• Title/Summary/Keyword: Uterine cervix

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Adjuvant Radiotherapy Following Radical Hysterectomy and Bilateral Pelvic Lymph Node Dissection for the Uterine Cervical Cancer : Prognostic Factors and Failure Patterns (근칙적 절제술과 술후 방사선치료를 시행한 자궁경부암 환자의 치료성적, 예루인자와 실패양상)

  • Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.357-367
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    • 1997
  • Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.

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Gene Expression Profiles in Cervical Cancer with Radiation Therapy Alone and Chemo-radiation Therapy (자궁경부암의 방사선치료 및 방사선항암화학 병용치료에 따른 유전자발현 조절양상)

  • Lee Kyu Chan;Kim Meyoung-kon;Kim Jooyoung;Hwang You Jin;Choi Myung Sun;Kim Chul Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.54-65
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    • 2003
  • Purpose : To analyze the gene expression Profiles of uterine ceulcal cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a CDNA microarray. Materials and Methods :Sixteen patients, 8 with squamous ceil carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated w14h concurrent chemo-radiation, were Included in the study. Before the starling of the treatment, tumor biopsies were carried out, and the second time biopsies were peformed after a radiation dose of 16.2$\~$27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were peformed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradlation therapy. The 33P-iabeled CDNAS were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the CDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage, and were exported to Microsoft Excel The data were normalized by the Z transformation, and the comparisons were peformed on the Z-ratio values calculated. Results : The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved In cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, Including G protein coupled receptor kinase 5, were decreased with the Z-ratio values of below -2.0. After the radiation thorapy, most of the genes, with a previously Increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotlde gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in anglogenesis (angiopoietln-2), immune reactions (formyl peptide receptor-iike 1), and DNA repair (CAMP phosphodiesterase) were increased, however, the expression of gene involved In apoptosls (death associated protein kinase) was decreased. Conclusion : The different kinds of genes involved in the development and progression of cervical cancer were identified with the CDNA microarray, and the proposed theory is that the proliferation signal stalls with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are Increased with the increased expression oi Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated 4he evidence of the decreased cancer cell proliferation. There was no sigificant difference in the morphological findings of cell death between the radiation therapy aione and the chemo-radiation groups In the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.

Immunocytochemical Staining for p16 of Atypical Squamous Cells in Cervicovaginal Smear (자궁목질 바른표본에서 비정형 편평세포의 p16에 대한 면역세포화학염색)

  • Kim, Hwal-Woong;Lee, Jong-Sil;Lee, Jeong-Hee;Ko, Gyung-Hyuck
    • The Korean Journal of Cytopathology
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    • v.15 no.1
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    • pp.28-32
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    • 2004
  • It was reported that the main cause of intraepithelial neoplasm and squamous cell carcinoma of the uterine cervix is human papilloma virus infection, and that the expression of p16 is increased in cells infected by human papilloma virus. We performed an immunocytochemical staining for protein p16 in 17 cases of cervocovaginal smears initially diagnosed as atypical squamous cells of undetermined significance, to know whether the staining could help the differentiation of neoplastic cells from reactive atypical cells. Of 17 smears, 6 were diagnosed finally as high grade intraepithelial neoplasm or invasive squamous cell carcinoma by follow-up biopsy and smear, and 5 of the 6 were positive for p16. Three were diagnosed as koilocytosis, and one of them was weakly positive for p16. Eight were diagnosed as reactive atypical cells, and all of them were negative for p16. We thought that immunocytochemical staining of p16 in cervocovaginal smears could help the differentiation of neoplastic cells from reactive atypical cells.

Changes of Sex Hormones and Cervical Mucus in Estrus-synchronized Himalayan Tahrs (Hemitragus jemlahicus) in Non-breeding Season

  • Yong, Hwan-Yul;Kim, Myoung-Ho;Ha, Yong-Hee;Kim, Han-Woong;Kim, Mi-Young;Cho, Dong-Gil;Oh, Chang-Sik;Kim, Doo-Hee;Lim, Yang-Mook;Yoo, Mi-Hyun;Bae, Bok-Soo;Kim, Seung-Dong
    • Journal of Embryo Transfer
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    • v.26 no.3
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    • pp.219-222
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    • 2011
  • Eight female Himalayan tahrs (Hemitragus jemlahicus) were estrus-synchronized, and transcervically inseminated with frozen-thawed semen in September, 2009, about 2 to 3 months earlier than their natural breeding season. Intravaginal progesterone-releasing devices were inserted into vaginas of six Himalayan tahrs on September 7, and the other two on September 8 to suppress luteal function of ovaries. The devices had been placed deep inside the vagina prior to withdrawal on September 23. A day before CIDR removal, a combination of PMSG 400 IU and hCG 200 IU was intramuscularly injected. Forty hours later, frozen-thawed semen was transcervically inseminated. Pregnancy diagnosis was performed 39 days later by analyzing progesterone level of serum. Every treatment was done under anesthesia inducted by xylazine injection. In conclusion, vaginal discharge of cervical mucus, hormonal changes induced by implant-typed or muscularly injectable hormones and widening of cervix enough to insert an insemination gun into uterine body were achieved in non-breeding season. Moreover, the first inseminated Himalayan tahr, 36 hours after CIDR removal was assumed to be pregnant but the fetus may have been lost due to the use of anesthetic drug.

Multifocal kaposiform hemangioendothelioma of soft tissue with bilateral pulmonary involvement in an adolescent

  • Azma, Roxana;Alavi, Samin;Khoddami, Maliheh;Arzanian, Mohammad Taghi;Nourmohammad, Armin;Esteghamati, Sadaf
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.500-504
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    • 2014
  • Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor of intermediate malignancy with resemblance to Kaposi sarcoma. It occurs predominantly in pediatric age groups as a cutaneous lesion with focal infiltration into the adjacent soft tissue and bone. Although visceral involvement is very uncommon, several cases with bone, retroperitoneal, or mediastinal involvement have been described. KHE has been reported to occasionally occur in unusual sites such as the thymus, tonsils, larynx, paranasal sinuses, deltoid muscle, spleen, uterine cervix, thoracic spine, and even the breast. Multifocal KHE is an extremely rare entity with few reports available in the literature, none of which describes pulmonary involvement. Herein, we report a unique case of multifocal KHE in a 13-year-old boy presenting with a huge soft tissue mass in the upper extremity complicated by bilateral pulmonary nodules that developed into large, necrotic tumor masses.

Palliative Radiotherapy (증상완화목적의 방사선치료)

  • Lee, Chang-Geol
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.1-4
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    • 2009
  • The aim of palliative radiotherapy (RT) is to control cancer-related local symptoms with minimal radiation reaction. About one third of all radiation treatments are given with palliative intent. Indications for RT in symptom palliation are as follows: Pain from bone metastasis, pressure symptom from brain and spinal cord, obstruction of bronchus, esophagus, superior vena cava and malignant cancer bleeding from bronchus, urinary tract, uterine cervix and rectum. In hospice palliative care, RT is very effective for symptom palliation and improvement of quality of life without influence on survival.

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Human papilloma virus in oral cancer

  • Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.327-336
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    • 2016
  • Cervical cancer is the second most prevalent cancer among women, and it arises from cells that originate in the cervix uteri. Among several causes of cervical malignancies, infection with some types of human papilloma virus (HPV) is well known to be the greatest cervical cancer risk factor. Over 150 subtypes of HPV have been identified; more than 40 types of HPVs are typically transmitted through sexual contact and infect the anogenital region and oral cavity. The recently introduced vaccine for HPV infection is effective against certain subtypes of HPV that are associated with cervical cancer, genital warts, and some less common cancers, including oropharyngeal cancer. Two HPV vaccines, quadrivalent and bivalent types that use virus-like particles (VLPs), are currently used in the medical commercial market. While the value of HPV vaccination for oral cancer prevention is still controversial, some evidence supports the possibility that HPV vaccination may be effective in reducing the incidence of oral cancer. This paper reviews HPV-related pathogenesis in cancer, covering HPV structure and classification, trends in worldwide applications of HPV vaccines, effectiveness and complications of HPV vaccination, and the relationship of HPV with oral cancer prevalence.

Autophagy in Cervical Cancer: An Emerging Therapeutic Target

  • Pandey, Saumya;Chandravati, Chandravati
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4867-4871
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    • 2012
  • Cervical cancer is a leading cause of morbidity and mortality in women worldwide. Although the human papillomavirus (HPV) is considered the major causative agent of cervical cancer, yet the viral infection alone is not sufficient for cancer progression. The etiopathogenesis of cervical cancer is indeed complex; a precise understanding of the complex cellular/molecular mechanisms underlying the initiation, progression and/or prevention of the uterine cervix is therefore essential. Autophagy is emerging as an important biological mechanism in targeting human cancers, including cervical cancer. Furthermore, autophagy, a process of cytoplasm and cellular organelle degradation in lysosomes, has been implicated in homeostasis. Autophagic flux may vary depending on the cell/tissue type, thereby altering cell fate under stress conditions leading to cell survival and/or cell death. Autophagy may in turn govern tumor metastasis and subsequent carcinogenesis. Inflammation is a known hallmark of cancer. Vascular insufficiency in tumors, including cervical tissue, leads to depletion of glucose and/or oxygen perturbing the osmotic mileu causing extracellular acidosis in the tumor microenvironment that may eventually result in autophagy. Thus, targeted manipulation of complex autophagic signaling may prove to be an innovative strategy in identification of clinically relevant biomarkers in cervical cancer in the near future.

Central Venous Access for Chemoterapy in Patients with Malignant Disease (항암 화학요법을 받는 환자들에서의 중심정맥삽관술)

  • Kim, Uk-Seong;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.483-487
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    • 1993
  • From July 1990 to August 1992,78 Hickman catheters and 22 chemoports were inserted in 98 patients for chemotherapy.We analyzed the clinical data of these patients. The results were as follows: 1]Mean age of patients was 42.8$\pm$1.6[SE] years 2]Male to female ratio was 1.09:1 3]The diseases of the cases were leukemia[66] ,lymphoma[8], stomach cancer[8],uterine cervix cancer[5],ovarian cancer[4],lung cancer[3],aplastic anemia[2],maxillary gland cancer[1],pancreas cancer[1],malignant mesothelioma[1] and multiple myeloma[1] 4]Mean values of preoperative WBC counts,platelet counts,PT and APTT were 31,500$\pm$ 8,132[SE]/mm,104,000$\pm$ 12,200 [SE]/mm,82$\pm$ 1.9[SE]% and 32$\pm$ 0.8[SE] sec,respectively. 5]The average duration of catheter uses was 121.7$\pm$ 17.3[SE]days. 6]The complications were subcutaneous tunnel bleeding or hematoma[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1]. 7]The causes of catheter removal were patient`s death or hopeless discharge[22],completion of treatment[6],subcutaneus hematoma or bleeding[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1].So,we concluded that Hickman catheter and chemoport were useful vascular access for chemotherapy in patients with malignant diseases, with low rate of complication and longterm duration.

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A Clinical Survey of Patients of Pain Clinic (통증치료실 환자의 임상통계적 고찰)

  • Jang, Young-Ho;Lee, Jung-Koo;Cheun, Jae-Kyu;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.103-109
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    • 1995
  • The pain clinic in our institution opened on of June, 1984. since then until December 1994, we have had 1,741 patients who had been treated on an out-patient basis. The patients were analysed retrospectively according to their sex, age, and retrospective disease. There were 969 male(55.7%) and 772 female patients(44.3%) In the age distribution of the patients, the highest incidence was in the forties with 463 patients(26.6%). The second highest age incidence was in the thirties with 357 patients(20.5%), and the third highest age incidence was in the sixties with 341 patients(19.6%). In this figure, there were 203(26.6%) stomach cancer patients, 135(17.7%) cervix and uterine cencer patients, 81(10.6%) colorectal cancer patients, 74(9.7%) hepatoma patients, and 68 (8.9%) pancreatic cancer patients. The patients with non malignant chronic pain numbered 977(56.1%). In this figure, there were low back pain of 188(19.2%), sudden deafness of 17.5%, Buerger's disease of 63(6.5%) and postherpetic neuralgia of 56(5.7%).

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