• 제목/요약/키워드: Cervical lesions

검색결과 317건 처리시간 0.02초

Human Telomerase Gene and High-Risk Human Papillomavirus Infection are Related to Cervical Intraepithelial Neoplasia

  • Zhao, Xu-Ye;Cui, Yongm;Jiang, Shu-Fang;Liu, Ke-Jun;Han, Hai-Qiong;Liu, Xiao-Su;Li, Yali
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.693-697
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    • 2015
  • Our aims were to evaluate the clinical performance of human telomerase RNA gene component (hTERC gene) amplification assay with high-risk human papillomavirus (HR-HPV) DNA test of Hybrid Capture 2 DNA test (HC2), for the detection of high grade cervical precancerous lesions and cancer (CIN 2+). In addition, the association shown between hTERC gene amplification and HPV DNA test positive in women with and without cervical neoplasia was assessed. There were 92 women who underwent cytology, HR-HPV DNA test, hTERC gene amplification test, colposcopy and biopsy. We compared the clinical performance of hTERC gene test along with HR-HPV DNA test of women with colposcopy and routine screening. The samples were histology-confirmed high-grade cervical intraepithelial neoplasia (CIN 2) or worse (CIN2+) as the positive criterion. The test of hTERC gene showed the hTERC gene amplification positivity increased with the severity of histological abnormality and cytological abnormality. The test of hTERC gene showed higher specificity than HR-HPV DNA test for high-grade lesions (84.4% versus 50%) and also higher positive predictive value (90.4% versus 76.5%). Our results predicted that hTERC gene amplification demonstrated more specific performance for predicting the risk of progression and offer a strong potential as a tool for triage in cervical cancer screening, with the limited sensitive as HR-HPV DNA test.

Significance of Human Telomerase RNA Gene Amplification Detection for Cervical Cancer Screening

  • Chen, Shao-Min;Lin, Wei;Liu, Xin;Zhang, You-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2063-2068
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    • 2012
  • Aim: Liquid-based cytology is the most often used method for cervical cancer screening, but it is relatively insensitive and frequently gives equivocal results. Used as a complementary procedure, the high-risk human papillomavirus (HPV) DNA test is highly sensitive but not very specific. The human telomerase RNA gene (TERC) is the most often amplified oncogene that is observed in cervical precancerous lesions. We assessed genomic amplification of TERC in liquid-based cytological specimens to explore the optimal strategy of using this for cervical cancer screening. Methods: Six hundred and seventy-one residual cytological specimens were obtained from outpatients aged 25 to 64 years. The specimens were evaluated by the Digene Hybrid Capture 2 (HC2) HPV DNA test and fluorescence in situ hybridization (FISH) with a chromosome probe to TERC (3q26). Colposcopic examination and histological evaluation were performed where indicated. Results: The TERC positive rate was higher in the CIN2+ (CIN2, CIN3 and SCC) group than in the normal and CIN 1 groups (90.0% vs. 10.4%, p < 0.01). In comparison with the HC2 HPV DNA test, the TERC amplification test had lower sensitivity but higher specificity (90.0% vs. 100.0%, 89.6% vs. 44.0%, respectively). TERC amplification test used in conjunction with the HC2 HPV DNA test showed a combination of 90.0% sensitivity and 92.2% specificity. Conclusion: The TERC amplification test can be used to diagnose cervical precancerous lesions. TERC and HPV DNA co-testing shows an optimal combination of sensitivity and specificity for cervical cancer screening.

Long-term Outcomes of a Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia in a High Incidence Country

  • Sangkarat, Suthi;Ruengkhachorn, Irene;Benjapibal, Mongkol;Laiwejpithaya, Somsak;Wongthiraporn, Weerasak;Rattanachaiyanont, Manee
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.1035-1039
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    • 2014
  • Aim: To evaluate the operative, oncologic and obstetric outcomes of the loop electrosurgical excision procedure (LEEP) in cases with cervical neoplasia. Materials and Methods: A retrospective cohort study was conducted on patients who were suspected of cervical neoplasia and therefore undergoing LEEP at Siriraj Hospital, Mahidol University, Thailand, during 1995-2000. Outcome measures included operative complications in 407 LEEP patients and long-term outcomes in the 248 patients with cervical intraepithelial neoplasia (CIN) who were treated with only LEEP. Results: There were 407 patients undergoing LEEP; their mean age was $39.7{\pm}10.5$ years. The histopathology of LEEP specimens revealed that 89 patients (21.9%) had lesions ${\leq}CIN$ I, 295 patients (72.5%) had CIN II or III, and 23 patients (5.6%) had invasive lesions. Operative complications were found in 15 patients and included bleeding (n=9), and infection (n=7). After diagnostic LEEP, 133 patients underwent hysterectomy as the definite treatment for cervical neoplasia. Of 248 CIN patients who had LEEP only, seven (2.8%) had suffered recurrence after a median of 16 (range 6-93) months; one had CIN I, one had CIN II, and five had CIN III. All of these recurrent patients achieved remission on surgical treatment with re-LEEP (n=6) or simple hysterectomy (n=1). A significant factor affecting recurrent disease was the LEEP margin involved with the lesion (p=0.05). Kaplan-Meier analysis showed 5-year and 10-year disease-free survival (DFS) estimates of 99.9%. Twelve patients became pregnant a total of 14 times, resulting in 12 term deliveries and two miscarriages - one of which was due to an incompetent cervix. Conclusions: LEEP for patients with cervical neoplasia delivers favorable surgical, oncologic and obstetric outcomes.

Human Papillomavirus Vaccine

  • Lee, Yu-Jeung
    • Biomolecules & Therapeutics
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    • 제15권3호
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    • pp.133-136
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    • 2007
  • Human papillomavirus (HPV) infection is the most common sexually transmitted disease in the United States. An estimated 6.2 million people are infected with HPV every year. Randomized controlled studies consistently show that HPV vaccine is effective in preventing infection and HPV related cervical lesions. In June 2006, Gardasil (qadrivalent HPV recombinant vaccine) was approved by the FDA for use in females 9-26 years of age. This article reviews published data to evaluate the effectiveness of HPV vaccine for the prevention of cervical cancer.

Effect of dentin roughening and type of composite material on the restoration of non-carious cervical lesions: an in vivo study with 18 months of follow-up

  • Sanjana Verma;Rakesh Singla;Gurdeep Singh Gill;Namita Jain
    • Restorative Dentistry and Endodontics
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    • 제48권4호
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    • pp.35.1-35.14
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    • 2023
  • Objectives: The purpose of this study was to evaluate the impact of dentin roughening and the type of composite resin used (either bulk-fill flowable or nanohybrid) on the restoration of non-carious cervical lesions (NCCLs) with an 18-month follow-up period. Materials and Methods: This prospective split-mouth study included 36 patients, each with a minimum of 4 NCCLs. For each patient, 4 types of restorations were performed: unroughened dentin with nanohybrid composite, unroughened dentin with bulk-fill flowable composite, roughened dentin with nanohybrid composite, and roughened dentin with bulk-fill flowable composite. A universal bonding agent (Tetric N Bond Universal) was applied in self-etch mode for all groups. The restorations were subsequently evaluated at 6, 12, and 18 months in accordance with the criteria set by the FDI World Dental Federation. Inferential statistics were computed using the Friedman test, with the level of statistical significance established at 0.05. Results: The 4 groups exhibited no significant differences in relation to fracture and retention, marginal staining, marginal adaptation, postoperative hypersensitivity, or the recurrence of caries at any follow-up point. Conclusions: Within the limitations of the present study, over an 18-month follow-up period, no significant difference was present in the clinical performance of bulk-fill flowable and nanohybrid composite restorations of non-carious cervical lesions. This held true regardless of whether dentin roughening was performed.

Assessment of Cervical Cytological Data in Albanian Females

  • Filipi, Kozeta;Xhani, Anila
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2129-2132
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    • 2014
  • Background: Cervical cancer is one of the most common female malignancies with high mortality rates in developing countries. Our purpose was to determine the prevalence of cervical cytological abnormalities by cervical cytology (CC) and the analysis of risk factors in Albanian population. Materials and Methods: A total of 5,416 conventional pap smear tests collected between January 2009 and January 2012 from Tirana University Hospital Obstetrics-Gynecology "Queen Geraldine" were retrospectively analyzed. Results: A total of 258 (4.8%) cases had epithelial abnormalities. The numbers and rates were as follows: atypical squamous cell of undetermined significance (ASCUS; n=150 [2.76%]); atypical glandular cells of undetermined significance (AGUS; n=8 [0.14%]); low-grade squamous intraepithelial lesion (LSIL; n=87 [1.6%]); high- grade squamous intraepithelial lesion (HSIL; n=10 [0.18%]); and squamous cell carcinoma (SCC; n=3 [0.05%]). Conclusions: The prevalence of cervical cytological abnormality in our study was 4.8%. A larger community-based study may establish the exact prevalence of malignant and premalignant lesions, so as to plan for future screening.

Value of PAX1 Methylation Analysis by MS-HRM in the Triage of Atypical Squamous Cells of Undetermined Significance

  • Li, Shi-Rong;Wang, Zhen-Ming;Wang, Yu-Hui;Wang, Xi-Bo;Zhao, Jian-Qiang;Xue, Hai-Bin;Jiang, Fu-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5843-5846
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    • 2015
  • Background: Detection of cervical high grade lesions in patients with atypical squamous cells of undetermined significance (ASCUS) is still a challenge. Our study tested the efficacy of the paired boxed gene 1 (PAX1) methylation analysis by methylation-sensitive high-resolution melting (MS-HRM) in the detection of high grade lesions in ASCUS and compared performance with the hybrid capture 2 (HC2) human papillomavirus (HPV) test. Materials and Methods: A total of 463 consecutive ASCUS women from primary screening were selected. Their cervical scrapings were collected and assessed by PAX1 methylation analysis (MS-HRM) and high-risk HPV-DNA test (HC2). All patients with ASCUS were admitted to colposcopy and cervical biopsies. The Chisquare test was used to test the differences of PAX1 methylation or HPV infection between groups. Results: The specificity, sensitivity, and accuracy for detecting CIN2 + lesions were: 95.6%, 82.4%, and 94.6%, respectively, for the PAX1 MS-HRM test; and 59.7%, 64.7%, and 60.0% for the HC2 HPV test. Conclusions: The PAX1 methylation analysis by MS-HRM demonstrated a better performance than the high-risk HPV-DNA test for the detection of high grade lesions (CIN2 +) in ASCUS cases. This approach could screen out the majority of low grade cases of ASCUS, and thus reduce the referral rate to colposcopy.

경부 임파선 질환 306예의 임상적 고찰 (Clincal Analysis of 306 Cases of Cervical Lymphadenopathy)

  • 류우진;임병성;최완영;신동호;박성수;이정희
    • Tuberculosis and Respiratory Diseases
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    • 제38권1호
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    • pp.45-52
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    • 1991
  • Clinical analysis was performed on 306 patients with cervical lymphadenopathy who were diagnosed histologically by fine needle aspiration biopsy cytology (FNABC) and/or excisional biopsy from Jan 1986 to Jan 1990 at Hanyang University hospital. The results obtained were as follows: 1) Of 306 patients with cervical lymphadenopathy, 216 (70.6%) were inflammatory lesions, and 90 (29.4%) malignant lesions. Tuberculous lymphadenitis of inflammatory lesions was most common (134 cass: 62%). Of malignant lesions, metastatic cancer was more frequent (75 cases: 83.3%). 2) The sex ratio were as follows: inflammatory lesion; M:F=1 : 1.8 (tuberculous lymphadenitis;M : F=1:2.3) malignant lesion; M : F=1.5 : 1 (metastatic cancer; M : F=2.6 : 1) 3) The peak age of inflammatory lymphadenopathy was 20-29 years old (38.9%), and that of malignant lesion 50-59 years old (46.7%). 4) In more than half of tuberculous lymphadenitis and metastatic cancer, the location of enlarged lymph nodes was one side of the neck and the number was more than one. 5) The common primary sites of metastatic cancer were lung and stomach. In 11 cases (14.7%), the primary site could not be found. 6) The sensitivity and the specificity of fine needle aspiration biopsy cytology (FNABC) was 0.83 & 1.0 in metastatic cancer respectively.

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Strategies Against Human Papillomavirus Infection and Cervical Cancer

  • Jung Woon-Won;Chun Taehoon;Sul Donggeun;Hwang Kwang Woo;Kang Hyung-Sik;Lee Duck Joo;Han In-Kwon
    • Journal of Microbiology
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    • 제42권4호
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    • pp.255-266
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    • 2004
  • Papillomaviruses infect a wide variety of animals, including humans. The human papillomavirus (HPV), in particular, is one of the most common causes of sexually transmitted disease. More than 200 types of HPV have been identified by DNA sequence data, and 85 HPV genotypes have been well char­acterized to date. HPV can infect the basal epithelial cells of the skin or inner tissue linings, and are, accordingly, categorized as either cutaneous or mucosal type. HPV is associated with a panoply of clin­ical conditions, ranging from innocuous lesions to cervical cancer. In the early 1980s, studies first reported a link between cervical cancer and genital HPV infection. Genital HPV infections are now rec­ognized to be a major risk factor in at least $95\%$ of cervical cancers. 30 different HPV genotypes have been identified as causative of sexually transmitted diseases, most of which induce lesions in the cervix, vagina, vulva, penis, and anus, as the result of sexual contact. There is also direct evidence demon­strating that at least four of these genotypes are prerequisite factors in cervical cancer. The main aim of this review was to evaluate the current literature regarding the pathovirology, diagnostics, vaccines, therapy, risk groups, and further therapeutic directions for HPV infections. In addition, we reviewed the current status of HPV infections in South Korean women, as evidenced by our data.

경부 결핵성 림프절염에서 외과적 절제수술후 항결핵제 요법시의 치료 성적 (The Treatment Result of Antituberculous Chemotherapy Followed by Surgical Excisions in Tuberculous Cervical Lymphadenitis)

  • 박동은;김상호
    • 대한두경부종양학회지
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    • 제18권2호
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    • pp.192-196
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    • 2002
  • Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.