Neoplasia intraepitelial escamosa cervical: abordagem por estimativas de risco / Cervical squamous intraepithelial neoplasia: risk estimation approach

As neoplasias intraepiteliais cervicais representam a fase pré-tumoral da neoplasia invasiva do colo uterino; são identificadas por citologia e testes de DNA-HPV e conduzidas por intervenções ambulatoriais. A perspectiva de estimativas de risco, para abordagem de tais lesões, constitui uma verdadeira mudança de paradigma, tendo em vista que as recomendações serão baseadas em riscos, não em resultados.(AU)

Cervical intraepithelial neoplasms represent the pre-tumor phase of invasive cervical cancer; identified by cytology, HPV-DNA testing and conducted by outpatient interventions. The perspective of risk estimates, to address such injuries, constitutes a true paradigm shift, considering that recomendations will be based on risks, not results.(AU)

Histerectomia radical após parto cesáreo por adenocarcinoma de colo uterino: relato de caso / Radical hysterectomy after c-section in cervical adenocarcinoma: a case report

Mundialmente, o câncer de colo uterino ocupa o quarto lugar das neoplasias em mulheres, porém, nos países em desenvolvimento, as taxas de incidência superam de forma impactante os casos de países desenvolvidos. Apesar de ser um evento incomum durante a gestação, é cada vez mais observado, o que talvez possa ser atribuído às gestações programadas em idades mais avançadas. O caso descrito refere-se a uma paciente de 32 anos de idade, diagnosticada no terceiro trimestre da gestação com adenocarcinoma de origem endocervical com estadiamento anatomopatológico final (FIGO 2018) 1B2. Ela foi submetida à abordagem cirúrgica como tratamento inicial. Foi adotada como conduta a resolução da gestação, com boa vitalidade fetal, ao final da 34ª semana, após corticoterapia para maturação pulmonar fetal. Foi realizado parto cesariano seguido de histerectomia radical tipo C1 na classificação de Querleu e Morrow associado a linfadenectomia pélvica, no mesmo ato operatório.(AU)

Worldwide, cervical cancer ranks fourth in female cancers, but when assessing data from developing countries, incidence rates are significantly higher than in developed countries. Although it is an uncommon event during pregnancy, it is increasingly observed, which may perhaps be justified due to pregnancies postponed at older ages. The case described relates to a 32-year-old woman diagnosed in the third trimester of pregnancy with endocervical adenocarcinoma, whose final anatomopathological staging (FIGO 2018) was IB2. The same was submitted to the surgical approach as an initial treatment. It was adopted as a conduct, the resolution of pregnancy, with good fetal viability, at the end of the 34th week, after corticosteroid therapy for fetal lung maturation. The patient underwent cesarean section followed by radical type C1 hysterectomy in the classification of Querleu and Morrow associated with pelvic lymphadenectomy in the same surgery.(AU)

Clinical significance of pancreatic intraepithelial neoplasia in resectable pancreatic cancer on survivals

PURPOSE: Noninvasive precursor lesions for pancreatic adenocarcinoma include pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm. PanIN is often found synchronously adjacent to resected pancreatic ductal adenocarcinoma (PDAC) tumors. However, its prognostic significance on outcome after PDAC resection is unknown. The purpose of the current study was to determine if the presence of PanIN has a prognostic or predictive effect on survival after resection for PDAC with curative intent. METHODS: We retrospectively reviewed the clinicopathologic data of patients who underwent pancreatectomy for PDAC from January 2002 to January 2013. Intraductal papillary mucinous lesions and mucinous cystic neoplasms were excluded. All available postoperative imaging and clinical follow-up data were reviewed. RESULTS: There were 95 patients who underwent pancreatectomy. Tumors were most commonly located in the pancreas head and as such pancreaticoduodenectomy was the most commonly performed operation. The median tumor size was 3.2 cm. An absence of PanIN lesions was identified in 39 patients (41%). Of the patients with PanIN lesions, high-grade PanIN (grade 3) was the most common type (64.3%) followed by grade 2 (28.6%). There was no significant difference in overall survival or disease-free survival between the non-PanIN and PanIN groups. CONCLUSION: The presence or absence of PanIN lesions did not affect survival in patients undergoing resection for pancreatic cancer. However, patients with high-grade PanINs tended to have better overall survival. Larger studies with longer follow up are needed to accurately determine its clinical significance.

Effects of esomeprazole on the healing process of post-endoscopic submucosaldissection gastric ulcers: a single arm, prospective trial / Journal of Rural Medicine

<p><b>Objectives:</b> Gastric endoscopic submucosal dissection (ESD) is currently astandard procedure. ESD enables <i>en-bloc</i> resection of large lesions, whileinducing larger artificial ulcers to a greater extent than conventional procedures.Several studies have reported that proton pump inhibitors (PPIs) prevent delayed bleedingand expedite the artificial ulcer healing process. Esomeprazole, an<i>S</i>-isomer of omeprazole, is reportedly one of strongest inhibitors ofgastric acid secretion. Previous studies have examined the effectiveness of esomeprazole.Our goal was to verify the effects of esomeprazole on artificial ulcers in a prospectivestudy.</p><p><b>Methods:</b> A total of 185 patients underwent ESD for gastric neoplasms at ourhospital between January 2013 and June 2015. Among these 185 patients, 49 post-ESD scarlesions were included in this prospective trial. First, 20 mg esomeprazole was orallyadministered to all subjects before and after the procedure. We then evaluated the delayedbleeding rate and ulcer scarring rates at 4 weeks and 8 weeks after the procedure by usinga gastric ulcer stage system.</p><p><b>Results:</b> There was one case of delayed bleeding (2.0%).Regardless of <i>Helicobacter pylori</i> infection status, ulcer scarring ratesat weeks 4 and 8 were respectively 28.6% (14/49) and 98% (48/49).</p><p><b>Conclusions:</b> Our resultssuggest that oral administration of esomeprazole alone may be sufficient for prompthealing of artificial gastric ulcers induced by ESD (UMIN000009367).</p>

Regresión de las lesiones escamosas cervicales intraepiteliales de alto grado en gestantes

Objetivos: Determinar la regresión colposcópica de las lesiones cervicales intraepiteliales de alto grado en gestantes. Diseño: Estudio observacional descriptivo, transversal. Institución: Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Perú. Participantes: Gestantes con diagnóstico de lesión cervical intraepitelial de alto grado - LIEAG (NIC II, NIC III, cáncer in situ). Intervenciones: Se procedió a la búsqueda en el software de anatomía patológica sobre los resultados de Papanicolaou con informe citológico de LIEAG, desde el año 2004 hasta 2008. Principales medidas de resultados: Regresión colposcópica de lesiones de alto grado en mujeres puérperas. Resultados: La distribución de las LIEAG difirió estadísticamente entre la muestra de Papanicolaou y la colposcopia, pero en ambas se mantuvo el orden de NIC II, III y cáncer in situ. Según la colposcopia, en el preparto la LIEAG más frecuente fue NIC II (83,3%), seguida de NIC III y cáncer in situ (15% y 1,7%, respectivamente). En el control posparto, 38,3% presentó un estudio colposcópico normal y los casos que continuaban siendo patológicos (61,7%) mostraron mejoría hacia lesiones de riesgo bajo, como NIC I (26,7%). Solo en 35% persistieron las lesiones de riesgo alto (NIC II, III, cáncer in situ, con 25%, 6,7% y 3,3%, respectivamente). Estas modificaciones de las LIEAG en el posparto fueron estadísticamente significativas. El parto vía vaginal se relacionó con menor persistencia de lesiones de riesgo alto, a diferencia de la vía cesárea. Destacó la mejoría del estudio colposcópico en las pacientes de 36 a más años de edad, las que habían tenido una sola pareja y en quienes iniciaron las relaciones sexuales después de los 20 años. Conclusiones: La regresión espontánea de las lesiones cervicales de grado alto en el posparto ocurrió en 65%, más en quienes fueron atendidas de parto vaginal, quienes tenían 36 años o más, las monógamas y quienes iniciaron relaciones sexuales después de los 20 años.

Objectives: To determine high-grade intraepithelial cervical lesions colposcopic regression in pregnant women. Design: Cross-sectional observational study. Setting: Hospital Nacional Docente Madre Niño San Bartolome, Lima, Peru. Participants: Pregnant women with high grade intraepithelial cervical lesion diagnosis - HSIL (CIN II, CIN III, cancer in situ). Interventions: Results of HSIL in Papanicolaou cytology reports from 2004 until 2008 were searched in Pathology Service software. Main outcome measures: Colposcopic regression of high degree lesions in puerperal women. Results: HSIL distribution was statistically different between Papanicolaou and colposcopy reports but both maintained CIN II, CIN III and cancer in situ order. According to colposcopy HSIL was more frequent than CIN II (83.3%) and cancer in situ followed by CIN III and cancer in situ (15% and 1.7% respectively). In post partum control 38.3% had normal colposcopy and 61.7% of cases remained pathological but presented improvement to low-risk lesions such as CIN I (26.7%). Only 35% persisted as high-risk lesions (CIN II, CIN III, cancer in situ: 25%, 6.7% and 3.3% respectively). These post partum changes were statistically significant. Birth by vaginal delivery was related to lower persistence of high risk lesions in the post partum compared to birth by caesarean section. Thirty-six and older women showed improvement in the post partum as well as those having a single sexual partner and beginning sexual relations after age 20. Conclusions: Post partum spontaneous regression of high degree cervical lesions occurred in 65% of puerperal women, more in those with vaginal delivery, 36 year-old or older, history of one sexual partner and beginning sexual relations after age 20.

Correlation of ER with Bcl-2 in cervical cancer and pre-cancerous lesion / 中国肿瘤临床

Objective:This study aimed to investigate the relationship between estrogen receptor (ER) and Bcl-2 in cervical can-cer and precancerous lesions. Methods:ER and Bcl-2 were evaluated by immunohistochemistry in 20 non-tumor tissues, 30 low-grade cervical intraepithelial neoplasias, 70 high-grade cervical intraepithelial neoplasias, and 80 cervical cancers. Results:The positive rate of ER was 75%in non-tumor tissues;this rate decreased with disease severity (χ2=24.266, P<0.01). The overexpression of ER protein was remarkably lower in cervical intraepithelial neoplasias (CIN) Ⅱ-Ⅲ and carcinomas than in non-tumorous cervices. Differences were not significant between CINⅠand non-tumorous cervices (χ2=0.751, P=0.386). Furthermore, ER expression was not correlated with histological type and tumor grade. The positive rate of Bcl-2 was 75.38%in squamous cell carcinoma. This rate increased with dis-ease severity (χ2=27.715, P<0.01). The Bcl-2 protein overexpression was remarkably higher in CINⅠ, CINⅡ-Ⅲ, and carcinomas than in non-tumorous cervices. Bcl-2 expression was also not correlated with histological type (P=0.500);by comparison, Bcl-2 expression was correlated with tumor pathological grade (χ2=4.862, P=0.027). The co-expression of ER and Bcl-2 was 38.57%and 15.38%in CINⅡ-Ⅲand squamous cell carcinoma, respectively;the differences between these two values were significant (χ2=9.108, P=0.003). A cor-relation between ER and Bcl-2 was observed in CINⅡ-Ⅲ(r=0.506, P<0.01);no correlation was observed between other groups. Con-clusion: ER expression was inversely correlated with Bcl-2 in cervical cancer progression. The co-expression of these markers may have an important function in the course of high-grade cervical intraepithelial neoplasia.

Respuesta inmune celular en pacientes con lesiones benignas y malignas del cuello uterino / Cellular immune response in patients presenting with benign and malignant lesions of cervix

Objetivo: estudiar parámetros inmunológicos en pacientes con lesiones intraepiteliales (NIC) y carcinoma in situ del cuello uterino en el Instituto Nacional de Oncología y Radiobiología durante el año 2009. Métodos: se realizó un estudio en 20 pacientes donde se determinaron las características inmunofenotípicas de los linfocitos de sangre periférica mediante citometría de flujo y la capacidad funcional frente a diversos mitógenos utilizando el método de síntesis de DNA. El análisis de correlación entre variables inmunológicas y epidemiológicas se realizó mediante el cálculo del coeficiente de correlación de Pearson. Para las pruebas estadísticas se utilizó el paquete estadístico SPSS (versión 11.5). Resultados: la subpoblación de los linfocitos Tc CD8+, mostró valores superiores estadísticamente significativos (p=0,004) solo para las pacientes con NIC I. En todas las pacientes, independientemente del estadio de la enfermedad y del mitógeno utilizado, los índices de estimulación (IE) resultaron inferiores a los valores del grupo control. Conclusión: las alteraciones en el sistema inmune en las pacientes con patología de cuello están asociadas al progreso de la enfermedad y las células T son fundamentales en el control de la progresión de las lesiones

Objective: To study the immunologic parameters in patients presenting with intraepithelial lesions (IEL) and carcinoma in situ of cervix in the National Institute of Oncology and Radiotherapy over 2009. Methods: A study was conducted in 20 patients to determine the immuno-phenotypical of lymphocytes in peripheral blood by flow-cytometry and the functional ability in face of diverse mitogen using the AND synthesis method. The correlation analysis among the immunologic and epidemiologic variables was carried out by an estimation of Pearson's correlation coefficient. For the statistic test the SPSS statistical package was used (version 11.5). Results: The subgroup of Tc + CD8 lymphocytes showed higher values statistically significant ( p= 0.004) only for patients presenting with IEL. In all patients, independently of disease stage and of the mitogen used, the stimulation rates (SR) were lower than the values of controls. Conclusions: The alterations in the immune system in patients with cervix pathology are associated with the progress of lesions

Prevalência dos genótipos do papilomavírus humano: comparação entre três métodos de detecção em pacientes de Pernambuco, Brasil / Prevalence of human papillomavirus genotypes: comparison between three detection methods in patients of Pernambuco, Brazil

OBJETIVO: comparar três métodos para detecção do HPV e determinar a prevalência dos genótipos encontrados. MÉTODOS: um total de 120 amostras de raspagem da região cervical de mulheres portadoras de neoplasia intraepitelial cervical foram analisadas pela reação em cadeia da polimerase convencional, usando os sistemas de primers MY09/11, GP05+/06+ e pela Nested-PCR. As amostras foram submetidas à extração de DNA e, logo após, amplificadas com os primers GH20 e PC04 (β-globina) para verificação da qualidade do DNA obtido e pela reação em cadeia da polimerase convencional e Nested-PCR. Os fragmentos amplificados foram visualizados em gel de agarose a 1,2 por cento, corados com Blue Green Loading Dye I. As amostras positivas foram sequenciadas usando o sequenciador automático de DNA "MegaBACE 1000". Para análise estatística foram utilizados os teste do Χ2 e o de Fisher com nível de significância de 5 por cento. RESULTADOS: quinze amostras não se amplificaram para os primers de β-globina, sendo eliminadas do estudo. Das amostras restantes, 40 por cento (42/105) foram positivas para os primers MY09/11, 98 por cento (103/105) para os primers GP05+/06+ e 92 por cento (97/105) para Nested-PCR. Considerado as técnicas MY09/11 e GP05+/06+, foi possível observar 100 por cento de amostras positivas para o HPV. Neste estudo, a prevalência dos genótipos foi de 58, 23, 5, 4 e 3 por cento para HPVs 16, 18, 31, 33 e 56, respectivamente. Os HPV 67 e 83 apresentaram 2 por cento e os HPV 6, 11, 58 e candHPV85, 1 por cento cada. A prevalência dos genótipos neste estudo está de acordo com o reportado em todo o mundo (IC95 por cento=0,4657-0,8976). CONCLUSÕES: para obter resultados mais confiáveis, é necessário o uso de mais que um sistema de primers para detecção do HPV. Acredita-se que as três técnicas estudadas são importantes e adequadas para o diagnóstico clínico do HPV quando apropriadamente combinadas.

PURPOSE: to compare three methods for the detection of HPV infection and to determine the prevalence of the genotypes found. METHODS: a total of 120 cervical scrape samples from patients with cervical intraepithelial neoplasia were analyzed by the conventional polymerase chain reaction using the MY09/11 and GP05+/06+ primers, and by the Nested polymerase chain reaction. The samples were subjected to DNA amplification with the GH20 and PC04 primers (β-globin) to verify DNA quality and also by polymerase chain reaction and Nested polymerase chain reaction. The amplicons were visualized in 1.2 percent agarose gel stained with Blue Green Loading Dye I. Positive samples also were sequenced using the automatic DNA sequencer "MegaBACE 1000". The Χ2 and Fisher tests were used for statistical analysis with the level of significance set at 5 percent. RESULTS: fifteen samples were eliminated from the study because they failed to amplify the β-globin gene. Of the remaining samples, 40 percent (42/105) were positive using primers MY09/11, 98 percent (103/105) using primers GP05+/06+, and 92 percent (97/105) using Nested-PCR. With the MY09/11 and GP05+/06+ techniques, it was possible to obtain 100 percent HPV-positive samples. In this study, the prevalence of the genotypes found was 57, 23, 5, 4 and 3 percent for HPV genotypes 16, 18, 31, 33 and 56, respectively. HPVs 67 and 83 were present in 2 percent, and genotypes 6, 11, 58 and candHPV85 were present in 1 percent each. The prevalence of the more common genotypes (HPV 16 and 18) in this study agrees with that reported worldwide (IC95 percent=0.4657-0.8976). CONCLUSIONS: to obtain more reliable results, it is necessary the use of more than one primer system to detect HPV infections. We believe that the three techniques studied are important and suitable for the clinical diagnosis of HPV, when they are appropriately combined.

Determinantes de la regresión de lesiones cervicales de bajo grado en una cohorte de mujeres colombianas / Determinants of LSIL regression in women from a colombian cohort

Objective: To analyze the role of Human Papillomavirus (HPV) and other risk factors in the regression of cervical lesions in women from the Bogotá Cohort. Methods: 200 HPV positive women with abnormal cytology were included for regression analysis. The time of lesion regression was modeled using methods for interval censored survival time data. Median duration of total follow-up was 9 years. Results: 80 (40%) women were diagnosed with Atypical Squamous Cells of Undetermined Significance (ASCUS) or Atypical Glandular Cells of Undetermined Significance (AGUS) while 120 (60%) were diagnosed with Low Grade Squamous Intra-epithelial Lesions (LSIL). Globally, 40% of the lesions were still present at first year of follow up, while 1.5% was still present at 5 year check-up. The multivariate model showed similar regression rates for lesions in women with ASCUS/AGUS and women with LSIL (HR= 0.82, 95% CI 0.59-1.12). Women infected with HR HPV types and those with mixed infections had lower regression rates for lesions than did women infected with LR types (HR=0.526, 95% CI 0.33-0.84, for HR types and HR=0.378, 95% CI 0.20-0.69, for mixed infections). Furthermore, women over 30 years had a higher lesion regression rate than did women under 30 years (HR= 1.53, 95% CI 1.03-2.27). The study showed that the median time for lesion regression was 9 months while the median time for HPV clearance was 12 months. Conclusions: In the studied population, the type of infection and the age of the women are critical factors for the regression of cervical lesions.

Objetivo: Analizar el papel del virus del papiloma humano (VPH) y otros factores en la regresión de lesiones del cuello del útero en mujeres de la cohorte de Bogotá, Colombia. Métodos: El tiempo medio de seguimiento fue nueve años. Se incluyeron 200 mujeres VPH positivas con citología anormal. El tiempo de regresión de lesión fue modelado mediante análisis de supervivencia censurando por intervalos. Resultados: 80 mujeres (40%) tuvieron células escamosas atípicas de significado indeterminado (ASCUS) o células glandulares atípicas de significado indeterminado (AGUS) y 120 (60%) tuvieron lesiones escamosas intraepiteliales de bajo grado (LEI-BG). El 40% de las lesiones estaban presentes en el primer año de seguimiento, mientras que el 1,5% aún estaba a los cinco años. Se observaron tasas similares de regresión para ASCUS/AGUS y LEI-BG (HR=0,82, IC 95% 0,59-1,12). Mujeres infectadas con VPH de alto riesgo y aquéllas con infecciones mixtas tuvieron tasas inferiores de regresión de las lesiones que las mujeres con VPH de bajo riesgo (HR=0,526, IC 95% 0,33-0,84, para los VPH de alto riesgo, y HR=0,378, IC 95% 0,20-0,69, para las infecciones mixtas). Las mujeres mayores de 30 años tuvieron una mayor tasa de regresión de lesiones que las menores de 30 (HR= 1,53, IC 95% 1,03-2,27). El tiempo medio de regresión de las lesiones fue 9 meses, y el tiempo medio para la eliminación del VPH fue 12 meses. Conclusiones: En la población estudiada, el tipo de infección y la edad de las mujeres son factores críticos para la regresión de lesiones cervicales.

Correlação entre a expressão da proteína p16 INK4a e o grau de neoplasia intraepitelial anal: uma revisão sistemática / Correlation between expression of p 16 INK4A protein and degree of anal intraepithelial neoplasia (ain): a systematic review

Objetivo: identificar pela revisão sistemática a expressão da proteína p16INK4a nos diferentes graus de neoplasias intraepiteliaisanais (NIA). Método: revisão sistemática de pesquisa nas bases de dados: PubMed, MedLine Old, MedLine,LILACS, SciELO e Science Direct. Foram excluídos artigos de revisão e que não correlacionavam a expressão dap16INK4a com o grau de NIA. Resultados: foram encontrados 483 artigos, dos quais 223 na PubMed, 151 na Medline,34 na Medline Old, 3 no Lilacs e 72 na Science Direct. Apenas cinco artigos foram selecionados baseados no critériode inclusão e exclusão. Conclusão: a proteína p16INK4a utilizada como marcador mostra-se eficaz para o diagnóstico deNIA, principalmente em lesões anais de alto grau.

Objective: to identify through a systematic review the expression of p16INK4a protein in different degrees of analintraepithelial neoplasia (AIN). Method: the review was realized through research on databases PubMed, MedLineOld, MedLine, LILACS, SciELO e Science Direct. Review articles and the ones without correlation between theexpression the p16INK4a with the level of AIN were excluded. Results: it were found 483 articles, which 223 inPubMed, 151 in Medline, 34 in Medline Old, 3 in Lilacs and 72 in Science Direct. Only five articles were selectedbased on inclusion and exclusion criteria. Conclusion: the p16INK4a protein used as a marker has shown to be effectivefor diagnostic of AIN, mainly in high-grade anal lesions.

Association of the E-cadherin gene polymorphism with cervical intraepithelial neoplasm and cervical cancer in Korean population / 대한산부인과학회지

OBJECTIVE: The aim of this study was to explore the association between E-cadherin promoter -160C>A polymorphism and the risk of cervical cancer and cervical intraepithelial neoplasm (CIN) in a Korean population. METHODS: We investigate 107 patients with histopathologically confirmed cervical cancer, 119 patients with histopathologically confirmed CIN and 112 control group women who were surgically proven to have normal cervices. The genetic distribution of E-cadherin promoter -160C>A polymorphism were analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products. RESULTS: We found no overall association between each individual E-cadherin promoter -160C>A genotype and the risk of cervical cancer and CIN. In the cervical cancer group, the allele frequency of C was 83.6%, in the control group 83.5%, showing no significant difference (p=0.941). Similarly, in the CIN group, the allele frequency of C was 81.9%, in the control group 83.5%, showing no significant difference (p=0.645). A subgroup analysis of the clinical parameters in CC, CA, AA genotype also showed no significant difference suggesting the lack of an association between E-cadherin promoter -160C>A polymorphism and cervix cancer stages (p=0.413), then its polymorphism and HPV infection (p=0.634). CONCLUSION: our results show that Korean women with specific polymorphism in E-cadherin promoter -160C>A are neither more susceptible to develop the cervical cancer or CIN nor more valuable for the cancer progression.

Correlation of adenoassociated virus type 2 and high-risk human papillomavirus type 16 and 18 infection in the cervix of Korean women / 대한산부인과학회지

OBJECTIVE: Previous studies were showed that adenoassocited virus (AAV) infection was had negative effects on human papillomavirus (HPV) infection and that the cervical cancer cell growth is inhibited by AAV infection. We detected of AAV 2 and high-risk HPV infection and researched correlation with AAV 2 and HPV in cervical cell. METHODS: Cell of normal cervix (49 persons), infected HPV cervix (45 persons), cervical intraepithelial neoplasm (CIN) I (31 persons), II (20 persons), III (35 persons), and invasive cancer (30 persons) were investigated by PCR using AAV-2 and HPV type 16 and 18 specific primers. RESULTS: AAV 2 was detected in 8 out of 49 normal cervix (16.3%), 2 out of 45 infected HPV cervix (4.4%), 3 out of 31 CIN I (9.7%), 4 out of 20 CIN II (20%), 8 out of 35 CIN III (22.8%), and 3 out of 30 invasive cervical cancer cases (30%). However, HPV 16 was detected in 5 out of 49 normal cervix (10.2%), 20 out of 45 infected HPV cervix (44.4%), 13 out of 31 CIN I (42%), 11 out of 20 CIN II (55%), 19 out of 35 CIN III (54.3%), and 21 out of 30 invasive cervical cancer cases (70%). HPV 18 was detected in 6 out of 49 normal cervix (12.2%), 18 out of 45 infected HPV cervix (40%), 16 out of 31 CIN I (51.6%), 10 out of 20 CIN II (50%), 22 out of 35 CIN III (62.8%), and 13 out of 30 invasive cervical cancer cases (43.3%). CONCLUSION: AAV 2 was detected in normal and infected HPV cervix, CIN (I, II, III) and invasive cervical cancer. As compared to normal, CIN I and CIN II, suggesting significant correlation between AAV 2 and HPV type 16. Further, researches continue to be done relationship to AAV 2 and HPV infection in cervix.

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.