RESUMEN
OBJECTIVE: To determine the prevalence and age of patients with cervical carcinoma missed by a loop electrosurgical excision procedure. MATERIALS AND METHODS: A total of 253 women with cervical dysplasia who underwent conization and 248 women who later underwent hysterectomy were retrospectively reviewed. The age and prevalence of those with cervical carcinoma diagnosed and missed by conization were determined. RESULTS: Of the 248 patients, 11 cases (4.4%) of cervical carcinoma were missed by cervical conization. The age of those with cervical carcinoma missed by conization was significantly greater than those whose diagnosis was not missed (p < 0.05). CONCLUSION: Women with severe cervical dysplasia who no longer wish to preserve fertility should be advised to undergo hysterectomy if the conization margins are not free of disease. Older women with incomplete resection margins tend to have undiagnosed hidden cervical carcinoma after cervical conization.
Asunto(s)
Conización , Electrocirugia , Histerectomía , Neoplasia Residual , Neoplasias del Cuello Uterino , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Errores Diagnósticos/prevención & control , Femenino , Humanos , Persona de Mediana Edad , Neoplasia Residual/epidemiología , Neoplasia Residual/patología , Neoplasia Residual/cirugía , Prevalencia , Estudios Retrospectivos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugía , Adulto JovenRESUMEN
Antisperm antibodies (ASA) are present in 20% of couples seeking treatment for infertility. Antibody-binding proteins in seminal plasma may protect sperm from ASA-induced damage. We have previously isolated several IgG-binding proteins from human seminal plasma using IgG affinity chromatography. Here, we report another such protein which we have identified by amino acid sequencing and confirmed by western blotting to be prolactin-inducible protein (PIP). PIP binds via the Fc fragment of IgG. We have determined the level of PIP in normal seminal plasma to be 3.4 mg/ml (interquartile range 2.0-4.4 mg/ml). We have found there is no difference in the mean level of PIP in seminal plasma from fertile or infertile men regardless of ASA status. PIP was shown to exist in several isoforms in seminal plasma by Western blot. There is a complex pattern of PIP isoform variability in seminal plasma from fertile and infertile men but one multimeric form of PIP was absent from the seminal plasma of men with ASA who were fertile. This may reflect consumption of PIP in these men. The physiological function of PIP remains unknown, but the ability of PIP to bind IgG-Fc suggests PIP may have an immunomodulatory role.