Résumé
Background: Cervical cancer is a major global health problem, with a high burden in developing countries. Early detection and management of precancerous conditions, such as cervical intraepithelial neoplasia (CIN), can help to prevent the development of cervical cancer. Colposcopy, which involves the visualization of the cervix through optical instruments, is considered the gold standard for the diagnosis of cervical abnormalities. The aim of the study was to assess the correlation between colposcopy findings and histopathological results in cases where visual inspection of the cervix with acetic acid (VIA) was positive. Material & Methods: This cross-sectional study was conducted at the Department of Gynecology, Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh. The study duration was 1 year, from November 2017 to October 2018. Participants were recruited from the hospital’s gynecology outpatient department and included 95 women who had a positive VIA test. A Purposive consecutive sampling method was followed for the selection of the participants. Results: The study included 95 patients in Bangladesh who had a positive VIA test. The age distribution of the patients ranged from 25 to 60 years, with a mean age of 35.89±8.88 years. The majority of patients (85.3%) had acetowhite areas, followed by 11 (11.5%) punctuation and 3 (3.2%) mixed (acetowhite area and mosaicism). Histopathological findings revealed that one-third (33.6%) of patients had chronic cervicitis, with 36 (378.8%) having moderate dysplasia, 16 (16.8%) having mild dysplasia, 7 (7.5%) having invasive carcinoma, and 4 (4.2%) having chronic cervicitis with sq. metaplasia. Among the cases, the comparison between colposcopy-directed biopsy results and Colposcopy findings. It was observed that more than one-fourth of 24(29.7%) patients were chronic cervicitis in pure acetowhite area, 8(72.7%) in punctuation, and all patients were mild dysplasia in mixed (acetowhite area and mosaicism). Among 81 patients 53 patients presented with pre-cancerous lesions. The difference was statically significant (p<0.05) in the study patients. Conclusion: Colposcopy, which involves the visualization of the cervix through optical instruments, was found to be an effective tool for the diagnosis of cervical abnormalities in these cases. These findings highlight the importance of colposcopy as a diagnostic tool for cervical abnormalities, particularly in resource-limited settings where access to other screening methods may be limited.
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Objective ToexplorethevalueofMRIiterativedecompositionofwaterandfatwithechoasymmetryandleastsquares estimationquantificationsequence(IDEALIQ)techniquetoevaluatemyelosuppressionduringradiotherapyandchemotherapyincervicalcancer. Methods 25femalesubjectswereenrolledinthisstudy,whowereclinicallydiagnosedascervicalcancerandacceptedtheradiotherapyand chemotherapy.AllthesubjectswereperformedwithsagittalMRIIDEALIQscansineachweek’streatmentandattheendofwhole fiveweeks’therapy,soeachpatienthad6timesMRIscans.ROIweremanuallyplacedonL4,L5andS1vertebralbodyandsubcutaneousfatto measurethefatfraction.ThefatfractioncolorimageswerereconstructedonaAW (AdvantageWorkstation)4.6workstation.Results Asthe radiationandchemotherapyprocess,thevaluesoffatfractionincreasedprogressivelyonL4,L5andS1vertebralbody(P<0.001), whilethefatfractionvaluesinsubcutaneousfatappearedstableallthetime(P=0.987).Conclusion MRIIDEALIQtechniquecan evaluatethereal-timefatfraction,andradiotherapyandchemotherapyplansmaybeoptimizedaccordingtothefatfractionresult.
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Objective This study was conducted to determine the prognostic factors of cervical adenocarcinoma.Methods Between July 2008 and June 2013, 211 consecutive patients were treated because of International Federation of Gynecology and Obstetrics(FIGO) stage IA-IVB cervical adenocarcinoma.Overall survival was analyzed by the Kaplan-Meier method.Results One-year OS rate was 96.2%,and 3-year OS rate was 88.6%,and 5-year OS rate was 74.7%.Patients'age,FIGO stage,postoperative clinicopathological factors such as depth of stromal invasion,number of pelvic lymph node metastasis and para-aortic lymph node metastasis,were analyzed to discriminate their prognostic role.In the univariate analysis, age,FIGO stge,deep stromal invasion, lymph-vascular space invasion, number of pelvic lymph node metastasis,para-aortic lymph node metastasis were associated with poorer survival(P< 0.05).In the cox analysis, age (RR=4.940,95%CI:1.925-12.678),pelvic lymph node metastasis(RR=2.391,95%CI:1.311-4.360),para-aortic lymph node metastasis (RR=6.344,95%CI:1.007-39.990)and FIGO stage(Ⅲ vs I,RR=5.315,95%CI:2.760-12.203;Ⅳ vs I,RR=9.932,95%CI:2.905-18.846)were independent prognostic factors of invasive cervical adenocarcinoma.Conclusion Early detection and early treatment is very important for cervical adenocarcinoma patients.Give the patient suitable and maybe more aggressive adjuvant therapy according to surgical pathology is helpful for imporving adenocarcinoma treatment.
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Objective To investigate the infection status and genotype distribution of human papillomavirus (HPV) infection in Changzhou district ,and to provide a theoretical basis for the prevention ,development and clinical diagnosis and treatment of HPV . Methods From October 2015 to July 2016 ,1 718 cases of female cervical epithelial cells were collected ,and 28 kinds of gene typing were detected by PCR‐reverse dot blot hybridization .Results The infection rate:1 718 cases of women were collected ,the positive HPV infections were 34 .23% .The infection types :single infection rate was 23 .57% (405/1 718) .The high‐risk HPV subtype in‐fections accounted for 17 .17% (295/1 718) and the low‐risk HPV subtype infections accounted for 5 .18% (89/1 718) ,suspected high‐risk infection was 1 .22% (21/1 718) .Multiple infection rate was 10 .94% (188/1 718) .HPV52 was the most common infec‐tion among high‐risk HPV infection ,the positive rate was 16 .16% (95/588) .HPV61 was the most common infection among low‐risk HPV infection ,the positive rate was 4 .08% (24/588) .There was no significant difference between age and HPV positive rate . The 61-70 age group had the highest HPV multiple infection rate in all age groups .Conclusion The high HPV infection is ob‐served in Changzhou district ,among which single HPV52 infection and the high‐risk HPV infection are the most common infec‐tions .There is difference in HPV infection among different age groups .