Findings from colposcopy and colposcopy directed biopsy in cervical precancerous lesions

Background: Pap smear test has been less successful in identifying those women with the highest risk for pre-malignant disease, so the patients with equivocal Pap smear would need further evaluation with colposcopy. Performing the colposcopy with more accuracy would result in better prognosis of pre-malignant lesions. However, performing a comparison with directed biopsy is required to obtain more definite results. The aim of this study was to determine colcoscopic findings in VIA positive cases.Methods: This observational study was conducted at the Department of Gynaecology and Obstetrics in Chittagong Medical College Hospital, Chittagong from September 2014 to February 2015. A total 72 women of VIA positive cases attended at colposcopy clinic of CMCH were included in this study. These patients were selected nonrandomly according to inclusion criteria. All patients were sign a written informed consent before recruitment into the study. According to colposcopy diagnosis was done by Reid colposcopic index. All patients were undergone directed biopsy followed by histopathology. Data were collected under guidance and advice of the supervisor through a structured questionnaire.Results: Almost two-thirds of the cases were 30-39 years age group. Among the 72 cases the presentations were mainly excessive vaginal discharge 61.1%, dyspareunia 16.7%, post-coital bleeding 9.7% and abnormal inter-menstrual bleeding 12.5%. Colposcopically 90.3% had CIN and invasive lesions, while 9.7% was normal. Colposcopically directed punch biopsy revealed in 84.7% cases positive lesions and 15.3% had not any CIN or invasive lesions.Conclusions: This study demonstrated high accuracy. Sensitivity is lower in our studies, probably because biopsies were performed in all case

CTC together with Shh and Nrf2 are prospective diagnostic markers for HNSCC

Abstract Background The lack of appropriate prognostic biomarkers remains a significant obstacle in the early detection of Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer type with a high mortality rate. Despite considerable advancements in treatment, the success in diagnosing HNSCC at an early stage still needs to be improved. Nuclear factor erythroid 2-related factor 2 (Nrf2) and Sonic Hedgehog (Shh) are overexpressed in various cancers, including HNSCC, and have recently been proposed as possible therapeutic targets for HNSCC. Circulating Tumor Cell (CTC) is a novel concept used for the early detection of cancers, and studies have suggested that a higher CTC count is associated with the aggressiveness of HNSCC and poor survival rates. Therefore, we aimed to establish molecular markers for the early diagnosis of HNSCC considering Shh/Nrf2 overexpression in the background. In addition, the relation between Shh/Nrf2 and CTCs is still unexplored in HNSCC patients. Methods In the present study, we selected a cohort of 151 HNSCC patients and categorized them as CTC positive or negative based on the presence or absence of CTCs in their peripheral blood. Data on demographic and clinicopathological features with the survival of the patients were analyzed to select the patient cohort to study Shh/Nrf2 expression. Shh and Nrf2 expression was measured by qRT-PCR. Results Considering significant demographic [smoking, betel leaf (p-value < 0.0001)] and clinicopathological risk factors [RBC count (p < 0.05), Platelet count (p < 0.05), Neutrophil count (p < 0.005), MCV (p < 0.0001), NLR (p < 0.05), MLR (p < 0.05)], patients who tested positive for CTC also exhibited significant overexpression of Shh/Nrf2 in both blood and tissue compared to CTC-negative patients. A strong association exists between CTCs and tumor grade. Following chemotherapy (a combination of Cisplatin, 5FU, and Paclitaxel), the frequency of CTCs was significantly decreased in patients with HNSCC who had tested positive for CTCs. The Kaplan–Meier plot illustrated that a higher number of CTCs is associated with poorer overall survival (OS) in patients with HNSCC. Conclusions Detecting CTCs, and higher expression of Shh and Nrf2 in HNSCC patients’ blood, can be a promising tool for diagnosing and prognosticating HNSCC

Additional file 1 of CTC together with Shh and Nrf2 are prospective diagnostic markers for HNSCC

Additional file 1