No abstract

Upper genital tract infection was investigated in 45 women admitted to hospital for suspected acute pelvic inflammatory disease (PID). Salpingitis was diagnosed by laparoscopy in 30 (67%) women. Histopathological evidence of endometritis was found significantly more often in the 30 women with salpingitis (87%) than in the other 15 women without salpingitis (33%). C. trachornatis or N . gonorrhoeae, or both, were isolated from the upper genital tract in 14 of the 31 women who had both salpingitis and endometritis or endometritis only but in none of the four women who had salpingitis alone and in none of the 10 women who had no evidence of PID. Bacterial vaginosis was associated with histopathological evidence of upper tract infection. Non-chlamydia1 nongonococcal organisms were frequently isolated from the upper genital tract. Noorganismswereisolatedfrom the uppergenitaltractfrom9of35 women with laparoscopic or histopathological evidence of PID compared with 7 of 10 women without evidence of PID. C. trachomatis or N . gonorvhaeae in the endometrium was associated with lymphoid follicles comprising transformed lymphocytes, and correlated with the density of plasma cells on biopsy. The microbiological results support the recommendations of broad spectrum antimicrobial therapy for PID.The concept of the pathogenesis of acute pelvic inflammatory disease (PID) has remained

BACKGROUND Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant diseases. Some cytokines have been shown to have potential in the diagnosis of cancer. METHODS A total of 111 patients with ovarian, cervical, or endometrial carcinomas or benign ovarian or uterine tumors were enrolled on the study, and the levels of interleukin (IL)‐2, IL‐4, IL‐6, IL‐10, interferon (IFN)‐γ, granulocyte‐colony stimulating factor (G‐CSF), granulocyte‐macrophage‐colony stimulating factor (GM‐CSF), macrophage‐colony stimulating factor (M‐CSF), and tumor necrosis factor (TNF)‐α were measured by cytokine specific, enzyme‐linked immunoadsorbent assays. In addition, ratios of IL‐2, IL‐4, and IFN‐γ production were studied to characterize the type of T‐cell response that occurred in the peritoneal cavities of the patients. RESULTS High levels of M‐CSF (mean for all patients, 26,050 pg/mL) and G‐CSF (mean for all patients, 20,267 pg/mL) were observed in virtually all patients, but no significant differences between the study groups were observed. Similarly, no differences in the levels of IL‐2, IL‐4, IL‐10, IFN‐γ, GM‐CSF, or TNF‐α were found. However, IL‐6 levels were significantly higher in patients with ovarian carcinoma (mean ± standard error of the mean [SEM]: 5572 ± 1266) or benign tumors (mean ± SEM: 4474 ± 2008) than in those with cervical (mean ± SEM: 1222 ± 546) or endometrial carcinoma (mean ± SEM: 1977 ± 616). A predominantly Th1 type cytokine profile, irrespective of the diagnosis, was observed in patients with gynecologic tumors. CONCLUSIONS With the exception of IL‐6, the cytokine synthesis profiles in the peritoneal fluids of patients with benign and malignant gynecologic tumors were found to be similar. These results suggest that cytokine production in these patients is a result of nonspecific inflammation rather than a specific response against the tumor cells, and that skewing of cytokine synthesis toward either the Th1 or the Th2 phenotype is not the underlying mechanism resulting in the malignant process in women with gynecologic tumors. Cancer 1998;83:788‐796. © 1998 American Cancer Society.

No abstract