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At least 19 recordsLinked to original sources
PubMed2006

Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies.

Tobacco smoking has been classified as a cause of cervical cancer, but the effect of different patterns of smoking on risk is unclear. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 13,541 women with and 23,017 women without cervical carcinoma, from 23 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of carcinoma of the cervix in relation to tobacco smoking were calculated with stratification by study, age, sexual partners, age at first intercourse, oral contraceptive use and parity. Current smokers had a significantly increased risk of squamous cell carcinoma of the cervix compared to never smokers (RR = 1.60 (95% CI: 1.48-1.73), p<0.001). There was increased risk for past smokers also, though to a lesser extent (RR = 1.12 (1.01-1.25)), and there was no clear trend with time since stopping smoking (p-trend = 0.6). There was no association between smoking and adenocarcinoma of the cervix (RR = 0.89 (0.74-1.06) and 0.89 (0.72-1.10) for current and past smokers respectively), and the differences between the RRs for smoking and squamous cell and adenocarcinoma were statistically significant (current smoking p<0.001 and past smoking p = 0.01). In current smokers, the RR of squamous cell carcinoma increased with increasing number of cigarettes smoked per day and also with younger age at starting smoking (p<0.001 for each trend), but not with duration of smoking (p-trend = 0.3). Eight of the studies had tested women for cervical HPV-DNA, and in analyses restricted to women who tested positive, there was a significantly increased risk in current compared to never smokers for squamous cell carcinoma (RR = 1.95 (1.43-2.65)), but not for adenocarcinoma (RR = 1.06 (0.14-7.96)). In summary, smokers are at an increased risk of squamous cell but not of adenocarcinoma of the cervix. The risk of squamous cell carcinoma increases in current smokers with the number of cigarettes smoked per day and with younger age at starting smoking.

Adult↗
PubMed1999

Expression of transglutaminase K in normal cervix tissue and cervix carcinomas.

The localization and expression of transglutaminase K has been investigated immunohistochemically in normal cervix tissue (n = 15) and in cervix carcinomas (n = 23). The distribution of the transglutaminase K was compared with the staining patterns of cytokeratin 10, Ki-67, p53, and oestrogen and progesterone receptors in these tumours. Weak to strong membrane-bound immunoreactivity for transglutaminase K was detected in almost all cervix carcinomas analyzed. The immunostaining was heterogeneous, with visual differences between individual tumour cells. 66.7% of normal cervix tissues revealed no immunoreactivity for the transglutaminase K. In normal cervix tissue, the immunoreactivity was confined to upper cervix layers, predominantly to the superficial and intermediate cell layers. The intensity of both the immunostaining and the number of transglutaminase K-positive cells were upregulated in cervix carcinomas as compared to normal cervix tissue. When the coexpressions of transglutaminase K with markers of proliferation and differentiation were analyzed, no statistically significant correlation was found. Our findings indicate that (1) transglutaminase K is upregulated at the protein level in cervix carcinomas as compared to normal cervix tissue; (2) upregulation of the transglutaminase K in cervix carcinoma is not exclusively induced by alterations of epithelial differentiation or proliferation, but by different, unknown mechanisms; and (3) upregulation of transglutaminase K in cervix carcinomas may play an important role for the regulation of tumour invasive properties by modulating cell-cell interactions.

Biomarkers↗
PubMed1989

Hormonal control of the cervix in pregnant gilts. I. Changes in the physical properties of the cervix correlate temporally with elevated serum levels of estrogen and relaxin.

The time course of changes in the physical properties of both the uterine and vaginal portions of the cervix were studied during the last two thirds (days 40 to approximately 115) of pregnancy in the gilt. To obtain insight concerning the hormonal control of these physical changes, serum levels of relaxin, estrone, 17 beta-estradiol, and progesterone were also determined. Throughout midpregnancy, the extensibility (softness), lumen diameter, and wet weight of the uterine portion of the cervix were less than those of the vaginal portion of the cervix. After day 80, marked and sustained increases in these three physical parameters occurred in the uterine portion of the cervix whereas slight (extensibility) or moderate (lumen diameter and wet weight) increases occurred in the vaginal portion of the cervix. By day 110, extensibility, lumen diameter, and wet weight of the uterine portion of the cervix were similar to those of the vaginal portion of the cervix. Because the uterine portion of the cervix has a relatively firm consistency and small lumen throughout most of pregnancy, we conclude that it probably plays a more important role than the vaginal portion of the cervix in protecting the uterus and its contents during pregnancy. The marked changes in the physical properties of the uterine portion of the cervix are temporally correlated with elevated serum estrogen levels (days 80-100) or estrogen and relaxin levels (day 100 to term). We conclude that estrogen or, more likely, estrogen and relaxin in combination may promote the modifications in the physical properties of the cervix that occur during the last 35 days of gestation.

Animals↗
PubMed1989

Hormonal control of the cervix in pregnant gilts. II. Relaxin promotes changes in the physical properties of the cervix in ovariectomized hormone-treated pregnant gilts.

The effects of relaxin on the physical properties of both the uterine and vaginal portions of the cervix were studied between days 80 and 110 of pregnancy in ovariectomized gilts given progesterone to maintain pregnancy. In controls gilts the extensibility, lumen diameter, and wet weight of the uterine portion of the cervix were less than those of the vaginal portion of the cervix on day 80, but increased thereafter, and by day 110 did not differ (extensibility and wet weight) or approached (lumen diameter) those values of the vaginal portion of the cervix. When gilts were ovariectomized on either days 80 or 100 and given progesterone only (groups OP-100 and OP-110) extensibility, lumen diameter, and wet weight failed to increase in both the uterine and vaginal portions of the cervix. After replacement therapy with progesterone plus relaxin (groups OPR-100 and OPR-110), extensibility, lumen diameter, and wet weight increased to values as least as large as those in control groups in both portions of the cervix. In all groups the uterine portion of the cervix changed more dramatically than the vaginal portion. After hormone replacement therapy, blood levels of relaxin were moderately higher, and blood levels of progesterone were somewhat lower than those in control gilts. There was little or no difference in estrogen levels between ovariectomized and control gilts. We conclude that relaxin plays an important role in promoting increased growth and extensibility in both the uterine and vaginal portions of the cervix after day 80 of gestation in the gilt.

Animals↗
PubMed1993

Hormonal control of the cervix in pregnant gilts. IV. Relaxin promotes changes in the histological characteristics of the cervix that are associated with cervical softening during late pregnancy in gilts.

We recently described relaxin-induced changes that occur in both the physical properties and the biochemical composition of the uterine and vaginal portions of the cervix during the last third of gestation in the gilt. This study employed morphometric analysis to examine both the changes that occur in the histological characteristics of the uterine and vaginal portions of the cervix between days 80 and 110 of pregnancy in intact gilts and the effects of relaxin on these changes in ovariectomized gilts given progesterone to maintain pregnancy. There were four treatment groups: intact day 80 control gilts, sham-ovariectomized day 110 control gilts, ovariectomized progesterone-treated day 110 gilts, and ovariectomized progesterone- plus relaxin-treated day 110 gilts. The histological characteristics of the uterine portion of cervices obtained from intact controls on day 110 differed markedly from those of intact controls on day 80; there was a reduction in the density and organization of collagen fiber bundles, a reduction in the density of smooth muscle fiber bundles, and an increase in amorphous ground substance. The histological characteristics of cervices removed on day 110 from ovariectomized gilts given progesterone only did not differ from those of day 80 controls. After replacement therapy with progesterone plus relaxin, however, the histological characteristics of the cervix on day 110 did not differ from those in intact day 110 controls. Additionally, this study demonstrates that the relaxin-dependent changes are more dramatic in the uterine than in the vaginal portion of the cervix. These findings are consistent with and extend our earlier findings that relaxin-dependent changes in the physical properties and biochemical composition of the uterine portion of the cervix far exceed those in the vaginal portion of the cervix during late pregnancy in the gilt. We conclude that the relaxin-dependent changes in the histological characteristics of the cervix described in this report may contribute at least in part to the cervical softening that occurs during late pregnancy in gilts.

Animals↗
PubMed1996

Head-to-cervix force: an important physiological variable in labour. 1. The temporal relation between head-to-cervix force and intrauterine pressure during labour.

OBJECTIVE: To investigate the relation between the rise in intrauterine pressure and rise in fetal head to cervix force in normal, slow and induced labour. DESIGN: Prospective observational study. SETTING: The labour ward of a London teaching hospital. PARTICIPANTS: Forty patients were recruited from the antenatal clinic and labour ward of a West London Hospital. Five had normal onset and progression of labour, 14 had slow progression of labour and 21 had induced onset of labour. METHOD: Intrauterine pressure and head-to-cervix force was measured simultaneously using an intrauterine pressure catheter and a specially designed four sensor head-to-cervix force probe. RESULTS: For each contraction of each labour, scattergrams of force by pressure were plotted. Three patterns were observed. When the rise in pressure preceded the rise in force, a positive 'loop' was generated. When the rise in pressure and force occurred simultaneously a linear pattern was generated (a neutral 'loop'). When the rise in pressure lags the rise in force, a negative 'loop' was generated. In normally progressive labour the distribution of loops was 29.1%, 22.6% and 48.3%, respectively, in slow labour the distribution was 26.1%, 14.1% and 59.8% and in induced labour the distribution was 33.8%, 14.4% and 51.8%. These distributions were not statistically different. However, a higher proportion of negative loops was observed in labours augmented with oxytocin compared to those receiving no oxytocin (MW-U = 87, P = 0.036). No differences were observed comparing parity, use of PGE2, epidural analgesia, or mode of delivery. Contraction frequency (number/10 minutes) was inversely correlated to the percentage of negative loops (rs = -0.34, P = 0.033) and positively correlated with percentage of positive loops (rs = 0.36, P = 0.027). CONCLUSIONS: This is the first report of the temporal relation between intrauterine pressure and head-to-cervix force in labour. The most common pattern is that the rise in pressure lags the rise in force, suggesting that a seal has to be created between the fetal head and cervix before a rise in pressure can occur. When oxytocin is given in labour, a higher proportion of loops are negative indicating that there is poor application of the fetal head and cervix in a greater proportion of contractions.

Adult↗
PubMed1984

[Plethysmogram of the human uterine cervix in late pregnancy--with special reference to maturation of the cervix].

Plethysmograms of the human pregnant uterine cervix have been recorded to elucidate same facets of the local hemodynamics in terms of the characteristic plethysmographic patterns referable to cervical maturation in late pregnancy. The author has developed a transparent type of transducer by which the plethysmograms have been able to be recorded serially from the entire tissue layer of the cervical wall. With this method, it has also been possible to calibrate quantitatively and to analyze the wave patterns in the same way as with finger tip plethysmography. A monophasic plethysmogram pattern is peculiar to the cervix of non-pregnant women. With the progress of pregnancy, it has been observed frequently that the wave height has become low with fine oscillations in the descending phase of waves. These changes found in late pregnancy have disappeared immediately in the early stage of puerperium. The characteristic patterns of plethysmogram in late pregnancy were classified into four types, A, B, C and D. In late pregnancy, when the cervix reached mature status, types C and D, lower height of waves showing a plateau pattern, with fine oscillations in the descending phase of waves, have been observed frequently. From these observations, it would appear that this characteristic plethysmographic pattern indicates the matured cervix prepared for labor. The plethysmographic changes of pregnant cervix with special reference to the histological characteristics of pregnant cervix have been discussed.

Adult↗
PubMed1989

[Evaluating the cervix in pregnancy using vaginal sonography. Studies of cervix insufficiency].

Transvaginal ultrasound provides important detailed information, which cannot be obtained by routine manual vaginal examination. By measuring the outside-inside distance (from os externum to os internum), we can determine the actual length of the cervix. By depicting the cervical canal, we can identify early dilatation. Visualizing the os internum with a possible opening, forming a conus, helps reveal an incompetent cervix. A total of 485 measurements of the cervix was carried out. Fifty patients with normal clinical findings between 28 and 32 weeks of pregnancy were compared to the same number of patients in the 28th to 32nd week of pregnancy, with the clinical diagnosis of an incompetent cervix. A cervical length of 46.3-39.3 mm was found in normal pregnancies, and a length of 34.0-21.4, when a clinically incompetent cervix had been diagnosed, a difference of 12.3-17.9 mm.

Cervix Uteri↗
PubMed1983

Sonographic appearance of the uterine cervix in pregnancy: the vertical cervix.

The uterine cervix, internal os, and endocervical canal can be accurately identified in pregnant women without distortion when the maternal bladder is empty. The internal os may vary in appearance from a flat to a very slightly funneled shape; a protuberance at the internal os is a variant of normal. In a series of 50 consecutive patients, the cervix was well visualized in 30. With the maternal bladder empty, it was clearly seen in all patients of less than 20 weeks gestation, in 13 of 19 patients at 20-30 weeks gestation, and in three of 17 patients at 30-40 weeks gestation. The mean length of the cervix was 3.25 cm with no difference between primagravida and multigravida patients. When the bladder was partially filled, the mean length of the region of the cervix was 4.6 cm which was significantly greater than with the bladder empty. This suggests that even partial filling of the bladder distorts the appearance of the cervix.

Cervix Uteri↗
PubMed1994

Expression of transforming growth factor-alpha in the normal cervix and in benign and malignant lesions of the uterine cervix.

OBJECTIVE: To investigate the expression and distribution of transforming growth factor-alpha (TGF-alpha) in the normal cervix and in benign and malignant lesions of the uterine cervix. SUBJECTS AND METHODS: Immuno-histochemical reactivity with a monoclonal antibody against TGF-alpha was examined in tissue specimens from 15 normal cervices, six cervical polyps, four cervical condylomata acuminata, 34 cervical intra-epithelial neoplasias, 35 invasive squamous cell carcinomas, five adenocarcinomas, and three mixed adenosquamous carcinomas. RESULTS: Normal squamous cells of the exocervix were found to be negative for TGF-alpha immunoreactivity, whereas reserve cells and metaplastic squamous cells in the transformation zone were positive for TGF-alpha. Although TGF-alpha immuno-reactivity was variable in the cervical condylomas, most cases of cervical intra-epithelial neoplasia with or without koilocytotic atypia were negative for TGF-alpha. In the invasive carcinomas, however, TGF-alpha immuno-reactivity was observed in 17 out of the 35 cases of squamous carcinoma, and in all cases of adeno- and adenosquamous carcinomas. In addition, intense TGF-alpha immuno-reactivity was found in clinically advanced tumours. CONCLUSION: These results suggest that the expression of TGF-alpha is associated with squamous metaplasia in the normal cervix, and that TGF-alpha may play an important role in cervical carcinogenesis, especially in its progression.

Adenocarcinoma↗
PubMed1989

[The use of the cervix brush for early diagnosis of cervix uteri cancer: quality of the smear].

From may 1988 till may 1989, a cervix-brush has been used to take smears by a group of general practitioners involved in a cervical cancer screening program. These smears are compared--retrospectively--with a selection of smears from previous cervical cancer screening programs. The collection devices previously used were an Ayre spatula and an Ayre spatula combined with a cotton tipped swab. All smears have been cytologically examined by the Center for Cancer Prevention of the UIA and have been described using the standardized KOPA-method. 3 Groups of smears have been included in the study: --group 1 (n = 299): use of a cervix-brush --group 2 (n = 1315): use of an Ayre spatula --group 3 (n = 1450): use of an Ayre spatula + cotton tipped swab. Concerning their previous experience in taking smears, all the participating GP's are considered to be comparable. There was a slight difference in the age distribution of the women examined, between group 1 and the other 2 groups. From this study, we concluded: --a larger number of smears from the group using the cervix-brush (group 1) has been described as having "good quality". This result was confirmed after matching for age group. --the number of abnormal smears detected was comparable for all groups.

Female↗
PubMed1998

Local dynamic changes of the cervix associated with incompetent cervix before and after Shirodkar's operation.

A 31-year-old woman, gravida 2 para 1, visited our clinic for routine follow-up at 20 weeks' gestation. Although she had no abdominal pain or pressure, digital vaginal examination revealed dilatation of the internal cervical os of 1.5 cm, and transvaginal sonography demonstrated dynamic changes in the shape of the cervical canal. The patient underwent Shirodkar's operation. Routine postoperative assessment of the cervix with transvaginal sonography showed dynamic dilatation of the upper cervix (above the cerclage), which was accompanied by a sensation of pelvic pressure but no apparent uterine contractions. A healthy male infant weighing 2,980 g was delivered at 38 weeks' gestation.

Adult↗
PubMed1989

Studies of lectin binding to the human cervix uteri: I. Normal cervix.

Lectins of Bauhinia purpurea (BPA), Canavalin ensiformis (Con A), Griffonia simplicifolia I (GS I), Griffonia simplicifolia II (GS II), Maclura pomifera (MPA), Arachis hypogaea (PNA), Glycine max (SBA), Ulex europaeus I (UEA I) and Triticum vulgaris (WGA) were used to evaluate cell surface carbohydrates in formalin-fixed paraffin-embedded tissue sections of normal human cervix uteri. Consistent patterns of staining of the squamous epithelium were obtained in all 30 cases with BPA, GS II, MPA, PNA, SBA and WGA. A variable distribution of lectin binding was seen in squamous epithelium with Con A, GS I and UEA I. The patterns of GS I and GS II binding reflected squamous epithelial maturation. Columnar epithelium did not stain with GS II, stained variably with Con A, and stained consistently with the remaining seven lectins in all cases. No association between lectin binding and blood group or phase of the menstrual cycle was found. These findings may be used as a baseline for evaluation of lectin binding in both preinvasive and invasive lesions of the cervix uteri.

Adult↗
PubMed1989

Endocrine cell hyperplasia of the uterine cervix. A precursor of neuroendocrine carcinoma of the cervix?

A 33-year-old woman who presented with vaginal bleeding was diagnosed to have neuroendocrine small cell carcinoma based on cervical smear and biopsy. Hysterectomy was performed, and a tumor measuring 5.5 X 2 mm was found at the squamocolumnar junction of the uterine cervix. In the immediate vicinity of the tumor, there was proliferation of cytologically benign endocrine cells in the normal endocervical glands and in the glands showing intraepithelial glandular neoplasia. Both the hyperplastic endocrine cells and the invasive tumor cells showed argyrophilia and immunostaining for neuron-specific enolase, neurofilament, and chromogranin. The topographical relationship suggests that endocrine cell hyperplasia may represent a precursor of neuroendocrine carcinoma of the cervix.

Adult↗
PubMed1982

[Birth readiness of the uterine cervix. II. Cervix readiness score and its problems because of the variability of individual criteria].

Cervical ripeness was scored in nulliparous and parous women not in labor at term according to Bishop's pelvic score. The frequency distributions of the scores for the single criteria as well as of the total score reveal the problems of all those scoring systems caused by the grouping process as sequelae of the choice of width of the classes as well as of their limits. E.g. for cervical dilatation in none case 2 or 3 points had been reached and similar findings had to be stated concerning station of the presenting part. An other point of discussion erases from the results of the analysis for linear correlation of the single criteria between each other and between the single criteria and the total score. The total score is mostly influenced by the consistency (r = 0,81 in nulliparous and parous women) and the effacement (r = 0,80 and r = 0,81) of the cervix, whereas for dilatation and station lower correlation coefficients were found. In contrast, when labor had started spontaneously, even if the status of cervix was not advanced, a significant change in the correlative influence of the total score by the single criteria could be stated with high correlation coefficients for dilatation and station and lower one's for consistency and effacement.

Cervix Uteri↗