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2.
Gynecol Oncol ; 114(3): 452-6, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19576623

RESUMO

OBJECTIVES: In a RCT, we have previously shown that the levonorgestrel intrauterine system (LNG-IUS, Mirena) produces a decidual response protecting the endometrium at one year follow-up. We here report on the long-term follow-up of this group of women, to test the hypothesis that a LNG-IUS could prevent the pro-proliferative uterine responses of tamoxifen for up to 4.5 years. METHODS: A randomised-controlled trial of postmenopausal women who had taken at least one year of adjuvant tamoxifen therapy. RESULTS: One hundred twenty-two women were recruited. Nine were found to be ineligible after randomisation. The average duration of follow-up was 26.25 months (IQR 14.5-36 months) in the surveillance group and 24.2 months (IQR 13.75-32.5 months) in the LNG-IUS group. Women with LNG-IUS in situ at the time of final assessment had decidualised endometrium, and no polyps. In the surveillance group new polyps arose in 8 cases. There were 3 new polyps in the group initially randomised to LNG-IUS, one in a patient who did not have the device inserted and 2 occurred in patients following the removal of the LNG-IUS. Univariate Cox proportional hazards regression models identified only endometrial thickness at trial entry as a statistically significant variable (HR 1.12, 95% CI 1.02 to 1.22, p=0.01) for the development of polyps. CONCLUSION: This study confirms that LNG-IUS induces benign endometrial changes and prevents endometrial polyps but only during its use in women taking tamoxifen. Endometrial thickness is a risk factor for the development of polyps.


Assuntos
Levanogestrel/administração & dosagem , Pólipos/induzido quimicamente , Pólipos/prevenção & controle , Tamoxifeno/efeitos adversos , Doenças Uterinas/induzido quimicamente , Doenças Uterinas/prevenção & controle , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante , Feminino , Seguimentos , Humanos , Dispositivos Intrauterinos , Pólipos/diagnóstico por imagem , Pós-Menopausa , Tamoxifeno/administração & dosagem , Ultrassonografia , Doenças Uterinas/diagnóstico por imagem
3.
Int J Gynecol Pathol ; 21(4): 360-7, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12352184

RESUMO

There is continuing interest in the study of adenocarcinoma of the cervix and its precursors because of its increase in incidence, both absolute and relative, to squamous neoplasia and the complexity of benign glandular lesions with which endocervical neoplasia may be confused. Investigative techniques may be applied as aids to diagnosis, as prognostic markers, and to further our understanding of etiopathogenesis. This article focuses on recent developments in the four areas of epithelial glycoproteins, molecular markers, cell proliferation markers, and human papillomaviruses as applied to endocervical pathology. Although immunohistochemistry remains dominant, a wide range of other techniques is discussed.


Assuntos
Adenocarcinoma/diagnóstico , Biomarcadores Tumorais/metabolismo , Neoplasias do Colo do Útero/diagnóstico , Adenocarcinoma/genética , Adenocarcinoma/metabolismo , Adenocarcinoma/virologia , Feminino , Genes Supressores de Tumor , Humanos , Imuno-Histoquímica , Lectinas/metabolismo , Mucinas/metabolismo , Oncogenes , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Infecções Tumorais por Vírus/virologia , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/virologia
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