RESUMO
OBJECTIVE: In our review article we focused on the circulating HPV DNA and its potential role in the pathogenesis of cervical cancer and in the evaluation of patients´ prognosis with cervical cancer Design: The article is a systematic review study analyzing available scientific articles focused on the circulating HPV DNA. SETTING: Clinic of Obstetrics and Gynecology, Jesenius faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia. METHODS: In our study we searched the medical database PubMed with the key words: circulating HPV DNA, cervical cancer, cervical precanceroses. The core of our work is focused on the scientific articles published in English language since year 1995. RESULTS: We identified 13 studies in PubMed database analyzing the circulating HPV DNA in the process of cervical carcinogenesis. It is clear from the results that circulating HPV DNA is a significant prognostic marker of cervical malignant diseases including the early stages. CONCLUSION: The results focused on circulating HPV DNA show the significance of molecular biology in assessing the prognosis of cervical cancer. This idea has to be supported by further relevant studies. The uniformity of studies and use of the most sophisticated methods could help to answer the question about the real role of circulating HPV DNA in the process of cervical carcinogenesis and disease progression.
Assuntos
Ácidos Nucleicos Livres , Papillomaviridae , Infecções por Papillomavirus , Lesões Pré-Cancerosas , Displasia do Colo do Útero , Neoplasias do Colo do Útero , DNA , Feminino , Humanos , Papillomaviridae/genética , EslováquiaRESUMO
The integration of HPV infection in the epithelial cells is a key step in the induction of malignant changes of cervical cancer. In addition, there appear also other genomic alterations. Multi-step nature of carcinogenesis includes sequential accumulation of genetic changes that lead to invasive growth and progression. It is therefore necessary to understand the cervical carcinogenesis accompanied by chromosomal aberrations. The most common aberrations contain regions 5p15 and 3q26 coding the enzyme telomerase. For cervical cancer, telomerase is already active in case of precancerous lesions. Amplification of chromosomal region 3q26 detected by fluorescence in situ hybridization has the highest combined sensitivity and specificity in distinguishing low-grade lesion of high-grade lesions or invasive disease compared to the liquid-based cytology (LBC) and HPV DNA.
Assuntos
Transformação Celular Neoplásica/metabolismo , Transformação Celular Neoplásica/patologia , Telomerase/metabolismo , Neoplasias do Colo do Útero/enzimologia , Neoplasias do Colo do Útero/patologia , Animais , Feminino , HumanosRESUMO
Tumors of the uterine corpus can be divided into two main groups: endometrial tumors and mesenchymal tumors. The former ones are common gynecological diseases, whereas malignant mesenchymal tumors, which behave in a much more aggressive way, are quite rare with a poorer prognosis. The most common type of endometrial tumors is endometrioid adenocarcinomas, and in case of mesenchymal tumors, these are carcinosarcomas, or leiomyosarcomas, if only clear types of tumors are taken into account. The objective of this article is to review molecular-genetic abnormalities associated with tumorigenesis of both types of tumors, with focus on the most aggressive forms. This view includes a different expression pattern of genes, usually aberrant in cases of uterine cancer that can arise due to epigenetic modifications, mostly hypermethylation of promoters or microRNA (miRNA)'s interference with concrete genes. Furthermore, clinical predispositions of tumorigenesis, involving hormonal factors, age, and ethnicity, are also mentioned.
Assuntos
Neoplasias do Endométrio/genética , Leiomiossarcoma/genética , Proteínas de Neoplasias/genética , Neoplasias Uterinas/genética , Carcinogênese/genética , Neoplasias do Endométrio/patologia , Feminino , Humanos , Leiomiossarcoma/patologia , Mesoderma/patologia , Prognóstico , Neoplasias Uterinas/patologiaRESUMO
The World Health Organization (WHO) defines PEComas as mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular cells. Uterus is the most common site of a subgroup of PEComas not otherwise specified(NOS). PEComas of the uterine cervix are extremely rare, and only thirteen cases have been described in the English literature to date. In this review, we summarize the available data concerning diagnostics, immunohistochemical analysis, genetics and treatment of cervical PEComas. Radical hysterectomy with bilateral salpingooophorectomy is the best surgical approach available. Adjuvant therapy in its present form is not efficient. Therefore, further studies are needed to evaluate the newest treatment strategies.