Histopathological Analysis of Hysterectomy Specimens in a Tertiary Care Centre: A Retrospective Study.

Introduction The uterus is a crucial reproductive organ that is susceptible to the development of several non-neoplastic and neoplastic diseases in women, greatly increasing morbidity and mortality. Although there are various therapeutic options, hysterectomy is still a popular treatment option throughout the world. Abnormal uterine bleeding, pelvic pain, pelvic inflammatory disease (PID), prolapse of the uterus, adenomyosis, endometriosis, fibroids, gynecological malignancies, and obstetric problems that require hysterectomy, all samples must be examined histopathologically. Histopathological examination of the specimens obtained after hysterectomy is important for both diagnosis and treatment. The current work aimed to identify the various clinical indications, analyze the clinicopathological correlation in hysterectomy specimens, and analyze the patterns of lesions in hysterectomy specimens. Materials and methods This study was conducted in the Department of Pathology at the Datta Meghe Medical College, Wanadongari, Nagpur, from February 2022 to January 2023. All types of hysterectomy specimens received during this year were examined, and the tissues were processed and stained with H&E. Histopathological examination was performed, and various lesions in the hysterectomy specimens were examined. The study included all forms of hysterectomy, including abdominal, vaginal, laparoscopic, and total abdominal hysterectomy. Results An analysis of 110 cases of hysterectomy revealed that abdominal hysterectomy was the type of hysterectomy in 79 (71.82%) cases, with a maximum age range of 35 to 45 years (42.72%). The proliferative phase endometrium was the most common endometrial pathology, accounting for 43 (39.09%) cases, followed by the atrophic endometrium in 35 (31.82%) cases. Leiomyoma was the most prevalent myometrial lesion, accounting for 52 (47.28%) cases, followed by adenomyosis, accounting for 23 (20.91%) cases. Chronic cervicitis was the most common incidental finding in the hysterectomy samples, accounting for 85 (77.28%) cases. Follicular cysts, representing 22 (20%) cases, were the most common ovarian lesions, followed by serous cystadenoma in seven (6.37%) cases. Two cases of malignant tumors were noted: one case of endometrial carcinoma and one case of mucinous cystadenocarcinoma of the ovary. In most cases, ranging from 70% to 100%, the final histopathological diagnosis supports the preoperative clinical diagnosis. Conclusion Hysterectomy is the most common major gynecological surgery performed under elective conditions. Although histological studies and clinical diagnoses are closely correlated, several lesions, including chronic cervicitis and adenomyosis, were discovered incidentally. Therefore, every hysterectomy specimen must undergo a thorough histological investigation, even if it appears superficially normal, to confirm the diagnosis and improve postoperative care.

Chronic Cervicitis and Cervical Cancer Detection Based on Deep Learning of Colposcopy Images Toward Translational Pharmacology.

With the rapid development of deep learning, automatic image recognition is widely used in medical development. In this study, a deep learning convolutional neural network model was developed to recognize and classify chronic cervicitis and cervical cancer. A total of 10,012 colposcopy images of 1,081 patients from Hunan Provincial People's Hospital in China were recorded. Five different colposcopy image features of the cervix including chronic cervicitis, intraepithelial lesions, cancer, polypus, and free hyperplastic squamous epithelial tissue were extracted to be applied in our deep learning network convolutional neural network model. However, the result showed a low accuracy (42.16%) due to computer misrecognition of chronic cervicitis, intraepithelial lesions, and free hyperplastic squamous epithelial tissue with high similarity. To optimize this model, we selected two significant feature images: chronic cervicitis and cervical cancer to input into a deep learning network. The result indicates high accuracy and robustness with an accuracy of 95.19%, which can be applied to detect whether the patient has chronic cervicitis or cervical cancer based on the patient's colposcopy images.

Histomorphological Spectrum of Cervical Lesions in a Rural Hospital.

Background Pathologically the cervix is affected by infective, inflammatory, and neoplastic diseases. Non­neoplastic lesions of the cervix are seen often in sexually active women. Inflammatory lesions include chronic granulomatous cervicitis, acute and chronic cervicitis. In India, cervical cancer is a significant health problem. Many factors contribute to the differences in the spectrum of cervical diseases in the rural population compared to urban areas, but the studies in these populations are scarce. Materials and methods A retrospective analysis of all gynecological lesions over one year was studied. All case files were manually extracted, and the data was entered in an Excel sheet. The information included was clinical history (symptoms, signs, menstrual history, duration of illness, parity status), physical examination, per vaginal examination, investigations, including pathological diagnosis. The curated data was then analyzed using IBM SPSS for Windows version 22 (IBM Corp., Armonk, NY). Results There were 164 women in the study, with a mean age of 46.07 ± 8.17 years. A majority (n = 124, 75.6%) presented with excessive bleeding. Two-thirds of the study population had a normal cervix on examination. Twenty-seven women had squamous metaplasia, six had low-grade (LSIL) and high-grade squamous intraepithelial lesions (HSIL), and one had malignancy. Excessive bleeding was significantly associated only with LSIL. Among the microscopic findings, only squamous metaplasia (p < 0.001) and dysplasia (p < 0.001) were significantly associated with the final diagnoses, such as LSIL, HSIL, and chronic cervicitis. Conclusion Most studies involving rural populations have involved the knowledge, attitude, and practices of the study cohort rather than the histomorphological spectrum of cervical lesions. Since these disorders are also influenced by education, parity, hygiene, and socioeconomic status, it behooves us to be aware of the spectrum of cervical lesions in a rural cohort who differ in these aspects when compared to urban populations. Most of such lesions of the cervix in the population that our medical institution served were benign in nature.

Effectiveness of focused ultrasound for high risk human papillomavirus infection-related cervical lesions.

OBJECTIVE: The purpose of this study was to compare the efficacy of focused ultrasound (FU) and interferon drug therapy for cervical intraepithelial neoplasia 1 (CIN1) and chronic cervicitis associated with high risk human papillomavirus (HR-HPV) infection, as well as analyze the influencing factors. METHODS: A retrospective cohort study was performed from January 2017 to December 2019. A total of 592 patients were enrolled, of which 300 patients were treated with FU and 292 patients were treated with interferon drugs. Kaplan-Meier curves and a COX regression model were used to compare the curative effects of the two therapeutic methods using HR-HPV clearance as the main outcome. The relationship between age, HR-HPV infection type, pathological type, preoperative HR-HPV status and HR-HPV clearance were also analyzed. RESULTS: The median time for HR-HPV clearance was 6.00 months (95% CI: 5.24-6.76) in the FU group and 26.00 months (95% CI: 22.32-29.68) in the medication group. A significant difference was observed between the two groups (χ2 =198.902, p = 0.000). The HR-HPV clearance rate was 4.927 (95% CI 3.840-6.321; p = 0.000) times higher in the patients treated with FU than those treated with interferon drugs. In the FU group, no significant difference was observed in HR-HPV clearance rate between CIN1 and chronic cervicitis (χ2=0.660, p = 0.416), which was also insignificant between HR-HPV persistent and non-persistent infections (χ2=0.751, p = 0.386). CONCLUSION: FU therapy can eliminate HR-HPV infections in a short period of time. Moreover, the treatment efficacy of FU was significantly superior to that of interferon drugs.

Russell Body Cervicitis-rare But Relevant.

Russell boy cervicitis is a rare form of cervicits characterised by the accumulation of intracytoplasmic eosinophilic inclusion bodies in the plasma cells. Extensive literature search revealed previous four reported cases of Russell body cervicitis. Here, we report a case of Russell body cervicitis in a 44-year-old female who presented with recurrent endocervical polyps.

A Clinical Conundrum: Chronic Cervicitis.

BACKGROUND: Cervicitis is most commonly caused by sexually transmitted infections. "Normal vaginal flora" are rarely responsible for inflammation of the cervix. CASE: We describe a 22-year-old female patient with chronic cervicitis who had negative test results for bacterial and viral pathogens most commonly responsible for cervicitis. After 21 months of symptoms and multiple courses of empiric antibiotics addressing the most common causes of cervicitis, a course of antibiotics targeting group B streptococcus found on a genital culture resolved the patient's illness. SUMMARY AND CONCLUSION: Bacteria considered to be "normal vaginal flora" in a nonpregnant young female adult should be considered as a potential pathogen when test results for more routine pathogens associated with cervicitis are negative.

Effect of Dialyzable Leukocyte Extract on chronic cervicitis in patients with HPV infection.

The objective of the study was to assess the clinical, histopathological and immunochemical changes induced by dialyzable leukocyte extract (DLE) treatment in patients with chronic cervicitis associated to HPV infection. Fifty-four female Mexican patients diagnosed with chronic cervicitis, cervical intra-epithelial neoplasia grade 1 (CIN 1) and HPV infection were divided into two groups: patients treated with placebo and patients treated with DLE. Clinical and colposcopy evaluations were performed before and after treatments. Cervix biopsies were obtained to analyze histopathological features and to determine the local immunological changes by immunohistochemistry analyses. Placebo-treated patients showed no significant changes in the evaluated parameters. Interestingly, in DLE-treated patients, clinical manifestations of cervicitis diminished and 89% of them remitted the colposcopic lesions. Histological analyses of biopsies from DLE-treated patients showed a decreasing leukocyte infiltrate. Immunochemical analyses showed an increased expression of TGF-ß, while expression of IFN-γ, PCNA, and IL-32 decreased. Our results suggest that DLE can stimulate innate immunity of cervical mucosae, diminishing chronic cervicitis in HPV-infected patients. TRIAL REGISTRATION: Register ISRCTN16429164 Abbreviations: HPV = Human Papilloma Virus; DLE = Dialyzable leukocyte extract.

Efficacy of Baofukang combined with clindamycin injection in treatment of chronic cervicitis patients with high-risk human papilloma virus infection / 药物评价研究

Objective To discuss the efficacy of Baofukang combined with clindamycin injection in treatment of chronic cervicitis patients with high-risk human papilloma virus infection (hr-HPV).Methods Totally 100 patients who had chronic cervicitis with hr-HPV were selected and divided into two groups randomly.The patients in control group (49 cases) were given Baofukang.The patients in observation group (51 cases) were given Baofukang combined with clindamycin injection.The efficacy of Baofukang combined with clindamycin injection in treatment of chronic cervicitis patients with hr-HPV was evaluated by efficacy,HPV negative rate,inflammatory factors before and after treatment and adverse reaction during treatment.Results After treatment,the effective rate of observation group was 92.1％,and the effective rate of control group was 75.5％,the effective rate of observation group was higher than that of control group (P ＜ 0.05).After treatment,the HPV negative rate in observation group was 90.2％,the control group was 59.2％,the HPV negative rate of observation group was higher than that of control group (P ＜ 0.05).Before treatment,there was no statistical significance on hs-CRP,IL-6,and TNF-α between two groups.After treatment,the hs-CRP,IL-6,and TNF-α were decreased in two groups (P ＜ 0.05).The hs-CRP,IL-6,and TNF-α of observation group were lower than those of control group (P ＜ 0.05).There was no statistical significance on adverse reaction between two groups.Conclusion Baofukang combined with clindamycin injection had a good therapeutic effect on chronic cervicitis with hr-HPV.It could inhibit HPV and inflammatory factors well.It was safe and worthy of clinical use.

Clinical efficacy of LEEP knife combined with chitosan cervical antibacterial film in the treatment of chronic cervicitis and its psychological intervention / 中国生化药物杂志

Objective To investigate and analyze the clinical efficacy of LEEP knife combined with chitosan cervical antibacterial membrane in the treatment of chronic cervicitis and to observe the psychological intervention. Methods 100 cases of Chronic Cervicitis Patients in our hospital from January 2015 to October 2016 were selected as the research object. They were randomly divided into the control group and the experimental group, each group had 50 cases. Patients in the control group were treated with LEEP knife surgery, and no drugs were used after the operation. The patients in the experimental group were treated with LEEP knife combined with chitosan and cervical antibacterial membrane. Psychological intervention was carried out, and the mental health of the patients was paid close attention to, and communication and communication with patients were strengthened. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the effective rate of the experimental group and the control group was 100.0%. The cure rate of the control group was 80.0%, significantly lower than that of the experimental group(96.0%), the difference was statistically significant (P<0.05). After treatment, the SAS score of the experimental group was (40.1±6.2) points, and the SDS score was (38.4±7.9) points. The scores of SAS in the control group were (49.6±7.2) points, and the SDS score was (48.2±8.5) points. There were three cases of complications in the experimental group, the incidence of complications was significantly lower than that of the control group (20.0%), The difference was statistically significant (P<0.05). Conclusion The clinical effect of LEEP knife combined with chitosan cervical antibacterial membrane in the treatment of chronic cervicitis treated with psychological intervention, high cure rate, low probability of complications, significantly improve patients' negative emotions, has clinical significance.

Expressions of p16INK4a protein in cervical lesion tissues of Mongolian patients and their significances / 吉林大学学报(医学版)

Objective:To detect the expressions of p16INK4a protein in the cervical lesion tissues of the Mongolian patients, and to explore the relationship between its expression and the occurrence and development of cervical cancer in the Mongolian patients.Methods:A total of 100 cases of paraffin sections of cervical cancer, cervical intraepithelial neoplasia(CIN),chronic cervicitis and uterine leiomyoma were divided into 25 cases of cervical cancer, 35 cases of CIN, 20 cases of chronic cervicitis, and 20 cases of uterine leiomyoma groups. The expressions of p16INK4a protein in different cervical tissues were detected by immunohistochemical SP method.Results:The positive rates of p16INK4a protern in cervical cancer, CIN, chronic cervicitis and uterine leiomyoma tissnes were 100.0%, 74.3%, 25.0%,and 10.0%, respectively.The results of K-W H rank sum test for multiple sample comparisons showed that the positive expression rate of p16INK4a protein in cervical cancer tissue was significantly higher than those in CIN, chronic cervicitis and uterine leiomyoma tissues(P<0.05).Conclusion:p16INK4a protein can be used as a indicator to screen the Mongolian patients with early cervical cancer.

Evaluation and clinical significance of cyclin-dependent kinase5 expression in cervical lesions: a clinical research study in Guangxi, China.

BACKGROUND: Studies have been reported that cyclin-dependent kinase5 (CDK5) was associated with the development of several cancers. However, the relationship between CDK5 level and clinicopathological factors is still poorly understood in cervical diseases. The aim of the current study was to investigate the expression of CDK5 and its clinical significance in variant cervical lesions. METHODS: Immunohistochemistry (IHC) was used to detect CDK5 expression in 54 cases of chronic cervicitis, 42 cases of condyloma acuminate (CA), 38 cases of carcinoma in situ, and 360 cases of cervical cancers [adenocarcinoma, n = 63; squamous cell carcinoma (SCC), n = 263; adenosquamous carcinoma, n = 34]. The clinicopathological characteristics in relation to CDK5 were examined by Pearson's Chi-square test. RESULTS: The positive rates of CDK5 were 27.8, 31.0, 50, 54.0, 58.8, and 62.7 % in chronic cervicitis, CA, carcinoma in situ, adenocarcinoma, adenosquamous carcinoma and SCC, respectively. Statistically analysis showed that CDK5 expression in cervical cancer tissues was higher than non-cervical cancer tissues (inflammation and CA) (P < 0.001). The overexpression of CDK5 was significantly correlated with lymph node metastasis (r = 0.317; P < 0.001), histological type (r = 0.198; P < 0.001), FIGO stage (r = 0.358; P < 0.001), TNM stage (r = 0.329; P < 0.001) and pathological grade (r = 0.259; P < 0.001) in cervical lesions evaluated by Pearson's Chi-square test. Furthermore, the positive relationships were found between CDK5 and lymph node metastasis (P < 0.001), FIGO stage (P < 0.001), TNM stage (P < 0.001) and pathological grade (P < 0.001) in SCC. CDK5 was positively interrelated to TNM stage (P = 0.017) in adenosquamous carcinoma. CONCLUSIONS: CDK5 may play a vital role in the development of cervical cancer, which may be a marker for the diagnosis, therapy and prognosis of cervical cancer.

The Short-term and Long-term Clinical Effect of Leep Knife Treatment of Chronic Cervicitis / 昆明医科大学学报

Objective To explore the short-term and long-term clinical effect of leep knife treatment of chronic cervicitis. Methods A single-center, prospective, randomized, controlled study was used, 120 patients with chronic cervicitis were randomly divided into observation group and control group, each group of 60 patients. Patients in the observation group were treated with (LEEP) knife, parameters setting frequency was 3.8 MHz, power was 30 ~ 40W, patients in the control group were treated with microwave. The intraoperative and postoperative recovery and relapse were compared between two groups. Results The intraoperative blood loss, operative time, postoperative vaginal discharge time in the observation group were significantly less than control group, there was a significantly statistical difference (P<0.001) . After two weeks and three months , the cure rate in observation group were 70% and 98.33% respectively, the cure rate in control group were 16.67% and 51.67%, there was a significantly statistical difference (P <0.01) . After 2 weeks and 3 months, the infection rate and recurrence rate in the observation group were significantly lower than the control group, there was a significantly statistical difference (P <0.05) . Conclusion Leep knife for treatment of chronic cervicitis patients has lower postoperative recurrence, lower infection rate and higher cure rate in short-term and long-term, and less intraoperative trauma, shorter operation time, and has important clinical significance for the prognosis of patients.

Curative efficacy of longxuejie capsule combinated with tinidazole in treatment of cervicitis and its effects on levels of immunoglobulin / 中国生化药物杂志

Objective To investigate the clinical effect of longxuejie capsule in combination with tinidazole in the treatment of chronic cervicitis and its effects on levels of immunoglobulin.Methods 90 cases in our hospital from January 2013 to June 2014, with chronic cervicitis meeting the inclusion critera were randomly divided into 2 groups by method of stratified randomization equally.Control group (n=45) was treated with tinidazole and conventional treatments, while observation group ( n =45 ) was treated with tinidazole and longxuejie capsule.Then, the curative efficacy, scale of symptoms and levels of immunoglobulin were observed and compared.Results The therapeutic efficiency ratio of observation group was 95.6%, which was significantly higher than that of control group ( 80.0%, P<0.05 ).After the treatment, in comparison with the control group, scale of cervical secretion and severity of cervical lesion was statistically lower respectively than observation group ( P<0.05 ).As to immunological function, concentrations of IgG, IgM, IgA in observation group were statistically higher than that in control group after the treatment (P<0.05).The control group and observation group respectively in 2 cases and 3 cases of abdominal pain, alleviated by themselves without treatment.Conclusion longxuejie capsule combined with tinidazole is effective and reliable for patients with chronic cervicitis, which significantly improves symptoms and elevates levels of immunoglobulin.

Application of comfort care in loop electrosurgical excision procedure in treatment of chronic cervicitis / 中国实用护理杂志

Objective To explore the application of comfort care in loop electrosurgical excision procedure (LEEP) in treatment of chronic cervicitis.Methods 130 patients who used LEEP to treat chronic cervicitis were collected from June to December 2011 in our Hospital,then they were randomly divided into the observation group (68 cases) and the control group (62 cases).The observation group used comfort care and the control group used general nursing.The effects of care,operation time,bleeding volume,anxiety and pain degree of the two groups were compared.Results The effect of care in the observation group was superior to the control group.Compared with the control group,the operation time was shortened,the amount of bleeding was decreased,the degree of anxiety and pain was obviously relieved.Conclusions Comfort care can improve the degree of comfort of the patients who used LEEP to treat chronic cervicitis,and is conducive to the rehabilitation of the disease.

Mitochondrial DNA 4977 bp Deletion in Chronic Cervicitis and Cervix Cancers.

Mitochondrial DNA (mtDNA) mutations have been implied in many diseases including cancer and inflammatory diseases. The aim of this study is to investigate the relationship between the 4977 bp deletion of the mtDNA and chronic cervicitis or cervix cancer in patients. The study included a group of patients with chronic cervicitis or cervix cancer, and a control group consisting of individuals without any cervical tissue disease. A total of 72 subjects in an East Turkish population were included in the study. Of these, 35 had chronic cervicitis, 21 had cervix cancer and 16 served as the control group. Isolation of mtDNA was performed from the tissues of these patients and then mtDNA deletions were studied using polymerase chain reaction (PCR). In the cancer groups, there were 9.5% heteroplasmic and homoplasmic deletions. There were no homoplasmic deletions in the cervicitis and control groups, but the frequencies of heteroplasmic deletions were 80.0 and 31.2%, respectively. Chronic inflammation leading to increased reactive oxygen species (ROS) may be the cause of the high mtDNA 4977 bp deletion frequencies in cancer and cervicitis. The older age of the cancer patient may suggest that ageing in addition to long time exposure to ROS may lead to deletions and subsequently cancer. This is the first study to investigate the relationship of the mtDNA 4977 bp deletion to chronic cervicitis and cervix cancer.

Expression of osteopontin in local tissues of patients with cervical cancer / 肿瘤研究与临床

Objective To detect the expression of osteopontin (OPN) in cervical local tissues of patients with chronic cervicitis, cervical intraepithelial neoplasia (CIN), cervical cancer. To investigate the possibility that OPN is used as tumor marker of cervical cancer. Methods The expression of OPN in 25 cases of chronic cervicitis, 18 cases of CIN and 21 cases of cervical cancer was detected by immuohistochemistry SP method. Results The positive expression rates of OPN in the chronic cervicitis, CIN and the cervical cancer had a rising trend (48 %, 77.78 % and 80.95 %, respectively) and their differences had statistical significant (P 0.05). Although OPN expression level in cervical cancer wasn' t related with tumor clinical stage, positive expression rates of OPN had a gradually increased trend along with the clinical stage. Conclusion High expression of OPN is found in cervical cancer and may be related to the occurrence and development of cervical cancer.

The analysis of joint Kangfuxin solution with Baofukangshuan in the treatment of 90 patients with chronic cervicitis / 国际中医中药杂志

Objective To investigate the clinical effects of Kangfuxin Solution used together with Baofukangshuan on chronic cervicitis after having been processed cervical LEEP circumcision.Methods Retrospective analysis was made among 176 out-patients diagnosed of chronic cervicitis from November 2007 to January 2009.Of all these patients,90 patients were treated with Kangfuxin Solution and Baofukangshuan after LEEP circumcision(the treatment group),and 86 patients were treated with simple cervical LEEP circumcision(the control group).The wound healing,vaginal discharge,bleeding volume,and side effects were observed in both groups.Results The method in the treatment group significantly reduced the amount of vaginal discharge and the duration,decreased the amount of bleeding and the duration;excluded wound infection and adverse reactions,and facilitated cervical wound recovery.The curative rate(98.89%)in the treatment group was significantly higher as compared to the control group(86.05%)after 8 weeks of the treatment.Conclusion Cervical LEEP circumcision surgery supplemented by Kangfuxin solution and Baofukangshuan therapy has better efficiency than treated by simple cervical LEEP circumcision.

Comparison of Transcervical Resection and Loop Electrical Excision Procedure for the Treatment of Moderate-to-severe Chronic Cervicitis / 中国微创外科杂志

Objective To compare the therapeutic effects of transcervical resection(TCRC) and loop electrical excision procedure(LEEP) for the treatment of moderate-to-severe chronic cervicitis.MethodsFrom January 2003 to July 2006,totally 520 patients with moderate-to-severe chronic cervicitis were randomly divided into two groups to receive TCRC or LEEP.ResultsThe intraoperative blood loss in the TCRC group was significantly less than that in the LEEP group [(4.2?1.3) ml vs(10.1?4.5) ml,t=-20.310,P=0.000].Whereas,no significantly differences were found in the drainage and bleeding time and cure rates between the two groups [(15.9? 3.7) d vs(16.2? 3.3) d,t=-0.976,P=0.330;and 95.2%(236/248) vs 93.2%(235/252),?2=0.832,P=0.362].ConclusionsBoth TCRC and LEEP are effective for chronic cervicitis.TCRC is superior to LEEP in the surgical outcomes;however the latter is easier to perform than TCRC.

Cryosurgery as a form of treatment in chronic cervicitis (A preliminary study)

Chronic cervicitis is one of the many problems that beset a woman. Many forms of treatment are available but problems are encountered with their use. This preliminary study was done to document the authors experience regarding the use of cryosurgery as a form of treatment in chronic cervicitis There were 16 patients. All were multigravid with erosions extending both on the anterior and posterior lip of the cervix. Initial Paps smear and colposcopy (for those at risk for cervical malignancy) were done. Results were all negative. However 10 of the 16 patients showed moderate inflammation The patients underwent cryosurgery using a gun type of appliance. The procedure was done for about 2 to 2.5 minutes or until such time that the ice formed has covered the erosions Postcryosurgery follow-up ranged from 11 to 150 days. All showed smooth and healed cervix. Repeat Paps smear of those with moderate inflammation revealed no infection. (Author)