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A Leminen

Publications and source records attributed to A Leminen.

At least 37 records · Page 2Linked to original sources
PubMed1995

Therapeutic and prognostic considerations in primary carcinoma of the vagina.

We analyzed 46 patients with primary carcinoma of the vagina treated between 1969 and 1990. Median age of the patients was 67 years (range 33-89 years). Most (52%) of them were obese and 35% were nulliparous. Four (9%) had suffered from other gynecologic carcinoma and had been operated six to 23 years before the current carcinoma. Forty (87%) patients had squamous cell carcinoma. Stage 0 (carcinoma in situ) was found in three (7%) cases and stage I-IV in 21 (54%), 10 (22%), four (9%) and eight (17%) cases, respectively. Most (81%) of the patients were treated with radiotherapy (alone or in combination with other treatments): combination of brachytherapy and external radiotherapy were used in 45% of the cases. Surgery was used in all stage 0 cases and in 52% of stage I cases. Recurrence of the disease was found in 20 (43%) cases during the follow-up of 10 years. Most often (40%) site of the recurrence was the vagina. Both 5- and 10-year survival were 38%. Stage and extent of the tumor were independent prognostic factors in stepwise multivariate analysis.

Adenocarcinoma↗
PubMed1994

Tumour-associated trypsin inhibitor (TATI): comparison with CA125 as a preoperative prognostic indicator in advanced ovarian cancer.

We have evaluated the prognostic value of tumour-associated trypsin inhibitor (TATI) in stage III or IV ovarian cancer. Tumour-associated trypsin inhibitor (TATI) and CA 125 were determined in serum samples from 66 patients taken before primary surgery. TATI was elevated (> 22 micrograms l-1) in 27 patients (41%). These had a 5 year cumulative survival of 8%, whereas survival was 45% in 39 patients with normal preoperative TATI values. By contrast, the preoperative CA 125 level did not predict survival. In multivariate analysis which included age, stage, histological grade and preoperative TATI and CA 125 levels, patients with elevated preoperative TATI levels had a 2.3-fold relative risk of death (95% confidence interval 1.23-4.20; P = 0.002) compared with patients with normal preoperative levels. This result was comparable with the predictive value of primary residual tumour size, since patients with residual tumour larger than 2 cm in diameter had a 5.2-fold relative risk of death (95% confidence interval 2.55-10.68) compared with patients with a smaller or no residual tumour. Thus, preoperative determination of serum TATI may have a place in the pretreatment evaluation of patients with advanced ovarian cancer.

Adolescent↗
PubMed1993

Pretreatment sonographic evaluation of inguinal lymph nodes in patients with vulvar malignancy.

The state of the inguinal nodes is a major prognostic factor in vulvar carcinoma. Because of new surgical trends with selective inguinal lymphadenectomy, the preoperative evaluation of inguinal lymph nodes is essential for adequate treatment of vulvar carcinoma. To evaluate the adequacy of clinical examination and high-frequency transducer sonography in detecting metastatic inguinal lymph nodes, we studied 25 patients with vulvar malignancy who underwent operation. Histopathologically proved lymph node metastases were found in 11 (22%) of 50 inguinal areas studied. All of the suspected metastases were in patients with stage III-IV disease. The inguinal lymph node metastases were found by sonography in nine (82%), by preoperative palpation in one (9%), and by operative palpation in six (55%) of 11 areas. The difference between sonography and palpation was statistically significant (P < 0.01). The sensitivity and specificity were 82% and 87% for sonography, 9% and 100% for preoperative palpation, and 55% and 90% for operative palpation.

Adult↗
PubMed1992

Pre- and posttreatment serum antibody responses to HPV 16 E2 and HSV 2 ICP8 proteins in women with cervical carcinoma.

Serum antibodies to early proteins of human papillomavirus type 16 (HPV 16 E2 protein) and herpes simplex virus type 2 (HSV 2 ICP8) can be measured by ELISA. In the serum of 122 newly diagnosed cervical carcinoma patients and age-matched controls, enhanced IgA antibody levels to an HPV-16 E2 protein derived peptide no. 245 indicated a 9.5-fold (95% confidence limits 2.8-57.2) relative risk of cervical carcinoma. No significant risk was found with a corresponding HPV 6 E2 peptide or HSV 2 ICP8. To evaluate the HPV 16 E2 peptide as a possible tumor marker for cervical carcinoma serial postoperative serum samples were tested from 27 women with cervical carcinoma. Antibody responses to the HPV 16 E2 peptide depended on the clinical stage. Stage I and II patients showed decreasing posttreatment IgA and/or IgG antipeptide antibody levels. Stage III and IV patients initially showed decreasing antipeptide antibody levels followed by increasing levels. These patients also showed increasing IgG antibody levels to the HSV 2 ICP8. However, increasing antibody levels to the HPV 16 E2 peptide indicated significantly (P less than 0.05) worse 2-year disease free survival (recurring disease) than did stable or decreasing antibody levels. The results suggest that serum antipeptide antibodies to the HPV 16 E2 peptide no. 245 can be used for the monitoring of cervical carcinoma.

Adenocarcinoma↗
PubMed1992

Predominance of serum antibodies to synthetic peptide stemming from HPV 18 open reading frame E2 in cervical adenocarcinoma.

AIMS: To determine if there are type specific differences in serum antibody responses to synthetic peptides derived from human papillomavirus (HPV) open reading frame (ORF) E2 in patients with cervical carcinoma. METHODS: Diagnostic phase sera from 88 age-matched women with cervical adenocarcinoma (AC), cervical squamous cell carcinoma (SC), ovarian cancer (OC) or no gynaecological malignancy were available. Serum IgG and IgA antibodies to synthetic peptides corresponding to a residue of HPV 6, 11, 16, and 18 ORF E2 18 amino acids long and a control peptide from mumps virus were determined by ELISA. RESULTS: Both IgA and IgG antibody positivity to the HPV 18 peptide were associated with increased risk (9.0-fold, confidence limits 1.5-199) for AC. IgA positivity to HPV 11, 16, and 18 peptides was associated with an increased risk for SC. However, the association of IgG antibodies to HPV 16 peptide with SC was not significant. IgA or IgG antibodies to HPV 6 or mumps virus peptides were not associated with increased risk for AC, SC, or OC. CONCLUSIONS: These results suggest a specific role for HPV 18 in AC. Differences in antibody responses to HPV peptide in AC and SC suggest immunopathogenetic differences between the two types of cervical carcinoma.

Adenocarcinoma↗
PubMed1992

Chemotherapy as initial treatment for cervical carcinoma: clinical and tumor marker response.

Chemotherapy was given as initial therapy to 23 patients with previously untreated early and advanced cervical carcinoma. A combination of cisplatin and VP-16 was given in squamous cell carcinoma, and cisplatin, epirubicin and cyclophosphamide in adenocarcinoma in one to three courses at 4-week intervals. The overall clinical response rate to initial chemotherapy was 78% (80% in early and 78% in advanced disease). A complete response was achieved in 3 (13%) and a partial response in 15 (65%) patients. To obtain independent information on treatment response serial tumor marker determinations were used in patients with elevated pretreatment levels. Squamous cell carcinoma antigen (SCC) responded to chemotherapy by decreasing levels in 91% of the cases, carcinoembryonic antigen (CEA) in 33%, CA 125 in 83%, and tumor-associated trypsin inhibitor (TATI) in 50%, respectively. These results show that cervical carcinoma is a drug-responsive tumor and that SCC and CA 125 can be used as an aid in the evaluation of response to chemotherapy. Initial chemotherapy appears be of value by reducing tumor volume thus providing better conditions for surgery and radiotherapy.

Adenocarcinoma↗
PubMed1992

Transvaginal sonographic findings in ambulatory patients with suspected pelvic inflammatory disease.

OBJECTIVE: To evaluate transvaginal sonographic findings in ambulatory patients with suspected pelvic inflammatory disease (PID). METHODS: We studied 51 outpatients with a mean age of 26.8 years (range 16-52) who had a history of low abdominal pain, negative pregnancy test, and no gynecologic procedures performed during the last month. Endometrial biopsy was used for the histopathologic diagnosis. The presence of plasma cell endometritis was used as the criterion standard for the diagnosis of PID. Sonography was performed before biopsy in a blinded fashion without knowledge of the clinical findings and laboratory results except for the pregnancy test. Repeat pelvic and ultrasound examinations were performed 4 weeks after antimicrobial therapy. RESULTS: Endometrial biopsy revealed plasma cell endometritis in 13 cases (25%). Thickened fluid-filled tubes were seen in 11 of 13 patients (85%) with plasma cell endometritis and in none of those without. Other sonographic findings associated with plasma cell endometritis were polycystic-like ovaries and free pelvic fluid. A sonogram suggestive of PID, ie, thickened fluid-filled tube with or without free pelvic fluid, had a sensitivity of 85% and a specificity of 100% for the diagnosis of plasma cell endometritis. None of the patients with a normal sonogram or simple cyst had plasma cell endometritis. Repeat examination after 4 weeks showed that the sonographic findings had resolved in 60% of the patients who had had histologic evidence of infection. CONCLUSION: Transvaginal sonography can facilitate the outpatient management of patients with suspected PID.

Adolescent↗
PubMed1991

Human papillomavirus types 16 and 18 in adenocarcinoma of the uterine cervix.

Many reports have shown a link between human papillomavirus (HPV) and cervical squamous neoplasia. However, the association of HPV with cervical adenocarcinoma has been studied less extensively. The authors evaluated the presence of HPV-DNA in 106 patients with adenocarcinoma of the uterine cervix by in situ hybridization, using 35S-labeled probes for HPV 16 DNA and HPV 18 DNA. The overall prevalence of HPV-DNA was 18% (19 of 106). HPV 16 was present in 2 (2%) cases, HPV 18 was observed in 15 (14%) cases, and both HPV 16 and HPV 18 were found in 2 (2%) cases. There was a correlation between HPV-DNA positivity and tumor stage (P less than 0.01) and tumor size (P less than 0.05), but there was no relationship between HPV-DNA positivity and tumor differentiation, proliferation (S-phase fraction), ploidy, lymph node metastases, or five-year survival rate. These results suggest that HPV 18 DNA is associated with cervical adenocarcinoma but the presence of HPV 18 has no influence on overall survival.

Adenocarcinoma↗
PubMed1990

Adenocarcinoma of the uterine cervix.

In Finland, the incidence of cervical cancer has shown a decreasing tendency since the 1960s. The same trend, however, has not been noticed in the incidence of cervical adenocarcinoma. The reason for this is not known, although many studies have shown differences in the cause, epidemiology, and biology of the epidermoid and adenocarcinoma of the uterine cervix. A total of 106 new patients with cervical adenocarcinoma were treated at our institution from 1976 to 1980, which represents 20.4% of all cervical carcinomas treated. The mean age of the patients was 58.1 years (range, 29 to 82 years) and the peak incidence was in the group 60 to 69 years of age. Most of the patients were postmenopausal (71.7%) and the main symptom was abnormal vaginal bleeding (78.3%). The proportion of Stage I was 61.3%. Combined operative and radiation therapy was used in 74.5% of the patients. The overall 5-year survival rate was 65.1% (corrected 74.5%), which did not differ from that of patients with squamous cell carcinoma. The most significant prognostic factors were the size of the tumor, presence of pelvic lymph node metastases, and the stage of the disease.

Adenocarcinoma↗
PubMed1990

Deoxyribonucleic acid flow cytometric analysis of cervical adenocarcinoma: prognostic significance of deoxyribonucleic acid ploidy and S-phase fraction.

Paraffin-embedded tumor samples from 125 patients with cervical adenocarcinoma were analyzed by deoxyribonucleic acid flow cytometry. Thirty-one percent of the tumors were aneuploid. Triploid deoxyribonucleic acid content predominated (51.3%) and one third of the deoxyribonucleic acid aneuploid tumors were tetraploid, whereas near-diploid deoxyribonucleic acid aneuploidy was seen infrequently. Deoxyribonucleic acid aneuploidy was associated with tumor size, histologic grade, clinical stage, and high S-phase fraction. Deoxyribonucleic acid ploidy and S-phase fraction value were independent prognostic parameters, together with the presence of lymph node metastases and tumor size. In conclusion, our results indicate that flow cytometric deoxyribonucleic acid analysis helps to predict the prognosis and may thus influence the choice of treatment.

Adenocarcinoma↗
PubMed1990

Tumor markers CA 125, carcinoembryonic antigen and tumor-associated trypsin inhibitor in patients with cervical adenocarcinoma.

Tumor markers CA 125, carcinoembryonic antigen (CEA) and tumor-associated trypsin inhibitor (TATI) were studied in 42 patients with cervical adenocarcinoma. Pretreatment levels of CA 125 were elevated in 73% of 33 patients, CEA in 48% of 27 patients, serum TATI in 23% of 22 patients, and urine TATI in 38% of 26 patients. Elevated CA 125 levels were associated with histological grade (P = 0.002), and elevated CEA levels with the presence of lymph node metastases (P = 0.008), respectively. No associations were found between elevated tumor marker levels and stage, or tumor size. Serum CA 125 levels increased in 71% of the patients with progressive disease, CEA levels in 36%, serum TATI levels in 46%, and urine TATI levels in 20% of the patients. In all patients with regressive disease the tumor marker levels decreased or stayed unchanged. Regression of the disease was significantly correlated (P less than 0.05) with stage, histological grade, tumor size, and nodal status. The results suggest that CA 125 and, to a lesser extent, CEA and TATI are useful in the follow-up of patients with cervical adenocarcinoma.

Adenocarcinoma↗
PubMed1985

Strategies for improving compliance in hypertensive patients.

The results of the present trial, aimed at elucidating and improving the treatment situation of hypertensives, show that--within the domain of the Finnish community health centres--it continues to be unsatisfactory. The prevalence of the male hypertensives (those without treatment and with a permanent diastolic pressure level of at least 100 mmHg and those under treatment) aged 35 to 49 years, was 12.8%. Only half of them were receiving treatment and of these the treatment was adequate (diastolic pressure less than 90 mmHg) in only one case out of five. Overweight turned out to be common among hypertensives, 63.2% of them had at least 10% overweight (BMI greater than or equal to 27.0 kg/m2) while 15.7% had at least 30% overweight (BMI greater than or equal to 32.0 kg/m2). There were no differences worth noting in overweight between treated and untreated cases. With respect to tobacco smoking there was a clear difference in favour of the hypertensives receiving treatment, among whom only 26.1% were regular smokers, while the corresponding figure for untreated hypertensives were 41.7%. Within short time an improved, supervising physician-based treatment system could be seen to have led to favourable results in the treatment of hypertensive community health centre patients. The proportion of those receiving adequate treatment among subjects already under treatment prior to the screening, for instance, had become threefold within a few months.

Adult↗