• Journal of Preventive Medicine and Public Health
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• v.7 no.2
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• pp.367-372
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• 1974

Authors reviewed 2,362 cases of consecutive vaginal and cervical smears submitted to the Department of Pathology, Pusan Gospel Hospital during one year period from Jan. 1, 1974 to Dec. 31, 1974. Prevalence of dysplasia, carcinoma in situ and invasive carcinoma of the uterine cervix was analyzed, and cost per a lesion was calculated. The followings are conclusions: 1. Prevalence of dysplasia, carcinoma in situ and invasive carcinoma was 2.88%, 0.34% and 2.58% restectively. 2. Cost per a lesion for dysplasia was calculated as 34,735 Won, for carcinoma in situ, as 295,250 Won and for invasive carcinoma as 38,721 Won. Cost per a lesion for dysplasia and carcinoma in situ was calculated as 31,079 Won and for dysplasia and for all the lesions as 17,248 Won. 3. The results obtained suggested that mass cytologic screeiding for detection of dysplasia, carcinoma in situ and invasive carcinoma was reasonable in the present status of economy.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.178-184
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• 2004

This research focuses on the overall evaluation of tumor protein (p53) and cell growth marker (Ki-67) in their functions as carcinogenic factors in both a HPV-infected group and in a HPV-noninfected group with the precancerous dysplasia of uterine cervix. Histological grades were determined by the H&E staining and the expression level of p53 and Ki-67 were tested by the immunohistochemistry method. The results were as follows. Among the total of 66 cases, p53 (+) was observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values correlate with the increase of dysplasia intensity in HPV-noninfected group and showed significant correlation (p<0.05), but there were no significant difference from the HPV-infected group. Among a total of 66 cases, the mitotic index of Ki-67 (+) were observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values were significantly different against dysplasia intensity (p<0.05), but showed no significant difference from HPV infection. After cross comparing the statistical parameters of p53 and ki-67 in their significance, p53 was shown to be statistically significant with Ki-67 while there was no statistically significant difference with Ki-67 (p<0.05). Taken together, tumor protein (p53) and an index of Ki-67 observed in cervical dysplasia and in HPV related dysplasia of cervix uterine did not have any notable significance with HPV infection. The incidence rate of p53, however, had some significant correlation with dysplasia while Ki-67 had no particular statistical significance. As a result, p53 and Ki-67 can be considered as effective diagnostic markers in predicting the disease progression of dysplasia to cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6039-6045
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• 2012

This study was conducted to assess the predictive value of p-glycoprotein (p-gp) and p53 immunoexpression in human papillomavirus (HPV) infected cases of cervical dysplasia. Expression of both p-gp and p53 proteins was detected in cervical smears from 177 squamous intraepithelial lesions (SIL) cases along with 183 "atypical squamous cells of unknown significance" (ASCUS) and 150 normal cases. HPV 16 and 18 infection was detected by polymerase chain reaction using type-specific primers for HPV sub-types. There were no significant detectable p53 and p-gp expression in the normal cervix smears (p>0.05). In the ASCUS group 10 cases were positive for both p53 and p-gp immunoreactivity. In cervical dysplasia cases, p53 was positive in 86 (48.58%) while p-gp was positive in 93 (52.54%) and the two markers showed a highly significant correlation (r=0.92, p<0.001). Expression of p53 and p-gp was associated with grade of SIL (p<0.001). A positive correlation between the presence of HPV and expression of proteins p53 and p-gp in smears of patients with cervical lesions was also noted (p<0.001). Thus, p53 and p-gp immunostaining in cervical smears may act as an auxiliary biomarker for detection of HPV-associated cervical lesions. Additionally, a significant positive correlation between ascending grades of SIL and labeling indices of markers suggests that p53 and p-gp can be used as an adjunct to cytomorphological interpretation of conventional cervical Pap smears.

• The Korean Journal of Cytopathology
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• v.12 no.1
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• pp.31-37
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• 2001

Whlie cytologic characteristics of squamous dysplasia, carcinoma in situ, and invasive squamous cell carcinoma of the uterine cervix are well documented, relatively few studios have dealt with the cellular features of microinvasive carcinoma. In order to describe the cellular characteristics of microinvasive squamous cell carcinoma, we retrospectively reviewed 45 cervovaginal smears(15 carcinoma in situ, 15 microinvasive cancer, 15 invasive cancer) which were confirmed by histologic examination of specimens obtained by hysterectomy at the Seoul National University Hospital during S years from 1995 to 1999. The cytologic features about tumor diathesis, inflammatory background, ceil arrangement, anisonucleosis, nuclear membrane irregularity, nuclear chromatin pattern, and nucleoli were observed. The cytologlc characteristics of microinvasive squamous cell carcinoma of the uterine cervix are syncytial pattern, mild tumor diathesis, the irregularity of nuclear membrane, irregularly distributed nuclear chromatin, and occurrence of micronucleoli. But, correlation between the depth of Invasion and the cytologic feature had limited value.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.23 no.2
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• pp.166-176
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• 2016

Purpose: The purpose of this study was to investigate the knowledge and prevention attitudes of female North Korean refugees regarding cervical cancer and human papillomavirus(HPV) infection. Methods: A descriptive study was conducted. Data were collected from November 2015 to March 2016 and 130 female North Korean refugees participated. Data were analyzed using SPSS 21.0. Results: Score on knowledge and prevention attitudes regarding cervical cancer and HPV were 2.53 out of 8 points, 1.67 out of 17 points, and 28.90 out of 36 points. There were significant differences between entry duration, the number of children, previous cervical cancer tests, Precognition about HPV, preferred education method, and knowledge of cervical cancer. There were significant differences between previous cervical cancer tests, Precognition about HPV and knowledge of HPV. The correlation between knowledge and prevention attitudes regarding cervical cancer and HPV was significant positive. Conclusion: Female North Korean refugees' knowledge level of cervical cancer and HPV is very low. However, their attitudes towards prevention was higher. These results imply a need for education, aimed at guiding North Korean female refugees, so as to enhance their knowledge regarding cervical cancer and HPV, and to promote their sexual health.

• 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.

• 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.

• 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.

• Biomedical Science Letters
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• v.4 no.2
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• pp.143-151
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• 1998

To study the incidence and epidemiological factors of uterine cervical cancer in medical underserved area females, the questionnaire survey and Pap. smear for uterine cervical cancer was done on total 330 women who lived in Ullungdo from 5th to 12th August, 1998. The results were summarized as follows： The age distribution of subjects was 50s (24.5%), 60s (24.5%) and their educational level was “no schooling” (14.2%) and “elementary school” (42.7%). The first coital age of subjects was 19∼21yrs (30.0%), 16∼18yrs (13.9%) and the first pregnancy age was 22∼24yrs (36.7%) and 19∼21yrs (30.0%). The frequency of total pregnancy of subjects was over 5 times (52.1%). The frequency of total delivery was “3∼4 times” (35.5％) and “5∼6 times” (15.2％). 68.8% of subjects had experience of abortion and 80.0% of their husband were on the phimosis. 172 (52.1%) subjects had gynecological symptoms, their symptoms were leukorrhea (48.3%), pruritus (21.5%) and leukorrhea with pruritus (20.3%). 63.9% of total subjects have been received Pap. smear and the frequency of their Pap. smear was “only 1 time” (44.1 ％), “irregularly” (30.3%) and the reason of respondents who have not been received Pap. smea. was “no specific symptom” (51.3%). Among the 330 women screened there were negative (45.8%), inflammation (47.3%), trichomoniasis and candidiasis (1.8%), atypical cells (4.5%) and dysplasia (0.6%).

• 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.