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Abramson Cancer CenterNCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Cervical Cancer - July 2002
National Cancer Institute®
Last Modified: July 1, 2002
- Significance of the cytologic diagnosis of endocervical glandular involvement in high-grade squamous intraepithelial lesions.
- Alterations in promoter usage and expression levels of insulin-like growth factor-II and H19 genes in cervical carcinoma exhibiting
- Glassy cell carcinoma of the uterine cervix. Cytologic features and expression of estrogen and progesterone receptors.
- [Analysis of risk factors for cervical cancer in Xiangyuan County, Shanxi Province]
- Restoration of p53 tumor suppressor pathway in human cervical carcinoma cells by sodium arsenite.
- Anti-CD3/anti-epidermal growth factor receptor-bispecific antibody retargeting of lymphocytes against human neoplastic keratinocytes in an
- Lobular endocervical glandular hyperplasia, not otherwise specified: a clinicopathologic analysis of thirteen cases of a distinctive
- Multimodal therapy including neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) for stage IIB to IV cervical cancer.
- Aberrant expression of E-cadherin in cervical intraepithelial neoplasia correlates with a false-negative Papanicolaou smear.
- [Differences in cervical cancer mass screening results in Greater-Helsinki area]
- The Papanicolaou test: its utility and efficacy in cancer detection.
- Is screening for cervical cancer effective?
- How can we develop a cost-effective quality cervical screening programme?
- Time to consider HPV testing in cervical screening.
- Audit of cervical screening, the law and ethics committees.
- [DNA multiparametric analysis by flow cytometry of cancer of the uterine cervix]
- Microglandular hyperplasia-adenocarcinoma.
- Current diagnosis and management of cervical cancer.
- Thin-layer Pap test vs. conventional Pap smear. Analysis of 400 split samples.
- Superficial endometriosis of the uterine cervix: a report of 20 cases of a process that may be confused with endocervical glandular dysplasia or
- [Clinical and morphologic aspects of cervical papillomavirus infection]
- Down-regulation of p27 is associated with malignant transformation and aggressive phenotype of cervical neoplasms.
- A new method to aid complete lymphadenectomy in radical treatment of cancer of the cervix.
- [Cervix dysplasia and cervix carcinoma]
- Implications of adrenomedullin expression in the invasion of squamous cell carcinoma of the uterine cervix.
- Frequency of cervical cancer screening by age group, 2000.
- Dual sampling of the endocervix and its impact on AutoCyte Prep endocervical adequacy.
- Bony landmarks are not an adequate substitute for lymphangiography in defining pelvic lymph node location for the treatment of cervical cancer
- FDA panel conditionally approves DNA pap test without ACOG support.
- [Prognostic factors in the primary invasive vaginal carcinoma]
- [Identification of encoding and regulatory sequences of RAR-alpha receptor in intraepithelial neoplasia and in invasive cervical
- Molecular biology of cervical cancer and its precursors.
- Amplification at 9p in cervical carcinoma by comparative genomic hybridization.
- Effect of type of screening laboratory on population-based occurrence of cervical lesions in Finland.
- Grade of malignancy of cervical cancer in regions of Uganda with varying malarial endemicity.
- Evaluation of downstaging in the detection of cervical neoplasia in Kolkata, India.
- Cervical cancer risk as a predictor of pap smear use in rural North Carolina.
- Cervical cancer audit: and what is quality?
- Evaluation of liquid-based cytology in cervical screening of high-risk populations: a split study of colposcopy and genito-urinary medicine
- Transcriptional profiling of a human papillomavirus 33-positive squamous epithelial cell line which acquired a selective growth advantage after
- Carcinogenicity of trichloroethylene.
- [Molecular markers of the cervical cancer]
- Automated identification of diploid reference cells in cervical smears using image analysis.
- Invasive cervical cancer as an AIDS-defining illness in Europe.
- Equity in prevention and health care.
- Can cervicography be improved? An evaluation with arbitrated cervicography interpretations.
- Breast and cervical carcinoma screening practices among women in rural and nonrural areas of the United States, 1998-1999.
- Decreased incidence of cervical cancer in medicare-eligible California women.
Table of Contents
1
UI - 11933266
AU - Levine PH; Waisman J; Mittal K
TI -
Significance of the cytologic diagnosis of endocervical glandular
involvement in high-grade squamous intraepithelial lesions.
SO - Diagn Cytopathol 2002 Apr;26(4):217-21
AD - Department of Pathology, New York University School of Medicine and
Kaplan Comprehensive Cancer Center, New York, New York 10016, USA.
pascale.levine@med.nyu.edu
The cytologic criteria for the diagnosis of endocervical gland
involvement (EGI) by high-grade squamous intraepithelial lesions
(HGSILs) have been described, and this diagnosis occasionally is made.
This study evaluates the accuracy of a cytologic diagnosis compared with
that of follow-up cone biopsies. Twenty-eight patients with Papanicolaou
(Pap) smear diagnoses of HGSILs with EGI, with follow-up cone biopsies,
were identified from New York University computerized files. Results
were compared with those of a control group of 28 patients showing
cervical intra-epithelial neoplasia grades II/III (CIN-II/III),
irrespective of previous Pap smear findings. On subsequent cone biopsy
samples, 26 of the 28 study cases showed signs of HGSIL. Of these 26
patients, 17 (65%) showed evidence of HGSIL with EGI. Among the 28
control cases, 20 (71.4%) had EGI on the cone biopsies (P = NS). We also
examined previous Pap smear findings in a control group of 42 cone
biopsies with CIN-II or CIN-III, with or without EGI. EGI was diagnosed
in previous Pap smears in 3 of the 31(10%) cases that showed signs of
EGI on cone biopsies and in 2 of the 11 cases (18%) that did not
evidence EGI on subsequent cone biopsies (P = NS). In our experience,
the cytologic diagnosis of EGI on Pap smears did not identify a group of
patients with increased frequency of EGI on subsequent cone biopsies.
Copyright 2002 Wiley-Liss, Inc.
2
UI - 11997082
AU - Kim SJ; Park SE; Lee C; Lee SY; Jo JH; Kim JM; Oh YK
TI -
Alterations in promoter usage and expression levels of insulin-like
growth factor-II and H19 genes in cervical carcinoma exhibiting
biallelic expression of IGF-II.
SO - Biochim Biophys Acta 2002 Apr 24;1586(3):307-15
AD - Comprehensive Gynecologic Cancer Center, Pundang CHA General Hospital,
Sungnam, Kyonggi-do, South Korea.
Biallelic expression of insulin-like growth factor-II (IGF2) has been
reported to be associated with progression of several tumors. Here, we
report that the promoter usage and expression levels of IGF2 and H19
were altered in cervical carcinoma showing loss of imprinting. The
imprinting status was examined in 32 cervical carcinomas and their
matched normal tissues. Loss of imprinting (LOI) of IGF2 was observed in
seven of 18 (39%) informative cases. LOI of H19 gene was detected in
five of 14 informative cases. The usage of promoter P1 was observed in
LOI tumors of IGF2, but not in the tumors showing maintenance of IGF2
imprinting (MOI) and in the normal cervical tissues. Unlike MOI tumors,
some LOI tumors revealed the lack of IGF2 transcription from promoter
P3. LOI tumors of IGF2 showed an increased expression level of IGF2 but
a down-regulation of H19 relative to the normal tissues whereas MOI
tumors did not reveal significant alterations. These results suggest
that promoter P1 could be involved in the biallelic expression of IGF2
and that the altered expression levels of IGF2 and H19 gene might be
associated with the progression of cervical carcinoma showing biallelic
expression of IGF2.
3
UI - 10934948
AU - Chung JH; Koh JS; Lee SS; Cho KJ
TI -
Glassy cell carcinoma of the uterine cervix. Cytologic features and
expression of estrogen and progesterone receptors.
SO - Acta Cytol 2000 Jul-Aug;44(4):551-6
AD - Department of Pathology, Korea Cancer Center Hospital, Nowon-gu, Seoul,
Korea. jhc@mail.kcch.re.kr
OBJECTIVE: To identify the cytomorphologic features and investigate the
expression of estrogen receptor (ER) and progesterone receptor (PR) in
glassy cell carcinoma (GCC) of the uterine cervix. STUDY DESIGN: A
retrospective analysis of nine GCCs encountered at Korea Cancer Center
cervical smears were obtained prior to histologic diagnosis of GCC. The
cytomorphologic and clinical features were reviewed, and the expression
of ER and PR was investigated immunohistochemically on histologic
sections. RESULTS: Smears of GCC were hypercellular and remarkably
cohesive. The tumor cells were large and characterized by abundant
granular cytoplasm, distinct cell membranes and round to polygonal,
large nuclei with prominent nucleoli. In the background tumor diathesis
and numerous inflammatory cells containing eosinophils were present. The
inflammatory cells (mainly eosinophils) were intimately associated with
tumor cells to form "granuloepithelial complex." Immunohistochemically,
ER was identified in two of the nine cases and PR in one of them.
CONCLUSION: Cytology of GCC has characteristic features that differ from
those of other carcinomas or atypical reparative cells. Although there
are deceptive mimics of GCC, the characteristic cytologic findings
should prompt a diagnosis of GCC. ER and PR positivity was found in two
cases (22%) and one case (11%), respectively, of GCC, suggesting that
this tumor might be hormonally responsive.
4
UI - 11955348
AU - Rong S; Chen W; Wu L; Zhang X; Shen G; Liu Y; Zhao F; Ma J; Qiao Y
TI -
[Analysis of risk factors for cervical cancer in Xiangyuan County,
Shanxi Province]
SO - Zhonghua Yu Fang Yi Xue Za Zhi 2002 Jan;36(1):41-3
AD - Department of Epidemiology, Cancer Institute/Hospital, Chinese Academy
of Medical Sciences, Beijing 100021, China.
OBJECTIVES: To investigate the risk factors for cervical cancer in the
areas of high incidence, and provide evidence for current intervention
of cervical cancer. METHODS: In the areas of Xiangyuan County, Shanxi
Provicne with high incidence of cervical cancer, 1 997 women were
interviewed using a questionnaire, including baseline information,
menstrual, marital and pregnancy histories, sexual behavior, health
habits, contraception, medical history and family history of cancer,
etc., after its screening with six kinds of methods. All subjects,
including 84 cases with pathological diagnosis of greater than cINI, and
1 784 cases with pathological diagnosis of normal, were tested for
high-risk HPV. RESULTS: The overall rates of HPV infection were 20.8%
(415/1 997) in high-risk subjects, 97.7% and 14.2% in the cases and
control groups, respectively. Univariate analysis showed that risk
factors with statistical significance included high-risk HPV infection,
age at first sexual intercourse, history of pregnancy and abortion, the
number of sexual partners and family history of cancer. Analysis with
non-conditional logistic regression model revealed high-risk HPV
infection, multiple sexual partners and family history of cancer
associated obviously with occurrence of cervical cancer. In addition,
there was significantly positive relationship between HPV infection,
which increased with the number of sexual partners, and extramarital
sexual activity both in males or females. CONCLUSIONS: The main risk
factor for cervical cancer in this region was high-risk HPV infection,
which related to sexual behavior, hygienic habits during menstruation
and puerperium. It was particularly important to detect and treat
precancerous lesions and to implement behavior modification. In
addition, further research on genetic susceptibility was suggested.
5
UI - 12054599
AU - Chou RH; Huang H
TI -
Restoration of p53 tumor suppressor pathway in human cervical carcinoma
cells by sodium arsenite.
SO - Biochem Biophys Res Commun 2002 Apr 26;293(1):298-306
AD - Department of Life Science, National Tsing-Hua University, HsinChu
30043, Taiwan, ROC.
In most cervical cancer cells, p53 and Rb are disrupted by human
papillomaviruses (HPVs) E6 and E7, respectively. Restoration of p53 or
Rb function by blocking E6/p53 or E7/Rb pathway might be a potential
therapeutic purpose for these cancer cells. Treatment with sodium
arsenite (SA) resulted in significant repression of E6 and E7 mRNA
levels in SiHa cells. After E6 and E7 repression, p53 was dramatically
induced and accumulated in cellular nuclei and Rb was also induced. Two
p53-responsive genes, p21(waf1/cip1) and mdm2, were induced after SA
treatment. Furthermore, SA also reduced the expressions of Cdc25A and
cyclin B, blocked cell cycle progression at G2/M phase, and induced
apoptosis in SiHa cells. SA-induced apoptosis was greatly reduced by
expression of a dominant-negative mutated p53. In this study, we have
first demonstrated that SA did repress E6 and E7 oncogenes, restore the
p53 tumor suppressor pathway and induce apoptosis in SiHa cells.
Therefore, it would be a potential strategy to promote SA as therapeutic
purpose for HPV-positive cancer cells.
6
UI - 11786405
AU - Renard I; Mezzanzanica D; Canevari S; Ferrini S; Boniver J; Delvenne P;
TI -
Jacobs N
Anti-CD3/anti-epidermal growth factor receptor-bispecific antibody
retargeting of lymphocytes against human neoplastic keratinocytes in an
autologous organotypic culture model.
SO - Am J Pathol 2002 Jan;160(1):113-22
AD - Department of Pathology, University of Liege, Liege, Belgium.
isabelle.renard@student.ulg.ac.be
Local cellular immune defects have been described in several tumors
including human papillomavirus (HPV)-associated cervical cancer. This
observation suggests the potential therapeutic benefit of immune
manipulations that restore cellular immunity. Here, we evaluated the
ability of bispecific monoclonal antibodies (bimAbs) to redirect T cells
against keratinocytes transformed in vitro by HPV in an autologous
three-dimensional culture model (organotypic cultures). The epidermal
growth factor receptor (EGFR) was chosen as target for an
anti-CD3/anti-EGFR bimAb because it is overexpressed in many malignant
epithelial lesions and only weakly expressed in the basal layers of
normal squamous epithelium. Interestingly, in organotypic cultures, the
pattern of expression of EGFR was similar to that observed in vivo. The
ability of T cells retargeted by CD3/EGFR bimAb to lyse HPV-transformed
cell lines was confirmed in monolayer cultures. In autologous
organotypic cultures, an increase in apoptotic HPV(+) keratinocytes and
a significant decrease in the thickness of HPV(+) organotypic cultures
were observed when activated lymphocytes and bimAbs were added to the
cultures, whereas organotypic cultures of normal keratinocytes were not
significantly affected. These data were similar to those obtained in the
allogeneic model. These results suggest the potential usefulness of
CD3-EGFR bimAb-retargeted lymphocytes in immunotherapeutic protocols for
malignant epithelial lesions.
7
UI - 10435557
AU - Nucci MR; Clement PB; Young RH
TI -
Lobular endocervical glandular hyperplasia, not otherwise specified: a
clinicopathologic analysis of thirteen cases of a distinctive
pseudoneoplastic lesion and comparison with fourteen cases of adenoma
malignum.
SO - Am J Surg Pathol 1999 Aug;23(8):886-91
AD - Department of Pathology, Brigham and Women's Hospital and Harvard
Medical School, Boston, MA 02115, USA.
We report 13 cases of a previously undescribed pseudoneoplastic lesion
of the uterine cervix, which we have designated "lobular endocervical
glandular hyperplasia, not otherwise specified." The patients' ages
ranged from 37 to 71 years (mean, 45 years; median, 49 years). Three
(27%) patients had a history of hormone use. Seven lesions were
incidental findings in hysterectomy specimens. In the six other cases,
the patient came to clinical attention because of a mucoid cervical
discharge (two cases), increased vaginal discharge (two cases),
abdominal discomfort (one case), or a 3.5-cm cervical mass found when
being examined because of ovarian carcinoma (one case); hysterectomy was
performed in each of these six cases. Microscopic examination showed a
distinctly lobular proliferation of small to moderately sized rounded
glands often centered around a larger central gland. The lobular
proliferation was well to poorly demarcated and usually confined to the
inner half of the cervical wall. Glands within the lobules were usually
separated from each other by unaltered or hypercellular cervical stroma
and were lined by columnar mucinous cells similar to the normal
endocervix. Occasional reactive atypia of the endocervical cells and
mitoses were seen, but no significant cytologic atypia was identified.
Neither of the two cases stained showed cytoplasmic immunoreactivity for
carcinoembryonic antigen. Follow-up of seven patients showed no evidence
of recurrence of the cervical lesion, with an average length of
follow-up of 3.4 years; three patients were lost to follow-up and three
cases are recent. The principal consideration in the differential
diagnosis was adenoma malignum (minimal deviation adenocarcinoma). The
features most helpful in this distinction, in addition to the orderly
lobular arrangement of the glands, were a lack of the following:
irregular stromal infiltration, a desmoplastic stromal response, and
focal malignant cytologic features. Lobular endocervical gland
hyperplasia should be added to the list of previously described
pseudoneoplastic glandular lesions of the cervix and, like them, not
misinterpreted as neoplastic.
8
UI - 12066092
AU - Dowdy SC; Boardman CH; Wilson TO; Podratz KC; Hartmann LC; Long HJ
TI -
Multimodal therapy including neoadjuvant methotrexate, vinblastine,
doxorubicin, and cisplatin (MVAC) for stage IIB to IV cervical cancer.
SO - Am J Obstet Gynecol 2002 Jun;186(6):1167-73
AD - Section of Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
OBJECTIVE: The purpose of this study was to determine the survival rates
and toxicity levels that are associated with multimodal therapy
(including neoadjuvant methotrexate, vinblastine, doxorubicin, and
cisplatin [MVAC]) in patients with stage IIB to IVB cervical cancer.
STUDY DESIGN: We retrospectively reviewed the cases of 49 patients who
were treated between 1989 and 1997 with neoadjuvant MVAC for advanced
cervical cancer. RESULTS: The clinical response rate was 90% (27 partial
responders, 17 complete responders). Grade 3 or greater toxicity was
mostly limited to neutropenia; no deaths were attributed to MVAC.
Combined therapy after MVAC included operation in 34 patients (69%) and
radiation in 41 patients (84%). Twenty-one patients (43%) had <2 cm
residual tumor at histologic evaluation. Pelvic control was achieved in
86% of patients. Five-year disease-specific survival for patients with
stage III disease was 60%. CONCLUSION: For patients with advanced
cervical cancer, neoadjuvant MVAC had a high response rate (90%) and an
acceptable toxicity level. Compared with historic control subjects,
multimodal treatment may be associated with improved rates of pelvic
control.
9
UI - 12066114
AU - Felix JC; Lonky NM; Tamura K; Yu KJ; Naidu Y; Lai CR; Lonky SA
TI -
Aberrant expression of E-cadherin in cervical intraepithelial neoplasia
correlates with a false-negative Papanicolaou smear.
SO - Am J Obstet Gynecol 2002 Jun;186(6):1308-14
AD - Department of Pathology and Obstetrics and Gynecology, Keck School of
Medicine, University of Southern California, Los Angeles 90033, USA.
felix@hsc.usc.edu
OBJECTIVES: E-cadherin is responsible for cell adhesion in normal
cervical epithelium. It is normally absent in the superficial epithelial
layers, allowing for exfoliation. We investigated the correlation
between E-cadherin distribution and Papanicolaou smear in subjects with
cervical dysplasia. STUDY DESIGN: Tissue samples from 25 women with
cervical dysplasia were tested for E-cadherin, beta-catenin, and
alpha-catenin expression by immunohistochemistry. The expression pattern
of these proteins, whether full thickness or restricted to the basal
layers, was correlated with the Papanicolaou smear result. RESULTS: Of
12 women with normal Papanicolaou smears, 10 of 11 informative cases
demonstrated E-cadherin expression throughout all epithelial layers.
Eight of 10 informative cases with an abnormal Papanicolaou smear showed
E-cadherin only at the basal layers. Alpha-catenin was distributed
throughout the entire epithelium in samples of all 25 women.
CONCLUSIONS: Expression of E-cadherin throughout all epithelial layers
was correlated with a false-negative Papanicolaou smear. It is likely
that aberrant persistence of E-cadherin in these lesions interferes with
the exfoliation of abnormal cells.
10
UI - 12053343
AU - Nieminen P; Tarkkanen J; Timonen T; Meyer B; Hakama M; Anttila A
TI -
[Differences in cervical cancer mass screening results in
Greater-Helsinki area]
SO - Duodecim 2000;116(22):2489-96
AD - HUS:n naistensairaala PL 140, 00029 HUS. pekka.nieminen@hus.fi
11
UI - 11785862
AU - Hartikainen J
TI -
The Papanicolaou test: its utility and efficacy in cancer detection.
SO - Contemp Nurse 2001 Sep;11(1):45-9
AD - Oncology and Palliative Care Ward, Western Hospital, Melbourne.
The Papanicolaou (PAP) test is one of the simplest tests in the
detection of cancer. This article addresses the concerns/fears women
have surrounding the PAP test and why it is not more widely used.
12
UI - 11824890
AU - Symonds RP
TI -
Is screening for cervical cancer effective?
SO - Clin Oncol (R Coll Radiol) 2001;13(6):473-5
AD - University of Leicester, Leicester Royal Infirmary, UK.
psymonds@uhl.trent.nhs.uk
13
UI - 12051215
AU - Wilson S; Lester H
TI -
How can we develop a cost-effective quality cervical screening
programme?
SO - Br J Gen Pract 2002 Jun;52(479):485-90
AD - Department of Primary Care and General Practice, Public and Occupational
Health, University of Birmingham. s.wilson@bham.ac.uk
This article discusses the evidence base underpinning the United Kingdom
cervical screening programme and proposes that there is now sufficient
evidence to suggest that too many women are screened too frequently. The
financial savings generated from increasing the screening interval to
five years and restricting routine screening to women aged 25 to 50
years may, we suggest, be better spent on improving the quality of the
cervical screening programme. Re-awakening this debate must not however
deflect energy and effort from recruiting women who have never been
screened or further developing quality control systems. Any debate must
also fully engage women of all ages as the key stakeholders in the
decision-making process.
14
UI - 11822748
AU - Cuzick J
TI -
Time to consider HPV testing in cervical screening.
SO - Ann Oncol 2001 Nov;12(11):1511-4
AD - Imperial Cancer Research Fund, London, UK. j.cuzick@icrf.icnet.uk
15
UI - 11936338
AU - Paul C
TI -
Audit of cervical screening, the law and ethics committees.
SO - N Z Med J 2002 Jan 25;115(1146):25
16
UI - 11935698
AU - Kornovski Ia; Balev S; Ivanova F
TI -
[DNA multiparametric analysis by flow cytometry of cancer of the uterine
cervix]
SO - Akush Ginekol (Sofiia) 2002;42(1):32-5
17
UI - 11843562
AU - Alvarez-Santin C
TI -
Microglandular hyperplasia-adenocarcinoma.
SO - Acta Cytol 2002 Jan-Feb;46(1):67-8
18
UI - 12094548
AU - Comerci JT Jr; Goldberg GL
TI -
Current diagnosis and management of cervical cancer.
SO - Cancer Invest 2002;20(4):524-30
AD - Division of Gynecologic Oncology, Magee Women's Hospital, Pittsburgh,
Pennsylvania, USA.
19
UI - 11838315
AU - Biscotti CV; O'Brien DL; Gero MA; Gramlich TL; Kennedy AW; Easley KA
TI -
Thin-layer Pap test vs. conventional Pap smear. Analysis of 400 split
samples.
SO - J Reprod Med 2002 Jan;47(1):9-13
AD - Departments of Anatomic Pathology, Obstetrics and Gynecology, and
Biostatistics, Cleveland Clinic Foundation, 9500 Euclid Avenue,
Cleveland, OH, USA. biscotc@ccf.org
OBJECTIVE: To analyze our experience with 400 Thin-Prep (TP) split
samples (Cytyc Corp., Boxborough, Massachusetts) as an initial
assessment of this new technology's effect in our laboratory. STUDY
DESIGN: Three gynecologic oncologists and two general gynecologists
obtained the 400 split samples using a broom sampling device. Following
conventional smear (CS) preparation, they rinsed the broom in Preservcyt
solution (Cytyc) for subsequent TP processing. The paired samples were
separated, independently analyzed and classified by the Bethesda System.
All available follow-up surgical pathology material was reviewed and
compared to the cytologic diagnoses. RESULTS: TP had significantly more
abnormal results (22% vs. 16%, P = .007), including more atypical
squamous cells of undetermined significance (ASCUS) (9.5% vs. 6.3% P =
.07) and low grade squamous intraepithelial lesion (LSIL) (7.8% vs.
5.3%, P = .03). Both methods had 3.3% high grade squamous
intraepithelial lesion (HSIL). For TP, ASCUS/squamous intraepithelial
lesion (SIL) = 0.86 and for CS, ASCUS/SIL = 0.74. Ten TP SILs had a
paired negative CS, including LSIL (nine cases) and HSIL (one case).
Consensus review of these 10 TP slides confirmed the HSIL and four
LSILs. No CS SILs had a paired negative TP. Only 36 (9%) cases had
surgical pathology follow-up. The surgical specimens included 17
cervical intraepithelial neoplasia (CIN) 2 or above. The TP method had
no false negatives, while the CS method had 3 false negatives among the
17 confirmed cases of CIN 2 or above. CONCLUSION: TP appears to be
superior to CS for detecting SILs.
20
UI - 12090586
AU - Baker PM; Clement PB; Bell DA; Young RH
TI -
Superficial endometriosis of the uterine cervix: a report of 20 cases of
a process that may be confused with endocervical glandular dysplasia or
adenocarcinoma in situ.
SO - Int J Gynecol Pathol 1999 Jul;18(3):198-205
AD - James Homer Wright Pathology Laboratories of the Massachusetts General
Hospital, Department of Pathology, Harvard Medical School, Boston 02114,
USA.
Twenty cases of superficial endometriosis of the uterine cervix that
occurred in patients from 20 to 51 (mean 37.1) years of age are
described. The majority of the cases were seen in consultation and were
usually referred because of diagnostic problems; endocervical glandular
dysplasia, adenocarcinoma in situ, or rarely invasive adenocarcinoma
were a frequent consideration of the contributor. The endometriosis was
almost always an incidental microscopic finding. The endometriotic foci
were usually confined to the superficial third of the cervical wall, but
in one case there was also involvement of the middle third of the
cervical wall. Deep cervical endometriosis was not present in any case.
The endometriotic glands were typically evenly spaced and were
surrounded at least focally by endometriotic stroma in all cases. The
endometriotic stromal cells, however, were significantly obscured by
inflammatory cells (two cases), inflammatory cells and hemorrhage (two
cases), hemorrhage (four cases), and in one case by smooth muscle
metaplasia causing initial failure to recognize the stromal component of
the process. The presence of mitotic figures in the glandular epithelium
contributed to an initial diagnosis of a premalignant or malignant
glandular lesion being made or seriously entertained in 10 cases.
Awareness that mitotic figures may be conspicuous in endometriosis from
women of reproductive age, the usually bland cytologic features of the
endometriotic epithelium, and the presence of associated endometrial
stromal cells all facilitate establishing the correct diagnosis.
21
UI - 12101564
AU - Kolomiets LA; Urazova LN; Sevost'ianova NV; Churuksaeva ON
TI -
[Clinical and morphologic aspects of cervical papillomavirus infection]
SO - Vopr Onkol 2002;48(1):43-6
AD - Research Institute of Oncology, Research Center, Russian Academy of
Medical Sciences, Siberian Branch, Tomsk.
415 female residents of the City of Tomsk and Tomsk Region (patients
with cervical carcinoma--22, dysplasia stage I-III--23 and healthy
subjects--71) were screened for HPV16/18 infection, which was diagnosed
in 18.3%. In the cervical carcinoma group, infection was detected in
27.4%, among patients with advanced cervical dysplasia--25.7%, and in
those with background pathologies and healthy females--12.3 and 38%,
respectively. Infection peaks were reported for the age brackets of
31-40 years (19.7%) and 51-60 years (19.6%). HPV-infection showed a wide
range of colposcopic symptoms: areas of atypical blood vessels,
leukoplakia, atypical epithelium and iodine-negative patches.
Papillomavirus-related morphological changes in endometrial cells were
typical of those associated with any viral infection and showed no
specific features.
22
UI - 12051885
AU - Huang LW; Chao SL; Hwang JL; Chou YY
TI -
Down-regulation of p27 is associated with malignant transformation and
aggressive phenotype of cervical neoplasms.
SO - Gynecol Oncol 2002 Jun;85(3):524-8
AD - Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial
Hospital, Taipei, Taiwan. m002057@ms.skh.org.tw
OBJECTIVES: p27Kip1 (p27) is a member of the cyclin-dependent kinase
inhibitor family. The level of p27 protein expression decreases during
tumor development and progression in some epithelial tumors. To identify
the potential implications of the p27 gene in the development of
cervical carcinoma and explore the clinical importance of change in gene
expression, we assessed the level of p27 protein in precancerous lesions
and carcinomas of the cervix. METHODS: In our study, 20 low-grade
squamous intraepithelial lesions (LSIL), 35 high-grade squamous
intraepithelial lesions (HSIL), 12 microinvasive carcinomas, and 103
invasive carcinomas were evaluated. The expression of p27 was studied by
immunohistochemistry using a monoclonal antibody specific for the
protein. RESULTS: p27 was expressed in all samples of normal epithelium,
LSIL, and HSIL, and the mean values of expression were 55.1, 52.8, and
45.4%, respectively. Conversely, the expression of p27 was significantly
reduced in microinvasive (15.9%) and invasive carcinomas (11.2%).
Furthermore, loss of p27 expression was significantly associated with
lymph node metastasis (P = 0.009). However, p27 down-regulation had no
influence on overall survival using univariate analysis. CONCLUSIONS:
The trend of reduced p27 expression in microinvasive and invasive
carcinomas suggests that down-regulation of p27 expression is strongly
linked to neoplastic transformation of cervical epithelium, and
inactivation of p27 may be an early event in cervical carcinogenesis.
Moreover, loss of p27 expression was related to lymph node metastasis in
cervical carcinoma. These results imply that inactivation of p27 is
associated with highly aggressive phenotype of cervical carcinoma.
23
UI - 12070578
AU - Pharaon SR; Al-Saleh WM
TI -
A new method to aid complete lymphadenectomy in radical treatment of
cancer of the cervix.
SO - Saudi Med J 2002 May;23(5):546-7
AD - Zahrawi Maternity Hospital, Damascus, Syria. sphar.frcog@mail.sy
OBJECTIVE: A simple, new and not previously reported method to improve
the complete ablation of the pelvic lymph nodes in the surgical
treatment of cervical cancer is briefly reported. METHODS: Fourteen
patients had been operated upon at Zahrawi Maternity Hospital, Damascus,
Syria using radical Wertheim hysterectomy for surgical treatment. Five
to 10 days prior to surgery, patients are given intramuscular iron
injections that help easy visualization of the lymph nodes during
operation. RESULTS: In all the 14 cases treated with this simple
pre-operative medication, pelvic lymph nodes were easily identified and
completely removed. CONCLUSION: Pre-operative iron injections help in
better identification of even the smallest pelvic lymph nodes and
improve their complete removal.
24
UI - 11928150
AU - Bol P
TI -
[Cervix dysplasia and cervix carcinoma]
SO - Ned Tijdschr Tandheelkd 1998 Dec;105(12):455-6
25
UI - 11828944
AU - Li Z; Takeuchi S; Otani T; Maruo T
TI -
Implications of adrenomedullin expression in the invasion of squamous
cell carcinoma of the uterine cervix.
SO - Int J Clin Oncol 2001 Dec;6(6):263-70
AD - Department of Obstetrics and Gynecology, Kobe University Graduate School
of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
BACKGROUND: Adrenomedullin (AM) is a multifunctional peptide involved in
a variety of physiological functions, including vasodilatation, growth
regulation, and carcinogenesis. To elucidate the possible role of AM in
the growth and invasion of uterine cervical carcinoma, the presence and
distribution of AM and AM mRNA was examined in the neoplastic changes of
squamous epithelium of the uterine cervix. METHODS: The expression of AM
mRNA by CaSki, a uterine squamous cell carcinoma cell line, was examined
by reverse transcriptase-polymerase chain reaction (RT-PCR). The
presence and distribution of AM and AM mRNA in sections of normal
cervical tissues, cervical intraepithelial neoplasia (CIN), and invasive
squamous cell carcinomas were evaluated by immunohistochemical staining
with a specific antibody against AM and by in situ RT-PCR, respectively.
RESULTS: AM mRNA expression in CaSki cells was demonstrated by RT-PCR.
Immunohistochemical staining for AM and in situ RT-PCR revealed that AM
and AM mRNA were expressed in invasive squamous carcinoma cells, but not
in normal cervical epithelium or in CIN lesions. Abundant expression of
AM and AM mRNA was localized in the cytoplasm of carcinoma cells of
bulky invasive carcinomas, while in early invasive carcinoma, the
expression of AM and AM mRNA was more prominent in stromal cells
adjacent to the early invasive carcinoma cells than in the carcinoma
cells themselves. CONCLUSIONS: Because AM expression was evident only in
invasive cervical squamous carcinoma cells and the stromal cells
adjacent to early invasive carcinomas, it is likely that AM may play an
important role in the growth and invasion of squamous cell carcinoma of
the uterine cervix.
26
UI - 12072540
AU - Anonymous
TI -
Frequency of cervical cancer screening by age group, 2000.
SO - J Natl Cancer Inst 2002 Jun 19;94(12):879
27
UI - 12109854
AU - Day SJ; Deszo EL; Freund GG
TI -
Dual sampling of the endocervix and its impact on AutoCyte Prep
endocervical adequacy.
SO - Am J Clin Pathol 2002 Jul;118(1):41-6
AD - Carle Clinic Association, Urbana, IL, USA.
We compared satisfactory for evaluation but limited by (limited by) and
unsatisfactory gynecologic cytologic diagnoses for samples collected by
conventional smearing with those generated with the AutoCyte Prep in a
population with a historic squamous intraepithelial lesion (SIL) rate of
less than 1%. Results from 18,819 AutoCyte Preps were compared with
53,835 conventional cervical smears. Furthermore, 23 women ages 18 to 65
years undergoing annual Papanicolaou tests underwent sequential sampling
with the AutoCyte Prep and the Surgipath C-E brush. Comparison of the
AutoCyte Prep with conventional cytologic diagnoses revealed the
following: unsatisfactory rate, down 97%; limited by rate, down 67%;
low-grade SIL rate, up 86%; cervical cancer rate, up 300%; and
high-grade SIL rate, unchanged. Examination of unsatisfactory and
limited by cases for the AutoCyte Prep showed that 88% were due to
absence of endocervical cells (ECs). Dual sampling showed no improvement
in EC recovery over the AutoCyte collection device. Compared with
conventional Papanicolaou smears, the AutoCyte Prep significantly
decreased the rate of unsatisfactory and limited by specimens while
increasing low-grade SIL and cancer detection and EC recovery. The
majority of limited by specimens with the AutoCyte Prep were due to
absence of ECs, but use of a brush-type device for better endocervical
sampling did not enhance EC recovery.
28
UI - 12118547
AU - Bonin SR; Lanciano RM; Corn BW; Hogan WM; Hartz WH; Hanks GE
TI -
Bony landmarks are not an adequate substitute for lymphangiography in
defining pelvic lymph node location for the treatment of cervical cancer
with radiotherapy.
SO - Int J Radiat Oncol Biol Phys 1996 Jan 1;34(1):167-72
AD - Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia,
PA 19111, USA.
PURPOSE: Curative radiotherapy (RT) for carcinoma of the cervix requires
adequate irradiation of regional lymph node groups. The best nonsurgical
method of defining lymph node anatomy in the pelvis remains the
lymphangiogram (LAG). This study was designed to determine if bony
landmarks could accurately substitute for LAG as a means of determining
lymph node position for the purpose of pelvic RT treatment planning.
METHODS AND MATERIALS: The post-LAG simulation films of 22 patients
treated at the Fox Chase Cancer Center for cervical cancer were
examined. On anterior/posterior (A/P) simulation films, the distance of
lymph nodes was determined from the top, middle, and bottom of the
sacroiliac joint, and at the pelvic rim, 1 and 2 cm above the
acetabulum. On lateral (LAT) simulation films, lymph node position was
measured at points 0, 4, and 8 cm along a line from the bottom of L5 to
the anterior aspect of the pubic symphysis. Positive values represent
lateral and anterior distances relative to the reference point on A/P
and LAT films, respectively. Negative values represent distances in the
opposite direction. The adequacy of standard pelvic fields as defined by
the Gynecologic Oncology Group (GOG) (A/P: 1.5 cm margin on the pelvic
rim; LAT field edge is a vertical line anterior to the pubic symphysis)
was also examined. Data are expressed as the mean +/- two standard
deviations, (i.e. 95% confidence level). RESULTS: On A/P simulation
films, the distance of visualized lymph nodes had mean values of -1.6
+/- 1.7 cm (range -4.1 to -0.4 cm), -1.3 +/- 1.5 cm (range -3.4 to 0.0
cm), and 1.2 +/- 1.8 cm (range -1.0 to 2.6 cm) from the sacro-iliac (SI)
joint at the superior, middle, and inferior points, respectively. The
mean distance of the nodes from the pelvic rim at points 1 and 2 cm
above the acetabulum was 0.3 +/- 1.2 cm (range -0.6 to 1.8 cm) and 0.2
+/- 1.8 cm (range -1.6 to 2.1 cm), respectively. On LAT simulation
films, the distance of lymph nodes from points 0, 4, and 8 cm from the
previously described reference line had mean values of 2.0 +/- 1.0 cm
(range 1.3 to 3.0 cm), 0.9 +/- 3.9 cm (range -1.9 to 5.1 cm), and 1.8
+/- 2.1 cm (range -0.8 to 3.5 cm), respectively. Ten of 22 (45%)
patients would have had inadequate nodal irradiation if their fields had
been designed according to standard GOG parameters. In all cases, these
incompletely irradiated lymph nodes were from the lowest of the lateral
external iliac group. CONCLUSION: Great variability in pelvic lymph node
location is demonstrated when LAG is used to directly visualize their
location. Bony structures are inaccurate landmarks for pelvic lymph node
position. The GOG standard pelvic fields are not consistently adequate
to cover all lateral external iliac lymph nodes, although the clinical
significance of this subgroup of lymph nodes is not known. At this time,
LAG remains the ideal radiographic modality to define anatomic location
of regional lymph nodes for pelvic RT treatment planning. The clinical
importance of the most lateral group of external iliac lymph nodes in
various stages of cervical cancer represents a potential area of future
research.
29
UI - 12078919
AU - Ostrzenski A
TI -
FDA panel conditionally approves DNA pap test without ACOG support.
SO - J Natl Med Assoc 2002 Jun;94(6):418
30
UI - 12092247
AU - Kojs Z; Urbanski K; Fabisiak W; Reinfuss M
TI -
[Prognostic factors in the primary invasive vaginal carcinoma]
SO - Ginekol Pol 2002 Mar;73(3):163-6
In the period 1965-1988, 125 women with primary invasive vaginal
carcinoma were treated with radiotherapy. 53 (42.4%) survived 5-year
without evidence of disease. In the Cox multivariate analysis three
variables were independently related to survival: age of the patients,
grade of differentiation of tumor and the clinical stage of illness.
31
UI - 12092248
AU - Kwasniewska A; Zimna K; Sominka J; Gozdzicka-Jozefiak A; Semczuk M
TI -
[Identification of encoding and regulatory sequences of RAR-alpha
receptor in intraepithelial neoplasia and in invasive cervical
carcinomas associated with HPV types 16 and 18]
SO - Ginekol Pol 2002 Mar;73(3):167-70
AD - Kliniki Poloznictwa i Patologii Ciazy AM w Lublinie.
The purpose of the study was the analysis of regulatory (region 5 gen)
and encoding sequences of RAR-alpha receptor in cervical dysplasia and
invasive cancer associated with HPV infection. A PCR method with the use
of specific primers was applied to amplify and detect DNA sequence of
various HPV types. A PCR-SSCP method was used to analyse the sequence of
RAR--a receptor. The study revealed changes in structure of regulatory
and encoding sequences of the investigated RAR receptor. Utmost changes
were found in DNA isolated from tissues with diagnosis of adenocarcinoma
colli uteri.
32
UI - 12112980
AU - Heilmann V; Kreienberg R
TI -
Molecular biology of cervical cancer and its precursors.
SO - Curr Womens Health Rep 2002 Feb;2(1):27-33
AD - Department of Obstetrics and Gynecology, University of Ulm,
Prittwitzstr. 43, 89075 Ulm, Germany. volker.heilmann@medizin.uni-ulm.de
There is strong clinical and experimental evidence that the human
papilloma virus (HPV) plays a central role in the development and growth
of cervical cancer. However, it is known that the carcinogenesis is a
multistep process. Changes in the cytogenetic equilibrium, such as
chromosomal imbalances, allelic loss, and structural aberrations, happen
during the transformation from normal epithelium to cervical cancer.
Numerous studies support the hypothesis that HPV infection is associated
with development of malignant or pre-malignant changes of the lower
genital tract. However, there is little clinical evidence that HPV
detection would allow prediction of development of cervical cancer.
Regarding the "human aspect" of carcinogenesis, there are efforts to
detect markers that predict the risk of progression.
33
UI - 11455035
AU - Jee KJ; Kim YT; Kim KR; Aalto Y; Knuutila S
TI -
Amplification at 9p in cervical carcinoma by comparative genomic
hybridization.
SO - Anal Cell Pathol 2001;22(3):159-63
AD - Department of Medical Genetics, Haartman Institute and Helsinki
University Central Hospital, University of Helsinki, Finland.
DNA copy number changes were studied by comparative genomic
hybridization on 10 tumor specimens of squamous cell carcinoma of cervix
obtained from Korean patients. DNA was extracted from paraffin-embedded
sections after removal of non-malignant cells by microdissection
technique. Copy number changes were found in 8/10 tumors. The most
frequent changes were chromosome 19 gains (n=6) and losses on
chromosomes 4 (n=4), 5 (n=3), and 3p (n=3). A novel finding was
amplification in chromosome arm 9p21-pter in 2 cases. Gains in 1, 3q,
5p, 6p, 8q, 16p, 17, and 20q and losses at 2q, 6q, 8p, 9q, 10p, 11, 13,
16q, and 18q were observed in at least one of the cases.
34
UI - 12115508
AU - Nieminen P; Hakama M; Tarkkanen J; Anttila A
TI -
Effect of type of screening laboratory on population-based occurrence of
cervical lesions in Finland.
SO - Int J Cancer 2002 Jun 10;99(5):732-6
AD - Department of Obstetrics and Gynecology, Helsinki University Central
Hospital, Helsinki, Finland. pekka.nieminen@hus.fi
The incidence of cervical cancer decreased in Finland over a 30-year
period because of an effective screening program, but in the beginning
of the 1990s it began to increase. Reasons for such an increase are
variable: changes in sexual habits, shortcomings in attendance for
screening and possibly variation in laboratory quality. We evaluated the
impact of 3 laboratories in the greater Helsinki area on screening
performance and on the incidence of invasive cervical cancer and
preinvasive cervical lesions in the target population. We studied time
trends, geographic differences in attendance and detection rates from
screening and the incidence of invasive cancer in the greater Helsinki
area (population about 1 million) during the 1990s, when screening was
reorganized from the Cancer Society of Finland laboratory to the
municipal one (Helsinki) and to a private laboratory (Espoo), while in
Vantaa screening remained with the same Cancer Society laboratory. The
attendance rate for screening increased during the study period in all 3
cities. The numbers of cytologically suspected and histologically
confirmed precancerous lesions found, including severe lesions,
decreased significantly with the change of laboratory in Espoo; but in
Helsinki and Vantaa, they increased. The overall incidence of invasive
cervical cancer increased in all cities in the age groups screened but
mostly in Espoo. The rather rapid changes and variation in trends in the
number of screening findings cannot be explained by changes in etiologic
factors or attendance. They may be related more to the quality of the
laboratory performance and perhaps to the criteria used in cytology and
colposcopy. A well-organized auditing system is proposed to maintain
high quality in screening. Copyright 2002 Wiley-Liss, Inc.
35
UI - 12115509
AU - Odida M; Schmauz R; Lwanga SK
TI -
Grade of malignancy of cervical cancer in regions of Uganda with varying
malarial endemicity.
SO - Int J Cancer 2002 Jun 10;99(5):737-41
AD - Department of Pathology, Makerere University, Kampala, Uganda.
As in a prior study on malignant lymphomas, 3 and 6 areas of Uganda
showing low and high malarial endemicity, respectively, were selected
for analysis and the data retrieved from the Kampala Cancer Registry,
which in the 1960s and 1970s collected cases of cancer through a widely
used free biopsy service from the whole country. Overall incidence rates
were derived from 924 cases from the 12-year period 1964-1975. For
reasons of economy, grade of tumour was determined only in cases
pertaining to the 6-year period 1968-1973. Of 457 cases, 304 could be
reviewed histologically. Only the group of squamous cell carcinomas
(84.9%, 258 cases) was large enough for subsequent geographic analysis.
High incidence rates of CC were found in areas with high malarial
endemicity, whereas low incidence rates occurred where malaria was
either frequent or rare. A correlate to malarial infection was the
proportion of high-grade carcinomas irrespective of the overall
incidence of CC. With high prevalence of malaria and high CPRs of
35-74%, the relative share of high-grade cancer amounted to 50-67%.
Where malaria was rare with low CPRs of 8-11%, these values were lower
and varied only from 25-39% with a similar range of 14%. Geographic
agreement between malarial endemicity and the PI of high-grade cancer
was high in the 9 study areas and only slightly lower than for BL, for
which the association with malaria is beyond doubt. Compared to areas
with little malaria, the RR for the incidence of high-grade carcinomas
in areas with severe malaria was increased. The value was 2.04 with a
95% confidence interval of 1.37-3.04. Attributable to secondary
immunodeficiency, lifelong exposure to malaria may result in excess
frequency of high-grade malignant tumours not only in the group of
malignant lymphomas but also in CC. Copyright 2002 Wiley-Liss, Inc.
36
UI - 12115593
AU - Basu P; Sankaranarayanan R; Mandal R; Roy C; Das P; Choudhury D; Datta
TI -
K; Karamakar S; Tsu V; Chakrabarti RN; Siddiqi M; The Calcutta Cervical
Neoplasia Early Detection Strudy (CEDS) Group
Evaluation of downstaging in the detection of cervical neoplasia in
Kolkata, India.
SO - Int J Cancer 2002 Jul 1;100(1):92-6
AD - Chittaranjan National Cancer Institute, Kolkata, India.
Unaided visual inspection or "downstaging" has been suggested as a
potential alternative method for cervical cancer screening in developing
countries. Our study was designed to evaluate the accuracy of
downstaging to detect cervical neoplasia in a low-resource setting. A
total of 6,399 women aged 30-64 years were screened with downstaging by
trained nonmedical health workers. Two thresholds were used to define
positive downstaging: "low threshold" when any visible abnormality on
the cervix was considered positive and "high threshold" when selected
abnormalities such as bleeding on touch, bleeding erosion, hypertrophied
oedematous cervix, congested stippled cervix and growth or ulcer
constituted the positive test. All women underwent a colposcopy
examination. Biopsies were directed when colposcopy revealed abnormal
lesions. True disease status was defined as histologically proven
moderate dysplasia and worse lesions. Since all the participants
received a diagnostic (reference) investigation (biopsy and/or
colposco
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