Objectives: (1) To evaluate the various causes of unhealthycervix in Kashmiri women. (2) To assess the utility of colposcopy and cytology in detecting the various causes of unhealthycervix. (3) To correlate the findings of cytology and colposcopy with each otherand with histopathology. Methodology: 200 women attending gynecology OPD with clinicallyunhealthy cervix were subjected to evaluation by liquid- based cytology, colposcopy and directed biopsyand the findings were noted. Results: Majority of women were in the age group of 30-39 years. Commonest complaint was vaginaldischarge in 50% cases followed by menorrhagia in 19.5% women18% had abnormal discharge in 50% cases followed by menorrhagia in 19.5% women, 18% had abnormal LBC findings with 11% women had LSIL, 5.5% had HSIL, and 1.5% had squamous cellcarcinoma (SCC). 32.5% had abnormal women had LSIL, 5.5% had HSIL, and 1.5% had squamous cell carcinoma (SCC). 32.5% had abnormal colposcopic findings, 21% had low grade lesion and 11.5% had high grade lesion. In our study, on correlating LBC findings with histopathology, out of 8.5% women with ASCUS on LBC, 4% had positive histopathological findings. Out of 5% patients with LSIL on LBC, 3.5% were having positive histopathologicalfindings. Out of 3% patients with HSIL on LBC, 1.5% were positive on histopathological examination. On correlating colposcopic findings with histopathology, 5.5% patients which appeared normal on colposcopic evaluation had dysplasia on histopathology, 15.5% women with low grade lesion on colposcopy had
Neerja B et al, studied evaluation of adjunctive tests for cervical screening in low resource settings and found presenting complaint was vaginal discharge in 80 women, irregular vaginal bleeding in 13 women and post coital bleeding in one woman. Unhealthycervix was seen on speculum examination in 38 women and prevalence of biopsy-confirmed high-grade and low-grade SIL did not differ within the different age groups: three cases of HSIL and one of LSIL were found in the age group of < 40 year and the majority (9/15) of HPV positive women belonged to the age group of < 40 years. 8 Post coital
Background: In present study colposcopic evaluation of unhealthycervix was donr and it’s correlation with Papanicolau smear in screening of Cancer cervix. Objective of present study was to critically evaluate the sensitivity and specificity of PAP smear with that of Colposcopy in screening of Cancer Cervix in women with unhealthycervix. Methods: 100 women with clinically unhealthycervix on naked eye examination and / or abnormal symptoms attending Gynaecology Out patient department in 2 years period were subjected to PAP smear, Colposcopy, biopsies under Colposcopic guidance and findings correlated with Histopatholgy at Govt. Medical college, Aurangabad, Maharashtra. India. The sensitivity and specificity of PAP smear with that of Colposcopy in screening of Cancer Cervix was evaluated.
Background: Cervical cancer, the most common malignancy among Indian women, is the second most common and fifth most fatal cancer in women world‑wide. Aim The study is aimed to determine the risk factors, incidence of cervical malignancy in women with grossly unhealthycervix in a rural population and to get an overview of effectiveness of the existing screening programs. Subjects and Methods: This cross‑sectional prospective pilot study was carried in a tertiary care hospital in a span of 6 months. A total of 300 females with grossly unhealthycervix with suspicions of malignancy, who had never undergone cervical cytology or any other cervical neoplasia screening procedure, were included. Unaided visual inspection with Cusco’s speculum was performed followed by digital examination. Clinical staging was carried out in patients according to International Federation of Gynecology and Obstetrics (FIGO’S) Classification. Cervical punch biopsy was taken under colposcopic guidance and histopathological examinations were done. Data were analyzed using SPSS, version 15.0 (Chicago Illinois, USA) and presented as simple percentages. Results: Among 300 females, 63.4% (190/300) were aged between 40 and 59 years. Nearly, 70.7% were illiterate and 52.6% had monthly family income between Rs. 2,000 and 5,000. Majority was married and 72.7% had parity between 1 and 3 and 58.7% had early marriages. Unaided visual examination of the women showed 62.7% of them had visible growth and 48.7% of them had bleeding erosions. Visible growths along with bleeding erosions were present in 11.3% cases. Histopathological examination of cervical biopsy specimens revealed mild, moderate and severe dysplasia in 14, 22 and 36 cases, respectively. A total of 212 patients had invasive squamous cell carcinoma. Only 16 patients had normal histopathology findings. Nearly, 56.61% had Stage II disease; among them 27 had Stage IIa and 33 had Stage IIb disease, 26 patients had Stage I disease. Stage IIIa and IIIb have been found in 50 and 12 cases respectively. Four cases had cancer extending to urinary bladder and rectum (Stage IVa). Conclusions: Cervical carcinoma not only has a biomedical spectrum, but also has a wide cultural and socio‑economic background. Extensive screening campaigns needs to be implemented with immediate effect to early diagnose cases to decrease the social burden of the disease.
In the present study screening was done in 200 women with abnormal symptoms like excessive white discharge post coital bleeding, post menopausal bleeding etc, women with unhealthycervix, and woman with dysplastic smears, with colposcopy and its results were correlated with pap smear and biopsy to determine the sensitivity and specificity of these methods in detecting CIN. Regarding age distribution, high incidence of CIN was found among the age group of 30-49 years with mean age of 41 years which was seen in 16.7% of cases. Kushtagi and Fernandes, in their study showed the prevalence of CIN was higher in women over 30 years. Vaidya showed in his study that CIN was more prevalent in the age group of >35 years. Shalini et al showed the mean age of patients with cancer cervix was 41 vs 32 in patients with benign pathology in cervix.
All the women in the study underwent a Pap smear on their first visit. 52 (43.33%) out of 120 patients were having normal Pap smear, followed by 50 (41.67%) having inflammatory changes. 9 (7.5%) were having low grade squamous intraepithelial lesions and 8 (6.67%) having high grade squamous intraepithelial lesions and 1 (0.8) patient had squamous cell carcinoma (Table 2). Following Pap smear, all of them had a colposcopic examination. 60 (50%) women out of 120 were having normal colposcopy, followed by 39 (32.5%) having acetowhite changes. 6 (5%) were showing mosaic pattern. 10 (8.33%) had unsatisfactory colposcopy i.e in these women the new SCJ could not be visualized, it was also found that these women had an atrophic cervix on clinical examination along with normal Pap smear find, thus these women were excluded from the study and advised follow-up (Table 3).
Berchuck A , et al(1990) (90) studied about expression of epidermal growth factor receptor and HER-2/ neu in normal and neoplastic cervix , vulva and vagina. They found that in squamous epithelia of the cervix, vulva, and vagina, epidermal growth factor receptor and HER-2/neu both were expressed most strongly by basal keratinocytes. Expression of both of these cell surface molecules decreased as cells underwent differentiation towards the mucosal surface. In contrast, both epidermal growth factor receptor and HER-2/neu were expressed throughout the entire thickness of the epithelium by undifferentiated squamous cells in squamous metaplasia, raised condyloma and carcinoma in situ. Staining of 34 cases of vulval, vaginal, cervical lesions, 33 of these cancers for HER-2/neu was weak, although one patient who presented with distant metastases had strong staining for HER-2/neu.
The HPV life cycle depends on the replication machinery of the host cell and the differentiation of the squamous epi- thelium of the cervix [9,15]. The cycle begins when infec- tious viral particles arrive at the basal layer of the epithelium, where they enter the host cell. In the cells of the basal layer of the epithelium, the virus remains stable within an episome with a low number of copies, making up the virus reservoir [15,16]. Once the infected cells of the basal layer are divided, some migrate towards the superficial layer, lose their ability to divide, and initiate their terminal differentiation, whereas the others remain in the basal layer, self-renewing the population and maintaining the infection. In the external layers of the epithelium, the viral DNA is packed in capsids and the lineage is released to initiate the infection again (Figure 1) [9,10,15,16].
Over the years, several attempts have been made to relate prognosis of carcinoma of the cervix with histological parameters. Majority of the cancers were SCC of the well- differentiated, large cell keratinizing variety in accordance with other local and international studies. [3,9,20,22,23,26,27] There
In conclusion, the results of this study have demonstrated that (i) the proportion of collagen to smooth muscle altered depending on stages of the estrous cycle and suggest that such changes are related to the milieu of ovarian hormones, (ii) a higher proportion of collagen was found in bitches with open-cervix pyometra where the cervix was fully relax and a lower proportion of collagen was found in cases of closed- cervix pyometra where the cervix was tightly closed, indicat- ing different structural function of cervical collagen in dogs with a uterine pathology and (iii) the distribution of cervical GAGs varied among tissue layers of the canine cervix, the stages of the estrous cycle and between open- closed-cervix pyometra. HA, the predominant cervical GAG, may have a role in remodeling collagen and in cervical relaxation via either an increase in the water content of the tissue or by acting in conjunction with tissue cytokines. It is interesting to note that our results suggest that HA is not involved in the patency of the cervix in bitches with pyometra, but that the highly sulfated GAGs (KS and HS) along with cytokines produced by local neutrophils seem to be responsible. ACKNOWLEDGMENTS. The study was supported fi- nancially by the Royal Thai Golden Jubilee (RGJ) Ph.D. program, the Thailand Research Fund, the Project Research Fund and the Research Unit for Obstetrics and Reproduction in Animals at Faculty of Veterinary Science, Chulalongkorn University. The authors thank Em.Prof. RJ Scaramuzzi for assistance on linguistic correction.
Process algebras have been studied over 20 years, and researchers have extended them in some aspects, e.g., PEPA , SPAs , , probabilistic PAs , ,  and so on. Among all of them, there is only one common executing policy: maximum progress. What’s more, this policy is not enough to specify all the situations esp. for unhealthy complex
Due to the rarity of this type of cervical cancer and the absence of prospective studies, no guidelines for treatment have been proposed so far. Thus, most of the patients are treated in a similar way as recommended for squamous cell cancer of the cervix. This aspect was considered in our patient and a radical treatment was performed. The management of the initial stages of the cervical ACC (stages I-II according to International Federation of Gynaecology and Obstetrics classi- fication) involves surgical intervention, and radiotherapy is generally recom- mended as an adjuvant treatment. This recommendation is due to the fact that uterine cervix are considered radiosensitive tumors, and in previously reported cases, even in the early stages, better results were seen with adjuvant radiothera- py compared to surgical treatment alone . The role of chemotherapy as ad- junctive or primary treatment is still undefined, although in some case reports, chemotherapy has been indicated only for recurrent disease . In our case, chemotherapy was used during radiotherapy.
According to Murthy et al the frequency of cancer cervix showed a progressive risk with increasing parity mostly between Para 2 and 3. But our findings contradict with the findings of Murthy et al and in our study the frequency of cancer cervix is more in Para 1 and 2. According to Castenada et al the relative risk of cervical cancer increases with the more number of abortions. This is similar to the results shown by Gandhi et al where one of the patients with advanced stage cancer cervix had six spontaneous abortions. This is well correlated with our study. In our present study there is linear association between the number of abortions and stage of cancer cervix.
Aim: To asses the role of MRI in the accurate staging of cancer cervix compared with the clinical FIGO staging. Patients And Methods: A total number of 37 patients with untreated first diagnosed cervical cancer scheduled for MRI. MRI data were compared to the data of the clinical FIGO stage using our golden standard as referance . Results: Our study revealed that MRI can accurately stage the cervical cancer if compared to the clinical FIGO staging system. Conclusions: Magnetic resonance imaging is the imaging modality of choice for staging the primary cervical tumour, evaluate response to treatment and detect tumour recurrence and potential complications. Adequate patient preparation, protocol optimization and MRI reporting expertise are essential to achieve high diagnostic accuracy.
Carcinoma cervix is an extremely common cancer worldwide and there is every need to prevent and cure it. Several studies done to explore the etiopathogenesis of cervical cancer concluded that HPV is the causative agent and MMPS have a vital role in tissue pathology in cervix. It has also been to some extent substantiated that HPV and MMPS accentuate each other’s actions and raise the damage to the tissues multifold resulting in malignancy. The status of HPV and MMP expression has prognostic implications in carcinoma cervix. Hence a knowledge regarding their association and mode of action would be of great significance and it would also lay a path for the production of new therapeutic agents targeting HPV and MMPs. New research projects have to be conducted with this background.
Our patient was diagnosed as having at least clinical stage IB2 cervical cancer at the time of presentation. From the results shown in Table 1, it seems that PNET of the cervix can happen at any age. In a literature review performed by Snijders-Keilholz et al . , the range of age at diagnosis of the disease was between 21 and 60 years. PNET of the uterine cervix belongs to the Ewing ’ s sarcoma family . Although such tumors usually occur in younger adults, often around the