Metástasis cerebral de carcinoma de cuello uterino / Brain metastasis from cervical carcinoma

El cáncer de cuello uterino es una neoplasia maligna frecuente en las mujeres, que se disemina hacia pulmones, ganglios linfáticos supraclaviculares, hígado y hueso como metástasis a distancia. La resultante es mala y la supervivencia varía de 3 a 6 meses. Se presenta un caso de paciente de 67 años de edad con antecedente de carcinoma de células escamosas de cuello uterino estadio IIB hacía 5 años tratada con cirugía más radio-quimioterapia, quien presentó alteraciones de la marcha, cefalea y vómitos. Las imágenes de resonancia magnética revelaron múltiples lesiones con aumento de edema perilesional hipointensas en T1 e hiperintensas en T2. La paciente murió una semana después del diagnóstico. Los hallazgos de la necropsia demostraron carcinoma de células escamosas pobremente diferenciado de origen en cuello uterino.

Cervical cancer is a frequent malignancy of women that spreads to lungs, supraclavicular lymph nodes, liver, and bones as distant metastasis. Prognosis is poor and survival varies from 3 to 6 months. We report the case of a 67-yearold woman with history of squamous cell carcinoma of cervix stage IIB 5 years ago treated with surgery plus radio-chemotherapy who presented walking impairment, headache and vomiting. Cranial magnetic resonance imaging revealed multiple lesions with increasing perilesional edema, T1-hypointense and T2-hyperintense. The patient died one week after the diagnosis. Necropsy findings showed poorly differentiated carcinoma of cervical origin.

The clinical application value of flow-cytometry combined with colposcope ultra high frequency electric knife for diagnosis of uterine cervix carcinoma and cervical intraepithelial neoplasia / 实用肿瘤学杂志

Objective To explore the clinical application value of flow -cytometry combined with colpo-scope ultra high frequency electric knife for diagnosis of uterine cervix carcinoma ( UCC) and cervical intraepitheli-al neoplasia(CIN).Methods A total of 705 cases was included in this study who were screened from April 2014 to April 2016 and accepted colposcopy biopsy .DNA flow cytometry was performed to determine DNA index ( DI) and proliferative index ( PI) .Results Colposcopy diagnosis results showed that the detection rate of CINⅠ,CINⅡ,CINⅢ/CIS and UCC were 62.2%,78.0%,62.2% and 78.0% respectively.The sensitivity and specificity were 87.7%(213/243)and 90.2%(417/462)for DNA ploidy test using flow-cytometry.DI and PI of CINⅠ, CINⅡ,CINⅢ/CIS and UCC increased gradually with significant differences (P<0.05).Conclusion Flow-cytometry combined with colposcopy biopsy may be a useful tool for cervical cancer screening in developing coun -tries and has a competitive sensitivity and specificity ,which is worthy of popularization and application .

NQO1 overexpression is associated with poor prognosis in the uterine cervix carcinoma / 实用肿瘤学杂志

Objective To investigate the clinicopathological significance of upregulated NQO 1 protein expression in uterine cervix carcinoma ( UCC) .Methods Immunohistochemical staining was performed on paraf-fin-embedded UCC specimens from 123 patients.Disease-free survival(DFS)and overall survival(OS)rates for all cervical UCC patients were calculated using the Kaplan -Meier method ,and univariate or multivariate analyses were performed using the Cox proportional hazards regression model .Results The NQO1 protein showed a main-ly cytoplasmic staining pattern in cervical cancer cells ,and the strongly positive rate of NQO 1 was significantly higher in UCC.High-level NQO1 was closely associated with poor differentiation ,late-stage,lymph node metas-tasis and high-risk for HPV infection.Additionally,high-level NQO1 was associated with lower DFS and OS rates .Furthermore ,Cox analysis revealed that NQO 1 expression emerged as a significant independent hazard factor for DFS rate in patients with UCC .Conclusion NQO1 overexpression might be an independent biomarker for prognostic evaluation of UCCs .

Accelerated Hyperfractionated Radiotherapy for Locally Advanced Uterine Cervix Cancers / 대한방사선종양학회지

PURPOSE: To assess the efficacy of the use of accelerated hyperfractionated radiotherapy (AHRT) for locally advanced uterine cervix cancers. MATERIALS AND METHODS: Between May 2000 and September 2002, 179 patients were identified with FIGO stage IIB, IIIB, and IVA cancers. Of the 179 patients, 45 patients were treated with AHRT (AHRT group) and 134 patients were treated with conventional radiotherapy (CRT group), respectively. Patients undergoing the AHRT regimen received a dose of 30 Gy in 20 fractions (1.5 Gyx2 fractions/day) to the whole pelvis. Subsequently, with a midline block, we administered a parametrial boost with a dose of 20 Gy using 2 Gy fractions. Patients also received two courses of low-dose-rate brachytherapy, up to a total dose of 85~90 Gy to point A. In the CRT group of patients, the total dose to point A was 85~90 Gy. The overall treatment duration was a median of 37 and 66 days for patients that received AHRT and CRT, respectively. Statistical analysis was calculated by use of the Kaplan-Meier method, the log-rank test, and Chi-squared test. RESULTS: For patients that received cisplatin-based concurrent chemotherapy and radiotherapy, the local control rate at 5 years was 100% and 79.2% for the AHRT and CRT group of patients, respectively (p=0.028). The 5-year survival rate for patients with a stage IIB bulky tumor was 82.6% and 62.1% for the AHRT group and CRT group, respectively (p=0.040). There was no statistically significant difference for severe late toxicity between the two groups (p=0.561). CONCLUSION: In this study, we observed that treatment with AHRT with concurrent chemotherapy allows a significant advantage of local control and survival for locally advanced uterine cervix cancers.