Hepatocellular carcinoma (HCC) is one of the most deadly cancers worldwide. In patients with HCC, histopathogical differentiation is an important indicator of prognosis; however, because determination of HCC differentiation is difficult, the recently described immunohistochemical (IHC) marker glypican3 (GPC3) might assist in HCC prognostication.The goal of our study was to investigate GPC3's IHC staining pattern and define the relationship between its expression and patients' clinicopathologic features and overall survival. We retrieved clinical parameters from 101 pathologically diagnosed HCC patients' medical records and classified these patients into 4 clinical score categories (0–3) based on increasing GPC3 staining intensity and the percentage of stained tumor cells in their resection and biopsy specimens. Histopathological samples were well, moderately, and poorly differentiated in 33, 22, and 12 patients, respectively, and the GPC3 expression rate was 63%, 86%, and 92%,respectively. The median overall survival was 49.9 months (confidence interval (CI): 35.3–64.6 months) for clinical scores 0–1 and 30.7 months (CI: 19.4–41.9 months) for clinical scores 2–3. This difference was not statistically significant (P = .06) but showed a strong trend. In conclusion, a greater GPC3 expression is associated with a worse HCC prognosis and may be a promising prognostic marker.

Maternal peritonitis secondary to fetal vernix caseosa is considered an infrequent complication of cesarean section in which commonly spilled amniotic fluid is incompletely lavaged. Nine of the 10 reported cases have been diagnosed in the postpartum period after an uneventful cesarean section. Characteristically, vernix elicits granulomatous inflammation, occasionally with a mass lesion simulating bowel perforation and leading to colectomy. One case of antenatal leakage of amniotic fluid has been Amniotic fluid contains vernix caseosa that consists of lanugo, cheesy sebaceous matter, and epithelial squames from fetal skin. With leakage or spillage into maternal serous spaces, these components can elicit an inflammatory response in maternal peritoneal membranes and adjacent structures.Maternal vernix caseosa peritonitis (VCP) was first described in 1976 by Krumerman and Pouliot.1 Considered a complication of cesarean section, a total of nine cases have been reported with intervals after cesarean section of 3 to 35 days.1 " 6 Another case was diagnosed at cesarean section and was attributed to the antenatal uterine-tubal reflux of amniotic fluid. 7 We report two additional cases unrelated to a previous cesarean section. In one case, VCP was discovered at a laparotomy performed for tubal ligation on the same day of a vaginal delivery. The second case was discovered at cesarean section. Histopathologic features of VCP are reviewed. Cases initiated antenatally or intrapartum are compared with those manifesting during the postpartum period. M a n u s c r i p t received April 11, 1997; revision accepted July 3,1997.Address reprint requests to Dr Davis: Department of Pathology, University Medical Center, University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724.reported, also with granulomatous inflammation. We report two additional cases of antenatal leakage, both with acute inflammation lacking granulomatous features or mass lesions. The interval between amniotic fluid contamination and histopathologic evaluation is the basis for variations in the inflammatory pattern.

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It is now well established that cervical cancer is caused by oncogenic human papillomavirus (HPV) infections that com- Key words: HPV; viral load; squamous intraepithelial lesions; cervical dysplasia; cervical cancerIt is now well established that cervical cancer is caused by oncogenic human papillomavirus (HPV) infections that commonly infect women worldwide. 1 More recent reports from HPV natural history studies have demonstrated that HPV infections are predominantly transient and that only a minority of infections persist and progress to clinically relevant lesions. What remains to be understood are the factors that contribute to cervical cancer in the presence of HPV infection. Several HPV cofactors have been under investigation, including smoking, parity, oral contraceptive use, nutritional status and cervical inflammation. 2,3 Depending on the study population and statistical method used to adjust for HPV infection, differing results have been obtained.To investigate the factors that contribute to cervical carcinogenesis in the presence of HPV infection, most researchers have conducted case-control studies and have either statistically adjusted for HPV infection in their models or limited their analyses to HPV positive women. 2 In our present study, we conducted a case-control analysis of women recruited at the US-Mexico border 4 to simultaneously evaluate factors associated with 3 cytologic outcomes: atypical squamous cells of undetermined significance or atypical glandular cells of undetermined significance (ASCUS/ AGUS), low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL). We present analyses to suggest that both statistical approaches to identifying HPV cofactors yield similar results in this binational population. MATERIAL AND METHODS Study designA cross-sectional survey was conducted from January 1997 to June 1998, recruiting women 15 years and older living at the AZ, US-Sonora, Mexico border. A detailed description of the study design and methods of the US-Mexico Border Binational HPV, Cervical Dysplasia, and Chlamydia trachomatis Infection Study has been previously published. 4 Briefly, participants were women who self-referred to Community Health Centers, County Health Departments, and Planned Parenthood clinics in Arizona, and Public Health Clinics in Sonora for routine gynecologic care. Women who were (i) 15 years and older; (ii) residents of AZSonora border communities, Hermosillo, Sonora, or Tucson, AZ; (iii) nonpregnant or a minimum of 2 months postpartum and (iv) still having menstrual periods (e.g., no hysterectomy) were invited to participate in our study. The overall response rate was 92.8% (2,436 women interviewed/2,626 women approached for participation). There were 2,578 women who met our study eligibility criteria. Study participants (94.5% of eligible women) completed an interviewer-administered risk-factor questionnaire that assessed reproductive, sexual and medical histories and demographic data. Of the 2,436 women interviewed, 2...