Expression of neuroendocrine markers in endometrial carcinomas — an immunohistochemical analysis

The main aim of this study was the analysis of undifferentiated cancers and mixed ones positive for neuroendocrine biomarkers without morphological features — typical for this type of cancer. The obtained results indicated the necessity for neuroendocrine marker tests in undifferentiated cancers and mixed ones. Immunopositive results revealed enhanced malignancy of these cancers and the necessity for additional chemotherapy

Agresive variants of uterine cervical cancers

Three different variants of biologically agressive cervical cancers, such as: basaloid carcinoma, glassy cell carcinoma and small cell endocrine carcinoma, have been reported. Hematoxylin and eosin, periodic acid-Schiff and immunohistochemical stains were used. The course of disease and aplication of treatment has been analyzed as well. Characteristic morphologic features of these cancers have been emphasized. Rather limited susceptibility for radiotherapy and chemiotherapy of these cancers has not gone unnoticed. The description of these types of cervical cancers might enable us to arrive at right conclusions, both clinical and diagnostic

Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus: clinicoimmunohistochemical and histogenetic characteristics

Aims: To search for favorable prognostic factors in CS on the basis of clinical, morphological and immunocytochemical data, while simultaneously considering  histogenesis of this neoplasm. Methods and Results: Thirty two uterine CS patients were analyzed based on clinical and morphological data. In addition, each specimen was immunohistochemically stained with appropriately selected antibodies characterizing relevant types of cells and tissues. The presence of both carcinomatous and sarcomatous patterns was observed in all tumors. Among carcinomatous patterns, endometrioid carcinoma was most common, while serous, clear cell, and undifferentiated were less common. Among sarcomatous patterns, endometrioid sarcomas represented the largest group, while leiomyosarcomas, chondrosarcomas, fibrosarcomas, osteosarcomas, rhabdosarcomas were rarely observed. Mitotic activity was evidently higher in carcinomas. Among seven neoplasms  the expression of both cytokeratin and vimentin was noted in cells of carcinomatous patterns. Conclusions: This study shows that an early diagnosis (stage I-II) and an initial aggressive surgical cytoreduction are favorable prognostic factors in CS. Furthermore, cytokeratin-vimentin positive cells in carcinomatous patterns suggest sarcomatous metaplasia of adenocarcinoma. Unfortunately, the study did not identify histological structures of prognostic value

Ocena wartości testu DNA HPV HR u kobiet po leczeniu z powodu śródnabłonkowej neoplazji szyjki macicy jako markera nawrotu procesu chorobowego

Summary Aim: The basic assumption of the prevention of cervical cancer is to early detect and treat CIN (cervical intraepithelial neoplasia) as well as to prevent recurrence of neoplasia after therapy. This study involved comparison of the cytology test value and determination of HPV (human papilloma virus) DNA in women treated for CIN so as to find a sensitive and specific marker of disease recurrence. Methods: A group of 107 females after CIN treatment underwent 14-month follow-up and regular cytological and molecular evaluations. Results: Based on the follow-up data the recurrence of CIN was found in 9 females who despite effective therapy for the entire follow-up period were HPV positive. Evaluation of value of HR (high risk) - HPV DNA assay used to detect CIN showed its 100% sensitivity. Conclusion: The HR-HPV DNA assay is likely to be a valuable diagnostic tool facilitating more precise detection of recurrent neoplasia risk than cytological test alone.Streszczenie Cel pracy: Podstawowym założeniem profilaktyki raka szyjki macicy, jest wczesne wykrycie i leczenie CIN a także zapobieganie nawrotom neoplazji po leczeniu. W pracy porównano wartość testu cytologicznego oraz oznaczania DNA HPV u kobiet leczonych z powodu CIN w celu poszukiwania czułego i swoistego markera nawrotu procesu chorobowego. Metoda: 14-miesięcznej obserwacji poddano 107 kobiet po leczeniu CIN, u których regularnie wykonywano ocenę cytologiczną i molekularną. Wyniki: Nawrót CIN wykryto u 9 obserwowanych kobiet, które mimo skutecznej terapii przez cały okres obserwacji były HPV pozytywne. Ocena wartości testu na obecność DNA HPV HR, użytego do wykrycia CIN wykazała 100% czułość tej metody. Wnioski: Test na obecność DNA HPV HR może być cennym narzędziem diagnostycznym, pozwalającym bardziej precyzyjnie niż badanie cytologiczne wykryć ryzyko nawrotu neoplazji

Comparison of the diagnostic value of cervical cytology and HPV HR DNA testing for the diagnosis of low-grade and high-grade squamous intraepithelial lesions across different age groups

Objectives: To assess the diagnostic value of cervical cytology and HPV HR DNA testing for the diagnosis of low grade and high-grade squamous intraepithelial lesions across different age groups. Material and methods: The study included 1103 patients, age 25–70 years. All patients underwent in-depth diagnostic tests following either an abnormal Pap test result or a clinically suspicious cervical lesion. In all women the following examinations were performed: a molecular test detecting 14 high-risk types of HPV, a colposcopy examination, as well as directed-biopsy of the cervix. The studied population was subdivided into four age groups. Results: It was observed that the percentage of high grade squamous intraepithelial lesions (HSIL) and cancers increased with women’s age. Sensitivity of both methods for detecting high-grade squamous intraepithelial lesions was highest for women aged 40–49 years. Sensitivity values of HPV testing was higher than that of cervical cytology among women under age 50. Conclusions: Specificity of HPV testing increased significantly with age of women and was several fold higher across all age groups than the specificity of cervical cytology

Mechanism of the cancerogenesis in cervix paraepidermal epithelium cells with chronic infection of oncogenic types of human papiloma virus

The human papillomavirus family is composed of a large number of different and variably related types, each of which is associated with a characteristic set of epithelial lesions. Each of the many identified types of human papillomavirus have shown considerable specificity of different anatomical sites and different characteristic lesions. HPV 6 and 11 are frequently associated with benign condylomas, while HPV 16 and 18 are associated with malignant progression and cervical cancer. The genome of papillomaviruses is composed of a circular double stranded DNA. Various open reading frames (ORFs) are located on only one DNA strand. The coding strand contains from 8 to 10 translational ORFs. Among them, only 6 to 8 were designated as early and 2 as late. The role of HPVs 16 and 18 in uterine cervix carcinoma has been well-documented, but their contriobution to carcinogenesis of other neoplasias is still questionable

Perinatal transmission of Chlamydia trachomatis and its complication in preterm infants

Introduction: Chlamydia trachomatis is the most common agent of sexually transmitted infections. In pregnant women it can cause premature delivery. In newborns the clinical manifestation are pneumonia and conjunctivitis. Aim: The aim of the study was to estimate the perinatal transmission of Chlamydia trachomatis and the prevalence of neonatal complications. Material and methods: The study included 82 mothers with deliver

The incidence of cervical intraepithelial neoplasia in a population of pregnant women with an abnormal cytology

Objectives: To assess the incidence of cervical intraepithelial neoplasia — SIL and cervical cancer in a population of pregnant women with an abnormal cytology. Material and methods: In pregnant women with abnormal cytology results according to The Bethesda System, a verifying diagnostics was carried out, including colposcopy and cervical biopsy. Results: The most common histological and oncologic diagnosis in the whole study group of pregnant women were HGSIL changes, covering cervical intraepithelial neoplasia of medium and high grade — CIN 2 and CIN 3. Conclusions: HGSIL changes are the most common oncological pathology in a population of pregnant women with an abnormal cytology. Precise risk identification of HGSIL changes with the use of molecular tests can significantly reduce the number of surgical procedures in a population of pregnant patients with a cytological diagnosis of ASCUS and LSIL

Child sexual abuse as an etiological factor of overweight and eating disorders — considerations for primary health care providers

Despite the recognition of the clinical importance of child sexual abuse, primary health care providers are often not ad­equately prepared to perform medical evaluations and diagnose child sexual maltreatment. Paper presents basic symptoms and signs of CSA, which may suggest the need for further patient’s diagnosis and referral. Since the great majority of sexually abused children do not have any abnormal physical findings, special attention is paid to the silent warning signs of CSA, such as changes in attitude towards own body and eating habits. Numerous studies suggest that victims of CSA may develop obesity or eating disorders of various forms and intensities

Cervical cancer screening in Poland and worldwide

High cervical cancer morbidity remains an unresolved epidemiologic problem in Poland. Prevention programs used in the past years did not lead to significant decrease in cervical cancer mortality and morbidity. Countries that introduced active prevention programs several decades ago achieved significant decrease by up to 80%, in the cervical cancer morbidity. We present in this paper the principles of the screening program introduced in Poland in 2006 and compare it with the screening models applied in the other countries. The special attention is drawn to the age at which screening is commenced and stopped as well as to the screening intervals. Advantages and disadvantages of the PAP smear are discussed in great details. Additionally the potential role of HPV DNA testing is discussed, including the possibility of replacement of cytological tests with HPV testing