• Biomedical Science Letters
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• v.7 no.3
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• pp.133-138
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• 2001

The recently proposed Bethesda system for cervical/vaginal cytology has made a standardization related to "atypia". In cellular change due to inflammation or repair, the word "benign cellular change" has been suggested as a substitute for atypia. Terminology related to atypia cells may become standardized, but the cytologic criteria has not been well defined yet Among 8113 cases screened, we evaluated 182 cases as atypia squamous cells undetermined significance (ASCUS) by the Bethesda system (TBS): 52 cases of ASCUS were cytologically diagnosed and 33 cases were histologically verified. ASCUS was diagnosed based on nuclear enlargement and nonclassical signs of condyloma. The results are as follows; Six cases (16.6%) turned out to have benign cellular change. Twenty five cases (69.1%) demonstrated squamous intraepthelial lesion, condyloma was 2 cases (6.0%) and mild dysplasia was not revealed. Moderate and severe dysplasia were 1 case (3.0%) and 16 cases (48.4%), squamous cell carcinoma and adenocarcinoma were 4 (12.1%) and 1 cases (3.0%), respectively. Our data suggested that patients with ASCUS are highly recommended to be examined colposcopic biosy to cornfim.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3201-3206
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• 2016

Purpose: To evaluate the expression of p16 and Ki67 in cervical intraepithelial neoplasia (CIN) and cancer. Materials and Methods: We performed a immunohistochemical study of p16 and Ki67 in 243 cervical tissues - 53 non-dysplastic lesions, 106 CIN1, 61 CIN2/3 and 23 squamous cell carcinomas. The expression of p16 and Ki67 was interpreted independently by 2 researchers and the sensitivity and specificity to detect clinically significant lesions (${\geq}CIN2$) were determined. Results: The overall agreement results of positive or negative immunostaining of intra-inter observer variability were 0.659 for p16 and 0.808 for Ki67. p16 expression was demonstrated in 91.3% of invasive carcinomas, 78.7% of CIN2/3, 10.4% of CIN1 and 9.4% of non-dysplasic lesions. The corresponding Ki67 expression was: 100% of all invasive carcinomas, 75.4% of CIN2/3, 22.6% of CIN1, and 11.3% with non-dysplasia. The expression was significantly different between CIN2/3 vs CIN1 for both p16 and Ki67 (p-values <0.001 both), and cancer vs CIN2/3 for Ki67 (p-value 0.008). The differences were not significant between CIN1 vs non-dysplasia (p-values 1.000 for p16 and 0.130 of Ki67), and cancer vs CIN2/3 for p16 (p value 0.219). The sensitivity and specificity to detect > CIN2 were 84.5% and 90.5% by p16 and 82.1% and 88.6% by Ki67. Conclusions: The rates for 16 and Ki67 expression were directly associated with the severity of cervical lesions. Significant differences in these markers expression may be useful in cases with equivocal histologic features among cervical intraepithelial lesions, but not between CIN1 and non-dysplastic lesions. The two markers had high sensitivity and specificity in determining >CIN2.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6257-6261
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• 2014

Background: HPV related cervical cancer as one of the most common women cancers in developing countries. Regarding accessibility of commercial vaccines, any long or short term modality for integrating preventive immunization against HPV in a national program needs comprehensive information about HPV prevalence and its genotypes. The important role of selecting most accurate diagnostic technologies for obtaining relevant data is underlined by different assays proposed in the literature. The main objective of the present study was to introduce an in-house HPV typing assay using multiplex real time PCR with reliable results and affordable cost for molecular epidemiology surveys and diagnosis. MATERIALS AND METHODS: 112 samples of formalin fixed paraffin embedded tissues and liquid based cytology specimens from patients with known different grades of cervical dysplasia and invasive cancer, were examined by this method and the result were verified by WHO HPV LabNet proficiency program in 2013. RESULTS: HPV was detected in 105 (93.7%) out of 112 samples. The dominant types were HPV 18 (61.6%) and HPV 16 (42.9%). Among the mixed genotypes, HPV 16 and 18 in combination were seen in 12.4% of specimens. CONCLUSIONS: According to acceptable performance, easy access to primers, probes and other consumables, affordable cost per test, this method can be used as a diagnostic assay in molecular laboratories and for further planning of cervical carcinoma prevention programs.

• 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.

• Journal of Microbiology and Biotechnology
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• v.19 no.9
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• pp.1051-1054
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• 2009

This cross-sectional study examined the distribution of HPV 58 sequence variation in Korean women for the first time. Among 1,750 Korean women, 53 women were positive for HPV 58 single infection, of whom 26 were without disease, 20 were with cervical intraepithelial neoplasia (CIN) 1, and 7 with CIN 2 or 3. Altogether, 36 different nucleotide sequence variations were identified with the L1, 20 within E2, 5 within E6, and 10 within E7. Further studies on variants of oncogenic HPVs are necessary, particularly for the purpose of developing more predictive HPV detection methods.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.169-180
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• 1999

Background: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screening test of cervical cancer. Materials and Methods: Cervicography was taken from 482 women at department of obstetrics and gynecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999. Of the 482 women, 172 women were exc1uded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology (Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. Results: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chronic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05). The sensitivity and specificity of cytology were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13. 3%) (p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%) (p<0.05). Conclusion: It seems inappropriate to use cervicography as a single screening test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.3
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• pp.132-139
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• 2015

Recently, $p16^{INK4a}$/Ki-67 dual immunostaining has been introduced as a new biomarker protocol for early detection of uterine cervical dysplasia and cancer in liquid-based cytology (LBC). We performed the $p16^{INK4a}$/Ki-67 dual immunostaining using a CINtec$^{(R)}$ PLUS kit in a total of 109 LBC cases of cervicovaginal smear and compared its results with those from LBC, HPV hybrid capture II (HC II) test and histological diagnosis. Expression of $p16^{INK4a}$ and Ki-67 was significantly associated with cases of LSIL or higher in cytological diagnosis and cases of cervical intraepithelial neoplasia (CIN) 1 or higher in histological diagnosis (p<0.001 and p<0.001, respectively). Among forty-six cases of atypical squamous cells of undetermined significance (ASCUS) in LBC, $p16^{INK4a}$ and Ki-67 was expressed in 31 (67.4%), which were positively associated with cases of CIN I lesion or higher in histology. The sensitivity of $p16^{INK4a}$/Ki-67 dual immunostaining for finding lesions of CIN 1 or higher was 89.0%, which was higher than LBC. The specificity was 73.5%, which was higher than that of the HC II test. Based on these results, the $p16^{INK4a}$/Ki-67 dual immunostaining method can be a useful diagnostic marker for improving the sensitivity of LBC and the specificity of HC II test.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.172-176
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• 1999

Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.189-193
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• 2018

Background: This study aimed to reveal the clinicopathologic features and causes of bleeding in older patients with postmenopausal bleeding (PMB) and to investigate the correlation between the ultrasonographic findings and etiology of PMB. Methods: We retrospectively analyzed the causes and clinical characteristics of PMB in 498 patients who were diagnosed between January 2007 and December 2017. The population with PMB was divided into 2 groups according to age: Group A (n=204) included individuals more than 65 years of age and group B (n=294) included those less than 65 years of age. Clinical characteristics such as age, parity, underlying conditions, previous surgical history, and previous menopausal hormone therapy were compared between the groups. Cervical cytology testing and transvaginal ultrasonography were performed in all patients with PMB. Endometrial biopsy was performed in all cases of endometrial thickness ${\geq}5mm$. Results: We examined 498 patients with PMB. In group A, atrophic endometrium (n=125, 61.27%) was the most common cause of PMB. Twenty-three patients had gynecological malignancy (cervical cancer: n=12, 5.88%; endometrial cancer: n=8, 3.42%; ovarian cancer: n=3, 1.46%), and 30 patients had benign gynecological disease (endometrial polyp: n=10, 4.90%; submucosal myoma: n=6, 2.94%; uterine prolapse: n=7, 3.42%; cervical dysplasia; n=5, 2.45%; cervical polyp: n=2, 0.98%). Forty patients had endometrial thickness ${\geq}5mm$. Eight patients were diagnosed with endometrial cancer. All cases of endometrial cancer were diagnosed with endometrial thickness >10 mm. Conclusion: Atrophic endometrium was the most common cause of PMB in both groups, and approximately 12% of cases were associated with gynecological malignancy in older patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.903-907
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• 2013

Primary screening by HPV DNA testing is an effective method for reducing cervical cancer and has proven more sensitive than cytology. To advance this approach, many molecular methods have been developed. Hybrid capture 2 provides semi-quantitative results in ratios of relative light units and positive cutoff values (RLU/PC). Twenty-five thousand and five patients were included in this study to analyze the correlation between the ratio of RLU/PC and stage of cervical dysplasia. The results show that the RLU/PC ratios ranged from 0-3500 while almost normal cases, ASC-US and ASC-H, had values below 200. Of those samples negative for cytology markers, 94.6% were normal and their RLU/PC ratios were less than 4. With an RLU/PC ratio greater than 4 and less than or equal to 300, the percentages in all age groups were normal 53.6%, LSIL 20.2%, ASC-US 17.2%, HSIL 6.13%, ASC-H 2.72%, and AGC 0.11%, respectively. In contrast, 64.0% of samples with a RLU/PC ratio greater than 300 and less than or equal to 3500 were LSIL. These results should contribute to cost effective cervical cancer management strategies. Further studies of associations with particular HPV genotypes would be useful to predict the risk of progression to cancer.