Effect of LEEP knife combined with biopsy in patients with small invasive cervical cancer / 中国内镜杂志

Objective To explore the effect of the application of cervical loop electric knife (LEEP) in the patients with cervical micro invasive cancer.Methods Clinical data of 66 patients with minimal invasive carcinoma diagnosed by LEEP cone resection in our hospital from June 2013 to June were retrospectively analyzed. Preoperative and postoperative patients with LEEP were compared with 66 patients who underwent biopsy with biopsy, the diagnosis of micro invasive carcinoma was compared with LEEP cone resection.Results The results of colposcopy biopsy were detected in 2 cases of LSIL, 60 cases of HSIL and 1 cases of AIS, 3 cases were diagnosed as cervical microinvasive carcinoma or suspicious cervical microinvasive carcinoma, the sensitivity was 4.54%, the misdiagnosis rate was 95.46%; LEEP conization were detected in 1 cases of LSIL, 44 cases of HSIL and 1 cases of AIS, 20 cases negative margin. There was no significant difference in the thickness and area of the resected tissue between the three groups (P > 0.05). The depth of the resected tissue was significantly higher than that in the HSIL and AIS group, the HSIL and AIS groups were significantly higher than the LSIL group, the difference was statistically significant (P 0.05). Cut edge positive group, positive margin group and interstitial fiber positive margin group of patients with postoperative residual disease rates were 25.00%, 15.38% and 23.80%, the difference was not statistically significant (P > 0.05).Conclusion The rate of missed diagnosis of small invasive cervical cancer is higher, and the diagnosis rate can be improved by the combination of LEEP and cone resection.

Clinical efficacy of photodynamic therapy

OBJECTIVE: The management of cervical intraepithelial neoplasia (CIN) and early invasive cancer of the uterine cervix is very difficult to approach, especially in case of young woman who wants to preserve her fertility. Conization of the cervix may have various kinds of disadvantage. The objective of this clinical retrospective study is to investigate the therapeutic effects and clinical efficacy of photodynamic therapy (PDT) including combined chemo-photodynamic therapy in patients with pre-malignant CIN and malignant invasive cervical cancer. METHODS: Total number of PDT trial case was 50 cases and total number of patient was 22 patients who registered to PDT clinic. We used photogem sensitizer and 632 nm diode laser in early two cases. After then we performed PDT using photofrin sensitizer and 630 nm diode laser in other cases. We used flat-cut, microlens, cylindrical diffuser, and interstitial type optic fibers in order to irradiate the lesions. 240 J/cm² energy was irradiated to the lesions. RESULTS: CIN 2 were 4 cases (18.2%) and CIN 3 were 15 (68.2%) and invasive cervical cancer were 3 (13.6%). Complete remission (CR) was found in 20 patients (91%). One case of 19 patients with CIN lesion recurred at 18 months after PDT treatment. CR was found in 18 cases in the patients with CIN lesions (95%). CR was found in 2 cases in the patients with invasive cervical cancer (67%). CONCLUSION: Our data showed that CR rate was fantastic in CIN group (95%). This study suggests that PDT can be recommended as new optimistic management modality on the patients with pre-malignant CIN lesions including carcinoma in situ and relatively early invasive cancer of the uterine cervix. Combined chemo-photodynamic therapy is essential in case of invasive cervical cancer. For the young age group who desperately want to preserve their fertility and have a healthy baby, PDT can be a beacon of hope.

Impact of human papillomavirus multi-infections on the risk of high-grade squamous intraepithelial lesion and invasive cervical cancer / 实用医学杂志

Objective To determine the incidence rate of HPV infection or multi-infections at different stages of cervical lesions in the development of cervical cancer , and the impact of specific types of HPV multi-infections on the risk of cervical cancer. Methods 103 samples of cervical tissues were detected and then divid-ed into ICC/HSIL group and LSIL/NILMF group according to the degree of pathological changes. HPV type was determined by PCR product sequencing. E6 nested multiplex PCR was performed to detect HPV multi-infections. Odds ratios were calculated to determinate the association between the sample category (LSIL/NILM or ICC/HSIL) and the specific types of HPV multi-infections. Results In HPV-positive samples, the rate of multi-in-fections had no significant differences between the two groups. Coinfection of HPV68 with HPV16 increased the risk of ICC/HSIL, as compared with HPV16 or HPV68 infection alone. Conclusions High-risk HPV coinfec-tions has a higher risk to induce ICC/HSIL than does HPV infection alone.

HPV Positivity and its’ Influencing Factors among Invasive Cervical Cancer Women in Malaysia

Cervical cancer (CC) is the second most prevalent female cancer in Malaysia. Almost 70% of its’ causal factors are attributable to oncogenic human papillomavirus (HPV) types 16, 18 and other risk factors. HPV genotypes distributions are also noted to differ by geographical area. This was cross sectional study conducted in 2007, to determine the influencing factors of HPV positivity and prevalence of HPV infections among patients with cervical cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Patients’ paraffin-embedded cervical tissues kept in the Pathology Department from 1999 to 2007 were randomly selected. A total of 81 medical records with complete information were chosen as samples and patients were contacted for consent. Tissue samples were further derived for PCR DNA for HPV genotyping. Analyses included descriptive statistics; bivariate χ2 test and correlation were used to determine relationship between factors and HPV positivity. Significance level of less than 0.05 was taken as statistically significant. Mean age of cancer diagnosis was at 52 ± 12.2 years. Women of Chinese ethnicity was the highest ethnicity to be HPV positive at 65.4% and squamous cell carcinoma was more commonly found (59.3%) compared with other types of cancers. The prevalence of HPV positivity was 92.6% with type 16 being the most common (74.1%), followed by type 33 (30.9%) and 18 (22.2%). Multiple HPV infections were a common finding at 54.3%. Factors thought to influence positivity i.e. age of intercourse, number of sexual partners, number of parity, smoking status of patients and their partners, oral contraceptive usage, presence of chronic illnesses and cancer stage were not significantly associated with HPV positivity. Increased CC severity level was not associated with increased number of HPV infections (Pearson correlation 0.58; p =0.607). High HPV positivity at 92.6% was found among ICC patients. Factors thought to influence HPV positivity were not significant. The top three HPV genotypes were type 16 followed by type 33 and 18. However, local women HPV serotypes findings need to be replicated in a larger population sample.

Clinical Evaluation and Treatment of Unexpected Invasive Cervical Cancer Found at Simple Hysterectomy / 대한산부인과학회지

OBJECTIVE: The objective of this study was to analyze the clinical aspects, the problems in diagnstic process, proper complimentary treatment of invasive cervical cancer found after simple hysterectomy. METHODS: From February 1990 till December 2003, of the 2013 patients who underwent simple hysterectomy at Departments of Obstetrics and Gynecology, College of Medicine, Kyung Hee University, 4 cases who were able to be followed up with the pathological diagnosis of invasive cervical cancer, were picked. One patient transferred to KHMC of a recurrence at the vaginal stump after vaginal hysterectomy performed at a nearby clinic was chosen. The archives of the 5 patients were analyzed. RESULTS: Of the 5 cases, 2 were treated with whole-pelvis external radiation for 6 weeks. The follow-up periods after radiotherapy were after 5 months and 48 months, and they are both disease-free and are in satisfactory health conditions. The patients who underwent simple hysterectomy and received re-operations, one case after one month, and the other after 2 months in case 2 and 3, showed negative results in the biopsy and the follow-up periods after the operation were 12 months and 42 months, maintaining healthy conditions. The patient in case 5 who received pelvic exenteration after additional staging operations and 7 cycles of chemotherapy done after whole-pelvis external radiation/intracavitary radiotherapy for 6 weeks after simple hysterectomy, showed negative biopsy results and is currently being followed up at the outpatient clinic. CONCLUSION: To prevent for invasive cervical cancer diagnosed pathologically after simple hysterectomy, a variety of complimentary tests should be performed and thorough step-by-step pre-operative exams should be emphasized as in the well-established diagnostic guidelines. Invasive lesions as more than post-operative stage Ia2 found after simple hysterectomy need much more aggressive supportive treatment. But between pelvic irradiation and secondary radical re-operation, which treatment is advisable is not yet concluded. Therefore, the treatment should be chosen case-by-case according to the patient's condition.

The Pattern of Fhit and p53 Expression in Cervical Intraepithelial Neoplasm and Invasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: To evaluate Fragile histidine triad (Fhit) and p53 expression pattern in cervical intraepithelial neoplasm (CIN) and invasive cervical cancer, and to verify the correlation between the loss of Fhit and clinicopathological parameters of invasive cervical carcinoma and the relationship between Fhit and p53 expression. METHODS: 10 low-grade squamous intraepithelial lesions (LSIL), 16 high-grade squamous intraepithelial lesions (HSIL), and 21 invasive cervical carcinomas were evaluated by immunohistochemical staining for Fhit and p53 primary antibody. Their expression patterns in CIN and invasive cervical cancer were analysed semiquantitatively as positive and negative by the staining area and intensity. Clinicopathological data were obtained by review of patients' hospital records. RESULTS: Compared with CIN (LSIL and HSIL), invasive cervical carcinoma showed significantly loss of Fhit expression (p<0.05). P53 expression did not show the significant difference between CIN and invasive cervical cancer. There was no relationship between loss of Fhit and p53 expression in CIN and invasive cervical cancer. But loss of Fhit expression in invasive cervical cancer was also significantly associated with FIGO stage (p<0.05). CONCLUSION: Our results suggest that loss of Fhit expression may play an important role in the malignant transformation of CIN to invasive cancer. However, further molecular studies are needed to elucidate the role of Fhit gene in the carcinogenesis of cervical cancer.

Vascular Endothelial Growth Factor and Angiopoietin-1 and -2 mRNA Expressions in Invasive Cervical Carcinoma / 대한산부인과학회잡지

OBJECTIVE: This study was aimed to investigate the vascular endothelial growth factor (VEGF) mRNA and angiopoietin (Ang) -1 and -2 mRNA expressions between cervical cancer and normal cervix, and to assess the relationships among their expression and other prognostic factors of invasive cervical cancer. METHODS: The tissues were obtained from 34 patients with cervical cancer and 14 patients with normal cervix undergoing hysterectomy. Total RNA was extracted and reverse transcribed into cDNA. RT-PCR and QC-PCR was performed to evaluate VEGF and Ang-1 and -2 mRNA expressions. Clinicopathologic factors of cervical cancer were reviewed with the patient's charts and results were analyzed with Mann-Whitney U test, Spearman correlation test and logistic regression analysis. RESULTS: VEGF, Ang-1 and -2 mRNA expression in cervical cancer was higher than that in normal cervix (p<0.05) and there were significant correlations between Ang-2 mRNA expression and VEGF mRNA expression in all stage of cervical cancer (p<0.05). A definite correlation was found between VEGF mRNA expression and clinical stage, SCC-Ag levels, lymph node metastasis of cervical cancer (p<0.05). Also, There was significant correlation among Ang-2 mRNA expression and clinical stage, tumor sizes, SCC-Ag levels, lymph node metastasis of cervical cancer (p<0.05). Ang-1 mRNA expression was significantly correlated with clinical stage of cervical cancer (p<0.05). CONCLUSION: The expression of VEGF mRNA, Ang-1 and -2 mRNA could be associated with the progression and metastasis of cervical cancer and might have a role as prognostic parameters in cervical cancer.

The alteration of p16 protein in invasive cervical cancer / 대한산부인과학회잡지

OBJECTIVE: Recently p16 gene has been found as a new factor for cervical carcinogenesis. The purpose of this study is to investigate the p16 protein alteration in invasive cervical cancers, and to find the correlation with the p53 protein overexpression, HPV infection and the clinicopathologic prognostic parameters, as well as to predict the prognosis by examining the influences of the p16 gene, p53 gene, HPV to the survival rate. MATERIAL & METHODS: We examined 29 invasive cervical cancer patients who visited and operated in Obstetrics & Gynecology department of Kosin University Gospel Hospital from Jan. 1994 to Dec. 1995. We investigated clinicopathologic parameters and p16 protein alteration, p53 protein overexpression, HPV 16, 18 infection in these patients. p16 protein and p53 protein were examined by immunohistochemistry method and HPV was done by PCR method. The survival rate was examined by Kaplan-Meier method. RESULTS: The rate of p16 protein alteration, p53 protein overexpression, HPV infection were respectively 31% (9/29), 72.4% (21/29), 80.6% (26/29), and all of these factors had no statistical correlations with the clinicopathologic parameters (p>0.05).Among the 21 positive cases for p53 protein overexpression, p16 protein alteration was positive in 6 (28.6%), negative in 15 (71.4%) cases and among the 8 negative cases for p53 overexpression, p16 showed positive in 3 (37.5%), negative in 5 (62.5%). Finally among the 26 positive cases of HPV infection, p16 alteration was positive in 9 (34.6%) and negative in 17 (65.4%) and all of the 3 HPV infection negative cases showed no p16 alteration. The p16 alteration had no significant correlation with the p53 overexpression and HPV infection.The total 5 years survival rate in 29 cases of invasive cervical cancer patients was 86.2%. In the negative group of p16 protein alteration the survival rate was 80% and the positive group was all alive. In the positive groups of p53 protein overexpression and HPV infection the survival rate were 80.9% and 84.6% respectively and the negative groups were all alive. And these factors had no significant correlation with the survival rates. CONCLUSION: This results indicate that p16 protein alteration had no correlation with clinicopathologic prognostic parameters and survival rates in invasive cervical cancer. In addition p16 protein alteration had no correlation with p53 protein overexpression and HPV infection respectively.

An Immunohistochemical study on the Expression of EGFR, TGF-alpha and Ki-67 in the Uterine Cervical Neoplasia / 대한산부인과학회잡지

OBJECTIVE: Cervical carcinoma of the uterus, the most common maliganacy among women in Korea, which its etiology and pathogenesis are not yet determined. Recently, since it has been found about the function of the growth factor and its receptor, involved in the regulation of cellular growth and differentiation, many studies have been undertaken about the role of growth factors and its receptors in the growth and differentiation of the tumor cell. METHODS: In this study, we examined the expression of EGFR, TGF-alpha and Ki-67 in 50 CINs and 20 invasive cervical cancers using immunohistochemical stain. RESULTS: Positive rate of EGFR was 92% in CIN, 80% in invasive cancer, negative rate of TGF-alpha was 74% in CIN, 80% in invasive cancer and Ki-67 labelling index(LI) in normal basal cell, CIN I-II, CIN III were 5+/-0.7, 13+/-2.5, 65+/-5.4 repectively and in invasive cancer, LI was over 90. from this result as cervical carcinoma progresses, the expression of EGFR and Ki-67 increase while that of TGF-alpha decreases. CONCLUSION: As cervical carcinoma progress, the expression of EGFR and Ki-67 increase while that of TGF-alpha decreases. Further studies on the expression of EGFR and TGF-alpha and its growth-stimulation mechanism in cervical carcinoma are warranted to establish the pathogenesis of the cervical carcinoma.

The Matrix metalloproteinase-2 & -9, Tissue inhibitor of metalloproteinase-1 & -2 mRNA Expression in Invasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: Invasive cancer cells penetrate the extracellular matrix(ECM), including basement membrane during the metastatic cascades. Matrix metalloproteinases(MMPs) play a critical role in tumor invasion and metastasis and their activities are regulated by specific tissue inhibitors of metalloproteinase(TIMPs). Aberrant ECM degradation in tumor biology is attributed to an imbalance in local MMP and TIMP activity, resulting in the overexpression or enhanced activation of MMPs or reduced TIMP expression. The aim of this study was to compare the MMP-2 & -9, TIMP-1 & -2 mRNA expression in cervical cancer with those in normal cervix and to investigate that their expression is related to cancer stages and other prognostic factors. METHODS: The normal cervix and cervical cancer tissues were obtained from healthy women(n=14), and the patients with cervical cancer(n=31), respectively. Total RNA was extracted and reverse transcribed into cDNA. The expression of MMP-2 & -9, TIMP-1 & -2 mRNA was examined by quantative competitive PCR(QC PCR) and each results were analyzed by t-test and univariate analysis. RESULTS: The expression of MMP-2, TIMP-1 mRNA in cervical cancer was higher than that in nomal cervix(p0.05). CONCLUSIONS: These results suggested that increased MMP-2, TIMP-1 & -2 mRNA expression is an early event during malignant transformation of cervical cancer.

Matrix Metalloproteinase-2, -9 Immunohistochemical staining in Cervical carcinoma: The Relationship with Clinicopathologic Prognostic Factors / 대한산부인과학회잡지

OBJECTIVE: Matrix metalloproteinase (MMP) has been reported to have a key role in the sequence of events that lead to local tumor invasion and metastasis. The present study was conducted to evaluate the role of MMP-2 and MMP-9 in cervical neoplasia. METHODS: Ten cases of cervical intraepithelial neoplasia, and 40 cases of cervical carcinoma were analysed by immunohistochemical staining. Paraffin-embedded archival tissue sections were examined for the expression of MMP-2 and MMP-9. RESULTS: of overexpression were analyzed for the correlation with clinical characteristics and prognostic factors. RESULTS: The overexpression of MMP-2 and MMP-9 was significantly higher in invasive cervical carcinoma than in CIN cases. There was no statistical significance in the correlation between MMP-2 or MMP-9 overexpression and the clinical prognostic factors. However, higher degree of MMP expression was observed in tumors of larger size, poorly differenciated and with lymph node metastasis compared to tumors of smaller size, well differentiated and without lymph node metastasis. CONCLUSIONS: From these findings, it can be postulated that MMPs may possibly play a role in the late stage of tumorigenesis, implying prognostic value. However, to draw a definite conclusion on their prognostic value, larger number of cases should be studied further.

The Clinical Significance of Cystoscopy and Computed Tomography in Pretrearment Evaluation of Invasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: Cystoscopy has been included as diagnostic procedure for pretreatment evaluation of cervical cancer by FIGO. However, its invasiveness brings up a question regarding the necessity of inclusion in staging work up of cervical cancer. We performed this study to evaluate the clinical implication of cystoscopy in cervical cancer staging. METHODS: 128 patients with invasive cervical cancer patients who were histologically diagnosed from Jan 1995 to Dec 1999 were retrospectively reviewed. Physical examination, computed tomography (CT), cystoscopy were performed in all patients. The distribution of FIGO stage was Ib 48.4%, II 35.2%, III 8.6%, and IV 7.8%. Bladder invasion was evaluated in CT and histopathologic examination was performed on cystoscopy when invasion was suspected. McNemar test was used to compare the finding in CT and cystoscopy for matched patients. P-value of 0.05 was regarded as statistically significant. RESULTS: Among seven patients whose bladder was suspected to be invaded by cervical cancer in CT scan, three patients had actual bladder invasion confirmed by cystoscopy (positive predictive rate = 42.9%). CT was statistically comparable to cystoscopy (P = 0.375, McNemar test; contingency coefficient = 0.481). CONCLUSION: Cystoscopy, which is an invasive procedure, may not be necessary and might be substituted by CT scan for pretreatment evaluation in some subset of cervical cancer patients.

A Case of Postirradiation Uterine Papillary Serous Carcinoma / 대한산부인과학회잡지

Uterine papillary serous carcinoma is a morphologically distinct variant of endometrial carcinoma that is associated with an aggressive behavior with rapid progression and high recurrence, and poor response to salvage treatment. The most common type of malignancy developing in the uterus after radiation therapy is the malignant mixed mullerian tumor, however, the papillary serous carcinomas have rarely been reported.Here we report a case of uterine papillary serous carcinoma which had developed 7 years after radiation therapy for invasive cervical cancer.

Papanicolaou smear in cervical intraepithelial neoplasm and invasive cancer / 대한산부인과학회잡지

OBJECTIVES: To investigate whether the aspects of Pap smear affect cervical abnormality in our country. METHODS: We compared the sensitivity of Pap smear of 241 cases of pathologic proven CIN & invasive cancer, compared to that of 655 cases with normal cervical biopsy, and reviewed the history of the test of 138 cases, retrospectively. RESULTS: The sensitivity of the test was 89.6%, 92.7% in CIN & invasive cancer group, respectively, with 96.9% specificity. Among 241 cases, 138 cases were examined for the frequency of test during the 3 years with the result of 2.42, 2.17/3yr in CIN and invasive cancer. And distribution of the test was not different between the two groups. The mean intervals of last two Pap smear before diagnosing final pathology in CIN and cancer were 12.1, 13.7 months, respectively, with no statistical significance (p>0.05). CONCLUSION: We concluded that in our country the aspects of Pap smear such as frequency and interval do not influence the result of cervical abnormality, so recommend the annual Pap test as a screening.

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.

Predictive Value of Clinical Examination, Computed Tomography and Magnetic Resonance Imaging in the Clinical Staging of the Cervical Carcinoma / 대한부인종양콜포스코피학회잡지

A total of 162 patients with invasive cervical cancer was investigated retrospectively with a view to elucidate the efficacy of pretreatment staging procedures of application with intravenous pyelography, cystoscopy, rectosigmoidoscopy. All 72 intravenous pyelograms, 155 sigmoidoscopies, 158 cystoscopies were normal. Of 111 patients with stage Ib who had paraaortic lymph node biopsies, two patients had a positive node(0.02%). Of 51 patients with stage II who had paraaortic lymph node biopsies, five patients had positive paraaortic lymph node(10%). And the accuracy of computed tomography and magnetic resonance imaging in the evaluation of invasive cervical cancer was assessed. In evaluating stage of cervical cancer, clinical staging had an accuracy of 78.9%, compared with 65.7% for CT and 58.9% for MRI. And for detection of parametrial invasion, clincal staging had an accuracy of 85.9%, compared with 85.1% for CT and 78.9% for MRI. Both modalities were comparable in evaluating lymph node metastasis ( 76.1% for CT, 74.4% for MRI ). IVP, cystoscopy and sigmoidoscopy for staging procedure evaluated in this study are unnecessary and should no longer be performed in patients with early stage cervical cancer. In addition, paraaortic lymph node biopsies in the absence of clinically suspicious nodes are not warranted. Compared with CT and MRI, pelvic examination offered improved evaluation of cervical cancer staging, parametrial invasion, but CT and MRI was useful in detecting the pelvic lymph node metastasis which was nearly impossible by clinical evaluation.

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.

Comparison study of interferon-a combined chemotherapy versus chemotherapy only in patients with invasive uterine cervical cancer / 대한부인종양콜포스코피학회잡지

This study is to evaluate therapeutic effects between interferon-a combined chemotherapy and chemotherapy(5-fluorouracil, cisplatin) only in invasive uterine cervical cancer. The study included 35 cases of interferon-a combined chemotherapy group and 50 cases of chemotherapy(5-FU, cisplatin) only group. Then we analyzed the therapeutic effects with respect to size of tumor, number of lymphocyte subsets and NK activity, and SCC Ag(squamous cell carcinoma antigen) level in peripheral blood. (continue)

Invasive Cervical Cancer in Women Aged 35 or Less / 대한부인종양콜포스코피학회잡지

The incidence in women less than 35 years of age is increasing despite an overall decrease in newly diagnosed invasive cervieal cancer among all age groups. However the influence of young age on prognosis remains controversial. So 163 patients of invasive cervical cancer in women aged 35 or less treated from Jan. 1, 1984 to Dec. 31. 1993 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea, were studied retrospectively. We obtained the following results; The 5-year survival rates by clinical stage were 88.7Y% in stage I b, 71.5% in stage IIa, 31.2% in stage IIb and O% in stage III or above. The lymph node metastasis rates by stage in RAH group, were 21.3% in stage I b and 31.8% in stage IIa. The lymph nodc metastasis rates by lesion size in RAH group, were 19.2% in 2cm below, 20.7% in 2-4cm and 40.0% in 4cm above. The 5-year survival rates in RAH group were 74,9% in lymph node positive group and 89.0% in lymph node negative group. The recurrenee rates by clinieal stage were 0% in stage Ia, 20.6% in stage I b, 22.2% in stage IIa, 50.0% in stage Ilb and 90.9% in stage III or above.