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At least 1,369 records · Page 76Linked to original sources
PubMed2002

[Some aspects of diagnosis and treatment of cervical intraepithelial neoplasia (review of the literature)].

Cervical cancer has remained close to the forefront of oncologic studies even in our days. The incidence of the disease has changed little, except in those countries with effective screening programs. The morbidity in Lithuania reached 23.9/100,000 in the 2000's, while in comparison the morbidity in the 1994's was 20.4/100,000. The mortality was 13.2 and 11.3/100,000, respectively. Over the last 50 years our understanding of the etiology and pathogenesis of lower genital tract squamous neoplasia has increased enormously and, particularly in the last 15 years, progress in our understanding of the molecular events associated with lower anogenital tract neoplasia has developed rapidly. Cervical cancer is the second most common type of cancer in women worldwide, after breast cancer. Since 1978 it is known that Human Papillomavirus is closely related to genital neoplasia--cervical, vulva, vagina, penis, anus intraepithelial neoplasia and invasive carcinoma. It is also known that cytologic smear is one of the most important way to diagnose cervical intraepithelial neoplasia and cancer as well, because we can not evaluate cervical lesion visually. Cytologic smear remains the main principle of cancer screening because of its simplicity and accessibility, while colposcopy remains the method of examination in choice, when pathologic cytologic findings are determined.

Adolescent↗
PubMed1960

Carcinoma in situ of the uterine cervix--diagnosis by biopsy.

In 50 cases of carcinoma in situ of the cervix uteri, the lesion was present in the cervical canal in 36 instances, but the squamous epithelium of the portio was involved in only 14 cases. Since single biopsy from the portio or external os may show no malignant change even in cases in which vaginal smears are positive for cancer, single biopsy is indicated only in the presence of gross suspicious lesions. When positive smears have been obtained, cold-knife cone biopsy is indicated (a) whenever gross lesions are not visible on the ectocervix, (b) if carcinoma in situ is found in a biopsy of the external os, in order to determine the presence or absence of invasion, and (c) when there are repeated positive smears and biopsy of the portio has not shown the presence of malignancy. The technique of cone biopsy is given in detail.

Biopsy↗
PubMed1964

THE CYTOLOGY PROGRAM IN BRITISH COLUMBIA. III. MANAGEMENT OF PRECLINICAL CARCINOMA OF THE CERVIX.

Between 1949 and 1961, 200,509 women were examined by routine cervical cytology in the Province of British Columbia. Cone biopsy is done when cytology is suspicious or positive, because the authors believe that proper management can be planned only after step serial sections of an adequate biopsy specimen. If the cone biopsy shows in situ carcinoma or microscopic foci of invasion, total hysterectomy is carried out in most cases. If occult but fully confluent invasion is present, radiotherapy is used. Of 1177 cases of preclinical carcinoma found in this study, 1051 were purely in situ carcinoma; 73 showed, in addition, microscopic foci of invasion; and 53 showed confluent active invasion but had not produced a clinical lesion. Mean age studies of the different groups of preclinical carcinoma support the contention that all are sequential stages of a single disease process. The only instances of recurrent invasive disease or mortality have been in the occult invasive group.

Biopsy↗
PubMed1965

A CERVICAL CYTOLOGY PROGRAM IN GENERAL PRACTICE.

In a six-year period 723 women were examined using cervical cytology smears. Fifteen cancers of the cervix were discovered, including two invasive growths and 13 carcinoma in situ. A careful follow-up was carried out, and the later appearance of cancer was noted in 12 of 41 patients who initially showed only atypical cells. It is recommended that all patients showing "positive" cells (atypical, suspicious, or cancer morphology cells) undergo cone biopsy for definitive histological diagnosis. Target lesions should have punch biopsy. Four cancers were found in 170 obstetrical patients, and it is recommended that this proved high-risk group be screened both prenatally and postnatally. The importance of annual screening of all women over 20 years of age for cancer of the cervix by cytological methods is emphasized.

Adult↗
PubMed2003

Hysterectomy in women with cervical stenosis. Surgical indications and pathology.

OBJECTIVE: To evaluate indications for surgery and final pathology results in patients who underwent hysterectomy with a concurrent diagnosis of cervical stenosis. STUDY DESIGN: Retrospective chart review of 25 women who underwent hysterectomy after diagnosis of cervical stenosis. RESULTS: The average age was 59 years (range, 38-80). Indications for surgery included postmenopausal bleeding in 10 patients, previous dysplasia with inadequate Papanicolaou test follow-up in 4, recurrent high grade squamous intraepithelial lesion in 1, chronic pelvic pain in 5, acute pain in 2, dysfunctional uterine bleeding in 2 and thickened endometrial stripe in 1 patient on tamoxifen. An attempt to obtain an endometrial sample was unsuccessful in 14 patients. Twenty patients had undergone prior gynecologic surgery. The results of final cervical pathologic examination revealed severe cervical dysplasia or carcinoma in situ in 3. Final uterine pathology revealed 1 patient with uterine adenocarcinoma and 19 patients with benign pathology, including endometritis, fibroids, adenomyosis and endometrial hyperplasia. CONCLUSION: The majority of patients with cervical stenosis resulting in inadequate cancer screening and/or symptoms resulting from stenosis will have significant benign pathology (64%), cervical dysplasia (12%) or uterine cancer (4%). For these patients, hysterectomy is a reasonable option.

Adenocarcinoma↗
PubMed2003

[Is the directed biopsy accurate?].

The aim of the present study was to evaluate the diagnostic accuracy of the colposcopically directed biopsy of cytologically signalized women. Retrospectively were analyzed sixty women aged between 20 and 69 (mean 37.4), to whom was performed colposcopically directed biopsy and consequent in the interval of no more than 3 months extended excision (to 30 of them--surgical conisation and to another 30--LLETZ/LEEP). Summarized data shows, that in 47 (78.3%) of them there are coincidence to one degree difference in the histological findings, and of the remain 13 cases--in 4 (6.7%) there are false positive results, and in 9 (15.0%)--false negative. The value of the sensitivity is 83% and of the predictive value of the positive results is 91.7%, which put them in the borders of the good performance of the diagnostic test. The conclusion is that the accuracy of the directed biopsy is determined by the presence or absence of the good correlation between cytological, colposcopical and histological investigation, as the implementation of the excisional biopsies enlarged the possibilities of the diagnostic protocol for the following adequate therapeutic action.

Adult↗
PubMed2003

Borderline ovarian tumors in reproductive-age women. Fertility-sparing surgery and outcome.

OBJECTIVE: To evaluate the fertility and survival outcomes in young women with borderline ovarian tumors treated with fertility-sparing surgery. STUDY DESIGN: From 1985 to 2002, 25 women with borderline ovarian cancers surgically managed with preservation of the uterus and at least a portion of 1 ovary were identified from tumor registry databases at 2 southern California hospitals. Data for analysis were collected from hospital charts, office records and tumor registry files. RESULTS: Twenty-five patients (median age, 29 years) with borderline ovarian tumors, including 10 with stage IA, 3 with stage IC, 1 with stage IIIA and 11 with unstaged disease, underwent fertility-sparing surgery, consisting of unilateral adnexectomy in 19, unilateral adnexectomy with contralateral cystectomy in 5 and unilateral cystectomy in 1. No disease recurred, providing an overall survival of 100%. Fertility status was available on 15 patients 4-157 months after surgery; 6 of them attempted to become pregnant. Five women had successful pregnancies, with a total of 5 live births. One woman underwent assisted reproductive techniques, became pregnant but aborted. The median follow-up was 80 months (range, 4-157). CONCLUSION: Conservative surgery for borderline ovarian tumors should be considered for women in the reproductive age group who desire preservation of fertility.

Adenocarcinoma, Mucinous↗
PubMed2004

[Our experience with the LEEP/LLETZ technique in the diagnostics and treatment of the precancer lesions of the uterine cervix].

The aim of the present study was to asses the possibilities of the LEEP/LLETZ technique at the diagnostics and treatment of the precancer lesions of the uterine cervix. For the period 2000-2004, the study involved 114 women, aged between 17-68 years (mean 38.4) with different grades of cytological, colposcopical and histological abnormalities. The loop electroexcision of the transformation zone or the changed area of the uterine cervix under local anesthesia was performed to all of the patients using the original Cooper Surgical system (USA), followed by histological assessment of the findings. The results obtained show: in 9 women (7.9%) was found normal or other benign epithelium, in 3 (2.6%) histological data of a pure HPV infection, in - 64 CIN I (56.1 %) of which in 28 cases, associated with HPV, in 23 CIN II (20.2%) in 15 with signs of HPV, in 13 CIN III (11.4%) in 7 of the cases with HPV and in 2 (1.8%) microinvasive cancer. More excessive bleeding was presented during the excision at 7 women (6.1%), which was attributed to the pilot step of the introduction of the technique. Coagulation artifacts were presented at 42 women (36.8%), they were significant at 8 (19.1%) of them. Residual disease was found at 7 women (4.9%), all of them with involved margins, but the special attention should receive two cases, one of them with micro invasion up to 750 micron, at the subsequent hysterectomy the residual changes were not found. At the second case the following radical hysterectomy found the residual small cell no keratinized squamous cell cancer with microinvasion up to 3000 micron, without metastases at the regional lymph nodes. The analyses of the morphological findings, as well as the follow-up of the patients support the good possibilities of the LEEP/LLETZ technique at the diagnostics and treatment of the precancer lesions of the uterine cervix. The advantages and failings of this technique are discussed.

Cervix Uteri↗