moreover, Sanger’s sequencing method was applied for polymorphism analysis. Results. A set of 4 single-nucleotide polymorphisms (SNPs) was determined; all of them most significantly associated with endometriosis: rs4986938 (G>A)(chromosome 14), rs928554 (A>G) (chromosome 14), rs10046 (C>T) (chromosome 15), and rs4646 (C>A) (chromosome 15). There were no differences in the distribution of genotypes and alleles in the studied groups, taking into account ESR2 and CYP19A1 gene expressions. Conclusion. The ESR2 and CYP19A1 polymorphisms may not be correlated with endometriosis susceptibility. Further analysis is needed to specify the role of these polymorphisms in the pathogenesis of endometriosis.

To assess anti-Müllerian hormone (AMH) levels as a marker of early abortion in the first trimester among women younger than 35 years.Prospective study of women aged 18-34 years with a spontaneous pregnancy at less than 12.6 gestational weeks in Łódź, Poland, between January 2017 and November 2018. Cases of anembryonic abortion and assisted conception were excluded. Blood samples were collected and assayed for serum AMH levels. Data were compared between women with an embryo with no cardiac activity by ultrasound (n=30) and those with a normal embryo (n=33) by using Statistica12 software.The 10th and 90th percentiles of serum AMH concentration among control women were used to identify a reference AMH range (1.1-4.5 ng/mL). Risk of pregnancy loss in the first trimester was found to be higher for both low AMH (1.1 ng/mL; relative risk [RR], 3.66; 95% confidence interval [CI], 2.1-6.4; P0.001) and high AMH (4.5 ng/mL; RR, 3.0; 95% CI, 1.61-5.59; P0.001).Both very low and very high AMH concentrations were found to significantly increase the risk of abortion in the first trimester of pregnancy. Serum AMH might be a valuable marker to predict the risk of early abortion.

Endometriosis is defined as the presence of endometrial foci, localized beyond their primary site, i.e., the uterine cavity. The etiology of this disease is rather complex. Its development is supported by hormonal, immunological, and environmental factors. During recent years, particular attention has been focused on the genetic mechanisms that may be of particular significance for the increased incidence rates of endometriosis. According to most recent studies, ESR2 and CYP19A1 genes may account for the potential risk factors of infertility associated with endometriosis. The paper presents a thorough review of the latest reports and data concerning the genetic background of the risk for endometriosis development.

The expression level of Mac-1 on the surface of neutrophils is an important indicator of neutrophil activation. Under pathological conditions, Mac-1 is believed a key adhesion molecule that facilitates cancer progression and mediates the adhesion of tumour cells to the endothelium of blood vessels. Our previous findings indicated that circulating peripheral blood neutrophils in patients with advanced epithelial ovarian cancer (EOC) expressed enhanced levels of Mac-1, which was functionally associated with an increased adhesive function of neutrophils. The objective of the current study was to analyse whether the value of individual components of the differential white cell count, including the neutrophil and lymphocyte ratios, which are markers of blood neutrophil activation, might be associated with certain types of ovarian cancer. We showed the increase in Mac-1 expression along with a parallel decrease of L-selectin and PSGL-1 on peripheral blood neutrophils of patients with EOC of early and advanced FIGO stages, which indicates an activated state of neutrophils in comparison to neutrophils of individuals without cancer. Despite a significant difference between Mac-1 expression in patients with and without cancer, a dramatic increase in Mac-1 expression was observed in the blood of patients with undifferentiated carcinomas compared with patients with other histological types of EOC. Moreover, the expression level of Mac-1 correlated with the number of neutrophils in patients with serous, endometrioid and undifferentiated EOC. The results of an ROC analysis demonstrated that the patients with the undifferentiated type of EOC form a distinct group with regard to Mac-1 expression on blood neutrophils. The results suggested a diverse biological cadre of immune cells in patients with undifferentiated ovarian carcinomas compared with patients with other histological types of EOC.

Endometrial cancer is one of the most common cancers experienced by women throughout the world. It is also the most common malignancy within the female reproductive system, representing 37.7% of all disorders. The incidence increases with age, and is diagnosed most frequently in women between 45 and 65 years old. In the last few years, numerous studies have been performed to identify tumour biomarkers. Biomarkers include not only protein routinely used as tumour markers but also genes and chromosomes. The limiting factor in the use of markers in the diagnosis of endometrial cancer is their lack of specificity. However, specific markers for endometrial cancer are the subject of much research attention. Although moderately elevated levels of markers are present in a number of inflammatory or non-malignant diseases, significantly increased levels of markers indicate the development of cancer. Recently, research has been focused on the identification of molecular changes leading to different histological subtypes of endometrial cancer. In this paper the authors reviewed several currently investigated markers. Progress in these investigations is very important in the diagnostics and treatment of endometrial cancer. In particular, the identification of novel mutations and molecular profiles should enhance our ability to personalise adjuvant treatment with genome-guided targeted therapy.

OBJECTIVE To determine the long-term impact of laparoscopic cystectomy for endometriomas and benign cysts on ovarian reserve and selection of the most effective method of assessment. METHODS The present study was carried out between November 2013 and December 2016. Participants were assigned to laparoscopic cystectomy for diagnosed unilateral benign ovarian cysts and divided into groups: the endometrioma group (EG) (n=35) and the other benign ovarian tumor group (OG) (n=35). Before and at 3 and 12 months after the procedure, transvaginal ultrasonography was performed to assess antral follicle count (AFC) and ovarian volume (OvVol); laboratory tests were ordered for anti-Műllerian hormone (AMH) serum concentration assays. Pregnancy rates were counted in a 12-month follow-up. Statistica12 software was used for analysis. RESULTS The present study included 70 women aged 18-40 years. AMH serum concentration decreased significantly 3 months after laparoscopic cystectomy (4.89 ± 3.66 ng/mL to 3.45 ± 3.37 ng/mL; P

Objective Endometriosis is a common gynaecological disease, associated with severe pelvic pain and reduced fertility; however, molecular mechanisms remain largely unknown. Genome-wide association studies (GWAS) are able to identify genetic loci, which can play significant role during endometriosis development. Aim The study aimed at localisation of new genes and chromosomal loci, the nucleotide variants of which determine the level of susceptibility to endometriosis. Study design Blood samples from 171 patients with endometriosis were used as material for studies. The patients were recruited to the study at the Department of Operative Gynaecology of the Institute of the Polish Mother’s Memorial Hospital in Lodz. A control group (n = 2934) came from the POPULOUS collection registered at Biobank Lab, Department of Molecular Biophysics, University of Lodz. DNA of the patients with endometriosis was compared with DNA of women free from that disease, the comparison being supported by GWAS. Results Genome-wide significant correlation was identified between one new, not previously described, single nucleotide polymorphism (SNP), rs10129516, localised on chromosome 14 in intergenic region between PARP1P2 and RHOJ genes (p = 1.44 × 10−10, OR = 3.104, 95% CI = 2.329–4.136) and endometriosis. We have also identified significant association with endometriosis of 18 SNPs localised on chromosome 6 in position range 31883957 − 32681631 (C2 and HLA-DRA genes region) with the lowest observed p value for rs644045 in C2 gene (p = 2.04 × 10−8, OR = 1.955, 95% CI = 1.541–2.480). Conclusion Reported GWAS identified the novel loci associated with endometriosis in Polish women, not previously reported. The most interesting observation shown in our study are regions associated with susceptibility to endometriosis of loci located near C2, HLA-DRA and RHOJ genes. Results of that study did not correspond to previously published data about polymorphism in that regions and further evaluations are necessary in groups with higher numbers of patients to explain whether the above-mentioned genetic variant may be the risk factor for pathogenesis of endometriosis.

Primary cytoreduction, followed by chemotherapy, is a standard treatment of patients with epithelial ovarian cancer (EOC). However, the effectiveness of this treatment depend on various elements e.g. type of operation. It is accepted that optimal surgery correlates with longer survival of patients. The other element, an efficiency of immune system after surgical intervention although important is less elucidated. The aim of this study was to establish the impact of optimal and sub-optimal operation on immunological status of EOC patients regarding also their overall survival (OS). On the day of primary cytoreduction and 7 days after, the selected serum immunological parameters were determined in 49 patients with confirmed EOC. We found that, the level of immunosuppressive (interleukin 10; transforming growth factor-β − TGF-β1) and pro-inflammatory (interleukin-6 and 8) cytokines was significantly higher in the group of patients with advanced stage of disease, compared to early stage. However, the number of circulating CD3 + , CD4 + or CD8 + cells, CD19 + and NK cells was similar in both group of EOC patients. The overall survival of patients who underwent optimal cytoreduction was significantly higher than that in whom only sub-optimal surgery was performed. Sub-optimal cytoreduction only partially weakened the serum level of TGF-β1 and IL-8 and what is more enhanced the number of circulating CD4 + CD25 +high cells in patients with advanced stage of disease. Sub-optimal surgery and high post-operative level of TGF-β1 increased the hazard ratio for patients. Besides, we noticed that the high pre-operative concentration of TGF-β1 could distinguish all EOC patients (independently of FIGO classification) for whom optimal or sub-optimal surgery would be applied. Sub-optimal debulking resulted in higher immunosuppression and lower OS of EOC patients.

Supplemental Digital Content is available in the text, Smouldering inflammation, thrombocytosis, and platelet hyper-reactivity are linked to malignancy. The relationships between preoperative diagnostic blood morphology parameters and cancer have been the focus of much interest, because some of these parameters are correlated with advanced cancer stages and poor patient survival rates. This study aimed to perform an observational, retrospective analysis of the intradiversity of blood platelet parameters in patients with different International Federation of Gynaecology and Obstetrics (FIGO) stages and different histological types of epithelial ovarian carcinomas (EOC), and also an analysis of the overall survival rate. In all, 94 EOC patients were included in this analysis (23 mucinous, 33 serous, 20 undifferentiated, 14 endometrioid, and 4 clear cell carcinoma cases). Peripheral blood samples were collected and analyzed before drug or surgical treatment. The platelet-to-neutrophil ratio (PNR) was related to the histological type of EOC, particularly mucinous carcinoma. In patients with mucinous cancer, the PNR was significantly lower compared with patients with nonmucinous cancer, and this parameter distinguished between mucinous and nonmucinous groups of patients (area under receiver-operating characteristic [ROC] curve 0.721 ± .056; sensitivity 82.6%; specificity 61%; P

Integration of the HPV genome into a host cell DNA leads to the deregulated overexpression of the viral E6 and E7 oncoproteins, and this is a key factor for progression from low-grade cervical lesions to high-grade lesions and invasive cervical cancer. The aim of our study was to analyze the expression levels of HPV E6*I/E6*II and E7 genes in cervical neoplasia of different grades. The analysis involved 10 low-grade squamous intraepithelial lesions (CIN1), 15 high-grade lesions (CIN2 and CIN3), as well as normal cytology samples (n=10). HPV genotyping was done using RealLine HPV 16/18 kit. The expression analysis was performed in real-time PCR assay using gene-specific primers and SYBR Green. HPV16 DNA was found in 65.71% patients, including also normal cytology samples. The increased expression level of E6*I was observed in 12 (34.3%) patients. The expression of E6*II was increased in 10 (28.6%) samples, and E7 overexpression was found in 14 (40%) patients. Significant positive correlation was observed between the amount of HPV16 DNA and the levels of E6*I and E6*II expression. There were no statistically significant differences in expression levels of the studied genes between the groups (CIN1 vs. CIN2/CIN3 vs. normal cytology). Statistically significant differences were found in CIN2/CIN3 group, with the higher expression of E6*II as compared with E6*I. We suggest that the expression level of E6*II gene might be used as an indicator of cervical cancer severity, in patients with high-grade cervical neoplasia, but these observations need to be confirmed in a larger patient cohort.

Objectives: Endometrioid and clear cell ovarian adenocarcinomas are suspected to derive from ectopic endometrial foci. The aim of the study was to determine PTEN and MMP-2 immunoexpression in endometrial ovarian cysts, endometrioid and clear cell ovarian carcinomas and to assess the relationship between the abovementioned values and clinical data of patients in order to find the marker of increased risk of malignant proliferation based on ovarian endometriotic lesions. Detailed analysis of the collected data was conducted to investigate the correlation between immunohistochemical expression of the examined antigens, histopathological diagnosis and clinical condition of patients. Material and methods: 20 endometrial adenocarcinomas, 21 clear cell ovarian cancers and 26 endometrial cysts were included in the study. The control group consisted of 29 specimens of physiological endometrium: 16 samples of the proliferative phase and 13 samples of the secretory phase. Protein expression of PTEN and MMP-2 was evaluated by immunohistochemistry. Protein immunoexpression in the collected specimens was estimated with the use of light microscope and MultiScan software. Immunoreactivity of the PTEN antigen was assessed by the quantitative method, whereas MMP-2 immunoexpression was evaluated by the semi-quantitative method. Two-sided tests were used for statistical inference. Generalized linear models were used to compare the studied groups. Error distributions were selected using the Akaike criterion (AIC). Statistical analysis was conducted with the use of the R Statistical Package. Results: MMP-2 immunoreactivity differed significantly between the study groups and controls (p

Endometriosis is defined by endometrial glands and stroma outside of the endometrial cavity Three types of endometriosis have been described: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis. Endometriosis afflicts 6-15% of women population. It occurs mainly in the group of women in reproductive age, but also in the group of minors and approximately 3% of women after menopause. Within the group of women suffering from infertility the frequency of endometriosis increased to 35-50% of cases. Endometriosis is associated with pain symptoms which can bear the character of pain occurring periodically and altering into constant pain, dysmenorrhea, dyspareunia, dysuria and dyschezia. The correlation between the stage of endometriosis and intensity of pain symptoms not always has to be proportionate. Laparoscopy can be perceived as a standard procedure in endometriosis diagnostics as it allows simultaneous treatment. Profound interview as well as visual diagnostics (USG, MRI) should precede laparoscopy Treatment of endometriosis can be divided into pharmacological and surgical treatment, which can be invasive or non-invasive. The type of treatment depends on patient's age and her procreation plans, occurring ailments and endometriosis type. Important role is played by adjuvant treatment such as appropriate diet and lifestyle. Treatment of advanced endometriosis should be conducted in reference centres that are appointed with adequate equipment and have the possibility of interdisciplinary treatment. Presented standards can digest and outline the order of proceedings both in diagnostics and endometriosis treatment. The research group believes that the above compilation will facilitate undertaking appropriate decision in diagnosis and treatment of the disease, which will subsequently contribute to therapeutic success.

Summary Background: Primary presacral tumour is extremely rare among adults. Such lesions are often found inciden-tally, because they may not show any clinical symptoms. Moreover, differentiation between cystic changes in ovary and presacral region is extremely difficult; it might even be a diagnostic challenge. Imaging studies should include transvaginal and transrectal ultrasound, computed tomography and magnetic resonance imaging, which are useful in identifying the exact location and suggest char-acter of the tumour. Such diagnostics are helpful in determining the optimal surgical procedure. Case Report: We present a case of a 26-year-old patient with abdominal pain. Imaging studies were performed; they revealed a presacral cyst 5 cm in diameter. Laparoscopic removal of the cyst was performed. Histopathological examination of the lesion confirmed a mature teratoma. The postoperative pe -riod was uneventful. Conclusions: Due to the rarity of reported changes no firm guidelines exist. In the literature, depending on the anatomical conditions, descriptions of various surgical procedures are reported. The presented case confirms that surgical treatment can be performed by laparoscopy.

Endometriosis is a common gynaecological disease of unknown etiology. Angiogenesis appears to be one of the processes involved in its pathogenesis. Angiogenic factors VEGF level is increased in patients with endometriosis. Studies have shown that endometriosis maybe associated with VEGF single nucleotide polymorphism (SNP) polymorphisms. Results from studies that assayed VEGF polymorphism in endometriosis are reviewed. Data in the literature suggest that VEGF SNPs such as: -460C/T +405G/C and 936C/T seem to be a risk factor for endometriosis.

Despite advanced diagnostic and therapeutic procedures, endometrial cancer (EC) is still responsible for high morbidity and mortality of women. The genetic variability in RAD51 may contribute to the appearance and progression of various cancers including EC.We investigated the association of polymorphisms in the DNA repair genes RAD51 135GC and 172GT with endometrial cancer risk.The genotypes of RAD51 135GC and 172GT polymorphism were determined by PCR-RFLP methods in endometrial tissue of 240 cancer subjects and 240 healthy subjects who served as controls.In the present work we demonstrated a significant positive association between the RAD51 C/C genotype and endometrial carcinoma, with an adjusted odds ratio (OR) of 13.0 (p0.0001). The distribution of genotypes for 135GC SNP in endometrial cancer patients vs. controls was: 10% vs. 27% for GG, 13% vs. 58% for GC and 77% vs. 15% for CC genotype, respectively. Variant 135C allele of RAD51 increased the cancer risk (OR = 1.81; 95% CI 0.11-2.93, p = 0.022). The higher risk of EC occurrence was associated with the combined C135C-G172T genotype (OR = 7.69; 95% CI 3.45-17.12).The results indicated that the polymorphism 135GC of the RAD51 gene may be positively associated with endometrial carcinoma in the Polish population. Further studies, conducted on a larger group, are required to clarify this point.

Polymorphisms in the human oxoguanine glycosylase 1 ( hOGG1 ) and X-ray repair cross-complementing 1 ( XRCC1 ) genes have been extensively studied in the association with various human cancers such as endometrial cancer.The genotype analysis of hOGG1 Ser326Cys and XRCC1 Arg399Gln gene polymorphisms for 150 endometrial cancer patients and 150 controls of cancer-free subjects, in the Polish population, were performed using PCR-based restriction fragment length polymorphism (PCR-RFLP).Although there were no significant (p0.05) differences in the frequencies of genotypes or alleles of hOGG1 genes between patients and controls, the frequency of the XRCC1 399Gln allele was significantly greater in endometrial cancer patients compared with controls (p = 0.033) with an odds ratio of 1.39 (95% confidence interval 0.99 to 1.95). The distributions of genotypes and alleles of the genes hOGG1 and XRCC1 were not significantly associated with different grades of endometrial cancer (p0.05).In conclusion, these findings indicated that XRCC1 Arg399Gln polymorphism may be a genetic determinant for developing endometrial cancer. The hOGG1 Ser326Cys may not play an important role in susceptibility to endometrial cancer in Polish women.

Cervical Cancer Screening Program has been operational in Poland for over four years. Colposcopy and guided biopsy methods constitute an essential part of population-based screening, enable stating right diagnosis and planning treatment procedures.The aim of the following study was to analyse the diagnostic acuity of cyto- and histopathological examination.We examined 510 patients with the following result of cytological smear: ASCUS--265 women (51.96%), LSIL--167 cases (35.75%), HSIL--78 women (15.29%). Complete agreement between cytological smear and guided biopsy histopathology was observed among 81.13% cases of ASCUS, in 88.02% of women with LSIL and in 76.92% cases with the diagnosis of HSIL. As with cytology-biopsy comparisons, discordant cases were significantly more frequent in the group with stated HSIL than among patients with the diagnosis of ASCUS or LSIL (p0.001).1. High cyto-histopathological accordance (82%) has been obtained, what is comparable with the data in literature. 2. The highest cyto- histopathological compatibility was obtained in the group of patients with LSIL--over 88%, and the lowest in the group of patients with HSIL--less than 77%. 3. Failure to confirm the histopathological diagnosis of cytological HSIL requires further molecular and morphological evaluation.

Cytokines produced by tumour and immune cells may play a significant role in a modulation of immune cells response against tumour. We investigated an ability of peripheral blood mononuclear cells (PBMC) of patients with early and advanced stages of ovarian cancer and from non-cancer patients to produce various cytokines in the presence or absence of autologous ovarian cancer (OC) cells or benign ovarian tumour (BOT) cells. Activated PBMC of patients with advanced stage of cancer produced slight amount of interferon gamma (IFN-gamma) and what's more, the production of IFN-gamma was decreased in the presence of OC cells. PBMC of patients with ovarian cancer or benign ovarian tumour generated comparable amounts of interleukin 6 and 10 (IL-6, IL-10), and transforming growth factor beta1 (TGF-beta1). PBMC of the patients with cancer produced higher amount of tumour necrosis factor alpha (TNF-alpha) than PBMC of non-cancer patients. We demonstrated here that the reciprocal contact of OC cells from advanced cancer with autologous PBMC altered the direction of produced cytokines and leads to the down-regulation of IFN-gamma and TNF-alpha as well as to up-regulation of immunosuppressive (IL-10, TGF-beta1) and pro-inflammatory (IL-6) cytokines production.

Our purpose was to evaluate the effects and safety of laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament in treating symptomatic myomas.We studied 40 women, aged 31 to 50, with symptomatic uterine fibroids undergoing laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament Ultrasound examination of uterus and dominant fibroid were performed. Their volume reduction was measured. Clinical response was evaluated according to questionnaire assessing the level of menstrual bleeding, pain and urgency.There were no complications during operations. Within 6 months after the surgery the mean uterus volume was reduced by 22% and mean volume of dominant fibroid was reduced by 51%. Six months after the surgery menstrual bleeding was reduced in case of 34/38 patients (85%), completed pain relief has been observed in case of 19/25 patients (76%). In case of 11/15 (73%) patients, a regression of urgency has been observed.Laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament is a safe and effective method of treating symptomatic myomas. It is an alternative to hysterectomy, especially for women who wish to preserve their uterus.

Women with high circulating estrogens concentration have increase risk of breast, endometrium and ovarian cancer, thus it is important to identify factors, including environmental and genetic variability that may be alter estrogen concentration.In the present work the distribution of genotypes and frequencies of alleles of the T/C polymorphism of CYP19 and G/A polymorphism of COMT gene in subjects with endometrial cancer were investigated. Paraffin embedded tumour tissues was obtained from 151 postmenopausal women with endometrial cancer. The polymorphism's were determined by PCR-RFLP methods.The distribution of the genotypes of the T/C and G/A polymorphism in both control and patients did not differ significantly (p0.05) from those predicted by the Hardy-Weinberg distribution. Additionally, there were no significant differences (p0.05) in genotype distributions and allele frequencies between subgroups assigned to histological stage.The results suggest that the CYP19 and COMT polymorphism may not be linked with appearance and development of endometrial cancer but further research, conducted on larger population, are needed to clarify this point.

Endogenous estrogen exposure is an important determinant of endometrial cancer risk. The CYP 17 and CYP 19 genes encode 17alphahydroxylase/17,20-lyase and aromatase, respectively, both involved in sex hormone synthesis. The genes CYP17 and CYP19 are polymorphic and gene variability could contribute to the level of protein biosynthesis. In the present work the distribution of genotypes and frequency of alleles of the C/T polymorphism in promoter region of CYP17 and G/A polymorphism at position Val80 in CYP19 in subjects with endometrial cancer were investigated. Paraffin embedded tumor tissues were obtained from 100 women with endometrial cancer. DNA from normal endometrial tissue (n=106) served as control. The polymorphisms were determined by PCR-RFLP. The distribution of the genotypes of the C/T polymorphism of CYP17 and G/A polymorphism of CYP19 in both control and patients did not differ significantly (p0.05) from those predicted by the Hardy-Weinberg distribution. There were no significant differences (p0.05) in genotype distributions and allele frequencies between subgroups assigned to histological stage. The results suggest that the C/T polymorphism of CYP17 gene as well as G/A polymorphism of CYP19 may not be linked with appearance and development of endometrial cancer.

In recent years a dynamic development of research on endometriosis has been observed. Complex and not definitively recognized etiopathogenesis, impedes diagnostic progress and effective treatment. Frequent incidence of endometriosis in reproductive age and high percentage of the illness in the group of patients with infertility, both determine the importance of that issue. The article below presents the latest lines of research on efficient therapeutical scheme, covering reproductive abilities. Attempts of implementation of aromatase inhibitors, selective estrogen receptor modulators, immunomodulators and antiinflammatory agents have been described. Considering groups of medicines mentioned in the article, the outcome of examination using aromatase inhibitors, immunomodulators mainly IL-2, INF-alpha-2b, as well as antiinflammatory agents--recombinant human TNF binding protein-1, seem to be most encouraging. Part of the survey was conducted on animal models therefore it requires verification of usefulness and effectiveness on people. The results are very promising, they set the trend of future research aimed at application of modern and efficient treatment of endometriosis.

Matrix metalloproteinases (MMPs) are proteolytic enzymes capable of degrading extracellular matrix. Their role has been emphasized in tumor invasion, metastasis and tumor-induced angiogenesis. The gene encoding MMP-3 is polymorphic and an insertion (6A)/deletion (5A) polymorphism (5A/6A polymorphism) in the MMP-3 gene may have functional significance in the regulation of its expression. In the present work the distribution of genotypes and frequency of alleles of the 5A/6A polymorphism in subjects with ovarian cancer were investigated. Paraffin embedded tumor tissues were obtained from 118 postmenopausal women with node-negative and node-positive ovarian cancer. The 5A/6A polymorphism was determined by PCR amplification using the allele specific primers. The distribution of the genotypes of the 5A/6A polymorphism in both control and study patients did not differ significantly (p0.05) from those predicted by the Hardy-Weinberg distribution. There were no significant differences (p0.05) in genotype distributions and allele frequencies between subgroups assigned to histological stage. The results suggest that the 5A/6A polymorphism of MMP-3 gene may not be linked with appearance and/or progression of ovarian cancer.

Endometriosis is a serious clinical problem among the women treated because of gynecological reasons. The frequency of its occurrence is estimated for 10-15% of all women at reproductive age.This study evaluates the chosen phenomenons participating in innate immunity and their role in the pathogenesis of endometriosis.42 patients aged 22 to 39 years old treated in Surgical Gynecology Department of Polish Mother Health Centre Research Institute were the study group. Comparative group consisted of 22 age-matched women with no clinical complains. We evaluated production of reactive oxygen intermediates by peripheral blood neutrophils in both groups of women (both spontaneous and stimulated with fMLP) using the chemiluminescence test. We used neutrophils, both resting and previously preactivated with TNF-alpha. The activity of C3 and C4 complement components and total antioxidant status were also measured.Showed that the chemiluminescence values were higher in patients with endometriosis than in comparative group. Preactivation of neutrophils with the use of TNF-alpha was significantly weakened. Both C3 and C4 complement components revealed higher activity in women with endometriosis as compared to those without this disease. Total antioxidant status values were significantly lower in patients with endometriosis than in women from the comparative group.Innate immunity may play a significant role in the pathogenesis of endometriosis due to changes in its components activity that are observed in the course of this disease.

Endometriosis is a disease causing the growth of endometrial tissue outside its proper localisation. The frequency of this disease occurrence is estimated for about 10% of women at reproductive age. More and more often scientific studies reveal the key role of immunological disorders as the factor contributing to the development of endometriosis. Investigators pay their attention not only on the composition of immunological cells, but on the amount and proportion of their products, including cytokines, as well. Aim of the study was the evaluation of cytokine generation by peripheral blood lymphocytes derived from women with endometriosis, as well as the estimation of combined surgical and pharmacological treatment influence on this production.The study group consisted of 72 patients treated in Surgical Gynecology Department of Polish Mother Health Centre Research Institute in Lodz, in years 1998-2002. Endometriosis was diagnosed during laparoscopy or laparotomy in 60 of them. The diagnosis was confirmed in histopathological examination. 14 of those patients were qualified to 6 months long Zoladex therapy (AstraZeneca), following the operation. Zoladex was used in a dose of 3.6 mg per month. Evaluation of the cytokine generation was performed before the treatment and repeated after the full therapy. 12 women with no signs of endometriosis lesions existence were the comparison group. Immunofluorescence method ELISA and ENDOGEN commercial kits were used for evaluating the cytokine concentration levels.Significant decrease in IFN-gamma generation (p0.05) by peripheral blood lymphocytes was noted in women with endometriosis before the treatment as compared to women without this disease. Therapy caused its increase and the difference was statistically significant. Significantly higher levels of the IL-4 generation after PHA stimulation were also observed in women with endometriosis then in women from the comparative group. The therapy of endometriosis caused the decrease in IL-4 production, but the differences were not statistically significant (p0.05). Significant differences in IL-4 generation after the treatment as compared to the values noted before the treatment were observed only after using conkanavaline A as the lymphocyte stimulator. Generation levels of IL-2, IL-10 and IL-12 did not vary significantly after the combined surgical and pharmacological treatment of endometriosis.1. Significant decrease in IFN-gamma concentration was shown in patients with endometriosis, which proves the role of this cytokine in the pathogenesis of this disease. 2. Combined surgical and pharmacological treatment causes the increase in IFN-gamma production by peripheral blood lymphocytes.

Background:Endometriosis, uncontrolled proliferation of ectopic and eutopic endometriotic tissues, is common in women at reproductive age, and may affect fertility. The role of macrophages in the pathogenesis is well proved, but engagement of T cells in the pathogenesis of endometriosis is a matter of controversyAims:T-cell involvement in the pathogenesis of endometriosis was the objective of our study performed on women aged 24-46 years with diagnosed endometriosis. All the patients that were studied underwent diagnostic laparoscopy.Methods:We evaluated the distribution of T-lymphocyte subpopulations in peripheral blood (PB), peritoneal fluid (PF) and in endometriotic tissues (ET), as well as cytokines [interleukin (IL)-2, IL-4, IL-10, IL-12, interferon (IFN)-γ] production by peripheral blood lymphocytes. IFN-γ, tumor necrosis factor (TNF)-α, IL-4 and IL-6 were investigated for their intracellular presence. The experiments were carried out before and after 6 months treatment with the GnRH-Analogous Goserelin (Zeneca Pharmaceuticals). The number of performed investigations is presented. Statistical analysis was performed using Statistica/Win 5.0 software and Student't-test, the paired Studentt-test and Fisher's exact test when appropriate.Results:We have compared the lymphocyte subset re-distribution with regard to the American Fertility Society (AFS) stages and scores, but no differences were observed. The significant increase in CD4:CD8 ratio, the decrease in the number of natural killer (NK) cells in PB and the decrease in CD4:CD8 ratio in PF and ET of women with endometriosis was noted. The diminished IFN-γsecretion by phytohemagglutinim (PHA)-stimulated lymphocytesin vitroderived from women with endometriosis and increased IL-4 production may be responsible for defective immunosurveillance against overgrowth of endometriotic tissues. The diminished NK cells number in PB of women with endometriosis argues for such a hypothesis. The increased deposits of proinflammatory IL-6 and TNF-α in the T lymphocytes of women with endometriosis may be related to T-regulatory lymphocyte function and their inability to suppress cell proliferation in endometriosis. GnRH-Analogous Goserelin treatment normalises cytokine production and induces patient recovery.Conclusions:The significant functional and phenotypic differences between the lymphocytes from healthy women and women with endometriosis were noted. The diminished IFN-γproduction in relation to decreased NK cells number and the increased IL-4 production before the treatment and normalisation after the treatment suggest the involvement of the deregulated T-cell system in the growth stimulation and recruitment of endometriotic cells. The increased CD4:CD8 ratio, IL-6, TNF-α deposits and diminished anti-inflammatory IL-10 production by lymphocytes may participate in the pathogenesis of endometriosis, and may secondarily affect the monocyte/macrophage function.

Apoptotic cell death plays a central role in the pathogenesis and disease progression of cancer as well as in the response to treatment. In the present work we investigated the association between the presence of apoptotic peripheral blood cells in breast and ovarian cancer progression. Apoptosis was analysed in blood cells of breast (n=82) and ovarian cancer patients (n=79). Blood samples from age matched healthy women served as control (n=70). The apoptotic peripheral blood cells were detected by agarose gel electrophoresis. The apoptotic cells were identified in 83% (68/82) of the breast cancers and in 65% of ovarian cancer patients (51/79). The number of positive samples was significantly higher among cancer samples than among control samples (p0.05). Additionally, there were significant differences (p0.05) in the presence of apoptosis between subgroups assigned to histological stage. The high frequency of apoptotic peripheral blood cells in breast and ovarian tumours suggests a potential role of apoptosis in cancer appearance and/or progression.