scholarly journals Incidences of Cervical Intraepithelial Neoplasia 2-3 or Cancer Pathologic Diagnoses in Patients with a High Grade Squamous Intraepithelial Lesion Pap Smear Attending a Colposcopy Clinic at Srinagarind Hospital

2012 ◽  
Vol 13 (12) ◽  
pp. 6203-6206 ◽  
Author(s):  
Navakorn Ingkapairoj ◽  
Sanguanchoke Luanratanakorn ◽  
Bandit Chumworathayi ◽  
Chumnan Kietpeerakool ◽  
Amornrat Supoken
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Colposcopy Clinic

Adjunctive Human Papillomavirus Testing in the 2-Year Follow-up of Women With Low-Grade Cervical Cytologic Abnormalities: A Randomized Trial and Economic Evaluation

2003 ◽  
Vol 127 (9) ◽  
pp. 1169-1175 ◽  
Author(s):  
Alice Lytwyn ◽  
John W. Sellors ◽  
James B. Mahony ◽  
Dean Daya ◽  
William Chapman ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Abstract Context.—Although human papillomavirus (HPV) testing may aid in managing low-grade abnormality on screening cervical cytology, patient compliance with repeat testing programs requires consideration. Objectives.—To determine effectiveness and costs of repeated Papanicolaou (Pap) test and oncogenic HPV testing for detecting cervical intraepithelial neoplasia 2 or 3. Design.—We conducted a randomized controlled trial of combined Pap test and cervical HPV testing by Hybrid Capture 1 test compared with Pap test alone; tests were performed every 6 months for up to 2 years. The study end point was colposcopic examination performed on all women at 2 years, or earlier if an HPV test was positive or if a Pap test showed high-grade squamous intraepithelial lesion. Setting.—Sixty-six community family practices. Participants.—Two hundred fifty-seven women with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion on screening cervical cytology. Main Outcome Measures.—Detection of histologically confirmed cervical intraepithelial neoplasia 2 or 3, fully allocated costs, and loss to follow-up. Results.—Combined Pap test and HPV testing detected 11 (100%) of 11 cases of cervical intraepithelial neoplasia 2/3, whereas Pap test alone detected 7 (63.6%) of these 11 cases (P = .14); corresponding specificities were 39 (46.4%) of 84 and 45 (71.4%) of 63 (P = .005). The cost-effectiveness ratio was Can $4456 per additional case of high-grade cervical intraepithelial neoplasia. Sixty-nine (26.8%) of the 257 women (24.6% combined group vs 29.1% Pap test only group, P = .41) defaulted from testing or from colposcopy when referred with an abnormal result. Conclusions.—Combined testing was more costly but may detect more cases of cervical intraepithelial neoplasia 2/3 than Pap test alone. However, poor adherence limits usefulness of a management strategy that requires repeated follow-up.

Significance of Margin and Extent of Dysplasia in Loop Electrosurgery Excision Procedure Biopsies Performed for High-Grade Squamous Intraepithelial Lesion in Predicting Persistent Disease

2007 ◽  
Vol 131 (4) ◽  
pp. 622-624
Author(s):  
Lisa N. Tyler ◽  
Nancy Andrews ◽  
Rudolph S. Parrish ◽  
Linda J. Hazlett ◽  
Soheila Korourian
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Positive Margins ◽  
Biopsy Specimens ◽  
The Status ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Abstract Context.—High-grade squamous intraepithelial lesions (cervical intraepithelial neoplasia 2 and 3) are commonly treated with loop electrosurgery excision procedure (LEEP) biopsies. Objective.—To highlight the significance of positive margins and extent of positive margins of the cervical LEEP biopsies in predicting the persistence of high-grade squamous intraepithelial lesion and to provide suggestions for reporting margins in cervical LEEP biopsies. Design.—The pathology files at the University of Arkansas for Medical Sciences were searched for cervical intraepithelial neoplasia 2 and 3 treated by LEEP biopsy from 1990 to 2001. Results.—A total of 489 LEEP biopsy specimens were retrieved and reviewed; 270 patients had follow-up within 1 year. The biopsy specimens of 110 patients showed positive endocervical margins. One hundred sixty specimens had negative ectocervical-endocervical margins. Follow-up of 54% of the cases with initial positive margins showed residual high-grade squamous intraepithelial lesions. This association was even greater when multiple blocks showed positive endocervical margins and in cases with positive deep margins. On the other hand, a negative margin predicted ability to completely remove the lesion in 95% of patients. Conclusion.—This study reiterates the significance of the evaluation of the margin, even in samples that were received as multiple fragments. Reporting of LEEP biopsy findings should include the extent of the dysplasia, the status of the ectocervical-endocervical margin, and the status of the deep margin.

Cytology and Human Papillomavirus Screening Test Results Associated With 2827 Histopathologic Diagnoses of Cervical Intraepithelial Neoplasia 2/3

2012 ◽  
Vol 137 (7) ◽  
pp. 942-947 ◽  
Author(s):  
Chengquan Zhao ◽  
Milon Amin ◽  
Baoying Weng ◽  
Xiangbai Chen ◽  
Amal Kanbour-Shakir ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Screening Test ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Test Results ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Intraepithelial Lesion

Context.—Cervical screening in the United States increasingly involves newer US Food and Drug Administration–approved cytologic methods and adjunctive high-risk human papillomavirus (hrHPV) DNA testing. Objective.—To document cervical screening test performance preceding histopathologic cervical intraepithelial neoplasia (CIN) 2/3 diagnoses. Design.—Preceding screening test results with computer-imaged, liquid-based cytology (LBC) and hrHPV results were analyzed for 2827 patients with histopathologic CIN 2/3 diagnoses. Results.—Of 2827 patients with CIN 2/3 diagnoses, 2074 (73.4%) had system LBC findings within 4 months of CIN 2/3 diagnoses: high-grade squamous intraepithelial lesion (n = 862; 41.6%), low-grade squamous intraepithelial lesion (n = 464; 22.4%), atypical squamous cells of undetermined significance (n = 445; 21.5%), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (n = 288; 13.9%), and atypical glandular cells/adenocarcinoma in situ (n = 15; 0.7%). Of the 2827 patients, 1488 (52.6%) also had earlier system LBC results at more than 4 months to 3 years before CIN 2/3 diagnoses: one or more abnormal LBC results (n = 978; 65.7%), one or more negative LBC results (n = 911; 61.2%), both abnormal and negative LBC (n = 401; 26.9%). Of 807 patients with hrHPV cotest results within 4 months of CIN 2/3 diagnoses, 786 (97.4%) had hrHPV+ results. Of 454 patients who also had earlier hrHPV results at more than 4 months to 3 years before CIN 2/3 diagnoses: 377 (83.0%) had one or more hrHPV+ result, 110 (24.2%) had one or more hrHPV− result, and 33 (7.3%) had both positive and negative HPV results. Conclusion.—Patients with histopathologic CIN 2/3 had recent abnormal LBC results, most often, high-grade squamous intraepithelial lesions. Among cotested patients, 97.4% (786 of 807) tested hrHPV+. However, a significant number of patients tested during an extended period of several years had earlier negative Papanicolaou or negative HPV test results, suggesting the recent development of some CIN 2/3 lesions and supporting the value of cotesting for enhanced detection of other developing, small, inaccessible, or nondiagnostic precursor lesions.

scholarly journals Kanker serviks dan gen Fas-promoter-670

2019 ◽  
Vol 2 (3) ◽  
pp. 90-91
Author(s):  
ML Edy Parwanto
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Incidence Rate ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Kanker serviks merupakan keganasan pada serviks. Jenis kanker tersebut terjadi pada perempuan dan masih menjadi masalah di Indonesia. Indonesia merupakan negara urutan ke 4 di Asia Tenggara dengan insiden kanker serviks terbesar setelah Kamboja, Myanmar dan Thailand. Berdasar data statistik tahun 2012, tingkat insidensi (incidence rate) kanker serviks di Indonesia 17 per 100.000 perempuan per tahun.(1) Telah terbukti bahwa penyebab primer terjadinya kanker serviks yaitu virus papilloma atau yang lebih dikenal dengan istilah “human papillomavirus (HPV)”. Terdapat beberapa jenis serotype HPV, tetapi tidak semua jenis serotype bersifat progesif menjadikan kanker serviks. Salah satu serotype yang bersifat progesif menjadikan kanker serviks yaitu HPV serotype 16. HPV serotype 16 mampu mengubah sel epitel squamosa serviks (cervical-squamous-epithelial cells=CSEC) normal menjadi lesi intraepitelial squamosa tingkat rendah (low-grade squamous intraepithelial lesion=LSIL) atau neoplasia intraepitel serviks (cervical intraepithelial neoplasia=CIN) 1. Selanjutnya, LSIL atau CIN 1 berkembang menjadi lesi intraepitelial squamosa tingkat tinggi (high-grade squamous intraepithelial lesion=HSIL) atau CIN 2, dan akhirnya menjadi kanker serviks yang invasif (invasive cervical cancer=CIN3).(2)

scholarly journals Epidemiology of pre invasive and invasive lesions of the cervix at tertiary health centre in Punjab

2021 ◽  
Author(s):  
Garima Bhardwaj ◽  
Amritpal Kaur ◽  
Permeet Kaur Bagga
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Socioeconomic Status ◽  
High Risk ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Smear ◽  
Health Centre ◽  
Intraepithelial Neoplasia ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Background: Cervical cancer is the fourth most frequent cancer in women globally, next to breast, colorectal and lung cancer and it is also the fourth most common cause of cancer death in women. According to the Indian council of medical research (ICMR), in India one woman dies of cervical cancer every 9 minutes. This study used PAP smear and histopathology to find out about the epidemiology of pre invasive and invasive lesions of the cervix at tertiary health centre in Punjab and their correlation with various social and demographic features.Methods: This prospective clinical study was carried out in the Department of Obstetrics and Gynaecology in Amritsar Medical College from May 2018 to April 2020, after taking approval from the Institutional Ethical Committee. The study selected 500 women randomly among the patients attending the Gynaecology OPD who met the inclusion criteria. Detailed history and PAP smear was taken at first visit followed by cervical biopsy amongst women with abnormal cytology report or with frank lesions of cervix.Results: Out of 500 women included in the study, majority of women (82.5%) were Negative for intraepithelial lesion or malignancy (NILM), 4% women had Atypical squamous cells of undetermined significance (ASCUS), 6.1% had low grade squamous intraepithelial lesion (LSIL) and 16 (3.2%) had High grade squamous intraepithelial lesion (HSIL). Amongst the histopathology reporting 15.62% patients had cervical intraepithelial neoplasia 1 (CIN I), 6.25% patients had cervical intraepithelial neoplasia II (CIN II), 3.12% patients had cervical intraepithelial neoplasia III (CIN III), 6.3% patients had squamous cell carcinoma and 3.1% patient had adenocarcinoma of cervix. Age, low level of education, poor socioeconomic status, early marriage and multiparity are the risk factors found to be associated with pre invasive and invasive lesions of the cervix. (p<0.001).Conclusions: Though infection with human papilloma virus (HPV) is essential for the development of the disease, there are other high-risk factors like age, poor education, low socioeconomic status, early age at marriage and high parity which are significantly associated with the occurrence of the disease. Therefore, our primary and secondary preventive measures must include the women who come under these high-risk categories. 

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