Objective: Cervix cancer is one of the most common gynecological cancer types that cause cancer deaths among women. This study was planned based on a descriptive method in order to evaluate the results of PAP smear screening during pregnancy for prevention of cancer. Materials and Methods: The research involved 110 pregnant women registered at the Obstetrics and Gynecology Polyclinic of Bagcilar Training and Research Hospital and 86 non-pregnant women of the same ages as a control group. As criteria for acceptance were conditions such as not being in coitus within the last 48 hours, not using vaginal ovule, and not performing vaginal lavage. A survey consisting of 33 questions was conducted and the results were processed using Bethesda. Results: The average ages were $27.1{\pm}4.70$ for the pregnant women and $28.8{\pm}4.24$ for the control group. 60.7% of cases had previously heard of a PAP smear test, 49% were aware of why PAP smear tests were conducted, 26.4% of pregnant participants and 27.3% of non-pregnant participants had previously undergone a smear test. In this study, smear results of all cases were 95.4% sufficient. 18.2% of pregnant cases had an infection, 54.5% had reactive cellular change, and 0.9% had atypical squamous cells of undetermined significance (ASC-US). 16.3% of non-pregnant cases had an infection, 58.1% had reactive cellular change, 3.5% had atypical squamous cells of undetermined significance (ASC-US), and 1.2% had low-grade squamous intraepithelial lesions (LGSIL). Conclusion: PAP smear test is a good opportunity to identify pre-invasive lesions in early phases of pregnancy.
Kim Hunjung;Cho Young Kap;Kim Chulsu;Kim Woo Chul;Lee Sukho;Loh J K
Radiation Oncology Journal
/
v.17
no.2
/
pp.113-119
/
1999
Purpose : To evaluate possible acute toxicity and early response of concurrent radiation therapy and low dose daily cisplatin as a radiosensitizer in patients with locally advanced uterine cervical carcinomas. Materials and Method : From December 1996 to January 1999, 38 previously untreated Patients with locally advanced squamous cell carcinoma of the uterine cervix (from stage IIB to stage IIIB) were treated at Inha University Hospital. All patients underwent standard pretreatment staging Procedures after the initial evaluation by gynecologists and radiation oncologists. Sixteen Patients with huge cervical mass (>4 cm) were submitted to the group treated with concurrent radiation therapy and low dose daily cisplatin while the remainder was treated with radiation therapy alone. Radiation therapy consisted of 4500 cGy external beam irradiation to whole pelvis (midline block after 3000 cGy), 900$\~$1000 cGy boost to involved parametrium, and high dose-rate intracavitary brachytherapy (a total dose of 3000$\~$3500 cGy/500 cGy per fraction to point A, twice per week). In the group treated with low dose cisplatin concurrently, 10 mg of daily intravenous cisplatin was given from the 1st day of radiation therapy to the 20th day of radiation therapy. Acute toxicity was measured according to expanded common toxicity criteria of the NCI (C) Clinical Trials. Early response data were analyzed at minimum 4 weeks' follow-up after completion of the treatment protocol. Results: Hematolgic toxici쇼 was more prominent in patients treated with radiation therapy and cisplatin. Six of 16 patients (37.5$\~$) treated with radiation therapy and cisplatin and one of 22 patients (4.5$\~$) treated with radiation therapy alone experienced grade 3 leukopenia. In Fisher's exact test, there was statistically significant difference between two groups regarding leukopenia (P=0.030). There was no apparent difference in the frequency of gastrointestinal and genitourinary toxicity between two groups (P=0.066). Three of 16 patients (18.7$\~$) treated with radiation therapy and cisplatin and two of 22 patients (9.1$\~$) treated with radiation therapy alone experienced more than 5 kg weight loss during the treatment. There was no statistically significant difference on weight loss between two groups (P=0.63). Two patients on each group were not evaluable for the early response because of incomplete treatment. The complete response rate at four weeks' follow-up was 80$\~$(16/20) for the radiation therapy alone group and 78$\~$ (11/14) for the radiation therapy and cisplatin group. There was no statistically significant difference in early response between two treatment groups (P=0.126). Conclusion : This study led to the conclusion that the hematologic toxicity from the treatment with concurrent radiation therapy and low dose daily cisplatin seems to be more prominent than that from the treatment of radiation therapy alone. There was no grade 4 hematologic toxicity or mortality in both groups. The hematologic toxicity in both treatment groups seems to be well managable modically. Since the risk factors were not balanced between two treatment groups, the direct comparison of early response of both groups was not possible. However, preliminary results regarding early response for patients with bulky cervical tumor mass treated with radiation therapy and low dose daily cisplatin was encouraging. Longer follow-up is necessary to evaluate the survival data. A phase III study is needed to evaluate the efficacy of concurrent daily low dose cisplatin with radiation therapy in bulky cervical cancer.
Cervical dysplasia induces morphologic changes in the cervical epithelium which involve changes in the nuclear/cytoplasmic (N/C) ratio. Since the nucleus is one of the significant scattering sources, the N/C ratio change reflects the degree of circular polarization (DOCP) with the depth of signals. Therefore, we used the polarization-sensitive OCT (PS-OCT) technique to measure the polarization changes caused by scattering. Cervical tissues were obtained from a high-grade squamous intraepithelial lesion (H-SIL) of one woman and from low normal women. We obtained the mean of the DOCP as a function of depth in the cervix and quantified the change ratio of the DOCP using slopes that were determined by linear fits in the epithelium layer. We found that DOCP of H-SIL decayed faster than that of normal tissue because of the higher scattering in H-SIL as expected. This result indicates that the PS-OCT system might be useful in measurements of change ratio of DOCP with depth for screening of cervical dysplasia.
Endometrial carcinoma is one of the most common gynecologic malignancies and which is predominant in postmenopausal women. Clinically many patients are hospitalized in early stage due to clinical sign and symptom such as vaginal bleeding and in this case, patient's prognosis is known to be good. However, considerable number of patients with advanced and relapsed disease reveal poor prognosis. Therefore, exact staging work up is essential for proper treatment as is primary lesion detection. $^{18}F-FDG-PET$ has been widely used for the evaluation of gynecologic malignancies such as cervical carcinoma and ovarian cancer. In contrast, FDG PET application to endometrial carcinoma is limited until now and there is no sufficient data to validate the usefulness of FDG PET for this disease yet. However, several studies showed promising results that FDG PET is sensitive and specific in detection of recurrent or metastatic lesions. Therefore further active investigation in this field can facilitate the use of FDG PET for endometrial carcinoma.
Background: Non-Hodgkin's lymphoma (NHL) is a heterogeneous type of neoplasm of the lymphatic system. To have a more accurate and early diagnosis we need to know signs, symptoms and complications of lymphoma in early stages besides pathology and immunohistochemistry. Materials and Methods: This prospective study included 110 cases of NHL that were followed since February 2012 till November 2013. Biopsies were taken from all the patients besides bone marrow study. Signs and symptoms were categorized into "B" symptoms, general, lymphadenopathy and extranodal involvement and we compared the frequencies by stage and grade. Results: Of 110 cases, 88.9% had B-cell and 11.1% T-cell type with mean age $48.5{\pm}18.6$ years. "B" symptoms and lymphadenopathy were more common in men. Cervical lymphadenopathy was the most common sign (44.8%). and hematologic, bone marrow, bone and neurologic lesions were the most common complications. All complications were more common in males. "B" symptoms were seen mostly in stage III, general signs and symptoms in stage IV, and lymphadenopathy in stage II. Intermediate grade was also the most common in all signs and symptoms. In this study 12 (10.9%) patients had relapse, with neurologic and bone marrow as the most common sites of tumor recurrence. Conclusions: There is a meaningful relationship between male gender for NHL and anemia that can be due in part to higher incidence of bone marrow involvement and stage IV disease in male cases. We also found a strong relationship between low grade NHL and age. On the other hand extranodal involvement is more common in female groups.
Purpose: To investigate the clinical features and prognosis of papillary thyroid carcinoma (PTC) with a background of benign disease. Method: A total of 709 patients with papillary thyroid carcinoma undergoing surgical resection were analyzed retrospectively. In 147 patients who underwent surgery for benign thyroid disease, incidental PTC (IPC group) were identified by intraoperative or postoperative pathological examination of surgical specimens but were not detected by preoperative imaging studies. In the other group, according to the pathological examination with or without co-existing benign thyroid disease, 253 cases were clarified as concomitant PTC and 309 cases were clarified as dominant PTC. Results: Incidental PTC was more common in women, about 85.7%, the mean age was $47.6{\pm}11.3$ years old. Average tumor diameter was $4.4{\pm}2.2$ mm, multiple lesions accounted for 12.9% (19/147), and the cervical lymph node metastasis rate was 6.1% (9/147). After radical resection 8 cases recurred, the median time of recurrence was about 12 months (0.5 to 162), there was no tumor-related death. The tumor-free survival rates were 97.3%, 95.9%, 91.5%, and 79.3% in 1, 5, 10 and 14 year respectively. Conclusion: Incidental PTC with a background of benign lesions is common, and the generally good prognosis can be attributed to tumor early detection and early treatment. On the intraoperative finding of incidental PTC, lobectomy (unilateral) or total thyroidectomy (bilateral) should be the first choice, but with a postoperative pathologic finding of incidental PTC, further treatment, such as completion thyroidectomy or immediate lymph dissection is not necessary. Central lymph node dissection is also not needed unless lymphadenectasis is present.
Oral squamous cell carcinoma (OSCC) is the most prevalent head and neck malignancy, with frequent cervical lymph-node metastasis, leading to a poor prognosis in OSCC patients. The present study aimed to identify potential markers, including microRNAs (miRNAs) and genes, significantly involved in the etiology of early-stage OSCC. Additionally, the main OSCC's dysregulated Gene Ontology annotations and significant signaling pathways were identified. The dataset GSE45238 underwent multivariate statistical analysis in order to distinguish primary OSCC tissues from healthy oral epithelium. Differentially expressed miRNAs (DEMs) with the criteria of p-value < 0.001 and |Log2 fold change| > 1.585 were identified in the two groups, and subsequently, validated targets of DEMs were identified. A protein interaction map was constructed, hub genes were identified, significant modules within the network were illustrated, and significant pathways and biological processes associated with the clusters were demonstrated. Using the GEPI2 database, the hub genes' predictive function was assessed. Compared to the healthy controls, main OSCC had a total of 23 DEMs. In patients with head and neck squamous cell carcinoma (HNSCC), upregulation of CALM1, CYCS, THBS1, MYC, GATA6, and SPRED3 was strongly associated with a poor prognosis. In HNSCC patients, overexpression of PIK3R3, GIGYF1, and BCL2L11 was substantially correlated with a good prognosis. Besides, "proteoglycans in cancer" was the most significant pathway enriched in the primary OSCC. The present study results revealed more possible mechanisms mediating primary OSCC and may be useful in the prognosis of the patients with early-stage OSCC.
One hundred and twenty six patients with early uterine cervical cancer who had been treated at Departmen of Radiation Oncology of Korea University Hospital from Jan.1981 to Dec.1988 were analysed retrospectively by the treatment result and pattern of of failures. All patients had stage Ia to IIa disease and were grouped whether they had combination of operation and postop irradiation or radiation therapy alone. 1) Sixty six patients belonged to the combination treatment group and 60 patients to the radiation alone group. 2) Combination group consisted of $18.1\%$(12/66) stage Ia, $71.2\%$(47/66) stage Ib and $10.6\%$ (7/66) stage IIa patients. There were no stage Ia, 18.8$\%$(l1/60) stage Ib and 81.6$\%$(49/60) stage IIa patients for RT alone gronp. 3) There were total 23$\%$(29/126) treatment failures,13 patients in combination group and 16 patients in RT alone group. In 66 patients of combination group, they were found to have 5 locoregional failures, 7 distant failures and 1 at both sites. In 60 patients of RT alone group, 9 locoreginal failure and 7 distant failures occured. Eighty six percent (25/29) of total failures appeared within 18 month after completion of treatment. About 60$\%$ of the patients with regional recurrences which were located at pelvic side wall or pelvic lymph nodes paesented their recurrent disease after 1 year of completion of treatment, whereas same percent of distant failures appeared within 6 month. 5) In RT alone group, the first sites of distant failure were mostly para-aortic lymph node and/or left supraclavicular lymph node (71.4$\%$,5/7). In combination group, various sites such as inguinal lymph node, mediastinal lymph node, liver, lung and bone appeared first or at the same time with para-aortic and supraclavicular lymph node metastasis. 6) Logistic regression analysis was done for multivariate analysis of the factors contributing to locoregional and distant failures. In combination group, adequacy of the resection margin and the presence of positive pelvic node were found to be the most significant factors (p=0.0423 & 0.0060 respectively). In RT alone group, less than complete regression of the tumor at the end of treatment was the only significant contributing factor for the treatment failures (p=0.0013) with good liklihood ratio.
Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngocervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.
Sung, Mi Hee;Lee, Hoon Taek;Shin, Min Shik;Oh, Seo Young;Kim, Wook Youn
Korean Journal of Clinical Laboratory Science
/
v.47
no.3
/
pp.132-139
/
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.
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