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Sample records for anal intraepithelial neoplasia

  1. [Anal intraepithelial neoplasia].

    Science.gov (United States)

    de Parades, Vincent; Fathallah, Nadia; Barret, Maximilien; Zeitoun, Jean-David; Lemarchand, Nicolas; Molinié, Vincent; Weiss, Laurence

    2013-01-01

    Anal intraepithelial lesions are caused by chronic infection with oncogenic types of human papillomavirus. Their incidence and prevalence are increasing, especially among patients with HIV infection. Their natural history is not well known, but high-grade intraepithelial lesions seem to have an important risk to progress to squamous cell carcinoma. Their treatment can be achieved by many ways (surgery, coagulation, imiquimod, etc.) but there is a high rate of recurrent lesions. Pretherapeutic evaluation should benefit from high-resolution anoscopy. Periodic physical examination and anal cytology may probably be interesting for screening the disease among patients with risk factors. Vaccine against oncogenic types of papillomavirus may prevent the development of anal intraepithelial neoplasia. PMID:23122632

  2. 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.

  3. Anal intraepithelial neoplasia: review and recommendations for screening and management.

    Science.gov (United States)

    Smyczek, Petra; Singh, Ameeta E; Romanowski, Barbara

    2013-11-01

    Anal cancer is a rare malignancy of the distal gastrointestinal tract, often associated with human papillomavirus, the most common sexually transmitted infection worldwide. Currently available screening methods for anal intraepithelial neoplasia, a precursor for anal cancer, combine anal Papanicolaou cytology and high resolution anoscopy with biopsy of suspicious lesions. Significant barriers to establishing anal cancer screening programmes include the small number of healthcare professionals performing high resolution anoscopy and the lack of data showing that anal cancer screening can reduce morbidity and mortality related to anal carcinoma. Despite several controversies surrounding anal cancer screening, the rising incidence of this disease in some groups supports routine screening programmes in high-risk populations, especially in HIV-positive men who have sex with men. This review outlines the epidemiology of anal intraepithelial neoplasia and anal cancer and summarizes issues related to the introduction of anal cancer screening programmes. PMID:23970583

  4. 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.

  5. Anal cancer and intraepithelial neoplasia screening: A review.

    Science.gov (United States)

    Leeds, Ira L; Fang, Sandy H

    2016-01-27

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations. PMID:26843912

  6. Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia.

    Science.gov (United States)

    Long, Kevin C; Menon, Raman; Bastawrous, Amir; Billingham, Richard

    2016-03-01

    The prevalence of anal intraepithelial neoplasia has been increasing, especially in high-risk patients, including men who have sex with men, human immunodeficiency virus positive patients, and those who are immunosuppressed. Several studies with long-term follow-up have suggested that rate of progression from high-grade squamous intraepithelial lesions to invasive anal cancer is ∼ 5%. This number is considerably higher for those at high risk. Anal cytology has been used to attempt to screen high-risk patients for disease; however, it has been shown to have very little correlation to actual histology. Patients with lesions should undergo history and physical exam including digital rectal exam and standard anoscopy. High-resolution anoscopy can be considered as well, although it is of questionable time and cost-effectiveness. Nonoperative treatments include expectant surveillance and topical imiquimod or 5-fluorouracil. Operative therapies include wide local excision and targeted ablation with electrocautery, infrared coagulation, or cryotherapy. Recurrence rates remain high regardless of treatment delivered and surveillance is paramount, although optimal surveillance regimens have yet to be established. PMID:26929753

  7. Current treatment options for management of anal intraepithelial neoplasia.

    Science.gov (United States)

    Weis, Stephen E

    2013-01-01

    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-fluorouracil or imiquimod. Topical therapies have the advantage of being nonsurgical and are well suited for treating widespread multifocal disease. Topical treatments have the disadvantage of requiring extended treatment courses and causing a symptomatic

  8. Anal intraepithelial neoplasia--is treatment better than observation?

    Science.gov (United States)

    Orchard, M; Roman, A; Parvaiz, A C

    2013-01-01

    Anal Intraepithelial Neoplasia (AIN) is an increasingly common condition for which the best treatment has not been well established. Traditional management was based on a 'watch and wait' strategy, but as the natural history of AIN and its progression to anal cancer is becoming better understood, more active treatment strategies are warranted. A best evidence topic in surgery was written according to a structured protocol to address the question whether treatment is indicated in patients with AIN. A total of 169 papers were identified using the defined search criteria. This included only one randomised controlled trial. Case series were therefore also included to help answer the question. The details of the papers were tabulated including relevant outcomes and study weaknesses. We conclude that treatment of high grade AIN, particularly in high risk groups is recommended to try to avoid progression to anal cancer. Treatment options that have shown some benefit include topical use of imiquimod cream or ablation directed by high resolution anoscopy. PMID:23643642

  9. Current treatment options for management of anal intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  11. [Early detection of anal intraepithelial neoplasia in high-risk patients].

    Science.gov (United States)

    Sendagorta, E; Herranz, P; Guadalajara, H; Zamora, F X

    2011-12-01

    The incidence of anal squamous cell carcinoma has increased alarmingly, particularly in high-risk groups such as men who have sex with men and immunosuppressed patients. Infection with an oncogenic strain of the human papillomavirus in the anal canal or perianal skin leads to anal intraepithelial neoplasias (AIN), progressive dysplastic intraepithelial lesions that are the precursors of anal squamous cell carcinoma. AIN can be diagnosed through cytological screening and biopsy guided by high-resolution anoscopy and can be treated using a range of procedures in an effort to prevent progression to invasive anal carcinoma. Given the recent advances in the understanding of this disease, and the increasing calls from experts for the establishment of screening programs to identify AIN, we review current knowledge on the condition, its diagnosis, and treatment from the point of view of dermatology. PMID:21764027

  12. Current treatment options for management of anal intraepithelial neoplasia

    OpenAIRE

    Weis SE

    2013-01-01

    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 intraepi...

  13. Anal cancer and intraepithelial neoplasia screening: A review

    OpenAIRE

    Leeds, Ira L.; Fang, Sandy H

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors earl...

  14. 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...

  15. High prevalence of high grade anal intraepithelial neoplasia in HIV-infected women screened for anal cancer.

    Science.gov (United States)

    Hou, June Y; Smotkin, David; Grossberg, Robert; Suhrland, Mark; Levine, Rebecca; Smith, Harriet O; Negassa, Abdissa; McAndrew, Thomas C; Einstein, Mark H

    2012-06-01

    There is no consensus on optimal screening for anal cancer (AC) in HIV+ women. Seven hundred fifteen unique asymptomatic women in a high-prevalence HIV+ community were screened for AC with anal cytology and triage to high-resolution anoscopy after routine screening was implemented in a large urban hospital system. Of these, 75 (10.5%) had an abnormal anal cytology and 29 (38.7%) of those with an abnormality had high-grade anal intraepithelial neoplasia (AIN). Women with poorly controlled HIV were significantly more likely to have high-grade AIN (P = 0.03). Given the high rate of AIN in screened HIV-infected women, routine AC screening in all HIV-infected women should be strongly considered. PMID:22466085

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

    OpenAIRE

    Sidney Roberto Nadal; Carmen Ruth Manzione

    2008-01-01

    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...

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

    OpenAIRE

    Richel, Olivier; Henry J C de Vries; 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 ana...

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Effects of Referral Bias on Estimates of Anal Intraepithelial Neoplasia Progression and Regression Rates in a 3-State Markov Model

    Science.gov (United States)

    Mathews, William Christopher; Cachay, Edward Rafael; Agmas, Wollelaw; Jackson, Christopher

    2015-01-01

    Abstract The study aim is to compare anal intraepithelial neoplasia (AIN) progression and regression rates in a cytology inception cohort to estimates based on the subcohort referred for ≥1 high-resolution anoscopies (HRAs). A cytology-based retrospective cohort was assembled including the anal cytology histories and invasive anal cancer (IAC) outcomes of all HIV-infected adults under care between 2001 and 2012. A 3-state Markov model (400, and to have HSIL at baseline and thereafter. They also had more anal cytology examinations (median 6 vs 3) and longer follow-up (median 5.5 vs 3.6 years). State transition rates were overestimated in the HRA subcohort relative to inception cohort, but the degree of discordance varied by transition: for

  20. Evaluation and Management of Anal Intraepithelial Neoplasia in HIV-Negative and HIV-Positive Men Who Have Sex with Men

    OpenAIRE

    Park, Ina U.; Palefsky, Joel M.

    2010-01-01

    The incidence of human papillomavirus (HPV)–associated anal cancer in men who have sex with men (MSM) is striking and has not been mitigated by the use of highly active antiretroviral therapy. Detection and treatment of high-grade anal intraepithelial neoplasia (HGAIN) may reduce the incidence of anal cancer. Anal cytology is a useful tool to detect HGAIN; annual screening of HIV-positive MSM and biennial screening of HIV-negative MSM appears to be cost-effective. MSM with abnormal cytology s...

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

    Directory of Open Access Journals (Sweden)

    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

  2. High grade anal intraepithelial neoplasia among HIV-1-infected men screening for a multi-center clinical trial of a human papillomavirus vaccine

    Science.gov (United States)

    Wilkin, Timothy; Lee, Jeannette Y.; Lensing, Shelly Y.; Stier, Elizabeth A.; Goldstone, Stephen E.; Berry, J. Michael; Jay, Naomi; Aboulafia, David M.; Einstein, Mark H.; Saah, Alfred; Mitsuyasu, Ronald T.; Palefsky, Joel M.

    2013-01-01

    Purpose High-grade anal intraepithelial neoplasia (HGAIN) is the precursor lesion to invasive anal cancer. HPV vaccination holds great promise for preventing anal cancer. Methods We examined 235 HIV-1-infected men screening for participation in a multi-site clinical trial of a quadrivalent HPV vaccine. All participants had anal swabs obtained for HPV testing and cytology, and high resolution anoscopy with biopsies of visible lesions to assess for HGAIN. Results HPV 16 and 18 were detected in 23% and 10%, respectively; abnormal anal cytology was found in 56% and HGAIN in 30%. HGAIN prevalence was significantly higher in those with HPV 16 detection compared to those without (38% vs. 17%, P=.01). Use of antiretroviral therapy, nadir and current CD4+ cell count were not associated with abnormal anal cytology or HGAIN. Conclusion HGAIN is highly prevalent in HIV-infected men. Further studies are needed on treatment and prevention of HGAIN. PMID:23611828

  3. The evaluation of the feasibility and clinical utility of liquid based cytology, human papillomavirus testing and high-resolution anoscopy to screen for anal intraepithelial neoplasia in high-risk groups

    OpenAIRE

    Schofield, Alice

    2016-01-01

    The evaluation of the feasibility and clinical utility of liquid based cytology, human papillomavirus testing and high-resolution anoscopy to screen for anal intraepithelial neoplasia in high-risk groups. Dr Alice Martha Schofield: The University of Manchester for the degree of Doctor of Medicine, January 2016. Background: The increased incidence and natural history of anal cancer in high-risk groups, provides a screening opportunity to detect precancerous lesions, anal intraepithelial neopla...

  4. Fractal Analysis of Cervical Intraepithelial Neoplasia

    Science.gov (United States)

    Fabrizii, Markus; Moinfar, Farid; Jelinek, Herbert F.; Karperien, Audrey; Ahammer, Helmut

    2014-01-01

    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. PMID:25302712

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

    OpenAIRE

    Gandra S; Azar A; Wessolossky M

    2015-01-01

    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 evalu...

  6. Management of Anal Squamous Intraepithelial Lesions

    OpenAIRE

    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 ...

  7. Histopathologic characteristics of the prostatic intraepithelial neoplasia

    International Nuclear Information System (INIS)

    The prostate disease is a health problem nowadays due to its high morbidity and mortality in adults older than 50 years. Based on this, a descriptive and cross sectional study was carried out on the histopathologic findings of the prostatic intraepithelial neoplasia in the useful prostate biopsies examined in the Pathology Department of 'Dr. Ambrosio Grillo Portuondo' Clinical Surgical Teaching Hospital in Santiago de Cuba during the biennium 2008-2009. Among the main results there were: the confirmation of prostate fibroadenomatous hyperplasia, prostatic lesions, carcinomas and other alterations in that male gland, all through biopsy. The obtained data confirmed that the diagnosis through samples from the prostatic intraepithelial neoplasia tissue, constitutes one of the ways by which pathologists can contribute to the opportune detection of the prostatic carcinoma. (author)

  8. High-Grade Prostatic Intraepithelial Neoplasia

    Science.gov (United States)

    Bostwick, David G; Liu, Lina; Brawer, Michael K; Qian, Junqi

    2004-01-01

    High-grade prostatic intraepithelial neoplasia is considered the most likely precursor of prostatic carcinoma. The only method of detection is biopsy; prostatic intraepithelial neoplasia (PIN) does not significantly elevate serum prostate-specific antigen concentration and cannot be detected by ultra-sonography. The incidence of PIN in prostate biopsies averages 9% (range, 4%–16%), representing 115,000 new cases of PIN diagnosed each year in United States. PIN has a high predictive value as a marker for adenocarcinoma, and its identification warrants repeated biopsy for concurrent or subsequent invasive carcinoma. Carcinoma will develop in most patients with PIN within 10 years. PIN is associated with progressive abnormalities of phenotype and genotype that are intermediate between normal prostatic epithelium and cancer, indicating impairment of cell differentiation and regulatory control with advancing stages of prostatic carcinogenesis. Androgen deprivation therapy decreases the prevalence and extent of PIN, suggesting that this form of treatment may play a role in chemoprevention. PMID:16985598

  9. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    OpenAIRE

    Newton Sérgio de Carvalho; Aliana Meneses Ferreira; Camila Caroline Tremel Bueno

    2011-01-01

    In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be us...

  10. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Directory of Open Access Journals (Sweden)

    Newton Sérgio de Carvalho

    2011-10-01

    Full Text Available In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.

  11. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Science.gov (United States)

    Carvalho, Newton Sérgio de; Ferreira, Aliana Meneses; Bueno, Camila Caroline Tremel

    2011-01-01

    In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy. PMID:22230855

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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....

  17. Anal intraepitelial neoplasia: a narrative review

    OpenAIRE

    Garazi Elorza; Yolanda Saralegui; José María Enríquez-Navascués; Carlos Placer; Leyre Velaz

    2016-01-01

    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 ca...

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

    OpenAIRE

    Arain Shehla; Walts Ann; Thomas Premi; Bose Shikha

    2005-01-01

    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...

  19. [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. PMID:27531273

  20. 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...

  1. Anal cytology in women with cervical intraepithelial or invasive cancer: interobserver agreement

    Directory of Open Access Journals (Sweden)

    Sandra A. Heráclio

    2015-10-01

    Full Text Available ABSTRACTIntroduction:Incidence rates of anal cancer have been rising worldwide in the last 20 years. Due to embryological, histological and immunohistochemical similarities between the anal canal and the cervix, routine screening with anal cytology for precursor lesions in high-risk groups has been adopted. Objective: To determine interobserver agreement for the diagnosis of anal neoplasia by anal cytology.Material and methods:A cross-sectional observational study was conducted in 324 women with cervical intraepithelial or invasive cancers, for screening of anal cancer, from December 2008 to June 2009. Three hundred twenty-four cytological samples were analyzed by three cytopathologists. Cytological evaluation was based on the revised Bethesda terminology; samples were also classified into negative and positive for atypical cells. We calculated the kappa statistic with 95% confidence interval (95% CI to assess agreement among the three cytopathologists.Results:Interobserver agreement in the five categories of the Bethesda terminology was moderate (kappa for multiple raters: 0.6. Agreement among cytopathologists 1, 2 and 3 with a consensus diagnosis was strong (kappa: 0.71, 0.85 and 0.82, respectively.Conclusion:Interobserver agreement in anal cytology was moderate to strong, indicating that cervical cytomorphological criteria are reproducible also in anal samples.

  2. 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.

  3. Anal intraepitelial neoplasia: A narrative review.

    Science.gov (United States)

    Elorza, Garazi; Saralegui, Yolanda; Enríquez-Navascués, Jose María; Placer, Carlos; Velaz, Leyre

    2016-01-01

    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. PMID:26765233

  4. ACOG Committee Opinion No. 509: Management of vulvar intraepithelial neoplasia.

    Science.gov (United States)

    2011-11-01

    Vulvar intraepithelial neoplasia (VIN) is an increasingly common problem, particularly among women in their 40s. The term VIN is used to denote high-grade squamous lesions and is subdivided into usual-type VIN (including warty, basaloid, and mixed VIN) and differentiated VIN. Usual-type VIN is commonly associated with carcinogenic genotypes of human papillomavirus (HPV) and other HPV persistence risk factors, such as cigarette smoking and immunocompromised status, whereas differentiated VIN usually is not associated with HPV and is more often associated with vulvar dermatologic conditions, such as lichen sclerosus. Biopsy is indicated for any pigmented vulvar lesion. Treatment is indicated for all cases of VIN. When occult invasion is not a concern, VIN can be treated with surgical therapy, laser ablation, or medical therapy. After resolution, women should be monitored at 6 and 12 months and annually thereafter. PMID:22015906

  5. 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.

  6. Detection and Identification of Human Papiliomavirus in Vulvar Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    GUO Yi; WU Juan-hua; LI Wei; WANG Qian; LI Hui

    2007-01-01

    Objective: To evaluate the rate and types of human papillomavirus infection in vulvar intraepithelial neoplasia. Methods: We detected and identified HPV in 40 VIN cases with 67 lesions using PCR based reverse line blot hybridization and DNA sequencing. Among the 40 patients, 13 were diagnosed as VIN Ⅲ, 11 as VIN Ⅱ, and 16 as VIN Ⅰ. 31 patients had multifocal disease. First a fragment of 150 bp was amplified from the L1 region of HPV with GP5/GP6 primers. If the result was negative, a short fragment of 65 bp was amplified also from the L1 region with SPF1/SPF2 primers. Results: Using general primer GP5/GP6, the positive rate was 52.2% (35/67). Using a short PCR fragment (SPF PCR), the positive rate of the rest 32 lesions was 81.2% (26/32). The total positive rate was 91.0% (61/67). 90% of the HPV types found in VIN were high risk types. All 35 GP PCR products were analyzed by sequencing. The gene types of 31 mono-infection lesions were in accordance with the reverse line blot results, while sequence results of the 4 multi-infection samples could not be analyzed. The SPF PCR products were also sequenced, 24 of the 26 SPF PCR products could be analyzed and 2 samples failed. 80.6% (25/31) cases with multifocal VIN displayed the identical type of HPV, suggesting monoclonality in different lesions from the same patient. Conclusion: The high risk type of HPV is associated with vulvar intraepithelial neoplasia and may be necessary for development of HPV-associated invasive vulvar carcinoma.

  7. 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.

  8. Magnifying endoscopy with narrow-band imaging may improve diagnostic accuracy of differentiated gastric intraepithelial neoplasia: a feasibility study

    Institute of Scientific and Technical Information of China (English)

    WANG Shu-fang; YANG Yun-sheng; YUAN Jing; LU Zhong-sheng; ZHANG Xiu-li; SUN Gang; PENG Li-hua; LING-HU En-qiang; MENG Jiang-yun

    2012-01-01

    Background Magnifying narrow-band imaging has enabled observation of the mucosal and vascular patterns of gastrointestinal lesions.This study investigated the potential value of magnifying endoscopy with narrow-band imaging for the classification of gastric intraepithelial neoplasia.Methods Seventy-six patients with gastric intraepithelial neoplasia (82 lesions) at People's Liberation Army General Hospital from December 2009 to November 2010 were analyzed.All patients underwent magnifying endoscopy with narrow-band imaging,and their lesions were differentiated into probable low-grade intraepithelial neoplasia or possible high-grade intraepithelial neoplasia on the basis of the imaging features.Pathologic proof was subsequently obtained by endoscopic submucosal dissection in every case.The validity of magnifying endoscopy with narrow-band imaging was calculated,considering histopathology to be the gold standard.Results Magnifying endoscopy with narrow-band imaging showed 22 low-grade intraepithelial neoplastic lesions and 60 high-grade intraepithelial neoplastic lesions.Of the 22 low-grade intraepithelial neoplastic lesions,16 showed the same results on both imaging and pathology.Of the 60 high-grade intraepithelial neoplastic lesions,53 showed the same results on both imaging and pathology.Thus,the sensitivity of magnifying endoscopy with narrow-band imaging for high-grade intraepithelial neoplasia was 89.83%,which was higher than that for low-grade intraepithelial neoplasia (69.57%).However,the specificity for high-grade intraepithelial neoplasia (69.57%) was lower than that for low-grade intraepithelial neoplasia (89.83%).The overall accuracy of magnifying endoscopy with narrow-band imaging was 84.15%.Conclusions Magnifying endoscopy with narrow-band imaging can distinguish between gastric low- and high-grade intraepithelial neoplasia.It may be a convenient and effective method for the classification of gastric intraepithelial neoplasia.

  9. 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

  10. 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.

  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. Increased incidence of penile cancer and high-grade penile intraepithelial neoplasia in Denmark 1978-2008

    DEFF Research Database (Denmark)

    Baldur-Felskov, Birgitte; Hannibal, Charlotte Gerd; Munk, Christian;

    2012-01-01

    To assess the trends in incidence of penile cancer during 1978-2008 and high-grade penile intraepithelial neoplasia (PIN2/3) during 1998-2008 in Denmark.......To assess the trends in incidence of penile cancer during 1978-2008 and high-grade penile intraepithelial neoplasia (PIN2/3) during 1998-2008 in Denmark....

  13. 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

  14. Differential detection of Human Papillomavirus genotypes and cervical intraepithelial neoplasia by four commercial assays

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Preisler, Sarah;

    2016-01-01

    intraepithelial neoplasia (CIN) in 2.5 years after the baseline testing were determined from the national pathology register. HPV-positive women undergoing primary screening having concordant samples were more likely to harbor high-risk infections and less likely to harbor only low-risk infections than women...

  15. 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

  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. Frequency of cervical intraepithelial neoplasia treatment in a well-screened population

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjaer; Rebolj, Matejka; Andersen, Erik Søgaard;

    2012-01-01

    Treatment of cervical intraepithelial neoplasia (CIN) detectable at screening has helped reduce the incidence of cervical cancer, but has also led to overtreatment. The estimates of overtreatment have often focused on a particular grade of CIN or age group. The aim of this paper was to provide a ...

  18. 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 ...

  19. Presumed corneal intraepithelial neoplasia associated with contact lens wear and intense ultraviolet light exposure.

    OpenAIRE

    Guex-Crosier, Y.; Herbort, C P

    1993-01-01

    Corneal intraepithelial neoplasia (CIN) is a rare dysplastic process affecting mostly elderly fair-skinned people. A variant of the disease associated with contact lens wear was recently described. The three cases reported here had a history of contact lens wear together with strong ultraviolet light exposure. These two conditions may represent a serious risk factor for the development of CIN.

  20. Endoscopic features predictive of gastric cancer in superficial lesions with biopsy-proven high grade intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    Wei Wu; Yun-Lin Wu; Yan-Bo Zhu; Qing Wei; Yan Guo; Zheng-Gang Zhu; Yao-Zong Yuan

    2009-01-01

    AIM: To investigate the macroscopic and clinicopathologic features of gastric cancer in patients with biopsy-suggested high grade intraepithelial neoplasia.METHODS: Patients with biopsy-confirmed gastric high grade intraepithelial neoplasia were reviewed from January 2001 to March 2008. Pathologic sections were re-evaluated by two senior pathologists.Patients with an en-bloc resection of the lesion within two months after the diagnosis of high grade intraepithelial neoplasia were enrolled in the study.Clinical manifestations, endoscopic features, biopsy and surgical pathology of all patients were collected and analyzed. The data acquired were subjected to univariate and multivariate analysis.RESULTS: Seventy-two superficial gastric lesions with a pathologic diagnosis of high grade intraepithelial neoplasia based on biopsy specimens were enrolled.True high grade intraepithelial neoplasia was finally proved in 16 lesions and gastric cancer in the rest 56 lesions, most of which (96.4%) were differentiated carcinomas. The result of univariate analysis indicated that the size and the presence of marked ulcer plaque or scar in a superficial lesion were independently associated with gastric cancer ( P < 0.05), when high grade intraepithelial neoplasia was diagnosed by biopsy pathology. The results of multivariate analysis revealed the size greater than 1.5 cm [odds ratio (OR) 18.400,P < 0.001] and the presence of 5-odd mm ulcer plaque or scar (OR 10.000, P = 0.044) were associated with gastric cancer. Accordingly, the sensitivity, specificity and negative predictive value of multivariate analysis for predicting"true high grade intraepithelial neoplasia"was 87.5%, 89.3% and 96.2%, respectively.CONCLUSION: Macroscopic findings are of value in differentiation between high grade intraepithelial neoplasia and superficial gastric cancer. This may simplify patient work-up and save costs for patients and healthcare system.

  1. Cytological Analysis for Human Papillomavirus DNAs in Cervical Intraepithelial Neoplasia by In situ Hybridization

    OpenAIRE

    Nagai, Nobutaka; Takehara, Kazuhiro; Murakami, Takahiro; Ohama, Koso

    1994-01-01

    Human papillomavirus (HPV) type 16 and 18 DNAs are reported to be associated with uterine cervical cancer. In order to investigate the relationship between the presence of HPV DNA and cervical intraepithelial neoplasia (CIN), we attempted the cytological detection of HPV DNAs in uterine cervical smear samples. The samples included those of severe dysplasia and carcinoma in situ (CIS). They were analysed by DNA-DNA in situ hybridization using biotinylated HPV DNA probes.  The results of in sit...

  2. Cytological Analysis for Human Papillomavirus DNAs in Cervical Intraepithelial Neoplasia by In situ Hybridization

    OpenAIRE

    Nagai, Nobutaka; Takehara, Kazuhiro; Murakami, Takahiro; Ohama, Koso

    1994-01-01

    Human papillomavirus (HPV) type 16 and 18 DNAs are reported to be associated with uterine cervical cancer. In order to investigate the relationship between the presence of HPV DNA and cervical intraepithelial neoplasia (CIN), we attempted the cytological detection of HPV DNAs in uterine cervical smear samples. The samples included those of severe dysplasia and carcinoma in situ (CIS). They were analysed by DNA-DNA in situ hybridization using biotinylated HPV DNA probes.   The results of i...

  3. 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...

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

    OpenAIRE

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

    2015-01-01

    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 t...

  5. 外阴上皮内瘤样病变%Vulvar Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    高志华

    2013-01-01

    随着外阴癌发病率上升,发病年龄年轻化,外阴上皮内瘤样病变(VIN)作为癌前病变受到更多关注.阐述VIN病因学及分类、病理特征、临床特点、治疗方法、复发及恶化.VIN治疗方法目前缺乏统一标准,治疗目的是去除病灶、预防恶变、保留功能.治疗后复发是临床常见问题.虽然手术是解决该病主要手段,但免疫疗法、光动力疗法、聚焦超声治疗有助于保留外阴结构和功能,易于为患者接受.咪喹莫特是一种有前景的保守治疗药物,人乳头瘤病毒(HPV)疫苗接种将成为预防寻常型VIN的有力措施.%With the vulvar cancer increases in incidence and younger age of onset,vulvar intraepithelial neoplasia lesions are more concerned about as precancerous lesions.This paper describes the vulvar intraepithelial neoplasia lesions of the etiology and classification,clinical features,pathology character,treatment progress and treatment options,recurrence and progression.The therapeutic approach for vulvar intraepithelial neoplasia is variours.The objectives of treatment are not only eliminating lesions to prevent development of invasive vulvar cancer,but also including preservation of normal vulvar function and anatomy.The recurrence,even after extensive surgical procedures,are common.Surgical excision is currently the standard treatment for vulvar intraepithelial neoplasia,The new treatment modalities,including immunotherapy,focused ultrasound therapy and photodynamic therapy,are easy accepted by patients because of the effectiveness and maintaining relatively normal-appearing and functioning anatomy.Imiquimod is possibly an alternative to currently available methods of treatment.Vaccine against Human Papillomavirus is going to be a dominant modality to prevent vulvar intraepithelial neoplasia.

  6. 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)....

  7. 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.

  8. 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.

  9. 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)....

  10. 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].

  11. 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.

  12. Effectiveness and safety of endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction

    Institute of Scientific and Technical Information of China (English)

    Wen Jing; Linghu Enqiang; Yang Yunsheng; Liu Qingsen; Yang Jing; Wang Shufang; Wang Xiangdong

    2014-01-01

    Background Endoscopic submucosal dissection of the esophagogastric junction is the most difficult gastric and esophageal dissection procedure.No reports of endoscopic submucosal dissection for Siewert type ii carcinoma of the esophagogastric junction have compared the outcomes of endoscopic submucosal dissection for all three Siewert types of adenocarcinoma.This study aimed to evaluate the efficacy and safety of endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction.Methods From October 2008 to June 2013,73 patients underwent endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction.The patients were prospectively evaluated regarding the executability of the technique,short-term results of the procedure,en bloc resection rate,curative resection rate,complications and additional treatment after endoscopic submucosal dissection,and follow-up outcomes.Results Sixty-eight of the 73 patients (93.2%) underwent en bloc resection; the mean maximum specimen diameter was 33.7 mm.Fifty-seven of 61 patients (93.4%) who underwent curative resection were successfully followed-up for 1.0 to 56.0 months (average,24.1 months).Local recurrence developed in one patient with high-grade intraepithelial neoplasm.Twelve patients underwent noncurative resection,including lateral resection margin residues in three,vertical resection margin residues in one,signet ring cell carcinoma or undifferentiated adenocarcinoma in four,lymphatic or vessel invasion in one,vertical residual margin residues combined with signet ring cell carcinoma in one,and undifferentiated adenocarcinoma with lymphatic or vessel invasion in two.In the noncurative resection group,one patient was lost to follow-up,seven underwent additional surgery,and the remaining four were periodically followed up; none had local recurrence or distant metastases.The only complication was delayed bleeding in three patients,which was successfully controlled

  13. 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...

  14. 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...

  15. High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise T; 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 cer...

  16. 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...

  17. 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.

  18. 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.

  19. 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

  20. L1 sequence of a new human papillomavirus type-58 variant associated with cervical intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    V.S. Veras

    2005-01-01

    Full Text Available The present study on molecular characterization of a human papillomavirus (HPV isolated in Central Brazil describes the L1 gene sequence from a new variant of HPV-58, the isolate Bsb-02. The sample was from a smear obtained from a woman with cervical intraepithelial neoplasia grade II. The whole L1 gene from isolate Bsb-02 was sequenced automatically, showing 99.1% nucleotide identity with the gene from the HPV-58 reference. The clustering between Bsb-02 and HPV-58 reference sequence was also supported by phylogenetic analysis. Fourteen nucleotide substitutions were observed: eight were synonymous and six were associated with amino acid substitutions. A10V and V144I have not been previously described. At GenBank, the only complete L1 sequence from HPV-58 in addition to the HPV-58 reference one is that of Bsb-02. These data provide information that may be relevant to HPV diagnosis and to rational vaccine strategies. HPV variants may also be associated with host immune responses and with the risk of cervical neoplasia.

  1. Intraepithelial lymphocytosis is a frequent finding in biopsies from ileal pouch-anal anastomoses.

    Science.gov (United States)

    Schaeffer, David F; Walsh, Joanna C; Tyler, Andrea D; Ben-Bassat, Ofer; Silverberg, Mark S; Riddell, Robert H; Kirsch, Richard

    2016-08-01

    Following restorative proctocolectomy with an ileal pouch-anal anastomosis, the small bowel mucosa undergoes several specific histologic adaptions, which may be unrelated to the underlying disease or symptoms of pouchitis. An increase in intraepithelial lymphocytes (IELs) has not been described as part of this spectrum. Mucosal biopsies of the ileal pouch and afferent limb of 230 patients (mean age: 45.7y [18.3-74.7], gender [female/male]: 117/113) with a functioning ileal pouch-anal anastomosis (mean time since ileostomy closure: 10.8months) and associated clinically annotated outcome data were assessed for IELs/100 enterocytes. Forty-two patients (18.3%) showed an increase in IELs (≥20 IELs/100 enterocytes [range 20-39]), in pouch and/or afferent limb biopsies. Intraepithelial lymphocytosis was more commonly observed in afferent limb compared to pouch biopsies (18.8% vs 8.3%; P = .42) and in familial adenomatous polyposis compared to ulcerative colitis patients (16% vs 8%; P = 0.36), but neither difference reached statistical significance. No cases with increased IELs displayed severe villous blunting. Increased IELs were not significantly associated with age, sex, ethnicity, smoking history, time since ileostomy, use of antibiotics, biologic agents, anti-diarrheal agents or probiotics, C-reactive protein levels or differential white cell count. None of the 42 patients with increased IELs had positive celiac serology (anti-human tissue transglutaminase IgA [ELISA] with corresponding total serum IgA). Intraepithelial lymphocytosis in pouch biopsies may represent a subclinical response to an altered bacterial microenvironment. Pathologists should be aware that intraepithelial lymphocytosis is part of the spectrum of changes in pouch biopsies, and only rarely is due to celiac disease. PMID:27063473

  2. 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

  3. 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.

  4. 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.

  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 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.

  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. Vulval intraepithelial neoplasia%外阴上皮内肿瘤形成

    Institute of Scientific and Technical Information of China (English)

    鲍冬梅; 回允中

    2009-01-01

    @@ 外阴上皮内肿瘤形成(vulvar intraepithelial neoplasia,VIN)是外阴鳞状细胞癌的前驱病变已经得到公认.外阴鳞状细胞癌是一种多因素的疾病,一般认为外阴鳞状细胞癌的发生至少有两种非常独特的途径,即伴随普通性VIN的人乳头状瘤病毒(HPV)相关性途径和伴随分化性VIN的非HPV相关性途径[1].这两种途径各具不同的临床、组织病理学和生物学特性.长期以来有关VIN的命名和概念十分混乱.普通性VIN又叫典型性VIN、未分化性VIN和Bowen样VIN,而分化性VIN又叫单纯性VIN或高分化性VIN.对于VIN的所有这些修饰性术语均不甚满意,为了避免混乱,这里采用国际外阴阴道疾病研究学会(International Society for the Study of Vulvovaginal Disease,ISSVD)命名委员会选定的命名,即普通性VIN和分化性VIN[2-3].

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

    Science.gov (United States)

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

    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, 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. PMID:23690785

  10. Metabonomic changes from pancreatic intraepithelial neoplasia to pancreatic ductal adenocarcinoma in tissues from rats.

    Science.gov (United States)

    Wen, Shi; Li, Zhishui; Feng, Jianghua; Bai, Jianxi; Lin, Xianchao; Huang, Heguang

    2016-06-01

    Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant tumors and is difficult to diagnose in the early phase. This study was aimed at obtaining the metabolic profiles and characteristic metabolites of pancreatic intraepithelial neoplasia (PanIN) and PDAC tissues from Sprague-Dawley (SD) rats to establish metabonomic methods used in the early diagnosis of PDAC. In the present study, the animal models were established by embedding 7,12-dimethylbenzanthracene (DMBA) in the pancreas of SD rats to obtain PanIN and PDAC tissues. After the preprocessing of tissues, (1) H nuclear magnetic resonance (NMR) spectroscopy combined with multivariate and univariate statistical analysis was applied to identify the potential metabolic signatures and the corresponding metabolic pathways. Pattern recognition models were successfully established and differential metabolites, including glucose, amino acids, carboxylic acids and coenzymes, were screened out. Compared with the control, the trends in the variation of several metabolites were similar in both PanIN and PDAC. Kynurenate and methionine levels were elevated in PanIN but decreased in PDAC, thus, could served as biomarkers to distinguish PanIN from PDAC. Our results suggest that NMR-based techniques combined with multivariate statistical analysis can distinguish the metabolic differences among PanIN, PDAC and normal tissues, and, therefore, present a promising approach for physiopathologic metabolism investigations and early diagnoses of PDAC. PMID:27019331

  11. Hypermutation in the E2 gene of human papillomavirus type 16 in cervical intraepithelial neoplasia.

    Science.gov (United States)

    Kukimoto, Iwao; Mori, Seiichiro; Aoyama, Satoru; Wakae, Kousho; Muramatsu, Masamichi; Kondo, Kazunari

    2015-10-01

    Persistent infection with oncogenic human papillomavirus (HPV) causes cervical cancer. However, viral genetic changes during cervical carcinogenesis are not fully understood. Recent studies have revealed the presence of adenine/thymine-clustered hypermutation in the long control region of the HPV16 genome in cervical intraepithelial neoplasia (CIN) lesions, and suggested that apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like (APOBEC) proteins, which play a key role in innate immunity against retroviral infection, potentially introduce such hypermutation. This study reports for the first time the detection of adenine/thymine-clustered hypermutation in the E2 gene of HPV16 isolated from clinical specimens with low- and high-grade CIN lesions (CIN1/3). Differential DNA denaturation PCR, which utilizes lower denaturation temperatures to selectively amplify adenine/thymine-rich DNA, identified clusters of adenine/thymine mutations in the E2 gene in 4 of 11 CIN1 (36.4%), and 6 of 27 CIN3 (22.2%) samples. Interestingly, the number of mutations per sample was higher in CIN3 than in CIN1. Although the relevance of E2 hypermutation in cervical carcinogenesis remains unclear, the observed hypermutation patterns strongly imply involvement of APOBEC3 proteins in editing the HPV16 genome during natural viral infection. PMID:25914233

  12. 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.

  13. Endometrial intraepithelial neoplasia terminology in practice: 4-year experience at a single institution.

    Science.gov (United States)

    Kane, Sarah E; Hecht, Jonathan L

    2012-03-01

    An alternative WHO classification system for endometrial precancers and hyperplasia separates a lesion called endometrial intraepithelial neoplasia (EIN) from diffuse hormonal effects and cancer, resulting in a 3-category system. EIN is a localized lesion with objective histologic criteria, characterized by monoclonal growth of mutated cells, and associated with a 45-fold elevated cancer risk. This study summarizes our department's experience with EIN diagnoses in the 4 years since conversion to the new terminology. We identified all reports from endometrial samples diagnosed as EIN or including the terms "gland crowding" or "atypia" since conversion and obtained follow-up information from subsequent pathology specimens or clinic notes (82%). The diagnoses were reported by a mixture of pathologists, the majority of whom are not subspecialized to gynecologic pathology and the slides were not reviewed. Overall, 17.1% of women with EIN had carcinoma and 34.9% had either carcinoma or persistent EIN. The proportion of women with EIN or cancer on follow-up did not trend with years since adoption of EIN terminology. The median age at the time of diagnosis was 55 years in an overall population of women who underwent sampling at a median age of 47 years. The median follow-up time was 4 months. All cancers were of endometrioid histology; all but 2 were International Federation of Gynecology and Obstetrics grade 1. In comparison with a previous reproducibility study among expert pathologists on a comparable population from our department, these results for general pathologists show a higher false positive rate for subsequent cancer. PMID:22317874

  14. The PapilloCheck Assay for Detection of High-Grade Cervical Intraepithelial Neoplasia.

    Science.gov (United States)

    Crosbie, Emma J; Bailey, Andrew; Sargent, Alex; Gilham, Clare; Peto, Julian; Kitchener, Henry C

    2015-11-01

    Human papillomavirus (HPV) testing is used in primary cervical screening, as an adjunct to cervical cytology for the management of low grade abnormal cytology, and in a test of cure. PapilloCheck (Greiner Bio-One) is a PCR-based DNA microarray system that can individually identify 24 HPV types, including the 13 high-risk (HR) types identified by Hybrid Capture 2 (HC2). Here, we compare PapilloCheck with HC2 for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a total of 8,610 cervical cytology samples from the ARTISTIC population-based cervical screening study. We performed a retrospective analysis of 3,518 cytology samples from round 1 ARTISTIC enriched for underlying CIN2+ (n = 723) and a prospective analysis of 5,092 samples from round 3 ARTISTIC. Discrepant results were tested using the Roche reverse line blot (RLB) or Linear Array (LA) assay. The relative sensitivity and specificity of HR PapilloCheck compared with that of HC2 for the detection of CIN2+ in women aged over 30 years were 0.94 (95% confidence interval [CI], 0.91, 0.97) and 1.05 (95% CI, 1.04, 1.05), respectively. HC2 missed 44/672 (7%) CIN2+ lesions, while HR PapilloCheck missed 74/672 (11%) CIN2+ lesions. Thirty-six percent of HC2-positive normal cytology samples were HR HPV negative by both PapilloCheck and RLB/LA, indicating that the use of HR PapilloCheck rather than HC2 in population-based primary screening would reduce the number of additional tests required (e.g., reflex cytology) in women where underlying CIN2+ is extremely unlikely. HR PapilloCheck could be a suitable HPV detection assay for use in the cervical screening setting. PMID:26338859

  15. 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.

  16. Abnormal Pap Smear and Diagnosis of High-Grade Vaginal Intraepithelial Neoplasia: A Retrospective Cohort Study.

    Science.gov (United States)

    Sopracordevole, Francesco; Mancioli, Francesca; Clemente, Nicolò; De Piero, Giovanni; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea

    2015-10-01

    The aim of this study was to analyze the correlation between the first diagnosis of high-grade Vaginal Intraepithelial Neoplasia (HG-VaIN: VaIN 2-VaIN 3) and the cytological abnormalities on the referral pap smear.All the women with histological diagnosis of HG-VaIN consecutively referred to the Gynecological Oncology Unit of the Aviano National Cancer Institute (Aviano, Italy) from January 1991 to April 2014 and with a pap smear performed in the 3 months before the diagnosis were considered, and an observational cohort study was performed.A total of 87 women with diagnosis of HG-VaIN were identified. Major cytological abnormalities (HSIL and ASC-H) on the referral pap smear were significantly more frequent than lesser abnormalities (ASC-US and LSIL) in postmenopausal women (64.9% vs 36.7%, P = 0.02) and in women with a previous diagnosis of HPV-related cervical preinvasive or invasive lesions (70.5% vs 39.5%, P = 0.01). Diagnosis of VaIN 3 was preceded by major cytological abnormalities in most of the cases (72.7% vs 27.3%, P diagnosis of HG-VaIN can be preceded by different abnormalities on referral pap smear. Major abnormalities are usually reported in postmenopausal women and in women with previous cervical HPV-related disease. However, ASC-US or LSIL do not exclude HG-VaIN, especially VaIN2. An accurate examination of the whole vaginal walls (or vaginal vault) must be performed in all the women who underwent colposcopy for an abnormal pap smear, and a biopsy of all suspicious areas is mandatory. PMID:26496321

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Prostatic atrophy: its spatial proximity to carcinoma and intraepithelial neoplasia based on annotation of digital slides.

    Science.gov (United States)

    Iczkowski, Kenneth A; Torkko, Kathleen C; Wilson, R Storey; Lucia, M Scott; Bostwick, David G

    2014-01-01

    Whether atrophy is a precursor to high-grade prostatic intraepithelial neoplasia (HGPIN) and cancer is controversial. A virtual slide set comprising 48 prostatectomy cases was used to investigate associations among the amounts and spacing of these entities. Foci of atrophy without inflammation (A), atrophy with inflammation (AI), cancer (by patterns), and HGPIN were digitally annotated. Atrophy's proximity to cancer and HGPIN was assessed with two measurements: abutment (touching) or nearness (≤2 μm without touching). Area sums per specimen were computed for A, AI, cancer, and HGPIN. Abutment rates of AI and A foci to cancer were 23% versus 21% (p = NS); for nearness, 29% of AI foci were near to cancer versus 12% of A (P = .0001). Abutment or nearness of A and AI to HGPIN were in the 1.4% to 2.4% range. When A, AI, or HGPIN abutted cancer, it was disproportionately to Gleason grade 3 cancer foci even after adjusting for the lesser frequency of higher-grade cancer foci. Area sums of A, AI, or (A + AI) per specimen showed no correlations with those of HGPIN, and mostly negative ones with area sum and with tumor volume of cancer. In conclusion, atrophy with inflammation showed some preferential spatial association to cancer, although area sums of atrophy with or without inflammation correlated negatively with those of cancer. These divergent spatial associations suggest that atrophy and inflammation in biopsy specimens may have clinical relevance. The frequency of inflammatory atrophy (AI) merging with HGPIN was far less than reported previously, weakening the theory that AI gives rise to HGPIN. PMID:24157066

  19. 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.

  20. 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.

  1. 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.

  2. Feature-based analysis of mouse prostatic intraepithelial neoplasia in histological tissue sections.

    Science.gov (United States)

    Ruusuvuori, Pekka; Valkonen, Mira; Nykter, Matti; Visakorpi, Tapio; Latonen, Leena

    2016-01-01

    This paper describes work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Prostatic intraepithelial neoplasia (PIN) represents premalignant tissue involving epithelial growth confined in the lumen of prostatic acini. In the attempts to understand oncogenesis in the human prostate, early neoplastic changes can be modeled in the mouse with genetic manipulation of certain tumor suppressor genes or oncogenes. As with many early pathological changes, the PIN lesions in the mouse prostate are macroscopically small, but microscopically spanning areas often larger than single high magnification focus fields in microscopy. This poses a challenge to utilize full potential of the data acquired in histological specimens. We use whole prostates fixed in molecular fixative PAXgene™, embedded in paraffin, sectioned through and stained with H&E. To visualize and analyze the microscopic information spanning whole mouse PIN (mPIN) lesions, we utilize automated whole slide scanning and stacked sections through the tissue. The region of interests is masked, and the masked areas are processed using a cascade of automated image analysis steps. The images are normalized in color space, after which exclusion of secretion areas and feature extraction is performed. Machine learning is utilized to build a model of early PIN lesions for determining the probability for histological changes based on the calculated features. We performed a feature-based analysis to mPIN lesions. First, a quantitative representation of over 100 features was built, including several features representing pathological changes in PIN, especially describing the spatial growth pattern of lesions in the prostate tissue. Furthermore, we built a classification model, which is able to align PIN lesions corresponding to grading by visual inspection to more advanced and mild lesions. The classifier allowed both determining the probability of early histological changes for uncategorized

  3. Feature-based analysis of mouse prostatic intraepithelial neoplasia in histological tissue sections

    Directory of Open Access Journals (Sweden)

    Pekka Ruusuvuori

    2016-01-01

    Full Text Available This paper describes work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Prostatic intraepithelial neoplasia (PIN represents premalignant tissue involving epithelial growth confined in the lumen of prostatic acini. In the attempts to understand oncogenesis in the human prostate, early neoplastic changes can be modeled in the mouse with genetic manipulation of certain tumor suppressor genes or oncogenes. As with many early pathological changes, the PIN lesions in the mouse prostate are macroscopically small, but microscopically spanning areas often larger than single high magnification focus fields in microscopy. This poses a challenge to utilize full potential of the data acquired in histological specimens. We use whole prostates fixed in molecular fixative PAXgene™, embedded in paraffin, sectioned through and stained with H&E. To visualize and analyze the microscopic information spanning whole mouse PIN (mPIN lesions, we utilize automated whole slide scanning and stacked sections through the tissue. The region of interests is masked, and the masked areas are processed using a cascade of automated image analysis steps. The images are normalized in color space, after which exclusion of secretion areas and feature extraction is performed. Machine learning is utilized to build a model of early PIN lesions for determining the probability for histological changes based on the calculated features. We performed a feature-based analysis to mPIN lesions. First, a quantitative representation of over 100 features was built, including several features representing pathological changes in PIN, especially describing the spatial growth pattern of lesions in the prostate tissue. Furthermore, we built a classification model, which is able to align PIN lesions corresponding to grading by visual inspection to more advanced and mild lesions. The classifier allowed both determining the probability of early histological changes

  4. Progression from high-grade prostatic intraepithelial neoplasia to cancer: a randomized trial of combination vitamin-E, soy, and selenium

    NARCIS (Netherlands)

    Fleshner, N.E.; Kapusta, L.; Donnelly, B.; Tanguay, S.; Chin, J.; Hersey, K.; Farley, A.; Jansz, K.; Siemens, D.R.; Trpkov, K.; Lacombe, L.; Gleave, M.; Tu, D.; Parulekar, W.R.

    2011-01-01

    PURPOSE: High-grade prostatic intraepithelial neoplasia (HGPIN) is a putative precursor of invasive prostate cancer (PCa). Preclinical evidence suggests vitamin E, selenium, and soy protein may prevent progression of HGPIN to PCa. This hypothesis was tested in a randomized phase III double-blind stu

  5. 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; 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

  6. 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

  7. Transition of high-grade cervical intraepithelial neoplasia to micro-invasive carcinoma is characterized by integration of HPV 16/18 and numerical chromosome abnormalities.

    NARCIS (Netherlands)

    Hopman, A.H.N.; Smedts, F.; Dignef, W.; Ummelen, M.; Sonke, G.; Mravunac, M.; Vooijs, G.P.; Speel, E.J.; Ramaekers, F.C.S.

    2004-01-01

    Cervical intraepithelial neoplasia (CIN I, II, and III) and cases of CIN III associated with micro-invasive cervical carcinoma (CIN III & mCA) were analysed for evidence of episomal or integrated human papillomavirus (HPV) 16/18 DNA by fluorescence in situ hybridization (FISH). In parallel, numerica

  8. 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. PMID:24898764

  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. PMID:23934991

  10. 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

  11. 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

  12. 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...... on cervical cancer prevention. More than 6,000 women diagnosed with HG-CIN or ICC from 17 European countries were enrolled in two parallel cross-sectional studies (108288/108290). Centralised histopathology review and standardised HPV-DNA typing were applied to formalin-fixed paraffin-embedded cervical...... specimens dated 2001-2008. The pooled prevalence of individual HPV types was estimated using meta-analytic methods. A total of 3,103 women were diagnosed with HG-CIN and a total of 3,162 with ICC (median ages: 34 and 49 years, respectively), of which 98.5 and 91.8% were HPV-positive, respectively. The most...

  13. Molecular Biomarkers of Pancreatic Intraepithelial Neoplasia and Their Implications in Early Diagnosis and Therapeutic Intervention of Pancreatic Cancer

    Science.gov (United States)

    Guo, Junli; Xie, Keping; Zheng, Shaojiang

    2016-01-01

    Lack of early detection and effective interventions is a major reason for the poor prognosis and dismal survival rates for pancreatic cancer. Pancreatic intraepithelial neoplasia (PanIN) is the most common precursor of invasive pancreatic ductal adenocarcinoma (PDAC). Each stage in the progression from PanIN to PDAC is well characterized by multiple significant genetic alterations affecting signaling pathways. Understanding the biological behavior and molecular alterations in the progression from PanIN to PDAC is crucial to the identification of noninvasive biomarkers for early detection and diagnosis and the development of preventive and therapeutic strategies for control of pancreatic cancer progression. This review focuses on molecular biomarkers of PanIN and their important roles in early detection and treatment of pancreatic cancer. PMID:26929736

  14. Impact of immunosuppression and region of birth on risk of cervical intraepithelial neoplasia among migrants living with HIV in Sweden.

    Science.gov (United States)

    Carlander, Christina; Wagner, Philippe; Svedhem, Veronica; Elfgren, Kristina; Westling, Katarina; Sönnerborg, Anders; Sparén, Pär

    2016-10-01

    Little is known about the incidence and risk of cervical intraepithelial neoplasia (CIN) grade 3, adenocarcinoma in situ and invasive cervical cancer (CIN3+) among migrants living with HIV in a European setting. We assessed the cumulative incidence (CuI) and hazard ratio (HR) of CIN2+ and CIN3+ in a cohort of women living with HIV (WLWH) (n = 893) identified from the Swedish national HIV register and HIV-negative women (n = 205,842) identified from the Swedish Population Register, matched on region of birth and age. Data was collected between 1993 and 2011 by linking our cohort with the Swedish National Cervical Screening Registry, collecting all cytological and histological results since 1993. The CuI of CIN3+ was 13.1% [95% confidence interval (CI) 8.9-17.2] for WLWH and 2.1% (95% CI 2.0-2.2) for HIV-negative after 18 years of follow-up. WLWH had more than eight times higher, age and region of birth matched, risk of CIN3+ than HIV-negative (HR 8.8: 95% CI 6.9-11.3). WLWH born in the East region, dominated by Thai women, had a two times higher risk of CIN3+ compared with WLWH born in Sweden (HR 2.47: 95% CI 1.2-5.0), which remained after adjusting for immunosuppression. Our results showed a substantially increased risk of CIN3+ among WLWH, which differed depending on birth region. Early HIV diagnosis and attendance to cervical cancer screening, with focus on migrants, is of crucial importance to minimize the incidence of cervical intraepithelial neoplasia. PMID:27177207

  15. 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.

  16. Automated Sputum Cytometry for Detection of Intraepithelial Neoplasias in the Lung

    Directory of Open Access Journals (Sweden)

    Gerald Li

    2012-01-01

    Full Text Available Background: Despite the benefits of early lung cancer detection, no effective strategy for early screening and treatment exists, partly due to a lack of effective surrogate biomarkers. Our novel sputum biomarker, the Combined Score (CS, uses automated image cytometric analysis of ploidy and nuclear morphology to detect subtle intraepithelial changes that often precede lung tumours.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. Gastric Intraepithelial Neoplasia: Evolvement and Reversal Treatment%胃上皮内瘤变的演变和逆转治疗

    Institute of Scientific and Technical Information of China (English)

    吕宾

    2011-01-01

    Gastric intraepithelial neoplasia is an important process in gastric carcinogenesis. Clinical follow-up studies showed that part of the low grade intraepithelial neoplasia is reversible and could regress after suitable treatment, and only a few will progress to cancer. Enhancing the reversal of intraepithelial neoplasia is of key importance for the prevention of gastric cancer. Eradication of Helicobacter pylori infection might reduce gastric mucosal atrophy, reverse intraepithelial neoplasia, and delay the progress of intestinal metaplasia. Antioxidant and micronutrients supplement might be helpful for preventing gastric cancer. However, the limited clinical trial evidence is not yet adequate for verifying the reversal effect. Inhibiting cyclooxygenase (COX)-2 expression might be a hopeful therapeutic target. Chinese traditional medicine has accumulated many experiences for the treatment of gastric intraepithelial neoplasia, however, high quality proofs of evidence-based medicine are needed for verification.%胃上皮内瘤变是胃黏膜癌变过程中的重要环节,临床随访研究显示部分低级别上皮内瘤变是可逆的,经适当的治疗,大部分可以消退,仅少数加重或癌变.促进胃上皮内瘤变逆转对预防胃癌具有积极意义.根除幽门螺杆菌有助于减轻胃黏膜萎缩,逆转部分低级别上皮内瘤变,延缓肠化生的发展,补充各种抗氧化剂和微量元素可能有助于预防胃癌,但有限的临床试验证据尚不足以证明其逆转效果;环氧合酶(COX)-2有望成为治疗的靶点;中医中药在治疗胃上皮内瘤变方面积累了许多经验,但尚需更多高质量的循证医学证据.

  7. 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.

  8. 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.

  9. 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).

  10. A Phase II Randomized Trial of Lycopene-Rich Tomato Extract Among Men with High-Grade Prostatic Intraepithelial Neoplasia.

    Science.gov (United States)

    Gann, Peter H; Deaton, Ryan J; Rueter, Erika Enk; van Breemen, Richard B; Nonn, Larisa; Macias, Virgilia; Han, Misop; Ananthanarayanan, Viju

    2015-01-01

    A diverse body of evidence suggests that lycopene might inhibit prostate cancer development. We conducted a 6-mo repeat biopsy randomized trial among men with high-grade prostatic intraepithelial neoplasia (HGPIN). Here we report results for serum lycopene, prostate specific antigen (PSA) and insulin-like growth factor (IGF) proteins, histopathological review, and tissue markers for proliferation [minichromosome maintenance protein 2 (MCM-2)] and cell cycle inhibition (p27). Participants consumed placebo or tomato extract capsules containing 30 mg/day lycopene. Pre- and posttreatment biopsies were immunostained and digitally scored. Serum lycopene was determined by LC-MS-MS. In secondary analyses, pathologists blindly reviewed each biopsy to score histological features. Fifty-eight men completed the trial. Serum lycopene increased 0.55 μmol/L with treatment and declined 0.29 μmol/L with placebo. We observed no meaningful differences in PSA, IGF-1, or IGF binding protein 3 concentrations between groups, nor any differences in expression of MCM-2 or p27 in epithelial nuclei. Prevalences of cancer, HGPIN, atrophy, or inflammation posttreatment were similar; however, more extensive atrophy and less extensive HGPIN was more common in the lycopene group. Despite large differences in serum lycopene following intervention, no treatment effects were apparent on either the serum or benign tissue endpoints. Larger studies are warranted to determine whether changes observed in extent of HGPIN and focal atrophy can be replicated. PMID:26422197

  11. Periampullary localized pancreatic intraepithelial neoplasia-3 (PanIN-3): evaluation with contrast-enhanced MR cholangiography (MRCP)

    International Nuclear Information System (INIS)

    The early determination of premalignant lesions of pancreas can prevent unnecessary excessive surgical procedures and can reduce morbidity and mortality. Pancreatic intraepithelial neoplasia-3 (PanIN-3) is a preinvasive form of adenocarcinoma (carcinoma in situ). PanINs have not taken place in the literature of radiology yet, it should be considered in differential diagnosis of pancreatic cystic lesions. A patient with preliminary diagnosis of chronic cholecystitis who had choledocolithiasis and periampullary pancreatic cyst detected by noncontrast-enhanced (NCE) and contrast-enhanced (CE) magnetic resonance cholangiography (MRCP) is presented. Pathological examination results of gallbladder and pancreatic cyst were reported as gallbladder adenocarcinoma and PanIN-3, respectively. Pancreatic cystic lesions with thin septa which enhances slightly with the administration of contrast material may represent PanIN-3. In patients with cystic pancreatic lesion localized at periampullary region, using CE-MRCP together with NCE-MRCP could be useful in the evaluation of pancreatic cystic masses as well as other abdominal pathologies

  12. 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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  15. 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

  16. [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.

  17. Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review.

    Science.gov (United States)

    Stier, Elizabeth A; Sebring, Meagan C; Mendez, Audrey E; Ba, Fatimata S; Trimble, Debra D; Chiao, Elizabeth Y

    2015-09-01

    The aim of this study was to systematically review the findings of publications addressing the epidemiology of anal human papillomavirus (HPV) infection, anal intraepithelial neoplasia, and anal cancer in women. We conducted a systematic review among publications published from Jan. 1, 1997, to Sept. 30, 2013, to limit to publications from the combined antiretroviral therapy era. Three searches were performed of the National Library of Medicine PubMed database using the following search terms: women and anal HPV, women anal intraepithelial neoplasia, and women and anal cancer. Publications were included in the review if they addressed any of the following outcomes: (1) prevalence, incidence, or clearance of anal HPV infection, (2) prevalence of anal cytological or histological neoplastic abnormalities, or (3) incidence or risk of anal cancer. Thirty-seven publications addressing anal HPV infection and anal cytology remained after applying selection criteria, and 23 anal cancer publications met the selection criteria. Among HIV-positive women, the prevalence of high-risk (HR)-HPV in the anus was 16-85%. Among HIV-negative women, the prevalence of anal HR-HPV infection ranged from 4% to 86%. The prevalence of anal HR-HPV in HIV-negative women with HPV-related pathology of the vulva, vagina, and cervix compared with women with no known HPV-related pathology, varied from 23% to 86% and from 5% to 22%, respectively. Histological anal high-grade squamous intraepithelial lesions (anal intraepithelial neoplasia 2 or greater) was found in 3-26% of the women living with HIV, 0-9% among women with lower genital tract pathology, and 0-3% for women who are HIV negative without known lower genital tract pathology. The incidence of anal cancer among HIV-infected women ranged from 3.9 to 30 per 100,000. Among women with a history of cervical cancer or cervical intraepithelial neoplasia 3, the incidence rates of anal cancer ranged from 0.8 to 63.8 per 100,000 person-years, and in

  18. 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.

  19. Prevalence of high-risk human papillomavirus types in Mexican women with cervical intraepithelial neoplasia and invasive carcinoma

    Directory of Open Access Journals (Sweden)

    Sánchez-Garza Mireya

    2008-02-01

    Full Text Available Abstract Background Prevalence of high risk (HR human papillomavirus (HPV types in the states of San Luis Potosí (SLP and Guanajuato (Gto, Mexico, was determined by restriction fragment length-polymorphism (RFLP analysis on the E6 ~250 bp (E6-250 HR-HPV products amplified from cervical scrapings of 442 women with cervical intraepithelial neoplasia and invasive carcinoma (280 from SLP and 192 from Gto. Fresh cervical scrapings for HPV detection and typing were obtained from all of them and cytological and/or histological diagnoses were performed on 383. Results Low grade intraepithelial squamous lesions (LSIL were diagnosed in 280 cases (73.1%, high grade intraepithelial squamous lesions (HSIL in 64 cases (16.7% and invasive carcinoma in 39 cases (10.2%. In the 437 cervical scrapings containing amplifiable DNA, only four (0.9% were not infected by HPV, whereas 402 (92.0% were infected HR-HPV and 31 (7.1% by low-risk HPV. RFLP analysis of the amplifiable samples identified infections by one HR-HPV type in 71.4%, by two types in 25.9% and by three types in 2.7%. The overall prevalence of HR-HPV types was, in descending order: 16 (53.4% > 31 (15.6% > 18 (8.9% > 35 (5.6 > 52 (5.4% > 33 (1.2% > 58 (0.7% = unidentified types (0.7%; in double infections (type 58 absent in Gto it was 16 (88.5% > 31 (57.7% > 35 (19.2% > 18 (16.3% = 52 (16.3% > 33 (2.8% = 58 (2.8% > unidentified types (1.0%; in triple infections (types 33 and 58 absent in both states it was 16 (100.0% > 35 (54.5% > 31 (45.5% = 52 (45.5% > 18 (27.3%. Overall frequency of cervical lesions was LSIL (73.1% > HSIL (16.7% > invasive cancer (10.2%. The ratio of single to multiple infections was inversely proportional to the severity of the lesions: 2.46 for LSIL, 2.37 for HSIL and 2.15 for invasive cancer. The frequency of HR-HPV types in HSIL and invasive cancer lesions was 16 (55.0% > 31 (18.6% > 35 (7.9% > 52 (7.1% > 18 (4.3% > unidentified types (3.6% > 33 (2.9% > 58 (0.7%. Conclusion Ninety

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Ye Zheng

    2013-05-01

    Full Text Available 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.

  3. 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.

  4. 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

  5. 胃上皮内肿瘤中西医研究进展%Research Progress of Chinese and Western Medicine in Gastric Intraepithelial Neoplasia

    Institute of Scientific and Technical Information of China (English)

    杨洋

    2014-01-01

    上皮内肿瘤(intraepithelial neoplasia,IN)为病理学概念,指细胞形态和组织结构上与其发源的正常组织存在不同程度的差异,被视为胃癌前病变.对于胃上皮内瘤变的研究,因胃癌发病率的居高不下,而逐渐受到人们的重视.

  6. 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.

  7. MALDI Mass Spectrometry Imaging Reveals Decreased CK5 Levels in Vulvar Squamous Cell Carcinomas Compared to the Precursor Lesion Differentiated Vulvar Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Chao Zhang

    2016-07-01

    Full Text Available Vulvar cancer is the fourth most common gynecological cancer worldwide. However, limited studies have been completed on the molecular characterization of vulvar squamous cell carcinoma resulting in a poor understanding of the disease initiation and progression. Analysis and early detection of the precursor lesion of HPV-independent vulvar squamous cell carcinoma (VSCC, differentiated vulvar intraepithelial neoplasia (dVIN, is of great importance given dVIN lesions have a high level of malignant potential. Here we present an examination of adjacent normal vulvar epithelium, dVIN, and VSCC from six patients by peptide Matrix-assisted laser desorption/ionization Mass Spectrometry Imaging (MALDI-MSI. The results reveal the differential expression of multiple peptides from the protein cytokeratin 5 (CK5 across the three vulvar tissue types. The difference observed in the relative abundance of CK5 by MALDI-MSI between the healthy epithelium, dVIN, and VSCC was further analyzed by immunohistochemistry (IHC in tissue from eight VSCC patients. A decrease in CK5 immunostaining was observed in the VSCC compared to the healthy epithelium and dVIN. These results provide an insight into the molecular fingerprint of the vulvar intraepithelial neoplasia that appears to be more closely related to the healthy epithelium than the VSCC.

  8. 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.

  9. MALDI Mass Spectrometry Imaging Reveals Decreased CK5 Levels in Vulvar Squamous Cell Carcinomas Compared to the Precursor Lesion Differentiated Vulvar Intraepithelial Neoplasia.

    Science.gov (United States)

    Zhang, Chao; Arentz, Georgia; Winderbaum, Lyron; Lokman, Noor A; Klingler-Hoffmann, Manuela; Mittal, Parul; Carter, Christopher; Oehler, Martin K; Hoffmann, Peter

    2016-01-01

    Vulvar cancer is the fourth most common gynecological cancer worldwide. However, limited studies have been completed on the molecular characterization of vulvar squamous cell carcinoma resulting in a poor understanding of the disease initiation and progression. Analysis and early detection of the precursor lesion of HPV-independent vulvar squamous cell carcinoma (VSCC), differentiated vulvar intraepithelial neoplasia (dVIN), is of great importance given dVIN lesions have a high level of malignant potential. Here we present an examination of adjacent normal vulvar epithelium, dVIN, and VSCC from six patients by peptide Matrix-assisted laser desorption/ionization Mass Spectrometry Imaging (MALDI-MSI). The results reveal the differential expression of multiple peptides from the protein cytokeratin 5 (CK5) across the three vulvar tissue types. The difference observed in the relative abundance of CK5 by MALDI-MSI between the healthy epithelium, dVIN, and VSCC was further analyzed by immunohistochemistry (IHC) in tissue from eight VSCC patients. A decrease in CK5 immunostaining was observed in the VSCC compared to the healthy epithelium and dVIN. These results provide an insight into the molecular fingerprint of the vulvar intraepithelial neoplasia that appears to be more closely related to the healthy epithelium than the VSCC. PMID:27399691

  10. 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. PMID:25940055

  11. 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.

  12. Abnormal cervical smears in the unchanged uterine cervix: difficulties in the screening, diagnosis, and treatment of cervical intraepithelial neoplasias and microinvasive cancer

    Directory of Open Access Journals (Sweden)

    L. I. Korolenkova

    2011-01-01

    Full Text Available The author analyzes an algorithm for identifying and treating w omen with cervical intraepithelial neoplasias (CIN and microinv asive cancer of the cervix uteri in cases of the hidden area of transformation and in the absence of visible cervical changes. There are excep- tional difficulties of making the diagnosis of epithelial damages due to the incomplete reproducibility of cytological abnormal ities and the low informative value of a histological study of scrapes from the cervical canal. To avoid hypodiagnosis, it is justifiable to prefer human papillomavirus testing (Hybrid Capture 2 (HC2 to repeat smears for the choice of a management tactic. Conization is recommend ed as a diagnostic and/or therapeutic procedure when the viral load is high in over 35-year-old patients with abnormal smears anda hidden transformation area.

  13. 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...

  14. 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。

  15. Elements of an anal dysplasia screening program.

    Science.gov (United States)

    Jay, Naomi

    2011-01-01

    The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is highly elevated compared to the general population, as is the incidence of its precursor lesion, high-grade anal intraepithelial neoplasia (HGAIN). MSM in general and other immunocompromised populations are also at higher risk. Treatment of HGAIN may prevent development of cancer, similar to the decrease in cervical cancers that has occurred since the advent of cervical cancer screening programs in women. Cervical cancer screening tools have been adapted and validated for screening, diagnosis, and treatment of anal HGAIN. Anal cancer screening programs have now been available for more than a decade, although they are not yet standards of care. Incorporating screening procedures into practice depends on the available resources in a particular community. This article discusses the procedures for anal cancer screening including cytology, digital anal rectal examinations, high-resolution anoscopy, and biopsy. PMID:22035526

  16. 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

  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. 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。

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

    OpenAIRE

    Euridice Maria de Almeida Figueiredo

    1998-01-01

    O câncer cérvico-uterino é muito comum em vários países da América Latina. As estatísticas de mortalidade e as taxas de incidência demonstram a sua real importância. O cânver cérvico-uterino freqüentemente é uma doença progressiva iniciada com mudanças intra-epiteliais, que podem se transformar em um processo invasivo, sendo o nosso objetivo tratar precocemente estas lesões quando ainda é possível a cura de 100%. Em nosso estudo prospectivo foram selecionadas 21 pacientes com neoplasia cervic...

  1. The prognostic effects analysis of the LEEP treatment of cervical intraepi-thelial neoplasia%影响LEEP治疗宫颈上皮内瘤变预后的因素分析

    Institute of Scientific and Technical Information of China (English)

    孙娟娟

    2015-01-01

    Objective:To explore and investigate the prognostic effects of the loop electrosurgical excision procedure ( LEEP ) to treat cervical intraepithelial neoplasia. Methods:Selected 170 cervical intraepithelial neoplasia patients from August 2011 to Decem-ber 2013 in our hospital for treatment,all patients were given LEEP,observed the prognosis efficacy and adverse reactions. Results:All patients were completed LEEP surgery;the effective rate was 94. 7%. 14 cases had adverse reactions,with rate 8. 2% and all improved after symptomatic treatment. Logistic regression model analysis showed that age,disease classification,cervical erosion situation were the major independent risk factors for cervical intraepithelial neoplasia prognosis ( P<0. 05 ) . Conclusion:LEEP treatment for cervical in-traepithelial neoplasia has better prognosis efficacy and fewer side effects,and its main prognostic factors are age,disease classification and cervical erosion conditions.%目的::探讨影响宫颈环状电切术(loop electrosurgical excision procedure,LEEP)治疗宫颈上皮内瘤变(cervical in-traepithelial neoplasia,CIN)的预后因素。方法:2011年8月至2013年12月选择在我院进行诊治的宫颈上皮内瘤变患者170例,都给予LEEP治疗,观察术后疗效及其不良反应发生情况。结果:所有患者都完成LEEP术,有效率为94.7%;发生不良反应14例,发生率为8.2%,都经过对症处理后好转。 Logistic回归模型进行分析结果显示年龄、CIN分级、宫颈糜烂状况是影响宫颈上皮内瘤变预后的主要独立危险因素(P<0.05)。结论: LEEP治疗宫颈上皮内瘤变具有很好的预后疗效,不良反应较少,影响其预后的因素主要为年龄、疾病分级与宫颈糜烂状况。

  2. 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 D; Andersen, Klaus K;

    2015-01-01

    screening were age-matched with post-conization HPV-negative women, leaving 13,230 and 477 women, respectively, for analysis. By linkage to the Pathology Data Bank, we identified all cases of CIN2+ by December 2013. The 3-, 5-, 8- and 10-year risks for CIN2+ were 0.7, 0.9, 2.8 and 5.7% after a negative HPV......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...... compared risk of CIN2+ following a negative HPV test in women after conization with that in women from the general population. During 2002-2005, 667 women treated for CIN2+ were tested for HPV and cytology 46 months after conization. Only HPV-negative women were included. Women participating in routine...

  3. 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

  4. 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

  5. Gastroscope Biopsy Intraepithelial Neoplasia High-level Clinical Pathological Diagnosis Analysis%胃镜活检上皮内瘤变高级别的临床病理诊断分析

    Institute of Scientific and Technical Information of China (English)

    秦岭; 蔡江义

    2016-01-01

    Objective To gastroscope biopsy intraepithelial neoplasia high-level discusses and analyzes the clinical pathological diagnosis. Methods 42 patients with epithelial neoplasia gastroscope biopsy in diagnosis of paral el operation,postoperative routine pathological section for testing. Results Two kinds of test results was no significant difference(P > 0.05). Conclusion Gastroscope biopsy of intraepithelial neoplasia high level clinical pathological diagnosis effect is remarkable.%目的:对胃镜活检上皮内瘤变高级别的临床病理诊断进行探讨分析。方法42例上皮瘤变患者均行胃镜活检诊断,并行手术治疗,术后应用常规病理切片进行检测。结果两种检查结果比较无差异(P >0.05)。结论胃镜活检对上皮内瘤变高级别临床病理诊断效果显著。

  6. 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

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    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.

  7. 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.

  8. Discrimination of grade 2 and 3 cervical intraepithelial neoplasia by means of analysis of water soluble proteins recovered from cervical biopsies

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    Skaland Ivar

    2011-06-01

    Full Text Available Abstract Background Cervical intraepithelial neoplasia (CIN grades 2 and 3 are usually grouped and treated in the same way as "high grade", in spite of their different risk to cancer progression and spontaneous regression rates. CIN2-3 is usually diagnosed in formaldehyde-fixed paraffin embedded (FFPE punch biopsies. This procedure virtually eliminates the availability of water-soluble proteins which could have diagnostic and prognostic value. Aim To investigate whether a water-soluble protein-saving biopsy processing method followed by a proteomic analysis of supernatant samples using LC-MS/MS (LTQ Orbitrap can be used to distinguish between CIN2 and CIN3. Methods Fresh cervical punch biopsies from 20 women were incubated in RPMI1640 medium for 24 hours at 4°C for protein extraction and subsequently subjected to standard FFPE processing. P16 and Ki67-supported histologic consensus review CIN grade (CIN2, n = 10, CIN3, n = 10 was assessed by independent gynecological pathologists. The biopsy supernatants were depleted of 7 high abundance proteins prior to uni-dimensional LC-MS/MS analysis for protein identifications. Results The age of the patients ranged from 25-40 years (median 29.7, and mean protein concentration was 0.81 mg/ml (range 0.55 - 1.14. After application of multistep identification criteria, 114 proteins were identified, including proteins like vimentin, actin, transthyretin, apolipoprotein A-1, Heat Shock protein beta 1, vitamin D binding protein and different cytokeratins. The identified proteins are annotated to metabolic processes (36%, signal transduction (27%, cell cycle processes (15% and trafficking/transport (9%. Using binary logistic regression, Cytokeratin 2 was found to have the strongest independent discriminatory power resulting in 90% overall correct classification. Conclusions 114 proteins were identified in supernatants from fresh cervical biopsies and many differed between CIN2 and 3. Cytokeratin 2 is the

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

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    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.

  10. Distribution of HPV Genotype in Invasive Cervical Carcinoma and Cervical Intraepithelial Neoplasia in Zhejiang Province, Southeast China: Establishing the Baseline for Surveillance

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    Xiao-Xian Xu

    2015-09-01

    Full Text Available Human papillomavirus (HPV are firmly established as the principal causative agent for cervical carcinoma. Current vaccines may provide some protection for women from cervical carcinoma linked to HPV genotype 16 and 18. This may be the best vaccine for Western women, but the geographical variation in HPV distributions may not make it the most appropriate vaccine for China or Asia. This study provided an observational, retrospective, hospital-based cross-sectional study on the distribution of HPV genotypes among 5410 women with invasive cervical cancer (ICC or cervical intraepithelial neoplasia (CIN. Overall, the positive rates of the four HPV types included in current prophylactic vaccines were counted, the two high-risk types (HPV-16 and -18 covered by current vaccines represented 66.9% of women with squamous cancer, 55.0% with adenocarcinoma, 64.9% with adenosquamous carcinoma and 77.4% of other type ICC, as well as 59.5% of CIN III, 45.0% of CIN II and 38.1% of CIN I cases. As expected, two low-risk types (HPV-6 and -11 included in the quadrivalent vaccine did not show good coverage data. Particularly worth mentioning is the fact that the addition of HPV-52 and -58 to the vaccine cocktail would increase cancer protection in our population, potentially preventing up to beyond 16% of squamous/adenosquamous carcinoma and other type of cervical cancers, and 7.75% of adenocarcinomas. It might also potentially reduce the rate of CIN III by a further 28.6% and CIN II and I by a third. This study established the baseline for surveillance in Zhejiang Province, and provides data for further vaccine designs: a quadrivalent HPV vaccine covering HPV-16/-58/-18/-52, would be more welcome in our region in the forthcoming year compared to the currently available vaccine.

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

    Science.gov (United States)

    Gosvig, Camilla F; Huusom, Lene D; Andersen, Klaus K; Duun-Henriksen, Anne Katrine; Frederiksen, Kirsten; Iftner, Angelika; Svare, Edith; Iftner, Thomas; Kjaer, Susanne K

    2015-12-15

    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 compared risk of CIN2+ following a negative HPV test in women after conization with that in women from the general population. During 2002-2005, 667 women treated for CIN2+ were tested for HPV and cytology 46 months after conization. Only HPV-negative women were included. Women participating in routine screening were age-matched with post-conization HPV-negative women, leaving 13,230 and 477 women, respectively, for analysis. By linkage to the Pathology Data Bank, we identified all cases of CIN2+ by December 2013. The 3-, 5-, 8- and 10-year risks for CIN2+ were 0.7, 0.9, 2.8 and 5.7% after a negative HPV test and 0.5, 0.8, 2.9 and 6.1% in HPV and cytology-negative women. HPV-negative women in the general population had similar 3-year and 5-year risks of 0.4 and 1.0%; thereafter, they had lower risks of 1.9% at 8 years and 2.7% at 10 years. Our results indicate that HPV testing may be used as a test of cure after conization. In the first 5 years after testing, the risk for CIN2+ of women who were HPV-negative at 34 months after conization was similar to that of HPV-negative women in the general population. After 67 years, however, women who have undergone conization may be at higher risk for CIN2+. PMID:26139420

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

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    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.

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

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    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. Anti-HPV16 E2 protein T-cell responses and viral control in women with usual vulvar intraepithelial neoplasia and their healthy partners.

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    Simon Jacobelli

    Full Text Available T-cell responses (proliferation, intracellular cytokine synthesis and IFNγ ELISPOT against human papillomavirus 16 (HPV16 E2 peptides were tested during 18 months in a longitudinal study in eight women presenting with HPV16-related usual vulvar intraepithelial neoplasia (VIN and their healthy male partners. In six women, anti-E2 proliferative responses and cytokine production (single IFNγ and/or dual IFNγ/IL2 and/or single IL2 by CD4+ T lymphocytes became detectable after treating and healing of the usual VIN. In the women presenting with persistent lesions despite therapy, no proliferation was observed. Anti-E2 proliferative responses were also observed with dual IFNγ/IL2 production by CD4+ T-cells in six male partners who did not exhibit any genital HPV-related diseases. Ex vivo IFNγ ELISPOT showed numerous effector T-cells producing IFNγ after stimulation by a dominant E2 peptide in all men and women. Since the E2 protein is absent from the viral particles but is required for viral DNA replication, these results suggest a recent infection with replicative HPV16 in male partners. The presence of polyfunctional anti-E2 T-cell responses in the blood of asymptomatic men unambiguously establishes HPV infection even without detectable lesions. These results, despite the small size of the studied group, provide an argument in favor of prophylactic HPV vaccination of young men in order to prevent HPV16 infection and viral transmission from men to women.

  15. 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.

  16. Metabonomic alterations from pancreatic intraepithelial neoplasia to pancreatic ductal adenocarcinoma facilitate the identification of biomarkers in serum for early diagnosis of pancreatic cancer.

    Science.gov (United States)

    Lin, Xianchao; Zhan, Bohan; Wen, Shi; Li, Zhishui; Huang, Heguang; Feng, Jianghua

    2016-08-16

    Pancreatic cancer is a highly malignant disease with a poor prognosis and it is essential to diagnose and treat the disease at an early stage. The aim of this study was to understand the underlying biochemical mechanisms of pancreatic intraepithelial neoplasia (PanIN) and pancreatic ductal adenocarcinoma (PDAC) and to identify potential serum biomarkers for early detection of pancreatic cancer. 7,12-Dimethylbenz(a)anthracene (DMBA)-induced PanIN and PDAC rat models were established and the serum samples were collected. The serum samples were measured using (1)H nuclear magnetic resonance (NMR) spectroscopy and analyzed by chemometric methods including principal component analysis (PCA) and (orthogonal) partial least squares discriminant analysis ((O)PLS-DA). The related biochemical pathways were derived from KEGG analysis of the significantly different metabolites. As results, some serum metabolites demonstrated alarming metabolic changes in the precursor lesion of pancreatic cancer (PanIN-2 in this study). These changes involved elevated levels of ketone compounds including 3-hydroxybutyrate, acetoacetate, and acetone, some amino acids including asparagine, glutamate, threonine, and phenylalanine, glycoproteins and lipoproteins including N-acetylglycoprotein, LDL and VLDL, and some metabolites that have been shown to contribute to mutagenicity and cancer promotion such as deoxyguanosine and cytidine. More metabolites were shown to be significantly different between PanIN and PDAC, suggesting that a more complex set of changes occurs from noninvasive precursor lesion to invasive cancer. The serum metabonomic changes of rats with PanIN and PDAC may extend our understanding of pancreatic molecular pathogenesis, and the metabolic variations from PanIN to PDAC will be helpful to understand evolution processes of the pancreatic disease. NMR-based metabonomic analysis of animal models will be beneficial for the human study and will be helpful for the early detection of

  17. Length but not transverse diameter of the excision specimen for high-grade cervical intraepithelial neoplasia (CIN 2-3) is a predictor of pregnancy outcome.

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    Liverani, Carlo A; Di Giuseppe, Jacopo; Clemente, Nicolò; Delli Carpini, Giovanni; Monti, Ermelinda; Fanetti, Fabiana; Bolis, Giorgio; Ciavattini, Andrea

    2016-09-01

    The objective of this study was to analyze the impact of cone characteristics (depth, transverse diameter, and volume) on subsequent pregnancies after the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2-3). Pregnancy outcomes (preterm birth, gestational age at birth, mode of delivery, and birth weight) of 501 women with singleton gestations and no previous preterm birth or history of late miscarriage, who had previously undergone a single LEEP for CIN 2-3, were retrospectively analyzed with respect to length, transverse diameter, and volume of the excision specimen. The overall incidence of preterm birth was 2.4%. The rate of preterm birth in women with length greater than 20 mm or volume greater than 2.5 cm was significantly higher than that in women with length between 15 and 19 mm (15.6 vs. 3.9%, P=0.02) or women with volume between 2.0 and 2.4 cm (5.8 vs. 1.6%, P=0.04). A linear inverse correlation (r=-0.3, P<0.001) between gestational age at birth and length, but not volume (r=0.0, P=0.9) or transverse diameter (r=0.2, P<0.0001), emerged. The mode of delivery was not affected by cone characteristics. Length, but not transverse diameter and volume, of the excised specimen seems to be related to a lower gestational age at birth. When excisions are performed under strict colposcopic guidance, with a correct modulation of cone length, the risk for preterm birth and cesarean delivery in subsequent pregnancies is not increased. PMID:26317385

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

    International Nuclear Information System (INIS)

    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. 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). 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). 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)

  19. Clinical analysis of patients underwent hysterectomy for stage Ⅰ cervical cancer or high grade ;cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia%Ⅰ期子宫颈癌和子宫颈上皮内瘤变Ⅲ患者合并阴道上皮内瘤变的临床分析

    Institute of Scientific and Technical Information of China (English)

    何玥; 吴玉梅; 赵群; 樊蓓; 徐小红; 朱力; 张为远

    2015-01-01

    Objective To analyse the necessity of colposcopic directed biopsy to vaginal intraepithelial neoplasia (VAIN) before hysterectomy due to early stage cervical cancer (stage Ⅰ) or high grade cervical intraepithelial neoplasia (CIN). Methods A total of 669 patients who underwent a hysterectomy due to early stage cervical cancer (stage Ⅰ) and CINⅢin Beijing Obstetrics and Gynecology Hospital, Capital Medical University,from January 1, 2009 to December 31, 2013 and followed up, 99 patients with VAIN were enrolled. The clinical data and following up the prognosis were prospectively analyzed retrospectively. Results The occurrence rate of VAIN before and after hysterectomy due to cervical dysplasia was 14.8%(99/669), the occurrence rate and the grade of VAIN showed that significantly increased from CINⅢto cervical cancer stageⅠ(P0.05)。(3)99例Ⅰ期子宫颈癌或CINⅢ合并VAIN行子宫切除术的患者中,术后随访1~5年发现残端VAIN 12例(其中术后3年内发现11例);这12例残端VAIN患者中11例术前未行阴道镜下阴道壁活检,其中4例残端VAIN病变进展(指病变级别升高),总进展率为4.0%(4/99),这4例病变进展患者中2例为残端阴道癌,残端复发率为2.0%(2/99)。结论对于因Ⅰ期子宫颈癌或CINⅢ行子宫切除术的患者,建议术前常规行阴道镜下阴道壁活检病理检查,以决定手术中阴道切除的范围;且术后应对阴道残端定期随诊,尤其术后3年内,以避免VAIN病变进展。

  20. 结直肠上皮内瘤变中 LGR5的表达及其意义%Expression of LGR5 in Colorectal Intraepithelial Neoplasia and Its Clinical Significance

    Institute of Scientific and Technical Information of China (English)

    肖幼华; 李荣; 蔡联明; 谢旭平; 卢致洋; 陈汉民; 王冬梅; 雷先华

    2014-01-01

    Objective To investigate the expression of stem cell marker LGR 5( rich in leucine repeated units of G pro-tein coupled receptor 5) protein in colorectal intraepithelial and its relationships with clinicopathologic characteristics .Methods LGR5 expression was immunohistochemically determined on paraffin-embedded ,formalin-fixed biopsy tissues in 60 cases of color-ectal intraepithelial neoplasia (32 cases of adenoma and high-grade intraepithelial neoplasia ,28 cases of adenoma and low level in-traepithelial neoplasia ) ,10 cases of adenoma and 20 cases of well-differentiated adenocarcinoma .Results The expression rate of LGR5 in well-differentiated adenocarcinoma was 100.00%(20/20),significantly higher than 83.33%(50/60)in colorectal in-traepithelial neoplasia adenoma and 40.00%(4/10)in colorectal adenoma (P0.05).Conclusion LGR5 may be considered as an important reference index in selsecting operation method for colorectal intraepithelial neoplasia .%目的:检测干细胞标记物LGR5(富含亮氨酸重复单位的G蛋白偶联受体5)蛋白在人结直肠上皮内瘤变中的表达,探讨与其临床病理特征的关系。方法采用免疫组织化学染色法,分别检测60例结直肠上皮内瘤变(腺瘤并高级别上皮内瘤变32例,腺瘤并低级别上皮内瘤变28例)、10例腺瘤,20例高分化腺癌标本中LGR5表达水平。结果LGR5在高分化腺癌中表达率为100.00%(20/20),明显高于结直肠上皮内瘤变[83.33%(50/60)]和腺瘤[40.00%(4/10)],P<0.01。高级别上皮内瘤变组和低级别上皮内瘤变组中其阳性表达率分别为84.37%(27/32)、82.14%(23/28),LGR5表达水平与结直肠上皮内瘤变病理分级无相关性(P>0.05)。结论 LGR5可作为选择结直肠上皮内瘤变手术方式的重要参考指标。

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Biliary intraepithelial neoplasia (BilIN) is frequently found in surgical margins of biliary tract cancer resection specimens but has no clinical implications.

    Science.gov (United States)

    Matthaei, Hanno; Lingohr, Philipp; Strässer, Anke; Dietrich, Dimo; Rostamzadeh, Babak; Glees, Simone; Roering, Martin; Möhring, Pauline; Scheerbaum, Martin; Stoffels, Burkhard; Kalff, Jörg C; Schäfer, Nico; Kristiansen, Glen

    2015-02-01

    Biliary tract cancers are aggressive tumors of which the incidence seems to increase. Resection with cancer-free margins is crucial for curative therapy. However, how often biliary intraepithelial neoplasia (BilIN) occurs in resection margins and what its clinical and therapeutic implications might be is largely unknown. We reexamined margins of resection specimens of adenocarcinoma of the biliary tree including the gallbladder for the presence of BilIN. When present, it was graded. The findings were correlated with clinicopathological parameters and overall survival. Complete examination of the resection margin could be performed on 55 of 78 specimens (71%). BilIN was detected in the margin in 29 specimens (53%) and was mainly low-grade (BilIN-1; N = 14 of 29; 48%). In resection specimens of extrahepatic cholangiocarcinoma, BilIN was most frequent (N = 6 of 8; 75%). BilIN was found in the resection margin more frequently in extrahepatic cholangiocarcinomas (P = 0.007) and in large primary tumors (P = 0.001) with lymphovascular (P = 0.006) and perineural invasion (P = 0.049). Patients with cancer in the resection margin (R1) had a significantly shorter overall survival than those with resection margins free of tumor (R0) irrespective of the presence of BilIN (R0 vs R1; P < 0.001) or BilIN grade (BilIN-positive vs BilIN-negative, P = 0.6, and BilIN-1 + 2 vs BilIN-3, P = 0.58). BilIN is frequently found in the surgical margin of resection specimens of adenocarcinoma of the biliary tract. Hepatopancreatobiliary surgeons will be confronted with this recently defined entity when an intraoperative frozen section of a resection margin is requested. However, this diagnosis does not require additional resection and in the intraoperative evaluation of resection, the emphasis should remain on the detection of residual invasive tumor. PMID:25425476

  6. 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

  7. 宫颈细胞学筛查阴性患者中高危型HPV-DNA 负荷量价值分析%The role of high-risk human papillomavirus in diagnosing cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    徐秀君; 江叶娟; 李蓉珍

    2015-01-01

    目的:探讨高危型 HPV 负荷量对宫颈液基细胞学阴性妇女的宫颈上皮内瘤变( cervical intraepithelial neoplasias,CIN)的诊断价值。方法收集宫颈液基细胞学联合 HC2法检测高危型 HPV-DNA 进行宫颈癌筛查中的细胞学阴性而 HR-HPV 阳性患者526例,并行阴道镜下宫颈活检。分析 HR-HPV 负荷量与宫颈癌及 CIN 的关系。结果526例细胞学阴性、HR-HPV 阳性的患者中,CIN2+以上病变者共77例,占14.6%。以20~29岁年龄妇女组为参照年龄,30~39、40~49、60~72岁组患 CIN2+风险高(均 P <0.05),在30~39、40~49、50~59岁组中,随着宫颈病变程度加重,HR-HPV-DNA 负荷量随之增加(均 P <0.05)。结论30~49岁是 HR-HPV 感染所致宫颈上皮内瘤变的高发年龄;HR-HPV-DNA 负荷量与宫颈上皮内瘤变级别密切相关,HR-HPV-DNA 负荷量越高,患CIN2+的危险度越高。%Objective To evaluate the role of high-risk human papillomavirus ( HR-HPV) in detecting cervical intraepithelial neoplasia in women tested as negative with liquid-based cytology.Method A total of 526 women with positive HPV DNA and negative cytology were chosen as the subjects.All cases underwent colposcopic indicated biopsy and pathological diagnosis.Analysis was conducted into the correlation of HR-HPV to cervical cancer and CIN.Findings Of the 526 subjects with positive HPV DNA and negative cytology, 77 (14.6%) were found to have cervical intraepithelial neoplasia of grade 2 or worse (CIN2 +) lesions.Compared with those in the age bracket of 20 ~29 years, the subjects in the age brackets of 30 ~39 years, 40 ~49years, and 60 ~72years had a higher proportion of patients with CIN2 +.The difference was significant (P <0.05).Cervical lesions increased as the HR-HPV-DNA level increased in the women of the age brackets of 30 ~39 years, 40 ~49 years and 50 ~59 years (Pall <0.05).Conclusion The women in the

  8. Study on HPV genotype in cervical intraepithelial neoplasia%宫颈上皮内瘤样变中HPV基因型的研究

    Institute of Scientific and Technical Information of China (English)

    袁令芹; 郭花玲; 程德军; 岳天孚

    2011-01-01

    Objective: To explore the relationship between human papillomavirus (HPV) infection of different genotypes and the occurrence of cervical intraepithelial neoplasia (CIN) of different grades. Methods: 284 patients diagnosed as CIN definitely in outpatient department of gynecology in the hospital from November 2007 to December 2009 were analyzed retrospectively; PCR amplification and gene chip probe hybridization were used to detect HPV genotypes. Results: The infection rate of HPV increased gradually with the increase of CIN grades. Among the patients with CIN Ⅰ , low risk HPV infection was the main type; among the patients with CIN Ⅲ, single high risk HPV - 16 infection was the dominant type, followed by HPV -58. There was significant difference in infection rate of HPV - 16 between CIN Ⅰ and CIN Ⅱ , as well as between CIN Ⅱ and CIN Ⅲ ( P <0. 01 ) . Conclusion: The infection rate of HPV increase gradually with the development of CIN, the genotypes of HPV infection are different, the main HPV genotypes of CIN Ⅰ are HPV - 11 and HPV - 6; the main HPV genotypes of CIN Ⅱ are HPV - 16 and HPV -6; the main HPV genotypes of CIN Ⅲ are HPV - 16 and HPV -58. The relationship between infection rate of HPV - 16 and grades of CIN is from quantitative relationship to qualitative relationship.%目的:探讨不同基因型的HPV感染与各级别CIN发病的关系.方法:回顾性分析天津医科大学总医院2007年11月~2009年12月妇科门诊就诊患者中经组织学检查确诊为CIN的患者共284例.HPV基因型的检测采用PCR扩增、基因芯片探针杂交分型检测法.结果:随CIN级别进展,HPV感染率逐渐升高.CIN Ⅰ中主要为LR-HPV感染;CIN Ⅲ中主要为单一高危型HPV-16感染,HPV-58为第二优势感染的基因型.HPV-16感染率在CIN Ⅰ与CIN Ⅱ、CIN Ⅱ与CINⅢ之间差异均具有高度统计学意义(P<0.01).结论:随CIN病情发展和病变严重,HPV感染率逐渐升高,HPV感

  9. Prophylactic HPV vaccination and anal cancer.

    Science.gov (United States)

    Stier, Elizabeth A; Chigurupati, Nagasudha L; Fung, Leslie

    2016-06-01

    The incidence of anal cancer is increasing. High risk populations include HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer. HPV has been detected in over 90% of anal cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The quadrivalent HPV (qHPV) vaccine has been demonstrated to prevent vaccine associated persistent anal HPV infections as well as anal intraepithelial neoplasia grades 2-3 (AIN2+) in young MSM not previously infected. A retrospective analysis also suggests that qHPV vaccination of older MSM treated for AIN2+ may significantly decrease the risk of recurrence of the AIN2+. The HPV types detected in anal cancer are included in the 9-valent vaccine. Thus, the 9-valent HPV vaccine, when administered to boys and girls prior to the onset of sexual activity, should effectively prevent anal cancer. PMID:26933898

  10. 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

  11. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  12. Environmental scan of anal cancer screening practices: worldwide survey results.

    Science.gov (United States)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-08-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening. PMID:24740973

  13. STAT3在食管上皮内瘤变及食管癌组织中的表达及其意义%Expression of STAT3 in tissue of esophageal intraepithelial neoplasia and esophageal neoplasm and its significance*

    Institute of Scientific and Technical Information of China (English)

    刘惠民; 郭梅艳; 王彦华; 王蕾; 赵琰龙; 韩起廷; 瞿峰; 王智红; 王秀清

    2012-01-01

    目的 探讨STAT3 mRNA及STAT3蛋白在食管上皮内瘤变演变过程中的作用.方法 选取食管癌高发区的食管上皮内瘤变病例150例(Ⅰ、Ⅱ、Ⅲ级各50例)及食管癌100例进行研究,将其中60例接受食管癌切除术患者的食管上、下残端的正常黏膜组织作为对照.采用原位杂交技术和免疫组织化学法检测正常食管黏膜、食管上皮内瘤变及食管癌组织中STAT3在mRNA及蛋白水平的表达情况.结果 STAT3 mRNA在正常食管黏膜、食管上皮内瘤变及食管癌组织中的阳性表达率分别为3.33%、53.33%及89.00%;STAT3蛋白在上述组织中的阳性表达率分别为6.67%、60.67%及94.00%.不同程度的食管上皮内瘤变病例中,病变组织中STAT3 mRNA及STAT3蛋白的表达随食管上皮内瘤变病变程度的加重而增加.STAT3在mRNA和蛋白水平的表达存在一致性(r=0.768,P<0.05).结论 STAT3在食管上皮内瘤变及食管癌组织中高表达,它可能在食管上皮内瘤变的演变过程中发挥重要作用.%Objective To explore the role of STAT3 mRNA and STAT3 protein in the evolution of esophageal intraepithelial neoplasia. Methods 150 cases of esophageal intraepithelial neoplasia(grade Ⅰ , Ⅱ and Ⅲ with 50 cases in each) and 100 cases of e-sophageal neoplasm in area with high incidence of esophageal neoplasia were selected. The normal mucosal tissue in upper and lower esophageal stump of 60 patients among them who had undergone esophageal carcinoma resection served as control. In situ hybridization and immunohistochemistry were employed to detect STAT3 expression at mRNA and protein levels in tissue of normal esophageal mucosa,esophageal intraepithelial neoplasia and esophageal neoplasm. Results The positive expression rates of STAT3 mRNA in tissue of normal esophageal mucosa, esophageal intraepithelial neoplasia and esophageal neoplasm were 3. 33%,53. 33% and 89. 00% respectively,and those of STAT3 protein in tissue above were 6. 67% ,60

  14. 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

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. 胃黏膜上皮内瘤变与胃癌的关系研究%Gastric intraepithelial neoplasia and gastric cacinoma

    Institute of Scientific and Technical Information of China (English)

    孙萍胡; 吴云林

    2008-01-01

    胃癌很少从正常的胃黏膜上皮直接发生,通常需经历多年持续的癌前病变过程,对于癌前病变的及早识别和治疗,不失为防治胃癌的有效途径。2000年,国际癌症研究机构(IARC)出版的WHO肿瘤分类《消化系统肿瘤病理学和遗传学》一书,对胃肠道癌前病变和癌的诊断名称、定义和标准作了一些新的规定,首次将上皮内瘤变(intraepithelial neoplasia,IN)的定义引入到消化系统肿瘤中,以解决癌前病变的一些术语如异型增生(dysplasia)、不典型(atypia)、原位癌(carcinoma in situ)等在使用上的混淆。现就胃黏膜上皮内瘤变(gastric intraepithelial neoplasia,GIN)与胃癌的关系研究作一简要介绍和评述。

  17. Clinical Analysis of 18 Cases of Colorectal Intraepithelial Neoplastic Changes%结直肠上皮内瘤变18例临床分析

    Institute of Scientific and Technical Information of China (English)

    肖幼华; 蔡联明; 李荣

    2012-01-01

    Objective To explore the clinical and pathological characteristics of colorectal intraepithelial neoplasia. Methods Retrospective analysis of the clinical data of 18 patients with colorectal intraepithelial neoplasia. Of the 18 cases,2 ca-ses were low-grade colorectal intraepithelial neoplasia, 16 cases were high-grade colorectal intraepithelial neoplasia. 7 cases were endoscpic electrotomy,2 cases were transanal local excisions,2 cases were colon period of resection,5 cases were colorectomy, 1 case was pancoloctomy and 1 case was exploratory laparotomy. Results In 18 cases,pre-operative pathology diagnosis of 2 cases were low-grade colorectal intraepithelial neoplasia while post-operative pathology diagnosis were adenoma and low-grade colorectal intraepithelial neoplasia. Pre-operative pathology diagnosis of 16 csaes were high-grade colorectal intraepithelial neoplasia while post-operative pathology diagnosis were 8 cases of high-grade colorectal intraepithelial neoplasia, and 8 case of adenocarcinoma. Pathologic findings were 50% of pre-operative pathology diagnosis of high-grade colorectal intraepithelial neoplasia were adenocar-cinoma. Conclusion The pre-operative high-grade colorectal intraepithelial neoplasia is most likely to be adenocarcinoma. If the pathological result is not involved to anal sphincter, segmental resection of colon is preferred choice. Patients must receive colorec-tomy if the tumor is diagnosed as adenocarsinoma pre-operation or in-operation.%目的 探讨结直肠上皮内瘤变的临床病理特征.方法 回顾性分析18例结直肠上皮内瘤变患者的临床资料,其中低级别上皮内瘤变2例,高级别上皮内瘤变16例.行肠镜下电切术7例,经肛门局部切除术2例,肠段切除术2例,根治性手术5例,全结肠切除术1例,剖腹探查术1例.结果 18例中术前诊断为低级别上皮内瘤变2例,术后病理结果为腺瘤伴低级别上皮内瘤变;高级别上皮内瘤变16

  18. Study on clinic curative effect of cervical intraepithelial neoplasia after LEEP conization%子宫颈病变电环切术后的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    乌兰娜; 刘志红; 周艳秋; 汤惠茹; 张礼婕; 李瑞珍; 吴瑞芳

    2005-01-01

    目的探讨宫颈病变患者行子宫颈电环切术(loop electrosurgical excision procedure,LEEP)后的临床疗效.方法对宫颈薄层液基细胞学(liquid-based cytology test,LCT)、人乳头瘤病毒(human papillomavirus,HPV)检测阳性,阴道镜活检病理诊断为宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)I 58例、CIN Ⅱ 72例、CINⅢ 95例(原位癌10例)患者行LEEP,切除组织标记后均行病理检查.结果LEEP术后3个月随访CIN I 100%治愈,CIN Ⅱ 98.6%治愈,CINⅢ 98.9%治愈,宫颈糜烂100%愈合,宫颈肥大89.8%完全恢复正常大小.术后6个月随访CIN 100%治愈.术后3、6、9、12个月随访患者HPV检测转阴率显著,10例原位癌术后随访1年正常.结论LEEP术是目前临床上治疗宫颈病变的最有效方法.

  19. 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.

  20. 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...

  1. 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

    Institute of Scientific and Technical Information of China (English)

    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

  2. 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; M Aranguren; 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 ...

  3. 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.

  4. The effect of colposcopy in diagnosis of cervical intraepithelial neoplasia%阴道镜在宫颈上皮内瘤样病变诊断中的作用

    Institute of Scientific and Technical Information of China (English)

    张毅红

    2013-01-01

    目的 探讨阴道镜在宫颈上皮内瘤样病变(CIN)诊断中的作用.方法 回顾分析146例患者在阴道镜下行CIN的诊断;并做组织病理学检查.结果 146例CIN患者,在阴道镜下行宫颈定位活检,经病理确诊CIN 123例,符合率为84.2%,不符合者23例,占15.8%;最终确诊CIN I共52例,占符合率的72.7%;确诊CINⅡ共40例,占符合率的90.1%;确诊CINⅢ共23例,占符合率的96.6%;最终诊断为宫颈浸润癌2例,漏诊率为1.0%.阴道镜下活检符合率随CIN型级增加而上升,各型级间差异有统计学意义(P<0.05).结论 CIN患者采用阴道镜下诊断宫颈上皮内瘤病变,可提高宫颈早期癌及瘤前病变诊断的准确率,是一种微创、经济、方便、可靠的诊断CIN的方法,值得临床使用、推广.%Objective To study the effect of colposcopy in diagnosis of cervical intraepithelial neoplasia.Methods Retrospective analysis of 146 cases of colposcopy down in patients with cervical intraepithelial neoplasia (CIN) diagnosis and histopathological examinations.Results 146 was CIN patients,in vaginal mirror down cervical positioning biopsy,by pathological confirmed CIN 123 cases,meet rate was 84.2%,23 cases does not meet,accounted for 15.8%,eventually confirmed CIN Ⅰ total 52 cases,accounted for meet rate of 72.7%,confirmed C1N Ⅱ total 40 cases,accounted for meet rate of 90.1%,confirmed CIN Ⅱ total 23 cases,accounted for meet rate of 96.0%,eventually diagnosis for cervical invasion run cancer 2 cases,leak diagnosis rate for 1.0%.Biopsy under colposcope in line with rates rise with CIN grade increases,the differences between various levels was statistically significant (P <0.05).Conclusion Use of colposcopy in diagnosis of patients with CIN lesions,can improve the diagnosis of early cervical cancer and precancerous lesions of accuracy,is a minimally invasive,economical,convenient,reliable method of diagnosis of CIN,and worthy of clinical use,promotion.

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Diagnosis and differential diagnosis of atypical adenomatous hyperplasia and prostatic intraepithelial neoplasia%前列腺不典型性腺瘤样增生和前列腺上皮内瘤的诊断和鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    邓仲端

    2001-01-01

    @@ 现已公认,前列腺不典型性腺瘤样增生(atypical adenomatous hyperplsia, AAH)和前列腺上皮内瘤(prostatic intraepithelial neoplasia, PIN) 是前列腺癌的癌前病变,虽然PIN与前列腺癌的关系多于AAH[1].这两种病变与前列腺其他病变,特别是前列腺癌,往往相互混淆,以致造成误诊或漏诊.

  11. 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

  12. 食管鳞状上皮低级别上皮内瘤变的内镜表现与食管癌形成关系分析%Pathological Esophageal Squamous Intraepithelial Neoplasia of Low-level and Effect Analysis of the Formation of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    谭莫伟; 张乐星; 黄小津

    2015-01-01

    Objective To explore the pathological esophageal squamous intraepithelial neoplasia of low-level and ef ect analysis of the formation of esophageal cancer. Methods Chose from May 2007 to May 2010, 41 cases of gastroscopy diagnosis of patients with esophageal squamous epithelium low level intraepithelial neoplasia. To fol ow-up of its research object, analyzes its neoplasia outcome and pathological manifestations. The fol ow-up of patients was stil at the termination of the esophageal squamous epithelium low level intraepithelial neoplasia or disappearance of low-level epithelial neoplasia in patients classified as stable lesion group, the patients at the end of fol ow-up for high-grade intraepithelial neoplasia or esophageal cancer patients classified as lesions progress group. Results Sharing at the end of the 10 patients were fol ow-up for high level intraepithelial neoplasia or esophageal cancer, 31 patients were stil low level intraepithelial neoplasia or neoplasia . Group of patients with lesions progress erosion and shal ow ulcer significantly higher proportions of stable lesion group ( < 0.05), pathological changes and stable group of patients is significantly higher proportions of erythema and uplift melee lesion group ( < 0.05). Lesions progress group in the scope of lesions acuity 2.0 cm and 2.0 ~ 2.0 cm range significantly higher proportions of stable lesion group ( <0.05), and a stable lesion group within the scope of lesions in the range 1.0 cm or less progress significantly higher proportions of lesion group ( <0.05).Conclusion Esophageal squamous epithelium low level intraepithelial neoplasia is closely related to the occur ence of esophageal cancer, is associated with esophageal gastroscope pathological classification and scope of lesions.%目的探讨食管鳞状上皮低级别上皮内瘤变的病理表现及食管癌形成作用分析。方法选择我院2007年5月~2011年5月胃镜检查确诊的41例食管鳞状上皮低级别上皮内瘤变

  13. Significance of high risk human papillomavirus monitoring in follow-up of cervical intraepithelial neoplasia Ⅰ%高危型HPV监测在宫颈上皮内瘤变Ⅰ随访中的意义

    Institute of Scientific and Technical Information of China (English)

    王欢华; 陈丽; 陈梅; 吴利玲; 李景平

    2012-01-01

    Objective; To explore the significance of high risk human papillomavirus (HPV) monitoring in follow -up of cervical intraepithelial neoplasia (CIN) I . Methods; One hundred and fifty - eight patients with CIN I were followed up every eight months for two years. The contents of follow - up included high risk HPV infection detected by hybrid capture II technique, cervical cytological examination , the patients with abnormal results underwent colposcopy and biopsy, the endpoint of follow - up was CIN II , CIN M , and cervical cancer (the three diseases were designed as CIN II + ) . Results: Among 57 patients with negative high risk HPV and 63 patients with transient high risk HPV, one patient was found with aggravation of the disease; among 38 patients with continuous high risk HPV infection, 17 patients were found with aggravation of the disease, there was significant difference in the aggravation rate among the three groups (P 0. 05 ) . Conclusion: The aggravation rate of CIN among the patients with continuous high risk HPV infection is high, close follow - up or surgery should be performed.%目的:探讨HR-HPV监测在宫颈上皮内瘤变Ⅰ级(CINⅠ)随访中的意义.方法:对158例CINⅠ级患者每8个月随访1次,共2年.随访内容为采用HC-2检测技术检测HR-HPV感染、宫颈细胞学检查,异常者行阴道镜检查及活检,随访终点为病理诊断为CINⅡ、CINⅢ及宫颈癌(此3项定义为CINⅡ+).结果:57例HR-HPV阴性者及63例一过性HR-HPV者中无一例病变进展;38例持续性HR-HPV感染者17例病变进展,3组间病变进展率之间有统计学差异(P<0.05),病毒负荷量与病变进展无相关性(P>0.05).结论:持续性HR-HPV感染者CINⅠ病变进展率高,应密切随访或采用手术治疗.

  14. Genomic amplification patterns of human telomerase RNA gene and C-MYC in liquid-based cytological specimens used for the detection of high-grade cervical intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Chen Shaomin

    2012-04-01

    Full Text Available Abstract Background The amplification of oncogenes initiated by high-risk human papillomavirus (HPV infection is an early event in cervical carcinogenesis and can be used for cervical lesion diagnosis. We measured the genomic amplification rates and the patterns of human telomerase RNA gene (TERC and C-MYC in the liquid-based cytological specimens to evaluate the diagnostic characteristics for the detection of high-grade cervical lesions. Methods Two hundred and forty-three residual cytological specimens were obtained from outpatients aged 25 to 64 years at Qilu Hospital, Shandong University. The specimens were evaluated by fluorescence in situ hybridization (FISH using chromosome probes to TERC (3q26 and C-MYC (8q24. All of the patients underwent colposcopic examination and histological evaluation. A Chi-square test was used for categorical data analysis. Results In the normal, cervical intraepithelial neoplasia grade 1 (CIN1, grade 2 (CIN2, grade 3 (CIN3 and squamous cervical cancer (SCC cases, the TERC positive rates were 9.2%, 17.2%, 76.2%, 100.0% and 100.0%, respectively; the C-MYC positive rates were 20.7%, 31.0%, 71.4%, 81.8% and 100.0%, respectively. The TERC and C-MYC positive rates were higher in the CIN2+ (CIN2, CIN3 and SCC cases than in the normal and CIN1 cases (p p p > 0.05. Conclusions The TERC test is highly sensitive and is therefore suitable for cervical cancer screening. The C-MYC test is not suitable for cancer screening because of its lower sensitivity. The amplification patterns of TERC become more diverse and complex as the severity of cervical diseases increases, whereas for C-MYC, the amplification patterns are similar between the normal/CIN1 and CIN2+ groups. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1308004512669913.

  15. Treatment effect Analysis of 99 Cases on Intraepithelial Neoplasia Using Loop Electrosurgical Procedure%LEEP治疗宫颈上皮内瘤变99例效果分析

    Institute of Scientific and Technical Information of China (English)

    叶娟华; 陈智明

    2014-01-01

    Objective:To study the feasibility, efficacy and postoperative recurrence of loop electrosurgical exci-sion procedure (LEEP) in the diagnosis and management of cervical intraepithelial neoplasia (CIN). Methods:Retro-spectively studied 99 patients undergoing LEEP because of CIN after biopsy under colposcopy treatment.Results:The mean operative time was 6.5 min, average blood loss was 8.5ml, 4 cases occurred more postoperative vaginal bleeding, but improved after treatment. Histologic findings revealed that 33 cases (33.33%)CIN was grade lowed,60cases (60.61%)CIN grade was remained the same and 6 cases (6.06%)CIN grade was gone up. LEEP once treatment effi-ciency is 97.98%(97/99), 2 patients relapsed. Conclusion:LEEP is a kind of safe and effective method for treatment of CIN with few complications, in addition, it can make the diagnosis of a higher level to make up for the lack of colpo-scopic biopsy diagnosis. But the postoperative follow-up is very important.%目的:探讨宫颈电环切术(LEEP)诊治宫颈上皮内瘤变(CIN)的可行性,疗效及术后复发情况。方法:回顾性分析经阴道镜活检明确为CIN者99例行LEEP术的诊治资料。结果:LEEP治疗CIN平均时间6.5±2.3min,术中出血量平均8.5±3.5ml,4例术后阴道出血较多,经治疗后好转。病理降级33例(33.33%),等级60例(60.61%),升级6例(6.06%)。LEEP术一次治疗有效率达97.98%(97/99),2例LEEP术后复发。结论:LEEP术治疗CIN安全有效,并发症少,且能在治疗宫颈病变的同时诊断出更高级别病变,弥补阴道镜点活检诊断的不足,但是术后随诊非常重要。

  16. 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.

  17. 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

  18. 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.

  19. 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. PMID:27529629

  20. 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. PMID:27529629

  1. 宫颈上皮内瘤变与人类乳头瘤病毒不同亚型感染的关系%Correlation between cervical intraepithelial neoplasia and papillomavirus genotypes

    Institute of Scientific and Technical Information of China (English)

    许雪; 张杰; 武景波; 韩非

    2011-01-01

    Objective: To investigate the clinical significance of various genotypes of human papillomavirus (HPV) infection in cervical intraepithelial neoplasia (CIN). Methods: PCR-reverse dot blot (PCR-RDB) genotyping chip was used to examine HPV genotype in various cervical lesions (including 100 cases of histological biopsy specimens and 70 matched cases of cytological brushing specimens). Results:The positive rate of HPV infection in the 100 cases of histological biopsy specimens was 82%. Fifteen HPV genotypes were detected in these cases. HPV-16 (37%), HPV-58 (11%), HPV-33 (11%) and HPV-52 (7%) were most common genotypes of high risk (HR)-HPV. There was a trend of increased positive rates of HR-HPV with the increased grade of cervical lesion (P<0.05). It was observed that the positive rates of HR-HPV genotypes were 16.67% in squamous metaplasia and hyperplasia, 57.14% in CIN Ⅰ, 68.18% in CIN Ⅱ, and 75.68% in CINⅢ and 85.71% in invasive cervical cancer. The significant difference was found in HPV16 infection among CIN Ⅰ, CINⅡ and CINⅢ groups (P<0.05). The positive rate of HPV detected in 70 cases of cytological brushing specimens was 64.28%, whereas it was 80.00% in the matched cases of histological biopsy specimens. The consistency of HPV genotyping between the cytological brushing specimens and histological biopsy specimens was dissatisfied (kappa<0.40). Conclusion: The grade of cervical lesion was significantly associated with HR-HPV infection especially for HPV-16. The patients infected with low risk (LR)-HPV frequently have a mixed infection of HR-HPV. The detection of HPV by using cervical histological biopsy specimens was more sensitive than by using cytological brushing specimens.%目的:探讨宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)与人类乳头瘤病毒(human papillomavirus,HPV)不同亚型感染之间的关系.方法:采用PCR-反向斑点杂交(PCR-reverse dot blot,PCRRDB)

  2. 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

  3. 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].

  4. 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

  5. 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

  6. 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

  7. 281例宫颈上皮内瘤变患者阴道微生态研究%Study on vaginal microecosystem of 281 patients with cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    朱丽红; 袁宁霞; 杜冬青

    2013-01-01

    Objective:To reveal the characteristics of cervical intraepithelial neoplasia (CIN) by researching the vaginal microecosystem of 281 patients with CIN,provide a basis for drug intervention,recovery of balance of cervical-vaginal microecosystem and block of CIN development.Methods:Vaginal secretion samples of the patients were obtained to detect pH value,microecosystem evaluation was conducted after Gram staining,the spores and hyphae of Candida mycoderma bacteria,the diversities and intensities of Trichomonas vaginalis,clue cells,Gardnerella vaginalis,pyocytes,Lactobacillus and flora were observed ; secretion samples of cervical canals were obtained to detect mycoplasma and Chlamydia trachomatis (CT),and then the characteristics of cervical-vaginal microecosystem of CIN patients were studied.Results:The total detection rate of vaginal microecological imbalance in patients with CIN was 68.68%,the detection rate of clue cells in smears of vaginal secretions of CIN patients was the highest,followed by trichomonad.The detection rate of CT in cervical canals was the highest,followed by Ureaplasma urealyticum (Uu).Conclusion:Vaginal microecological imbalance induced by clue cells,trichomonad,CT and Uu infection might be correlated with occurrence of CIN,there was no correlation between Candida mycoderma bacteria and Mycoplasma hominis infection and CIN.The total detection rate of vaginal lactobacillus in CIN patients was not high,pH value showed an abnormal increasing trend.%目的:通过281例宫颈上皮内瘤变(CIN)患者宫颈局部阴道微生态研究,揭示其发病特点,为药物干预,恢复宫颈局部阴道微生态平衡、阻断CIN发展演化提供依据.方法:取患者阴道分泌物行PH值测定、革兰染色后进行微生态评价(观察假丝酵母菌孢子及菌丝、阴道毛滴虫、线索细胞、加德纳菌、脓细胞、乳酸杆菌及菌群的多样性、密集度),同时取宫颈管分泌物检测支原体

  8. 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.

  9. HPV and anal cancer in HIV-infected individuals: a review.

    Science.gov (United States)

    Schim van der Loeff, Maarten F; Mooij, Sofie H; Richel, Oliver; de Vries, Henry J C; Prins, Jan M

    2014-09-01

    HIV infection is one of the strongest risk factors for anal squamous cell cancer (ASCC). Most ASCC are caused by HPV, and most HPV-associated ASCC are caused by HPV-16. Anal HPV infections are very common in men who have sex with men (MSM), and nearly universal among HIV-infected MSM. High-grade anal intraepithelial neoplasia (HGAIN), the precursor for ASCC, is present in about 30 % of HIV+ MSM, but neither the progression rate to ASCC nor the regression rate are known. The incidence rate of ASCC among HIV-infected people has risen in the first decade after cART became available, but appears to be plateauing recently. Anal cytology has poor sensitivity and specificity. High resolution anoscopy (HRA) is advocated by some as a screening tool in high-risk groups, but is cumbersome and time-consuming and it is unknown whether HRA followed by treatment of HGAIN prevents ASCC. More research is needed on progression and regression rates of HGAIN, on effective therapy of HGAIN, and on biomarkers that predict HGAIN or anal cancer. HPV vaccination and earlier start of cART may prevent most anal cancers in the long run. PMID:24990810

  10. 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).

  11. 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

    Directory of Open Access Journals (Sweden)

    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

  12. 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

  13. Clinicopathologic analysis of 19 cases of usual type vulvar intraepithelial neoplasia%普通型外阴上皮内瘤变19例临床病理学研究

    Institute of Scientific and Technical Information of China (English)

    顾宇; 朱兰; 冯瑞娥; 郎景和

    2009-01-01

    Objective To reclassify the patients with former diagnosis of vulvar intraepithelial neoplasia (VIN)Ⅱ, VIN Ⅱ - Ⅲ, VIN Ⅲ, Bowen disease and Bowenoid papulosis according to the 2004 modified terminology of International Society for the Study of Vulvar Disease (ISSVD) and evaluate the effects of surgical treatment. Methods According to the 2004 modified terminology of ISSVD, a retrospective review of the histological slides of 19 cases, who diagnosed as VIN Ⅱ , VIN Ⅱ - Ⅲ, VIN Ⅲ,Bowen disease and Bowenoid papulosis treated in Peking Union Medical College Hospital from 1999 to 2006,were performed to reclassify by pathologist and the clinicopathologic data were also analyze& Results According to the 2004 modified terminology of ISSVD, all 19 cases were reclassified as usual type VIN and were belonged to the subtype of warty type except one, the only Bowen disease patient whose one of focuses belonged to the subtype of basaloid type and the other focus belonged to the subtype of warty type. The primary cure rate of extended local excision was 89% (17/19). There were two cases recurred during follow-up period, and were cured by second surgical treatment and the focuses of recurrence site were still diagnosed as warty type VIN. Conclusions The patients with former diagnosis of VIN Ⅱ , VIN Ⅱ-Ⅲ, VINⅢ, Bowen disease and Bowenoid papulosis are basically reclassified as usual type VIN (warty type) according to the 2004 modified terminology of ISSVD. The results showed that the diagnosis of VIN could be simplified by new terminology. The surgical excision is the good choice and combined cytologic and human papillomavims (HPV) test during follow up is also important for patients of VIN.%目的 探讨按照国际外阴疾病学会(ISSVD)2004年新分类标准对原外阴上皮内瘤变(VIN)Ⅱ级及以上级别以及鲍温病、鲍温样丘疹病的病理切片进行重新判读的结果及其手术治疗效果.方法 调阅北京协和医院1999年至2006

  14. 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,

  15. 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

  16. Cost-effectiveness of surveillance strategies after treatment for high-grade anal dysplasia in high risk patients

    Science.gov (United States)

    Mayer, Kenneth H.; Panther, Lori; Linas, Benjamin P.; Kim, Jane J.

    2013-01-01

    Background Anal cancer is one of the most common cancers affecting human immunodeficiency virus (HIV)-infected male patients. Currently, there is no consensus on post-treatment surveillance of HIV-infected men who have sex with men (MSM) who have been treated for high-grade intraepithelial neoplasia (HGAIN), the likely precursor to anal cancer. Objective To assess the cost-effectiveness of a range of strategies for anal cancer surveillance in HIV-infected MSM previously treated for HGAIN. Methods We developed a Markov model to project quality-adjusted life expectancy (QALE), lifetime costs, and the incremental cost-effectiveness ratios (ICER) of five strategies using high resolution anoscopy (HRA) and/or anal cytology testing after treatment. Results Performing HRA alone at 6- and 12-month visits was associated with a cost-effectiveness ratio of $4,446 per QALY gained. In comparison, combined HRA and anal cytology at both visits provided the greater health benefit at a cost of $ 17,373 per QALY gained. Our results were robust over a number of scenarios and assumptions, including patients’ level of immunosuppression. Results were most sensitive to test characteristics and cost, and progression rates of normal to HGAIN and HGAIN to cancer. Conclusions Our results suggest that combined HRA and anal cytology at 6 and 12 months may be a cost-effective surveillance strategy following treatment of HGAIN in HIV-infected MSM. PMID:23486494

  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

    Directory of Open Access Journals (Sweden)

    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. 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

  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. Use of human papillomavirus DNA, E6/E7 mRNA, and p16 immunocytochemistry to detect and predict anal high-grade squamous intraepithelial lesions in HIV-positive and HIV-negative men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Nittaya Phanuphak

    Full Text Available Men who have sex with men (MSM are at high risk of having anal cancer. Anal high-grade squamous intraepithelial lesion (HSIL is the precursor of anal cancer. We explored the use of different biomarkers associated with human papillomavirus (HPV infection and HPV-mediated cell transformation to detect and predict HSIL among HIV-positive and HIV-negative MSM.A total of 123 HIV-positive and 123 HIV-negative MSM were enrolled and followed for 12 months. High-resolution anoscopy (HRA with biopsies were performed at every visit along with anal sample collection for cytology, high-risk HPV DNA genotyping, HPV E6/E7 mRNA, and p16 immunocytochemistry. Performance characteristics and area under the receiver operator characteristics curve were calculated for these biomarkers at baseline, and Cox regression compared the usefulness of these biomarkers in predicting incident HSIL. High-risk HPV DNA, E6/E7 mRNA, and p16 immunocytochemistry each identified 43-46% of MSM whose baseline test positivity would trigger HRA referral. E6/E7 mRNA had the highest sensitivity (64.7% and correctly classified the highest number of prevalent HSIL cases. With the exception of p16 immunochemistry, most tests showed significant increases in sensitivity but decreases specificity versus anal cytology, while the overall number of correctly classified cases was not significantly different. Baseline or persistent type 16 and/or 18 HPV DNA was the only test significantly predicting incident histologic HSIL within 12 months in models adjusted for HIV status and low-grade squamous intraepithelial lesions at baseline.Countries with a high HIV prevalence among MSM and limited HRA resources may consider using biomarkers to identify individuals at high risk of HSIL. E6/E7 mRNA had the highest sensitivity for prevalent HSIL detection regardless of HIV status, whereas type 16 and/or 18 HPV DNA performed best in predicting development of incident HSIL within 12 months.

  3. Properties of the Neosquamous Epithelium After Radiofrequency Ablation of Barrett's Esophagus Containing Neoplasia

    NARCIS (Netherlands)

    R.E. Pouw; J.J. Gondrie; A.M. Rygiel; C.M. Sondermeijer; F.J. ten Kate; R.D. Odze; M. Vieth; K.K. Krishnadath; J.J. Bergman

    2009-01-01

    OBJECTIVES: Endoscopic radiofrequency ablation (RFA) eradicates intestinal metaplasia and intraepithelial neoplasia associated with Barrett's esophagus (BE), restoring an endoscopically normal neosquamous epithelium (NSE). We evaluated the post-RFA NSE for genetic abnormalities and buried glandular

  4. 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

  5. Treatment of anal human papillomavirus-associated disease: a long term outcome study.

    Science.gov (United States)

    Nathan, M; Hickey, N; Mayuranathan, L; Vowler, S L; Singh, N

    2008-07-01

    Treatment for human papillomavirus (HPV)-associated anal canal disease has been unsatisfactory. The objective of our study was to determine the treatment outcome in our cohort with anal HPV disease. Overall, 181 patients were evaluated over a median period of 19.1 months (range = 2.8-125.5). Eighty-eight patients (48.6%) with high-grade anal intraepithelial neoplasia (AIN) and 82 patients (45.3%) with low-grade AIN underwent treatment. One hundred and forty-one patients (77.9%) received laser ablative treatment as an outpatient procedure. The treatment yielded cure, defined as a disease-free state at 12 months after treatment, in 63.0% (114/181). Median time to cure for the cohort was 31.5 months (95% confidence interval: 23.0-40.0). Treatment outcome showed no evidence of being affected by age, sexual preference, history of smoking or presence of high-grade disease. Median time to cure was significantly affected by a positive HIV status (P = 0.02) and the extent (volume) of the disease (P = 0.01). Contrary to the current view that treatment of HPV-related anal disease is difficult, unrewarding due to recurrences and may lead to substantial morbidity, we demonstrate that effective treatment is possible for both low- and high-grade AIN. These findings should help with the general desire to introduce screening for AIN for at-risk groups. PMID:18574114

  6. 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

  7. 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

  8. 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.

  9. The residual or recurrent high-risk factors of cervical intraepithelial neoplasia after conization:a Meta-analysis%宫颈上皮内瘤变锥切术后残留或复发高危因素的Meta分析

    Institute of Scientific and Technical Information of China (English)

    陈颖颖; 洪颖

    2012-01-01

    目的 利用Meta分析来综合评价宫颈上皮内瘤变(CIN)锥切术后残留或复发的高危因素.方法 计算机检索2006年1月至2011年6月Pubmed数据库、Elsevier数据库、中国生物医学文献数据库、中国期刊网知网中国期刊全文数据库,纳入研究CIN锥切术后残留或复发危险因素的文献,试验数据的统计分析采用Cochrane协作网提供的RevMan 4.2软件.结果 检索到符合纳入标准的文章10篇,病例组348例,对照组1608例.Meta分析结果显示:切缘阳性组锥切术后残留或复发率明显高于切缘阴性组;宫颈腺体累及组锥切术后残留或复发率是宫颈腺体未累及组的4.51倍;术后6个月HPV阳性组锥切术后残留或复发率明显高于术后6个月HPV阴性组;HIV感染阳性组锥切术后残留或复发率高于HIV感染阴性组;绝经组锥切术后残留或复发率高于未绝经组;年龄≥50岁组锥切术后残留或复发率高于年龄<50岁组.结论 切缘阳性、宫颈腺体累及、术后6个月HPV感染、HIV感染、绝经、年龄≥50岁是CIN锥切术后残留或复发的高危因素.%Objective Using Meta analysis to comprehensively evaluate the residual or recurrent high -risk factors of cervical intraepithelial neoplasia (CIN) after conization. Methods Searched in January 2006 to June 2011 Pubmed database, Elsevier database , China biological medical literature database , the website CNKI, included the study of risk factors for residual or recurrent CIN after conization . The data were input and analyzed by RevMan 4. 2 software. Results Ten case control studies about the high -risk factors of the residual or recurrent of cervical intraepithelial neoplasia after conization according to the selective criteria were assessed . The cumulative cases and controls were 348 and 1608 respectively. Meta analysis results were shown : The residual or recurrence rate after conization of positive margin group , HPV infection after 6 months, HIV

  10. 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.

  11. Evaluation on the Accuracy of Histopathology after LEEP and Colposcopy Cervical Biopsy for the Diagnosing of Cervical Intraepithelial Neoplasia%LEEP术后病理检查与阴道镜宫颈活检对宫颈癌前病变的诊断准确性

    Institute of Scientific and Technical Information of China (English)

    徐水芳; 徐凤英; 王桂芳; 顾明华; 封友权

    2013-01-01

    Objective To compare the difference between histopathology after LEEP and colposcopy cervical biopsy ,and to evaluate the accuracy of diagnosing cervical intraepithelial neoplasia with colposcopy cervical biopsy . Methods 315 patients with cervical diseases were examined by colposcopy cervical biopsy and pathology after loop electrosurgicai excision procedure . Results Coincidence rate of colposcopic cervical biopsy and histopathology after LEEP was 57. 15% (180/315) ,under diagnosis rate was 20. 95% (66/315) and over diagnosis rate was 21.90% (69/315); Coincidence rate of CINI was 76.67% (23/ 30) , missed 2 cases of CIN Ⅱ /CIN Ⅲ and there was no misdiagnosed carcinoma in situ and tiny invasive cancer . Coincidence rate of CIN Ⅱ / CIN Ⅲ (including carcinoma in situ) was 56. 67% (63/111), missed 33 cases of invasive carcinoma (33/111). High grade of CIN diagnosed by colposcopy and cytological examination ≥ HSIL were risk factors of missed diagnosis (P < 0. 05 ). Conclusion The accuracy of diagnosing cervical intraepithelial neoplasia with colposcopy cervical biopsy is not satisfying , there are risks of misdiagnosis tiny invasive cancer. Patients with high-grade CIN diagnosd by colposcopic cervical biopsy should receive LEEP to avoid missed diagnosis of cervical carcinoma .%目的 通过比较LEEP术后病理检查和阴道镜宫颈活检对宫颈癌前病变诊断结果的差异,评价阴道镜宫颈活检诊断宫颈癌前病变的准确性.方法 对 315例行妇科检查的患者行阴道镜宫颈活检和LEEP手术以及术后病理组织检查.结果 阴道镜下宫颈活检与LEEP术后组织病理诊断的总符合率为57.15%(180/315),诊断不足20.95%(66/315),诊断过度21.90%(69/315);CINⅠ级诊断符合率为76.67% (23/30),漏诊CINⅡ/CINⅢ级2例,无原位癌和微小浸润癌漏诊.CINⅡ/CINⅢ级(含原位癌)符合率为56.67%(63/111),漏诊浸润癌33例(33/111).相关因素对比分析发现,阴道镜活检结果为高级别CIN和

  12. Exploration of clinical value of colposcopy directed biopsy in diagnosis of vaginal intraepithelial neoplasia%阴道镜指导下活检诊断阴道上皮内瘤变临床价值探讨

    Institute of Scientific and Technical Information of China (English)

    宋芳; 吴玉梅

    2013-01-01

    Objective To explore the clinical value of colposcopy directed biopsy in diagnosis of vaginal intraepitheal neoplasia (VaIN).Methods The clinical data of 106 VaIN patients diagnosed by colposcopy directed biopsy were reviewed and analyzed retrospectively.In the past medical history of 106 patients,46 patients had cervical cancer history,43 patients had cervical intraepithehal neoplasia history,13 patients had previous hysterectomy because of benign disease and 4 patients had uncertain past medical history.Results Among 106 patients,97 patients(91.51%,97/106) had abnormal pap smears of vagina,9 patients (8.49%,9/106) had abnormal pap smears of cervix.Histological analysis revealed that 69 patients were VaIN Ⅰ,24 patients were VaIN Ⅱ,13 patients were VaIN Ⅲ.The high-risk human papilloma virus (HPV) test at diagnosis were positive in 98 patients (92.45%,98/106),negative in 8 patients (7.55%,8/106).Eighty-seven patients VaIN were localized in the upper one third of the vagina,19 patients VaIN were localized in other parts of vaginal wall.Ninety-eight patients VaIN affected to the multifocal vaginal wall,8 patients VaIN affected to the focal vaginal wall.Conclusions It has highly therapeutic value of colposcopy directed biopsy in diagnosis of VaIN.But should closely correlated to past medical history,colposcopy should performed on the whole vagina wall and multiple punch biopsy to elevated positive rate.%目的 探讨阴道镜指导下活检诊断阴道上皮内瘤变(VaIN)的临床价值.方法 回顾性分析阴道镜指导下活检诊断的106例VaIN患者的临床资料.既往有宫颈癌病史46例,宫颈上皮内瘤变病史43例,因良性疾病切除子宫病史13例,无明确病史4例.结果 106例患者97例(91.51%,97/106)阴道残端细胞学检查异常,9例(8.49%,9/106)宫颈细胞学检查异常.诊断出VaIN Ⅰ 69例,VaINⅡ24例,VaINⅢ13例.VaIN患者高危型人乳头瘤病毒(HPV)阳性者98例(92.45%,98/106),阴性者8例(7.55

  13. 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

    OpenAIRE

    Juliana Barroso Zimmermmann; Victor Hugo de Melo; Lúcia Porto Fonseca de Castro; Márcio José Martins Alves; Sebastião Guerra Zimmermmann; Dora Mendez Del Castillo

    2006-01-01

    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 quand...

  14. 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

  15. 宫颈上皮内瘤变和宫颈癌中LMX1A和PAX1基因甲基化的定量分析%Quantitative analysis of LMX1A and PAX1 gene methylation in cervical cancer and cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    陈蔚; 杨慧娟; 徐军; 朱昊平

    2015-01-01

    Background and purpose:DNA methylation is a common epigenetic alteration in cervical carcino-genesis. The aim of this study was to measure the levels of LMX1A and PAX1 gene methylation in cervical cancer and pre-cursors and to identify their potential in clinical application. Methods:Cervical specimens were collected from 121 female patients including 27 cases with invasive cervical cancers (ICC), 34 cases with high-grade cervical intraepithelial neoplasia (HG-CIN), 32 cases with low-grade cervical intraepithelial neoplasia (LG-CIN) and 28 cases with chronic cervicitis as normal controls (NLM). DNA methylations of the LMX1A and PAX1 gene were quantified using the techniques of nest PCR and pyrosequencing. The mean methylation values of the 6 gene loci on the LMX1A gene and the 9 gene loci on the PAX1 gene were respectively calculated for a given sample. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of gene methylation analysis to discriminate the cervical diseases. Results:The mean methylation value of the LMX1A gene in ICC was 14.36%, which was significantly higher than those in HG-CIN (4.70%), LG-CIN (5.05%) and NLM (4.53%) (P<0.01). The mean methylation value of the PAX1 gene in ICC was 41.97%, which was significantly higher than those in HG-CIN (10.21%), LG-CIN (5.55%) and NLM (4.92%) (P<0.01). The area under the ROC curve (AUC) was 0.603 for LMX1A gene methylation, and was 0.883 for PAX1 gene methylation, to discriminate ICC from HG-CIN, LG-CIN, and NLM (P=0.104 and<0.001, respectively). The optimal cut-off value for PAX1 gene methylation was set at 20.50%with the sensitivity of 81%and with the specificity of 93%. If the cut-off value was set at 9.58%, the sensitivity and the specificity of PAX1 gene methylation were 89%and 84%respectively. Conclusion:Quantitative analysis of the PAX1 gene methylation in cervical tissue might be helpful to differentiate invasive cancers from precursors, while the clinical applica-tion of the

  16. 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

  17. DNA定量分析联合阴道镜在诊断宫颈癌及高级别宫颈上皮内瘤变中的价值%Value of DNA quantitative analysis combined with colposcopy for diagnosis of cervical cancer and high- grade cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    李苗; 刘芳芳; 邸媛媛; 邓清华; 钟培根

    2012-01-01

    目的:探讨宫颈细胞DNA定量分析法联合阴道镜在宫颈癌及高级别宫颈上皮内瘤变(CIN)诊断中的价值.方法:对4 577名妇女的宫颈细胞采用DNA定量分析系统和常规细胞学进行检查,常规细胞学诊断低级别鳞状上皮内瘤变(LSIL)及以上级别或DNA定量分析异常者在阴道镜下行宫颈活组织病理检查.结果:50名妇女做了病理活检,病理诊断宫颈癌及CIN 2以上病变共27例,其中DNA定量分析方法异常25例(92.6%),常规细胞学异常6例(22.2%),阴道镜异常22例(81.5%),三者间差异有统计学意义(P<0.005).DNA定量分析及阴道镜检查筛查子宫颈癌及高级别宫颈上皮内瘤变(≥CIN2)的敏感度、特异度均高于常规细胞学.结论:DNA定量分析方法联合阴道镜在早期诊断宫颈癌及高级别宫颈上皮内瘤变方面有更高的敏感性,适合在基层单位大力推广.%Objective: To explore the value of DNA quantitative analysis of cervical cells combined with colposcopy for diagnosis of cervical cancer and high-grade cervical intraepithelial neoplasia (CIN) . Methods: The cervical cells of 4 577 women were examined by DNA quantitative analysis system and routine cytologic test, the women diagnosed as low - grade squamous intraepithelial lesion (LSIL) and lesions above by routine cytologic test and the women with abnormal results of DNA quantitative analysis underwent cervical biopsy under col-poscope and pathological examination. Results: Fifty women underwent pathological biopsy, and 27 women were diagnosed as cervical cancer and &CIN Ⅱ lesions, 25 women (92. 6% ) were found with abnormal results of DNA quantitative analysis, 6 women (22. 2% ) were found with abnormal results of routine cytologic test, 22 women (81. 5% ) were found with abnormal results of colposcopy, there was statistically significant difference among the three rates (P < 0. 005 ) . The sensitivities and specificities of DNA quantitative analysis and

  18. Stepwise radical endoscopic resection for eradication of Barrett's oesophagus with early neoplasia in a cohort of 169 patients

    NARCIS (Netherlands)

    R.E. Pouw; S. Seewald; J.J. Gondrie; P.H. Deprez; H. Piessevaux; H. Pohl; T. Rösch; N. Soehendra; J.J. Bergman

    2010-01-01

    Background and Aims Endoscopic resection is safe and effective to remove early neoplasia (ie, high-grade intra-epithelial neoplasia/early cancer) in Barrett's oesophagus. To prevent metachronous lesions during follow-up, the remaining Barrett's oesophagus can be removed by stepwise radical endoscopi

  19. Clinical observation of cervical intra-epithelial neoplasia with high risk HPV infection after LEEP treatment%高频电波刀治疗宫颈上皮内瘤样变伴人乳头瘤病毒感染的临床观察

    Institute of Scientific and Technical Information of China (English)

    苏璿; 吴伟

    2013-01-01

    Objective To explore the curative effect of loop electrosurgical excision procedure (LEEP) on cervical intra-epithelial neoplasia(CIN) infected with high risk human papilloma virus (HR-HPV).Methods 80 CIN patients with HPV infection underwent LEEP were selected.HR-HPV DNA load was detected before operation and 3 months after operation,and at the same time,vaginal examination and cervical directed biopsy were conducted.Results Before LEEP operation,the differences between different levels of CIN HPV load were not significant(P >0.05,F =0.45).3 months after operation,CIN Ⅰ grade 19 cases (86.4%) turned to chronic inflammation,CIN Ⅱgrade 36 cases (83.7%) turned to chronic inflammation,CINⅢ grade 13 patients (86.6%) were chronic inflammation.Cervical HPV load postoperatively negative rate was 85% and the lower HPV load,the higher postoperatively negative rate.Conclusion LEEP is the effective treatment for cervical lesion and can significantly decrease the HPV-DNA loading at cervix.%目的 探讨宫颈上皮内瘤样变(CIN)伴人乳头瘤病毒(HR-HPV)采用高频电波刀行宫颈环形电切术(LEEP)治疗效果.方法 选择收治80例宫颈上皮内瘤变伴HPV感染患者行LEEP手术治疗并分别检测手术前及术后3个月HR-HPV DNA负荷量,同时行阴道检查及宫颈定点活检.结果 LEEP手术前不同级别CIN的HPV荷量之间差异不显著(F=0.45,P>0.05);术后3个月CIN Ⅰ级19(86.4%)转为慢性炎症、CINⅡ级36(83.7%)例转为慢性炎症;CINⅢ级13(86.6%)例转慢性炎症,宫颈HPV负荷量术后转阴率为85%且HPV负荷量低的患者较负荷量高的患者术后转阴的概率更高.结论 LEEP刀在治疗宫颈上皮内瘤变中效果显著,同时可有效降低宫颈HPV负荷量,值得临床大力推广应用.

  20. 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

  1. 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

  2. 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

  3. 宫颈上皮内瘤变石蜡标本 hTERC 基因检测与高危型人乳头瘤病毒分型测定的临床意义%An A nalysis on Detection of hTERC Gene in Paraffin Embedded Specimens and Human Papillomavirus Typing Detection for Cervical Intraepithelial Neoplasia Screening

    Institute of Scientific and Technical Information of China (English)

    石琳; 帅翰林

    2014-01-01

    Objective To explore genomic amplification of the human telomerase gene ( hTERC) in cervical intraepithelial neoplasia ( CIN) ,and demonstrate the clinical significance with the high-risk human papilloma virus detection.Methods From October 2009 to October 2012,148 cases of cervical tissue paraffin specimens were collected from first affiliated hospital of Jinan Univer-sity,including 20 cases of normal cervix in control group,128 cases in test group( CINⅠ30 ca-ses, CINⅡ53 cases,CIN Ⅲ45 cases ) .Of which the hTERC gene expression were detected by fluorescence in situ hybridization ( FISH) and the high-risk HPV infection were detected by using flow-through hybridization an d gene chip technology.Results ( 1) With the increase of the grade of cervical lesions, the positive expression rate of hTERC gene increased.Compared with control group,the hTERC gene′s amplification rates of cervical intraepithelial neoplasia( CIN)Ⅰ, CINⅡand CINⅢwere statistically significant (χ2=63.707,P<0.05) .The hTERC gene′s amplifi-cation rates of CINⅡ and CINⅢ were significantly higher than those of CINⅠ and the differ-ence was significant(χ2=36.973,P<0.05.( 2) The positive rate of HPV infection in subjects was 74.3%( 110/148);Comparing the hTERC gene′s amplification rates of the high-risk HPV infec-tion positive group with that of the negative group,the difference was statistically significant(χ2=26.9,P<0.05) .Conclusion The hTERC gene amplification is associated with HPV infection.%目的:探讨宫颈上皮内瘤变石蜡标本中人染色体端粒酶基因( hTERC)表达情况及其与高危型人乳头瘤病毒测定的临床意义。方法收集2009年10月至2012年10月湖北民族学院附属民大医院及暨南大学附属第一医院148例宫颈石蜡组织标本,其中对照组20例(正常宫颈),研究组128例( CINⅠ级30例,CINⅡ级53例,CINⅢ级45例)。应用荧光原位杂交( FISH)技术检测其hTERC基因的表达

  4. 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

  5. Germ Cell Neoplasia In Situ (GCNIS). Evolution of the Current Nomenclature for Testicular Pre-invasive Germ Cell Malignancy

    DEFF Research Database (Denmark)

    Berney, D M; Looijenga, Lhj; Idrees, M;

    2016-01-01

    , and disagreement on its name. Initially termed 'carcinoma in situ' (CIS), it has also been known as 'Intra-tubular germ cell neoplasia, unclassified' (IGCNU) and 'testicular intra-epithelial neoplasia' (TIN). We wish here, to review the history of discovery and controversy on these names, and introduce...... the reasoning for uniting behind a new name, endorsed unanimously at the WHO consensus classification 2016: Germ cell neoplasia in situ (GCNIS). This article is protected by copyright. All rights reserved....

  6. 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

  7. 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

  8. 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.

  9. 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、

  10. 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

  11. 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

  12. 宫颈环形电切术治疗高级别宫颈上皮内瘤变的远期疗效分析%Analysis of long-dated security and effectiveness for high-grade cervical intraepithelial neoplasia with loop electrosurgical excision procedure

    Institute of Scientific and Technical Information of China (English)

    张楠; 何莲芝

    2014-01-01

    AIM:To evaluate the security and effectiveness of loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CINⅡ,CINⅢ).METHODS:To analyze the clinical information of 87 patients whose pathology diagnosed as CINⅡ,CINⅢ through LEEP in the First Affiliated Hospital of Wannan Medical College between January 2008 and December 2008 for 5 years and their disease outcome.RESULTS:During 5 years follow-up,85 cases cured (97.7%) and 2 cases recurred (2.3%); Binary logistic regression analysis showed that age was the risk factor of recrudescence(P<0.05),but no significant relationship between gland involvement and recrudescence of CINⅡ,CINⅢ after LEEP(P>0.05) ; 5 patients who had no fertility history of preoperative owned natural conception.The conception rate was 100%.All of them had cesarean delivery(1 case/twice),without adverse pregnancy outcomes.5 cases received induced abortion,who did not have fertility desires pregnancy.1 case had missed abortion.CONCLUSION:LEEP is a secure and effectiveness treatment to CINⅡ,CINⅢ and does not affect the pregnancy outcome.TCT combined with HPV test is a reliable method to postoperative follow-up.%目的:探讨宫颈环形电切术(LEEP)治疗高级别宫颈上皮内瘤变(CINⅡ、CINⅢ)中的安全性与有效性.方法:总结分析2008年1月至2008年12月在皖南医学院第一附属医院经LEEP治疗后87例高级别宫颈上皮内瘤变患者5年的随访资料,分析患者的病情转归.结果:随访5年内治愈85例(97.7%),复发2例(2.3%);二分类Logistic回归分析显示:年龄是术后复发的危险因素(P<0.05),累及腺体与否对术后复发无显著影响(P>0.05);5例术前无生育史者术后均自然受孕,受孕率为100%,无不良妊娠结局,均择期剖宫产分娩,5例因非意愿怀孕行人工流产术,1例稽留流产.结论:LEEP治疗CINⅡ、CINⅢ是安全、有效的,不影响妊娠结局.TCT联合HPV检测是术后随访的可靠方法.

  13. [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.

  14. 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

  15. 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

  16. The Study of the Prevention of Anal Cancer (SPANC): design and methods of a three-year prospective cohort study

    OpenAIRE

    Machalek, Dorothy A; Grulich, Andrew E; Hillman, Richard J; Jin, Fengyi; Templeton, David J; Tabrizi, Sepehr N.; Garland, Suzanne M; Prestage, Garrett; McCaffery, Kirsten; Howard, Kirsten; Tong, Winnie; Fairley, Christopher K.; Roberts, Jennifer; Farnsworth, Annabelle; Poynten, I Mary

    2013-01-01

    Background The incidence of human papillomavirus (HPV)-associated anal cancer is increasing in men who have sex with men (MSM). Screening for the presumed cancer precursor, high-grade anal squamous intraepithelial lesions (HSIL) in a manner analogous to cervical cancer screening has been proposed. Uncertainty remains regarding anal HPV natural history and the role of anal cytology and high-resolution anoscopy (HRA) as screening tests. Well-designed cohort studies are required to address these...

  17. 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

  18. Cervical intraepithelial lesions in females attending Women's Health Clinics in Alexandria, Egypt

    OpenAIRE

    Mona Abdel-Hadi; Adel Khalaf; Hanaa Aboulkassem; Noha Naeem; Mohamed Abdel Baqy; Hassan Sallam

    2015-01-01

    Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN)   in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to hav...

  19. 子宫颈上皮内瘤变患者CD4+、CD8+T细胞表达与高危型HPV感染的关系%The relationship between the expressions of CD4+ , CD8+ T cell and high risk human papillomavirus in cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    黎华文; 张丽帆; 冯家成

    2012-01-01

    Objective To investigate the expression of CD4+ , CD8+ T cell and hrHPV virus load in cervical intraepithelial neoplasia (CIN) and the value of HPV vaccine selection. Methods Data of 72 patients who underwent LEEP for CIN between January 2005 and August 2008 in the People's Hospital of Zhuhai were analyzed retrospectively. The expression of CD4+ , CD8+ T cell in 30 CIN1, 43 CIN2/3 and 10 normal cervical tissue specimens was determined by immunohistochemical method. hrHPV DNA virus load was detected by HC - II system. Results hrHPV-DNA virus load in normal group, CIN1 and CIN2/3 group were (6.47±12.83) pg/tnl, (187.64± 169.31) pg/ml and (312. 46±287.46) pg/ml. hrHPV - DNA virus load in CIN group was significant higher than that in normal group (P<0.01), and hrHPV - DNA virus load in CIN2/3 group was higher than in that in CIN 1 group (P<0.05). In normal group, CIN1 and CIN2/3 group, the expression rate of CD4+T cell was 60.0%, 43.3% and 33. 3%, the expression rate of CD8+ T cell was 70.0%, 46.7% and 31.0%. The expression of CD4+ and CD8+ T cell in CIN groups was significant lower than that in normal group (P<0.05). Conclusion Decreased expression of CD4+ , CD8+ T cell may result in high hrHPV - DNA virus persistence and thus enhance cervical cancerous.%目的 探讨不同级别宫颈上皮内瘤变(CIN)组织中CD4+、CD8+T细胞表达及与高危型人乳头瘤病毒(HR-HPV)的关系.方法 对2005年1月至2008年8月在珠海市人民医院阴道镜下宫颈活检诊断为CIN并行宫颈锥切治疗的72例患者的资料进行分析,采用杂交捕获第二代方法(HC-Ⅱ)检测高危型HPVDNA含量;采用免疫组化检测30例CIN1、43例CIN2/3及10例正常宫颈组织中CD4+、CD8+T细胞的表达.结果 CIN2/3组的HR-HPV感染率显著高于CIN1组(P<0.05),CIN组HR-HPV感染率高于慢性宫颈炎组(P<0.01).慢性宫颈炎组、CIN1组和CIN 2/3组CD4+T细胞表达率分别为60.0%、43.3%和33.3%,CD8+T细胞的表达率分别为70.0

  20. 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

  1. 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

  2. 北京地区已婚妇女生殖道高危型人乳头状瘤病毒感染与宫颈病变相关性研究%Study on the relations between high risk human papillomavirus and cervical intraepithelial neoplasia in married women from Beijing

    Institute of Scientific and Technical Information of China (English)

    武明辉; 张淞文; 张为远; 周保利; 谢争; 王建东; 代荫梅

    2010-01-01

    Objective To investigate the prevalence and relationship between high risk human papillomavirus(HR-HPV)and cervical intraepithelial neoplasia(CIN)in married women from Beijing.Methods From March 2007 to September 2008,a total of 6185 married women were sampled,covering 137 communities in 12 districts.The samples were screened by high-risk HPV DNA test(HC2)and cytological test.For those participants with cytological test results≥ASCUS,pathological tests were performed.An interview was also carried out with the same questionnaire.Results from the tests were inputted into the database twice using EpiData 3.0,reviewed,analyzed,using SPSS 15.0.Results(1)The prevalence rates of HR-HPV and CIN were 9.9% and 6.0%,respectively for the age group 25 to 54.(2)The peak age groups for HR-HPV and CIN prevalence rates were 30 to 34 years old.(3)The prevalence rates of positive cytology(40.3%)and CIN (30.4%)in HR-HPV positive female population were significantly higher than that in HR-HPV negative group.(4)Data from unconditional logistic regression analysis showed that,when comparing with the normal subjects,the risk odds ratios of HR-HPV with low grade CIN and cervical cancer/high grade CIN were 8.385 and 97.416 and the attributable risk proportions with these groups were 88.1% and 99.0%,respectively.Conclusion HR-HPV infection seemed to be the main risk factor for CIN.Married women,from age group 30-34,were under the high risk group in both HR-HPV infection and CIN incidence.%目的 探讨北京地区已婚妇女生殖道高危型人乳头状瘤病毒(HR-HPV)感染与宫颈上皮内瘤变(CrN)的现患状况及其相关性.方法 于2007年3月至2008年9月采用多阶段整群随机抽样的方法,在北京地区抽取12个区县137个社区25~54岁已婚妇女6185名,进行妇科体检、宫颈HR-HPV及细胞学检测,并进行问卷调查.对出现不典型鳞状上皮细胞及以上细胞学异常改变的妇女进行宫颈病理学检查.应用EpiData 3.0软件双次

  3. Expression of Human Papillomavirus-18 E6, E2 and Cellular Bromodomain Protein Brd4 in Cervical Intraepithelial Neoplasia and Cervical Carcinoma%HPV-18病毒E2、E6与Brd4对宫颈癌及癌前病变的意义分析

    Institute of Scientific and Technical Information of China (English)

    吕跃峰; 雷艳; 王雪; 张春莲; 方彩云; 王世宣

    2013-01-01

    目的:研究HPV-18病毒E2、E6与Brd4对宫颈癌及癌前病变的意义.方法:选择2009年3月至2011年3月我院接诊的17例宫颈炎患者,19例CIN Ⅰ级(轻度非典型增生)患者,14例CIN Ⅱ级(中度非典型增生)患者,15例CIN Ⅲ级(重度非典型增生及原位癌)患者,19例宫颈癌患者.分别采用RT-PCR对各组的E2 mRNA、E6mRNA阳性表达情况进行测定,采用蛋白印迹(Western Blot)法对各组患者的E2蛋白与Brd4表达情况进行测定.从而分析HPV-18病毒E2、E6与Brd4对宫颈癌及癌前病变的临床意义.结果:各项检测后,发现宫颈癌组患者的E2mRNA阳性表达率明显低于宫颈炎组、CIN组(P<0.05);宫颈癌组患者的E6mRNA阳性表达率明显高于宫颈炎组、CIN组(P<0.05).HPV-18病毒E2 mRNA与E6mRNA阳性表达情况呈负相关(P<0.05).宫颈癌组患者的E2蛋白阳性率明显低于宫颈炎组、CIN组(P<0.05);宫颈癌组患者的Brd4蛋白阳性率明显低于宫颈炎组、CIN组(P<0.05).结论:HPV-18病毒E2、E6与Brd4对宫颈癌及癌前病变的检测有重要意义,可用于对于宫颈癌演变过程的监控.%Objective:To study the expression of human papillomavirus-18 E6,E2 and cellular bromodomain protein Brd4 in cervical intraepithelial neoplasia and cervical carcinoma.Methods:The patients from March 2009 to March 2011 were studied,there were 17 patients with cervicitis patients,19 cases ofCIN Ⅰ (mild dysplasia),14 patients ofCIN Ⅱ level (moderate dysplasia) patients,15 cases ofCIN Ⅲ level in patients with (severe dysplasia and carcinoma in situ),19 cases of cervical cancer.RT-PC R were used for each group E2 mR NA,E6 mR NA positive expression was measured using western blot (Western Blot) method of the E2 protein and Brd4 expression of the patients in each group were measured.To analyze the clinical significance of the HPV-18 virus E2,E6 the Brd4 of cervical cancer and precancerous lesions.Results:After tested,we found that the E2 mRNA positive

  4. 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

  5. Prior colorectal neoplasia is associated with increased risk of ileoanal pouch neoplasia in patients with inflammatory bowel disease

    NARCIS (Netherlands)

    Derikx, L.A.A.P.; Kievit, W.; Drenth, J.P.H.; Jong, D.J. de; Ponsioen, C.Y.; Oldenburg, B.; Jong, A.E. de; Dijkstra, G.; Grubben, M.J.A.L.; Laarhoven, C.J.H.M. van; Nagtegaal, I.D.; Hoentjen, F.

    2014-01-01

    BACKGROUND & AIMS: Although restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) substantially reduces the risk of colorectal cancer in patients with inflammatory bowel disease (IBD), subsequent pouch neoplasia can develop. There are few data on the incidence of and risk factors for

  6. Prior Colorectal Neoplasia Is Associated With Increased Risk of Ileoanal Pouch Neoplasia in Patients With Inflammatory Bowel Disease

    NARCIS (Netherlands)

    Derikx, Lauranne A. A. P.; Kievit, Wietske; Drenth, Joost P. H.; de Jong, Dirk J.; Ponsioen, Cyriel Y.; Oldenburg, Bas; van der Meulen-de Jong, Andrea E.; Dijkstra, Gerard; Grubben, Marina J. A. L.; van Laarhoven, Cornelis J. H. M.; Nagtegaal, Iris D.; Hoentjen, Frank

    2014-01-01

    BACKGROUND & AIMS: Although restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) substantially reduces the risk of colorectal cancer in patients with inflammatory bowel disease (IBD), subsequent pouch neoplasia can develop. There are few data on the incidence of and risk factors for

  7. p16 as a diagnostic marker of cervical neoplasia: a tissue microarray study of 796 archival specimens

    OpenAIRE

    Hamilton-Dutoit Stephen; Lidang Marianne; Lesnikova Iana; Koch Jørn

    2009-01-01

    Abstract Background To evaluate the usefulness of this biomarker in the diagnosis of cases of cervical neoplasia we studied the immunohistochemical expression of p16INK4a in a large series of archival cervical biopsies arranged into tissue microarray format. Methods TMAs were constructed with tissue cores from archival formalin fixed, paraffin-embedded donor tissues from 796 patients, and included cases of cervical intraepithelial neoplasia (CIN)1 (n = 249), CIN2 (n = 233), CIN3 (n = 181), an...

  8. 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.

  9. The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

    Directory of Open Access Journals (Sweden)

    Felicidad Gimenez

    2011-06-01

    Full Text Available CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. High-resolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. OBJECTIVES: To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. METHODS: A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. RESULTS: The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy

  10. 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

  11. 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

  12. 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

  13. The status and younger trends analysis of temporary residence in densely populated areas of cervical intraepi-thelial neoplasia%流动人口密集地区宫颈上皮内瘤变现状及瘤变年轻化趋势分析

    Institute of Scientific and Technical Information of China (English)

    李柳翠; 梁翠霞; 李琪

    2014-01-01

    Objective To know temporary residence in densely populated areas to understand women' s status and cervical neoplasia younger trend neoplasia. Method Gynecological clinic in nearly two years,or tjrougj visual observation of cervical cancer screening suspec-ted cervical neoplasia in patients witj biopsy needed to be done preliminary registration basic information,and tjen tjrougj access to outpa-tient surgery consents and registration of electronic medical records one by one biopsy results and otjer relevant information. Results 142 cases surveyed total neoplasia(cancer)61 cases accounted for 42. 9%,of wjicj:CINⅠ25 Cases(17. 6%),CINⅡ11 Cases(7. 8%) CINⅢand carcinoma in situ of 10 cases(7. 0%),cervical carcinoma in situ tired gland 8 patients(5. 6%),seven cases of invasive cer-vical cancer(4. 9%);various stages of cervical neoplasia average age of onset were:CIN(Ⅰ,Ⅱ)group 33. 5 years,carcinoma in situ group( CIN Ⅲ)group 34. 8 years,invasive group 42. 3 years old,tje minimum age of all ages were:CIN group,22 years old,DCIS group of 23 years old,invasive group 37 years old. Conclusion Temporary residence in densely populated areas women cervical intraepitjelial neo-plasia( cancer)cjanges early onset,jigj incidence of cervical neoplasia( cancer)becomes younger evident.%目的:了解流动人口密集地区女性宫颈瘤变的现状及瘤变年轻化趋势。方法:对妇科门诊近两年来通过宫颈癌筛查或肉眼观察发现疑似宫颈瘤变需要做活检的患者进行基本资料初步登记,再通过查阅门诊手术同意书及电子病历逐一登记病理活检结果等相关资料。结果:142例调查对象总瘤变(癌变)61例占42.9%,其中:CINⅠ25例(17.6%),CINⅡ11例(7.8%) CINⅢ及原位癌10例(7.0%),宫颈原位癌累腺8例(5.6%),宫颈浸润癌7例(4.9%);宫颈瘤变各阶段平均发病年龄分别为:CIN(Ⅰ、Ⅱ)组33.5岁,原位癌组( CINⅢ)组34.8

  14. 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

  15. 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.

  16. Marijuana Use is Not Associated with Cervical Human Papillomavirus Natural History or Cervical Neoplasia in HIV-seropositive or HIV-seronegative Women

    OpenAIRE

    D’Souza, G; Palefsky, J.M.; Zhong, Y; Minkoff, H; Massad, L.S.; Anastos, K; Levine, AM; Moxley, M; Xue, X.; Burk, R; Strickler, HD

    2010-01-01

    Marijuana use was recently reported to have a positive cross-sectional association with human papillomavirus (HPV)-related head and neck cancer. Laboratory data suggest that marijuana could have an immunomodulatory effect. Little is known, however, regarding the effects of marijuana use on cervical HPV or neoplasia. Therefore, we studied the natural history (ie, prevalence, incident detection, clearance/persistence) of cervical HPV and cervical neoplasia (ie, squamous intraepithelial lesions ...

  17. 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....

  18. 低温高频电波刀在宫颈上皮内瘤样病变治疗中的应用%The Application of Low Temperature-high Freguency Electric Knife(LEEP)Treatment in Cervical Intraepithelial Neoplasia Lesions

    Institute of Scientific and Technical Information of China (English)

    闫玲玲; 邵映秀; 张静

    2008-01-01

    目的:评价低温高频电刀(LEEP)治疗宫颈上皮内瘤样病变(Cervical intraepithelial neopla,CIN),探讨其治疗效果.方法:通过2006年4月~2007年12月门诊患者及体检人群,经宫颈细胞学检查(薄层液基细胞学,Liquid-based Cytology),在阴道镜检(colposcopy)下多点活组织检查(multi-point biopsy),筛查出宫颈上皮内瘤样病变(CIN)174例患者,采用低温高频电刀(LEEP)治疗.结果:12周一次成功率98.85%(172/174),术中出血量平均35 mL,平均手术时间9.8分钟.结论:LEEP刀治疗宫颈上皮内瘤病变(CIN),操作简便、快捷、安全、有效、出血少、手术时间短,不需住院,患者容易接受,有效的治疗可以降低宫颈癌的发生率.

  19. 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.

  20. Multiple Endocrine Neoplasia Syndromes

    Science.gov (United States)

    ... type 2A disease. Almost everyone with type 2A disease develops medullary thyroid cancer (see Medullary cancer ). About 40 to ... stones in about 25% of people. Type 2B disease Multiple endocrine neoplasia type 2B can consist of Medullary thyroid cancer Pheochromocytomas Growths around nerves (neuromas) Many ...

  1. Laser capture microdissection as a tool to evaluate human papillomavirus genotyping and methylation as biomarkers of persistence and progression of anal lesions

    OpenAIRE

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

    2015-01-01

    Introduction Anal squamous cell carcinoma is preceded by persistent infection with high-risk human papillomavirus (HPV) and the cancer precursor, high-grade squamous intraepithelial lesion (HSIL). Detection of specific HPV genotypes and HPV-related biomarkers may be an option for primary anal screening. However, more data on the natural history of HPV-related anal lesions are required. The outcomes from this study will enhance our understanding of the clinical and biological behaviour of HPV-...

  2. 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 anorretal nos pacientes portadores do vírus da imunodeficiência humana (HIV por meio da anuscopia de alta resolução (AAR e da citologia anal. MÉTODOS: Desenvolvemos um estudo observacional, transversal e duplo-cego em que participaram 31 pacientes portadores do HIV independente de queixas proctológicas. Os pacientes foram submetidos à AAR e citologia anal cujas lâminas foram enviadas ao setor de anatomia patológica para coloração e posterior análise. RESULTADOS: Verificamos 22 pacientes do sexo masculino e 9 do sexo feminino entre 20 e 67 anos. Dos 31 analisados, quatro encontravam-se em estágio de imunodepressão, 23 utilizavam terapia antirretroviral, 16 com passado de sexo anal receptivo e 12 com passado de condiloma acuminado. À AAR 11 pacientes tinham alterações e 7 foram confirmados pela citologia. Verificamos ainda oito pacientes com alterações à citologia os quais possuíam ausência de alterações à AAR. À citologia apresentaram três células escamosas atípicas de significância (Ascus, do inglês atypical squamous cells of undetermined significance, cinco com paraceratose e/ou hiperceratose, seis lesões intraepiteliais de baixo grau e uma lesão intraepitelial de alto grau. CONCLUSÃO: Sugerimos a utilização da AAR aliada à citologia anal para rastreamento nos pacientes portadores do HIV, visto que esses exames complementam-se para a detecção de lesões que estejam relacionadas ao câncer anorretal.OBJECTIVE: Screening for HPV as well as its correlation with anorectal cancer in patients carrying the human immuno deficiency virus (HIV through high-resolution anoscopy (HRA and anal cytology. METHODS: We developed an observational study, double-blind attended by 31 patients with HIV independent proctologic complaints. Patients underwent HRA and anal cytology slides were sent to which sector pathology staining and

  3. Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil Lesões precursoras do câncer anal em pacientes HIV-positivos e HIV-negativos atendidos numa instituição de saúde terciária no Brasil

    OpenAIRE

    Ivan Tramujas da Costa e Silva; José Ribamar de Araújo; Rosilene Viana de Andrade; Celso Rômulo Barbosa Cabral; Felicidad Santos Gimenez; Adriana Gonçalves Daumas Pinheiro Guimarães; Ticiane Costa Martins; Lucília Rocha Lopes; Luiz Carlos de Lima Ferreira

    2011-01-01

    Purpose: To investigate the prevalence of anal squamous intraepithelial lesions (ASIL) or anal cancer in patients attended at the Tropical Medicine Foundation of Amazonas. Methods: 344 patients consecutively attended at the institution, in 2007/2008, were distributed in the following strata according to presence/abscense of at risk conditions for anal cancer: Group 1 _ HIV-positive men-who-have-sex-with-men (101); Group 2 _ HIV-positive females (49); Group 3 _ patients without any at risk con...

  4. Increased expression of sialic acid in cervical biopsies with squamous intraepithelial lesions

    Directory of Open Access Journals (Sweden)

    Vallejo-Ruiz Verónica

    2010-11-01

    Full Text Available Abstract Background Altered sialylation has been observed during oncogenic transformation. Sialylated oligosaccharides of glycoproteins and glycolipids have been implicated in tumor progression and metastases. In the cervical cancer high levels of sialic acid have been reported in the patients serum, and an increased of total sialic acid concentration has been reported for the cervical neoplasia and cervical cancer. This study investigates the changes in expression and distribution of α2,3-linked sialic acid and α2,6- linked sialic acid in low and high squamous intraepithelial lesions and in normal tissue. Methods Lectin histochemistry was used to examine the expression and distribution of sialic acid in different grades of cervical neoplasia. We applied Maackia amurensis lectin, which interacts with α2,3-linked sialic acid and Sambucus nigra lectin specific for α2,6-linked sialic acid. Results The histochemical analysis showed that α2,3-linked sialic acid and α2,6- linked sialic acid increased in intensity and distribution in concordance with the grade of squamous intraepithelial lesion (SIL. These results are in concordance with a previous study that reports increased RNAm levels of three sialyltransferases. Conclusions These results show that the change in sialylation occurs before cancer development and may play an important role in cellular transformation. These findings provide the basis for more detailed studies of the possible role of cell surface glycoconjugates bearing sialic acid in the cellular cervix transformation.

  5. p16 as a diagnostic marker of cervical neoplasia: a tissue microarray study of 796 archival specimens

    DEFF Research Database (Denmark)

    Lesnikova, Iana; Lidang, Marianne; Hamilton-Dutoit, Stephen;

    2009-01-01

    BACKGROUND: To evaluate the usefulness of this biomarker in the diagnosis of cases of cervical neoplasia we studied the immunohistochemical expression of p16INK4a in a large series of archival cervical biopsies arranged into tissue microarray format. METHODS: TMAs were constructed with tissue cores...... from archival formalin fixed, paraffin-embedded donor tissues from 796 patients, and included cases of cervical intraepithelial neoplasia (CIN)1 (n = 249), CIN2 (n = 233), CIN3 (n = 181), and invasive cervical carcinoma (n = 133). p16INK4a expression was scored using two different protocols: 1...

  6. Accuracy of liquid-based cytology in diagnosis of high-grade squamous cervical intraepithelial neoplasia%影响宫颈液基细胞学高度鳞状上皮内病变诊断的因素分析

    Institute of Scientific and Technical Information of China (English)

    李旻; 梅平; 罗东兰; 王小冰; 刘艳辉

    2012-01-01

    目的 探讨影响宫颈液基细胞学高度鳞状上皮内病变(HSIL)诊断准确性的原因.方法 收集2007至2010年间415例细胞学诊断为HSIL的病例,将细胞学结果与组织学结果对照分析,复查液基细胞学制片及组织学切片,分析误诊原因.结果 共42209例受检者进行了ThinPrep液基细胞学检查,其中细胞学诊断为HSIL者415例,占筛查人群的1.0%.HSIL患者的平均年龄41.6岁,30~ 49岁为高发年龄.325例细胞学诊断为HSIL的病例其组织学诊断结果为:阴性/炎性改变23例(7.1%),宫颈上皮内病变(CIN)1级/人乳头状瘤病毒(HPV)感染22例(6.8%),CIN2级/CIN3级223例(68.6%),鳞状细胞癌(SCC)57例(17.5%).细胞学HSIL对组织学CIN2级及以上病变的阳性预测值为86.2% (280/325),对组织学CIN1级以上病变的阳性预测值为92.9%(302/325).细胞学假阳性的原因主要是组织学取材阴性、细胞学片中出现反应性腺上皮、孤岛状萎缩及放化疗反应等.细胞学诊断为HSIL而组织学诊断为SCC者57例(17.5%),误诊的原因主要为社会因素、对部分低分化SCC的细胞学表现认识不足,以及细胞学片中缺乏典型癌性特征.结论 细胞学HSIL对宫颈CIN2级/CIN3级及SCC的阳性预测值较高,但存在与组织学诊断结果不符的情况,细胞学医师和妇科医师应注意避免造成不一致的因素.%Objective To investigate factors affccting the diagnostic accuracy of cervical liquidbased cytology for high-grade squamous intraepithelial lesion (HSIL).Methods A retrospective evaluation of cytological and histological slides was performed in 415 patients who had cytological HSIL between 2007and 2010.Results Among 42 209 cases screened by ThinPrep liquid-based cytology,415 cases ( 1.0% )of HSIL were eventually identified.The mean age of HSIL patients was 41.6 years,and 30 -49 years were the most common age group.Among 415 cases,325 patients had available histological diagnosis as follows

  7. Study on the expression of T lymphocyte cell of cervical intraepithelial neoplasiaI and high risk human papilloma virus infection in localized tissue and peripheral blood during ozone therapy%臭氧治疗对宫颈病变及人乳头瘤病毒感染患者局部组织及外周血中T淋巴细胞表达的影响

    Institute of Scientific and Technical Information of China (English)

    张雪梅; 同军; 夏义欣; 白晟遥; 张晓莉

    2014-01-01

    癌的一种有效治疗手段.%Objective To explore the effect of ozone therapy on cervical intraepithelial neoplasia (CIN Ⅰ) and high risk human papilloma virus(HR-HPV) infection with the changes of T lymphocyte cell in peripheral blood and in local tissue.Methods Totally 144 patients with CINⅠ) and HR-HPV infection were divided into high viral load (>1 000 RLU/CO,67 cases),moderate viral load (500-1 000 RLU/CO,45 cases) and low viral load (<500 RLU/CO,32 cases).Flow cytometry and immunohistochemistry S-P method were used to determine CD4 +,CD8 +,CD4 +/CD8 + ratio change in CIN Ⅰ,HR-HPV and control group patients.Before and after ozone treatment,patients were followed up for one,three,six,nine and twelve months.Results CD4 + reduced,CD8 + increased and CD4 +/CD8 + ratio of peripheral blood decreased in CIN Iand HPV patients ; there was no significant difference (P > 0.05) between CIN Ⅰ group and control group; low expression of CD4 +,CD8 + developed in local tissue.There was significant difference(P < 0.05) between CINⅠgroup and normal control group; CD4 + increased [control group:35.8 ± 1.2 vs 34.7 ± 1.2,CINⅠ group:36.7 ± 0.5 vs 36.6 ± 0.6],CD8+ decreased [control group:23.1 ± 1.2 vs 24.1 ± 1.1,CINⅠ group:22.7 ± 1.1 vs 23.2 ± 1.0] and CD4 +/CD8 + ratio increased,after ozone therapy in both CIN Ⅰ group and control group.1 week after ozone treatment,compared with those before treatment,positive expression of CD4 + and CD8 + of cervical tissue between control group and CIN Ⅰ group increased [control group:57.6% (83/144),46.7% (67/144),56.9% (82/144),50.0% (72/144),CIN Ⅰ group:75.0% (108/144),63.3% (91/144),63.9% (92/144),53.3% (77/144)],the difference was statistically significant (P < 0.05).After treatment,the rate of cervical tissue expression positive CD4 + and CD8 + increased more in CIN Ⅰ group than that in control group; the difference was statistically significant (P < 0.01).The efficient rate of

  8. The Artificial Anal Sphincter

    OpenAIRE

    Christiansen, John

    2000-01-01

    The artificial anal sphincter as treatment for end stage anal incontinence was first described in 1987. Published series concern a total of 42 patients, with a success rate of approximately 80%. Infection has been the most serious complication, but a number of technical complications related to the device have also occurred and required revisional procedures in 40% to 60% of the patients. The artificial anal sphincter may be used for the same indications as dynamic graciloplasty except in pat...

  9. Optoelectronic method for detection of cervical intraepithelial neoplasia and cervical cancer

    Science.gov (United States)

    Pruski, D.; Przybylski, M.; Kędzia, W.; Kędzia, H.; Jagielska-Pruska, J.; Spaczyński, M.

    2011-12-01

    The optoelectronic method is one of the most promising concepts of biophysical program of the diagnostics of CIN and cervical cancer. Objectives of the work are evaluation of sensitivity and specificity of the optoelectronic method in the detection of CIN and cervical cancer. The paper shows correlation between the pNOR number and sensitivity/specificity of the optoelectronic method. The study included 293 patients with abnormal cervical cytology result and the following examinations: examination with the use of the optoelectronic method — Truscreen, colposcopic examination, and histopathologic biopsy. Specificity of the optoelectronic method for LGSIL was estimated at 65.70%, for HGSIL and squamous cell carcinoma of cervix amounted to 90.38%. Specificity of the optoelectronic method used to confirm lack of cervical pathology was estimated at 78.89%. The field under the ROC curve for the optoelectronic method was estimated at 0.88 (95% CI, 0.84-0.92) which shows high diagnostic value of the test in the detection of HGSIL and squamous cell carcinoma. The optoelectronic method is characterised by high usefulness in the detection of CIN, present in the squamous epithelium and squamous cell carcinoma of cervix.

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

    Directory of Open Access Journals (Sweden)

    Neerja Bhatla

    2013-01-01

    Methods: A total of 600 consecutively selected women aged 30-74 yr with persistent vaginal discharge, intermenstrual/postcoital bleeding or unhealthy cervix underwent conventional Pap smear, Hybrid Capture 2® (HC2 testing for HPV and CT DNA and colposcopy, with directed biopsy of all lesions. Results: HPV DNA was positive in 108 (18.0% women, CT DNA in 29 (4.8% women. HPV/CT co-infection was observed in only four (0.7% women. Of the 127 (21.2% women with Pap >ASCUS, 60 (47.2% were HPV positive and four (3.1% were CT positive. Of the 41 women with CIN1 lesions, 11 (26.8% were HPV positive, while two were CT positive. Of the 46 women with CIN2+ on histopathology, 41 (89.1% were HPV positive, two (4.3% were CT positive and one was positive for both. The risk of CIN2+ disease was significantly increased (P35 yr, higher parity, use of oral contraceptives or smoking did not show any significant association with HPV or abnormal histopathology. Parity >5 was the only risk factor positivity associated with CT infection (P<0.05. Interpretation & conclusions: Our findings showed that CT infection was not significantly associated with CIN, and most of its risk factors, including HPV infection, in symptomatic women. Longitudinal studies with carefully selected study sample would be able to answer these questions.

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

    DEFF Research Database (Denmark)

    Barken, Sidsel S; Lynge, Elsebeth; Andersen, Erik S.;

    2013-01-01

    % obtained the recommended tests for 5 years. Five-year adherence was substantially better outside the capital area, for example, the odds ratio for women from Jutland compared with women from the capital area was 1.70 (95% confidence interval 1.60-1.82). CONCLUSIONS: Adherence to follow-up after conization...

  12. Human papilloma virus : association with vulvovaginitis and genital intra-epithelial neoplasia

    OpenAIRE

    Bodén, Elisabeth

    1991-01-01

    In many women with gynecological complaints such as itching, burning, discharge, and fissures causing dyspareunia, examination of the vulvovaginal mucosa reveals hyperkeratotic and papillomatous changes. Polymerase Chain Reaction (PCR) technique revealed 64% of such lesions to harbour Human Papilloma Virus (HPV)- DNA, whereas Southern blot (SB) technique showed 50% to be positive for HPV- DNA. Women with papillomatous lesions were more often HPV-DNA positive than those with/Zat hyperkeratotic...

  13. Viral and Cellular Biomarkers in the Diagnosis of Cervical Intraepithelial Neoplasia and Cancer

    Directory of Open Access Journals (Sweden)

    Maria Lina Tornesello

    2013-01-01

    Full Text Available Cervical cancer arises from cells localized in the ectoendocervical squamocolumnar junction of the cervix persistently infected with one of about 13 human papillomavirus (HPV genotypes. The majority of HPV infections induces low grade squamous epithelial lesions that in more than 90% of cases spontaneously regress and in about 10% eventually progress to high grade lesions and even less frequently evolve to invasive cancer. Tumor progression is characterized by (1 increased expression of E6 and E7 genes of high risk HPVs, known to bind to and inactivate p53 and pRb oncosuppressors, respectively; (2 integration of viral DNA into host genome, with disruption of E2 viral genes and host chromosomal loci; and (3 molecular alterations of key regulators of cell cycle. Molecular markers with high sensitivity and specificity in differentiating viral infections associated with cellular abnormalities with high risk of progression are strongly needed for cervical cancer screening and triage. This review will focus on the analysis of clinical validated or candidate biomarkers, such as HPV DNA, HPV E6/E7 mRNA, HPV proteins, p16(INK4a and Ki67, TOP2A and MCM2 cellular factors, and DNA methylation profiles, which will likely improve the identification of premalignant lesions that have a high risk to evolve into invasive cervical cancer.

  14. Association of TAP Gene Polymorphisms and Risk of Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Camilla Natter

    2013-01-01

    Full Text Available Background. Transporter associated with antigen processing (TAP is responsible for peptide loading onto class I major histocompatibility complex (MHC-I molecules. TAP seems to facilitate the detection of HPV by MHC-I molecules and contributes to successful eradication of HPV. TAP polymorphisms could have an important impact on the course of HPV infection. Objective. The aim of this study is to evaluate the association between five TAP gene polymorphisms and the risk of CIN. Methods. This case-control study investigated five common TAP polymorphisms in TAP1 (1341 and 2254 and TAP2 (1135, 1693, and 1993 in 616 women with CIN and 206 controls. Associations between gene polymorphisms and risk of CIN were analysed by univariate and multivariable models. The combined effect of the five TAP gene polymorphisms on the risk for CIN was investigated by haplotype analysis. Results. No significant difference in genotype distribution of the five TAP polymorphisms was observed in women with CIN and controls. Haplotype analysis revealed that women with haplotype mut-wt-wt-wt-wt (TAP polymorphisms t1135-t1341-t1693-t1993-t2254 had a significantly lower risk for CIN, compared to women with the haplotype wt-wt-wt-wt-wt (; OR 0.5 []. Conclusion. Identification of this haplotype combination could be used to identify women, less susceptible for development of CIN following HPV infection.

  15. Multimodal nonlinear optical microscopy improves the accuracy of early diagnosis of squamous intraepithelial neoplasia

    Science.gov (United States)

    Teh, Seng Khoon; Zheng, Wei; Li, Shuxia; Li, Dong; Zeng, Yan; Yang, Yanqi; Qu, Jianan Y.

    2013-03-01

    We explore diagnostic utility of a multicolor excitation multimodal nonlinear optical (NLO) microscopy for noninvasive detection of squamous epithelial precancer in vivo. The 7,12-dimenthylbenz(a)anthracene treated hamster cheek pouch was used as an animal model of carcinogenesis. The NLO microscope system employed was equipped with the ability to collect multiple tissue endogenous NLO signals such as two-photon excited fluorescence of keratin, nicotinamide adenine dinucleotide, collagen, and tryptophan, and second harmonic generation of collagen in spectral and time domains simultaneously. A total of 34 (11 controlled and 23 treated) Golden Syrian hamsters with 62 in vivo spatially distinct measurement sites were assessed in this study. High-resolution label-free NLO images were acquired from stratum corneum, stratum granulosum-stratum basale, and stroma for all tissue measurement sites. A total of nine and eight features from 745 and 600 nm excitation wavelengths, respectively, involving tissue structural and intrinsic biochemical properties were found to contain significant diagnostic information for precancers detection (p<0.05). Particularly, 600 nm excited tryptophan fluorescence signals emanating from stratum corneum was revealed to provide remarkable diagnostic utility. Multivariate statistical techniques confirmed the integration of diagnostically significant features from multicolor excitation wavelengths yielded improved diagnostic accuracy as compared to using the individual wavelength alone.

  16. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women

    DEFF Research Database (Denmark)

    Joura, Elmar A; Giuliano, Anna R; Iversen, Ole-Erik;

    2015-01-01

    BACKGROUND: The investigational 9-valent viruslike particle vaccine against human papillomavirus (HPV) includes the HPV types in the quadrivalent HPV (qHPV) vaccine (6, 11, 16, and 18) and five additional oncogenic types (31, 33, 45, 52, and 58). Here we present the results of a study...... of the efficacy and immunogenicity of the 9vHPV vaccine in women 16 to 26 years of age. METHODS: We performed a randomized, international, double-blind, phase 2b-3 study of the 9vHPV vaccine in 14,215 women. Participants received the 9vHPV vaccine or the qHPV vaccine in a series of three intramuscular injections...... vaccine and those not included) in the modified intention-to-treat population (which included participants with and those without prevalent infection or disease) was 14.0 per 1000 person-years in both vaccine groups. The rate of high-grade cervical, vulvar, or vaginal disease related to HPV-31, 33, 45, 52...

  17. Human papillomavirus and natural history of cervical intraepithelial neoplasia : clinical consequences

    NARCIS (Netherlands)

    M.A.E. Nobbenhuis (Marielle)

    2001-01-01

    textabstractCervical cancer is the second most common cancer in women world-wide after breast cancer. Each year, there are approximately 437,000 new cases of invasive cancer of the cervix diagnosed and more than 200,000 women die from the disease, 79% of which occur in developing countries. In the

  18. Anal condyloma acuminatum.

    Science.gov (United States)

    McCutcheon, Tonna

    2009-01-01

    Anal condyloma acuminatum is a human papillomavirus (HPV) that affects the mucosa and skin of the anorectum and genitalia. Anal condyloma acuminatum is the most commonly diagnosed sexually transmitted disease in the United States. To date, there are more than 100 HPV types, with HPV-6, HPV-10, and HPV-11 predominately found in the anogenital region and causing approximately 90% of genital warts. Risk factors for anal condyloma acuminatum include multiple sex partners, early coital age, anal intercourse, and immunosuppression. Transmission occurs by way of skin-to-skin contact through sexual intercourse, oral sex, anal sex, or other contact involving the genital area. The virus may remain latent for months to years until specific mechanisms cause production of viral DNA, leading to the presentation of anal condyloma acuminatum.Patients with anal condyloma acuminatum may be asymptomatic or present with presence of painless bumps, itching, and discharge or bleeding. It is not uncommon to have involvement of more than one area, and multiple lesions may also be present and extend into the anal canal or rectum. To date, there is no serologic testing or culture to detect anal condyloma acuminatum; therefore, diagnosis is made clinically or by detection of HPV DNA. Multiple factors determine the choice of treatment, which may range from patient-applied medications to surgical intervention. Despite treatment choice, recurrence rates are high, indicating the importance of patient education on prevention of HPV infection and reinfection. Unfortunately, at this time, no cure exists for anal condyloma acuminatum; however, recently Gardasil and Cervarix (in Australia only) vaccines have become available and are showing promising results. PMID:19820442

  19. Laryngeal Squamous Intraepithelial Lesions: An Updated Review on Etiology, Classification, Molecular Changes, and Treatment.

    Science.gov (United States)

    Gale, Nina; Gnepp, Douglas R; Poljak, Mario; Strojan, Primož; Cardesa, Antonio; Helliwell, Tim; Šifrer, Robert; Volavšek, Metka; Sandison, Ann; Zidar, Nina

    2016-03-01

    Laryngeal carcinogenesis is a multistep process, characterized by an accumulation of genetic changes associated with architectural and cytologic alterations, ranging from squamous hyperplasia to carcinoma in situ and encompassed by the terminology of squamous intraepithelial lesions (SILs). The etiology, classification, genetic changes, and malignant progression of these lesions are reviewed. Tobacco remains the principal etiological factor with gastroesophageal reflux disease recently considered as a possible factor. In contrast, there is little evidence that microbiological agents, especially human papillomavirus infection, are frequently involved in laryngeal carcinogenesis and probably subjectivity, remains the mainstay of accurate diagnosis, prognosis, and guidance for a patient's treatment. The currently used classifications, the dysplasia system, squamous intraepithelial neoplasia, and the Ljubljana classification, reflect different standpoints on this important topic. The modified Ljubljana classification, with good interobserver agreement, could be considered as a proposal for a unified classification of laryngeal SILs. This review also briefly discusses recently discovered genetic changes, such as CDKN2A and CTNNB1 genes, and chromosome instability of chromosomes 1 and 7; however, none of these can at present improve histologic diagnosis. Malignant progression of precursor lesions varies from 2% to 74%, according to different studies. Cold-steel microinstruments, CO2 laser, and radiotherapy are used to treat the different grades of precursor lesions. There is as yet no worldwide agreement on the treatment of high-grade lesions and carcinoma in situ. PMID:26849814

  20. EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR AND HUMAN PAPILLOMAVIRUS (HPV L1 CAPSID PROTEIN IN CERVICAL SQUAMOUS INTRAEPITHELIAL LESIONS

    Directory of Open Access Journals (Sweden)

    Balan Raluca

    2010-09-01

    Full Text Available We analyzed the immunohistochemical pattern of epidermal growth factor receptor (EGFR in cervical squamous intraepithelial lesions (SILs in correlation with L1 HPV capsid protein, in order to determine the relationship between EGFR expression and the infection status of human papillomavirus (HPV. The study included 40 cases, 24 LSIL (low grade SIL (CIN1, cervical intraepithelial neoplasia and 16 HSIL (high grade SIL (6 cases of CIN2 and 10 cases of CIN3. The immunoexpression of L1 HPV protein was assessed on conventional cervico-vaginal smears and EGFR was immunohistochemically evaluated on the corresponding cervical biopsies. The HPV L1 capsid protein was expressed in 45.83% of LSIL and 25% of HSIL. EGFR was overexpressed in 62,4% of HSIL (58,4% CIN2 and 41,6% CIN3 and 37,6% LSIL. The immunoexpression of L1 HPV has clinical application in the progression assessment of the cervical precancerous lesions without a correlation to the grade of the cervical SIL. EGFR is expressed by all proliferating squamous epithelial cells, thus corresponding with the grade of SIL. The evaluation of EGFR status, correlated with L1 HPV protein expression, can provide useful data of progression risk of cervical squamous intraepithelial lesions

  1. Association of HPV infection and Chlamydia trachomatis seropositivity in cases of cervical neoplasia in Midwest Brazil.

    Science.gov (United States)

    da Silva Barros, Narriman Kennia; Costa, Maria Cecília; Alves, Rosane Ribeiro Figueiredo; Villa, Luísa Lina; Derchain, Sophie Françoise Mauricette; Zeferino, Luiz Carlos; Dos Santos Carneiro, Megmar Aparecida; Rabelo-Santos, Silvia Helena

    2012-07-01

    High-risk human papillomavirus (HPV) is considered the main etiological agent for cervical neoplasia. However, the presence of a single type HPV infection alone is unlikely to be sufficient to cause cervical cancer. There is epidemiologic evidence suggesting that HPV and Chlamydia trachomatis play a central role in the etiology of cervical intraepithelial neoplasia and subsequent cervical cancer. To evaluate the HPV prevalence and the seropositivity for C. trachomatis in women referred to the colposcopy clinic due to an abnormal cervical smear and to examine the effect of this association on the severity of cervical neoplasia. Following enrollment, 131 patients underwent colposcopy and biopsies when necessary. HPV DNA was detected by the polymerase chain reaction (PCR) and genotyping was performed by reverse line-blot hybridization assay. C. trachomatis seropositivity was tested by ELISA for the detection of IgG antibodies. The prevalence of HPV infection was 86.3%. Seropositivity for C. trachomatis was 26%. Thirty-one women (27.4%) were positive for C. trachomatis antibodies and HPV-DNA. The most prevalent HPV type in C. trachomatis-seropositive women were HPV 16 (51.6%) and this HPV type was present mainly in neoplasia cases. Positivity for HPV, particularly HPV types 16 and 18, and C. trachomatis seropositivity was significantly associated with a diagnosis of high grade neoplasia. Borderline significance was observed after adjustment for HPV. C. trachomatis seropositivity is associated with high grade neoplasia in women infected with HPV, mainly when the types 16 and 18 were involved. PMID:22585734

  2. Intrathoracic neoplasia: Epidemiology and etiology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1992-05-01

    Neoplasms of the thorax encompass those derived from the thoracic wall, trachea, mediastinum, lungs and pleura. They represent a wide variety of lesions including benign and malignant tumors arising from many tissues. The large surface area, 60 to 90 m{sup 2} in man, represented by the respiratory epithelium and associated thoracic structures are ideal targets for carcinogens carried by inspired air. The topic of discussion in this report is the epidemiology, etiology, and mechanisms of spontaneous intrathoracic neoplasia in animals and man. Much of what we know or suspect about thoracic neoplasia in animals has been extrapolated from experimentally-induced neoplasms.

  3. Anal cancer; Cancer du canal anal

    Energy Technology Data Exchange (ETDEWEB)

    Fesneau, M.; Champeaux-Orange, E. [Service de radiotherapie, Centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hopital Bretonneau, 37 - Tours (France); Champeaux-Orange, E. [Service d' oncologie-radiotherapie, Centre hospitalier regional d' Orleans, 45 - Orleans (France); Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 75 - Paris (France)

    2010-07-01

    Anal canal epidermoid carcinomas represent 1.2% of digestive cancers and 6% of ano-rectal cancers. For localized diseases, the treatment is based on radiotherapy with or without chemotherapy (5-FU and cisplatin or mitomycin), according to tumour and nodal extension. The recommended treatment dose is 45 Gy in the anal canal, the mesorectum, para-rectal lymph nodes, and inguinal lymph nodes. An additional dose of 15 to 20 Gy is delivered in the initial tumour for good responders. Salvage surgery is necessary in case of poor response. The organs at risk to be considered are bladder, femur heads, small intestine and vulva. The objective of this work is to summarize the epidemiological and radio-anatomic and prognostic characteristics of this tumour. The conformal radiotherapy technique is illustrated by a case report. (authors)

  4. A six-year experience with anal cytology in women with HPV in the lower genital tract: utility, limitations, and clinical correlation.

    Science.gov (United States)

    Cardinal, L H; Carballo, P; Lorenzo, M C Cabral; García, A; Suzuki, V; Tatti, S; Vighi, S; Díaz, L B

    2014-05-01

    This study assessed the utility and limitations of anal cytology as a screening method for women infected with human papilloma virus (HPV) in the lower genital tract. Furthermore, this study aimed to establish risk factors for pathological anal cytology/biopsy findings, the prevalence of anatomopathological lesions associated with positive anal brushings, and the frequency of concomitant lesions of the lower genital tract. A cross-sectional, retrospective, descriptive study in 207 women with HPV-associated lesions of the lower genital tract and 25 women with immunosuppression was carried out. Anal cytology, high resolution anoscopy, and biopsy of suspicious lesions were performed. In total, 232 anal brushings were performed: 184 (79.3%) were negative, 24 (10.34%) showed atypical squamous cells of undeterminated significance, 18 (7.7%) showed low-grade squamous intraepithelial lesions, and 6 (2.6%) showed high-grade squamous intraepithelial lesion. Cytohistological correlation was obtained for 70 cases. The sensitivity of anal cytology in detecting intraepithelial lesions was 70%, whereas the specificity was 93%. The sensitivity of the method for detecting high-grade lesions (84%) was higher, than that for detecting low-grade lesions (66%). The most frequently associated pathology was vulvar lesion. It is important to perform anal brushings in women who have had lower genital tract biopsies for HPV-associated lesions due to the high prevalence of anal lesions in such patients. Anal cytology is useful for detecting high-grade lesions but the sensitivity for detecting low-grade lesions is low. It is of the utmost importance to perform high-resolution anoscopy and biopsy in women with suspicious lesions in order to confirm the pathology. PMID:24166879

  5. Multilocus Inherited Neoplasia Alleles Syndrome

    DEFF Research Database (Denmark)

    Whitworth, James; Skytte, Anne-Bine; Sunde, Lone;

    2016-01-01

    as multilocus inherited neoplasia alleles syndrome [MINAS]) in patients with unusual inherited cancer syndrome phenotypes. To facilitate the clinical management of novel cases of MINAS, we have established a database to collect information on what is likely to be an increasingly recognized cohort...

  6. Obstetric anal sphincter injuries

    Institute of Scientific and Technical Information of China (English)

    Remon Keriakos; Deepa Gopinath

    2015-01-01

    Obstetric anal sphincter injuries can be associated with significant short and long term consequences causing devastating impacts on the quality of lives of young, otherwise healthy women. The major consequence is anal incontinence which may be short or long term and vary in severity. The other consequences include pain, infection, dyspareunia and sexual dysfunction. This may in turn result in considerable economic burden to health care providers and patients. It also has an implication on future deliveries. Although it can never be eliminated, it can be reduced by improving practice, training and provision of high quality multidisciplinary care in order to reduce long-term morbidity. Obstetric anal sphincter injuries are also a source of litigation which can be distressing to both patients and clinicians. The aim of this review article is to explore the available evidence on epidemiology, strategies for preventions, prognosis and also how to deal with governance issues.

  7. Inflammation and Atrophy Precede Prostate Neoplasia in PhIP Induced Rat Model

    Energy Technology Data Exchange (ETDEWEB)

    Borowsky, A D; Dingley, K; Ubick, E; Turteltaub, K; Cardiff, R D; DeVere-White, R

    2006-06-01

    2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP) has been implicated as a major mutagenic heterocyclic amine in the human diet and is carcinogenic in the rat prostate. In order to validate PhIP induced rat prostate neoplasia as a model of human prostate cancer progression, we sought to study the earliest histologic and morphologic changes in the prostate and to follow the progressive changes over time. We fed 67 male Fischer F344 5 week old rats with PhIP (400 PPM) or control diets for 20 weeks, and then sacrificed animals for histomorphologic examination at age 25 weeks, 45 weeks, and 65 weeks. Animals treated with PhIP showed significantly more inflammation (P=.002 (25wk), >.001(45wk), .016(65wk)) and atrophy (P=.003(25wk), >.001(45wk), .006 (65wk)) in their prostate glands relative to controls. Prostatic intraepithelial neoplasia (PIN) occurred only in PhIP treated rats. PIN lesions arose in areas of glandular atrophy, most often in the ventral prostate. Atypical cells in areas of atrophy show loss of glutathione S-transferase pi immunostaining preceding development of PIN. None of the animals in this study developed invasive carcinomas differing from previous reports. Overall, these findings suggest that the pathogenesis of prostatic neoplasia in the PhIP treated rat prostate proceeds from inflammation to post-inflammatory proliferative atrophy to PIN.

  8. Inflammation and Atrophy Precede Prostatic Neoplasia in a PhIP-Induced Rat Model

    Directory of Open Access Journals (Sweden)

    Alexander D. Borowsky

    2006-09-01

    Full Text Available 2-Amino-1-methyl-6-phenylimidazo(4,5-bpyridine (PhIP has been implicated as a major mutagenic heterocyclicamine in the human diet and is carcinogenic in the rat prostate. To validate PhIP-induced rat prostatic neoplasia as a model of human prostate cancer progression, we sought to study the earliest histologic and morphologic changes in the prostate and to follow progressive changes over time. We fed sixty-seven 5-week-old male Fischer F344 rats with PhIP (400 ppm or control diets for 20 weeks, and then sacrificed animals for histomorphologic examination at the ages of 25, 45, and 65 weeks. Animals treated with PhIP showed significantly more inflammation (P = .002, > .001, and .016 for 25, 45, and 65 weeks, respectively and atrophy (P = .003, > .001, and .006 for 25, 45, and 65 weeks, respectively in their prostate glands relative to controls. Prostatic intraepithelial neoplasia (PIN occurred only in PhIP-treated rats. PIN lesions arose in areas of glandular atrophy, most often in the ventral prostate. Atypical cells in areas of atrophy show loss of glutathione S-transferase π immunostaining preceding the development of PIN.None of the animals in this study developed invasive carcinomas, differing from those in previous reports. Overall, these findings suggest that the pathogenesis of prostatic neoplasia in the PhIP-treated rat prostate proceeds from inflammation to postinflammatory proliferative atrophy to PIN.

  9. Diagnosis of gastric epithelial neoplasia: Dilemma for Korean pathologists

    Institute of Scientific and Technical Information of China (English)

    Joon Mee Kim; Eunsil Yu; Eun Sun Jung; Mee Soo Chang; Jong Eun Joo; Mee Joo; Youn Wha Kim; Do Youn Park; Yun Kyung Kang; Sun Hoo Park; Hye Seung Han; Mee-Yon Cho; Young Bae Kim; Ho Sung Park; Yang Seok Chae; Kye Won Kwon; Hee Jin Chang; Jin Hee Sohn; Dae Young Kang; Cheol Keun Park; Woo Ho Kim; So-Young Jin; Kyoung Mee Kim; Hee Kyung Chang

    2011-01-01

    The histopathological diagnosis of gastric mucosal biopsy and endoscopic mucosal resection/endoscopic submucosal dissection specimens is important, but the diagnostic criteria, terminology, and grading system are not the same in the East and West. A structurally invasive focus is necessary to diagnose carcinoma for most are active. Additionally, Korean doctors are familiar with Western style medical terminology. As a result, the terminology, definitions, and diagnostic criteria for gastric intraepithelial neoplasia are very heterogeneous in Korea. To solve this problem, the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has made an effort and has suggested guidelines for differential diagnosis: (1) a diagnosis of carcinoma is based on invasion; (2) the most important characteristic of low grade dysplasia is the architectural pattern such as regular distribution of crypts without severe branching, budding, or marked glandular crowding; (3) if nuclear pseudostratification occupies more than the basal half of the cryptal cells in three or more adjacent crypts, the lesion is considered high grade dysplasia; (4) if severe cytologic atypia is present, careful inspection for invasive foci is necessary, because the risk for invasion is very high; and (5) other structural or nuclear atypia should be evaluated to make a final decision such as cribriform pattern, papillae, ridges, vesicular nuclei, high nuclear/cytoplasmic ratio, loss of nuclear polarity, thick and irregular nuclear membrane, and nucleoli.

  10. New concepts in neoplasia as applied to diagnostic pathology

    Energy Technology Data Exchange (ETDEWEB)

    Fenoglio-Preiser, C.M.; Weinstein, R.S.; Kaufman, N.

    1986-01-01

    This book contains 13 selections. Some of the titles are: Cellular Aspects of Neoplasia; Oncogenes and Cancer; Chromosome and Oncogene Rearrangements in Leukemia and Lymphoma; Ionizing Radiation and Neoplasia; and Papillomaviruses and Neoplasia in Man.

  11. High grade squamous intraepithelial lesion in inmates from Ohio: cervical screening and biopsy follow-up

    Directory of Open Access Journals (Sweden)

    Rofagha Soraya

    2006-01-01

    Full Text Available Abstract Background Cervical carcinoma remains the second leading cause of cancer death in women worldwide and sexual behavior is regarded as the main contributing factor. We studied cervical cytology screening with surgical biopsy follow-up in women prisoners and compared the findings to those in the general population. Methods We reviewed 1024 conventional cervical smears, 73 cervical biopsies and 2 loop electrosurgical excision procedure (LEEP specimens referred to us from the Correctional Center in Columbus, Ohio during a 12-month period. The results were compared to 40,993 Pap smears from the general population for the same 12-month period. Results High grade squamous intraepithelial lesion (HGSIL was diagnosed in 1.3% of the cervical smears from the inmate population versus 0.6% in the general population (p < 0.01. The unsatisfactory rate was 1.6% compared to 0.3% in the general population (p < 0.01. Among the study population, follow-up tissue diagnosis was obtained in 24.3% of the abnormal cytology results (ASCUS, LGSIL, and HGSIL. Of the HGSIL Pap smears, 61.5% had a subsequent tissue diagnosis. Thirty-nine biopsies (52% of the all inmate biopsies and LEEP showed CIN II/III (cervical intraepithelial neoplasia II/III. Eight of these thirty-nine follow-up biopsies diagnosed as CIN II/III had a previous cervical cytology diagnosis of ASCUS. The average age for HGSIL was 30.5 years (S.D. = 5.7 and for low grade squamous intraepithelial lesion (LGSIL was 27.2 years (S.D. = 6.1. Conclusion A significantly higher prevalence of HGSIL cervical cytology and unsatisfactory smears was encountered in female inmates, with tissue follow-up performed in less than two thirds of the patients with HGSIL. These results are in keeping with data available in the literature suggesting that the inmate population is high-risk and may be subject to less screening and tissue follow-up than the general population. Clinicians should proceed with urgency to improve

  12. Penile Analogue of Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: The First Described Case. A Diagnostic Pitfall.

    Science.gov (United States)

    Michal, Michael; Michal, Michal; Miesbauerova, Marketa; Hercogova, Jana; Skopalikova, Barbora; Kazakov, Dmitry V

    2016-05-01

    The authors report a case where undifferentiated (classic) penile intraepithelial neoplasia was associated with the presence of goblet cells throughout the full epithelial thickness and which later progressed into an invasive carcinoma. The lesion evolved in three consecutive biopsies from only surface epithelium occupying numerous goblet cells in the first to variably sized solid nodules in the dermis composed of atypical squamous and/or basaloid cells intermixed with numerous goblet cells in the third biopsy. Both cellular components expressed CK7 and p16 protein. Human Papillomavirus (HPV) genotyping revealed high risk HPV type 16. To the best of our knowledge, this is the first description of such a lesion occurring on the penis, which can be considered the penile analogue of cervical stratified mucin-producing intraepithelial lesion (SMILE). The correct diagnosis was rendered retrospectively, after recognition of the existence of a vulvar lesion resembling cervical SMILE. The initial biopsy was misinterpreted as extramammary Paget disease, which also constitutes the main pitfall in the differential diagnosis. Another important differential diagnosis is penile/vulvar mucinous metaplasia. The finding of atypical squamous epithelial cells positive for p16 associated with mucinous cells present throughout the full epithelial thickness is a clue to the diagnosis of penile SMILE. PMID:27097242

  13. Schwannoma intercostal simulando neoplasia pulmonar

    OpenAIRE

    Henn L.A.; Gonzaga R.V.; Crestani J.; Cerski M.R.

    1998-01-01

    Schwannoma é uma neoplasia mesenquimal, usualmente solitária, encontrada no mediastino, retroperitônio ou pelve, sendo rara sua apresentação na parede torácica. OBJETIVO: Relatar o caso de um paciente masculino, tabagista, com um nódulo pulmonar direito com características de malignidade, detectado em radiografia de tórax de rotina, cujo diagnóstico anatomopatológico foi de schwannoma benigno de nervo intercostal. MÉTODOS: Revisaram-se os dados referentes ao quadro clínico, exames laboratoria...

  14. Inflammatory Bowel Disease and Cervical Neoplasia

    DEFF Research Database (Denmark)

    Rungoe, Christine; Simonsen, Jacob; Riis, Lene;

    2015-01-01

    BACKGROUND & AIMS: We examined the risk of cervical neoplasia (dysplasia or cancer) in women with ulcerative colitis (UC) or Crohn's disease (CD). We also calculated the reverse, the risk for diagnosis with cervical neoplasia before development of inflammatory bowel disease (IBD). METHODS: We...

  15. Anal anatomy and normal histology.

    Science.gov (United States)

    Pandey, Priti

    2012-12-01

    The focus of this article is the anatomy and histology of the anal canal, and its clinical relevance to anal cancers. The article also highlights the recent histological and anatomical changes to the traditional terminology of the anal canal. The terminology has been adopted by the American Joint Committee on Cancer, separating the anal region into the anal canal, the perianal region and the skin. This paper describes the gross anatomy of the anal canal, along with its associated blood supply, venous and lymphatic drainage, and nerve supply. The new terminology referred to in this article may assist clinicians and health care providers to identify lesions more precisely through naked eye observation and without the need for instrumentation. Knowledge of the regional anatomy of the anus will also assist in management decisions.

  16. Carcinoma of the anal sac glands in ranch mink.

    Science.gov (United States)

    Hadlow, W J

    1985-05-01

    During a 14-year period, carcinoma of the anal sac apocrine glands was found in 52 pastel and 8 sapphire mink (Mustela vison) kept for studies on slow viral diseases. The pastel mink varied in age from 72 to 135 months (mean age 108 months), the sapphire mink from 63 to 100 months (mean age 81 months). All but one pastel mink were females. The primary tumor varied in size from masses that caused bulges in the perineum to those that were found only after microscopic examination of the anal sac glands. Although the primary tumor grew mainly by expansion with little local infiltration, 41 of the 60 tumors had metastasized to the regional lymph nodes and sometimes also to more distant sites. The striking propensity of the carcinoma to metastasize while still small, even microscopic, often resulted in massive secondary growths, notably in the iliac lymph nodes. Hypercalcemia did not accompany the carcinoma. Its varied microscopic appearance included solid, glandular, squamous cell, and spindle or round cell components. Combinations of them formed mixed or complex histologic patterns, no doubt largely attributable to neoplastic proliferation of myoepithelial cells and squamous metaplasia of the apocrine gland epithelium. Although its cause remains obscure, the carcinoma appeared to arise from small foci of hyperplastic apocrine glands, sometimes in relation to both anal sacs. The tumor is a common and distinctive expression of neoplasia in older ranch mink.

  17. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...

  18. Hypertrophied anal papillae and fibrous anal polyps, should they be removed during anal fissure surgery?

    Institute of Scientific and Technical Information of China (English)

    Pravin J. Gupta

    2004-01-01

    AIM: Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice.They are mostly ignored being considered as normal structures. The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus.METHODS: Two groups of patients were studied. A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm. Another group of a hundred patients who also had papillae or fibrous polyps, were treated by lateral sphincterotomy alone. They were followed up for one year.RESULTS: Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated. Group A patients showed a marked reduction with regard to pain and irritation during defecation (P= 0.0011),pricking or foreign body sensation in the anus (P = 0.0006)and pruritus or wetness around the anal verge (P = 0.0008).CONCLUSION: Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure. This would add to effectiveness and completeness of the procedure.

  19. Radiology of gestational trophoblastic neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Allen, S.D. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Lim, A.K. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Seckl, M.J. [Department of Medical Oncology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Blunt, D.M. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Mitchell, A.W. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom)]. E-mail: amitchell@hhnt.org

    2006-04-15

    Gestational trophoblastic neoplasia (GTN) encompasses a broad spectrum of placental lesions from the pre-malignant hydatidiform mole (complete and partial) through to the malignant invasive mole, choriocarcinoma and rare placental site trophoblastic tumour (PSTT). Ultrasound remains the radiological investigation of choice for initial diagnosis, and it can also predict invasive and recurrent disease. Magnetic resonance imaging is of invaluable use in assessing extra-uterine tumour spread, tumour vascularity, and overall staging. Positron emission tomography and computed tomography undoubtedly have a role in recurrent and metastatic disease, while angiography has a place in disease and complication management. This review will describe the relevant pathophysiology and natural history of GTN, and the use of imaging techniques in the diagnosis and management of these conditions.

  20. Multiple endocrine neoplasia type 2.

    Science.gov (United States)

    Lodish, Maya

    2013-01-01

    Multiple endocrine neoplasia type 2 (MEN2) is an autosomal-dominant cancer syndrome characterized by variable penetrance of medullary thyroid carcinoma(MTC), pheochromocytoma (PHEO), and primary hyperparathyroidism (PHPT). MEN2 consists of two clinical subtypes, MEN2A and MEN2B. Familial medullary thyroid cancer is now viewed as a phenotypic variant of MEN2A with decreased penetrance for PHEO and PHPT rather than a distinct entity. All subtypes are caused by gain-of-function mutations of the RET proto-oncogene. Genotype-phenotype correlations exist that help predict the presence of other associated endocrine neoplasms as well as the timing of thyroid cancer development. Recognition of the clinical entity in individuals and families at risk of harboring a germline RET mutation is crucial for the management and prevention of associated malignancies. Recent guidelines released by the American Thyroid Association regarding the management of MTC will be summarized in this chapter.

  1. The cross-talk between enterocytes and intraepithelial lymphocytes.

    Science.gov (United States)

    Vitale, Serena; Picascia, Stefania; Gianfrani, Carmen

    2016-12-01

    The gut mucosa is continuously exposed to food and microbial antigens. Both enterocytes and intraepithelial lymphocytes have a pivotal role in maintaining the integrity of intestinal mucosa, as these cells guarantee a first line of defense against pathogens and toxic molecules. Enterocytes maintain a physical barrier against microbes and directly contribute to the gut homeostasis by sampling the luminal agents through several pattern recognition receptors or presenting antigen to mucosa T cells. Similarly, due to a close physical contact with the intestinal epithelial cells, the intraepithelial lymphocytes represent an important part of the gut lymphoid tissue, contrasting the entry and spread of pathogens. An alteration of the cross-talk between intestinal epithelial cells and intraepithelial lymphocytes might actively contribute to the development of intestinal immune disorders, as occurring in patients with celiac disease. In genetically predisposed individuals, the gluten exposure results in a massive production of interleukin-15, activation of intraepithelial lymphocytes, and modification of small intestinal mucosa architecture and function. We will review the recent studies on the pathophysiology of cross-talk between enterocytes and intraepithelial T cells, and how this interaction is crucial for intestinal integrity and homeostasis. PMID:27251606

  2. Cross-sectional imaging of gastric neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Hargunani, R. [Royal Free Hampstead NHS Trust (United Kingdom)], E-mail: rikin@doctors.org.uk; Maclachlan, J. [Royal Free Hampstead NHS Trust (United Kingdom); Kaniyur, S. [Lister Hospital, East and North Hertfordshire NHS Trust (United Kingdom); Power, N. [Barts and The London NHS Trust (United Kingdom); Pereira, S.P. [University College London Hospitals NHS Foundation Trust (United Kingdom); Malhotra, A. [Royal Free Hampstead NHS Trust (United Kingdom)

    2009-04-15

    The detection of gastric neoplasia has traditionally been limited to barium examination and direct visualization at endoscopy. The rapid development of techniques such as multidetector computed tomography (MDCT) and endoscopic ultrasound (EUS) has resulted in more accurate diagnosis and staging of gastric neoplasia. In this review we describe the normal anatomy of the stomach with multi-modality illustrations and review the imaging manifestations of gastric neoplasia, including adenocarcinoma, lymphoma, neuroendocrine and gastro-intestinal stromal tumours. We also describe the optimal techniques for up-to-date and accurate gastric imaging, outlining the role of MDCT and EUS.

  3. Diagnosis of gastric epithelial neoplasia: Dilemma for Korean pathologists.

    Science.gov (United States)

    Kim, Joon Mee; Cho, Mee-Yon; Sohn, Jin Hee; Kang, Dae Young; Park, Cheol Keun; Kim, Woo Ho; Jin, So-Young; Kim, Kyoung Mee; Chang, Hee Kyung; Yu, Eunsil; Jung, Eun Sun; Chang, Mee Soo; Joo, Jong Eun; Joo, Mee; Kim, Youn Wha; Park, Do Youn; Kang, Yun Kyung; Park, Sun Hoo; Han, Hye Seung; Kim, Young Bae; Park, Ho Sung; Chae, Yang Seok; Kwon, Kye Won; Chang, Hee Jin

    2011-06-01

    The histopathological diagnosis of gastric mucosal biopsy and endoscopic mucosal resection/endoscopic submucosal dissection specimens is important, but the diagnostic criteria, terminology, and grading system are not the same in the East and West. A structurally invasive focus is necessary to diagnose carcinoma for most Western pathologists, but Japanese pathologists make a diagnosis of cancer based on severe dysplastic cytologic atypia irrespective of the presence of invasion. Although the Vienna classification was introduced to reduce diagnostic discrepancies, it has been difficult to adopt due to different concepts for gastric epithelial neoplastic lesions. Korean pathologists experience much difficulty making a diagnosis because we are influenced by Japanese pathologists as well as Western medicine. Japan is geographically close to Korea, and academic exchanges are active. Additionally, Korean doctors are familiar with Western style medical terminology. As a result, the terminology, definitions, and diagnostic criteria for gastric intraepithelial neoplasia are very heterogeneous in Korea. To solve this problem, the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has made an effort and has suggested guidelines for differential diagnosis: (1) a diagnosis of carcinoma is based on invasion; (2) the most important characteristic of low grade dysplasia is the architectural pattern such as regular distribution of crypts without severe branching, budding, or marked glandular crowding; (3) if nuclear pseudostratification occupies more than the basal half of the cryptal cells in three or more adjacent crypts, the lesion is considered high grade dysplasia; (4) if severe cytologic atypia is present, careful inspection for invasive foci is necessary, because the risk for invasion is very high; and (5) other structural or nuclear atypia should be evaluated to make a final decision such as cribriform pattern, papillae, ridges, vesicular nuclei

  4. [Surgery of anal fistulas].

    Science.gov (United States)

    Ricchi, E; Carriero, A; Spallanzani, A; Fundarò, S; Heydari, A; Piccoli, M; Gelmini, R

    1997-06-01

    The authors report a study on 120 patients with anal fistula (111 males and 9 females). The average age was 44.3 years (median 44, SD +/- 14.807). 64.1% of patients had an intersphincteric fistula, 23.3% hanal transphincteric fistula, 1.6% a suprasphincteric fistula, 7.5% a horseshoe fistula and the 3.3% an extrasphincteric fistula. We treated 14 patients (11.66%) with direct surgical treatment. The other 106 had various types of treatment depending on the localisation and the involvement of the anorectal sphincter. We had 11 cases (9.1%) of complications, such as recurrence in 5 patients (4.1%) transitory incontinence in 2 cases (1.6%) and finally postoperative bleeding in 3 patients (2.5%). PMID:9324655

  5. Ocular Surface Squamous Neoplasia in Xeroderma Pigmentosum

    Directory of Open Access Journals (Sweden)

    Rajesh R Nayak

    2013-11-01

    Full Text Available Xeroderma pigmentosum (XP is a rare genetic disorder associated with multiple oculocutaneous and neurological manifestations. It occurs due to deficiency of the enzymes responsible for repairing ultraviolet radiation-induced DNA damage. Persistence of un-repaired DNA results in somatic mutations, leading to neoplasia of the skin and ocular surface. As this condition is rare, only isolated case reports of XP with ocular surface squamous neoplasia (OSSN are found in literature.

  6. Ocular Surface Squamous Neoplasia in Xeroderma Pigmentosum

    OpenAIRE

    Nayak, RR; Kamath, GM; Kamath, MM; Kamath, AR; D'Souza, S.

    2013-01-01

    Xeroderma pigmentosum (XP) is a rare genetic disorder associated with multiple oculocutaneous and neurological manifestations. It occurs due to deficiency of the enzymes responsible for repairing ultraviolet radiation-induced DNA damage. Persistence of un-repaired DNA results in somatic mutations, leading to neoplasia of the skin and ocular surface. As this condition is rare, only isolated case reports of XP with ocular surface squamous neoplasia (OSSN) are found in literature.

  7. Non‐operative breast pathology: lobular neoplasia

    OpenAIRE

    Reis‐Filho, Jorge S; Pinder, Sarah E

    2006-01-01

    Lobular neoplasia is a relatively uncommon lesion, which is frequently diagnosed in biopsy specimens taken for other reasons. Although the histological features of this lesion are well known, its biological significance as a “risk indicator” or “breast cancer precursor” has been a matter of debate. This review provides an update on recent clinicopathological and molecular data on lobular neoplasia and how these have changed the way these lesions are perceived and, most importantly, managed. F...

  8. 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

    OpenAIRE

    Sidney Roberto Nadal; Carmen Ruth Manzione

    2009-01-01

    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 hu...

  9. Neoplasia intra-epitelial córneo-conjuntival (NIC): relato de um caso atípico Conjunctival corneal intraepithelial neoplasia (CIN): report of an atypical case

    OpenAIRE

    Luciene Alves da Silva Santos; Renata Leal Barbosa; Luciene Barbosa de Sousa

    2004-01-01

    As autoras relatam um caso de NIC com apresentação e epidemiologia atípicos, bem como sua evolução com diferentes tratamentos. A paciente feminina, 41 anos, encaminhada ao departamento de córnea e doenças externas do HOS, queixava-se de baixa acuidade visual em olho direito (OD) e foi submetida a exame oftalmológico completo. Ao exame, detectou-se em ambos os olhos opacidades corneanas epiteliais digitiformes e, diante da hipótese de NIC, realizaram-se 3 ciclos de 14 dias de colírio de mitomi...

  10. Neoplasia intra-epitelial córneo-conjuntival (NIC: relato de um caso atípico Conjunctival corneal intraepithelial neoplasia (CIN: report of an atypical case

    Directory of Open Access Journals (Sweden)

    Luciene Alves da Silva Santos

    2004-10-01

    Full Text Available As autoras relatam um caso de NIC com apresentação e epidemiologia atípicos, bem como sua evolução com diferentes tratamentos. A paciente feminina, 41 anos, encaminhada ao departamento de córnea e doenças externas do HOS, queixava-se de baixa acuidade visual em olho direito (OD e foi submetida a exame oftalmológico completo. Ao exame, detectou-se em ambos os olhos opacidades corneanas epiteliais digitiformes e, diante da hipótese de NIC, realizaram-se 3 ciclos de 14 dias de colírio de mitomicina C a 0,02% 4x/dia em OD e ressecção associada a crioterapia em olho esquerdo (OE. Observamos recidiva em OD, após a qual realizamos ressecção associada a crioterapia com nova recidiva, seguida de nova ressecção e crioterapia, sem recidiva até o último exame (seguimento de 3 anos. Não houve recidiva em OE.The authors report a case of NIC with atypical presentation and epidemiology as well as its evolution with different modalities of treatment. A forty-one-year-old female was referred to the Department of Cornea and External Diseases complaining about low visual acuity in the right eye and was submitted to complete ophthalmologic examination. The patient presented with corneal epithelial opacities with pseudopodia-like extensions in both eyes. The hypothesis for the case was CCIN and the patient received 3 cycles of topical 0.02% mitomycin C drops 4 times daily for 14 days in the right eye and surgical excision associated with cryotherapy in the left eye. After detection of recurrence of the lesion in the right eye, this lesion was submitted to excision and cryotherapy, which was followed by recurrence. The patient underwent excision and cryotherapy in the right eye once more and there was no recurrence since then. The lesion in the left eye never recurred (3 years of follow-up.

  11. Fluorescence detection of esophageal neoplasia

    Science.gov (United States)

    Borisova, E.; Vladimirov, B.; Avramov, L.

    2008-06-01

    White-light endoscopy is well-established and wide used modality. However, despite the many technological advances that have been occurred, conventional endoscopy is suboptimal and usually detects advanced stage lesions. The limitations of standard endoscopy initiate development of spectroscopic techniques, additional to standard endoscopic equipment. One of the most sensitive approaches is fluorescence spectroscopy of gastrointestinal mucosa for neoplasia detection. In the recent study delta-aminolevulinic acid/Protoporphyrin IX (5-ALA/PpIX) is used as fluorescent marker for dysplasia and tumor detection in esophagus. The 5-ALA is administered per os six hours before measurements at dose 20 mg/kg weight. Excitation source has max of emission at 405 nm and light is delivered by the standard light guide of the endoscopic equipment. Through endoscopic instrumental channel a fiber is applied to return information about fluorescence to microspectrometer. Spectral features observed during endoscopic investigations could be distinct as the next regions: 450-630 nm region, where tissue autofluorescence is observed; 630-710 nm region, where fluorescence of PpIX is clearly pronounced; 530-580 nm region, where minima in the autofluorescence signal are observed, related to reabsorption of blood. The lack of fluorescence peaks in the red spectral area for normal mucosa is an indication for selective accumulation of 5-ALA/PpIX only in abnormal sites Very good correlation between fluorescence signals and histology examination of the lesions investigated is achieved.

  12. Multiple endocrine neoplasia type 1

    Directory of Open Access Journals (Sweden)

    R V Thakker

    2012-01-01

    Full Text Available Multiple endocrine neoplasia type 1 (MEN1 is characterized by the occurrence of parathyroid, pancreatic islet and anterior pituitary tumors. Some patients may also develop carcinoid tumors, adrenocortical tumors, facial angiofibromas, collagenomas, and lipomas. MEN1 is an autosomal-dominant disorder, due to mutations in the tumor suppressor gene MEN1, which encodes a 610 amino acid protein, menin. Thus, the finding of MEN1 in a patient has important implications for family members because first-degree relatives have a 50% risk of developing the disease and can often be identified by MEN1 mutational analysis. Patients with MEN1 have a decreased life-expectancy and the outcomes of current treatments, which are generally similar to that for the respective tumors occurring in non-MEN1 patients, are not as successful because of multiple tumors, which may be larger, more aggressive, and resistant to treatment, and the concurrence of metastases. The prognosis for MEN1 patients might be improved by pre-symptomatic tumor detection and undertaking treatment specific for MEN1-tumors. Thus, it is recommended that MEN1 patients and their families should be cared for by multi-disciplinary teams comprising relevant specialists with experience in the diagnosis and treatment of patients with endocrine tumors.

  13. Comparative study of anal acoustic reflectometry and anal manometry in the assessment of faecal incontinence

    DEFF Research Database (Denmark)

    Hornung, B R; Mitchell, P J; Carlson, G L;

    2012-01-01

    Anal acoustic reflectometry (AAR) is a reproducible technique providing a novel physiological assessment of anal sphincter function. It may have advantages over conventional anal manometry. The aims of this study were to determine the ability of AAR and anal manometry to identify changes in anal...

  14. Electrocautery for Precancerous Anal Lesions

    Science.gov (United States)

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  15. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-01

    Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore, well accepted in clinical practise. However, for the more complex fistulae where a significant proportion of the anal sphincter is involved, great concern remains about damaging the sphincter and subsequent poor functional outcome, which is quite inevitable following conventional surgical treatment. For this reason, over the last two decades, many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function. Among them, the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula. Another technique, the anal fistula plug, derived from porcine small intestinal submucosa, is safe but modestly effective in long-term follow-up, with success rates varying from 24%-88%. The failure rate may be due to its extrusion from the fistula tract. To obviate that, a new designed plug (GORE BioA®) was introduced, but long term data regarding its efficacy are scant. Fibrin glue showed poor and variable healing rate (14%-74%). FiLaC and video-assisted anal fistula treatment procedures, respectively using laser and electrode energy, are expensive and yet to be thoroughly assessed in clinical practise. Recently, a therapy using autologous adipose-derived stem cells has been described. Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae, and studies remain in progress. The aim of this present article is to review the pertinent literature, describing the advantages and limitations of

  16. Inter-Rater Agreement of Anal Cytology

    OpenAIRE

    Darragh, Teresa M.; Tokugawa, Diane; Castle, Philip E.; Follansbee, Stephen; Borgonovo, Sylvia; LaMere, Brandon J.; Schwartz, Lauren; Gage, Julia C.; Fetterman, Barbara; Lorey, Thomas; Wentzensen, Nicolas

    2012-01-01

    Most anal cancers are caused by persistent infections with carcinogenic human papillomaviruses (HPV). Similar to cervical carcinogenesis, the progression from HPV infection to anal cancer goes through precancerous lesions that can be treated to prevent invasion. In analogy to cervical cytology, anal cytology has been proposed as a screening tool for anal cancer precursors in high-risk populations. We analyzed the inter-observer reproducibility of anal cytology in a population of 363 HIV-infec...

  17. Multiple endocrine neoplasia type 1

    Directory of Open Access Journals (Sweden)

    Luzi Ettore

    2006-10-01

    Full Text Available Abstract Multiple Endocrine Neoplasia type 1 (MEN1 is a rare autosomal dominant hereditary cancer syndrome presented mostly by tumours of the parathyroids, endocrine pancreas and anterior pituitary, and characterised by a very high penetrance and an equal sex distribution. It occurs in approximately one in 30,000 individuals. Two different forms, sporadic and familial, have been described. The sporadic form presents with two of the three principal MEN1-related endocrine tumours (parathyroid adenomas, entero-pancreatic tumours and pituitary tumours within a single patient, while the familial form consists of a MEN1 case with at least one first degree relative showing one of the endocrine characterising tumours. Other endocrine and non-endocrine lesions, such as adrenal cortical tumours, carcinoids of the bronchi, gastrointestinal tract and thymus, lipomas, angiofibromas, collagenomas have been described. The responsible gene, MEN1, maps on chromosome 11q13 and encodes a 610 aminoacid nuclear protein, menin, with no sequence homology to other known human proteins. MEN1 syndrome is caused by inactivating mutations of the MEN1 tumour suppressor gene. This gene is probably involved in the regulation of several cell functions such as DNA replication and repair and transcriptional machinery. The combination of clinical and genetic investigations, together with the improving of molecular genetics knowledge of the syndrome, helps in the clinical management of patients. Treatment consists of surgery and/or drug therapy, often in association with radiotherapy or chemotherapy. Currently, DNA testing allows the early identification of germline mutations in asymptomatic gene carriers, to whom routine surveillance (regular biochemical and/or radiological screenings to detect the development of MEN1-associated tumours and lesions is recommended.

  18. Mutations in thep16 gene in DMBA-induced pancreatic intraepithelial neoplasia and pancreatic cancer in rats

    Institute of Scientific and Technical Information of China (English)

    Zhu Zhu; Tao Liu; Fei Han; Su-Dong Zhan; Chun-You Wang

    2015-01-01

    BACKGROUND: 7, 12-dimethylbenzanthracene (DMBA)-induced pancreatic intraepithelial neoplasia (PanIN) and pancreatic cancer in rats provide a classic model for uncovering the molec-ular mechanisms underlying pancreatic cancer. However, this model has not been characterized genetically, and in particular, the major genetic alterations in the p16 gene are unknown. METHODS: Lesions of PanIN and pancreatic cancer were in-duced with DMBA implantation in 40 rats, and control pancre-atic tissue was obtained from 10 age-matched rats without ex-posure to DMBA. Pancreatic tissue was harvested three months after DMBA implantation and DNA was extracted. Homozy-gous deletions and point mutations of the p16 (exons 1 and 2) gene were detected by PCR ampliifcation and direct sequencing. RESULTS: DMBA implantation in the 40 rats induced 26 Pan-INs and 9 carcinomas. The overall frequency of p16 alterations in the pancreatic tissue of these rats was 42.86% (15/35), and the changes were point mutations, not homozygous deletions. p16 mutations were present in 30.77% (8/26) of the rats with PanIN and 77.78% (7/9) of the rats with carcinoma (P CONCLUSION: Our ifndings indicated that p16 alteration is a common event in the carcinogenesis of this model and that the mutation pattern is analogous to that of human lesions.

  19. Human papillomavirus type influences the extent of chromosomal lag during mitosis in cervical intraepithelial neoplasia grade III

    NARCIS (Netherlands)

    Burger, MPM; VanLeeuwen, AM; Hollema, H; Quint, WGV; Pieters, WJLM

    1997-01-01

    The level of risk for carcinoma in the uterine cervix depends on the type of human papillomavirus (HPV) present. We examined whether the HPV type influences the proliferation rate and occurrence of mitotic figures with lagging chromosomes in the precursor of cervical carcinoma. The study group compr

  20. 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

    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 intraepithel...

  1. The impact of antiretroviral therapy on HPV and cervical intraepithelial neoplasia: current evidence and directions for future research

    Directory of Open Access Journals (Sweden)

    Sahasrabuddhe Vikrant V

    2010-05-01

    Full Text Available Abstract Increasing numbers of human immunodeficiency virus (HIV-infected women are now accessing life-prolonging highly active antiretroviral therapy (HAART in developing countries. There is a need for better understanding of interactions of human papillomavirus (HPV and HIV, especially in the context of increasing life expectancy due to HAART. The data regarding the impact of HAART on reducing the incidence and progression and facilitating the regression of HPV infection and cervical abnormalities is largely inconsistent. Published studies differ in their study designs (prospective or retrospective cohorts or record linkage studies, screening and diagnostic protocols, duration and type of HAART use, recruitment and referral strategies, and definitions of screening test and disease positivity. Due to the ethical and resource limitations in conducting randomized trials of the impact of HAART on incidence of HPV, CIN, and cervical cancer among HIV-infected women, it is important to consider innovative study designs, including quasi-experimental trials and operations research in sentinel populations to answer the critical research questions in this area.

  2. Basal cell hyperplasia (BCH) versus high grade prostatic intraepithelial neoplasia (HGPIN) in tiny prostatic needle biopsies: Unusual diagnostic dilemma

    International Nuclear Information System (INIS)

    Histopathological differentiation between BCH and HGPIN in prostatic needle biopsies is a diagnostic challenge. The gold standard for detection of HGPIN and BCH is histopathological examination; however subjectivity in interpretation and tiny volume of obtained tissue hamper reliable diagnosis. Aims: The aim of this study was to assess usefulness of using the p63 and p504s to solve this problem. Although the use of p63 and p504s is now well established in differentiation between preneoplastic and neoplastic prostatic lesions, their usefulness in tiny tissue material is, however, not fully studied. Methods: The study included a spectrum of 30 prostatic needle biopsies (5 BCH, 10 HGPIN, 10 indefinite luminal proliferations where BCH and HGPIN could not be distinguished from each other and 5 adenocarcinomas). H and E stained sections were examined for histopathological features. Other sections were stained immunohistochemically with p63 and p504s. Results: The mean age of patients was 69 (SD = 7.6) years. PSA range was 1.3-2.7 ng/ml. Ultra- songraphic findings were unremarkable. All BCH showed p504s-/p63+ pattern, All HGPIN had p504s + /p63 + pattern while carcinomas were p504s + /p63-. After immunostaining combined with histopathological features; the 10 indefinite specimens could be diagnosed as 4 BCH and 6 HGPIN. The article explains how applying this staining pattern on the challenging specimens, combined with histopathological features, can be helpful in proper identification of prostatic proliferations.

  3. Bitter melon extract impairs prostate cancer cell cycle progression and delays prostatic intraepithelial neoplasia in TRAMP model

    OpenAIRE

    Ru, Peng; Steele, Robert; Nerurkar, Pratibha V.; Phillips, Nancy; Ray, Ratna

    2011-01-01

    Prostate cancer remains the second leading cause of cancer deaths among American men. Earlier diagnosis increases survival rate in patients. However, treatments for advanced disease are limited to hormone ablation techniques and palliative care. Thus, new methods of treatment and prevention are necessary for inhibiting disease progression to a hormone refractory state. One of the approaches to control prostate cancer is prevention through diet, which inhibits one or more neoplastic events and...

  4. U19/Eaf2 knockout causes lung adenocarcinoma, B-cell lymphoma, hepatocellular carcinoma and prostatic intraepithelial neoplasia

    OpenAIRE

    Xiao, W; Zhang, Q; Habermacher, G; Yang, X.; Zhang, A-y; Cai, X.; Hahn, J.; Liu, J; Pins, M; Doglio, L; Dhir, R; Gingrich, J; Wang, Z.(Institute of High Energy Physics, Beijing, China)

    2007-01-01

    Upregulated gene 19 (U19)/ELL-associated factor 2 (Eaf2) is a potential human tumor suppressor that exhibits frequent allelic loss and downregulation in high-grade prostate cancer. U19/Eaf2, along with its homolog Eaf1, has been reported to regulate transcriptional elongation via interaction with the eleven-nineteen lysine-rich leukemia (ELL) family of proteins. To further explore the tumor-suppressive effects of U19/Eaf2, we constructed and characterized a murine U19/Eaf2-knockout model. Hom...

  5. Ultrastructural localization of human papilloma virus by nonradioactive in situ hybridization on tissue of human cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Multhaupt, H A; Rafferty, P A; Warhol, M J

    1992-01-01

    BACKGROUND: A nonradioactive in situ hybridization was developed to localize human papilloma virus (HPV) at the ultrastructural level. EXPERIMENTAL DESIGN: Cervical biopsies from human uterine cervices clinically suspicious of condyloma were embedded in Lowicryl K4M at low temperature....... Postembedding in situ hybridization was performed with DNA probes specific for HPV types 6/11, 16, and 18. The hybrids were detected by anti-horseradish peroxidase antibodies conjugated with 10 nm colloidal gold particles. RESULTS: Localization for HPV 16 and 18 both was to intranuclear and cytoplasmic sites....... Cytoplasmic detected HPV signals were between masses of intermediate filaments and in vacuoles; other organelles were devoid of positive signal. Within the nucleus the precise localization of the viral nucleic acid was episomal, vacuolar, and chromosomal. In situ hybridization with plasmid control DNA...

  6. Risk for cervical intraepithelial neoplasia grade 3 or worse in relation to smoking among women with persistent human papillomavirus infection

    DEFF Research Database (Denmark)

    Jensen, Kirsten Egebjerg; Schmiedel, Sven; Frederiksen, Kirsten;

    2012-01-01

    , and subsequently cervical cells were obtained for HPV DNA testing. Women with high-risk HPV infection and no prevalent cervical disease at baseline (n=1,353) were followed through the Pathology Data Bank for cervical lesions for up to 13 years. Separate analyses of women with persistent high-risk HPV infection.......05-3.22, adjusted for length of schooling, parity and HPV type at baseline). The average number of cervical cytology screening tests per year during follow-up did not explain the differences in risk in relation to smoking (p=0.4). CONCLUSIONS: Smoking is associated with an increased risk for subsequent high...

  7. Multiple endocrine neoplasia: the Chilean experience

    Directory of Open Access Journals (Sweden)

    René E. Diaz

    2012-01-01

    Full Text Available Multiple endocrine neoplasia (MEN types 1 and 2 are genetic diseases that are inherited as autosomal traits. The major clinical manifestations of multiple endocrine neoplasia type 1 include the so-called "3 P's": parathyroid, pituitary, and pancreatic tumors, including gastroenteroneuroendocrine tumors. Genetic testing can be performed on patients and the potential carriers of the menin gene mutation, but the genotype-phenotype correlation in multiple endocrine neoplasia type 1 is less straightforward than multiple endocrine neoplasia type 2. Most likely, the main advantage of genetic testing in MEN1 is to exclude from further studies those who are negative for the genetic mutation if they belong to a family with a known history of MEN1. In Chile, we started with rearranged during transfection proto-oncogene genetic testing (MEN2 15 years ago. We carried out a prophylactic total thyroidectomy to prevent medullary thyroid carcinoma in a three-year-old girl who presented with microscopic medullary thyroid carcinoma. More than 90% of the individuals who tested positive using a genetic test achieved a biochemical cure compared with only 27% of patients who receive a clinical diagnosis. Mutations are mainly located in exon 11; the most common is C634W, rather than C634R. Hypertensive crisis was the cause of death in three patients, and extensive distant metastases occurred in nine (including two patients with multiple endocrine neoplasia type 2B of 14 patients. Earlier recognition of medullary thyroid carcinoma and the other features of the disease, especially pheochromocytoma, will improve the survival rate of patients with multiple endocrine neoplasia.

  8. Utilidade da citologia anal no rastreamento dos homens heterossexuais portadores do HPV genital Anal cytology for screening heterosexual men harboring genital HPV infection

    Directory of Open Access Journals (Sweden)

    Raphael Marianelli

    2010-09-01

    Full Text Available Os papilomavírus humanos (HPV de alto risco estão fortemente relacionados à etiologia do carcinoma espinocelular (CEC anogenital e suas lesões precursoras. O HPV-16 é o tipo mais freqüente, estando presente em até 87% dos CEC do canal anal HPV-positivo. Apesar de ser relativamente raro, vem sendo cada vez mais diagnosticado, nas últimas décadas, sobretudo em indivíduos do sexo masculino. A incidência é ainda mais elevada nos grupos considerados de risco, particularmente, os homens e as mulheres HIV-positivo e os homens que fazem sexo com homens (HSH. Grande parte das pesquisas direcionadas à infecção anal pelo HPV e sua relação com neoplasia intraepitelial-anal (NIA e com o carcinoma esteve focada nos grupos de risco. Pouco interesse vem sendo destinado à investigação dos homens heterossexuais. Estudos epidemiológicos da prevalência da infecção pelo HPV em homens, mostraram que os heterossexuais masculinos apresentavam infecção anal pelo HPV em até 12%. As Sociedades médicas e os especialistas recomendam o rastreamento dos portadores de imunodepressão e dos HSH com citologia do raspado do canal anal. Entretanto, até o momento, não há recomendação de rastreamento para homens que fazem sexo com mulheres.The oncogenic human papillomaviruses (HPV are straightly associated with anogenital cancer and dysplasia. The HPV-16 is the most common type, isolated in 87% of the HPV-positive anal squamous cell carcinoma (SCC. Despite being a rare tumor, the incidence of SCC has increased in the last decades, especially in males. Incidence is particularly high amongst men who have sex with men (MSM and among HIV infected men and women. For decades anogenital HPV researches have largely focused risk groups. Poor interest was intended to men who have sex with women (MSW. Prevalence studies of HPV infection in MSW have demonstrated that anal infection was identified in as far as 12%. Medical societies and specialists recommend anal

  9. Human papilloma virus genotypes in women from Nayarit, Mexico, with squamous intraepithelial lesions and cervical cancer

    Science.gov (United States)

    Ortega-Cervantes, Laura; Aguilar-Lemarroy, Adriana; Rojas-García, Aurora Elizabeth; Barrón-Vivanco, Briscia Socorro; Vallejo-Ruiz, Verónica; León, David Cantú-De; Hernández, Yael Yvette Bernal; Jáuregui-Martínez, Armando; Medina-Díaz, Irma Martha

    2016-01-01

    Objective In Mexico cervical cancer (CC) is the most common cause of death from neoplasia in women. Study aimed to analyze the current distribution of Human papillomavirus (HPV) types in women from Nayarit, Mexico, with Squamous intraepithelial lesions (SIL) and Cervical cancer (CC). Methodology Between January 2011 and July 2013, cervical samples were collected from female residents of the Mexican state of Nayarit and were analyzed by means of a LINEAR ARRAY® HPV genotyping test. Data analyses were performed using Stata ver. 8.0 statistical software. Results Of the samples analyzed, 91.2%, HPV DNA was detected. Of these positive samples, 82% were High-risk (HR) viral types. The most prevalent HPV genotypes identified were 16, 58, 31, 18, and 70. Forty two percent of participants had a single infection, while 23 and 26% of participants were infected with two or more HPV genotypes, respectively. HPV 16 was the most prevalent genotype identified and was frequently present as a co-infection with HPV types 18, 51, 52, 59, 66, or 70. Conclusion Women <20 years of age were most often infected with HPV, and the HPV Quadrivalent vaccine (types 16, 18, 6, and 11), currently available in Mexico, no confers protection against a subset of the HPV genotypes identified in the present study (58, 31, 70, and 35). Thus, it is important evaluate the geographical distribution of specific HPV genotypes in all health of center across Mexico in order to implement a successful vaccination program and to diagnose CC in its early stages. PMID:27610056

  10. Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women

    Directory of Open Access Journals (Sweden)

    Vidal Adriana C

    2011-11-01

    Full Text Available Abstract Background Infection with human papillomavirus (HPV is associated with uterine cervical intraepithelial neoplasia (CIN and invasive cancers (ICC. Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeastern Tanzania, we recruited 215 women from the Reproductive Health Clinic at Kilimanjaro Christian Medical Centre. Cervical scrapes and biopsies were obtained for cytology and HPV DNA detection. Results 79 out of 215 (36.7% enrolled participants tested positive for HPV DNA, with a large proportion being multiple infections (74%. The prevalence of HPV infection increased with lesion grade (14% in controls, 67% in CIN1 cases and 88% in CIN2-3. Among ICC cases, 89% had detectable HPV. Overall, 31 HPV genotypes were detected; the three most common HPV genotypes among ICC were HPV16, 35 and 45. In addition to these genotypes, co-infection with HPV18, 31, 33, 52, 58, 68 and 82 was found in 91% of ICC. Among women with CIN2-3, HPV53, 58 and 84/83 were the most common. HPV35, 45, 53/58/59 were the most common among CIN1 cases. Conclusions In women with no evidence of cytological abnormalities, the most prevalent genotypes were HPV58 with HPV16, 35, 52, 66 and 73 occurring equally. Although numerical constraints limit inference, findings that 91% of ICC harbor only a small number of HPV genotypes suggests that prevention efforts including vaccine development or adjuvant screening should focus on these genotypes.

  11. Cervical intraepithelial lesions in females attending Women′s Health Clinics in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Mona Abdel-Hadi

    2015-01-01

    Full Text Available Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN   in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to have a representative sample for women living in Alexandria. All women included did not have any cervical disorder related complaints. Conventional Pap smears were obtained and diagnosed using the Bethesda system. Women with abnormal Pap smears were managed according to the 2006 consensus guidelines within the available facilities. Persistent abnormal cytological results were referred for colposcopic biopsy. Histological results were grouped into: Reactive changes, CIN 1, CIN 2/CIN 3 and adenocarcinoma in-situ (AIS. Results: Out of the 6173 smears included in the study 6072 (98.36% were normal and only 101 (1.63% were abnormal. After colposcopic biopsies, 0.08% had CIN 1, 0.03% had CIN 2, 3 and 0.01% had AIS. Conclusion: We concluded that cervical cancer screening programs, although life-saving for a number of women, are not a sufficiently high priority in our community. Money for national health screening programs should preferably be directed more towards recruiting women for breast cancer screening, since breast cancer accounts for about 33% of all female cancers in Egypt ranking number one, while cervical cancer ranks number 13.

  12. Molecular signatures of thyroid follicular neoplasia

    DEFF Research Database (Denmark)

    Helweg-Larsen, Rehannah Holga Andrea; Rossing, Maria; Henao, Ricardo;

    2010-01-01

    The molecular pathways leading to thyroid follicular neoplasia are incompletely understood, and the diagnosis of follicular tumors is a clinical challenge. To provide leads to the pathogenesis and diagnosis of the tumors, we examined the global transcriptome signatures of follicular thyroid...... involved in growth arrest and apoptosis. In the latter group, the combined loss of transcripts encoding the nuclear orphan receptors NR4A1 and NR4A3, which were recently shown to play a causal role in hematopoetic neoplasia, was noteworthy. The analysis of differentially expressed transcripts provided...

  13. Neurocutaneous spectrum of multiple endocrine neoplasia-1

    Directory of Open Access Journals (Sweden)

    Shireen Furtado

    2012-01-01

    Full Text Available Multiple endocrine neoplasia type I or Wermer syndrome is characterized by primary hyperparathyroidism, enteropancreatic endocrine tumor, and a pituitary pathology. A 35-year-old male presented with visual field defects, hyperprolactinemia, and hypogonadism. He also had multiple infraumbilical skin-colored nodules. A syndromal association of Wermer syndrome was derived using the dermal, pituitary, parathyroid, and gastrointestinal hormonal manifestations of the tumor. The radiological and histological findings of lesion which underwent biopsy are discussed. The presence of collagenomas, lipomas, and hypopigmented macules in a patient with neuroendocrine symptoms should raise the suspicion of an underlying multiple endocrine neoplasia.

  14. Correlation of p16INK4a immunoexpression and human papillomavirus (HPV) detected by in-situ hybridization in cervical squamous neoplasia.

    Science.gov (United States)

    Cheah, P L; Koh, C C; Nazarina, A R; Teoh, K H; Looi, L M

    2016-04-01

    Persistence and eventual integration of high-risk HPV (hrHPV) into the cervical cell is crucial to the progression of cervical neoplasia and it would be beneficial to morphologically identify this transformation in routine surgical pathology practice. Increased p16(INK4a) (p16) expression is a downstream event following HPV E7 binding to pRB. A study was conducted to assess the correlation between hrHPV detection using a commercial in-situ hybridization assay (Ventana INFORM HPV ISH) and p16 immunoexpression (CINtec Histology Kit) in cervical squamous intraepithelial lesions and squamous carcinoma. 27 formalin-fixed, paraffin-embedded cervical low-grade squamous intraepithelial lesions (LSIL), 21 high-grade squamous intraepithelial lesions (HSIL) and 51 squamous carcinoma (SCC) were interrogated. hrHPV was significantly more frequent in HSIL (76.2%) and SCC (88.2%) compared to LSIL(37.0%). p16 expression was similarly more frequent in HSIL (95.2%) and SCC (90.2%) compared to LSIL(3.7%). That the rates of hrHPV when compared with p16 expression were almost equivalent in HSIL and SCC while p16 was expressed in only 1 of the 10 LSIL with hrHPV, are expected considering the likelihood that transformation has occurred in HSIL and SCC but does not occur in majority of LSIL.

  15. Surgery for Crohn's anal fistulas.

    Science.gov (United States)

    Sugita, A; Koganei, K; Harada, H; Yamazaki, Y; Fukushima, T; Shimada, H

    1995-11-01

    The aim of this study was to analyze the features of Crohn's anal fistulas and to evaluate the efficacy of seton treatment. In 119 patients with Crohn's disease, the incidence of anal fistula was 56% (67/119), with no significant difference in the incidence among patients with ileitis, colitis, and ileocolitis. "Intractable" anal fistulas were found in 17% of patients with ileitis, compared to 64% of those with colitis (P = 0.051) and 68% of those with ileocolitis (P = 0.014). Seton treatment, i.e., non-cutting, long-term seton drainage, was performed for 21 patients (5 with intersphincteric, and 16 with transsphincteric fistulas). In the 16-month follow up, 9 patients required redrainage for recurrent fistulous abscess, mainly because of progressive colorectal disease. Finally, a good result was obtained in 17 of the 21 patients (81%) and no recurrent fistulous abscess developed in the 8 patients in whom all setons were removed. Anal continence was preserved in all the patients. These results indicate that anal fistulas with Crohn's ileitis were cured more easily than those with colitis or ileocolitis, and that seton treatment was effective for intersphincteric fistula with multiple fistula openings and for transphincteric fistulas in patients exhibiting remission of intestinal Crohn's disease. PMID:8563879

  16. Meta-analysis on prevalence and attribution of human papillomavirus types 52 and 58 in cervical neoplasia worldwide.

    Directory of Open Access Journals (Sweden)

    Paul K S Chan

    Full Text Available To estimate the prevalence and attribution of two non-vaccine-covered HPV types (HPV52 and HPV58 across the world.Meta-analysis on studies reported in English and Chinese between 1994 and 2012.The pooled prevalence and attribution rates of HPV52 and HPV58 in invasive cervical cancers were significantly higher in Eastern Asia compared to other regions (HPV52 prevalence: 5.7% vs. 1.8-3.6%, P<0.001; HPV52 attribution: 3.7% vs. 0.2-2.0%; HPV58 prevalence: 9.8% vs. 1.1-2.5%, P<0.001; HPV58 attribution: 6.4% vs. 0.7-2.2%, P<0.001. Oceania has an insufficient number of studies to ascertain the prevalence of HPV52. Within Eastern Asia, the attribution of HPV58 to invasive cervical cancer was 1.8-fold higher than that of HPV52. Similarly, HPV52 and HPV58 shared a higher prevalence and attribution among cervical intraepithelial neoplasia in Eastern Asia. In contrast to the classical high-risk type, HPV16, the prevalence and attribution of HPV52 and HPV58 decreased with increasing lesion severity. Thus, HPV52 and HPV58 behave as an "intermediate-risk" type.The attribution of HPV52 and HPV58 to cervical intraepithelial neoplasia and invasive cancer in Eastern Asia were respectively 2.5-2.8 and 3.7-4.9 folds higher than elsewhere. Changes in the attributed disease fraction can serve as a surrogate marker for cross-protection or type replacement following widespread use of HPV16/18-based vaccines. This unique epidemiology should be considered when designing HPV screening assays and vaccines for Eastern Asia.

  17. Intraepithelial Giardia Intestinalis: A Case Report and Literature Review

    OpenAIRE

    Martínez-Gordillo, Mario Noé; González-Maciel, Angélica; Reynoso-Robles, Rafael; Montijo-Barrios, Ericka; Ponce-Macotela, Martha

    2014-01-01

    Abstract The giardiasis is a neglected parasitic disease. The WHO has estimated more than 280 million of human infections each year; however, intraepithelial giardiasis is a rare entity, there are only 5 reports showing invasive giardiasis. A pediatric female patient with chronic abdominal pain, diarrhea, or pasty stools, without fever, was seen in the Gastroenterology and Nutrition Service. The stool studies were negative for pathogens and lactose hydrogen breath test was positive. The presu...

  18. Intraepithelial lymphocytes in the jejunal mucosa of malnourished rats.

    OpenAIRE

    Maffei, H V; Rodrigues, M. A.; de Camargo, J L; Campana, A. O.

    1980-01-01

    Intraepithelial lymphocytes (IEL) have been counted in the jejunal mucosa of adult Wistar rats submitted to a protein-free diet for 84 days and of a control group receiving a 20% casein diet, in order to evaluate the effect of protein deprivation. Relative counts (IEL/100 epithelial cells), absolute counts (number of IEL per millimetre of muscularis mucosae), and the proportion of lymphocytes crossing the basement membrane have been evaluated. Both relative and absolute IEL counts were dimini...

  19. Microparticles and Exosomes in Gynecologic Neoplasias

    NARCIS (Netherlands)

    R. Nieuwland; J.A.M. van der Post; C.A.R. Lok Gemma; G. Kenter; A. Sturk

    2010-01-01

    This review presents an overview of the functions of microparticles and exosomes in gynecologic neoplasias. Growing evidence suggests that vesicles released from cancer cells in gynecologic malignancies contribute to the hypercoagulable state of these patients and contribute to tumor progression by

  20. Molecular signatures of thyroid follicular neoplasia

    DEFF Research Database (Denmark)

    Borup, R.; Rossing, M.; Henao, Ricardo;

    2010-01-01

    The molecular pathways leading to thyroid follicular neoplasia are incompletely understood, and the diagnosis of follicular tumors is a clinical challenge. To provide leads to the pathogenesis and diagnosis of the tumors, we examined the global transcriptome signatures of follicular thyroid carci...... and robust genetic signature for the diagnosis of FA and FC. Endocrine-Related Cancer (2010) 17 691-708...

  1. Intraepithelial giardia intestinalis: a case report and literature review.

    Science.gov (United States)

    Martínez-Gordillo, Mario Noé; González-Maciel, Angélica; Reynoso-Robles, Rafael; Montijo-Barrios, Ericka; Ponce-Macotela, Martha

    2014-12-01

    The giardiasis is a neglected parasitic disease. The WHO has estimated more than 280 million of human infections each year; however, intraepithelial giardiasis is a rare entity, there are only 5 reports showing invasive giardiasis. A pediatric female patient with chronic abdominal pain, diarrhea, or pasty stools, without fever, was seen in the Gastroenterology and Nutrition Service. The stool studies were negative for pathogens and lactose hydrogen breath test was positive. The presumptive clinical diagnosis was giardiasis and the patient was empirically treated with nitazoxanide. But, the patient persisted with abdominal pain and pasty stools. Endoscopy was indicated to search for Helicobacter and Giardia. Guardian and patient gave written informed consent. Hematological profile was normal. The endoscopy was performed under general anesthesia and the biopsies and duodenal aspirate were obtained. The microscopic analyses of duodenal fluid showed Giardia trophozoites. Electron microscopic analysis was negative for Helicobacter pylori, but Giardia trophozoites with a typical crescent shape within the tissue were found. The patient was treated with tinidazole, subsequent tests showed that lactose absorption was normal, stool examinations were negative for Giardia and abdominal pain had stopped. This case suggest that intraepithelial giardiasis could be a common entity but unseen because the giardiasis diagnosis is usually made on fecal samples. Future studies are necessary to determine the role of intraepithelial trophozoites in giardiasis pathogenic mechanisms. PMID:25546671

  2. Seminal vesicle intraepithelial involvement by prostate cancer: putative mechanism and clinicopathological significance.

    Science.gov (United States)

    Miyai, Kosuke; Kristiansen, Anna; Egevad, Lars; Pina-Oviedo, Sergio; Divatia, Mukul K; Shen, Steven S; Miles, Brian J; Ayala, Alberto G; Park, Yong Wook; Ro, Jae Y

    2014-09-01

    We have recently shown seminal vesicle intraepithelial involvement of prostate cancer in cases with seminal vesicle invasion (pT3b). Based on the manner of seminal vesicle invasion, there could be 2 possible mechanisms of seminal vesicle intraepithelial involvement: direct intraepithelial invasion from prostate carcinoma in the muscular wall of seminal vesicles or intraepithelial involvement of cancer from the invaginated extraprostatic space (IES)/ejaculatory duct system to extraprostatic seminal vesicle. We aimed to clarify the manner and clinicopathological significance of seminal vesicle intraepithelial involvement. Of 1629 consecutive radical prostatectomies, 109 cases (6.7%) showed seminal vesicle invasion in whole-mounted radical prostatectomy specimens. In these pT3b cases, 18 (17%) showed seminal vesicle intraepithelial involvement by prostate cancer. Stromal invasion of the IES/ejaculatory duct system and ejaculatory duct intraepithelial invasion by prostate cancer were identified in 62 and 5 of 109 pT3b cases, respectively. However, the presence/absence of IES/ejaculatory duct system involvement by prostate cancer does not predict seminal vesicle intraepithelial involvement. No statistically significant correlation was observed between all pathologic parameters/biochemical recurrence and the presence/absence of seminal vesicle intra-epithelial involvement in the pT3b cases. These findings suggest that seminal vesicle intraepithelial involvement is more likely due to direct invasion of carcinoma from the muscular wall of seminal vesicles rather than intraepithelial extension from the ejaculatory duct system in the IES. Further studies with a substantially greater case number are needed to clarify the clinicopathological significance of seminal vesicle intraepithelial involvement in a better manner.

  3. Delay in diagnosis of congenital anal stenosis

    OpenAIRE

    Weledji, Elroy P; Motaze Sinju

    2016-01-01

    Although a minor anorectal malformation the delay in diagnosis and treatment of anal stenosis may result in significant early or late complications. Early inspection of the perineum in the neonate to pick up and correct anorectal malformation improves long term outcome but this requires proper anal examination or it could be missed. We present and discuss a case of delayed diagnosis of congenital anal stenosis (a low anorectal anomaly) with an imminent colonic perforation. Severe anal stenosi...

  4. Human Papillomaviruses; Epithelial Tropisms, and the Development of Neoplasia.

    Science.gov (United States)

    Egawa, Nagayasu; Egawa, Kiyofumi; Griffin, Heather; Doorbar, John

    2015-07-01

    Papillomaviruses have evolved over many millions of years to propagate themselves at specific epithelial niches in a range of different host species. This has led to the great diversity of papillomaviruses that now exist, and to the appearance of distinct strategies for epithelial persistence. Many papillomaviruses minimise the risk of immune clearance by causing chronic asymptomatic infections, accompanied by long-term virion-production with only limited viral gene expression. Such lesions are typical of those caused by Beta HPV types in the general population, with viral activity being suppressed by host immunity. A second strategy requires the evolution of sophisticated immune evasion mechanisms, and allows some HPV types to cause prominent and persistent papillomas, even in immune competent individuals. Some Alphapapillomavirus types have evolved this strategy, including those that cause genital warts in young adults or common warts in children. These strategies reflect broad differences in virus protein function as well as differences in patterns of viral gene expression, with genotype-specific associations underlying the recent introduction of DNA testing, and also the introduction of vaccines to protect against cervical cancer. Interestingly, it appears that cellular environment and the site of infection affect viral pathogenicity by modulating viral gene expression. With the high-risk HPV gene products, changes in E6 and E7 expression are thought to account for the development of neoplasias at the endocervix, the anal and cervical transformation zones, and the tonsilar crypts and other oropharyngeal sites. A detailed analysis of site-specific patterns of gene expression and gene function is now prompted. PMID:26193301

  5. Human Papillomaviruses; Epithelial Tropisms, and the Development of Neoplasia

    Directory of Open Access Journals (Sweden)

    Nagayasu Egawa

    2015-07-01

    Full Text Available Papillomaviruses have evolved over many millions of years to propagate themselves at specific epithelial niches in a range of different host species. This has led to the great diversity of papillomaviruses that now exist, and to the appearance of distinct strategies for epithelial persistence. Many papillomaviruses minimise the risk of immune clearance by causing chronic asymptomatic infections, accompanied by long-term virion-production with only limited viral gene expression. Such lesions are typical of those caused by Beta HPV types in the general population, with viral activity being suppressed by host immunity. A second strategy requires the evolution of sophisticated immune evasion mechanisms, and allows some HPV types to cause prominent and persistent papillomas, even in immune competent individuals. Some Alphapapillomavirus types have evolved this strategy, including those that cause genital warts in young adults or common warts in children. These strategies reflect broad differences in virus protein function as well as differences in patterns of viral gene expression, with genotype-specific associations underlying the recent introduction of DNA testing, and also the introduction of vaccines to protect against cervical cancer. Interestingly, it appears that cellular environment and the site of infection affect viral pathogenicity by modulating viral gene expression. With the high-risk HPV gene products, changes in E6 and E7 expression are thought to account for the development of neoplasias at the endocervix, the anal and cervical transformation zones, and the tonsilar crypts and other oropharyngeal sites. A detailed analysis of site-specific patterns of gene expression and gene function is now prompted.

  6. Delay in diagnosis of congenital anal stenosis

    Directory of Open Access Journals (Sweden)

    Elroy P. Weledji

    2016-03-01

    Full Text Available Although a minor anorectal malformation the delay in diagnosis and treatment of anal stenosis may result in significant early or late complications. Early inspection of the perineum in the neonate to pick up and correct anorectal malformation improves long term outcome but this requires proper anal examination or it could be missed. We present and discuss a case of delayed diagnosis of congenital anal stenosis (a low anorectal anomaly with an imminent colonic perforation. Severe anal stenosis will always require examination under anesthesia with graded Hegar's dilatation followed by postoperative maintenance. The Hegar dilator is thus both diagnostic and therapeutic in congenital anal stenosis.

  7. Evaluation of DNA Single and Double Strand Breaks in Women with Cervical Neoplasia Based on Alkaline and Neutral Comet Assay Techniques

    Directory of Open Access Journals (Sweden)

    Elva I. Cortés-Gutiérrez

    2012-01-01

    Full Text Available A hospital-based unmatched case-control study was performed in order to determine the relation of DNA single (ssb and double (dsb strand breaks in women with and without cervical neoplasia. Cervical epithelial cells of 30 women: 10 with low grade squamous intraepithelial lesions (LG-SIL, 10 with high-grade SIL (HG-SIL, and 10 without cervical lesions were evaluated using alkaline and neutral comet assays. A significant increase in global DNA damage (ssb + dsb and dsb was observed in patients with HG-SIL (48.90 ± 12.87 and 23.50 ± 13.91, patients with LG-SIL (33.60 ± 14.96 and 11.20 ± 5.71, and controls (21.70 ± 11.87 and 5.30 ± 5.38; resp.. Pearson correlation coefficient reveled a strong relation between the levels ssb and dsb (2=0.99, =0.03, and 2=0.94, =0.16, resp. and progression of neoplasia. The increase of dsb damage in patients with HG-SIL was confirmed by DNA breakage detection-FISH (DBD-FISH on neutral comets. Our results argue in favor of a real genomic instability in women with cervical neoplasia, which was strengthened by our finding of a higher proportion of DNA dsb.

  8. Evaluation of DNA Single and Double Strand Breaks in Women with Cervical Neoplasia Based on Alkaline and Neutral Comet Assay Techniques

    Science.gov (United States)

    Cortés-Gutiérrez, Elva I.; Hernández-Garza, Fernando; García-Pérez, Jorge O.; Dávila-Rodríguez, Martha I.; Aguado-Barrera, Miguel E.; Cerda-Flores, Ricardo M.

    2012-01-01

    A hospital-based unmatched case-control study was performed in order to determine the relation of DNA single (ssb) and double (dsb) strand breaks in women with and without cervical neoplasia. Cervical epithelial cells of 30 women: 10 with low grade squamous intraepithelial lesions (LG-SIL), 10 with high-grade SIL (HG-SIL), and 10 without cervical lesions were evaluated using alkaline and neutral comet assays. A significant increase in global DNA damage (ssb + dsb) and dsb was observed in patients with HG-SIL (48.90 ± 12.87 and 23.50 ± 13.91), patients with LG-SIL (33.60 ± 14.96 and 11.20 ± 5.71), and controls (21.70 ± 11.87 and 5.30 ± 5.38; resp.). Pearson correlation coefficient reveled a strong relation between the levels ssb and dsb (r2 = 0.99, P = 0.03, and r2 = 0.94, P = 0.16, resp.) and progression of neoplasia. The increase of dsb damage in patients with HG-SIL was confirmed by DNA breakage detection-FISH (DBD-FISH) on neutral comets. Our results argue in favor of a real genomic instability in women with cervical neoplasia, which was strengthened by our finding of a higher proportion of DNA dsb. PMID:23093842

  9. Development and progression of colorectal neoplasia

    OpenAIRE

    Manne, Upender; Shanmugam, Chandrakumar; Katkoori, Venkat R.; Bumpers, Harvey L.; Grizzle, William E.

    2010-01-01

    A variety of genetic and molecular alterations underlie the development and progression of colorectal neoplasia (CRN). Most of these cancers arise sporadically due to multiple somatic mutations and genetic instability. Genetic instability includes chromosomal instability (CIN) and microsatellite instability (MSI), which is observed in most hereditary non-polyposis colon cancers (HNPCCs) and accounts for a small proportion of sporadic CRN. Although many biomarkers have been used in the diagnos...

  10. 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

    OpenAIRE

    Hugo Leonardo Madeiro Arcanjo Silva; Leandro Valério Costa Batista; Luciane de Lima Moura; Luís Carlos Vieira Tavares Júnior; Juliana Aroucha; Sandra Gico Belo; Manoel Álvaro Lins Neto

    2010-01-01

    OBJETIVO: Rastreamento do papilomavírus humano (HPV) assim como sua correlação com a neoplasia anorretal nos pacientes portadores do vírus da imunodeficiência humana (HIV) por meio da anuscopia de alta resolução (AAR) e da citologia anal. MÉTODOS: Desenvolvemos um estudo observacional, transversal e duplo-cego em que participaram 31 pacientes portadores do HIV independente de queixas proctológicas. Os pacientes foram submetidos à AAR e citologia anal cujas lâminas foram enviadas ao setor de a...

  11. Evaluation of the hybrid capture 2 assay for detecting anal high-grade dysplasia.

    Science.gov (United States)

    Goldstone, Stephen E; Lowe, Brian; Rothmann, Thomas; Nazarenko, Irina

    2012-10-01

    Hybrid Capture 2 (HC2) Human Papillomavirus (HPV) DNA Test® is FDA approved and is a proven aid in detecting HPV infections of the cervix and as an aid in diagnosing, with cytology, cervical disease. A prospective feasibility study was conducted to determine if HC2 testing has utility when screening for high-grade anal dysplasia (AIN2+). We enrolled 298 patients (45% HIV+) who had AIN2+ screening with cytology, histology and HC2 testing for two specimens: a swab into liquid-based cytology medium and either a swab or a brush collection in specimen transport medium (STM). High-resolution anoscopy was performed on all patients with biopsy of AIN2+ suspicious lesions. Cytology was benign (42%), atypical squamous cells of undetermined significance (30%), low-grade squamous intraepithelial lesion (18%), high-grade squamous intraepithelial lesion (1%), ASCUS possibly high-grade dysplasia (1.7%) and nondiagnostic (7%) and 36% had AIN2+ histology. Sensitivity and specificity for predicting AIN2+ histology for any abnormal cytology were 77 and 52%, whereas HC2 sensitivity and specificity were 91 and 40% (p = 0.005 for sensitivity), respectively. There was no significant difference in HC2 sensitivity or specificity between brush and swab or STM and residual cells from cytology. AIN2+ was found in 20% of patients with benign cytology. Only nine AIN2+ specimens were HC2-. This prospective study indicates that HC2 may be useful when screening for anal dysplasia; however, a larger study is recommended. PMID:22234750

  12. Internal anal sphincter: an anatomic study.

    Science.gov (United States)

    Uz, A; Elhan, A; Ersoy, M; Tekdemir, I

    2004-01-01

    The anatomy of the internal anal sphincter and surrounding structures was investigated in 24 cadavers using a surgical microscope (6-25 x magnification). An understanding of the anatomy of the internal anal sphincter is helpful in avoiding complications during surgical procedures in the anorectal region. The external anal sphincter was composed of three ellipsoid rings of skeletal muscle (subcutaneous, superficial, and deep) that encircle the anal canal; in contrast, we found that the internal anal sphincter was composed of flat rings of smooth muscle bundles stacked one on top of the other, like the slats of a Venetian blind. In each anal canal, the average number of ring-like slats observed was 26.33 +/- 2.93 (range = 20-30) and each was covered by its own fascia. The smooth muscle fibers and fascia coalesced at three equidistant points around the anal canal to form three columns that extended distally into the lumen and differed in form from the other anal columns. When viewed from an anterior position, the columns were located anteriorly at the observer's right (5 o'clock position), posteriorly at the right (1 o'clock position), and laterally at the left (9 o'clock position). This heretofore unreported anatomy of the internal anal sphincter may play an important role in closing off the lumen of the anal canal and maintaining bowel continence. PMID:14695582

  13. Study of rainbow trout neoplasia in the region of Haraz

    OpenAIRE

    Notash, Shahab

    2006-01-01

    This study was carried out in order to determine neoplasia presence in rainbow trout in Haraz area. Neoplasia in various species of fishes including freshwater, brackish water and marine fishes was reported in other countries. But up to now there is no documented report of rainbow trout neoplasia in Iran. The study was performed in 20 farms of Haraz area during 2004-2005. All fishes of each farm firstly were observed in order to any abnormal mass which is suspicious to neoplasia. Besides in o...

  14. Clinical response to glycyrrhizinic acid in genital infection due to human papillomavirus and low-grade squamous intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Marcelino Hernandez Valencia

    2011-11-01

    Full Text Available Human papilloma virus (HPV can infect any of the mucosal areas of the body and cause cervical cancer. Until recently, no specific treatments were available for this condition; therefore, any damaged tissue had to be removed or destroyed, which may have presented obstetrical repercussions for some women. Recently, new drugs have been developed that have shown to be effective for the cure of HPV infection. Glycyrrhizinic acid (GA has shown fewer side effects and its systemic use makes it possible to reach difficultto- treat lesions. The purpose of this study was to evaluate the clinical outcome of GA to eliminate the epithelial lesion and HPV. We carried out a longitudinal, descriptive study that included women of reproductive age who were diagnosed with HPV associated with low-grade squamous intraepithelial lesion (LSIL. Subjects began treatment based on GA using two routes of administration - systemic (oral and topical (spray - with assessments every month to determine the clinical changes of the lesions through colposcopy and Papanicolaou (Pap smear. Simple statistics were used along with two-tailed Student’s t-test; P<0.05 was considered statistically significant before and after treatment. There were 70 eligible patients, of whom 62 fulfilled the inclusion criteria. Age of subjects was 27.8±9.5 years. At the time of the study, 100% of the patients had HPV infection, 40% were associated with LSIL, and only 16% used a barrier contraceptive (condom method. Resolution was achieved in all patients from 4 weeks of treatment initiation and improvement was achieved in the majority of patients at 12 weeks (74% (P<0.001. However, there was persistence of LSIL in 27.7% of patients and only one patient progressed to cervical intraepithelial neoplasia (CIN II. The use of GA proved to be effective in resolving clinical HPV lesions. For cervical lesions with epithelial changes (LSIL, treatment may be required for a longer period as with other drugs used

  15. Chemoresistant gestational trophoblastic neoplasia: a case report.

    Science.gov (United States)

    Cp, Sudha; M, Sahana

    2014-07-01

    Gestational trophoblastic neoplasia (GTN) is a disease of women in reproductive age. It is one of the most chemotherapy responsive and highly curable cancer. It is diagnosed when there is clinical, radiologic, pathologic, and/or hormonal evidence of persistent or relapsed gestational trophoblastic disease. In most instances, it is cured by surgical evacuation of the uterus. If persistent, it is treated with chemotherapy which provides response in >90% of the cases. In the unresponsive persistent cases and if the women has completed her child bearing, hysterectomy is generally recommended. Here, we report a rare case of chemoresistant GTN which was confirmed to be placental-site trophoblastic tumour (PSTT) on biopsy.

  16. New Developments in Ocular Surface Squamous Neoplasia

    Directory of Open Access Journals (Sweden)

    Ayşe Yağcı

    2014-09-01

    Full Text Available Ocular surface squamous neoplasia originates from conjunctiva epithelium and covers a broad spectrum of disease ranging from dysplasia to squamous cell carcinoma. Clinical features may vary from case to case. Traditional treatment of excision with no-touch technique combined with adjuvant therapies because of high recurrence rate. Main adjuvant treatments are cryotherapy and chemotherapy. In this review, clinical forms, differential diagnosis, American Joint Committee on Cancer classification and recent approaches to the management of ocular surface squamous dysplasia were described. (Turk J Ophthalmol 2014; 44: Supplement 8-14

  17. Zollinger-Ellison syndrome, acromegaly, and colorectal neoplasia

    NARCIS (Netherlands)

    Tobi, M; Cats, A; Maliakkal, BJ; Kinzie, JL; Maliakkal, R; Dullaart, RPF; Luk, GD

    1997-01-01

    Zollinger-Ellison syndrome (ZES) and acromegaly are two hypersecretory states in which colorectal neoplasia has been described, but the incidence in the former condition may not be increased. We describe four patients with colorectal neoplasia associated with the ZES and review other published cases

  18. Primary pulmonary neoplasia in the dog and cat

    International Nuclear Information System (INIS)

    This article covers the pertinent clinical, physical, and radiographic findings in dogs and cats with primary pulmonary neoplasia. Diagnostic and treatment recommendations are made. Although primary pulmonary neoplasia is rare in both the dog and cat, it appears to be diagnosed with increasing frequency. Early detection and surgical treatment of carefully selected cases can prolong a good quality of life

  19. Colonoscopic yield of colorectal neoplasia in daily clinical practice

    Institute of Scientific and Technical Information of China (English)

    Jochim S Terhaar sive Droste; Mike E Craanen; Rene WM van der Hulst; Joep F Bartelsman; Dick P Bezemer; Kim R Cappendijk; Gerrit A Meijer; Linde M Morsink; Pleun Snel; Hans ARE Tuynman; Roy LJ van Wanrooy; Eric IC Wesdorp; Chris JJ Mulder

    2009-01-01

    AIM: To assess the prevalence and location of advanced neoplasia in patients undergoing colonoscopy,and to compare the yield per indication.METHODS: In a multicenter colonoscopy survey (n = 18 hospitals) in the Amsterdam area (Northern Holland),data of all colonoscopies performed during a three month period in 2005 were analyzed. The location and the histological features of all colonic neoplasia were recorded. The prevalence and the distribution of advanced colorectal neoplasia and differences in yield between indication clusters were evaluated. Advanced neoplasm was defined as adenoma > 10 mm in size,with > 25% villous features or with high-grade dysplasia or cancer.RESULTS: A total of 4623 eligible patients underwent a total colonoscopy. The prevalence of advanced neoplasia was 13%, with 281 (6%) adenocarcinomas and 342 (7%) advanced adenomas. Sixty-seven percent and 33% of advanced neoplasia were located in the distal and proximal colon, respectively. Of all patients with right-sided advanced neoplasia (n = 228), 51%had a normal distal colon, whereas 27% had a synchronous distal adenoma. Ten percent of all colonoscopies were performed in asymptomatic patients, 7% of whom had advanced neoplasia. In the respective procedure indication clusters, the prevalence of rightsided advanced neoplasia ranged from 11%-57%.CONCLUSION: One out of every 7-8 colonoscopies yielded an advanced colorectal neoplasm. Colonoscopy is warranted for the evaluation of both symptomatic and asymptomatic patients.

  20. Increased intraepithelial innervation in women with vulvar vestibulitis syndrome.

    Science.gov (United States)

    Bohm-Starke, N; Hilliges, M; Falconer, C; Rylander, E

    1998-01-01

    Women with vulvar vestibulitis syndrome (VVS) suffer from severe pain and discomfort in the area around the introitus at almost any stimulus that causes pressure within the vestibule. In spite of the severe sensory symptoms present in these women, the influence of the peripheral nerves in the vulvar vestibulum has not been clarified before. In this study the nerve supply in the vestibular mucosa in women with VVS and in healthy women free from vulvar symptoms has been revealed by PGP 9.5 immunohistochemistry. The results show a significant increase in the number of intraepithelial nerve endings in women with VVS, indicating an alteration in the nerve supply in the afflicted area. PMID:9813445

  1. Endometrial intraepithelial carcinoma: A case report and brief review

    Directory of Open Access Journals (Sweden)

    Ram Manisha

    2008-10-01

    Full Text Available This case report describes the precursor lesion of uterine papillary serous carcinoma (UPSC. A 65-year-old post-menopausal female presented with prolapse and vaginal discharge and underwent a hysterectomy revealing an atrophic endometrium, highly atypical endometrial glands, the lining cells of which showed pseudostratification, hobnailing, a high nuclear to cytoplasmic ratio, and prominent nucleoli. A p53 immunoreactivity score of 8 and a MIB-1 index of 80% was obtained leading to a diagnosis of endometrial intraepithelial carcinoma (EIC. Since serous EIC is commonly associated with extra-uterine serous carcinoma, it is a uniquely aggressive precursor lesion. Molecular studies support the hypothesis that EIC is a precursor of both uterine and extra-uterine invasive serous carcinomas. This is why the treatment protocol for EIC cases is total abdominal hysterectomy (TAH, accompanied by a staging procedure. In our patient, EIC was limited to the endometrium; associated with an excellent clinical outcome.

  2. Viscoelastic assessment of anal canal function using acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2012-01-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis....

  3. Effect of Thin Prep® imaging system on laboratory rate and relative sensitivity of atypical squamous cells, high-grade squamous intraepithelial lesion not excluded and high-grade squamous intraepithelial lesion interpretations

    Directory of Open Access Journals (Sweden)

    Brooke R Koltz

    2013-01-01

    Full Text Available Introduction: Automated screening of Thin Prep ® Papanicolaou Tests has become increasingly common in clinical practice. Increased productivity has initiated laboratory use of the Thin Prep ® Imaging System (TIS. Increased sensitivity is a potential additional benefit of TIS. Published studies have shown an increase in discovery of dysplastic cells. This study evaluates the effect of TIS on the incidence of atypical squamous cells high-grade squamous intraepithelial lesion not excluded (ASC-H and high-grade squamous intraepithelial lesion (HGSIL results on Thin Prep ® Pap Tests by comparing TIS-assisted and manual screening findings and the diagnoses on subsequent follow-up in a screening population over a 1-year time period. Materials and Methods: A compilation of all ASC-H and HGSIL cases was prepared by conducting a computerized search over a 1-year period (7/06-6/07. The accumulated cases include Thin Prep Pap tests that were both TIS and manually screened. Follow-up results of cytologic and histologic cervical specimens were obtained for a time period extending to 2010. Interpretation utilizing TIS was in place 10 months prior to the study′s initiation. Results: During the study period 70,522 Pap tests were performed in our laboratory. One third (33% of Pap tests were screened with assistance of TIS. Manual screening was performed on 47,380 Pap tests of which 153 (0.32% were interpreted as ASC-H and 164 (0.35% were interpreted as HGSIL. During the same time period automated screening (TIS was performed on 23,111 Pap tests. Interpretation of 62 (0.27% cases provided an ASC-H result, while 71 (0.31% were HGSIL. Follow-up cervical dysplasia by colposcopic biopsy and cone biopsy was distributed proportionally between TIS and manual screening for both ASC-H and HGSIL categories. Cervical intraepithelial neoplasia (CIN II/III was identified on follow-up biopsy of 41% TIS cases and 45% manually screened cases for ASC-H. In the HGSIL subset 71

  4. Nocturnal faecal soiling and anal masturbation.

    OpenAIRE

    A. F. Clark; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised.

  5. Pap smears for men: a vision of the future?

    LENUS (Irish Health Repository)

    Oon, S F

    2012-02-01

    BACKGROUND: Anal intraepithelial neoplasia (AIN) rarely receives as much publicity as its neighbouring orifice, the cervix. As in the cervix, intraepithelial neoplasias are precursors to cancer in the anal canal. AIN and cervical interstitial neoplasia (CIN) undergo dysplasia as a consequence of human papillomavirus (HPV) infection. Since the advent of screening with the Pap smear in CIN, cervical cancer has plummeted to a fifth of its initial incidence. Anal cancer, however, has been rising, with a predilection for human immunodeficiency virus-infected men. HPV causes a squamous epithelial dysplasia and converts healthy tissue into AINs of increasing severity until anal cancer manifests. CLINICAL CASE: This article describes a clinical case of anogenital HPV infection refractory to medical and surgical therapy. It also describes an effective surgical excision technique associated with a good cosmetic outcome. CONCLUSIONS: The paper concludes by briefly discussing the implications of a national screening programme against AIN in the future.

  6. Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    GU Jin; LI Jiyou; YAO Yunfeng; LU Aiping; WANG Hongyi

    2007-01-01

    It is difficult to distinguish a tectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas.The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified.Here,we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma.Five months after resection,he developed an adenocarcinoma in the anal canal.The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were performed.The index tumor demonstrated CK 7-/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately.It is very important to difierentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

  7. Variantes de lesões intra-epiteliais escamosas: relato de quatro casos Variants of intraepithelial squamous lesions: report of four cases

    Directory of Open Access Journals (Sweden)

    Álvaro P. Pinto

    2005-04-01

    Full Text Available Entre a rotina de biópsias e produtos cirúrgicos provenientes do colo uterino, um número significativo de lesões intra-epiteliais escamosas (LIE pode causar dificuldade quanto a caracterização e graduação histológica. Tais lesões têm sido identificadas e descritas isoladamente por artigos científicos como variantes histológicas de LIE cervicais. São elas a metaplasia papilar imatura atípica (MPIA e as variantes de neoplasia intra-epitelial cervical graus II/III: queratinizante, com padrão metaplásico imaturo de crescimento e escamomucinosa. Neste artigo são exemplificados quatro casos representativos das entidades citadas acima, provenientes das rotinas do Programa de Prevenção do Câncer Ginecológico do Estado do Paraná e de um laboratório privado especializado em patologia ginecológica de Curitiba, o Laboratório de Citopatologia e Anatomia Patológica Annalab. Os principais critérios diagnósticos são descritos, assim como a correlação citológica e molecular relacionada à presença e à localização do ácido nucleico viral (papilomavírus humano [HPV] nas lesões.In routine basis, among biopsies and surgical specimens derived from uterine cervix, a significant number of squamous intraepithelial lesions (SIL may be difficult to diagnose and grade. Some of these lesions were identified, isolated and reported in scientific articles as histological variants of SIL. They are: metaplastic papillary immature atypia (MPIA and the following grade II/III cervical intraepithelial neoplasia variants: keratinized, immature metaplastic-like proliferation and mucin-producing. In this article four cases representative of these variants are described. They were retrieved from the routines of a large scale gynecological cancer screening program and a private laboratory specialized on gynecological pathology, both from Paraná State, Brazil. The main histological criteria for diagnosis are described, as well cytological and

  8. Prevalência de papilomavirus humano (HPV anal, genital e oral, em ambulatório geral de coloproctologia Prevalence of anal, genital and oral human papillomavirus (HPV in general ambulatory for diseases of colon and rectum

    Directory of Open Access Journals (Sweden)

    João Carlos Magi

    2006-09-01

    /penis sample and an anus sample. The result indicated that of the 15,62% of the patients that had anal, oral, or genital HPV; 4,68% of them presented anal HPV, one person with high risk of HPV to neoplasia had it associated to genital HPV; another one had a medium risk HPV and other a low risk one. The conclusion is that the prevalence of anal, genital and oral HPV was high, among this number, 4,68% suffers from anal HPV and among HPV positive patient 30% had anal pain as the main complainty.

  9. Limitations on the Detection Rate of High-Risk HPV by Hybrid Capture 2 Methodology in High Grade Intraepithelial (HSIL or Atypical Squamous Cells-Cannot Exclude HSIL (ASC-H Cytological Lesions with Proved CIN2+

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Noël

    2015-01-01

    Full Text Available Recent literature data suggest that the high-risk human papillomaviruses (HR-HPVs testing with several molecular techniques could be an alternative to cytology in the detection of cervical intraepithelial neoplasias of grade 2 or worse (CIN2+. However, any molecular techniques have its own limits and may give false negative results which must be clearly known before undertaking a primary HPV screening. This study aims to evaluate the performance of the high-risk HPV hybrid capture II detection kit (HCII which is considered as a “gold standard technique” in a series of 100 women having proved both cytological lesions of atypical squamous cells-cannot exclude an HSIL (ASC-H or high-grade squamous intraepithelial lesion (HSIL and histological lesions of CIN2+. The clinical sensitivity of HCII in women with a cytological diagnosis of ASC-H/HSIL and a diagnosis of CIN2+ is high but not absolute and estimated at 96% (95,6% and 100% of women with a diagnosis of CIN2/3 or invasive squamous cell carcinoma, resp.. These data although they are infrequent must be clearly referred before to start an HPV primary screening of CIN2+ especially with HCII methodology.

  10. Neoplasia endocrina múltiple tipo-2b

    OpenAIRE

    Lastra, Guido; de Franco, Roberto; Rueda P., Pedro Nel; Pradilla S., Lina P.; Paz C., Óscar

    2014-01-01

    La neoplasia endocrina multiple tipo 2 comprendetres sindromes : la neoplasia endocrina múltiple2A con predisposición genética para desarrollarcarcinoma medular del tiroides,feocromocitoma e hiperplasia primaria deparatiroides. La neoplasia endocrina múltiple 2B,desorden autosómico dominante con feocromocitomay carcinoma medular del tiroides quegeneralmente se presenta a una edad más tempranay es más agresivo que la de tipo 2A, porlo que su diagnóstico precoz es crítico; estospacientes, que t...

  11. Anal erogeneity: the goose and the rat.

    Science.gov (United States)

    Shengold, L

    1982-01-01

    A case is presented in which the patient's traumatically derived intense anal erogeneity (associated with traumatic anxiety as well as with castration anxiety) inhibited his phallic sensations and potency and also his power to sustain productive thought. His passive cravings were disguised and reacted against in his compulsive-exhibitionistically phallic role of a Don Juan. He described at least two levels of anal feelings: a dangerous but exciting, tolerable or even pleasurable tension associated with the imago of the goose; and an unbearable, terrifying overcharged level embodied in the imago of the rat. (He had read of, and had felt himself identified with, Freud's Rat Man.) Contrasts are presented with François Rabelais' account of the instinctual development and anal training of Gargantua, in which the connotations of the goose lead to a happy anal, phallic and intellectual control. Generalizations are ventured about the crucial attainment of command over the anal sphincter for the taming of 'primal affect'(Fliess). With early psychopathology there is a defensive overcathexis of anal control (and of anal mechanisms and character traits) to try to contain over-stimulation. In contrast true anal mastery contributes to the acquisition of optimal genital feelings and functioning and to the capacity for sustaining integrative thinking so necessary for 'owning' one's affects and impulses, and therefore for a feeling of identity. Finally, some remarks of Freud on Rabelais are reviewed in relation to levels of urethral erogeneity, seen as developmental way stations between the anal and the phallic, and partaking of both.

  12. VERJETNOSTNE VARNOSTNE ANALIZE JEDRSKE ELEKTRARNE V ZAUSTAVITVI

    OpenAIRE

    Antončič, Mitja

    2016-01-01

    Pričujoča magistrska naloga obravnava verjetnostne varnostne analize jedrske elektrarne v zaustavitvenih stanjih. Verjetnostne varnostne analize so namenjene ocenjevanju in izboljšanju varnosti kompleksnih sistemov, tudi jedrskih elektrarn. Skozi analizo izvemo možne neželene dogodke, do katerih lahko pride v sistemu, verjetnost nastopa teh dogodkov, način njihovega razvoja in končne posledice. Na podlagi analize lahko določimo pomembnost posameznih komponent, kar je koristna informacija pri ...

  13. Piecemeal Versus En Bloc Resection of Large Rectal Adenomas

    Science.gov (United States)

    2016-05-10

    Colorectal Adenoma With Mild Dysplasia; Colorectal Adenoma With Severe Dysplasia; Colorectal Adenomatous Polyp; Colorectal Low Grade Intraepithelial Neoplasia; Colorectal High Grade Intraepithelial Neoplasia

  14. Marijuana use is not associated with cervical human papillomavirus natural history or cervical neoplasia in HIV-seropositive or HIV-seronegative women.

    Science.gov (United States)

    D'Souza, Gypsyamber; Palefsky, Joel M; Zhong, Ye; Minkoff, Howard; Massad, L Stewart; Anastos, Kathy; Levine, Alexandra M; Moxley, Michael; Xue, Xiao N; Burk, Robert D; Strickler, Howard D

    2010-03-01

    Marijuana use was recently reported to have a positive cross-sectional association with human papillomavirus (HPV)-related head and neck cancer. Laboratory data suggest that marijuana could have an immunomodulatory effect. Little is known, however, regarding the effects of marijuana use on cervical HPV or neoplasia. Therefore, we studied the natural history (i.e., prevalence, incident detection, clearance/persistence) of cervical HPV and cervical neoplasia (i.e., squamous intraepithelial lesions; SIL) in a large prospective cohort of 2,584 HIV-seropositive and 915 HIV-seronegative women. Marijuana use was classified as ever/never, current/not current, and by frequency and duration of use. No positive associations were observed between use of marijuana, and either cervical HPV infection or SIL. The findings were similar among HIV-seropositive and HIV-seronegative women, and in tobacco smokers and nonsmokers. These data suggest that marijuana use does not increase the burden of cervical HPV infection or SIL.

  15. Relation between electromyography and anal manometry of the external anal sphincter.

    OpenAIRE

    Sørensen, M; Tetzschner, T; Rasmussen, O O; Christiansen, J

    1991-01-01

    Thirteen patients with faecal incontinence and 26 control subjects were studied to investigate whether a quantitative electromyographic (EMG) signal could be correlated to anal manometry. Three different electrodes were used--a concentric needle electrode, a disposable sponge electrode, and a hard anal plug electrode. The maximum amplitude of the EMG recording was used as a quantitative parameter. Linear regression showed significant correlation between EMG and anal manometry with the sponge ...

  16. Anal Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Anal Disorders URL of this page: https://medlineplus.gov/languages/analdisorders.html Other topics A-Z A B ...

  17. Colorectal neoplasia in juvenile polyposis or juvenile polyps.

    OpenAIRE

    Giardiello, F.M.; Hamilton, S R; Kern, S. E.; Offerhaus, G. J.; Green, P A; Celano, P.; Krush, A J; Booker, S V

    1991-01-01

    Juvenile (retention) polyps are usually solitary lesions in the colorectum but may be multiple in juvenile polyposis. The association between juvenile polyps and colorectal neoplasia is controversial. We present three patients with juvenile polyposis who had colorectal adenomas or adenomatous epithelium in juvenile polyps at ages 3, 4, and 7 years. In a retrospective study of 57 additional patients with one or more juvenile polyps, 10 patients (18%) had colorectal neoplasia including three wi...

  18. Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

    OpenAIRE

    Inoue, Izumi; Kato, Jun; Yoshimura, Noriko; Maeda, Yoshimasa; Moribata, Kosaku; Shingaki, Naoki; Deguchi, Hisanobu; Enomoto, Shotaro; Maekita, Takao; UEDA, KAZUKI; Iguchi, Mikitaka; Tamai, Hideyuki; FUJISHIRO, MITSUHIRO; Yamamichi, Nobutake; Takeshita, Tatsuya

    2012-01-01

    In a previous population-based case-control study, we demonstrated an elevated risk of colorectal neoplasia with Helicobacter pylori (H. pylori) infection. The present study investigated the effects of H. pylori-associated chronic gastritis on the development of colorectal neoplasia by analyzing the recurrence of colorectal neoplasia subsequent to endoscopic resection. Ninety-nine patients who had undergone endoscopic resection of colorectal neoplasia were monitored under colonoscopy, and the...

  19. Papilomavírus Humano (HPV e sua associação entre lesões cervical e anal em mulheres

    Directory of Open Access Journals (Sweden)

    Luciane Maria Oliveira Brito

    2016-09-01

    Full Text Available Introdução: Entre as doenças virais sexualmente transmissíveis, a infecção pelo Papilomavírus Humano (HPV configura-se como a mais comum, e sua incidência vem aumentando acentuadamente nos últimos trinta anos. A infecção anal por subtipos específicos do HPV predispõe o indivíduo à neoplasia intraepitelial anal, que pode evoluir para o câncer de forma similar ao colo uterino. Objetivo: avaliar a associação tipo-específica entre infecções anais e cervicais, assim como os aspectos citopatológicos das lesões anais pelo vírus HPV em mulheres de São Luís, Maranhão. Métodos: Estudo analítico transversal com 27 mulheres atendidas no Centro de Pesquisa Clínica da UFMA, entre agosto de 2012 e julho de 2015, mediante entrevista e realização de exames complementares. Resultados: As mulheres tinham, em média, 32 anos. Em relação ao resultado do PCR, 77,7% das pacientes apresentaram resultado positivo para HPV anal, sendo o subtipo 16 o mais frequente (47,6%. Na região cervical, 88,8% apresentaram PCR positivo, sendo o mais comum o subtipo 16 (47,8%. A coinfecção anal e cervical pelo HPV foi observada em 74% das mulheres. 93,3% dos resultados de citologia anal não apresentaram alteração, assim como 72,2% das anuscopias realizadas. Conclusões: A infecção cervical por HPV é um fator sugestivo de risco para o desenvolvimento da infecção na região anal.

  20. Anal acoustic reflectometry: a new technique for assessing anal sphincter function

    DEFF Research Database (Denmark)

    Mitchell, P J; Klarskov, N; Hosker, G;

    2010-01-01

    Anal acoustic reflectometry (AAR) is a new technique that offers an assessment of anal sphincter function by the measurement of additional parameters not available with conventional manometry. The aim of this study is to describe the technique, methodology and initial pilot study results....

  1. Gamma/delta intraepithelial lymphocytes in the mouse small intestine.

    Science.gov (United States)

    Ogata, Masaki; Itoh, Tsunetoshi

    2016-09-01

    Although many studies of intraepithelial lymphocytes (IELs) have been reported, most of them have focused on αβ-IELs; little attention has been paid to γδ-IELs. The function of γδ-IELs remains largely unclear. In this article, we briefly review a number of reports on γδ-IELs, especially those in the small intestine, along with our recent studies. We found that γδ-IELs are the most abundant (comprising >70 % of the) IELs in the duodenum and the jejunum, implying that it is absolutely necessary to investigate the function(s) of γδ-IELs when attempting to delineate the in vivo defense system of the small intestine. Intraperitoneal injection of anti-CD3 mAb stimulated the γδ-IELs and caused rapid degranulation of them. Granzyme B released from their granules induced DNA fragmentation of duodenal and jejunal epithelial cells (paracrine) and of the IELs themselves (autocrine). However, perforin (Pfn) was not detected, and DNA fragmentation was induced even in Pfn-knockout mice; our system was therefore found to present a novel type of in vivo Pfn-independent DNA fragmentation. We can therefore consider γδ-IELs to be a novel type of large granular lymphocyte without Pfn. Fragmented DNA was repaired in the cells, indicating that DNA fragmentation alone cannot be regarded as an unambiguous marker of cell death or apoptosis. Finally, since the response was so rapid and achieved without the need for accessory cells, it seems that γδ-IELs respond readily to various stimuli, are activated only once, and die 2-3 days after activation in situ without leaving their site. Taken together, these results suggest that γδ-IELs are not involved in the recognition of specific antigen(s) and are not involved in the resulting specific killing or exclusion of the relevant antigen(s).

  2. Duodenal intraepithelial T lymphocytes in patients with functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    Gilles Gargala; Stéphana Lecleire; Arnaud Frangois; Serge Jacquot; Pierre Déchelotte; Jean Jacques Ballet; Loic Favennec; Philippe Ducrotté

    2007-01-01

    AIM:To quantify the intraepithelial lymphocytes (IELs) and to document the membrane expression of CD4,CD8,TCRγδ and adhesion and/or activation-associated molecules (CD103,CD28,CD44,CD69,HLA-DR,CD95/Fas) in the duodenal mucosa of patients with functional dyspepsia (FD) in order to provide arguments for an immunological process in FD.METHODS:Twenty-six FD patients according to Rome Ⅱ criteria (20 were H pylori negative) were studied and compared to 12 healthy adults.IELs were isolated from five duodenal biopsy samples,then quantified by microscopy and flow cytometry while the membrane phenotypes were determined by cytofluorometry.RESULTS:Duodenal histological examination was normal.In H pylori negative patients,the number of IELs was not different from that in healthy controls.Median percentage expression of CD4,CD8,or TCRγδ and CD103,CD44,CD28,CD69 on CD3+ IELs,among the adhesion/activation associated molecules tested,was not different from that in healthy controls.In contrast,the median percentage expression of CD95/Fas [22(9-65) vs 45(19-88),P=0.03] and HLADR expressing CD3+ IELs [4(0-30) vs 13(4-42),P=0.041 was signifcantly lower in the H pylori negative FD group than in healthy controls,respectively.The number of IELs was significantly greater in H pylori positive FD patients than in healthy controls [median ratio for 100 enterocytes 27.5 (6.7-62.5) vs 10.8 (3-33.3), P = 0.02] due to a higher number of CD8+ CD3+ IELs.CONCLUSION: In H pylori negative FD patients, the phenotypic characterization of IELs suggests that we cannot exclude a role of IELs in FD.

  3. DEGRO practical guidelines: radiotherapy of breast cancer II. Radiotherapy of non-invasive neoplasia of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Souchon, R. [University Hospital Tuebingen, Klinik fuer Radioonkologie, Tuebingen (Germany); Sautter-Bihl, M.L. [Municipal Hospital Karlsruhe, Karlsruhe (Germany); Sedlmayer, F. [LKH Salzburg, Paracelsus Medical University Hospital, Salzburg (Austria); Budach, W. [University Hospital Duesseldorf, Duesseldorf (Germany); Dunst, J. [University Hospital Schleswig-Holstein, Luebeck (Germany); Feyer, P. [Klinikum Neukoelln, Berlin (Germany); Fietkau, R.; Sauer, R. [University Hospital Erlangen, Erlangen (Germany); Harms, W. [St. Clara Hospital, Basel (Switzerland); Wenz, F. [University Hospital Mannheim, Mannheim (Germany); Haase, W.

    2014-01-15

    To complement and update the 2007 practice guidelines of the breast cancer expert panel of the German Society of Radiation Oncology (DEGRO) for radiotherapy (RT) of breast cancer. Owing to its growing clinical relevance, in the current version, a separate paper is dedicated to non-invasive proliferating epithelial neoplasia of the breast. In addition to the more general statements of the German interdisciplinary S3 guidelines, this paper is especially focused on indication and technique of RT in addition to breast conserving surgery. The DEGRO expert panel performed a comprehensive survey of the literature comprising recently published data from clinical controlled trials, systematic reviews as well as meta-analyses, referring to the criteria of evidence-based medicine yielding new aspects compared to 2005 and 2007. The literature search encompassed the period 2008 to September 2012 using databases of PubMed and Guidelines International Network (G-I-N). Search terms were ''non invasive breast cancer'', ''ductal carcinoma in situ, ''dcis'', ''borderline breast lesions'', ''lobular neoplasia'', ''radiotherapy'' and ''radiation therapy''. In addition to the more general statements of the German interdisciplinary S3 guidelines, this paper is especially focused on indications of RT and decision making of non-invasive neoplasia of the breast after surgery, especially ductal carcinoma in situ. Among different non-invasive neoplasia of the breast only the subgroup of pure ductal carcinoma in situ (DCIS; synonym ductal intraepithelial neoplasia, DIN) is considered for further recurrence risk reduction treatment modalities after complete excision of DCIS, particularly RT following breast conserving surgery (BCS), in order to avoid a mastectomy. About half of recurrences are invasive cancers. Up to 50?% of all recurrences require salvage mastectomy

  4. [Heredity in renal and prostatic neoplasia].

    Science.gov (United States)

    Prayer Galetti, T; D'Arrigo, L; De Zorzi, L; Patarnello, T

    1997-09-01

    There is an ever growing report of data supporting the evidence that accumulated genetic changes underlie the development of neoplasia. The paradigma of this multistep process is colon cancer were cancer onset is associated, over decades, with at least seven genetic events. The number of genetic alterations increases moving from adenomatous lesions to colon cancer and, although the genetic alterations occur according to a preferred sequence, the total accumulation of changes rather than their sequential order is responsible of tumor biological behavior. It is noteworthy that, at least for this neoplasia, carcinogenesis appears to arise as a result of the mutational activation of oncogenes coupled with the mutational inactivation of tumor suppressor genes. In some cases mutant suppressor genes appear to exert a phenotypic effect even when present in the heterozygous state thus been non "recessive" at the cellular level. The general features of this model may apply also to renal cell cancer (RCC) and prostate cancer (CaP). Extensive literature exists on the cytogenetic and molecular findings in RCC. Only 2% of RCC are familiar, but molecular genetic studies of these cancers have provided important informations on RCC pathogenesis. As with other cancers, familiar RCC is characterized by an early age of onset and frequent multicentricity. A pathological classification useful in studying these patients subdivide renal cancers in papillary (pRCC) and non papillary (RCC) neoplasms. The most common cause of inherited RCC is the Von Hippel Lindau disease (VHL) a dominantly inherited multisystem disorder characterized by retinal and cerebellar hemangioblastomas, pheochromocytomas, pancreatic cysts and RCC. Over 70% of these patients will develop an RCC by their sixth decade. In 1993 the isolation of the tumor suppressor gene in VHL disease at the level of chromosome 3p25-p26 have lead to a better understanding of RCC. Most missense mutations are associated with high risk of

  5. [Heredity in renal and prostatic neoplasia].

    Science.gov (United States)

    Prayer Galetti, T; D'Arrigo, L; De Zorzi, L; Patarnello, T

    1997-09-01

    There is an ever growing report of data supporting the evidence that accumulated genetic changes underlie the development of neoplasia. The paradigma of this multistep process is colon cancer were cancer onset is associated, over decades, with at least seven genetic events. The number of genetic alterations increases moving from adenomatous lesions to colon cancer and, although the genetic alterations occur according to a preferred sequence, the total accumulation of changes rather than their sequential order is responsible of tumor biological behavior. It is noteworthy that, at least for this neoplasia, carcinogenesis appears to arise as a result of the mutational activation of oncogenes coupled with the mutational inactivation of tumor suppressor genes. In some cases mutant suppressor genes appear to exert a phenotypic effect even when present in the heterozygous state thus been non "recessive" at the cellular level. The general features of this model may apply also to renal cell cancer (RCC) and prostate cancer (CaP). Extensive literature exists on the cytogenetic and molecular findings in RCC. Only 2% of RCC are familiar, but molecular genetic studies of these cancers have provided important informations on RCC pathogenesis. As with other cancers, familiar RCC is characterized by an early age of onset and frequent multicentricity. A pathological classification useful in studying these patients subdivide renal cancers in papillary (pRCC) and non papillary (RCC) neoplasms. The most common cause of inherited RCC is the Von Hippel Lindau disease (VHL) a dominantly inherited multisystem disorder characterized by retinal and cerebellar hemangioblastomas, pheochromocytomas, pancreatic cysts and RCC. Over 70% of these patients will develop an RCC by their sixth decade. In 1993 the isolation of the tumor suppressor gene in VHL disease at the level of chromosome 3p25-p26 have lead to a better understanding of RCC. Most missense mutations are associated with high risk of

  6. Radiogenic neoplasia in thyroid and mammary clonogens

    International Nuclear Information System (INIS)

    We have developed rat thyroid and mammary clonogen transplantation systems for the study of radiogenic cancer induction at the target cell level in vivo. The epithelial cell populations of both glands contain small subpopulations of cells which are capable of giving rise to monoclonal glandular structures when transplanted and stimulated with appropriate hormones. During the end of the last grant year and the first half of the current grant year, we have completed analyses and summarized for publication: investigations on the relationship between grafted thyroid cell number and the rapidity and degree of reestablishment of the thyroid-hypothalamicpituitary axis in thyroidectomized rats maintained on a normal diet or an iodine deficient diet; studies of the persistence of, and the differentiation potential and functional characteristics of, the TSH- (thyrotropin-) responsive sub-population of clonogens during goitrogenesis, the plateau-phase of goiter growth, and goiter involution; studies of changes in the size of the clonogen sub-population during goitrogenesis, goiter involution and the response to goitrogen rechallenge; and the results of the large carcinogenesis experiment on the nature of the grafted thyroid cell number-dependent suppression of promotion/progression to neoplasia in grafts of radiation-initiated thyroid cells. We are testing new techniques for the culture, cytofluorescent analysis and characterization mammary epithelial cells and of clonogens in a parallel project, and plan to apply similar technology to the thyroid epithelial cells and clonogen population. Data from these studies will be used in the design of future carcinogenesis experiments on neoplastic initiation by high and low LET radiations and on cells interactions during the neoplastic process

  7. Radiogenic neoplasia in thyroid and mammary clonogens

    International Nuclear Information System (INIS)

    We have developed rat thyroid and mammary clonogen transplantation systems for the study of radiogenic cancer induction at the target cell level in vivo. The epithelial cell populations of both glands contain small subpopulations of cells which are capable of giving rise to monoclonal glandular structures when transplanted and stimulated with appropriate hormones. Previous results indicated that these clonogens are the precursor cells of radiogenic cancer, and that initiation, is common event at the clonegenic cell level. Detailed information on the physiologic control of clonogen proliferation, differentiation, and total numbers is thus essential to an understanding of the carcinogenic process. We report here studies on investigations on the relationships between grafted thyroid cell number and the rapidity and degree of reestablishment of the thyroid-hypothalamus-pituitary feedback axis in thyroidectomized rats maintained on a normal diet or an iodine deficient diet; studies of the persistence of, and the differentiation potential and functional characteristics of, the TSH-(thyrotropin-) responsive sub- population of clonogens during goitrogenesis, the plateau-phase of goiter growth, and goiter involution; studies of changes in the size of the clonogen sub-population during goitrogenesis, goiter involution and the response to goitrogen rechallenge; and a large carcinogenesis experiment on the nature of the grafted thyroid cell number-dependent suppression of promotion/progression to neoplasia in grafts of radiation-initiated thyroid cells. Data from these studies will be used in the design of future carcinogenesis experiments on neoplastic initiation by high and low LET radiations and on cell interactions during the neoplastic process

  8. Radiogenic neoplasia in thyroid and mammary clonogens

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, K.H.

    1992-05-20

    We have developed rat thyroid and mammary clonogen transplantation systems for the study of radiogenic cancer induction at the target cell level in vivo. The epithelial cell populations of both glands contain small subpopulations of cells which are capable of giving rise to monoclonal glandular structures when transplanted and stimulated with appropriate hormones. Previous results indicated that these clonogens are the precursor cells of radiogenic cancer, and that initiation, is common event at the clonegenic cell level. Detailed information on the physiologic control of clonogen proliferation, differentiation, and total numbers is thus essential to an understanding of the carcinogenic process. We report here studies on investigations on the relationships between grafted thyroid cell number and the rapidity and degree of reestablishment of the thyroid-hypothalamus-pituitary feedback axis in thyroidectomized rats maintained on a normal diet or an iodine deficient diet; studies of the persistence of, and the differentiation potential and functional characteristics of, the TSH-(thyrotropin-) responsive sub- population of clonogens during goitrogenesis, the plateau-phase of goiter growth, and goiter involution; studies of changes in the size of the clonogen sub-population during goitrogenesis, goiter involution and the response to goitrogen rechallenge; and a large carcinogenesis experiment on the nature of the grafted thyroid cell number-dependent suppression of promotion/progression to neoplasia in grafts of radiation-initiated thyroid cells. Data from these studies will be used in the design of future carcinogenesis experiments on neoplastic initiation by high and low LET radiations and on cell interactions during the neoplastic process.

  9. Radiogenic neoplasia in thyroid and mammary clonogens

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, K.H.

    1991-05-31

    We have developed rat thyroid and mammary clonogen transplantation systems for the study of radiogenic cancer induction at the target cell level in vivo. The epithelial cell populations of both glands contain small subpopulations of cells which are capable of giving rise to monoclonal glandular structures when transplanted and stimulated with appropriate hormones. During the end of the last grant year and the first half of the current grant year, we have completed analyses and summarized for publication: investigations on the relationship between grafted thyroid cell number and the rapidity and degree of reestablishment of the thyroid-hypothalamicpituitary axis in thyroidectomized rats maintained on a normal diet or an iodine deficient diet; studies of the persistence of, and the differentiation potential and functional characteristics of, the TSH- (thyrotropin-) responsive sub-population of clonogens during goitrogenesis, the plateau-phase of goiter growth, and goiter involution; studies of changes in the size of the clonogen sub-population during goitrogenesis, goiter involution and the response to goitrogen rechallenge; and the results of the large carcinogenesis experiment on the nature of the grafted thyroid cell number-dependent suppression of promotion/progression to neoplasia in grafts of radiation-initiated thyroid cells. We are testing new techniques for the culture, cytofluorescent analysis and characterization mammary epithelial cells and of clonogens in a parallel project, and plan to apply similar technology to the thyroid epithelial cells and clonogen population. Data from these studies will be used in the design of future carcinogenesis experiments on neoplastic initiation by high and low LET radiations and on cells interactions during the neoplastic process.

  10. Proctology - diseases of the anal region.

    Science.gov (United States)

    Kreuter, Alexander

    2016-04-01

    Proctology is a medical subspecialty that encompasses diseases of the perianal region, anal canal, and rectum. Dermatologists play a pivotal role in this realm, as inflammatory perianal disorders, infectious and sexually transmitted diseases, as well as perianal tumors and their precursor lesions fall within the core competency of dermatology. In a concise manner, the present article highlights all relevant disease groups in the field of proctology. With a particular focus on aspects pertinent to dermatologists, this includes inflammatory disorders, "classic" proctologic diseases, sexually transmitted diseases, malignancies of the anal region, as well as pathogen-induced diseases. Despite the wide variety of disorders, there are only five key symptoms prompting patients to consult a proctologist, including anal pruritus and burning, discharge, bleeding, pain, and foreign body sensation. A simple algorithm, which incorporates these symptoms as well as key clinical features, may assist in quickly establishing the correct diagnosis in everyday clinical practice. PMID:27027745

  11. Sonographic appearance of renal neoplasia in the dog

    International Nuclear Information System (INIS)

    Eight dogs with renal neoplasia were radiographically and sonographically examined. An enlarged, nonopacified kidney was seen on the excretory urogram in four dogs, but differentiation between a solid mass or severe hydronephrosis was not possible. The excretory urogram suggested an avascular lesion in one kidney, but differentiation between solid or cystic disease was not possible. Renal neoplasia was diagnosed in two dogs by excretory urography. Radiographic examination suggested splenic neoplasia in one dog. Solid masses were sonographically diagnosed in all dogs. A metastatic lesion was sonographically diagnosed in the opposite kidney of one dog that was missed on the radiographic examination. Ultrasonography complemented radiography as a diagnostic modality in eliciting additional information on renal disease. Sonograms did not allow determination of tumor cell type or whether the tumor was benign or malignant

  12. Seoseid loov kunstiteose analüüs / Anneli Porri

    Index Scriptorium Estoniae

    Porri, Anneli, 1980-

    2013-01-01

    Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

  13. PRIMENA SWOT ANALIZE NA SISTEM INTEGRALNOG TRANSPORTA VOJSKE SRBIJE

    OpenAIRE

    Dragan Pamučar

    2008-01-01

    U radu je prikazana primena SWOT analize na sistem integralnog transporta Vojske Srbije. Kao rezultat analize predstavljeni su ciljevi daljeg usavršavanja integralnog transporta, kao i mogući problemi generisani strateškim upravljanjem.

  14. Methylation Markers for CCNA1 and C13ORF18 Are Strongly Associated with High-Grade Cervical Intraepithelial Neoplasia and Cervical Cancer in Cervical Scrapings

    NARCIS (Netherlands)

    Yang, Nan; Eijsink, Jasper J. H.; Lendvai, Agnes; Volders, Haukeline H.; Klip, Harry; Buikema, Henk J.; van Hemel, Bettien M.; Schuuring, Ed; van der Zee, Ate G. J.; Wisman, G. Bea A.

    2009-01-01

    Purpose: Recently, we reported 13 possible cervical cancer-specific methylated biomarkers identified by pharmacologic unmasking microarray in combination with large-genome computational screening. The aim of the present study was to perform an in-depth analysis of the methylation patterns of these 1

  15. Inhibition of chronic pancreatitis and pancreatic intraepithelial neoplasia (PanIN) by capsaicin in LSL-KrasG12D/Pdx1-Cre mice

    OpenAIRE

    Bai, Han; Li, Haonan; Zhang, Wanying; Matkowskyj, Kristina A.; Liao, Jie; Srivastava, Sanjay K.; Yang, Guang-Yu

    2011-01-01

    Capsaicin is a major biologically active ingredient of chili peppers. Extensive studies indicate that capsaicin is a cancer-suppressing agent via blocking the activities of several signal transduction pathways including nuclear factor-kappaB, activator protein-1 and signal transducer and activator of transcription 3. However, there is little study on the effect of capsaicin on pancreatic carcinogenesis. In the present study, the effect of capsaicin on pancreatitis and pancreatic intraepitheli...

  16. RESEARCH PROGRESS OF SCREENING METHOD OF CERVICAL INTRAEPITHELIAL NEOPLASIA%宫颈上皮内瘤变筛查方法的研究进展

    Institute of Scientific and Technical Information of China (English)

    张俊绘; 宋静慧

    2011-01-01

    宫颈癌是女性最常见的恶性肿瘤之一,从癌前病变发展到癌大约需要10a时间,及早发现癌前病变对宫颈癌的防治具有重要意义.目前筛查宫颈癌前病变的方法有液基细胞学检测、HPV-DNA检测、阴道镜检查、组织病理学检查等.综述宫颈癌前病变的筛查方法,探讨最为高效合理的宫颈癌的筛查方法,提高诊断的准确率,从而降低宫颈癌的发病率和死亡率.%Cervical cancer is one of the most common cancers of women, it will take about 10 years from precancerous lesion to cancer, early detection of precancerous lesion is significant for prevention and cure of cervical cancer. At present, the methods of screening precancerous lesions of cervical cancer mainly include thin prep liquid based cytology test, HPV - DNA test, colposcopy examination , histopathology examination, etc. This article summarized the screening methods of precancerous lesions of cervical cancer, seek the most effective and rational screening methods of cervical cancer , improve the accuracy of diagnosis, so as to decrease the incidence and mortality of cervical cancer.

  17. 宫颈上皮内瘤变及宫颈癌272例临床分析%Clinical analysis of cervical intraepithelial neoplasia and cervical cancer

    Institute of Scientific and Technical Information of China (English)

    汤福想; 刘玉玲; 王会娟; 张东亚

    2011-01-01

    目的 通过分析272例宫颈病变患者的临床资料,探讨宫颈病变的诊断及治疗方法.方法 回顾分析CIN2/3级178例及宫颈癌94例,对比年龄、临床表现、症状、组织病理结果及治疗方法.结果 CIN2/3级年龄峰值为30~50岁,有阴道出血表现者71例(39.9%)宫颈癌的年龄峰值后移至40岁以上,有阴道出血表现者68例(72.3%).CIN患者术前术后病理结果完全诊断一致者122例(68.5%),遗漏15例(8.4%)宫颈浸润癌.125例CIN2/3行宫颈锥切术,CIN2和CIN3的切缘阳性率分别为6.45% (2/31)和24.47% (23/94),18例宫颈锥切术后行全子宫切除标本发现CIN残留3例.结论 对宫颈癌患者的筛查应根据性生活情况提前到30岁以前,对阴道出血及宫颈糜烂患者要高度重视,阴道镜活检有助于早期诊断,但也存在一定漏诊率.宫颈锥切术可作为CLN2/3患者的首选治疗方法.%Objictive Analyzed 272 cases clinical data of patients with cervical lesions, to explore the diagnosis of cervical lesions and treatment. Methods Retrospective analysis of 94 cases of cervical cancer cases and CIN2/3 178 cases, compared the age, clinical manifestations, symptoms, pathological findings and treatment. Results CIN2/3 peak age of 30 -50 years old, 71 cases of vaginal bleeding, the peak age of cervical cancer over the age of 40, there were 68 cases of vaginal bieed-ing, CIN diagnosis before and after surgery entirely consistent with pathological findings in 122 cases, missing 15 cases invasive cervical cancer. 125 cases of CIN2 / 3 cervical conization, CIN2 and CIN3 in the positive margin rate was 6. 45% and 24. 47% After 18 cases of cervical conization hysterectomy specimens found in 3 cases of residual CIN. Conclusions Screening for cervical cancer should be based on the living conditions of sex before age 30 in advance, Should attaches great importance to the vagina bleeding and the cervical erosion, colposcopy biopsy in early diagnosis, but there are some missed diagnosis. Conization as CIN2/3 the first choice for treatment of patients.

  18. Multiple small "imaging" branch-duct type intraductal papillary mucinous neoplasms (IPMNs) in familial pancreatic cancer: indicator for concomitant high grade pancreatic intraepithelial neoplasia?

    Science.gov (United States)

    Bartsch, D K; Dietzel, K; Bargello, M; Matthaei, E; Kloeppel, G; Esposito, I; Heverhagen, J T; Gress, T M; Slater, E P; Langer, P

    2013-03-01

    Most screening programs for familial pancreatic cancer are currently based on endoscopic ultrasonography and/or magnetic resonance imaging (MRI). Cystic lesions, especially those suspicious for small intraductal pancreatic mucinous neoplasms (IPMNs) of the branch ducts, can be visualized in up to 40 % of individuals at risk, but their pathological importance in the setting of FPC is yet not well established. Individuals at risk from a prospective screening program for familial pancreatic cancer with small "imaging" IPMNs of the branch-duct type (BD-IPMN) who underwent pancreatic resection were analysed regarding clinico-pathological data and the locations of pancreatic lesions. Five of 125 individuals at risk who underwent screening had multiple small (size 2-10 mm) unicystic lesions and/or multicystic single lesions in the pancreatic body and tail suspicious for BD-IPMNs upon MRI imaging and decided to undergo surgical resection after interdisciplinary counselling, although none fulfilled the consensus criteria for IPMN resection. Histological examination revealed BD-IPMNs with low or moderate dysplasia of the gastric type in combination with multifocal PanIN2 and PanIN3 lesions in 4 individuals. The remaining patient had only tiny ductectasias in the pancreatic tail with multifocal PanIN 2 lesions in the entire gland and one PanIN3 lesion in the pancreatic head. Intriguingly, the location of the most dysplastic histological lesions (PanIN3) did not correspond to the preoperatively detected lesions and were not visible in preoperative imaging. In the setting of FPC, the presence of multiple small "imaging" BD-IPMNs may indicate the presence of high-grade PanIN lesions elsewhere in the pancreas.

  19. Laser conization for the treatment of cervical intraepithelial neoplasia: the experience of the Colposcopy and Laser Surgery Unit, Department of Obstetrics and Gynecology, Conegliano Hospital

    Science.gov (United States)

    Fantin, Gian P.; Grasso, Alessandra; Tasinazzo, Raffaella; Bortolozzi, Giorgio

    1998-01-01

    From November 1990 to December 1995 eighty patients were treated with laser conization. They were high grade CIN extending to the endocervical canal and/or with purely ectocervical lesions and patients with low grade endocervical CIN persisting more than one year or cyto- histological discrepancy. Before surgery all the patients had colposcopy, cytology and guided cervical biopsies. Seventy-six out of eighty underwent local anaesthesia and in three cases a general anaesthetic was required although one case was treated without any anaesthesia. Complementary vaporization of the cone bed was performed in every single case. All specimens were judged fully evaluable by the pathologist. The accuracy of the preconization histology as evaluated in 79 patients. Exact agreement or a one degree discrepancy between punch biopsies and cone specimens was found in 96.25%. We did not find any unexpected invasive carcinoma. The apex of the specimen was free of disease in 93.75% of cases. A high grade lesion on the endocervical margin was found in 4 out of 5 cases with an apex involvement. Stenosis of the external cervical os occurred in 7 cases, 3 of which were symptomatic. In our experience laser conization is an effective and safe treatment of CIN with the results comparable to the literature.

  20. Immunostaining for p16(INK4a) used as a conjunctive tool improves interobserver agreement of the histologic diagnosis of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Horn, L.C.; Reichert, A.; Oster, A.;

    2008-01-01

    The quality of cervical histopathology is critical to cervical cancer prevention, cancer treatment, and research programs. On the basis of the histology results further patient management is determined. However, the diagnostic interpretation of histologic hematoxylin-eosin (H&E)-stained slides...

  1. Clinical analysis of 35 cases of vulvar intraepithelial neoplasia grade Ⅲ%外阴上皮内瘤变Ⅲ级35例临床分析

    Institute of Scientific and Technical Information of China (English)

    张功逸; 吴令英; 李斌; 杨琳; 赵丹; 俞高志

    2009-01-01

    目的 探讨外阴上皮内瘤变Ⅲ级(VINⅢ)的病因、临床病理特点、治疗方式以及预后.方法 对中国医学科学院肿瘤医院1993年1月至2008年4月收治的35例VINⅢ患者的临床及病理资料进行回顾性分析.结果 35例患者均因出现临床症状而就诊,表现为外阴瘙痒及肿物;其中28例(80%)病灶呈多发性斑块,7例(20%)病灶为单发性.15例(43%)合并人乳头状瘤病毒(HPV)相关疾病.22例(63%)病理检查发现有HPV感染证据(镜检时在病变范围内发现挖空细胞).35例患者中,1例未治疗,其余34例(97%)患者接受了手术治疗,其中14例患者行肿物局部扩大切除术;另20例行单纯外阴切除术,其中4例同时行肛门周围皮肤切除术.2例切缘阳性,其中1例术后补充局部放疗.4例患者分别于术后2、4、6及22个月局部复发,分别接受了激光及手术治疗.对本组病例随访1-166个月(中位随访时间为66个月),除1例死于宫颈癌外,无一例死于本病.接受生活质量调查的26例患者中有9例(35%)术后性生活质量受到不同程度的影响,其中1例接受了外阴整形术.结论 VINⅢ的发生可能与HPV感染有关,部分患者可同时合并HPV相关疾病.本病预后良好,手术为主要治疗手段,但可能影响性生活质量.%Objective To evaluate the etiology, clinicopathological characteristics, treatment and prognosis of VIN Ⅲ. Methods Thirty-five patients with VIN Ⅲ admitted in Cancer Hospital of Chinese Academy of Medical Sciences between 1993 and 2008 were analyzed retrospectively. Results All 35 patients attended to hospital with the symptoms of pruritus vulvae and lumps. Among of them, there were 28 (80%) cases whose lesions presented as multiple plaques, while 7 (20%) eases lesion were monofocal.Fifteen out of 35 eases had coexistent with human papillomavirus (HPV) related lesions, and there were the evidence of HPV in 22 patients whose pathologic sections revealed koilocytes. 34 cases (97%) except one received different types of surgical resections, including wide local resection (14/34), simple vulvectomy (16/34) and simple vulvectomy plus perianal skin resection (4/34), while there two cases shown positive cut-edges and one of them received radiotherapy postoperatively. Four out of the 34 cases recurred locally in 2, 4, 6 and 22 months and received surgical treatment again or laser therapy, respectively. The median follow-up period was 66 months ( range 1-166), and none of them were died of the disease itself except one case died of the concurrent cervical cancer. Among 26 cases received the investigation of the quality of life,there were nine cases (35%) suffered from sexual dysfunction after the operation, and one of them received vulvoplasty. Conclusions VIN Ⅲ has good prognosis. The development of VIN Ⅲ may be related to the infection of HPV, because most of them concurrent with HPV diseases. Its primary treatment is surgical resection, while affecting on the quality of life.

  2. Clinical case: multiple endocrine neoplasia type 1 (MEN 1

    Directory of Open Access Journals (Sweden)

    A K Lipatenkova

    2012-12-01

    Full Text Available Multiple endocrine neoplasia syndrome type 1 (MEN1, Wermer syndrome – group o а heterogeneous inherited deseases, caused by hyperlasia or neoplasia of several endocrine glands. The phenotype of MEN1 is broad, and over 20 different combinations of endocrine and non-endocrine metabolic manifestations have been described. This case demonstrates multiple formations of endocrine organs, starting non-classical with macroprolactonoma resistant to dopamine agonists therapy, other endocrine disorders developed gradually eventually: hyperparathyreoidism and hypoglycemia caused by pancreas lesions, produced proinsulin in high levels.

  3. Association between Cysticercosis and Neoplasia: A Study Based on Autopsy Findings

    OpenAIRE

    Camila Lourencini Cavellani; Aline Cristina Souza da Silva; Grace Kelly Naves de Aquino Ribeiro; Lívia Ferreira Oliveira; Mara Lúcia Fonseca Ferraz; Vicente de Paula Antunes Teixeira

    2013-01-01

    Chronic infections including the cysticercosis induce inflammatory cells to produce free radicals and synthesize carcinogenic toxins. The cells with genetic mutations proliferate in a disorganized manner, leading to the development of neoplasia. The aim of the present study was to demonstrate the relation between cysticercosis and neoplasia. Patients autopsied were divided into 4 groups: patients with neoplasia and cysticercosis (NC), patients with neoplasia only (NN), patients with cysticerc...

  4. Teaching Men's Anal Pleasure: Challenging Gender Norms with "Prostage" Education

    Science.gov (United States)

    Branfman, Jonathan; Ekberg Stiritz, Susan

    2012-01-01

    To help students critique sex/gender norms, sexuality educators should address men's anal pleasure. Men's anal receptivity blurs accepted binaries like male/female, masculine/feminine, and straight/queer. By suppressing men's receptivity, the taboo against men's anal pleasure helps legitimize hegemonic sex/gender beliefs--and the sexism,…

  5. Spontaneous mammary intraepithelial lesions in dogs: a model for breast cancer

    OpenAIRE

    Antuofermo, Elisabetta; Pirino, Salvatore; Burrai, Giovanni; Miller, Margaret; BADVE, SUNIL; Mohamed, Sulma

    2007-01-01

    Noninvasive mammary intraepithelial lesions (IELs) in humans are detected with increasing frequency because of routine mammographic screening. The presence of IELs may herald increased risk of developing invasive breast carcinoma in women. An animal model is needed to study breast cancer and spontaneous IELS. This study describes the histologic and immunohistochemical similarity between human and canine IELs.

  6. KRAS and BRAF mutations in anal carcinoma

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid;

    2015-01-01

    The EGF receptor (EGFR) is expressed in most cases of anal carcinomas. Anecdotal benefit from EGFR-targeted therapy has been reported in anal cancer and a negative correlation with Kirsten Ras (KRAS) mutation status has been proposed. The purpose of this retrospective study was to investigate...... the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...... and January 2010. KRAS mutations were detected using Therascreen(®)KRAS real-time PCR assay (Qiagen) and V600E or V600D/K BRAF mutations were uncovered using Pyrosequencing. The frequency of KRAS and BRAF mutations was low; KRAS mutations were detected in 1.6% and BRAF mutations in 4.7% of the biopsies...

  7. [Diagnostics and conservative treatment of anal incontinence].

    Science.gov (United States)

    Geile, Dorothea; Osterholzer, Georg; Rosenberg, Robert

    2004-01-01

    Anal incontinence is diagnosed primarily by clinical and proctologic examination. Etiological factors of the disease are found in 85% of the patients by additional examinations. Motility dysfunction of colon and rectum has to be excluded (stenosis, dyschezia, internal hernias). Because anal incontinence is a multifactorial disease as a rule, the single compounds have to be diagnosed and have to undergo therapy. Accordingly, useful investigations are: endorectal ultrasound (defect of muscle, inflammatory or tumour infiltration), manometry (alteration of either anal resting pressure and/or anal squeezing pressure) and surface electromyography (ability of contraction, duration of contraction, strength). Neurophysiological examinations are: needle electromyography, pudendal nerve latency time measurement (PNLT). The occurrence of nerve damage determines the outcome of operative intervention! Conservative treatment is indicated in 80 to 90% of all patients, even higher when one includes all patients in the perioperative period. Possible therapy modalities are: nutrition consultation, physiotherapy, pelvic floor training, biofeedback training of pelvic floor and sphincter muscles, electrostimulation and the combination of both (EMG-triggered electrostimulation). Short-term results are satisfying in up to 85% of patients, but later, successful results depend on the patient's willingness or ability to continue training, and on his/her age.

  8. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be ...

  9. Testicular neoplasia in undescended testes of cryptorchid boys-does surgical strategy have an impact on the risk of invasive testicular neoplasia?

    DEFF Research Database (Denmark)

    Cortes, Dina; Thorup, Jorgen; Petersen, Bodil Laub

    2004-01-01

    UNLABELLED: We investigated whether or not surgical strategy has an impact on the risk of invasive testicular neoplasia in cases of cryptorchidism. We made a database study of the incidence of testicular neoplasia at surgery for cryptorchidism in childhood, and evaluated if such abnormalities were...... found in special categories of patients, and also of the incidence of testicular neoplasia after orchiopexy with a simultaneous testicular biopsy in childhood. At surgery for cryptorchidism the risk of testicular neoplasia was 7/182 (4%) in cases with intra-abdominal testis, abnormal external genitalia...... (Fisher's exact test, p neoplasia was 7/830 (1%). The relative risk of testicular neoplasia was about 4. CONCLUSION: Based on our data and the literature we recommend: 1) Taking a testicular biopsy at surgery for cryptorchidism in childhood in intra...

  10. Imaging Finding of Multiple Endocrine Neoplasia Type 1: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yum, Tae Jun; Cho, Hee Woo [Dept. of Radiology, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited syndrome with characteristic clinical and radiological manifestations. Many reports on MEN1 have been published; however, no cases of radiologically diagnosed MEN1 have been reported. Therefore, we report on a radiologically diagnosed case of MEN1 with clinical symptoms of gastroduodenal ulcer.

  11. Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia.

    LENUS (Irish Health Repository)

    Alazzam, Mo'iad

    2012-12-01

    Gestational trophoblastic neoplasia (GTN) is a highly curable group of pregnancy-related tumours; however, approximately 25% of GTN tumours will be resistant to, or will relapse after, initial chemotherapy. These resistant and relapsed lesions will require salvage chemotherapy with or without surgery. Various salvage regimens are used worldwide. It is unclear which regimens are the most effective and the least toxic.

  12. Thyroid incidentalomas in patients with multiple endocrine neoplasia type 1

    NARCIS (Netherlands)

    Lodewijk, L.; Bongers, P.J.; Kist, J.W.; Conemans, E.B.; Laat, J.M. de; Pieterman, C.R.; Horst-Schrivers, A.N. van der; Jorna, C.; Hermus, A.R.M.M.; Dekkers, O.M.; Herder, W.W. de; Drent, M.L.; Bisschop, P.H.; Havekes, B.; Rinkes, I.H.; Vriens, M.R.; Valk, G.D.

    2015-01-01

    OBJECTIVE: Currently, little is known about the prevalence of thyroid tumors in multiple endocrine neoplasia type 1 (MEN1) patients and it is unclear whether tumorigenesis of these thyroid tumors is MEN1-related. The aim of the study was to assess the prevalence of thyroid incidentalomas in MEN1 pat

  13. Thyroid incidentalomas in patients with multiple endocrine neoplasia type 1

    NARCIS (Netherlands)

    Lodewijk, Lutske; Bongers, Pim J.; Kist, Jakob W.; Conemans, Elfi B.; de Laat, Joanne M.; Pieterman, Carla R. C.; van der Horst-Schrivers, Anouk N. A.; Jorna, Ciska; Hermus, Ad R.; Dekkers, Olaf M.; de Herder, Wouter W.; Drent, Madeleine L.; Bisschop, Peter H.; Havekes, Bas; Rinkes, Inne H. M. Borel; Vriens, Menno R.; Valk, Gerlof D.

    2015-01-01

    Objective: Currently, little is known about the prevalence of thyroid tumors in multiple endocrine neoplasia type 1 (MEN1) patients and it is unclear whether tumorigenesis of these thyroid tumors is MEN1-related. The aim of the study was to assess the prevalence of thyroid incidentalomas in MEN1 pat

  14. Modeling human endothelial cell transformation in vascular neoplasias

    Directory of Open Access Journals (Sweden)

    Victoria W. Wen

    2013-09-01

    Full Text Available Endothelial cell (EC-derived neoplasias range from benign hemangioma to aggressive metastatic angiosarcoma, which responds poorly to current treatments and has a very high mortality rate. The development of treatments that are more effective for these disorders will be expedited by insight into the processes that promote abnormal proliferation and malignant transformation of human ECs. The study of primary endothelial malignancy has been limited by the rarity of the disease; however, there is potential for carefully characterized EC lines and animal models to play a central role in the discovery, development and testing of molecular targeted therapies for vascular neoplasias. This review describes molecular alterations that have been identified in EC-derived neoplasias, as well as the processes that underpin the immortalization and tumorigenic conversion of ECs. Human EC lines, established through the introduction of defined genetic elements or by culture of primary tumor tissue, are catalogued and discussed in relation to their relevance as models of vascular neoplasia.

  15. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen;

    2012-01-01

    Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  16. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  17. Comparison between anal endosonography and digital examination in the evaluation of anal fistulae.

    Science.gov (United States)

    Choen, S; Burnett, S; Bartram, C I; Nicholls, R J

    1991-04-01

    A prospective trial was performed comparing the accuracy of digital examination and anal endosonography in defining the anatomy of anal fistulae. Before operation 38 consecutive patients were assessed by the consultant in charge of the case, by a research fellow and by anal endosonography involving two radiologists. These findings were compared with the operative findings. Consultants correctly identified 26 of 33 internal openings, 29 of 34 primary tracks and 15 of 21 secondary tracks. The research fellow correctly identified 26 internal openings, 24 primary tracks and 10 secondary tracks. There was no significant difference between the accuracy of consultants and the research fellow. Anal endosonography identified 10 internal openings based on initial criteria. This rose to 24 when revised ultrasonographic criteria were applied. There was no statistical difference between consultant assessment and anal ultrasonography in correctly identifying intersphincteric and transphincteric tracks. Ultrasonography is unable to assess primary superficial, suprasphincteric and extrasphincteric tracks or secondary supralevator and infralevator tracks. Consultant assessment of secondary supralevator and infralevator tracks was correct in 78 per cent of cases. PMID:2032103

  18. Development of a pulse height analizer

    International Nuclear Information System (INIS)

    The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author)

  19. Biochemical, bone and renal patterns in hyperparathyroidism associated with multiple endocrine neoplasia type 1

    Directory of Open Access Journals (Sweden)

    Delmar M. Lourenço Jr.

    2012-01-01

    Full Text Available Primary hyperparathyroidism associated with multiple endocrine neoplasia type I (hyperparathyroidism/multiple endocrine neoplasia type 1 differs in many aspects from sporadic hyperparathyroidism, which is the most frequently occurring form of hyperparathyroidism. Bone mineral density has frequently been studied in sporadic hyperparathyroidism but it has very rarely been examined in cases of hyperparathyroidism/multiple endocrine neoplasia type 1. Cortical bone mineral density in hyperparathyroidism/multiple endocrine neoplasia type 1 cases has only recently been examined, and early, severe and frequent bone mineral losses have been documented at this site. Early bone mineral losses are highly prevalent in the trabecular bone of patients with hyperparathyroidism/multiple endocrine neoplasia type 1. In summary, bone mineral disease in multiple endocrine neoplasia type 1related hyperparathyroidism is an early, frequent and severe disturbance, occurring in both the cortical and trabecular bones. In addition, renal complications secondary to sporadic hyperparathyroidism are often studied, but very little work has been done on this issue in hyperparathyroidism/multiple endocrine neoplasia type 1. It has been recently verified that early, frequent, and severe renal lesions occur in patients with hyperparathyroidism/multiple endocrine neoplasia type 1, which may lead to increased morbidity and mortality. In this article we review the few available studies on bone mineral and renal disturbances in the setting of hyperparathyroidism/multiple endocrine neoplasia type 1. We performed a meta-analysis of the available data on bone mineral and renal disease in cases of multiple endocrine neoplasia type 1-related hyperparathyroidism.

  20. Sutureless amniotic membrane transplantation following excision of ocular surface neoplasia

    Institute of Scientific and Technical Information of China (English)

    Altan; Ozcan; Ebru; Esen; Emine; Ciloglu

    2015-01-01

    <正>Dear Sir,S uccess of surgical management of conjunctival neoplasias primarily depends on the complete excision of the mass and eradication of tumor cells from the ocular surface[1-3].Especially in cases that extensive resections are required,primary closure may not be feasible;so ocular surface reconstruction can be a challenging problem for the surgeons.For conjunctival tissue defects different surgical

  1. Hematopoietic Neoplasias in Horses: Myeloproliferative and Lymphoproliferative Disorders

    OpenAIRE

    Muñoz, Ana; Riber, Cristina; Trigo, Pablo; Castejón, Francisco

    2010-01-01

    Leukemia, i.e., the neoplasia of one or more cell lines of the bone marrow, although less common than in other species, it is also reported in horses. Leukemia can be classified according to the affected cells (myeloproliferative or lymphoproliferative disorders), evolution of clinical signs (acute or chronic) and the presence or lack of abnormal cells in peripheral blood (leukemic, subleukemic and aleukemic leukemia). The main myeloproliferative disorders in horses are malignant histiocytosi...

  2. The prevalence and characteristics of colorectal neoplasia in acromegaly.

    Science.gov (United States)

    Renehan, A G; Bhaskar, P; Painter, J E; O'Dwyer, S T; Haboubi, N; Varma, J; Ball, S G; Shalet, S M

    2000-09-01

    An increased prevalence of colorectal neoplasia has been reported in acromegalic patients, and recommendations have been made for early colonoscopic screening and regular surveillance. This assumption, however, is frequently drawn from studies using selected control populations. To clarify colonoscopic management in these patients, we undertook a 2-center prospective screening colonoscopy study in 122 acromegalics (age range, 25-82 yr). In the absence of ideal age-matched controls, we calculated prevalence rates of occult adenocarcinomas and adenomas in the general population using cumulative data in the published literature from 8 autopsy studies (model 1, n = 3,559) and 4 screening colonoscopy studies (model 2, n= 810), applying linear regression models. Of the 115 patients with complete examinations, adenocarcinomas were discovered in 3 (2.6%), and at least 1 adenoma was found in 11, giving an overall prevalence of neoplasia of 12% (14 of 115). Prevalence rates for age bands 30-40, 40-49, 50-59, 60-69, and 70+ yr were 0%, 8%, 12%, 20%, and 21%, respectively. Compared with the 2 control models, the prevalence of occult colorectal cancer was not significantly increased (acromegalics vs. models 1 and 2, 2.6% vs. 2.3% and 0.9%), nor was there an increase in the prevalence of adenomas in any age band. Pathological characteristics showed some differences, in that adenomas in acromegalics tended to be right sided (68% vs. 57% and 56%), larger (for > or =10 mm, 27% vs. 13% and 9%), and of advanced histology (for tubulovillous, 27% vs. 4% and 22%). No associations were found between the presence of colonic neoplasia and the duration of disease, total GH exposure, cure status, and serum insulin-like growth factor I. This study has failed to demonstrate an increased prevalence of neoplasia in acromegalic patients compared with the expected prevalence in the general population and questions the need for an aggressive colonoscopic screening policy.

  3. Placental-type alkaline phosphatase in cervical neoplasia.

    OpenAIRE

    McLaughlin, P. J.; Warne, P H; Hutchinson, G. E.; Johnson, P. M.; Tucker, D. F.

    1987-01-01

    Monoclonal antibodies reactive with placental-type alkaline phosphatase have formed the basis of methods for detection of this oncodevelopmental antigen in patients with pre-invasive and invasive cervical neoplasia, with or without evidence of papilloma virus infection. Disease-related elevations of placental-type alkaline phosphatase were not observed in patients' sera. Solubilised cervical smears or biopsy material, and cervical mucus swabs, often contained substantial amounts of this isoen...

  4. Gestational trophoblastic neoplasia: A 6 year retrospective study

    Directory of Open Access Journals (Sweden)

    Sushruta Shrivastava

    2014-01-01

    Full Text Available Aims and Objectives: To study the clinical presentations of gestational trophoblastic neoplasia and its response to chemotherapy. Materials and Methods: This is a retrospective study of 28 women of gestational trophoblastic neoplasia evaluated over a period of 6 years from January 2004 to December 2009. Patients were evaluated on the basis of their age, number of deliveries, history of abortion or molar pregnancy, and the treatment received. All patients were scored on the basis of WHO scoring system. Patients with low risk (score /=7 received multiple agent chemotherapy with EMACO regimen. After completion of chemotherapy patients were followed for a minimum of 2 years. The response to treatment was evaluated during follow-up by clinical examination, beta hCG levels and imaging as and when required. Results: Out of 28 women only 27 could be evaluated, because 1 patient was lost to follow-up. Out of 27 patients, 18 patients (66.67% achieved complete remission with the first-line chemotherapy and additional 25.92% (7/27 achieved complete remission with second line chemotherapy resulting in complete remission of 92.5% (25/27. Conclusion: Gestational trophoblastic neoplasia is curable if patient is properly evaluated and scored. It shows good response to chemotherapy.

  5. Electrophysiological observations on the human pudendo-anal reflex.

    OpenAIRE

    Varma, J S; Smith, A N; McInnes, A

    1986-01-01

    A reproducible electrophysiological technique is described to determine the latency of reflex contraction of the external anal sphincter in response to stimulation of the dorsal genital nerve: the pudendo-anal reflex. This was studied in 38 asymptomatic control subjects and 20 women with neurogenic faecal incontinence, supplemented by determination of the mean motor unit potential duration (MUPD) of the external anal sphincter and anorectal manometry. The reflex latency in the control group w...

  6. Environmental scan of anal cancer screening practices: worldwide survey results

    OpenAIRE

    Patel, Jigisha; Salit, Irving E.; Berry, Michael J.; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey ...

  7. The four steps in the prevention of human papillomavirus-associated neoplasia: considerations for preventive measures, screening, disease impact, and potential overtreatments in HPV-related pathology.

    Science.gov (United States)

    Liverani, Carlo A

    2013-11-01

    There is no cure currently available for HPV infections, although ablative and excisional treatments of some dysplasias often result in a clinical and virological cure. Effective control measures of HPV-associated cancers rely on the prevention at four different levels. Apart from sexual abstinence, primary prevention is realized through vaccines targeting the most frequent HPV types: negative attitudes towards HPV vaccination and high costs are the main obstacles. The aim of secondary prevention is to detect precancerous changes before they develop into invasive cancer, while tertiary prevention involves actual treatment of high-grade lesions: in many countries routine screening with cytology is being challenged with HPV DNA testing. Quaternary prevention comprehends those actions adopted to mitigate or avoid unnecessary or excessive medical interventions, and may well be addressed in avoiding treatments for low-grade intraepithelial neoplasia. Though some gynecologists commonly recommend treatment for low-grade disease and women tend to prefer active management if not properly informed, harms arising from unnecessary treatments, increased costs, work overload for second-level health services, and induced psychosocial distress are causing on-going problems. Prevention efforts of genital HPV-associated cancers should concentrate in: (1) enhancing primary prevention through vaccination of all eligible subjects, (2) achieving high levels of adherence to routine screening programs, (3) treating precancerous lesions, and (4) monitoring current guidelines recommendations to avoid overtreatments. Novel research projects should be designed to study the delicate mechanisms of immune response to HPV. PMID:23974280

  8. 5-bp Classical Satellite DNA Loci from Chromosome-1 Instability in Cervical Neoplasia Detected by DNA Breakage Detection/Fluorescence in Situ Hybridization (DBD-FISH

    Directory of Open Access Journals (Sweden)

    Jaime Gosálvez

    2013-02-01

    Full Text Available We aimed to evaluate the association between the progressive stages of cervical neoplasia and DNA damage in 5-bp classical satellite DNA sequences from chromosome-1 in cervical epithelium and in peripheral blood lymphocytes using DNA breakage detection/fluorescence in situ hybridization (DBD-FISH. A hospital-based unmatched case-control study was conducted in 2011 with a sample of 30 women grouped according to disease stage and selected according to histological diagnosis; 10 with low-grade squamous intraepithelial lesions (LG-SIL, 10 with high-grade SIL (HG-SIL, and 10 with no cervical lesions, from the Unidad Medica de Alta Especialidad of The Mexican Social Security Institute, IMSS, Mexico. Specific chromosome damage levels in 5-bp classical satellite DNA sequences from chromosome-1 were evaluated in cervical epithelium and peripheral blood lymphocytes using the DBD-FISH technique. Whole-genome DNA hybridization was used as a reference for the level of damage. Results of Kruskal-Wallis test showed a significant increase according to neoplastic development in both tissues. The instability of 5-bp classical satellite DNA sequences from chromosome-1 was evidenced using chromosome-orientation FISH. In conclusion, we suggest that the progression to malignant transformation involves an increase in the instability of 5-bp classical satellite DNA sequences from chromosome-1.

  9. Analýza vybrané firmy

    OpenAIRE

    Křemečková, Tereza

    2013-01-01

    Tato bakalářská práce obsahuje celkovou analýzu firmy Pegas NONWOVENS. Práce se zabývá analýzami SWOT a SLEPTE, Porterovým pětifaktorovým modelem, Kralickovým Quick testem a vybranými ukazateli finanční analýzy. Na základě zpracování těchto analýz jsou navržena doporučení, která by mohla zlepšit situaci firmy.

  10. Risk of Anal Cancer in People Living with HIV: Addressing Anal Health in the HIV Primary Care Setting.

    Science.gov (United States)

    Walker, Crystal Martin; Likes, Wendy; Bernard, Marye; Kedia, Satish; Tolley, Elizabeth

    2016-01-01

    Anal health and anal cancer are rarely addressed in HIV primary care. We sought to understand factors that impeded or promoted addressing anal health in HIV primary care from providers' perspectives. In this exploratory study, HIV primary care providers from the Mid-South region of the United States participated in brief individual interviews. We analyzed transcribed data to identify barriers and facilitators to addressing anal health. Our study sample included five physicians and four nurse practitioners. The data revealed a number of barriers such as perception of patient embarrassment, provider embarrassment, external issues such as time constraints, demand of other priorities, lack of anal complaints, lack of resources, and gender discordance. Facilitators included awareness, advantageous circumstances, and the patient-provider relationship. Anal health education should be prioritized for HIV primary care providers. Preventive health visits should be considered to mitigate time constraints, demands for other priorities, and unequal gender opportunities. PMID:27080925

  11. Surgical treatment of pancreatic endocrine tumors in multiple endocrine neoplasia type 1

    Directory of Open Access Journals (Sweden)

    Marcel Cerqueira Cesar Machado

    2012-01-01

    Full Text Available Surgical approaches to pancreatic endocrine tumors associated with multiple endocrine neoplasia type 1 may differ greatly from those applied to sporadic pancreatic endocrine tumors. Presurgical diagnosis of multiple endocrine neoplasia type 1 is therefore crucial to plan a proper intervention. Of note, hyperparathyroidism/multiple endocrine neoplasia type 1 should be surgically treated before pancreatic endocrine tumors/multiple endocrine neoplasia type 1 resection, apart from insulinoma. Non-functioning pancreatic endocrine tumors/multiple endocrine neoplasia type 1 >1 cm have a high risk of malignancy and should be treated by a pancreatic resection associated with lymphadenectomy. The vast majority of patients with gastrinoma/multiple endocrine neoplasia type 1 present with tumor lesions at the duodenum, so the surgery of choice is subtotal or total pancreatoduodenectomy followed by regional lymphadenectomy. The usual surgical treatment for insulinoma/multiple endocrine neoplasia type 1 is distal pancreatectomy up to the mesenteric vein with or without spleen preservation, associated with enucleation of tumor lesions in the pancreatic head. Surgical procedures for glucagonomas, somatostatinomas, and vipomas/ multiple endocrine neoplasia type 1 are similar to those applied to sporadic pancreatic endocrine tumors. Some of these surgical strategies for pancreatic endocrine tumors/multiple endocrine neoplasia type 1 still remain controversial as to their proper extension and timing. Furthermore, surgical resection of single hepatic metastasis secondary to pancreatic endocrine tumors/multiple endocrine neoplasia type 1 may be curative and even in multiple liver metastases surgical resection is possible. Hepatic trans-arterial chemo-embolization is usually associated with surgical resection. Liver transplantation may be needed for select cases. Finally, pre-surgical clinical and genetic diagnosis of multiple endocrine neoplasia type 1 syndrome and

  12. 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

    OpenAIRE

    Luiz Roberto Wendt; Alessandro Bersch Osvaldt; Vivian Pierre Bersch; Rita de Cássia Schumacher; Maria Isabel Albano Edelweiss; Luiz Rohde

    2007-01-01

    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 pancreat...

  13. Technická analýza

    OpenAIRE

    NĚMEC, Ondřej

    2014-01-01

    Předmětem diplomové práce je technická analýza – vytvoření investičních strategií. V teoretické části jsou popsána teoretická východiska vztahující se k technické analýze a indikátorům. V praktické části je zmapována současná situace v prostředí investování na forexu – porovnání brokerů, výběr platformy apod. Vlastní řešení potom obsahuje popis investičních strategií, které byly naprogramovány v jazyku Meta Quotes Language 4 a testovány a optimalizovány pomocí genetických algoritmů v prostřed...

  14. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy

    Science.gov (United States)

    Mandaliya, Rohan; DiMarino, Anthony J.; Moleski, Stephanie; Rattan, Satish; Cohen, Sidney

    2015-01-01

    Background Despite the surge of new medical and surgical approaches to treat fecal incontinence, the types of sphincter abnormalities in patients with incontinence have not been well characterized. We aimed to categorize anal sphincter dysfunction using anorectal manometry in patients with fecal incontinence as a potential guide for improved treatment. Methods A retrospective review of 162 consecutive patients with fecal incontinence referred for anorectal manometry was performed. Resting anal pressure and maximal squeeze pressure were considered as measures of internal anal sphincter and external anal sphincter function respectively. Results Mean age of the patients was 63 years (13-89); females (81.5%) and males (18.5%). 74% of the patients had sphincter dysfunction on anorectal manometry. Internal anal sphincter dysfunction was present in 62% patients vs. external anal sphincter dysfunction present in 44% patients. 80% females had abnormal manometry vs. 44% in males (P<0.0001). Internal anal sphincter dysfunction was present in 68% females vs. 37% in males (P=0.0026). Conclusions Overall, abnormal anorectal manometry studies revealed that internal anal sphincter dysfunction is the most common finding, alone or in combination with external anal sphincter dysfunction. We suggest that anorectal manometry may be important to delineate anal sphincter function prior to using newer therapeutic mechanical devices. Future studies using pharmacological agents to increase internal anal sphincter tone may be of clinical importance. Finally, the classification of fecal incontinence based on the type of sphincter dysfunction may be an improved guide in the selection of newer agents in treating fecal incontinence. PMID:26423466

  15. [The anal incontinence-- study on 20 operated cases].

    Science.gov (United States)

    Iusuf, T; Sârbu, V; Grasa, C; Cristache, C; Botea, F

    2001-01-01

    The authors present 20 cases operated for anal incontinence. Two techniques were performed: direct repair (18 cases) and Musset-Cottrell procedure (2 cases). The results were excellent in 12 cases, good in 5 cases and satisfactory in 3 cases. The method of choice seems to be the direct repair of the anal sphincter after a proper local and general preparation. PMID:12731180

  16. Kirurgisk behandling af anale fistler ved Crohns sygdom

    DEFF Research Database (Denmark)

    Heyckendorff-Diebold, Tina; Maeda, Yasuko; Buntzen, Steen;

    2012-01-01

    The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional o...

  17. Obstetrical anal sphincter injuries and outcome of primary repair

    Directory of Open Access Journals (Sweden)

    Gauri J. Desai

    2016-10-01

    Conclusions: Nulliparity, instrumental delivery, increasing birth weight were high risk factors for obstetrical anal sphincter injuries. Obstetrician needs to be more careful while delivering a patient with multiple risk factors for OASIs. Primary suturing of anal sphincter injury with good post-operative care has a favorable outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3568-3571

  18. Sotsiaalvõrgustike analüüs / Innar Liiv

    Index Scriptorium Estoniae

    Liiv, Innar, 1982-

    2005-01-01

    Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

  19. Multiple Endocrine Neoplasia Syndromes: A Comprehensive Imaging Review.

    Science.gov (United States)

    Grajo, Joseph R; Paspulati, Raj Mohan; Sahani, Dushyant V; Kambadakone, Avinash

    2016-05-01

    MEN1, MEN2, and MEN4 comprise a series of familial disorders involving the simultaneous occurrence of tumors in more than one endocrine organ, collectively known as multiple endocrine neoplasia. Patients with this family of disorders develop tumors of the parathyroid gland, pancreas, pituitary gland, adrenal gland, and thyroid gland, along with miscellaneous neuroendocrine tumors of the respiratory and gastrointestinal tracts. Although some patients undergo early prophylactic surgical management, particularly in the setting of familial medullary thyroid carcinoma, many develop tumors later in life. These tumors are often discovered at imaging for screening purposes. Recognition of the imaging features of the known tumors is important for appropriate patient management. PMID:27153782

  20. Chronic anal fissure: new approaches to chemical sphincterotomy

    Directory of Open Access Journals (Sweden)

    Mohammad hassan Emami

    2008-06-01

    Full Text Available

    • An anal fissure is a split in the mucosa extending from the anal verge towards the dentate line. It currently affects 10% of patients attending proctology clinics. Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. Acute fissures usually heal with conservative management. Fissures lasting greater than two months with features of chronicity, are unlikely to heal with conservative management. Lateral internal sphincterotomy has been the treatment of choice for chronic anal fissures. Because of the disability associated with surgery for healing anal fissure and the risk of incontinence, medical alternatives for surgery have been sought. Among different chemical agents, Glyceryl trinitrate (GTN has been shown to be the first line treatment for chronic anal fissure but the transient sphincteric relaxation effect of pharmacologic agents such as GTN, makes them less effective than surgery. Although we have different forms of GTN products, they do not show a long acting effect on relaxing and enhancing the perfusion of anal sphincter, because they are soon metabolized. Most difficulties with current usage of drugs are due to poor compliance of patients. It can be taken into consideration that new formulation and novel combination of GTN with other treatments, in slow releasing forms may lead to acceptable strategies in the management of chronic anal fissure. As authors’ experience in this field, other clinical trials on the drug combination and slow releasing formulations are warranted to generate new data on the subject.
    • Key word: chronic anal fissure, review, chemical sphincterotomy 

  1. The role of smoking and alcohol intake in the development of high-grade squamous intraepithelial lesions among high-risk HPV-positive women

    DEFF Research Database (Denmark)

    Tolstrup, Janne; Munk, Christian; Thomsen, Birthe Lykke;

    2006-01-01

    BACKGROUND: Infection with human papillomavirus is considered a necessary factor in developing high-grade squamous intraepithelial lesions of the cervix. However, most human papillomavirus positive women do not develop high-grade squamous intraepithelial lesions and other factors may be important...

  2. Myoepithelial cells: their origin and function in breast morphogenesis and neoplasia

    DEFF Research Database (Denmark)

    Gudjonsson, Thorarinn; Adriance, Melissa C; Sternlicht, Mark D;

    2005-01-01

    and surrounding myoepithelial cells in normal breast morphogenesis and neoplasia. In this review we discuss data from our laboratories and from others regarding the cellular origin of human myoepithelial cells, their function in maintaining tissue polarity in the normal breast, and their role during neoplasia....

  3. Examination for intratubular germ cell neoplasia at operation for undescended testis in boys

    DEFF Research Database (Denmark)

    Cortes, D; Thorup, J; Frisch, M;

    1994-01-01

    A total of 843 consecutive boys (median age 12.7 years) who had undergone testicular biopsy at operation for undescended testis was followed into adulthood (median age 25.2 years) to examine for testicular germ cell neoplasia. Five cases of testicular germ cell neoplasia were identified, including...

  4. Testicular neoplasia in undescended testes of cryptorchid boys-does surgical strategy have an impact on the risk of invasive testicular neoplasia?

    DEFF Research Database (Denmark)

    Cortes, Dina; Thorup, Jorgen; Petersen, Bodil Laub

    2004-01-01

    UNLABELLED: We investigated whether or not surgical strategy has an impact on the risk of invasive testicular neoplasia in cases of cryptorchidism. We made a database study of the incidence of testicular neoplasia at surgery for cryptorchidism in childhood, and evaluated if such abnormalities were...... other than cryptorchidism, or diagnosed abnormal karyotype, versus no case in the 1281 patients without these characteristics (Fisher's exact test, p ... (Fisher's exact test, p

  5. Levels of oxidative damage and lipid peroxidation in thyroid neoplasia.

    LENUS (Irish Health Repository)

    Young, Orla

    2012-02-01

    BACKGROUND: This study assessed the presence of oxidative damage and lipid peroxidation in thyroid neoplasia. METHODS: Using tissue microarrays and immunohistochemistry, we assessed levels of DNA damage (8-oxo-dG) and lipid peroxidation (4-HNE) in 71 follicular thyroid adenoma (FTA), 45 papillary thyroid carcinoma (PTC), and 17 follicular thyroid carcinoma (FTC) and matched normal thyroid tissue. RESULTS: Cytoplasmic 8-oxo-dG and 4-HNE expression was significantly higher in FTA, FTC, and PTC tissue compared to matched normal tissue (all p values < .001). Similarly, elevated nuclear levels of 8-oxo-dG were seen in all in FTA, FTC, and PTC tissue compared to matched normal (p values < .07, < .001, < .001, respectively). In contrast, a higher level of 4-HNE expression was detected in normal thyroid tissue compared with matched tumor tissue (p < .001 for all groups). Comparing all 3 groups, 4-HNE levels were higher than 8-oxo-dG levels (p < .001 for all groups) except that cytoplasmic levels of 8-oxo-dG were higher than 4-HNE in all (p < .001). These results were independent of proliferation status. CONCLUSION: High levels of DNA damage and lipid peroxidation in benign and malignant thyroid neoplasia indicates this damage is an early event that may influence disease progression.

  6. Analysis of digitized cervical images to detect cervical neoplasia

    Science.gov (United States)

    Ferris, Daron G.

    2004-05-01

    Cervical cancer is the second most common malignancy in women worldwide. If diagnosed in the premalignant stage, cure is invariably assured. Although the Papanicolaou (Pap) smear has significantly reduced the incidence of cervical cancer where implemented, the test is only moderately sensitive, highly subjective and skilled-labor intensive. Newer optical screening tests (cervicography, direct visual inspection and speculoscopy), including fluorescent and reflective spectroscopy, are fraught with certain weaknesses. Yet, the integration of optical probes for the detection and discrimination of cervical neoplasia with automated image analysis methods may provide an effective screening tool for early detection of cervical cancer, particularly in resource poor nations. Investigative studies are needed to validate the potential for automated classification and recognition algorithms. By applying image analysis techniques for registration, segmentation, pattern recognition, and classification, cervical neoplasia may be reliably discriminated from normal epithelium. The National Cancer Institute (NCI), in cooperation with the National Library of Medicine (NLM), has embarked on a program to begin this and other similar investigative studies.

  7. Synchronous high-risk melanoma and lymphoid neoplasia.

    LENUS (Irish Health Repository)

    Cahill, R A

    2012-02-03

    Large population-based studies have shown a significant association between melanoma and lymphoid neoplasia, particularly non-Hodgkin\\'s lymphoma (NHL) and chronic lymphocytic leukaemia (CLL), that is independent of any treatment received for the initial tumour. This study examines the presentation, diagnosis, treatment and progress of three patients who developed advanced melanoma concurrently with a lymphoid neoplasm (one NHL, two CLLs), in order to illustrate their association, discuss common aetiological factors and examine possible therapeutic options. As it is the melanoma rather than the lymphoid neoplasm that represents the bigger threat to overall survival, initial treatment should be targeted towards this cancer. However, because of the interplay between the diseases and the possible side-effects of the various treatments, the choice of adjuvant therapy requires careful consideration. Immunosuppression associated with chemotherapy may permit a more aggressive course for the melanoma, while locoregional radiotherapy is contraindicated following lymph node dissections. As immunotherapy is of benefit in the treatment of melanoma and has also been recently shown to be effective in the management of lymphoid neoplasia, we instituted interferon-alpha as adjuvant therapy for these patients, thereby utilizing a single agent to treat the dual pathologies. The three patients have now been followed-up for 6 months without evidence of disease recurrence or progression.

  8. Scrotal neoplasia: would truck drivers be at greater risk?

    Directory of Open Access Journals (Sweden)

    Daniel Seabra

    2007-08-01

    Full Text Available OBJECTIVE: To analyze how scrotal neoplasias have been managed during the past decade and to question possible factors or professions associated to its presence. MATERIALS AND METHODS: We retrospectively evaluated every case reported from 1995 to 2005 at our hospital. We described the clinical scenario, complementary exams, treatments and outcomes. We also tried to verify if there was any risk, predisposing factors or professions that would explain the cancer origin. RESULTS: Six cases were reviewed. Out of these, three patients were truck drivers. Five of them showed restricted lesions without inguinal lymph nodes enlargement. Histologically, six patients presented squamous carcinoma, with two of them having the verrucous type. The median age of patients was 52 years old (31 to 89. The five patients who are still alive had their lesions completely removed with safety margin and primary closure. CONCLUSIONS: We have noticed that the scrotal carcinoma behavior is similar to that of the penis, where removal of the lesion and study of the regional lymph nodes help to increase the patient survival rate. The outstanding fact was that three out of six patients were truck drivers, raising the hypothesis that such profession, maybe due to the contact or attrition with the diesel exhaust expelled by the engine or to sexual promiscuity, would imply in a larger risk of developing this rare neoplasia.

  9. Analýza vybrané firmy

    OpenAIRE

    Žahourek, Martin

    2010-01-01

    V dnešní nelehké situaci musí organizace obzvlášť pečlivě sledovat svoje hospodaření a plánovat. Cílem této práce je zhodnotit aktuální situace společnosti Centropen a.s.. Použitými nástroji jsou finanční analýza, fundamentální analýza, SLEPTE analýza a Porterova analýza pěti sil. Výsledky těchto analýz jsou dále zpracovány ve SWOT analýza, ta je potom porovnána se SWOT analýzou k situaci z roku 2006. Today, in the hard situation, must organization very carefully observe its economy and pl...

  10. Metachronous tubulovillous and tubular adenomas of the anal canal