High risk HPV in situ hybridization, p16 INK 4A, and survivin expressions in cervical carcinomas and intraepithelial neoplasms: evaluation of prognostic factors.

BACKGROUND: Cervical carcinoma (CC) is one of the most important health problems of adult women in developing countries. CC is the second most common carcinoma of the women worldwide. Efficient screening and early therapeutic programmes are vital because of the higher burden of the disease. MATERIALS AND METHODS: The authors included a total of 53 cases in this study. Distribution of diagnoses among cases was as follows: cervical intraepithelial neoplasm (CIN) (n=44), squamous cell carcinoma (SCC) (n=7), adenocarcinoma in situ (n=1), and condyloma accuminatum (n=l). Presence, density, and nuclear identification form of human papilloma virus (HPV) DNA in relation with host cell DNA were evaluated by in situ hybridization (ISH) and p16 and survivin by immunohistochem- ical methods (IHC). RESULTS: The authors determined that the presence, density, and nuclear identification form of high risk HPV DNA had diagnostic and prognostic importance in CC and CIN (p < 0.05). p16 and survivin also had diagnostic significance. Since p16 and survivin expressions signalled progressive oncogenic events, p16 and survivin were persistent HPV markers (for p16, p < 0.001, for survivin p < 0.01). The authors determined that expressions, density, and prevalence of all three markers showed correlation with increasing CIN grade (for p 16, p < 0.001, for survivin, p < 0.01, for HPV, p = 0.002). The episomal pattern which is the independent visit of Hr HPV DNA to host cell DNA, signalled early HPV infection (p = 0.001). When it is integrated into host cell DNA, especially if HPV DNA signal intensity and prevalence increases, then this signal signifies persistent HPV infection (p = 0.001). CONCLUSION: With the aid of these findings, the authors determined that HPV is infectious in CIN I and proliferative (neoplastic) in CIN II-CIN III lesions.

Comparison of dual X-ray laser and dual energy X-ray absorptiometry techniques of osteodensitometry.

Dual X-ray laser (DXL) heel measurements of bone mineral density (BMD) and dual energy X-ray absorptiometry (DEXA) total hip and lumbar spine BMD measurements were compared for their ability to detect osteoporosis and osteopenia according to World Health Organization criteria. The study included 164 women aged 40 - 83 years. DXL heel measurements were recorded for all patients and 89 of the women underwent DEXA. For DXL heel measurements/DEXA lumbar spine measurements, the relative sensitivity was 50%, relative specificity was 97% and relative reliability (Kappa score) was 0.55 for osteoporosis detection. For detecting osteoporosis or osteopenia, the relative sensitivity increased to 86% but the relative specificity reduced to 38% and the relative reliability was considerably lower (Kappa score 0.21). Although previous studies have shown DXL heel measurement to be a good technique in the diagnosis and assessment of osteoporosis based on BMD, particularly for fast, cost-effective bone scanning, we suggest that there are currently insufficient data to prove its use as a standard measurement technique for BMD.