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1.
West Indian med. j ; 48(4): 173-8, Dec. 1999. ilus, tab
Artigo em Inglês | MedCarib | ID: med-1578

RESUMO

There is a broad spectrum of benign and pre-malignant breast disease that may be diagnosed on biopsy. Some of these conditions place affected women at significantly increased risk for breast cancer, particularly the atypical hyperplasias. All health care workers should be aware of recent developments in this important aspect of breast disease. The classification, criteria for diagnosis, associated risks for cancer development and various controversies related to these benign and borderline breast diseases are discussed.(AU)


Assuntos
Feminino , Humanos , Doença da Mama Fibrocística , Lesões Pré-Cancerosas , Hiperplasia/patologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Doenças Mamárias/classificação , Doenças Mamárias/patologia , Mama/patologia , Carcinoma in Situ/diagnóstico , Doença da Mama Fibrocística/classificação , Doença da Mama Fibrocística/patologia , Lesões Pré-Cancerosas/genética , Lesões Pré-Cancerosas/patologia , Fatores de Risco
2.
J Med Virol ; 59(1): 60-5, Sept. 1999.
Artigo em Inglês | MedCarib | ID: med-1377

RESUMO

Evidence from several sources has suggested that adeno-associated virus (AAV) infection might protect against cervical cancer, in part, by interfering with human papillomavirus (HPV)-induced tumorigenesis. Detection of AAV type 2 (AAV-2) DNA in cervical tissues has been reported. However, there have been few in vivo studies of women with cervical HPV infection or neoplasia, and these have reported inconsistent results. Therefore, we used polymerase chain reaction (PCR) assays targeted to the AAV-2 rep and cap genes to test tissue specimens from women in an epidemiological study of cervical neoplasia in Jamaica. We tested 105 women with low-grade cervical intraepithelial neoplasia (CIN-1), 92 women with CIN-3/carcinoma in situ or invasive cancer (CIN-3/CA), and 94 normal subjects. PCR amplification of human beta-globin DNA was found in almost all cervical specimens, indicating that these materials were adequate for PCR testing. The prevalence of HPV DNA, determined by HPV L1 consensus primer PCR was, as expected, strongly associated with presence and grade of neoplasia. Each of the AAV PCR assays detected as few as 10 copies of the virus genome. However, none of the 291 cervical specimens from Jamaican subjects tested positive for AAV DNA. Negative AAV PCR results were also obtained in tests of cervical samples from 79 university students in the United States. Exposure to AAV was assessed further by serology. Using a whole virus AAV-2 sandwich enzyme-linked immunosorbent assay, we found no relationship between AAV antibodies and presence or grade of neoplasia in either the Jamaican study subjects or women enrolled in a U.S. cervical cancer case (n = 74) - control (n = 77) study. Overall, the data provide no evidence that AAV infection plays a role in cervical tumorigenesis or that AAV commonly infects cervical epithelial cells.(Au)


Assuntos
Adulto , Adolescente , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/virologia , Dependovirus/isolamento & purificação , Infecções por Parvoviridae/virologia , Carcinoma in Situ/virologia , Displasia do Colo do Útero/virologia , Neoplasias do Colo do Útero/epidemiologia , Dependovirus/genética , DNA Viral/análise , Globinas/genética , Papillomavirus Humano/genética , Papillomavirus Humano/isolamento & purificação , Reação em Cadeia da Polimerase , Infecções Tumorais por Vírus/virologia
3.
Cancer Epidemiol Biomarkers Prev ; 4(3): 295-8, Apr.-May 1995.
Artigo em Inglês | MedCarib | ID: med-12300

RESUMO

Neopterin, a marker of cellular immune activation, was elevated in patients who had cervical cancer in previous studies. To examine neopterin in the presence of precursors to cervical cancer (i.e. cervical intraepithelial) we measured serum levels in 185 colposcopy patients in Jamaica, a country with high cervical cancer incidence, and in 72 age-matched Jamaican women selected from a large population-based sample. We also measured serum levels of B-2 microglobulin, another commonly used marker of immune activation. Neopterin and B-2 microglobulin levels were not elevated in colposcopy patients; neither were they rel ted to severity of cervical neoplasia. In multivariable analysis, neither adjustments for detection of cervical human papillomavirus DNA by PCR nor detection of antibodies to human T-cell lymphotropic virus type 1 (a retrovirus endemic to Jamaica) altered our findings. The absence of serologically detectable increase in cellular immune activation linked to cervical intraepithelial neoplasmia does not involve susbtantial systemic immune activation. (AU)


Assuntos
Feminino , Humanos , Neoplasias do Colo do Útero/imunologia , Biomarcadores Tumorais/sangue , Carcinoma in Situ/sangue , Biopterina/análise , Biopterina/sangue , Carcinoma in Situ/patologia , Neoplasias do Colo do Útero/patologia , Colposcopia , Jamaica , Estadiamento de Neoplasias , Imunidade Celular
4.
West Indian med. j ; 42(2): 62-4, June 1993.
Artigo em Inglês | MedCarib | ID: med-9601

RESUMO

The technique of large loop excision of the transformation zone (LLETZ) as an alternative to destructive/ablative method of treatment of cervical intraepithelial neoplasia (CIN) such as cryotherapy, laser vaporization and cone biopsy of uterine cerix is assessed. Forty-five patients underwent this procedure for either diagnostic or therapeutic reasons. It was well-tolerated, and minor bleeding occurred in 4.4 per cent of patients. The quality of the histological specimen was excellent in all cases, only two showing evidence of charring artefacts. In 11 patients (24.4 per cent), a more serious lesion was detected than that found at punch biopsy of the cervix. This method offers a cheaper and more effective alternative to laser vaporization and combines the benefits of the gold standard cone biopsy of the cervix with that of local ablative techniques. (AU)


Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Neoplasias do Colo do Útero/cirurgia , Eletrocirurgia/métodos , Biópsia , Carcinoma in Situ , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/terapia
5.
Am J Public Health ; 80(6): 722-4, June 1990.
Artigo em Inglês | MedCarib | ID: med-12528

RESUMO

Cervix and breast cancer incidence in 1978-82 was computed for immigrant and United States-born Black women in Brooklyn, New York. Compared to the national SEER (Surveillance, Epidemiology and Enf Results) rates, US-born and Haitian women had high rates of invasive cervical cancer, while English-speaking Caribbean immigrants had an average rate. However, while US-born women had an average rate of carcinoma in situ of the cervix, both immigrant groups had low rates. Both immigrant groups had low rates of breast cancer, whereas US-born Black women had an average rate. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/etnologia , Carcinoma in Situ/etnologia , Neoplasias do Colo do Útero/etnologia , Neoplasias da Mama/epidemiologia , Carcinoma in Situ/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Emigração e Imigração , Haiti/etnologia , Invasividade Neoplásica , Índias Ocidentais/etnologia
6.
West Indian med. j ; 34(suppl): 55, 1985.
Artigo em Inglês | MedCarib | ID: med-6657

RESUMO

Cancer of the cervix is the second most common cancer affecting women in Curacao. We reviewed, retrospectively, the records of all women with a newly diagnosed, histologically proven, cancer of the cervix or carcinoma in situ over a 10-year period (1973-1983). Although the total number of newly diagnosed cases of cervical cancer rose from 59 during the first five-year period to 70 in the second five-year period, the age-standardized prevalence rate remained the same (16.8 per 100,000 women per year). There was also an increase in the total number of newly diagnosed cases of carcinoma in situ during the second five-yuear period (1973- 1978 n=9 versus 1978-1983 n=31). However, no difference in age-standardized prevalence rate of carcinoma in situ could be established for the two five-year periods. The ratio of carcinoma in situ to cervical cancer was found to be low (1:2, 3-5, 6). Because the effectiveness of cytological screening for cervical cancer in terms of reducing the development of the disease (i.e. lowering the prevalence) and if the disease occurs, by reducing its severity (i.e. higher ratio of carcinoma in situ to cervical cancer) is well established, routine screening of women between 30 and 55 years of age is advised (AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/epidemiologia , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/prevenção & controle
7.
Int J Gynaecol Obstet ; 14(3): 273-9, 1976.
Artigo em Inglês | MedCarib | ID: med-9311

RESUMO

Twenty-five patients with the diagnosis of carcinoma-in-situ (CIS) of the cervix were treated with colposcopy guided epithelial conization. During the follow-up study of 4-7 years duration, there was no recurrence of CIS in 20 of the 25 patients. Between 6 and 12 months after conization, 3 patients showed recurrence of CIS. Two of these patients were treated with further epithelial conization with no evidence of further recurrence 4 years after the second treatment. The third patient refused to accept further epithelial conization and modified radical hysterectomy was done without any evidence of residual tumour in the hysterectomy specimen. One patient showed stromal invasion in both colposcopically guided biopsy and bone biopsy. Modified radical hysterectomy specimen showed remnants of stromal invasion. One patient with Class IV smear failed to show any atypical transformation zone and cervicitis was proven on colposcopy guided biopsy following treatment with Flagyl. For two of the 25 patients, cytology was Class II and therefore failed to diagnose the pre-malignant condition; but colposcopy showed a grade 3 atypical transformation zone and the presence of CIS was confirmed histologically. Simultaneous use of cytology, colposcopy and colposcopically guided biopsy confirmed the diagnosis of CIS in all cases. The authors recommended colposcopically guided epithelial conization in younger patients, provided the malignant lesion is strictly intra-epithelial, and limited to the ectocervix. Routine follow-up with the aid of cyto-colposcopy remains the key factor in this schedule of therapy. (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Feminino , Carcinoma in Situ/cirurgia , Neoplasias do Colo do Útero/cirurgia , Carcinoma in Situ/patologia , Cauterização/métodos , Neoplasias do Colo do Útero/patologia , Colo do Útero/citologia , Colo do Útero/patologia , Colposcopia , Seguimentos , Recidiva Local de Neoplasia , Esfregaço Vaginal
8.
West Indian med. j ; 16(3): 186, Apr. 21-24, 1967.
Artigo em Inglês | MedCarib | ID: med-7298

RESUMO

Carcinoma-in-situ is a stage in a spectrum having on one side atypicalities of the cervical epithelium, relatively benign and possibly reversible, and on the other side progressing to the stage of microinvasion and then to frank invasiveness. By diagnosing Carcinoma-in-situ and stopping the cancer spectrum at the in-situ stage, invasive cancer of the cervix might be eliminated from a population. Cytology has been developed as an avenue in this pursuit. It is difficult to observe the histological progression of this lesion in any one patient wherein biopsy or conization may have removed the lesion be it for primary diagnosis or for confirmation of a positive cytology. Histological diagnosis of carcinoma-in-situ was made in 52 cases over the last 10 years at the University Hospital (8.5 percent of all malignant lesions of the cervix). Definite treatment, conization or hysterectomy with or without a vaginal cuff was a adopted in the majority of cases because of the pre-invasiveness of the lesion. The presenting symptoms, signs, diagnosis, treatment and follow-up are analysed. The establishment of cytology screening for cervical cancer (JAMAICA 1966) should alter the picture of the future (AU)


Assuntos
Humanos , Feminino , Carcinoma in Situ , Neoplasias do Colo do Útero , Histerectomia Vaginal
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