Abstract: OBJECTIVE: In recent years, many studies have been published regarding telomere length and telomerase activity in malignant tissues. However, it is not enough that telomere length and telomerase activity in gynecologic cancers have been measured at same time. We investigated the relationship between telomere length and telomerase activity in gynecologic cancers. METHODS: A total of 52 gynecologic cancers (15 ovarian cancers, 23 endometrial cancers, 14 cervical cancers) were obtained at the time of surgery. The specimens were analyzed for telomerase activity and telomere length with the TRAP(EZE) ELISA kit and Southern blot, respectively. RESULTS: Telomerase activity was detected in 42 of 50 (84.0%) of all evaluable specimens, in 11/15 (73.3%) ovarian, 18/22 (81.8%) endometrial, and in 13/13 (100%) cervical cancers. The difference of positive strength (DeltaA value) between stage I and III was statistically significant (P = 0.01, ANOVA test). Changes in telomere length by shortening or elongation were detected in 35 of 52 (67.3%) tumors, in 9/15 (60.0%) ovarian, 17/23 (73.9%) endometrial, and 9/14 (64.3%) cervical cancers. There was no detectable relationship between telomere length and stage of disease, pathologic diagnosis (ovarian, endometrial, and cervical cancers), or telomerase activity. CONCLUSIONS: There was no relationship between telomerase activity and telomere length. The clinical significance of telomere length appears to be limited in gynecologic cancers.

Abstract: The fertility and pregnancy outcomes of the patients were studied, who previously underwent preservative operation for malignant tumors, including those of borderline malignancy, in our ward from 1981 to 1995. For each of the 9 patients, unilateral ovary was preserved, the range of their ages before operation was 10 to 28 years old, and histologically, 7 patients had tumors derived from germ cells, and 2 had those from epithelial cells. As for clinical stages according to the FIGO's criteria, 5, 1, 2 and 1 patients were in stage I, II, III and IV, respectively. The regimens of the combination chemotherapy for patients with germ cell tumors were PVB (cisplatin, vinblastine and bleomycin), PEP (cisplatin, etopside and pepleomycin), PVP (cisplatin, vinblastine and pepleomycin), AVAC (doxorubicin, vincristine, actinomycin-d and cyclophosphamide). Those for the patient with epithelial tumors were CAP (cyclophosphamide, doxorubicin and cisplatin), CP (cyclophosphamide and cisplatin). Eight patients have been doing well, although 1 of them experienced recurrence and died. Amenorrheic periods of 2 to 12 months were noticed in 3 patients, although in all of them, ovulatory cycles recovered. Eight pregnancies were reported: 5 term delivery with normal babies, and others were preterm termination due to abruptio placenta with a baby of appropriate for date, spontaneous abortion, and artificial termination. We suppose that the combination chemotherapy applied for the patients in the present study affected neither the fertility of the patients nor the outcomes of the pregnancies.