MD, PhD. Gynae Oncologist (Dept. GYN&OB) and Medical Adviser (Tampere Surgical Education Centre) in Tampere University Hospital, Tampere, Finland. Research interests: sentinel node techniques in gynaecological cancer, cancer surgery, surgical education and surgical skills training. Other interests: eating disorders, Family-Based Treatment and its variations. Phone: +358503847500 Address: Tampere University Hospital Dept. GYN&OB PO Box 272 FI - 33101 Tampere
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial ... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Syömisen välttämis-ja rajoittamishäiriö (avoidant-restrictive food intake disorder, ARFID) on uus... more Syömisen välttämis-ja rajoittamishäiriö (avoidant-restrictive food intake disorder, ARFID) on uusi syömishäiriö DSM-5-ja ICD-11-tautiluokituksissa. Syömisen erityispiirteet, ruoan aistittaviin ominaisuuksiin tai syömisen seurauksiin liittyvät pelot tai vähäinen ruokahalu rajoittavat sairastuneen syömistä niin paljon, että kasvu, painonkehitys tai ravitsemustila häiriintyvät tai syömisen rajoittuneisuus aiheuttaa huomattavaa psykososiaalista haittaa. Diagnoosi perustuu terveydentilan monipuoliseen arviointiin. Syömisen erityispiirteitä voidaan kartoittaa oirekyselyillä tai diagnostisilla haastatteluilla. Syömisen välttämis-ja rajoittamishäiriöön liittyy usein kroonisia sairauksia, mielenterveyden oireita ja autismikirjon piirteitä. Vaikeimmin oireilevat tarvitsevat moniammatillista kuntoutusta. Ravitsemusterapeutin, toimintaterapeutin, puheterapeutin, psykologin tai psykoterapeutin erityisosaaminen on hyödyksi kuntoutuksen suunnittelussa. Lasten ja nuorten ruokavalion kehittymistä monipuoliseksi voidaan tukea myös ruokakasvatuksen keinoin.
Ulkosynnytinsyövistä suurin osa on levyepiteelisyöpiä, jotka kehittyvät joko kroonisten ihosairau... more Ulkosynnytinsyövistä suurin osa on levyepiteelisyöpiä, jotka kehittyvät joko kroonisten ihosairauksien tai papilloomavirusinfektion seurauksena. Tyyppioireita ovat ulkosynnyttimien paikallishoitoon huonosti reagoiva kipu, ärsytys ja kutina. Perusterveydenhuollossa olennaista on tutkia potilas gynekologisessa asennossa ja ottaa epäilyttävistä alueista kudosnäytteet. Levinneisyyttä selvitetään vartalon TT:llä ja lantion magneettikuvauksella. Paikalliset kasvaimet hoidetaan kirurgisesti. Kookkaiden kasvaimien ensileikkauksissa käytetään apuna plastiikkakirurgiaa. Paikallisesti levinneet syöpäkasvaimet hoidetaan kemosädehoidolla. Laajalle levinneessä syövässä hoitolinjana on hidastaa syövän etenemistä. Kura? tiivisen hoidon jälkeen potilasta seurataan erikoissairaanhoidossa viiteen vuoteen saakka ja sen jälkeen perusterveydenhuollossa. Uusiutumien toteamisen lisäksi seurannan tarkoitus on havaita ja lievittää syöpähoitojen aiheuttamia jälkioireita, joita ulkosynnytinsyövän sairastaneilla potilailla usein esiintyy.
Kun ulkosynnytinsyöpä todetaan alkuvaiheessa, sen hoito on kirurginen. Imusolmukelevinneisyys on ... more Kun ulkosynnytinsyöpä todetaan alkuvaiheessa, sen hoito on kirurginen. Imusolmukelevinneisyys on tärkeä ennustetekijä, ja noin kymmenen vuoden ajan sitä on voitu määrittää myös vartijaimusolmuketutkimuksella. Vartijaimusolmukkeet paikannetaan tavanomaisesti siniväri- ja isotooppiruiskutuksen jälkeen gammakoettimen avulla ja silmämääräisesti. Uudet kuvantamistekniikat helpottavat vartijaimusolmukkeiden paikantamista. Kuvaamme potilaan, jonka vartijaimusolmuketutkimus tehtiin sinivärin ja teknetiumisotoopin avulla, ja lisäksi leikkauksessa käytettiin nykyaikaisempaa merkkiainetta, indosyaniinivihreää. Yksifotoniemissiotomografia (SPECT-TT) ennen leikkausta helpotti vartijaimusolmukkeen paikantamista keskilinjan kasvaimen yhteydessä.
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, May 1, 2017
Intraoperative detection of ovarian sentinel nodes has been shown to be feasible. We examined the... more Intraoperative detection of ovarian sentinel nodes has been shown to be feasible. We examined the detection rate and locations of sentinel nodes in patients with ovarian tumors. We also aimed to assess the reliability of sentinel node method in predicting regional lymph node metastasis. Twenty patients scheduled for laparotomy because of a pelvic mass were recruited to the study. In the beginning of the laparotomy, radioisotope and blue dye were injected under the serosa next to the junction of the ovarian tumor and suspensory ligament. The number and locations of the hot and/or blue nodes/spots were recorded during the operation. If the tumor was malignant according to the frozen section, systematic lymphadenectomies were performed, the sentinel nodes sampled separately, and their status compared with other regional lymph nodes. Eleven patients had a right-sided ovarian tumor, 7 patients a left-sided tumor, and 2 patients had bilateral tumors. A median of 2 sentinel nodes/locations...
OBJECTIVE ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and inflam... more OBJECTIVE ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and inflammatory processes in both normal and cancer cells. Chronic inflammation induced by lichen sclerosus (LS) or human papilloma virus (HPV) precedes vulvar squamous cell carcinoma (vulvar SCC). We investigated the expression of ERRα, ERRβ and ERRγ in normal vulvar skin, LS as well as LS-dependent and LS-independent/HPV-related vulvar SCC. METHODS A total of 203 samples were analyzed for ERRα, ERRβ and ERRγ by using immunohistochemistry. These included 37 normal vulvar skin samples, 110 LS samples, 6 vulvar intraepithelial neoplasia (VIN) samples and 50 vulvar SCC samples. RESULTS A substantial reduction in or disappearance of ERRα was detected in all vulvar SCC samples. A total of 79% of childhood-onset LS and 51% of adulthood-onset LS lesions showed decreases in ERRα staining. A gradual reduction in ERRα cytoplasmic staining was observed from healthy vulvar skin to precursor lesions and further to SCC. Nuclear ERRα staining was observed in 8/33 (24%) LS-dependent and 10/17 (59%) LS-independent SCC samples. CONCLUSIONS ERRα, a key regulator of cell energy metabolism, may play a role in the pathogenesis of both LS and vulvar SCC.
Backround and Aims: Soft-tissue reconstruction of the vulva following resection of malignancies i... more Backround and Aims: Soft-tissue reconstruction of the vulva following resection of malignancies is challenging. The function of perineal organs should be preserved and the reconstructed area should maintain an acceptable cosmetic appearance. Reconstruction with local flaps is usually sufficient in the primary phase after a radical vulvectomy. Numerous flaps have been designed for vulvar reconstruction usually based on circulation from the internal pudendal artery branches. In this paper we introduce our modification of the gluteal fold V–Y advancement flap as a primary reconstruction after a radical vulvectomy. Patients and Methods: Twenty-two patients were operated with a radical vulvectomy because of vulvar malignancies. The operation was primary in eight and secondary in 14 patients. The reconstruction of the vulva was performed in the same operation for each patient Results: All flaps survived completely. Wound complications were registered in three patients. Late problems with ...
ObjectiveTo examine whether the intraoperative combined injection technique is feasible in locati... more ObjectiveTo examine whether the intraoperative combined injection technique is feasible in locating the sentinel node(s) of the ovary.Methods/MaterialsIn 16 patients with high-risk uterine cancer and normal postmenopausal ovaries, technetium isotope and blue dye were injected in the right or left ovary during laparotomy, respectively. During the operation, the pelvic and para-aortic lymphatic areas were searched, and the number, method of detection, and location(s) of the hot and/or blue node(s) were recorded.ResultsOne to 3 sentinel nodes per patient were identified in all but 1 patient (15 of 16, 94%). The sentinel nodes (n = 30) were all located in the para-aortic area. The sentinel nodes of the left ovary were mainly (9 of 14, 64%) located above the inferior mesenteric artery level, as the most sentinel nodes of the right ovary (15 of 16, 94%) were found below the inferior mesenteric artery level (P = 0.001). There were no contralateral or bilateral sentinel nodes.ConclusionsThe...
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009
European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 143, Issue 1, Pa... more European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 143, Issue 1, Pages 61-62, March 2009, Authors:Johanna U. Mäenpää; Reita Nyberg; Jyrki Parkkinen. Journal Home, Register or Login: Password: Auto-Login [Reminder]. ...
Acta Obstetricia et Gynecologica Scandinavica, 2007
There is growing interest to apply the sentinel node technique in the treatment of vulvar cancer.... more There is growing interest to apply the sentinel node technique in the treatment of vulvar cancer. All charts of the patients operated on for vulvar cancer at Tampere University Hospital from January 1, 2001 through June 30, 2005 were retrospectively reviewed. Demographic, clinical, and histopathological information was collected from each patient. The sentinel lymph node mapping was done intraoperatively either with a combination of the radioisotope and dye techniques (40 patients) or with the dye technique alone (7 patients). The sentinel lymph node was dissected separately for histopathological evaluation, and then a routine inguinal lymphadenectomy was performed. The final FIGO surgical Stage distribution was: Stage I, 11 (23%); Stage II, 14 (30%); Stage III, 21 (45%); and Stage IV, 1 (2%). Sentinel lymph node was identified in 46 (98%) women with either one or both of the methods. In Stage I-II, the sentinel lymph node identification rate was 25/25 (100%) with the combined method. The only patient with unidentified sentinel lymph node had lymphatic spread beyond inguinal area or Stage IV disease. Eighteen of the sentinel lymph nodes (39%) were positive for tumor cells, and in 5 cases additional metastatic nodes were found. One patient with macroscopically enlarged metastatic inguinal nodes and Stage III disease had a negative sentinel lymph node. In the 25 patients with Stage I-II disease, the false-negative rate of the sentinel lymph node method was 0/4, giving a negative predictive value of 1.00. A sentinel node identification rate of 98% with a false-negative rate of 0% in the patients with Stage I-II disease is an encouraging finding.
Objective: ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and infla... more Objective: ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and inflammatory processes in both normal and cancer cells. Chronic inflammation induced by lichen sclerosus (LS) or human papillo-ma virus (HPV) precedes vulvar squamous cell carcinoma (vulvar SCC). We investigated the expression of ERRα, ERRβ and ERRγ in normal vulvar skin, LS as well as LS-dependent and LS-independent/HPV-related vulvar SCC.
Methods: A total of 203 samples were analyzed for ERRα, ERRβ and ERRγ by using immunohistochemistry. These included 37 normal vulvar skin samples, 110 LS samples, 6 vulvar intraepithelial neoplasia (VIN) samples and 50 vulvar SCC samples.
Results: A substantial reduction in or disappearance of ERRα was detected in all vulvar SCC samples. A total of 79% of childhood-onset LS and 51% of adulthood-onset LS lesions showed decreases in ERRα staining. A gradual reduction in ERRα cytoplasmic staining was observed from healthy vulvar skin to precursor lesions and further to SCC. Nuclear ERRα staining was observed in 8/33 (24%) LS-dependent and 10/17 (59%) LS-independent SCC samples.
Conclusions: ERRα, a key regulator of cell energy metabolism, may play a role in the pathogenesis of both LS and vulvar SCC.
Purpose: The two main etiological factors for vulvar squamous cell carcinoma (vSCC) are the vulva... more Purpose: The two main etiological factors for vulvar squamous cell carcinoma (vSCC) are the vulvar dermatosis lichen sclerosus (LS) and high-risk human papillomavirus (hrHPV). Serpin A1 (α1-antitrypsin) is a serine protease inhibitor, which plays a role in the tumorigenesis of various cancer types. The aim of the study was to evaluate the expressions of Serpin A1 in LS, premalignant vulvar lesions, and vSCC using immunohistochemistry (IHC) and serum analysis, and to compare Serpin A1 stainings to the tumor markers p53 and p16. Methods: In total, 120 samples from 74 patients were studied with IHC for Serpin A1, p53 and p16: 18 normal vulvar skin, 53 LS, 9 premalignant vulvar lesions (dVIN/HSIL) and 40 vSCC samples. Serum concentrations of Serpin A1 were analyzed from 30 LS, 44 vSCC and 10 control patients. Expressions were compared to clinical data. Results: Tumor cell-specific Serpin A1 overexpression was detected in 88% of vSCC samples, independent of the etiology. The intensity of Serpin A1 expression was significantly higher in vSCC than in healthy vulvar skin, LS, or premalignant vulvar lesions. Serpin A1 showed an association with p53 positivity. No difference in overall survival was found between Serpin A1-, p53-, or p16-positive vSCC patients. Serum concentrations of Serpin A1 were equal in the LS, vSCC, and control groups. Conclusion: Tumor cell-specific Serpin A1 overexpression is a potential biomarker in vSCC.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial ... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Syömisen välttämis-ja rajoittamishäiriö (avoidant-restrictive food intake disorder, ARFID) on uus... more Syömisen välttämis-ja rajoittamishäiriö (avoidant-restrictive food intake disorder, ARFID) on uusi syömishäiriö DSM-5-ja ICD-11-tautiluokituksissa. Syömisen erityispiirteet, ruoan aistittaviin ominaisuuksiin tai syömisen seurauksiin liittyvät pelot tai vähäinen ruokahalu rajoittavat sairastuneen syömistä niin paljon, että kasvu, painonkehitys tai ravitsemustila häiriintyvät tai syömisen rajoittuneisuus aiheuttaa huomattavaa psykososiaalista haittaa. Diagnoosi perustuu terveydentilan monipuoliseen arviointiin. Syömisen erityispiirteitä voidaan kartoittaa oirekyselyillä tai diagnostisilla haastatteluilla. Syömisen välttämis-ja rajoittamishäiriöön liittyy usein kroonisia sairauksia, mielenterveyden oireita ja autismikirjon piirteitä. Vaikeimmin oireilevat tarvitsevat moniammatillista kuntoutusta. Ravitsemusterapeutin, toimintaterapeutin, puheterapeutin, psykologin tai psykoterapeutin erityisosaaminen on hyödyksi kuntoutuksen suunnittelussa. Lasten ja nuorten ruokavalion kehittymistä monipuoliseksi voidaan tukea myös ruokakasvatuksen keinoin.
Ulkosynnytinsyövistä suurin osa on levyepiteelisyöpiä, jotka kehittyvät joko kroonisten ihosairau... more Ulkosynnytinsyövistä suurin osa on levyepiteelisyöpiä, jotka kehittyvät joko kroonisten ihosairauksien tai papilloomavirusinfektion seurauksena. Tyyppioireita ovat ulkosynnyttimien paikallishoitoon huonosti reagoiva kipu, ärsytys ja kutina. Perusterveydenhuollossa olennaista on tutkia potilas gynekologisessa asennossa ja ottaa epäilyttävistä alueista kudosnäytteet. Levinneisyyttä selvitetään vartalon TT:llä ja lantion magneettikuvauksella. Paikalliset kasvaimet hoidetaan kirurgisesti. Kookkaiden kasvaimien ensileikkauksissa käytetään apuna plastiikkakirurgiaa. Paikallisesti levinneet syöpäkasvaimet hoidetaan kemosädehoidolla. Laajalle levinneessä syövässä hoitolinjana on hidastaa syövän etenemistä. Kura? tiivisen hoidon jälkeen potilasta seurataan erikoissairaanhoidossa viiteen vuoteen saakka ja sen jälkeen perusterveydenhuollossa. Uusiutumien toteamisen lisäksi seurannan tarkoitus on havaita ja lievittää syöpähoitojen aiheuttamia jälkioireita, joita ulkosynnytinsyövän sairastaneilla potilailla usein esiintyy.
Kun ulkosynnytinsyöpä todetaan alkuvaiheessa, sen hoito on kirurginen. Imusolmukelevinneisyys on ... more Kun ulkosynnytinsyöpä todetaan alkuvaiheessa, sen hoito on kirurginen. Imusolmukelevinneisyys on tärkeä ennustetekijä, ja noin kymmenen vuoden ajan sitä on voitu määrittää myös vartijaimusolmuketutkimuksella. Vartijaimusolmukkeet paikannetaan tavanomaisesti siniväri- ja isotooppiruiskutuksen jälkeen gammakoettimen avulla ja silmämääräisesti. Uudet kuvantamistekniikat helpottavat vartijaimusolmukkeiden paikantamista. Kuvaamme potilaan, jonka vartijaimusolmuketutkimus tehtiin sinivärin ja teknetiumisotoopin avulla, ja lisäksi leikkauksessa käytettiin nykyaikaisempaa merkkiainetta, indosyaniinivihreää. Yksifotoniemissiotomografia (SPECT-TT) ennen leikkausta helpotti vartijaimusolmukkeen paikantamista keskilinjan kasvaimen yhteydessä.
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, May 1, 2017
Intraoperative detection of ovarian sentinel nodes has been shown to be feasible. We examined the... more Intraoperative detection of ovarian sentinel nodes has been shown to be feasible. We examined the detection rate and locations of sentinel nodes in patients with ovarian tumors. We also aimed to assess the reliability of sentinel node method in predicting regional lymph node metastasis. Twenty patients scheduled for laparotomy because of a pelvic mass were recruited to the study. In the beginning of the laparotomy, radioisotope and blue dye were injected under the serosa next to the junction of the ovarian tumor and suspensory ligament. The number and locations of the hot and/or blue nodes/spots were recorded during the operation. If the tumor was malignant according to the frozen section, systematic lymphadenectomies were performed, the sentinel nodes sampled separately, and their status compared with other regional lymph nodes. Eleven patients had a right-sided ovarian tumor, 7 patients a left-sided tumor, and 2 patients had bilateral tumors. A median of 2 sentinel nodes/locations...
OBJECTIVE ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and inflam... more OBJECTIVE ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and inflammatory processes in both normal and cancer cells. Chronic inflammation induced by lichen sclerosus (LS) or human papilloma virus (HPV) precedes vulvar squamous cell carcinoma (vulvar SCC). We investigated the expression of ERRα, ERRβ and ERRγ in normal vulvar skin, LS as well as LS-dependent and LS-independent/HPV-related vulvar SCC. METHODS A total of 203 samples were analyzed for ERRα, ERRβ and ERRγ by using immunohistochemistry. These included 37 normal vulvar skin samples, 110 LS samples, 6 vulvar intraepithelial neoplasia (VIN) samples and 50 vulvar SCC samples. RESULTS A substantial reduction in or disappearance of ERRα was detected in all vulvar SCC samples. A total of 79% of childhood-onset LS and 51% of adulthood-onset LS lesions showed decreases in ERRα staining. A gradual reduction in ERRα cytoplasmic staining was observed from healthy vulvar skin to precursor lesions and further to SCC. Nuclear ERRα staining was observed in 8/33 (24%) LS-dependent and 10/17 (59%) LS-independent SCC samples. CONCLUSIONS ERRα, a key regulator of cell energy metabolism, may play a role in the pathogenesis of both LS and vulvar SCC.
Backround and Aims: Soft-tissue reconstruction of the vulva following resection of malignancies i... more Backround and Aims: Soft-tissue reconstruction of the vulva following resection of malignancies is challenging. The function of perineal organs should be preserved and the reconstructed area should maintain an acceptable cosmetic appearance. Reconstruction with local flaps is usually sufficient in the primary phase after a radical vulvectomy. Numerous flaps have been designed for vulvar reconstruction usually based on circulation from the internal pudendal artery branches. In this paper we introduce our modification of the gluteal fold V–Y advancement flap as a primary reconstruction after a radical vulvectomy. Patients and Methods: Twenty-two patients were operated with a radical vulvectomy because of vulvar malignancies. The operation was primary in eight and secondary in 14 patients. The reconstruction of the vulva was performed in the same operation for each patient Results: All flaps survived completely. Wound complications were registered in three patients. Late problems with ...
ObjectiveTo examine whether the intraoperative combined injection technique is feasible in locati... more ObjectiveTo examine whether the intraoperative combined injection technique is feasible in locating the sentinel node(s) of the ovary.Methods/MaterialsIn 16 patients with high-risk uterine cancer and normal postmenopausal ovaries, technetium isotope and blue dye were injected in the right or left ovary during laparotomy, respectively. During the operation, the pelvic and para-aortic lymphatic areas were searched, and the number, method of detection, and location(s) of the hot and/or blue node(s) were recorded.ResultsOne to 3 sentinel nodes per patient were identified in all but 1 patient (15 of 16, 94%). The sentinel nodes (n = 30) were all located in the para-aortic area. The sentinel nodes of the left ovary were mainly (9 of 14, 64%) located above the inferior mesenteric artery level, as the most sentinel nodes of the right ovary (15 of 16, 94%) were found below the inferior mesenteric artery level (P = 0.001). There were no contralateral or bilateral sentinel nodes.ConclusionsThe...
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009
European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 143, Issue 1, Pa... more European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 143, Issue 1, Pages 61-62, March 2009, Authors:Johanna U. Mäenpää; Reita Nyberg; Jyrki Parkkinen. Journal Home, Register or Login: Password: Auto-Login [Reminder]. ...
Acta Obstetricia et Gynecologica Scandinavica, 2007
There is growing interest to apply the sentinel node technique in the treatment of vulvar cancer.... more There is growing interest to apply the sentinel node technique in the treatment of vulvar cancer. All charts of the patients operated on for vulvar cancer at Tampere University Hospital from January 1, 2001 through June 30, 2005 were retrospectively reviewed. Demographic, clinical, and histopathological information was collected from each patient. The sentinel lymph node mapping was done intraoperatively either with a combination of the radioisotope and dye techniques (40 patients) or with the dye technique alone (7 patients). The sentinel lymph node was dissected separately for histopathological evaluation, and then a routine inguinal lymphadenectomy was performed. The final FIGO surgical Stage distribution was: Stage I, 11 (23%); Stage II, 14 (30%); Stage III, 21 (45%); and Stage IV, 1 (2%). Sentinel lymph node was identified in 46 (98%) women with either one or both of the methods. In Stage I-II, the sentinel lymph node identification rate was 25/25 (100%) with the combined method. The only patient with unidentified sentinel lymph node had lymphatic spread beyond inguinal area or Stage IV disease. Eighteen of the sentinel lymph nodes (39%) were positive for tumor cells, and in 5 cases additional metastatic nodes were found. One patient with macroscopically enlarged metastatic inguinal nodes and Stage III disease had a negative sentinel lymph node. In the 25 patients with Stage I-II disease, the false-negative rate of the sentinel lymph node method was 0/4, giving a negative predictive value of 1.00. A sentinel node identification rate of 98% with a false-negative rate of 0% in the patients with Stage I-II disease is an encouraging finding.
Objective: ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and infla... more Objective: ERRs (estrogen-related receptors) regulate energy metabolism, the cell cycle and inflammatory processes in both normal and cancer cells. Chronic inflammation induced by lichen sclerosus (LS) or human papillo-ma virus (HPV) precedes vulvar squamous cell carcinoma (vulvar SCC). We investigated the expression of ERRα, ERRβ and ERRγ in normal vulvar skin, LS as well as LS-dependent and LS-independent/HPV-related vulvar SCC.
Methods: A total of 203 samples were analyzed for ERRα, ERRβ and ERRγ by using immunohistochemistry. These included 37 normal vulvar skin samples, 110 LS samples, 6 vulvar intraepithelial neoplasia (VIN) samples and 50 vulvar SCC samples.
Results: A substantial reduction in or disappearance of ERRα was detected in all vulvar SCC samples. A total of 79% of childhood-onset LS and 51% of adulthood-onset LS lesions showed decreases in ERRα staining. A gradual reduction in ERRα cytoplasmic staining was observed from healthy vulvar skin to precursor lesions and further to SCC. Nuclear ERRα staining was observed in 8/33 (24%) LS-dependent and 10/17 (59%) LS-independent SCC samples.
Conclusions: ERRα, a key regulator of cell energy metabolism, may play a role in the pathogenesis of both LS and vulvar SCC.
Purpose: The two main etiological factors for vulvar squamous cell carcinoma (vSCC) are the vulva... more Purpose: The two main etiological factors for vulvar squamous cell carcinoma (vSCC) are the vulvar dermatosis lichen sclerosus (LS) and high-risk human papillomavirus (hrHPV). Serpin A1 (α1-antitrypsin) is a serine protease inhibitor, which plays a role in the tumorigenesis of various cancer types. The aim of the study was to evaluate the expressions of Serpin A1 in LS, premalignant vulvar lesions, and vSCC using immunohistochemistry (IHC) and serum analysis, and to compare Serpin A1 stainings to the tumor markers p53 and p16. Methods: In total, 120 samples from 74 patients were studied with IHC for Serpin A1, p53 and p16: 18 normal vulvar skin, 53 LS, 9 premalignant vulvar lesions (dVIN/HSIL) and 40 vSCC samples. Serum concentrations of Serpin A1 were analyzed from 30 LS, 44 vSCC and 10 control patients. Expressions were compared to clinical data. Results: Tumor cell-specific Serpin A1 overexpression was detected in 88% of vSCC samples, independent of the etiology. The intensity of Serpin A1 expression was significantly higher in vSCC than in healthy vulvar skin, LS, or premalignant vulvar lesions. Serpin A1 showed an association with p53 positivity. No difference in overall survival was found between Serpin A1-, p53-, or p16-positive vSCC patients. Serum concentrations of Serpin A1 were equal in the LS, vSCC, and control groups. Conclusion: Tumor cell-specific Serpin A1 overexpression is a potential biomarker in vSCC.
Esityksen sisältö:
Mitä on vulvodynia?
Milloin vulvodyniaa voisi epäillä?
Vulvodyniapotilaan tutk... more Esityksen sisältö: Mitä on vulvodynia? Milloin vulvodyniaa voisi epäillä? Vulvodyniapotilaan tutkiminen Vulvodynian hoito Erityistilanteita hoidossa Vulvodyniapotilaan selviytymisen tukeminen
Nordic Conference of Gynaecological Endoscopy, 2015
Incorporating OSATS (Objective Structured Assessment of Technical Skills) into clinical training ... more Incorporating OSATS (Objective Structured Assessment of Technical Skills) into clinical training of gynaecological surgery.
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Papers by Reita H Nyberg
Methods: A total of 203 samples were analyzed for ERRα, ERRβ and ERRγ by using immunohistochemistry. These included 37 normal vulvar skin samples, 110 LS samples, 6 vulvar intraepithelial neoplasia (VIN) samples and 50 vulvar SCC samples.
Results: A substantial reduction in or disappearance of ERRα was detected in all vulvar SCC samples. A total of 79% of childhood-onset LS and 51% of adulthood-onset LS lesions showed decreases in ERRα staining. A gradual reduction in ERRα cytoplasmic staining was observed from healthy vulvar skin to precursor lesions and further to SCC. Nuclear ERRα staining was observed in 8/33 (24%) LS-dependent and 10/17 (59%) LS-independent SCC samples.
Conclusions: ERRα, a key regulator of cell energy metabolism, may play a role in the pathogenesis of both LS and vulvar SCC.
Methods: In total, 120 samples from 74 patients were studied with IHC for Serpin A1, p53 and p16: 18 normal vulvar skin, 53 LS, 9 premalignant vulvar lesions (dVIN/HSIL) and 40 vSCC samples. Serum concentrations of Serpin A1 were analyzed from 30 LS, 44 vSCC and 10 control patients. Expressions were compared to clinical data.
Results: Tumor cell-specific Serpin A1 overexpression was detected in 88% of vSCC samples, independent of the etiology. The intensity of Serpin A1 expression was significantly higher in vSCC than in healthy vulvar skin, LS, or premalignant vulvar lesions. Serpin A1 showed an association with p53 positivity. No difference in overall survival was found between Serpin A1-, p53-, or p16-positive vSCC patients. Serum concentrations of Serpin A1 were equal in the LS, vSCC, and control groups. Conclusion: Tumor cell-specific Serpin A1 overexpression is a potential biomarker in vSCC.
Methods: A total of 203 samples were analyzed for ERRα, ERRβ and ERRγ by using immunohistochemistry. These included 37 normal vulvar skin samples, 110 LS samples, 6 vulvar intraepithelial neoplasia (VIN) samples and 50 vulvar SCC samples.
Results: A substantial reduction in or disappearance of ERRα was detected in all vulvar SCC samples. A total of 79% of childhood-onset LS and 51% of adulthood-onset LS lesions showed decreases in ERRα staining. A gradual reduction in ERRα cytoplasmic staining was observed from healthy vulvar skin to precursor lesions and further to SCC. Nuclear ERRα staining was observed in 8/33 (24%) LS-dependent and 10/17 (59%) LS-independent SCC samples.
Conclusions: ERRα, a key regulator of cell energy metabolism, may play a role in the pathogenesis of both LS and vulvar SCC.
Methods: In total, 120 samples from 74 patients were studied with IHC for Serpin A1, p53 and p16: 18 normal vulvar skin, 53 LS, 9 premalignant vulvar lesions (dVIN/HSIL) and 40 vSCC samples. Serum concentrations of Serpin A1 were analyzed from 30 LS, 44 vSCC and 10 control patients. Expressions were compared to clinical data.
Results: Tumor cell-specific Serpin A1 overexpression was detected in 88% of vSCC samples, independent of the etiology. The intensity of Serpin A1 expression was significantly higher in vSCC than in healthy vulvar skin, LS, or premalignant vulvar lesions. Serpin A1 showed an association with p53 positivity. No difference in overall survival was found between Serpin A1-, p53-, or p16-positive vSCC patients. Serum concentrations of Serpin A1 were equal in the LS, vSCC, and control groups. Conclusion: Tumor cell-specific Serpin A1 overexpression is a potential biomarker in vSCC.
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