The objective of this study was to evaluate the value of platelet count, p53, MDM2, c-erbB-2, and cathepsin D immunoreactivity as predictors of lymph node metastasis (LNM) as well as their prognostic significance in patients with stage IB cervical cancer treated by radical hysterectomy between 1991 through 1995. We also report on the outcome of a protocol considering lymph-vascular space invasion (LVSI) in addition to LNM as a strong motivation for adjuvant radiotherapy. A total of 93 patients were the subject of this retrospective study. The incidence of positive nodes was high (30.1%). Thrombocytosis (>/= 400.000/mm3) was present in 6.7% of patients. Positive immunostaining was found for p53 (50.6%), MDM2 (21.7%), c-erbB-2 (14.5%), and cathepsin D (45.8%), but none of them was able to predict LNM. Only thrombocytosis was associated with an unfavorable prognosis: a statistically significant association was shown with relapse-free and overall survival in an univariate analysis (P = 0.0431 and P = 0.0012, respectively) with a tendency to significance in multivariate analysis (P = 0.079 and P = 0.0882, respectively). We postulate that thrombocytosis in early stage cervical cancer could be a marker for subclinical tumor burden. LVSI, regarded as an indication for adjuvant radiotherapy, was no longer associated with poor relapse-free or overall survival, but resulted in a 41% postoperative irradiation rate. Further research is needed to establish the value of LVSI in postoperative radiotherapy decision making.

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de Jonge ETM, Makin JD, Lindeque BG, Brune P, Amant F. Ethnic differences in thrombocytosis in patients with cervical cancer. Int J Gynecol Cancer 1998; 8: 189–192. The aim of this descriptive study is to show the prevalence of and ethnic differences in thrombocytosis in patients with invasive cervical cancer and to establish its clinical relevance. Pre‐treatment platelet counts of 254 white and 839 black patients with cervical cancer stages I–IV were correlated with ethnic group, stage of disease, and lymph node status. Thrombocytosis was defined as a platelet count of more than 400,000 per mm3. Results showed that significantly more black patients than white patients with cervical cancer had thrombocytosis (P < 0.001). Race continued to be an independent variable of thrombocytosis in a logistic regression analysis (P = 0.0238). Thrombocytosis was associated with advanced stage of disease in a logistic regression analysis (P = 0.0042), but failed to predict positive lymph nodes in stage IB disease. This study demonstrates an ethnic difference in thrombocytosis in patients with cervical cancer and confirms a correlation between thrombocytosis and stage of disease. The interpretation of these findings may suggest that thrombocytosis could be a paraneoplastic phenomenon.

Le compte rendu complet que nous avons pu publier sur l'activité de la Croix-Rouge Néerlandaise en 1917 mentionnait de nouveaux statuts adoptés définitivement par l'assemblée générale du 7 juillet 1917. Ils ont été revêtus de la sanction royale par le décret royal que nous reproduisons ci-dessous, cela conformément à notre habitude.