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1.
Medicine (Baltimore) ; 99(6): e19135, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028440

RESUMO

This study is to evaluate the screening methods of cervical cancers for rural females in Kash bachu, Xinjiang, China.A total number of 3000 married females were surveyed, and subjected to the gynecological examination. In these subjects, 1993 females received the careHPV (human papillomavirus) test, while 1007 females underwent the visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI). The subjects positive for careHPV detection were subjected to Cervista, Cobas 4800, and Aptima HPV detection, and Thinprep Cytologic Test (TCT). The subjects positive for 1 detection only received colposcopy cervical biopsy.A total of 569 subjects received the cervical biopsy, and the positive rate was 2.3% (69/3000), while the detection rate for CIN (cervical intraepithelial neoplasia) II and above levels was 1.13% (34/3000). Receiver operator characteristic (ROC) curve analysis showed that, the area under the curve (AUC) value for the careHPV test was 0.671, which was higher than the VIA/VILI (0.619), suggesting higher diagnostic value for the careHPV test. For the Cervista, Cobas 4800, Aptima HPV detection, and TCT methods, the highest AUC value was observed for the TCT method, indicating that the TCT method is the most valuable for the cervical cancer screening.The diagnostic value of careHPV test is superior to the VIA/VILA detection method. The TCT method has the greatest value for the cervical cancer screening. The Cervista HPV detection method should be considered where the conditions are limited.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Biópsia , Colo do Útero/patologia , China , Colposcopia , Feminino , Humanos , Infecções por Papillomavirus/diagnóstico , População Rural , Neoplasias do Colo do Útero/patologia
2.
Anticancer Res ; 40(2): 999-1006, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014945

RESUMO

BACKGROUND/AIM: We aimed to evaluate the efficacy of high-dose-rate brachytherapy techniques selected according to pre-brachytherapy magnetic resonance imaging (MRI) findings in asymmetrical cervical cancer (ACC). PATIENTS AND METHODS: We analyzed 33 ACC patients. Asymmetric tumors were defined as those in which the difference between the distance from the cervical canal to the farthest end of the tumor [long distance (LD)] and the distance from the cervical canal to the contralateral tumor edge [short distance (SD)] is equal to or greater than 2 cm on the basis of MRI prior to treatment. On pre-treatment and pre-brachytherapy MRI, the median LDs were 40 mm and 21 mm, respectively. Patients with LD≥2 cm and LD - SD≥1 cm on pre-brachytherapy MRI received non-conventional intracavitary brachytherapy (ICBT). RESULTS: Sixteen patients (48%) received non-conventional ICBT. There was no significant difference in 3-year local control between the two treatment groups (100% vs. 81.2%, p=0.07); two patients had grade 2 radiation proctitis. CONCLUSION: Brachytherapy techniques selected according to pre-brachytherapy MRI findings were effective for ACC treatment.


Assuntos
Braquiterapia , Dosagem Radioterapêutica , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/radioterapia , Adulto , Idoso , Braquiterapia/efeitos adversos , Braquiterapia/métodos , Feminino , Humanos , Estimativa de Kaplan-Meier , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Seleção de Pacientes , Resultado do Tratamento , Neoplasias do Colo do Útero/diagnóstico
3.
DNA Cell Biol ; 39(2): 255-272, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977248

RESUMO

Cervical squamous cell carcinoma (CESC) is a human papillomavirus-driven tumor that the underlying molecular mechanisms are unclear. This study aimed to elucidate the key candidate genes and potential mechanism in CESC by bioinformatics analysis. A total of 132 common differentially expressed genes (DEGs) were identified based on three expression profile data sets. A multivariate Cox proportional regression model was used to develop a four-gene prognostic signature. Mechanistically, the correlationship between MMP1 and tumor-infiltrating lymphocytes was further analyzed. Furthermore, annotations were investigated by Gene Ontology (GO) and The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Finally, potential drugs for CESC treatment were predicted by Connectivity Map. We profiled four genes (EFNA1, ANLN, MMP1, and ZWINT) with significant prognostic values for CESC. Multiple public available data sets were used for mRNA expression and prognostic characterization. Subsequently, GO and KEGG pathway analyses showed DEGs were mainly enriched in cell cycle, immunity, and metabolic-related pathway. We then conducted an integrated analysis of MMP1, and the expression of MMP1 showed significantly inverse association with the amount of CD8+ T cells, CD4+ T cells, and macrophages infiltration. Our findings suggest the four-gene signature may be associated with prognosis. We further revealed that MMP1 may be a novel biomarker for immunotherapy, and prognostic judgment of patients with cervical cancer.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Regulação Neoplásica da Expressão Gênica , Metaloproteinase 1 da Matriz/genética , Neoplasias do Colo do Útero/genética , Carcinoma de Células Escamosas/diagnóstico , Feminino , Perfilação da Expressão Gênica/métodos , Redes Reguladoras de Genes/genética , Humanos , Prognóstico , Mapas de Interação de Proteínas/genética , Neoplasias do Colo do Útero/diagnóstico
4.
Acta Cytol ; 64(1-2): 63-70, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30889579

RESUMO

The association between high-risk genotypes of human papillomavirus (hr-HPV) and cervical cancer is well established. As hr-HPV testing is rapidly becoming a part of routine cervical cancer screening, either in conjunction with cytology or as primary testing, the management of hr-HPV-positive women has to be tailored in a way that increases the detection of cervical abnormalities while decreasing unnecessary colposcopic biopsies or other invasive procedures. In this review, we discuss the overall utility and strategies of hr-HPV testing, as well as the advantages and limitations of potential triage strategies for hr-HPV-positive women, including HPV genotyping, p16/Ki-67 dual staining, and methylation assays.


Assuntos
Citodiagnóstico/métodos , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adulto , Detecção Precoce de Câncer/métodos , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Papillomaviridae/fisiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Triagem , Neoplasias do Colo do Útero/complicações
5.
Acta Cytol ; 64(1-2): 155-165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30982025

RESUMO

The Papanicolaou (PAP) test is widely used to screen for cervical cancer. All high-grade lesions such as atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H), and high-grade squamous intraepithelial lesion, identified on a PAP test should be followed-up by a confirmatory cervical biopsy. In this review, we discuss the challenges in interpreting cervical tissue specimens and the various ancillary techniques used in the evaluation of cervical dysplasia. Ancillary studies include deeper levels, p16 immunohistochemistry (IHC), human papillomavirus (HPV) testing, and, importantly, cyto-histologic correlation. Of these, p16 IHC is consistently sensitive and specific for detecting HSIL. HPV RNA in situ hybridization (ISH) is a newer technique with excellent sensitivity and specificity for detecting virally infected cells and it may be more broadly applicable to both low- and high-grade squamous intraepithelial lesions.


Assuntos
Células Escamosas Atípicas do Colo do Útero/patologia , Neoplasia Intraepitelial Cervical/patologia , Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Biópsia , Neoplasia Intraepitelial Cervical/diagnóstico , Curetagem , Feminino , Humanos , Teste de Papanicolaou/métodos , Papillomaviridae/fisiologia , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Neoplasias do Colo do Útero/diagnóstico
6.
Lancet Psychiatry ; 7(1): 52-63, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31787585

RESUMO

BACKGROUND: Since people with mental illness are more likely to die from cancer, we assessed whether people with mental illness undergo less cancer screening compared with the general population. METHODS: In this systematic review and meta-analysis, we searched PubMed and PsycINFO, without a language restriction, and hand-searched the reference lists of included studies and previous reviews for observational studies from database inception until May 5, 2019. We included all published studies focusing on any type of cancer screening in patients with mental illness; and studies that reported prevalence of cancer screening in patients, or comparative measures between patients and the general population. The primary outcome was odds ratio (OR) of cancer screening in people with mental illness versus the general population. The Newcastle-Ottawa Scale was used to assess study quality and I2 to assess study heterogeneity. This study is registered with PROSPERO, CRD42018114781. FINDINGS: 47 publications provided data from 46 samples including 4 717 839 individuals (501 559 patients with mental illness, and 4 216 280 controls), of whom 69·85% were women, for screening for breast cancer (k=35; 296 699 individuals with mental illness, 1 023 288 in the general population), cervical cancer (k=29; 295 688 with mental illness, 3 540 408 in general population), colorectal cancer (k=12; 153 283 with mental illness, 2 228 966 in general population), lung and gastric cancer (both k=1; 420 with mental illness, none in general population), ovarian cancer (k=1; 37 with mental illness, none in general population), and prostate cancer (k=6; 52 803 with mental illness, 2 038 916 in general population). Median quality of the included studies was high at 7 (IQR 6-8). Screening was significantly less frequent in people with any mental disease compared with the general population for any cancer (k=37; OR 0·76 [95% CI 0·72-0·79]; I2=98·53% with publication bias of Egger's p value=0·025), breast cancer (k=27; 0·65 [0·60-0·71]; I2=97·58% and no publication bias), cervical cancer (k=23; 0·89 [0·84-0·95]; I2=98·47% and no publication bias), and prostate cancer (k=4; 0·78 [0·70-0·86]; I2=79·68% and no publication bias), but not for colorectal cancer (k=8; 1·02 [0·90-1·15]; I2=97·84% and no publication bias). INTERPRETATION: Despite the increased mortality from cancer in people with mental illness, this population receives less cancer screening compared with that of the general population. Specific approaches should be developed to assist people with mental illness to undergo appropriate cancer screening, especially women with schizophrenia. FUNDING: None.


Assuntos
Neoplasias da Mama , Neoplasias Colorretais , Detecção Precoce de Câncer/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Neoplasias do Colo do Útero , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Feminino , Humanos , Transtornos Mentais/fisiopatologia , Prevalência , Qualidade de Vida , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle
7.
Int J Cancer ; 146(3): 617-626, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30861114

RESUMO

US guidelines recommend that most women older than 65 years cease cervical screening after two consecutive negative cotests (concurrent HPV and cytology tests) in the previous 10 years, with one in the last 5 years. However, this recommendation was based on expert opinion and modeling rather than empirical data on cancer risk. We therefore estimated the 5-year risks of cervical precancer (cervical intraepithelial neoplasia grade 3 or adenocarcinoma in situ [CIN3]) after one, two and three negative cotests among 346,760 women aged 55-64 years undergoing routine cotesting at Kaiser Permanente Northern California (2003-2015). Women with a history of excisional treatment or CIN2+ were excluded. No woman with one or more negative cotests was diagnosed with cancer during follow-up. Five-year risks of CIN3 after one, two, and three consecutive negative cotests were 0.034% (95% CI: 0.023%-0.046%), 0.041% (95% CI: 0.007%-0.076%) and 0.016% (95% CI: 0.000%-0.052%), respectively (ptrend < 0.001). These risks did not appreciably differ by a positive cotest result prior to the one, two or three negative cotest(s). Since CIN3 risks after one or more negative cotests were significantly below a proposed 0.12% CIN3+ risk threshold for a 5-year screening interval, a longer screening interval in these women is justified. However, the choice of how many negative cotests provide sufficient safety against invasive cancer over a woman's remaining life represents a value judgment based on the harms versus benefits of continued screening. Ideally, this guideline should be informed by longer-term follow-up given that exiting is a long-term decision.


Assuntos
Adenocarcinoma in Situ/epidemiologia , Neoplasia Intraepitelial Cervical/epidemiologia , Infecções por Papillomavirus/epidemiologia , Lesões Pré-Cancerosas/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Adenocarcinoma in Situ/diagnóstico , Adenocarcinoma in Situ/patologia , California/epidemiologia , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/patologia , Colo do Útero/patologia , Detecção Precoce de Câncer/normas , Feminino , Humanos , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Guias de Prática Clínica como Assunto , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Estudos Prospectivos , Medição de Risco/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia
8.
Int J Cancer ; 146(3): 810-818, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30980692

RESUMO

Primary prevention through the use of human papillomavirus (HPV) vaccination is expected to impact both cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS). While CIN is well described, less is known about the epidemiology of AIS, a rare cervical precancer. We identified AIS and CIN grade 3 (CIN3) cases through population-based surveillance, and analyzed data on HPV types and incidence trends overall, and among women screened for cervical cancer. From 2008 to 2015, 470 AIS and 6,587 CIN3 cases were identified. The median age of women with AIS was older than those with CIN3 (35 vs. 31 years; p < 0.01). HPV16 was the most frequently detected type in both AIS and CIN3 (57% in AIS; 58% in CIN3), whereas HPV18 was the second most common type in AIS and less common in CIN3 (38% vs. 5%; p < 0.01). AIS lesions were more likely than CIN3 lesions to be positive for high-risk types targeted by the bivalent and quadrivalent vaccines (HPV16/18, 92% vs. 63%; p < 0.01), and 9-valent vaccine (HPV16/18/31/33/45/52/58, 95% vs. 87%; p < 0.01). AIS incidence rates decreased significantly in the 21-24 year age group (annual percent change [APC] overall: -22.1%, 95% CI: -33.9 to -8.2; APC among screened: -16.1%, 95% CI: -28.8 to -1.2), but did not decrease significantly in any older age group. This report on the largest number of genotyped AIS cases to date suggests an important opportunity for vaccine prevention of AIS, and is the first to document a decline in AIS incidence rates among young women during the vaccine era.


Assuntos
Adenocarcinoma in Situ/epidemiologia , Neoplasia Intraepitelial Cervical/epidemiologia , Papillomavirus Humano 16/isolamento & purificação , Papillomavirus Humano 18/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Lesões Pré-Cancerosas/epidemiologia , Adenocarcinoma in Situ/prevenção & controle , Adenocarcinoma in Situ/virologia , Adolescente , Adulto , Fatores Etários , Neoplasia Intraepitelial Cervical/prevenção & controle , Neoplasia Intraepitelial Cervical/virologia , DNA Viral/isolamento & purificação , Feminino , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Humanos , Incidência , Programas de Rastreamento/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/uso terapêutico , Lesões Pré-Cancerosas/prevenção & controle , Lesões Pré-Cancerosas/virologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Adulto Jovem
9.
J Clin Pathol ; 73(1): 30-34, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31315894

RESUMO

AIMS: The purpose of the present study was to elucidate the presence of human herpesvirus 6A (HHV-6A), HHV-6B and HHV-7 in samples of the uterine cervix through detection of viral DNA. We analysed normal tissues, samples with low-grade squamous intraepithelial lesions (LSILs) and high-grade squamous intraepithelial lesions (HSILs). We correlated the presence of HHV-6 and HHV-7 with the finding of human papillomavirus (HPV) in mucosal samples. METHODS: Cervical samples were examined and grouped as follows: group 1 (n=29), normal cytology; group 2 (n=61), samples with LSIL; group 3 (n=35), samples with HSIL. Molecular biology examinations were performed in all samples to detect HHV-6, HHV-7 and HPV DNA and to typify HHV-6 species. RESULTS: Group 1: normal cytology and HPV (-): HHV-6: 6.8% (2/29), HHV-7: 79.3% (23/29); group 2: LSIL and HPV (-): HHV-6: 93.1% (27/29), HHV-7: 96.5% (28/29); LSIL and HPV (+): HHV-6: 0% (0/32), HHV-7: 90.6% (29/32); group 3: HSIL and HPV (-): HHV-6: 20% (2/10), HHV-7: 70% (7/10); HSIL HPV (+): HHV-6: 12% (3/25), HHV-7: 68% (17/25). HHV-6A DNA was not detected in any samples. CONCLUSIONS: (1) Both HHV-6 and HHV-7 infect the mucosal cells of the cervix with higher prevalence of HHV-7. (2) The higher prevalence of HHV-6 in LSIL HPV (-) samples compared with those with normal cytology indicates that it constitutes a possible risk factor for atypia production. (3) The presence of HHV-7 in all samples questions its role in the production of atypia. (4) The finding of HHV-6 and HHV-7 suggests that the cervical mucosa is a possible transmission pathway for these viruses.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , DNA Viral/genética , Herpesvirus Humano 6/genética , Herpesvirus Humano 7/genética , Técnicas de Diagnóstico Molecular , Infecções por Roseolovirus/diagnóstico , Lesões Intraepiteliais Escamosas Cervicais/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adolescente , Adulto , Argentina , Neoplasia Intraepitelial Cervical/genética , Neoplasia Intraepitelial Cervical/virologia , Feminino , Testes de DNA para Papilomavírus Humano , Humanos , Pessoa de Meia-Idade , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/genética , Infecções por Papillomavirus/virologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Infecções por Roseolovirus/genética , Infecções por Roseolovirus/transmissão , Infecções por Roseolovirus/virologia , Lesões Intraepiteliais Escamosas Cervicais/genética , Lesões Intraepiteliais Escamosas Cervicais/virologia , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/virologia , Adulto Jovem
10.
BJOG ; 127(1): 58-68, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31541495

RESUMO

OBJECTIVES: To estimate long-term cervical intraepithelial neoplasia grade 3 (CIN3) risks associated with different triage strategies for human papillomavirus positive (HPV+) women with a view to reducing unnecessary referrals. DESIGN: The ARTISTIC trial cohort was recruited in Manchester in 2001-03 and was followed up for CIN3 and cancer notification through national registration until December 2015. RESULTS: The 10-year cumulative risk of CIN3+ was much higher for women with HPV16/18 infection (19.4%, 95% CI 15.8-23.8% with borderline/low-grade cytology and 10.7%, 95% CI 8.3-13.9% with normal cytology) than for those with other HPV types (7.3%, 95% CI 5.4-9.7% with borderline/low-grade cytology and 3.2%, 95% CI 2.2-4.5% with normal cytology). Among the 379 women with normal to low-grade cytology and new HPV infection, the 10-year cumulative CIN3+ risk was 2.9% (95% CI 1.6-5.2%). CONCLUSIONS: The CIN3 risk is confined to women with persistent type-specific HPV so partial genotyping test assays identifying HPV16/18 as a minimum are essential for efficient risk stratification. Immediate referral to colposcopy for HPV+ women with borderline or low-grade cytology and referral after a year if still HPV+ with normal cytology may be unnecessary. Low-grade lesions can safely be retested to identify those with persistent HPV. Recall intervals of 1 year for HPV16/18 and 2 years for other high-risk HPVs are justified for women with normal cytology and might also be considered for women with borderline/low-grade cytology. The minimal risk of invasive cancer that has progressed beyond stage 1A must be weighed against the advantages for patients and the NHS of reducing the number of referrals to colposcopy. TWEETABLE ABSTRACT: Cervical screening would be better for women and cheaper for the NHS if women with HPV and normal to low-grade cytology were retested after a year or two when many infections will have cleared.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Infecções por Papillomavirus/diagnóstico , Triagem , Neoplasias do Colo do Útero/diagnóstico , Adulto , Distribuição por Idade , Idoso , Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/virologia , Detecção Precoce de Câncer , Inglaterra/epidemiologia , Feminino , Seguimentos , Papillomavirus Humano 16 , Papillomavirus Humano 18 , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Fatores de Risco , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Adulto Jovem
11.
Praxis (Bern 1994) ; 108(16): 1079-1083, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31822234

RESUMO

First Diagnosis of a Squamos Cell Carcinoma of the Cervix Uteri FIGO 1B1 in Pregnancy Abstract. The squamous cell cancer of the cervix uteri is one of the most frequent detected cancers in pregnancy. As the tumor is in direct contact to the pregnancy, the treatment is challenging and has to be tackled individually. So far, standard concepts or studies are missing. Treatment should be focused on the oncological security of the mother like in non-pregnant women and should be according to current guidelines. Thanks to the existing therapy options during pregnancy, it is a reasonable option to maintain the pregnancy in compliance with oncological standards. An interdisciplinary approach is therefore necessary.


Assuntos
Carcinoma de Células Escamosas , Complicações Neoplásicas na Gravidez , Neoplasias do Colo do Útero , Carcinoma de Células Escamosas/diagnóstico , Colo do Útero , Feminino , Humanos , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias do Colo do Útero/diagnóstico
12.
Orv Hetil ; 160(49): 1948-1956, 2019 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-31786940

RESUMO

Introduction: The organized breast and cervical screening programs were implemented in the framework of public health program in Hungary in order to reduce breast cancer mortality by 30% and cervical cancer mortality by 60% in given age groups within 10 years by 2012. Aim: The aim of our study was to conduct a retrospective analysis of mortality and morbidity data and to evaluate the effectiveness of the implemented screening programs. Method: Descriptive statistical analysis was performed by age-standardized mortality and morbidity data between 1980 and 2015 with special regard to the period of 2002-2012. Results: Breast cancer mortality of women aged 45-64 reduced by 28.3%, the incidence reduced by 23.6% and the incidence of in situ carcinoma increased by 242% between 2002 and 2012. Cervical cancer mortality of women aged 25-64 years reduced by 25.5%, the incidence reduced by 21.2%, and the incidence of in situ carcinoma increased by 13.3% during 2002-2012. Conclusion: Although both breast cancer and cervical cancer mortality substantially decreased in Hungary, the decrease in cervical cancer did not reach the target value. Orv Hetil. 2019; 160(49): 1948-1956.


Assuntos
Neoplasias da Mama/mortalidade , Detecção Precoce de Câncer/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Neoplasias do Colo do Útero/mortalidade , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Hungria/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias do Colo do Útero/diagnóstico
13.
J Exp Ther Oncol ; 13(2): 165-167, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31881134

RESUMO

Objective: Cervical carcinosarcomas (Malignant Mixed Mullerian Tumour [MMMT] ) are very rare neoplasms. Fewer than 100 cases were documented until recently. Because of the rarity, etiologic factors, prognosis and treatment modalities are unclear. A 53 year-old woman presented with postmenauposal vaginal bleeding and abnormal cervical cytology. Cervical biopsy followed by loop electrosurgical excision procedure (LEEP) and cold knife conisation (CKC) was documented as cervical intraepithelial neoplasia III (CIN III). Without follow-up, two years later, the patient was referred with a cervical 6,5 cm mass invading vagina, parametriums and rectum. Biopsy was reported as cervical carcinosarcoma with squmous carcinoma and homologous sarcoma component. Neoadjuvant chemotherapy provided partial response. Subsequently external beam whole pelvis radiotherapy with chemotherapy and brachytherapy was applied. In despite of the treatment, the patient developed sistemic recurrence and died of disease within 10 months. In previous reports most of the patients were in early stage and had better prognosis than uterine carcinosarcomas. Here in we present a case who had a history of high-grade cervical displasia and presented at advanced stage, managed with neoadjuvant chemotherapy and definitive chemoradiotherapy.


Assuntos
Carcinossarcoma , Neoplasia Intraepitelial Cervical , Neoplasias do Colo do Útero , Carcinossarcoma/diagnóstico , Conização , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias do Colo do Útero/diagnóstico
14.
Rev. méd. Urug ; 35(4): 267-280, dic. 2019. tab, fig
Artigo em Espanhol | LILACS | ID: biblio-1026117

RESUMO

Introduccción: en Uruguay, el cáncer de cuello uterino ocupó el tercer lugar con una incidencia promedio de 312 nuevos casos por año; fallecieron 134 mujeres promedio por año en el período 2010 - 2014. Objetivo: el objetivo de este trabajo fue analizar los primeros resultados de una experiencia piloto con la aplicación del test de HPV captura híbrida HC2 (QiagenR) como test de tamizaje primario del cáncer de cuello uterino en una zona del departamento de Canelones. Método: se estudiaron 1.010 mujeres asintomáticas entre 30 y 64 años que concurrieron a realizarse el test de PAP a dos unidades de toma de muestras del Programa de prevención del cáncer de cuello uterino. Se realizó la extracción conjunta de la muestra para PAP, que fue derivada a uno de los laboratorios de citología de la Red de Atención Primaria de Salud y la muestra de HPV que fue procesada con la técnica de captura híbrida en el laboratorio de biología molecular del Centro Hospitalario Pereira Rossell. Las usuarias con resultados HPV + y PAP anormales (ASC-US+) fueron derivadas a colposcopia, con biopsia y posterior tratamiento cuando correspondió. Resultados: el test de HPV fue positivo en 126/1.010 mujeres (12,5%) y el PAP anormal en 167/1.010 (16,5%). El test de HPV fue positivo en todos los casos CIN2+ 13/13 (100%) mientras que el PAP fue anormal (ASCUS+) en 7/13 (54%) para CIN2+ por biopsia. Conclusión: el test de HPV resultó más eficaz y eficiente que el PAP para la detección de lesiones precancerosas de cuello uterino.


Introduction: in Uruguay, cervical cancer occupied the third place with an average incidence of 312 new cases per year. 134 women died in the 2010 -2014 period. Objective: the study aims to analyse the first results in a pilot experience with the application of Hybrid Capture® 2 High-Risk HPV DNA Test™ (hc2) (QiagenR) as the primary screening test for cervical cancer, in the Department of Canelones. Method: 1.010 asymptomatic women whose ages ranged between 30 and 64 years old were studied when they requested a pap smear at two units of sample taking within the Cervical Cancer Prevention Program. Samples were taken along with the pap smear, and sent to one of the cytology labs in the primary health care network, the HPV sample being processed with the hybrid capture technique in the molecular biology laboratory of the Pereira Rossell Hospital Center. Users with abnormal HPV+ and abnormal pap smear results (ASCUS+) were referred to colposcopy, with subsequent biopsy and treatment if required. Results: HPV test was positive in 126/1010 women (12.5%) and PAP was abnormal in 167/1010 cases (16.5%). HPV test was positive in all cases CIN2+ 13/13 (100%) whereas PAP was abnormal (ASCUS+) in 7/13 54%) for CIN2+ in biopsy. Conclusion: HPV test was more effective and efficient than pap smear to detect pre-cancer lesions in the cervix.


Introdução: no Uruguai, no período 2010 - 2014, o câncer de colo do útero foi a terceira causa com uma incidência média de 312 novos casos por ano e uma média de 134 mortes por ano. Objetivo: o objetivo deste trabalho foi analisar os primeiros resultados de uma experiência piloto com a utilização do exame de HPV Captura Híbrida HC2 (QiagenR) na tamizagem primária do câncer de colo do útero em una zona do departamento de Canelones. Método: foram estudadas 1010 mulheres assintomáticas, com idades entre 30 e 64 anos que foram a duas unidades do Programa de Prevenção do Câncer do Colo do Útero para a coleta de amostra para exame de Papanicolau (PAP). Realizou-se uma única extração para duas amostras: uma para PAP, que foi encaminhada a um laboratório de citologia da rede de atenção primária de saúde e outra para o exame de HPV que foi processada com a técnica de captura híbrida no laboratório de biologia molecular do Centro Hospitalario Pereira Rossell. As usuárias com resultados HPV + e PAP anormais (ASCUS+) foram encaminhadas para realização de colposcopia, com biopsia e tratamento quando fosse necessário. Resultados: o exame de HPV foi positivo em 126/1010 mulheres (12.5%) e o PAP foi anormal em 167/1010 (16.5%). O exame de HPV foi positivo em todos los casos CIN2+ 13/13 (100%) e o PAP foi anormal (ASCUS+) em 7/13 (54%) para CIN2+ por biopsia. Conclusão: o exame de HPV foi mais eficaz e eficiente que o PAP para detecção de lesões pré-cancerosas de colo do útero.


Assuntos
Humanos , Feminino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Programas de Rastreamento/métodos , Infecções por Papillomavirus/diagnóstico , Teste de Papanicolaou
15.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 840-847, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31874474

RESUMO

Objective: To evaluate the feasible cervical cancer screening strategies in rural China. Methods: The study was based on the health industry scientific research project of National Health Commission in 2015, cervical cancer screening technology and demonstration research suitable for rural areas in China, we collected health economics and epidemiological parameters and established the unscreening model and screening model with Treeage Pro 2011 software. Combining with the data acquired from site investigation, including population screening, treatment-related clinical materials and cost data, we simulated the occurrence and the development of cervical cancer of rural women in China under different screening and intervention programs and predicted the screening effects [cumulative incidence, cumulative risk of disease, life years and quality adjusted life years (QALY) , gains] and costs after 20 years, and using health economic evaluation analysis (cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis). Screening programs included five screening strategies [visual inspection with acetic acid/lugol's iodine (VIA/VILI), careHPV, ThinPrep cytology test (TCT), careHPV+TCT, careHPV+VIA/VILI] and three screening intervals (1-year, 3-year, 5-year), a total of fifteen screening programs. Results: Compared with no screening, fifteen screening programs reduced the cumulative incidence by 22.65%-51.76%. Compared with TCT or VIA/VILI, for the same screening interval, the reduced cumulative incidence, the amounts of life-year saved and QALY and benefits gained of careHPV were the highest. The cost-effectiveness ratios of these screening programs ranged (0.44-3.24)×10(4) Yuan per life-year saved, cost-utility ratios ranged (0.15- 1.01)×10(4) Yuan per QALY, benefit-cost ratios ranged 7.73-59.10. The results of incremental costeffectiveness ratios showed that VIA/VILI every five years, VIA/VILI every three years, careHPV every five years, careHPV every three years and careHPV every year were dominant programs. Conclusions: VIA/VILI screening is cost-effective, careHPV is slightly more expensive but more effective. In rural China, careHPV screening every five years could be recommended. This study provides a basis for the determination of cervical cancer screening methods feasible for rural areas in China.


Assuntos
Detecção Precoce de Câncer/economia , Programas de Rastreamento/economia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , China , Análise Custo-Benefício , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Cadeias de Markov , Programas de Rastreamento/métodos , Saúde da População Rural , Neoplasias do Colo do Útero/economia
16.
Pan Afr Med J ; 34: 48, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31762914

RESUMO

Neuroendocrine tumors of the cervix are rare accounting for only 0.9-1.5% of these tumors. The non-specificity of the clinical signs and the absence of a screening test delay diagnosis. Immunohistochemical and histological studies play a crucial role to confirm the diagnosis. Today, therapeutic management is difficult and prognosis is unfavorable. We report a case of neuroendocrine tumor of the cervix and we will outline the peculiarities of this rare disease.


Assuntos
Tumores Neuroendócrinos/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Tumores Neuroendócrinos/patologia , Prognóstico , Neoplasias do Colo do Útero/patologia
17.
BMC Public Health ; 19(1): 1492, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703661

RESUMO

BACKGROUND: A Brazilian guideline on cervical cancer screening was released in 2011. The objective was to verify changes in screening indicators around this period. METHODS: An audit study which sample was all screening tests performed by the public health system of Campinas city from 2010 to 2016. Variables were absolute tests numbers, excess tests, intervals and results, by age. For trend analysis was used Cochran-Armitage × 2 and linear regression. RESULTS: Were carried out 62,925 tests in 2010 and 43,523 tests in 2016, a tendency at a reduction (P = 0.001). Excess tests were higher than 50% over the years, with a tendency at a reduction (P < 0.001). Tests performed on women under 25 ranged from 20.2 to 15.4% in the period (P < 0.001), while in the 25-64 years age-group, it ranged from 75.1 to 80.2% (P < 0.001). In 2010 the most frequent interval was annual (47.5%) and in 2016 biennial (34.7%). There was a tendency at a reduction in the proportion of tests performed at the first time and those with an annual interval (P < 0.001), and also a tendency at an increase in tests with intervals equal to or greater than biannual (P < 0.001). We observed a tendency at a reduction in LSIL and HSIL-CIN2 results (P = 0.04 and P = 0.001, respectively), and a tendency at an increase in HSIL-CIN3 result (P = 0.02). CONCLUSION: The proportion of cervical cancer screening tests performed out of the recommendation showed a significant reduction in the period. This indicates a tendency to align cervical cancer screening in Campinas with the standards recommended.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Guias como Assunto , Saúde Pública/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Adulto , Brasil/epidemiologia , Comissão Para Atividades Profissionais e Hospitalares , Detecção Precoce de Câncer/normas , Feminino , Política de Saúde , Humanos , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Saúde Pública/normas , Adulto Jovem
18.
BMC Infect Dis ; 19(1): 842, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615443

RESUMO

BACKGROUND: HPV test implementation as a primary screening tool has the potential to decrease cervical cancer incidence as shown by several studies around the world. However, in many low-resource settings, the HPV test introduction has been backed down mainly due to its price. In this study, we present a novel low-cost strategy involving simple devices and techniques for high-risk human papillomavirus (HR-HPV) detection. The analytical performance to detect HR-HPV infections of this novel strategy was assessed by comparing it with the Hybrid Capture 2 system (HC2), which is used as gold standard. METHODS: Paired-cervical samples were collected from 541 women assisting to gynecological services in an outpatient clinic. One sample was transported in the Hybrid Capture Standard Transport Medium for HR-HPV detection by the HC2. The second sample was transported on glass slide for detection by PCR-based techniques (GP-EIA, BSGP-EIA and pU 1 M-L/2R). RESULTS: The level of agreement between the PCR-based techniques and HC2 system was determined with the Cohen's kappa value. The kappa values between HC2 and GP-EIA, BSGP-EIA and pU 1 M-L/2R were 0.71 (CI 95% 0.63-0.78), 0.78 (CI 95% 0.71-0.84) and 0.63 (CI 95% 0.55-0.72), respectively. However, when the results from both BSGP-EIA and pU 1 M-L/2R were combined, the level of agreement with HC2 was increased to 0.82 (CI 95% 0.76-0.88), reflecting a very good agreement between the two HR-HPV detection strategies. Furthermore, the sensitivity of both techniques combined was also increased compared to the BSGP-EIA (88.7% vs 77.4%) and the pU (88.7 vs 60.9%) without penalizing the specificity obtained with the BSGP-EIA (95.1% vs 96.9%) and the pU (95.1% vs 96.5%). CONCLUSIONS: This novel strategy, combining two PCR-based techniques for HR-HPV detection, could be useful for cervical cancer screening in self-collected samples in low-income countries.


Assuntos
DNA Viral/análise , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Reação em Cadeia da Polimerase/métodos , Neoplasias do Colo do Útero/diagnóstico , Colo do Útero/patologia , DNA Viral/metabolismo , Detecção Precoce de Câncer , Feminino , Genótipo , Humanos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Reação em Cadeia da Polimerase/economia , Kit de Reagentes para Diagnóstico , Risco , Sensibilidade e Especificidade , Análise de Sequência de DNA , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia
19.
Adv Clin Exp Med ; 28(10): 1377-1383, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31638746

RESUMO

BACKGROUND: Poland is considered among the European countries with an average incidence of cervical cancer (CC; about 3,000-3,500/year) and at the same time with high mortality (5-year survival rate - 55.2%). For this reason, in 2006 Poland introduced a Population-Based Cervical Cancer Prevention and Early Detection Program addressed to women aged 25-59 years, in which a cytological test is carried out every 3 years. OBJECTIVES: The aim of the study was to assess the changes in the curability of CC patients brought by the introduction of the Screening Program in the Lower Silesian voivodeship and to identify the subpopulation of women for whom activities aimed at increasing adherence rates must be intensified. MATERIAL AND METHODS: The 5-year relative survival in 3,586 CC patients from 2000-2010 registered in the Lower Silesian Cancer Registry was analyzed. RESULTS: In the Lower Silesian voivodeship, a 55.1% 5-year survival rate was recorded in 2000-2004 and 70.5% in 2010. The highest increase in 5-year relative survival rates was found in rural communities (from 53.1% in 2000-2004 to 77.7% in 2010) and in Wroclaw (56.8% and 74.2%, respectively). In the study group, the number of patients with invasive CC (C53) detected in the local stage of the disease increased systematically from 61.5% in 2000-2004 to 74.3% in 2010. CONCLUSIONS: The introduction of the population-based screening program improved the curability rate in CC patients in the Lower Silesian voivodeship. In order to maintain the recent positive trends, further education should be continued, and activities aimed at increasing adherence to screening tests should be intensified, especially in urban-rural communities.


Assuntos
Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Detecção Precoce de Câncer , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cooperação do Paciente/psicologia , Polônia/epidemiologia , Vigilância da População , Avaliação de Programas e Projetos de Saúde , Taxa de Sobrevida/tendências , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/patologia
20.
JSLS ; 23(3)2019.
Artigo em Inglês | MEDLINE | ID: mdl-31595144

RESUMO

Background and Objective: Laparoendoscopic single-site surgery has been used in treating gynecologic diseases including early-stage cervical and endometrial cancer, but less so in early-stage adnexal cancer. We aimed to demonstrate the use of laparoendoscopic single-site surgery with suture suspension for staging of early-stage ovarian/fallopian-tube cancer and describe the study results. Methods: Seven patients with early-stage adnexal cancer underwent staging surgery via laparoendoscopic single-site surgery at West China Second University Hospital of Sichuan University from November 2017 to September 2018. Results: All cases were successfully staged via this technique. Two patients underwent the high-level para-aortic lymphadenectomy up to the infrarenal vein, and four patients underwent para-aortic lymphadenectomy at the level of the inframesenteric artery; one patient underwent the para-aortic lymph node sampling. The operation time was 305-365 minutes. The estimated intraoperative blood loss was 50-200 mL. No intra-operative complications occurred; one patient developed pneumonia 48 hours postoperation. The number of pelvic and para-aortic nodes was 15-39 and 1-18, respectively. Pain scores 12 and 24 hours postsurgery were 2-3 and 1-2 with the use of butorphanol tartrate, respectively. On 4-14 months followup, the umbilical incision had good cosmesis; no umbilical hernia or vaginal dehiscence and no neoplasm recurrence were noted. Conclusion: Laparoendoscopic single-site surgery may be a feasible and safe technique for staging early-stage ovarian/tubal cancer. This approach has some advantages included providing easier access to the upper abdominal regions when performing high-level infrarenal para-aortic lymphadenectomy; the 2-cm elastic incision favors fast specimen extraction and colpotomy are avoided. However, the long-term oncologic outcomes need to be further investigated.


Assuntos
Neoplasias do Endométrio/diagnóstico , Laparoscopia/métodos , Estadiamento de Neoplasias/métodos , Técnicas de Sutura/instrumentação , Suturas , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Neoplasias do Colo do Útero/cirurgia
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