ABSTRACT
PURPOSE OF INVESTIGATION: The absence of cervical intraepithelial neoplasia (CIN) in a loop electrosurgical excision procedure (LEEP), cold-knife conization and hysterectomy for treatment of CIN is an occasional finding of uncertain clinical significance. The aim of this study was to estimate the frequency of a negative procedure and its relationship to disease recurrence. METHODS: A retrospective study was conducted on 263 specimens from women submitted to the LEEP (n = 142), conization (n = 101) or hysterectomy (n = 20) due to CIN. RESULTS: The frequency of negative conization, LEEP and hysterectomy were, respectively, 15.5%, 19.8% and 25%. Recurrence occurred from 16 to 44 (median = 42) months in women with negative surgical specimens (LEEP or cold knife conization), and after five to 31 (median = 20) months after histological findings of CIN in surgical specimens, respectively, 7.1% and 11.2%. CONCLUSION: The absence of CIN in those procedures of biopsy-confirmed CIN is a not an uncommon finding. Patients with positive or negative specimens should be carefully followed.
Subject(s)
Electrosurgery/methods , Hysterectomy/methods , Neoplasm Recurrence, Local/pathology , Uterine Cervical Dysplasia/surgery , Uterine Cervical Neoplasms/surgery , Adult , Aged , Biopsy, Needle , Colposcopy/methods , Female , Follow-Up Studies , Humans , Immunohistochemistry , Incidence , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Retrospective Studies , Risk Assessment , Treatment Outcome , Uterine Cervical Neoplasms/pathology , Uterine Cervical Dysplasia/pathologyABSTRACT
The phenomenon of multidrug resistance (MDR), that involves the efflux pump P-glycoprotein, can be reversed by a number of substances known as MDR modulators or reversing agents. In the present study we investigated the action of three anthracyclines, mitoxantrone and vincristine on short-term (72 h) cultures using 2 methods ([3H] incorporation and MTT (3-[4,5-dimethylthiasol-2-yl]-2,5-diphenyltetrazolium bromide)), on 2 cell lines: K562, a human erythroleukemia, and a vincristine-resistant subline K562-Lucena 1. Using the same culture methods plus flow cytometry analysis, the reversing potentials of cyclospotin A and verapamil were studied in both cell lines. There were differences in the sensitivity and resistance profiles of the two lines to the various drugs but daunorubicin (5 mug/ml) and idarubicin (0.035 mug/ml) were the most effective when each was used in high concentration. Cyclosporine at 200 mug/ml and verapamil at 5 mug/ml reversed MDR in the resistant line, and had a synergistic action with chemotherapeutic agents on the sensitive line. Again differences were demonstrable between combinations of the various drugs and reversal was only clearly shown with the method measuring cell proliferation ([3H] incorporation) but not by the method measuring metabolic activity (MIT). The efflux of rhodamine-123 mimics the functional activity of the pump and cyclosporine was a better reversing agent by this criteria. These data show that the results obtained in in vitro studies attempting to identify treatments for different types of leukemias depend to a large extent on the methods used to measure cell response.
