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Sample records for anal intraepithelial neoplasia

  1. Anal squamous intraepithelial neoplasia.

    Science.gov (United States)

    Bejarano, Pablo A; Boutros, Marylise; Berho, Mariana

    2013-12-01

    Diagnosis, follow up, and treatment of anal intraepithelial neoplasia are complex and not standardized. This may be partly caused by poor communication of biopsy and cytology findings between pathologists and clinicians as a result of a disparate and confusing terminology used to classify these lesions. This article focuses on general aspects of epidemiology and on clarifying the current terminology of intraepithelial squamous neoplasia, its relationship with human papilloma virus infection, and the current methods that exist to diagnose and treat this condition.

  2. Anal intraepithelial neoplasia in HIV+ men

    NARCIS (Netherlands)

    Richel, O.

    2014-01-01

    In this thesis we investigated several aspects of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM). This condition has gained clinical interest because of the impressive increase of the anal cancer incidence in HIV+ MSM since the introduction of combination antiretroviral

  3. Anal cancer and intraepithelial neoplasia screening: Areview

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. Anumber of risk-stratification strategies as well as screeningtechniques have been suggested, and currently littleconsensus exists among national societies. Much ofthe current clinical rationale for the prevention of analcancer derives from the similar tumor biology of cervicalcancer and the successful use of routine screening toidentify cervical cancer and its precursors early in thedisease process. It is thought that such a strategy ofidentifying early anal intraepithelial neoplasia will reducethe incidence of invasive anal cancer. The low prevalenceof anal cancer in the general population prevents theuse of routine screening. However, routine screeningof selected populations has been shown to be a morepromising strategy. Potential screening modalities includedigital anorectal exam, anal Papanicolaou testing, humanpapilloma virus co-testing, and high-resolution anoscopy.Additional research associating high-grade dysplasiatreatment with anal cancer prevention as well as directcomparisons of screening regimens is necessary todevelop further anal cancer screening recommendations.

  4. Learning discriminative classification models for grading anal intraepithelial neoplasia

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    Kainz Philipp

    2016-09-01

    Full Text Available Grading intraepithelial neoplasia is crucial to derive an accurate estimate of pre-cancerous stages and is currently performed by pathologists assessing histopathological images. Inter- and intra-observer variability can significantly be reduced, when reliable, quantitative image analysis is introduced into diagnostic processes. On a challenging dataset, we evaluated the potential of learning a classifier to grade anal intraepitelial neoplasia. Support vector machines were trained on images represented by fractal and statistical features. We show that pursuing a learning-based grading strategy yields highly reliable results. Compared to existing methods, the proposed method outperformed them by a significant margin.

  5. Fractal dimension and image statistics of anal intraepithelial neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ahammer, H., E-mail: helmut.ahammer@medunigraz.a [Institute of Biophysics, Center of Physiological Medicine, Medical University of Graz, Harrachgasse 21, A-8010 Graz (Austria); Kroepfl, J.M. [Human Performance Research Graz (HPR Graz), Karl-Franzens and Medical University of Graz, Max-Mell Allee 11, A-8010 Graz (Austria); Hackl, Ch. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Sedivy, R. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria)

    2011-01-15

    Research Highlights: Human papillomaviruses cause anal intraepithelial neoplasia (AIN). Digital image processing was carried out to classify the grades of AIN quantitatively. The fractal dimension as well as grey value statistics was calculated. Higher grades of AIN yielded higher values of the fractal dimension. An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

  6. Anal intraepithelial neoplasia: A review of diagnosis and management

    Science.gov (United States)

    Roberts, Joseph R; Siekas, Lacey L; Kaz, Andrew M

    2017-01-01

    Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal mucosa that is a precursor to anal cancer. Although anal cancer is relatively uncommon, rates of this malignancy are steadily rising in the United States, and among certain high risk populations the incidence of anal cancer may exceed that of colon cancer. Risk factors for AIN and anal cancer consist of clinical factors and behaviors that are associated with the acquisition and persistence of human papilloma virus (HPV) infection. The strongest HPV-associated risk factors are HIV infection, receptive anal intercourse, and high risk sexual behavior. A history of HPV-mediated genital cancer, which suggests infection with an oncogenic HPV strain, is another risk factor for AIN/anal cancer. Because progression of AIN to anal cancer is known to occur in some individuals over several years, screening for AIN and early anal cancer, as well as treatment of advanced AIN lesions, is reasonable in certain high-risk populations. Although randomized controlled trials evaluating screening and treatment outcomes are lacking, experts support routine screening for AIN in high risk populations. Screening is performed using anal cytological exams, similar to those performed in cervical cancer screening programs, along with direct tissue evaluation and biopsy via high resolution anoscopy. AIN can be treated using topical therapies such as imiquimod, 5-flurouracil, and trichloroacetic acid, as well as ablative therapies such as electrocautery and laser therapy. Reductions in AIN and anal cancer rates have been shown in studies where high-risk populations were vaccinated against the oncogenic strains of HPV. Currently, the CDC recommends both high-risk and average-risk populations be vaccinated against HPV infection using the quadrivalent or nonavalent vaccines. It is important for clinicians to be familiar with AIN and the role of HPV vaccination, particularly in high risk populations. PMID:28255426

  7. Current treatment options for management of anal intraepithelial neoplasia

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    Weis SE

    2013-06-01

    Full Text Available Stephen E Weis1,2 1Division of Dermatology, Department of Internal Medicine, University of North Texas Health Science Center at Fort Worth, 2Preventive Medicine Clinic, Tarrant County Public Health, Fort Worth, TX, USA Abstract: Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepithelial neoplasia (HGAIN, the precursor of anal cancer, is identified by clinicians providing care for patients with anorectal disease, and is increasingly being identified during screening of immunosuppressed patients for anal dysplasia. The traditional treatment for HGAIN has been excision of macroscopic disease with margins. This approach is effective for patients with small unifocal HGAIN lesions. Patients with extensive multifocal HGAIN frequently have recurrence of HGAIN after excision, and may have postoperative complications of anal stenosis or fecal incontinence. This led to the suggestion by some that treatment for HGAIN should be delayed until patients developed anal cancer. Alternative approaches in identification and treatment have been developed to treat patients with multifocal or extensive HGAIN lesions. High-resolution anoscopy combines magnification with anoscopy and is being used to identify HGAIN and determine treatment margins. HGAIN can then be ablated with a number of modalities, including infrared coagulation, CO2 laser, and electrocautery. These methods for HGAIN ablation can be performed with local anesthesia on outpatients and are relatively well tolerated. High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent. Another treatment approach for HGAIN is topical treatment, principally with 5

  8. Manejo dos portadores das neoplasias intraepiteliais anais Managment of anal intra-epithelial neoplasia patients

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    Sidney Roberto Nadal

    2008-12-01

    Full Text Available Acredita-se que a neoplasia intraepitelial anal (NIA, provocada pelo HPV, seja a lesão precursora do carcinoma anal. Segundo a literatura, são encontradas entre 11% e 52% dos homens infectados pelo HIV, entre 6% a 20% dos homens e 1% a 2,8% das mulheres sem essa infecção. Entre 8,5% e 13% das NIA de alto grau evoluirão para carcinoma invasivo, indicando a necessidade do rastreamento e do seguimento desses doentes para prevenção. Não há tratamento satisfatório com baixos índices de morbidez e a recidiva é comum. Em geral, as formas de tratamento podem de ser divididas em tópicas, entre elas, ácido tricloroacético, podofilina, podofilotoxina, imiquimod, terapia fotodinâmica, e ablativas, ou seja, excisão cirúrgica, ablação pelo LASER, coagulação pelo infravermelho e eletrofulguração. Há, ainda, os que consideram aceitável a conduta expectante. O tratamento tópico se justifica pelo caráter multifocal da lesão e os ablativos têm taxas de complicação e recidiva muito semelhantes. De qualquer forma, doentes com qualquer anormalidade histológica necessitam de seguimento adequado, principalmente com colposcopia e citologia anal.Anal intra-epithelial neoplasia (AIN, provoked by HPV, is considered as an anal cancer precursor. Some articles noticed that it occurred among 11% and 52% of men who have sex with men (MSM infected with HIV and, among seronegatives, from 6% to 20% of men and from 1% to 2.8% of women. From 8.5% to 13% of high grade AIN will evolve to invasive carcinoma, needing follow-up and screening for prevention. There is no satisfactory treatment with low morbidity and recurrence is frequent. There are two main forms of treatment: topics (trichloroacetic acid, podophylin, podophylotoxin, imiquimod, photodynamic therapy and ablatives (chirurgical excision, LASER, infrared, eletrocautery. Others consider acceptable an expectant management. Topical therapy is justified because of multifocal presentation of HPV

  9. Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

    DEFF Research Database (Denmark)

    Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

    2012-01-01

    The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all......-associated histological types levelled out or even declined during the 30 years of observation. In women, the increase in HPV-associated cancers was more pronounced among those under 60 years of age. Our findings indicate that vaccines against HPV might play an important role in the prevention of anal cancer and its...... cases of AIN2/3 during the study period. The average annual percentage change of 5% between 1998 and 2008 represents a steep increase in the incidence of AIN in both genders. Furthermore, the incidence rate of HPV-associated anal cancers increased significantly, whereas that of non-HPV...

  10. Ki-67 expression in anal intraepithelial neoplasia in AIDS

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    Edenilson Eduardo Calore

    2001-05-01

    Full Text Available CONTEXT: AIDS is one of the most important risk factors for progression and recurrence of anogenital condyloma. In a previous work, we observed that patients with warts and high-grade AIN (HAIN had recurrences more frequently than did patients with warts without AIN. The mechanisms of this increased incidence of high-grade lesions in AIDS are not known. OBJECTIVE: We studied the expression of the proliferative marker Ki-67 by immunohistochemical methods, in specimens of anal condyloma from HIV+ patients to clarify whether its expression can be associated to the grade of AIN. DESIGN: A retrospective study of hiltological specimens. SETTING: University referral unit. SAMPLE: 34 patients were divided into two groups: (1 condylomas with low grade AIN (LAIN, with 25 patients; and (2 condylomas with HAIN, with 9 patients. In this latter group we examined two areas: 2A (HAIN area and 2B (LAIN area. MAIN MEASUREMENTS: The immunohistochemical reaction for Ki-67 was done on histological sections. Slices were lightly stained with hematoxylin, to help us in Ki-67 positive cell counting. The percentage of Ki-67 marked nuclei was calculated. We applied one-way variance analysis for statistics. RESULTS: The mean number of Ki-67 positive cells in group 1 was 19.68 ± 10.99; in group 2 (area A it was 46.73 ± 10.409; and in area B it was 36.43 ± 14.731. There were statistical differences between groups 1 and 2A and between groups 1 and 2B. Ki-67 positive cells predominated in the lower layer in LAIN. Positive Ki-67 cells were found in all layers in group 2A, and in group 2B they predominated in the two lower or in all layers of the epithelium. CONCLUSIONS: Our results suggest that LAIN areas (using routine staining techniques in HAIN can have a biological behavior more similar to HAIN.

  11. Risk Factors for the presence of anal intraepithelial neoplasia in HIV+ men who have sex with men.

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    Olivier Richel

    Full Text Available OBJECTIVE: Anal Intraepithelial Neoplasia (AIN is present in the majority of HIV+ men who have sex with men (MSM and routine AIN-screening is subject of discussion. In this study we analysed a wide range of potential risk factors for AIN in order to target screening programs. METHODS: We screened 311 HIV+ MSM by high resolution anoscopy, with biopsies of suspect lesions. HIV-parameters, previous sexual transmitted infections (STI's, anal pathology, sexual practices and substance use were analysed in relation to AIN by uni- and multivariable logistic regression. RESULTS: AIN (any grade was found in 175/311 MSM (56%, high grade (HGAIN in 30%. In the univariable analysis, years since HIV diagnosis, years of antiretroviral therapy (cART and anal XTC use decreased AIN risk, while a history of anogenital warts and use of GHB (γ-hydroxybutyric acid increased this risk. In the multivariable analysis three parameters remained significant: years of cART (OR=0.92 per year, p=0.003, anal XTC use (OR=0.10, p=0.002 and GHB use (OR=2.60, p=0.003. No parameters were significantly associated with HGAIN, but there was a trend towards increased risk with anal enema use prior to sex (>50 times ever; p=0.07 and with a history of AIN (p=0.06. CD4 count, STI's, anal pathology, smoking, number of sex partners and anal fisting were not associated with (HGAIN. CONCLUSION: GHB use increases the risk for AIN, while duration of cART and anal XTC use are negatively correlated with AIN. Given the high prevalence of AIN in HIV+ MSM, these associations are not helpful to guide a screening program.

  12. Risk Factors for the Presence of Anal Intraepithelial Neoplasia in HIV+ Men Who Have Sex with Men

    Science.gov (United States)

    Richel, Olivier; De Vries, Henry J. C.; Dijkgraaf, Marcel G. W.; Van Noesel, Carel J. M.; Prins, Jan M.

    2013-01-01

    Objective Anal Intraepithelial Neoplasia (AIN) is present in the majority of HIV+ men who have sex with men (MSM) and routine AIN-screening is subject of discussion. In this study we analysed a wide range of potential risk factors for AIN in order to target screening programs. Methods We screened 311 HIV+ MSM by high resolution anoscopy, with biopsies of suspect lesions. HIV-parameters, previous sexual transmitted infections (STI’s), anal pathology, sexual practices and substance use were analysed in relation to AIN by uni- and multivariable logistic regression. Results AIN (any grade) was found in 175/311 MSM (56%), high grade (HG)AIN in 30%. In the univariable analysis, years since HIV diagnosis, years of antiretroviral therapy (cART) and anal XTC use decreased AIN risk, while a history of anogenital warts and use of GHB (γ-hydroxybutyric acid) increased this risk. In the multivariable analysis three parameters remained significant: years of cART (OR=0.92 per year, p=0.003), anal XTC use (OR=0.10, p=0.002) and GHB use (OR=2.60, p=0.003). No parameters were significantly associated with HGAIN, but there was a trend towards increased risk with anal enema use prior to sex (>50 times ever; p=0.07) and with a history of AIN (p=0.06). CD4 count, STI’s, anal pathology, smoking, number of sex partners and anal fisting were not associated with (HG)AIN. Conclusion GHB use increases the risk for AIN, while duration of cART and anal XTC use are negatively correlated with AIN. Given the high prevalence of AIN in HIV+ MSM, these associations are not helpful to guide a screening program. PMID:24367625

  13. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

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    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  14. Oncogenicidade do papilomavírus humano e o grau de neoplasia intra-epitelial anal em doentes HIV positivo Human papillomavirus oncogenicity and grade of anal intraepithelial neoplasia in HIV positive patients

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    Carmen Ruth Manzione

    2004-09-01

    Full Text Available OBJETIVO: Avaliar se o grau de neoplasia intra-epitelial anal (NIA está associado ao tipo do HPV em doentes HIV positivo, já que esses apresentam imunodepressão durante longos períodos. MÉTODOS: Identificamos os tipos do HPV, pelo método da reação em cadeia da polimerase (PCR, e realizamos exame anatomo-patológico para avaliar o grau de NIA em 39 homens HIV positivo portadores de condilomas acuminados perianais. RESULTADOS: Observamos NIA de alto grau em nove (23,1% e NIA de baixo grau em 30 doentes (76,9%. Os tipos virais mais observados foram os não oncogênicos 6 e 11 em 64% e os oncogênicos 16, 18 e 31 em 20,5%. Não identificamos o tipo viral em quatro doentes (10,2%, embora o teste revelasse a presença do DNA viral. Comparando o padrão histológico e os tipos virais, observamos que os tipos não oncogênicos do HPV também podem estar associados ao desenvolvimento de NIA de alto grau. CONCLUSÃO: Os resultados obtidos nas condições de execução deste estudo permitem concluir que tanto os tipos oncogênicos como os não oncogênicos de HPV podem estar associados ao desenvolvimento de NIA de alto grau em doentes HIV positivo.OBJECTIVE: We decided to evaluate if grade of anal intraepithelial neoplasia (AIN was associated to the HPV type in HIV positive patients, since this group of patients has immunodeficiency over long periods. We identified HPV types by PCR (polimerase chain reaction and histological examination to determine the AIN grade in 39 HIV positive males with anal condylomata acuminata. RESULTS: We observed high grade AIN (HAIN in 9 (23.1 percent and low grade AIN (LAIN in 30 patients (76.9 percent. The most frequent HPV types were 6 and 11 (64 percent and oncogenic types 16, 18 and 31 appeared in 20.5 percent of patients. We could not identify viral type in four patients (10.2 percent despite tests revealing presence of viral deoxiribonucleic acid. Comparing AIN grades with viral types we observed that non

  15. PROSTATIC INTRAEPITHELIAL NEOPLASIA: HISTOLOGICAL ASSOCIATIONS

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    E. N. Gorbunova

    2009-01-01

    Full Text Available The authors determined the detection rates of prostatic intraepithelial neoplasia (PIN in 2317 patients with benign prostatic hyperplasia (BPH and prostate cancer (PC; and those of chronic prostatitis and fibrosis in patients with PIN, BPH, or PC. There was no difference in median age between the groups. PC was found to be more concurrent with PIN 2 than with BPH. The severer inflammation or fibrosis is, more likely there is a concomitance with PIN 2 or PC. There is evidence for the theory of inflammation is a factor of carcinogenesis. Prostatic fibrosis may also initiate carcinogenesis.

  16. PROSTATIC INTRAEPITHELIAL NEOPLASIA: HISTOLOGICAL ASSOCIATIONS

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    E. N. Gorbunova

    2014-08-01

    Full Text Available The authors determined the detection rates of prostatic intraepithelial neoplasia (PIN in 2317 patients with benign prostatic hyperplasia (BPH and prostate cancer (PC; and those of chronic prostatitis and fibrosis in patients with PIN, BPH, or PC. There was no difference in median age between the groups. PC was found to be more concurrent with PIN 2 than with BPH. The severer inflammation or fibrosis is, more likely there is a concomitance with PIN 2 or PC. There is evidence for the theory of inflammation is a factor of carcinogenesis. Prostatic fibrosis may also initiate carcinogenesis.

  17. CRYOTHERAPY IN CERVICAL INTRAEPITHELIAL NEOPLASIA

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    Naina Kumar

    2013-01-01

    Full Text Available Cryotherapy is a time proven ablative method of treating lower grades of cervical dysplasia. It  is done using compressed CO2 or N2O refrigerant with the aim of creating an ice ball with a depth of freeze denoted by a peripheral margin of 4-5 mm of frost. It is performed using a double freeze or single freeze technique. Currently the double freeze technique of cryotherapy is an accepted treatment for mild and focal moderate dysplasia of the uterine cervix. The success of cryotherapy is determined by five factors : patient anatomy, pathology, equipment, technique and physician skill. Here we have a brief review of cryotherapy as an effective modality in treatment of lower grades of cervical intraepithelial neoplasias.

  18. Management of Anal Squamous Intraepithelial Lesions

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    Pineda, Carlos E.; Welton, Mark L.

    2009-01-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is ...

  19. Fractal analysis of cervical intraepithelial neoplasia.

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    Markus Fabrizii

    Full Text Available INTRODUCTION: Cervical intraepithelial neoplasias (CIN represent precursor lesions of cervical cancer. These neoplastic lesions are traditionally subdivided into three categories CIN 1, CIN 2, and CIN 3, using microscopical criteria. The relation between grades of cervical intraepithelial neoplasia (CIN and its fractal dimension was investigated to establish a basis for an objective diagnosis using the method proposed. METHODS: Classical evaluation of the tissue samples was performed by an experienced gynecologic pathologist. Tissue samples were scanned and saved as digital images using Aperio scanner and software. After image segmentation the box counting method as well as multifractal methods were applied to determine the relation between fractal dimension and grades of CIN. A total of 46 images were used to compare the pathologist's neoplasia grades with the predicted groups obtained by fractal methods. RESULTS: Significant or highly significant differences between all grades of CIN could be found. The confusion matrix, comparing between pathologist's grading and predicted group by fractal methods showed a match of 87.1%. Multifractal spectra were able to differentiate between normal epithelium and low grade as well as high grade neoplasia. CONCLUSION: Fractal dimension can be considered to be an objective parameter to grade cervical intraepithelial neoplasia.

  20. Clinical effectiveness and cost-effectiveness of quadrivalent human papillomavirus vaccination in HIV-negative men who have sex with men to prevent recurrent high-grade anal intraepithelial neoplasia.

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    Deshmukh, Ashish A; Chiao, Elizabeth Y; Das, Prajnan; Cantor, Scott B

    2014-12-05

    We examined the long-term clinical and economic benefits of quadrivalent human papillomavirus (qHPV) vaccine as a secondary/adjunct prevention strategy in the prevention of recurrent high-grade intraepithelial neoplasia (HGAIN) in HIV-negative men who have sex with men (MSM) and are 27 years or older. We constructed a Markov model to evaluate the clinical effectiveness and cost-effectiveness of two strategies: (1) no qHPV vaccine after treatment for HGAIN versus (2) qHPV vaccine after treatment for HGAIN. Model parameters, including natural history of anal cancer, vaccine efficacy measured in terms of hazard ratio (HR) (decrease in the risk of recurrent HGAIN), HGAIN treatment efficacy, utilities, and costs, were obtained from the literature. The outcomes were measured in terms of lifetime risk of anal cancer, lifetime cost, quality-adjusted life years, and incremental cost-effectiveness ratios (ICERs). Sensitivity analysis was conducted on all model parameters. We found that vaccinating HIV-negative MSM reduced the lifetime risk of anal cancer by 60.77% at an ICER of US$87,240 per quality-adjusted life-year. The results were highly sensitive to vaccine efficacy, transition of HGAIN to anal cancer, cost of treatment for HGAIN, vaccine degree of protection over time, and the vaccine duration of protection and less sensitive to HPV clearance, cost of qHPV vaccine, and the transitions from normal to low-grade anal intraepithelial neoplasia (LGAIN) and normal to HGAIN. With an HR of 0.3, the ICER was well below a $50,000 willingness-to-pay threshold; with an HR of 0.5, the ICER was still below a threshold of $100,000. The most critical disease-related factor influencing the cost-effectiveness was the progression of HGAIN to anal cancer. At an annual transition probability below 0.001, the ICER was below $50,000. Vaccinating HIV-negative MSM treated for HGAIN decreases the lifetime risk of anal cancer and is likely to be a cost-effective intervention.

  1. Management of anal squamous intraepithelial lesions.

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    Pineda, Carlos E; Welton, Mark L

    2009-05-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is unknown, there is significant evidence that untreated HSIL progresses to squamous cell carcinoma in 11% of patients and in up to 50% of patients with extensive disease and immunosuppression. Anal cytology and reflex HPV DNA testing are used to screen for disease, particularly among patients with the aforementioned risk factors. Evaluation of the patient should include physical examination and high-resolution anoscopy (HRA) to evaluate for disease above and below the dentate line. Intervention is warranted and this can be achieved in many ways. The treatment option associated with the best outcomes is ablation directed with HRA, which can be performed in the office or in the operating room with minimal morbidity. This strategy is effective in patients with both low-volume and high-volume disease and is associated with a malignant progression rate of 0.4% in patients with treated HSIL.

  2. Photodynamic therapy of cervical intraepithelial neoplasia

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    Inada, Natalia M.; Lombardi, Welington; Leite, Marieli F. M.; Trujillo, Jose R.; Kurachi, Cristina; Bagnato, Vanderlei S.

    2014-03-01

    Photodynamic therapy (PDT) is a technique that has been used for the treatment of tumors, especially in Gynecology. The photodynamic reaction is based on the production of reactive oxygen species after the activation of a photosensitizer. Advantages of the PDT in comparison to the surgical resection are: ambulatory treatment and tissue recovery highly satisfactory, through a non-invasive procedure. The cervical intraepithelial neoplasia (CIN) grades I and II presents potential indications for PDT. The aim of the proposed study is to evaluate the safety and efficacy of the PDT for the diagnostics and treatment of CIN I and II. The equipment and the photosensitizer are produced in Brazil with a representative low cost. It is possible to visualize the fluorescence of the cervix and to treat the lesions, without side effects. The proposed clinical protocol shows great potential to become a public health technique.

  3. Histologic classification of penile intraepithelial neoplasia.

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    Velazquez, Elsa F; Chaux, Alcides; Cubilla, Antonio L

    2012-05-01

    Penile squamous cell carcinomas (SCCs) and their corresponding precancerous lesions can be classified in 2 major groups: human papillomavirus (HPV) related and HPV unrelated. In the former (warty and basaloid SCC), there is a predominance of undifferentiated basaloid cells. In the latter (eg, usual, papillary, and verrucous SCC), the predominant cell is larger with abundant eosinophilic cytoplasm. Based on these morphologic features, a new term, "penile intraepithelial neoplasia" (PeIN), was proposed. PeIN was further subclassified into differentiated and undifferentiated, with the latter being subdivided into basaloid, warty, and warty-basaloid subtypes. Macroscopically, PeIN subtypes are indistinguishable. Microscopically, differentiated PeIN is characterized by acanthosis, parakeratosis, enlarged keratinocytes with abundant "pink" cytoplasm (abnormal maturation), and hyperchromatic cells in the basal layer. In basaloid PeIN the epithelium is replaced by a monotonous population of uniform, small, round, and basophilic cells. Warty PeIN is characterized by a spiky surface, prominent atypical parakeratosis, and pleomorphic koilocytosis. Warty-basaloid PeIN show features of both warty and basaloid PeIN. There is a significant association of subtypes of PeIN with specific variants of invasive SCCs. This is a simple and reproducible nomenclature for penile precancerous lesions based on cell type and differentiation. It takes into account the similarities between vulvar and penile pathology and the hypothesis of a bimodal pathway of penile cancer progression.

  4. Telomerase activity in cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    王淑珍; 孙建衡; 张伟; 金顺钱; 王洪平; 金玉生; 曲萍; 刘毅; 李茉

    2004-01-01

    Background It was reported that telomerase expression is closely associated with cellular immortality and cancer. This study was designed to investigate the relationship between telomerase expression and the carcinogenesis of cervical cancer, the possible use of telomerase as a marker of cervical intraepithelial neoplasia (CIN) progression or regression, and the natural history of CIN. Methods Telomeric repeat amplification protocol (TRAP) assay was used to measure telomerase activity in cervical scrapings and biopsy samples obtained from 105 cases affected with various cervical conditions, including chronic cervicitis (n=20), CIN (n=64, 16 cases of CIN Ⅰ , 20 cases of CIN Ⅱ, and 28 cases of CIN Ⅲ ), and invasive squamous cell carcinoma (n =21 ).Results In exfoliated cell samples, telomerase activity was detected in 5 of 20 (25. 0% ) cases of cervicitis, 10 of 16 (62.5%) cases of CIN Ⅰ , 11 of 20 (55.0%) cases of CIN Ⅱ, 23 of 28 (82.1%) cases of CIN Ⅲ, and 13 of 21 (61.9%) cases of carcinoma. In cervical biopsy samples, telomerase activity was detected in 6 of 20 (30. 0%) cases of cervicitis, 8 of 16 (50. 0%) cases of CIN Ⅰ , 9 of 20 (45.0%) cases of (CIN Ⅱ, 27 of 28 (96. 4%) cases of CIN Ⅲ, and 20 of 21 (95. 2%) cases of carcinoma. Telomerase activation was significantly higher in CIN samples than in cervicitis samples. Telomerase activity was detected at similar frequency in samples from cervical scrapings and cervical biopsies.Conclusion These results seem to suggest that telomerase expression may be associated with carcinogenesis of the cervix. TRAP assay of cervical scraping samples could be used to monitor and predict the development of CIN in clinical practice.

  5. Long-term adherence to follow-up after treatment of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjær; Lynge, Elsebeth; Søgaard-Andersen, Erik;

    2013-01-01

    OBJECTIVE: To measure adherence to annual follow-up among women treated for cervical intraepithelial neoplasia. DESIGN: Prospective, population-based, register study. SETTING: Denmark, 1996-2007. POPULATION: All women treated for cervical intraepithelial neoplasia with conization. METHODS: Treate...

  6. Association of human immunodeficiency virus-induced immunosuppression with human papillomavirus infection and cervical intraepithelial neoplasia.

    Science.gov (United States)

    Henry, M J; Stanley, M W; Cruikshank, S; Carson, L

    1989-02-01

    Human papillomavirus infection plays an important causal role in cervical intraepithelial neoplasia and carcinoma. The rate of infection with human papillomavirus as well as the incidence of cervical intraepithelial neoplasia and carcinoma are increased in immunosuppressed patients. We report a possible association between infection with human immunodeficiency virus and cervical intraepithelial neoplasia with human papillomavirus infection.

  7. Molecular biological factors in the diagnosis of cervical intraepithelial neoplasias

    Directory of Open Access Journals (Sweden)

    Yu. N. Ponomareva

    2010-01-01

    Full Text Available The authors have made a complex analysis of the molecular biological factors associated with cervical intraepithelial neoplasia. They have revealed that infection by oncogenic human papillomavirus types is associated with suppressed apoptosis and enhanced cellular proliferative activity, which can be effectively used in the diagnosis and prediction of cervical neoplasias to optimize management tac- tics and to improve the results of treatment.

  8. Chlamydia trachomatis infection and risk of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Lehtinen, Matti; Ault, Kevin A; Lyytikainen, Erika

    2011-01-01

    High-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. As Chlamydia trachomatis is also linked to cervical cancer, its role as a potential co-factor in the development of cervical intraepithelial neoplasia (CIN) grade 2 or higher was examined....

  9. Anal cytology and p16 immunostaining for screening anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men: a cross-sectional study.

    Science.gov (United States)

    Arora, Rahul; Pandhi, Deepika; Mishra, Kiran; Bhattacharya, Sambit N; Yhome, Vizodilhou A

    2014-09-01

    Summary Akin to cervical cancer in sexually-active women, men who have sex with men (MSM) are predisposed to anal cancers, especially those with HIV co-infection. This cross-sectional study endeavored to assess the prevalence of anal dysplasia using Pap smears and p16 immunostaining amongst Indian MSM. A total of 31 consecutive HIV-positive and 34 HIV-negative MSM, from a cohort of sexually transmitted infection clinic attendees, underwent anal cytological evaluation with Pap smear and p16 staining. Chi square test and coefficient of correlation were used for comparison. Eighteen (27.7%) had abnormal anal cytology; increased in HIV-positive as compared to HIV-negative men (35% versus 20%, p = 0.180). Similarly, both low-grade (25.8% versus 17.6%) and high-grade lesions (8.3% versus 4.8%) were comparable in HIV-positive and HIV-negative group. Thirteen (20%) smears were p16-positive with a sensitivity and specificity for anal dysplasia of 72.3% and 100%, respectively. Anal cytology may be used to screen for anal dysplasia in MSM irrespective of HIV status. Furthermore, the addition of p16, with greater specificity for high-grade lesions, may improve diagnostic accuracy especially for high-grade lesions. A larger study to further corroborate these observations is warranted.

  10. Risk of cervical intraepithelial neoplasia in women with glomerulonephritis.

    OpenAIRE

    Hartveit, F.; Bertelsen, B; Thunold, S; Maehle, B O; Skaarland, E; J. Christensen

    1991-01-01

    OBJECTIVE--To investigate the occurrence of cervical intraepithelial neoplasia in women with glomerulonephritis and its possible association with immunosuppressive treatment. DESIGN--Retrospective study of cytological or histological specimens from women presenting with glomerulonephritis and a group of case and age matched controls. SETTING--University department of pathology, Norway. PATIENTS--81 women presenting with glomerulonephritis from 1981 to 1988, from whom gynaecological cytologica...

  11. Vaginal cancer in a patient treated for cervical intraepithelial neoplasia (CIN 3): case report.

    Science.gov (United States)

    Androutsopoulos, G; Adonakis, G; Ravazoula, P; Kourounis, G

    2006-01-01

    In 1% to 3% of patients with cervical intraepithelial neoplasia (CIN), vaginal intraepithelial neoplasia (VAIN) will either coexist or occur at a later date. The time interval from an earlier diagnosis of CIN 3 to a current diagnosis of VAIN 3 varies from two to 17 years. Invasive vaginal cancer occurred in a woman five years after total abdominal hysterectomy for cervical intraepithelial neoplasia. In women who have undergone total hysterectomy for cervical intraepithelial neoplasia or cervical cancer, postoperative cytologic and colposcopic follow-up of the vagina is necessary.

  12. Anal intraepitelial neoplasia: a narrative review

    Directory of Open Access Journals (Sweden)

    Garazi Elorza

    2016-01-01

    Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

  13. Neoplasia intraepitelial vulvar: um problema atual Vulvar intraepithelial neoplasia: a current problem

    Directory of Open Access Journals (Sweden)

    José Alberto Fonseca-Moutinho

    2008-08-01

    Full Text Available A neoplasia intraepitelial da vulva (VIN é uma denominação que foi introduzida incialmente pela International Society for Study of Vulvo-vaginal Diseases (ISSVD e reconhecida posteriormente pela International Society of Gynaecological Pathology (ISGYP e Organização Mundial da Saúde. É uma entidade patológica a que correspondem as VIN de tipo usual (verrucoso, basalióide e misto e as VIN de tipo diferenciado. A incidência das lesões de VIN tem aumentado progressivamente, principalmente em mulheres jovens. A infecção pelo papilomavírus humano (HPV de alto risco, pelo vírus da imunodeficiência humana (HIV, o tabagismo e a neoplasia intraepitelial do colo do útero, da vagina e região anal são factores de risco estabelecidos para as VIN. Não existem sintomas e sinais característicos das VIN, mas a doença se traduz sempre por lesões clinicamente identificáveis. A biópsia com o auxílio do colposcópio permite o diagnóstico. O tratamento da doença está sempre justificado pelo elevado risco de progressão para cancro invasivo. A excisão alargada das lesões ou a sua destruição com laser CO2 têm sido os métodos mais populares de tratamento. Independentemente do método terapêutico utilizado, as taxas de recidiva são elevadas, pelo que está aconselhada a vigilância apertada das doentes após tratamento. A terapêutica tópica com imiquimod se afigura promissora no tratamento das VIN. As vacinas profiláticas contra os tipos de HPV de alto risco prometem se tornar armas poderosas na prevenção primária da doença.Vulvar intraepithelial neoplasia (VIN is a pathological denomination coined by the International Society for Study of Vulvo-vaginal Diseases (ISSVD and adopted by the International Society of Gynaecological Pathology (ISGYP and by the World Health Organization. VIN is a heterogeneous pathological entity with a usual type (warty, basaloid and mixed and a differentiated type. The incidence of the disease is

  14. [New challenges to the treatment of cervical intraepithelial neoplasia].

    Science.gov (United States)

    Sun, J H

    2016-07-01

    Due to the progress of intracavitary afterloading technology and dosage of brachytherapy, a similar dose distribution as that of cervical conization can be achieved and can be applied to the treatment of cervical intraepithelial neoplasia (CIN), it is called "afterloading conization" . Being adjusted the radioactive source movement and weight, low exposure doses to the ovary, endometrium and vagina can be assured. So a high quality of life after treatment could be maintained and overcomes the shortcomings of cervical conization and hysterectomy, such as anesthesia, bleeding, over or insufficient treatment, early ovarian ageing and operative complications.

  15. Photodynamic therapy of cervical intraepithelial neoplasia using hexaminolevulinate and methylaminolevulinate

    Science.gov (United States)

    Soergel, Philipp; Staboulidou, Ismini; Hertel, Herrmann; Schippert, Cordula; Hillemanns, Peter

    2009-06-01

    Cervical intraepithelial neoplasia (CIN) is the precursor of invasive cervical cancer. Previous studies indicated that photodynamic therapy (PDT) represents an effective treatment modality in CIN. In 28 patients with CIN 1 - 3, 1 - 2 cycles of PDT were conducted using hexaminolevulinate (HAL) or methylaminolevulinate (MAL) and a special light delivery system. After 6 months, biopsies were obtained to assess response. The overall response rate for complete or partial response was 65%. Photodynamic therapy using new ALA esters is effective and may offer unique advantages in the therapy of CIN.

  16. Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Njor, Sisse; Lynge, Elsebeth

    2015-01-01

    BACKGROUND: Treatment of cervical intraepithelial neoplasia (CIN) is a common minor surgical procedure to prevent uterine cervical cancer. However, news of an abnormality detected at screening for cancer might cause the woman to worry. OBJECTIVES: To investigate the psychological consequences...... psychological outcomes in women with a histological diagnosis or treatment of CIN, and in women having an outcome other than CIN at cervical screening. DATA COLLECTION AND ANALYSIS: We abstracted the data using a pre-specified list of study characteristics and measured outcomes. For studies not reporting...... statistical testing, we estimated the statistical significance of the differences between the compared groups using unpaired t tests. MAIN RESULTS: From 5099 retrieved abstracts, 16 studies were included. Diagnosis and treatment of CIN were associated with worse psychological outcomes than normal cytology...

  17. Treatment of cervical intraepithelial neoplasia in Denmark 1991 to 2007

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjær

    2010-01-01

    Abstract: Objectives: The number of invasive cervical cancers peaked in Denmark in 1966 with 963 cases. Cervical cancer is prevented by treatment of screen-detected cervical intraepithelial neoplasia (CIN). We assessed the trend in CIN treatments in Denmark. Material and Methods: From highly...... the data using the unique Danish identification numbers, and excluded all duplicate registrations. We excluded all destructive therapies and hysterectomies for which no CIN or cervical cancer diagnosis was found in the period from 3 months before to 1 month after the treatment date. We age......-standardized the number of cervical treatments using Danish women in 2007 as standard population. Results: The preliminary analysis shows that the number of treatments increased from about 6,000 in 1991 to about 8,200 in 2007, most noticeably due to an increase of about 2,600 in the number of conisations (Figure 1...

  18. Photodynamic therapy of Cervical Intraepithelial Neoplasia (CIN) high grade

    Science.gov (United States)

    Carbinatto, Fernanda M.; Inada, Natalia M.; Lombardi, Welington; da Silva, Eduardo V.; Belotto, Renata; Kurachi, Cristina; Bagnato, Vanderlei S.

    2016-02-01

    Cervical intraepithelial neoplasia (CIN) is the precursor of invasive cervical cancer and associated with human papillomavirus (HPV) infection. Photodynamic therapy (PDT) is a technique that has been used for the treatment of tumors. PDT is based on the accumulation of a photosensitizer in target cells that will generate cytotoxic reactive oxygen species upon illumination, inducing the death of abnormal tissue and PDT with less damaging to normal tissues than surgery, radiation, or chemotherapy and seems to be a promising alternative procedure for CIN treatment. The CIN high grades (II and III) presents potential indications for PDT due the success of PDT for CIN low grade treatment. The patients with CIN high grade that were treated with new clinic protocol shows lesion regression to CIN low grade 60 days after the treatment. The new clinical protocol using for treatment of CIN high grade shows great potential to become a public health technique.

  19. Endometrial Intraepithelial Neoplasia (EIN In An Endometrial Polyp

    Directory of Open Access Journals (Sweden)

    Devic Ana

    2015-12-01

    Full Text Available Endometrial intraepithelial neoplasia (EIN is a monoclonal neoplastic cell proliferation of the endometrium associated with a significantly increased risk of endometrioid endometrial adenocarcinoma. We herein present the case of a 58-year-old female patient who underwent a hysterectomy with bilateral salpingo-oophorectomy because of the existence of endometrial intraepithelial neoplasia in an endometrial polyp. The patient had irregular uterine bleeding, which lasted 10 days. An endometrial polyp was diagnosed by ultrasound examination. The polyp was located in the isthmus of the uterus, on the back wall, and measured 32 mm × 25 mm. The patient underwent fractional dilation and curettage, and the specimens were subjected to a histopathological examination. The histopathological findings were EIN, endometrioid type, a focus of which was found within the endometrial polyps, as well as the endometrial polyp and proliferative endometrium. The endocervical tissue was normal. Given the age of the patient and the histopathological findings, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The final histopathological findings were EIN, endometrioid type with a focus found within the endometrial polyp; endometrial polyp; simple hyperplasia; chronic inflammation of the uterine cervix; hyperkeratosis of the cervical squamous epithelium; and cervicitis chronica. There was also hydrosalpinx of the left fallopian tube, and cystic follicles in the left ovary. There was no significant morphological change in the right ovary or fallopian tube. The surgical and postoperative course were normal. The patient was sent home on the fifth postoperative day in good general condition. A check-up performed one month after surgery showed normal findings.

  20. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions

    Directory of Open Access Journals (Sweden)

    Arain Shehla

    2005-01-01

    Full Text Available Abstract Background Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs. This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. Methods The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. Results Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK, atypical parakeratotic cells (APK, and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. Conclusions In this study liquid based anal smears had a high sensitivity (98% for detection of ASIL but a low specificity (50% for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46–56% of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  1. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions.

    Science.gov (United States)

    Arain, Shehla; Walts, Ann E; Thomas, Premi; Bose, Shikha

    2005-02-16

    BACKGROUND: Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs). This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. METHODS: The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. RESULTS: Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK), atypical parakeratotic cells (APK), and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. CONCLUSIONS: In this study liquid based anal smears had a high sensitivity (98%) for detection of ASIL but a low specificity (50%) for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46-56%) of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  2. Genome-wide methylation profiling identifies hypermethylated biomarkers in high-grade cervical intraepithelial neoplasia

    NARCIS (Netherlands)

    Lendvai, Ágnes; Johannes, Frank; Grimm, Christina; Eijsink, Jasper J H; Wardenaar, René; Volders, Haukeline H; Klip, Harry G; Hollema, Harry; Jansen, Ritsert C; Schuuring, Ed; Wisman, G Bea A; van der Zee, Ate G J

    2012-01-01

    Epigenetic modifications, such as aberrant DNA promoter methylation, are frequently observed in cervical cancer. Identification of hypermethylated regions allowing discrimination between normal cervical epithelium and high-grade cervical intraepithelial neoplasia (CIN2/3), or worse, may improve curr

  3. Pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia:repor t of a case

    Institute of Scientific and Technical Information of China (English)

    Rajkumar Krishnasamy; Shaleen Agarwal; Shivendra Singh; Sunil Puri; Puja Sakhuja; Anil K Agarwal

    2007-01-01

    BACKGROUND:The presence of pancreatic ductal intraepithelial neoplasia in patients with chronic pancreatitis is a risk factor for development of pancreatic adenocarcinoma. METHOD: A case of pancreatic ductal adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia was diagnosed in the setting of chronic pancreatitis. RESULTS:Distal pancreatectomy combined with splenec-tomy was performed with a diagnosis of pancreatic body carcinoma. Histopathological examination suggested adenocarcinoma associated with pancreatic ductal intraepithelial neoplasia. The tumor was detected in the remaining head of the pancreas, for which a total pancreatectomy was done. CONCLUSIONS: When a patient with pancreatic ductal intraepithelial neoplasia associated with adenocarcinoma of the pancreas in the setting of chronic pancreatitis is at an increased risk of recurrence in the remaining pancreatic parenchyma, total pancreatectomy may be feasible.

  4. Observer variation in histopathological diagnosis and grading of cervical intraepithelial neoplasia.

    OpenAIRE

    Ismail, S. M.; Colclough, A. B.; Dinnen, J. S.; Eakins, D.; Evans, D M; Gradwell, E.; O'Sullivan, J. P.; Summerell, J M; Newcombe, R G

    1989-01-01

    To assess the variability among histopathologists in diagnosing and grading cervical intraepithelial neoplasia eight experienced histopathologists based at different hospitals examined the same set of 100 consecutive colposcopic cervical biopsy specimens and assigned them into one of six diagnostic categories. These were normal squamous epithelium, non-neoplastic squamous proliferations, cervical intraepithelial neoplasia grades I, II, and III, and other. The histopathologists were given curr...

  5. Cervical Intraepithelial Neoplasia Is Associated With Genital Tract Mucosal Inflammation

    Science.gov (United States)

    Mhatre, Mohak; McAndrew, Thomas; Carpenter, Colleen; Burk, Robert D.; Einstein, Mark H.; Herold, Betsy C.

    2013-01-01

    Background Clinical studies demonstrate increased prevalence of human papillomavirus (HPV)-associated disease in HIV-infected individuals and an increased risk of HIV acquisition in HPV-infected individuals. The mechanisms underlying this synergy are not defined. We hypothesize that women with cervical intraepithelial neoplasia (CIN) will exhibit changes in soluble mucosal immunity that may promote HPV persistence and facilitate HIV infection. Methods The concentrations of immune mediators and endogenous anti-Escherichia coli activity in genital tract secretions collected by cervicovaginal lavage were compared in HIV-negative women with high-risk HPV-positive (HRHPV+) CIN-3 (n = 37), HRHPV+ CIN-1 (n = 12), or PAP-negative control subjects (n = 57). Results Compared with control subjects, women with CIN-3 or CIN-1 displayed significantly higher levels of proinflammatory cytokines including interleukin (IL)-1α, IL-1β, and IL-8 (P < 0.002) and significantly lower levels of anti-inflammatory mediators and antimicrobial peptides, including IL-1 receptor antagonist, secretory leukocyte protease inhibitor (P < 0.01), and human β defensins 2 and 3 (P < 0.02). There was no significant difference in endogenous anti-E. coli activity after controlling for age and sample storage time. Conclusion HRHPV+ CIN is characterized by changes in soluble mucosal immunity that could contribute to HPV persistence. The observed mucosal inflammation suggests a mechanism that may also contribute to the epidemiologic link between persistent HPV and HIV. PMID:22801340

  6. In vivo detection of cervical intraepithelial neoplasia by multimodal colposcopy

    Science.gov (United States)

    Ren, Wenqi; Qu, Yingjie; Pei, Jiaojiao; Xiao, Linlin; Zhang, Shiwu; Chang, Shufang; Smith, Zachary J.; Xu, Ronald X.

    2016-03-01

    Cervical cancer is the leading cause of cancer death for women in developing countries. Colposcopy plays an important role in early screening and detection of cervical intraepithelial neoplasia (CIN). In this paper, we developed a multimodal colposcopy system that combines multispectral reflectance, autofluorescence, and RGB imaging for in vivo detection of CIN, which is capable of dynamically recording multimodal data of the same region of interest (ROI). We studied the optical properties of cervical tissue to determine multi-wavelengths for different imaging modalities. Advanced algorithms based on the second derivative spectrum and the fluorescence intensity were developed to differentiate cervical tissue into two categories: squamous normal (SN) and high grade (HG) dysplasia. In the results, the kinetics of cervical reflectance and autofluorescence characteristics pre and post acetic acid application were observed and analyzed, and the image segmentation revealed good consistency with the gold standard of histopathology. Our pilot study demonstrated the clinical potential of this multimodal colposcopic system for in vivo detection of cervical cancer.

  7. Challenges in automated detection of cervical intraepithelial neoplasia

    Science.gov (United States)

    Srinivasan, Yeshwanth; Yang, Shuyu; Nutter, Brian; Mitra, Sunanda; Phillips, Benny; Long, Rodney

    2007-03-01

    Cervical Intraepithelial Neoplasia (CIN) is a precursor to invasive cervical cancer, which annually accounts for about 3700 deaths in the United States and about 274,000 worldwide. Early detection of CIN is important to reduce the fatalities due to cervical cancer. While the Pap smear is the most common screening procedure for CIN, it has been proven to have a low sensitivity, requiring multiple tests to confirm an abnormality and making its implementation impractical in resource-poor regions. Colposcopy and cervicography are two diagnostic procedures available to trained physicians for non-invasive detection of CIN. However, many regions suffer from lack of skilled personnel who can precisely diagnose the bio-markers due to CIN. Automatic detection of CIN deals with the precise, objective and non-invasive identification and isolation of these bio-markers, such as the Acetowhite (AW) region, mosaicism and punctations, due to CIN. In this paper, we study and compare three different approaches, based on Mathematical Morphology (MM), Deterministic Annealing (DA) and Gaussian Mixture Models (GMM), respectively, to segment the AW region of the cervix. The techniques are compared with respect to their complexity and execution times. The paper also presents an adaptive approach to detect and remove Specular Reflections (SR). Finally, algorithms based on MM and matched filtering are presented for the precise segmentation of mosaicism and punctations from AW regions containing the respective abnormalities.

  8. Imiquimod in cervical, vaginal and vulvar intraepithelial neoplasia: a review.

    Science.gov (United States)

    de Witte, C J; van de Sande, A J M; van Beekhuizen, H J; Koeneman, M M; Kruse, A J; Gerestein, C G

    2015-11-01

    Human papillomavirus (HPV) infection is in the vast majority of patients accountable for the development of vulvar, cervical and vaginal intraepithelial neoplasia (VIN, CIN, VAIN); precursors of vulvar, cervical and vaginal cancers. The currently preferred treatment modality for high grade VIN, CIN and VAIN is surgical excision. Nevertheless surgical treatment is associated with adverse pregnancy outcomes and recurrence is not uncommon. The aim of this review is to present evidence on the efficacy, safety and tolerability of imiquimod (an immune response modifier) in HPV-related VIN, CIN and VAIN. A search for papers on the use of imiquimod in VIN, CIN and VAIN was performed in the MEDLINE, EMBASE and Cochrane library databases. Data was extracted and reviewed. Twenty-one articles met the inclusion criteria and were analyzed; 16 on VIN, 3 on CIN and 2 on VAIN. Complete response rates in VIN ranged from 5 to 88%. Although minor adverse effects were frequently reported, treatment with imiquimod was well tolerated in most patients. Studies on imiquimod treatment of CIN and VAIN are limited and lack uniformly defined endpoints. The available evidence however, shows encouraging effect. Complete response rates for CIN 2-3 and VAIN 1-3 ranged from 67 to 75% and 57 to 86% respectively. More randomized controlled trials on the use of imiquimod in CIN, VAIN and VIN with extended follow-up are necessary to determine the attributive therapeutic value in these patients.

  9. [Cervical intraepithelial neoplasia: Chlamydia trachomatis and other co-factors].

    Science.gov (United States)

    Núñez-Troconis, J T

    1995-09-01

    The incidence of Chlamydia trachomatis (Ct) in patients with diagnosis of Cervical Intraepithelial Neoplasia (CIN) was studied in one hundred eighty patients. The Chlamydiazyme test was performed in all of them. Endocervical samples were taken from 103 patients with CIN and 77 women who sought medical attention for different gynecological reasons (CG). Twenty three tests (12.8%) were positive; 15 of them had CIN (14.6%) and 8 were from the control group (10.4%). It was found a statistical significant difference between NIC III and early intercourse, NIC III and age, NIC and vaginal douches and, among NIC and number of pregnancies and deliveries. There was not a significant difference among Ct and early intercourse, number of sexual partners, pregnancies, deliveries, vaginal douches, oral contraceptives (OC), and vaginal discharge. No statistically significant differences were found between NIC and number of sexual partners, and OC and vaginal discharge. The low incidence of Ct in patients with CIN does not mean that Ct does not play a role in the origin and development of the cervical pathology.

  10. Laparoscopic wedge resection of synchronous gastric intraepithelial neoplasia and stromal tumor: A case report

    OpenAIRE

    2010-01-01

    Synchronous occurrence of epithelial neoplasia and gastrointestinal stromal tumor (GIST) in the stomach is uncommon. Only rare cases have been reported in the literature. We present here a 60-year-old female case of synchronous occurrence of gastric high-level intraepithelial neoplasia and GIST with the features of 22 similar cases and detailed information reported in the English-language literature summarized. In the present patient, epithelial neoplasia and GIST were removed en bloc by lapa...

  11. Risk factors for the development of vaginal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    LI Hua; GUO Yan-li; ZHANG Jing-xu; QIAO Jie; GENG Li

    2012-01-01

    Background Vaginal intraepithelial neoplasia (VAIN),as aprecursor of vaginal cancer,is a rare disease.Its prevalence has not been well analyzed.This research is to ascertain the risk factors for VAIN in a Chinese population.@@Methods A case-control study was conducted,including 63 VAIN cases and 64healthy controls.In all subjects Pap smear and HPV tests were performed.A questionnaire survey was distributed,covering information on socio-demographic characteristics,smoking,past history,reproductive and sexual histories.The clinical pathological data were collected from medical records including symptoms,Pap smear results,grade of lesions,and human papillomavirus (HPV) status.@@Results Postmenopausal women had a 2.09 times higher risk for VAIN than pre-menopausal women (95% C/:1.10-3.85; P=0.024).The patients with previous hysterectomy had an increased risk of VAIN (OR=4.69; P=0.003).Patients with a history of cervical cancer or CIN were predisposed to VAIN (OR=78.75; P <0.0001).The rate of HPV infection in VAIN was significantly higher than in controls,and an increased risk of VAIN was observed in patients with higher viral load (OR=126.00; P=0.000).Multivariate analysis showed that HPV infection and a history of CIN or cervical cancer were still found to be significant in patients.@@Conclusion HPV infection and a history of CIN or cervical cancer are the main risk factors for the development of VAIN.

  12. RAP1 GTPase overexpression is associated with cervical intraepithelial neoplasia.

    Directory of Open Access Journals (Sweden)

    Marcelo Antonio Pascoal-Xavier

    Full Text Available RAP1 (RAS proximate 1, a small GTP-binding protein of the RAS superfamily, is a putative oncogene that is highly expressed in several malignant cell lines and types of cancers, including some types of squamous cell carcinoma. However, the participation of RAP1 in cervical carcinogenesis is unknown. We conducted a cross-sectional study of paraffin-embedded cervical biopsies to determine the association of RAP1 with cervical intraepithelial neoplasia (CIN. Standard and quantitative immunohistochemistry assessment of RAP1 expression in fixed tissue was performed on 183 paraffin-embedded cervical biopsies that were classified as normal or non-dysplastic mucosa (NDM (n = 33; CIN grade 1 (n = 84 and CIN grade 2/3 (n = 66. A gradual increase in RAP1 expression in NDM < CIN 1 < CIN 2/3 (p<0.001 specimens was observed and was in agreement with the histopathologic diagnosis. A progressive increase in the RAP1 expression levels increased the risk of CIN 1 [odds ratio (OR = 3.50; 95% confidence interval (CI 1.30-10.64] 3.5 fold and the risk of CIN 2/3 (OR = 19.86, 95% CI 6.40-70.79 nearly 20 fold when compared to NDM. In addition, stereotype ordinal regression analysis showed that this progressive increase in RAP1 expression more strongly impacted CIN 2/3 than CIN 1. Our findings suggest that RAP1 may be a useful biomarker for the diagnosis of CIN.

  13. High resolution anoscopy in the planned staged treatment of anal squamous intraepithelial lesions in HIV-negative patients.

    Science.gov (United States)

    Pineda, Carlos E; Berry, J Michael; Jay, Naomi; Palefsky, Joel M; Welton, Mark L

    2007-11-01

    Anal dysplasia (low-grade squamous intraepithelial lesions, LSIL; high-grade squamous intraepithelial lesions, HSIL) is a challenging disease for the surgeon. We reviewed 42 patients that underwent high-resolution anoscopy (HRA)-targeted surgical therapy of anal dysplasia in the past 10 years. Patients were followed up in the Anal Neoplasia Clinic with physical examination, cytology, HRA, and biopsy if indicated. Patients with disease amenable to local therapy were treated with office-based HRA-directed therapies. There were 30 men (mean age 39 years, range 21-63) and 12 women (mean age 50 years, range 31-71) included in the study. HSIL was present in 33, with four undergoing planned staged treatment due to circumferential disease. HSIL recurred in 45%, and most were re-treated successfully in-office. Progression to HSIL was seen in one patient with LSIL and to squamous cell carcinoma in one patient with HSIL despite therapy. No patients with LSIL had dysplasia at last follow-up. Minor complications occurred in three patients. HRA-targeted surgical therapy coupled with surveillance and re-treatment with office-based therapies offered an effective method in controlling anal dysplasia in the immunocompetent patient. Morbidity is minimal, and our progression to cancer rate is low (2.4%).

  14. Cervical and Vulvar Intraepithelial Neoplasia after Treatment with Oral Isotretinoin for Severe Acne Vulgaris

    Directory of Open Access Journals (Sweden)

    M.N. Al Hallak

    2009-09-01

    Full Text Available Oral isotretinoin is the drug of choice for severe acne vulgaris, but its use is still controversial in preventing, treating or stopping the progression of the cervical intraepithelial neoplasia [6–8]. It induces cell differentiation, inhibits cell proliferation, stimulates host immune reaction, inhibits the oncogene expression, augments cell-mediated cytotoxicity, and induces apoptosis [5]. The isotretinoin has many side effects including teratogenicity. There is no previous report of developing cervical intraepithelial neoplasia (CIN or vulvar intraepithelial neoplasia (VIN after introducing oral isotretinoin to a patient. We are reporting a 37-year-old female with no risk factors for cervical cancer who had developed CIN-I and VIN-I during a 6-month treatment period of oral isotretinoin for her severe acne vulgaris. Interestingly, the patient had complete spontaneous pathologic-proven remission after stopping the isotretinoin. Further case reports are warranted to support this incidence.

  15. Clinical and pathological heterogeneity of cervical intraepithelial neoplasia grade 3.

    Directory of Open Access Journals (Sweden)

    Hannah P Yang

    Full Text Available OBJECTIVE: Cervical intraepithelial neoplasia grade 3 (CIN3, the immediate cervical cancer precursor, is a target of cervical cancer prevention. However, less than half of CIN3s will progress to cancer. Routine treatment of all CIN3s and the majority of CIN2s may lead to overtreatment of many lesions that would not progress. To improve our understanding of CIN3 natural history, we performed a detailed characterization of CIN3 heterogeneity in a large referral population in the US. METHODS: We examined 309 CIN3 cases in the SUCCEED, a large population-based study of women with abnormal cervical cancer screening results. Histology information for 12 individual loop electrosurgical excision procedure (LEEP segments was evaluated for each woman. We performed case-case comparisons of CIN3s to analyze determinants of heterogeneity and screening test performance. RESULTS: CIN3 cases varied substantially by size (1-10 LEEP segments and by presentation with concomitant CIN2 and CIN1. All grades of CINs were equally distributed over the cervical surface. In half of the women, CIN3 lesions were found as multiple distinct lesions on the cervix. Women with large and solitary CIN3 lesions were more likely to be older, have longer sexual activity span, and have fewer multiple high risk HPV infections. Screening frequency, but not HPV16 positivity, was an important predictor of CIN3 size. Large CIN3 lesions were also characterized by high-grade clinical test results. CONCLUSIONS: We demonstrate substantial heterogeneity in clinical and pathological presentation of CIN3 in a US population. Time since sexual debut and participation in screening were predictors of CIN3 size. We did not observe a preferential site of CIN3 on the cervical surface that could serve as a target for cervical biopsy. Cervical cancer screening procedures were more likely to detect larger CIN3s, suggesting that CIN3s detected by multiple independent diagnostic tests may represent cases

  16. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik;

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  17. 3-GROUP METAPHASE AS A MORPHOLOGIC CRITERION OF PROGRESSIVE CERVICAL INTRAEPITHELIAL NEOPLASIA

    NARCIS (Netherlands)

    MOURITS, MJE; PIETERS, WJLM; HOLLEMA, H; BURGER, MPM

    1992-01-01

    OBJECTIVE: The purpose of our study was to investigate the presence of three-group metaphase in progressive cervical intraepithelial neoplasia. STUDY DESIGN: This was a retrospective histologic study on the conization specimens of 41 women with microinvasive cervical carcinoma, 28 of whom were enrol

  18. Discovery of new methylation markers to improve screening for cervical intraepithelial neoplasia grade 2/3

    NARCIS (Netherlands)

    Boers, A; Wang, R; van Leeuwen, R W; Klip, H G; de Bock, G H; Hollema, H; van Criekinge, W; de Meyer, T; Denil, S; van der Zee, A G J; Schuuring, E; Wisman, G B A

    2016-01-01

    BACKGROUND: Assessment of DNA promoter methylation markers in cervical scrapings for the detection of cervical intraepithelial neoplasia (CIN) and cervical cancer is feasible, but finding methylation markers with both high sensitivity as well as high specificity remains a challenge. In this study, w

  19. Natural history of high-grade cervical intraepithelial neoplasia : a review of prognostic biomarkers

    NARCIS (Netherlands)

    Koeneman, Margot M.; Kruitwagen, Roy F. P. M.; Nijman, Hans W.; Slangen, Brigitte F. M.; Van Gorp, Toon; Kruse, Arnold-Jan

    2015-01-01

    The natural history of high-grade cervical intraepithelial neoplasia (CIN) is largely unpredictable and current histopathological examination is unable to differentiate between lesions that will regress and those that will not. Therefore, most high-grade lesions are currently treated by surgical exc

  20. Laparoscopic wedge resection of synchronous gastric intraepithelial neoplasia and stromal tumor: a case report.

    Science.gov (United States)

    Mou, Yi-Ping; Xu, Xiao-Wu; Xie, Kun; Zhou, Wei; Zhou, Yu-Cheng; Chen, Ke

    2010-10-21

    Synchronous occurrence of epithelial neoplasia and gastrointestinal stromal tumor (GIST) in the stomach is uncommon. Only rare cases have been reported in the literature. We present here a 60-year-old female case of synchronous occurrence of gastric high-level intraepithelial neoplasia and GIST with the features of 22 similar cases and detailed information reported in the English-language literature summarized. In the present patient, epithelial neoplasia and GIST were removed en bloc by laparoscopic wedge resection. To the best of our knowledge, this is the first reported case treated by laparoscopic wedge resection.

  1. The prognostic significance of virus-associated changes in grade 1 cervical intra-epithelial neoplasia

    DEFF Research Database (Denmark)

    Bagi, P; Worning, A M; Nordsten, M;

    1987-01-01

    Virus-associated changes of the cervix uteri were assessed in patients treated for grade 1 cervical intra-epithelial neoplasia (CIN). Of 106 patients evaluated, 67 (63%) had virus-associated changes. The patients were treated without regard to the presence/absence of virus-associated changes. In 26...... patients the treatment was unsuccessful (persistence, recurrence, or progression of the neoplasia). The frequency of treatment failure was 33% in patients with, and 10% in patients without virus-associated changes (p less than 0.025). It is recommended that patients with CIN 1 and virus-associated changes...... should, after initial treatment, be followed-up with increased attention....

  2. Penile intraepithelial neoplasia with pagetoid features: report of an unusual variant mimicking Paget disease.

    Science.gov (United States)

    Amin, Ali; Griffith, Rogers C; Chaux, Alcides

    2014-04-01

    Precancerous lesions of the penis frequently share the morphologic features of the invasive counterpart. We have recently subclassified penile intraepithelial neoplasia into differentiated, warty, and basaloid subtypes, each one with distinctive microscopic morphology. Nevertheless, in our experience, some cases depart from this classification scheme and show unusual morphologic features, hindering the proper diagnosis on routine morphology alone. Herein we present a case of penile intraepithelial neoplasia with a pagetoid growth pattern, closely mimicking Paget disease. We describe the necessary steps to reach the final diagnose, including the use of immunohistochemistry for cytokeratin (CK) 7, CK20, CK34βE12, CAM 5.2, AE1/AE3, CEA, S100, Melan-A, and p63. We also discuss other differential diagnoses that should be considered such as malignant melanoma and urothelial carcinoma in situ with pagetoid spread and less common lesions such as pagetoid dyskeratosis, clear cell papulosis, and mucinous metaplasia.

  3. Cervical glandular atypia associated with squamous intraepithelial neoplasia: a premalignant lesion?

    OpenAIRE

    Brown, L J; Wells, M

    1986-01-01

    Recent studies have described premalignant changes in the endocervical epithelium, but morphological criteria for the diagnosis of cervical glandular atypia of lesser severity than adenocarcinoma in situ have not been established. Adenocarcinoma in situ is often associated with cervical intraepithelial neoplasia (CIN). The endocervical mucosa in 105 cases of CIN grade III was evaluated and compared with that of 100 controls. Sixteen cases of cervical glandular atypia and one case of adenocarc...

  4. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    OpenAIRE

    Oscar Peralta-Zaragoza; Jessica Deas; Claudia Gómez-Cerón; Wendy Argelia García-Suastegui; Geny del Socorro Fierros-Zárate; Nadia Judith Jacobo-Herrera

    2013-01-01

    Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia...

  5. Prognostic Significance of Immunohistochemical Phenotypes in Patients Treated for High-Grade Cervical Intraepithelial Neoplasia

    OpenAIRE

    Massimo Origoni; Marta Parma; Giacomo Dell'Antonio; Chiara Gelardi; Chiara Stefani; Stefano Salvatore; Massimo Candiani

    2013-01-01

    Strong evidence exists that the host's immune system plays a crucial role for the development of human papillomavirus-related cervical premalignant and malignant lesions. In particular, effective cell-mediated immunity (CMI) promotes spontaneous infection clearance and cancer precursors regression in healthy subjects, while immunosuppressed individuals are more likely to experience infection persistence, cervical intraepithelial neoplasia (CIN) lesions, and cervical cancer. In this study, the...

  6. Association of Chlamydia trachomatis infection with human papillomavirus (HPV) & cervical intraepithelial neoplasia - A pilot study

    OpenAIRE

    Neerja Bhatla; Kriti Puri; Elizabeth Joseph; Alka Kriplani; Venkateswaran K. Iyer; Sreenivas, V

    2013-01-01

    Background & objectives: Human papillomavirus (HPV) is the necessary cause of cervical cancer and Chlamydia trachomatis (CT) is considered a potential cofactor in the development of cervical intraepithelial neoplasia (CIN). The objective of this pilot study was to determine the association of CT infection with HPV, other risk factors for cervical cancer, and CIN in symptomatic women. Methods: A total of 600 consecutively selected women aged 30-74 yr with persistent vaginal discharge, inter...

  7. Frequency of clinically occult intraepithelial and invasive neoplasia in reduction mammoplasty specimens: a study of 516 cases.

    Science.gov (United States)

    Dotto, Jorge; Kluk, Michael; Geramizadeh, Bita; Tavassoli, Fattaneh A

    2008-01-01

    Reduction mammoplasty is a frequently performed procedure for the treatment of macromastia and for the achievement of symmetry in breast cancer patients following lumpectomy. Slides from 516 consecutive bilateral reduction mammoplasties performed for macromastia over 15 years were reviewed. Among these, 92 (18%) low-risk ductal intraepithelial neoplasia/intraductal hyperplasia, 28 (5%) ductal intraepithelial neoplasia 1 (1 low-grade ductal carcinoma in situ, 11 atypical intraductal hyperplasia, and 16 flat type), 17 (3%) lobular intraepithelial neoplasia, and 1 (0.2%) tubular carcinoma were identified. The patients were categorized into 3 age groups: clinically occult malignancies identified in reduction mammoplasty specimens and provide substantial information about the frequency of a variety of intraepithelial proliferations. Preoperative mammography, specimen orientation, and inking of margins with 1 color are advised when reduction mammoplasty is scheduled for women>or=40 years of age.

  8. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M;

    2010-01-01

    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  9. Anal Squamous Intraepithelial Lesions and HPV Among Young Black Men Who Have Sex with Men

    Science.gov (United States)

    Keglovitz, Kristin; Lancki, Nicola; Walsh, Tim; Schneider, John A.

    2017-01-01

    Abstract Purpose: Limited data are available on anal squamous intraepithelial lesions (ASILs) and anal human papillomavirus (HPV) infection in young, Black populations. The purpose of this study was to examine the prevalence of and relationships between ASILs and high-risk HPV infection in a young (sex with men (MSM) population. Methods: Results of anal cytology and HPV DNA were gathered for 83 individuals. Results: Forty-two percent of individuals (35) had atypical squamous cells of undetermined significance and 33% (27) had low-grade squamous intraepithelial lesion by cytology. Only 9% tested positive for both high-risk HPV subtypes 16 and 18. Conclusion: Low rates of infection with both HPV types 16 and 18 may provide further evidence that we should continue to vaccinate young, Black MSM against HPV. PMID:27673362

  10. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, Thomas; Bower, Mark

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  11. The Analysis of Genetic Polymorphism. The Relationship between Interleukin – 4 Polymorphisms and Intraepithelial Cervical Neoplasia

    Directory of Open Access Journals (Sweden)

    Florin STAMATIAN

    2010-09-01

    Full Text Available Objectives: Interleukin 4 plays a critical role in T helper 2 responses to HPV infection and angiogenesis. The present study aim to study the association between the IL4 promoter polymorphism – 590 C>T, respectively VNTR intron 2 polymorphism and cervical intraepithelial neoplasia. Material and method: We have realized a prospective case controls study that included 128 cases of intraepithelial neoplasia positive for HPV HR testing and 111 controls negative for intraepithelial lesion and also negative for HPV HR. Clinical examination was performed on each patient; blood and cervical sample were obtained. Cervical probes were analyzed regarding cytology and HPV HR testing. From peripheral blood DNA sample was obtain followed by genotype analysis for IL4 -590 C>T using PCR RFLP, respectively IL4 70 bp VNTR determined by PCR. Results: The absolute frequency of genotypes for IL4 -590 C>T was T/T-5, C/T-42, C/C-81 in the cases group respectively T/T-2, C/T-32, C/C-77 in the control group. The chi-square test had a value of 0.983 (p=0.321 while considering the presence of a minimum one single variant allele as a risk factor for cervical cancer, respectively 0.926 (p=0.336 for homozygous variant genotype. Odds ratio was 0.761 (95%CI [0.443-1.306] while considering C/T+T/T respectively 2R/3R, 2R/2R as a risk factor, and 0.451 (95%CI 95% [0.086-2.374] - TT respectively 2R/2R as a risk factor. Conclusion: No linear statistical significant association has been found between IL4 polymorphism and cervical neoplasia (p = 0.322.

  12. The role of apparent diffusion coefficient values in detecting testicular intraepithelial neoplasia: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Tsili, Athina C., E-mail: a_tsili@yahoo.gr [Department of Radiology, Medical School, University of Ioannina, 45110 Ioannina (Greece); Ntorkou, Alexandra, E-mail: alexdorkou@yahoo.com [Department of Radiology, Medical School, University of Ioannina, 45110 Ioannina (Greece); Baltogiannis, Dimitrios, E-mail: Greece.dbaltog@cc.uoi.gr [Department of Urology, Medical School, University of Ioannina, 45110 Ioannina (Greece); Goussia, Anna, E-mail: agoussia@uoi.gr [Department of Pathology, Medical School, University of Ioannina, 45110 Ioannina (Greece); Astrakas, Loukas G., E-mail: astrakas@uoi.gr [Department of Medical Physics, Medical School, University of Ioannina, 45110 Ioannina (Greece); Malamou-Mitsi, Vasiliki, E-mail: vmalamou@cc.uoi.gr [Department of Pathology, Medical School, University of Ioannina, 45110 Ioannina (Greece); Sofikitis, Nikolaos, E-mail: akrosnin@hotmail.com [Department of Urology, Medical School, University of Ioannina, 45110 Ioannina (Greece); Argyropoulou, Maria I., E-mail: margyrop@cc.uoi.gr [Department of Radiology, Medical School, University of Ioannina, 45110 Ioannina (Greece)

    2015-05-15

    Highlights: • ADC values proved useful in the discrimination between TGCNs and normal testis. • Testicular intraepithelial neoplasia represents the precursor of most TGCNs. • ADC values cannot be used to detect testicular intraepithelial neoplasia. - Abstract: Introduction: The aim of this study is to improve detection of testicular intraepithelial neoplasia (TIN) by measurement of apparent diffusion coefficient (ADC) values. Materials and methods: Fifty-six MRI examinations of the scrotum, including 26 histologically proven testicular germ cell neoplasms were retrospectively evaluated. DWI was performed using a single shot, multi-slice spin-echo planar diffusion pulse sequence and b-values of 0 and 900 s mm{sup −2}. ADC measurements were classified into three groups according to their location: group 1 (n = 19), non-tumoral part, adjacent to testicular carcinoma, where the possible location of TIN was; group 2 (n = 26), testicular carcinoma; and group 3 (n = 60), normal testicular parenchyma. Analysis of variance (ANOVA) followed by post hoc analysis (Dunnett T3) was used for statistical purposes. Results: The mean ± s.d. of ADC values (×10{sup −3} mm{sup 2}/s) of different groups were: group 1, 1.08 ± 0.20; group 2, 0.72 ± 0.27; and group 3, 1.11 ± 0.14. ANOVA revealed differences of mean ADC between groups (F = 38.859, P < 0.001). Post hoc analysis showed differences between groups 2 and 3 (P < 0.001), groups 2 and 1 (P < 0.001), but not between groups 3 and 1 (P = 0.87). Conclusions: Based on our preliminary results, ADC values do not provide a reliable differentiation between TIN and testicular carcinoma or normal testicular parenchyma.

  13. Risk of head-and-neck cancer following a diagnosis of severe cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Svahn, M F; Munk, C; Jensen, S M;

    2016-01-01

    OBJECTIVE: Women with a history of cervical intraepithelial neoplasia grade 3 including adenocarcinoma in situ (CIN3/AIS) may be more prone to develop cancers of the ano-genital region and head-and-neck cancers. The current literature is, however, limited. METHODS: We established a nationwide...... intervals (CIs) for the association between CIN3/AIS and risk of head-and-neck squamous cell carcinoma (HNSCC). HRs were presented for any HNSCC and for four subgroups categorized by their anticipated degree of association with human papillomavirus (HPV). RESULTS: A history of CIN3/AIS was significantly...

  14. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M;

    2010-01-01

    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata).......To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  15. Neoplasia intra-epitelial cervical: diagnóstico e tratamento Cervical intraepithelial neoplasia: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Sophie Françoise Mauricette Derchain

    2005-07-01

    Full Text Available O câncer do colo uterino é hoje doença passível de prevenção secundária. Os métodos de detecção das lesões precursoras e da infecção pelo papilomavírus humano, tais como a citologia oncológica e biologia molecular, são de uso mundialmente difundido. Entretanto, ainda há muita controvérsia em relação à aplicação destes métodos na prática ginecológica. Qual o melhor exame ou a melhor associação de exames que podem ser utilizados, com que intervalo e em quais mulheres permanecem questões que com freqüência geram ansiedade nos consultórios ou nas unidades de saúde. Por outro lado, uma vez detectada a infecção viral ou a neoplasia intra-epitelial cervical, o tratamento dessas mulheres ainda não é consensual e muitos fatores interferem na definição da conduta ótima. O tipo de infecção, gravidade da neoplasia intra-epitelial, tipo histológico encontrado, todos estes aspectos tendem a dificultar o planejamento terapêutico. Esta revisão tem como objetivo abordar, dentro do conhecimento atual e baseado nos consensos vigentes no país, vários aspectos relacionados ao rastreamento das lesões cervicais e as possíveis condutas terapêuticas vigentes.Cervical cancer is nowadays a disease amenable to secondary prevention. Methods for the detection of its precursor lesions and human papillomavirus infection, such as cervical cytology and molecular biology, achieved widespread use worldwide. However, there is still too much controversy regarding the use of these methods in gynecological practice. Which is the best examination or the best association of examinations, and the most adequate time intervals to proceed with screening, are still pending questions, generating anxiety in patients and doctors. On the other hand, the management of women who have been diagnosed with viral infection and/or cervical intraepithelial neoplasia is not yet consensual, and several factors may affect the clinical decision on how to

  16. Economic burden of vulvar and vaginal intraepithelial neoplasia: retrospective cost study at a German dysplasia centre

    Directory of Open Access Journals (Sweden)

    Kok Patrick

    2011-03-01

    Full Text Available Abstract Background Human papillomavirus is responsible for a variety of diseases including grade 2 and 3 vulvar and vaginal intraepithelial neoplasia. The aim of this study was to assess parts of the burden of the last diseases including treatment costs. The direct medical resource use and cost of surgery associated with neoplasia and related diagnostic procedures (statutory health insurance perspective were estimated, as were the indirect costs (productivity losses associated with surgical treatment and related gynaecology visits for diagnostic purposes. Methods Data from 1991-2008 were retrospectively collected from patient records of the outpatient unit of the Gynaecological Dysplasia Clinic, Heinrich Heine University, Dusseldorf, Germany. Two subgroups of patients were analysed descriptively: women undergoing one surgical procedure related to a diagnosis of vulvar and/or vaginal intraepithelial neoplasia, and women undergoing two or more surgical procedures. Target measures were per-capita medical resource consumption, direct medical cost and indirect cost. Results Of the 94 women analysed, 52 underwent one surgical intervention and 42 two or more interventions (mean of 3.0 interventions during the total period of analysis. Patients undergoing one surgical intervention accrued €881 in direct costs and €682 in indirect costs; patients undergoing more than one intervention accrued €2,605 in direct costs and €2,432 in indirect costs. Conclusions The economic burden on German statutory health insurance funds and society induced by surgical interventions and related diagnostic procedures for grade 2/3 vulvar and vaginal neoplasia should not be underrated. The cost burden is one part of the overall burden attributable to human papillomavirus infections.

  17. Perbedaan Ekspresi P16INK4a dan HPVL1 pada Cervical Intraepithelial Neoplasia 1, Cervical Intraepithelial Neoplasia 2, Cervical Intraepithelial Neoplasia 3 dan Squamous Cell Carcinoma Serviks Uteri

    Directory of Open Access Journals (Sweden)

    Arlene Elizabeth Padang

    2014-09-01

    Full Text Available Human papillomavirus (HPV memegang peranan penting dalam proses karsinogenesis kanker serviksuteri; namun hanya sebagian kecil wanita yang terinfeksi tersebut akan berkembang menjadi kankerserviks yang invasif. Cervical intraepithelial neoplasia (CIN merupakan spektrum dari lesi servikalyang mewakili lesi prekursor dari squamous cell carcinoma (SCC serviks uteri yang dikategorikanmenjadi CIN1, CIN2, CIN3. Interaksi protein HPV (E6 dan E7 dengan protein pengatur selular (pRbdan p53 akan menyebabkan up regulation protein P16INK4a. P16INK4a merupakan tumor supresorprotein cyclin dependen kinase inhibitor yang menghambat cyclin dependent kinase 4 dan 6 yangmerupakan produk dari gen INK4a yang terlibat dalam fosforilasi protein retinoblastoma (pRb.Human papillomavirus-late 1 (HPVL1 merupakan protein kapsid yang terekspresi pada saat awalfase produktif karsinogenesis serviks uteri. Tujuan dari penelitian ini adalah untuk mengetahuiperbedaan ekspresi protein P16INK4a dan HPVL1 pada CIN1, CIN2, CIN3, dan SCC serviks uteri,dimana ekspresi P16INK4a dapat membantu untuk membedakan berbagai derajat displasia serviksuteri dan ekspresi HPVL1 dapat membantu untuk memprediksi progresivitas dari berbagai derajatdisplasia serviks uteri, sehingga penanganan pasien menjadi lebih tepat. [MEDICINA 2013;44:77-81].

  18. Comparison of telomerase activity in prostate cancer, prostatic intraepithelial neoplasia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Soleiman Mahjoub

    2006-11-01

    Full Text Available BACKGROUND: Telomerase is a reverse transcriptase enzyme that synthesizes telomeric DNA on chromosome ends. The enzyme is important for the immortalization of cancer cells because it maintains the telomeres. METHODS: Telomerase activity (TA was measured by fluorescence-based telomeric repeat amplification protocol (FTRAP assay in prostate carcinoma and benign prostatic hyperplasia (BPH. RESULTS: TA was present in 91.4% of 70 prostate cancers, 68.8% of 16 prostatic intraepithelial neoplasia (PIN, 43.3% of 30 BPH*, 21.4% of 14 atrophy and 20% of 15 normal samples adjacent to tumor. There was not any significant correlation between TA, histopathological tumor stage or gleason score. In contrast to high TA in the BPH* tissue from the cancer-bearing gland, only 6.3% of 32 BPH specimens from patients only diagnosed with BPH were telomerase activity-positive. CONCLUSIONS: These results indicate that TA is present in most prostate cancers. The high rate of TA in tissue adjacent to tumor may be attributed either to early molecular alteration of cancer that was histologically unapparent, or to the presence of occult cancer cells. Our findings suggest that the re-expression of telomerase activity could be one step in the transformation of BPH to PIN. KEY WORDS: Telomerase activity, prostate cancer, prostatic intraepithelial neoplasia, benign prostatic hyperplasia.

  19. Prognostic Significance of Immunohistochemical Phenotypes in Patients Treated for High-Grade Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Massimo Origoni

    2013-01-01

    Full Text Available Strong evidence exists that the host’s immune system plays a crucial role for the development of human papillomavirus-related cervical premalignant and malignant lesions. In particular, effective cell-mediated immunity (CMI promotes spontaneous infection clearance and cancer precursors regression in healthy subjects, while immunosuppressed individuals are more likely to experience infection persistence, cervical intraepithelial neoplasia (CIN lesions, and cervical cancer. In this study, the prognostic significance of immunohistochemical profiling of CD4+ T-cells, CD8+ T-cells, dendritic cells (CD11c+, T-bet+, and GATA-3+ transcription factors has been studied in surgical specimens of 34 consecutive women affected by high-grade cervical intraepithelial neoplasia (CIN2-3 submitted to cervical conization. Results have been correlated with the clinical outcomes at 24 months after treatment and statistically analyzed. Higher rates of CD4+ T-cells, CD11c+ dendritic cells, and T-bet+ transcription factor positivity showed a strong statistically significative correlation with favourable clinical outcomes (P≤0.0001. These data reinforce the evidence of the relevance of the host’s immune status in the natural history of HPV-related cervical disease and add a prognostic significance of the cervical immunological profile in terms of predicting significant lower recurrence rates.

  20. Multiphoton imaging of low grade, high grade intraepithelial neoplasia and intramucosal invasive cancer of esophagus

    Science.gov (United States)

    Xu, Jian; Jiang, Liwei; Kang, Deyong; Wu, Xuejing; Xu, Meifang; Zhuo, Shuangmu; Zhu, Xiaoqin; Lin, Jiangbo; Chen, Jianxin

    2017-04-01

    Esophageal squamous cell carcinoma (ESCC) is devastating because of its aggressive lymphatic spread and clinical course. It is believed to occur through low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and intramucosal invasive cancer (IMC) before transforming to submucosal cancer. In particular, these early lesions (LGIN, HGIN and IMC), which involve no lymph node nor distant metastasis, can be cured by endoscopic treatment. Therefore, early identification of these lesions is important so as to offer a curative endoscopic resection, thus slowing down the development of ESCC. In this work, spectral information and morphological features of the normal esophageal mucosa are first studied. Then, the morphological changes of LGIN, HGIN and IMC are described. Lastly, quantitative parameters are also extracted by calculating the nuclear-to-cytoplasmic ratio of epithelial cells and the pixel density of collagen in the lamina propria. These results show that multiphoton microscopy (MPM) has the ability to identify normal esophageal mucosa, LGIN, HGIN and IMC. With the development of multiphoton endoscope systems for in vivo imaging, combined with a laser ablation system, MPM has the potential to provide immediate pathologic diagnosis and curative treatment of ESCC before the transformation to submucosal cancer in the future.

  1. Controversies in the management of anal high-grade squamous intraepithelial lesions.

    Science.gov (United States)

    Pineda, C E; Welton, M L

    2008-10-01

    Anal squamous dysplasia is recognized as a spectrum of disease that ranges from low-grade intraepithelial lesions (LSIL) to high-grade squamous intraepithelial lesions (HSIL) to invasive anal squamous cell carcinoma (SCC). Recent reports have shown a significant increase in both the incidence and prevalence of both HSIL and anal SCC, particularly in immunocompromised patients and in men who have sex with men. These lesions are associated with chronic infection with the human papillomavirus. The natural history is unknown, yet reports of untreated patients have shown progression rates of up to 50% in high risk patients. There are controversies as to the optimal management of patients with HSIL. However, there is evidence that screening of high-risk patients with anal cytology is useful in identifying those that require further evaluation. Examination of the anorectal region is enhanced with the use of high resolution anoscopy. Treatment modalities vary in terms of morbidity and success rates. Wide local excision is associated with significant morbidity. Newer therapies such as topical immunomodulation, photodynamic therapy and therapeutic vaccines have been proposed, but long-term follow-up is unavailable. High resolution anoscopy can be used in the office or in the operating room to direct therapy. Using a comprehensive approach of cytology and office-based and/or operating room procedures directed with high resolution anoscopy results in clearance of HSIL in up to 80% of patients, malignant progression in 1%, and less morbidity than wide local excision.

  2. Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe

    DEFF Research Database (Denmark)

    Tjalma, Wiebren A; Fiander, Alison; Reich, Olaf

    2013-01-01

    Knowledge of differences in human papillomavirus (HPV)-type prevalence between high-grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) is crucial for understanding the natural history of HPV-infected cervical lesions and the potential impact of HPV vaccination...

  3. Long-term absolute risk of cervical intraepithelial neoplasia grade 3 or worse following human papillomavirus infection: role of persistence

    DEFF Research Database (Denmark)

    Kjær, Susanne K; Frederiksen, Kirsten; Plum, Christian Edinger Munk;

    2010-01-01

    Infection with high-risk human papillomavirus (HPV) is the main cause of high-grade cervical intraepithelial neoplasia (CIN) and cancer. It has been suggested that information about high-risk HPV type-specific infection might make cervical cancer screening more effective. Persistent HPV infection...

  4. TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia (TOPIC trial): Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    M.M. Koeneman (Margot); A.J. Kruse; L.F.S. Kooreman; A. Zur Hausen (Axel); A.H.N. Hopman (Anton); S.J.S. Sep (Simone); T. van Gorp (Toon); A.H.L. Slangen (Arjen); H.J. van Beekhuizen (Heleen); M. van de Sande; C.G. Gerestein (Kees); H.W. Nijman (Hans); R.F.M.P. Kruitwagen (Roy)

    2016-01-01

    textabstractBackground: Cervical intraepithelial neoplasia (CIN) is the premalignant condition of cervical cancer. Whereas not all high grade CIN lesions progress to cervical cancer, the natural history and risk of progression of individual lesions remain unpredictable. Therefore, high-grade CIN is

  5. TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia (TOPIC trial) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Koeneman, M. M.; Kruse, A. J.; Kooreman, L. F. S.; zur Hausen, A.; Hopman, A. H. N.; Sep, S. J. S.; van Gorp, T.; Slangen, B. F. M.; van Beekhuizen, H. J.; van de Sande, M.; Gerestein, C. G.; Nijman, H. W.; Kruitwagen, R. F. P. M.

    2016-01-01

    Background: Cervical intraepithelial neoplasia (CIN) is the premalignant condition of cervical cancer. Whereas not all high grade CIN lesions progress to cervical cancer, the natural history and risk of progression of individual lesions remain unpredictable. Therefore, high-grade CIN is currently tr

  6. Prostatic intraepithelial neoplasia-like ductal prostatic adenocarcinoma: A case suitable for active surveillance?

    Directory of Open Access Journals (Sweden)

    Soroush Rais-Bahrami

    2017-01-01

    Full Text Available In contrast to typical prostatic ductal adenocarcinoma, prostatic intraepithelial neoplasia (PIN-like ductal adenocarcinoma is a rare variant of prostate cancer with low-grade clinical behavior. We report a case of a 66-year-old African-American male with an elevated serum prostate-specific antigen who underwent multiparametric prostate magnetic resonance imaging (MRI and MRI/ultrasound fusion-guided biopsies. Pathology demonstrated low-volume Gleason score 3 + 3 = 6 (Grade Group 1, acinar adenocarcinoma involving one core and PIN-like ductal adenocarcinoma on a separate core. Herein, we discuss the potential role of active surveillance for patients with this rare variant of prostate cancer found in the era of advanced imaging with multiparametric MRI for prostate cancer.

  7. Current concepts in the diagnosis and pathobiology of intraepithelial neoplasia: A review by organ system.

    Science.gov (United States)

    Voltaggio, Lysandra; Cimino-Mathews, Ashley; Bishop, Justin A; Argani, Pedram; Cuda, Jonathan D; Epstein, Jonathan I; Hruban, Ralph H; Netto, George J; Stoler, Mark H; Taube, Janis M; Vang, Russell; Westra, William H; Montgomery, Elizabeth A

    2016-09-01

    Answer questions and earn CME/CNE In this report, a team of surgical pathologists has provided a review of intraepithelial neoplasia in a host of (but not all) anatomic sites of interest to colleagues in various medical specialties, namely, uterine cervix, ovary, breast, lung, head and neck, skin, prostate, bladder, pancreas, and esophagus. There is more experience with more readily accessible sites (such as the uterine cervix and skin) than with other anatomic sites, and the lack of uniform terminology, together with divergent biology in various sites, makes it difficult to paint a unifying, relevant portrait. The authors' aim was to provide a framework from which to move forward as we care for patients with such precancerous lesions. CA Cancer J Clin 2016;66:408-436. © 2016 American Cancer Society.

  8. Protein kinase D1 drives pancreatic acinar cell reprogramming and progression to intraepithelial neoplasia

    Science.gov (United States)

    Liou, Geou-Yarh; Döppler, Heike; Braun, Ursula B.; Panayiotou, Richard; Scotti Buzhardt, Michele; Radisky, Derek C.; Crawford, Howard C.; Fields, Alan P.; Murray, Nicole R.; Wang, Q. Jane; Leitges, Michael; Storz, Peter

    2015-02-01

    The transdifferentiation of pancreatic acinar cells to a ductal phenotype (acinar-to-ductal metaplasia, ADM) occurs after injury or inflammation of the pancreas and is a reversible process. However, in the presence of activating Kras mutations or persistent epidermal growth factor receptor (EGF-R) signalling, cells that underwent ADM can progress to pancreatic intraepithelial neoplasia (PanIN) and eventually pancreatic cancer. In transgenic animal models, ADM and PanINs are initiated by high-affinity ligands for EGF-R or activating Kras mutations, but the underlying signalling mechanisms are not well understood. Here, using a conditional knockout approach, we show that protein kinase D1 (PKD1) is sufficient to drive the reprogramming process to a ductal phenotype and progression to PanINs. Moreover, using 3D explant culture of primary pancreatic acinar cells, we show that PKD1 acts downstream of TGFα and Kras, to mediate formation of ductal structures through activation of the Notch pathway.

  9. Loop electrosurgical excision procedure for the treatment of cervical intraepithelial neoplasia: how much excision is enough?

    Science.gov (United States)

    Le, T; El-Sugi, R; Hicks-Boucher, W; Weberpals, J; Faught, W

    2013-08-01

    This is a retrospective observational study to compare outcomes in patients with cervical intraepithelial neoplasia (CIN) treated with loop electrosurgical excision procedure (LEEP) using combined ectocervical/endocervical resection vs ectocervical resection alone. We demonstrated that additional endocervical resection during loop electrosurgical excision procedure did not significantly lower the risk of subsequent recurrence compared with ectocervical resection alone, in the treatment of CIN. With current published data supporting subsequent increased adverse effects of LEEP on future obstetrical outcomes, endocervical excision should be applied selectively. We recommend that additional endocervical excision should be reserved only for patients with a strong suspicion of underlying endocervical canal involvement based on colposcopic assessment or in patients with unsatisfactory colposcopy, where it is essential to evaluate the endocervical canal.

  10. Increased burden of treatment of cervical intraepithelial neoplasia: Denmark 1991 to 2007

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjær; Rebolj, M; Lynge, Elsebeth;

    2011-01-01

    Introduction: Since the introduction of cytological screening in Denmark in the late 1960s, the incidence of cervical cancer decreased from 40 to 14 per 100,000 due to treatment of screen-detected cervical intraepithelial neoplasia (CIN). However, some overtreatment is inevitable and its side...... on conisations, destructive therapies, excisions, hysterectomies and cervical treatments NOS from: The Pathology, Hospital Discharge, Health Insurance and Danish Cancer Register, for all female Danish residents aged 15 to 84 between 1991 and 2007. After linking the data using the unique Danish identification...... numbers, we excluded all duplicates and all destructive therapies and hysterectomies for which no cervical diagnosis was found in the period around the treatment. The total number of treatments was age-standardized using the Danish female population in 2007 as the standard population. Results...

  11. Stratified epithelium in prostatic adenocarcinoma: a mimic of high-grade prostatic intraepithelial neoplasia.

    Science.gov (United States)

    Hameed, Omar; Humphrey, Peter A

    2006-07-01

    Typically glands of prostatic adenocarcinoma have a single cell lining, although stratification can be seen in invasive carcinomas with a cribriform architecture, including ductal carcinoma. The presence and diagnostic significance of stratified cells within non-cribriform carcinomatous prostatic glands has not been well addressed. The histomorphological features and immunohistochemical profile of cases of non-cribriform prostatic adenocarcinoma with stratified malignant glandular epithelium were analyzed. These cases were identified from needle biopsy cases from the consultation files of one of the authors and from a review of 150 consecutive in-house needle biopsy cases of prostatic adenocarcinoma. Immunohistochemistry was performed utilizing antibodies reactive against high molecular weight cytokeratin (34betaE12), p63 and alpha-methylacyl-coenzyme-A racemase (AMACR). A total of 8 cases were identified, including 2 from the 150 consecutive in-house cases (1.3%). In 4 cases, the focus with glands having stratified epithelium was the sole carcinomatous component in the biopsy, while such a component represented 5-30% of the invasive carcinoma seen elsewhere in the remaining cases. The main attribute in all these foci was the presence of glandular profiles lined by several layers of epithelial cells with cytological and architectural features resembling flat or tufted high-grade prostatic intraepithelial neoplasia, but lacking basal cells as confirmed by negative 34betaE12 and/or p63 immunostains in all cases. The AMACR staining profile of the stratified foci was variable, with 4 foci showing positivity, and 3 foci being negative, including two cases that displayed AMACR positivity in adjacent non-stratified prostatic adenocarcinoma. Prostatic adenocarcinoma with stratified malignant glandular epithelium can be identified in prostate needle biopsy samples harboring non-cribriform prostatic adenocarcinoma and resembles glands with high-grade prostatic

  12. Photodynamic therapy of cervical intraepithelial neoplasia grades II and III with Photolon.

    Science.gov (United States)

    Istomin, Y P; Lapzevich, T P; Chalau, V N; Shliakhtsin, S V; Trukhachova, T V

    2010-09-01

    The objective of the present study was to test in clinics a previously developed novel organ-saving approach for the treatment of CIN using PDT with the photosensitizer Photolon applied in women of a childbearing age with CIN II and III. A total number of 112 patients aged 35.2+/-1.6 with morphologically proven diagnosis of CIN II and III were enrolled into the study. All 112 patients had been observed at least during 1-year follow-up period after PDT. Among them 53 patients (44.1%) were subjected to a dynamic observation for less than 2 years; 29 patients (24.1%) were under the observation for less than 3 years; 13 patients (10.8%) - for 3-4 years and 17 women - for more than 4 years. A complete response represented by the complete regression of neoplastic lesions, which was proved by the results of morphological examinations, was revealed in 104 (92.8%) of treated women. In 3 months after treatment a complete eradication of the HPV infection was proven by PCR-analysis in 47 (53.4%) from 88 patients who have been infected with HPV of a highly oncogenic strains before PDT. PDT with Photolon is an alternative approach for the treatment of cervical intraepithelial neoplasia which can be recommended for women of childbearing age. The simplicity of the procedure as well as its' high therapeutic efficacy defines the reasonability of its' introduction into the clinical practice as a new organ-saving method for the treatment of patients with cervical intraepithelial neoplasia.

  13. Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity.

    Science.gov (United States)

    Mitra, A; MacIntyre, D A; Lee, Y S; Smith, A; Marchesi, J R; Lehne, B; Bhatia, R; Lyons, D; Paraskevaidis, E; Li, J V; Holmes, E; Nicholson, J K; Bennett, P R; Kyrgiou, M

    2015-11-17

    Persistent infection with oncogenic Human Papillomavirus (HPV) is necessary for cervical carcinogenesis. Although evidence suggests that the vaginal microbiome plays a functional role in the persistence or regression of HPV infections, this has yet to be described in women with cervical intra-epithelial neoplasia (CIN). We hypothesised that increasing microbiome diversity is associated with increasing CIN severity. llumina MiSeq sequencing of 16S rRNA gene amplicons was used to characterise the vaginal microbiota of women with low-grade squamous intra-epithelial lesions (LSIL; n = 52), high-grade (HSIL; n = 92), invasive cervical cancer (ICC; n = 5) and healthy controls (n = 20). Hierarchical clustering analysis revealed an increased prevalence of microbiomes characterised by high-diversity and low levels of Lactobacillus spp. (community state type-CST IV) with increasing disease severity, irrespective of HPV status (Normal = 2/20,10%; LSIL = 11/52,21%; HSIL = 25/92,27%; ICC = 2/5,40%). Increasing disease severity was associated with decreasing relative abundance of Lactobacillus spp. The vaginal microbiome in HSIL was characterised by higher levels of Sneathia sanguinegens (P disease severity is associated with increasing vaginal microbiota diversity and may be involved in regulating viral persistence and disease progression.

  14. Association between bacterial vaginosis and cervical intraepithelial neoplasia: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Evy Gillet

    Full Text Available OBJECTIVE: Bacterial vaginosis (BV, the most common vaginal disorder among women of reproductive age, has been suggested as co-factor in the development of cervical cancer. Previous studies examining the relationship between BV and cervical intra-epithelial neoplasia (CIN provided inconsistent and conflicting results. The aim of this study is to clarify the association between these two conditions. METHODS: A systematic review and meta-analysis were conducted to summarize published literature on the association between BV and cervical pre-cancerous lesions. An extensive search of electronic databases Medline (Pubmed and Web of Science was performed. The key words 'bacterial vaginosis' and 'bacterial infections and vaginitis' were used in combination with 'cervical intraepithelial neoplasia', 'squamous intraepithelial lesions', 'cervical lesions', 'cervical dysplasia', and 'cervical screening'. Eligible studies required a clear description of diagnostic methods used for detecting both BV and cervical pre-cancerous lesions. Publications were included if they either reported odds ratios (OR and corresponding 95% confidence intervals (CI representing the magnitude of association between these two conditions, or presented data that allowed calculation of the OR. RESULTS: Out of 329 articles, 17 cross-sectional and 2 incidence studies were selected. In addition, two studies conducted in The Netherlands, using the national KOPAC system, were retained. After testing for heterogeneity and publication bias, meta-analysis and meta-regression were performed, using a random effects model. Although heterogeneity among studies was high (χ(2 = 164.7, p<0.01, I(2 = 88.5, a positive association between BV and cervical pre-cancerous lesions was found, with an overall estimated odds ratio of 1.51 (95% CI, 1.24-1.83. Meta-regression analysis could not detect a significant difference between studies based on BV diagnosis, CIN diagnosis or study population

  15. Hyperspectral wide gap second derivative analysis for in vivo detection of cervical intraepithelial neoplasia

    Science.gov (United States)

    Zheng, Wenli; Wang, Chaojian; Chang, Shufang; Zhang, Shiwu; Xu, Ronald X.

    2015-12-01

    Hyperspectral reflectance imaging technique has been used for in vivo detection of cervical intraepithelial neoplasia. However, the clinical outcome of this technique is suboptimal owing to multiple limitations such as nonuniform illumination, high-cost and bulky setup, and time-consuming data acquisition and processing. To overcome these limitations, we acquired the hyperspectral data cube in a wavelength ranging from 600 to 800 nm and processed it by a wide gap second derivative analysis method. This method effectively reduced the image artifacts caused by nonuniform illumination and background absorption. Furthermore, with second derivative analysis, only three specific wavelengths (620, 696, and 772 nm) are needed for tissue classification with optimal separability. Clinical feasibility of the proposed image analysis and classification method was tested in a clinical trial where cervical hyperspectral images from three patients were used for classification analysis. Our proposed method successfully classified the cervix tissue into three categories of normal, inflammation and high-grade lesion. These classification results were coincident with those by an experienced gynecology oncologist after applying acetic acid. Our preliminary clinical study has demonstrated the technical feasibility for in vivo and noninvasive detection of cervical neoplasia without acetic acid. Further clinical research is needed in order to establish a large-scale diagnostic database and optimize the tissue classification technique.

  16. Spontaneous conception in 40-year-old infertile woman with polycystic ovaries after complete reversal of endometrial intraepithelial neoplasia: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Swati Verma

    2016-01-01

    Full Text Available We report a case of polycystic ovary syndrome and prolonged infertility in which endometrial intraepithelial neoplasia was reversed with high dose progesterone therapy. Spontaneous conception after failure of assisted reproductive techniques highlights the role of endometrial receptivity.

  17. Warty/basaloid penile intraepithelial neoplasia is more prevalent than differentiated penile intraepithelial neoplasia in nonendemic regions for penile cancer when compared with endemic areas: a comparative study between pathologic series from Paris and Paraguay.

    Science.gov (United States)

    Soskin, Ana; Vieillefond, Anicke; Carlotti, Agnes; Plantier, Francoise; Chaux, Alcides; Ayala, Gustavo; Velazquez, Elsa F; Cubilla, Antonio L

    2012-02-01

    Penile squamous cell carcinoma shows an ample geographic variation in its prevalence with regions of low (North America, Europe, Japan, and Israel) and high (Africa, Asia, and South America) incidence. However, the geographic variation in the distribution of penile intraepithelial neoplasia is not well established. The aim of the present study was to compare the distribution of in situ and invasive lesions between geographic areas with low (France) and high (Paraguay) penile cancer incidence using a series of consecutive cases. The French series included 86 cases (57 in situ and 29 in situ + invasive squamous cell carcinoma), and the Paraguayan series, 117 cases (31 in situ and 86 in situ + invasive squamous cell carcinoma). Incidence of invasive squamous cell carcinoma in the overall samples was higher in the Paraguayan series (P < .00001). Comparing the Paraguayan and the French series, differentiated penile intraepithelial neoplasia was more prevalent in the former (65.0% versus 19.8%), whereas lesions showing warty and/or basaloid features predominated in the latter (35.0% versus 80.2%) to a significant level (P < .00001). This distinctive pattern of differential distribution was maintained when cases with associated invasive squamous cell carcinoma were excluded. The pattern of distribution of lichen sclerosus was also distinctive, with a significantly higher prevalence in the Paraguayan population when compared with the French series (32.5% versus 12.8%, P = .0015). In summary, there appears to be a distinctive distribution of penile precursor lesions depending on the geographic region in consideration. Penile intraepithelial neoplasia with warty and/or basaloid features predominated in low-incidence areas, whereas differentiated penile intraepithelial neoplasia was more prevalent in endemic regions for penile cancer. Further prospective studies in matched populations and from different geographic regions are needed to further clarify the reasons for this

  18. Twist and YB-1 gene expression in cervical cancer and cervical intraepithelial neoplasia tissue as well as its correlation with epithelial-mesenchymal transition

    Institute of Scientific and Technical Information of China (English)

    Qin Liu; Hong Li; Yu Zhang

    2016-01-01

    Objective:To study the Twist and YB-1 gene expression in cervical cancer and cervical intraepithelial neoplasia tissue as well as its correlation with epithelial-mesenchymal transition. Methods:Normal cervical tissue, cervical intraepithelial neoplasia tissue and cervical cancer tissue were collected for study. ELISA kits were used to detect Twist, YB-1, E-cadherin,β-catenin, N-cadherin and Vimentin contents in cervical tissue, and immunohistochemistry was used to detect Twist and YB-1 expression levels in cervical tissue.Results:Twist and YB-1 contents, cell positive rate and immunohistochemical scores as well as N-cadherin and Vimentin contents in cervical cancer tissue and cervical intraepithelial neoplasia tissue were significantly higher than those in normal cervical tissue while E-cadherin andβ-catenin contents were lower than those in normal cervical tissue; Twist and YB-1 contents, cell positive rate and immunohistochemical scores as well as N-cadherin and Vimentin contents in cervical cancer tissue were significantly higher than those in cervical intraepithelial neoplasia tissue while E-cadherin andβ-catenin contents were lower than those in cervical intraepithelial neoplasia tissue; the higher the Twist and YB-1 expression levels in cervical cancer tissue, the lower the E-cadherin andβ-catenin contents, and the higher the N-cadherin and Vimentin contents.Conclusions: Twist and YB-1 gene overexpression can promote epithelial-mesenchymal transition to be involved in the occurrence of cervical cancer and cervical intraepithelial neoplasia.

  19. Lack of Commensal Flora in Helicobacter pylori–Infected INS-GAS Mice Reduces Gastritis and Delays Intraepithelial Neoplasia

    OpenAIRE

    Lofgren, Jennifer L.; Whary, Mark T.; Ge, Zhongming; Muthupalani, Sureshkumar; Taylor, Nancy S.; Mobley, Melissa W.; Potter, Amanda; Varro, Andrea; Eibach, Daniel; Suerbaum, Sebastian; Wang, Timothy C.; James G. Fox

    2010-01-01

    Background & Aims Transgenic FVB/N insulin-gastrin (INS-GAS) mice have high circulating gastrin levels, and develop spontaneous atrophic gastritis and gastrointestinal intraepithelial neoplasia (GIN) with 80% prevalence 6 months after Helicobacter pylori infection. GIN is associated with gastric atrophy and achlorhydria, predisposing mice to nonhelicobacter microbiota overgrowth. We determined if germfree INS-GAS mice spontaneously develop GIN and if H pylori accelerates GIN in gnotobiotic...

  20. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

    Directory of Open Access Journals (Sweden)

    Darin Ruanpeng

    Full Text Available Anal cancer, one of human papillomavirus (HPV related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM and HIV-infected (HIV+ persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL using Papanicolau (Pap screening among MSM in northern Thailand and its associated factors.Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification.Mean age was 27.2 years (range 18-54. Overall, 86 (43.0% had ASIL: 28 (14.2% with atypical cells of undetermined significance (ASCUS, 1 (0.5% with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H, 56 (28.4% with low-grade squamous intraepithelial lesion (LSIL, and 1 (0.5% with high-grade squamous intraepithelial lesion (HSIL. ASIL was associated by univariate analysis (p ≤0.05 with older age, gender identity other than bisexual (i.e., gay men and transgender women, rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002 and HIV infection (p = 0.01.ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA, not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

  1. The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea.

    Science.gov (United States)

    Oh, H Y; Kim, B-S; Seo, S-S; Kong, J-S; Lee, J-K; Park, S-Y; Hong, K-M; Kim, H-K; Kim, M K

    2015-07-01

    Recent studies have suggested potential roles of the microbiome in cervicovaginal diseases. However, there has been no report on the cervical microbiome in cervical intraepithelial neoplasia (CIN). We aimed to identify the cervical microbiota of Korean women and assess the association between the cervical microbiota and CIN, and to determine the combined effect of the microbiota and human papillomavirus (HPV) on the risk of CIN. The cervical microbiota of 70 women with CIN and 50 control women was analysed using pyrosequencing based on the 16S rRNA gene. The associations between specific microbial patterns or abundance of specific microbiota and CIN risk were assessed using multivariate logistic regression, and the relative excess risk due to interaction (RERI) and the synergy index (S) were calculated. The phyla Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria, Tenericutes, Fusobacteria and TM7 were predominant in the microbiota and four distinct community types were observed in all women. A high score of the pattern characterized by predominance of Atopobium vaginae, Gardnerella vaginalis and Lactobacillus iners with a minority of Lactobacillus crispatus had a higher CIN risk (OR 5.80, 95% CI 1.73-19.4) and abundance of A. vaginae had a higher CIN risk (OR 6.63, 95% CI 1.61-27.2). The synergistic effect of a high score of this microbial pattern and oncogenic HPV was observed (OR 34.1, 95% CI 4.95-284.5; RERI/S, 15.9/1.93). A predominance of A. vaginae, G. vaginalis and L. iners with a concomitant paucity of L. crispatus in the cervical microbiota was associated with CIN risk, suggesting that bacterial dysbiosis and its combination with oncogenic HPV may be a risk factor for cervical neoplasia.

  2. Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women

    Directory of Open Access Journals (Sweden)

    Nara Chartuni Pereira Teixeira

    2012-04-01

    Full Text Available OBJECTIVES: To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN among HIV-infected women. METHODS: Cross-sectional study of 494 HIV-infected women in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors. RESULTS: CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1. Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm³ (OR 5.0, 95% CI 2.5-10.1, with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5, and with age < 34 years old (OR 1.5, 95% CI 1.0-2.4. HIV viral load and antiretroviral use were not independent risk factors for CIN. CONCLUSIONS: Severity of immunosupression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.

  3. INDUCTION OF GASTRIC INTRAEPITHELIAL NEOPLASIA OF GLANDULAR STOMACH OF MONGOLIAN GERBILS BY ELICOBACTER PYLORI

    Institute of Scientific and Technical Information of China (English)

    ZHOU Pin; GU Lian-kun; ZHOU Jing; WANG Ru-ming; ZHAO Zi-hou; DENG Da-jun

    2005-01-01

    Objective: To setup an animal model of gastric carcinogenesis by Helicobacter pylori (Hp) for basic, prevention and therapeutic research of Hp-related diseases. Methods: 22 young male Mongolian gerbils were administrated with suspension of Hp strain TN2 by intragastric gavage for 5 consecutive times (4×108 CFU/time, 1 time/4 days). 10 male gerbils were used as negative control. Two infected gerbils were killed at 10, 20, and 30 weeks, respectively, after inoculation to monitor the development of gastric lesions. Other animals were killed at 40 experimental weeks.Pathological changes of glandular stomach were examined histologically. Results: Gastric intraepithelial neoplasias (GIN) and low-grade dysplasias were observed only in the pyloric antrum of Hp-treated gerbils (3 and 2 ones,respectively), but not in control group (5/13 vs. 0/10, P<0.04). High incidence of chronic active gastritis and chronic atrophic gastritis were observed in Hp-treated animals (10/13, 76.9%). Low incidence of chronic atrophic gastritis was also detected in negative control gerbils (3/10, 30%; P<0.04). Conclusion: Hp inoculation could induce chronic inflammation and malignant lesions of the glandular stomach of Mongolian gerbils conveniently.

  4. Patterns of persistent HPV infection after treatment for cervical intraepithelial neoplasia (CIN): A systematic review.

    Science.gov (United States)

    Hoffman, Sarah R; Le, Tam; Lockhart, Alexandre; Sanusi, Ayodeji; Dal Santo, Leila; Davis, Meagan; McKinney, Dana A; Brown, Meagan; Poole, Charles; Willame, Corinne; Smith, Jennifer S

    2017-01-25

    A systematic review of the literature was conducted to determine the estimates of and definitions for human papillomavirus (HPV) persistence in women following treatment of cervical intra-epithelial neoplasia (CIN). A total of 45 studies presented data on post-treatment HPV persistence among 6,106 women. Most studies assessed HPV persistence after loop excision (42%), followed by conization (7%), cryotherapy (11%), laser treatment (4%), interferon-alpha, therapeutic vaccination, and photodynamic therapy (2% each) and mixed treatment (38%). Baseline HPV testing was conducted before or at treatment for most studies (96%). Follow-up HPV testing ranged from 1.5 to 80 months after baseline. Median HPV persistence tended to decrease with increasing follow-up time, declining from 27% at 3 months after treatment to 21% at 6 months, 15% at 12 months, and 10% at 24 months. Post-treatment HPV persistence estimates varied widely and were influenced by patient age, HPV-type, detection method, treatment method, and minimum HPV post-treatment testing interval. Loop excision and conization appeared to outperform cryotherapy procedures in terms of their ability to clear HPV infection. This systematic review provides evidence for the substantial heterogeneity in post-treatment HPV DNA testing practices and persistence estimates.

  5. Pure Laparoscopic Left Hemihepatectomy for Hepatic Peribiliary Cysts with Biliary Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Akira Umemura

    2016-01-01

    Full Text Available Introduction. Hepatic peribiliary cysts (HPCs usually originate due to the cystic dilatation of the intrahepatic extramural peribiliary glands. We describe our rare experience of pure laparoscopic left hemihepatectomy (PLLH in a patient with HPCs accompanied by a component of biliary intraepithelial neoplasia (BilIN. Case Presentation. A 65-year-old man was referred for further investigation of mild hepatic dysfunction. Contrast-enhanced computed tomography showed dilatation of the left-sided intrahepatic bile duct, and biliary cytology showed class III cells. The patient was highly suspected of having left side-dominated cholangiocarcinoma and underwent PLLH. Microscopic findings revealed multiple cystic dilatations of the extramural peribiliary glands; hence, this lesion was diagnosed as HPCs. The resected intrahepatic bile duct showed that the normal ductal lumen comprised low columnar epithelia; however, front formation on the BilIN was observed in some parts of the intrahepatic bile duct, indicating that the BilIN coexisted with HPCs. Conclusion. We chose surgical therapy for this patient owing to the presence of some features of biliary malignancy. We employed noble PLLH as a minimally invasive procedure for this patient.

  6. Plasma Protein Profiles Differ Between Women Diagnosed with Cervical Intraepithelial Neoplasia (CIN 1 and 3

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    Edward E. Partridge

    2006-01-01

    Full Text Available Early detection of precancerous cells in the cervix and their clinical management is the main purpose of cervical cancer prevention and treatment programs. Cytological findings or testing for high risk (HR-human papillomavirus (HPV are inadequately sensitive for use in triage of women at high risk for cervical cancer. The current study is an exploratory study to identify candidate surface-enhanced laser desorption/ionization (SELDI time of flight (TOF mass spectrometry (MS protein profiles in plasma that may distinguish cervical intraepithelial neoplasia (CIN 3 from CIN 1 among women infected with HR-HPV. We evaluated the SELDI-TOF-MS plasma protein profiles of HR-HPV positive 32 women with CIN 3 (cases and 28 women with CIN1 (controls. Case-control status was kept blinded and triplicates of each sample and quality control plasma samples were randomized and after robotic sample preparations were run on WCX2 chips. After alignment of mass/charge (m-z values, an iterative method was used to develop a classifier on a training data set that had 28 cases and 22 controls. The classifier developed was used to classify the subjects in a test data set that has six cases and six controls. The classifier separated the cases from controls in the test set with 100% sensitivity and 100% specificity suggesting the possibility of using plasma SELDI protein profiles to identify women who are likely to have CIN 3 lesions.

  7. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Oscar Peralta-Zaragoza

    2013-01-01

    Full Text Available Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia, and in treatment strategies for invasive cervical cancer. It is known that during the development of cervical cancer associated with HPV infection, a cascade of abnormal events is induced, including disruption of cellular cycle control, alteration of gene expression, and deregulation of microRNA expression. Thus, the identification and subsequent functional evaluation of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis, identifying cervical cancer molecular markers, and developing specific targeting strategies against tumor cells. Therefore, in this paper, we discuss the main diagnostic methods, management strategies, and followup of HPV-associated cervical lesions and review clinical trials applying gene therapy strategies against the development of cervical cancer.

  8. Comparison between two portable devices for widefield PpIX fluorescence during cervical intraepithelial neoplasia treatment

    Science.gov (United States)

    Carbinatto, Fernanda M.; Inada, Natalia Mayumi; Lombardi, Welington; Cossetin, Natália Fernandez; Varoto, Cinthia; Kurachi, Cristina; Bagnato, Vanderlei Salvador

    2015-06-01

    The use of portable electronic devices, in particular mobile phones such as smartphones is increasing not only for all known applications, but also for diagnosis of diseases and monitoring treatments like topical Photodynamic Therapy. The aim of the study is to evaluate the production of the photosensitizer Protoporphyrin IX (PpIX) after topical application of a cream containing methyl aminolevulinate (MAL) in the cervix with diagnosis of Cervical Intraepithelial Neoplasia (CIN) through the fluorescence images captured after one and three hours and compare the images using two devices (a Sony Xperia® mobile and an Apple Ipod®. Was observed an increasing fluorescence intensity of the cervix three hours after cream application, in both portable electronic devices. However, because was used a specific program for the treatment of images using the Ipod® device, these images presented better resolution than observed by the Sony cell phone without a specific program. One hour after cream application presented a more selective fluorescence than the group of three hours. In conclusion, the use of portable devices to obtain images of PpIX fluorescence shown to be an effective tool and is necessary the improvement of programs for achievement of better results.

  9. Infection with human papillomaviruses of sexual partners of women having cervical intraepithelial neoplasia

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    Rombaldi R.L.

    2006-01-01

    Full Text Available Epidemiological studies show that human papillomaviruses (HPV are strongly related to cervical cancer and cervical intraepithelial neoplasias (CIN. Unlike the case for women, there are no consistent data on the natural history of HPV in the male population even though these viruses are prevalent in males. We carried out a prospective study to assess the prevalence of HPV in males as well as the factors that determine such infections in 99 male sexual partners of women with CIN. The genitalia of the males were physically examined and subjected to peniscopy for the collection of scrapings which were subjected to the polymerase chain reaction and restriction fragment length polymorphism to detect HPV. Of the 99 males sampled, 54 (54.5% were positive for HPV DNA, 24% of whom presented normal peniscopy, 28% presented evident clinical lesions and 48% isolated lesions consistent with subclinical infection. In the HPV-negative group, 53% showed normal peniscopy, 4% presented evident clinical lesions and 42% isolated lesions consistent with subclinical infection. The study detected a statistically significant association (P < 0.02, Pearson chi-square test between HPV infection and both the mean number of sexual partners which a male had during his life and the mean number of sexual partners in the year prior to testing. Viral types 6 and 11 were most frequently encountered. The study shows that infection with HPV was frequent in male sexual partners of women with CIN.

  10. Reconstituting development of pancreatic intraepithelial neoplasia from primary human pancreas duct cells

    Science.gov (United States)

    Lee, Jonghyeob; Snyder, Emily R.; Liu, Yinghua; Gu, Xueying; Wang, Jing; Flowers, Brittany M.; Kim, Yoo Jung; Park, Sangbin; Szot, Gregory L.; Hruban, Ralph H.; Longacre, Teri A.; Kim, Seung K.

    2017-01-01

    Development of systems that reconstitute hallmark features of human pancreatic intraepithelial neoplasia (PanINs), the precursor to pancreatic ductal adenocarcinoma, could generate new strategies for early diagnosis and intervention. However, human cell-based PanIN models with defined mutations are unavailable. Here, we report that genetic modification of primary human pancreatic cells leads to development of lesions resembling native human PanINs. Primary human pancreas duct cells harbouring oncogenic KRAS and induced mutations in CDKN2A, SMAD4 and TP53 expand in vitro as epithelial spheres. After pancreatic transplantation, mutant clones form lesions histologically similar to native PanINs, including prominent stromal responses. Gene expression profiling reveals molecular similarities of mutant clones with native PanINs, and identifies potential PanIN biomarker candidates including Neuromedin U, a circulating peptide hormone. Prospective reconstitution of human PanIN development from primary cells provides experimental opportunities to investigate pancreas cancer development, progression and early-stage detection. PMID:28272465

  11. Natural history of high-grade cervical intraepithelial neoplasia: a review of prognostic biomarkers.

    Science.gov (United States)

    Koeneman, Margot M; Kruitwagen, Roy F P M; Nijman, Hans W; Slangen, Brigitte F M; Van Gorp, Toon; Kruse, Arnold-Jan

    2015-04-01

    The natural history of high-grade cervical intraepithelial neoplasia (CIN) is largely unpredictable and current histopathological examination is unable to differentiate between lesions that will regress and those that will not. Therefore, most high-grade lesions are currently treated by surgical excision, leading to overtreatment and unnecessary complications. Prognostic biomarkers may differentiate between lesions that will regress and those that will not, making individualized treatment of high-grade CIN possible. This review identifies several promising prognostic biomarkers. These biomarkers include viral genotype and viral DNA methylation (viral factors), human leukocyte antigen-subtypes, markers of lymphoproliferative response, telomerase amplification and human papillomavirus-induced epigenetic effects (host factors) and Ki-67, p53 and pRb (cellular factors). All identified biomarkers were evaluated according to their role in the natural history of high-grade CIN and according to established criteria for evaluation of biomarkers (prospective-specimen-collection, retrospective-blinded-evaluation [PROBE] criteria). None of the biomarkers meets the PROBE criteria for clinical applicability and more research on prognostic biomarkers in high-grade CIN is necessary.

  12. Adverse Psychosexual Impact Related to the Treatment of Genital Warts and Cervical Intraepithelial Neoplasia

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    Adriana Bittencourt Campaner

    2013-01-01

    Full Text Available Objective. To compare the psychosexual impact related to the treatment of genital warts and cervical intraepithelial neoplasia (CIN in women. Methods. 75 patients presenting with HPV-induced genital lesions, belonging to one of two patient groups, were included in the study: 29 individuals with genital warts (GWs and 46 individuals with CIN grades 2 or 3 (CIN 2/3. Initially, medical charts of each woman were examined for extraction of data on the type of HPV-induced infection and treatment administered. Subjects were interviewed to collect sociodemographic data as well as personal, gynecologic, obstetric, and sexual history. After this initial anamnesis, the Sexual Quotient-Female Version (SQ-F questionnaire was applied to assess sexual function. After application of the questionnaire, patients answered specific questions produced by the researchers, aimed at assessing the impact of the disease and its treatment on their sexual lives. Results. It is noteworthy that patients with CIN 2/3 had statistically similar classification of sexual quotient to patients with GWs (P=0.115. However, patients with GWs more frequently gave positive answers to the specific questions compared to patients with CIN 2/3. Conclusion. Based on these findings, it is clear that GWs have a greater impact on sexual behavior compared to CIN 2/3.

  13. Plasma proteome analysis of cervical intraepithelial neoplasia and cervical squamous cell carcinoma

    Indian Academy of Sciences (India)

    Mee Lee Looi; Saiful Anuar Karsani; Mariati Abdul Rahman; Ahmad Zailani Hatta Mohd Dali; Siti Aishah Md Ali; Wan Zurinah Wan Ngah; Yasmin Anum Mohd Yusof

    2009-12-01

    Although cervical cancer is preventable with early detection, it remains the second most common malignancy among women. An understanding of how proteins change in their expression during a particular diseased state such as cervical cancer will contribute to an understanding of how the disease develops and progresses. Potentially, it may also lead to the ability to predict the occurrence of the disease. With this in mind, we aimed to identify differentially expressed proteins in the plasma of cervical cancer patients. Plasma from control, cervical intraepithelial neoplasia (CIN) grade 3 and squamous cell carcinoma (SCC) stage IV subjects was resolved by two-dimensional gel electrophoresis and the resulting proteome profiles compared. Differentially expressed protein spots were then identified by mass spectrometry. Eighteen proteins were found to be differentially expressed in the plasma of CIN 3 and SCC stage IV samples when compared with that of controls. Competitive ELISA further validated the expression of cytokeratin 19 and tetranectin. Functional analyses of these differentially expressed proteins will provide further insight into their potential role(s) in cervical cancer-specific monitoring and therapeutics.

  14. Grading of cervical intraepithelial neoplasia using spatial frequency for optical histology

    Science.gov (United States)

    Pu, Yang; Jagtap, Jaidip; Pradhan, Asima; Alfano, Robert R.

    2014-03-01

    It is important to detect cervical dysplasia, Cervical Intraepithelial Neoplasia (CIN). CIN is the potentially premalignant and abnormal squamous cells on surface of cervix. In this study, the spatial frequency spectra of pre-cancer cervical tissues are used to detect differences among different grades of human cervical tissues. Seven sets of thick tissue sections of human cervix of normal, CIN 1, CIN 2, and CIN 3 tissues are studied. The confocal microscope images of the stromal region of normal and CIN human tissues were analyzed using Fast Fourier Transform (FFT) to generate the spatial spectra. It is observed that higher frequency components exist in CIN tissues than those in normal tissue, as well as those in higher grade CIN tissue than those in lower grade CIN tissue. The width of the spatial frequency of different types of tissues is used to create a criterion for CIN grading by training a support vector machine (SVM) classifier. The results show that the randomness of tissue structures from normal to different stages of precancer in cervical tissue can be recognized by fingerprints of the spatial frequency. The efficacy of spatial frequency analysis for CIN grading is evaluated as excellent since high AUC (area under the ROC curve), sensitivity and specificity are obtained by the statistics study. This works lays the foundation of using spatial frequency spectra for a histology evaluation.

  15. In vivo Diagnosis of Cervical Intraepithelial Neoplasia Using 337-nm- Excited Laser-Induced Fluorescence

    Science.gov (United States)

    Ramanujam, N.; Mitchell, M. F.; Mahadevan, A.; Warren, S.; Thomsen, S.; Silva, E.; Richards-Kortum, R.

    1994-10-01

    Laser-induced fluorescence at 337-nm excitation was used in vivo to differentiate neoplastic [cervical intraepithelial neoplasia (CIN)], nonneoplastic abnormal (inflammation and human papilloma viral infection), and normal cervical tissues. A colposcope (low-magnification microscope used to view the cervix with reflected light) was used to identify 66 normal and 49 abnormal (5 inflammation, 21 human papilloma virus infection, and 23 CIN) sites on the cervix in 28 patients. These sites were then interrogated spectroscopically. A two-stage algorithm was developed to diagnose CIN. The first stage differentiated histologically abnormal tissues from colposcopically normal tissues with a sensitivity, specificity, and positive predictive value of 92%, 90%, and 88%, respectively. The second stage differentiated preneoplastic and neoplastic tissues from nonneoplastic abnormal tissues with a sensitivity, specificity, and positive predictive value of 87%, 73%, and 74%, respectively. Spectroscopic differences were consistent with a decrease in the absolute contribution of collagen fluorescence, an increase in the absolute contribution of oxyhemoglobin attenuation, and an increase in the relative contribution of reduced nicotinamide dinucleotide phosphate [NAD(P)H] fluorescence as tissue progresses from normal to abnormal in the same patient. These results suggest that in vivo fluorescence spectroscopy of the cervix can be used to diagnose CIN at colposcopy.

  16. Vulvar intraepithelial neoplasia and vaginal intraepithelial neoplasia%外阴上皮内瘤变及阴道上皮内瘤变

    Institute of Scientific and Technical Information of China (English)

    孔为民; 孙建衡

    2009-01-01

    外阴上皮内瘤变(vulvar intraepithelial neoplasia,VIN)及阴道上皮内瘤变(vaginal intraepithelial neoplasia,VAIN)是临床报道较少的女性生殖道鳞状细胞癌的癌前病变,虽然对其认识已长达半个世纪以上,但对其病因、发展过程、转归至今尚未明了。20世纪60年代末,出现了宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的概念,将以往宫颈浸润癌发生前的鳞状上皮的病理变化过程.

  17. Development of a reactive stroma associated with prostatic intraepithelial neoplasia in EAF2 deficient mice.

    Directory of Open Access Journals (Sweden)

    Laura E Pascal

    Full Text Available ELL-associated factor 2 (EAF2 is an androgen-responsive tumor suppressor frequently deleted in advanced prostate cancer that functions as a transcription elongation factor of RNA Pol II through interaction with the ELL family proteins. EAF2 knockout mice on a 129P2/OLA-C57BL/6J background developed late-onset lung adenocarcinoma, hepatocellular carcinoma, B-cell lymphoma and high-grade prostatic intraepithelial neoplasia. In order to further characterize the role of EAF2 in the development of prostatic defects, the effects of EAF2 loss were compared in different murine strains. In the current study, aged EAF2(-/- mice on both the C57BL/6J and FVB/NJ backgrounds exhibited mPIN lesions as previously reported on a 129P2/OLA-C57BL/6J background. In contrast to the 129P2/OLA-C57BL/6J mixed genetic background, the mPIN lesions in C57BL/6J and FVB/NJ EAF2(-/- mice were associated with stromal defects characteristic of a reactive stroma and a statistically significant increase in prostate microvessel density. Stromal inflammation and increased microvessel density was evident in EAF2-deficient mice on a pure C57BL/6J background at an early age and preceded the development of the histologic epithelial hyperplasia and neoplasia found in the prostates of older EAF2(-/- animals. Mice deficient in EAF2 had an increased recovery rate and a decreased overall response to the effects of androgen deprivation. EAF2 expression in human cancer was significantly down-regulated and microvessel density was significantly increased compared to matched normal prostate tissue; furthermore EAF2 expression was negatively correlated with microvessel density. These results suggest that the EAF2 knockout mouse on the C57BL/6J and FVB/NJ genetic backgrounds provides a model of PIN lesions associated with an altered prostate microvasculature and reactive stromal compartment corresponding to that reported in human prostate tumors.

  18. AKT1 loss correlates with episomal HPV16 in vulval intraepithelial neoplasia.

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    Arucha L Ekeowa-Anderson

    Full Text Available Anogenital malignancy has a significant association with high-risk mucosal alpha-human papillomaviruses (alpha-PV, particularly HPV 16 and 18 whereas extragenital SCC has been linked to the presence of cutaneous beta and gamma-HPV types. Vulval skin may be colonised by both mucosal and cutaneous (beta-, mu-, nu- and gamma- PV types, but there are few systematic studies investigating their presence and their relative contributions to vulval malignancy. Dysregulation of AKT, a serine/threonine kinase, plays a significant role in several cancers. Mucosal HPV types can increase AKT phosphorylation and activity whereas cutaneous HPV types down-regulate AKT1 expression, probably to weaken the cornified envelope to promote viral release. We assessed the presence of mucosal and cutaneous HPV in vulval malignancy and its relationship to AKT1 expression in order to establish the corresponding HPV and AKT1 profile of normal vulval skin, vulval intraepithelial neoplasia (VIN and vulval squamous cell carcinoma (vSCC. We show that HPV16 is the principle HPV type present in VIN, there were few detectable beta types present and AKT1 loss was not associated with the presence of these cutaneous HPV. We show that HPV16 early gene expression reduced AKT1 expression in transgenic mouse epidermis. AKT1 loss in our VIN cohort correlated with presence of high copy number, episomal HPV16. Maintained AKT1 expression correlated with low copy number, an increased frequency of integration and increased HPV16E7 expression, a finding we replicated in another untyped cohort of vSCC. Since expression of E7 reflects tumour progression, these findings suggest that AKT1 loss associated with episomal HPV16 may have positive prognostic implications in vulval malignancy.

  19. Up regulation in gene expression of chromatin remodelling factors in cervical intraepithelial neoplasia

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    Van Niekerk Dirk

    2008-02-01

    Full Text Available Abstract Background The highest rates of cervical cancer are found in developing countries. Frontline monitoring has reduced these rates in developed countries and present day screening programs primarily identify precancerous lesions termed cervical intraepithelial neoplasias (CIN. CIN lesions described as mild dysplasia (CIN I are likely to spontaneously regress while CIN III lesions (severe dysplasia are likely to progress if untreated. Thoughtful consideration of gene expression changes paralleling the progressive pre invasive neoplastic development will yield insight into the key casual events involved in cervical cancer development. Results In this study, we have identified gene expression changes across 16 cervical cases (CIN I, CIN II, CIN III and normal cervical epithelium using the unbiased long serial analysis of gene expression (L-SAGE method. The 16 L-SAGE libraries were sequenced to the level of 2,481,387 tags, creating the largest SAGE data collection for cervical tissue worldwide. We have identified 222 genes differentially expressed between normal cervical tissue and CIN III. Many of these genes influence biological functions characteristic of cancer, such as cell death, cell growth/proliferation and cellular movement. Evaluation of these genes through network interactions identified multiple candidates that influence regulation of cellular transcription through chromatin remodelling (SMARCC1, NCOR1, MRFAP1 and MORF4L2. Further, these expression events are focused at the critical junction in disease development of moderate dysplasia (CIN II indicating a role for chromatin remodelling as part of cervical cancer development. Conclusion We have created a valuable publically available resource for the study of gene expression in precancerous cervical lesions. Our results indicate deregulation of the chromatin remodelling complex components and its influencing factors occur in the development of CIN lesions. The increase in SWI

  20. Co-expression of p16 and p53 characterizes aggressive subtypes of ductal intraepithelial neoplasia.

    Science.gov (United States)

    Bechert, Charles; Kim, Jee-Yeon; Tramm, Trine; Tavassoli, Fattaneh A

    2016-12-01

    In the USA alone, approximately 61,000 new diagnoses of ductal intraepithelial neoplasia 1c-3 (DIN) are made each year. Around 10-20 % of the patients develop a recurrence, about 50 % of which are invasive. Prior studies have shown that invasive breast carcinomas positive for p16 or p53 have a higher frequency of recurrence and a more aggressive course; however, the co-expression of these markers across the entire spectrum of DIN and its potential correlation with grade of the lesions has not been studied previously. Immunohistochemical staining for p16 and p53 was evaluated on 262 DIN lesions from 211 cases diagnosed between 1991 and 2008. The lesions ranged from DIN1b (atypical intraductal hyperplasia) to DIN3 (DCIS, grade 3) and included 45 cases with associated invasive carcinoma. Frequency of staining for both p16 and p53 increased with increasing grade of DIN. Strong co-expression was found exclusively in higher grade DIN lesions (DIN2 and DIN3) particularly those associated with periductal stromal fibrosis and lymphocytic infiltrate. Strong co-expression was seen in 8 of 12 DIN3 lesions (67 %) associated with invasive carcinoma. In conclusion, co-expression of p16 and p53 increases with advancing grade of DIN and is maximal in high grade DIN lesions associated with invasive carcinoma, indicating a more aggressive phenotype. A distinctive variant of DIN with periductal fibrosis and lymphocytic infiltrate invariably falls into the high-grade category, based on either morphology or marker expression. Co-expression of p16/p53 may be of help in distinguishing between high-grade and low-grade DIN lesions.

  1. Proteomic analysis of pancreatic intraepithelial neoplasia and pancreatic carcinoma in rat models

    Institute of Scientific and Technical Information of China (English)

    Lei Wang; Hai-Lin Liu; Ya Li; Ping Yuan

    2011-01-01

    AIM: To detect the proteomic variabilities of pancreatic intraepithelial neoplasia (PanIN) and pancreatic carcinoma (PC) induced by 7,12-dimethylbenzanthracene (DMBA) in rat models and to identify potential biomarkers. METHODS: Sixty adult male Sprague Dawley rats were randomized into three groups. The rats had DMBA implanted into their pancreas for one (n = 20) or two months (n = 20) or assigned to the normal group (n = 20). The rats were killed after one or two months, and were evaluated histopathologically. Three tissue samples from each group of rats with either normal pancreas, PanIN (PanIN-2) or PC were examined by 2D-DIGE. The different expression spot features were analyzed by matrix-assisted laser desorption/ionizationtime of flight/time of flight (MALDI-TOF/TOF) tandem mass spectrometry. The expression of enolase 1, a differentially expressed protein, was identified by immunohistochemistry. RESULTS: There was significant difference in the proportions of neoplastic changes between the 1- and 2-mogroups (P = 0.0488). There was an increase in the frequency of adenocarcinomas in the 2-mo group compared with the 1-mo group (P = 0.0309). No neoplastic changes were observed in any of the animals in the normal group. Enolase 1, pancreatic ELA3B, necdin, Hbp23, CHD3, hnRNP A2/B1, Rap80, and Gnb2l1 were up-regulated in the PanIN and PC tissues, and CEL, TPT1, NME2, PCK2, an unnamed protein product, and glycine C-acetyltransferase were down-regulated in the PanIN and PC tissues. The immunohistochemical results showed that enolase 1 expression was up-regulated in the pancreatic cancer tissues of rats and humans. CONCLUSION: The pancreatic protein expression changes induced by DMBA suggest potential molecular targets for the early diagnosis and treatment of PC.

  2. A dietary pattern associated with LINE-1 methylation alters the risk of developing cervical intraepithelial neoplasia.

    Science.gov (United States)

    Piyathilake, Chandrika J; Badiga, Suguna; Kabagambe, Edmond K; Azuero, Andres; Alvarez, Ronald D; Johanning, Gary L; Partridge, Edward E

    2012-03-01

    There is a paucity of research examining the relationships between dietary patterns and risk of developing precancerous lesions as well as biomarkers associated with such dietary patterns. The purpose of the current study was to identify dietary patterns that are associated with higher grades of cervical intraepithelial neoplasia (CIN 2+) and to determine whether these dietary patterns are associated with the degree of DNA methylation in the long interspersed nucleotide elements (L1s) of peripheral blood mononuclear cells (PBMCs), a biomarker associated with risk of developing CIN 2+. Study population consisted of 319 child-bearing age women. Dietary patterns were derived by factor analysis. The degree of PBMC L1 methylation was assessed by pyrosequencing. Logistic regression models were used to evaluate the associations between dietary patterns and CIN 2+. Similar models were used to evaluate the associations between dietary patterns and degree of PBMC L1 methylation in women free of CIN 2+. Women with the unhealthiest dietary pattern were 3.5 times more likely to be diagnosed with CIN 2+ than women with the healthiest dietary pattern [OR = 3.5; 95% confidence interval (CI), 1.2-10.1; P = 0.02]. Women at risk for developing CIN 2+ with the healthiest dietary pattern were 3.3 times more likely to have higher PBMC L1 methylation than women with the unhealthiest dietary pattern (OR = 3.3; 95% CI, 1.0-10.6; P = 0.04). Our findings suggest that human papilloma virus associated risk of developing CIN 2+ may be reduced by improving dietary patterns. The degree of PBMC L1 methylation may serve as a biomarker for monitoring the effectiveness of dietary modifications needed for reducing the risk of CIN 2+.

  3. Conization Using an Electrosurgical Knife for Cervical Intraepithelial Neoplasia and Microinvasive Carcinoma.

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    Libing Xiang

    Full Text Available The aim of the present study was to evaluate the incidences of margin involvement, disease relapse, and complications in patients who had undergone conization using an electrosurgical knife (EKC for cervical intraepithelial neoplasia (CIN or microinvasive carcinomas (micro-CAs.A retrospective case series analysis was performed with a total of 1359 patients who underwent EKC in Fudan University Shanghai Cancer Center between June 2004 and July 2010.The median age of the patients was 39 years old (range: 19-72. Conization revealed the presence of CIN in 1113 (81.9% patients, micro-CA in 72 (5.3% patients and invasive carcinomas in 44 (3.2% patients. The remaining 130 (9.6% patients were free of diseases in the cone specimens. Positive surgical margins, or endocervical curettages (ECCs were found in 90 (7.6% patients with CINs or micro-CAs. Three factors were associated with positive margins and ECCs and included age (>50 years; odds ratio (OR, 3.0, P<0.01, postmenopausal status (OR, 3.1, P<0.01 and microinvasive disease (OR, 2.7, P<0.01. One thousand and eighty-nine (92.0% patients were followed-up regularly for a median follow-up duration of 46 months (range: 24-106 months. Disease relapse was documented in 50 (4.6% patients. Eighty-two (6.0% cases experienced surgical complications that needed to be addressed, including early or late hemorrhages, infections, cervical stenosis, etc.Our patients demonstrated that EKC was an alternative technique for diagnosis and treatment of CIN or micro-CAs with relatively low rate of recurrence and acceptable rate of complications. A randomized clinical trial is warranted to compare EKC, CKC and LEEP in the management of CIN or micro-CA.

  4. Value of frozen section examination in diagnosis and treatment of high-grade cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    REN Fang; FENG Wei; SHI Hui-rong; WU Qing-hua; CHEN Zhi-min

    2012-01-01

    Background Invasive cancer of the cervix is considered a preventable disease because it has a long pre-invasive state,cervical cytology screening programs are currently available,and treatment of pre-invasive lesions is effective.We tested the accuracy of frozen section examination (FSE) of cone specimens to identify the endocervical margin and rule out invasion in patients with high-grade cervical intraepithelial neoplasia (CIN).Methods For 320 consecutive patients with a preoperative biopsy result of CIN stage 2/3,cold-knife conization (CKC)was performed followed by FSE.The results from analyses of permanent paraffin sections (PS) were compared with the FSE findings.Results The accuracy of FSE was 87% (278/320).For all of the seven patients with an invasive squamous cell carcinoma of the cervix identified by FSE,the diagnosis was confirmed by PS analysis.For one patient,the FSE result was cervicitis,whereas PS ananlysis showed microinvasive carcinoma.Appropriate surgery was performed for all patients based on the FSE and biopsy results.The FSE and PS results were not significantly different (P=0.000).Definitive examination of margin status using PS was concordant with FSE findings in all cases.Conclusions FSE is a rapid and reliable method for evaluating CKC specimens.It can identify frank invasion,permit adequate treatment in a one-stage procedure,and reliably detect clear resection margins.Since discrepancies do exist and may result in inappropriate treatment,further research is required to decrease these discrepancies and avoid missing even one case.

  5. Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia.

    Science.gov (United States)

    Güdücü, Nilgün; Sidar, Güliz; Başsüllü, Nuray; Türkmen, Ilknur; Dünder, Ilkkan

    2013-08-01

    This study aimed to evaluate the rate of endocervical glandular involvement, positive surgical margins, multicentricity, and disease extent between low-grade and high-grade cervical intraepithelial lesions after loop electrosurgical excision procedure (LEEP). Pathology medical records of patients who underwent LEEP were reviewed retrospectively. Patients with negative LEEP results were excluded. Loop electrosurgical excision procedure reports of patients with cervical intraepithelial neoplasia (CIN) 1, 2, and 3 were compared. There was no statistically significant difference between patients with CIN 1 (n=24), CIN 2 (n=27), and CIN 3 (n=64) when age and surgical margin positivity were considered. Endocervical glandular involvement, multicentricity, and disease extent were higher in patients with CIN 3 (P=.001, P=.002, and P=.001, respectively). In conclusion, we recommend that patients with endocervical glandular involvement, lesions involving more than two-thirds of the LEEP specimen, and multicentricity be followed up more closely.

  6. Relationship between high risk HPV infection and potential malignant biological behavior of patients with cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    Cai-Yun Bai; Yan-Ming Wang

    2015-01-01

    Objective: To study the relationship between high risk HPV infection and potential malignant biological behavior of patients with cervical intraepithelial neoplasia. Methods: Patients with cervical intraepithelial neoplasia treated in our hospital from May 2012 to May 2014 were chosen for study; 40 cases of patients each in CIN I stage, CIN II stage and CIN III stage were screened; HPV subtypes as well as mRNA contents of proliferation related genes and chromosome related genes were detected. Results: (1) HPV subtypes: there were no differences in positive rates and contents of HPV-31, 33, 51, 52 and 58 of patients in different CIN stages; there were differences in positive rates and contents of HPV-16 and 18, and the higher the CIN stage is, the higher the positive rates and contents of HPV-16 and 18 are; (2) Proliferation related genes: mRNA contents of proliferation genes IMP3, MUC1 and TS in cervical tissue of patients with high risk HPV infection displayed higher expressions; mRNA contents of tumor suppressor genes p16ink4a and p53 displayed lower expressions; (3) Chromosome related genes: mRNA contents of MCM2, MCM7, hTERC, hTERT, hTP1 and CA-IX in cervical tissue of patients with high risk HPV infection displayed higher expressions. Conclusion: HPV-16 and 18 are high risk HPV of patients with cervical intraepithelial neoplasia and will cause increased expressions of proliferation genes and inhibited expressions of tumor suppressor genes, and affect chromosome replication and extension process.

  7. The regularly on Treatment of Cervical Intraepithelial Neoplasia%宫颈上皮内瘤变的治疗

    Institute of Scientific and Technical Information of China (English)

    邢育柏

    2014-01-01

    宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)是宫颈癌的癌前病变,合理干预宫颈上皮内瘤变对降低宫颈癌的发生有着至关重要的作用,规范处理宫颈上皮内瘤变意义重大.对不同级别的宫颈上皮内瘤变采用不同的治疗方法,同时需兼顾患者的具体情况予以合适的个体化治疗方案.

  8. Adenocarcinoma arising from vaginal stump: unusual vaginal carcinogenesis 7 years after hysterectomy due to cervical intraepithelial neoplasia.

    Science.gov (United States)

    Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya

    2013-11-01

    Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation.

  9. Progression of anal high-grade squamous intraepithelial lesions to invasive anal cancer among HIV-infected men who have sex with men.

    Science.gov (United States)

    Berry, J Michael; Jay, Naomi; Cranston, Ross D; Darragh, Teresa M; Holly, Elizabeth A; Welton, Mark L; Palefsky, Joel M

    2014-03-01

    The incidence of anal cancer is elevated in human immunodeficiency virus (HIV)-infected men-who-have-sex-with-men (MSM) compared to the general population. Anal high-grade squamous intraepithelial lesions (HSIL) are common in HIV-infected MSM and the presumed precursors to anal squamous cell cancer; however, direct progression of HSIL to anal cancer has not been previously demonstrated. The medical records were reviewed of 138 HIV-infected MSM followed up at the University of California, San Francisco, who developed anal canal or perianal squamous cancer between 1997 and 2011. Men were followed up regularly with digital anorectal examination (DARE), high-resolution anoscopy (HRA) and HRA-guided biopsy. Although treatment for HSIL and follow-up were recommended, not all were treated and some were lost to follow-up. Prevalent cancer was found in 66 men. Seventy-two HIV-infected MSM developed anal cancer while under observation. In 27 men, anal cancer developed at a previously biopsied site of HSIL. An additional 45 men were not analyzed in this analysis due to inadequate documentation of HSIL in relation to cancer location. Of the 27 men with documented progression to cancer at the site of biopsy-proven HSIL, 20 men progressed from prevalent HSIL identified when first examined and seven men from incident HSIL. Prevalent HSIL progressed to cancer over an average of 57 months compared to 64 months for incident HSIL. Most men were asymptomatic, and cancers were detected by DARE. Anal HSIL has clear potential to progress to anal cancer in HIV-infected MSM. Early diagnosis is facilitated by careful follow-up. Carefully controlled studies evaluating efficacy of screening for and treatment of HSIL to prevent anal cancer are needed.

  10. Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand

    Science.gov (United States)

    Ruanpeng, Darin; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

    2016-01-01

    Background Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Methods Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Results Mean age was 27.2 years (range 18–54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells—cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). Conclusions ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population

  11. Clinical significance of colposcopy on screening cervical intraepithelial neoplasia in cytological negative and smooth cervices

    Institute of Scientific and Technical Information of China (English)

    Dianyun Shi; Saiying Chen; Yan Sun

    2014-01-01

    Objective:The aim of the study was to evaluate the clinical value of the video colposcopy in screening cervical intraepithelial neoplasia (CIN) in cytological negative and smooth cervices by optical y gynecological examination. Methods:The 1050 women, whose cervices had been shown smooth and cytological negative by optical examine, were examined with electronic colposcopy in gynecological clinic, and biopsy was taken when the double abnormality of aceto-white epithelium and iodine negative, and other abnormal images were shown. A retrospective analysis of these cases was performed. Re-sults:(1) The 514 samples from 458 cases, including 458 samples of abnormal tissues under colposcopy and 56 samples of polyp or polypoid tumors by optical y, were examined by biopsy. Among them, 68 samples were found to be CIN, including 11 cases of CINII/CINIII;(2) The 72 of 1050 cases showed the double-abnormality of aceto-white epithelium and iodine nega-tive. Among them, 64 cases were CIN determined by biopsy. And the positive predictive value of the double-abnormality of aceto-white epithelium and iodine negative under colposcopy was 88.9%, with a false negative rate of 3.3%;(3) Among 458 women examined by biopsy, only one of 350 samples from cervical polyp tissue was CIN (0.3%), while 67 of 164 samples from the tissues with abnormal colposcopic images were found to be CIN (40.9%), indicating the close relation between abnormal colposcopic findings and CIN;(4) The results of age-distribution analysis showed that, in the 164 cases with abnormal features under colposcopy, the incidence of double abnormality of aceto-white epithelium and iodine negative was higher in the age of sexual activity, just the same as the age distribution feature of CIN;while single abnormality of iodine negative appeared more in the age of over 50 years. Conclusion:Abnormal features displayed by colposcopy, especial y the double abnormality of aceto-white epithelium and iodine negative, has an important

  12. Predictors and clinical significance of the positive cone margin in cervical intraepithelial neoplasia Ⅲ patients

    Institute of Scientific and Technical Information of China (English)

    SUN Xiao-guang; MA Shui-qing; ZHANG Jin-xia; WU Ming

    2009-01-01

    Background Conization is being widely accepted for diagnosis and treatment of cervical intraepithelial neoplasia (CIN). There is controversy as to which factors are most predictive of a positive cone margin and the clinical significance of it. We conducted this study to identify the predictive factors and to evaluate the clinical significance of a positive cone margin in CIN Ⅲ patients.Methods A retrospective review was conducted of 207 patients who had undergone conization due to CIN Ⅲ from January 2003 to December 2005 at Peking Union Medical College Hospital. Of these, 67 had a subsequent hysterectomy. Univariate and multivariate analysis were utilized to define the predictive factors for a positive cone margin, and to compare the pathologic results of conization with subsequent hysterectomy.Results One hundred and fifty-one (72.9%) were margin free of CIN Ⅰ or worse, 37 (17.9%) had CIN lesions close to the margin and 19 (9.2%) had margin involvement. A total of 56 cases (27.1%) had positive cone margins (defined as the presence of CIN at or close to the edge of a cone specimen). Univariate analysis showed that the parity, cytological grade, multi-quadrants of CIN Ⅲ by punch biopsy, gland involvement, as well as the depth of conization were significant factors correlated with a positive cone margin (P0.05). Multivariate analysis revealed that the cytological grade (OR=1.92), depth of conization (OR=2.03), parity (OR=3.02) and multi-quadrants of CIN Ⅲ (OR=4.60) were significant predictors with increased risk for positive margin. The frequency of residual CIN Ⅰ or worse in hysterectomy specimens was found to be 55.6% (20/36) in patients who were margin free, 71.4% (15/21) in patients with CIN occurring close to margin, and 80.0% (8/10) in patients with margin involvement. The frequency of residual CIN Ⅲ or worse was found to be 13.9% (5/36), 23.8% (5/21) and 50.0% (5/10) respectively in different groups.Conclusions Cytological grade, depth of

  13. Loss of Sirt1 promotes prostatic intraepithelial neoplasia, reduces mitophagy, and delays PARK2 translocation to mitochondria.

    Science.gov (United States)

    Di Sante, Gabriele; Pestell, Timothy G; Casimiro, Mathew C; Bisetto, Sara; Powell, Michael J; Lisanti, Michael P; Cordon-Cardo, Carlos; Castillo-Martin, Mireia; Bonal, Dennis M; Debattisti, Valentina; Chen, Ke; Wang, Liping; He, Xiaohong; McBurney, Michael W; Pestell, Richard G

    2015-01-01

    Prostatic intraepithelial neoplasia is a precursor to prostate cancer. Herein, deletion of the NAD(+)-dependent histone deacetylase Sirt1 induced histological features of prostatic intraepithelial neoplasia at 7 months of age; these features were associated with increased cell proliferation and enhanced mitophagy. In human prostate cancer, lower Sirt1 expression in the luminal epithelium was associated with poor prognosis. Genetic deletion of Sirt1 increased mitochondrial superoxide dismutase 2 (Sod2) acetylation of lysine residue 68, thereby enhancing reactive oxygen species (ROS) production and reducing SOD2 activity. The PARK2 gene, which has several features of a tumor suppressor, encodes an E3 ubiquitin ligase that participates in removal of damaged mitochondria via mitophagy. Increased ROS in Sirt1(-/-) cells enhanced the recruitment of Park2 to the mitochondria, inducing mitophagy. Sirt1 restoration inhibited PARK2 translocation and ROS production requiring the Sirt1 catalytic domain. Thus, the NAD(+)-dependent inhibition of SOD2 activity and ROS by SIRT1 provides a gatekeeper function to reduce PARK2-mediated mitophagy and aberrant cell survival.

  14. Cervical squamous and glandular intraepithelial neoplasia: identification and current management approaches

    OpenAIRE

    Wright V Cecil

    2003-01-01

    Certain types of human papillomaviruses (HPV) are associated with squamous intraepithelial lesions and cancer and these are termed high-risk. HPV type 16 is detected in approximately half of the high-grade squamous intraepithelial lesions and cancer. Because of the high rate of spontaneous regression of low-grade squamous lesions, follow-up by cytology, colposcopy and possible biopsy appears preferable. Due to the higher rate of progression to malignancy of the high-grade lesions conservative...

  15. Follow-up strategies after treatment (large loop excision of the transformation zone (LLETZ)) for cervical intraepithelial neoplasia (CIN): Impact of human papillomavirus (HPV) test

    NARCIS (Netherlands)

    Heijden, E.M. van der; Lopes, A.D.; Bryant, A.; Bekkers, R.L.M.; Galaal, K.

    2015-01-01

    BACKGROUND: Development of cancer of the cervix is a multi-step process as before cervical cancer develops, cervical cells undergo changes and become abnormal. These abnormalities are called cervical intraepithelial neoplasia (CIN) and are associated with increased risk of subsequent invasive cancer

  16. Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma

    NARCIS (Netherlands)

    van de Nieuwenhof, Hedwig P.; Bulten, Johan; Hollema, Harrie; Dommerholt, Rianne G.; Massuger, Leon F. A. G.; van der Zee, Ate G. J.; de Hullu, Joanne A.; van Kempen, Leon C. L. T.

    2011-01-01

    Lichen sclerosus is considered to be the precursor lesion of vulvar squamous cell carcinoma, of which only 2-5% progress to squamous cell carcinoma. Differentiated vulvar intraepithelial neoplasia (VIN) has been proposed to be the direct precursor lesion, but this is a recently recognized, and a dif

  17. In the absence of (early) invasive carcinoma, vulvar intraepithelial neoplasia associated with lichen sclerosus is mainly of undifferentiated type: New insights in histology and aetiology

    NARCIS (Netherlands)

    M. Seters, van (Manon); F.J.W. ten Kate (Fiebo); M. van Beurden (Marc); R.H.M. Verheijen (René); C.J.L.M. Meijer; M.P.M. Burger; T.J.M. Helmerhorst (Theo)

    2007-01-01

    textabstractBackground: Differentiated vulvar intraepithelial neoplasia (VIN) is presumed to be the precursor of invasive squamous cell carcinoma (SCC) of the vulva. It is commonly assumed that differentiated VIN is related to lichen sclerosus (LS). However, evidence for this is limited to a small n

  18. The molecular genetics and morphometry-based Endometrial Intraepithelial Neoplasia classification system predicts disease progression in Endometrial hyperplasia more accurately than the 1994 World Health Organization classification system

    NARCIS (Netherlands)

    Baak, JP; Mutter, GL; Robboy, S; van Diest, PJ; Uyterlinde, AM; Orbo, A; Palazzo, J; Fiane, B; Lovslett, K; Burger, C; Voorhorst, F; Verheijen, RH

    2005-01-01

    BACKGROUND. The objective of this study was to compare the accuracy of disease progression prediction of the molecular genetics and morphometry-based Endometrial Intraepithelial Neoplasia (EIN) and World Health Organization 1994 (WHO94) classification systems in patients with endometrial hyperplasia

  19. mRNA sequencing of novel cell lines from human papillomavirus type-16 related vulval intraepithelial neoplasia: consequences of expression of HPV16 E4 and E5.

    Science.gov (United States)

    Bryant, Dean; Onions, Tiffany; Raybould, Rachel; Flynn, Áine; Tristram, Amanda; Meyrick, Sian; Giles, Peter; Ashelford, Kevin; Hibbitts, Samantha; Fiander, Alison; Powell, Ned

    2014-09-01

    Vulval intraepithelial neoplasia is a precursor of vulval cancer and is commonly caused by infection with Human Papillomavirus (HPV). Development of topical treatments for vulval intraepithelial neoplasia requires appropriate in vitro models. This study evaluated the feasibility of primary culture of vulval intraepithelial neoplasia biopsy tissue to produce cell lines for use as in vitro models. A potentially immortal cell line was produced which gave rise to three monoclonal lines. These lines were characterized for HPV genomic integration and for viral gene expression using ligation-mediated PCR and quantitative PCR. Distinct patterns of viral integration and gene expression were observed among the three lines. Integration and expression data were validated using deep sequencing of mRNA. Gene ontology analyses of these data also demonstrated that expression of the HPV16 E4 and E5 proteins resulted in substantial changes in the composition of the cell membrane and extracellular space, associated with alterations in cell adhesion and differentiation. These data illustrate the diverse patterns of HPV gene expression potentially present within a single lesion. The derived cell lines provide useful models to investigate the biology of vulval intraepithelial neoplasia and the interactions between different HPV gene products and potential therapeutic agents.

  20. Long-term follow-up after large-loop excision of the transformation zone: evaluation of 22 years treatment of high-grade cervical intraepithelial neoplasia.

    NARCIS (Netherlands)

    Hamont, D. van; Ham, M.A. van; Struik-van de Zanden, N.; Keijser, K.G.G.; Bulten, J.; Melchers, W.J.G.; Massuger, L.F.A.G.

    2006-01-01

    Early treatment of cervical intraepithelial neoplasia (CIN) significantly reduces the risk of invasive cancerous progression. Residual and recurrent high-grade CIN should be detected and retreated in an early phase. Therefore, a postsurgery cytologic follow-up protocol was introduced at 3, 6, 9, and

  1. Long-term follow-up of the risk for cervical intraepithelial neoplasia grade 2 or worse in HPV-negative women after conization

    DEFF Research Database (Denmark)

    Gosvig, Camilla F; Huusom, Lene Drasbek; Andersen, Klaus K;

    2015-01-01

    Little research has been conducted on the long-term value of human papillomavirus (HPV) testing after conization. We investigated whether cytology adds to the value of a negative HPV test for long-term prediction of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In addition, we...

  2. Addition of high-risk HPV testing improves the current guidelines on follow-up after treatment for cervical intraepithelial neoplasia

    NARCIS (Netherlands)

    M.A.E. Nobbenhuis (Marielle); C.J.L.M. Meijer (Chris); A.J.C. van den Brule; L. Rozendaal (Lawrence); F. Voorhorst (Feja); E.K.J. Risse (Elle); R.H.M. Verheijen (René); T.J.M. Helmerhorst (Theo)

    2001-01-01

    textabstractWe assessed a possible role for high-risk human papillomavirus (HPV) testing in the policy after treatment for cervical intraepithelial neoplasia (CIN) 2 or 3 (moderate to severe dysplasia). According to the Dutch guidelines follow-up after treatment consists of cervical cytology at 6, 1

  3. MUC4 is increased in high grade intraepithelial neoplasia in Barrett's oesophagus and is associated with a proapoptotic Bax to Bcl-2 ratio

    NARCIS (Netherlands)

    Bax, DA; Haringsma, J; Einerhand, AWC; van Dekken, H; Blok, P; Siersema, PD; Kuipers, EJ; Kusters, JG

    2004-01-01

    Background: Patients with Barrett's oesophagus (BO) are at risk of oesophageal adenocarcinoma. Because the pattern of mucosal mucins changes during neoplastic progression, it may serve as a marker of intraepithelial neoplasia. Aims: To determine the expression pattern of mucins in neoplastic BO epit

  4. Diagnosis of gastric intraepithelial neoplasia by narrowband imaging and confocal laser endomicroscopy

    Institute of Scientific and Technical Information of China (English)

    Shu-Fang Wang; Yun-Sheng Yang; Li-Xin Wei; Zhong-Sheng Lu; Ming-Zhou Guo; Jin Huang; Li-Hua Peng

    2012-01-01

    AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnification endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE).METIHIODS:Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and treatment were recruited for this study.Excluded from the study were patients who had liver cirrhosis,impaired renal function,acute gastrointestinal (GI) bleeding,coagulopathy,esophageal varices,jaundice,and GI post-surgery.Also excluded were those who were pregnant,breastfeeding,were younger than 18 years old,or were unable to provide informed consent.All patients had all mucus and bile cleared from their stomachs.They then received upper GI endoscopy.When a mucosal lesion is found during observation with whitelight imaging,the lesion is visualized using maximal magnification,employing gradual movement of the tip of the endoscope to bring the image into focus.Saved images are analyzed.Confocal images were evaluated by two endoscopists (Huang J and Li MY),who were familiar with CLE,blinded to the related information about the lesions,and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria.The results were compared with the final histopathologic diagnosis.ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI,blinded to the related information about the lesions and CLE images,and were asked to classify each lesion as a LGD or HGD according to the "microvascular pattern and surface pattern" classification system.The results were compared with the final histopathologic diagnosis.RESULTS:The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities.CLE and ME-NBI enabled clear visualization of the vascular

  5. Utility of Ki-67 and p53 in distinguishing cervical intraepithelial neoplasia 3 from squamous cell carcinoma of the cervix.

    Science.gov (United States)

    Tan, Geok Chin; Sharifah, Noor Akmal; Shiran, Mohd Sidik; Salwati, Shuib; Hatta, Ahmad Zailani; Paul-Ng, Hock Oon

    2008-01-01

    The differentiation between cervical intraepithelial neoplasia 3 (CIN 3) and early squamous cell carcinoma (SCC) of the cervix may be difficult in certain situations. Identification of invasion beyond the basement membrane is the gold standard for the diagnosis of the latter. The objective of this study was to determine whether the use of Ki-67 and p53 could help in solving the above dilemma. This was a retrospective study on 61 cases of cervical neoplasms comprising of 25 cases of CIN 3 and 36 SCC. All cases were evaluated by immunohistochemistry using Ki-67 and p53 monoclonal antibodies. Results showed that the differences of Ki-67 and p53 expression between CIN 3 and SCC were statistically significant. In conclusion, Ki-67 and p53 may serve as helpful adjuncts to routinely-stained histological sections in differentiating between CIN 3 and SCC.

  6. Chlamydia trachomatis and risk of cervical intraepithelial neoplasia grade 3 or worse in women with persistent human papillomavirus infection

    DEFF Research Database (Denmark)

    Jensen, Kirsten E; Thomsen, Louise T; Schmiedel, Sven;

    2014-01-01

    intraepithelial neoplasia grade 3 or worse (CIN3+) in women with prevalent HPV infection and in a subgroup of women with persistent HPV infection. METHODS: Participants in this population-based cohort study underwent a structured interview, including history of CT infection, and subsequently cervical exfoliated......OBJECTIVES: Some studies suggest that Chlamydia trachomatis (CT) enhances cervical carcinogenesis; however, a possible confounding effect of persistent human papillomavirus (HPV) infection was not addressed. We examined the potential role of CT infection in the development of subsequent cervical...... cells were obtained for HPV DNA and CT DNA testing. Women with high-risk HPV DNA infection and no prevalent cervical disease constituted the overall study population (n=1390). A subgroup of women with persistent HPV infection (n=320) was also identified. All women were passively followed for development...

  7. High-risk and low-risk human papillomavirus and the absolute risk of cervical intraepithelial neoplasia or cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise; Frederiksen, Kirsten; Munk, Christian;

    2014-01-01

    OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

  8. Analysis the factors related to the cone marginal status of the patients with cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    Dai Zhi-qin; Pan Ling-ya; Huang Hui-fang; Lang Jing-he

    2008-01-01

    Objective:To assess the factors related to the cone marginal status of patients with cervical intraepithelial neo-plasia Ⅲ(CINⅢ)after conization.Method:A retrospective analysis of consecutive patients with CIN Ⅲ accepted conization between Jan.1st 1999 and Dec 31th 2004 was performed.To assess the relationships between the positive margin of conization of the pa-tients with cervical intraepithelial neoplasia Ⅲ and the patient's age,size of lesion and the operator.To assess the management of the positive cone margin and follow-up of the patient with CIN Ⅲ.Results:361 patients first accepted conization.Among them were 58 patients(16.1%)with positive cone mar-gin.There was no difference in the positive margin of conization in the different age groups,size of lesions and oper-ators.The rate of positive margin of conization was 14.3% with the surgeon of the gynecological oncologist,and the 20.4 % with the non-gynecological oncologist.The rate of the follow-up was 70%.According to the rate of the ab-normal cytology of follow-up,the positive margin of conization was 21.4%,and the negative margin of conization was 10.6%,there was no significant difference.Conclusion:The status of the resection margin of the conization may be related to the surgical skill.The patients with CINⅢ should be accepted a regular postoperative follow up,especially the patients with positive margin.

  9. Protein p 16INK4A expression in cervical intraepithelial neoplasia and invasive squamous cell carcinoma of uterine cervix

    Directory of Open Access Journals (Sweden)

    Gupta Ruchi

    2010-01-01

    Full Text Available The association of human papilloma virus (HPV infection and cervical intraepithelial neoplasia (CIN is well recognized. Interaction of HPV oncogenic proteins with cellular regulatory proteins leads to up regulation of p16 INK4A , a CDK inhibitor, which is a biomarker for HPV infection. We investigated p16 expression in CIN and invasive squamous cell carcinoma (SCC which has not been reported in the Indian population previously. Materials and Methods: Retrospective analysis of 100 cases with 20 cases each of histologically normal cervical epithelium, CIN1, 2, 3 and invasive SCC for p16 expression was performed by immunohistochemistry using commercially available mouse monoclonal antibody to p16 (clone 6H12. Statistical Analysis: For differences in expression among groups, statistical analysis was carried out using ANOVA and post hoc test of Scheffe. Results: p16 immunoreactivity was found to be both nuclear and/or cytoplasmic. The normal cervical epithelium was predominantly negative for p16 (18/20. There was a progressive increase of p16 expression with the grade of CIN. In CIN 1, two cases (20% showed nuclear and nucleocytoplasmic positivity respectively. In contrast, diffuse strong nuclear or nucleocytoplasmic expression was observed in 45 and 55% cases of CIN 2 and CIN 3 respectively. All except one squamous cell carcinoma stained strongly positive for p16. The difference in expression between CIN 2/3 and SCC versus normal cervix was found highly significant (p is equal to 0.008 and p less than 0.001. Conclusions: p16 expression correlates excellently with the grade of CIN and is a sensitive marker of cervical intraepithelial neoplasia.

  10. Number of fragments, margin status and thermal artifacts of conized specimens from LLETZ surgery to treat cervical intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Dulcimary Dias Bittencourt

    Full Text Available CONTEXT AND OBJECTIVE: Large loop excision of the transformation zone (LLETZ is a nontraumatic cut and coagulation method with several advantages, but it induces thermal artifacts in the cut region. The aim here was to assess the correlations of age, number of fragments, lesion grade and degree of thermal artifacts with margin quality in conized specimens from LLETZ for cervical intraepithelial neoplasia (CIN. DESIGN AND SETTING: Cross-sectional study at Universidade Federal de São Paulo (Unifesp. METHODS: The records and histopathology findings of 118 women who underwent LLETZ between 1999 and 2007 were reviewed. Age, number of fragments, lesion grade, degree of thermal artifacts and margin quality were assessed. RESULTS: The patients' mean age was 27.14 years; 63.6% had been diagnosed with CIN II and 36.4% with CIN III. The lesion was removed as a single fragment in 79.6% of the cases. The margins were free from intraepithelial neoplasia in 85.6% and compromised in the endocervical margin in 6.8%. Fragment damage due to artifacts occurred in 2.5%. Severe artifacts occurred in 22.8%. Women aged 30 years or over presented more cases of CIN III (P < 0.0004. Neoplastic compromising of surgical margins and severe artifacts occurred more often in cases in which two or more fragments were removed, and in patients aged 30 years or over. CONCLUSION: CIN III in women aged 30 or over, when removed in two or more fragments during LLETZ, presented a greater number of compromised margins and greater severity of thermal artifacts.

  11. Differentiating between endocervical glandular neoplasia and high grade squamous intraepithelial lesions in endocervical crypts: cytological features in ThinPrep and SurePath cervical cytology samples.

    Science.gov (United States)

    Thiryayi, Sakinah A; Marshall, Janet; Rana, Durgesh N

    2009-05-01

    A recent audit at our institution revealed a higher number of cases diagnosed as endocervical glandular neoplasia on ThinPrep (TP) cervical cytology samples (9 cases) as opposed to SurePath (SP) (1 case), which on histology showed only high-grade cervical intraepithelial neoplasia (CIN) with endocervical crypt involvement (CI). We attempted to ascertain the reasons for this finding by reviewing the available slides of these cases, as well as slides of cases diagnosed as glandular neoplasia on cytology and histology; cases diagnosed as high-grade squamous intraepithelial lesions (HSIL) on cytology which had CIN with CI on histology and cases with mixed glandular and squamous abnormalities diagnosed both cytologically and histologically. Single neoplastic glandular cells and short pseudostratified strips were more prevalent in SP than TP with the cell clusters in glandular neoplasia 3-4 cells thick, in contrast to the dense crowded centre of cell groups in HSIL with CI. The cells at the periphery of groups can be misleading. Cases with HSIL and glandular neoplasia have a combination of the features of each entity in isolation. The diagnosis of glandular neoplasia remains challenging and conversion from conventional to liquid based cervical cytology requires a period of learning and adaptation, which can be facilitated by local audit and review of the cytology slides in cases with a cytology-histology mismatch.

  12. Prolactin and prolactin receptor expression in cervical intraepithelial neoplasia and cancer.

    Science.gov (United States)

    Ascencio-Cedillo, Rafael; López-Pulido, Edgar Ivan; Muñoz-Valle, José Francisco; Villegas-Sepúlveda, Nicolás; Del Toro-Arreola, Susana; Estrada-Chávez, Ciro; Daneri-Navarro, Adrian; Franco-Topete, Ramón; Pérez-Montiel, Delia; García-Carrancá, Alejandro; Pereira-Suárez, Ana Laura

    2015-04-01

    Prolactin receptor (PRLR) overexpression could play a role in tumorigenesis. The aim of this study was to determine prolactin (PRL) and PRLR expression in biopsies from patients with precursor lesions and uterine cervical cancer. PRLR expression was analyzed in 63 paraffin-embedded biopsies of uterine cervical tissue. In total, eleven low-grade squamous intraepithelial lesions (LSIL), 23 high-grade squamous intraepithelial lesions (HSIL), 21 uterine cervical cancers (UCC) and 8 normal epithelium (NE) were examined using immunoperoxidase staining and Western blot analysis. Additionally, PRL expression was identified in human cervical cancer serum and tissues. The PRLR expression was found to be significantly increased in cervical cancer in comparison with normal tissue and precursor lesions (P prolactin expression was similar in precursor lesions and cervical cancer by Western blot analysis. Our data suggest a possible role for PRLR in the progression of cervical cancer.

  13. Características de um grupo de adolescentes com suspeita de neoplasia intra-epitelial cervical Characteristics of a group of adolescents with suspected cervical intraepithelial neoplasia

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    Maria Isabel do Nascimento

    2005-10-01

    suspected cervical neoplasia and to compare it with young adult women. METHODS: a cross-sectional, retrospective study that analyzed 366 medical records of females referred to clarify diagnosis of the suspected cervical neoplasia. The patients had been classified into two groups defined by age. The Adolescent group was composed of 129 females between 13 and 19 years and the Adult group was composed of 237 females between 20 and 24 years. Data were analyzed statistically by the prevalence ratio (PR, respective confidence intervals (CI at 95% for each variable, chi2 test, or Fisher exact test used to compare proportion. RESULTS: the first sexual intercourse coitarche occurred on average at 15.0 years in the Adolescent group and 16.6 years in the Adult group. The possibility of diagnosis of cytological alterations in the first Papanicolaou smears (PR=2.61; CI 95%: 2.0-3,4, the condition of non-clarified cervical intraepithelial neoplasia (CIN (PR=1.78; CI 95%: 1.26-2,52, and the colposcopic impressions of low grade (PR=1.42; CI 95%: 1.08-1.86 were statistically significant in the Adolescent group. The histopathologic analysis did not show differences at any grade of CIN. However, two cases of microinvasive carcinoma, one in each group, and three cases of clinical invasive carcinoma in the Adult group were identified. CONCLUSION: our study suggests that cervical cancer is rare among adolescents, but we verified that alterations associated with it occurred even in younger women. The evaluation of cervical intraepithelial neoplasia with the careful application of the same tools used for adult women was appropriate also in adolescence.

  14. Intraepithelial macrophage infiltration is related to a high number of regulatory T cells and promotes a progressive course of HPV-induced vulvar neoplasia.

    Science.gov (United States)

    van Esch, Edith M G; van Poelgeest, Mariette I E; Trimbos, J Baptist M Z; Fleuren, Gert Jan; Jordanova, Ekaterina S; van der Burg, Sjoerd H

    2015-02-15

    Human papilloma virus (HPV)-induced usual-type vulvar intraepithelial neoplasia (uVIN) is infiltrated by myeloid cells but the type and role of these cells is unclear. We used triple immunofluorescent confocal microscopy to locate, identify and quantify myeloid cells based on their staining pattern for CD14, CD33 and CD163 in a cohort of 43 primary and 20 recurrent uVIN lesions, 21 carcinomas and 26 normal vulvar tissues. The progressive course of uVIN is characterized by an increase in both intraepithelial and stromal mature M1 and M2 macrophages. While the M2 macrophages outnumber M1 macrophages in healthy controls and uVIN, they are matched in number by M1 macrophages in cancer. Importantly, uVIN patients with a dense intraepithelial infiltration with mature CD14+ macrophages (irrespective of M1 or M2 type) displayed approximately a six times higher risk to develop a recurrence and a high number of these cells constituted an independent prognostic factor for recurrence. In addition, a dense intraepithelial CD14+ cell infiltration was associated with high numbers of intraepithelial CD4+ Tregs and low numbers of stromal CD8+TIM3+ T cells. Patients with low numbers of intraepithelial CD14+ cells and high numbers of stromal CD8+TIM3+ cells showed the best recurrence-free survival. These data clearly show the importance of the local immune response in HPV-induced vulvar neoplasia and may be of help in predicting the prognosis of patients or their response to immunotherapy.

  15. Expression of transcription factors Twist and Snail in cervical intraepithelial neoplasia tissues and their relationship with epithelial-mesenchymal transition and cell proliferation

    Institute of Scientific and Technical Information of China (English)

    Hai-Dan Fu

    2016-01-01

    Objective:To study the expression of transcription factors Twist and Snail in cervical intraepithelial neoplasia tissues and their relationship with epithelial-mesenchymal transition and cell proliferation.Methods: cervical intraepithelial neoplasia tissues (n=67) and normal cervical tissues (n=85) were collected, and the contents of Twist and Snail as well as epithelial-mesenchymal transition-related molecules and proliferation-related molecules in the tissues were detected.Results:Twist and Snail contents in CIN cervical tissues were lower than those in normal cervical tissues; Twist, Snail, PI3K, Akt, STAT3, Vimentin, N-cadherin, Prdx4, EZH2 and STOML-2 contents in CIN cervical tissues were higher than those in normal cervical tissues, and E-cadherin content was significantly lower than that in normal cervical tissues; E-cadherin content in CIN tissues with high expression of Twist and Snail was significantly lower than that in CIN tissues with low expression of Twist and Snail, and Vimentin, N-cadherin, Prdx4, EZH2 and STOML-2 contents were higher than those in CIN tissues with low expression of Twist and Snail.Conclusions:Transcription factors Twist and Snail expression increase and downstream signaling pathway function is enhanced in cervical intraepithelial neoplasia tissues; Twist and Snail can regulate epithelial-mesenchymal transition and cell proliferation.

  16. Conditional Expression of Human 15-Lipoxygenase-1 in Mouse Prostate Induces Prostatic Intraepithelial Neoplasia: The FLiMP Mouse Model

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    Uddhav P. Kelavkar

    2006-06-01

    Full Text Available The incidence and mortality of prostate cancer (PCa vary greatly in different geographic regions, for which lifestyle factors, such as dietary fat intake, have been implicated. Human 15-lipoxygenase-1 (h15-LO-1, which metabolizes polyunsaturated fatty acids, is a highly regulated, tissue-specific, lipid-peroxidating enzyme that functions in physiological membrane remodeling and in the pathogenesis of atherosclerosis, inflammation, and carcinogenesis. We have shown that aberrant overexpression of 15-LO-1 occurs in human PCa, particularly high-grade PCa, and in high-grade prostatic intraepithelial neoplasia (HGPIN, and that the murine orthologue is increased in SV40-based genetically engineered mouse (GEM models of PCa, such as LADY and TRansgenic Adenocarcinoma of Mouse Prostate. To further define the role of 15-LO-1 in prostate carcinogenesis, we established a novel GEM model with targeted overexpression of h15-LO-1 in the prostate [human fifteen lipoxygenase-1 in mouse prostate (FLiMP]. We used a Cre- mediated and a loxP-mediated recombination strategy to target h15-LO-1 specifically to the prostate of C57BL/6 mice. Wild-type (wt, FLiMP+/-, and FLiMP+/+ mice aged 7 to 21, 24 to 28, and 35 weeks were characterized by histopathology, immunohistochemistry (IHC, and DNA/RNA and enzyme analyses. Compared to wt mice, h15-LO-1 enzyme activity was increased similarly in both homozygous FLiMP+/+ and hemizygous FLiMP+/- prostates. Dorsolateral and ventral prostates of FLiMP mice showed focal and progressive epithelial hyperplasia with nuclear atypia, indicative of the definition of mouse prostatic intraepithelial neoplasia (mPIN according to the National Cancer Institute. These foci showed increased proliferation by Ki-67 IHC. No progression to invasive PCa was noted up to 35 weeks. By IHC, h15-LO-1 expression was limited to luminal epithelial cells, with increased expression in mPIN foci (similar to human HGPIN. In summary, targeted overexpression of h

  17. Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia

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    Jiang YM

    2016-06-01

    Full Text Available Yan-Ming Jiang, Chang-Xian Chen, Li LiDepartment of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaObjective: This meta-analysis aimed to compare the superiority of loop electrosurgical excision procedure (LEEP or large loop excision of the transformation zone (LLETZ versus cold-knife conization (CKC in the surgical treatment of cervical intraepithelial neoplasia (CIN.Methods: Systematic searches were performed in the MEDLINE, EMBASE, Cochrane databases, and the China National Knowledge Infrastructure Databases to identify all potential articles involving patients with CIN treated with LEEP/LLETZ or CKC published up to February 2016. Risk ratios (RRs or weighted mean difference (MD with a 95% confidence interval (95% CI were calculated.Results: Seven randomized controlled trials, one prospective cohort study, and twelve retrospective cohort studies were included in this meta-analysis. There were no significant differences following LEEP/LLETZ compared with CKC in recurrence rate (RR =1.75, 95% CI =0.99–3.11, P=0.06, positive margin rate (RR =1.45; 95% CI =0.85–2.49, P=0.17, residual disease rate (RR =1.15, 95% CI =0.73–1.81, P=0.48, secondary hemorrhage (RR =1.16, 95% CI =0.74–1.81; P=0.46, or cervical stenosis. Moreover, subgroup analyses based on randomized trials also revealed that no statistical significance was observed in the above outcomes. However, women treated with CKC had a significantly deeper cervical cone than those treated with LLETZ/LEEP (MD =−5.71, 95% CI =−7.45 to −3.96; P<0.001.Conclusion: LEEP/LLETZ is as effective as CKC with regard to recurrence rate, positive margin rate, residual disease rate, secondary hemorrhage, and cervical stenosis for the surgical treatment of CIN. Further large-scale studies are needed to confirm our findings.Keywords: cervical intraepithelial neoplasia, cold-knife conization, loop electrosurgical excision

  18. Association between micronucleus frequency and cervical intraepithelial neoplasia grade in Thinprep cytological test and its significance.

    Science.gov (United States)

    Shi, Yong-Hua; Wang, Bo-Wei; Tuokan, Talaf; Li, Qiao-Zhi; Zhang, Ya-Jing

    2015-01-01

    A micronucleus is an additional small nucleus formed due to chromosomes or chromosomal fragments fail to be incorporated into the nucleus during cell division. In this study, we assessed the utility of micronucleus counting as a screening tool in cervical precancerous lesions in Thinprep cytological test smears under oil immersion. High risk HPV was also detected by hybrid capture-2 in Thinprep cytological test smears. Our results showed that micronucleus counting was significantly higher in high-grade squamous intraepithelial lesion (HSIL) and invasive carcinoma cases compared to low-grade squamous intraepithelial lesion (LSIL) and non-neoplastic cases. Receiver operating characteristic (ROC) curve analysis revealed that micronucleus counting possessed a high degree of sensitivity and specificity for identifying HSIL and invasive carcinoma. Cut-off of 7.5 for MN counting gave a sensitivity of 89.6% and a specificity of 66.7% (P = 0.024 and AUC = 0.892) for detecting HSIL and invasive carcinoma lesions. Multiple linear regression analysis showed that only HSIL and invasive cancer lesions not age, duration of marital life and number of pregnancy are significantly associated with MN counting. The positive rate of high risk HPV was distinctly higher in LSIL, HSIL and invasive cancer than that in non-neoplstic categories. In conclusions, MN evaluation may be viewed as an effective biomarker for cervical cancer screening. The combination of MN count with HPV DNA detection and TCT may serve as an effective means to screen precancerous cervical lesions in most developing nations.

  19. Cervical squamous and glandular intraepithelial neoplasia: identification and current management approaches

    Directory of Open Access Journals (Sweden)

    Wright V Cecil

    2003-01-01

    Full Text Available Certain types of human papillomaviruses (HPV are associated with squamous intraepithelial lesions and cancer and these are termed high-risk. HPV type 16 is detected in approximately half of the high-grade squamous intraepithelial lesions and cancer. Because of the high rate of spontaneous regression of low-grade squamous lesions, follow-up by cytology, colposcopy and possible biopsy appears preferable. Due to the higher rate of progression to malignancy of the high-grade lesions conservative treatment is recommended. One of the most common reasons for persistence relates to the human immunodeficiency virus. Adenocarcinoma in situ is an uncommon disorder and not well identified by cytologic sampling or colposcopic inspection. The diagnosis is made by cone biopsy, the specimen having negative margins for disease. Hysterectomy is the treatment procedure of choice unless fertility is an issue. Excisional methods (particularly electrosurgical loop can interfere with accurate histological interpretation in some cases of both squamous disease and adenocarcinoma in situ.

  20. Cervical intraepithelial neoplasia clinical pathological features%子宫颈上皮内瘤变临床病理特征分级

    Institute of Scientific and Technical Information of China (English)

    王玉琳

    2014-01-01

    目的:研究分析子宫颈上皮内瘤变临床病理特征分级。方法采取回顾性分析法,总结分析我院2010年10月~2014年5月所收治的27例子宫颈上皮内瘤变患者的临床资料,实施光镜检查,观察瘤变临床病理特征,并进行分级。结果通过分析,有5例患者为子宫颈上皮内瘤变Ⅰ级,有8例患者为子宫颈上皮内瘤变Ⅱ级,有14例患者为子宫颈上皮内瘤变Ⅲ级。实施宫颈换锥切的患者有17例,所占比例为62.9%,剩余10例患者均为子宫颈上皮内瘤变Ⅲ级患者均实施子宫全切,所占比例为37.1%。结论通过本次研究结果分析发现,采取宫颈三阶梯检查,实施病理特征分级,能够早诊断以及治疗子宫颈上皮内瘤变,降低癌症的发生率和病死率。%Objective To study the analysis of the clinicopathological features of cervical intraepithelial neoplasia. Methods A retrospective analysis, summarizes the analysis of our hospital in October 2010~2014 on May 27 treated by examples the clinical data of patients with cervical intraepithelial neoplasia, implement light microscope examination, to observe neoplasia clinical pathological characteristics, and classification. Results Through the analysis of 5 patients of cervical intraepithelial neoplasia grade Ⅰ, eight patients for cervical intraepithelial neoplasia grade Ⅱ, 14 patients of cervical intraepithelial neoplasia grade Ⅲ. Implementation of cervix in 17 patients with taper cutting of, proportion is 62.9%, the remaining 10 cases were cervical intraepithelial neoplasia grade Ⅲ.patients are implementing the womb all cut, the proportion of 37.1%. Conclusion Through the analysis found that the study results to the cervical three ladder inspection, the implementation of the pathological characteristics of classification, to early diagnosis and treatment of cervical intraepithelial neoplasia, reduce the incidence and mortality of cancer.

  1. 重复穿刺活检中高级别上皮内瘤对前列腺癌的预测价值%Prediction value of high-grade prostatic intraepithelial neoplasia for prostate cancer on repeat biopsies

    Institute of Scientific and Technical Information of China (English)

    Huilian Hou; Xuebin Zhang; Xu Li; Xingfa Chen; Chunbao Wang; Guanjun Zhang; Honghan Wang; Huilin Gong; Yuan Deng; Min Wang

    2011-01-01

    Objective: The significance of isolated high-grade prostatic intraepithelial neoplasia in initial biopsy as an predictor for prostate cancer has been extensively research, and the true relationship remnant is no clear till now. The aim of this study is to evaluate prediction value of cancer on repeat biopsy in patients with high-grade prostatic intraepithelial neoplasia,using multivariate analysis. Methods: Thirty-eight men with a diagnosis of isolated high-grade prostatic intraepithelial neoplasia in initial needle biopsy were studies, in the Fist Affiliated Hospital of Medical School of Xi'an Jiaotong University, from January 2003 to March 2009. These samples were using immunostaining of p63 and 34βE12 and P504s, with a median follow-up of 525 (range, 7 to 1650) days, and to researched the incidence of subsequent prostate cancer, and to predicted the risk of prostate cancer in clinicopathological parameters of isolated high-grade prostatic intraepithelial neoplasia on repeat biopsies by logistic regression analysis. Results: There were 10 of 38 (26.3%) men with prostate cancer on repeat biopsies after diagnosis isolated high-grade prostatic intraepithelial neoplasia in initial biopsy, of the rates of prostate cancer were 80% for micropapillary and 75% for cribriform high-grade prostatic intraepithelial neoplasia (P < 0.05), respectively. The positive cores of isolated high-grade prostatic intraepithelial neoplasia was the important for the risk of prostate cancer using Multifactor logistic regression analysis. The time range in 30 to 690 days was stronger risk for prostate cancer detection after diagnosis isolated HGPIN in initial biopsy. p63 and 34βE12 were disrupted positive expression, and P504S was weak positive expression in the 61% isolated high-grade prostatic intraepithelial neoplasia. Conclusion: Isolated high-grade prostatic intraepithelial neoplasia on repeat biopsy conferred a 26.3% risk of prostate cancer, and this risk level is lower than the

  2. Cyto-histological correlation of 219 patients submitted to surgical treatment due to diagnosis of cervical intraepithelial neoplasia

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    Sheila Jorge Adad

    1999-03-01

    Full Text Available CONTEXT: Cervical cytology continues to be the most appropriate method for investigating cervical neoplasia and its precursors. Greater diagnostic acuity is obtained by combining cytology, colposcopy and guided biopsy methods. OBJECTIVE: To analyze the diagnostic acuity of cyto- and histopathological exams and causes of diagnostic error. DESIGN: Retrospective study. SETTING: A public tertiary referral center. SAMPLE: Reports on 219 patients submitted to cone biopsy and/or hysterectomy due to diagnosis of cervical intraepithelial neoplasia (CIN in the period between January 1982 and March 1997 were reviewed, comparing. MAIN MEASUREMENTS: cytological and histological exams (guided biopsy and surgically-removed tissue. In cases of discordance, the cyto- and histological preparations were reviewed to try to evaluate the causes of errors. RESULTS: In 193 cases (88.1% there was cyto-histological agreement but none in 26 (11.9%. Review of the discordant cases showed that in 2 (0.9% there was invasion of the stromata to a depth greater than 3mm, and in 7 (3.2% microinvasion, unsuspected via cytology; in 2 (0.9% microinvasion was suspected via cytology but not confirmed by the final histological exam; and in 15 (6.8% there was disagreement about the degree of CIN. CONCLUSION: The principal causes of error in the cytological exam were the lack of reliable morphological criteria for microinvasion, absence of sampling of the squamocolumnar junction, and scarcity of neoplastic cells in the sample. As for the histological exam, the errors were related to inadequate technical processing and underestimation of focal lesions.

  3. Cervical squamous and glandular intraepithelial neoplasia: identification and current management approaches Neoplasia intraepitelial cervical escamosa y glandular: identificación y estrategias de manejo

    Directory of Open Access Journals (Sweden)

    V Cecil Wright

    2003-01-01

    Full Text Available Certain types of human papillomaviruses (HPV are associated with squamous intraepithelial lesions and cancer and these are termed high-risk. HPV type 16 is detected in approximately half of the high-grade squamous intraepithelial lesions and cancer. Because of the high rate of spontaneous regression of low-grade squamous lesions, follow-up by cytology, colposcopy and possible biopsy appears preferable. Due to the higher rate of progression to malignancy of the high-grade lesions conservative treatment is recommended. One of the most common reasons for persistence relates to the human immunodeficiency virus. Adenocarcinoma in situ is an uncommon disorder and not well identified by cytologic sampling or colposcopic inspection. The diagnosis is made by cone biopsy, the specimen having negative margins for disease. Hysterectomy is the treatment procedure of choice unless fertility is an issue. Excisional methods (particularly electrosurgical loop can interfere with accurate histological interpretation in some cases of both squamous disease and adenocarcinoma in situ.Ciertos tipos de virus del papiloma humano (VPH, denominados de alto riesgo, están asociados con lesiones escamosas intraepiteliales y cáncer invasor. El VPH tipo 16 es detectado en aproximadamente la mitad de las lesiones escamosas intraepiteliales de alto grado y cáncer. Sin embargo, existe una elevada proporción de regresión espontánea en lesiones escamosas de bajo grado, por lo que para su monitoreo es preferible la utilización de citología, colposcopía y biopsia. Asimismo, debido a la elevada tasa de progresión a malignidad de lesiones de alto grado se recomienda un tratamiento conservador. Una de las razones comunes relacionadas con la persistencia de infección por el VPH es el virus de inmunodeficiencia humana. Por otra parte, el adenocarcinoma in situ es un trastorno raro, no bien identificado en muestras citológicas o de inspección colposcópica; el diagnóstico se

  4. The frequency of herpes simplex virus changes in anal Pap smear and its association with squamous intraepithelial lesions in high-risk male patients.

    Science.gov (United States)

    Greebon, Leslie J; Avery, Diane L; Prihoda, Thomas J; Valente, Philip T; Policarpio-Nicolas, Maria Luisa C

    2014-06-01

    While there are studies postulating a model of synergism between human papillomavirus (HPV) and herpes simplex virus (HSV) in cervical carcinogenesis, the frequency of anal herpes as well as its association with anal squamous intraepithelial lesions (ASILs) has been understudied in men. This study evaluates the frequency of HSV changes in anal Pap smears and its association with ASILs in a high-risk population. A computerized search for specimens associated with anal cytology that had positive findings of HSV was performed. The electronic medical records were examined for past diagnosis of herpes, HSV serology prior to or after cytology, and if the patient received treatment after cytologic diagnosis of HSV. Of the 470 anal Pap smears (Thin-prep) examined, seven had cellular changes consistent with HSV infection. All patients were asymptomatic human immunodeficiency virus (HIV) positive males with no prior HSV serology tests. Two patients had prior diagnoses of HSV infection. Cytologic abnormalities were identified in 86% ranging from atypical squamous cells of undetermined significance to high grade squamous intraepithelial lesion. Three patients were treated after the HSV cytologic diagnosis. The frequency of HSV changes in anal Pap smear is low (1.48%), but the presence of concomitant cytologic abnormalities is high (86%). While our findings suggest the possible role of HSV as a HPV co-factor in ASILs, larger studies are needed to support this. Identification of HSV infection on anal Pap smear is important for institution of patient treatment and subsequent reduction of transmission.

  5. Comparison of loop electrosurgical conization with one or two passes in high-grade cervical intraepithelial neoplasias.

    Science.gov (United States)

    Rivoire, Waldemar Augusto; Monego, Heleusa Ione; Dos Reis, Ricardo; Binda, Márcia Appel; Magno, Valentino; Tavares, Eduardo Belmonte; Hammes, Luciano Serpa; Capp, Edison; Edelweiss, Maria Isabel

    2009-01-01

    The use of loop electrosurgical conization (LEC) for the treatment of large high-grade cervical intraepithelial neoplasias (CINs) is often associated with a difficult procedure that results in accidental sample fragmentation, thermal damage and sometimes the presence of positive margins. This study aims to compare LEC that removes the cervical cone in two blocks (anterior and posterior cervical lips - LEC2) with LEC performed with one pass of the loop (LEC1). In a randomized, controlled trial, patients that needed conization due to high-grade CIN were assigned to one of the techniques. There were no differences in terms of age, cone histopathological diagnosis, blood loss, vaginal injuries, stenosis of the cervical os and specimen artifacts. LEC2 required less hemostatic sutures. LEC2 showed no specimen fragmentation, while LEC1 did (0 vs. 5.9%; p = 0.10). As expected, LEC2 samples were heavier (p = 0.01), included a larger ectocervical area (p = 0.001) and, therefore, had a greater volume (p treatment choice: it is safe for the patient, with better outcomes regarding sample quality than LEC1. Further studies are encouraged regarding this procedure.

  6. The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy.

    Science.gov (United States)

    Farante, Gabriel; Zurrida, Stefano; Galimberti, Viviana; Veronesi, Paolo; Curigliano, Giuseppe; Luini, Alberto; Goldhirsch, Aron; Veronesi, Umberto

    2011-07-01

    The management of ductal intraepithelial neoplasia (DIN) has substantially changed over the past 30 years, as its incidence has increased (from 2-3% to more than 20%), mainly due to the widespread use of mammography screening. This article describes not only the more widespread theoretical concepts on DIN but also the differences in the practical applications of the theory between different countries, different oncology specialists, and different cancer centers. Papers related to the international multicentre-randomized trials and retrospective studies were analyzed. We include articles and papers published between 1993 and 2010 related to patients with DIN, and abstracts and reports from MEDLINE and other sources were indentified. The standard of care for DIN consists of (a) breast conservative surgery (mastectomy is still indicated in large lesions--masses or microcalcifications--in about 30% of cases); (b) radiotherapy (RT) after conservative surgery, and (c) medical treatment in estrogen receptors-positive patients. However, most studies have shown significant differences between theory and practical application. Moreover, there are differences regarding (a) the indications of sentinel lymph node biopsy, (b) the definition and identification of low-risk DIN subgroups that can avoid RT and tamoxifen, and (c) the research into new alternative drugs in adjuvant medical therapy. A general agreement on the best management of DIN does not exist as yet. New large trials are needed in order to define the best management of DIN patients which is (in most respects) still complex and controversial.

  7. Human telomerase gene amplification and high-risk human papillomavirus infection in women with cervical intra-epithelial neoplasia.

    Science.gov (United States)

    Takac, Iztok; Arko, D; Kodric, T; Poljak, M; Zagorac, A; Erjavec-Skerget, A; Kokalj-Vokac, N

    2009-01-01

    This study was designed to investigate whether a correlation exists between amplification of the human telomerase gene (human telomerase RNA component [TERC]) and high-risk human papillomavirus (HR-HPV) infection in 101 women with cervical intra-epithelial neoplasia (CIN). Eight patients (7.9%) had CIN 1, 24 (23.8%) had CIN 2 and 69 (68.3%) had CIN 3. TERC was amplified in 31.7% of all CIN patients. The difference in frequency of TERC amplification between patients with low-grade CIN (CIN 1) and those with high-grade CIN (CIN 2 and CIN 3) was not significant. HR-HPV infection was detected in 88.1% of all CIN cases and was significantly more frequent in patients with CIN 2 and CIN 3 than in patients with CIN 1. There was no significant difference in the frequency of HR-HPV infection between groups of patients with and without TERC amplification. In conclusion, this study found no correlation between TERC amplification and HR-HPV infection in patients with CIN.

  8. A lectin-based diagnostic system using circulating antibodies to detect cervical intraepithelial neoplasia and cervical cancer.

    Science.gov (United States)

    Jin, Yingji; Kim, Seung Cheol; Kim, Hyoung Jin; Ju, Woong; Kim, Yun Hwan; Kim, Hong-Jin

    2016-01-01

    In the present study, we developed serological strategies using immunoglobulin fractions obtained by protein A chromatography to screen for cervical cancer and cervical intraepithelial neoplasia I (CIN I). The reactivities of the immunoglobulins purified from sera of women with normal cytology, CIN I and cervical cancer were compared in enzyme-linked immunosorbent assays (ELISA) and enzyme-linked lectin assays (ELLAs). To capture the immunoglobulins, ELISAs and ELLAs were performed in protein A immobilized microplates. The reactivity of immunoglobulin in ELISA was in the increasing order normal cytology, CIN I and cervical cancer, while that in ELLAs for detecting fucosylation was in the decreasing order normal cytology, CIN I and cervical cancer. It was confirmed that women with CIN I were distinguishable from women with normal cytology or women with cervical cancer in the ELISA or the ELLA for detecting fucosylation with considerable sensitivity and specificity. Women with cervical cancer were also distinguishable from women with normal cytology with high sensitivity (ELISA: 97%, ELLA: 87%) and specificity (ELISA: 69%, ELLA: 72%). Moreover, the logistic regression model of the ELISA and the ELLA discriminated cervical cancer from normal cytology with 93% sensitivity and 93% specificity. These results indicate that the ELISAs and the ELLAs have great potential as strategies for primary screening of cervical cancer and CIN. It is expected that the ELISA and the ELLA can provide new insights to understand systemic changes of serum immunoglobulins during cervical cancer progression.

  9. An Intelligent Clinical Decision Support System for Patient-Specific Predictions to Improve Cervical Intraepithelial Neoplasia Detection

    Directory of Open Access Journals (Sweden)

    Panagiotis Bountris

    2014-01-01

    Full Text Available Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV, including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS, composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%, high specificity (97.1%, high positive predictive value (89.4%, and high negative predictive value (97.1%, for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+. In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions.

  10. Pretreatment plasma levels and diagnostic utility of hematopoietic cytokines in cervical cancer or cervical intraepithelial neoplasia patients.

    Science.gov (United States)

    Ławicki, Sławomir; Będkowska, Grażyna E; Gacuta-Szumarska, Ewa; Knapp, Paweł; Szmitkowski, Maciej

    2012-07-04

    In this study, we compared plasma levels and the diagnostic utility of hematopoietic growth factors (HGFs) with SCC-Ag in cervical cancer patients in relation to control groups and cervical intraepithelial neoplasia (CIN) patients and healthy subjects. Pretreatment plasma levels of HGFs (SCF, GM-CSF, G-CSF and M-CSF) were determined by the use of immunoenzyme assay (ELISA), and SCC-Ag by chemiluminescent microparticle immunoassay (CMIA). Significantly different concentrations of GM-CSF, G-CSF and M-CSF were observed in the group of patients with cervical cancer and CIN compared to the healthy controls. Significant differences in plasma levels of GM-CSF and M-CSF between cervical cancer and benign lesions patients were also found. The HGFs and SCC-Ag diagnostic specificities received high values. The diagnostic sensitivity and the predictive value of a positive and negative test result were higher for M-CSF than for antigen SCC in the cancer group. The M-CSF area under the ROC curve (AUC) was the largest from hematopoietic cytokines and SCC-Ag. These results suggest the potential utility of M-CSF as a good candidate for a marker of cervical cancer as well as benign lesions of this organ (CIN).

  11. Endometrial Intraepithelial Neoplasia (EIN) in endometrial biopsy specimens categorized by the 1994 World Health Organization classification for endometrial hyperplasia.

    Science.gov (United States)

    Li, Xiao-Chao; Song, Wen-Jing

    2013-01-01

    Our study is to determine the presence of endometrial intraepithelial neoplasia (EIN) in endometrial biopsy specimens classified by the 1994 World Health Organization (WHO) criteria for endometrial hyperplasia. Endometrial biopsy specimens that were stained with hematoxylin and eosin (HE) were examined and categorized by the WHO 1994 criteria and for the presence of EIN as defined by the International Endometrial Collaborative Group. β-catenin expression was examined by immunohistochemistry. A total of 474 cases of HE stained endometrial biopsy tissues were reviewed. There were 379 cases of simple endometrial hyperplasia, 16 with simple atypical endometrial hyperplasia, 48 with complex endometrial hyperplasia, and 31 with complex atypical endometrial hyperplasia. Among the 474 endometrial hyperplasia cases, there were 46 (9.7%) that were classified as EIN. Of these 46 cases, 11(2.9%) were classified as simple endometrial hyperplasia, 1 (6.3%) as simple atypical endometrial hyperplasia, 6 (12.5%) as complex endometrial hyperplasia, and 28 (90.3%) as complex atypical endometrial hyperplasia. EIN was associated with a higher rate of β-catenin positivity than endometrium classified as benign hyperplasia (72% vs. 22.5%, respectively, P hyperplasia, high β-catenin expression was noted in the cell membranes, whereas in EIN and endometrial adenocarcinoma high expression was noted in the cytoplasm. In conclusion, EIN is more accurate than the WHO classification for the diagnosis of precancerous lesions of the endometrium.

  12. Immunohistochemical study of the expression of epidermal growth factor receptor in benign prostatic hypertrophy, prostatic intraepithelial neoplasia and prostatic carcinoma.

    Science.gov (United States)

    Rana, Shveta; Sen, Rajeev; Kalra, Rajnish; Arora, B; Sharma, Puja; Gahlawat, Sapna

    2006-10-01

    The present study provides an analysis of immunohistochemical expression and localization of epidermal growth factor receptor (EGFR) in formalin fixed paraffin embedded specimens of prostate. Thirty-five cases each of benign prostatic hypertrophy (BPH) and prostatic carcinoma and 30 cases of prostatic intraepithelial neoplasia (PIN) were taken up for study. Streptavidin biotin peroxidase method was employed for immunohistochemical staining. EGFR positivity was observed in all the cases (100%) of BPH and PIN and in only 10 cases (28.5%) of prostatic carcinoma. In both BPH and PIN the basal cells revealed significantly higher intensity and percentage cell positivity than the luminal cells. Intensity and percentage of positively stained basal cells in BPH was higher than PIN basal cells but the difference was not statistically significant. The intensity and percentage cell positivity of BPH basal cells and PIN basal and luminal cells were significantly greater than the epithelial cells of prostatic carcinoma. Presently, the significance of variable expression of EGFR in various types of prostatic lesions is unknown.

  13. Intervenciones para el tratamiento de la neoplasia intraepitelial anal y la prevención de conductas sexuales de riesgo

    OpenAIRE

    Macaya Pascual, Antoni

    2016-01-01

    La prevalencia de neoplasia intraepitelial del canal anal (NICA) está incrementándose, principalmente en hombres que tienen sexo con hombres VIH+. No hay consenso sobre el manejo óptimo de la NICA, ni se ha procedido a un estudio global sobre la evidencia disponible del efecto preventivo que puedan tener las distintas intervenciones conductuales (IC). Objetivos: Sintetizar y analizar cualitativamente la evidencia disponible sobre la eficacia de las intervenciones terapéuticas en la NICA y ...

  14. Vaporização a laser do cervix para tratamento da neoplasia intraepitelial cervical Laser vaporization of the cervix for the management of cervical intraepithelial neoplasia

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    Euridice Maria de Almeida Figueiredo

    1998-04-01

    cervicais intra-epiteliais (NIC ou virais tem sido estimulado como uma alternativa digna de ser seguida pelas seguintes razões: cirurgia de não contato, tratamento rápido e indolor, diminuição das custas da internação; complicações mínimas e sem efeito subseqüente sobre a fertilidade e competência cervical, menor necrose térmica, e possibilidade de novo tratamento ambulatorial. Por estas razões e pelo alto percentual de cura podemos concluir que a cirurgia proposta foi vantajosa para o tratamento da neoplasia cervical intra-epitelial, quando comparada com outros métodos de tratamento.The incidence of cervical-uterine cancer is very high in many countries of Latin America and the rales of mortality, statistically have shown its social importance. This malignancy emerges very often as a progressive disease beginning from intrauterine changes to invasive processes. Therefore surgeon’s aim is to detect and treat these lesions in their very early phase when the cure of 100% is still possible. The author studied prospectively 21 patients with intraepithelial cervical neoplasia. The patients were screened by citology and had their diagnosis confirmed by histopathological examinations after colposcopic biopsy. The therapy employed was the vaporization with CO2 laser. The criteria for patients selection were: 1 The safe evidence of the changed area after colposcopy eliminating the possibility of a invasive lesion. 2 The inicial cervical neoplasia should be limited to the ectocervix without extension forward the cervical canal. 3 The correspondence among citology, colposcopy and histology. The use of the CO2 laser with microscope has made the procedure more precise which is applied in outpatient basis. No anesthetic has been needed and the operative time was 15 minutes on average. The final healing was completed after the third week and no special postoperative care has been necessary. Two cases had slight vaginal bleeding on 5th and 10th postoperative days but

  15. HPV 16 Is Related to the Progression of Cervical Intraepithelial Neoplasia Grade 2: A Case Series

    Science.gov (United States)

    Loffredo D'Ottaviano, Maria Gabriela; Andreoli, Maria Antonieta; Costa, Maria Cecília; Rabelo-Santos, Silvia H.; Villa, Luisa Lina; Zeferino, Luiz Carlos

    2013-01-01

    Purpose. To describe the acquisition, persistence, and clearance of HPV infection in women with CIN 2 followed up for 12 months. Methods. Thirty-seven women with CIN 2 biopsy, who have proven referral to cervical smear showing low-grade squamous intraepithelial lesions or atypical squamous cells of undetermined significance and tested for HPV, were followed up for one year with cervical smear, colposcopy, and HPV test every three months. HPV DNA was detected by the polymerase chain reaction and genotyping by reverse line blot hybridization assay. Results. CIN 2 regression rate was 49% (18/37), persistence as CIN 1 or CIN 2 was 22% (8/37), and progression to CIN 3 was 29% (11/37). Multiple HPV types were observed at admission in 41% (15/37) of cases. HPV 16 was detected at admission in 58% (11/19) of the cases that persisted/progressed and in 39% (7/18) of the cases that regressed. HPV 16 was considered possibly causal in 67% (10/15) of the cases that persisted or progressed and in 10% (1/10) of the cases that regressed (P = 0.01). Conclusion. Multiple HPV infections were frequently detected among women with CIN 2 at admission and during the followup. The CIN 2 associated with HPV 16 was more likely to persist or to progress to CIN 3. PMID:24369469

  16. HPV 16 Is Related to the Progression of Cervical Intraepithelial Neoplasia Grade 2: A Case Series

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    Maria Gabriela Loffredo D’Ottaviano

    2013-01-01

    Full Text Available Purpose. To describe the acquisition, persistence, and clearance of HPV infection in women with CIN 2 followed up for 12 months. Methods. Thirty-seven women with CIN 2 biopsy, who have proven referral to cervical smear showing low-grade squamous intraepithelial lesions or atypical squamous cells of undetermined significance and tested for HPV, were followed up for one year with cervical smear, colposcopy, and HPV test every three months. HPV DNA was detected by the polymerase chain reaction and genotyping by reverse line blot hybridization assay. Results. CIN 2 regression rate was 49% (18/37, persistence as CIN 1 or CIN 2 was 22% (8/37, and progression to CIN 3 was 29% (11/37. Multiple HPV types were observed at admission in 41% (15/37 of cases. HPV 16 was detected at admission in 58% (11/19 of the cases that persisted/progressed and in 39% (7/18 of the cases that regressed. HPV 16 was considered possibly causal in 67% (10/15 of the cases that persisted or progressed and in 10% (1/10 of the cases that regressed (P=0.01. Conclusion. Multiple HPV infections were frequently detected among women with CIN 2 at admission and during the followup. The CIN 2 associated with HPV 16 was more likely to persist or to progress to CIN 3.

  17. Factors associated with colposcopy-histopathology confirmed cervical intraepithelial neoplasia among HIV-infected women from Rio De Janeiro, Brazil.

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    Angela Cristina Vasconcelos de Andrade

    Full Text Available INTRODUCTION: Despite the availability of preventive strategies (screening tests and vaccines, cervical cancer continues to impose a significant health burden in low- and medium-resourced countries. HIV-infected women are at increased risk for infection with human papillomavirus (HPV and thus development of cervical squamous intraepithelial neoplasia (CIN. METHODS: Study participants included HIV-infected women enrolling the prospective open cohort of Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation (IPEC/FIOCRUZ. At cohort entry, women were subjected to conventional Papanicolaou test, HPV-DNA test and colposcopy; lesions suspicious for CIN were biopsied. Histopathology report was based on directed biopsy or on specimens obtained by excision of the transformation zone or cervical conization. Poisson regression modeling was used to assess factors associated with CIN2+ diagnosis. RESULTS: The median age of the 366 HIV-infected women included in the study was 34 years (interquartile range: 28-41 years. The prevalence of CIN1, CIN2 and CIN3 were 20.0%, 3.5%, and 2.2%, respectively. One woman was found to have cervical cancer. The prevalence of CIN2+ was 6.0%. Factors associated with CIN2+ diagnosis in the multivariate model were age < years compared to ≥ 35 years (aPR  =  3.22 95%CI 1.23-8.39, current tobacco use (aPR  =  3.69 95%CI 1.54-8.78, nadir CD4 T-cell count <350 cells/mm3 when compared to ≥ 350 cells/mm3 (aPR  =  6.03 95%CI 1.50-24.3 and concomitant diagnosis of vulvar and/or vaginal intraepithelial lesion (aPR  =  2.68 95%CI 0.99-7.24. DISCUSSION: Increased survival through wide-spread use of highly active antiretroviral therapy might allow for the development of cervical cancer. In Brazil, limited cytology screening and gynecological care adds further complexity to the HIV-HPV co-infection problem. Integrated HIV care and cervical cancer prevention programs are needed for the prevention of cervical

  18. Association of Human Papillomavirus 31 DNA Load with Risk of Cervical Intraepithelial Neoplasia Grades 2 and 3

    Science.gov (United States)

    Liu, Xia; Schiffman, Mark; Hulbert, Ayaka; He, Zhonghu; Shen, Zhenping; Koutsky, Laura A.

    2015-01-01

    The association between human papillomavirus 31 (HPV31) DNA loads and the risk of cervical intraepithelial neoplasia grades 2 and 3 (CIN2–3) was evaluated among women enrolled in the atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) triage study (ALTS), who were monitored semiannually over 2 years and who had HPV31 infections detected at ≥1 visit. HPV31 DNA loads in the first HPV31-positive samples and in a random set of the last positive samples from women with ≥2 HPV31-positive visits were measured by a real-time PCR assay. CIN2–3 was histologically confirmed at the same time as the first detection of HPV31 for 88 (16.6%) of 530 women. After adjustment for HPV31 lineages, coinfection with other oncogenic types, and the timing of the first positive detection, the odds ratio (OR) per 1-log-unit increase in viral loads for the risk of a concurrent diagnosis of CIN2–3 was 1.5 (95% confidence interval [CI], 1.2 to 1.9). Of 373 women without CIN2–3 at the first positive visit who had ≥1 later visit, 44 had subsequent diagnoses of CIN2–3. The initial viral loads were associated with CIN2–3 diagnosed within 6 months after the first positive visit (adjusted OR, 1.5 [95% CI, 1.0 to 2.4]) but were unrelated to CIN2–3 diagnosed later. For a random set of 49 women who were tested for viral loads at the first and last positive visits, changes in viral loads were upward and downward among women with and without follow-up CIN2–3 diagnoses, respectively, although the difference was not statistically significant. Results suggest that HPV31 DNA load levels at the first positive visit signal a short-term but not long-term risk of CIN2–3. PMID:26292291

  19. [Human papillomaviruses in the pathogenesis of intraepithelial neoplasia (AIN) and carcinoma of the anus].

    Science.gov (United States)

    von Knebel Doeberitz, M; Reuschenbach, M

    2010-01-01

    HPV infections have been implicated in the pathogenesis of anal cancers. The mode of infection and subsequent transformation resembles very much the pathogenesis of cervical and other HPV-associated cancers. The molecular dissection of individual steps required to achieve cellular transformation within an HPV-infected cell led to the identification of novel biomarkers that make it possible to identify HPV-transformed cells with substantially higher precision in comparison to conventional methods. Since effective antiretroviral therapy allows for possible long-term survival of HIV-infected individuals who are at very high risk to develop HPV-associated cancers in the anogenital tract, these new developments have become increasingly relevant for practicing dermatologists and proctologists. We here briefly review the basic concepts and some clinical applications of this recent research.

  20. Evaluation of PpIX formation in Cervical Intraepithelial Neoplasia I (CIN) using widefield fluorescence images

    Science.gov (United States)

    Carbinatto, Fernanda M.; Inada, Natalia M.; Fortunato, Thereza C.; Lombardi, Welington; da Silva, Eduardo V.; Vollet Filho, José D.; Kurachi, Cristina; Pratavieira, Sebastião.; Bagnato, Vanderlei S.

    2016-03-01

    Optical techniques has been described as auxiliary technology for screening of neoplasia because shows the potential for tissues differentiation in real-time and it is a noninvasive detection and safe. However, only endogenous fluorophores presents the lesion may be insufficient and needed of the administration of the fluorophores synthesized, such as, precursor molecule of protoporphyrin IX (PpIX) induced by 5- aminolevulinic acid and your derivatives. Topical application of methylaminolevulinate (MAL), induces formation of the endogenous photosensitizer, PpIX in tissues where carcinogenesis has begun. The PpIX tend to accumulate in premalignant and malignant tissues and the illumination with light with appropriate wavelength beginning to excitation of PpIX fluorescence, which helps to localize PpIX-rich areas and identify potentially malignant tissues. The aim of the study is to evaluate the production of PpIX in the cervix with CIN I through of the fluorescence images captured after 1 hour of cream application. It was possible to visualize PpIX fluorescence in cervix and it was possible to observe the selectivity in fluorescence in squamous-columnar junction, which a pre-cancerous condition (CIN) and usually is localized. Through the image processing it was possible to quantify the increase of red fluorescence. For the CIN I the increase of red fluorescence was approximately of 4 times indicating a good PpIX formation.

  1. Expression of the CXCL12/CXCR4 and CXCL16/CXCR6 axes in cervical intraepithelial neoplasia and cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yu Huang; Jia Zhang; Zhu-Mei Cui; Jing Zhao; Ye Zheng

    2013-01-01

    The chemokine CXCL12 is highly expressed in gynecologic tumors and is widely known to play a biologically relevant role in tumor growth and spread.Recent evidence suggests that CXCL16,a novel chemokine,is overexpressed in inflammation-associated tumors and mediates pro-tumorigenic effects of inflammation in prostate cancer.We therefore analyzed the expression of CXCL12 and CXCL16 and their respective receptors CXCR4 and CXCR6 in cervical intraepithelial neoplasia (CIN) and cervical cancer and further assessed their association with clinicopathologic features and outcomes.Tissue chip technology and immunohistochemistry were used to analyze the expression of CXCL12,CXCR4,CXCL16,and CXCR6 in healthy cervical tissue (21 cases),CIN (65 cases),and cervical carcinoma (60 cases).The association of protein expression with clinicopathologic features and overall survival was analyzed.These four proteins were clearly detected in membrane and cytoplasm of neoplastic epithelial cells,and their distribution and intensity of expression increased as neoplastic lesions progressed through CIN1,CIN2,and CIN3 to invasive cancer.Furthermore,the expression of CXCR4 was associated significantly with the histologic grade of cervical carcinoma,whereas the expression of CXCR6 was associated significantly with lymph node metastasis.In Kaplan-Meier analysis,patients with high CXCR6 expression had significantly shorter overall survival than did those with low CXCR6 expression.The elevated co-expression levels of CXCL12/CXCR4 and CXCL16/CXCR6 in CIN and cervical carcinoma suggest a durative process in cervical carcinoma development.Moreover,CXCR6 may be useful as a biomarker and a valuable prognostic factor for cervical cancer.

  2. RELATIONSHIP BETWEEN CYCLIN G1 AND HUMAN PAPILLOMA VIRUS INFECTION IN CERVICAL INTRAEPITHELIAL NEOPLASIA AND CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To evaluate the overexpression of cyclin G1 in cervical intraepithelial neoplasia (CIN) and cervical carcinoma, and the correlation between cyclin G1 and high-risk human papilloma virus (HPV) infection.Methods All of the specimens were obtained from the Department of Pathology of China-Japan Friendship Hospital from January 2000 to August 2004. We detected the expression of cyclin G1 with immunohistochemistry, HPV16/18infection with in situ hybridization, and high-risk HPV infection with Hybrid capture system Ⅱ (HC-Ⅱ) in normal group (25 cases), CIN Ⅰ (48 cases), CIN Ⅱ (56 cases), CIN Ⅲ (54 cases), and invasive cervical squamous-cell carcinoma (SCC, 31 cases).Results The positive rates of cyclin G1 expression in CIN (77. 85%) and SCC cervical tissues (87.10%) were significantly higher than normal (8.00%,P<0.01), and the intensities of cyclin G1 expression in CIN (40.60%)and SCC cervical tissues (61.51%) were significantly higher than normal (2.72%,P<0.05). The positive rates and intensities of cyclin G1 expression increased gradually with the grade of cervical lesions. High-risk HPV infection rates were higher in CIN and SCC than normal groups (P<0.05). There was a positive correlation between cyclin G1 expression and high-risk HPV infection detected with HC-Ⅱ (Kendall's tau-b =0.316, 0.269, 0.352, and 0. 474 in CIN Ⅰ, CINⅡ, CIN Ⅲ, and SCC, respectively, P<0.05).Conclusions Cyclin G1 is overexpressed in CIN and SCC. Cyclin G1 may be a biomarker for detecting CIN and SCC. Cyclin G1 may play an important role in the oncogenesis of CIN and SCC by high-risk HPV infection.

  3. Trisomy of the Dscr1 gene suppresses early progression of pancreatic intraepithelial neoplasia driven by oncogenic Kras

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jang Choon; Shin, Jimin; Baek, Kwan-Hyuck, E-mail: khbaek@skku.edu

    2013-10-11

    Highlights: •A single extra copy of Dscr1 restrains progression of PanIN-1A to PanIN-1B lesions. •Dscr1 trisomy attenuates calcineurin–NFAT pathway in neoplastic ductal epithelium. •Dscr1 trisomy leads to upregulation of p15{sup INK4b} in neoplastic ductal epithelium. •A single extra copy of Dscr1 reduces epithelial proliferation in early PanIN lesions. •Dscr1 trisomy may protect Down syndrome individuals from pancreatic cancer. -- Abstract: Individuals with Down syndrome exhibit remarkably reduced incidence of most solid tumors including pancreatic cancer. Multiple mechanisms arising from the genetic complexity underlying Down syndrome has been suggested to contribute to such a broad cancer protection. In this study, utilizing a genetically engineered mouse model of pancreatic cancer, we demonstrate that trisomy of the Down syndrome critical region-1 (Dscr1), an endogenous calcineurin inhibitor localized on chromosome 21, suppresses the progression of pancreatic intraepithelial neoplasia-1A (PanIN-1A) to PanIN-1B lesions without affecting the initiation of PanIN lesions mediated by oncogenic Kras{sup G12D}. In addition, we show that Dscr1 trisomy attenuates nuclear localization of nuclear factor of activated T-cells (NFAT) accompanied by upregulation of the p15{sup Ink4b} tumor suppressor and reduction of cell proliferation in early PanIN lesions. Our data suggest that attenuation of calcineurin–NFAT signaling in neoplastic pancreatic ductal epithelium by a single extra copy of Dscr1 is sufficient to inhibit the progression of early PanIN lesions driven by oncogenic Kras, and thus may be a potential mechanism underlying reduced incidence of pancreatic cancer in Down syndrome individuals.

  4. The Relationship between Syntactic Structure Analysis Features, Histological Grade and High-Risk HPV DNA in Cervical Intraepithelial Neoplasia

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    Arnold‐Jan Kruse

    2004-01-01

    Full Text Available Aim: To assess the correlation between syntactic structure analysis (SSA features, revised dysplasia grade and the presence of high‐risk human papillomavirus DNA in cervical intraepithelial neoplasia (CIN. Materials and methods: HPV polymerase chain reaction (PCR was assessed in 101 consecutive biopsies and consensus in CIN grade between the experts occurred in 88 cases (CIN1=16, CIN2=27, CIN3=45. SSA was performed in the diagnostic histological section of the CIN lesions in these patients and SSA features were compared with the blind review CIN grade, and presence/absence of high‐risk HPV DNA. Results: One of the SSA features (points from which the surrounding surfaces has 4 edges, PECO‐4 was significantly different between all three consensus CIN grades. Many more features revealed significant differences between CIN1 and CIN2 or between CIN2 and CIN3 cases. With stepwise discriminant analysis, the best multivariate combination of features to distinguish the different CIN grades were the Maximum MST Line Length (MML and the Area Disorder. Crude overall classification of the consensus grades with these features was 69%. The MML and the Area Disorder is also the best combination to distinguish cases with and without high‐risk HPV DNA (77% correct classifications. Conclusions: SSA features are correlated with both CIN grade and presence of high‐risk HPV DNA, but the discrimination power is not good enough to be used as a routine method for quality control of subjective grade or as a surrogate marker for high‐risk HPV DNA presence.

  5. Lack of commensal flora in H. pylori-infected INS-GAS mice reduces gastritis and delays intraepithelial neoplasia

    Science.gov (United States)

    Lofgren, Jennifer L.; Whary, Mark T.; Ge, Zhongming; Muthupalani, Sureshkumar; Taylor, Nancy S.; Mobley, Melissa; Potter, Amanda; Varro, Andrea; Eibach, Daniel; Suerbaum, Sebastian; Wang, Timothy C.; Fox, James G.

    2010-01-01

    Background & Aims Transgenic, insulin–gastrin (INS–GAS) mice have high circulating levels of gastrin. On a FVB/N background, these mice develop spontaneous atrophic gastritis and gastrointestinal intraepithelial neoplasia (GIN) with 80% prevalence 6 months after Helicobacter pylori infection. GIN is associated with gastric atrophy and achlorhydria, predisposing mice to non-helicobacter microbiota overgrowth. We determined if germ-free INS–GAS mice spontaneously develop GIN and if H. pylori accelerates GIN in gnotobiotic INS–GAS mice. Methods We compared gastric lesions and levels of mRNA, serum inflammatory mediators, antibodies, and gastrin among germ-free and H. pylori-monoinfected INS-GAS mice. Microbiota composition of specific pathogen-free (SPF) INS-GAS mice was quantified by pyro-sequencing. Results Germ-free INS-GAS mice had mild hypergastrinemia but did not develop significant gastric lesions until they were 9 months old; they did not develop GIN through 13 months. H. pylori monoassociation caused progressive gastritis, epithelial defects, oxyntic gland atrophy, marked foveolar hyperplasia and dysplasia, and strong serum and tissue proinflammatory immune responses (particularly in male mice) between 5 and 11 months post infection (P<0.05, compared with germ-free controls). Only 2 of 26 female, whereas 8 of 18 male, H. pylori-infected INS-GAS mice developed low- to high-grade GIN by 11 months post infection. Stomachs of H. pylori-infected SPF male mice had significant reductions in Bacteroidetes and significant increases in Firmicutes. Conclusions Gastric lesions take 13 months longer to develop in germ-free INS–GAS mice than male SPF INS-GAS mice. H. pylori-monoassociation accelerated gastritis and GIN but caused less-severe gastric lesions and delayed onset of GIN compared to H. pylori-infected INS-GAS mice with complex gastric microbiota. Changes of gastric microbiota composition might promote GIN in the achlorhydric stomachs of SPF mice. PMID

  6. Cervical intraepithelial neoplasia in pregnancy: Interference of pregnancy status with p16 and Ki-67 protein expression

    Science.gov (United States)

    Ciavattini, Andrea; Sopracordevole, Francesco; Di Giuseppe, Jacopo; Moriconi, Lorenzo; Lucarini, Guendalina; Mancioli, Francesca; Zizzi, Antonio; Goteri, Gaia

    2017-01-01

    To date, there are evidence-based guidelines available for cervical dysplasia diagnosed in pregnancy. Certain functional biomarkers have proven useful in the prediction of regressing and non-regressing cervical intraepithelial neoplasia (CIN) lesions in non-pregnant women. In the present study, Ki-67 and p16 immunostaining were evaluated in different grades of CIN lesions diagnosed in pregnant or non-pregnant women with the aim to identify any differences in order to better understand the behavior of CIN in pregnancy. The current retrospective case-control study included 17 pregnant patients that conceived naturally with first-time onset of CIN occurring at no later than 16 gestational weeks. The control group included 17 non-pregnant patients matched for age, parity and number of previous sexual partners. Exclusion criteria included previous cervical treatment, immunocompromised status, chronic hepatitis B and/or C and cigarette smoking. p16 and Ki-67 protein expression were respectively detected using the CINtec Histology kit and monoclonal antibodies against Ki-67. p16 and Ki-67 staining were analyzed using a classification system based on the distribution of positivity on a semi-quantitative three point-scale. p16 and Ki-67 immune reactivity correlated positively with the grade of epithelial dysplasia in the total cohort of pregnant and non-pregnant patients; expression increased linearly from CIN1 to CIN3. Furthermore, the association between p16 immunostaining and CIN grade was significant in non-pregnant patients but not in pregnant patients. In pregnant patients, positivity for Ki-67 was less intense than in non-pregnant patients. These results appear to suggest that pregnancy status interferes with the expression of cellular proteins involved in cell-cycle regulation and the carcinogenic process induced by high-risk human papilloma virus, exhibiting increased variability in their staining. PMID:28123559

  7. Conventional cytology, visual tests and evaluation of P16INK4A as a biomarker in cervical intraepithelial neoplasia

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    S Kava

    2015-01-01

    Full Text Available Objectives: (1 To detect cervical intraepithelial neoplasia (CIN using Papanicolaou test (PAP test, visual tests (visual inspection after the application of acetic acid [VIA], visual inspection after the application of Lugol's iodine [VILI], colposcopy, and biopsy. (2 To study the biomarker p16INK4A expression by immunostaining. Materials And Methods: Experimental study was conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional PAP test, VIA, and VILI. Sensitivity, specificity, positive, and negative predictive values of these tests were calculated individually, sequentially, and in parallel. Women having positive results underwent colposcopy and biopsy if required. p16INK4Aexpression in biopsy samples was studied using immunohistochemistry. Results: All test positive cases (n = 235 underwent colposcopy. Sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of PAP with atypical squamous cells of undetermined significance (ASCUS as cut-off was 40%, 99.25%, 35.25%, and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4%, and 99.76%, respectively. When PAP, VIA, and VILI were used in parallel sensitivity, specificity, PPV, and NPV improved to 100%, 85.18%, 6.38%, and 100%, respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15. p16INK4A expression was seen in eight of 15 CIN cases. Conclusions:(1 PAP test and visual techniques are complementary. (2 p16INK4Aexpression was seen in majority of CIN 2 lesions suggesting a higher grade lesion.

  8. Clinical analysis of 28 cases of vaginal intraepithelial neoplasia%阴道上皮内瘤变28例临床分析

    Institute of Scientific and Technical Information of China (English)

    陈波; 朱兰; 郎景和

    2012-01-01

    Objective To investigate the clinical characteristics, risk factors, diagnosis and treatment, prognosis of vaginal intraepithelial neoplasia (VAIN). Methods A retrospective study was made of 28 patients with VAIN, who were hospitalized at Peking Union Medical College Hospital between 2005 and 2011. Those patients' clinical characteristics,liquid-based cytology, human papillomavirus ( HPV ) test, correlation to previous hysterectomy and cervical intraepithelial neoplasia, diagnosis and treatments are analyzed respectively. Results The patients ranged from 29 to 76 ( median 48) years old 26 cases shown specific clinical manifestation,in 25 patients the VAIN lesions were located in the upper of the vagina,27 cases had abnomal cytology,23 patients had positive HPV infection. 15 cases had a history of hysterectomy, 10 of them were cervical intraepithelial neoplasia or invasive cervical cancer. The average interval of the VAIN occurrence after hysterectomy with or without cervical disease was 3. 1 years and 8. 8 years respectively. 10 patients were accompanied with cervical intraepithelial neoplasia and cervical cancer. There were no different significant between VAIN Ⅱ and VAIN Ⅲ in age,hysterectomy,accompanied cervical disease,TCT. All cases were treated by surgery,3 cases recurred. Conclusions Human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer, previous hysterectomy due to CIN/ cervical cancer were risk factors of VAIN. Cytology( HPV DNA test) -colposcopic biopsies-pathological diagnosis are very important in diagnosis and follow-up for vaginal intraepithelial neoplasia, after the treatment of CIN/cervical cancer, strict follow-up are needed, especially the first 3 years.%目的 探讨阴道上皮内瘤变(VAIN)的临床特点、危险因素、诊治及预后.方法 回顾性分析北京协和医院2005-2011年住院收治VAIN病例28例临床资料.其中VAINⅡ7例,VAINⅢ21例.结果 患者年龄29 ~76岁(中位年龄48

  9. Human papillomavirus mRNA testing for the detection of anal high-grade squamous intraepithelial lesions in men who have sex with men infected with HIV.

    Science.gov (United States)

    Sendagorta, Elena; Romero, Maria P; Bernardino, Jose I; Beato, María J; Alvarez-Gallego, Mario; Herranz, Pedro

    2015-08-01

    Currently, screening for anal high-grade squamous intraepithelial lesions (anal HSIL) relies on anal cytology and high-resolution anoscopy. Since this approach has limited sensitivity and specificity for detecting anal HSIL, there is increasing interest in the role of biomarkers for predicting anal HSIL. The aim of this study is to evaluate the diagnostic accuracy of HPV E6/E7-mRNA expression for the detection of anal HSIL in MSM infected with HIV, in comparison to DNA-HR-HPV and anal cytology. This cross-sectional screening study included 101 MSM followed at the HIV-unit of La Paz University Hospital. Intra-anal swabs from patients participating in a screening program including cytology, high-resolution anoscopy and histology were analyzed. HR-HPV-DNA detection was performed by means of the CLART® HPV2 assay (GENOMICA S.A.U., Madrid, Spain). E6/E7-mRNA detection of HR-HPV-types 16, 18, 31, 33, and 45 was performed using the NucliSENS-EasyQ assay (BioMérieux, Marcy ĺEtoile, France). HR-HPV DNA and HPVE6/E7 mRNA were detected in 82% and 57% of the anal smears respectively. Anal cytology screening was abnormal in 70.3%. For the detection of HSIL sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 71.7%, 55.6%, 57.9%, and 69.8% for E6/E7-mRNA testing, respectively, compared to 100%, 31.5%, 55.4%, and 100% for HR-HPV-DNA testing and to 83%, 40.7%, 54.9%, 73.3% of cytology testing. In comparison with the other tests, HPVE6/E7 mRNA testing yielded a lower clinical sensitivity but a higher clinical specificity and PPV for the detection of anal HSIL in MSM infected with HIV.

  10. Oncogenicidade do papilomavírus humano e o grau de neoplasia intra-epitelial anal em doentes HIV positivo

    OpenAIRE

    Manzione,Carmen Ruth; NADAL, Sidney Roberto; Calore,Edenilson Eduardo

    2004-01-01

    OBJETIVO: Avaliar se o grau de neoplasia intra-epitelial anal (NIA) está associado ao tipo do HPV em doentes HIV positivo, já que esses apresentam imunodepressão durante longos períodos. MÉTODOS: Identificamos os tipos do HPV, pelo método da reação em cadeia da polimerase (PCR), e realizamos exame anatomo-patológico para avaliar o grau de NIA em 39 homens HIV positivo portadores de condilomas acuminados perianais. RESULTADOS: Observamos NIA de alto grau em nove (23,1%) e NIA de baixo grau em ...

  11. Cervical squamous and glandular intraepithelial neoplasia: identification and current management approaches Neoplasia intraepitelial cervical escamosa y glandular: identificación y estrategias de manejo

    OpenAIRE

    V Cecil Wright

    2003-01-01

    Certain types of human papillomaviruses (HPV) are associated with squamous intraepithelial lesions and cancer and these are termed high-risk. HPV type 16 is detected in approximately half of the high-grade squamous intraepithelial lesions and cancer. Because of the high rate of spontaneous regression of low-grade squamous lesions, follow-up by cytology, colposcopy and possible biopsy appears preferable. Due to the higher rate of progression to malignancy of the high-grade lesions conservative...

  12. The role of inner border sign and ridge sign in detecting high-grade cervical intraepithelial neoplasia

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    Mihaela Grigore

    2016-11-01

    Conclusions: Pathognomonic signs - inner sign and ridge sign- have a good specificity in predicting high-grade cervical intraepithelial lesions, but they are present in only 9.8%, respectively 20.5% of cases with high-grade cervical intraepithelial lesions. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3717-3721

  13. Associations between methylation of paternally expressed gene 3 (PEG3, cervical intraepithelial neoplasia and invasive cervical cancer.

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    Monica D Nye

    Full Text Available Cytology-based screening for invasive cervical cancer (ICC lacks sensitivity and specificity to discriminate between cervical intraepithelial neoplasia (CIN likely to persist or progress from cases likely to resolve. Genome-wide approaches have been used to identify DNA methylation marks associated with CIN persistence or progression. However, associations between DNA methylation marks and CIN or ICC remain weak and inconsistent. Between 2008-2009, we conducted a hospital-based, case-control study among 213 Tanzania women with CIN 1/2/3 or ICC. We collected questionnaire data, biopsies, peripheral blood, cervical scrapes, Human papillomavirus (HPV and HIV-1 infection status. We assessed PEG3 methylation status by bisulfite pyrosequencing. Multinomial logistic regression was used to estimate odds ratios (OR and confidence intervals (CI 95% for associations between PEG3 methylation status and CIN or ICC. After adjusting for age, gravidity, hormonal contraceptive use and HPV infection, a 5% increase in PEG3 DNA methylation was associated with increased risk for ICC (OR = 1.6; 95% CI 1.2-2.1. HPV infection was associated with a higher risk of CIN1-3 (OR = 15.7; 95% CI 5.7-48.6 and ICC (OR = 29.5, 95% CI 6.3-38.4. Infection with high risk HPV was correlated with mean PEG3 differentially methylated regions (DMRs methylation (r = 0.34 p<0.0001, while the correlation with low risk HPV infection was weaker (r = 0.16 p = 0.047. Although small sample size limits inference, these data support that PEG3 methylation status has potential as a molecular target for inclusion in CIN screening to improve prediction of progression. Impact statement: We present the first evidence that aberrant methylation of the PEG3 DMR is an important co-factor in the development of Invasive cervical carcinoma (ICC, especially among women infected with high risk HPV. Our results show that a five percent increase in DNA methylation of PEG3 is associated with

  14. Associations between Methylation of Paternally Expressed Gene 3 (PEG3), Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer

    Science.gov (United States)

    Nye, Monica D.; Hoyo, Cathrine; Huang, Zhiqing; Vidal, Adriana C.; Wang, Frances; Overcash, Francine; Smith, Jennifer S.; Vasquez, Brandi; Hernandez, Brenda; Swai, Britta; Oneko, Olola; Mlay, Pendo; Obure, Joseph; Gammon, Marilie D.; Bartlett, John A.; Murphy, Susan K.

    2013-01-01

    Cytology-based screening for invasive cervical cancer (ICC) lacks sensitivity and specificity to discriminate between cervical intraepithelial neoplasia (CIN) likely to persist or progress from cases likely to resolve. Genome-wide approaches have been used to identify DNA methylation marks associated with CIN persistence or progression. However, associations between DNA methylation marks and CIN or ICC remain weak and inconsistent. Between 2008–2009, we conducted a hospital-based, case-control study among 213 Tanzania women with CIN 1/2/3 or ICC. We collected questionnaire data, biopsies, peripheral blood, cervical scrapes, Human papillomavirus (HPV) and HIV-1 infection status. We assessed PEG3 methylation status by bisulfite pyrosequencing. Multinomial logistic regression was used to estimate odds ratios (OR) and confidence intervals (CI 95%) for associations between PEG3 methylation status and CIN or ICC. After adjusting for age, gravidity, hormonal contraceptive use and HPV infection, a 5% increase in PEG3 DNA methylation was associated with increased risk for ICC (OR = 1.6; 95% CI 1.2–2.1). HPV infection was associated with a higher risk of CIN1-3 (OR = 15.7; 95% CI 5.7–48.6) and ICC (OR = 29.5, 95% CI 6.3–38.4). Infection with high risk HPV was correlated with mean PEG3 differentially methylated regions (DMRs) methylation (r = 0.34 p<0.0001), while the correlation with low risk HPV infection was weaker (r = 0.16 p = 0.047). Although small sample size limits inference, these data support that PEG3 methylation status has potential as a molecular target for inclusion in CIN screening to improve prediction of progression. Impact statement We present the first evidence that aberrant methylation of the PEG3 DMR is an important co-factor in the development of Invasive cervical carcinoma (ICC), especially among women infected with high risk HPV. Our results show that a five percent increase in DNA methylation of PEG3 is associated with

  15. Risk of preterm delivery with increasing depth of excision for cervical intraepithelial neoplasia in England: nested case-control study

    Science.gov (United States)

    Castanon, Alejandra; Landy, Rebecca; Brocklehurst, Peter; Evans, Heather; Peebles, Donald; Singh, Naveena; Walker, Patrick; Patnick, Julietta

    2014-01-01

    Objective To determine the association between depth of excision of cervical intraepithelial neoplasia and risk of preterm birth. Design Case-control study nested in record linkage cohort study. Setting 12 hospitals in England. Participants From a cohort of 11 471 women with at least one histological sample taken at colposcopy and a live singleton birth (before or after colposcopy), 1313 women with a preterm birth (20-36 weeks) were identified and frequency matched on maternal age at delivery, parity, and study site to 1313 women with term births (38-42 weeks). Main outcome measures Risk of preterm birth and very/extreme preterm birth by depth of excisional treatment of the cervical transformation zone. Results After exclusions, 768 preterm births (cases) and 830 term births after colposcopy remained. The risk of preterm birth was no greater in women with a previous small (<10 mm) excision (absolute risk 7.5%, 95% confidence interval 6.0% to 8.9%) than in women with a diagnostic punch biopsy (7.2%, 5.9% to 8.5%). Women with a medium (10-14 mm) (absolute risk 9.6%; relative risk 1.28, 0.98 to 1.68), large (15-19 mm) (15.3%; 2.04, 1.41 to 2.96), or very large (≥20 mm) excision (18.0%; 2.40, 1.53 to 3.75) had a higher risk of preterm delivery than those with small excision. The same pattern was seen in 161 women with very/extremely preterm births (20-31 weeks) and with increasing volume excised. Most births were conceived more than three years after colposcopy, and the risk of preterm delivery did not seem to depend on time from excision to conception. Conclusions The risk of preterm birth is at most minimally affected by a small excision. Larger excisions, particularly over 15 mm or 2.66 cm3, are associated with a doubling of the risk of both preterm and very preterm births. The risk does not decrease with increasing time from excision to conception. Efforts should be made to excise the entire lesion while preserving as much healthy cervical tissue as possible

  16. Gain of human telomerase RNA gene is associated with progression of cervical intraepithelial neoplasia grade Ⅰ or Ⅱ

    Institute of Scientific and Technical Information of China (English)

    LAN Yong-lian; YU Lan; JIA Chan-wei; WU Yu-mei; WANG Shu-yu

    2012-01-01

    Background The 3q26 chromosome region,where the human telomerase RNA gene (hTERC) is located,is a biomarker for cervical cancer and precancerous lesions.The aim of this study was to confirm the value of measuring hTERC gene gain in predicting the progression of cervical intraepithelial neoplasia grade Ⅰ or Ⅱ (CIN-Ⅰ and -Ⅱ,respectively) to CIN-Ⅲ and cervical cancer.Methods Liquid-based cytological samples from 54 patients with CIN-Ⅰ or CIN-Ⅱ lesions were enrolled in this study.Follow-up was performed with colposcopy and biopsy within 24 months after the diagnosis of CIN-Ⅰ or CIN-Ⅱ.Copy numbers of the hTERC gene were measured by fluorescence in situ hybridization with a dual-color probe mix containing the hTERC gene probe (labeled red) and the control,the chromosome 3 centromere-specific probe (labeled green).Results All patients whose lesions progressed from CIN-Ⅰ or CIN-Ⅱ to CIN-Ⅲ displayed a gain of the hTERC gene,whereas patients where the hTERC gene was not amplified did not subsequently progress to CIN-Ⅲ or cervical cancer.The signal ratio pattem per cell was recorded as N∶N (green∶ red).The numbers of cells with the signal ratio pattern of 4∶4or N∶≥5 in patients whose lesions progressed to CIN-Ⅲ were significantly higher than those whose lesions did not progress.Significantly,none of the patients with a 4∶4 signal ratio pattern regressed spontaneously.Conclusions In conclusion,measurement of hTERC gene gain in CIN-Ⅰ or CIN-Ⅱ patients using liquid-based cytological samples could be a useful biomarker to predict the progression of such cervical lesions.In addition,a 4∶4 or N∶≥5 signal ratio pattern may indicate the unlikeness of spontaneous regression of CIN-Ⅰ or CIN-Ⅱ lesions.

  17. MYC overexpression induces prostatic intraepithelial neoplasia and loss of Nkx3.1 in mouse luminal epithelial cells.

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    Tsuyoshi Iwata

    Full Text Available Lo-MYC and Hi-MYC mice develop prostatic intraepithelial neoplasia (PIN and prostatic adenocarcinoma as a result of MYC overexpression in the mouse prostate. However, prior studies have not determined precisely when, and in which cell types, MYC is induced. Using immunohistochemistry (IHC to localize MYC expression in Lo-MYC transgenic mice, we show that morphological and molecular alterations characteristic of high grade PIN arise in luminal epithelial cells as soon as MYC overexpression is detected. These changes include increased nuclear and nucleolar size and large scale chromatin remodeling. Mouse PIN cells retained a columnar architecture and abundant cytoplasm and appeared as either a single layer of neoplastic cells or as pseudo-stratified/multilayered structures with open glandular lumina-features highly analogous to human high grade PIN. Also using IHC, we show that the onset of MYC overexpression and PIN development coincided precisely with decreased expression of the homeodomain transcription factor and tumor suppressor, Nkx3.1. Virtually all normal appearing prostate luminal cells expressed high levels of Nkx3.1, but all cells expressing MYC in PIN lesions showed marked reductions in Nkx3.1, implicating MYC as a key factor that represses Nkx3.1 in PIN lesions. To determine the effects of less pronounced overexpression of MYC we generated a new line of mice expressing MYC in the prostate under the transcriptional control of the mouse Nkx3.1 control region. These "Super-Lo-MYC" mice also developed PIN, albeit a less aggressive form. We also identified a histologically defined intermediate step in the progression of mouse PIN into invasive adenocarcinoma. These lesions are characterized by a loss of cell polarity, multi-layering, and cribriform formation, and by a "paradoxical" increase in Nkx3.1 protein. Similar histopathological changes occurred in Hi-MYC mice, albeit with accelerated kinetics. Our results using IHC provide novel

  18. Evaluation of T, B and natural killer lymphocyte in the cervical stroma of HIV-positive and negative patients with cervical intraepithelial neoplasia.

    Science.gov (United States)

    Lucena, Adriana A S; Guimarães, Mírian Viviane M B; Michelin, Márcia A; Lodi, Cláudia T C; Lima, Maria Inês M; Murta, Eddie Fernando Candido; Melo, Victor Hugo

    2016-01-01

    Cervical intraepithelial neoplasias (CIN) are closely associated with oncogenic subtypes of the human papillomavirus (HPV). In the presence of this virus, it is known that the activation or suppression of immune system is the key to the development, progression and/or regression of cervical lesions. Therefore, the objective of this study is to compare the local immune response among HIV-seropositive and seronegative patients with cervical intraepithelial neoplasia regarding the expression of T lymphocytes (CD3+, CD4+ and CD8+), B lymphocytes (CD20+) and natural killers cells (CD56+) in the cervical stroma. A cross-sectional study of paraffin blocks containing cervical tissue after conization by the Loop Electrosurgical Excision Procedure (LEEP) from 47 HIV-seropositive and 38 seronegative patients with CIN. Cervical stroma immunohistochemistry was performed in the CIN area. The Fisher's exact test was used for the statistical analysis. When HIV-seropositive and seronegative women were compared, the seropositive women had a higher count of CD8+ T lymphocytes (52.1% versus 28.9%, PHIV-seronegative patients with CIN 1 had a low count of CD20+B-lymphocytes (7.1%) in comparison with CIN 1 HIV seropositive and with CIN 2/3 HIV-seronegative patients, respectively 50% (PHIV infection and degree of CIN influenced the cytotoxic lymphocytes inducing an increase in the number of cells high count of CD20+ lymphocytes with CIN 1.

  19. Protective effect of zinc on N-methyl-N-nitrosourea and testosterone-induced prostatic intraepithelial neoplasia in the dorsolateral prostate of Sprague Dawley rats.

    Science.gov (United States)

    Banudevi, Sivanantham; Elumalai, Perumal; Sharmila, Govindaraj; Arunkumar, Ramachandran; Senthilkumar, Kalimuthu; Arunakaran, Jagadeesan

    2011-09-01

    Previous studies have suggested that zinc exerts anticarcinogenic and antiproliferative effects against prostate cancer both in vitro and in rat ventral prostate. Zinc accumulation diminishes early in the course of prostate malignancy and it inhibits the growth of several carcinoma cells through induction of cell cycle arrest and apoptosis. In this study, we have investigated the influence of zinc on N-methyl-N-nitrosourea (MNU) and testosterone (T)-induced prostatic intraepithelial neoplasia in the dorsolateral prostate of Sprague Dawley (SD) rats. The results indicate that zinc plays an important role in prostate carcinogenesis. Increased tumor incidence was accompanied by a decrease in prostatic acid phosphatase activity, citrate, zinc, glutathione-S-transferase, reduced glutathione, p53, B-cell lymphoma protein (Bcl-2)-associated X protein and caspase-3 levels in MNU + T-treated rats. On the contrary, significantly increased phase I drug metabolizing enzyme activities, lipid peroxide, hydrogen peroxide, proliferating cell nuclear antigen, Bcl-2 and Bcl-X(L) protein levels were observed in the dorsolateral prostate of MNU + T-treated rats. Simultaneous zinc supplementation significantly reversed these effects in MNU + T-treated rats. Signs of dysplasia, a characteristic of prostatic intraepithelial neoplasia, were evident in the dorsolateral prostatic tissue sections by MNU + T administration. However, zinc supplementation has reversed these effects in the dorsolateral prostatic histoarchitecture. These results suggest that zinc may act as an essential trace element against MNU and testosterone-induced prostatic preneoplastic progression in SD rats.

  20. Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia without colposcopic tissue information; a step toward automation for low resource settings

    Science.gov (United States)

    Yamal, Jose-Miguel; Zewdie, Getie A.; Cox, Dennis D.; Neely Atkinson, E.; Cantor, Scott B.; MacAulay, Calum; Davies, Kalatu; Adewole, Isaac; Buys, Timon P. H.; Follen, Michele

    2012-04-01

    Optical spectroscopy has been proposed as an accurate and low-cost alternative for detection of cervical intraepithelial neoplasia. We previously published an algorithm using optical spectroscopy as an adjunct to colposcopy and found good accuracy (sensitivity=1.00 [95% confidence interval (CI)=0.92 to 1.00], specificity=0.71 [95% CI=0.62 to 0.79]). Those results used measurements taken by expert colposcopists as well as the colposcopy diagnosis. In this study, we trained and tested an algorithm for the detection of cervical intraepithelial neoplasia (i.e., identifying those patients who had histology reading CIN 2 or worse) that did not include the colposcopic diagnosis. Furthermore, we explored the interaction between spectroscopy and colposcopy, examining the importance of probe placement expertise. The colposcopic diagnosis-independent spectroscopy algorithm had a sensitivity of 0.98 (95% CI=0.89 to 1.00) and a specificity of 0.62 (95% CI=0.52 to 0.71). The difference in the partial area under the ROC curves between spectroscopy with and without the colposcopic diagnosis was statistically significant at the patient level (p=0.05) but not the site level (p=0.13). The results suggest that the device has high accuracy over a wide range of provider accuracy and hence could plausibly be implemented by providers with limited training.

  1. Advances in diagnosis and treatment of vaginal intraepithelial neoplasia%阴道上皮内瘤变诊治的研究进展

    Institute of Scientific and Technical Information of China (English)

    彭琦; 洪颖

    2014-01-01

    Vaginal intraepithelial neoplasia (VAIN) represents a rare and asymptomatic pre-neoplastic lesion of the lower genital tract squamous cells carcinoma .Cervical intraepithelial neoplasia and VAIN are caused by prevalence and distribution of human papillomavirus infection.Due to widely use of vaginal cytology and HPV test , the cases of VAIN is increasing .Surgery is considered as the most effective treatment at present .It is essential to have long-term and standard follow-up for the cases to reduce the reocurrence and improve survival rate.%阴道上皮内瘤变是少见的女性生殖道鳞状细胞癌癌前病变。与宫颈上皮内瘤变相同,阴道上皮内瘤变的主要病因是高危型人乳头瘤病毒的持续性感染所致。随着阴道细胞学检查及人乳头瘤病毒检测的广泛开展应用,诊断病例呈逐年上升趋势。目前认为手术治疗是疗效最好的方法。对阴道上皮内瘤变的患者进行定期规范的随访是降低复发率和提高生存率的必要条件。

  2. Prevalence of cervical intraepithelial neoplasia in relation to knowledge, attitudes/beliefs, and practices among university students in North-Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    James O Adisa

    2013-01-01

    Full Text Available Background: The involvement of communities in control of cervical cancer cannot be overemphasized, but this must take cognizance of their current knowledge, attitudes/beliefs, and practices (KABP of the people if it will be sustainable. This study assessed the prevalence of cervical intraepithelial neoplasia (CIN among university students and their level of KABP concerning cervical screening in Maiduguri North-Eastern, Nigeria. Materials and Methods: Two hundred and fifty-two subjects (age range: 18-69 years were screened using pap smear screening method and acetowhite method. A structured questionnaire was administered on each subject to elicit information on KABP that could predispose them to the disease. Results: CIN was recorded in 12.8% of subjects with low-grade squamous intraepithelial lesion in 10.8% and high-grade squamous intraepithelial lesion 2.0% of the women, respectively. The average general level of knowledge of various aspect of was 43.3% average positive attitudes/beliefs about the disease was recorded in 17.1% of subject, while positive practices that could lead to prevention of the disease was obtained in 30.0%. Conclusion: The level of knowledge of the disease and screening is very low and together with high levels of negative attitudes and practices, will adversely affect control measures and therefore have to be addressed.

  3. Interferón alfa-2b tópico como primera opción en las neoplasias intraepiteliales corneoconjuntivales Topical interferon alfa-2b for primary treatment of conjunctiva-cornea intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    M. Pérez de Arcelus

    2012-04-01

    Full Text Available Se describen dos casos de neoplasia intraepitlelial corneo-conjuntival (CIN tratados con interferón alfa-2b (IFN alfa-2b tópico como primera elección. El tratamiento clásico de los CIN ha sido tradicionalmente la resección completa con márgenes de seguridad seguida de crioterapia en el lecho quirúrgico. No obstante, y puesto que la tasa de recidivas puede alcanzar el 50% han sido propuestos coadyuvantes como la mitomicina C y el 5 fluoracilo, con el consiguiente riesgo de toxicidad corneal y límbica. El IFN alfa-2b presenta una eficacia similar a la cirugía en la erradicación completa de la masa tumoral como primera opción, con escasos efectos secundarios y nulo potencial carcinogénico, incluso en casos de recurrencia a terapia con mitomicina C, lesiones quirúrgicas residuales y formas difusas.We describe two cases of conjunctival-cornea intraepithelial neoplasia (CIN, treated with topical IFN alfa 2b. The traditional treatment for CIN is surgical excision usually with adjunctive cryotherapy. However, residual tumour may remain, which can lead to recurrence rates of more than 50%. 5-Fluorouracil, mitomicyn C and interferon alfa 2b are new pharmacological agents that have proved their efficacy in the treatment of CIN. As side effects are common, we present IFN alfa 2b as a single therapeutic agent as an effective and optimal treatment for presumed recurrent corneal and conjunctival intraepithelial neoplasia. It offers the benefits of topical therapy and avoids the risks of surgical or other interventions - specifically, ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cell deficiency.

  4. Histopathologic extent of cervical intraepithelial neoplasia 3 lesions in the atypical squamous cells of undetermined significance low-grade squamous intraepithelial lesion triage study: implications for subject safety and lead-time bias.

    Science.gov (United States)

    Sherman, Mark E; Wang, Sophia S; Tarone, Robert; Rich, Laurie; Schiffman, Mark

    2003-04-01

    Cervical intraepithelial neoplasia 3 (CIN3) is the precursor of mostsquamous carcinomas and serves as a surrogate end point. However, small CIN3 lesions are rarely associated with concurrent invasion. We hypothesized that aggressive follow-up for cytology of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) leads predominantly to detection of smaller CIN3 lesions than those usually associated with cancer. We assessed this hypothesis in a masked histopathologic review of 330 CIN3 lesions in the ASCUS LSILTriage Study, focusing on ASCUS referrals. ASCUS referrals underwent randomized management [colposcopy for repeat cytology of high-grade squamous intraepithelial lesion (HSIL), colposcopy for oncogenic human papillomavirus (HPV) detection or repeat HSIL, or immediate colposcopy]; then all were followed with repeat cytology for 2 years, followed by colposcopy and aggressive treatment. We assessed all CIN3 lesions qualitatively and measured 39 of them. CIN3 lesions were overwhelmingly small. Compared with enrollment, lesions found at follow-up or exit involved fewer tissue fragments (P < 0.01) and showed less diffuse gland involvement (P = 0.03). CIN3 lesions found postenrollment after HPV testing involved the fewest tissue fragments [versus immediate colposcopy (P = 0.04) or repeat cytology of HSIL (P = 0.02)], and none showed diffuse gland involvement. The median distal-proximal length was 6.5 mm (median replacement of total epithelium = 5%) in the 39 measured cases. We conclude that CIN3 lesions underlying ASCUS or LSIL generally lack features associated with invasion, particularly if managed using HPV testing, suggesting that aggressive management leads to early detection of CIN3 but probably prevents relatively few cancers in screened populations.

  5. MEKK3 and NF-κB expression levels in cervical intraepithelial neoplasia tissue and their correlation with high-risk HPV infection

    Institute of Scientific and Technical Information of China (English)

    Ping Liu; Hong-Li Zhang

    2016-01-01

    Objective:To study the MEKK3 and NF-κB expression levels in cervical intraepithelial neoplasia (CIN) tissue and their correlation with high-risk human papilloma virus (HPV) infection.Methods:A total of 500 patients with cervical intraepithelial neoplasia were selected as CIN group, 450 chronic cervicitis patients with matched general data were selected as control group, cervical tissue was collected, immunohistochemical method was used to detect the protein expression levels of mitogen-activated protein kinase/ERK kinase kinase 3 (MEKK3) and nuclear factors-κB (NF-κB), fluorescence quantitative PCR method was used to detect the mRNA expression levels ofMEKK3, NF-κB, JAK2, STAT3, p16INK4a, p27kip1 andp53kip3.Results:The protein expression levels and mRNA expression levels of MEKK3 and NF-κB in cervical tissue of CIN group were significantly higher than those of control group; the protein expression levels and mRNA expression levels ofMEKK3 and NF-κB in cervical tissue with high-risk HPV infection (+) were significantly higher than those in cervical tissue with high-risk HPV infection (-); mRNA levels ofJAK2andSTAT3in CIN cervical tissue with positive expression of MEKK3 and NF-κB were significantly higher than those in CIN cervical tissue with negative expression of MEKK3 and NF-κB, and mRNA levels ofp16INK4a, p27kip1 andp53kip3were significantly lower than those in CIN cervical tissue with negative expression of MEKK3 and NF-κB.Conclusions:High-risk HPV infection can increase the expression levels of MEKK3 and NF-κB in cervical intraepithelial neoplasia tissue, and then down-regulate the expression of tumor suppressor genesp16INK4a, p27kip1 andp53kip3 through the JAK2/STAT3 signaling pathway.

  6. Multicolor immunofluorescence reveals that p63- and/or K5-positive progenitor cells contribute to normal breast epithelium and usual ductal hyperplasia but not to low-grade intraepithelial neoplasia of the breast.

    Science.gov (United States)

    Boecker, Werner; Stenman, Göran; Schroeder, Tina; Schumacher, Udo; Loening, Thomas; Stahnke, Lisa; Löhnert, Catharina; Siering, Robert Michael; Kuper, Arthur; Samoilova, Vera; Tiemann, Markus; Korsching, Eberhard; Buchwalow, Igor

    2017-03-16

    We contend that knowledge about the cellular composition of normal breast epithelium is a prerequisite for understanding proliferative breast disease. Against this background, we used multicolor immunofluorescence to study normal breast epithelium and two types of intraepithelial proliferative breast lesion for expression of the p63, basal keratin K5, glandular keratin K8/18, SMA, ER-alpha, and Ki67. We studied eight normal breast epithelium samples, 12 cases of usual ductal hyperplasia, and 33 cases of low-grade intraepithelial neoplasia (9 flat epithelial atypia, 14 low-grade ductal carcinoma in situ and 10 cases of lobular neoplasia). Usual ductal hyperplasia showed striking similarity to normal luminal breast epithelium including p63+ and/or K5+ luminal progenitor cells and the full spectrum of luminal progeny cells. In normal breast epithelium and usual ductal hyperplasia, expression of ER-alpha was associated with lack of expression of the proliferation antigen Ki67. In contrast, we found in both types of low-grade intraepithelial neoplasia robust expression of keratin K8/18 and a positive association between ER-alpha and Ki67 expression. However, these lesions were consistently negative for p63 and/or K5. Our observational study supports the view that usual ductal hyperplasia and low-grade intraepithelial neoplasia are different entities rather than part of a spectrum of the same disease. We propose a new operational model of cell differentiation that may serve to better understand correlations between normal breast epithelium and proliferative breast diseases. From our data we conclude that p63+ and/or K5+ progenitor cells contribute to maintenance of normal epithelium and usual ductal hyperplasia, but not to low-grade intraepithelial neoplasia of the breast.

  7. Long-term results of exclusive low-dose rate curie-therapy for a high-grade vaginal intraepithelial neoplasia; Resultats a long terme de la curietherapie exclusive de bas debit de dose pour neoplasie vaginale intraepitheliale de haut grade

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, P.; Monnier, L.; Dumas, I.; Azoury, F.; Mazeron, R.; Haie-Meder, C. [Institut Gustave-Roussy, 94 - Villejuif (France)

    2010-10-15

    The authors report the results of an exclusive low dose rate curie therapy for female patients treated for a grade 3 vaginal intraepithelial neoplasia. They reviewed the medical files of patients treated since 1983, i.e. 28 women. They analysed demographic characteristics, the clinic description of lesions, possible treatments which occurred before this high-grade vaginal intraepithelial neoplasia, possible previous history of cervical or endometrial cancer, curie therapy detailed data, presence of tumorous relapse. According to that, they conclude that a 60 Gy exclusive low- vaginal dose-rate curie-therapy is an efficient and well tolerated treatment for high-grade vaginal intraepithelial neoplasia. Short communication

  8. Overtreatment and undertreatment of cervical intraepithelial neoplasia%子宫颈上皮内瘤变治疗过度与不足得失分析

    Institute of Scientific and Technical Information of China (English)

    钱德英

    2011-01-01

    Cervical intraepithelial neoplasia (CIN) is precancerous cervical lesion. Reasonable intervention is one of primary measures for prevention and treatment of cervical cancer. In this paper, we investigated overtreatment and undertreatment of CIN in order to effectively block progression of CIN.%子宫颈上皮内瘤变是子宫颈癌的癌前病变,合理干预子宫颈上皮内瘤变是防治子宫颈癌的主要措施之一.文章就子宫颈上皮内瘤变干预过程出现的治疗过度与不足的原因和结果加以剖析,以期待有效阻断病变发展.

  9. Decreased D2-40 and increased p16INK4A immunoreactivities correlate with higher grade of cervical intraepithelial neoplasia

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    Lu Zhouping

    2011-07-01

    Full Text Available Abstract Background D2-40 has been shown a selective marker for lymphatic endothelium, but also shown in the benign cervical basal cells. However, the application of D2-40 immunoreactivity in the cervical basal cells for identifying the grade of cervical intraepithelial neoplasia (CIN has not been evaluated. Methods In this study, the immunoreactive patterns of D2-40, compared with p16INK4A, which is currently considered as the useful marker for cervical cancers and their precancerous diseases, were examined in total 125 cervical specimens including 32 of CIN1, 37 of CIN2, 35 of CIN3, and 21 of normal cervical tissue. D2-40 and p16INK4A immunoreactivities were scored semiquantitatively according to the intensity and/or extent of the staining. Results Diffuse D2-40 expression with moderate-to-strong intensity was seen in all the normal cervical epithelia (21/21, 100% and similar pattern of D2-40 immunoreactivity with weak-to-strong intensity was observed in CIN1 (31/32, 97.2%. However, negative and/or focal D2-40 expression was found in CIN2 (negative: 20/37, 54.1%; focal: 16/37, 43.2% and CIN3 (negative: 22/35, 62.8%; focal: 12/35, 34.3%. On the other hand, diffuse immunostaining for p16INK4A was shown in 37.5% of CIN1, 64.9% of CIN2, and 80.0% of CIN3. However, the immunoreactive pattern of D2-40 was not associated with the p16INK4A immunoreactivity. Conclusions Immunohistochemical analysis of D2-40 combined with p16INK4A may have a significant implication in clinical practice for better identifying the grade of cervical intraepithelial neoplasia, especially for distinguishing CIN1 from CIN2/3.

  10. Distribution and characterization of subtypes of penile intraepithelial neoplasia and their association with invasive carcinomas: a pathological study of 139 lesions in 121 patients.

    Science.gov (United States)

    Chaux, Alcides; Velazquez, Elsa F; Amin, Ali; Soskin, Ana; Pfannl, Rolf; Rodríguez, Ingrid M; Barreto, José E; Lezcano, Cecilia; Ayala, Gustavo; Netto, George J; Cubilla, Antonio L

    2012-07-01

    We are presenting the morphological features of 121 cases of atypical penile intraepithelial lesions. The term penile intraepithelial neoplasia (PeIN) was used to encompass all of them, and lesions were classified into 2 major groups, differentiated and undifferentiated. The latter was further divided in warty, basaloid, and warty-basaloid subtypes. Ninety-five cases were associated with invasive squamous cell carcinomas. Differentiated lesions predominated (68%), followed by warty-basaloid (14%), basaloid (11%), and warty (7%) subtypes. Multifocality was found in 15% of the cases. Differentiated lesions were preferentially located in foreskin, whereas warty and/or basaloid subtypes were more prevalent in the glans. The former lesions were preferentially seen in association with keratinizing variants of squamous carcinoma, whereas the latter subtypes were found mostly in conjunction with invasive warty, basaloid, and warty-basaloid carcinomas. Lichen sclerosus was present in 51% of cases of differentiated lesions and absent in warty and/or basaloid subtypes. In summary, PeIN can be classified into 4 distinctive morphological subtypes. The proper pathological characterization of these lesions may provide important clues to the understanding of the pathogenesis and natural history of penile cancer.

  11. Diagnosis and treatment progress of vaginal intraepithelial neoplasia%阴道上皮内瘤变的诊疗进展

    Institute of Scientific and Technical Information of China (English)

    刘秀荣

    2016-01-01

    Vaginal intraepithelial neoplasia (VAIN)is a class of lesions which is occurring in the vaginal squamous dysplasia and carcinoma in situ.It is closely related with human papillomavirus infection and incidence of invasive cervical cancer.It is precancerous lesions of vaginal carcinoma,the detection rate increased significantly in recent years.But so far there is no uniform standard clinical treatment program.In this paper,recent progress about the diag-nosis and treatment of VAIN are reviewed.%阴道上皮内瘤变(vaginal intraepithelial neoplasia,VAIN)是指发生在阴道的鳞状上皮不典型增生及原位癌的一类病变。与人乳头状瘤病毒感染及宫颈浸润癌的发生密切相关,是阴道浸润癌的癌前病变,近年检出率明显增加。但至今尚无统一的临床诊疗标准方案。本文就近年来 VAIN 的诊疗进展作一综述。

  12. The relationship of community biopsy-diagnosed cervical intraepithelial neoplasia grade 2 to the quality control pathology-reviewed diagnoses: an ALTS report.

    Science.gov (United States)

    Castle, Philip E; Stoler, Mark H; Solomon, Diane; Schiffman, Mark

    2007-05-01

    We examined the predictors (cytologic interpretations, pathology review, human papillomavirus [HPV] testing results, and colposcopic impressions) of precancer among 545 women with clinical center biopsy diagnoses of cervical intraepithelial neoplasia (CIN) 2 in the ASCUS LSIL Triage Study. Among women with a CIN 2 biopsy result, there was an increasing likelihood that the loop electrosurgical excision procedure (LEEP) tissue sample was diagnosed as precancer (CIN 3) with an increasing number of clinical risk factors of cervical precancer (high-grade squamous intraepithelial lesion [HSIL] cytology, high-grade colposcopy, detection of HPV type 16; Ptrend biopsy and LEEP tissue samples, HPV-16 was positively associated (odds ratio [OR], 4.8; 95% confidence interval [CI], 2.6-8.8) with a CIN 3 diagnosis, whereas testing negative for HPV or positive for noncarcinogenic HPV types was negatively associated (OR, 0.32; 95% CI, 0.14-0.75) with a CIN 3 diagnosis. Although we found clear evidence that HPV-16 detection helped clarify whether a biopsy specimen diagnosed as CIN 2 represented HPV infection or cervical precancer, this relationship was not sufficiently robust to be clinically useful for reducing the overtreatment of women with HPV infection.

  13. Preliminary study of vulvar and vaginal intraepithelial neoplasias%外阴和阴道上皮内瘤变的临床初步研究

    Institute of Scientific and Technical Information of China (English)

    郭艳利; 耿力; 游珂; 乔杰; 刘从容

    2009-01-01

    目的:探讨外阴和阴道上皮内瘤变(vulvar intraepithelial neoplasias,VIN,and vaginal intraepithelial neopla-sias,VAIN)的发病特点.方法:对2004年9月至2007年12月在北京大学第三医院阴道镜门诊行外阴或阴道活检的148例女性患者进行回顾性分析.结果:148例中经病理诊断为VIN 2,3或VAIN 2,3级23例,VIN1或VAIN 1级16例,外阴或阴道湿疣61例,以及外阴癌1例,外阴或阴道炎症47例.VIN或VAIN患者中85%(33/39)年龄在30岁以上,并且高于宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)患者的年龄.VIN,VAIN及湿疣的高危型人乳头瘤病毒(human papillomavirus,HPV)DNA检测结果阳性率达84%(84/100),其中23例VIN 2,3或VAIN 2,3患者的高危型HPV DNA检测结果均为阳性.超过90%(69/75)的VAIN病灶位置在阴道上段.VIN或VAIN常与CIN或宫颈癌伴随存在或继其后发生(79%,31/39),并且高级别的VIN或VAIN常合并高级别的CIN或宫颈癌(70%,16/23).结论:高危型HPV感染也是VIN或VAIN及癌的主要致病因素,对宫颈病变或宫颈癌患者应仔细检查外阴和阴道黏膜.

  14. Discussion of Detection Method for Cervical Glandular Intraepithelial Neoplasia%宫颈腺上皮瘤样病变检测方法的探讨

    Institute of Scientific and Technical Information of China (English)

    周红荣; 马成斌; 王忠英

    2014-01-01

    目的:探讨宫颈涂片、宫颈活检等的筛选方法在宫颈腺上皮瘤样病变术前检测中的作用。方法对2007.1~2013.6在我院做过宫颈锥切和全子宫切除诊断为宫颈腺上皮瘤样病变(CGIN)的患者进行鉴别。收集宫颈锥切和子宫切除前来自宫颈涂片、宫颈组织活检、颈管搔刮的结果。 Fisher确切概率法用于统计分析。结果经宫颈组织病理证实的67例CGIN患者宫颈细胞学涂片中,23例有细胞病变,未见上皮内瘤样病变44例。宫颈涂片腺体病变检出灵敏度34.3%。23例涂片异常结果中异型的腺上皮有8例(11.9%),高度鳞状上皮内瘤样病变1例(1.5%),低度鳞状上皮瘤样病变的5例(7.5%),不典型鳞状上皮9例(13.4%),。腺上皮异常组与鳞状上皮异常组对单纯性CGIN的检出率无统计学差异(P=0.379)。结论在CGIN锥切前,宫颈涂片检测腺体病变异常的敏感度较低,但加上宫颈组织活检和宫颈管搔刮则明显提高,宫颈疾病的术前精确预测对怀疑有宫颈腺体病变患者治疗计划的制定具有重要意义。%Objective Discuss the role of screening method for cervical smear, cervical biopsy and etc in preoperative detecting of cervical glandular intraepithelial neoplasia (CGIN). Methods: Patients with a cervical biopsy or hysterectomy diagnosis of CGIN from 2007.1 to 2013.6 at our institution were identified. Results from Papanicolaou smears or TCT、cervical biopsies and endocervical curet age (ECC) preceding the cone excision or hysterectomy were col ected from medical records. Fisher exact test was used for statistical analysis. Results: The pathology confirmed of 67, found a total of 23 cases had untypical cells, negative for intraepithelial lesion or malignancy (NILM) 44 patients (65.7%). Positive predictive value of cervical smear for glandular lesion is 34.3%. Atypical glandular epithelium has 8 cases (11.9%), high-grade squamous intraepithelial

  15. 阴道镜检查在阴道上皮内瘤变中的应用%Application of colposcopy in vaginal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    鞠宏艳

    2012-01-01

    目的:探讨电子阴道镜检查在阴道病变中的临床应用价值.方法:对2007年8月~2010年8月在的吉林市妇产医院妇科门诊就诊的宫颈上皮内瘤变、阴道上皮内瘤变或宫颈癌术后31例患者行阴道细胞学涂片检查,结果异常者15例行电子阴道镜检查,在可疑病变区取活检送病理检查.16例细胞学检查为正常或鳞状上皮非典型增生者给予阴道用药治疗1~3个疗程,3个月后复查宫颈阴道涂片,2例细胞学仍异常,行阴道镜下活检送病理检查,余14例细胞学阴性者定期复查细胞学.结果:15例涂片异常者中检出阴道上皮内瘤变9例,原位癌2例,余4例避免活检.阴道镜检查准确率达73.33%,与病理学诊断符合率达81.82%.结论:阴道镜对阴道上皮内瘤变的诊断至关重要,活检定位准确,避免不必要的活检.%Objective: To explore the clinical application value of electronic colposcopy in vaginal lesions. Methods: Thirty - one patients with cervical intraepithelial neoplasia ( CIN ) , vaginal intraepithelial neoplasia or after cervical cancer surgery who were treated in gynecological department of the hospital from August 2007 to August 2010 underwent vaginal cytological smears, then IS patients with abnormal results underwent colposcopy, biopsy was conducted in suspected lesion areas for pathological examination. Sixteen patients with normal results or atypical hyperplasia of squamous epithelium were treated with vaginal administration for 1 - 3 courses, cervicovaginal smears were re-examined after 3 months, 2 patients were still found with abnormal cytological results, biopsy under colposcope was performed for pathological examination; the other 14 patients with negative cytological results were reexamined regularly. Results: Among 15 patients with abnormal cytological results, 9 patients were found with vaginal intraepithelial neoplasia, 2 patients were found with carcinoma in situ, the other 4 patients didn

  16. Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H cannot be ruled out

    Directory of Open Access Journals (Sweden)

    Andréa Cytryn

    Full Text Available CONTEXT AND OBJECTIVE: The latest update of the Bethesda System divided the category of atypical squamous cells of undetermined significance (ASCUS into ASC-US (undetermined significance and ASC-H (high-grade intraepithelial lesion cannot be ruled out. The aims here were to measure the prevalence of pre-invasive lesions (cervical intraepithelial neoplasia, CIN II/III and cervical cancer among patients referred to Instituto Fernandes Figueira (IFF with ASC-H cytology, and compare them with ASC-US cases. DESIGN AND SETTING: Cross-sectional study with retrospective data collection, at the IFF Cervical Pathology outpatient clinic. METHODS: ASCUS cases referred to IFF from November 1997 to September 2007 were reviewed according to the 2001 Bethesda System to reach cytological consensus. The resulting ASC-H and ASC-US cases, along with new cases, were analyzed relative to the outcome of interest. The histological diagnosis (or cytocolposcopic follow-up in cases without such diagnosis was taken as the gold standard. RESULTS: The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55% and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764. Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83; P = 0.2786998. There were no uterine cervical cancer cases. CONCLUSION: The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions.

  17. Neoplasia intra-epitelial grau III da vulva e da região perianal tratada com vulvectomia superficial: relato de caso High-grade vulvar and perianal intraepithelial neoplasia treated with skinning vulvectomy: a case report

    Directory of Open Access Journals (Sweden)

    Walquíria Quida Salles Pereira Primo

    2003-05-01

    Full Text Available A neoplasia intra-epitelial vulvar grau III (NIV III se manifesta de modo visível, portanto, acessível à biópsia e, por conseguinte, ao diagnóstico histológico. Há duas formas precursoras do câncer vulvar: a NIV associada ao papiloma vírus humano (HPV e a NIV associada ao líquen simples crônico, hiperplasia de células escamosas e líquen escleroso, não tratados. Porém, pode existir sobreposição das duas formas. O termo papulose bowenóide, apesar de ser desencorajado, define uma das formas clínicas da NIV, que se apresenta como lesões pigmentadas, verruciformes, papulares e múltiplas. A NIV III está associada com HPV em mais de 80% dos casos e em 40% das vezes, nota-se envolvimento perianal. O seu tratamento é muito difícil e pode ocorrer recorrência em qualquer tempo e por muitos anos. Embora não exista tratamento padrão definido, os trabalhos apontam para a cirurgia, respeitando margem de segurança, como o mais adequado.High-grade vulvar intraepithelial neoplasia (VIN III is a visible lesion; therefore, it is accessible to biopsy and thus, to a histological diagnosis. There are two forms of vulvar cancer precursors: VIN caused by human papillomavirus (HPV and VIN associated with untreated lichen simplex chronicus, squamous cell hyperplasia, and lichen sclerosus. There may be overlap of the two forms. The term bowenoid papulosis, although discouraged, identifics a clinical form of VIN III. Such lesion appears as pigmented, wart-like growths or papules. VIN III is associated with HPV in more than 80% of the cases, and there is perianal involvement in 40% of the times. Vulvar intraepithelial neoplasia is difficult to cure and relapses can occur at any time for many years. Although there is no defined standard treatment, studies point to surgery, respecting a free margin, as the most adequate one.

  18. Predictors of persistent cytologic abnormalities after treatment of cervical intraepithelial neoplasia in Soweto, South Africa: a cohort study in a HIV high prevalence population

    Directory of Open Access Journals (Sweden)

    McIntyre James A

    2008-07-01

    Full Text Available Abstract Background In the presence of both HIV infection and cervical intraepithelial neoplasia (CIN, the risk of cancer development despite treatment may be greater. We investigated clinical predictors of persistent cytological abnormalities in women who had had a large loop excision of the transformation zone (LLETZ. Methods Women with high grade squamous intraepithelial lesions or worse (HSIL, less severe abnormalities which persisted and any abnormality in women who are HIV-infected, were referred to the colposcopy clinic. HIV infection was ascertained by self-report. A LLETZ was performed on all patients with HSIL or higher on Papanicolaou (Pap smear or colposcopy, LSIL or higher in patients who are HIV-infected, where the colposcopy is inadequate, and when there was a discrepancy between colposcopy and cytology by one or more grades. Women with abnormal follow-up smears were compared to those with normal smears. We examined the association between abnormal follow-up smears and demographic and clinical predictors using logistic regression Results The median time between LLETZ and first follow-up Pap smear was rather short at 122 days. Persistent cytological abnormalities occurred in 49% of our patients after LLETZ. Predictors of persistence included the presence of disease at both margins and HIV infection. Among the latter, disease at the excision margins and CD4+ cell count were important predictors. In these women, disease at the endocervical margin, both margins, and disease only at the ectocervical margin were associated with increased odds of persistent abnormalities on follow-up cervical smear. Conclusion We showed extremely high risk of cytological abnormality at follow-up after treatment more so in patients with incomplete excision and in the presence of immunocompromise. It remains uncertain whether recurrent CIN is a surrogate marker for invasive cervical cancer.

  19. 子宫颈上皮内瘤变120例临床病理分析%Clinical and pathological analysis of 120 cases cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    陈仲涛; 张英

    2012-01-01

    Objective: To evaluate the diagnosis and differential diagnosis, prognosis and early prevention of cervi-cal intraepithelial neoplasia. Methods: Total of 120 cases of cervical intraepithelial lesions were followed - up, and ob-served the characteristics and classification. Results:The diagnosis of CIN Ⅰ in 12 cases (10% ) ,CIN Ⅱ grade 44 ca-ses (36.7%),CIN Ⅲ 64 cases (53.3%).CIN I -1 grade cervical loop conization 77 cases (64.2%),CIN Ⅲ grade hysterectomy in 43 cases (35.8%). Conclusion: Cervical three - step examination of the cervical CIN is useful to early diagnosis and early treatment and reduce the cervical carcinoma incidence rate and mortality.%目的:探讨子宫颈上皮内瘤变的诊断与鉴别诊断要点、预后及早期防治.方法:收集120例子宫颈上皮内瘤样病变,进行随访,并对光镜下的特点进行观察和分级.结果:诊断CIN Ⅰ级12例(10%),CINⅡ级44例(36.7%),CIN Ⅲ级64例(53.3%).CIN Ⅰ-Ⅲ级官颈环锥切77例(64.2%),CIN Ⅲ级子宫全切43例(35.8%).结论:宫颈三阶梯检查,对宫颈CIN可早诊断,早治疗,减低了宫颈浸润癌的发生率及死亡率.

  20. The Clinical Analysis of Cervical Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia%LEEP刀治疗宫颈上皮内瘤变的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    陆维仙

    2013-01-01

    Objective To evaluate the clinical curative effect of LEEP in cervical intraepithelial neoplasia. Methods 100 cases with cervical intraepithelial neoplasia from January 2011 to June 2012 treated with LEEP,were selected for retrospective analysis.Results The correspondence rate was 76%by comparing multipoint biopsy under the vaginoscope with LEEP pathological examination,the recovery rate was 93%.Conclusion LEEP operation in treatment of cervical intraepithelial neoplasia is signiifcantly effective,which is worth popularizing in the clinic works.%目的:观察LEEP刀治疗宫颈上皮内瘤变的临床疗效。方法选取2011年1月~2012年6月采取LEEP刀治疗宫颈上皮内瘤变患者100例临床资料进行总结。结果阴道镜下宫颈活检与LEEP病理检查完全相符者占76%(76/100),治愈率为93%(93/100)。结论 LEEP刀术治疗宫颈上皮内瘤变临床效果显著,值得推广。

  1. Hypertrophic herpes simplex simulating anal neoplasia in AIDS patients: report of five cases.

    Science.gov (United States)

    Nadal, Sidney R; Calore, Edenilson E; Manzione, Carmen R; Horta, Sergio C; Ferreira, Aurea F; Almeida, Lis V

    2005-12-01

    Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.

  2. Recurrence of cervical intraepithelial neoplasia grades 2 or 3 in HIV-infected women treated by large loop excision of the transformation zone (LLETZ

    Directory of Open Access Journals (Sweden)

    Fábio Russomano

    Full Text Available CONTEXT AND OBJECTIVE: Women infected by HIV are more likely to have cervical cancer and its precursors. Treatment of the precursor lesions can prevent this neoplasia. The aim of this study was to assess the likelihood of recurrent cervical intraepithelial neoplasia grades 2 or 3 (CIN 2-3 in HIV-infected women, compared with HIV-negative women, all treated by large loop excision of the transformation zone (LLETZ. DESIGN AND SETTING: A cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF-Fiocruz, Rio de Janeiro. METHOD: 55 HIV-positive and 212 HIV-negative women were followed up after LLETZ for CIN 2-3 (range: 6-133 months. RESULTS: The incidence of recurrent CIN 2-3 was 30.06/10,000 woman-months in the HIV-positive group and 4.88/10,000 woman-months in the HIV-negative group (relative risk, RR = 6.16; 95% confidence interval, CI: 2.07-18.34. The likelihood of recurrence reached 26% at the 62nd month of follow-up among the HIV-positive women, and remained stable at almost 0.6% at the 93rd month of follow-up among the HIV-negative women. We were unable to demonstrate other prognostic factors relating to CIN recurrence, but the use of highly active antiretroviral therapy (HAART may decrease the risk of this occurrence among HIV patients. CONCLUSION: After LLETZ there is a higher risk of recurrence of CIN 2-3 among HIV-positive women than among HIV-negative women. This higher risk was not influenced by margin status or grade of cervical disease treated. The use of HAART may decrease the risk of this occurrence in HIV patients.

  3. Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study

    Science.gov (United States)

    Smith, Megan; Lew, Jie-Bin; Walker, Robert; Moss, Sue; Kitchener, Henry; Patnick, Julietta; Canfell, Karen

    2012-01-01

    Objectives To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). Design Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. Setting English NHS Cervical Cancer Screening Programme. Interventions Management guidelines after treatment of CIN involving annual cytology follow-up for 10 years, compared with alternative protocols using the human papillomavirus test to reduce the amount of post-treatment surveillance. Main outcome measures Cases of underlying CIN3+ averted at 10 years and costs per 1000 women treated. Results Model predictions indicated that, at observed levels of compliance with post-treatment recommendations, management with only cytological follow-up would result in 29 residual cases of recurrent CIN3+ by 10 years and would cost £358 222 (€440 426; $574 910) (discounted) per 1000 women treated. Implementation of human papillomavirus test of cure in cytologically negative women according to the sentinel sites protocol would avert an additional 8.4 cases of CIN 3+ and reduce costs by £9388 per 1000 women treated. Conclusions Human papillomavirus test of cure would be more effective and would be cost saving compared with cytology only follow-up. The results of this evaluation support the full scale implementation of human papillomavirus test of cure after treatment of CIN within the NHS Cervical Screening Programme. PMID:23117060

  4. p16INK4A immunohistochemical staining and predictive value for progression of cervical intraepithelial neoplasia grade 1: a prospective study in China.

    Science.gov (United States)

    Liao, Guang-Dong; Sellors, John W; Sun, Hai-Kui; Zhang, Xun; Bao, Yan-Ping; Jeronimo, Jose; Chen, Wen; Zhao, Fang-Hui; Song, Yan; Cao, Zhi; Zhang, Shao-Kai; Xi, Ming-Rong; Qiao, You-Lin

    2014-04-01

    p16(INK4A) is strongly expressed in tissues diagnosed as cervical intraepithelial neoplasia (CIN) and cancer in women infected with human papillomavirus (HPV), but few prospective studies have evaluated p16(INK4A) as a marker for the risk of low-grade CIN (CIN1) progression. We investigated the prevalence of p16(INK4A) immunostaining by CIN grade and whether overexpression of p16(INK4A) in CIN1 predicts future risk for high-grade CIN in Chinese women. 6,557 Chinese women aged 30-49 years were screened from 2003 to 2005 using cytology and carcinogenic HPV test. Colposcopy was performed on women with any abnormal result. p16(INK4A) Immunostaining was performed on biopsies from all women with CIN1, as well as randomly selected women with normal or CIN grade 2 and worse (CIN2+) biopsies. Women with CIN1 were followed up without treatment. Colposcopy was performed on all untreated women at a 2-year interval. The prevalence of p16(INK4A) staining was 2.7%, 42.7%, 75.5%, 79.6% and 100% among women with normal, CIN1, 2, 3 and cancer biopsies, respectively (p lesions.

  5. The negative predictive value of p16INK4a to assess the outcome of cervical intraepithelial neoplasia 1 in the uterine cervix

    DEFF Research Database (Denmark)

    Hariri, Jalil; Øster, Anne

    2007-01-01

    The immunohistochemical expression of p16 in formalin-fixed and paraffin-embedded histological sections was evaluated in a retrospective study comprising a low-grade group of 100 cases of cervical intraepithelial neoplasia (CIN) 1, a high-grade group of 50 cases of CIN 2 to 3, and a benign group...... of 50 cases of normal tissue or benign lesions in the uterine cervix. The cases were consecutive within each group and had a minimum follow-up period of 5 years. Positive reaction for p16 was detected in all cases in the high-grade group and in only 3 cases in the benign group. In the low-grade group......, a total of 9 cases had to be excluded. The remaining 91 cases in the low-grade group showed positive reaction for p16 in 65 cases (71%), including 23 cases that progressed to a high-grade lesion, 36 cases that revealed normal cytological and/or histological picture during the follow-up period, and 6 cases...

  6. Helper T Lymphocyte Response in the Peripheral Blood of Patients with Intraepithelial Neoplasia Submitted to Immunotherapy with Pegylated Interferon-α

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    Márcia Antoniazi Michelin

    2015-03-01

    Full Text Available Immunotherapy in cancer patients is a very promising treatment and the development of new protocols and the study of the mechanisms of regression is imperative. The objective of this study was to evaluate the production of cytokines in helper T (CD4+ lymphocytes during immunotherapy with pegylated IFN-α in patients with cervical intraepithelial neoplasia (CIN. We conducted a prospective study with 17 patients with CIN II-III using immunotherapy with pegylated IFN-α subcutaneouly weekly, and using flow cytometry we evaluated the peripheric CD4+ T lymphocytes. The results show that in the regression group the patients presented a significant increase in the amount of IFN-γ during the entire immunotherapy, compared with the group without a response. The amount of CD4+ T lymphocytes positive for IL-2, IL-4, IL-10 and TGF-β is significantly lower in patients with good clinical response. The results also demonstrate that patients with regression have a higher amount of intracellular TNF-α in CD4+ T lymphocytes before the start of treatment. Analyzing these data sets, it can be concluded that immunotherapy is a viable clinical treatment for patients with high-grade CIN and that the regression is dependent on the change in the immune response to a Th1 pattern.

  7. 胃上皮内瘤变发生及内镜检测准确性的影响因素探讨%Influencing factors of gastric intraepithelial neoplasia and the accuracy of endoscopic detection

    Institute of Scientific and Technical Information of China (English)

    陈旭峰; 李科军; 向正国; 葛继强; 郑扬

    2015-01-01

    Objective To explore the dangerous factors affecting gastric intraepithelial neoplasia and the influence factors for accuracy of endoscopy that be applied to detect gastric intraepithelial neoplasia .Methods There were 102 patients selected for gastric mucosal lesions under endoscopic resection treatment , and 73 of them confirmed for intraepi-thelial neoplasia were selected as the neoplasia group , while 70 healthy persons were collected as healthy controls .The dangerous factors affecting gastric intraepithelial neoplasia and the influence factors for accuracy of endoscopy be applied to detect gastric intraepithelial neoplasia were explored .Results The dangerous factors that causing stomach intraepithe-lial neoplasia were long-term drinking, skipping breakfast , greasy food, staying up late and Helicobacter pylori (H.py-lori) infection.The lesion size was independent related factors influencing the accuracy of the endoscopic biopsy patho -logic diagnosis.Conclusion The patients with long-term drinking, skipping breakfast , greasy food, staying up late or H.pylori infection that suffered from stomach atrophic gastritis or intestinal metaplasia should be active intervented .And lesions of a diameter of 3 cm or more should be treated with endoscopic submucosal resection .%目的:探讨影响胃上皮内瘤变的危险因素及应用内镜对检测胃上皮内瘤变准确性的影响因素。方法选取因胃黏膜病变行内镜下切除术治疗的患者102例,其中73例证实为胃上皮内瘤变作为瘤变组,随机选择健康体检者70名作为对照组,观察影响胃上皮内瘤变的危险因素及应用内镜对检测胃上皮瘤变准确性的影响因素。结果长期饮酒、不吃早餐、喜好油腻食物、熬夜及伴幽门螺旋杆菌( Helicobacter pylori , H.pylori)感染是引起胃上皮内瘤变的危险因素;病变大小是影响内镜活检病理诊断准确性的独立相关因素。结论积极干预胃萎缩性胃

  8. Diagnosis and Treatment of Vaginal Intraepithelial Neoplasia%阴道上皮内瘤变的诊断及治疗

    Institute of Scientific and Technical Information of China (English)

    石杏先; 高国兰; 崔雪; 李霞; 吴乾凤; 余立群

    2016-01-01

    Objective: To investigate the diagnosis and treatment of vaginal intraepithelial neoplasia (VAIN).Methods:The clinical data of 72 patients with VAIN were retrospectively analyzed, 72 cases of VAIN I, 20 cases of VAIN.Results: Patients ranged in age from 18 to 61 years old, most without clinical symptoms, the performance of a small number of vaginal secretion grow in quantity, 96% of patients in the vaginal fornix or 1/3, the remaining 4% in the third of the vagina, 30% of patients with cervical intraepithelial neoplasia (CIN) II ~ III. 52 cases of VAIN I have 18 cases of patients with CIN II to III of the patients underwent LEEP, I was to observe; 20 cases of patients with VAIN II ~ III patients with lesions, 6 cases of patients with CIN. 20 cases of VAIN II to III patients with high-risk human papillomavirus (HPV) negative, 19 cases of high-risk HPV positive, 3 months to 1 years after the turn to negative.Conclusion:VAIN often in the second step of the cervical screening test for the occasional discovery, often combined with CIN, the lesion of electric burn can play an effective therapeutic effect, the wound is small, the cure rate is high.%目的:探讨阴道上皮内瘤变(VAIN)的诊断及治疗方法。方法:回顾性分析VAIN的72例患者的临床资料,72例患者VAINⅠ52例,VAIN Ⅱ~Ⅲ20例。结果:患者年龄18~61岁,绝大多数无临床症状,少数表现为阴道分泌物增多,96%患者病变位于阴道穹窿或上1/3,其余4%位于阴道中1/3,30%患者合并宫颈上皮内瘤变(CIN)Ⅱ~Ⅲ。52例VAINⅠ中有18例合并CINⅡ~Ⅲ的患者行LEEP术,余予以观察;20例VAINⅡ~Ⅲ患者行病灶电灼术,其中6例合并CINⅡ~Ⅲ的患者同时行宫颈LEEP术。20例VAINⅡ~Ⅲ患者有1例高危型人乳头瘤病毒(HPV)阴性,19例高危型HPV阳性,均在术后3个月~1年内转为阴性。结论:VAIN常在宫颈筛查的第二阶梯阴道镜检查时偶然发现,常合并CIN,病灶

  9. 阴道上皮内瘤变六例临床分析%Clinical analysis of six cases of vaginal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    张庆霞; 朱兰; 郎景和; 沈铿; 黄惠芳; 潘凌亚

    2008-01-01

    Objective To investigate the clinical characteristics,diagnosis and treatment of vaginal intraepithelial neoplasia(VAIN).Methods A retrospective study was made of 6 patients with VAIN.who were hospitalized at Peking Union Medical College Hospital from 1980 to 2006.Results Five cases had a history of hysterectomy,two of whom were because of cervical intraepithelial neoplasia(CIN)or invasive cervical cancer.Four cases had the infection of high-risk oncogenic human papillomaviruses detected with hybrid capture Ⅱ(HC-Ⅱ),the other two had no record.In all patients the VAIN lesions were within the upper one third of the vagina.They were all diagnosed by colposcopic examination and directed biopsy after the abnormal cytology by thinprep cytology test(TCT).Six cases of VAIN Ⅱ-Ⅲ were treated by excisional surgery.One case had residual lesion and had another surgery 3 months after the first one.Two patients obtained remission at one-year follow-up,three had abnormal cytology by TCT 6 months after surgery,and one had abnormal cytology by TCT at six-month follow-up but normal at one-year follow-up.Conclusions A history of CIN is the main risk factor for VAIN,so routine vaginal cytology is needed for the patients after hysterectomy due to CIN.Cytology,colposcopic examination and directed biopsy are the mainstays of VAIN diagnosis.Excisional surgery is recommended for the patients with VAIN Ⅱ-Ⅲ.Long term follow-up is necessary after treatment.%目的 探讨阴道上皮内瘤变(VAIN)的临床特点、诊断和治疗方法.方法 回顾性分析1980-2006年间北京协和医院收治的6例VAIN患者的临床资料.结果 5例VAIN患者(5/6)发生于子宫全切除术后,其中2例因宫颈癌和(或)宫颈上皮内瘤变(CIN)切除子宫.4例患者检测过人乳头状瘤病毒,结果均为阳性.6例患者均无特异的临床症状,均是在细胞学涂片检查发现异常后经阴道镜活检确诊为VAIN,其病变部位均位于阴道上1/3.6例VAIN患者均

  10. High-dose-rate Intracavitary Radiotherapy in the Management of Cervical Intraepithelial Neoplasia 3 and Carcinoma In Situ Presenting With Poor Histologic Factors After Undergoing Excisional Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Bae, E-mail: ybkim3@yuhs.ac [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Cho, Nam Hoon [Department of Pathology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Koom, Woong Sub [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Sunghoon; Kim, Sang Wun; Nam, Eun Ji [Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Gwi Eon [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2012-09-01

    Purpose: To assess the effectiveness of high-dose-rate intracavitary radiotherapy (HDR-ICR) in patients with cervical intraepithelial neoplasia 3 (CIN 3) and carcinoma in situ (CIS) presenting with poor histologic factors for predicting residual disease after undergoing diagnostic excisional procedures. Methods and Materials: This study was a retrospective analysis of 166 patients with CIN 3 (n=15) and CIS (n=151) between October 1986 and December 2005. They were diagnosed by conization (n=158) and punch biopsy (n=8). Pathologic analysis showed 135 cases of endocervical gland involvement (81.4%), 74 cases of positive resection margins (44.5%), and 52 cases of malignant cells on endocervical curettage (31.3%). All patients were treated with HDR-ICR using Co{sup 60} or Ir{sup 192} at a cancer center. The dose was prescribed at point A located 2 cm superior to the external os and 2 cm lateral to the axis of the tandem for intact uterus. Results: Median age was 61 years (range, 29-77). The median total dose of HDR-ICR was 30 Gy/6 fractions (range, 30-52). At follow-up (median, 152 months), 2 patients developed recurrent diseases: 1 CIN 2 and 1 invasive carcinoma. One hundred and forty patients survived and 26 patients died, owing to nonmalignant intercurrent disease. Rectal bleeding occurred in one patient; however, this symptom subsided with conservative management. Conclusions: Our data showed HDR-ICR is an effective modality for CIN 3 and CIS patients presenting with poor histologic factors after excisional procedures. HDR-ICR should be considered as a definitive treatment in CIN 3 and CIS patients with possible residual disease after undergoing excisional procedures.

  11. Role of IAPs in prostate cancer progression: immunohistochemical study in normal and pathological (benign hyperplastic, prostatic intraepithelial neoplasia and cancer human prostate

    Directory of Open Access Journals (Sweden)

    Olmedilla Gabriel

    2010-01-01

    Full Text Available Abstract Background In this study was investigate IAPs in normal human prostate (NP, benign prostatic hyperplasia (BPH, prostatic intraepithelial neoplasia (PIN and prostatic carcinoma (PC, and their involvement in apoptosis/proliferation via NF-kB (TNF-α, IL-1 stimulation. Methods Immunohistochemical and Western blot analyses were performed in 10 samples of normal prostates, 35 samples of BPH, 27 samples diagnosis of PIN (with low-grade PIN or high-grade PIN and 95 samples of PC (with low, medium or high Gleason grades. Results In NP, cytoplasm of epithelial cells were positive to c-IAP1/2 (80% of samples, c-IAP-2 (60%, ILP (20%, XIAP (20%; negative to NAIP and survivin. In BPH, epithelial cells were immunostained to c-IAP1/2 (57.57%, c-IAP-2 (57.57%, ILP (66.6%, NAIP (60.6%, XIAP (27.27%, survivin (9.1%. Whereas low-grade PIN showed intermediate results between NP and BPH; results in high-grade PIN were similar to those found in PC. In PC, epithelial cells were immunostained to c-IAP1/2, c-IAP-2, ILP, NAIP, XIAP (no Gleason variation and survivin (increasing with Gleason. Conclusions IAPs could be involved in prostate disorder (BPH, PIN and PC development since might be provoke inhibition of apoptosis and subsequently cell proliferation. At the same time, different transduction pathway such as IL-1/NIK/NF-kB or TNF/NF-kB (NIK or p38 also promotes proliferation. Inhibitions of IAPs, IL-1α and TNFα might be a possible target for PC treatment since IAPs are the proteins that inhibited apoptosis (favour proliferation and IL-1α and TNFα would affect all the transduction pathway involucrate in the activation of transcription factors related to survival or proliferation (NF-kB, Elk-1 or ATF-2.

  12. Tyrosine kinase Etk/BMX is up-regulated in human prostate cancer and its overexpression induces prostate intraepithelial neoplasia in mouse.

    Science.gov (United States)

    Dai, Bojie; Kim, Oekyung; Xie, Yingqiu; Guo, Zhiyong; Xu, Kexin; Wang, Bin; Kong, Xiangtian; Melamed, Jonathan; Chen, Hegang; Bieberich, Charles J; Borowsky, Alexander D; Kung, Hsing-Jien; Wei, Guo; Ostrowski, Michael C; Brodie, Angela; Qiu, Yun

    2006-08-15

    The nonreceptor tyrosine kinase Etk/BMX was originally identified from the human prostate xenograft CWR22. Here, we report that Etk is up-regulated in human prostate tumor specimens surveyed. Knocking down Etk expression by a specific small interfering RNA (siRNA) in prostate cancer cells attenuates cell proliferation, suggesting an essential role of Etk for prostate cancer cell survival and growth. Targeted expression of Etk in mouse prostate epithelium results in pathologic changes resembling human prostatic intraepithelial neoplasia, indicating that up-regulation of Etk may contribute to prostate cancer development. A marked increase of luminal epithelial cell proliferation was observed in the Etk transgenic prostate, which may be attributed in part to the elevated activity of Akt and signal transducers and activators of transcription 3 (STAT3). More interestingly, the expression level of acetyltransferase cyclic AMP-responsive element binding protein-binding protein (CBP) is also increased in the Etk transgenic prostate as well as in a prostate cancer cell line overexpressing Etk, concomitant with elevated histone 3 acetylation at lysine 18 (H3K18Ac). Down-modulation of Etk expression by a specific siRNA leads to a decrease of H3 acetylation in prostate cancer cell lines. Our data suggest that Etk may also modulate chromatin remodeling by regulating the activity of acetyltransferases, such as CBP. Given that Etk may exert its effects in prostate through modulation of multiple signaling pathways altered in human prostate cancer, the Etk transgenic mouse model may be a useful tool for studying the functions of Etk and identification of new molecular markers and drug targets relevant to human diseases.

  13. Cervical cancer screening and treatment of cervical intraepithelial neoplasia in female sex workers using “screen and treat” approach

    Directory of Open Access Journals (Sweden)

    Joshi S

    2015-05-01

    Full Text Available Smita Joshi,1 Vinay Kulkarni,2 Trupti Darak,2 Uma Mahajan,1 Yogesh Srivastava,3 Sanjay Gupta,3 Sumitra Krishnan,1 Mahesh Mandolkar,2 Alok Chandra Bharti31Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI, Jehangir Hospital Premises, Pune, Maharashtra, India; 2Prayas Health Group, Amrita Clinic, Pune, India; 3Institute for Cytology and Preventive Oncology, Indian Council of Medical Research, New Delhi, IndiaObjective: Female sex workers (FSWs are at an increased risk of human immunodeficiency virus (HIV as well as human papillomavirus (HPV infections and thus have an increased risk of cervical intraepithelial neoplasia (CIN and cervical cancer. We evaluated the feasibility of “screen and treat approach” for cervical cancer prevention and the performance of different screening tests among FSWs.Methods: Women were screened using cytology, VIA (visual inspection with acetic acid, and VILI (visual inspection with Lugol’s iodine and underwent colposcopy, biopsy, and immediate treatment using cold coagulation, if indicated, at the same visit.Results: We screened 300 FSWs of whom 200 (66.67% were HIV uninfected and 100 (33.34% were HIV infected. The overall prevalence of CIN 2–3 lesions was 4.7%. But all women with CIN 2–3 lesions were HIV infected, and thus the prevalence of CIN 2–3 lesions in HIV-infected FSWs was 14/100 (14%, 95% confidence interval: 7.2–20.8. All of them screened positive by all three screening tests. Cold coagulation was well tolerated, with no appreciable side effects.Conclusion: Cervical cancer prevention by “screen and treat” approach using VIA, followed by ablative treatment, in this high-risk group of women is feasible and can be implemented through various targeted intervention programs. Keywords: cytology, VIA, VILI, CIN, cold coagulation, cervical cancer, HPV, FSWs

  14. Phase III trial of selenium to prevent prostate cancer in men with high-grade prostatic intraepithelial neoplasia: SWOG S9917.

    Science.gov (United States)

    Marshall, James R; Tangen, Catherine M; Sakr, Wael A; Wood, David P; Berry, Donna L; Klein, Eric A; Lippman, Scott M; Parnes, Howard L; Alberts, David S; Jarrard, David F; Lee, W Robert; Gaziano, J Michael; Crawford, E David; Ely, Benjamin; Ray, Michael; Davis, Warren; Minasian, Lori M; Thompson, Ian M

    2011-11-01

    The threat of prostate cancer and the significant and often negative impact of its treatment underscore the importance of prevention. High-grade prostatic intraepithelial neoplasia (HGPIN) has been identified as a potential premalignant lesion marking an increased risk of prostate cancer and substantial evidence suggests that men with HGPIN are in need of prostate cancer prevention. In vitro, in vivo, epidemiologic, and clinical trial evidence that selenium supplementation protects against prostate cancer motivated the study we report here: a double-blind, randomized, placebo-controlled trial of selenium 200 (μg/d) as selenomethionine in men with HGPIN. The primary endpoint was progression of HGPIN to prostate cancer over a 3-year period. This National Cancer Institute Intergroup trial was coordinated by the Southwest Oncology Group (SWOG). Of 619 enrolled patients, 423 randomized men with HGPIN (212 selenium and 211 placebo) were eligible (by central pathology review) and included in the primary analysis. Three-year cancer rates were 36.6% (placebo) versus 35.6% (selenium; P = 0.73, adjusted). The majority of patients who developed cancer on trial (70.8%, selenium and 75.5%, placebo) had a Gleason score of 6 or less than 6; there were no differences in Gleason scores between the two arms. Subset analyses included the finding of a nonsignificantly reduced prostate cancer risk (relative risk = 0.82; 95% CI: 0.40-1.69) in selenium versus placebo patients in the lowest quartile of baseline plasma selenium level (selenium levels, selenium supplementation had no effect on prostate cancer risk. The 36% prostate cancer rate in men with HGPIN indicates the association of this lesion with an elevated prostate cancer risk. Future study in this setting should focus on selenium-deficient populations and selenium pharmacogenetics.

  15. Risk factors for cervical intraepithelial neoplasia in HIV-infected women on antiretroviral treatment in Cote d'Ivoire, West Africa.

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    Antoine Jaquet

    Full Text Available BACKGROUND: Facing the dual burden of invasive cervical cancer and HIV in sub-Saharan Africa, the identification of preventable determinants of Cervical Intraepithelial Neoplasia (CIN in HIV-infected women is of paramount importance. METHODS: A cervical cancer screening based on visual inspection methods was proposed to HIV-infected women in care in Abidjan, Côte d'Ivoire. Positively screened women were referred for a colposcopy to a gynaecologist who performed directed biopsies. RESULTS: Of the 2,998 HIV-infected women enrolled, 132 (4.4% CIN of any grade (CIN+ were identified. Women had been followed-up for a median duration of three years [IQR: 1-5] and 76% were on antiretroviral treatment (ART. Their median most recent CD4 count was 452 [IQR: 301-621] cells/mm3. In multivariate analysis, CIN+ was associated with a most recent CD4 count >350 cells/mm3 (OR: 0.3; 95% CI: 0.2-0.6 or ≥200-350 cells/mm3 (OR 0.6; 95% CI 0.4-1.0 (Ref: <200 cells/mm3 CD4 (p<10-4. CONCLUSIONS: The presence of CIN+ is less common among HIV-infected women with limited or no immune deficiency. Despite the potential impact of immunological recovery on the reduction of premalignant cervical lesions through the use of ART, cervical cancer prevention, including screening and vaccination remains a priority in West Africa while ART is rolled-out.

  16. Widespread high grade prostatic intraepithelial neoplasia on biopsy predicts the risk of prostate cancer: A 12 months analysis after three consecutive prostate biopsies

    Directory of Open Access Journals (Sweden)

    Cosimo De Nunzio

    2013-06-01

    Full Text Available Purpose: To evaluate the risk of prostate cancer (PCa on a third prostate biopsy in a group of patients with two consecutive diagnoses of high grade intraepithelial neoplasia (HGPIN. Materials and methods: From November 2004 to December 2007, patients referred to our clinic with a PSA ! 4 ng/ml or an abnormal digital rectal examination (DRE were scheduled for trans-rectal ultrasound (TRUS guided 12-core prostate biopsy. Patients with HGPIN underwent a second prostate biopsy, and if the results of such procedure yielded a second diagnosis of HGPIN, we proposed a third 12-core needle biopsy regardless of PSA value. Crude and adjusted logistic regressions were used to assess predictors of PCa on the third biopsy. Results: A total of 650 patients underwent 12 cores transrectal ultrasound prostatic biopsy in the study period. Of 147 (22% men with a diagnosis of HGPIN, 117 underwent a second prostatic biopsy after six months and 43 a third biopsy after other six months. After the third biopsy, 19 patients (34% still showed HGPIN, 15 (35% were diagnosed with PCa and 9 (21% presented with chronic prostatitis. Widespread HGPIN on a second biopsy was significantly associated with PCa on further biopsy (!2 = 4.04, p = 0.04. Moreover, the presence of widespread HGPIN significantly predicted the risk of PCa on crude and adjusted logistic regressions. Conclusions: Widespread HGPIN on second biopsy is associated with the presence of PCa on a third biopsy. Nonetheless, the relationship between HGPIN and PCa remains complex and further studies are needed to confirm our findings.

  17. Inhibition of Pancreatic Intraepithelial Neoplasia Progression to Carcinoma by Nitric Oxide-Releasing Aspirin in p48Cre/+-LSL-KrasG12D/+ Mice

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    Chinthalapally V. Rao

    2012-09-01

    Full Text Available Nitric oxide-releasing aspirin (NO-aspirin represents a novel class of promising chemopreventive agents. Unlike conventional nonsteroidal anti-inflammatory drugs, NO-aspirin seems to be free of adverse effects while retaining the beneficial activities of its parent compound. The effect of NO-aspirin on pancreatic carcinogenesis was investigated by assessing the development of precursor pancreatic lesions and adenocarcinomas in KrasG12D/+ transgenic mice that recapitulate human pancreatic cancer progression. Six-week-old male p48Cre/+-LSL-KrasG12D/+ transgenic mice (20 per group were fed diets containing 0, 1000, or 2000 ppm NO-aspirin. The development of pancreatic tumors was monitored by positron emission tomography imaging. All mice were killed at the age of 41 weeks and assessed for pancreatic intraepithelial neoplasia (PanIN and pancreatic ductal adenocarcinoma (PDAC and for molecular changes in the tumors. Our results reveal that NO-aspirin at 1000 and 2000 ppm significantly suppressed pancreatic tumor weights, PDAC incidence, and carcinoma in situ (PanIN-3 lesions. The degree of inhibition of PanIN-3 and carcinoma was more pronounced with NO-aspirin at 1000 ppm (58.8% and 48%, respectively than with 2000 ppm (47% and 20%, respectively. NO-aspirin at 1000 ppm significantly inhibited the spread of carcinoma in the pancreas (∼97%; P < .0001. Decreased expression of cyclooxygenase (COX; with ∼42% inhibition of total COX activity, inducible nitric oxide synthase, proliferating cell nuclear antigen, Bcl-2, cyclin D1, and β-catenin was observed, with induction of p21, p38, and p53 in the pancreas of NO-aspirin-treated mice. These results suggest that low-dose NO-aspirin possesses inhibitory activity against pancreatic carcinogenesis by modulating multiple molecular targets.

  18. Efficacy of Poly-Gamma-Glutamic Acid in Women with High-Risk Human Papillomavirus-Positive Vaginal Intraepithelial Neoplasia: an Observational Pilot Study.

    Science.gov (United States)

    Koo, Yu-Jin; Min, Kyung-Jin; Hong, Jin-Hwa; Lee, Jae-Kwan

    2015-07-01

    Poly-gamma-glutamic acid (γ-PGA) is a natural polymer that is synthesized by Bacillus species and has been reported to have antitumor activity. The aim of this study was to investigate the effect of γ-PGA on the treatment of vaginal intraepithelial neoplasia (VAIN). A retrospective observational study on γ-PGA therapy for biopsy-proven VAIN was conducted. The efficacy was assessed by evaluating the results of Pap cytology and the viral load of high-risk HPV at three time points: at enrollment, and at the first and second post-treatment visits. Of 17 patients treated with γ-PGA, only 12 patients who had a high-risk HPV infection were included in the analysis. Histology was VAIN1 in seven patients, VAIN2 in two patients, and VAIN3 in three patients. γ-PGA was administered for newly diagnosed VAIN in five (41.7%) patients and persistent VAIN in seven (58.3%) patients for the mean time of 4.5 months. At the first and second post-treatment visits, cytological regression was observed in five (41.7%) and six (50%) patients, respectively. Regarding the HPV load, the overall response rate was 66.7%, and the mean level was 670.6 ± 292.5 RLU at the first follow-up, which was lower than the initial viral load of 1,494.8 ± 434.5 RLU (p = 0.084). At the second follow-up, the overall response rate was 58.3%, and the mean viral load level was 924.2 ± 493.7 RLU. γ-PGA may be helpful for the cytological regression and reduction of viral load in patients with high-risk HPV-positive VAIN, suggesting that γ-PGA is a promising treatment option for primary or persistent VAIN.

  19. Low Prostate Concentration of Lycopene Is Associated with Development of Prostate Cancer in Patients with High-Grade Prostatic Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Simone Mariani

    2014-01-01

    Full Text Available Prostate cancer (PC is a frequent male malignancy and represents the second most diagnosed cancer in men. Since pre-cancerous lesions, i.e., the high-grade prostatic intraepithelial neoplasia (HGPIN, can be detected years before progression to PC, early diagnosis and chemoprevention are targeted strategies to reduce PC rates. Animal studies have shown that lycopene, a carotenoid contained in tomatoes, is a promising candidate for the chemoprevention of PC. However, its efficacy in humans remains controversial. The present study aimed to investigate the relevance of plasma and prostate concentration of lycopene after a lycopene-enriched diet in patients diagnosed with HGPIN. Thirty-two patients diagnosed with HGPIN were administered a lycopene-enriched diet (20–25 mg/day of lycopene; through 30 g/day of triple concentrated tomato paste for 6 months. A 6-month follow-up prostate biopsy assessed progression to PC. Patients were classified into three groups according to the histopathological features of the 6-month follow-up biopsy results: prostatitis; HGPIN and PC. PSA and plasma lycopene levels were measured before and after the dietary lycopene supplementation. Prostatic lycopene concentration was only assessed after the supplementation diet. Only prostatic lycopene concentration showed significant differences between the three groups (p = 0.03. Prostatic lycopene concentration below a 1 ng/mg threshold was associated with PC at 6-month follow-up biopsy (p = 0.003. We observed no overall benefits from a 6-month lycopene supplementation, as the rate of HGPIN progression to PC in our population (9/32, 28% was similar to rates reported in the literature. Baseline PSA levels also showed no significant changes after a lycopene-enriched diet. Our findings point to prostatic lycopene concentration as a promising biomarker of PC. Further prospective longitudinal studies are needed to assess the prognostic role of prostatic lycopene in PC.

  20. 宫颈环形电切术在宫颈上皮内瘤变中的应用%Clinical application of cervical loop electrosurgical excision procedure in cervical intraepithelial neoplasia (CIN)

    Institute of Scientific and Technical Information of China (English)

    余方

    2013-01-01

    目的 探讨宫颈环形电切术(LEEP)在诊断和治疗宫颈上皮内瘤变(CIN)中的应用价值.方法 对广东医学院附属深圳西乡人民医院2008年12月至2012年4月收治的宫颈上皮内瘤病变患者58例行LEEP治疗,并与病理检查结果进行对比分析.结果 58例CIN患者经LEEP手术后治愈51例,治愈率为87.9%,复发3例,复发率为5.2%;有4例患者病变持续存在,行冷刀锥切术后治愈.结论 LEEP是一种诊断和治疗宫颈上皮内瘤变较为常见的方法,同时也是预防及发现早期宫颈癌的有效方法.%Objective To investigate the cervical loop electrosurgical excision procedure ( LEEP) value in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Methods The patients were treated in our hospital from December 2008 to April 2012 cervical intraepithelial neoplasia lesions 58 routine LEEP treatment, and compared with the results of the pathological examination. Results Totally 58 cases of CIN patients after LEEP surgery 51 cases were cured, the cure rate was 87. 9% , 3 cases of recurrence, the recurrence rate was 5. 2% ; 4 patients with lesions persist, the line cold knife conization cure. Conclusion LEEP is a diagnosis and treatment of cervical intraepithelial neoplasia ideal method, but also the prevention and effective way to find early cervical cancer.

  1. 宫颈上皮内瘤变临床治疗方案及效果初评%Evaluation of clinical treatment plan and effect of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    曹颖一

    2015-01-01

    目的:探讨宫颈上皮内瘤变的有效治疗方法。方法:收治宫颈上皮内瘤变患者100例为试验组,行宫颈环形电切术,同时,收治患者100例为对照组,行宫颈椎切术,比较两组的治疗效果。结果:试验组切口愈合时间、术中出血量和手术时间均优于对照组(P<0.05)。结论:在宫颈上皮内瘤变患者的临床治疗中,采用超高频电波刀宫颈椎切术具有较好的临床效果。%Objective:To explore the effective treatment for cervical intraepithelial neoplasia.Methods:100 patients with cervical intraepithelial neoplasia were selected as the experimental group.They were given cervical loop electrosurgical excision.At the same time,100 patients were selected as the control group,and they were given cervical cone excision.We compared two groups of treatment effect.Results:In the experimental group,the wound healing time,the amount of bleeding and operation time were superior to the control group(P<0.05).Conclusion:In the clinical treatment of patients with cervical intraepithelial neoplasia,the use of ultra high frequency electric wave knife cervical cone resection had better clinical effect.

  2. hTERC基因检测在宫颈上皮内瘤变差异化治疗的应用%The application of hTERC genetic testing in differentiation treatment to cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    蒋光愉; 甘丹卉; 潘晓婷

    2012-01-01

    目的:探讨hTERC基因检测在宫颈上皮内瘤变差异化治疗的应用.方法:利用荧光原位杂交技术(FISH)观察人类染色体端粒酶基因(hTERC)扩增程度与宫颈上皮内瘤变(CIN)程度关系.检测63例宫颈液基薄层细胞涂片(TCT)和50例宫颈活检石蜡切片hTERC基因的扩增程度.结果:两组结果均显示,随着TBS分级或病理分级的升高,hTERC基因阳性率增加.hTERC基因异常细胞比例与TBS分级或病理分级呈正相关,等级相关系数为0.403/0.612.结论:hTERC基因扩增程度可能为宫颈疾病发展的重要风险预测因子,反映宫颈上皮内瘤变的病变程度,可辅助病理分级的准确判断.%Aim;To observe the association between the human telomerase RNA component (hTERC) amplification degree and cervical intraepithelial neoplasia with the technology of fluorescence in situ hybridization (FISH) and discuss the application of hTERC genetic testing in cervical intraepithelial neoplasia. Methods; Respectively, 63 cases of cervical liquid-based cell and 50 cases of cervical bioptic paraffin sections were detected the hTERC gene amplification by FISH, the positive rate of hTERC gene amplification increased with increasing TBS classification or pathologic grading. Results; In the both group, it was positively correlated between the proportion of the hTERC abnormal cells and the grade of cervical intraepithelial neoplasia (P <0. 05). The correlation coefficient was 0.413/0. 612. Conclusion: It' s reflected that the extent of cervical intraepithelial neoplasia lesions, assisted to judge the pathological grade accurately, determined further to guide the clinical treatment of cervical precancerous lesions program formulation.

  3. Anal squamous intraepithelial lesions are frequent among young HIV-infected men who have sex with men followed up at the Spanish AIDS Research Network Cohort (CoRIS-HPV).

    Science.gov (United States)

    González, Cristina; Torres, Montserrat; Benito, Amparo; Del Romero, Jorge; Rodríguez, Carmen; Fontillón, María; Trastoy, Mónica; Viciana, Pompeyo; Del Amo, Julia; Ortiz, Marta; Hernández-Novoa, Beatriz

    2013-09-01

    The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papillomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI = 78.0-85.2). Multiple infections (≥2 HR-HPV genotypes) were documented in 77.7% (95% CI = 73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types.

  4. 阴道上皮内瘤变13例临床分析%Clinical analysis of 13 cases with vaginal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    杨悦; 高永良; 于爱军; 章杰捷

    2010-01-01

    目的 探讨阴道上皮内瘤变(VAIN)的病因、临床特点、诊断、治疗及预后.方法 回刎顾性分析浙江省肿瘤医院2002年3月至2008年12月收治的13例VAIN患者的临床资料,其中2例为VAINⅡ、11例为VAINⅡ~Ⅲ或VAINⅢ.结果 13例VAIN患者中,行人乳头状瘤病毒(HPV)检测12例,其阳性率为92%(11/12).VAIN临床表现无特异性,1例阴道分泌物增多;4例阴道局部糜烂充血或呈乳头状增生,2例小结节状改变.13例VAIN患者中,合并宫颈癌6例、宫颈上皮内瘤变(CIN)4例外阴上皮内瘤变(VIN)3例;与宫颈病变(包括宫颈癌和CIN)同时确诊5例、与外阴病变(即VIN)同时确诊3例,其余5例均在复查这些疾病时确诊.与宫颈病变或外阴病变同时确诊的8例VAIN患者采用手术治疗,其中l例VAIN合并CIN因病变广泛术后补充氩气刀治疗,1例VAIN合并VIN因术后切缘阳性补充氩气刀治疗;1例中晚期宫颈癌行同步放化疗后随访时发现的VAIN患者行根治性放疗;3例术后随访时发现的VAIN(VAINⅡ、VAINⅡ~Ⅲ、VAINⅢ各1例)行氩气刀治疗;1例官颈癌Ⅲb期合并VAINⅢ患者治疗.本组患者的平均随访时间为25.6个月(6~87个月),2例患者因官颈癌发生远处转移而死亡,11例活检或阴道液基薄层细胞学检查(TCT)无异常,随访期内无一例进展为浸润癌.结论 HPV感染是VAIN发病的主要原因;VAIN的临床表现隐匿,多在治疗或复查宫颈病变、外阴病变时确诊;治疗以手术为主;VAIN很少进展为浸润癌,预后较好.%Objective To investigate the pathogenesis,high risk factors,clinical characteristics,methods of diagnosis and treatment,and prognosis of vaginal intraepithelial neoplasia (VAIN).Methods The clinical data of thirteen cases of VAIN treated in Zhejiang Provincial Cancer Hospital dated Mar.2002 through Dec.2008 were reviewed and analyzed retrospectively.Results Twelve of 13 VAIN cases were performed the human papillomavirus

  5. 阴道上皮内瘤变20例临床分析%Clinical analysis of 20 patients with vaginal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    李淑敏; 章文华; 白萍; 李洪君; 张蓉; 吴令英

    2009-01-01

    Objective To explore the clinical-pathologic characteristics, treatment modalities and prognosis of patients with vaginal intracpithelial neoplasia ( VAIN ). Methods The clinical, pathologic and follow-up data of 20 cases with vaginal intraepithelial neoplasia treated primarily in Cancer Hospital of Chinese Academy of Medical Sciences from Jan. 1999 to Dec. 2007, were reviewed and analyzed retrospectively. Results There were not any of symptoms on diagnosis in all patients, and most of them ( 17 cases, 85% ) were frequently detected VAIN for the abnormal pap smears or pelvic examination from cervical carcinoma patients and under the colposcopy as well as colposcopic biopsies. There were 3 cases (15%) with cervical cancer were diagnosed as VAIN during the postoperative follow up, while 17 cases (85%) of patients were accompanied with cervical cancer( 12 eases) or cervical intraepithelial neoplasia (CIN, 5 cases ) concomitantly or antecedently. Ninety percent of patients were diagnosed as VAIN Ⅲ,17 cases (85%) were mainly localized in the upper third of vagina, and 13 cases (65%) affected to the multiple vaginal walls. Thirteen cases were performed surgery, and 7 cases were treated by irradiation. The local control rate was achieved to 100% in all of patients. Three cases ( included 1 post-irradiated and 2 post-operative) were relapsed after treatment, but still be controlled completely by radiotherapy or surgery. Conclusions VAIN was difficult to be diagnosed independently, which was frequently accompanied by cervical cancer or CIN, significantly localized in the upper third of vagina involving the multiple walls of vagina, and treated synchronously with cervical carcinoma and CIN accompanying. Surgery and radiotherapy was equally effective to control VAIN, and then follow-up post-treatment should be closely to detect, diagnose and treat recurrent VAIN as soon as possible after treatment.%目的 探讨阴道上皮内瘤变(VAIN)的临床特征

  6. Clinical analysis of 15 cases with vaginal intraepithelial neoplasia and vaginal cancer after operations of cervical cancer or cervical intraepithelial neoplasia%子宫颈癌或癌前病变术后再发阴道癌或癌前病变的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘琦; 施雅; 张秦; 税迎春; 管群; 石群立

    2014-01-01

    Objective Although the correlation between high risk human papilloma virus (hrHPV) infection and cervical cancer ( CC ) or cervical intraepithelial neoplasia ( CIN ) is well known , vaginal cancer ( VC ) or vaginal intraepithelial neoplasia ( VAIN) also caused by hrHPV has not received enough attention .This article aims to explore the clinical characteristics of VC or VAIN after operations of CC or CIN in order to provide evidence for the treatment of these diseases . Methods The clinical charac-teristics and treatment of 15 cases with VC or VAIN after operations of CC or CIN were reviewed from Jan 2010 to May 2013 in our hos-pital. Results The mean age was (53.6 ±10.82) years, ranged from 39 to 73 years.The duration from the first operation to devel-oped VAIN or VC was (25.07 ±18.31) months, ranged from 1 to 60 months.There are 4 cases developed VC, 4 cases VAINⅢand 2 cases VINⅡfrom 10 CC patients;and 3 cases developed VC , 2 cases VAINⅢfrom 5 CINⅢpatients.hrHPV test were positive in all 15 patients.Treatment in these series were performed including total vaginectomy in 8 patients (3 VC, 4 VAINⅢ and 1 VAINⅡpatients), pelvic lymphonectomy in 1;upper vaginectomy in 2 patients (1 VC, 1 VAINⅢ), radiation or chemo-radiation therapy in 3 (3 VC), interferon muscle injection combined with topical application of estrogen and acyclovir gel in 2 (1 VC, 1 VAINⅡ). Conclusion Careful follow-up after CC or CIN operations are very important because continued hrHPV infection may result VC and VAIN lesions.Vaginectomy may be the best therapy .Interferon muscle injection combined with topical application of estrogen and acyclovir gel are also alternatively therapy , especially for hard to operate patients . Radiation therapy seems to be not very adaptable for VAIN patients .%目的:高危型人乳头瘤病毒( high risk human papilloma virus , hrHPV)与子宫颈癌及宫颈上皮内瘤样病变( cervical intraepithelial neoplasia , CIN)的相关性

  7. The correlation between vaginal intraepithelial neoplasia and cervical intraepithelial neoplasia, and their risk factors%阴道上皮内瘤变与宫颈上皮内瘤变的关联性及高危因素分析

    Institute of Scientific and Technical Information of China (English)

    马莉; 洪颖

    2015-01-01

    Objective To investigate the correlation and risk factors between vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN).Methods A total of 121 cases of VAIN patients was retrospectively analyzed with examination results such as clinical manifestations,liquid based cytology (TCT),human papilloma virus infection,virus infection type,and clinical data of treatment and follow up.Results VAIN Ⅰ,VAIN],and VAIN Ⅲ] were accounted for 33.9% (41/121),38.0% (46/121),and 24.4% (34/121) ; for 40 or less years old patients,VAIN Ⅲ was accounted for 10.7% (3/28) ; for more than 40 years old patients,VAIN Ⅲ was accounted for 33.3% (31 /93).Among 121 VAIN patients,77.7% (94/121) patients had CIN history,15.7% of which (19/121) had a history of cervical cancer; 27.3% (33/121) with hysterectomy history,of which 75.8% (25/33) was due to cervical intraepithelial neoplasia and cervical cancer resection of the uterus.Papilloma viral load in patients with VAIN Ⅰ was detected with a (HPV-HC2) positive rate of 87.8% (36/41),while in VAIN Ⅱ and VAIN [patients,the positive rate was 100%,the infection of high risk type of HPV ratio was 95.9% (116/ 121).of which the mixed infection was accounted for 56.9% (66/116).There was 94.6% in oatients with VAIN (114/121),and liquid-based cytology test results suggest abnormality; 88.4% (107/121) in patients with VAIN lesions occurred in upper 1/3 of vaginal.After diagnosed cervical disease,the onset time of VAIN was (3.45 ± 2.02) years,non-total-hysterectomy was (3.24 ± 1.97) years,after hysterectomy to pathological diagnosis time for VAIN was (5.01 ± 3.95) years:for the diagnosis of VAIN disease after resection of cervical original time was (3.96 ± 2.99) years,and rather than non cervical disease resection was an average of (9.94 ±5.37) years.In the course of treatment of the 12l cases of CIN patients,6 cases of patients were progressed to invasive carcinoma.Conclusions The

  8. Risk of preterm birth after treatment for cervical intraepithelial neoplasia among women attending colposcopy in England: retrospective-prospective cohort study

    Science.gov (United States)

    Castanon, Alejandra; Brocklehurst, Peter; Evans, Heather; Peebles, Donald; Singh, Naveena; Walker, Patrick; Patnick, Julietta

    2012-01-01

    Objective To explore the association between preterm delivery and treatment at colposcopy. Design Retrospective-prospective cohort study using record linkage. Setting 12 National Health Service hospitals in England. Participants Women who had a cervical histology sample taken between 1987 and 2009. These women were linked by hospital episode statistics to hospital obstetric records between 1998 and 2009 for the whole of England to identify singleton live births between 20-43 gestational weeks before or after cervical histology. Main outcome measures Proportion of preterm births (<37 weeks); the relative risk for the strength of association between preterm births and treatment for cervical intraepithelial neoplasia. Results 18 441 singleton births occurred: 4176 before histology and 14 265 after histology. Of the singleton births after histology, 9.0% (n=1284) were preterm compared with 6.7% of all births in England over the same period (excess risk 2.3 per 100 births, 95% confidence interval 1.8% to 2.8%). Among first births after histology, the adjusted relative risk associated with previous treatment was 1.19 (95% confidence interval 1.01 to 1.41); among first births before histology the relative risk associated with subsequent treatment was 1.47 (1.05 to 2.05). Combining these, the relative risk associated with treatment adjusted for timing relative to histology was 0.91 (0.66 to 1.26) corresponding to an absolute difference of −0.25 (−2.61 to 2.11) per 100 singleton births. Among 372 women who gave birth both before and after treatment, there were 30 preterm births after treatment and 32 before treatment (relative risk 0.94, 0.62 to 1.43). Conclusion The risk of preterm delivery in women treated by colposcopy in England was substantially less than that in many other studies, predominantly from Nordic countries. The increased risk may be a consequence of confounding and not caused by treatment. Although this study is reassuring for large loop excision of

  9. The detection of hTERC amplification using fluorescence in situ hybridization in the diagnosis and prognosis of cervical intraepithelial neoplasia: a case control study

    Directory of Open Access Journals (Sweden)

    Yin Geping

    2012-08-01

    Full Text Available Abstract Background Currently the routine non-invasive screening methods for cervical intraepithelial neoplasia (CIN and cervical cancer are Thinprep cytology test (TCT and human papillomavirus testing. However, both methods are limited by the high false positive and false negative rates and lack of association with patients’ prognosis, especially for the early detection of pro-malignant CIN. The aim of the study was to investigate the role of genomic amplification of human telomerase gene (hTERC in the diagnosis and prognosis of CIN. Methods The study group consisted of specimens of exfoliated cervical cells from 151 patients, including 27 with CIN I, 54 with CIN II/III, 17 with carcinoma in situ, and 28 with invasive squamous carcinoma, as well as 25 patients who were at 2-year follow-up after either Loop Electrosurgical Excision treatment (n = 11 or radical surgery (n = 14. hTERC amplification was detected by dual-color interphase fluorescence in situ hybridization (FISH, and the results were compared with TCT and histologic examination. The final diagnosis was determined by the pathological examination. The control group consisted of specimens of exfoliated cervical cells from 40 normal women. Results The percentage of cervical exfoliated cells with positive hTERC amplification and incidence rates of hTERC amplification were 9.2% ± 4.6% and 44.4% (12/27 respectively in patients with CIN I; 16.0% ± 14.4% and 85.1% (46/54 in patients with CIN II/III; 19.7% ± 13.3% and 88.3% (15 /17 in patients with carcinoma in situ; 47.0% ± 25.2% and 100% (28/28in patients with invasive squamous carcinoma. There was statistically significant difference between the control and study group (P Conclusion The detection of genomic amplification of hTERC using FISH is a non-invasive and effective approach for CIN.

  10. The Explore of Prostatic Intraepithelial Neoplasia with MSCT Perfusion Imaging%前列腺上皮内瘤CT灌注成像表现初探

    Institute of Scientific and Technical Information of China (English)

    吕绍茂; 吴莉; 韩丹

    2009-01-01

    目的 了解前列腺增生(BPH)中前列腺上皮内瘤(PIN)的CT灌注成像表现,并初步探讨PIN与前列腺癌(PCa)及良性BPH的灌注成像表现的关系.资料与方法 BPH25例,其中PIN样变9例,良性BPH 16例.PCa 34例,行前列腺病变中心层面灌注扫描,得到各组灌注图(PF)、强化峰值图(PEI)、达峰时间图(TTP)、血容量(BV)值和时间密度曲线(TDC),并对各组灌注值进行对比分析.结果 PIN的PF值大于良性BPH,TTP值小于良性BPH,差异有统计学意义.PIN的TTP值大于PCa组,PF值小于PCa组,差异有统计学意义. 结论 PIN的CT灌注成像表现提示,PIN的PF值和邢值与PCa和良性BPH不同,介于两者间.这种灌注特征可能为早期发现PCa提供一定帮助.%Objective To understand the CT perfusion imaging performance of prostatic intraepithelial neoplasia (PIN) in benign prostatic hyperplasia (BPH) and to explore the relationship between PIN,PC and BPH in the perfusion imaging performance. Materials and Methods All cases underwent routine CT pain scan and perfusion CT scan. The patients were divided into BPH group (25 eases,9 cases of PIN were included) ,and PC group (34cases). All the original maps of perfusion CT scan were transferred to an outline workstation to create color perfusion maps and to measure the blood flow parameters containing PF,PEI,TTP, BV of the prostate cortex and medulla using the function CT software. Results The PF value of PIN was greater than that of benign BPH. The TTP value of PIN was less than that of benign BPH. The differences between PIN and BPH in the TIP value and the PF value had statistical significance. The TrP value of PIN is greater than that of PC group and the PF value is less than that of PC group, which had statistical significant differences. Conclusion The performance of CT perfusion imaging in PIN is different from that of benign BPH and PC. The features of the CT perfusion imaging may be useful for the early detection of PC.

  11. No viral association found in a set of differentiated vulvar intraepithelial neoplasia cases by human papillomavirus and pan-viral microarray testing.

    Directory of Open Access Journals (Sweden)

    Ozlen Saglam

    Full Text Available Vulvar Intraepithelial Neoplasia (VIN is the precursor lesion of Vulvar Squamous Cell Carcinoma (VSCC, and the differentiated type (dVIN is more frequently observed in relation to VSCC. In contrast to usual-type VIN (uVIN, which is related to infection by human papillomavirus (HPV, a germline mutation in the p53 gene is thought to be associated with ~90% of dVIN cases. To date, no infectious agent has been identified in association with dVIN, and studies investigating this possibility have been hindered by the difficulty in accurately diagnosing dVIN from small biopsies. Here, we used immunostaining for p16ink4a, a biomarker for HPV infection, to study 14 uVIN high-grade VIN and 14 dVIN cases, and to select 10 dVIN cases to broadly screen for all kn(own viruses using a pan-viral microarray platform (ViroChip. All of the uVIN tissue samples, including 8 warty and 6 basaloid cases, showed positivity with the p16(ink4a immunostain. The staining pattern was full-thickness for all except two cases in which positive staining was localized in the lower 1/3 of the epidermis. In contrast, immunostaining for p16(ink4a was negative in all dVIN cases. ViroChip analysis of 10 pure dVIN samples confirmed the absence of human papillomavirus subtypes or any other virus with the exception of a single sample that showed a weak microarray signature to a porcine herpesvirus. Follow-up PCR testing of the sample was negative for herpesvirus, and in-depth metagenomic next-generation sequencing revealed only sequences corresponding to non-pathogenic viral flora and bacterial contamination. In this study, we demonstrated lack of a virus association in 10 dVIN cases. Alternative pathways for carcinogenesis such as the p53 mutation should be considered for investigation of potential treatment options in dVIN.

  12. Residual disease and HPV persistence after cryotherapy for cervical intraepithelial neoplasia grade 2/3 in HIV-positive women in Kenya.

    Directory of Open Access Journals (Sweden)

    Hugo De Vuyst

    Full Text Available To assess residual cervical intraepithelial neoplasia (CIN 2/3 disease and clearance of high-risk (hr human papillomavirus (HPV infections at 6 months after cryotherapy among HIV-positive women.Follow-up study.79 HIV-positive women received cryotherapy for CIN2/3 in Nairobi, Kenya, and underwent conventional cytology 6 months later. Biopsies were performed on high grade cytological lesions and hrHPV was assessed before (cervical cells and biopsy and after cryotherapy (cells.At 6 months after cryotherapy CIN2/3 had been eliminated in 61 women (77.2%; 95% Confidence Interval, (CI: 66.4-85.9. 18 women (22.8% had residual CIN2/3, and all these women had hrHPV at baseline. CD4 count and duration of combination antiretroviral therapy (cART were not associated with residual CIN2/3. CIN3 instead of CIN2 was the only significant risk factor for residual disease (odds ratio, OR vs CIN2 = 4.3; 95% CI: 1.2-15.0 among hrHPV-positive women after adjustment for age and HPV16 infection. Persistence of hrHPV types previously detected in biopsies was found in 77.5% of women and was associated with residual CIN2/3 (OR = 8.1, 95% CI: 0.9-70. The sensitivity, specificity, and negative predictive value of hrHPV test in detecting residual CIN2/3 were 0.94, 0.36, and 0.96 respectively.Nearly one quarter of HIV-positive women had residual CIN2/3 disease at 6 months after cryotherapy, and the majority had persistent hrHPV. CD4 count and cART use were not associated with residual disease or hrHPV persistence. The value of hrHPV testing in the detection of residual CIN2/3 was hampered by a low specificity.

  13. 阴道镜下LEEP治疗宫颈上皮内瘤变临床观察%Vaginal microscopically LEEP treatment cerical intraepithelial neoplasia of clinical observation

    Institute of Scientific and Technical Information of China (English)

    王洁华; 秦福杰

    2009-01-01

    Objective Explore high frequency electric circle cervix sword waves( LEEP) therapy eeri-eal intraepithelial neoplasia(GIN) the effect. Methods Using vaginal under endoscopic assistance of cervical ring,CIN patients to 53 patients treated for its curative effect and were retrospectively analyzed. Results Ac-cording to the test results, the cervix smear cytology for diagnosis of squamous epithelium LSIL)and highly varia-ble(squamons epithelial turnout HSIL(within),the pathology was diagnosed CIN Ⅰ~Ⅲ LEEP,awl to cut, postoperative histopathologic examination results acuteness wet wart in 2 eases( 3.77% ), CIN Ⅰ level 25 cases (47.2%) ,CIN Ⅱ level 20 eases(37.7% )CIN Ⅲ level 6 cases( 11.3% ). After six months of TCT review a- typical cells. Conclusion The LEEP CIN treatment is a safe and effective method.%目的 探讨宫颈高频电波刀电圈切除术(LEEP)治疗宫颈上皮内瘤变(CIN)的效果.方法 采用阴道镜辅助下的宫颈环形电切术,对53例CIN患者进行治疗并对其疗效进行回顾性分析.结果 根据官颈细胞学涂片检查结果,诊断为低度鳞状上皮内瘤变(LSIL)和高度鳞状上皮内瘤变(HSIL),经活检病理诊为CIN Ⅰ~Ⅲ,行LEEP锥切,术后病理检查结果尖锐湿疣2例(3.77%);CIN Ⅰ级25例(47.2%):CINⅡ级20例(37.7%),CINⅢ级6例(11.3%).术后6个月复查TCT,均未见不典型细胞.结论 LEEP是治疗CIN的一种安全有效的方法.

  14. Contralateral biopsies in patients with testicular germ cell tumours: patterns of care in Germany and recent data regarding prevalence and treatment of testicular intra-epithelial neoplasia.

    Science.gov (United States)

    Ruf, C G; Gnoss, A; Hartmann, M; Matthies, C; Anheuser, P; Loy, V; Pichlmeier, U; Dieckmann, K-P

    2015-01-01

    The precursor of testicular germ cell tumours (GCTs), called testicular intra-epithelial neoplasia (TIN/CIS), is safely diagnosed immunohistologically. Testicular biopsy provides a valuable tool for early detection of GCTs in risk groups. Although this knowledge is undisputed, testicular biopsies are utilized poorly. The patterns of care regarding the use of biopsies remain unknown. Uncertainty exists about the prevalence and specific treatment of TIN/CIS. We asked clinical urologists in Germany whether or not they employed contralateral biopsies in GCT patients. We evaluated the prevalence of contralateral TIN/CIS in a retrospective analysis of 780 consecutive GCT patients. All had contralateral double biopsies. Discordance of TIN/CIS findings among biopsy pairs as well as age, histology of the primary tumour and clinical stage was noted. Evaluation of data comprised descriptive statistical methods. To evaluate treatment options for TIN/CIS, we performed a literature search. 52.1% of German urologists always perform the biopsy, 17% do it mostly, 27.3% in select cases, 3.5% never. Curiously, there was a geographic north-south gradient regarding biopsy use. Contralateral TIN/CIS was found in 5%. The median ages of patients with TIN/CIS and those without were 31.8 and 34.9 years respectively (p = 0.02). The discordance rate among biopsy pairs was of 33%. Two-site biopsies provide a 17% gain in diagnostic sensitivity. Local radiotherapy with 20 Gy is the safest treatment of TIN/CIS failing in 2%. Chemotherapy has significantly lower efficacy. Contralateral testicular biopsies in GCT patients are well accepted among German urologists. The prevalence of contralateral TIN/CIS found in this series is in accordance with previous reports. Double biopsies should be the diagnostic standard because of their diagnostic superiority. Local radiotherapy with 20 Gy is the safest way of eradicating TIN/CIS. Failures occur in only 2%, usually many years after irradiation

  15. Clinical value of LEEP for the diagnosis and treatment of cervical intraepithelial neoplasia%子宫颈电圈切除术诊断和治疗子宫颈上皮内瘤变的临床价值

    Institute of Scientific and Technical Information of China (English)

    沈荣; 刘冬青

    2009-01-01

    Objective To investigate the clinical values of loop electrosurgical excision procedure (LEEP) in diagnosis and treatment of cervical intraepithelial neoplasia(CIN). Methods Fifty-two patients with cervical intraepithelial neoplasia underwent LEEP following cytology, colposcopy and multiple biopsies, were treated by LEEP. The cure rate, the operative time, bleeding volume and patients reaction of LEEP to the cervical intraepithelial neoplasia were investigated during the follow-up. Results The effective rate was 98.07 % in the patients treated by LEEP. The effective rate was 100 % in the patients in grade CIN Ⅰ or CIN Ⅱ by LEEP. No patients in grade CIN Ⅰ and Ⅱ had recurrence during the follow-up 1 year. The mean operative time was 7.8 minutes. The mean bleeding volume was 10 ml. No secondary bleeding and post-operative infection occurred. All these surgical specimens were checked successfully for pathology diagnosis. Conclusion The advantages to use the LEEP to manage cervical intraepithelial neoplasia include its simpleness to handle, short operative time,less bleeding, less vaginal discharge, safety, and high cure rate. LEEP can offer intact sample for pathological diagnosis. LEEP electrotome is a very ideal therapy for the cervical intraepithelial neoplasia, and can block the development of precancerosis to infiltrating carcinoma effectively.%目的 探讨高频电波刀行子宫颈电圈切除术(LEEP)诊治子宫颈上皮内瘤变(CIN)的临床应用价值.方法 对经子宫颈脱落细胞学检查、阴道镜下子宫颈多点活检病理初步诊断为CIN的患者52例,采用LEEP治疗,对LEEP术后患者随访同时观察手术时间、出血量及术后疗效.结果 LEEP对患者治愈率达98.07%(51/52),对于CIN Ⅰ、Ⅱ级患者治愈率达100%,术后定期随诊,术后1年无CIN复发.平均手术时间7.8min,出血量10ml,无继发性出血和感染的发生,手术标本经病理学检查明确诊断.结论 LEEP治疗CIN手术操作简单

  16. 子宫切除术后残端阴道上皮内瘤变临床分析%Clinical analysis of vaginal intraepithelial neoplasia after hysterectomy

    Institute of Scientific and Technical Information of China (English)

    郑爱文; 孙海燕; 陈雅卿; 杨悦; 章捷杰

    2015-01-01

    Objective To analyze the clinical features of vaginal intraepithelial neoplasia (VAIN) after hysterectomy. Methods The clinical data of 43 patients with VAIN after hysterectomy admitted in Zhejiang Cancer Hospital from January 2008 to December 2013 were col ected. The underlying diseases, clinical characteristics, human papil oma virus ( HPV) infection, diag-nosis,treatments and prognosis were retrospectively analyzed. Results The underlying diseases included cervical intraepithelial neoplasia (CIN,17/43, 39.5%) ,cervical cancer (CC,24/43,55.8%) uterine myoma (1 case) and uterine endometrial carcinoma (1 case).The average interval of the VAIN after hysterectomy was 21 months.Twenty four cases (55.8%) had no clinical symptoms, 13 cases (30.2%) had vaginal discharge, 6 cases (14.0%) had vaginal burn- like pain. The lesions were located in the upper vagina mostly (34/43, 79.1%). Thirty eight patients underwent HPV screening and 35 had high risk HPV infection with a detective rate of 92.1%, including 30 cases (69.8%) with positive results in both courses of disease. Forty patients were treated with opera-tions:4 cases underwent transabdominal total vaginectomy, 7 cases underwent partly vaginal resection and 29 underwent argon high- frequency electrocautery mucosectomy. There were 2 cases (4.7%) sustained, 5 cases (11.6%) recurred, among whom 4 cases underwent mucosectomy again, none of them progressed to invasive carcinoma. Conclusion VaIN after hysterectomy is more common in CC and CIN. Injury of vaginal mucosa may be the cause for the occurrence of VaIN after hysterectomy. Argon high- frequency electrocautery mucosectomy is effective in treatment of VaIN.%目的:探讨子宫切除术后残端阴道上皮内瘤变(VaIN)的临床特点、治疗及预后。方法2008年1月至2013年12月收治子宫切除术后残端阴道VaIN 43例,对其先期疾病、临床表现、辅助检查、治疗方法及预后进行回顾性分析。结果先期

  17. 阴道上皮内瘤变与宫颈上皮内瘤变的相关性及其诊治的初步研究%Analysis of diagnosis and treatment of vaginal intraepithelial neoplasia and correlation to cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    李华; 耿力; 郭艳利; 郭红燕; 游珂; 乔杰

    2009-01-01

    Objective To investigate the diagnosis and therapy of vaginal intraepithelial neoplasia (VAIN) and correlation to cervical intraepithelial neoplasia (CIN). Methods The clinical and pathological data about age, liquid-based cytology, human papillomavirus (HPV) DNA test, colposcopy,histology types and treatment in 35 patients with VAIN were reviewed to investigate the diagnosis and therapy of VAIN and correlation to CIN. Results Mean age at presentation was 43.9 years. The percentage of VAIN I, VAINⅡ and VAINⅢ were 52% (18/35), 34% (12/35) and 14% (5/35), respectively. 8% (1/13) of patients were younger than 40 years developed VAIN Ⅲ, while 18% (4/22) patients were eider than 40 years. There were 83% (29/35) cases were diagnosed from 2007 to June 2008. 69% (24/35) or 17% (6/35) cases had the history of CIN or cervical cancer, respectively. VAIN Ⅱ - Ⅲ accounted for 3/9, 53% (8/15) and 4/6 of CIN I , CIN Ⅱ - Ⅲ and cervical cancer, respectively. There were 87% (13/15) positive high risk HPV infection in VAIN Ⅰ , while 100% in VAIN Ⅱ and VAINⅢ. There were 97% (33/34) cases with abnormality for liquid-based cytology and 86% (30/35) cases of lesions were located in the upper 1/3 vagina. Among 19 cases received therapy, 14 eases (74%) were treated by surgery, 2 eases (11%) by brachytherapy, 3 cases (16%) used drug on the surface of vagina and the lesions were shown recovery in 9 cases followed up. Conclusion The clinical characteristics of VAIN are similar to CIN and the principles of diagnosis and treatment are also the same as that of CIN.%目的 探讨阴道上皮内瘤变(VAIN)与宫颈上皮内瘤变(CIN)的相关性及其诊断和治疗.方法 回顾性分析35例VAIN患者的临床表现、阴道脱落细胞学、人乳头状瘤病毒(HPV)感染以及治疗方法等资料.结果患者平均年龄43.9岁.VMN Ⅰ、VAIN Ⅱ和VMNⅢ分别占52%(18/35)、34%(12/35)和14%(5/35).VAINⅢ在年龄≤40岁者和>40岁者中分别为8%(1/13)和18

  18. The Role of Polymerase Chain Reaction of High-Risk Human Papilloma Virus in the Screening of High-Grade Squamous Intraepithelial Lesions in the Anal Mucosa of Human Immunodeficiency Virus-Positive Males Having Sex with Males

    OpenAIRE

    Carmen Hidalgo-Tenorio; Mar Rivero-Rodriguez; Concepción Gil-Anguita; Javier Esquivias; Rodrigo López-Castro; Jessica Ramírez-Taboada; Mercedes López de Hierro; Miguel A López-Ruiz; R Javier Martínez; Llaño, Juan P.

    2015-01-01

    Objectives To evaluate the advantages of cytology and PCR of high-risk human papilloma virus (PCR HR-HPV) infection in biopsy-derived diagnosis of high-grade squamous intraepithelial lesions (HSIL = AIN2/AIN3) in HIV-positive men having sex with men (MSM). Methods This is a single-centered study conducted between May 2010 and May 2014 in patients (n = 201, mean age 37 years) recruited from our outpatient clinic. Samples of anal canal mucosa were taken into liquid medium for PCR HPV analysis a...

  19. Clinical analysis of cervical cold knife conization in the treatment of cervical intraepithelial neoplasia%宫颈冷刀锥切术治疗宫颈上皮内瘤变的临床分析

    Institute of Scientific and Technical Information of China (English)

    阳晓红; 张攀

    2014-01-01

    Objective:To evaluate the effect of cold knife conization(CKC) in the treatment of cervical intraepithelial neoplasia(CIN) and the regression of the high risk HPV after the operation.Methods:We retrospectively analyzed the clinical datas of 249 cases with cervical intraepithelial neoplasia and they all had the cold knife conization treatment from 2001 to 2012.Results:The results of before and after the cervical cold knife conization were consistent in 171 cases(69%).The results were different in 78 cases(31%).The degree of cervical lesions by pathological examination results:42 cases were CIN grade Ⅰ(17%),96 cases were CIN Ⅱ(39%),111 cases were CIN Ⅲ(44%),including 216 cases were HPV infection(87%).The clearance rates of the high risk HPV infection before operation of cervical intraepithelial neoplasia after 6 months,12 months,24 months were 82.1% ,90.1% , 94.4%.Conclusion:The cervical cold knife conization has advantages in the diagnosis and treatment of cervical CIN.The high-risk HPV largely faded away after the operation.%目的:评价宫颈上皮内瘤变(CIN)冷刀锥切(CKC)治疗的效果及术后高危型HPV的消退情况。方法:回顾性分析2001-2012年行冷刀锥切术治疗249例宫颈上皮内瘤变患者的临床资料。结果:宫颈冷刀锥切术前后结果一致171例(69%);两者结果有差异78例(31%)。宫颈病变程度按照病理检查结果分级:CIN Ⅰ42例(17%),CIN Ⅱ96例(39%),CIN Ⅲ111例(44%),其中 HPV 感染216例(87%)。术前高危型 HPV 感染的宫颈上皮内瘤变患者术后6个、12个、24个月清除率分别为82.1%、90.1%、94.4%。结论:宫颈冷刀锥在宫颈CIN的诊断及治疗上具有优势,术后高危型HPV大部分消退。

  20. Cervical vaginal intraepithelial neoplasia after analysis of 11 cases%宫颈癌术后阴道上皮内瘤变11例分析

    Institute of Scientific and Technical Information of China (English)

    付敏; 梁慧; 肖宁

    2011-01-01

    Objective To study cervical carcinoma after vaginal intraepithelial neoplasia(VaIN) path,part of early diagnosis,treatment and prognosis.Methods summarizing 2007-2011 in patients with cervical cancer after ValNll cases discovered in the follow-up,its clinical manifestations,HPV(human papilloma virus) infection,vaginal Speculum,treatment and prognosis for retrospective analysis.Results 11 cases of HPV infection in 11 cases,positive rate of 100%;TCT:ASCUS 2 cases, positive rate 18.19%, vaginal mirror Xia positive rate up 100%,which 2 cases VaIN treatment half Hou recurrence,to again laser treatment.Conciusion the main reasons for the occurrence of high-risk HPV infection is VaIN,in particular strengthening of HPV 16 positive after operation of cervical carcinoma screening,and combined with colposcopy for postoperative follow-up,VaIN CO2 laser therapy in the treatment effective,prognosis is good.%目的 探讨宫颈癌术后阴道上皮内瘤变(VaIN)的早期诊断路径、发生部位、治疗及预后.方法 总结2007年至2011年宫颈癌术后患者在门诊随访中发现VaIN 11例,对其临床症状、HPV(人乳头瘤病毒)感染情况、阴道镜表现、治疗及预后进行回顾性分析.结果 患者中HPV感染11例,阳性率100%,其中HPV16阳性8例、HPV18阳性1例、HPV33阳性1例、HPV52阳性1例;TCT:ASCUS 2例,阳性率为18.19%,阴道镜下阳性率达100%,阴道镜下活检病理示VaINⅠ(4例),VaINⅡ(6例),VaINⅢ(1例),仅1例VaINIII行手术治疗,余病例均行CO2激光消融治疗,所有患者病变部位均位于阴道上段,呈多灶性表现,其中2例VaIN治疗半年后复发,予再次激光治疗.结论 高危型HPV感染是VaIN发病的主要原因,尤其需加强宫颈癌术后HPV16阳性的筛查,并联合阴道镜进行术后随访,CO2激光治疗对VaIN治疗有效,预后好.

  1. Study of the Treatment of Cervical Intraepithelial Neoplasia by Loop Electrosurgical Excision Procedure%LEEP刀宫颈环切术治疗宫颈上皮内瘤变98例分析

    Institute of Scientific and Technical Information of China (English)

    陈碧芳

    2012-01-01

    目的 探讨宫颈环形环切除术(loop electrosurgical excision procedure,LEEP)在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的临床价值.方法 对98例宫颈上皮内瘤变(CIN)采用LEEP治疗,切除组织全部送病理检查,同时观察术后疗效.结果 98例患者LEEP术前术后病理诊断级别相符89例,符合率为82.65%.结论 LEEP治疗操作简单,术后并发症少,是目前治疗宫颈上皮内瘤变较好的方法.

  2. Long-term risk of cervical intraepithelial neoplasia grade 3 or worse according to high-risk human papillomavirus genotype and semi-quantitative viral load among 33,288 women with normal cervical cytology

    DEFF Research Database (Denmark)

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian;

    2014-01-01

    In this prospective cohort study, we estimated the long-term risk of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) by high-risk human papillomavirus (hrHPV) genotype and semi-quantitative viral load at baseline among 33,288 women aged 14-90 years with normal baseline cytology. During...... 2002-2005, residual liquid-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark. Samples were HPV-tested with Hybrid Capture 2 (HC2) and genotyped with INNO-LiPA. Semi-quantitative viral load was measured by HC2 relative light units in women......HPV genotyping during cervical cancer screening may help identify women at highest risk of CIN3+....

  3. Clinical study of cervical cone resection in the treatment of cervical intraepithelial neoplasia%子宫颈锥切术在治疗子宫颈上皮内瘤变中的临床研究

    Institute of Scientific and Technical Information of China (English)

    葛小琴

    2015-01-01

    Objective: To investigate the clinical effect of cervical cone resection in the treatment of cervical intraepithelial neoplasia.Methods:In our hospital from February 2013 to 2014 March take awl of neck of uterus resection in the treatment of cervical intraepithelial neoplasia (31 cases), the take cervical cone excision surgery and colposcopic multiple biopsy were examined, and given cervical conization treatment and follow-up inspection process, accurately record the relevant data.Results: (1): two kinds of diagnosis methods and pathological detection results: through this diagnosis and inspection, for patients diagnosed with disease, given symptomatic treatment has a certain role in promoting. Which take the cervical cone excision surgery and colpo-scopic multiple biopsy pathology results fully in line with the 15 patients, accounted for the proportion is 48.4%, does not tally with 16 cases, accounts for the proportion was 51.6% of; (2) treatment on the diagnosis of cervical intraepithelial neoplasia suffering from uterine cervical resection, 15 cases were markedly effective, invalid in 2 cases, accounts for the proportion is 6.5%, the total efficiency was 93.5%.Conclusion:The cervical cone resection in the treatment of cervical intraepithelial neoplasia has a certain clinical significance, can be promoted and implemented.%目的 探讨子宫颈锥切术在治疗子宫颈上皮内瘤变中的临床效果.方法 选取我院从2013年2月到2014年3月采取子宫颈锥切术在治疗子宫颈上皮内瘤变患者31例,对其采取宫颈锥切除手术和阴道镜下多点活检术分别检查,同时,给予宫颈锥切术治疗,跟踪检查过程,准确记录相关数据.结果 (1):两种诊断方法 病理检测结果 :通过这种不同方式的诊断检查,对于已确诊病情的患者,给予对症治疗具有一定的促进作用.其中采取宫颈锥切除手术和阴道镜下多点活检术检查的病理结果 完全符合的患者15例,所占的比例是48

  4. Positive Surgical Margin, HPV Persistence, and Expression of Both TPX2 and PD-L1 Are Associated with Persistence/Recurrence of Cervical Intraepithelial Neoplasia after Cervical Conization.

    Directory of Open Access Journals (Sweden)

    Hui Zhang

    Full Text Available To determine the clinicopathologic and immunohistochemical predictors of the persistence/recurrence of cervical intraepithelial neoplasia (CIN after cervical conization.Medical records of 502 patients who received cervical conization treatment of CIN between 2005 and 2012 were reviewed. The clinicopathologic parameters were analyzed using Cox hazard regression. Fifty patients with CIN persistence/recurrence were matched to 50 cases without CIN persistence/recurrence. These 100 cervical specimens were assessed for expression of insulin-like growth factor II messenger RNA (mRNA-binding protein 3 (IMP3, targeting protein for xenopus kinesin-like protein 2 (TPX2, and programmed cell death-1 ligand-1 (PD-L1 using immunohistochemical staining.Multivariate analysis found that the independent predictors of CIN persistence/recurrence were positive surgical margin (hazard ratio 5.777, 95% confidence interval 2.334-14.301, p < 0.001 and human papilloma virus persistence for 6 months (hazard ratio 20.685, 95% confidence interval 7.350-57.657, p < 0.001. Co-expression of TPX2 and PD-L1 was significantly higher in CIN persistence/recurrence group than the group without CIN persistence/recurrence (p = 0.013. The depth of glandular involvement (GI was less than 3mm in about 86.8% (59/68 CIN2-3 lesions, However, No statistically significant associations between GI and persistence/recurrence were observed (P = 0.58.Positive surgical margin, HPV persistence, and expression of both TPX2 and PD-L1 are associated with persistence/recurrence of cervical intraepithelial neoplasia after cervical conization.

  5. Identificação de tipos de papilomavirus e de outros fatores de risco para neoplasia intra-epitelial cervical Identification of papillomavirus types and other risk factors for cervical intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Terezinha Tenório da Silva

    2006-05-01

    infecção por HPV oncogênico, com os tipos 16, 18, 33, 35, 51, 52, 58 e 83. Dentre as portadoras de lesões de alto grau, houve predomínio de HPV-16 ou variante 16. Nas pacientes com colo morfologicamente normal, também foram identificados os tipos oncogênicos 51, 58 e variante 51.PURPOSE: to identify risk factors for cervical intraepithelial neoplasia (CIN and human papillomavirus (HPV types among women with CIN, and to compare with HPV types among patients with normal cervix. METHODS: a total of 228 patients were studied, of whom 132 with CIN (cases and 96 with normal cervix (controls. In the two groups consisting of women selected among outpatients attended in the same hospital, living near the place of the research, mean ages were similar (34.0±8.3 years and there was a predominance of married women. Possible risk factors for CIN were investigated with the application of a questionnaire surveying age, marital status, level of schooling, age at first coitus, number of pregnancies, number of sexual partners, method of used contraception, reference of previously sexually transmitted diseases (STDs and smoking habits, with a comparison between the studied groups. Samples were collected for oncologic colpocytology and HPV search through polymerase chain reaction (PCR, using MY09/MY11 primers; then colposcopic and histopathological examinations were performed. For statistical analysis of the association between risk factors and CIN, odds ratio with 95% confidence interval and chi2 and Fisher tests were used at a significance level of 0.05. The logistic regression method with the significance expressed by the p value with maximum likelihood was also applied. RESULTS: the following variables remained in the logistic regression model: HPV infection of high oncogenic risk (OR=12.32; CI 95%: 3.79-40.08, reference of previous STDs (OR=8.23; CI 95%: 2.82-24.04, early age at first coitus (OR=4.00; CI 95%: 1.70-9.39 and smoking habit (OR=3.94; CI 95%: 1.73-8.98. PCR was

  6. 宫颈癌前病变和早期宫颈浸润癌的监测%Observation on cervical intraepithelial neoplasia and early cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    刘洪梅; 孙玉琴; 解正新; 王晓云; 张华; 董娟

    2008-01-01

    Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.%目的 探讨官颈癌及癌前病变筛查的可行性.方法 行程控超薄细胞检测系统(TCT)检查5545例,对其中307例阳性和219例阴性但临床可疑宫颈病变共计526例进一步行阴道镜及镜下取活检病理检查,以病理组织学为金标准,对结果进行分析.结果 单因素Logistic回归分析与宫颈上皮内瘤变(CIN)相关的危险因素为宫颈HPV感染、性活动开始年龄、性伴数

  7. Relationship between human papillomavirus subtypes infections in cervical adenocarcinoma patients complicated with squamous intraepithelial neoplasia and expression of p16 protein%宫颈腺癌合并鳞状上皮内瘤变人乳头状瘤病毒亚型感染与 p16蛋白表达的关系

    Institute of Scientific and Technical Information of China (English)

    何惠华; 刘汉忠; 涂宁芳; 李蓓; 杨继洲; 敖启林

    2014-01-01

    目的:探讨宫颈腺癌发生鳞状上皮内瘤变(CIN)中人乳头状瘤病毒(HPV)感染及其亚型特点,并探讨p16蛋白在宫颈腺癌组织或CIN病变组织的表达。方法收集2010年1月-2012年12月宫颈腺癌病例66例,对发生CIN患者利用表面等离子体谐振技术进行HPV基因分型检查,免疫组织化学检测p16蛋白,采用SPSS 13.0分析。结果宫颈腺癌发生CIN 21例患者HPV感染率为100.0%,HPV 16型7例为33.3%、HPV 18型6例为28.6%和HPV52型3例为14.3%,18例 p16蛋白阳性患者中宫颈腺癌组织及CIN 病变组织内均为强阳性。结论宫颈腺癌发生CIN中的宫颈腺癌组织及CIN病变组织均与HPV感染关系密切,HPV16型感染较宫颈腺癌不伴CIN略多见,与p16蛋白表达密切相关。%OBJECTIVE To explore the subtypes of human papillomavirus (HPV) causing infections in patients with cervical adenocarcinoma complicated with squamous intraepithelial neoplasia and study the expression of p 16 pro‐tein in the cervical adenocarcinoma tissues or cervical intraepithelial neoplasia tissues . METHODS Totally 66 patients with cervical adenocarcinoma who were treated in the hospitals from Jan 2010 to Dec 2012 were enrolled in the study ,including 21 patients complicated with cervical intraepithelial neoplasia ,then the genotypes of HPV were examined by using surface plasmon resonance technique ,the p16 protein was detected by means of immuno‐histochemistry method ,and the statistical analysis was performed with the use of SPSS13 .0 software .RESULTS The incidence of HPV infections was 100 .0% in the 21 cervical adenocarcinoma patients complicated with cervical intraepithelial neoplasia ,among whom there were 7 ( 33 .3% ) cases of HPV 16 infection ,6 (28 .6% ) cases of HPV 18 infection ,and 3 (41 .3% ) cases of HPV52 infection .The cervical adenocarcinoma tissues and cervical in‐traepithelial neoplasia tissues showed intensively positive for p

  8. Cáncer anal en la era del VIH: papel de la citología anal Anal cancer in the HIV era

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    Juan Carlos Cataño Correa

    2004-09-01

    Full Text Available El cáncer anal solía ser una neoplasia infrecuente que afectaba principalmente a mujeres y personas mayores de 65 años, pero recientemente su incidencia ha venido en aumento debido a la pandemia de VIH, fenómeno que tiende a empeorar porque la terapia antirretroviral altamente activa (HAART, por su sigla en inglés no solo alarga la vida de los pacientes, sino que al mismo tiempo hace posible una prolongada evolución de las lesiones precancerosas que conducen a cáncer anal; además, está plenamente demostrado que la HAART no evita la evolución de las lesiones intraepiteliales escamosas hacia cáncer anal. La citología anal ha demostrado ser una prueba de tamización poblacional útil y costoefectiva para el diagnóstico de las lesiones precancerosas producidas por Papilomavirus humano en el canal anal de hombres homosexuales y bisexuales, principalmente de aquellos positivos para VIH. Esta revisión tiene como objetivo llamar la atención sobre la creciente incidencia de cáncer anal en la población de pacientes VIH positivos, y sobre la utilidad del diagnóstico temprano utilizando la citología anal en este grupo de pacientes de riesgo. Anal cancer used to be an uncommon neoplasia that affected mainly women and people aged over 65 years, but recently its incidence has been growing, mostly due to the HIV pandemic, and it will become worse because highly active antiretroviral therapy (HAART at the same time that lengthens life expectancy in HIV positive subjects, will increase the possibility to develop anal cancer; it has already been demonstrated that HAART does not prevent the evolution of intraepithelial squamous lesions to anal cancer. Anal cytology has demonstrated to be an useful and cost-effective screening tool for detection of precancerous lesions associated with human Papillomavirus (HPV infection in the anal canal of homosexual and bisexual men, specially in those that are HIV positive. This article is an update of the

  9. Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV Association between CD4+ T-cell count and intraepithelial cervical neoplasia diagnosed by histopathology in HIV-infected women

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    Juliana Barroso Zimmermmann

    2006-06-01

    Full Text Available OBJETIVO: avaliar a associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical em pacientes HIV positivas. MÉTODOS: estudo transversal no qual foram incluídas 87 pacientes infectadas pelo HIV, confirmado por testes sorológicos prévios. Todas eram portadoras do HPV cervical, diagnosticado por meio da reação em cadeia da polimerase. Foram realizados anamnese, exame físico e colposcopia de todas em pacientes. A biópsia do colo uterino foi realizada quando indicada pelo exame colposcópico. Os resultados histopatológicos foram classificados com neoplasia intra-epitelial de baixo grau (NIC I ou de alto grau (NIC II e II. A associação entre a contagem de linfócitos T CD4+ e a gravidade da lesão foi verificada por meio da comparação de médias utilizando a análise da variância (ANOVA. RESULTADOS: entre as 60 pacientes biopsiadas foram encontrados 24 casos (40,0% com NIC I, oito (13,3% NIC II, três (5% NIC III, 14 (23,3% pacientes somente com cervicite crônica e 11 (18,3% apresentando efeito citopático produzido pelo HPV, mas sem perda da polaridade celular. Isso equivale a 35 mulheres com lesão intra-epitelial de baixo grau (NIC I + HPV (58,3% e 11 (18,3% com lesão intra-epitelial de alto grau (NIC II + NIC III. A associação entre a média da contagem de linfócitos T CD4+ e a gravidade da lesão intra-epitelial cervical não foi significativa (p=0,901. CONCLUSÕES: não houve associação entre a contagem de linfócitos T CD4+ e a gravidade da lesão intra-epitelial do colo uterino, diagnosticada pelo exame histopatológico.PURPOSE: to evaluate association between CD4+ cell count and cervical intraepithelial lesion severity in HIV-infected women. METHODS: cross-sectional study of 87 HIV-infected patients which were confirmed by previous serologic examinations. All had cervical HPV diagnosed by polymerase chain reaction (PCR. All patients underwent anamnesis, physical examinations and

  10. 高频电波刀术对宫颈上皮内瘤变(CIN)Ⅰ的治疗价值%Application of high frequency loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia (CIN) Ⅰ

    Institute of Scientific and Technical Information of China (English)

    李明艳; 张宇; 苏光; 鞠蕊; 邓春霞; 张凡; 杨文静; 杨雪梅; 王敬; 王春敏

    2012-01-01

    目的 探讨高频电波刀术(LEEP术)对宫颈上皮内瘤(CIN)Ⅰ合并宫颈人乳头状瘤病毒(HPV)感染的治疗效果.方法 选择符合入组标准CIN Ⅰ伴HPV感染患者60例,分成两组.治疗组(30例)采用LEEP术;观察组(30例)不做治疗.3个月后复查TCT、HPV和阴道镜点活检,首次复查后每6个月复查TCT、HPV和阴道镜点活检,随访2年.观察两组C1N Ⅰ转归情况及HPV清除率.结果 LEEP术治疗组ClN Ⅰ显效率/HPV转阴率第3、6、12、24个月分别为60.0%/46.7%、70.0%/56.67% 、76.7%/73.3% 、86.7%/83.3%;观察组为30.0%/16.7%、36.7%/30.0%、46.7%/ 36.7%、63.3%/50.0%,治疗组优于观察组,差异有统计学意义(P<0.01).结论 LEEP术能有效破坏宫颈表面病灶,抑制CINI进展复发,是诊断和治疗CIN安全有效的方法,能提高HPV清除率.%Objective To evaluate the role of high frequency loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia (CINI). Methods An analysis was conducted in 367 patients with ASC or cervical intraepithelial neoplasia preliminarily diagnosed by Liquid-based thin-layer cytology technique selected from 19397 patients between June, 2008 and February, 2010 at Chuiyangliu Hospital.Sixty patients with cervical intraepithelial neoplasia were caused by by human papilloma virus infection. They were divided into two groups, one with 30 patients treated by loop electrosurgical excision procedure and another with 30 patients without treatment. Two groups underwent liquid-based cytology test, colposcopie assessment and the cervical cells for HPV genotype testing by the polymerase chain reaction (PCR) respectively at 3rd, 6th, 12th, 18th, 24th months after treatment. Prognosis and clearing rate of HPV of the two groups were evaluated. Results The effective rate of treatment of CIN I and the HPV clearing rate was 60.0%/46.7%、70.0%/56.7%、76.7%/73.3%,86.7%/83.3% and 30.0%/16.7%,36.7%/30

  11. Clinical and pathological analysis of endometrial hyperplasia and endometrial intraepithelial neoplasia%子宫内膜增生与子宫内膜上皮内瘤变的临床病理分析

    Institute of Scientific and Technical Information of China (English)

    李晓超; 宋文静

    2011-01-01

    Purpose To study the morphological characteristics of the two classification systems of endometrial hyperplasia ( EH ) which is defined by World Health Organization 1994 and endometrial intraepithelial neoplasia ( EIN ) system and to evaluate the advantage of EIN system. Methods 474 cases endometrial hiopsy and curettage specimens of endometrial hyperplasia( including simple or complex hyperplasia with or without atypia ) were observed by used of optical microscope and EIN was found in these endometrial hyperplasia,then sumed up and statisticed the relation of EIN and endometrial hyperplasia. Results At the sametime , we followed up part of the patients with EIN. EIN was detected 11 in 48 cases simple hyperplasia with atypia( 2. 9% ) of EH,1 of 16 cases simple hyperplasia with atypia ( 6. 25% ),6 ones of 48 cases complex hyperplasia without atypia( 12. 5% ) and 28 ones of 31 cases complex hyperplasia with atypia( 90. 3% ). 13 cases patients of EIN were followed up and the uterus of 3 cases were excised because of malignant change ( 23. 70% ). Conclusions Endometrial intraepithelial neoplasia should be as monoclonal hyperplasia ( neoplastic proliferation ) with higher malignant transformation potential and it is completely different concepts from benign endometrial hyperplasia as its special morphological characteristics and biological behaviour, EIN classification system has many superior in WHO1994 classification system in diagnostic criteria and anticipation of malignant transformation potential. It is very important to clear the pathological diagnosis characteristics of EIN.%目的 探讨WHO1994有关子宫内膜增生(endometrial hyperplasia,EH)和子宫内膜上皮内瘤变(endometrial intraepithelial neoplasia,EIN)的形态学特点以及分类的优点.方法 观察474例刮宫标本HE切片中的EH性病变(包括子宫内膜单纯性增生、复杂性增生及两者伴有的不典型增生),根据新标准找出EIN,总结分析EH分类与EIN分

  12. Neoplasia intraepitelial cervical de alto grau durante a gestação: experiência de um serviço do Sul do Brasil High-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil

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    Vinícius Basso Preti

    2009-12-01

    Full Text Available OBJETIVO: avaliar o tratamento instituído a portadoras de neoplasia intraepitelial cervical de alto grau e o seguimento destas pacientes durante a gestação. MÉTODOS: estudo retrospectivo baseado na revisão dos prontuários de 30 pacientes atendidas no período de 1990 a 2002 no Hospital Erasto Gaertner, com diagnóstico de neoplasia intraepitelial cervical de alto grau durante a gestação. O diagnóstico foi realizado por colposcopia e biópsia, e a colposcopia foi realizada novamente durante o período gestacional e após o parto. Foram avaliados os diagnósticos de regressão e progressão das lesões. RESULTADOS: das 30 pacientes, 3 foram excluídas por não-confirmação do diagnóstico de lesão intraepitelial escamosa de alto grau (LEAG pela colposcopia com biópsia. Quatro pacientes foram submetidas ao tratamento durante a gestação, e uma delas apresentou parto pré-termo na 32ª semana de gestação. Vinte e três pacientes foram submetidas a tratamento expectante, realizando-se nova colposcopia e biópsia, sendo então submetidas à conização ou cirurgia de alta frequência em média na 11ª semana de gestação. Em 7,4% dos casos houve regressão da lesão na peça cirúrgica, embora a biópsia evidenciasse lesão de alto grau após o término da gestação. CONCLUSÕES: toda paciente com diagnóstico de lesão intraepitelial escamosa de alto grau (LEAG deve ser submetida à colposcopia e biópsia para excluir lesão invasiva. A conduta expectante para as lesões intraepiteliais é o tratamento de escolha e mais seguro pela possibilidade de regressão destas lesões no período pós-parto.PURPOSE: to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL are submitted, as well as their follow-up during pregnancy. METHODS: retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL during

  13. 宫颈癌与宫颈上皮内瘤变组织中mPGES-1与COX-2的表达及意义%Cervical cancer and cervical intraepithelial neoplasia tissue expression of mPGES-1 and COX-2 and its correlation analysis

    Institute of Scientific and Technical Information of China (English)

    陈勤

    2011-01-01

    Objective : To investigate the cervical cancer and cervical intraepithelial neoplasia tissue mPGES-l expression with pathological characteristics and the relationship between cell differentiation and analysis of mPGES-1 and COX-2 relevance. Method: Real-time fluorescence quantitative PCR method , were used to detect cervical cancer surgery in our hospital and all levels of cervical intraepithelial neoplasia tissue mPGES-1 and COX-2 mRNA, analysis of mPGES-1 and COX-2 related as well as the type of pathology ,classification relationship.Result:The cervical cancer and cervical intraepithelial neoplasia tissue mPGES-1 and COX-2 expression was significantly increased, respectively , 110 times the normal tissue and 25 times,both mRNA expression and tumor histological type or grading associated with low differentiation and malignant tumor tissue with high expression of high. In the lesions of mPGES-1 and COX-2 expression was positive correlation. Conclusion : mPGES-1 in mRNA in cervical intraepithelial neoplasia and cervical tissues were significantly higher than benign organizations, and the pathological type , grading, and COX-2 expression was positive correlation. This study has important clinical significance for cervical cancer and cervical intraepithelial neoplasia diagnosis and treatment of the development of new drugs.%目的:探讨宫颈癌与宫颈上皮内瘤变(CIN)组织中mPGES-1和Cox-2的表达及意义.方法:采用实时荧光定量PCR法,分别检测我院手术切除宫颈癌组织和各级CIN组织中mPGES-1和COX-2的mRNA表达.结果:宫颈癌与CIN组织中mPGES-1和COX-2的表达量显著增高,分别是正常组织的110倍和25倍,两者的mRNA表达量和肿瘤的病理类型或分级相关,低分化的肿瘤组织表达量高.结论:mPGES-1 mRNA在宫颈癌与宫颈上皮内瘤变组织中显著高于良性组织,并且和组织病理类型、分级有关,和COX-2表达呈直线正相关.这对宫颈癌及宫颈上皮内瘤变的诊断及治疗均有重要意义.

  14. Clinical study of Colposcopy and liquid-based cytology Test in the cervical intraepithelial neoplasia%阴道镜联合液基细胞学检查在宫颈上皮内瘤变的临床研究

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    张丽英

    2012-01-01

    目的 探讨阴道镜联合液基细胞学(TCT)检查对宫颈上皮内瘤变(CIN)的诊断价值.方法 回顾性分析了2006年6月~2010年12月在我院妇科就诊行TCT涂片的已婚妇女436例,同时对阳性者行阴道镜下宫颈活检病理学检查,以病理结果为金标准,评价阴道镜检联合TCT对宫颈上皮内瘤变诊断的准确性.结果 细胞学检测阳性者143例,与病理诊断结果比较,CINI诊断符合率为61.0%,CIN Ⅱ、CINI Ⅱ诊断符合率为42.9%.通过TCT检测再行阴道镜检查,CINI诊断符合率为78.7%,CIN Ⅱ、CINI Ⅱ诊断符合率为69.6%.结论 TCT与阴道镜联合应用明显提高了宫颈上皮内瘤变的诊断符合率,具有较高的临床应用价值.%Objective To investigate the diagnostic value of colposcopy and liquid-bas ed cytology (TCT) in patients with cervical intraepithelial neoplasia (CIN).Methods A total of 436 females were suspected cervical intraepithelial neoplasia between June 2006 and December 2010 in the gynecological clinic of our hospital.All the patients with liquid-based cytology smears,while cytology positive line colposcopy and c ervical biopsy pathology multi-point inspection,the pathology results as the gold standard,to evaluated the diagnostic accuracy of colposcopy combined TCT for cervical intraepithelial neoplasia.Results 143 cases of patients with pos itive cyto logy,compared with the results of pathological diagnosis,cytology tests CINI diagnosis rate was 61.0%,C1NII,CINIII diagnosis rate was 42.9%; through the test with liquid-based cytology and colposcopy,CINI diagn osis rate was 78.7%,CINII,CINIII diagnosis rate was 69.6%.Conclusion TCT in combination with colposcopy was significantly improved the diagnosis rate of cervical intraepithelial neoplasia.as a diagnostic cervical intraepithelial neoplasia of the method with high clinical value.

  15. A clinical investigation on detection of hTERC and HPV-DNA for cervical intraepithelial neoplasia screening%hTERC和HPV联合检测在宫颈上皮内瘤变筛查中应用

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    梅佳; 李桂梅; 杨志慧

    2011-01-01

    Purpose To investigate the expression of the human telomerase mRNA componentgene ( hTERC ) in cervical intraepithelial neoplasia( CIN ) and cervical cancer, and to evaluate the clinical screening significance of hTERC in cervical lesions.Methods The fluorescence signal of histologic samples of cervix were detected by using interphase FISH inchromosome enumeration double-color DNA probes TERC.According to the histology biopsy, 135 specimens were divided into normal group ( n = 24 ), cervical intraepithelial neoplasia group ( CIN ,n = 100 ) and carcinomas of the cervix group( n = 11 ).Among this 85 cases who received HPV-DNA examination,49 were positive and 36 were negative.Results ( 1 ) Positive expression of the hTERC gene in normal group, CIN and cervical cancer were 4.2% ,38.0% and 90.9%( P <0.01 ).There was obviously positive correlation between hTERC expression rate and the degree of disease( r =0.419,P <0.01 ).( 2 ) Positive expression of the hTERC gene in CIN 1, CIN 2 and CIN 3 were 10.0% ,48.0% and 55.0% , there was statistically significant difference among CIN 1, CIN 2 and CIN 3( P < 0.01 ), which no difference among CIN 2 and CIN 3( P > 0.05 ).There was obviously positive correlation between hTERC expression rate and the degree of disease( r = 0.354, P <0.01 ).( 3 ) Amplification of hTERC gene in 49 cases with HPV infected was significant more than that in the 36 cases without HPV infection( 57.14% vs 25% , P < 0.005 ).Conclusion The positive rate of hTERC gene increased with the cervical lesion grade which makes it a screening test marker for CIN 2/3 and may help to determine the progressive potential of individual lesions.The gain of hTERC gene may be an early stage event which related to the activation of telomerase resulted from HPV infection.The detection of HPV-DNA and hTERC can be used as an ideal tumor index for early cervical intraepithelial neoplasia screening.%目的 观察人端粒酶mRNA基因(human telomerase m

  16. Impact of an HPV6/11/16/18 L1 virus-like particle vaccine on progression to cervical intraepithelial neoplasia in seropositive women with HPV16/18 infection

    DEFF Research Database (Denmark)

    Haupt, Richard M; Wheeler, Cosette M; Brown, Darron R;

    2011-01-01

    The impact of a human papillomavirus (HPV) vaccine on development of cervical intraepithelial neoplasia grade 2-3 or adenocarcinoma in situ (CIN2-3/AIS) in women with ongoing HPV16 or 18 infections prevaccination is reported. Seventeen thousand six-hundred and twenty-two women aged 16-26 were...... enrolled in 1 of 2 randomized, placebo-controlled, efficacy trials (Protocols 013 and 015). Vaccine or placebo was given at day 1, month 2 and 6. Women were tested for HPV6/11/16/18 DNA and antibodies at day 1. We focus on the subset of women who were seropositive and DNA positive to HPV16 or HPV18...... prevaccination. Incidence is expressed as the number of women with an endpoint per 100 person-years-at-risk. In total, 419 vaccine and 446 placebo recipients were both seropositive and DNA positive to HPV16 or HPV18 prevaccination and had at least one follow-up visit. In Protocol 013, the incidence of HPV16...

  17. Research progress of cervical intraepithelial neoplasia and high-risk human papilloma virus%宫颈上皮内瘤变与高危型 HPV 感染的研究进展

    Institute of Scientific and Technical Information of China (English)

    许莉莉; 赵仁峰

    2015-01-01

    宫颈上皮内瘤变( CIN)是与子宫颈癌密切相关的一组宫颈病变,高危型人乳头瘤病毒( HR-HPV)感染是CIN的发病原因之一,因此有关HR-HPV的研究对于CIN的早期诊断、治疗以及评估治疗疗效有重要的意义。该文就CIN与HR-HPV感染的研究进展进行综述。%Cervical intraepithelial neoplasia ( CIN) is a group of cervical lesions that are closely associated with cervical cancer , and high-risk human papilloma virus ( HR-HPV) infection is one of the causes of CIN ,hence the study of HR-HPV has an important significance in CIN′s early diagnosis , treatment and evaluation of the treatment effect.In this paper, we review the research progress of CIN and HR-HPV.

  18. The Application of Classification and Regression Trees for the Triage of Women for Referral to Colposcopy and the Estimation of Risk for Cervical Intraepithelial Neoplasia: A Study Based on 1625 Cases with Incomplete Data from Molecular Tests

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    Abraham Pouliakis

    2015-01-01

    Full Text Available Objective. Nowadays numerous ancillary techniques detecting HPV DNA and mRNA compete with cytology; however no perfect test exists; in this study we evaluated classification and regression trees (CARTs for the production of triage rules and estimate the risk for cervical intraepithelial neoplasia (CIN in cases with ASCUS+ in cytology. Study Design. We used 1625 cases. In contrast to other approaches we used missing data to increase the data volume, obtain more accurate results, and simulate real conditions in the everyday practice of gynecologic clinics and laboratories. The proposed CART was based on the cytological result, HPV DNA typing, HPV mRNA detection based on NASBA and flow cytometry, p16 immunocytochemical expression, and finally age and parous status. Results. Algorithms useful for the triage of women were produced; gynecologists could apply these in conjunction with available examination results and conclude to an estimation of the risk for a woman to harbor CIN expressed as a probability. Conclusions. The most important test was the cytological examination; however the CART handled cases with inadequate cytological outcome and increased the diagnostic accuracy by exploiting the results of ancillary techniques even if there were inadequate missing data. The CART performance was better than any other single test involved in this study.

  19. Cervical ring type electrical treatment cervical intraepithelial neoplasia%宫颈环型电切术治疗宫颈上皮内瘤变疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡木君

    2010-01-01

    目的 探讨宫颈环型电切术(loop electrosurgical excision procedure,LEEP)应用于宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的治疗效果.方法 2004年6月~2008年11月在我院宫颈疾病门诊诊断为CIN的部分患者采用LEEP进行治疗,术后随访至少2年.结果 术后6个月治愈率为98.29%,其中CIN Ⅰ组治愈率为98.18%,CIN Ⅱ~Ⅲ组治愈率为97.67%,两组比较差异无统计学意义(P>0.05),术后1年复发率为1.82%.结论 采用LEEP治疗CIN安全、有效、创伤小、并发症少,术后需长期随访.

  20. 子宫颈环形电切术治疗子宫颈上皮内瘤变54例%Loop electrosurgical excisional procedure for cervical intraepithelial neoplasia in 54 cases

    Institute of Scientific and Technical Information of China (English)

    王立群

    2009-01-01

    目的:探讨子宫颈环形电切术(loop electrosurgical excisional procedure,LEEP)治疗子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的有效性、可行性.方法:采用阴道镜辅助下的子宫颈环形电切术,对54例CIN患者进行治疗,观察手术时间、出血量、组织病理变化及术后随访情况,并对其疗效进行回顾性分析.结果:LEEP手术时间平均约4.5 min,手术出血量约8.6 ml.术前、术后病理符合率66.67%,术后20.37%升级,12.96%降级.一次治愈率达94.4%.结论:LEEP治疗子宫颈上皮内瘤变,是安全、有效、经济的术式,易被接受,值得在妇产科临床中进一步推广应用.

  1. 子宫颈电环切除术治疗子宫颈上皮内瘤变的疗效评价%Loop electrosurgical excision circumcise electrotome for treatment of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    郑贤芳

    2010-01-01

    目的:观察子宫颈电环切除术(loop electrosurgical excision,LEEP)诊断及治疗子宫颈上皮内瘤变(cervical intraepithelial neoplasia ,CIN)的临床效果.方法:对经子宫颈脱落细胞学检查、阴道镜及子宫颈活检初步诊断为CIN的62例患者采用LEEP治疗,根据术前、术后病理变化及随访,判断LEEP的疗效.结果:LEEP术后病理诊断与阴道镜下点活检的病理诊断差异有统计学意义(P<0.01).LEEP对患者治愈率达98.33%,对CIN 1、2者治愈率达100%,术后1年无CIN复发.结论:LEEP可提供完整的标本送病理检查,是诊断和治疗CIN的理想方法.

  2. 多环黏膜切除术治疗食管高级别上皮内瘤变的临床疗效%Clinical efficacy of multi-band mucosectomy for high-grade esophageal intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    王慧超; 葛相栓; 钱峰; 刘小玲; 李建平; 赵作静; 王瑞

    2014-01-01

    Objective To investigate the efficacy and safety of multi-band mucosectomy (MBM) for the treatment of high-grade intraepithelial neoplasia.Methods The clinical data of 24 patients with high-grade esophageal intraepithelial neoplasia who were admitted to the Henan Honliv Hospital from April 2011 to October 2012 were retrospectively analyzed.All the 24 patients received MBM,and the operation time,resection of the lesion and complications were observed.All the patients were followed up with gastroscopy at postoperative 1,3,6,12 months.The follow-up was ended in April 2013.Results A total of 26 lesions in 24 patients were resected successfully by MBM (2 patients received MBM twice).The mean operation time was 42 minutes.The mean length of the lesions was 3.1 cm (range,0.8-6.0 cm),and it occupied 3/4 of the circumference of the esophagus to the maximum.The mean number of the band used was 4 (range,1-6).During the operation,bleeding was occurred in 4 patients,and they were cured by hot biopsy forceps.No perforation of the esophagus was detected.The results of post-MBM pathological examination showed that 22 patients were with severe atypical hyperplasia,and 2 were with carcinoma in situ.During the follow-up of 6-24 months,22 patients were cured,and esophageal stricture occurred in 1 patient at post-MBM 1 month,and the symptoms were successfully relieved by endoscopic balloon dilatation.Neoplasia recurrence was observed in 1 patient (2 lesions were resected twice) at post-MBM 3 months,and he received surgical treatment.Histopathological diagnosis showed that he had esophageal squamous cell carcinoma.No stricture or neoplasia was detected by gastroscopy at postoperative month 12.Conclusions MBM is a relatively safe and effective endoscopic technique for the treatment of high-grade esophageal intraepithelial neoplasia.The resection range should not be blindly extended.For patients whose lesions are beyond 3/4 of the circumference of the esophagus in width or with multiple

  3. Interferón alfa-2b tópico como primera opción en las neoplasias intraepiteliales corneoconjuntivales Topical interferon alfa-2b for primary treatment of conjunctiva-cornea intraepithelial neoplasia

    OpenAIRE

    M. Pérez de Arcelus; Aranguren, M.; J. Andonegui

    2012-01-01

    Se describen dos casos de neoplasia intraepitlelial corneo-conjuntival (CIN) tratados con interferón alfa-2b (IFN alfa-2b) tópico como primera elección. El tratamiento clásico de los CIN ha sido tradicionalmente la resección completa con márgenes de seguridad seguida de crioterapia en el lecho quirúrgico. No obstante, y puesto que la tasa de recidivas puede alcanzar el 50% han sido propuestos coadyuvantes como la mitomicina C y el 5 fluoracilo, con el consiguiente riesgo de toxicidad corneal ...

  4. Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Anal HPV diagnosis in women with NIC: anal cancer prevention?

    Directory of Open Access Journals (Sweden)

    Alice Capobiango

    2009-12-01

    Full Text Available Os objetivos deste estudo foram avaliar a frequência de HPV anal em pacientes com neoplasia intraepitelial cervical (NIC, verificar a concordância entre os subtipos encontrados nos dois locais e investigar os fatores que influenciaram a ocorrência de HPV anal em mulheres com NIC sem evidências clínicas de imunodepressão. Foram avaliadas 52 mulheres com idades entre 16 e 72 anos e diagnóstico de neoplasia intraepitelial cervical graus I, II e III. A identificação do DNA (ácido desoxirribonucleico do HPV e de sete subtipos dos vírus foi realizada por meio da reação em cadeia da polimerase (PCR em material colhido no ânus e colo uterino. Foram pesquisados fatores que poderiam contribuir para a infecção anal, como paridade, número de parceiros, tabagismo, manipulação e coito anal e o tipo de doença ginecológica. Das 52 mulheres, foi diagnosticado HPV na região anal em 25 (48%, das quais 23 (44% também apresentavam HPV no colo uterino - resultado significativo para existência do HPV em portadoras de NIC. Em 16 (31% o HPV foi diagnosticado somente no colo uterino e em 11 (21% não foi identificado em colo ou ânus. Houve associação significativa nas variáveis paridade (p=0,02 e número de parceiros (p=0,04. Concluiu-se que: as mulheres com HPV genital têm mais probabilidade de serem acometidas por HPV anal; não há concordância unânime entre os subtipos do HPV do colo do útero e do ânus e a paridade e o número de parceiros contribuem para aumentar a incidência de HPV anal nas mulheres sem imunodeficiência e com HPV cervical.This study aims were to assess the frequency of HPV anal infection in patients with cervical intra-epithelial neoplasia (CIN, to find out the relation between the found subtypes, when present in both regions, and investigate factors that influenced the occurrence of anal HPV in women with CIN. Fifty two women with age between 16 and 72 years and cervical intra-epithelial neoplasia (CIN diagnosis

  5. 宫颈上皮内瘤变患者术后阴道病原体感染的影响因素研究%Influencing factors of vaginal pathogen infection in patients with cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    刘正玲; 王增艳; 郝长宏; 李开芹; 田永会

    2016-01-01

    intraepithelial neoplasia grade ,postoperative posi‐tive margin and persistent HPV infection after conization were closely related with vaginal pathogen infection of CIN patients ,and the differences were significant (P< 0 .05) .CONCLUSION Vaginal pathogen infection in pa‐tients with cervical intraepithelial neoplasia has many risk factors ,postoperative patients should be strengthened pathogens and drug resistance tests ,so as to reduce infection rates .

  6. Human papillomavirus (HPV infection and intraepithelial neoplasia and invasive cancer of the uterine cervix: a case-control study in Zaragoza, Spain

    Directory of Open Access Journals (Sweden)

    Moros Manuel

    2008-05-01

    Full Text Available Abstract Introduction The raw incidence of cancer of the uterine cervix is Spain is 7,8 per 100.000 inhabitants (adjusted incidence is 5.6. The incidence of this tumor is still low, but a steady increase has been seen, probably related to increasing risk factors. Aim To determine the frequency of infection by different types of human papillomavirus (HPV in Papanicolau smears from women with and without cancer of the uterine cervix in Spain. Patients and methods A case-control study was performed in women with and without cervical cancer from Zaragoza, Spain. Pap smears from 600 cases (540 women with cervical intraepithelial neoplasms (CIN and 60 with invasive cancer and 1200 controls (women without those lesions were tested by polymerase chain reaction (PCR and typed by oligonucleotide microarray-based detection. Results HPV was detected in 93.3% of all samples with invasive cancer versus 17.5% of controls. OR for invasive cancer was 55 (95% CI 21.5–140,5. Statistically significant associations were also found for different grades of cervical dysplasia. Conclusion The strong association found between HPV infection, specifically types 16 and 18 and cancer of the uterine cervix in Zaragoza, Spain, stresses the importance of ongoing efforts to institute a vaccine program with recently approved HPV vaccines in order to prevent cervical cancer in this population.

  7. “即诊即治”法在宫颈上皮内瘤样病变诊疗中的价值%Value of "See and Treat" Method in the Diagnosis and Treatment of Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    耿晓慧; 李鸿燕

    2013-01-01

    Objective:To evaluate the application of the "see and treat" approach of the loop electrosurgical excision procedure (LEEP) in women with cervical intraepithelial neoplasia(CIN).Methods:Three hundred women having childbearing history with cervical intraepithelial neoplasia were included in this study.According to the test of cervical liquid-based cytology (TCT),cases were divided into two groups,group A(low lesions) and group B (high lesions).Group A,included 162 cases with atypical squamous cells of undetermined significance (ASCUS),atypical glandular cells of undetermined significance (AGUS),low-grade squamous intraepithelial lesion (LSIL) patients.Group B included 138 cases with high-grade squamous intraepithelial neoplasia (HSIL).All cases were scored by the electronic colposcope quantitative scoring system(RCI).Cases of group A were treated by the cervical biopsy combined with colposcopy and electrosurgery (LEEP).Cases of group B were treated by the "see and treat" approach of LEEP.Then pathological results were analyzed.Results:There is not significant difference in the CIN Ⅱ detection rates between by cervical biopsy and by LEEP within group A(P>0.05).In group A,the pathologic diagnosis of CIN Ⅱ,or above,was 18.52%; while the over-treatment rate was 81.48%.In group B,the pathologic diagnosis of CIN Ⅱ] or above was 80.43%,while the over-treatment rate was 19.57%.In group B,if combined with the RCI high score,the diagnosis sensitivity of CIN Ⅱ or above was 84.68%,specificity 81.48%,positive predictive value 94.94%,the omission diagnose rate 15.31%,and the over-treatment rate 5.05%.Conclusions:For those patients with HSIL by TCT and high scores by RCI,the "see and treat" approach can reduce the over-treatment rate and the omission diagnose rate.%目的:探讨“即诊即治”法在宫颈上皮内瘤样病变(CIN)诊疗中的价值.方法:选取2009年5月-2011年12月经宫颈液基薄层细胞学(TCT)检查

  8. Recurrence of cervical intraepithelial neoplasia in human immunodeficiency virus-infected women treated by means of electrosurgical excision of the transformation zone (LLETZ in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Fábio Russomano

    Full Text Available CONTEXT AND OBJECTIVE: Human immunodeficiency virus (HIV-infected women have higher incidence, prevalence, persistence and recurrence of pre-invasive cervical lesions (CIN II or III. The aim here was to investigate the risk of recurrence of CIN II/III among HIV-infected women (HIV+ and uninfected women in a cohort treated by means of large-loop excision of the transformation zone (LLETZ. DESIGN AND SETTING: Cohort study conducted at Instituto Fernandes Figueira/Fundação Oswaldo Cruz (IFF/Fiocruz. METHODS: 60 HIV+ and 209 HIV-negative patients were included in a cohort for follow-up after undergoing LLETZ to treat CIN II/III. A histopathological diagnosis of CIN II/III during the follow-up was taken to constitute recurrence. The following possible confounding variables were assessed: age at treatment and at end of follow-up; histological grade of intraepithelial disease treated; surgical margin involvement; adequacy of colposcopy during the follow-up; CD4+ lymphocyte count; HIV viral load; and type of antiretroviral therapy. RESULTS: Among the 60 HIV+ women, six showed recurrent disease during the follow-up. However, among the 209 HIV-negative women, seven showed a new precursor lesion. The relative risk of disease recurrence in the HIV+ women was 4.21 (95% CI = 1.42 to 12.43. The Kaplan-Meyer curve showed that the risk of recurrence was significantly higher among HIV+ women (log-rank test: P = 0.0111. CONCLUSION: The HIV+ women in our cohort presented a risk of CIN II/III recurrence at least 42% higher than among the HIV-negative women. These patients should form part of a rigorous screening and follow-up protocol for identification and appropriate treatment of cervical cancer precursor lesions.

  9. Expressions and clinical significances of TS and PCNA in cervical intraepithelial neoplasia and cervical carcinoma%宫颈上皮内瘤变及宫颈癌中TS、PCNA的表达及其意义

    Institute of Scientific and Technical Information of China (English)

    郑巧荣; 崔金全

    2011-01-01

    目的:探讨胸苷酸合成酶(thymidylate synthase,TS)在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)及宫颈癌发生、发展中的作用及与预后的关系.方法:采用免疫组化SP法检测TS、增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)在慢性宫颈炎、宫颈上皮内瘤变及宫颈癌中的表达.结果:与慢性宫颈炎相比,CIN及宫颈癌中 TS 的表达率明显增高(P值分别为0.006、0.004);而CIN与宫颈癌组比较,差异无统计学意义(P=0.780);CIN各组之间差异亦无显著性.在宫颈癌中,TS的表达与临床分期、淋巴结转移有关(P值分别为0.033、0.015),与细胞分化程度及肌层浸润深度无关(P值分别为0.343、0.350).PCNA在CIN和宫颈癌中的表达率明显高于慢性宫颈炎(P值分别为0.029、0.000),在宫颈癌中的表达率也明显高于CIN(P值为0.000).在CIN和宫颈癌中,TS和PCNA的表达存在关联性(Pearson列联系数=0.319 6,x2=8.371,P<0.005).结论:TS作为一种促细胞增殖的蛋白与宫颈病变的发生有一定关系,对预测宫颈癌的预后有一定参考价值.%Objective: To explore the role of thymidylate synthase (TS) in occurrence and development of cervical intraepithelial neoplasia (CIN) and cervical carcinoma and its relationship with prognosis.Methods: Immunohistochemical SP method was used to detect the expression levels of TS and proliferating cell nuclear antigen (PCNA) in chronic cervicitis, CIN and cervical carcinoma.Results: Compared with chronic cervicitis group, the expression rates of TS in CIN group and cervical carcinoma group increased significantly ( P = 0.006,0.004, respectively).There was no significant difference in expression rate of TS between CIN group and cervical carcinoma group ( P =0.780); there was no significant difference in expression rate of TS among subgroups of CIN group; in cervical carcinoma group, the expression of TS correlated with clinical stages ( P = 0.033 ) and lymph node

  10. HPV-16在宫颈癌和宫颈上皮内瘤变组织中的表达%Evaluation of the Gene Expression of HPV-16 in Cervical Intraepithelial Neoplasia and Cervical Carcinoma

    Institute of Scientific and Technical Information of China (English)

    秦莉; 王桂芳

    2015-01-01

    Objective To study cervical intraepithelial neoplasia and cervical HPV-16 tissue expression and clinical signiifcance.Methods 200 cases of high-risk HPV treated in the gynecology clinic in our hospital between July 2011and June 2013, gene capture technology (HC2)was performed to detect the human papilloma virus (HPV-DNA), and analyzed HPV infection and expression of the relationship between cervical lesions. Results The detection of HPV infection in 16 cases, including 28 cases of HPV-16 type, HPV-18 type 2 cases, 31 cases of others. Pathologically conifrmed 19 cases of cervical squamous cell carcinoma, CIN Ⅰ grade 20 cases, Ⅱ grade 19 cases, Ⅲ grade 3 cases. CC group of HPV-16 was signiifcantly higher than the normal group and CINⅠ, CIN Ⅱ, HPV-18 positive rate was signiifcantly higher than CIN group and the normal group,P0.05). Conclusion HPV-16 cervical tissue overexpression of cervical intraepithelial neoplasia and cervical squamous cell carcinoma is closely related to the development, testing HPV-16 help to elucidate the etiology and pathogenesis of cervical cancer, early screening and predicting cervical intraepithelial neoplasia become of great signiifcance.%目的:研究宫颈癌以及宫颈上皮内瘤变组织中HPV-16的表达及其临床意义。方法随机选择2011年7月至2013年6月期间,我院妇科门诊收治的HPV高危病例200例,以基因捕获技术(HC2)对人乳头病毒(HPV-DNA)进行检测,并分析HPV感染及表达与宫颈病变之间的关系。结果本组共检出HPV感染61例,其中HPV-16型28例,HPV-18型2例,31例其他。经病理证实宫颈鳞癌19例, CINⅠ级20例,Ⅱ级19例,Ⅲ级3例。CC组的HPV-16显著高于正常组及CINⅠ、CINⅡ,HPV-18的阳性率显著高于CIN组及正常组, P0.05

  11. 宫颈上皮内瘤变组织中HPV感染基因型的比较研究%A comparative study of HPV infective genotypes distribution in cervical intraepithelial neoplasias

    Institute of Scientific and Technical Information of China (English)

    王懿; 梅静; 耿建祥; 阚延静; 范雪梅; 夏林; 王宏景; 龙秀荣; 赵雪

    2015-01-01

    目的:比较三级别宫颈上皮内瘤变(CIN)组织标本中人乳头瘤病毒(HPV)感染的基因型分布情况及其临床意义。方法采用聚合酶链式反应和基因芯片检测技术对20例宫颈正常组织、185例宫颈CIN1级、98例宫颈CIN2级和118例宫颈CIN3级患者宫颈组织标本进行23种HPV基因分型检测,并对受检者进行相关资料分析。结果20例宫颈正常组织检出 HPV感染者2例,总的HPV感染率为10.00%(2/20);185例宫颈CINⅠ组织检出 HPV感染者83例,总的 HPV感染率为44.87%(83/185);98例宫颈CINⅡ组织检出HPV感染者83例,总的HPV感染率为84.69%(83/98);118例宫颈CINⅢ组织检出 HPV感染者108例,总的 HPV感染率为91.53%(108/118)。结论聚合酶链式反应结合基因芯片技术可应用于宫颈上皮内瘤变组织标本的HPV基因分型检测,对我国女性宫颈病变 HPV感染基因型分布的研究及宫颈癌瘤的防治及其疫苗的研发具有十分重要的意义。%Objective To compare the distribution of 23 kinds of human papillomavirus genotypes in 3 grades tissues of cervical intraepithelial neoplasias(CIN1、2、3) in women and its clinical significance .Methods Polymerase chain reaction (PCR)and gene‐chips technology were utilized for the detection of 23 kinds of HPV genotypes in cervical tissue specimens from 20 cases of normal tissues ,185 cases of CIN1grades、98 cases of CIN2grades and 118 cases of CIN3grades .And related materials of all subjects were analyzed .Results In cervical normal tissues of 20 women ,total infection rate of HPV was 10 .00% (2/20 ) ,In 185 cases of CIN1grades ,total infection rate of HPV was 44 .87% (83/185) ,In 98 cases of CIN2grades ,total infection rate of HPV was 84 .69%(83/98)and In 118 cases of CIN3 grades ,total infection rate of HPV was 91 .53% (108/118) .Conclusion PCR and gene‐chip tech‐nology can detect single and multiple HPV genotypes

  12. The value of cervical biopsies under colposcopy in the diagnosis of cervical intraepithelial neoplasia%阴道镜下宫颈活检在诊断宫颈上皮内瘤变中的价值

    Institute of Scientific and Technical Information of China (English)

    李占贵; 王影

    2012-01-01

    Objective: To evaluate the value of cervical biopsies under colposcopy in the diagnosis of cervical intraepithelial neoplasia. Methods: The clinical and pathological data of 157 patients with all types of C1N diagnosed by colposcopically directed cervical biopsies and then treated with loop electrosurgical excision procedure and (or) cervical conization and (or) hysterectomy in the short term in our hospital from January 2009 to December 2010 were analyzed retrospectively. Results: There were 118 cases (75. 2% ) of the diagnosis by colposcopically directed cervical biopsies were consistent and 39 cases (24. 8% ) cases were not consistent with the final diagnosis in 157 cases. The consistence rate of the CINI, Ⅱ and Ⅲ by colposcopically directed cervical biopsies and the final diagnosis were 62. 9% , 77. 8% , 82.6% , including 18 cases (11.5% ) were pathologically diagnosed downgrade, 21 cases (13. 4% ) were pathologically diagnosed upgrades , 4 cases (2.5% ) diagnosed as invasive cervical cancer. Conclusion: Great attention should be paid to early screening of cervical disease and application of the colposcopically directed cervical biopsies in cervical intraepithelial neoplasia; colposcopy can provide a accurate site for biopsy, increase positive rate of biopsy and reduce the rate of misdiagnosis. Although the colposeopically directed cervical biopsies have a certain proportion of missed diagnosis of invasive cervical cancer, but it is still a convenient, economical, less invasive and reliable method of diagnosis of CIN.%目的:探讨阴道镜下宫颈活检在诊断宫颈上皮内瘤变中的价值.方法:回顾性分析2009年1月~ 2010年12月该院妇科门诊阴道镜下宫颈活检诊断为各类宫颈上皮内瘤变( CIN),并在短期内行宫颈电刀环切术、宫颈锥切术或子宫全切术的157例患者的临床资料.结果:157例患者中阴道镜下活检诊断结果与最后诊断符合者118例( 75.2%),不符合者39例(24.8%),其中

  13. Inhibition of Chronic Pancreatitis and Murine Pancreatic Intraepithelial Neoplasia by a Dual Inhibitor of c-RAF and Soluble Epoxide Hydrolase in LSL-KrasG¹²D/Pdx-1-Cre Mice.

    Science.gov (United States)

    Liao, Jie; Hwang, Sung Hee; Li, Haonan; Liu, Jun-Yan; Hammock, Bruce D; Yang, Guang-Yu

    2016-01-01

    Mutation of Kirsten rat sarcoma viral oncogene homolog (KRAS) and chronic pancreatitis are the most common pathogenic events involved in human pancreatic carcinogenesis. In the process of long-standing chronic inflammation, aberrant metabolites of arachidonic acid play a crucial role in promoting carcinogenesis, in which the soluble epoxide hydrolase (sEH), as a pro-inflammatory enzyme, generally inactivates anti-inflammatory epoxyeicosatrienoic acids (EETs). Herein, we determined the effect of our newly-synthesized novel compound trans-4-{4-[3-(4-chloro-3-trifluoromethyl-phenyl)-ureido]-cyclohexyloxy}-pyridine-2-carboxylic acid methylamide (t-CUPM), a dual inhibitor of sEH and RAF1 proto-oncogene serine/threonine kinase (c-RAF), on inhibiting the development of pancreatitis and pancreatic intraepithelial neoplasia (mPanIN) in LSL-Kras(G12D)/Pdx1-Cre mice. The results showed that t-CUPM significantly reduced the severity of chronic pancreatitis, as measured by the extent of acini loss, inflammatory cell infiltration and stromal fibrosis. The progression of low-grade mPanIN I to high-grade mPanIN II/III was significantly suppressed. Inhibition of mutant Kras-transmitted phosphorylation of mitogen-activated protein kinase's kinase/extracellular signal-regulated kinases was demonstrated in pancreatic tissues by western blots. Quantitative real-time polymerase chain reaction analysis revealed that t-CUPM treatment significantly reduced the levels of inflammatory cytokines including tumor necrosis facor-α, monocyte chemoattractant protein-1, as well as vascular adhesion molecule-1, and the levels of Sonic hedgehog and Gli transcription factor (Hedgehog pathway). Analysis of the eicosanoid profile revealed a significant increase of the EETs/dihydroxyeicosatrienoic acids ratio, which further confirmed sEH inhibition by t-CUPM. These results indicate that simultaneous inhibition of sEH and c-RAF by t-CUPM is important in preventing chronic pancreatitis and carcinogenesis.

  14. Clinicopathological analysis of endometrial hyperplasia and endometrial intraepithelial neoplasia%子宫内膜增生与子宫内膜上皮内瘤变的临床病理分析

    Institute of Scientific and Technical Information of China (English)

    李龙; 王月玲

    2013-01-01

    目的:探讨子宫内膜增生(EH)与子宫内膜上皮内瘤变(EIN)的临床病理特征.方法:选取的500例刮宫标本,观察标本中EH病变,并找出其中的EIN,总结EH与EIN的关系.结果:EIN在不同类型的EH中发病率不同,且在伴有不典型增生的复杂增生中发病率最高(P<0.05).结论:EIN在伴有不典型增生的复杂增生的发病率较高,因而明确EIN的临床病理特征对EIN的诊断及治疗均具有重要的意义.%Objective:( EH ) in endometrial hyperplasia and endometrial intraepithelial neoplasia ( EIN ) analysis of the clinical pathology .Methods :500 cases of curettage specimens collected in our hospital , were observed in EH lesions , and finds out the EIN, analyzed and summarized the relationship between EH and EIN, and statistical analysis was performed using statistical software .Results :EIN in different types of EH at different rates , and in complex hyperplasia with atypical hyperplasia of the highest incidence (P<0 .05 ) .The incidence was higher than that in complex hyperplasia with atypical hyperplasia .Conclusion :EIN ,which clinical and pathological signs of EIN have great significance for the diagnosis and treatment of EIN ,clinical research value.

  15. Research status of cervical intraepithelial neoplasia of gradeⅠ infected by human papilloma virus%人乳头瘤病毒感染Ⅰ级宫颈上皮内瘤变的研究现状

    Institute of Scientific and Technical Information of China (English)

    杨文静; 苏光

    2012-01-01

    Cervical intraepithelial neoplasia of grade I (CIN I for short) is the common precancerous lesions of cervical cancer in gynaecology department, and it closely relates to infection of human papilloma virus. However, because of the uneven technology of pathology physicians and colposcopy physicians, and the restriction of colposcopy itself, the consistency of CIN I diagnosis has difference, and the treatment of CIN I also has controversy. In order to avoid over-treatment and undertreatment of CIN I , many scholars struggle to find out an accurate biological index to forecast the development trend of CIN I . This paper summarizes the basic research and clinical treatment status of CIN I .%宫颈上皮内瘤变Ⅰ级简称为CINⅠ,是妇科常见的宫颈癌前病变,与人乳头瘤病毒感染密切相关.然而由于病理科医师、阴道镜检查医师的技术参差不齐及阴道镜本身的制约,CINⅠ诊断的一致性存在差异,且CINⅠ的治疗至今仍存在争议.为了避免CINⅠ的过度治疗与治疗不足,许多学者不懈努力以期寻找到一个准确的生物学指标预测CINⅠ的发展趋势.本文就CINⅠ的基础研究与临床治疗现状进行综述.

  16. 宫颈环形电切术诊治宫颈上皮内瘤变82例%Role of loop electrosurgical excision procedure in diagnosis and treatment of vervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    安亚丽; 张宏伟

    2008-01-01

    宫颈上皮内瘤变(Cervical intraepithelial neoplasia, CIN)是宫颈浸润癌演变发展过程中的癌前病变阶段,从宫颈癌前病变发展成宫颈癌有一个较长的时间过程,大约10年。因此,对宫颈癌防治的重点在于对CIN的诊断和治疗上。目前,年轻宫颈癌的发生率有明显上升的趋势,以每年2%~3%的速度增长,因此对CIN的诊治尤为重要。近年来,宫颈锥切术在宫颈病变诊治中的作用引起重视,特别是宫颈环形电切术(Loop electrosurgical excision procedure, LEEP)的应用,无论作为宫颈病变的诊断还是治疗都具有重要的作用。笔者对2004年4月~2007年4月我院行LEEP术的82例CIN患者的诊断及治疗情况,以及术后的随访观察,术后并发症的处理进行临床分析。

  17. Increased expression of programmed death (PD)-1 and its ligand PD-L1 correlates with impaired cell-mediated immunity in high-risk human papillomavirus-related cervical intraepithelial neoplasia.

    Science.gov (United States)

    Yang, Wen; Song, Yan; Lu, Yun-Long; Sun, Jun-Zhong; Wang, Hong-Wei

    2013-08-01

    Impaired local cellular immunity contributes to the pathogenesis of persistent high-risk human papillomavirus (HR-HPV) infection and related cervical intraepithelial neoplasia (CIN), but the underlying molecular mechanisms remain unclear. Recently, the programmed death 1/programmed death 1 ligand (PD-1/PD-L1; CD279/CD274) pathway was demonstrated to play a critical role in attenuating T-cell responses and promoting T-cell tolerance during chronic viral infections. In this study, we examined the expression of PD-1 and PD-L1 on cervical T cells and dendritic cells (DCs), respectively, from 40 women who were HR-HPV-negative (-) or HR-HPV-positive (+) with CIN grades 0, I and II-III. We also measured interferon-γ, interleukin-12 (IL-12) and IL-10 in cervical exudates. The most common HPV type was HPV 16, followed by HPV 18, 33, 51 and 58. PD-1 and PD-L1 expression on cervical T cells and DCs, respectively, was associated with HR-HPV positivity and increased in parallel with increasing CIN grade. The opposite pattern was observed for CD80 and CD86 expression on DCs, which decreased in HR-HPV+ patients in parallel with increasing CIN grade. Similarly, reduced levels of the T helper type 1 cytokines interferon-γ and IL-12 and increased levels of the T helper type 2 cytokine IL-10 in cervical exudates correlated with HR-HPV positivity and CIN grade. Our results suggest that up-regulation of the inhibitory PD-1/PD-L1 pathway may negatively regulate cervical cell-mediated immunity to HPV and contribute to the progression of HR-HPV-related CIN. These results may aid in the development of PD-1/PD-L1 pathway-based strategies for immunotherapy of HR-HPV-related CIN.

  18. 宫颈癌术后阴道断端VAIN55例临床分析%Clinicopathologic Study of 55 Patients with Vaginal Cuff Intraepithelial Neoplasia after Operation of Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    张小红; 王平

    2007-01-01

    目的:研究宫颈癌术后阴道断端上皮内瘤变(vaginal intraepithelial neoplasia,VMN)的诊断、治疗及阴道断端VAIN级别与宫颈癌病理类型、临床分期、转移部位、癌灶大小、患者年龄的关系.方法:总结2001年1月至2006年5月共55例宫颈癌术后阴道断端VAIN患者的临床资料,对其临床表现、病理、治疗方法及复发等进行回顾分析.结果:55例患者中年龄≤40岁13例,>40岁42例,其中阴道断端VAINⅠ 11例,VAINⅡ11例,VMNⅢ33例,均经病理检查确诊,采用手术治疗,术前或术后加用放化疗,随访1例患者复发.结论:阴道断端VAIN级别与宫颈癌病理类型、临床分期、转移部位癌灶大小、患者年龄均无关.但因它们有相似的病因,常同时或相继发生,故对宫颈癌术后发现阴道断端VMN患者应加强随访,以便早期发现阴道浸润癌.

  19. The Investigation and Analysis of HPV Infection in Cervical Intraepithelial Neoplasia and Cervical Carcinoma%人乳头状瘤病毒感染与宫颈病变的相关性分析∗

    Institute of Scientific and Technical Information of China (English)

    卢春冬; 徐燕; 任玉香; 李玉艳; 胡华; 唐帅; 包碧惠

    2014-01-01

    Objective: To investigate 21 HPV genotypes infection in cervical cancer and cervical intraepithelial neoplasia ( CIN) , and the relationship between HPV infections and cervical cancer. Methods:Cases with chronic cervici-tis or abnormal cervical cells detected by liquid-based Thinprep cytology test ( TCT) had 21 HPV genotypes detected and accepted cervical biopsy during colposcopy. HPV infection status in 2 481 cases with cervical carcinoma or cervical intraep-ithelial neoplasia were analyzed. Results: Among 2 481 cases of CIN and cervical carcinoma, HPV-positive patients ac-counted for 85. 0%. There was statistically significant relevance between HPV infection and abnormal cervical histology (P<0. 001, Pearson correlation coefficient=0. 648). HPV16, HPV18 infection were most common in patients with CC and CINⅢ, CINⅡ, followed by HPV58, HPV 33, HPV31, HPV52, HPV45, HPV59, HPV68 subtype infections. In 304 pa-tients who got cervical infection with a subtype of HPV16, HPV18, HPV58, HPV52, HPV33, the incidence of high-grade squamous intraepithelial lesions (HSIL), atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) rose significant (P=0. 002, Pearson correlation coefficient=0. 322). Morover, CC, CIN III and CIN II had a high rate of HSIL, ASCUS. There were significant correlations between abnormal cervical cytology and histological results (P=0. 026, Pearson correla-tion coefficient=0. 172). Conclusion:Infection of high risk HPV types such as HPV16, HPV18, PHV58, HPV33, HPV52, HPV31, HPV45 is the main risk factor of cervical carcinoma ( CC) and precancerous lesion ( CIN) . With high-risk HPV infection, cervical cytologic diagnoses of HSIL, ASCUS and LSIL increase. The correlation between cytological and histological findings for CC and CIN promotes timely detection, prevention, intervention,and effective treatment.%目的::分析宫颈上皮内瘤变( CIN)及宫颈癌( CC

  20. ZNF217在宫颈上皮内瘤变及宫颈癌中的表达及意义%The expression and significance of ZNF217 in human cervical intraepithelial neoplasia and cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    郝汇平; 纪新强; 王晓红

    2014-01-01

    Objective To detect the expressions of zinc finger protein 217 ( ZNF217 ) in human normal cervical epithelium , cervical intraepithelial neoplasia ( CIN) and cervical carcinoma to investigate the roles of ZNF 217 in the carcinogenesis and development of cervical carcinoma, and to provide theoretical basis for clinical diagnosis and therapy .Methods The expressions of ZNF217 were detected by immunohistochemistry SP method in 60 patients with cervical carcinoma ( cervical carcinoma group ) , 18 cases with low grade of cervical intraepithelial neoplasia (CIN Ⅰgroup), 32 cases with high grade of cervical intraepithelial neoplasia (CIN Ⅱ-Ⅲ group) and 20 cases with normal cervical epithelium ( normal group ) .Results ZNF217 was mainly located in cervical cytoplasm .The positive-expression rate of ZNF217 was 25.0%, 33.3%, 50.0% and 81.5% in normal cervical epithelium tissues , CIN Ⅰ tissues, CIN Ⅱ-Ⅲtissues and the tissues of cervical carcinoma , respectively.There was significant difference in the positive-expression rate of ZNF217 between cervical carcinoma group and normal cervical epithelium group , between CINⅠgroup and cervical carcinoma group , between CINⅡ-Ⅲgroup and cervical carcinoma group (χ2 value was 18.755, 12.874 and 7.762, respectively, all P0.05 ).In the cervical carcinoma group , the expression of ZNF217 was correlated with histological grade and lymphatic metastasis (χ2 value was 12.851 and 6.222, respectively, both P0.05).Conclusion High expression of ZNF217 plays an important role in the carcinogenesis and development of cervical carcinoma .%目的:研究ZNF217在宫颈癌、宫颈上皮内瘤变及正常宫颈组织中的表达,探讨ZNF217在宫颈癌的发生、发展中的作用,为宫颈癌的临床诊断和治疗提供重要的理论依据。方法采用免疫组织化学SP法检测ZNF217在60例宫颈癌(宫颈癌组)、18例低度宫颈上皮内瘤变( CINⅠ组)、32例高度宫颈上皮内瘤变( CIN

  1. 云南白药促进宫颈上皮内瘤变宫颈冷刀锥切术后的康复%Yunnan Baiyao for Promoting Postoperative Rehabilitation of Cervical Intraepithelial Neoplasia by Cold Knife Conization

    Institute of Scientific and Technical Information of China (English)

    俞晶; 杨宏英; 张红平

    2013-01-01

    Objective: To observe the clinical effects of Yunnan Baiyao for promoting postoperative rehabilitation of cervical intraepithelial neoplasia by cold knife conization ( CKC ). Method: Ninety-six postoperatives of cervical intraepithelial neoplasia LI by CKC were randomly divided into observation group and control group (n =48 each). CKC postoperative wound was fulgerized and packed with gauze strip for the control group and conventional anti-infection treatment was given for 4 days; CKC postoperative wound was fulgerized and covered with Yunnan Baiyao powder and packed with gauze strip for the observation group and conventional anti-infection treatment was given for 4 days. Yunnan Baiyao capsule was added to the observation group, 2 softgels each time, tid, all for 5 days. Postoperative vaginal drainage time, drainage quantity, vaginal bleeding time, amount of bleeding, decrustation of cervical scab and cervical wound healing was observed in 1 , 2, 5, 8 weeks. Result: Postoperative vaginal bleeding time and average amount of bleeding of the observation group were lower than the control group ( P < 0. 01 ) ; Postoperative vaginal drainage time and average drainage quantity in the observation group were lower than those in control group (P < 0. 01). For the observation group, there was 23 cases after operating 5 weeks and 45 cases after operating 8 weeks of wound healing which were superior to 12 cases and 34 cases of the same period in the control group ( P < 0. 05 ). Cleaning degree of vagina after 5 weeks in the observation group was obviously superior to the control group (P <0. 01) ; there was no obvious difference between the curative effect of the two groups. Conclusion: Postoperatives of cervical intraepithelial neoplasia M by CKC treated with electrocautery and covered wound with Yunnan Baiyao powder, and supplemented with Yunnan Baiyao capsule orally could reduce postoperative complications and promote recovery.%目的:探讨云南白药促进宫颈上皮

  2. 两种宫颈锥切术在围绝经期女性宫颈上皮内瘤变Ⅲ中的效果分析%The Effect Analysis of Two Kinds of Cervical Cone Cutting Technique in Perimenopausal Women Cervical Intraepithelial Neoplasia Ⅲ Change

    Institute of Scientific and Technical Information of China (English)

    刘鹰; 姚旭阳; 陈敬

    2013-01-01

    Objective:To observe the clinical effect of cervical cold knife cone cutting technique and cervical circular electric cutting in the treatment of perimenopausal women cervical intraepithelial neoplasia become Ⅲ level.Methods:200 cases of perimenopausal women cervical intraepithelial neoplasia becomeⅢ stage patients were selected and randomly divided into treatment group and control group,who were given cervical circular electrotomy and cervical cold knife cone cutting operation treatment,observation two sets of patients during operation time,amount of bleeding,postoperative infection and treatment success rate for the first time.Results:The treatment group patients surgical treatment time,intraoperative amount of bleeding were less than control group patients,with significant difference(P0.05).Conclusion:Cold knife cone cutting surgical in treatment of cervical intraepithelial neoplasia become Ⅲ stage postoperative infection probability is small,while round electrotomy is shorter operation time,less intraoperative amount of bleeding,curative effect is similar for two kinds of methodall for the treatment of cervical intraepithelial neoplasia of grade change Ⅲ .%  目的:观察宫颈冷刀锥切术和宫颈环行电切对治疗围绝经期女性宫颈上皮内瘤变Ⅲ级的临床效果.方法:选择笔者所在医院进行治疗的围绝经期女性宫颈上皮内瘤变Ⅲ级患者200例,随机分成治疗组和对照组,分别给予宫颈环行电切术和宫颈冷刀锥切术治疗,观察两组患者的手术时间、术中出血量、术后感染率及首次治疗成功率.结果:治疗组患者手术治疗时间、术中出血量均少于对照组患者,差异有统计学意义(P0.05).结论:冷刀锥切术治疗宫颈上皮内瘤变Ⅲ级术后感染几率较小,环行电切术则手术时间短、术中出血量少,两类方法疗效相似,均为治疗宫颈上皮内瘤变Ⅲ级的有效方法.

  3. CpG Methylation Analysis of HPV16 in Laser Capture Microdissected Archival Tissue and Whole Tissue Sections from High Grade Anal Squamous Intraepithelial Lesions: A Potential Disease Biomarker.

    Science.gov (United States)

    Molano, Monica; Tabrizi, Sepehr N; Garland, Suzanne M; Roberts, Jennifer M; Machalek, Dorothy A; Phillips, Samuel; Chandler, David; Hillman, Richard J; Grulich, Andrew E; Jin, Fengyi; Poynten, I Mary; Templeton, David J; Cornall, Alyssa M

    2016-01-01

    Incidence and mortality rates of anal cancer are increasing globally. More than 90% of anal squamous cell carcinomas (ASCC) are associated with human papillomavirus (HPV). Studies on HPV-related anogenital lesions have shown that patterns of methylation of viral and cellular DNA targets could potentially be developed as disease biomarkers. Lesion-specific DNA isolated from formalin-fixed paraffin-embedded (FFPE) tissues from existing or prospective patient cohorts may constitute a valuable resource for methylation analysis. However, low concentrations of DNA make these samples technically challenging to analyse using existing methods. We therefore set out to develop a sensitive and reproducible nested PCR-pyrosequencing based method to accurately quantify methylation at 10 CpG sites within the E2BS1, E2BS2,3,4 and Sp1 binding sites in the viral upstream regulatory region of HPV16 genome. Methylation analyses using primary and nested PCR-pyrosequencing on 52 FFPE tissue [26 paired whole tissue sections (WTS) and laser capture microdissected (LCM) tissues] from patients with anal squamous intraepithelial lesions was performed. Using nested PCR, methylation results were obtained for the E2BS1, E2BS2,3,4 and Sp1 binding sites in 86.4% of the WTS and 81.8% of the LCM samples. Methylation patterns were strongly correlated within median values of matched pairs of WTS and LCM sections, but overall methylation was higher in LCM samples at different CpG sites. High grade lesions showed low methylation levels in the E2BS1 and E2BS2 regions, with increased methylation detected in the E2BS,3,4/Sp1 regions, showing the highest methylation at CpG site 37. The method developed is highly sensitive in samples with low amounts of DNA and demonstrated to be suitable for archival samples. Our data shows a possible role of specific methylation in the HPV16 URR for detection of HSIL.

  4. 6例分化型外阴上皮内瘤变临床病理观察%Clinicopathologic observation of 6 cases of differentiated-type vulvar intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    张和平; 陈先侠; 解正新; 赵彩霞; 汪勤; 刘婷珽

    2015-01-01

    目的:探讨分化型外阴上皮内瘤变( differentiated-type vulvar intraepithelial neoplasia, dVIN)的临床病理学特征、鉴别诊断、治疗及预后。方法回顾性分析6例dVIN的临床特点、病理形态学和免疫表型特征,并复习相关文献。结果患者均为女性,年龄53~80岁,平均62岁,临床特点大多表现为外阴白斑、激惹、瘙痒、疼痛、溃疡、触血。病理组织学特征表现:基底与副基底层显著增生,上皮角下延、吻合,细胞显著异型,核仁明显,核分裂活跃,伴异常角化;中、表层细胞高度分化,细胞间桥显著,伴明显的胞质嗜酸性改变,表层角化过度与角化不全;邻近上皮真皮水肿与胶原化,带状淋巴细胞浸润,表皮增生与角化过度。免疫表型:p53在dVIN中的阳性率为83.3%(5/6),p16不表达(0/6),dVIN基底层和副基底层细胞Ki-67增殖指数>90%。4例随访时间为6~36个月,平均17个月,其中1例术后9个月死亡,1例术后6个月复发,复发和死亡的2例同时或异时伴浸润性鳞状细胞癌,其余2例术后分别随访18个月和36个月,均无复发。结论 dVIN是一种少见的高级别外阴上皮内病变,具有高的、潜在进展危险性,p53、p16及Ki-67联合使用有助于dVIN的诊断。%Purpose To investigate the clinicopathologic characteristics, differential diagnosis, treatment and prognosis of differentia-ted-type vulvar intraepithelial neoplasia ( dVIN) . Methods Clinicopathologic findings and immunophenotypes of 6 cases diagnosed as“dVIN” were retrospectively analyzed, and the relevant literatures were also reviewed. Results 6 patients were all female ranged 53~80 years old with mean age of 62 years old. Clinical aspects included leukoplakia vulvar, pruitis, irritation, pain, ulcer and so on. The histopathological features were hyperplasia of basal and parabasal layer with elongation and anastomosing reteridges. Cells were marked atypia with obvious nucleoli, atypical

  5. The role of polymerase chain reaction of high-risk human papilloma virus in the screening of high-grade squamous intraepithelial lesions in the anal mucosa of human immunodeficiency virus-positive males having sex with males.

    Directory of Open Access Journals (Sweden)

    Carmen Hidalgo-Tenorio

    Full Text Available To evaluate the advantages of cytology and PCR of high-risk human papilloma virus (PCR HR-HPV infection in biopsy-derived diagnosis of high-grade squamous intraepithelial lesions (HSIL = AIN2/AIN3 in HIV-positive men having sex with men (MSM.This is a single-centered study conducted between May 2010 and May 2014 in patients (n = 201, mean age 37 years recruited from our outpatient clinic. Samples of anal canal mucosa were taken into liquid medium for PCR HPV analysis and for cytology. Anoscopy was performed for histology evaluation.Anoscopy showed 33.8% were normal, 47.8% low-grade squamous intraepithelial lesions (LSIL, and 18.4% HSIL; 80.2% had HR-HPV. PCR of HR-HPV had greater sensitivity than did cytology (88.8% vs. 75.7% in HSIL screening, with similar positive (PPV and negative predictive value (NPV of 20.3 vs. 22.9 and 89.7 vs. 88.1, respectively. Combining both tests increased the sensitivity and NPV of HSIL diagnosis to 100%. Correlation of cytology vs. histology was, generally, very low and PCR of HR-HPV vs. histology was non-existent (<0.2 or low (<0.4. Area under the receiver operating characteristics (AUROC curve analysis of cytology and PCR HR-HPV for the diagnosis of HSIL was poor (<0.6. Multivariate regression analysis showed protective factors against HSIL were: viral suppression (OR: 0.312; 95%CI: 0.099-0.984, and/or syphilis infection (OR: 0.193; 95%CI: 0.045-0.827. HSIL risk was associated with HPV-68 genotype (OR: 20.1; 95%CI: 2.04-197.82.When cytology and PCR HR-HPV findings are normal, the diagnosis of pre-malignant HSIL can be reliably ruled-out in HIV suppression with treatment protects against the appearance of HSIL [corrected].

  6. Correlation between human papillomavirus (HPV) infection and cervical intraepithelial neoplasia after pregnancy%妊娠期HPV病毒感染和宫颈鳞状上皮内瘤变的相关性研究

    Institute of Scientific and Technical Information of China (English)

    金玉; 金华; 张同一; 金丽; 刘芳; 赵静

    2016-01-01

    目的:探讨妊娠期 H PV感染与宫颈鳞状上皮内瘤变风险及病理分级之间关联性,为临床治疗提供参考依据。方法回顾性分析2012年1月-2015年3月在医院门诊就诊的2475名非妊娠妇女,将所有受试者调查期间分未孕随访组2380名,孕后随访组27名;分析HPV感染与宫颈鳞状上皮内瘤变之间的关系,数据采用SPSS 18.0软件进行统计分析。结果本研究共记录了95名妇女在随访期间怀孕,其中27名妇女在产后接受了随访,而另外68名妇女则拒绝妊娠后随访;在27名产后随访对象中,仅出现1例高级别鳞状上皮内瘤变;在未孕组和产后继续随访组的比较中,发现妊娠与低级别鳞状上皮内瘤变和任何等级鳞状上皮内瘤变都无任何关联。结论妊娠与HPV感染、宫颈鳞状上皮内瘤变之间并无显著关联。%OBJECTIVE To investigate the possible relationship of HPV infection and cervical intraepithelial neopla‐sia as well as pathological grading after pregnancy ,so as to provide references for clinical treatment .METHODS A total of 2475 women without pregnancy from Jan .2012 to Mar .2015 were enrolled in the study ,and divided into 2380 cases of unpregnancy follow‐up group and 27 cases of post‐pregnancy follow‐up group .The correlations be‐tween pregnancy and HPV infection or cervical intraepithelial neoplasia were analyzed .The data were analyzed by SPSS 18 .0 .RESULTS Totally 95 women with pregnancy during follow‐up ,27 patients received the whole follow‐up ,and 68 patients with pregnancy refused the follow‐up after childbirth .Only one HSIL case occurred after pregnancy .Likewise ,there was no association between pregnancy and risk of low grade SIL or any‐grade SIL at the next visit .CONCLUSION There was no correlation between pregnancy and HPV infection and LSIL .

  7. 308例宫颈瘤组织中HPV感染基因型分布的对比研究%A comparative study of HPV infection genotypes distribution in 308 cases of cervical intraepithelial neoplasia tissues

    Institute of Scientific and Technical Information of China (English)

    朱晓珏; 耿建祥

    2014-01-01

    目的:比较宫颈上皮内瘤病变(cervical intraepithelial neaplasia,CIN)组织标本中人乳头瘤病毒(human papillomavir-us,HPV)感染的基因型分布情况及其临床意义。方法采用聚合酶链式反应和基因芯片检测技术对53例 CINⅠ、67例 CINⅡ和188例 CINⅢ病变组织标本进行23种 HPV 基因分型检测,并对受检者进行相关资料分析。结果53例 CINⅠ患者检出 HPV感染者29例,总的 HPV 感染率为54.72%(29/53);67例 CINⅡ患者检出 HPV 感染者51例,总的 HPV 感染率为76.12%(51/67);188例 CINⅢ患者检出 HPV 感染者175例,总的 HPV 感染率为93.09%(175/188)。结论 CINⅠ、CINⅡ和 CINⅢ组织中总的 HPV 感染率存在着明显的差异性,聚合酶链式反应与基因芯片检测技术可应用于宫颈组织标本检测,一次可检测23种HPV 基因型别,对我国女性宫颈 HPV 感染的分子流行病学调查、宫颈癌瘤的防治及其疫苗研究具有非常重要的意义。%Objective To compare the distribution situation of human papillomavirus(HPV)genotypes in the tissue specimens of cervical intraepithelial neoplasia(CINⅠ,CINⅡ and CINⅢ)and its clinical significance.Methods The polymerase chain reaction (PCR)and gene-chips technology were utilized for detecting 23 kinds of HPV genotypes in the cervical tissue specimens from 53 ca-ses of CINⅠ,67 cases of CINⅡ and 188 cases of CINⅢ.And the related data of all subjects were analyzed.Results Among 53 ca-ses of CINⅠ,29 cases of HPV infection were detected with the total HPV infection rate of 54.72%9;among 67 cases of CINⅡ,52 cases of HPV infection were detected with the total HPV infection rate of 76.12%;among 188 cases of CINⅢ,175 cases of HPV infection were detected with the total HPV infection rate of 93.09%.Conclusion The significant difference of the total HPV infec-tion rate exists in the tissues of CINⅠ,CINⅡ and CINⅢ.PCR and the gene

  8. Bioinformatics analysis of genes related to the progress of cervical intraepithelial neoplasia%宫颈上皮内瘤变进展相关基因的生物信息学分析

    Institute of Scientific and Technical Information of China (English)

    蒋燕明; 李力

    2016-01-01

    Objective:To investigate the potential genes associated with cervical intraepithelial neoplasia (CIN) progression through mi-croarray expression profiling data analysis and bioinformatics approaches. Methods:mRNA expression microarray data related to CIN progression were screened from GEO database for the first time. They were re-analyzed by bioinformatics analysis. Results: Two mRNA expression microarray datasets were obtained from the GEO database. Pathway enrichment analysis of the common differen-tially expressed genes identified 3 signaling pathways associated with CIN progression, including Wnt, Endocytosis, and Vibrio cholerae infection. Fourteen differentially expressed genes were also identified. Biological annotation and text mining showed that 3 genes were directly related to CIN progression, and 9 other genes were associated with tumor progression and recurrence. GeneMania tool analysis demonstrated the protein interaction network formed between all the differentially expressed genes and the 24 reported genes. CCND2 and TGFBR2 formed direct interaction with many reported genes. Conclusion:Three signaling pathways and 14 differen-tially expressed genes were associated with CIN progression, as indicated by microarray data analysis results.%目的:基于芯片数据采用生物信息学方法,挖掘与宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)进展相关的信号通路和潜在差异表达基因。方法:在GEO数据库中筛选CIN进展相关mRNA表达谱芯片数据,并通过生物信息学方法进行再次分析。结果:在GEO数据库获得GSE63514、GSE51993芯片数据,将共同差异表达基因信号通路富集获得Wnt、Endocytosis、Vibrio cholerae infection与CIN进展显著相关的3条信号通路,及调控这些信号通路的14个差异表达基因。通过生物学注释与文本挖掘,发现3个基因与CIN进展相关,另有9个基因与肿瘤的进展和复发相关。通过GeneMania工具

  9. Uso de mitomicina C tópico no tratamento da neoplasia intra-epitelial córneo-conjuntival e carcinoma espinocelular conjuntival: resultados preliminares Topical use of mitomycin C for the treatment of corneal-conjunctival intraepithelial neoplasia and conjunctival squamous cell carcinoma: preliminary results

    Directory of Open Access Journals (Sweden)

    Priscilla Luppi Ballalai

    2003-10-01

    Full Text Available OBJETIVO: Avaliar a segurança, a eficácia e a recidiva tumoral após o uso de mitomicina C (MMC tópica no tratamento de neoplasias intra-epiteliais (NIC primárias e recidivadas e carcinomas espinocelulares (CEC recidivados. MÉTODOS: Dois grupos de pacientes foram tratados. Grupo 1 com diagnóstico de NIC primário ou recidivado fez uso do colírio de MMC 0,02%, 4 vezes ao dia por 28 dias. O grupo 2 com diagnóstico de CEC recidivado fez uso do colírio de MMC 0,02%, 4 vezes ao dia por 21 a 28 dias. Após o término do tratamento era feita citologia exfoliativa para controle ou biópsia nos casos de lesão residual. RESULTADOS: Oito pacientes com NIC e 1 com CEC mostraram regressão total da lesão e citologia exfoliativa de controle negativa para células neoplásicas. Em 1 paciente com NIC e 2 com CEC, houve regressão parcial das lesões, tendo sido necessária exérese cirúrgica da lesão residual, com exame anatomopatológico negativo para neoplasia. Os efeitos colaterais foram transitórios e desapareceram após a suspensão do colírio. Não houve recidiva tumoral num seguimento médio de 24,9 meses. CONCLUSÃO: Os resultados preliminares desse estudo su-gerem que o uso da MMC tópica é opção segura e eficaz como tratamento único de NIC primária ou recidivada e no tratamento do CEC recidivado, porém não evitando a cirurgia na maioria dos pacientes com CEC. Não foram observadas recidivas tumorais durante o segmento. Mais estudos são necessários, com maior número de pacientes e maior tempo de seguimento para confirmar esses resultados.PURPOSE: The purpose of this study is to evaluate the safety, efficacy and recurrence after topical use of mitomycin C (MMC for primary or recurrent corneal-conjunctival intraepithelial neoplasia (CIN and recurrent squamous cell carcinoma (SCC. METHODS: Two groups of patients were trated. Group 1 patients with primary or recurrent CIN were treated with topical 0.02% MMC, qid for 28 days. Group

  10. The biological features of pancreatic intraepithelial neoplasia arising from endogenous activated Kras%Kras突变小鼠胰腺癌前病变PanIN细胞的生物学特性

    Institute of Scientific and Technical Information of China (English)

    王立夫; David A.Tuveson

    2006-01-01

    背景与目的:胰腺腺管内上皮瘤(pancreatic intraepithelial neoplasia,PanIN)是近几年提出的新术语,目前对其缺乏足够认识.在首次建立小鼠PanIN细胞系的基础上探索Kras突变小鼠PanIN细胞的生物学特性.方法:通过免疫组化分析基因打靶KrasG12D突变小鼠PanIN组织,分离和建立LoxP-Stop-LoxP-KrasG12D;Pdx1-Cre产生的小鼠PanIN细胞系,鉴定其体外贴壁依赖性生长及在软琼脂半固体培养基中集落形成,对PanIN细胞中抑癌基因Tp53、Smad4、p16进行突变分析.结果:KrasG12D激活突变产生了各期小鼠胰腺癌前病变-胰腺腺管内上皮瘤(PanIN);PanIN细胞的胞浆和核中的磷酸化MAPK染色强阳性和高表达,EGFR、Her-2/Neu、和β-Catenin在PanIN细胞中也表现了高表达,Tp53在早期PanIN细胞和Smad4在各期PanIN细胞中的表达无异常;PanIN细胞在体外培养中的增殖速度与原发胰腺癌相似,并且能在软琼脂中形成光学显微镜下所见的集落,随着培养时间的延长而集落增大;PanIN细胞中除可检测到KrasG12D突变外无p16、Tp53、Smad4突变或缺失.结论:单纯Kras的激活突变足以启动PanIN,是胰腺癌发生的早期主要分子遗传学改变事件,PanIN细胞已在一定程度上具备了恶性转化的肿瘤细胞的生物学特性.

  11. 城镇妇女宫颈上皮内瘤变高危因素流行病学调查%Epidemiological survey of high risk factors for cervical intraepithelial neoplasia in women

    Institute of Scientific and Technical Information of China (English)

    曹树军; 钱金风; 朱凌; 万小平

    2008-01-01

    One hundred and twenty-two patients with confirmed cervical intraepithelial neoplasia (CIN), as a result of occasional screening for uterine cervix cancer in our out-patient clinic between July 2006 and August 2007, and 122 control patients with cervicitis who received colposcopy during the same period were enrolled in this study. Our results showed that 72% participants didn't receive uterine cervix cancer screening during the past 2 years; 55% women had premarital sexual behavior. CIN was most commonly seen in 30 to 34 year old women. Occasional screening could identify 75% CIN. In comparison with the control group, the incidence of earlier first sexual behavior, marriage, and delivery, multiple pregnancy, and frequent abortion was significantly increased in the study group (P < 0.05). We suggest that increased access to uterine cervix cancer screening might be more important than technical improvement.%将2006月7日至2007年8月在门诊开展宫颈癌机会性筛查确诊为宫颈上皮内瘤变(CIN)122例患者作为调查对象(CIN组),并取同期宫颈炎症患者122例作对照组,开展流行病学问卷调查.结果表明,72%的妇女2年内未做过宫颈癌筛查;55%的妇女有婚前性行为;CIN发病高峰集中在30~34岁;75%的CIN是通过机会性筛查确诊;CIN组初次性交年龄早、早婚、早育、多次妊娠、多次流产者明显高于对照组(P<0.05).提示加强门诊宫颈癌机会性筛查,扩大受益人群比改进筛查技术更重要.

  12. Distinctive association of p16INK4a overexpression with penile intraepithelial neoplasia depicting warty and/or basaloid features: a study of 141 cases evaluating a new nomenclature.

    Science.gov (United States)

    Chaux, Alcides; Pfannl, Rolf; Lloveras, Belén; Alejo, María; Clavero, Omar; Lezcano, Cecilia; Muñoz, Nubia; de Sanjosé, Silvia; Bosch, Xavier; Hernández-Pérez, Marier; Velazquez, Elsa F; Cubilla, Antonio L

    2010-03-01

    From the pathogenic point of view, penile cancers may be grouped in human papillomavirus-related and unrelated tumors, each one of them with distinctive morphologic features. The former are predominantly composed of small, undifferentiated basaloid cells, with more or less prominent koilocytic changes, and the latter of keratinizing differentiated squamous cells. The same cellular types are observed in precancerous lesions. On the basis of these observations, we constructed a novel nomenclature for penile precancerous lesions and classified them as penile intraepithelial neoplasia (PeIN) of differentiated, warty, basaloid, and warty-basaloid types. The aim of this study was to test the usefulness of immunohistochemical p16 overexpression, considered as a surrogate for high-risk human papillomavirus infection, using this classification system. We pathologically evaluated 141 patients with PeIN, associated (123 cases) and unassociated (18 cases) with invasive cancer. Distribution of PeIN types was: differentiated, 72%; basaloid, 9%; warty-basaloid, 7%; warty, 4%; and mixed, 7%. There was a striking similarity in the morphology of in situ and invasive squamous cell carcinomas. Differentiated PeIN was commonly associated with usual, verrucous, papillary, and other low-grade keratinizing variants of squamous cell carcinoma whereas in basaloid and warty carcinomas the presence of in situ lesions with similar morphology was habitual. We evaluated p16 overexpression using a 4-tiered (0, 1, 2, and 3) pattern-based system. To properly distinguish differentiated PeIN from in situ lesions with warty and/or basaloid features only pattern 3, which requires full-thickness staining in all epithelial cells, was considered positive. Using this approach, there was a significant association of the negative patterns and differentiated PeIN and of the positive pattern and warty, basaloid, and warty-basaloid PeIN (P<0.0001). Basaloid variant had the strongest association. The sensitivity

  13. 宫颈环形电切术治疗宫颈上皮内瘤样病变的临床观察%Clinical observation of loop electrosurgical excision procedure for the treatment of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    李艳兵; 郭瑞宝; 谢洪芹

    2009-01-01

    目的 探讨宫颈环形电切术(LEEP)治疗宫颈上皮内瘤样病变(CIN)的临床效果.方法 回顾性分析近2年来我院应用LEEP诊治67例CIN患者的临床资料.结果 本组65例患者术后3~7 d宫颈创面逐渐脱痂,第10 d有少量出血,20 d后阴道排液逐渐减少,1个月创面愈合95%.术后病理结果:23例CINⅡ级患者中1例上升为CIN Ⅲ级,25例CIN Ⅲ级患者中1例为原位癌,原位癌6例中1例为浸润癌.术后对所有患者进行随访,时间至少6个月,术后患者创面愈合好,阴道排液量减少,月经周期、经期无改变.结论 LEEP具有操作简单、出血少、时间短、术后恢复快的特点,在CIN临床诊断和治疗上具有重要的使用价值.%Objective To explore the clinical observation of loop electrosurgical excision procedure for (LEEP) the treatment of cervical intraepithelial neoplasia(CIN). Methods The clinical data were analyzed retro-spectively. 67 patients recieved LEEP and CIN for diagnosis and therapy. Results The cervical wound in 65 cases of patients scabbed off gradually 3 ~ 7 days after surgery and article 10 d a small amount of bleeding occurred on the 10th day. After 20 days vaginal discharge gradually decreased. 1-month wound healing rate was 95%. results of pathology showed that 1 of 23 cases of CIN Ⅱ raised CIN Ⅲ. One of 25 cases of CIN Ⅲ proved to be carcinoma in situ in. One of 6 cases of carcinoma in situ case proved to be invasive carcinoma. Conclusion LEEP is a simple operation with little bleeding and quick postoperative recovery, showing an important value for the clinical diagnosis and treatment of CIN.

  14. Survey on types and risk factors of HPV infection among 9 328 persons with cervical intraepithelial neoplasia in Chongqing%重庆市9328例宫颈上皮内病变HPV感染型别及危险因素调查

    Institute of Scientific and Technical Information of China (English)

    严园; 周晓

    2014-01-01

    目的:了解重庆市宫颈上皮内病变中高危型人乳头瘤病毒(H PV )感染型别和危险因素,为宫颈癌的防治提供依据。方法选取2012年6月至2013年12月于重庆市多家医院就诊并做宫颈癌液基细胞学筛查的患者做 HPV分型成功9328例,统计分析不同等级宫颈上皮内病变中HPV感染主要型别,确定危险因素。结果 HPV16是重庆地区最常见的感染型别,其次为HPV52、58、33、18,性伴侣多、第一次性生活年龄小、人工流产等因素是HPV感染的危险因素。结论重庆市不同宫颈病变人群中HPV感染主要以单一型别、高危型感染为主,宫颈细胞学病变级别越高HPV感染率越高。对于HPV感染的危险因素应加强宣教,有助于预防宫颈癌的发生。%Objective To understand the types and risk factors of human papillomavirus (HPV ) infection among the patients with cervical intraepithelial neoplasia in Chongqing to provide a scientific basis for prevention and treatment of cervical cancer . Methods The patients with TCT screening in many hospital of Chongqing from June 2012 to December 2013 were selected and performed the HPV typing ,9 328 cases succeeded in HPV typing .The main types of HPV infection in different grades of cervical intraepithelial neoplasia were statistically analyzed for determining the risk factors .Results HPV16 was the most common infection type among patients with cervical intraepithelial neoplasia in Chongqing area ,followed by HPV52 ,58 ,33 ,18 .Some factors such as multiple sex partners ,young female with sexual debut and induced abortion were the risk factors of HPV infection .Conclusion Single and high-risk type is the main feature of HPV infection among the patients with cervical intraepithelial neoplasia in Chongqing .The infection rate is higher with the higher grade of cervical intraepithelial neoplasia .Publicity and education for risk factors of HPV infection should be strengthened

  15. 外阴上皮内肿瘤形成20例临床病理学观察%Vulvar intraepithelial neoplasia: a clinicopathologic study of twenty cases

    Institute of Scientific and Technical Information of China (English)

    丁效蕙; 回允中; 卢立军; 杨哲存; 姚婵娟; 孙丽娟; 陈志华; 石峥

    2012-01-01

    Objective To investigate the clinical,pathological and immunohistochemical features of vulvar intraepithelial neoplasia (VIN).Methods According to the 2004 modified terminology of International Society for the Study of Vulvovaginal Diseases (ISSVD),the cases were diagnosed as VIN from patients who had performed vulvar biopsy in Beijing Wuzhou Women's Hospital from February 2009 to December 2011,which were reclassified as usual VIN and differentiated VIN.The clinical and pathological studies were conducted respectively.MaxVision immunohistochemical staining was used to detect the expression of Ki-67,pl6 and p53 proteins.Results There were 20 cases of VIN in 237 patients,and the incidence of VIN was 8.4% in all of contemporary vulvar biopsy.In 17 cases of usual VIN,mean age was 29.6 years,the lesion typically presented with atypical cells involving almost all layers of the epithelium,which was equivalent to the higl-grade squamous intraepithelial neoplasia of cervix.Immtmohistochemistry for Ki-67 and p16 was strongly positive in usual VIN.High risk human papillomavirus (HPV) detection was also positive.The incidence of differentiated VIN was less than usual VIN,and there were only 3 cases in this study.In differentiated VIN,patients aged over 50 years,with mean of 53.7 years,and the lesion most commonly presented with lichen sclerosis background.There were epithelial thickening and extending,and parakeratosis,and atypia was strictly confined to the basal and parabasal layers of the epithelium where the cells enlarged with abundant eosinophilic cytoplasm,presented with prominent nucleoli,increased cellularity and abnormal keratinization.In differentiated VIN,p53 was strongly positive,Ki-67 and p16 immunohistochemical expression was confined to the basal layer only.Conclusions VIN is a precursor of invasive squamous cell carcinoma of the vulva.The modified terminology of ISSVD classifies VIN as highgrade lesions.Definitive pathological diagnosis of VIN plays an

  16. The follow-up research and clinical features on vaginal intraepithelial neoplasia%阴道上皮内瘤变患者的临床特征及随访结果研究

    Institute of Scientific and Technical Information of China (English)

    沈谷群; 董岩; 周萍; 李芬; 程静新

    2015-01-01

    目的:探讨阴道上皮内瘤变(VAIN)患者的临床特征及随访结果。方法对新疆医科大学附属肿瘤医院2008年1月-2013年12月就诊的53例 VAIN 患者的临床资料进行回顾性分析。结果(1)53例 VAIN患者中高危型人乳头瘤病毒(HPV)阳性47例(88.68%);其中宫颈鳞状细胞癌病史36例,宫颈上皮内瘤变(CIN)病史17例。(2)VAIN Ⅰ级患者的发病年龄为(49.75±8.43)岁,低于 VAIN Ⅱ/Ⅲ级患者的(58.37±9.10)岁,差异有统计学意义(P <0.05)。(3)VAIN Ⅰ级患者干扰素栓治疗和 VAIN Ⅱ/Ⅲ级患者阴道病灶局部扩切术后阴道切缘均无病灶残留。(4)随访4~70个月,随访至2014年3月,VAIN Ⅰ级患者中有2例病灶持续存在,1例进展至 VAINⅡ级;VAIN Ⅱ/Ⅲ级患者中有2例复发,1例阴道鳞状上皮癌,均存在高危型 HPV 持续感染。结论VAIN 发病与高危型 HPV 感染密切相关,与宫颈鳞状细胞癌及 CIN 病史有相关性;阴道病灶局部扩切术治疗高级别 VAIN 疗效较好;高危型 HPV 持续感染是术后复发及进展的高危因素。%Objection To analyze the clinical features and follow-up of women with vaginal intraepithelial neoplasia (VAIN).Methods A retrospective chart review was performed that encompassed patients with VAIN at Affiliated Tumor Hospital of Xinjiang Medical University from Jan 2008 to Dec 2013.Results Of 47 patients,88.68% had high-risk human papilloma virus (HR-HPV)infection.Of 36 cases underwent cervical squamous cell carcinoma and 17 cases did cervical intraepithelial neoplasia (CIN).The mean age was significantly different (P =0.013)between the patient with VAIN I (49.75 ± 8.43)and them with VAINⅡ/Ⅲ (58.37 ± 9.10).Patients with VAIN I get treatment of Interferon suppository,and others with VAINⅡ/Ⅲ were treated in the wide local excision.The patient was followed up to Mar.2013,the pe-riod for 4 months

  17. Pancreatic intraepithelial neoplasia and ductal adenocarcinoma induced by DMBA in mice: effects of alcohol and caffeine Neoplasia pancreática intraepithelial e adenocarcinoma ductal induzidos pelo DMBA em camundongos: efeitos do álcool e da cafeína

    Directory of Open Access Journals (Sweden)

    Luiz Roberto Wendt

    2007-06-01

    Full Text Available PURPOSE: To evaluate the effects of alcohol and caffeine in a pancreatic carcinogenesis mouse model induced by 7,12-dimethylbenzantracene (DMBA, according to the PanIN classification system. METHODS: 120 male, Mus musculus, CF-1 mice were divided into four groups. Animals received either water or caffeine or alcohol or alcohol + caffeine in their drinking water. In all animals, 1 mg of DMBA was implanted into the head of the pancreas. After 30 days, euthanasia was performed; excised pancreata were then fixed in formalin, stained with hematoxylin-eosin and categorized as follows: normal ducts, reactive hyperplasia, PanIN-1A, PanIN-1B, PanIN-2, PanIN-3 or adenocarcinoma. RESULTS: PanIN lesions were verified in all groups. Adenocarcinoma was detected in 15% of animals in the caffeine group, 16.6% in the water group, 23.8% in the alcohol + caffeine group and 52.9% in the alcohol group (POBJETIVO: Avaliar os efeitos do álcool e da cafeína na carcinogênese pancreática induzida pelo 7,12-dimetilbenzantraceno (DMBA em camundongos, descrevendo as lesões de acordo com a classificação das neoplasias pacreáticas intraepiteliais (PanIN. MÉTODOS: 120 camundogos machos, Mus musculus, CF-1 foram divididos em quatro grupos. Animais receberam água ou cafeína ou álcool ou álcool + cafeína para beber. Em todos animais, 1 mg de DMBA foi implantado na cabeça do pâncreas. Após 30 dias, eutanásia foi realizada, o pâncreas foi removido, fixado em formalina e corado com hematoxilina e eosina sendo classificado em: ductos normais, hiperplasia reativa, PanIN-1A, PanIN-1B, PanIN-2, PanIN-3 ou adenocarcinoma. RESULTADOS: Neoplasias pancreáticas intraepiteliais foram encontradas em todos grupos. Adenocarcinoma foi detectado em 15% dos animais do grupo cafeína, 16,6% do grupo água, 23,8% do grupo álcool + cafeína e 52,9% do grupo álcool (P<0,05. CONCLUSÕES: O modelo experimental de carcinogênese pancreática em camundongos utilizando DMBA induz

  18. Conjunctival intraepithelial neoplasia with corneal furrow degeneration

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    Pukhraj Rishi

    2014-01-01

    Full Text Available A 68-year-old man presented with redness of left eye since six months. Examination revealed bilateral corneal furrow degeneration. Left eye lesion was suggestive of conjunctival squamous cell carcinoma, encroaching on to cornea. Anterior segment optical coherence tomography (AS-OCT confirmed peripheral corneal thinning. Fluorescein angiography confirmed intrinsic vascularity of lesion. Patient was managed with "no touch" surgical excision, dry keratectomy without alcohol, cryotherapy, and primary closure. Pathologic examination of removed tissue confirmed clinical diagnosis. Management of this particular case required modification of standard treatment protocol. Unlike the alcohol-assisted technique of tumor dissection described, ethyl alcohol was not used for risk of corneal perforation due to underlying peripheral corneal thinning. Likewise, topical steroids were withheld in the post-operative period. Three weeks post-operatively, left eye was healing well. Hence, per-operative usage of absolute alcohol and post-operative use of topical steroids may be best avoided in such eyes.

  19. 宫颈上皮内瘤变与宫颈癌患者人乳头状瘤病毒感染的临床分析%Clinical analysis of cervical intraepithelial neoplasia and human papillomavirus infection in cervical cancer patients

    Institute of Scientific and Technical Information of China (English)

    揭伟霞; 薛武进; 史志华; 李婷; 刘伍高

    2016-01-01

    目的 宫颈上皮内瘤变及宫颈癌患者人乳头状瘤病毒(HPV)感染的临床分析,为宫颈上皮内瘤变和宫颈癌患者的临床检测以及防治提供依据.方法 选取2010年1月-2015年1月128例在医院进行诊治的宫颈上皮内瘤变和宫颈癌患者进行HPV感染亚型调查,随机分为试验组与对照组,每组各64例;观察两组患者的HPV检出的临床特点.结果 试验组64例患者中单一型HPV感染41例,多重型HPV感染23例;对照组64例患者中单一型HPV感染44例,多重型HPV感染20例,两组比较差异无统计学意义;在128例宫颈上皮内瘤变及宫颈癌患者中检出率较高的HPV类型有HPV16型54株 、HPV58型17株 、HPV33型16株 、HPV52型9株 、HPV18型8株 、HPV31型8株;各级宫颈上皮内瘤变和宫颈癌患者中高危险HPV感染检出率较低,低危型HPV感染检出率较高.结论 宫颈上皮内瘤变和宫颈癌患者中的HPV感染率较高,可以使用导流杂交技术检测方法对HPV亚型进行检测,对于临床预防宫颈上皮内瘤变以及宫颈癌等方面的疾病具有重要的意义.%OBJECTIVE To investigate the cervical intraepithelial neoplasia and human papillomavirus (HPV) infec-tion in cervical cancer patients so as to provide guidance for clinical detection and prevention of the cervical intraep-ithelial neoplasia and cervical cancer .METHODS A total of 128 cervical intraepithelial neoplasia and cervical cancer patients who were treated in the hospital from Jan 2010 to Jan 2015 were enrolled in the study ,then the subtypes of HPV infection were investigated ,the enrolled patients were randomly divided into the experimental group and the control group ,with 64 cases in each .The clinical characteristics of detection of HPV were observed and com-pared between the two groups of patients .RESULTS Of the 64 patients in the experimental group ,41 had single type HPV infection ,and 23 had multiple types of HPV infection .Of the 64 patients in the

  20. The expression of SHH signaling pathway in cervical cancer or cervical intraepithelial neoplasia cells and its significance%SHH信号通路在宫颈癌或宫颈上皮内瘤变细胞中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    阿艳妮; 江敏; 汤云; 刘维琴

    2016-01-01

    Objective To investigate the expression and significance of Shh,Ptch,Smo protein and its downstream transcription factors Glil,Gli2,Gli3 protein in Sonic hedgehog signaling pathway in cervical cancer or cervical intraepithelial neoplasia.Method Sonic hedgehog signaling pathway expression in 57 cases of normal cervical epithelium (NC),86 cases of cervical intraepithelial neoplasia (CIN) tissues,137 cases of cervical squamous cell carcinoma (SCC) tissues were detected by immunohistochemical method.Results The expression of Shh,Ptch,Smo protein and its downstream transcription factors Glil,Gli2 and Gli3 protein in normal cervical tissues,cervical intraepithelial neoplasia tissue and cervical cancer tissue showed a gradual upward trend,with statistically significant difference among three groups (P<0.05).The expression of Shh,Ptch and Smo protein in cervical carcinoma were positively correlated with lymph node metastasis (P<0.01).Conclusion The high activation of Sonic hedgehog signaling pathway in cervical cancer patients is closely related to the occurrence and metastasis of cervical cancer.%目的 探讨Sonic hedgehog(SHH)信号通路中Shh、Ptch、Smo蛋白及其下游转录因子Gli1、Gli2、Gli3蛋白在宫颈癌或宫颈上皮内瘤变细胞中的表达及其意义.方法 采用免疫组织化学方法分别检测57例正常宫颈上皮组织(NC),86例宫颈上皮内瘤变组织(CIN),137例子宫颈鳞状细胞癌组织(SCC)中Sonic hedgehog信号通路的表达.结果 Shh、Ptch、Smo蛋白及其下游转录因子Gli1、Gli2、Gli3蛋白在正常宫颈组织、宫颈上皮内瘤变组织及宫颈癌组织的表达呈逐渐上升趋势,三组比较差异有统计学意义(P<0.05),Shh、Ptch、Smo蛋白在宫颈癌中的表达与淋巴结转移成正相关(P<0.01).结论 Sonic hedgehog信号通路在宫颈癌患者体内高度激活与宫颈癌的发病、转移密切相关.

  1. Application of colposcopy in diagnosing cervical intraepithelial neoplasia and cervical cancer%阴道镜检查在宫颈上皮内瘤变及宫颈癌诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    袁靖君

    2012-01-01

    Objective: To explore the value of colposcopy in the diagnosis of cervical diseases. Methods; A total of 5,833 patients were examined with Thinprep Cytologic Test(TCT) in the Third Hospital of Datong Colliery Corporation, Shanxi Province from Jul. 2006 to Oct. 2010. Two hundred and sixty-three patients with TCT positive were selected to do the electronic colposcopy test and the pathological examination of biopsy at the same time. Results: Among two hundred and sixty-three patients with TCT positive and cervical lesions, there were 37 cases of chronic cervicitis; 181 cases of cervical intraepithelial neoplasia (CIN) including 93 cases of CINⅠ, 50 cases of CINⅡ and 38 cases of CINⅢ; and 45 cases of cervical cancer according to colposcopy examination diagnosis. There were 36 cases of chronic cervicitis; 180 cases of CIN including 97 cases of CINⅠ, 46 cases of CINⅡ and 37 cases of CINⅢ; and 47 cases of cervical cancer according to the pathological examination results. Colposcopy examination in the diagnosis of CIN and cervical cancer showed that sensitivity was 97. 8%, specificity 94. 4%, accuracy 92. 2%, positive predictive 99. 1% and negative predictive 91. 9%. For patients with cervical cancer and CIN, the diagnostic accordance rate with colposcopy and pathological examination was more than 90%. Conclusions: Colposcopy has the great value in early diagnosis and treatment of cervical precancerous lesions, reducing the cervical cancer incidence.%目的 探讨阴道镜检查在宫颈疾病诊断中的应用价值. 方法 对2006年7月至2010年10月我院5,833例进行阴道脱落细胞液基薄层细胞学检查(TCT)呈阳性的患者263例行电子阴道镜检查,并在阴道镜下行定点多点宫颈活组织病理学检查. 结果 263例TCT阳性宫颈病变患者中,阴道镜检查诊断结果为慢性宫颈炎37例;宫颈上皮内瘤变(CIN)181例,其中CIN Ⅰ 93例,CIN Ⅱ 50例,CIN Ⅲ 38例;宫颈癌45例.经宫颈活组织病理学检查

  2. 阴道镜联合MRI对宫颈癌及宫颈上皮内瘤变的诊断价值%Colposcopy Combined MRI in the Diagnosis of Cervical Cancer and Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    刘占东; 张凌慧

    2015-01-01

    目的:探讨阴道镜联合MRI对宫颈癌及宫颈上皮内瘤变的诊断价值。方法对574例进行宫颈癌筛查的患者,采用阴道镜及活检方法进行宫颈病变检测,活检病理检测结果为宫颈癌的患者进行MRI诊断检测,诊断后行手术病理分期检测,对比各个检测结果。结果阴道镜诊断宫颈病变总正确率为85.02%,诊断CIN的正确率为90.48%,诊断宫颈癌的正确率为100%,阴道镜诊断灵敏度为82.89%,特异性为92.61%,误诊率为7.39%,漏诊率为17.11%;MRI诊断检出率为96.87%。与手术病理分期比较,MRI病理分期符合率81.25%高于临床病理分期符合率62.50%,P<0.05,差异具有统计学意义。结论阴道镜对宫颈病变诊断具有较高的正确率,可作为筛查宫颈癌的有效方法,MRI对早期宫颈癌病理分期符合率优于临床病理分期,可为早期宫颈癌治疗方案提高有效的依据。%Objective To explore the diagnostic value of colposcopy combined with MRI on cervical cancer and cervical intraepithelial neoplasia. Methods 574 cases of cervical cancer screening of patients with colposcopy and biopsy method for detection of cervical lesions, biopsy pathological examination results for MRI diagnostic test for cervical cancer patients after operation pathologic staging diagnosis, detection, and various test results contrast. Results The colposcopy in the diagnosis of cervical lesions: the total accuracy rate was 85.02%, the diagnostic accuracy rate of CIN was 90.48%, the correct rate of diagnosis of cervical cancer was 100%; colposcopy diagnostic sensitivity was 82.89%, speciifcity was 92.61%, the misdiagnosis rate was 7.39%, the misdiagnosis rate was 17.11%;the detection rate of MRI diagnosis 96.87%; compared with the operation and pathological MRI staging, pathological staging rate 81.25% was higher than the clinical pathological staging rate 62.50%, P<0.05, had difference statistically significance

  3. Investigation of diagnosis and treatment method of cervical intraepithelial neoplasiaUAN Xiao-yan%探讨宫颈上皮内瘤样病变的诊断及治疗方法

    Institute of Scientific and Technical Information of China (English)

    袁小燕

    2014-01-01

    Cervical intraepithelial neoplasia (CIN) refers to continuously precancerous lesions process from cervical epithelial atypical hyperplasia to carcinoma in situ. In recent years, the morbidity rates of CIN and cervical cancer have increased, and the patients tend to be younger. Therefore, it is important to have CIN correctly diagnosed and properly treated. The traditional Pap smear, thinprep cytology test (TCT), examination of human papilloma virus (HPV), colposcopy test, and cervical biopsy are the main diagnosing methods of CIN. Due to the features of high accuracy, non-invasion, and repeatable operation, colposcopy is the major method in diagnosis of cervical lesions. The common CIN treatment methods include physical therapy and operation therapy. CO2 laser therapy, cryotherapy, and electric coagulation therapy are included in the physical therapy, and cervical conization and hysterectomy are the operation therapy. Loop electrosurgical excision procedure (LEEP) has become the main treatment method for precancerous lesions of cervical cancer and early-stage cervical cancer, because of its characteristics of short treatment time, simple operation, less damage, deeper and wider range of lesions treatment, and pathological examination of the resected tissues.%宫颈上皮内瘤样病变(CIN)是指子宫颈上皮非典型增生至原位癌这一系列癌前病变的连续过程,近年CIN及宫颈癌的发病率增加且患者年龄趋于年轻化,因此及时正确诊断CIN并得到合适的治疗尤为重要。CIN的诊断有传统巴氏涂片法、液基细胞学(TCT)检查、人乳头瘤病毒(HPV)检查、阴道镜检查、宫颈活检等多种方法,其中阴道镜因其准确性高、无创伤、可重复操作等特点,是目前诊断宫颈病变的重要方法。常用的CIN治疗方法有物理治疗和手术治疗。物理治疗方法包括CO2激光治疗、冷冻治疗、电凝治疗等。手术治疗包括宫颈锥切术和全子宫切除术等

  4. Clinical curative effect analysis of Loop electrosurgical excision in treatment of cervical intraepithelial neoplasia%宫颈电环切术治疗宫颈上皮内瘤变临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    戴萍; 王琳

    2012-01-01

    OBJECTIVE To investigate the efficacy and safety of cervical loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia (CIN). METHODS From 2009 January -2011 year in December, 79 CIN patients were selected from department of gynaecology. Patients were divided into two groups by the methods of grouping, including 47 cases with line loop electrosurgical excision (electrocautery group) , 32 cases in cervical cold knife conization (cold knife group). The treatment efficacy of the two groups was compared. RESULTS The diagnosis coincidence rate was 83.54% by comparing preoperative and postoperative pathological examination results; The electric knife set and cold knife group in the operation time, postoperative bleeding, the incidence of adverse reactions did not show significantly different (P > 0.05). The amount of intraoperative bleeding and wound full time to crust electrocautery group was significantly shorter than the cold knife group (P < 0.05); After 3 months of cervical recovered smooth state, cervical liquid based cytological results were returned to normal (100%). CONCLUSION The cervical loop electrosurgical. Excision procedure in the treatment of CIN is safe and effective, which is effective in the treatment of CIN means.%目的 探讨宫颈电环切术在治疗宫颈上皮内瘤变(CIN)的疗效及其安全性.方法 选取在2009年1月-2011年12月期间某院妇科门诊共诊治CIN患者79例,按照患者手术方法分组,其中行宫颈电环切术患者47例(电刀组),行宫颈冷刀锥切术者32例(冷刀组),比较治疗疗效.结果 术前与术后病理检查结果比较,前后诊断符合率83.54%;电刀组与冷刀组在手术时间、术后出血时间、不良反应发生率比较差异无统计学意义(P>0.05),术中出血量及创面完全结痂时间电刀组明显短于冷刀组,比较差异有统计学意义(P<0.05);术后3个月复查宫颈均恢复光滑状态,宫颈液基细

  5. LEEP刀治疗宫颈上皮内瘤变后对妊娠分娩方式的影响研究%The impact of LEEP knife treatment of cervical intraepithelial neoplasia on pregnancy and delivery mode

    Institute of Scientific and Technical Information of China (English)

    高青翠

    2013-01-01

    目的 探讨LEEP刀治疗宫颈上皮内瘤变(CIN)后对妇女妊娠结局及分娩方式的影响.方法 选取我院2009年1-12月行CIN LEEP手术,2011年12月前正常妊娠妇女共58例,列入研究组另随机选取2010年1月至2011年12月无LEEP治疗CIN手术史的健康妊娠妇女60例,列入对照组.回顾性分析研究患者妊娠情况、两组受试者分娩方式、妊娠结局等.结果 研究组患者流产率、阴道分娩率和剖宫产率与对照组比较差异均无统计学意义(P均>0.05).研究组患者早产率(12.07%)明显高于对照组(1.67%),数据经统计学比较差异有统计学意义(x2 =5.049,P<0.05);研究组胎膜早破、产生宫颈裂伤、产后出血、新生儿低体重和新生儿窒息发生率与对照组比较差异均无统计学意义(P均>0.05).结论 LEEP刀治疗CIN后对分娩方式无明显影响,对妊娠结局影响不大,但可能增加早产发生率,对于有CIN经LEEP手术史的妊娠妇女应加强管理.%Objective A retrospective analysis was conducted to explore the impact of LEEP knife treatment of cervical intraepithelial neoplasia (CIN) on women's pregnancy outcomes and modes of delivery.Methods Fifty-eight women were recruited as the experimental group from our hospital.They accepted LEEP surgery for treatment of CIN during 2009 and became pregnant before December 2011.Sixty pregnant women without history of LEEP surgery were randomly selected as the control group from January 2010 to December 2011.A retrospective analysis of the study groups was conducted to investigate the pregnancy situations,two-wire receiver modes of delivery and pregnancy outcome of participants.Results There was no significant difference between the two groups on rates of abortion,vaginal delivery and cesarean section (P > 0.05).The experimental group had significantly higher rates of preterm birth than control group (12.07% vs.1.67%,x2 =5.049,P < 0.05).No significant difference was observed

  6. Prevalência de lesões intraepiteliais em atipias de significado indeterminado em um serviço público de referência para neoplasias cervicais Prevalencia de lesiones intraepiteliales en atipias de significado indeterminado en un servicio público de referencia para neoplasias cervicales Prevalence of atypical squamous cell intraepithelial lesions of undetermined significance in a public health referral service for cervical cancer

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    Railda Fraga Costa

    2011-01-01

    Full Text Available OBJETIVOS: Determinar a prevalência de lesões intraepiteliais de baixo e alto grau, em mulheres com diagnóstico colpocitológico de atipias de significado indeterminado no Município de Maceió, Alagoas. Conhecer a influência da idade e dos agentes etiológicos para doenças sexualmente transmissíveis sobre o risco de desenvolvimento das lesões intraepiteliais de baixo e alto grau. MÉTODOS: Estudo transversal de prevalência em um serviço público de referência para neoplasias cervicais. Foram estudados 253 prontuários de mulheres com diagnóstico de atipias de significado indeterminado, no ano de 2007. RESULTADOS: A prevalência de lesões intraepiteliais foi a de 23,7%, sendo 26,7% de baixo grau e 73,3% de alto grau. CONCLUSÕES: A prevalência de lesões intraepiteliais de alto grau em mulheres com diagnóstico colpocitológico de atipias de significado indeterminado (ASCUS foi de 23,7%, o aumento do risco foi diretamente proporcional ao da idade e houve maior prevalência de lesão intraepitelial de baixo grau,associada à infecção pelo Papilomavirus humano.OBJETIVOS: Determinar la prevalencia de lesiones intraepiteliales de bajo y alto grado, en mujeres con diagnóstico colpocitológico de atipias de significado indeterminado en el Municipio de Maceió, Alagoas. Conocer la influencia de la edad y de los agentes etiológicos para enfermedades sexualmente transmisibles sobre el riesgo de desarrollo de las lesiones intraepiteliales de bajo y alto grado. MÉTODOS: Se trata de un estudio transversal de prevalencia realizado en un servicio público de referencia para neoplasias cervicales. Fueron estudiadas 253 historias clínicas de mujeres con diagnóstico de atipias de significado indeterminado, en el año 2007. RESULTADOS: La prevalencia de lesiones intraepiteliales fue del 23,7%, siendo 26,7% de bajo grado y 73,3% de alto grado. CONCLUSIONES: La prevalencia de lesiones intraepiteliales de alto grado en mujeres con diagn

  7. Repeat conization in patients with residual or recurrent cervical intraepithelial neoplasia%再次宫颈锥切术在处理残留或复发宫颈上皮内瘤变中的应用

    Institute of Scientific and Technical Information of China (English)

    向礼兵; 蔡祎品; 徐晓丽; 杨文涛; 吴小华; 王华英; 李子庭; 杨慧娟

    2013-01-01

      Background and purpose:Repeat conization is a conservative surgical choice for the treatment failure after primary conization in patients with cervical intraepithelial neoplasia (CIN), however, there were limited evidences to show its efficacy and safety. The aim of the present study was to evaluate the treatment and diagnostic value of repeat conization in the management of residual or recurrent CIN. Methods:From 2003 to 2010, 65 CIN patients underwent repeat conization for positive margin, persistent or recurrent disease after primary conization in Fudan University Shanghai Cancer Center. The medical records and pathological slides were reviewed on histopathological outcomes, margin involvement, complications during and after repeat conization, and reappearance of CIN lesions during follow-up, as well as obstetric outcomes. Results:Among the 50 patients for the treatment of positive margin after primary conization, invasive carcinoma was confirmed in 2(4.0%) patients (1 adenocarcinoma and 1 microinvasive squamous carcinoma), and residual CIN lesions were present in 23 patients (46.0%). In the rest 15 cases for the treatment of persistent or recurrent disease after primary conization, 11(73.3%) patients had CIN lesions in the cone specimens, none had invasive carcinoma. After the secondary conization, 58 patients had clear margins. Involvement of the ectocervical or endocervical margins was found in 1 adenocarcinoma case and 6 CIN cases. Additional hysterectomy was carried out in the adenocarcinoma case, 3 cases with positive margin and 1 case with cervical occlusion and amenorrhea because of cervical adhesion. Massive hemorrhage was another severe complication and occurred in 2 cases. In the 60 cases who preserved their uteruses after secondary conization, reappearance of CIN disease was documented in 4 (6.7%) cases during the median follow-up of 41 months (25-87). Conclusion:Repeat conization appears to be a rational treatment choice for young patients

  8. FISH检测宫颈上皮内瘤变及其旁组织中hTERC基因表达的变化及意义%Expression Change and Significance of hTERC Gene by FISH Detection in Cervical Intraepithelial Neoplasia and Its Adjacent Tissues

    Institute of Scientific and Technical Information of China (English)

    曹志星; 陈细妹; 吕威; 赵晔; 莫海波; 谢亚峰; 吴晓媚; 李玉梅; 周宾; 范思格

    2014-01-01

    目的:检测宫颈活检组织中上皮内瘤变(CIN)及其旁组织中hTERC基因的表达情况,对比分析其阳性率的变化,试图找到基因水平上CIN手术治疗范围。方法:采用荧光原位杂交技术(FISH)检测63例宫颈活检标本中hTERC基因的表达变化情况。结果:宫颈高级别上皮内瘤变(HSIL)区、瘤变边缘≤1 mm、1 mm0.05);HSIL与瘤变边缘2 mm以外范围各点比较差异有统计学意义(P0.05),而LSIL与瘤变边缘1 mm以外范围点比较差异有统计学意义(P2 mm和>1 mm或许可以分别作为HSIL和LSIL基因水平上(更精确意义上的)CIN的手术治疗范围。%To detect the expression of the human telomerase(hTERC)gene of cervical intraepithelial neoplasia(CIN)and its adjacent tissues in cervical biopsy samples,to contrast and analyze the change of positive rate,to try to find the scope of surgical treatment on the CIN gene level.Method:The expression of hTERC gene was detected by FISH from 63 cases cervical biopsy specimen.Result:Positive rate of expression of hTERC gene in high-grade squamous intraepithelial lesion(HSIL),the range from the edge of neoplasia to≤1 mm,1 mm0.05). But the difference of HSIL and the range from the edge of neoplasia to >2 mm was statistically significant( P0.05). But the difference of LSIL and the range from the edge of neoplasia to>1 mm was statistically significant(P2 mm and LSIL edge>1 mm may be the scope of surgical treatment on the CIN gene level,respectively(a more precise sense).

  9. Desempenho do exame colpocitológico com revisão por diferentes observadores e da captura híbrida II no diagnóstico da neoplasia intra-epitelial cervical graus 2 e 3 Performance of cervical cytology with review by different observers and hybrid capture II in the diagnosis of cervical intraepithelial neoplasia grades 2 and 3

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    André Luís Ferreira Santos

    2003-08-01

    Full Text Available Para avaliar o desempenho da colpocitologia (CO de encaminhamento e daquela coletada no serviço de referência, com revisão por diferentes técnicas e observadores, e da captura híbrida II (CH II no diagnóstico da neoplasia intra-epitelial cervical (NIC de alto grau, foram incluídas 105 mulheres atendidas entre agosto de 2000 e junho de 2001 por atipias pré-neoplásicas na CO. Todas foram submetidas à coleta de nova CO e CH II para detecção do DNA-HPV. Foi realizada biópsia cervical em 91, sendo o diagnóstico histológico considerado padrão ouro. Foram descritas a sensibilidade, especificidade e razão de verossimilhança positiva (RVP dos métodos propedêuticos com intervalo de confiança de 95% (IC95%. A sensibilidade e especificidade da CO de encaminhamento foi de 57% e 82% para o diagnóstico de NIC 2 e 3, e a RVP de 3,2 (IC95%: 1,5-6,8. A CO do serviço mostrou uma sensibilidade e especificidade 79% e 84%, respectivamente e RVP de 5,0 (IC95%: 2,5-10,0. A sensibilidade (86%, especificidade (80% e RVP (4,3 foram semelhantes com a revisão lenta realizada pelo segundo observador, havendo uma queda significativa da sensibilidade (64% à revisão rápida pelo terceiro observador. A CH II mostrou alta sensibilidade (100%, baixa especificidade (43% e baixa RVP (1,7, IC95%: 1,4-2,2.To evaluate the performance of initial cervical cytology and that collected at the reference service with a review conducted by different observers and techniques, as well as hybrid capture II, in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN, 105 women attended from August 2000 to June 2001 for preneoplastic atypia upon cervical cytology were included. A new cervical cytology and hybrid capture II for DNA-HPV were conducted in all the patients. Cervical biopsies were taken in 91 women. Performance of the investigative procedures was described by estimating the sensitivity, specificity, and positive likelihood ratio (PLR, with a 95

  10. Presença da Proteína p53 como Prognóstico de Recidiva/Progressão de Neoplasia Intra-epitelial Vulvar III p53 Protein Overexpression as a Prognostic Marker for Vulvar Intraepithelial Neoplasia III Recurrence/Progression

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    Isabel Cristina Chulvis do Val Guimarães

    2002-01-01

    Full Text Available Objetivo: avaliar o valor da presença da proteína p53 nos casos de recidiva/progressão da neoplasia intra-epitelial vulvar (VIN III. Métodos: foram selecionadas 20 pacientes com VIN III indiferenciada, seguidas semestralmente por período de até quatro anos, divididas em dois grupos: quatorze sem e seis com recidiva/progressão da lesão. Os casos de recidiva/progressão foram distribuídos da seguinte forma: em três pacientes a recidiva ocorreu uma única vez, em duas, houve dupla recorrência e apenas uma evoluiu para carcinoma escamoso. Em ambos os grupos foram avaliados o sítio vulvar acometido e a presença da proteína p53 com análise do padrão de marcação imunohistoquímica. Estudo semelhante foi realizado nos casos de recidiva/progressão além da análise do intervalo de tempo para o surgimento de recidiva/progressão. Resultados: observou-se recidiva da VIN III em 25% dos casos e, em 5%, progressão para carcinoma. O tempo médio de recidiva foi de 24,5 meses. A localização multifocal da lesão primária foi a mais freqüente (50% em ambos os grupos. Na maioria dos casos (87,5%, a recidiva/progressão ocorreu na mesma localização da lesão vulvar primária. A presença da proteína p53 mostrou-se positiva em 50% das lesões primárias de VIN III e em 75% dos casos de recidiva/progressão. Conclusões: a presença da proteína p53 parece desempenhar papel importante na gênese e na predição do curso clínico das VIN III. As recidivas/progressão das VIN III tendem a ocorrer na mesma área da doença inicial, sugerindo a presença de campo molecular alterado.Purpose: to evaluate p53 overexpression value in vulvar intraepithelial neoplasia (VIN III recurrence/progression. Methods: twenty patients with undifferentiated VIN III were selected and followed up every six months for four years and divided into two groups: fourteen without and six with recurrence/progression lesion. The recurrence/progression cases were

  11. Taxa de detecção do papilomavírus humano pela captura híbrida II, em mulheres com neoplasia intra-epitelial cervical Detection rate of human papillomavirus by hybrid capture II in women with cervical intraepithelial neoplasia

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    Sonia Cristina Vidigal Borges

    2004-03-01

    Full Text Available OBJETIVO: avaliar a taxa de detecção do papilomavírus humano (HPV de alto risco oncogênico em pacientes portadoras de neoplasia intra-epitelial cervical (NIC e verificar se existe associação entre a presença do vírus e a carga viral com a gravidade da lesão cervical, assim como qual o melhor ponto de corte para predizer a gravidade desta lesão. MÉTODOS: estudo de corte transversal, no qual foram selecionadas 110 mulheres com citologia e/ou biópsia com diagnóstico de NIC. Todas foram submetidas à coleta de nova citologia oncológica, captura híbrida II (CH II, colposcopia e conização pela cirurgia de alta freqüência com alça. RESULTADOS: a taxa global de detecção do HPV de alto risco oncogênico na população estudada foi de 77,3%. À avaliação histopatológica, 81 (73,7% mulheres apresentavam NIC e, nestas mulheres, a taxa de detecção do DNA-HPV foi de 87,6%, sendo de 85,9% nas mulheres com NIC 2 ou 3. A CH II apresentou sensibilidade de 87,7%, especificidade de 56%, valor preditivo positivo de 86,6% e valor preditivo negativo de 58,3%, com odds ratio (OR de 7,76 (2,47 PURPOSE: to evaluate the high-risk oncogenic human papillomavirus (HPV detection rate of patients with cervical intraepithelial neoplasia (CIN, checking the association between high-risk HPV, viral load and severity of the lesion, as well as the best viral load cutoff to predict lesion severity. METHODS: this is a cross-sectional study. One hundred and ten patients were selected by cytology and/or biopsy with CIN diagnosis. All of them were submitted to a new oncologic cytology, hybrid capture II (HC II, colposcopy, and loop electrosurgical excision and fulguration procedures (LEEP. RESULTS: the global detection rate of high-risk oncogenic HPV in these women was 77.3%. Eighty-one women (73.7% had CIN with a detection rate of HPV-DNA of 87.6%. In women with CIN 2 or 3 the detection rate was 85.9%. HC II had a sensitivity of 87.8%, specificity of 56

  12. Expression and significance of RhoA and ROCK2 in cervical intraepithelial neoplasia and cervical cancer%RhoA/ROCK2信号通路在宫颈上皮内瘤样病变及宫颈癌组织中的临床意义

    Institute of Scientific and Technical Information of China (English)

    顾颖; 张晔

    2012-01-01

    Objective:To investigate the expression of RhoA and ROCK2 in cervical intraepithelial neoplasia (CIN) and cervical cancer and its correlation with invasiveness. Methods: The expressions of RhoA and ROCK2 were examined respectively by im-munohistochemical S-P method in 10 cases of cervicitis tissue,30 cases of cervical intraepithelial neoplasia and 30 cases of cervical cancer. The correlation between the immunohistochemical results and the clinicopathological features were analyzed. Results: (D The expression rate of RhoA and ROCK2 were 0% in cervicitis tissues,36.7% and 30.0% in cervical intraepithelial neoplasia, 83.3% and 76.7% in cervical cancer, respectively. The positive rate was significantly higher in the cervical cancer group than in the normal control group(P 0.05). Conclusion: Expression of RhoA and ROCK2 may serve as a parameter for evaluating metastasisand prognosis in cervical cancer.%目的:研究RhoA、ROCK2在宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)及宫颈癌组织中的表达,探讨其与CIN疾病及宫颈癌进展的相关性.方法:应用免疫组化S-P法,检测10例宫颈炎、30例不同级别CIN、30例宫颈癌组织中RhoA、ROCK2蛋白的表达情况,分析比较其表达与临床病理特征的关系.结果:①RhoA、ROCK2蛋白在宫颈炎组织中的表达率均为0%,在CIN宫颈组织中的表达率分别为36.7%、30.0%,在宫颈癌组织中的表达率分别为83.3%、76.7%,两者在宫颈癌组织中的表达水平高于CIN及宫颈炎组织(P<0.01),从CIN进展为宫颈癌,二者的阳性表达率呈递增趋势.②RhoA、ROCK2蛋白表达与宫颈癌病理组织分级及淋巴结转移相关(P<0.05),与宫颈癌患者的年龄、临床分期无明显相关关系(P>0.05).③RhoA、ROCK2蛋白二者表达水平呈正相关关系(P=0.005).结论:RhoA、ROCK2蛋白的表达水平与CIN疾病及宫颈癌进展呈正相关,检测RhoA、ROCK对了解CIN及宫颈癌生物学行

  13. Initiation of an anal cancer screening in HIV+MSM: results of cytology, biopsy and determination of risk factors

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    A Libois

    2012-11-01

    Full Text Available Incidence of anal cancer is increasing and risk of anal cancer is higher in MSM, especially if they are HIV+. European guidelines for treatment of HIV-infected adults recommend anal cancer screening by digital rectal exam±Pap test with anuscopy if Pap test is abnormal. A systematic anal cancer screening in HIV+MSM with anal cytology (Pap smears was established in June 2011 in our reference centre in Brussels. If anal cytology was abnormal, high-resolution anuscopy (HRA with biopsy was performed. 353 MSM HIV+were screened by anal smears between June 2011 and May 2012. 90% were Caucasians, median age was 44.5 years, 83% were on HAART and 74% had an undetectable viral load, median CD4 was 632/µl and 33% had a nadir CD4<200. Thirty-three (9.3% were excluded because of poor quality. Cytology was abnormal in 46% of the 320 remaining patients: high-grade squamous intraepithelial lesion (HSIL 3%, low-grade squamous intraepithelial lesion (LSIL 24%, atypical squamous cells of undetermined significance (ASC-US 16%, and atypical squamous cells / cannot rule out a high-grade lesion (ASC-H 3%. Viral load (VL was more frequently undetectable (82% vs 64%, p=0.0003 and median duration of HAART was longer (111 vs 61 months, p=0.0145 in patients with normal cytology. 80 HRA with biopsies have been performed. 12.5% were normal, 44% showed anal intraepithelial neoplasia (AIN 1, 24% AIN 2 and 19% AIN 3. For this analysis, high-grade AIN (2 and 3 were put together (AIN 2+. Among patients with AIN 2+(n=33, cytology had showed 8 (24% ASC-US, 3 (9% ASC-H, 19 (57% LSIL, 3 (9% HSIL. When patients with normal cytology or normal biopsy and patients with AIN 2+were compared, the only significant risk factor found for AIN 2+was a nadir CD4<100/µl (32% of the patients with AIN 2+vs 14% in patients with normal smear, p=0.0073. Anal precancerous lesions are frequent and at different stages. Among 46% abnormal cytology, 87% had abnormal biopsy including half AIN 2+.Cytology

  14. Survey on HPV infection and cervical intraepithelial neoplasia in childbearing women in Anji County%安吉县育龄妇女 HPV感染及 CIN患病情况的调查分析

    Institute of Scientific and Technical Information of China (English)

    陈秀堂; 黄小芳

    2014-01-01

    目的:调查安吉县育龄妇女宫颈上皮内瘤变( CIN)的患病情况,以及人乳头瘤病毒( HPV)感染状况,以获得更合理的预防与治疗新方案。方法选取2008年1月至2013年4月在浙江省安吉县人民医院妇产科门诊进行宫颈癌筛查,有性生活的978例育龄妇女为研究对象,根据液基细胞学检查及HPV检测结果,将其分为HPV阳性组和阴性组,分析CIN病变程度及与HPV感染的状况。结果①HPV感染率14.5%,CIN1患病率16.9%,CIN2/3患病率3.6%;②HPV阳性人群中CIN1患病率与HPV阴性组的CIN1患病率差异显著(χ2=211.8,P<0.01),HPV阳性组CIN1患病率(54.9%)显著高于HPV阴性组的(9.7%);HPV阳性人群中CIN2/3患病率与HPV阴性组的CIN2/3患病率有显著性差异(χ2=166.6,P<0.01),HPV阳性组CIN2/3患病率为22.5%,显著高于HPV阴性组(0.5%);③CIN2/3组的HPV检测阳性率(88.9%)显著高于CIN1(50.9%)(χ2=17.5,P<0.01)。结论安吉市女性的CIN患病率与HPV感染率较高,HPV感染率越高,提示CIN病变越严重。%Objective To investigate the prevalence of cervical intraepithelial neoplasia ( CIN ) and humanpapilloma virus ( HPV ) infection among childbearing women in Anji County , so as to explore more reasonable prevention and new treatment scheme .Methods Study subjects included 978 sexually active childbearing women taking screening of cervical cancer in outpatient clinic of gynecology and obstetrics in People’s Hospital of Anji County during the period of January 2008 to April 2013.They were divided into HPV positive group and HPV negative group according to liquid -based cytologic test and HPV test .Prevalence of CIN and HPV infection were analyzed . Results The infection rate of HPV was 14.5%, the prevalence rate of CIN1 was 16.9%, and the prevalence rate of CIN2/3 was 3.6%, respectively.There was

  15. Curative effects of different LEEP in treatment of cervical intraepithelial neoplasia and cervical erosion%不同LEEP术式治疗宫颈上皮内瘤样病变和宫颈糜烂的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张肖青; 徐惠群

    2012-01-01

    Objective To investigate the curative effects of high-frequency loop electrosurgical excision procedure ( LEEP) in treatment of cervical intraepithelial neoplasia ( CIN) and cervical erosion. Methods The clinical data of 192 patients with CIN and cervical erosion undergoing LEEP were retrospectively analysed. According to different conditions in patients, shallow cervical ring excision ( SRE) , deep ring excision ( DRE) or LEEP conization ( LEEPC) were performed. The curative effects of LEEP in treatment of CIN and cervical erosion were evaluated, the effect of cervical regeneration was assessed, and the prevalence of complications was observed. Results There were 84, 68 and 40 patients undergoing SRE, DRE and LEEPC respectively. Six months after operation, the cure rate of CIN was 95. 59% (65/68), there was lesion residue after operation in 2 patients with CIN II and 1 patient with CIN IE , and there was relapse in 1 patient with CIN II and 1 patient with CIN III. Three months after operation, the cure rate of cervical erosion was 94. 35% ( 117/124) , and the cure rates of SRE, DRE and LEEPC were 96.43% (54/56), 91.11% (41/45) and 95. 65% (22/23) respectively. Three months after operation, the satisfaction rate of cervical regeneration from patients undergoing LEEP was 93.75% (180/192), and the satisfaction rates of cervical regeneration from patients undergoing SRE, DRE and LEEPC were 92. 86% (78/84), 95. 66% (65/68) and 92.5% (37/40) respectively. Three months after operation, the prevalence of cervical mucous eversion was 4. 17% (8/192), among which SRE accounted for 7. 14% (8/84), and DRE accounted for 2.94% (2/68). Carotid stenosis occurred in 7. 5% (3/40) of patients undergoing LEEPC. Conclusion Corresponding LEEP should be adopted according to different cervical diseases, which may yield higher cure rate and better cervical regeneration. Individualized procedure should be carried out for the treatment of CIN and cervical erosion.%目的 观察高频电波

  16. 农村少数民族已婚妇女CIN患病及危险因素分析%Prevalence of cervical intraepithelial neoplasia and its risk factors among rural minority married women

    Institute of Scientific and Technical Information of China (English)

    赵苏萍; 沈振华; 韦艳萍; 魏萍; 杨康玉; 班文芬; 唐晓永; 李溥

    2011-01-01

    Objective To investigate the prevalence of cervical intraepithelial neoplasia ( CIN) and its influencing factors among rural minority married women in Guizhou province for providing reference of CIN diagnostic criteria. Methods From December 2009 to 2010,3 968 married women at age of 18 to 55 years were selected randomly for a cross sectional survey in 40 villages of Qiannan area of Guizhou province. The survey was carried out with a unified questionnaire interview and gynecological examination. The cervical smear cytology and high-risk human papillomavirus(HR-HPV) infection of cervical secretion were detected. Women with abnormal cervical cytology underwent colposcopy and cervical biopsy. Odd ratio( OR)and 95% confidence interval(95% Cl) of related risk factors with CIN were calculated with logistic regression. Results Among the women, 12.02% had abnormal cytological result. The colposcopy and cervical biopsy showed a CIN rate of 9. 35% in all women selected and the rate was 77.78% in the women with abnormal cervical cytology. The rate of cervical lesions was 5. 89% in Shui women, 1.49% in Maonan women, 1.18% in Buyi women, and 0.78% in Miao women (P<0.01).The multinomial regression analyses showed that HR-HPV infection,history of trichomonas vaginitis, oral contraceptives,age less than 40 years old,smoking,number of sex partners ≥2,age of first intercourse ≤18 years,and nationality were related to CIN. Conclusion The prevalence rate of CIN in the monority area was high. The propaganda and education on knowledge of prevention and control of CIN should be strengthened in the rural area.%目的 了解农村少数民族已婚妇女宫颈上皮内瘤变(CIN)患病现状及其危险因素,为预防和控制CIN提供依据.方法 采取整群抽样方法随机抽取黔南地区18 ~55岁3 968名农村已婚少数民族妇女进行问卷调查、妇科检查、宫颈细胞涂片液基薄层细胞学(TCT)及宫颈分泌物高危人乳头状瘤病毒(HR-HPV)检测,

  17. Inspeção visual do colo uterino após aplicação de ácido acético no rastreamento das neoplasias intra-epiteliais e lesões induzidas por HPV Cervical visual inspection after application of acetic acid in screening intraepithelial neoplasia and HPV-induced lesions

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    Maria Rachel Aguiar Cordeiro

    2005-02-01

    Full Text Available OBJETIVO: estimar a validade da inspeção visual após aplicação de ácido acético (IVA no rastreamento das neoplasias intra-epiteliais cervicais (NIC e lesões induzidas por HPV, comparando seu desempenho com o da colpocitologia e da colposcopia. MÉTODOS: estudo de validação de teste diagnóstico realizado em 893 mulheres de 18 a 65 anos, rastreadas simultaneamente com colpocitologia, IVA e colposcopia, em unidade de saúde pública de Recife, PE. A IVA foi realizada por embrocação do colo com ácido acético a 5% e observação a olho nu, com auxílio de foco clínico comum. Considerou-se como positividade o achado de qualquer lesão aceto-branca no colo. O padrão-ouro foi o histopatológico de biópsia cervical, realizado sempre que qualquer um dos três testes resultasse anormal. Foram estimados e comparados os indicadores de validade de cada teste, com os respectivos intervalos de confiança a 95%. A concordância entre os resultados dos testes foi avaliada pelo coeficiente kappa (k. RESULTADOS: das 303 mulheres biopsiadas, o estudo histopatológico foi anormal em 24. Deste total, a IVA foi positiva em 22, conferindo-lhe sensibilidade estimada de 91,7%, especificidade de 68,9%, valor preditivo positivo de 7,5% e valor preditivo negativo de 99,7%. Comparando-se os intervalos de confiança a 95%, a IVA mostrou maior sensibilidade que a colpocitologia, mas com menores especificidade e valor preditivo positivo. Houve fraca concordância entre os resultados da IVA e da colpocitologia (k=0,02 e excelente concordância com os da colposcopia (k=0,93. CONCLUSÃO: a IVA foi muito mais sensível que a colpocitologia no rastreamento das NIC e lesões HPV-induzidas e teve o mesmo desempenho da colposcopia. Sua baixa especificidade foi responsável por um elevado número de resultados falso-positivos.PURPOSE: to estimate the validity of visual inspection of cervical intraepithelial neoplasia (CIN and HPV-induced lesion screening, after acetic

  18. Relação entre diagnóstico citopatológico de neoplasia intra-epitelial cervical e índices de células CD4+ e de carga viral em pacientes HIV-soropositivas Association of cervical intraepithelial neoplasia with CD4 T cell counts and viral load in HIV-infected women

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    Raquel Autran Coelho

    2004-03-01

    -RNA viral load in HIV-positive patients. METHODS: one hundred and fifteen HIV patients were evaluated retrospectively in the present study, during the period from January 2002 to April 2003, at a university hospital. Eighty-three patients presented cervical intraepithelial neoplasia (CIN in Pap smear, in comparison with thirty-two with no lesions. Patients were divided into three groups, according to CD4 counts: CD4 more than 500 cells/mm³, between 200 and 500 cells/mm³, and less than 200 cells/mm³, and other three groups, according to HIV viral load: less than 10,000 HIV-RNA copies/mL, between 10,000 and 100,000 HIV-RNA copies/mL, or more than 100,000 HIV-RNA copies/mL. Correlation was investigated by the Fisher test. RESULTS: of the eighty-three patients with CIN, 73% presented CD4 counts less than 500 cells/mm³. In all CD4 groups, more than 50% of the patients presented CIN. According to the viral load, 71.7% of the patients with less than 10,000 HIV-RNA copies/mL presented CIN I, compared with 11.3% that showed CIN III. In the group with higher viral load (>100.000 HIV-RNA copies/mL, 61.5% showed CIN I and 30.8% presented CIN III. CONCLUSION: association between viral load and CIN was established (p=0.013, which was not observed with CD4 cell counts and CIN. Concomitant cervicovaginal infection was considered a potential confounding factor.

  19. Study about the potential risk factors in the cervical cancer and the cervical intraepithelial neoplasia patients%宫颈癌及癌前病变相关危险因素的探索研究

    Institute of Scientific and Technical Information of China (English)

    范岩峰; 李健; 许榕仙; 周裕林

    2011-01-01

    目的 探讨潜在危险因素对宫颈癌及癌前病变的影响.方法 收集本市三家市级医院确诊并尚未治疗过的宫颈癌92例、宫颈上皮内瘤样变Ⅲ级(即CINⅢ)63例及正常组252例,分析各因素与宫颈癌发病的关系.结果 单因素分析显示妇科疾病史(χ2=19.31,P<0.01)、月经初潮年龄(F=11.62,P<0.01)、首次性生活年龄(F=25.76,P<0.01)、首次生育年龄(F=28.02,P<0.01)、怀孕次数(F=13.98,P<0.01)、分娩次数(F=4.78,P<0.01)、文化程度(χ2=10.70,P<0.05)、HPV感染(χ2=179.95,P<0.01)、叶酸水平(F=3.39,P<0.05)(与宫颈癌及癌前病变的发生均有相关性(P<0.05),而叶酸与维生素B12呈正相关相关系数r=0.482,P<0.05);Logistic回归显示经常饮茶(OR=0.321,β=-1.136,P<0.05)、性生活后洗外生殖器的习惯(OR=0.387,β=-0.950,P<0.05)、首次性生活年龄越迟(OR=0.551,β=0.596,P<0.05)、体内叶酸水平越高(OR=0.502,β=-0.688,P<0.01)是宫颈癌发病的保护因素;HPV感染(OR=27.215,β=3.304,P<0.01)、分娩次数越多(OR=1.846,β=0.613,P<0.05)及有被动吸烟史(OR=1.673,β=0.515,P<0.05)则是宫颈癌发病的危险因素.结论 体内叶酸水平越高,宫颈癌的发病可能性越低,首次性生活年龄偏早、性生活后未洗外生殖器、HPV感染、多次孕产史及长期处于被动吸烟状态对宫颈癌的发病有影响,有饮茶习惯、补充叶酸及维生素B12可能有预防宫颈癌发病的作用.%Objective To discuss about the relationship between the occurrence of the uterine cervix cancer and the risk factors.Methods Among the patients we collected,92 patients were diagnosed to have the cervical cancer,63 patients were diagnosed as CINⅢ (the cervical intraepithelial neoplasia,CIN),and 252 patients belonged to the control group.All patients had not been cured before.We used the questionnaire to investigate them about the dietary habit and other

  20. 液基细胞学联合 HPV 分型检测在妊娠合并宫颈上皮内瘤变患者的应用%Liquid-based cytology in combination with human papilloma virus test for cervical intraepithelial neoplasia during pregnancy

    Institute of Scientific and Technical Information of China (English)

    郑寰宇; 马冬; 李鸥; 李月红; 张丽芬; 刘桂艳; 杨利华

    2013-01-01

    Objective: The present study aimed to investigate the relationship between cervical intraepithelial neoplasia (CIN) and human papilloma virus (HPV) infection during pregnancy using liquid-based cytology and HPV test. Methods: We prospectively studied the clinical data of 72 pregnant women with CIN who were hospitalized between January 2006 and January 2012 at Tangshan Gongren Hospital. All patients underwent liquid-based thin-layer cytology technique and/or HPV test. Results: Thirty two cases, which included 16 cases each of CIN Ⅰ and Ⅱ, displayed high-grade squamous intraepithelial lesion. The other 40 cases were CIN Ⅲcharacterized by low-grade squamous intraepithelial lesion based on biopsy pathology through colposcopy. A total of 48 (85.7% ) HPV-positive cases were determined among 56 antenatal patients. Moreover, 32 of the 48 HPV-positive cases had either HPV16 infection alone or a mixture of different infection types. Conclusion: Results indicated that the CIN pregnant patients exhibited high frequency of HPV infections, and its HPV16 type is closely associated with the pathological development of high-grade lesions.%  目的:应用液基细胞学联合HPV分型方法检测妊娠合并宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN),初步了解此类患者中TCT及HPV感染情况与妊娠宫颈病变的关系.方法:对象为2006年1月至2012年1月确诊为妊娠合并宫颈上皮内瘤变的72例患者,初次孕期保健均进行细胞学、HPV检测,对这些临床资料进行回顾性分析研究.结果:妊娠合并CIN发生率为2.1%.72例患者中全部产前行宫颈TCT检测,HSIL为32例,LSIL为40例,56例于产前保健时检测HPV,其中48例(85.7%)为阳性结果,32例为HPV16型单独或混合感染.72例孕期保健时行阴道镜活检病理诊断CINⅠ16例、CINⅡ16例、CINⅢ40例.结论:液基细胞学联合HPV分型检测在妊娠合并宫颈上皮内瘤变患者的应用是安全而且有效的.在妊娠

  1. 宫颈Belinson活检钳与传统活检钳在宫颈上皮内瘤变活检中的应用价值比较%Comparison of the application value of Belinson biopsy forceps and traditional biopsy ;forceps in cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    张燕

    2015-01-01

    目的:研究宫颈Belinson活检钳与传统活检钳在宫颈上皮内瘤变(CIN)活检中的应用价值。方法:选择接受阴道镜下宫颈活检的240例CIN患者,采用随机数表法将其分为观察组和对照组。观察组接受Belinson活检钳活检取材,对照组接受传统活检钳活检取材,并比较两组患者宫颈活检与最终病理诊断的符合率、活检情况以及应激反应程度。结果:观察组患者宫颈活检与最终病理诊断的符合率高于对照组,活检组织块体积和阴道出血量小于对照组,而活检后的疼痛评分低于对照组、宫颈修复时间短于对照组,血清促肾上腺皮质激素、皮质醇及去甲肾上腺素水平均低于对照组。结论:宫颈Belinson活检钳活检有助于提高诊断准确率,控制组织创伤程度和应激反应程度,促进活检后宫颈的修复并减少局部出血和疼痛,是CIN理想的活检方法。%Objective:To study the application value of Belinson biopsy forceps and traditional biopsy forceps in cervical intraepithelial neoplasia. Methods:Two hundred and fourty cases of cervical intraepithelial neoplasia patients received cervical biopsy under colposcopy from 2011 August to 2014 March were enrolled and randomly divided into observation group received Belinson biopsy forceps biopsy and control group received conventional biopsy forcep. Then coincidence rate between cervical biopsy and final pathological diagnosis, biopsy condition and stress levels of two groups were compared. Results:Coincidence rate between cervical biopsy and final pathological diagnosis of observation group was higher than that of control group;biopsy tissue volume, vaginal bleeding amount were less than those of the control group; pain scores after biopsy was lower than control group and cervical repair time was shorter than control group. Serum ACTH, Cor, NE levels were lower than control group. Conclusion:Belinson biopsy forceps biopsy is

  2. LEEP电切术治疗196例宫颈上皮内瘤样变患者的疗效观察%Clinical effect analysis of high-frequency radio wave LEEP resection on 196 cases with cervical intraepithelial neoplasia-like lesions

    Institute of Scientific and Technical Information of China (English)

    张英; 唐乾坤

    2011-01-01

    目的 探讨LEEP环型电切术在官颈上皮内瘤样变诊断、治疗中的作用.方法 应用LEEP对196例宫颈上皮内瘤样变(Cervical Intraepithelial Neoplasia-like Lesions,CIN)患者进行诊断和治疗,采用自身对照法对其疗效及病理检查进行回顾性分析.结果 196例患者LEEP术后病理诊断结果,CINⅠ级92例(46.94%);CIN Ⅱ级75例(38.26%),CINⅢ级29例(14.79%,包括宫颈原位癌3例);196例患者术前进行阴道镜下多点活检,将病理检查结果进行对比,完全符合者178例(90.82%).手术时间3~10 min,出血量约5~15 ml.所有患者经4~8周后随访观察宫颈形态基本正常.术后6个月细胞学复查转阴率为100.0%.结论 宫颈LEEP环型电切术具有操作简单,手术时间短,痛苦小,出血少,不需麻醉,并发症少等优点,是一种较理想的CIN诊断、治疗手段.%Objective To evaluate the clinical roles of LEEP ring electrosurgical excision in cervical intraepithelial neoplasia-like lesions.Methods LEEP ring electrosurgical excision was employed to diagnosis and treat 196 cases with cervical intraepithelial neoplasia-like lesions.Its efficacy and pathological changes were retrospectively analyzed.Results Of the 196 CNI patients, 92 cases (46.94%) were pathologically diagnosed CIN grade Ⅰ , 75 cases (38.26 % ) CIN grade Ⅱ , and 29 cases CIN grade Ⅲ (14.79%).Compared with the colposcopic multi-site biopsy before LEEP treatment, the pathological diagnosis of 178 cases ( 90.82% ) were consistent with their colposcopic multi-site biopsy.The LEEP time lasted for 3~10min, and the blood loss were about 5~15ml.By follow-up study of 4 to 8 weeks, all patients' cervical shapes were normal, and cytology negative turn rate was 100.0% in 6 months after the LEEP treatments.Conclusions Cervical LEEP ring electrosurgical excision is a simple procedure with short operation time, less pain, less bleeding, no anesthesia and fewer complications.

  3. Expression and Effect of ROCK2 in Cervical Intraepithelial Neoplasia and Early-Stage Cervical Carcinoma%ROCK2在宫颈上皮内瘤样病变及早期宫颈癌组织中的表达及其作用

    Institute of Scientific and Technical Information of China (English)

    顾颖

    2012-01-01

    Objective To investigate the expression of ROCK2 in CIN and cervical squamous carcinoma and its correlation with invasiveness. Methods The expression of R0CK2 was examined respectively by immunohistochemical S-P method in 30 cases of normal cervical tissue, 30 cases of cervical intraepithelial neoplasia and 30 cases of early-stage cervical cancer. This study analyzed statistically the correlation between the immunohistochemical results and the clinicopathological features. Result ①The expression rate of ROCK2 was 0% in normal cervical tissues, 30.0% in cervical intraepithelial neoplasia and 76.7% in cervical squamous carcinoma respectively. The positive rate was significantly higher in the cervical cancer group than in the normal control group (P 0. 05 ) . Conclusion Expression of ROCK2 may serve as an effective parameter for evaluating CIN and prognosis in cervical squamous carcinoma clinically.%目的:研究ROCK2在宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)及早期宫颈癌组织中的表达,探讨其与CIN疾病及早期宫颈癌进展的相关性.方法:应用免疫组化S-P法,检测30例正常宫颈、30例不同级别CIN、30例宫颈癌组织中ROCK2蛋白的表达情况.分析其表达结果与临床病理特征的关系.结果:①ROCK2蛋白在正常宫颈组织中的表达率为0%,在CIN病变组织中的表达率为30.0%,在早期宫颈癌组织中的表达率为76.7%,在宫颈癌组织中的表达水平,高于CIN及正常宫颈组织(P<0.01),随着从正常宫颈组织→CIN病变组织→宫颈癌的转化,阳性表达率呈递增趋势.②ROCK2的表达与病理组织分级、有无淋巴结转移相关(P<0.05),与宫颈癌患者的年龄、临床分期则无明显相关关系(P>0.05).结论:检测ROCK2对临床CIN及宫颈癌的预后,可供作有效用的一项参数.

  4. Study on the Focused Ultrasound in treatment with cervical intraepithelial neoplasia Ⅰcombined with HPV infection%聚焦超声治疗宫颈上皮内瘤变Ⅰ级病变合并HPV感染的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    陶春霞; 周欣; 刘小红; 章卉; 肖菊花

    2016-01-01

    Objective To investigate the clinical efficacy of Focused ultrasound for treatment of cervical intraepithelial neo-plasia Ⅰcombined with HPV infection. Methods 152 women with cervical intraepithelial neoplasia Ⅰcombined with HPV infec-tion cases were given Focused ultrasound therapy,follow up the treatment effect and the number of HPV negative cases. Results Ultrasound therapy was performed well,no severe complications were observed in any patient. Vaginal discharge was disappeared 7-14 days after ultrasound therapy. 6 months after therapy,139 with cervical intraepithelial neoplasia were healed,136 patients with HPV negative. Total effectiveness was 91.44%,treatment of HPV overcast rate was 89.47%. Conclusion HIFI is a safe and effective treatment of cervical HPV infection means of CIN1 and be worthy of wide application and popularization in clinic.%目的:探讨聚焦超声治疗宫颈上皮内瘤变Ⅰ(CINⅠ)级合并HPV感染的的临床治疗效果。方法152例HPV阳性,经阴道镜取活检,病理确诊为宫颈上皮内瘤变Ⅰ级同时经检测合并HPV感染的患者,应用聚焦超声治疗,随访观察疗效及HPV的转阴情况。结果所有患者治疗顺利,未出现创面大出血情况,阴道排液时间约为1-2周,未见脱痂致大量阴道出血,所有患者治疗后六个月门诊随诊:139例患者宫颈恢复为正常生理结构形态,无瘢痕形成,阴道镜检查见成熟鳞状上皮、柱状上皮、转化区上皮,对13例异常阴道镜表现患者取活检行病理检查结果为11例仍为CINⅠ,两例进展为CINⅡ,有效率91.44%;136例患者HPV转阴,HPV的转阴率为89.47%。结论聚焦超声是一种安全、有效的治疗宫颈CINⅠ级合并HPV感染的手段,值得在临床上广泛应用和推广。

  5. Clinical observation of cut healing with gelatin paste after cervical intraepithelial neoplasia surgery by LEEP%止血明胶对高频电切治疗宫颈上皮内瘤样变术后创面恢复的价值

    Institute of Scientific and Technical Information of China (English)

    陈瑶; 卓静; 李淳; 黄明通; 黄慧君

    2008-01-01

    目的 观察止血明胶对高频电切(LEEP刀)治疗宫颈上皮内瘤样变(CIN)创面愈合、预防术后出血的临床效果,寻找预防LEEP刀治疗CIN后创面并发症的有效方法.方法 100例宫颈上皮内瘤样变病例,应用LEEP刀手术后,随机分成治疗组60例,对照组40例,治疗组的创面采用止血明胶粘贴,对照组的创面采用纱布填塞,观察术后两组短期阴道出血、感染及宫颈修复情况.结果 治疗组60例,阴道出血0例,感染0例,宫颈修复不良0例;对照组40例,短期阴道出血3例,感染2例,宫颈修复不良3例;两组术后阴道出血、感染及宫颈修复不良发生率比较差异有统计学意义(P<0.05).结论 LEEP刀治疗CIN后,采用止血明胶粘贴处理创面可减少阴道出血、感染及宫颈修复不良并发症的发生.%Objective To observe the poet-operative clinical inpact on cervical intraepithelial neoplasia surgery by Loop elcctrosurgical excision procedure(LEEP),gelatin paste to improve the healing of the Cut,prevent the post-operative bleeding,and find out effective methods of preventing LEEP complications.Methods 100 patients with cervical intraepithelial neoplasia underwent LEEP in clinic.Divide them into two groups randomly,60 patients were adopted gelatin paste post-LEEP ag the cure group.while 40 patients were adopted as control group.Observation Vaginal bleeding,infection and cervical rear in short-term.Results In 60 patients of cure group,never patients with vaginal bleeding,infection and the cut healing in the short time.In 40 patients of control group,three patients with vaginal bleeding,two patients with infection,and three patients with bad healing.The different between two group with vaginal bleeding,infection and the cut healing time was significant(P<0.05).Condusion gelatin paste can reduce bleeding.infection and cervical repair bad cmpllcations after cervical intraepithelial neoplasia surgery by LEEP.

  6. Relationship between cervical intraepithelial neoplasia and high-risk human papillomavirus in areas with dense floating population%流动人口密集地区宫颈上皮内瘤变与高危型人乳头瘤病毒关系调查

    Institute of Scientific and Technical Information of China (English)

    李玉梅; 李柳翠; 梁翠霞

    2014-01-01

    Objective To investigate the relevant factors and relationship between cervical intraepithelial neoplasia and high-risk human papillomavirus happened in the areas with dense floating population.Methods The basic data of the patients infected by HPV16,HPV18,and HPV31 subgroups from the gynecological clinic were collected,and the relevant data were completed reviewing their electronic medical records or through telephone follow-up.Results The HPV infection frequency was 217 in the 198 patients.Among them,61.75% were infected by HPV16,25.35% by HPV18,and 12.90% by HPV31.In the 198 patients,16.16% had sex life in too young age or had more than one sex mate,32.83% had been pregnant,delivered,or aborted more than once,90.40% got vaginal infection,81.82% had chronic cervicitis,and 26 patients (13.13%),including 22 cases infected by HPV16 and having higher malignancy degree,had cervical intraepithelial neoplasia and cervical carcinoma.Conclusions Cervical intraepithelial neoplasia closely relates to high-risk HPV16 infection in the areas with dense floating population.Low immunity caused by chronic cervicitis and cervical and vaginal infections,was the main factors for high risk HPV infection.%目的 了解流动人口密集地区宫颈上皮内瘤变与高危型人乳头瘤病毒间的关系及相关因素.方法 对妇科门诊所有感染HPV16、HPV18、HPV31亚型患者的基本资料进行初步登记,再通过查阅电子病历或电话回访逐一完善相关资料.结果 从198例高危HPV感染患者中检出的217频次的阳性结果中发现:HPV16感染比率最多,占61.75%,HPV18其次,占25.35%,HPV31位居第三,占12.90%.198例患者中过早或多伴侣性生活的占16.16%,多孕、多产和多次人流占32.83%、感染性阴道炎占90.40%、慢性宫颈炎占81.82%;在198例高危HPV感染者中共发现了宫颈上皮内瘤变及宫颈浸润癌26例,26例宫颈上皮内瘤变及宫颈浸润癌患者中22例感染HPV16,

  7. Outcomes from a prospective trial of endoscopic radiofrequency ablation of early squamous cell neoplasia of the esophagus

    NARCIS (Netherlands)

    J.J.G.H.M. Bergman; Y.M. Zhang; S. He; B. Weusten; L. Xue; D.E. Fleischer; N. Lu; S.M. Dawsey; G.Q. Wang

    2011-01-01

    Background: Radiofrequency ablation (RFA) is safe and effective for eradicating neoplasia in Barrett's esophagus. Objective: To evaluate RFA for eradicating early esophageal squamous cell neoplasia (ESCN) defined as moderate-grade squamous intraepithelial neoplasia (MGIN) and high-grade squamous int

  8. 深圳人群人乳头瘤病毒感染亚型分布与宫颈上皮内瘤变现况横断面调查%Crosssectional survey of human papilloma virus subtype distribution and cervical intraepithelial neoplasia in Shenzhen

    Institute of Scientific and Technical Information of China (English)

    梁凌云; 杜辉; 王纯; 张薇; 陈芸; 渠新风; 杨斌; 吴波; 吴若松

    2013-01-01

    To investigate the prevalence of human papilloma virus (HPV) infection and cervical intraepithelial neoplasia (CIN) and pathogenecity of the HPV subtyping and virus loads in Shenzhen district. Methods; In the study, 10 000 sexually active women from Shenzhen city and rural areas around were screened for cervical cancer, and all the cases were examined with cytology tests and several kinds of high risk HPV (HR-HPV) tests. Those with cytology ≥ atypical squamous cells of undetermined sign ( ASC-US) or positive HPV results underwent colposcopy with biopsy for a pathological diagnosis. Results; The average age of this study population was 38. 9 years. The total prevalence of HPV infection was 16. 6% , with age-specific prevalence increasing with age. The morbidity rate of the low grade cervical intraepithelial neoplasia CIN1 was 17. 0% , but that with those aged ≥55 years showed a sharp drop. The morbidity rate of the high grade cervical intraepithelial neoplasia CIN2/3 was 2. 6% , and was higher in the 45 to 59 years age group than in the 25 to 44 years age group. HR-HPV infection was an obvious relevant factor of CIN1 and CIN2/3, and the OR values increased as the virus loads increased, but they had different relevant HPV subtypes. We found that HPV-16, -58, -31, -33, -18 were the first five ones for CIN2/3 while HPV-39, -58, -59, -52, -66 for CIN1. Conclusion-. There is a high level of HPV infection and CIN in Shenzhen district. The prevalence of HPV infection has a trend to increase with age, and the people aged 45 years and more are key objects for CIN2/3 screening, with the virus load and subtyping of HR-HPV infection as indicative factors.%目的:研究深圳地区人群人乳头瘤病毒(human papilloma virus,HPV)感染与宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的患病情况及HPV亚型与病毒载量的致病性.方法:以深圳市及周边农村地区10 000名有性生活的女性为研究对象,以液基细胞学联合多种高危

  9. Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer

    Science.gov (United States)

    2012-06-08

    Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

  10. Prediction of cervical intraepithelial neoplasia grade 2+ (CIN2+ using HPV DNA testing after a diagnosis of atypical squamous cell of undetermined significance (ASC-US in Catalonia, Spain

    Directory of Open Access Journals (Sweden)

    Ibáñez Raquel

    2012-01-01

    Full Text Available Abstract Background A protocol for cervical cancer screening among sexually active women 25 to 65 years of age was introduced in 2006 in Catalonia, Spain to increase coverage and to recommend a 3-year-interval between screening cytology. In addition, Human Papillomavirus (HPV was offered as a triage test for women with a diagnosis of atypical squamous cells of undetermined significance (ASC-US. HPV testing was recommended within 3 months of ASC-US diagnosis. According to protocol, HPV negative women were referred to regular screening including a cytological exam every 3 years while HPV positive women were referred to colposcopy and closer follow-up. We evaluated the implementation of the protocol and the prediction of HPV testing as a triage tool for cervical intraepithelial lesions grade two or worse (CIN2+ in women with a cytological diagnosis of ASC-US. Methods During 2007-08 a total of 611 women from five reference laboratories in Catalonia with a novel diagnosis of ASC-US were referred for high risk HPV (hrHPV triage using high risk Hybrid Capture version 2. Using routine record linkage data, women were followed for 3 years to evaluate hrHPV testing efficacy for predicting CIN2+ cases. Logistic regression analysis was used to estimate the odds ratio for CIN2 +. Results Among the 611 women diagnosed with ASC-US, 493 (80.7% had at least one follow-up visit during the study period. hrHPV was detected in 48.3% of the women at study entry (mean age 35.2 years. hrHPV positivity decreased with increasing age from 72.6% among women younger than 25 years to 31.6% in women older than 54 years (p At the end of the 3 years follow-up period, 37 women with a diagnosis of CIN2+ (18 CIN2, 16 CIN3, 2 cancers, and 1 with high squamous intraepithelial lesions -HSIL were identified and all but one had a hrHPV positive test at study entry. Sensitivity to detect CIN2+ of hrHPV was 97.2% (95%confidence interval (CI = 85.5-99.9 and specificity was 68.3% (95%CI

  11. Natural history of anal dysplasia in an HIV-infected clinical care cohort: estimates using multi-state Markov modeling.

    Directory of Open Access Journals (Sweden)

    William C Mathews

    Full Text Available (1 To model the natural history of anal neoplasia in HIV-infected patients using a 3-state Markov model of anal cancer pathogenesis, adjusting for cytology misclassification; and (2 to estimate the effects of selected time-varying covariates on transition probabilities.A retrospective cytology-based inception screening cohort of HIV-infected adults was analyzed using a 3-state Markov model of clinical pathogenesis of anal neoplasia.Longitudinally ascertained cytology categories were adjusted for misclassification using estimates of cytology accuracy derived from the study cohort. Time-varying covariate effects were estimated as hazard ratios.(1 There was a moderate to high probability of regression of the high grade squamous intraepithelial lesion (HSIL state (27-62% at 2 years after initial cytology screening; (2 the probability of developing invasive anal cancer (IAC during the first 2 years after a baseline HSIL cytology is low (1.9-2.8%; (3 infrared coagulation (IRC ablation of HSIL lesions is associated with a 2.2-4.2 fold increased probability of regression to

  12. The Clinical Application of TCT,Colposcopy and LEEP in Cerical Intraepithelial Neoplasia%液基薄层细胞学、电子阴道镜和宫颈环形电切术在宫颈上皮内瘤变中的临床应用

    Institute of Scientific and Technical Information of China (English)

    梅芳

    2014-01-01

    目的:探讨液基薄层细胞学、电子阴道镜和宫颈环形电切术在子宫颈上皮内瘤病变诊断治疗中的临床应用价值。方法:回顾性分析2011年本院收治的经液基薄层细胞学与电子阴道镜宫颈病理活检确诊的106例宫颈上皮内瘤变患者的临床资料,其中103例患者行宫颈环形电切术(LEEP),3例CIN-Ⅲ级于LEEP术后追加筋膜外子宫全切除术,术后标本行病理学检查,比较分析TCT、阴道镜活检与LEEP术后病理结果的差异。结果:TCT与阴道镜活检结果符合率LSIL为81.25%,HSIL为89.66%。阴道镜下活检、病理与LEEP术后标本CIN-Ⅰ的符合率为59.18%,CIN-Ⅱ的符合率为79.31%,CIN-Ⅲ的符合率为82.14%,总体负荷率70.75%。结论:TCT与阴道镜下病理活检筛查上皮内瘤变主要方法、宫颈环形电切术是治疗CIN的有效技术,同时具有一定的诊断价值,对于临床减少宫颈上皮内瘤变漏诊、误诊率有一定价值。%Objective:To investigate the clinical value of TCT,colposcopic biopsies and LEEP in diagnosis and treatment of cervical intraepithelial neoplasia.Method:The clinical data of 106 patients with cerical intraepithelial neoplasia diagnosed with TCT and colposcopic biopsy in our hospital from January 2011 to December 2011 were retrospectively analyzed.All patients were treated with LEEP.Three cases of them with CIN- Ⅲreceived extra fascial hysterectomy resection besides LEEP.The postoperative specimens were detected pathological examination.The difference and consistence rates of the results of TCT,colposcopic multiple biopsies and LEEP were compared.Result:The coincidence rate of TCT and colposcopy biopsy results was LSIL 81.25%,HSIL 89.66%,respectively.The overall consistence rate of pathology between colposcopic multiple biopsies and post-LEEP was 70.75%,and those of CIN-Ⅰ, CIN-Ⅱand CIN-Ⅲwere 59.18%,79.31%,82.14%,respectively(P<0.05).Conclusion:TCT and the

  13. Application value of human papilloma virus E6/E7 mRNA detection combined with cervical biopsy in diagnosis of cervical intraepithelial neoplasia%人乳头瘤病毒E6/E7 mRNA检测联合宫颈活检在宫颈病变中的应用价值

    Institute of Scientific and Technical Information of China (English)

    董立军; 宋国军

    2013-01-01

    目的 探讨经过新柏超薄液基细胞学检测(TCT)的标本检测高危人乳头瘤病毒(HPV) E6/E7 mRNA联合宫颈活检在宫颈病变筛查中的可行性及应用价值. 方法 采用杂交信号放大的核酸检测技术,对100例TCT示不同程度宫颈上皮瘤样病变和宫颈癌的标本进行高危HPV E6/E7 mRNA检测,并对HPV E6/E7 mRNA阳性者和阴性者同时行宫颈活检,同时就HPV E6/E7 mRNA表达在不同细胞学级别中的分布情况行统计学分析. 结果 不同细胞诊断级别E6/E7转录数有统计学差异(P<0.05),随着宫颈病变程度增加,HPV E6/E7 mRNA的转录数相应增加.HPV E6/E7mRNA的转录数越高,宫颈活检阳性率越高. 结论 高危HPV E6/E7 mRNA检测联合宫颈活检对宫颈上皮内瘤变和宫颈癌的筛查有临床意义.%Objective:To research the diagnosis value by determining high risk human papilloma virus(HPV) E6/E7 mRNA combined with cervical biopsy in the sample with cervical intraepithelial neoplasia after detected by liquid based thin-prep cytology test(TCT).Methods..The high risk HPV E6/E7 mRNA was detected in 100 TCT samples with different degrees of cervical lesions.The cervical biopsy examination was done for all the patients with positive or negative of HPV E6/E7 mRNA test.The correlation between the expression of HPV E6/E7 mRNA and the cytological grades was analyzed.Results:The copy number of HPV E6/E7 rnRNA was statistically different in various cytological grades (P<0.05).The copy number of HPV E6/E7 rmRNA was correlated with severe degree of epithelial cervical dysplasia.The copy number of HPV E6/E7 rmRNA was positively correlated with positive rate of cervical biopsy.Conclusions:High risk HPV E6/E7 mRNA test combined with cervical biopsy is of clinical value for diagnosis of cervical intraepithelial neoplasia.

  14. Clinical Application of Colposcopy Combined with HPV Scan in the Diagnosis of Cervical Cancer and Cervical Intraepithelial Neoplasia%阴道镜联合 HPV 检测对宫颈癌及宫颈上皮内瘤变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李惠卿

    2014-01-01

    目的:探讨阴道镜联合高危型人乳头瘤病毒( HR-HPV)检测对宫颈癌及宫颈上皮内瘤变的诊断价值。方法对644例行宫颈癌筛查的妇女行阴道镜和HR-HPV检测,并应用阴道镜取宫颈多点活组织进行病理检查。结果HR-HPV诊断结果阳性率为17.70%,阴道镜诊断结果阳性率为18.01%,HR-HPV+阴道镜诊断结果阳性率为18.79%;HR-HPV+阴道镜检测灵敏度和符合率与单一使用阴道镜或HR-HPV检测比较,P<0.05,差异具有统计学意义;HR-HPV检测低危病变阳性率和高危病变阳性率比较,P<0.05,差异具有统计学意义。结论阴道镜联合HR-HPV检测可提高宫颈癌及宫颈上皮内瘤变的诊断灵敏度和符合率,高危病变HR-HPV检测阳性率更高。%Objective To investigate the clinical application value of colposcopy and high -risk human papilloma virus ( HR-HPV) in the diagnosis of cervical cancer and cervical intraepithelial neoplasia .Methods 644 women who received colpos-copy and HR-HPV test for cervical cancer screening were taken more points of cervical tissues by colposcope for pathological ex -amination.Results HR-HPV diagnosis positive rate was 17.70%,the results of colposcopy diagnosis positive rate was 18.01%, HR-HPV+colposcopy diagnosis positive rate was 18.79%.Sensitivity and accuracy of HR-HPV+colposcopy detection compared with single use of colposcopy or HR-HPV detection,P<0.05,the difference was statistically significant;Comparison of HR-HPV positive detection rate of low-risk lesions and high-risk lesions,P<0.05,the difference was statistically significant .Conclusion Colposcopy combined with HR-HPV examination can improve the diagnostic sensitivity and accuracy of cervical cancer and cervi -cal intraepithelial neoplasia ,and high-risk lesions has higher HR-HPV positive rate.

  15. Discussion on the Treatment of Positive Margin for Patients with Cervical Intraepithelial Neoplasia after Conization and the Prognosis%子宫颈高级别上皮内瘤变患者锥切术后切缘阳性的处理及预后探讨

    Institute of Scientific and Technical Information of China (English)

    陈冰亚

    2014-01-01

    Objective To investigate the treatment of positive margin for patients with cervical intraepithelial neoplasia after conization and the prognosis, and summarize the experience of treatment. Methods 228 cases of cervical intraepithelial neoplasia patients with positive margin after conization underwent surgical treatment for the second time were selected as the subjects. Based on the second postoperative pathology results, the subjects were divided into two groups of residual lesions and no residue, and the related factors of two groups of patients were compared and analyzed. Results The lesions without residual in 133 cases, accounting for 58.33%, residual in 95 cases, accounting for 41.67%; the difference between two groups in age was not statistical-ly significant (P>0.05), but the differences between the groups in the first mode of operation, pathological grade, positive margin lesion grade, positive margin part, and HPV were statistically significant (P<0.05). Conclusion Preoperative HPV high copy, high grade lesions, especially carcinoma in situ, positive margins in the neck tube end of the lesions in patients with residual high risk, need the second conization or close follow-up. Expanding uterus excision is suggested for the patients whose cutting edge part is carcinoma in situ. The specific treatment should be combined with the patient's wish, fertility requirements and follow-up conditions.%目的:探讨子宫颈高级别上皮内瘤变锥切术后切缘阳性的处理及预后,总结治疗经验。方法以子宫颈高级别上皮内瘤变患者锥切术后切缘阳性再行手术治疗的228例作为研究对象,根据第2次术后病理结果将研究对象分为病变残留和无残留两组,对两组患者相关因素进行比较分析。结果病变无残留者133例,占58.33%,残留者95例,占41.67%,两组患者年龄差异无统计学意义(P>0.05),首次手术方式、病变级别、阳性切缘病变级别、阳性切缘

  16. The Advances of Cytokeratins and P16INK4a in Cervical Intraepithelial Neoplasia and Cervical Cancer%细胞角蛋白与P16INK4a在宫颈癌前病变及宫颈癌中的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘微

    2012-01-01

    The cervical cancer is one of the common gynecologic malignant tumors,and in recent years the amount of the young patients has obviously risen. The cervical intraepithelial neoplasia (CIN)is closely related to cervical invasive carcinoma as a group of precancerous lesions,which is also an important stage in the cervical cancer progression. The proceeding from cervical intraepithelial neoplasia (CIN)to cervical cancer is a long period,so the effective diagnosis and treatments of CIN are the best way to prevent the cervical cancer. Some studies claimed that CK17 was a marker of the cervical stem cells and reflected the phenomena from immature to mature of cervical cell metaplasia. The expression level of CK8 and CK17 is related to the degree of CIN and cervical cancer. Analysis the expression level of CK8,CK17 can be as a predictor for the high-risk cases.The P16INK4a 's abnormal methrlation is related to the the clinical stages and pathological classification of cervical cancer. In terminal and high malignant degree's tissues,its activities is obviously enhanced. This review will discuss the advances of cytokeratins and P16INK4a in the cervical cancer and CIN in terms of occurrence and development.%宫颈癌是常见的妇科恶性肿瘤之一,且近年来年轻患者有明显上升的趋势.子宫颈上皮内瘤变(CIN)是与子宫颈浸润癌密切相关的一组癌前病变,也是宫颈癌防治的重要阶段.从宫颈癌前病变发展成宫颈癌是一个较长时间的过程,有效的诊断和治疗CIN是预防宫颈癌的最佳途径.有研究认为,细胞角蛋白17(CK17)是宫颈干细胞的标记物,反映了一种细胞化生由不成熟向成熟转化的现象.CK8、CK17表达水平与宫颈上皮内瘤样病变程度及宫颈癌有关,分析CK8、CK17表达水平可作为预测宫颈癌高危患者的指标.P16INK4a异常甲基化与宫颈癌的临床分期及病理分级有关,在晚期及恶性程度较高的组织中,其活性明显增强

  17. Clinical Analysis of Cold-knife Conization in Diagnosis and Treatment of 106 Patients with Cervical Intraepithelial Neoplasia%冷刀宫颈锥切术诊治宫颈上皮内瘤106例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘佳汭; 薛梅; 代瑞娟

    2011-01-01

    目的 探讨冷刀宫颈锥切术(cold knife conization,CKC)对宫颈上皮内瘤变的诊断治疗作用,并评价临床疗效.方法 回顾性分析曲靖市第二人民医院妇产科2006年至2010年因宫颈病变行宫颈细胞学检查、阴道镜下多点活检和宫颈锥切术的患者106例,对比宫颈锥切术和阴道镜下多点活检的病理检查结果,分析冷刀宫颈锥切术的临床疗效和并发症.结果 两者病理完全符合69例,占65.1%,不符合37例,占34.9%.8例(7.5%)患者锥切边缘受累,103例患者随访6~30个月,2例复发.发现早期浸润癌6例,其中2例仅行宫颈锥切随访无复发;6例患者后行子宫切除术或扩大子宫切除术(不在统计范围);术后主要并发症为出血和宫颈管狭窄.结论 宫颈锥切术比阴道镜下多点活检对宫颈上皮内瘤变的诊断更准确,并具有重要治疗作用.%Objective To explore the role of cold-knife conization in diagnosis and treatment of cervical intraepithelial neoplasia, and evaluate the clinical efficacy. Methods The clinical data of 106 patients with cervical lesions who received cervical cytologic examination, colposcopic multiple points biopsy and cervical comization from 2006 to 2010 were analyze retrospectively. The pathological examination results of colposcopic multiple points biopsy and cervical comization were compared, and the therapeutic effects and complications of cervical comization were analyzed. Results The pathological examination results of colposcopic multiple points biopsy and cervical comization were accordant in 69 cases, accounting for 65.1%, discordant in 37 cases,accounting for 34.9%. There were 8 cases (7.5%) of cervical conization in patients with marginal involvement.103 cases were followed up for 6 ~ 30 months, and 2 cases relapsed. There were 6 cases of early invasive carcinoma, including 2 cases of only cervical cone biopsy without recurrence in follow up period. 6 cases underwent hysterectomy or

  18. 阴道镜联合不同宫颈电热圈环切术术式治疗宫颈上皮内瘤变临床研究%Clinical research on the treatment of cervical intraepithelial neoplasia by colposcopy combined with LEEP

    Institute of Scientific and Technical Information of China (English)

    李文艺; 陈俐俐

    2013-01-01

    目的 探讨阴道镜联合不同宫颈电热圈环切术(LEEP)术式治疗不同程度宫颈上皮内瘤变(CIN)临床疗效.方法 回顾分析阴道镜联合不同LEEP术式治疗不同程度CIN 240例患者临床资料,分析不同术式出血量及愈合时间、并发症,及LEEP术前、后病理符合情况.结果 不同LEEP术式术中出血量随着手术范围的增加呈上升趋势(P<0.01),愈合时间随着手术范围的增加逐渐延长(P<0.01);LEEP术前、术后宫颈组织病理学检查结果不符合者16.66%(40/240),术后病理较术前活检病理升级14.58%(35/240),不同程度CIN术前、术后病理符合率差异有统计学意义(P<0.01);LEEP手术并发症包括出血、感染、宫颈管黏膜外翻、宫颈管狭窄等,不同术式的发生率不同.结论 阴道镜直视下,选择下不同LEEP术式治疗CIN可减少并发症,更加明确宫颈病变程度,同时达到治疗目的.%Objective To study the clinical effect of colposcopy combined with LEEP at different degree in the treatment of cervical intraepithelial neoplasia (CIN).Methods The clinical data of 240 CIN patients treated with colposcopy combined with different LEEP surgery at different degree were reviewed.Different operative bleeding and healing time,together with the adverse reaction were analysed.Whether the pathology was consistent with the situation before and after LEEP was evaluated.Results Bleeding in the operation with the operation scope of the increase showed ascendant trend (P <0.01).Healing time in the operation with the operation scope of the increase showed ascendant trend(P <0.01).Cervical histopathology examination result before and after operation was not consistent with the 16.66%.LEEP postoperative pathology was aggravated by 14.58%(35/240) compared to preoperative biopsy pathology.There were pathological differences of CIN in different degree pre-operation and post-operation(P <0.01).LEEP operation complications included

  19. 宫颈液基细胞学检查及上皮内瘤变中Ki-67和PTEN表达的临床意义%Liquid-based cervical cytology and expression of Ki-67 and PTEN in the clinic significance of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    张观宇; 许立莉; 王建琴; 孙凤娟; 韩吉萍

    2011-01-01

    Objective: To investigate liquid-based cervical cytology and expression of Ki-67 and PTEN in the clinic significance of cervical intraepithelial neoplasia to provide guidance for clinical treatment. Methods: 1 330 patients were detected by liquid-based cervical cytology (LCT), antitypical squamous cells were found in 61 cases, 24 cases were cervical intraepithelial neoplasia by biopsy, in which CIN I were 11, CIN II -CIN Ⅲ were 13, Ki-67 and PTEN were detected by im-mmunohistochemical method (Ultrasensitive TMHRP) in 24 cases of CIN and 20 cases cervicitis. Results: In cervicitis, Ki-67 and PTEN expression rates were 5% and 100% respectively. In CIN I , Ki-67 and PTEN expression rates were 18.2% and 72.7% respectively, which was no significantly difference with cervicitis (P>0.05). In CIN II -CIN Ⅲ, Ki-67 and PTEN expression rates were 76.9% and 15.4% respectively, which was significantly diference with CIN I (P<0.05). Correlation association was found between Ki-67 and PTEN in CIN (r=-0.818 ,P<0.05). Conclusion: Liquid-based cervical cytology and expression of Ki-67, PTEN can be used as important markers to distinguish benign cervical lesions, it plays important role in evaluating the risk of CIN.%目的:探讨宫颈液基细胞学检查(TCT)及上皮内瘤变中Ki-67和PTEN表达的临床意义.方法:收集液基细胞检查患者1 330例,其中,有非典型鳞状细胞以上病变61例,经活检证实24例为上皮内瘤变,包括低度上皮内瘤变(CINⅠ)11例,高度上皮内瘤变(CINⅡ~CINⅢ)13例.同时选取20例宫颈炎作为对照,分别进行超敏TMHRP法免疫组织化学染色,检测Ki-67和PTEN表达情况.结果:对照组Ki-67阳性率5%,PTEN阳性率100%;低度上皮内瘤变(CINⅠ)Ki-67阳性率18.2%,PTEN阳性率72.7%;高度上皮内瘤变(CINⅡ~CINⅢ)Ki-67阳性率76.9%,PTEN阳性率15.4%.对照组与低度上皮内瘤变比较差异无统计学意义(P>0.05),低度上皮内瘤变与高度上皮内瘤变比

  20. Comparison of loop electrosurgical excision procedure and cold knife conization in the treatment of cervical intraepithelial neoplasia 2-3%子宫颈环形电切术及冷刀锥切术治疗宫颈上皮内瘤变2~3级效果比较

    Institute of Scientific and Technical Information of China (English)

    王宁宁; 花茂方

    2014-01-01

    目的:比较宫颈冷刀锥切术(cold knife conization,CKC)和宫颈环行电切除术(loop electrosurgical excision procedure,LEEP)治疗宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)2~3级的临床价值.方法:回顾性分析172例CIN 2~3级患者的临床资料,通过观察CKC和LEEP两种宫颈锥切术治疗CIN 2~3级的临床疗效,比较二者的临床价值.结果:与CKC组相比,LEEP组手术时间短,术中平均出血量少,术后出血发生率及宫颈管黏连率低,术后病变复发率高,术后高危人乳头瘤病毒(HPV)清除率低(P均<0.05).CKC组术后病灶残留率低于LEEP组,但差异无统计学意义(P>0.05).两组患者手术后高危HPV感染均较术前明显下降.术后病理显示,LEEP组病变复发患者均为CIN 3级,80%标本为多象限受累,病变残留占60%.结论:LEEP手术时间短、术中出血少、术后并发症少,但在减少复发(尤其是病变级别高,标本多象限受累的情况)及高危HPV持续感染方面不及CKC,因此LEEP尚不能完全取代传统的CKC.%Objective:To evaluate the clinical effects of cold knife conization (CKC) and loop electrosurgical excision procedure (LEEP) in the treatment of cervical intraepithelial neoplasia 2-3 (CIN2-3).Methods:A retrospective analysis of the clinical data was carried out in 172 cases with CIN 2-3.The clinical effects of CKC and LEEP on the treatment of CIN 2-3 were compared and evaluated.Results:Compared with the CKC group,the LEEP group had shorter operation time,less average intraoperative blood loss,lower rate of postoperative bleeding and cervical adhesion,higher postoperative recurrent rate,and lower risk HPV clearance rate after operation (both P < 0.05).Although the rate of residual disease after operation in CKC group was lower than that in the LEEP group,the difference was not statistically significant(P >0.05).Postoperative pathology showed the relapsed patients in the LEEP group were all CIN 3,80% samples

  1. 围术期整体护理在宫颈上皮内瘤样病变行高频电波刀环切术后的应用效果%Application effect of perioperative holistic nursing after high frequency electrosurgical knife loop electrosurgical excision of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    杨小云

    2014-01-01

    目的:探讨宫颈上皮内瘤样病变高频电波刀环形电切术治疗的围术期护理效果。方法选取2011年6月~2013年6月需于本院进行高频电波刀环形电切术治疗的宫颈上皮内瘤样病变患者110例,按数字随机法将患者分为观察组和对照组,每组55例。患者均进行常规高频电波刀环形电切术治疗。对照组采取常规护理,观察组采取围术期整体护理。比较两组的治疗效果、平均住院时间、并发症发生情况以及患者满意度。结果观察组治愈率为96.36%,高于对照组的83.64%,差异有统计学意义(P<0.05)。与对照组比较,观察组平均住院时间缩短,总并发症发生率降低,患者满意度提高,差异有统计学意义(P<0.05)。结论围术期整体护理有利于患者的治疗,可缩短患者的住院时间,减少各类并发症的发生并提高患者的满意度,值得临床推广应用。%Objective To investigate the effect of applying perioperative nursing after the high frequency electrosurgical knife loop electrosurgical excision of cervical intraepithelial neoplasia. Methods 110 patients with cervical intraepithe-lial neoplasia received high frequency electrosurgical knife loop electrosurgical excision in our hospital from June 2011 to June 2013 were selected and divided into the observation group and the control group according to the random number method,with 55 patients in each group.All the patients were received conventional high frequency electrosurgi-cal knife loop electrosurgical excision.The control group were received conventional nursing and the observation group were received perioperative holistic nursing.The treatment effects,average hospital stay,complications and patient satis-faction of the two groups were compared. Results The cure rate of the observation group was 96.36%,which was higher than 83.64% of the control group,with significant difference (P<0.05).Compared with the control group

  2. Excision of the cervical cone biopsy under colposcopic diagnosis of cervical intraepithelial neoplasia and cervical cancer early re-evaluation%宫颈锥形切除对阴道镜下多点活检诊断宫颈上皮内瘤样病变及早期宫颈癌的再评价

    Institute of Scientific and Technical Information of China (English)

    张金瑾

    2014-01-01

    Objective To observe and analyze the excision of cervical cone biopsy under colposcopic cervical intraepithelial neoplasia and cervical cancer early re-evaluation to improve the diagnosis of cervical cancer ,to provide a reference for further treatment of dis-ease.Methods The hospital 112 cases in 2005 to 2012 by colposcopic biopsy diagnosis of CIN patients with early cervical cancer or cervical sword in LEEP conization biopsy pathology further data were analyzed retrospectively .Results The pathology of cervical conization prevail,CIN Ⅰ23 Case,CINⅡ38 Case,CINⅢ34 cases,11 cases of carcinoma in situ,invasive carcinoma in 6 cases,con-trast colposcopic biopsy results consistent with 67 cases,do not meet the 45 cases,of which underdiagnosis of 21 cases,24 cases of over-diagnosis.LEEP 112 cases of invasive cervical cancer are diagnosed in 11 cases,colposcopic biopsy missed was 8.6%.Conclusion colposcopic cervical biopsy diagnosis of CIN limitations on joint conization can achieve a correct diagnosis of cervical cancer ,and to a-void misdiagnosis of occult cancer ,can provide important reference for further diagnosis of cervical cancer .%目的:观察并分析宫颈锥形切除对阴道镜下多点活检诊断宫颈上皮内瘤样病变( cervical intraepithelial neoplasia ,CIN)及早期宫颈癌的再评价,提高宫颈癌的确诊率,给疾病进一步治疗提供参考依据。方法对该院2005-2012年112例经阴道镜活检病理诊断CIN或早期宫颈癌的病人在LEEP刀下行宫颈锥切术再行病理检查病理诊断资料作回顾性分析。结果以宫颈锥切病理为准,CINⅠ23例,CINⅡ38例,CINⅢ34例,原位癌11例,浸润癌6例,对比阴道镜多点活检病理结果相符合有67例,不符合45例,其中诊断不足有21例,诊断过度24例。112例LEEP诊断为宫颈浸润癌的有11例,阴道镜下活检漏诊率为8.6%。结论阴道镜下多点宫颈活检对CIN的诊治有局限性,联合宫颈

  3. Comparison of the efficacy of Baofukang suppository and policresulen suppositories in patients with cervical cancer after treatment of vaginal intraepithelial neoplasia%保妇康栓和聚甲酚磺醛栓治疗宫颈癌患者术后阴道上皮内瘤变的疗效比较

    Institute of Scientific and Technical Information of China (English)

    王雁; 赵虹

    2016-01-01

    Objective To investigate the clinical effect of vaginal intraepithelial neoplasia and Baofukang suppository policresulen suppository in the treatment of cervical cancer patients after operation. Methods In January 2010 to January 2015 in our hospital for treatment of 86 cases of cervical cancer patients with vaginal intraepithelial neoplasia patients as the research object, the use of computer method were randomLy divided into treatment group (80) and control group (60). Treat-ment group treated with CO2 laser combined with Baofukang suppository in the treatment, the control group were treated with CO2 laser combined with policresulen suppository in the treatment of observation the clinical effects were compared between the two groups. Results After treatment, the total effective rate of the treatment group and the control group were 97.50% and 88.33% respectively, and the difference between the two groups was statistically significant. After treatment, the cure rate of the treatment group and the control group were 93.68% and 81.46% respectively, and the difference between the two groups was statistically significant. After treatment, the treatment group and control group HPV clearance rates were 78.66% and 61.38%, the difference between the groups was statistically significant. There were no serious adverse reactions in the two groups during the treatment. Conclusion CO2 laser combined with breast Baofukang suppository in treatment of cervical cancer high risk HPV infection in vain with vain higher cure rate and HPV clearance rate. It is worthy of clinical application.%目的:探讨保妇康栓和聚甲酚磺醛栓治疗宫颈癌患者术后阴道上皮内瘤变的临床疗效。方法:以2010年1月-2015年1月在我院接受治疗的86例宫颈癌患者术后阴道上皮内瘤变患者为研究对象,采用计算机法进行随机分为治疗组(80)和对照组(60)。治疗组行 CO2激光联合保妇康栓治疗,对照组行 CO2激光联合聚

  4. Human papilloma virus types distribution in patients with cervical cancer and cervical intraepithelial neoplasia in Chongqing%重庆市宫颈癌及宫颈上皮内瘤变患者中人乳头瘤病毒感染率及型别分布

    Institute of Scientific and Technical Information of China (English)

    王冬; 周琦; 唐郢; 肖觉

    2010-01-01

    目的 研究浸润性子宫颈癌(infiltrative cervical cancer,ICC)及子宫颈上皮内瘤变(intraepithelial neoplasia,CIN)中人乳头瘤病毒(human papilomavirus,HPV)感染率及型别分布. 方法 选取重庆市肿瘤医院组织病理学诊断为CINⅡ、CINⅢ级和宫颈鳞癌的组织标本58例作为研究对象,SPF10 LiPA25及HPV DNA酶免疫检测法(DNA enzyme immunoassay,DEIA)进行DNA的提取及扩增;采用线形探针反向杂交技术检测病变组织中HPV型别. 结果 58例标本中有56例检测出HPV感染,HPV感染率96.55%,其中CINⅡ、CIN Ⅲ级和子宫颈癌中HPV感染的阳性率分别为100.00%、100.00%、95.00%.共检测出13种HPV型别,HPV16感染率最高(60.00%),其次为HPV18(7.69%)、HPV58(7.69%)和HPV31(4.62%).宫颈鳞癌、CINⅢ、CINⅡ级HPV多重感染率分别为6.06%、26.31%、33.33%.41~50岁高危型HPV感染率最高(44.64%). 结论 HPV16为重庆市最常见的HPV感染型别,HPV18、HPV58和HPV31也有较高感染率.

  5. Clinical Research of Cervical Intraepithelial Neoplasia with Human Papillomavirus Infection in Biological Padded Interventional Therapy%生物衬垫式介入疗法对伴有人乳头瘤病毒感染的宫颈上皮内瘤变的临床研究

    Institute of Scientific and Technical Information of China (English)

    王虹

    2013-01-01

    目的:观察壳聚糖宫颈抗菌膜衬垫式介入治疗并发人乳头瘤病毒(human papillomavirus, HPV)感染的宫颈上皮内瘤CINⅢ型患者的临床疗效。方法:选取本院伴有HPV感染的宫颈上皮内瘤CINⅢ型患者152例,随机分为治疗组和对照组各76例。治疗组LEEP术后当天及第7、14、21天均行宫颈创面消毒,彻底擦拭干净消毒液后放置壳聚糖宫颈抗菌膜1枚于创面,并使抗菌膜紧贴创面,再向阴道内填塞带线棉球以防止抗菌膜脱落,12 h后取出。对照组术后未给予上述治疗。术后第7、14、21天均对两组患者复诊,观察阴道分泌物、阴道流血及创面愈合等情况。术后3个月复查宫颈行LCT及阴道镜检查。结果:术后第7、14、21天,治疗组阴道分泌物、阴道流血的综合评分和创面愈合情况及愈合时间均优于对照组,两组比较差异均有统计学意义(P<0.05)。治疗3个月后,对照组HPV感染转阴率为50.00%,治疗组为71.05%,两组比较差异有统计学意义(P<0.05)。电子阴道镜检查显示对照组慢性炎症转化率为55.27%,治疗组为34.21%,两组比较差异有统计学意义(P<0.05)。结论:壳聚糖宫颈抗菌膜衬垫式介入治疗伴有人乳头瘤病毒感染的宫颈上皮内瘤CINⅢ型患者有较好的治疗作用,值得推广应用。%Objective: To observe the clinical effect of patients of cervical intraepithelial neoplasia CINⅢ type with human papillomavirus (HPV)infection in chitosan cervical anti-bacterial membrane padded interventional therapy.Method: One hundred and fifty-two patients of cervical intraepithelial neoplasia CINⅢ type with HPV infection were randomly divided into the treatment group and the control group, each group had 76 cases. The same day and 7, 14, 21 days after operation of leep cutter technology, the treatment group was treated by cervical wound disinfection, put one chitosan cervical anti

  6. Role of LCT on the diagnosis of cervical intraepithelial neoplasia%液基细胞学在诊断宫颈上皮内瘤变中的作用

    Institute of Scientific and Technical Information of China (English)

    杨西江

    2009-01-01

    Objective To study the role of LCT(Liquid-Based Cytology Test,LCT) in the diagnosis of CIN (cervical intraepithelial neophrsia,CIN and the clinical significance for cervical cancer prevention.Methods 8515 patients were examined by LCT,and multiple biopsies were performed on the suspicious patients to get correct diagnosis.Results Atypical cells were seen in 158 patients,75(47.5%)of them were diagnosed as ASCUS,55(34.8%)were LSIL and 28(17.7%)were HSIL.Multiple biopsies were performed on the patients who were diagnosed as LSIL and HSIL by LCT.The results showed that 42.2% of them were CINI,49.4% were CIN Ⅱ and 8.4% Were CIN Ⅲ.The accurate diagnosis of CIN1、CINⅡ、CINⅢ diseasesby LCT were 63.6%,56.1%and77.4%,respectively-Conclusions LCT combined with biopsy is a good method for diagnosis of cervical diseases,燼nd takes a crucial role on the diagnosis ard treatment of early stage of cervical cancer.%目的 探讨液基细胞学诊断宫颈上皮内瘤变(CIN)及预防宫颈痛的临床意义.方法 对8515例妇女进行宫颈液基细胞学检查,对可疑病例作阴道镜下多点活检以进一步确诊.结果 8515例液基细胞学检查有异型细胞的共158例,其中诊断为细胞学异常(ASCUS)75例,约占47.5%,低度上皮内瘤变(LSIL)55例,约占34.8%,高度上皮内瘤变(HSIL)28例,约占17.7%.LSIL及HSIL病例经阴道镜下多点活检后.CINⅠ病例约占42.2%,CINⅡ约占49.4%,CINⅢ约占8.4%.与组织学诊断相比较,液基细胞学在诊断CINⅠ级、Ⅱ级和Ⅲ级符合率分别为:63.63%、56.10%和77.43%.结论 采用液基细胞学筛查、结合阴道镜及组织学诊断宫颈病变,对宫颈癌的早期发现、早期诊断及早期治疗有非常重要的意义.

  7. Rapid tumor progression in a patient with HPV type 16 associated anal squamous cell carcinoma suffering from long-standing Crohn's disease: A case report

    Directory of Open Access Journals (Sweden)

    Fischer AK

    2016-10-01

    Full Text Available Background and aim: Squamous cell carcinoma (SCC is the most common cancer of the anal region, typically associated with high-risk (hr HPV infection. Furthermore, there is evidence that Crohn's disease predisposes to adenocarcinoma in patients with perianal disease. Materials and methods: A 57-year old patient presenting with long history of Crohn's disease since the age of mid-twenties, went through several surgeries including ileocolectomy and anal fistula resection, combined with immunosuppressive therapy additionally periodically since 2008. One year before death (in 2015 a painful fistula was diagnosed with extensive high grade anal intraepithelial neoplasia (AIN-HG and evidence of invasive growth as non-keratinizing SCC. Tissue samples from several previous and current resection specimens were re-evaluated and extensively investigated for Crohn´s type inflammation, dysplasia and HPV both by immunohistochemistry (p16/Ki67 and molecular subtyping of HPV. Results: AIN-HG and invasive anal squamous cell carcinoma turned out to be strongly positive for p16/Ki67 staining and molecular analysis disclosed a HPV-16 subtype. In contrast, HPV-analysis was negative in all available previous tissue samples including one anal fistula resected five years before (in 2009 which was lined by non-keratinized squamous epithelium without any evidence of dysplasia. Thus, the patient was diagnosed as Crohn's disease with hr-HPV infection that rapidly (< 5ys progressed to AIN-HG and anal SCC. Finally, osseous metastases occurred and the patient died shortly after. Conclusions: This case of a patient diagnosed with SCC of the anal canal in combination with Crohn's disease as well as HPV Type 16 infection, points to the pathomechanism leading to dysplasia and finally cancer. We assume that immunosuppressive therapy in Crohn's disease may predispose to both persistent HPV infection and HPV related invasive anal carcinoma. The accelerated progression of HPV

  8. Detection of gene amplification in MYCN, C-MYC, MYCL1, ERBB2, EGFR, AKT2, and human papilloma virus in samples from cervical smear normal cytology, intraepithelial cervical neoplasia (CIN I, II, III, and cervical cancer

    Directory of Open Access Journals (Sweden)

    Dabeiba Adriana García

    2011-06-01

    Full Text Available Introducción: El cáncer cervical es el segundo cáncer más importante en mujeres a nivel mundial y es la segunda causa de muerte por cáncer en mujeres. Se ha demostrado que el proceso de carcinogénesis cervical presenta componentes tanto genéticos como epigenéticos y medio ambientales. En la actualidad, hay gran interés en la búsqueda de marcadores moleculares asociados con la progresión de esta enfermedad, uno de los posibles mecanismos y que además está poco estudiado en cáncer cervical es la amplificación génica de algunos oncogenes como la familia MYC, EGFR y AKT entre otros. Objetivos: Detectar la amplificación génica de MYCN, C-MYC, MYCL1, ERBB2, EGFR y AKT2 además de la presencia del virus de papiloma humano en cepillados cervicales en mujeres con citología normal o con neoplasia intraepitelial cervical (NIC I, II y III o con cáncer cervical. Métodos: Se genotipificó mediante reverse line blot (RLB el virus de papiloma humano (VPH y se determinó el estado de amplificación génica de los genes mencionados mediante PCR en tiempo real utilizando sondas taqman. Resultados: El VPH se encontró presente en 4% de las pacientes con citología normal, en 48% en NIC I, 63.6% en NIC II, 64% en NIC III y 70.8% en cáncer cervical. Los genes MYCN, MYCL1 y ERBB2 mostraron mayor amplificación en lesiones de alto grado y cáncer con diferencias estadísticamente significativas  a las lesiones de bajo grado y citología normal, en 39.1%, 34.7% y 30.4% respectivamente. Además, se encontraron amplificados los genes C-MYC, EGFR y AKT2, en muestras de pacientes con cáncer cervical, en 12%, 18% y 13% respectivamente. Sin embargo, no se observaron diferencias estadísticamente significativas con respecto a las lesiones de alto y bajo grado y citología normal. Conclusión: En las lesiones de alto grado como en cáncer cervical, se encuentra mayor prevalencia del virus al igual que se detectan mayor cantidad de alteraciones gen

  9. 联合筛查对 CIN 患者的诊治价值研究%Study of Diagnostic and Therapeutic Value of Combined Screening in Patients with Cer-vical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    吴淑英

    2014-01-01

    Objective To explore the clinical value of thin-layer cytological test system ( TCT) ,loop electrosurgical ex-cision procedure (LEEP),and colposcopic biopsy in the treatment of cervical intraepithelial noeplasia (CIN).Methods 1 397 female patients were examined by TCT .113 patients with positive results received colposcopic biopsy and pathological examina-tion.Patients diagnosed as CIN received LEEP .The results were compared between clinical and pathological analysis .Results Among 1 397 patients,113 patients were cytologically diagnosed as positive ,including 74 cases of ASCUS+AGUS (65.5%),4 cases of ASC-H (3.5%),23 cases of LSIL (20.4%),8 cases of HSIL (7.1%),and 4 cases of cancer (3.5%).All patients received pathological examination under colposcopic biopsy .There were 91 cases with abnormal colposcopic images (80.5%),in-cluding 33 cases of inflammation (29.2%),40 cases of CINⅠ(35.4%),13 cases of CINⅡ(11.5%),4 cases of CINⅢ(3.5%),and 1 case of cancer (0.9%).The pathological results of the specimen resected through LEEP indicated that there were 8 cases of inflammation (14.0%),34 cases of CINⅠ(59.6%),11 cases of CINⅡ(19.3%),3 cases of CIN Ⅲ(5.2%), and 1 case of infiltrative cancer (1.9%).Conclusion The combination of the TCT,LEEP,and colposcopic biopsy contribute to the accurate diagnosis and timely treatment of patients with CIN .%目的:探讨液基薄层细胞学检测( TCT)联合电子阴道镜及环形电切除术( LEEP)治疗在宫颈上皮内瘤变( CIN)患者中的临床应用价值。方法选取1397例行TCT检查的已婚女性纳入研究,其中检查呈阳性者113例,行阴道镜下多点活检并进行病理学检查。检查确诊为宫颈上皮内瘤变患者行LEEP治疗。结果进行临床和病理学分析比较。结果 TCT检测病例数1397例,其中检出阳性涂片113例(8.1%):其中ASCUS+AGUS 74例(65.5%),ASC-H 4例(3.5%),LSIL 23例(20.4%),HSLL 8例(7.1

  10. Defensive anality and anal narcissism.

    Science.gov (United States)

    Shengold, L

    1985-01-01

    This paper aims at demonstrating a currently beleaguered assumption: the central importance, the continuing vitality, and the appropriate complexity of Freud's theory of the drives and of his idea of the primacy of the body ego. It is not enough to consider man a thinking machine or a social being; his animal nature must be given a central place in psychology. The paper postulates that 'anal or sphincter defensiveness' is one of the precursors of the repression barrier. Anality has been comparatively neglected in recent psychoanalytic literature, and so has its explorer, Karl Abraham. The paper's thesis is that there is a special defensive importance to anal erogeneity and libido, and to those aspects of ego and superego that are functionally operative (as the 'sadistic-anal organization' (Freud, 1917)) during the so-called 'sadistic-anal' developmental phase. Any of the psychic danger situations can evoke regression to manifestations of 'anal narcissim'--an attempt to master overwhelming feeling by a kind of emotional sphincter action, narrowing down the world to the controllable and the predictable. The basic assumption here is Fliess's idea that the attainment of anal sphincter control functions--with, as-it-were, 'psychic resonance'--as a means to master primal (murderous, cannibalistic) affect. For optimal psychic development, a proper balance must be attained between anal control of, and anal expression of, instinctual derivatives--especially of affect laden with aggression.

  11. 高危型人乳头瘤病毒检测对宫颈上皮内瘤样病变诊断价值的探讨%Value of high-risk human papillomavirus DNA testing to diagnosis of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    何善阳; 杨炜敏; 袁力; 沈丽萍; 游泽山; 姚书忠

    2011-01-01

    目的:探讨在ASC-H患者中检测HR-HPV DNA预测宫颈上皮内瘤样病变(CIN)和浸润癌的价值,为完善CIN和浸润癌的筛查方案提供依据.方法:研究宫颈薄层液基细胞学诊断为ASC-H的患者68例,均进行HR-HPV DNA检测并在阴道镜下行宫颈组织活检,综合评价HR-HPV预测高级别CIN的价值.结果:在ASC-H中CIN发生率为52.9%(36/68),CINⅡ及以上病变(CINⅡ、CINⅢ及浸润癌)发生率为33.8%(23/68); HR-HPV检测阳性率为70.6%(48/68),HR-HPV阳性组CINⅡ及以上病变发生率为47.9%(23/48),HR-HPV阴性组CINⅡ及以上病变发生率为0(0/20),两组比较差异有统计学意义,x2=14.797,P=0.001,HR-HPV诊断CINⅡ及以上病变的敏感度和特异度分别为100.0%和44.4%,阳性预测价值和阴性预测价值分别为47.9%和100.0%.结论:初步研究结果提示,HR-HPV阳性ASC-H患者应高度警惕CINⅡ及以上病变发生,建议立即行阴道镜检查;而HR-HPV阴性患者可不进行阴道镜检查.%OBJECTIVE: To investigate the significance of high-risk HPV(HR-HPV) DNA testing in atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion ( ASC-H) to predict cervical intraepithelial neoplasia (CIN), invasive cancer and guide further treatment. METHODS: A total of 68 patients with ASC-H diagnosed by Thin-Prep-liquid-based cytology were undergone with HR-HPV testing and cervical biopsies. RESULTS:Incidence of CIN and CIN II and worse (CIN Ⅱ . CIN Ⅲ , and invasive cancer) in the ASC-H was 52. 9% (36/68) and 33. 8%(23/68),respectively. Positive rate of HR-HPV test was 70. 6%(48/68) and rate of CIN Ⅱ and worse was 47. 9% (23/48) in HR-HPV positive group,but positive rate was 0(0/20) in HR-HPV negative group. There was statistically significant difference (x2 = 14. 797,P = 0. 001). HR-HPV diagnosed CIN Ⅱ and worse in ASC-H with the 100. 0% sensitivity and 44. 4% specificity, respectively and with 47. 9% positive predictive value and 100. 0

  12. 阴道镜联合LEEP术对宫颈癌前病变的临床诊疗价值研究%Study on the value of colposcopy combined with LEEP in clinical diagnosis and treatment of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    曹迎九; 高涛; 张跃; 程雪菊

    2016-01-01

    目的 观察和探讨阴道镜联合LEEP术对宫颈癌前病变(Cervical intraepithelial neoplasia,CIN)的诊疗价值.方法 选择2011年10月-2014年9月在南京医科大学附属无锡人民医院妇产科确诊的150例具有LEEP手术指征的CIN患者,对其进行阴道镜下LEEP手术.对比阴道镜诊断与活检诊断结果、阴道镜活检结果与LEEP术后病理结果,并统计术中情况.结果 宫颈活检结果:CIN Ⅰ 48例,CINⅡ66例,CINⅢ36例;150例患者的阴道镜检测结果为LSIL 57例,HSIL 72例,阴道镜不满意21例;手术时间4~ 11 min,平均(6.8±1.2) min,术中出血量3.2~47 ml,平均(10.8±1.1) ml,12例出现轻微下腹坠胀不适,7例阴道灼热感,均未影响手术进行,术后3个月复查转阴率为94.7%,6个月后转阴率100.0%;术后患者宫颈均送病理切片,136例与阴道镜下病理诊断一致,诊断符合率为90.6%.结论 阴道镜联合LEEP术可提高宫颈病变的诊断阳性率,治疗效果佳且无严重并发症,能更早的发现宫颈癌及其癌前病变,为该病的筛查与防治提供了有效的手段.

  13. Clinical value of thinprep cytology test, colposcopic multiple biopsies and loop electrosurgical excision procedure in the diagnosis and treatment of cervical intraepithelial neoplasia%液基细胞学、阴道镜下活检及LEEP术联合对宫颈上皮内瘤变诊治的临床价值

    Institute of Scientific and Technical Information of China (English)

    赵虹; 潘惠艳; 卢丹; 王雁; 吴玉梅; 张为远

    2013-01-01

    目的:探讨液基细胞学、阴道镜下活检与LEEP术在诊治宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)中的价值.方法:回顾性分析近3年来,在我院妇科门诊行LEEP手术的CIN患者560例,对比研究液基细胞学检查(thinprep cytology test,TCT)、阴道镜下活检及LEEP术后病理结果的差异及符合情况.结果:细胞学与阴道镜活检结果符合率LSIL 30.8%(45/146),HSIL 84.2%(133/158).TCT检查HSIL病理符合率高于LSIL,差异具有统计学意义(P<0.05).TCT检查结果为ASC-H活检病理CINⅡ和CINⅢ的比率高于ASCUS患者,差异具有统计学意义(P<0.05).阴道镜下活检病理与LEEP术后标本病理符合率:总符合率为57.9%,CIN Ⅰ符合率为42.1%,CINⅡ为61.5%,CINⅢ为73.7%.CIN级别越高,符合率随之升高,其有统计学意义(P<0.05).结论:LEEP术是一种能够准确诊断CIN病变的较好方法,其弥补了液基细胞学与阴道镜下活检的局限性和盲目性,三者联合使宫颈癌前病变的诊断和治疗更加完善,减少漏诊、误诊率.

  14. 宫颈上皮内瘤变患者宫颈环形电切术后切缘阳性的研究%Study of Positive Incisal Margin for Cervical Loop Electrosurgical Excision Procedure in Patients with Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    廖庆梅; 王红霞; 王燕英

    2013-01-01

    Objective:To study the situation of positive incisal margin and residual lesions for cervical loop electrosurgical excision procedure in patients with Cervical intraepithelial neoplasia(CIN).Method:398 patients with CIN were as research subjects to study the relative causes of positive incisal margin after LEEP.Result:Positive margin rate (14.2%)in patients with Age>40 was higher than patients with Age ≤ 40 (7.0%),there was statistically significant (χ²=5.598,P40,HPV infection,lesions involving glands and multi-point lesions are the factors caused high positive rate for incisal margin after treatment of LEEP.Different patients in the clinical LEEP procedure should choose the different depth and scope of excision to reduce the residual lesions.%  目的:探究宫颈上皮内瘤变(CIN)患者宫颈环形电切术(LEEP)后切缘阳性及病灶残留情况。方法:选择2008年8月-2011年8月本院采用LEEP治疗后的CIN患者398例作为研究对象,研究引起LEEP术后切缘阳性的相关因素。结果:年龄>40岁的患者切缘阳性率(14.2%)明显高于年龄≤40岁的患者(7.0%),差异有统计学意义(字2=5.598,P40岁、HPV感染、病变累及腺体及多点病灶都是引起LEEP术后切缘阳性率高的因素。临床中LEEP术时不同的患者应该选择不同的切除深度和范围,减少病灶的残留。

  15. Evaluation of cervical conization in diagnosis and treatment of cervical intraepithelial neoplasia and early cervical cancer%宫颈电刀锥切术在诊治宫颈上皮内瘤变及早期宫颈癌中的价值

    Institute of Scientific and Technical Information of China (English)

    许秀华

    2011-01-01

    目的 探讨宫颈电刀锥切术在宫颈上下宫颈皮内瘤变(GIN)及早期宫颈癌诊治中的价值.方法 回顾性分析142例行宫颈电刀锥切术和阴道镜下宫颈多点活组织检查患者的临床资料,对比研究宫颈电刀锥切术和阴道镜下宫颈多点活组织检查结果的差异以及术后并发症等.结果 宫颈电刀锥切术与阴道镜下宫颈多点活组织检查结果完全符合70例(49.3%,70/142);术中及术后的并发症主要为术中出血和宫颈粘连.宫颈粘连发生率为2.8%(4/142).出血200ml 1例.结论 宫颈电刀锥切术具有手术时间短,出血量少,切净率高的优点.其对CIN和早期宫颈浸润癌的诊断率高.%Objective To determine the clinical value of cervical conization in diagnosis and treatment of cervical intraepithelial neoplasia(CIN)and early cervical Cancer.Methods The clinical data of 142 patients who underwent cervical conization and vaginoscope multiple biopsies were analyzed retrospectively,and the results and complications were compared.Results There was a correlation in pathology cervical conization and vaginoscope multiple biopsies in 70 cases(49.3%,70/142).The major complication of cervical conization was hemorrhage and cervix adherence.The percentage of cervix adherence was 2.8%(4/142).The blood volume200ml were 125,10,6 and 1 case respectively.Conclusions Cervical conization plays a very important role in diagnosis of CIN and early cervical cancer.It is simple,short time,little hemorrhage and high excision rate.

  16. Short-term risk of cervical intraepithelial neoplasia grades 2 and 3 for women with normal cytology and human papillomavirus infection Riesgo a corto plazo de lesiones intraepiteliales cervicales grados 2 y 3 en mujeres con citología vaginal normal e infección por el virus del papiloma humano

    Directory of Open Access Journals (Sweden)

    Gustavo Hernández-Suárez

    2010-12-01

    Full Text Available OBJECTIVE. To assess the risk of cervical intraepithelial neoplasia grades 2, 3 or higher (CIN 2/3+ for women with normal cytology and concurrent high-risk human papillomavirus infection (HR-HPV. MATERIAL AND METHODS. We examined 2 200 women every 6 months for an average of 9 years. Cervical smears and samples for HPV DNA were obtained at each visit. Absolute risk of subsequent CIN2/CIN3+ was estimated using the Kaplan-Meier method. RESULTS. The absolute risk of CIN2/CIN3+ among HR-HPV-positive women with normal Pap smear results was 1.06% (95%CI, 0.57-2.20, 5 times higher the risk among all women with normal Pap smears (0.20%; 95%CI, 0.12-0.32 but 7 times lower than that for women with HR-HPV infection and LSIL (7.24%; 95%CI, 3.78-15.2. CONCLUSION. Short-term absolute risk of CIN2/3+ after a normal Pap smear with concurrent HR-HPV infection is low (~1%, suggesting that the HR-HPV test has limited utility in short-term clinical decision-making for women with normal cytology.OBJETIVO. Evaluar el riesgo a corto plazo de neoplasia intraepitelial cervical de alto grado (CIN2/CIN3+ en mujeres con citologí-a cervicouterina normal e infección por virus del papiloma humano de alto riesgo (HR-HPV. MATERIAL Y MÉTODOS. Cohorte prospectiva de 2200 mujeres evaluadas cada seis meses durante 9 años en promedio. En cada visita se tomó muestra cervical para extendido y detección de HPV DNA. El riesgo absoluto de CIN2/CIN3+ a la siguiente visita fue calculado utilizando el método de Kaplan-Meier. RESULTADOS. En mujeres con citologí-a normal e infección concomitante por HR-HPV el riesgo absoluto de presentar CIN2/CIN3+ fue de 1.06% (95%CI, 0.57-2.20. Este riesgo fue cinco veces mayor al observado en todas las mujeres con citologí-a normal (0.20%; 95%CI, 0.12-0.32 pero siete veces menor que el observado en mujeres con lesiones intraepiteliales escamosas de bajo grado con infección concomitante (7.24%; 95%CI, 3.78-15.2. CONCLUSIÓN. El riesgo absoluto de

  17. Rastreamento e seguimento dos portadores das lesões anais induzidas pelo papilomavírus humano como prevenção do carcinoma anal Screening and follow-up of patients with anal HPV induced lesions for anal carcinoma prevention

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-06-01

    Full Text Available O Papilomavírus humano (HPV é o agente sexualmente transmissível mais comum na região perianal. O vírus provoca lesões clínicas e subclínicas que podem evoluir para carcinoma anal. É descrito o aumento da incidência desse tipo de tumor naqueles que praticam sexo anal; nos portadores, de ambos os sexos, de lesões genitais HPV induzidas; nas pessoas com neoplasias intraepiteliais anais de alto grau, o precursor do carcinoma, com maior incidência nos infectados pelo vírus da imunodeficiência humana (HIV, e com outras causas de supressão imunológica. Outra característica das lesões HPV induzidas é a elevada incidência de recidivas. Daí, a importância do seguimento por longo prazo e da pesquisa de meios terapêuticos para reduzir essa ocorrência. A possibilidade da detecção das lesões precursoras indica que programas padronizados de rastreamento para a prevenção do câncer anal deveriam ser instituídos. Os esfregaços anais para citologia vêm sendo realizados, com eficácia semelhante a das coletas cervicais e a colposcopia anal tem sido indicada para biópsias dirigidas quando a citologia mostrou-se alterada, embora muitos recomendam-na, também, como método de rastreamento. Nesse artigo, descrevemos a padronização da coleta de material para citologia anal e o método de realização da colposcopia anal, bem como a periodicidade com que devem ser repetidos.The human papillomavirus is the most frequent sexually transmitted agent in anorectal area. This virus provokes clinical and sub-clinical lesions that can evolve to anal carcinoma. Its incidence is increasing among those who practice anal receptive sex; in both gender patients with genital HPV induced lesions; in those with high grade anal intra-epithelial neoplasia, anal carcinoma precursor, mainly among HIV infected persons or with other causes of immunodeficiency. Another HPV induced lesions characteristic is their elevated incidence of recurrences. Therefore

  18. Anal fissure

    Science.gov (United States)

    ... split or tear in the thin moist tissue ( mucosa ) lining the lower rectum (anus). Causes Anal fissures ... Chronic Constipation in infants and children Crohn disease Mucosa Review Date 5/24/2016 Updated by: Mary ...

  19. hCTR1、FHIT与PCNA在子宫颈上皮内瘤变和子宫颈鳞癌中表达及意义%Expression of hCTR1, FHIT and PCNA in cervical intraepithelial neoplasia and cervical invasive squamous cell carcinoma and their clinical significance

    Institute of Scientific and Technical Information of China (English)

    刘洪博; 何春年; 李聪; 杜红丽

    2012-01-01

    Purpose To study the expression of human copper transporters 1 ( hCTRl ), fragile histidine triad ( FHIT ) and proliferating cell nuclear antigen ( PCNA ) in cervical intraepithelial neoplasia ( CIN ) and cervical invasive squamous cell carcinoma ( SCC ) and investigate their correlativity in SCC. Methods hCTRl, FHIT and PCNA were examined by immunohistochemical staining ( SP method ) in 94 cases of CIN, 40 cases of cervical invasive SCC, and 23 cases of normal cervical squamous epithelia. Results The positive rates of hCTRl in SCC ( 87. 50% ) and in the level CIN 2 ~ 3 ( 74. 63% ) were significantly higher than those of normal cervical squamous epitheliums ( 17. 39% ) and CIN I ( 29.63% ) ( P 0. 05 , r = - 0. 296 ) or hCTRl and PCNA ( P > 0. 05 , r = 0. 026 ). Conclusions hCTRl expression intensity and positive rate in cervical carcinoma in situ were higher than that in early invasive cancer in cervix, which may prove that there is a negative correlation between hCTRl expression and malignant biological characteristics of invasiveness. There is a balance between FHIT and PCNA, which take part in the regulation of cell proliferation. Therefore, the detection of hCTRl and FHIT expression plays an important role in screening and predicting high-grade CIN and SCC.%目的 观察人类铜转运蛋白(human copper transporters 1,hCTR1)、脆性组氨酸三联体(fragile histidine triad,FHIT)和增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)在子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)及子宫颈鳞癌(squamous cell carcinoma,SCC)中的表达,探讨SCC中三指标之间的相关性.方法 采用免疫组化SP法检测94例CIN、40例SCC及23例正常宫颈组织中hCTR1、FHIT和PCNA的表达.结果 (1)hCTR1在SCC(87.50%)及CIN 2~3(74.63%)的阳性率均明显高于正常组(17.39%)、CIN 1(29.63%),差异有统计学意义(P<0.001).(2)FHIT从正常组(100%)、CIN 1(74.07%)、CIN 2~3(44.78%)到SCC(32.50%),FHIT阳性细胞表达逐

  20. Multivariate Analysis on Post-conization Positive Surgical Margin in Patients with Stage Ⅲ Cervical Intraepithelial Neoplasia%宫颈上皮内瘤变Ⅲ锥切术后病理切缘阳性的多因素分析

    Institute of Scientific and Technical Information of China (English)

    郭文萍; 郭红燕; 王静

    2011-01-01

    Objective To assess the high-risk factors associated with conization margin status and management options in patients with cervical intraepithelial neoplasia Ⅲ ( CIN Ⅲ ). Methods A retrospective analysis on 442 patients with CIN Ⅲ who underwent conization between January 2004 and April 2010 in our hospital. Postoperative pathological analysis showed positive surgical margin in 41 cases ( positive group ), and negative margin in the other 401 cases ( negative group ). Results Binary logistic analysis showed that positive margin is correlated with severe cervical erosion ( OR = 3. 438, 95% CI = 1. 323 - 8. 933 ), in situ carcinoma ( OR =3. 792, 95% CI = 1. 594 -9. 022) , involvement of the glands ( OR = 3. 940, 95% CI = 1. 724 - 9. 004 ) , and > 3 lesions (OR =5. 083, 95% CI =2. 192- 11. 787 ). In our patients, the 21 cases of positive margin received a second surgery, after which the rate of residual lesion was 38.1% (8/21), which was similar to that in the negative group ( 14.8% , 8/54; Z = 1. 898, P =0.058). A follow-up was achieved in 20 of the 21 positive patients, during the follow-up, 3 patients showed recurrence or persisitence of the lesion ( 15.0% ); the rate was significantly higher than that in the negative group ( 1.7% , 3/241, Z = 2. 799, P = 0.005 ).Conclusions More than 3 lesions, glands involvement, in situ carcinoma, and cervical erosion are high-risk factors of positive surgical margin in patients with CIN Ⅲ. The positive margin is associated with recurrence/persistence. If re-conization is technically impossible, simple hysterectomy is the treatment option for the patients with positive margins. The patients with CIN Ⅲ should be followed up closely, especially for those with positive margins.%目的 探讨影响宫颈上皮内瘤变Ⅲ(cervical intraepithelial neoplasia Ⅲ,CINⅢ)锥切病理切缘阳性的高危因素及进一步处理的选择. 方法 回顾性分析我院2004年1月~2010年4月442例因CIN Ⅲ住

  1. 早期食管癌和上皮内瘤变多环黏膜套切术的疗效和安全性评价%Safety and efficacy of endoscopic multiband mucosectomy for early esophageal carcinoma and intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    汪芳裕; 刘炯; 袁柏思; 张新华; 王建东; 路又可; 徐小芹

    2012-01-01

    -perforation occurred in 1,which was cured by metal clip.Histopathological diagnoses revealed 3 cases of intramucosal squamous carcinoma,19 high grade intraepithelial neoplasia,17 low grade intraepithelial neoplasia,and 7 inflammatory hyperplasia.No recurrence was found during the follow-up of 1 to 53 months.Conclusion EMBM is effective and safe for the treatment of early cancer and precancerous lesions of the esophagus.Appropriate indication and manipulation can decrease complication occurrence.

  2. 宫颈细胞病理学液基制片技术在宫颈上皮内瘤样变筛查中的应用价值%Application analysis of the cervical cell pathology liquid production technology in cervical intraepithelial neoplasia screening

    Institute of Scientific and Technical Information of China (English)

    林丽; 徐海苗

    2015-01-01

    目的:分析研究宫颈细胞病理学液基制片技术在宫颈上皮内瘤样变(CIN)筛查中的应用价值。方法选取4212例患者,采用新柏氏液基制片技术、巴氏染色、TBS(the Bethesda system)分级诊断进行液基薄层细胞学检查,其中558例患者行宫颈组织活检,对病理结果进行分析。结果对于组织病理学检查结果为 CIN1、CIN2、CIN3和宫颈癌的病例中,薄层液基细胞学检查的检出率分别为76.00%(57/75)78.21%(61/78),95.76%(113/118),100.00%(7/7),CIN3组 CIN2组之间比较,薄层液基细胞学检出率差异有统计学意义(χ2=14.53,P <0.01),随着组织病理学检测宫颈病变的加重,薄层液基细胞学检出率呈明显上升趋势。宫颈液基细胞学检查筛查宫颈病变(CIN 及以上)的灵敏度为85.61%(238/278)、特异度为83.73%(206/246)、阳性预测值76.28%(238/312)、阴性预测值72.79%(206/283)。结论采用新柏氏液基制片技术来筛查宫颈上皮内瘤样变(CIN)的阳性结果与组织病理学结果符合率高,对癌前病变的筛查和预防有着重要意义,值得临床推广。%Objective To study the application value of the cervical cell pathology liquid production technol-ogy in cervical intraepithelial neoplasia (CIN)screening.Methods 4 212 patients were chosen and detected by TCT and the pap staining,TBS (the Bethesda system)to finish thin layer liquid based cytology grading diagnosis,including 558 patients with cervical biopsy,the pathological results were analyzed.Results for histopathological examination results of CIN1,CIN2,CIN3 and cervical cancer cases,a thin layer of liquid based cytology detection rate was 76.00%(57 /75),78.21%(61 /78),95.76%(113 /118),100.00%(7 /7),the comparison between the CIN3 CIN2 group,a thin layer of liquid based cytology detection rate had differences in significant

  3. 宫颈环形电切术联合α-干扰素栓治疗宫颈上皮内瘤变的临床观察%Clinical Observation of Cervical Loop Electrosurgicai Excision Procedure Combined with Interferon α-Suppository in Treatment of Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    曹培勇; 张宗莲; 周丽; 鲁娟; 张琴; 毛惠杰; 杨娜

    2011-01-01

    目的 探讨宫颈环形电切术(loop electrosurgical excision procedure,LEEP)联合α-干扰素栓在治疗宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)中的作用.方法 选择我院CIN I~Ⅲ级的83例,随机分为两组.研究组43例,在LEEP术后第1次月经干净后即开始阴道后穹隆放置α-干扰素栓,隔日1次,1次1枚,连用3个月,经期停用.对照组40例单纯行LEEP.两组分别于治疗前行宫颈薄层液基细胞学检查(TCT)、阴道镜下定位多点活检及人乳头瘤病毒(HPV)检测,治疗后3、6、9、12个月行TCT及阴道镜下定位多点活检,且术后6、12个月时加行HPV检测.结果 两组手术时间、创面愈合时间、术后并发症,治疗前TCT、阴道镜下活检、HPV检测结果比较差异均无统计学意义(P>0.05).治疗后两组比较:①TCT:研究组术后3、6、9、12个月TCT正常率高于对照组;非典型鳞状上皮细胞内瘤变术后发生率低于对照组,两组比较差异有统计学意义(P<0.05);②阴道镜下活检:两组术后3、6、9、12个月CIN均为阴性,差异无统计学意义(P>0.05);③HPV检测:研究组术后6、12个月HPV阴性率高于对照组,差异有统计学意义(P<0.05).结论 LEEP伍用α-干扰素栓治疗CIN有协同作用,CIN的一次性治愈率明显提高.%Objective To observe the effects of cervical loop electrosurgical excision procedure(LEEP) combined with interferon α-suppository in treatment of cervical intraepithelial neoplasia(CIN). Methods 83 cases of CIN I ~ Ⅲ in our hospital were randomly divided into two groups. Based on LEEP, The study group (43 cases) was inserted an interferon α-suppository in vaginal fornix after the first menstrual ended( every other day for once, continued for 3 months) and was disabled in the period of menstrual. The control group ( 40 cases) simply received LEEP without any special treatment.TCT, mutiple punch biopsy by colposcope and HPV test were given to both groups before

  4. 宫颈上皮内瘤变术后联合氯喹那多/普罗雌烯的临床应用%Clinical Observation of Combined Therapy of Chlorquinaldol/Promestriene after Loop Electrosurgi-cal Excison Procedure in Treating Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    宋志琴; 王蔼明

    2014-01-01

    目的:观察宫颈上皮内瘤变术后应用氯喹那多/普罗雌烯,减少术后并发症,促进上皮愈合的情况。方法将2009年3月至2012年5月海军总医院妇科门诊收治的384例因宫颈上皮内瘤变行宫颈高频电波刀切除术( LEEP)的患者采用随机数字表法分成两组,氯喹那多/普罗雌烯组(观察组)195例,口服抗生素组(对照组)189例,其中观察组于术后第2日阴道填塞氯喹那多/普罗雌烯1片,每日1次,连用18 d,对照组术后常规口服抗生素3 d。术后2周观察阴道分泌物、创面脱痂及出血情况;术后4、6、8周观察宫颈上皮修复情况,术后3个月复查液基薄层细胞学与阴道镜,了解病变的改善情况。结果术后2周,观察组患者宫颈创面均完全脱痂,观察组创面脱痂率显著高于对照组(100% vs 22.22%,P<0.01)。观察组宫颈创面出血率显著低于对照组(5.64% vs 53.97%, P<0.01)。观察组无阴道清洁度异常发生,阴道清洁度正常率显著高于对照组(100% vs 57.14%, P<0.01)。术后4周复查,观察组在宫颈创面的修复情况显著优于对照组(P<0.01)。术后6周和术后8周,观察组痊愈率及上皮完全成熟度方面均显著高于对照组(72.31% vs 42.32%,96.41% vs 86.77%,P<0.01)。结论氯喹那多/普罗雌烯可明显减少LEEP术后出血、感染等并发症,缩短宫颈上皮愈合时间。%Objective To observe the effect of chlorquinaldol/promestriene therapy in decreasing inci-dence rate of postoperative complications and promoting epithelial healing after surgical operation for patients with cervical intraepithelial neoplasia(CIN).Methods A total of 384 women with CIN underwent cervical loop electrosurgical excisions procedure ( LEEP) in Navy General Hospital of PLA from Mar .2009 to May 2012 were randomly divided into two groups:patients in

  5. Análise retrospectiva das neoplasias de ânus em pacientes atendidos no HC-FMRP-USP de 1979 a 2004 e revisão da literatura Retrospective analysis of patients with anal tumors diagnosed at the school of medicine of Ribeirão Preto Hospital and clinics (HC-FMRP, between 1979 and 2004 and literature review

    Directory of Open Access Journals (Sweden)

    Rogério Serafim Parra

    2007-06-01

    Full Text Available Foram analisados, retrospectivamente, 49 casos de pacientes com neoplasia de ânus, sendo 23 de 1979-1996 e 26 de 1997-2004, 49% masculinos e 51% femininos. Em 81,6% dos pacientes o tratamento foi adjuvante, com radioterapia e esquema de NIGRO, 12,2% metástases à distância e 36,7% perderam o seguimento. Óbitos ocorreram em 20,4%. Notou-se diminuição da necessidade da cirurgia de Miles (30,8% vs 43,3%. A perda de seguimento foi menor (19,5% vs 56,5%, mas a mortalidade foi discretamente maior (23,1% vs 17,4%. O tratamento neo-adjuvante com radio e quimioterapia em 96% dos pacientes com neoplasia anal foi capaz de promover remissão da lesão na maioria dos casos (57,5%, confirmados pela biópsia da cicatriz residual, evitando-se amputação cirúrgica do reto. Dados mais recentes mostram que 45% dos pacientes permanecem sem recidiva (seguimento médio 3,5 anos. A alta taxa de mortalidade e o diagnóstico de lesões avançadas podem decorrer da procura tardia do serviço médico.In total, 49 cases of anal tumor were studied, 23 cases from 1979-1996 and 26 cases from 1997-2004. From the cases studied, 49 % were male and 51 % were female patients. Patients that were submitted to radio and chemotherapy by the "nigro scheme" totalized 81.6 %; 12.2 % presented metastasis, 36.7 % lost follow up and 20.4 % died. There was a reduction of the Miles surgery indication (30.8 % vs 43.3 % and the follow up loss (19.5 % vs 56.5 %. The mortality rate was a little higher (23.1 % vs 17.4 %. Radio and chemotherapy was used in 96 % of patients, and promoted lesion remission in 57.5 % of cases (confirmed by negative anal scar biopsy, avoiding the anal amputation surgery indication. Recent data indicate that 45 % of patients (3.5 years of average follow up are still with no recidivated tumor. The prevalence of high mortality rates and the diagnosis of high stage lesions are due to a delay of patients in search for a diagnosis. This might be due to a difficult

  6. Antioxidant Prophylaxis in the Prevention of Prostatic Intraepithelial Neoplasia (PIN)

    Science.gov (United States)

    2008-02-01

    epidemiological studies with a variety of antioxidants such as selenium, tocopherols, lycopene , β-carotene etc. have been found to be effective in...dark cycle and a temperature of 23+2oC with access to food and water. At 6 weeks of age animals were randomized into 4 groups of 10 animals each

  7. Determination of malignant potential of cervical intraepithelial neoplasia.

    Science.gov (United States)

    Kudela, E; Holubekova, V; Farkasova, A; Danko, J

    2016-02-01

    Basic diagnostic procedures in cervical cancer screening are able to set the diagnosis but they do not provide any information about the biological nature and behavior of lesions. The causal link of HPV infection and cervical cancer and discoveries of complex interactions between host and HPV genome opened new possibilities in molecular diagnostics. HPV DNA analysis, determination of viral load, detection of E6 and E7 mRNA transcripts, identifying of methylation profiles, genomic changes, miRNAs, and telomerase activity should be the right choice for exact diagnostics and prediction of behavior of premalignant lesions of the cervix. These findings set a completely new light not only in diagnostic but also in management and treatment of cervical dysplasia and cervical cancer.

  8. Colposcopy in diagnosis and treatment of cervical intraepithelial neoplasia (CIN)

    NARCIS (Netherlands)

    W.M. Huisman (Wouter); J.A. Wijnen (Hans)

    1987-01-01

    textabstractAIMS OF THE STUDIES 1. To investigate the diagnostic value of colposcopy under research conditions, in patients with an indication for colposcopy. (Wouter M. Huisman) 2. To investigate the possibility of accurately predicting histopathology by means of the colposcopic impression, when a

  9. 宫颈上皮内瘤变术后人乳头瘤病毒持续感染与 Stathmin-1表达相关性及临床意义%The associations between human papilloma viruse persistent infection and Stathmin-1 expression and the clinical significance in cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    孔守芳; 吕腾; 袁汇; 钟金妍; 李旭日; 孙选; 戴淑真

    2016-01-01

    Objective To explore the relationship between Stathmin-1 and human papilloma viruse (HPV) persistent infection after conization of uterine cervix, and to show the clinical significance to recurrent of cervical intraepithelial neoplasia (CIN). Methods One hundred and six patients who were treated with conization of uterine cervix for CIN 2-3 grades were enrolled. Thirty-six recurrent patients were enrolled in recurrence group, and the others were enrolled in control group. The expression of Stathmin-1 in primary CIN tissues in two groups was detected by immunohistochemistry. The HPV infection was detected by HPV-DNA test. The relationship of HPV persistent infection and recurrence was analyzed. Results The positive expression rate of HPV persistent infection and HPV persistent infection rate in recurrence group were 88.89%(32/36), 83.33%(30/36), in control group were 34.29%(24/70) and 22.86%(16/70), and there were significant difference (P 0.05). Conclusions Stathmin-1 positive expression is related to HPV persistent infection. The two factors can affect the prognosis of high-grade CIN, and can provide new cues and theory basis for the prevention of recurrence.%目的:探讨 Stathmin-1与宫颈锥形切除术后人乳头瘤病毒(HPV)持续感染的相关性及临床意义。方法收集106例2009年1月至2013年1月因宫颈上皮内瘤变(CIN)2~3级行宫颈锥形切除术病例,将其中36例复发病例设为复发组,70例未复发病例设为对照组。免疫组织化学法检测两组宫颈锥形切除组织 Stathmin-1表达情况,HPV-DNA 法检测高危 HPV 感染情况,分析两组术后 HPV 感染持续情况及与复发的关系。结果复发组 Stathmin-1阳性表达率及 HPV 持续感染率显著高于对照组[88.89%(32/36)比34.29%(24/70),83.33%(30/36)比22.86%(16/70)],差异有统计学意义(P<0.01)。56例 Stathmin-1阳性表达病例中,42例存在 HPV 持续感染,46例 Stathmin-1

  10. 基质金属蛋白酶9在宫颈柱状上皮异位及宫颈上皮内瘤变中不同表达的研究%The research on the different expression of matrix metalloproteinase-9 in cervical columnar ectopy and cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    原玮; 曹树军; 高丽萍; 杨道华; 秋承敏

    2014-01-01

    目的 通过研究基质金属蛋白酶9(MMP-9)在宫颈柱状上皮异位、正常光滑宫颈及宫颈上皮内瘤变(CIN)组织中的不同表达,探讨三者癌变几率的不同及治疗的必要性.方法 对2007-2012年收治的30例宫颈柱状上皮异位、28例CIN、30例正常光滑宫颈组织石蜡标本,应用免疫组织化学方法检测MMP-9的表达.结果 宫颈柱状上皮异位组织MMP-9表达总阳性率23.3%(7/30),正常光滑宫颈组织MMP-9表达总阳性率20.0%(6/30),CIN组织MMP-9表达总阳性率96.4%(27/28).宫颈柱状上皮异位组织和正常光滑宫颈组织MMP-9表达总阳性率均显著低于CIN组织,差异有统计学意义(P<0.01),而宫颈柱状上皮异位组织与正常光滑宫颈组织MMP-9表达总阳性率比较差异无统计学意义(P>0.05).结论 宫颈柱状上皮异位是一种生理表现,不应过度治疗.但生育年龄妇女应定期进行宫颈癌筛查.%Objective To explore the different probability of carcinoma and the necessity of treatment in cervical columnar ectopy (CCE),normal smooth cervix and cervical intraepithelial neoplasia(CIN) by investigating the different expression of matrix metalloproteinase-9(MMP-9).Methods The expression of MMP-9 was detected by using immunohistochemical method in 30 cases of CCE,28 cases of CIN and 30 cases of normal smooth cervix from 2007 to 2012.Results The positive expression of MMP-9protein in CIN was 96.4% (27/28),CCE was 23.3% (7/30) and normal smooth cervix was 20.0% (6/30)respectively.The positive expression of MMP-9 protein was higher in CIN than CCE and normal smooth cervix,the difference has statistical significance (P< 0.01),there was no significant difference between CCE and normal smooth cervix (P > 0.05).Conclusions CCE,which was a physiological performance of cervical erosion,should not be overtreated.But the women of childbearing age should be routinely performed in cervical cancer screening.

  11. 探讨三维能量多普勒超声在宫颈癌与重度宫颈上皮内瘤变的应用价值%An evaluation of application value of three-dimensional power Doppler sonography in cervical cancer and cervical intraepithelial neoplasia grade Ⅲ(CIN 3)

    Institute of Scientific and Technical Information of China (English)

    耿京; 唐军; 赵旸; 魏丽惠

    2011-01-01

    Objective To evaluate the diagnostic value of the three- dimensional power Doppler sonography in cervical intraepithelial neoplasia grade Ⅲ (CIN 3) and cervical cancer. Methods 37 patients with CIN 3, 37 patients with cervical cancer (21 patients of stage Ⅰ , 16 patients of stage Ⅱ ) and 34 patients of control group were studied by the three - dimensional power Doppler sonography, and relevant data (cervical volume, vascularization index Ⅵ, flow index FI, vascularization - flow index VFI and resistance index RI) were measured. Meanwhile, cervical blood vessels were categorized. Results The cervical volume, Ⅵ, FI, VFI of stage Ⅰ and stage Ⅱ cervical cancer group were significantly greater than those of CIN 3 group and control group, while RI was significantly lower than that of CIN 3 group and control group (P<0. 05). The cervical volume, Ⅵ and VFI were significantly different (P<0. 05) between stage Ⅰ and stage Ⅱ cervical cancer groups; no significant difference was observed in cervical volume, Ⅵ, FI, VFI and RI between CIN 3 group and the control group (P>0. 05). Blood categorization indicated the following: cervical cancer is mainly type Ⅲ or Ⅳ vessels, CIN 3 is mostly type Ⅱ vessel and control group is largely type Ⅰ vessel. Conclusion Three- dimensional power Doppler sonography can objectively reflect the state of blood supply of the cervix, which provides important reference information for the staging of cervical cancer and CIN 3 and thus has great application value.%目的 评价应用三维能量多普勒超声在重度官颈上皮内瘤变(CIN 3)及宫颈癌的诊断价值.方法 对宫颈CIN3患者37例、官颈癌患者37例(Ⅰ期患者21例,Ⅱ期患者16例)及对照组患者34例(宫颈细胞学正常)进行阴道三维能量多普勒超声检查并测量相关数据(宫颈体积、血管化指数VI、血流指数FI、血管化血指流指数VFI及阻力指数RI),同时对宫颈血管进行分型.结果 Ⅰ期、

  12. 人乳头瘤病毒检测在宫颈上皮内瘤变诊断及随访中的意义%Significance of human papilloma virus detection in diagnosis and follow-up of cervical intraepithelial neoplasias

    Institute of Scientific and Technical Information of China (English)

    杨俐; 邓少君

    2014-01-01

    Objective To explore the expression of human papilloma virus (HPV) in cervical intraepithelial neoplasias (CIN) and their relation. To make screening of high risk group with CIN through HPV detection. To dynamically observe and analyze the change of high risk HPV and recurrent residual lesion, in order to take effective prevention and treatment measures.Methods A total of 169 CIN patients received HPV screening by hybrid capture technique, and biopsy for suspicious lesions by colposcope.Results Among the 169 CIN cases, there were 68 HPV positive cases (40.2%), 101 negative cases (59.8%), and 73 cases with chronic cervicitis (43.2%), 96 cases with cervical cancer and precancerous lesions (56.8%). The rate of cervical cancer and precancerous lesions in HPV positive cases was 70.8% (68/96).Conclusion The detection of high risk HPV can not only find CIN patients, but also discover high risk group. It is an important indicator for detecting CIN. This high risk HPV detection, along with targeted biopsy, can provide effective guidance, and is helpful for explore pathogenesis of CIN.%目的:探讨人乳头瘤病毒(HPV)在宫颈上皮内瘤变(CIN)中的表达,以及它们之间的相互关系,通过HPV检测尽早筛查出患宫颈上皮内瘤变的高危人群。并对术前术后随访中高危型HPV变化与病变残留复发情况进行动态观察及分析,以便采取有效的预防和治疗措施。方法对169例宫颈病变患者采用杂交捕获技术对HPV进行筛查,并通过阴道镜对可疑病灶多点活检。结果169例宫颈病变患者中HPV阳性者68例(40.2%),阴性者101例(59.8%);病理活检慢性炎症73例(43.2%),宫颈癌及癌前病变96例(56.8%);HPV阳性患者的宫颈癌及癌前病变率为70.8%(68/96)。结论检测高危型HPV不仅可以发现现行的宫颈疾病患者,还可以发现存在高危风险的人群,是监测 CIN的一个重要的指标;通过检测高危型HPV,有针对性地进行活组织病理检查,可有

  13. Comparison of clinical efficacies of two kinds of cervical conization methods in treatment of cervical intraepithelial neoplasia%两种宫颈锥切方法治疗宫颈上皮内瘤样病变疗效比较

    Institute of Scientific and Technical Information of China (English)

    胡莉琴; 杨晶珍; 李梅; 黎春; 易姗祺

    2011-01-01

    Objective: To compare the clinical efficacies of lcop electrosurgical excision procedure (LEEP) and cervical cold knife conizafion (CKC) in treatment of cervical intraepithelial neoplasia (CIN) . Methods: 198 patientswith CIN were selected from the outpatient department of cervical diseases in the hospital from November 2005 to August 2009, then they were divided into two groups randomly,the patients in observation group were treated with LEEP, and the patients in control group were treated with CKC; the operation times, the amounts of blood loss during operation, surgical fees, postoperative complications and clinical efficacies in the two groups were observed. Results: The operation time, the amount of blood loss during operation and surgical fee in CKC group were significantly higher than those in LEEP group ( P < 0. 01 ); there was no significant difference in the incidence of postoperative complications, the residual rate of lesion, the recurrence rate between the two groups ( P > 0. 05 ) . Conclusion: LEEP is simple, safe, effective and less bleeding in treatment of cervical CIN, the recovery of cervix is good, close follow - up should be conducted after treatment because partial patients still have persistent lesion and recurrence is possible.%目的:比较宫颈环形电切术(LEEP)和宫颈冷刀锥切术(CKC)治疗宫颈上皮内瘤样病变(CIN)的临床效果.方法:选取2005年11月~2009年8月在江西省赣州市妇幼保健院宫颈疾病门诊就诊的CIN患者198例,随机分成两组,观察组应用高频环形电刀行宫颈锥切术,对照组采用冷刀行宫颈锥切术,观察手术时间、术中出血量、手术费用、术后并发症、术后效果等.结果:手术时间、术中出血量、手术费用CKC组高于LEEP组,差异有高度统计学意义(P<0.01);术后并发症两组比较,差异无统计学意义(P>0.05);术后病灶残留率、病变复发率比较,差异无统计学意义(P>O.05).结论:宫颈环形电切

  14. OBSERVATION ON THE EFFICACY OF RECOMBINANT HUMAN INTERFERON α-2b GEL IN COMBINATION WITH LASER IN THE TREATMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA GRADE I%重组人干扰素α-2b凝胶配合激光治疗宫颈上皮内瘤变I级疗效观察

    Institute of Scientific and Technical Information of China (English)

    韦静; 谭广萍; 莫西玲

    2011-01-01

    [目的]观察重组人干扰素α-2b凝胶配合激光治疗官颈上皮内瘤变I级(CIN I)的临床效果.[方法]将CIN I合并官颈糜烂患者随机分为两组,观察组49例子月经干净3d予单纯激光治疗.对照组47例则于月经干净3d予激光治疗及治疗后再以尤靖安(重组人干扰素α-2b凝胶)1g阴道给药,隔日1次,共10次(月经期停用)为一疗程.两组均于治疗后2个月(月经期干净后3~7 d)随访治疗后官颈糜烂好转情况.6个月随访官颈细胞学情况.[结果]纳入疗效分析82例(观察组40例,对照组42例),治疗2月后两组有效率比较,对照组高于观察组,差异有统计学意义(P< 0.05);6个月随访复发率明显低于观察组,差异有统计学意义(P<0.05).[结论]重组人干扰素α-2b凝胶配合激光治疗CINI比单纯激光治疗治愈率高,复发率低,且术后官颈糜烂恢复情况也较单纯激光组好,值得临床推广.%[Objective] To observe the clinical effect of the recombinant human intetferon alpha-2b gel in combination with laser in the treatment of Cervical Intraepithelial Neoplasia Grade I . [Methods] The patients with CIN1 and cervical erosion were divided into two groups. Laser was done during 3 days after menstrual clean in both groups. Observation group of 49 cases was simply treated by laser. Control group of 47 cases was treated by placing 1g Yallafero (recombinant human interferon alpha-2b gel) into vagina every other day in total of ten times after laser. Both groups were followed up on the improvement of cervical erosion for two months and on the cervical cells for six months after treatment. [Results] Among the 82 evaluable patients (40 in observation group and 42 in control group), there was a significant difference between the observation group and control group in the effective rate after two months (P < 0.05) and in the relapse rate after the six months (P< 0.05). [Con-Clusion] The use of recombinant human interferon

  15. 环形电切术治疗宫颈上皮内瘤样病变后人乳头瘤病毒持续感染的临床分析%Clinical Analysis of Loop Electrosurgical Excision Procedure Treating Persistent HPV Infection after Cervical Intraepithelial Neoplasia Treatment

    Institute of Scientific and Technical Information of China (English)

    李江宁; 刁海丹

    2015-01-01

    Objective To investigate the clinical effect of loop electrosurgical excision procedure trea-ting persistent human papilloma virus ( HPV ) infection after cervical intraepithelial neoplasia ( CIN ) treat-ment.Methods From Feb.2011 to Feb.2013,in Dalian Third People′s Hospital,70 cases of persistent CIN HPV infection were included in the study,and divided into two groups according to random number-table method,35 cases in each group:the control group received cold-knife conization treatment, the observation group received loop electrosurgical excision procedure,and the clinical effect of the two groups was observed after treatment.Results The postoperative residual rate, the cure rate, relapse rate and sustained infection rate of the control group were 14.3%, 68.5%, 11.4%, 14.3%;of the observation group were 11.4%, 80.0%, 8.6%, 11.4% respectively,no significant differences between the two groups(P>0.05);while the blood loss,operative time, wound healing time,postoperative blood loss,hospital stay,HPV turning nega-tive time and complication incidence of the two groups had statistically significant difference(P <0.05). Conclusion Loop electrosurgical excision procedure not only can cut advanced CIN,but also can remove persistent high-risk HPV infection,with significant clinical effect.%目的:探讨环形电切术治疗宫颈上皮内瘤样病变( CIN)后人乳头瘤病毒( HPV)持续感染临床效果。方法选取2011年2月至2013年2月大连市第三人民医院妇科收治的70例 CIN 后HPV持续感染患者为研究对象,采用随机数字表法分成两组,每组35例,对照组予以冷刀宫颈锥切术治疗,观察组用环形电切术治疗,观察两组治疗后临床效果。结果对照组手术残留率、治愈率、感染持续率和复发率分别为14.3%、68.5%、11.4%、14.3%;观察组手术残留率、治愈率、感染持续率和复发率分别为11.4%、80.0%、8.6%、11.4%,两组比

  16. Clinical effect of loop electrosurgical excision procedure combined with Baofukang suppository in cervical intraepithelial neoplasia%宫颈环形电切术联合保妇康栓治疗宫颈上皮内瘤变的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴文

    2012-01-01

    目的 探讨宫颈环形电切术(LEEP)联合保妇康栓治疗宫颈上皮内瘤变(CIN)的临床疗效.方法 将某院收治的CIN患者174例随机分为单纯手术组和联合治疗组,每组各67例.单缝手术组行LEEP术,联合治疗组在术后次月月经干净后使用保妇康栓,连用6d.将两组切下组织行病理检查,并与术前阴道镜病理检查的结果比较.观察术后阴道排液时间、创面愈合情况及并发症发生情况.结果 LEEP术后病理结果与阴道活检结果的符合率为77.6%.联合治疗组的阴道排液时间、创面愈合时间均显著低于单纯手术组,差异有统计学意义(P<0.05).联合治疗组术后创面感染、宫颈管狭窄及宫颈管粘连等并发症的发生率均显著低于单纯手术组,差异有统计学意义(P<0.05).结论 LEEP联合保妇康栓是治疗CIN一种安全有效的方法,可减少术后排液及术后并发症.%OBJECTIVE To explore the clinical effect of loop eleetrosurgieal excision procedure (LEEP) combined with Baofukang suppository in cervical intraepithelial neoplasia (CIN). METHODS 174 patients with CIN who were treated in our hospital were randomly divided into two groups. The single operation group (n = 67) was treated with LEEP alone, and the combined treatment group (n - 67) was treated with Baofukang suppository for six days after menstruation in the next month. The specimens cut by LEEP from the two groups were accepted pathological examination, and compared with preoperative diagnosis by biopsy under colposcopy. The vaginal fluiding time, the wound healing time and postoperative complications were observed. RESULTS The consistent rate of pathology diagnosis after LEEP and the preoperative diagnosis by biopsy under colposcopy were 77.6%. The vaginal fluiding time, the wound healing time in combined treatment group was significantly less than that in single operation group (P < 0.05). There were significant differences in postoperative

  17. Analysis on 21 cases with vaginal intraepithelial neoplasia treated by laser combined with recombinant human interferon α-2b gel%激光联合重组人干扰素α-2b凝胶治疗阴道上皮内瘤样病变21例分析

    Institute of Scientific and Technical Information of China (English)

    杨君; 周德平; 王彬; 刘玉明; 王敏

    2013-01-01

    Objective: To explore the clinical characteristics of vaginal intraepithelial neoplasia (VIN) and the clinical efficacy of laser combined with local treatment of recombinant human interferon α - 2b gel. Methods: Twenty - one patients diagnosed as VIN definitely by histological examination in cervical special outpatient of the hospital from May 2006 to December 2010 were selected, then the clinical characteristics were summarized, the infection status of human papillomavirus ( HPV) was analyzed; the patients were treated with laser combined with vaginal treatment with recombinant human interferon α - 2b gel; all the patients were followed up more than twelve months, the clinical efficacy was evaluated. Results: The infection rate of high risk HPV in twenty - one patients with VIN was 100. 00% , HPV16 was the most common type (61. 90% , 13/21) . Mulifocality was common (71.43% , 15/21), and most of focus was located in vaginal fornix and upper 1/3 of vaginal side wall (90.48% , 19/21 ) . The clinical curative rate was 80. 95% ( 17/21 ) , the improvement rate was 14.29% (3/21), the ineffective rate was 4. 76% (1/21), and the recurrence rate was 19. 05% (4/21) . The postoperative complications were few, no scar of vaginal wall, large vaginal bleeding, and vaginal adhesion occurred. Conclusion: High risk HPV infection is closely correlated with occurrence of VIN, laser combined with local treatment of interferon is safe and effective, the short -term efficacy is good, while the long - term efficacy needs observation.%目的:探讨阴道上皮内瘤变(VAIN)的临床特征及采用激光联合干扰素局部治疗的临床疗效.方法:选择2006年5月~2010年12月重庆市妇幼保健院宫颈专科门诊经组织学确诊的VAIN患者21例,总结其临床特征,分析人乳头瘤病毒(HPV)感染状况,采用激光联合阴道给药重组人干扰素α-2b凝胶治疗,随访12个月以上,评价临床疗效.结果:①21例VAIN患者高危型HPV感染率为100.00

  18. Analysis of high risk factors associated with cervical intraepithelial neoplasia in married women aged 25- 54 years in Beijing between 2007-2008%2007-2008年北京地区25~54岁已婚妇女子宫颈上皮内瘤变的高危因素分析

    Institute of Scientific and Technical Information of China (English)

    李长东; 张为远; 武明辉; 张凇文; 周保利; 朱力; 潘静; 王建东

    2010-01-01

    目的 探讨北京地区25~54岁已婚妇女宫颈上皮内瘤变(CIN)的高危因素.方法 采用横断面调查方法,于2007年3月至2008年9月,对北京地区12个区县共137个社区内随机抽取的25~54岁已婚妇女6339例进行问卷调查、妇科检查、宫颈细胞涂片液基薄层细胞学检查(TCT)、宫颈分泌物高危型人乳头状瘤病毒(HR-HPV)检测,并对TCT结果异常者行阴道镜下宫颈活组织检查.采用logistic回归分析方法,分析CIN的高危因素及危险度比值比(OR)和95%可信区间(95%CI).结果 6339例妇女中,CIN患病率为5.90%[(374/6339,包括4例鳞状上皮细胞癌(SCC)因例数少,未单独统计].多元回归分析结果显示,HR-HPV感染(95%CI=9.953~15.811)、滴虫性阴道炎病史(95%CI=1.046~2.104)、口服避孕药避孕(95%CI=1.087~1.806)以及年龄<45岁(95%CI=1.069~1.828)等因素与CIN患病相关.结论 HR-HPV感染是CIN患病的独立危险因素,而滴虫性阴道炎病史、口服避孕药避孕及年龄<45岁是CIN患病相关危险因素.%Objective To investigate high risk factors associated with cervical intraepithelial neoplasia (CIN) in married women aged 25 to 54 years in Beijing. Methods From Mar. 2007 to Sep.2008, 6339 married women at age of 25 to 54 years were selected randomly by cross sectional survey in a total of 137 communities of 12 districts or counties in Beijing. The interview was carried out with unified questionnaires, gynecological examination. The cervical smear cytology and high-risk human papillomavirus (HR-HPV) infection of cervical secretion were detected. Women with abnormal cervical cytology underwent colposcopy and cervical biopsy. Odd ratio (OR) and 95% confidence interval (CI) of related high risk factors with CIN were studied by logistic regression analysis. Results Among 6339 women, the prevalence rate of CIN including 4 squamous cell carcinoma (SCC) was 5. 90% (374/6339). By multinomial regression analysis, HR-HPV infection (95

  19. Effect of human papilomavirus genotypes on severity and prognosis of cervical intraepithelial neoplasia%人乳头瘤病毒基因型对宫颈上皮内瘤变严重程度及LEEP术预后的影响

    Institute of Scientific and Technical Information of China (English)

    刘芳; 张琳

    2015-01-01

    目的:探究HPV基因型对患者发生宫颈上皮内瘤变的严重程度和对患者行LEEP术后预后的影响。方法收集2007-2013年我院223例有宫颈上皮内瘤变(CIN)并行LEEP环切术的患者进行研究,患者按CIN严重程度分为CIN1~2和CIN3(含原位癌CIS)两组;HPV基因型按:(1)低危;(2)中危(;3)高危HPV16;(4)高危HPV18;(5)未归类;共分为五组;术后患者按手术切缘是否存在残留病灶分为手术切缘阳性组和阴性组。采用核酸杂交技术检测患者所感染的HPV基因型,比较组间HPV型别的分布差异。结果 CIN3是所选患者中最常见的CIN类型(占68.6%),HPV16是CIN患者中最常见的基因型(占26.9%)。与CIN1~2组的患者比较,中危、16、18型的HPV在CIN3组患者中所占比例更高(P<0.05)。HPV18型感染组手术切缘阳性发生率最高(占60%)(P<0.05)。结论 HPV基因型别与患者的CIN严重程度密切相关,开展HPV筛查可为宫颈病变提供早期诊断和预后判断;HPV基因型所致患者手术切缘的阳性率不同,其中HPV18型患者手术切缘阳性率最高,因此感染HPV18型的CIN患者在术后更需仔细追踪。%Objective To explore the effect of the specific human papilomavirus (HPV) genotypes on the severity and prognosis of cervical intraepithelial neoplasia (CIN) after surgery. Methods A total of 223 patients of CIN treated with loop electrosurgical excision procedure (LEEP) from 2007 to 2013 were enrolled. Based on the severity of CIN, the pa-tients were categorized as CIN1~2 group and CIN3 group. HPV genotypes were categorized as low risk, intermediate risk, high risk/HPV16, high risk/HPV18, unclassified. Patients were divided into positive margins and negative margins after LEEP. All of them were conducted HPV test with nucleic acid hybridization. Results CIN3 was the most common CIN type among these patients (33.2%), and high-risk/HPV16 was the most common genotype (26.91%). Intermediate

  20. [Alternative therapeutic excision of intraepithelial conjunctival carcinoma with corneal extension].

    Science.gov (United States)

    Zemba, M; Stamate, Alina-Cristina; Avram, Corina Ioana; Sîrbu, Laura Nicoleta Urucu; Camburu, Raluca Lăcrămioara; Ochinciuc, Uliana; Burcea, M

    2013-01-01

    Surgical treatment for conjunctival neoplasms, with wide local excision, with or without supplemental cryotherapy to the surgical margins represents the treatment of choice for this pathology. In some cases, these neoplasms can be diffuse or multifocal, with borders that are difficult to detect clinically, such that topical therapies offer a more efficient method for treating the entire ocular surface, delivering high drug concentrations at this level, with negligible systemic side effects. Beginning from the clinical case of a patient diagnosed with conjunctival intraepithelial neoplasia, we try to present other therapeutical alternatives, although in this case the therapeutical approach was the classic one.

  1. Correlação entre o Diagnóstico Histológico da Biópsia e o da Conização por Cirurgia de Alta Freqüência por Alça (CAF no Tratamento da Neoplasia Intra-epitelial Cervical Correlation between the Histological Report of Biopsy and Conization by the Loop Electrosurgical Excision Procedure (LEEP in the Treatment of Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Cássia Raquel Teatin Juliato

    2000-03-01

    Full Text Available Objetivos: avaliar a utilização da conização por cirurgia de alta freqüência por alça (CAF na neoplasia intra-epitelial cervical (NIC, a importância do comprometimento das margens de ressecção e o seguimento das pacientes. Métodos: foram avaliadas 95 mulheres submetidas à CAF por NIC entre janeiro de 1996 e dezembro de 1997. Para análise estatística, utilizamos o coeficiente de concordância kappa e o teste de tendência de Cochran Armitage. Resultados: dos 63 casos submetidos à biópsia dirigida antes da conização, o cone por CAF apresentou lesões mais graves que a biópsia em 24 casos, sendo um caso microinvasor, e em 8 mulheres a biópsia eliminou a lesão. Entre as pacientes submetidas à conização com biópsia prévia compatível com cervicite ou NIC 1, 14/25 (56% apresentavam NIC 2 ou 3. Das 32 mulheres que não tinham biópsia prévia, 15 apresentavam NIC 2 ou 3, e quatro, carcinoma microinvasor no cone. Em relação às margens do cone, 25 casos (26% apresentaram margens endocervicais comprometidas e quanto maior o grau da lesão cervical maior a possibilidade de presença de lesão nas margens (p = 0,024. Dessas pacientes, 2 de 10 submetidas a novo procedimento apresentavam doença residual na peça cirúrgica. Entre as 70 pacientes com margens livres foram realizadas três conizações a frio e uma histerectomia e duas apresentavam doença residual na peça cirúrgica. Conclusões: a conização por CAF sem biópsia prévia depende da combinação entre o diagnóstico citológico e a experiência do colposcopista e, em princípio, deve ser reservada para os casos em que a colpocitologia e a colposcopia são concordantes e compatíveis com NIC 2 ou 3. Por outro lado, a ampliação cirúrgica pós-CAF no tratamento da NIC não é determinada exclusivamente pelo comprometimento das margens, mas sim pelo seguimento, excluindo-se os casos de microinvasão e lesões glandulares que se beneficiam com a avaliação histol

  2. Frequencies and role of regulatory T cells in patients with (pre)malignant cervical neoplasia

    NARCIS (Netherlands)

    Visser, J.; Nijman, H. W.; Hoogenboom, B.-N.; Jager, P.; van Baarle, D.; Schuuring, E.; Abdulahad, W.; Miedema, F.; van der Zee, A. G.; Daemen, T.

    2007-01-01

    Oncogenic human papillomavirus (HPV)-infection is crucial for developing cervical cancer and its precursor lesions [cervical intraepithelial neoplasia (CIN)]. Regulatory T cells (T-regs) might be involved in the failure of the immune system to control the development of HPV-induced cancer. We invest

  3. In vivo and in vitro hyperspectral imaging of cervical neoplasia

    Science.gov (United States)

    Wang, Chaojian; Zheng, Wenli; Bu, Yanggao; Chang, Shufang; Tong, Qingping; Zhang, Shiwu; Xu, Ronald X.

    2014-02-01

    Cervical cancer is a prevalent disease in many developing countries. Colposcopy is the most common approach for screening cervical intraepithelial neoplasia (CIN). However, its clinical efficacy heavily relies on the examiner's experience. Spectroscopy is a potentially effective method for noninvasive diagnosis of cervical neoplasia. In this paper, we introduce a hyperspectral imaging technique for noninvasive detection and quantitative analysis of cervical neoplasia. A hyperspectral camera is used to collect the reflectance images of the entire cervix under xenon lamp illumination, followed by standard colposcopy examination and cervical tissue biopsy at both normal and abnormal sites in different quadrants. The collected reflectance data are calibrated and the hyperspectral signals are extracted. Further spectral analysis and image processing works are carried out to classify tissue into different types based on the spectral characteristics at different stages of cervical intraepithelial neoplasia. The hyperspectral camera is also coupled with a lab microscope to acquire the hyperspectral transmittance images of the pathological slides. The in vivo and the in vitro imaging results are compared with clinical findings to assess the accuracy and efficacy of the method.

  4. Reflex Human Papillomavirus Test Results as an Option for the Management of Korean Women With Atypical Squamous Cells Cannot Exclude High-Grade Squamous Intraepithelial Lesion

    OpenAIRE

    Ryu, Ki-Jin; Lee, Sanghoon; Min, Kyung-Jin; Kim, Jae Won; Hong, Jin Hwa; SONG, JAE YUN; Lee, Jae Kwan; Lee, Nak Woo

    2015-01-01

    Current guidelines recommend universal colposcopy for the management of women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) on cytology, but the present study suggested that human papillomavirus (HPV) cotesting in patients with ASC-H cytology can provide more detailed and useful information regarding the risk of high-grade cervical intraepithelial neoplasia lesions and the need for further treatment. Reflex HPV testing should be an option for ...

  5. 液基薄层细胞学、活检病理和宫颈环形电切术(LEEP)诊断早期宫颈癌及宫颈上皮细胞内瘤样病变的比较研究%Comparison of Liquid Based Cytology, Biopsy, and Loop Electrosurgical Excisional Procedure(LEEP)for Diagnosis of Cervical Cancer and Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    杨波; 杨凤云; 曹云桂; 顾萍; 朱梅娟; 甘晓卫

    2012-01-01

    Objective: To compare liquid based cytology, biopsy, and loop electrosurgical excisional procedure (LEEP) histopathology for diagnosis of cervical cancer and cervical intraepithelial neoplasia (CIN). Methods: A total of 201 patients who referred for LEEP were enrolled in this study. The diagnostic results of thinprep cytologic tests (TCT), previous biopsies, and LEEP pathology were compared and evaluated. Results: In LEEP pathology of 201 patients, 92 cases (45.8%) were identified to have CIN2 or above lesion, and 4 cases were confirmed as invasive cancer. Among them, 71 (71/92) biopsy was CIN2 or above cervical lesions. Biopsy and LEEP determined 22 and 23 CIN2 or above cases in 66 LSIL cases by TCT, respectively. The concordance rate of biopsy and LEEP was 86.5%, and the Kappa value was 0.718. Among 113 CIN1 patients conformed by biopsy, LEEP pathology found 16 cases of CIN2 or above. Conclusion: Biopsy may improve the diagnosis of CIN2 or above cervical lesions in LSIL patients by TCT, and will be helpful for determination of index for LEEP in clinical practice.%目的:比较细胞学、活检病理和宫颈环形电切术(loop electrosurgical excisional procedure,LEEP)病理诊断早期宫颈癌和宫颈上皮细胞内瘤样病变(cervical intraepithelial neoplasia,CIN)的准确性.方法:回顾性比较分析201例进行LEEP患者术后病理、术前活检病理和液基薄层细胞学(thinprep cytologic test,TCT)3种诊断方法的检测结果.结果:201例LEEP术后组织病理分析显示92例(45.8%)患者具有CIN2~3病变及4例浸润癌患者,其中71例患者术前病理为CIN2及以上鳞状上皮内瘤样病变.在细胞学检查结果为LSIL的66例患者中活检病理和LEEP病理结果为CIN2及以上病变的分别有22例和23例.活检病理与LEEP病理符合率为86.5%,Kappa值为0.718.活检病理结果为CIN1的113例患者中有16例LEEP病理结果为CIN2及以上病变.结论:活检病理可以提高细胞学结果为LSIL的患

  6. 环形电切术治疗高级别宫颈上皮内瘤样病变后人乳头瘤病毒16、18持续感染的影响因素分析%Analysis of influencing factors associated with human papillomavirus 16,18 persistent infection after the treatment for high-grade cervical intraepithelial neoplasia with loop electrosurgical excision procedure

    Institute of Scientific and Technical Information of China (English)

    孙晶雪; 李立

    2013-01-01

    Objective:To discuss the short-term efficacy of loop electrosurgical excision procedure (LEEP) in the treatment of human papillomavirus(HPV) 16,18 persistent infection after the operation for high-grade cervical intraepithelial neoplasia(CIN) and to explore the influcing factor of HPV16,18 persistent infection. Methods:Totally 167 cases of CIN II /HI were confirmed by coloposcopy cervical biopsy and received treatment in the department of gynecology of Iiuzhou People' s Hospital from January 2007 to June 2009 were enrolled. HPV16,18 DNA was detected in all patients and cervical LEEP was performed on all of them. Thinprep cytologic test (TCT) ,HPV16,18 DNA detection and follow-up were applied at six months after the operation. Results:HPV infection rate was 77.951% preoperatively and 7.87% at six months after the operation in the follow-up visit. Cervix biopsy was performed in 43 patients with persistent positive HPV-DNA, abnormal TCT or positive surgical margin. Rate of residual lesions was 9.3%. Conclusions-, ①HPV16,18 infection in female genital tract can be effectively cleared by LEEP. ②Influencing factors of persistent HPV16,18 infection after the treatment of high-grade CIN by LEEP include age,age at first sexual activity,multiple deliver)' and positive margin involvement.③Positive margin involvement is the risk factor for the residual lesion of high-grade CIN after treating by LEEP.%目的:探讨宫颈环形电切术(loop electrosurgical excision procedure,LEEP)治疗高级别宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)术后人乳头瘤病毒(human papillomavirus,HPV) 16、18清除的近期效果并分析对HPV16、18持续感染的相关影响因素.方法:选取2007年1月至2009年6月就诊于柳州市人民医院妇科,阴道镜下宫颈活检确诊为CINⅡ/Ⅲ的患者167例.均对其检测HPV16、18 DNA并行宫颈LEEP治疗.术后6个月检测HPV 16、18 DNA及液基薄层细胞学检查(thinprep cytologic test,TCT)进

  7. Elective cesarean hysterectomy for treatment of cervical neoplasia. An update.

    Science.gov (United States)

    Hoffman, M S; Roberts, W S; Fiorica, J V; Angel, J L; Finan, M A; Cavanagh, D

    1993-03-01

    From January 1, 1979, to March 31, 1991, 37 patients underwent elective cesarean hysterectomy for early cervical neoplasia. Thirty-four patients had cervical intraepithelial neoplasia III, and three patients had stage IA-1 squamous cell carcinoma of the cervix. Twenty-eight were primary cesarean sections; nine had obstetric indications. The mean operative time was 128 minutes; mean estimated blood loss was 1,400 mL. One patient experienced an intraoperative hemorrhage (3,500 mL). There were no other recognized intraoperative complications. Four significant postoperative complications included a vaginal cuff abscess, a wound dehiscence and pelvic abscess, one patient with febrile morbidity and an ileus and ligation with partial transection of a ureter. Patients were discharged on a mean of postoperative day 5.7. Although significant complications occurred, we believe that the noncompliant nature of our patient population justifies elective cesarean hysterectomy for treatment of cervical neoplasia.

  8. Clinical observation on the diagnosis and treatment of cervical intraepithelial neoplasia Ⅲ and microinvasive carcinoma by cold- knife conization and general electrosurgical conization%冷刀与普通电刀行宫颈锥切术诊治宫颈上皮内瘤变Ⅲ和微小浸润癌的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨丽; 史宏晖; 刘志茹

    2011-01-01

    Objective: To explore the clinical application values of general electrosurgical conization and cold -knife conization (CKC) in diagnosis and treatment of cervical intraepithelial neoplasia (CIN) Ⅲ and microinvasive carcinoma. Methods: The clinical data of 236 cases diagnosed as CIN Ⅲ/carcinoma in situ (CIS) or early invasive ovarian carcinoma by biopsy and pathological examination under colposcope from January 2005 to December 2006 were analyzed retrospectively, 107 cases received general electrosurgical conization ( general electrosurgical conizatinn group) and 129 cases received CKC (CKC group) . The operation times, the amounts of blood loss during operation and postoperative complications in the two groups were compared; 36 cases in general electrosurgical conization group and 15 cases in CKC group received subsequent treatment such as total hysterectomy and radical surgery, the pathological results of uterine samples and resected cervical samples in the two groups were compared; 71 cases in general electrosurgical conization group and 114 cases in CKC group were followed up after operation; the curative rates and the ratios of exist rate/recurrence rate in the two groups at 3, 6, 9 and 24 months after operation were compared. Results: The operation time in general electrosurgical conization group was ( 25.55 ± 8. 25 ) minutes, which was shorter than that in CKC group [ (29. 52 ± 8. 96) minutes [ ( P = 0. 001 ); the amount of blood loss during operation in general electrosurgical conization group was ( 14. 52 ± 10. 78) nd, which was lower than that in CKC group [ (26. 07 ± 13. 40) ml] ( P =0. 00); the incidence of complications after operation in general electrosurgical conization group was 6. 54%, which was lower than that in CKC group ( 14. 73% ) (P<0. 05) . There was no significant difference in residual lesion ( ≥CIN Ⅱ ) in resected uterine samples between the two groups ( P = 1.00); there was no significant difference in positive rate of

  9. Resultados do exame anátomo-patológico e "Polymerase Chain Reaction (PCR" na forma clinica e subclinica da infecção anal pelo Papilomavirus Humano (HPV: estudo em quatro grupos de pacientes Histopathological and PCR results for clinical and subclinical forms of HPV anal infection: study of four groups of patients

    Directory of Open Access Journals (Sweden)

    João Carlos Magi

    2006-12-01

    patients with condyloma underwent wart biopsy, and high-resolution anoscopy with directed biopsy was performed in the remaining 22 patients. Paraffin wax embedded biopsy specimens were sent to pathological analysis, and later PCR was carried out on the same samples. Results: Through the pathological examination, the presence of HPV is positive in all patients studied: clinically in the eight patients with condyloma, and subclinically in the others 22. Thirteen of these 22 patients presented and associated intraepithelial neoplasia. PCR was positive in 91,9% of the 22 patients those who presented the subclinical infection at pathology examination and 87,5% of the eight patients that presented the clinical infection the most common type of anal subclinical HPV infection was HPV-16 and HPV-11 when warts were presented. Conclusions: Pathological findings related to HPV were presented in all patients studied, and 13 cases were diagnosed two of them were carcinoma in situ. PCR was positive in 91,9% of patients presenting the subclinical infection, and in 87,5% with the clinical infection was HPV-16, and for warts HPV-11.

  10. miR-199a在宫颈癌及宫颈上皮内瘤样病变中的表达及意义%Clinical Significance of miR-199a Expression in Cervical Cancer and Cervical Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    邹阮敏; 胡芝; 陈昊; 张丽芳; 张文淼; 薛向阳; 黄引平

    2011-01-01

    目的 探讨miR-199a在宫颈癌及宫颈上皮内瘤样病变(CIN)中的表达情况及与宫颈癌各种临床病理特征的关系.方法 采用茎环 Realtime RT-PCR方法检测48例宫颈癌、12例CIN及正常宫颈组织中miR-199a-3p和miR-199a-5p的表达,分析miR-199a-3p和miR-199a-5p表达与宫颈癌常见的临床病理特征的关系.结果 用茎环 Realtime RT-PCR方法检测miR-199a-3p和miR-199a-5p表达的敏感性和特异性良好;miR-199a-3p和miR-199a-5p在宫颈癌及CIN组织中的表达低于非肿瘤组织,差异性显著(P<0.05),miR-199a-5p/miR-199a-3p表达比值未见明显差异(P=0.219).其中miR-199a-5p的表达与宫颈癌的组织分化程度存在一定相关性.小细胞型(Ⅲ级)宫颈癌的miR-199a-5p表达低于其他组织分化类型的标本(P=0.054)).miR-199a-3p和miR-199a-5p的表达与年龄、肿块大小、大体类型、病理类型及FIGO分期未见显著相关性(P>0.05).结论 miR-199a-3p和miR-199a-5p在宫颈癌及CIN组织中的表达显著低于正常宫颈组织.miR-199a-5p的表达与肿瘤的分化程度存在一定相关性.miR-199a在宫颈癌组织中的异常表达,可能在宫颈癌的发生和发展过程中发挥重要作用,有望成为宫颈癌新的治疗靶点.%Objective To explore the expression of miR - l99a in cervical cancer and cervical intraepithelial neoplasia ( CIN) and study its association with clinicopathologic fealures of cervical cancer.Methods The expression levels of miR - 199a - 3p and miR 199a -5p in 48 cervical cancer, 12 CIN and 20 non - tumor tissue specimens were examined by stem -loop real - time RT - PCR.The correlations between the expression levels of miR - 199a - 3p and miR - 199a - 5p and related clinicopathologic features of cervical cancer ( age, tumor size, general type, pathological type, tissue differentiation, FIGO stage) were further analyzed.Results The stem - loop RT realtime - PCR was sensitive and specific enough to detect miR - 199a - 3p and miR - 199a

  11. Expression of p63 and Ki-67 protein in cervical intraepithelial neoplasia and its clinical significance%p63和Ki-67蛋白在子宫颈上皮内瘤变中的表达及其临床意义

    Institute of Scientific and Technical Information of China (English)

    钟辉; 刘锦钰

    2011-01-01

    目的:探讨子宫颈上皮内瘤变(CIN)组织中p63和Ki-67蛋白的表达及其临床意义.方法:选择126例子宫颈活检组织标本,采用免疫组织化学技术检测p63、Ki-67和人乳头状瘤病毒(HPV)表达,其中12例正常子宫颈组织为对照组,CIN1 40例、CIN2 31例、CIN3 33例及浸润性癌组织10例.对浸润性癌用原位杂交技术(ISH)加做低危型和高危型HPV DNA检测.结果:对照组组织中p63呈阴性,但在增厚的鳞状上皮可出现阳性细胞.在CIN1、CIN2、CIN3和浸润性癌组织中,p63阳性率分别为80.0%、96.8%、100.0%和10/10,Ki-67蛋白阳性率分别为0.0%、27.5%、64.5%、54.5%和8/10,HPV阳性率分别为33.3%、17.5%、51.6%、39.4%和3/10,差异均有统计学意义(P<0.05~P<0.01).在浸润性癌组织中低危型和高危型HPV DNA阳性率分别为5/10和8/10.p63在CIN组织中表达强度随病理分级明显增强,且与HPV感染有相关关系(P<0.05).结论:p63和Ki-67蛋白联合检测,有助于子宫颈癌前病变的筛查、早期诊断和治疗.%Objective: To explore the expression of p63 and Ki-67 protein in cervical intraepithelial neoplasia( CIN ) and its significance. Methods : One hundred and twenty-six biopsy samples of the cervix were selected , and the expression of p63 , Ki-67 protein and human papillomavirus( HPV ) was detected by immunohistochemical technique. Among the samples,12 were normal controls,40 CIN1 ,31 CIN2 ,33 CIN3 and 10 invasive carcinomas. The invasive carcinomas were probed by low risk( LR )-HPV DNA and high risk human papilloma virus( HR )-HPV DNA using in situ hybridization( ISH ) method. Results : The expression of p63 in the control group was negative, but that in the thickening cervical squamous epithelium might present positive cells. In the CIN1 ,CIN2 ,CIN3 and invasive carcinoma groups,the positive rates of p63 were 80. 0% ,96. 8% ,100. 0% and lO/lO;the positive rates of Ki-67 protein were 0. 0 % , 27.5% ,64. 5% ,54.5% and 8

  12. The clinical value of Loop Electrosurgical Excision Procedure in the diagnosis and treatment of low grade cervical intraepithelial neoplasia%LEEP锥切术在低度宫颈上皮内瘤变诊治中价值的探讨

    Institute of Scientific and Technical Information of China (English)

    康琳棣; 耿宇宁

    2014-01-01

    Objective To evaluate the clinical value of Loop Electrosurgical Excision Procedure ( LEEP) in the diag-nosis and treatment of cervical intraepithelial neoplasia I ( CINI) . Method The clinical data of 286 cases of colpo-scopically directed biopsy with CINI treated with LEEP from 2007 to 2012 were analyzed retrospectively. Result①53(18. 53%) of the women with CINI on directed biopsy had high grade lesions found in loop excursion speci-mens, included CINII 42(14. 68%) and CINⅢ11(3. 85%). ②In the follow-up of the 233 patients who had same or lower grade pathological diagnosis via LEEP among 12 to 72 mouths, it detected that the persistent cases was 19, the progressive cases was 6 which including 5 cases in CINII and 1case in CINⅢ. There were 15 cases having per-sistence infection of HR-HPV after operations in these 25 patients. And in patients who were beyond 50 years old, there were 10 cases having persistent or progression.③There were 107 cases having negative HPV after operations . In 157 patients who had HPV positive per operation. Conclusion We suggest that the LEEP is necessary in further diagnosis to patients who have the HSIL report in cytological test, complicating the infection of HR-HPV and confir-ming CINI by multiple punch biopsies via colposcope. Either the persistent infection of HR-HPV after LEEP or the age beyond 50 years old is the high risk of the persistence and the progression. The patient who has these high risks needs the accurate follow-up. The LEEP is an available, safety and effective measure in both the diagnosis and the treatment of CINI.%目的:探讨LEEP锥切术在低度宫颈上皮内瘤变宫颈上皮轻度非典型增生( CINⅠ)临床诊断和治疗中的价值。方法:对2007年1月至2012年12月期间286例经阴道镜宫颈活检病理证实的CINⅠ患者行LEEP锥切术的完整病例及随访资料进行回顾性分析。结果:①286例CINⅠ患者行LEEP锥切术后病理升级者53例(18.53%),

  13. Analysis of the risk factors in cutting edge positive after taper cutting treatment of the childbearing age women cervical intraepithelial neoplasia%育龄期妇女宫颈上皮内瘤变锥切治疗后切缘阳性的高危因素分析

    Institute of Scientific and Technical Information of China (English)

    梅丽; 刘婷婷; 李丽

    2013-01-01

    目的探讨宫颈环形电切术(LEEP)及宫颈冷刀锥切术(CKC)治疗育龄期妇女宫颈上皮内瘤变(CIN)后切缘阳性的高危因素。方法回顾2007年1月~2011年11月在我院经阴道镜活检初步诊断为CIN(包括CIN1,CIN2,CIN3)的患者265例,年龄30~49岁,经宫颈锥切治疗后,切缘阳性者32例,切缘阴性者233例,随访1年,于术后6个月、12个月复查TCT,HPV,必要时行阴道镜、活检及进一步手术治疗。结果切缘阳性组年龄明显大于切缘阴性组(P<0.05);切缘阳性组的HPV负荷量明显高于切缘阴性组;切缘阳性组的术前TCT结果以HSIL(上皮内高度病变)为主,与切缘阴性组有统计学差异(P<0.05);病变累及腺体者的百分比在两组无明显差异(P>0.05),诊断CIN的级别,诊断CIN3者在切缘阳性组明显多于切缘阴性组(P<0.05)。结论育龄期妇女的年龄(≥40岁)、HPV负荷量(≥500)、TCT病变程度(≥HSIL)、诊断高级别CIN(CIN3)是CIN切缘阳性的高危因素。切缘阳性与病变复发/持续有关。在术前,对这部分高危患者安排有经验的医生进行,手术时谨慎操作,结合患者生育情况适当扩大手术范围,如果各种原因导致再次锥切不可能时,CIN3切缘阳性的患者可行子宫全切术,对于要求保留生育功能的患者应严密随访。%Objective To investigate the effect of LEEP and cervical cold knife conization (CKC) for treatment of women of childbearing age of cervical intraepithelial neoplasias after margin risk factors of positive. Methods A retrospective in 2007 January to 2011 November in our hospital were diagnosed by colposcope CIN (including CIN1, CIN2, CIN3) in 265 cases of patients, aged between 30 to 49 years old, after cervical conization after treatment, 32 cases with positive margin, 233 cases with negative margins, follow-up of 1 years, after June, December review

  14. Focused ultrasound vs laser coagulation in treatment of cervical intraepithelial neoplasia Ⅰ with high-risk HPV infection: report of 618 cases%聚焦超声和激光加电凝治疗HPV高危亚型感染的CIN Ⅰ疗效比较

    Institute of Scientific and Technical Information of China (English)

    任玉香; 吴凤英; 蔡惠芬; 徐惠成

    2012-01-01

    Objective To evaluate and compare the clinical therapy efficacy of focused ultrasound and laser coagulation in the treatment of cervical intraepithelial neoplasia (CIN) I with high-risk subtypes of HPV infection. Methods A total of 618 cases of CIN I with high-risk types of HPV infection who were treated in our department from April 2006 to April 2010 were prospectively randomized into focused ultrasound group (n = 320) and laser power coagulation group ( n=298). The effectiveness and safety were evaluated by biopsy and HPV detection before and in 6 months after treatment. Follow-up were carried out in 2, 6 and 12 months after treatment. Results There was no significant difference in blood loss between the 2 groups. Postoperative vaginal bleeding and vaginal fluid were significantly lesser in focused ultrasound than in laser coagulation group (P < 0. 05 ) . In the first 6 months after treatment, among the 300 cases with follow:up out of focused ultrasound group, there were 292 cases of CIN I subsided, with a cure rate of 97. 3%. And 200 cases had high-risk types of HPV entire negative, with a clearance rate of 66. 7% , and 40 cases were partial negative, with an effective rate of 80%. Among the 290 cases of laser coagulation who were followed up, CIN I cured in 280 cases, with a cure rate of 96. 6% ; 185 cases of high-risk types of HPV infection were entire negative, with a clearance rate of 63. 8% , and 30 cases were in the partial negative, with an effective rate of 74. 1% . There was no significant difference in the cure rate of CIN I and the clearance rate of HPV between the 2 groups. Significant correlation was found between the regression of CIN I and the clearance of HPV in the 2 groups ( P < 0. 05 , r =0. 175 9 for focused ultrasound group and 0. 147 3 for laser coagulation group). Conclusion In the clearance of high-risk HPV types and CIN I , the effectiveness of focused ultrasound treatment and laser coagu-lation treatment are very significant and have no

  15. 中药"凤香洗液"对伴HPV感染的CIN患者宫颈局部IL-2和IL-4的影响%Effects of traditional Chinese medicine"Fengxiang Lotion"on local cervical IL-2 and IL-4 in patients of cervical intraepithelial neoplasia with HPV infection

    Institute of Scientific and Technical Information of China (English)

    李小宁; 贺丰杰; 吉喆

    2015-01-01

    Objective To observe the effects of traditional Chinese medical compound"Fengxiang Lotion"on the local vaginal immune state for patients of cervical intraepithelial neoplasia (CIN) with human papillomavirus (HPV) infection.Methods Sixty patients with high risk HPV infection diagnosed with cervical biopsy using colpos-copy in the Affiliated Hospital of Shaanxi University of Chinese Medicine and Xi'an XD Group Hospital from July 2013 to February 2015 were selected in the study,which were divided into CINⅠand CINⅡgroup (n=30 each).Thirty healthy women coming for medical examination during the same period served as the control group.CINⅠgroup received Fengxiang Lotion for treatment,while the other two groups not.The levels of interleukin (IL)-2 and IL-4 in cervical-vaginal lavage solution,which were synthesized by type 1 and type 2 helper T cells respective-ly,were tested by ELISA.Results (1) IL-2 levels of CINⅠgroup and CINⅡgroup were significantly lower than that of the control group (P<0.01),while IL-4 levels of CINⅠgroup and CINⅡ group were significantly higher (P<0.05).The ratios of IL-2 to IL-4 in CINⅠgroup and CINⅡgroup were significantly lower than that of the con-trol group (P<0.05).What's more,all these changes was more significant in CINⅡgroup than CINⅠgroup (P<0.05).(2) In CINⅠgroup,the IL-2 level increased significantly after medication (P<0.05),while IL-4 decreased significantly (P<0.05),with the ratio of IL-2 to IL-4 increased significantly (P<0.01).Conclusion The IL-2 lev-els and IL-2/IL-4 ratio in CIN patients with HPV decreased,while IL-4 increased.These changes were consistent with the severity of CIN."Fengxiang Lotion"may block the progression of CIN through regulating the balance of Th1 and Th2.%目的 观察中药"凤香洗液"对伴有HPV感染的CINⅠ、CINⅡ患者阴道局部免疫状态的影响及治疗效果.方法 选取2013年7月至2015年2月于陕西中医学院附属医院、西安西电集团医院门诊就

  16. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  17. Anal transition zone in the surgical management of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jennifer Holder-Murray; Alessandro Fichera

    2009-01-01

    Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis. The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis (RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis;these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery. Each technique has advantages and disadvantages in long-term functional outcomes, operative and postoperative complications, and risk of neoplasia. Therefore, we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation.

  18. Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett's esophagus

    NARCIS (Netherlands)

    M.A. Kara; F.P. Peters; P. Fockens; F.J.W. ten Kate; J.J.G.H.M. Bergman

    2006-01-01

    Background: Video-autofluorescence imaging (AFI) and narrow band imaging (NBI) are new endoscopic techniques that may improve the detection of high-grade intraepithelial neoplasia (HGIN) in Barrett's esophagus (BE). AFI improves the detection of lesions but may give false-positive findings. NBI allo

  19. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett's neoplasia

    NARCIS (Netherlands)

    Pouw, Roos E.; van Vilsteren, Frederike G. I.; Peters, Femke P.; Herrero, Lorenza Alvarez; ten Kate, Fiebo J. W.; Visser, Mike; Schenk, Boudewijn E.; Schoon, Erik J.; Peters, Frans T. M.; Houben, Martin; Bisschops, Raf; Weusten, Bas L. A. M.; Bergman, Jacques J. G. H. M.

    2011-01-01

    Background: Endoscopic resection (ER) is an important treatment for high-grade intraepithelial neoplasia and early cancer in Barrett's esophagus. ER-cap requires submucosal lifting and positioning of a snare in the cap, making it technically demanding and laborious. Multiband mucosectomy (MBM) uses

  20. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett's neoplasia

    NARCIS (Netherlands)

    R.E. Pouw; F.G.I. van Vilsteren; F.P. Peters; L. Alvarez Herrero; F.J.W. ten Kate; M. Visser; B.E. Schenk; E.J. Schoon; F.T.M. Peters; M. Houben; R. Bisschops; B.L.A.M. Weusten; J.J.G.H.M. Bergman

    2011-01-01

    Endoscopic resection (ER) is an important treatment for high-grade intraepithelial neoplasia and early cancer in Barrett's esophagus. ER-cap requires submucosal lifting and positioning of a snare in the cap, making it technically demanding and laborious. Multiband mucosectomy (MBM) uses a modified v

  1. Seguimento dos doentes soropositivos e soronegativos para o HIV com carcinoma espinocelular do canal anal Follow-up for HIV negative and HIV-positive patients with anal squamous cells carcinoma

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-09-01

    Full Text Available A incidência do carcinoma espinocelular (CEC anal e das neoplasias intra-epiteliais anais (NIA é maior nos pacientes infectados pelo papilomavírus humano (HPV, e está relacionada à imunidade e à infecção pelo vírus da imunodeficiência humana (HIV. A associação com viroses de transmissão sexual indica que seja tumor sexualmente transmitido. A infecção pelo HIV mudou o perfil dos portadores do CEC anal. A doença que anteriormente acometia mulheres na 6ª década de vida, hoje atinge preferencialmente homens na 3ª e 4ª décadas. Nos Estados Unidos, a expectativa de diagnóstico desse tumor aumentou de 19/100.000, na época pré-HAART (1992-1995, para 48,3/100.000 no período pós-HAART imediato (1996-1999 e para 78,2/100.000 pessoas por ano, nos anos mais recentes (2000-2003. O tratamento do CEC anal, descrito por Nigro em 1974, combina radio e quimioterapia. Operações de resgate estão indicadas caso haja persistência ou recidiva da doença. Estudos comparando, respectivamente, doentes imunodeprimidos e imunocompetentes vêm mostrado envolvimento linfonodal em 60% e 17%, recidivas em 75% e 6%, boa resposta à radio e quimioterapia em 62% e 85%, toxicidade a esse tratamento em 80% e 30%, e sobrevivência global de 1,4 e 5,3 anos. A contagem sérica baixa de linfócitos T CD4 prediz mau prognóstico. Quando acima de 200/mm³, os resultados são comparáveis aos observados entre os imunocompetentes.Anal squamous cell carcinoma (ASCC and anal intra-epithelial neoplasia (AIN incidences are bigger among human papillomavirus (HPV infections, and are associated to immunity and to HIV infection. These viruses with sexual transmission in association suggested ASCC is a sexually transmitted tumor. HIV infection changed ASCC patient profile. This kind of tumor committed women in theirs sixties, but nowadays, affects mainly men in the third and forth decades of life. In the United States of America, ASCC was diagnosed in 19/100.000, in the

  2. Squamous morules are functionally inert elements of premalignant endometrial neoplasia.

    Science.gov (United States)

    Lin, Ming-Chieh; Lomo, Lesley; Baak, Jan P A; Eng, Charis; Ince, Tan A; Crum, Christopher P; Mutter, George L

    2009-02-01

    Squamous morules are a common component of premalignant glandular lesions that are followed by glandular, rather than squamous, carcinomas. We tested the hypothesis that the appearance of glands associated with morules predicts cancer risk, and undertook molecular testing to determine the clonal and hormonal response properties of admixed squamous and glandular elements. A total of 66 patients with squamous morules in an index endometrial biopsy had follow-up clinical data (average follow-up: interval 31 months, 2.5 biopsies) showing development of carcinoma in 11% (7/66) of cases. The histological appearance of morule-associated glands in the index biopsy was significantly associated with this clinical outcome, with the majority (71%, 5/7) of cancer occurrences following an overtly premalignant lesion (endometrial intraepithelial neoplasia) with squamous morules. Eight endometrial intraepithelial neoplasias with squamous morules were examined by immunohistochemistry for estrogen and progesterone receptors and mitotic activity (Ki-67 antigen percent stained). Glandular components had abundant estrogen and progesterone receptors, and high levels of mitotic activity in all cases. In sharp contrast, all squamous morules were devoid of sex hormone receptors and had undetectable or extremely low-proliferation rates. When mutated, the same specific PTEN mutation was detected in squamous and glandular elements, indicating that both are of common lineage. The clinical and laboratory data are consistent with a model of morule biology in which squamous morules are a hormonally incompetent subpopulation of endometrial glandular lesions. Isolated morules might result from artifactual displacement from their native glandular context, or selective hormonally induced regression of the glandular but not squamous components over time. Subsequent cancer risk, as promoted by estrogens, is greatest when the glandular component has the appearance of endometrial intraepithelial

  3. Resultados do tratamento do carcinoma espinocelular anal e do seu precursor em doentes HIV-positivos Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2007-08-01

    and evolution from HAIN to cancer. This is a report of cases treated at the "Instituto de Infectologia Emílio Ribas", Sao Paulo, Brazil. METHODS: We attended 45 HIV-positive patients between July 1996 and June 2006. Most were male (97.7%, with ages ranging from 23 to 55 years (mean: 38.5 years. Thirty patients had high grade anal intra-epithelial neoplasia (HAIN, treated with local resection, and 15 with anal canal invasive squamous cell carcinoma were first submitted to chemo radiation, while biopsies were obtained during follow-up. RESULTS: Patients with HAIN had recurrences in 16.7% of cases and remained cancer free for up to five years. Chemoradiation was not possible in five patients with invasive carcinoma (40% because three had advanced AIDS and two refused treatment. Eight (88.8% out of nine patients had complete response to chemoradiation and remained cancer free for a period from three to six years. Chemoradiation failed in the ninth patient: abdominal perineal resection was performed, and there was no recurrence over a five-year period. CONCLUSION: We concluded that HAIN can recur after local resection in HIV-positive patients but does not evolve to invasive carcinoma. Invasive cancer can be treated in the same way as in HIV seronegative persons, when clinical conditions permit.

  4. Anal Abscess/Fistula

    Science.gov (United States)

    ... to determine if antibiotics are indicated. TREATMENT OF ANAL FISTULA Currently, there is no medical treatment available for ... surgery is almost always necessary to cure an anal fistula. If the fistula is straightforward (involving minimal sphincter ...

  5. Indicação da anuscopia de alta resolução e citologia anal na prevenção de HPV e câncer colorretal em pacientes portadores de HIV Indication of high resolution anoscopy and anal cytology for prevention of HPV and colorectal cancer in HIV patients

    Directory of Open Access Journals (Sweden)

    Hugo Leonardo Madeiro Arcanjo Silva

    2010-12-01

    Full Text Available OBJETIVO: Rastreamento do papilomavírus humano (HPV assim como sua correlação com a neoplasia a