Premalignant Lesions Of Cervix Research Articles

Evaluation of Sirtuin1 Overexpression by Immunohistochemistry in Cervical Intraepithelial Lesions and Invasive Squamous Cell Carcinoma.

Cervical cancer is one of the most common genital cancers in the woman with approximately half a million new cases per year. Development of invasive squamous cell carcinoma (SCC) is the result of persistent and frequent human papilloma virus infection in premalignant lesions of cervix. Thereby identification of biomarkers that could predict progression of dysplastic mucosa to invasive cancer is of great clinical significance. Overexpression of SIRT1 has been reported to induce tumorogenesis in several organs. We evaluated SIRT1 expression in normal squamous epithelium of cervix, low-grade and high-grade cervical intraepithelial lesions and invasive SCC. A total of 104 cases were selected including 34 low-grade cervical intraepithelial lesions (CINs), 37 high-grade CINs, and 35 cases of invasive SCC. The normal cervical epithelium showed negative or weak SIRT1 positivity only in basal layers. SIRT1 cytoplasmic expression was found in 13 of 34 (38.2%) of low-grade CINs, 31 of 37 (83.8%) of high-grade CINs and all 35 (100%) cases of invasive SCC. Expression between 2 groups of CIN was statistically significant ( P =0.001). Thus, SIRT1 appears to be a promising biomarker for predicting the progression of CIN to invasive SCC.

P16INK4a Expression of Uterine Cervical Biopsy Specimen in SBMCH

Introduction: The cervix is the lower portion of the uterus which connects this organ to the vagina through the endocervical canal. It is divided into the vagina (portiovaginalis) and one that lies above the vaginal vault (supravaginal portion). The outer surface of the portiovaginalis is known as the ectocervix or exocervix and the portion related to the endocervical canal corresponds to the endocervix. Carcinoma cervix accounts for the most common form of cancer by 13% of all the women affected cancers. The P16INK 4a is a tumour suppressor protein which is a CDKN2A gene product, an inhibitor of cyclin dependent kinase (CDK) 4 and 6 which is encoded by tumour suppressor gene INK 4a.
 Objective: The present study is to evaluate the P16INK 4a expression in cervical biopsy specimens and to correlate it with the histopatholgical findings.
 Materials and Methods: Cervical biopsy specimens were processed using rotary microtome and tissue blocks cut in sections of 3-5 μm was taken.
 Results: P16INK4a expression on cervical biopsy specimen showed that those with inflammatory cervical histology, benign lesions of the cervix along with premalignant lesions of cervix are negative for P 16INK4a and all malignant lesions are P 16INK4a positive.
 Conclusion: Hence P16INK4a immunoreactivity may be used for the diagnosis of neoplastic lesions of the cervix. But in our study, only a small size sample was positive. So, P16INK4a is used as one of the valuable markers for diagnosing neoplastic lesions of the cervix.

Cervical Cancer Screening in Pregnancy and Postpartum: A North Indian Hospital Based Prospective Observational Study

Introduction: In India, cervical cancer stands as the 2nd most common female cancer and it is the 2nd most leading cause of deaths in women aged 15 to 44 years. The first visit to the gynecologist for most of the women in India is during pregnancy, thereby making it a fair opportunity for the screening of premalignant and malignant cervical disease. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, AIIMS, Rishikesh, Uttarakhand, India from January 2018 to January 2019. The Pap smear testing of 237 spontaneously conceived antenatal women, aging between 20 to 35 years was performed. The same women were followed up for postnatal testing after 6 weeks of delivery. Results: Out of 237, 8 women were reported positive for pre malignant lesions of cervix in the antenatal testing, 5 cases of ASCUS, 1 case of AGC, 1 case of ASC-H & 1 case of HSIL. In the postnatal Pap smear testing, 37 women were lost to follow-up including 1 case of ASCUS. Postnatal Pap smear testing of the remaining 200 women showed that 193 women who were reported NILM in the antenatal period remained unchanged in the postnatal screening too. Out of the 7 women who tested positive, 4 cases of ASCUS, 1 case of AGC and 1 case of ASC-H showed regression, giving result as NILM in the postnatal screening test. Out of the 7 positive antenatal tests, 1 case which was reported as HSIL in the antenatal screening, remained unchanged in the postnatal period.Conclusion: The study concluded that there is significant regression (p<0.01) of Positive Pap smear findings from antenatal to postnatal period. Hence, it is imperative to repeat Pap smear test in postnatal period.

Comparison of Diagnostic Methods in Detection of Squamous Cell Abnormalities in Iranian Women with Abnormal Pap's Smear Test and Associated Demographic and Issues.

Premalignant lesions of cervix have increased dramatically in recent years. Early diagnosis and management of abnormalities have an effective role in preventing the invasion of the disease and also in timely treatment. This study aimed to compare diagnostic methods in the detectionof squamous cell abnormalities with abnormal Pap smear test. This cross-sectional study was performed on 1000 women with abnormal Pap smears in 2007-2018. Sampling was performed with simple method. All samples were subjected to an immediate assessment of colposcopy and histopathology if suspected. The checklist included demographic information as well as symptoms, cytopathology, colposcopy and histopathology findings. Data analysis was performed using descriptive and statistical analysis (P<0.05). A significant relationship between histopathology and Pap smear findings was found (P=0.009), also there was a significant correlation between histopathology and colposcopy findings (P=0.001). However, there was no significant relationship between clinical symptoms and histopathology findings (p=0.8). Sensitivity , specificity , positive and negative predictive value of Pap smear were 43%, 65.9%, 75.4%, 32.2% and of colposcopy were 74.7%, 39.5%, 75%, 39.1%, and of clinical symptoms were 72.6%, 28.1%, 71.1%, 29.7%, respectively. Pap smear findings have the appropriate diagnostic accuracy in comparison with colposcopy and histopathology findings for screening and diagnosis of squamous intra-epithelial lesions. Also, there was higher sensitivity of colposcopy compared with Pap smear to detect cervical lesions. Therefore, it is advisable to use these methods simultaneously.

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Evaluation of spectrum of cervical lesions by PAP smear in rural medical college

Introduction: Heart of India lies in the rural population and health care systems are reaching many of these rural areas. But still in some of the Indian rural population, measures of health and living standards are low. Rural women are also vulnerable to many risk factors. The incidence of premalignant lesions of cervix may be higher due to these risk factors. Pap smear is the best and economical screening method for detection of cervical premalignant lesions. Objective: To understand the spectrum of lesions and prevalence of precancerous lesion in one of the rural areas in Maharashtra Materials and Methods: All pap smears received in the Department of Pathology, Indian Institute of Medical Science and Research, Warudi, Maharashtra from January 2018 to May 2018 are evaluated and the findings are correlated with age. Results: Out of the 252 cases that were studied, 4.76% of cases (n=12) showed epithelial cell abnormality. 85.7% of cases (n=216) were Negative for Intraepithelial Lesion or Malignancy in which 33.7% cases (n=85) showed inflammation. 8.3% cases (n=21) showed the presence of an organism Conclusion: Pap smear test is the simplest, painless and cost-effective screening tool for cervical cancer. Awareness is needed among the rural population about this gold standard test for cervical cancer screening. Keywords: Awareness, Cervical cytology, Rural population.

A Study on Effectiveness of Pap Smear in Mass Screening of Premalignant Lesions of Cervix

A Study on Effectiveness of Pap Smear in Mass Screening of Premalignant Lesions of Cervix

A Basic Screening Approach for Detection of Premalignant Lesions of Cervix in Rural India: A Prospective Observational Study

A Basic Screening Approach for Detection of Premalignant Lesions of Cervix in Rural India: A Prospective Observational Study

Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000-2012.

Burden of cervical cancer (CC) is highest for women in low- and middle-income countries (LMICs). Human papillomavirus (HPV) is implicated as the necessary cause of CC although a number of other factors aid the long process of CC development. One among them is the presence of reproductive tract infections (RTIs). This study investigated the associations between RTIs and CC from India. This study utilized secondary data from the Cancer Detection Centre of the ICS, Delhi. Data were accessed from MS access database and were analyzed using MS Excel and SPSS 16.0. Multivariate analysis using unconditional logistic regression produced odds ratios (ORs) and 95% confidence intervals (CIs). This study used data from 11,427 women over a period of 2000-2012. Women with RTIs had Candida, Trichomonas vaginalis (TV) or coccoid infections with all having similar prevalence (~4-5%). 9.4% of women had premalignant lesions of cervix; ASCUS was most common (7.9%) followed by LSIL (1.3%). TV was significantly associated with ASCUS, LSIL and all premalignant lesions of cervix (P<0.001). Regression discovered an important association of TV with premalignant lesions of cervix (OR 2.79; 95% CI 2.14, 3.64). Earlier studies have depicted associations between TV and HPV with possible enhancement of HPV virulence due to TV. Lack of awareness and hygiene, and limited access to gynecologists in LMICs lead to frequent and persistent RTIs which aid and abet HPV infection and CC occurrence. These also need to be addressed to reduce CC and RTIs among women in LMICs.

Importance of Colposcopy for screening of Premalignant Lesions of Cervix: An Experience of Tertiary Public Health Hospital in India

Importance of Colposcopy for screening of Premalignant Lesions of Cervix: An Experience of Tertiary Public Health Hospital in India

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AIMS AND OBJECTIVES: To evaluate the potential of VIA & VILI in the screening of preinvasive and invasive lesions in unhealthy cervix and comparing them with colposcopy guided biopsy thereby determining its usefulness in screening. Also to evaluate the correlation of demographic data like age, socioeconomic status, education, residential area, parity, age at marriage, use of various contraceptive methods in premalignant lesions of cervix. METHODS STUDY was conducted on 200 symptomatic and asymptomatic women with abnormal cervices who attended outdoor department of SSMC associated hospital SGMH. All cases were subjected to Pap smear, VIA, VILI and colposcopy, women with premalignant lesion were subjected to directed biopsy from suspicious areas and sent for histopathological examination (HPE). Results of Pap smear, VIA, VILI and colposcopy are compared to HPE report. OBSERVATIONS: On cytology 27.5% of cases had LSIL & HSIL. All were positive by VIA & VILI, of which 80% had dysplasia on biopsy. On colposcopy, incidence of CIN was 38.5%. all were positive on VIA & VILI, out of which, 76.6% were proved dysplastic on colposcopy guided biopsy. VIA when compared with HPR had sensitivity & specificity of 80% & 67% respectively, while that of VILI was found to be 80% & 87% respectively. CONCLUSION: VIA & VILI are simple, inexpensive, low technology test. Both when combined has high sensitivity as well as specificity. This can be practiced by clinicians and paramedics on wide scale. Another advantage is immediate availability of results, so that treatment can be started during same visit.