Changing pattern of cervical carcinoma: A report of 709 cases of invasive carcinoma treated in 1970–1974
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Objective: To detect the expression of Her-2 protein in cervical carcinoma,and explore the related clinical significance.Methods: A total of 60 cases with cervical cancer resection from 2008 January to 2010 January were collected,and were divided into three stages according to TNM stages: 18 cases at Ⅰstage,II 29 cases,Ⅲ13 cases.Normal cervical epithelial tissues in 20 cases were selected as control group.Expression of Her-2 protein was detected in cervical tissue by immunohistochemistry.Results: Her-2 protein was expressed in cervical carcinoma tissues and normal tissues,the positive rate in cervical cancer tissues was 68.3%,significantly higher than those in normal cervical tissue of 20%(P0.01).Positive rates of Her-2 protein at Ⅰ,II,III clinical staging were 44.4%,75.7%,84.6%,there was significant difference in positive rate between different clinical stages(P0.05),with the increase of clinical stage of Her-2 protein expression,the rate of the corresponding was increased(P0.05).Conclusions: Her-2 protein plays a certain role in the development of cervical cancer,and can be used for tumor grading and prognosis.It may also be a potential therapeutic target in cervical cancer,with significant clinical value.
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Clinical Significance
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Objective:To study the prevention,treatment and early detection of carcinoma of cervical stump.Methods:To review data of two cases of cervical stump cancer and related literature.Results:Its treatment is the same as the general cervical cancer.effect of surgical treatment of early carcinoma of cervical stump is the same with the cervical cancer in general.Conclusion:Carcinoma of cervical stump is less common.Its incidence rate is related to the number of cases of hysterectomy follow-up and residual cervical detection of carcinoma of cervical stump are important.
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Objective: To explore the value of pushing up the edematous uterline cervix with hand during the stages of labor. Method: 46 cases of pregnant women with edematous uterline cervix were randomly divided into two groups . 25 cases , whose edematous uterline cervix were pushed up with hand in the stages of labor were in the experimental group, and the other 21 cases were in the control group. Results:There were significant differences between the two groups. The time of the second stage of labor, the bleeding amount, and complications of newborns in the experimental group is lower than that in control group, and there was no signifinant difference of Apgar scores between the two groups Conclusions: Pushing up the edematous uterline cervix with hand is effective for the edematous uterline cervix cases.
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The cervix uteri is a rigid tube which connects the uterus with the vagina and during most of the time it is firmly closed. During oestrus, late pregnancy and parturition, the morphological appearance in the cervix changes markedly, resulting in a softer cervix, which during parturition can even be stretched open to a diameter that is more than a tenfold larger than before.
During gyneacological interventions, such as artificial inseminations in several animal species, or in women it would be beneficial to penetrate the cervix with ease. Clinical obsterical problems occur when insufficient closure of the cervix during pregnancy causes premature birth, or when the cervix fails to dilate during birth. Collagen is one of the most important components of the cervix that causes the rigidness of the cervix and during softening of the cervix, collagen has been shown to undergo significant changes in its structure. Several hormones are involved in regulating these changes, by stimulating or depressing processes that are mostly associated with the inflammation cascade.
So far studies that aimed to get more insight into the many factors involved in cervical softening have been using cross-sectional study protocols. Ethical and practical considerations in the subjects that are mostly used (women, small laboratory animals or small ruminants) make it almost impossible to perform longitudinal studies in these species. Another limiting factor in these type of studies is the fact that functional changes in the cervix are usually related to the gestational age, rather than the stage of gestation, relative to parturition. The hormonal changes in the maternal blood and the changes that take place in the cervix during parturition are more dramatic compared towhat happens during late pregnancy or the oestous phase of the cycle. It is therefore, logic to assume that during parturition functional changes in the cervix are differently regulated than during the other two stages, that they may differ in several biochemical and cellular aspects, and that timing of these changes relative to the moment of birth is critical.
With the studies described in this thesis we aimed to find out if the cow could be a more suitable model for longitudinal studies of the cervix. By using a newly described biopsy technique to study samples that were repeatedly obtained from cows during different stages of gestation we were able to differentiate the biochemical changes that occur in the collagen of the bovine cervix during cervical ripening and during parturition. By adapting an ultrasound cervimetry technique, previously used in women, combining it with frequent blood-sampling and electromyographic (EMG) measurements of the uterus, we were able to continuosly monitor cervical dilatation during parturition and relate this to temporal changes in hormone levels and myometrial activity. In addition, studies of the cervix of the non-pregnant cow have shown that regional differences exist in biochemical aspects of collagen and expression of oestrogen and progesterone receptors, indicating that it is critical for the interpration of studies on cellular or biochemical changes, to describe in detail the area were samples were obtained.
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The technique of wiping the cervix with vinegar (acetic acid) and then inspecting it visually can be used to detect most cases of cervical cancer and precancer, according to a study carried out in Zimbabwe (Lancet 1999;353:869-73).
The technique could be used to screen women for cervical cancer in developing countries, where cancer of the cervix remains the leading cause of death from cancer among women. An estimated 300000 women …
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The thesis begins with a historical review of dilatation of the cervix and then considers the anatomical and physiological properties of the cervix which affect its physical properties. The ease with which the cervix can be dilated is determined by the diameter of the cervical canal prior to dilatation and by the compliance of the cervical tissue. The diameter of the cervix is influenced by the number of pregnancies which the patient has had. The compliance of cervical tissue is affected by the complex changes which take place in the collagen fibre matrix and ground substance of the cervical stroma. A review of the complications of first trimester termination of pregnancy has shown that the earlier a pregnancy is terminated, the less likely the patient is to have complications. The cervix may sustain damage during dilatation of the cervix, which may compromise her future reproductive capacity. Attention is then turned to the problem of cervical incompetence. The history of this condition is reviewed and a discussion of the aids to diagnosis is presented. The original work described in the thesis hinges on measurements of the force applied during surgical dilatation of the cervix. These measurements were made using an instrument which was developed by the author and his associates, specifically for the purpose of the studies here presented. The factors which influence the passage of a dilator through the cervix are discussed. Measurement of the force required to dilate a cervix from 3 mm to 8 mm which was defined as the Cervical Resistance Index (CRI), takes account of many of these variable factors. Measurement of Cervical Resistance Index was performed on a total of 590 patients in 3 groups:- 1. 200 non-pregnant patients. 2. 355 pregnant patients undergoing first trimester termination of pregnancy. 3. 35 patients with a history of previous spontaneous mid-trimester abortion. The study of non-pregnant patients was undertaken to establish baseline values of cervical resistance. The influence of parity, hormone status contraception and the stage of the menstrual cycle on CRI is presented. Increasing parity significantly reduces CRI. Postmenopausal women show significantly higher CRI than pre-menopausal women, while patients using Depo-Provera for contraception have significantly lower CRI than normal cycling women. The study of pregnant patients undergoing termination of pregnancy was performed in order to evaluate the use of four hormones (oestradiol, progesterone, medroxy-progesterone acetate and prostaglandin E2) in bringing about changes in cervical compliance. All these substances are thought to play a role in the biological control of cervical softening in late pregnancy. An increase in cervical compliance makes the cervix easier to dilate and thus reduces the likelihood of damage being sustained during dilatation. Such damage has been shown to compromise a patient's future reproductive capacity. Prostaglandin E2 was shown to significantly reduce the cervical resistance index in multiparous patients. In nulliparous patients, this hormone did not have the consistent effect on CRI seen in multiparous patients. Since nulliparous patients are more likely than multiparous patients to suffer damage to the cervix during dilatation, further research should concentrate on making termination of pregnancy safer for these women. A study to measure cervical resistance index in patients with a history of spontaneous mid-trimester abortions is then described. This study was undertaken to evaluate the use of this technique in assisting in the diagnosis of cervical incompetence. The study identified patients with abnormally low CRI. The number of these patients who have subsequently conceived is small but knowledge of the CRI has allowed a more rational management and consequently improved obstetric performance.
Dilator
Cervical canal
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Objective:To investigate the expression of Bcl-2,Bag-1 in the pathogenesis and progression of cervical cancer and their relationship.Methods:S-P immunohistochemical analysis was performed in 36 cervical carcinoma and 64 cases of CIN.Results:Overexpression of Bcl-2 and Bag-1 protein in CIN and cervical cancer was remarkably higher than that in the control(P0.01),whereas the difference between CIN and cervical cancer was not significant(P0.05).Bcl-2 protein expression was positive correlation with Bag-1 protein expression in cervical carcinoma.Conclusion:Bag-1 and Bcl-2 overexpression might play an important role in the pathogenesis and development of cervical cancer.The overexpressions of Bcl-2 and Bag-1 are the early event of cervical carcinogenesis which are associated with the development of cervical carcinoma.Bcl-2 and Bag-1 protein in the development of cervical carcinoma enhance each other.
Pathogenesis
P53 protein
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