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1. Campagne G, Roca M, Martínez A: Successful treatment of a high-grade intraepithelial neoplasia with imiquimod, with vulvar pemphigus as a side effect. Eur J Obstet Gynecol Reprod Biol; 2003 Aug 15;109(2):224-7
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  • [Title] Successful treatment of a high-grade intraepithelial neoplasia with imiquimod, with vulvar pemphigus as a side effect.
  • Imiquimod modulates the immune response, and is a new approach for treatment of papillomavirus-associated lesions, although it has not been approved for the treatment of intraepithelial neoplasia.
  • We present a case of a patient treated with imiquimod on account of high-grade intraepithelial neoplasia in the vulva and other locations.
  • The posterior biopsies confirm the absence of lesions but show drug-induced pemphigus as a side effect.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / therapy. Genital Neoplasms, Female / therapy. Pemphigus / chemically induced. Vulvar Diseases / chemically induced
  • [MeSH-minor] Adult. Carcinoma in Situ / diagnosis. Carcinoma in Situ / therapy. Carcinoma in Situ / virology. Female. Humans. Papillomaviridae / drug effects. Papillomavirus Infections / chemically induced. Treatment Outcome. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / therapy. Uterine Cervical Neoplasms / virology. Vaginal Neoplasms / diagnosis. Vaginal Neoplasms / therapy. Vaginal Neoplasms / virology. Vulvar Neoplasms / diagnosis. Vulvar Neoplasms / therapy. Vulvar Neoplasms / virology

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  • [CommentIn] Eur J Obstet Gynecol Reprod Biol. 2004 Aug 10;115(2):242-3 [15262368.001]
  • (PMID = 12860347.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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2. Tristram A, Fiander A: Clinical responses to Cidofovir applied topically to women with high grade vulval intraepithelial neoplasia. Gynecol Oncol; 2005 Dec;99(3):652-5
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  • [Title] Clinical responses to Cidofovir applied topically to women with high grade vulval intraepithelial neoplasia.
  • It has previously been used in a number of clinical settings, including high grade intraepithelial disease in the cervix and low grade vulval disease.
  • This pilot study was set up to assess whether Cidofovir might be useful in treating high grade vulval intraepithelial neoplasia.
  • METHODS: Women with high grade non-cervical anogenital intraepithelial neoplasia were treated with a topical formulation of 1% Cidofovir in Unguentum Merck.
  • RESULTS: 12 women with high grade vulval, vaginal or perianal intraepithelial neoplasia were recruited, 10 of whom completed follow up.
  • Diseased tissue underwent ulceration in the majority of cases, with no effect seen on neighbouring normal skin.
  • CONCLUSION: These complete responses, in women with long standing disease, together with preservation of normal tissue, suggest that topical treatment with Cidofovir may have a place in the therapeutic armamentarium of high grade vulval intraepithelial neoplasia.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Carcinoma in Situ / drug therapy. Cytosine / analogs & derivatives. Organophosphonates / administration & dosage. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy

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  • (PMID = 16169066.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Organophosphonates; 8J337D1HZY / Cytosine; JIL713Q00N / cidofovir
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3. van Hamont D, Bekkers RL, Massuger LF, Melchers WJ: Detection, management, and follow-up of pre-malignant cervical lesions and the role for human papillomavirus. Rev Med Virol; 2008 Mar-Apr;18(2):117-32
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  • [Title] Detection, management, and follow-up of pre-malignant cervical lesions and the role for human papillomavirus.
  • High-grade cervical intraepithelial neoplasia (CIN) detected by cervical cytological screening is extensively visualised by colposcopy and successively treated by, for instance, large loop electro-surgical excision of the transformation zone.
  • HPV assessment, either DNA detection or HPV genotyping, could enhance the current cervical cancer screening programmes.
  • [MeSH-major] Papillomaviridae / classification. Papillomaviridae / isolation & purification. Papillomavirus Infections / diagnosis. Papillomavirus Infections / drug therapy. Precancerous Conditions / diagnosis. Precancerous Conditions / drug therapy
  • [MeSH-minor] Cervical Intraepithelial Neoplasia / diagnosis. Cervical Intraepithelial Neoplasia / drug therapy. Cervical Intraepithelial Neoplasia / virology. DNA, Viral / analysis. Electrosurgery. Female. Humans. Papillomavirus Vaccines. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / virology. Vaginal Smears

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  • (PMID = 18001004.001).
  • [ISSN] 1052-9276
  • [Journal-full-title] Reviews in medical virology
  • [ISO-abbreviation] Rev. Med. Virol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Viral; 0 / Papillomavirus Vaccines
  • [Number-of-references] 125
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4. Diaz-Arrastia C, Arany I, Robazetti SC, Dinh TV, Gatalica Z, Tyring SK, Hannigan E: Clinical and molecular responses in high-grade intraepithelial neoplasia treated with topical imiquimod 5%. Clin Cancer Res; 2001 Oct;7(10):3031-3
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  • [Title] Clinical and molecular responses in high-grade intraepithelial neoplasia treated with topical imiquimod 5%.
  • OBJECTIVE: To assess the clinical and molecular response of patients with recurrent high-grade vulvar, vaginal, or cervical intraepithelial neoplasia treated with topical 1-2(2-methylpropyl)-1H-imidazo [4,5-c] quinolin-4-amine (imiquimod) cream 5%, an immune response modifier with known efficacy in the treatment of external genital warts.
  • METHODS: This is the first case series in the peer-reviewed literature reporting the use of imiquimod in high-grade intraepithelial neoplasia of the lower genital tract.
  • Eight patients with high-grade intraepithelial neoplasia were treated with imiquimod in the gynecological oncology clinic and the HIV gynecology clinic at The University of Texas Medical Branch at Galveston.
  • Frozen biopsies were available for RNA extraction on four patients before and after therapy.
  • RESULTS: Of the patients treated, four had complete responses, two had partial responses, one progressed, and one did not tolerate the therapy.
  • 2',5'-Oligoadenylate synthetase RNA expression showed an increased trend after therapy.
  • CONCLUSIONS: These results obtained in this small and heterogeneous group merit further study in the use of topical 5% imiquimod use in the treatment of intraepithelial neoplasia.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Cervical Intraepithelial Neoplasia / drug therapy. Genital Neoplasms, Female / drug therapy
  • [MeSH-minor] 2',5'-Oligoadenylate Synthetase / genetics. Administration, Topical. Adult. Female. Follow-Up Studies. Gene Expression Regulation, Enzymologic / drug effects. Gene Expression Regulation, Neoplastic / drug effects. Humans. Middle Aged. Ointments. RNA, Neoplasm / genetics. RNA, Neoplasm / metabolism. Time Factors. Treatment Outcome. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / genetics. Vaginal Neoplasms / drug therapy. Vaginal Neoplasms / genetics. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / genetics

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  • (PMID = 11595691.001).
  • [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] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / Ointments; 0 / RNA, Neoplasm; 99011-02-6 / imiquimod; EC 2.7.7.- / 2',5'-Oligoadenylate Synthetase
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5. Stanley M: Chapter 17: Genital human papillomavirus infections--current and prospective therapies. J Natl Cancer Inst Monogr; 2003;(31):117-24
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  • [Title] Chapter 17: Genital human papillomavirus infections--current and prospective therapies.
  • Many therapies are available for the treatment of human papillomavirus (HPV)-associated disease, particularly external genital warts.
  • However, at present, these therapies aim to remove the lesion rather than specifically target HPV infection.
  • When disease and infection are local, as in cervical intraepithelial neoplasia (CIN), excisional therapies removing lesion and transformation-susceptible cells are highly effective.
  • However, when infection is regional, as is usually the case for the anogenital warts, vulval intraepithelial neoplasia (VIN), anal intraepithelial neoplasia (AIN), penile intraepithelial neoplasia, and vaginal intraepithelial neoplasia, then current treatments are generally inadequate, with high recurrence rates.
  • Future therapies will be directly or indirectly antiviral, targeting HPV protein functions or enhancing the ability of the immune system to resolve infection or inducing apoptosis indirectly in HPV-infected cells.
  • In the short to the medium term, immunotherapies for low-grade disease are the most likely to be in the clinic.
  • Vaccines designed to target high-grade intraepithelial disease, even when used in combination with immunomodulators, are unlikely to effect lesion clearance in more than a fraction of the cases.
  • However, they may have a role as adjunct therapy after cervical conization to prevent the recurrence of CIN or HPV reinfection.
  • They certainly appear to have a role in multifocal disease, such as VIN and AIN, where partial clearance may be effected and lesion size reduced enough for effective ablative or excisional therapy.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Anticarcinogenic Agents / therapeutic use. Antiviral Agents / therapeutic use. Papillomaviridae. Papillomavirus Infections / therapy. Tumor Virus Infections / therapy. Uterine Cervical Neoplasms / prevention & control. Uterine Cervical Neoplasms / virology
  • [MeSH-minor] Anus Neoplasms / prevention & control. Anus Neoplasms / virology. Cancer Vaccines / therapeutic use. Cervical Intraepithelial Neoplasia / prevention & control. Cervical Intraepithelial Neoplasia / virology. Clinical Trials as Topic. Combined Modality Therapy. Conization. DNA, Viral / isolation & purification. Female. Humans. Indoles / therapeutic use. Male. Photochemotherapy. Precancerous Conditions / therapy. Precancerous Conditions / virology. Retinoids / therapeutic use. Sexually Transmitted Diseases, Viral / therapy. Viral Vaccines / therapeutic use


6. Kuppermann M, Melnikow J, Slee C, Tancredi DJ, Kulasingam S, Birch S, Helms LJ, Bayoumi AM, Sawaya GF: Preferences for surveillance strategies for women treated for high-grade precancerous cervical lesions. Gynecol Oncol; 2010 Aug 1;118(2):108-15
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  • [Title] Preferences for surveillance strategies for women treated for high-grade precancerous cervical lesions.
  • OBJECTIVES: Data are lacking on how women view alternative approaches to surveillance for cervical cancer after treatment of high-grade cervical intraepithelial neoplasia.
  • We measured and compared patient preferences (utilities) for scenarios with varying surveillance strategies and outcomes to inform guidelines and cost-effectiveness analyses of post-treatment surveillance options.
  • Participation consisted of one face-to-face interview, during which utilities for 11 different surveillance scenarios and their associated outcomes were elicited using the time tradeoff metric.
  • Mean utilities ranged from 0.989 (undergoing only a Pap test, receiving normal results) to 0.666 (invasive cervical cancer treated with radical hysterectomy or radiation and chemotherapy).

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  • [Copyright] Copyright (c) 2010 Elsevier Inc. All rights reserved.
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  • (PMID = 20553960.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA109142-01A1; United States / NCI NIH HHS / CA / P30 CA093373; United States / NCI NIH HHS / CA / R01 CA109142; United States / NCI NIH HHS / CA / R01 CA109142-01A1
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS210073; NLM/ PMC2926130
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7. Indraccolo U, Del Frate E, Cenci S, Ubertosi M, Donati Sarti R, Donati Sarti C, Baldoni A: [Vaginal intraepithelial neoplasia and human papillomavirus infection: a report of 75 cases]. Minerva Ginecol; 2006 Apr;58(2):101-8
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  • [Title] [Vaginal intraepithelial neoplasia and human papillomavirus infection: a report of 75 cases].
  • [Transliterated title] La neoplasia intraepiteliale vaginale e l'infezione da virus del papilloma umano. Un resoconto di 75 casi.
  • AIM: Vaginal intraepithelial neoplasia (VaIN) is an uncommon and poorly understood disease.
  • Risk factors other than human papillomavirus (HPV) infection could be linked to the onset and evolution of some VaIN.
  • METHODS: In this paper, the results achieved from the analysis of 75 patients with VaIN are reported.
  • From these cases, women with HIV, previous hysterectomy, autoimmune diseases and radio- and chemotherapy have been excluded.
  • They have been examined after a distinction between grade and association with coilocytosis.
  • VaIN preferential localization, mean age of patients and manifestation pattern after vaginal colposcopy have then been examined.
  • RESULTS: Although the population size cannot allow evidences, it seems that VaIN with coilocytosis and VaIN I without coilocytosis have preferential localization in the upper third of the vagina.
  • It does not appear that mean age of patients for each grade of VaIN differs significativly, both associated and not associated with coilocytosis.
  • Finally, after vaginal colposcopy, the pattern of VaIN for each grade is absolutely not typical, and it seems that white thin epithelium or negative Lugol area are usually the manifestation of high grades of VaIN too.
  • CONCLUSIONS: These results, if confirmed, could mean that VaIN due to HPV may have a different natural history relating to the site of localization in the vagina and, moreover, that also VaIN of high grade could appear with an innocent vaginal pattern.
  • [MeSH-major] Carcinoma in Situ / complications. Carcinoma in Situ / pathology. Papillomaviridae. Papillomavirus Infections / complications. Papillomavirus Infections / pathology. Vaginal Neoplasms / complications. Vaginal Neoplasms / pathology

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  • (PMID = 16582866.001).
  • [ISSN] 0026-4784
  • [Journal-full-title] Minerva ginecologica
  • [ISO-abbreviation] Minerva Ginecol
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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8. Marchesoni D, Driul L, Mozzanega B, Nardelli GB, Parenti A: Intraepithelial G3 adenocarcinoma of the endometrium after tamoxifen treatment. Arch Gynecol Obstet; 2005 Jan;271(1):62-5
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  • [Title] Intraepithelial G3 adenocarcinoma of the endometrium after tamoxifen treatment.
  • She came to our department because of vaginal bleeding 2 years after the end of tamoxifen treatment.
  • TREATMENT: She underwent hysteroscopy and a D and C.
  • A polypoid endometrium completely filled the uterine cavity and was carefully removed by curettage; histology showed a highly undifferentiated neoplasia with a component of serous adenocarcinoma, which was likely to originate from endometrial polyps.
  • OUTCOME: The patient underwent radical hysterectomy, but no residual tumor was found in the uterus or in the tubes, ovary, or pelvic nodes, in spite of its low differentiation grade and high potential aggressiveness, and even though the patient was already symptomatic.
  • [MeSH-minor] Breast Neoplasms / drug therapy. Breast Neoplasms / surgery. Carcinoma, Ductal / drug therapy. Carcinoma, Ductal / surgery. Chemotherapy, Adjuvant. Dilatation and Curettage. Endometrium / drug effects. Endometrium / pathology. Female. Humans. Hysteroscopy. Mastectomy, Radical. Middle Aged

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  • (PMID = 15290168.001).
  • [ISSN] 0932-0067
  • [Journal-full-title] Archives of gynecology and obstetrics
  • [ISO-abbreviation] Arch. Gynecol. Obstet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Anticarcinogenic Agents; 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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9. González Sánchez JL, Flores Murrieta G, Chávez Brambila J, Deolarte Manzano JM, Andrade Manzano AF: [Topical 5-fluorouracil for treatment of vaginal intraepithelial neoplasms]. Ginecol Obstet Mex; 2002 May;70:244-7
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  • [Title] [Topical 5-fluorouracil for treatment of vaginal intraepithelial neoplasms].
  • [Transliterated title] 5-fluorouracilo tópico en el tratamiento de la neoplasia intraepitelial vaginal.
  • OBJECTIVE: Our purpose was to determine the effectiveness of 5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial neoplasia (VAIN).
  • MATERIALS AND METHODS: The study was performed in 30 patients with a mean age of 54 years and previous diagnoses from reviewed records and histopathology slides selected from a group of 65 patients with VAIN from 1980 to 1998.
  • Patients received intravaginal treatment with 5-FU, 1.5 g once weekly for 10 weeks and all patients were followed up for at least 2-years.
  • RESULTS: Twenty eight (93%) patients with VAIN had prior or concurrent anogenital squamous neoplasia, including 5 with invasive cervical carcinoma and 23 with cervical intraepithelial neoplasia.
  • In 23 of 30 treated patients (77%), VAIN went into remission after a single treatment; in 3, (10%), it went into remission after two treatment; 3 (10%) had recurrent VAIN 3; and in 1 (3%) it progressed to invasive vaginal cancer.
  • The treatment was well tolerated.
  • CONCLUSIONS: The 5-FU is an option choice for VAIN treatment.
  • Its use should be confined to treating extensive or multifocal high-grade VAIN.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Cervical Intraepithelial Neoplasia / drug therapy. Fluorouracil / therapeutic use. Vaginal Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Middle Aged. Papanicolaou Test. Papilloma / drug therapy. Papilloma / pathology. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / pathology. Vaginal Smears

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  • (PMID = 12148464.001).
  • [ISSN] 0300-9041
  • [Journal-full-title] Ginecología y obstetricia de México
  • [ISO-abbreviation] Ginecol Obstet Mex
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Mexico
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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10. Lin H, Huang EY, Chang HY, ChangChien CC: Therapeutic effect of topical applications of trichloroacetic acid for vaginal intraepithelial neoplasia after hysterectomy. Jpn J Clin Oncol; 2005 Nov;35(11):651-4
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  • [Title] Therapeutic effect of topical applications of trichloroacetic acid for vaginal intraepithelial neoplasia after hysterectomy.
  • OBJECTIVE: We attempted to evaluate the therapeutic effect of trichloroacetic acid (TCA) for vaginal intraepithelial neoplasia (VaIN) after hysterectomy and to identify factors affecting persistence/recurrence.
  • METHODS: Twenty-eight post-hysterectomy patients with various grades of VaIN were enrolled in this study between January 2001 and December 2003.
  • RESULTS: In 20 of 28 patients (71.4%) VaIN went into remission.
  • Treatment success was observed in all 11 patients with VaIN I, whereas only 9 out of 17 patients (53%) with VaIN II/III went into remission (P = 0.009).
  • Severity of VaIN was the only significant independent predictor of persistence/recurrence (odds ratio = 3.5; 95% confidence interval = 1.1, 11.6; P = 0.038).
  • The treatment was well tolerated with no major side effects.
  • CONCLUSIONS: Based on our findings, 50% TCA was a potential agent with minimal side effects for low-grade VaIN.
  • However, as for high-grade lesions, further investigation with different TCA concentration is compelling.
  • [MeSH-major] Carcinoma in Situ / drug therapy. Hysterectomy. Trichloroacetic Acid / therapeutic use. Vaginal Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Postoperative Care

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  • (PMID = 16275678.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 5V2JDO056X / Trichloroacetic Acid
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11. Caprara L, Monari F, De Bianchi PS, Amadori A, Bondi A: [ASCUS in screening]. Pathologica; 2001 Dec;93(6):645-50
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  • The significance and use of the cytological diagnosis "atypical squamous cells of undetermined significance" (ASCUS) remain a major problem in cervical cancer screening.
  • The prevalence of diagnoses of low-grade squamous intraepithelial lesions (LG-SIL) decreased progressively with age while that of high-grade SIL was slightly higher between 30 and 39 years.
  • The observed peak reflects the prevalence of (1) cytological changes closely associated with perimenopausal age and at least compatible with the ASCUS diagnosis, and (2) cytological abnormalities induced by hormone replacement therapy.
  • [MeSH-major] Cervix Uteri / pathology. Mass Screening. Papanicolaou Test. Vaginal Smears
  • [MeSH-minor] Adult. Aged. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / pathology. Cervical Intraepithelial Neoplasia / diagnosis. Cervical Intraepithelial Neoplasia / pathology. Epithelial Cells / drug effects. Epithelial Cells / ultrastructure. Estrogens / pharmacology. False Positive Reactions. Female. Hormone Replacement Therapy. Humans. Italy. Menopause. Middle Aged. Neoplastic Stem Cells / ultrastructure. Progesterone / pharmacology. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / pathology






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