Human papilloma virus prevalence and types among Iranian women attending regular gynecological visits

Introduction: Human papilloma virus prevalence data is scarce in Iran. This study was performed to evaluate type-specific human papilloma virus prevalence and to compare it with Pap smear results among Iranian women attending regular gynecological visits

Patients and methods: A total of 851 women aged 18-65 years, attending regular gynecological visits were retrospectively evaluated. Human papilloma virus detection and genotyping was performed using polymerase chain reaction technique. Cytological evaluation was performed by Papanicolaou method and the association between cytological results and human papilloma virus profile was analyzed

Results: Nineteen different types of human papilloma virus were detected in 265 of 851 patients [31.1%]. Overall infection as well as infection with high risk human papilloma virus types; were highest in women aged 18-25 years and decreased with age. Type-specific prevalence of human papilloma virus -16 and 18 was 7.3% and 2.8% respectively. There was also an upward trend in the prevalence of high risk human papilloma virus infection as the abnormality in cytology increased. The prevalence of human papilloma virus related events was 29.1% among virus positive patients and declined from low grade squamous intraepithelial lesion [18.2%] to high grade squamous intraepithelial lesion [3.9%]

Conclusion: Our study indicated that the burden of human papilloma virus infection among Iranian females was higher in comparison with previous estimates reported from Iran. Furthermore, higher prevalence of premalignant changes in Iranian women infected with high risk human papilloma virus types other than vaccine types should be considered in immunization programs and development of population-specific human papilloma virus vaccines

Sphincter preservation and pathologic response in rectal cancer undergoing neoadjuvant chemoradiation with and without oxaliplatin according to thymidilate synthase [TS] expression

Oxaliplatin [OX] significantly enhanced the antitumor activity of 5-FU in patients with advanced colorectal cancer and recently some phase II trials have evaluated the feasibility and efficacy of oxaliplatin in neoadjuvant setting for treatment of locally advanced rectal cancer. On the other hand various studies have demonstrated that the overexpression of thymidylate synthase [TS] can induce resistance to 5-FU in colorectal carcinoma. The aim of this study was to assess the value of TS expression as a predictive factor in the efficacy of neoadjuvant chemoradiation with and without oxaliplatin in rectal cancer. This study was performed in 61 patients [that ultimately 50 patients had including criteria] with locally advanced rectal adenocarcinoma that inferior margin of the tumor had to be located no farther than 6 cm from the anal verge. Preoperative radiotherapy was delivered to the pelvis with CO 60 to 50/4 Gy. All patients received simultaneous chemotherapy: 5-fluorouracil [5-FU], 300 mg/square meter i.v. 24 h infusion during radiotherapy on days 1-5 every week. Thirty patients received oxaliplatin 50-60 mg /square meter weekly during radiotherapy.TS expression was assessed by immunohistochemical staining technique in pretreatment specimen, and the patients were categorized into TS [+] and TS [-] groups. A total of 23 of 50 tumors showed TS positive status at biopsy [46%] . Overall 36 patients [72%] achieved pathologic response [40% complete and 32% partial] that was significantly better in the TS [-] group than in the TS [+] group [85.1 vs 56.5%, p=0.024] and in the OX [+] group than in the OX [-] group [86.6 vs 50%, p=0.005]. Among TS [-] patients there was no difference in pathologic response [88.2 vs 80%, p=0.561] or sphincter preservation [76.4 vs 80%, p= 0.831] as a result of whether oxaliplatin therapy was carried out or not. But among the TS [+] patients there was a significant gain in pathologic response [84.6 vs 20 %, p=0.002] and sphincter preservation [84.6 vs 40 %, p= 0.026] in favor of oxaliplatin group. Our study indicate that oxaliplatin can improves poor outcome of TS positive rectal cancer and TS expression may be used for selecting patients for oxaliplatin containing neoadjuvant chemoradiation protocols that can have major role in the tumor down staging and preservation of sphincter and ultimately better quality of life

Simultaneous occurrence of ovarian and bladder carcinoma of transitional cell type; a rare case report

Ovarian carcinoma of transitional cell type are rare, however, their simultaneous occurrence with bladder carcinoma of the same type is even a rarer condition. To our knowledge, 3 cases of this uncommon event have been reported in the literature.We present an 87-year-old female who had a previous history of bladder carcinoma of transitional type twelve years ago. She had ovarian carcinoma of the same type. She had undergone TUR several times; optimal cystoreductive surgery was performed for ovarian carcinoma. Chemotherapy was given following surgery and in a 6-month follow up there were no signs of a residual tumor