Cervical Neoplasia Research Articles

Mediating Effect of White Blood Cells and Tobacco Exposure on Cervical Neoplasm Risk Among Taiwanese Women.

Background: Both the high-risk human papillomavirus (HR-HPV) infection and tobacco exposure are significantly associated with cervical neoplasm risk. Immune cells play important roles in carcinogenesis. However, it is still unclear whether immune cells have a mediating effect on the HR-HPV infection and tobacco exposure with cervical neoplasm development. Aim: The aim of this study was to determine how the increased white blood cell (WBC) count affects the relationship between HR-HPV DNA load and tobacco exposure in the development of cervical neoplasia. Methods: A hospital-based case-control study design was conducted with a total of 108 cases of Taiwanese women with ≥ cervical intraepithelial neoplasia (CIN) I confirmed by biopsy, and 222 healthy Taiwanese female subjects with negative findings on a Pap smear were assigned to the control group. The study evaluated HR-HPV status and immune cell counts (WBCs, natural killer (NK) cells) and tobacco exposure by a self-construct questionnaire. Results: Both HR-HPV DNA load and tobacco exposure significantly independently increased cervical neoplasm risk (AORs: 1.28 and 1.42, respectively). Similar significant results were found for WBCs and NK cells, with respective AORs of 1.20 and 1.00. Moreover, increased WBCs (β = 0.04, 95% CI corrected: 0.01-0.07) and tobacco exposure (β = 0.02, 95% CI corrected: 0.01-0.04) mediated the relationship between the high-risk HPV DNA load and cervical neoplasm risk. Conclusions: Elevated WBC count acts as both predictor and mediator in cervical neoplasm development linked to HR-HPV DNA load. Monitoring and maintaining WBC levels within the normal range could be a preventive strategy for cervical neoplasm development.

Serum miRNA Combined With Transvaginal Color Doppler Ultrasound Diagnosis Clinical Research on Cervical Cancer.

To explore clinical value of miRNA-18a, miRNA-130a, and miRNA-92a combined with transvaginal color Doppler ultrasound (TVCDS) in the diagnosis of cervical cancer (CC). One hundred patients with pathologically confirmed CC (CC group), 100 patients with cervical epithelial neoplasia (disease group), and 100 patients with benign uterine lesions (control group) were selected. TVCDS was performed, and the levels of serum miRNA-18a, miRNA-130a, and miRNA-92a were detected. The systolic blood velocity of the cancer group, the disease group, and the control group decreased sequentially, while the resistance index and pulsatility index increased sequentially. The serum miR-18a, miR-130a, miR-92a, and expression levels of the patients' increased sequentially. Multivariate logistic regression analysis showed that age, high-risk human papillomavirus (HR-HPV) infection, menopause, blood flow RI, serum miRNA-18a, miRNA-92a, and miRNA-130a were the influencing factors of CC. The receiver operating characteristic curve showed that the sensitivity, specificity, accuracy, and area under curve of transvaginal Doppler ultrasound in the diagnosis of CC were 86.43%, 88.01%, 84.32%, and 0.913; serum miR-18a were, respectively, 76.56, 81.30, 80.36, and 0.839; serum miR-130a were 77.88%, 76.97%, 78.32%, and 0.0.864; serum miR-92a were 71.04%, 80.39%, 80.74%, and 0.894; 90.33%, 95.14%, 91.25%, and 0.947, the area under curve of the combined detection of the 3 was greater than that of the single detection. Serum miRNA combined with TVCDS has the advantages of it being noninvasive, and having high sensitivity and high specificity in the diagnosis of CC.

The importance of health education in relation to cytopathology testing

The uterine cervix, also known as the cervix, is the lower and narrower part of the uterus, establishing the connection between the vaginal canal and the internal organs of the female reproductive system. This type of cancer is mostly associated with persistent infection by the Human Papillomavirus (HPV) and is the third most common type of cancer among women. The role of the nursing professional is crucial in the process of detecting and diagnosing cervical neoplasia. Nursing actions include advising the population on the importance of regular preventive examinations. The aim of this study is to analyze the importance of health education in the context of the cytopathological examination, exploring the relationship between health education and the performance of this examination. Methodologically, this is an integrative literature review, using the following databases: PUBMED, SCIELO and BVS, using the following descriptors: "cytopathological examination", and "pap smear", "health education", and "patient adherence". A total of 120 articles were found and 11 were selected for analysis based on the inclusion and exclusion criteria. It was concluded that raising awareness about testing is essential and should be done with humanized care and proximity to the woman. Health education is a tool that should be used by the entire multi-professional team. Its benefits include the dissemination of quality information to more people, increased demand for health services, counseling, thus reducing the incidence of cervical cancer, early diagnosis and effective treatment of these patients.

Detection of Multiple HPV Types in Liquid Biopsies of Cervical Neoplasia.

More than 95% of cervical cancers and their precancerous lesions are caused by human papillomavirus (HPV). Cell-free (cf) HPV DNA detection in blood samples may serve as a monitoring tool for cervical cancer. In our methodological study, an HPV panel for simultaneous detection of 24 types using mass spectrometry-based analysis was developed for liquid biopsy approaches and tested on HPV positive cell lines, plasmid controls, and cervical high-grade squamous intraepithelial lesions (HSIL) in positive smear samples (n = 52). It was validated in cfDNA blood samples (n = 40) of cervical cancer patients. The HPV panel showed proficient results in cell lines and viral plasmids with a limit of detection of 1 IU (international units)/µL for HPV16/18 and 10GE/µL for HPV11/31/33/39/45/51/52/58/59 and a specificity of 100% for the tested HPV types. In cervical smear samples, HPV DNA was detected with a sensitivity of 98.14%. The overall agreement between the new HPV panel and clinical records was 97.2% (κ = 0.84). In cervical cancer cfDNA, 26/40 (65.0%) tested positive for any HPV type, with most infections due to hrHPV (24/26). HPV positive samples were found in all FIGO stages, with the highest positivity ratio in FIGO III and IV. Even the lowest stage, FIGO I, had 12/23 (52.2%) patients with a positive HPV plasma status. This proof-of-concept paper shows that the described assay produces reliable results for detecting HPV types in a multiplex mass spectrometry-based assay in cervical smear and cfDNA with high specificity and sensitivity in both cohorts. The assay shows potential for liquid biopsy-based applications in monitoring cervical cancer progression.

Factors Influencing CRP levels in Laparoscopic and Robotic Total Hysterectomy.

Patients with high postoperative C-reactive protein levels are known to have a high risk of complications such as intestinal injuries than those with low levels. However, the factors that influence postoperative C-reactive protein levels in patients without complications are unknown. In this study, we aimed to determine the factors affecting postoperative C-reactive protein levels in patients undergoing laparoscopic and robotic total hysterectomy. We conducted a retrospective cohort study of patients who had undergone laparoscopic or robotic total hysterectomy for uterine fibroids, adenomyosis, or cervical neoplasia. The study was conducted between July 2016 and December 2022 at our hospital. In total, 185 patients underwent laparoscopic or robotic total hysterectomy during the relevant period. Of these, 180 patients were included, excluding 3 who underwent laparotomy, 1 who developed an abscess, and 1 who did not have a postoperative blood draw. The measured outcome was the C-reactive protein level on the first postoperative day. Patient age, body mass index, operative time, blood loss, and uterine weight were deemed the possible influencing factors. Multiple regression analysis was performed to evaluate the influence of these factors on the postoperative C-reactive protein values. Statistical significance was defined as a P value less than .05. The median value was 1.72 (interquartile range, 1.11-2.52). Body mass index and operative time were determined to be the most significant factors. Patients' body mass index and operative time were found to be associated with first postoperative day C-reactive protein levels in uncomplicated cases.

Investigating under-reported human papillomavirus genotypes in Grenadian women through self-sampling for cervical cancer screening.

To compare the adequacy, agreement, and acceptability of Papanicolaou testing (cytology) for cervical cancer screening using self-collected samples compared to physician-collected samples in Grenada in the Caribbean. Furthermore, the study identifies the human papillomavirus (HPV) genotypes present among asymptomatic women testing positive for HPV, the etiologic cause of cervical cancer. Participants were divided into two groups and two cervical samples were collected from the women in each group: a self-collected sample and a physician-collected sample. Cervical specimens were tested for cytology and HPV. HPV genotyping was performed on positive specimens. Self-collected samples were adequate and in agreement with physician-collected samples, showing no difference between the two sampling methods. Oncogenic high-risk HPV genotypes were identified in cervical samples which were positive for atypical squamous cells and low-grade squamous intraepithelial lesions. The high-risk HPV genotypes found, notably HPV 45 and 53, differed from those most commonly reported. Although the commonly reported high-risk genotypes HPV 16 and 18 were found, so were 31, 33, 35, 52, 66, 68, and 82. Using self-collection facilitated the discovery of unexpected HPV genotypes among asymptomatic women in Grenada. These findings add new information to the literature regarding cervical cancer and neoplasia screening and HPV genotypes in the Caribbean. This genotype information may impact surveillance of women with low-grade lesions, HPV vaccine selection, and possibly further vaccine research. Research regarding HPV in Caribbean pathology samples of cervical neoplasia and cancer is needed.

Рак шейки матки во время беременности

Aim. To analyze modern data on the effect of cervical cancer on the body of a pregnant woman, current criteria for its diagnosis, surgical and chemoradiotherapy methods of treatment and possible complications of therapy carried out at different stages of the disease. Key points. In modern obstetrics and gynecologic oncology, much attention is paid to problems diagnosed during pregnancy that significantly increase the risks of complications of gestation and labor. One of the urgent and significant issues is the detection of cervical cancer during pregnancy. Based on the analysis of literature data presented on the topic under study in the databases Meline, Google Scholar and PubMed for 2019-2023, the impact on the body of a pregnant woman of cervical cancer depending on the stage of spread of the process and the beginning of therapy is studied, the methods of diagnosis and treatment of the disease are presented, and the features of its impact the course of pregnancy and the outcome of childbirth. Conclusion. Modern medical science offers new methods of diagnostics and treatment of the most dangerous diseases, including cervical cancer. In the daily practice of gynecologists and oncologists, technologies that were unavailable in the past are being introduced. This allows not only timely detection of cervical malignant neoplasms, but also treatment at all stages of the disease, including during pregnancy. However, today it is impossible to exclude the risk of disease recurrence and lethal outcomes in mother and fetus. Further clinical trials are needed to improve the quality of medical care for women with cervical cancer diagnosed during pregnancy. Key words: cervical cancer, immunosuppression, cervical neoplasia, immunohistochemical typing, colposcopy, hysterectomy.

A Review on the Extraction Process and Therapeutic Activity of Curcumin on Diabetes Mellitus and Cancer

Abstract: Turmeric or Curcuma Longa is a natural product whose medicinal properties have been widely studied and a wide range of therapeutic effects in various diseases, including neurodegenerative, liver, kidney damage, cancer and diabetes have been linked mainly to its curcuminoid content. In recent decades Diabetes has become an alarming global health problem due to the increasing prevalence of diabetes. The people who suffer from this disease and the consequences for them are devastating. In this review article we review the current basic and clinical evidence on the potential of curcumin / curcuminoids for the treatment of diabetes mainly due to its hypoglycemic, antioxidant and anti-inflammatory properties. Action of curcumin or curcuminoids as a hypoglycemic agent or only as a healing aid improve metabolic profile and improve diabetes-related complications such as diabetes nephropathy and cardiopathy are discussed. Interactions between curcumin and conventional antidiabetic drugs could be investigated in the treatment of diabetes Curcumin has also been shown to be a mediator of chemoresistance and radioresistance. Anticancer effects have been observed in a number of clinical trials, mainly a natural chemopreventive agent in colon and pancreatic cancer, cervical neoplasia and Barrett's metaplasia. Something clinical studies in healthy volunteers have shown low bioavailability of curcumin, calling into question the use of curcumin alone food additive Our clinical experience with curcumin and the antimetabolite gemcitabine in patients with advanced pancreatic cancer resulted in an objective response in less than 10% of patients with a small effect on survival. However, the safety of this combination has been proven. The potent antiproliferative effects of curcumin, which interact with multiple intracellular signaling pathways, may enhance the antitumor effects of gemcitabine. The Preclinical data lead to various, but still few, clinical trials (some ongoing) that demonstrated the potential effectiveness of the drug. this treatment as a chemopreventive or chemotherapeutic agent. This review focuses on clinical evidence including our experience with curcumin as a chemopreventive and therapeutic agent and background results in vitro.

Polygenic risk scores for cervical HPV infection, neoplasia and cancer show potential for personalised screening: comparison of two methods

The era of precision medicine requires the achievement of accurate risk assessment. Polygenic risk scores (PRSs) have strong potential for increasing the benefits of nationwide cancer screening programs. The current pool of evidence on the role of a PRS as a risk stratification model in actual practice and implementation is limited. To better understand the impact of possible method-induced variance, we constructed and validated two PRSs for cervical cancer (CC) using the Estonian Biobank female population (691 CC cases and 13,820 controls) and evaluated their utility in predicting incident cervical neoplasia (CIN), cancer, and human papillomavirus (HPV) infection using two methods (LDPred and BayesRR-RC). This study demonstrated that two genetic risk scores were significantly associated with CIN, CC, and HPV infection incidence. Independent of the method, we demonstrated that women with elevated PRS values reached the observed cumulative risk levels of CIN or CC much earlier. Our results indicated that the PRS-based discrimination rules could differ substantially when the PRSs contain similar predictive information. In summary, our analysis indicated that PRSs represent a personalized genetic component that could be an additional tool for cervical cancer risk stratification, and earlier detection of abnormalities provides invaluable information for those at high risk.

Margin status after loop electrosurgical excision procedure (LEEP) and laser excision in patients with high-grade cervical neoplasia

IntroductionEarly management of high-grade cervical intraepithelial neoplasia is one of the key steps in cervical cancer prevention after vaccination and screening. It relies on lesion removal by surgical excision, and the French National Cancer Institute (INCa) in 2016 recommend using a loop electro excision procedure (LEEP). However, the laser excision method seems to be as effective with similar rates of negative excision margins and postoperative clearance of HPV. ObjectiveThe main objective of our study was to compare the laser excision method to LEEP by evaluating the quality of the surgical margins. We also studied factors associated with the status of the margins and the depth of cones. MethodsWe conducted a retrospective unicentric study between 2009 and 2017. ResultsTwo hundred and thirty-one patients were included: 154 laser excisions and 77 LEEP. Negative surgical margin was achieved in 69.5 % of laser excisions and 72.7 % of LEEP (p = 0.649). Concerning factors predicting margin status, only a greater cone depth was associated with negative margins (OR: 0.91 (95 %CI: 0.84, 0.89); p = 0.02). The surgical technique was not found to be associated with the status of the margins (OR: 0.85 (95 %CI: 0.46,1.56); p = 0.61). Concerning factors predicting cone depth, only the LEEP was associated with a shorter cone depth (OR: 0.24 (95 %CI: 0.08, 0.69); p 0.008). Significant results are based on univariate analysis. ConclusionNo difference was found between the two technics concerning the rate of negative margins. However, LEEP seems to be associated with shorter cone depth in this study.

The E6 gene polymorphism of Human papillomavirus 16 in relation to the risk of cervical cancer in Tunisian women

Human papillomavirus type 16 (HPV-16) is the most prevalent HPV type worldwide and in Tunisia and the major carcinogenic HPV type found in cervical precancers and cancers. Previous studies have reported that genetic diversity of HPV16-E6 oncoprotein might be associated with cervical intraepithelial neoplasia progression. In this study we aimed to investigate the prevalence of HPV-16 E6 variants in precancerous lesions in Tunisian population to assess potential correlation with disease severity.Positive HPV cervical samples were obtained from the Laboratory of Anatomy Pathology of Pasteur Institute of Tunis. Cytological study was performed to identify cervical precancerous lesions. HPVs were typed using Reverse Line Hybridization. Only samples with HPV-16 single infection were selected for HP16-E6 genetic diversity investigation. HPV-16 E6 gene amplification was performed by PCR using specific primers and sequenced by Sanger Sequencing. The multiple alignment of generated sequences was performed using MEGAX software. Phylogenetic tree was constructed using Maximum Likehood method. The ternary complex of E6, E6AP and p53 core domain was used to perform in silico point mutations and thermodynamic calculations to assess stability and binding affinity. Genetic analysis of Tunisian E6-HPV16 sequences showed the presence of three lineages: European (A), African (C) and Asian American (D). Interestingly, the EUR variants were identified as the dominant lineage of HPV-16 and HPV-16 E6 350 G (L83V) was the most detected mutation in precancerous lesions. Modelling data showed that African variants induced the largest destabilizing effect on E6 structure and decreasing thereby in the affinity toward E6AP. Therefore, women infected with European variants are associated with low and high intraepithelial lesions.The findings give useful information for personalized decision algorithms of intra-epithelial cervical neoplasia in Tunisian women.

Recent advances in treating female genital human papillomavirus related neoplasms with topical imiquimod.

Human papillomavirus (HPV) encompasses a group of viruses that infect the skin and mucous membranes. In the presence of certain factors, persistent infection with high-risk HPVs can trigger a process of neoplastic transformation. Imiquimod is a topical agent that acts as a Toll-like receptor 7/8 agonist, stimulating the innate and adaptive immune system to exert antitumor and antiviral effects. It has been approved for the treatment of various skin conditions, however, its efficacy and safety in the management of HPV-related-neoplasms of the lower genital tract, such as vulvar, vaginal, and cervical neoplasia, are still under investigation. This review summarizes the current evidence on the use of imiquimod for the treatment of HPV-induced lesions of the female lower genital tract, focusing on its indications, mechanisms of action, outcomes, and predictors of response.

Incidence and survival of gynecologic cancer including cervical, uterine, ovarian, vaginal, vulvar cancer and gestational trophoblastic neoplasia in Korea, 1999-2019: Korea Central Cancer Registry.

To investigate the incidence, trends, and survival rates of all gynecologic cancers using the Korea Central Cancer Registry (KCCR) database from 1999-2019. Gynecologic cancer data were obtained from the KCCR database between 1999 and 2019. Age-standardized incidence rates (ASRs), annual percentage changes, and average annual percentage changes (AAPCs) were calculated. The relative survival rate (RSR) was reported by age group, stage, and 6-year period (I: 1999-2005, II: 2006-2012, III: 2013- 2019). The gynecologic cancer ASRs were 26.2 and 24.9 per 100,000 individuals in 1999 and 2019, respectively. Trends of incidence in gynecologic cancer revealed a decrease in cervical cancer and gestational trophoblastic neoplasia (GTN) with AAPCs of -3.4 and -4.3, respectively. Conversely, the incidence of uterine, ovarian, and vulvar cancers increased with AAPCs of 4.7, 2.3, and 2.1, respectively. AAPC for vaginal cancer showed no change. The 5-year survival rate was highest for GTN (90.5%) and lowest for vaginal cancer (56.6%). An increase in age was correlated with poorer survival rates across all gynecologic cancers, excluding vaginal cancer. For all gynecologic cancer types, the prognosis deteriorates with advancing cancer stages. The RSR of uterine cancer improved consistently across all periods. The ovarian cancer RSR improved more in period III than in periods I or II. Additionally, the vulvar cancer RSR improved more in periods II and III than in period I. In Korea, the incidence of cervical cancer and GTN decreased, whereas the incidence of uterine, ovarian, and vulvar cancer increased from 1999 to 2019. The RSR for uterine, ovarian, and vulvar cancers showed consistent improvements over different periods. Effective screening programs and the adoption of advanced treatments may be necessary to further reduce the burden of gynecologic cancer.

P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV.

The expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV. This is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result defined as strong abnormal nuclear expression in a continuous block segment of cells (at least 10-20 cells). Among the 200 women with CIN2+ randomized to cryotherapy, 160 (80%) had a baseline cervical biopsy specimen available, of whom 94 (59%) were p16-positive. p16 expression at baseline was associated with presence of any one of 14 hrHPV genotypes [Odds Ratio (OR) = 3.2; 95% Confidence Interval (CI), 1.03-9.78], multiple lifetime sexual partners (OR = 1.6; 95% CI, 1.03-2.54) and detectable plasma HIV viral load (>1,000 copies/mL; OR = 1.43; 95% CI, 1.01-2.03). Longer antiretroviral therapy duration (≥2 years) at baseline had lower odds of p16 expression (OR = 0.46; 95% CI, 0.24-0.87) than <2 years of antiretroviral therapy. Fifty-one women had CIN2+ recurrence over 2-years, of whom 33 (65%) were p16-positive at baseline. p16 was not associated with CIN2+ recurrence (Hazard Ratio = 1.35; 95% CI, 0.76-2.40). In this population of women with HIV and CIN2+, 41% of lesions were p16 negative and baseline p16 expression did not predict recurrence of cervical neoplasia during two-year follow up.

Quality of breaking bad news to patients diagnosed with neoplasia of the uterine cervix

ObjectiveLittle is known about the quality of receiving bad news (BN) for women diagnosed with cervical neoplasia. We evaluated adherence to the SPIKES protocol in three cohorts of women with different stages of the disease and treatment modalities.Patients and methodsWe included women with cervical cancer who underwent radical vaginal trachelectomy (RVT group, n = 110), radical hysterectomy or chemo-radiation (HE/RCT group, n = 101), and women with CIN 3 treated by loop excision (CIN group, n = 108). We asked the participants about how they received the bad news delivery in reality and how they would envision an ideal communication process based on the main items of the SPIKES protocol. The participants filled out a questionnaire with 38 items of the Marburg Breaking Bad News (MABBAN) Scale representing the six SPIKES subscales.ResultsOnly 72% of all patients reported being satisfied with their BBN experience. The following factors were considered important by 90% of the patients: an undisturbed atmosphere, taking enough time, coherent explanation of the disease, and the possibility to ask questions. However, the reality of their experiences fell significantly short of their expectations. Asking about the patient’s knowledge of the disease, addressing their concerns, allowing them to show emotions, providing clarity about the change in quality of life, informing them about alternative therapies, and involving them in further planning were also significantly lacking in the actual BBN encounters compared to the patients’ preferences. The experience of RVT patients was more negative compared to the HE/RCT patients (p = 0.036). The CIN patients had an overall satisfactory impression (p < 0.0001).ConclusionThe process of breaking bad news in German women diagnosed with cervical neoplasia requires substantial improvement. The SPIKES protocol can be used as a guideline for enhancement but should be supplemented by incorporating a second consultation as the norm rather than the exception. Continuous monitoring and improvement of the quality of BBN is recommended for all oncologic institutions, utilizing the MABBAN questionnaire as a valuable tool.

Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias

Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias

Efficacy of Loop Electrosurgical Excision Procedure in the Management of Cervical Intraepithelial Neoplasia (CIN) –in A Tertiary Level Hospital

Background: Cervical intraepithelial neoplasia (CIN) is the potentially premalignant transformation and abnormal growth of surface epithelial cells of the cervix. CIN is a precancerous condition and curable. Loop electrosurgical excision procedure (LEEP) is a simple, outpatient procedure of removing the transformation zone of cervix. The aim of our study was to evaluate the efficacy of large loop electrosurgical excision procedure (LEEP) as a treatment procedure for cervical intraepiethelial neoplasia. Methods: This prospective observational study was conducted at Colposcopy clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from June, 2017 to May, 2019. All consecutive patients having colposcopicaly and histopathologicaly proven high grade lesion by colposcopy directed punch biopsy were included in this study. All eligible patients with high grade lesion were underwent LEEP and followed up on 15 days post-procedure, 6 months, 12 months with colposcopy. Results: Sixty (60) cases were undergone LEEP, among them 48 (80%) cases were diagnosed as CIN2 and 12 (20%) cases were CIN3 by colposcopy- directed biopsy. One patient (1.7%) needed hospital admission to controll intra-operative bleeding and in postoperative period 7 (11.7%) patients had mild to moderate post-operative bleeding which was controlled well after application of morsel’s pastes and electro-cautery, one patient (1.7%) had pelvic infection. On 6 months follow-up, in case of CIN2 patients, cure rate was 93.5% (43 of 46) and 1 (2.2%) patient had persistent CIN-2. Patient with persistent CIN2 had re-excision and followed up at 12 month with colposcopy. Among case of CIN-3, the cure rate was 81.8% (9 of 11) and 1 (9.1%) case had CIN2. P-value was 0.244, which was not statistically significant. Overall cure rate on 6 month follow-up was 91.2%. On 12 months follow-up cure rate for CIN2 was 97.8% and for CIN3 was 90.9%. Overall cure rate was 96.5%. P-value was 0.352, which was not statistically significant. Conclusion: Loop electrosurgical excision procedure (LEEP) has a good outcome as a diagnostic and treatment procedure for cervical intraepithelial neoplasia. Bangladesh Medical Res Counc Bull 2023; 49(2): 113-119

Comparison of the Accuracy of Visual Inspection with Acetic Acid, Visual Inspection with Lugol Iodine and coloscope in Screening for Cervical Neoplasia

Comparison of the Accuracy of Visual Inspection with Acetic Acid, Visual Inspection with Lugol Iodine and coloscope in Screening for Cervical Neoplasia

Current approaches in the diagnosis, treatment and prevention of HPV-associated cervical diseases: practical recommendations. A review

Papillomavirus infection is one of the most important infectious diseases of the reproductive system. The genome of human papillomavirus (HPV) transforms the cervical epithelial cells, leading to progressive changes: from cervical epithelial neoplasia to carcinoma in situ and further to invasive cancer. More than 550 000 cases of cervical cancer (CC) are reported yearly. In Russia, the incidence of CC in 2020 decreased for the first time in 20 years, and the average annual rate of increase in incidence was 1.27%. It became possible thanks to the introduction of a new system of diagnosis, treatment, and prevention of cervical cancer, in particular, the introduction of screening and a program of modern methods of diagnosis and treatment. Uniform for all countries, screening cervical diseases aims to diagnose changes in the cervical epithelium that occur due to HPV, which may be silent. Until now, the basis of screening programs was a cytological study (pap-test). Since 2018, most EU countries have switched to primary screening for HPV (HPV test) due to its greater sensitivity compared to the cytological method. No etiopathogenetic methods of HPV therapy have been developed yet. However, numerous studies have described the effective treatment of HPV-associated cervical lesions. It was shown that the most effective is a comprehensive approach involving treatment aimed at abnormal tissues and nonspecific antiviral and immunomodulatory therapy. The basis of the CC prevention strategy, of course, is primary prevention through vaccination. Studies are ongoing on the effectiveness of the new generation of vaccines based on the L2 viral protein and therapeutic vaccines against HPV.

Trichomonas vaginalis infection and risk of cervical neoplasia: A systematic review and meta-analysis.

The evidence in the literature regarding the relationship between Trichomonas vaginalis (TV) infection and cervical neoplasia is conflicting. The main aim of this study was to evaluate the magnitude of the risk of cervical neoplasia associated with TV infection. A meta-analysis of observational studies, which provided raw data on the association of TV infection with cervical neoplasia, was performed. For this aim, we searched scientific databases (PubMed/Medline, Scopus, the Web of Sciences, and Embase) from inception to March 15, 2023. A random-effects model was applied by Stata 17.0 to calculate the pooled and adjusted odds ratios (ORs) with 95% confidence intervals (CI), including subgroup, sensitivity, and cumulative analyses to explore sources of heterogeneity. Of the 2584 records initially identified, 35 eligible studies contributed data for 67,856 women with cervical neoplasia, and 933,697 healthy controls from 14 countries were included. The pooled (2.15; 1.61-2.87; I2 = 87.7%) and adjusted (2.17; 1.82-2.60; I2 = 31.27%) ORs indicated a significant positive association between TV infection and the development of cervical neoplasia. There was no significant change in pooled and adjusted ORs by applying sensitivity and cumulative analyses, indicating the robustness of our findings. The pooled OR was significant in most sub-group analyses. There was no publication bias in the included studies. Our findings indicated that women with a TV infection are at significantly greater risk of cervical neoplasia. Future research, particularly longitudinal and experimental studies, should be done to better understand the various aspects of this association.