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Comprehensive endometrial cancer staging requires mandatory lymph node status assessment. However, some randomized clinical studies show that full lymphadenectomy may have no therapeutic benefit in patients presented with early-stage disease. Sentinel lymph node mapping can be considered in patients at low to intermediate risk for nodal metastases and is an acceptable alternative to systemic lymphadenectomy for lymph node staging in FIGO stage I/II patients. Similarly, patients with serious comorbidities who might not tolerate a standard systemic lymphadenectomy may benefit from the procedure. Sentinel lymph node detection rates depend on cancer stage, histology, and technique used. The procedure is most performed with the use of radioactive technetium colloid (99mTc) combined with a blue dye or indocyanine green. Recently, more interest is also paid to new nanoparticles including carbon, superparamagnetic iron oxide, and mannose tracer agents. Growing interest in sentinel lymph node mapping technique has led to design increasing number of research projects regarding various mapping approaches in different endometrial cancer populations. Much attention has been paid to a non-invasive sentinel lymph node mapping technique e.g., radiomics. This article reviews the latest research on sentinel lymph node mapping perspectives in endometrial cancer patients.

Uncontrollable cell division and disorders of the apoptotic processes constitute the key phenomena in cancer transformation. The theory that the tumour growth above critical density is possible due to creation of the new blood vessels during angiogenesis process was put forward in 1971 by Folkman. The panendotelial antibodies targeted against such markers as CD34 are used most frequently in cancer vessel evaluation. The anti-CD34 reacts with the largest number of endoepithelial cells. The second group constitutes the antibodies that agglomerate with the antigens characteristic for proliferous endoepithelial cells. The most popular marker used for functional endothelial tissues is endoglin called CD105. The subject of this publication is to find the answer to a question whether the practical usage of the CD34 and CD 105 as a prognostic factor in predicting failure of a planned treatment, determining expected remission and the total survival rate is possible. 74 patients with the diagnosed ovarian cancer, treated in the I Clinic of Gynecology Oncology and Gynecology, Medical University in Lublin, between years 1999-2004 were included into the analysis. Representative paraffin blocks with the embedded ovarian cancer fragments were used for immunohistochemical research. Density of the microvessels was being evaluated basing on the expression of the antigen CD34 and CD105. Evaluation of the microvessel density with CD34 and CD105 markers is not useful in forecasting survival rate and disease recurrence in patients with ovary cancer.

The initiation of labor is accompanied by alterations in the level of maternal immune tolerance toward fetal antigens. It is a complex molecular response leading to a brief activation of the maternal immune system with an accompanying capacity to restrict this same activation. The aim of our study was to evaluate the subpopulation of regulatory T cells (Tregs) and B7-H4 macrophages in the decidua basalis during cesarean sections performed on patients in various stages of labor.The decidual tissue samples evaluated in our study were obtained from 23 pregnant women who underwent cesarean sections at term. Moreover, the patients were divided into three subgroups according to the progression of labor at the time of the cesarean. The presence of Treg cells and B7-H4 positive macrophages were analysed by fluorescence-activated cell sorter.The percentages of FOXP3+ cells in the subpopulation of CD25+ CD4+ T lymphocytes found in the deciduas of patients decreased with the successive stages of labor, while the percentages of B7-H4 positive cells in the macrophage subpopulation remained almost constant.These changes in the Treg cell subpopulation in the decidua would seem to be related to a brief activation of the maternal immune system as labor begins and lack of analogical changes in the subpopulation of decidual suppressive B7-H4+ macrophages that enable the restriction of this same activation as labor progresses.

Alterations in RCAS1 (a receptor-binding cancer antigen expressed on SiSo cells) expression in the placenta and decidua may be related to the regulation of the process of maternal immune tolerance against fetal antigens. Moreover, it has been demonstrated that the occurrence of the spontaneous beginning of stillbirth is related to a decrease in the placental expression of RCAS1. There are no data currently available on the immune processes in decidua during stillbirth. The aim of this study was to evaluate the RCAS1 immunoreactivity level in decidua and to identify the cytotoxic immune cells present during labor, induced after intrauterine fetal death either with a combination of oxytocin (OT) and prostaglandins or with OT alone; a further objective was to assess the potential impact of these molecular alterations on the effectiveness of stillbirth induction.The immunoreactivity of RCAS1, CD3, CD56, CD69, and CD25 was assessed by immunohistochemistry in 31 decidual samples derived from patients in whom the stillbirth occurred before the onset of labor.The RCAS1 immunoreactivity level was higher in a statistically significant manner in decidual tissue samples derived from patients in whom OT alone proved insufficient to induce labor after the diagnosis of intrauterine fetal death but required additionally the use of prostaglandins when compared with samples from women in whom stillbirth was induced successfully with OT alone. However, we did not observe any differences either in CD56 and CD3 positive cell presence or in CD25 and CD69 antigen immunoreactivity in the respective decidua of these two groups of patients.The level of RCAS1 in decidua seems to influence the effectiveness of stillbirth induction.

The expression of the HLA-G antigen from implantation toward term is crucial for the growth of a semiallogenic fetus as it shields this fetus from the maternal cytotoxic response. Little is known, however, about the potential role of soluble HLA-G isoforms during delivery. The initiation of labor is associated with a complex molecular response leading to a brief activation of the maternal immune system with an accompanying capacity to restrict this activation, and HLA-G seems to be an important factor in enabling the proper immune response at the maternal fetal interface.In our study the levels of soluble HLA-G concentration were evaluated in the blood serum samples obtained from 47 pregnant women who either underwent cesarean sections or delivered vaginally. The patients were divided into three subgroups according to the progression of labor at the time of the cesarean or, in cases of vaginal delivery, according to the duration of the pregnancy.We have observed that the progression of labor is associated with a continuous increase in the sHLA-G plasma level. The sHLA-G levels were statistically significantly higher in the blood sera obtained from the women in advanced labor than from the women who were at the beginning of labor.The changes in sHLA-G concentration levels observed during the stages of labor may indicate that this isoform participates in maintaining reproductive tract homeostasis.

HLA-G is an antigen whose participation in the regulation of the immune system is well documented. The aim of the present study has therefore been to evaluate the sHLA-G blood serum concentrations levels in both women with ovarian endometriosis and women with uterine leiomyomas.In our study, the soluble HLA-G concentration level was evaluated in the blood serum samples obtained from 98 women who underwent laparotomies or laparoscopies due to either ovarian endometriosis or leiomyomatous uterus. The control group consisted of 42 women, including women on whom a diagnostic laparoscopy identified no lesions, and volunteers-healthy women who returned their blood serum samples during menstrual bleeding.Patients who underwent surgical treatment because of ovarian endometriosis or uterine leiomyoma, as well as patients from the control group, exhibited no sHLA-G blood serum concentration level fluctuations between the proliferative and secretory menstrual cycle phases. The sHLA-G levels were significantly lower in the patients with ovarian endometriosis and in the patients from the control group during the menstrual cycle phase than in those patients with leiomyoma. A similar relation between the sHLA-G levels of the postmenopausal patients suffering from leiomyoma and the control patients was found. In contrast, the postmenopausal women suffering from endometriosis were typified by levels of sHLA-G blood serum concentration comparable to those of the patients with leiomyoma, and the levels were significantly higher than those observed in the blood sera of the postmenopausal patients from the control group.The soluble HLA-G blood serum level would seem to be a useful marker for evaluating the status of the microenvironment, where the tumor-immune cell and ectopic and eutopic endometrial interactions take place.