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1. Samuels SE, Knowles AL, Tilignac T, Debiton E, Madelmont JC, Attaix D: Higher skeletal muscle protein synthesis and lower breakdown after chemotherapy in cachectic mice. Am J Physiol Regul Integr Comp Physiol; 2001 Jul;281(1):R133-9
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  • [Title] Higher skeletal muscle protein synthesis and lower breakdown after chemotherapy in cachectic mice.
  • The influence of cancer cachexia and chemotherapy and subsequent recovery of skeletal muscle protein mass and turnover was investigated in mice.
  • Cancer cachexia was induced using colon 26 adenocarcinoma, which is characteristic of the human condition, and can be cured with 100% efficacy using an experimental nitrosourea, cystemustine (C(6)H(12)CIN(3)O(4)S).
  • Acute cytotoxicity of chemotherapy did not appear to have an important effect on skeletal muscle protein metabolism in either healthy or tumor-bearing mice.
  • Recovery began 2 days after treatment; skeletal muscle mass was only 11% lower than in healthy mice 11 days after chemotherapy.
  • This study showed that skeletal muscle wasted from cancer cachexia and after chemotherapeutic treatment is able to generate a strong anabolic response by making powerful changes to protein synthesis and degradation.
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / metabolism. Animals. Colonic Neoplasms / drug therapy. Colonic Neoplasms / metabolism. Disease Models, Animal. Male. Mice. Mice, Inbred BALB C. Organ Size / drug effects. Phenylalanine / metabolism

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  • (PMID = 11404286.001).
  • [ISSN] 0363-6119
  • [Journal-full-title] American journal of physiology. Regulatory, integrative and comparative physiology
  • [ISO-abbreviation] Am. J. Physiol. Regul. Integr. Comp. Physiol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Muscle Proteins; 0 / Nitrosourea Compounds; 47E5O17Y3R / Phenylalanine; 79955-36-5 / N'-(2-chloroethyl)-N-(2-(methylsulfonyl)ethyl)-N'-nitrosourea
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2. Giraudo E, Inoue M, Hanahan D: An amino-bisphosphonate targets MMP-9-expressing macrophages and angiogenesis to impair cervical carcinogenesis. J Clin Invest; 2004 Sep;114(5):623-33
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  • [Title] An amino-bisphosphonate targets MMP-9-expressing macrophages and angiogenesis to impair cervical carcinogenesis.
  • A mouse model involving the human papillomavirus type-16 oncogenes develops cervical cancers by lesional stages analogous to those in humans.
  • In this study the angiogenic phenotype was characterized, revealing intense angiogenesis in high-grade cervical intraepithelial neoplasias (CIN-3) and carcinomas.
  • ZA therapy increased neoplastic epithelial and endothelial cell apoptosis without affecting hyperproliferation, indicating that ZA was not antimitotic.
  • Given its track record in clinical use with limited toxicity, ZA holds promise as an "unconventional" MMP-9 inhibitor for antiangiogenic therapy of cervical cancer and potentially for additional cancers and other diseases where MMP-9 expression by infiltrating macrophages is evident.
  • [MeSH-major] Cervical Intraepithelial Neoplasia / blood supply. Diphosphonates / pharmacology. Imidazoles / pharmacology. Macrophages / drug effects. Matrix Metalloproteinase Inhibitors. Neovascularization, Pathologic / drug therapy. Uterine Cervical Neoplasms / blood supply
  • [MeSH-minor] Angiogenesis Inhibitors / pharmacology. Animals. Cell Movement / drug effects. Enzyme Activation / drug effects. Female. Humans. Macrophage Activation / drug effects. Matrix Metalloproteinase 9 / metabolism. Mice. Mice, Transgenic. Vascular Endothelial Growth Factors / metabolism

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  • (PMID = 15343380.001).
  • [ISSN] 0021-9738
  • [Journal-full-title] The Journal of clinical investigation
  • [ISO-abbreviation] J. Clin. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Diphosphonates; 0 / Imidazoles; 0 / Matrix Metalloproteinase Inhibitors; 0 / Vascular Endothelial Growth Factors; 6XC1PAD3KF / zoledronic acid; EC 3.4.24.35 / Matrix Metalloproteinase 9
  • [Other-IDs] NLM/ PMC514591
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3. Keefe KA, Schell MJ, Brewer C, McHale M, Brewster W, Chapman JA, Rose GS, McMeeken DS, Lagerberg W, Peng YM, Wilczynski SP, Anton-Culver H, Meyskens FL, Berman ML: A randomized, double blind, Phase III trial using oral beta-carotene supplementation for women with high-grade cervical intraepithelial neoplasia. Cancer Epidemiol Biomarkers Prev; 2001 Oct;10(10):1029-35
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  • [Title] A randomized, double blind, Phase III trial using oral beta-carotene supplementation for women with high-grade cervical intraepithelial neoplasia.
  • To evaluate the effect of daily beta-carotene (30 mg) versus placebo over a 2-year period on cervical intraepithelial neoplasia (CIN) 2 and 3 lesions.
  • Variables that influence the risk of HPV infection and CIN, such as cigarette smoking and sexual behavior, were evaluated.
  • Cervical biopsies were performed before treatment and after 6 and 24 months to evaluate response.
  • Persistence of or progression to CIN 3 resulted in removal from the study, whereas treatment continued for 2 years on all others.
  • The presence and type of HPV was determined by PCR.
  • Response was defined as an improvement in CIN by 2 grades.
  • Mantel-Haenszel chi(2) test was used to analyze response to treatment.
  • Fisher's exact test was used to determine the effect of HPV and CIN grade on response Wilcoxon's rank-sum tests were used to compare micronutrient levels between groups.
  • Twenty-one of 124 enrolled women were not randomized because they either moved, became pregnant, voluntarily withdrew, or the pathological review of their initial cervical biopsies did not confirm CIN 2 or 3.
  • The overall regression rate (32%) was similar between treatment arms and when stratified for CIN grade.
  • CIN regression was negatively correlated with retinol levels.
  • In conclusion, beta-carotene does not enhance the regression of high-grade CIN, especially in HPV-positive subjects.
  • [MeSH-major] Antioxidants / administration & dosage. Cervical Intraepithelial Neoplasia / drug therapy. Uterine Cervical Neoplasms / drug therapy. beta Carotene / administration & dosage
  • [MeSH-minor] Administration, Oral. Adolescent. Adult. Biopsy, Needle. Dietary Supplements. Double-Blind Method. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Logistic Models. Long-Term Care. Middle Aged. Probability. Reference Values. Severity of Illness Index. Treatment Outcome. Vaginal Smears


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4. Follen M, Atkinson EN, Schottenfeld D, Malpica A, West L, Lippman S, Zou C, Hittelman WN, Lotan R, Hong WK: A randomized clinical trial of 4-hydroxyphenylretinamide for high-grade squamous intraepithelial lesions of the cervix. Clin Cancer Res; 2001 Nov;7(11):3356-65
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

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  • [Title] A randomized clinical trial of 4-hydroxyphenylretinamide for high-grade squamous intraepithelial lesions of the cervix.
  • PURPOSE: Previous trials of topical trans-retinoic acid treatment of cervical intraepithelial neoplasia (CIN) grades 2 and 3 led to a statistically significant regression of CIN 2, but not CIN 3.
  • We tested N-(4-hydroxyphenyl)retinamide (4-HPR), a promising oral retinoid that has been shown to induce apoptosis through nonretinoic receptor acid-mediated pathways, for its toxicity and efficacy against CIN 2/3.
  • EXPERIMENTAL DESIGN: In a blinded randomized trial, 4-HPR at 200 mg/day for 6 months (with a 3-day/month drug holiday) was compared with placebo in patients with biopsy-proven CIN-2/3 [high-grade squamous intraepithelial lesions (HGSILs)].
  • When the code was broken because of the poorer outcomes, we discovered that the 4-HPR treatment arm was performing more poorly than was the placebo at 6 and 12 months (25 versus 44% response rates at 6 months; 14 versus 50% at 12 months).
  • CONCLUSIONS: 4-HPR at 200 mg/day with a 3-day/month drug holiday is not active compared with placebo in the treatment of HGSIL.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cervical Intraepithelial Neoplasia / drug therapy. Fenretinide / therapeutic use. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Cheilitis / chemically induced. Cross-Over Studies. Exanthema / chemically induced. Female. Humans. Medical Futility. Patient Compliance. Photosensitivity Disorders / chemically induced. Time Factors. Treatment Outcome

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  • (PMID = 11705848.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 187EJ7QEXL / Fenretinide
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5. Lee SH, Kim MJ, Lee HJ, Kim SJ, Park JS, Hur SY: A case of inguinal lymph node squamous cell carcinoma of unknown origin, accompanied with carcinoma in situ of cervix. J Gynecol Oncol; 2008 Jun;19(2):145-9

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  • [Title] A case of inguinal lymph node squamous cell carcinoma of unknown origin, accompanied with carcinoma in situ of cervix.
  • Several authors have reported poor prognosis of this malignancy, because there is no consensus on diagnostic guidelines and optimal therapy.
  • Historically, chemotherapy has been the cornerstone of treatment for patients with CUP.
  • We experienced a case of inguinal lymph node squamous cell carcinoma of unknown origin, accompanied with carcinoma in situ of the cervix.

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  • (PMID = 19471557.001).
  • [ISSN] 2005-0380
  • [Journal-full-title] Journal of gynecologic oncology
  • [ISO-abbreviation] J Gynecol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2676454
  • [Keywords] NOTNLM ; Inguinal lymph node / Metastatic cancer of unknown primary site
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6. Russomano F, Reis A, Camargo MJ, Grinsztejn B, Tristão MA: Recurrence of cervical intraepithelial neoplasia grades 2 or 3 in HIV-infected women treated by large loop excision of the transformation zone (LLETZ). Sao Paulo Med J; 2008 Jan 2;126(1):17-22
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  • [Title] Recurrence of cervical intraepithelial neoplasia grades 2 or 3 in HIV-infected women treated by large loop excision of the transformation zone (LLETZ).
  • CONTEXT AND OBJECTIVE: Women infected by HIV are more likely to have cervical cancer and its precursors.
  • Treatment of the precursor lesions can prevent this neoplasia.
  • The aim of this study was to assess the likelihood of recurrent cervical intraepithelial neoplasia grades 2 or 3 (CIN 2-3) in HIV-infected women, compared with HIV-negative women, all treated by large loop excision of the transformation zone (LLETZ).
  • DESIGN AND SETTING: A cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF-Fiocruz), Rio de Janeiro.
  • METHOD: 55 HIV-positive and 212 HIV-negative women were followed up after LLETZ for CIN 2-3 (range: 6-133 months).
  • RESULTS: The incidence of recurrent CIN 2-3 was 30.06/10,000 woman-months in the HIV-positive group and 4.88/10,000 woman-months in the HIV-negative group (relative risk, RR = 6.16; 95% confidence interval, CI: 2.07-18.34).
  • We were unable to demonstrate other prognostic factors relating to CIN recurrence, but the use of highly active antiretroviral therapy (HAART) may decrease the risk of this occurrence among HIV patients.
  • CONCLUSION: After LLETZ there is a higher risk of recurrence of CIN 2-3 among HIV-positive women than among HIV-negative women.
  • This higher risk was not influenced by margin status or grade of cervical disease treated.
  • [MeSH-major] Cervical Intraepithelial Neoplasia / surgery. HIV Infections / complications. Neoplasm Recurrence, Local / prevention & control. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antiretroviral Therapy, Highly Active. Brazil / epidemiology. CD4 Lymphocyte Count. Cohort Studies. Colposcopy / methods. Female. Follow-Up Studies. HIV Seropositivity / complications. HIV Seropositivity / drug therapy. HIV Seropositivity / virology. Humans. Middle Aged. Recurrence. Risk Factors. Time Factors. Young Adult


7. Corona Gutierrez CM, Tinoco A, Navarro T, Contreras ML, Cortes RR, Calzado P, Reyes L, Posternak R, Morosoli G, Verde ML, Rosales R: Therapeutic vaccination with MVA E2 can eliminate precancerous lesions (CIN 1, CIN 2, and CIN 3) associated with infection by oncogenic human papillomavirus. Hum Gene Ther; 2004 May;15(5):421-31
International Agency for Research on Cancer - Screening Group. diagnostics - Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers .

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  • [Title] Therapeutic vaccination with MVA E2 can eliminate precancerous lesions (CIN 1, CIN 2, and CIN 3) associated with infection by oncogenic human papillomavirus.
  • Human papillomavirus (HPV) infection is associated with cervical cancer.
  • Cervical cancer is a serious problem in developing countries because it is usually not detected at an early stage.
  • In a phase I/II clinical trial, we evaluated the potential use of the MVA E2 recombinant vaccinia virus to treat cervical intraepithelial neoplasia CIN 1, CIN 2, and CIN 3 lesions associated with human papillomavirus (HPV) infection.
  • Seventy-eight women with CIN 1-, CIN 2-, and CIN 3-grade lesions were treated with either an MVA E2 recombinant virus vaccine or with cryosurgery.
  • The type of immune response after MVA E2 injection was determined by measuring antibody titers against MVA E2 virus and the E2 protein, and by the presence of cytotoxic activity against cancer cells bearing papillomavirus DNA.
  • Thirty-four of 36 patients showed complete elimination of precancerous lesions after treatment with the MVA E2 vaccine.
  • In two patients, precancerous lesions were reduced from grade CIN 3 to CIN 1.
  • Three other patients presented isolated koilocytes after treatment with MVA E2.
  • Colposcopy revealed no lesions in 85% of patients, and only small aceto-white spots were detected in 15% of patients after treatment with MVA E2.
  • All patients developed antibodies against the MVA E2 vaccine, and vaccination generated a specific cytotoxic response against HPV-transformed cells.
  • Furthermore, 50% of patients showed no evidence of papillomavirus after treatment with MVA E2, while the remaining 50% showed persistence of HPV DNA, but at approximately only 10% of the original viral load.
  • Cryosurgery eliminated the lesions of CIN 1 in all patients, but patients so treated did not develop cytotoxic activity against cancer cells.
  • These results show that therapeutic vaccination with MVA E2 vaccine is an excellent prospective means for stimulating the immune system and causing the regression of precancerous CIN 1, CIN 2, and CIN 3 lesions when the vaccine is given locally.
  • [MeSH-major] Cervical Intraepithelial Neoplasia / drug therapy. Uterine Cervical Neoplasms / prevention & control. Vaccines, DNA / therapeutic use. Vaccinia virus / immunology
  • [MeSH-minor] Adult. Cell Transformation, Viral. Colposcopy. Cytotoxicity Tests, Immunologic. Enzyme-Linked Immunosorbent Assay. Female. Humans. Middle Aged. Papillomaviridae / immunology. Papillomavirus Infections / blood. Patient Selection. Treatment Outcome. Viral Load

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  • (PMID = 15144573.001).
  • [ISSN] 1043-0342
  • [Journal-full-title] Human gene therapy
  • [ISO-abbreviation] Hum. Gene Ther.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Vaccines, DNA
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8. Keefe KA, Tadir Y, Tromberg B, Berns M, Osann K, Hashad R, Monk BJ: Photodynamic therapy of high-grade cervical intraepithelial neoplasia with 5-aminolevulinic acid. Lasers Surg Med; 2002;31(4):289-93
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  • [Title] Photodynamic therapy of high-grade cervical intraepithelial neoplasia with 5-aminolevulinic acid.
  • BACKGROUND AND OBJECTIVES: To determine the safety and efficacy of 5-aminolevulinic acid (ALA) as a topically applied photosensitizer for photodynamic therapy (PDT) of cervical intraepithelial neoplasia (CIN).
  • STUDY DESIGNS/MATERIALS AND METHODS: Forty women, who were at least 18 years old with persistent biopsy-proven CIN 2 and CIN 3 within the previous 3 months of enrollment, underwent PDT in a phase I and II design.
  • ALA was placed in a cervical cap fitted to the cervix.
  • Success was defined as the absence of CIN on Pap smear or colposcopic examination at 12-months.
  • Sixty percent had CIN 3 and 40% CIN 2.
  • Three patients progressed from CIN 2 to CIN 3.
  • CONCLUSIONS: PDT at this light and ALA dose is well tolerated but has minimal activity in the treatment of CIN 2 and CIN 3.
  • [MeSH-major] Aminolevulinic Acid / therapeutic use. Cervical Intraepithelial Neoplasia / drug therapy. Photochemotherapy / adverse effects. Photosensitizing Agents / therapeutic use. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Humans. Outcome Assessment (Health Care). Severity of Illness Index. Time Factors

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • (PMID = 12355576.001).
  • [ISSN] 0196-8092
  • [Journal-full-title] Lasers in surgery and medicine
  • [ISO-abbreviation] Lasers Surg Med
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 1K23CA87558; United States / NCI NIH HHS / CA / CA-32248
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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9. Maneo A, Chiari S, Bonazzi C, Mangioni C: Neoadjuvant chemotherapy and conservative surgery for stage IB1 cervical cancer. Gynecol Oncol; 2008 Dec;111(3):438-43
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  • [Title] Neoadjuvant chemotherapy and conservative surgery for stage IB1 cervical cancer.
  • OBJECTIVES: To assess the effectiveness of chemo-surgical conservative therapy for stage IB1 cervical tumors in patients desiring to preserve fertility.
  • METHODS: From 1995 to April 2007 51 nulliparous patients with tumor <or=3 cm, aged <or=40 years with no uterine and lymphnode neoplastic involvement were evaluated.
  • When intraoperative frozen section revealed massive neoplastic cervical persistence a radical total hysterectomy was performed.
  • Adenocarcinoma was present in 12 cases (57%) and indifferentiated neoplasia in 10 (48%).
  • Following neoadjuvant treatment, pathological complete response was observed in 5 cases, in situ or microinvasive residue in 12 and stromal invasion >3 mm in 4.
  • Four women deemed ineligible for conservative surgery after chemotherapy and one refusing to preserve her genital apparatus underwent radical hysterectomy.
  • CONCLUSIONS: The high rate of pathological response confirms the effectiveness of the preoperative treatment for reducing the tumor volume allowing the removal only of a cervical cone instead of the entire cervix with cardinal ligaments as needed by radical trachelectomy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adult. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Conization. Epirubicin / administration & dosage. Epirubicin / adverse effects. Female. Humans. Hysterectomy. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Lymph Node Excision. Neoadjuvant Therapy. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Young Adult


10. Orbell S, Hagger M, Brown V, Tidy J: Appraisal theory and emotional sequelae of first visit to colposcopy following an abnormal cervical screening result. Br J Health Psychol; 2004 Nov;9(Pt 4):533-55
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  • [Title] Appraisal theory and emotional sequelae of first visit to colposcopy following an abnormal cervical screening result.
  • OBJECTIVES: Attendance at colposcopy following an abnormal cervical smear is potentially a highly distressing event.
  • We also compare the psychological sequelae of immediate treatment at first colposcopy (See and Treat, ST) vs. colposcopy with treatment deferred to a later date (Diagnose and Defer, DD).
  • RESULTS: Diagnosis and cognitive appraisals were each significantly associated with emotion, together accounting for between 3 and 15% of variance in different emotions.
  • Women with Cervical Intraepithelial Neoplasia (CIN) 2 or CIN 3 undergoing 'ST' were less anxious, less embarrassed and significantly more relieved compared with a matched sample of women undergoing 'DT', and perceived their first appointment as more motivationally congruent.
  • CONCLUSION: Diagnosis, motivationally incongruent experiences and low emotion-focused coping potential are the most important determinants of anxiety after colposcopy.
  • [MeSH-major] Affect. Attitude to Health. Colposcopy / psychology. Office Visits. Psychological Theory. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / epidemiology
  • [MeSH-minor] Adolescent. Adult. Aged. Cognition. Female. Humans. Middle Aged. Surveys and Questionnaires. Time Factors


11. Andikyan V, Kronschnabl M, Hillemanns M, Wang X, Stepp H, Hillemanns P: [Fluorescence diagnosis with 5-ALA thermogel of cervical intraepithelial neoplasia]. Gynakol Geburtshilfliche Rundsch; 2004 Jan;44(1):31-7
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  • [Title] [Fluorescence diagnosis with 5-ALA thermogel of cervical intraepithelial neoplasia].
  • [Transliterated title] Fluoreszenzdiagnostik mit 5-ALA-Thermogel bei zervikaler intraepithelialer Neoplasie.
  • OBJECTIVE: To study the pharmacokinetics and selectivity of 5-aminolevulinic acid (5-ALA) from 5-ALA thermolabile gel formulation in cervical intraepithelial neoplasia (CIN).
  • The novel thermogel Pluronic F127 is liquid at cold temperatures and turns into a gel-like consistency at body temperature, thereby improving adhesion of 5-ALA to the cervix uteri.
  • METHODS: 27 female patients with CIN 1-3 were included in this study.
  • Thirty minutes to 12 h before conisation, 10 mL of thermo-gel containing either 4, 10, or 20% of 5-ALA were topically applied to the cervix.
  • Biopsies were taken from the lesions as well as normal surrounding epithelial tissue for histological examination, fluorescence microscopy and spectrometry.
  • We observed the higher porphyrin fluorescence intensity within the CIN lesions (1,116 +/- 241 AU), as compared to normal adjacent epithelium (704 +/- 166 AU).
  • Four to six hours after application, porphyrin fluorescence in dysplastic epithelium reached maximal intensity, and tumor selectivity was the highest in CIN 3 achieving a tumor-to-normal ratio of 3.5.
  • CONCLUSIONS: The thermogel Pluronic F127 seems to improve the local cervical drug application.
  • Based on these results, we recommend the application of a 10% 5-ALA thermogel formulation 4-6 h prior to photodynamic therapy in CIN.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Cervical Intraepithelial Neoplasia / diagnosis. Cervical Intraepithelial Neoplasia / drug therapy. Photochemotherapy. Photosensitizing Agents / administration & dosage. Poloxamer. Spectrometry, Fluorescence. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adult. Biopsy. Cervix Uteri / pathology. Conization. Data Interpretation, Statistical. Female. Gels. Humans. Middle Aged. Porphyrins. Time Factors


12. Wang J, Xu J, Chen J, He Q, Xiang L, Huang X, Ding G, Xu S: Successful photodynamic therapy with topical 5-aminolevulinic acid for five cases of cervical intraepithelial neoplasia. Arch Gynecol Obstet; 2010 Sep;282(3):307-12
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  • [Title] Successful photodynamic therapy with topical 5-aminolevulinic acid for five cases of cervical intraepithelial neoplasia.
  • OBJECTIVES: Photodynamic therapy (PDT) is a minimally invasive treatment for cervical intraepithelial neoplasia.
  • The purpose of this study was to assess the feasibility and effectiveness of PDT in patients with CIN and high-risk HPV infection.
  • METHODS: Five patients diagnosed CIN 2 or CIN 3 with human papillomavirus (HPV) infection were included.
  • Each patient had gynecologic examination including cervical cytology, HPV DNA testing, colposcopy and biopsy.
  • Two grams of 5-aminolevulinic acid (ALA) gel (118 mg/g) was topically applied to the cervix and covered with a special plastic cap for 3-4 h, followed by 20 min illumination of both ecto- and endo-cervical canal with red coherent light (wavelength 633 nm) using a PDT laser and a special light catheter.
  • The PDT therapy was repeated with an interval of 1 week.
  • RESULTS: Treatment could be accomplished in all cases and no severe side effect was encountered.
  • All the CIN2 patients had a complete response for 9 months and one CIN3 HPV remained positive for 6 months after three or four treatments.
  • CONCLUSION: PDT seems to be a non-invasive, repeatable procedure for CIN and cervical HPV infection with minimal side effects and can be easily performed on outpatient basis.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Cervical Intraepithelial Neoplasia / drug therapy. Papillomavirus Infections / drug therapy. Photochemotherapy. Photosensitizing Agents / administration & dosage. Uterine Cervical Neoplasms / drug therapy


13. Kiatpongsan S, Niruthisard S, Mutirangura A, Trivijitsilp P, Vasuratna A, Chaithongwongwatthana S, Lertkhachonsuk R: Role of human papillomavirus DNA testing in management of women with atypical squamous cells of undetermined significance. Int J Gynecol Cancer; 2006 Jan-Feb;16(1):262-5
International Agency for Research on Cancer - Screening Group. diagnostics - A practical manual on visual screening for cervical neoplasia .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Role of human papillomavirus DNA testing in management of women with atypical squamous cells of undetermined significance.
  • To find the sensitivity, specificity, and positive and negative predictive values of the high-risk group human papillomavirus (HPV) DNA testing as a triage tool to detect high-grade squamous intraepithelial lesions (HSILs, ie, cervical intraepithelial neoplasia [CIN] 2 or worse) in women with a cytologic smear showing atypical squamous cells of undetermined significance (ASC-US).
  • Cervical cell samplings were done by cervical cytobrush technique and tested for high-risk group HPV with the Hybrid Capture 2 (HC2) test.
  • Then cervicographs were taken before colposcopic-directed cervical biopsies were done.
  • Of the 90 ASC-US cases enrolled, the pathologic results were normal in 30.0%, squamous metaplasia in 16.7%, CIN 1 in 37.8%, CIN 2 in 1.1%, CIN 3 in 11.1%, and microinvasive cervical carcinoma in 3.3%.
  • The prevalence of HSILs and the prevalence of high-risk HPV detection were 15.6% and 38.9%, respectively.
  • Using pathologic results from cervical biopsy as the gold standard, the HC2 has the sensitivity, specificity, and positive and negative predictive values of 85.7%, 69.7%, 34.3%, and 96.4%, respectively, to detect HSILs.
  • High-risk group HPV detection can be used as an additional triage test to detect HSILs in women having ASC-US with high sensitivity and negative predictive value.
  • [MeSH-major] Carcinoma, Squamous Cell / virology. Cervical Intraepithelial Neoplasia / virology. DNA, Viral / analysis. Papillomaviridae / isolation & purification. Uterine Cervical Neoplasms / virology
  • [MeSH-minor] Adolescent. Adult. Biopsy, Needle. Cohort Studies. DNA Probes, HPV. Female. Humans. Immunohistochemistry. Middle Aged. Papillomavirus Infections / diagnosis. Papillomavirus Infections / drug therapy. Risk Assessment. Sensitivity and Specificity. Thailand. Triage

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  • (PMID = 16445642.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA Probes, HPV; 0 / DNA, Viral
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14. Ishiko O, Sumi T, Yoshida H, Ogita S, Yamada R: Expression of apoptosis regulatory proteins in advanced cancer of the uterine cervix after cyclic balloon-occluded arterial infusion chemotherapy. Int J Oncol; 2001 Jun;18(6):1151-5
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  • [Title] Expression of apoptosis regulatory proteins in advanced cancer of the uterine cervix after cyclic balloon-occluded arterial infusion chemotherapy.
  • We have already reported satisfactory therapeutic results of cisplatin-based cyclic balloon-occluded arterial infusion chemotherapy (BOAI) because it enabled advanced cervical cancer of the uterus (cervical cancer) to be treated by simple total hysterectomy (STH).
  • In the present study, we investigated the expression of apoptosis regulatory proteins in advanced cervical cancer treated by cyclic BOAI.
  • The proportion of Bax-positive cells was significantly higher in group C than in group I throughout the treatment period, but there was no significant difference in Bcl-2 expression between the two groups.
  • These results suggest that the antitumor effect of cyclic BOAI is closely associated with apoptotic cell death, which may in part be influenced by the expression of Bax.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Apoptosis. Carcinoma, Squamous Cell / metabolism. Proto-Oncogene Proteins / metabolism. Proto-Oncogene Proteins c-bcl-2 / metabolism. Uterine Cervical Neoplasms / metabolism
  • [MeSH-minor] Aged. Combined Modality Therapy. DNA, Neoplasm / analysis. Female. Humans. Immunoenzyme Techniques. In Situ Nick-End Labeling. Infusions, Intra-Arterial. Middle Aged. Neoplasm Staging. Patient Selection. Survival Rate. bcl-2-Associated X Protein

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  • (PMID = 11351244.001).
  • [ISSN] 1019-6439
  • [Journal-full-title] International journal of oncology
  • [ISO-abbreviation] Int. J. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / BAX protein, human; 0 / DNA, Neoplasm; 0 / Proto-Oncogene Proteins; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / bcl-2-Associated X Protein
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15. Patti G, Nusca A, Chello M, Pasceri V, D'Ambrosio A, Vetrovec GW, Di Sciascio G: Usefulness of statin pretreatment to prevent contrast-induced nephropathy and to improve long-term outcome in patients undergoing percutaneous coronary intervention. Am J Cardiol; 2008 Feb 1;101(3):279-85
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  • Contrast-induced nephropathy (CIN) is an important cause of mortality and morbidity in patients undergoing angiography.
  • This study investigated whether statins decrease incidence of CIN in the setting of percutaneous coronary intervention (PCI) and evaluated the influence of such potential benefit on long-term outcome.
  • Patients were stratified according to preprocedural statin therapy (260 statin treated, 174 statin naive).
  • CIN was defined as a postprocedural increase in serum creatinine of >or=0.5 mg/dl or>25% from baseline.
  • Statin-treated patients had a significantly lower incidence of CIN (3% vs 27%, p<0.0001; 90% risk decrease) and had better postprocedural creatinine clearance (80+/-20 vs 65+/-16 ml/min, p<0.0001).
  • Benefit of statin before treatment was observed in all subgroups, except in patients with a pre-existing creatinine clearance<40 ml/min.
  • During follow-up, CIN was a predictor of poorer outcome; 4-year survival free of major adverse cardiac events was highest in statin-treated patients without CIN (95%, p<or=0.015) and lowest in statin-naive patients with CIN (53%, p<or=0.018).
  • In conclusion, patients receiving statins before PCI have a significant decrease of CIN; this early protective effect translates into better long-term event-free survival.
  • These results may lend further support to utilization of statins as adjuvant pharmacologic therapy before PCI.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Contrast Media / adverse effects. Heptanoic Acids / therapeutic use. Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use. Kidney Diseases / prevention & control. Pyrroles / therapeutic use
  • [MeSH-minor] Aged. Atorvastatin Calcium. Female. Fluorobenzenes / therapeutic use. Humans. Length of Stay. Male. Middle Aged. Multivariate Analysis. Pravastatin / therapeutic use. Preoperative Care. Pyrimidines / therapeutic use. Rosuvastatin Calcium. Simvastatin / therapeutic use. Sulfonamides / therapeutic use

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  • (PMID = 18237585.001).
  • [ISSN] 0002-9149
  • [Journal-full-title] The American journal of cardiology
  • [ISO-abbreviation] Am. J. Cardiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Fluorobenzenes; 0 / Heptanoic Acids; 0 / Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0 / Pyrimidines; 0 / Pyrroles; 0 / Sulfonamides; 48A5M73Z4Q / Atorvastatin Calcium; 83MVU38M7Q / Rosuvastatin Calcium; AGG2FN16EV / Simvastatin; KXO2KT9N0G / Pravastatin
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16. Nyman U, Björk J, Aspelin P, Marenzi G: Contrast medium dose-to-GFR ratio: a measure of systemic exposure to predict contrast-induced nephropathy after percutaneous coronary intervention. Acta Radiol; 2008 Jul;49(6):658-67
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  • BACKGROUND: The contrast medium (CM) dose-to-eGFR (estimated glomerular filtration rate) ratio has recently been advocated to express systemic exposure to CM in assessing the risk of contrast medium-induced nephropathy (CIN).
  • PURPOSE: To evaluate how CIN risk might vary with decreasing eGFR at fixed CM-dose/eGFR ratios and other CIN risk factors, and to find a relatively safe CM-dose/eGFR ratio.
  • CM dose (grams iodine; g I), eGFR (ml/min), and preprocedural CIN risk factors were entered into a multiple logistic regression model.
  • From the established statistical model, the probability of CIN (>or=44.2 micromol/l serum creatinine rise or oliguria/anuria) was calculated at various eGFR levels based on g-I/eGFR ratios of 1:2, 1:1, 2:1, and 3:1.
  • RESULTS: At a g-I/eGFR ratio <1 the risk of CIN was 3%, while it was 25% at a g-I/eGFR ratio >or=1.
  • Independent predictors of CIN were CM dose, eGFR, left ventricular ejection fraction (LVEF) and cardiogenic shock (ROC area =0.87).
  • An estimated CIN risk of 10% would for example occur at a g-I/eGFR ratio of 1.5:1 in patients with 50% LVEF without shock.
  • At a 1:2, 1:1, 2:1, and 3:1 g-I/eGFR ratio with 50% LVEF without shock, the CIN risk was about 2, 6, 18, and 30%, respectively, over a wide range of eGFR values (30-90 ml/min).
  • At a 1:1 g-I/eGFR ratio with 50% LVEF+shock, 25% LVEF without shock, or 25% LVEF+shock, the CIN risk was 20, 55, and 80%, respectively.
  • CONCLUSION: Relating CM dose to eGFR appears to be an attractive pharmacotoxic model to assess CIN risk.
  • At fixed CM-dose/eGFR ratios, CIN risk increased marginally with decreasing eGFR.
  • Limiting the CM dose in g I numerically to the eGFR value in ml/min or less may be relatively safe with regard to CIN, unless multiple risk factors are present.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Contrast Media / administration & dosage. Contrast Media / adverse effects. Glomerular Filtration Rate / drug effects. Renal Insufficiency / chemically induced
  • [MeSH-minor] Acute Kidney Injury / chemically induced. Adult. Aged. Aged, 80 and over. Biomarkers / blood. Creatinine / blood. Dose-Response Relationship, Drug. Female. Humans. Male. Middle Aged. Models, Statistical. Myocardial Infarction / therapy. Predictive Value of Tests. ROC Curve. Risk Assessment / methods. Sensitivity and Specificity

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  • (PMID = 18568558.001).
  • [ISSN] 1600-0455
  • [Journal-full-title] Acta radiologica (Stockholm, Sweden : 1987)
  • [ISO-abbreviation] Acta Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Contrast Media; AYI8EX34EU / Creatinine
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17. Zou C, Vlastos AT, Yang L, Wang J, Nishioka K, Follen M: Effects of difluoromethylornithine on growth inhibition and apoptosis in human cervical epithelial and cancerous cell lines. Gynecol Oncol; 2002 May;85(2):266-73
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  • [Title] Effects of difluoromethylornithine on growth inhibition and apoptosis in human cervical epithelial and cancerous cell lines.
  • OBJECTIVE: Difluoromethylornithine(DFMO), an irreversible inhibitor of ornithine decarboxylase and an angiogenesis inhibitor, has been used in phase I cervical intraepithelial neoplasia (CIN) trials, producing a 50% regression of CIN 3 lesions.
  • METHODS: Four immortalized cervical epithelial cell lines, serving as in vitro models of precancerous CIN lesions, and nine cervical carcinoma cell lines were studied.
  • DFMO's growth inhibitory effect was tested in monolayer culture and in semisolid medium, and concentrations required for a 50% growth inhibition (IC(50)) with a 5-day treatment were determined.
  • RESULTS: DFMO inhibited growth of immortalized cervical epithelial cell lines and cervical cancer cell lines in monolayer culture and in semisolid medium.
  • The immortalized cervical epithelial cell lines were more sensitive than the cervical cancer cell lines to DFMO's growth inhibitory effect.
  • Concentrations required for 50% growth inhibition after a 5-day treatment ranged from 100 microM to >5 mM for cervical carcinoma cell lines and from 100 microM to 1 mM for immortalized cervical epithelial cell lines.
  • DFMO induced apoptosis in precancerous and cancerous cell lines at a concentration of 5 mM, regardless of the cells' human papillomavirus status.
  • CONCLUSION: DFMO inhibits the growth of cervical precancerous and cancerous cells in vitro in a dose-dependent and time-dependent manner, partially through inducing apoptosis.
  • [MeSH-major] Anticarcinogenic Agents / pharmacology. Apoptosis / drug effects. Eflornithine / pharmacology. Uterine Cervical Neoplasms / prevention & control
  • [MeSH-minor] Cell Division / drug effects. Cervical Intraepithelial Neoplasia / drug therapy. Cervical Intraepithelial Neoplasia / pathology. Female. Growth Inhibitors / pharmacology. Humans. Neoplastic Stem Cells / drug effects. Neoplastic Stem Cells / pathology. Tumor Cells, Cultured


18. Van Pachterbeke C, Bucella D, Rozenberg S, Manigart Y, Gilles C, Larsimont D, Vanden Houte K, Reynders M, Snoeck R, Bossens M: Topical treatment of CIN 2+ by cidofovir: results of a phase II, double-blind, prospective, placebo-controlled study. Gynecol Oncol; 2009 Oct;115(1):69-74
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  • [Title] Topical treatment of CIN 2+ by cidofovir: results of a phase II, double-blind, prospective, placebo-controlled study.
  • OBJECTIVE: Randomized controlled trial evaluating a topical treatment for cervical intraepithelial neoplasia 2 and 3 (CIN 2+) using cidofovir.
  • METHODS: Fifty-three women with a biopsy-proven CIN 2+ were randomly assigned, 6 weeks before their planned conisation, either 3 applications of 3 ml 2% cidofovir in Intrasite gel in a cervical cap or a placebo (the same volume of Intrasite alone).
  • A cervical sample for high-risk types of human papillomaviruses (HPV) (Hybrid Capture 2 or HC2) was taken before treatment and before conisation.
  • The cone was submitted for pathological examination, and subsequently, along with the initial biopsy, to in situ hybridization (ISH) for high-risk HPV.
  • Fourteen of the 23 cones were free of any CIN (60.8%) in the cidofovir group.
  • Only 5 of 25 cones were free of any CIN (20%) in the placebo group (p<0.01).
  • CONCLUSION: The medical topical treatment with cidofovir, at this point, cannot replace conisation, but it is a promising candidate for topical chemotherapy of CIN 2+ lesions; a larger prospective randomized study is needed to confirm our results.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Cervical Intraepithelial Neoplasia / drug therapy. Cytosine / analogs & derivatives. Organophosphonates / administration & dosage. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Combined Modality Therapy. Conization. Contraceptive Devices, Female. Double-Blind Method. Female. Gels / administration & dosage. Humans. Papillomavirus Infections / pathology. Papillomavirus Infections / virology. Placebos. Prospective Studies


19. Del Priore G, Gudipudi DK, Montemarano N, Restivo AM, Malanowska-Stega J, Arslan AA: Oral diindolylmethane (DIM): pilot evaluation of a nonsurgical treatment for cervical dysplasia. Gynecol Oncol; 2010 Mar;116(3):464-7
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  • [Title] Oral diindolylmethane (DIM): pilot evaluation of a nonsurgical treatment for cervical dysplasia.
  • OBJECTIVE: Standard surgical treatment for CIN may impair fertility generating a need for alternative treatment options.
  • We tested the efficacy and toxicity of oral DIM in the treatment of CIN 2 or 3 lesions.
  • METHODS: Patients with biopsy-proven cervical intraepithelial neoplasia (CIN) 2 or 3 scheduled for loop electrosurgical excision procedure (LEEP) were randomized 2:1 to receive diindolylmethane (DIM) (BioResponse-DIM, BioResponse, Boulder, CO) orally at approximately 2 mg/kg/day for 12 weeks or placebo (defatted rice bran, BioResponse).
  • At enrollment, 58% were diagnosed with CIN 2 and 42% with CIN 3, 57% of subjects were Caucasian, 15% African American, 12% Hispanic and 17% Asian.
  • During treatment 2 subjects (3%) complained of nausea (grade 2) at the 3- to 4-month visit.
  • Twenty-one subjects (47%) in the DIM group had improved CIN with a decrease by 1-2 grades or a normal result.
  • Median time to improvement was 5 months.
  • Improved Pap smear was seen in 49% (22/45) with either a less severe abnormality or normal result.
  • Stratifying by level of dysplasia, age, race, HPV status, tobacco use, contraceptive used did not alter the results.
  • We observed a high rate of clinically significant improvement in confirmed CIN 2 or 3 lesions among both treatment groups in this randomized clinical trial.
  • [MeSH-major] Cervical Intraepithelial Neoplasia / drug therapy. Indoles / administration & dosage. Uterine Cervical Neoplasms / drug therapy


20. Acién P, Abad M, Mayol MJ, Garcia S, Garde J: Primary squamous cell carcinoma of the ovary associated with endometriosis. Int J Gynaecol Obstet; 2010 Jan;108(1):16-20
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  • [Title] Primary squamous cell carcinoma of the ovary associated with endometriosis.
  • OBJECTIVE: To analyze the clinical, therapeutic, and pathologic features of published cases presenting primary squamous cell carcinoma (SCC) of the ovary associated with endometriosis.
  • METHODS: A case report, 15 cases of infiltrating SCC of the ovary associated with or arising from endometriosis, and 1 case of synchronous carcinoma in situ in the cervix and ovary from a review of the literature were studied.
  • RESULTS: Young age, advanced stage of the disease, and hypogastric pain were frequent at the time of diagnosis.
  • Adjuvant chemotherapy with paclitaxel and carboplatin or cisplatin appeared to improve the results.
  • The best therapeutic results are obtained with paclitaxel and carboplatin or cisplatin after radical surgery.
  • [MeSH-major] Carcinoma, Squamous Cell / pathology. Endometriosis / complications. Ovarian Neoplasms / pathology
  • [MeSH-minor] Abdominal Pain / etiology. Adult. Age Factors. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Chemotherapy, Adjuvant / methods. Cisplatin / administration & dosage. Female. Humans. Middle Aged. Neoplasm Staging. Neoplasms, Multiple Primary. Paclitaxel / administration & dosage. Prognosis. Uterine Cervical Neoplasms / pathology

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  • (PMID = 19782981.001).
  • [ISSN] 1879-3479
  • [Journal-full-title] International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • [ISO-abbreviation] Int J Gynaecol Obstet
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 24
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21. Grady WM: Genomic instability and colon cancer. Cancer Metastasis Rev; 2004 Jan-Jun;23(1-2):11-27
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  • (1) microsatellite instability (MSI), (2) chromosome instability (i.e. aneusomy, gains and losses of chromosomal regions) (CIN), and (3) chromosomal translocations.
  • CIN is found in the majority of colon cancers and leads to a different pattern of gene alterations that contribute to tumor formation.
  • CIN appears to result primarily from deregulation of the DNA replication checkpoints and mitotic-spindle checkpoints.
  • These studies have revealed mutation of the mitotic checkpoint regulators BUB1 and BUBR1 and amplification of STK15 in a subset of CIN colon cancers.
  • The etiology of CIN in the other unexplained cases of colon cancer remains to be determined.
  • Hopefully, discovery of the cause and specific role of genomic instability in colon cancer will yield more effective chemotherapy strategies that take advantage of this unique characteristic of cancer cells.
  • [MeSH-minor] Base Pair Mismatch. Carcinoma / genetics. DNA Repair. Humans. Models, Biological. Mutation. Translocation, Genetic

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  • (PMID = 15000146.001).
  • [ISSN] 0167-7659
  • [Journal-full-title] Cancer metastasis reviews
  • [ISO-abbreviation] Cancer Metastasis Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Review
  • [Publication-country] United States
  • [Number-of-references] 121
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22. Alphandery C, Dagrada G, Frattini M, Perrone F, Pilotti S: Neuroendocrine small cell carcinoma of the cervix associated with endocervical adenocarcinoma: a case report. Acta Cytol; 2007 Jul-Aug;51(4):589-93
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  • [Title] Neuroendocrine small cell carcinoma of the cervix associated with endocervical adenocarcinoma: a case report.
  • BACKGROUND: Small-cell carcinoma (SCC) of the cervix is an uncommon member of the neuroendocrine group of cervical carcinomas that is frequently intermixed with a non-SCC component in the form of an adenocarcinoma (ADC) or squamous carcinoma.
  • CASE: Colposcopy revealed a cervical mass in a 41-year-old woman and a Pap smear the presence of some tumor cells from SCC, which was confirmed by subsequent biopsy.
  • The patient received 3 cycles of chemotherapy and then underwent major surgery.
  • The cervical samples showed areas of endocervical ADC adjacent to and intermixed with the SCC.
  • On subsequent molecular investigation to assess clonality by microsatellite analysis, the presence of HR-HPV DNA18 on real-time polymerase chain reaction, p16(INK4a) fluorescence in situ hybridization status and the corresponding immunohistochemical expression supported the hypothesis that the two components of the tumor shared the same cell origin.
  • CONCLUSION: SCC of the cervix is a rare but distinct HR-HPV-18-related cervical carcinoma often intermixed with a clonally related non-small cell component consisting of an ADC or squamous carcinoma.
  • The presence of SCC tumor cells in a cervical smear should prompt a search for malignant glandular or squamous tumor cells.
  • [MeSH-major] Carcinoma, Small Cell / pathology. Neuroendocrine Tumors / pathology. Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Adult. Antigens, CD56 / metabolism. Biopsy. Cervix Uteri / pathology. Chromogranin A / metabolism. Chromosomes, Human, Pair 17 / genetics. Chromosomes, Human, Pair 18 / genetics. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Female. Humans. In Situ Hybridization, Fluorescence. Microsatellite Repeats / genetics. Papanicolaou Test. Synaptophysin / metabolism. Vaginal Smears

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  • (PMID = 17718130.001).
  • [ISSN] 0001-5547
  • [Journal-full-title] Acta cytologica
  • [ISO-abbreviation] Acta Cytol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD56; 0 / Chromogranin A; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / Synaptophysin
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23. Ahdieh-Grant L, Li R, Levine AM, Massad LS, Strickler HD, Minkoff H, Moxley M, Palefsky J, Sacks H, Burk RD, Gange SJ: Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women. J Natl Cancer Inst; 2004 Jul 21;96(14):1070-6
International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women.
  • BACKGROUND: Women infected with human immunodeficiency virus (HIV) have an increased risk of persistent squamous intraepithelial lesions (SILs) of the cervix.
  • We assessed the association between use of highly active antiretroviral therapy (HAART) and regression of SIL in HIV-infected women enrolled in the Women's Interagency HIV Study, a large, multicenter, prospective cohort study.
  • METHODS: Of 2059 HIV-infected participants, 312 HIV-infected women had normal cervical cytology at baseline and were subsequently diagnosed during 7 years of follow-up with incident SIL.
  • Pap smears, CD4+ T-cell counts, and information regarding use of HAART were obtained every 6 months.
  • RESULTS: Of 312 women, 141 had lesions that regressed to normal cytology, with a median time to regression of 2.7 years.
  • Overall, the incidence of regression increased (P(trend) =.002) over time after HAART was introduced.
  • At incident SIL, median CD4+ T-cell counts were lower in women whose lesions did not regress than in women whose lesions regressed (230 versus 336 cells/microL; P<.01).
  • After HAART was introduced, the rate was 12.5% (95% CI = 9.9% to 15.1%) and was related to post-HAART CD4+ T-cell counts (P(trend) =.002).
  • CONCLUSIONS: HAART use was associated with increased regression of SIL among HIV-infected women, and among women who used HAART, increased CD4+ T-cell counts were associated with a greater likelihood of regression.
  • However, the majority of cervical lesions among HIV-infected women, even among individuals who used HAART, did not regress to normal.
  • [MeSH-major] AIDS-Related Opportunistic Infections / complications. Antiretroviral Therapy, Highly Active. Carcinoma in Situ / pathology. Carcinoma, Squamous Cell / pathology. HIV Seropositivity / drug therapy. Papillomaviridae. Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Adult. CD4-Positive T-Lymphocytes. Female. Follow-Up Studies. Humans. Lymphocyte Count. Papanicolaou Test. Papillomavirus Infections / complications. Prospective Studies. Research Design. Treatment Outcome. Vaginal Smears

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  • [CommentIn] J Natl Cancer Inst. 2004 Jul 21;96(14):1051-3 [15265960.001]
  • (PMID = 15265968.001).
  • [ISSN] 1460-2105
  • [Journal-full-title] Journal of the National Cancer Institute
  • [ISO-abbreviation] J. Natl. Cancer Inst.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / M01-RR00079; United States / NCRR NIH HHS / RR / M01-RR00083; United States / NIAID NIH HHS / AI / U01-AI-31834; United States / NIAID NIH HHS / AI / U01-AI-34989; United States / NIAID NIH HHS / AI / U01-AI-34993; United States / NIAID NIH HHS / AI / U01-AI-34994; United States / NIAID NIH HHS / AI / U01-AI-35004; United States / NIAID NIH HHS / AI / U01-AI-42590; United States / NICHD NIH HHS / HD / U01-HD-32632
  • [Publication-type] Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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