Phototheranostics of Cervical Neoplasms with Chlorin e6 Photosensitizer

(1) Purpose: Improving the treatment effectiveness of intraepithelial neoplasia of the cervix associated with human papillomavirus infection, based on the application of the method of photodynamic therapy with simultaneous laser excitation of fluorescence to clarify the boundaries of cervical neoplasms. (2) Methods: Examination and treatment of 52 patients aged 22 to 53 years with morphologically and cytologically confirmed mild to severe intraepithelial cervix neoplasia, preinvasive, micro-invasive, and squamous cell cervix carcinoma. All patients were carriers of human papillomavirus infection. The patients underwent photodynamic therapy with simultaneous laser excitation of fluorescence. The combined use of video and spectral fluorescence diagnostics for cervical neoplasms made it possible to control the photodynamic therapy process at all stages of the procedure. Evaluation of the photodynamic therapy of intraepithelial cervical neoplasms was carried out with colposcopic examination, cytological conclusion, and morphological verification of the biopsy material after the photodynamic therapy course. The success of human papillomavirus therapy was assessed based on the results of the polymerase chain reaction. (3) Results. The possibility of simultaneous spectral fluorescence diagnostics and photodynamic therapy using a laser source with a wavelength of 660 nm has been established, making it possible to assess the fluorescence index in real-time and control the photobleaching of photosensitizers in the irradiated area. The treatment of all 52 patients was successful after the first photodynamic therapy procedure. According to the PCR test of the discharge from the cervical canal, the previously identified HPV types were not observed in 48 patients. Previously identified HPV types were absent after repeated PDT in four patients (CIN III (n = 2), CIS (n = 2)). In 80.8% of patients, regression of the lesion was noted. (4) Conclusions. The high efficiency of photodynamic therapy with intravenous photosensitizer administration of chlorin e6 has been demonstrated both in relation to eradication therapy of human papillomavirus and in relation to the treatment of intraepithelial lesions of the cervix.

Colposcopic features of cervical oncotropic papilloma-virus infection in patients with various pathology of uterine cervix

In order to estimate the colposcopic manifestations of cervical oncotropic human papilloma-virus (HPV)-infection, a total of 693 patients were examimed. Among them, there were 298 patients with benign tumors pathology, 57 patients with 1-3 Grade cervical dysplasia of mucosa, 50 patients with uterine cervix cancer, 288 healthy women. All patients underwent bimanual examination, taking of cervical smears for cytological examination and uterine cervix colposcopy. Diagnosis for HPV16/18 infection was made by the method of polimerase chain reaction. А large variety in colposcopic manifestations of HPV-infection was found, namely: areas of atypical vessels, leukoplakia sites,fields of atypical epithelium, iodine-negative sites. It was related to the influence of oncogenic types of HPV infection. In these patients,fields of atypical epithelium, atypical vessels, iodinenegative areas were observed 1.2, 2.5, 10.5 times more frequently, respectively. It was found that all varieties of papillomas occurred among patients with pathology, whereas flat condylomas presenting the most difficulties of or diagnosis prevailed in patients with cervical neoplasms and uterine cervix cancer The most pronounced colposcopic evidences of uterine cervix epithelium malignancy were observed in patients with virus-positive uterine cervix cancer.

Fatores que interferem na não adesão de mulheres ao teste de Papanicolaou: revisão integrativa

Objetivo: Identificar os fatores que interferem na não adesão de mulheres ao Teste de Papanicolaou. Métodos: Trata-se de uma revisão integrativa, realizada de forma pareada nas bases de dados CINAHL, LILACS, MEDLINE e na biblioteca virtual Scielo, entre maio e agosto de 2021 por meio dos Descritores em Saúde Women, Papanicolaou Test Uterine Cervical Neoplasms e Risk Factors, cruzados pelo operador booleano and. Selecionaram-se 19 artigos para amostra final. Resultados: Diversos fatores foram identificados como preditivos à não adesão do Teste de Papanicolaou, dentre eles: baixa renda, escolaridade, faixa etária, falta de conhecimento sobre o teste, não possuir companheiro, uso de tabaco, álcool e outras drogas, vergonha ou medo do procedimento, acreditar estar bem de saúde, dificuldade de acesso aos serviços e falta de integralidade da assistência prestada. Considerações finais: Percebe-se que os fatores associados à não adesão do Teste de Papanicolaou remetem a presença de iniquidades sociais e raciais, fatores individuais, condições e oferta dos serviços de saúde deficiente, além da cobertura insuficiente da realização do teste; sendo necessário, portanto, realizar ações educativas para sensibilizar a população sobre a importância de realizar o exame para a detecção precoce, tratamento oportuno da doença e realização de busca ativa.

Uterine cervical neoplasms mass screening at the University Hospital Centre of Libreville, Gabon: Associated factors with precancerous and cancerous lesions

The objectives of this study were to identify the associated factors with cancerous and precancerous lesions of cervix. In Africa, the incidence of uterine cervical neoplasms varies from one region to another, where most women with uterine cervical neoplasms are seen at an advanced stage. For this reason, uterine cervical neoplasms mass screening reduces the incidence and mortality due to this disease, similar to what is being done in Europe. A cross-sectional analytical study was conducted. Socio-demographic characteristics, gynaecological-obstetrical history, risk factors, data from visual inspection with acetic acid and visual inspection with Lugol, colposcopy impressions and results of cytological analysis were performed. A simple and multiple regression were performed to establish a statistically significant difference between certain factors and the presence of precancerous or cancerous lesions of uterine cervical. In this study, of 63 women diagnosed histologically, 43 had precancerous lesions and 20 had cancerous lesions. we found that being older than 35, having the first intercourse before 18, having an antecedent of STI, being a widow and using of tobacco were risk factors associated with precancerous lesions (p = 0.013 with OR = 3.44 (1.22–9.73), p = 0.009 with OR = 4.07 (1.69–13.08), p < 0.001 with OR = 3.80 (1.94–7.47), p < 0.001 with OR = 9.77 (3.87–24.70) and p < 0.001 with OR = 5.47 (2.60–11.52)) respectively. Only being older than 45, being a widow and using tobacco were risk factors associated with cancerous lesions (p = 0.021 with OR = 2.01 (1.58–3.56), p = 0.02 with OR = 2.96 (2.10–3.87), p = 0.041 with OR = 1.98 (1.46–2.44)) respectively. Among participants diagnosed with uterine cervical neoplasms, there was a significant association with the STI, marital status and smoking. Despite the integration of the detection of precancerous uterine cervical neoplasms lesions into health facilities in Gabon, uterine cervical neoplasms ranks second among women’s cancers in terms of incidence and first in terms of mortality.

Exame de Papanicolaou e câncer cervical em homens transgêneros: revisão integrativa

Introdução: O exame de Papanicolaou é o principal método de rastreamento para o câncer do colo do útero, que pode acometer os homens transgêneros que apresentam esse órgão. Objetivo: Destacar a importância do exame citopatológico no combate ao câncer cervical em homens transgêneros. Metodologia: Trata-se de uma revisão integrativa da literatura de cunho descritivo e abordagem qualitativa, realizada nas bases SciELO, PUBMED, MEDLINE, LILACS, BVS e Science Direct, utilizando os descritores “Transgender Persons”, “Uterine Cervical Neoplasms” e “Papanicolaou Test”. Foram incluídos artigos de 2015 a 2020 que abordam sobre o exame de Papanicolaou, e o câncer do colo do útero ou lesões precursoras do câncer em homens transgêneros. A análise ocorreu através de leitura crítica e categorização temática. Resultados e discussão: Foram encontrados oito artigos que originaram três categorias: Rastreamento do câncer cervical em homens transgêneros, histórico relacionado ao exame de Papanicolaou e percepções sobre o rastreamento do câncer cervical. Assim, constatou-se que os homens transgêneros não realizam rastreamento do câncer cervical como as mulheres cisgêneros e enfrentam desafios únicos no exame de Papanicolaou, pertinentes a cada realidade, levando-os a buscar alternativas que minimizem seus desconfortos. Conclusão: Os dados revelam a importância do exame de Papanicolaou no rastreamento do câncer cervical em homens transgêneros, visto que comparado a meios alternativos buscados, o mesmo é o mais confiável atualmente. Ainda, reforçam a necessidade de conhecimento para um rastreamento de forma individualizada nesse público.

Minireview: Situación actual del cáncer de cuello uterino en Ecuador, 2019

Cervical cancer is a neoplasm mainly caused by the human papillomavirus (HPV), which is acquired through sexual contact. Cervical cancer is more prevalent in low and middle income countries; 88% of worldwide deaths from this cause, occur in developing countries, such as Ecuador. The ELEVATE project (Early detection of cervical cancer in hard-to-reach populations of women through portable and point-of-care HPV testing), funded by the European Union, seeks to characterize the national context of this disease; with this purpose, we carried out a systematic search for scientific articles and gray literature, produced in Ecuador, using specialized search engines, and virtual repositories from universities and government institutions. KEYWORDS: UTERINE CERVICAL NEOPLASMS, HUMAN PAPILLOMAVIRUS, PAPANICOLAOU TEST, PREVENTIVE HEALTH SERVICES, ECUADOR