• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.1
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• pp.94-107
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• 2019

Purpose: To report the effect of Traditional Korean medical treatments on 5 patients with cervical intraepithelial neoplasia with high-risk human papilloma virus (HPV). Methods: The patients were diagnosed with cervical intraepithelial neoplasia with High-Risk human papilloma virus. The patients were treated by Traditional Korean Medicine such as herb medication and fumigation therapy. Results: After 3~6 months treatments, cervical intraepithelial neoplasia grades 1-2 lesions regressed and high-risk HPV infections were not detected. Conclusions: The case report shows that Korean medical treatment can be an effective option for treating lower grade of cervical intraepithelial neoplasia with high-risk human papilloma virus.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.4
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• pp.174-185
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• 2022

Objectives: The purpose of this study is to report the improvement of recurrent cervical intraepithelial neoplasia (CIN) and chief complaint including dysmenorrhea, premenstrual syndrome after Korean medicine treatment. Methods: The patient who diagnosed CIN even after undergoing two times of loop electrosurgical excision procedure (LEEP) and complained dysmenorrhea with premenstrual syndrome was treated by acupuncture, moxibustion and herbal medicine as Ojeok-san-gami-bang along with mistletoe extract injection (Abnobaviscum^®). The effect of treatment was evaluated by the results of liquid based cytology and HPV genotyping. Other symptoms were evaluated according to the patient's subjective complaint. Results: Before the treatment, the result of cytology was low grade squamous intraepithelial lesion and a low-risk group for HPV was detected. At the first examination after treatment, cytology showed negative for intraepithelial lesion or malignancy and the HPV genotyping was negative. The result showed negative findings in 3 consecutive follow-up tests. In addition, the chief complaint and general conditions were improved. Conclusion: This study shows that the recurrent cervical intraepithelial neoplasia (CIN) was improved after the Korean traditional treatment and it can be effective medical alternatives or options for patients receiving mistletoe injection during follow-up.

• Korean Journal of Clinical Laboratory Science
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• v.37 no.3
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• pp.197-206
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• 2005

To determine the correlation between mast cells(MCs) and neoangiogenesis in the growth and progression of cervical cancer, we investigated mast cell density(MCD), microvessel density(MVD) and the expression of vascular epithelial growth factor(VEGF) in cervical intraepithelial neoplasia and invasive suqamous cell carcinoma of the uterine cervix. Forty-five cervical intraepithelial neoplasia(CIN I, II and III), 15 microinvasive carcinomas, 15 invasive squamous cell carcinomas and 20 normal cervical epithelia were included in this study. MCs were stained with anti-c-Kit antibody and alcian blue, microvessels with anti-factor VIII antibody and VEGF with anti-VEGF antibody. The adjacent fields of both normal and neoplastic epithelium were used for counting MCs and microvessels. Computerized image analysis was used to evaluate MCD and MVD. MCD and MVD were the mean numbers per $1mm^2$ counted in 5-10 high and low power fields respectively. In both c-Kit and alcian blue stained sections, MCD progressively increased along the continuum from CIN I to invasive squamous cell carcinoma(p<0.001). MVD increased significantly with cervical neoplasia progression, from CIN to invasive squamous cell carcinoma (p<0.001). In double c-Kit and Factor VIII-stained sections, MCs were mainly present in the areas adjacent to newly formed blood vessels. However, there were no significant differences in MCD and MVD between normal epithelum and CIN I. A strong correlation was also observed between MCD and MVD. In double VEGF and alcian blue-stained sections, VEGF was expressed in only MCs. Strong VEGF-positive MCs were particularly abundant around the tumorous region. Our results suggest that MCs may upregulate neoangiogenesis by VGEF secretion in the development and progression of cervical neoplasia.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3837-3841
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• 2013

Objectives: To analyse HPV integration prevalence and genotype distributions in cervical intraepithelial neoplasia (CIN) in east part of China, furthermore to assess preferential sites for common HPV integrations and provide baseline information for cervical abnormality screening and prevention. Methods: Integration of HPV in 113 paraffin-embedded cervical intraepithelial neoplasia samples was assessed using Gencap technology in Key Laboratory of Biotechnologies in BGI-Shenzhen. Results: 64 samples were HPV-integrated and as the cervical lesions increased, the integration rate became higher significantly (P=0.002). Fifteen different HPV genotypes were detected, 14 high-risk (16, 18, 31, 33, 51, 52, 56, 58, 66, 68) and 1 low-risk (11). The most common genotypes were HPV-16, 58, 33, 52, 66, and 56. Thirteen patients had co-integration involving mainly HPV-16 and 58. The frequency of HPV gene disruption was higher in L1 and E1 genes than in other regions of the viral genomes. Conclusion: Some 56.6% of CIN lesions in Qingdao had HPV integrations, and 67.2% of HPV-integrated patients were HPV-16 and 58, more prone to be integrated in younger patients below 45 years old. There exist preferential sites for HPV-16 and HPV-58 integration, and they are more likely to be disrupted in the L1 and E1 loci.

• Journal of Physiology & Pathology in Korean Medicine
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• v.34 no.3
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• pp.149-158
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• 2020

The positive margins after LEEP(loop electrosurgical excision procedure) in cervical intraepithelial neoplasia are generally considered to be a risk factor for the recurrence or persistence of CIN currently. When positive margin exists, secondary LEEP or hysterectomy is performed. The aim of this study was to observe effects of Traditional Korean Medicine treatment for patients with surgical margin positive after LEEP. It was conducted retrospective chart review for 4 patients with the surgical margin positive after LEEP, who were scheduled to have secondary LEEP 3 months later. Patients were treated with herbal medicine, pharmacopuncture and herbal liquid vaginal treatment. They were followed up by cytology, colposcopy, human papillomavirus DNA test and punch-biopsy at 1, 3 and 6 months. After 3 month of treatment, three patients did not need secondary LEEP because of normal cytology, negative HPV status and normal colposcopy, while the other patient underwent secondary LEEP because of ASCUS cytology and positive high-risk HPV. After 6 month of treatment, the other patient also had normal cytology, negative HPV status and normal colposcopy and had been in fifth week of pregnancy. This study suggest that Traditional Korean Medicine treatment may be an effective to the patients with surgical margin positive after LEEP in cervical intraepithelial neoplasia.

• Biomedical Science Letters
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• v.19 no.4
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• pp.348-352
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• 2013

microRNAs (miRNAs) play pivotal roles in controlling cell proliferation and differentiation. miRNA expression in human is becoming recognized as a new molecular mechanism of carcinogenesis. microRNA-34a (miR-34a), a member of the p53 network, was found to be regulated in multiple types of tumor. The purpose of this study was to define roles of miR-34a expression in cervical intraepithelial neoplasia with human papillomavirus infection, and its relationship with p53 protein expression. This study was performed to analyze expression of miR-34a by using qRT-PCR, and to evaluate p53 protein expression by using immunohistochemistry in 40 cases. Down-regulation of miR-34a expression was detected in 27 (67.5%) out of 40 cases and Immunoreactivity for p53 was found in 17 (42.5%) out of 40 cases. Nineteen (82.6%) of the 23 cases with a negative p53 expression showed a down-regulation miR-34a expression, there was a significant associations between miR-34a and p53 protein expression (P=0.04). These results suggest that miRNA-34a expression tend to be reduced depending on the advanced histologic grade, and down-regulation of miR-34a expression might be associated with inactivation of p53 protein expression by human papillomavirus infection.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.1035-1039
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• 2014

Aim: To evaluate the operative, oncologic and obstetric outcomes of the loop electrosurgical excision procedure (LEEP) in cases with cervical neoplasia. Materials and Methods: A retrospective cohort study was conducted on patients who were suspected of cervical neoplasia and therefore undergoing LEEP at Siriraj Hospital, Mahidol University, Thailand, during 1995-2000. Outcome measures included operative complications in 407 LEEP patients and long-term outcomes in the 248 patients with cervical intraepithelial neoplasia (CIN) who were treated with only LEEP. Results: There were 407 patients undergoing LEEP; their mean age was $39.7{\pm}10.5$ years. The histopathology of LEEP specimens revealed that 89 patients (21.9%) had lesions ${\leq}CIN$ I, 295 patients (72.5%) had CIN II or III, and 23 patients (5.6%) had invasive lesions. Operative complications were found in 15 patients and included bleeding (n=9), and infection (n=7). After diagnostic LEEP, 133 patients underwent hysterectomy as the definite treatment for cervical neoplasia. Of 248 CIN patients who had LEEP only, seven (2.8%) had suffered recurrence after a median of 16 (range 6-93) months; one had CIN I, one had CIN II, and five had CIN III. All of these recurrent patients achieved remission on surgical treatment with re-LEEP (n=6) or simple hysterectomy (n=1). A significant factor affecting recurrent disease was the LEEP margin involved with the lesion (p=0.05). Kaplan-Meier analysis showed 5-year and 10-year disease-free survival (DFS) estimates of 99.9%. Twelve patients became pregnant a total of 14 times, resulting in 12 term deliveries and two miscarriages - one of which was due to an incompetent cervix. Conclusions: LEEP for patients with cervical neoplasia delivers favorable surgical, oncologic and obstetric outcomes.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.85-98
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• 1995

In 1989, the Bethesda System (TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia (CIN) and Papanicolaou Class System, which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade types. TBS recommends a specific format for cytologic report, starling with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studios performed over last 10 years have provided evidence that human papillomavirus (HPV) plays a significant role in the development of cervical neoplasia, TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2411-2414
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• 2016

Purpose: To determine the incidence of high-grade cervical intraepithelial neoplasia (CIN2-3) among patients with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou (Pap) smears. Materials and Methods: One-hundred and eighty-seven patients with ASC-US Pap smears who underwent colposcopy with histological study were enrolled between September 2007 and August 2015. Patient factors (including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners) were obtained. Logistic regression analysis was used to evaluate clinical factors associated with CIN2-3. Results: CIN was diagnosed in 92 of 187 women (49.2%). Sixty-one of these (32.6%) had CIN1 and 31 (16.6%) had CIN2-3. There was no woman who had invasive cancer. There was no correlation of high-grade CIN with factors in this study including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners. Conclusions: Data from this study showed no invasive cervical cancer was found in patients with ASC-US. There was no patient factor associated with high grade intraepithelial neoplasia in patients with ASC-US Pap smears.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.700-707
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• 2005

The purpose of this study was to investigate the implications of dietary intake and the level of serum micronutrients (Se, Mn, Cu, Zn), lipid peroxidation, and antioxidant capacity in Korean women with cervical intraepithelial neoplasia (CIN) . From October 2002 to March 2003, 50 patients diagnosed with CIN (confirmed with colposcopy directed biopsy) and 50 patients without any cervical disease as the control group were enrolled in the study at the Department of Gynecology Cancer Center at Samsung Cheil Hospital. Animal fat intake in CIN group was significantly higher than that of the control group, but plant protein intake in the CIN group was significantly lower than that of the Control group. Energy and zink intakes were similar in the two groups. The serum concentration of antioxidant minerals in the CIN group were not significantly different from the control group. The total radical trapping antioxidant potential concentration of plasma was significantly lower in the CIN group (1.12mM) than in the control group (1.25mM) (p<0.05). But MDA (malondialde-hyde) of serum was significantly higher in the CIN group (7.60mM) than in the control group (4.99mM) (p<0.005). The serum selenium concentration of the control group showed significant positive correlation with the MDA level (r=0.311). These findings are suggestive of protective roles for healthy dietary habit including increasing antioxidant nut-rients and decreasing intake of fat.