Articles de revues : « CIN (cervical intraepithelial neoplasia) »

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Wang, Yinhai, Danny Crookes, Osama Sharaf Eldin, Shilan Wang, Peter Hamilton et Jim Diamond. « Assisted Diagnosis of Cervical Intraepithelial Neoplasia (CIN) ». IEEE Journal of Selected Topics in Signal Processing 3, n^o 1 (février 2009) : 112–21. http://dx.doi.org/10.1109/jstsp.2008.2011157.

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Koonings, P. P., G. d'Ablaing, J. B. Schlaerth, C. P. MorRow et J. P. Curtin. « Cervical intraepithelial neoplasia (CIN) following cryotherapy failure ». Gynecologic Oncology 40, n^o 2 (février 1991) : 188. http://dx.doi.org/10.1016/0090-8258(91)90200-o.

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Atkin, Niels B., et Marion C. Baker. « DNA ploidy of cervical intraepithelial neoplasia (CIN) ». Cancer Genetics and Cytogenetics 94, n^o 2 (avril 1997) : 151–52. http://dx.doi.org/10.1016/s0165-4608(96)00212-9.

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Das, Reba, Mahfuza Jebun Mouri, Ratim Mir, Shahnaj Begum, Nondita Mudi et Enamul Kabir. « Expression of p63 in Cervical Intraepithelial Neoplasia (CIN) and Cervical Cancer ». Sir Salimullah Medical College Journal 29, n^o 2 (7 avril 2022) : 141–46. http://dx.doi.org/10.3329/ssmcj.v29i2.58973.

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Background: Cervical cancer is a major public health problem worldwide. Persistent infection with High-Risk Human Papilloma Virus (HPV) has been the main cause of squamous intraepithelial neoplasia which in turn leads to invasive squamous cell carcinoma. p63 is necessary for the activation of HPV, epithelial proliferation and differentiation. It also regulates the expression of certain cell cycle regulators. It has been reported that, from CIN I to CIN III, p63 expression increases progressively from basal layer to surface. In squamous cell carcinoma, it is expressed throughout the entire thickness of the tumor. Thereby it plays a significant role in diagnosing cervical premalignant and malignant lesions. Objective: To evaluate the relationship of p63 expression with different grades of CIN & invasive SCC. Method: Total 86 paraffin embedded tissue blocks of histopathologically diagnosed cases of CIN and cervical cancer were evaluated by immunohistochemical staining for p63 expression. The study was performed in Sir Salimullah Medical College, Dhaka (from March, 2018 to February, 2020). Statistical analyses were carried out by using SPSS version 22 for Windows. A descriptive analysis was performed for all data. Observations were indicated by frequencies and percentages. Statistical significance was set at “p” value <0.05. Results: Present study showed progressive increase in p63 expression from CIN I to CIN III from basal layer to surface. In invasive squamous cell carcinoma, higher expression of p63 was noted throughout the entire thickness of the tumor. No expression was seen in cervical adenocarcinoma and small cell carcinoma. In adenosquamous carcinoma only the area showing squamous differentiation revealed positive p63 expression. Statistically significant association of p63 expression was found with parity of patients and among grades of CIN . Conclusion: The results of this current study revealed that, p63 has significant association among different grades of CIN. It is also a useful marker in confirming a poorly differentiated squamous cell carcinoma & predicting the progression of a squamous neoplastic lesion from cervical intraepithelial neoplasia to invasive squamous cell carcinoma. Moreover, it is useful to differentiate invasive squamous cell carcinoma from cervical adenocarcinoma. Sir Salimullah Med Coll J 2021; 29(2): 141-146

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ROKITA, WOJCIECH. « Topography of the cervical intraepithelial neoplasia in women ». PRZEGLĄD GINEKOLOGICZNO-POŁOŻNICZY 6, n^o 2 (23 mai 2006) : 95–98. http://dx.doi.org/10.1066/s10014060005.

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Hasegawa, Kazuo, Ryuichiro Nisimura, Masaaki Yamasaki, Satoshi Yamaguchi, Yoshio Tenjin, Tadashi Sugishita, Tetsuya Muroya et Hotaka Sakunaga. « Study on Photodynamictherapy for Cervical Intraepithelial Neoplasia (CIN) ». JOURNAL OF JAPAN SOCIETY FOR LASER SURGERY AND MEDICINE 17, Supplement (1996) : 357–60. http://dx.doi.org/10.2530/jslsm1980.17.supplement_357.

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Herich, Olena, Olha Horbatiuk, Anatoliy Hryhorenko, Larysa Dudikova, Alla Kondratiuk, Anelia Shatkovska, Alla Binkovska et Valeriy Garbuziuk. « Modern Conservative Etiopathogenetic Treatment of Cervical Intraepithelial Neoplasia (literature review) ». Reports of Vinnytsia National Medical University 24, n^o 2 (12 octobre 2020) : 332–38. http://dx.doi.org/10.31393/reports-vnmedical-2020-24(2)-23.

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Annotation. We used PubMed, Cochrane Library, Google Scholar databases, mostly referring to publications from the last five years (2016–2020). The long-term persistence of oncogenic types of human papilloma virus is the main etiological factor for cervical intraepithelial neoplasia (CIN). Prolonged persistence of herpes infection can also have a transformative effect on cervical epithelium. Since this pathology is most often diagnosed in women of reproductive age, the maximum preservation of reproductive function, prevention of perinatal complications requires the search for new conservative CIN treatments aimed at the complete elimination of viruses and neoplastic cells. The effectiveness of conservative antiviral therapy of CIN I, II without the use of surgical methods has been proved, especially in women who have not fulfilled their reproductive plans. In addition, antiviral therapy during pre- and postoperative periods contributes to the reduction of complications and relapses in women with severe cervical neoplasia.

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Khanam, Afroza, Zannatul Ferdous Jesmin, Fauzia Begum, N. Akhter, Mst Akter, Shamsun Nahar, AR Barua et A. Nessa. « Prevalence of Cervical Intraepithelial Neoplasia (CIN) at Khulna Division of Bangladesh ». Bangladesh Journal of Obstetrics & ; Gynaecology 33, n^o 1 (22 septembre 2019) : 21–28. http://dx.doi.org/10.3329/bjog.v33i1.43270.

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Back ground: Cervical cancer is the most common genital tract cancer and the important cause of cancer death among Bangladeshi women. Information about actual number of women living with preinvasive phase of cervical cancer and their diagnosis and treatment is limited. For strengthening the programme and policy for cervical cancer prevention , the baseline prevalence of cervical intraepithelial neoplasia ( CIN) need to be assessed. Methods: This population based study aimed to determine the prevalence of CIN among women of Khulna division of Bangladesh. Data has been collected from four upazila of four districts of Khulna division. VIA and colposcopy and histopathology was used for detection of cervical pre-cancers and early cancers among 1232 women of the mentioned population. Results: Crude prevalence of CIN was 5.84 %,CIN-II 1.1% and CIN- III .73% in colposcopically directed biopsy. Ninety two participants with CIN received treatment at the Colposcopy Clinic of Obstetrics and Gynaecology department of Khulna Medical College Hospital (KMCH). Conclusion: This population based prevalence study of CIN and socio demography would have conducive effect on future cervical cancer prevention programme. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 21-28

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Mkrtchian, Liana S., Liudmila Iu Grivtsova, Valentina I. Kiseleva, Anna M. Aleshina et Liudmila I. Krikunova. « Comprehensive treatment of cervical intraepithelial neoplasia ». Gynecology 23, n^o 1 (21 mars 2021) : 62–67. http://dx.doi.org/10.26442/20795696.2021.1.200670.

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Aim. To study the effectiveness of the use of Neovir (sodium oxodihydroacridinyl acetates) as immunomodulatory and antiviral drug in the comprehensive treatment of various grade cervical intraepithelial neoplasia (CIN). Study design: prospective comparative study. Materials and methods. The study included 60 patients (mean age 34.78.2 years) with morphologically verified various grade CIN, who were received comprehensive treatment, including the use of Neovir (sodium oxodihydroacridinyl acetate) as the drug with immunomodulatory and antiviral activity, 250 mg/2 ml intramuscularly every 48 hours, 10 injections before (group 1) or after (group 2) multi-stage radiosurgical diagnostic and treatment procedure or only a similar surgical intervention (group 3). All patients underwent complete clinical, morphological and laboratory examination with monitoring for the presence of high-risk human papillomavirus (HPV) in the cervical scraping and the dynamics of peripheral blood lymphocyte subpopulations. Results. Dynamic follow-up showed that in a month after surgery, patients who were treated with radiosurgical resection as monotherapy (group 3) had the lowest rate of complete epithelialization of the cervical stump 30.0% vs 55.0 and 65,0% in the group 1 and group 2 respectively. In this group, the proportion of patients with persistent viral infection was 1.52 times higher than in the groups where an antiviral drug was used in combination with radiosurgical intervention 35.7% vs 17.6 and 22.2% in the group 1 and group2, respectively. In 6 months, elimination of high-risk HPV in groups with comprehensive treatment reached 94.5 in the group 1 and 94.1% in the group 2 (p0.05) vs 78.6% in the group 3. The lowest number of TNK- and NK-cells was found in the group of patients who received radiosurgical treatment as monotherapy, which correlated with the highest incidence of high-risk HPV persistence after treatment in this group. Conclusions. In patients with various grade CIN, the use of an immunomodulatory drug with antiviral activity in combination with radiosurgical intervention promotes early epithelialization of the cervix and elimination of high-risk HPV, which is confirmed by significant changes in the lymphocyte subpopulations which provide antiviral immunity.

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Vinogradova, O. P., N. A. Andreeva, O. I. Artemova et O. V. Epifanova. « Cervical Stage II Intraepithelial Neoplasia : Antivirals Efficacy ». Doctor.Ru 21, n^o 1 (2022) : 54–58. http://dx.doi.org/10.31550/1727-2378-2022-21-1-54-58.

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Study Objective: To assess the efficacy of an antiviral in the management of HPV-associated cervical stage II intraepithelial neoplasia (CIN II), using the analysis of the apoptotic marker levels and cytokine profile — caspase 3 and 9, interferon (INF) γ, interleukin (IL) 18. Study Design: Perspective study. Materials and Methods. We examined 126 women of reproductive age. The study included two groups: controls (40 relatively healthy fertile women without any cervical pathologies and HPV) and a group of 86 women with HPV-associated CIN II. All subjects underwent an examination; and their cytokine response and apoptotic marker level were assessed. All patients in CIN II group had the affect area excised. 43 post-excision women were followed up (sub-group A); other 43 subjects had surgery and an antiviral (sub-group B). The antiviral was administered subcutaneously once daily, 3 injections before and 3 injections after the excision. The primary efficacy criteria were absence of HPV or reduction in the viral load below significant values, and absence of pathology relapses after 6 and 12 months of the study. Study Results. In subjects with CIN II, pre-therapy caspase 3 and 9 levels were significantly higher vs controls; INF-γ was 1.8 times higher than in controls, and mean IL-18 concentration was considerably lower (p < 0.05 in both cases). In sub-groups A and B, caspase 3 and 9 concentration in 3 and 6 months after therapy also differed significantly from controls, and in 6 months, caspase 3 and 9 concentration in sub-group В was considerably lower than in sub-group А. Women in sub-groups А and В demonstrated statistically significant difference in cytokine profile: in both sub-groups, INF-γ concentration in 10 days increased, while in 12 months it almost reached its baseline value. IL-18 in sub-group B in 10 days and 12 months was significantly higher than in sub-group А. Conclusion. The results of the study demonstrate high HPV elimination and reduction in relapse probability after excision in patients with CIN II with the use of antivirals. Keywords: human papilloma virus, cervical intraepithelial neoplasia, caspase 3, caspase 9, apoptosis, cytokines, interleukin18, tumour necrosis factor α, interferon γ, cervical cancer, genetic typing, high risk of cancer.

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Penna, Carlo, Maria Grazia Fallani, Maria Maggiorelli, Elisa Zipoli, Alessandra Cardelli et Mauro Marchionni. « High-Grade Cervical Intraepithelial Neoplasia (CIN) in Pregnancy : Clinicotherapeutic Management ». Tumori Journal 84, n^o 5 (septembre 1998) : 567–70. http://dx.doi.org/10.1177/030089169808400511.

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An increasing incidence of cervical intraepithelial neoplasia (CIN) among young women has been noticed in recent years. For this reason pregnancy might represent a peculiar opportunity to undergo cytocolposcopic examination for those women who do not take part in a screening program for cervical carcinoma. Diagnosis of CIN during pregnancy poses the question of the management of this disease and particularly of whether it is better to treat the lesion or not during pregnancy. To contribute to the solution of this issue we initiated a study on the management of high-grade CIN in pregnancy. Material and methods Five hundred and seventy-one pregnant women underwent cytologic, colposcopic and, when necessary, histologic examination. Those in whom a CIN was discovered in the first four months of gestation underwent laser conization. When the diagnosis of CIN was made after the sixteenth week of gestation, cytocolposcopic monitoring was performed every eighth week during pregnancy and two months after childbirth. Laser conization was performed under colposcopic guidance in the outpatient setting in all cases. All treated patients were submitted to cytologic, colposcopic and, if necessary, histologic examination every third month in the first year after treatment, every sixth month in the second year and yearly from the third year onwards. Results In 14 (2.4%) of the 571 examined women a CIN III was discovered, 6 of which associated with a human papilloma virus (HPV) infection. Of these, 8 patients, whose diagnosis was made within the sixteenth week of pregnancy, underwent laser conization. In one case a minor hemorrhage occurred during treatment. Two patients reported minor bleeding up to ten days after treatment. No major hemorrhages or cervical stenosis were observed. Histologic examination of the cones confirmed the preoperative diagnosis based on cervical biopsies and the lesion was entirely removed by conization in all cases. Seven of the 8 patients who underwent laser conization during pregnancy had a spontaneous delivery at term. The remaining patient, who had had a previous cesarean section, was again delivered by cesarean section. All treated patients were cured after the first-year follow-up visit. In 6 patients CIN was diagnosed after the sixteenth week of pregnancy. These women underwent cytocolposcopic examination every eighth week during pregnancy and two months after delivery, when the cervical changes associated with gestation had disappeared. Four of these patients showed persistence of CIN at postpartum follow-up and therefore underwent laser conization. In two patients spontaneous regression of the lesion was observed. In no case did progression to invasive carcinoma occur. Conclusions Given the increasing incidence of CIN in young women, the beginning of pregnancy may represent a peculiar opportunity for all pregnant women who do not take part in cervical screening programs to undergo a cytocolposcopic examination. In case of a diagnosis of high-grade CIN within the first 16 weeks of pregnancy, a conservative excisional treatment, which does not expose the pregnancy to any risk, should be carried out in order to confirm the intraepithelial localization of the lesion.

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Boyle, D. C. M., S. E. Barton, S. Uthayakumar, P. E. Hay, J. W. Pollock, P. J. Steer et J. R. Smith. « Is bacterial vaginosis associated with cervical intraepithelial neoplasia ? » International Journal of Gynecologic Cancer 13, n^o 2 (février 2003) : 159–63. http://dx.doi.org/10.1136/ijgc-00009577-200303000-00010.

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Previous research has produced conflicting results regarding the association of bacterial vaginosis (BV) and cervical intraepithelial neoplasia (CIN). These studies have been weakened in their conclusions mainly by failure to adequately control for the presence of sexually transmitted infections (STIs). One proposed mechanism suggesting that carcinogenic nitrosamines acting either independently or via human papilloma virus (HPV) has not been fully tested previously. We undertook a prospective, case-controlled, cross-sectional study where the presence of STIs, in particular human papillomavirus (HPV) which is known to be associated with the development of CIN, was controlled for. Women with BV were not found to have CIN more frequently than women with normal vaginal flora and the quantities of nitrosamines produced by women with BV did not differ significantly from women without BV. We thus found that BV is not associated with CIN.

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Ershov, V. A., A. S. Lisyanskaya et G. M. Manikhas. « Expression of human papillomavirus L1 protein and NuMA1 at cervical intraepithelial neoplasia ». Scientific Notes of the Pavlov University 26, n^o 2 (9 novembre 2019) : 18–27. http://dx.doi.org/10.24884/1607-4181-2019-26-2-18-27.

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Relevance. Cervical cancer – one of malignant new growths most often met among women. Intraepithelial changes precede to it; these changes can disappear spontaneously or progress to cancer. For the present moment, there are no markers describing the outcome of cervical intraepithelial neoplasia.The objective was to research the expression L1 HPV and NuMA1 as factors of prognosis HPV-positive cervical intraepithelial neoplasias by high-risk human papillomavirus.Material and methods. The biopsies of 178 women from HPV-positive cervical neoplasias were studied by cytological, histological, immunocytochemical methods and PCR.Results. We verified HPV-HR-positive: mild (42.7 %), moderate (34.27 %), severe (21.91 %) dysplasias, Ca in situ (1.12 %). In 81.13 % of researches, CIN with expression of L1 and NuMA1 had regression of dysplasia, in 13.21 % – persistence of grade squamous intraepithelial lesion, in 5.66 % – progression of dysplasia. In 73.33 % of cases, CIN with expression of NuMA1 had regression, in 26.67 % – persistence of dysplasia. In 45.45 % of researches, CIN with expression of L1 had regression of dysplasia, in 48.48 % – persistence of grade squamous intraepithelial lesion, in 6.06 % – progression of dysplasia. Regression or progression of dysplasia with expression L1 and NuMA1 or one of these proteins for the first time was revealed later 6 months.Conclusion. CIN could come to the end with regression, persistence or progression. At expression of atypical cells L1 and NuMA1, the greatest quantity – 81.13 %, of cases of CIN regression was noted. At expression of atypical cells only NuMA1, CIN came to the end with regression or long persistence. Course of CIN with expression L1 HPV was characterized by the greatest parameters of persistence and progression marked, accordingly, in 48.48 and 6.06 % of cases.

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August, Carey Z., Masoud Ganji et Evelyn Froula. « Misdiagnosis of High-Grade Vulvar Intraepithelial Neoplasia (VIN III) as Mild Cervical Intraepithelial Neoplasia (CIN I) on Papanicolaou Tests ». Archives of Pathology & ; Laboratory Medicine 127, n^o 1 (1 janvier 2003) : 68–70. http://dx.doi.org/10.5858/2003-127-68-mohgvi.

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Abstract Context.—Although high-grade vulvar intraepithelial neoplasia (VIN III) is a clinically significant lesion, it can be overlooked because of nonspecific clinical findings and the fact that its cytomorphologic features mimic those of mild cervical intraepithelial neoplasia (CIN I). Objective.—To determine if there are cytomorphologic features on Papanicolaou tests that can reliably distinguish between VIN III and CIN I. Design.—Papanicolaou tests diagnosed as CIN I from patients with biopsy-proven CIN I were compared with Papanicolaou tests diagnosed as CIN I from patients with biopsy-proven VIN III but with no biopsy-proven CIN I. Results.—None of the cytomorphologic features evaluated could reliably distinguish CIN I from VIN III. Conclusion.—Since the Papanicolaou test cannot be used to distinguish between CIN I and VIN III, the clinician must pay careful attention to the clinical and colposcopic findings. Further research evaluating the use of ancillary studies, such as human papillomavirus typing, may be useful.

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Yu, Li, Mian He, Zheng Yang, Guidong Chen, Mengzhen Li, Liantang Wang et Shangwu Chen. « Olfactomedin 4 Is a Marker for Progression of Cervical Neoplasia ». International Journal of Gynecologic Cancer 21, n^o 2 (janvier 2011) : 367–72. http://dx.doi.org/10.1097/igc.0b013e31820866fe.

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Introduction:Olfactomedin 4 (OLFM4) is expressed in gastrointestinal cancers and related to progression and differentiation of these malignancies. However, whether OLFM4 contributes to tumorigenesis of other tissues has not been thoroughly investigated. The purpose of the study was to investigate OLFM4 expression in cervical epithelium and its association with progression of cervical neoplasia and differentiation of cervical carcinomas.Methods:Immunohistochemistry and real-time reverse transcription-polymerase chain reaction were used to evaluate the expression and distribution of OLFM4 in cervical intraepithelial neoplasia (CIN) and invasive squamous cell carcinomas (ISCCs).Results:The overall positive OLFM4 staining levels in normal cervical epithelia, CIN I, CIN II, CIN III, and ISCCs are 22.0%, 94.2%, 93.7%, 94.6%, and 96.7%, respectively. The intensity of OLFM4 staining was enhanced according to increased pathologic grade of cervical squamous intraepithelial lesion. The immunoreactivity to OLFM4 was stronger in well-differentiated ISCCs than in poorly differentiated ISCCs.Conclusions:Olfactomedin 4 expression has been associated with progression of CIN and differentiation of cervical cancer. The results provide new evidence that OLFM4 plays an important role in tumorigenesis in the female reproductive tract.

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RYUKO, Kanji, Ritsuto FUJIWAKI, Kohkichi HATA, Kentaro TAKAHASHI et Kohji MIYAZAKI. « Tricks of Laser Surgery for Cervical Intraepithelial Neoplasia (CIN) ». JOURNAL OF JAPAN SOCIETY FOR LASER SURGERY AND MEDICINE 21, n^o 1 (2000) : 63–71. http://dx.doi.org/10.2530/jslsm1980.21.1_63.

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NAVARRE, GERALD L. « Office Biopsy as Treatment for Cervical Intraepithelial Neoplasia (CIN) ». Journal of Gynecologic Surgery 2, n^o 1 (janvier 1986) : 59–63. http://dx.doi.org/10.1089/gyn.1986.2.59.

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Ismail, S. M., et A. N. Fiander. « How should we grade CIN ? Grading cervical intraepithelial neoplasia ». Histopathology 40, n^o 4 (avril 2002) : 385–90. http://dx.doi.org/10.1046/j.1365-2559.2002.t01-2-01365.x.

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AL-NAFUSSI, A. I., et M. K. COLQUHOUN. « Mild cervical intraepithelial neoplasia (CIN 1) : a histological overdiagnosis ». Histopathology 17, n^o 6 (décembre 1990) : 557–61. http://dx.doi.org/10.1111/j.1365-2559.1990.tb00796.x.

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GORHAM, H., A. WOODMAN, S. GOODISON, J. MARSH, M. CHARNOCK, S. MANEK, T. SUGINO et D. TARIN. « CD44 expression in cervical intraepithelial neoplasia (CIN) and carcinoma ». Molecular Diagnosis 4, n^o 1 (mars 1999) : 45–56. http://dx.doi.org/10.1016/s1084-8592(99)80049-6.

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Khan, Kelly A., Debora A. Smith et Michael J. Thrall. « Only a Small Fraction of High-Grade Cervical Lesions Are Discovered After an Interpretation of Atypical Squamous Cells of Undetermined Significance When Using Imager-Assisted, Liquid-Based Papanicolaou Tests and the Bethesda 2001 System ». Archives of Pathology & ; Laboratory Medicine 137, n^o 7 (20 septembre 2012) : 936–41. http://dx.doi.org/10.5858/arpa.2012-0358-oa.

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Context.—Previous work has reported that most high-grade cervical neoplasia is seen in patients with preceding Papanicolaou test results of atypical squamous cells of undetermined significance. This information was based on conventional test results and the Bethesda 1991 reporting system and was determined before the current treatment guidelines. Objective.—Our objective was to perform a retrospective review of all histologically confirmed, high-grade cervical neoplasia to determine the diagnosis of the preceding liquid-based Papanicolaou test. Design.—A total of 189 histologically confirmed, high-grade cervical intraepithelial neoplasia (CIN) cases grade 2 and greater were identified for a 1-year period. Results.—Of the 189 cases, 10 (5.3%) had a previous diagnosis of atypical squamous cells of undetermined significance; 55 (29.1%) had low-grade squamous intraepithelial lesions; 31 (16.4%) had low-grade squamous intraepithelial lesions, unable to rule out a high-grade squamous intraepithelial lesion; 21 (11.1%) had atypical squamous cells, unable to rule out a high-grade squamous intraepithelial lesion; 68 (36%) had high-grade squamous intraepithelial lesions; 1 (0.5%) had atypical glandular cells; 1 (0.5%) had adenocarcinoma in situ; and 2 (1%) had invasive carcinoma. Combined “low grade” Papanicolaou test results (atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion) preceded 51 of 103 cases of CIN 2 (49.5%) and 14 of 103 cases (13.6%) of CIN 3/cancer, whereas “high grade” Papanicolaou test results (atypical squamous cells, unable to rule out a high-grade squamous intraepithelial lesion; low-grade squamous intraepithelial lesions, unable to rule out a high-grade squamous intraepithelial lesion; high-grade squamous intraepithelial lesions; atypical glandular cells; adenocarcinoma in situ; and invasive carcinoma) preceded 52 of 103 CIN 2 cases (50.5%) and 72 of 103 CIN 3/cancer cases (69.9%). Conclusions.—Our data show that we can now more-reliably predict high-grade dysplasia on routine Papanicolaou tests. Only a small fraction of histologically confirmed CIN 2/3 cases are found following a Papanicolaou test diagnosis of atypical squamous cells of undetermined significance.

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KAPETANIOS, V., A. C. LAZARIS, P. BOGRIS, S. KOUNELI, A. NONNI, H. ARVANITI, E. KOURI et al. « Extracellular regulated kinase-2 immunoreactivity increases in parallel with cervical intraepithelial neoplasia grade in cervical neoplasia ». International Journal of Gynecologic Cancer 18, n^o 3 (mai 2008) : 540–45. http://dx.doi.org/10.1111/j.1525-1438.2007.01057.x.

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The cell cycle control system includes cyclins, cyclin-dependent kinases (CDK), and their inhibitors (CDK1). Extracellular regulated kinase (ERK1/2) (p44 and p42 mitogen-activated protein kinases [MAPKs]) is a component of the MAPK pathway, which is associated with cyclin D1 and CDK. It is a critical signaling system for the induction of cell proliferation, differentiation, and cell survival. The aim of this study was to investigate the usefulness of ERK2 expression as a marker of biological aggressiveness complementary to cervical intraepithelial neoplasia (CIN) grade as well as to compare its expression in preinvasive lesions with that in invasive carcinoma. Paraffin-embedded sections of 146 CIN lesions (32 CIN I, 49 CIN II, and 43 CIN III) and 22 invasive cervical carcinomas (13 squamous and 9 adenocarcinomas) were used for the standard immunohistochemical procedure with the application of the ERK2 monoclonal antibody. ERK2 staining displayed a cytoplasmic and nuclear pattern. The staining intensity was gradually increased according to the severity of the dysplastic lesions; ERK2 immunoreactivity was significantly increased in high-grade dysplastic lesions (CIN II and CIN III) and invasive carcinomas by comparison to low-grade dysplastic lesions (CIN I) (P < 0.001). When high-grade lesions were separately assessed, the differences between each one of them and CIN I retained their statistical significance: CIN II versus CIN I (P < 0.001) and CIN III versus CIN I (P < 0.001). In conclusion, our study found a direct relationship between the increasing grade of the dysplastic cervical lesions and the intensity of ERK2 staining, thus implying a role of ERK2 as an early event in cervical carcinogenesis.

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Medina de la Cruz, Omar, Edgar Villegas Hinojosa, Darío Gaytán Hernández, Sandra Olimpia Gutiérrez Enríquez et Verónica Gallegos García. « Identificación de cofactores nutricionales asociados a neoplasia intraepitelial cervical en mujeres de San Luis Potosí ». Tequio 2, n^o 4 (1 septembre 2018) : 37–47. http://dx.doi.org/10.53331/teq.v2i4.4577.

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Cervical Cancer (CeCa) is a public health problem worldwide. The natural history of the disease goes through different degrees of cervical intraepithelial neoplasms that modulate its transformation, depending on various co-factors related to the eating habits of patients, overweight and obesity, the consumption of food supplements and the intake of light products. The objective of this article is to identify those nutritional co-factors associated with the development of cervical intraepithelial neoplasia (CIN) in women from the city of San Luis Potosí, through the study of cases (100) and controls (300) of patients diagnosed with different grades of CIN by colposcopy, in addition to this, a validated questionnaire was applied, descriptive and inferential statistics were carried out, as well as the calculation of Odds Ratio (OR). The results indicate that the nutritional co-factors identified with a statistical significance were the intake of light and green tea soft drinks, as they are linked to the appearance of cervical intraepithelial neoplasm.

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Tkachenko, L. V., N. I. Sviridova, T. V. Skladanovskaya, I. A. Gritsenko et S. V. Shishimorova. « Immunological substantiation of complex therapy in patients with mild HPV-associated cervical intraepithelial neoplasia ». Meditsinskiy sovet = Medical Council, n^o 5 (20 avril 2022) : 118–27. http://dx.doi.org/10.21518/2079-701x-2022-16-5-118-127.

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Introduction. As is known, the development of invasive cervical cancer is preceded by cervical intraepithelial neoplasia of varying severity, which is a pathological process in which cells with varying degrees of atypia and impaired differentiation appear in the thickness of the stratified squamous epithelium of the cervix.Objective. To study the effect of complex therapy in patients with mild HPV-associated cervical intraepithelial neoplasia on the dynamics of local cytokine status and autoimmunity parameters.Materials and methods. The study included 86 patients aged 35 to 40 years with morphologically verified mild cervical intraepithelial neoplasia. The main group consisted of 52 patients who, along with radio wave destruction of the cervix, were prescribed an immunostimulating drug with antiviral activity “Groprinosin-Richter” 1000 mg 3 times a day for 10 days 10–14 days before destruction and similar 2 courses after 10–14 days after it. The comparison group included 34 patients who underwent only radio wave destruction of the cervix.Results. An analysis of the outcomes of low-grade squamous intraepithelial lesions after 6 months showed that in the main group, CIN I regression was observed in 92.3% of patients, persistence – in 7.7% of cases, while in the comparison group, CIN I regression was noted in 73,5% of cases, persistence – in 26.5% of patients.Conclusions. Conducting complex therapy, including radio wave destruction and the use of a drug with immunostimulating and antiviral activity “Groprinosin-Richter” in patients with low-grade HPV-associated cervical intraepithelial neoplasia, leads to the elimination of the initial imbalance of cytokines and normalization of autoantibody levels, helping to reduce the likelihood of HPV persistence and CIN progression to invasive cervical cancer uterus.

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Inada, Natalia Mayumi, Hilde Harb Buzzá, Marieli Fernanda Martins Leite, Cristina Kurachi, Jose Roberto Trujillo, Cynthia Aparecida de Castro, Fernanda Mansano Carbinatto, Welington Lombardi et Vanderlei Salvador Bagnato. « Long Term Effectiveness of Photodynamic Therapy for CIN Treatment ». Pharmaceuticals 12, n^o 3 (12 juillet 2019) : 107. http://dx.doi.org/10.3390/ph12030107.

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(1) Background: Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in women worldwide. The highest incidence rates are in Africa, followed by South-Central Asia and South America. According to the Brazilian National Institute of Cancer (INCA), 16,370 new cases of cervical cancer were estimated for each year of the biennium of 2018–2019. About 90% of cervical cancers originate from the malignant progression of cervical intraepithelial neoplasia (CIN) which is classified based on cytohistological characteristics (low- and high-grade lesions). The present study reports the long-term effectiveness of topical photodynamic therapy (PDT) for CIN grades 1 and 2/3 with up to two years of follow up. (2) Methods: A total of 56 patients with CIN 1, ten with CIN 2, and 14 patients for the placebo group were enrolled in this study. (3) Results: 75% (n = 42) of CIN 1 patients presented a complete response to PDT and only 23.2% (n = 13) of recurrence, progression, and/or lesions remaining two years after PDT. For CIN 2/3 patients, 90% were observed to be cured after one and two years of follow up. (4) Conclusions: PDT presented best results two years after a non-invasive, fast, and low-cost procedure and in comparison with the placebo group, preventing the progression of cervical intraepithelial neoplasia and preserving the cervix.

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Zakharova, N. M., O. N. Vetchinnikova et A. B. Zulkarnaev. « Cytological features of crypt involvement by cervical intraepithelial neoplasia ». Voprosy ginekologii, akušerstva i perinatologii 20, n^o 4 (2021) : 22–28. http://dx.doi.org/10.20953/1726-1678-2021-4-22-28.

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Objective. To determine the cytological criteria of crypt lesion by cervical intraepithelial neoplasia (CIN). Patients and methods. The retrospective cohort study included 76 women who underwent a comprehensive medical evaluation after screening tests: cervical cytology test, colposcopy, biopsy and histological examination of the cervix, polymerase chain reaction (PCR) test for human papillomavirus (HPV). Cytological material was obtained using an endocervical brush (Cytobrush); it was stained by the Pappenheim method and examined by light microscopy; the Bethesda system was used. Results. Cytological examination of the cervical smears (cervical ectopy and endocervix) in 59 (78%) women revealed squamous epithelial cells with features typical for dysplasia of different severity: mild – LSIL (low-grade squamous intraepithelial lesions) and severe – HSIL (high-grade squamous intraepithelial lesion). Smears of 31 (53%) women also showed cylindrical (glandular) epithelial cells with signs of pronounced proliferation: 2 (9.5%) with LSIL and 29 (76.3%) with HSIL. Histological examination of the cervix in all 59 women revealed dysplasia of varying severity. Features of endocervical crypt involvement were detected in 28 women: 1 (4.8%) with LSIL and 27 (71.1%) with HSIL. The sensitivity and specificity of cytological diagnosis of cervical crypt involvement in LSIL were 100 and 95%, in HSIL – 87 and 67%, respectively. Conclusion. The cytological feature of crypt involvement by CIN is the presence in cervical mucus smears of clusters and papillary structures of proliferating, immature cylindrical epithelial cells, partially with cellular and nuclear polymorphism. Key words: crypts, cervical intraepithelial neoplasia, cytological examination

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Plisko, Olga, Jana Zodzika, Irina Jermakova, Kristine Pcolkina, Amanda Prusakevica, Inta Liepniece-Karele, Gilbert G. G. Donders et Dace Rezeberga. « Aerobic Vaginitis—Underestimated Risk Factor for Cervical Intraepithelial Neoplasia ». Diagnostics 11, n^o 1 (9 janvier 2021) : 97. http://dx.doi.org/10.3390/diagnostics11010097.

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The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University Hospital Outpatient department in the study group. 118 women without cervical pathology were chosen as controls. Certified colposcopists performed interviews, gynaecological examinations and colposcopies for all participants. Material from the upper vaginal fornix was taken for pH measurement and wet-mount microscopy. Cervical biopsy samples were taken from all subjects in the study group and in case of a visual suspicion for CIN in the control group. Cervical pathology was more often associated with smoking (34.6% vs. 11.0%, p < 0.0001), low education level (47.2% vs. 25.5%, p = 0.001), increased vaginal pH (48.2% vs. 25.4%, p < 0.0001), abnormal vaginal microbiota (50% vs. 31.4%, p = 0.004) and moderate to severe aerobic vaginitis (msAV) (13.6% vs. 5.9%, p = 0.049) compared to controls. The most important independent risk factors associated with CIN2+ were smoking (OR 3.04 (95% CI 1.37–6.76), p = 0.006) and msAV (OR 3.18 (95% CI 1.13–8.93), p = 0.028). Bacterial vaginosis (BV) was found more often in CIN1 patients (8/31, 25.8%, p = 0.009) compared with healthy controls (8/118, 6.8%), or CIN2+ cases (8/79, 10.1%). In the current study msAV and smoking were the most significant factors in the development of CIN in HPV-infected women, especially high grade CIN. We suggest that AV changes are probably more important than the presence of BV in the pathogenesis of CIN and progression to cervix cancer and should not be ignored during the evaluation of the vaginal microbiota.

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Plisko, Olga, Jana Zodzika, Irina Jermakova, Kristine Pcolkina, Amanda Prusakevica, Inta Liepniece-Karele, Gilbert G. G. Donders et Dace Rezeberga. « Aerobic Vaginitis—Underestimated Risk Factor for Cervical Intraepithelial Neoplasia ». Diagnostics 11, n^o 1 (9 janvier 2021) : 97. http://dx.doi.org/10.3390/diagnostics11010097.

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The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University Hospital Outpatient department in the study group. 118 women without cervical pathology were chosen as controls. Certified colposcopists performed interviews, gynaecological examinations and colposcopies for all participants. Material from the upper vaginal fornix was taken for pH measurement and wet-mount microscopy. Cervical biopsy samples were taken from all subjects in the study group and in case of a visual suspicion for CIN in the control group. Cervical pathology was more often associated with smoking (34.6% vs. 11.0%, p < 0.0001), low education level (47.2% vs. 25.5%, p = 0.001), increased vaginal pH (48.2% vs. 25.4%, p < 0.0001), abnormal vaginal microbiota (50% vs. 31.4%, p = 0.004) and moderate to severe aerobic vaginitis (msAV) (13.6% vs. 5.9%, p = 0.049) compared to controls. The most important independent risk factors associated with CIN2+ were smoking (OR 3.04 (95% CI 1.37–6.76), p = 0.006) and msAV (OR 3.18 (95% CI 1.13–8.93), p = 0.028). Bacterial vaginosis (BV) was found more often in CIN1 patients (8/31, 25.8%, p = 0.009) compared with healthy controls (8/118, 6.8%), or CIN2+ cases (8/79, 10.1%). In the current study msAV and smoking were the most significant factors in the development of CIN in HPV-infected women, especially high grade CIN. We suggest that AV changes are probably more important than the presence of BV in the pathogenesis of CIN and progression to cervix cancer and should not be ignored during the evaluation of the vaginal microbiota.

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Gupta, Nidhi. « Significance of Persistent Inflammatory Cervical Smears in Sexually Active Women of Reproductive Age Group—A Prospective Study ». Journal of South Asian Federation of Obstetrics and Gynaecology 2, n^o 1 (2010) : 45–48. http://dx.doi.org/10.5005/jp-journals-10006-1059.

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ABSTRACT To study the significance of persistent inflammatory cervical Papanicolaou smears, in sexually active women of reproductive age group attending the out patient department of department of obstetrics and gynecology, Sarojini Naidu Medical College and Hospitals, Agra were recruited. Patients with persistent inflammatory cervical smears were subjected to Schiller directed cervical biopsy for histopathological examination. Persistent inflammatory changes were seen in 37.6% cervical smears. Underlying cervical intraepithelial neoplasia (CIN) on histopathologic examination was found in 13.6% persisters. Prevalence of CIN was higher in women over 30 years and significantly so in women with parity higher than 2. It was further observed that severity of underlying CIN lesions increased with increasing duration of marital life. Objective To study the significance of persistent inflammatory cervical smears in sexually active women of reproductive age. Study design A prospective tertiary teaching hospital based study on 3000 sexually active women aged between 18 to 45 years attending the OPD from October 2006 to December 2008. Material and methods Sexually active women aged between 18 to 45 years with inflammatory smears attending the OPD of the department of obstetrics and gynecology, SN Medical College and Hospital were recruited for the study. Repeat cervical smears were taken after 3 months of systemic antimicrobials plus local antiseptics. Patients with persistent inflammatory cervical smears were subjected to Schiller directed cervical biopsy for histopathological examination. Relationship of age, parity, duration of marital life, different contraceptive practices and other high-risk factors were studied vis-ì-vis histopathological findings of cervical intraepithelial neoplasia. Results Persistent inflammatory changes were noted in 37.6% cervical smears. Underlying cervical intraepithelial neoplasia (CIN) on histopathalogic examination was seen in 13.6% persisters. Prevalence of CIN was higher in women over 30 years, and over para 3 uninfluenced by the presence of cervical lesion. Severity of underlying CIN lesions increased with increasing duration of marital life. Conclusion Women with persistent inflammatory cervical smears, especially if she is above 30 years, sexually active for 10 years and is third para, should have further evaluation with cervical biopsy.

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Goodkin, Karl, Michael H. Antoni, Lynne Helder et Berndt Sevin. « Psychosocial factors in the progression of cervical intraepithelial neoplasia—CIN ». Journal of Psychosomatic Research 37, n^o 5 (juillet 1993) : 554–57. http://dx.doi.org/10.1016/0022-3999(93)90011-4.

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Ramanujam, N., M. F. Mitchell, A. Mahadevan, S. Thomsen, E. Silva et R. Richards-Kortum. « Fluorescence Spectroscopy : A Diagnostic Tool for Cervical Intraepithelial Neoplasia (CIN) ». Gynecologic Oncology 52, n^o 1 (janvier 1994) : 31–38. http://dx.doi.org/10.1006/gyno.1994.1007.

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Hanselaar, Antonius G. J. M., Neal Poulin, Martin M. M. Pahlplatz, David Garner, Calum MacAulay, Jasenka Matisic, Jean LeRiche et Branko Palcic. « DNA-Cytometry of Progressive and Regressive Cervical Intraepithelial Neoplasia ». Analytical Cellular Pathology 16, n^o 1 (1998) : 11–27. http://dx.doi.org/10.1155/1998/649024.

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A retrospective analysis was performed on archival cervical smears from a group of 56 women with cervical intraepithelial neoplasia (CIN), who had received follow‐up by cytology only. Automated image cytometry of Feulgen‐stained DNA was used to determine the differences between progressive and regressive lesions. The first group of 30 smears was from women who had developed cancer after initial smears with dysplastic changes (progressive group). The second group of 26 smears with dysplastic changes had shown regression to normal (regressive group). The goal of the study was to determine if differences in cytometric features existed between the progressive and regressive groups. CIN categories I, II and III were represented in both groups, and measurements were pooled across diagnostic categories. Images of up to 700 intermediate cells were obtained from each slide, and cells were scanned exhaustively for the detection of diagnostic cells. Discriminant function analysis was performed for both intermediate and diagnostic cells. The most significant differences between the groups were found for diagnostic cells, with a cell classification accuracy of 82%. Intermediate cells could be classified with 60% accuracy. Cytometric features which afforded the best discrimination were characteristic of the chromatin organization in diagnostic cells (nuclear texture). Slide classification was performed by thresholding the number of cells which exhibited progression associated changes (PAC) in chromatin configuration, with an accuracy of 93 and 73% for diagnostic and intermediate cells, respectively. These results indicate that regardless of the extent of nuclear atypia as reflected in the CIN category, features of chromatin organization can potentially be used to predict the malignant or progressive potential of CIN lesions.

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Chang, Ching Wen, Shun-Fa Yang, Christopher J. Gordon, Wen Chun Liao, Shu Fen Niu, Cheng Wei Wang et Hsiu Ting Tsai. « Physical Activity of ≥7.5 MET-h/Week Is Significantly Associated with a Decreased Risk of Cervical Neoplasia ». Healthcare 8, n^o 3 (10 août 2020) : 260. http://dx.doi.org/10.3390/healthcare8030260.

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Cervical cancer is one of the most prevalent malignant neoplasms worldwide. We investigated whether leisure-time physical activity is sufficient to decrease the cervical neoplasia risk and provide suggested guidance of metabolic equivalents of task–hours per week (MET-h/week) spent on leisure-time physical activity to prevent cervical neoplasia. Ultimately, 433 participants, including 126 participants with cervical intraepithelial neoplasia I or higher disease (≥CIN 1) and 307 healthy controls, were recruited. All participants completed a standardized questionnaire about leisure-time physical activity engagement (MET-h/week) and a general health questionnaire and had cervical specimens taken to detect human papillomavirus (HPV) infection. CIN 1 staging was identified from the specimens. Participants with physical activity of ≥3.75 MET-h/week had a significantly lower CIN risk compared to those with physical activity of <3.75 MET-h/week (p = 0.01). However, among participants with HPV infection or smokers, the minimal requirement of leisure-time physical actively to lessen the CIN risk was ≥7.5 MET-h/week. Lifetime leisure-time physical activity of ≥0.12 MET-h/week–year also significantly decreased the CIN risk, but women with HPV infection needed ≥13.2 MET-h/week–year to protect them from a CIN risk. We concluded that regular leisure-time physical activity of ≥7.5 MET-h/week and sustained lifetime leisure-time physical activity ≥13.2 MET-h/week–year are vital factors for protecting women against cervical neoplasia risk.

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Barbosa, Lyliana Coutinho Resende, Ismael Dale Cotrim Guerreiro da Silva, José Carlos Corrêa et Julisa Chamorro Lascasas Ribalta. « Survivin and Telomerase Expression in the Uterine Cervix of Women With Human Papillomavirus-Induced Lesions ». International Journal of Gynecologic Cancer 21, n^o 1 (2011) : 15–21. http://dx.doi.org/10.1097/igc.0b013e318203d42b.

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Introduction:Infection by human papillomavirus is the most important risk factor in the pathogenesis of uterine cervical cancer. The aims of this study were to evaluate the expression of survivin protein and telomerase enzyme in samples of uterine cervix from women with human papillomavirus-induced lesions and to determine the relationship between survivin and telomerase expression and the different grades of cervical squamous intraepithelial neoplasia and invasive cervical carcinoma.Methods:Biopsy samples from the uterine cervix of 105 women aged 18 to 80 years were analyzed. The patients were divided into 5 groups: WN group, 20 patients without neoplasia; CIN-1 group, 24 patients with grade 1 cervical intraepithelial neoplasia (CIN), grade 1; CIN-2 group, 20 patients with CIN grade 2; CIN-3 group, 24 patients with CIN, grade 3; and ICC group, 17 patients with invasive cervical carcinoma. Human papillomavirus detection, telomerase activity, and survivin expression were assessed using polymerase chain reaction (PCR), real-time PCR (RT-PCR), and immunochemistry, respectively.Results:There was a significant increase in the expression of telomerase and survivin associated with the severity of the lesion.Conclusions:The results suggest that mechanisms that promote both cell proliferation (telomerase activity) and cell survival (survivin expression) are active in cervical cancer and its precursor lesions. There was a negative correlation between survivin expression and the number of PCR cycles necessary to detect telomerase activity in the total sample, achieving statistical significance in patients in the CIN-3 group.

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McLucas, Bruce, Eric Vail, Katherine Jane Chua et Gabriel Walt. « Cervical intraepithelial neoplasia grade 3 in a patient following Gardasil vaccination ». BMJ Case Reports 12, n^o 8 (août 2019) : e230366. http://dx.doi.org/10.1136/bcr-2019-230366.

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Essentially all cervical dysplasia is caused by human papilloma virus (HPV). Three HPV vaccines have been available, with Gardasil-9 being the most recently approved in the USA. Gardasil-9 covers high-risk HPV strains 16, 18, 31, 33, 45, 52 and 58 as well as low-risk strains 6 and 11. A 33-year-old woman (Gravida 2, Para 2) received Gardasil in 2006. Subsequently, her pap smear revealed low grade squamous intraepithelial lesion. Cervical biopsies performed in 2015 and 2016 revealed cervical intraepithelial neoplasia grade 1 (CIN 1). She underwent loop electrosurgical excision procedure for persistent CIN 1, which demonstrated CIN 3. Genotyping revealed HPV type 56 infection. The advancement of Gardasil-9 vaccine only offers 90% protection to patients against HPV-related disease. Lay literature may mislead patients to think they have no risk of HPV infection.

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Parwanto, ML Edy. « Kanker serviks dan gen Fas-promoter-670 ». Jurnal Biomedika dan Kesehatan 2, n^o 3 (29 septembre 2019) : 90–91. http://dx.doi.org/10.18051/jbiomedkes.2019.v2.90-91.

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Kanker serviks merupakan keganasan pada serviks. Jenis kanker tersebut terjadi pada perempuan dan masih menjadi masalah di Indonesia. Indonesia merupakan negara urutan ke 4 di Asia Tenggara dengan insiden kanker serviks terbesar setelah Kamboja, Myanmar dan Thailand. Berdasar data statistik tahun 2012, tingkat insidensi (incidence rate) kanker serviks di Indonesia 17 per 100.000 perempuan per tahun.(1) Telah terbukti bahwa penyebab primer terjadinya kanker serviks yaitu virus papilloma atau yang lebih dikenal dengan istilah “human papillomavirus (HPV)”. Terdapat beberapa jenis serotype HPV, tetapi tidak semua jenis serotype bersifat progesif menjadikan kanker serviks. Salah satu serotype yang bersifat progesif menjadikan kanker serviks yaitu HPV serotype 16. HPV serotype 16 mampu mengubah sel epitel squamosa serviks (cervical-squamous-epithelial cells=CSEC) normal menjadi lesi intraepitelial squamosa tingkat rendah (low-grade squamous intraepithelial lesion=LSIL) atau neoplasia intraepitel serviks (cervical intraepithelial neoplasia=CIN) 1. Selanjutnya, LSIL atau CIN 1 berkembang menjadi lesi intraepitelial squamosa tingkat tinggi (high-grade squamous intraepithelial lesion=HSIL) atau CIN 2, dan akhirnya menjadi kanker serviks yang invasif (invasive cervical cancer=CIN3).(2)

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Wang, Xue, Li Fu, Wenhai Lin, Wei Zhang, Qing Pei, Xiaohua Zheng, Shi Liu, Tao Zhang et Zhigang Xie. « Vaginal delivery of mucus-penetrating organic nanoparticles for photothermal therapy against cervical intraepithelial neoplasia in mice ». Journal of Materials Chemistry B 7, n^o 29 (2019) : 4528–37. http://dx.doi.org/10.1039/c9tb00984a.

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Tirone, Nelson Ranieri, Carolina Guissoni Campos, Kézia Jesus Aguiar Ferreira, Léticia Montes Stark, Jéssica Ferreira Vieira, Eddie Fernando Cândido Murta et Márcia Antoniazi Michelin. « Pathways of IFN-alpha Activation in Patients with Cervical Intraepithelial Neoplasia (CIN) ». Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 43, n^o 09 (septembre 2021) : 682–89. http://dx.doi.org/10.1055/s-0041-1735301.

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Abstract Objective The aim of the present study was to compare the local and systemic expression of the factors linked to the interferon alpha (IFN-α) activation pathway in different degrees of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods A total of 128 patients with CIN I, CIN II, CIN III and cervical cancer was evaluated. The real-time polymerase chain reaction (RT-PCR) technique was used to evaluate the gene expression of IFNR1, IFNR2, IFN-α, oligoadenylate synthase (2'5′OAS), cytokine signal suppressor 1 (SOCS) 1, SOCS3, signal transducer and transcription activator 1 (STAT1), and IRF9 from 128 biopsies. A total of 46 out of 128 samples were evaluated by flow cytometry for IFNAR1, IFNAR2, STAT1, IRF7 and IFN-α in peripheral blood cells. Results Patients with CIN II and III (63 samples) had a low local expression of IFNR1, but not IFNR2. Patients with some degree of injury showed high expression of SOCS1 and SOCS3. Systemically, patients with CIN II and III (20 samples) had a significant increase in IFNR1, IFNR2, STAT1, IRF7, and IFN-α in helper, cytotoxic T lymphocytes, and in monocytes. Conclusion Patients with high-grade lesions have increased systemic expression of IFN-α and its activation pathways in helper and cytotoxic T lymphocytes, as well as in monocytes due to an exacerbation of the immune response in these patients. This phenomenon is not accompanied by resolution of the lesion due to a defect in the IFN-α activation pathway that revealed by low local IFNAR1 expression and high local expression of SOCS1 and SOCS3.

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Al-Nafussi, A. I., M. K. Colquhoun et A. R. W. Williams. « Accuracy of cervical smears in predicting the grades of cervical intraepithelial neoplasia ». International Journal of Gynecologic Cancer 3, n^o 2 (1993) : 89–93. http://dx.doi.org/10.1046/j.1525-1438.1993.03020089.x.

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This is a retrospective study carried out to assess the correlation between the cytology and histology of cervical intraepithelial neoplasia in 1325 women. A poor correlation between the cytologic and histologic diagnosis of the various grades of CIN was shown. Forty-one percent of smears with repeated borderline change and 50% of those predicting CIN1 showed a higher grade of CIN on histology. The overall apparent false negative rate of cervical smears for high grade CIN (CIN2 and CIN3) was 19% and for CIN3 alone was only 3%. It is therefore concluded that there is a consistent tendency for cervical cytology to underestimate the severity of histologic lesions and it is therefore important that the clinicians ensure adequate follow-up of patients whose smears show a lesser degree of abnormality.

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Vinogradova, O. P., O. I. Artemova, N. A. Andreeva et O. V. Epifanova. « Changes in immune response factors in therapy of cervical intraepithelial neoplasia ». Siberian Medical Review 6 (2022) : 71–77. http://dx.doi.org/10.20333/25000136-2022-6-71-77.

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Th e aim of the research. Assessment of changes in immune response factors during antiviral therapy of cervical intraepithelial neoplasia of severity grades I and II against the background of human papillomavirus. Material and methods. An outpatient examination of 232 female subjects of reproductive age was carried out. Among these, 172 women were with a histologically confi rmed diagnosis of mild to moderate cervical intraepithelial neoplasia (CIN I-II) associated with papillomavirus infection. During the work, each patient underwent cytological and colposcopic examination as well as real-time HPV typing with viral load evaluation. To establish the fi nal diagnosis, if necessary, a multifocal biopsy of the cervix was used. Within the framework of the designated goal, changes in the cervical zone were studied and analysed by means of assessing caspase-3, caspase-9, IFN-γ, IL-18. Results. As part of the study, changes in the caspase and cytokine profi le were analysed in HPV-associated cervical intraepithelial neoplasia of grades I-II, which substantiated the use of immune system correction for successful treatment of patients with mild to moderate dysplastic processes. Conclusion. The results obtained in the study make it possible to optimise management of patients with HPV-associated cervical intraepithelial neoplasia of severity degrees I-II.

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Siddiqui, Syeda Rumman Aktar, M. Ariful Islam et M. Zillur Rahman. « Diagnosis of cervical lesion by colposcopy, VIA, pap smear tests, and their correlation with histopathology in a tertiary level laboratory in Chattogram, Bangladesh ». International Journal of Research in Medical Sciences 11, n^o 3 (28 février 2023) : 801–7. http://dx.doi.org/10.18203/2320-6012.ijrms20230563.

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Background: Cervical carcinoma is one of the most common causes of mortality among women. This mortality rate can be reduced by early detection of cervical neoplasm by different screening tests. The main objective of this study was to diagnose cervical diseases by colposcopy, by pap smears for cytological examination as well as correlate these findings as screening tests with histopathological diagnosis. Methods: In this cross-sectional observational study, total 143 cases were included. History was taken and clinical examination was done. Colposcopy and VIA test was done, pap smear sample was collected and reporting was made. Cytological findings were correlated with histopathology. Results: Mean age of the study cases was 41.2±11.5 years. VIA test was positive in 98 study cases (68.5%). On colposcopy, most of the cases show neoplastic proliferation (80 cases, 55.9%). Among them, most cases were diagnosed as cervical intraepithelial neoplasia-I (CIN-I). Sixty-three (63) cases (44.1%) were non-neoplastic. Most of the biopsies was diagnosed histopathologically as cervical intraepithelial neoplasia-I (CIN-I) (20 cases, 14.0%). Association of colposcopy findings with histopathological diagnosis was done which was significant. Sensitivity of diagnosis of cervical malignancy by colposcopy was 33.33% and specificity was 98.57%. Conclusions: The study provides good cyto-histopathology correlation in detecting different cervical lesions and malignancy with colposcopy. Although colposcopy sensitivity was low but it can be increased by adequate training and avoiding technical errors. Bethesda system is strongly recommended for adequacy of sampling to minimize inconsistency. Early and regular screening should be advised for reduction of mortality rates from cervical carcinoma.

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Phaliwong, Paweena, Piyawan Pariyawateekul, Nathaya Khuakoonratt, Worrawan Sirichai, Kornkarn Bhamarapravatana et Komsun Suwannarurk. « Silent High Grade Cervical Intraepithelial Neoplasia Diagnosis of Atypical Smear between Conventional and Liquid Based Papanicolaou Smear in Suburban Area of Thailand ». Asian Pacific Journal of Cancer Care 3, n^o 3 (17 septembre 2018) : 47. http://dx.doi.org/10.31557/apjcc.2018.3.3.47.

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Objectives: To evaluate the prevalence of silent high grade cervical intraepithelial neoplasia diagnose in atypical squamous cells of undetermined significance (ASC-US) in cytology result between conventional (CPP) and liquid-based cervical cytology (LBP) methods to suggest the proper management for Thai women.Methods: This retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2011 and December 2016. Medical records of 28,564 patients who attended for cervical cancer screening were reviewed. Prevalence of silent high grade cervical intraepithelial neoplasia (CIN) in atypical squamous cells of undetermined significance (ASC-US) cytology result was determinedResults: During the study period, 28,564 cases were enrolled. There were 22,552 and 6,012 of CPP and LBP cases, respectively. A total of 644 cases of ASC-US cytology were enrolled. In women with ASC-US in cytology, the mean age was younger than women with negative screening cytology group and approximately 70% were in pre-menopausal status. Prevalence of high grade cervical intraepithelial neoplasia in ASC-US cytology from CPP and LBP were 9.5 and 11.9%, respectively. Ten percent (23/248) of atypical glandular cytology pattern was cancer. One-quarter of them was endometrial cancer.Conclusion: Silent high grade cervical intraepithelial neoplasia in ASC-US cytology and the rate of cancer in atypical glandular cytology pattern were high. We recommended colposcopy for women who had the cervical cytological report as atypical squamous and glandular cytology pattern.

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Manzhura, E. P. « Cervical intraepithelial neoplasia (CIN). Modern approaches to the diagnosis, treatment and rehabilitation ». HEALTH OF WOMAN, n^o 5(111) (20 juin 2016) : 19–25. http://dx.doi.org/10.15574/hw.2016.111.19.

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The aim of the study: to evaluate the clinical efficacy of the drug Ravitax in the form of vaginal plugs in the postoperative treatment of the cervix. Materials and methods. To evaluate the clinical efficacy were studied 2 medicines in the group of patients after surgical treatment of the cervix, namely, candle Ravitax and candle Methyluracil. The study was open, in the examined group consisted of 50 women, 25 of whom were appointed candle Ravitax, and 25 - Methyluracil candles. All the patients were performed cervical conization by the united method - electrosurgical and in the postoperative period assigned to the candles once a day for the night - 14 from the 3rd postoperative day. Examination of patients was carried out for 30-35 days and 60-65 days after surgery. There were evaluated the degree of epithelialization, stricture of the cervical canal and bacterioscopy stroke, as well as the subjective feeling of the woman of comfort on a 10-point system. Results. As can be seen from the results, patients who received the drug Ravitax in the form of vaginal plugs had a higher percentage of epithelialization, in contrast to patients treated with vaginal suppositories Methyluracil. So, under Ravitax 30-35 days of examination of epithelialization was higher by 13±2.3%, and 60-65 days - 12±3.4%. When examination noted that the wound surface was cleaned more effectively with the use of the drug Ravitax, the number of strictures after 2 months was 25% less and the comfort level was higher by 35.6%, which is very important for the quality of life of women. This action is generally due to the rational components of the drug Ravitax. Conclusion. Thus, the drug Ravitax an exaggeration to say that he established himself in the past many years as an effective, reliable drug which improves reparative processes after operations on the cervix. It has no damaging effect on the epithelium, has no contraindications due to the lack of corrosive reagents. It was shown in reproductive, before and postmenopausal women. Key words: pathology of the cervix, dysplasia, cancer, classification, Ravitax.

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Pradhan, Renee, U. Pant et B. Aryal. « Efficiency of HPV DNA Test versus Pap Smear in the Screening of Cervical Cancer ». Journal of Karnali Academy of Health Sciences 1, n^o 2 (6 octobre 2018) : 9–13. http://dx.doi.org/10.3126/jkahs.v1i2.24128.

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Introduction: Cancer cervix is a common genital cancer. Human papillomavirus is the main cause of cervical cancer because of the strong association of certain HPV genotypes and the development of cervical cancer and its precursor lesions, cervical intraepithelial neoplasia CIN 2 or CIN3. Methods: The study was conducted on 180 gynecological patients seen at the outpatient department of Manipal Hospital, Bangalore. A comparative study of HPV DNA test with Pap smear in the screening of cervical neoplasia was carried out over the period of 24 months from August 2011 to June 2013. Results: The incidence of cervical cancer and its associated mortality has declined in recent years, largely due to the widespread implementation of screening programs by Pap smear testing. The management and the prevention of cervical cancer should change with HPV DNA testing for high risk HPV, which is more sensitive than pap smear testing. Infection of cervix with HPV is necessary to cause cervical neoplasia and cervical cancer. Persistent infection with HPV is required for the development of cervical dysplasia and invasive cervical cancer. Conclusions: HPV testing alone for primary screening appears promising in women aged 30 years and older as this group is at greatest risk of developing CIN 3. As compared with Pap testing, HPV testing has greater sensitivity for detection of cervical intraepithelial neoplasia.

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Zarochentseva, N. V., L. K. Dzhidzhikhiya et V. N. Nabieva. « Monitoring of patients with cervical intraepithelial neoplasia after excisional treatment ». Voprosy ginekologii, akušerstva i perinatologii 20, n^o 1 (2021) : 113–20. http://dx.doi.org/10.20953/1726-1678-2021-1-113-120.

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Cervical intraepithelial neoplasia (CIN) refers to precancerous changes in the cervix. After surgical treatment, a certain proportion of patients remain at risk of disease reccurence. Therefore, monitoring of patients after CIN surgery is an important and necessary part of their management tactics. Objective. Review of world literature on modern approaches to patients monitoring after using excisional methods of CIN treatment. Materials and methods. The information material includes data from scientific articles on the subject available in Pubmed and published over the past 20 years. Results. The analysis of data contained in modern literature on the frequency and risk factors for the development of reccurent CIN after excisional methods of treatment, diagnostic methods, the timing of follow-up examinations during post-operative monitoring, the main approaches to monitoring in different countries and the effectiveness of the proposed strategies for postoperative follow-up of patients after treatment was conducted. It was established that the approaches to the observation of this category of patients differ in various countries. Almost everywhere, the priority tool for monitoring of patients with CIN after treatment is a combined test, which involves a joint use of cytology and human papillomavirus tests. The main difference between countries is the timing of the first post-treatment follow-up visit. In some countries a follow-up visit is recommended within 24 months, while in others it is suggested to return to routine screening if the primary combined test is negative. Conclusion. Despite existing disagreements, the proposed post-operative monitoring strategies for CIN patients provide a fairly high percentage of “healing” and return to routine screening. Key words: human papillomavirus, monitoring, cervical cancer, cervical intraepithelial neoplasia, excisional treatment

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Berceanu, Costin, Stefan Paitici, Sabina Berceanu, Elvira Bratila, Anca Maria Ofiteru, Claudia Mehedintu, Sorin Ion Berbece, Dan Navolan, Cosmin Vasile Obleaga et Tudor Adrian Balseanu. « Colposcopic, Histologic and Immunohistochemical Assessment in Cervical Intraepithelial Lesions ». Revista de Chimie 69, n^o 8 (15 septembre 2018) : 2245–50. http://dx.doi.org/10.37358/rc.18.8.6509.

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It is widely accepted that HPV infection precedes the occurrence of neoplastic disease in a varying time frame, and HPV testing can detect 30-100% more cervical precancers than conventional cytology and 20-50% more precancers than liquid-based cytology. Low-grade squamous intraepithelial lesions include the categories of mild dysplasia, respectively cervical intraepithelial neoplasia grade 1, and complementary, various descriptors indicating the presence of Human papilloma virus, such as koilocytotic atypia or condilomatous dysplasia. High-grade squamous intraepithelial lesions cytologically consist of moderate and severe dysplasia, respectively cervical intraepithelial neoplasia grade 2, 3 and carcinoma in situ. The purpose of our paper is to analyze the cytological and colposcopic characteristics in low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions cervical lesions and to accomplish histological and immunohistochemical correlations in these cervical intraepithelial lesions. Systematic three-step colposcopic evaluation using successively, normal saline with or without green filter, acetic acid and Lugol staining provides enhanced efficiency to the colposcopic examination and allows a more individualized and targeted surgical, medical or expectant management. Special microscopic techniques are very important in diagnosing and grading cervical intraepithelial neoplasia.

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Vinogradova, Ol’ga P., Natal’ya A. Andreeva, Ol’ga V. Epifanova et Ol’ga I. Artemova. « Long-term effect of antiviral therapy for grade II cervical intraepithelial neoplasia ». V.F.Snegirev Archives of Obstetrics and Gynecology 9, n^o 4 (24 décembre 2022) : 239–46. http://dx.doi.org/10.17816/2313-8726-2022-9-4-239-246.

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BACKGROUND: The production of many molecular markers at different grades of cervical intraepithelial neoplasia is currently being studied to predict the outcome of the disease and build an individual prognosis. However, no clear criteria for the course of neoplasia are available at this time. AIM: This study aimed to assess the efficiency of the antiviral immunomodulator Allokin-alpha (Alloferon) in the treatment of cervical intraepithelial neoplasia of moderate severity from the perspective of long-term follow-up. DESIGN: Prospective study. MATERIALS AND METHODS: We examined 86 women of reproductive age with grade II cervical intraepithelial neoplasia (CIN II) associated with human papillomavirus (HPV). In the CIN II group, all patients underwent excision of the affected area. According to the study design, 43 women were followed up after excision (Group 1a), while 43 participants were treated surgically and used the study drug (Group 1b). By cytological and colposcopic examination, the efficiency of the chosen therapy was assessed after 3, 12, and 18 months. However, the main criteria for the efficiency of treatment were the absence of HPV or a decrease in the viral load below significant values and the absence of recurrence of the pathological process. RESULTS: The combination of excision and the use of Allokin-alpha (Alloferon) showed significant advantages over monosurgical treatment. CONCLUSIONS: The data obtained indicate high HPV elimination and reduced probability of recurrence after excisional treatment in patients with CIN II when using Allokin-alpha (Alloferon).

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Dudea-Simon, Marina, Dan Mihu, Laura Ancuta Pop, Razvan Ciortea, Andrei Mihai Malutan, Doru Diculescu, Cristina Alexandra Ciocan et al. « Alteration of Gene and miRNA Expression in Cervical Intraepithelial Neoplasia and Cervical Cancer ». International Journal of Molecular Sciences 23, n^o 11 (27 mai 2022) : 6054. http://dx.doi.org/10.3390/ijms23116054.

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Background: Cervical cancer is one of the most common malignancies in women in terms of prevalence and mortality. Cervical cancer has some particularities that distinguish it from any other oncologic pathology: first, it is completely preventable by prompt detection of its precursor, cervical intraepithelial neoplasia (CIN); second, the Human Papillomavirus (HPV) infection is a known etiological agent; third, the mean age at diagnosis is much lower than in other oncologic conditions, as a consequence of the sexually-transmitted HPV. Methods: We evaluated the expression level of several long noncoding RNAs and a microRNA in samples from 30 patients with CIN, 9 with cervical cancer and 38 normal samples using qRT-PCR technology. Results: We observed higher expression levels for MEG3, DAPK1, MLH1 and MALAT1 in CIN samples than in normal samples, whereas TIMP3 and SOX1 had lower expression levels. For cancer samples, DAPK1, MLH1 and MALAT1 had higher expression, and MEG3, TIMP3 and SOX1 had lower expression when compared to normal samples. In the case of CIN versus cancer samples, only MEG3 gene showed a statistically significant difference. The expression of miR-205-5p was lower in both CIN and cancer samples compared to normal samples. Conclusion: Decreased MEG3 expression could be considered an alarm signal in the transition from a premalignant cervical lesion to invasive cancer, while altered expression levels of TIMP3, SOX1, MLH1, MALAT1 and miR-205-5p could serve as early biomarkers in the diagnosis of premalignant cervical lesions. Future studies, including a larger number of patients with CIN, will be of particular importance in validating these observations.

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Pino, Marta del, Isabel Matas, Pilar Carrillo, Cristina Martí, Ariel Glickman, Núria Carreras-Dieguez, Lorena Marimon et al. « Natural History of Anal HPV Infection in Women Treated for Cervical Intraepithelial Neoplasia ». Cancers 15, n^o 4 (10 février 2023) : 1147. http://dx.doi.org/10.3390/cancers15041147.

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Women with high-grade squamous intraepithelial lesions/cervical intraepithelial neoplasia (HSIL/CIN) are at high risk of anal human papillomavirus HPV infection, and it has also been suggested that self-inoculation of the virus from the anal canal to the cervix could explain HPV recurrence in the cervix after treatment of HSIL/CIN. We aimed to evaluate the bidirectional interactions of HPV infection between these two anatomical sites. We evaluated 68 immunocompetent women undergoing excisional treatment for HSIL/CIN. Immediately before treatment, samples from the anus and the cervix were obtained (baseline anal and cervical HPV status). Cervical HPV clearance after treatment was defined as treatment success. The first follow-up control was scheduled 4–6 months after treatment for cervical and anal samples. High resolution anoscopy (HRA) was performed on patients with persistent anal HPV infections or abnormal anal cytology in the first control. Baseline anal HPV was positive in 42/68 (61.8%) of the women. Anal HPV infection persisted after treatment in 29/68 (42.6%) of the women. One-third of these women (10/29; 34.5%) had HSIL/anal intraepithelial neoplasia (AIN). Among women achieving treatment success, cervical HPV in the first control was positive in 34.6% and 17.6% of the patients with positive and negative baseline anal HPV infection, respectively (p = 0.306). In conclusion, patients with persisting anal HPV after HSIL/CIN treatment are at high risk of HSIL/AIN, suggesting that these women would benefit from anal exploration. The study also suggests that women with anal HPV infection treated for HSIL/CIN might be at higher risk of recurrent cervical HPV even after successful treatment.

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Zheng, Lei, Ai-Lan Liu, Tao Qi, Qian Wang, Zhen Cai, Ya-Juan Su, Yan-Wei Hu, Guo-Bing Liu et Li-Hui Wei. « Human Telomerase RNA Gene Amplification Detection Increases the Specificity of Cervical Intraepithelial Neoplasia Screening ». International Journal of Gynecologic Cancer 20, n^o 6 (juillet 2010) : 912–17. http://dx.doi.org/10.1111/igc.0b013e3181e5c424.

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Objectives:The purpose of this study was to evaluate the clinical significance of genomic amplification of the human telomerase RNA gene (TERC) for cervical cancer screening and explore whether it can serve as a biomarker to improve the specificity of human papillomavirus (HPV) DNA testing for cervical cancer screening.Methods:One hundred twenty women, including 20 cases of normal (control), 14 cases of cervical intraepithelial neoplasia grade I (CIN I), 35 cases of CIN II, 36 cases of CIN III, and 15 cases of squamous cervical cancer diagnosed by histopathologic evaluation, were subjected to cytopathologic examination, TERC detection by fluorescence in situ hybridization (FISH), and HPV DNA testing by Hybrid Capture II.Results:TERC amplification was significantly associated with cytopathologic diagnosis (P < 0.001) and histopathologic evaluation (P < 0.001). The positive rate of TERC gain was significantly higher in patients with CIN III or squamous cervical cancer than in patients with CIN I or those in the control group (P < 0.001). The specificity and positive predictive value of FISH for detecting CIN II or more severe cervical lesions (≥CIN II) were obviously higher than those of HPV DNA testing (97.1% vs 52.9%, 98.7% vs 83.8%).Conclusions:TERC amplification analyzed by FISH may serve as an adjunctive test to HPV DNA testing for improving the specificity and positive predictive value of cervical cancer screening.

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