[Sex of the first child as a prognostic factor in cervix neoplasms].
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The study aimed to verify the probable correlation between the incidence of cervical cancer and the presence of human papilloma virus (HPV) in relation to a state of folic acid hypovitaminosis. In this context, however, it is important not to overlook the important protective role played by vitamins A and C in cancer prevention, as mentioned in the paper. Numerous authors agree that this is a real finding in cervical pathology, as shown in our research, even if folic acid therapy does not alter the course and prognosis of disease. On the contrary, low blood levels of folic acid appear to increase the risk of contracting the disease. Extensive and radical surgery therefore appears to be even more justified in order to increase the probability of recovery on the operating table in view of the irrational and inexorable progress of this pathology, especially if metastases are already present.
The importance of health care in the mortality caused by cervical uterine cancer in the age group 30 to 64 years is evaluated in the different health centers, excluding the effect of the quality or level of live in those areas. A model of multiple regression predicts the expected mortality rate according to the economic level of the population served by the health center. The different between the observed and predicted rates (the residual rate) is attributed to health care. Another multiple regression model with health variables checks the direct association between the magnitude of the residual rate and medical gynecological consultations; this variable is related significantly and positively to the number of consultations (patient visits) for general morbidity; specialities and with the numbers of midwives. The higher mortality rate associated with higher morbidity rate reflects defects in programs of early diagnosis and identified five deficitiary services. As the activities realized by midwives (such as prenatal check ups and gynecological consultation) are important and the lack of an inverse relation with the mortality rates shown, it is suggested that the resignation of activities and functions to strengthen secondary prevention of cervical uterine cancer be reviewed and modified.
In the gynecological department of Rostov Oncological Institute endolymphatic polychemotherapy with a preliminary determination of tumor sensitivity to chemotherapy was employed in 54 patients with cervical cancer, 3 of them in stage III and IV having contraindications to radiotherapy. A combination of chemical substances and the dosage of single administration were as follows: thio-TEPA--100--150 mg + methotrexate 75--100 mg; thio-TEPA--100--150 mg + 5-fluoruracil--1000 mg; cyclophosphane--2000 mg + methotrexate--75--100 mg; cyclophosphane--1600 mg + methotrexate--75--100 mg + 5-fluoruracil--750 mg. Lymphoinfusion was made in the lower extremity, and after 7--10 days it was repeated in the second one. Visual disappearance of the tumor was noted in 17 patients, lessening of the tumor size by two-thirds--in 16, a 1/2 decrease--in 20. Among 23 patients in stage III after the treatment parametrial infiltrations disappeared entirely in 11 cases and only in pelvic walls--in 12. In 40 cases an extensive extirpation of the uterus with adnexa was performed. In all cases degenerative changes in tumor tissues were observed, whereas in 7 cases no tumor cells were found.
Twenty-three HLA antigens were investigated in 121 patients with clinical cancer as well as 188 male and 212 female controls. Patients with cervical carcinoma showed significant differences in some HLA frequencies from that of controls. Patients with cervical carcinoma showed significant differences in some HLA frequencies from that of controls. In the localized form of the neophasia HLA-A3 was decreased, HLA-A9 and B 12 were increased. In the disseminated form of cervical carcinoma HLA-A 1 were found decreased and AW 32 and B 12 increased. HLA antigens could be factors, together with others yet unknown, i.e. immune response genes, HSV-2-infection, which produce an increased susceptibility to the disease.
38-years-old female patient was referred to the Pulmonary Diseases Ward because of suspicion of the right lung infiltrative tuberculosis. Anamnesis included cervical carcinoma treated surgically two years earlier. Neither radio- nor chemotherapy was applied. Infectious etiology was not confirmed. Lab tests, bronchoscopy and abdominal USG did not show any abnormalities. Contributory anamnesis, cardiorespiratory failure, variability of X-ray picture, enlargement of the heart in subsequent X-ray examinations suggested chronic pulmonary embolism. Large tumor masses were seen within the right ventricule on USG examination. The patient died in the course of the surgical procedure. Grey-yellow, elastic masses remaining in pulmonary arteries and between trabeculae carneae were found on autopsy. Enlarged and infiltrated paraaortic and iliac lymph nodes were observed. Planoepithelial nonkeratinizing carcinoma cells were confirmed in the above mentioned masses.
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Between 1970 and 1986, 252 women under 36 years of age with cervical carcinoma were treated in the Center of Oncology in Cracow. The five-year disease-free survival for all patients was 52.8%. In the multivariate analysis tumor stage IIB and III and the age under 30 years were adverse prognostic factors.
To document the first reported synchronous occurrence of Hodgkin lymphoma and adenosquamous carcinoma involving the female genital tract. Review of cytologic, histologic, and immunohistochemical studies obtained from a 50-year-old, multiparous, postmenopausal, Hispanic female who had a left inguinal mass, bilateral lower extremity pain and numbness, fatigue, anorexia, a 20- to 30-pound weight loss, and a malodorous vaginal discharge at presentation is presented. Cervical squamous cell carcinoma was diagnosed by routine cytologic and histologic analysis. Hodgkin lymphoma subsequently was diagnosed in the inguinal lymph nodes by fine-needle aspiration biopsy and excisional biopsy before the patient underwent hysterectomy. In addition to invasive and in situ adenosquamous carcinoma of the uterine cervix, the hysterectomy specimen also contained previously unsuspected Hodgkin lymphoma. To our knowledge, this is the first reported case of adenosquamous carcinoma and Hodgkin lymphoma synchronously involving the female reproductive tract.
Cervix neoplasms are the most frequent of female neoplasms in Madagascar. The authors reported a prospective study carried out at the Hospital Center of the University of Mahajanga for ten months (January-October 1993). 500 patients were investigated. 465 results of cervix and vaginal smears were considered. The Bethesda group classification was used to interpret lesions. 333 specific pathological lesions were listed. Bacterial infections and trichomoniasis were their principal causes. 4 cases were presumed as human papillomavirus condylomata. 39 SIL low-grade and 24 SIL high-grade were detected. 5 cervix neoplasms were diagnosed. Only few patients had consultation to perform cervix and vaginal smears because these exams are expensive. It may be an explication to the chronicity of lesions, a favourising factor of cancer. The role of viruses, especially human papillomavirus, in the development of cervix neoplasms is mentioned. The authors conclude that the low number of cervix neoplasms they founded is misleading. Cervix neoplasms are the first female cancers in Madagascar. A systematic surveillance of all female genitalia diseases must be programed. While its settling, cervix neoplasms control must be centred on Information--Education--Communication.
Fourteen thousand three hundred fifty six cervical smears were performed in the Obstetric and gynaecologic Department of Casorate Primo Hospital (USSL no. 77) and Oncologic Center of Milan (USSL no. 75/II) between 1-1-1987 and 30-6-1991. The incidence and mortality of uterine cervix neoplasm are discussed and the uterine cervix neoplasm are discussed and the analysis of data shows a reduction of this cancer in all countries. In italy it is estimated that the incidence is of 20.88 per 1000,000 women of all ages.
The patient described synchronous mucinous tumors of the cervix and ovary and concurrent annular tubules, but without the classical stigmata of Peutz-Jeghers syndrome. The cervical tumor was an invasive mucinous adenocarcinoma with mixed components of minimal deviation and less-well-differentiated endometrioid morphology. The ovarian tumor had the benign appearance of a mucinous adenoma but histologically revealed areas of invasive carcinoma. Immunohistochemical studies of the mucinous neoplasms of the cervix and ovary are discussed. Neither the staining properties of mucin, the pattern of immunostaining for carcinoembryonic antigen, nor any other common markers were helpful in distinguishing the mucinous neoplasms. Positive immunostaining for low-molecular-weight cytokeratin in the filament profile of sex cord tumors with annular tubules was of particular interest since it has not to our knowledge been previously described.
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The authors compared the results in the regression of uterus cervix tumour after intracavital therapy with gamma-neutron irradiation by 252cf and conventional sources of radiation gamma 226Ra in the course of a combined radiotherapy procedure. On the basis of a randomized study in 20 patients for a group it became obvious that due to the irradiation of the tumour in the initial phase of therapeutic cycle by physical dose 2 Gy of neutron component of 252Cf in the point A there was an increased regression of the tumour process causing in the 6th week since the beginning of the therapy a significant difference in the size of the tumours in both groups of patients. The time period required for 50% tumour reduction from the beginning of the therapy proved to be 23 days in patients treated with the 252Cf nuclide as compared with 48 days in the group of patients after conventional therapy.
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