BACKGROUND Spilled gallstones from previous cholecystectomy is not an uncommon situation.It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with co...BACKGROUND Spilled gallstones from previous cholecystectomy is not an uncommon situation.It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with computed tomography([18F]FDG PET/CT).CASE SUMMARY A 63 year-old patient was diagnosed with a cancer of the cervix.Pretreatment[18F]FDG PET/CT showed a peritoneal lesion suspicious for metastasis.Surgical exploration and histologic examination revealed the lesion to be a spilled gallstone from a previous cholecystectomy.CONCLUSION[18F]FDG PET/CT carries pitfalls since benign conditions such as intraperitoneal gallstones may be confused as malignant lesions.This case highlights the importance to be aware of the possible implications of dropped gallstones for the future,minimize its occurrence,and make all efforts to properly evaluate cancer staging,particularly for the cervix cancer.展开更多
Research has demonstrated facilitative effects of social support on psychological and physical well-being of individuals suffering from chronic health problems. Social support can change not only patients’ perception...Research has demonstrated facilitative effects of social support on psychological and physical well-being of individuals suffering from chronic health problems. Social support can change not only patients’ perception of their health problems, but also the consequences of their illness. In the present study with cervix cancer patients, the relationship of social support and illness control agency with illness consequences and health outcome beliefs was examined. Emotional, informational, social companionship and practical supports were found to be negatively correlated with the severity of interpersonal, physiological and psychological consequences of illness. Patients’ belief in self-control and doctor-control was related to less severity and less pain of illness, and strong hope for better health outcomes.展开更多
Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy c...Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer be-tween April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50 - 65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea;80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classifi-cation. Cervix cancer remains a major public health problem in Mali. The di-agnosis is often late, therefore, resulting in late care and unfavorable progno-sis. Sensitization, vulgarization of vaccination and systematization of screen-ing could be helpful in the fight against this cancer.展开更多
OBJECTIVETo investigate the short-term and long-termtherapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB_2-IIB uterine cervix cancer (UCC).METHODS A total of 143 patients with St...OBJECTIVETo investigate the short-term and long-termtherapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB_2-IIB uterine cervix cancer (UCC).METHODS A total of 143 patients with Stage IB_2-IIB UCCwere divided into a clinical trial group and a control group.Thepatients in the clinical trial group(n=86)were treated with acombined therapy,i.e.,preoperative intra-arterial infusion chemo-embolization,surgical therapy and postoperative radiotherapy,and those in the control group (n=57) were given surgical therapyand post-operative radiotherapy.The adverse effects,changes inlocal lesion and pathological examinations of the cancer,and thestate during the surgery were observed after the intra-arterialinfusion chemo-embolization.The survival rate and recurrencerate between the two groups were compared.RESULTS The total effective rate of the intra-arterial infusionchemo-embolization on Stage IB_2-IIB UCC was 93.02%.Thetreatment could reduce tumor size,bring about retro-conversionsof the clinical stage of the tumors and pathological grade of thecancer cells,and decrease the quantity of intra-operative bloodloss as well as the operating time.It could significantly improvethe 5-year survival rate (P<0.05),and reduce the 2 and 5-yeartumor recurrence rates (P<0.05).Moreover,its side effects werelittle.CONCLUSION Preoperative intra-arterial infusion chemo-embolization can create conditions for radical operation,lower thepostoperative recurrence rate,and improve the prognosis in thepatients with UCC.It is an effective therapy in treating UCC.展开更多
The purpose of this cross-sectional study was to investigate the importance of health vigilance in the prevention of cervical cancer. The sample consisted of 536 women. To identify which risk factors were associated w...The purpose of this cross-sectional study was to investigate the importance of health vigilance in the prevention of cervical cancer. The sample consisted of 536 women. To identify which risk factors were associated with cervical cancer or with an increase in the mortality rate of this kind of cancer, a logistic regression model was used. The Odds Ratios (OR) and their respective 95% confidence intervals were also calculated. Most of them were at the age of highest incidence of cervical cancer (21 - 59 years old), had an unstable conjugal situation, minimal educational level (78.7%), low income (58.3%), consumed alcoholic beverages (56.4%), had a history of smoking (57.0%) and possessed limited knowledge about the prevention. These results are discussed in terms of a predictive model for cervical cancer that considers the importance of public health vigilance in the screening and precocious diagnosis.展开更多
Introduction: Cervical cancer is a public health problem in Cameroon, due to low screening and late diagnosis. We sought to assess practice of colposcopy at the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) i...Introduction: Cervical cancer is a public health problem in Cameroon, due to low screening and late diagnosis. We sought to assess practice of colposcopy at the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon and its contribution to the fight against cervical cancer in our context. Method: This is a retrospective cross-sectional study of 99 colposcopies after which 71 exploitable biopsies were retained at the Douala for a period of 1year (December 1, 2019-December 1, 2020). The nomenclature of the French Society of Colposcopy and Cervico-Vaginal Pathology (SFCPCV) was used. Results: Mean age of the participants was 44 years, mostly multiparous (80%). Cytological abnormalities were the main reference pattern. During the examination 22% of colposcopies were found to be normal, 37% of TAG 1-2A, 31% of TAG 2B-C, and 5% suspected of cancer. After histological analysis of biopsies guided by colposcopy, we found 42% (30/71) of Cervical Intraepithelial Neoplasia (CIN) 1, 15.5% (11/71) of CIN 2 - 3, and 24% (17/71) cancer. Upon analysis of the diagnosed CIN1/CIN2-3/Cancers, we noted a concordance with colposcopy in 62% (23/37), 37% (10/27) and 85% (6/7) respectively. Colposcopic performance in the detection of high-grade lesions and above was 36% (26/71), with a sensitivity of 92.86%, specificity 83.33%, PPV 78.79% and NPV 94.59%. Conclusion: Despite the difficult socioeconomic context, colposcopy retains all its importance in the diagnosis of precancerous lesions of the uterine cervix. With the imminent putting in place of a national health policy, the goals 90-70-90 by 2030 of the World Health Organization for the fight against cervical cancer can be achieved in our sub-Saharan African countries.展开更多
<strong>Objective:</strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "="">The aim was to ta...<strong>Objective:</strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "="">The aim was to take stock of the screening and treatment of precancerous and cancerous lesions of the cervix in the health district of commune V of Bamako, the </span><span style="font-family:;" "="">“</span><span style="font-family:;" "="">G</span><span style="font-family:;" "="">”</span><span style="font-family:;" "=""> point and the Gabriel Touré University Hospital <span>in Bamako, Mali. <b>Patients and Methods:</b> This was a descriptive, cross-sectional</span>, analytical study with retrospective and prospective data collection over an 8-year period from January 1, 2010 to December 31, 2017. This was a multi-center study. <b>Results: </b>From January 1, 2010 to December 31, 2017, 42</span><span style="font-family:;" "="">,</span><span style="font-family:;" "="">492 women were screened, representing a frequency of 24.30%. The median age of the women screened was 32 years;25% were under the age of 25. Three-fourth of the women screened was in the 20</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">49 age group. Of the 22</span><span style="font-family:;" "="">,</span><span style="font-family:;" "="">842 women screened</span><span style="font-family:;" "="">,</span><span style="font-family:;" "=""> 90.1% of them had a normal col to IVA/IVL. However</span><span style="font-family:;" "="">,</span><span style="font-family:;" "=""> 4.1% of cervical positivity </span><span style="font-family:;" "="">had </span><span style="font-family:;" "="">with acetic acid and 5.1% of positivity to Lugol. 0.7% of the women screened clinically had cancerous lesions. Histologically, 96.5% of the women screened had a normal cervix with benign lesions. For pathological histological findings, we noted 2.6% of precancerous lesions and 0.8% of squamous cell carcinomas and 0.1% of adenocarcinoma. <b>Conclusion: </b>Improved screening indicators with IVA/IV reduce the rate of morbidity and mortality from cervical cancer.</span>展开更多
Brachytherapy forms an integral part of the radiation therapy in cancer cervix. The dose prescription for intracavitary brachytherapy(ICBT) in cancer cervix is based on Tod and Meredith's point A and has been in p...Brachytherapy forms an integral part of the radiation therapy in cancer cervix. The dose prescription for intracavitary brachytherapy(ICBT) in cancer cervix is based on Tod and Meredith's point A and has been in practice since 1938. This was proposed at a time when accessibility to imaging technology and dose computation facilities was limited. The concept has been in practice worldwide for more than half a century and has been the fulcrum of all ICBT treatments, strategies and outcome measures. The method is simple and can be adapted by all centres practicing ICBT in cancer cervix. However, with the widespread availability of imaging techniques, clinical use of different dose-rates, availability of a host of applicators fabricated with image compatible materials, radiobiological implications of dose equivalence and its impact on tumour and organs at risk; more and more weight is being laid down on individualised image based brachytherapy. Thus, computed tomography, magnetic-resonance imaging and even positron emission computerized tomographyalong with brachytherapy treatment planning system are being increasingly adopted with promising outcomes. The present article reviews the evolution of dose prescription concepts in ICBT in cancer cervix and brings forward the need for image based brachytherapy to evaluate clinical outcomes. As is evident, a gradual transition from "point" based brachytherapy to "profile" based image guided brachytherapy is gaining widespread acceptance for dose prescription, reporting and outcome evaluation in the clinical practice of ICBT in cancer cervix.展开更多
Background: To evaluate local control, survival, radiation side effects and treatment outcome in locally advanced cervical cancer patients. Materials and Methods: Among 2006-2011, 178 patients with locally advanced ce...Background: To evaluate local control, survival, radiation side effects and treatment outcome in locally advanced cervical cancer patients. Materials and Methods: Among 2006-2011, 178 patients with locally advanced cervical cancer were treated with chemoradiotherapy +/-?radiotherapy and high dose rate (HDR) brachytherapy. Follow-up was complete for all patients. Concomitant chemotherapy was not administered in 44 patients due to renal impairments and ECOG of 2 - 3. Results: The median follow-up period was 34.5 months (range, 5 to 93) and 42 months (range, 14 to 93 months) for alive patients. Five years local-regional control, progression-free survival and overall survival rates were 87.8%, 58.9% and 67.3% in all patients, respectively. In this retrospective study young age, tumor diameter, stage, presence of residual tumor and administration of chemotherapy were effected in survival analysis. The parameters which affected the complete response of patients were defined as presence of concomitant chemotherapy and number of courses <5. Central region recurrence rate was defined higher in the group with treatment duration of 9 weeks and higher (p = 0.044). Conclusion: Primary chemoradiotherapy +/-?radiotherapy achieved a satisfactory rate of local control and survival rates with acceptable complications in locally advanced cervical cancer. Concomitant chemotherapy and treatment duration were the important prognostic factors for completed response locally advanced cervical cancers.展开更多
Objective:To study the anti-tumor activities of furanodiene(C15H20O),a primary sesquiterpene compound isolated from the essential oil of the rhizome of Curcuma wenyujin YH Chen et C.Ling(Wen Ezhu),in vitro and in vivo...Objective:To study the anti-tumor activities of furanodiene(C15H20O),a primary sesquiterpene compound isolated from the essential oil of the rhizome of Curcuma wenyujin YH Chen et C.Ling(Wen Ezhu),in vitro and in vivo.Methods:In vitro MTT assay was used to further study the effects of time and dosage on anti-proliferation of furanodiene against the sensitive Hela,Hep-2,HL-60,U251 cells,based on the cytotoxic effects of furanodiene on 12 human malignant tumor cell lines with the essential oil of Wen Ezhu as control.,and the half-inhibitory concentration(IC50) was observed.In vivo uterine cervix(U14) tumor cell was selected and the conventional assay method of anti-tumor activity was employed.Furanodiene liposome was administered intraperitoneally,and tumor-inhibitory rate,thymus and spleen indexes were observed.Results:The inhibitive effects on cell proliferation were shown in all of the twelve cell lines and the cytotoxic effects of furanodiene against Hela,Hep-2,HL-60,U251 cells were observed after 12 h of administration,the effect could last for at least 48 h in a dose dependent manner,and the IC50 values were 0.6,1.7,1.8,7.0 μg/ml,respectively.Furanodiene was also found to show inhibitive effects on the proliferation of uterine cervix(U14) tumor induced in mice.The tumor inhibition rates were 36.09%(40 mg/kg),41.55%(60 mg/kg),58.29%(80 mg/kg),respectively.Conclusion:Furanodiene is one of primary anti-cancer active components in the essential oil of Wen Ezhu,and also a very effective agent against uterine cervix cancer,and has protection effect on the immune function.展开更多
Objective This work aims to investigate the expression pattern and clinicopathologic significance of centromere protein H(CENP-H) in uterine cervical cancer(UCC). Methods The level of CENP-H expression in the paraffin...Objective This work aims to investigate the expression pattern and clinicopathologic significance of centromere protein H(CENP-H) in uterine cervical cancer(UCC). Methods The level of CENP-H expression in the paraffin sections of 62 UCC cases was determined by the SP immunohistochemical method,with complete clinicopathologic data in all cases.Statistical analysis was conducted to evaluate the prognostic and diagnostic significance of CENP-H using SPSS13.0 software package. Results Immunohistochemical assay showed strong CENP-H expression in 61.29% (38/62) of the paraffin-embedded cervical cancer tissues.Statistical analysis revealed a strong correlation between the CENP-H expression and the clinical classification(P=0.038) of the cervical carcinoma.The expression increased with rise of the stages.The analysis of Cox proportional hazards regression model suggested that CENP-H expression(P=0.002) and tumor stage(P=0.001) were independent prognostic markers for the survival of UCC patients.The survival analysis showed that the survival rate was significantly lower in patients with high expression of CENP-H than in those with low expression of CENP-H(P=0.001). Conclusions CENP-H is likely to be a valuable marker for carcinogenesis and progression of UCC.It might be used as the important diagnostic and prognostic marker for cervical carcinoma patients,especially for those at early stage.展开更多
Background: Surgery is the treatment for early-stage cervical cancer. Radiochemotherapy is used in the treatment of locally advanced stages. But the choice of treatment can be difficult. Objective: The objective of th...Background: Surgery is the treatment for early-stage cervical cancer. Radiochemotherapy is used in the treatment of locally advanced stages. But the choice of treatment can be difficult. Objective: The objective of this work was to evaluate the therapeutic aspects of cervical cancer in the early stages IA to IIA in the oncology department of A Ledantec Hospital in Dakar. Patients and methods: This was a descriptive retrospective study, from January 2015 to December 2020, in the oncology department of A Ledantec Hospital, including all the patients who had been treated for early-stage invasive cervical cancer. Results: We included 28 patients. The average age was 49.54 years old. There were 11 patients (39.3%) with a stage ≤ IB1. Surgery was the first in 14 patients (50%). The initial approach was a midline supra and subumbilical laparotomy. The surgery was R0 in 65.22%. Postoperative complications were found in 4 patients including 1 case of operative wound suppuration, 1 case of dysuria, 1 case of postoperative eventration and 1 case of rectovaginal fistula. Concomitant Radiochemotherapy was neoadjuvant in 7 cases (25%), adjuvant in 14 cases (50%). The chemotherapy was neoadjuvant in 09 cases (56.25%) and adjuvant in 7 cases (43.75%) with minor toxicities. We had recorded 2 deaths. Conclusion: The treatment of the early stages of invasive cervical cancer is based on surgery. Neoadjuvant treatments may be useful in particular situations.展开更多
Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on t...Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.展开更多
Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay...Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay in seeking early diagnosis and treatment of cervical cancer among women in Malawi. The study was exploratory and utilized qualitative data collection and analysis method. In-depth interviews were conducted using a semi-structured interview guide on a purposive sample of 24 women who were diagnosed of cervical cancer at the gynaecological wards of Zomba and Queen Elizabeth Central Hospitals in Malawi between July and September, 2011. Thematic content analysis was used to analyze the qualitative data. Two major themes (individual and health facility) emerged from the participants’ narratives as factors that contributed to their delay in seeking early diagnosis and treatment. The individual factors included;limited knowledge on symptoms and signs and limited financial resources. The health facilities factors included;limited accessibility and unavailability of cancer screening facilities in the health centres. Results show that there is a need to strengthen the screening of cervical cancer among women in the country. In addition, there is a need to create community awareness on the signs and symptoms of cervical cancer and the merits of seeking early diagnosis and treatment.展开更多
OBJECTIVE To analyze clinical characteristics and treatmentmethods of the patients with adenocarcinoma of the uterine cervix(AUC) and adenosquamous carcinoma of the cervix (ASCC). Tocompare the survival time of the pa...OBJECTIVE To analyze clinical characteristics and treatmentmethods of the patients with adenocarcinoma of the uterine cervix(AUC) and adenosquamous carcinoma of the cervix (ASCC). Tocompare the survival time of the patients in 2 groups and analyzethe prognostic factors.METHODS Clinical data of both 123 patients with AUC and32 patients with ASCC treated at the Cancer Hospital, ChineseAcademy of Medical Science (CAMS) & Peking Union MedicalCollege (PUMC), were retrospectively analyzed.RESULTS The median age of the AUC patients was 50 years, andthat of the ASCC patients was 44, P = 0.019. Poorly-differentiated(grade 3) cases accounted for 59.5% of the total ASCC patients,while only 32.5% of the AUC patients were in grade 3, P = 0.002.In 123 AUC patients, relapse or failure of the treatment occurredin 63 of the patients (51.2%), and the median relapse time was6 months (0-59 months). In 32 ASCC patients, relapse or failureof the treatment occurred in 8 of these patients (51.2%), with amedian relapse time of 4.5 months (0-52 months). The overall5-year survival rate of the AUC patients was 49.8%, which wassignificantly lower than that of the ASCC patients (74.1%), P =0.015. The 5-year survival rates of the ASCC patients in Stage Ⅰ-Ⅲwere higher than that of the AUC patients with the same stages.However, statistical significant difference could only be foundamong the patients in Stage Ⅱ, P = 0.006. The 5-year survival ratesof the ASCC patients with various differential grade were higherthan those of the AUC patients with the same differential grade,but statistical significant difference could only be found amongthe patients in the two groups with moderately differentiation,P = 0.039. It was found by Cox regression analysis that onlyclinical stage (P < 0.001) and histological type (P = 0.046) were theindependent prognostic factors.CONCLUSION Clinical stage and histological type were theindependent prognostic factors of the AUC and ASCC patients.The prognosis of ASCC patients is better than that of the AUCpatients.展开更多
Adenoid cystic carcinoma (ACC) is usually an epithelial neoplasm of the salivary glands but can also occur in the lacrimal glands and the mucous glands of the respiratory tract, breasts and skin. Very rarely, it may a...Adenoid cystic carcinoma (ACC) is usually an epithelial neoplasm of the salivary glands but can also occur in the lacrimal glands and the mucous glands of the respiratory tract, breasts and skin. Very rarely, it may affect the uterine cervix. We report here a case of a woman with postmenopausal bleeding for 7 months, who on physical examination presented with a vegetative and friable tumor lesion in the uterine cervix, measuring about 5 cm in diameter. The abdominal and pelvic computed tomography scans showed a hypodense and heterogeneous mass in the cervix and uterine isthmus. Histopathological examination and immunohistochemical assays confirmed the diagnosis of ACC. The different pathological aspects, therapeutic options and prognostic factors of ACC are discussed.展开更多
Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a ...Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a retrospective descriptive study of 7 years from 1 January 2006 to 31 December 2012. Records of invasive cervical cancer were histologically confirmed. The clinical and therapeutic data collected were transferred to Epi info 7 and SSPS version 18 software with a significance level p as used to provide information on the vital condition after confidential agreement. Kaplan Meier was used to assess the overall survival rate. Results: Invasive cancer of the cervix was frequent (58.79%) with an annual median rate of 16.7%, with extremes of 5.8% and 20.6%. 88.70% of the patients was referred from regions of the country (54.02%);the median age was 50 years with extremes of 16 and 84 years and a peak of 29.6% between 35 and 44 years;76.20% were housewives;uneducated women were about 60.12%;Stage III was about 45.3%. Most of the patients were confirmed histologically after 30 days (68%). The means of treatment were surgery about 91 (29.26%), palliation 75 (24.12%), radiotherapy 59 (18.97%) and chemotherapy 41 (13.18%) with surgery (9, 65%) or radiotherapy (4.82%). The main complication was metrorrhagia, 164 cases (56.55%), with overall survival rate of 51.8% at 2 years and 5.1% at 5 years. Conclusion: Invasive cervical cancer in later stages is treated for low survival in the context of our work. Early detection and treatment of precancerous lesions would reduce the incidence and mortality of this cancer.展开更多
文摘BACKGROUND Spilled gallstones from previous cholecystectomy is not an uncommon situation.It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with computed tomography([18F]FDG PET/CT).CASE SUMMARY A 63 year-old patient was diagnosed with a cancer of the cervix.Pretreatment[18F]FDG PET/CT showed a peritoneal lesion suspicious for metastasis.Surgical exploration and histologic examination revealed the lesion to be a spilled gallstone from a previous cholecystectomy.CONCLUSION[18F]FDG PET/CT carries pitfalls since benign conditions such as intraperitoneal gallstones may be confused as malignant lesions.This case highlights the importance to be aware of the possible implications of dropped gallstones for the future,minimize its occurrence,and make all efforts to properly evaluate cancer staging,particularly for the cervix cancer.
文摘Research has demonstrated facilitative effects of social support on psychological and physical well-being of individuals suffering from chronic health problems. Social support can change not only patients’ perception of their health problems, but also the consequences of their illness. In the present study with cervix cancer patients, the relationship of social support and illness control agency with illness consequences and health outcome beliefs was examined. Emotional, informational, social companionship and practical supports were found to be negatively correlated with the severity of interpersonal, physiological and psychological consequences of illness. Patients’ belief in self-control and doctor-control was related to less severity and less pain of illness, and strong hope for better health outcomes.
文摘Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer be-tween April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50 - 65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea;80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classifi-cation. Cervix cancer remains a major public health problem in Mali. The di-agnosis is often late, therefore, resulting in late care and unfavorable progno-sis. Sensitization, vulgarization of vaccination and systematization of screen-ing could be helpful in the fight against this cancer.
文摘OBJECTIVETo investigate the short-term and long-termtherapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB_2-IIB uterine cervix cancer (UCC).METHODS A total of 143 patients with Stage IB_2-IIB UCCwere divided into a clinical trial group and a control group.Thepatients in the clinical trial group(n=86)were treated with acombined therapy,i.e.,preoperative intra-arterial infusion chemo-embolization,surgical therapy and postoperative radiotherapy,and those in the control group (n=57) were given surgical therapyand post-operative radiotherapy.The adverse effects,changes inlocal lesion and pathological examinations of the cancer,and thestate during the surgery were observed after the intra-arterialinfusion chemo-embolization.The survival rate and recurrencerate between the two groups were compared.RESULTS The total effective rate of the intra-arterial infusionchemo-embolization on Stage IB_2-IIB UCC was 93.02%.Thetreatment could reduce tumor size,bring about retro-conversionsof the clinical stage of the tumors and pathological grade of thecancer cells,and decrease the quantity of intra-operative bloodloss as well as the operating time.It could significantly improvethe 5-year survival rate (P<0.05),and reduce the 2 and 5-yeartumor recurrence rates (P<0.05).Moreover,its side effects werelittle.CONCLUSION Preoperative intra-arterial infusion chemo-embolization can create conditions for radical operation,lower thepostoperative recurrence rate,and improve the prognosis in thepatients with UCC.It is an effective therapy in treating UCC.
文摘The purpose of this cross-sectional study was to investigate the importance of health vigilance in the prevention of cervical cancer. The sample consisted of 536 women. To identify which risk factors were associated with cervical cancer or with an increase in the mortality rate of this kind of cancer, a logistic regression model was used. The Odds Ratios (OR) and their respective 95% confidence intervals were also calculated. Most of them were at the age of highest incidence of cervical cancer (21 - 59 years old), had an unstable conjugal situation, minimal educational level (78.7%), low income (58.3%), consumed alcoholic beverages (56.4%), had a history of smoking (57.0%) and possessed limited knowledge about the prevention. These results are discussed in terms of a predictive model for cervical cancer that considers the importance of public health vigilance in the screening and precocious diagnosis.
文摘Introduction: Cervical cancer is a public health problem in Cameroon, due to low screening and late diagnosis. We sought to assess practice of colposcopy at the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon and its contribution to the fight against cervical cancer in our context. Method: This is a retrospective cross-sectional study of 99 colposcopies after which 71 exploitable biopsies were retained at the Douala for a period of 1year (December 1, 2019-December 1, 2020). The nomenclature of the French Society of Colposcopy and Cervico-Vaginal Pathology (SFCPCV) was used. Results: Mean age of the participants was 44 years, mostly multiparous (80%). Cytological abnormalities were the main reference pattern. During the examination 22% of colposcopies were found to be normal, 37% of TAG 1-2A, 31% of TAG 2B-C, and 5% suspected of cancer. After histological analysis of biopsies guided by colposcopy, we found 42% (30/71) of Cervical Intraepithelial Neoplasia (CIN) 1, 15.5% (11/71) of CIN 2 - 3, and 24% (17/71) cancer. Upon analysis of the diagnosed CIN1/CIN2-3/Cancers, we noted a concordance with colposcopy in 62% (23/37), 37% (10/27) and 85% (6/7) respectively. Colposcopic performance in the detection of high-grade lesions and above was 36% (26/71), with a sensitivity of 92.86%, specificity 83.33%, PPV 78.79% and NPV 94.59%. Conclusion: Despite the difficult socioeconomic context, colposcopy retains all its importance in the diagnosis of precancerous lesions of the uterine cervix. With the imminent putting in place of a national health policy, the goals 90-70-90 by 2030 of the World Health Organization for the fight against cervical cancer can be achieved in our sub-Saharan African countries.
文摘<strong>Objective:</strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "="">The aim was to take stock of the screening and treatment of precancerous and cancerous lesions of the cervix in the health district of commune V of Bamako, the </span><span style="font-family:;" "="">“</span><span style="font-family:;" "="">G</span><span style="font-family:;" "="">”</span><span style="font-family:;" "=""> point and the Gabriel Touré University Hospital <span>in Bamako, Mali. <b>Patients and Methods:</b> This was a descriptive, cross-sectional</span>, analytical study with retrospective and prospective data collection over an 8-year period from January 1, 2010 to December 31, 2017. This was a multi-center study. <b>Results: </b>From January 1, 2010 to December 31, 2017, 42</span><span style="font-family:;" "="">,</span><span style="font-family:;" "="">492 women were screened, representing a frequency of 24.30%. The median age of the women screened was 32 years;25% were under the age of 25. Three-fourth of the women screened was in the 20</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">49 age group. Of the 22</span><span style="font-family:;" "="">,</span><span style="font-family:;" "="">842 women screened</span><span style="font-family:;" "="">,</span><span style="font-family:;" "=""> 90.1% of them had a normal col to IVA/IVL. However</span><span style="font-family:;" "="">,</span><span style="font-family:;" "=""> 4.1% of cervical positivity </span><span style="font-family:;" "="">had </span><span style="font-family:;" "="">with acetic acid and 5.1% of positivity to Lugol. 0.7% of the women screened clinically had cancerous lesions. Histologically, 96.5% of the women screened had a normal cervix with benign lesions. For pathological histological findings, we noted 2.6% of precancerous lesions and 0.8% of squamous cell carcinomas and 0.1% of adenocarcinoma. <b>Conclusion: </b>Improved screening indicators with IVA/IV reduce the rate of morbidity and mortality from cervical cancer.</span>
文摘Brachytherapy forms an integral part of the radiation therapy in cancer cervix. The dose prescription for intracavitary brachytherapy(ICBT) in cancer cervix is based on Tod and Meredith's point A and has been in practice since 1938. This was proposed at a time when accessibility to imaging technology and dose computation facilities was limited. The concept has been in practice worldwide for more than half a century and has been the fulcrum of all ICBT treatments, strategies and outcome measures. The method is simple and can be adapted by all centres practicing ICBT in cancer cervix. However, with the widespread availability of imaging techniques, clinical use of different dose-rates, availability of a host of applicators fabricated with image compatible materials, radiobiological implications of dose equivalence and its impact on tumour and organs at risk; more and more weight is being laid down on individualised image based brachytherapy. Thus, computed tomography, magnetic-resonance imaging and even positron emission computerized tomographyalong with brachytherapy treatment planning system are being increasingly adopted with promising outcomes. The present article reviews the evolution of dose prescription concepts in ICBT in cancer cervix and brings forward the need for image based brachytherapy to evaluate clinical outcomes. As is evident, a gradual transition from "point" based brachytherapy to "profile" based image guided brachytherapy is gaining widespread acceptance for dose prescription, reporting and outcome evaluation in the clinical practice of ICBT in cancer cervix.
文摘Background: To evaluate local control, survival, radiation side effects and treatment outcome in locally advanced cervical cancer patients. Materials and Methods: Among 2006-2011, 178 patients with locally advanced cervical cancer were treated with chemoradiotherapy +/-?radiotherapy and high dose rate (HDR) brachytherapy. Follow-up was complete for all patients. Concomitant chemotherapy was not administered in 44 patients due to renal impairments and ECOG of 2 - 3. Results: The median follow-up period was 34.5 months (range, 5 to 93) and 42 months (range, 14 to 93 months) for alive patients. Five years local-regional control, progression-free survival and overall survival rates were 87.8%, 58.9% and 67.3% in all patients, respectively. In this retrospective study young age, tumor diameter, stage, presence of residual tumor and administration of chemotherapy were effected in survival analysis. The parameters which affected the complete response of patients were defined as presence of concomitant chemotherapy and number of courses <5. Central region recurrence rate was defined higher in the group with treatment duration of 9 weeks and higher (p = 0.044). Conclusion: Primary chemoradiotherapy +/-?radiotherapy achieved a satisfactory rate of local control and survival rates with acceptable complications in locally advanced cervical cancer. Concomitant chemotherapy and treatment duration were the important prognostic factors for completed response locally advanced cervical cancers.
基金supported by the Natural Science Foundation of Shandong Province of China (No Y2008C67)the Sci & Tech Development Plan Project of Shandong Provincial Education Department (No J07W01)
文摘Objective:To study the anti-tumor activities of furanodiene(C15H20O),a primary sesquiterpene compound isolated from the essential oil of the rhizome of Curcuma wenyujin YH Chen et C.Ling(Wen Ezhu),in vitro and in vivo.Methods:In vitro MTT assay was used to further study the effects of time and dosage on anti-proliferation of furanodiene against the sensitive Hela,Hep-2,HL-60,U251 cells,based on the cytotoxic effects of furanodiene on 12 human malignant tumor cell lines with the essential oil of Wen Ezhu as control.,and the half-inhibitory concentration(IC50) was observed.In vivo uterine cervix(U14) tumor cell was selected and the conventional assay method of anti-tumor activity was employed.Furanodiene liposome was administered intraperitoneally,and tumor-inhibitory rate,thymus and spleen indexes were observed.Results:The inhibitive effects on cell proliferation were shown in all of the twelve cell lines and the cytotoxic effects of furanodiene against Hela,Hep-2,HL-60,U251 cells were observed after 12 h of administration,the effect could last for at least 48 h in a dose dependent manner,and the IC50 values were 0.6,1.7,1.8,7.0 μg/ml,respectively.Furanodiene was also found to show inhibitive effects on the proliferation of uterine cervix(U14) tumor induced in mice.The tumor inhibition rates were 36.09%(40 mg/kg),41.55%(60 mg/kg),58.29%(80 mg/kg),respectively.Conclusion:Furanodiene is one of primary anti-cancer active components in the essential oil of Wen Ezhu,and also a very effective agent against uterine cervix cancer,and has protection effect on the immune function.
基金supported by grants from the Social Development Projects of Guangdong SciTech Planning (No.2010B031600201)
文摘Objective This work aims to investigate the expression pattern and clinicopathologic significance of centromere protein H(CENP-H) in uterine cervical cancer(UCC). Methods The level of CENP-H expression in the paraffin sections of 62 UCC cases was determined by the SP immunohistochemical method,with complete clinicopathologic data in all cases.Statistical analysis was conducted to evaluate the prognostic and diagnostic significance of CENP-H using SPSS13.0 software package. Results Immunohistochemical assay showed strong CENP-H expression in 61.29% (38/62) of the paraffin-embedded cervical cancer tissues.Statistical analysis revealed a strong correlation between the CENP-H expression and the clinical classification(P=0.038) of the cervical carcinoma.The expression increased with rise of the stages.The analysis of Cox proportional hazards regression model suggested that CENP-H expression(P=0.002) and tumor stage(P=0.001) were independent prognostic markers for the survival of UCC patients.The survival analysis showed that the survival rate was significantly lower in patients with high expression of CENP-H than in those with low expression of CENP-H(P=0.001). Conclusions CENP-H is likely to be a valuable marker for carcinogenesis and progression of UCC.It might be used as the important diagnostic and prognostic marker for cervical carcinoma patients,especially for those at early stage.
文摘Background: Surgery is the treatment for early-stage cervical cancer. Radiochemotherapy is used in the treatment of locally advanced stages. But the choice of treatment can be difficult. Objective: The objective of this work was to evaluate the therapeutic aspects of cervical cancer in the early stages IA to IIA in the oncology department of A Ledantec Hospital in Dakar. Patients and methods: This was a descriptive retrospective study, from January 2015 to December 2020, in the oncology department of A Ledantec Hospital, including all the patients who had been treated for early-stage invasive cervical cancer. Results: We included 28 patients. The average age was 49.54 years old. There were 11 patients (39.3%) with a stage ≤ IB1. Surgery was the first in 14 patients (50%). The initial approach was a midline supra and subumbilical laparotomy. The surgery was R0 in 65.22%. Postoperative complications were found in 4 patients including 1 case of operative wound suppuration, 1 case of dysuria, 1 case of postoperative eventration and 1 case of rectovaginal fistula. Concomitant Radiochemotherapy was neoadjuvant in 7 cases (25%), adjuvant in 14 cases (50%). The chemotherapy was neoadjuvant in 09 cases (56.25%) and adjuvant in 7 cases (43.75%) with minor toxicities. We had recorded 2 deaths. Conclusion: The treatment of the early stages of invasive cervical cancer is based on surgery. Neoadjuvant treatments may be useful in particular situations.
文摘Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.
文摘Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay in seeking early diagnosis and treatment of cervical cancer among women in Malawi. The study was exploratory and utilized qualitative data collection and analysis method. In-depth interviews were conducted using a semi-structured interview guide on a purposive sample of 24 women who were diagnosed of cervical cancer at the gynaecological wards of Zomba and Queen Elizabeth Central Hospitals in Malawi between July and September, 2011. Thematic content analysis was used to analyze the qualitative data. Two major themes (individual and health facility) emerged from the participants’ narratives as factors that contributed to their delay in seeking early diagnosis and treatment. The individual factors included;limited knowledge on symptoms and signs and limited financial resources. The health facilities factors included;limited accessibility and unavailability of cancer screening facilities in the health centres. Results show that there is a need to strengthen the screening of cervical cancer among women in the country. In addition, there is a need to create community awareness on the signs and symptoms of cervical cancer and the merits of seeking early diagnosis and treatment.
文摘OBJECTIVE To analyze clinical characteristics and treatmentmethods of the patients with adenocarcinoma of the uterine cervix(AUC) and adenosquamous carcinoma of the cervix (ASCC). Tocompare the survival time of the patients in 2 groups and analyzethe prognostic factors.METHODS Clinical data of both 123 patients with AUC and32 patients with ASCC treated at the Cancer Hospital, ChineseAcademy of Medical Science (CAMS) & Peking Union MedicalCollege (PUMC), were retrospectively analyzed.RESULTS The median age of the AUC patients was 50 years, andthat of the ASCC patients was 44, P = 0.019. Poorly-differentiated(grade 3) cases accounted for 59.5% of the total ASCC patients,while only 32.5% of the AUC patients were in grade 3, P = 0.002.In 123 AUC patients, relapse or failure of the treatment occurredin 63 of the patients (51.2%), and the median relapse time was6 months (0-59 months). In 32 ASCC patients, relapse or failureof the treatment occurred in 8 of these patients (51.2%), with amedian relapse time of 4.5 months (0-52 months). The overall5-year survival rate of the AUC patients was 49.8%, which wassignificantly lower than that of the ASCC patients (74.1%), P =0.015. The 5-year survival rates of the ASCC patients in Stage Ⅰ-Ⅲwere higher than that of the AUC patients with the same stages.However, statistical significant difference could only be foundamong the patients in Stage Ⅱ, P = 0.006. The 5-year survival ratesof the ASCC patients with various differential grade were higherthan those of the AUC patients with the same differential grade,but statistical significant difference could only be found amongthe patients in the two groups with moderately differentiation,P = 0.039. It was found by Cox regression analysis that onlyclinical stage (P < 0.001) and histological type (P = 0.046) were theindependent prognostic factors.CONCLUSION Clinical stage and histological type were theindependent prognostic factors of the AUC and ASCC patients.The prognosis of ASCC patients is better than that of the AUCpatients.
文摘Adenoid cystic carcinoma (ACC) is usually an epithelial neoplasm of the salivary glands but can also occur in the lacrimal glands and the mucous glands of the respiratory tract, breasts and skin. Very rarely, it may affect the uterine cervix. We report here a case of a woman with postmenopausal bleeding for 7 months, who on physical examination presented with a vegetative and friable tumor lesion in the uterine cervix, measuring about 5 cm in diameter. The abdominal and pelvic computed tomography scans showed a hypodense and heterogeneous mass in the cervix and uterine isthmus. Histopathological examination and immunohistochemical assays confirmed the diagnosis of ACC. The different pathological aspects, therapeutic options and prognostic factors of ACC are discussed.
文摘Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a retrospective descriptive study of 7 years from 1 January 2006 to 31 December 2012. Records of invasive cervical cancer were histologically confirmed. The clinical and therapeutic data collected were transferred to Epi info 7 and SSPS version 18 software with a significance level p as used to provide information on the vital condition after confidential agreement. Kaplan Meier was used to assess the overall survival rate. Results: Invasive cancer of the cervix was frequent (58.79%) with an annual median rate of 16.7%, with extremes of 5.8% and 20.6%. 88.70% of the patients was referred from regions of the country (54.02%);the median age was 50 years with extremes of 16 and 84 years and a peak of 29.6% between 35 and 44 years;76.20% were housewives;uneducated women were about 60.12%;Stage III was about 45.3%. Most of the patients were confirmed histologically after 30 days (68%). The means of treatment were surgery about 91 (29.26%), palliation 75 (24.12%), radiotherapy 59 (18.97%) and chemotherapy 41 (13.18%) with surgery (9, 65%) or radiotherapy (4.82%). The main complication was metrorrhagia, 164 cases (56.55%), with overall survival rate of 51.8% at 2 years and 5.1% at 5 years. Conclusion: Invasive cervical cancer in later stages is treated for low survival in the context of our work. Early detection and treatment of precancerous lesions would reduce the incidence and mortality of this cancer.