A cervical cancer tissue-derived decellularized extracellular matrix scaffold for cervical cancer tissue reconstruction in vitro / 南方医科大学学报

OBJECTIVE@#The prepare decellularized extracellular matrix (ECM) scaffold materials derived from human cervical carcinoma tissues for 3D culture of cervical carcinoma cells.@*METHODS@#Fresh human cervical carcinoma tissues were treated with sodium lauryl ether sulfate (SLES) solution to prepare decellularized ECM scaffolds. The scaffolds were examined for ECM microstructure and residual contents of key ECM components (collagen, glycosaminoglycan, and elastin) and genetic materials by pathological staining and biochemical content analysis. In vitro 3D culture models were established by injecting cultured cervical cancer cells into the prepared ECM scaffolds. The cells in the recellularized scaffolds were compared with those in a conventional 2D culture system for cell behaviors including migration, proliferation and epithelial-mesenchymal transition (EMT) wsing HE staining, immunohistochemical staining and molecular biological technology analysis. Resistance to 5-fluorouracil (5-Fu) of the cells in the two culture systems was tested by analyzing the cell apoptosis rates via flow cytometry.@*RESULTS@#SLES treatment effectively removed cells and genetic materials from human cervical carcinoma tissues but well preserved the microenvironment structure and biological activity of ECM. Compared with the 2D culture system, the 3D culture models significantly promoted proliferation, migration, EMT and 5-Fu resistance of human cervical cancer cells.@*CONCLUSION@#The decellularized ECM scaffolds prepared using human cervical carcinoma tissues provide the basis for construction of in vitro 3D culture models for human cervical cancer cells.

Role of Ki-67 and Argyrophilic Nucleolar Organiser Region (AgNoR) Counts in Squamous Cell Carcinoma

Background: Squamous cell carcinoma of the cervix is the most common subtype of cervical cancer and it usually accounts for 80-90% of the cases. These carcinomas mostly grow at the squamocolumnar junction (SCJ). The tumour tends to grow outward showing an exophytic growth especially at the squamocolumnar junction outside the external uterine wall whereas cancer tends to grow along the cervical canal showing an endophytic growth pattern where the SCJ is located within the cervical canal. This study has experimentally shown the role of AgNOR and Ki-67 scores in tumour proliferation. Methods: Cervical specimens were obtained and prepared in a specified fashion as described. The samples were de-waxed and staining was done with AgNOR. Then, the AgNOR was counted and scoring was done. Again, the samples were also stained with Ki-67. Results: This study has included 235 cases from the Department of Pathology of Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, India. The mean value of AgNOR count in the Control group came to be 10.62�45 while the mean AgNOR count was found to be 10.62�45, 15.10�79, 18.39�67, 19.75�74 and 19.59�59 for in-Situ SCC, well-differentiated SCC, moderately differentiated SCC, poorly differentiated SCC, SCC with basaloid differentiation, respectively. Conclusion: The study confirmed that AgNOR count increases with a higher grade of malignancy. It was concluded that AgNOR and Ki-67 scores can be used as an efficient predictor of tumour proliferation.

Infection with high-risk genotypes of human papillomavirus and cervical cytological findings among kidney transplant recipients in Kenya: a single centre experience

Background: High-risk human papillomavirus (hrHPV) infection is linked with uterine cervix premalignant lesions and invasive carcinoma of the uterine cervix. Methods: Descriptive cross sectional study carried out among female kidney transplant (KTx) recipients in Kenyatta National Hospital, Nairobi-Kenya. We studied the risk factors for acquisition of hrHPV, examined cervical cytology and assayed for 14 hrHPV DNA using Cervista® HPV HR test and Cervista® MTA (Hologic®) automated platforms. Results: The 14-hrHPV genotypes assayed were 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 and the prevalence rate was 31.25 % (10/32). Abnormal cervical cytology was noted in 4/32 (12.5%) and included low-grade squamous intraepithelial lesion (2/32), atypical squamous cells of undetermined significance (1/32) and atypical glandular cells (1/32). The average age was 41.9years with mean age at first coitus being 20.4 years. Majority of the women 20(62.5%) were married while 8(25%) were single. About 18(56.3%) had only one sexual partner. About 20% of women were nulliparous and 4(12.5%) had a parity of five. Duration sincetransplantation ranged between 1-21 years. Conclusions: The burden of hrHPV and abnormal cervical cytology in our study seemed lower than that reported elsewhere and even in general population. This study may form basis for further studies about HPV infections and carcinoma of the uterine cervix among the kidney allograft recipients in our setting

LINC00649 Regulates Endoplasmic Reticulum Stress-mediated Cervical Carcinoma Cell Apoptosis via miR-424-5p/IGF1R Axis / 肿瘤防治研究

Objective To explore the effects of LINC00649/miR-424-5p/IGF1R on ERs-mediated apoptosis of cervical carcinoma (CC) cells. Methods CC-related data was obtained from GEO database, then the differentially-expressed miRNAs were analyzed. The bioinformatics database was used to predict the upstream and downstream targets of miR-424-5p. LINC00649 and IGF1R were included. Dual luciferase reporter assay was adopted to confirm the targeting relationship. qRT-PCR was used to detect the expression levels of LINC00649, miR-424-5p and IGF1R in CC tissue and cells. CCK-8 and flow cytometry were used to evaluate the proliferation and apoptosis of CC cells. Western blot was used to detect the expression of ERs-related proteins GRP78, CHOP and Caspase-12. Results Compared with paracancerous tissue and H8 cells, LINC00649 and IGF1R were up-regulated in CC tissue and cells, while miR-424-5p was down-regulated (both P < 0.05). The abnormally high expression of LINC00649 in CC was related to poor prognosis. The knockdown of LINC00649 inhibited CC cell viability and induced cell apoptosis by promoting ERs (all P < 0.05). LINC00649 upregulated the expression of IGF1R via absorbing miR-424-5p. miR-424-5p inhibitor or IGF1R overexpression partially reversed the effects of LINC00649 knockdown on CC cells (both P < 0.05). Conclusion LINC00649 could reduce cell apoptosis and improve cell viability by inhibiting the ERs process via regulating miR-424-5p/IGF1R axis in CC.

Rectovaginal fistula: An early complication of radiotherapy in a sexagenarian with cervical cancer

A 62-year-old Nigerian woman was admitted on account of cervical carcinoma Stage IV and was requested to undergo radiotherapy and chemotherapy. Six weeks after commencing this treatment she starting passing feces involuntarily through the vagina. Imaging studies revealed a high sited, medium sized, and rectovaginal fistula (RVF). RVFs have been documented as a late complication of radiotherapy for any gynecological malignancy but it occurred earlier in this patient. A preliminary surgical procedure, a sigmoid-ostomy, was performed successfully and a definitive surgery, a sigmoido-rectal anastomosis, was planned to be done in 18 months after the diagnosis of the RVF but the patient died shortly after the first procedure. The present case indicates that a RVF can occur as an early complication of radiotherapy even when it presents with mild symptoms.

Expression of PKCι/YAP1 in Cervical Cancer and Its Clinical Significance / 肿瘤防治研究

Objective To investigate the role of PKCι, YAP1 and high-risk HPV infection in the local immune microenvironment of cervical cancer. Methods We chose 80 cases of normal tissue of the cervix (NCT), cervical low-grade squamous intraepithelial lesion (LSIL), cervical high-grade squamous intraepithelial lesion (HSIL) and early cervical squamous cell carcinoma (SCC) each. Four groups were collected.The infection rate of high-risk HPV in four groups was determined by real-time fluorescence PCR method. The expression levels of PKCι, YAP1, CD4 and CD8 in four groups were measured and correlated by IHC and clinicopathologic features were also analyzed. Results The differences of high-risk HPV infection rate and PKCι, YAP1, CD4, CD8 positive rate among groups of NCT, LSIL, HSIL and SCC had statistical significance (P < 0.05). The level of cervical lesions was positively associated with high-risk HPV infection and positive PKCι, YAP1, CD8 expression (P < 0.05), while negatively associated with positive CD4 expression (P < 0.05). HPV infection and positive PKCι, YAP1, CD8 expression were positively correlated with each other in SCC, while were all negatively correlated with positive CD4 expression(P < 0.05). The differences of HPV infection, PKCι, YAP1 and CD8 positive expression were significant in different levels of differentiation and vascular invasion of SCC (P < 0.05). Conclusion The patients with cervical lesions are often accompanied by high-risk HPV infection and abnormal expression of PKCι, YAP1, CD4 and CD8, which may have synergistic effects on each other, causing the local immunosuppression microenvironment of SCC. It provides a possible strategy for the study of pathogenesis, diagnosis and treatment of cervical cancer.

Value of Endocervical Curettage in Detection of High-grade Cervical Squamous Intraepithelial Lesion / 肿瘤防治研究

Objective To explore the value of endocervical curettage (ECC) in the detection of high-grade cervical squamous intraepithelial lesion (HSIL). Methods We retrospectively analyzed the clinical features and colposcopical characteristics of 678 female patients with complete clinical data. Results Among 678 cases, 391 cases were confirmed by cervical biopsy only and 7 cases by ECC only (57.67% vs. 1.03%, P < 0.001). ECC checked out 287 HSIL patients (42.33%, including cervical biopsy positive and negative cases) and cervical biopsy checked out 671 HSIL cases (98.97%, including ECC positive and negative cases). There were 68 positive ECC cases in the conversion area of Type 1+Type 2 and 247 positive ECC cases in the conversion area of Type 3(33.33% vs. 52.11%, P < 0.001). The positive rates of ECC in patients≥45 years old and < 45 years old were 145 and 170, respectively (55.13% vs. 40.96%, P < 0.001). Conclusion The cervical biopsy plays a dominant role in the detection of HSIL, and ECC can only be used as a supplement to it. Female patients older than 45 years or with Type 3 transformation zone examined by colposcopy should be concerned with cervical lesions.

A rare case of a primary signet-ring cell carcinoma of the cervix / Philippine Journal of Obstetrics and Gynecology

@#A 44‑year‑old woman presented with an abnormal vaginal discharge. She was initially diagnosed with cervical intraepithelial neoplasia‑1 through Papanicolaou smear and was managed with cryotherapy and completed human papillomavirus vaccinations. Nine years later, gynecologic examination showed a cervical mass, and biopsy revealed a signet‑ring cell‑type mucinous adenocarcinoma. Extensive systemic evaluation performed revealed no other malignancies. Radical hysterectomy was performed, and final pathology report showed a primary signet-ring cell cervical carcinoma stage 1B2. Concurrent chemotherapy with adjuvant external beam radiation therapy was then given. The patient has no evidence of disease for 24 months now since diagnosis. Primary signet‑ring cell carcinoma of the cervix is rare. It is diagnosed when no other tumor is found in extragenital sites, histology consists of signet‑ring morphology, tumor includes areas of adenocarcinoma in situ, and case has a prolonged survival. Overall patient education plays a vital role in management.

Evaluation of unhealthy cervix by Pap smear and colposcopy guided biopsy

Cancer of cervix ranks as the third common malignancy in females worldwide. In developing countries like India, carcinoma cervix is the second commonest malignancy affecting females. India accounts for 18% of the global burden of carcinoma cervix. To address the above problem a literature review was done using search engines like PubMed, Google scholar etc to evaluate the unhealthy cervix by comparison of Pap smear and colposcopy guided biopsy.

A comparative study of Pap smear and colposcopy guided biopsy in the evaluation of unhealthy cervix

Background: Cancer of cervix ranks as the third common malignancy in females worldwide. In developing countries like India, carcinoma cervix is the second commonest malignancy affecting females. In India, every year 1,26,000 new cases are identified and 67,477 deaths occur due to cervical carcinoma. Cervical carcinoma affects women of age 15-44 years and disease peaks at 55-66 years. On average, Indian women have a 2.5% risk of developing carcinoma cervix. It was estimated worldwide that every 5th woman, who suffer from cervical cancer belongs to India.Methods: A comparative study which included 110 married women of age 20 to 65 years. Women who presented with white discharge, lower abdominal pain, post coital bleeding and post-menopausal bleeding were subjected to Pap smear and colposcopy guided biopsy.Results: A total 53.6% women had inflammatory smear, followed by 34.5% women with normal Pap smear, 0.1% women had bacterial vaginosis, 6.4% women had LSIL and 4.5% women had HSIL. Authors found that 63.6% women had chronic cervicitis. 15.4% had chronic endo papillary cervicitis, 13.6% had CIN 1, 5.4% women had CIN 2 and 1.8% women had squamous cell carcinoma. Association of Pap smear with histopathology is statistically significant (p value <0.001).Conclusions: Pap smear can be used as screening test for detecting premalignant lesions of cervix. Colposcopy guided cervix biopsy has got better specificity than Pap smear, so all symptomatic women should be subjected to colposcopy guided cervix biopsy to detect carcinoma at early stage.

Study on Reversal Effects of Levoshikonin on Cisplatin Resistance of Human Cervical Carcinoma HeLa Cells / 中国药房

OBJECTIVE：To investigate the reversal effects and potential mechanism of levoshikonin （L-SHK）on cisplatin （DDP）resistance of human cervical carcinoma HeLa cells. METHODS ：Human cervical carcinoma HeLa cells were used as research objects ，and drug-resistant HeLa/DDP cells were induced by DDP. CCK- 8 assay was used to determine drug resistance index of HeLa/DDP cells ，the inhibition rate of different doses of L-SHK （0.125，0.25，0.5，1，2，4，8，16 μmol/L）on cell proliferation，IC50 and the reversion index of L-SHK on HeLa/DDP cells. Effects of low ，medium and high doses of L-SHK （0.3， 0.6，1.2 μmol/L）combined with DDP on cell cycle and apoptosis rate were determined by flow cytometry. Western blotting assay was used to detect the effects of low ，medium and high doses of L-SHK （0.3，0.6，1.2 μmol/L）combined with DDP on the expression of apoptosis-related protein （Cleaved caspase- 3，Bcl-2 and Bax ）. RESULTS ：The drug resistance index of HeLa/DDP cells was 11.8. The inhibition rate of L-SHK on HeLa/DDP cells increased with the increase of dose. Compared with DDP alone ， IC50 of DDP+low-dose ，medium-dose and high-dose L-SHK groups were decreased significantly ，with a dose-dependent manner （P＜0.05）. The reversion indexes were 1.38，2.80，6.71 in DDP+low-dose ，medium-dose and high-dose L-SHK groups. Compared with blank control group ，the proportion of cells at phase G 0/G1 and phase S in administration groups ，as well as early and late apoptosis rate and total apoptosis rate of cells ，the protein expression of Bax and Cleaved caspase- 3 in L-SHK combination groups were increased significantly ；the proportion of cells at phase G 2/M in administration group as well as the protein expression of Bcl-2 in L-SHK combination groups were decreased significantly （P＜0.05）. Compared with DDP group ，the proportion of cells at phase S and G 2/M and the protein expression of Bcl- 2 in L-SHK combination groups were significantly decreased ；the proportion of cells at phase G 0/G1，early and late apoptosis rate and total apoptosis rate ，the protein expression of Bax and Cleaved caspase- 3 in L-SHK combination groups were significantly increased （P＜0.05）. CONCLUSIONS ：HeLa/DDP cells are resistant to DDP ，and L-SHK can reverse the drug resistance. L-SHK combined with DDP can promote the apoptosis of HeLa/DDP cells ，which is better than DDP alone. Its mechanism may be related to the influence of cell cycle and the regulation of apoptosis-related protein expression.

FIGO 2018 staging of cervical cancer and related issues / 中华肿瘤杂志

Globally, cervical cancer continues to be one of the most common cancers among females. Although screening for cervical cancer has been gradually carried out, the incidence and mortality of cervical cancer in China are still at a high level. So the prevention and treatment of cervical cancer in China still has lots of work to do. The International Federation of Obstetrics and Gynecology (FIGO) gynecological oncology committee revised the staging of cervical cancer in 2018. The new staging changed in terms of stage ⅠB and stage Ⅲ compared with previous FIGO staging. FIGO also provided prevention and treatment strategies and the treatment regimens of each stage, which had an important impact on the prevention and treatment of cervical cancer as well as an important enlightenment for China.

LC-MS/MS-based screening of new protein biomarkers for cervical precancerous lesions and cervical cancer / 南方医科大学学报

OBJECTIVE@#To screen potential plasma protein biomarkers for the progression of cervical precancerous lesions into cervical carcinoma and analyze their functions.@*METHODS@#Plasma samples obtained from healthy control subjects, patients with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), cervical cancer (CC), and patients with CC after treatment were enriched for low-abundance proteins for liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. The MS data of the samples were analyzed using Discoverer 2.2 software, and the differential proteins (peptide coverage ≥20%, unique peptides≥2) were screened by comparison of LSIL, HSIL and CC groups against the control group followed by verification using target proteomics technology. Protein function enrichment and coexpression analyses were carried out to explore the role of the differentially expressed proteins as potential biomarkers and their pathological mechanisms.@*RESULTS@#Compared with the control group, both LSIL group and HSIL group showed 9 differential proteins; 5 differentially expressed proteins were identified in CC group. The proteins ORM2 and HPR showed obvious differential expressions in LSIL and HSIL groups compared with the control group, and could serve as potential biomarkers for the progression of cervical carcinoma. The expression of F9 increased consistently with the lesion progression from LSIL to HSIL and CC, suggesting its value as a potential biomarker for the progression of cervical cancer. CFI and AFM protein levels were obviously decreased in treated patients with CC compared with the patients before treatment, indicating their predictive value for the therapeutic efficacy. Protein function enrichment analysis showed that all these differentially expressed proteins were associated with the complement system and the coagulation cascades pathway.@*CONCLUSIONS@#We identified 5 new protein biomarkers (F9, CFI, AFM, HPR, and ORM2) for cervical precancerous lesions and for prognostic evaluation of CC, and combined detection of these biomarkers may help in the evaluation of the development and progression of CC and also in improving the diagnostic sensitivity and specificity of cervical lesions.

In vitro study of black phosphorus quantum dot-loaded liposomes for photothermal therapy of cervical cancer / 药学学报

In this study, black phosphorus quantum dots (BPQDs)-loaded liposomes (liposome-BPQDs) were prepared to explore physicochemical properties and photothermal effects on cervical cancer cells. BPQDs were fabricated by ultrasonic method. Liposome-BPQDs were prepared by thin film dispersion. Surface morphology, particle size, zeta potential and Raman spectra of liposome-BPQDs were characterized. The cytotoxicity of the liposome-BPQDs against human cervical cancer cells (HeLa) was examined by CCK-8 assay. Confocal laser scanning microscope (CLSM) and fluorescence microscopy were used to observe the uptake and apoptosis of HeLa cells. The results indicated that liposome-BPQDs were ellipsoidal or spherical under scanning electron microscope, TEM observation showed liposome-BPQDs were about 90-110 nm in diameter. The particle size measurements showed liposome-BPQDs were (104.2±0.35) nm in diameter, and zeta potential were examined to be (-11.3±3.01) mV. The encapsulation efficiency was (84.40±2.13)%.Under natural conditions with outdoor ventilation, temperature range of 25 ℃-34 ℃ and relative humidity of 80%-82%, the photothermal effects of liposome-BPQDs was better and the degradation denaturation of liposome-BPQDs were slower than those of BPQDs. The results also reflected that liposome-BPQDs could be uptaken by HeLa cells easily. After near-infrared laser irradiation, the mortality of HeLa cells rise significantly when the amount of BPQDs reach 20 μg·mL-1. In summary, liposome-BPQDs with high stability exhibited good photothermal effects, which can be expected to be applied to photothermal therapy of cervical carcinoma.

Relationship between the expression of DcR3 and high-risk human papilloma virus infection in cervical carcinoma / 中华疾病控制杂志

@# Objective To explore the relationship between the expression of decoy receptor 3 (DcR3) and high-risk human papilloma virus(HR-HPV)infection in cervical carcinoma. Methods Immunohistochemistry and hybird capture Ⅱ assay were used to detect the expression of DcR3 and HR-HPV in 35 cases of normal cervical tissues(NCE), 39 cases of cervical intraepithelial neoplasm(CIN)and 44 cases of cervical squamous epithelial carcinoma(CSES). Specific HR-HPV16 E7 siRNA and nonspecific HR-HPV16 E7 siRNA were synthesized and transfected to SiHa cells by Lipofectamine. The expression of DcR3 at mRNA and protein levels was examined by real-time polymerase chain reaction and western blot. The growth inhibition was examined by MTT assay. Results In NCE, CIN and CSES, the positive expression rates of DcR3 were 8.6%(3/35), 48.7%(19/39)and 77.3%(34/44), respectively, and the expression intensity was increasing(2=36.942, P<0.001). In NCE, CIN and CSES, the infection rates of HR-HPV were 5.7%(2/35), 56.4%(22/39)and 93.2%(41/44), respectively(2=60.322, P<0.001) . The protein expression of DcR3 was positively correlated with the infection of HR-HPV in CSES(r=0.893, P=0.004). Conclusions DcR3 was highly expressed in cervical cancer. Its expression was positively correlated with HR-HPV infection, which may contribute to the occurrence and development of cervical cancer. HR-HPV silencing inhibited cellular growth and proliferation by down-regulating the expression of DcR3.

Expression of TC1 and β-catenin in Cervical Carcinoma and Precancerous Lesions and Their Significance / 中国医科大学学报

Objective To investigate the expression of thyroid cancer-1 (TC1) and β-catenin in cervical carcinoma and precancerous lesions and their significance. Methods Immunohistochemical methods were used to examine the expression of TC1 and β-catenin in80 cervical squamous cell carcinoma (CSCC) tissues, 40 high-grade squamous intraepithelial lesions (HSIL), 40 low-grade squamous intraepithelial lesions (LSIL), and 30 normal cervical tissues. Results Although TC1 expression in CSCC was significantly higher than that in LSIL (P = 0.002) and normal cervical tissues (P ＜ 0.001), it was similar to that in HSIL (P = 0.576). TC1 expression was positively correlated with poor differentiation (P = 0.005) and advanced FIGO stage (P = 0.004) in CSCC. β-catenin expression in CSCC was significantly higher than that in LSIL (P ＜ 0.001) and normal cervical tissues (P ＜ 0.001), but was similar to that in HSIL (P = 0.907). The abnormal β-catenin expression was also correlated with poor differentiation (P = 0.025) and advanced FIGO stage (P = 0.001) in CSCC. TC1 expression was positively correlated with the abnormal β-catenin expression in CSCC (r = 0.294, P = 0.008) and cervical squamous intraepithelial lesions (r = 0.549, P ＜ 0.001). Conclusion TC1 and β-catenin expression in CSCC and HSIL was significantly higher than that in LSIL and normal cervical tissues. TC1 expression correlated with the abnormal β-catenin expression, and with poor differentiation and advanced FIGO stage of CSCC.

Histopathological and cytopathological findings comparison in cervical lesions at tertiary care center

Introduction: Cervical cancer is the major health burden in India. For detection in early stage, the screening test is Pap smear. To check the sensitivity and specificity of Bethesda system, the cytological findings have to be correlated with histology considering histopathology as gold standard. Materials and methods: This was a retrospective study conducted in Pathology Department of at tertiary care center; Saraswati Institute of Medical Science (SIMS), Hapur. Cytopathological findings were correlated with corresponding follow-up histopathological findings using revised 2014 Bethesda System. Results: Most of patients were of age group 41-50 years which was 56 (37.33%), followed by the age group 51-60 years which was 40 (26.67%). Majority cases were of parity 3 which were 51 cases (34%) followed by parity 4 which were 40 (26.67) with mean parity of patient being 3.30. Conclusion: The Pap smear has good sensitivity and specificity in detecting pre-neoplastic lesions of uterine cervix and it is cost effective too.

Study of p53 Expression in Carcinoma Cervix and Normal Cervical Epithelium

Introduction: Cervical carcinomas are one of the leading causes of mortality in women worldwide and various screening methods are developed for early detection, which includes clinical, pathological and molecular methods. Biomarker- p53 protein is useful in differentiating neoplastic from non-neoplastic and CIN lesions and the p53 expression is also a prognostic marker for cervical carcinoma as it correlates with other clinico-pathological prognostic parameters. Aim and objectives: To study expression of p53 in cervical carcinomas of various histological types and normal cervical epithelium and Correlation of p53 expression with the histopathological grade of cervical carcinomas. Materials and methods: 40 cases of cervical biopsy/ hysterectomy specimens of carcinoma cervix and 20 cases of hysterectomy specimens for other gynecologic causes received at department of pathology, CAIMS, Karimnagar from January 2014 to October 2015 were examined for gross and microscopic features. Immunohistochemistry was used to study the p53 expression in normal and neoplastic cervical epithelium. The p53 expression was correlated with various clinicopathological prognostic parameters. Results: Of the 40 cases of carcinoma cervix, 80% cases showed p53 positivity. The predominant histological type of carcinoma cervix positive for p53 was moderately differentiated squamous cell carcinoma (SCC). One out of three cases of Adenocarcinoma (ADC) was p53 positive. The single case of CIN III showed p53 positive cells in all the layers of squamous Radhika Mucharla, Pingle Prathyusha, Geeta Voolapalli, T. Ravinder, Vemula Sreenivas. Study of p53 Expression in Carcinoma Cervix and Normal Cervical Epithelium. IAIM, 2019; 6(7): 37-48. Page 38 epithelium. The p53 positivity showed a statistically significant association with the microscopic type of carcinoma cervix (p value=0.019). The p53 positivity increased with the age, parity, clinical stage and grade of the disease. Conclusion: The expression of p53 was high in premalignant cervical lesion in invasive cervical carcinoma compared to normal cervical epithelium. Our study indicates that p53 is a powerful prognostic marker.

Role of Pap smear in detection of precancerous lesions of cervix-A case study

Background: The pap smear is the screening test for the detection of premalignant lesion of the cervix. It should be done annually in all women of age 35 years and above. Pap smear screening of cervix can significantly reduce the deaths due to cervical carcinoma. Materials and methods: This was a prospective and descriptive study done for the period of 6 months from February 2018 to July 2018. A total of 158 women above the age of 21 years and married were included in the study. A Pap smear test was done after clinical examination in all women and sent to the department of Pathology of our tertiary care centre for cytopathological examination. Results: There were 150 cases with inflammatory smear, 2 cases of ASCUS, 3 cases of LSIL and 3 cases of HSIL. Women who were positive for ASCUS, LSIL and HSIL underwent colposcopy and guided biopsy. Most women with inflammatory smear were of age group 20-40 years, 2cases of ASCUS were of ages 35 years and 38 years, 3cases of LSIL were of age group 35-45 years and 3 cases of HSIL were of age group 45-55years. Conclusion: Thus cervical cancer is a preventable cancer if regular Pap smear screening test is done. It is simple, cost effective, non-invasive and easy to perform screening test for precancerous lesions of cervix.

Role of Neoadjuvant Chemotherapy followed by Concurrent Chemo-radiation in Locally Advanced Cervical Carcinoma: Our Experience

Background: Cervical carcinoma is the second most common cancer in females in India. Majority of them are reported in advanced stage. We have given platinum based neoadjuvant chemotherapy followed by CTRT in our study to reduce the local recurrence and decrease the tumor burden. The primary objective of our study was to assess the efficacy of NACT in terms of clinical and radiological response at the end of completion of treatment. Methods: This was a single arm prospective study in which we enrolled 79 patients from  2015-2017 who received 3 cycles of NACT, triweekly Cisplatin and 5-FU followed by concurrent chemo radiation (Radiotherapy-External beam radiotherapy 50Gy/25# plus intracavitary brachytherapy). Response was assessed at 12 weeks of completion of treatment by MRI pelvis using RECIST criteria 1.1 and toxicities were assessed weekly using CTCAE 4.03. Results: Mean age was 54 years; compliance rate was 88.6%. Complete response rate was 58.57% and partial response rate was 18.57% at 12 weeks post-treatment. Grade 2 or higher toxicities were seen in 52.85% patients during NACT and chemo radiation. Skin toxicities were seen in 37.14% followed by rectal-32.85%, haematological-27.14% and urinary bladder-24.28%. Conclusions: Neoadjuvant chemotherapy followed by Concurrent chemo radiation is a feasible treatment option with a good response rate with acceptable rate of treatment related toxicities.