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PubMed2004

A study on sampling strategies in the figure cognitive process.

This study was aimed at investigating the sampling strategies for 2 types of figures: 3-D cubes and human faces. The research was focused on: (a) from where the sampling process started; (b) in what order the figures' features were sampled. The study consisted of 2 experiments: (a) sampling strategies for 3-D cubes; (b) sampling strategies for human faces. The results showed that: (a), for 3-D cubes, the first sampling was mostly located at the outline parts, rarely at the center part; while for human faces, the first sampling was mostly located at the hair and outline parts, rarely at the mouth or cheek parts, in most cases, the first sampling-position had no significant effects on cognitive performance and that (b), the sampling order, both for 3-D cubes and for human faces, was determined by the degree of difference among the sampled-features.

Cognition↗
PubMed2001

Meaning in life in three samples of elderly persons with high cognitive functioning.

The study examined the relationships between meaning in life and cognitive functioning in three elderly samples. The participants in Sample I were 78 persons aged 82-87, in Sample II 182 persons aged 83-92, and in Sample III 299 persons aged 65-69. The samples took part in interviews and cognitive tests in 1996-1997. Several interview questions together with the Sense of Coherence questionnaire were used to study the degree and content of meaning in life. Cognitive functioning was measured by Digit Span, Digit Symbol, and Word Fluency in Sample I and Mini-D in Samples II and III. Each sample was divided into the group of persons with high cognitive functioning (including those whose results in cognitive tests fell in the top third of their age cohort) and the comparison group (including the rest of the sample). The analysis showed no difference between the groups in the degree of meaning in life in any of the three samples. The content of meaning in life differed in the two groups: human relationships were reported as a reason for meaning in life and a source of strength in life more often by the persons with high cognitive functioning than by the comparison group. Moreover, those with high cognitive functioning reported that they had taken up a new activity (especially one involving social interests) that gave a sense of meaning in life after retirement more often than the comparison group. Death had positive meaning for the majority of the participants and the groups did not differ in meaning of death. The interactions between the various measures of meaning in life showed that having a sense of coherence and zest for life were factors related to the sense of meaningfulness in life. Meaning of death was not related to other measures.

Aged↗
PubMed2000

Effect of sample number and time on determination of plasma clearance of technetium Tc 99m pentetate and orthoiodohippurate sodium I 131 in dogs and cats.

OBJECTIVE: To determine the effect of number of blood samples and sampling times on plasma clearance of technetium Tc 99m pentetate (Tc99mP) and orthoiodohippurate sodium I 131(OIH). ANIMALS: 20 dogs and 14 cats. PROCEDURE: Plasma clearances of OIH and Tc99mP were calculated by use of a 2-compartment model, on the basis of a 12-point curve as a reference method. Plasma clearance was calculated by use of all possible combinations of 4 to 11 samples. Time schedule yielding the smallest difference from the reference method was considered to be optimal. Regression analysis was performed between the 12-point model and models using a reduced number of samples. RESULTS: SD of the difference between the 12-point clearance and the models with reduced numbers of samples increased when the number of samples decreased. The SD of the difference between 12-point clearance and 4-point clearance was 4.17 ml/min for OIH and 0.94 ml/min for Tc99mP in dogs and 0.45 ml/min for OIH and 0.11 ml/min for Tc99mP in cats. Optimal schedules were distributed logarithmically and included an early sample at 5 or 10 minutes, a late sample at 2.5, 3, 4, or 5 hours for OIH, and a late sample at 4 or 5 hours for Tc99mP. CONCLUSIONS AND CLINICAL RELEVANCE: Plasma clearances of OIH and Tc99mP can be accurately calculated in dogs and cats by use of a single-injection 2-compartment pharmacologic model with a reduced number of blood samples, resulting in an acceptable margin of error.

Animals↗
PubMed1992

Information, discrimination and divergence in cytology. VI. Biases and errors of measurement in small samples.

Total discrimination and total divergence have been shown to be useful measures of performance in diagnostic cytology. The sample size, Ns (observed number of cytology-histology pairs, essential components of a confusion matrix), may be small for the comparison of two or more laboratories or periodic quality control using observed values. From actual data from previous reports in this series, the best estimation of the confusion matrix of a population was obtained by fitting a Gaussian-type curve after pseudoscalar transform of ranks (row and column numbers). Small sample confusion matrices were generated by Monte Carlo simulation to 2.5 x 10(-7) resolution. To keep measurement biases within +/- 0.5 decits, we found that 100-200 samples of cytology-histology pairs were required in the best classifications of three, four and five category-states. At these sample sizes, measurement errors (standard errors) were also contained within +/- 0.5 decits. This study also confirmed that previously reported overestimated propagated errors in small samples were in fact overestimation and that their use for testing a null hypothesis was valid. The number of samples with indefinable statistics due to a zero denominator can be as high as 30% when the sample sizes are 500 for three, four and five category-state classifications. Biases due to small samples were positive for most category-states except for the optimum three category-states, in which bias changed to negative ("bias inversion"), and observed errors of discrimination and divergence paradoxically decreased as Ns decreased ("error-sample paradox") for a small sample size (Ns less than 700).(ABSTRACT TRUNCATED AT 250 WORDS)

Cytodiagnosis↗
PubMed1992

Effects of sample size on the latency and amplitude of the auditory evoked response.

Experiment I investigated the effects of sample size (500 to 1500 stimulus repetitions) on the auditory brainstem response as a function of intensity (20 to 80 dB nHL) on a group of 10 normally hearing subjects. There was little change in identifiability, reliability, latencies, or amplitudes of Waves I, III, and V as the sample size increased from 500 or 750 to 1500 repetitions. These results suggest that 500 to 750 repetitions may be adequate when methods similar to those in the present study are used, and that the common clinical practice of employing approximately 1500 repetitions may unnecessarily prolong testing. Experiment II employed 12 hearing-impaired subjects who were tested at 10 to 40 dB SL using sample sizes from 250 to 4500 stimulus repetitions. Identifiability of all waves increased as sample size increased from 250 to 4500 repetitions. The largest changes in identifiability occurred when sample size increased from 250 to 1500 or 3000 repetitions, with little improvement as sample size increased from 3000 to 4500 repetitions. Examiners should monitor averaged responses and terminate testing as soon as a wave is identified. Contrary to expectation, there was no systematic change in the standard error of measurement for latency (approximately 0.07 ms) as sample size increased from 250 to 4500 repetitions. The standard error of measurement for amplitude decreased from approximately 100 nV with 500 repetitions to approximately 45 nV at 3000 repetitions. The improvement in reliability with increasing sample size may be explained by a decrease in the variability of background noise. A systematic decrease in amplitude also was observed as sample size increased. This observation may be explained by a reduction in the residual noise levels or because of time jitter or adaptation within the auditory pathways. Nonetheless, investigators who wish to use ABR amplitude measures for diagnosis may benefit from using a relatively large sample size.

Adult↗
PubMed1997

Electrospray sample preparation for improved quantitation in matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

The goal of this work is the development of a rapid and objective matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) method for the quantitation of peptides and proteins in human plasma suitable for use in the Good Laboratory Practices (GLP) environment, where the analytical method, validation and pharmacokinetic parameters derived from concentration data will be scrutinized by global regulatory agencies. Electrospray deposition has traditionally been used to prepare thin, uniform samples for a number of techniques, including Cf-252 plasma desorption and secondary ion mass spectrometry. Here the electrospray process of sample application is used to reduce the segregation of analyte from matrix during the sample drying step. The small droplets formed during the electrospray process are found to significantly improve the homogeneity of the sample surface prepared. Experiments comparing the traditional air dried and electrosprayed methods of sample preparation show that the increase in sample homogeneity from electrosprayed samples decreases both the within-sample spot and between-sample spot variability, resulting in a decrease in percent coefficient of variation (%CV) for the recorded MALDI mass spectra. The increase in sample homogeneity permits a more objective use of MALDI-TOFMS as a quantitative analytical method and has led to the development of an assay for the determination of desamino-[8-D-arginine] vasopressin (DDAVP) using arginine vasopressin (AVP) as internal standard in human plasma. The range of quantitation observed (2.0-10 micrograms/mL) is of limited value for bioanalytical application; however, the analysis of neat standards shows lower quantitation limits are easily achieved.

Arginine Vasopressin↗
PubMed1991

Variability in DNA measurements in multiple tumor samples of human colonic carcinoma.

The DNA ploidy and cell-cycle distribution of three separate fresh tissue samples of 60 colorectal adenocarcinomas were analyzed by flow cytometry. DNA ploidy was concordant among the three samples in 38 cases (63.3%). In the remaining 22 cases (36.6%), the DNA histograms of two of the three multiple samples were similar; however, the ploidy of the third sample was discordant. No relationship was observed between Dukes' stage and histologic grade with concordance or discordance among samples. Thus, in about one third of the colonic carcinomas, a single sample showing either a diploid or diploid-cycling DNA histogram would not detect aneuploid DNA patterns. Comparison of scrapes and fine-needle aspirates of tumors as alternative sampling methods of tumors for DNA ploidy analysis indicated a strong association with the tumor ploidy (84% and 96%, respectively) only when the ploidy of the multiple samples was concordant. In about 25% of the cases, tumor scrapes and fine-needle aspirates did not correlate with the "most abnormal" ploidy observed in one of the three tissue samples. The data suggest that single or even double tissue samples may not show aneuploid DNA patterns in a substantial proportion of colorectal cancers.

Adenocarcinoma↗
PubMed2000

Bacterial counts associated with poultry processing at different sampling times.

Aerobic plate counts, Enterobacteriaceae counts and Pseudomonas counts were performed on neck skin samples from six processing steps in a poultry abattoir at three different sampling times. Sampling time 1 was shortly after start-up of processing operations, time 2 after a tea break which was preceded by a cold water rinse-down of equipment surfaces, and time 3 before shut-down. No significant differences (P > 0.05) in microbial numbers of neck skin samples were observed between the three sampling times at the six sampling sites. At this particular processing plant, therefore, sampling at any time of the processing shift would thus not lead to significantly different bacterial counts of neck skins. The lowest aerobic plate counts, over all three sampling times, were obtained for neck skins sampled after spray washing, and the highest for neck skins sampled after packaging. This indicated the efficacy of the washing step in reducing microbial contamination but subsequent re-contamination of carcasses. Despite the Pseudomonas counts of neck skins being lower than the Enterobacteriaceae counts at the beginning of processing, packaging of carcasses resulted in Pseudomonas counts that were higher than the Enterobacteriaceae counts.

Abattoirs↗
PubMed2004

Decreased reactive oxygen generation during H2O2 decomposition in the presence of samples from human rectal cancer.

Reactive oxygen species (ROS) have generated a great deal of interest in the clinical field since experimental studies showed the involvement of these species in carcinogenesis. This paper reports the detection of ROS during the decomposition of H2O2 in the presence of samples obtained from tissues of 16 patients with rectal carcinoma (age 64 +/- 9 years) operated on in the Division of Surgical Oncology of Pomeranian Medical University, Szczecin (Poland). The samples were cut from the middle of the resected tumors and from the colonic mucosa (10 cm distant from the tumor and free of disease); they were processed and the supernatants, representing the soluble fraction, were used for measurements. Various methods for measuring free radical activity of the examined samples were used, such as chemiluminescence, fluorescent probe 2',7'-dichlorodihydrofluorescein, spin trap 5,5-dimethyl-pyrroline-1-oxide and EPR, the spectrophotometrically examined formation of diformazan during reduction of the p-nitroblue tetrazolium salt, and bleaching of p-nitrosodimethylalanine. A statistically significant difference (P < 0.001) was noticed in mean chemiluminescence +/- standard error of the mean in the presence of the tumor samples (42.6 +/- 7.3) in comparison to the control samples (234.6 +/- 36.0). Significantly decreased generation of ROS from the decomposition of H2O2 in the presence of the tumor samples in comparison to the control samples was also observed when the above-mentioned methods were used. Tumor samples had significantly lower superoxide dismutase activity (33 +/- 4 U/mg protein) than controls (93 +/- 14 U/mg, P < 0.001), which should contribute to a lower capacity of endogenous H2O2 production and therefore less ROS generation upon H2O2 decomposition. We conclude that the tested samples have different redox properties; this supports a possible role of ROS activity during carcinogenesis. Moreover, we propose a new, simple, and sensitive chemiluminescent method, which might be effective in sample differentiation.

Aged↗
PubMed2002

A sample injection device for flow cytometers.

BACKGROUND: The sample injection systems of flow cytometers employ either a pressure differential between the sample vial and the sheath fluid reservoir or volumetric injection of the sample from a syringe. The pressure differential method facilitates rapid and efficient flushing to eliminate carryover between samples, but does not allow accurate determination of the rate of sample flow and cell concentration. Volumetric injection, which comprises a valve for switching the sample flow, facilitates highly accurate measurement of the cell concentration, but requires a less efficient and more time-consuming flushing procedure. METHODS: Applying a removable syringe, which connects to the inlet of the sample tubing via a tight sealing, we eliminate the valve and obtain efficient flushing while maintaining the advantage of volumetric sample injection. RESULTS: This device gives highly constant sample flow rates strictly proportional to syringe velocity over the range 0.2-50 microl/min with a settling time of about 2 sec. CONCLUSION: This device has the same precision as the conventional sample injection system, whereas the speed and efficiency of flushing are improved greatly.

Flow Cytometry↗
PubMed2003

Investigation of the mechanism of pH-mediated stacking of anions for the analysis of physiological samples by capillary electrophoresis.

Capillary electrophoresis has been widely used for the analysis of physiological samples such as plasma and microdialysate. However, sample destacking can occur during the analysis of these high-ionic strength samples, resulting in poor separation efficiency and reduced sensitivity. A technique termed pH-mediated stacking of anions (base stacking) has previously been developed to analyze microdialysate samples and achieve on-line preconcentration of analytes by following sample injection with an injection of sodium hydroxide. In this work, the mechanism of base stacking was investigated. Peak efficiency was shown to be a function of background electrolyte and sample ionic strength. Analytes representing several classes of compounds with a wide range of mobilities were used to study the effects of multiple parameters on sample stacking. The length of hydroxide injection required for stacking was shown to be dependent on analyte mobility and the type of amine background electrolyte used. Combinations of electrokinetic and hydrodynamic injections of sample and hydroxide were examined and it was concluded that although stacking could be achieved with several injection modes, electrokinetic injection of both sample and hydroxide was most effective for sample stacking. The mechanism of pH-mediated stacking for each of these modes is presented.

Anions↗
PubMed2007

Human papillomavirus testing on self-sampled cervicovaginal brushes: an effective alternative to protect nonresponders in cervical screening programs.

Women not attending cervical screening programs are at increased risk of cervical cancer. We investigated in these nonresponders to what extent offering self-sampling devices for cervicovaginal brushes for high-risk human papillomavirus (hrHPV) testing would induce participation and, if so, what the yield of precursor (i.e. CIN2 or worse) lesions following self-sampling would be. In addition, we assessed screening history of participants and costs per detected high-grade CIN2 or worse ("CIN2+") lesion in comparison to the regular program in the Netherlands. Nonresponders received a device for hrHPV testing (self-sampling group, n=2,546) or an extra recall for conventional cytology (control group, n=284). The percentage of self-sampling responders were compared with responders in the recall group. hrHPV positive self-sampling responders were invited for cytology and colposcopy. CIN2+ yield and costs per detected CIN2+ were evaluated. Active response was higher in the self-sampling than in the control group (34.2 vs. 17.6%; p<0.001). hrHPV positive self-sampling responders were less likely to have a prior screening history than screening participants (p<0.001), indicating that they are regular nonresponders. hrHPV prevalence was similar (8.0 vs. 6.8%; p=0.11), but CIN2+ yield was higher in self-sampling responders compared to screening participants (1.67 vs. 0.97%; OR=2.93, 95% CI 1.48-5.80; p=0.0013). Costs per CIN2+ lesion detected via self-sampling were in the same range as those calculated for conventional cytological screening (euro 8,836 vs. euro 7,599). Offering self-sampling for hrHPV testing in nonresponders is an attractive adjunct to effectively increase population coverage of screening without the adverse effect of markedly increased costs per detected CIN2+ lesion.

Carcinoma in Situ↗
PubMedDate not supplied

Toxicity detection from EILATox-Oregon Workshop samples by using kinetic photobacteria measurement: the Flash method.

The Flash test, which can be used to measure the toxicity from clear, turbid and coloured samples with identical protocol, was used in the EILATox-Oregon Workshop. During the workshop, 17 synthetic samples and three environmental samples were tested. In the Flash method the photobacteria Vibrio fischeri are initially dispensed on top of the sample and the light output of the bioluminescence reaction is recorded at a rate of several readings per second. The change in the light production was measured at two points: 30 s and 30 min after exposure at room temperature. Toxicity calculations were done by using either the peak height of the sample or the peak height of the control sample (maximum signal at 0-2 s). When the peak height of the sample is used as a reference, the colour and turbidity effect of solid particles are taken into account throughout the whole measurement period. In the EILATox-Oregon Workshop toxicity was seen in samples 1 (chlordimeform), 4 (phosdrin), 5 (HgCl(2)), 6 (sodium arsenite), 8 (metham sodium), 12 (p-chlorophenol), 14 (sodium selenite) and 17 (MNNG). Only samples 1, 4 and 12 showed different ec(50) values between different calculations of toxicity. The ec(50) values were calculated and compared with the ec(50) values of Microtox derived from the literature. The Flash test will not replace the standardized photobacteria test, but is the advanced version of it and is needed when the sample matrix is complex and when speed and low costs are required.

Biosensing Techniques↗
PubMed2002

Novel method for the plan-view TEM preparation of thin samples on brittle substrates by mechanical and ion beam thinning.

A new preparation method has been developed in order to avoid the breaking of brittle samples for plan-view TEM investigation during and after mechanical and ion beam thinning. The thinning procedure is carried out on a reduced size piece of the sample (about 1.6 x 0.8 mm(2) or about 1-1.6 mm diameter) that is embedded into a 3-mm-diameter Ti disk, which fits the sample holder of the TEM. The small sample size and the supporting metal disk assure the mechanical stability and minimize the possibility of breaking during and after the preparation: The Ti disk is placed on adhesive kapton tape, a cut piece of the sample is put into the slot of the disk, pressed onto the tape and embedded with glue. The tape keeps the parts in place and in the same plane, keeps the sample surface safe from the embedding glue and can be removed easily after the glue solidifies. Subsequently, the embedded sample is thinned from the rear by well-known mechanical and ion beam techniques until electron transparency. This simple solution lowers the risk of failed sample preparation remarkably and makes it possible to reduce the thickness of the sample to about 50 microm by mechanical thinning. As a result, dimpling becomes unnecessary and low angle ion milling gives a large transparent area for TEM. Its efficiency has been proved by successful preparation of numerous thin film samples on Si, sapphire, and glass substrates. The method is compatible with the widespread cross-sectional thinning procedures, and can be easily adopted by TEM laboratories.

Microscopy, Electron↗
PubMed2002

Strategies for the isolation and detection of fetal cells in transcervical samples.

OBJECTIVE: The aim of the study was to evaluate the detection of fetal cells from transcervical samples, collected in early pregnancy, by means of different molecular techniques. The value of the isolation of trophoblasts using an inverted microscope, also referred to as micromanipulation, is discussed. METHODS: All the 89 specimens were obtained by intrauterine lavages before termination of pregnancy (TOP), between 7 and 12 weeks of gestation. Micromanipulation was carried out in a subgroup of 57 for the isolation of fetal material. Fetal sexing was achieved by FISH (fluorescent in situ hybridisation) using fluorescently labelled probes for X and Y chromosomes and by polymerase chain reaction (PCR). Male samples were also investigated for aneuploidy of the chromosome 21. Quantitative fluorescent (QF)-PCR using two short tandem repeat (STR) markers for chromosome 21 was carried out in 26 micromanipulated samples. RESULTS: FISH analysis revealed that 45/89 placental samples derived from pregnancies with male fetuses. Correct sexing of the lavage samples from male pregnancies was achieved in 41/45 (91%) using dual-FISH technique, and in 43/45 (95.5%) with PCR. All the samples derived from male pregnancies tested for chromosome 21 were normal. From 57 samples subjected to micromanipulation, 51 (89.5%) showed discernible chorionic villous filaments or cell clumps of possible trophoblastic origin. One case of tetraploidy and two cases of monosomy were recorded. The rate of fetal cells, in the non-micromanipulated samples, was between 4% and 97% (mean 54.3%). In micromanipulated specimens, maternal contaminant cells were absent or extremely rare (1-2%). The efficiency of the QF-PCR analysis in detecting paternal peaks in all lavage samples was only 61.5%. CONCLUSION: The present study confirms the presence of fetal cells in a very high proportion of both whole and micromanipulated intrauterine lavage samples. The isolation of trophoblastic elements can be achieved in most cases by micromanipulation. FISH and PCR techniques allowed the analysis of the most common fetal aneuploidies, confirming the power of this minimally invasive method.

Adult↗
PubMed2006

Adaptation of multiple logistic regression to a multiple inverse sampling design: application to the Isfahan healthy heart program.

In observational and experimental studies in the health sciences involving human populations, it is sometimes considered desirable to recruit subjects according to designs that specify a predetermined number of subjects in each of several mutually exclusive classes (generally but not necessarily demographic in nature). This type of adaptive sampling design, now generally referred to as multiple inverse sampling (MIS), has received recent attention, and estimation methods are now available for several sequential MIS sampling designs. In this class of designs, subjects are sampled randomly and sequentially, usually one at a time, until all classes have the pre-specified number of subjects. In this paper, we extend MIS for finite population sampling to estimation of the parameters in multiple logistic regression under MIS. Using estimated logistic regression parameters and cost components obtained from the Isfahan Healthy Heart Program (IHHP), we report findings from a simulation experiment in which it appears that, at fixed cost, MIS at the last stage of sampling compares favourably to simple random sampling. The IHHP is a large community intervention study for prevention of cardiovascular disease being conducted in Isfahan, Iran and two other cities in Iran. The IHHP identified subjects through a multistage sample survey in which MIS was used at the final stage of sampling. MIS is one of several methods of adaptive sampling that are generating considerable interest and show promise of being useful in a wide variety of applications.

Age Factors↗
PubMed1995

DNA strand breakage, thymine glycol production, and hydroxyl radical generation induced by different samples of crystalline silica in vitro.

Five preparations of alpha-quartz [Min-U-Sil 5 (MQZ), MQZ pretreated with hydrofluoric acid (HFMQZ), Chinese standard alpha-quartz (CSQZ), and two German samples, DQ-12 and F600] and two preparations of the crystalline silica polymorphs, cristobalite and tridymite, previously characterized for surface area and surface charge, were evaluated for their relative activities in the following assays: (i) in vitro assays of short duration (< or = 15 min) for oxygen consumption and for generation of hydroxyl radicals (measured by electron spin resonance spin trapping), and (ii) in vitro assays of longer duration for DNA strand breakage (measured using linear DNA as a detector molecule) and for production of the oxidized DNA base, thymine glycol (measured by gas chromatography-mass spectrometry). Marked differences among the samples were found for their levels of oxygen consumption and of hydroxyl radicals' generation. All samples caused increased formation of thymine glycol, with wide variations in activity among samples. When normalized for equal surface area, the samples produced different levels of DNA strand breakage. Addition of hydrogen peroxide strongly accelerated DNA damage--more for cristobalite than for the alpha-quartz samples. DNA damage by quartz was enhanced by ferric chloride and inhibited by iron chelators. The order of relative activity of the samples varied with different types of in vitro assays and was not directly correlated to surface area. Electrophoretic mobility, as measured by zeta potential, was not significantly different among samples. The results suggest that the ability of different crystalline silica samples to generate a rapid burst of oxygen free radicals is distinct from their ability to induce DNA damage and DNA base oxidation over longer time periods. The relative activities of the samples in cellular assays (hemolysis of human erythrocytes; cytotoxicity and neoplastic transformation of BALB/3T3/A31-1-1 cells) were in turn markedly different from those listed above, suggesting a more critical role for surface area. The mechanisms of carcinogenesis by crystalline silica need to be further investigated in relation to the underlying physicochemical characteristics.

Animals↗
PubMed1995

Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling.

From 1969 to 1990, 649 patients with adenocarcinoma of the endometrium were surgically managed by gynecologic oncologists from the University of Alabama at Birmingham. All patients underwent TAH-BSO and washings. Two hundred twelve patients had multiple-site pelvic node sampling (mean number of nodes, 11), 205 patients had limited site pelvic node sampling (mean number of nodes, 4), and in 208 patients, nodes were not sampled. Historical prognostic features, including tumor grade, depth of invasion, adnexal metastasis, cervical involvement, and positive cytology, were equally distributed in the three groups. Mean follow-up was 3 years. Patients undergoing multiple-site pelvic node sampling had significantly better survival than patients without node sampling (P = 0.0002). When patients were categorized as low risk (disease confined to the corpus) or as high risk (disease in the cervix, adnexa, uterine serosa, or washings) multiple-site pelvic node sampling again provided a significant survival advantage compared to patients without node sampling (high risk, P = 0.0006; low risk, P = 0.026). In a comparison of patients receiving whole pelvic radiation for grade III lesions or deep myometrial invasion, patients with multiple-site pelvic node sampling had better survival than those in whom nodes were not sampled (P = 0.0027). The significant survival advantage for patients having multiple-site node sampling, overall and in high- and low-risk groups, strongly suggests a therapeutic benefit. Additionally, adjuvant therapy may be more appropriate directed in these patients.

Adenocarcinoma↗