• Title/Summary/Keyword: 자궁경부세포검사

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Relating Factors in Pap Smears by Stages of Change among Married Nurses (기혼간호사 대상 자궁경부세포 검진의 변화 단계에 따른 관련요인)

  • Kim, Hae-Won;Jung, Yeon-Yi
    • Women's Health Nursing
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    • v.16 no.4
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    • pp.317-325
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    • 2010
  • Purpose: This study was to examine the differences in health belief variables and HPV (Human Papillomavirus) knowledge in Pap smears according to the stages of change using Trans-theoretical Model (TTM) among married nurses. Methods: The research design was a cross sectional survey. Participants were 387 married nurses working in general hospital located metropolitan city. Measurement variables were perceived threatening, perceived severity, benefits of Pap, HPV knowledge and stages of the change in Pap smear. Results: Classified stages were pre-contemplation 3.9%, contemplation 17.8%, relapsing 29.5%, action 31.0%, and maintenance 17.8%. Accuracy rate of HPV knowledge were low ranging from 15% to 45%. Among the variables, perceived threatening (F=3.56, p=.007), perceived severity (F=9.73, p<.001) and HPV knowledge (F=7.52, p<.001) were significantly different by stages of change. Conclusion: Application of TTM to Pap smears was efficient to know the nurse's level of health behaviors, Health belief variables and HPV knowledge were main factors to identify the stages of change. The continuation of Pap smears and the education in relation to HPV knowledge should be encouraged for married nurses.

A Comparative Study of Cytology & Cervicography for Cervical Cancer Screening (자궁경부 세포진검사 및 자궁경부 확대촬영술의 비교연구)

  • Ha, Jung-Gyu;Yun, Dal-Sik;Lee, Jun-Gi;Choe, Chang-Geun;U, Yang-Rye;Lee, Jin-Su;Lee, Yun-Hui;Park, Jae-Yeong;Lee, Yeong-Im
    • Journal of Korea Association of Health Promotion
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    • v.2 no.1
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    • pp.27-37
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    • 2004
  • Background 'For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although cervical cytology screening programmes have result in the reduction of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. So cervicography is introduced. Cervicography is an adjunct method of cervical cancer screening intended to complement Papanicolaou smear. Cervicography involve obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the efficacy of Papanicolaou smear and cervicography in cervical cancer screening. Materials & Methods : This study population was of 74 women, who visited department of obstetrics & Gynecology, Korea association of Health Promotion Chung-nam branch from January, 20O2 to October, 2003. All patients were taken Pap smear before cervicography, and then two cervicography was obtained with applying5% acetic acid. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen. Results : 1. The sensitivity and the specificity of Papanicolaou smear was 92.1% and 72.7%respectively.2. The sensitivity and the specificity of cervicography was 88.9% and 54.5% respectively. The false negative rate, and false positive rate of Papanicolaou smear were 7.9%, 27.2% respectively. The false negative rate, and false positive rate of cervicography were 11.1%,45.5% respectively. Conclusions . Papanicolaou smear is a useful method and an important tool for detecting cervical cancer. However when Papanicolaou smear and Cervicograpy is used together, the sensitivity is higher than for Papanicolaou smear used alone.

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Gene Expression Profiles in Cervical Cancer with Radiation Therapy Alone and Chemo-radiation Therapy (자궁경부암의 방사선치료 및 방사선항암화학 병용치료에 따른 유전자발현 조절양상)

  • Lee Kyu Chan;Kim Meyoung-kon;Kim Jooyoung;Hwang You Jin;Choi Myung Sun;Kim Chul Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.54-65
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    • 2003
  • Purpose : To analyze the gene expression Profiles of uterine ceulcal cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a CDNA microarray. Materials and Methods :Sixteen patients, 8 with squamous ceil carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated w14h concurrent chemo-radiation, were Included in the study. Before the starling of the treatment, tumor biopsies were carried out, and the second time biopsies were peformed after a radiation dose of 16.2$\~$27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were peformed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradlation therapy. The 33P-iabeled CDNAS were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the CDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage, and were exported to Microsoft Excel The data were normalized by the Z transformation, and the comparisons were peformed on the Z-ratio values calculated. Results : The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved In cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, Including G protein coupled receptor kinase 5, were decreased with the Z-ratio values of below -2.0. After the radiation thorapy, most of the genes, with a previously Increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotlde gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in anglogenesis (angiopoietln-2), immune reactions (formyl peptide receptor-iike 1), and DNA repair (CAMP phosphodiesterase) were increased, however, the expression of gene involved In apoptosls (death associated protein kinase) was decreased. Conclusion : The different kinds of genes involved in the development and progression of cervical cancer were identified with the CDNA microarray, and the proposed theory is that the proliferation signal stalls with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are Increased with the increased expression oi Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated 4he evidence of the decreased cancer cell proliferation. There was no sigificant difference in the morphological findings of cell death between the radiation therapy aione and the chemo-radiation groups In the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.

Cytologic Evaluation of $CellPrep^{(R)}$ Liquid-based Cytology in Cervicovaginal, Body Fluid, and Urine Specimens - Comparison with $ThinPrep^{(R)}$ - (자궁경부, 체액 및 소변의 탈락 세포진 검사에서 $CellPrep^{(R)}$ 액상세포검사의 세포학적 평가 -$ThinPrep^{(R)}$과 비교분석-)

  • Cho, Soo-Yeon;Ha, Hwa-Jeong;Kim, Jung-Soon;Shin, Myung-Soon;Koh, Jae-Soo
    • The Korean Journal of Cytopathology
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    • v.18 no.1
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    • pp.29-35
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    • 2007
  • This study purposed to evaluate a $CellPrep^{(R)}$ (CP) of liquid-based cytology (LBC) to search for a less expensive and automated alternative cytologic preparation technique applicable to usually encountered cytologic specimens. Cervicovaginal direct-to-vial split samples from 457 gynecologic patients, 40 body fluid samples, and 34 urine samples were processed with the CP technique and the results were compared with those of currently used $ThinPrep^{(R)}$ (TP) method. Both CP and TP methods provide evenly distributed thin layers of cells with little cellular overlaps or significant obscuring elements in most of cases. Staining quality of both preparations showed a little difference due to the difference of fixative solutions without significant distractions in cytologic interpretation. On the supposition that TP was a gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of CP cytology were 89%, 98%, 86%, and 99% in the cervicovaginal smear, 89%, 82%, 80%, and 90% in body fluid, and all of these values were 100% in urine samples. To testify the availability of immunohistochemistry on CP preparations, cytokeratin, vimentin, and Ki-67 were applied on body fluid specimens, and all of these antibodies were specifically stained on targeted cells. Conclusively, the CP method gave comparable results to those of TP in terms of smear quality and cytologic diagnostic evaluation, and was available on immunohistochemistry. The CP method could offer a cost-effective and automated alternative to the current expensive techniques of liquid-based cytology on popular cytologic materials including cervicovaginal, body fluid, and urine specimens.

Prevalence and Genotype Analysis of High Risk-human Papillomavirus Infection in Busan Women (부산지역 여성의 고위험군 인유두종 바이러스 유병률과 유전자형 분석)

  • Kang, Chang-Soo;Lee, Kyung Eun
    • Journal of Life Science
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    • v.29 no.11
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    • pp.1267-1272
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    • 2019
  • The main cause of cervical cancer is the human papillomavirus (HPV), and HPV DNA has been reported in 99.7% of patients with cervical cancer. The worldwide prevalence is highest for the HPV 16 and 18 genotypes, but HPV 52 and 58 have the highest prevalence in Asian countries, including Korea. The purpose of this study was to obtain basic data for the prevention of cervical cancer by analyzing the prevalence of HPV and the genotypes of high risk-human papillomavirus (HR-HPV) infection in women in Busan, Korea. We analyzed 1,995 cases of HPV in women who visited a Busan obstetrics and gynecology hospital from January 2016 to December 2017. The prevalence of HPV among these women was 28.3% (565/1995), and the HR-HPV infection rate was 75.4% (426/565). The HR-HPV genotype with the highest prevalence was HPV-52 (63/565, 11.2%), followed by HPV-58 (56/565, 9.9%), HPV-53 (55/565, 9.7%), and HPV-16 (53/565, 9.4%). The HR-HPV infection rate of young women 18-39 years old was 60.3% (257/426), so this age group should undergo continuous monitoring. The cytological results revealed a high infection rate for HPV-16 in high grade squamous intraepithelial lesions (HSIL) and squamous cell carcinoma (SCC). However, further evaluation of more samples is needed to confirm the HR-HPV genotypes related to the development of cervical epithelial neoplasias.

Cytologic Screening for Cervical Cancer and Factors Related to Cervical Cancer (대구시(大邱市) 기혼(旣婚) 여성(女性)의 자궁경부암(子宮頸部癌) 유병률(有病率)과 그 관련요인(關聯要因))

  • Jeon, Yong-Jae;Lee, Chi-Young;Chun, Byung-Yeol;Kam, Sin;Yeh, Min-Hae
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.428-440
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    • 1991
  • This study was conducted to estimate the prevalence rate of cervical cancer and to investigate its risk factors. 5,417 asymptomatic married women were screened from March, 1984 to December, 1990 in Taegu city. Of 5,417 examinees, 3,817 (70.46%) were normal, 1,542 (28.7%) showed inflammatory change, 51 (0.94%) were dysplasia and 7 (0.13%) were carcinoma in situ or invasive carcinomas. The prevalence of abnormal finding (dysplasia, carcinoma in situ or invasive carcinoma) was 1,070 per 100,000 population. The prevalence of dysplasia was 940 per 100,000 and that of carcinoma in situ or invasive carcinoma was 130 per 100,000. Age-adjusted prevalence rate for abnormal finding adjusted with standard population of Taegu city was estimated to be 850 per 100,000. The prevalence of cervical cancer was significantly increased with age (P<0.05). The prevalence of cervical cancer was significantly decreased with age at marriage and educational level (P<0.05). The history of induced abortion and the number of pregnancies were significantly associated with the prevalence of cervical cancer (p<0.05), whereas, the number of parity was not. Age at marriage was significantly associated with the prevalence of cervical cancer after stratification by age (p<0.05). However, the level of education, parity, induced abortion, number of pregnancies were not significant. Inflammation and human papiloma virus infection were associated with cervical cancer with odds ratio of 13.48 (95% confidence interval $7.80{\sim}23.40$) and 474.29 (95% confidence interval $196.80{\sim}1143.10$), respectively. In conclusion, for early detection of cervical cancer it should be recommended to perform mass cytological screening. In particular, regular and periodic cytologic screening, starting at age 25, for cervical cancer should be recommended for those women who have frequent cervical inflammation and for those women married before age of 20.

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Clinical and Histopathological Studies on Carcinoma of the Uterine Cervix in Taegu (대구지방으 자궁경부암에 재한 임상 및 병리조직학적 연구)

  • Choi, Joon-Hyuk;Choi, Won-Hee;Hong, Suk-Jae;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.121-128
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    • 1988
  • Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstertrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarised as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases(96.5%) were squamous cell carcinoma, in which 60 cases(30.0%) of carcinoma in situ, 9 cases(4%) of microinvasive, and 126 cases(62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old. ; In cases of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows. ; vaginal bleeding(47.5%), abnormal cytology(15.4%), and abnormal vaginal discharge(9.4%). 5. Duration of the chief complaints was most commanly less than 6 months(73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years 0Id(46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5~8 times, and average 6.2 times. The parity was 61.9% in 1~4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases(31.8%), stage II, 54 cases(42.9%), stage III, 11 cases(8.7%), and stage IV, 8 cases(6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows. ; large cell keratinizing type, 25 cases(19.8%), large cell nonkeratinizing type, 101 cases(80.2%). 10. In the cytologic diagnosis, class I was 2 cases(l.9%), class II was 16 cases(15.1%), class III was 33 cases(31.1%), class IV was 31 cases(29.3%), class V was 24 cases(24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.

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Diagnostic Availability of Estrogen Receptor Alpha mRNA on Cervical Cancer Tissue (자궁경부암 조직에서 에스트로겐 수용체 알파 mRNA의 진단적 유용성)

  • Kim, Geehyuk;Yu, Kwangmin;Kim, Jungho;Kim, Seoyong;Park, Sunyoung;Ahn, Sungwoo;Lee, Ji-Young;Kim, Sunghyun;Park, Ho-Hyun;Lee, Dongsup
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.449-456
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    • 2018
  • Cervical cancer is the fourth most frequently diagnosed cancer in women worldwide. In lower Human Development Index countries, it has the second highest incidence and mortality among cancer in women. Therefore, better diagnosis and treatment systems are needed. Among them, estrogen receptor alpha ($ER-{\alpha}$) mRNA expression has been analyzed with RT-qPCR since several studies reported that $ER-{\alpha}$ is necessary in the maturation of the uterus and is related to cervical cancer. In this study, $ER-{\alpha}$ quantitative analysis was performed on various lesions and normal tissue samples. Based on the receiver operating characteristic (ROC) curve, its sensitivity and specificity were 85% and 75%, respectively, showing higher or similar results to those of conventional HPV tests. In addition, its expression level was analyzed with clinical information. With regression analysis, the R square value between the $ER-{\alpha}$ mRNA expression level and menopause status was 0.5041, indicating a strong correlation. This study was performed as part of a pilot study and suggests that $ER-{\alpha}$ is related to carcinogenesis. Future studies will examine other hormones and menopausal factors with a larger sample size.

Diagnostic Accuracy of Cervicovaginal Cytology in the Detection of Squamous Epithelial Lesions of the Uterine Cervix; Cytologic/Histologic Correlation of 481 Cases (자궁경부 편평상피병변에서 자궁경부질도말 세포검사의 진단정확도 : 481예의 세포-조직 상관관계)

  • Jin, So-Young;Park, Sang-Mo;Kim, Mee-Sun;Jeen, Yoon-Mi;Kim, Dong-Won;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.111-118
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    • 2008
  • Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

Prevalence of Human Papillomavirus by DNA Chip Test in Women (여성에 있어 DNA 칩검사에 의한 인유두종바이러스 감염률의 조사)

  • Kim, Jae-Woo;Kim, Yun-Tae;Kim, Dae-Sik;Choi, Seok-Cheol
    • Journal of Life Science
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    • v.18 no.12
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    • pp.1657-1664
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    • 2008
  • We determined the prevalence of human papillomavirus (HPV) by DNA chip test in 549 women and cytologic diagnosis. 237 of 549 women (43.17%) subjected with HPV DNA Chip examination were found positive for HPV. 210 (88.60%, High group) were infected with high-risk HPV types. 17 (7.17%, Low group) were infected with low-risk HPV types (6, 11, 40, 44, 70) and 17 (7.17%, Mixed group) were infected with mixed types. According to age, in their twenties, thirties, forties, fifties and over sixties, the prevalence of infection with high-risk HPV types were 1.26% (3/237), 15.61% (37/237), 31.65% (75/237), 23.21% (55/237), and 13.92% (33/237), respectively. In the Low and Mixed group, percentages of infection with HPV were significantly lower than that of the High group. On the comparison of cytologic diagnosis (224 women) by Pap smear and DNA chip positive (237 women) for HPV, 132 out of 194 cases in the High group (68.04%) suffered cervical lesions with ASCUS (atypical squamous cells of undetermined significance, 7.22%), LSIL (low grade squamous intraepithelial lesion, 15.98%), HSIL (high grade SIL, 23.20%) and ICC (invasive cervical cancer, 21.65%). The Low group (14/224 women) showed 1 case of ASCUS and 6 cases of LSIL, whereas the Mixed group (4/224 women) had only 2 cases of ASCUS. According to the HPV subtypes, the high-risk types 16 and 18 induced 26 and 7 cases of ICC, respectively, whereas other HPV subtypes induced lower or no ICC incidence. In conclusion, the present data imply that the prevalence of HPV was 43.17%, high-risk HPV type 16 is a major factor, which causes precancerous and/or cervical cancer in woman and that HPV DNA chip is an accurate and useful tool for detecting HPV.