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At least 775 records · Page 43Linked to original sources
PubMed1996

The association of human papillomavirus type 16 E6 and E7 antibodies with stage of cervical cancer.

OBJECTIVE: Previous investigators have reported higher HPV type 16 antibody positivity among cervical cancer patients than among healthy women. The objective of this study was to determine the association of HPV 16 antibody levels with the stage of cervical cancer. METHODS: Pretreatment tumor biopsies and sera were obtained from 137 newly diagnosed cervical cancer patients residing in Mexico. Using peptide ELISA and radioimmunoprecipitation assay (RIPA), HPV 16 E6- and E7-specific antibodies were measured. RESULTS: By ELISA, elevated antibody titers to HPV 16 E6 and E7 were detected in 16.8 and 32.8% of the women, respectively. While sera positivity did not differ by disease stage, the mean absorbance in the E7-positive sera was 0.42, 0.62, 0.91, and 0.81 for stages I to IV, respectively. Using RIPA, anti-E6 and E7 positivity was demonstrated in 46.7 and 38.7% of the females, respectively. Although no difference across disease stage was detected for E6, increasing proportions of positivity to E7 with stage of disease was detected. The rates for increasing disease stage were 0.14, 0.37, 0.40, and 0.67. Sera from the 6-month postradiation follow-up examinations of a small group of patients demonstrated a statistically significant decrease in antibody positivity from pretreatment positivity to HPV 16 E6 (n = 14; P = 0.01) and HPV 16 E7 (n = 20; P = 0.0001) using ELISA. CONCLUSIONS: These data suggest that HPV 16 E7 antibody positivity may be associated with stage of cervical cancer. Such immune parameters may be applicable to disease staging, monitoring of recurrence and, perhaps, diagnosis. Further investigation into the relationship of HPV 16 E6 and E7 antibodies with stage of cervical cancer and response to therapy is warranted.

Adult↗
PubMed2001

[Status of screening tests for cervical cancer and its precancerous lesion].

Several screening methods for cervical cancer and its precancerous lesion are reviewed. Cervical cancer screening using visual inspection, colposcopy, oncogenic human papillomavirus DNA testing, liquid-based monolayers and automated Pap smear screening instruments are all potentially valuable when used alone or in combination. Newly developed techniques provide an opportunity to extend practical cervical cancer screening to large population in limited resource areas, and help do more cost-effectiveness of screening tests in high risk population.

Colposcopy↗
PubMedDate not supplied

Awareness and use of cervical cancer tests in a southern Appalachian community.

The knowledge and use of cervical cancer screening (Papanicolaou smear test) by female members of a prepaid health plan (Health Maintenance Organization--foundation-type) based in souther Appalachia were surveyed. Of the 105 members of the plan interviewed, 81 indicated that they had experienced one or more Papanicolaou tests. This percentage (77.1%) was greater than might have been expected on the basis of a review of previous research. Factors contributing to this higher percentage were the subjects' membership in the prepaid health care plan and the increasing tendency of physicians to perform cervical cancer screening tests on patients who visit them for reasons unrelated to cancer detection. The latter phenomenon, coupled with inadequate patient education at the time of the service, is viewed as a major cause of the discrepancy found between the women's Papanicolaou test experience and their Papanicolaou test awareness. Of the 81 women in the study reporting one or more previous cervical cancer screening tests, only 49 were able to identify a specific test for detecting cervical cancer. Most of the results of previous research concerning the relationship of Papanicolaou test experience to age, to education, to economic, employment, and marital status, or to number of children were supported by the current study. The results of this study, conducted in a relatively isolated American community, suggest that the nationwide cervical cancer educational efforts of a multitude of agencies and individuals have met with considerable success.

Adult↗
PubMed2005

Evaluation of patients after extraperitoneal lymph node dissection for cervical cancer.

OBJECTIVE: The presence of nodal metastases is an important prognostic factor in patients with cervical cancer. To adjust our therapy to the anatomic extent of the disease, we performed a surgical staging with extraperitoneal lymph node dissection (EPLND). The goal of our study was to evaluate the clinical outcome and side effects of the combined treatment approach of EPLND and either radical hysterectomy in case of early stage cervical cancer (FIGO Ia/b and IIa) and negative nodes, or pelvic radiotherapy/extended field radiotherapy with concomitant chemotherapy in case of positive nodes or advanced stage cervical cancer (FIGO IIb, III, and IVa). PATIENTS AND METHODS: Fifty-nine patients with primarily diagnosed invasive cervical cancer underwent EPLND. The value of this procedure as a diagnostic tool for evaluating the extent of disease was determined. Additionally, treatment-related complications and clinical outcomes were monitored. RESULTS: A total of 983 lymph nodes were removed during EPLND (mean 16.7). According to the results of EPLND, radical hysterectomy was abandoned due to histopathologically confirmed lymph node involvement by frozen section in 11 out of 36 patients with early stage cervical cancer (31%). The most common adverse effects directly related to surgery in general (EPLND or combined EPLND and radical hysterectomy) were lymph cysts in seven patients (12%). Only in the group of patients who received EPLND followed by radical hysterectomy, 2 out of 25 patients (8%) developed a severe ileus postoperatively (WHO Grade 3 toxicity). The treatment approach of combined EPLND followed by radio- and chemotherapy was without major complications (WHO Grade 3 or 4 toxicity). After a mean follow up of 28 months (range 6-60), 44 out of 58 patients (one patient lost to follow up) are without evidence of disease (76%), 2 patients have progressive disease (3%), and 12 patients died of their disease (21%). Using Kaplan-Meier analysis, the estimated 5-year overall survival rate for all patients is 64% (SD +/- 9%). Performing the Cox proportional regression analysis, in contrast to clinical FIGO staging (P = 0.24; ns), lymph node involvement was the only significant independent predictor for overall survival (P = 0.04). CONCLUSION: Our data support the approach of pretherapeutic surgical staging by performing EPLND as a diagnostic tool with a low complication rate. This allows an individualized treatment for cervical cancer patients.

Adult↗
PubMed2005

Cost effectiveness of concurrent chemoradiation in comparison with radiation alone in locally advanced cervical cancer.

INTRODUCTION: Concurrent chemoradiation has been advocated to be more effective than radiation alone in the treatment of cervical cancer. However, it certainly has more side effects. Hence, it is worthwhile to investigate the cost-effectiveness (CE) of concurrent chemoradiation in comparison with radiation alone in locally advanced cervical cancer. MATERIAL AND METHOD: The treatment of cervical cancer was modeled using the decision tree where the treatment option would be either concurrent chemoradiation or radiation alone. Patients receiving each treatment had different risks of tumor recurrence. Costs in this analysis were separated into four major categories: costs for treatment of cervical cancer, costs for treatment of major side effects, costs for follow up cancer patients, and costs for diagnosis including supportive care of recurrent cervical cancer Charges were used for the costs of chemotherapy, radiotherapy, drugs, and accessories. Unit cost was used for the costs of laboratory investigations, in-patient and out-patient services. Costs incurred after the first year were discounted at an annual rate of 5%. The benefit was measured as months of life survived. The present study evaluated the patients to 5 years after complete treatment. RESULTS: The CE ratio in the concurrent chemoradiation group was 2,855 and 1,835 Baht/month survived if the chemotherapy was given as in-patient and out-patient respectively. The CE ratio in the radiation group equaled 2,366 Baht/month survived. For the sensitivity analysis, in the situation that chemoradiation was not much better than radiation alone in terms that the recurrent rate from chemoradiation group was not more than 20% lower than the radiation group, radiation therapy alone would be more cost effective even if chemotherapy was given as an out-patient basis. CONCLUSION: Radiation alone was more cost effective than chemoradiation in the treatment of cervical cancer. Nevertheless, if chemotherapy was administered on an out-patient basis, chemoradiation will be more cost effective only if the recurrent rate from the chemoradiation group was more than 20% lower than the radiation group.

Ambulatory Care↗
PubMed2005

Promoter polymorphism in the matrix metalloproteinase-1 and risk of cervical cancer in Korean women.

The aim of this investigation was to analyze the association between a single nucleotide polymorphism (SNP) in the matrix metalloproteinase (MMP)-1 promoter gene -1607 bp region and cervical cancer risk in Korean women. The blood samples of 232 cervical cancer patients and 332 non-cancer control subjects who managed at Seoul National University Hospital from 1999 to 2002 were collected. Polymorphism in MMP-1 promoter -1607 region was determined using TaqMan method. Allele frequency and genotype distribution in the cervical cancer group were compared with those of the control group to determine whether this polymorphism elevates the susceptibility of Korean women to cervical cancer. The relationship between this SNP and cancer invasiveness was also evaluated by collating clinicopathologic data of those in the cancer group, such as FIGO stage, lymph node status, histologic type and parametrial invasion. In the cervical cancer group, the allele frequency of 2G was 66.1%, in the control group 68.2%, showing no significant difference (P=0.41). Similarly the genotypes with insertion (2G/2G) or deletion (1G/1G) polymorphism showed no increased risk for cervical cancer susceptibility compared with 1G/2G genotype. A subgroup analysis of the clinicopathologic parameters in cancer group also showed no significant difference suggesting the lack of an association between SNP of the MMP-1 promoter -1607 bp region and cervical cancer invasiveness. In conclusion, this study shows that Korean with specific polymorphism in MMP-1 are neither more susceptible to develop cervical cancer nor more vulnerable for cancer progression.

Female↗
PubMed2003

Pelvic inflammatory disease is a risk factor for cervical cancer.

The acquisition of human papillomavirus (HPV), the most important etiological agent of cervical cancer, does not cause clinical complaints. Although HPV spreads together with agents causing pelvic inflammatory disease (PID) with complaints forcing the patient to seek medical advice, PID has not yet been evaluated as a predictor of cervical cancer. The present study aimed to determine the relationship between PID and HPV in order to evaluate the possible risk factor role of PID for cervical cancer. Two groups of patients were studied: (i) 2,215 women with PID; (ii) 4,217 women participating in a cervical cancer screening programme who were found to have cytological atypia, mucopurulent cervicitis or other colposcopically detected disorders but were free of symptoms of PID. The presence of HPV and other STD agents in cervical smears was detected with polymerase-chain reaction. HPV prevalence was 33.74% in patients with PID and 26.40% in the group of women without PID (p < 0.001). This suggests that patients suffering from PID apparently have a higher risk of cervical cancer.

Adolescent↗
PubMed1984

CT of the normal and abnormal parametria in cervical cancer.

To evaluate CT criteria for differentiating a cervical cancer confined to the cervix from a lesion that invades the parametria, 16 patients with newly diagnosed, untreated cervical cancer were studied with CT. Twenty-five parametria were confirmed by radical hysterectomy, transvaginal parametrial fine-needle aspiration cytology, or excretory urography. In eight tumor-free parametria, CT findings indicating confined tumor were: (1) smooth, well defined cervical margins; (2) lack of prominent parametrial soft-tissue strands; (3) no parametrial soft-tissue mass; and (4) preservation of the periureteral fat plane. The simultaneous occurrence of these four findings was seen in six of eight tumor-free parametria and in no tumor-infiltrated parametria. In 17 tumor-positive parametria, CT findings associated with parametrial tumor invasion were: (1) irregularity or poor definition of the lateral cervical margins; (2) prominent parametrial soft-tissue strands; (3) obliteration of the periureteral fat plane; and (4) an eccentric parametrial soft-tissue mass. The latter two findings were seen only in tumor-positive parametria. Irregularity of the cervical margins and prominent parametrial strands were seen most commonly with parametrial tumor invasion, but were also occasionally seen with parametrial inflammation. On the basis of the criteria developed in this report, CT may be used as an adjunct to the physical examination in differentiating stage I cervical cancer from more advanced disease in selected patients.

Adnexa Uteri↗
PubMed1990

Association of oral contraceptive use and human papillomaviruses in invasive cervical cancers.

In a study of 197 cases of histologically confirmed invasive cervical cancer, 61% of biopsies were positive for human papillomavirus (HPV) DNA by Southern or dot-blot hybridization. An association between detection of HPV DNA and oral contraceptive use was observed when HPV-positive and -negative cases were compared. Women reporting recent or long-term (greater than 4 yrs) oral contraceptive use were at 2.3 and 2.9-fold increased risks of HPV positivity, respectively. An increased risk of HPV positivity was also associated with formal education and with urban residence, while long-term smoking was negatively associated with HPV detection. A non-significant trend of increasing risk of HPV positivity with increasing number of sexual partners of the women and of the male partners of monogamous women was observed. Detection of HPV DNA was not associated with other cervical cancer risk factors examined, including age at first coitus, number of pregnancies, and Pap smear screening history. Our findings suggest either an interaction between HPV infection and oral contraceptive use in the genesis of cervical cancer or an increased expression of HPV genome in neoplasms of oral contraceptive users. These observations also support a multifactorial model of cervical cancer causation.

Adult↗
PubMed1995

Frequent ras gene mutations in squamous cell cervical cancer.

Eighty samples of cervical invasive squamous cell carcinoma were examined for ras gene mutations using polymerase chain reaction (PCR) followed by restriction enzyme digestion. We found 28 (35%) cervical cancers contained ras mutations at H-ras codon 12, 49 (61%) at K-ras codon 12, and 5 (6%) at K-ras codon 13. There were no significant differences in incidence of the ras gene mutations among different histologic grades or clinical stages of the cancer (P > 0.05). This result suggests that ras mutation may be an important step involved in a substantial number of cervical carcinoma. The interaction of ras with other genes and/or events may also be involved in pathogenesis of this malignancy.

Alleles↗
PubMed1983

[Treatment of cervical cancer in the aged].

The incidence of elderly patients in cervical cancer cases at The Department of Obstetrics & Gynecology, Okayama Medical School has been increases to 7.8% during the recent 5 years (1975-1979), comparing to that of the past period 1.9% (1934-1962). According to the statistics of The Ministry of Health and Welfare, the mortality of cervical cancer has been decreased in all the ages except the elderly patients, in which the mortality showed no marked fluctuation or somewhat elevation. According to the report of The Ministry of Health and Welfare, among the 2,014,843 cases of mass screening examination of cervical cancer, the incidence of elderly patient over 70 year old was 0.3% only, and the suspiciously malignant rate was 4.58% in this group. This means that in the elderly group, the incidence of mass screening examination was very low, and the morbidity was relatively high. Reviewing the elderly patients of the recent period, we found that about half of the patients were belong to the Stage III or IV, and even in the early cancer cases, the general diseases were complicated so much, that the main therapy was radiation rather than operation. Reviewing the prognosis and the irradiation dose in the radiation group, we found that the prognosis of the cases who received 4,000 rads external irradiation were better than that of the cases who received 5,000 approximately 6,000 rads. However, sometimes the complication of irradiation were too severe to continue, resulting in an incomplete treatment and bad prognosis. Considering about this, we select the cases to operate according to the physical state but not the age as indicated up to date, and the result was that, even in the aged group, the prognosis of the operable cases were comparable to that of the young aged. As a conclusion, the following can be said: 1) As the mean age has been prolonging, the incidence of the elderly cancer cases will increase progressively, and this will influence the treatment result of cervical cancer. 2) In the aged patients, the prognosis were influenced by the stage rather than the age, therefore, consideration of the treatment according to the stage is important.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Trends in cervical cancer incidence among young black and white women in metropolitan Detroit.

BACKGROUND: Although the overall incidence of invasive cervical cancer in the United States has declined over the past several decades, recent studies suggest that rates for both invasive and in situ cervical cancer are rising among younger women. METHODS: Trends in cervical cancer incidence among females between the ages of 15 and 39 years were evaluated using data from the Metropolitan Detroit Cancer Surveillance System, a population-based registry and founding participant in the SEER Program of the National Cancer Institute. Age-adjusted and age-specific rates for all black and white women in this age group were evaluated as well as rates for married and single women for the period 1973-1991. RESULTS: Incidence trends vary by race and marital status. A nonlinear increasing trend was evident (P < 0.01), for in situ cervical cancer among white women, with rates for single white women exhibiting the largest increase. Rates among black women for in situ cervical cancer exhibited a nonlinear decreasing trend (P < 0.01), with rates for married black women declining by 75%. Among single white women, invasive cervical cancer exhibited an increasing linear trend (P < 0.01), although the number of cases was small. CONCLUSIONS: Differences in trends among black and white women may reflect a combination of greater exposure to risk factors associated with cervical carcinoma as well as differential access to diagnostic and treatment services. Appropriate groups should be targeted for educational, screening, and follow-up services.

Adolescent↗
PubMedDate not supplied

Vitamin D receptor (VDR) expression is not a prognostic factor in cervical cancer.

BACKGROUND: The aim of this study was to analyze whether VDR status is a prognostic factor that may be of importance for the assessment of recurrence in cervical cancer. MATERIALS AND METHODS: VDR-, Ki-67- and p53-status were analyzed immunohistochemically in cervical cancer patients (n=50) and in benign cervical tissue (n=15). The histopathological data of the tumours were evaluated. RNA was extracted from normal cervical tissue (n=4) and cervical carcinomas (n=8) using the method of Chomczynski. RNA was reverse-transcribed and RNA-levels were semiquantitatively detected by PCR. RESULTS: The expression of VDR was significantly increased in cervical cancer compared to normal cervical tissue on the protein-level but not on the RNA-level. No statistically significant correlations were found comparing VDR status with histopathological data (tumour stage, lymph node status, grading, histological tumour type), with the expression of the proliferation marker Ki-67 and of the tumour suppressor gene p53. CONCLUSION: Our findings indicate that VDR protein expression is not a prognostic factor in cervical cancer. The strong I/DR immunoreactivity that we observed in cervical cancer specimens supports the body of evidence that cervical cancer may be a target for therapeutically applied vitamin D analogues.

Adenocarcinoma↗
PubMed1995

[Human papilloma virus and cervical cancer].

More than 13 years have passed since HPV DNA was first detected in cervical cancer. Vigorous studies, basic and clinical, during these years have elucidated the causative relationship of HPV with cervical cancer. There are more than seventy types of HPV, among which types 16, 58, 52, 18 and 31 were detected from cervical cancers obtained from Japanese women. HPV-DNA was detected from more than 90% of the cases of cervical dysplasia whose types were shown to be more widely distributed than those of cervical cancer. The serum antibody to HPV has been detected by Western blot or ELISA using fusion protein as antigen. Anti HPV-16/E7 antibody was detected in cervical cancer patients at significantly higher rates than in control patients. The expression of E6/E7 genes of high-risk HPVs (16, 18 and others) seems to be an essential but not a sufficient factor for malignant conversion of the cervical epithelium.

Antibodies, Viral↗
PubMed2005

Mexican physicians' knowledge and attitudes about the human papillomavirus and cervical cancer: a national survey.

OBJECTIVE: To assess Mexican physicians' knowledge about the human papillomavirus (HPV) and cervical cancer and their opinions and practices related to screening, managing, and counselling women on these topics. METHODOLOGY: In August 2002 we surveyed 1206 general practitioners (GPs) and obstetricians-gynaecologists (Ob-Gyns) working in a nationally representative sample of public and private facilities in urban Mexico. Eligible physicians completed a self administered questionnaire. We conducted a weighted analysis and used chi(2) tests to compare GPs and Ob-Gyns on outcome variables. RESULTS: 76% of recruited physicians responded to the survey. 43% of Ob-Gyns had performed a hysterectomy in the last year to treat a case of CIN I or II. With respect to HPV, while 80% of respondents identified the virus as the principal cause of cervical cancer, many lacked detailed knowledge about this association. Ob-Gyns were more likely than GPs to have heard about specific oncogenic strains of HPV (p<0.001). Nearly all respondents thought that women should be informed that HPV causes cervical cancer; nevertheless, physicians believed that positioning cervical cancer as a sexually transmitted infection (STI) could cause problems in partner relationships (60%), confusion (40%), and unnecessary anxiety among women (32%). CONCLUSIONS: Mexican physicians support patient education on the HPV-cervical cancer link. However, findings suggest the need to present clear messages to women (emphasising, for example, that only certain types of HPV are oncogenic), to consider the conflicts such information might create for couples, and to further educate physicians about this topic and about overall cervical cancer screening and treatment protocols.

Adult↗
PubMed2006

Advances in cervical cancer screening and human papillomavirus vaccines.

Cervical cancer is causally linked to human papillomavirus (HPV) and constitutes a major health problem for women. Nearly 80% of the 510,000 cases reported worldwide each year occur in developing countries which lack organized screening programmes. Cervical screening has effectively reduced the incidence of and mortality from invasive cervical cancer in industrialized countries, but is not completely protective. Cervical screening is now undergoing modernization and has seen several changes in recent years. These aim to enhance the overall efficiency and effectiveness of screening, reduce rates of inadequate sampling, increase sensitivity rates and facilitate ancillary technologies, such as HPV testing. This review discusses these advances and the development of HPV vaccines.

Female↗
PubMed2006

Survival rate of recurrent cervical cancer patients.

OBJECTIVES: To determine the survival rate of recurrent cervical cancer patients and factors influencing survival. MATERIAL AND METHOD: The subjects were identified from the Gynecologic Oncology Unit tumor registry record The pathological, clinical data including the follow-up information of recurrent cervical cancer patients who were treated in the Gynecologic Oncology Unit, Bangkok Metropolitan Administration Medical College and Vajira Hospital between 1992 and 2003 were retrospective reviewed. RESULTS: During the study period, 144 recurrent cervical cancer patients were identified. Mean age of the patients was 52 years. The median time from complete primary treatment to disease recurrence was 14.8 months. Seventy-two patients (50%) had previous stage III disease. The most common histopalogy was squamous cell carcinoma (72.9%). Approximately half of the recurrences were local (73 patients or 50.7%) and distal recurrences were encountered in 71 patients or 49.3%. Overall 109 patients received treatmentfor their recurrences, i.e. radiation alone (55 patients, 38.2%), chemotherapy (31 patients, 21.5%), chemotherapy and radiation (18 patients, 12.5%), surgery (5 patients, 3.5%), and 35 patients (24.3%) received only supportive treatment. Two-year survival rate of the group was 18.5%. Median survival was 8 months (95%CI, 7-10 months). The patients with only local recurrence had a 2-year survival rate of 22.2% compared to 14.6% in those with distant recurrence. (p = 0.245). Two-year survival rate of those who received any kind of treatment was 22.4% compared to 4.0% in those who received only supportive treatment (p = 0.014 and 0.017 in univariable and multivariable analysis respectively). CONCLUSION: Survival rate of recurrent cervical cancer was low, especially in those who received only supportive treatment.

Carcinoma, Squamous Cell↗
PubMed1988

A case-control study of the effectiveness of cervical cancer screening in Osaka, Japan.

In the small town of Nose in Osaka, Japan, a population-based screening program for cervical cancer by Papanicolaou smear has been conducted since 1965. In order to evaluate the effectiveness of screening in terms of the reduction of the mortality and the incidence of invasive cervical cancer, two types of case-control studies were carried out. In the first study, the case series consisted of all women who died of cervical cancer under 80 years of age at the time of diagnosis in 1965-1987 (N = 15). For each case, 10 controls were chosen from living residents, matched by year of birth. It showed that the odds ratio (OR) of dying of cervical cancer for screened versus non-screened women was 0.22 (95% CI = 0.03-1.95). In the second study, the case series consisted of all women who were diagnosed as having invasive cancer under 80 years of age at the time of diagnosis in the same period (N = 28). For each case, 10 controls were chosen from living residents without invasive cancer, matched by year of birth and according to whether or not they were screened at the year of the diagnosis of the matched case. It showed that the OR of getting invasive cancer for screened versus non-screened women was 0.41 (95%CI = 0.13-1.29). From these results, it was estimated that 78% of cervical cancer mortality and 59% of invasive cervical cancer incidence among non-screened women could be prevented by cervical cancer screening.

Adult↗