PubMed · 3432914
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B Le Thai, A Le Duc. 1987. [Bladder tumors].. https://pubmed.ncbi.nlm.nih.gov/3432914/
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Women not attending cervical screening programs are at increased risk of cervical cancer. We investigated in these nonresponders to what extent offering self-sampling devices for cervicovaginal brushes for high-risk human papillomavirus (hrHPV) testing would induce participation and, if so, what the yield of precursor (i.e. CIN2 or worse) lesions following self-sampling would be. In addition, we assessed screening history of participants and costs per detected high-grade CIN2 or worse ("CIN2+") lesion in comparison to the regular program in the Netherlands. Nonresponders received a device for hrHPV testing (self-sampling group, n=2,546) or an extra recall for conventional cytology (control group, n=284). The percentage of self-sampling responders were compared with responders in the recall group. hrHPV positive self-sampling responders were invited for cytology and colposcopy. CIN2+ yield and costs per detected CIN2+ were evaluated. Active response was higher in the self-sampling than in the control group (34.2 vs. 17.6%; p<0.001). hrHPV positive self-sampling responders were less likely to have a prior screening history than screening participants (p<0.001), indicating that they are regular nonresponders. hrHPV prevalence was similar (8.0 vs. 6.8%; p=0.11), but CIN2+ yield was higher in self-sampling responders compared to screening participants (1.67 vs. 0.97%; OR=2.93, 95% CI 1.48-5.80; p=0.0013). Costs per CIN2+ lesion detected via self-sampling were in the same range as those calculated for conventional cytological screening (euro 8,836 vs. euro 7,599). Offering self-sampling for hrHPV testing in nonresponders is an attractive adjunct to effectively increase population coverage of screening without the adverse effect of markedly increased costs per detected CIN2+ lesion.
Pancreatic cancer is the fourth leading cause of death due to cancer. The most common cancer in the pancreas is ductal adenocarcinoma. Pancreatic cancer is characterized by alterations in K-Ras, INK4a, Tp53 and SMAD4. Similar to colon cancer a cancer progression model for pancreatic cancer has been proposed. The precursor lesions are called pancreatic intraepithelial neoplasia. Patients with tumors in the head of the pancreas may present deep jaundice without pain. Multidetector CT incorporating dual-phase imaging in the arterial and venous phases of enhancement is the preferred imaging modality for the diagnosis and staging of pancreatic cancer. Gemcitabine is still the standard for unresectable locally advanced disease or distant metastasis.
Only early diagnosis of laryngeal cancer can prevent major or mutilating treatment. Recently, autofluorescence endoscopy has been developed to enhance endoscopic information and succeeded in facilitating the detection and demarcation of precancerous lesions, carcinoma in situ and cancer of the larynx. The aim of the present study is to quantify autofluorescence imaging by spectroscopy in order to validate the above mentioned findings. In a prospective study, 42 patients with suspected one-sided precancerous or cancerous lesions of the vocal folds were investigated during microlaryngoscopy. Autofluorescence (AF) was induced by filtered blue light (375-440 nm) of a xenon short arc lamp and processed by a CCD camera system (D-light AF System, STORZ, Germany). Autofluorescence images were gathered in a contact mode. For spectrometric measurements an optical multi channel analyzer (AVS-USB 2000, Avantes, The Netherlands) was applied. The results were compared to pathohistological findings. Under blue light excitation normal mucosa presented a bright green fluorescence. Intensity increased from the ventricular folds to the subglottic area. Averaged spectra of the normal laryngeal mucosa demonstrated different fluorescence maxima at 475, 515, 550, 600 and 630 nm. Highest intensity was measured at 515 nm explaining the green appearance of the autofluorescence picture. In contrast, precancerous as well as cancerous lesions showed a significant decrease in autofluorescence intensity with a reddish-violet color. Highest loss of autofluorescence intensity was measured at 515 nm. At this wave length intensity dropped 70% on average in comparison to the regularly appearing contralateral vocal fold. In contrast to 515 nm, the loss of intensity at 630 nm amounted to 38%. Sensitivity amounted to 97% and specificity to 82%. Comparable to autofluorescence endoscopy a differentiation between precancerous and cancerous lesions could not be detected. The reason for the loss of autofluorescence may predominantly be caused by mucosal thickening but also by changes in metabolism and higher nuclei density.