Table of Contents
1
UI - 11336720
AU - Lorenzato F; Singer A; Mould T; Santos LC; Maia A; Cariri L
TI -
Cervical cancer detection by hybrid capture and evaluation of local risk
factors.
SO - Int J Gynaecol Obstet 2001 Apr;73(1):41-6
AD - Department of Gynecology and Obstetrics, Instituto Materno-Infantil de
Pernambuco (IMIP), Recife, PE, Brazil. f.lorenzato@ucl.ac.uk
The city of Recife, northeastern Brazil, is reported to have the highest
incidence of cervical cancer worldwide (83.2/100000 women). OBJECTIVE:
To evaluate the efficacy of Hybrid Capture I (HC I) in cervical cancer
detection and some risk factors in Recife. METHOD: Cervical scrapes for
HC I analysis followed by colposcopy were collected from 140 women (70
with cervical cancer and 70 with normal cervix) from three screening
services in Recife. RESULT: HC I sensitivity and specificity were 82.9
and 41.4%, respectively. The odds ratios for cervical cancer when Gesta
> or = 5 and vaginal parity > or = 4 were, respectively, 5.30 and 4.27.
CONCLUSION: HC I is a moderately sensitive method to detect cervical
cancer, but it does not seem to be useful as a primary screening tool
for it's low specificity. Early pregnancy, high Gesta/Para and living in
rural areas were important local risk factors.
2
UI - 11434573
AU - Cibere J; Sibley J; Haga M
TI -
Systemic lupus erythematosus and the risk of malignancy.
SO - Lupus 2001;10(6):394-400
AD - Arthritis Research Centre of Canada. Vancouver.
The objective of this study was to determine the relative risks of
malignancy and of site-specific malignancies in patients with systemic
lupus erythematosus (SLE). A cohort of 297 patients (91% Caucasian) with
SLE were seen between 1975 and 1994 and followed for a mean of 12 years
at the University of Saskatchewan Rheumatic Disease Unit. Expected
cancer incidence rates were determined based on Province of Saskatchewan
population statistics matched to each study patient for age, sex and
calendar year of follow-up. Standardized incidence ratios (SIRs) of
observed to expected cancers and 95% confidence intervals (95% CI) were
calculated. A total of 27 cases of cancer were observed, whereas only
16.9 were expected (SIR 1.59 (95% CI 1.05-2.32)). For site-specific
malignancies, an excess of cancer of the cervix (SIR 8.15 (95% CI
1.63-23.81)) as well as hemopoietic malignancy (SIR 4.9 (95% CI
1.57-11.43)) was found. The hemopoietic cancers were predominantly
non-Hodgkin's lymphoma (SIR 7.01 (95% CI 1.88-17.96)). We did not find
an association of malignancy with known risk factors, including use of
cytotoxic agents. Increased risk of malignancy, notably non-Hodgkin's
lymphoma and perhaps cervical cancer, should be regarded as a
complication of SLE.
3
UI - 11440066
AU - Arillo-Santillan E; Nigenda G; Sanchez-Prado VM; de Ruiz PA;
TI -
Najera-Aguilar P; Lazcano-Ponce EC
Mexico City physicians' awareness about cervical cancer prevention:
implications for cancer screening.
SO - J Cancer Educ 2001 Summer;16(2):75-9
AD - Teaching Department, Academic Secretariat, National Public Health
Institute, Cuernavaca, Morelos, Mexico.
BACKGROUND: In spite of an early cancer detection program (CCSP), Mexico
has a mortality rate for cervical cancer of 16.5 per 100,000 women.
METHOD: A cross-sectional study of 330 physicians at the Mexico City
General Hospital evaluated their knowledge of the CCSP, etiology,
diagnostic alternatives, and treatment guidelines. Variance analysis was
the statistical procedure used. Replies to a questionnaire about
cervical cancer prevention awareness were scored on a scale from 1 to 9.
RESULTS: According to the awareness scale, the global average
classification was 4.4, with 50% of the physicians scoring 4 or less.
There was no difference in the CCSP knowledge scores of gynecologists
(mean 4.92, 95% CI 4.2-5.3), oncologists (mean 4.85, 95% CI 4.3-5.5),
pathologists (mean 5.23, 95% CI 4.9-5.6), and those in other specialties
(mean 4.29, 95% CI 4.2-5.0), p > 0.05. Many respondents attributed
CCSP's lack of effectiveness to public apathy (68.12%). CONCLUSIONS: The
effectiveness of the CCSP can be improved by educating health
professionals if this education is combined with elimination of
obstacles to its use. More information is needed to justify revising how
doctors are educated in terms of not only quality of the training but
also the contents of pre- and postgraduate training programs.
4
UI - 11446478
AU - Markowska J; Fischer N; Warchol JB; Fischer Z
TI -
Detection of Chlamydia trachomatis infection in women with CIN and
invasive carcinoma. Controversial results of different methods.
SO - Eur J Gynaecol Oncol 2001;22(2):134-6
AD - Faculty of Medicine, K. Marcinkowski University School of Medicine,
Poznan, Poland.
Chlamydia (Ch.) trachomatis infection as a sexually transmitted disease
is highly important, but reliable methods of diagnosing it remain to be
worked out. We used three methods of detection: an immunoenzymatic
technique for detection of Ch. trachomatis antigen in endocervical
material, in situ PCR, and enzyme-immuno assay for detection of IgG
class anti-Ch. trachomatis antibodies in serum. We have compared the
IS-PCR technique and method of detection of the endocervical antigen. We
have not confirmed compatibility of the results obtained in these two
methods. Parallel positive results obtained in patient serum and
detection of chlamydial DNA by IS-PCR have been accepted to be
indicative of persistent infection of Ch. Trachomatis.
5
UI - 11446486
AU - Pekin T; Kavak Z; Yildizhan B; Kaya H
TI -
Prognosis and treatment of primary adenocarcinoma and adenosquamous cell
carcinoma of the uterine cervix.
SO - Eur J Gynaecol Oncol 2001;22(2):160-3
AD - Department of Gynecologic Oncology, Marmara University Hospital,
Istanbul, Turkey.
PURPOSE: To evaluate a cohort of women with primary invasive carcinomas
of the uterine cervix, and to compare the biological characteristics and
behavior of a cohort of adenosquamous carcinomas with a cohort of
adenocarcinomas and squamous cell carcinomas. METHODS: One hundred and
fourteen cases of primary invasive cervical carcinoma presenting between
with adenosquamous cell carcinomas and eight (7%) adenocarcinomas were
compared with 90 (79%) women with squamous cell carcinomas. Patients
with Stage Ib and IIa were treated by radical hysterectomy and pelvic
lymph node dissection. All patients with stage IIb and over were treated
by radiation. Patients with bulky, large, barrel-shaped lesions were
selected for treatment by a combination of radiation and extrapelvic
hysterectomy. RESULTS: The corrected survival rate for stage Ib patients
with adenosquamous cell carcinoma was only 27.2%, compared with a 92.2%
corrected survival rate for squamous cell, and a 100% corrected survival
rate for adenocarcinoma. CONCLUSION: There is a higher proportion of
adenosquamous cell and adenocarcinoma of the cervix than generally
appreciated. The epidemiological risk factors associated with
adenosquamous carcinomas of the cervix are more similar to those of
squamous cell carcinomas than of adenocarcinomas. The survival
difference between two groups is explained by effects of clinical stage,
nodal spread, and vascular space involvement.
6
UI - 11446489
AU - Patnick J; Monsonego J; de Wolf C; Verbeek A; Bonte J; Agnantis N; De
TI -
Oliveira CF; Dexeus S; Maggino T; Onnis A; Zielinski J
ESGO consensus document on cervical cancer screening. European Society
of Gynaecological Oncology.
SO - Eur J Gynaecol Oncol 2001;22(2):99-101
7
UI - 11456227
AU - Weinstein SJ; Ziegler RG; Selhub J; Fears TR; Strickler HD; Brinton LA;
TI -
Hamman RF; Levine RS; Mallin K; Stolley PD
Elevated serum homocysteine levels and increased risk of invasive
cervical cancer in US women.
SO - Cancer Causes Control 2001 May;12(4):317-24
AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute,
NIH, Bethesda, MD 20892, USA.
OBJECTIVES: To explore the relationship between serum homocysteine, a
sensitive biomarker for folate inadequacy and problems in one-carbon
metabolism, and invasive cervical cancer. METHODS: A large case-control
study was conducted in five US areas with up to two community controls,
obtained by random-digit dialing, individually matched to each case.
Cervical cancer risk factors were assessed through at-home interview.
Blood was drawn at least 6 months after completion of cancer treatment
from 51% and 68% of interviewed cases and controls. Serum homocysteine
was measured by high-performance liquid chromatography, and exposure to
human papillomavirus (HPV) type 16, the most prevalent oncogenic type,
was assessed using an enzyme-linked immunosorbent assay. Cases with
advanced cancer and/or receiving chemotherapy were excluded, leaving 183
cases and 540 controls. RESULTS: Invasive cervical cancer risk was
substantially elevated for women in the upper three homocysteine
quartiles (> 6.31 micromol/L); multivariate-adjusted odds ratios ranged
from 2.4 to 3.2 (all 95% CIs excluded 1.0). A trend was apparent and
significant (p = 0.01). When cases were compared with HPV-16
seropositive controls only, odds ratios were comparable. CONCLUSIONS:
Serum homocysteine was strongly and significantly predictive of invasive
cervical cancer risk. This association could reflect folate, B12 and/or
B6 inadequacy, or genetic polymorphisms affecting one-carbon metabolism.
8
UI - 11455035
AU - Jee KJ; Kim YT; Kim KR; Aalto Y; Knuutila S
TI -
Amplification at 9p in cervical carcinoma by comparative genomic
hybridization.
SO - Anal Cell Pathol 2001;22(3):159-63
AD - Department of Medical Genetics, Haartman Institute and Helsinki
University Central Hospital, University of Helsinki, Finland.
DNA copy number changes were studied by comparative genomic
hybridization on 10 tumor specimens of squamous cell carcinoma of cervix
obtained from Korean patients. DNA was extracted from paraffin-embedded
sections after removal of non-malignant cells by microdissection
technique. Copy number changes were found in 8/10 tumors. The most
frequent changes were chromosome 19 gains (n=6) and losses on
chromosomes 4 (n=4), 5 (n=3), and 3p (n=3). A novel finding was
amplification in chromosome arm 9p21-pter in 2 cases. Gains in 1, 3q,
5p, 6p, 8q, 16p, 17, and 20q and losses at 2q, 6q, 8p, 9q, 10p, 11, 13,
16q, and 18q were observed in at least one of the cases.
9
UI - 11475387
AU - Hagen MD; Garber AM; Goldie SJ; Lafata JE; Mandelblatt J; Meltzer D;
TI -
Neumann P; Siegel JE; Sox HC Jr; Tsevat J
Does cost-effectiveness analysis make a difference? Lessons from Pap
smears. Symposium.
SO - Med Decis Making 2001 Jul-Aug;21(4):307-23
10
UI - 11474018
AU - Lanham S; Herbert A; Basarab A; Watt P
TI -
Detection of cervical infections in colposcopy clinic patients.
SO - J Clin Microbiol 2001 Aug;39(8):2946-50
AD - Department of Molecular Microbiology, Southampton General Hospital,
Southampton SO16 6YD, United Kingdom. sal3@soton.ac.uk
The purpose of this study was to determine if Neisseria gonorrhoeae;
Chlamydia trachomatis; herpes simplex virus; cytomegalovirus;
Epstein-Barr virus; human herpesviruses 6, 7, and 8; or adeno-associated
virus influenced the production of cervical intraepithelial neoplasia.
Two hundred thirty-one cervical smear samples were tested for the
presence of the organisms by PCR. In addition, human papillomavirus
types in the samples were determined by PCR and classified into cancer
risk types of high, moderate, and low. There was no link with cervical
intraepithelial neoplasia status and detection of herpes simplex virus,
cytomegalovirus, Epstein-Barr virus, human herpesviruses 6 and 8,
gonorrhea, or chlamydia. However, high-grade cervical intraepithelial
neoplasia was found more frequently with mixed infection by
moderate-risk human papillomavirus types and human herpesvirus 7 than
with these papillomavirus types alone. The presence of human herpesvirus
7 may increase the oncogenic potential of moderate-risk human
papillomavirus types.
11
UI - 11501771
AU - Matsushita M; Kurata H; Kase H; Arakawa M; Aoki Y; Tanaka K
TI -
MR imaging underestimates stromal invasion in patients with
adenocarcinoma of the uterine cervix.
SO - Eur J Gynaecol Oncol 2001;22(3):201-3
AD - Department of Obstetrics and Gynecology Niigata University Faculty of
Medicine, Japan.
PURPOSE OF INVESTIGATION: To evaluate magnetic resonance (MR) imaging in
assessing the depth of stromal invasion in patients with adenocarcinoma
of the uterine cervix. METHODS: Twenty-three women with adenocarcinoma
of the cervix underwent T2-weighted and dynamic MR imaging before
surgical evaluation. The images were evaluated for the depth of stromal
invasion and compared with histological results. RESULTS: Twelve of 23
patients (52%) were correctly diagnosed in agreement with the
histological findings. However, the depth of stromal invasion was
underestimated in ten patients (44%). In four of nine patients who
exhibited scattered type lesions, no lesions were detected by MR
imaging, although deep stromal invasion (more than 1/3) was recognized
histologically. In contrast, all 11 patients showed cancer lesions in
solid type adenocarcinomas with deep stromal invasion. CONCLUSION: MR
imaging detected less stromal invasive lesions in adenocarcinoma of the
cervix than surgical specimens, and some scattered type adenocarcinomas
could not be visualized.
12
UI - 11501781
AU - Diakomanolis E; Elsheikh A; Voulgaris Z; Rodolakis A; Vlachos G;
TI -
Michalas S
Cervical intraepithelial neoplasia in the young female. Diagnosis and
management.
SO - Eur J Gynaecol Oncol 2001;22(3):236-7
AD - Department of Obstetrics & Gynecology, University of Athens, Alexandra
Hospital, Greece.
The prevalence of HPV and CIN in young women has increased in recent
years. During a 5-year period (1996-2000), 78 sexually active young
females, aged 15-20 years, were referred to the Colposcopic Unit of the
1st Department of Obstetrics and Gynecology of the University of Athens
in the major University-appointed hospital in Greece, because of an
abnormal cytology or a suspicious cervical abnormality in the presence
of negative cytology. Colposcopic examinations were found to be within
normal limits in 12/78 (15.4%) of cases. Cervical pathology was related
in 22 cases (28.2%) to HPV infection, 23 (29.5%) cases to CIN 1, 18
(23.1%) cases to CIN II and 3 (3.8%) to CIN III. No relation between
oral contraceptive use and cigarette smoking with HPV infection was
found. Our findings strongly confirm the necessity of obtaining
cervicovaginal smears on all sexually active gynecologic and obstetric
teenage patients.
13
UI - 11509647
AU - Sheu BC; Lin RH; Lien HC; Ho HN; Hsu SM; Huang SC
TI -
Predominant Th2/Tc2 polarity of tumor-infiltrating lymphocytes in human
cervical cancer.
SO - J Immunol 2001 Sep 1;167(5):2972-8
AD - Department of Obstetrics and Gynecology, National Taiwan University
Hospital, National Taiwan University College of Medicine, Taipei,
Taiwan. bcsheu@ha.mc.ntu.edu.tw
Cytotoxic T lymphocytes (Tc) play a central role in cellular immunity
against cancers. The cytotoxic potential of freshly isolated
tumor-infiltrating lymphocytes (TILs) is usually not expressed. This
suggests the possible existence of as yet unspecified and perhaps
complex immunosuppressive factors or cytokines that affect the
anti-tumor capacity of these TILs in the tumor milieu. In the present
study, we demonstrated for the first time that TILs derived from human
cervical cancer tissue consist mainly of Th2/Tc2 phenotypes. In vitro
kinetic assays further revealed that cancer cells could direct the
tumor-encountered T cells toward the Th2/Tc2 polarity. Cancer cells
promote the production of IL-4 and down-regulate the production of
IFN-gamma in cancer-encountered T cells. The regulatory effects of
cervical cancer cells are mediated mainly by IL-10, and TGF-beta plays
only a synergistic role. The cancer-derived effects can be reversed by
neutralizing anti-IL-10 and anti-TGF-beta Abs. IL-10 and TGF-beta are
present in cancer tissue and weakly expressed in precancerous tissue,
but not in normal cervical epithelial cells. Our study strongly suggests
important regulatory roles of IL-10 and TGF-beta in cancer-mediated
immunosuppression.
14
UI - 11544692
AU - Anttila A; Pukkala E; Nieminen P; Hakama M
TI -
[Incidence of cervical cancer is clearly increasing in Finland]
SO - Duodecim 1998;114(11):1117-24
AD - Suomen Syoparekisteri, joukkotarkastusrekisteri Liisankatu 21 B, 00170
Helsinki. ahti.anttila@cancer.fi
15
UI - 11544696
AU - Nieminen P
TI -
[How to read a PAP report?]
SO - Duodecim 1998;114(11):1138-43
AD - HYKS:n naistenklinikka PL 140, 00029 HYKS. pekka.nieminen@huch.fi
16
UI - 11525590
AU - Yeo AS; Schiff MA; Montoya G; Masuk M; van Asselt-King L; Becker TM
TI -
Serum micronutrients and cervical dysplasia in Southwestern American
Indian women.
SO - Nutr Cancer 2000;38(2):141-50
AD - Department of Public Health and Preventive Medicine, Oregon Health
Sciences University, Portland 92701-3098, USA.
We carried out a clinic-based case-control study to assess serum
micronutrients as risk factors for cervical dysplasia among Southwestern
American Indian women, a group with high rates of cervical preinvasive
lesions. Cases were American Indian women with biopsy-proven cervical
intraepithelial neoplasia (CIN I or CIN II/III). Controls were from the
same Indian Health Service clinics with normal cervical epithelium. We
interviewed women about histories of sexually transmitted diseases,
sexual behavior, diet, hygienic practices, cigarette smoking, and
reproductive factors. Laboratory assays included serum for retinol
(vitamin A), ascorbic acid (vitamin C), alpha-tocopherol (vitamin E),
and red blood cell folate levels, DNA for human papillomavirus (HPV)
typing, and tests for other sexually transmitted diseases. The strongest
risks for cervical dysplasia were associated with cervical HPV infection
[odds ratio (OR) = 3.2, 95% confidence interval (CI) = 2.2-4.6 and OR =
7.9, 95% CI = 4.8-13.1 for CIN I and CIN II/III, respectively]. With
adjustments made for HPV infection and other relevant confounders,
subjects in the lowest serum retinol quartile were at increased risk of
CIN I compared with women in the highest quartile (OR = 2.3, 95% CI =
1.3-4.1). The data suggest that low serum alpha-tocopherol was
associated with CIN I/III, although the adjusted OR was not
statistically significant (OR = 2.0, 95% CI = 0.9-4.8). Low serum
ascorbic acid and red blood cell folate were not associated with
cervical dysplasia.
17
UI - 11527105
AU - Bottorff JL; Balneaves LG; Sent L; Grewal S; Browne AJ
TI -
Cervical cancer screening in ethnocultural groups: case studies in
women-centered care.
SO - Women Health 2001;33(3-4):29-46
AD - School of Nursing, University of British Columbia, Vancouver, Canada.
Bottorff@nursing.ubc.ca
INTRODUCTION: The purpose of this study was to identify and describe
critical elements of women-centered care within the context of providing
cervical screening to three ethnocultural groups in Canada: Asian, South
Asian and First Nations. METHODS: Data for this collective case study
included open-ended interviews with purposive samples of women and key
informants from each target group. Following thematic analysis,
cross-case analysis was completed by comparing and contrasting issues
and contextual factors influencing women's and providers' experiences.
RESULTS: Cervical screening services for each group were shaped by
attention to ethnocultural values, women's desire for thorough
explanations, and the importance of a comfortable setting. While
participation rates varied across clinics, women were positive about
their experiences in obtaining cervical screening. Some women's
expectations that they could address a range of health concerns with
female health providers at the clinics were stymied by structural
barriers that prevented staff from addressing issues beyond those
directly related to cervical screening. Cross-case analysis revealed
three key elements of women-centered care: respectful and culturally
appropriate interactions between women and health providers, the
importance of providing acceptable alternatives for women, and the need
for comprehensive health services. CONCLUSION: While the establishment
of Pap test clinics for ethnocultural groups has the potential to
enhance participation in cervical screening, changes in health policy
and the structure of health services are required for existing programs
to fully implement the elements of women-centered health care identified
in this study. Other models of providing health care to women in
ethnocultural groups, including the use of clinics staffed by nurse
practitioners, should be evaluated.
18
UI - 11549855
AU - Hachisuga T; Fukuda K; Kawarabayashi T
TI -
Local immune response in squamous cell carcinoma of the uterine cervix.
SO - Gynecol Obstet Invest 2001;52(1):3-8
AD - Department of Obstetrics and Gynecology, School of Medicine, Fukuoka
University, Fukuoka, Japan. hachisug@fukuoka-u.ac.jp
The role of Langerhans cells as antigen-presenting cells was examined in
cervical carcinomas. Frozen samples were obtained from 34 women with
stage Ib and II cervical carcinomas. Langerhans cells (CD1), T
lymphocytes (CD4 and CD8), B lymphocytes (CD22), and natural killer
(CD57, NK) cells were all quantitatively assessed in cervical carcinomas
using immunohistochemical methods. These results were related to the MHC
class I and II expression on the tumor cells. The majority of Langerhans
cells were distributed among cancer cells and they were positively
correlated with CD4+, NK and B cells in cervical carcinomas. This is
suggestive of the presence of local immune response. The numbers of
Langerhans, CD4+, CD8+ and NK cells did not significantly correlate with
age at operation, lymph node metastases or depth of cervical wall
invasion. The downregulation of MHC class I expression found in 8 (24%)
carcinomas was not associated with the decrease in the number of
immunologic cells. The upregulation of MHC class II expression found in
26 (76%) carcinomas was significantly associated with the increase in
the number of Langerhans cells (p < 0.007). However, the association
between the upregulation of MHC-II expression and CD4+ cells did not
reach statistical significance (p < 0.07). This is probably due to a
small case in this study. MHC-II-restricted immunity may partly
contribute to the local immune response in stages Ib and II squamous
cell carcinoma of the uterine cervix. Copyright 2001 S. Karger AG, Basel
19
UI - 11549862
AU - Duttagupta C; Basu J; Ray M; Romney SL
TI -
Apoptotic changes in cervical intraepithelial neoplasia.
SO - Gynecol Obstet Invest 2001;52(1):38-42
AD - Department of Obstetrics and Gynecology, Albert Einstein College of
Medicine, Bronx, NY, USA. chandra@isical.ac.in
We examined apoptosis in paraffin-embedded archival cervical tissues
from cervical intraepithelial neoplasia (CIN) cases to determine whether
the apoptotic process is involved in the cellular changes of CIN.
Apoptotic bodies, determined by the Tunel method, were largely found at
the surface epithelium in a few tissue specimens with no significant
abnormality and in most tissues with CIN. Apoptotic bodies were also
found within the stratified epithelium of CIN lesions and were
altogether absent in specimens with no significant abnormalities. The
apoptotic index was significantly associated with the severity of CIN
and not with either age or human papillomavirus infection. Based on the
findings of increased numbers of apoptotic bodies and their presence
within the stratified epithelium in CIN tissues, we hypothesize that
dysregulation in the exfoliation of apoptotic cells and resistance
towards apoptosis may be prerequisites for the pathogenesis of CIN.
Copyright 2001 S. Karger AG, Basel
20
UI - 11563564
AU - Apgar BS
TI -
New tests for cervical cancer screening.
SO - Am Fam Physician 2001 Sep 1;64(5):729-30, 732
21
UI - 11563569
AU - Nuovo J; Melnikow J; Howell LP
TI -
New tests for cervical cancer screening.
SO - Am Fam Physician 2001 Sep 1;64(5):780-6
AD - Department of Family and Community Medicine, University of California,
Davis, School of Medicine, Sacramento 95817, USA.
jim.nuovo@ucdmc.ucdavis.edu
The Papanicolaou (Pap) smear has been used to screen women for cervical
cancer since 1940. Recently, a number of new technologies have been
developed to improve the detection of cervical cancer and its
precursors. However, there is substantial controversy about whether the
new tests offer meaningful advantages over the conventional Pap smear.
Ideally, these new tests will increase the early detection of meaningful
Pap smear abnormalities, reduce the number of unsatisfactory smears and
provide fewer ambiguous results. It is also hoped that these new
screening methods will not increase the number of false-positive
results, but will improve the productivity of cytology laboratories
without substantially increasing costs. The new tests include
liquid-based/thin-layer preparations to improve the quality and adequacy
of the Pap smear; computer-assisted screening methods to improve Pap
smear interpretation; and new-generation human papillomavirus testing
methods that may be useful in triaging patients with atypical squamous
cells of undetermined significance or low-grade squamous intraepithelial
lesions. Evidence on these new tests is reviewed and the advantages and
disadvantages of their use are discussed.
22
UI - 11562771
AU - Imura J; Ichikawa K; Takeda J; Fujimori T
TI -
Beta-catenin expression as a prognostic indicator in cervical
adenocarcinoma.
SO - Int J Mol Med 2001 Oct;8(4):353-8
AD - Department of Surgical Pathology, Dokkyo University School of Medicine,
880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
imura@dokkyomed.ac.jp
The purpose of this study was to assess the prognostic influence of
beta-catenin expression by immunohistochemistry in patients with
cervical adenocarcinomas. The study group comprised of 51 patients who
underwent total hysterectomy for cervical cancer. The median follow-up
was 39 months (range 1-138 months). beta-catenin was expressed strongly
on the membranes of normal cervical epithelial and glandular cells.
Uniform membranous beta-catenin staining localized to intercellular
borders was observed in 35% of tumors, whereas 65% of tumors
demonstrated an abnormal pattern of reduced or aberrant beta-catenin
expression (i.e., cytoplasmic and/or nuclear staining patterns).
Abnormal beta-catenin immunoreactivity was associated statistically with
advanced pathologic stage (p=0.018). The 10-year disease-free survival
was 51.0% in patients with preserved expression of beta-catenin. On the
other hand, a poorer prognosis was noted in the group with abnormal
expression of beta-catenin with a 10-year disease-free survival of
43.4%. By multivariate analysis, low pathologic stage (stages I and II,
p=0.001) and preservation of beta-catenin expression (p=0.012) were
independently favorable prognostic factors. Our results indicate that
changes in beta-catenin expression occur during the progression of
cervical adenocarcinoma to an invasive phenotype. These results suggest
that beta-catenin is an important intercellular adhesion molecule.
Assessment of beta-catenin immunoreactivity may be a useful prognostic
tool in cervical adenocarcinoma complementary to established prognostic
factors. Furthermore, we developed a strategy for choosing biomarkers
representing the steps in malignant progression in an effort to identify
patients with occult metastases who will need adjuvant therapy and spare
women from unnecessary interventions.
23
UI - 11562779
AU - Odunsi K; Ganesan T
TI -
Motif analysis of HLA class II molecules that determine the HPV
associated risk of cervical carcinogenesis.
SO - Int J Mol Med 2001 Oct;8(4):405-12
AD - Department of Gynecological Oncology, Roswell Park Cancer Institute,
Buffalo, NY 14263, USA. kunle.odunsi@roswellpark.org
In previous studies, the HLA class II haplotype HLA DRB1*0401-DQB1*0301
was shown to correlate with susceptibility to HPV infection, CIN and
cervical cancer while DRB1*0101-DQB1*0501 indicated protection. The
present study was designed to identify naturally processed peptide
sequences bound to the susceptibility and protective HLA DR-DQ
molecules, and use this for T-helper epitope prediction from HPV 16. The
HLA class II molecules were obtained by immuno-affinity purification of
Epstein-Barr virus B lymphoblastoid cell lines (BCL) homozygous for HLA
DQA1*0301-DQB1*0301 and HLA DQA1*0101-DQB1*0501. Peptide pools eluted
from the HLA molecules were sequenced by Edman degradation. On the basis
of the peptide sequence data obtained, the E6, E7, L1 and L2 proteins of
HPV 16 were examined to identify sequences which are likely to bind to
HLA DQB1*0301 and DQB1*0501. In addition, motif prediction as well as
the binding affinity of predicted peptide motifs for HLA DRB1*0401 and
DRB1*0101, the DR alleles associated with susceptibility and protection
respectively, was accomplished using published data and a prediction
algorithm for the naturally processed peptide sequences bound to these
molecules. The HLA DQB1*0501 peptide ligand sequence showed that proline
gives an outstanding signal at position 2, Asn/Arg at P1,
aliphatic/aromatic amino acids in the central portion, a hydrophobic
cluster at P5 with a small contribution by small polar residues and
another cluster of aromatic residues towards the C-terminus. The HLA
DQB1*0301 sequence also showed that proline gives an outstanding signal
at position 2, Thr/Arg at P1, aliphatic/aromatic amino acids in the
central portion and an aliphatic cluster with a small contribution by
small polar residues at P5. There were no differences in the number of
HPV peptides that were predicted as being capable of binding to HLA
DQB1*0301 and HLA DQB1*0501, but more HPV peptide motifs were predicted
to bind with high affinity to HLA DRB1*0101 than DRB1*0401. The results
suggest that HPV 16 peptide epitopes bind with higher affinity to the
protective than to susceptible HLA DR-DQ molecules which may lead to a
more effective immune response.
24
UI - 11563867
AU - Davies P; Kornegay J; Iftner T
TI -
Current methods of testing for human papillomavirus.
SO - Best Pract Res Clin Obstet Gynaecol 2001 Oct;15(5):677-700
AD - BMI Health Services, The Advanced Diagnostic Centre, Cumberland House,
Victoria Road, London, NW10 6RF, UK.
Human papillomavirus DNA testing is gaining wider acceptance, yet the
majority of testing is still undertaken in the research setting using
protocols that are unsuitable for clinical diagnostic laboratories.
Large-scale clinical human papillomavirus DNA testing is likely to be
introduced as an adjunct to cervical cytology, so the cytology
laboratory is an appropriate place for it to be undertaken. This poses a
challenge for any human papillomavirus DNA test since it will be
performed by technicians not specifically trained in virology or
molecular biology, and will need to produce consistently reliable
results in this setting. This is only realistically possible with a
standardized and quality-controlled, commercially produced human
papillomavirus DNA test. There is currently only one such commercially
available assay, although there are a number of research-based tests
that could logically lead to additional commercial products. The
technological basis of these assays, together with available performance
data, is reviewed in this chapter and the clinical utility of the tests
is evaluated. Copyright 2001 Harcourt Publishers Ltd.
25
UI - 11563868
AU - Man S; Fiander A
TI -
Immunology of human papillomavirus infection in lower genital tract
neoplasia.
SO - Best Pract Res Clin Obstet Gynaecol 2001 Oct;15(5):701-14
AD - Department of Medicine, University of Wales College of Medicine, Tenovus
Building, Heath Park, Cardiff, UK.
Despite its being a relatively common virus, the study of human
papillomavirus infection has lagged behind that of other viruses. Human
papillomaviruses do not provoke strong systemic antibody or T-cell
responses. Furthermore, the majority of those infected do not display
clinical symptoms and are able to clear the virus by unknown mechanisms.
In the last decade, however, research into human papillomavirus
immunology has blossomed, for two main reasons. First, there is strong
circumstantial evidence that the immune system can control
papillomavirus infection, since the prevalence of human
papillomavirus-associated neoplasia is increased in immunocompromised
individuals. Second, the strong association between human papillomavirus
infection and cervical cancer has led to attempts to develop
prophylactic or therapeutic vaccines. In this chapter, our current
knowledge of human papillomavirus immune responses will be reviewed, and
how this relates to clinical practice will be discussed. Copyright 2001
Harcourt Publishers Ltd.
26
UI - 11563870
AU - Dillner J
TI -
Primary screening for human papillomavirus infection.
SO - Best Pract Res Clin Obstet Gynaecol 2001 Oct;15(5):743-57
AD - Department of Medical Microbiology, Lund University, MAS University
Hospital, Malmo, Sweden.
As human papillomavirus infection is now known to be a necessary risk
factor for at least 95% of cervical cancers, the medical community has a
responsibility to assess and evaluate how this knowledge should best be
used for the prevention of cervical cancer. Organized screening
strategies combining cytological screening with human papillomavirus
testing in older age groups could theoretically be more sensitive than
current screening programmes in reducing the incidence of cervical
cancer. If it is possible safely to extend the screening interval in
human papillomavirus-negative women, such programmes could also both be
more effective and more cost-efficient. Although some modelling studies
have indicated that this could indeed be the case, evidence from
clinical trials evaluating the long-term protective effect of primary
human papillomavirus screening is still lacking. The key issues on the
research agenda for primary human papillomavirus screening are reviewed.
Copyright 2001 Harco
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