Publications (5)12.49 Total impact
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Article: Comparative assessment of hypercoagulability in women with and without gynecologic malignancies using the thromboelastograph coagulation analyzer.
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ABSTRACT: The hypercoagulability status of women with and without gynecologic malignancies was compared using the thromboelastograph coagulation analyzer. Blood specimens from 25 women with newly diagnosed gynecologic malignancies and from 21 age-matched controls were analyzed. Hypercoagulability is defined by a short R value (min), a short K value (min), an elevated maximum amplitude (MA) value (mm), and a broad alpha-angle (degrees). A two-tailed, two-sample t-test was used for statistical analysis. When compared with specimens from age-matched controls, specimens from women with gynecologic malignancies demonstrated values consistent with hypercoagulability. The specific parameters are presented as a mean (+/- SD). Patients with gynecologic malignancies were found to have a short R value (7.1 +/- 2.1 vs. 11.8 +/- 1.8 min; P < 0.001), a short K value (3.1 +/- 0.9 vs. 4.6 +/- 0.9 min; P < 0.001), a prolonged MA value (64.7 +/- 5.4 vs. 58.8 +/- 6.1 mm; P = 0.001), and a greater alpha-angle (70.6 +/- 5.3 vs. 61.6 +/- 4.9 degrees ; P < 0.001). Detection of hypercoagulability as measured by thromboelastography is statistically more common among women with gynecologic malignancies compared with age-matched controls. Future studies may address the use of thromboelastography to identify patients at risk for gynecologic malignancies.Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 03/2010; 21(2):140-3. · 1.25 Impact Factor -
Article: Elevated aromatase expression correlates with cervical carcinoma progression.
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ABSTRACT: We have previously demonstrated that aromatase mRNA is induced in cervical carcinomas compared to normal tissue, suggesting that in situ aromatase expression leading to elevated local estrogen production may contribute to cervical carcinogensis. Our objectives are to examine 1) whether aromatase protein and activity are induced in cervical carcinomas, 2) aromatase expression correlates with disease stage, and 3) inflammatory cytokines (e.g., IL-6 and TNFalpha) may correlate with aromatase expression. RNA and protein were isolated from human cervical carcinomas and normal cervical biopsies to examine aromatase expression, using real-time RT-PCR, Western blot analysis, and immunohistochemistry. Aromatase activity in tissue was measured using the tritiated water release method. IL-6 and TNFalpha expression was also examined. Aromatase protein and activity levels were increased in cervical carcinomas compared to normal tissue. RNA levels correlated significantly with disease progression, with highest aromatase expression detected in stage IV tumors (p<0.001, R(2)=0.77). Aromatase promoters 1.3 and 1.4 were elevated in cervical carcinomas and in cervical cancer cells. The expression of inflammatory cytokines IL-6 and TNFalpha, known to induce aromatase, significantly correlated with aromatase expression (R(2)>0.9). TNFalpha treatment induced aromatase expression in cervical cancer cells. Increased aromatase protein and activity in cervical carcinomas and the correlation of its expression with disease stage implicates it in cervical carcinogenesis. The correlation of IL-6 and TNFalpha expression with aromatase suggests that these inflammatory cytokines may induce aromatase expression, which is confirmed by induction of aromatase expression due to TNFalpha treatment of cervical cancer cells.Gynecologic Oncology 07/2009; 114(3):496-500. · 3.89 Impact Factor -
Article: Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer.
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ABSTRACT: The Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system. Information on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The chi(2) test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis. Of 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors. African-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.Gynecologic Oncology 05/2003; 89(2):218-26. · 3.89 Impact Factor -
Article: The significance of hyperkeratosis/parakeratosis on otherwise normal Papanicolaou smears.
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ABSTRACT: The purpose of this study was to determine whether hyperkeratosis/parakeratosis found on an otherwise normal Papanicolaou smear was associated with abnormalities after comprehensive evaluation. We conducted a retrospective cohort study of 566 women identified with hyperkeratosis/parakeratosis on Papanicolaou smears from a 7-year period. All women underwent repeat Papanicolaou smear, colposcopy, and biopsy as indicated. Statistical analysis included chi(2) and Fisher exact tests as appropriate. Final abnormal diagnoses included human papillomavirus (HPV) changes (17%), mild dysplasia (5%), and moderate/severe dysplasia (0.4%). We found no carcinomas. Women younger than age 50 years were more likely to have an abnormality (34% vs 19%, relative risk 1.3, 95% CI 1.1-1.4, P <.001), primarily because of a higher prevalence of HPV changes on the biopsy specimen (21% vs 9%, relative risk 1.3, 95% CI 1.2-1.5, P <.001). Hyperkeratosis/parakeratosis on an otherwise normal Papanicolaou smear is associated with low-grade changes, particularly among reproductive-age women.American Journal of Obstetrics and Gynecology 10/2002; 187(4):997-1001. · 3.47 Impact Factor -
Article: Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer
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ABSTRACT: ObjectiveThe Department of Defense health care system provides access to care without respect to age, race, or socioeconomic status. We sought to determine the effect of race as a predictor of survival in patients with endometrial cancer treated in the Department of Defense medical system.MethodsInformation on patients with endometrial carcinoma was extracted from the Department of Defense centralized tumor registry for the period 1988 to 1995. Data included age at diagnosis, military status, race, tumor histology, grade, FIGO surgical stage, adjuvant therapies, and disease-free survival. The χ2 test was used for analysis of prognostic factors and adjuvant treatments between racial groups. Actuarial survival curves were calculated by using the method of Kaplan and Meier and compared by the log-rank test. Variables found to be significant on univariate analysis (P < 0.05) were entered into a multivariate Cox regression analysis.ResultsOf 1811 patients meeting criteria for the study, racial distribution was 90% Caucasian, 4.4% African-American, and 5.5% Asian-Pacific Islander. African-Americans had more advanced stages of disease compared to Caucasians (P < 0.001). Both African-Americans and Asian-Pacific Islanders had higher grade tumors and less favorable histologic types than Caucasians (P < 0.05). The extent of adjuvant therapies was similar for racial groups. African-Americans and Asian-Pacific Islanders had significantly worse 5-year disease-free survivals than Caucasians (P = 0.007). Additional poor prognostic factors included age >60 years, grade, unfavorable histology, and stage. On multivariate analysis age >60 years, stage, and Asian-Pacific Islander race remained significant prognostic factors.ConclusionAfrican-Americans and Asian-Pacific Islanders had worse survivals than Caucasians. After controlling for imbalances in clinicopathologic factors, Asian-Pacific Islander race was found to be a newly identified poor prognostic factor.Gynecologic Oncology.
