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PubMed1998

[Cervix carcinoma: staging, therapy, after-care. Experiences with magnetic resonance tomography of cervix carcinoma based on recent literature 1993 to 1997].

The investigation of cervix carcinoma with magnetic resonance tomography (MRT) is still controversially discussed with regard to its diagnostic value as well as for planning radiation therapy. The purpose of this article is to present and discuss papers published between 1993 and 1997 in this field with respect to the technique used, the contrast media applied and its clinical value. A literature search using three different databases (Medline, Embase, Cancerlit) identified 39 publications, which were then analysed. Despite the partially suboptimal presentation of results in these papers MRT proved superior to other imaging modalities. Due to better demarcation of cervix carcinoma with MRT, it was possible to calculate tumor value as well as to correctly judge the infiltrative character. This allows for a more precise treatment and staging of the patient's prognosis. In the future, MRT might be useful in diagnosing recurrence at relatively early stage. Unfortunately lymphatic nodes can only be insufficiently verified using MRT.

Cervix Uteri↗
PubMed2001

Histologic subtype has minor importance for overall survival in patients with adenocarcinoma of the uterine cervix: a population-based study of prognostic factors in 505 patients with nonsquamous cell carcinomas of the cervix.

BACKGROUND: The incidence of adenocarcinoma of the uterine cervix is increasing. For better prognostic information, the authors studied all nonsquamous cell carcinomas (non-SCCs) in the Norwegian population over a total of 15 years. METHODS: All non-SCCs from three 5-year periods (1966-1970, 1976-1980, and 1986-1990) were reviewed and classified according to the World Health Organization classification system, and histopathologic and clinical parameters were registered. Tissue blocks were available from all patients. RESULTS: Of 505 patients, 417 had tumors classified as adenocarcinoma, and 88 had tumors classified as other non-SCC. The mean ages were 53 years and 52 years for patients with adenocarcinoma and non-SCC, respectively. Sixty-two percent of the staged patients had clinical Stage I disease according to the classification system of the International Federation of Gynecology and Obstetrics (FIGO). In univariate analyses, histology, architectural and nuclear grade, extension to the vagina or corpus uteri, tumor length (> 20 mm) or tumor volume (> 3000 mm(3)), infiltration depth (in thirds of the cervical wall), thickness of the remaining wall (< 3 mm), vascular invasion, lymph node metastases, treatment, and patient age were significant variables in patients with FIGO Stage I disease. Variables with no significance in patients with Stage I disease were number of mitoses, state of resection margins, infiltration to ectocervix, tumor thickness, lymphoid reaction, earlier or concomitant cervical intraepithelial neoplasia, stump carcinoma, DNA ploidy or DNA index, or time period. Multivariate analyses of patients with FIGO Stage I disease identified small cell carcinoma, corpus infiltration, vascular invasion, and positive lymph nodes as independent prognostic factors. CONCLUSIONS: Small cell carcinoma was the only histologic subgroup of independent importance for prognosis in patients with non-SCC of the uterine cervix. No significant difference between major subtypes of adenocarcinoma favored a simplified classification. Extension to the corpus in patients with early-stage disease was of independent significance and should be acknowledged in planning treatment.

Adenocarcinoma↗
PubMed1975

[The detection of the carcinoma in situ of the cervix of the uterus and of the invasive carcinoma of the cervix of the uterus (author's transl)].

Report of the detection of 203 cases (87 of a carcinoma in situ of the cervix of the uterus, 116 of carcinoma of the uterus) out of 7769 cytologically examined patients at the ob.-gyn. deptm. of the Hospital Vienna-Lainz (Austria). The accuracy of cytology with respect to the detection of the carcinoma of the cervix: 95%. The importance of a gynecological examination performed at least once a year together with a cytological test and the examination of the breast is hereby stressed.

Adult↗
PubMed1992

[Behavior of SCC marker level in cervix erosion, cervix dysplasia and cervical pre-invasive carcinoma].

The work presents the results of studies on the behaviour of SCC antigen in 52 patients aged 21-70 years, with pathologic changes involving the uterine cervix and classified to the groups of erosion, dysplasia and carcinoma in different stage of advancement. The SCC antigen was determined in patients blood sera by radioimmunologic method, on the basis of Abbott Firm testes. An increase in concentration was observed exceed the norm (2 ng/ml) in cases of CIN and CIS. The rise of marker depended on the stage of the neoplastic process advancement in the uterine cervix.

Adult↗
PubMed1987

[Value of magnetic resonance imaging of cancers of the uterine cervix and corpus. Preliminary study apropos of 9 cases of cancer of the corpus and 20 cases of cancer of the cervix].

We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometrial invasion is not seen with accuracy: the interruption of "junctional zone" is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI.

Evaluation Studies as Topic↗
PubMed1979

[Does cancer preventive care on the cervix need to be reformed? Gynecological preventive care and early diagnosis--current knowledge on cervix neoplasms].

A comparative study shows high incidence of preclinical cancerous lesions of the uterine cervix in women under thirty years of age. The rate of positive cytology in this age group was the same as in the group of women over thirty (0.3 per cent each). The histological findings revealed intraepithelial lesions like dysplasia and carcinoma in situ in the younger group compared to more advanced lesions like microinvasive cancer in the higher-aged group. The use of colposcopy rendered optical evidence--predominantly in the younger group--of lesions which under long-term observation preceded positive cytology for years as well as the consequent histological proof of dysplasia and preclinical carcinoma. As a result of the given and discussed clinical data in both compared age groups the value of colposcopy is stressed in improving the quality of detection of preclinical neoplasia in the uterine cervix and the necessity of cancer-screening in younger-aged women is emphasized.

Adult↗
PubMed1990

[Biochemical changes in cervix mucus in stepwise malignant transformation of cervix epithelium].

The authors investigated 10 free amino acids, LDH, pyruvic acid and the levels of glucose in mucus of the cervix of patients in cases of gradually malignisation. We could show that the levels of all free amino acids are lower in cases of invasive carcinomas than in cases with dysplasias. LDH and pyruvic acid had an higher level in cases invasive carcinomas. We found no differences in cases of dysplasias and normal patients cervical mucus.

Amino Acids↗
PubMed1989

Enzymatic collagen degradation in the pregnant guinea pig cervix during physiological maturation of the cervix and after local application of prostaglandins.

The role of enzymatic collagen degradation in prostaglandin-induced and physiological cervical ripening was studied in guinea pigs. The cervices were removed from (a) 8 non-pregnant guinea pigs, (b) 8 animals at day 45 of pregnancy, (c) 14 pregnant animals of comparable gestational age which had either an intracervical application of 0.2 ml 5% tylose or 10 micrograms sulprostone gel, and (d) 8 guinea pigs at day 63 to 65 of pregnancy. Collagenase activity was assayed in a highly specific and sensitive system using native collagen type I as substrate. Protease activity was measured by the method of Green and Shaw. Collagen fragments were identified by SDS-polyacrylamide electrophoresis (SDS-PAGE) of acetic-soluble fractions. Collagenase and protease activities were found in all extracts from the different groups. However, there were no differences in enzymatic activities between the non-pregnant, early-pregnant and late-pregnant cervical specimens. Prostaglandin pre-treatment of the cervix led to no significant increase in either collagenase or protease activity as compared to the control groups. The absence of typical collagen degradation products in the SDS-PAGE suggested that no significant collagen breakdown had taken place. In contrast to previously published literature, we conclude that enzymatic collagen degradation is unlikely to be a key factor in prostaglandin-induced and physiological cervical ripening.

Animals↗
PubMed1982

[Induction of cervix maturation by oxytocin vs. PGF2 alpha infusion, vs. intracervical PGE2 gel in risk cases with immature cervix].

From April 1, 1978 to March 31, 1979 199 patients with a high risk pregnancy and a Bishop score of less than 7 among a total number of deliveries of 2075 needed induction of labour for medical indications. In 143 patients oxytocin infusions were given, in 56 patients PGF2 alpha infusions were given. It was shown that PGF2 alpha by infusion showed no advantages over oxytocin infusions. The duration of labour and delivery was not shortened. The foetal morbidity was not decreased. The incidence of Caesarean section remained unchanged at a high 32% and the incidence of vaginal operative delivery remained high at 50%. The incidence of post-partum acidosis in the newborn remained at around 14%. Therefore induction of labour was tried on the unripe cervix in the following 12 months with the intra-cervical application of 0.4 mg. PGE2 gel in 202 patients. The same criteria of high risk pregnancies and unripe cervices were used in the following 12 months. In contradistinction to the induction of labour with oxytocin infusion or PGF2 alpha infusion statistically very significant differences in favor of PGE2 gel were found. The foetal morbidity during labour, the duration of labour, the mode of delivery, the neonatal morbidity and the post-partum maternal condition regarding haemoglobin and pyrexia were improved. The low incidence of Caesarean section at 8% and the low incidence of post-partum acidosis in the newborn was especially noteworthy in the PGE2 gel group. Although excellence of prenatal care is essential for the improvement of obstetric results the timely termination of a high risk pregnancy is the second important step to reduce maternal and foetal morbidity. PGE2 gel intracervically improves this second step.

Berlin↗
PubMed1993

[Evaluation of tumor extension in invasive cancer of the uterine cervix. Diagnostic evaluation of cervix cancer].

Cancer of the uterine cervix accounts for approximately 30% of deaths from malignancies in gynecology and this rate has remained unchanged for more than 40 years. The most important prognostic factor is the extent of the disease at the beginning of treatment. There is, however, a discrepancy of some 50% between clinical and postoperative staging. The aim of this study was to evaluate different diagnostic investigations leading to the preoperative classification (FIGO) of 261 patients with cervical cancer. Data of presurgical clinical and radiological examinations were compared with postoperative histopathological findings. Rectovaginal palpation and computerized tomography (CAT) both showed a positive predictive value of 60%. The performance of CAT and lymphography in the diagnosis of lymph node metastasis was poor with positive predictive values of 36.3 and 20%, respectively. In the absence of parametrial infiltration on palpation, cystoscopy and rectoscopy are superfluous since they are always normal. Urography, because of the possibility to show the topographic anatomy of the urinary tract, was justified in all cases. The value of surgical staging and more recent techniques such as sonography and magnetic resonance is discussed.

Adult↗
PubMed1987

[Human papillomavirus infection and carcinogenesis of cancer of uterine cervix. II. Immunoperoxidase localization of papilloma-virus antigen in tissues of the uterine cervix].

244 cervical tissue specimens with different diagnoses were stained by peroxidase-anti-peroxidase technique (PAP) for assay of the human papillomavirus (HPV) genus-specific antigen, the first of its kind performed in China. HPV antigen was detected in 41.93% of simple condyloma group, in 35.29% of dysplasia with condyloma and in 27.27% of carcinoma with condyloma. There was no positive in the control, dysplasia or carcinoma groups. The antigen positive nuclei were found in the koilocytes or parakeratosis cells in the upper layers of the epithelium. The severer the condyloma, the higher the positive rate of antigen. In the severe condyloma group, the positive rate was as high as 64.71%. The koilocytes were observed in every HPV antigen positive section. In view of the coexistence and continuous transformation of condyloma, dysplasia and carcinoma in pathomorphology, these results provide an important evidence to the further studies on the relation between HPV infection and carcinogenesis of cancer of uterine cervix.

Antigens, Viral↗
PubMedDate not supplied

[Prostaglandin E2 gel for ripening the cervix and/or labor induction in the unripe cervix at the end of pregnancy].

Endocervical instillation of a Prostaglandin-E2-containing-gel is a well accepted method to ripen the cervix before induction or to induce labor directly. Until now the main problem of this method were difficulties with the preparation of the Prostaglandin-gel-mixture. In the present study a prefabricated 0.5 mg PGE2 containing gel was tested with relation to its safety and efficacy. During the period of one year no gel-specific difficulties e.g. stability, homogeneity or sterility occurred. 57% of the nulliparas and 71% of the multiparas with a modified Bishop-score of smaller or equal to 5 could be delivered within 12 hours of the first gel-application. In most of the remaining women no substantial cervical ripening could be detected. In only 12% of nulliparas and 6% of multiparas labor could not be induced by means of the second gel-application. The rate of operative deliveries in this group of low risk patients was low (4.1% in nulliparas and 1.9% in multiparas). The fetal outcome was excellent in all instances. Maternal side effects could be detected in 5 women. Based on our experience endocervical PGE2-gel-instillation can be considered a safe and very efficacious method of induction of labor in unfavorable cervical-score.

Cervix Uteri↗
PubMed1993

Detection of the HPV16 E6 transforming gene by PCR in tissue samples from normal cervix and from cervix with precancerous lesions and carcinomas.

A study of 130 biopsies from cases of histologically confirmed normal cervix (30), cervicitis (28), cervical intraepithelial neoplasia (CINI-CIN III, 29), and cervical cancer (43) was performed to determine the presence of human papillomavirus (HPV) type 16 DNA sequences. The polymerase chain reaction technique was adopted using two oligonucleotides as primer pairs in the HPV16 early 6 (E6) gene open reading frame (ORF). The rates of HPV16 infection in normal tissues, cervicitis, CINI-CIN III and cervical cancer were found to be 16.67% (5/30), 25.00% (7/28), 41.38% (12/29) and 69.77% (30/43), respectively. Statistical analysis showed that the relative risk (RR) of association between HPV16 infection and the development of cervicitis, CINs and cervical carcinomas was increased with the severity of cervical lesions, from 1.0 (normal) to 1.67, 4.62 (P < 0.05; 95% CI 0.28-8.95) and 11.54 (P < 0.001; 95% CI 3.94-33.81), respectively. Our results strongly support the idea that the development of cervical precancerous lesions and cervical carcinomas is closely associated with HPV16 infection.

Adult↗
PubMed1990

Development of melanosis of uterine cervix after cryotherapy for epithelial dysplasia. A case report and brief review of the literature on pigmented lesions of the cervix.

A case of melanosis of the exocervix, which developed within eight months after cryotherapy for epithelial dysplasia, is reported. The literature on pigmented lesions of the cervix is briefly summarized and the importance of biopsy and histologic examination for diagnosis and classification of these lesions is emphasized.

Adult↗
PubMed2003

Unique collision of hodgkin lymphoma and adenosquamous carcinoma in the uterine cervix: synchronous malignant neoplasms of the cervix.

To document the first reported synchronous occurrence of Hodgkin lymphoma and adenosquamous carcinoma involving the female genital tract. Review of cytologic, histologic, and immunohistochemical studies obtained from a 50-year-old, multiparous, postmenopausal, Hispanic female who had a left inguinal mass, bilateral lower extremity pain and numbness, fatigue, anorexia, a 20- to 30-pound weight loss, and a malodorous vaginal discharge at presentation is presented. Cervical squamous cell carcinoma was diagnosed by routine cytologic and histologic analysis. Hodgkin lymphoma subsequently was diagnosed in the inguinal lymph nodes by fine-needle aspiration biopsy and excisional biopsy before the patient underwent hysterectomy. In addition to invasive and in situ adenosquamous carcinoma of the uterine cervix, the hysterectomy specimen also contained previously unsuspected Hodgkin lymphoma. To our knowledge, this is the first reported case of adenosquamous carcinoma and Hodgkin lymphoma synchronously involving the female reproductive tract.

Journal Article↗
PubMed1984

The Medical Research Council trial of misonidazole in carcinoma of the uterine cervix. A report from the MRC Working Party on misonidazole for cancer of the cervix.

153 patients from 13 centres were entered into a randomised controlled trial of the hypoxic cell sensitiser , misonidazole, in the radiotherapy of Stage III carcinoma of the uterine cervix. In an interim analysis at a time when follow-up periods extended from 9 to 45 months, no benefit in survival or local tumour control has been demonstrated. When disease-free survival of all cases was considered it was found that the younger patients did less well than the older patients and that the greater the immediate response to radiotherapy the longer was the duration of survival free of disease.

Adult↗
PubMed1990

[Cervix cytology--frequency and quality of earlier examinations in women with cervix carcinoma].

The course of cervical cytological examinations is reviewed in 41 patients in whom the diagnosis of carcinoma of the uterine cervix was established during the period 1985-1987 in the Department of Pathology of the Central Hospital in Nykøbing Falster, Denmark. Nine of these patients were adequately examined and the course of the examinations was satisfactory. Thirteen patients had never been examined previously. The remaining nineteen patients had been examined previously but to an insufficient extent. The present investigation supports the importance of following the guiding directives for cervical cytological examination recommended by the Danish Board of Health. In addition, it is emphasized that thoroughness in taking samples is of decisive significance for the quality of the examination. Finally, it is recommended that clinicians and pathologists should cooperate in compiling a description of the consequences for control and treatment of positive findings.

Adolescent↗
PubMed1986

A case report of mixed mesodermal tumor of the uterine cervix (mixed, heterologous and homologous sarcoma of the uterine cervix).

A case of mixed sarcoma of the uterine cervix in a 17-year-old girl is reported. The tumor showed polypoid features resembling sarcoma botryoides, and was histologically composed of chondrosarcoma as a heterologous element and stromal sarcoma as a homologous one. Leiomyosarcoma was also found in the tumor, but striated rhabdomyoblasts were not present. No epithelial component was detected. After a total hysterectomy, the patient was given chemotherapy and is in good condition.

Adolescent↗