Identification of Target Genes in the Endometrial Carcinomas with Microsatellite Mutator Phenotype / 대한산부인과학회지

OBJECTIVE: Recent molecular genetic studies have revealed that two major types of genomic instabilities, chromosomal instability and microsatellite instability (MSI), exist in the endometrial carcinomas. Tumors with microsatellite mutator phenotype (MMP) are caused by defects in DNA mismatch repair genes. MMP tumors are believed to progress by accumulating frameshift mutations in coding microsatellite sequences of various cancer related genes including tumor suppressor genes, apoptosis related genes and DNA repair genes. Thus, the identification of the specific target genes in the MMP endometrial carcinomas is important for the elucidation of molecular pathogenesis of endometrial carcinomas. METHODS: We classified the MMP endometrial carcinomas and evaluated the frameshift mutations of the 11 genes containing coding microsatellite sequences by using 34 endometrial carcinomas and 4 MMP endometrial carcinoma cell lines. RESULTS: MSI was found in 6 of 34 endometrial carcinomas. In the endometrial carcinoma tissues, frequent mutations were found in TAF1B (68%), HT001 (50%), SLC23A1 (50%) and ACVR II (50%) in the MMP endometrial carcinoma tissues. The other 7 genes were infrequently mutated. Mutations of these target genes were more frequent in MMP endometrial carcinoma cell lines. CONCLUSION: we identified specific target genes in MMP endometrial carcinomas. These data demonstrate the mechanism of tumor progression in the MMP endometrial carcinomas.

Colposcopy Directed Cone Biopsy and Endocervical Curettage as Management of Carcinoma in Situ of the Uterine Cervix / 대한산부인과학회잡지

OBJECTIVE: The goal of this study was to evaluate the prognostic factors in relation with residual cervical intraepithelial neoplasia (CIN) in hysterectomized specimen of the patients diagnosed as carcinoma in situ of the uterine cervix (CIS) and underwent cone knife biopsies first. Also we investigated if colposcopically directed wide cone knife biopsy with endocervical curettage followed by electrocauterization could substitute for traditional hysterectomy as a conservative management of CIS. METHODS: Data were collected retrospectively from 169 patients who were diagnosed as CIS after colposcopy directed conization in Yonsei University Hospital from Jan 1997 to Dec 2001. The patients were divided into two groups, those who underwent colposcopically directed cone biopsy only (Group A) and those who received colposcopically directed cone biopsy and extrafascial abdominal hysterectomy (Group B). Pap smear, pelvic examination and punch biopsy of the uterine cervix according to symptoms and physical findings of the patients were performed for follow-up. Patient characteristics, histologic results and follow-up outcomes were compared using student t-test, x2 test, and logistic regression analysis. RESULTS: Among 169 patients, 82 (study group) received no further treatment while 87 (control group) were hysterectomized. 58 of control group showed residual CIN in colposcopically directed cone biopsy and 12 from these patients, residual CIN were found in hysterectomized specimen. Positive endocervical margin on conization was found as a significant predictor for residual disease after conization. Abnormal Pap smear results were reported in 10 patients of study group only, of whom 2 cases of CIN I, 8 cases cervicitis. CONCLUSION: The residual CIN in endocervical margin can predict whether hysterectomized specimen might contain residual CIN and no difference in life threatening prognosis existed between the patients received colposcopically directed cone biopsy only and hysteretomy, regardless of the residual CIN in cone biopsy margin. Based on these results, it is reasonable to choose expectant management over hysterectomy for treating CIS patients with marginal involvement.

A Case of Metastasis to Lung of Benign Metastasizing Leiomyoma / 대한산부인과학회잡지

Leiomyoma of the uterus is the most common benign uterine tumor affecting 40-50% of women older than 40 years of age. The pathogenesis of uterine leiomyoma is unknown, but several studies have suggested that each leiomyoma arises from a single neoplastic cell within the smooth muscle of the myometrium. Uterine leiomyoma can be extended outside the uterus growing into the pelvic veins, and in exceptional cases, even into the lung. Even if this was first reported more than 90 years ago, the pathogenesis and treatment of benign metastasizing leiomyoma was not still established. We experienced a case of benign metastasizing leiomyoma and report with a brief review of literature.

Adjuvant therapy in invasive cervical cancer patients with histopathologic high risk factors following pretreatment laparotomy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy of postoperative adjuvant therapy was evaluated in preventing treatment failure occurring after primary treatment with surgery in early invasive cervical cancer patients associated with histopathologic high risk factors such as lymph node metastasis, either macroscopic or microscopic, parametrial extension, lymphovascular permeation and depth of invasion >or=10 mm. METHODS: Postoperative adjuvant concurrent chemoradiotherapy (PCCRT), postoperative adjuvant chemotherapy (PCT) or postoperative adjuvant radiotherapy (PRT) alone was administered to the 80 early invasive cervical cancers with at least one of the high risk factors. Each of 61 patients was received three to six cycles of chemotherapy at about 3-weeks intervals. For squamous cell carcinoma, cisplatin 100 mg/m2 IV, or paraplatin 350 mg/m2 IV was infused followed by 5-FU 1000 mg/m2 IV infusion for 5 days. Twenty three patients were treated with PCCRT, 38 patients were treated with PCT alone. And 19 patients received PRT. RESULTS: The five-year survival rate of patients with macroscopic metastasis was 66.7% and 35.7%, in PCCRT and PRT, respectively. With microscopic lymph node metastasis, the 5-year survival rate was 83.3%, 60.0%, and 70.1% in PCCRT, PCT and PRT, respectively. With parametrial extension, the 5-year survival rate was 58.1% in PCCRT. The five-year survival rate of patients with lymphovascular permeation was 100%, 90.9% and 66.7% in PCCRT, PCT and PRT, respectively. With depth of invasion >or=10 mm, the 5-year survival rate was 100% and 91.3%, in PCCRT and PCT, respectively. CONCLUSION: PCCRT appears to be superior to PRT or PCT alone in early invasive cervical cancer patients with histopathologic high risk factors.

Results of Definitive Radiation Therapy in Adenosquamous Cell Carcinoma of the Uterine Cervix / 대한암학회지

PURPOSE: To define the clinical features and pattern of failure and to evaluate the results of radiation treatment in of adenosquamous cell carcinoma of the uterine cervix. MATERIALS AND METHODS: From Jun. 1981 to Dec. 1997, 43 patients with adenosquamous cell carcinoma of the uterine cervix were retrospectively analyzed external radiation treatment and HDR-ICR from Yonsei cancer center and Wonju cristian hospital. The median age was 51. Stage distribution according to FIGO were stage 1b in 10, 2a in 5, 2b in 18, 3b in 9, 4a in 1. Median follow-up period was 41 months. RESULTS: Overall survival rate and disease free survival rate were 57.2% and 60.2%. Complete response rate was 86.0%. Locoregional failure was observed in seven patients. CONCLUSION: Major pattern of failure was locoregional failure. Adenosquamous cell carcinoma was not more aggressive than other pathologic types.

Concurrent chemotherapy and radiotherapy in invasive cervical cancer patients with high risk factors

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.

Concurrent chemotherapy and radiotherapy in invasive cervical cancer patients with high risk factors

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.

Analysis of Tumor Angiogenesis in Invasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: Tumor angiogenesis is believed to conelate with tumor growth, progression and metastasis. Studies of angiogenesis in breast, prostate and melanoma have shown that angiogenesis, the induction of new capillaries and venules, is associated with tumor metastases and recurrences. The purpose of this study was to investigate the angiogenesis as a prognostic factor in invasive cervical cancer. METHODS: Forty-three formalin fixed embedded blocks of invasive cervical cancers were examined using immunohistochemical staining with a monoclonal antibody against factor VIII-related antigen. RESULTS: The miaovessel counts were 53.50+/-20,07 in patients with lymph node metastasis, and 45.97+/-28.12 in those without such metastasis. There was a trend for the microvessel count to increase with lymph node metastasis. However, thae was no significant difference in microvessel counts regarding node status. There was no significant difference between microvessel counts in patients with stage I(47.90+/-25.89) and those with stage Il(45.50+/-29.27), The microvessel counts in squamous cell carcinoma(46.54+/-27.79) were not significantly different from those in adenocarcinoma(47,50+/-27.05), The microvessel count in patients with tumor size >-4 cm(53.00+/-21.17) was not significantly higher than in those with tumar size <4 cm(46.20+/-27.94). CONCLUSION: There was no significant correlation between microvessel counts and clinical stage of disease, pathological type, tumor size or lymph node metastasis in patients with invasive cervical cancer. There was a trend for the microvessel count to increase with lymph node etastasis.

Two Cases of Surgical Intervention in Persistent Localized Choriocarcinoma / 대한산부인과학회잡지

Gestational trophoblastic tumors including choriocarcinoma bave become one of the most curable human malignancies with an overall cure rate exceeding 90%. Although systemic chemotherapy is the initial treatment for chorio- carcinoma, some patients with chemotherapy-resistant choriocarcinorna can be treated by integration of cbemotherapy, surgery and radio- therapy. We report two cases of persistent localized choriocarcinoma which was treated by surgical intervention.

Adjuvant therapy in cervical cancer patients with high risk factors

Neoadjuvant and adjuvant chemotherapies are used adjunctively with surgery or radiation and are among the treatment options that are now employed for reducing treatment failure in early-stage cervical cancers with high-risk prognostic factors. Adjuvant therapies have been reported to significantly improve survival than would otherwise be possible with surgery or radiotherapy alone. However, for advanced cervical cancers, sequential or concurrent chemo-radiotherapy does not appear to significantly increase survival. The combination of radiotherapy with IFN-a2a and RA in the treatment of patients with locally advanced cervical cancer showed high response rates, however this should be confirmed in larger studies. Recent reports show that postoperative adjuvant radiotherapy has no benefit in survival, but that postoperative adjuvant chemotherapy has improved survival. Toxicities and the optimum number of cycles of neoadjuvant and adjuvant chemotherapy, as well as biologic therapy, will follow along with individualized treatment based on high-risk prognostic factors. Although more comprehensive studies and longer follow up will be required for complete evaluation of these adjuvant therapies, preliminary results are promising.

Analysis of p53 Protein Overexpression in Invasive Cervical Cancer / 대한산부인과학회잡지

The p53 gene is a tumor suppressor gene and mutations in this gene play an import-ant role in the development of many human malignancies. The purpose of this study was to investigate the overexpression of p53 protein as a prognostic factor in invasive cervical cancer. Forty-three formalin fixed, paraffin wax embedded blocks of invasive cervical can-cers were examined using immunohistochemical staining with a monoclonal antibody against p53. The result were as follows : 1. Immunostaining for p53 consistent with overexpression was seen in 23.8%(5 of 21) of stage I cancers and in 13.7%(4 of 22) of stage II cancers. 2. Immunostaining for p53 consistent with overexpression was seen in 21.6%(8 of 37) of squamous cell carciomas and in 0%(0 of 6) of adenocarcinomas. 3. The incidence of p53 overexpression was 25.0%(1 of 4) in cases with lymph node metastasis, compared with 17.9%(7 of 39) in cases without lymph node metastasis. 4.. The incidence of p53 overexpression was 20.0%(8 of 40) in cases with less than 4 cm, compared with 0%(0 of 3) in cases with equal to or larger than 4cm. In conclusion, p53 overexpression was not associated with stage, histologic type, and tumor size. However, there were trend for p53 overexpression to increase in patients with lymph node metastasis.

Cervical Cytology: A Randomized Comparison of False-Negative Rate in Three Sampling Methods / 대한산부인과학회잡지

No abstract available.

Analysis of risk factors for postmolar trophoblastic disease: categorization of risk factors and effect of prophylactic chemotherapy

Early identification of high risk molar pregnancy is important in preventing the development of subsequent postmolar trophoblastic disease (PMTD). In the present study, evaluation of risk factors of developing PMTD, and indications for initiating prophylactic chemotherapy, and investigation of the effects of prophylactic chemotherapy were undertaken. One hundred and forty complete molar pregnancies treated at Yonsei University College of Medicine were retrospectively analyzed. Thirty-six cases of PMTD developed in these molar pregnancies during follow-up. Risk factors for PMTD were ranked according to frequency with which they were associated with PMTD. The patients with no risk factors were classified in the low-risk group, with one or two in the medium-risk group, and with three or more in the high-risk group. Prophylactic chemotherapy was administered to 14 of 52 low-risk, to 21 of 46 medium-risk, and to 17 of 42 high-risk patients. Among the high-risk patients, the time required for remission was significantly shorter in the group with prophylactic chemotherapy (13.5 weeks) than in the group without prophylactic chemotherapy (22.4 weeks). There were no differences in the duration until remission among the low- and medium-risk patients. Of the 52 patients who received prophylactic chemotherapy, 8 (15.4%) developed PMTD. Among the high-risk patients the occurrence of PMTD was significantly lower in the prophylactic chemotherapy group. Among the low-risk and medium-risk patients, there were no differences in the occurrence of PMTD between the chemoprophylaxis treated and untreated groups. Our results strongly support the use of prophylactic chemotherapy for patients that were designed under our high risk criteria. Prophylactic chemotherapy helps to prevent or reduce the risk of developing PMTD, and shorten the time required for complete remission in high-risk patients.

The effects of wild type p53 tumor suppressor gene expression on the normal human cervical epithelial cells or human epidermal keratinocytes transformed with human papillomavirus type 16 DNA

The inactivation of p53 and p105RB by viral proteins or by mutations plays a key role in the oncogenesis of cervical carcinoma. The E6 and E7 proteins of HPV type 16 can bind to p53 and p105RB tumor suppressor gene products, respectively. In the present study, we tested a simple in vivo model that could explain the interactions between HPV E6 oncoprotein and p53 tumor suppressor protein. Our results showed that the life span of normal cervical epithelial cells was increased up to 4.5 times when transfected with expression vector containing E6/E7 ORF of HPV type 16. However, these cells did not divide after second crisis. Therefore, we employed an established human epidermal keratinocytes, RHEK-1. When transfected with an expression vector containing E6 ORF of HPV type 16, RHEK-1 cells showed anchorage independent growth character. When RHEK-E6 cells were transfected with wild type p53 expression vector, the growth rate of the RHEK-E6 cells was diminished. After 48 hours of transfection, many cells showed apoptotic signal but no more apoptotic signal was observed thereafter. These results suggested that the overexpression of the wild type p53 could overcome the dysfunction of the p53 on the cell cycle regulation imposed by E6 protein although not being of physiological condition.

1991 cancer incidence in Seoul, Korea: results of the Implementation Study of the Seoul Cancer Registry

This article presents the results of the Implementation Study of the Seoul Cancer Registry, which started in July, 1991 as a population based cancer registry in Seoul, Korea. The completeness and validity of the registered data were evaluated using Mortality/Incidence ratio (M/I ratio), Histologically Verified Cases (HV%), Primary Site Uncertain (PSU%), and Age Unknown (Age UNK%). Owing to the additional active surveillance, the completeness of the data turned out to be fairly acceptable, except for the aged over 75(Mortality/Incidence ratio was over 100%). Eventhough the Seoul cancer registry(SCR) has further way to go in the completeness especially among elderly persons, the validity of SCR data was also acceptable in terms of HV%, PSU%, and Age UNK%. However, PSU% and Age UNK% might need to be further reduced to be comparable with other well established cancer registries. The age standardized incidence rates(ASR) of all cancers between July 1, 1991 and June 30, 1992 were 232.4/100,000 in males and 147.9/100,000 in females. The top five major sites of cancers in Seoul were the stomach, liver, lung, colo-rectum, and bladder in order in males, and the uterine cervix, stomach, breast, colo-rectum, and liver in females. Those 5 cancer sites comprised 68.9% and 64.7% of the total cancer incidence in males and females, respectively.

Interferon-alpha2a, 13-cis-retinoic Acid and Radiotherapy for Locally Advanced Squamous Carcinoma of the uterine Cervix: Preliminary Study / 대한부인종양콜포스코피학회잡지

Locally advanced cancer of the uterine cervix is a major cause of death worldwide. Standard treatment with rdiolherepy for locally advanced cancer of the uterine cnvix has a response rate of less than 50%. Resently concurrent chcmoradirothcrpay has been introduced but with some contvovesy. Interferon and retinoic acid are inducible proteins which posses many hiologic activities such as, antiproliferative, immunomodulatory and antineoplastic properties. Combination of interferon and retinoic acid has produced high response rates especially for patients with squamous cell carcinoma . And they may potentiate the radiation cytotoxicity as adiosensitizer. This study was underaken to assess the clinical efficacy of combination regimen with interferon-alpha2a, 13-cis-retinoic acid and radiotherapy from Dec. 1988 to Dex. 1994 at Severance hospital Yonsei uniersity. Twenty seven patients of locally advanced squamous cell carcionma of the uterine cervix enrolled in this study are evaluated for response and toxicity. The results were as follow: 1. Preliminary results of interferon-alpha2a 13-cis-retinoic acid and radiotherapy are 46.7% of response rate(33.3% complete response)and those of concurrent chemoradiotherapy are 41.7% of response rate(46.7% complete response). 2. Major toxicity of interferon-alpha2a, 13-cis-retinoic acid and radiotherapy is fever(60.0%), and only case of grade 2 anemia and one case of grade 1 AST/ALT elevation was noted. There was no grade 3 or 4 toxicity. Systemic interferon-alpha2a, 13-cis-retinoc acid and radiotherapy is highly active, well tolerated therapy for locally advanced cervical cancer.

Interferon-alpha2a, 13-cis-retinoic Acid and Radiotherapy for Locally Advanced Squamous Carcinoma of the uterine Cervix: Preliminary Study / 대한부인종양콜포스코피학회잡지

Locally advanced cancer of the uterine cervix is a major cause of death worldwide. Standard treatment with rdiolherepy for locally advanced cancer of the uterine cnvix has a response rate of less than 50%. Resently concurrent chcmoradirothcrpay has been introduced but with some contvovesy. Interferon and retinoic acid are inducible proteins which posses many hiologic activities such as, antiproliferative, immunomodulatory and antineoplastic properties. Combination of interferon and retinoic acid has produced high response rates especially for patients with squamous cell carcinoma . And they may potentiate the radiation cytotoxicity as adiosensitizer. This study was underaken to assess the clinical efficacy of combination regimen with interferon-alpha2a, 13-cis-retinoic acid and radiotherapy from Dec. 1988 to Dex. 1994 at Severance hospital Yonsei uniersity. Twenty seven patients of locally advanced squamous cell carcionma of the uterine cervix enrolled in this study are evaluated for response and toxicity. The results were as follow: 1. Preliminary results of interferon-alpha2a 13-cis-retinoic acid and radiotherapy are 46.7% of response rate(33.3% complete response)and those of concurrent chemoradiotherapy are 41.7% of response rate(46.7% complete response). 2. Major toxicity of interferon-alpha2a, 13-cis-retinoic acid and radiotherapy is fever(60.0%), and only case of grade 2 anemia and one case of grade 1 AST/ALT elevation was noted. There was no grade 3 or 4 toxicity. Systemic interferon-alpha2a, 13-cis-retinoc acid and radiotherapy is highly active, well tolerated therapy for locally advanced cervical cancer.

The utilization of Doppler ultrasonography with color flow mapping in the diagnosis and evaluation of malignant trophoblastic tumors

The Doppler ultrasound with color flow mapping image has been recently applied for the evaluation of gynecologic diseases, in particular, malignant trophoblastic tumors with the characteristic abundant blood flow. Doppler color flow mapping of uterine artery and intratumoral blood vessels was performed at a regular interval in all 26 patients including 3 cases of lost for follow up. Systolic/diastolic (S/D) ratio representing blood flow was measured in 19 cases of malignant trophoblastic tumors and 7 cases of hydatidiform mole diagnosed at the department of Obstetrics and Gynecology, Yonsei University, College of Medicine. The initial mean S/D ratio and standard deviation(SD) of uterine artery in 11 remitted and 5 non-remitted patients were 2.72 +/- 1.31 and 2.69 +/- 1.80, respectively. No significant difference was noted between two groups. However, the final S/D ratio of uterine artery in remitted group showed significantly higher values than non-remitted group, of which values were 6.23 +/- 2.38 and 3.08 +/- 1.54, respectively (p< 0.05). In aspect of blood flow changes in malignant trophoblastic tumors after chemotherapy, remitted group showed entirely disappeared blood flow, while non-remitted group had persistent blood flow. The mean S/D ratio and SD measured in hydatidiform mole patients were 5.43 +/- 1.65, of which value reflects higher resistance than malignant trophoblastic tumors. Also blood flow was not detected in all cases. This study suggests that color flow mapping Doppler ultrasound can be a useful method in diagnosing and monitoring the treatment in malignant trophoblastic tumors along with the conventional serum beta-hCG titration.

The Assessment of Proliferating Cell Nuclear Antigen (PCNA) in Cervical Tumors / 대한부인종양콜포스코피학회잡지

Proliferating cell nuclear ntigen (FCNA) iis a nuclear protein that is syntheaimd in late Gl and S phases of cell cycle and is correlated with the cell proliferative stale. The recent study demonstrated that FCNA functions in 13NA replication. The present study evaluated proliferetive iindices (PI) for the assessment of tumor proliferation and for investigating prognostic significancx, in cervical tumors. lmmunohiatoehemical PCNA staining was perfurmed in formalin-fixed paraffin-embedded cervical tissues via the avidin-biotin-complex immunoperoxidase methad. Mean PI was 36.03+/-5.14% in normaI controls, as compared to 66.19+/-11.36% in cerviml intraepithelial neoplasia. and 63.19+/-10.94% in invasive cervical cancer. Our results showed no significant correlation between Pll and histological type. Among invasive cervical cancer (24 cases), PI waa 64.43+/-10.94% in squamoua cell carcinoma and 59.00+/-4.10% in adenocarcinoma. There was no eipiifiant relationship between Fl and clinical etage, and between PI and lesion size. This study auggeste that Pl may not serve as a new prognostie factor in cervical tumors.

A Case of Invasive Cervical Carcinoma in Immunosuppressed Renal Allograft Recipient / 대한부인종양콜포스코피학회잡지

A case of 42-year-oldI kidney transplant patient who developed invasive carcinama of the cervix after immunoauppresawe therepy is reported and the literature related to this diease is revuewed. The iatmgenic immunosuppresaionn renal transplantation recipients has been associated with increased incidence of malignancy in these patients. In particular, immunosuppressed women are al greater risk of developing cervical intraepithelial neoplasia and buman papillomavirus type 16 or 18 infection. So, all such individuals are required to receive periodic gynecologic examination before renal transplantation and at regular intervals thereafter so that the development of CIN may be diagnosed at an early Stage and treated effestively.