C.B. Coulam

Ovarian hormones have been implicated in a number of neoplastic conditions. Chronic anovulation syndrome, a spontaneous biologic experiment of unopposed secretion of estrogen by the ovaries, was identified in a cohort of 1270 patients, and the risk of these patients having neoplasia was studied. Of the 1270 patients studied, 30 had a subsequent malignancy develop; the expected number was 29.8. When the individual types of subsequent malignancy were analyzed, the endometrium was the only site at increased risk. The relative risk of developing carcinoma of the endometrium after the diagnosis of chronic anovulation syndrome is 3.1 (95% confidence interval 1.1 to 7.3). The long-term risk of developing adenocarcinoma of the endometrium might be considered when treating patients who have this syndrome.

Receptors, specific for hLH, were found in human luteal tissue. Binding of 125I-hLH was a time-dependent, saturable process that could be competitively inhibited by unlabeled human LH. The dissociate constant of the receptor-LH interaction, using human luteal tissue, was found to be 1.1 × 10−9M, which is in reasonable agreement with the dissociation constant found using rat luteal tissue. The concentration of LH binding site showed considerable variability among corpora lutea obtained from ten different subjects.

To evaluate the usefulness of autoantibody detection as a nonoperative method of diagnosing endometriosis, we tested 221 sera from 215 patients from the infertility, gynecology, and gynecologic oncology services by an indirect immunofluorescence assay using monolayer cultures of an endometrial carcinoma cell line. The assay showed positive cytoplasmic staining, demonstrating a sensitivity of 83% in the patients with laparoscopically confirmed endometriosis. The specificity of the assay was 65% for the infertility patients and 76% for the infertility and gynecology patients combined. Several gynecologic cancer patients showed either nuclear or nuclear and cytoplasmic staining, but few showed exclusive cytoplasmic staining. These initial results suggest that detection of antibodies might be useful for the diagnosis of endometriosis.