Determining the relationship between serum acute phase reactants and cervical premalignant lesions: a cohort study

Abstract BACKGROUND: Acute phase reactants play a role in the progression and prognosis of many malignant and premalignant tumors. This study investigated the diagnostic value of certain reactants as markers for cervical premalignant lesions. OBJECTIVES: Despite advanced screening and vaccination programs, cervical cancer remains a serious health problem worldwide. We aimed to determine the possible relationship between premalignant cervical disease and serum acute phase reactant levels. DESIGN AND SETTING: This study included 124 volunteers who underwent cervical cancer screening. We divided the patients into three groups according to cervical cytology and histopathological findings as follows: no cervical lesion, low-grade neoplasia, or high-grade neoplasia. METHODS: We included women aged 25-65 years with benign smear or colposcopy results, low- and high-grade squamous intraepithelial lesions. The benign group was based only on cytology findings, whereas the other groups were based on histopathology findings. Demographic data and serum albumin, fibrinogen, ferritin, and procalcitonin levels were evaluated in the three groups. RESULTS: We found significant differences among the three groups in terms of age, albumin level, albumin/fibrinogen ratio, and procalcitonin level. The regression analysis revealed lower serum albumin levels in the low- and high-grade squamous intraepithelial lesion groups compared with the benign group. CONCLUSION: This is the first study to evaluate the importance of serum inflammatory markers in cervical intraepithelial lesions. Our results indicate that serum albumin level, albumin/fibrinogen ratio, procalcitonin level, and neutrophil values differ among cervical intraepithelial lesions.

FIPLIQ: an alternative solution for gynecological and oral cytology / FIPLIQ: uma solução alternativa para exames citológicos ginecológicos e bucais

ABSTRACT Introduction: Liquid-based solution for cytology has been developed to improve Pap test. Some liquid media are commercially available, however, due to the high cost there are difficulties in implementing it in the public health programs of many countries. Objectives: To study the suitability of alternative liquid media for the collection and preservation of samples for cytologic examinations, comparing the results with the conventional Papanicolaou methodology. Material and methods: In this study, 127 different compositions of alternative liquid-based solutions were tested with samples from 10 volunteers for oral cytology and 20 samples from volunteers for cervical cytology. Formaldehyde-isopropanol-phosphate (FIPLIQ) was used to preserve cervical samples prepared and analyzed on the same day and 3, 7, and 15 days after collection, compared with Pap smear. Evaluations on quality and adequacy of cell types, microorganisms or their cytopathic effects, reactive, degenerative and dysplastic cell alterations were performed. Results: Samples processed with FIPLIQ showed results similar to those of conventional Pap smear when analyzing staining cytoplasm with indistinct cytoplasm borders, chromatin structure, presence or absence of different types of cell and microorganisms, reparative process, preneoplastic, and neoplastic cell changes; the samples were stored for up to 15 days after collection. Conclusion: Preliminary results suggest that FIPLIQ is suitable for the preparation and preservation of cytology specimens for up to 15 days.

RESUMEN Introducción: La citología en medio líquido fue desarrollada para mejorar la prueba de Papanicolaou. Algunos medios líquidos son comercialmente disponibles; no obstante, debido al costo elevado, hay dificultades para su implementación en programas de salud pública en muchos países. Objetivos: Estudiar la adecuación de medios líquidos alternativos para recolecta y la preservación de muestras para exámenes citológicos, comparando los resultados con la metodología convencional de Papanicolaou. Material y métodos: En este estudio, 127 diferentes composiciones de soluciones alternativas de medios líquidos fueron testadas con muestras de 10 voluntarios para citología oral y 20 muestras de voluntarias para citología cervical. El fosfato de formaldehído- isopropanol (FIPLIQ) fue usado para preservación de muestras cervicales preparadas y analizadas en el mismo día, y tres, siete y 15 días después de la recolecta, en comparación con la citología convencional. Se hicieron evaluaciones de calidad y adecuación de los tipos celulares, microorganismos o sus efectos citopáticos, cambios celulares reactivos, degenerativos y displásicos. Resultados: Las muestras procesadas con FIPLIQ presentaron resultados similares a los de la prueba convencional de Papanicolaou cuando analizados color y bordes citoplasmáticos mal definidos, estructura de cromatina, presencia o ausencia de diferentes tipos de células y microorganismos, proceso reparativo, pre-neoplásico y alteraciones celulares neoplásicas; las muestras se conservaron hasta 15 días después de la recolección. Conclusión: Los resultados preliminares sugieren que el FIPLIQ es adecuado para preparación y preservación de especímenes citológicos hasta 15 días.

RESUMO Introdução: A citologia em meio líquido foi desenvolvida para melhorar o teste de Papanicolaou. Alguns meios líquidos são comercialmente disponíveis, no entanto, devido ao alto custo, há dificuldades para sua implementação em programas de saúde pública em muitos países. Objetivos: Estudar a adequabilidade de meios líquidos alternativos para a coleta e a preservação de amostras para exames citológicos, comparando os resultados com a metodologia convencional de Papanicolaou. Material e métodos: Neste estudo, 127 diferentes composições de soluções alternativas de meios líquidos foram testadas com amostras de 10 voluntários para citologia oral e 20 amostras de voluntárias para citologia cervical. O fosfato de formaldeído-isopropanol (FIPLIQ) foi utilizado para preservar amostras cervicais preparadas e analisadas no mesmo dia e três, sete e 15 dias após coleta, em comparação com a citologia convencional. Avaliações de qualidade e adequação dos tipos celulares, de microrganismos ou seus efeitos citopáticos, de alterações celulares reativas, degenerativas e displásicas foram realizadas. Resultados: As amostras processadas com FIPLIQ apresentaram resultados semelhantes aos do teste convencional de Papanicolaou quando analisados coloração e apagamento de bordas citoplasmáticas, estrutura de cromatina, presença ou ausência de diferentes tipos de células e microrganismos, processo reparativo, pré-neoplásico e alterações celulares neoplásicas; as amostras foram conservadas por até 15 dias após a coleta. TOPICO Conclusão: Os resultados preliminares sugerem que o FIPLIQ é adequado para a preparação e a preservação de espécimes citológicos por até 15 dias.

Resultados de la conización por radiocirugía en pacientesatendidas en consulta de patología de cuello uterino / Results of Conization by Radiosurgery in patients treated in a Cervical Pathology Clinic

Introducción: La radiocirugía tiene como objetivo proporcionar una herramienta de diagnóstico y tratamiento. Objetivos: Describir los resultados de la conización por radiocirugía en pacientes atendidas en la consulta de patología de cuello uterino de la institución. Métodos: Se realizó una investigación descriptiva de corte transversal en el Hospital General Docente Mártires del 9 de Abril de Sagua la Grande, Villa Clara, Cuba. La población de estudio estuvo conformada por la totalidad de 256 pacientes atendidas en la consulta de patología de cuello uterino que fueron sometidas a conización por radiocirugía, entre enero 2013 y diciembre 2015. Para la recogida de la información se empleó la revisión de documentos y se confeccionó un modelo de recogida de datos. Resultados: El diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa) (78 casos; 30,5 por ciento). Conclusiones: Las lesiones premalignas en el presente estudio comenzaron a aparecer con marcada incidencia a partir de los 20 años y hasta los 49, sobresaliendo el grupo de 30 - 39 años. El aumento en el número de parejas sexuales, así como el comienzo temprano de las relaciones sexuales incrementan el riesgo de padecer lesiones intraepiteliales en el cuello del útero. A partir de los cinco años de iniciada las relaciones sexuales comienzan a aparecer las lesiones intraepiteliales cervicales, el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa). En los diagnósticos histológicos por sacabocado y cono existió correspondencia en todos los casos(AU)

Introduction: Radiosurgery aims to provide a diagnostic and treatment tool. Objectives: To describe the results of conization by radiosurgery in patients treated in the cervical pathology clinic of the institution. Methods: A descriptive cross-sectional investigation was carried out at Mártires del 9 de abril General Teaching Hospital, in Sagua la Grande, Villa Clara, Cuba. The study population consisted of 256 patients attended in the cervical pathology clinic who underwent conization by radiosurgery, from January 2013 to December 2015. For the collection of the information, the document review was used and a data collection form was made. Results: The preoperative diagnosis that contributed the greatest number of cases was IAS III (severe dysplasia) (78 cases; 30.5 percent). Conclusions: The premalignant lesions in the present study began to appear with a marked incidence from the age of 20 and up to 49, with the group of 30-39 years standing out. The increase in the number of sexual partners, as well as the early sexual intercourse increase the risk of suffering intraepithelial lesions in the cervix. After five years of beginning sexual intercourse, cervical intraepithelial lesions begin to appear, the preoperative diagnosis that contributed the greatest number of cases was IAS III (severe dysplasia). In histological diagnoses by punch and cone correspondence existed in all cases(AU)

Prevalence of Oral mucosal lesions and their association with Pattern of tobacco use among patients visiting a dental institution

Background: Oral mucous membrane is an integral part of the complex oral cavity which is associated with maintenance of oral as well as general body health. Oral mucosal lesion (OML) is one of the most prevalent diseases in India, which is caused by consumption of smokeless and smoked forms of tobacco. Aim: To assess the prevalence of OMLs and their association with pattern of tobacco use among patients visiting dental institution in Bhilai. Materials and Methods: This descriptive cross-sectional study included 872 participants who visited the Department of Oral Medicine and Radiology, Rungta College of Dental Science and Research, and fulfilled the inclusion criteria, and the study was carried out from July to September 2016. Self-designed proforma was used for recording demographic details, and WHO Assessment Form for Oral Mucosal Diseases was used to record the tobacco use status and findings of the clinical and laboratory investigation. Statistical analysis was performed using IBM SPSS version 23, and the mean, frequency, and percentage were calculated. Results: Among the 872 participants, 69.26% were male and 30.74% were female. The mean age of the study population was 46.19 ± 12.33 years. The prevalence of tobacco use among study participants was 51.26% and that of the OML was 36.36%. Aphthous ulcer was the most prevalent OML followed by oral submucous fibrosis and leukoplakia. Conclusion: The study emphasizes the harmful effects of tobacco use toward oral mucous membrane and also serves as a path for future tobacco cessation programs that would be helpful to prevent OML.

A Statistical Study of Cutaneous Malignant Tumors and Premalignant Lesions in Southeastern Gyeonggi-do Province over an 11-year Period (2006~2016) / 대한피부과학회지

BACKGROUND: The incidence of cutaneous malignant tumors and premalignant lesions has recently increased worldwide. However, studies investigating the incidence and clinical manifestations of cutaneous malignant tumors and premalignant lesions in Korea are rare, especially in southeastern Gyeonggi-do Province. OBJECTIVE: To analyze the recent trends in the incidence of cutaneous malignant tumors and premalignant lesions in southeastern Gyeonggi-do Province. METHODS: We retrospectively reviewed 451 cases of cutaneous malignant tumors and 455 cases of premalignant lesions from 2006 to 2016. RESULTS: The average annual incidence rates of cutaneous malignant tumors and premalignant lesions among the total number of outpatients was 0.84% and 0.85%, respectively, and both these rates increased significantly over time. Basal cell carcinoma was most commonly diagnosed cutaneous malignant tumor (50.8%), followed by squamous cell carcinoma (24.6%), malignant melanoma (8.2%), and metastatic carcinoma (5.1%). The most common premalignant lesion was actinic keratosis (60.0%). The mean age of the patients with cutaneous malignant tumors and premalignant lesions was 68.8 years and 70.8 years, respectively. The ratio of male to female patients was 1 : 1.19 for cutaneous malignant tumors and 1 : 2.01 for premalignant lesions. The face was the most common site for both cutaneous malignant tumors and premalignant lesions (at 71.9% and 75.8%, respectively). CONCLUSION: This retrospective study provided data about the incidence and clinical patterns of cutaneous malignant tumors and premalignant lesions among patients in southeastern Gyeonggi-do Province.

Manejo das lesões de colo uterino durante a gestação / Management of cervical lesions during pregancy

Introdução: O câncer de colo de útero é a neoplasia mais comum durante a gestação. A frequência da doença precursora e do câncer do colo estimada em gestantes é de 0,22% e 0,01%, respectivamente. O manejo dessas lesões ainda não está bem estabelecido em virtude da dificuldade de realização de estudos nessa população. Métodos: Revisão de publicações dos últimos 7 anos foi realizada, pelas palavras-chave citadas no banco de dados Pubmed, base de dados do Ministério da Saúde do Brasil, diretrizes brasileiras para rastreio de câncer de colo de útero do INCA e livro "Ginecologia básica e avançada" do Serviço de Ginecologia do Hospital São Lucas da PUCRS. Resultados: De acordo com as evidências analisadas sobre lesões precursoras e câncer de colo de útero invasivo em gestantes observou-se que o diagnóstico, através do exame citopatológico e a colposcopia, é semelhante ao das não grávidas. Em contrapartida o manejo e o tratamento diferem das não gestantes devido ao envolvimento de fatores maternos como religiosidade, crenças e idade gestacional. Conclusão: Alterações na citologia cervical de gestantes devem ser avaliadas individualmente. A grande maioria das lesões sofre regressão no período pós-parto, mas o acompanhamento individualizado das gestantes com diagnóstico de câncer é imprescindível, levando em consideração características pessoais, éticas e religiosas de cada paciente.

Introduction: Cervical cancer is the most common neoplasm during pregnancy. The prevalence of precursor disease and cervical cancer in pregnant women is 0.22% and 0.01%, respectively. The management of these lesions is still not well established due to the difficulty of conducting studies in this population. Methods: Literature from the last 7 years was reviewed, using Pubmed database, database of the Brazilian Ministry of Health, Guidelines Brazilian women for cervical cancer screening at INCA and "Ginecologia Básica e Avançada" ­ book of the Gynecology Departament of the Hospital São Lucas da PUCRS. Results: According to evidence analyzed on precursor lesions and invasive cervical cancer in pregnant women, it was observed that the diagnosis, through cytopathological examination and colposcopy, is similar to that of non-pregnant women. On the other hand, the management and treatment differ from non-pregnant due to the involvement of maternal factors such as religiosity, beliefs and gestational age. Conclusion: Abnormalities in the cervical cytology during pregnancy should be evaluated individually. The vast majority of lesions regress in the postpartum period, but the individualized follow-up of pregnant women diagnosed with cancer is essential, taking into account the personal, ethical and religious characteristics of each patient.

Resultados de la conización por radiocirugía en pacientes atendidas en consulta de patología de cuello uterino / Results of conization by radiosurgery in cervical pathology patients

Introducción: la radiocirugía tiene como objetivo proporcionar una herramienta de diagnóstico y tratamiento. Objetivos: describir los resultados de la conización por radiocirugía en pacientes atendidas en la consulta de patología de cuello uterino. Método: se realizó una investigación descriptiva de corte transversal en el Hospital General Docente Mártires del 9 de abril, de Sagua la Grande, Villa Clara, Cuba. La población de estudio estuvo conformada por 256 pacientes atendidas en la consulta de patología de cuello uterino que fueron sometidas a conización por radiocirugía, desde enero de 2013 a diciembre de 2015. Para la recogida de la información se empleó la revisión de documentos mediante la confección de un modelo de recogida de datos. Resultados: el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa) con 78 casos (30,5 por ciento). Conclusiones: en el presente estudio las lesiones premalignas comenzaron a aparecer con notada incidencia desde los 20 años y hasta los 49, con marcada ocurrencia en el grupo de 30 a 39 años. El aumento en el número de parejas, así como el comienzo temprano de las relaciones sexuales incrementan el riesgo de padecer lesiones intraepiteliales en el cuello del útero. A partir de los cinco años de iniciada las relaciones sexuales, comienzan a aparecer las lesiones intraepiteliales cervicales, el diagnóstico preoperatorio que aportó mayor cantidad de casos fue el NIC III (displasia severa). Existió correspondencia en todos los casos en los diagnósticos histológicos por sacabocado y cono(AU)

Introduction: radiosurgery aims to provide a diagnostic and treatment tool. Objectives: describe the results of radiosurgery conization in patients treated at the cervical pathology clinic. Method: adescriptive cross-sectional study was carried out at Mártires del 9 de Abril General Teaching Hospital, Sagua la Grande, Villa Clara, Cuba. The study population consisted of 256 patients treated at the cervical pathology clinic, who were submitted to radiosurgery conization, from January 2013 to December 2015. For the collection of the information, a review of documents was done by making a data collection model. Results: CIN III (severe dysplasia was) the preoperative diagnosis that contributed the most cases ( 78 cases (30.5 percent)). Conclusions: in the present study, premalignant lesions began to appear with a marked incidence from the age of 20 to 49, with a distinct occurrence in the group aged 30 to 39 years. The increase number of couples as well as the early beginning of sexual intercourse increase the risk of intraepithelial lesions in the cervix. After five years of sexual intercourse, cervical intraepithelial lesions began to appear, the preoperative diagnosis with the highest number of cases was CIN III (severe dysplasia). There was correspondence in all cases in the histological diagnoses by punch and cone(AU)

Aumento de detección de lesiones gástricas premalignas mediante protocolo Sydney en comparación con biopsias no protocolizadas / Increased detection of premalignant gastric lesions through Sydney protocol in comparison with non-protocolized gastric biopsies

Introduction: Gastric cancer (GC) is the leading cause of cancer mortality in Chile. The development ofgastric adenocarcinoma its preceded by a histopathologic cascade composed of gastric atrophy, intestinal metaplasia and gastric dysplasia. Sydney protocol has been proposed as the standard method for diagnosingthese conditions. The aim of this research study was to establish whether Sydney protocol increase thedetection of premalignant gastric lesions, as gastric atrophy and intestinal metaplasia, compared to non protocolizedendoscopies/biopsies. Methods: Upper gastroduodenal endoscopies (GDE) from Hospital Clí-nico Universidad Católica de Chile between April-May 2015 and April-May 2016 was analyzed. Patientswith histological study with 18 years-old or older were included. Patients with history of GC or malignantlesions at GDE where excluded. Detection of gastric atrophy, intestinal metaplasia and suggestive findingsof autoimmune gastritis where compared between Sydney protocol and non-protocolized endoscopies/biopsies...

Introducción: El cáncer gástrico (CG) es la principal causa de muertes por cáncer en Chile. El desarrollo del adenocarcinoma gástrico es precedido por una cascada histopatológica (gastritis; atrofia gástrica/AG; metaplasia intestinal/MI). Se ha propuesto la biopsia del cuerpo, ángulo y antro a través del protocolo de Sydney para la búsqueda de estas condiciones. Objetivo: Determinar la diferencia en la detección delesiones premalignas gástricas a través del protocolo de Sydney comparado con el estudio endoscópico habitual. Métodos: Se analizaron las endoscopias digestivas altas (EDA) realizadas en el Centro de Endoscopia Digestiva del Hospital Clínico de la Universidad Católica en los períodos entre abril y mayo del 2015 y 2016. Se incluyeron las EDA de pacientes mayores de 18 años con estudio histológico. Fueron excluidos los pacientes con antecedente personal de CG o lesiones de aspecto maligno macroscópicas. Se comparó la detección de AG, MI y gastritis autoinmune (GA) en el estudio histológico entre los pacientes con protocolo Sydney y el estudio endoscópico no protocolizado...

Study of PAP smear examination in patients complaining of leucorrhoea – A 2 years prospective study in a teaching hospital

Background: Leucorrhoea is the clinical evidence of infection and can be treated satisfactorily whenever diagnosed. Occurrence of cervical cancer associated with discharge/leucorrhoea can be easily prevented if detected early. Majority of patients attending hospital present with varying degree of vaginal discharge and cytological monitoring of these subjects is mandatory to know any cellular changes in the cervical epithelium as well as the presence of any sexually transmitted diseases (STD’s) in the genital tract. Materials and methods: This research study was done at Malla Reddy Institute of Medical Sciences (MRIMS), Suraram, Hyderabad, Telangana State, India for a period of 2 years. A total of 500 cases were included in the study with women of age ranging from 20-50 years, complaining of Leucorrhoea. As told by the patients on questioning as a part of clinical history, the Leucorrhoea was found to be of different types white discharge, yellowish discharge, greenish discharge; blood stained and fouls smelling discharge. Smears were taken with a thorough history in particular reference to age at first child birth, parity, personal and genital hygiene, history of husband suffering from any sexually transmitted diseases, vaginal discharge, mass per vaginum, duration of labour and history of sexually transmitted diseases were elicited. Results: In our study of 500 cases, 348 (69.6 %) cases showed reactive cellular changes associated with repair (Inflammatory smear), 56 (11.2%) cases were due to various infectious agents, 32 cases P. Sujatha, V. Indira, Kandukuri Mahesh Kumar. Study of PAP smear examination in patients complaining of leucorrhoea - A 2 years prospective study in a teaching hospital. IAIM, 2016; 3(5): 106-112. Page 107 (6.4%) were of Reactive changes with Atrophic vaginitis, Low grade squamous intraepithelial lesion (LSIL) 18 cases (3.6%), High grade squamous intraepithelial lesion (HSIL) 5 cases (1%), Atypical squamous cells of undetermined significance (ASCUS) 4 cases (0.8%), Atypical glandular hyperplasia 4 cases (0.8%),Suspicious of malignancy 9 cases (1.8%),Shift in flora suggesting Bacterial vaginosis 7 cases (1.4%), Normal smear/ Normal study 13 cases (2.6%) ,Unsatisfactory for evaluation as more than 75 % of smear is obscured by blood – 4 cases (0.8%). Conclusion: A Pap test (Pap smear) is a quick and simple test that checks for changes to the cells of your cervix that may lead to cervical cancer. Pap smear reduces the mortality and morbidity with cervical cancer. This cytological screening should gain much popularity and should be accessible to all. It is recommended as part of routine medical examination in gynecological practice.

Detección del receptor de factor de crecimiento epidérmico en lesiones orales premalignas por relaxometría / Detection of the epidermal growth factor receptor by relaxometry of oral premalignant lesions

OBJETIVO: detectar la sobreexpresión del receptor de factor de crecimiento epidérmico en células epiteliales de lesiones premalignas de la mucosa bucal, marcadas magnéticamente por relaxometría. MÉTODOS: las células exfoliadas de mucosa oral de individuos sanos y enfermos se marcaron con el sistema: IgG anti-EGF-R biotinilada/IgG anti-biotina conjugada con partículas superparamagnéticas y se midieron los tiempos de relajación T1 y T2. RESULTADOS: disminuyeron los tiempos de relajación (T1 y T2) de las células marcadas respecto a las no marcadas, en todas las muestras analizadas. Al comparar los valores de T1 y T2 de las células marcadas de la lesión con los valores de las células sanas, se encontró una disminución estadísticamente significativas del tiempo de relajación. Al comparar los tiempos de relajación de células marcadas sanas con los de las células de las diferentes lesiones encontramos diferencias estadísticamente significativas para los casos de células de leucoplasias y liquen plano tanto en T1 como T2; no así con células de queratosis. CONCLUSIONES: los resultados muestran que es posible detectar por relaxometría células que expresen el receptor de factor de crecimiento epidérmico, utilizando el sistema conjugado empleado y que el EGF-R se sobreexpresa en células de lesiones como leucoplasia y liquen plano.

OBJECTIVE: Detect the overexpression of the epidermal growth factor receptor in epithelial cells of premalignant lesions of the oral mucosa magnetically marked by relaxometry. METHODS: Exfoliated oral mucosa cells from healthy and sick individuals were marked with the system biotinylated anti-EGF-R IgG / anti-biotin IgG conjugated with supermagnetic particles and measurements were taken of relaxation times T1 and T2. RESULTS: In all the samples analyzed there was a decrease in the relaxation times (T1 and T2) of marked cells with respect to unmarked cells. Comparison of the T1 and T2 values of marked cells from the lesion with the values of healthy cells revealed a statistically significant decrease in relaxation time. Comparison of the relaxation times of healthy marked cells with those of cells from the various lesions revealed statistically significant differences in both T1 and T2 in cells from lichen planus and leukoplakias, but not in cells from keratoses. CONCLUSIONS: Results show that relaxometry may be used to detect cells expressing the epidermal growth factor receptor, using the conjugated system described herein, and that EGF-R is overexpressed in cells from lesions such as leukoplakia and lichen planus.

Study of High Grade Prostatic Intraepithelial Neoplasia for a Period of Five Years

A relatively new development in the arena of prostatic histopathological study is the premalignant proliferative high grade prostatic intraepithelial neoplasia (HGPIN) in the glandular epithelium, possibly relating to carcinoma. Aim of the study is HGPIN and its association with Prostatic hyperplasia and Prostatic carcinoma. The present study was undertaken in the Upgraded Department of Pathology, King George Hospital, Andhra Medical College for a period of five years from January 2002 to December 2006. A total of 340 cases evaluated, 277 (81.47%) were benign, 11 (3.23%) were premalignant and 52 (15.29%) malignant lesions. Premalignant lesions were preceded by a decade as compare to malignant lesions, with a mean age of 8 years difference. Among premalignant lesions only high grade prostatic intraepithelial lesion is seen in association with prostatic carcinoma (40%).

Recent Advances in Molecular Imaging of Premalignant Gastrointestinal Lesions and Future Application for Early Detection of Barrett Esophagus

Recent advances in optical molecular imaging allow identification of morphologic and biochemical changes in tissues associated with gastrointestinal (GI) premalignant lesions earlier and in real-time. This focused review series introduces high-resolution imaging modalities that are being evaluated preclinically and clinically for the detection of early GI cancers, especially Barrett esophagus and esophageal adenocarcinoma. Although narrow band imaging, autofluorescence imaging, and chromoendoscopy are currently applied for this purpose in the clinic, further adoptions of probe-based confocal laser endomicroscopy, high-resolution microendoscopy, optical coherence tomography, and metabolomic imaging, as well as imaging mass spectrometry, will lead to detection at the earliest and will guide predictions of the clinical course in the near future in a manner that is beyond current advancements in optical imaging. In this review article, the readers will be introduced to sufficient information regarding this matter with which to enjoy this new era of high technology and to confront science in the field of molecular medical imaging.

An update on precancerous lesions of oral cavity.

Oral cancer is the most common head and neck cancer, found in 270,000 patients annually worldwide. Some cancers develop from precancerous lesions; however, there is no definitive clinico pathological factor or biomarker that reliably enables malignant transformation to be predicted in an individual patient. Early detection and early treatment of oral cancer are important for improving the survival rate of patients; prevention of oral cancer will clearly contribute most to decreasing its death rate. So correct diagnosis and timely treatment of premalignant lesions with high risk of malignant transformation may help to prevent malignant transformation.

Verrucous Carcinoma - Now And Then.

Verrucous carcinoma is a highly differentiated variant of squamous cell carcinoma which tends to occur more commonly in the men in the 6-7th decade of life. There are reports to indicate the lesions arise from proliferative verrucous leukoplakia. Both the lesions have a greater tendency to occur in patients with smokeless tobacco use. Verruocus carcinoma is an innocuous lesion with a late tendency to metastasize. It responds well to surgical management. Here we report the occurrence of verrucous carcinoma from a preexisting case of proliferative verrucous leukoplakia in a 72 year old female patient.

Comportamiento del cáncer cérvicouterino en el municipio San Antonio del Sur de Guantánamo / Behavior of cervicouterine cancer in the San Antonio del Sur municipality, Guantanamo province

Introducción: no son pocos los esfuerzos que se realizan para combatir el cáncer cérvicouterino, a pesar de que existe un programa de detecci¾n precoz, estamos lejos aún de alcanzar la meta propuesta. Objetivo: conocer el comportamiento del cáncer cérvicouterino en el municipio de San Antonio del Sur de la provincia Guantánamo en el periodo 2006-2010. Métodos: el universo de estudio quedó constituido por las 254 pacientes que tuvieron una citología orgánica con diagnóstico positivo de lesiones premalignas o malignas de cuello uterino. Los datos se extrajeron de las tarjetas de citología de cada área de salud, se procesaron en hojas de cálculo de Microsoft Excel, se expresaron en números absolutos y porcientos y se representaron en tablas y gráficos...

Introduction: many efforts are made to fight against the cervicouterine cancer despite a program of early detection the goal is far from to be achieved yet. Objective: to know the behavior of cervicouterine cancer in the San Antonio del Sur municipality in the Guantánamo province during 2006-2010. Methods: the study universe included 254 patients with a organic cytology and positive diagnosis of premalignant or malignant lesions of cervix. Data were collected from the cytology cards of each health area, the calculus sheets of Microsoft Excel were processed, expressed in absolute figures and percentages represented in tables and charts...

A Clinical Observation of Cutaneous Malignant Tumors and Premalignant Lesions in Gangwon Province over 10 Years (1999~2008) / 대한피부과학회지

BACKGROUND: The incidence of cutaneous malignant tumors and premalignant lesions has recently increased according to extended life span, social and medical environment changes. However, a few clinical data have been reported on the survey of cutaneous malignant tumors and premalignant lesions in Gangwon province. OBJECTIVE: To investigate the incidence and clinical patterns of cutaneous malignant tumors and premalignant lesions in Gangwon province. METHODS: We reviewed 485 cases of cutaneous malignant tumors and premalignant lesions from January 1999 to December 2008, at the Department of Dermatology at Wonju Christian Hospital. RESULTS: The average annual incidence of cutaneous malignant tumors among the total number of outpatients was 0.51% and that of premalignant lesions was 0.48%. Both incidences tended to increase with time in 10 year intervals. The most common cutaneous malignant tumor was basal cell carcinoma (47.98%), followed by squamous cell carcinoma (24.19%), extramammary paget's disease (7.26%), metastatic cancer (5.65%), malignant melanoma (4.44%), and lastly, lymphoma (4.44%). Among premalignant lesions, actinic keratosis (74.68%) and Bowen's disease (25.32%) were common. The mean age of onset was 67.53 years in cutaneous malignant tumors and 70.51 years in premalignant lesioins. The most common site for both, the cutaneous malignant tumors and premalignant tumors, was the face (63.97% and 81.43%, respectively). The ratio of men to women was 1.11:1 in cutaneous malignant tumors and 1:2.48 in premalignant lesions. CONCLUSION: The incidence of cutaneous malignant tumors and premalignant lesions has gradually increased in Gangwon province. This data will be made available for the study about the association of cutaneous malignant tumors and premalignant lesions.

Valor de la prueba de sangre oculta en heces fecales para la detección de lesiones premalignas y malignas del colon / Value of the hidden blood test in feces for detection of premalignant and malignant lesions of colon

Introducción: el cáncer colorrectal es la tercera neoplasia en orden de frecuencia, la segunda causa de muerte por cáncer en mujeres y la tercera entre los hombres. Objetivo: evaluar la eficacia de la prueba de sangre oculta en heces fecales en relación con el diagnóstico endoscópico de lesiones malignas y premalignas del colon. Métodos: se estudiaron 212 pacientes que acudieron a consulta de gastroenterología del CIMEQ en el período comprendido entre enero de 2006 y mayo de 2007, a los que se les realizó prueba inmunoquímica de sangre oculta en heces fecales y estudio endoscópico del colon. Se determinaron sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo de la prueba de sangre oculta en heces fecales. Resultados: la prueba resultó positiva en el 36 por ciento de los pacientes. Se diagnosticó en el 51 por ciento de los pacientes lesiones premalignas donde predominaron los pólipos mayores de 1 cm. Se realizó diagnóstico de lesiones malignas al 16 por ciento de los pacientes. Conclusiones: la prueba inmunoquímica para sangre oculta en heces fecales utilizada tiene una adecuada eficacia en la detección de lesiones malignas y premalignas del colon

Introduction: the colorectal cancer is the third neoplasm in frequency order, the second death cause for cancer in women and the third one in men. Objective: to assess the effectiveness of hidden blood test in feces related to endoscopic diagnosis of malignant and premalignant lesions of colon. Methods: a total of 212 patients came to Gastroenterology consultation of CIMEQ from January, 2006 to May, 2007 and underwent a hidden blood immunochemical test in feces. Results: test was positive in the 36 percent of patients and the 51 percent of patients was diagnosed with premalignant lesions with predominance of polyps greater than 1 cm. The diagnosis of malignant lesions in the 16 percent of patients was made. Conclusions: the immunochemical test used for hidden blood in feces has an appropriate effectiveness in detection of malignant and premalignant lesions of colon

Rastreamento de lesões precursoras do carcinoma espino-celular anal em indivíduos portadores do HIV / Tracking precursor lesions of anal squamous cell carcinoma in individuals with HIV

INTRODUÇÃO: O carcinoma espino-celular do canal anal é doença que atinge os adultos de meia idade e corresponde a 4 por cento dos cânceres do trato gastrointestinal baixo. Na população geral a incidência é de 1 em 100.000 habitantes, e entre os homens que fazem sexo com homens essa incidência atinge 35 por 100.000 habitantes, sendo que os portadores de HIV têm esse risco duplicado (70 por 100.000 habitantes). MÉTODO: Foi realizada revisão da literatura com consulta nos periódicos das bases Medline/Pubmed, Scielo e Lilacs cruzando os descritores Rastreamento, Lesões pré-cancerosas, Neoplasias do ânus e HIV. Além da revisão bibliográfica, foi adicionada a este trabalho a experiência pessoal dos autores, e a obtida no Departamento de Gastroenterologia - Divisão Cirúrgica, no ICESP - Instituto do Câncer do Estado de São Paulo Octávio Frias de Oliveira, no Departamento de Moléstias Infeciosas - Casa da AIDS e no Serviço de Coloproctologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brasil. CONCLUSÕES: HIV+ é um grande fator de risco no desenvolvimento de carcinoma espino-celular anal em indivíduos infectados por HPV. A avaliação desses pacientes não deve se restringir à erradicação de condilomas, mas principalmente incluir o rastreamento de lesões displásicas subclínicas potencialmente neoplásicas. Apesar dos métodos de rastreamento ainda não serem ideais, o grande benefício do rastreamento baseia-se no fato de oferecer acompanhamento rigoroso, tornando possível à prevenção ou detecção cada vez mais precoce do carcinoma espino-celular anal.

INTRODUCTION: Squamous cell carcinoma of the anal canal is a disease that affects the middle-aged adults and accounts for 4 percent of cancers of the gastrointestinal tract below. In the general population the incidence is 1 in 100,000, and among men who have sex with men the incidence is 35 per 100,000 inhabitants, those with HIV have doubled this risk (70 per 100,000 inhabitants). METHODS: Was performed literature review in consultation with periodic Medline / Pubmed, Lilacs and Scielo crossing Trackingm, Precancerous conditions, Anus neoplasms and HIV descriptors. Besides the review,was added to this work the authors'personal experiences, and obtained at the Department of Gastroenterology - Surgical Division, in ICESP - Cancer Institute of the State of São Paulo Octavio Frias de Oliveira, in Department of Diseases Infectious - House of AIDS and in the Department of Coloproctology, Hospital das Clinicas, University of São Paulo, Brazil. CONCLUSIONS: HIV + is a major risk factor in developing squamous cell carcinoma anal in individuals infected with HPV. The evaluation of these patients should not restrict itself to the eradication of warts, but mainly include the screening of subclinical dysplastic lesions potentially neoplastic. Despite the screening methods are still not ideal, the great benefit of screening is based on the fact offer closely monitored, making possible the prevention or detection of increasingly early anal squamous cell carcinoma.

Pacientes remitidos por el Programa de Detección de Cáncer Bucal: Facultad de Estomatología de La Habana: 1999-2006 / Patients referred by the Program for Detection of buccal cancer: Stomatology Faculty of La Habana, 1999-2006

Nos propusimos caracterizar los pacientes remitidos por el Programa de Detección de Cáncer Bucal (PDCB) a la Clínica de Patología Bucal de la Facultad de Estomatología de febrero de 1999 a julio de 2006. Se realizó un estudio transversal, descriptivo, observacional de los pacientes inscritos en el registro de remitidos por el PDCB a la Clínica de Patología de la Facultad de Estomatología de La Habana. Se estudiaron 1 008 pacientes, el diagnóstico presuntivo y definitivomás mayormente representado fue el de otra lesión, con 33,7 por ciento de presentación, seguido por la leucoplasia con 33,7 por ciento. La coincidencia entre el diagnóstico presuntivo y el definitivo fue de 69,0 por ciento, el carrillo estaba afectado en un 25,8 por ciento. El carcinoma epidermoide representó un 85,0 por ciento de las neoplasias malignas diagnosticadas. No hubo diferencias entre los sexos de los pacientes remitidos y el rango de edades más afectado fue el de 34 a 59 años de edad. La mitad de los pacientes remitidos tenían hábito de fumar, mucho más elevado en los pacientes con leucoplasia y neoplasias malignas. Las localizaciones anatómicas más afectadas por las lesiones motivo de remisión fueron carrillo, encía y paladar. El carcinoma epidermoide grado I y la etapa clínica I mostraron los mayores porcentajes(AU)

The aim of present paper was to characterize the patients referred by the Program for Detection of Buccal Cancer (PDBC) to Clinic of Buccal Pathology of the Stomatology Faculty from February, 1999 to July, 2006. An observational, descriptive and cross-sectional study was conducted in patients inscribed in Referred Registry by PDBC to Clinic of Pathology from the Stomatology Faculty of La Habana. A total of 1 008 patients were studied, the more numerous presumptive diagnosis and the definitive diagnosis of other lesion with 33,7 percent followed by leucopenia with 33,7 percent, coincidence between the presumptive diagnosis and the definitive one was of 69,0 percent, the cheek was involved in the 25,9 percent. Epidermoid carcinoma accounted for the 85,0 percent and the diagnosed malignant neoplasm. There were not differences among sexes of referred patients and the more involved age rank was that from 34 to 59 years. The half of referred patients had smoking being higher in patients presenting with leukoplakia and malignant neoplasms. The anatomical locations more involved by the lesions were cheeks, gingiva and palate. The Grade I epidermoid carcinoma and the grade I clinical stage showed the higher percentages. Are needed further studies allowing to emphasize the success of PDBC and to correct the deficiencies preventing to fulfill appropriately the objectives(AU)

Lesiones gástricas preneoplásicas y helicobacter pylori en despistaje endoscópico para cáncer gástrico en población de nivel socioeconómico medio y alto / Preneoplastic gastric lesions and helicobacter pylori in endoscopic detection and early diagnosis of gastric cancer in a population of a medium and high socio-economic level

OBJETIVO: Estudiar la frecuencia y características de las lesiones gástricas preneoplásicas y su relación con el helicobacter pylori (HP). MÉTODO: Se realizó un estudio transversal retrospectivo en una población de nivel socioeconómico medio y alto participante en una campaña de despistaje de cáncer gástrico, desde enero a junio del 2008 en el Hospital Central de la FAP. Se evaluaron variables demográficas, clínicas y endoscópicas. RESULTADOS: De 2616 pacientes estudiados, 187 (7.1%) presentaron diagnostico histológico de lesiones gástricas preneoplásicas: 34 (1.3%) gastritis atrófica (GA), 55(%) metaplasia intestinal completa (MIC), 92 (3.5%) metaplasia intestinal incompleta (MII), y 6 (0.2%) displasia. La frecuencia de infección por HP fue de 76.5% (p=0.04), 65.5% (p=NS), 55.4% (p=NS) y 16.7% (p=0.03), en la GA, MIC, MII y displasia, respectivamente. La edad media de presentación fue similar entre las 4 lesiones: 53.5 (±9.3), 52.6 (±11.2), 54.3 (±7.8) y 54.2 (±12.1) años en la GA, MIC, MII y displasia, respectivamente. Las lesiones preneoplásicas fueron mas frecuentes en varones y menores de 60 años de edad (p=NS). No se encontró asociación entre las lesiones preneoplásicas y el antecedente familiar de cáncer gástrico, consumo de alcohol y tabaco (p=NS). CONCLUSIONES: La prevalencia de las lesiones gástricas preneoplásicas en nuestro estudio fue baja. La frecuencia de la infección por HP fue decreciente en las lesiones preneoplásicas mas avanzadas. Solo se encontró asociación entre la infección por HP y la gastritis atrófica y la displasia gástrica.

OBJECTIVES: To determine the prevalence and characteristics of premalignant gastric lesions and its relationship with helicobacter pylori infection. METHODS: We performed a cross-sectional retrospective study. Between january and june 2008, consecutive subjects of middle and high socioeconomic status were evaluated by upper gastrointestinal endoscopy during a gastric cancer screening in Central FAP Hospital. The demografic, clinic and endoscopic information were analysed. RESULTS: 2616 patients were evaluated. Diagnosis histological of premalignant gastric lesions was made in 187 patients (7.1%), 34 (1.3%) atrophic gastritis (AG), 55 (2.1%), complete intestinal metaplasia (CIM), 92 (3.5%) incomplete intestinal metaplasia (IIM), and 6 (0.2%) dysplasia. The frequency of helicobacter pylori infection was 76.5% (p=0.04), 65.5% (p=NS), 55.4% (p=NS) and 16.7% (p=0.03), in AG, CIM, IIM and dysplasia, respectively. The medianage of presentation was similar between the lesions: 53.5 (±9.3), 52.6 (±11.2), 54.3 (±7.8) y 54.2 (±12.1) years in AG, CIM, IIM and dysplasia, respectively. The premalignant gastric lesions were more frequent in male subjects and under 60 years (p=NS). There were no significant differences among the differents gastric premalignant lesions and family history of gastric cancer, smoking and alcohol consumption (p=NS). CONCLUSIONS. The prevalence of premalignant gastric lesions in our study was low. The frequency of H. pylori infection was decreased in premalignant lesions more advanced. Asociation significant was only found among H. pylori infection and AG and dysplasia.