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1.
Femina ; 50(1): 35-50, 20220131. ilus
Article in Portuguese | LILACS | ID: biblio-1358220

ABSTRACT

As neoplasias intraepiteliais cervicais correspondem a alterações identificadas por rastreamento citológico cervical e estudo histológico, pós-biópsia incisional guiada por colposcopia ou procedimento diagnóstico excisional. Podem ser tratadas com abordagens conservadoras e procedimentos excisionais. A vacinação anti-HPV e o tratamento excisional oportuno constituem, respectivamente, prevenção primária e secundária contra o câncer do colo uterino.(AU)


Cervical intraephitelial neoplasms correspond to changes identified by cervical citological screening and histological study, post-incisional biopsy guided by colposcopy or excisional diagnostic procedure. They can be treated with conservative approaches and excision procedures. Anti-HPV vaccination and timely excional treatment are primary and secondary prevention against cervical cancer, respectively.(AU)


Subject(s)
Humans , Female , Cervix Uteri/cytology , Cervical Intraepithelial Neoplasia/surgery , Cervical Intraepithelial Neoplasia/diagnosis , Squamous Intraepithelial Lesions/surgery , Squamous Intraepithelial Lesions/diagnosis , Squamous Intraepithelial Lesions/diagnostic imaging , Cervical Intraepithelial Neoplasia/diagnostic imaging , Colposcopy , Conization/instrumentation , Papillomavirus Infections/pathology , High-Intensity Focused Ultrasound Ablation , Hysterectomy
2.
Article in English | LILACS | ID: biblio-1369046

ABSTRACT

Introduction: Cervical cancer is the third most common malignant tumor in the female population and the fourth cause of death from cancer in women in Brazil. The squamocolumnar junction and the transformation zone concentrate 90% of pre-invasive and invasive cervical lesions. Objective: To evaluate the prevalence of cytology without cells of the squamocolumnar junction and feasibility of active search. Methods: Cross-sectional study at a university hospital between 2017 and 2018. The prevalence of cytology without squamocolumnar junction cells was calculated. A convenience sample was obtained and mean age and relationship with presence of transformation zone cells were calculated. An active search was performed and cytology collected, with estrogen preparation if indicated. Medical records of the other women were analyzed. Results: Squamocolumnar junction cells were not found in 28.84% of samples. Mean age was 53 years, without association with presence of squamocolumnar junction cells (p=0.409). Seventy-six women returned, 36 of which (47.37%) used estrogen. Level 2 or 3 cervical intraepithelial neoplasia, microinvasive carcinoma or cancer was not identified. A total of 134 medical records were analyzed; only 36 women (26.87%) completed screening. Conclusions: The presence of squamocolumnar junction cells indicates quality of cytology; the use of estrogen in postmenopausal women favors its collection. There were difficulties in active search. An immediate repetition of cytology should be considered.


Introdução: O câncer de colo uterino é o terceiro tumor maligno mais frequente na população feminina e a quarta causa de morte de mulheres por câncer no Brasil. A junção escamo-colunar e a zona de transformação concentram 90% das lesões pré-invasoras e invasoras cervicais. Objetivo: Avaliar prevalência de colpocitologias sem células da junção escamo-colunar e a viabilidade de busca ativa. Métodos: Estudo transversal em hospital universitário entre 2017 e 2018. Calculada prevalência de citologias sem células da junção escamo-colunar. Obtida amostra por conveniência, calculada média de idade e relação com a presença da junção escamo-colunar. Realizada busca ativa e colhidas citologias com preparo estrogênico, se indicado. Analisados os prontuários das demais mulheres. Resultados: A prevalência de ausência de células da junção escamo-colunar foi de 28,84%. A média de idade foi 53 anos, sem associação com presença da junção escamo-colunar (p=0,409). Retornaram 76 mulheres e 36 (47,37%) usaram estrogênio. Não identificamos neoplasia intraepitelial cervical graus 2 ou 3, carcinoma microinvasor e câncer. Analisados 134 prontuários, dos quais apenas 36 mulheres (26,87%) concluíram o rastreio. Conclusões: A presença de células da junção escamo-colunar indica qualidade da coleta, e o uso de estrogênio na pós-menopausa favorece sua obtenção. Houve dificuldade de busca ativa. A repetição imediata da citologia deve ser considerada.


Subject(s)
Humans , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Women , Carcinoma , Prevalence
3.
HU rev ; 48: 1-9, 2022.
Article in Portuguese | LILACS | ID: biblio-1371597

ABSTRACT

Introdução: O diagnóstico precoce e referenciamento ao serviço especializado são essenciais para melhorar as taxas de cura e sobrevida das mulheres acometidas pelo câncer de colo de útero. Assim, a realização deste estudo tornará possível o levantamento de informações que serão essenciais para o desenvolvimento de medidas preventivas, que almejam contribuir com o desenvolvimento de ações de educação em saúde e o diagnóstico precoce para reduzir a morbimortalidade dessa enfermidade. Objetivo: Identificar o perfil dos resultados dos exames citopatológicos do colo do útero de mulheres residentes no estado de Minas Gerais a partir dos dados de exames correspondentes ao ano de 2019, utilizando as variáveis disponibilizadas pelo Sistema de Informação do Câncer. Métodos: Trata-se de um estudo retrospectivo, exploratório, quantitativo realizado por meio de base de dados secundários. Os dados foram submetidos à análise no software SPSS, versão 20.0. Realizou-se estatística descritiva (frequência absoluta, porcentagem, média e desvio padrão). Para verificar associação entre variáveis qualitativas foi utilizado teste qui-quadrado (x²) e exato de Fisher. A força das associações entre as variáveis foi aferida pelo risco relativo (RR) e intervalos de confiança (IC 95%). Resultados: As principais alterações presentes nos exames foram: alterações por células escamosas atípicas de significado indeterminado e lesão intraepitelial de baixo grau. Após análises estatísticas, notou-se que algumas alterações possuem risco maior de se desenvolverem no público fora da faixa etária preconizada, ou seja, entre mulheres com idade <25 anos ou >64 anos. Conclusão: O estudo realizado contribui para identificação do perfil atual vivenciado na área da saúde da mulher e possibilita a criação de condutas e ações que visem intervir frente aos resultados obtidos, impactando positivamente na realidade de Minas Gerais


Introduction: Early diagnosis and referral to a specialized service are essential to improve the cure and survival rates of women affected by cervical cancer. Thus, carrying out this study will make it possible to collect information that will be essential for the development of preventive measures, which aim to contribute to the development of health education actions and early diagnosis to reduce the morbidity and mortality of this disease. Objective: Identify the profile of the results of cervical cytopathological examinations of women residing in the State of Minas Gerais from the data of examinations corresponding to the year 2019, using the variables made available by the Cancer Information System.Methods: This is a retrospective, exploratory, quantitative study carried out by means of a secondary database. The data were submitted to analysis using the SPSS software, version 20.0. Descriptive statistics (absolute frequency, percentage, mean and standard deviation) were performed. To verify the association between qualitative variables, the chi-square test (x²) and Fisher's exact test were used. The strength of the associations between the variables was measured by the relative risk (RR) and confidence intervals (95% CI). Results: The main alterations present in the cytopathological exams performed were: changes due to atypical squamous cells of undetermined significance and low- grade intraepithelial lesion. After statistical analysis, it was noted that some changes have a higher risk of developing in the public outside the recommended age range, that is, among women aged <25 years or> 64 years. Conclusion: The study carried out contributes to the identification of the current profile experienced in the area of women's health and enables the creation of conducts and actions that aim to intervene in view of the results obtained, positively impacting the reality of Minas Gerais.


Subject(s)
Uterine Cervical Neoplasms , Uterus , Cervix Uteri , Indicators of Morbidity and Mortality , Health Education , Survival Rate , Colonic Neoplasms , Disease Prevention , Papanicolaou Test , Atypical Squamous Cells of the Cervix
4.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 229-234, set 29, 2021. tab
Article in English | LILACS | ID: biblio-1354390

ABSTRACT

Introduction: the prevalence of cervical and anal human papillomavirus (HPV) infection in women infected with human immunodeficiency virus (HIV) is high. However, little is known about the differences in the susceptibility of these infections and related lesions. The aim of this study was to describe the association between the prevalence of cervical and anal HPV infection and HPV-related lesions in HIV-positive women. Methods: this study included 88 HIV-positive women attending an outpatient clinic in a university hospital. Ectocervical, endocervical, and anal samples were collected for colpocytology and anal cytology. A polymerase chain reaction-based technique was used to detect HPV deoxyribonucleic acid in endocervical and anal swab samples. Results: the cervical and anal HPV positivity rates were 35.21% and 78.8%, respectively. The presence of HPV-related lesions on colpocytology was associated with anal HPV positivity (P = 0.027). The ratio between cervical HPV infection and cervical HPV-related lesions was 2.5. The ratio between anal HPV infection and anal HPV-related lesions was 4.3. Overall, 30% had concomitant HPV DNA in the cervix and anus. Conclusion: there are differences in the susceptibility of infections and related lesions between the cervix and anus. Despite a higher incidence of anal HPV, the progression to HPV-related lesion does not occur via the same manner in the cervix and anus. Moreover, cervical HPV-related lesions in HIV-positive women may serve as a cue for anal preventive strategies, and further investigations in these women may be useful.


Introdução: as infecções cervicais e anais pelo papilomavírus humano (HPV) em mulheres infectadas com o vírus da imunodeficiência umana (HIV) são muito prevalentes. Entretanto, pouco se sabe sobre as diferenças na suscetibilidade entre essas infecções e as lesões HPV-relacionadas. Objetivo: descrever a associação entre as prevalências de infecção cervical e anal pelo HPV e lesões relacionadas em mulheres HIV-positivas. Metodologia: este estudo incluiu 88 mulheres HIV-positivas atendidas em ambulatório de hospital universitário. Amostras ectocervicais, endocervicais e anais foram coletadas para colpocitologia e citologia anal. Uma técnica baseada na reação em cadeia da polimerase foi usada para detectar o ácido desoxirribonucléico (DNA) do HPV em amostras de swabs endocervical e anal. Resultado: as taxas de positividade do HPV cervical e anal foram de 35,21% e 78,8%, respectivamente. As lesões relacionadas ao HPV na colpocitologia foram associadas à positividade anal para o HPV (P = 0,027). A proporção entre infecção cervical por HPV e lesões cervicais relacionadas foi de 2,5. A proporção entre a infecção anal por HPV e as lesões anais relacionadas foi de 4,3. 30% tinham DNA-HPV concomitante no colo do útero e ânus. Conclusão: existem diferenças na suscetibilidade de infecções e de lesões relacionadas entre o colo e o ânus. Apesar de maior incidência de HPV anal, a progressão para lesões relacionadas não ocorre da mesma forma no colo e no ânus. Além disso, lesões cervicais relacionadas ao HPV em mulheres HIV positivas podem servir como pista para estratégias preventivas anais. Investigações adicionais podem ser úteis.


Subject(s)
Humans , Female , Anus Neoplasms , HIV , Cervical Intraepithelial Neoplasia , Alphapapillomavirus , Cross-Sectional Studies
5.
Rev. bras. ginecol. obstet ; 43(9): 682-689, Sept. 2021. graf
Article in English | LILACS | ID: biblio-1351778

ABSTRACT

Abstract Objective The aim of the present study was to compare the local and systemic expression of the factors linked to the interferon alpha (IFN-α) activation pathway in different degrees of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods A total of 128 patients with CIN I, CIN II, CIN III and cervical cancer was evaluated. The real-time polymerase chain reaction (RT-PCR) technique was used to evaluate the gene expression of IFNR1, IFNR2, IFN-α, oligoadenylate synthase (2'5′OAS), cytokine signal suppressor 1 (SOCS) 1, SOCS3, signal transducer and transcription activator 1 (STAT1), and IRF9 from 128 biopsies. A total of 46 out of 128 samples were evaluated by flow cytometry for IFNAR1, IFNAR2, STAT1, IRF7 and IFN-α in peripheral blood cells. Results Patients with CIN II and III (63 samples) had a low local expression of IFNR1, but not IFNR2. Patients with some degree of injury showed high expression of SOCS1 and SOCS3. Systemically, patients with CIN II and III (20 samples) had a significant increase in IFNR1, IFNR2, STAT1, IRF7, and IFN-α in helper, cytotoxic T lymphocytes, and in monocytes. Conclusion Patients with high-grade lesions have increased systemic expression of IFN-α and its activation pathways in helper and cytotoxic T lymphocytes, as well as in monocytes due to an exacerbation of the immune response in these patients. This phenomenon is not accompanied by resolution of the lesion due to a defect in the IFN-α activation pathway that revealed by low local IFNAR1 expression and high local expression of SOCS1 and SOCS3.


Resumo Objetivo O objetivo do presente estudo foi comparar a expressão local e sistêmica dos fatores ligados à via de ativação do interferon alfa (IFN-α) em diferentes graus de neoplasia intraepitelial cervical (NIC) e câncer cervical (CA) Métodos Foram avaliados 128 pacientes com NIC I, NIC II, NIC III e CA. A técnica de reação de cadeia de polimerase em tempo real (RT-PCR, na sigla em inglês) foi realizada para avaliar a expressão gênica do receptor de interferon (IFNR) 1, IFNR2, IFN-α, 2′-5′- oligoadenilato sintetase (2′5′OAS), supressor de sinalização de citocina (SOCS)1, SOCS3, transdutor de sinal e ativador de transcrição 1 (STAT1) e fator regulador de interferon 9 (IRF9) das 128 biópsias. Das 128 amostras, 46 foram avaliadas por citometria de fluxo para IFNAR1, IFNAR2, STAT1, IRF7 e IFN-α em células de sangue periférico. Resultados Pacientes com NIC II e III (63 amostras) tiveram baixa expressão local de IFNR1 mas não de IFNR2. Pacientes com algum grau de lesão apresentaram alta expressão de SOCS1 e SOCS3. Sistemicamente, os pacientes com NIC II e III (20 amostras) tiveram um aumento significativo de IFNR1, IFNR2, STAT1, IRF7 e IFN-α em linfócitos T auxiliares, citotóxicos e monócitos. Conclusão Pacientes com lesões de alto grau apresentam expressão sistêmica aumentada de IFN-α e suas vias de ativação em linfócitos T auxiliares e citotóxicos, bem como em monócitos, devido à exacerbação da resposta imune nesses pacientes. Este fenômeno não é acompanhado pela resolução da lesão devido a um defeito na via de ativação do IFN-α que é revelado pela baixa expressão local de IFNR1 e alta expressão local de SOCS1 e SOCS3.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/genetics , Cervical Intraepithelial Neoplasia/genetics , Interferon-alpha , Suppressor of Cytokine Signaling Proteins/metabolism
6.
Rev. APS ; 23(1): 113-127, jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1357569

ABSTRACT

Objetivo: Analisar os fatores associados às alterações citológicas cervicais em mulheres usuárias da Atenção Primária à Saúde, de um município do interior do Rio Grande do Sul (RS), no período de 2014 a 2017. Métodos: Estudo descritivo e transversal com base nos exames citopatológicos registrados no Sistema de Informações do Câncer (Siscan), do município do interior do RS e Prontuários Eletrônicos. Os dados foram analisados por meio de estatística descritiva e pelo Teste de Associação Exato de Fisher (p≤0,05). Resultados: Observou-se aumento no diagnóstico de alterações citológicas no período estudado, com predomínio de mulheres na faixa etária entre 25-64 anos (77,8%), de baixa escolaridade (68,7%), com companheiro (63,3%) e de cor branca (83,3%). As atipias de significado indeterminado apresentaram associação com a faixa etária <25 anos (p=0,040) e cor da pele branca (p=0,033). As lesões intraepiteliais de alto grau (HSIL) estiveram associadas à faixa etária entre 25-64 anos (p=0,040). Escolaridade, estado civil, uso de anticoncepcional oral, histórico de infecção sexualmente transmissível, vaginose bacteriana e Gardnerella vaginallis não apresentaram associação com as alterações citológicas. Conclusão: O estudo permitiu a identificação dos fatores associados às alterações citológicas cervicais, contribuindo com informações para o desenvolvimento de ações que qualifiquem o rastreamento do câncer cervical.


Objective: To analyze the factors associated with cervical cytological alterations in women using Primary Health Care in a municipality in the interior of the state of Rio Grande do Sul (RS), in the period from 2014 to 2017. Methods: Descriptive and cross-sectional study based on cytopathological exams registered in the cancer information system (Siscan) and Electronic Medical Records of the municipality of the interior of RS. Data were analyzed using descriptive statistics and Fisher's Exact Association Test (p≤0.05). Results: An increase in the diagnosis of cytologic changes was observed in the period studied, with a predominance of women aged between 25-64 years (77.8%), low schooling (68.7%), with partner (63.3% %), and white (83.3%). The atypia of indeterminate meaning was associated with age <25 years (p = 0.040) and white skin color (p = 0.033). High-Grade Squamous Intraepithelial Lesions (HSIL) were associated with the age range between 25-64 years (p = 0.040). Schooling, marital status, oral contraceptive use, history of Sexually Transmitted Infections (STI's), bacterial vaginosis, and Gardnerella Vaginallis were not associated with cytologic alterations. Conclusion: The study allowed the identification of the factors associated with the cervical cytological alterations, contributing with information to the development of actions that qualify the cervical cancer screening.


Subject(s)
Primary Health Care , Uterine Cervical Neoplasms
7.
Rev. APS ; 23(4): 853-872, 2021-06-23.
Article in Portuguese | LILACS | ID: biblio-1358359

ABSTRACT

Objetivo: Compreender estado de vulnerabilidade de mulheres em condição de reclusão de uma instituição prisional acerca das infecções sexualmente transmissíveis e câncer de colo de útero. Método: Pesquisa qualitativa exploratória alicerçada no referencial conceitual de vulnerabilidade individual, social e programática realizada com 28 mulheres em reclusão. Dados coletados de forma cursiva por formulário e tratados por análise de conteúdo temático-categorial. Resultado: Emergiram duas categorias: Percepções e compreensão das reclusas sobre infecções sexualmente transmissíveis e medidas adotadas para preveni-las e Práticas educativas e concepções sobre prevenção das infecções sexualmente transmissíveis e câncer de colo de útero. Conclusão: Há fragilidades no sistema prisional relacionadas à efetividade de ações educativas, preventivas e assistenciais perante a saúde reprodutiva e sexual das mulheres em reclusão. A equipe multiprofissional juntamente com o enfermeiro necessita efetivar ações preventivas e educativas nas prisões para evitar o adoecimento dessa população vulnerável da mesma maneira que são realizadas nas unidades básicas de saúde da rede pública.


Objective: To understand the vulnerability condition of women in prison concerning sexually transmitted infections and cervical cancer. Method: A qualitative exploratory research based on the conceptual framework of individual, social and programmatic vulnerability carried out with 28 women in prison. Data collection took place in a cursive way by form and was interpreted by thematic and categorical content analysis. Result: Two categories emerged: Prisoners' perceptions and understanding of sexually transmitted infections and measures taken to prevent them, as well as Educational practices and concepts on the prevention of sexually transmitted infections and cervical cancer. Conclusion: There is some fragility in the prison system related to the effectiveness of educational, preventive and assistance actions concerning reproductive and sexual health of women in prison. The multi-professional team, together with the nurse, must carry out preventive and educational actions in prisons to prevent the illness of this vulnerable population the same way they are carried out in basic public health units.


Subject(s)
Sexually Transmitted Diseases , Uterine Cervical Neoplasms , Health Vulnerability
8.
Rev. Fac. Med. Hum ; 21(1): 157-168, Ene.-Mar. 2021.
Article in English, Spanish | LILACS-Express | LILACS | ID: biblio-1147374

ABSTRACT

Objetivo: Determinar el efecto del consumo de tabaco en el desarrollo de neoplasia intraepitelial cervical en mujeres. Métodos: Se realizó una revisión sistemática. Se realizó la búsqueda electrónica, utilizando la pregunta de investigación: ¿Cuál es la asociación entre el tabaquismo y el desarrollo de neoplasia intraepitelial cervical? cuya pregunta PEO fue: Población: Mujeres. Exposición: Uso de tabaco. Resultado: Neoplasia intraepitelial cervical. Se seleccionaron los artículos publicados desde el 1 de enero de 2014 hasta diciembre de 2019. Resultados: Se encontraron 71 artículos, de los cuales 55 fueron excluidos por no cumplir con los criterios de selección, quedando 16 artículos para el análisis de este artículo. Aquellas mujeres que consumían tabaco tenían una asociación significativa para el desarrollo de neoplasia intraepitelial de alto grado (OR = 1,43, IC del 95% = 1,14-1,80). Asimismo, se observó asociación entre el tabaquismo severo y el uso de anticonceptivos orales, con mayor riesgo de neoplasia intraepitelial grado II y III (OR = 11,5; IC 95%, 1,88-70,40). Conclusión: La evidencia disponible sugiere la asociación entre el consumo de tabaco y el desarrollo de neoplasia intraepitelial cervical, particularmente lesiones intraepiteliales cervicales de alto grado.


Objective: To determine the effect of tobacco consumption with the development in women of cervical intraepithelial neoplasia. Methods: A systematic review was conducted. The electronic search was carried out, using the research question: What is the association between smoking and the development of cervical intraepithelial neoplasia? whose PEO question was: Population: Women. Exposure: Tobacco use. Outcome: Cervical intraepithelial neoplasia. Articles published from January 1, 2014 to December 2019 were selected. Results: 71 articles were found, 55 being excluded because they did not meet the selection criteria, leaving 16 articles for this paper analysis. Those women who smoked tobacco had a significant association for the development of high-grade intraepithelial neoplasia (OR = 1.43, 95% CI = 1.14-1.80). Likewise, synergy was observed between severe smoking and the use of oral contraceptives, with a greater risk of grade II and III intraepithelial neoplasia (OR = 11.5; 95% CI, 1.88-70.40). Conclusion: The available evidence suggests the association between tobacco use and the development of cervical intraepithelial neoplasia, particularly high-grade cervical intraepithelial lesions.

9.
Cancer Research and Clinic ; (6): 423-427, 2021.
Article in Chinese | WPRIM | ID: wpr-912900

ABSTRACT

Objective:To explore the application value of combined detection of p16 and human papillomavirus (HPV) typing in the diagnosis of cervical intraepithelial neoplasia (CIN).Methods:A total of 8 346 patients aged between 25 years old and 65 years old at Baoji Central Hospital of Shaanxi Province from February 2019 to February 2020 were selected. There were 2 882 patients with cervical lesions diagnosed by colposcopy biopsy. Patients were divided into the different groups based on the age range, and then the condition of HPV infection in all age groups was analyzed. Taking biopsy as the gold standard and according to the pathological results, the detection rate of p16 and HPV typing and the diagnostic value of the single and combined detection in CIN were also analyzed.Results:The age group with the highest positive rate of p16 and HPV was 31-40 years old [47.42% (1 014/2 427) and 36.84% (894/2 427), respectively], followed by 41-50 years old group [30.15% (907/2 942) and 28.11% (827/2 942)], and there were statistically significant differences in positive rate of p16 and HPV in all age groups (all P < 0.05). Among 2 882 patient with cervical lesions diagnosed by pathological examination, there were 2 572 cases (89.24%) of p16 positive, and 2 169 cases (75.26%) of HPV positive. With the disease progression of cervical lesions, the positive rate of p16 and HPV was gradually increased, and the positive rate of p16 of inflammation, CINⅠ, CINⅡ, CIN Ⅲ, cervical squamous cell carcinoma (SCC) was 11.68% (23/197), 94. 85% (1 105/1 165), 93.57% (771/824), 96.76% (538/556), 96.43% (135/140), respectively; the positive rate of HPV was 17.77% (35/197), 77.60% (904/1 165), 80.22% (661/824), 80.40% (447/556), 87.14% (122/140), respectively, and HPV infection was mostly HPV16/18 infection type with the disease progression of cervical lesions. The sensitivity, specificity, positive predictive value and negative predictive value in detecting CIN of HPV was 75.26%, 81.13%, 67.78% and 86.14%, respectively; the sensitivity, specificity, positive predictive value and negative predictive value in detecting CIN of p16 was 89.24%, 84.74%, 75.51% and 93.72%, respectively; the diagnostic efficacy of p16 was higher than that of HPV in detecting CIN, and the difference was statistically significant ( P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of HPV combined with p16 in detecting CIN was 94.10%, 91.33%, 85.12%, 96.71%, which were higher compared with those of single detection (all P < 0.05). Conclusions:HPV infection mainly occurs in women aged 31-40 years old followed by 41-50 years old, and the infected population of CIN tends to be younger. p16 is superior to HPV in detecting the diagnostic efficacy of CIN; combined detection of p16 and HPV can increase the sensitivity and specificity, reduce the rate of misdiagnosis, and can play a key clinical value in early diagnosis and treatment of CIN.

10.
Article in Chinese | WPRIM | ID: wpr-910177

ABSTRACT

Objective:To screen out high risk factors of cervical intraepithelial neoplasia (CIN) of grade Ⅱ or worse (CIN Ⅱ +) by analyzing related factors for CIN Ⅱ + detection in grade 1 abnormal colposcopic finding (G1) of cervix and provide reference for individual management of colposcopic performance. Methods:A retrospective study was performed on patients who were reffered to colposcopy for abnormal results of cervical cancer screening and only had G1 colposcopic findings of cervix at the First Affiliated Hospital of Nanjing Medical University, from April 2017 to January 2021. The factors influencing the detection of CIN Ⅱ + were analyzed by univariate and multivariate analysis. Results:(1) A total of 403 patients were included in this study whose median age was 38 years old (range: 22-67 years old), and utimately 108 had high-grade squamous intraepithelial lesion, 1 had adenocarcinoma in situ and 1 had adenocarcinoma. The overall detection rate of CIN Ⅱ + was 27.3% (110/403). (2) Univariate analysis showed that the detection rate of CIN Ⅱ +, in patients ≥50 years old was higher than that in patients <50 years old (38.3% vs 25.4%; χ2=4.328, P=0.037), and in HPV 16 positive cases was higher than that in non-HPV 16 positive cases (41.8% vs 21.8%; χ2=16.080, P<0.01); as the cytological severity ( χ2=6.775, P=0.009) and the number of involving quadrants ( χ2=31.117, P<0.01) increased, the risk of CIN Ⅱ + detection increased; but the types of colpolscopic signs were not related to detection of CIN Ⅱ +( χ2=0.323, P=0.851). Multivariable analysis showed that the age of ≥50 years old ( OR=2.504, 95% CI: 1.299-4.830, P=0.006), HPV 16 positive type ( OR=3.353, 95% CI: 2.004-5.608, P<0.01) and the increase of involving quadrants ( OR=1.899, 95% CI: 1.518-2.376, P<0.01) were independent risk factors. (3) The detection rate of CIN Ⅱ + was highest in the women with HPV 16 positive type and four quadrants of G1 (73.7%), while lowest in the women with non-HPV 16 positive type and one quadrant of G1 (10.4%). Conclusions:The age of ≥50 years old, HPV 16 positive type and the increase of involving quadrants are independent risk factors of detecting CIN Ⅱ + in G1 colposcopic findings. So the key point of the individual management of G1 groups with different risk stratification is to adequately biopsy in high-risk group to avoid miss diagnosis of CIN Ⅱ +.

11.
Article in Chinese | WPRIM | ID: wpr-909261

ABSTRACT

Objective:To detect the expression of miR-378 in cervical cancer and investigate its effects on the proliferation and invasion of cancer cells as well as the underlying mechanism.Methods:A total of 185 cervical tissue samples of women who received gynecological examination in Qilu Hospital of Shandong University from January 2012 to January 2016 were included in this study. Reverse transcription-quantitative polymerase chain reaction was performed to determine the expression of miR-378 in cervical tissue and C-33A cells. Western blot assay was performed to detect the expression of different cancer genes ATG12, CCND1 and pRb in C-33A cells. BrdU cell proliferation and Transwell invasion assay were performed to determine cell proliferation and invasion. Target Scan was used to predict and screen miR-378 gene targets and verified by a dual-luciferase reporter assay system.Results:The expression of miR-378 in cervical intraepithelial neoplasia (CIN) III lesioned tissue and cervical cancer tissue was significantly higher than that in normal cervical tissues ( F = 103.091, t = 9.381, 8.936, both P < 0.05). The expression of miR-378 in cervical cancer tissues with positive lymph node metastasis was significantly higher than that in cervical cancer tissues with negative lymph node metastasis ( t = 1.007, P < 0.01). The overexpression of miR-378 in cervical cancer tissues significantly promoted the migration and invasion of C-33A cells ( t = 5.285, P < 0.05), while low expression of miR-378 in cervical cancer tissues significantly inhibited the migration and invasion of HeLa cells ( t = 2.941, P < 0.05). The overexpression of miR-378 in C-33A cells significantly decreased the expression of ATG12, CCND1and pRb ( t = 1.382, 1.431 and 2.086, all P < 0.05). The low expression of miR-378 in C-33A cells significantly increased the expression of ATG12, CCND1 and pRb ( t = 3.961, 3.062 and 2.894, all P < 0.05). Conclusion:miR-378 can greatly promote the metastasis of cervical cancer cells. ATG12, as a direct target of miR-378, provides new insights into the molecular mechanism underlying cervical cancer pathology and therapeutic target.

12.
Article in Chinese | WPRIM | ID: wpr-909139

ABSTRACT

Objective:To compare the application value of intracellular free heme concentration (FH) detection and high-risk human papillomavirus (HPV) detection in screening cervical cancer and precancerous lesions.Methods:A total of 238 patients with cervical abnormalities who received FH and HPV detection in Huainan First People's Hospital, China from October 2017 to October 2019 were included in this study. Taking liquid-based ThinPrep cytologic test (TCT) results and pathological biopsy results as gold standard, the diagnostic value of FH detection and TCT detection for cervical cancer and precancerous lesions were compared.Results:TCT results revealed normal/inflammatory diagnosis in 97 patients, and atypical squamous cells of undetermined significance (ASCUS) or higher grade diagnosis in 141 patients. Pathological biopsy results reported cervical intraepithelial neoplasia (CIN) grade II or above in 70 out of the 141 patients. The detection rate of FH detection for CIN grade II or above cervical lesions was 92.86% (65/70) and the detection rate of high-risk HPV detection was 95.71% (67/70). The sensitivity and specificity of FH detection in the screening CIN grade II or above cervical lesions were 82.86% (58/70) and 85.92% (60/70), respectively and they were 94.29% (66/70) and 98.59% (69/70) for high-risk HPV detection. There were significant differences in diagnostic sensitivity and specificity between FH dection and high-risk HPV detection ( χ2 = 4.52, 10.25, both P < 0.05). Conclusion:High-risk HPV detection is of high application value in the diagnosis of cervical cancer and precancerous lesions. It has higher sensitivty and specificity in screening cervical cancer and precancerous lesions than FH detection. But FH detection is simpler, more economical and easier to use and is more suitable for large-scale screening of cervical cancer and precancerous lesions than high-risk HPV detection.

13.
Article in Chinese | WPRIM | ID: wpr-907430

ABSTRACT

Objective:To explore the detection capability of p16/Ki-67 double staining technique in women with various abnormal thinprep cytologic test (TCT) results and its diagnostic value for cervical intraepithelial neoplasia Ⅱ+ grade (CIN2+).Methods:A total of 225 women with abnormal TCT results, i.e. the atypical squamous cells of undetermined significance(ASC-US), in the Tianjin Central Hospital of Gynecology Obstetrics, Nankai University Affiliated Maternity Hospital from December 2018 to December 2019 were enrolled. p16/Ki-67 double staining were detected and compared with the high risk human papillomavirus (HR-HPV) and pathological results.Results:The positive rates of p16/Ki-67 double staining increased with cytologic and pathologic categories. For diagnosis of CIN2+, p16/Ki-67double staining (90.1%) was less sensitive than HR-HPV testing (98.2%)( P<0.05), but the specificity of p16/Ki-67 double staining (58.8%) was significantly higher than HR-HPV(21.6%) ( P<0.001). Conclusions:Compared with HR-HPV, p16/Ki-67 double staining has better effect on diagnosing CIN2+. p16/Ki-67 double staining can be considered as triaging method for management of ASC-US and LSIL patients, significantly reduce the colposcopy referral rate (nearly 50%), which has high clinical application value.

14.
Article | IMSEAR | ID: sea-212639

ABSTRACT

Background: Cervical cancer is known to have a good response to radiotherapy. The response and prognosis are dependent on the level of apoptosis. Pap smear and histopathology are cost-effective methods in diagnosing premalignant and malignant lesions of cervix but not accurate in classifying and estimating the progression of the disease, especially in premalignant lesions. Therefore this study was undertaken to know the role of Ki-67 expression and apoptotic index in classifying accurately the premalignant lesions for better management.Methods: The study included 540 cases diagnosed histologically as cervical intraepithelial neoplasia or carcinoma. The apoptotic index is calculated for all the 540 cases using light microscopy on Haematoxylin and Eosin stained sections. Ki-67 immunohistochemical staining was done for 100 cervical biopsies. Ki-67 expression was graded and the Ki-67 labelling index was calculated. Statistical evaluation was done using the unpaired t-test.Results: The Apoptotic index increased with increasing grade of dysplasia. There is a significant difference in the mean apoptotic index between premalignant and malignant lesions of the cervix. The ki-67 index increased with increasing grade of dysplasia. There is a significant difference in the mean Ki-67 index between premalignant and malignant lesions of the cervix.Conclusions: Apoptotic index and proliferative indices have been found useful in distinguishing between premalignant and malignant lesions of the cervix and gives an idea about the proliferative activity of the tumour for better management of the patient and to determine prognosis.

15.
Femina ; 48(8): 499-503, 20200830. graf, tab
Article in Portuguese | LILACS | ID: biblio-1118622

ABSTRACT

O artigo tem o objetivo de determinar a frequência de neoplasia intraepitelial cervical (NIC) e de papilomavírus humano (HPV) no Rio Grande do Sul (RS). Tratou-se de um estudo retrospectivo, em que se analisou a frequência de NIC e de HPV no RS durante o período de janeiro de 2015 a junho de 2018. Foram analisados 1.249 laudos histopatológicos de colo uterino, tendo sido possível observar na análise global que a maioria dos casos se manteve estável (183 casos), porém 107 progrediram em um nível. Dos 64 casos de NIC I em 2015, 12 apresentaram a presença de HPV; em 2016, 19 casos de NIC I, e todos com HPV; em 2017 teve uma diminuição de casos de NIC I mais HPV (12 casos). Até junho de 2018, apenas 2 casos de HPV foram registrados. Com este estudo, ficou evidente que, na população estudada, houve diminuição no número de casos de NIC (22%), o que pode estar relacionado a campanhas e incentivo aos cuidados com a saúde e prevenção.(AU)


The article aims to determine the frequency of cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) in Rio Grande do Sul (RS). This was a retrospective study, in which the frequency of CIN and HPV in RS, from January 2015 to June 2018, was analyzed. 1,249 cases of histopathological reports of the cervix were analyzed, being It is possible to observe in the global analysis that the majority of cases remained stable (183 cases), but 107 progressed at one level. Of the 64 cases of CIN I in 2015, 12 presented the presence of HPV, in 2016, 19 cases of CIN I, and all with HPV, in 2017 there was a decrease in cases of CIN I plus HPV (12 cases). As of June 2018, only 2 cases of HPV have been reported. With this study it was evident that in the studied population there was a decrease in the number of CIN cases (22%), which may be related to campaigns and incentives to health care and prevention.(AU)


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/epidemiology , Papillomavirus Infections/epidemiology , Papillomaviridae/pathogenicity , Brazil/epidemiology , Diseases Registries , Cross-Sectional Studies , Health Status Indicators
16.
Article | IMSEAR | ID: sea-207460

ABSTRACT

Postmenopausal patient presenting with pain and lump in abdomen should be considered as a complication caused by gynaecological malignancy unless proved otherwise pyometra is most common in postmenopausal women but it can affect women of child bearing age as well. Usually it is caused by impairment of natural drainage of the cervix due to malignant diseases of genital tract and consequences of their treatment with radiotherapy. Authors report one such case with cervical intraepithelial neoplasia with uterus markedly enlarged to 26-28 weeks size with Vaginal stenosis in an eighty-year-old postmenopausal patient.

17.
Rev. chil. obstet. ginecol. (En línea) ; 85(1): 74-98, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092778

ABSTRACT

El cáncer cérvico uterino (CaCu) corresponde al 10% de los cánceres femeninos, se describe prevenible y con viabilidad de curación, no obstante, con la optimización de las terapias las sobrevivientes superan los cinco años en el 70% de los casos, evidenciando efectos adversos producto principalmente del tratamiento que deterioran la calidad de vida e impactan sobre su sexualidad. OBJETIVO: Identificar efectos de la enfermedad y tratamiento que comprometen la calidad de vida sexual de la mujer con CaCu. METODOLOGÍA: Revisión de artículos originales entre los años 2010 y 2019 desde las bases de datos Pubmed, Scopus, Scielo, Google Académico, Science Direct, Elsevier, Redalyc, Springer Link, Wiley Online Library, Dialnet y Ovid, seleccionando 51 artículos de 90 en inglés, español y portugués a texto completo, que reportaran efectos físicos y psicosociales que comprometieran la calidad de vida sexual de mujeres con CaCu. RESULTADOS: La sexualidad de estas mujeres es impactada por efectos físicos, relacionadas con el estadio de la enfermedad y tratamiento como dispareunia, anorgasmia, alteraciones digestivas, urinarias, insomnio, inapetencia, linfedema y neuropatía periférica. Desde el ámbito psicosocial manifiestan efectos sobre su autoestima, depresión e inseguridad en la permanencia del vínculo de pareja. Emerge la comunicación sexual de pareja como condición categórica en el nivel de afectación de la calidad de vida sexual. CONCLUSIONES: la sexualidad de la mujer con CaCu está comprometida por efectos físicas y psicosociales secundarias principalmente al tratamiento recibido. La comunicación sexual de pareja surge como interviniente para superar estos efectos y debe considerarse en la atención profesional.


Cervical uterine cancer (CaCu) corresponds to 10% of female cancers, it is described as preventable and with viability of cure, however, with the optimization of therapies the survivors exceed five years in 70% of the cases, evidencing adverse effects mainly due to the treatment that deteriorates the quality of life and impact on their sexuality. OBJECTIVE: To identify the effects of the disease and treatment that compromises the quality of sexual life of women with CaCu. METHODOLOGY: Review of original articles between 2010 and 2019 from Pubmed, Scopus, Scielo, Google Scholar, Science Direct, Elsevier, Redalyc, Springer Link, Wiley Online Library, Dialnet, and Ovid databases, selecting 51 articles out of 90 in English, Spanish, and Portuguese in full text, which reported physical and psychosocial effects that compromises the quality of sexual life of women with CaCu. RESULTS: The sexuality of these women is impacted by physical effects, related to the stage of the disease and treatment, such as dyspareunia, anorgasmia, digestive and urinary disorders, insomnia, inappetence, lymphedema and peripheral neuropathy. From the psychosocial perspective, they show effects on their self-esteem, depression and insecurity in the permanence of the couple's relationship. Sexual communication between couples is emerging as a categorical condition in the level of affectation of the quality of sexual life. CONCLUSIONS: The sexuality of women with CaCu is compromised by physical and psychosocial effects mainly secondary to the treatment received. Couple's sexual communication emerges as an intervention to overcome these effects and should be considered in professional care.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/complications , Uterine Cervical Neoplasms/psychology , Cervical Intraepithelial Neoplasia/complications , Cervical Intraepithelial Neoplasia/psychology , Sexuality , Quality of Life , Sexual Behavior , Uterine Cervical Neoplasms/therapy , Cervical Intraepithelial Neoplasia/therapy , Sexual Health
18.
Rev. saúde pública (Online) ; 54: 27, 2020. tab, graf
Article in English | LILACS | ID: biblio-1094408

ABSTRACT

ABSTRACT OBJECTIVES To determine the efficacy and safety of the use of cryotherapy, cold knife or thermocoagulation compared to Loop Electrosurgical Excision Procedure (LEEP) for the treatment of cervical intraepithelial neoplasia. METHODS Systematic review with meta-analysis of randomized controlled trials in women with cervical intraepithelial neoplasia undergoing treatment with cryotherapy, cold knife, or thermo-coagulation compared with LEEP, to estimate its efficacy and safety. The search was conducted on MEDLINE/PUBMED, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus, until September 2018. RESULTS The total of 72 studies were identified, of which only 8 studies met the inclusion criteria. The treatment of CIN with cold knife decreases the risk of residual disease compared with LEEP (RR, 0.54, 95%CI, 0.30-0.96, p = 0.04). The management of premalignant lesions with cryotherapy, compared with LEEP, increases the risk of disease recurrence by 86% (RR, 1.86, 95%CI, 1.16-2.97, p = 0.01), increases the risk of infections (RR, 1.17, 95%CI, 1.08-1.28, p < 0.001) and reduces the risk of minor bleeding by 51% (RR, 0.49, 95%CI) %, 0.40-0.59, p ≤ 0.001). CONCLUSIONS The treatment of premalignant lesions of cervical cancer with cold knife reduces the risk of residual disease. Nevertheless, cryotherapy reduces the risk of minor bleeding in the 24 hours after treatment and increases the risk of recurrence of disease and infections.


RESUMEN OBJETIVOS Evaluar la eficacia y seguridad del uso de crioterapia, cono frio o termo-coagulación en comparación con el procedimiento de escisión electroquirúrgica en asa (LEEP) para el manejo de neoplasias intraepiteliales cervicales. MÉTODOS Revisión sistemática de ensayos controlados aleatorizados en mujeres con neoplasia intraepitelial cervical en tratamiento con crioterapia, cono frio, o termo coagulación y LEEP, para estimar su eficacia y seguridad. La búsqueda se realizó en MEDLINE/PUBMED, Registro Cochrane Central de Ensayos Controlados (CENTRAL) y Scopus, hasta setiembre de 2018. RESULTADOS Se identificaron 72 estudios, ocho cumplieron los criterios de inclusión. Cono frio disminuyó el riesgo de enfermedad residual en comparación con LEEP (RR 0,54; IC del 95%, 0,30-0,96, p = 0,04). Crioterapia en comparación con LEEP incrementó el riesgo de recurrencia de enfermedad en un 86,0% (RR 1,86; IC del 95%, 1,16-2,97, p = 0,01) con un tiempo de seguimiento de seis a 24 meses, y de infecciones (RR, 1,17; IC del 95%, 1,08-1,28, p < 0,001); pero redujo el riesgo de sangrado menor en un 51,0% (RR 0,49; IC del 95%, 0,40-0,59, p ≤ 0,001). CONCLUSIONES Cono frio reduce el riesgo de enfermedad residual. Sin embargo, la crioterapia reduce el riesgo de sangrado menor en las 24 horas posteriores al tratamiento e incrementa el riesgo de recurrencia de enfermedad y de infecciones.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/surgery , Cryotherapy/methods , Cervical Intraepithelial Neoplasia/surgery , Conization/methods , Electrocoagulation/methods , Postoperative Complications , Uterine Cervical Neoplasms/pathology , Risk , Risk Factors , Cervical Intraepithelial Neoplasia/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Recurrence, Local/pathology
19.
Article in Chinese | WPRIM | ID: wpr-799641

ABSTRACT

Objective@#To explore the positive expressions of P16 and Ki-67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid-based thin-layer cytology test(TCT), and the clinical value in predicting occurrence of early cervical cancer.@*Methods@#A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive) and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis, immunohistochemical staining was used to detect P16 and Ki-67 proteins.@*Results@#There were up to 66 patients with HPV-16 positive, 34 cases with HPV-18 positive, other 20 cases with 16 and 18 positive; 6 cases of atypical squamous epithelial cells(ASC), 46 cases of low-grade squamous intraepithelial lesions (LSIL), 60 cases of high-grade SIL(HSIL), other 8 cases of cervical squamous cell carcinoma(SCC) were diagnosed by TCT; 5 cases of inflammation, 105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation, CIN and SCC[0(0/5), 36.2%(38/105), 70.0%(7/10), χ2=4.382, P=0.036; 0(0/5), 40.0%(42/105), 80.0%(8/10), χ2=5.945, P=0.015]. The patients with CIN were followed up for 21~36 months, median time 29.5 months.Twenty-six patients progressed to SCC, at the end of follow-up, the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress[61.5%(16/26) vs.39.2%(31/79), χ2=3.934, P=0.047; 69.2%(18/26) vs.41.8%(33/79), χ2=5.905, P=0.015].@*Conclusion@#The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high-risk HPV infection and abnormal TCT, which in patients with pathologically diagnosis of SCC are higher than CIN patients, the same results in CIN patients with SCC progression than non-progressing patients, suggesting that P16 and Ki-67 proteins are of great value in predicting occurrence of early cervical cancer.

20.
Article in Chinese | WPRIM | ID: wpr-799599

ABSTRACT

Objective@#This study aimed to evaluate the clinical performance of p16/Ki-67 dual staining for triage high risk HPV (HR-HPV) infected women.@*Method@#Target objects were women who infected HR-HPV and received colposcopy examination between April and December of 2016 at the Second Affiliated Hospital of Zhengzhou University. Gynecologists collected the cervical exfoliated cells from eligible women for p16/Ki-67 dual staining, LBC testing and HPV DNA testing. Histology diagnosis were used as gold standard. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs) of p16/Ki-67 dual staining, LBC testing and HPV16/18 testing for triage of HR-HPV positive population were calculated and compared.@*Results@#A total of 295 HR-HPV infected women were selected, and the mean age was (44.29±11.48) years old. Positive rates of p16/Ki-67 dual staining, HPV16/18 testing and LBC testing were 70.17% (207), 56.95% (168) and 85.76% (253), respectively. When CIN2+as the endpoint, among the three triage methods, sensitivity of p16/Ki-67 dual staining was 90.00% (95%CI: 85.06%-93.43%), higher than the value of HPV 16/18 testing, but lower than the value of LBC testing. Specificity, PPV and NPV of p16/Ki-67 dual staining were the highest [71.58% (95%CI: 61.81%-79.67%), 86.96% (95%CI:81.69%-90.88%) and 77.27% (95%CI: 67.49%-84.78%)]. When detection for CIN3+, sensitivity of p16/Ki-67 dual staining was 92.90% (95%CI: 87.74%-95.99%), lower than the value of LBC testing, but higher than the value of HPV16/18 testing. Specificity of p16/Ki-67 dual staining was 55.00% (95%CI: 46.74%-63.00%), lower than the value of HPV16/18 testing, but higher than the value of LBC testing. PPV of p16/Ki-67 dual staining was 69.57% (95%CI: 62.99%-75.43%), lower than the value of HPV 16/18 testing, but higher than the value of LBC testing. NPV of p16/Ki-67 dual staining was 87.50% (95%CI: 78.99%-92.87%), higher than value of HPV 16/18 testing, but lower than the value of LBC testing.@*Conclusion@#p16/Ki-67 dual staining has better clinical effects than HPV 16/18 testing and LBC testing for triage women with HR-HPV infection.

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