Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
Clin Nucl Med ; 43(2): 120-122, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29261618

ABSTRACT

A 76-year-old man with histopathologically proven prostate cancer (initial prostate-specific antigen 110 ng/mL, Gleason 3 + 4 = 7) received F-DCFPyL PET/CT for initial staging. Both the primary tumor and pathologically enlarged pelvic lymph nodes showed no increased F-DCFPyL uptake. Subsequent histopathologic lymph node biopsy revealed prostate cancer metastasis. Prostate-specific membrane antigen tracers, such as F-DCFPyL, are promising radiopharmaceuticals for prostate cancer imaging. False-negative prostate-specific membrane antigen PET/CT findings have been reported earlier for prostate tumors with neuroendocrine differentiation. However, this report presents false-negative F-DCFPyL PET findings of an adenocarcinoma of the prostate without neuroendocrine differentiation.


Subject(s)
Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Lysine/analogs & derivatives , Positron Emission Tomography Computed Tomography , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Urea/analogs & derivatives , Aged , Humans , Male , Neoplasm Metastasis , Neurosecretory Systems/pathology
2.
J Low Genit Tract Dis ; 18(4): 338-43, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24769656

ABSTRACT

OBJECTIVE: Women treated for high-grade cervical disease (cervical intraepithelial neoplasia grade 2 or grade 3 [CIN2/3]) face a significant risk of developing post-treatment disease. Therefore, in most European countries, they are monitored by cytologic testing at 6, 12, and 24 months after treatment. Although testing for high-risk types of the human papillomavirus (hrHPV) in the follow-up seems to be a valuable supplementary method, its use is not yet fully explored. METHODS: Besides reviewing the literature, we completed a long-term follow-up study describing the cumulative risk for CIN2/3 or cancer (CIN2+) of different hrHPV and cytology test results after treatment. CONCLUSIONS: High-risk HPV testing improves the sensitivity to detect posttreatment CIN2/3 (relative sensitivity=1.15, 95% confidence interval [CI]=1.06-1.25), but the highest sensitivity (95%, 95% CI=91%-98%) is reached by performing cotesting (both cytology and hrHPV). The CIN2+ risk after a single negative cotesting result taken 6 months after treatments was similar to the risk after 3 consecutive negative cytologic test results (5-y CIN2+ risk being 3.0% [95% CI=1.5%-6.1%] and 2.9% [95% CI=1.2%-7.1%], respectively). Women who test negative for cotesting at both 6 and 24 months after treatment have a minimal risk of developing CIN3+ in the next 5 years (0.0%, 95% CI=0.0%-3.0%). RECOMMENDATIONS: We propose a new posttreatment surveillance protocol, consisting of combined testing with both cytology and hrHPV at 6 and 24 months after treatment. After 2 negative cotesting results, women should be retested after 5 years.


Subject(s)
Cytological Techniques/methods , Early Detection of Cancer/methods , Microbiological Techniques/methods , Papillomaviridae/isolation & purification , Papillomavirus Infections/complications , Uterine Cervical Dysplasia/therapy , Uterine Cervical Neoplasms/therapy , Cytological Techniques/statistics & numerical data , Early Detection of Cancer/statistics & numerical data , Female , Follow-Up Studies , Humans , Microbiological Techniques/statistics & numerical data , Netherlands , Papillomaviridae/classification , Papillomaviridae/genetics , Papillomavirus Infections/diagnosis , Treatment Outcome , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Dysplasia/diagnosis
3.
Gynecol Oncol ; 125(2): 500-7, 2012 May.
Article in English | MEDLINE | ID: mdl-22266548

ABSTRACT

OBJECTIVE: Currently, women treated for high-grade cervical intraepithelial neoplasia (CIN 2/3) are followed-up by cytology to monitor them for residual and recurrent (post-treatment) disease. This systematic review and meta-analysis determine the test performance of testing for high-risk types of the human papillomavirus (hrHPV), cytology and co-testing (combined hrHPV testing and cytology) in predicting high-grade post-treatment disease (CIN2+). METHODS: Studies that compared at least two of three post-treatment surveillance methods, and were published between January 2003 and May 2011, were identified through a bibliographic database search (PubMed, Embase.com and Wiley/Cochrane Library). Identification of relevant studies was conducted independently by two reviewers with a multi-step process. The reference standard used to diagnose post-treatment disease was histologically confirmed CIN2+. Sensitivity, specificity, diagnostic odds ratios and relative sensitivity and specificity were calculated for each study. Pooled estimates were calculated using a random effects model if heterogeneity among studies was significant, otherwise by using a fixed effects model. Estimates were reported with 95% confidence intervals (95%CI). RESULTS: Out of 2410 potentially relevant citations, 8 publications, incorporating 1513 treated women, were included. Pooled sensitivities were 0.79 (95%CI 0.72-0.85) for cytology, 0.92 (0.87-0.96) for hrHPV testing, and 0.95 (0.91-0.98) for co-testing. HrHPV testing was more sensitive than cytology to predict post-treatment CIN2+ (relative sensitivity 1.15; 95%CI 1.06-1.25). Pooled specificities were 0.81 (95%CI 0.74-0.86) for cytology, 0.76 (0.67-0.84) for hrHPV testing and 0.67 (0.60-0.74) for co-testing. HrHPV testing and cytology had a similar specificity (relative specificity 0.95, 95%CI 0.88-1.02). CONCLUSIONS: This review indicates that the hrHPV test should be included in post-treatment testing 6months after treatment, because hrHPV testing has a higher sensitivity than cytology in detecting high-grade post-treatment disease and has a similar specificity.


Subject(s)
Papillomavirus Infections/diagnosis , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/virology , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Female , Humans , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/virology , Neoplasm, Residual/pathology , Neoplasm, Residual/virology , Papillomaviridae/isolation & purification , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Vaginal Smears
4.
J Low Genit Tract Dis ; 15(4): 309-15, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21959574

ABSTRACT

We have developed a Europe-wide consensus statement on "HPV Vaccination and Colposcopy" under the aegis of the European Federation for Colposcopy. We look at the historical perspective, the currently available vaccines, cervical vaccination programs, future perspectives, and the impact all this will have on cervical cancer screening and colposcopy services.


Subject(s)
Colposcopy/methods , Consensus , Early Detection of Cancer/methods , Papillomavirus Infections/diagnosis , Papillomavirus Vaccines/administration & dosage , Uterine Cervical Neoplasms/diagnosis , Colposcopy/standards , Early Detection of Cancer/standards , Europe , Female , Humans , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/immunology , Uterine Cervical Neoplasms/prevention & control , Vaccination/methods
5.
Gynecol Oncol ; 122(2): 297-302, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21620450

ABSTRACT

OBJECTIVE: Over 90% of all cervical adenocarcinoma are caused by a transforming infection with a high-risk type human papillomavirus (hrHPV). Previous studies demonstrated that the association between hrHPV positivity and cervical clear-cell adenocarcinoma (CCAC) varies between 0% and 100%. As approximately 60% of all CCAC are associated with intra-uterine diethylstilbestrol (DES) exposure, we determined in a cohort of both DES-exposed and DES-unexposed women the prevalence of hrHPV infections, and the potential etiological role of hrHPV by additional analysis of p16INK4a and p53 expression. METHODS: Representative slides of 28 women diagnosed with CCAC were tested for hrHPV by two PCR methods (the clinically validated GP5+/6+ PCR and the very sensitive SPF(10)PCR/LiPA(25)). Fifteen women were DES-exposed, 10 unexposed and of 3 women DES-exposure was unknown. Twenty-one cases with sufficient material were immuno-histochemically stained for p16INK4a and p53. RESULTS: Seven tumors, of which four DES-exposed and two unexposed tested positive for hrHPV with GP5+/6+ PCR. Thirteen tumors, of which five DES-exposed and seven unexposed, tested positive with SPF(10)PCR/LiPA(25). In one women with unknown exposure, a CCAC tested positive in both assays. Only three cases, none in DES-exposed women, and all positive with both hrHPV assays, revealed diffuse p16INK4a immuno-staining and weak p53 staining as well, supporting indisputable hrHPV involvement. CONCLUSIONS: Although the prevalence of hrHPV was high, only two DES-unrelated CCAC (25%) and one tumor in a woman with unknown exposure could be attributed to hrHPV.


Subject(s)
Adenocarcinoma, Clear Cell/etiology , Diethylstilbestrol/adverse effects , Papillomaviridae/isolation & purification , Prenatal Exposure Delayed Effects , Uterine Cervical Neoplasms/etiology , Adenocarcinoma, Clear Cell/chemically induced , Adenocarcinoma, Clear Cell/virology , Adolescent , Adult , Cyclin-Dependent Kinase Inhibitor p16 , Female , Humans , Immunohistochemistry , Middle Aged , Neoplasm Proteins/analysis , Polymerase Chain Reaction , Pregnancy , Risk , Tumor Suppressor Protein p53/analysis , Uterine Cervical Neoplasms/chemically induced , Uterine Cervical Neoplasms/virology
6.
Lancet Oncol ; 12(5): 441-50, 2011 May.
Article in English | MEDLINE | ID: mdl-21530398

ABSTRACT

BACKGROUND: 15% of women treated for high-grade cervical intraepithelial neoplasia (CIN grade 2 or 3) develop residual or recurrent CIN grade 2 or 3 or cervical cancer, most of which are diagnosed within 2 years of treatment. To gain more insight into the long-term predictive value of different post-treatment strategies, we assessed the long-term cumulative risk of post-treatment CIN grade 2 or 3 or cancer and different follow-up algorithms to identify women at risk of residual or recurrent disease. METHODS: Women who were included in three studies in the Netherlands and who were treated for CIN grade 2 or 3 between July, 1988, and November, 2004, were followed up by cytology and testing for high-risk human papillomavirus (hrHPV) at 6, 12, and 24 months after treatment, and subsequently received cytological screening every 5 years. The primary endpoint was the cumulative risk of post-treatment CIN grade 2 or higher by December, 2009. We also assessed the cumulative risk of CIN grade 2 or higher in women with three consecutive negative cytological smears and women with negative co-testing with cytology and hrHPV at months 6 and 24. This study is registered in the Dutch trial register, NTR1468. FINDINGS: 435 women were included, 76 (17%) of whom developed post-treatment CIN grade 2 or higher, of which 39 were CIN grade 3 or higher. The 5-year risk of developing post-treatment CIN grade 2 or higher was 16·5% (95% CI 13·0-20·7) and the 10-year risk was 18·3% (13·8-24·0). The 5-year risk of developing post-treatment CIN grade 3 or higher was 8·6% (95% CI 6·0-12·1) and the 10-year risk was 9·2% (5·8-14·2). Women with three consecutive negative cytological smears had a CIN grade 2 or higher risk of 2·9% (95% CI 1·2-7·1) in the next 5 years and of 5·2% (2·1-12·4) in the next 10 years. The 5-year risk of CIN grade 3 or higher was 0·7% (95% CI 0·0-3·9) and the 10-year risk was 0·7% (0·0-6·3). Women with negative results for co-testing had a 5-year risk of CIN grade 2 or higher of 1·0% (95% CI 0·2-4·6) and a 10-year risk of 3·6% (1·1-10·7). The 5-year risk of CIN grade 3 or higher was 0·0% (95% CI 0·0-3·0) and the 10-year risk was 0·0% (0·0-5·3). INTERPRETATION: The 5-year risk of post-treatment CIN grade 2 or higher in women with three consecutive negative cytological smears or negative co-testing for cytology and hrHPV at 6 and 24 months was similar to that of women with normal cytology in population-based screening and therefore justifies their return to regular screening. FUNDING: VU University Medical Center, Erasmus University Medical Center, Netherlands.


Subject(s)
Mass Screening/methods , Neoplasm Recurrence, Local/diagnosis , Population Surveillance/methods , Uterine Cervical Dysplasia/diagnosis , Uterine Cervical Neoplasms/diagnosis , Adult , Aged , Algorithms , Alphapapillomavirus/isolation & purification , Cohort Studies , Confounding Factors, Epidemiologic , Female , Humans , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/therapy , Neoplasm Recurrence, Local/virology , Papillomavirus Infections/complications , Papillomavirus Infections/virology , Risk Assessment , Risk Factors , Severity of Illness Index , Tumor Virus Infections/complications , Tumor Virus Infections/virology , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/therapy , Uterine Cervical Neoplasms/virology , Vaginal Smears , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/therapy , Uterine Cervical Dysplasia/virology
7.
Hum Vaccin ; 6(12): 1054-61, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21157180

ABSTRACT

This pooled analysis of data from four Phase III clinical trials was undertaken to assess the correlation between levels of anti-human papillomavirus (HPV)-16/18 antibodies in serum and cervicovaginal secretions (CVS) in girls and women vaccinated with the HPV-16/18 AS04-adjuvanted vaccine. Serum and CVS samples were collected from a subset of women aged 10-65 years (N=350) at pre-specified time-points from 7 to 36 months post-vaccination. Anti-HPV-16/18 antibody levels in serum and CVS were measured by enzyme-linked immunosorbent assay. Pearson correlation coefficients between serum and CVS antibody levels, standardized for total immunoglobulin G, were calculated at each time-point in women with detectable antibodies in both serum and CVS. All subjects had seroconverted at Month 7 and remained seropositive through Month 36 for both antigens. Geometric mean titers of anti-HPV-16/18 antibodies in serum were substantially higher at all time-points than those in a control group of women who had cleared a natural HPV infection in another trial. In women with detectable antibodies in both serum and CVS, good correlation was seen between HPV-16/18 antibody levels at all time-points (Pearson correlation coefficient: 0.84-0.92 for HPV-16 and 0.90-0.91 for HPV-18). The strong correlation between levels of HPV-16/18 antibodies in serum and CVS up to 36 months post-vaccination in girls and women vaccinated with the HPV-16/18 AS04-adjuvanted vaccine supports transudation of serum antibodies as the mechanism by which antibodies are introduced into CVS. These CVS antibodies may play a role in the protective efficacy of this vaccine.


Subject(s)
Antibodies, Viral/analysis , Antibodies, Viral/blood , Cervix Uteri/immunology , Papillomavirus Vaccines/immunology , Serum/immunology , Vagina/immunology , Adjuvants, Immunologic/administration & dosage , Adolescent , Adult , Aged , Bodily Secretions/immunology , Child , Enzyme-Linked Immunosorbent Assay , Female , Human papillomavirus 16/immunology , Human papillomavirus 18/immunology , Humans , Immunoglobulin G/analysis , Immunoglobulin G/blood , Middle Aged , Papillomavirus Vaccines/administration & dosage , Young Adult
8.
J Low Genit Tract Dis ; 14(1): 49-55, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20040836

ABSTRACT

OBJECTIVE: Because high-risk human papillomavirus (hrHPV) is the necessary factor in the development of high-grade cervical lesions, knowing the colposcopic differences between hrHPV-positive and hrHPV-negative lesions could be of value. We have evaluated whether there are colposcopic differences between lesions testing hrHPV-positive or hrHPV-negative. MATERIALS AND METHODS: This study was conducted as a retrospective case-control study. We designed a scoring system for colposcopic criteria that might be of relevance to distinguish hrHPV-positive from hrHPV-negative lesions. Colposcopic images were analyzed from patients at the VU University Medical Center Amsterdam, the Netherlands, in whom a GP5+/6+ polymerase chain reaction hrHPV test had been performed within a month of the colposcopic examination (n = 507). RESULTS: Visibility of the transformation zone (corrected for age), a (very) coarse and irregular punctation pattern, and a large lesion (>25% of the visible cervix) were more often associated with a positive hrHPV test status (p =.001, odds ratio [OR] = 2.29, 95% CI = 1.41-3.73; p =.036, OR 2.37, 95% CI = 1.08-5.19; and p =.044, OR = 1.78, 95% CI = 1.08-2.94, respectively). After correction for histologic diagnosis, the difference between hrHPV-positive and hrHPV-negative lesions for visibility of the transformation zone and lesion size remained statistically significant (OR = 2.44, 95% CI = 1.35-4.41 and OR = 1.92, 95% CI = 1.04-3.54, respectively). CONCLUSIONS: This study indicates that visibility of the transformation zone, (very) coarse punctation pattern, and larger lesion size were the main colposcopic features associated with a hrHPV-positive test status.


Subject(s)
Colposcopy , Papillomavirus Infections/diagnosis , Papillomavirus Infections/pathology , Uterine Cervical Diseases/diagnosis , Uterine Cervical Diseases/pathology , Adolescent , Adult , Aged , Case-Control Studies , DNA, Viral/genetics , DNA, Viral/isolation & purification , Female , Humans , Middle Aged , Netherlands , Polymerase Chain Reaction/methods , Retrospective Studies , Severity of Illness Index , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...