scholarly journals Management of Precancerous Lesions of the Uterine Cervix according to Demographic Data

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Olga Modinou ◽  
Lykourgos Liaropoulos ◽  
Dafni Kaitelidou ◽  
kyriakos Kioulafas ◽  
Eleni-Maria Theodoraki
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Uterine Cervix ◽  
Precancerous Lesions ◽  
Demographic Data ◽  
Intraepithelial Neoplasia ◽  
Diagnostic Procedures ◽  
Educational Status ◽  
Pap Smears ◽  
Low Grade ◽  
Treatment Profile

Aims. Worldwide, cervical cancer is the fifth most deadly cancer in women, but screening prevents cancer by detecting precancerous lesions. The purpose of this study is to present the treatment profile for precancerous lesions of the uterine cervix, according to demographic data. Methods. An annual retrospective study was conducted in two public primary health care centres in Greece. The total number of Pap smears and colposcopies performed as well as the management of women with cervical intraepithelial neoplasia was collected and analysed. Results. Demographic characteristics and correlations with levels of Cervical Intraepithelial Neoplasia (CIN) and treatment path are presented. For each case, we noted the patients' age, the marital and educational status, and the professional and insurance type. From a total of 238 diagnostic procedures, 118 (49.5%) showed precancerous lesions, 83.3% of these were high grade while 16.7% were low grade. Conclusions. This study provides an estimate of the extensiveness of precancerous lesions of the uterine cervix. Management of CIN should be accounted for when balancing the benefits and unfavourable effects of this screening.

scholarly journals Photodynamic Therapy for Low-grade Cervical Intraepithelial Neoplasia (CIN1): A Case Report

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Yinyin Zhang ◽  
Hong Lin ◽  
Huizhen Fan
Keyword(s):  
Photodynamic Therapy ◽  
Cervical Intraepithelial Neoplasia ◽  
Persistent Infection ◽  
Precancerous Lesions ◽  
Irradiation Time ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Cervical Canal ◽  
Low Grade ◽  
Oxygen Inhalation

As a drug-mechanical combination technology, photodynamic (PDT) can achieve accurate and targeted therapy for malignant tumors and benign diseases through the production of reactive oxygen species, oxygen free radicals or singlet oxygen by photosensitizers at specific wavelengths. Compared with traditional surgery, it has the advantages of selective killing, repeatable treatment, preserving target organ function and so on. The purpose of this study was to explore the clinical value of photodynamic therapy in cervical precancerous lesions by taking the patients with low-grade cervical intraepithelial neoplasia (CIN1) with high-risk human papillomavirus (HR-HPV) persistent infection diagnosed by "three-step diagnosis and treatment procedure" as an example. Using HiPorfin as a photosensitizer, photodynamic therapy was performed 48 hours after intravenous drip. Set laser wavelength 630nm, light dose density 137.58J/cm2, transmission efficiency 1.42, output power 2w. 3cm columnar optical fiber was placed around the 2cm in the cervical canal to cover all the lesions, and the irradiation time was 900s (600s in the cervical canal and 300s outside the cervical canal). The patients were given oxygen inhalation for 6 hours after operation, and the patients were observed for itching and other discomfort, and paid attention to avoid light. Photodynamic therapy was performed again in the same way on the second day. After two months of treatment, pathological biopsy showed chronic cervicitis, indicating that the disease had been effectively controlled. Theoretically, although the patient is not the absolute indication of photodynamic therapy (that is, meeting CIN ? or CIN ?, having fertility requirements and not undergoing surgery), this therapy can remove not only the superficial lesions inside and outside the cervix, but also the potential lesions not found under colposcopy. It can also block the persistent infection of HPV by inhibiting the expression of HPV18, E6 and E7mRNA in Hela cells. In combination with Baofukang suppository, it can block HPV infection. Increase the negative conversion rate of cervical HPV and reduce the probability of recurrence after CIN1 cure. For young female patients with persistent HR-HPV infection and fertility requirements, photodynamic therapy is an effective choice for clinical treatment of CIN1.

scholarly journals B7-H4 Expression in Precancerous Lesions of the Uterine Cervix

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Qianqian Zhang ◽  
Liju Zong ◽  
Hui Zhang ◽  
Wei Xie ◽  
Fan Yang ◽  
...  
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Uterine Cervix ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Interferon Γ ◽  
Control Group ◽  
Low Grade ◽  
Chronic Cervicitis ◽  
Cervical Conization

Over 10% of patients diagnosed with cervical intraepithelial neoplasia (CIN) have no lesions detected in their cervical conization specimens. The purpose of this study was to determine the factors related to the absence of such lesions. We particularly sought to investigate whether the expression of B7-H4 in precancerous lesions and cancer of the uterine cervix plays a role in the presence or absence of residual lesions in conization specimens and whether this protein is associated with T cells (i.e., Foxp3+ regulatory T cells, CD4+, and CD8+) and interferon-γ production. Of the 807 patients with CIN treated by conization, 104 (12.9%) had no lesions in their conization specimens. Seventy-five of these patients were deemed the study group and were matched with 75 patients who did have CIN detected in their conization specimens (the control group). Immunohistochemistry and immunofluorescence staining were used to detect B7-H4, Foxp3, CD4, CD8, and interferon-γ in the 75 pairs of specimens obtained via biopsy; 20 samples were found to have chronic cervicitis, and another 20 had squamous cell carcinoma of the cervix. Menopause, the absence of human papillomavirus, low-grade histological findings, and a diagnosis of CIN1 and CIN2 on biopsy correlated with a low probability of lesions on conization specimens. B7-H4 expression was detected in 11.1% of CIN2, 46.6% of CIN3, and 70% of cervical cancer samples, but not in tissues representing chronic cervicitis or CIN1. B7-H4 expression was associated with the presence of lesions on conization specimens, increased regulatory T cells, decreased CD8+ T cells, and lower interferon-γ production. These data suggest that close follow-up and thorough reevaluation should be considered for patients diagnosed with CIN2 who are negative for B7-H4 expression on biopsy before proceeding with cervical conization.

scholarly journals Human Papillomavirus Distribution in Women with Abnormal Pap Smear and/or Cervical Intraepithelial Neoplasia in Vaccination Era. A Single-Center Study in the North Italian population

2021 ◽  
Vol 9 (4) ◽  
pp. 729
Author(s):  
Barbara Gardella ◽  
Mattia Dominoni ◽  
Cecilia Sosso ◽  
Anna Arrigo ◽  
Andrea Gritti ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Smear ◽  
Prevalence Ratio ◽  
Intraepithelial Neoplasia ◽  
Pap Smears ◽  
Low Grade ◽  
Italian Population ◽  
The North ◽  
Hpv Types

Time trends prevalence of human papillomavirus (HPV) genotypes including negative and untypable infections were analyzed during a 15-year period (2005–2019) among 5807 subjects with abnormal pap-smears and/or cervical intraepithelial neoplasia (CIN). The rates of HPV16 dropped by 13% every 3 years (Prevalence Ratio, PR = 0.87, 95% CI = 0.82–0.93) in the CIN1 biopsy, while HPV16 status was unchanged over time in the CIN2+ biopsy. In CIN1 lesions, there was a corresponding increase of HR-HPV types unrelated to nonavalent vaccine. The rates of HPV 18, 31, and 52, decreased by 35% (PR = 0.65, 95% CI = 0.54–0.79), 19% (PR = 0.81, 95% CI = 0.73–0.91), and 21% (PR = 0.79, 95% CI = 0.73–0.86) every 3-year interval in CIN2+, respectively. Overall, the prevalence of negative/untypable HPV specimens in the entire database increased from 9.6% (129/1349) in the period 2011–2013 to 17.6% (161/913) and 28.4% (224/790) in the 2014–2016 period and in the 2017–2019 period, respectively (PR = 1.69,95% CI = 1.52–1.88). HPV 16 prevalence decreased significantly among subjects with low-grade cervical squamous lesions. A significant increase of both HPV types unrelated to nonavalent vaccination and negative/untypable HPV infections was reported. The prevalence of HPV types among subjects with abnormal pap smears in Northern Italy is changing. Many variables including demographic factors and possibly vaccination could be responsible for this modification.

The role of immunohistochemistry in the diagnosis of cervical intraepithelial neoplasia of different severity

2016 ◽  
pp. 138-140
Author(s):  
S.I. Zhuk ◽  
◽  
O.A. Taran ◽  
A.N. Koshmienskaya ◽  
T.V. Lobastova ◽  
...  
Keyword(s):  
Protein Expression ◽  
Cervical Intraepithelial Neoplasia ◽  
Precancerous Lesions ◽  
Molecular Genetic ◽  
Intraepithelial Neoplasia ◽  
Reproductive Age ◽  
Moderate Degree ◽  
Ki 67 ◽  
The Third ◽  
Diagnosis And Prognosis

The objective: the finding of protein expression of apoptosis regulator BCL-2, Smooth Muscule Actin and the antigen Ki-67 in cervical intraepithelial neoplasia of different severity to optimize the diagnosis and prognosis of the disease. Patients and methods. The study involved 42 women of reproductive age with cervical intraepithelial the neoplasia of the cervix varying degrees applied to the doctor of cervical pathology Zhitomir regional oncologic dispensary. All women (n=42) were divided into groups. The first group included 15 patients (35.7%) with cervical intraepithelial neoplasia with mild. The second group included 13 women (31%) with cervical intraepithelial neoplasia a moderate degree. The third group was represented by patients with cervical intraepithelial neoplasia with severe – 14 respondents (33.3 per cent). Results. Marker BCL-2 in patients of the first group was positive in 7 patients (46.7%), Smooth Muscule Actin was positive in 9 patients (60%) and Ki-67 was diagnosed in 8 of the surveyed women (53.3%). In the second group of BCL-2 was positive in 8 patients (61.5%), Clone 124, Smooth Muscule Actin, Clone 1A4 was positive in 9 patients (69.2%), and Ki-67 was diagnosed in 12 of the surveyed women (92.3%). Marker BCL-2 in patients of the third group was positive in 12 patients (85.7%), Smooth Muscule Actin was positive in 10 patients (71.4%) and Ki-67 was diagnosed in 13 of the surveyed women (92.9% ). Conclusion. Carcinogenesis is associated with molecular genetic damage to the cervix. Some of the products of this process can be used as prognostic and diagnostic markers of tumor progression. Determination of protein expression of apoptosis regulator BCL-2, Smooth Muscule Actin and the antigen Ki-67 in cervical intraepithelial neoplasia makes it possible to accurately verify the diagnosis and to predict the course of pathological changes in the flat epithelium of the cervix. Key words: cervical intraepithelial neoplasia, cervical cancer, morphological diagnostics of precancerous lesions, BCL-2, Smooth Muscule Actin, Ki-67.

scholarly journals Multicentre Evaluation of Hepika Test Clinical Accuracy in Diagnosing HPV-Induced Cancer and Precancerous Lesions of the Uterine Cervix

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 619
Author(s):  
Daniela Gustinucci ◽  
Lucia Ciccocioppo ◽  
Luigi Coppola ◽  
Giovanni Negri ◽  
Gianfranco Zannoni ◽  
...  
Keyword(s):  
Uterine Cervix ◽  
Protein Complexes ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Enzyme Linked Immunosorbent Assay ◽  
Lower Sensitivity ◽  
Adenocarcinoma In Situ ◽  
Clinical Accuracy ◽  
Grade 3

Objective: To evaluate the clinical accuracy of Hepika test to identify cancer/precancerous lesions of the uterine cervix. Materials and Methods: A multicentre retrospective study was carried out in 2018 and included 330 liquid-based cytology samples from three Italian centres of women aged 25–64 who had been tested for the human papillomavirus (HPV) and whose histology or follow-up outcome was known. Hepika is an enzyme-linked immunosorbent assay (ELISA) targeting the protein complexes E6#p53 and E7#pRb. After excluding samples without sufficient residual material, the clinical accuracy of Hepika test was evaluated in 274 samples: adenocarcinoma (ADC) (4), squamous cell carcinoma (SCC) (7), adenocarcinoma in situ (AIS) (1), cervical intraepithelial neoplasia (CIN) grade 3 (60), CIN2 (51), CIN1 (34), and negative histology (117). Association, sensitivity, and specificity for carcinoma, CIN3+ and CIN2+ are reported. Results: Positive Hepika test was associated with a high probability of carcinoma (odds ratio (DOR) = 33.68, 95% confidence interval (CI) 7.0–163.1); sensitivity was 81.8%, specificity, 88.2%. A positive Hepika test showed a weaker association with CIN3+ lesions (DOR = 3.5; 95% CI 1.75–6.99) and lower sensitivity (27.8%). Conclusion: The Hepika test was found to be an accurate biomarker for HPV-induced cervical carcinoma. Population-based prospective studies are needed to confirm the clinical usefulness of the Hepika test in the differential diagnosis of HPV-induced invasive lesions.

P16 Methylation Is an Early Event in Cervical Carcinogenesis

2011 ◽  
Vol 21 (3) ◽  
pp. 452-456 ◽  
Author(s):  
Lee-Wen Huang ◽  
Hun-Shan Pan ◽  
Yu-Hung Lin ◽  
Kok-Min Seow ◽  
Heng-Ju Chen ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Promoter Methylation ◽  
Intraepithelial Neoplasia ◽  
Promoter Hypermethylation ◽  
Early Event ◽  
Low Grade ◽  
Neoplastic Progression ◽  
Frequent Event ◽  
Significant Difference ◽  
Low Grade Dysplasia

BackgroundAberrant gene promoter methylation is a critical event in tumorigenesis. The aim of this study was to explore the promoter hypermethylation of p16 and DAPK1 during the progression of cervical precancerous lesions.MethodsA series of 98 cervical neoplasms (72 cervical intraepithelial neoplasia and 26 cervical carcinomas) were evaluated. The promoter methylation status of p16 and DAPK1 was assessed from cervical scrapings by methylation-specific polymerase chain reaction.ResultsFor p16, the frequency of promoter hypermethylation showed an increasing trend from normal to dysplastic to invasive squamous cancer specimens, and this increase reached statistical significance (P < 0.0001). However, there was no significant difference in the promoter methylation state of DAPK1 with regard to the various grades of cervical lesions (P = 0.077). Specifically, methylation of p16 was a frequent event in the cervical carcinoma samples, and these figures were statistically significant compared with the normal and cervical intraepithelial neoplasia I cases (P = 0.015 and P = 0.021, respectively).ConclusionsThese results imply that promoter hypermethylation of p16 occurs at an early stage of cervical neoplastic progression. This early event may play an initiating role in the malignant transformation of low-grade dysplasia into high-grade dysplasia and invasive carcinoma. We suggest that aberrant promoter methylation of p16 may serve as a useful biomarker during the follow-up of low-grade dysplasia.

scholarly journals AYURVEDIC MANAGEMENT OF ATROPHIC VAGINITIS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA- A CASE REPORT

2020 ◽  
pp. 69-72
Author(s):  
Giby Thomas ◽  
Lakshmi Devi.R
Keyword(s):  
Case Report ◽  
Cervical Intraepithelial Neoplasia ◽  
Vaginal Discharge ◽  
Symptomatic Relief ◽  
Intraepithelial Neoplasia ◽  
Burning Sensation ◽  
Low Grade ◽  
Atrophic Vaginitis ◽  
Genital Area ◽  
Intraepithelial Lesion

Vaginitis in postmenopausal women is termed as atrophic vaginitis, characterised by vaginal bleeding or spotting, vaginal discharge and discomfort or dryness in vulva. As the symptoms are not usually disclosed by women it may become chronic and can adversely affect the quality of life. In cervical intraepithelial neoplasia the squamous epithelium of cervix is replaced by the cells of varying degree of atypia. Even though CIN1 and CIN2 regress spontaneously, untreated CIN1 and CIN2 lesions may progress to invasive carcinoma. Ayurvedic management for the above conditions focuses on symptomatic relief and improvement of general health and immunity. Oral medication and Sthanika Chikitsa like Kshara Karma and Varthi play vital role in this. A 70 year old lady presented with complaints of burning sensation and itching over genital area. On examination haemorrhagic spots were observed on vaginal walls. She was sent to Early Cancer Detection Centre for cytological screening. The reports showed low grade sqamous intraepithelial lesion. She was managed with oral medications and Sthanika chikitsa. During follow up she was relieved from the symptoms like burning sensation and itching over genital area and vaginal discharge. Bleeding spots on vaginal walls were absent and cytology revealed a negative smear for intraepithelial lesion or malignancy. From this case report it is evidenced that Ayurvedic treatment modality is effective and successful for the management of Atrophic vaginitis with CIN.

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