scholarly journals Assessment of the natural course and treatment of premalignant uterine cervical lesions in pregnancy

2013 ◽  
Vol 141 (3-4) ◽  
pp. 192-197 ◽  
Author(s):  
Dragisa Sljivancanin ◽  
Vesna Kesic ◽  
Lidija Tulic ◽  
Jelena Dotlic
Keyword(s):  
Preterm Births ◽  
Spontaneous Remission ◽  
Natural Course ◽  
High Rate ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Similar Frequency ◽  
Intraepithelial Lesion ◽  
The Impact

Introduction. Premalignant changes of the uterine cervix occur with similar frequency during pregnancy and in non?pregnant women. Due to the fact that any surgery on the cervix can jeopardize pregnancy, it is important to define the protocol of procedures for the treatment of these changes during pregnancy. Objective. The aim of the study was to investigate the natural course of premalignant cervical changes during pregnancy and the impact of their treatment on the pregnancy course. Methods. Study involved all patients with colposcopically, cytologically and hystopathologically diagnosed premalignant cervical changes during pregnancy from 2002 to 2008. Patients were divided into two groups according to the applied treatment during pregnancy: surgery or monitoring by regular colposcopic and cytological examinations. The two groups were compared concerning treatment outcome, persistence or regression of changes and pregnancy duration. Results. Study involved 58 patients. Spontaneous remission of lesions occurred after pregnancy in 63.79% of cases. Highgrade squamous intraepithelial lesion (H?SIL) demonstrated a higher rate of persistency in comparison with low?grade squamous intraepithelial lesion (L?SIL) (?2=25.115; p<0.05). Only one finding of L?SIL progressed into H?SIL in the monitored group. Patients who underwent conization during pregnancy had a significantly more frequent preterm deliveries (?2=14.369; p<0.05). Conclusion. The obtained high rate of spontaneous regression of cervical changes after pregnancy as well as the lower incidence of preterm births in patients who were not treated by conization during pregnancy, confirm that patients with premalignant cervical changes should be, if invasion is excluded, under follow?up throughout pregnancy by regular colposcopic and cytological examinations. Therapeutic conization, due to numerous complications, should be performed only when there is a suspected presence of a more severe form of the disease (micro invasive and invasive carcinoma).

scholarly journals Gynaecological cytology in women under the age of 30—the impact of P16/KI67 dual-staining cytology

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
F Silva ◽  
C Rocha ◽  
P Teixeira ◽  
R Oliveira ◽  
D Martins ◽  
...  
Keyword(s):  
High Rate ◽  
Medical Visit ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Ki 67 ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
The Impact ◽  
Dual Staining

Abstract Background The HPV detection test is not recommended as a primary screening of cervical lesions, before the age of 30, because the high rate of HPV infections with a high rate of spontaneous resolution in this age group. This study aims to evaluate the performance of p16/Ki67 dual staining in detecting high-grade squamous cervical lesions in these women. Methods Cervical-vaginal samples from 67 women HPV positives under the age of 30 and cervical biopsies of 41 of these women. Results of p16/Ki67 dual staining, cytology and histology were analysed. In 53 of the women, 159 results of p16/Ki67 dual staining, HPV test and cytology, obtained in 3 follow-up medical visit, were compared. Results The p16/ki67 dual staining was positive in 23.9% and negative in 76.1% of all 67 women. All women with high squamous intraepithelial lesion cytology, 39.1% with low squamous intraepithelial lesion cytology, 17.4% with negative for intraepithelial lesion cytology and 10% with atypical squamous cells cytology, were p16/Ki-67 dual staining positives. In the 41 women with histological diagnosis, p16/ki67 dual staining showed a sensitivity of 87.5% and a specificity of 96% to detect HSIL. When comparing, the tests differ significantly (P &lt; 0.001), p16/ki67 dual staining was positive in 24% of positive cytology and in 19.5% of positive HPV tests. Conclusions Our results demonstrate that p16/Ki67 dual stain has good sensitivity and specificity to detect HSIL and can be useful on women under the age of 30, avoiding excessive diagnosis and reducing colposcopy referrals. Further studies are required in a large number of women.

scholarly journals Separation of Normal and Premalignant Cervical Epithelial Cells Using Confocal Light Absorption and Scattering Spectroscopic MicroscopyEx Vivo

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Ling Yang ◽  
Wen-Tao Liu ◽  
Hao Wu ◽  
Cheng Wang ◽  
Bo Ping ◽  
...  
Keyword(s):  
Light Absorption ◽  
Pap Smear ◽  
Precancerous Lesions ◽  
Scattered Light ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Pap Smear Test ◽  
Intraepithelial Lesion ◽  
Cervical Squamous Intraepithelial Lesion

Confocal light absorption and scattering spectroscopic (CLASS) microscopy can detect changes in biochemicals and the morphology of cells. It is therefore used to detect high-grade cervical squamous intraepithelial lesion (HSIL) cells in the diagnosis of premalignant cervical lesions. Forty cervical samples from women with abnormal Pap smear test results were collected, and twenty cases were diagnosed as HSIL; the rest were normal or low-grade cervical squamous intraepithelial lesion (LSIL). The enlarged and condensed nuclei of HSIL cells as viewed under CLASS microscopy were much brighter and bigger than those of non-HSIL cells. Cytological elastic scattered light data was then collected at wavelengths between 400 and 1000 nm. Between 600 nm to 800 nm, the relative elastic scattered light intensity of HSIL cells was higher than that of the non-HSIL. Relative intensity peaks occurred at 700 nm and 800 nm. CLASS sensitivity and specificity results for HSIL and non-HSIL compared to cytology diagnoses were 80% and 90%, respectively. This study demonstrated that CLASS microscopy could effectively detect cervical precancerous lesions. Further study will verify this conclusion before the method is used in clinic for early detection of cervical cancer.

scholarly journals Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesion among Women in Jimma town, Ethiopia

2019 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Screening Tests ◽  
Cancer Case ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Value ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology

Abstract BackgroundCervical cancer is the second leading type of female cancer in Ethiopia and screening is based on visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used. MethodWomen aged 21-65 years were enrolled. Liquid based cytology and VIA were done for the detection of cervical dysplasia. Logistic regression analysis were conducted to identify factors associated. Finally Cohen’s K was done to test agreement between the methods of diagnostics.ResultsFrom the total 448 participants, (296, 66%) were 35-65 years old. Four hundred nineteen (93.5 %) were screened using LBC of which, 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high grade squamous intraepithelial lesion (HSIL). Among women with LSIL, 84(86.6%) women as well as all those HSIL were 35-65 years old and women aged 35-65 years old had 4.7 times higher odds of having intraepithelial lesions (P=0.00). A total of 294/448 (65.6%) women underwent VIA examination, of these 18 (6.1%) were found positive. Two hundred seventy two (60.7%) women screened using both LBC and VIA. Of this 6 (2.2%) were positive with both LBC and VIA screening tests. The level of agreement between the two methods was weak and statistically significant (kappa value=0.155, p=0.006). ConclusionPrevalence of cervical lesions is higher among older women. There is high variability in LBC and VIA results. Though more expensive and requiring equipment, using LBC where possible would increase cervical cancer case detection.

scholarly journals Comparative study of papanicolaou smear and colposcopy in the evaluation of cervical lesions

2019 ◽  
Vol 8 (6) ◽  
pp. 2400
Author(s):  
Priyanka Mohan ◽  
Lakshmidevi M. ◽  
Shreedhar Venkatesh
Keyword(s):  
Pap Smear ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Research Centre ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Intraepithelial Lesion ◽  
Punctate Pattern

Background: Cervical cancer is the third most common type of cancer among females. Study aims to critically evaluate the sensitivity and specificity of colposcopy versus papanicolaou (Pap) smear in the early detection of dysplasias. Its secondary objective to correlate the findings in the evaluation of unhealthy cervix by cytology, colposcopy and colposcopy guided biopsy.Methods: This was a tertiary care teaching hospital based, prospective, cross sectional study done in Department of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, conducted on 200 women attending Gynaecology OPD.Results: PAP smear was taken for all 200 patients. 73% of smear was found to be normal, 11% showed inflammatory atypia, 9% showed low grade squamous intraepithelial lesion (LSIL), 3.5% showed atypical squamous cells of undetermined significance (ASCUS) and 3.5% showed High Grade Squamous Intraepithelial Lesion (HSIL). Among the 200 cases studied, 38% (76/200) were diagnosed as colposcopically abnormal. Among the abnormal cases, AW areas were diagnosed in 4%. Punctate pattern of vessels was seen in 5% of women. Normal findings was present in 62%, Erosion cervix in 6%, inflammatory changes were seen in 6% and polyps were diagnosed in 7.5%, leucoplakia was found in 2% and unsatisfactory colposcopy finding was seen in 4% and underwent endocervical curettage. 32 cases out of 200 women were positive on Pap smear. 66 out of 200 women were positive on Biopsy. Pap smear was positive in 22 out of 66 biopsy proven positive cases.Conclusions: The commonest presenting complaint was vaginal discharge (182/200; 91% of the patients. the PAP smear  is found to have sensitivity of 33.33%  and specificity of 92.54%. colposcopy is found to have sensitivity of 81.82%  and specificity of 82.84%.

scholarly journals Prevalence and Distribution of High-Risk Genotypes of HPV in Women with Severe Cervical Lesions in Madrid, Spain: Importance of Detecting Genotype 16 and Other High-Risk Genotypes

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Maria Luisa Mateos Lindemann ◽  
Juan Manuel Sánchez Calvo ◽  
Jesús Chacón de Antonio ◽  
Itziar Sanz ◽  
Esperanza Diaz ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Tests ◽  
Hpv Infection ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Normal Cytology ◽  
Capture Assay ◽  
Intraepithelial Lesion ◽  
Low Prevalence

Background. Persistent infection with high-risk human papillomavirus (HR-HPV) has been demonstrated to be the necessary causal factor for developing cervical cancer. To know the most prevalent HR-HPV in different geographical areas is important to design diagnostic tests and implementation of vaccines.Objectives. The goal of this study is to evaluate the prevalence of HR-HPV in a total of 1001 patients, 198 with normal cytology results, 498 with low-grade squamous intraepithelial lesion (LSIL), and 205 with high-grade squamous intraepithelial lesion (HSIL) who attended our gynaecology department for opportunistic screening of HPV infection.Study design. Cervical samples were taken in a PreservCyt vial (Cytyc Corporation, Boxborough, MA). Hybrid capture assay was carried out following the manufacturer's instructions (Digene Corp., Gaithersburg, MD). All samples were further studied with polymerase chain reaction (PCR) (Linear Array HPV Genotyping Test, Roche Diagnostics, Mannheim, Germany).Results. Genotype 16 was the most prevalent HR-HPV in the three groups, 17.8% in the patients with normal cytology results, 22.3% in the LSIL group, and 60% in the HSIL group. Genotype 18 had a very low prevalence in all groups. Other HR-HPV genotypes such as genotype 31, genotype 58 and genotype 52 were found in significant numbers in HSIL patients.Discussion. Our data show that genotypes 16, 31, 58, and 52 are the most prevalent HR-HPV in cervical samples with severe intraepithelial lesion in Spain. There may be some geographical variation in prevalence of carcinogenic types, and it must be considered for designing diagnostic tests and vaccine.

scholarly journals Clinical response to glycyrrhizinic acid in genital infection due to human papillomavirus and low-grade squamous intraepithelial lesion

2011 ◽  
Vol 1 (4) ◽  
pp. 93 ◽  
Author(s):  
Marcelino Hernandez Valencia ◽  
Adia Carrillo Pacheco ◽  
Tomás Hernández Quijano ◽  
Antonio Vargas Girón ◽  
Carlos Vargas López
Keyword(s):  
Pap Smear ◽  
Hpv Infection ◽  
The Body ◽  
Reproductive Age ◽  
New Drugs ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Glycyrrhizinic Acid ◽  
Intraepithelial Lesion

Human papilloma virus (HPV) can infect any of the mucosal areas of the body and cause cervical cancer. Until recently, no specific treatments were available for this condition; therefore, any damaged tissue had to be removed or destroyed, which may have presented obstetrical repercussions for some women. Recently, new drugs have been developed that have shown to be effective for the cure of HPV infection. Glycyrrhizinic acid (GA) has shown fewer side effects and its systemic use makes it possible to reach difficultto- treat lesions. The purpose of this study was to evaluate the clinical outcome of GA to eliminate the epithelial lesion and HPV. We carried out a longitudinal, descriptive study that included women of reproductive age who were diagnosed with HPV associated with low-grade squamous intraepithelial lesion (LSIL). Subjects began treatment based on GA using two routes of administration - systemic (oral) and topical (spray) - with assessments every month to determine the clinical changes of the lesions through colposcopy and Papanicolaou (Pap) smear. Simple statistics were used along with two-tailed Student’s t-test; P&lt;0.05 was considered statistically significant before and after treatment. There were 70 eligible patients, of whom 62 fulfilled the inclusion criteria. Age of subjects was 27.8±9.5 years. At the time of the study, 100% of the patients had HPV infection, 40% were associated with LSIL, and only 16% used a barrier contraceptive (condom) method. Resolution was achieved in all patients from 4 weeks of treatment initiation and improvement was achieved in the majority of patients at 12 weeks (74%) (P&lt;0.001). However, there was persistence of LSIL in 27.7% of patients and only one patient progressed to cervical intraepithelial neoplasia (CIN) II. The use of GA proved to be effective in resolving clinical HPV lesions. For cervical lesions with epithelial changes (LSIL), treatment may be required for a longer period as with other drugs used for this infection, as well as monitoring for at least 1 year according to the natural evolution of the disease.

Effects of Implementing the Dual Papanicolaou Test Interpretation of ASC-H and LSIL Following Bethesda 2014

2020 ◽  
Vol 154 (4) ◽  
pp. 553-558
Author(s):  
Abha Goyal ◽  
Ami P Patel ◽  
Thomas L Dilcher ◽  
Susan A Alperstein
Keyword(s):  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
The Impact

Abstract Objectives To evaluate the impact of implementing the dual interpretation of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and low-grade squamous intraepithelial lesion (LSIL) after the Bethesda System 2014 and to compare it with other indeterminate interpretations. Methods Rates of high-risk human papillomavirus (HPV) positivity and histologic follow-up and the proportion of women with high-grade squamous intraepithelial lesion on histologic follow-up were compared for the combined interpretation of ASC-H and LSIL (ASCHL) and the categories of LSIL, cannot exclude high-grade squamous intraepithelial lesion (LSIL-H) and ASC-H. Results The percentage of ASCHL HPV-positive cases (86.0%) was similar to that of LSIL-H but significantly higher in comparison to that of ASC-H. The rates of cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) and CIN 3+ for ASCHL (29.6% and 3.6%, respectively) were similar to those of LSIL-H and ASC-H. When stratified by HPV test results, the proportions of patients with CIN 2+ and CIN 3+ remained statistically similar to those with ASCHL and with LSIL-H and ASC-H. Conclusions Considering the similar risks of CIN 2+ and CIN 3+ for ASCHL and ASC-H, having a separate category of ASCHL for reporting cervical cytology appears to be redundant.

scholarly journals Association between asymptomatic sexually transmitted infections and high-risk human papillomavirus in cervical lesions

2019 ◽  
Vol 47 (11) ◽  
pp. 5548-5559 ◽  
Author(s):  
Lei Wang ◽  
Lizhe Zhu ◽  
Han Li ◽  
Nan Ma ◽  
Huifang Huang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Sexually Transmitted Infections ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Intraepithelial Lesion

Objective This study aimed to determine the association of asymptomatic sexually transmitted infections (STIs), including Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium, Chlamydia trachomatis, and herpes simplex virus type 2, with high-risk human papillomavirus (hrHPV) in cervical intraepithelial lesions and neoplasms. Methods A total of 320 hrHPV-positive and 160 hrHPV-negative women were divided into high-grade squamous intraepithelial lesion (HSIL) + invasive cervical cancer and low-grade squamous intraepithelial lesion + normal subgroups, respectively, on the basis of pathological cervical lesions. Cervical brush specimens were amplified and hybridized using polymerase chain reaction kits. Results MH was associated with hrHPV infection, but not with specific hrHPV genotypes or with single or multiple genotypes. Coinfection of hrHPV and UU serotype 14 (Uup14) showed an increased risk of HSILs and cervical carcinoma (odds ratio [OR]: 12.541, 95% confidence interval [CI]: 3.625–43.390). U. urealyticum biovar (Uuu) and Uup1 infections showed a similar increased risk (OR: 11.646, 95% CI: 1.493–90.850; OR: 7.474, 95% CI: 1.140–49.015, respectively) without hrHPV. Conclusions Asymptomatic STIs are widespread. This study shows an association between UU subtypes and cervical cancer, providing new insight into cervical lesion etiology. Screening for MH, Uup14, Uup1, and Uuu is important under different hrHPV statuses.

ATL

2013 ◽  
Vol 23 (5) ◽  
pp. 785-790 ◽  
Author(s):  
Xiuhui Zheng ◽  
Peihe Liang ◽  
Yingru Zheng ◽  
Ping Yi ◽  
Qiang Liu ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Gene Amplification ◽  
Predictive Value ◽  
Low Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Cin Iii ◽  
Intraepithelial Lesion

ObjectiveTo investigate the clinical significance of abnormal human telomerase RNA gene component (hTERC) gene amplification tested by fluorescence in situ hybridization in cervical lesions.MethodsIn 373 patients with cytologic abnormalities, high-risk human papilomavirus (HR-HPV) was detected by the hybrid capture II method, and abnormal amplification of the hTERC gene in exfoliated cells was detected by fluorescence in situ hybridization.ResultsCell smear findings suggested atypical squamous cells in 148 patients, low-grade squamous intraepithelial lesion in 62 patients, and high-grade squamous intraepithelial lesion in 107 patients, squamous cell carcinoma in 56 patients, and cervical biopsy-revealed inflammation in 89 patients, cervical intraepithelial neoplasia (CIN) I in 36 patients, CIN II in 43 patients, CIN III in 129 patients, and infiltrating carcinoma in 76 patients. In the inflammation, CIN I, CIN II, CIN III, and infiltrating carcinoma groups, the infection rates of HR-HPV were 29.21%, 52.78%, 74.42%, 92.25%, and 93.42% (P < 0.01), respectively; the positive rates of hTERC gene amplification were 0.00%, 13.89%, 41.86%, 78.29%, and 89.47% (P < 0.01), respectively. With respect to advanced cervical lesions (≥CIN II), cytology (≥ low-grade squamous intraepithelial lesion), HR-HPV testing, and hTERC testing differed insignificantly in the negative predictive value (P > 0.05), but they differed significantly in the sensitivity, specificity, and positive predictive value (P < 0.01). Among the 3 methods, hTERC testing showed the highest specificity and positive predictive value, and HR-HPV testing showed the highest sensitivity. In 41 patients with untreated CIN I and CIN II, the sensitivity of detection of hTERC gene amplification to predict lesion progression was 88.89%, and the specificity was 93.75%.ConclusionDetection of abnormal amplification of the hTERC gene can assist in screening cervical lesions and identifying CIN I/II patients with a high progression risk.

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