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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to evaluate the etiology, incidence of malignancy, clinical risk factors and the interval between menopause and the onset of abnormal vaginal bleeding in postmenopausal women, 381 cases with a complete medical history and available histologic findings were enrolled in this study at the National Taiwan University Hospital from 1989 to 1991. The results showed that 212 (55.6%) of these women had normal histologic findings and 83 (21.9%) had benign pathologic findings, whereas 14 (3.6%) had cervical intraepithelial neoplasia (CIN), 42 (11%) had endometrial hyperplasia, 19 (5%) had cervical cancer and 11 (2.9%) had endometrial cancer. Twenty-nine (7.6%) of the cases suffered from either CIN III or cervical cancer; this number was twice as high as those with endometrial atypical hyperplasia and endometrial cancer (n = 13, 3.4%). In addition, various risk factors, especially obesity, were found to be significantly correlated with malignancy. Fractional curettage should be performed for postmenopausal bleeding patients to ensure accurate diagnosis and correct management.
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PMID:Clinical study of 381 postmenopausal bleeding patients. 810 77

The PAPNET system is an automated interactive instrument for analysis of conventional (Papanicolaou) cervical smears. The instrument, described in this paper, introduces several important innovations to cytology automation. The cell selection system is composed of two stages: an algorithmic classifier, followed by a trained neural network allowing for great flexibility and precision in recognition of abnormal cell images. Contrary to other attempts at cytology automation, this machine does not attempt to diagnose cell abnormalities. Instead, it is interactive, leaving the assessment of the cells displayed on a high-resolution video screen to trained human observers. The slides judged to contain abnormal cells or to be inadequate are referred for a second microscopic review. Two versions of the instrument (Alpha and Beta) were evaluated in several modes. Initial testing was performed on archival smears with known, histologically confirmed neoplastic lesions of the uterine cervix. These lesions comprised the entire spectrum of abnormalities, from low-grade lesions to invasive cancers of several types. The Alpha machine displayed recognizable abnormal cells in 97% of the 201 cases, and the Beta machine displayed such cells in 97.2% of 176 cases. The Beta instrument was subsequently tested on 500 sequential archival cervical smears that had been previously subjected to a rigorous quality control. One hundred forty smears (28%), which either displayed atypical cells or were considered "inadequate," were referred for further rescreening. Fifteen of 16 previously diagnosed neoplastic smears were appropriately identified with the help of the machine. The one missed case contained a single cluster of vacuolated cancer cells from an endometrial carcinoma. As a result of PAPNET-triggered review, three new cases of low-grade squamous intraepithelial lesions view, three new cases of low-grade squamous intraepithelial lesions (SIL) came to light in previously negative smears; three additional cases, previously classified as atypical, were also reclassified as SIL, for a net gain of six neoplastic abnormalities. In two additional atypical cases, colposcopic follow-up was recommended, even though the diagnosis was not modified. Two cases of cervical intraepithelial neoplasia, represented by tiny single clusters of abnormal cells missed on original screening, quality control, and on machine rescreening, came to light on second review of the residual 360 cases. The initial experience with the PAPNET system suggests that the instrument may be valuable in quality control and may assist in significantly reducing false-negative cervical smears in an efficient and timely manner. Further testing of the instrument on a much larger number of cervical smears is in progress.
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PMID:Evaluation of the PAPNET cytologic screening system for quality control of cervical smears. 811 79

The usefulness of prognostic factors in gynecological cancer was evaluated using the oncogenes, tumor suppressor genes and DNA viruses detected with the molecular biological technique. In uterine cervical cancer, HPV types 16 and 18 are considered to have a high oncogenic risk, and are commonly associated with high grade CIN and invasive cancer under persistent HPV infection. C-myc overexpression in advanced stage and p53 mutation in HPV negative case are associated with poor survival. In endometrial cancer, oncogene activation and expression are less frequent than in cervical and ovarian cancer. K-ras point mutation (codon 12) tumors are more aggressive and c-erbB-2 overexpression are associated with metastasis and poor survival. In ovarian cancer, there are numerous abnormalities of oncogenes and tumor suppressor genes. Especially, EGF-R and PDGF-R alpha expression are associated with decreased survival. p53 mutation also decreases survival and response to chemotherapy. Recently. MSH2 (Lynch II syndrome) and BRCA1 gene are known to relate with familial ovarian cancer.
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PMID:[Evaluation of prognostic factors in gynecological cancer examined by molecular biological study]. 868 14

A retrospective review is presented of 89 patients with glandular dyskaryosis in order to formulate a management protocol. Fifteen patients had cervical intraepithelial neoplasia (CIN) without glandular abnormality (17%). One patient had adenocarcinoma in situ of the cervix and one patient had vaginal intraepithelial neoplasia (VAIN) grade III. Twenty-two patients had endometrial carcinoma (24.5%) and 11 patients had cervical carcinoma (12.5%). Of the patients presenting with post-menopausal bleeding as well as having glandular dyskaryosis, 69% had a gynaecological malignancy. In conclusion, colposcopy and out-patient endometrial sampling are recommended in all cases. Patients with abnormal endometrial sampling require hysteroscopy. Cone biopsy is necessary to exclude occult glandular disease if cytology remains abnormal despite negative colposcopy and sampling.
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PMID:A study to determine the underlying reason for abnormal glandular cytology and the formulation of a management protocol. 920 2

The aim of this study was to define the clinical implications of semi-quantitative telomerase activity in gynecological tumors by comparing the telomerase activity of cancerous lesion and the adjacent non-cancerous lesion. In 118 cases of gynecologic tumors, including 41 uterine cervical tumors, 43 uterine body tumors and 34 ovarian tumors, telomerase activities were determined using TRAPeze telomerase detection kit for the extension reaction of the telomere sequence and the PCR reaction for amplification of the sequence, and using fluorecence-based telomere repeat amplification protocol (F-TRAP) method for the detection. In all gynecologic cancers examined, telomerase activity of the cancerous lesion was significantly higher than that of the non-cancerous lesion. Telomerase activity in the uterine cervix increased in the following order of the normal uterine cervix, cervical dysplasia and cervical cancer. Regarding the endometrial cancer, telomerase activity at the primary lesion in patients with lymph node metastases was significantly higher than that in patients without lymph node metastases. When telomerase activity was compared by histologic subtypes of the ovarian cancer, clear cell adenocarcinoma showed significantly lower telomerase activity than the other subtypes, especially endometrioid adenocarcinoma. In all gynecologic cancers examined, there was no clear correlation between the telomerase activity and age at diagnosis or age of menopause. Although all tumors with 100 units or more telomerase activity were cancerous, the sensitivity was 39% in cervical cancer, 41% in endometrial cancer and 21% in ovarian cancer, respectively. Cervical intraepithelial neoplasia (CIN) had already increased telomerase activity and endometrial cancer with lymph node metastases had also greater activity than that without lymph node metastases. Although telomerase activity in ovarian cancer tended to increase as stage advances, it is noteworthy that clear cell adenocarcinoma showed significantly lower telomerase activity than endometrioid adenocarcinoma.
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PMID:Telomerase activity in gynecological tumors. 1094 30

Between 1982 and 1992, 32 patients with squamous cell vaginal cancer were treated. Fourteen patients had stage I, 11 stage II, two stage III and five stage IV disease. The mean age of stage I and II patients was 64, of stage III and IV patients 73. Six patients were pessary-bearing, two had a total procidentia, eight had been treated for cervical intraepithelial neoplasia (CIN), one for cervical cancer and one for vulvar cancer 5-21 years before diagnosis. One patient had had external irradiation for endometrial cancer 15 years before. Nine patients had no follow-up examinations after treatment for CIN, for vulvar cancer or after insertion of a pessary. In 14 patients doctors' or patients' delays were considerable. Most patients presented with vaginal discharge or bleeding, and urinary symptoms. Various treatment modalities were used. The selected patients who could be treated by surgery did best. Only patients with a stage I tumor or a stage II tumor with a diameter of at most 30 mm survived. Tumor stage and tumor diameter were the important prognostic factors. No patient died of disease after 33 months. Failure in obtaining local control was the usual cause of death. Recommendations for prevention or early diagnosis are formulated.
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PMID:Squamous cell carcinoma of the vagina: a report of 32 cases. 1157 39

The use of condoms as protection for women at risk for cervical cancer against some of the deleterious effects of sexual intercourse by limiting exposure to agents introduced by male sexual partners is discussed. In a recent study, 286 women with diagnosed cervical intraepithelial neoplasia who received cryosurgery or conization were instructed to use condoms during intercourse. 40 showed regression of the disease. 136 of 139 women treated with condoms alone also showed complete regression. 18 of the 286 women had recurrences, 12 showed regression after condom use was reinstituted. None of the patients showed progression of the disease while relying on condoms. Other contraceptives have also shown noncontraceptive benefits: oral contraceptives offer protection against pelvic inflammatory disease, ovarian and endometrial cancer; progestin releasing IUDs decrease dysmenorrhea and menstrual blood loss; and spermicidal agents may protect women against infection.
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PMID:Consider condoms for the woman at high risk of cervical cancer. 1226 4

The risk of breast cancer is increased by an early menarche, late age at 1st birth, and by a late menopause which implicates ovarian steroids in the initiation or promotion of breast cancer, as some breast cancers are estrogen dependent. A study from the Centers for Disease Control found no association between breast carcinoma and duration of combined oral contraceptive (COC) use. A recent analysis of 27 reports published between 1980 and 1990 suggests that the risk of breast cancer may be slightly increased in younger, nulliparous women who have used the older, higher dose COCs for more than 8 years. The ever-decreasing doses of estrogen and progestogen cause confusion regarding COCs and the risk of breast cancer. Of 15 major publications, 8 have identified no increased risk of cervical neoplasia and 7 have found significant increased risk. The Oxford Family Planning Association Study showed that both cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma occurred more frequently in the oral contraceptive group related to the duration of use. The Royal College of General Practitioners' Study showed that women taking the COC for more than 10 years had an increased risk of cervical cancer. With the effects of sexual activity controlled, COC users had no increased risk of invasive cervical cancer, however, they had an increased risk of CIN. A reduction in risk of endometrial cancer (an estrogen-dependent tumor) by 20%, 40%, and 60% after COC pill use containing potent progestogens for 1, 2, and 4 or more years has been reported. Several studies confirm the protective effect of COCs against the risk of ovarian cancer. Hepatocellular carcinomas seem to occur more frequently in COC users than in nonusers. Depot medroxyprogesterone acetate has been implicated in causing breast tumors, but it was successful in the treatment of endometrial carcinoma. There is some evidence that the risk of CIN may be increased with COC use, but the risk of breast cancer is still no clear.
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PMID:Contraception and the big "C". 1234 24

We reviewed recent cytological reporting of abnormal glandular cells on cervical smears in order to assess the predictive value of these reports and the contribution of colposcopy in the assessment of these abnormalities. The study consisted of a 5-year retrospective review of the clinical management of 80 women with abnormal glandular cells on a cervical smear, with clinical and histopathological data available for review in the interval 1992-1996. There were two groups of women: (i) those referred with gynaecological symptoms and (ii) those with screen detected abnormalities who were asymptomatic and significantly younger than the first group. The predictive value of a glandular smear for malignancy was 42.5% and for premalignancy 28.8%. The most common lesions detected were cervical intraepithelial neoplasia (CIN) (13), endometrial cancer (13), cervical adenocarcinoma (10) and cervical intraepithelial glandular neoplasia (CIGN) (8). Four cases of endometrial carcinoma presented through screening. In the remainder a variety of benign conditions were identified as responsible for the abnormal smear. Failure to find an explanation for the abnormal smear only occurred in 8.8%. In developing a protocol for abnormal glandular smears, our observations indicate that: (a) those with abnormal bleeding require endometrial sampling; (b) for those with screen detected abnormality, colposcopy is valuable as it is a sensitive predictor of early invasion and can predict glandular abnormality; (c)diseases of the entire genital tract, non-gynaecological viscera and metastatic cancer can generate cytological abnormality; (d) screen detected borderline abnormality in endocervical cells is associated with CIN III.
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PMID:The abnormal glandular smear: cytologic prediction, colposcopic correlation and clinical management. 1551 97

Mouse models show that progressive shortening of telomeres with ageing causes chromosomal instability, which can lead to the initiation of cancer. However, it is unclear what roles telomere shortening plays in human carcinogenesis. The present study has investigated the involvement of telomere dynamics in uterine carcinogenesis. Using telomere-FISH (telo-FISH) assays, telomere lengths in premalignant and malignant cervical and endometrial lesions were measured and compared with chromosomal arm loss or gain. Telo-FISH signals were visualized with Cy3-labelled telomere-specific probes and presented as telomere intensity (TI). Early-stage cervical intraepithelial neoplasias (CINs), especially CIN2, had significantly shorter telomeres than corresponding normal squamous epithelia (p = 0.019), together with increased rates of chromosomal arm loss/gain (p < 0.001). Cervical cancers had relatively short telomeres, but they also showed greater heterogeneity than other sampled tissues, including those with long telomeres. In contrast, there was no significant difference between the telomere length of normal endometrium and of endometrial hyperplasia and endometrial cancer. There was no significant difference in the rate of chromosomal arm loss/gain between normal endometrium and endometrial hyperplasia. These findings suggest that progressive shortening of telomeres occurs in CIN, in association with chromosomal instability, which may play critical roles in cervical carcinogenesis. In contrast, endometrial hyperplasias have relatively stable telomeres without widespread chromosome alteration, implying that endometrial carcinogenesis involves mechanisms distinct from those of cervical carcinogenesis, possibly including microsatellite instability.
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PMID:Distinct telomere length regulation in premalignant cervical and endometrial lesions: implications for the roles of telomeres in uterine carcinogenesis. 1690 12


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