Tehran University Medical Journal

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Listeria infection is still a dominant infectious problem in Iran, particularly in abortion. Looking for a paraclinical technique other than bacterial methods (which is not always available) lead to serological survey indicating estimation anti listeria antibody by Immunoflourescent test. Unfortunately the false positive results due to cross reaction between "listeria monocytogenesis" and certain gram positive cocci, made it an unacceptable technique. Here we performed a test to extract the Listeria M. (Stranin 4a and 1b) soluble antigen and detecting the antibody by counter immunoelectrophoresis (CEI). The results indicated that of four bacterial soluble antigen fractions F1 and F3 were significantly positive with patients sera. We will discuss using the soluble antigen by CEI technique may be helpful to omit the false positive reactions.

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Acute amniotic fluid infection has emerged as a possible cause of many heretofore unexplained preterm births. Our purpose was to determine the effect of ampicillin in the prolongation of pregnancies receiving tocolysis for preterm labor. A blinded, placebo-controlled, randomized trial was conducted to study ampicillin in women hospitalized for preterm labor between 24 and 37 weeks' gestation. A total of 60 patients with intact membranes and without chorioamnionitis who were receiving magnesium sulfate were screened. Thirty women with preterm labor received ampicillin, and 30 received placebos. The primary end point was prolongation of gestation. There was no difference in age of delivery (37.6±9.7 days vs 36.08±3.9 days, P=0.085) and no difference in retardation of delivery (4.7±3.1 vs 4.1±2.1, P=0.39). The mean degree of preterm delivery were 0.62±1.93 and 1.8±3.3 weeks in ampicillin and placebo groups, respectively (not significant, P>0.1). Conclusions: Ampicillin had no effect on interval to delivery or duration of pregnancy in women treated for preterm labor. So rotine clinical use of ampicillin during tocolysis should not be recommended.

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Low back pain is among the most frequent medical complaints and a major public health problem. 1.7 percent of cases are caused by herniated disc, 20 percent of which require interventional treatment. Percutaneous laser disc decompression (P.L.DD) can be considered as an effective therapeutic alternative in certain cases.

Materials and Methods: To determine the efficacy of this method in Iran in patient's with low back pain due to disc herniation, 40 patients according to medical history, physical examination and MRI findings were selected for this study. Patients who had canal stenosis, marginal, osteophyte, advanced disc dehydration, ruptured posterior ligament and other contraindication were excluded. CT scan was used only for needle navigation. After proper positioning of needle, nucleous pulposus was evapourated with Nd-YAG laser. Total energy was 1200-1600j. The procedure was done out patient and follow up has been done at 1 day, 1 week, 1,3, 6 and 12 months.

Results: There was no serious complication. 80 percent of patients in one-year follow up showed significant clinical improvement.

Conclusion: Our findings suggests that percutaneous laser disc decompression can be considered as an effective alternative method of treatment for disc herniation and patient selection is the critical factor which determines success rate.

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Primitive Peripheral Malignant Neuroectodermal Tumor is a malignant neoplasm of neural origin with high mortality which occurs mostly in children and adolescents. The most common site of involvements are chest wall and paraspinal regions. Head and neck involvement is rare. The diagnosis is based upon histopathologic and immuno-histochemical studies. Treatment is combination of surgery, radiotherapy and chemotherapy. In this article we present a rather rare case of PNET which occurred in the neck area of a child.

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Introduction: Ischemic heart disease is the most common cause of mortality in developed countries. CABG (Coronary Artery Bypass Graft) is one of the therapeutic methods in ischemic heart disease.

Methods and Materials: Considering the increased incidence of coronary artery disease in Iran, and with increased rate of CABG, we performed a cross sectioned study (1996-1999). In 635 patients 467 male (73.5 percent), 168 female (26.5 percent) about risk factors of mortality after CABG in cardiac surgery department "Imam Khomeini hospital. 20 risk factors were included in our study: age, gender, smoking, family history, diabetes mellitus, morbid obesity, hypercholesterolemia, hypertension, palpitation, renal failure COPD, (chronic obstructive pulmonary disease), history of myocardial infarction, CHF, angina, cerebral vascular disease, pace maker, Ejection fraction<40 percent, history of PTCA, history of CPR, and coronary endarterectomy.

Results: Cigarette smoking (P=0.40), CHF in female (P=0.003). Endarterectomy in both gender (P=0.0001). Pace maker in both gender (P=0.00006), palpitation in both gender (P=0.0001). CPR in both gender (P=0.0000001), were associated with increased risk of mortality after CABG.

Conclusion: We found that, endarterctomy, cigarette smoking, CHF. Pace maker, CPR, and palpitation are important risk factors for mortality after CABG.

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Introduction: Unwanted pregnancy is one of the most important problems in family planning programs especially in developing countries. This cross-sectional study was conducted to determine the prevalence of unwanted pregnancy and factors that contributes to it's existence in ten cities in Islamic Republic of Iran.

Methods and Materials: From cases, 1548 subjects referring to the antenatal clinics of university hospitals in the following cities were included in the study: Fars, Systan and Balochestan, Hamedan, Kerman, West-Azarbayjan, Gillan, Khorasan, Khozestan, Isfahan. A face to face interview was conducted to fill out a questionnaire.

Results: The result suggests that the rate of unwanted pregnancy was reported around 34.96 percent. Familiarity with contraceptive methods was quite poor in some cities. Usage of contraceptive pills and condoms were also not correct and led to failure of the method by the rate of 12.5 percent and 8.8 percent respectively.

Conclusion: It is concluded that there is a need to plan a suitable educational plan in order to reduce the rate of the unwanted pregnancy.

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Background: The damaging effect of exposure to loud noise on the structures of internal ear has been studied from many years ago. The effect of drill-generated noise on the non-operated ear is one of the problems that are less discussed. This study aims to evaluate the hearing loss that occurs in the non-operated ear in patients who undergo mastoidectomy by use of PTA (pure tone audiometery) and DPOAE (distortion product otoacoustic emission).

Materials and Methods: In this descriptive- analytic study, 49 patients who underwent mastoidectomy in Amir-Alam and Iman Khomeini hospitals, were evaluated for noise trauma generated by drilling on the non-operated ear. Patients were between 9-55 years old (mean age= 29) and they consisted of 25 males and 24 females. The patient's preoperative state were measured by PTA and DPOAE on the opposite ear also the postoperative state were re-evaluated by PTA and DPOAE.

Results: As a result, in 4 cases a significant change in PTA thresholds were observed, while two of them showed recovery after one month. Seven cases showed significant change in DPOAE amplitudes, of whom five cases recovered later.

Conclusion: In conclusion, the drill-induced hearing loss on the non-operated ear occurs in a few patients and it is often reversible.

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Background: Umbilical cord blood gas analysis is a useful method for assessment of oxygenation and acid-base status in neonates. Severe fetal acidemia is associated with increased perinatal mortality and increased risk of subsequent impaired neurological development. Due to high percentage of C/S in our country and the effect of anesthetic medications on umbilical blood gases which can cause neonatal acidosis and hypoxemia, the study of umbilical cord blood gas in vaginal delivery versus cesarean section is mandatory.

Methods: In this cross-sectional study one hundred samples were taken from Mostafa Khomeini hospital in summer 2004. The samples were taken immediately of umbilical vein after clamping the umbilical cord and analyzed after 10 minutes. Cases were classified in to 3 groups: vaginal delivery (n=40), elective C/S under general anesthesia (n=35) and C/S under spinal anesthesia (n=25). Duration of anesthesia and its effect on blood gas and infants apgar were assessed.

Results: In the first group (vaginal delivery) mean blood gase parameters were pH=7.3064.73, pO2=25.246.87, HCO3=20.562.03, Apgar=8.820.38 and pCO2=41.826.57. In the second group (general anesthesia) mean blood gaze parameters were: pH=7.3044.73, pO2=38.7014.02, pCO2=43.265.87, HCO3=21.1113 and apgar score=8.170.7. In the third group (spinal anesthesia) mean blood gaze parameters were: pH=7.3014.50, pCO2=44.14.99, HCO3=21.382.15, pO2=26.625.5 and apgar=8.600.62. The apgar scores and pO2 demonstrated significant relationship with type of anesthesia. The apgar score was lower and pO2 was higher in C/S under general anesthesia compared with the other two groups. There was significant relationship between duration of anesthesia and umbilical pO With increasing duration of anesthesia, pO2 was reduced. Between the type of delivery and anesthesia duration with PH, pO2, pCO2 and HCO3 were not meaningful relationship (P<0.05).

Conclusion: There was no significant difference between type of delivery and umbilical blood gas parameters. Neonatal apgar score in NVD is higher than the other groups. With increasing duration of general anesthesia in C/S, umbilical po2 is reduced.

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Background: This prospective phase III study was designed to compare the activity of two combinations chemotherapy drugs in advanced gastric adenocarcinoma
Methods: In a double blinded clinical trial, From Jan. 2002 to Jan. 2005, ninety patients with advanced gastric adenocarcinoma were randomly assigned to 1) Cisplatin and continuous infusion of 5FU and Epirubicin (ECF), and 2) Cisplatin and continuous infusion of 5FU with Docetaxel (TCF). Reduction in tumor mass, overall survival (OS), time to progression (TTP), and safety were measured outcome.
Results: About 90% of patients had stage III or IV disease and the most common sites of tumor spread were peritoneal surfaces, liver and Paraaortic lymph nodes in either group. The objective clinical response rate (more than 50% decreases in tumor mass) was 38% and 43% in ECF and TCF group respectively. Global quality of life increased (p=0 002) and symptoms of pain and insomnia decreased after chemotherapy. Patients in TCF had more grade one or two skin reactions, neuropathy and diarrhea. Fourteen patients underwent surgery. Complete microscopic (R0) resection had done in two of ECF and six of TCF tumors (p=0.015). Two cases in TCF group showed complete pathologic response. Median TTP was nine months and 10 months in ECF and TCF group respectively. Median OS was 12 months in both groups.
Conclusion: Although there wasn’t statistically significant difference regarded to clinical response or survival between two groups, TCF showed more complete pathologic response.

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Background: A variable hematological value without clinical sign of sepsis or hematological disorder is often observed in newborns. The purpose of this study was to investigate hematological measurements in umbilical cord vein of newborns delivered spontaneously or by cesarean section.
Methods: We studied 150 pregnant women who delivered term normal infants. The patients were divided into two groups according to the route of delivery: vaginal (n=75) and cesarean section (n=75). Immediately after delivery, umbilical cord blood samples were collected. Any possible relationship between mode of delivery, gestational age, gravidity, parity, sex, weight of the new born infant, and the duration of different phase of labor with the hematological parameters was investigated.
Results: We observed a significant increase in all hematologic parameters including hemoglobin and hematocrit levels and WBC, platelet and RBC counts in newborns delivered spontaneously (p<0.001). The lymphocyte counts were similar in two groups. Male infants and newborns with higher gestational age showed a higher hemoglobin and hematocrit levels. Increased parity and gravidity correlated with a decrease in all hematological values of umbilical vein blood except of lymphocyte count (p<0.001). Prolonged duration of first and second stage was associated with higher mean leukocyte, neutrophil, platelet, hemoglobin and hematocrit values.
Conclusion: The mode of delivery, gestational age, parity, gravidity, sex and weight of newborn, and the duration of first and second stage of labor can influence on hematological parameters of umbilical cord blood.

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Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.

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Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.

Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI), Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ² and the logistic regression method.

Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001). The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001).

Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Chlamydia trachomatis is a common and curable STI that may be symptomatic or asymptomatic. The few studies on C. trachomatis among Iranian women have had, for the most part, small sample sizes and are therefore unsuitable for epidemiological deductions. The aim of this study was to estimate the prevalence of urogenital C. trachomatis infections by PCR on urine samples of married women in their fertile years in order to determine the need for a C. trachomatis screening program for asymptomatic women in Iran.
Methods: This descriptive-analytical and cross-sectional study was performed on 991 married women. The research material consisted of questionnaires and urine samples, which were transported daily to Avesina Research Institute, Tehran, Iran, to extract their DNA and prepare them for PCR tests. The gathered data were analyzed by SPSS, version 13, and evaluated statistically by t-test, chi-square test, Fisher's exact test and logistic regression, considering p<0.05 as significant.
Results: Of all the subjects, 127 (12.8%) were positive by PCR for C. trachomatis. The mean age of the participants was 28.88± 6.19 years. Infection was more prevalent among those with lower levels of education, who were employed and not pregnant. This infection was more prevalent among those who were using contraception, especially condoms. Reproductive history revealed that infection was more prevalent among participants with a history of vaginal discharge, pelvic pain, infertility and low birth-weight infants, and less prevalent among those with a history of abortion, preterm delivery and ectopic pregnancy. However, these patterns were not statistically significant.
Conclusion: In populations with C. trachomatis prevalences higher than 4%, screening programs are recommended. Thus, Chlamydia screening should be part of the health care program in Iran to reduce the burden of this disease. 

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Background: The relationship between coping styles and psychological adaptation during the recovery process was investigated in a sample of coronary heart disease (CHD) patients.

Methods: One hundred and fifty patients from Shahid Rajaee Heart Center, Tehran, Iran, were included in this study at intake and forty five patients (27 men, 18 women) participated in the follow-up study. All participants were asked to complete the Tehran Coping Styles Scale (TCSS) and Mental Health Inventory (MHI). The Recovery Process Questionnaire (RPQ) was completed using each patient's medical file and clinical examinations by cardiologists. Styles of coping with stress were categorized as problem-focused, positive emotional-focused and negative emotional-focused. Psychological adaptation included psychological well-being and psychological distress.

Results: Objective recovery status showed no significant correlation with either coping styles or psychological adaptation. Perceived recovery revealed a significant positive association with negative emotional-focused coping (p<0.05), but no significant correlation with other coping and psychological adaptation variables. Perceived recovery revealed a significant negative association with psychological distress (p<0.05), but showed no significant correlation with psychological well-being.

Conclusions: Perceived recovery in CHD patients is positively influenced by negative emotional-focused coping styles. Results and implications are discussed specifically in terms of the possible reasons for the positive relationship between perceived recovery and negative emotional-focused coping.

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Background: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis.

Methods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study). Using a questionnaire developed by COPCORD group (Asia & Oceania), we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations.

Results: Age (OR 1.096 CI95%: 1.091-1.1 P: 0.00) and sex (OR 2.85 CI95%: 2.49-3.28 P: 0.00) showed significant association with knee osteoarthritis. Overweight (OR 1.81 CI95%: 1.28-2.55 P: 0.00) and obesity (OR 3.3 CI95%: 2.34-4.66 P: 0.00) both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44 P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR 0.54 CI95%: 0.38-0.78 P: 0.00).

Conclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.

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Background: There are several evidences that genetic factors besides environmental triggers have important role in initiating the rheumatoid arthritis (RA). The aim of this study was to investigate the association of rheumatoid arthritis with different subtypes of HLA DR4 in Iranian patients.

Methods: In an un-matched case control study, 110 rheumatoid arthritis patients (case) and 56 knee osteoarthritis patients (control) of outpatient clinic in Shariati Hospital were entered to the study. After blood sampling from case and control groups, DNA was isolated by using salting-out method and HLA DR4 and its subtypes were detected. Association of HLA DR4 and its subtypes with rheumatoid arthritis, rheumatic factor and clinical manifestations of diseases was evaluated.

Results: Eighty nine (80.9%) of rheumatoid arthritis patients were female and 21 were male. Thirty four of the RA patients (30.9%) and eleven subjects from the control group (19.6%) were HLA DR4 positive (p=0.12). The most frequent subtype of HLA DR4 in RA patients was 0404 and in control group was 0401 (p=0.03). There were not statistically significant association between HLA DR4 and age of disease onset, family history, morning stiffness and rheumatoid factor. Joint swelling and tenderness had association with HLA DR4 (p=0.04 and p=0.03).

Conclusion: Although there were no statistically significant association between rheumatoid arthritis and HLA DR4, but prevalence of this HLA was higher in patients than control. It is possible that in some ethnics, other HLAs may have role in pathogenesis of disease.

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Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community.
Methods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden’s/ Bouchard’s nodes, CMC1’s squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis.
Results: Symptomatic hand osteoarthritis was present in 2.8%(CI 2.3-3.4) (52.6% female, mean age 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people <30 versus 23% in people >70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement.
Conclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Breast cancer is the most common cancer and the second most common cause of death from cancer in women. HER2 is an epidermal growth factor receptor which plays a substantial role in pathogenesis of breast cancer and also a target for new antineoplastic drug Herceptin. This study was conducted for determining the correlation between HER2 overexpression and histopathologic characteristics of breast cancer and also degree of intraobserver and interobserver agreement in scoring of Immnohistochemistry (IHC) slides between pathologists in samples referred to pathology ward.
Methods: This study was conducted as a descriptive cross sectional study. Among the breast cancer samples referred to pathology ward in Shariati Hospital in Tehran, Iran. 140 samples have been selected sequentially using simple non-random sampling method. All the information has been extracted using medical records and pathology reports.
Results: This study showed significant difference between diagnosis and HER2 status (p<0.05). Significant difference observed between lymph node invasion and HER2 status (p<0.05). Positive significant association between the size and tumor grade with HER2 status (r=0.188, p=0.026), Significant difference between histopathologic types with scoring of HER2 (p=0.001). Significant difference between histopathologic types with lymph node invasion (p=0.001). Agreement level of HER-2 scoring was shown to be nearly perfect between two observers (kappa statistic= 0.715) and the same observer (Kappa statistic= 0.78).
Conclusion: We do not recommend IHC and FISH test in invasive lobular carcinoma of breast and uncommon subgroups of breast cancer except in invasive ductal carcinoma and its subgroups.

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Background: Intravaginal misoprostol has been shown to be an effective agent forcervical ripening and induction of labor. The aim of present study was to assess the effects of adding hyoscine to vaginal misoprostol on its success rate. Methods: In a clinical trial, 74 women who were referred to undergo legal induction of labor during first pregnancy trimester in Arash Hospital, in Tehran, Iran, between March 2006 and March 2007 were enrolled, and were randomly divided in to two groups of misoprostol (400 μg/4h, vaginal) (n=37) or misoprostol (400 μg/4h, vaginal) plus hyoscine (20 mg IV) (n=37). Their complications including nausea, vomiting, fever, abdominal pain, need for analgesics, diarrhea, vaginal bleeding, decline in hemoglobin more than 3 g/dl, need for blood transfusion and failure of treatment according to the failure of induction of labor or cervical opening in 24 hours after starting treatment and the total duration of hospitalization were compared between groups. Results: There were no significant differences between groups regarding the rate of side effects like nausea, abdominal pain and vaginal bleeding. In misoprostol plus hyoscine group, the success rate in abortion was significantly higher (40.5% vs. 18.9%, p=0.04) and total duration of hospitalization were significantly lower (1.16±0.41 vs. 1.42±0.45 days, p=0.01). There was no case of fever, need for blood transfusion or significant vaginal bleeding in both groups. Conclusions: Adding 20 mg hyoscine via IV rout to vaginal misoprostol will raise the success rate in induction of abortion, and decreases the total duration of hospitalization without adding adverse effects.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Uterine smooth muscle tumors classified as leiomyoma, leiomyosarcoma and tumors with uncertain malignant potential. The leiomyoma and leiomyosarcoma are separated tumors biologically. Uterine smooth muscle tumors with uncertain malignant potential include a group of tumors which are not specifically placed into two others groups which result in a serious problem in a way of their treatment. In the present study expression of marker "p16" in smooth muscle tumors of uterine and normal myometrium has been investigated.
Methods: The entire paraffin blocks related to hysterectomy cases with diagnosis of normal myometrium, leiomyoma and leiomyosarcoma (3768 cases) available in pathology lab. in Shariati Hospital in Tehran, Iran from 1372 to 1387 were investigated. Among them 62 normal myometrium, 62 leiomyoma and 12 leiomyosarcoma had been chosen and after staining for marker "p16" were investigated separately.
Results: There were a statistically significant difference in both intensity and percentage of staining for this marker between leiomyoma and leiomiosarcoma (p< 0.001) and between leiomyosarcoma and normal myometrium (p< 0.001) but not between leiomyoma and normal myometrium (p= 3.6).
Conclusion: Based on this study if strong and more than focal immunoreactivity for marker "p16" suppose as positive then leiomyosarcoma will be positive for this marker but leiomyoma and normal myometrium will not be and this could be considered as a good guide for categorizing the uterine smooth muscle tumors.