Lesions Of Cervix Research Articles

A Case Report: Conservative Treatment Modalities as Loop Electrosurgical Excision Procedure (LEEP) Can Be Used to Treat Precancer Cervix Lesion High Grade Squamous Intraepithelial Lesion (HSIL) or Moderate and Severe Dysplasia (CIN II and III) with Post Coital Bleeding Disorders

Precancer cervix lesion High Grade Squamous Intraepithelial Lesion (HSIL) or moderate and severe Dysplasia (CIN II and III) is cervical Intraepithelial Neoplasia (CIN) which changes cervix epithelial cells without invasive to basalis membrane cells. This change step cervical epithelial cells through high-risk Human Papilloma Virus (HPV) infection such are HPV 16, 18, 31, 33, 34, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, and 70. Precancer cervix lesion HSIL could cause erosion of the cervix and cause post coital bleeding disorders. Loop Electrosurgical Excision Procedure (LEEP) treatment could cure HSIL or moderate and severe dysplasia (CIN II and III). Therefore, it relieves post coital bleeding disorders to the patients. Cervical precancerous lesions High Grade Squamous Intraepithelial Lesion (HSIL) or moderate and severe dysplasia (CIN II and III) are Cervical Intraepithelial Neoplasia (NIS) or Cervical Intraepithelial Neoplasia (CIN) where changes in cervical epithelial cells occur without penetrating the basement membrane. The stages of normal cervical epithelial changes begin with high-risk Human Papilloma Virus (HPV) infection, namely HPV 16, 18, 31, 33, 34, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, and 70 The HSIL cervical precancerous lesion could cause erosion of the cervix and cause complaints of post-coital bleeding disorders. Loop Electrosurgical Excision Procedure (LEEP) therapy could cure HSIL or moderate and severe dysplasia (CIN II and III) which could eliminate post-coitus bleeding disorders that suffered by patients.

Effectiveness of Visual Inspection with Acetic Acid and Cervical Cytology in Early Detection of Precursors of Cervical Cancer in Nepal

Background Cervical cancer ranks as the first, most frequent cancer amongst Nepalese women. This can be prevented through primary prevention and early detection using screening techniques. Though cervical cytology is a standard screening tool in most of the developed countries, it fails to be the screening method of choice in low and middle income countries (LMICs) with limited resources due to financial and technical constraints.
 Objective This study aims at early detection of pre-cancerous lesion in cervix with cervical cytology and visual inspection with acetic acid.
 Method This is a hospital based, descriptive cross-sectional study. It included 104 women attending Obstetrics and Gynecology out-patient department (OPD) in Dhulikhel Hospital. Visual inspection of cervix with acetic acid (VIA) and liquid based cytology (LBC) was performed followed by cervical biopsy for positive VIA, or having abnormal cytology, or having unhealthy appearance of cervix even after treatment.
 Result The incidence of positive VIA and cytology screening was 38.5% and 7.7% respectively. The negative predictive value of VIA and cytology were similar whereas VIA was found to be more sensitive than cytology.
 Conclusion Cytology screening is used as an investigation of choice for screening of cervical cancer. In Nepal, VIA can be a good alternative for early detection of cervical cancer as it is found to be more sensitive than cytology.

The role of topic vaginal products as part of the therapeutic strategy in uterine cervix lesions

It has been widely demonstrated so far that lactobacilli represent probably the most important microorganisms which are developed at the level of the vaginal cavity and which are responsible for the maintenance of an adequate environment and pH at this level. Once the number of these microorganisms decrease the pH value increase leading to the apparition of a basic medium, which favors the development of certain microorganisms such as human papilloma virus. Meanwhile it is widely known that the presence of this virus is associated with an increased risk of developing premalignant and even malignant conditions. The aim of the current paper is to investigate the correlation between the vaginal pH, the risk of human papilloma virus infection and, in the meantime, to explore the possible benefits of local application of Cerviron, a topic, vaginal product which seems to significantly influence the risk of cervical lesions development.

Immunohistochemical expression of P16 and Ki-67 in uterine cervical neoplasms

To study the expression of Ki-67 and p16 in neoplastic lesions of uterine cervix and to evaluate the prognostic significance of tumour differentiation, histological type, stage and grade, depth of tumour invasion and lymphovascular invasion in women with neoplasia of uterine cervix. This study was performed on 50 biopsies and surgically resected specimens of uterine cervix, which were fixed in 10% formalin, processed, paraffin embedded and cut into 3-5 microns thickness, stained with hematoxylin and eosin stains and immunohistochemical staining by p16 and Ki-67 antibodies was performed and studied. Majority of cases of invasive carcinoma cervix were large cell non-keratinizing squamous cell carcinoma, 58 cases (48.2%). Majority of cases of invasive carcinoma cervix were seen in stage 2B, 40 (40.8%) cases followed by stage 3B, 24 (24.4%) cases. Out of 18 cases of large cell non-keratinizing squamous cell carcinoma, 12 (66.7%) showed 3+ positivity for Ki-67. 7 (53.8%) cases of stage 2A showed 3+ positivity, 3 (23.1%) cases each showed 2+ positivity for p16. 7 (36.8%) cases of moderately differentiated SCC showed 3+ positivity, 4 (21.1%) showed 2+ positivity and 5 (26.3%) showed 1+ positivity of Ki-67. Out of 10 stable patients, 4 (40.0%) showed negative p16 immunoexpression and all the 3 cases (100%) with recurrence showed 2+ positivity and 2 (100%) patients with metastasis showed 3+ positivity. Out of 10 stable patients, 6 (60%) showed negative Ki-67 immunoexpression and all the 3 (100%) cases with recurrence showed 3+ positivity and one each (50.0%) patient with metastasis showed 2+ positivity and 3+ positivity. p16 and Ki-67 immunomarkers are useful as a diagnostic and prognostic tool in cases with recurrence and metastasis, helping in early detection of disease progression.

794P Comparative study of effectiveness of Pap smear and visual inspection with acetic acid for screening of premalignant and malignant lesion of cervix in a tertiary care setup

Cervical cancer is one of the leading causes of death for women in developing world and it is a preventable cancer, if precancerous lesions are identified early and treated promptly. India accounts for nearly one-third of the global cervical cancer deaths, with women facing a 1.6% cumulative risk of developing cervical cancer and 1.0% cumulative death risk from cervical cancer. This high incidence of deaths in India is mainly due to its detection in advanced stage. Reduction in mortality of the disease is possible only by effective screening methods which is reachable to peripheries of our country.

Orbital Ameloblastic Carcinoma – Unusual Presentation in A Non-Odontogenic Location

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

Stratified Mucin-Producing Intraepithelial Lesion (SMILE) of the Uterine Cervix: High-Risk HPV Genotype Predominance and p40 Immunophenotype.

Stratified mucin-producing intraepithelial lesion (SMILE) is a rare high-grade cervical precancerous lesion designated a variant of adenocarcinoma in situ (AIS) in the WHO classification. We aimed to determine HPV genotypes, immunohistochemical phenotype and mucin presence in SMILE. Between 2010 and 2018, SMILE was diagnosed in 34 out of 6958 (0.5%) cervical biopsies, in 23 patients. Twenty-six tissue samples from twenty-one patients were available for further analysis, including 13 with SMILE alone, 12 with SIL and/or AIS and one with HSIL, AIS and endocervical adenocarcinoma. HPV genotyping was performed using the Seegene Anyplex II HPV 28 assay. Of the 26 samples, a single HPV genotype was identified in the majority of cases (n = 22), including 12/13 SMILEs associated with SIL/AIS. All but one were high-risk HPV genotypes (23/24; 96.8%). We identified seven different HPV genotypes, the most common being HPV16 (n = 10; 43.5%), HPV18 (n = 8, 34.8%) and HPV 31 (n = 5, 21.7%). All SMILEs showed a strong positive reaction to p16, CK7, CK19 and high Ki67 expression comparable to adjacent HSIL and/or AIS if present. SMILE showed variable mucin presence and p40-positive squamous differentiation suggesting phenotypic diversity in cervical precancerous lesions infected by single HPV.

Meniere’s Disease: Its Possible Cause

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

Evaluation of Pre-malignant Lesions of the Uterine Cervix by Shear Wave Elastography: A New Diagnostic Tool

The objective of the study was to evaluate the difference in the stiffness between a healthy cervix (no pre-invasive lesions [NPILs]) and a cervix with a pre-invasive lesion (PIL). In the PIL group, we determined whether there was a difference in stiffness between the cervix with persistent low-grade lesions (>2 y, LSIL-persistent) and that with high-grade lesions (HSILs). Evaluation was performed using 2-D shear-wave elastography (SWE) in the midsagittal-plane of the uterine cervix (UC) at 0.5 cm (cervical canal, anterior and posterior cervical lips). In this prospective observational study (consecutive series), we evaluated 96 non-pregnant women: a group with PIL (LSIL-persistent, 22 cases; HSIL, 26 cases) with indications for cervical conization (48 cases) and a group without UC pathology (NPIL, 48 cases). Although we did not observe statistically significant differences (SSDs) in epidemiological characteristics, we did find an SSD in the speed and stiffness between the PIL versus NPIL groups at all evaluated depths (speed: 4.1 m/s vs 3.0 m/s, stiffness: 58.6 and 34.5kPa in the PIL and NPIL groups, respectively, p < 0.001). An SSD in speed and stiffness (speed: 4.9 m/s vs. 3.2 m/s, and stiffness: 76.1 and 38.0 kPa) between the HSIL (26 cases) and LSIL-persistent (22 cases) groups, respectively, was also detected (p < 0.001). The area under the curve of speed differentiation between a cervix with HSILs and without lesions was 73.4% (95% confidence interval [CI]: 63.1–83.7), and the best cutoff of speed was 3.25 m/s (sensitivity = 62.5%, 95% CI: 47.3–76.0), with a specificity of 75.5% (95% CI: 60.4–87.1).

Detailed analysis of different risk factors of cervical cancer including HPV infection at different stages of follow up of squamous intraepithelial lesions of cervix (SIL) in rural women

Background: As situation regarding carcinoma cervix is still alarming in rural population of India, the management of HPV infection and other risk factors contributing to the development of cervical cancer might play a great role in checking the incidence of the disease. Methods: Rural cervical cancer screening is in progress since May 2013 in the western rural region of Lucknow through camp approach and till date, follow up is available in 264 of the totals 498 Squamous Intraepithelial Lesions of Cervix (SIL) showing regression (204) and persistence of the lesions (60). The risk factors including HPV infection have been studied in detail at different stages of follow up in these two groups. Results: Number of risk factors as obvious showed decline in the regressed cases with subsequent follow up which was lacking in the persistent group. Individually, young age factor showed decline with subsequent follow up while multiparity has been found prominent risk factors in both the groups at all stages of follow up. It was seen that the regression rate was high in women above the age of 30 years with multiparity. The decrease in number of vaginal discharge and erosion cervix cases was also found associated with regression of SIL. Conclusion: The risk factors can predict the biological behavior of SIL towards the progression or regression of the lesions and lead to the better management of any cancer screening program. This will also reduce the follow up burden and treatment costs and will thus enhance the overall acceptability at rural level.

Novel Personalized Biologic Driven Strategies in Head and Neck Cancers – Empirical Cancer Care Leaping Towards Precision Care

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

Uterine cervical neoplasms mass screening at the University Hospital Centre of Libreville, Gabon: Associated factors with precancerous and cancerous lesions.

The objectives of this study were to identify the associated factors with cancerous and precancerous lesions of cervix. In Africa, the incidence of uterine cervical neoplasms varies from one region to another, where most women with uterine cervical neoplasms are seen at an advanced stage. For this reason, uterine cervical neoplasms mass screening reduces the incidence and mortality due to this disease, similar to what is being done in Europe. A cross-sectional analytical study was conducted. Socio-demographic characteristics, gynaecological-obstetrical history, risk factors, data from visual inspection with acetic acid and visual inspection with Lugol, colposcopy impressions and results of cytological analysis were performed. A simple and multiple regression were performed to establish a statistically significant difference between certain factors and the presence of precancerous or cancerous lesions of uterine cervical. In this study, of 63 women diagnosed histologically, 43 had precancerous lesions and 20 had cancerous lesions. we found that being older than 35, having the first intercourse before 18, having an antecedent of STI, being a widow and using of tobacco were risk factors associated with precancerous lesions (p = 0.013 with OR = 3.44 (1.22-9.73), p = 0.009 with OR = 4.07 (1.69-13.08), p < 0.001 with OR = 3.80 (1.94-7.47), p < 0.001 with OR = 9.77 (3.87-24.70) and p < 0.001 with OR = 5.47 (2.60-11.52)) respectively. Only being older than 45, being a widow and using tobacco were risk factors associated with cancerous lesions (p = 0.021 with OR = 2.01 (1.58-3.56), p = 0.02 with OR = 2.96 (2.10-3.87), p = 0.041 with OR = 1.98 (1.46-2.44)) respectively. Among participants diagnosed with uterine cervical neoplasms, there was a significant association with the STI, marital status and smoking. Despite the integration of the detection of precancerous uterine cervical neoplasms lesions into health facilities in Gabon, uterine cervical neoplasms ranks second among women's cancers in terms of incidence and first in terms of mortality.

Congenital Laryngeal Web in Adult Female: Impromptu &amp; Incidental

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

Ehlers-Danlos Syndrome (EDS) : A Common and often Disregarded Cause of Serious Gastrointestinal Complications in Children and Adults

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

On Recurrence Detection of Squamous Cell Carcinoma of The Head and Neck; A Critical Survey

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

The Migration of a Fish Bone into Posterior Cervical Space

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

TO STUDY THE PATTERN OF VARIOUS CERVICAL LESION

Background: Cancer of the cervix is an increasing health problem and an important cause of mortality in women worldwide. The incidence of cervical cancer arises worldwide.&#x0D; Methods: A retrospective study was conducted in the Department of Pathology, JLN Medical College &amp; Hospital Ajmer.&#x0D; Results: A total of 100 smears were analyzed. Out of which 96.00% smears were satisfactory for evaluation. Out of 96.00% satisfactory smears, 30.00% shows normal smear and 52.00% shows benign cellular changes and 4.00% shows epithelial cells abnormality. 5.00% smears shows Bacterial vaginosis. 45.00% were inflammatory smears.&#x0D; Conclusion: We concluded that cervical cytology by Pap smear is a simple, safe and effective test to detect premalignant and malignant lesions of cervix at an early stage, and thus help the clinicians in early and more efficient management of the patients.&#x0D; Keywords: Pap smear, Cervix, Cytology.

A Giant Ranula: The Rima Oris Lantern – A Catch-All Approach

Flexible endoscopy was used in examination cervix lesion the first was studied by Nishiyama et al was reported the used of endoscopy for diagnosing cervical neoplasms. The second study of K Uchita et al.

Computer-aided diagnostic system based on deep learning for classifying colposcopy images

BackgroundColposcopy is widely used to detect cervical cancer, but developing countries lack the experienced colposcopists necessary for accurate diagnosis. Artificial intelligence (AI) is being widely used in computer-aided diagnosis (CAD) systems. In this study, we developed and validated a CAD model based on deep learning to classify cervical lesions on colposcopy images.MethodsPatient data, including clinical information, colposcopy images, and pathological results, were collected from Qilu Hospital. The study included 15,276 images from 7,530 patients. We performed two tasks in this study: normal cervix (NC) vs. low grade squamous intraepithelial lesion or worse (LSIL+) and high-grade squamous intraepithelial lesion (HSIL)− vs. HSIL+. The residual neural network (ResNet) probability was calculated for each patient to reflect the probability of lesions through a ResNet model. Next, a combination model was constructed by incorporating the ResNet probability and clinical features. We divided the dataset into a training set, validation set, and testing set at a ratio of 7:1:2. Finally, we randomly selected 300 patients from the testing set and compared the results with the diagnosis of a senior colposcopist and a junior colposcopist.ResultsThe model that combines ResNet and clinical features performs better than ResNet alone. In the classification of NC and LSIL+, the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 0.953, 0.886, 0.932, 0.846, 0.838, and 0.936, respectively. In the classification of HSIL− and HSIL+, the AUC, accuracy, sensitivity, specificity, PPV, and NPV were 0.900, 0.807, 0.823, 0.800, 0.618, and 0.920, respectively. In the two classification tasks, the diagnostic performance of the model was determined to be comparable to that of the senior colposcopist and exhibited a stronger diagnostic performance than the junior colposcopist.ConclusionsThe CAD system for cervical lesion diagnosis based on deep learning performs well in the classification of cervical lesions and can provide an objective diagnostic basis for colposcopists.

Abstract 479: mRNA in situ expression of candidate genes for progression risk tissue biomarkers, in premalignant cervical lesions

Abstract Background Comparing the in situ differences in mRNA expression of candidate genes between normal cervical tissue and premalignant lesions, could contribute to detect progression risk biomarkers. Use of RNAscope chromogenic in situ hybridization (CISH) that amplifies specific mRNA signals and detects molecules as points that can be quantified, could help the detection of these biomarkers. Methods A tissue microarray was constructed from cervical samples (conization and histerectomy). Representative areas of normal cervix, low-grade (LSIL), and high-grade squamous intraepithelial lesions (HSIL) were chosen. RNAscope 2.5HD Red HPV-HR18 assay that detect E6/E7 mRNA for eighteen high-risk (HR) HPV genotypes, and RNAscope 2.5HD Red assays to detect mRNA from: KRT16, TMEM45A and RBP1, were performed. The stainings were scored by two pathologist from 0 to 4 in a semi-quantitative analysis based on the average number of dots per cell; mean score values were compared using GraphPad Prism 7.0. A p&amp;lt;0.05 was considered statistically significant. Results A total of 390 cervical tissues cores from 169 patients with mean age 36.08 years (SD ±10.48) were included. Mean mRNA expression of HR-HPV E6/E7, TMEM45A and RBP1 were significantly higher in HSIL compared to LSIL and normal cervix squamous epithelium. KRT16 mRNA expression scores in normal cervix squamous epithelium, LSIL, and HSIL, were not significantly different (Table 1). Conclusions CISH allowed to detect E6/E7 mRNA molecules for eighteen HR-HPV genotypes in routinely processed tissues, and to evaluate the expression of the described candidate genes in their context without destroying the tissue morphology. Identification of differential expression between normal cervical tissue and HSIL supports the possible role of TMEM45A and RBP1 in cervical cancer progression and its potential use as progression risk tissue biomarkers. Table 1.Biomarkers candidate genes expression profiles in normal cervix, LSIL and HSILCISH scoresMean (±SD)95% CINormal cervixLSILHSILp valueHR-HPV E6/E7 mRNAn=640.4098(±0.7611)0.2149-0.6048n=640.4098 (±0.7611)0.2149-0.6048n=1381.294 (±1.189)1.078-1.51&amp;lt;0.0001*TMEM45A mRNAn=761.105 (± 1.322)0.8031-1.407n=691.232 (±1.477)0.8771-1.587n=2381.514(± 1.491)1.264-1.7650.046*RBP1 mRNAn=660.4242(±0.7658)0.236-0.6125n=740.5135 (±0.9826)0.2859-1.159n=1301.3 (±1.186)1.094-1.506&amp;lt;0.0001*KRT16 mRNAn=840.9524(±1.15)0.7028-1.202n=770.8831 (±1.214)0.6076-1.159n=1571.115 (±1.41)0.8924-1.3370.573* Citation Format: Ines Benedetti, Felipe Ruiz, Reinhard Rodríguez. mRNA in situ expression of candidate genes for progression risk tissue biomarkers, in premalignant cervical lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 479.