National Cancer Institute®
Last Modified: July 1, 2002
UI - 11933266
AU - Levine PH; Waisman J; Mittal K
TI - Significance of the cytologic diagnosis of endocervical glandular involvement in high-grade squamous intraepithelial lesions.
SO - Diagn Cytopathol 2002 Apr;26(4):217-21
AD - Department of Pathology, New York University School of Medicine and Kaplan Comprehensive Cancer Center, New York, New York 10016, USA. email@example.com
The cytologic criteria for the diagnosis of endocervical gland involvement (EGI) by high-grade squamous intraepithelial lesions (HGSILs) have been described, and this diagnosis occasionally is made. This study evaluates the accuracy of a cytologic diagnosis compared with that of follow-up cone biopsies. Twenty-eight patients with Papanicolaou (Pap) smear diagnoses of HGSILs with EGI, with follow-up cone biopsies, were identified from New York University computerized files. Results were compared with those of a control group of 28 patients showing cervical intra-epithelial neoplasia grades II/III (CIN-II/III), irrespective of previous Pap smear findings. On subsequent cone biopsy samples, 26 of the 28 study cases showed signs of HGSIL. Of these 26 patients, 17 (65%) showed evidence of HGSIL with EGI. Among the 28 control cases, 20 (71.4%) had EGI on the cone biopsies (P = NS). We also examined previous Pap smear findings in a control group of 42 cone biopsies with CIN-II or CIN-III, with or without EGI. EGI was diagnosed in previous Pap smears in 3 of the 31(10%) cases that showed signs of EGI on cone biopsies and in 2 of the 11 cases (18%) that did not evidence EGI on subsequent cone biopsies (P = NS). In our experience, the cytologic diagnosis of EGI on Pap smears did not identify a group of patients with increased frequency of EGI on subsequent cone biopsies. Copyright 2002 Wiley-Liss, Inc.
UI - 11997082
AU - Kim SJ; Park SE; Lee C; Lee SY; Jo JH; Kim JM; Oh YK
TI - Alterations in promoter usage and expression levels of insulin-like growth factor-II and H19 genes in cervical carcinoma exhibiting biallelic expression of IGF-II.
SO - Biochim Biophys Acta 2002 Apr 24;1586(3):307-15
AD - Comprehensive Gynecologic Cancer Center, Pundang CHA General Hospital, Sungnam, Kyonggi-do, South Korea.
Biallelic expression of insulin-like growth factor-II (IGF2) has been reported to be associated with progression of several tumors. Here, we report that the promoter usage and expression levels of IGF2 and H19 were altered in cervical carcinoma showing loss of imprinting. The imprinting status was examined in 32 cervical carcinomas and their matched normal tissues. Loss of imprinting (LOI) of IGF2 was observed in seven of 18 (39%) informative cases. LOI of H19 gene was detected in five of 14 informative cases. The usage of promoter P1 was observed in LOI tumors of IGF2, but not in the tumors showing maintenance of IGF2 imprinting (MOI) and in the normal cervical tissues. Unlike MOI tumors, some LOI tumors revealed the lack of IGF2 transcription from promoter P3. LOI tumors of IGF2 showed an increased expression level of IGF2 but a down-regulation of H19 relative to the normal tissues whereas MOI tumors did not reveal significant alterations. These results suggest that promoter P1 could be involved in the biallelic expression of IGF2 and that the altered expression levels of IGF2 and H19 gene might be associated with the progression of cervical carcinoma showing biallelic expression of IGF2.
UI - 10934948
AU - Chung JH; Koh JS; Lee SS; Cho KJ
TI - Glassy cell carcinoma of the uterine cervix. Cytologic features and expression of estrogen and progesterone receptors.
SO - Acta Cytol 2000 Jul-Aug;44(4):551-6
AD - Department of Pathology, Korea Cancer Center Hospital, Nowon-gu, Seoul, Korea. firstname.lastname@example.org
OBJECTIVE: To identify the cytomorphologic features and investigate the expression of estrogen receptor (ER) and progesterone receptor (PR) in glassy cell carcinoma (GCC) of the uterine cervix. STUDY DESIGN: A retrospective analysis of nine GCCs encountered at Korea Cancer Center cervical smears were obtained prior to histologic diagnosis of GCC. The cytomorphologic and clinical features were reviewed, and the expression of ER and PR was investigated immunohistochemically on histologic sections. RESULTS: Smears of GCC were hypercellular and remarkably cohesive. The tumor cells were large and characterized by abundant granular cytoplasm, distinct cell membranes and round to polygonal, large nuclei with prominent nucleoli. In the background tumor diathesis and numerous inflammatory cells containing eosinophils were present. The inflammatory cells (mainly eosinophils) were intimately associated with tumor cells to form "granuloepithelial complex." Immunohistochemically, ER was identified in two of the nine cases and PR in one of them. CONCLUSION: Cytology of GCC has characteristic features that differ from those of other carcinomas or atypical reparative cells. Although there are deceptive mimics of GCC, the characteristic cytologic findings should prompt a diagnosis of GCC. ER and PR positivity was found in two cases (22%) and one case (11%), respectively, of GCC, suggesting that this tumor might be hormonally responsive.
UI - 11955348
AU - Rong S; Chen W; Wu L; Zhang X; Shen G; Liu Y; Zhao F; Ma J; Qiao Y
TI - [Analysis of risk factors for cervical cancer in Xiangyuan County, Shanxi Province]
SO - Zhonghua Yu Fang Yi Xue Za Zhi 2002 Jan;36(1):41-3
AD - Department of Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
OBJECTIVES: To investigate the risk factors for cervical cancer in the areas of high incidence, and provide evidence for current intervention of cervical cancer. METHODS: In the areas of Xiangyuan County, Shanxi Provicne with high incidence of cervical cancer, 1 997 women were interviewed using a questionnaire, including baseline information, menstrual, marital and pregnancy histories, sexual behavior, health habits, contraception, medical history and family history of cancer, etc., after its screening with six kinds of methods. All subjects, including 84 cases with pathological diagnosis of greater than cINI, and 1 784 cases with pathological diagnosis of normal, were tested for high-risk HPV. RESULTS: The overall rates of HPV infection were 20.8% (415/1 997) in high-risk subjects, 97.7% and 14.2% in the cases and control groups, respectively. Univariate analysis showed that risk factors with statistical significance included high-risk HPV infection, age at first sexual intercourse, history of pregnancy and abortion, the number of sexual partners and family history of cancer. Analysis with non-conditional logistic regression model revealed high-risk HPV infection, multiple sexual partners and family history of cancer associated obviously with occurrence of cervical cancer. In addition, there was significantly positive relationship between HPV infection, which increased with the number of sexual partners, and extramarital sexual activity both in males or females. CONCLUSIONS: The main risk factor for cervical cancer in this region was high-risk HPV infection, which related to sexual behavior, hygienic habits during menstruation and puerperium. It was particularly important to detect and treat precancerous lesions and to implement behavior modification. In addition, further research on genetic susceptibility was suggested.
UI - 12054599
AU - Chou RH; Huang H
TI - Restoration of p53 tumor suppressor pathway in human cervical carcinoma cells by sodium arsenite.
SO - Biochem Biophys Res Commun 2002 Apr 26;293(1):298-306
AD - Department of Life Science, National Tsing-Hua University, HsinChu 30043, Taiwan, ROC.
In most cervical cancer cells, p53 and Rb are disrupted by human papillomaviruses (HPVs) E6 and E7, respectively. Restoration of p53 or Rb function by blocking E6/p53 or E7/Rb pathway might be a potential therapeutic purpose for these cancer cells. Treatment with sodium arsenite (SA) resulted in significant repression of E6 and E7 mRNA levels in SiHa cells. After E6 and E7 repression, p53 was dramatically induced and accumulated in cellular nuclei and Rb was also induced. Two p53-responsive genes, p21(waf1/cip1) and mdm2, were induced after SA treatment. Furthermore, SA also reduced the expressions of Cdc25A and cyclin B, blocked cell cycle progression at G2/M phase, and induced apoptosis in SiHa cells. SA-induced apoptosis was greatly reduced by expression of a dominant-negative mutated p53. In this study, we have first demonstrated that SA did repress E6 and E7 oncogenes, restore the p53 tumor suppressor pathway and induce apoptosis in SiHa cells. Therefore, it would be a potential strategy to promote SA as therapeutic purpose for HPV-positive cancer cells.
UI - 11786405
AU - Renard I; Mezzanzanica D; Canevari S; Ferrini S; Boniver J; Delvenne P;
TI - Jacobs N Anti-CD3/anti-epidermal growth factor receptor-bispecific antibody retargeting of lymphocytes against human neoplastic keratinocytes in an autologous organotypic culture model.
SO - Am J Pathol 2002 Jan;160(1):113-22
AD - Department of Pathology, University of Liege, Liege, Belgium. email@example.com
Local cellular immune defects have been described in several tumors including human papillomavirus (HPV)-associated cervical cancer. This observation suggests the potential therapeutic benefit of immune manipulations that restore cellular immunity. Here, we evaluated the ability of bispecific monoclonal antibodies (bimAbs) to redirect T cells against keratinocytes transformed in vitro by HPV in an autologous three-dimensional culture model (organotypic cultures). The epidermal growth factor receptor (EGFR) was chosen as target for an anti-CD3/anti-EGFR bimAb because it is overexpressed in many malignant epithelial lesions and only weakly expressed in the basal layers of normal squamous epithelium. Interestingly, in organotypic cultures, the pattern of expression of EGFR was similar to that observed in vivo. The ability of T cells retargeted by CD3/EGFR bimAb to lyse HPV-transformed cell lines was confirmed in monolayer cultures. In autologous organotypic cultures, an increase in apoptotic HPV(+) keratinocytes and a significant decrease in the thickness of HPV(+) organotypic cultures were observed when activated lymphocytes and bimAbs were added to the cultures, whereas organotypic cultures of normal keratinocytes were not significantly affected. These data were similar to those obtained in the allogeneic model. These results suggest the potential usefulness of CD3-EGFR bimAb-retargeted lymphocytes in immunotherapeutic protocols for malignant epithelial lesions.
UI - 10435557
AU - Nucci MR; Clement PB; Young RH
TI - Lobular endocervical glandular hyperplasia, not otherwise specified: a clinicopathologic analysis of thirteen cases of a distinctive pseudoneoplastic lesion and comparison with fourteen cases of adenoma malignum.
SO - Am J Surg Pathol 1999 Aug;23(8):886-91
AD - Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
We report 13 cases of a previously undescribed pseudoneoplastic lesion of the uterine cervix, which we have designated "lobular endocervical glandular hyperplasia, not otherwise specified." The patients' ages ranged from 37 to 71 years (mean, 45 years; median, 49 years). Three (27%) patients had a history of hormone use. Seven lesions were incidental findings in hysterectomy specimens. In the six other cases, the patient came to clinical attention because of a mucoid cervical discharge (two cases), increased vaginal discharge (two cases), abdominal discomfort (one case), or a 3.5-cm cervical mass found when being examined because of ovarian carcinoma (one case); hysterectomy was performed in each of these six cases. Microscopic examination showed a distinctly lobular proliferation of small to moderately sized rounded glands often centered around a larger central gland. The lobular proliferation was well to poorly demarcated and usually confined to the inner half of the cervical wall. Glands within the lobules were usually separated from each other by unaltered or hypercellular cervical stroma and were lined by columnar mucinous cells similar to the normal endocervix. Occasional reactive atypia of the endocervical cells and mitoses were seen, but no significant cytologic atypia was identified. Neither of the two cases stained showed cytoplasmic immunoreactivity for carcinoembryonic antigen. Follow-up of seven patients showed no evidence of recurrence of the cervical lesion, with an average length of follow-up of 3.4 years; three patients were lost to follow-up and three cases are recent. The principal consideration in the differential diagnosis was adenoma malignum (minimal deviation adenocarcinoma). The features most helpful in this distinction, in addition to the orderly lobular arrangement of the glands, were a lack of the following: irregular stromal infiltration, a desmoplastic stromal response, and focal malignant cytologic features. Lobular endocervical gland hyperplasia should be added to the list of previously described pseudoneoplastic glandular lesions of the cervix and, like them, not misinterpreted as neoplastic.
UI - 12066092
AU - Dowdy SC; Boardman CH; Wilson TO; Podratz KC; Hartmann LC; Long HJ
TI - Multimodal therapy including neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) for stage IIB to IV cervical cancer.
SO - Am J Obstet Gynecol 2002 Jun;186(6):1167-73
AD - Section of Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
OBJECTIVE: The purpose of this study was to determine the survival rates and toxicity levels that are associated with multimodal therapy (including neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin [MVAC]) in patients with stage IIB to IVB cervical cancer. STUDY DESIGN: We retrospectively reviewed the cases of 49 patients who were treated between 1989 and 1997 with neoadjuvant MVAC for advanced cervical cancer. RESULTS: The clinical response rate was 90% (27 partial responders, 17 complete responders). Grade 3 or greater toxicity was mostly limited to neutropenia; no deaths were attributed to MVAC. Combined therapy after MVAC included operation in 34 patients (69%) and radiation in 41 patients (84%). Twenty-one patients (43%) had <2 cm residual tumor at histologic evaluation. Pelvic control was achieved in 86% of patients. Five-year disease-specific survival for patients with stage III disease was 60%. CONCLUSION: For patients with advanced cervical cancer, neoadjuvant MVAC had a high response rate (90%) and an acceptable toxicity level. Compared with historic control subjects, multimodal treatment may be associated with improved rates of pelvic control.
UI - 12066114
AU - Felix JC; Lonky NM; Tamura K; Yu KJ; Naidu Y; Lai CR; Lonky SA
TI - Aberrant expression of E-cadherin in cervical intraepithelial neoplasia correlates with a false-negative Papanicolaou smear.
SO - Am J Obstet Gynecol 2002 Jun;186(6):1308-14
AD - Department of Pathology and Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA. firstname.lastname@example.org
OBJECTIVES: E-cadherin is responsible for cell adhesion in normal cervical epithelium. It is normally absent in the superficial epithelial layers, allowing for exfoliation. We investigated the correlation between E-cadherin distribution and Papanicolaou smear in subjects with cervical dysplasia. STUDY DESIGN: Tissue samples from 25 women with cervical dysplasia were tested for E-cadherin, beta-catenin, and alpha-catenin expression by immunohistochemistry. The expression pattern of these proteins, whether full thickness or restricted to the basal layers, was correlated with the Papanicolaou smear result. RESULTS: Of 12 women with normal Papanicolaou smears, 10 of 11 informative cases demonstrated E-cadherin expression throughout all epithelial layers. Eight of 10 informative cases with an abnormal Papanicolaou smear showed E-cadherin only at the basal layers. Alpha-catenin was distributed throughout the entire epithelium in samples of all 25 women. CONCLUSIONS: Expression of E-cadherin throughout all epithelial layers was correlated with a false-negative Papanicolaou smear. It is likely that aberrant persistence of E-cadherin in these lesions interferes with the exfoliation of abnormal cells.
UI - 12053343
AU - Nieminen P; Tarkkanen J; Timonen T; Meyer B; Hakama M; Anttila A
TI - [Differences in cervical cancer mass screening results in Greater-Helsinki area]
SO - Duodecim 2000;116(22):2489-96
AD - HUS:n naistensairaala PL 140, 00029 HUS. email@example.com
UI - 11785862
AU - Hartikainen J
TI - The Papanicolaou test: its utility and efficacy in cancer detection.
SO - Contemp Nurse 2001 Sep;11(1):45-9
AD - Oncology and Palliative Care Ward, Western Hospital, Melbourne.
The Papanicolaou (PAP) test is one of the simplest tests in the detection of cancer. This article addresses the concerns/fears women have surrounding the PAP test and why it is not more widely used.
UI - 11824890
AU - Symonds RP
TI - Is screening for cervical cancer effective?
SO - Clin Oncol (R Coll Radiol) 2001;13(6):473-5
AD - University of Leicester, Leicester Royal Infirmary, UK. firstname.lastname@example.org
UI - 12051215
AU - Wilson S; Lester H
TI - How can we develop a cost-effective quality cervical screening programme?
SO - Br J Gen Pract 2002 Jun;52(479):485-90
AD - Department of Primary Care and General Practice, Public and Occupational Health, University of Birmingham. email@example.com
This article discusses the evidence base underpinning the United Kingdom cervical screening programme and proposes that there is now sufficient evidence to suggest that too many women are screened too frequently. The financial savings generated from increasing the screening interval to five years and restricting routine screening to women aged 25 to 50 years may, we suggest, be better spent on improving the quality of the cervical screening programme. Re-awakening this debate must not however deflect energy and effort from recruiting women who have never been screened or further developing quality control systems. Any debate must also fully engage women of all ages as the key stakeholders in the decision-making process.
UI - 12094548
AU - Comerci JT Jr; Goldberg GL
TI - Current diagnosis and management of cervical cancer.
SO - Cancer Invest 2002;20(4):524-30
AD - Division of Gynecologic Oncology, Magee Women's Hospital, Pittsburgh, Pennsylvania, USA.
UI - 11838315
AU - Biscotti CV; O'Brien DL; Gero MA; Gramlich TL; Kennedy AW; Easley KA
TI - Thin-layer Pap test vs. conventional Pap smear. Analysis of 400 split samples.
SO - J Reprod Med 2002 Jan;47(1):9-13
AD - Departments of Anatomic Pathology, Obstetrics and Gynecology, and Biostatistics, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA. firstname.lastname@example.org
OBJECTIVE: To analyze our experience with 400 Thin-Prep (TP) split samples (Cytyc Corp., Boxborough, Massachusetts) as an initial assessment of this new technology's effect in our laboratory. STUDY DESIGN: Three gynecologic oncologists and two general gynecologists obtained the 400 split samples using a broom sampling device. Following conventional smear (CS) preparation, they rinsed the broom in Preservcyt solution (Cytyc) for subsequent TP processing. The paired samples were separated, independently analyzed and classified by the Bethesda System. All available follow-up surgical pathology material was reviewed and compared to the cytologic diagnoses. RESULTS: TP had significantly more abnormal results (22% vs. 16%, P = .007), including more atypical squamous cells of undetermined significance (ASCUS) (9.5% vs. 6.3% P = .07) and low grade squamous intraepithelial lesion (LSIL) (7.8% vs. 5.3%, P = .03). Both methods had 3.3% high grade squamous intraepithelial lesion (HSIL). For TP, ASCUS/squamous intraepithelial lesion (SIL) = 0.86 and for CS, ASCUS/SIL = 0.74. Ten TP SILs had a paired negative CS, including LSIL (nine cases) and HSIL (one case). Consensus review of these 10 TP slides confirmed the HSIL and four LSILs. No CS SILs had a paired negative TP. Only 36 (9%) cases had surgical pathology follow-up. The surgical specimens included 17 cervical intraepithelial neoplasia (CIN) 2 or above. The TP method had no false negatives, while the CS method had 3 false negatives among the 17 confirmed cases of CIN 2 or above. CONCLUSION: TP appears to be superior to CS for detecting SILs.
UI - 12090586
AU - Baker PM; Clement PB; Bell DA; Young RH
TI - Superficial endometriosis of the uterine cervix: a report of 20 cases of a process that may be confused with endocervical glandular dysplasia or adenocarcinoma in situ.
SO - Int J Gynecol Pathol 1999 Jul;18(3):198-205
AD - James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, Department of Pathology, Harvard Medical School, Boston 02114, USA.
Twenty cases of superficial endometriosis of the uterine cervix that occurred in patients from 20 to 51 (mean 37.1) years of age are described. The majority of the cases were seen in consultation and were usually referred because of diagnostic problems; endocervical glandular dysplasia, adenocarcinoma in situ, or rarely invasive adenocarcinoma were a frequent consideration of the contributor. The endometriosis was almost always an incidental microscopic finding. The endometriotic foci were usually confined to the superficial third of the cervical wall, but in one case there was also involvement of the middle third of the cervical wall. Deep cervical endometriosis was not present in any case. The endometriotic glands were typically evenly spaced and were surrounded at least focally by endometriotic stroma in all cases. The endometriotic stromal cells, however, were significantly obscured by inflammatory cells (two cases), inflammatory cells and hemorrhage (two cases), hemorrhage (four cases), and in one case by smooth muscle metaplasia causing initial failure to recognize the stromal component of the process. The presence of mitotic figures in the glandular epithelium contributed to an initial diagnosis of a premalignant or malignant glandular lesion being made or seriously entertained in 10 cases. Awareness that mitotic figures may be conspicuous in endometriosis from women of reproductive age, the usually bland cytologic features of the endometriotic epithelium, and the presence of associated endometrial stromal cells all facilitate establishing the correct diagnosis.
UI - 12101564
AU - Kolomiets LA; Urazova LN; Sevost'ianova NV; Churuksaeva ON
TI - [Clinical and morphologic aspects of cervical papillomavirus infection]
SO - Vopr Onkol 2002;48(1):43-6
AD - Research Institute of Oncology, Research Center, Russian Academy of Medical Sciences, Siberian Branch, Tomsk.
415 female residents of the City of Tomsk and Tomsk Region (patients with cervical carcinoma--22, dysplasia stage I-III--23 and healthy subjects--71) were screened for HPV16/18 infection, which was diagnosed in 18.3%. In the cervical carcinoma group, infection was detected in 27.4%, among patients with advanced cervical dysplasia--25.7%, and in those with background pathologies and healthy females--12.3 and 38%, respectively. Infection peaks were reported for the age brackets of 31-40 years (19.7%) and 51-60 years (19.6%). HPV-infection showed a wide range of colposcopic symptoms: areas of atypical blood vessels, leukoplakia, atypical epithelium and iodine-negative patches. Papillomavirus-related morphological changes in endometrial cells were typical of those associated with any viral infection and showed no specific features.
UI - 12051885
AU - Huang LW; Chao SL; Hwang JL; Chou YY
TI - Down-regulation of p27 is associated with malignant transformation and aggressive phenotype of cervical neoplasms.
SO - Gynecol Oncol 2002 Jun;85(3):524-8
AD - Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. email@example.com
OBJECTIVES: p27Kip1 (p27) is a member of the cyclin-dependent kinase inhibitor family. The level of p27 protein expression decreases during tumor development and progression in some epithelial tumors. To identify the potential implications of the p27 gene in the development of cervical carcinoma and explore the clinical importance of change in gene expression, we assessed the level of p27 protein in precancerous lesions and carcinomas of the cervix. METHODS: In our study, 20 low-grade squamous intraepithelial lesions (LSIL), 35 high-grade squamous intraepithelial lesions (HSIL), 12 microinvasive carcinomas, and 103 invasive carcinomas were evaluated. The expression of p27 was studied by immunohistochemistry using a monoclonal antibody specific for the protein. RESULTS: p27 was expressed in all samples of normal epithelium, LSIL, and HSIL, and the mean values of expression were 55.1, 52.8, and 45.4%, respectively. Conversely, the expression of p27 was significantly reduced in microinvasive (15.9%) and invasive carcinomas (11.2%). Furthermore, loss of p27 expression was significantly associated with lymph node metastasis (P = 0.009). However, p27 down-regulation had no influence on overall survival using univariate analysis. CONCLUSIONS: The trend of reduced p27 expression in microinvasive and invasive carcinomas suggests that down-regulation of p27 expression is strongly linked to neoplastic transformation of cervical epithelium, and inactivation of p27 may be an early event in cervical carcinogenesis. Moreover, loss of p27 expression was related to lymph node metastasis in cervical carcinoma. These results imply that inactivation of p27 is associated with highly aggressive phenotype of cervical carcinoma.
UI - 12070578
AU - Pharaon SR; Al-Saleh WM
TI - A new method to aid complete lymphadenectomy in radical treatment of cancer of the cervix.
SO - Saudi Med J 2002 May;23(5):546-7
AD - Zahrawi Maternity Hospital, Damascus, Syria. firstname.lastname@example.org
OBJECTIVE: A simple, new and not previously reported method to improve the complete ablation of the pelvic lymph nodes in the surgical treatment of cervical cancer is briefly reported. METHODS: Fourteen patients had been operated upon at Zahrawi Maternity Hospital, Damascus, Syria using radical Wertheim hysterectomy for surgical treatment. Five to 10 days prior to surgery, patients are given intramuscular iron injections that help easy visualization of the lymph nodes during operation. RESULTS: In all the 14 cases treated with this simple pre-operative medication, pelvic lymph nodes were easily identified and completely removed. CONCLUSION: Pre-operative iron injections help in better identification of even the smallest pelvic lymph nodes and improve their complete removal.
UI - 11928150
AU - Bol P
TI - [Cervix dysplasia and cervix carcinoma]
SO - Ned Tijdschr Tandheelkd 1998 Dec;105(12):455-6
UI - 11828944
AU - Li Z; Takeuchi S; Otani T; Maruo T
TI - Implications of adrenomedullin expression in the invasion of squamous cell carcinoma of the uterine cervix.
SO - Int J Clin Oncol 2001 Dec;6(6):263-70
AD - Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
BACKGROUND: Adrenomedullin (AM) is a multifunctional peptide involved in a variety of physiological functions, including vasodilatation, growth regulation, and carcinogenesis. To elucidate the possible role of AM in the growth and invasion of uterine cervical carcinoma, the presence and distribution of AM and AM mRNA was examined in the neoplastic changes of squamous epithelium of the uterine cervix. METHODS: The expression of AM mRNA by CaSki, a uterine squamous cell carcinoma cell line, was examined by reverse transcriptase-polymerase chain reaction (RT-PCR). The presence and distribution of AM and AM mRNA in sections of normal cervical tissues, cervical intraepithelial neoplasia (CIN), and invasive squamous cell carcinomas were evaluated by immunohistochemical staining with a specific antibody against AM and by in situ RT-PCR, respectively. RESULTS: AM mRNA expression in CaSki cells was demonstrated by RT-PCR. Immunohistochemical staining for AM and in situ RT-PCR revealed that AM and AM mRNA were expressed in invasive squamous carcinoma cells, but not in normal cervical epithelium or in CIN lesions. Abundant expression of AM and AM mRNA was localized in the cytoplasm of carcinoma cells of bulky invasive carcinomas, while in early invasive carcinoma, the expression of AM and AM mRNA was more prominent in stromal cells adjacent to the early invasive carcinoma cells than in the carcinoma cells themselves. CONCLUSIONS: Because AM expression was evident only in invasive cervical squamous carcinoma cells and the stromal cells adjacent to early invasive carcinomas, it is likely that AM may play an important role in the growth and invasion of squamous cell carcinoma of the uterine cervix.
UI - 12109854
AU - Day SJ; Deszo EL; Freund GG
TI - Dual sampling of the endocervix and its impact on AutoCyte Prep endocervical adequacy.
SO - Am J Clin Pathol 2002 Jul;118(1):41-6
AD - Carle Clinic Association, Urbana, IL, USA.
We compared satisfactory for evaluation but limited by (limited by) and unsatisfactory gynecologic cytologic diagnoses for samples collected by conventional smearing with those generated with the AutoCyte Prep in a population with a historic squamous intraepithelial lesion (SIL) rate of less than 1%. Results from 18,819 AutoCyte Preps were compared with 53,835 conventional cervical smears. Furthermore, 23 women ages 18 to 65 years undergoing annual Papanicolaou tests underwent sequential sampling with the AutoCyte Prep and the Surgipath C-E brush. Comparison of the AutoCyte Prep with conventional cytologic diagnoses revealed the following: unsatisfactory rate, down 97%; limited by rate, down 67%; low-grade SIL rate, up 86%; cervical cancer rate, up 300%; and high-grade SIL rate, unchanged. Examination of unsatisfactory and limited by cases for the AutoCyte Prep showed that 88% were due to absence of endocervical cells (ECs). Dual sampling showed no improvement in EC recovery over the AutoCyte collection device. Compared with conventional Papanicolaou smears, the AutoCyte Prep significantly decreased the rate of unsatisfactory and limited by specimens while increasing low-grade SIL and cancer detection and EC recovery. The majority of limited by specimens with the AutoCyte Prep were due to absence of ECs, but use of a brush-type device for better endocervical sampling did not enhance EC recovery.
UI - 12118547
AU - Bonin SR; Lanciano RM; Corn BW; Hogan WM; Hartz WH; Hanks GE
TI - Bony landmarks are not an adequate substitute for lymphangiography in defining pelvic lymph node location for the treatment of cervical cancer with radiotherapy.
SO - Int J Radiat Oncol Biol Phys 1996 Jan 1;34(1):167-72
AD - Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
PURPOSE: Curative radiotherapy (RT) for carcinoma of the cervix requires adequate irradiation of regional lymph node groups. The best nonsurgical method of defining lymph node anatomy in the pelvis remains the lymphangiogram (LAG). This study was designed to determine if bony landmarks could accurately substitute for LAG as a means of determining lymph node position for the purpose of pelvic RT treatment planning. METHODS AND MATERIALS: The post-LAG simulation films of 22 patients treated at the Fox Chase Cancer Center for cervical cancer were examined. On anterior/posterior (A/P) simulation films, the distance of lymph nodes was determined from the top, middle, and bottom of the sacroiliac joint, and at the pelvic rim, 1 and 2 cm above the acetabulum. On lateral (LAT) simulation films, lymph node position was measured at points 0, 4, and 8 cm along a line from the bottom of L5 to the anterior aspect of the pubic symphysis. Positive values represent lateral and anterior distances relative to the reference point on A/P and LAT films, respectively. Negative values represent distances in the opposite direction. The adequacy of standard pelvic fields as defined by the Gynecologic Oncology Group (GOG) (A/P: 1.5 cm margin on the pelvic rim; LAT field edge is a vertical line anterior to the pubic symphysis) was also examined. Data are expressed as the mean +/- two standard deviations, (i.e. 95% confidence level). RESULTS: On A/P simulation films, the distance of visualized lymph nodes had mean values of -1.6 +/- 1.7 cm (range -4.1 to -0.4 cm), -1.3 +/- 1.5 cm (range -3.4 to 0.0 cm), and 1.2 +/- 1.8 cm (range -1.0 to 2.6 cm) from the sacro-iliac (SI) joint at the superior, middle, and inferior points, respectively. The mean distance of the nodes from the pelvic rim at points 1 and 2 cm above the acetabulum was 0.3 +/- 1.2 cm (range -0.6 to 1.8 cm) and 0.2 +/- 1.8 cm (range -1.6 to 2.1 cm), respectively. On LAT simulation films, the distance of lymph nodes from points 0, 4, and 8 cm from the previously described reference line had mean values of 2.0 +/- 1.0 cm (range 1.3 to 3.0 cm), 0.9 +/- 3.9 cm (range -1.9 to 5.1 cm), and 1.8 +/- 2.1 cm (range -0.8 to 3.5 cm), respectively. Ten of 22 (45%) patients would have had inadequate nodal irradiation if their fields had been designed according to standard GOG parameters. In all cases, these incompletely irradiated lymph nodes were from the lowest of the lateral external iliac group. CONCLUSION: Great variability in pelvic lymph node location is demonstrated when LAG is used to directly visualize their location. Bony structures are inaccurate landmarks for pelvic lymph node position. The GOG standard pelvic fields are not consistently adequate to cover all lateral external iliac lymph nodes, although the clinical significance of this subgroup of lymph nodes is not known. At this time, LAG remains the ideal radiographic modality to define anatomic location of regional lymph nodes for pelvic RT treatment planning. The clinical importance of the most lateral group of external iliac lymph nodes in various stages of cervical cancer represents a potential area of future research.
UI - 12092247
AU - Kojs Z; Urbanski K; Fabisiak W; Reinfuss M
TI - [Prognostic factors in the primary invasive vaginal carcinoma]
SO - Ginekol Pol 2002 Mar;73(3):163-6
In the period 1965-1988, 125 women with primary invasive vaginal carcinoma were treated with radiotherapy. 53 (42.4%) survived 5-year without evidence of disease. In the Cox multivariate analysis three variables were independently related to survival: age of the patients, grade of differentiation of tumor and the clinical stage of illness.
UI - 12092248
AU - Kwasniewska A; Zimna K; Sominka J; Gozdzicka-Jozefiak A; Semczuk M
TI - [Identification of encoding and regulatory sequences of RAR-alpha receptor in intraepithelial neoplasia and in invasive cervical carcinomas associated with HPV types 16 and 18]
SO - Ginekol Pol 2002 Mar;73(3):167-70
AD - Kliniki Poloznictwa i Patologii Ciazy AM w Lublinie.
The purpose of the study was the analysis of regulatory (region 5 gen) and encoding sequences of RAR-alpha receptor in cervical dysplasia and invasive cancer associated with HPV infection. A PCR method with the use of specific primers was applied to amplify and detect DNA sequence of various HPV types. A PCR-SSCP method was used to analyse the sequence of RAR--a receptor. The study revealed changes in structure of regulatory and encoding sequences of the investigated RAR receptor. Utmost changes were found in DNA isolated from tissues with diagnosis of adenocarcinoma colli uteri.
UI - 12112980
AU - Heilmann V; Kreienberg R
TI - Molecular biology of cervical cancer and its precursors.
SO - Curr Womens Health Rep 2002 Feb;2(1):27-33
AD - Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075 Ulm, Germany. email@example.com
There is strong clinical and experimental evidence that the human papilloma virus (HPV) plays a central role in the development and growth of cervical cancer. However, it is known that the carcinogenesis is a multistep process. Changes in the cytogenetic equilibrium, such as chromosomal imbalances, allelic loss, and structural aberrations, happen during the transformation from normal epithelium to cervical cancer. Numerous studies support the hypothesis that HPV infection is associated with development of malignant or pre-malignant changes of the lower genital tract. However, there is little clinical evidence that HPV detection would allow prediction of development of cervical cancer. Regarding the "human aspect" of carcinogenesis, there are efforts to detect markers that predict the risk of progression.
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.
UI - 12115508
AU - Nieminen P; Hakama M; Tarkkanen J; Anttila A
TI - Effect of type of screening laboratory on population-based occurrence of cervical lesions in Finland.
SO - Int J Cancer 2002 Jun 10;99(5):732-6
AD - Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland. firstname.lastname@example.org
The incidence of cervical cancer decreased in Finland over a 30-year period because of an effective screening program, but in the beginning of the 1990s it began to increase. Reasons for such an increase are variable: changes in sexual habits, shortcomings in attendance for screening and possibly variation in laboratory quality. We evaluated the impact of 3 laboratories in the greater Helsinki area on screening performance and on the incidence of invasive cervical cancer and preinvasive cervical lesions in the target population. We studied time trends, geographic differences in attendance and detection rates from screening and the incidence of invasive cancer in the greater Helsinki area (population about 1 million) during the 1990s, when screening was reorganized from the Cancer Society of Finland laboratory to the municipal one (Helsinki) and to a private laboratory (Espoo), while in Vantaa screening remained with the same Cancer Society laboratory. The attendance rate for screening increased during the study period in all 3 cities. The numbers of cytologically suspected and histologically confirmed precancerous lesions found, including severe lesions, decreased significantly with the change of laboratory in Espoo; but in Helsinki and Vantaa, they increased. The overall incidence of invasive cervical cancer increased in all cities in the age groups screened but mostly in Espoo. The rather rapid changes and variation in trends in the number of screening findings cannot be explained by changes in etiologic factors or attendance. They may be related more to the quality of the laboratory performance and perhaps to the criteria used in cytology and colposcopy. A well-organized auditing system is proposed to maintain high quality in screening. Copyright 2002 Wiley-Liss, Inc.
UI - 12115509
AU - Odida M; Schmauz R; Lwanga SK
TI - Grade of malignancy of cervical cancer in regions of Uganda with varying malarial endemicity.
SO - Int J Cancer 2002 Jun 10;99(5):737-41
AD - Department of Pathology, Makerere University, Kampala, Uganda.
As in a prior study on malignant lymphomas, 3 and 6 areas of Uganda showing low and high malarial endemicity, respectively, were selected for analysis and the data retrieved from the Kampala Cancer Registry, which in the 1960s and 1970s collected cases of cancer through a widely used free biopsy service from the whole country. Overall incidence rates were derived from 924 cases from the 12-year period 1964-1975. For reasons of economy, grade of tumour was determined only in cases pertaining to the 6-year period 1968-1973. Of 457 cases, 304 could be reviewed histologically. Only the group of squamous cell carcinomas (84.9%, 258 cases) was large enough for subsequent geographic analysis. High incidence rates of CC were found in areas with high malarial endemicity, whereas low incidence rates occurred where malaria was either frequent or rare. A correlate to malarial infection was the proportion of high-grade carcinomas irrespective of the overall incidence of CC. With high prevalence of malaria and high CPRs of 35-74%, the relative share of high-grade cancer amounted to 50-67%. Where malaria was rare with low CPRs of 8-11%, these values were lower and varied only from 25-39% with a similar range of 14%. Geographic agreement between malarial endemicity and the PI of high-grade cancer was high in the 9 study areas and only slightly lower than for BL, for which the association with malaria is beyond doubt. Compared to areas with little malaria, the RR for the incidence of high-grade carcinomas in areas with severe malaria was increased. The value was 2.04 with a 95% confidence interval of 1.37-3.04. Attributable to secondary immunodeficiency, lifelong exposure to malaria may result in excess frequency of high-grade malignant tumours not only in the group of malignant lymphomas but also in CC. Copyright 2002 Wiley-Liss, Inc.
UI - 12115593
AU - Basu P; Sankaranarayanan R; Mandal R; Roy C; Das P; Choudhury D; Datta
TI - K; Karamakar S; Tsu V; Chakrabarti RN; Siddiqi M; The Calcutta Cervical Neoplasia Early Detection Strudy (CEDS) Group Evaluation of downstaging in the detection of cervical neoplasia in Kolkata, India.
SO - Int J Cancer 2002 Jul 1;100(1):92-6
AD - Chittaranjan National Cancer Institute, Kolkata, India.
Unaided visual inspection or "downstaging" has been suggested as a potential alternative method for cervical cancer screening in developing countries. Our study was designed to evaluate the accuracy of downstaging to detect cervical neoplasia in a low-resource setting. A total of 6,399 women aged 30-64 years were screened with downstaging by trained nonmedical health workers. Two thresholds were used to define positive downstaging: "low threshold" when any visible abnormality on the cervix was considered positive and "high threshold" when selected abnormalities such as bleeding on touch, bleeding erosion, hypertrophied oedematous cervix, congested stippled cervix and growth or ulcer constituted the positive test. All women underwent a colposcopy examination. Biopsies were directed when colposcopy revealed abnormal lesions. True disease status was defined as histologically proven moderate dysplasia and worse lesions. Since all the participants received a diagnostic (reference) investigation (biopsy and/or colposco