• 대한세포병리학회지
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• 제6권2호
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• pp.85-98
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• 1995

In 1989, the Bethesda System (TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia (CIN) and Papanicolaou Class System, which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade types. TBS recommends a specific format for cytologic report, starling with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studios performed over last 10 years have provided evidence that human papillomavirus (HPV) plays a significant role in the development of cervical neoplasia, TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2411-2414
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• 2016

Purpose: To determine the incidence of high-grade cervical intraepithelial neoplasia (CIN2-3) among patients with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou (Pap) smears. Materials and Methods: One-hundred and eighty-seven patients with ASC-US Pap smears who underwent colposcopy with histological study were enrolled between September 2007 and August 2015. Patient factors (including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners) were obtained. Logistic regression analysis was used to evaluate clinical factors associated with CIN2-3. Results: CIN was diagnosed in 92 of 187 women (49.2%). Sixty-one of these (32.6%) had CIN1 and 31 (16.6%) had CIN2-3. There was no woman who had invasive cancer. There was no correlation of high-grade CIN with factors in this study including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners. Conclusions: Data from this study showed no invasive cervical cancer was found in patients with ASC-US. There was no patient factor associated with high grade intraepithelial neoplasia in patients with ASC-US Pap smears.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1643-1647
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• 2013

Background: To identify the risk factors and assess the role of survivin in predicting progessivity precancerous cervical lesions. Materials and Methods: This case-control study was conducted from October 2009 until May 2010. We obtained 74 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 19 samples for CIN 1, 18 samples for CIN 2, 18 samples for CIN 3, and 19 samples as controls. Demographic profiles and risk factors assesment, histopathologic examination, HPV DNA tests, immunocytochemistry (ICC) and immunohistochemistry (IHC) staining for survivin expression were performed on all samples. Data was analyzed with bivariate and multivariate analysis. Results: Multivariate analysis revealed significant risk factors for developing precancerous cervical lesions are age <41 years, women with ${\geq}2$ sexual partners, course of education ${\geq}13$ years, use of oral contraceptives, positive high-risk HPV DNA, and high survivin expression by ICC or IHC staining. These factors were fit to a prediction model and we obtained a scoring system to predict the progressivity of CIN lesions. Conclusions: Determination of survivin expression by immunocytochemistry staining, along with other significant risk factors, can be used in a scoring system to predict the progressivity of CIN lesions. Application of this scoring system may be beneficial in determining the action of therapy towards the patient.

• 대한지역사회영양학회지
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• 제10권5호
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• pp.700-707
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• 2005

The purpose of this study was to investigate the implications of dietary intake and the level of serum micronutrients (Se, Mn, Cu, Zn), lipid peroxidation, and antioxidant capacity in Korean women with cervical intraepithelial neoplasia (CIN) . From October 2002 to March 2003, 50 patients diagnosed with CIN (confirmed with colposcopy directed biopsy) and 50 patients without any cervical disease as the control group were enrolled in the study at the Department of Gynecology Cancer Center at Samsung Cheil Hospital. Animal fat intake in CIN group was significantly higher than that of the control group, but plant protein intake in the CIN group was significantly lower than that of the Control group. Energy and zink intakes were similar in the two groups. The serum concentration of antioxidant minerals in the CIN group were not significantly different from the control group. The total radical trapping antioxidant potential concentration of plasma was significantly lower in the CIN group (1.12mM) than in the control group (1.25mM) (p<0.05). But MDA (malondialde-hyde) of serum was significantly higher in the CIN group (7.60mM) than in the control group (4.99mM) (p<0.005). The serum selenium concentration of the control group showed significant positive correlation with the MDA level (r=0.311). These findings are suggestive of protective roles for healthy dietary habit including increasing antioxidant nut-rients and decreasing intake of fat.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5153-5158
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• 2015

Infection with high-risk human papillomavirus (HR-HPV) is an essential cause of cervical cancer. Because of substantial geographical variation in the HPV genotype distribution, data regarding HPV type-specific prevalence for a particular country are mandatory for providing baseline information to estimate effectiveness of currently implemented HPV-based cervical cancer prevention. Accordingly, this review was conducted to evaluate the HR-HPV genotype distribution among Thai women with precancerous cervical lesions i.e. cervical intraepithelial neoplasia grade 2-3 (CIN 2-3), adenocarcinoma in situ (AIS), and invasive cervical cancer by reviewing the available literature. The prevalence of HR-HPV infection among Thai women with CIN 2-3 ranged from 64.8% to 90.1% and the three most common genotypes were HPV 16 (38.5%), HPV 58 (20.0%), and HPV 18 (5.5%). There were high squamous cell carcinoma/CIN 2-3 prevalence ratios in women with CIN 2-3 infected with HPV 33 and HPV 58 (1.40 and 1.38, respectively), emphasizing the importance of these subtypes in the risk of progression to invasive cancer among Thai women. Data regarding the prevalence and genotype distribution of HR-HPV in Thai women with AIS remain unavailable. Interesting findings about the distribution of HPV genotype in cervical cancer among Thai women include: (1) a relatively high prevalence of HPV 52 and HPV 58 in invasive squamous cell carcinoma; (2) the prevalence of HPV 18-related adenocarcinoma is almost double thepreviously reported prevalence, and (3) 75% of neuroendocrine carcinomas are HPV18-positive when taking into account both single and multiple infections.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.91-96
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• 2012

Objectives: To determine the prevalence of HPV and cervical neoplasia among HIV-infected women in southwestern China. Methods: Cervical cytology, HPV detection by Hybrid Capture-$2^{TM}$ assay, and diagnostic colposcopy were followed by cervical biopsy if indicated. Logistic regression analysis was used to analyze associations between HPV co-infection and cervical intraepithelial neoplasia (CIN), and HIV-related clinical and laboratory parameters. Results: Colposcopic-histopathologically proven CIN2+ lesions were present in 7/83 (8.4%) HIV-infected women. Nearly half (41/83, 43%) were co-infected with carcinogenic HPV genotypes. HPV co-infection was higher in women with colposcopic-histopathologically proven CIN2+ lesions than women with $cells/{\mu}L$ had higher CIN2+ prevalence after adjusting for current ART status and age (adjusted OR: 6.3, 95% CI: 1.1, 36.5). Conclusions: HIV/AIDS care and treatment programs should integrate effective cervical cancer prevention services to mitigate the risk of invasive cervical cancer among HIV-infected women in China.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6203-6206
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• 2012

The aim of this study was to evaluate the outcomes of women with high-grade squamous intraepithelial lesion (HSIL) smears who had undergone the "see and treat" approach compared to those who underwent a conventional approach. The records of women with HSIL smears undergoing colposcopy at Srinagarind Hospital were reviewed. In those undergoing the conventional approach, the final histological diagnosis was made on the most severe histological results obtained after initial colposcopy. In the "see and treat" group, the final histological diagnosis was made on the examination of LEEP specimens obtained after initial colposcopy. Overtreatment in the see and treat group was defined as the LEEP specimens containing cervical intraepithelial neoplasia (CIN) 1 or less. During the study period, 302 women with HSIL underwent colposcopy. Twenty (6.6%) were nulliparous. One hundred and ninety-four (64.2%) underwent conventional management while the remaining 108 (35.8%) received the see and treat management. The prevalence of underlying high-grade lesions in women undergoing the conventional approach was significantly higher than that observed among women undergoing the see and treat approach (89.2% and 47.2%, respectively, P<0.001). The overtreatment rate in the see and treat group was 52.8%. Multivariate analysis revealed that only parity status was a statistically significant factor for predicting the overtreatment after undergoing the see and treat approach. In conclusion, the overtreatment rate among women undergoing see and treat in this study is notably high and therefore this approach should not be routinely practiced.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1023-1026
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• 2013

Cervical cancer is the most important female gynecological cancer, the second leading cause of cancer mortality in women worldwide and the second most common cancer in Thai women. The major cause of cervical cancer is persistent infection of human papillomavirus (HPV), leading to abnormal epithelial lesions, with progression to precancerous and invasive cancer. This study was conducted to investigate the frequency and type distribution of HPV in Thai women who had abnormal cytology. HPV detection from FFPE confirmed abnormal of high grade cervical intraepithelial lesions were for SPF-10-Innogenic Line Probe Assay. HPV-positivity was detected in 320/355 cases (90.14%) and HPV-negativity in 35/355 (9.86%). HPV-positive was found 147/320 cases (41.4%) of single infection, whereas 173/320 cases (48.7%) showed the multiple HPV infection. The most common seven types were HPV-16, -52, -18, -11, -51, -31 and -33, in that order. HPV 16 and 18, the important oncogenic HPV type, were observed in 64.8% of HSIL cases. Interestingly, a high proportion of multiple infections was found in this study and more than ten types could be detected in one case. Therefore, HPV infection screening program in women is essential, particularly in Thailand. Effective primary and secondary prevention campaigns that reinforce HPV screening for HPV detection and typing may be decrease the incidence and mortality of cervical cancer in the future and may lead to significantly improve the quality of life in Thai women.

• Journal of Microbiology and Biotechnology
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• 제19권9호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7757-7761
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• 2014

Aim: To report long term outcomes of laser conization for high grade cervical intraepithelial neoplasia (CIN) in Thai women. Materials and Methods: A retrospective cohort study was conducted in patients undergoing laser conization due to abnormal cervical cytology suggesting neoplasia during 1989 to 1994 and having follow-up data until December 2010. Conization was performed under colposcopy using a 0.5-mm $CO_2$ laser beam with power density of $18,000-20,000watts/cm^2$, and the surgical base was vaporized using a low power defocused beam. The follow-up protocol included cervical cytology and colposcopy. Long term outcome measures were failure rate (persistence and recurrence), post-conization status of transformation zone, and obstetric outcomes. Results: Of 104 patients undergoing conization, 71 had therapeutic conization for high grade CIN and were followed up for a median time of 115 (range 12-260) months. There was one case of persistent and one of recurrent disease comprising a failure rate of 2.8%. The post treatment transformation zone was well visualized in 68.3% of 63 patients with an intact uterus. Sixteen patients achieved 25 pregnancies; none had second trimester miscarriage. The obstetric outcomes were unremarkable. Conclusions: Laser conization under colposcopic visualization for the treatment of high grade CIN in Thai women has a low failure rate of 2.8%. The post-conization transformation zone could not be evaluated completely in approximately 30% of cases; therefore the follow-up protocol should include both cytology and colposcopy. Obstetric outcomes are not adversely affected by this therapeutic procedure.