scholarly journals Successfully Pregnancy Outcome After LLETZ in Women with Cervical Intraepithelial Neoplasia: A Case Series

2021 ◽  
Vol 9 (C) ◽  
pp. 308-312
Author(s):  
Junita Indarti ◽  
Raymond Surya ◽  
Reyhan Aditya ◽  
Muhammad Ikhsan ◽  
Kristian Alda ◽  
...  

BACKGROUND: Human papillomavirus (HPV) has an important role in cervical cancer development and the incidence of cervical intraepithelial neoplasia (CIN) was 1.3–2.7/1000 pregnancies. The HPV and its treatments such as loop electrosurgical excisional procedure (LEEP) or large loop electrosurgical excisional procedure (LLETZ) have an association with poor obstetric outcomes. CASE REPORT: Here, we present four case studies of successful live birth after treatment of CIN. We reported that four patients had been performed LLETZ, with abnormal colposcopy results and liquidbased cytology results were one ASCUS, one ASCH, and two HSIL. The histopathology results were one CIN 1, one CIN 2, and two CIN 3. There was a higher rate of pregnancy for treated women than untreated women. The higher the CIN grades, the more prevalence of cesarean section rate. CONCLUSION: The HPV testing or cotesting at 3-year intervals is recommended after treatment due to the sensitivity of HPV testing. Although pregnancy could delay the progression of precancerous lesions, it is recommended to follow the individualized algorithm in the ASCCP guideline to reduce the risk of cervical cancer progression.

2018 ◽  
Vol 1 (2) ◽  
pp. 9-13
Author(s):  
Renee Pradhan ◽  
U. Pant ◽  
B. Aryal

Introduction: Cancer cervix is a common genital cancer. Human papillomavirus is the main cause of cervical cancer because of the strong association of certain HPV genotypes and the development of cervical cancer and its precursor lesions, cervical intraepithelial neoplasia CIN 2 or CIN3. Methods: The study was conducted on 180 gynecological patients seen at the outpatient department of Manipal Hospital, Bangalore. A comparative study of HPV DNA test with Pap smear in the screening of cervical neoplasia was carried out over the period of 24 months from August 2011 to June 2013. Results: The incidence of cervical cancer and its associated mortality has declined in recent years, largely due to the widespread implementation of screening programs by Pap smear testing. The management and the prevention of cervical cancer should change with HPV DNA testing for high risk HPV, which is more sensitive than pap smear testing. Infection of cervix with HPV is necessary to cause cervical neoplasia and cervical cancer. Persistent infection with HPV is required for the development of cervical dysplasia and invasive cervical cancer. Conclusions: HPV testing alone for primary screening appears promising in women aged 30 years and older as this group is at greatest risk of developing CIN 3. As compared with Pap testing, HPV testing has greater sensitivity for detection of cervical intraepithelial neoplasia.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyu Zhu ◽  
Ji Ren ◽  
Dianqin Xu ◽  
Di Cheng ◽  
Wei Wang ◽  
...  

Outside a few affluent countries with adequate vaccination and screening coverage, cervical cancer remains the leading cause of cancer-related deaths in women in many countries. Currently, a major problem is that a substantial proportion of patients are already at an advanced cancer stage when diagnosed. There is increasing evidence that indicates the involvement of translationally controlled tumor protein 1 (TPT1) overexpression in cancer development, but little is known about its implication in cervical cancer. We assessed the levels of TPT1 in surgical tissue and sera of patients with cervicitis, cervical intraepithelial neoplasia III, and cervical cancer, as well as in normal and cancerous cervical cell lines. Gene sets, pathways, and functional protein interactions associated with TPT1 were identified using the TCGA data cohort of cervical cancer. We found that the TPT1 expression was significantly increased in cervical cancer tissue compared to all nonmalignant cervical tissues, including samples of cervicitis, cervical intraepithelial neoplasia III, and normal controls. Serum level of TPT1 was also increased in cervical cancer patients compared to healthy subjects. Furthermore, elevated TPT1 expression was significantly correlated with lymph node metastasis and a low differentiation degree of the cancer. In the cancerous tissues and cell lines, selective markers of PI3K/AKT/mTOR pathway over-activation, apoptosis repression, and EMT were detected, and their interaction with TPT1 was supported by biometrics analyses. Our results, for the first time, demonstrate a strong correlation of upregulated TPT1 expression with cervical cancer progression, suggesting that TPT1 might provide a potential biomarker for cervical cancer progression.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jia Yang ◽  
Zhiling Yan ◽  
Yingying Wang ◽  
Jinmei Xu ◽  
Rui Li ◽  
...  

Abstract Background miR-21, miR-26b, miR-221/222 and miR-126 play crucial roles in cervical cancer development. Studies have shown that polymorphisms in miRNA genes can affect miRNA expression, which might be associated with cancer development. Methods Ten single-nucleotide polymorphisms (SNPs) in the miR-21, miR-26b, miR-221/222 and miR-126 genes (rs1292037, rs13137 in miR-21; rs2227255, rs2227258 in miR-26b; rs2858061, rs34678647, rs2858060, rs2745709 in miR-221/222; rs2297537, rs2297538 in miR-126) were selected, and genotyped in a total of 2176 individuals, including 435 patients with cervical intraepithelial neoplasia (CIN), 743 patients with cervical cancer (CC) and 998 healthy persons using TaqMan assays, and their associations with CIN and CC were evaluated. Results Our results showed significant differences for the rs2297538 genotypes between the CIN and CC groups (P = 0.001). In addition, our results also showed significant differences for the rs2297537 alleles between the CIN and CC groups (P = 0.003), and the C allele of rs2297537 might be associated with a decreased risk of CC (OR = 0.72, 95%CI: 0.58–0.90). At the inheritance analysis, between the CIN and control groups, the T/T-T/C genotype in rs1292037 and A/A-A/T genotype in rs13137 might be associated with an increased risk of CIN in the recessive model (OR = 1.61, 95% CI: 1.17–2.20 and OR = 1.58, 95% CI: 1.15–2.15). In addition, the C/C-T/T genotype of rs2745709 might be associated with a decreased risk of CIN in the overdominant model (OR = 0.66, 95% CI: 0.52–0.82). Between, CIN and CC group, the T/T-C/C genotype in rs1292037 and A/A-T/T genotype in rs13137 might be associated with an increased risk of CC in the overdominant model (OR = 1.43, 95% CI: 1.12–1.81 and OR = 1.42, 95% CI: 1.12–1.80). The rs2297538 G/G-A/G genotype might be associated with an increased risk of CC in the recessive model (OR = 2.83, 95% CI: 1.52–5.25). The rs2297537 2C/C + C/G genotype might be associated with a decreased risk of CC (OR = 0.71, 95% CI: 0.57–0.89) in the log-additive model. The rs2745709 T/T-C/C genotype might be associated with an increased risk of CC (OR = 1.44, 95% CI: 1.13–1.83) in the overdominant model. Conclusion Our results indicate that rs2297538 and rs2297537 in miR-126, rs1292037 and rs13137 in miR-21, and rs2745709 in miR-221/222, may have important roles in the development of CIN or CC.


Author(s):  
Travis T. Sims ◽  
Lauren E. Colbert ◽  
Ann H. Klopp

ABSTRACT The microbiome, which refers to the microbiota within a host and their collective genomes, has recently been demonstrated to play a critical role in cancer progression, metastasis, and therapeutic response. The microbiome is known to affect host immunity, but its influence on human papilloma virus (HPV) gynecologic malignancies remains limited and poorly understood. To date, studies have largely focused on the cervicovaginal microbiome; however, there is growing evidence that the gut microbiome may interact and substantially affect therapeutic response in gynecologic cancers. Importantly, new developments in microbiome sequencing and advanced bioinformatics technologies have enabled rapid advances in our understanding of the gut and local tumor microbiota. In this review, we examine the evidence supporting the role of the microbiome in HPV-associated cervical intraepithelial neoplasia (CIN) and cervical cancer, explore characteristics that influence and shape the host microbiota that impact HPV-driven carcinogenesis, and highlight potential approaches and considerations for future and ongoing research of the microbiome's effect on HPV-associated cancer.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Rhafaela L. Causin ◽  
Luciane S. da Silva ◽  
Adriane F. Evangelista ◽  
Letícia F. Leal ◽  
Karen C. B. Souza ◽  
...  

New prevention strategies are needed to detect cervical intraepithelial neoplasia (CIN). The microRNA expression analysis has already been reported as molecular biomarkers in the early detection of cervical cancer (CC) through minimally invasive samples, such as liquid biopsy, obtained through collection using liquid-based cytology (LBC). In this study, we aimed to identify molecular signatures of microRNAs in cervical precursor lesions from LBC cervical and the molecular pathways potentially associated with the CC progression. We analyzed 31 LBC cervical samples from women who underwent colposcopy. These samples were divided into two groups: the first group was composed of samples without precursor lesions of CC, considering the control group, referred to as healthy female subjects (HFS; n = 11 ). The second group corresponded to women diagnosed with cervical interepithelial neoplasia grade 3 (CIN 3; n = 20 ). We performed microRNA and gene expression profiling using the nCounter® miRNA Expression Assays (NanoString Technology) and PanCancer Pathways (NanoString Technology), respectively. A microRNA target prediction was performed by mirDIP, and molecular pathway interaction was constructed using Cytoscape. Bidirectional in silico analyses and Pearson’s correlation were performed for associated the relation between genes, and miRNAs differentially expressed related cervical cancer progression were performed. We found that the expression of nine microRNAs was significantly higher, two were downregulated (miR-381-3p and miR-4531), and seven miRNAs were upregulated (miR-205-5p, miR-130a-3p, miR-3136-3p, miR-128-2-5p, let-7f-5p, miR-202-3p, and miR-323a-5p) in CIN 3 ( fold   change ≥ 2 and p ≤ 0.05 ). The miRNA expression patterns were independent of hr-HPV infection. We identified four miRNAs (miR-205-5p, miR-130a-3p, miR-4531, and miR-381-3p) that could be used as biomarkers for CIN 3 in LBC samples through multiple logistic regression analyses. We found 16 genes differentially expressed between CIN 3 and HSF samples ( fold   change ≥ 2 and p ≤ 0.05 ). We found the correlation between miR-130a-3p and CCND1( R = − 0.52 ; p = 0.0029 ), miR-205-5p and EGFR ( R = 0.53 ; p = 0.0021 ), and miR-4531 and SMAD2 ( R = − 0.54 ; p = 0.0016 ). In addition, we demonstrated the most significant pathways of the targets associated with cervical cancer progression (FDR-corrected p < 0.001 ). This study demonstrated that miRNA biomarkers may distinguish healthy cervix and CIN 3 and regulate important molecular pathways of carcinogenesis.


1995 ◽  
Vol 81 (5) ◽  
pp. 330-333 ◽  
Author(s):  
Silvia Cecchini ◽  
Stefano Ciatto ◽  
Marco Zappa ◽  
Annibale Biggeri

Aims and background The objective of this study was to investigate the detection rate of cervical intraepithelial neoplasia grade III (CIN 3) in previously unscreened women, in order to reveal trends over time in the prevalence of CIN 3 in the District of Florence, where a population-based screening for cervical cancer has been going on since 1973. Study design We considered the women, recorded in the computerized archives of CSPO, who had had no pap test for at least 10 years. Trends of CIN 3 (histologically proven) were analyzed within age groups; the effect of age, cohort and period were considered by means of a Poisson regression model. Results A total of 648 cases of histologically proven CIN 3 were detected in the study period. The detection rates of CIN 3 increased steadly within age groups over birth cohort and calendar period simultaneously. The Poisson regression analysis showed that only the model with age + time trend was statistically significant. Conclusions Although several biases should be taken into account, the analysis seemed to indicate a real increase in CIN 3 prevalence. An increase in frequency of precancerous lesions for cervical cancer in more recent birth cohorts supports the need to keep screening coverage and efficiency as high as possible.


Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3291
Author(s):  
Akihito Yamamoto ◽  
Seiryu Kamoi ◽  
Keisuke Kurose ◽  
Marie Ito ◽  
Toshiyuki Takeshita ◽  
...  

(1) Background: Previous reports have indicated that cancers of the stomach, lung, and pancreas can be detected by dog sniffing, but results have been varied. Here, a highly trained dog was used to determine whether urine from patients with cervical premalignant lesions and malignant tumors have a cancer-specific scent. (2) Methods: A total of 195 urine samples were collected from patients with cervical cancer, cervical intraepithelial neoplasia grade 3 (CIN3), benign uterine diseases, and healthy volunteers. Each test was performed using one urine sample from a cancer patient and four samples from different controls. Each of the five urine samples was placed in a separate box. When the cancer sniffing dog stopped and sat in front of the box with a sample from a cancer patient, the test was considered as positive. (3) Results: 83 patients with cervical cancer (34 cases of cervical cancer and 49 cases of cervical intraepithelial neoplasia grade 3), 49 patients with uterine benign diseases, and 63 healthy volunteers were enrolled, and their urine samples were collected. In 83 times out of 83 runs in a double-blind test, the trained dog could correctly identify urine samples of cervical cancer patients. (4) Conclusion: A trained dog could accurately distinguish the urine of all patients with cervical cancer or CIN3, regardless of the degree of cancer progression.


Author(s):  
Ji Zhang ◽  
Seyed Ali Nazeri ◽  
Amir Sohrabi

AbstractHuman papillomavirus genotypes (HPVs) have been confirmed to be the major cause of cervical intraepithelial neoplasia (CIN) that remains to be one of the most common women cancers around the world. It seems other risk factors have synergistic effects on cervical cancer occurrence including smoking, dietary pattern, sexual behavior, ethnicity, epigenetics, and environmental hazardous materials. Our study characterized the potential cancerous role of lead (Pb) as a common toxic environmental pollutant agent on CIN outcomes. Lead concentration was quantified using an atomic absorption spectrometer in liquid-based cytology specimens of 40 CIN-HPV positive subjects, 50 HPV infected non-cancerous cases, and 43 non-HPV infected/non-cancerous women. Pb concentration was 5.5 (4.7–6.4) μg/dL, 4.7 (4.2–8.7) μg/dL, and 4.7 (4.5–5.4) μg/dL in the CIN-HPV positive group, HPV infected non-cancerous cases, and non-HPV infected/non-cancerous group, respectively. The results showed higher Pb concentration is associated with higher risk for cervical malignancy in comparison with non-HPV infected/non-cancerous subjects, after controlling for age effect (aOR = 4.55, 95% CI: 1.55–15.07, P < 0.01). Our finding suggested a direct significant association between Pb accumulation and CIN existence. The consequences need to be further validated by including more relevant risk factors and controlling the confounders for better understating of Pb impact from outdoor air pollution on cervical cancer progression.


2019 ◽  
Vol 74 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Nadia Escobar ◽  
Emma Plugge

Background and objectivesImprisoned women have higher rates of abnormalities at cervical screening and some studies suggest that cervical cancer is the most common cancer in this population. The aim of this work was to summarise the current evidence on the prevalence of human papilloma virus (HPV) infection, cervical cancer and precancerous lesions in women in prison worldwide and to compare these rates with the general population.MethodsWe systematically searched and reviewed published and unpublished data reporting the prevalence of any HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer in imprisoned women. We created forest plots with prevalence estimates from studies with comparable outcomes and of prevalence ratios using data from national screening programmes as a comparison group.FindingsA total of 53 533 imprisoned women from 10 countries and 35 studies were included in the review. The prevalence of HPV among prisoners ranged from 10.5% to 55.4% with significant heterogeneity. The prevalence of CIN diagnosed by cytology in prisoners ranged from 0% to 22%. Ratios comparing the prevalence of CIN in imprisoned women to that in the community ranged from 1.13 to 5.46. Cancer prevalence estimates were at least 100 times higher than in populations participating in national screening programmes.ConclusionImprisoned women are at higher risk of cervical cancer than the general population. There is a high prevalence of HPV infection and precancerous lesions in this population. Targeted programmes for control of risk factors and the development of more effective cervical screening programmes are recommended.PROSPERO registration numberCRD42014009690.


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